Background: Placenta accreta spectrum (PAS) often results in significant blood loss and peripartum hysterectomy; the mother may not survive. In many cases, timely prenatal diagnosis allows for careful birth planning in a specialized facility with a highly qualified multidisciplinary team. This has been shown to reduce maternal morbidity. Scheduled deliveries are associated with lower rates of bleeding and emergency procedures when compared to emergency deliveries. Objective: The aim of this study is to identify the preoperative and postoperative complication of planned management and emergency management of patients with PAS disorder. Methods: The cross-sectional comparative study was conducted in the Department of Obstetrics & Gynaecology, Dhaka Medical College Hospital, Dhaka from 18th January 2020 to 17th July 2020. A total of 84 patients diagnosed as a case of PAS disorder (antenatally and peroperative diagnosed) and scheduled for planned management or emergency management of PAS were included according to inclusion and exclusion criteria. 42 planned management of PAS disorder patients as Group A and 42 emergency management of PAS disorder patients as Group B. The questionnaire was pretested, corrected and finalized. Data were collected by face-to-face interview and analyzed by appropriate computer based programmed software Statistical Package for the Social Sciences (SPSS), version 24. Results: In this study, mean ± SD of age was calculated 26.3 ± 4.3 years for Group – A and 28.1 ± 3.2 years for Group – B. Urban population were predominant in group-A. About 30 (70.0%)) patients in group-A and 10 (23.8%) patients in group-B came from urban. Large number of respondents 22 (52.4%) and 10 (50.0%) were housewife in both groups. Among the patients, the lower class 18 (42.9%) and 23 (54.8%) comprised the major percentage of the patients in both groups. More participants in Group-A 29 (69.00%) received ANC regularly than Group B 10 (23.80%), the difference was statistically significant (p<0.05). In group-A maximum patients presented with only USG findings of PAS disorders and with APH or without APH 26 (61.8%). In group-B, PPH and internal haemorrhage 10 (23.8) was noted predominantly. The mild anemia was more in 23 (54.8%) patients in group A and 16 (38.1%) patients in group B which was statistically significant (p < 0.001). More participants in Group-B 26 (61.9%) required early termination, whereas majority of group A 35 (83.3%) was terminated at 35-36 weeks. There was a statistically significant difference between groups. Maximum patients were managed by peripartum hysterectomy 35 (82.0%) and 31 (73.8%) in group A & B respectively. Presence of multidisciplinary team was arranged in 38 (90.4%) in group A and 18 (42.9%) in group B. General anesthesia and CV line was given in 36 (85.7%) patients in group-A and 27 (64.3%) patients in group-B. Massive blood transfusion was needed in 23 (54.8%) patients in Group B & only 3 (7.1%) patients in Group A. Placenta acreta was present 11 (26.2%) patients in group A and 7 (16.7%) patients in group B. Placenta percreta with bladder invasion and peroperative bladder injury was higher in group-B patients. More than 3 L blood was transfused 3 (7.1%) patients in group A and 23 (54.8%) patients in group B. PPH, Sepsis, Re-exploration, DIC and ICU admission were the significant complication in Group-B patients, reported 41 (95.0), 4 (9.5%), 8 (19.0%), 9 (21.4%) and 21 (50.0%) of women and in less complication in Group A 13 (31.0), 0%, 0%, 1 (2.3) and 4 (9.5). In this study mortality rate was 2 (4.8%) in group-B (due to irreversible shock &DIC). Poor outcomes were significantly higher in group-B. NICU admission for prematurity was required in 9 (21.4%) of the babies in group-A and 23 (54.8%) babies of group-B. Birth asphyxia was observed in 4 (9.5%) of the babies in group-A and 13 (31.0%) in Group-B. Conclusion: Prenatal diagnosis and placenta preservation may be linked to lower rates of morbidity in mothers. For morbidly adherent placenta linked with placenta previa, we advise hysterectomy as the preferred course of therapy following extremely thorough prenatal counseling. Maternal problems and fetal outcomes may be improved by early risk factor identification and proactive management.

Objective: The aim of this study was to assess the association between oculo-orbital CT scan results and Ocular Trauma Score (OTS) in open globe injuries. Methods: In 65 eyes with open globe injuries undergoing oculo-orbital CT, they were classified into 5 major types: intraocular foreign body/air, scleral irregularity with decreased globe volume, lens dislocation, abnormal vitreous density, choroid layer thickening, and choroidal detachment. The association between different types and the number of CT findings with OTS stages was evaluated. Results: The average age of patients was 37 ± 15.8 years. The most common CT findings were the presence of intraocular foreign bodies (63.1%), severe scleral irregularity (18.5%), and abnormal vitreous density (23.1%). The most frequent OTS stages were III (47.7%) and II (21.5%). Univariate analysis showed that severe scleral irregularity (OR = 0.015; p = 0.001), abnormal vitreous density (OR = 0.095; p < 0.004), choroidal layer thickening (OR = 0.211; p = 0.006), and foreign body (OR = 9.50; p = 0.004) were associated with more advanced OTS stages (I and II). The discovery of more anomalies on CT was associated with severe ocular injuries, namely OTS I (p < 0.001) with corresponding low final visual acuity. Conclusion: CT results can aid in predicting OTS stage and visual prognosis in open globe eye injuries.

IBD is a recurrent inflammation of the gastrointestinal tract caused by an abnormal immune response to gut microbiota. It is a genetically predisposed condition, with incidence rates ranging from 4 to 10 per 100,000 people annually. It is more prevalent in highly industrialized countries and affects the entire bowel wall. Both forms are categorized by their location and degree of involvement. IBD is characterized by diffuse inflammation of the intestinal mucosa, proctitis, and transmural ulceration. Treatment focuses on immunosuppressive drugs and anti-inflammatory compounds, but achieving remission remains a clinical challenge. A 23-year-old female patient with pat history of Arthritis was admitted to the hospital. She complained of weight loss (lost about 5 – 10 kg in the last month), diminished appetite, weakness, blood in her faeces, and abdominal pain. The patient had significant anaemia and a tentative diagnosis of UGI-bleed. She is married, has a son who is nine years old, has regular bowel and bladder habits. The patient's MCHC was 29.4 g/dl, mean MCV was 72.8 fL, and haemoglobin was 11.1%. The patient's colonoscopy revealed Crohn's disease and colitis with rectal sparing. ANA screening tested positive and Negative for RF-IgM. The Patient’s medication regimen includes Intravenous dextrose, Vitamin supplementation, Magnesium sulphate, tranexamic acid, Metronidazole, Cefoperazone & Sulbactam, and Pantoprazole. The oral supplementations include Syrup Sucralfate, probiotic capsule, Tab. Hydroxychloroquine, Tab. Tramadol & Acetaminophen, Mesalamine in tablet and sachet usually taken by mixing in water.

This review examines the changing insights into C-peptide and its potential for therapeutic actions against the backdrop of diabetic microvascular complications. C-peptide, formerly regarded as just a byproduct of insulin production, has recently surfaced as a bioactive peptide with important physiological effects. Findings indicate that C-peptide has anti-inflammatory and antioxidant capabilities, strengthens glucose utilization, and raises insulin sensitivity. Trial results for C-peptide replacement therapy show hope for treating diabetic neuropathy and nephropathy conditions. The article reviews the influence of C-peptide on cells, focusing on interactions with cell surface receptors and the stimulation of signaling molecules inside cells. C-peptide's role in generating nitric oxide, activating Na+K+ATPase, and improving the flow of blood in microvessels is emphasized. The review explores how C-peptide affects red blood cell deformability and its potential capabilities in reducing multiple diabetic complications. Besides, the article examines current research into C-peptide analogs that have a long-lasting effect and clinical trials that assess C-peptide replacement therapy. ErsattaTM, a new generation of weekly dosage disease-modifying replacement peptides, is seen as a promising advance in the treatment of chronic diabetes complications. Overall, this review stresses the increased acceptance of C-peptide as a powerful agent for the management of microvascular complications in diabetes, giving hope for superior results in patients with both type 1 and potentially type 2 diabetes.

Background: For a long time, researchers have extensively studied the health advantages of natural products derived from plants. Objective: The main goal of this study is to investigate the effects of palm heart extract (PHE) on the lipid profile and various parameters of the heart, liver, and reproductive system in male rabbits. Methods: The male rabbits were divided into four groups by chance; one group was given a standard diet for comparison, while the other three received a PHE supplement. The control group did not get any treatment while three groups were given medium to high doses of PHE daily for 8 weeks. Troponin and lipid profile levels were assessed for health indicators, while liver enzyme levels (ALT, AST, ALP) and total bilirubin were analyzed to evaluate liver function. Furthermore, hormone levels such as testosterone, LH (luteinizing hormone), and FSH (follicle stimulating hormone) were also observed during the entire study period. Outcomes: Lipid profile parameters, including cholesterol (TC), triglycerides (TG), low density lipoprotein cholesterol (LDL), and high density lipoprotein cholesterol (HDL), were assessed before and after the intervention period. Results: The results indicated a reduction in TC and LDL levels in the treatment group compared to the control group was statistically significant (p < 0.05). Nonetheless, there were no changes observed in the levels of TG and HDL in both groups, with a p-value greater than 0.05. These results indicate that heart palm water extract might have the ability to lower lipid levels, especially in decreasing total cholesterol and LDL levels. Testosterone levels showed a small drop in the high dose group when compared to the control group, although there was no statistical significance (p > 0.05). LH levels did not significantly decrease in the medium dose group compared to the control group (p < 0.05). There were no notable variations in FSH levels among the groups (p < 0.05). In conclusion, male rabbits showed reduced troponin levels in a dose-dependent manner, indicating potential cardioprotective effects of HDP extract. The administration of HDP extract did not have any impact on liver function. Although reproductive hormone levels varied, additional research is required to understand the effects of heart palm extract on male reproductive health.

Background: It is an indispensable tool for ensuring patient safety, while its practice raises numerous questions in developing countries, including Bangladesh. This paper aims at determining medical students’ Knowledge, attitude and practice (KAP) of pharmacovigilance to inform ADR reporting. Objective: To evaluate the KAP of pharmacovigilance with second-year students, final-year students, and interns enrolled in a community-oriented medical college in Bangladesh. Methods: A quantitative study design using the cross-sectional survey approach was used together with a self-administered, well-validated structured questionnaire. Second-year, final-year, and intern groups were selected with one hundred participants from each group. Descriptive statistical analysis and chi-square analysis were used in data analysis. Results: A total of 49 percent of the participants were able to correctly define pharmacovigilance; final-year students had the highest knowledge score of 72 percent. A total of 80–85% of the participants endorsed the need to report ADRs, and 75–84% believed that reporting ADRs is a professional responsibility. However, ADR reporting practice varied significantly: In the final-year students, 90% reported having filled out an ADR form, while the corresponding numbers for second-year students and interns were 12% and 34%, respectively. While 70-90% of the participants claimed to have ever been trained on how to report an ADR, only 20-28% of the participants reported to have ever experienced an ADR. Conclusion: Thus, though attitudes toward pharmacovigilance were mostly positive, major knowledge and practical implementation deficits were found, mainly concerning interns. The study underscores the need for enhanced systematic, comprehensive, and clinically focused instruction in pharmacovigilance learning in medical schools. This paper recommends that foresulfide should strengthen the existing knowledge prerequisite, integrate compulsory continuous education programs, advance practical practice, and smoothen the procedure of reporting ADRs to amplify the practices in pharmacovigilance among future healthcare human resources of Bangladesh.

When we discuss homoeopathy, invariably the Indian drugs are an integral part of homoeopathic material medica. Out of the leading 50 drugs of Indian origin, one drug that the article discusses the drug ‘Gymnema Sylvestre’. The common name of this plant is ‘Gurmar’ in hindi language which means ‘sugar killer’. This indicates its ancient use in diabetes since the last 2000 years. The article looks into the scientific aspects of the drug, human proving of the drug in homoeopathy & the various literatures that mentions about drug. The future use of the drug in the Non Communicable Disease like diabetes on a large scale will only benefit the masses. The drug is cost effective, therapeutically active with no side effects & these properties only augur well for its large scale application. For the benefit of the masses, the homoeopathic perspective, use, method of preparation is described. The authority books of homoeopathic material medica & the encyclopedia of homoeopathy are referred in the article.