Umbilical cord contains two arteries and one vein connecting fetus to the placenta and is responsible for blood flow between the two. It is surrounded by Wharton’s jelly which is a gelatinous substance and functions as adventitia layer of umbilical vessels, thereby providing insulation and protection to the umbilical cord. Umbilical cord abnormalities are associated with poor perinatal outcomes. Very few cases of absent Wharton’s jelly are reported in literature. Ours might be the 8th one in which we did a lower segment caesarean section for meconium stained liquor but the baby died after 12 hours.

Objective: To assess prevalence of overweight and obesity in government and private school adolescents by using BMI and measurements of skinfold thickness as parameter of obesity and to evaluate diagnostic value of skinfold thickness measurement as compared to BMI in identifying overweight and obese adolescents. Methods: This was questionnaire based, voluntary response prospective study. Data were collected from 600 adolescents aged between 10-19 years divided equally between government and private school of both genders. Height, weight and skinfold thickness (Triceps skinfold and Subscapular skinfold) were measured.BMI calculated. Prevalence of overweight and obesity were determined and TSFT and SSFT compared with BMI as obesity parameters. Results: Prevalence of overweight and obesity were significantly less in government school adolescents as compared to private school (7% vs 21.67% and 3.33% vs 8.33% respectively)(p<0.001 significant). TSFT in comparison to BMI carried sensitivity 49.59%, specificity 100%, positive predictive value100%, negative predictive value 88.70% and efficacy 89.83%. SSFT in comparison to BMI carried sensitivity 41.32%, specificity 100%, positive predictive value 100%, negative predictive value 87.09% and efficacy 88.17%. Correlation of BMI with TSFT(r=0.508) and SSFT(r=0.604) was significant (p<0.001). Correlation of TSFT and SSFT with age was not significant. Correlation of TSFT and SSFT with genders (in both boys and girls) was found significant (p<0.001). Conclusion: BMI measures body weight. It cannot give accurate assessment of body composition or body fat. Skinfold thickness measurements are better predictors for body fat in both boys and girls which do not correlates with age.

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Background & Objective: To compare the outcomes of urinary catheter removal at 12 Hours versus at or >24 Hours post elective cesarean section. To assess and compare symptomatic UTI, time of ambulation, length of hospital stays and need for recatherization amongst these 2 groups. Methods: In all patients undergoing elective primary cesarean section,  Preoperative urine routine and microscopy¯ were sent, UTI was ruled out, clinical examination was performed and were NPO at least 8 hours prior to surgery and given antibiotics. A foley catheter was inserted on the operating table immediately before starting cesarean section. Cesarean sections were performed in the usual manner under spinal anesthesia. After this, in Group 1 patients, catheter were removed 12hours post-operatively while in Group 2 it was removed 24 hours post-operatively.  After catheter removal, women were encouraged to void and helped to ambulate. Results: 2 groups were compared and the overall rates of post caesarean section urinary complaints dysuria (8.69%), urinary frequeny(14.13%), urgency(10.86%), burning micturition(9.76%) were higher in 24 hours catheter removal group. The Mean duration of first Post-op voiding time (4 hours), ambulatory time(4 hours) and hospital stay(4 days) were shorter in 12 hours catheter removal group. Conclusion: Urinary catheter removal post Caesarean section at duration of 12 hours postoperatively is associated with decreased complications and morbidity in post Caesarean section women.

Objective: To identify and evaluate the Predictive symptoms of ovarian tumours so that diagnosis can be made at early stage. Methods: This study was conducted on 100 patients admitted in Department of Obstetrics and Gynaecology in Zenana Hospital who were diagnosed with ovarian tumour clinically, ultrasonographically and histopathologically. A detailed history was taken and patients surveyed about their age, menopausal status and type of ovarian tumour by histopathological report. Results: In our study abdominal bloating was present in 74% of cases, abdominal pain present in 45% of cases; abdominal lump/swelling present in 66% of cases; bleeding per vaginum present in 8% of cases; fatigue present in 58% of cases; altered bowl habits present in 14% cases; urinary complaints present in 15% cases and others (backache) present in 8% of cases. Duration of symptoms before seeking medical attention 40% had symptoms for 3-6 months; 28% 1-3 months; 16% < 1 month; 15% 6-12 months and 1 case > 1 year. On final diagnosis with histopathological report 69 were malignant ovarian tumours, 29 were benign ovarian tumours and 2 were borderline tumours. Frequency of symptoms per month was more in malignant group. Conclusion: Ovarian cancer is not a silent killer. As no screening test exists for ovarian cancer so the frequency and number of such symptoms are key factors in diagnosis of ovarian cancer even at early stage to decrease morbidity and mortality associated with ovarian tumours.