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Aim:To determine the efficacy of levonorgestrel intrauterine system (LNG IUS) in treatment of abnormal uterine bleeding (AUB) in women over 35 years and to determine satisfaction of users of LNG IUS in case of AUB.Materials and Methods:This was a multicentric, retrospective, and observational study. Case records of patients with AUB from the hospitals in Pune, Delhi, and Gurgaon for the last 6 years were examined. Records of 80 women who had an LNG IUS inserted were included. The chief complaints and their duration were recorded. Investigation results, histopathology reports, and date of LNG IUS insertion were noted. The incidence of spotting, heavy menstrual bleeding, pain, expulsion, and amenorrhea were recorded at 3, 6, 12, and 18 months following treatment. Following this a telephonic interview was conducted to determine the efficacy of LNG IUS in treating the symptoms. Patients’ satisfaction in percentage was also noted and they were asked if they would recommend the LNG IUS to other women.Results:The mean age of women was 42.3 years. 77.5% of the women had menorrhagia as the chief complaint, and the mean duration was 12 months. Fibroids and adenomyosis were the most common pathology, present in 21.3% and 20% of the patients respectively. At 3 months, spotting seemed to be the predominant symptom (59.4%) and only 15% women had heavy bleeding. 49.3% of women were asymptomatic at 6 months. 27.5% had amenorrhea by the end of 18 months. 14 women in whom the device was expelled or removed due to persistent symptoms, underwent hysterectomy at various stages during the study period. Overall patient satisfaction was high at about 80%. Furthermore, 73.8% patients agreed to recommend it to other women.Conclusion:LNG IUS seems to be a viable and effective treatment option for AUB in women after 35 years. There is a high rate of patient satisfaction in appropriately selected patients.

Background Bone turnover is high during lactation. However, studies on bone status of Indian urban mothers are scarce. Hence, the objective was to conduct a crosssectional study on the lactation-related changes in bone health status of Indian mothers postpartum using Dual X-ray Absorptiometry (DXA) at 3 time points: within a week of delivery, at 1-and 3-years postpartum. We also explored the association of dietary calcium intake, physical activity, serum vitamin D status, and dietary traditional food supplements (Dietary Food supplements) with bone health. Methods A cross-sectional study was conducted; 300 full-term, healthy primiparous women (28.6 ± 3.4 year) were randomly selected and categorized into 3 groups: 128 mothers within 7 days of delivery (Group A), 88 with 1-year-old children (B), and 84 with 3-year-old children (C). Anthropometry, lactation history, physical activity, diet, biochemical tests (vitamin D, parathyroid hormone), body composition, areal bone mineral density (a-BMD) at total body (TB), AP spine (APS), and dual neck femur (DF) were assessed by DXA (GE-Lunar DPX). Results Significantly higher APS-BMD (mean ± SD) was observed in Group C (1.107 ± 0.098 g/cm 2 ) than that in A (1.045 ± 0.131 g/cm 2 ) (p \ 0.05). When adjusted for breastfeeding practices, mean (±standard error) APS-BMD was lowest in women in Group A (1.024 ± 0.013 g/cm 2 ),

BACKGROUND Overweight and obese women represent a significant and increasing problem encountered in obstetric practice. With most authors agreeing that overweight and obese women show increased maternal and perinatal morbidity. Controlled weight gain by various lifestyle changes has proved to be useful in decreasing maternal and foetal risks. We wanted to determine the change in gestational weight gain with lifestyle modifications and its effect on various maternal and foetal outcomes. METHODS A prospective observational study was done for 2 years with a total of 482 antenatal women after considering the inclusion and exclusion criteria. The study participants were divided into 2 groups-241 cases and 241 controls and were advised specific lifestyle modifications with thorough follow up in one group and routine advise without repeated follow ups in another. RESULTS Non-compliants and controls were found to have more gestational weight gain. Although the overall rate of developing GDM was found to be comparable in all 3 groups-compliant (13.1%), non-compliant (19.2%) and controls (14.1%), hypertensive disorders were found to be higher among non-compliants (24.7%) and controls (27.4%) as compared to compliant cases (11.3%). Rates of Inductions and post-partum complications were also comparable in all 3 groups. However, compliants showed higher rates of normal delivery while rates of Caesarean section were found to be higher among non-compliants and controls. In case of foetal outcomes, non-compliants and controls had more babies with birth weight >3.5 kg and greater NICU admissions. CONCLUSIONS Lifestyle modification has significant positive impact on foetomaternal outcome.