Maternal mortality-a three-year retrospective study in a rural medical college of India

Background: Maternal mortality is a tragic event as family revolves around a mother. The deadly obstetrical triad of hemorrhage, preeclampsia and infection has accounted for a third of all deaths. This study was conducted to assess maternal mortality ratio, demographic profile and causes of maternal death.Methods: This retrospective longitudinal study was conducted in the department of obstetrics and gynecology for a period of three years from 1st January 2018-31st December, 2020. Total no of death during this period was 134.Records of deaths and demographic profiles were retrieved from the medical record library of aforesaid hospital.Results: There were 134 maternal deaths amongst 56815 live births with MMR 235.85. The majority of deaths were in 20-29 year of age group and most of the deaths seen in multigravida. The 91.79% death was observed within the 24 hours and after 72 hours. Eclampsia, preeclampsia and hemorrhage were leading cause of maternal death seen in the study.Conclusions: Maternal mortality is higher than national MMR. Majority of maternal death were preventable by proper antenatal care, early detection of high-risk pregnancies and their timely referral to tertiary care centre

Comparison Between Lng Ius Vs Hysterectomy In Management Of Endometriosis

Introduction: Adenomyosis is a disorder characterized by the presence of islets within the myometrium that consist of both epithelial and stromal elements of endometrial tissue. In fact, adenomyosis has been referred to as the “neglected diagnosis” and “elusive disease” due to its uncharacteristic clinical profile Objective: To evaluate the efficacy, safety, and impact on quality of life of LNG-IUS versus hysterectomy in the management of endometriosis. Materials and Methods: The present study was a comparative study. This Study was conducted from 2years at Department of Gynae & OBST Burdawan Medical College, P.O. Rajabati Baburbag, Burdawan 713104. Result: In Mirena, the mean Gravidity (mean± s.d.) of patients was 4.0 (3.0). In Hysterectomy, the mean Gravidity (mean± s.d.) of patients was 5.0 (3.0). Distribution of mean Gravidity with Group was not statistically significant (p=0.729). Conclusion: The LNG-IUS offers a less invasive option with the advantage of preserving reproductive organs and maintaining fertility, making it suitable for women seeking to manage symptoms without undergoing major surgery. In contrast, hysterectomy provides a more definitive treatment for severe cases but comes with considerable implications regarding fertility and long-term hormonal changes. The choice between LNG-IUS and hysterectomy should be individualized based on patient preferences, symptom severity, and reproductive goals

A case of placenta increta in placenta previa: a rare case report

Placenta increta, one type of morbidly adherent placenta, is characterized by entire or partial absence of the decidua basalis, and by the incomplete development of the fibrinoid or Nitabuch’s layer and villi actually invading the myometrium. When the internal os is covered partially or completely by placenta, it is described as a placenta previa. Simultaneously these two complications occurring in a post LSCS scarred uterus is a very rare scenario and anticipated frequently to cause catastrophic obstetric outcome. A 32-years-old woman of second gravida, para 1, with previous history of LSCS 7 years back, with living issue one, admitted in our hospital at 35 weeks 5 days gestation with asymptomatic placenta previa with placenta increta. The case was diagnosed effectively by ultrasonography. Intra-operatively, compression sutures and bilateral uterine artery ligature was tried to control hemorrhage which were failed and a quick decision of caesarean hysterectomy was done. Preserving both ovaries, total hysterectomy was the only option to save the mother in our case. Other options attempting to preserve uterus could have ended up with grave consequences in this case. This was a very rare case of asymptomatic placenta previa with placenta increta in a post LSCS scarred uterus and it was successfully managed by judicious caesarean hysterectomy

Bleeding abdominal scar endometriosis-a case report

Presence of functional endometrial tissue anywhere outside the uterine mucosa is called endometriosis. It is hormone dependent and almost exclusively it affects the women of reproductive age. Abdominal scar endometriosis is a rare condition and it is due to deposition of endometriotic tissue in the wound site during various obstetric or gynecological operative procedures. Scar endometriosis followed by lower segment caesarean section (LSCS) is very rare and presents with co-menstrual pain and bleeding. Our case presented with active bleeding from abdominal LSCS scar during menstruation which is extremely a rare presentation. Wide excision and histo-pathological examination confirm the diagnosis. A 28-year-old lady with previous history of LSCS 2 years back presented with complaining of swelling and bleeding from the previous LSCS scar during menstruation, persisting for 4-5 days, repeatedly in every menstrual cycle for last 6 months. On examination a swelling with active bleeding from it was noted over the previous LSCS scar. Routine investigation and coagulation profile was with in normal limit and on ultrasonography a firm mass was noted. After wide excision and histo-pathological Examination, the diagnosis was confirmed. Co-menstrual swelling, pain and bleeding from the previous LSCS scar should not be neglected and may be due to scar endometriosis

Cervical Exfoliative Cytology by Papainicoula Stain and Visual Inspection with Acetic Acid in Screening of Cervical Cancer: A Cross Sectional Observational Study

Introduction: Invasive cervical cancer, the second most common cancer among women globally is preceded by a long precancerous phase that can be detected by screening and treated effectively. Early detection by exfoliative cervical cell cytology by PAP smear and VIA to detect Ca Cx in precancerous CIN stage needs to be incorporated in preventive public health strategy. Methods: A cross-sectional observational comparative study, conducted over 1 year on 300 symptomatic women undergoing PAP smear and then subjected to VIA for screening of cervical carcinoma. Result: Although VIA is 100% sensitive its diagnostic accuracy was much less than PAP smear cytology. Discussion: PAP testing is one of the most important preventive screening interventions which reduce mortality from cervical cancer that has received recommendations. VIA is an alternative with sensitivity of 100% and lots of false positive results. Conclusion: VIA could be an effective and diagnostically suitable alternative to PAP in resource poor setting. Keywords: Papanicoula (PAP), Cervical Cancer, Visual inspection with Acetic acid (VIA

Impact of Consumer Market Preferences on Expansion Strategies : Strategies Used by IKEA in the International Market

The thesis aimed to examine and discuss the impact of changing consumer markets on the strategies used by multinational corporations (MNCs) in international markets. The thesis focused on how changes in consumer markets have influenced standardization and localization as well as the impact the shift has on management practices, marketing, and human resource management. The thesis used primary and secondary data from relevant studies on the topic in the post-recession era in a bid to understand the change in consumer behaviours and tact of MNCs. The thesis applied a quantitative research design to develop inferences on the strategies IKEA uses in the Chinese market compared to the Finnish market. A comparison was made between the approaches used in China and Finland to understand essential aspects of international expansion, marketing and integration. Consumer markets vary from preferences to choices with the changing times and innovations as well as development in technology. Changes in the markets pose a challenge to corporates globally and shape the marketing strategies of MNCs in different regions. The thesis answered the research ques-tion of how the changes in consumer markets may affect international corporations and how the shift in the expansion approaches used by IKEA affects critical business areas of marketing, management practices, and human resource. It, moreover, examined how replication, together with other strategies like localization, and standardization blend in with different cultures and environments, thereby citing how IKEA managed to enter into different markets successfully. The thesis used valuable literature and accurately attained data in analysing the marketing strategies employed by IKEA in China, as well as gathering information on cultural influences on consumer groups and the influence they have on market entr