Objective(s): The aim of the study wasto evaluate the safety and feasibility of non-descent vaginal hysterectomy in advancing gynaecological practice.Materials and methods: This prospective observational study was conducted from 1st July 2013 to 31st June 2014 in Obstetrics and Gynaecology Department of Kumudini Women’s Medical College & Hospital, Mirzapur, Tangail. Fifty patients who needed hysterectomy for benign gynaecological disorders and who had no descent of uterus or vagina were the target population for this study. Main outcome measures were i) difficulty of operation, ii) procedures for overcoming the difficulties,iii) switch over to abdominal route, iv) time taken to complete the operation, v) blood loss during operation vi) need of blood transfusion and vii) postsurgical hospital stay.Results: In all (100%) cases vaginal hysterectomy was completed successfully. Commonest age group (46%) was between 41-45 years. All patients were parous. Size of the uterus was less then 8 wks in 21 cases, 8wks to 12 wks in 27 cases and more than 12 wks in 02 cases. Commonest indication was dysfunctional uterine bleeding (DUB) (44%). Mean duration of surgery was 50.5 ± 5.46 minutes. Mean blood loss was 100± 22.43 ml.Blood transfusion was required in four cases. Average duration of hospital stay was 3.1± 1.2 days. Complications were minimum which included, bladder injury, UTI and Vault infection.Conclusions: In properly selected cases non-descent vaginal hysterectomy is safe, feasible and patient friendly.Bangladesh J Obstet Gynaecol, 2015; Vol. 30(1) : 15-19

Retained placenta is a condition in which the placenta is retained for more than half-an hour after the birth of a child. It accounts for 5-10% of all postpartum haemorrhage (PPH). The present study was conducted to find out the incidence, causes and management of retained placenta of admitted cases in In-Patient Department (IPD) of Obstetrics & Gynaecology of Dhaka Medical College Hospital, Dhaka during the period from June 01 to December 31, 2003. 163 patients were included in the study who presented with retained placenta and developed retained placenta in IPD who had undergone vaginal delivery, with pregnancy equal to or more than 28 weeks both stillbirths and live-births, both singleton and multiple pregnancy. The incidence of retained placenta was found 3.54% of total admissions. Retained placenta developed in 1.53% cases among 1,506 vaginal deliveries in this hospital during this period. The mean age of the respondents was 27.19±1.54 and most of the patients were aged between 21 to 30 years, multipara, illiterate and from low income group and poor socio-economic status. Among them 81.60% had home delivery, 64.42% delivered between 37 to 40 weeks of pregnancy. Majority of the patients i.e. 61.96% reached the hospital within 2 to 6 hours of development of retained placenta and 49.07% had shock with PPH. About 23.92% respondents had predisposing factors like D & C, manual removal of RP and caesarean section. A considerable percentage (19.63%) had history of MR. About 96.93% respondents required manual removal of retained placenta. 124 (76.07%) received blood transfusion ranging from 1 to 13 units of blood. The causes of retained placenta were uterine inertia (38.65%), morbid adhesion (52.76%) and less expulsive efforts of the patients (7.98%). Placenta accreta was the major (96.51%) cause of morbid adhesion. The range of hospital stay was between 6 to 15 days. Of the total retained placenta cases, 98.77% patients improved and 1.23% patients died of irreversible shock due to PPH. Key words: Retained Placenta; Caesarean Section. DOI: 10.3329/jdmc.v18i1.6300 J Dhaka Med Coll. 2009; 18(1) : 20-24

Objective: Aim of the study is to identify changes that occur in renal function in eclampsia patients and to determine the effect of impaired renal function on pregnancy outcome Materials and Methods: This cross-sectional study on the impairment of renal function in eclamptic patients was carried out in the Eclampsia ward of Dhaka Medical College Hospital from July 2009 to December 2009. Study group comprised of 50 diagnosed cases of eclampsia and 50 patients with uncomplicated pregnancy was taken as control. Results: In this study 30% of the eclamptic patients were found to have impairment of renal function. Incidence of impaired renal function was significantly increased among the patients > 25 years of age. Multigravida eclamptic patients were found to be more prone to develop impaired renal function compared to primigravida patients. Blood pressure was significantly increased and platelet count was significantly low in the impaired renal function group of eclamptic patients compared to the normal renal function group. Incidence of foetal complications was significantly higher among the patients with impaired renal function. The eclamptic patients who had proteinuria of >1 gm in 24 hours had more foetal complications than those who had protienuria of <1 gm/day.Conclusion: It has been observed that impairment of renal function is common among the patients with eclampsia. So, special attention should be paid to assess renal function in this group of patient DOI: http://dx.doi.org/10.3329/bjog.v26i1.13758 Bangladesh J Obstet Gynaecol, 2011; Vol. 26(1) : 31-36

A 25 years old nulliparous regularly menstruating woman presented inShSMC Hospital with the complaints of swelling in the right side of vulva and Dysparunia for 4 months. The swelling was initially small and painless but later on it became painful. The swelling recurred after surgical treatment. Examination revealed a swelling in the right Labium majus which was about 4x3 cm, bulging into right side of vagina. It was diagnosed as a case of recurrent bartholin cyst but during surgical procedure it was apparent that the swelling was not bartholin cyst but some other fleshy structure. The removed mass was 7x4 cm. Histopathology revealed benign lesion containing hypocellular structure with large blood vessels and no malignancy. It was diagnosed as Aggressive angoimyxoma. Aggressive Angoimyxoma is a very rare mesenchymal tumor, uptil now only 200 case have been reported in the world. It is a slow growing benign tumor which is typically located in the pelvis and perineum. It often presents with asymptomatic perineal or vulval mass and may be confused with Bartholin’s cyst, lipoma or hernia. Local recurrence is upto 70%; metastasis is very rare. Treatment is surgical resection Histology reveals a mass of mixed mesenchymal origin with low mitotic activity.It is a hypocellular and highly vascular tumor with myxoid stroma.Bangladesh J Obstet Gynaecol, 2014; Vol. 29(1) : 46-48

Objectives: Mechanical ventilation in the prone position has been shown to improve outcomes in randomized trials of patients with moderate to severe acute respiratory distress syndrome and is recommended in clinical practice guidelines. However, data is lacking on the results of attempts to implement this practice in the community outside of clinical trials. To describe our early outcomes implementing mechanical ventilation in the prone position. Design: Retrospective cohort study. Setting: Medical intensive care unit of a large community-based teaching hospital. Participants: All patients ventilated in the prone position between June 2013 and October 2016. Measurements and Main Results: We describe patient characteristics, mortality, and frequency of complications (such as skin breakdown and accidental extubation) at our center. Eighty-one patients with a mean age of 55 years underwent mechanical ventilation in the prone position during the study period. Most patients also received vasopressors, neuromuscular blockade, and steroids. Overall mortality was 43%. The duration of the first proning session ranged from 1.5 to 40.5 hours. Mortality was lower (34%) in those ventilated in the prone position for more than 16 hours during the first session. In the 50 patients without treatment limitations, only 14% expired. There were no accidental extubations during prone positioning. Most of those who died had limitations placed on treatment prior to death. Conclusions: Overall mortality was higher in our cohort than in the randomized trial. However, differences such as lack of stabilization period, different cultures impacting end-of-life decisions, and timing of enrollment in the course of illness limit interpretation of this comparison. This exercise allows identification of areas for future quality improvement efforts such as increasing the duration of some proning sessions. Complications of prone positioning were uncommon.