Pregnancy with Invasive Carcinoma of the Cervix- A Case Report

Carcinoma of the cervix is a preventable female malignancy. Recently, a 30 years old 5th gravid lady was referred to Bangabandhu Sheikh Mujib Medical University (BSMMU) from Jahurul Islam Medical College & Hospital, Bajitpur, Kishorganj after diagnosing as a case of 32 weeks pregnancy coupled with invasive carcinoma of the cervix. Histopathology of cervical tissue showed moderately differentiated squamous cell carcinoma. Her cervical growth was confined in the anterior lip of the cervix and clinical stage was 1B. She was severely anemic. Her anemia had been corrected by blood transfusion. Injection dexamethasone was given for fetal lung maturity. Renal function tests and all other investigations for surgical fitness were done. At her 34th weeks of pregnancy caesarean section followed by Wertheim's hysterectomy was performed. Baby was alive, birth weight was 2.3 kg, Apgar score was good. Postoperative period was un-event full. At her 23rd postoperative day she was discharged from Obs and Gynae department and referred to Oncology institute for further management. At the time of discharge her baby was healthy. Key Words: Cervical cancer, pregnancy, Wertheim's hysterectomy.DOI: 10.3329/bsmmuj.v2i1.3712 BSMMU J 2009; 2(1): 47-4

Presentation of invasive cervical cancer in Bangladesh

Background: Cervical cancer is a disease of significant worldwide morbidity and mortality. More than 85% of the disease occurs in developing countries. Bangladesh, like other developing countries faces a burden of the disease. ObJec­tive: To find out the different way of presentation of invasive cervical cancer patients. Methods: This cross-sectional study was carried out in the Gynaecologic Oncology wing of the Department of Obstetrics and Gynaecology of Bang­abandhu Sheikh Mujib Medical University (BSMMU) during 1st January 2007 to 30th April 2008. One hundred and four patients with invasive cervical cancer admitted in hospital were enrolled in the study by purposive sampling. All the infor­mation were collected in a pre-designed structured questionnaire. Data were analyzed using statistical program SPSS version: 17.0. Frequency distributions were used to present the characteristics of the patients. Chi-square test was calcu­lated and the significant level was set at P<0.05. Results: Maximum patients (60.6%) were in stage II. Majority of the patients (61.5%) presented with abnormal bleeding. Exophytic growth was found in the majority of the patients (71.2%). Squamous cell carcinoma was more (92.3%) in the majority of patients and adenocarcinoma was more in younger age group. Conclusion: The status of the patients irJ this study reflects advanced stage of the disease at presentation and the peak incidence was observed in 36-45 years age group

Association of kisspeptin in patients with poly cystic ovarian syndrome

Background: Poly cystic ovarian syndrome (PCOS) is a complex multifactorial disorder, affecting millions of women worldwide. Kisspeptin, a hypothalamic peptide encoded by the KISS1 gene, is widely reported as a key factor in the regulation of luteinizing hormone (LH)/follicular stimulating hormone (FSH) secretion, which may be potentially involved with the development of PCOS. The aim of the study was to estimate the serum kisspeptin level in PCOS patients and evaluate the association of kisspeptin with other biochemical, and hormonal parameters in women with PCOS. Methods: This case-control study was conducted at the department of reproductive endocrinology and infertility, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh from August 2020 to July 2021. A total of 90 patients between age 18-30 years were enrolled in this study. Data was collected on variables of interest by using the structured questionnaire designed for interview, observation, clinical examination, and biochemical investigation of the patients and analyzed by using the t-test, non-parametric test (Mann-Whitney U test) and chi-square test as appropriate. Results: We found no significant difference between PCOS & control group, but acanthosis nigricans (AN), waist hip (W:H) ratio were statistically significant in PCOS group. We found serum LH (11.98±6.29 mIU/ml), LH: FSH (1.71±0.92), AMH (10.09±3.8 ng/ml), fasting insulin (26.53±28.34 µU/ml), ovarian volume (16.91±4.57), was significantly higher in PCOS patients. Kisspeptin value in PCOS patients was 85.92±56.59 pg/ml and control group was 63.74±43.16 pg/ml. In the PCOS group, there was a positive correlation between kisspeptin and LH, AMH, and ovarian volume. Conclusions: Serum kisspeptin levels were similar in women with or without PCOS but positively correlated with ovarian volume, serum LH and AMH in PCOS patients

Frequency of ABO and Rh-D blood groups in cervical cancer

There is much evidence that the ABO blood group system may play a role in the pathogenesis of the disease. The relationship between ABO and Rhesus blood groups and cancer risk has been demonstrated in many research works. However, concerning gynaecological malignancies, these findings are inconsistent. This study aimed to evaluate the frequency of ABO and Rh-D blood groups in patients with carcinoma cervix. This cross-sectional study was conducted in the Department of Transfusion Medicine, Department of Gynaecological Oncology and Department of Pathology of Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka. A total of 110 clinically suspected cervical cancer patients were included in this study. Pap smear tests was done in all cases and the patients were divided into case (Pap test positive) and control group (Pap test negative). A total of 55 patients were included in each group. Blood groups (ABO & Rh-D) of all the patients were recorded. A higher number of the patients in the cervical cancer group were multiparous than in the control group. Almost in two-thirds of the population, the age of marriage was <18 years in the cervical cancer group compared to 34.5% in the control group. More than one-third population had “O” blood group in the case group, while it was 31% in the control group. The almost equal number had Rh D+ve in the case and control (92.7% vs. 94.5%). The differences between the blood group and Rh D were not statistically significant between the two groups. Nearly half (40.0%) of the participants had used a hormonal contraceptive in the case and 61.8% in control. The differences in hormonal contraceptives use were statistically significant within the two groups. The distribution of “O” blood group and Rh D +ve cases was found to be higher in patients with cervical cancer than in non-cancer patients although the difference was not statistically significant. BSMMU J 2022; 15(2): 70-7

56 Pregnancy with Invasive Carcinoma of the Cervix- A Case Report

Carcinoma of the cervix is a preventable female malignancy. Recently, a 30 years old 5th gravid lady was referred to Bangabandhu Sheikh Mujib Medical University (BSMMU) from Jahurul Islam Medical College &amp; Hospital, Bajitpur, Kishorganj after diagnosing as a case of 32 weeks pregnancy coupled with invasive carcinoma of the cervix. Histopathology of cervical tissue showed moderately differentiated squamous cell carcinoma. Her cervical growth was confined in the anterior lip of the cervix and clinical stage was 1B. She was severely anemic. Her anemia had been corrected by blood transfusion. Injection dexamethasone was given for fetal lung maturity. Renal function tests and all other investigations for surgical fitness were done. At her 34th weeks of pregnancy caesarean section followed by Wertheim’s hysterectomy was performed. Baby was alive, birth weight was 2.3 kg, Apgar score was good. Postoperative period was un-event full. At her 23rd postoperative day she was discharged from Obs and Gynae department and referred to Oncology institute for further management. At the time of discharge her baby was healthy

Presentation of invasive cervical cancer in Bangladesh

Background: Cervical cancer is a disease of significant worldwide morbidity and mortality. More than 85% of the disease occurs in developing countries. Bangladesh, like other developing countries faces a burden of the disease. ObJec­tive: To find out the different way of presentation of invasive cervical cancer patients. Methods: This cross-sectional study was carried out in the Gynaecologic Oncology wing of the Department of Obstetrics and Gynaecology of Bang­abandhu Sheikh Mujib Medical University (BSMMU) during 1st January 2007 to 30th April 2008. One hundred and four patients with invasive cervical cancer admitted in hospital were enrolled in the study by purposive sampling. All the infor­mation were collected in a pre-designed structured questionnaire. Data were analyzed using statistical program SPSS version: 17.0. Frequency distributions were used to present the characteristics of the patients. Chi-square test was calcu­lated and the significant level was set at P<0.05. Results: Maximum patients (60.6%) were in stage II. Majority of the patients (61.5%) presented with abnormal bleeding. Exophytic growth was found in the majority of the patients (71.2%). Squamous cell carcinoma was more (92.3%) in the majority of patients and adenocarcinoma was more in younger age group. Conclusion: The status of the patients irJ this study reflects advanced stage of the disease at presentation and the peak incidence was observed in 36-45 years age group

Study on serum Lipoprotein (a) level in preeclamptic

It is a case control study which was design to know the association of serum Lipoprotein (a) level in preeclamptic (PE) in women. This study was carried out in department of Obstetrics and Gynecology, Sir Salimullah Medical College Hospital, Mitford, Dhaka. Total number of subjects was 100. Out of which 50 were cases and 50 were controls. Cases were physically and clinically proved PE patients. Controls were age, parity and gestational age matched. Three ml of blood were collected from each subjects, serum fasting LP(a) level were measured The mean age of study group was 24.49 ± 6.48 years. Serum Lipoprotein(a) level was 51.51 ± 29.38mg/dl Vs 17.40 ± 7.89 mg/dl in cases and controls respectively. This difference was statistically significant (p&lt;0.001). Mean serum Lipoprotein(a) level was found to be raised in severe preeclampsia (74.87mg/dl) and lowest in control subject Severe preeclampsia was found to be associated with higher level of lipoprotein (a) than both control (p&lt;0.01) and mild preeclamptic (p&lt;0.01) subjects. Mild preeclampsia was also found to have higher average serum Lipoprotein (a) than the normal (P&lt;0.01) subjects

Impact of Industrially Affected Soil on Humans: A Soil-Human and Soil-Plant-Human Exposure Assessment

Heavy metal (HM) contaminated soil can affect human health via ingestion of foodstuffs, inhalation of soil dust, and skin contact of soil. This study estimates the level of some heavy metals in soils of industrial areas, and their exposures to human body via dietary intake of vegetables and other pathways. Mean concentrations of Cr, Fe, Cu, Zn, As and Pb in the studied soil were found to be 61.27, 27,274, 42.36, 9.77, 28.08 and 13.69 mg/kg, respectively, while in vegetables the respective values were 0.53, 119.59, 9.76, 7.14, 1.34 and 2.69 mg/kg. Multivariate statistical analysis revealed that Fe, Cu, Zn, and Pb originated from lithogenic sources, while Cr and As are derived from anthropogenic sources. A moderate enrichment was noted by Cr, As, and Pb in the entire sampling site, indicating a progressive depletion of soil quality. The bioaccumulation factor (BCF) value for all the vegetables was recorded as BCF &lt; 1; however, the metal pollution index (MPI) stipulates moderately high value of heavy metal accumulation in the vegetable samples. Hazard Index (HI) of &gt;0.1 was estimated for adults but &gt;1 for children by direct soil exposure, whereas HI &lt; 1 for both children and adults via dietary intake of vegetables. Estimated Total carcinogenic risk (TCR) value due to soil exposure showed safe for adults but unsafe for children, while both the population groups were found to be safe via food consumption. Children are found more vulnerable receptors than adults, and health risks (carcinogenic and non-carcinogenic) via direct soil exposure proved unsafe. Overall, this study can be used as a reference for similar types of studies to evaluate heavy metal contaminated soil impact on the population of Bangladesh and other countries as well.</jats:p