A huge benign ovarian mucinous cystadenoma in post-menopausal woman

Mucinous cystadenomas are the second most common type of epithelial tumor of ovary. Most of these tumors are benign. However some tumor can grow to enormous size. In modern world giant benign tumor of ovary are rare because of improved diagnostic technologies and general awareness of public.This report presents the case of 50 year old post-menopausal, grand multiparous woman having a very large mucinous cystadenoma. She had laparotomy followed by total hysterectomy with bilateral salpingo- oophorectomy. Her post-operative course was uneventful. She came for follow up in healthy condition

A life threatening intracerebral hemorrhage during pregnancy

Intracerebral hemorrhage (ICH) during antenatal period is an infrequent but serious complication. This is a case of elderly woman with pregnancy induced hypertension who developed spontaneous ICH during the thirty five week of pregnancy. She presented to our emergency department with altered sensorium, aphasia and hemiparesis. Intracerebral hemorrhage was diagnosed by MRI. Magnetic resonance angiography failed to identify an aneurysm or arteriovenous malformation.  She underwent successful emergency cesarean section. In this case we report the rare Intracerebral hemorrhage (ICH) during antenatal period and its challenging complication, diagnosis and managemen

A comparative study of depression among infertile and fertile women

Background: Infertility has been a major medical and social preoccupation since the dawn of human existence and women have always been the symbol of fertility. Infertility is a stressful life event and depressive symptoms are normal responses to the life crisis of the infertile women. Aim and objective of the study was to determine the severity of depression in infertile females as compared to control group and to correlate the duration of infertility to depression in infertile females.Methods: The Present study was carried out on 70 patients in both groups. After randomization, assessment of Sociodemographic details was done with the help of semi-structured performa and severity of depression by beck depression rating scale. The proposed study was conducted in phased manner observing ethics of voluntary participation and informed consent of the participants were taken.Results: Both the groups were comparable with respect to age, socioeconomic status, occupation, education, religion, family type and area. No significant differences found between both groups with respect to the sociodemographic profile (p-value >0.05). The mean age of infertile women was 28.72 year and fertile women 27.45 years. We found that maximum female was from a middle class in both groups, 48 (68.57%) in infertile and 50 (71.42%) in the fertile group.Conclusions: Depression was more in infertile women. Depression severity was positively correlated with age of women and duration of infertility. Low socioeconomic status, low educated and rural background was a risk factor for severity of depression for infertile women.

Uterine perforation with bowel prolapsing through vagina following an unsafe abortion

An unwanted pregnancy may lead to induced abortion that means willful termination of pregnancy before the period of viability. Most of the times when termination of pregnancy is done by skilled person in fully aseptic environment, complications are low. But severe complication including uterine perforation, bowel injury, sepsis and sometimes death is common when the procedure is carried out by unskilled personnel in unhealthy condition. This case representing the neglected scenario of our maternal health facilities in rural areas where many untrained care providers are still performing illegal and unsafe abortion without knowledge of its grave consequences

Impact of government schemes on maternal mortality

Background: To analyze the causes of maternal death over a period of 5 years with respect to direct and indirect causes and to see the effect of various government schemes in MMR reduction.Methods: A retrospective study of maternal death cases was conducted over a 5-year period, from January 2016 to December 2020, in our tertiary health center. Each case was analyzed with respect to age, parity, residence, antenatal booking, admission- mortality interval, etc. Results were analyzed by using percentage and proportion.Results: In our study, there were total 161 maternal death and 66,806 live births giving an MMR of 240.9 per one lac live birth. In the year 2016, there was total 12303 live birth, and it was increased to 14783 in the year 2020. MMR in 2016 was 243.84, and it also increased by 277.34 in the year 2020. Obstetric hemorrhage (28.57%), severe PIH, and eclampsia (19.87%) followed by septicemia (9.93%) were common direct causes of death. Anemia was the most important indirect cause of death.Conclusions: Although various government maternity programs like JSY and JSSK are successful in improving the number of institutional deliveries, but they are still less effective in the reduction of MMR. Besides these schemes, MMR can be reduced by improving female literacy, health, and good antenatal care and by the provision of quality of emergency obstetric care with skilled birth attendance

A randomised controlled trial to compare the efficacy, safety, and tolerability of low dose, short course primaquine in adults with uncomplicated P. vivax malaria in two hospitals in India

Background: Plasmodium vivax remains a major challenge for malaria control and elimination due to its ability to cause relapsing illness. To prevent relapses the Indian National Center for Vector Borne Diseases Control (NCVBDC) recommends treatment with primaquine at a dose of 0.25 mg/kg/day provided over 14 days. Shorter treatment courses may improve adherence and treatment effectiveness. Methods: This is a hospital-based, randomised, controlled, open-label trial in two centres in India. Patients above the age of 16 years, with uncomplicated vivax malaria, G6PD activity of ≥ 30% of the adjusted male median (AMM) and haemoglobin levels ≥ 8 g/dL will be recruited into the study and randomised in a 1:1 ratio to receive standard schizonticidal treatment plus 7-day primaquine at 0.50 mg/kg/day or standard care with schizonticidal treatment plus 14-day primaquine at 0.25 mg/kg/day. Patients will be followed up for 6 months. The primary endpoint is the incidence risk of any P. vivax parasitaemia at 6 months. Safety outcomes include the incidence risk of severe anaemia (haemoglobin 25% fall in haemoglobin and an acute drop in haemoglobin of > 5 g/dL during primaquine treatment. Discussion: This study will evaluate the efficacy and safety of a 7-day primaquine regimen compared to the standard 14-day regimen in India. Results from this trial are likely to directly inform national treatment guidelines. Trial registration: Trial is registered on CTRI portal, Registration No: CTRI/2022/12/048283

Incidence of cord around the neck and its effects on labour and neonatal outcome

Background: The umbilical cord is a narrow tube-like structure that connects the developing baby to the placenta. Most of the nuchal cords diagnosed in early pregnancy get spontaneously uncoiled. This study was carried out to show that such natural occurrence does not have significant effect on pregnancy, labour and neonates if proper intra-partum foetal heart rate (FHR) monitoring could be provided by a caregiver. Materials and Methods: This study was conducted in the Department of Obstetrics and Gynaecology at Sardar Patel Medical College, Bikaner (Rajasthan). For completing 100 cases with nuchal cord, we had to observe 506 cases and by which we took out the incidence of nuchal cord and which was separately categorised into single, double, triple and four and more than four groups. Results: The present study showed mean cord length also increases with number of loops (50.93 cm in single loop as compared to 72.33 cm) in cases with four loops and showed that patients having tight nuchal cord have higher incidence of caesarean as well as forceps delivery, but these were not statistically significant (P = 0.56 and P= 0.57) and Apgar score <7 at 1 min, FHR deceleration and meconium staining of liquor were statistically higher significant (P = 0.001,P= 0.0001 and P= 0.001, respectively). Conclusion: At present, expertise to diagnose multiple and tight loops on ultrasound are limited, which should be the aim for future. Multicentric and large studies are further required in association with more specific and sensitive diagnostic aid for tight and multiple loops so as to provide the best perinatal management with good foetal outcome