Cardiomyopathy is a group of diseases that affect the heart muscle. Dilated cardiomyopathy, a form of cardiomyopathy, is characterised by ventricular chamber enlargement and contractile dysfunction, and has recurrences in subsequent pregnancies. Pregnancy by itself is associated with significant hemodynamic burden and cardiovascular changes, which when coupled with dilated cardiomyopathy results in increased morbidity and mortality in both mother and child. Management of such a condition presents serious therapeutic challenge to a multidisciplinary team. Here, we report a case of a 36-year-old woman primigravida with gestational age of 11 weeks, known case of dilated cardiomyopathy. Despite the risks and associated complications with the disease, she continued her pregnancy. Patient was managed by a team of obstetrician, cardiologist and anaesthesiologist and underwent caesarean section giving birth to a live baby. The aim of this article is to provide guidance on how to manage a patient with dilated cardiomyopathy throughout her pregnancy. Early diagnosis of heart disease, regular antenatal check-ups, institutional delivery and multidisciplinary approach can reduce the maternal and perinatal morbidity and mortality.

According to the latest National Cancer Registry Programme (NCRP 2020) report, India had the highest incidence rate of cervical cancer (27.7 per 100,000) in Asia and also cervix uteri was the leading anatomical site of cancer in women population of Nagaland (16.4%). Lack of access to healthcare and awareness has led to the increased cases of cervical cancer, in particularly the resource-limited areas. A retrospective study involving 711 samples of cervical smears of women collected in the Department of Gynaecology were analysed between May 2019-May 2021 at CIHSR hospital. The objective of this study was to address this preventable cancer burden and also to determine a fraction of pap cervical smear finding through LBC in a secondary level hospital in Dimapur, Nagaland. 711 Pap smears using LBC technique were processed in the Department of Pathology of which 20 samples (2.81%) yielded unsatisfactory result or were rejected. Of the remaining 691 samples, 16.35% (113/691) had abnormal results. The Bethesda System (TBS-2014) for cervical cancer screening was used for classifying the categories, of which ASC-US was 48.67% (55/113), LSIL 7.96% (9/113), ASC-H 22.12% (25/113), High grade squamous intraepithelial lesion (HSIL) 17.69% (20/113), Squamous cell carcinoma 2.65% (3/113) and adenocarcinoma 0.88% (1/113). The chief complaints among women with abnormal cytology were pain in the lower abdomen (27.4%), white discharge per vaginum (22.1%) and bleeding per vaginum (15.0%). This study determines the first retrospective analysis of Pap smear finding through LBC in the state and highlights the deficiency of effective screening programme and testing facilities.

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Immune (idiopathic) thrombocytopenic purpura (ITP), an autoimmune disease characterized by destruction of platelets, is a hematological disorder that can present in both pregnant and non-pregnant patients. It can occur in any trimester but generally, platelet counts start to decline in early pregnancy and continue to decline until delivery. Unlike most pregnancy-related thrombocytopenia, which is usually mild, ITP can have devastating consequences for mother, fetus, and neonate. It is a diagnosis of exclusion, and management should be based on a multidisciplinary care approach. ITP in pregnancy requires careful monitoring and may need treatment to improve platelet counts before delivery. Corticosteroid is the most commonly used first-line therapy to stop further destruction of platelets. Here, we report a case of a 26-year-old multigravida with gestational age of 24 weeks, diagnosed with ITP during routine antenatal check-up. Patient was managed with various treatment combinations consisting of platelet transfusion, steroids and intravenous immunoglobulin (IVIG) to reach the optimal platelet level. The aim of the study was to provide guidance on how to manage a patient with ITP throughout pregnancy