Background: Premature rupture of membranes (PROM) increases early-onset neonatal sepsis (EONS) risk, raising morbidity and mortality. Neonatal sepsis presents nonspecifically, hindering early diagnosis. Procalcitonin (PCT) and other inflammatory markers are emerging as sensitive tools for timely detection. Objective: To find out the association between maternal serum procalcitonin level in preterm premature rupture of membrane patients with early onset of neonatal sepsis. Methods: This prospective cohort study was conducted in the Fetal-Maternal Medicine unit of the Obstetrics & Gynecology department of Dhaka Medical College Hospital, Dhaka, from January 2022 to December 2022. In this study, 99 preterm PROM patients were enrolled. After consent, the researcher interviewed each woman using a standardized questionnaire. Maternal venous blood (3ml) was collected aseptically on admission. Serum procalcitonin was measured via chemiluminescence (sandwich technique). Neonates were followed for EONS signs within 3 days, confirmed by CBC/CRP. SPSS 26.0 analyzed the data. Results: Most patients (53.5%) were aged 18–25 years (mean 25.2±5.1). Elevated maternal procalcitonin (>0.05 ng/ml) occurred in 61.6%. Neonatal survival was 90.9% (90/99); 9.1% died. Among 90 live neonates, 17.7% had lethargy/poor feeding, 10% respiratory distress. EONS was culture-confirmed in 8 babies (8.9%), all with elevated maternal procalcitonin (p=0.016, RR 1.74, 95% CI). Conclusion: Early-onset neonatal sepsis occurred in 8.9%, significantly linked to elevated maternal procalcitonin. Thus, maternal serum procalcitonin in preterm PROM is a useful, non-invasive biomarker for assessing EONS association.

Background: Rising caesarean section rates and concerns regarding maternal safety continue to shape modern obstetric practice, especially in low-resource settings. Therefore, this study assessed postpartum hemorrhage and perineal injury among women undergoing VBAC at Dhaka Medical College Hospital. Methods: This cross sectional study was conducted in the Department of Obstetrics and Gynaecology, Dhaka Medical College Hospital (DMCH), Dhaka, Bangladesh, from 16 April to 15 October 2023, enrolling 100 pregnant women with one or two prior caesarean sections planned for vaginal delivery. After ethical approval and informed consent, data were collected with a structured questionnaire, and women undergoing trial of labour after caesarean (TOLAC) were monitored using maternal and fetal parameters, partogram, and oxytocin as per protocol. Outcomes included induction to delivery interval, mode of delivery, and maternal complications, and data were analyzed in SPSS. Results: Among 100 VBAC cases, mean age was 29.8 ± 11.4 years, with most aged 20–30 years (58.0%) and 82.0% at ≥37 weeks gestation. Hemoglobin ≥11 g/dL was seen in 72.0%, and membrane status was nearly equal (intact 52.0%, ruptured 48.0%). Mean induction–delivery interval was 8.37 ± 5.3 hours, with 64.0% delivering within 7–12 hours. VBAC success was 76.0% and repeat caesarean 24.0%. Overall, 83.0% had no complications; PPH occurred in 9.0%, perineal injury in 3.0%, and no uterine rupture was noted. Conclusion: VBAC is a safe and effective mode of delivery in appropriately selected women, with low rates of postpartum hemorrhage and perineal injury.

Background: Abnormal vaginal discharge is among the most frequent gynaecological complaints encountered in clinical practice, especially among women of reproductive age. The etiology of abnormal vaginal discharge is broadly categorized into infectious and non-infectious causes. The major infectious causes include bacterial vaginosis (BV), vulvovaginal candidiasis (VVC), and trichomoniasis. Present study was aimed to study abnormal vaginal discharge in women of reproductive age group at a tertiary hospital. Material and Methods: Present study was hospital-based prospective observational study, conducted in sexually active women in age group 21 to 49 year with abnormal vaginal discharge. Results: The age distribution showed that most women with abnormal vaginal discharge belonged to the 26-35 years age group, constituting 69% of the study population. Type of residence had a moderate influence, with 54.5% urban and 45.5% rural participants Socio-demographic variables such as education and economic status played a significant role. Symptomatology was diverse, with vaginal itching (58.5%) being the most common symptom. The characteristics of vaginal discharge provided valuable diagnostic clues. White discharge was reported in 48% of cases, followed by curdy white (36%) and yellowish white (16%). Thick discharge consistency (47%) was most prevalent, consistent with fungal infections, particularly vulvovaginal candidiasis. Microbiological diagnosis revealed vulvovaginal candidiasis in 27%, bacterial vaginosis in 14%, and mixed infections in 2.5%, while 56% had no identifiable pathogen. Treatment was administered per syndromic guidelines. A majority (56%) were reassured with no specific therapy, indicating likely physiological or non-infective causes. Green Kit (29.5%) and metronidazole (14.5%) were used in symptomatic cases. At follow-up, 78% showed complete symptom resolution and 15% no relief,7% loss to follow up. Conclusion: Treatment based on definitive laboratory investigations allows for precise diagnosis and tailored therapy, thereby offering greater accuracy and efficacy compared to the syndromic approach which is primarily symptom-driven.

Background: Although male infertility is highly prevalent in sub-Saharan African countries, minimal studies have been undertaken to identify its determinants, factors and root causes. We undertook this study to determine the association between oxidative stress markers and seminal fluid quality parameters among a cohort of Nigerian men attending an infertility clinic at the University of Benin Teaching Hospital in Southern Nigeria. Methods: This comparative cross sectional study involved 90 men attending the infertility clinic at the University of Benin Teaching Hospital, Benin City. The study consisted of 45 participants with abnormal semen parameters and 45 with normal semen parameters. Oxidative stress markers: superoxide dismutase and malondialdehyde levels in semen were assayed in both normal and abnormal semen group using the Adrenalin inhibition method by Misra and Fridovich for Superoxide dismutase and the Thiobarbituric acid assay by Buege and Aust for Malondialdehyde. Data were analysed using univariate, bivariate, and binary logistic regression to test the association between oxidative stress markers and the risk of abnormality in seminal fluid parameters, and Pearson's correlation to assess the direction of association. Results: The mean levels of superoxidase dismutase were higher in the normal group (1.37 u/g ± 0.34) as compared with the abnormal (0.78u/g ± 0.36, p < 0.001). The mean (SD) malondialdehyde level in the control group was (0.59mol/g ± 0.19) and was significantly lower than in the cases (1.38 ± 0.45mol/g, P < 0.001). There was a positive correlation between superoxide dismutase levels and a negative correlation between malondialdehyde levels and sperm concentration, motility and morphology in both cases and controls. However, after adjusting for cofounders in logistic regression, Superoxide dismutase had a statistically significant effect on motility, while Malondialdehyde had a substantial impact on motility and concentration. Conclusion: We conclude that levels of a marker of oxidative stress (Malondialdehyde) are higher in men with poor semen quality. In contrast, levels of the anti-oxidative stress marker (superoxide dismutase) were higher in men with better semen quality. Superoxide dismutase had a significant impact on sperm motility, while Malondialdehyde affected both sperm motility and concentration. We believe these results would serve as an adjunct when evaluating infertile males.