Objective:The objective of this study is to analyze the role of diagnostic hysterolaparoscopy (DHL) for evaluation of infertility in a tertiary care hospital.Materials and Methods:This retrospective study was conducted from July 2014 to June 2016.Results:Out of 151 patients, 58.28% and 41.72% had primary and secondary infertility, respectively. In primary infertility group 37.5% and in secondary infertility group 49.2% had abnormal findings. Most common finding was adnexal adhesions (pelvic inflammatory disease) and laparoscopic findings were more common than the hysteroscopic ones.Conclusion:DHL was helpful in finding some reversible causes of infertility such as adnexal adhesions, tubal blockade, and uterine synechiae, etc.

Background: Ovarian cystic neoplasms are common in gynaecological practice. These may pose diagnostic difficulty to the pathologists. This study was conducted to analyse the clinical and histological profile of ovarian cystic neoplasms.Methods: This is a retrospective study done from January 2016 to April 2017 in a tertiary care hospital in North East India. All the patients, who were clinically and radiologically diagnosed as ovarian cysts, which had histopathological confirmation were included in the study. Data including the age, parity, clinical symptoms, laterality and histopathological findings were analysed.Results: A total of 101 patients operated for ovarian cysts in the study period were analysed. The most common clinical presentation was lower abdominal pain. There were 11 (10.9%) malignant cases, 4 (4%) were intermediate grade and borderline in nature, and 85 (84.1%) cases were benign in nature. There was 1 (1%) case of metastasis to ovary. Mature cystic teratoma was most common (20.8%) histopathological diagnosis. The second most common cyst was serous cystadenoma (19.8%).Conclusion: Ovarian cysts are commonly encountered in gynaecological practice and equally encountered by the pathologists. Most commonly found ovarian cysts were mature cystic teratoma followed by serous cystadenoma.

Schwannomas are neurogenic tumors, which are among the most varied tumors with respect to morphology, clinical associations, and presentations; they occur in a wide variety of sites. The uterine cervix is a rare site of occurrence and only 15 cases of schwannomas of the uterine cervix, including 5 benign and 10 malignant cases, have been reported to date. Thus, schwannomas of the uterine cervix may pose diagnostic difficulty. Here, we report a case of benign schwannoma of the uterine cervix in a 37-year-old female, who presented with vaginal spotting.

Placenta previa and placenta accreta are important causes of serious fetal and maternal morbidity and even mortality necessitating hysterectomy. We report a case of total placenta previa with accreta in a 39-year-old female in the 32+2 weeks of pregnancy with successful delivery by cesarean. However, hysterectomy was performed to control postpartum hemorrhage.

Background: Abnormal placentation such as placenta accreta, increta, and percreta are frequent causes of post-partum hemorrhage, which results in maternal morbidity and mortality. A previous history of cesarean section, placenta previa, and pre-eclampsia are the important risk factors for abnormal placentation. A reliable antenatal diagnosis and planned surgical approach can reduce the incidence of maternal morbidity and mortality from massive hemorrhage. Aim: To study the incidence of abnormal placentation and the association of various risk factors with abnormal placentation. Material and methods: A retrospective study over a period of eight years in patients with peripartum hysterectomies due to abnormal placentation presenting with massive hemorrhage. Results: We received a total of 10 emergency hysterectomy specimens during an eight‑year period. Of the cases, placenta accreta accounted for 40% (4/10), increta up to 40% (4/10), and percreta 20% (2/10). Analysis of these findings with parity showed 20% of the women were uniparous (2/10), and 80% were multiparous (8/10). Risk factor analysis showed previous cesarean sections in 40% (4/10), placenta previa in 50% (5/10), and pre‑eclampsia in 10% (1/10). Conclusion: The present study highlights the incidence of abnormal placentation in a tertiary care institute in Northeast India. Placenta accreta and increta constituted the major forms of abnormal placentation. Multiparous women with placenta previa followed by previous lower segment cesarean section were more at risk of having abnormal placentation. These findings will guide in antenatal care by risk prioritization and management planning of these patients.

Placental chorangioma stands out to be most common benign tumour of the placenta with an incidence of 1% in all pregnancies. It is classified under vascular tumours of placenta. Usually they are small in size and often underdiagnosed. Because of this reason this entity is underreported. However, diagnosis of chorangioma placenta mandates a careful clinical examination of placenta. Often the larger sized chorangioma poses a challenge to the obstetricians, as it may lead to various complications. Here we are reporting and highlighting a case of large chorangioma with a successful pregnancy outcome in an elderly primigravida.

Background: Lack of hand hygiene inside the operation theatre (OT) is a major cause of health care associated infection (HCAI) leading to increased morbidity and mortality. There is need to strengthen the hand hygiene protocol adherence to reduce the same. Aim: We tried to qualitatively observe compliance of hand hygiene amongst the various OT staff while handing patients and equipments and put it into quantitative terms. Methods: Various operation theatre staff was monitored discreetly during 45 surgical procedures while performing their daily shifts. The number of hand hygiene opportunities were counted compliance of hand hygiene was recorded. Results: In 5476 minutes of operative time, 623 hand hygiene opportunities were created. The compliance of hand hygiene was 28.57%, most compliant being the medical students (46.26%) followed by multipurpose workers (38.55%) and anesthetists (34.23%). Ophthalmology OT had the highest incidence of hand hygiene compliance (57.89%) followed by orthopaedics OT (33.34%). Conclusion: Compliance of hand hygiene was found to be quite low amongst the staff inside the OT. Strict hand hygiene protocols in place and administrative implementation of the same can increase the overall compliance.A monitoring team for the same would be beneficial for strict adherence of hand hygiene protocol.

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