This study is a review of our experience of using the cell saver in obstetrics. The main aim was to determine its role in decreasing the need for homologous blood transfusion. A retrospective study of patients identified as being at high risk of massive obstetric haemorrhage at the time of caesarean section during the period between July 2005 and August 2008, was undertaken. Cases were identified from our electronic database. A of 147 cases were identified. Cell saver was used in 77 (52%) of these cases. A total of 13 units of salvaged blood were transfused successfully, saving approximately GB£1,800. Cell salvage in our practice has not been very effective due to non-availability of trained staff in emergencies and unfamiliarity of techniques, leading to poor salvage via suction. Most of our blood loss is swabbed not suctioned and lack of salvaging blood from swabs is a contributory factor.

Background: The aim of this paper is to compare the outcomes of veress needle entry versus direct trocar for laparoscopy in terms of the duration of the procedure, ease of performance and the complications encountered during each technique.Methods: The present study was conducted on a retrospective basis from April ‘2008 to September 2017, in the dept of Obstetrics and Gynecology, in a 100 bedded hospital, ABGH hospital. All the cases who underwent laparoscopic ligation procedure during this time were taken into account. From 2008 to 2012 traditional technique of veress needle entry was used for access(group -1) but it had been switched over to direct trocar since 2013(group -2) These two groups were compared in terms of the demographic profile, duration of procedure, previous h/o surgical interventions ,ease of performance and various complications encountered during the procedure.Results: The total number of patients who underwent ligation during this period were 1912, which were divided into two groups ,till 2012(veress needle entry group,group-1) 754 patients(39.44%),and after 2012 (direct trocar,group -2) 1158 patients(60.56%).Duration of procedure was 4.5±1.2 min in group 1 which was significantly higher than group 2,2.2±0.8 min(p-value <0.001).Amount of gas required was greater in group 1, 4.9±1.3 lts as compared to group 2,2.4±0.5lts.Conclusions: Direct trocar entry is a reliable alternative to traditional technique for pneumoperitoneum establishment and should be regarded as a part of the surgical armamentarium of a trained laparoscopic surgeon.

Maxillary defects can occur due to certain bacterial, fungal and viral infections. But in recent time mucormycosis has become prevalent secondary to covid-19 infection. Mucormycosis is an opportunistic fungal infection, which primarily affects diabetic and immunocompromised patients. Surgical excision and debridement of the affected areas can result in significant defects. Reconstruction and rehabilitation of these defects remains a significant challenge for the clinicians because 3-D anatomy of the maxilla serves speech, swallowing and aesthetic roles. This review article discusses the reconstructive and rehabilitative methods of mucormycosis maxillary defects.

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Complete edentulism for longer period of time and aging causes flaccid of facial musculature which leads to sunken cheeks and unpleasing appearance of face. In order to get a supplemental support for the drooping cheek muscles, fabrication of conventional complete denture with adjunct detachable cheek plumpers are simple, acceptable non-invasive and economical. Despite the discussion of various attachment used for cheek plumper in literature each have their own disadvantages. The present clinical report demonstrated the use of chairside available lingual sheath and stainless steel wire for the attachment of cheek plumpers to the maxillary complete denture.

Background: A retrospective study was done to compare the maternal and neonatal complications of caesarean delivery performed in the second stage compared with the first stage of labor.Methods: This is a one year retrospective study done in a 100-bedded hospital, govt of NCT OF Delhi, New Delhi from 1st November 2015 to 31st October 2016.  Total number of deliveries in this one year duration were 1785, including both normal and caesarean deliveries. Total number of patients who underwent caesarean delivery in the first stage of labor were 159, and in 2nd stage of labor were 15 during this time period. These were designated into two groups, group 1 and group 2. These two groups were then compared in terms of maternal demographics, labor characteristics, maternal outcomes and neonatal outcomes. Numerical variables were compared between groups by calculating P-value for each variable. P-value <0.05 was considered statistically significant.Results: Caesarean deliveries performed in the second stage were associated with increased maternal morbidity in terms of blood loss, unintended extensions, blood transfusions, prolonged hospital stay, febrile morbidity. Similarly, Neonatal morbidity was much higher in the patient who underwent LSCS in 2nd stage of labor compared to 1st stage. There was increase in neonatal complications, for e. g. –5 minute Apgar <7, NICU admissions >24 hrs, neonatal septicaemia, (P-value <0.05).Conclusions: In conclusion, present study suggests that women undergoing caesarean section in the second stage of labor have increased maternal and fetal morbidity. Therefore, selection of birthing method should be made very carefully and meticulously to decrease maternal and neonatal morbidity.

BackgroundObliterated posterior cul-de-sac has been a real surgical challenge during vaginal hysterectomy. The present study demonstrates an anteroposterior approach to accomplish the vaginal hysterectomy in cases faced with an obliterated posterior cul-de-sac.MethodsIn a retrospective study in private setup, 51 consecutive cases with obliterated posterior cul-de-sac during vaginal hysterectomy due to severe benign pelvic adhesions were studied to know the feasibility of the anteroposterior approach. The upper limit of uterus size was that of 16 weeks of gestation.ResultsVaginal hysterectomy was completed in 49 (96.08%) cases with obliterated posterior cul-de-sac due to severe benign pelvic adhesions. Two (3.92%) cases needed laparoscopic assistance to complete vaginal hysterectomy. Mean operation time was 109.92±40.13 (45–217) minutes due to the need for careful separation of adhesions from the uterus and indicated additional procedures. Mean weight of specimen uterus was 162±106.51 (40–460) grams. There was no major intra- or postoperative morbidity.ConclusionCompletion of vaginal hysterectomy was feasible using the anteroposterior approach in most of the cases with obliterated posterior cul-de-sac due to severe benign pelvic adhesions.

With advancements in the treatment protocol of oral cancer, the survival rate of these patients has dramatically increased. Rehabilitation for people with oral cancer extends beyond orofacial prosthesis reconstruction to include offering comprehensive care by combining specialties. In the diagnosis and treatment of patients, maxillofacial prosthodontists (MFPs) should be a part of the team of consultants. The MFP is an important member of the multidisciplinary team that coordinates the treatment. The prosthodontist must monitor the patient closely. Be conversant with the various hospital protocols and the patient's medical health. He is best qualified to assist the surgeon with prosthetics by making facial moulages and surgical stents to aid recuperation. To improve the prosthesis' retention, stability, and support, recommendations might be made to preserve tissues or reinforce existing anatomical features. Collaboration with a speech pathologist to learn about the mechanics and physiology of speech can help in the construction of a prosthesis that meets resonance, phonation, and articulation needs.