A 20-year-old patient with 3 months of amenorrhea presented in the labor room with bleeding per vaginum and having experienced lower abdominal pain for 2 h. She had a history of difficult intercourse and prolonged menstrual flow. Inspection revealed a bleeding point over an obstructing membrane at the level of the vaginal introitus. Subsequent vaginal examination confirmed the diagnosis of microperforate hymen. Her urine pregnancy test was positive and an ultrasound examination revealed the presence of retained products of conception in the endometrial cavity. Hymenectomy was carried out to evacuate the retained products of conception and the margins of the hymen were sutured to prevent restenosis. The outcome was uneventful. This case study suggests that even though subocclusive hymenal anomalies, such as microperforate hymen, can interfere with normal vaginal intercourse, it does not lead to infertility and can permit pregnancy. Hence, awareness about this rare entity may lead to early detection and improvement in the patient's quality of life.

This study conclusively points out the beneficial effects of metformin in cases of PCOS in Asian women, both in the adolescent and the reproductive age. This mode of treatment is successful and has an etiological rationale behind its use. The additional benefits are a relatively low cost of therapy and diminished hazards associated with surgical intervention.

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Introduction: Gestational trophoblastic diseases (GTD) refers to a spectrum of pregnancy related trophoblastic abnormalities. The objective of this study was to determine the incidence of molar pregnancies in SCB Medical College & Hospital along with the demographics and risk factors associated and to evaluate its management and outcome.  Methods: The study was a prospective epidemiological study which includes fifty eight patients with gestational trophobastic diseases treated at the gynecological ward, S.C.B. Medical College & Hospital, Cuttack, Odisha during July 2015 to July 2017. Results: The incidence was 2.85 in 1000 deliveries in the institution. Most of the patients belonged to low socioeconomic status and in the age group of 21 to 30 years. Primigravida were more prone to the disease and no patients had history of molar in prior pregnancies. Most commonly encountered symptom was vaginal bleeding following a period of amenorrhea. Second trimester was the most common time of presentation with mean gestational age around 12 weeks. Out of 57 patients treated with suction and evacuation, 23 patients developed persistent trophoblastic disease who were further managed by methotrexate and folinic acid. Failure rate of single agent chemotherapy was 21.7% which were successfully managed by triple agent chemotherapy [EMA-CO regimen]. Conclusion: Incidence of molar pregnancies in this study was much higher as this hospital is the referral centre for South Eastern Odisha. However, proper reporting and follow up can prevent mortality associated with malignant transformation. Keywords: Beta hCG, Chemotherapy, Gestational trophoblastic disease, Hydatidiform mole, molar pregnancy

Background: Polycystic ovary syndrome (PCOS), a common endocrine disorder affecting 5%–10% of reproductive age women worldwide, associated with various metabolic morbidities. One potential molecular mechanism could be epigenetic modifications, such as deoxyribonucleic acid (DNA) methylation. Aims: The aim is to determine the association of global DNA methylation in peripheral blood leucocyte (PBL) cells and PCOS women. Also to assess abnormal lipid profile, insulin resistance, gonadotropins and reproductive markers in them. Settings and Design: The study design involves a hospital-based prospective case–control study. Materials and Methods: Fifty women with PCOS, diagnosed as per Rotterdam criteria and the rest 50 without PCOS or any disease, attending outpatient department were recruited. Serum biochemical markers and Global DNA methylation assay were done by using standardised kit. Statistical Analysis Used: Data were compared using Independent t-test or Mann–Whitney U test using IBM SPSS version 26.0. P < 0.05 was considered statistically significant. Results: Majority, 72% of PCOS and 82% non-PCOS women were between 20 and 25 years. Most common presenting symptom was menstrual irregularity. Women with PCOS have high serum cholesterol and triglyceride level, elevated serum luteinising hormone (LH), follicle-stimulating hormone (FSH), LH/FSH ratio and testosterone but low estradiol levels as compared to non-PCOS. Statistically significant high mean Global DNA methylation percentage was found in PBLs of women with PCOS. Conclusion: Despite study limitations, this study provided insight into Global DNA methylation in PBLs was associated with PCOS. It requires further research to better understand the influence of epigenetic factors including genome-wide DNA methylation profiling in PCOS development.