It can be interpreted that teenage primigravidae had a significant number of complications in pregnancy, leading cause being anaemia, more preterm incidences and higher rates of LSCS, followed by higher number of NICU admissions. Since teenage pregnancy is a multifaceted problem, it demands multidimensional solutions. Teenage pregnancies are more common in populations with low socio-economic statuses, due to lack of education, awareness of complications of teenage pregnancies, and various other factors. Hence, awareness should be created and various programmes should be taken up, to educate mainly the poor in our rural setup. As early marriages cannot be prevented in our culture, so, possibly creating awareness on late conceptions is of utmost importance.

This is a review on the transition from our empirical approach to treat ovarian cancer to a specific treatment based on molecular signature. We have reviewed not only the evidence-based medicine focused on the origin and tumor morphology of ovarian cancer but also the molecular signature era based on molecular phenotyping of the tumor and its microenvironment, which influences the direct targeted therapy. Evidence-based medicine has shown that the targeted therapy studies are mainly biomarker driven, more focused, and hence treat only those patients who have the underlying molecular abnormality. This molecular abnormality is the target of the drug, leading to higher rates of response. These findings will carry important implications for screening, detection, and treatment of ovarian cancer in the future.

Ehlers-Danlos syndrome (EDS) is a group of connective tissue disorders which are divided into various distinguishable phenotypes. The type of EDS determines the potential obstetric complications. Due to the spectrum of clinical manifestation and overlap between phenotypes, there are no standardised obstetric management guidelines. Existing literature illustrates different obstetric management in hypermobility type of EDS, including uneventful term vaginal deliveries as well as preterm cesarean section deliveries. This paper discusses obstetric management of a woman with EDS hypermobility type. Cesarean section was deemed the most appropriate delivery method in this patient due to the possible complications including risk of joint dislocation and pain morbidity. No obstetric complications were experienced, and good maternal and neonatal outcomes were achieved.

Central pontine myelinolysis (CPM) is an acute demyelination within the central basis pontis. Though exact mechanism is not known it is seen commonly with rapid correction of hyponatremia and also with pontine ischemia or infarction, demyelinating diseases, pontine neoplasm and different metabolic diseases. We report a rare association of CPM in a patient of Infantile Tremor Syndrom (ITS). ITS is a syndrome of tremor, mental and physical retardation, pigmentary changes of hair and skin and anemia in malnourished children. Though first reported in Indian subcontinent many identical cases were reported from around the world. Our case is a 15 month old child with generalized tremor, mild hepatosplenomegaly with features of grade II malnutrition including skin and hair changes. All the signs and symtoms of tremor improved after treatment with the World Health Organization (WHO) protocol for protein energy malnutrition (PEM) and administration of propranolol without any side effects.

Background and Objectives Leiomyoma of uterus forms the most common type of benign tumor of uterus and also the most common pelvic tumor in women. The symptomatology continues to be variable. Surgery has for long been the main mode of therapy for the myomas. For women who wish to retain the uterus for future pregnancies or other reasons, myomectomy is preferred. Recent trend has been toward nonsurgical approaches like GnRH hormone analogs/agonists, RU 486, or selective uterine artery embolization, laparoscopic cryoablation, radiofrequency thermal ablation, and MRGUs. This multicentric study was an attempt to analyze the clinicopathological spectrum in cases of leiomyoma of the uterus at Cheluvamba Hospital, Adichunchanagiri Institute of Medical Sciences, and to know regarding the pattern of presentation, pathological correlation, with type of fibroid, and endometrial and ovarian changes. Results Leiomyoma is the most common benign tumor of the uterus and commonly affects the women of childbearing age, most commonly in the third decade, 55 %. The most common mode of presentation was menstrual disturbances (76 %), among which menorrhagia was seen in 54 % of the cases. Primary infertility was seen in 15 % of the patients. Intramural fibroids were the most common variety occurring in 60 % of the cases. Endometrial pattern was proliferative in 66.3 %. Cystic ovaries were seen in 8 % of the patients, adenomyosis in 16 % indicating hyperestrogenism. Conclusion Fibromyoma (leiomyoma) is the most common benign tumor of the pelvis. It commonly affects the women of child-bearing age, mostly in the third decade and is most commonly seen in multipara. The most common mode of presentation is menstrual disturbances. Intramural fibroid is the most common variety. The proliferative and hyperplastic endometrium was commonly reported. The presence of proliferative endometrium, adenomyosis, and cystic ovaries all are indicative of hyperestrogenic state associated with development of fibroids.

Aim:This study is aimed to analyze the socio-demographic factors of teenage pregnancy compared to adult pregnancies. Method: A Hospital based prospective study of all teenage pregnant females admitted to Rural Medical College Hospital in Karnataka. Data was collected by detailed history taking and following up the patient from admission till delivery by using a proforma devised for the study. For each teenage two simultaneous adults primigravidas were studied. Result: Most of teenage mothers (53.5%) haven't had primary education itself compared to 8.1% in adults. In the present study, majority of the population 47.5% in teenage and 72.5% in adults belonged to middle socioeconomic class (upper and lower) and 43.75% of teenage belong to low socioeconomic class compared to 15% of adults. In my study 98% of the population belonged to rural area. 61.25% of teenage mothers were booked. In present study the TT Immunization was adequate for both the groups. Conclusion: Teenage pregnancy is still a huge problem in India mainly related to early menarche, early age at marriage, low education, unemployment, joint family structure, lack of antenatal care. The problem of teenage pregnancy cannot be removed instead focus can be diverted towards reducing chances of early pregnancy which can be difficult for a teenage girl.

Referral is essential part of maternal and child services. Major causes of referral to a tertiary center includes preterm labor, preeclampsia, eclampsia, previous CS, Rh negative blood group, antepartum hemorrhage, postpartum hemorrhage and sometimes due to lack of manual resources. To identify the primary reasons and pattern of obstetric case referral to our hospital and to study the maternal and perinatal outcome in those cases. Two Hundred obstetric referred cases of more than 28 weeks gestation admit ­ ted to IQ City Medical College, Durgapur were analyzed for the maternal and perinatal outcome. In this study of the total studied patients majority were in the group 21-25 yrs constituting about 72.09%. Of the total studied patients majority of them around 66.1 % are of Socioeconomic class III. Primigravidas constitute the majority of about 62% of the referral. Majority of the cases about 72% are booked mostly at government hospitals and only 28% of the cases are unbooked. 38.7% of the referral was from the areas like Raniganj, Bolpur, Panagarh. About 87.1% of the referral has been made with an obstetric indication. 12.6% of the referral had medical indication for referral. Only 1.3% of the cases had lack of manual resource as an indication for referral. Analyzing at the quality of referral according to the predefined criteria only 55% of the cases had adequate referral whereas about 25% of the cases had poor referral most of which were from the PHCs. 37.7% of the patients delivered vaginally, with about 62.3% of the patient delivered by caesarean section. In the present study there were a total of 131 live births, 5 still births and 7 early neonatal deaths making the perinatal mortality rate (PNMR) of 95.23 per 1000 live births, which shows a much better outcome than the other similar studies. Perinatal outcome was best for patients with age group 21-25 years and was worst for age group more than 30 years. Although better than the national data, there is indeed no doubt that rural health care infrastructure is falling short of the existing requirement. However, educating the population about the existing health care delivery system and sensitizing the public toward improving maternal and child health would go a long way in optimally utilizing the existing infrastructure and improving the maternal and perinatal outcome.

Objectives: Evaluation of a new surgical technique (Dutta’s) to prevent postpartum hemorrhage due to major degree placenta previa during cesarean section. Methods:This study was conducted at tertiary care hospital(JNM,& NSGH) at Kalyani, Nadia, West Bengal, India from the period January 2004 to December 2009.Ninty four (94) cases diagnosed to be having major degree placenta previa, undergoing LSCS operation, were selected for this study. New surgical technique(Dutta’s) was adopted in a stepwise manner = delivery of baby > bilateral uterine artery ligation by chromic catgut no-1 suture >injection tranexamic acid (1000mg) IM > injection oxytocin in intravenous infusion(10 units 30 drop /min in 500 ml of 5% dextrose)>delivery of placenta and membranes> checked properly if any tear or laceration in placental site > closure of uterine wound was done after securing bleeding from placental bed >closure of abdomen in layers by polyglycolic acid no 1 suture. Results: It was observed from this study that good effectiveness to control bleeding and intra operative blood loss less than 300cc were seen in 89(94.68%) cases respectively. Six (6.3%) cases required underlying interrupted suture for bleeding from placental bed. Subtotal cesarean hysterectomy was advocated in 3(3.28%) cases due to failure to control uterine atony. Immediate post operative bleeding less than 200c.c was found in 81 (86.16%) cases. Maternal mortality was found to be absent. Maternal morbidity was seen in 12(12.76%) cases. Subsequent menstrual cycles were found to be normal in 80(87.91%) cases and repeated pregnancy was observed in 26(28.57%) cases indicating non effect on gonadal function. Conclusion: Dutta’s new surgical technique during LSCS for major degree placenta previa was found to be simple, safe and quick procedure. It reduces perfusion pressure, permits time for further steps, thereby avoiding unnecessary ligation of bilateral internal iliac arteries and cesarean hysterectomy. Maternal mortality and morbidity were also found to be reduced. This technique is suitable for rural based hospital in absence of adequate blood transfusion facility.DOI: http://dx.doi.org/10.3126/ajms.v4i2.7958 Asian Journal of Medical Sciences 4(2013) 1-7