Background: Change of liver biochemical profiles is normal during pregnancy. It is almost impossible to understand disease processes that can threaten women during pregnancy without understanding normal physiological change. Aim of this study is to evaluate changes in serum liver function tests in normal pregnant women in first, second and third trimester. Material and Methods: The cross-sectional comparative study was carried out in the Department of Obstetrics & Gynaecology of Rajshahi Medical College Hospital, Bangladesh in 2019. This study consists of 90 pregnant women and 90 matched control. Among the 90 pregnant women, 30 were in first trimester, 30 were in second trimester and 30 were in third trimester. Blood samples were taken for routine liver function and protein profiles Results: Serum total and direct bilirubin concentrations were significantly lower in second and third trimester. The mean ALP level was slightly increased in 2nd trimester and drastically increased in 3rd trimesters during pregnancy. Serum ALT and AST activity was significantly increased in third trimester. No significant change in serum total proteins concentration, but serum albumin concentration was significantly lower and serum globulin concentration was significantly higher in all three trimester. Serum albumin/globulin ratio was significantly reduced in second and third trimester. Conclusion: Relative values of various liver function tests during gestational trimesters appear to be the best guide to confirm the diagnosis and treatment strategies. Thus, gynecologists should routinely monitor liver function tests in all gestational trimesters to avoid the future complications to mother and offspring. TAJ 2020; 33(1): 17-24

Objectives: Clinical evaluation and identification of aetiology of asymptomatic raised serum alanine aminotransferase (ALT) level in newly detected adult diabetic and impaired glucose tolerance (IGT) patients.Methods: In this cross-sectional study, newly detected adult diabetic and IGT patients having asymptomatic raised serum ALT level of > 1.5 times of upper limit of normal were evaluated clinically and by laboratory tests.Results: Total number of patients was 120, which was 3.1% of all newly registered diabetic and IGT patients over the study period. Male were 74 and female 46. Diabetes mellitus (DM) was found in 93.3% cases and IGT in 6.7%. Mean age was 43.1 years, mean body weight was 64.5 kg and mean body mass index (BMI) was 25.5 kg/m 2 . Central (abdominal) obesity was found in 61.5% cases. Increased waist hip ratio was found in 86.3% cases. Hypertension and hepatomegaly were present in 35% and 5.8% cases respectively. Dyslipidaemia was found in 98.3% cases and 45% patients fulfilled criteria for metabolic syndrome. Regarding etiology, 76.7% cases had non-alcoholic fatty liver disease (NAFLD), 8.3% had HBsAg sero-positivity, 4.2% had anti-HCV seropositivity and 3.3% had both NAFLD and HBsAg seropositivity. In 7.5% cases no cause was found. Raised serum ALT level had a significant correlation with metabolic syndrome (p= 0.016) and increasing age (p= 0.008). Conclusion

Objective: To describe the clinical presentation and feto-maternal outcome of preterm prelabor rupture of the membrane of patients admitted in a tertiary care hospital of Bangladesh. Methods and Material: This is a cross-sectional observational type study carried out in Rajshahi Medical College Hospital, Rajshahi, Bangladesh during the year 2019 in the Department of Obstetrics and Gynecology. Sixty pregnant women with preterm prelabor rupture of the membrane (gestational age 28 to 37 weeks) were included in this study. Results: The mean age of the women was 27.03±6.13 years. Forty (66.7%) of them were from rural area. Majority were studied up to primary school (33.30%). Sixty five percent were house wife. Thirty seven (61.7%) women were multi gravid. Mean gestational age of the patient was 34.43±2.75 weeks. Antenatal care of the women was low. Most of the women have associated one or more diseases like anemia (35%), Urinary tract infection (28.33%), Pregnancy induced hypertension (20%), Lower genital infection (13.33 %,), gestational diabetes mellitus (10%) and heart disease (3.33%). The mean time interval between membrane rupture and delivery was 29±9 hours. Thirty one patients (51.7%) were delivered by caesarian section. Twenty eight (46.7%) women did not experience any complication and other suffered from wound infection (20%), PPH (10%), puerperal sepsis (8.33%) and chorioamnionitis (11.7%). Mean birth weight of the newborns was 2.16±0.42 Kg. Thirty eight (63.33%) newborn suffered from complications like neonatal asphyxia (30%), respiratory distress syndrome (13.3%), neonatal jaundice (11.7%) and neonatal sepsis (3.3%). Neonatal death was noticed in three (5%) cases. Fetal outcome was found significantly (p< 0.001) associated with low gestational age. Conclusion: Women with low education, associated co-morbidity, long latency and neonate with low birth weight have unfavorable outcome. Antenatal care is an important tool to prevent preterm prelabor rupture of the membrane by identifying the risk factors and its management. Optimum obstetric and medical care is essential for the reduction of these devastating complications. TAJ 2020; 33(2): 1-9

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Breast abscess is the localized collection of pus in breast tissue. Various treatment protocols used now a day like oral drugs, hot compression, surgical incision and drainage and ultrasound guided needle aspiration. Aim of this article was to identify the ultrasound guided needle aspiration of breast abscess is an alternative to surgical incision and drainage by analysis of previous study reports. It was found that though ultrasound guided aspiration of breast abscess has some benefit than traditional surgical drainage but it not applicable for all cases. TAJ 2020; 33(1): 1-4