The study was conducted to assess the effect of ambulation and birthing ball on the maternal and newborn outcome from 01.08.2011 to 31.10.2011. This randomized control study was conducted on 60 primigravida mothers. Purposive sampling technique was used for the selection of samples followed by random allocation of 20 samples each to the three groups namely, ambulation, birthing ball and control group respectively using lottery method. Ambulation and birthing ball therapy were given to the respective samples between cervical dilatation of 1-3cm during first stage of labour, whereas the control group was not given any intervention. Here maternal outcome st nd includes1 stage duration (Area1), 2 stage duration (Area2), cervical dilatation rate (Area3), and type of delivery(Area4) and newborn outcome includes heart rate, respiratory rate, colour, reflex and muscle tone. Since the t calculated value in Area 1 (5.257), Area 2 (2.781), Area 3(5.438) is greater than t table value (2.042) and in Area 4, 75% of ambulation group underwent normal vaginal delivery, it shows that there is significant improvement in maternal outcome after the use of ambulation. The t calculated value in Area 1(7.223), Area 2 (5.556), Area 3(6.178) is greater than t table value (2.030) and in Area 4, 95% of birthing ball group underwent normal vaginal delivery. It shows that there is significant improvement in maternal outcome after the use of birthing ball therapy. Comparison of ambulation and birthing ball therapy on maternal outcome showed that, there is significant difference in second stage duration (t tab 2.031(df=36)< t cal 2.231= S) and type of delivery. In this study ambulation and birthing ball were found to be effective to improve maternal outcome and there was no harm to the baby. Both the experimental group mothers expressed that they were satisfied and comfortable.

We report a case of post operative repeated wound infection due to Mycobacterium Tuberculosis. A 25 yr old woman presented to us with watery discharge from Caesarean section wound, done elsewhere 3 months ago. Discharge from the wound showed Acid fast bacilli on Ziehl Neelsen stain, and Histopathology report confirmed tubercular infection. Patient was treated with standard anti tubercular drugs, and is responding well to treatment. A high degree of suspicion is required for exact identification of unusual pathogens in cases of recurrent postoperative wound infection.

Granulosa cell tumour of the ovary is rare neoplasm. They belong to the group of ovarian sex-cord stromal tumour. It represents less than 2% of all ovarian tumour, but account for 6% of all ovarian malignancy. (1) The prognosis of Juvenile Granulosa cell tumours is excellent tumour recurrence and metastasis is rare, where as Adult are low-grade indolent malignant neoplasm, that display a significant propensity for recurrence and metastasis and can complicate management. KEY WORDS: Granulosa cell tumour, sex-cord tumour, Call-Exner bodies INTRODUCTION:The spectrum of ovarian neoplasm covers an extremely wide range of tumours. The best recognised of these are epithelial cell tumour , and Granulosa cell tumour is the less common variant and it accounts for 70% of all sex-cord tumour. (2 ) Based on histopathology findings two histological types of granulosa cell tumours can be distinguished Juvenile and Adult type. The adult type of granulosa cell tumour is more common (95%) then the juvenile type and usually causes symptoms that are related to excessive estrogen production, such as vaginal bleeding, endometrial hyperplasia and carcinoma. Here we report a case of huge granulosa cell tumour of ovary in a postmenopausal woman.