Aims and objectives:To classify the cesarean section (CS) in different groups of Robson's ten-group classification system (TGCS) and comparing the rate and relative size of groups with that of previous year at the tertiary hospital. . The data collected included parity, mode of previous delivery, gestational age, onset of labor-spontaneous or induced, delivery notes of labor ward, and operative notes of CS. This data was then applied to the Robson's TGCS for the year 2014 and compared with that of 2013. Results:The total deliveries during 2014 were 12,930 and in 2013 were 15,182. The number of CSs during 2014 was 3,793 and in 2013 it was 3,917. Cesarean section rate in 2014 was 29.33% while in 2013 it was 25.8%.The CS rate has come down to half in group I (nulliparous, single, cephalic ≥ 37 weeks, in spontaneous labor) and to onefourth in group III [multiparous (excluding previous CS) single, cephalic ≥ 37 weeks, in spontaneous labor] in 2014. Conclusion:Robson's TGCS is easy to classify. Clinical significance:The study showed reduction in CS rate by half in group I and by one-third in group III in 2014 in our institution. This was probably due to the increased awareness among the staff of the institute by the previous year study about higher CS rate.

Angiomyofibroblastoma (AMF) is a rare benign soft-tissue tumor that most frequently affects the lower genital tract of young to middle-aged women. It mainly consists of two components: stromal cells and prominent vasculature. Clinically, it is usually asymptomatic and resembles Bartholin's cyst. Although it is a benign tumor, cases with recurrence and sarcomatous transformation have been reported. Due to the overlapping of histopathological picture, diagnostic perplexity often arises between AMF and aggressive angiomyxoma (AAM). AMF being benign in nature is treated by local excision, whereas AAM is a more infiltrative lesion that has a higher tendency for local recurrence.

Background: Neonatal sepsis is one of the leading causes of mortality in developing countries because of its non-specific presentation. Blood culture is the gold standard for diagnosing sepsis, but culture results take 48 – 72 hours. Therefore, there is a need for an indicator that could be used as a simple parameter to indicate the possibility of evolving sepsis to the clinician. The efficacy of mean neutrophil volume as an indicator must be evaluated. Materials and methods: The study aims to evaluate the utility of the mean neutrophil volume in the early diagnosis of neonatal sepsis. Following ethical clearance, the study involved analyzing mean neutrophil volume from peripheral smears of 50 newborns clinically diagnosed with neonatal sepsis. The control group included mean neutrophil volume findings from peripheral smears of normal newborns. Maternal or fetal factors like pregnancy-induced hypertension and birth asphyxia that could cause changes in neutrophils were excluded. The mean neutrophil value was calculated after establishing the mean diameter of 100 neutrophils per case using the National Institutes of Health Image J software. Results: The average mean neutrophil volume was found to be significantly increased in the sepsis group (181x104fl) than in the control group (739x103fl). A statistically significant difference (p= < 0.0001) in the mean neutrophil volume was observed. Conclusions: Mean neutrophil volume is a potential indicator to distinguish neonates with and without sepsis and help clinicians in the early diagnosis and management of sepsis.

The hymen is a thin fold of mucous membrane; partially closing the external vaginal opening.1It is composed mainly of elastic, collagenous connective tissue and covered on its both surfaces by stratified squamous epithelium. At pregnancy, the epithelium of hymen becomes very thick and rich in glycogen, which may lead to spontaneous closure. We aim to report a rare case of spontaneous closure of hymen in a 23-year old primigravida in labour with no prior history of menstrual problems or problems during intercourse. Two conditions can cause the secondary closure of the hymen: following previous scarring and in pregnancy. In pregnancy, it could be spontaneous closure due to increase glycogen content of the hymen or due to extensive scarring as seen in previous hymenal surgeries. Spontaneous closure of hymen during pregnancy though very rare can occur. Along with extensive scarring, prolonged abstinence and oestrogenic effect on hymen, gonococcal infection can also cause sponatenous closure of hymen during pregnancy.

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