Mucocutaneous findings in 150 HIV+ve cases (F, 79; M, 71) were evaluated over a one-year period. Mucocutaneous manifestations were seen in 96% with 2.9 mean number of dermatoses and mean cluster of differentiation (CD4) count of 196.33 cells/mm(3). The highest number of mean dermatoses, 3.29, was seen in individuals with severe immunosuppression. The most common mucocutaneous manifestation seen was candidiasis (35.33%), followed by seborrhoeic dermatitis (31.33%), oral pigmentation (29.33%), xerosis/ichthyosis (22.67%), pyodermas (22%), periodontitis (17.33%) and nail pigmentation (16.67%). Patient stratification according to the WHO immunological staging, according to CD4 counts, showed a statistically significant association (P < 0.05) for candidiasis, scabies, paronychia, oral pigmentation and diffuse hair loss. Nail and oral pigmentary changes, trichomegaly and subcutaneous fungal infections caused by dermatophytes were highlights of the study. Incidences of xerosis/ichthyosis, pyodermas, scabies and molluscum contagiosum reported in our study were higher and pruritic popular eruptions was lower than those in previous Indian studies. Cutaneous neoplasms were not seen in the present study.

No abstract

Background: All women with postmenopausal uterine bleeding mandate examination for endometrial diseases especially endometrial carcinoma. In current scenario, hysteroscopy has replaced traditional Dilatation and Curettage as diagnostic procedure of choice. However, office endometrial sampling with pipelle combined with vaginal ultrasonography being easier and less expensive is recommended. Aim and objectives of the study was to evaluate the combined use of vaginal ultrasonography and office endometrial sampling for the diagnosis of endometrial disease in postmenopausal women with uterine bleeding.Methods: One hundred consecutive postmenopausal women presenting with uterine bleeding were enrolled in the study. Vaginal ultrasonography was used to measure the endometrial thickness. Endometrial sampling was done using endometrial biopsy pipelle, as office procedure, in the OPD examination room. The sample was sent for Histopathological Examination (HPE), The accuracy of vaginal ultrasound and pipelle was measured.Results: In 21% patients, endometrial carcinoma was found, endometrial hyperplasia in 26%, atrophic endometrium in 18%, endometrial polyp in 10% and no specific pathology in 20%. Endometrial thickness measured by Transvaginal ultrasound ranged from 1mm to 28mm with mean of 10.16mm and median of 11.5mm. The mean endometrial thickness in subgroup without disease was 5.26±3.8mm, with benign disease 12.8±3.1mm and in carcinoma 16.97±5.6mm. All cases with carcinoma had endometrial thickness exceeding 5mm (range 5.7mm to 28mm).Conclusions: The study illustrates that by combined use of Trans Vaginal Sonography (TVS) and office endometrial sampling, sufficient diagnostic information was obtained for women with postmenopausal bleeding, obviating the need for more invasive diagnostic procedures.

Incidence of subclinical hypothyroidism and overt hypothyroidism in pregnant patients have been reported as 0.25-2.5% and 0.2-0.3 % respectively. In North India prevalence of subclinical and overt hypothyroidism in pregnant population has been reported as 13.5% and 0.25 % respectively. Medical termination of pregnancy by mifepristone and misoprostol is increasingly being used. We do not know the efficacy of this method in hypothyroidism.

Hypertensive disorders have a 5-10% incidence in pregnancy and are associated with considerable perinatal morbidity and mortality. It has been hypothesized that, the earliest pathology starts with the impaired conversion of spiral arteries to uteroplacental arteries. The problem starts in uterine circulation and is eventually reflected in the cerebral circulation. Increased blood supply to foetal brain is one of the compensatory mechanisms in cases of decreased placental blood flow. Brain sparing is maximum 2-3 weeks before late decelarations appear on CTG. Hence, patients with high risk of unfavourable outcomes can be identified 2-3 weeks earlier and early intervention may be done. Cerebro-uterine ratio which is the ratio of pulsatility index of Middle cerebral artery and mean pulsatility indices of bilateral uterine arteries decreases with gestational age. A value less than 5 th percentile for a gestational age, particularly in third trimester of pregnancy is a marker for poor perinatal outcome. There were 65% patients with preeclampsia, and the rest were diagnosed with gestational hypertension. The relationship between CUR and birth weight statistically significant with a p value of 0.04. The relationship between CUR and still birth and that with low APGAR score at 5 minutes of life was also significant with a p-value of 0.01 and 0.009 respectively. It was also found that among the 13 neonatal mortalities in our study group, 69.2% had a Cerebro-uterine ratio of less than 5 th percentile for their gestational age at delivery. The p-value was 0.009. Cerebro-uterine ratio has a high sensitivity for predicting neonatal mortality (69.2%) and for predicting low APGAR score at 5 minutes of life. The specificity was highest for the prediction of NICU admissions for more than 2 days (87.7%). Hence, cerebro-uterine ratio can be a good tool in deciding mode and time of termination of hypertensive pregnancies and for appropriate preparation for management of possible neonatal complications.