Critically ill obstetric patients require a team approach of the obstetrician, anesthesiologist and intensive care specialist for the optimal care of these patients.

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Objectives To ascertain the prevalence, presentation, diagnosis, severity, and complications of HELLP syndrome. Materials and Methods This is a prospective observational study analyzing the conditions and the data of 24 cases of HELLP syndrome in a tertiary care hospital. The analysis was done for the demographic characteristics, presentation of these patients, complications associated, and the perinatal outcome. Results 0.45 % of the patients admitted for delivery developed HELLP syndrome. Majority of the patients developed the condition in 30-36 weeks period of gestation, while five patients developed it in the postpartum period. The condition led to 12.5 % of maternal and 45.8 % of perinatal mortality.Conclusion HELLP syndrome is an important cause for maternal and perinatal morbidity and mortality.

Women with multiple risk factors for cesarean can be taken up for elective cesarean section rather than inducing them at term.

Background Autoimmune fetal congenital heart block (CHB) is the most severe manifestation of neonatal lupus, and it is seen when maternal autoimmune antibodies cross the placenta and damage the AV node of the fetus. CHB is mainly associated with maternal SLE with anti-Ro/SSAand anti-La/SSB-positive status, and incidence of CHB increases when both the antibodies are present. This study was conducted to know the incidence of fetal CHB in patients of SLE who had ANA, anti-Ro/SSA and anti-La/ SSB positivity. Methods A prospective study was conducted in a tertiarycare teaching hospital of Indian Armed Forces between Jan 2012 to Sep 2014 where 13 cases of SLE were studied. All these patients were tested for ANA, anti-Ro/SSA and antiLa/SSB antibodies and fetal heart abnormalities. Fetuses with CHB were treated with steroids. Results Incidence of SLE was 0.14 %, 92 % of SLE patients were positive for ANA, and 46 % had anti-Ro/ SSA-and anti-La/SSB-positive status. Two fetuses had congenital heart block, and one fetus required pacemaker placement 5 months after delivery. Conclusion All the fetal congenital heart blocks are associated with maternal anti-Ro/SSA and anti-La/SSB and ANA antibodies. Treatment by steroids may improve the outcome in early stages of fetal CHB, and delivery with follow-up should be planned in a tertiary-care center where pacemaker placement facility is available.Dr. Dey Madhusudan MS and Agarwal Raju MD are Reader; Nambula Vijaya MBBS is a Resident

We describe here the reprogramming of CD34 cells isolated from umbilical cord blood obtained after full term delivery of a healthy female child of Indian origin. The cells were nucleofected by episomal vectors expressing Oct4, Sox2, L-Myc, Klf4, Lin28 and p53DD (negative mutation in p53). Colonies were identified by alkaline phosphatase staining and characterized for expression of pluripotency markers at protein level by immunofluorescence, flow cytometry and at transcript level by PCR. Genomic stability of the cell line was checked by G-banded karyotype. The ability to differentiate to endoderm, mesoderm and ectoderm in vitro was confirmed by immunofluorescence staining.

Background: MRI is a useful modality for preoperative imaging in endometrial cancer. We report our experience in Indian population managed at a tertiary care center regarding accuracy of preoperative MRI in prediction of deep myometrial invasion and cervical stromal invasion.Methods: 30 patients with endometrioid adenocarcinoma endometrium on endometrial biopsy underwent preoperative MRI in the week preceding surgery. MRI impression of depth of myometrial invasion, cervical stroma involvement and positive nodes were compared with final histopathology findings to calculate the accuracy of MRI.Results: The accuracy of MRI for estimation of tumour size was 72% and for detection of myometrial invasion was 76%. The accuracy for detection of cervical, adnexal and nodal involvement was 96%, 100% and 96% respectively.Conclusions: MRI is an accurate modality for preoperative assessment in endometrial cancer and can significantly assist in surgical planning.

Background: Organ transplantation is one such field of modern medical sciences which has progressed over the years and has given hope for those suffering with end stage organ diseases. There are lot of advancement in technology to preserve and transplant of organs but with this technological advancement also there are still gaps in awareness regarding the subjects. To find the gaps this study was carried out in medical college students.Methods: A cross-sectional analytical study was conducted in medical college of Pune. 400 students were included in study with keeping 50% of prevalence about awareness in mind. Tool of data collection was a pre-structured questionnaire. Frequency, percentage, and chi square test Chi-square test for linear trend and was used to find associationResults: The 308 (77%) MBBS students and 92 (23%). Nursing students of all batches were included in the study. The 49.3% were aware about brain death, 68% students had fair knowledge and 10% had good knowledge about organ donation issues. The 82% students were positive, 94.5% students opined positively on policy on promotion of organ donation. The 52% students were ready to donate to anyone, while 30% students preferred to donate their organs to family members, 16% were ready to donate to their friends.Conclusions: Encouraging level of knowledge regarding organ donation, its legislative implications were present in medical and nursing students which was brought in this study.