Background: Postmenopausal bleeding (PMB)accounts for 5% of gynecology visit. All with unexpected uterine bleeding should be evaluated for endometrial carcinoma since this potentially lethal disease is the cause of bleeding in approximately 10 percent patients (range 1 to 25 percent, depending upon risk factors). The aim of the study was to evaluate endometrial causes of postmenopausal bleeding (PMB) with it's correlation with endometrial thickness (ET)and hysteroscopy findings and endometrial tissue histopathology.Methods: A total 50 consecutive cases of PMB fulfilling the inclusion and exclusion criteria and giving informed consent were selected. Each patient was subjected to transvaginal sonography (TVS) in which uterus, adnexa and endometrial thickness (ET) was assessed. Then hysteroscopy and/or dilation and curettage was scheduled at subsequent visit. Endometrial sample was sent for histopathological examination. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and diagnostic accuracy was calculated for ET by TVS and hysteroscopy findings, considering histopathological diagnosis as the gold standard.Results: Most common endometrial cause of PMB was atrophic endometrium (44%). The other causes were endometrial carcinoma (18%), endometrial hyperplasia (18%), endometrial polyp (12%), endometritis (4%), and leiomyoma (4%). The diagnostic accuracy of ET by TVS at a cut-off point of 5 mm was 94% with sensitivity 89.3%, specificity 100%, PPV 100% and NPV 88%. The diagnostic accuracy of hysteroscopy was 98% with sensitivity 96.4%, specificity 100%, PPV 100% and NPV 95.7%.Conclusions: Being relatively cheap, easily accessible, non-invasive, TVS with ET measurement should first line investigation in the evaluation of women with postmenopausal bleeding with suspected endometrial pathology. Although hysteroscopy is more specific and sensitive, in poor resource settings it should be limited to cases with ill-defined endometrial lining, recurrent/ persistent bleeding and cases with endometrial thickness greater than 5 mm irrespective of endometrial echotexture.

Introduction:Osteoporosis amongst post-menopausal females is regarded as a important public health matter associated with significant socioeconomic burden and morbidity. It is generally divided into primary type and secondary type depending upon its underlying causation. The present study was conducted with the aim to determine the risk factors of osteoporosis amongst postmenopausal women reporting to the Hospital. Material and methods:The present cross sectional survey was conducted amongst 270 post-menopausal females reporting to the Hospital for a period of 1 year. It was a multiple choice questionnaire in which the subjects were made to select the most related terms. The variables in the questionnaire had information regarding exercise, family history, alcohol and smoking history etc. Student t test was used for the purpose of comparison. Probability value of less than 0.05 was considered significant.Results: The present study was conducted using 270 subjects. The mean age of the study subjects was 59.76+/-9.82 years and the mean duration of menopause was 8.96+/-6.21 years. There were 20.7% subjects with osteoporosis, 27.3% with osteopenia and 30% normal subjects indulged in regular exercise. There were only 0.9% subjects with osteopenia that had a habit of smoking Conclusion: Osteoporosis is increasing at an alarming rate amongst post menopausal women. The prime reason behind it is the diagnosis at later stage and very subjects are aware about it.

BACKGROUND To increase the incidence of safe and legalised abortions, it is important to know the clients. This study is a 6 years research of the records of MTP performed at the public hospital attached to a medical college, to know the trend, socio-demographic and obstetric status of the women undergoing MTP. The objectives of the study were to find trend, sociodemographic factors, obstetric status and complications of MTPs. MATERIALS AND METHODS A study of the records of all the MTP operations performed at the gynaecology department of the hospital from 2010 to 2016. Data analysis was done on MS excel. RESULTS Most women who underwent MTP were young, sexually active women and had completed 2 child family. Along with MTP, younger women preferred IUCD and elder women preferred Tubal Ligation as contraception. There is an overall gradual increase in the incidence of MTPs conducted which could be attributed to increase in population of the city and nearby areas. CONCLUSION In this study, most of the women preferred MTP after 2 nd Pregnancy and at the age of 21-35 years. Most women accepted permanent method of sterilization after MTP shows that women had completed family by the age of 30 years and had no access to effective contraceptive services. MTPs thus seems to be used as an emergency treatment for failed contraception. This trend should be discouraged but at the same time safe abortion should be legalised to safeguard the health of the women.

Background: Entanglement of the umbilical cord around the foetal neck (nuchal cord) is a common finding at delivery, but its clinical relevance is not entirely clear. Nuchal cords have generally been considered to be rather benign. However, the insufficiency in data regarding the role of nuchal cord in foetal morbidity and mortality is a source of anxiety and frustration to both parturient and healthcare professionals. Considering the above facts the present study was taken up to establish the incidence of nuchal cord at delivery in the existing setup.Methods: This was a cross sectional comparative study conducted over a period of one year from May 2013 to April 2014. A total of 362 women were selected for the study. These women were briefed about the nature of the study and a written informed consent was obtained. The demographic data and obstetrical history were documented on predesigned proforma. The data obtained was analysed using percentages and comparison done using chi-square test for discrete variables.Results: Incidence of Nuchal Cord was 17.7% among study cases. Based on this study gestational age may have an effect on the presence of nuchal cord (p<0.05). Out of 64 cases with nuchal cord’, 11.4% of cases had meconium stained liquor present. 9.8% of cases with nuchal cord had FHR irregularity, which was significantly less as compared to 20.0% of cases who did not show FHR irregularity. This was statistically significant. (p=0.032). 18.7% of mother who showed presence of nuchal cord had delivery by caesarean section. 22.7% of cases with nuchal cord had NICU admissions, which was insignificantly more as compared to 17.0% of cases who did not have NICU admissions.Conclusions: Intrapartum events such as meconium staining of liquor and foetal heart rate irregularities were more commonly associated with nuchal cord but it did not affect the perinatal outcome. However, the mode of delivery was independent of the presence of nuchal cord, thereby reducing the morbidity to the mother. Hence nuchal cord is not associated with adverse perinatal outcomes and the presence of a nuchal cord per se is not found to be an indication of operative delivery.

Background: Thrombocytopenia is second most common hematological abnormality in pregnancy after anemia (Incidence 8-10%). The aim of this study is to observe the obstetric and neonatal outcomes of pregnancies complicated with thrombocytopenia and to compare its maternal and fetal outcomes.Methods: The prospective observational study was conducted at tertiary care institute over period of one and half year and 100 cases of thrombocytopenia in present pregnancy were included after fulfilling inclusion and exclusion criteria and obtaining written informed valid consent. Complete history, physical examination and relevant investigations of the patient were documented. Patients were followed up to delivery and outcomes (obstetric, maternal, fetal, neonatal) were studied. The data obtained for all the patients was analyzed with SPSS (SPSS Inc, Chicago) software packages. Statistical comparisons were performed with Pearson’s Chi- square where appropriate with p-value of <0.05 considered statistically significant.Results: Most common cause of thrombocytopenia in pregnancy was gestational thrombocytopenia in (25%) cases followed by preeclampsia (20%). Most cases (94%) were diagnosed in antepartum period out of which most (58%) at >37 weeks of gestation. Most (53%) had moderate thrombocytopenia. Incidence of maternal complications was statically significant (P-value 0.038) with most common complication being caesarian section site oozing (9%) followed by placental abruption (4%). There was no statistical significance in degree of thrombocytopenia and need for blood and blood product transfusion (P-value 0.67). Only (2%) neonates of thrombocytopenic mothers had thrombocytopenia and both required treatment.Conclusions: Most common cause of thrombocytopenia in pregnancy was gestational thrombocytopenia with uneventful pregnancy and perinatal outcomes. Few severe cases associated with medical or systematic causes leads to serious catastrophic events which can be avoided by increasing antenatal surveillance and appropriate management by multidisciplinary team of obstetrician, hematologist, anesthesiologist, neonatologist and physician.