Serum calcium and phosphate level in normal pregnant women.

Background and Objectives: Pregnancy is the physiological process in which progressive anatomical, physiological and biochemical changes occur. Secretion of different hormones during pregnancy is responsible for maternal adaptation to the increasing demand of the growing fetus. The present study was aimed to evaluate serum calcium and phosphate status in normal pregnant women in different trimesters. Materials and Methods: A total number of 140 subjects, age range 20-40 (yrs) were recruited in the study which includes 100 normal pregnant women termed as study group (Group B) and 40 healthy women without pregnant (Group A), served as Control. Group B subjects were subdivided into Group B1 (n=12), Group B2 (n=30) and Group B3 (n=58) on the basis of duration of pregnancy- 1st, 2nd and 3rd trimesters respectively. Calcium was measured by CPC (photometric method for Ca) and serum phosphate by colorimetric method. Statistical analysis was done using SPSS for Windows, Version 10. Unpaired Student's -'t' test performed to calculate statistical differences between groups. Results: Age (yrs) (mean±SD) and BMI of the pregnant women in different groups did not show statistical difference. Serum calcium (mean±SD) levels in the 1st (p=0.0001) and 2nd (p=0.02) trimester was significantly higher compared to the Controls. In 3rd the value was significantly lower (p=0.015) compared to the Controls and of 1st and 2nd trimesters (p=0.001). Serum phosphate (mean±SD) levels in three trimesters did not show statistical significant difference compared to the Controls and among the pregnancy groups. Conclusion: The data concluded that serum calcium level was lower during third trimester of the study subjects which may be explained by the fact of increased demand of the growing fetus and exposing the mother at risk of complications related to low serum calcium.

Outcome of pregnancy in women 35 years of age and above.

Pregnancy outcome among women in the age group of 35 years and more are considered to be less favorable than those of younger women. To observe those, this case control study was conducted in the department of Obstetrics & Gynaecology, Mymensingh Medical College Hospital during the period of 1st June 2003 to 31st May 2004. The study includes 100 patients of 35 years of age or above and 100 controls of 20-30 years of age. Observed complications during the pregnancy and delivery were increased incidence of placenta previa, malpresentation, intrauterine death, preterm labour, obstructed labour ruptured uterus etc. Pregnancy related complications were found significantly high (p<0.001) in case group (80%) compared to control group (51%). Rate of caesarian section was also more among the cases. Post delivery maternal complications were more in case group (53%) compared to control (30%) (p<0.001). Perinatal morbidity and mortality was significantly high. Cause of late fetal death in older women include, failure of the uterine vasculature in older women to adapt sufficiently to the increase haemodynamic demands of pregnancy, reduced fetal oxygenation with maternal age and also a rise in the frequency of preexisting hypertension with age. Maternal age is an important and independent risk in pregnancy outcome.

Recent updates of management of endometrial carcinoma.

Endometrial carcinoma is a low grade curable malignancy and most patients present with early disease with excellent survival. Of all female pelvic malignancies, it seems to have more advocates for different treatment plans than any other. Total extrafascial hysterectomy and bilateral salphingo-oophorectomy is the primary operative procedure. Pelvic lymhadenectomy is performed in most centres on therapeutic and prognostic grounds and to individualize adjuvant treatment. Postoperative irradiation are used to reduce pelvic and vaginal recurrences in high risk cases. Treatment planning are conservative in order to reduce patients morbidity and overtreatment while maintaining acceptable recurrence and survival rates.

Use of Wigglesworth classification for the assessment of perinatal mortality in Bangladesh--a preliminary study.

The Wigglesworth pathophysiological classification was used to analyse perinatal deaths occurring in 5 health centres in Bangladesh. The aims were to assess the feasibility of this classification, to determine the causes of perinatal deaths and thereby to identify the areas in need of intervention. A total of 8058 births were recorded at 5 centres during the period of 11 months from mid-January to mid-December 2001. There were 1069 deaths in the perinatal period. Stillbirths were slightly more frequent (53.5%) than early neonatal deaths (46.5%). Among the stillbirths, fresh stillbirths predominated over normally formed macerated ones at all centers except BIRDEM, where the majority (52.5%) was macerated. The majority (71.6%) of perinatal deaths were in the groups comprising asphyxial conditions (46.8%), conditions associated with immaturity (13.3%), and normally formed macerated stillbirths (NFMSB, 11.5%). In the group, 'other specific conditions' which was responsible for 9.3% of perinatal deaths, all but one case was attributed to sepsis. When the cases were subdivided by birth groups, asphyxia predominated in all but the <1000g group, in whom immaturity was responsible. Conditions associated with immaturity were second highest in number. The majority of the perinatal deaths (83.4%) was in babies less than 2500g. The study has shown that the Wigglesworth classification can be used in different types of health facilities in Bangladesh by doctors, nurses and midwives. The areas which need intervention are antepartum care, obstetric and newborn care practices, and environmental factors responsible for the high prevalence of prematurity and low birth weight.

Patients' adherence to diabetes treatment.

OBJECTIVES: a) To evaluate the patients' adherence to the treatment prescriptions and b) to analyse the reasons for non adherence. METHODS: A random sample of 386--type 2 diabetic subjects (M:F 223:163) were studied. Each subject was personally interviewed using a computerised proforma. The mean age of the study group was 52 +/- 10 years and 53% were treated with oral hypolycenic agent (OHA) and the rest with a combination of insulin and OHA. The mean duration of diabetes was 11.0 +/- 6.9 yrs. The overall adherence to the treatment regimen, diet and drug prescriptions and also regularity of home glucose monitoring by blood or urine tests were assessed. RESULTS: It was noted that only 25% of the study group were adhering to the treatment regularly. Dietary prescriptions were followed regularly only by thirty seven percent. Home glucose monitoring was being done only by twenty three percent. Non adherence was not related either to the age or duration of diabetes. Non adherence was more in the lower socio-economic group and was inversely related to the educational status. It was noted that approximately 20% of the subjects had an indifferent attitude to the advice given. CONCLUSIONS: The results showed that the rate of non adherence of treatment prescriptions was high. It stresses the need for constant motivation and one to one level education at frequent intervals to ensure better compliance to the treatment.

Effect of homeopathic drugs plumbum and opium on experimentally induced lead toxicity in rats.

Homeopathic drugs plumbum 1M and Opium 30 were partially effective in the recovery of delta ALAD activity of the lead (150 mg% lead acetate) intoxicated rats. Plumbum 1M did not exhibit protective effect when dietary lead at high concentrations (> 25 mg% lead acetate) were given concurrently as assessed by blood delta ALAD activity and hemoglobin concentration. However it was partially effective in the recovery of delta ALAD activity and relieving anemia caused by chronic exposure of low doses of lead (below 15 mg% lead acetate).

Geographical distribution & seasonal pattern of diarrhoeal diseases in Bangladesh.

The district wise distribution and seasonal pattern of diarrhoeal diseases from 1987 to 1989 of Bangladesh are compiled and reported. The districts of Lalmonirhat, Kurigram, Gaibandha, Rajbari and Banderban showed higher incidences of diarrhoeal diseases to mean range of 8 and above. Among the remaining districts, 18 districts were in the medium ranges of incidences between 4 to less than 8% and 41 districts with lower range of incidences i.e. less than 4%. Two peaks of diarrhoeal diseases were found, once during the months of September-October in the post monsoon period and other during April-May.

Disease profile in respect of health services of Upazila health complex.

This study was carried out to identify the disease profile in relation to medical services at upazila health complex. Thirty different types of diseases were identified. Diarrhoeal diseases were found to be highest (53%), the second highest was intestinal worms (44%). About ninety seven percent patient attended the OPD and only 2% were attended in the emergency Department. On average 172 patients were admitted per month and the highest of admission was found in the months of September and October. The average length of stay in the hospital was 11.6 days. Among the patients admitted 55% were male, and 45 were female. 5% pregnant mothers attended in U.H.C. for antenatal checkup and 2% mother were admitted into the hospital after delivery. Metronidazole was the drug of highest consumption followed by B-Complex and Penicillin.

Study of food habits, food practices and taboos in Bangladesh: their implications in nutrition education.

The paper reports the findings of a retrospective study conducted to determine the prevailing food habits, food taboos and practices among 381 mothers selected randomly from twelve villages situated in 4 administrative divisions of Bangladesh. Undesirable food taboos and practices, maldistribution of food, lack of understanding of the nutritional needs of the vulnerable groups and bad cooking practices were found to be widespread in rural Bangladesh. Nutritional and health implications of these are discussed and remedial measures suggested.