Harlequin ichthyosis is a very rare condition that affects the skin of newborns. It is associated with poor barrier function of the skin leading to dehydration and leaves newborns prone to infections. It is due to mutations in adenosine triphosphate binding cassette A12 gene transmitted as an autosomal recessive disorder. The prognosis is very poor in these cases. Here, we report one such rare case.

Background: Pap smear is the most commonly used screening test for cervical cancer, however it has disadvantage of having low sensitivity. Colposcopy has higher sensitivity as compared to Pap smear but low specificity. Sequential screening with both Pap smear and colposcopy can overcome these problems. Aim:The study was aimed to find out the diagnostic efficacy of both Pap smear and colposcopy. It was also intended to find out the advantages of sequential use of Pap smear and colposcopy in screening for cervical cancer. Design: It was a cross-sectional study conducted in colposcopy clinic of KLE's Dr. Prabhakar Kore Hospital and MRC, Belgaum from November 2006 to September 2008.Material and methods: A total of 190 patients with complaints of postcoital bleeding, intermenstrual bleeding, postmenopausal bleeding, persistent vaginal discharge or those found to have an unhealthy cervix on per speculum examination were included in the study. In all the 190 cases Pap smear, colposcopic evaluation and colposcopic directed biopsy were performed.Statistical analysis: Sensitivity, specificity, positive predictive value, negative predictive value of both Pap smear and colposcopy were calculated with histopathology as a gold standard , keeping LSIL as a disease threshold for test positivity.Results: Pap smear was positive in 14.21% (27/190) cases, colposcopy was positive in 37.89% (72/190) cases. Biopsy confirmed LSIL and higher lesions in 31.57% cases. The sensitivity, specificity, positive predictive value and negative predictive value of Pap smear were 41.66%, 96.92%, 86.21% and 78.26% respectively and 80%, 81.54%, 66.66% and 89.83% respectively for colposcopy. Combined colposcopy and Pap smear could accurately diagnose 53/60 biopsy confirmed cases of LSIL and higher lesions with an accuracy of 88.33%.Conclusion: Sequential use of Pap smear and colposcopy in screening for cervical cancer increases the accuracy of the test. ORIGINAL CONTEMPORARY STUDYcervical cancer, but it has certain disadvantages like low sensitivity (<50%) and a delay in providing immediate results. 4,5 In limited resource settings WHO has recommended once in a life time screening for early detection of cancer in all women between 35 and 40 years of age. 6 Therefore it becomes important to use an adjunctive screening test like colposcopy which has high sensitivity (64-99%) 7 and can provide immediate results for evaluation of cervical precancerous lesions. Colposcopy further helps in executing a targeted biopsy which can be useful in defining diagnosis of precancerous lesions and carcinoma of cervix. 8 We conducted a study using combination of Pap smear and colposcopy in symptomatic women to find out the advantage of using sequential testing as compared to either test when performed alone.

Background. Birth of a fetus with no signs of life after a predefined age of viability is a nightmare for the obstetrician. Stillbirth is a sensitive indicator of maternal care during the antepartum and intrapartum period. Though there has been a renewed global focus on stillbirth as a public health concern, the decline in stillbirth rate (SBR) has not been satisfactory across the nations, with a large number of stillbirths occurring in the low- to middle-income countries (LMICs). Hence, the study was carried out to analyze maternal and fetal risk factors and their association with stillbirths in a tertiary care center in South India. Methods. This observational prospective study included pregnant women with stillbirth beyond 20 weeks of gestation or fetal weight more than 500 grams. Stillbirths were classified according to the simplified causes of death and associated conditions (CODAC) classification. Association between the risk factor and stillbirths was calculated with chi-square test and odds ratio with 95% confidence interval. Results. There were 171 stillbirths (2.97%) among total 5755 births. The SBR was 29.71/1000 births. Risk factors such as preterm delivery (OR: 22.33, 95% CI: 15.35–32.50), anemia (OR: 21.87, 95% CI: 15.69–30.48), congenital malformation (OR: 11.24, 95% CI: 6.99–18.06), abruption (OR: 10.14, 95% CI: 6.43–15.97), oligohydramnios (OR: 4.88, 95% CI: 3.23–7.39), and hypertensive disorder (OR: 3.01, 95% CI: 2.03–4.46) were significantly associated with stillbirths. The proportion of intrapartum stillbirths was found to be 5 (3%) among the study population. Conclusion. Highest prevalent risk factors associated with stillbirth are anemia and prematurity. Intrapartum stillbirths can be reduced significantly through evidence-based clinical interventions and practices in resource-poor settings. There is a need to provide and assure access to specialized quality antenatal care to pregnant women to control the risk factors associated with stillbirths.

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Background Cervical cancer is the fourth most common cancer in the world, affecting mainly women residing in low- and middle-income countries. Progression from a pre-invasive phase to that of an invasive phase generally takes years and provides a window of opportunity to screen for and treat precancerous lesions. Methods This study is being conducted at four sites in north Karnataka, India. Community sensitization activities have been organized in the study areas to create awareness among stakeholders, including elected representatives, physicians, health care workers, and potential participants. Organized community based as well as hospital-based screening is being conducted using visual inspection with acetic acid (VIA). Screen positive women are referred to respective study hospitals for colposcopy and directed biopsy. Participants with confirmed high-grade cervical dysplasia (high-grade squamous intraepithelial lesions or HSIL) who fit all other eligibility criteria will be recruited to the study and will receive cryotherapy using CryoPop®, an innovative new cryotherapy device. Discussion There is a need to develop an inexpensive, simple, and effective cryotherapy device for use by frontline health care providers at locations where screening and timely treatment can be given, accelerating access to cervical cancer prevention services and minimizing loss to follow-up of women with precancerous lesions who need treatment. Trial registration Clinical Trial Registry - India CTRI/2019/01/017289 ClinicalTrials.Gov number NCT04154644. Registered on November 6, 2019.

Aim: To estimate the occurrence of musculoskeletal pain syndrome in postpartum women. Method and Measures: A cross sectional study was conducted from August 2018 to February 2020 among 115 postpartum women attending at a tertiary care hospital in north Karnataka. Standardized and pre validated questionnaires “Brief Pain Inventory” and “Visual Analogue Scale” were used for subjective rating of pain. Result expressed in frequency and percentage. Results: Musculoskeletal pain syndrome was present among 99% women and most common complaint was low back pain (74%). General activity, walking ability and mood were much interfered by pain. Conclusions: The results showed there is high occurrence of musculoskeletal pain syndrome in postpartum women at a tertiary care hospital; most common is low back pain. Keywords: Brief Pain Inventory, musculoskeletal syndrome, postpartum women, Visual Analogue Scale.

Background: Cervical cancer is the fourth most common cancer in the world, affecting mainly women residing in low- and middle-income countries. Progression from a pre-invasive phase to that of an invasive phase generally takes years and provides a window of opportunity to screen for and treat precancerous lesions. Methods: This study is being conducted at four sites in north Karnataka, India. Community sensitization activities have been organized in the study areas to create awareness among stakeholders, including elected representatives, physicians, health care workers and potential participants. Organized community based as well as hospital-based screening is being conducted using Visual Inspection with Acetic acid (VIA). Screen positive women are referred to respective study hospitals for colposcopy and directed biopsy. Participants with confirmed high-grade cervical dysplasia (high grade squamous intraepithelial lesions or HSIL) who fit all other eligibility criteria will be recruited to the study and will receive cryotherapy using CryoPop®, an innovative new cryotherapy device.Discussion: There is a need to develop an inexpensive, simple and effective cryotherapy device for use by frontline health care providers at locations where screening and timely treatment can be given, accelerating access to cervical cancer prevention services and minimizing loss to follow-up of women with precancerous lesions who need treatment.Trial Registration: Clinical Trial Registry - India CTRI/2019/01/017289 ClinicalTrials.Gov number NCT04154644 on November 6, 2019. https://bit.ly/3yRQWC4

Aim and objective: Pregnancy is often accompanied by physiological variations, especially variations in the respiratory function. However, there is insufficient information regarding the association of hormonal changes and pulmonary function tests in different trimesters of pregnancy. Hence This was aimed to assess the effects of progesterone levels on the lung function of pregnant women. Materials and methods: A total of 150 pregnant women comprising 50 women in each of the 3 trimesters of pregnancy were recruited for this study to compare the lung function variations across the trimesters. Both dynamic and static pulmonary function tests were measured. Serum progesterone and blood hemoglobin levels were also estimated. Data was analyzed using ANOVA and Kruskal-Wallis test. Tukey's HSD and Dunn's test were used as post hoc tests. p < 0.05 was considered as statistically significant. Results: Variations in the lung functions were observed across all the trimesters of pregnancy. Among the dynamic lung function tests, peak expiratory flow rate (PEFR, p = 0.0043) and forced expiratory flow (FEF, p = 0.0151) were significant in the first trimester. PEFR (p = 0.0047) and FEF (p = 0.016) were significant in the second trimester. Among the static lung function tests, maximum voluntary ventilation (p = 0.0003) was a significant variable in the second trimester. Progesterone levels were significant in all the 3 trimesters of pregnancy (p < 0.0001) and were associated with increased gestational age. In contrast, hemoglobin levels were insignificant throughout pregnancy (p = 0.8548). Conclusion: The progesterone levels did not have any significant association with the pulmonary function test during gestation. Clinical significance: The chronic respiratory diseases ranked third most cause and in order to evaluate any respiratory ailment during pregnancy, an accurate knowledge of the physiological changes in pulmonary functions during normal pregnancy is necessary.