Laparoscopic (Falope ring) sterilization should be preferred in women who are willing for interval sterilization and it should be done at isthmic segment of the tube, whereas the Pomeroy's method is to be reserved for occasional postpartum procedure. Reversal of sterilization should be done with strict adherence to principles of microsurgery.

GDM is defined as any degree of glucose intolerance with onset or first recognition during pregnancy. The prevalence of GDM varies, widely based on the diagnostic criteria used and the ethnic group studied. It is associated with adverse maternal and perinatal outcome. Incidence of GDM in India is 1-14%. There are several screening and diagnostic tests for GDM. It is important to diagnose early and treat to prevent these complications. The present study was done to compare Diabetes in Pregnancy Study Group India (DIPSI) with International Association of the Diabetes and Pregnancy Study Groups (IADPSG) criteria for diagnosis of GDM and to assess the validity of these methods.Methods: It was a cross sectional study done in 144 pregnant women who fulfilled the inclusion criteria. They underwent non - fasting OGTT with 75 grams glucose which was given irrespective of the last meal. A venous blood sample was drawn two hours after glucose administration. They were advised to come two to three days later and repeated with 75 grams OGTT after an overnight fast of atleast 8 hours. Venous blood sample was drawn at fasting, one hour and two hours after load with 75 grams of glucose. Plasma glucose was measured by using an autoanalyzer by glucose - oxidase peroxidase (GOD - POD) technique.Results: The epidemiological parameters like Age, BMI, Parity and Gestational age did not have any difference between two groups. 17.4% was diagnosed by DIPSI criteria and 15.3% was diagnosed by IADPSG criteria and 6.9% was diagnosed by both. Sensitivity and specificity of DIPSI was 45% and87% and sensitivity and specificity of IADPSG was 40% and89% respectively. According to kappa statistics, the p-value is 0.000.Conclusions: In present study it was concluded that screening is very essential in all pregnant women due to high prevalence of GDM in India. By comparing these two criteria, sensitivity of DIPSI was found better than IADPSG criteria in diagnosing GDM. Though IADPSG is universally accepted for diagnosis, DIPSI has still got a place in low resource countries as it is easy, cost effective and non fasting test.

INTRODUCTIONThyroid gland dysfunctions in the form of hypo or hyperthyroidism have been known to have a deleterious effect on fertility as well as pregnancy. The various hypofunction thyroid disorders encountered in pregnant women are clinical or clinical and subclinical hypothyroidism. Pregnancy itself modifies thyroid gland functions in the form of 50% increase in thyroxine (T4) and triiodothyronine (T3) production, decreased levels of thyrotropin (TSH) due to effect of human chorionic gonadotropin and 50% increase in daily iodine requirement.1 Clinical hypothyroidism is defined as decreased free thyroxine levels with an increased value of thyrotropin (>2.5miu/L). This has been associated with increased incidence of gestational hypertension and diabetes, preterm delivery and Caesarean section in pregnant women.2 This study is undertaken to find out the effects of adequately treated clinical hypothyroidism in pregnancy when compared with pregnant euthyroid controls. METHODSThis study was conducted in a tertiary care centre over a period of one year and 144 cases of clinical hypothyroidism in pregnancy were taken into account who formed the case group. Inclusion criteriaNewly diagnosed clinical hypothyroidism in pregnancy, TSH>2.5 mIU/L in 1 st and 3mIU/L in the 2 nd and 3 rd trimesters respectively according to American thyroid association guidelines. ABSTRACTBackground: Hypothyroidism in pregnancy is generally associated with various adverse outcomes. Also worldwide, there is an increased awareness about morbidity caused by this endocrinological disorder in pregnancy .This study is undertaken to evaluate the outcome of this condition in pregnancy. Methods: 144 newly diagnosed clinical hypothyroid pregnant women were taken as the case group and 145 age and parity matched euthyroid pregnant women were taken as controls. The outcome compared in between these two groups were pregnancy complications like gestational diabetes and hypertension , oligohydramnios, intrauterine growth restriction , intrauterine demise, Caesarean section rates and it's indication as well as neonatal outcome like birth weight and need for neonatal intensive care.Results: Clinical hypothyroidism in pregnancy constituted 6.1% of the total number of deliveries. There was a significantly higher number of gestational diabetes in the case group (p=0.0001). Caesarean sections done for the indication of foetal distress was significantly higher when compared with the control group (p=0.00002). Large for gestational age babies were more common in case group. Conclusions: Clinical hypothyroidism in pregnancy even when treated adequately might lead to complications.

Bowel evisceration through vaginal vault is a rare but serious complication of pelvic surgery specifically hysterectomy. It represents a surgical emergency and is associated with significant morbidity. Small bowel is the most common viscous to eviscerate. The present case is report of small bowel evisceration through vaginal vault in the immediate post-operative period managed vaginally. Bowel evisceration through vaginal vault following vaginal cuff dehiscence is a rare and serious complication of pelvic surgery; specifically, hysterectomy. Small bowel is the most common viscous to eviscerate. Bowel evisceration is usually managed abdominally either laparoscopically or by a laparotomy. We present a case of small bowel evisceration through vaginal vault in the immediate post-operative period which was managed vaginally.