Background:The rate of primary cesarean section (CS) is on the rise. More and more women report with a history of a previous CS. A trial of vaginal delivery can save these women from the risk of repeat CS.Aims:The study was conducted to assess the safety and success rate of vaginal birth after CS (VBAC) in selected cases of one previous lower segment CS (LSCS).Materials and Methods:The prospective observational study was carried out in a tertiary care teaching hospital over a period of two years. One hundred pregnant women with a history of one previous LSCS were enrolled in the study.Results:In the present study, 85% cases had a successful VBAC and 15% underwent a repeat emergency LSCS for failed trial of vaginal delivery. Cervical dilatation of more than 3 cm at the time of admission was a significant factor in favor of a successful VBAC. Birth weight of more than 3,000 g was associated with a lower success rate of VBAC. The incidence of scar dehiscence was 2% in the present study. There was no maternal or neonatal mortality.Conclusion:Trial of VBAC in selected cases has great importance in the present era of the rising rate of primary CS especially in rural areas.

Background: The modified WHO partograph is an inexpensive but valuable tool that provides a continuous pictorial overview of progress of labor. It helps to detect the abnormal progress of labor. It guides the obstetrician to decide about the need for augmentation of labor and helps to recognize prolong labour before obstruction occurs. Objectives: The objectives were to study the course of normal and abnormal labour, to study various types of abnormalities of active phase of labour and to evaluate the maternal and perinatal outcome in normal and abnormal labour. Methods: A prospective hospital based observational study of 100 selected cases coming for delivery during January 2010 to Dec 2010 was done. Progress of Labor was assessed by the use of Modified WHO Partograph. Various parameters like duration of normal and abnormal labor, type of labor abnormalities, mode of delivery, need for augmentation etc. were studied. Results: The average duration of active stage was 5.5 hours in normal labor. Protracted active phase and secondary arrest of labor were the commonest active phase abnormalities observed. Problems like prolonged and obstructed labor were avoided by timely intervention in the form of caesarean section and instrumental delivery .Perinatal outcome was satisfactory. Conclusion: Routine use of partograph helps in early detection of abnormal course of labour. It assures the best possible maternal and perinatal outcome .It is suggested that every woman in labour must be benefitted by this scientific approach of labour management i.e. with the use of Modified WHO partograph.

HIV seroprevalence among the pregnant population is declining steadily. More and more women are availing the facilities of ICTC centres. Integration of PPTCT (Prevention of Parent To Child Transmission) and RNTCP (Revised National Tuberculosis Control Programme) has improved the uptake of services. Free Anti-Retroviral Treatment (ART) for seropositives will help in controlling the disease progression and will reduce the vertical transmission.

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Breast cancer continues to be the commonest cancers among women all over the world.Incidence is more in developed countries as compared to underdeveloped countries.Life style changes ,late marriages,genetic predisposition and  unopposed action of  oestrogen have been documented to be the risk factors.Infilterating ductal carcinomas form the  most common pathological type. Diagnostic modalities like sonomamography,fine needle aspiration and histopathology of breast tumours help in the detection of breast carcinoma.Self breast examination and regular preventive check ups by trained health workers have helped in early diagnosis of cancers in developed countries.Ignorance,reluctance in examining own breasts and inadequate screening facilities are responsible for diagnosis in late inoperable stages in underdeveloped world.Early diagnosis and prompt treatment in the form of surgery,chemotherapy or radiation therapy can result into reduction in breast cancer related mortality.

Background: An Intrauterine Fetal Demise (IUFD) is a major obstetrical catastrophe at any gestational age but the emotional pain and distress caused by this event increases in direct relation to the duration of pregnancy. The objective of the present study was to determine the incidence and possible causes of Intrauterine Fetal Demise (IUFD), and to determine preventive measures.Methods: Retrospective observational study was done from Jan 2015 to Dec 2017 at Smt. Kashibai Navale Medical College and General Hospital, Narhe, Pune. Inclusion criteria were all the pregnant women with IUFD delivered at the centre, at or above 24 weeks of gestation. The methodology followed were parameters of assessment for analysis were maternal age, parity, probable causes for IUFD, booked or unbooked cases, mode of delivery, maternal complications, and placental histopathology. Statistical data were analyzed using SPSS version 25.Results: The incidence of IUFD at authors’ hospital was 27/1000 live births. The IUFD rate was similar in maternal age <20years and >30years (p value 0.26). The incidence of IUFD increased with decreasing gestational age which was statistically significant (p value 0.001). IUFD incidence was higher in multiparous women compared to primiparous women (p value 0.036 with OR of 1.6 and 95% CI 1.02 to 2.54). The rate of IUFD was similar when sex of the baby was analyzed. 49.4% of fetuses had signs of maceration. The major cause of IUFD was severe preeclampsia (48.1%) which included HELLP syndrome, IUGR, Abruption. Maternal anemia (20.4%), GDM (3.8%), SLE (2.5%), APLA positive (2.5%), anhydramnios (6.3%) were some of the other important causes of IUFD.Conclusions: This study was conducted to determine the incidence of IUFD and associated maternal risk factors. By understanding the contributing factors, we can seek ways of avoiding recurrence of IUFD by proper antenatal care and early diagnosis of obstetric complications and its appropriate management.

Burnout in health care professionals has gained significant attention over the last few decades. As a result of the intense emotional demands of the work environment, clinicians are particularly susceptible to developing burnout above and beyond usual workplace stress. Residency training, in particular, can cause a significant degree of burnout, leading to interference with individuals' ability. Overall, burnout is associated with a variety of negative consequences including depression, suicidal ideation, physical symptoms related to fatigue, risk of medical errors, and negative effects on patient safety. The purpose of this review is to provide medical educators and administrators with an overview of the factors that contribute to burnout, the impact of burnout, specialty wise variation, and suggestions for interventions to decrease burnout. Unlike medical institutions and the universities running postgraduate courses in developed countries, the importance of the post and the role of residency coordinator are underestimated in most of the medical schools in India. Residency coordinator has greater role to play between various key persons involved in residency training programme.

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