Genital tuberculosis is a frequent cause of chronic PID and infertility. Cervical TB is rare in postmenopausal women. We present a case of a post menopausal patient, who presented with a complaint of blood mixed discharge per vaginum for six months. Her preliminary investigations were consistent with that of HSIL/ High grade cervical dysplasia. Upon further evaluation, histopathological examination confirmed the possibility of tuberculosis instead. Key words: HSIL, Genital tuberculosis, Cervical biopsy.

Background: In developing and resource-limited countries alternative screening methods like VIA, VILI, and Pap smear are used in detection of premalignant and malignant lesions of cervix. The aim of our study was to compare the efficacies of VIA, VILI, and Pap smear in detection of premalignant and malignant lesions of cervix.Methods: The study was conducted for a period of one year in the department of obstetrics and gynaecology, Dr. Rajendra Prasad Government Medical College, Kangra at Tanda, Himachal Pradesh. Women who attended the outdoor patient department of obstetrics and gynecology were subjected to collection of Pap Smear, VIA followed by VILI and a thorough pelvic examination.Results: Among the 350 women studied, 59 women (16.9%) had abnormal VIA, 64 women (18.2%) had abnormal VILI. On pap smear, 10 women were reported as ASCUS, 11 as L-SIL and 1 as H-SIL. Cervical biopsy was done in 98 women, out of which 70 had one or more abnormality on VIA, VILI, or Pap, and 28 women who had normal results. Sixteen women (16.3%) reported as CIN-1 and 2 women (2.07%) as CIN-3. VIA and VILI had a higher sensitivity as compared to pap. However, pap was more specific. The PPV of pap was also much higher as compared to VIA and VILI, whereas there was no difference in NPV of the three.Conclusions: Authors observed that VIA presented the best sensitivity (88.8%), followed by VILI (83.3%), and Pap (72.2%). Pap smear had the highest specificity of 97.2%. The positive predictive value of Pap was higher as compared to VIA and VILI, whereas there was no difference in NPV of the three. VIA and VILI have good sensitivity, with reasonable specificity and because of their cost effectiveness and ease of availability, these can be an alternative screening modality for cervical cancer screening.

Background:  Rate of cesarean section (CS) is one of the most frequently used indicators of healthcare quality at the national and international levels for clinical governance.  Audit of indications of CS and to propose measures to reduce the rate of CS in our institution Methods: Prospective observational study was conducted at Department of Obstetrics and Gynaecology at Dr Rajendra Prasad Government Medical College Kangra at Tanda (HP) Results: In our study, previous CS (group 5) contributed the most (30.44%) of overall CS.Second largest contributor was nulliparous women with cephalic presentation at term (group 1 and 2).Induction of labor (group 2) was associated with higher CS (23.66%), as compare spontaneous labor (group1). Women with breech presentation (group 6 and 7) also showed high CS rate. Conclusion: In conclusion, RTGCS permits the easy identification of the leading contributing groups to CS increases. RTGCS is an internationally accepted classification that is much needed to scientifically study the effects of the rising CS rate. It identifies the contributors to differences in the CS rate but does not provide any explanation for these differences across various subgroups. Keywords: RTGCS, CS, NVD, Women.

Hyperemesis gravidarum might require hospitalisation in patients, and upto two-thirds of women with hyperemesis gravidarum have transient hyperthyroidism. We undertook a study of pregnant women admitted with no known cause of vomiting. These patients were subjected to tests for TSH, Total T4, and Total T3 hormones to establish hyperthyroidism, and the values of these tests were serially monitored. We studied pregnancy outcomes such as period of gestation, and weight at birth, Apgar score at three and five minutes, and maternal TSH values at birth. The Total T4, Total T3, and TSH levels had normalised by gestational age of 14-16 weeks, and TSH at birth was found to be normal. Birth weight showed only a small deviation. The results suggest that asymptomatic patients with TSH value indicating hyperthyroidism in the first trimester need no further revaluation. Key words: Hyperemesis gravidarum, pregnancy, hyperthyroidism.

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