In most of South Asia, prevalences and phenotypes of polycystic ovary syndrome (PCOS) among women in the community are unknown. The authors aimed to estimate prevalence and phenotype in a community setting in Sri Lanka and to test a valid, feasible screening approach to early diagnosis. A community-based, cross-sectional study was carried out in 2005-2006. A random sample of 3,030 women aged 15-39 years was selected by cluster sampling proportionate to population size. An interviewer-administered questionnaire was utilized to screen for "probable cases" of PCOS based on menstrual history and clinical manifestations of hyperandrogenism. Selected "probable cases" underwent clinical, biochemical, and ovarian ultrasound assessment. The response rate was 96.2% (n = 2,915). A total of 220 (7.5%) "probable cases" were identified: 209 women with oligo/amenorrhea (95%) and 11 women with hirsutism (5%). Further evaluation of the 220 probable cases confirmed 164 newly diagnosed cases of PCOS based on the 2003 Rotterdam diagnostic criteria. With 19 previously diagnosed cases already present, total prevalence was 6.3% (95% confidence interval: 5.9, 6.8). Of the women with "oligo/amenorrhea and/or hirsutism," 91.1% were confirmed to have PCOS; 99.4% of women with "regular cycles in the absence of clinical hyperandrogenism" were confirmed as normal. The most common phenotypes of PCOS were oligo/amenorrhea and polycystic ovaries (91.4%) and oligo/amenorrhea and hirsutism (48.3%).

Objective To determine the risk of metabolic syndrome (MS) and polycystic ovary syndrome (PCOS) in a cohort of indigenous South Asian women with a recent history of gestational diabetes mellitus (GDM).Design Case-control study.Setting Department of Obstetrics & Gynaecology, University of Colombo, Sri Lanka.Sample Two hundred and seventy-four indigenous Sri Lankan women with previous GDM and 168 ethnically matched controls. Of these, 147 with previous GDM and 67 controls not taking hormonal contraception participated in an in-depth endocrine study.Methods Assessing the prevalence of MS and PCOS based on clinical features, biochemistry and ovarian ultrasound examination at 3 years postpartum. Main outcome measures Prevalence of MS and PCOS.Results Women with previous GDM and controls were studied at a mean (range) of 34.6 (13.4-84.1) and 46.5 (17.5-78) months postpartum, respectively. Those with previous GDM had a larger mean ± 95% confidence interval waist circumference (90.9 ± 1.3 versus 81.2 ± 2.8 cm, P = 0.0004) and were more likely to have hypertension (17.6 versus 7.4%, P = 0.001), glucose intolerance (51.7 versus 10.4%, P = 0.00001), hypertriglyceridaemia (16.3 versus 5.9%, P = 0.02) and a lower level of high-density lipoprotein (70 versus 56.7%, P = 0.04) than the controls. Of the women who had GDM, 72 (49%) had MS, 86 (58.5%) had polycystic ovaries and 59 (40%) had PCOS, significantly more than the control women-4 (6%), 9 (13%) and 2 (3%), respectively (P = 0.00001).Conclusions The prevalence of MS and PCOS in indigenous Sri Lankan women 3 years postpartum is significantly higher in those with previous GDM compared with ethnically matched controls. This confirms an association between GDM and subsequent PCOS and MS.

Introduction: Transvaginal colour Doppler is a non-invasive ultrasound-based technique that allows an in-vivo assessment of tumor vascularization. Several researches done in the last decade have evaluated the role of this technique in assessing carcinoma of the cervix. However there is a significant paucity of literature linked to pre-malignant lesions of the cervix and its diagnosis based on transvaginal colour doppler and its pulstality index (PI). In this paper we present a case control study conducted to assess the validity of transvaginal colour doppler scan and PI in diagnosing malignant and pre-malignant lesions of the cervix. Methodology: A case control study with a total sample of 57 women was conducted at the Nawaloka Hospital for duration of two years. 19 cases of recently diagnosed patients with cervical carcinoma, using cytobrush and colposcopy guided biopsy, evaluated by a consultant histopathologist, were recruited. Staging was done according to FIGO classification. 40 age-matched patients with histologically confirmed normal cervix were selected as controls and 2 were excluded from the study due to the presence of cervical infection. All cases and controls were subjected to transvaginal colour doppler sonography using a 1.94 (range 1.2 -3.1) and the mean PI value for the controls were 0.805 (range 0.3 -1.5). Neovascularization was markedly seen in the patients with invasive cervical carcinoma with a PI ranging between 1.99 and 3.10. Chi square test results showed a very high statistically significant difference of PI values between cases and controls (p value < 0.0001). An ROC analysis revealed the optimal cut-off value of PI at 1.475 with a sensitivity of 89.5% and a specificity of 93.5%. Conclusion: Transvaginal doppler ultrasonography and PI of the descending cervical branch of the uterine artery and its branch vasculature allow a non-invasive assessment of tumor vascularization in cervical carcinoma and pre-malignancy. PI with a cut off value of 1.475, can be reliably used to detect and screen pre-malignancies and malignancies at a relatively early stage with a sensitivity of 89.5% and a specificity of 93.5% enabling further definitive evaluation, in a routine gynecology trans vaginal ultrasound assessment.

Pregnant women with clinical antiphospholipid syndrome when treated with low-dose aspirin and heparin, the live birth rate of 7% in the previous pregnancy resulted in live births of 74% in a resource limited South Asian setting.

Introdction:The prevalence of pregnancy-related acute biliary pancreatitis (ABPP) is not infrequent especially in the third trimester. Timely intervention of ABPP will reduce the maternal and fetal morbidity and mortality.Methods: A single center retrospective study was carried out. Randomly selected 1000 medical records of the pregnant mothers who were hospitalized from 2012 to 2022 were retrieved. Selection of patients who had ABPP were done according to exclusion and inclusion criteria. The following parameters were reviewed: the patient's age, pregnancy trimester, ABPP severity, risk factors for ABPP, imaging modalities, biochemical tests, treatment methods, length of hospital stay (LOS), and maternal or fetal morbidity and mortality. Ethical approval was granted by Nawaloka Hospital Research and Education Foundation. No conflict of interest. Results:In total of 7 with ABPP were identified [0.7% (7/1000)]. Epigastric pain was the main complaint of all ABPP patients. Biliary pathology were detected in abdominal ultra sonography (USG). Majority were in the third trimester [57.1% (4/7)]. The mean age of the patients was 27.6±5.3 (range, 18-44) years. The most of the women were multiparous [71.4%(5/7)]. Out of 7 patients 4 (57.1%) had mild symptoms and 3 (42.8%) had moderate symptoms of pancreatitis. The mean length of hospital stay (LOS) was 4.6±1.5 (range, 3-7) days. All patients were conservatively managed. None reported with a recurrent episode of ABPP during pregnancy. 5 (71.4%) patients in the pregnant group underwent planned laparoscopic cholecystectomy (LC) in the first 6 to 12 months after delivery. Conclusion:This study sample highlighted that mild to moderate ABPP can be managed with conservative treatment. The recurrence and their severity are unpredictable. Therefore following initial management, early cholecystectomy can be considered as a treatment modality. To generalize these findings further studies are recommended.