Analysis of Socio Demographic Risk Factors of Cervical Intraepithelial Neoplasia at Colposcopic Clinic in Mymensingh Medical College Hospital

Cervical intraepithelial neoplasia (CIN) is a pre-malignant lesion of the cervix of uterus. Several risk factors increased the risk of developing CIN. Purpose of this study was to evaluate the socio-demographic risk factors related to CIN at our setting. This Cross sectional observational study was performed at Colposcopic clinic of Mymensingh Medical College Hospital (MMCH), Mymensingh, Bangladesh from 9th November 2017 to 8th May 2018. Overall demographic features of 50 patients of precancerous cervical lesion show that, most of the patients belonged to the age group 30-39 years (46.0%), mean age was 32.7±10.3 years. Maximum numbers of respondents came from rural area (58.0%), followed by urban area (42.0%). Among them house wife- 46.0%, daily worker- 30.0% and illiterate 36.0%, primary level of education 32.6%. Among the patients the poor class 46.0% and 58.0% of the respondents were married at age ≤19 year. Among the respondents, (26.0%) were conceived their first child 1 month after their marriage and 54.0% of the women within 12 months of marriage. In this study multipara were (62.0%). Oral contraceptive pill was taken by (42.0%) of patients. The association of risk factors revealed that betel or tobacco chewing present in 28.0% cases; history of menstrual regulation (MR), dilatation, evacuation and curettage (DE&C), miscarriage were in 26.0% cases, family history of cancer were in 16.0% cases and multiple sexual exposure was in 10.0% cases. Women develop pre-malignant cervical lesions require early treatment. It is recommended that provision of proper health care support, early detection of CIN and proper management, can reduce the fatal outcome of the disease.

In silico design of epitope-based peptide vaccine against non-typhoidal Salmonella through immunoinformatic approaches

Non-typhoidal Salmonella (NTS) is one of the leading bacterial causes of many invasive human infections with a high antibiotic resistance profile. With this concern, the current study aimed to design an effective epitope-based peptide vaccine against NTS species as a successive and substitutive protective measure of invasive NTS disease. To design rationally, the current study considered a comprehensive in silico workflow combination of both immunoinformatics and molecular modeling approaches, including molecular docking and molecular dynamics (MD) simulation. We identified the two most promising T cell epitopes KVLYGIFAI and YGIFAITAL, and three B cell epitopes AAPVQVGEAAGS, TGGGDGSNT, and TGGGDGSNTGTTTT, in the outer membrane of NTS. Using these epitopes, a multiepitope vaccine was subsequently constructed along with appropriate adjuvant and linkers, which showed a good binding affinity and stability with toll-like receptor 2 (TLR2) in both molecular docking and MD simulation. Furthermore, in silico immune simulation described a strong immune response with a high number of antibodies, interferon-γ, and activated B and T cells. This study collectively suggests that predicted vaccine constructs could be considered potential vaccine candidates against common NTS species.Communicated by Ramaswamy H. Sarma.

Assessment of Indications and Complications of Caesarean Section in A Private Medical College Hospital of Bangladesh

Caesarean section (CS) is the most frequently performed major operation in obstetrics. Its frequency is gradually increasing because of extended indications. Now-a-days, caesarean section is also being performed at patient's request in absence of a medical indication. It is necessary to assess the risk and benefits to take a judicious decision to select cases for caesarean section. The cross sectional descriptive type of observational study was carried out among purposively selected 100 pregnant women admitted to the department of Obstetrics and Gynaecology of Community Based Medical College Hospital, Mymensingh, Bangladesh during the period of August 2011 to January 2012 to identify elective and emergency indications of caesarean section, to identify the common complications to identify the risk factors associated with complications and to establish a comparison between complications of elective and emergency caesarean section. The median age group of patients being operated was 20 to 25 years and operation were carried out on patients due to various indications. Principal indications were faetal distress (26%), PROM (15%), failed progress of labour and breech presentation were 8% each, other indications were eclampsia (4%), obstructed labour (5%), scar tenderness (4%), history of previous 2 caesarian section 5%. The rate of elective caesarean section was 21% while emergency operations were done in 79% of cases. Among the 100 patients 19% patients developed complications. Among the complications wound infection was most common (37%), then post partum haemorrhage and urinary tract infection 26% and 11% respectively. Other complications were abdominal distension, Puerperal sepsis, anaemic heart failure, wound dehiscence and Wound haematoma 5% each. We should try to keep the rate of caesarean section within optimum ranges (10%) as recommended by World Health Organization.

Induction of labor by intracervical prostaglandin gel and oxytocin infusion in primigravid women with unfavorable cervix

The rate of Cesarean Section for failed induction of labor and maternal and fetal compilations are high when labor is induced in a nulliparas women with an unripe cervix by amniotomy and oxytocin infusion. Prostaglandins (PG) in different forms have been used for ripening the cervix with an aim of reducing these problems. A prospective randomized trial was performed on one hundred primigravid women between 37 and 42 weeks of gestation with singleton pregnancy, cephalic presentation and unfavorable cervix (Modified Bishop Score < or = 5) in the department of Obstetrics & Gynaecology of Institute of Postgraduate Medicine & Research from 1st May 1996 to 30th April 1997. In this study the efficiency of prostaglandin E2 intracervical (PGE2 IC) gel in induction of labor in a group of primigravid women with unripe cervix was assessed and compared with another group with similar characteristics using oxytocin infusion and artificial rupture of membrane (ARM). The Modified Bishop Score (MBS), interval between IOL and onset of labor and the duration of labor after insertion of PGE2 gel was significantly different from those of oxytocin infusion group. But the Apgar Score at 1 & 5 min had shown no statistically significant difference. Any significant difference could also not be detected in the mode of delivery between the two induction group. The proportion of emergency Cesarean Section (CS) was high in the oxytocin infusion group than that of in the prostaglandin group. There was also no significant difference regarding the acceptability of both the induction methods.