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Lipomas are common benign adipose tumors generally located at superficial locations. Mostly they measure a few centimeters in size; however, giant lipomas measuring more than 10 cm in size or weighing 1000 g are also seen. Deep seated lipomas are rather infrequent out of which retroperitoneal location of giant lipoma is rare. Fibrolipoma is one of the uncommon variant of lipomas. A giant retroperitoneal fibrolipoma is extremely rare and only five case reports of such tumors are there in the literature. We herein present one such case in a 36-years-old female.

Heterotopic pregnancy is defined as the coexistence of intrauterine and extrauterine gestation. The incidence is low and estimated to be 1 in 30,000 of spontaneous pregnancies though it is becoming commoner with assisted reproductive technique. It can be a life-threatening condition and can be easily missed with the diagnosis being overlooked. We present a rare case of spontaneous heterotopic pregnancy with live intrauterine gestation and ruptured left adnexal gestation.

Background: Ectopic pregnancy is one of the most dreaded complications of early pregnancy which risks the life of young women. However, in the present scenario, with better health care facilities, maternal mortality has been reduced drastically; it still remains a matter of concern in third world countries. Methods: This prospective study was conducted in the department of Obstetrics and Gynecology, Dr. Rajendra Prasad Government Medical College Kangra at Tanda, Himachal Pradesh after all ethical permissions, to study the incidence, management and outcome of ectopic pregnancy. 98 women, who were diagnosed as having ectopic gestation, were enrolled for the study after their informed consent. Results: In the present study, the incidence of ectopic pregnancy was 9.1 per thousand deliveries. 58.16% of the patients presented at the gestational age of 6-8 weeks. History of abdominal and pelvic surgery (30.61%) and infertility (22.45%) were the most common associated risk factors. The typical triad of amenorrhea, pain abdomen and bleeding was observed in 40% of cases. 7.95% of the patients were severely anemic and 5 patients presented with shock. Adnexal tenderness was the most common sign elicited clinically (84.69%), whereas, complex adnexal mass was confirmed in 96.93% of the patients on sonography. 84.69%, 16.32% and 1.02% of the total patients were managed with surgical, medical and expectant treatment respectively. The most common procedure performed was unilateral salpingectomy in 75.56% of the patients. 76.53% of the cases required blood transfusion for resuscitation in their operative and postoperative period and 8 patients needed ICU admission. There was no maternal mortality in the current study. Conclusion:Rising incidence rates of ectopic pregnancy should alert gynecologist in general, efforts should be made for early diagnosis of ectopic pregnancy and timely referral to reduce maternal morbidity and mortality.

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Background: India is considered the world capital of diabetes, proper care and management of the same is the demand of society. The present study is carried out to identify the disease burden of GDM/ overt DM among antenatal cases. The main objective was to study the maternal and fetal outcome of diabetes complicating pregnancy.Methods: The present study was conducted at Dr. Rajendra Prasad Government Medical College at Tanda, District KangraHP from October 2015 to September 2016. All antenatal cases were screened for diabetes by OGTT 75 gm, 2-hour blood glucose level as per DIPSI guidelines and labelled as GDM/ overt DM. Those who fulfilled selection criteria were enrolled in the study. A total of 6452 cases who attended antenatal clinic during the study duration and were screened were selected for the study. 116 cases were found to have GDM / overt DM. Seventy-nine had GDM with OGTT>140 mg/dl (DIPSI guidelines) and 37 had overt DM with 2 hours PP >200 mg/dl (WHO criteria). Total 100 cases comprised of study group were followed till delivery to study maternal and fetal outcome.Results: The prevalence of diabetes in pregnancy was found to be low 1.79%. GDM was found to be more prevalent than overt diabetes in pregnant women (66% versus 34%). Among the antenatal maternal complications observed missed abortion (11.8% versus 1.55; p=0.026), polyhydraminos (26.4% versus 10.6%; p=0.04) and preterm labour (17.6% versus 4.5%; p=0.003) were significantly more common in overt diabetics than GDM cases. IUFD (8.8% versus 0; p=0.014) was also significantly more common in overt diabetics than GDM case. RDS was found significantly higher in neonates of overt diabetics as compared to GDM mothers (14.7 % versus 1.5%; p=0.009).Conclusions: Early detection and good glycemia control by MNT and insulin, regular antenatal check-ups, patient counselling and compliance, intrapartum fetal monitoring and early neonatal care are keys to improved outcome.

Non-obstetric vulval haematoma is infrequently seen following blunt trauma to perineum. We, here present a series of six cases of non-obstetric vulval haematoma which were reported in our institution in recent years. Evacuation of haematoma and repair of lacerated tissues were successfully performed. Our experience confirms that prompt surgical intervention is the best modality in treating such patients as it reduces the associated morbidity and minimize hospital stay.

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