Background: The objectives of the study was to establish the role of histopathological diagnosis of uterine endometrial lesions in patients of AUB at perimenopausal age and to correlate the transvaginal sonographic (TVS) finding with histopathological examination.Methods: This prospective observational study was carried out over 1 and 1/2 years in the two apex level teaching hospitals in eastern India. A total of 197 women in the age group of 40-49 years and ≥50 years (up to 55 years) who presented with abnormal uterine bleeding were included in the study. After selecting the patient with eligibility criteria in the OPD, detailed clinical history, systemic and gynecological examinations and investigations were done as per proforma. TVS study of endometrial pattern and thickness was measured followed by dilatation and curettage (D and C) and HPE of the endometrial curetting was done.Results: Menorrhagia (44.67%) was the most common clinical finding. Mean endometrial thickness measured by TVS was 7.04±2.11 mm in proliferative phase and 10.25±1.27 mm in the secretory phase. Proliferative endometrium (37.06%) was the most frequent finding in HPE followed by secretory endometrium (20.3%). Hyperplasia of endometrium was noted in 27 cases (100%) at 12-15 mm of endometrial thickness on TVS whereas endometrial hyperplasia with and without atypia and endometrial carcinoma was noted in 25 cases (92.59%) at the same thickness of 12-15 mm of uterine endometrium on HPE. Endometrial hyperplasia and polyp both had sensitivity of 84.21% and 71.43% respectively on TVS as compared with histopathology.Conclusions: Increased endometrial thickness and echo pattern by TVS correlated well with abnormal endometrial tissue histopathology in perimenopausal women with AUB.

Background and Objectives: Hypertensive disorders are the most common medical complications of pregnancy with an incidence of 12-22% and are rampant globally. The aim of the study was to establish whether a spot urinary protein -creatinine ratio (UPCR) measured between 20-24 weeks of gestation can predict subsequent development of preeclampsia Methods: The prospective observational study included 120 pregnant mothers with singleton pregnancy with normal renal function having no proteinuria, attending antenatal clinics between 20-24 weeks of gestational age in two tertiary care teaching hospitals. Spot UPCR test was done in a mid-stream urine sample and protein was estimated by immunoturbidimetric microalbumin method and creatinine by modified Jaffe's method. Data was expressed as urine protein (mg/dl)/ urine creatinine (g/dl) = UPCR in mg/g or mg/mmol multiplying by 0.113. Results: Prevalence of preeclampsia was 12.93%. The mean UPCR (mg//mmol) in unaffected group and preeclampsia groups was 26.84±4.69 and 44.12± 9.43 respectively. The optimal cut-off value of spot UPCR was considered 35.5 mg/mmol. The relative risk (RR) of developing preeclampsia in women with UPCR ≥35.5 mg/mmol was 21.78 (95% CI, 6.82-69.54, p=0.0001). The sensitivity, specificity, PPV and NPV are of 80% and 94.06%, 66.67% and 96.94% respectively at or above UPCR cut-off value of 35.5 mg/mmol. The area under curve (AUC) of spot UPCR in ROC curve was 0.949 (95% CI, 0.891-1.000). Conclusions: A Spot UPCR ≥ 35.5 mg/mmol in the early part of mid trimester with high sensitivity and specificity is an accurate, reliable and steady fast time saving test that can predict the development of preeclampsia in later part of pregnancy.

Background: The rapidly expanding field of psychopharmacotherapy is challenging the traditional concepts of psychiatric treatment and research and is constantly seeking new and improved drugs to treat psychiatric disorders.Methods: The present study was undertaken to analyse the pattern of drug utilization of antipsychotic medications in outdoor patients of psychiatry department of a tertiary care hospital. 600 prescriptions of 600 patients suffering from different psychiatric illnesses were taken for analyses in which antipsychotic agents were prescribed either as a main drug or as a concomitant agent after proper taking written informed consent.Results: A total of 1681 drugs were prescribed in our study population The average number of drugs prescribed per prescription in the study population was 2.61±1.32. Schizophrenia, bipolar disorder, depression were among the most common illnesses for which antipsychotics were prescribed. Atypical antipsychotics were most commonly prescribed in the study population out of which olanzapine was prescribed in most of the patients. Considering the cost analysis of the present study, the average cost per prescription was 475.02 INR. Average cost of antipsychotics per prescription was 208.1 INR.Conclusions: The present study provides valuable insight into the overall pattern of antipsychotic drugs prescribed in patients suffering from different psychiatric illnesses and mental health disorders and the principles of rational prescribing were followed in accordance with the various drug use indicators mentioned by WHO.

Serpiginous choroiditis is a rare recurrent eye disorder which is characterized by formation of irregularly shaped (serpiginous) lesions involving two layers of the eye surface (the retinal pigment epithelium and the choriocapillaris). It is a rare clinical entity which causes less than 5% of posterior uveitis cases (3.9/1, 00,000 person-years). Diagnosing this rare disorder is a challenge in itself followed by its complex pharmacotherapeutic approach which is seen in the following case report. It will aid in bringing to light the various challenges faced in treatment to open a window for early diagnosis and better treatment regimens while keeping in mind the constant motivation and relaxed mind a patient needs to fight such a rare disease.