Aims:This study is aimed at finding out a logical solution for perimenopausal menorrhagia in normal or bulky uterus.Settings and Design:The study is carried out at a tertiary care hospital at Odisha. In our setup, nearly 900 hysterectomies are done per year out of which 60% are for menorrhagia with bulky uterus.Subjects and Methods:There were sixty cases of menorrhagia between the ages of 40 and 55 years who completed child bearing treated with ormeloxifene. Their endometrial thickness (ET) and hemoglobin (Hb) level were determined at the start of the study and also at 6 months and compared. At 1 year from the start of treatment, patients' satisfaction and status of menstrual cycle were reassessed.Statistical Analysis Used:Age and parity variables were expressed as mean ± standard deviation and range. We used the paired samples t-test to estimate the mean, median, range, P and t value. All statistical analyses were performed using SPSS software version 11.5 (IBM Corp) and tests of statistical significance were two-sided and differences were taken as significant when P < 0.05.Results:After 1 year of follow-up, 90% of patients found to be amenorrhoic and only two out of them presented with mild irritability and vasomotor complaints which resolved with counseling and placebo therapy. There was a significant reduction (P < 0.0001) in ET and rise in Hb level (P < 0.0001).Conclusions:Ormeloxifene is a safe drug which can be used to treatment of perimenopausal bleeding with minimal focal pathology.

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A 12 years old girl reported with a history of unsuccessful attempt at vaginoplasty. During admission, she was found to be in septic shock and detected to have pyoperitoneum as well as, involuntary leakage of urine. Exploratory laparotomy was carried out as the life saving measure. After 1 year, she was taken up for the repair of vesicovaginal fistula (VVF). She presented again with complaints of mass in lower abdomen after 8 months. When evaluated the mass was diagnosed as hematometra and blood was drained out, by syringing the uterus in a surgical procedure. Further she developed severe pain along with recurrence of the mass, which was progressively increasing in size. The repeat vaginoplasty was attempted but found unsuccessful, resulting in hysterectomy at 15 years. How to cite this article Pati T, Nayak S, Mohapatra S, Sahu MC, Padhy RN. Hysterectomy of a 15 Years Old Girl: A Rare Case Report. Donald School J Ultrasound Obstet Gynecol 2015;9(3):331-334.

Introduction: Infectious diseases are a common cause of maternal and perinatal morbidity and mortality especially in tropical and subtropical countries. They encompass viral diseases like viral hepatitis, HIV, rubella, CMV, genital herpes and protozoan diseases like malaria and toxoplasma. Most of these are related to poverty, poor sanitation, parasitic infestations and restricted access to proper health care. Aims and Objective: To study common infectious diseases in pregnancy and analyse perinatal outcome Material and Methods: This is a prospective study conducted by taking detailed history of the patients and doing certain investigations like blood hemoglobin, liver function test, coagulation profile, HIV, HBsAg, HCV, TORCH panel, immune chromatography for malaria and ultrasonography for assessment of fetal condition. Neonates were assessed as per its birth weight, fever, irritability, feeding problems, anemia, petechial, jaundice, cyanosis, hepato-splenomegaly and congenital malformations. Results: Spontaneous abortions were most commonly seen in case of Rubella infection (37.5%) followed by HCV (30%) and malaria (14.7%). HIV infected women were most IUGR fetuses (48%) followed by malaria (34.7%). Most of the intrauterine fetal demise occurred in Toxoplasma gondii infection (44%). Rubella contributed 29.1% of IUFD. Congenital malformations were mostly evident in Rubella infection (20.8%). Most of the perinatal deaths seen in HIV positive women (16%) followed by malaria (6.6%). Conclusion: Infections in pregnancy are important contributor to maternal and perinatal morbidity and mortality. Awareness, primary prevention, early diagnosis and treatment are required to control seasonal and epidemic diseases such as malaria.

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