BACKGROUND: This study was planned with an aim to identify the nature and distribution of cranial lesions on magnetic resonance imaging (MRI) and its correlation with clinical and laboratory data in eclampsia and severe preeclampsia. MATERIAL AND METHODS: 40 patients admitted for indication of severe preeclampsia or eclampsia with or without neurological signs were first stabilized and then underwent cranial MRI. Following MRI they were divided into two groups; Group MP (n=24) including patients with positive finding on the cranial MRI and Group MN (n=16) which included patients with normal Cranial MR imaging. Nature and distribution of the lesions were documented and statistical comparison was made on the basis of clinical findings, arterial blood pressure and laboratory data in both the groups. Patient with cerebral changes in the MRI were also called back for repeat MRI postnatal after two 2 months. RESULTS: Out of the 40 patients who underwent cranial MRI 24 patients had cerebral changes (Group MP) whereas 16 patients had normal scan (Group MN). In 21 out of 24 (87.5%) MRI finding positive patients the finding was consistent with diagnosis of posterior reversible encephalopathy syndrome (PRES). The most commonly involved areas in patients with PRES were parietal (85.7%,), frontal (71.42%) and occipital lobe (71.42), followed by temporal lobe (38.09) and basal ganglia (33.33) and cerebellum. All the patients who were diagnosed with PRES had a normal MR scan on the follow up at two months after the initial presentation. There was a significantly greater incidence of seizures and neurological disturbances in patients with positive MRI findings as compared to patients with no MRI findings (p<0.001). There was no statistical difference between the blood pressure measurements of the two groups. Markers of endothelial dysfunction like Serum LDH (p=0.002) Serum creatinine (p=0.006) and abnormal red blood cell morphology (0.002) was significantly higher in patients with positive MRI findings compared to MRI Finding Negative group. CONCLUSION: Our study suggests that PRES is the core component of the pathogenesis of cerebral findings of eclampsia and development of PRES is associated with endothelial dysfunction and not elevated blood pressure alone.

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To evaluate the role of non-descent vaginal hysterectomy in advancing gynaecological practice and to study the safety and feasibility of performing vaginal hysterectomy for non-prolapsed uterus as primary route in benign gynaecological condition. METHODS: A prospective study of 120 cases was conducted at the department of obstetrics and gynaecology of PES institute of medical sciences and research from January 2012 to December 2014 120 patients planned for hysterectomy for a wide range of benign indications like fibroid uterus, AUB, adenomyosis were chosen for non-descent vaginal hysterectomy. Data regarding age, parity, uterine size, and estimated blood loss, length of operation, intra-operative and postoperative complications and hospital stay were recorded. RESULTS: A total of 120 cases were selected for non-descent vaginal hysterectomy. Among them 113(94.16%) cases successfully underwent non-descent vaginal hysterectomy. Majority were aged 40-45 years (53.33%) with 8 nullipara and 21primipara. Commonest indication was fibroid (58%) and largest uterine size was 16 weeks. Different morcellation techniques were used in more than 10weeks sized uterus. Adnexal surgeries were performed in 11 cases without much difficulty. In uncomplicated cases average blood loss was 200 ml and operating time was 60minutes. Most of the patients were discharged by 4 th post-operative day, 7 patients were converted to abdominal route due to various difficulties, 3 patients had bladder injury and 1 patient was subjected to laparotomy due to hemoperitoneum post operatively. CONCLUSION: Proper training and proper case selection can lead a gynecologist to consider the vaginal approach as the standard route for hysterectomy and good patient compliance