Objective Levonorgestrel-releasing intrauterine system (LNG-IUS) has been shown to be an effective treatment for patients with abnormal uterine bleeding (AUB) in many Western studies. The purpose of study was to examine the effectiveness of LNG-IUS in the treatment of Indian women with AUB.Methods We conducted a retrospective observational study of 70 women diagnosed with AUB and treated with LNG-IUS insertion between February 2010 and 2014 at the Department of Gynecology of Sree Narayana Institute of Medical Sciences. Baseline endometrial biopsies were done before insertion of LNG-IUS, and outpatient followup with symptom diary was undertaken at 3-month intervals after insertion of LNG-IUS. Results Primary outcome in the two treatment groups was significantly greater among women assigned to levonorgestrel-IUS than among those assigned to usual treatment (mean difference in scores over the course of 1 year 13.4 points; 95 % confidence interval [CI] 9.9-16.9; P \ 0.001). All six domains of the MMAS favored the levonorgestrel-IUS at every time point (P \ 0.001) with the use of a test for trend. Conclusion In conclusion, our study showed that both the levonorgestrel-IUS and usual medical treatments reduced 123 the adverse effect of menorrhagia on women's lives over the course of 2 years, but the levonorgestrel-IUS was the more effective first choice, as assessed by the impact of bleeding on the women's quality of life.

Background: Early detection of cervical cancer is possible with Pap smear tests. The proportion of women who undergo Pap smear testing ranges from 68% to 84% in developed countries as compared to India where the rates range from 2.6% to 6.9% among women in communities. This study is to assess the knowledge of women about cervical cancer, its screening, role of doctor and source of information.Methods: Cross-sectional study – observational study of Women attending gynecology camps/op clinics held in rural areas of Ernakulam and Thrissur who are between 25 and 65 years of age Non-random sampling with Sequential inclusion of the women who met the study criteria. A questionnaire devised collecting Basic sociodemographic profile like age, parity, educational qualification, Questions to assess knowledge about symptoms of cervical cancer Questions to assess the knowledge about cervical cancer screening and prevention doctor as Source of knowledge from the subjects. Correct response for questions carried score of 1 mark. So, the maximum was 6 and minimum was 0. The knowledge was graded as: <2 being poor knowledge; 2-5 being satisfactory knowledge and ≥5 being good knowledge.Results: 32.9% of women identified discharge per vaginum as the most common symptom. When 50.9% thought multiparity was a risk factor 30% identified early sexual activity. 2.3% women knew that pas smear screening has to be done repeatedly. 8.3% of participants already had screening done. Only 8.3%of doctors advised pap screening during their consultations. Uptake of pap smear after awareness program was 100%.Conclusions: Awareness classes are needed for increasing the coverage for pap smear screening. The women should be educated about cervical cancer, its screening methods and the facilities available for screening in the hospitals. An Information Leaflet has to be provided to these women in the local language. Training programs should be conducted for general practitioners and gynecologists to conduct awareness classes for the public and also to motivate women to undergo screening at every possible opportunity.

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A 58-year-old postmenopausal woman presented with mass prolapsing per vagina hematochezia, tenesmus, constipation and loss of appetite of six months duration. On general examination patient was thin built with pallor. Abdominal examination was unremarkable. Speculum examination showed second degree uterovaginal prolapse, cystocele and rectocele. Vaginal examination showed uterus atrophic retroverted and fornices free. Recto vaginal examination showed mass in rectum/rectovaginal septum with atrophic perineal body per rectal examination revealed a soft swelling in the anterior wall of rectum measuring approximately 3x3 cm, 6 cm above the anal verge, with smooth surface and the overlying mucosa was free. She underwent colonoscopy which showed a submucous mass in the rectum of size 3 cm x 3 cm at about 6 cm from the anal verge. Contrast enhanced CT scan of the abdomen revealed rectal submucosal soft tissue mass suggestive of lipoma of size 3 cm x 3 cm (Figure 1). She underwent vaginal hysterectomy with pelvic floor repair. This was followed by transanal delivery of the rectal lipoma (Figure 2).Overlying mucosa was incised and lipoma was excised. The macroscopic appearance was suggestive of lipoma. Histological examination confirmed the diagnosis of lipoma.