:Objectives: Various diagnostic techniques have been evolved over the periods to determine the etiology of abnormal uterine bleeding in peri-menopausal women, but their accuracy has not been compared properly. In this study diagnostic accuracy of trans-vaginal sonography (TVS), saline infusion sonography (SIS) and dilatation & curettage (D & C) were compared with hysteroscopic guided biopsy to determine the etiology. Methods: In this study, 252 patients had to undergo trans-vaginal sonography and saline infusion sonography in the same sitting followed by hysteroscopic-guided biopsy and dilatation and curettage. All the materials were sent for histopathological examination. Results: In determining uterine pathology, positive likelihood ratio (PLR) of TVS, SIS and D & C are 2.81, 7.5 and 3.81 respectively considering hysteroscopy as standard. Conclusion: Sensitivity of SIS as a test for detecting pathology in abnormal uterine bleeding (AUB) is high and can be easily performed on out patient basis. D&C has a very low sensitivity and is unacceptable as a screening test for the same conditions.

Objective: To study the difference in causes of maternal deaths at two tertiary centers one being rural and the other urban. Methods: A five years retrospective study from January 2001 to December 2005. Results: The maternal mortality ratio has decreased at Eden (6.09 to 2.81/1000 live births) and risen at Bankura (2.68 to 4.18/1000 live births) over the last five years. Most of the deaths were in the age group of 21-30 (65.48% and 60.62%) and unbooked (81.14% and 67.71%) at Eden and Bankura respectively. Greater number of deaths were noted in early puerperium (68.58% vs. 37.79%) and in multigravidas (71.68% vs. 50.78%) at Eden. Sepsis (30.70%) and jaundice (30.08%) were the major causes of death at Bankura and Eden respectively. Death due to toxaemia has gradually decreased. Conclusion: Majority of the deaths are preventable by proper antenatal care, counseling and asepsis practice. Antenatal care and EmOC are complementary to each other in reducing maternal mortality.

The present paper reports a case of human vaginal myiasis in a 22 year old woman. This is the first report of this fly species to cause vaginal myiasis in human till now. The infested maggots were removed from the vagina and cultured in laboratory. Entomological studies on the emerged flies showed that the infested larvae were Oriental latrine fly Chrysomya megacephala Fabricius. Clinical presentation and treatment strategies are discussed also.

No abstract