AIM AND OBJECTIVE:To analyze pregnant women with heart disease and to assess its influence on feto-maternal outcome. MATERIALS AND METHODS: The study was carried out during the period of November 2011 to October 2014. 45 pregnant women with cardiac diseases who were admitted in department of obstetrics and gynecology at KIMS hospital were included in the study. RESULTS: Rheumatic heart disease (n-24, 53.33 %) with isolated mitral stenosis (24.4%) was the predominant cardiac problem among the study subjects while atrial septal defect (11.1%) was the most common form of congenital heart disease. Based on the NYHA functional classification 74 % were in class I, 22.3% patients were in class II and 2.22 % were in class IV on presentation .28.9 percent deliveries were preterm. The pregnancy duration was shortened in more advanced classes of heart disease. 60% of the cases were delivered by cesarean section. Average birth weight of babies in class I WAS 2.63 +/-0.2 kg, 2.5 +/-0.3 kg in class II, 2.1 kg in class IV. Out of 45, 2 patients had heart failure during the hospital stay. There were 2 perinatal mortalities and one maternal mortality. CONCLUSION: RHD was the predominant type of heart disease in pregnancy and most women were class I at the time of admission. The preterm delivery and cesarean rates were significantly high. A multidisciplinary approach is needed to reduce morbidity, mortality and to optimize the outcome.

Purpose of Review The prevalence of pediatric obesity has increased significantly over the past couple of generations. While monogenic obesity, syndromic obesity, and endocrinopathies associated with obesity have been increasingly recognized, they do not account for the increase in prevalence. We describe these rare conditions and the dysregulation of neuropathways in obesity and review successes and failures in treatments in both syndromic and nonsyndromic obesity. Recent Findings The best-described form of syndromic obesity is Prader-Willi Syndrome (PWS). While recent pharmacotherapies (specifically beloranib) demonstrated improvements in weight in PWS, the unfortunate adverse effect of deep vein thrombosis and pulmonary embolism necessitated the halting of its further development. Additional treatments are in development which target the signaling of ghrelin and other hypothalamic targets known to be dysregulated in PWS. For nonsyndromic obesity, lifestyle modifications remain the mainstay of treatment. However, recent large-scale interventions have had disappointing results. Bariatric surgery in children holds some promise, though complications and reoperations are common. Pharmacotherapies have been developed that treat rare monogenic forms of obesity, including MC4R agonists, which hold promise for these uncommon explanations for early childhood weight gain. There is evidence that methylation patterns in key genes in the neuroregulation of appetite are altered in individuals with obesity. Interestingly, this altered methylation is evident in sperm, which may have an impact on the heritability of gene expression across generations. Summary Pediatric obesity is complex and multifactorial. Efforts in rare monogenic and syndromic obesity may give rise to potential treatment opportunities in circumstances where lifestyle interventions are unsuccessful.

Background: Episiotomy is a planned surgical incision made in perineum during childbirth. The type of suture material used for perineal repair following episiotomy will have effect on the intensiy of the pain experienced by mother. The objective of the present study is to determine the effects of rapide vicryl and catgut suture material on the amount of short term pain experienced by mother and to assess the amount of analgesia used following episiotomy suturing.Methods: Women with episiotomy cut was divided into two groups: group A consisted of episiotomy repair with catgut and group B with rapide vicryl. Following episiotomy pain will be assessed by visual analogue scale.Results: In KIMS hospital Bangalore - there was significant reduction in short term pain by vicryl rapide compared to chromic catgut and the need for analgesia.Conclusions: Vicryl rapide is effective in reducing the morbidity associated with episiotomy repair. There was significant reduction in short term pain and the need for analgesia, with decrease incidence of wound dehiscence.

BACKGROUND:Polycystic ovary syndrome is a condition associated with chronic anovulation, insulin resistance and androgen excess. Dyslipidemia, diabetes, obesity are all potent cardiovascular risk factors that tend to cluster in women with PCOD. These cannot be explained by obesity alone. Thus the need arises to study the effect of insulin resistance on these factors. This will help in assessing the long term cardiovascular morbidity in PCOD patients and take necessary preventive steps. OBJECTIVES: To analyze the infuence of obesity on lipid profile of PCOS women. To analyze the influence of insulin resistance on lipid profile in PCOS women. MATERIALS AND METHODS: In this prospective study done from December 2013 to September 2014, 50 women with PCOS had their body mass index and waist to hip ratio calculated. GTT, fasting and post prandial insulin, lipid profile was also done for each case. Insulin resistance was defined by fasting glucose to insulin ratio of less than or equal to 4.5. The association of obesity markers and insulin resistance with lipid markers was then studied. Statistical analysis using Student t test and ANOVA was done as indicated. Significance is assessed at 5% level of significance. RESULTS: Insulin resistance was seen in 56 percent of the cases. There was no correlation between markers of obesity (BMI and Waist to Hip ratio) and the various lipid parameters. But in PCOS women with insulin resistance the lipid profile was significantly different (high triglycerides and lower high density lipoprotein) compared to the insulin sensitive women. The difference between the two groups for triglycerides and HDL was statistically significant but that for LDL and total cholesterol was not statistically significant. CONCLUSION: Insulin resistance is associated with dyslipidemia in women with PCOS, independent of obesity.

Oligohydramnios, defined as when the AFI is less than 5. Definition of increased or decreased amniotic fluid volume are based on sonographic criteria. Oligohydramnios complicates approximately 1 to 2% of pregnancies Amniotic fluid provides the cushion effect against the constricting confines of the gravid uterus. It creates space and helps in musculoskeletal development of foetus, helps in normal fetal lung development and prevents compression of umbilical cord, placenta and hence protects the foetus from vascular and nutritional compromises. Oligohydramnios is associated with high risk adverse perinatal outcome like fetal distress, meconium aspiration, low APGAR, joint contracture, pulmonary hypoplasia etc., and associated with maternal morbidity in the form of increased rates of induction and/or operative interference. This study is conducted to find out the effects of oligohydramnios in determining the obstetric and perinatal outcome.To study, 1) Primary outcome- Obstetric outcome in terms of mode of delivery, indication for operative interference. 2) Secondary outcome- Neonatal outcome in terms of birth weight, Apgar score, colour of liquor, admissions to NICU. This is a prospective observational study conducted on 80 patients presenting to Department of Obstetrics and Gynecology at KIMS hospital, Bengaluru from January 2019 to June 2020 who were diagnosed with oligohydramnios with intact membranes with AFI<5cms using sonographic criteria. A total of 80 cases of Isolated Oligohydramnios were assessed. 38.7% cases delivered vaginally, 61.2% of cases underwent Cesarean section, 15% had meconium stained liquor, 15% had APGAR score of <7 at 1 minute, 42.5% had birth weight <2.5kgs and 37.5% of babies required NICU admissions. The present study was conducted to know the fetomaternal outcome in pregnancies with oligohydramnios. The study showed oligohydramnios was associated with higher rates of induction and Cesarean section and associated with Low birth weight babies.