Even though pregnancy is rare with cirrhosis and advanced liver disease, it may co-exist in the setting of non- cirrhotic portal hypertension as liver function is preserved. When encountered together it presents a complex clinical dilemma. Physiological hemodynamic changes associated with pregnancy, needed for meeting demands of the growing fetus, worsen the portal hypertension thereby putting mother at risk of potentially life-threatening complications like variceal hemorrhage. Pregnancy also predisposes the patient to develop hepatic decompensation. Thus, management of such cases requires multidisciplinary approach involving obstetricians experienced in dealing with high risk cases, hepatologists, anesthetists and neonatologists. Here through the case report of a 23 year old primigravida with Non Cirrhotic portal hypertension with 33 weeks gestational age in preterm labor we intend to focus upon different aspects of pregnancy with portal hypertension, its complications and management strategies.

Recurrent molar pregnancy is very rare. In this case report, we highlight a case of a patient who experienced five recurrent molar pregnancies without an intervening normal pregnancy. A 22-year-old patient was admitted to our labour room with a fifth consecutive molar pregnancy. The patient underwent suction and evacuation and was followed up with serial serum human chorionic gonadotropin (beta-hCG) estimation. The patient did not require chemotherapy. Karyotype of the patient and her husband was normal. Nonetheless, the couple was counselled for adoption.

AIM AND OBJECTIVE:To analyze pregnant women with heart disease and to assess its influence on feto-maternal outcome. MATERIALS AND METHODS: The study was carried out during the period of November 2011 to October 2014. 45 pregnant women with cardiac diseases who were admitted in department of obstetrics and gynecology at KIMS hospital were included in the study. RESULTS: Rheumatic heart disease (n-24, 53.33 %) with isolated mitral stenosis (24.4%) was the predominant cardiac problem among the study subjects while atrial septal defect (11.1%) was the most common form of congenital heart disease. Based on the NYHA functional classification 74 % were in class I, 22.3% patients were in class II and 2.22 % were in class IV on presentation .28.9 percent deliveries were preterm. The pregnancy duration was shortened in more advanced classes of heart disease. 60% of the cases were delivered by cesarean section. Average birth weight of babies in class I WAS 2.63 +/-0.2 kg, 2.5 +/-0.3 kg in class II, 2.1 kg in class IV. Out of 45, 2 patients had heart failure during the hospital stay. There were 2 perinatal mortalities and one maternal mortality. CONCLUSION: RHD was the predominant type of heart disease in pregnancy and most women were class I at the time of admission. The preterm delivery and cesarean rates were significantly high. A multidisciplinary approach is needed to reduce morbidity, mortality and to optimize the outcome.

Background: India is the second most populous country in the world next to China. Increasing the contraceptive awareness and practice and proper implementation of family planning services are the major tool for improving the health of the population along with stabilizing it. Knowledge and contraceptive practice in the Nursing personnel can positively or negatively influence the population coming in contact with them. Objective of this study was to investigate the knowledge and practice of contraceptive methods among the nursing staff at a tertiary care set up.Methods: Tertiary care set up, cross sectional study. This was a cross sectional study conducted over a period of three months. Fifty staff nurses under the age of 49 years were interviewed through a pre-designed questionnaire regarding knowledge and use of contraceptive methods.Results: Contraception was practiced in 88 percent of the staff nurses. Barrier method of contraception was the most commonly used form of contraception. Permanent method of contraception was opted in 14 percent of cases. Fifty-seven percent of the females were aware of emergency contraception. Twenty-eight percent of females had used emergency contraception in the past.Conclusions: A high percentage of nursing staff was practicing some form of contraception; however, the use of permanent methods and hormonal methods remains low. Only half of study population was aware of post coital methods of contraception with only 28 percent having used it in the past.

Aim Paediatric orthopaedics conditions are often managed in the outpatient department (OPD) setting. Due to the lack of official coding for these minor procedures in our OPD, the hospital receives neither financial benefit nor evidence for a formal auditing process. With the Paediatric Get It Right First Time (GIRFT) report underway, we have looked at building a coding pathway for paediatric interventions in our OPD. Method The number of paediatric orthopaedic interventions were collated and grouped in a 6-month period, and a clinical outcome form was created accordingly. After consulting with the coding department, a cost analysis of prospective earnings was conducted, as well as comparisons to current standard tariff rates for OPD attendance. Results From January 2021 to June 2021, 100 interventions were performed in our OPD with the breakdown of: 21 clubfoot serial casting, 70 serial casting for pathology such as tip toe walkers, 6 Botox injections in spastic contracture limbs and 3 Pavlik harnesses for developmental dysplasia of the hip. With the assistance of coding department, a new paediatric procedural coding form was created with 14 relevant interventions listed. A loss of £6110 was calculated due to tariff rates being solely attendance based compared to interventional based. Conclusions Paediatric orthopaedic OPD should have clinical coding outcomes in place for each intervention that is performed to ensure that the hospital trust receives appropriate financial commission as well as ensure a formal audit trial can be produced.