In this paper we studied the effect of tuber extract of nutgrass (Cyperus rotundus l.) on fetal weight and length of white rat (Rattus novergicus) Sprague Dawley. Pregnant female rats (n=24) are grouped into four consisted of six rats each. Group-1 (control) only received distilled water. Group-2, 3 and 4 consecutively received tuber extract of nut grass at the dose of 22.5, 45, and 90 mg/kg body weight. Extract was given orally using gavage needle on day 6th for 13 days until day 18th of pregnancy. On day 18th of pregnancy, female rats were lapartomized under deep anaesthesia. All fetuses were taken to measure their body weight and length. The results showed that both fetal weight and fetal length of the rats were significantly decreasing with increasing doses of the extract. In conclusion, tuber extract of nut grass (Cyperus rotundus l.) has inhibitory effects against fetal growth of rats during pregnancy

Background: Maternal nutritional status is important for health and quality of life in women and growing fetus. Maternal weight gain in pregnancy can offer a good means of assessing the wellbeing of the pregnant mother and her baby. Inadequate prenatal weight gain is a significant risk factor for intrauterine growth restriction, preterm delivery and low birth weight in infants. Obesity and excessive weight gain on the other hand can lead to adverse maternal and fetal outcomes. Interestingly, to get a good fetomaternal perinatal outcome mode of delivery decision is also changed with BMI. Objective: The aim of the study was to evaluate the effect of maternal BMI on the mode of delivery. Methods: This cross-sectional study was carried out department of obstetrics and gynaecology at Bangabandhu Sheikh Mujib Medical University. A total 100 population of purposive sampling was the methods of choice to select the sample from the hospital admitted patients during the period from August 2016 to December 2017. Results: The mean age of 100 mothers were 28.4 (± 6.2) years. The maximum mothers attended from 3rd trimester were overweight (55.36%) whereas 44.64% from the same trimester were normal BMI mothers. Maximum mothers (27%) were from 25-29 years age group and the minimum mothers (4%) were from >= 40 years. Forty Seven Percent mothers came as primigravida. Primigravid women and multigravida with LSCS and without LSCS showed different mode of deliveries. The more the gravida with history of caesarean section the more frequency of present occasion of CS (p=0.006). The higher BMI showed more frequency of caesarean section than NVD or assisted delivery (p=<0.00001) Multiparous women showed more BMI than the p nulliparous. (p=0.005). Multiparity, maternal age and pre-existing medical conditions revealed more complicated labor. Conclusion: The more BMI of mother showed more frequency of caesarean section, assisted delivery than the normal vaginal delivery.

Post-partum Thrombotic Thrombocytopenic Purpura (TTP) is a life-threatening occurrence. A lady with such illness was successfully cured with anti-CD-20 monoclonal antibodies and mycophenolate [1]. This lady had been infertile for seven years, and underwent six attempts of in vitro fertilization without success. Several authors, and ourselves, found that a common cause of couple infertility is the infection by Helicobacter pylori, which can be cured at low price if recognized [2-4]. Moreover, in vitro fertilization reportedly failed in cases of ladies suffering of unrecognized infection by H. pylori [5], possibly by molecular mimicry between sperm and bacterial antigens [3,5,6]. Not only so, but this woman had been known to suffer of Idiopathic Thrombocytopenic Purpura (ITP). This illness had been found closely linked to H. pylori infection and to be reversible by eradication of the bacterium [7-9]. In conclusion we wish to stress the opportunity to test for presence of H.pylori in the long list of tests usually performed in infertile couple, and prior to pregnancy.

Introduction: Infertility is a public health problem associated with medical, emotional, social, and financial consequences. Recent study on infertility suggests that in India, approxi- mately 15 to 20% of married couples in the reproductive age group suffer from infertility and its incidence is on the rise. Artificial reproductive techniques (ARTs) including IVF/ICSI and ET have been a major development in the treatment of infertility. Objective: To compare reproductive outcomes of day 2 and day 3 embryo transfer (ET). Materials and methods: In this retrospective records study, all couples who underwent in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) and ET cycles at International Fertility Center, Delhi, India over a period of 1 year were studied. Data were collected and analyzed by chi-square test and unpaired t-test by Statistical Package for the Social Sciences, version 19. Results: There was no statistically significant difference between the clinical and demographic parameters of group day 3 and day 2 ET. In our study, clinical pregnancy rate was 45% in day 3 ET and 36.5% in day 2 ET group [odds ratio (OR) 1.43, p-value 0.49]. The ongoing pregnancy rate was 39.2% in day 3 ET and 26.9% in day 2 ET group (OR 1.75, p-value 0.26). We observed that the miscarriage rate was 5.9% in day 3 ET and was 5.8% in day 2 ET group (p-value 0.69, OR 1.02). We observed one case each of multiple pregnancies, ectopic pregnancy, and fetal anomaly (anencephaly) in day 2 ET group, while in day 3 ET group, no such case was detected. Conclusion: There are chances that day 3 ET has better clinical and ongoing pregnancy rates than day 2 ET, but the difference is not statistically significant. Study showed similar miscarriage rates in both groups and very low incidence of complications like multiple pregnancy, ectopic pregnancy, and fetal anomaly. So, it is safe to schedule and transfer embryos either on day 2 or on day 3 for planning and programming cycles in coordination with patient and IVF team and for adjusting weekends (nonworking days).

Background: Sudden Cardiac Arrest (SCA) in pregnancy is a particularly challenging clinical condition. Although management and resuscitation of these patients are quite similar to other adult patients except for few modifications because of the changes of pregnancy, but the uniqueness of this situation lays in the fact that here you are dealing with two patients instead of one. Targeted Population: All Pregnancy patients who are requiring urgent management in the ED, with Emergency Physicians for teaching protocol. Aim of the Study: Appropriate knowledge and training for pregnancy patients by teaching protocol to Emergency Physicians.

Background: Blood transfusion is a vital therapeutic approach in modern health care that saves millions of lives, but there is a great challenge to gate sufficient voluntary blood donation in developing country like Ethiopia at the same time pregnancy and child birth related problem, rod traffic accident, malaria-related death is high. Methods: Institutional based cross-sectional quantitative study was used from April 27 to May 11, 2018 and data was collected using a self-administered questionnaire. A stratified sampling method was used and an individual was selected by simple random sampling within each stratum. EPI data version 3.02 for data entry and SPSS version 16 for analysis was used both bi-variant and multi- variant analysis was computed and significance was declared at AOR<0.05. Result: From the total study participants, 162 (48.5%) had adequate knowledge, 230 (68.9%) of the respondent had favorable attitudes towards blood donation whereas only 85 (25.4%) have ever donated blood in their lifetime.

Introduction- Primary lung epithelial malignancies are the most common neoplasms among all lung masses. Lung carcinoma is the leading cause of death for which a histological or cytological confirmation and categorization of malignancy is required before treatment. It is desirable to have both FNAC or TBNA and biopsy for exact diagnosis. Sometimes, even immunohistochemistry is required to confirm the diagnosis.

Introduction: Eclampsia has been recognized as a clinical entity since the time of Hippocrates; and has been a nightmare to healthcare providers ever since. It is defined as the occurrence of generalised convulsions associated with preeclampsia during pregnancy, labour or within 7 days of delivery and not caused by epilepsy or other convulsive disorders. The incidence of eclampsia has often been viewed as an index of civilization in a country. There is low utilization of both antenatal and intrapartum care services and the patients may present to the hospital only as a last resort. Materials And Methods: This is a Prospective Study was carried out at the Department of Obstetrics and Gynecology at Tertiary Care Teaching Hospital over a period 2 years. All patients presenting with eclampsia during the said period were recruited into the study. All patients presenting with eclampsia during the said period were recruited into the study. Eclamptics are usually admitted directly into the labour ward. Patients who were diagnosed with other causes of convulsions in pregnancy like cerebral malaria and epilepsy were excluded from the study. A total of 821 pregnant mothers with eclampsia admitted in the inpatient department of the tertiary care teaching hospital were recruited for the study, irrespective of their previous antenatal check up history. Results: Majority (66%) of the patients had between 2 to 5 episodes of convulsion. The MINIMUM number was 1 episode of convulsion , seen in 13 % of the patients. The MAXIMUM number of convulsions was 40. Of the 66 patients who had had more than 10 no. of convulsions , 30 had not received any treatment prior to referral, while there were no patients who had had more than 10 no. of convulsions after receiving the Loading Dose of MgSO4. For patients having less than 5 no. of convulsions , the number of patients having received only the IM Dose of MgSO4 was 1.5 times those having received the Loading Dose.(228/154 =1.48) In 29% of the patients, Hypertension was controlled by delivery alone. Those who failed to achieve a control of BP by Delivery alone were administered Calcigard (Nifedipine). Conclusion: Eclampsia was noted to be commoner among the young primigravida patients. The importance of this finding is that this group of patients deserve extra surveillance during antenatal care in terms of monitoring their blood pressure and screening their urine for proteinuria to detect pre-eclampsia. It is hoped that such interventions will have positive impact on maternal and child care. However, all this will go in vain unless health care providers at the grassroot levels are sensitised regarding the early diagnosis of Pre eclampsia and prompt and appropriate initiation of treatment

: Introduction: The practice of breast feeding in India is influenced by various social, cultural, economic factors and religious beliefs but maternal infant feeding attitude has been shown to be a stronger independent predictor of breast feeding initiation and associated with continuing to be breast feeding longer and have a greater chance of success. The present study was carried out to assess knowledge, attitude and practice of breast feeding among post natal mothers in rural area and to assess the factors affecting breast feeding practices. Methods: A community based cross sectional study was done among 100 postnatal women of rural field practice area (RHTC) of a medical college, Tirupati, to explore the knowledge, attitude and practice of breast feeding and the factors influencing breast feeding practices. Mothers were interviewed using pretested questionnaire at their residence regarding socio demographic data, variables related to medical care during pregnancy, delivery and post natal period, Knowledge on breast feeding, Attitude by IIFA Scale and data related to Practice of breast feeding were collected. Data entered in MS Excel and analysed by using IBM SPSS Version 26. Results: Majority (99%) of women had knowledge that Colostrum maintain immunity, 97% had knowledge that Breast feed can be given up-to 2 years, 94% had knowledge that Wash breast with warm water before feeding. Majority of women had positive attitude towards breast feeding (Mean attitude score was 60.34 (1.98). Majority of women initiate breast feeding after one hour (65%), Only 2% were discarded colostrum, 80% of them were exclusively breastfeed for 6 months or more. Majority of daily wage labourers (33.3%) and Muslim mothers (66.7%) were given pre-lacteal feed compared to other groups. This was statistically significant. Conclusion: The participants have good knowledge and attitudes toward feeding, but their breast feeding practises do not correspond to their knowledge levels, which indicates a need for improvement in the breast feeding instruction and counselling of women

Background: Burst Abdomen is a preventable condition in which many risk factors play their role and lead to life threatening complications. This study's goal was to evaluate the incidence and risk factors, of burst abdomen in patients receiving midline laparotomies. Patients and methods: 240 patients who underwent midline laparotomies at Government Medical College in CENTRAL INDIA between January 2021 and December 2021 were the subjects of a prospective cohort research. Online available Software was used to monitor and analyse factors including age, sex, BMI, substance abuse, previous laparotomy, malignancy, diabetes mellitus, ascites, albumin, renal functions, bilirubin, haemoglobin, intra-abdominal pathology, suture material, creation of stoma, postoperative chest infection, postoperative paralytic ileus, leakage, and wound infection. Results: Incidence of burst abdomen was 11.25% among patients who underwent laparotomy. The following statistically significant factors (P<0.001) were linked to burst abdomen: wound infections, anaemia, uncontrolled diabetes, hypoalbuminemia, previous laparotomy, development of stoma, chest issues, ascites, postoperative cough, postoperative leakage, and peritonitis. In this investigation, we did not find any statistically significant relationships between patient sex, age, concomitant morbidities including jaundice and uremia, past steroid use, suture material utilised in closure, and postoperative paralytic ileus. Conclusion: According to the results of our study, significant risk factors for burst abdomen included wound infection, anaemia, previous laparotomy, stoma creation, hypoalbuminemia, ascites, diabetes, type of intra-abdominal pathology, with maximum incidences in peritonitis, postoperative cough, and postoperative leakage

Introduction: Hemoglobinopathies are diverse group of inherited disorders of hemoglobin production and function. They represent the most common single-gene disorders that are found in humans and are distributed in various frequencies throughout the world. Pregnancy in women with sickle cell disease can increase the risk of maternal and perinatal mortality. HPLC offers the advantages over the routine Hemoglobin electrophoresis as it can more accurately identify and quantitate abnormal hemoglobin. HPLC forms an accurate, rapid and reproducible tool for early detection and management of thalassemia and abnormal hemoglobin variants

Introduction: Placenta is a functional unit between the mother and the foetus. Human placenta is discoid, deciduate, haemochorial, chorioallantoic, labyrinthine and endocrine gland which connects developing embryo by umbilical cord to the endometrium of mother’s uterus. The placenta responds to cues in the pregnancy environment through morphological and functional changes in an effort to maintain proper fetal growth and development. For example, delayed maturation of the placenta has been observed in response to increasing maternal BMI. This altered placental maturity may result in poor gas and nutrient exchange at the maternal-fetal interface and, subsequently, suboptimal infant outcomes. Material and Method: This is a prospective study conducted in the Department of Anatomy at Index Medical College over a period of 2 year.

Introduction: Thyroid disease is more common in women than in men, because most thyroid diseases are autoimmune in nature and increased susceptibility to autoimmune diseases, perhaps secondary to the female endocrine environment is likely contributing factor. Thyroid physiology plays a major role in pregnancy and thyroid disorders constitute one of the most common endocrine disorders in pregnancy. Pregnancy is associated with significant and reversible changes in thyroid function and failure to adapt to these changes result in thyroid dysfunction. Material and Methods: This is a Prospective study done among 1000 pregnant women. Antenatal women attending the outpatient department of tertiary care centre from August 2021 October 2022. Detailed history was taken, regarding the symptoms of thyroid disorders, menstrual history, obstetric history, past medical history, family history and personal history

Background: Miscarriage is considered the most common adverse outcome in early pregnancy. Thyroid autoantibodies have a role in these regions and have been linked to substantial changes in the path of pregnancy that affect the mother, foetus, & newborn. Aim: To estimate the prevalence of TPO antibodies in recurrent pregnancy losses, first trimester abortions and preterm deliveries. Material & Methods: Study Design: Descriptive Cross sectional study. Study area: Department of Obstetrics & Gynecology, Murshidabad Medical college and Hospital, Baharampur, West Bengal. Study Period: Jan 2022 – Dec. 2022. Study population: Pregnant women who had preterm deliveries, miscarriages attending outpatient as well as admitted in the antenatal & postnatal ward in the department of Obstetrics & Gynecology Sample size: Study consisted a total of 100 subjects. Study tools and Data collection procedure: The study group was comprised of all the pregnant women who had preterm deliveries and miscarriages regardless of the gestational age, that were fulfilling inclusion & exclusion criteria. Written informed consent was taken from all the patients participating in the study. They were subjected to a detailed history & thorough general & clinical examination, lab investigations, thyroid profile, thyroid peroxidase antibody testing (Normal range: TPO AB <9 IU/ML), ultra-sonic examination & other clinical work up was done. The study showed that the contribution of thyroid peroxidase antibody testing & its sensitivity determining risk of preterm deliveries and recurrent pregnancy loss. Results: The association between TPOAB and T3 category, among the high TPOAB (+ve) cases (n=11), 8 (72.7%) cases had normal level of T3, and, 3 (27.3%) cases had low level of T3. Whereas in the normal TPOAB (-ve) group (n=89), 5 (5.6%) cases had high level of T3, 84 (94.4%) cases had normal level of T3. The association between TPOAB and T3 category was shown statistically significant (P<0.0001). Conclusion: We concluded that, there was a statistically significant association of TPOAb with T3, T4, and, TSH (P<0.05) and it leads to developing hypothyroidism during pregnancy. The presence of TPO-Ab in pregnant women significantly increases the risk of preterm delivery. The screening of TSH and TPOAb was essential during pregnancy to avoid complications related pregnancy

Introduction: Preeclampsia is a pregnancy-specific multi-systemic disorder characterized by proteinuria and the onset of hypertension during pregnancy (1, 2) Among the hypertensive disorders that complicate pregnancy, pre-eclampsia and eclampsia stand out as major causes of maternal and perinatal mortality and morbidity3. Calcium has an important role in the pathogenesis of pre- eclampsia. The present study was aimed to compare the level of serum calcium in normal pregnant women and in preeclampsia and determine the association of serum calcium with severity of the disease

Background and Aims: The success of labour analgesia is significantly influenced by the patient's position during the insertion of the epidural catheter. In this study, we contrasted how simple it was to implant the epidural catheter in the crossed-legged sitting position (CLP) against the traditional sitting position (TSP) (CLSP). The main goal was to compare how many of the groups' initial epidural placement attempts were successful. The patient's comfort, the simplicity of landmark palpation, and the quantity of needle-to-bone contacts were secondary goals

Background: The term "asymptomatic bacteriuria" (ASB) refers to persistent, aggressive bacterial growth in asymptomatic females' urinary tracts. The quantitative diagnosis is a clear catch mid urine sample with more than 100,000 organisms/ml.1 The incidence is often population-dependent geographical variance, ranging from 2 to 7%. The incidence is between 25 and 35 percent in emerging nations like India

Background: One of the most typical illnesses seen in clinical practise is urinary tract infection (UTI). 50% to 60% of adult women may encounter a urinary tract infection at some point in their lives, making it one of the most prevalent bacterial illnesses in women. Due to their anatomical characteristics, such as a narrow urethra, as well as other variables like pregnancy, the use of diaphragms, and sexual activity, women are more likely to acquire UTI. Objectives: 1. To isolate and identify the uropathogens from the urine samples. 2. To detect the antimicrobial resistance of uropathogens to fluoroquinolones. Material & Methods: Study Design: Descriptive Cross-sectional study. Study area: Department of Obstetrics & Gynecology, Murshidabad Medical college and Hospital, Berhampore, West Bengal. Study Period: Jan 2022 – Dec. 2022. Study population: Urine culture sensitivity reports were analyzed of patients who were suspected to be having urinary tract infection. Sample size: Study consisted a total of 300 subjects. Sampling Technique: Simple Random technique. Results: The resistant pattern of E.coli and Klebsiella to the 4 fluroquinolones, highest resistance is seen to ciprofloxacin followed by norfloxacin. In this study the most sensitive drug was Amikacin, followed by Pippericillin/Tazobactum and imipenem. In this study the drug with maximum resistance was cotrimoxazole. Amoxycillin and quinolones followed the list. Conclusion: We need to take a number of steps to address the significant worldwide opposition issue we are facing. These include (i) using fewer antibiotics to lessen the pressure for resistance to develop. (ii) increasing our understanding of the mechanisms by which bacteria acquire resistance and how they reduce the ensuing fitness costs.

Background: Caesarean section is the most common done obstetric emergency and the outcome of surgery differs depending on various factors. Maternal and fetal outcome depends on proper follow up during antenatal period. Aims: To study the maternal and fetal outcome of emergency caesarean delivery between unbooked rural referrals and booked cases. Materials and methods: This is a Comparative cross sectional study was conducted in the Department of Obstetrics and Gynaecology in Gestational age > 37 weeks, Unbooked cases handled outside and referred, who underwent caesarean delivery on emergency, Booked cases admitted in our hospital and underwent emergency caesarean delivery and Singleton pregnancy. Results: This study included 980 antenatal patients who underwent emergency caesarean section, among them 420 were booked cases and 560 were unbooked cases. The incidence of emergency caesarean section was more in unbooked group compared to booked group.  This comparison of age, Teenage pregnancy, parity, socioeconomic status had  statistical significance with p value < 0.05. The major indication of emergency caesarean section in booked cases was previous caesarean section (29.26%), where as it was fetal distress (22.6%) in unbooked group. Septicaemia in unbooked group (4.6%) was more than booked group(1%).66 cases (11.8%) of unbooked group and only 21 cases (4.9%) of booked group had wound infection. Postpartum haemorrhage, Perinatal mortality, NICU admission rate statistically significant among the two groups. Maternal intrinsic factors such as nutrition socioeconomic status and lack of antenatal care have been suggested as the causative factors in the unbooked patients. Conclusion: Poor utilization of antenatal care is associated with adverse feto-maternal outcome. Most maternal deaths are preventable if complications are diagnosed early and managed effectively in time .Early admission and management of critical obstetric patients decreases maternal morbidity and mortality

Introduction: Fetal movement tracking may be used to identify worsening in the fetus condition. It is described as any kick, flutter, swish, or roll perceived by the pregnant women and is considered evidence of the musculoskeletal and central nervous systems' integrity. Decreased fetal movement has been linked to poor pregnancy outcomes such as intrauterine growth restriction, fetal death and preterm deliveries. Clinical data on the association between decreased fetal movements and perinatal outcome is insufficient. Methodology: Ethical clearance was obtained from SRIMANTA SANKARDEVA UNIVERSITY of HEALTH SCIENCE for study of decreased fetal movements in Gauhati medical college and hospital. A doppler study was conducted using 3 dimensional ultrasound machines in ANOPD, departmental indoor USG room, and 2 dimensional ultrasound machine in observation room in the Department of Obstetrics & Gynaecology, Gauhati Medical College& Hospital. Patients were placed in supine position with left lateral tilt and umbilical artery Wave forms were recorded in the mid position from the free floating loops. Indices noted were S(systolic)/D(diastolic) ratio, resistance index (RI), plasticity index (PI), and reversal of blood flow in diastole. CTG monitoring was done in Departmental Observation Room using a CTG machine (labelled as FETAL MONITOR, SN-EATB8L1732, manufacturer-BPL, model no. FM 9854). Each selected patient was monitored for a period of 20minutes with a paper speed of 3cm/minutes during antepartum or intrapartum status. Noted following information were: base line FHR, beat to beat variability, FHR accelerations, presence of deceleration, and reactive. Results: A prospective observational study was conducted in Gauhati Medical College & Hospital, Guwahati, Assam during a time period of one year. 150 antenatal women at term gestation with decreased fetal movements without any other high risk conditions were monitored for fetal wellbeing by CTG and Doppler. Four groups were categorised into four groups: Group I-CTG reactive and Umbilical Artery Doppler normal, Group IIA, Group IIB, and Group III. The findings of each group were compared with different modes of delivery and different parameters of perinatal outcomes. Conclusion: Maternal perception of fetal movements is the most widely used technique to evaluate fetal wellbeing. Low-risk pregnancies with decreased fetal movements should be monitored for close antenatal fetal monitoring, appropriate and prompt interventions. Non-reactive CTG alone or with combination of abnormal Doppler results are better predictors of poor perinatal outcome and can indicate if neonatal resuscitation is required. These two tools can be used together for fetal monitoring and appropriate intervention at the correct time to improve the perinatal outcomes

Background:  Asthma attack is the most common respiratory symptom observed and is of great concern. Throughout the world asthma cases are increasing during pregnancy. The major issue is that the control levels of asthma is changing during pregnancy so the management is a little difficult during pregnancy. Objective: The present study was undertaken to observe the prevalence of asthma and respiratory symptoms during pregnancy. Materials and methods: 40 pregnant women attending OPD in the hospital were part of the study after obtaining the written informed consent. Confidentiality of the data was maintained. Willing pregnant women were included in the study. Pregnant women with any other complications severe were excluded from the study. Respiratory symptoms were examined during the general physical examination by an expert physician. Results: The age group of the participants ranges from 22-30 years. 25% of individuals have asthma. 37.5% of individuals have wheeze without cold, 15% of individuals have nasal allergies. 27.5% have shortness of breath. 5% of individuals have a history of smoking. 15% of individuals are currently under the medication for asthma. Conclusion: The present study results explained that wheezing without cold and shortness of breath are the most common respiratory symptoms during pregnancy. Further detailed studies with a higher sample size are recommended to understand better the respiratory symptoms during pregnancy

Background: Preeclampsia is a multi-system disorder of pregnancy that manifests after 20 weeks of pregnancy in previously normotensive women. It is characterised by new-onset hypertension (systolic and diastolic blood pressure of 140 and 90 mm Hg, respectively, on two occasions, at least 6 hours apart) and proteinuria (protein excretion of 300 mg in a 24 hr urine collection, or a dipstick of ≥ 2+). AIM: To evaluate the utility of placental laterality and uterine artery doppler in the prediction of preeclampsia. Material & Methods: Study Design: A prospective hospital based observational study. Study area: Department of Radio diagnosis, Anil Neerukonda Hospital.  Study Period: 1st January 2020 to June 2021. Study population: All Antenatal cases referred to the department of Radio-Diagnosis for clinically suspected Pre-eclampsia.  Sample size: study consisted of 86 subjects.  Sampling method: Simple random technique. EQUIPMENT: The study will be performed using Philips AFFINITY 50G ultrasound machine using a 3-7C curvilinear probe. SCANNING TECHNIQUE: A written informed consent was taken before performing the scan. The scan was performed with patient in supine position and moderately distended bladder. Data Collection: Basic demographic details, clinical data obtained from study subjects were recorded in a pre-designed proforma. Location of the placenta and uterine artery doppler velocimetry was performed by using convex probe. During the first and second trimesters of pregnancy, ultrasound was used to identify uterine arteries on each side of the uterocervical junction. In third trimester it was seen at the crossover of external iliac vessels. Sample box was 2mm. Insonation angle was less than 60 degrees. Angle dependent Doppler indices are obtained during each examination. Results: In our study 63 (74%) subjects had central placenta and 23(26%) subjects had laterally located placenta. Fourteen of the 86 patients developed preeclampsia; eight (57%) had unilaterally located placentas while only six had centrally located placentas. According to our study, 8 (34%) out of 23 women bearing lateral placentas alone developed preeclampsia whereas 6 (85%) out of 7 women bearing lateral placentas with Doppler abnormalities developed preeclampsia. Conclusion: A lateral placenta puts a pregnant woman at significant risk of developing preeclampsia. In lateral placentas co-occurring with uterine artery Doppler abnormalities, preeclampsia risk significantly increases as compared to those of lateral placentas alone

Background: COVID 19 positive pregnantwomen form a very vulnerable group.  It adversely affects their physical and psychological health. These women are likely to develop new health problems or aggravation of existing problems during pregnancy and in the post-partum period. Materials and Methods: This was a prospective observational study of 100 consecutive Covid positive pregnant women who were admitted in the isolation wards of Government Medical College, Thrissur and delivered during the study period from 1st may 2021. These women were followed up till 6 months postpartum. Data was collected from recordsand bypersonal interview or telephonic call using astructuredquestionnaire. Demographic profile, Covid symptoms and their severity, obstetric details, breast feeding practices, neonatal outcomes and post Covid symptoms were studied. The association between breastfeeding, hygiene practices and neonatal positivity was also looked into/. Results: 51% of Covid positive pregnant women were asymptomatic. Nine women had severe Covid pneumonia with 2 of them requiring ventilatory support. There were no cases of vertical transmission or transmission through breastfeeding among the newborns studied. There was a strong association between strict adherence to hygienic practices and neonatal positivity. 24% of women had persistent symptoms at 6 months postpartum. Post exertion malaise was most commonly observed. Conclusion: Women with COVID-19 infection during pregnancy may continue to have health problems and hence need a close follow up

Background:  Hypertension in pregnancy is a systolic blood pressure ≥ 140 mmHg or diastolic blood pressure ≥ 90 mmHg or both. Both systolic and diastolic blood pressure raises are important in the identification of Pregnancy induced hypertension. Pregnancy induced hypertension (PIH) is hypertension that occurs after 20 weeks of gestation in women with previously normal blood pressure. The broad classification of pregnancy-induced hypertension during pregnancy is gestational hypertension (GE), pre-eclampsia and eclampsia. Serum uric acid and creatinine levels are a part of work up for the pregnant women with hypertension. The elevated levels of these parameters were due to decreased urinary clearance secondary to reduced Glomerular filtration Rate (GFR) and increased reabsorption. Materials and methods: The present study was carried out in the Department of Biochemistry, Dr VRK Womens Medical College, Teaching hospital and Research center. Total 70 patients of pregnancy were selected out of which 30 patients were of normal pregnancy and 40 patients were of pregnancy induced hypertension. Serum uric acid levels were estimated before delivery and after delivery in cases of pregnancy. Pregnant women with recurrent abortions, bad obstetric history, twins, preexisting medical disorders – such as diabetes mellitus, essential hypertension, renal disorders, cardiovascular, thyroid disorders, and liver disease – were excluded from the study. Results:  In our study, we observed a significantly elevated serum uric acid PIH (9.51 ± 1.33 mg/dl) and Normal pregnant women (5.29 ±0.8 mg/dl). Blood Urea was 5.29 ±0.8 mg/dl among Normal pregnant women and 9.51 ±1.33 mg/dl among PIH. Moreover, Serum Creatinine level was1.25±0.53 mg/dl among PIH and 0.97±0.23 mg/dl among Normal pregnant women. Conclusion: On the basis of study findings we, concluded that the increased levels of serum uric acid, serum creatinine and serum urea are better diagnostic and predictive marker for PIH and immediate medical attention required for PIH. With the help of these parameters most cases are detected early in the pregnancy before they can progress to eclampsia

Background: Every year, 60% to 80% of all newborn deaths are caused by low birth weight (LBW). Low birth weight is a significant public health issue in developing nations like India. The objective of this study was to assess the magnitude and associated factors of low birth weight in a tertiary care hospital of northern India.  Methods: This was across-sectional study conducted at tertiary care Hospital. A total of 650 individuals in the study were chosen via systematic sampling. Data were gathered using a standardised questionnaire that had been pre-tested. Epi Info V7 was used to analyse the data. To find related factors, bivariate and multiple logistic regression were utilised. An association was deemed statistically significant at a 0.05 p-value. Results: In this study, the magnitude of low birth weight was 14.2%. A low birth weight was three times more frequent in women with a history of chronic disease than in those without such a history [AOR=3.04(1.04,9.02)]. Pregnant women with haemoglobin levels below 11 g/dl had a higher risk of having babies with low birth weights than those with haemoglobin levels above 11 g/dl [AOR=3.06(1.08,8.96)]. Contrary to those who did, women who did not take iron/folic acid supplements during their pregnancies had a higher risk of having babies with low birth weights [AOR=0.28(0.12,0.78)]. The odds of having a low birth weight were higher for pregnant women who did not eat extra food or meals during their pregnancy than for those who did [AOR=0.26(0.11, 0.73)]. Conclusions: Hemoglobin level, iron/folic acid supplementation, extra meals during pregnancy, and a history of chronic medical conditions were all found to be significant predictors of low birth weight. To lower the risk of low birth weight, it is crucial to encourage pregnant women to take iron together with folic acid and extra meals

Aims and Objective- To study the prevalence of coagulation abnormalities associated with Intrauterine fetal death. Materials and Method-The study was conducted in Obst &gynec Dept, Tertiary care hospital, Southern Odisha in a study period Aug-2020 to Oct 2022. A detailed clinical history, demographic parameters, causes of IUFD, associated complications and examination findings will be recorded as per the proforma and the following investigations will be done in each case: CBC to ascertain thrombocytopenia, Prothrombin time(PT), Activated partial thromboplastin time(aPTT),D-Dimer ,Fibrinogen assay,Modified ISTH score taken consisting of  platelet count, PT and fibrinogen level. Results - Out of the total 116 cases of IUFD, 18 cases were clinically diagnosed with DIC; Prevalence is 15.5% in our study. The mean age of study participants was 25.10 ±6.30 years which ranged from 18 to 37 years. Majority of the cases were primigravida and presented at preterm. Apart from the undiagnosed cases, which was the major part ,from the rest of the cases PIH and Abruptio constituted the major proportion of identifiable causes of IUFD. PIH, Abruptio and HELLP syndrome were the major obstetrical complications contributing to clinical DIC as well as those at risk of developing subsequent DIC which was found to be statistically significant. The sensitivity was found to be more in pregnancy modified ISTH score --(83.3%) compare to ISTH overt score (50%). The specificity was found to be more in ISTH overt score (96.9%) compare to pregnancy modified ISTH score (78.5%) Conclusion- in obstetrics is a life-threatening complication that is secondary to obstetrical and non-obstetrical related complications of pregnancy. It is associated with high maternal and perinatal morbidity and mortality. The present study was conducted to determine the risk of DIC in the cases of IUFD.It is recommended that coagulation studies should be considered in IUFD specially when complicated by PIH. abruption or severe complications such as HELLP syndrome. However, our study is of small sample size (116) requires large studies meta analysis

Introduction: Acute intestinal obstruction is one of the commonest and potentially dangerous surgical emergencies with a high frequency of morbidity and mortality if managed inappropriately. Although the mortality is decreasing with a better understanding of pathophysiology, improvement in radiological diagnostic techniques, fluid and electrolyte correction, potent antimicrobials, surgical management, and improvement in anaesthesia. The present prospective study was conducted to find out various etiological factors of mechanical intestinal obstruction and to evaluate morbidity and mortality in adult patients. Material Methods: The present prospective observational study of 290 patients with adult intestinal obstruction was carried out from December 2016 to October 2018 in the Department of Surgery at a Tertiary Care Hospital. The study included a total of 290 patients out of which 218 underwent surgical management and 72 underwent management conservatively, hence aetiology of intestinal obstruction was studied in the operative patients. Results:The peak age incidence was seen between 31-60 years in small bowel obstruction. Abdominal pain 283(98%) and distension 278(96%) were the most common presenting complaints. Out of 290 patients 218 (75.17%) patients underwent a surgical procedure in whom the most common intraoperative findings were adhesions and bands seen in 84 cases (38.53%) which were post-operative. Malignancy was seen in 6 cases (9.17%) involving small bowel. Adhesiolysis was the most common procedure done in 94 cases, with 78 cases of postoperative adhesive intestinal obstruction. Surgical site infection was the most common complication 109(50%). Conclusion: Clinical, radiological, and operative findings put together can bring about the best and most accurate diagnosis of intestinal obstruction. Among the factors influencing mortality and morbidity are age, state of hydration, the viability of the bowel, aetiology of obstruction, site of obstruction, delay in diagnosis and surgical intervention and associated medical illness

Background: pregnancy is one of the important times in a woman’s life. Women's bodies become more sensitive to dangerous substances and they may develop different complications, such complications might be to pregnant women or the fetus. Some women don’t have proper knowledge about pregnancy complications or nutritional food products to be taken during pregnancy the main aim of the study is to study ABO blood groups and sociodemographic status in anomalies and normal fetuses in pregnant women. The present study is a cohort study carried out on 180 pregnant women. Among them, group 1 136 were normal pregnant women (without any fetal complications) and group 2 44 were anomaly pregnant women (with fetal complications). In groups, -1 & 2 majorities of the pregnant women were under the age group of 31 – 35 years (45.58%) and 20 – 25 years (27.27%) after comparing both groups – 1& 2 significance was observed at 20 -25 years (p<0.05). in group 1 majority of pregnant women have 1 fetus but in group 2 majority of the pregnant women have 2 fetuses. In comparing the ABO blood group of both groups 1 & 2 there is a significant difference was observed in blood group A and no significance was observed in blood group B, AB & O. as per the education status of a pregnant women in group 1 in education status of a pregnant women majority were upto degree 43.38% and in group 2 majority of pregnant women were not educated (45.45%). Complications observed in group 2 in 44 pregnant women having Hematocolpos 29.54% followed by Hydramnios 22.72%, Oligohydramnios 18.18%, Microcephaly 13.63%, Cleft palate 9.09% and Hygroma colli 6.81 %. Early age Pregnancy, more than 1 fetus, A blood group, no education about taking care during pregnancy and there complications such pregnant women may develop complication in fetus and even death of the fetus can be seen

Objective: To analyse Non-Stress Test as a Predictor for High-Risk Pregnancy-In Background of Fetal Color Doppler in Umbilical and Middle Cerebral Artery  by  means  of categorization intofour groups and comparing the prediction of perinatal outcome in high -risk pregnancies. Material and Method : This was  a  Prospective Observational study conducted on all ‘High Risk  Pregnancies’  in  Department  of  Obstetrics  &  Gynaecology,   Ruxmaniben  Deepchand   Gardi Medical  College,  Ujjainfrom  Oct 2020 to Nov 2021. A  total  of  182  antenatal  women  with ‘High  Risk’patients were  recruited.  They  were examined clinically,  and  Doppler  velocimetry  andnon- stress  test  were  performed.  The  main   vessels   studied   by  Doppler  were   umbilical   artery and   middle  cerebral  artery, to study and analyse the indices.   The  results  of   Non-Stress testwere  interpreted as  Reactive and Non-Reactive.  Based   on  the  results  of  Doppler  and   Non- Stress,  the  182 cases  were  categorized  into  four  groups  and  interpretation  of  results  was  done.Fetal outcome was considered on the basis of.APGAR score and NICU admissions Results: Among the182  cases of high-risk pregnancies, those with a normal Doppler study and a  reactive non-stress test had good perinatal outcome. When both were abnormal, there was a higher percentage of adverse out-come as compared to that of either Doppler or NST alone being abnormal or non-reactive. It was observed in this study that Abnornal Doppler  study  with Reactive  non-stress  test  had relatively  bad perinatal  outcome as compared  to  Normal  Doppler study  with  non reactive non stress test.In this study sensitivity and specificity of Doppler was 71%  and 73% while that of NST was 69%   and  54%  respectively  for  NICU  admissions. Conclusion: Color Doppler is comparatively a better in  predicting adverse  perinatal  outcome. However,  when  both test  are abnormal  perinatal  outcome  is  definitely  poor.NST can be used as an alternative in absence of colour doppler at rural PHCs and CHCs to identify adverse perinatal outcome and timely referral.

Introduction: Burst abdomen is considered to be there when intestine or other viscera are seen through the abdominal wound after surgery (general and obstetric surgeries).It can increase the length of hospital stay and result in significant social and economic costs for the patient and health care system. The present study aims at analyzing the incidence, etiological factors and management of this severe post-operative complication experienced by gynaecologists.  Materials and Methods: The present study comprises 25 cases of burst abdomen in the Department of Obstetrics and Gynaecology, MKCG Medical College Hospital, Berhampur, Odisha from August 2020 to July 2022. Using a check-list and a questionnaire, the patient’s demographic data, medical history, physical examination findings, laboratory investigation results, surgical procedures, and outcome of the repaired burst abdomen were collected.  Results: In our study period the incidence of burst abdomen was 0.19%. Majority of the cases, both caesarean delivery cases (100%) and gynaecological cases (60%), were emergency cases. The indication of laparotomy being ectopic pregnancy (40%) was the most common in gynaecological cases and the most frequent indication for caesarean delivery leading to burst abdomen was obstructed labor (40%). Obesity was the the most frequent (24%) comorbidity encountered in our setup. Majority of the cases (84%) had transverse incision and only 16% cases had sub-umbilical midline incisions. Layer closure was used in majority (92%) of the cases which led to burst abdomen as compared to mass closure which was seen in 8% of the burst abdomen cases. The majority (72%) of burst abdomen occurred between 6th and 7th post-operative day in our study, with the average mean of 6.72 days.  The post-operatively anemia was seen in 72% of the cases that led to burst abdomen. Operative area infection also seemed to pre-dispose patients to burst abdomen and was seen post-operatively in 36% of the patients.  Conservative treatment (daily saline dressings) was done in no case in our study. Immediate re-suturing of the wound in the operation theatre was done in 22 cases. In majority of cases (56%), secondary closure of burst abdomen was done with non absorbable polypopylene. In present study the range of stay for majority was within 21-35 days and mean duration of stay was 24.52 days. Two cases had burst abdomen recurrence, i.e. 8%. Conclusion: Burst abdomen is one of the serious postoperative complications faced by surgeons and is of greatest concern because of risk of evisceration, the need for immediate intervention and the possibility of repeat dehiscence. It poses tremendous impact on quality of life, health care cost for patients, their families and hospitals by requiring re-operations, need for antibiotics and prolonging hospital stay. Knowledge of the more common mechanisms and how to avoid or overcome these hazards should help to reduce the incidence of this dangerous complication such as maintaining asepsis, avoiding preoperative, intraoperative and postoperative precipitating factors of burst abdomen and providing good antibiotic coverage.

Introduction: Improving maternal health is one of the fifteen Sustainable goals  adopted by world leader in September 2015 by  an historic  international community at the United Nations Summit, which aims  to reduce the global maternal mortality ration to less than 70 per 100,000 live births by the year 2030.The MMR in developing countries is more than developed countries. MMR in developed country is 12/1,00,000 live birth Maternal mortality ratio of India is 97/lakh live births. Preeclampsia is a new onset of hypertension and proteinuria after 20 weeks of gestation  in a previously normotensive women.Severe Preeclampsia  is a serious clinical type of preeclampsia by atleast one of the following – persistent increase in blood pressure [≥160/110 mmhg ],hepatic and renal failure,platelet count less than 1,00,000 / mm3 , hemolysiselevsted liver enzymes and low platelet count [HELLP] Syndrome, Cerebral or visual disturbances, persistant epigastric pain and pulmonary oedema. Eclampsia is a serious obstetric emergency with new onset grand mal seizure during pregnancy or postpartum in women having signs and symptoms of preeclampsia. The sequel of severe preeclampsia and eclampsia include organ failure, loss of consciousness and finally loss of lives of both mother and fetes. Aims and Objectives: To study clinical outcome of Preeclampsia and Eclampsia in a Tertiary Care Centre. Materials and Method: The study was conducted in department of Obstetrics and Gynaecology, MKCG Medical College, Berhampur, Odisha, India for a period of 18 months extending from November 2020 to September 2022.A total of 400 patients were studied. At the end of the study, collected data were tabulated and analysed. Results: Present study was conducted on 400 cases, during the study period.Mean age was 31.19 ± 5.7 years. Majority of patients (194 cases, 48.5%) belonged to lower class followed by 129 cases (32.3%) belonging to middle class. Fifty four patients (13.5%) were from lower middle class. Upper middle class had 16 (4%) patients. Only 7 cases (1.7%) were from upper class. In 127 patients (31.8%) diabetes mellitus and in 227 patients (56.8%) pre-existing hypertension was reported respectively. Among 400 patients studied, 114 patients (28.5%) were primigravida and 286 patients (71.5%) were multigravida.  Twenty eight (16.8%) patients died of complication. Both age and age of gestation of patients were not significantly distributed across maternal mortality (Page=0.34, Paog=0.33). Cause of death was abruption placenta (10 cases), acute renal failure (6 cases), ARF with sepsis (1 case), eclampsia (4 cases), HELLP with PPH, PPH, pulmonary embolism, pulmonary embolism with PPH and wound infection (1 case each) and sepsis (2 cases). Out of 59 patients suffering from eclampsia, 4 (1%) patients died and 24 (6%) patients with pre-eclampsia died. Association of occurrence of eclampsia was robustly associated with patient mortality (P<0.0001).Two hundred and sixteen neonates (54%) had low birth weight while 279 (69.8%) were cases of intra uterine growth retardation. Preterm birth, birth asphyxia and NICU admission was seen in 175 (43.8%), 168 (42%) and 270 (67.5%) respectively. Eighty nine (22.3%) neonates died after birth while 52 (13%). Mean maternal age of deceased and survived neonates in present study was 31.51±5.6 years and 31.1±5.8 years respectively. Mean values for age of gestation of deceased and survived patients were 31.29±1.4 weeks and 31.59±2.2 weeks respectively. Both age and age of gestation of patients were not significantly distributed across maternal mortality (Page=0.56, Paog=0.24).  Conclusion: Preeclampsia and eclampsia tends to threaten maternal health and fetal viability adding to maternal and neonatal mortality and morbidity.There is high frequency of preeclampsia and eclampsia in our setting and the consequences are alarmingly high. There is need for patients education in recognizing the warning symptoms of the disease before intrauterine demise of fetus occurs or mother develops one of the grave complications, Antenatal care, treatment of anemia  and educating the women on significance of symptoms will go a long way in improving maternal and perinatal morbidity and mortality.Presence of NICU  with effective neonatal care will improve the fetal outcome.

Background: Malignancy of Gastrointestinal tract starting from Oesophgus to Anus may cause acute or sub-acute obstruction which requires emergency relief from the symptoms. Surgery with diversion, colostomy or ileostomy, Nutritional Management with feeding gastrostomy/jejunostomy and further chemoradiotherapy were required according to the different pathological variants at different site of G.I. tract to reduce the mortality rate and prolonging the survival time. Previous studies have been compared for the outcome of success rate, hospital stay, mean long term survival for different palliative interventions. None of them had proved to be most efficient for prolonged survival as most of cases were in the advanced stage of cancer. Objective: To determine the best palliative procedures undergone surgery and non-surgical procedures such as Chemotherapy/Stenting. Method A retrospective study of Seventy patients of malignant bowel obstruction was done with statistical analysis. Observation Among the Seventy patients 49 were male and 21 were female and mean age of the patient was 49.57. The overall symptoms improve rate was 75.71%. Among them symptom improve rate 96% in surgical group,42.80% in stenting group and 15.38% are in chemotherapy group. Median survival time was 270 days in surgery group. Conclusion Malignant obstruction is an emergency condition in most of times needs urgent symptom relief by any mean of palliation. Complete and unresectable malignant obstruction needs diversion colostomy or any by-pass surgeries. Among all type of surgeries resection and anastomosis with or without diversion of loop is best palliation.

Introduction: An ectopic pregnancy occurs when the developing blastocyst implants either outside the uterus i.e fallopian tube (interstitial, ampullary, isthmic, fimbrial), Ovary and abdominal cavity or in an abnormal position within the uterus i.e cornual, cervical. Around 98.3% of ectopic pregnancies occur in the fallopian tubes. Visualization of an intrauterine sac, with or without fetal cardiac activity, is often adequate to exclude ectopic pregnancy. The treatment modality also has evolved from radical surgery, conservative surgery to medical and expectant management. Laparoscopy is now recommended approach in surgical management of ectopic pregnancy.Materials and Methods: This is a prospective observational study conducted in Department of Obstetrics and Gynaecology from 2020 to 2022 where 118 cases were studied. Detailed history was taken for all cases with special reference to risk factors like smoking, PID, abortions, previous ectopic, IUD use, sterilization, D & C, IVF and LSCS followed by clinical examination. Routine and other relevant investigations were done including (UPT, CBC, ICTC, HCV, HbSAg, USG (TVS) and serum β-HCG and managed according to the condition of patient either medical, surgical or both. Data regarding intraoperative finding confirming site of ectopic pregnancy, ruptured or unruptured, operative techniques including salpingectomy, salpingo ophorectomy, cornual repair or hysterectomy and blood product transfusion were collected. Patients were followed up till discharge or death and the outcome were analysed. Results: Maximum numbers of cases, 45 cases (38.1%) were in the age group between 26 to 30 years. Among all cases, 24 cases (20.3%) had history of previous abortions, 22 cases (18.6%) had history of PID, 14 cases (11.9%) had undergone D & C earlier, 8 cases (6.8%) had earlier tubal ligation, 5 cases (4.2%) had h/o IUCD insertion and 1 case (0.8%) had previous history of ectopic pregnancy. The classical triad of amenorrhea, abdomen pain and abnormal vaginal bleeding was seen in 52 cases (44.0%). The most common site of ectopic pregnancy site was fallopian tube, of which 96 cases (81.3%) were in amupulla, 14 cases (11.9%) were in isthmus and only 3 cases (2.5%) were in infundibulum. Only 2 cases (1.7%) had cornual pregnancy with gestational sac implanted in the non communicating horn of unicornuate uterus. Maximum number of ectopic pregnancy cases underwent surgery, with 98 cases (83.0%) had undergone  unilateral salpingectomy as the most common procedure whereas 15 cases (12.7 %) had undergone unilateral salpingophorectomy in cases with unhealthy ovary and ovarian pregnancy out of 113 cases of tubal ectopic pregnancy. Only 2 cases (1.7%) with cornual pregnancy had cornual resection and repair. Hysterectomy was adopted as surgical treatment in 2 cases (1.7%) only.Conclusion: Patients with risk of ectopic pregnancy like PID, IUCD implantation, previous ectopic pregnancy and patients with history of D & C should undergo routine USG in first trimester to locate the site of early pregnancy. We recommend follow up above cases of ectopic pregnancy and analyzing the effect of ectopic pregnancy on future fertility and pregnancy.

Labour and delivery are focus and climax of the reproductive process. They are both physical and emotional challenge for the mother and a hazardous journey for the fetus. Labour is a dynamic phenomenon characterized by a progressive increase in the frequency, intensity and duration of uterine contractions with progressive dilatation and effacement of the cervix and the  fetal  descent  through  the  birth  canal.   This physiological process may lead to pathology and failure to recognize this would result in prolonged labour resulting in increased morbidity and mortality of mother and baby.2 Material And Methods A hospital-based prospective study of 100 pregnant women with high-risk pregnancy  attending  the  department  of  Obstetrics  and  Gynaecology, Gayatri vidyaparishad medical college, Vishakhapatnam, from December 2021- November 2022. The study groups randomly selected a hundred primigravida with high-risk pregnancy fulfilling the inclusion and exclusion criteria. Informed and written consent was taken from all the women participating in the study. The study's primi pregnant women fulfilling inclusion and exclusion criteria were divided into the PARTOGRAM GROUP (P) and the other NO PARTOGRAM (NP). Each group consists of 50 primi  pregnant  women.  In the partogram group,  the progress of labour was documented on MODIFIED  WHO PARTOGRAPH and the notes on the progress sheet of case record file while standard notes only in no partogram group. Results In our study, 80% of pregnant women gestational age was below 39 weeks. In the NP group, 34% of women at 38 weeks, followed by 32% at 39 weeks. In the P group, 54% were at 38weeks, followed by 18% at 39 weeks and 18% at 40 weeks. Oligohydramnios  was  predominantly  observed  in  women  presented  in  39 weeks  (48%)  gestational  age.  Gestational  hypertension  (38.6%)  and  gestational diabetes mellitus(18.1%) was commonly observed in women in 38 weeks of gestation as both conditions are delivered at 38 weeks. Hypothyroidism was predominantly observed in women at 37 weeks(36.3%) and 39 weeks(24%) of gestation.  In individuals' groups, among the NP group, most pregnant women were delivered by FTNVD (60%) followed by 30% cases by LSCS. In P group out of 50 deliveries, 78% of cases delivered by FTNVD, followed by 14% undergone LSCS.  Conclusion: Partogram is an excellent tool for reflecting quick and consistent review of labour events, handing over the patient in changing shift duties, especially in low resource settings. It leads to earlier decision making in labour management and shown to reduce cesarean section rates.

Background: Acute appendicitis is one of the commonest general surgical problems seen in pregnant females. Prompt evaluation and management is of utmost importance to avert maternal and fetal morbidity and mortality. The aims and objectives of this study were to study the presentation and management of acute appendicitis in pregnancy. Methods: This was a prospective cohort study of 50 pregnant patients presenting with acute appendicitis over a period of 4 years in a tertiary care hospital of a developing area.Results: The mean age of the patients was 29.31 ± 4.83 years with most of them being in the age group of 25 - 30 years. Thirty-one (62%) patients hailed from the rural areas. Twenty-eight (56%) patients were primigravida. Majority of patients presented in the 2ndtrimester [28 (56%) patients]. Ultrasonography was used as the diagnostic modality of choice in 48 (96%) patients. Majority of the patients [47(94%)] were managed conservatively on intravenous antibiotics, analgesics and fluids. The mean hospital stay was 4.26 ± 1.29 days. Simple open appendectomy was needed in two (4%) patients whereas one (2%) patient required laparotomy because of generalized peritonitis. No maternal or fetal loss was seen in our study.Conclusion:Acute appendicitis is a common surgical emergency encountered in the pregnant females and usually responds well to conservative therapy. However early surgical intervention is warranted in case of peritonitis to circumvent maternal and fetal complications.

Introduction: Intracranial metastases are most frequent in the brain and dura. 80% of the brain metastasis are located in the anterior border zones of the cerebral hemispheres, 3% are found in the basal ganglia and 15% in the cerebellum. In the cerebrum, metastasis occurs typically near the junction of cortex and white matter. Aims: To study the presenting symptoms in asymptomatic and known cases of malignancy and its correlation to the type of malignancy. Special emphasis will be on asymptomatic patients with their first presentation and correlation with age and sex, to estimate the incidence of metastatic lesions of CNS. Materials and Methods: The present study has been performed predominantly on CNS metastasis cases admitted in the department of Neurosurgery, SMS Medical College & Hospital Jaipur. 50 cases have been studied and cytological as well as histological diagnoses were compared. This diagnosis was then compared with diagnosis given on CT & MRI. Result: Backache was the symptom found in only spinal metastasis, not intracranial. 100% of spinal metastasis in our study complained of this symptom. In the Intracranial metastasis from unknown primary, moet were adenocarcinomas and surprisingly either from GIT or overy the patient remained asymptomatic for prolonged periods. This fact Is probably attributed to occull carcinoma. Conclusion: In the Intracranial metastasis from unknown primary, moet were adenocarcinomas and surprisingly either from GIT or overy the patient remained asymptomatic for prolonged periods. This fact Is probably attributed to occull carcinoma.

Background: Foetal growth restriction (FGR) is a significant cause of morbidity and mortality. Clinical methods for identifying women whose pregnancies are affected by FGR do not perform well. Despite this, the current approach to screening includes the clinical assessment of risk and thetargeted use of ultrasound. Objectives: To analyse the uteroplacental and fetoplacental blood flow using doppler ultrasound in FGR fetuses regarding UA and MCA flow velocity and waveform indices and compare the mode of delivery and perinatal outcomes in FGR pregnancy to normal and abnormal Doppler waveforms with those of pregnant women without FGR normal dopplers. Materials and Methods: A prospective observational study was conducted in the Department of Obstetrics and Gynaecology in collaboration with the Department of Radiology at Shadan Institute of Medical Sciences, Teaching Hospital and research centre, Hyderabad, from January 2019 to September 2019. A group of 100 cases were studied. Half of them (50 cases) comprised the study group, i.e., cases with FGR, 25 cases of which had abnormal doppler, and the remaining 25 cases of these 50 cases had FGR with normal doppler. The results in this study group were compared with 50 cases of normal pregnancies without FGR with normal doppler. Results: The operative delivery was 88% in abnormal doppler FGR, and 36% in normal doppler FGR, in contrast to 24% in the normal doppler non-FGR group. The mode of delivery was statistically significant among the groups with a p-value (<0.001). 64% of the abnormal doppler group had oligohydramnios compared to 36% in normal doppler with FGR versus 10% in the control group with a significant p-value (<0.001). The mean birth weight in FGR with abnormal doppler was 1.96±0.25kg compared to 1.94±0.16 kg in FGR with normal doppler and 3.06±0.31 kilograms in the control group, which had a significant p-value (<0.001). Conclusion: Abnormal UA and MCA indices are notably associated with operative abdominal deliveries, oligohydramnios, and low birth weight babies.

Background: Rheumatoid arthritis (RA) is an autoimmune, chronic inflammatory disease of unknown etiology characterized by symmetric polyarthritis. It is the most common form of chronic inflammatory arthritis. It can also cause a variety of extra-articular manifestations, such as vasculitis, nodules, and accelerated atherosclerosis. RA affects 0.5–1% of the adult population worldwide. Females are more commonly affected than males, which can be attributed to the role of estrogen in enhancing immune response. Genetic and environmental factors play an important role in the pathogenesis of RA. Materials and Methods: This is a prospective study conducted in the Department of OBGY and Orthopaedics. Data about RA pregnancies were collected before conception and during each trimester and post- partum period. All the patients were prospectively followed at the multidisciplinary Pregnancy Clinic for Rheumatic Diseases. Data collection was performed at five time points: preconception visit (3–6 months before conception), during each trimester of pregnancy (first: 8–12 weeks of gestation, second: 18–24 weeks, third: 30–36 weeks), and up to 6 months after delivery. Results: Flare rates during pregnancy in patients with RA are associated with active disease in early pregnancy. A total of 65 pregnant patients were identified. No patient with RA experienced more than one episode of flare during pregnancy. Comparing patients with flares with those without them, the discontinuation of TNFi in early pregnancy correlated with the risk of flares. Conclusion: Elevated disease activity and TNFi discontinuation in early pregnancy may cause a relapse of disease activity in patients with RA. Restart of medication controls disease activity in pregnant patients with RA but shows insufficient effect in pregnant patients. The data indicate that tailored medication should be considered beyond conception to stabilize low disease activity and to prevent a flare during pregnancy.

Material & Methods: Study Design: Hospital based prospective observational study.Study area:Department of Obstetrics & Gynecology, Mayo institute of Medical Sciences,Barabanki, Uttar Pradesh.Study Period:April 2022 toMarch 2023. Study population:All patients presenting with jaundice to Department of Obstetrics & Gynecologyin antepartum or intrapartum period.Sample size: Study consisted a total of 55 subjects.Sampling Technique:  Simple Random technique. Results: In 29% (n=16) of cases, jaundice is due to obstetric cholestasis, who are mostly presented with pruritis and abnormal LFT’s in their third trimester, In 27% (n=15)it is due to HELLP syndrome which is associated with preeclampsia in 14%, In 12.7%(n=7) cases jaundice is due to sickle cell anemia and Hepatitis B each, haemolytic anemia due to blood transfusion is seen in 5.45% (3), in 3.6%(n=2) cases cause is AFLP who presented with hepatic encephalopathy and hypoglycemia , cirrhosis is the cause of jaundice in 3.6%(n=2) who presented in their first and second trimester,1.8%(n=1) cases are due to malaria, cholelithiasis and autoimmune hepatitis each. So in nearly half of the cases the cause of jaundice is pregnancy specific causes. Conclusion:Jaundice in pregnancy is a dreadful condition resulting in high maternal and fetal mortality. Even though the blood bank facilities has increased, due to their advanced disease state at admission few patients could not be survived. So early referrals are helpful.Team effort is needed in the management of jaundice , team should constitute obstetrician , physician, gastroenterologist, anaesthetist and neonatologist, so that identification and treatment throughout antepartum, intrapartum and postpartum period prevent and reduce maternal and perinatal morbidity and mortality.

Background: Identifying the women who are likely to miss receiving complete ANC care during their pregnancy and understanding the causal factors is essential towards the development of effective and targeted public health interventions. Objectives: To assess the sociodemographic profile and the factors influencing the utilisation of antenatal services among pregnant women in rural Coimbatore. Methods: A community based cross-sectional study was conducted among antenatal women residing in the field practice area of Rural Health Training Centre using multi-stage sampling method from June 2021 to May 2022 (one year) in the Rural Field Practice Area of a Medical College in Coimbatore district using pre-tested, validated, semi-structured questionnaire. Results: Majority (55.2%) of the participants were aged between 18-25 years. Only 10% of the women were currently employed. Tests of association showed that sociodemographic factors were significantly associated with ANC utilization (p<0.05). Among the study participants, 80.4% utilized the services completely (ANC visit to healthcare facility, consumption of IFA tablets, Td vaccination, basic blood, and urine investigations and ultrasonogram); 19.6% had incomplete ANC care and none had “No ANC”. Conclusion: The overall high ANC utilisation in the study area could be attributed to the favourable knowledge, attitude, and practice of the antenatal women towards maternal and child health as a result of high literacy rate, ongoing IEC and health promotional activities. Attention should be given to regular and sustained contact between healthcare workers and antenatal mothers especially through home visits to develop mutual confidence in preparing them for pregnancy, childbirth, and care beyond.

Background: One form of hypertension in pregnancy is preeclampsia, which is characterized by blood pressure ≥ 140/90 mm of Hg and protein in urine at gestational age after 20 weeks. Preeclampsia is a global problem affecting 2-8% of pregnancies, and an estimated 8.3 million pregnant women experience preeclampsia every year.  In this review we will look at potential biomarkers and its correlation with uterine artery Doppler for early prediction and diagnosis of preeclampsia. Aim: To investigate the role of placental growth factor, and uterine artery diastolic notch to predict the early onset of preeclampsia. Materials And Methods: A hospital based prospective study conducted on 100 normotensive, non- proteinuric antenatal women less than 20 weeks of gestation were recruited. At 12-16 weeks, PLGF level was estimated from stored serum samples of all cases ad Doppler assessment of uterine circulation for uterine artery indices were done. These women were again rescanned at 24 weeks of gestation by transabdominal USG and further followed up clinically for development of preeclampsia. Methods used for the detection of PLGF is ELISA kit ad Uterine artery Doppler velocimetry was done by transabdominal ultrasound machine using a 4-6 MHz probe with the same sonographer Results: In this study,the median PLGF levels being significantly lower in pre-eclampsia cases (15 pg/ml) compared to normal (20.0pg/ml) with sensitivity being 90% and specificity being 23.4%, positive predictive value of 15.5% and negative predictive value of 93.8%. When Uterine arteries notch and RI >0.65 taken together increases sensitivity by 85.71%, 84.62% specificity and negative predictive value by 98.25%.  We found 52.3% sensitivity rate and 84.62% specificity with  70.51% of Negative predictive value regarding Uterine arteries PI  at >0.9573 with Optimal Cut off.  Conclusion: The combined measurement of maternal serum PlGF concentrations and The uterine artery notching, high Resistance Index and Pulsatility Index in uterine artery Doppler waveform at <20 weeks has shown as best screening test for early prediction of preeclampsia.

Background: The incidence of Central Nervous System tumors is low in India when compared to western countries. Now a days, the increase in incidence may be due to improved diagnosis with advancement of studies. They have a wide spectrum clinically and histopathologically.  Aims And Objectives: This study aims to provide the spectrum of CNS tumors histologically and clinically, along with radiological correlation,To analyse  various histological types of Cranial and spinal tumors ,to evaluate age and gender distribution and topography of tumors. Materials And Methods: A retrospective study was performed in the department of pathology, for a period of 18 months.The data and Hematoxylin and Eosin stainedslides were retrieved from the archives, the cases were analysed and graded according to 2021WHO grading system. Results And Conclusion: out of 76 CNS tumors, most common were Intracranialtumors 85.5% (65) cases and Spinal tumors were 14.4% (11) cases. There is male preponderance, 44 cases (57.8%)Majority were in 45 to 60 years. Tumors were more common on right side, 61% (47 cases) and most common location was cerebellopontine angle 13.1.% (10 cases) followed by frontal region 11.8% (9 cases). The most common histological type were Astrocytomas, followed by Meningiomas. WHO Grade I tumors are more common, 24.6% followed by Grade II, 21.7%. Most common tumors  inchildren were Medulloblastomas (Grade IV). Three cases ofsecondary deposit from epithelial malignancy were also included in the study.

Background: This prospective observational study delves into the intricate realm of Doppler indices in intrauterine growth restriction (IUGR) fetuses, aiming to illuminate their clinical relevance and predictive potential. Fetal growth restriction, a critical concern in maternalfetal medicine, is explored through the lens of Doppler ultrasound, which enables assessment of uteroplacental and fetoplacental blood flow dynamics. By evaluating umbilical arterial (Umb A) Doppler Velocimetry, this study establishes correlations between hypoxemia in IUGR-affected fetuses and abnormal Middle Cerebral Artery (MCA) pulsatility indices. The investigation comprehensively analyzes Doppler indices' performance in predicting perinatal outcomes, utilizing sensitivity, specificity, and diagnostic accuracy assessments. With a focus on both symmetrical and asymmetrical IUGR, this study demonstrates the importance of Doppler imaging in diagnosing growth retardation and predicting adverse outcomes. Findings underscore the significance of combined uteroplacental and fetoplacental assessments and the potential of umbilical artery Doppler in outcome prediction. The implications of abnormal Cerebro umbilical ratio and absent diastolic flow further underscore the utility of Doppler imaging in enhancing high-risk pregnancy surveillance and outcomes.

Background: Most occurrences of prostatic disease are caused by benign prostatic hyperplasia (BPH), then prostatic cancer. An adult male with prostatic hyperplasia requires a thorough study because prostate cancer is the second most frequently diagnosed malignancy in males. Different prostatic lesions have the same clinical characteristics; however, identification is crucial because treatment and prognosis vary greatly. Material & Methods: Study Design: A prospective hospital based observational study. Study area: Department of Pathology, Government Medical College, Kadapa, Andhra Pradesh. Study Period: 1 year. Study population: This prospective study includes TURP specimens that were collected during the study period. Sample size: The study consisted of 100 cases. Sampling method: Simple random technique. Results: Foci of Prostatic Intra-Epithelial Neoplasia (PIN) were identified in 10% of all cases that were studied. 40% of the HG PIN lesions were identified in association with adenocarcinoma of prostate and the rest (60%) were found along with BPH. Highest incidence of PIN was noted in 7th decade followed by 6th decade. Atypical adenomatous hyperplasia was found in 4 (4%) of all cases. Conclusion: Malignant lesions are less frequent than benign ones. BPH is the most common type of prostatic lesion among the histopathological patterns. In order to recognise premalignant lesions, proliferative activity, and degree of inflammation, it is required to examine all prostate biopsies (TURP and needle core).

Introduction: Gestational diabetes affects a significant proportion of pregnant women and can have adverse health effects for both the mother and the baby. Monitoring blood glucose levels and lipid profiles is crucial in managing this condition. This comparative study examines how glycosylated hemoglobin (HbA1c) and lipid profile parameters change in women with gestational diabetes compared to normoglycemic pregnant women, with the goal of improving diagnostic and management strategies for this condition. The aim of this study was to determine that HbA1c is an independent marker of dyslipidaemia among GDM cases and emphasize the link between the aforementioned parameters among pregnant women in Bihar. Materials and Methods: In this comparative study, we included fifty patients who were diagnosed with gestational diabetes during pregnancy. All of the antenatal women were in their third trimester. We also included another fifty pregnant women as controls, who did not have gestational diabetes or any other pregnancy complications in their third trimester. Both the cases and controls were randomly selected from the age group of 20 to 45 years. In this study, we measured the serum lipid profile parameters, oral glucose tolerance test blood glucose levels, and glycosylated haemoglobin levels in patients with gestational diabetes, and compared them with those of healthy pregnant women. Results: In this study, 50 pregnant women with GDM had a mean age of 31.2 years, while 50 pregnant women in the healthy control group had a mean age of 29.3 years. In the present study, serum triglycerides were observed at 193.12±10.12 mg/dL in GDM cases and 150.76±8.54 mg/dL in the control group, while serum total cholesterol was observed at 211.43±14.34 mg/dL in GDM cases and 168.83±18.19 mg/dL in the control group. The levels of serum triglycerides and serum cholesterol in GDM cases were statistically significantly higher as compared to the controls. The serum HDL cholesterol was observed at 57.98±5.78 mg/dL in GDM cases and 55.12±6.67 mg/dL in the control group, while serum LDL cholesterol was observed at 92.13±13.45 mg/dL in GDM cases and 82.03±10.16 mg/dL in the control group. There was no statistically significant difference in their HDL and LDL Cholesterol in the cases and control group. The fasting blood glucose was recorded at 116±9.65 mg/dL in GDM cases and 89±5.89 mg/dL in the control group, the blood glucose level after 1 hour of 75grams oral glucose administration in oral glucose tolerance test was observed at 198.13±12.74 mg/dL in GDM cases and 158.33±9.34 mg/dL in the control group while blood glucose level after 2 hours was observed at 174.38±11.48 mg/dL in GDM cases and 140.11±7.87 mg/dL in the control group. The differences between cases and controls were statistically significant. The mean value of the HbA1c of cases and control groups was 8.15±1.12 mg/dL and 6.02±0.18 mg/dL respectively. This difference between healthy pregnant women and women with GDM was statistically significant. Conclusion: The study's findings have conclusively demonstrated that triglyceride, high-density lipoprotein, glycated haemoglobin, and glucose levels in the blood all play a significant role in the development of dyslipidemia in gestational diabetes mellitus (GDM). Although it is well known that lipid parameters increase during a healthy pregnancy, the way they increase in GDM is different.

Conclusion: The study concluded that there is a strong positive strength of association between the gestational age and placental thickness. The thickness of placenta increased with increase in the gestational age and hence could be used as a predictor and a parameter of gestational age prediction when the last menstruation is uncertain or is unknown. The study also found there is strong strength of association between the estimated gestational age by FL, BPD and AC with the placental thickness. Also study documented the positive strength of association of placental thickness with other fetal biometry like FL, BPD and AC.

Background: Gestational Diabetes Mellitus (GDM) is a prevalent metabolic disorder during pregnancy, carrying significant health risks for both mothers and infants. Early detection and risk assessment are crucial for effective management. This study investigates the potential of first-trimester serum uric acid levels as an early predictor of GDM in pregnant women attending a tertiary care hospital in Uttar Pradesh, India. Material and Methods: A prospective cohort study was conducted, enrolling 500 pregnant women in their first trimester. Clinical data, including demographic information, medical history, and anthropometric measurements, were collected. Laboratory measurements of uric acid, fasting glucose, and insulin resistance indices were performed. Participants were followed throughout pregnancy, and GDM diagnosis was established using the standard oral glucose tolerance test (OGTT) during the second trimester. Statistical analysis included logistic regression, ROC curve analysis, and calculation of sensitivity, specificity, and predictive values. Results: Elevated first-trimester serum uric acid levels exhibited a significant association with GDM development. Participants with uric acid levels between 4.0 - 4.5 mg/dL had an odds ratio of 1.82 (95% CI: 1.51-2.21) compared to those with levels below 4.0 mg/dL, indicating increased GDM risk. Uric acid levels > 4.5 mg/dL showed a sensitivity of 85% but a specificity of 68%. Combining uric acid with traditional risk factors, such as maternal age and BMI, may enhance predictive accuracy. Conclusion: First-trimester serum uric acid levels are a potential early predictor of GDM. Elevated uric acid levels were associated with increased GDM risk, though specificity may benefit from a multi-factorial predictive model. This study underscores the clinical significance of uric acid in GDM risk assessment and highlights the potential for improved screening strategies.

Background: Eclampsia is a serious medical condition that affects women during pregnancy. Symptoms of eclampsia appear in pregnancy as a condition known as pre-eclampsia, (condition follows a high blood pressure), the condition can go undetected until it develops into eclampsia. This can create additional complications during pregnancy. Each case of eclampsia is unique, and the pregnant woman may share few or no characteristics with other women who develop the condition. Pregnancy histories, Patient age, Family history, Obesity, High blood pressure are major high risk factors for preeclampsia and eclampsia will vary from patient to patient. Materials and methods:The present study was carried out in the Department of Biochemistry, Rama Medical College and Research centre over a period of 1 year. Total 70 patients of pregnancy were selected out of which 30 patients were of normal pregnancy and 40 patients were of pregnancy induced hypertension. Serum uric acid levels were estimated before delivery and after delivery in cases of pregnancy. Pregnant women with recurrent abortions, bad obstetric history, twins, preexisting medical disorders – such as diabetes mellitus, essential hypertension, renal disorders, cardiovascular, thyroid disorders, and liver disease – were excluded from the study. Result:The result showed significantly high blood pressure (SBP-165.81±20.9 VS 125.69±7.24, DBP 109.74±10.41 VS 80.8±5.15) and Blood urea (31.48±2.33mg/dl VS 6.28+/-1.9mg/dl), serum creatinine (0.67±0.52mg/dl VS 0.67±0.03mg/dl), serum uric acid level (6.28±1.9 mg/dl VS 9.48±2.33mg/dl) in pregnancy induced hypertensive women compares to normal pregnant women. In the present study, in PIH, there is elevation of serum uric acid and serum creatinine elevated values are statistically significant. Conclusion:This study concluded that PIH showed significant elevation in the urea, uric acid, and Creatinine levels compared to normal pregnant women, although all parameters’ values for both groups were in the reference values for non-pregnancy.

Material & Methods: Study Design: Prospective hospital based observational study. Study area:  The study was carried out in the Department of General surgery, B.J Government Medical College and Sassoon general Hospital, Pune. Study Period:  1 year. Sample size: study consisted of 55 subjects. Sampling method: Simple random Sampling Technique. Study tools and Data collection procedure: The following protocol was followed • Clinically and radiologically (by Mammography) suspected cases of locally advanced Ca breast were enrolled for the study after informed written consent. • Histopathological diagnosis was made by FNAC. • In the cases where FNAC was not conclusive, tru-cut biopsy was done • Once histopathological diagnosis was confirmed estrogen and progesterone receptor status was found out by immunohistochemistry. • Clinical stage IIIa and IIIb i.e locally advanced breast cancer (LABC) patients were considered for the further study (total number of patients was 55). Results: A total of 18 (29%) patients had clinical complete response (CCR) of these 16 patients, only 10 patients (62.5%) had a correlating pathological complete response (pCR). In our study. 53 (90-4%) patients had an infiltrating ductal carcinoma while 2 had infiltrating lobular carcinoma. Majority (94 29%) of the patients had an infiltrating ductal carcinoma. Conclusion: The current study reveals that clinical assessment of response to NACT has higher sensitivity than radiological assessment, but the overall poor sensitivity and specificity rates of clinical assessment need the search for a better way of evaluation.

Purpose: To study the fundus changes in Pregnancy Induced Hypertension (PIH). Methods: It is a hospital based prospective observational study of 100 women with diagnosed PIH. Fundus was examined by direct and indirect ophthalmoscope at bedside. Result: PIH was more common in primigravida (58%); maximum in below 25 years (54%) and in >36 weeks of gestational age (59%). Retinal changes were noted in 45 patients (45%) in which grade I hypertensive retinopathy was 37.7% and grade IV was 24.44%.  Retinal changes were significantly associated with BP (systolic and diastolic), proteinuria and severity of preeclampsia and eclampsia. Most of the changes in the fundus resolved within one week of delivery. Conclusion: All the patients of PIH should be examined by an ophthalmologist for proper management.

Background: The placenta is arguably one of the most important organs in the body. It influences not just the health of a woman and her foetus during pregnancy, but also the lifelong health of both mother and child. Despite its importance, we know little about this critical but temporary organ. The placenta has evolved to support the development of the embryo and foetus during the different intrauterine periods of life. By necessity, its development must precede that of the embryo. There is now evidence that during embryogenesis and organogenesis, the development of the human placenta is supported by histotrophic nutrition secreted from endometrial glands rather than maternal blood. These secretions provide a plentiful supply of glucose, lipids, glycoproteins, and growth factors that stimulate rapid proliferation and differentiation of the villous trophoblast. The present study conducted to observe any gross morphological change in placenta of normal individuals in North Karnataka region. Materials & Methods: 50 placentas were carried in multiple medical institutions in Karnataka, which were collected from labor room and operation theaters of connected Hospitals, washed under tap water and blot dried. Weight of placenta was recorded by weighing machine. Maximum diameter was measured, radius of placenta was obtained, and surface area was calculated using the formula. Cord attachments were also observed. Results: Out of 50 placentas 86% of placenta were circular and 14% were oval. Diameter was <15cms in 12%, 16- 20 cms in 68%, > 21cms in 20%. Surface area was 100- 200 cms2 in 16%, 201- 300 cms2 in 60%, 301- 400 cms2 in 20%, > 401 cms2 in 4%. Placental weight was between 300- 400gms in 14%, 401- 500gms in 58% and > 501gms in 28%. Umbilical cord insertion on fetal surface was found to be central - 60%, Paracentral -18% and Peripheral- 22%. The average diameter was 22.86+4.2, the average surface 316.52+76.42 and the average placental weight was 512.86+42.36. Conclusion: The present study parameters and an adequate knowledge of the morphometric analysis of the placenta with its clinical relevance proves to be useful in the early assessment of placental sufficiency and also the state of the fetal wellbeing. In mothers who have had no previous antenatal checkup, a thorough examination of the placenta helps in the early diagnosis of the fetal complications, soon after parturition and thus helps in the early treatment of the baby by neonatologists.

Hypertensive disorders in pregnancy, encompassing conditions like gestational hypertension and preeclampsia, significantly impact maternal and fetal health. Understanding their incidence and associated risk factors is vital for improving prenatal care. Objectives: This study aims to determine the incidence of hypertensive disorders among pregnant women and identify key demographic and health-related factors associated with these conditions. Methods: Design: Cross-sectional study. Setting: Obstetric outpatient Department. Participants: 250 pregnant women, ranging from 18 to 45 years, at various stages of gestation. Data Collection: Medical histories, blood pressure measurements, and relevant biochemical markers were collected. Statistical Analysis: Descriptive statistics, chi-square tests, and logistic regression were used to analyze the data. Results: Incidence: The incidence of hypertensive disorders was found in a specific percentage of the participants. Risk Factors: Key risk factors such as age, BMI, and medical history were significantly associated with the development of hypertensive disorders. Demographics: The study also revealed demographic trends, such as a higher incidence in certain age groups or pre-existing conditions. Conclusion: This study highlights a significant incidence of hypertensive disorders in pregnant women, underscoring the need for targeted prenatal screening and management strategies. The identification of key risk factors can aid healthcare providers in developing personalized care plans.

Near miss maternal mortality cases generally occur more frequently than maternal deaths and therefore a more reliable quantitative analysis can be carried out, which can provide a more comprehensive profile of health system functioning. Present study was aimed to study clinical profile of maternal near miss cases at a tertiary hospital. Material and Methods: Present study was single-center, prospective, observational study, conducted in pregnant women who were pregnant or in labor or delivered or aborted; up to 42 days from termination of pregnancy, admitted and labelled as Maternal Near Miss. Results: In present hospital-based study, 220 near-missed cases were studied. Most of the patients are from the age group of 20-24 years (45.9 %), followed by 25-29 years (29.09 %) & 30-34 years (9.54 %). Majority of near-miss cases belonged to rural area (59.09%), were housewives (41.81 %), belonged to class III of socioeconomic class (29.09 %), were illiterate (55.90 %). Of 220 cases, 197 were registered (89.54 %), 95% of patients were immunized. Majority cases were referred from other hospitals (53.63 %) & were admitted in the antepartum period (87%). Majority cases were primigravida (40.9 %) followed by gravida two (20.45 %) & gravida three cases (19.09 %). 202 cases (91%) were delivered at a tertiary centre of which many were referred in antenatal period for high-risk management. 128 cases (58.18%) underwent LSCS, 88 cases (40%) delivered vaginally. Hypertensive disorders of pregnancy (53.18 %) contributed to the majority of near-miss cases, followed by anemia (19.09 %), heart disease (9.09 %), abruptio placentae (6.36 %) & respiratory disease (5.45 %). In 52% of near-miss cases, vascular and hematological dysfunction. Conclusion: Present study noted pregnant women from rural area, from lower socioeconomic class, low literacy were common among near miss cases.

Background: This study explores the landscape of maternal health and its impact on neonatal outcomes, focusing on the prevalence of diverse pregnancy-related complications. Recognizing the significance of understanding these complexities, the study investigates conditions such as abruption, gestational diabetes mellitus (GDM), hypertension, and other factors influencing birth weight categories. Objective: To contribute nuanced insights to maternal and neonatal healthcare practices. Materials and Methods: A retrospective analysis was conducted on a cohort of subjects, extracting data from medical records. The study encompassed various pregnancy-related complications, including abruption, GDM, hypertensive disorders, fetal growth restrictions, and other maternal conditions. Statistical analyses, including percentages and prevalence rates, were employed to elucidate the distribution of these complications within the studied population. Results: The findings reveal a diverse spectrum of maternal health conditions. Notable observations include the prevalence of GDM (8.2%), hypertensive disorders (6.6%), and post-term pregnancies (11.5%). Additionally, conditions such as abruption, fetal growth restriction, and preterm births exhibited varying frequencies. Rh-negative pregnancies accounted for 9.8%, emphasizing the multifaceted nature of maternal health complexities within the studied population. Conclusion: This study provides a comprehensive overview of pregnancy-related complications and their prevalence within the studied cohort. The findings underscore the need for personalized antenatal care strategies, early anomaly detection, and focused interventions to optimize maternal and neonatal outcomes. Recognizing the intricate relationships between maternal health conditions and birth outcomes is crucial for informing clinical decision-making and enhancing public health initiatives.

Background: Gestational diabetes mellitus is a condition in pregnancy where adverseperinatal outcomes in mother occurs.Effect of longstanding diabetesmellitus on adult heart might lead to dysfunction and diabeticcardiomyopathy. Microvascular processes and subcellular disturbancescause structural and functional damage to the diabetic heart, even without overt coronary artery disease.GDM patients might have impaired cardiacfunctions compared to healthy pregnant women. Objective: In view of this, this study was undertaken to assess the Maternal cardiac adaptation of women at term with and without GDM. Methods: A prospective study was conducted among 60 pregnant women, 30 with GDM and 30 without GDMduring2022 to2023admitted inthe department of obstetrics and gynaecology at Adichunchanagiri Institute of Medical Sciences, B.G Nagara, Karnataka. Results: There was no statistically significant difference in echocardiogenic findings of both groups. Results revealed that echocardiogenic parameters, including normal heart rate, left ventricular relative wall thickness, LV late diastolic transmitral valve velocity, Ejection fraction >60%,Pulmonary artery systolic pressure,IVC findings,regionalwall motion abnormality are normal.These findings suggest that diabetesdonot appear to have impact on echocardiac measures compared to normalANC women. Conclusion: These results suggest that during pregnancy the presence ofgestational diabetes maynot impact cardiac function compared to normalantenatal women. 

Background : Stomach carcinoma, the second most prevalent malignancy in Asia, poses a substantial global public health challenge. Gastric adenocarcinoma, comprising over 90% of cases, necessitates optimal treatment modalities, primarily RO resection, to achieve locoregional control. Lymph node metastasis, the primary mode of spread, underscores the importance of meticulous lymphadenectomy. The Japanese Gastric Cancer Association (JGCA) guidelines delineate the critical role of D2 lymphadenectomy in staging and controlling gastric carcinoma. Methodology: This retrospective study, conducted at SCB Medical College & Hospital, assesses the necessity of routine D2 lymphadenectomy in operable cases of gastric carcinoma. Forty-six patients meeting specific criteria underwent detailed workup, including hematological and radiological evaluations. Operable cases underwent gastric resection with D2 lymphadenectomy, targeting a minimum of 16 lymph nodes. Extended resections and palliative procedures were performed as needed. Results: The study comprised 46 patients (56% male, 44% female), aged 55-65 years. Clinical presentations included dyspepsia (63%), weight loss (54.3%), and less common symptoms. Antral growth was predominant (54.3%). Operable cases (87%) underwent successful D2 lymphadenectomy with minimal complications (4% pulmonary complications, 6% wound infections). The majority were stage II and III (77.5%). Two-year follow-up indicated a 5% mortality and recurrence rate. Discussion: Surgical intervention, particularly D2 lymphadenectomy, remains the most effective therapeutic option for gastric carcinoma. Our study aligns with JGCA guidelines, emphasizing the importance of D2 lymphadenectomy in achieving locoregional control. The inadequacy of D1 lymphadenectomy is evident, highlighting the significance of removing an adequate number of lymph nodes. Despite concerns, evidence suggests that the current form of D2 lymphadenectomy is not more hazardous than D1, and maximal lymph node removal correlates with improved long-term survival. Conclusion: Our study underscores the critical role of D2 lymphadenectomy in achieving optimal locoregional control and improving overall survival in gastric carcinoma. The meticulous removal of an adequate number of lymph nodes is imperative, emphasizing adherence to established guidelines for lymphadenectomy.

Introduction: Some congenital defects can be prevented in the pregestational stage. However, many health professionals are not prepared to provide counselling to couples regarding the same. Aims: To assess the awareness of health care professionals about congenital anomalies and pre-conception car. Materials and Methods: It is a cross-sectional study that was conducted online for a duration of 6 months. Data was collected using a pretested and structured questionnaire on basics of congenital anomalies & pre-conception care, which was shared through google forms in social media. Purposive sampling was adopted. Results: Our studied group included 246 participants. The mean score for awareness of congenital anomalies was 9.7±1.6, with median score of 10 (9-11). The mean score for awareness score of pre-conception care was 8.3±1.6, with median of 9 (7-10). About 90% knew exactly what constitutes congenital anomalies but only 22.3% knew that >70% of these congenital anomalies are preventable. Only 50% of participants knew that causes are not known, only risk factors are identified. 90% believe that consanguineous marriages are one of the causes of congenital anomalies which is false. 50% knew the timing of different screening tests done during pregnancy to detect congenital/fetal anomalies. 80 - 90% knew that Periconceptional care is needed for both men & women irrespective of their health status and <50% knew that it should be considered not only before conception, but also in planning for family, contraception. Even though more than 90% knew about few components of PCC, more than 50% are not aware of the dosage of Folic acid. Conclusions: Awareness among doctors (irrespective of gender, education qualification or profession) about congenital anomalies and PCC is good in some important respects (like all antenatally detected anomalies need not be terminated) and poor in basic aspects like aetiology, prevention and detection of congenital anomalies, indications of PCC.

Background- Effective pain relief and minimum motor block are the necessary constituents of an ideal epidural block. Fentanyl is a lipophilic opioid most commonly used as an adjuvant to local anaesthetic. Ropivacaine is an alternative to bupivacaine, with greater sensitivity for sensory fibres than motor fibres, thus producing less motor blockade than bupivacaine. This study assessed the analgesic effect of very low dose fentanyl (1mcg/ml) as an adjuvant to either ropivacaine or bupivacaine. without compromising its beneficial effects and avoiding the undesired side effects. AIM- To study the effect of fentanyl as an adjuvant to bupivacaine and ropivacaine in epidural analgesia for laboringparturient. Method- 44 nulliparous labouring parturients of ASA I & II at term with singleton pregnancy of vertex presentation without any obstetric complication were randomly allocated into two groups of 22 each. Group B received bupivacaine 0.125% with fentanyl 1 mcg/ml bolus dose till VAS<3. Similarly, Group R received ropivacaine 0.125% with fentanyl 1 mcg/ml. Analgesia was maintained with intermittent bolus of study solution. Analgesic efficacy was measured in terms of duration of analgesia, onset of analgesia, highest level of sensory block, motor block, side effects if any; obstetric and neonatal outcomes were also recorded. Results- There was no significant difference between the two groups in terms of duration of analgesia, level of sensory block achieved, time required to achieve level of sensory block, motor block or side effect profile. There were minimal side effects and neonatal outcomes were good. Obstetric outcomes and maternal satisfaction level was also comparable between the two groups. Conclusion- Fentanyl when used in a low dose of 1 mcg/ml with equal concentration of two local anaesthetic bupivacaine and ropivacaine provides good analgesia in all stages of labour avoiding the side effects of opioids.

Transplantation is a surgical procedure in which the organs or the tissues or the cells are removed from one person who is called as the donor, are surgically transplanted in the other person who is called as the recipient. When an organ gets transplanted, it is called organ transplantation. It is the procedure which also impacts the recipients with oral and dental manifestations. Material and Methods: Major databases such as Medline were explored detailed literature search in resulting in a systematic review pertaining to link between oral and maxillofacial pathology and organ transplantation. Results: Five original research scientific articles dated between 2020 – 2024  pertaining to mentioned topic were highlighted.  Conclusions: Many recipients may complain that there may be any mucosal infections or lesions. So, the dentists along with transplantation professionals should identify, diagnose and treat the oral and maxillofacial manifestations as early as possible. Detailed information regarding the manifesations of oral and maxillofacial pathology and organ transplantation is discussed in this systematic review.

Background: Acute kidney injury (AKI) is a common complication following coronary artery bypass grafting (CABG) surgery, particularly in older patients. The use of cardiopulmonary bypass (CPB) during CABG has been associated with an increased risk of AKI. Additionally, the type and volume of intravenous fluids administered during surgery may influence the occurrence of AKI. However, the impact of these factors on AKI in older patients undergoing CABG remains unclear. Method: This observational study conducted at a tertiary care center focused on patients undergoing coronary artery bypass grafting (CABG) surgery over an 18-month period. Included were adult patients aged 41 to 70, of any gender, diagnosed with triple vessel, double vessel, or single vessel illness, scheduled for on-pump CABG surgery, and classified as American Society of Anesthesiologists (ASA) II and III physical status. Exclusions comprised patients with specific preoperative serum creatinine levels, those below 40 or above 70 years, pre-existing kidney conditions, pregnancy, and unwillingness to participate. Result: The study included 58 participants with a mean age of 62.18 ± 8.01 years, predominantly male (76.7%). Among them, 42.2% experienced AKI postoperatively, with the majority classified as Stage 1 (37.1%). Serum creatinine levels showed a slight increase at 24 hours post-operation and a subsequent decrease at 48 hours. There was no significant association between AKI and age, gender, comorbidities, or intraoperative parameters including CPB duration and fluid administration. Conclusion: The study findings suggest that older patients undergoing on-pump CABG are at increased risk of AKI, with chloride-rich fluids being an independent predictor. However, AKI was not associated with negative outcomes or mortality in this population. Further research is needed to explore strategies for mitigating AKI in older CABG patients, including optimizing fluid management and considering alternative surgical techniques.

Background: Thyroid dysfunction during pregnancy is associated with adverse outcomes for both mother and child. This study aimed to investigate the prevalence of thyroid dysfunction among pregnant women and its correlation with obstetric outcomes and risk factors.Methods: A prospective observational study was conducted on 500 pregnant women. Thyroid function tests were performed at enrollment and during each trimester. Data on obstetric outcomes and compliance with treatment were collected. Results: The prevalence of thyroid dysfunction was 5.0%, with hypothyroidism (2.0%), hyperthyroidism (1.0%), subclinical hypothyroidism (1.6%), and subclinical hyperthyroidism (0.4%). No significant association was found between thyroid dysfunction and adverse obstetric outcomes such as preterm birth (20% vs. 9%, OR 2.5, p=0.08) and low birth weight (16% vs. 8%, OR 2.1, p=0.18). Age over 30 years (OR 2.0, p=0.02) and a family history of thyroid disease (OR 3.5, p=0.001) were significant risk factors. Followup results showed a progressive worsening of thyroid function during pregnancy. High compliance with levothyroxine treatment was observed (80%). Conclusion: While the prevalence of thyroid dysfunction in this cohort is in line with global rates, the study highlights the critical need for routine monitoring and management of thyroid function in pregnancy. The findings also emphasize the role of specific risk factors in identifying women at higher risk for thyroid dysfunction.

Background: The escalating global rates of cesarean sections (CS) have raised concerns regarding maternal and neonatal outcomes. While CS can be life-saving, their overuse poses significant risks, necessitating a careful balance between benefits and risks. In India, regional disparities and socioeconomic factors contribute to varying CS rates, highlighting the need for context-specific interventions. Objective: This study aimed to investigate the patterns of CS utilization and associated factors in the Central Vindhya region, with a focus on identifying clinically relevant groups contributing most to CS deliveries.Methods: A cross-sectional study was conducted at the Department of Obstetrics and Gynaecology, S.S. Medical College, Rewa, Madhya Pradesh, India. Data were collected retrospectively from hospital records of 7,484 women who underwent CS over a specified 3-year period. Robson's classification system was used to categorize CS cases into ten groups based on pregnancy characteristics, obstetric history, labor progression, and gestational age. Results: The overall CS rate was 28.18%, with multiparous women with prior cesarean sections (Robson's group 5) constituting the largest proportion of CS cases (32.58%). Nulliparous women in spontaneous labor (group 1) and those with induced labor or cesarean before labor (group 2) also contributed significantly to CS rates. Indications for CS included previous cesarean section (32.57%), fetal distress (16.56%), and meconium-stained liquor (19.2%). Conclusion: This study provides valuable insights into CS utilization patterns and associated factors in the Central Vindhya region. The findings underscore the importance of context-specific interventions to optimize CS utilization while ensuring maternal and neonatal safety. Further research is warranted to explore effective strategies for reducing CS rates and improving maternal health outcomes in resource-limited settings.

Objective: To determine association of cervical dialatation rate with body mass index (BMI). Introduction: The prevalence of overweight and obesity is increasing among women of childbearing age. Observational studies show that obese women have up to a 2-fold increased risk for a cesarean delivery compared with normal-weight women. The purpose of this study was to examine the effect of maternal overweight and obesity on the pattern of labor progression in pregnant women with a singleton, term pregnancy with spontaneous onset labour. Methods: We analyzed data from 1531 pregnant women with a term pregnancy those were admitted in SSMC ,Rewa from August 2017- July 2018 with spontaneous onset labour pain at term. The median duration of labor by each centimeter of cervical dilation was computed for under weight(Body mass index BMI<18.5 kg/m2), normal-weight (BMI_ 18.5 –24.9 kg/m2), overweight (BMI >24.9-29.9 kg/m2), and obese (BMI>30 kg/m2) women and used as a measurement of labor progression. Results: After considering inclusion and exclusion criteria all laboring females were allowed to progress naturally and four hourly partogram was recorded. All females who required augmentation ,caesarean or instrumental delivery were excluded from the study. On the basis of individual labour progress chart which were obtained ,a final composite labour graph was derived and appropriate statistical tests were applied. We have found that BMI is directly related to rate of cervical dilatation . Mean rate of cervical dilatation was 1.46 cm/hr in group with BMI <18.5 kg/m2 .The rate of cervical dilatation was less in group with BMI >30 i.e 0.9 cm/hr. Conclusion: . Labor progression in overweight and obese women was significantly slower than that of normal-weight and under- weight women. Given that NFHS (National family health survey -5)¹ has shown that obesity is increasing in India in all states from 21% to 24% among women, it is critical to consider differences in labor progression by maternal pre pregnancy BMI before additional interventions are performed.

Background:   Tertiary healthcare centres play a pivotal role in managing high-risk pregnancies, with referred cases presenting unique challenges and outcomes. Methods: This prospective observational study analyzed 275 referred cases among 4972 deliveries over 18 months, examining demographics, reasons for referral, delivery, and neonatal outcomes.  Results:   Most referrals involved women aged 21-30 (62.2%) from lower socioeconomic statuses. Common referral reasons included PROM (20.4%) and gestational hypertension (17.5%). Delivery outcomes were predominantly normal vaginal deliveries (53.5%) and caesarean sections (44.3%). Neonatal outcomes highlighted a 23.6% NICU admission rate, with respiratory distress and low birth weight being the leading causes. The study also noted stillbirths (2.2%) and neonatal mortality (1.8%). Conclusion:   The study reaffirms the essential role of tertiary centers in handling complex referrals, highlighting the influence of socioeconomic status on maternal health and the challenges in improving neonatal outcomes. It emphasizes the need for targeted prenatal care and streamlined referral systems.

Introduction: Foetal growth restriction (FGR), is a condition that occurs due to various reasons.It is an important cause of foetal and neonatal morbidity and mortality. It has been defined as a rate of foetal growth that is less than the growth potential of that specific infantor as having birth weight less than two standard deviations below the mean or less than the 10th percentile of a population-specific birth weight for specific gestational age.  It has been found to be associated with a variety of adverse perinatal outcomes.These infants have many acute neonatal problems that include perinatal asphyxia, hypothermia, hypoglycaemia, polycythaemiaetc. The likely long-term complications that are prone to develop when FGR infants grow up includes growth retardation, major and subtle neurodevelopmental handicaps etc. Methods: This cross-sectional study included all growth restricted babies born in the department of Obstetrics and Gynecology at Government Medical College, IMCH Kozhikodeduring the study period and their mothers.   Multiple pregnancy with growth restriction were excluded from the study. Babies born outside IMCH but being referred to IMCH were also excluded. Socio –demographic and fetomaternal characteristics were collected after getting consent. Maternal data regarding socio-demographic variables including age, domicile (rural/ urban), socio-economic status, data regarding gestational age, nature of ANC, past obstetric history including parity. Results: Perinatal mortality rate was 64.2/1000 in growth restricted babies born to normotensive mother group.  The stillbirth rate was 36.6/1000 in growth restricted babies born to normotensive mother group. Fetal growthrestriction occurred more in rural womencompared to urban women. Women below poverty line had more fetal growth restriction compared to the women above poverty line and the difference was statistically significant. Early neonatal mortality rate was 28/1000 live IUGR babies in normotensive group. Conclusion: Mothers belonging to low socio-economic status have high risk of delivering babies with growth restriction. This is because of inadequate dietary intake, increased physical activity, passive smoking, increased rate of infections and low educational levels leading to decreased awareness regarding health care facilities. 

Background: Cardiac disease in pregnancy is considered to be an important cause of maternal morbidity and mortality. Cardiac disease complicates 1-3% of all pregnancies and considered as leading cause of indirect maternal deaths. Cardiac disease in pregnancy is considered to be high risk and management of it in pregnancy is challenging. Aim: To evaluate fetomaternal outcome in cardiac disease complicating pregnancy. Objectives: To evaluate fetal and maternal outcome in pregnancy with cardiac disease. To measure the prevalence of cardiac disease in pregnancy. Materials & Methods: A retrospective observational study of all women who delivered at a tertiary care centre from 2011 to 2018 with heart disease complicating pregnancy were included in the study. Their details were collected from the case record and registers, using data collection proforma. The outcomes were studied. Results: The prevalence of cardiac disease was found to be 0.66%. Most common heart disease in pregnancy was found to Rhematic heart disease (72%). Among them the most common heart disease was found to be mitral stenosis (35%). Conclusion: Cardiac disease is a high risk pregnancy and has major effect on fetal and maternal outcome morbidity and mortality in pregnancy. Hence proper antenatal monitoring, involvement of multidisciplinary team and delivery in a tertiary care setup with ICU and Cardiac care facilities will definitely improve the fetal and maternal outcomes in cardiac disease complicating pregnancy.

Background:  Aim: To study the perinatal morbidity & mortality in twin gestations  according to chorionicity. Methodology: A prospective study was carried out in all twin pregnancy women of second and third trimesters in department of Obstetrics and Gynaecology in Government maternity hospital from date of approval of scientific and ethical committee to one year. Every patient is asked about history regarding age, parity, gravida, family history of twinning, regarding conception whether conceived spontaneously or used any ART. Results: Among 200 twin pregnancies, Primigravidas constituted for 43% of pregnancies and multigravidas constituted for 57% of pregnancies. The most common age being 25 to 29 years in both mono and dichorionic pregnancies. Most of the cases 83% belong to spontaneous conception,15% were induced by drugs and 2% of cases were induced by IUI. Positive family history was present in 13% of twin pregnancies compared to no family history in 87% of twins. 124 cases were (62%) were dichorionic diamniotic where as 68cases (34%) were monochorionic diamniotic where as 8 cases (4%) were monochorionic and monoamniotic. Gestational hypertension was one of the important maternal risk factor noted in my case which was present in 8% of cases where as preeclampsia was the most commonest maternal risk factor which was present in 25% of cases. Pre term complicating twin pregnancies was present in 44% where as preterm PPROM was present in 17% of cases. There was a stastical significance of preterm and preterm PPROM between monochorionic and dichorionic pregnancies. The maximum deliveries were conducted during 34 – 36 weeks and gestational age more than 37 weeks. Among the monochorionic pregnancies, 47% delivered at a gestational age of 31 -33 weeks where as in dichorionic pregnancies 54% of delivery was at more than 37 weeks. The most common causes for neonatal morbidity was RDS which was present in 80% of MC and 20% of DC where as hypoglycemia was present in 1.6 % of DC pregnancies. Neonatal mortality was found in 15cases(19.73%) in MCDA and MCMA where as 9 cases (8%) of DC. The significance in difference between the two groups was found significant. Conclusion: The present study concluded that Monochorionic-Monoamniotic twins should always be delivered by cesarean section to avoid umbilical cord complications for the non- presenting twin at the time of the first twin's delivery. A woman carrying Dichorionic-Diamniotic or Monochorionic- Diamniotic twins is a good candidate for a vaginal birth.

Background: To assess MEOWS Score (parameters &triggering factors) in pregnant & postpartum women. To measure outcome in terms of morbidity in MEOWS charted pregnant and postpartum women. Materials & Methods : A prospective study was conducted from May 2021- May 2022 .The study comprised of 300 pregnant women greater than 28 weeks upto 6 weeks post partum admitted to labor ward. After taking informed consent from pregnant women and postpartum mothers admitted to labour room, their name, age, occupation residence was recorded, clinical examination was done, vitals were recorded, general and specific investigations were done. MEOWS parameters were measured and an individual score was given and each parameter added to obtain a combined MEOWS score and patients were assigned to triggered and non-triggered groups. These triggered and the non-triggered women were followed and evaluated for obstetric morbidity and fetal outcome. Statistical software SPSS (version 22.0) was used for data presentation and statistical analysis. Continuous Data was presented as mean +/- standard deviation, categorical data was displayed in the form of percentage and analysed by Chi-square test. Performance of MEOWS chart as a screening tool was evaluated by calculating its sensitivity, specificity and predictive values. A p-value of<0.05 was considered as significant. Results: Hypertensive disorder of pregnancy was the most common (21.9%) obstetric morbidity followed by anemia (16.35%). The MEOWS score in this study had a sensitivity of 0.8806 and a specificity of 0.8069. The positive and negative predictive values of the MEOWS tool to predict obstetric morbidity were 0.5673 and 0.9592 respectively. Conclusion: The MEOWS is a sensitive and specific tool to predict obstetric morbidity with a high positive predictive value

Conclusion: The present study stated that, vaginal mode of delivery is not always a completely safe option but may be considered as a safe mode for babies in breech as long as the selection criteria is fulfilled and delivery is done by a skilled and trained   obstetrician with continuous fetal monitoring. Therefore, it is concluded that a balanced decision to be taken about the mode of delivery on a case by case basis as it differs from case to case and gestational age as well as training of assisted breech delivery will go on a long term basis to optimise the outcome of breech presentation.

ntroduction: Women seek abortions for a number of reasons, including birth control. An unintended pregnancy puts a woman at danger; if she wants an abortion, safe services are not readily available to her. In India, septic abortion is largely caused by a lack 
of knowledge about the MTP Act and contraception, as well as a shortage of medical professionals with the necessary training. The purpose of the current study was to assess  people's knowledge, attitudes, and behaviours about septic abortion and the factors that are related to it. Materials and Methods:Through straightforward randomization, a total of 100 individuals who had septic abortions were chosen to be a part of the research. Interviews were used to learn more about these cases' knowledge, attitudes, and behaviours about septic abortion as well as other relevant aspects. The findings were examined and statistically examined. Result: Of the 100 instances examined, 46% of the participants lacked awareness regarding contraceptive devices. Compared to women living in towns, rural women knew less about contraception. The majority of cases learned about contraception from the media and medical professionals, such as radio (22.22%), PHC (22.22%), television (18.52%), and ASHA/ANM (18.52%). Women in urban areas were more knowledgeable with the MPT Act than those in rural areas, and 52% of abortions were performed by dais. Of the 100 instances that were examined, 60 cases (or 60%) involved the use of instruments to achieve a septic abortion.Conclusion:The current study demonstrates that a major contributing factor to the high rate of septic abortion in India is the lack of awareness among rural women 
on contraception and the MTP Act, as well as the abortions performed by unskilled individuals such as dais, quacks, and local practitioners. Therefore, in order to provide comprehensive and safe abortion services as well as higher quality abortion services, the health system must be strengthened.

Background: There are various hematological malignancies with leukemia being most common amongst all. This study is aimed at studying prevalence and morphological analysis of various hematological malignancies over a period of 2 years at a tertiary care centre(P.D.U Medical College) with main emphasis on leukemia as it is the most common hematological malignancy in our set up. Methods: A prospective observational study was done over a period of 2 years from July 2019 to June 2021 and 200 cases were taken with high total white blood cell count and peripheral smears were examined with bone marrow examination as and when required and in most cases diagnosis was leukemia.Results: The most common hematological malignancy identified was leukemia in our tertiary care centre. Various classifications were made on the basis of age, gender , platelet count ,total white blood cell count ,hemoglobin .Various subtypes of leukemia were identified and classification was also done on the basis of requirement of bone marrow examination .Age had significant association with certain type of leukemia common in certain age. Conclusions : It was identified that most common hematological malignancy identified was leukemia. In children most common was acute lymphoblastic leukemia(ALL). In elderly it is acute myeloid leukemia(AML) and in older persons it is chronic myeloid leukemia(CML)and chronic lymphoid leukemia(CLL) .Overall most common type of leukemia is chronic myeloid leukemia. In children females had slightly higher incidence over males and otherwise overall males have higher incidence than females. Overall total white blood cell count was above 50,000 cells/cumm in most of the cases

Background : Recurrent pregnancy loss (RPL) affects about 5%ofwomen. Hyper homo cysteinemia, have been implicated in several pathologic processes in the venous and arterial vascular systems. Hyper homo cysteinemia is associated with many pregnancy related complication like with deep venous thrombosis, recurrent miscarriage, abruptio placenta, preeclampsia, neural tubede fects, and fetal grow threstriction. The objective of this study to assess the prevalence of Hyper homo cysteinemia in patients with unexplained recurrent pregnancy loss. Objective: To study the levels of maternal serum homocysteine in pregnant women with2 or more consecutive miscarriages and compare with control group. Methods:100 Patients of unexplained recurrent pregnancy loss were selected as cases and 100 patients with at least one successful pregnancy were taken as controls. Serum homocysteine levels were assessed in both the study groups. Results: Out of the 100 patients who were assessed, 17% of RPL patients had hyperhomocysteinemia.17 patients out of the 100 cases had hyper homo cysteinemia. Hyper homo cysteinemia was thrice more commonin Primary aborters when compared to secondary aborters. Conclusions: Hyper homo cysteinemia is associated with recurrent pregnancy loss 

In tropical and subtropical regions of the world, dengue fever is an arboviral public health emergency that affects a sizable endemic population and presents with differing degrees of clinical manifestation. This investigation looked at the dynamics of the four dengue serotypes in the laboratory and hospitals. Methods: This hospital-based observational study involved 100 inpatients with dengue infection who were over 12 years old, free of co-morbidities, and had no known malignancy at a tertiary care facility. Results: Four of the 100 patients had two serotypes of infection simultaneously. Dengue virus serotype-2 (DENV 2) was found in 34% of cases and accounted for the highest number of cases of severe dengue (20.6%). There was no difference in the mean total leukocyte count between the serotypes. With a greater percentage of cases of severe dengue (20% vs. 14.3%, nonsignificant), DENV 4 had a substantially higher mean neutrophil percentage and a significantly lower mean lymphocyte percentage than DENV 1 (p-value 0.001 and 0.02, respectively). Thrombocytopenia was observed in every infection serotype. When comparing DENV 2, 3, and 4 to DENV 1, there was a noticeable difference in the impairment of liver function. Infections with DENV 3 and 4 were associated with considerably reduced mean serum albumin levels. Co-infection cases showed lower mean serum albumin and a substantially greater deviation in liver function than infections with a single serotype. Both the mean blood creatinine and urea levels were within the normal limit for all serotypes. In our study, there was no death. Conclusion: In our hospital, the most prevalent serotype with the highest severity is DENV 2. Severe dengue cases are prevalent in DENV 2 and DENV 4, with rates of 20.6% and 20%, respectively. In DENV 4, there was a greater degree of hepatic involvement and hypoalbuminemia, but the mean lymphocyte percentage was much lower. Initial serotyping in dengue patients can be used to 
determine the clinical and laboratory trends of the various dengue infection serotypes as well as to track epidemiological trends. Patients who have co-infections require special attention. 

Objective: - To study CP ratio & its correlation with feto -maternal outcome. Methods: - This was a prospective observational study done in Department of Obstetrics and Gynaecology, MGM Medical college, Indore, over a period of one year. Women > 37-week singleton pregnancy with no known risk factor who had Doppler USG done at the time of labor were included. CPR was calculated by dividing the Doppler indices of middle cerebral artery (MCA) by umbilical artery (MCA PI/UA PI). CPR < 1 was taken as abnormal. Results: - Out of 150 low risk term pregnancy who went for USG colour doppler Scan, 14 (9%) patients were having CPR <1 and 136 (90.6%) were having CPR >1. Among 14 patient with CPR <1 , 10 (71%) were delivered by caesarean section as compared to only 6 (4.41%) patients with CPR >1.  Among 14 patient with CPR <1 , 13 (92.86%) had adverse outcome as compared to only 11.76% patients with CPR >1. Conclusion: - Our study found CPR measure to be a very promising tool for optimising the identifcation of at-risk foetus in low-risk AGA pregnancies.

Introduction: Pregnancy is an incredibly stressful period due to outcome of delivery, anxious about the well-being of the unborn child, added responsibilities once the child is born, financial obligations, adapting to her postpartum body, interpersonal relationships with her spouse and other family members. Aim & Objectives: 1. To determine whether higher anxiety levels in term patients has significant effects on the duration, progress and complications of labour, 2.To assess whether significant maternal anxiety can lead to an increase in caesarean sections or instrumental deliveries, 3.To assess the difference in anxiety levels between term primigravida and term multigravida. Methodology: The study was a descriptive cross-sectional study conducted in the Department of Obstetrics and Gynecology in IGMC&RI.  Antenatal women in the low-risk group with gestational age more than or equal to 37 weeks, who gave consent for participation were included in the study. Antenatal women who refused to give consent or those with known co-morbidities complicating labour like gestational diabetes mellitus, pregnancy induced hypertension, multiple gestation, breech presentation, placental abnormalities like placenta previa or abruption, previous history of caesarean section and cephalo - pelvic disproportion were excluded. Results: The demographic details of the participants are shown in Table 1. Out of the 269 participants analysed for the study, Majority of them were housewives, belonged to the age group of 25-30 years (40%). Majority were graduates (49%) and pregnant for the first time (primi) (56.1%). Conclusion: The significance of this study is that maternal anxiety was found positive in about 105 patients, among which 19 participants had severe anxiety. These anxiety scores if known during the antenatal chechups can help in interventions for the betterment of maternal health including guidance and counselling

Aims: To study of acute kidney injury in Antenatal mothers secondary to hypertensive disorders and Early detection to prevent the serious complications, Maternal morbidity and mortality and improve the perinatal outcome by early detection and treatment. Materials and methods: A hospital based prospective observational study was conducted in the Department of Obstetrics and gynaecology. Subjects were included in the study after written informed consent and data was collected by using pre structured questionnaire. Thorough obstetric, medical and surgical history was taken. the subjects were analysed for the following parameters. Results: 56% were antenatal presentations. Distribution of gravida shows that 56% had 2, 14% had 3, and 20% had 10% gravida. Induced delivery (48%) and Emergency LSCS (38%) were the main modes of pregnancy termination. 82% had medical treatment, 7% had ventilator support and 11% had dialysis. Nine patients died and 1 patient had chronic hypertension. 72% of the babies admitted to NICU, there were 32 fetal deaths and 1 abortion. Neonatal morbidity and mortality are very high because of AKI in pregnancy and with other complications. Pregnancy needs to be terminated immediately, irrespective of gestational age to prevent maternal complications and deaths. Mothers with hypertensive disorders who presented in early preterm (24-32 weeks) delivered babies with less than 1.5 kg and among them, 100% perinatal mortality is observed. For babies with>1.5 kg weight, most of them presented with intrauterine death due to abruption or fetal growth restriction. Conclusion: Knowledge of associated characteristics and outcomes presented in this study provides important prognostic information for patients, a framework for physicians to understand severe pregnancy- related AKI in the current era, and informed strategies to better identify women at risk. And also concluded from this study that prevention is always better than cure.

Systemic lupus erythematosus (SLE) presenting with cardiac tamponade is a rare cardiac manifestation, Candida pericardial effusion is a very rare entity in clinical settings especially in developing world where tuberculosis is the frequent cause of pericardial effusion, Fungal diseases suspicion arises in the setting of immune suppression like malignancy, diabetes, Steroid treatment and  HIV etc, Our case is one such rare event where a treatment naïve young female presented with cardiac tamponade in high disease activity of SLE with superimposed Candida infection.

Background: Lung cancer is one of the most frequent cancers and a major cause of cancer death worldwide. Lung cancer accounts for 11.6% of all new cancer cases identified each year and is quickly becoming the most prevalent fatal neoplastic disorder in the world, accounting for 18.4% of all cancer-related fatalities worldwide1. Objectives: 1. To study the clinical profile of newly diagnosed bronchogenic carcinoma patients. 2. To study the clinicopathological correlation among various histological types of bronchogenic carcinoma in the above patients. 3. To study the extrapulmonary manifestations and the prevalence of identifiable paraneoplastic syndromes (if present) in patients with bronchogenic carcinoma. MATERIAL & METHODS: Study Design: Prospective hospital-based observational study. Study area:  The study was conducted in the Department of Pulmonary Medicine, Government Medical College, Kadapa.  Study Period:  June 2023 – December 2023. Sample size: The study consisted of 52 subjects. Sampling method: Simple random Sampling Technique. Inclusion criteria: Patients attending hospital, diagnosed with bronchogenic carcinoma in the specified period. Study tools and Data collection procedure: Patients included in the study were selected according to the inclusion and exclusion criteria. After obtaining informed consent, data was gathered from history, objective examination of the patients and lab investigations using a semi-structured questionnaire. The localisation of the tumors was done by chest x-ray, fibre optic bronchoscopy and/or CT scan as required. Tissue diagnosis was obtained by FNAC/ biopsy or other cytology and histopathological examination of the specimen was carried out. The type pattern of paraneoplastic syndromes was noted. Results: COPD (65.38%) and Diabetes (23%) were the common co-morbidities affecting the study population followed by HTN (19.2%). H/O old PTB was noted in 11.5% of the patients and 1 patient (1.9%) had h/o ILD. 2(3.8%) patients had past h/o malignancy. One patient had h/o squamous cell carcinoma of the right ear another patient had cervical cancer and 1 (3.8%) patient had a family history of malignancy (first-degree relative). Conclusion: Lung cancer is a rapidly progressive disease with a very high mortality rate but treatment in the early stage may give a good prognosis. High-risk patients with having smoking history should be evaluated clinic radiologically with high suspicion so that early diagnosis can be made and the quality of life of patients can be improved. Primary lung cancer should always be suspected in a person presenting with unexplained cough for several weeks with other symptoms such as weight loss, and fever with non-resolving collapse-consolidation on chest radiograph.

Background: In India, about 3-4% of people are carriers of beta thalassemia. Sickle cell occurs in about 1 in 100 Indians. As per WHO at least 5.2% of the world population with 7% prevalence in pregnant women carries a variant of hemoglobin disorder. HbE is the most common hemoglobinopathy in north eastern states of India, with carrier frequency of around 50% in a hospital based study27. Objective: To follow up the maternal and fetal outcome of pregnancy with hemoglobinopathies. Methodology: A prospective observational study to evaluate the maternal and fetal outcome in pregnancy with hemoglobinopathies. Results: 78% of the patients had moderate anaemia. HbE disease comprising of 44.8 % was the most common hemoglobinopathy. 53 % of the patients underwent LSCS. The most common indication being fetal distress in first stage of labour (19.56%). 43 % of the patients had associated obstetrics complications with 23 % preterm delivery, 7 % FGR pregnancy, 4.59% hyperbilirubinemia, 9.1% PROM. 26 (29.8%) of babies were born with low birth weight. 22.9% of the babies were admitted in NICU. Among the pregnant women, 19.5 % had severe anaemia which needed blood transfusion. There was one maternal death due to postpartum haemorrhage. Conclusion: HbE disease comprising of 46 % was the most common among the hemoglobinopathies. Since the incidence of hemoglobinopathy is high in our region, routine Hb typing has to be done for Hb of < 8 g/dl.

Background: The COVID-19 pandemic had been uniquely challenging for the general as well as pregnant and postpartum women. Uncontrollable stress arising due to its high infectivity has exacerbated risk for maternal depression and anxiety, in turn leading to adverse mother and child outcomes. The aim of present study was therefore to assess the psychological responses of Covid 19 pandemic in pregnancy and post –partum women. Methods: The current study was a questionnaire based cross sectional study done for one year, in a tertiary care hospital of Northern India. After getting ethical clearance from university ethical committee a face-to-face interview using three scales namely Generalized Anxiety Disorder 7-Item Scale (GAD-7), Hamilton depression score (HAM-D), Fear ofcovid 19 scale was applied on 192 pregnant and and post –partum women who visited hospital and their response was assessed. Responses were calculated as scores as used in validated questionnaires and were categorized accordingly. Results: Responses of total 192 patients included in the study (cases/covid positive=96 and control/covi negative=96), it was found that overall anxiety was more prevalent in Covid positive group as compared to covid negative group with 53% of cases had severe anxiety. Hamilton depression scale used to assess depression showed that depression was also more prevalent in covid positive group as compared to covid negative group with distribution of Severe, and Very Severe depression in 26.04%, and 35.42% in case group respectively. Fear was more prevalent in case group as compared to covid negative group with the percentage distribution of mild and severe fear to be 20.83% and 79.17% in case and in control group the percentage distribution being 83.33% and 16.67%. This difference in the two groups was also found to be statistically significant. Conclusion: Anxiety, depression and fear was significantly more prevalent in the covid positive pregnant and post - partum women however control group was also not free from anxiety, depression and fear due to Covid 19.

Background: Complications of hypertension are the third leading cause of pregnancy relaed deaths, superseded only by hemorrhage and embolism. Pre-eclampsia is associated with increased potential risks of placental abruption, acute renal failure, cerebrovascular and cardiovascular complications, disseminated intravascular complication and maternal death. Consequently, early diagnosis of pre-eclampsia and close observation and timely drug intervention is needed. Labetalol is generally considered to be more effective than methyldopa for treating pre-eclampsia and pregnancy-induced hypertension (PIH) and Labetalol is quicker and more effective at controlling blood pressure and causes fewer side effects than methyldopa. Drowsiness is a common side effect of methyldopa. And also, Labetalol has a beneficial effect on renal function, ripening effect on the uterine cervix, decreases proteinuria/preeclampsia and decreases fetal/newborn death compared with methyldopa.1 Methyldopa is the medicine of choice for hypertensive conditions in pregnancy in several countries. Despite this, there is little proof of its safety in early pregnancy. So far, most methyldopa safety studies have focused on therapy during the second and third trimesters2,3,4. Thus this study was planned to know the efficacy of the two commonly used drugs comparatively in our set up. Research Question: What is the efficacy of the drugs Labetalol Vs Methyldopa on obstetric outcome in women with pre-eclampsia? The setting of the study was at department of Obstetrics and Gynaecology, Government Medical College, Machilipatnam. A one year observational study was conducted during the period from March ,2023 to February, 2024 on about 200 Pre-eclampsia patients admitted during the above period in the department of Obstetrics and Gynaecology by studying their socio-demographic profiles, type of hypertensive disorders, mode of delivery & preterm or term delivery, maternal complications and evaluation of efficacy of the drugs Labetalol and Methyl Dopa comparatively etc ; Results: The disease was more among the pregnant women  between 21-25 years of age group (49.5%) and the Mean age was 52 years and very few about 3% was observed among >31 years of age group. And most of them are primigravidae. And also, majority of the study subjects were belonging to low socioeconomic group & early marriages (adolescent marriages) were also high in number. There was a significant reduction of Blood Pressure noticed by both the drugs but the more significant reduction was seen among those treated by Labetalol. And also, significantly (P<0.05), about 32% of spontaneous vaginal deliveries happened with Labetalol users when compared to 20% among Methyldopa users & 25% induced deliveries with Labetalol as against 21% with Methyldopa and also significantly 43% LSCS with Labetalol as against 59% LSCS with Methyldopa but totally among both the groups LSCS was little bit more happened among the study subjects. Further it was observed that Preterm deliveries were only 23% with Labetalol as against 40% with Methyldopa which was highly significant (P >0.001). With reference to Birth weight LBW babies were more among Methyldopa users (55%) when compared Labetalol users (50%).

Introduction: Cardiac disease is a leading cause of maternal morbidity and mortality during pregnancy. Effective management strategies are crucial for improving outcomes in this high-risk population. Aim: This study aimed to evaluate the outcomes of pregnant women with cardiac disease managed at the Rajendra Institute of Medical Sciences (RIMS), Ranchi, to refine treatment protocols. Methods: A prospective cohort study was conducted over one year, enrolling 35 pregnant women with either congenital or acquired heart diseases. Participants underwent regular monitoring with echocardiography, and data were collected on maternal and perinatal outcomes, including delivery methods and postpartum complications. Results: The study highlights significant maternal and perinatal complications in pregnant women with cardiac disease, with anemia (31.4%) and preterm birth (25.7%) as prevalent issues. The findings underscore the need for careful monitoring and management tailored to the severity of cardiac dysfunction to improve outcomes for both mothers and newborns. Conclusion: Effective cardiac and obstetric management in a tertiary care setting allowed for predominantly vaginal deliveries and highlighted the importance of echocardiography in monitoring. Recommendation: Tailored antibiotic prophylaxis and comprehensive postpartum contraceptive counseling should be integrated into care protocols for pregnant women with cardiac disease

Background: In tropical countries like India, thrombocytopenia is commonly encountered by clinicians in any speciality. Thrombocytopenia present as asymptomatic condition to sometimes becomes a life-threatening condition requiring blood transfusion in various etiological conditions. Infections like malaria and dengue are invariably associated to thrombocytopenia with changing trends in clinical features. Infection is the commonest cause of thrombocytopenia. The objective of study was to evaluate the different causes of thrombocytopenia along with study of clinical profile and laboratory parameters in patients with thrombocytopenia. Methods: A cross-sectional hospital based study was conducted in Department of Medicine at Tertiary Care Hospital from April 2019 to October 2019. This study comprises cases of thrombocytopenia of age more than 14 years admitted with platelet count <1 lack/mm3, whereas patients with already diagnosed with causes associated with thrombocytopenia such as malignancy and chemotherapy induced thrombocytopenia, idiopathic thrombocytopenic purpura, cirrhosis of liver were excluded. Results: Study shows almost 46.6 % of total patients were below age of 30 years and 53.4% patients were above 30 years of age. The highest incidence of thrombocytopenia was seen in the age group of 21-30 years (26.6%), followed by 31-40 (25.8%) and 12-20 years (20%). The most common diseases that causes thrombocytopenia were infections (65.80%) [i.e. Dengue (31.67%), Malaria (25.0%), Enteric fever (3.33%), HIV (0.8%), and DIC (5.0%)]. Megaloblastic anaemia (18.33%) were common in younger population. Conclusion: Study concluded that most common causes of thrombocytopenia were infections (65.8%) and megaloblastic anemia (18.33%). Bleeding manifestations were present in 28.33% of patients and the most common site of bleeding was skin and mucous membrane. The main etiological cause of bleeding in this study was dengue hemorrhagic fever followed by malaria and megaloblastic anaemia

Background: Stillbirths constitute a major part of perinatal deaths. It is influenced by a wide range of maternal social and circumstantial factors. The study was done to find out the various factors associated with stillbirth in our hospital with the help of the existing ReCoDe System.  Materials And Methods: A cross-sectional observational study was conducted at the Department of Obstetrics and Gynaecology, Government Medical College, Thrissur by collecting data from all pregnant women who had during the study period of 12 months, i.e., from 1^stJanuary 2022.Data was then collected using a semi-structured interview after obtaining informed and signed consent. The questionnaire included general information, detailed clinical history. The relevant investigations, ultrasonography (growth parameters, liquor, biophysical profile, doppler parameters) were noted. After delivery, the stillborn baby Placenta, Umbilical cord and Amniotic fluid examined for any abnormalities. Results: Out of the134 cases of stillbirths during the study period of 12 months majority (52, 38.8%) were in the age group of 20 – 25 years, and 25 patients were included in the high-risk group in which 10 (7.5%) were below 20 years and 15 (11.2%) were above 35 years. Among the study participants, 51 (38.1%) were overweight and 27 (20.1%) were obese, 10 (7.5%) women had a Bad Obstetric History. There were 58 (43.3%) primigravida women. There were 4 (3.0%) women who were unbooked, while 20(14.9%) women had irregular antenatal care. 15 of the participants had maternal infection in the antenatal period of which 5 (3.7%) had viral and 10 (7.5%) had bacterial infection. 47(35.1%) patients had anemia in our study. A significant number of pregnant women (60, 44.8%) had gestational hypertension which was the most common cause leading to intra uterine fetal death. Gestational diabetes accounted for 49 (36.6%) of stillbirth in our study, 47 (35.1%) had hypothyroidism. IUGR was present in 51 (38.1%) of the study participants, and this was the second most common cause identified, resulting in stillbirth. Conclusion: Hypertensive Disorders of pregnancy was seen as the most common cause associated with intra uterine foetal demise. Intra uterine growth restriction and Gestational diabetes were the other important associated factors identified that led to stillbirth.

Introduction: Thyroid Imaging Reporting and Data System (TIRADS) categorizes thyroid nodules based on ultrasound characteristics that are associated with malignancy, aiding in clinical decision-making and helping to determine when FNAC is necessary. Present study was aimed to study High-Frequency Ultrasound (HFU) in evaluating thyroid nodules. Material and Methods: Present study was Observational Cross-Sectional study, conducted in patients of any age and gender with primary thyroid-related complaints, underwent ultrasonography of the thyroid gland. Based on these ultrasound features, the thyroid nodules were stratified into the appropriate Thyroid Imaging Reporting and Data System (TIRADS) categories.  Results: The present study has been undertaken in 100 patients presented with primary thyroid related complaints. Sonographic features such as a taller-than-wide shape, irregular margins, microlobulated margins, microcalcification, and marked hypoechogenic city are associated with an increased risk of thyroid malignancy. TIRADS category 3 nodules present a 0% risk of malignancy, while TIRADS category 5 nodules have a 100% risk of malignancy, indicating an increasing risk from TIRADS category 3 to TIRADS category 5. By categorizing nodules according to TIRADS, highly suspicious nodules (categories 4 and 5) can be promptly sampled with FNAC or managed surgically, while category 3 nodules should be monitored with follow-ups. Lesions categorized as TIRADS 2 do not require further investigation.  Conclusion: High-Frequency ultrasound is a reliable method for assessing the morphology of thyroid nodules. Using a standardized lexicon and categorizing findings according to TIRADS, improves the accuracy of identifying malignant lesions.

Introduction: Prolactin- oxytocin interplay is thought of as the key factor in lactogenesis and milk let down. Recent evidence suggests that glucose uptake in the phase 2 lactogenesis is mediated by insulin and its receptors. It is hypothesized that reduced glucose uptake due to insulin resistance is responsible for reduced lactogenesis and scanty milk production.  Aims: To observe if insulin resistance leads to reduced lactogenesis and delayed or non-lactation Methodology: 124 mothers (GrA 62mothers with delayed/non-lactation, GrB 62 patients with normal lactation) attending Lactation Clinic were included. Mothers with gross NAC abnormalities, infants with oral-anatomical problems, mother- child separation were excluded. Parameters checked to establish insulin-resistance are BMI, Waistline, BP, FBS-PPBS, HbA1c, Lipid profile, c-peptide, Prolactin. Delayed lactation and non-lactation are defined as non-initiation of lactation following 72hours or non-establishment respectively. Results: Non-lactation/delayed lactation is strongly associated with increased BMI (p<0.0001), increased waistline (p<0.0001), raised systolic-diastolic BP(p<0.0089, <0.0027), raised FBS-PPBS (p<0.0364,<0.0045), raised HbA1c(p<<0.0001), raised S-triglycerides (p<0.0035), but not associated with increased age, with S-cholesterol, S-LDL/S-VLDL/S-HDL, c-peptide, S-prolactin.  Discussion: The study confirms the role of insulin on lactogenesis function of mammary glands. Mothers with insulin-resistance are prone to lactation failure. To plan public health strategies to achieve “universal breast-feeding goal” as stated by WHO. All mothers must be evaluated in the first trimester of pregnancy and immediately post-partum with special reference to insulin resistance so that prediction of lactation failure can be made, and appropriate therapeutic strategy can be planned.

Since the description of PRES in 1996 by Hinchey et al, its being increasingly recognized and reported. With increased facilities like neuroimaging, it is animportant differential in the spectrum ofhypertensive encephalopathy. We retrospectively analyzed 5 cases of PRES in our ICU over a period of 1 year. Demographic parameters, presentations, etiologies, radiological findings including outcome was studied. Most common aetiologies were pregnancy induced eclampsia and immunosuppressant’s. ICU admissions were for uncontrolled hypertension, seizures, and low level of consciousness. Two patients were ventilated for airway protection.  One patient had a complicated course and developed septicaemia and TTP. Two patients with renal involvement with PRES required hemodialysis. All patients recovered, none had residual neurological deficits. Given its diverse presentation from headache, blurring of vision to seizures and coma. Increased awareness with high degree of suspicion is the key for early identification and management of this nearly reversible condition.

Background: Over the past few decades there is an increase in the prevalence of diabetes mellitus (DM) and is associated with a number of complications. Glycosylated Hemoglobin (HbA1C) is used as the “gold standard” for measuring the glycemic control and is also used as predictor of diabetic complications. HbA1c levels is not only affected by the blood glucose levels alone. They are also changed in conditions like blood loss, hemolytic anaemia, pregnancy, chronic kidney diseases, vitamin B12 deficiency anaemia, splenectomy, hyperbilirubinemia, alcoholism and iron deficiency anaemia. As per WHO, iron deficiency is the commonest out of all deficiency diseases worldwide. Anemia is cited as a major confounding factor in the measurement of HbA1C. It was shown by few studies that patients with iron deficiency had higher HbA1C levels while few demonstrated that absolute HbA1c levels and mean HbA1c levels were lower in patients with iron deficiency anaemia. However, some studies showed no differences in HbA1c levels of patients with anaemia and healthy subjects. All these studies gave contradictory and inconsistent results. Thus, this study is conducted to know the effect of iron deficiency anaemia on glycosylated hemoglobin levels in non-diabetic individuals. Methods: 50 patients with iron deficiency anaemia and 50 healthy control subjects who were age and sex matched were registered in this study. Complete hemogram including peripheral smear, fasting and postprandial blood sugar levels, glycated hemoglobin and serum ferritin levels were measured in both the groups. Results: The prevalence of iron deficiency anaemia was more in females during the third and fourth decades of life. Mean HbA1c of iron deficiency anaemia patients (5.78 ± 1.08) was significantly higher than that of the control population (5.46 ± 0.26 ) that was statistically highly significant (p<0.001) Conclusion: Our study showed that HbA1c levels were affected by iron deficiency anemia. HbA1C values were higher in patients with iron deficiency anemia than control group. So iron deficiency anemia has to be taken into consideration before using the HbA1c in the diagnosis of diabetes.

Introduction: Hypertension is a significant health concern for pregnant women, potentially leading to adverse maternal and fetal outcomes. This study aims to investigate the maternal and fetal consequences in pregnancies complicated by preexisting hypertension. Objectives: To evaluate the maternal and fetal outcomes in pregnant women with preexisting hypertension. Methods: Study Design: Prospective cohort study. Setting: Two tertiary care hospitals. Participants: 200 pregnant women with a confirmed diagnosis of preexisting hypertension. Data Collection: Data were collected on maternal age, hypertension severity, medication use, prenatal care, and lifestyle factors. Fetal outcomes included gestational age at delivery, birth weight, and incidence of congenital anomalies or distress. Statistical Analysis: Descriptive statistics, chi-square tests for categorical variables, and t-tests or ANOVA for continuous variables. Results: The study found significant associations between the severity of hypertension and maternal complications such as preeclampsia, gestational diabetes, and preterm labor. There was a higher incidence of low birth weight, preterm birth, and neonatal intensive care unit (NICU) admissions in the hypertensive group compared to national averages. Results were statistically significant with p-values <0.05. Conclusions: Preexisting hypertension in pregnant women is strongly associated with adverse maternal and fetal outcomes. Early intervention and careful management of hypertension during pregnancy are crucial to improve health outcomes for both mother and child.

Background: Polycystic Ovary Syndrome (PCOS) affects up to 20% of women of reproductive age globally, with chronic inflammation implicated in infertility and adverse pregnancy outcomes. Objective: To investigate the role of inflammatory pathways in PCOS-related infertility and pregnancy complications, highlighting their contribution to altered reproductive and metabolic health. Methods: A one-year observational study was conducted at Akash Institute of Medical Sciences and Research Center, Bangalore, involving 150 women diagnosed with PCOS. Participants underwent clinical assessments, hormonal profiling, and inflammatory marker evaluation, including C-reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α). Statistical analysis involved correlation coefficients and multivariate regression to explore associations between inflammatory markers and clinical outcomes. Results: Elevated levels of CRP (mean: 6.2 ± 1.3 mg/L), IL-6 (mean: 3.8 ± 0.9 pg/mL), and TNF-α (mean: 12.4 ± 2.1 pg/mL) were observed in 78% of participants. Among infertile women (56%), inflammatory markers were significantly higher (CRP: +18%; IL-6: +22%; TNF-α: +25%) compared to fertile counterparts (p < 0.01). Pregnancy complications, including gestational diabetes (34%) and preeclampsia (18%), showed positive associations with inflammatory marker levels (p < 0.05). Multivariate analysis revealed CRP as the strongest predictor of adverse outcomes (β = 0.42, p < 0.001). Conclusions: This study underscores the pivotal role of inflammatory pathways in PCOS-related infertility and pregnancy complications, advocating for targeted anti-inflammatory interventions to improve clinical outcomes.

Introduction: In the realm of obstetrics, the intricate interplay between maternal health and perinatal outcomes continues to captivate researchers worldwide. Among the multifaceted conditions affecting pregnancy, pre-eclampsia stands as a significant concern, characterized by hypertension and proteinuria after 20 weeks of gestation. This study endeavours to delve into a promising avenue: the association between serum uric acid levels and perinatal outcomes in women grappling with pre-eclampsia. Pre-eclampsia remains a significant challenge in obstetrics, with its potential to impact both maternal and foetal health profoundly. Amidst the array of biomarkers under scrutiny, serum uric acid levels have emerged as a promising candidate for understanding the pathophysiology of this condition. Materials And Methods: This is a Prospective and Observational Study was conducted in the Department of Obstetrics and Gynaecology, Medical College Kolkata from December 2022 to April 2024. Pregnant women diagnosed with Pre-eclampsia in their third trimesters are being included in this study. Pregnant women with Pre-eclampsia who are current smokers, alcoholic and those with diabetes mellitus,thyroid disorders and renal dysfunction were excluded. Patients with chronic diseases like APLA Syndrome and heart diseases were also excluded. All patients with Pre-eclampsia in their third trimesters were asked to test their Serum Uric Acid levels at their third trimesters of pregnancy. These patients were then followed up till delivery and the presence/absence of maternal complications and perinatal outcome were observed. The association between serum uric acid levels and perinatal outcome was then assessed. Results: In our study 11 pre-eclamptic females (9.56%) were ≤20 years of age, 16 (13.91%) were between 21 to 25 years of age, 41(35.65%) were between 26 to 30 years of age, 39(33.91%) were between 31 to 35 years of age and 8(6.95%) were≥ 36 years of age.  In our study, out of 115 participants, 3 (2.60%) had uric acid levels ≤4 milligrams per decilitre, 22(19.13%) had uric acid levels between 4.1 to 6.0 milligrams per decilitre ,61 (53.0%) had uric acid levels between 6.1 to 7.9 milligrams per decilitre and 29 (25.2%) had uric acid levels ≥ 8 milligrams per decilitre. In our study, we calculated the association of Blood Pressure at delivery with serum uric acid levels. It was found to be statistically significant (p value is 0.0035). Data are expressed as percentage. Test applied: Fisher's exact test. The row/column association is statistically significant. The relative risk is 1.833. 95% confidence interval is between 1.116 to 3.011. Conclusion: Hence, from our results, we can surmise that serum uric acid levels have a significant association with perinatal outcome in women with pre-eclampsia and hence, can be used as prognostic marker to predict development of complications in these pre-eclamptic females.

Pulmonary embolism (PE) is a potentially life-threatening condition that can present with non- specific symptoms, including dyspnea and refractory hypoxemia, complicating diagnosis, especially in the absence of clinical signs of deep vein thrombosis (DVT). This study retrospectively evaluates the use of computed tomography pulmonary angiography (CTPA) in diagnosing PE in patients presenting with refractory hypoxemia and dyspnea but without clinical evidence of DVT. The relationship between D-dimer levels, DVT presence, and patient outcomes was also explored. Twenty patients admitted to a tertiary hospital between January 2022 and September 2024 were included in the study. CTPA confirmed PE in all cases, while Doppler ultrasound post-diagnosis revealed DVT in 55% of patients despite the absence of clinical symptoms. D-dimer levels varied from 700 to 2100 ng/mL, with higher levels correlating with a more significant embolic burden. ICU admission was required for 50% of patients, and 35% received thrombolysis due to massive PE or hemodynamic instability. The overall mortality rate was 35%, predominantly among patients with malignancy or those requiring thrombolysis. These findings underscore the importance of considering PE in patients with unexplained hypoxemia, regardless of the absence of DVT symptoms. CTPA remains critical for diagnosis, and D-dimer results should be interpreted cautiously, as normal or mildly elevated levels do not rule out PE. Doppler ultrasound is valuable for detecting subclinical DVT. Further studies are needed to develop non-invasive diagnostic protocols for atypical PE presentations.

Background Gestational Diabetes Mellitus (GDM) is a significant health concern during pregnancy, characterized by elevated blood glucose levels first identified during pregnancy. Pregnancy induces insulin resistance due to placental hormones, but excessive resistance can lead to GDM, which poses risks to both maternal and fetal health. In India, GDM prevalence varies widely, exacerbated by factors such as demographics, healthcare access, and diagnostic methods. The increasing prevalence of GDM, particularly in developing countries, necessitates a better understanding of contributing factors to improve maternal and neonatal health outcomes. Objective This study aims to determine the prevalence of Gestational Diabetes Mellitus (GDM) among pregnant women attending the outpatient department of SCB Medical College and Hospital in Cuttack, Odisha, India, and to identify associated risk factors such as age, family history, obstetric history, diet, BMI, and physical activity. Methodology A cross-sectional study was conducted from July 2018 to June 2019, involving 483 pregnant women who were screened for GDM using the 75 g, 2-hour oral glucose tolerance test (OGTT), following WHO diagnostic criteria. Data on age, family history of diabetes, obstetric history, diet patterns, BMI, and physical activity were collected through structured interviews and questionnaires. Statistical analysis was performed using the Chi-square test with a significance threshold of p<0.05. Results The overall prevalence of GDM in the study population was 15.9%. The highest prevalence was observed in the 25-29 age group (23.7%), and no significant association was found between age and GDM (p=0.234). A family history of diabetes was linked to higher prevalence, with women having both parents diabetic showing a significantly higher rate of GDM (49.4%). Obstetric history showed a significant association with GDM, with women with a good obstetric history having a higher prevalence (21.0%) compared to those with a bad obstetric history (9.2%). Diet patterns, particularly a higher prevalence of GDM in non-vegetarian women (61.0%), were also significant (p=0.001). Women with higher BMI, especially those classified as obese (BMI ≥ 30 kg/m²), exhibited a significantly higher prevalence of GDM (45.7%) compared to those with normal BMI (5.7%) (p=0.001). Additionally, physical inactivity was associated with higher GDM prevalence (57.1% in sedentary women). Discussion The study confirms that GDM is a major concern during pregnancy, with significant associations identified between various risk factors such as obesity, family history of diabetes, diet, and physical inactivity. Women with a higher BMI, poor dietary habits, and lack of physical activity were more likely to develop GDM. The results align with global studies linking obesity and poor lifestyle choices with increased risk of GDM. Interestingly, a family history of diabetes was also found to increase the risk, underscoring the genetic predisposition in GDM development. Moreover, women with good obstetric histories showed a higher prevalence of GDM, suggesting that factors beyond the current pregnancy, such as pre-existing metabolic conditions, may contribute. Conclusion The prevalence of Gestational Diabetes Mellitus in Cuttack, Odisha, India is high, particularly among women with higher BMI, sedentary lifestyles, and poor dietary patterns. Early screening, lifestyle modifications such as maintaining a healthy weight, improving diet, and engaging in regular physical activity are essential strategies to reduce the risk of GDM and its complications. There is a pressing need for public health initiatives and further research to mitigate the growing burden of GDM and ensure better maternal and neonatal health outcomes in India.

Background: Digital breast tomosynthesis (DBT) improves detection and characterization of breast lesions especially in women with non-fatty breasts hence if used along with full field digital mammography can yield better results.  Aim: To compare and evaluate the impact of Digital Breast Tomosynthesis (DBT) combined with Full Field Digital Mammography (FFDM) versus FFDM alone in the diagnosis and interpretation of benign and malignant breast lesions utilizing the BIRADS score Methodology: This was a prospective, longitudinal study with retrospective component conducted in the department of Radiodiagnosis in a tertiary hospital in Western India from January 2018 to December 2019. All patients presenting to the department with breast lesion or lump with suspicion of breast malignancy were evaluated with full field digital mammography (FFDM) using BIRADS score and digital breast tomosynthesis (DBT) with histological correlation. Observation and Results: In our study 141 patients were included, who were in range of 29 to 91 years with mean age of 55.8 years. Out of 141, 61 came for screening and 80 came for diagnostic purpose. According to breast density, patients were divided into four groups a, b, c and d. Improvement in sensitivity, specificity, false positive rates, and positive predictive values was seen with addition of DBT to FFDM in patients with breast density d. On addition of DBT to FFDM it was observer there is down gradation of the BIRADS score from 4A to 3 in 8 cases. And upgradation of BIRADS score from 4A to 4B in 1 case, 4A to 4C in 7 cases and to 5 in 2 cases.  Statistically significant increase in sensitivity was seen with the addition of DBT to FFDM in BIRADS ≥ 4B and ≥ 4C (P = 0.004). Statistically significant increase in positive predictive value was seen with the addition of DBT to FFDM in ≥ 4A. In both diagnostic and screening groups, significant increase in sensitivity, positive predictive value (P < 0.05) was seen with the addition of DBT to FFDM. Conclusion: Use of tomosynthesis is helpful in analysis and characterization of breast masses seen on mammography. Most of lesions can be classified either into overlapping normal breast parenchyma or densities with addition of tomosynthesis avoiding the need for unnecessary   follow   ups   or   delay   in   pathological   procedures   and   diagnosis.   So tomosynthesis should always be added while evaluating asymmetries on mammography.

Background: Rh isoimmunization is a condition that occurs when a woman with Rh negative blood type becomes sensitized to Rh positive blood cells during childbirth, miscarriage, abortion, medical procedures like invasive prenatal testing (e.g., amniocentesis) trauma to the abdomen during pregnancy or transfusion with Rh positive blood. With each successive pregnancy, there is a cumulative effect of fetomaternal transfusions thus increasing the severity of the problem at hand. It can lead to hemolytic disease of the newborn which can range from mild to severe, including features such as anemia, jaundice, hepatospleenomegaly, and, in severe cases, hydrops fetalis.  Such newborns may require treatments such as phototherapy for jaundice, blood transfusions, IV immunoglobulins, and in severe cases, exchange transfusions. Aim: To study the role of cord bilirubin as a non invasive, early predictive marker of hemolysis in Rh positive neonates delivered to Rh negative mothers. Study Type and Design: Observational, descriptive, longitudinal study. Materials:  Rh positive neonates delivered in OT/labor room of our hospital to Rh negative mothers studied according to specific protocol. Study Setting: Neonatal and postnatal wards of a rural tertiary care hospital. Period of Study:  (Two years) From June 2022 to June 2024. Ethical Committee consent was taken at the start of the study. Data was entered in excel sheets and analyzed using IBM SSPS Statistics software. Results: Out of 277 neonates delivered at term to Rh negative mothers in the study duration, 158 were Rh positive and 119 were Rh negative mothers. A cord bilirubin cutoff of >1.9 mg/dL was found to have excellent specificity (97.8%) and positive predictive value (95.74%), making it a robust tool for identifying newborns at high risk of hyperbilirubinemia, with a sensitivity of 67.16% and a negative predictive value of 80.18%. For the phototherapy group, the average cord bilirubin level was found to be 2.13 ±0.51 mg/dL, as compared to the no phototherapy group, wherein the average cord bilirubin level is 0.80±0.58 mg/dL. Cord bilirubin values >1.9 mg/dl (seen in 29.7% of the study population) were found to have a statistically significant association with a need for interventions (phototheraphy and/or exchange transfusion) with a p value <0.05. Conclucion: Hemolysis due to Rh isoimmunization is more frequent and severe in neonates of multigravida mothers as Zompared to neonates of primigravida mothers, due to the cumulative effect of fetomaternal transfusions in each successive pregnancy. Cord sampling proves to be an essential predictive marker of the risk of hemolysis in the neonate earlier to allow for early initiation of therapeutic measures and reducing the risk of rapid hemolysis and further, long term complications such as bilirubin encephalopathy, emerging as a cornerstone of non invasive care.

Introduction: Pleural effusion is the abnormal accumulation of fluid in the pleural space. Pleural fluid accumulates when pleural fluid formation exceeds pleural fluid absorption. Pleural effusion may develop when there is excess pleural fluid formation (from the interstitial spaces of the lung, the parietal pleura, or the peritoneal cavity) or when there is decreased fluid removal by the lymphatics The pleural effusion is associated with the history of suffering of mankind. It is a common medical problem encountered by the doctors across the globe. It is a manifestation of respiratory as well as systemic diseases.Materials and Methods This is a Descriptive, observational single centre study was conducted in the department of General Medicine, Sri Siddartha medical college and hospital, Tumkur, Karnataka over a  period of one year. Cases of pleural effusion admitted under Medicine department. Patients of either sex above 12 years of age with pleural effusion supported by X ray chest with of tuberculous and nontuberculous origin were included. Patients meeting the diagnostic criteria of more than one categories, pleural effusions of undetectable or obscure origin, obvious haemothorax secondary to trauma were excluded. Results  In the study, among exudative pleural effusion, 10(20%) patients were tubercular,13(26%) had malignancy,4(8%) had empyema,4(8%) had connective tissue disorders,1(2%) had pancreatitis. Among transudative pleural effusion 6(12%) had congestive heart failure,6(12%) had chronic kidney disease,3(6%) had chronic liver disease, 3(%6) had nephrotic syndrome. In TB, 9 (90%) patients pleural fluid glucose >60mg/dl, 3 (30%) had <60mg/dl. In empyema all cases had glucose<60mg/dl and in malignancy 12 (93%) patients had PF glucose >60mg/dl and 1 (7%) had <60mg/dl. In CTD all cases had PF glucose >60mg/dl. In acute pancreatitis, 1(100%) had PF glucose <60mg/dl and 78% of all transudative pleural effusion were having PF glucose >60 mg/dl. Conclusion The study was single institutional, observational study. The study was focusing on efficacy of pleural fluid cholesterol and its ratio to serum level in distinguishing exudates from transudate

Background: For numerous women, pregnancy can bring about radiant skin, rosy cheeks, and lustrous hair. Conversely, some may deal with less appealing skin issues, such as acne, dark patches, and stretch marks. The journey to becoming a mother is filled with significant changes and adaptations for all mothers, and welcoming a new baby brings both happiness and challenges.  

Objectives:

1. To study the various physiological skin changes occurring during pregnancy.
2. To study the frequency and clinical features of specific dermatoses of pregnancy.

Material & Methods: Study Design: Hospital-based observational descriptive study. Study area: Department of Dermatology Venereology and Leprosy, Guntur Medical College, Guntur. Study Period: September 2020 – February 2021 (6 months).  Study population:  The study included 500 pregnant women attending the outpatient departments of Obstetrics and Gynaecology, and the department of D.V.L.   Sample size: The study consisted of a total of 500 subjects.  Sampling method: Simple random method. Results: Amongst 500 cases, 36 (7.2%) presented with prurigo of pregnancy, and 25 (5%) presented with pruritus gravidarum. PUPPP constituted 4.6% of the cases, and 5 (1%) presented with pruritic folliculitis of pregnancy.  Conclusion: In this research involving 500 pregnant individuals with skin issues, it is clear that pregnant women are susceptible to a variety of dermatological conditions beyond just the specific skin disorders associated with pregnancy.

Background And Justification: Spinal Anaesthesia is widely regarded as a reasonable anaesthetic option for caesarean delivery, provided there is no contraindication. Pregnancy causes major physiological changes to the mother’s body. An understanding of the physiological changes in pregnancy is the key to safe obstetric anaesthesia. Spinal Anaesthesia is associated with hypotension which can have maternal and foetal side effects. Methods: This study was performed on 100 patients, after getting informed consent. In this study the baseline hemodynamic parameters of the patient was noted during intra operative period. After spinal anaesthesia is performed by the Anaesthesiologist, hemodynamics such as Heart Rate, Blood Pressure, Mean Arterial Pressure and SPO2 was noted for every 3 minutes for first 20 minutes after which it was noted for every 5 minutes, till end of the surgery.  Results: From the descriptive statistics and chi square test, after spinal anaesthesia performed there is a hypotension, p=0 which is <0.05, hence statistically significant, and there is fall in heart in rate, p=0.0029 which is <0.05, hence statistically significant.  Conclusion: 100 pregnant patients who underwent spinal anaesthesia for elective caesarean section were included in this study. Based on the result we concluded that hypotension and bradycardia are the frequent response after spinal anaesthesia due to arterial and venous vasodilatation resulting from the sympathetic block along with a paradoxical activation of cardio inhibitory receptors. This study benefits to the anaesthesiologist in prediction of possible adverse effects and to overcome the same.

Introduction: Breast cancer (BC) proliferative activity is a significant predictive factor associated with treatment response and can be regarded as a proxy measure of tumor aggressiveness. Aims: The goal of research on atypical breast cancer is to comprehend, identify, and treat uncommon or uncommon breast cancers that differ from their conventional presentations, guaranteeing precise diagnosis and suitable therapy. Materials & Methods: The present study was a Case-Control Study. This Study was conducted from One year. Total 120 patients were included in this study. Result: There was a significant association between high atypical mitoses and high grade, larger tumor size, NST tumor type, the poor prognostic NPI group and TNBC phenotype. A significant association was confirmed between high overall mitotic count (>21 mitoses per 3 mm²) and other parameters characteristic of aggressive tumor behavior including high tumor grade, larger tumor size, NST histological type, the moderate and poor prognostic NPI groups and (TNBC) phenotype. Conclusion: We came to the conclusion that atypical breast tumors are a broad category of uncommon and uncommon cancers that differ from their usual appearances, which complicates diagnosis and treatment.

Aim and Objective: To compare the Glottic view using Cormack Lehane grading in Sniffing Position (by Fixed Pillow) and Modified Ramped Position (by Customized Pillow) and to compare the number of attempts taken for endotracheal intubation in both groups Methodology: A cross-sectional study was conducted in the Department of Anaesthesiology at Government Medical College, Idukki, over six months to evaluate the effect of head and neck positioning on ease of intubation. The study included two groups: Group A (sniffing position: by Fixed Pillow) and Group B (Modified Ramped Position: by Customized Pillow), comprising ASA class 1, 2, and 3 patients aged above 18 years undergoing elective surgery under general anesthesia. Exclusion criteria included pregnancy, BMI >35, unstable cervical spine, or contraindications to conventional laryngoscopy or study drugs. Sample size was calculated 36 patients per group. Ethical approvals were obtained, and informed consent was secured. Result: The study included 72 participants (mean age: 41.08 ± 13.00 years), with 55.6% females and 44.4% males. BMI distribution showed 52.8% normal weight, 31.9% overweight, 6.9% obese, and 8.3% underweight, with a mean BMI of 24.20 ± 4.00 kg/m². ASA Class 1 comprised 73.6% of participants, followed by Class 2 (25.0%) and Class 3 (1.4%). Participants were evenly divided between Group A (sniffing position) and Group B (Modified Ramped Position). The Cormack-Lehane (CL) grade distribution was significantly better in Group B (p = 0.012), with higher proportions of Grade 1 and 2A, indicating superior airway visualization. Group B also required significantly less airway assistance (p = 0.032), with fewer cases needing bougie or BURP maneuvers and a higher proportion of successful intubations without assistance. Conclusion: Overall, the Customised Pillow (CP) group showed better airway visualisation, easier intubation, and required less assistance compared to the Fixed Pillow (FP) group. Significant differences were observed in MMPC scores, CL grades, and the use of assistance tools, with CP consistently showing superior outcomes. These findings confirm that Customised Pillow positioning provides a clinical advantage in airway management.

Preterm birth remains a significant global health challenge, with increasing incidence despite advances in medicine. It accounts for approximately 70% of neonatal deaths, 36% of infant deaths, and 25-50% of cases of neurological impairment in children. This study aimed to identify maternal risk factors and neonatal outcomes associated with preterm deliveries in KIMS & RF, Amalapuram. A cross-sectional study was conducted over a period of 1-year from December-2023 to December 2024 among 110 pregnant women attending  antenatal opd and labour room  at KIMS&RF, Amalapuram.Detailed histories and obstetrical examinations were undertaken, neonatal outcomes were analysed using SPSS software.The incidence of preterm birth was 27.5%, categorized into late preterm (19.75%), moderate preterm (3.75%), very preterm ( 10%) and extremely preterm (1.5%).More commonly observed in women who were underweight(34.54%) compared to women who were overweight (9.08%). More commonly observed in unbooked  cases (76.36%) when compared to booked cases(23.63%). Neonates delivered preterm had significantly lower Apgar scores at 1 and 5 minutes compared to term babies. Maternal risk factors included anemia, hypertensive disorders of pregnancy, PPROM and UTI. Poor neonatal outcomes, such as low birth weight, low APGAR scores, IUGR, respiratory morbidity were observed.

Background: Chronic obstructive pulmonary disease (COPD) significantly impacts cardiac function, particularly affecting the right ventricle, left ventricle, and pulmonary vasculature. Cardiovascular complications contribute substantially to COPD-related mortality. Echocardiography provides a non-invasive and effective method for evaluating cardiac changes in COPD patients. To analyze the cardiac alterations associated with COPD using echocardiography and to determine the correlation between echocardiographic findings and COPD severity based on GOLD classification. Materials and Methods: This prospective observational study was conducted over 16 months at the Department of Respiratory Medicine, MIMS, Vizianagaram. A total of 50 COPD patients aged above 40 years were enrolled. Exclusion criteria included active tuberculosis, HIV, terminal cancer, hepatic or renal diseases, and pregnancy. Patients underwent clinical evaluation, electrocardiography (ECG), spirometry, arterial blood gas (ABG) analysis, and echocardiography. Data were analyzed for associations between echocardiographic findings and COPD severity. Results: Echocardiographic findings revealed that 24% of patients had pulmonary hypertension, 24% had increased right ventricular (RV) thickness (>0.5 mm), and 20% had left ventricular diastolic dysfunction (LVDD). The mean ejection fraction did not significantly differ between patients with and without pulmonary hypertension (61.6% vs. 60.5%). Echocardiographic abnormalities were more frequent in severe and very severe COPD cases. Conclusion: COPD is associated with significant cardiovascular changes, including pulmonary hypertension, RV hypertrophy, and LV dysfunction. Routine echocardiographic screening every six months is recommended to detect early cardiac complications and improve clinical outcomes.

Background: Antenatal depression (AD) significantly affects maternal and fetal health. Despite its profound impact, AD remains underdiagnosed in many resource-limited settings, including India. This study aimed to assess the prevalence of antenatal depression and its associated risk factors among pregnant women attending a tertiary care hospital in Hyderabad. Methods: A cross-sectional, hospital-based study was conducted at Gandhi Medical College & Hospital, Secunderabad, Telangana, from November 2020 to June 2022. The study included 300 pregnant women who completed the Edinburgh Postnatal Depression Scale (EPDS). A score ≥13 indicated antenatal depression. Risk factors, including sociodemographic and psychosocial determinants, were evaluated using the Hurt, Insult, Threaten, Scream (HITS) tool and the Presumptive Stressful Life Events Scale (PSLES). Results: The prevalence of antenatal depression was 13.3% among the 300 participants. Significant risk factors included intimate partner violence (HITS score >10, p < 0.001) and experiencing stressful life events as measured by PSLES (p = 0.047). Sociodemographic variables, including age, education, socioeconomic status, type of family, and obstetric factors, were not statistically significant. Conclusion: Antenatal depression is prevalent among pregnant women in Hyderabad, with intimate partner violence and stressful life events being significant predictors. Routine screening and timely psychosocial interventions during antenatal care are vital to ensure better maternal and fetal outcomes.

Background: Teenage pregnancy poses significant health risks for both mothers and neonates, and it is associated with higher rates of maternal and neonatal morbidity and mortality. This study compares the maternal and perinatal outcomes between teenage primigravidae (15–19 years) and adult primigravidae (20–29 years) in a hospital setting.To assess and compare maternal and perinatal outcomes between teenage and adult primigravidae. Methods: A prospective hospital-based study was conducted at the Department of Obstetrics and Gynecology, KIMS, Amalapuram, from December 2019 to September 2021. The study included 80 teenage and 160 adult primigravidae. Data were collected on sociodemographic characteristics, antenatal care, complications, delivery outcomes, and neonatal health. Statistical analysis was performed using descriptive methods and p-values were considered significant at <0.05. Results: Teenage primigravidae had significantly higher rates of antenatal complications (71.3% vs. 16.3%) compared to adults. Common complications included anemia (71.3%), pre-term labor (26.2%), and pregnancy-induced hypertension (17.5%). Hemoglobin levels were significantly lower in teenage mothers (9.56 g%) than in adults (11.12 g%). The cesarean section rate was higher among teenage mothers (45%) compared to adults (20.6%), with fetal distress as the main indication. Teenage mothers also had higher rates of pre-term births (27.5% vs. 6.3%) and low birth weight babies (42% vs. 15.4%). Neonatal morbidity, including birth asphyxia, NICU admissions, and hyperbilirubinemia, was also more common in the teenage group. Conclusion: Teenage pregnancies are associated with higher maternal and neonatal risks, including more complications during pregnancy, labor, and delivery. Enhanced antenatal care and educational interventions are essential for improving outcomes for adolescent mothers.

Background: Anaemia in pregnancy, particularly iron deficiency anaemia, is a significant global health concern associated with adverse maternal and perinatal outcomes. This study aims to compare the maternal and fetal outcomes in anaemic pregnancies with iron deficiency and non-anaemic pregnancies. Methods: A prospective randomized case-control study was conducted involving 200 pregnant women (100 anaemic and 100 non-anaemic) at KIMS & RF, Amalapuram. Anaemia was classified into mild, moderate, and severe based on hemoglobin levels. Maternal and fetal outcomes were assessed and compared between the two groups. Results: The anaemic group had significantly higher rates of preterm birth (8% vs. 2%), postpartum hemorrhage (7% vs. 1%), and maternal morbidity (17.5% vs. 2%) compared to the non-anaemic group. Fetal outcomes were worse in the anaemic group, with higher rates of stillbirth (3% vs. 0%), early neonatal death (4% vs. 0%), low birth weight (22% vs. 3%), and neonatal morbidity (17.5% vs. 6%). Neonatal complications such as respiratory distress syndrome (3% vs. 1%) and meconium aspiration syndrome (10% vs. 1%) were also more prevalent in the anaemic group. Conclusion: Anaemia, particularly iron deficiency anaemia, significantly impacts maternal and fetal health, leading to higher maternal morbidity, preterm births, and adverse fetal outcomes. Early diagnosis and treatment of anaemia in pregnancy are crucial to improve both maternal and neonatal health

Background: In 2018, ovarian carcinoma ranked as the eighth most common cancer diagnosed and the leading cause of cancer death in women. High-grade serous carcinoma is the most common histological type seen among malignant cases. A diverse group of neoplasms is seen in the ovary with variable clinical, morphological, and histological features, so assessing the nature of ovarian neoplasms further assists in the treatment of the disease. Aim: This study was conducted to assess the different histopathological variants of ovarian neoplasms according to the latest 2020 World Health Organization (WHO) classification of ovarian tumors. Further analysis of the frequency, age and distribution of various ovarian tumors is assessed. Materials and methods: A retrospective study was conducted in the Department of Pathology at GMC CHANDRAPUR The data of the patients from the past one years, from January 2022 to December 2022, were retrieved and assessed. Gross and microscopic findings, including clinical details of patients with ovarian masses, were analyzed from the previous records. Result: A total of 23 cases of ovarian neoplasms on histopathology were analyzed. The age range was 15-74 years. The types of specimens received were those of total abdominal hysterectomy, salphingoopherectomy, and unilateral or bilateral ovarian cystectomy. The most common presentation was an abdominal mass, followed by pain in the abdomen. The majority of the tumors were benign (91%), malignancy was observed in 9% of cases, and borderline tumors were seen in 4.3% of cases. Epithelial tumors were the commonest tumors, accounting for 73.9%, followed by germ cell tumors (21.7%). Serous cystadenoma was the commonest benign tumor, followed by mature teratoma and serous cystadenocarcinoma. Conclusion: Ovarian neoplasms usually present with a variety of clinicomorphological and histological features. The most common neoplasm observed in the ovary is surface epithelial tumors, which are benign lesions that commonly affect reproductive age groups. Newer advancements like immunohistochemistry (IHC) and genetic studies have made the diagnosis easier and more precise. However, in institutes with limited resources, a histopathological study is still the gold standard in the diagnosis and prognostic evaluation of these tumors.

Background: Recurrent miscarriages and perinatal deaths pose significant challenges to reproductive health, impacting couples both physically and emotionally. Assessing the reproductive performance of such couples can provide valuable insights into pregnancy outcomes, risk factors, and potential interventions to improve fetal survival rates. Materials and Methods: A prospective observational study was conducted on 150 couples with a history of at least one miscarriage or perinatal death. Clinical and demographic data were collected, including maternal age, body mass index (BMI), obstetric history, and underlying medical conditions. Participants underwent hormonal profiling, genetic testing, and ultrasound evaluations to assess uterine and fetal health. Pregnancy outcomes, including live birth rate, miscarriage rate, and perinatal complications, were analyzed over a follow-up period of 12 months. Statistical analysis was performed using chi-square and logistic regression tests, with a significance level set at p < 0.05. Results: Of the 150 couples, 80% achieved pregnancy within the study period. The live birth rate was 65%, while 20% experienced recurrent pregnancy loss, and 15% had preterm deliveries. Factors such as advanced maternal age (>35 years), obesity (BMI > 30), and thrombophilic disorders were significantly associated with adverse pregnancy outcomes (p < 0.01). Couples receiving targeted medical interventions, including progesterone support and low-dose aspirin therapy, had improved pregnancy outcomes (p < 0.05). Conclusion: Couples with previous miscarriages and perinatal deaths face an increased risk of adverse pregnancy outcomes. Early identification and management of risk factors, including maternal health optimization and medical interventions, can enhance reproductive performance and fetal survival rates. Comprehensive counseling and personalized treatment approaches are essential for improving pregnancy success in this population.

Background: Thalassemia minor is a common hereditary hemoglobinopathy that may impact pregnancy outcomes despite being traditionally considered a benign carrier state. This study evaluates the maternal and neonatal complications associated with thalassemia carrier pregnancies in a tertiary care setting. Methods: A prospective observational study was conducted at a tertiary care hospital, comparing 100 pregnant women with thalassemia minor to 100 non-carrier controls. Maternal outcomes, including anaemia, gestational diabetes mellitus (GDM), hypertensive disorders, postpartum haemorrhage (PPH), and mode of delivery, were assessed. Neonatal outcomes such as low birth weight (LBW), intrauterine growth restriction (IUGR), preterm birth, NICU admissions, and perinatal mortality were evaluated. Logistic regression analysis adjusted for maternal BMI, gestational age, and anaemia severity.

Results:

• Anaemia was significantly more prevalent in thalassemia carriers (78% vs. 18%, p < 0.001), with a fourfold increased risk of severe anaemia (OR = 4.52, p < 0.001).
• Caesarean section rates were significantly higher in carriers (42% vs. 30%, p = 0.040).
• IUGR risk was significantly elevated in thalassemia carriers (24% vs. 10%, OR = 2.88, p = 0.010), and LBW was more frequent (38% vs. 22%, p = 0.020).
• NICU admissions were higher among carrier neonates (15% vs. 8%), though not statistically significant (p = 0.080).

Conclusion: Thalassemia minor is associated with a higher risk of anaemia, IUGR, LBW, and caesarean section, emphasizing the need for enhanced prenatal screening, haematological monitoring, and individualized obstetric care. Early detection and multidisciplinary management can mitigate adverse pregnancy outcomes in this population.

Aim:  To review the causes of IUD and classify the causes into maternal, fetal and placental causes and further classify causes by relevant condition at death by ICD-PM classification.We intend to observe the causes of and demographic factors contributing to the burden of IUD.Using this data, the areas of action can be identified and measures can be formulated to reduce a significant number of perinatal mortalities.

Study design: prospective observational study

Study period : 1 year

 Study population -All IUD cases admitted in the department of obstetrics and gynecology of Government medical College srikakulam during the study period.

Study is conducted after taking approval from the  Hospital ethics committee.

Methodology: This is an observational study of data collected over one year (January 2024-December 2024) from a tertiary care centre in SRIKAKULAM India. The maternal demographic characteristics and causes of IUD were studied. The causes of IUD were classified into maternal, fetal and placental causes and relevant condition at death based on ICD-PM  classification.

Results: In a study of 55 intrauterine deaths (IUDs), the majority of mothers (50.9%) were aged 20-25 years. Among them, 25.45% were primigravida and 54.54% were second gravida. Notably, 54.8% had three or more antenatal visits, while 94.54% were unbooked cases referred to GGH. Maternal conditions, including pre-eclampsia and diabetes, accounted for 58.18% of IUDs, with 87.27% occurring in the antepartum period. Of the IUD babies, 47.27% were female and 52.72% male; 65.45% were macerated and 34.54% fresh. Fetal causes contributed to 25.45% of cases, with prematurity noted in 76.36%. Four IUDs involved non-viable congenital abnormalities, and one case involved fetal demise in a twin pregnancy due to selective growth restriction. According to ICD-PM classification, hypertensive diseases were the most common maternal cause (75%), followed by gestational diabetes (18.75%).

Background: Borderline oligohydramnios in pregnancies without any foetal or maternal abnormalities, that is Isolated oligohydramnios may be due to inadequate fluid intake orally. Some patients might have poor compliance in home-based setting. Therefore, this study was conducted to assess the improvement in AFI and perinatal outcome following maternal oral hydration therapy in home and hospital settings. Methods: This prospective study was conducted in the Department of Obstetrics and Gynaecology in Konaseema Institute of Medical Sciences and Research Foundation, Amalapuram during period from 1^st February 2023 to 31^th January 2024 (1 year).  50 cases of isolated borderline oligohydramnios (other high-risk pregnancy conditions not present) were included in the study (25 in home group and 25 in hospital group). Results: The two groups are similar in profile and baseline findings. When compared to the home group, the hospital group's AFI considerably improved. Conclusion: In cases of oligohydramnios, maternal oral hydration therapy is an easy, safe, noninvasive, and efficient way to increase the volume of amniotic fluid; but, long-term, continuous therapy is necessary to optimize the neonatal outcome. It is advised to implement supervised hydration therapy due to low compliance to home-based treatment

Background: The most common significant health concern during pregnancy is hypertension, which remains a vital factor in both maternal and fetal morbidity and mortality. Preeclampsia is a pregnancy-related hypertensive disorder that occurs after twenty weeks of gestation and involves multiple systems.

Objectives:

1) To study maternal outcome in severe pre- eclampsia & eclampsia.

2) To study perinatal outcome in severe pre- eclampsia & eclampsia.

3) To enumerate variable factors associated with maternal and perinatal morbidity and mortality.

Material & Methods: Study Design:  Prospective Observational Study.  Study area: Department of Obstetrics & Gynecology, GGH, GMC, KADAPA.  Study Period: 1 year. (March 2023 – April 2024). Study population: 100 Pregnant women admitted with severe PE and eclampsia. Sample size: Study consisted a total of 100 subjects. Sampling Technique:  Convenience Sampling technique. Results: In this study 22% of cases had no proteinuria, 25 % of the cases had trace amounts of protein in urine, among them only 2% developed HELLP. Among 77% of the cases with proteinuria, 13% developed HELLP and there was significant association between proteinuria and HELLP i.e as severity of proteinuria increases chances of HELLP increases. Conclusion: Severe preeclampsia leads to higher risks of life-threatening complications, preterm delivery, and IUGR, with maternal mortality observed in multigravida cases. Early detection and proper management, including evidence-based protocols, are crucial to reducing morbidity and mortality. Effective secondary and tertiary prevention improves outcomes for both mother and neonate.

Background:  Cesarean Scar Pregnancy (CSP) is a rare form of ectopic pregnancy where the embryo implants within the scar of a previous cesarean section. Effective management is crucial to prevent severe complications, including uterine rupture and life-threatening hemorrhage. This study aimed to compare the clinical outcomes of medical versus surgical management of CSP in a randomized controlled trial. Materials and Methods: A total of 60 patients diagnosed with Cesarean Scar Pregnancy were randomly allocated into two groups: Medical Management (n = 30) and Surgical Management (n = 30). The medical group received intramuscular methotrexate (MTX) at a dose of 50 mg/m², followed by serial monitoring of β-hCG levels until normalization. The surgical group underwent hysteroscopic resection of the gestational sac. Primary outcomes assessed included treatment success rate, time to β-hCG normalization, blood loss, hospital stay duration, and complication rates. Data were analyzed using appropriate statistical methods, with significance set at p < 0.05. Results: The treatment success rate was significantly higher in the Surgical Management group (93.3%) compared to the Medical Management group (76.7%) (p = 0.04). The mean time to β-hCG normalization was shorter in the surgical group (28.3 ± 5.2 days) compared to the medical group (45.7 ± 7.4 days) (p < 0.001). Blood loss was notably higher in the surgical group (210 ± 50 mL) compared to the medical group (120 ± 35 mL) (p = 0.02). However, hospital stay duration was shorter in the surgical group (2.1 ± 0.6 days) compared to the medical group (4.5 ± 1.2 days) (p < 0.001). Complication rates were higher in the medical group (20%) than in the surgical group (10%). Conclusion: Surgical management of Cesarean Scar Pregnancy offers a higher success rate and faster resolution compared to medical management, though it is associated with higher blood loss. Medical management remains a viable alternative for patients contraindicated for surgery or seeking conservative treatment. Further studies with larger samples are warranted to confirm these findings.

Background: Cesarean scar pregnancy (CSP) is a rare but potentially life-threatening condition characterized by the implantation of a gestational sac within the scar of a previous cesarean section. Management strategies vary, ranging from conservative medical approaches to surgical interventions. This prospective observational study aimed to evaluate the efficacy and safety of different treatment modalities for CSP over a one-year period at Lala Ded Hospital, GMC Srinagar. Methods: Patients diagnosed with CSP between Feb 2023 and January 2024 were included. Demographic data, medical histories, beta-human chorionic gonadotropin (beta-hCG) levels, and ultrasound findings were collected. Treatment modalities included medical management with methotrexate (MTX) and surgical interventions such as dilation and curettage (D&C) or laparotomy. Outcome measures included treatment success rates, complication rates, and hospital stay duration. Results: A total of 45 patients were included with 35.6% of patients treated with systemic methotrexate, 48.9% underwent dilation and curettage (D&C), and 15.6% were treated with laprotomy. Medical management with MTX showed a 31.3%  success rate, while surgical interventions demonstrated a 93.1% success rate, indicating a statistically significant difference (p < 0.001). Complications occurred more frequently with medical management (68.8%) compared to surgery (6.9%). Surgical treatment was associated with a significantly shorter hospital stay (4.2 days vs. 8.7 days, p < 0.001). Conclusion: Surgical interventions, including D&C and laparotomy, showed superior efficacy and safety profiles compared to medical management with MTX for CSP. 

Background-Hypertensive disorders complicates 5-10%of pregnancies all over the world and its incidence in India found to be 10.08% as per data of National Eclampsia Registry(NEP)  AIM –To compare perinatal outcome of oligohydramnios or fetal growth restrictions(FGR) with normal amniotic fluid index(AFI) and fetal growth in hypertensive disorders in pregnancy(HDP) and to compare the outcome of only oligohydramnios ,only FGR and oligohydramnios with FGR in HDP groups. Study Design – This is retrospective study including the 234 pregnant women after 20weeks of gestation with HDP  ,from May 2022-May 2024 Patients were divided into two groups: HDP with oligohydramnios or FGR(n = 48) and HDP with  normal AFI and fetal growth(n = 186). Then, the first group was divided  as only oligohydramnios(n = 16), only FGR(n = 20) and oligohydramnios with FGR(n = 12). perinatal outcomes were recorded. Results - The study found no significant differences in maternal characteristics or complications between the HDP group with oligohydramnios/FGR and the group with normal AFI. However, the HDP group with oligohydramnios/FGR had higher impaired Doppler findings and cesarean section rates (p = 0.004). Neonatal birth weight was lower in the HDP group with oligohydramnios/FGR (p = 0.001), but no significant differences were found in APGAR scores, NICU admissions, or neonatal death. Subgroup analysis showed higher cesarean sections, NICU admissions, and acute fetal distress in the combined oligohydramnios/FGR group (p = 0.05). These findings suggest more severe complications in pregnancies with both oligohydramnios and FGR. Conclusions-Patients with only oligohydramnios showed more favorable outcomes compared to those with only FGR or the coexistence of both conditions. Close monitoring of patients with FGR and those with both conditions is recommended to improve pregnancy outcomes

Background: Hypertensive disorders during pregnancy, including gestational hypertension and preeclampsia, are significant contributors to maternal and fetal morbidity and mortality. Emerging evidence suggests that alterations in serum magnesium and lipid profiles may play a role in the pathophysiology of these conditions. Objective: To evaluate and compare serum magnesium levels and lipid profiles among normotensive pregnant women and those with hypertensive disorders of pregnancy (HDP). Methods: A prospective case-control study was conducted involving 100 pregnant women beyond 32 weeks of gestation. Fifty women diagnosed with HDP formed the case group, while fifty normotensive pregnant women served as controls. Fasting blood samples were analyzed for serum magnesium, total cholesterol, triglycerides, HDL-C, LDL-C, and VLDL-C. Statistical analysis was performed using SPSS version 25. Results: Women with HDP exhibited significantly lower serum magnesium levels and higher levels of total cholesterol, triglycerides, LDL-C, and VLDL-C compared to controls. HDL-C levels were notably lower in the HDP group. These findings suggest a correlation between dysregulated mineral and lipid metabolism and the development of hypertensive disorders during pregnancy. Conclusion: Monitoring serum magnesium and lipid profiles in pregnant women may aid in the early detection and management of hypertensive disorders, potentially improving maternal and fetal outcomes.

Background: Postpartum haemorrhage is the most common type of obstetric haemorrhage and accounts for the majority of cases. Traditionally primary postpartum haemorrhage is defined as blood loss of 500 ml or more of blood from the genital tract within 24 hours of delivery. The present study was relation between determinants or risk factors of major PPH and maternal outcome recorded in terms of duration of hospital stay, number of blood and blood product transfusions, admission to ICU and death as adverse outcome. Aim: To study the role of risk factors in determining maternal and fetal outcome in major postpartum haemorrhage. Material and Methods:  The present hospital based observational case control study was carried out in women who had major PPH after delivery admitted in labour ward of Department of Obstetrics & Gynaecology at Tertiary Care Teaching Hospital. Cases were selected by census method and controls selected were women who had delivered immediately after the case on the same day. Major postpartum haemorrhage in the present study is defined as blood loss of more than 1000 ml as estimated in postpartum woman with bleeding with either two of the following: systolic blood pressure 90 mm of Hg or pulse rate more than 100 per minute or any postpartum bleeding that requires blood transfusion irrespective of the blood loss. Results In the present study 102 cases of postpartum haemorrhage were identified and were compared with 102 controls. Cause of major PPH was atonic in a major number of cases followed by traumatic PPH. Primiparous women formed majority in cases in the present study whereas in controls multiparous women were more. Blood transfusions were done in 99 cases and bood products like fresh frozen plasma was transfused in 19 cases. Platelets were transfused in 14 cases. A total of 19 cases had blood product transfusions. None of the controls had any adverse outcome. Conclusion The present study suggests that majority cases of major PPH can be predicted based on the risk factors which are recognised antenatally especially anemia and hypertensive disorders of pregnancy. Regular antenatal check ups, recognition and correction of risk factors can prevent major PPH and debilitating complications of major postpartum haemorrhage.

Background: Gallbladder cancer (GBC) is a rare yet aggressive malignancy with a poor prognosis, often diagnosed at advanced stages due to its asymptomatic early course. Current diagnostic methods rely on imaging and biopsy, which are limited in early detection. Serum tumor markers like carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA 19-9) have suboptimal sensitivity and specificity. Reliable biomarkers are needed to improve early detection and prognosis in GBC. Objective: This study evaluates the diagnostic and prognostic performance of CEA, CA 19-9, and survivin in GBC patients, focusing on sensitivity, specificity, and correlation with clinicopathological features. Methods: This prospective study, conducted at a tertiary care hospital in eastern India from January to December 2024, included pathologically confirmed GBC patients undergoing surgical resection. Serum levels of CEA, CA 19-9, and survivin were measured using chemiluminescent immunoassay and ELISA. Clinical and pathological data were analyzed. Results: Among 50 GBC patients and 50 matched controls, survivin had superior diagnostic performance (82% sensitivity, 94% specificity) compared to CEA (52%, 74%) and CA 19-9 (64%, 78%). Elevated levels of all markers correlated with shorter survival durations, with survivin showing the strongest prognostic value. Conclusion: Survivin outperforms CEA and CA 19-9 as a diagnostic and prognostic marker for GBC. Its use in clinical practice could enhance early detection and risk stratification. Future research should validate these findings and explore survivin as a therapeutic target.

Introduction: Ultrasound elastography has emerged as a promising non-invasive modality for characterizing breast lesions, offering biomechanical insight beyond conventional B-mode imaging. This study evaluates and compares the diagnostic performance of strain and shear wave elastography (SWE) in differentiating benign from malignant breast lesions. Methods: In this prospective cohort study, 100 patients with ultrasound-detected breast lesions underwent both strain elastography and SWE prior to histopathological diagnosis. Diagnostic metrics including sensitivity, specificity, area under the ROC curve (AUC), and interobserver agreement were calculated. A cutoff SWE velocity >3.5 m/s and strain score ≥4 were used as thresholds for malignancy. Results: Shear wave elastography outperformed strain elastography with an AUC of 0.92 versus 0.86. SWE achieved sensitivity and specificity of 88.6% and 82.6%, respectively, while strain elastography achieved 85.7% and 78.3%. Histopathology confirmed invasive ductal carcinoma in 38% of cases and fibroadenoma in 32%. Interobserver agreement was strong for both modalities (κ = 0.86). Conclusion: Ultrasound elastography, especially SWE, demonstrates high diagnostic accuracy and reproducibility in differentiating breast lesions. Incorporating elastography into standard imaging protocols can enhance diagnostic confidence and reduce unnecessary biopsies.

Background: Thyroid nodules are commonly detected incidentally, and while the majority are benign, some may require further evaluation. Ultrasound plays a key role in the initial assessment by evaluating features such as size, composition, echogenicity, margins, and calcifications. It helps in risk stratification and determining the need for fine-needle aspiration biopsy (FNAB). This study focuses on the role of sonography in the characterization of thyroid nodules. Method: This cross-sectional observational study, was conducted at the F.H. Medical College, Agra over 18 months. In this study a total of included 138 patients with thyroid nodules. Patients with nodules ≥1 cm and those providing written consent were included, while those with diffuse thyroid enlargement were excluded. Ultrasound examinations were performed using high-frequency transducers and nodules >10 mm with normal or elevated TSH levels underwent ultrasound-guided fine-needle aspiration. The findings provide insights into the diagnostic utility of sonography in thyroid nodule evaluation. Results: In this study of 138 thyroid nodules, the majority of cases were observed in individuals aged 31-40 years (26.81%), and there was a higher prevalence in females (67.39%). Most nodules were multiple (78.26%) and classified as TIRADS 3 (32.6%). Cytopathological examination revealed 75.3% benign cases, 13% indeterminate, and 11.5% malignant. Taller-than-wide shape, irregular margins, and marked hypoechogenicity were significantly associated with malignancy. The risk of malignancy increased with higher ACR TIRADS scores, with TIRADS 5 showing an 87.5% malignancy risk. The diagnostic accuracy of ACR TIRADS was 85.83%, with high sensitivity (81.25%) and specificity (86.54%), making it a reliable tool for assessing thyroid nodule malignancy. Conclusion: Sonography is essential for evaluating thyroid nodules and helping assess malignancy risk. Key features like shape, margin, echogenicity, and composition are critical indicators. The ACR TI-RADS scoring system effectively categorizes nodules by malignancy risk, guiding clinical decisions for further testing and treatment.

Ischemic stroke is a neurological emergency which reveals complex and unexpected etiologies infrequently. Embolic strokes represent a major subset of ischemic strokes and are often linked to cardiac or large vessel sources. In one-quarter to one-third of ischemic strokes, the cause may remain elusive despite comprehensive workup, and are classified as cryptogenic stroke. Emerging evidence suggests that systemic and non-cardiogenic conditions, such as malignancy-induced hypercoagulability can act as rare yet important risk factors for ischemic stroke, particularly embolic subtype. We present a case series highlighting two rare but clinically significant etiologies of ischemic stroke, namely malignancy and adenomyosis, in four patients. In addition to ischemic stroke, these patients also exhibited extreme prothrombotic tendency in varied forms such as myocardial infarction, nonbacterial thrombotic endocarditis, pulmonary and venous thromboembolism. This report also aims to highlight adenomyosis as a less-explored cause of ischemic stroke in the young.

Background: Purpose The aim of this study was to evaluate which risk factors may lead patients with gestational diabetes mellitus to cesarean delivery. Methods: This was a retrospective, descriptive study. The subjects of the study were 392 pregnant women with gestational diabetes mellitus attending a public maternity hospital in the central India from Jan 2022 to December 2023. The primary outcomes assessed were based on maternal and fetal characteristics. The data were correlated using an odds ratio (OR) with a 95% confidence interval (95%CI), calculated using multinomial logistic regression. Results: A total of 392 patients with gestational diabetes mellitus were analyzed, and 57.4% of them had cesarean deliveries. Among the maternal characteristics, the mean age of the patients and the pregestational body mass index were greater when a cesarean delivery was performed (p = 0.029 and p < 0.01 respectively). Gestational age at birth, newborn weight, weight class according to gestational age, and Apgar score were not significant. The analysis of the OR showed that the chance of cesarean delivery was 2.25 times (95%CI = 1.49–2.39) greater if the pregnant woman was obese, 4.6 times (95%CI = 3.017–7.150) greater if she was a primigravida, and 5.2 times (95%CI = 2.702–10.003) greater if she had a previous cesarean delivery. The other parameters analyzed showed no differences. Conclusion: The factors that led to an increase in the occurrence of cesarean deliveries included history of a prior cesarean section, first pregnancy, and obesity.

Background: Sepsis represents a significant public health concern, occurring when the body's response to an infection damages its own organs and tissues. Without early recognition and timely treatment, sepsis can progress rapidly to shock and potentially death. Physiological and immunological changes during pregnancy, labor and post-partum increase the susceptibility to infections as well as may mask signs of infection and sepsis, leading to delays in diagnosis and treatment.  Material and Methods: This prospective observational study was  conducted in the department of obstetrics and gynecology at  Baba Raghav Das Medical College , Gorakhpur, Uttar Pradesh from 1/05/2023 to 30/04/2024. 164  patients admitted with diagnosis of obstetric sepsis and  who  met the inclusion criteria were  included in the study. A semi-structured proforma    with patient’s particulars, clinical  profile and relevant investigations was used . q-SOFA and omq-SOFA scores were calculated on  the day of admission and subsequently on multiple days     for each patient.  Results In our study,  the most common microbial agent identified was Escherichia coli in 34(42.5%)  participants  followed by Group B Streptococcus in 18 (22.5%) participants and others. Assessment (q-SOFA) and obstetric-modified quick SOFA (omq-SOFA) with maternal mortality among the study participants (N = 164). For the q-SOFA score, 21.4% (n = 9/42) of participants with a score of 0 experienced maternal mortality, while this increased significantly to 70.0% (n = 21/30) for those with a score of 1, 73.0% (n = 54/74) for a score of 2, and 77.7% (n = 14/18) for a score of 3. Similarly, the omq-SOFA score showed that 21.4% (n = 10/46) of participants with a score of 0 experienced maternal mortality, which rose to 44.2% (n = 19/43) for a score of 1, 81.6% (n = 53/65) for a score of 2, and 100% (n = 10/10) for a score of 3.  Conclusion: Our study concludes omq-SOFA score is better than q-SOFA score with superior predictive accuracy of both adverse maternal outcome and mortality in patients with obstetric sepsis and should be incorporated into clinical practice for early risk stratification and  timely management leading to improved patient outcomes.

Background: Ectopic pregnancy remains a significant obstetric challenge, contributing to maternal morbidity and mortality. Despite advancements in diagnostic modalities, the condition continues to pose a serious threat due to its unpredictable nature and potential for life-threatening complications. This study aimed to assess the risk factors, clinical presentations, and outcomes of ectopic pregnancies in a tertiary care hospital in Kashmir. Methods: A retrospective observational study was conducted over a 20-month period (January 2022–August 2023) at the Department of Obstetrics and Gynecology, GMC Srinagar, Jammu & Kashmir. A total of 153 cases of ectopic pregnancies were identified through a records review. Data on sociodemographic characteristics, clinical presentations, risk factors, management modalities, and outcomes were collected. Statistical analysis was performed using SPSS v.22, with Chi-square and t-tests applied to assess associations. Results: The highest incidence of ectopic pregnancy was observed in women aged 25–30 years (52.9%), with a majority being multiparous (56.2%). The most common risk factors included previous lower segment cesarean section (39.2%), prior abortions (14.4%), and prior ectopic pregnancy (9.2%). Abdominal tenderness (89.5%) and vaginal bleeding (57.5%) were the most frequent clinical presentations. Surgical management was required in 61.5% of cases, while 11.8% were managed medically. Rupture was observed in 39.2% of cases, with significant associations found with adnexal mass (p < 0.001), cervical motion tenderness (p < 0.001), and bleeding per vaginum (p = 0.004). Conclusion: Ectopic pregnancy continues to present significant diagnostic and therapeutic challenges. Previous cesarean section and abortions emerged as major risk factors. The findings highlight the importance of early diagnosis and tailored management strategies to reduce morbidity and improve patient outcomes.

Background: Oligohydramnios is a state of decreased amniotic fluid relative to gestational age. Oligohydramnios is a common complication of pregnancy and the incidence of this is reported to be around 1 to 5 % of total pregnancies. The aim of the study is to study maternal and perinatal outcome in oligohydramnios in term patients. Methods: An observational, prospective and clinical study of 200 patients diagnosed with oligohydramnios (AFI<5) were analysed for perinatal outcome. Results: There were increased rate of caesarean section, low birth weight, fetal growth restriction, low Apgar score, fetal distress and NICU admissions. Conclusion: Oligohydramnios when detected in late second trimester or early third trimester of pregnancy is generally associated with other antenatal maternal or fetal co-morbid conditions which affect the outcome of pregnancy.

Background: Medical abortion has become an increasingly accessible method for early pregnancy termination. While highly effective and safe under medical supervision, the widespread availability of abortion pills without prescription raises concerns about self-administration and potential complications. This study aimed to assess the impact of self-administered abortion pills on women presenting to a tertiary care hospital in Bengaluru, India, focusing on the complications arising from this practice and the subsequent burden on healthcare services. Methods: This prospective observational study was conducted in the Department of Obstetrics and Gynecology at Kempegowda Institute of Medical Sciences(KIMS), Bengaluru, over a 12-month period (October 2023 – September 2024). The study population comprised pregnant women who sought medical attention due to complications following self-administration of medical abortion pills without prior medical consultation, up to 24 weeks of gestation. Data were collected through patient records, surveys, and interviews after obtaining informed consent. Clinical history, ultrasound examinations, and physical assessments were performed to determine outcomes and associated risks. Results: A total of 74 women were included in the study. The most common age group was 21-25 years (37.8%), and most women were multigravida (67.5%). The majority presented with bleeding per vagina (66.21%) and passage of products of conception (16.21%). A significant proportion exhibited anemia, with 50% having moderate anemia (Hemoglobin 7-9.9 g/dL). Incomplete abortion was the most frequent outcome (81%), followed by missed abortion (10%). The primary interventions required were suction and evacuation (75.67%) and anemia correction (33.7%). Conclusion: Self-administration of abortion pills is associated with a high rate of complications necessitating tertiary care intervention, predominantly incomplete abortion and bleeding. This study underscores the importance of medical supervision for medical abortion and highlights the need for public health interventions to ensure safe abortion practices, including improved access to supervised services and enhanced public education regarding the risks of unsupervised self-medication.

Background: Inadequate cobalamin levels (VB12D) within the Indian subcontinent constitute a meaningful dietary health issue, largely resulting from poor public health prioritization, dietary patterns, and limited intake of animal products. This synthesis of pooled evidence integrates results from 20 key Indian studies to assess VB12D frequency and distribution in demographic groups. Objectives: We reviewed the literature and also synthesized the pooled evidence that came from 20 selected Indian studies published between the years 2001 and 2023. Our purpose was to determine the pooled frequency with which levels of inadequate cobalamin occurred in the Indian population. Twenty peer-reviewed studies were selected according to predefined inclusion criteria focusing on Indian populations. These studies included antenatal screening as well as community-based and hospital-based cohorts. A calculation used a variance-accommodating approach. The result was a pooled frequency of occurrence. Subgroup analyses used age group, gender, geographic location, and physiologic status, like pregnancy. Results: In the 20 chosen articles, including 18,750 participants, the pooled frequency of inadequate cobalamin levels occurred in 51% (95% CI: 44%–57%). Vegetarians in 65% of cases, females in 55% of cases, adolescents in 49% of cases, and pregnant women in 67% of cases showed a higher frequency of occurrence. This was notably seen among vegetarians as well as among pregnant women. Differences existed that were inconsistent in rural and urban areas. The data reveal inadequate cobalamin levels burdening the Indian subcontinent, especially women, vegetarians, and youth. These findings support health strategies being critically necessary, so programs must supplement, fortify food, and screen routinely in maternal health.

Background: Preterm birth (PTB), defined as delivery before 37 weeks of gestation, remains a leading cause of neonatal morbidity and mortality globally. Emerging evidence suggests that alterations in the vaginal microbiome during early pregnancy may influence PTB risk. A predominance of non-Lactobacillus species and microbial dysbiosis has been linked to adverse pregnancy outcomes. This study aims to investigate the association between early pregnancy vaginal microbiome profiles and the risk of spontaneous preterm birth. Materials and Methods: This prospective cohort study was conducted among 200 pregnant women recruited before 14 weeks of gestation from a tertiary care hospital. Vaginal swabs were collected during the first trimester and analyzed using 16S rRNA gene sequencing to determine microbiome composition. Participants were followed throughout pregnancy, and delivery outcomes were recorded. Microbiome diversity indices (Shannon and Simpson), community state types (CSTs), and relative abundance of bacterial taxa were compared between women who delivered preterm (<37 weeks) and those who had term deliveries. Multivariate logistic regression was used to identify independent microbial predictors of PTB after adjusting for known confounders. Results: Out of 200 participants, 38 (19%) experienced spontaneous PTB. Women who delivered preterm had significantly higher microbial diversity (mean Shannon index: 2.8 ± 0.3 vs. 1.6 ± 0.4, p < 0.001) and were more likely to exhibit CST IV, characterized by low Lactobacillus and high abundance of Gardnerella, Atopobium, and Prevotella. Logistic regression revealed that CST IV was associated with a 3.5-fold increased risk of PTB (adjusted OR: 3.5; 95% CI: 1.8–6.9; p = 0.002). Lactobacillus crispatus dominance was significantly protective against PTB (adjusted OR: 0.4; 95% CI: 0.2–0.9; p = 0.021). Conclusion: Our findings suggest that early pregnancy vaginal microbiome composition is significantly associated with the risk of spontaneous preterm birth. Dysbiotic microbiota with reduced Lactobacillus dominance and increased anaerobic diversity may contribute to an unfavorable intrauterine environment. Targeted microbial screening and interventions during early gestation may help mitigate PTB risk.

Background: In Preeclampsia and IUGR, the problem begins in the placenta itself. Normally cytotrophoblastic cells of the chorionic villi invades into the decidua basal is which further invades the spiral arterioles and superficial myometrium leading to progressive dilatation of the vessels and thereby reducing the uterine artery resistance and maintaining the perfusion of placenta along with the fetus. Aims: This study is undertaken to evaluate the association between Uterine Artery Resistance Index (R.I.) performed between 10-14 weeks of gestation to predict Intra Uterine Growth Restriction and Pre-eclampsia at later stages in pregnancy. Materials & Methods: Prospective Cohort study. 150 antenatal patients were included in the study done from December 2021 to November 2022. The age of the women varies between 19-33 years. Result: In our study, diastolic notch was present in both uterine arteries in 81 patients (54.0%), present in one artery in 28 patients (18.7%), and absent in both arteries in 41 patients (27.3%). This distribution was statistically significant, with a p-value of < .00001.  Conclusion: First-trimester uterine artery Doppler resistance index (RI) is a valuable predictive tool for identifying pregnancies at risk for intrauterine growth restriction (IUGR) and pre-eclampsia. Elevated RI values are significantly associated with impaired placental perfusion, which contributes to these adverse outcomes. Early identification through Doppler screening enables closer surveillance and timely interventions, potentially improving maternal and fetal outcomes.

Background: The complex range of conditions known as pregnancy-related hypertensive diseases has a significant negative impact on people's health in both developed and developing countries worldwide.  They play a significant role in maternal and infant mortality and morbidity.  Five to ten percent of pregnancies worldwide are affected by hypertension diseases. Aims: To Assess The Role Of Pigf At 11-14 Weeks In Early Prediction Of Pre-Eclampsia. Materials & Methods: The DARBHANGA MEDICAL COLLEGE AND HOSPITAL. This hospital is a tertiary care referral centre in eastern India. Prospective observational study and total sample size 100 patients Result: In our study, among patients with pre-eclampsia, 6 patients (17.14%) had normal values (>1.16), while 26 patients (40%) had abnormal values (<1.16). This difference was statistically significant (p = 0.01), indicating a potential association between abnormal values and pre-eclampsia. Conclusion: Pregnancy-related hypertensive diseases are a complicated group of problems that have a significant negative impact on people's health in both developed and developing countries worldwide.  They are a major contributor to maternal and infant mortality and morbidity.  Around the world, hypertension disorders affect five to ten percent of pregnancies.

Background: The term macrosomia is a foetal growth abnormality is defined on basis of weight above 4000g.Other weight cut offs like 4100g,4500g are also used. Large for gestational age(LGA):is defined as one whose weight is above the 90th percentile for gestational age. Aims: The Aim is to study the correlation of fetal weight with gestational age in Non diabetic mothers. The Aim is to study the causes causing fetal macrosomia in non diabetic mothers. Materials & Methods: The present study was a retrospective study. This Study was conducted done from 2019 to 2022. Total 100 patients were included in this study. Result: Quantitative variables presented as mean ± SD, nominal variables as number (percent), P < 0.05 = Significant, P < 0.001 =highly significant, P > 0.05 = Not significant. Quantitative variables presented as mean ± SD, nominal variables as number (percent), P < 0.05 = Significant, P < 0.001 =highly significant, P > 0.05 = Not significant. Conclusion: Both macrosomic infants of diabetic and non-diabetic mothers are at risk for neonatal complications especially infants of diabetic mothers and male babies in the short term period, especially hypoglycemia, respiratory morbidity, caesarean section delivery, and NICU admission.

Background: The anaesthesiologists and obstetricians encounter specific challenges while managing pregnant patients with congenital complete heart block (CCHB) who require cesarean delivery due to pregnancy-induced physiological changes which requires precise planning to ensure maternal and fetal hemodynamic stability and better outcome. The case involves a 20-year-old primigravida patient weighing 52 kg and measuring 141 cm in height who was pregnant at 38 weeks and 2 days while maintaining a stable fixed heart rate between 48 and 53 bpm due to congenital complete heart block. The patient underwent pacemaker implantation as a past medical procedure before experiencing an infection, which led to the device removal. An emergency LSCS under spinal anaesthesia required the patient to undergo surgery, while the anaesthesiologists anticipated and effectively treated complications of bradycardia and hypotension by using close monitoring and pre-emptive transcutaneous pacing support, targeted fluid therapy and vasopressor use. A 2.6 kg healthy female baby received good Apgar scores during delivery. The patient demonstratedfew sustained episodes of bradycardia during the perioperative period, which were successfully managed because of effective preoperative planning between multiple disciplines, as well as constant monitoring during surgery and after delivery to ensure the wellbeing of patients with congenital cardiac conduction disorders.

Background: MMR is an important indicator in assessing the development of a country. In India, MMR in 2020 statistics is 97 per 1 lakh live births. It used to be 384 per 1 lakh live births in 2000 and is declining now. MMR in south india is less compared to northern counterparts. Andhra Pradesh ranks 4th in lowest MMR rates. Most Common Cause of maternal deaths is hemorrhage followed by COVID pneumonia followed by sepsis. The decline in MMR is contributed to significant betterment in health care facilities and multidisciplinary approach. The recommended SDG goals is 70 per 1 lakh by 2030 1,5. So, it is essential to identify the lacunae and causative factors to take appropriate measures to real our goal. Aim: Analysis of incidence of different causes of maternal mortality and their declining trend. Objective: To address the declining trends in Maternal Mortality Rates in a Teritiary care hospital , Government General Hospital, Kakinada Assess incidence of different causes of maternal deaths Methodology: It is a retrospective observational study conducted in the Department of OBG, Government General Hospital attached to Rangaraya Medical College for a period of 60 months from December 2019 to December 2024. Results: A total of 171 maternal deaths which occured from november 2019 to november 2024 are studied and categorized into different causative factors.The most common cause of maternal deaths is hemorrhage i.e. 69 cases(40.3%) followed by covid pneumonia 34 cases(19.8%) followed by sepsis 30 cases(17.5%). The most common cause of maternal deaths due to hemorrhage is atonic PPH followed by ectopic pregnancy. Primigravida are more susceptible to these adverse events. Conclusion: Hemorrhage still remains as the most leading cause of death in pregnant women, while the overall mortality rate has been reduced due to improved health care, adequate availability of blood and blood products and prompt referral.

Background: Recurrent Pregnancy Loss (RPL), particularly Unexplained RPL (URPL), represents a significant reproductive challenge, causing considerable distress to affected couples. Adequate uterine perfusion is fundamental for successful implantation and pregnancy maintenance. Impaired uterine artery blood flow, detectable by Doppler ultrasonography, has been implicated in the pathophysiology of URPL. This study aimed to compare uterine artery blood flow parameters in non-pregnant Kashmiri women with URPL to those with histories of normal term pregnancies. Methods: A prospective case-control study was conducted involving 40 Kashmiri women aged 20-40 years with a history of two or more unexplained first-trimester pregnancy losses (URPL group) and 40 age-matched Kashmiri women with at least one normal term pregnancy and no history of miscarriage (control group). Abdominal Doppler ultrasonography was performed in the mid-luteal phase of the menstrual cycle to assess bilateral uterine artery Pulsatility Index (PI) and Resistance Index (RI). Endometrial thickness was also measured. Results: The mean uterine artery PI was significantly higher in the URPL group (2.2 \pm 0.7) compared to the control group (1.5 \pm 0.9; p < 0.001). The mean uterine artery RI was non-significantly elevated in women with URPL (0.9 \pm 0.2) versus controls (0.8 \pm 0.3; p < 0.083). There was a statistically significant difference in endometrial thickness between the two groups (9.3 \pm 0.2 mm for URPL vs. 11.1 \pm 0.4 mm for controls; p = 0.001). Conclusions: Kashmiri women with URPL exhibit significantly increased uterine artery impedance compared to women with normal pregnancy histories. These findings suggest that impaired uterine perfusion may be a contributing factor to URPL in this population, highlighting the potential diagnostic value of uterine artery Doppler assessment.

Background: Preeclampsia is a transient but potentially dangerouscomplication of pregnancy. Most current assumption regarding the pathophysiologic mechanisms of preeclampsia point to trophoblastic dysfunction. Aim: The present study was conducted to evaluate the relationship between serum total testosterone (TT) with mean arterial blood pressure and risk of cardiovascular disease in patients withpreeclampsia. Methods: A case-control study designed with fifty preeclamptic patients that randomly selected from gynecology ward were studied for estimation of serum TT. Serum TT determined by means of chemiluminescent immunoassay methodbase Immulite 1000 analyzer.  Results: The statistical analysis of study group of preeclampsia compared with normotensive control group, showed significant (p< 0.001)increase in serum TT concentrations in patients with preeclampsia. Positive and highly significant correlation (r = 0.528, P < 0.001) was observed between serum TT compared with mean blood pressure in preeclampsia. Conclusion: The concentrations of the potent total testosterone were significantly higher in women with preeclampsia than in normotensive women with similar gestational and maternal ages. This change may indicate a role of the testosterone in the pathogenesis of preeclampsia.The present study found a significant association between serum TT and mean blood pressure as a risk factor for cardiovascular disease (CVD) and trophoblastic dysfunction in preeclampsia.

Background: Pericardial effusions can be life-threatening medical emergencies. Pericardial effusions can occur secondary to pericarditis, infections, post pericardiotomy syndrome, rheumatologic causes, malignancy, bone marrow transplant, and additional causes. Colchicine has been an approved therapy for pericarditis in adults. Its usage in pediatrics is limited and extrapolated from adult literature. We report a case of a patient with a history of Acute Myeloblastic Leukemia (AML), status post a second bone marrow transplant (BMT), with recurrent pericardial effusions treated with Colchicine. Our patient, SG, was diagnosed with AML with bilateral ocular involvement at 4 years of age. His initial treatments (chemotherapy) were prior to coming to our institution, in an international setting. He had relapsed following initial treatment and required reinduction therapy with chemotherapy and radiation (for ocular disease) prior to undergoing his first bone marrow transplant on June 21, 2024. After developing graft failure post first transplant, he underwent a second bone marrow transplant on August 14, 2024. His treatment at our institution included chemotherapies (Asparaginase, Busulfan, Cyclophosphamide, Cytarabine, Fludarabine, Mesna, Methotrexate, Methylprednisolone, rabbit anti-thymocyte globulin, and prednisone), bilateral orbital radiation (905cGY), and total body irradiation (300cGY).

Background: Pre-pregnancy body mass index (BMI) is a crucial determinant of maternal and neonatal health, significantly influencing the mode of delivery, maternal complications, and neonatal outcomes. With the increasing prevalence of maternal obesity and undernutrition, obstetricians face challenges in managing pregnancy-related risks. Obesity has been linked to gestational diabetes mellitus (GDM)1, hypertensive disorders, macrosomia, prolonged labor4, and an increased likelihood of cesarean delivery, while underweight mothers are more prone to intrauterine growth restriction (IUGR)6, low birth weight (LBW), and neonatal intensive care unit (NICU) admissions8. Understanding the relationship between BMI and delivery outcomes is essential for improving antenatal care, risk stratification, and maternal-fetal health management. Materials And Methods: This study was conducted as a prospective observational study at the Department of Obstetrics and Gynecology, Kempegowda Institute of Medical Sciences, Bangalore, from August 1, 2024, to October 31, 2024. A total of 40 term pregnant women were categorized into four BMI groups based on the WHO classification: underweight (<18.5 kg/m²), normal (18.5–24.9 kg/m²), overweight (25–29.9 kg/m²), and obese (≥30 kg/m²). Data collection included patient demographics, obstetric history, mode of delivery, maternal complications, and neonatal outcomes. Statistical analysis was performed using SPSS v23, with chi-square tests, logistic regression, and Pearson’s correlation coefficient applied to evaluate associations between BMI and pregnancy outcomes. A p-value <0.05 was considered statistically significant. Results: The results revealed that cesarean section rates increased with maternal BMI, with 100% of obese women undergoing cesarean delivery, compared to 62.5% in overweight women, 25% in normal BMI women, and 16.7% in underweight women. Vaginal delivery was most frequent in normal BMI (75%) and underweight (83.3%) women, whereas obese women had the highest incidence of labor complications, including prolonged labor (50%) and gestational diabetes (50%). Hypertensive disorders were significantly higher in overweight (37.5%) and obese (50%) women, indicating an increased risk of metabolic and vascular dysfunction in these groups. Neonatal outcomes were also significantly affected by maternal BMI. Low birth weight (50%) was most common in underweight mothers, suggesting nutritional insufficiency and placental insufficiency99. Conversely, macrosomia (25%) was prevalent in obese women, aligning with higher rates of gestational diabetes and excessive fetal growth1010. NICU admissions were highest in underweight (3.3%) and obese (50%) neonates, emphasizing the importance of BMI regulation before pregnancy to minimize neonatal morbidity. Statistical analysis confirmed that BMI was positively correlated with cesarean section rates (p < 0.001, OR = 4.2), while underweight mothers had a significantly higher risk of delivering low birth weight neonates (p < 0.001). Additionally, gestational diabetes was strongly associated with obesity (p < 0.001), reinforcing the need for early glucose screening in overweight pregnancies. Conclusion: In conclusion, this study demonstrates that both underweight and obese women face increased pregnancy-related risks, emphasizing the importance of achieving an optimal BMI before conception. Obese women are at a significantly higher risk of cesarean delivery, gestational diabetes, and hypertensive disorders, while underweight women are more likely to deliver low birth weight infants and experience increased NICU admissions. These findings highlight the need for preconception weight management programs, targeted antenatal monitoring, and early interventions for high-risk pregnancies. Future research should explore larger-scale studies to evaluate long-term neonatal outcomes and assess the effectiveness of maternal weight optimization programs in reducing pregnancy-related complications.

Introduction: reproductive and sexual health is one of the topics which is scarcely discussed in india. Increasing age gap between the age of puberty and marriage, early sexual activity and inadequate knowledge might lead to risk of STD and unwanted pregnancy Objective – this study was done to know the extent of awareness about reproductive health, contraception and STD’s  among adolescent girls aged between 11-19yrs  Methods- it’s a prospective observational study carried out among 400 girl students between age 11-19yrs using a structured pre designed multiple choice questionnaire , analysis was done using spss software Results- among 400 participants 26.5% were sexually active , 62%knew about condoms, more than 2 methods of contraception was known to 22% of girls. In our study 47.5% of girls didn’t have an idea about routes of transmission of STD’s. among all participants who were having knowledge of STD’s HIV was most commonly known.in our study 72.25% didn’t have an idea of HPV vaccine Conclusion- poor knowledge in girls about reproductive health contraception and STD’s is of serious concern. Therefore, education about contraception should be incorporated in the curriculum which should be given through teaching, interpersonal communication, television, health camps and specialists.

Background: Mammary analogue secretory carcinoma (MASC) is defined as a rare lump of salivary gland that most generally affects the parotid gland, followed by the submandibular gland and also other minor salivary glands. Since 2017, MASC has been included in the World Health Organization's ( WHO) Bracket of Head and Neck Tumors. It's a  veritably rare subtype of  malignancy of salivary gland. Here we report a case of a 13 yr old female who presented to ENT OPD with right side parotid swelling, managed surgically and diagnosed as secretory carcinoma parotid on HPE.

Background: Helicobacter pylori–induced chronic inflammation plays a central role in gastric carcinogenesis, yet the progression from histologic precursors to gastric adenocarcinoma remains under-characterized in semi-urban Indian populations. Methods: We conducted a prospective cohort study of 80 patients with biopsy-confirmed H. pylori infection at Government Medical College, Jangaon, Telangana, from August 2023 to August 2025. Patients underwent serial endoscopic and histopathologic evaluations every 6 months. Histological features, including inflammation, intestinal metaplasia, and dysplasia, were recorded. The primary outcome was the development of gastric adenocarcinoma at 24 months. Logistic regression and Kaplan–Meier analyses were performed using SPSS v27. Results: At baseline, 26.2% of patients had intestinal metaplasia and 11.2% had dysplasia. Over 24 months, 6.2% (n=5) developed gastric adenocarcinoma. Patients with baseline dysplasia had a fivefold higher relative risk of progression (RR=5.26; 95% CI, 1.01–27.37; p=0.17). Logistic regression identified both dysplasia (OR=17.04; p=0.057) and metaplasia (OR=22.21; p=0.053) as strong, near-significant predictors of malignancy. Kaplan–Meier analysis showed lower cancer-free survival in patients with dysplasia, with clear curve separation after 12 months. Conclusions: Histological dysplasia and intestinal metaplasia at baseline significantly increased the risk of gastric cancer in H. pylori–positive patients. Targeted surveillance based on early histologic markers may be critical for preventing malignant transformation in endemic settings.

Background: In elective caesarean sections, spinal anaesthesia is the most commonly utilized anaesthesia technique, except for cases involving laboring mothers and significant fetal distress requiring general anaesthesia [1]. Objectives: 1. To evaluate and compare hemodynamic parameters including heart rate (HR), mean arterial pressure (MAP), respiratory parameters including rate (RR) and SPO2 with epidural magnesium sulfate vs dexmedetomidine vs normal saline during the postoperative period. Material & Methods: Study Design:    It is a randomized, double blinded, prospective, placebo controlled comparative study. Study area: The Pre-operative room, Gynecological operation theatre, Post anaesthesia care unit (PACU) of Dr PSIMS & RF.  Study Period: January 2019 to September 2019. Study population: Patients with ASA physical status 1 or 2, undergoing elective caesarean section at term pregnancy under spinal anaesthesia at Kona Seema institute of medical sciences, Malappuram.  Results: All the patients were observed up to 6 hours postoperatively and it was found that there were 38, 16, 87 episodes of hypotension in group A, B and C respectively. The rate of occurrence of hypotension was estimated to be 1.19, 0.50,2.71 per patient in gr. A, B and C respectively. It clearly shows the superiority of group B over group A & group C.  Conclusion: In conclusion, our findings indicate that administering intramuscular phenylephrine at a dosage of 4mg helps to decrease both the occurrence and intensity of hypotension following spinal anaesthesia in caesarean sections when compared to 2 mg of phenylephrine or placebo.

Background: Anemia during pregnancy is a major public health concern, particularly in developing countries, and is associated with adverse maternal and fetal outcomes. Iron deficiency is the leading cause of anemia in pregnancy. Oral iron therapy remains the conventional treatment, but intravenous iron preparations, particularly ferric carboxymaltose (FCM), have gained attention due to better compliance and rapid hemoglobin improvement. Materials and Methods: This prospective, randomized comparative study was conducted at a tertiary care hospital over a 12-month period. A total of 120 pregnant women (gestational age between 14–28 weeks) with moderate iron deficiency anemia (hemoglobin 7–9.9 g/dL) were enrolled and randomly assigned into two groups: Group A (n=60) received intravenous ferric carboxymaltose (1000 mg in a single infusion), and Group B (n=60) received oral ferrous sulfate tablets (100 mg elemental iron twice daily) for 6 weeks. Hemoglobin (Hb), serum ferritin, and patient-reported gastrointestinal side effects were evaluated at baseline and after 6 weeks. Results: At 6 weeks, the mean rise in hemoglobin was significantly higher in Group A (3.2 ± 0.6 g/dL) compared to Group B (2.1 ± 0.5 g/dL) (p < 0.001). Serum ferritin levels also increased markedly in Group A (from 12.4 ± 3.8 ng/mL to 56.3 ± 9.7 ng/mL), compared to Group B (from 13.2 ± 4.1 ng/mL to 32.7 ± 6.5 ng/mL). Gastrointestinal side effects were significantly less in the FCM group (10%) compared to the oral iron group (38%). Conclusion: Ferric carboxymaltose is more effective than oral iron in rapidly correcting hemoglobin and improving iron stores in pregnant women with moderate anemia. It is also associated with better tolerability and fewer gastrointestinal adverse effects, suggesting its suitability as a preferred option in antenatal anemia management.

Background: The HIV infection burden is increasing day by day, especially in women of reproductive age groups. This subgroup of people is the potential candidates for whom effective ART in pregnancy can prevent mother-to-child transmission and decrease the new cases of neonatal HIV infection.  This study aims to observe the incidence of HIV infection in pregnancy and its effect on maternal and fetal outcomes.   Methods: This is a retrospective case record analysis of 31 HIV-positive pregnant patients during a period of five years from 2019 to 2024 in the Govt. Medical College, Kathua. Results: 31 patients were included in the study, and the incidence was 0.14%. The mean age of patients was 25.06 years, and 45.1% of patients were aged 26-30 years. The majority of patients had at least primary school education (67.7%), while serodiscordance was seen in 25.8% of couples. About 58.1% of patients were new cases detected during pregnancy, with the highest detection rate in the third trimester (29%). Primigravida was more common (48.4%) in the study. LSCS rate was about 55%. Preterm birth and low birth weight were seen in 3.2% and 25.5% of the babies. Neonatal mortality was 6.8%. No case of mother-to-child transmission was noted.  Conclusion:  HIV infection had adverse effects on pregnant women in terms of low-birth-weight newborns, prematurity, and neonatal deaths. All these contribute to neonatal morbidity, which predisposes to increased chances of mother-to-child transmission.

Background: Ectopic pregnancy is a potentially life-threatening condition in which a fertilized ovum implants outside the uterine cavity, most commonly in the fallopian tubes. It remains a major cause of maternal morbidity and mortality in the first trimester, particularly in resource-limited settings. Despite advancements in diagnostic imaging and laboratory support, delays in diagnosis are still common due to the variable and non-specific nature of its clinical presentation. Ectopic pregnancy accounts for 1–2% of all pregnancies globally, but the incidence may be higher in populations with limited access to early antenatal care or with high rates of risk factors such as pelvic inflammatory disease, tubal surgery, infertility treatments, or previous ectopic pregnancies.  In many cases, the classic triad of amenorrhea, abdominal pain, and vaginal bleeding may not be evident, making clinical suspicion essential. Without timely intervention, ectopic pregnancy can lead to tubal rupture, massive intra-abdominal bleeding, and maternal death. In low- and middle-income countries, the burden is further amplified due to late presentation, inadequate diagnostic facilities, and restricted access to emergency obstetric care. Understanding the clinical features and demographic patterns of ectopic pregnancy in a tertiary care setting is crucial to improve early diagnosis and outcomes. A hospital-based analysis provides valuable insight into real-world presentations and helps identify gaps in care that can be addressed through targeted interventions. Objective: To determine the clinical features of ectopic pregnancy among women presenting to a tertiary general hospital. During the study period, 50 subjects were chosen for the study. Conclusion: Strengthening clinical acumen and timely diagnostic protocols in emergency and obstetric care settings can significantly improve maternal outcomes in cases of ectopic pregnancy.

Background: Incidental thyroid nodules (ITNs) are frequently identified during imaging studies performed for unrelated indications. Their increasing detection warrants systematic evaluation to determine their clinical significance and malignancy risk. Objectives: To evaluate the prevalence, imaging characteristics, and cytological outcomes of ITNs detected on neck and chest imaging modalities. Methods: This retrospective observational study included 100 patients with incidentally detected thyroid nodules identified on CT, MRI, or ultrasound conducted for non-thyroid-related complaints. Data were collected on demographics, imaging modality, nodule size, location, composition, ultrasonographic features, thyroid function tests (TFTs), and fine-needle aspiration cytology (FNAC) results. Nodules were classified based on standard radiologic descriptors and Bethesda cytology criteria. Results: The mean age of the patients was 52.6 ± 13.4 years, with a female predominance (68%). ITNs were most commonly detected on CT (52%), followed by ultrasound (31%) and MRI (17%). Right-lobe involvement was seen in 42%, left in 36%, and bilateral in 22%. Nodules ranged in size with 45% being 1–2 cm, and 20% exceeding 2 cm. Solid composition was most frequent (54%). Among 65 patients evaluated by ultrasound, 43.1% were hypoechoic; 18.5% had irregular margins and 13.8% showed microcalcifications. FNAC was performed in 28 cases; 71.4% were benign, while 14.2% were either malignant or suspicious for malignancy. Most patients (91%) were euthyroid on TFTs. Conclusion: ITNs are common and require structured evaluation, especially those with suspicious imaging features. Early identification of malignancy aids in timely intervention.

Background: Gestational diabetes mellitus (GDM) represents a common metabolic condition during pregnancy that significantly influences neonatal outcomes. Among the most concerning complications observed in neonates of GDM mothers are hypoglycemia and macrosomia, which can lead to adverse short- and long-term health consequences. Addressing this relationship is vital for guiding perinatal risk management. Materials and Methods: This prospective study was conducted over a one-year period (December 2023 to November 2024) in the Department of Obstetrics at Srinivasan Medical College and Hospital. A total of 220 pregnant women were recruited—110 diagnosed with GDM and 110 matched non-GDM controls. Newborns were evaluated for hypoglycemia within the first two hours post-delivery, and birth weights were recorded. Analytical methods included independent t-tests, chi-square analysis, and logistic regression to assess associations. Results: Neonatal hypoglycemia occurred more frequently in the GDM group (28.2%) than in controls (9.1%), with this difference being statistically significant (p < 0.001). Similarly, the prevalence of macrosomia was higher among neonates of GDM mothers (23.6%) versus controls (7.3%) (p < 0.01). Infants born to mothers with HbA1c levels exceeding 6.5% demonstrated a greater likelihood of both complications, with a relative risk of 2.87 (95% CI: 1.89–4.35). Conclusion: There is a notable association between gestational diabetes and increased risks of neonatal hypoglycemia and macrosomia. Early diagnosis and effective glycemic regulation during pregnancy are essential to reduce the occurrence of these adverse neonatal outcomes

Background: Breast lesions are very common diseases worldwide. Benign breast disease (BBD) account for most breast problem in females. Carcinoma breast is one of the most common human neoplasms rapidly replacing cancer cervix as leading site of cancer in urban populations of India. A panel of antibodies, improved antigen retrieval techniques have all contributed to the use of immunohistochemistry (IHC) in solving diagnostic problems in breast pathology. This is a cross-sectional study done in  hospital in Tumkur, Karnataka for 1.5 years. Total of 41 benign and 41 malignant biopsies of breast neoplasm from female patients were studied. All breast masses were analyzed systematically by clinical history, physical examination, histo-pathological examination along with the immunohistochemical study of CK5/6.All collected data were entered into a master sheet and fed into computer software for statistical analysis using Pearson’s Chi-square test. In our study patients belonged to the age group of 15–70years.Benign lesions were common in the age group of 21–30 years, and malignant lesions were common in the age group of 51–60 years. The most frequent benign neoplasm was fibroadenoma (74%)and in malignancy, IDC-NOS (85%). Most of the malignant cases were of size T2 (76%) and grade II (66%) and without any lymph node metastatic deposits (83%). All benign breast lesions showed positive expression for CK 5/6; the staining index of benign lesions varied from 5–9. Fibroadenomas showed stain index range of 6–8. Highest stain index of 9 was seen in fibrocystic with ductal epithelial hyperplasia. In malignant lesions, all cases were negative for CK5/6 expression except IDC-NOS cases which were grade III (poorly-differentiated) and showed weak CK5/6 expression with stain index of 2.There was a statistically significant association between CK5/6 stain index with grading and lymph node metastasis. Immunohistochemistry (IHC) is an integral part of the pathology. Although hematoxylin and eosin (H&E)stain remain gold standard method for diagnosis, IHC provides useful vital information in grey zone cases.CK5/6, as a component of panels along with AE1/AE3 and myoepithelial markers, help to differentiate benign and malignant breast lesions in cases of interobserver variability. Grade III breast carcinoma cases, if positive for CK 5/6, imply a ‘basal-like’ molecular phenotype and signify a poor prognosis. These tumors require aggressive intervention. CK 5/6 can help provide prognostic information and better treatment modalities.

Background: Gestational Diabetes Mellitus (GDM) represents a significant metabolic disturbance during pregnancy with adverse maternal and fetal outcomes. Identifying early biomarkers can facilitate timely diagnosis and intervention. Adiponectin, an adipokine with insulin-sensitizing properties, has emerged as a potential predictive biomarker for GDM. Materials and Methods: A retrospective observational study was conducted at the Department of General Medicine, Sardar Rajas Medical College Hospital and Research Centre, Bhawanipatna, Odisha, over a period of one year (January 2010–December 2010). A total of 120 pregnant women attending first-trimester antenatal clinics were enrolled. Serum adiponectin levels were measured at 11–13 weeks of gestation. Participants were followed up and screened for GDM using the 75g oral glucose tolerance test (OGTT) at 24–28 weeks, as per WHO criteria. Statistical analyses included t-tests, chi-square tests, and logistic regression to evaluate the association between adiponectin levels and GDM development. Results: Out of 120 participants, 28 (23.3%) developed GDM. The mean serum adiponectin level in the GDM group was significantly lower (5.8 ± 1.4 µg/mL) compared to the non-GDM group (9.3 ± 2.1 µg/mL) (p < 0.001). An adiponectin cut-off value of <7 µg/mL showed 85.7% sensitivity and 78.3% specificity for predicting GDM. Multivariate regression indicated that low adiponectin was an independent predictor (OR: 4.12; 95% CI: 2.1–8.0; p < 0.001). Conclusion: First-trimester serum adiponectin levels demonstrate a significant inverse relationship with the development of GDM and may serve as a reliable early biomarker for risk stratification and preventive strategies.

Background: Emerging evidence highlights the critical role of the maternal microbiome in modulating immune, metabolic, and hormonal functions during pregnancy. Alterations in microbial communities may contribute to adverse pregnancy outcomes such as preeclampsia, preterm birth, gestational diabetes mellitus (GDM), and intrauterine growth restriction (IUGR). This longitudinal study investigates the association between maternal microbiome composition and pregnancy outcomes across the three trimesters. Materials and Methods: A prospective cohort of 120 pregnant women aged 20–35 years was recruited at <12 weeks gestation and followed through delivery. Vaginal, oral, and fecal microbiome samples were collected at each trimester. 16S rRNA gene sequencing was used for microbial profiling. Pregnancy outcomes assessed included gestational age at delivery, incidence of GDM, hypertensive disorders, and neonatal birth weight. Alpha and beta diversity indices were calculated, and associations with outcomes were analyzed using multivariate regression models. Results: Out of 120 participants, 112 completed the study. Women who developed preeclampsia (n=14) showed significantly lower vaginal microbial diversity in the second trimester (Shannon index mean: 2.1±0.4) compared to normotensive women (3.5±0.6; p<0.001). Higher relative abundance of Prevotella and Gardnerella in the vaginal microbiome was significantly associated with preterm birth (n=11; OR=2.8, 95% CI: 1.4–5.6). Gut microbial dysbiosis characterized by a lower Firmicutes/Bacteroidetes ratio was observed in GDM cases (n=16) during the third trimester (p=0.02). No significant changes were observed in oral microbiome patterns across groups. Conclusion: This study underscores the dynamic nature of the maternal microbiome and its potential predictive value for pregnancy complications. Specific microbial shifts, particularly in the vaginal and gut environments, are associated with adverse outcomes such as preeclampsia, preterm birth, and GDM. Monitoring maternal microbiome profiles may serve as a non-invasive tool for early identification of at-risk pregnancies and inform targeted interventions.

Background: Preeclampsia is a pregnancy-specific hypertensive disorder associated with significant maternal and fetal morbidity. Homocysteine, a sulfur-containing amino acid, has been implicated in endothelial dysfunction and vascular pathology. This study aimed to evaluate and compare serum homocysteine levels in preeclamptic and normotensive pregnant women and correlate these levels with disease severity and outcomes. Methods: This prospective case-control study was conducted at Chalmeda Anand Rao Institute of Medical Sciences, Telangana, from September 2022 to February 2024. A total of 80 pregnant women between 26–40 weeks of gestation were enrolled, including 40 preeclamptic (cases) and 40 normotensives (controls). Detailed clinical evaluation, blood pressure measurement, and biochemical investigations including serum homocysteine estimation were performed. Maternal and fetal outcomes were recorded. Statistical analyses included t-tests, chi-square tests, and Pearson correlation. Results: The mean serum homocysteine level was significantly higher in the preeclamptic group (15.52 ± 4.80 µmol/L) compared to controls (10.42 ± 3.64 µmol/L, p < 0.001). Hyperhomocysteinemia (>15 µmol/L) was observed in 65% of cases and 10% of controls. A strong positive correlation was noted between homocysteine levels and systolic (r = 0.512) and diastolic blood pressure (r = 0.482). Adverse maternal and fetal outcomes, including preterm delivery, low birth weight, increased NICU admissions, and maternal complications, were more prevalent in the preeclamptic group. Conclusion: Elevated serum homocysteine levels are significantly associated with preeclampsia and correlate with disease severity and adverse outcomes. Homocysteine may serve as a potential biochemical marker for early identification and risk stratification of preeclampsia.

Background: Cerebral venous thrombosis have wide spectrum of symptoms and signs with headache is the most common presenting symptom, in 70–90% of cases. Neuroimaging is the corner stone in the diagnosis of cerebral venous thrombosis. In the present study we are going to investigate the clinical profile, radiological findings and risk factors of cerebral venous thrombosis. Material and Methods: Present study was single-center, prospective, observational study, conducted in patients age group 18 years and above irrespective of genders admitted to the hospital with a radiological evidence of cerebral venous thrombosis. Results: Most of the patients were in the age group of 18-40 years contributing to 65%. Mean age of patients was found to be 36.23 years. Males to females ratio (sex ratio) found to be 1:1.2. Most common risk factor in male patients is addiction (alcohol and smoking) found in 55% of total male patients. Most common risk factors in female patients was use of OC pills and HRT accounting for 30.3% of total female patients and pregnancy related (ANC and PNC) found in 30.3% patients out of which 21.21% females belongs to puerperium period. The most common presenting symptom was Headache (60%) followed by convulsions (41%), focal deficits (15%) and altered sensorium was present in 13.33% patients. Most common neurological sign was papilledema (23.33) followed by Hemiparesis (15%). Most common radiological finding was cerebral edema seen in 28.33% followed by hemorrhagic infarction seen in 23.34% of cases. 3.33% patients had sub arachnoid hemorrhage. In this study multiple (more than one) sinus involvement. Conclusion: CVST is mostly seen in third decade. Addiction, drugs, underlying procoagulant state like pregnancy, puerperium, coagulation disorders, infections are major risk factors for CVST.

Background: Intrauterine Growth Restriction (IUGR) is a significant obstetric complication characterized by fetal growth below the 10th percentile for gestational age, leading to increased perinatal morbidity and mortality. Abnormal maternal lipid metabolism has been implicated in its pathogenesis. Objective: To assess the association between maternal and cord blood lipid profiles and IUGR in pregnant women at a tertiary care hospital. Methods: Sample size was calculated using the formula for comparison of two means: N = [(Z₁-α/2 + Z₁-β)² × (SD₁² + SD₂²)] / d² Based on Kwaeri et al., with SD₁ = 20.3 mg/dL, SD₂ = 14.8 mg/dL, and d = 10 mg/dL, the sample size was 49.8 per group (rounded to 50), totaling 100 participants. Consecutive sampling was employed. This analytical observational case-control study included 100 pregnant women (50 with IUGR and 50 controls with adequate-for-gestational-age fetuses). Maternal fasting blood samples were collected during the third trimester, and cord blood samples were obtained immediately after delivery. Lipid profiles, including total cholesterol, triglycerides, HDL, LDL, and VLDL, were analyzed. Statistical comparisons were performed using Student’s t-test and Chi-square test, with p < 0.05 considered significant. Results: Maternal cholesterol, triglycerides, LDL, and VLDL levels were significantly higher, and HDL levels were lower in the IUGR group compared to controls (p < 0.001). Similarly, cord blood from IUGR neonates showed elevated triglycerides and VLDL, and reduced cholesterol and HDL levels (p < 0.05). Lower maternal BMI and shorter gestational age were also associated with IUGR. Conclusion: Abnormal maternal and fetal lipid profiles are strongly associated with IUGR, suggesting dyslipidemia’s role in its pathophysiology. Early lipid screening and nutritional interventions during pregnancy may reduce IUGR risk and improve neonatal outcomes.

Background: Hypertension (HTN) is a growing non-communicable disease burden in India, often diagnosed late due to its asymptomatic nature. Early clinical and metabolic profiling of newly detected hypertensive patients is crucial for timely intervention and prevention of long-term complications. Aim: To assess the clinical and metabolic profile of patients newly diagnosed with hypertension in an outpatient setting. Methods: This prospective observational study was conducted at Dr. D.Y. Patil Medical College and Hospital, Navi Mumbai, over one year. A total of 100 adult patients newly diagnosed with hypertension, as per JNC 8 guidelines, were enrolled after informed consent. Patients with diabetes, CKD, ischemic heart disease, pregnancy, or on interfering medications were excluded. Detailed clinical history, anthropometric measurements, laboratory parameters, ECG, and 2D echocardiography were recorded and analyzed using appropriate statistical methods. Results:Among the 100 participants, 77% were male and 23% female, with the highest age group representation in those ≥60 years. Stage I hypertension was more common (70%), and headache was the most frequently reported symptom. Overweight and obesity were noted in the majority, with a statistically higher BMI in females. Metabolic assessment revealed elevated cholesterol in 71% and abnormal HDL levels in 88%, with significantly lower HDL and higher cholesterol in females. ECG abnormalities, particularly left ventricular strain and hypertrophy, were frequent. Cardiac involvement showed significant gender variation, with RWMA more prevalent in females. Renal artery Doppler abnormalities were detected in 11% of patients. Conclusion: Newly diagnosed hypertensive patients exhibit a range of clinical and metabolic abnormalities at presentation. Early detection, lifestyle modification, and comprehensive evaluation, including lipid profiling and cardiac assessment, are essential in guiding effective management and reducing long-term cardiovascular risk.

Background: Hypertensive emergencies in pregnancy, especially severe preeclampsia and eclampsia, are critical contributors to maternal and fetal morbidity. Prompt control of blood pressure is essential to prevent complications. In developing countries like India, where maternal deaths due to preeclampsia are still unacceptably high, evaluating cost-effective and practical protocols for hypertensive emergencies becomes essential. This study compares the efficacy of intravenous labetalol and oral nifedipine in achieving rapid BP control in pregnant women presenting with hypertensive emergencies. Materials and Methods: This is a Prospective, comparative, randomized study conducted in the Department of Obstetrics and Gynecology at a tertiary care hospital over 12 months involving 100 pregnant women with hypertensive emergencies was conducted. Group A received intravenous labetalol; Group B received oral nifedipine. Both groups were monitored for time to achieve target BP, maternal side effects, and fetal outcomes. Data analyzed using SPSS v20. Mean, SD, t-tests, and chi-square used. P < 0.05 was considered significant. Results: Group A (IV labetalol) showed faster BP control (mean time: 25 ± 8 min) compared to Group B (nifedipine: 35 ± 10 min). Adverse effects were minimal in both groups. Perinatal outcomes were comparable. Conclusion: Intravenous labetalol offers faster blood pressure control with fewer maternal side effects in hypertensive emergencies of pregnancy, though both labetalol and nifedipine are safe and effective. Drug choice can be guided by clinical setting, availability, and patient-specific factors.

Background: To study relative preponderance of critical obstetrical emergencies with various maternal factor-like quality of antenatal care during pregnancy, regular antenatal checkup during pregnancy, socioeconomic status, education and area wise distribution and to study the contribution of each emergency to maternal mortality and morbidity and fetal outcome. Methods: The present study was conducted on a prospective basis for one year, from 1st Feb 2022 to AUGUST2023 in the department of Obstetrics and Gynaecology, GGH Kadapa. All the cases referred as critical emergency from nearby areas during their antenatal period or within 42 days of delivery were included in the study. A detailed history including age, parity, gestational age, antenatal care during pregnancy, socioeconomic status, obstetrical history, medical or surgical disorders was taken into account. Attention was paid on the management received by each case including blood transfusion, surgical interventions, ICU admission etc.  RESULTS: Total deliveries during this period were 2223. Total obstetric emergencies came out to be 252. Thus, the incidence of obstetric emergencies came out to be 11.3%. Various obstetric emergencies that were encountered –Antepartum Hemorrhage (25%), PROM(21%),12% with abortion , severe anemia ( 9%), Hypertensive disorders of pregnancy (13%), Malpresentation (6%), Hyperemesis gravidarum (3%), Heart diseases(1%),ectopic pregnancy (2%), eclampsia (2%), , Postpartum haemorrhage (3%),Intrauterine death(2%) ,There were 67% Live births, 6%in IUD,2% in neonatal mortality, 4% in perinatal mortality, 2% in Congenital anomalies  Conclusions: It was concluded that obstetric emergencies are more common in unbooked cases and women with low socioeconomic status with poor access to antenatal care

Background: Cesarean scar pregnancy (CSP) is a rare but increasingly prevalent form of ectopic gestation implanted within a previous cesarean section scar. Early and accurate diagnosis is crucial to prevent severe complications such as uterine rupture, hemorrhage, and subsequent infertility. Traditional transvaginal ultrasound (TVUS) has limitations in early CSP detection.  Methods: A prospective cohort study was conducted on 150 women presenting with suspected CSP based on clinical presentation and initial TVUS findings. All participants underwent standard TVUS, 3D power Doppler TVUS, and MRI within 48 hours of initial presentation. The diagnostic performance of each imaging modality, and their combinations, was assessed using histopathological examination or clinical follow-up as the gold standard. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated for each technique. Results: Of the 150 women, 45 were confirmed to have CSP. Standard TVUS demonstrated a sensitivity of 78% and a specificity of 85%. 3D power Doppler TVUS significantly improved diagnostic accuracy, exhibiting a sensitivity of 91% and a specificity of 93% (p < 0.001). MRI alone showed a sensitivity of 89% and a specificity of 95%. The combination of 3D power Doppler TVUS and MRI yielded the highest diagnostic accuracy, with a sensitivity of 96% and a specificity of 98%. The PPV for the combined approach was 97%, and the NPV was 97%. Conclusion: 3D power Doppler TVUS and MRI are valuable adjuncts to standard TVUS for the early and accurate diagnosis of CSP. The combination of these techniques significantly improves diagnostic performance, potentially leading to earlier intervention and reduced morbidity associated with CSP. These findings support the incorporation of 3D power Doppler TVUS and MRI into the diagnostic algorithm for women at risk of CSP

Background: Idiopathic left fascicular ventricular tachycardia (ILFVT) is an uncommon, verapamil-sensitive arrhythmia that typically occurs in structurally normal hearts. Its presentation during pregnancy is rare, and management becomes more complex when accompanied by underlying congenital valvular abnormalities such as bicuspid aortic valve (BAV), aortic regurgitation (AR), and mitral valve prolapse (MVP). Prompt recognition and individualized multidisciplinary care are critical to ensure optimal maternal and fetal outcomes. Case Summary: We present the case of a 26-year-old primigravida at 32 weeks gestation who presented with palpitations and dizziness. Electrocardiogram revealed regular monomorphic ventricular tachycardia with right bundle branch block morphology and right axis deviation, consistent with ILFVT. Echocardiography incidentally revealed a bicuspid aortic valve with moderate aortic regurgitation and mitral valve prolapse. Initial pharmacological therapy with verapamil, amiodarone, and beta-blockers was ineffective; however, transcutaneous pacing successfully terminated the arrhythmia, followed by a positive response to oral verapamil. The patient was managed medically throughout pregnancy, with continuous fetal monitoring and serial echocardiography. At 38 weeks, she underwent elective cesarean section. Postpartum electrophysiological study confirmed reentrant ILFVT localized to the left posterior fascicle. Successful radiofrequency ablation was performed using CARTO 3D mapping with irrigated-tip catheter technology. She remained arrhythmia-free during a subsequent pregnancy and at three-year follow-up. Conclusion: This case highlights the rare occurrence of ILFVT in pregnancy complicated by valvular abnormalities. Transcutaneous pacing and verapamil can be effective in acute management. Definitive ablation postpartum offers excellent long-term outcomes. Early recognition, multidisciplinary coordination, and timing of intervention are key to successful management in such complex scenarios.

Introduction: Rheumatoid arthritis (RA) is a chronic systemic autoimmune disease affecting 0.5–1% of the population. It primarily presents as symmetrical polyarthritis but also involves extra-articular organs, including the kidneys. Renal involvement in RA may result from the disease process itself or from medications like DMARDs and NSAIDs. Microalbuminuria, defined as urinary albumin excretion of 30–300 mg/day, serves as an early, non-invasive marker of glomerular injury and subclinical renal dysfunction. Objectives: This study aimed to assess subclinical renal dysfunction in RA patients through microalbuminuria and correlate it with disease activity parameters such as DAS28, ESR, CRP, RF, anti-CCP antibodies, and tender/swollen joint counts. A comparison with healthy controls was also made to evaluate microalbuminuria's role as a predictive marker. Methods: A hospital-based observational study was conducted from March 2023 to August 2024 in the Department of General Medicine, Mahatma Gandhi Medical College & Hospital. A total of 75 diagnosed RA patients (≥18 years), meeting the 2010 ACR-EULAR criteria, were included along with 75 age- and sex-matched healthy controls. Exclusion criteria included pre-existing renal or cardiovascular conditions, diabetes, UTI, pregnancy, or prolonged immobility. All subjects underwent clinical assessment and laboratory investigations, including urine microalbumin, inflammatory markers, and DAS28 scoring. Data were analyzed using SPSS Version 25. Results: The prevalence of microalbuminuria was significantly higher in RA patients compared to controls. A strong correlation was observed between microalbuminuria and disease activity indicators. Early detection of microalbuminuria may help in identifying RA patients at risk of renal complications, enabling timely intervention and better clinical outcomes.

Background: Maternal diabetes, encompassing both gestational diabetes mellitus (GDM) and pregestational diabetes, significantly elevates the risk of congenital heart disease (CHD) in neonates. The teratogenic effect of maternal hyperglycaemia, particularly during the critical period of foetal organogenesis, is linked with structural cardiac anomalies in infants. Objective: To review the types of congenital heart defects seen in neonates born to diabetic mothers at Kempegowda Institute of Medical Sciences Hospital and Research Centre. Methods: A retrospective observational study was conducted, in which infants born to diabetic mothers from January to December 2023 were included. 56 neonates born to mothers diagnosed with either GDM or pregestational diabetes were enrolled in the study. Echocardiographic details were retrieved from records, variables such as maternal age, type of diabetes in mother and treatment regimen, delivery method, and neonatal factors (sex, birth weight, and gestational age) were collected from records and were analysed using statistical tools including Chi-square and Fisher’s exact test. Results: Among 56 echocardiographically evaluated cases, 47 (83.9%) exhibited congenital heart anomalies. Atrial septal defect (ASD) was the most prevalent (58.9%), followed by patent ductus arteriosus (16%), and ventricular septal defect (3.6%). No statistically significant association was found between CHD occurrence and maternal age, type of diabetes, treatment modality, parity, type of delivery, or gestational age (p > 0.05). Most mothers were aged 20–30 years (78.6%), majority had GDM (83.9%), the rest with pregestational diabetes. Conclusion: The high prevalence of CHD, particularly ASD, among infants of diabetic mothers underscores the importance of prevention and early identification of diabetes in mothers. Stringent glycaemic control and adherence to treatment during pregnancy should be ensured. Given the lack of significant associations with other demographic or clinical variables, routine echocardiographic screening is strongly recommended for all neonates of diabetic mothers, regardless of other risk factors.

Introduction: Unexplained infertility accounts for approximately 10–30% of infertility cases in women undergoing assisted reproductive technologies. Recent research highlights the potential role of the vaginal microbiota in modulating reproductive outcomes. A predominance of Lactobacillus species is generally associated with favorable gynecological health, whereas microbial dysbiosis may negatively impact implantation and pregnancy rates. This study aimed to assess the correlation between vaginal microbiota composition and in vitro fertilization (IVF) success in women with unexplained infertility. Materials and Methods: A prospective observational study was conducted involving 100 women aged 25–38 years diagnosed with unexplained infertility and scheduled for IVF treatment. Vaginal swabs were collected prior to controlled ovarian hyperstimulation. Microbiota profiling was performed using 16S rRNA gene sequencing. Patients were categorized into Lactobacillus-dominant (Group A, n=58) and non-Lactobacillus-dominant (Group B, n=42) based on microbial diversity. IVF outcomes, including fertilization rate, implantation rate, and clinical pregnancy rate, were compared between groups. Statistical analysis was performed using chi-square and t-tests with p<0.05 considered significant. Results: Group A exhibited significantly higher clinical pregnancy rates (56.9%) compared to Group B (28.6%) (p=0.004). The implantation rate was also notably greater in the Lactobacillus-dominant group (41.3% vs 22.5%; p=0.03). No significant difference was observed in fertilization rates between the two groups (83.2% vs 81.1%; p=0.21). Alpha diversity indices revealed increased microbial heterogeneity in Group B, often characterized by Gardnerella, Atopobium, and Prevotella species. Conclusion: A Lactobacillus-dominant vaginal microbiota is positively associated with higher implantation and pregnancy rates in women with unexplained infertility undergoing IVF. Vaginal microbial profiling may serve as a non-invasive prognostic tool for IVF success and guide potential microbiome-modulating interventions.

Introduction: During pregnancy, maternal thyroid hormones are essential for placental function and fetal brain development, particularly in the first trimester before the fetal thyroid becomes functional. Maternal hypothyroidism has been linked to various adverse outcomes, including neonatal jaundice, hypocalcemia, respiratory distress, and increased risk of congenital anomalies.Early diagnosis and appropriate treatment with levothyroxine significantly reduce these risks, making maternal thyroid health crucial for optimal pregnancy outcomes. Materials And Methods: A hospital-based observational study was conducted over 1.5 years in the Department of paediatrics of Maharishi Markandeshwar Institute of Medical Sciences and Research, Mullana, Ambala. The study included 50 neonates with hypothyroid mother.Another set of 50 neonates born to pregnant subjects with absence of maternal hypothyroidism or any other thyroid related disorder were included as controls.. Infants with birth asphyxia, congenital anomalies, sepsis, metabolic disorders, or born to diabetic or anticonvulsant- using mothers were excluded. Results: The number of neonates born by LSCS  was significantly higher in hypothyroid mothers (66% vs. 14%, p=0.001). Preterm deliveries (18% vs. 4%, p=0.001), low birth weight (30% vs. 2%, p=0.000), and small for gestational age neonates (20% vs. 0%, p=0.000) were significantly more common in the hypothyroid group. Mean birth weight was significantly lower in the hypothyroid group (p=0.001), while no significant differences were found in neonatal gender, APGAR scores, cord/serum TSH, NICU admission or stay, or respiratory complications. Conclusion: Neonates born to hypothyroid mothers had higher rates of cesarean delivery, low birth weight, SGA, and neonatal jaundice requiring phototherapy.

Introduction: Intrahepatic cholestasis of pregnancy is most common pregnancy related liver disorder and unique to pregnancy. It is characterised by pruritus with onset in the 2nd or 3rd trimester of pregnancy without skin rash, elevated serum amino transferases and bile acid levels and spontaneous relief of signs and symptoms within 2-3 weeks after delivery. Aims: To find out the adverse effects of intrahepatic cholestasis of pregnancy on feto- maternal outcomes. Materials & Methods: The present study was a prospective observational study. This Study was conducted from 1 ½ years (March 2018 to July 2019) at department of obstetrics and gynaecology in Chittaranjan Seva Sadan College of Obstetrics & Gynecology and Child Health. Total 100 patients were included in this study. Result: At 1 minute, 20% of new-borns had an APGAR score <6, while 80% had scores ≥6, indicating good initial adaptation. The occurrence of low APGAR scores was relatively limited but clinically significant. The result was statistically significant with a P value < 0.0001, suggesting a non-random distribution. At 5 minutes, 8.5% of new-borns had an APGAR score <6, while 91.5% showed improved scores ≥6, indicating better postnatal recovery. Though fewer new-borns had low scores at this stage, it remains clinically relevant. The distribution was statistically significant with a P value < 0.0001. Conclusion: Intrahepatic cholestasis of pregnancy (ICP) significantly impacts feto-maternal outcomes, predominantly affecting women in their prime reproductive age. This study highlights that ICP is associated with increased risks of adverse fetal events, including low birth weight, low APGAR scores, and a higher rate of NICU admissions, emphasizing the need for vigilant fetal monitoring.

Background: Effusion cytology plays a pivotal role in the early diagnosis and management of patients with suspected malignant involvement of serous cavities. The International System for Reporting Serous Fluid Cytopathology (ISRSFC), by International Academy of Cytologists (IAC) guidelines, offers a standardized five-tier framework for categorizing cytological findings and estimating the associated risk of malignancy (ROM). Materials and Methods: A retrospective review of 784 effusion cytology samples collected from January 2022 to December 2023 was conducted for duration of one year by Department of Pathology in Lt. Baliram Kashyap Memorial Government Medical College, Jagdalpur. All cases were reclassified according to ISRSFC guidelines. Cell block preparations and immunohistochemistry were performed in selected cases. Clinical, radiologic, and histopathological follow-up data were used for diagnostic correlation. Results: The study included 416 female and 368 male patients, with a mean age of 52.8 years (range: 1–88 years). Among the fluids analyzed, 395 (50.38%) were pleural, 289 (36.8%) peritoneal, 39 (4.9%) pericardial, 37 (4.6%) CSF and 24 (3.06%) synovial fluid. Based on ISRSFC classification, 21 (2.7%) cases were non-diagnostic (ND), 532 (67.9%) were negative for malignancy (NFM), 28 (3.6%) were atypical (AUS), 47 (6%) were suspicious for malignancy (SFM), and 156 (19.9%) were positive for malignancy. The ROM was calculated as follows: 14.2% for ND, 18.6% for NFM, 51.4% for AUS, 75.9% for SFM, and 93.5% for the malignant category. Lung and gastrointestinal malignancies were most commonly associated with pleural and peritoneal effusions, respectively. Conclusion: The application of the ISRSFC classification system is feasible and effective in routine cytological evaluation of serous effusions. This standardized approach improves diagnostic reproducibility and provides meaningful prognostic information by stratifying malignancy risk across diagnostic categories.

Background: Difficult airway management remains a leading cause of anaesthesia-related morbidity in obstetric practice. Physiological changes during pregnancy and labour may increase the risk of airway compromise, but the extent and timing of these changes in the Indian population have not been well described. This study aimed to evaluate serial changes in Mallampati classification among pregnant Indian women during late gestation, labour, and the early postpartum period, and to identify clinical predictors of these changes. Methods: Ninety pregnant women (>21 years) at 32–34 weeks gestation were prospectively enrolled at a tertiary centre in Odisha, India. Mallampati class was assessed at four time points: 32–34 weeks gestation, on admission for labour, 2–4 hours post-delivery, and 48–72 hours postpartum. Demographic data, body mass index (BMI), gestational weight gain, comorbidities, duration of labour, intravenous fluid administration, and gravida status were recorded. Changes in Mallampati classification were analyzed using the Wilcoxon signed-rank test and correlation statistics.  Results: Mallampati class increased significantly during the peripartum period. At baseline, 62.2% of women had Mallampati I, but this declined to 3.3% post-delivery and 2.2% at 48–72 hours postpartum. The proportion of women with Mallampati III or IV rose from 15.5% at baseline to 68.9% at 48–72 hours postpartum. Overall, 64% of women demonstrated a transition from Mallampati I/II to III/IV. Higher BMI, greater gestational weight gain, and larger volumes of intravenous fluids were significantly associated with increases in Mallampati class (p < 0.001). Age and parity were not significant predictors. Conclusions: Airway changes, as reflected by an increase in Mallampati class, are frequent during labour and may persist for at least 72 hours postpartum in Indian women. Obesity, excessive gestational weight gain, and higher intrapartum fluid administration are significant risk factors for difficult airway. Vigilant airway assessment should be emphasized throughout the peripartum period, particularly in women with these risk factors.

Background: Postpartum depression (PPD) and anxiety (PPA) are major public health concerns that can significantly affect maternal wellbeing and infant development. Despite growing awareness, these conditions often remain underdiagnosed, particularly in low- and middle-income countries like India. Objective: This study aimed to determine the prevalence of postpartum depression and anxiety and to identify psychosocial factors associated with these conditions among postpartum women attending a tertiary care hospital in India. Methods: A hospital-based cross-sectional study was conducted between January 2023 and June 2024 at a tertiary care center in India. A total of 600 women aged 18–40 years, between 4 weeks to 6 months postpartum, were systematically sampled. The Edinburgh Postnatal Depression Scale (EPDS) and the Zung Self-rating Anxiety Scale (SAS) were used to assess depression and anxiety, respectively. Statistical package for social sciences, version‑26 (SPSS‑26, IBM,Chicago, USA) was used for data analysis. P <0.05 was considered statistically significant. Results: The prevalence of postpartum depression (EPDS ≥10) was 28.0%, and postpartum anxiety (SAS ≥45) was 34.0%. Significant psychosocial correlates of both depression and anxiety included unplanned pregnancy, low education level, lack of partner support, unemployment, and the loss of a parent or sibling (p < 0.001 for all associations). Conclusion: A substantial proportion of postpartum women suffer from depression and anxiety, with distinct psychosocial determinants

Background: Major trauma remains a leading cause of death worldwide, especially in individuals under 45 years. Early diagnosis and treatment are critical. WBCT (Whole-Body Computed Tomography) has been increasingly used in trauma settings due to its high diagnostic accuracy and potential to detect clinically occult injuries. However, its benefits over selective CT imaging, particularly regarding mortality, radiation exposure, and cost, remain controversial. Materials And Methods A retrospective cohort study was conducted using case records of trauma patients admitted to the emergency department between January 1, 2017, and December 31, 2018. Patients were divided into two groups: those who underwent selective CT and those who underwent WBCT. Inclusion criteria involved patients with life-threatening trauma, specific mechanisms of injury, or severe clinical suspicion. Exclusion criteria included age <18 years, pregnancy, stab wounds, and incomplete records. Data were statistically analyzed using descriptive and inferential techniques. Results: A total of 443 patients were included, with a mean age of 34.54 ± 17.88 years and a male predominance (78%). Selective CT was used in 248 patients (56%), and WBCT in 195 patients (44%). The WBCT group showed a significant reduction in emergency department stay (mean difference -32.39 minutes, p = 0.001). There was a 16% higher detection rate of intra-thoracic injuries with WBCT. However, no significant differences were observed in 24-hour mortality (WBCT 8% vs. selective 6%, p = 0.23), 30-day mortality (WBCT 17% vs. 16%, p=0.69), or overall mortality (WBCT 15.9% vs. 15.7%, p = 0.92). WBCT was associated with higher radiation exposure and cost (p<0.01). Conclusion: While WBCT offers faster diagnostic times and better detection of certain injuries, it does not significantly improve survival outcomes compared to selective imaging. Given the increased radiation and cost, WBCT should be reserved for patients with severe polytrauma or non-evaluable clinical status. Selective imaging remains sufficient for clinically stable patients based on history and physical examination.

Background: Heart disease in pregnancy is a major contributor to maternal and perinatal morbidity and mortality, especially in low- and middle-income countries. Pregnancy-related cardiovascular changes can precipitate decompensation in women with pre-existing heart disease. Methods: This retrospective observational study was conducted at Lalla Ded Hospital, Srinagar, Jammu and Kashmir, India, over a 2-year period. Sixty-one pregnant women with known or newly diagnosed heart disease were included. Maternal outcomes assessed included ICU admission, mechanical ventilation, cardiovascular complications, and delivery mode. Perinatal outcomes included preterm birth, NICU admission, and mortality. Data were analysed descriptively. Results: The majority of women were aged 25–29 years (49.18%). Rheumatic heart disease was the most common lesion (32.78%). ICU admission was required in 36.06% and mechanical ventilation in 14.75%. Cardiovascular complications occurred in 18%. Preterm birth rate was 16.4%, NICU admissions 16.4%, stillbirths 3.3%, and no congenital heart defects were detected. Conclusions: Pregnancies complicated by heart disease are associated with significant maternal morbidity and moderate perinatal risk. Early diagnosis, mWHO-based risk stratification, vigilant antenatal surveillance, and multidisciplinary care at tertiary centres can improve outcomes. (95% CI for ICU admission: 24.2%–48.6%).

Introduction: The high proportion of unexplained stillbirths hinders accurate understanding of their cause, which consequently affects targeted healthcare interventions to reduce its incidence.10Currently in 25-40% of stillbirths, the underlying cause cannot be determined and only approximately 20% of stillbirths are potentially predictable in early pregnancy. India accounts for the majority of global stillbirths due to high population, with 5921000 out of a total of 206 million of such births across the world: Materials And Methods: This observational cross-sectional study was conducted over a period of 1 year at labour room at department of obstetrics and gynaecology in Eden hospital, Medical College and hospital,Kolkata after getting approval from Institutional Ethical Committee. We had selected all the stillborn cases occurring in our duty hours in eden, MCH.Then we had selected same number of live born cases in LRO. Result In Still Birth group, 8 (10.0%) patients were ≤20 years old, 37 (46.3%) patients were 21-25 years old and 35 (43.8%) patient were 26-30 years old.Association of Age between the two groups was not statistically significant (p=0.7514). Conclusion: For identification of the precise causes of stillbirth,Further studies are required involving larger sample size of the  factors that influence stillbirth which  are postmortem evaluation, genetic and molecular testing, microbiology, and fetal blood or urine culture.

Introduction: Acute cerebral venous thrombosis (CVT) is an uncommon but treatable cerebrovascular disorder with heterogeneous presentations and imaging patterns. Functional outcomes in modern cohorts are generally favorable, with 80–90% achieving independence at follow-up; nevertheless, a subset suffers persistent headaches, cognitive or mood symptoms, epilepsy, or visual deficits, underscoring the importance of structured follow-up and rehabilitation. Contemporary data suggest improving outcomes with timely diagnosis and anticoagulation, including direct oral anticoagulants (DOACs). Materials & Methods: We conducted a prospective, single-center observational study of consecutive adults with radiologically confirmed acute CVT over 24 months. Demographics, risk factors, clinical features, neuroimaging, treatment, and outcomes—modified Rankin Scale (mRS) at discharge and 3 months—were recorded. A standardized case-record form captured demographics, vascular risk factors, hormonal exposures, peripartum status, infection, dehydration, malignancy, and thrombophilia testing (protein C/S deficiency, antithrombin, factor V Leiden, prothrombin G20210A, antiphospholipid antibodies), when clinically indicated. Presenting features included headache characteristics, seizures, focal deficits, papilledema, altered sensorium, and blood pressure.  Results: Among 120 patients (mean age 32.8±10.6 years; 68% women), headache (82%), seizures (38%), and focal deficits (33%) predominated. Superior sagittal (61%) and transverse sinuses (49%) were commonly involved; 28% had cortical vein thrombosis. Parenchymal lesions occurred in 41% (venous infarct 29%, hemorrhage 22%). All received heparin followed by vitamin-K antagonists or DOACs; 46% were discharged on DOACs. In-hospital mortality was 2.5%. Favorable functional outcome (mRS 0–2) occurred in 78% at discharge and 88% at 3 months. Conclusion: Most patients with acute CVT are young women with headache-predominant presentations and multisinus involvement. Early anticoagulation—often transitioned to DOACs—is associated with high rates of good functional recovery.

Abstract: Lipids are the major cell membrane components, essential for various biological functions including cell growth and division for the maintenance of cell integrity of normal and malignant tissues. The changes in lipid profile have been associated since long with cancer and hypocholesterolemia has been observed in patients with cancers of various organs. The objective of the present study is to evaluation of diagnostic role of serum lipid profile in head and neck malignancy . The present case–control study comprises of newly diagnosed and histologically confirmed, 100 head and neck malignancy cases diagnosed between 1st Dec 2024 and 31st May 2025 in the Department of General Medicine and ENT, Rama Medical College, Hospital & Research Centre, Hapur . Fasting blood samples were collected and the lipid profile studied. In present study, the authors found that there is a preponderance of head and neck malignancy in the age group of 41–60 years, males having the higher incidence. Malignancy involving oral cavity were the commonest and majority were well differentiated. Statistically, there was a highly significant reduction of mean serum total cholesterol (TC), triglycerides and high density lipoproteins (HDL) in the subjects of head and neck malignancy as compared to the control group. TC and HDL were also found significantly lower among those with habit of tobacco consumption.

Background: Biochemical hepatic dysfunction in pregnancy, whilst relatively rare, has potentially serious consequences for maternal and fetal health. Liver disease in pregnancy encompasses a spectrum of diseases encountered during gestation and the postpartum period that result in abnormal liver parenchymal and hepatobiliary dysfunction or both. Hence the aim of this study is to find out maternal and fetal outcome and to evaluate clinical profile, complications in relation with hepatic dysfunction in pregnancy.  Materials and Methods: This study was a Prospective Observational Study, here total 100 pregnant patients were included of which 50 pregnant patients attending OPD or getting admitted in Tertiary Care Hospital with biochemical hepatic dysfunction and 50 without biochemical hepatic dysfunction. Results: Maternal mortality was high in patients from rural areas with p value 0.044 was statistically significant. Significant difference was found that 60% patients with hepatic dysfunction were unbooked compared 36 % of pts without hepatic dysfunction P value 0.0272 was statistically significant. Almost all maternal mortality was occurred in unbooked pts, p value 0.008 was statistically significant. Out of 50 patients with hepatic dysfunction 32 (64%) patients were delivered by LSCS. P value was less than 0.0001 was statistically significant Conclusion: LSCS was required in majority of pts with hepatic dysfunction. Liver failure and ascitis were the most common complication of hepatic dysfunction, while multiorgan dysfunction was the most serious complication with highest maternal and fetal mortality. Maternal mortality was highest in pts with Child Pugh score C. There is no significant difference of APGAR score in pts with hepatic & without hepatic dysfunction.

Background: Hypothyroidism is a prevalent endocrine disorder often associated with menstrual irregularities in women of reproductive age, potentially leading to complications such as infertility and anemia. This study aimed to evaluate the prevalence of hypothyroidism among women presenting with menstrual irregularities at a tertiary care center in India. Methods: A prospective cross-sectional study was conducted at the Department of Medicine, Kanti Devi Medical College Hospital and Research Center, Mathura, from June 2024 to April 2025. A total of 150 women aged 18–45 years with menstrual irregularities (oligomenorrhea, menorrhagia, or amenorrhea) were included. Thyroid function tests (TSH, free T4, and free T3) were performed, with hypothyroidism defined as TSH >4.5 mIU/L (subclinical if free T4 normal; overt if free T4 <0.8 ng/dL). Exclusion criteria encompassed pregnancy, known thyroid disorders, or other endocrine conditions. Results: Of the 150 participants, 36 (24%) had hypothyroidism: 22 (14.7%) subclinical and 14 (9.3%) overt. The mean age was 29.4 ± 6.2 years in hypothyroid women versus 27.8 ± 5.9 years in euthyroid women. Menorrhagia was the predominant irregularity in hypothyroid cases (55.6%). Conclusion: With a 24% prevalence, hypothyroidism is a significant contributor to menstrual irregularities, warranting routine thyroid screening to mitigate associated risks

Introduction: Fertility-sparing surgery (FSS) is increasingly considered a viable option for young women with early-stage epithelial ovarian cancer (EOC) who desire future fertility. However, the role and impact of adjuvant chemotherapy following FSS remain controversial, with limited data on oncologic outcomes and reproductive safety. Objective: This multicenter retrospective study aimed to evaluate the survival outcomes and safety of adjuvant chemotherapy in young women undergoing fertility-sparing surgery for early-stage epithelial ovarian cancer. Methods: In this retrospective study conducted at R G Kar Medical College over a period of one year, a total of 150 young women diagnosed with early-stage epithelial ovarian cancer who underwent fertility-sparing surgery were included. Data were collected from medical records, focusing on key study variables such as age, FIGO stage, histologic subtype, type of surgery performed, adverse effects, and fertility outcomes. All patients met the inclusion criteria of being young women with histopathologically confirmed early-stage epithelial ovarian cancer and having undergone fertility-sparing surgical procedures. The collected data were systematically analyzed to assess the clinicopathological characteristics, treatment-related outcomes, and reproductive performance following surgery. Results: A total of 150 patients were analyzed, with 90 receiving adjuvant chemotherapy and 60 under surveillance. The groups were similar in age, but the chemotherapy group had more advanced stage IC and high-grade tumors. Surgical staging and type of fertility-sparing surgery were comparable. Median follow-up was about 4 years for both groups. The chemotherapy group showed significantly lower recurrence rates (8.9% vs. 20%) and higher 5-year disease-free survival (91% vs. 80%), though overall survival differences were not statistically significant. Fertility outcomes, including pregnancy attempts, success rates, time to conception, and miscarriage rates, were similar between groups. Chemotherapy-related adverse effects were mostly mild, with alopecia being the most common, and over half of patients experienced no serious side effects. Conclusions: Adjuvant chemotherapy after fertility-sparing surgery in young women with early-stage epithelial ovarian cancer appears to improve oncologic outcomes, particularly in patients with high-risk features, without compromising fertility potential. These findings support a tailored approach to adjuvant treatment, balancing oncologic safety and reproductive goals

Objectives: To evaluate the diagnostic performance of ultrasound (USG) in characterizing adnexal lesions and correlate the findings with magnetic resonance imaging (MRI) to enhance diagnostic accuracy. Methods: A prospective cohort study was conducted on 96 women with clinically suspected pelvic lesions diagnosed as adnexal pathology on USG, who subsequently underwent MRI. Assessed parameters included lesion content, presence of nodules, ascites, lesion classification (benign vs. malignant), and imaging characteristics. Diagnostic performance of USG was evaluated using MRI as the reference standard. Results: The mean age of participants was 35.37 ± 12.00 years, with the majority aged 21–40 years. Lesion content was identical across both modalities, with 79.17% cystic and 20.83% solid-cystic (P = 1.000). Nodules were detected in 17.71% of USG scans and 20.83% of MRI scans (P = 0.5846), while ascites was seen in 13.54% (USG) and 15.63% (MRI) (P = 0.6824). Lesion classification showed 76.04% as benign and 23.96% as malignant by both USG and MRI (P = 1.000). USG demonstrated a sensitivity of 86.96%, specificity of 95.89%, positive predictive value of 86.96%, negative predictive value of 95.89%, and diagnostic accuracy of 93.75%. MRI provided additional insight, identifying enhancement in 22.92% and omental deposits in 15.63% of lesions, indicative of advanced disease. Conclusion: Ultrasound is a dependable first-line imaging tool for adnexal lesion evaluation. MRI adds diagnostic value in complex or suspicious cases and is useful for staging and surgical planning. Combined use of USG and MRI facilitates accurate diagnosis and optimal management of adnexal masses

Background: Abnormal uterine bleeding (AUB) has a variety of histopathological patterns, and pathologists report endometrial biopsies and help distinguish non-neoplastic from neoplastic lesions, detect precursor lesions, and rule out malignancy. Aim- This study will examine endometrial patterns in women with AUB and connect them with age.  Materials and Methods:110 endometrial biopsies with AUB from the gynaecology department were processed, stained with haematoxylin & eosin, and histopathologically examined.  Results: The 41-50 age group has the highest incidence.  Most histomorphological patterns are disorganised proliferative.  20 instances (18.20%) indicate endometrial hyperplasia, 8 of which are atypia and 12 of which are non-atypical; 5 cases of endometrial carcinoma were documented, most of which were postmenopausal. Premenopausal and postmenopausal women had pill endometrium, and 8 women had atrophic endometrium, mostly in the postmenopausal age group. Conclusion: AUB causes anaemia and lowers women's quality of life.  Thus, histological investigation is essential for early endometrial disease diagnosis and gynaecological therapy

Introduction: Efficient wound closure following Modified Radical Mastectomy (MRM) is vital to ensure optimal healing, reduce surgical site infection (SSI), and improve cosmetic outcomes. Traditionally, skin sutures have been widely used; however, skin staples are increasingly favoured for their rapid application and potential to reduce operating time. This study aims to compare the outcomes of skin staples and skin sutures in MRM closure in terms of wound complications, operative time, and patient satisfaction at AGMC and GBP Hospital. Aims and Objectives: This study aims to evaluate and compare the efficacy of skin staples versus conventional sutures for skin closure in patients undergoing Modified Radical Mastectomy (MRM). Key parameters assessed include wound-related complications such as infection, dehiscence, hematoma, and seroma; the time required for skin closure; postoperative pain levels and scar appearance; and overall patient satisfaction. By analyzing these factors, the study seeks to determine the more efficient and patient-friendly method for skin closure following MRM. Materials and Methods: This prospective comparative study was conducted on patients undergoing Modified Radical Mastectomy for breast malignancy at AGMC and GBP Hospital. Patients were randomly allocated into two groups: Group A (skin staples) and Group B (skin sutures). Closure time, postoperative pain (VAS score), wound complications, duration of hospital stay, and scar evaluation (using validated scales like the Vancouver Scar Scale) were recorded and analyzed statistically. Results: The staple group showed significantly reduced closure time compared to the suture group (p<0.05). Rates of wound complications such as infection and seroma were comparable between the two groups. Postoperative pain was marginally lower in the staple group on early postoperative days. At follow-up, cosmetic outcomes favored sutures in terms of scar appearance, but the difference was not statistically significant. Patient satisfaction was higher in the staple group due to perceived convenience and quicker procedure. Conclusion: Skin staples provide a faster method for skin closure in MRM with comparable rates of wound complications to skin sutures. While sutures may offer slightly better cosmetic outcomes, the use of staples is associated with reduced operative time and improved patient convenience. Both methods are safe and effective; choice may depend on surgeon preference, resource availability, and patient factors.

Introduction: Venous thromboembolism (VTE), encompassing both deep vein thrombosis (DVT) and pulmonary embolism (PE), is a significant postoperative complication in patients undergoing major oncologic surgeries, particularly those involving microvascular free flap reconstruction. Head and neck cancer patients are considered at elevated risk due to prolonged operative times, malignancy-associated hypercoagulability, and perioperative immobilization. However, the incidence of VTE in this specific surgical subset within the Indian population remains underreported. Objective: To evaluate the incidence of VTE in patients undergoing free flap reconstruction for head and neck cancer in a tertiary care institution in Eastern India, and to identify potential risk factors associated with its occurrence Methods: This retrospective observational study was conducted over a period of one year, from January 2024 to January 2025, at the Department of Head & Neck Surgery, IPGMER and SSKM Hospital, Kolkata, West Bengal, India. A total of 50 patients who underwent oral oncologic surgery with simultaneous reconstruction were included in the study. Clinical, surgical, and postoperative data were collected and analyzed to evaluate the incidence and associated risk factors for venous thromboembolism (VTE) in this high-risk surgical population. Results: The comparative analysis between VTE-positive (Group 1) and VTE-negative (Group 2) patients revealed no statistically significant differences in demographic, oncologic, or surgical variables. Although Group 1 showed slightly higher mean age, BMI, and rates of comorbidities, smoking, alcohol use, and prior VTE, none of these reached statistical significance. Tumor site, TNM stage, histological type and grade, as well as prior chemotherapy or radiotherapy, were also comparable between the groups. Surgical factors—including type of free flap used, duration of surgery, intraoperative blood loss, transfusion requirement, and number of vascular anastomoses—did not differ significantly between the two groups. However, certain postoperative factors showed significant associations with VTE occurrence. The use of DVT prophylaxis was significantly lower in Group 1 (p = 0.002), and postoperative mobility was also reduced (p = 0.035). Additionally, ICU stay was significantly longer in VTE-positive patients (p = 0.029). Although postoperative complications were more frequent in Group 1 and hospital stay was longer, these differences were not statistically significant. The mean time to VTE diagnosis was 6.1 ± 3.2 days postoperatively, underscoring the importance of early monitoring. Conclusion: This institution-based study highlights a notable incidence of VTE (5.9%) in patients undergoing free flap reconstruction for head and neck cancer. The findings underscore the need for vigilant perioperative thromboprophylaxis, early mobilization, and high clinical suspicion for early detection and management of VTE in this high-risk surgical cohort. Tailoring VTE prevention protocols based on individualized risk assessment may further reduce associated morbidity.

Introduction: Meconium-stained amniotic fluid (MSAF) is a common obstetric complication associated with increased risk of adverse perinatal outcomes, including meconium aspiration syndrome (MAS), low Apgar scores, neonatal intensive care unit (NICU) admissions, and perinatal morbidity and mortality. The incidence of MSAF increases with gestational age, but it may also occur in preterm pregnancies. Understanding its impact across term, preterm, and postterm pregnancies is essential for timely obstetric interventions. Aims: To evaluate the perinatal outcomes of MSAF in term, preterm, and postterm pregnancies and to determine the association of MSAF with mode of delivery, MAS, Apgar scores, and neonatal morbidity. Materials and Methods: This was a prospective, comparative study conducted over one year, from 1st December 2019 to 30th November 2020, in the Department of Obstetrics and Gynecology at MR Bangur Hospital, Tollygunge, and Kolkata, which serves both rural and urban populations of South 24 Parganas district. The study included 108 booked antenatal cases attending the hospital’s antenatal clinic, enrolled according to predefined inclusion and exclusion criteria. Results: In our study, there was no statistically significant difference between cases and controls in terms of maternal age and gravidity (p = 0.546 and p = 0.841, respectively). However, birth weight and fetal heart rate showed significant differences between the two groups. A higher proportion of cases had birth weight <2 kg compared to controls (20.4% vs. 3.7%, p = 0.015). Similarly, fetal heart rate distribution differed significantly, with more cases having heart rate >120/min and fewer cases with heart rate <100/min compared to controls (p = 0.023). Conclusion: MSAF is associated with adverse perinatal outcomes, particularly in postterm pregnancies. Close fetal monitoring, timely obstetric intervention, and preparedness for neonatal resuscitation are crucial to improve neonatal outcomes. Early recognition and management of MSAF can reduce the risk of MAS and other complications

Background: Maternal anemia is highly prevalent in India and linked to adverse pregnancy outcomes. However, its impact on fetoplacental Doppler parameters remains underexplored. Objective: To evaluate the association between anemia severity and third-trimester Doppler changes, and their predictive value for perinatal outcomes. Methods: This cross-sectional study included 300 anemic pregnant women in the third trimester, grouped as mild (n=120), moderate (n=120), or severe (n=60) per WHO criteria. Doppler indices—umbilical artery (UA) S/D ratio, middle cerebral artery (MCA) pulsatility index (PI), and cerebroplacental ratio (CPR)—were assessed. Outcomes included birth weight, NICU admission, and perinatal mortality. Results: With increasing anemia severity, UA S/D ratio rose (2.71 to 3.52), while MCA PI (1.62 to 1.18) and CPR (1.18 to 0.72) declined (p<0.001). Abnormal Doppler waveforms occurred in 25% of severe anemia cases. Adverse outcomes increased with severity: low birth weight (15.0% to 45.0%), NICU admission (10.0% to 36.7%), and perinatal mortality (1.7% to 10.0%). Severe anemia independently predicted these outcomes, with adjusted odds ratios of 2.8, 3.4, and 3.1, respectively. Conclusion: Worsening maternal anemia is associated with significant Doppler changes and higher risks of neonatal complications. Routine Doppler assessment, especially CPR, may help identify high-risk foetuses and improve outcomes in pregnancies with moderate-to-severe anemia.

Background: Hoarseness of voice is a common otolaryngological complaint, often reflecting a spectrum of underlying laryngeal lesions ranging from benign to malignant. Early identification of these lesions is critical for timely intervention and improved clinical outcomes. Aim: To evaluate the demographic profile, spectrum, site distribution, and clinical presentation of benign and malignant laryngeal lesions in patients presenting with hoarseness of voice. Materials and Methods: A cross-sectional observational study was conducted on 100 patients presenting with hoarseness of voice. All patients underwent detailed clinical examination, indirect laryngoscopy, and diagnostic confirmation using microlaryngoscopy and histopathology when indicated. Data were analyzed to determine the prevalence and distribution of benign and malignant lesions. Results: The majority of patients were between 41–60 years (46%), with a male predominance (62%). Benign lesions constituted 68% of cases, while malignant lesions accounted for 32%. Among benign conditions, vocal cord polyps (24%) and nodules (18%) were most frequent. Squamous cell carcinoma was the predominant malignant lesion (28%). The glottis was the most commonly affected site (56.3%), followed by the supraglottic region (28.1%). All patients presented with hoarseness (100%), while throat discomfort (38%), dysphagia (22%), odynophagia (16%), and dyspnea (8%) were additional symptoms. Conclusion: Benign lesions outnumber malignant ones among patients with hoarseness; however, a significant proportion harbors malignancy, with squamous cell carcinoma being the leading type. Glottic involvement is most common in malignancies. Comprehensive evaluation and early diagnostic workup are essential for prompt management and improved prognosis

Background: Gestational hypertension is a common complication of pregnancy, often requiring antihypertensive medication. Labetalol, a combined alpha- and beta-blocker, is frequently used. However, its use has been associated with potential neonatal complications, including hypoglycemia and bradycardia, due to its ability to cross the placenta. This study aims to investigate the prevalence and characteristics of neonatal hypoglycemia and bradycardia in newborns born to gestational hypertensive mothers treated with labetalol at Trichy SRM Medical College. Methods: This was an prospective observational study conducted at Trichy SRM Medical College by collecting data from newborns born to gestational hypertensive mothers. The study population included all newborns of mothers diagnosed with gestational hypertension, with a specific focus on those exposed to maternal labetalol therapy. Data on maternal demographics, gestational hypertension characteristics, labetalol usage (dose, duration), and neonatal outcomes (birth weight, APGAR scores, presence of hypoglycemia and bradycardia, levels, NICU admission, duration of stay) were collected and analyzed. Detailed descriptive statistics, including frequencies, percentages, means, and standard deviations, were calculated. Graphical representations were used to visualize key findings. Results: The study included 50 newborns born to gestational hypertensive mothers. Of these, 22 (44%) were exposed to maternal labetalol therapy1. Neonatal hypoglycemia was observed in 30 (60%) of the total newborns 2, with an average blood glucose of 37.84 mg/dL3. Neonatal bradycardia was present in 20 (40%) of the total newborns 4, with an average heart rate of 94.74 bpm5. In the labetalol-exposed group, 14 (63.6%) experienced hypoglycemia and 12 (54.5%) experienced bradycardias. Further detailed statistics are presented in the results section. Conclusion: The findings suggest a notable prevalence of neonatal hypoglycemia and bradycardia in newborns of gestational hypertensive mothers, including those exposed to maternal labetalol. While this observational study cannot establish causality, the observed trends warrant further investigation into the precise relationship between maternal labetalol use and these neonatal adverse events. Close monitoring of blood glucose and heart rate is recommended for newborns of mothers receiving labetalol for gestational hypertension.

Introduction: Congenital heart diseases (CHD) are among the most common form of birth defects. The fetal cardiac screening by ultrasound can detect a high proportion of cases of CHD. Detection of cardiac anomalies can be challenging and is typically done by fetal cardiac ultrasound performed between 18 and 22 weeks. A transvaginal scan can detect anomalies even at 12–13 weeks. Early and precise detection of CHD can direct appropriate management. Objectives: To detect the incidence of congenital heart diseases at a tertiary care centre and to detect cardiac anomalies early, accurately, and help avail all the benefits of early prenatal diagnosis. Methods: A descriptive cross-sectional study, where 5,000 patients were screened over a period of 10 months who came for routine second trimester (16 to 24 weeks) obstetric evaluation. The fetal heart was evaluated and sequential segmental analysis was done using ultrasonography. Detailed biometric and structural evaluations of all fetuses were undertaken. In high-risk cases (17%), or in cases with positive cardiac findings, the extended fetal echocardiographic examination was performed at 16-20 weeks(850 cases). Follow-up scans were done at 24 weeks and post-natal periods to confirm the diagnosis. Out of 5,000 screened cases, 25 fetuses had CHD. The most common indication for extended fetal echo was maternal (59.2%) followed by fetal (40.2%). In maternal indications, the most common was advanced maternal gestational age (>35 years), followed by bad obstetric history and gestational diabetes. In fetal indications, the most common was abnormal obstetric Doppler findings favouring IUGR. Results: Of 5,000 cases examined by us, at 16 – 24 weeks using Color Doppler, and a high-end ultrasound machine, we could diagnose VSD in 3 cases, ASD in 2 cases, TOF in 2 cases, Transposition of great vessels in 2 cases, Hypoplastic left heart syndrome in 2 cases, Ebstein’s anomaly in 1 case and severe fetal hydrops with bradycardia in 1 case. On follow-up scan at 24 weeks, 2 additional VSD cases, 2 additional ASD cases, 2 new cases of TOF, and 1 new case of TGA were diagnosed. However, the number of cases of other pathologies remained the same. On post-natal scan additional cases of VSD, TOF and TGA diagnosed were 2, 1, and 2. Conclusion: An apparently normal appearance at any stage of pregnancy does not exclude a major heart defect, and it seems likely that some defects may be amenable to diagnosis only after birth. Hence follow-up scans with minute observation and technical expertise are need of the hour. Most of the CHDs in our region are missed, primarily because of poor socioeconomic status, lack of availability and awareness of diagnostic echocardiography. Spreading awareness and skill of fetal echocardiography is need of the hour. 

Background: Thyroid nodules are a common clinical finding, but only a small fraction are malignant. Conventional B-mode ultrasonography (US), often coupled with systems like the Thyroid Imaging, Reporting, and Data System (TI-RADS), is the primary imaging modality but has limited specificity, leading to a high number of unnecessary fine-needle aspiration (FNA) biopsies. Strain elastography (SE) is an adjunctive technique that assesses tissue stiffness, a property often altered in malignant lesions. Methods: This prospective, single-center study included 162 thyroid nodules in 148 patients who were scheduled for FNA or thyroidectomy. All nodules underwent a standardized examination including B-mode US (to assign a TI-RADS score) and SE. SE was evaluated using a 4-point qualitative elastography score (ES) and a quantitative strain ratio (SR), calculated by comparing the nodule to adjacent normal thyroid tissue. The diagnostic performance of B-mode US alone, SE alone, and their combination was assessed against the final histopathological diagnosis. Results: Of the 162 nodules, 125 (77.2%) were benign and 37 (22.8%) were malignant. Malignant nodules demonstrated significantly higher mean ES (3.5 ± 0.7 vs. 1.9 ± 0.8; p < 0.001) and mean SR (4.8 ± 1.4 vs. 2.1 ± 0.9; p < 0.001) compared to benign nodules. Using a receiver operating characteristic (ROC) curve analysis, an optimal SR cutoff of 2.95 was determined. The combination of B-mode US (TI-RADS ≥4) and SE (SR > 2.95) yielded a sensitivity of 94.6%, specificity of 91.2%, positive predictive value of 76.1%, negative predictive value of 98.3%, and an overall accuracy of 92.0%. This combined approach showed significantly higher accuracy compared to B-mode US alone (84.0%, p = 0.02) and SE alone (88.9%, p = 0.04). Conclusion: Strain elastography, particularly the quantitative strain ratio, is a valuable adjunct to conventional B-mode ultrasonography. Its integration into the diagnostic algorithm significantly improves the accuracy of differentiating benign and malignant thyroid nodules, holding the potential to reduce the rate of unnecessary invasive procedures.

Introduction: Caesarean section is commonly performed surgery in obstetrics. As medical science and especially obstetrics has evolved over the recent years, there has been a parallel and steady increase in the rate of caesarean births. Primary caesarean section means first caesarean section done in the patients who had delivered vaginally once or more. Multipara means a women delivered at least once.1 Aims and Objectives: Primary: To evaluate the incidence of primary cesarean section among multiparous women with previous vaginal delivery. Secondary: To study maternal and fetal outcome. Inclusion Criteria: Multiparous women,       Who underwent cesarean section for the first time who had a vaginal delivery previously.        Term gestation.               Singleton pregnancy. Exclusion Criteria:  Previous cesarean section or hysterotomy, myomectomy or septal resection.     Multiple pregnancy.                Primigravida.    Gestational age <37 weeks Materials And Methods: This is a retrospective study of 160 cases of primary cesarean section in multiparous women from may 2022 to  july 2023, done in the Department of Obstetrics and Gynecology, Government General Hospital, Kadapa. Observation & Results: The frequency of primary cesarean section in multiparous women is 7.2% of total cesarean sections and 3.1 % of the total number of deliveries during the study period. Frequency of cesarean section among total multiparous women is 5.9%. Discussion: This is a prospective study undertaken to analyze 160 cases of caesarean section done for first time in multiparous women. There were 5173 deliveries, around 2208 caesarean section which represented 42.7% of all deliveries.Incidence of primary caesarean section in parous women is 3.1% of all deliveries and accounted for 7.2% of all sections done.

Introduction: Amniotic fluid acts as a protective layer which exerts a cushion-like effect for the growing fetus against mechanical and biological injury. Amniotic fluid may be regarded as the largest part of the fetal extracellular space, and it provides a more accessible means than fetal blood for investigation of the fetus and its environment. Amniotic fluid assessment is an integral part of the antenatal evaluation of pregnancies at risk for an adverse pregnancy outcome especially in the third trimester. 1, 2 Detecting the fetus at risk for in utero damage or death, quantifying, and balancing the fetal risk against the risk of neonatal complications from immaturity, and determining the optimal time and mode of intervention are the cornerstone of modern-day obstetrics care and perinatal medicine.3 Aim: Study of Amniotic fluid Index Measurements in High- Risk Pregnancies and Outcome OBJECTIVES: ● To Study the Patterns Of Changes In Amniotic Fluid Index From 32 Weeks Till Delivery In High Risk Pregnancies. ● To Study the Perinatal Outcome In Relation To APGAR Score. Materials and Methods: A prospective observational study conducted on 100 patients over a period of 18 months at GMC, Kadapa. Inclusion Criteria: Single ton pregnancy with gestational age > 32 weeks, Hypertensive disorders, Diabetes complicating pregnancy including Gestational diabetes, Intrauterine growth retardation, Past dates, Liquor abnormalities, Bad obstetric history Exclusion criteria: Pregnant women with GA< 32 weeks or in labour, Antepartum hemorrhage, Eclampsia, Multiple gestation, Ruptured membranes, Congenital anomalies, Intrauterine fetal death Results: This study was observational prospective study, 100 antenatal cases of >32 weeks gestation attending Government general hospital, Kadapa were included. The study individuals was divided into 4 categories based on AFI and the correlation between AFI and variables studied like NST, mode of delivery, colour of liquor, Apgar at 5mts, birth weight, Congenital malformations, NICU dmission of babies and neonatal death. Discussion: The study was prospective observational study, 100 antenatal cases of >32 weeks gestation attending Government general hospital, Kadapa were included. The study individuals was divided into 4 categories based on AFI and the correlation between AFI and variables studied like NST, mode of delivery, colour of liquor, Apgar at 5 mins, birth weight, IUGR, NICU admission of babies and neonatal death.

Background: Periodontal disease has been increasingly recognized as a potential risk factor for adverse pregnancy outcomes. Poor maternal oral health may contribute to systemic inflammation, which in turn can negatively influence gestational outcomes. This study aimed to assess the association between maternal periodontal disease and pregnancy outcomes, with particular focus on preterm birth and low birth weight. Methods: The study was conducted in the Department of Oral and Maxillofacial Surgery, Desh Bhagat Dental College over a period of one year with effect from May 2024 to April 2025. A total of 78 pregnant women fulfilling the inclusion criteria were enrolled after obtaining informed consent. Maternal and neonatal parameters including gestational age, birth weight, and oral health indices were systematically recorded and analyzed. Results: The study group demonstrated significantly higher plaque index, gingival index, and bleeding on probing scores compared to controls (p < 0.001). Preterm delivery occurred in 63.5% of cases versus 10.8% of controls, while low birth weight (<2.5 kg) was observed in 73.0% of cases compared to 12.2% of controls. The mean birth weight of neonates in cases was 2.28 ± 0.517 kg, which was significantly lower than 3.17 ± 0.614 kg in controls (p < 0.001). These findings indicate a strong and statistically significant association between maternal periodontal disease and adverse pregnancy outcomes. Conclusion: Maternal periodontal disease is strongly associated with increased risk of preterm birth and low birth weight. The findings highlight the importance of routine oral health screening and periodontal care during pregnancy to improve both maternal and neonatal outcomes.

Introduction: Feto-maternal haemorrhage (FMH) is the transplacental passage of fetal blood into the maternal circulation, which can lead to significant clinical consequences such as fetal anemia, alloimmunization, and even fetal demise. This study aims to evaluate the incidence, volume, and clinical implications of FMH during the third trimester of pregnancy and the immediate postpartum period in a sample size of 90 women. Materials and Methods: A prospective observational study was conducted on 90 pregnant women in their third trimester and immediate postpartum period. Inclusion criteria included singleton pregnancies with no known placental abnormalities, while exclusion criteria included multiple pregnancies, placental abruption, and preeclampsia. FMH was detected using the Kleihauer-Betke (KB) test and flow cytometry. Results: The incidence of FMH was 11.1% (10/90) during the third trimester and 16.7% (15/90) in the immediate postpartum period. The mean volume of FMH was 4.2 mL in the third trimester and 14.8 mL postpartum. Significant associations were found between FMH and maternal age, parity, and mode of delivery. Five tables summarize the findings, including demographic data, FMH incidence, volume, and clinical outcomes. Conclusion: FMH is a significant clinical event with a higher incidence in the immediate postpartum period. Early detection and monitoring are crucial to prevent adverse fetal outcomes. Further research is needed to establish standardized protocols for FMH screening and management

Introduction: Critically ill patients on mechanical ventilation experience catabolic stress and inflammation, predisposing them to malnutrition. Malnutrition worsens outcomes by prolonging ICU stay, increasing infection risk, and elevating mortality. The Nutritional Risk in Critically Ill (NUTRIC) score was designed specifically for ICU patients to identify those most likely to benefit from early nutrition therapy. This study evaluated nutritional risk using the NUTRIC score and its correlation with outcomes, with interleukin-6 (IL-6) assessed as a marker of systemic inflammation. Methods: An observational cross-sectional study was conducted in the ICU of Dr. D.Y. Patil Medical College, Kolhapur, over 18 months. Adults (≥18 years) requiring invasive mechanical ventilation were enrolled within 24 hours of intubation. Patients with burns, malignancy, AIDS, neuromuscular disorders, or readmissions were excluded. Demographic and clinical data, comorbidities, APACHE II and SOFA scores were collected. Serum IL-6 was measured by ELISA. NUTRIC scores (0–10) were calculated; scores ≥6 indicated high risk. Outcomes included ICU stay, ventilator days, time to weaning, and mortality. Correlations were analyzed statistically. Results: The cohort (mean age 59.5±16.1 years, male predominance) showed moderate-to-severe illness (APACHE II 26.46±8.0, SOFA 9.46±3.96). Mean IL-6 was 89.12±35.77 pg/mL, and mean NUTRIC score 5.06±1.87, with nearly half at high risk. Hypertension (46.9%) and neurological disorders (43.8%) were the most frequent comorbidities. Average ICU stay was 15.4 days, with 8.9 ventilator days and 8.0 days to weaning. High NUTRIC scores correlated positively with mortality (r=0.389, p<0.001) and IL-6 (r=0.319, p<0.001). Survivors were mainly low risk (88.6%), while more than half of non-survivors were high risk (p=0.001). High risk correlated negatively with ICU stay and ventilator duration due to early mortality. Sepsis and renal disease showed the strongest associations with high nutritional risk and elevated IL-6. Conclusion: The NUTRIC score is a simple and effective tool for identifying nutritional risk in ventilated ICU patients. High scores predicted increased mortality, greater inflammatory burden, and comorbidity impact. Early recognition of nutritionally vulnerable patients supports timely intervention and better utilization of ICU resources. Incorporating the NUTRIC score alongside illness severity indices can improve prognostication and guide personalized care.

Introduction: Uterine fibroids are common benign smooth muscle tumors of the uterus, affecting up to 70% of women during their lifetime. While often asymptomatic, fibroids may complicate pregnancy, leading to adverse maternal and fetal outcomes. The relationship between fibroids and pregnancy outcomes remains inadequately understood, necessitating focused evaluation. Aim: To determine the prevalence and fetomaternal outcomes in pregnancies complicated by fibroids at SMGS Hospital, Jammu over a one-year period. Methods: A retrospective analysis was conducted from July 2022 to June 2023 in the Department of Obstetrics and Gynecology, SMGS Hospital, Jammu. Antenatal cases with fibroid-complicated pregnancies were identified from hospital records. Demographic characteristics, parity, gestational age, maternal complications, delivery mode, and neonatal outcomes were analyzed. Multiple registers including admission, OT, delivery, and NICU records were reviewed. Pregnancies with multiple gestations were excluded. Results: Out of 18,682 deliveries, 61 were complicated by fibroids, giving a prevalence of 0.3%. The mean maternal age was 29.1 ± 4.7 years, with primigravidas forming the largest group (54.1%). The mean gestational age at delivery was 36 weeks. Cesarean delivery occurred in 55.8% of cases, primarily due to previous cesarean section, non-progression of labor, fetal distress, and malpresentation. Common maternal complications included preterm labor (16.4%), preterm premature rupture of membranes (14.7%), blood transfusion requirement (13.1%), intrauterine growth restriction (11.5%), malpresentation (11.5%), and postpartum hemorrhage (9.8%). There were 59 live births (96.7%) and 2 intrauterine deaths (3.3%). Low birth weight (<2.5 kg) was seen in 31.2% of neonates, while 11.8% required NICU admission. Conclusion: Pregnancy complicated with fibroids constitutes a high-risk condition with increased rates of cesarean delivery, preterm birth, malpresentation, growth restriction, and NICU admissions. Careful antenatal, intrapartum, and postpartum surveillance is essential to optimize maternal and fetal outcomes.

Background: Gallbladder cancer (GBC) is one of the most aggressive gastrointestinal malignancies, often diagnosed late due to vague clinical features. Imaging, particularly ultrasonography (USG), is widely used in the evaluation of gallbladder diseases, and gallbladder wall thickness (GBWT) has been identified as a potential marker of underlying malignancy. Aim: To assess the predictive value of gallbladder wall thickness in differentiating benign from malignant gallbladder diseases and to evaluate its correlation with histopathological findings. Methods: A prospective observational study was conducted at Government Medical College over a period of 18 months. Patients undergoing cholecystectomy for suspected gallbladder pathology were included. Preoperative ultrasonographic assessment of gallbladder wall thickness was documented. Based on USG findings, patients were stratified into normal (<3 mm), thickened (≥3 mm), and markedly thickened (>10 mm) categories. Final diagnoses were confirmed by histopathological examination (HPE). The diagnostic accuracy of GBWT was calculated, and associations with demographic and clinicopathological variables were analyzed. Results: A total of 76 patients were studied, with a mean age of 52.6 years; females constituted 68%. Among them, 59 cases were benign (chronic cholecystitis, xanthogranulomatous cholecystitis, adenomyomatosis), while 17 were malignant. Mean GBWT in malignant cases was significantly higher (12.4 ± 3.6 mm) compared to benign cases (5.2 ± 1.8 mm, p < 0.001). A cutoff of 10 mm yielded sensitivity of 82.3% and specificity of 88.1% for predicting malignancy. False positives were mainly due to xanthogranulomatous cholecystitis, which can mimic cancer radiologically. Conclusion: Gallbladder wall thickness on USG is a simple, cost-effective, and non-invasive marker that correlates significantly with gallbladder malignancy. While not definitive alone, its predictive accuracy improves when interpreted alongside clinical features and adjunctive imaging. It may serve as an important tool in early detection, particularly in high-risk populations.

Introduction: Oral cavity lesions, both premalignant and malignant, constitute a significant public health problem in India, with Western India being a high-prevalence region due to tobacco and betel quid use. Understanding the sociodemographic and histopathological profiles of these lesions is essential for planning effective preventive and diagnostic strategies.  Aim: To evaluate the sociodemographic and histopathological profile of premalignant and malignant oral cavity lesions in Western India.  Materials and Methods: A prospective observational study was conducted at a tertiary care center in Western India from December 2020 to June 2022. A total of 88 biopsy-proven cases were included, comprising 26 premalignant and 62 malignant lesions. Detailed sociodemographic data, clinical presentation, and habit history were collected. Specimens were processed with standard histopathological techniques and classified according to WHO criteria. Statistical analysis was performed using chi-square and t-tests, with p<0.05 considered significant.  Results: The mean age of patients was 49.1 ± 7.2 years, with a male predominance (67.0%). Rural residence (58.0%) and illiteracy (65.9%) were common. Tobacco chewing (83.0%) and smoking (75.0%) were the most prevalent risk factors. The commonest presenting complaint was a non-healing ulcer (79.5%), and the buccal mucosa was the most frequently affected site (62.5%). Histologically, keratosis without dysplasia (42.3%) and oral submucous fibrosis (15.4%) were the leading premalignant lesions, while well-differentiated squamous cell carcinoma accounted for 77.4% of malignancies. Most malignant cases were diagnosed at T2N1 stage (72.6%). No statistically significant associations were found between sociodemographic factors and lesion type. Conclusion: Oral cavity lesions in Western India predominantly affect middle-aged rural males with high rates of tobacco use and low literacy. Buccal mucosa was the commonest site, and well-differentiated squamous cell carcinoma was the dominant malignancy. These findings emphasize the need for community-level awareness, tobacco cessation programs, and early screening to reduce oral cancer morbidity and mortality.

Background: Non-communicable diseases (NCDs) such as hypertension, diabetes, thyroid disorders, and obesity are emerging as significant contributors to maternal morbidity and adverse fetal outcomes in low- and middle-income countries. In pregnancy, the burden of these conditions is increasing due to lifestyle changes, delayed childbearing, and rising prevalence of metabolic disorders . Understanding their impact on maternal and neonatal outcomes is critical for optimizing obstetric care. Aim: To study the prevalence of non-communicable diseases in pregnancy and their association with maternal and fetal outcomes in a hospital-based population. Methods: A cross-sectional study was conducted at Government Medical College Kathua from September  2023 to August  2024 on 100 pregnant women diagnosed with non-communicable diseases. Data regarding demographic profile, type of NCD, obstetric complications, and neonatal outcomes were collected and analyzed using descriptive statistics. Results: Among 100 women, hypertensive disorders in pregnancy were most common (42%), followed by gestational diabetes (28%), thyroid disorders (18%), and obesity (12%). Maternal complications included preeclampsia (24%), cesarean section (46%), and postpartum hemorrhage (6%). Fetal complications included low birth weight (22%), preterm birth (18%), intrauterine growth restriction (12%), and perinatal mortality (4%). Conclusion: Non-communicable diseases in pregnancy contribute substantially to adverse maternal and perinatal outcomes. Early screening, preconception counseling, and multidisciplinary management are essential to reduce morbidity and mortality associated with these conditions.

Background: Laryngeal carcinoma is a significant malignancy that affects the head and neck region. Early diagnosis and accurate staging are crucial for determining treatment plans and improving patient outcomes. Imaging techniques such as computed tomography (CT) and magnetic resonance imaging (MRI) are vital for evaluating laryngeal carcinoma. This article provides a comprehensive analysis comparing of CT and MRI in the diagnosis and staging of laryngeal carcinoma. MRI generally offers superior staging accuracy for laryngeal carcinoma due to its better detection of tumor invasion into the laryngeal cartilages and surrounding soft tissues, making it more useful for determining eligibility for conservative surgery. However, CT is more widely used for initial staging because it is faster, less expensive, and requires less patient cooperation than MRI. The choice between CT and MRI often depends on the specific clinical question, with CT providing a good overview and MRI offering more detailed "problem-solving" information in cooperative patients. MRI imaging offers more sensitivity than CT to cartilage invasion but results in a high rate of false-positive studies which decreases their overall accuracy. The objective is to compare accuracy of CT scan vs MRI in the laryngeal carcinoma. Subjects and Methods: All patients have been diagnosed, with and without contrast, including neck MRI and CT. In order to prevent invalidation, before laryngeal biopsy, MRI and CT scanning have been done such that the images are not altered by peri tumorous inflammation. Results: The MRI classification was right for 20 out of 25 patients (80 percent) and 5 outsized cases: three cT1b lesions were pT1a and two cT1a lesions were squamous cell papilloma’s during pathological examination. CT was accurately identified in 17 out of 25 patients (68%), with 8 understated cases: 3 cT1a lesions by CT were pT1b, 3 cT1a lesions were pT3, and 2 tumours had not been found in the CT scan. Conclusion: Both CT and MRI play critical roles in the diagnosis and management of laryngeal carcinoma. While CT is superior for assessing bone involvement and is more widely available, MRI provides superior soft tissue contrast, making it more effective in assessing the extent of tumor invasion and evaluating soft tissue structures. Our research showed that MRI in preoperative stage early glottic cancer is more sensitive than CT to accurately select eligible patients for conservatory larynx surgery like super cricoid laryngectomy and cordectomy.

Background: Urban India is experiencing a rapid rise in overweight and obesity among women of reproductive age, paralleling dietary transitions and sedentary lifestyles. This trend is linked to gestational diabetes mellitus (GDM), hypertensive disorders of pregnancy (HDP), cesarean section (CS), macrosomia, and neonatal intensive care unit (NICU) admissions. National surveys and recent Indian cohorts show higher adiposity in urban settings, highlighting a growing public health burden. [1–3] Aim: To quantify the association between maternal overweight/obesity and adverse pregnancy outcomes in an urban Indian tertiary-care hospital and to contextualize findings against recent Indian evidence. Methods: A hospital-based retrospective cohort of singleton deliveries (January–December 2024) in a large metropolitan public-sector tertiary center was analyzed. Early-pregnancy body mass index (BMI) was classified using Asia-Pacific cut-offs: normal (18.5–22.9 kg/m²), overweight (23.0–24.9), obesity (≥25.0). Outcomes included GDM (DIPSI one-step), HDP/preeclampsia (ISSHP 2021), induction, CS, preterm birth, macrosomia (>4.0 kg), and NICU admission. Multivariable logistic regression adjusted for age, parity, prior CS, anemia, and socioeconomic quintile. Diagnostic and classification frameworks follow Indian and international guidance. [4,9–11] Results: Among 1,200 women (mean age 27.1±4.6 years), BMI distribution was normal 45.3% (n=544), overweight 27.8% (n=334), and obesity 19.7% (n=236); underweight 7.2% (n=86). Crude risks (%) rose across BMI strata for GDM (10.1→18.0→28.4), HDP (8.2→14.1→22.0), CS (28.3→38.0→52.1), macrosomia (4.1→7.2→12.3), and NICU admission (8.7→13.8→18.2). Adjusted odds ratios (AOR) vs. normal BMI: overweight—GDM 1.67 (95% CI 1.22–2.29), HDP 1.80 (1.29–2.52), CS 1.48 (1.18–1.86); obesity—GDM 2.92 (2.13–4.01), HDP 2.59 (1.83–3.67), CS 2.46 (1.98–3.07), macrosomia 2.78 (1.84–4.21), NICU 2.06 (1.52–2.80). Population-attributable fraction using urban overweight/obesity prevalence from NFHS-5 (~31%) suggested ≈24% of GDM and ≈22% of CS may be attributable to maternal adiposity in urban settings. [1–3] Conclusion: Maternal overweight/obesity independently increases the risk of major obstetric and neonatal complications in urban India. Integration of pre-conception counseling, weight management, early ANC enrollment, universal GDM screening, and targeted intrapartum strategies could substantially reduce adverse outcomes and healthcare costs

Introduction: Oral cavity squamous cell carcinoma (OCSCC) remains a prevalent and aggressive malignancy, particularly in South Asian populations. Tumor stage and cervical nodal involvement are key determinants of prognosis, yet the lymph node ratio (LNR)-the ratio of metastatic to total lymph nodes-has recently emerged as a more precise indicator of tumor burden. This study aimed to determine the association between tumor stage and LNR in oral cavity malignancies. Methods: A retrospective analytical study was conducted in the Department of Surgical Oncology, VTSM Peripheral Cancer Centre, Kalaburagi, from 2022 to 2024. A total of 200 histopathologically confirmed cases of oral cavity squamous cell carcinoma were analyzed. LNR was calculated as the ratio of positive lymph nodes to total nodes retrieved. Tumors were staged using the AJCC 8th edition criteria. Statistical analysis included Welch’s t-test, chi-square tests, and Spearman’s correlation. Results: Of 200 patients, 109 (54.5%) had early-stage (T1-T2) and 91 (45.5%) had advanced-stage (T3-T4) tumors. Mean LNR was significantly higher in advanced stages (0.186 ± 0.107) than in early stages (0.082 ± 0.058), with a mean difference of +0.104 (95% CI 0.079-0.129; p < 0.001). A high LNR (≥0.12) was observed in 54.9% of advanced-stage cases versus 30.3% of early-stage cases (RR 1.81; p < 0.001). A strong positive correlation existed between T stage and LNR (Spearman ρ = 0.47; p < 0.001). High LNR was significantly associated with extranodal extension (OR 2.93; p = 0.00085) and nodal positivity (RR 1.62; p < 0.001). Conclusion: Lymph node ratio increases significantly with advancing tumor stage and correlates with adverse pathological features. LNR serves as a valuable prognostic adjunct to conventional TNM staging, offering improved risk stratification for postoperative management in oral cavity carcinoma.

Background: Hypertensive disorders of pregnancy, particularly pre-eclampsia, remain one of the leading causes of maternal and perinatal morbidity and mortality worldwide. Early identification of high-risk women allows timely interventions and improved pregnancy outcomes. Uterine artery Doppler ultrasonography, being a non-invasive technique, offers potential in predicting the development of pre-eclampsia by assessing uteroplacental circulation. Objectives: To determine the role of uterine artery Doppler in predicting pre-eclampsia in high-risk pregnant women and to evaluate its sensitivity, specificity, and predictive accuracy. Methods: A prospective observational study was conducted at the Department of Obstetrics and Gynaecology, Government Maternity Hospital, Tirupati, from January to December 2023. Eighty-seven antenatal women aged 18–38 years with high-risk factors such as advanced maternal age, obesity, diabetes, chronic hypertension, previous pre-eclampsia, or multifetal gestation were included after obtaining informed consent. Uterine artery Doppler studies were performed using a Toshiba Nemio 30 colour Doppler to assess resistance index (RI) and presence of diastolic notches. Women were followed throughout pregnancy for the development of pre-eclampsia, defined as blood pressure ≥140/90 mmHg with proteinuria after 20 weeks of gestation. Data were analyzed using SPSS v23.0, and statistical significance was considered at p < 0.05. Results: Out of 87 participants, 15 (17.2%) developed pre-eclampsia. Abnormal Doppler findings were noted in 16 women (18.39%), of whom 12 (75%) subsequently developed pre-eclampsia. Among Doppler abnormalities, unilateral RI >0.58 was most common (33.3%), followed by bilateral RI >0.58 (20%) and bilateral uterine artery notching (13.3%). The test demonstrated a sensitivity of 80%, specificity of 94.4%, positive predictive value of 75%, negative predictive value of 95.8%, and an overall diagnostic accuracy of 91.9%. Higher maternal age, obesity (BMI >30 kg/m²), previous history of pre-eclampsia, and comorbidities such as gestational diabetes mellitus were significantly associated with increased risk. Conclusion: Uterine artery Doppler ultrasonography is a reliable, non-invasive screening tool for predicting pre-eclampsia in high-risk pregnancies. An RI >0.58 and the presence of persistent diastolic notching are significant predictors of disease development. Incorporating uterine artery Doppler screening into routine antenatal assessment, especially for high-risk women, can facilitate early intervention, reduce maternal and perinatal complications, and improve pregnancy outcomes.

Peripartum cardiomyopathy (PPCM) is an uncommon but life-threatening condition that occurs in the peripartum period, affecting 1 in 1,000 to 1 in 4,000 live births worldwide, with regional variation [1]. Defined by the European Society of Cardiology (ESC) as an idiopathic cardiomyopathy with reduced left ventricular ejection fraction (LVEF <45%) developing toward the end of pregnancy or in the months following delivery, PPCM remains underdiagnosed due to its nonspecific symptoms [2].

Introduction: Thyroid nodules are a common endocrine presentation requiring accurate differentiation between benign and malignant lesions. The Thyroid Imaging Reporting and Data System (TIRADS) provides a structured ultrasound-based malignancy risk assessment, whereas serum thyroglobulin (Tg) serves as a biochemical marker reflecting follicular activity. Correlating these modalities with cytology may enhance preoperative diagnostic reliability. Aim: To compare the TIRADS scoring system with serum thyroglobulin levels in the cytological diagnosis of thyroid lesions. Methods: A cross-sectional study was conducted among 50 patients presenting with thyroid nodules at Shri Atal Bihari Vajpayee Medical College and Research Institute, Bengaluru. All patients underwent ultrasound-based TIRADS classification, fine-needle aspiration cytology (FNAC) using the Bethesda system, and serum Tg estimation by chemiluminescent immunoassay (Beckman Coulter Access 2). Data were analyzed using SPSS v21; ANOVA, chi-square, and ROC analyses determined associations and diagnostic performance. Results: Mean age was 42.7 ± 13.4 years, with females comprising 66 %. Distribution across TIRADS categories was TR2 (12 %), TR3 (34 %), TR4 (26 %), and TR5 (28 %). Mean serum Tg rose significantly with higher TIRADS grades (24.7 → 142.6 ng/mL, p < 0.001; η² = 0.55). Cytological diagnosis correlated strongly with both TIRADS (χ² = 16.04, p = 0.001) and Tg (ANOVA F = 13.91, p < 0.001). Mean Tg levels differed markedly between benign (45.3 ± 27.1 ng/mL) and malignant (138.9 ± 70.8 ng/mL) lesions (p < 0.001; AUC = 0.84). Integration of TIRADS, cytology, and Tg improved diagnostic accuracy to AUC = 0.91, surpassing cytology alone (ΔAUC = +0.09; p = 0.028). Conclusion: Serum thyroglobulin levels exhibit a significant positive correlation with increasing TIRADS category and cytological suspicion. The combined use of TIRADS scoring, cytology, and Tg estimation provides superior diagnostic precision for thyroid lesion assessment, offering a reliable, cost-effective triad for preoperative evaluation

Background: Thyroid carcinoma represents the most common endocrine malignancy worldwide, with increasing incidence rates. Despite being relatively rare, accounting for approximately 1-2% of all malignancies, thyroid cancer poses significant diagnostic and therapeutic challenges. Objectives: To evaluate the clinical presentation, pathological distribution, diagnostic accuracy of fine needle aspiration cytology (FNAC), and surgical outcomes of thyroid carcinoma patients at a tertiary care center. Methods: A prospective observational study was conducted from September 2018 to June 2020, including 49 patients with confirmed thyroid carcinoma. Clinical presentation, FNAC results, histopathological findings, surgical procedures, and postoperative complications were analyzed. Statistical analysis included sensitivity, specificity, and predictive values of FNAC compared to histopathology. Results: The mean age was 42.3 years with female predominance (71.4%). Thyroid swelling was the predominant presentation (95.9%). Papillary carcinoma constituted 79.5% of cases, followed by follicular carcinoma (16.3%). FNAC demonstrated 73.5% sensitivity and 98.7% specificity. Total thyroidectomy was performed in 83.7% of patients. According to AMES criteria, 63.8% were classified as low-risk. Transient hypoparathyroidism occurred in 20.4% of cases. Stage I disease was most common (61.2%) per AJCC 2017 classification. Conclusions: Papillary carcinoma remains the predominant thyroid malignancy with excellent prognosis when diagnosed early. FNAC serves as a reliable initial diagnostic tool despite moderate sensitivity. Total thyroidectomy remains the preferred surgical approach with acceptable complication rates.

Background: Labor induction is an obstetric procedure performed routinely across the globe including in India and it initiate labor before its onset spontaneously. Labor induction is advisable when benefits of termination of pregnancy are higher compared to the risks of pregnancy continuation. Concerning Indian context, incidence of labor induction are in the range of 5-22%. Aim: The present study was aimed to assess the impact of Induction Indications on Delivery Outcomes and modes. The study also assessed the degree of perinatal, fetal, and maternal morbidity with each indication for labor induction. Methods: The present study assessed 200 pregnant females that underwent induction of labor at the Institute within the defined study period for delivery modes and indications. The data gathered were assessed statistically for results formulation. Results: Among 200 subjects assessed, operative vaginal delivery, cesarean section, and vaginal delivery was done in 22% (n=44), 41% (n=82), and 37% (n=74) subjects respectively. Highest rate of induction was seen with PROM with 27%. Other conditions with high induction rate were hypertension, diabetes, and past dates with 10%, 14%, and 2% respectively. Normal vaginal delivery rates were high in hypertension, polyhydramnios, and PROM and were lowest with IUGR and diabetes. Highest cesarean rate was seen with IUGR and diabetes. High maternal morbidity was seen with operative vaginal delivery highest NICU admission was seen with cesarean section. Conclusion: The present study concludes that indications for induction of labor are affected greatly with the mode of delivery and also decrease the rate of emergency cesarean section and morbidity linked with it. The study outcomes were inefficient owing to a smaller sample size. Further, large randomized trials are needed to assess the impact of labor induction indication on the mode of delivery

Background Twin pregnancies are associated with increased maternal and perinatal risks compared to singleton gestations. They contribute significantly to maternal morbidity, obstetric complications, and adverse neonatal outcomes. This study aimed to evaluate the maternal and perinatal outcomes of twin pregnancies at a tertiary care hospital in Tezpur, Assam. Objectives To determine the incidence of twin pregnancies and analyse maternal complications, maternal morbidity and mortality, as well as neonatal morbidity and mortality. Methods This study was conducted over one year at Tezpur Medical College and Hospital. A total of 100 women with twin pregnancies beyond 28 weeks of gestation were included, fulfilling inclusion and exclusion criteria. Data were collected through structured proformas, clinical examinations, ultrasonography, and perinatal monitoring. Maternal and neonatal outcomes were analysed using descriptive statistics. Results The incidence of twin pregnancy was 0.7% among 13,737 deliveries. Most women were aged 20–29 years (73%), with nearly equal distribution between primigravida (49%) and multigravida (51%). Preterm delivery occurred in 84% of cases, and anemia (72%) was the most common maternal risk factor. Premature labour (76%) was the leading complication, with maternal mortality recorded in 2%. Caesarean delivery was slightly more common (54%) than vaginal birth (46%). Perinatal outcomes were marked by low birth weights (s (<2.5 kg in 80–90% of twins), intrauterine deaths (3–5%), and a high NICU admission rate (52–56%). Conclusion Twin pregnancies are high-risk with significant maternal and perinatal complications. Strengthening antenatal care, early risk identification, and skilled intrapartum management are essential to improve outcomes.

Background: Post-dated pregnancy, defined as gestation extending beyond 40 weeks, is associated with an increased risk of maternal and perinatal morbidity. The optimal management of such pregnancies—whether to await spontaneous onset or to induce labour—remains a critical obstetric consideration. Aim: To compare the maternal and fetal outcomes between spontaneous and induced labour among post-dated pregnancies. Methods: This prospective interventional study included 100 women with post-dated singleton pregnancies admitted to the Department of Obstetrics and Gynaecology at a tertiary care centre. Participants were divided into two groups: Group I (spontaneous onset of labour, n=50) and Group II (induced labour, n=50). Induction was performed using prostaglandin E₂ gel followed by oxytocin as needed. Maternal outcomes such as mode and duration of delivery, perineal injuries, and postpartum haemorrhage were compared. Fetal outcomes assessed included Apgar scores, meconium aspiration, NICU admissions, and perinatal mortality. Statistical analysis was performed using SPSS version 20.0, with p<0.05 considered significant. Results: Cesarean section rates were significantly higher in the induced group (50%) than in the spontaneous group (16%) (p<0.001). Vaginal delivery was more common in spontaneous labour (70% vs 42%; p=0.003). The mean duration of labour was longer in induced cases (10.48 ± 3.50 h vs 8.72 ± 3.81 h; p=0.018). Maternal complications and neonatal outcomes, including Apgar <7 at 5 minutes (12% vs 10%), meconium aspiration (10% each), and NICU admission (12% vs 10%), did not differ significantly between groups. Conclusion: Induction of labour in post-dated pregnancies is associated with an increased cesarean delivery rate and prolonged labour duration but does not adversely impact maternal or fetal outcomes when managed appropriately. Vigilant monitoring and individualized decision-making are essential for optimizing perinatal results

Background: Hypertensive disorders of pregnancy are a leading cause of maternal and perinatal morbidity and mortality. Alterations in lipid metabolism have been implicated in their pathogenesis through endothelial dysfunction and oxidative stress. This study evaluated and compared serum lipid profiles in hypertensive and normotensive pregnant women and correlated them with maternal and fetal outcomes. Objectives: To evaluate serum lipid profiles in hypertensive and normotensive pregnant women. To compare lipid parameters between both groups. To correlate abnormal lipid levels with maternal and fetal outcomes. Methods: A comparative prospective study was conducted among 100 pregnant women (50 hypertensive and 50 normotensive) attending the Department of Obstetrics and Gynaecology at a tertiary care hospital. Fasting venous blood samples were analyzed for total cholesterol, triglycerides, HDL-C, LDL-C, VLDL-C, and non-HDL-C using enzymatic methods. Maternal and neonatal outcomes were recorded. Statistical analysis included Welch’s t-test, chi-square test, relative risk, and 95% confidence intervals, with p < 0.05 considered significant. Results: Hypertensive women showed significantly higher mean values of total cholesterol (224.7 ± 32.9 mg/dL), triglycerides (204.3 ± 41.8 mg/dL), LDL-C (139.8 ± 27.6 mg/dL), and non-HDL-C (183.0 ± 31.8 mg/dL) and lower HDL-C (41.7 ± 6.9 mg/dL) compared with normotensive women (p < 0.001). Adverse neonatal outcomes such as preterm birth, low birth weight, and IUGR were more frequent among those with abnormal lipid levels. Elevated TC/HDL ratio (≥4.5) conferred the highest risk (RR = 3.02; p = 0.0007). Conclusion: Dyslipidemia is significantly associated with hypertensive disorders of pregnancy and adverse perinatal outcomes. Early lipid screening and targeted management may aid in reducing maternal and neonatal complications.

Background: Inflammation and thrombosis underlie acute coronary syndromes (ACS). Hematological indices derived from routine complete blood counts (CBC)—including neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR)—may offer low-cost prognostic value, particularly in resource-limited settings. Objectives: To evaluate whether admission NLR, PLR, platelet indices (MPV, PDW, PCT), and coagulation markers (PT, aPTT) predict in-hospital mortality and morbidity among patients with ACS. Methods: We performed a hospital-based longitudinal study at S.C.B. Medical College & Hospital, Cuttack, India (1 September 2022–31 August 2023). Consecutive adults with ACS (STEMI, NSTEMI, or unstable angina) were enrolled (N=516). Exclusions included immediate pre-hospital/ED cardiac arrest and chronic inflammatory, malignant, renal, hepatic disease, or pregnancy. Admission CBC-derived indices (NLR, PLR, MPV, PDW, PCT) and PT/aPTT were measured. Outcomes were in-hospital mortality and major adverse events: ventricular tachyarrhythmia, cardiogenic shock, left ventricular failure (LVF), and prolonged hospitalization (>5 days). Associations were tested using t-tests/χ², univariate and multivariable logistic regression, and ROC analysis. Results: Cohort mean age was 60.6±12.3 years; 64.1% were male; STEMI comprised 53.3%. Mortality was 5.8% (30/516). Morbidity included cardiogenic shock 20.9%, LVF 10.9%, ventricular tachyarrhythmia 3.5%, and prolonged hospitalization 10.9%. On multivariable analysis, NLR independently predicted all outcomes—mortality (adjusted OR 1.130 per unit; 95% CI 1.044–1.223), ventricular tachyarrhythmia (1.221; 1.097–1.359), cardiogenic shock (1.150; 1.071–1.234), LVF (1.104; 1.032–1.181), and prolonged hospitalization (1.224; 1.140–1.314). PLR independently predicted mortality (1.003; 1.001–1.006), cardiogenic shock (1.006; 1.003–1.009), and LVF (1.003; 1.001–1.006). MPV, PDW, and PCT were not independent predictors. PT prolongation was strongly associated with mortality. Discrimination was highest for NLR: AUC 0.909 for mortality (cut-off 9.38; sensitivity 87.5%, specificity 88.8%), with robust AUCs for other morbidities (≥0.774). PLR showed good but consistently lower performance (mortality AUC 0.862 at cut-off 201). Conclusions: Admission NLR—and to a lesser degree PLR—provides powerful, inexpensive prognostic information for in-hospital mortality and complications in ACS, outperforming platelet volume indices. PT adds complementary risk signal for mortality. Incorporating NLR/PLR into routine assessment and existing risk models may enhance early stratification, especially where advanced biomarkers are inaccessible

Background:  Post-dated pregnancy, defined as gestation extending beyond 42 completed weeks (294 days), poses significant risks to both maternal and fetal health. Despite advances in obstetric care, post-term pregnancies continue to be associated with increased perinatal morbidity and mortality. This study aimed to evaluate the effects of post-dated pregnancy on maternal and fetal outcomes in a tertiary care setting. Methods A prospective observational study was conducted from June 2023 to July 2024 at the Department of Obstetrics and Gynaecology, Tezpur Medical College and Hospital. A total of 106 pregnant women with gestational age beyond 40 weeks were included. Detailed maternal and fetal assessments were performed, including biophysical profile, non-stress test, and Doppler studies. Maternal outcomes assessed included mode of delivery, induction of labour, and maternal complications. Fetal outcomes evaluated were birth weight, Apgar scores, meconium-stained liquor, neonatal intensive care unit (NICU) admissions, and perinatal mortality. Results The mean gestational age at delivery was 41.2 ± 0.8 weeks. The caesarean section rate was 48.1%, with fetal distress being the most common indication (35.3%). Labour induction was required in 67.9% of cases. Meconium-stained amniotic fluid was observed in 42.5% of deliveries. Macrosomia (birth weight >4000g) occurred in 16.0% of neonates. Low Apgar scores (<7 at 5 minutes) were documented in 13.2% of newborns. NICU admission rate was 28.3%, significantly higher compared to term pregnancies. Maternal complications included postpartum haemorrhage (11.3%), perineal trauma (23.6%), and operative delivery morbidity. Conclusion Post-dated pregnancy is associated with increased maternal and fetal complications. Higher rates of operative delivery, meconium aspiration, macrosomia, and neonatal morbidity were observed. Active management with timely induction of labour and continuous intrapartum monitoring are essential to improve perinatal outcomes in post-term pregnancies

Hypertensive disorders of pregnancy (HDP), particularly preeclampsia, remain among the leading causes of maternal and perinatal morbidity and mortality globally. Early identification of women at risk allows preventive interventions such as low-dose aspirin therapy and closer surveillance. Uterine artery Doppler velocimetry in the first trimester provides a non-invasive assessment of uteroplacental circulation and may help predict preeclampsia before clinical onset. Abnormal uterine artery pulsatility index (PI) reflects impaired trophoblastic invasion and high vascular resistance, which precede the development of HDP and adverse perinatal outcomes. Aim: To evaluate the predictive value of mean uterine artery PI measured at 11–14 weeks of gestation in primigravida women with singleton pregnancies for the development of hypertensive disorders of pregnancy and adverse perinatal outcomes. Materials and Methods: A prospective cohort study was conducted on 75 primigravida women with singleton pregnancies between 11–14 weeks of gestation attending the antenatal clinic of a Tezpur Medical College and Hospital. Mean uterine artery PI was measured by transabdominal color Doppler ultrasonography. Participants were followed up till delivery and 7 days postpartum. Based on Doppler results, women were categorized into normal PI (≤95th percentile) and abnormal PI (>95th percentile) groups. The primary outcome was the development of HDP, and secondary outcomes included preterm delivery, intrauterine growth restriction (IUGR), mode of delivery, NICU admission, and perinatal mortality. Data were analyzed using the Chi-square test for categorical variables and independent t-test for continuous variables. A p-value <0.05 was considered statistically significant. Results: Out of 75 par0ticipants, 15 (20%) had abnormal mean uterine artery PI. Preeclampsia developed in 33.3% of women with abnormal PI compared to 6.6% with normal PI (p<0.01). The abnormal PI group also showed significantly higher rates of preterm delivery (33.3% vs. 10%; p=0.04), IUGR (26.6% vs. 8.3%; p=0.045), and NICU admissions (26.6% vs. 11.6%; p=0.05). Mean birth weight was significantly lower in the abnormal PI group (2.41 ± 0.42 kg) than in the normal PI group (2.87 ± 0.36 kg). No significant difference was found in mode of delivery or perinatal mortality. Discussion: Abnormal uterine artery PI in early pregnancy was strongly associated with subsequent HDP and adverse perinatal outcomes, supporting its role as an early screening marker of placental insufficiency. These findings are consistent with those of Papageorghiou et al. [9], Gómez et al. [10], and Plasencia et al. [12], who reported significantly higher rates of preeclampsia and IUGR among women with elevated first-trimester uterine artery PI. In accordance with the ASPRE trial by O’Gorman et al. [14] and recommendations by WHO and ACOG [15,17], early identification of at-risk women can guide the initiation of low-dose aspirin prophylaxis before 16 weeks to reduce the incidence of preeclampsia and its complications. Conclusion: Mean uterine artery PI measured at 11–14 weeks of gestation is a significant early predictor of preeclampsia and adverse perinatal outcomes. Incorporating first-trimester uterine artery Doppler screening into routine antenatal care can enable early risk stratification, timely prophylaxis, and improved maternal and neonatal outcomes, particularly in primigravida women

Background:  High-risk pregnancies contribute significantly to perinatal morbidity and mortality. Cardiotocography (CTG) remains a vital tool for intrapartum fetal monitoring, enabling early detection of distress and timely obstetric intervention. However, its predictive accuracy and effect on perinatal outcomes require further evaluation. Methods A prospective cross-sectional study was conducted in the Department of Obstetrics and Gynaecology, Tezpur Medical College and Hospital, from September 2023 to August 2024. A total of 180 antenatal women with ≥37 weeks of gestation and one or more high-risk factors were included. Admission CTG was performed for 20 minutes and categorized as reactive, non-reactive, or pathological. Maternal outcomes (mode of delivery) and neonatal outcomes (Apgar score, NICU admission, perinatal mortality) were recorded. Statistical analysis was done using SPSS v20.0, with p < 0.05 considered significant. Results Reactive CTG was observed in 70.55% of cases, non-reactive in 19.44%, and pathological in 10%. A significant association existed between CTG findings and mode of delivery (p < 0.0001), with 90.5% of reactive CTG cases delivering vaginally, while 97.47% of pathological CTG required caesarean section. Pathological CTG correlated with low Apgar scores (<7) and increased NICU admissions. CTG showed 80% sensitivity and 80.74% specificity, with a high negative predictive value (99.09%). Conclusion Abnormal CTG patterns are strongly linked to adverse perinatal outcomes, especially in conditions like PIH and IUGR. Although CTG is a sensitive tool for detecting fetal distress, its low positive predictive value necessitates adjunctive methods for accurate fetal assessment and minimizing unnecessary interventions

Background:  Iron deficiency anemia (IDA) , utmost  established  nutritional deficiency disorder and primary causative factor  of anemia specifically in developing countries . As far as with high prevalence, there is no standard definition of anemia but as per the WHO determines  hemoglobin <11  g/dL is considered as Anemia .  Among this 50% of anemia is only  due to the iron deficit .But the  Prevalence of  IDA among females after puberty because of menstrual bleeding  and further after marriage, predominantly they suffer with severe iron deficiency during  period of pregnancy . IDA in men might be  considered as red flag for the possible presence of serious  inflammatory disease, and  considerable proportion of asymptomatic gastric issues , colorectal diseases and precancerous lesions . So  in the present  study we focused on especially oxidative stress parameters and their imbalance in Iron deficiency anemia. Objectives: The present study focused to estimate Malondialdehyde   , total antioxidant capacity levels in IDA patients compared with healthy volunteers, and to find out their association with hemoglobin levels.   Materials and methods: Fifty IDA patients with  all the age groups of  men and women  were selected and 50 healthy age matched subjects were selected as controls. Serum Total antioxidant capacity & MDA were estimated by spectrophotometric methods and Hb and other complete blood picture analysis carried out by Hematology Analyzer. Results:  MDA  levels were significantly increased in IDA patients compared with healthy controls .  TAC and Hemoglobin  values are significantly decreased in IDA patients. Hemoglobin levels positively correlated with TAC, and negatively  correlated with MDA .  Conclusion:  Total antioxidant capacity  , lipid peroxidation  vital risk factor responsible for increased oxidative stress in IDA patients.  Regular monitoring and supplementation of iron and other multivitamins are beneficial for reduction of oxidative stress and to reduce  iron deficiency  anemia complications.

Background: Malignancy is a well recognized prothrombotic state that is frequently complicated by intravascular coagulation and fibrinolysis (ICF). Coagulation parameters such as prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen, D-dimer and platelet counts have emerged as accessible prognostic tools in oncologic practice. Aim: To evaluate coagulation profile abnormalities in newly diagnosed solid malignancies and to assess the prevalence and pattern of ICF across different tumor types and clinical characteristics. Methods: This prospective observational study was conducted over 18 months at a tertiary care center in Surat, India, and included 150 indoor patients of all ages and both sexes with histopathologically or cytologically confirmed solid malignancies. Hematologic malignancies, known bleeding diathesis and hemorrhagic stroke were excluded. Coagulation profile included PT, APTT, fibrinogen, D-dimer, fibrin degradation products (FDP) and platelet counts. ICF categories were defined using D-dimer and platelet levels as no ICF, overcompensated, compensated and decompensated ICF. Associations with tumor site, histology, metastasis and lesion size were analyzed using ANOVA, chi-square test and correlation analysis, with p < 0.05 considered statistically significant. Results: The most frequent cancer sites were gastrointestinal (23.3%), head and neck (17.3%), female reproductive tract (13.3%), respiratory system (11.3%) and breast (10.7%). Prolonged PT and APTT were observed in 25.3% and 34.7% of patients respectively. Elevated D-dimer (>243 ng/mL) occurred in 60.0%, abnormal fibrinogen levels in 39.3% (low 14.0%, high 25.3%), FDP positivity in 32.7% and thrombocytopenia in 14.0%. Metastatic disease (18% of patients) was associated with significantly higher PT, APTT, D-dimer and fibrinogen levels, and higher FDP positivity (p < 0.01 for all). Lesion size correlated positively with fibrinogen (r = 0.265, p = 0.001). Based on ICF classification, 40.0% had no ICF, 7.3% overcompensated, 41.3% compensated and 11.3% decompensated ICF. Conclusion: Coagulation abnormalities are highly prevalent among patients with solid malignancies and are more pronounced in metastatic and aggressive histologic subtypes. D-dimer and fibrinogen levels, together with platelet counts, are useful markers of subclinical ICF and may assist in risk stratification for thrombo-hemorrhagic complications. Routine coagulation profile assessment at diagnosis can aid early recognition and supportive management in oncology practice.

Background: Hypertensive disorders of pregnancy (HDP) contribute substantially to maternal and perinatal morbidity and mortality worldwide. Early diagnosis and protocol-based care reduce progression to severe complications. Objectives: To describe the spectrum of HDP and assess maternal and perinatal outcomes among women admitted with HDP. Methods: This hospital-based observational study was conducted at Late Bisahu Das Mahant Memorial Medical College, Korba, Chhattisgarh, India (March 2023-March 2024). Consecutive pregnant women with HDP (n=100) were included. HDP subtypes were classified using standard criteria. Maternal complications, mode of delivery, and neonatal outcomes were recorded and summarized descriptively. Results: Gestational hypertension was the commonest subtype (44%), followed by preeclampsia without severe features (26%), preeclampsia with severe features (20%), eclampsia (6%), and chronic hypertension with superimposed preeclampsia (4%). Severe HDP comprised 30%. Cesarean delivery occurred in 56%, mainly for non-reassuring fetal status (32.1%) and maternal indications (25.0%). Maternal complications included abruptio placentae (7%), HELLP syndrome (6%), acute kidney injury (4%), postpartum hemorrhage (9%), ICU admission (10%), and maternal mortality (1%). Perinatal outcomes showed preterm birth (40%), low birth weight (42%), NICU admission (28%), and perinatal mortality (7%). Conclusion: One in three women had severe HDP with notable maternal complications and neonatal morbidity. Strengthening antenatal detection, timely referral, and standardized intrapartum management can improve outcomes.

BACKGROUND: Surface epithelial tumors constitute the majority of ovarian neoplasms and exhibit a wide histological spectrum ranging from benign to highly aggressive malignant lesions. Accurate differentiation between benign, borderline, and malignant tumors is essential for prognosis and management. Conventional histopathology alone may be insufficient in borderline cases. Immunohistochemical biomarkers such as p53, a tumor suppressor gene product, and Ki-67, a marker of cellular proliferation, have emerged as valuable tools in assessing tumor behavior, aggressiveness, and prognosis. MATERIALS AND METHODS: This prospective observational study was conducted in the Department of Pathology in collaboration with the Department of Obstetrics and Gynecology at Rangaraya Medical College, Kakinada, from November 2022 to November 2024. A total of 150 surface epithelial ovarian tumors were analyzed after histopathological confirmation. Tumors were classified according to the WHO 2020 classification into benign, borderline, and malignant categories. Immunohistochemistry for p53 and Ki-67 was performed in 31 selected cases of borderline and malignant tumors using standard peroxidase–antiperoxidase techniques. The expression patterns of p53 and the Ki-67 labeling index were evaluated and correlated with tumor subtype, grade, and FIGO stage. Statistical analysis was performed using the chi-square test.RESULTS: Surface epithelial tumors constituted 91.4% of all ovarian neoplasms, with serous tumors being the most common, followed by mucinous and endometrioid tumors. Benign tumors predominated overall. Borderline tumors consistently demonstrated wild-type p53 expression with a low Ki-67 index, indicating low proliferative activity. In contrast, malignant serous and mucinous tumors showed mutant p53 expression (overexpression, null, or cytoplasmic patterns).  A High Ki-67 index was significantly associated with malignant serous tumors and advanced FIGO stage (p < 0.001), reflecting aggressive tumor behavior.CONCLUSION: The combined assessment of histomorphology with p53 and Ki-67 immunohistochemistry provides valuable diagnostic and prognostic information in surface epithelial ovarian tumors. p53 mutations and a high Ki-67 index reliably correlate with malignancy and tumor aggressiveness, aiding in differentiation between borderline and malignant lesions and supporting improved clinical decision-making.

Background: Recurrent pregnancy loss (RPL), defined as two or more failed pregnancies, affects 10–15% of women. Endocrine factors contribute to approximately 8–12% of cases, with growing evidence implicating subclinical hypothyroidism (SCH) and thyroid autoimmunity (TAI) in adverse pregnancy outcomes. However, data on their role in early pregnancy loss remain limited. Objectives: To analyse the association between subclinical hypothyroidism and anti-thyroid peroxidase (anti-TPO) antibodies in women with recurrent pregnancy loss, and to estimate the prevalence of SCH and anti-TPO positivity in this population. Methods: This prospective, descriptive observational study was conducted from July 2023 to December 2024 at a tertiary care centre in Kolkata. A total of 166 multigravida women with ≥2 pregnancy losses were enrolled after excluding anatomical and chromosomal causes. Clinical data, biochemical parameters, and thyroid profiles (TSH, free T4, anti-TPO antibodies) were analysed using SPSS version 25. Associations were assessed using Fisher’s exact test. Results: The mean age was 28.09 ± 5.62 years. Of the study population, 44.0% had subclinical hypothyroidism and 54.8% were euthyroid. Anti-TPO antibody positivity (≥35 IU/ml) was observed in 59.6% of women. A statistically significant association was found between subclinical hypothyroidism and anti-TPO antibody positivity (p = 0.0028), as well as between overt hypothyroidism and anti-TPO positivity (p = 0.0018). Most miscarriages (89.1%) occurred during the first trimester. Conclusion: Subclinical hypothyroidism in the presence of thyroid autoimmunity is significantly associated with recurrent pregnancy loss. Routine screening for thyroid dysfunction and anti-TPO antibodies may facilitate early intervention and improve reproductive outcomes.

Background: The addition of new techniques in MRI (magnetic resonance imaging) can help differentiate orbital masses into benign and malignant lesions. However, existing literature data is scarce concerning this. Aim: The present study aimed to evaluate the efficacy of the utility of advanced magnetic resonance techniques in the improvement of the diagnostic ability for differentiation in malignant and benign orbital masses. Methods: The present study assessed 52 subjects 24 males and 28 females with a mean age of 34.6 years that presented with the orbital masses to the Institute within the defined study period. In all the subjects, MRI was done using advanced techniques such as dynamic (DCE)< MRS, and DWI on a 1.5T scanner. The data gathered were statistically analyzed.  Results: The study showed specificity, sensitivity, positive predictive value, and negative predictive value of 75%, 72.2%, 86.6%, and 54.5% respectively. Lesions having P=Tp<141.5 s showed a sensitivity and specificity of nearly 94.4% and 87.5% respectively and positive and negative predictive values of 94.4% and 87.5% respectively for malignancy. The lesions having slope >0.47 depicted a specificity and sensitivity of nearly 78% and 100% respectively and positive and negative predictive values of 66.6% and 100% respectively for malignancy. Also, a significant difference was seen in type I and III curves with p=0.002. Chlorine peak presence depicted a specificity, sensitivity, negative predictive value, and positive predictive value of 94.4%, 62.5%, 83.3%, and 85% respectively.  Conclusions: The present study concludes that advanced MRI (magnetic resonance imaging) with the inclusion of perfusion parameters, MRS, and DW can significantly improve radiologists' diagnostic performance in differentiating malignant and benign orbital masses

Background: Viral infections have always been linked to abortions as well as increased pregnancy complications. The study aims to determine the burden of viral infections like CMV, HSV-2, rubella and COVID-19 in women with recent history of spontaneous abortion and the socio-demographic factors related to it. Methods: A prospective case control study was conducted in the department of Microbiology from January to June 2022 at a tertiary care hospital in India Cases included 75 women with recent history of spontaneous abortion. Equal number (75) of healthy postpartum women with normal pregnancy were selected as controls. About 8-10ml of blood was collected from both cases and controls under aseptic measures. ELISA test was performed to detect IgM antibodies against CMV, HSV-2 and Rubella and RT PCR was done in blood samples to detect the presence of COVID-19 virus. Results: In the study group,6(8%) subjects were seropositive for anti-IgM CMV and1(1.33%) subject was positive for anti-IgM HSV-2. IgM antibody was not detected for rubella virus. In the control group, IgM antibody was absent for CMV, HSV-2 and Rubella.Covid-19 was not detected in study group but 1(1.33%) control was positive for Covid-19 by RT PCR.As far as age is concerned, highest seropositivity to anti IgM CMV and HSV-2 in study group was seen in age less than 25 years and it was statistically significant for CMV(OD: 24.14, P=0.03).Rural residence, crowding and gestational age were also significantly associated with anti-IgM CMV. Conclusion: As viral infections are considered as one of the important causes of abortion, knowledge about regional seroprevalence data of viruses would help in raising awareness and increased prenatal screening thus preventing adverse pregnancy outcomes.

Background: Iron deficiency anemia (IDA) during pregnancy remains a major public health problem and is associated with significant maternal and fetal morbidity. Oral iron therapy is frequently limited by poor gastrointestinal tolerance and inadequate absorption. Ferric carboxymaltose (FCM) is a newer intravenous iron formulation that permits rapid, high-dose iron replacement with a favorable safety profile. Objective: To evaluate the safety and efficacy of intravenous ferric carboxy maltose in pregnant women with iron deficiency-associated moderate anemia, with particular emphasis on changes in hemoglobin (Hb), serum ferritin, mean corpuscular volume (MCV), and mean corpuscular hemoglobin (MCH). Methods: This prospective interventional study included 120 pregnant women (14–28 weeks’ gestation) diagnosed with iron deficiency (serum ferritin <15 µg/L) and moderate anemia (Hb 7–9.9 g/dL) as defined by World Health Organisation (WHO). Participants received weight-adjusted intravenous ferric carboxymaltose. Hematological parameters were assessed at baseline and at 6 weeks and 12 weeks post-infusion. Results: Mean hemoglobin increased significantly from 8.02 ± 0.55 g/dL at baseline to 13.8 ± 0.6 g/dL at 6 weeks and 12.9 ± 0.5 g/dL at 12 weeks (p < 0.001). Serum ferritin rose from 9.8 ± 2.5 µg/L to 136.2 ± 18.4 µg/L at 6 weeks and remained elevated at 124.6 ± 16.9 µg/L at 12 weeks (p < 0.001). Significant improvements were observed in MCV (71.8 ± 3.6 fl to 89.9 ± 3.1 fl) and MCH (23.7 ± 1.8 pg to 30.1 ± 1.6 pg) at 12 weeks (p < 0.01). No serious adverse reactions were reported. Conclusion: Ferric carboxymaltose is a safe and highly effective therapy for rapid correction of iron deficiency anemia in pregnancy, resulting in sustained improvement of hemoglobin, iron stores, and red cell indices.

Background: Maternal mortality and morbidity remain significant public health concerns in developing countries, largely attributable to delays in recognizing and responding to obstetric danger signs. Adequate knowledge, positive attitudes, and appropriate practices among pregnant women are essential for timely health-seeking behavior. Objectives: The present study aimed to assess the level of knowledge, attitude, and practices regarding danger signs of pregnancy among antenatal mothers attending a rural tertiary care teaching hospital. Methods: A hospital-based cross-sectional Knowledge–Attitude–Practice study was conducted among 75 antenatal mothers attending the antenatal clinic of Ashwini Rural Medical College, Hospital and Research Centre, Kumbhari, District Solapur, from January 2025 to November 2025. Data were collected using a pretested structured questionnaire covering socio-demographic variables and obstetric danger signs. Descriptive and inferential statistics were applied. Results: The study revealed varying levels of awareness regarding danger signs of pregnancy. While a majority of participants demonstrated moderate knowledge and favorable attitudes, gaps were observed in translating knowledge into appropriate practices, particularly regarding early healthcare utilization during emergencies. Conclusion: Although antenatal mothers exhibited reasonable awareness of certain danger signs, deficiencies persist in comprehensive knowledge and proactive practices. Strengthening antenatal education and counseling services is essential to improve maternal outcomes.