Alterations of the lipid profile are a well known phenomenon in thyroid dysfunction. Thyroid hormones regulate lipid metabolism through various mechanisms, but a key role is played by the LDL receptor pathway. Thyroid hormone influence on Lipoprotein (a) (Lp[a]) metabolism is unknown; therefore we studied Lp(a) concentrations in a group of 29 hypothyroid patients with post-surgical hypothyroidism and in a group of 14 hyperthyroid subjects with Graves' disease before and after the thyroid function was normalized by treatment. In hypothyroid patients total and LDL-cholesterol markedly decreased after T4 treatment (342 +/- 78 mg/dl before and 193 +/- 46 mg/dl after; 225 +/- 72 mg/dl before, 111 +/- 43 mg/dl after respectively, p < 0.001). Also HDL-cholesterol and triglycerides decreased (from 75 +/- 22 mg/dl to 56 +/- 18 mg/dl and from 182 +/- 87 mg/dl to 112 +/- 42 mg/dl respectively, p < 0.001). Lp(a) showed minor but not significant variations (median values 80 mg/l before 55 mg/l after treatment, p: N.S.). In hyperthyroid patients total and LDL-cholesterol increased after methimazole treatment (from 148 +/- 49 mg/dl before to 254 +/- 67 mg/dl after and from 87 +/- 38 mg/dl before to 178 +/- 51 mg/dl after, p < 0.001). HDL-cholesterol increased (from 39 +/- 9 to 50 +/- 15, p < 0.01) while triglycerides were unchanged. Lp(a) levels slightly rose (median values 57 mg/l before 84 mg/l after treatment, p < 0.05). These data suggest that the influence of thyroid hormones on Lp(a) metabolism is of minor entity and probably does not operate through the LDL receptor pathway.

LLETZ is a simple, outpatient means of removing the transformation Zone or morbidity to the patient. The aim of our study was to evaluate the therapeutic effectiveness of LLETZ in management of cervical lesions. This prospective study was conducted at Department obstetrics & Gynecology Zenana Hospital, SMS Medical College, Jaipur from December 2014 to June 2015. The study includes all patients who attended colposcopy clinic with complaints of persistent leucorrhea, postcoital bleeding, intermenstrual bleeding and postmenopausal bleeding. We had 29 cases of chronic endocervicitis, 27 showed an inflammatory smear while 2 showed LGSIL. 3 patients showing HGSIL on pap smear showed CIN -I on histopathology. This was false positive of Pap smear (6%). 1 patient of invasive squamous cell carcinoma showed HGSIL on pap smear. Thus LEEP was useful in diagnosing a case of invasive carcinoma which would have been missed with Pap smear alone. Also 3 patients of CIN -II on biopsy had inflammatory (1) and LGSIL (2) on pap smear. LEEP (Loop Electrosurgical Excision Procedure) is a feasible management strategy for cervical lesions especially in developing countries like India where incidence of cervical carcinoma remains high because of ineffective screening and poor patient compliance for follow up.

Objective: To identify and evaluate the Predictive symptoms of ovarian tumours so that diagnosis can be made at early stage. Methods: This study was conducted on 100 patients admitted in Department of Obstetrics and Gynaecology in Zenana Hospital who were diagnosed with ovarian tumour clinically, ultrasonographically and histopathologically. A detailed history was taken and patients surveyed about their age, menopausal status and type of ovarian tumour by histopathological report. Results: In our study abdominal bloating was present in 74% of cases, abdominal pain present in 45% of cases; abdominal lump/swelling present in 66% of cases; bleeding per vaginum present in 8% of cases; fatigue present in 58% of cases; altered bowl habits present in 14% cases; urinary complaints present in 15% cases and others (backache) present in 8% of cases. Duration of symptoms before seeking medical attention 40% had symptoms for 3-6 months; 28% 1-3 months; 16% < 1 month; 15% 6-12 months and 1 case > 1 year. On final diagnosis with histopathological report 69 were malignant ovarian tumours, 29 were benign ovarian tumours and 2 were borderline tumours. Frequency of symptoms per month was more in malignant group. Conclusion: Ovarian cancer is not a silent killer. As no screening test exists for ovarian cancer so the frequency and number of such symptoms are key factors in diagnosis of ovarian cancer even at early stage to decrease morbidity and mortality associated with ovarian tumours.

Hemangiopericytoma (HPC) is a rare tumor that arises from the pericytes of Zimmermann. HPCs have a characteristic clinical feature the rate of recurrence which is as high as 52% of cases mostly in the lungs, liver, and regional lymph nodes and which necessitates long-term follow-up after resection of the primary tumor. Complete surgical removal is the treatment of choice for primary tumor local recurrence and solitary metastasis. The liver is an unusual location to the primary HPC but has been described as one of the most common site of distal metastases besides the bones and lungs. We present a case of a 55 year old man who was known case of an isolated omental HPC treated with excision of the omental mass 6 year back which recurred solely to the liver. The tumor occupied almost the entire left lobe with 9 x 7x 8 cm of diameter. The patient was submitted to uneventful uncomplicated left hepatectomy. In cases of inoperable recurrence or metastasis palliative chemotherapy is indicated though there is currently no approved chemotherapy regimen. Even though HPC is a well known neoplasm its incidence is very low. This article describes a case and addresses questions regarding diagnosis prognosis and treatment of this rare event.

INTRODUCTIONInfertility is defined as one year of unprotected intercourse without conception during child bearing age affecting approximately 7.4% of the population. Intrauterine insemination (IUI) with husband's semen has been widely used as a low cost first line assisted reproductive therapeutic option for infertile couples. A newer modified form of IUI called intrauterine tuboperitoneal insemination (IUTPI) has been developed for infertile patients using 10ml of the inseminate instead of 0.5ml used in IUI. This procedure is made possible by a specially designed instrument, the Double Nut Bivalve speculum (DNB) which clamps the cervix tightly during the procedure preventing back flow of the inseminate. The objective of our study was to compare the clinical pregnancy rate of IUTPI and IUI in the treatment of infertile patients.1,2 ABSTRACT Background: Infertility management has become more substantial and relevant with an increase in the number of infertile patients as well as advances in the science of reproduction. The objective of our study was to assess the role of intrauterine tuboperitoneal insemination (IUTPI) and intrauterine insemination (IUI) in the treatment of infertile patients. Methods: 236 infertile patients, 118 in each group attending the infertility clinic, after applying both inclusion and exclusion criteria were enrolled in the present study. Patients in each study group were given clomiphene citrate for ovarian stimulation followed by injection hCG for triggering ovulation. Insemination with washed husband's sperm was performed about 36-40 hours after hCG administration, using 10ml of inseminate in IUTPI and 0.5ml inseminate in IUI. The patient was then called after 2 weeks for urine pregnancy test (UPT) which, if positive was considered as clinical pregnancy. Results: Out of the total 236 cases, 42 cases had a positive outcome. Out of these 42 positive cases, 27 were from IUTPI group whereas 15 from IUI group. The pregnancy rate was 22.88% in IUTPI and 12.71% in IUI (p=0.039), which was a statistically significant difference. Endometrial thickness, preovulatory follicle number and prewash sperm motility significantly affected positive outcome in IUTPI. Factors like patient's age, BMI<25, bilateral patent tubes and decreased duration of infertility also positively affected the treatment outcome. Conclusions: Our study found IUTPI to have better pregnancy rate compared to IUI. IUTPI may become a first line option for treatment of infertile patients.