BackgroundThere is no universal screening method for discrimination between benign and malignant adnexal masses yet. Various authors have tried tumor markers, imaging studies, cytology but no one yet is a definite method for screening of cancer ovary, for which a combined diagnostic modality has come to practice in form of RMI. With this background we conducted our study “Evaluation of risk malignancy index and its diagnostic value in patients with adnexal masses”.MethodsThe aim of the study was to determine the effectiveness of risk of malignancy index (RMI-3) in preoperative discrimination between benign and malignant masses and also to reveal the most suitable cut off value. We have conducted a prospective study between November 2014 to October 2016. We included the parameters like menopausal status, ultrasound features, and serum levels of tumor marker like CA-125 for calculating RMI 3. Then RMI was compared with the histopathological report which was taken as gold standard.ResultsIn the present study malignant tumors constitute 54.76% (69/126) & benign tumors 45.24% (57/126). Bilaterality in adnexal masses and multilocularity is higher in malignant tumors than benign tumor, but a P –value >0.005 failed to be proved significant in our study. Solid area is seen in 24.69% (20/81) of benign and 75.30% (61/81) of malignant tumor. Similarly ascites was found in 38.09% (48/126) of cases. Out of which 18.75% (9/48) cases were found to be benign and malignancy was confirmed in 81.25% (39/48) patients. There is statistically significant number of malignant ovarian cancer patients where ascites and solid area is seen in USG findings (p = 0.000). Risk of Malignancy Index compared with individual parameters of Ultrasound score, CA-125 or menopausal score and a cut-off point of 236 shows a very high sensitivity (72.5%), specificity (98.2%), positive predictive value (98.1%), negative predictive value (74.7%) and diagnostic accuracy (84.13%) for discriminating malignant and benign pelvic masses.ConclusionSimplicity and applicability of the method in the primary evaluation of patients with pelvic masses makes it a good option in daily clinical practice in non-specialized gynecologic departments and also in developing countries where access to a gynaecologist oncologist is limited.

Various anomalous relations between the brachial plexus or its branches and arteries are reported. The present study was conducted on 134 limbs to note the origin and course of the median artery and its relation to the median nerve. In 2 limbs (1.5%), the median artery split the median nerve into two roots in the forearm and the artery passed through the nerve. In both of these limbs (1.5%), the median artery arose from the ulnar artery. The median artery in these 2 limbs (1.5%) was considerably large and supplied the hand. Both the origin of the median artery from the ulnar artery and the splitting of the median nerve by the median artery are rare anomalies which have not been reported in the available literature.

Background: Eclampsia continues to be a measure health issue in developing country. In order to get a comprehensive data on eclamptic patients we conduct a prospective observational study to address the maternal and fetal complication during pregnancy.Methods: It is a prospective observational study conducted in a tertiary care medical college between the periods September 2016 to February 2017. During the period all patients with eclampsia admitted to the labour room were taken. Any patients with known epilepsy were excluded from the study.Results: During the period 3780 women were admitted to the labour room, out of which 56 women had eclampsia with an incidence of 1.48%. Out this antenatal eclampsia was most common with an incidence of 91.08% followed by intra partum 4 (7.14%) and postpartum eclampsia 1 (1.78%). Majority of patients 54 (96.43%) were unbooked or inadequately supervised. Most of the patient had normalization of blood pressure after oral nifedipine 46 (82.14%), only 10 (17.86%) patient required additional injection labetalol for control of blood pressure. The maternal complications were placental abruption 8 (14.28%), HELLP 6 (10.71%), pulmonary edema 1 (1.78%), acute renal failure 1 (1.78%), DIC 1 (1.78%) and maternal death 2 (3.57%). Out of fifty six babies delivered 42 (75%) had live birth and 14 (25%) had still birth. A total of 17 (40.42%) had IUGR, 17 (40.47%) require SNCU admission post-delivery.Conclusions:Eclampsia still remains the major cause of maternal and fetal morbidity. In low resource countries improvement in health care facility, adequate antenatal supervision, and timely referral will reduce the maternal and fetal complication.

BACKGROUND About 10 - 15 % of reproductive age couples are affected by infertility.1 According to WHO 60 - 80 million couples currently suffer from infertility.2 Prevalence of infertility is rapidly increasing globally.3 Uterine factors of infertility include uterine anomalies, fibroid uterus, synechiae, Asherman’s syndrome, and failure of implantation without any known primary causes. Congenital uterine malformations are seen in 10 % cases of infertile women. We wanted to evaluate the anomalies of uterus in case of primary and secondary infertility by DHL (diagnostic hysterolaperoscopy). METHODS This is a hospital-based, observational study, conducted in the Department of Obstetrics and Gynaecology, VIMSAR, Burla, from November 2017 to October 2019. Diagnostic hysterolaparoscopy was done in 100 infertility cases. RESULTS In our study, uterine anomaly i.e. septate uterus was the most common hysteroscopic abnormaly found in 23 cases followed by submucous fibroid, polyp, synechiae and bicornuate uterus. CONCLUSIONS With proper selection of cases, and when done by skilled surgeon, can be considered as standard day care procedure for female infertility evaluation. KEYWORDS Infertility, Uterine Anomalies, Diagnostic Hysterolaparoscopy