Objective To find the prevalence of thyroid autoimmunity in PCOS women of reproductive age group. Methods Study design: Observational study was done at ESIMC and PGIMSR K.K. Nagar March 2013-Feb 2014. Ninety cases of women with PCOS based on Rotterdam's criteria and an equal number of age-matched controls (women without PCOS) were included in the study. Thyroid profile, antithyroid peroxidase titre, serum progesterone, testosterone and fasting blood sugar were estimated using standardised techniques. Results Menstrual irregularity (oligomenorrhoea and amenorrhoea) was the most common abnormality found in patients with PCOS compared with non-PCOS (p \ 0.0001). Hyperandrogenism was the second most common manifestation present in PCOS of our study group. Hirsutism was the striking hyperandrogenic feature that was present in study group. PCOS patients had higher BMI compared to controls (p \ 0.0001). The prevalence of thyroid dysfunction was not significantly different in both the groups (p \ 0.80). Anti-TPO titre was higher in PCOS patients (25.8 ± 2.9 IU/ml) compared to the controls (14.5 ± 2.3 IU/ml) (p \ 0.009). Conclusion The present study shows that PCOS was associated with increased anti-TPO titres, thus emphasising the importance of screening all PCOS patients for anti-TPO along with routine thyroid profile.

Background: Wound infection is a common complication of obstetric and gynaecological surgeries. It is not clear whether single dose perioperative prophylaxis with antibiotics is sufficient to prevent wound infections. This study was conducted to assess whether perioperative single dose antibiotic is effective in preventing post-operative infections in women undergoing elective obstetric and gynaecological surgeries.Methods: Participants were administered a single dose of 1gm Cefotaxime intravenously before obstetric and gynecological surgery and followed up for the incidence of post-operative complications such as wound infections, wound resuturing etc.Results: Study included 154 electives obstetric and gynecologic cases. 86 were obstetric cases and 68 were gynecologic surgeries. For gynecologic surgeries Cefotaxime injection 1g IV was given 30 minutes before surgery and for obstetric surgeries the same was given after cord clamping. Incidence of febrile morbidity was 5.8% in obstetric cases and 10.3% in gynecologic cases. Incidence of wound infection was 2.32% in obstetric cases and 1.47% in gynecologic cases. Three cases had wound infection, the organisms isolated in wound infection were E. coli, Pseudomonas, Methicillin resistant staphylococcus which were sensitive to cefoperazone-sulbactum and linezolid. The mean duration of hospital stay was 8.2 days in obstetric and 8.03 days for gynecologic patients.Conclusions: Single dose Cefotaxime prophylaxis is equally effective compared to conventional multi-dose antibiotic therapy. It is cost effective and safe for both obstetric and gynecological surgeries.

INTRODUCTIONGestational Diabetes Mellitus (GDM) is defined as carbohydrate intolerance with onset or first recognition during pregnancy. GDM is a rising problem in India. Several risk factors including obesity, physical inactivity and family history of diabetes, have been reported to be associated with GDM.Primary objective of the study was assessing the first trimester uric acid levels and the development of GDM in the sampled women.The secondary objective was to also observe the need for insulin, the mode of delivery, and the development of maternal and neonatal complications.Uric acid is an important metabolite of purine metabolism in the body. Serial changes in serum uric acid concentrations have been studied in the preconception period and have been found to be associated with insulin resistance. Moreover, hyperuricemia is associated with the markers of metabolic syndrome like obesity and dyslipidaemia. It is possible that the association of uric acid with insulin resistance is causal. Several mechanisms have been proposed in the literature by which uric acid can cause insulin resistance. METHODSA prospective observational study was conducted among 85 pregnant women attending the antenatal OPD in a ABSTRACT Background: Prevalence of Gestational Diabetes Mellitus (GDM) is fast increasing in India. The association between serum uric acid levels and GDM is not well known. This study was conducted to assess the relationship between first trimester serum uric acid levels and the incidence of gestational diabetes. Methods: This prospective observational study included 85 antenatal women. Serum uric acid level and oral glucose challenge test (OGCT) were done in all three trimesters. Women with first trimester serum uric acid levels of <3.6 mg were classified as group A and >3.6 mg as group B. Both the groups were followed throughout the pregnancy to assess the development of gestational diabetes. Also, the mode of delivery, pregnancy outcome, and other maternal and neonatal complications were observed. Results: In the patients recruited into this study, 33.33% of group A (serum uric acid<3.6 mg/dl) and 17.5% of group B (serum uric acid>3.6 mg/dl) developed GDM. Conclusions: First trimester Serum Uric acid was not significantly related to development of GDM in the sampled women. Neither was it related to any adverse maternal or fetal outcomes.

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Context:Assessment of individual sonographic features provides vital clues about the biological behavior of breast masses and can assist in determining histological grade of malignancy and thereby prognosis.Aims:Assessment of individual sonographic features of biopsy proven invasive ductal breast carcinomas as predictors of malignancy grade.Settings and Design:A retrospective analysis of sonographic findings of 103 biopsy proven invasive ductal breast carcinomas.Materials and Methods:Tumor characteristics on gray-scale ultrasound and color flow were assessed using American College of Radiology (ACR) Breast Imaging Reporting and Data System (BI-RADS) Atlas Fifth Edition. The sonographic findings of masses were individually correlated with their histopathologic grades.Statistical Analysis Used:Chi square test, ordinal regression, and Goodman and Kruskal tau test.Results:Breast mass showing reversal/lack of diastolic flow has a high probability of belonging to histological high grade tumor (β 1.566, P 0.0001). The masses with abrupt interface boundary are more likely grade 3 (β 1.524, P 0.001) in comparison to masses with echogenic halos. The suspicious calcifications present in and outside the mass is a finding associated with histologically high grade tumors. The invasive ductal carcinomas (IDCs) with complex solid and cystic echotexture are more likely to be of high histological grade (β 1.146, P 0.04) as compared to masses with hypoechoic echotexture.Conclusions:Certain ultrasound features are associated with tumor grade on histopathology. If the radiologist is cognizant of these sonographic features, ultrasound can be a potent modality for predicting histopathological grade of IDCs of the breast, especially in settings where advanced tests such as receptor and molecular analyses are limited.

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Amyloid Light chain (AL) amyloidosis is a rare disease, which is seen in approximately one-tenth of patients with multiple myeloma. We report a 52 years old male, who presented with complaints of anorexia and weight loss. He was diagnosed to have multiple myeloma-international staging score (ISS) Stage 3 and was started on VTD (Bortezomib, Thalidomide, and Dexamethasone) chemotherapy. Within 2 weeks of therapy, he had abdominal symptoms like abdominal pain, loose stools, vomiting and hematochezia. Imaging showed dilated proximal bowel loops with fluid filled contents and prominent vessels in rectum. Emergency surgical exploration revealed thickened proximal jejunum with blood clots in the lumen. Resection of proximal jejunum was done. Histopathological examination of resected specimen was suggestive of AL amyloidosis. Post-surgical resection of jejunum, patient had initial improvement followed by deterioration. He was discharged against medical advice as per relative’s request. Hence an index of clinical suspicion of amyloidosis must been present in all Multiple myeloma patients.