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OBJECTIVE:To evaluate the efficacy and safety of ormeloxifene in the medical management of dysfunctional uterine bleeding. DESIGN AND SETTING: A descriptive observational study was conducted on women with dysfunctional uterine bleeding, who attended to out -patient department of Obstetrics & Gynaecology in a National Institute Of Medical Science Medical College, shobha nagar, Jaipur (Rajsthan). MATERIAL AND METHOD: 54 patients with dysfunctional uterine bleeding were recruited for the study. Ormeloxifene 60 mg twice a week for 3 months from first day of periods and once a week for next 3 months was given. Mean blood loss (MBL) was assessed using pictorial blood loss assessment chart (PBAC). And subjectively by a visual analog scale (VAS).Ultrasonography (USG) for endometrial thickness and blood hemoglobin levels were done as baseline and at 1, 3 and 6 months of treatment. Side-effects of the drug were recorded. Changes in PBAC scoring, endometrial thickness (ET) and hemoglobin levels (Hb) were analyzed by student's paired 't' tests using SPSS 17.0 version. p value ≤ 0.05 was taken as significant. RESULT: The mean pretreatment MBL (PBAC score) was 343.13 (140-765), which reduced to 222.22 (80-398) at 1 months and 90.0 (0-340) at 3 months with treatment.By end of 6 months, the mean PBAC score was 68.84 (0-320). There was a significant reduction in MBL in patients on ormeloxifene (p-value ≤ 0.001).The rise in haemoglobin and decrease in ET,in women on ormeloxifene was also satistically significant(p value

Background: Anemia is one of the common manageable problem among the pregnant women worldwide, which contributes to maternal and perinatal mortality. This study aims to compare the efficacy and safety of intravenous ferric carboxymaltose with intravenous iron sucrose in treating anemia during pregnancy. Objective of this study was to compare safety and efficacy of intravenous ferric carboxymaltose with intravenous ferric sucrose in iron deficiency anemia during pregnancy.Methods: It’s an interventional prospective study conducted in Department of Obstetrics and Gynecology at NIMS, Jaipur, Rajasthan, India constituting of 100 pregnant women. Group 1- 50 pregnant women were treated with intravenous ferric carboxymaltose and Group 2: 50 pregnant women were treated with intravenous iron sucrose. Hemoglobin and serum ferritin levels were measured pre and post treatment with parenteral iron therapy. The efficacy of intravenous ferric carboxymaltose in comparison to intravenous iron sucrose was assessed. The evaluation of safety and tolerance with the parenteral therapy was also performed.Results: Anemia during pregnancy was more prevalent among the reproductive age group and in multiparous women. The mean rise in the hemoglobin level with ferric carboxymaltose was 2.92 gm/dl and with that of iron, sucrose was 1.08 gm/dl. The man rise in the serum ferritin levels with ferric carboxymaltose was 64.97ng/ml and with iron sucrose was 31.64 ng/ml. Ferric carboxymaltose was observed to be safer with no adverse events in comparison to the Iron sucrose which was related with adverse events among 03 pregnant women.Conclusions: Intravenous ferric carboxymaltose was more efficacious and safer in comparison to intravenous iron sucrose among pregnant women. Hence, ferric carboxymaltose is the drug of choice in treatment of iron deficiency anemia during pregnancy.

Background: : The quest to improve diagnostic and therapeutic capabilities has led to the widespread acceptance of modern gynaecological endoscopy. Hysterolaparoscopy is a basic skill in the advanced scientific era and an effective and safe tool in comprehensive evaluation of infertility with an added advantage of treatment of some pathologies in same sitting. Methods: This clinical study is a prospective study of 100 selected cases of infertility. Patients who fulfills the inclusion and exclusion criteria were subjected to diagnostic laparoscopy and hysteroscopy in NIMS Infertility and Research centre, Jaipur over a period of one and half years from Jan 2014 -June 2015. Observation of pelvic and intrauterine cavity and chromopertubation test was done under general anaesthesia during hysterolaparoscopy. Surgical interventions were carried out whenever required and further treatment plan was decided. Results: A total of 100 women underwent hysterolaparoscopy. Age ranged from 21 to 40 years and mean age was 30.03 years. Prevalence of primary infertility was 64% and of secondary infertility was 36%. Among cases with primary infertility commonest pathology responsible were ovarian 20 (31.25%) followed by unexplained 19 (29.69%), uterine 11 (17.18%), tubal 8 (12.50%) and peritoneal 8 (12.50%) whereas in secondary infertility commonest pathology responsible were uterine 14 (38.88%), followed by tubal 13 (36.11%), peritoneal 9 (25%), ovarian 8 (22.22%) and unexplained being the least 2(5.55%). Therapeutic procedures were performed in the same sitting amongst 84.61% cases with primary infertility and 92% cases with secondary infertility.Conclusion: When done by experienced hands, with proper selection of patients, hysterolaparoscopy is an indispensable tool which can be considered as a definitive day care procedure for evaluation and treatment of female infertility.

AIM AND OBJECTIVES:To establish the prevalence and association of hypothyroidism in women affected with unexplained recurrent miscarriages. MATERIAL AND METHODS: This is an Observational case control study conducted in Obstetrics and Gynecology Department of NIMS Medical College and Hospital, Jaipur (Rajasthan); between July 2011 to June 2012.One hundred nonpregnant women with history of recurrent pregnancy losses were included in study group and one hundred non-pregnant women of similar age group with at least one successful pregnancy outcome were taken as control. All women who had known Thyroid disorder, diabetes, collagen and heart disease, were excluded from study. Detailed history, thorough physical examination was done and subjected to the quantitative estimation of triiodothyronine {T3}, Thyroxin {T4} and TSH hormone by CLIA method. RESULT: In the study 63% women experienced two or more pregnancy loss while 37% presented with three or more pregnancy losses. Total 7 patients were reported to have hypothyroidism out of which 3 were observed with subclinical hypothyroidism while 4 were detected overt hypothyroidism. In Control group 2 patient of subclinical hypothyroidism were detected. CONCLUSION: Prevalence of Hypothyroidism was 7 % and it has a statistically significant relationship with recurrent pregnancy losses in <20 weeks of gestation. Screening for thyroid dysfunction should be done early in pregnancy. Looking at the high percentage of abnormal TSH in pregnancies; universal screening should be considered as impaired thyroid function may predispose to miscarriage. KEY WORDS: Hypothyroidism, tri-iodothyronine{T3}, Thyroxin{T4} and TSH hormone, recurrent pregnancy losses. INTRODUCTION:Thyroid disorders are among the common endocrine disorders in pregnant women. It is now well established that not only overt hypothyroidism but also subclinical thyroid dysfunction can have adverse effects on fetal and maternal outcome. Maternal hypothyroidism during pregnancy raises serious concern about long-lasting psycho-neurologic consequences for the progeny, due to the risk of insufficient placental transfer of maternal thyroid hormones to the developing fetus during the first half of gestation. 1 The risk for miscarriage increased by 15% for each 1mlU/l elevation of the TSH level on the basis of logistic regression analysis. 2 During the last decade there has been an increasing appreciation of the incidence of thyroid dysfunction during pregnancy as well as the resultant adverse maternal and fetal effects. 3,4,5 In the hope that many of these adverse effects could be prevented or ameliorated by early detection and appropriate treatment the proposal to implement screening for thyroid function during pregnancy deserves consideration. To validate the need of antenatal screening for maternal thyroid dysfunction this study was undertaken to the prevalence of thyroid dysfunction among pregnant women in India. Recurrent pregnancy loss (RPL) is defined as three or more consecutive spontaneous pregnancy