INTRODUCTIONHysterectomy is one of the most common surgical procedures performed by the gynaecologist. It can be performed by abdominal and vaginal route. Vaginal hysterectomy (VH) has several advantages over abdominal hysterectomy (TAH), and may be appropriate for up to 80% of benign uterine conditions. 1,2 Evidence supports TAH only when documented pathologic conditions preclude the vaginal route. 3,4 Even recent study in United States shows 82% were TAH, only 13% were VH and 5% were laparoscopic assisted in teaching hospitals.5 Aim of our study is to compare between vaginal route versus abdominal route of hysterectomy in terms of intra operative and post operative complications. METHODSA retrospective study was done in department of Obstetrics and Gynaecology of Sri Manakula Vinayagar Medical College and Hospital in Puducherry, India from January 2010 to July 2012. Study was done in women who had undergone vaginal or abdominal hysterectomy in that period. Women in any age group who underwent vaginal or abdominal hysterectomy for benign conditions were included in the study. Women who underwent hysterectomy for uterine prolapse, indications that would generally require an abdominal approach such as endometriosis, pelvic inflammatory disease were excluded from the study. Vaginal hysterectomy was done in those with uterine size ≤ 14 weeks, unrestricted uterine mobility, and absence of adnexal pathology.Information such as clinical history, physical examination findings, haemoglobin level preoperatively, indication for ABSTRACT Background: Hysterectomy is one of the most common surgical procedures performed by the gynaecologist. It can be performed by vaginal and abdominal route. Gynaecologic surgeons worldwide continue to use the abdominal approach for a large majority of hysterectomies that could be performed vaginally despite well-documented evidence that vaginal hysterectomy has better outcome. Aim of our study is to compare vaginal route versus abdominal route of hysterectomy in terms of intra operative and post operative complications. Methods: A retrospective study was done in 229 women who had undergone hysterectomy (176 abdominal hysterectomies and 53 vaginal hysterectomies) from January 2010 to July 2012. Information on the indications, operative procedures, and complications were extracted and analysed. Results: The mean duration of surgery in VH group was 79.6 min and that of TAH group was 99.2 min. The mean blood loss was also more in case of TAH group than that of VH group (215ml vs. 167ml). Bladder injury occurred in 1 case in VH (1.9%) and in 4 cases in TAH (2.3%). Ureter injury occurred in 1(0.6%) case in TAH group. Wound infection developed in 10 cases of TAH group whereas only one case in VH group developed vault infection. Conclusions:Vaginal hysterectomy is associated with quicker recovery, early mobilization, shorter hospitalization, less operative and post operative morbidity when compared to abdominal hysterectomy.

Myiasis is the infestation of the tissues of vertebrate animals by the larvae of flies. Genital myiasis is a rare condition, as it commonly presents as mucocutaneous form. We present a case of 80 year old lady with third degree uterovaginal prolapse and maggot infestation of an ulcer over the posterior aspect of the prolapse.

Background: Anemia in pregnancy has detrimental effects on maternal and child health and prevalence of anemia during pregnancy is alarmingly high, inspite of the implementation of the national nutritional anemia prophylaxis programme which provides iron and folic acid which are the essential nutrients lacking in their diet. The purpose of this study was to assess the knowledge, attitude and practices of pregnant women regarding anemia, Iron rich food and iron supplements and also to assess the impact of these factors and other socio demographic variables on the hemoglobin levels of these vulnerable groups of women. Methods: This is a cross sectional, descriptive institution based study conducted at Sri Manakula Vinayagar medical college hospital, Puducherry, India. Sample size was calculated using formula for single proportion with 5% marginal error and 95% CI and a non-response rate of 10% and was found to be 316. Data collection was carried out using a predesigned, self-administered questionnaire in local language in the antenatal clinic at the time of routine antenatal checkup, from pregnant women who consented to participate in the study. At the same sitting, 1 ml of blood was collected for hemoglobin estimation, analyzed and the result was recorded and disclosed to the patient. The data was entered in SPSS and analyzed using descriptive and inferential statistics (Chi square test). A p value of <0.05 was considered to be statistically significant. Results: Assessment of knowledge revealed that only 39.87% of the participants were aware of and understood the term anemia. 53.8% of the participants accepted that pregnant women were more vulnerable to anemia and 66.1% responded correctly that the fetus will be affected by severe anemia. Only 32.6% gave the correct response that pregnant women should take iron supplementation in spite of taking a healthy diet. Only 44.62% of the participants were aware of their hemoglobin level in the current pregnancy. Knowledge about food rich in iron was poor among the participants. At least 1/5 th of the participants have not received educational information regarding anemia from any source. The overall attitude towards antenatal checkup, healthy diet and the benefits of iron supplementation was generally good among the participants 49.36% of the participants were taking only the usual diet during their pregnancy. 74.36% claimed to have taken iron supplementation regularly whereas 9.8% had not taken iron supplementation. On hemoglobin estimation it was found that 62.97% of the participants were anemic taking 11 grams as the cut off for anemia. The only significant determinants of hemoglobin levels were regular intake of iron supplements (p value 0.006) and timing of iron consumption (p value 0.0262). Conclusions:The present study indicated the lack of knowledge regarding anemia, iron rich foods and the importance of iron supplementation during pregnancy. Targeted estimation of hemoglobin levels in adolescent girls and women in reproductive age group, intensive counse...

Background: The most common complaint with which women present for gynecological consultation is abnormal uterine bleeding which may be due to varied etiology. Among non-structural causes for AUB, endocrinological disorders like thyroid dysfunction is very common. Thyroid dysfunction is often overlooked, and unnecessary hormonal or surgical interventions are performed in patients with AUB.Methods: This is a hospital based cross sectional study carried out in Sri Manakula Vinayagar Medical College and Hospital, Puducherry between January 2017 to June 2017 for a period of 6 months and the participants were 200 women attending gynecological OPD with complaints of abnormal uterine bleeding. After obtaining a written informed consent from the participants a detailed history and complete examination including a thorough gynecological examination was performed. A transvaginal ultrasound examination to note for any structural causes for AUB was performed. Thyroid function test (FT3, FT4, TSH) was performed in all study participants and they were then categorized into euthyroid, hypothyroid, hyperthyroid, subclinical hypo or hyperthyroid based on the results. After preliminary preparation all participants were subjected for an endometrial biopsy in the outpatient department and the tissue obtained was sent for histopathological analysis. All the information was tabulated and analyzed using SPSS 22 version with descriptive and inferential statistics (chi square test). A p value of < 0.05 was considered as statistically significant.Results: Heavy menstrual bleeding was the most common menstrual abnormality found in 85% of the study participants.77% had structural causes for AUB whereas 23% had non-structural causes. 79.5% of the patients with AUB were euthyroid whereas 20.5% had some form of thyroid dysfunction. Subclinical hypothyroidism was the most common thyroid dysfunction (15.5%) in this study followed by hypothyroidism (3.5%). Only 1.5% of patients had hyperthyroidism. In the present study no, significant association was found between any particular thyroid dysfunction and specific menstrual pattern or endometrial pattern in histopathology.Conclusions: Testing and treating for thyroid disorder would prove to be cost effective in patients with AUB particularly with nonstructural causes as it would avoid many costly interventions done for AUB.