OBJECTIVE:The objective was to evaluate the effect of endometrial biopsy (EB) on intrauterine insemination (IUI) outcome in controlled ovarian stimulation (COS) cycle.DESIGN:Prospective randomized control study.SETTING:Tertiary care center.MATERIALS AND METHODS:A total of 251 subjects were enrolled in the study. Subjects undergoing COS with IUI were randomly allocated into three groups. Group A: EB was taken between D19 and 24 of the spontaneous menstrual cycles that precedes the fertility treatment and IUI, which was done in next cycle (n = 86). Group B: EB was taken before D6 of the menstrual cycle, and fertility treatment and IUI was done in the same cycle (n = 90). Group C: (control group) no EB in previous 3 cycle (n = 75).MAIN OUTCOME MEASURE:Clinical pregnancy rate (CPR).RESULTS:Clinical pregnancy rate was 19.77%, 31.11%, and 9.3% for Group A, Group B, and Group C, respectively. The results show a highly significant value for the paired t-test of intervention Group B and control Group C of the cases (P = 0.000957). CPR was maximum after first cycle of ovulation induction and IUI following EB scratch in both Groups A and in Group B (P < 0.001).CONCLUSIONS:Endometrial biopsy done in early follicular phase in the same cycle of stimulation with IUI gives better CPR as compared with EB done in the luteal phase of the previous cycle.

Basic implementation of WHO near-miss approach helped in the systematic identification and evidence-based management of severe maternal complications thereby improving the quality of maternal health in a developing country.

Objective: A Hydatidiform mole is characterized by a hydropic swelling of the chorionic villi and trophoblastic proliferation. It is classified as a complete hydatidiform mole and partial hydatidiform mole on the basis of histopathological features and karyotype. Women of both extreme of reproductive age are most vulnerable. Untreated molar pregnancies almost always cause uterine bleeding that varies spotting to profuse hemorrhage. This study was conducted to calculate incidence of molar pregnancy, associated demographic factors and to analyze the various aspects of molar pregnancy at our hospital.

Objective: pregnancy beyond the uterine cavity is known as ectopic pregnancy and is a major cause of maternal morbidity and mortality. Dealing with ectopic pregnancy is always a challenge in clinical practice of obstetrics. With greater awareness in high-risk cases and better screening procedures, life threatening ectopic pregnancy can be prevented. This study was conducted to calculate incidence of ectopic pregnancy, to study the associated demographic factors and to analyze the various aspects of ectopic pregnancy in our hospital. Materials and Methods: A retrospective study was carried out to calculate the incidence, to study the associated demographic factors and outcomes of ectopic pregnancy. The study was done in Department of Obstetrics & Gynecology at S. K. Medical College, Muzaffarpur, Bihar for study period of one year from January 2017 to December 2017. Data regarding cases of ectopic pregnancy was collected, analyzed and interpreted. Results: In our study, for the period from January 2017 to December 2017, total of 9,027 deliveries were conducted. Total 47 cases were diagnosed as ectopic pregnancy. The incidence of ectopic pregnancy in our study is 1.56 in 300 deliveries. Most of the cases were in the age group of 20-30 years (63.83%). 29.78% cases had history of PID. Among various modalities of surgical management, salpingectomy was done in total of 59.57 % cases of ectopic pregnancies. Conclusion: Early detection of high risk pregnancies can save a lot of maternal lives. Women with previous ectopic pregnancy preventive measure can be taken in future pregnancies. Emergency management system should be sound and available round the clock at every level of health care delivery system.

A 32-year-old man, a known case of bronchial asthma was presented to our emergency department with chief complaint of sudden onset pain in the left lower chest wall after strong paroxysmal coughing due to aggravation of bronchial asthma symptoms. Chest pain was localised and aggravated with respiration without any radiation. There was no history of fever, abdominal pain, nausea and vomiting, diaphoresis or orthopnoea. History of any thoracic trauma, cardiac disease or osteoporosis due to chronic renal disease or any metabolic disease was not present. He was on intermittent oral and inhalational corticosteroid therapy, because of the uncontrolled bronchial asthma for last five years. On physical evaluation, he was tachypnoeic and vital was normal. He had tenderness over his left lower chest wall. Diffuse rhonchi were heard over both lung fields on auscultation. Cough is generally self-limited and uncomplicated, but can be associated with complications, particularly when it is paroxysmal and violent. Rib fracture is among the uncommon complications of cough. In this article, we report a case of 32year-old male who presented with complaints of acute chest pain after paroxysmal coughing and was diagnosed with cough fracture of the ninth rib on subsequent workup. Rib fracture in otherwise healthy young individual after coughing is not common. The purpose of this case report is to call attention on rib fracture as infrequent and often an unrecognised cause of sudden chest pain, so that it should be considered as differential diagnosis of acute chest pain after common causes. Coughing is a crucial defense mechanism in respiratory system and is usually uncomplicated, but sometimes can be with complications, especially when chronic. One of these complications is rib fracture. 1 In this case report, we present a case of cough fracture in young patient.

Objective: Congenital anomalies are defined as structural or functional anomalies that occur during intrauterine life and can be identified antenatally, at birth or later in life. Congenital malformations are becoming increasingly important and are the leading cause of infant mortality and morbidity. Neonatal morbidity and mortality is a matter of great concern in our society in context of health care delivery system. The occurrence and pattern of presentation vary from region to region. The aim of present study was to determine the prevalence and types of congenital anomalies in newborns and to study the associated factors.