CONTEXT/BACKGROUNDAdolescence, meaning "To grow up," is a transitional stage of physical, sexual and mental human development occurring between puberty and legal adulthood. The Government of India in National Youth Policy defines adolescents as individuals between 13 to 19 yrs. of age. AIMSTo study the magnitude of different adolescent gynecological problems in patients attending OPD of GRMC, Gwalior, MP. SETTINGS AND DESIGNProspective study in patients attending gynecological OPD of GRMC, Gwalior, MP. SAMPLE SIZE: 75 METHODS AND MATERIALSSeventy five adolescent girls in the age group of 13-19 yrs. attending gynecological OPD of GRMC, Gwalior, from November 2013 to October 2014 were included in the study. Detailed history, general examinations and investigations were done to evaluate their health. STATISTICAL ANALYSISWas done using Microsoft Excel. RESULTSIncidence of gynecological problem in our study was 3.33%. Different gynecological problems were menstrual disorders (60%), leucorrhoea (10.66%), infections (8%), ovarian cyst (5.33%), sexual assault (2.66%), teenage pregnancy (10.66%) and infertility (2.66%). Majority of girls with menstrual disorders suffered from puberty menorrhagia (55.55%). Dysfunctional uterine bleeding was diagnosed in 96% of girls suffering from puberty menorrhagia. Pelvic Inflammatory Disease was exclusively seen in married adolescent girls. Vaginal atresia and imperforate hymen were causes of primary amenorrhoea. PCOD was commonest cause of secondary amenorrhoea amongst adolescents. CONCLUSIONMenstrual abnormalities are the most common problems of adolescent girls. Setting up adolescent clinics is desirable.

Background: Maternal morbidity and mortality remains a major challenge to health systems worldwide. Referral services for identification and referral of high risk pregnancies are an integral part of maternal and child health services. Timeliness and appropriateness of referral are challenge to obstetricians, since delay in referral affects maternal outcome adversely, hence the identification of at risk patients and obstetric emergencies and their timely referral is of immense importance. The aim of this study was to review the pattern of obstetric cases referred to tertiary care centre, to identify their clinical course, mode of delivery and maternal outcomes.Methods: It was prospective observational study carried out from January 2015 to July 2016. Study population was all Obstetrics patients referred to Department of Obstetrics and Gynecology of Kamla Raja Hospital, G.R. Medical College, Gwalior, Madhya Pradesh, a tertiary care centre during the study period.Results: The total number of referred cases in above study period was 4085.The proportion of referred cases in the tertiary care hospital was 20.86%. Mode of transport used by the referred patients were hospital ambulances (38%) and private vehicles (62%). Most common diagnosis at the time of referral was anaemia (27.8%). Out of the total referred cases, 48% had vaginal delivery (either spontaneous or induced), 28% had caesarean section and 24% were managed conservatively. Hypertensive disorders (25.4%) constitutes the leading cause of maternal deaths amongst the referred cases.Conclusions: Peripheral health care system needs to be strengthened and practice of early referral needs to be implemented for better maternal outcome.

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To determine changes in semen and clinical parameters following varicocelectomy. Prospective comparative study conducted on 30 Methods: patients at Santosh Medical college and hospital, Ghaziabad., undergoing varicocelectomy. Study aimed at comparing the semen analysis and various clinical parameters (pain VAS score and size of the swelling) postoperatively, at 3 month and 6 monthly follow up. Semen pH Results: value and total semen volume did not show any statistically signicant improvement postoperatively. Post operatively statistically signicant improvement was seen in total sperm count, motility as well as sperm morphology. The improvement was more when preoperative parameters were in lower range compared to normal range parameters. 7 patients who were oligospermic preoperatively showed marked improvement in their sperm count at 3 and 6 months respectively(p value 0.001); which is more signicant improvement than preoperatively normospermic patients (p value 0.003). Postsurgery sperm motility showed signicant improvement, better results were seen when preoperative motility was < 28% versus when motility was >28%. Signicant improvement in sperm morphology postoperatively(p value 0.001)was seen, with better results in patients with preoperative sperm morphology <3% versus >3%. Mean VAS score showed statistically signicant decrease at 3 months and at 6 months postoperatively (p value 0.001).83.3% patients were relieved of pain at 6months follow up post surgery. Of the 12 patients who presented with swelling, 11 patients showed signicant decrease in swelling size at 6 months follow up postoperatively. We advice varicocelectomy Conclusions: in all patients of varicocele who are either clinically symptomatic with scrotal pain and swelling, and also in asymptomatic patients with subnormal semen parameters.