bluuebunny/crossref_metadata_2025 huggingface dataset:
Alpha Fetoprotein: Tumor Marker in Gynaecology
Authors:   Professor and Head of Department,  Department of Obstetrics and Gynecology, Annasaheb Chudaman Patil Memorial Medical College, Dhule, Maharashtra 424002, India., Patil Alka , N Jagtap Akshay ,   Junior Resident, Department of Obstetrics and Gynecology, Annasaheb Chudaman Patil Memorial Medical College, Dhule, Maharashtra 424002, India., U Sanap Sneha ,   Junior Resident, Department of Obstetrics and Gynecology, Annasaheb Chudaman Patil Memorial Medical College, Dhule, Maharashtra 424002, India.
Published: January 2024

Ovarian carcinoma is the fifth most common cause of cancer death. It is the second most common gynecologic malignancy in developed countries and the third most common gynecological cancer. There are several intrinsic problems that render ovarian cancer screening difficult. An optimal screening test has high sensitivity, specificity, patient acceptance. The three screening techniques available for ovarian malignancy are: Pelvic examination, Tumor Marker, TVS. Tumor markers are used to screen for or diagnose malignancies, determine prognosis or monitor therapy. Alpha Fetoprotein is tumour marker for Embryonal Carcinoma, Yolk Sac tumour, Immature Teratoma, Sertoli-Leydigs cell tumour. The concept of preventive oncology has been developed to approach cancer problem at various points in evolution with goal of reducing cancer suffering and death.
Acute Fatty Liver of Pregnancy - A Fatal Complication in Pregnancy: Case Series
Authors:   Third Year Postgraduate Resident, Department of Obstetrics and Gynecology, Bharati Vidyapeeth, Pune, Maharashtra 411030, India., Gupta Pooja , K Singh S ,   Professor, Department of Obstetrics and Gynecology, Bharati Vidyapeeth, Pune, Maharashtra 411030, India.
Published: January 2024

Introduction: Acute fatty liver of pregnancy (AFLP) is a rare, but potentially fatal condition, characterized by hepatic failure typically in the third trimester of pregnancy that is associated with multiorgan involvement resulting in several clinical and laboratory abnormalities. Aim and Objectives: To study the course of acute fatty liver of pregnancy which will help later to early diagnose, prompt delivery, and providing supportive care to improved maternal morbidity and mortality rates. Materials and Methods: The authors report an observational case series of patients who developed acute fatty liver of pregnancy and managed in critical care in a year that illustrated the compound challenges in recognition, monitoring, and management. One of the cases has been imprinted with maternal mortality because of deterioration of the condition leading to sepsis along with multiorgan dysfunction syndrome. Results: A total of three cases of acute fatty liver of pregnancy were found in a year. Nausea, vomiting, and anorexia were the most common symptoms among all. Jaundice and ascites were the most common findings. Deterioration of the condition can lead to complications like sepsis, Disseminated Intravascular Coagulation, multiorgan failure, and death. Conclusions: Early detection, delivery, and supportive care are sufficient to reduce fatality but in cases of deterioration of patients’ condition despite proper management can lead to multiple complications and ultimately mortality. Regular antenatal health check-ups can help in early detection.
A Case Series of Ovarian Tumor
Authors:   Third Year Postgraduate Resident, Department of Obstetrics and Gynecology, Bharati Vidyapeeth, Pune, Maharashtra 411030, India., Kumari Gitanjali , Dahabadkar Suchita ,   2Professor, Department of Obstetrics and Gynecology, Bharati Vidyapeeth, Pune, Maharashtra 411030, India., Taralekar Vaishali ,   Professor and HOD, Department of Obstetrics and Gynecology, Bharati Vidyapeeth, Pune, Maharashtra 411030, India.
Published: January 2024

Introduction: Ovarian-cancer is the 3rd mostcommon cancer in Indian-women, accounting for 3% of all malignancies and 6% of deaths from cancer. It is 5th most-common cause of death from malignancy in women.1 Case-presentation: This is a cases-series of 4 cases Case 1 62 year, postmenopausal-woman with abdominalpain and ultrasound report of 109x82x87mm rightovarian-simple-cyst of (410cc), Ca-125 -> 8.50, posted for Laparotomy. A 15x 10cm right- ovarian-cyst removed. Frozen-section -> benign. Histopathology-> serous-cystadenoma Case 2 43-year, nulligravida. With pain-abdomen, posted for laparoscopic-cholecystectomy for gall-bladderpolyp with intraoperative findings of bulky-ovaries with ascitic-fluid showing malignant-cells , Ca-125 -> 66 , ultrasound s/o enlarged (7.6x6.4 cm) right-ovary, .Posted for exploratory-Laparotomy .Bulky irregularovaries removed. Frozen-section ->granulosa-cell tumour, Histopathology-metastatic adenocarcinoma / malignant sex-cord-stromal tumour. Case 3 70-year-old, COVID-19-positive patient referred for ovarian-torsion, with Ca125 - 8.7. Ultrasound -> 66x55 mm left adnexal-cyst with torsion; Posted for leftovariotomy + right-salpingoophorectomy. A 7x7cm left-sided-haemorrhagic-ovarian-Cyst removed. Histopathology -> serous-cystadenofibroma.Case 4 67-year-old postmenopausal-woman with painabdomen, Ca-125-154, ultrasound showing 14 x 7.5cm right-ovarian-complex-cyst, posted for Exploratorylaparotomy, a 15x15 cm twisted-right-ovarianhaemorrhagic cyst removed. Frozen-section->benign Histopathology ->Rt ovary- serous-cystadenoma + torsion Discussion: Ovarian cancer has nonspecificsymptoms resembling those of less serious conditions. Eg. Pain-abdomen. Staging-laparotomy with frozen-section remains the preferred approach for ovarian-tumors. Conclusion: In my case-series 3/4 women were postmenopausal, all presented with vague symptoms of pain-abdomen. Frozen-section may not be conclusive in every case, hence staging-laparotomy is ideal modality of management.
Placenta Previa: Maternal and Perinatal Outcome
Authors:   3rd Year Postgraduate Resident, Department of Obstetrics and Gynecology, Bharati Vidyapeeth, Pune, Maharashtra 411030, India., Rathi Jyoti , Wagh Girija ,   Professor, Department of Obstetrics and Gynecology, Bharati Vidyapeeth, Pune, Maharashtra 411030, India.
Published: January 2024

Introduction: Placenta previa unpredictable obstetric emergency substantially contributing to maternal morbidity and mortality. Aim: To Determine the Maternal and Neonatal outcome associated with Placenta Previa. Materials and Methods: A Retrospective observational Hospital based study, conducted in the Department of Obstetrics and Gynecology of Bharati Hospital, Pune from March 2019 to September 2020. Results: Out of 20 cases studied 3 were Morbidly Adherent Placenta, out of these two underwent Hysterectomy. Placenta Previa risk increase with scarred uterus and increase linearly with number of prior caesarean sections and curettage. In present study 38.8 % of all cases present with massive PPH, 33.3% of these require massive blood transfusion. Newborns are most likely to be lowbirth weight due to increase in incidence of preterm delivery with placenta previa. Out of these 20 cases, 2 patients were missed on ultrasonography and were diagnosed on table. Conclusion: Placenta previa is a medical emergency, with timely diagnosis and proper management associated complications can be prevented. There is significant relationship between placenta previa and scarred uterus, this risk becomes very high with escalation in a number of cesarean sections. Clinical significance: In present era with increasing number cesarean sections number of placenta previa cases and associated complications require obstetricians on toes to manage these deadly complications. Timely diagnosis along with judicious expectant management with blood transfusion is required, and timely delivery can lead to the most favorable outcome.
Maternal Serum C – Reactive Protein: A Biomarker for Prediction of Preterm Delivery and Neonatal Outcome at Early Pregnancy
Authors:   Senior Resident, Department of Obstetrics and Gynecology, Government Medical College, Baramulla, Jammu and Kashmir, 193101, India,, Iqbal Suhail , Kaurani Heena ,   Senior Resident, Department of Obstetrics and Gynecology, Dr. Sampurnanand Medical College, Jodhpur, Rajasthan 342008, India,, Ashraf Asifa ,   Postgraduate, Department of Public Health Dentistry, ITS Dental College, Ghaziabad, Muradnagar, Uttar Pradesh 201206, India.
Published: January 2024

Background: Preterm labour defined as less than 37 weeks of gestation is responsible for most of the neonatal morbidity and mortality worldwide. This study was conducted to estimate the relation between C reactive protein (CRP) with preterm labour. Method: This prospective observational cohort study was conducted from February 2018 to January 2019 at Obstetrics and Gynecology department of Srimati Heera Kunwar Ba hospital, Jhalawar Medical College, Jhalawar, Rajasthan with 150 outpatient singleton pregnant women of <20 weeks of gestation enrolled at the prenatal visit. Baseline data and serum CRP values were taken in all participants. Conventional statistical methods were used for analysis. Result: We discovered measurably critical contrasts in the CRP levels estimated in early pregnancy between the women delivering preterm and those delivering at term. The baseline cut off value for maternal CRP was 5.5 mg/l with sensitivity of 100%, and specificity of 95.7%, positive and negative predictive value for serum CRP to predict preterm labour were 95.8 % and 99.2% respectfully. Conclusion: Maternal serum concentration of CRP can be utilized as fitting biomarker for foreseeing preterm delivery.
Abruptio Placenta: A Study on Maternal and Perinatal Outcome at Teaching Hospital
Authors:   Associate Professor, Department of Obstetrics and Gynecology, Jagadguru Jayadeva Murugarajendra Medical College, Davangere, Karnataka 577004, India., B Latha , Aruna Manchuru ,   Senior Resident, Department of Obstetrics and Gynecology, Jagadguru Jayadeva Murugarajendra Medical College, Davangere, Karnataka 577004, India.
Published: January 2024

Background: Abruptio placenta is separation of a normally situated placenta after 20 weeks of gestation and prior to the birth of the foetus. It is an important cause of antepartum haemorrhage and presents as an acute abdomen in the third trimester of pregnancy. The study was aimed to find out the incidence, obstetric risk factors, and various complications of abruptio placenta and to analyze the maternal and perinatal outcome of the same. Materials and Methods: The retrospective observational study was carried out in the obstetric department in CG hospital attached to JJM medical college, Davangere between October 2017 and September 2018. Results: Out of 9800 deliveries there were 64 cases of abruptio placentae. The incidence of Abruptio placentae was found to be 0.65%. Associated risk factors were preeclampsia (45%), previous caesarean section (18.6%). PPH occurred in 13(20%) of patients.22 (34%) of patients required blood transfusion. Eighty five percent (85%) babies required NICU and 54% had early neonatal death. Conclusion: Abruptio placenta is associated with poor maternal and fetal outco
Placenta Accreta Spectrum: A Diverse Clinical Experience
Authors:   3rd Year Postgraduate Resident , Department of Obstetrics and Gynaecology, Bharati Vidyapeeth (Deemed To Be) Univeristy Medical College, Pune, Maharastra 411030, India., Jain Atishay , Panchanadikar Tushar ,   Professor, Department of Obstetrics and Gynaecology, Bharati Vidyapeeth (Deemed To Be) Univeristy Medical College, Pune, Maharastra 411030, India.
Published: January 2024

Placenta Accreta Spectrum is a well-established life threatening complication during pregnancy. It is commonly seen due to an iatrogenic etiopathogenesis resulting from a previous surgery of the uterus. The presentation of these cases has been intriguing. A holistic approach by the obstetrician and radiologist is important in identifying such cases early to reduce the morbidity and mortality.This series highlights the experience of the cases of MAP that we managed at our institution. Aim and objectives: to study the diverse clinical course of placenta accrete spectrum which will help in early diagnosis using various diagnostic modalities and deciding the management of adherent placenta. This series highlights the challenges faced in the diagnosis, evaluation and management antepartum, intrapartum period as well as postpartum period. Materials and methods: A Hospital based observational case series conducted in the Department of Obstetrics and Gynecology of Bharati Hospital, Puneof patients who had morbidly adherent placenta Result: Previous LSCS and curettage were associated with higher incidence of adherent placenta. all the cases were associated with prematurity. Conclusion: Placenta accreta spectrum is associated with high feto-maternal morbidity and mortality which is preventable.. Incidence of MAP is increasing, previous caesarean section and placenta previa are important risk factors, so there is a need to keep the primary caesarean section rates low. Early preoperative diagnosis in the suspected women and careful planning of delivery involving multidisciplinary team is the key to save the woman’s life. Key words: Morbidly Adherent Placenta; Placenta Accreta Spectrum; Prematurity.
Unusual Presentation of Ectopic Pregnancy Treated by Medical Management
Authors:   2nd year post graduate, Department of obstetrics and gynecology, Vinayaka Mission’s Medical College (Vinayaka mission’s Research Foundation DU, Salem), Keezhakasakudy, Karaikal, Pondicherry Institute of Medical Sciences, Pondicherry 609609, India., . Manogna , . Narmadha ,   Senior Resident, Department of obstetrics and gynecology, Vinayaka Mission’s Medical College (Vinayaka mission’s Research Foundation DU, Salem), Keezhakasakudy, Karaikal, Pondicherry Institute of Medical Sciences, Pondicherry 609609, India., . Pallavi ,   Senior Resident, Department of obstetrics and gynecology, Vinayaka Mission’s Medical College (Vinayaka mission’s Research Foundation DU, Salem), Keezhakasakudy, Karaikal, Pondicherry Institute of Medical Sciences, Pondicherry 609609, India.
Published: January 2024

Implantation of the fertilized ovum outside the uterine cavity is called ectopic pregnancy. It is associated with adverse outcome if not treated earlier. The fate of ectopic pregnancy depends on many factors. Important among them being site and duration of ectopic pregnancy. The main serious outcome is rupture. If the ectopic pregnancy ruptures and the patient survives this catastrophe, the ectopic mass gets organized and presents as pelvic mass with pain. Methotrexate is a folic acid analog that inhibits dihydrofolate reductase and thereby prevents synthesis of DNA. It affects actively growing cells including trophoblastic tissues, malignant cells, bone marrow, intestinal mucosa and respiratory epithelium. Medical management of ectopic pregnancies with methotrexate is safe and effective, therapy can be considered for patients with confirmed ectopic pregnancy who are hemodynamic ally stable with no evidence of rupture. It should be used with caution and severe toxicity should be kept in mind. Key words: Ectopic Pregnancy; Methotrexate; Medical management.
Anemia Profile in Antenatal Patients - A Study at Tertiary Care Centre
Authors:   Associate Professor, Department of Obstetrics and Gynaecology, Madurai Medical College, Madurai, Tamilnadu 625020, India., Sivakumar Sudha , . Indrani ,   Associate Professor, Department of Obstetrics and Gynaecology, Madurai Medical College, Madurai, Tamilnadu 625020, India., . Divyapriya ,   Post Graduate, Department of Obstetrics and Gynaecology, Madurai Medical College, Madurai, Tamilnadu 625020, India.
Published: January 2024

Background: The aim of study is to determine whether maternal mortality due to anemia is preventable with focus on anemic cases in tertiary care hospital. Materials and Methods: This is retrospective analysis of anemia patients referred to GRH, Department of Obstetrics and Gynaecology, Madurai from January 2018 to December 2018. Cases were stratified based of age, parity, gestationalage, severity of anemia. Results: The total number of cases referred to GRH during the study period is 17556, in which anemia referral was 4120(23.4%), PIH 3400(19.3), others 10036 (57.16).53.6% were multigravida, 46.3% primigravida. Mean age of presentation is around 25 to 30 years. Anemia being more common in gestational age greater than 34 weeks. Among 53 maternal mortality,anemia as a direct or indirect cause of maternal mortality was found to be nil. Conclusion: We concluded by this study that anemia as a cause of maternal mortality was found to be NIL. Anemia as a cause of maternal death was due to lack of antenatal care, inadequate quality of care in primary and secondary centres. Cases referred in GRH with regular follow up did not develop complications and attained safe delivery with no mortality.
Enigma Still Unconquered- Ectopic Pregnancy
Authors:   Associate Professor, Department of Obstetrics and Gynecology, Coimbatore Medical College and Hospital, Coimbatore, Tamilnadu 641014, India., Mohanasundari K. P. , Pradeepa T. ,   Assistant Professor, Department of Obstetrics and Gynecology, Coimbatore Medical College and Hospital, Coimbatore, Tamilnadu 641014, India., Manonmani R. ,   Professor and HOD, Department of Obstetrics and Gynecology, Coimbatore Medical College and Hospital, Coimbatore, Tamilnadu 641014, India., Merlin A. ,   Junior Resident, Department of Obstetrics and Gynecology, Coimbatore Medical College and Hospital, Coimbatore, Tamilnadu 641014, India.
Published: January 2024

Background: A ruptured ectopic pregnancy is a true emergency and remains the leading cause of pregnancy related deaths worldwide. The objective is to study the clinical profile of ectopic pregnancy in a tertiary care hospital. Methods:A retrospective study conducted at Coimbatore Medical College Hospital from Jan 2019 to Dec 2020. A total of 149 patients with ectopic pregnancy were analysed on patient characteristics, risk factors, intraoperative findings and treatment modality. Results: A majority of patients with ectopic pregnancy (64.5%) did not have any risk factors, while 33.5% had predisposing risk factors associated with ectopic pregnancy. Most common presentation was ruptured tubal ectopic and the commonest site was ampulla (85.9%). There was 1 maternal death out of 149 cases reported (0.67%). Conclusion: Ectopic pregnancy still remains one of the major causes of maternal morbidity and mortality. Early diagnosis and referral in hemodynamically stable state along with use of minimal access surgery or medical management can change the scenario of ectopic pregnancy in the developing world.
An Observational Study of Maternal and Perinatal Outcome of 300 Covid-19 Positive Pregnant Women
Authors:   Associate Professor, Department of Obstetrics and Gynecology, Gandhi Medical College and Hospital, Secunderabad, Telangana, Andhra Pradesh 500025, India., Krishnaveni A. , Mahalakshmi Goli ,   Professor and HOD, Department of Obstetrics and Gynecology, Gandhi Medical College and Hospital, Secunderabad, Telangana, Andhra Pradesh 500025, India., Manasa Aluri ,   III year Postgraduate, Department of Obstetrics and Gynecology, Gandhi Medical College and Hospital, Secunderabad, Telangana, Andhra Pradesh 500025, India., Indu Bandi ,   III year postgraduate, Department of Obstetrics and Gynecology, Gandhi Medical College and Hospital, Secunderabad, Telangana, Andhra Pradesh 500025, India., Ravali Komala ,   II year postgraduate, Department of Obstetrics and Gynecology, Gandhi Medical College and Hospital, Secunderabad, Telangana, Andhra Pradesh 500025, India., Kumar Arige Sushruth ,   Intern, Department of Obstetrics and Gynecology, Gandhi Medical College and Hospital, Secunderabad, Telangana, Andhra Pradesh 500025, India.
Published: January 2024

Background: WHO declared coronavirus disease 2019(COVID-19) as a public health emergency of International concern on January 30,20201. Coronavirus disease 19(COVID-19) has become a global pandemic Aim: To study the effects of COVID-19 on maternal and perinatal outcome. Materials and Methods: Retrospective study was conducted in obstetrics and gynecology department, gandhi hospital,Secunderabad. Studied medical records of 300 pregnant women diagnosed with COVID-19,who delivered between 01-05-2020 to 31- 08-2020. Results: Out of 300 pregnant women, 176(58%) in the age group of 21-25 years.80.8% patients were asymptomatic. In symptomatic patients (19.2%) common presenting complaint was Dry cough (11.3%). Majority of patients (78%) were diagnosed with RTPCR.60 presented with comorbidities hypothyroidism being most common(40)%.Corticosteroids were given for 44 patients (14.6%),12(4%) patients for fetal lung maturity and 32(10.6%) patients for maternal lung inflammation admitted in ICU.207(69%) caesarean and 93(31%) vaginal deliveries.Previous caesarean section followed by fetal distress are the most common indications.252(84%) term deliveries (>37weeks) and 48(16%) preterm (<37weeks) deliveries.32 were admitted in maternal intensive care unit(10.6%) and 7 maternal deaths, 3 Neonatal deaths and 2 Intrauterine fetal deaths were reported.Case fatality rate was 2.3% for pregnant women and 1% for neonates.Out of 298 alive babies,9 COVID-19 positive and 289 COVID-19 negative.None of these neonates had contact with infected mothers except during delivery, which suggests vertical transmission risk(3%). Conclusion • 97.66% of mothers and 98.3% neonates discharged without any complications.10.6% maternal morbidity and Case fatality rate 2.3% for pregnant women and 1% for neonates. • Maternal-fetal transmission risk(3%) of SARS-C0V-2. • Careful monitoring of pregnancies with COVID-19 and measures to prevent neonatal infection was warranted.
Study of Primary Caesarean Section in Multiparous Women
Authors:   Associte Professor, Department of Obg. Melmaruvathur Adhiparaskthi institute of medical sciences, Melmaruvathur 603319, Tamilnadu., . Madhupatil , G Bhavya ,   Assistant Professor, Department of Obg, Dr Patnam Mahender Reddy Institute of medical sciences, Chevella 501503, Telangana, India.
Published: January 2024

Background: Caesarean Section is the operation which is commonly performed worldwide. Caesarean section is a boon to medical field where it has become an safe procedure for the delivery of the baby where delivery is associated with complications. The evolution of caesarean delivery has definitely reduced maternal and fetal mortality in practice of modern obstetrics. A caesarean delivery is typically performed when complications from pregnancy make traditional vaginal birth difficult which makes the life of the mother or child at risk. But there is an alarming increase in conducting caesarean section worldwide as most doctors have started practising defensive medicine. Methods: This prospective observational study was conducted by the Dept of OBG, Melmaruvathur Adhiparaskthi Institute of Medical sciences, Melmaruvathur, Tamil nadufrom November 2018 to April 2019.A total of 92 patients were included in the study on the basis of inclusion criteria. Results: The maximum cases 48(52.2%) were in the age of 21-25 yrs followed by 32(34.8%) in the age group 26-30years. The mean age of the patients was 28.76 (SD16.86) years .Themost common indications for caesarean sections were fetal distress which were seen in 39 cases(42.4%) followed by cephalopelvic disproportion seen in 21 cases (22.8%).Obstructed labour was the least indication noticed which was seen in 4 cases (4.4%).
An Evaluation Study on Accredited Social Health Activists (ASHA)
Authors:   Professor, Department of Community Health Nursing, Little Lourdes College of Nursing, Kidangoor P.O, Kottayam, Kerala-686572, India., Joseena Sr.
Published: January 2024

One of the core strategies of NRHM was to promote access to improved health care at household level through ASHA. A community based research study was conducted to assess the knowledge and functioning of ASHA with respect to three selected districts of Kerala and to analyze the problems faced by them in the delivery of Primary Health Care Services at the village level. A survey approach with selective employment of qualitative method was used.A descriptive cross sectional survey design was used. To represent the entire state of Kerala one district each from Northern (Wayanad, Central (Kottayam), and Southern (Thiruvananthapuram) region of Kerala was randomly selected. The Sample consists of 405 ASHAs and 73 JPHNs and they were selected using cluster sampling technique. Data collection instruments were structured knowledge questionnaire, self administered rating scale ,focus group interview guidelines, in-depth interview guidelines and opinionnaire. Quantitative analysis revealed that almost half (42.3%) of the ASHAs from Thiruvananthapuram belongs to the category of good knowledge level ,Thiruvananthapuram (good- 36.3%) has better functioning than Kottayam and Wayanad and Significant association was found between knowledge scores and educational status and level of satisfaction of ASHA workers(P>0.05). Themes derived from qualitative analysis are problems related to Maternal Child Health services, adoption of Family planning services, Communicable and Non communicable Disease monitoring, work load, Lack of transportation facilities, Inadequate payment structure, inappropriate Government health infrastructure ,lack of recognition by the Panchayat, lack of medicine kit, lack of follow up after initial training, inadequate knowledge and communication skill, lack of supervision and lack of co-operation from the families. Majority (49.3%) of the JPHNs have only average opinion regarding the functioning of ASHAs in the community. Only 16(21.9%) had good opinion about the services rendered by the ASHAs in the community. Key Words: ASHA; JPHN; Knowledge; Functioning; Primary Health Care Services.
A Prospective Clinical Study on Ectopic Pregnancy
Authors:   Assistant Professor,  Department of Obstetrics and Gynecology, Narayana Medical College, Nellore, Andhra Pradesh 524002, India., Priya Vellore Padma , Padma Priya pineni ,   Associate Professor, Department of Obstetrics and Gynecology, Narayana Medical College, Nellore, Andhra Pradesh 524002, India.
Published: January 2024

Background: Ectopic pregnancy is defined as when gestational sac implants itself outside the uterine cavity in the fallopian tubes, ovary, cervix, and peritoneum. Ectopic pregnancy has become one of the commonest acute abdominal emergencies encountered by gyneacologist in todays setup. The frequency of ectopic pregnancy is increasing throughout the globe and it is the most life threatening emergency in first trimester of pregnancy. Not only it increases the mortality rate but it also effects the fertility of the patient. Methods: This prospective observational study was conducted by the department of OBG at Narayana medical college, Nellore, Andhra Pradesh from December 2019 to May 2020. A total of 42 patients were included in the study on the basis of inclusion criteria. Results: The maximum 21(50%) were in the age group of 26-30 years followed by 14(33.3%) from the age group 20-25 years. The mean age of the patients was 26.62 (SD14.66) years ranging from 20 to 40 yrs. The study of previous reproductive performance revealed that the maximum incidence of ectopic gestation (71.3%) occurred among the third (42.9%) and fourth gravida (28.4%). There were no significnt corelations betweem other sites of ectopic pregnancy and condition of the tube. Keywords: Ectopic pregnancy; Ampulla; Fallopian tube.
Clinical Bleeding and Histopathology Pattern of Abnormal Uterine Bleeding
Authors:   Associate Professor, Department of Obstetrics and Gynecology, Narayana Medical College, Nellore, Andhra Pradesh 524002, India., Priya Vellore Padma , Padma Priya Ipineni ,   Assistant Professor, Department of Obstetrics and Gynecology, Narayana Medical College, Nellore, Andhra Pradesh 524002, India.
Published: January 2024

Background: Abnormal uterine bleeding (AUB) is bleeding from the uterus which is more than the usual or which occurs for a longer period than normal or which occurs at an irregular time. AUB can occur in all age groups with different modes of presentation and is also one of the important symptom or presenting complaint where in people tend to see their doctors. There are wide range of causes which include fibromyoma, adenomyosis, endometrial polyp, ovarian tumor, pelvic inflammatory disease (PID), endometrial hyperplasia, endometrial carcinoma, hormonal imbalance (like hypothyroidism) or hypothalamic pituitary diseases. Methods: This prospective observational study was conducted by the department of OBG at Narayana medical college, Nellore, Andhra Pradesh from December 2019 to May 2020. A total of 102 patients were included in the study on the basis of inclusion criteria. Results: The maximum cases 52 (50.1%) were in the age of 41-50yrs followed by 30(29.4%) in the age group 31-40 years. The mean age of the patients was 44.87(SD9.67) years. The most common mode of presentation was heavy menstrual bleeding seen in 55 cases (53.9%) followed by prolonged menstrual bleeding in 22 cases (21.6%). Proliferative endometrium was found in 44 (43.1%) cases followed by secretory endometrium in 36 (35.3%) cases and endometrial hyperplasia in 15 (14.7%) cases. Keywords: Abnormal uterine bleeding; Histopathology; Dysfunctional uterine bleeding.
Review of Female Infertility: Risk Factors and Management
Authors:   Senior Resident, Department of Obstetrics and Gynecology, Government Medical college, Baramulla, Jammu & Kashmir 191202, India,, Iqbal Suhail , Kaurani Heena ,   Senior Resident, Department of Obstetrics and Gynecology, Dr Sampurnanand Medical college, Jodhpur, Rajasthan 342003, India,, Ayub Malik Mehak ,   Junior Resident, Department of Obstetrics and Gynecology, Government Medical college, Baramulla, Jammu & Kashmir 191202, India,, Chauhan Divya ,   Senior Resident, Department of Obstetrics and Gynecology, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi 110095, India.
Published: January 2024

Infertility is a major health problem in couples of reproductive age group. Female factor is responsible for most of the cases of infertility. This review is done to enlighten the various risk factors causing infertility and its management. The aim of this review is to give information about female infertility to make it easy to evaluate a case of infertility. The conclusion is made from the review that by living healthy lifestyle, reducing body weight and proper treatment of medical diseases and sexually transmitted diseases, fertility can be achieved in infertile woman. Keywords: Fertility; Female infertility; Laparoscopy; Hysteroscopy.
Evaluation of HbA1c as a Diagnostic Tool for GDM
Authors:   Professor, Department of Obstetrics and Gynecology, Shri Sathya Sai Medical College and Research Institute, Ammapettai, Tamil Nadu 603108, India., Devi Gopalan Usha , Naidu Kanukolanu Rinda ,   Junior Resident, Department of Obstetrics and Gynecology, Shri Sathya Sai Medical College and Research Institute, Ammapettai, Tamil Nadu 603108, India.
Published: January 2024

Gestation Diabetes mellitus is a condition which leads to unfavorable maternal as well as fetal outcomes. Although the traditional method of screening GDM in pregnant women by OGTT has been widely used and accepted for decades, but there is always a need for better and more easier test for diagnosis of GDM. In our systematic review we have critically appraised few published studies for the demonstration of HbA1c as a diagnostic tool for GDM. It is understood from all these studies HbA1c evaluation have various advantages over the traditional OGTT because of the high reproducibility and improved instrumentation and standardization of HbA1c assay, less biological variability and it is not affected by short term lifestyle changes. It can be used as a primary screening test for all the pregnant women as does not require extensive patient preparation and less time consuming. But once the HbA1c value falls above the reference range it is mandatory to perform a confirmatory test for the diagnosis of GDM. In near future HbA1c can be used as a marker for diagnosis. Keywords: GDM; HbA1c.
Conjoint Twin-Thoraco-Omphalophagus: A Case Report and Literature Review
Authors:   Associate Professor, Department of Obstetrics and Gynecology, Mysore Medical College and Research Institute, Mysore, Karnataka 570001, India., K Mamatha , S Kavyashree ,   Senior Resident, Department of Obstetrics and Gynecology, Mysore Medical College and Research Institute, Mysore, Karnataka 570001, India., Antony Anjali ,   Post Graduate Student, Department of Obstetrics and Gynecology, Mysore Medical College and Research Institute, Mysore, Karnataka 570001, India.
Published: January 2024

Conjoined twins is a rare entity experienced by any obstetrician. The management of the same requires early diagnostic work up antenatally and involvement of parental decision making. A 27-year-old woman of term gestation presented with conjoined twins-thoraco-omphalophagus and was taken up for elective LSCS and delivered. This article reports presentation of conjoined twins and the literature is reviewed. Keywords: Conjoined twins; thoracoomphalophagus.
Knowledge, Attitude and Practice (KAP) Assessment Towards COVID- 19 Outbreak Among Pregnant Women at a Tertiary Care Hospital in Central India: A Cross Sectional Study
Authors:   Assistant Professor,  All India Institute of Medical Sciences, Nagpur, Maharashtra 441108, India., Dadaji Davile Medha , Nagpure Keshao ,   Assistant Professor, All India Institute of Medical Sciences, Nagpur, Maharashtra 441108, India.
Published: January 2024

Background: In an effort to curb the spread of COVID 19 outbreak, Government of India have imposed aseries of preventive measures along with the media campaigns, disseminate information to the general public during the pandemic. Adherence to these measures is important to combat this pandemic when there is no definitive treatment available. However the level of knowledge and practice of these preventive measures among pregnant women who constitute a vulnerable group is yet to be evaluated. Aims and Objectives: To assess the knowledge. attitude and practice towards COVID 19 outbreak among pregnant women and descibe the association of various demographic characters with KAP. Materials and methods: A cross sectional study was conducted for pregnant women attending antenatal OPD at Government Medical College and Hospital, Nagpur. We have interviewed 497 pregnant women attending our antenatal OPD with a questionnaire of 14 questions.The response rates were scored and also association of different demographic score with KAP score was analysed. Median and standard deviation (SD) were calculated for KAP score and Chi square test and Annova test were used to analyse the association of demographic variables with KAP. Results: In our study scores of good knowledge, positive attitude and good practice were 81%, 90.54% and 86.12% respectively. Education, socioeconomic status and parity had significant association with KAP score. Conclusion: Majority of the pregnant women attending our OPD had good knowledge, practices and positive attitude toward COVID 19. The results of our study may help health authorities in managing these vulnerable population and implementing educational programmes since awareness and prevention is the only way to curb the spread of this novel disease
A Comparative Study of Associated Factors for Intrapartum Meconium Staining of Amniotic Fluid in a Tertiary Care Hospital
Authors:   Post Graduation Training, Department of Obstetrics and Gynecology, Government Medical College, Surat 395001,, . Vaishali , Rajesh Babu Govindrajulu ,   Assistant Professor, 3Professor & Head of Department, New Civil Hospital, Surat 395001, India.
Published: January 2024

Aims and Objectives: • To study factors associated with intra-partum meconium stained liquor &feto maternal outcome. • To compare the fetal outcome in relation to MSAF and clear amniotic fluid also in thick v/s thin meconium. Material and methods: This study prospective of 100 subjects was done in a tertiary care hospital over six months. Fifty with MSAF detected at any time during the course of labour or prior to it were enrolled in the study group. The inclusion criteria were, a singleton, cephalic, term pregnancy without anomalies. For control, the next woman giving birth following the index patient who satisfied similar inclusion criteria and had clear amniotic fluid was selected. Result: Among risk factors, preeclampsia p=0.04, fetal growth restriction p=0.05, fetal distress p=0.0002 and labour dystocia p=0.0009 were found to be statically significant. Caesarean section was considerably higher in patients with MSAF, p=<0.001. 66% patients with MSAF had FHR abnormalities as compared to 2% controls. 47.6% babies with thin MSAF and 75.8% of babies with thick MSAF had nonreassuring CTG. 42% patients had thin meconium and 58% patient had thick meconium. Conclusion: Women with prelabour or early labour rupture of membranes were noted to have a higher association with MSAF. Presence of thick MSAF, necessitates intensive monitoring of labour including surveillance of fetal wellbeing to optimise the neonatal outcome. Vigilance during labour and timely referral to higher centre/ availability of trained staff for neonatal resuscitation and management is the key to reducing neonatal morbidity and mortality associated with MSAF.
Ectopic Pregnancy: A Paradigm Shift
Authors:   Senior Resident, Department of GSL Medical College, Rajahmurdry 533296, Andhra Pradesh, India., Jyothi Kondapaneni Purnima , Sri Sruthi Raparla ,   Junior Resident, Department of GSL Medical College, Rajahmurdry 533296, Andhra Pradesh, India., Annapoorna Y ,   Professor & HOD, Department of GSL Medical College, Rajahmurdry 533296, Andhra Pradesh, India.
Published: January 2024

Background: Ectopic pregnancy is a catastrophic and life-threatening condition and one of the commonest acute abdominal emergencies in day to day practice. The objectives of this present study were to know the incidence of ectopic pregnancy at the tertiary care center, evaluate age group, parity, and risk factors of ectopic pregnancy, and analyse clinical presentation, outcome, management, and associated morbidity and mortality with ectopic pregnancy. Methods: It was a retrospective study done at GSL Medical College and General Hospital, Rajahmundry from 1stAugust 2019 to 31st July 2020. A total of 58 patients with ectopic pregnancy were analysed on clinical presentation, clinicalfindings, investigations, operative findings and outcome. Results: A majority of women were in the age group of 22-32 years and most of them were multigravida. Commonest risk factors were previous history of abortion, tubal ligation and pelvic inflammatory disease. Amenorrhea and pain abdomen were the most common presenting symptoms. Ampulla of the fallopian tube was the commonest site for ectopic pregnancy. There were no maternal deaths and majority were discharged within seven days without serious morbidity. Conclusion: Ectopic pregnancy still remains one of the major causes of maternal morbidity and mortality. With the use of better diagnostic modalities, ectopic pregnancies can be detected early, and referral in hemodynamically stable condition along with use of minimal access surgery or medical management not only reduces maternal morbidity but also preserves future fertility
Multiple Birth Awareness
Authors:   Professor & HOD, Department OBGY, ACPM, Medical College, Dhule 424001, Maharashtra, India., B. Patil Alka , Sudani Hetashvi ,   Junior Resident, Department OBGY, ACPM, Medical College, Dhule 424001, Maharashtra, India.
Published: January 2024

Twin pregnancy has been a fascinating subject and has generated a lot of interest in obstetrics, many religions, communities, and cultures. Multiple gestation still pose challenging problems for modern medicine. Almost every maternal and neonatal problem is increased in multiple gestations justifying their high-risk status and need for specialized management. Awareness of multiple birth is vital amongst patients, families, community, society, health care professionals and national health policy makers. They should have awareness about diagnosis, complications, management, socio-economic impact of multiple birth.
Clinical Study of Right Iliac Fossa Mass: A Prospective Study
Authors:   Assistant professor,Department of General Surgery, Banaglore Medical College, Karnataka, 560001, India., Narayan Manisha , Khilari Priyanka ,   Senior Resident, Department of General Surgery, Banaglore Medical College, Karnataka, 560001, India.
Published: January 2024

A right iliac fossa mass is a ‘temple of surprises’ and a common presentation at emergency department, requiring skill and keeness to diagnose. Patients with right iliac fossa mass will be dealt by a general practitioner, a surgeon or a gynecologist and knowledge of anatomy, with detailed history, clinical examination directing towards the pathological process followed by lab analysis and imaging leads to a diagnosis. The most common differential diagnosis encountered are: appendicular mass, appendicular abscess, ileocecal tuberculosis, right ovarian mass, right ectopic kidney, rectus sheath hematoma, carcinoma caecum and ameboma, actinomycosis and crohn’s disease. An important differential diagnosis is often between an appendicular mass, carcinoma of the caecum and ileocecal tuberculosis.3 In Subcontinent, tuberculosis has been the main cause of intestinal obstruction and perforation. Cecal carcinoma is more common in the elderly and higher socio-economic group consuming less brous diet.1,5,6 Appendicular masses are seen in relatively younger people with both conservative and operative strategies. Other less common causes are diagnosed and managed accordingly.7
Conservative Management in Acute Appendicitis is it Superior to Surgery? A Retrospective Study
Authors:   Associate professor, Department of General Surgery, Malabar Medical College, Modakkallur, Kerala 673315, India., MV Dinesh Babu , V Asha Jose ,   Assistant Professor, Department of General Surgery, Malabar Medical College, Modakkallur, Kerala 673315, India., P Harris Mohammed ,   Associate professor, Department of General Surgery, Malabar Medical College, Modakkallur, Kerala 673315, India., VK Sheeba Mariyam ,   Assistant Professor, Department of General Surgery, Malabar Medical College, Modakkallur, Kerala 673315, India.
Published: January 2024

To see the merits of the surgical treatment and hence to reaffirm the superiority of surgery in acute appendicitis. Background: Surgery was the treatment of choice for acute Appendicitis which was practised over centuries. During the last decade, there were some publications about the conservative management of uncomplicated acute Appendicitis in adults and its advantages over the surgery. And all that studies also states that there was recurrence of about 20-30 %. Methods: The data of patients that came to the surgical department with acute appendicitis and recurrent appendicitis during the period November 2020 to December 2021 were analysed. The patients treated with surgery alone were included in the study. Detailed history, laboratory investigations and radiological investigation including Ultrasonogram (USG) were analysed to differentiate acute and recurrent cases. From the data we could identify the number of both acute and recurrent cases. Hospital admissions, number of episodes for the recurrent treatment, loss of working days and other relevant data were collected from the patients. Results: There were 61 patients who were operated for appendicitis including both acute and recurrent cases in the period of 1 year in the COVID era. Among these 34 were acute appendicitis and 27 recurrent appendicitis. Male: Female ratio was 39:22. Our study shows that majority are male patients and the most numbers are in the age group 10-30 years comparable to the standard statistics. Our study shows that 44.26% (27) of the total cases (61) operated was recurrent appendicitis. The number of recurrent episodes varied from the period of 1 week to 2 years after conservative treatment". In them treatment also varied from outpatient to inpatient in different individuals. The advantage of less hospital stays and decreased morbidity of conservative treatment is lost with subsequent investigation and surgical treatment in those. All the patients who got operated on follow up had an uneventful post operative period. Conclusion: So conservatively managed patients had lost many working days and had economic loss compared to patients operated for acute appendicitis early. Early surgery in acute appendicitis actually decreased the cost and morbidity. Keywords: Acute appendicitis; Recurrent Appendicitis; Appendicectomy; Conservative treatment; Appendicular perforation.
Role of Low Level Laser Therapy in Preventing Keystone Flap Necrosis
Authors:   Senior resident, Department of Plastic Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry 605006, India., Reddy K Sri Harsha , Chittoria Ravi Kumar ,   Professor and Registrar, Department of Plastic Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry 605006, India., Kerakada Nishad ,   Senior resident, Department of Plastic Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry 605006, India., Thomas Neljo ,   Senior resident, Department of Plastic Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry 605006, India.
Published: January 2024

In plastic and reconstructive surgery, skin flaps are widely employed. Large wounds that cannot be closed with normal treatments are treated with skin flap surgery. Skin flap necrosis is a well-known postflap cover issue that can affect cosmetic outcomes and patient satisfaction. Variable occurrence rates and inconsistent related factors have been reported in many retrospective studies of this condition. Despite advances in technology, the rate of flap necrosis remains significant in daily procedures. In this case study, we aim to evaluate the efficacy and safety of Low level laser therapy preventing flap failure. Keywords: Keystone flap failure; Necrosis; Lowlevel laser therapy; LLLT. Introduction Skin flap necrosis is a well-known post-flap cover issue that can affect cosmetic outcomes and patient satisfaction. Variable occurrence rates and inconsistent related factors have been reported in many retrospective studies of this condition. Despite advances in technology, the rate of flap necrosis remains significant in daily procedures. There are many methods which are used to ensure flap survival, one of them and with very few data available is low-level laser therapy (LLLT). In this article we share our experience of using LLLT and aim to evaluate the efficacy and safety in preventing flap failure.