OBJECTIVE:To study the effect of ormeloxifene in dysfunctional uterine bleeding in premenopausal age group by measuring menstrual blood loss by PBAC score, effect on blood hemoglobin levels and effect on endometrial thickness. METHODS: 35 cases of DUB of age 40 years and above coming to Gynecological OPD were recruited for study after applying exclusion criteria. 60 mg of Ormeloxifene was given twice a week for 3 months and then once a week for 1 month. Patients were followed-up at 1, 3 and 4 months of therapy and then at 3 months after treatment stopped. Menstrual blood loss was measured objectively by pictorial blood loss assessment chart (PBAC) score. RESULTS: The pretreatment median PBAC score was 587 with a range of 186-893. After 4 months of treatment, mean PBAC scores reduced to 76.94±77.73 with a mean change of 490.05±155.4. Which is statistically highly significant (P0.001). 26 (81.25%) patients were cured of menorrhagia at the end of 4 months of treatment. 2 patients had no response and underwent hysterectomy. Amenorrhoea occurred in 22 patients at the end of 4 months of therapy and persisted in 18 patients at 3 months of follow-up after therapy while 1 patient had PBAC scores in the heavy range but much less than her pretreatment levels. Adverse effects included vaginal discharge (15.62%), vague abdominal pain (12.5%), gastric upset (6.25%), headache (6.25%) and ovarian cyst (3.12%). CONCLUSION: Ormeloxifene is an effective and safe therapeutic option for the medical management of perimenopausal DUB.

OBJECTIVE(S):To examine the hypothesis correlating the association of raised maternal serum C-reactive protein levels with the increased risk of preterm labour and to identify the role of infections and inflammations in preterm labor. METHODS/STUDY DESIGN: The prospective study was conducted in 100 primigravida patients with singleton pregnancies aged between 18-35 years. Their quantitative serum C-reactive protein level was measured at 5-20weeks of gestation according to their enrolment in the antenatal clinic. RESULTS: Majority of patients who had serum CRP levels in higher range delivered at preterm. 70% of patients who delivered at preterm had serum CRP levels >7mg/L. None of the patients who had serum CRP levels <2.5mg/L delivered at preterm. 73.3% of preterm patients presented with leaking per vaginum along with other complications, in these patients mean CRP level was 7.6mg/L. CONCLUSION: Our Endeavour in this research was to examine a marker (Serum CRP) which is not only easily sampled but also is cost effective especially in our Indian set up. Raised serum CRP concentrations in early pregnancy are associated with increased risk of preterm birth.

Objective: The present study was conducted in a tertiary care health centre of southern Rajasthan to assess the prevalence of referred high risk pregnancy in the region and its outcome. Material & Methods: 200 high risk pregnancies referred to our tertiary healthcare centre during the study period, which were not registered in our antenatal record; with gestation of ≥ 28 weeks were included in the study. Obstetric outcomes were assessed in terms of maternal mortality and mode of delivery while neonatal outcomes were assessed in terms of incidences of intrauterine deaths, still births and live births. Results: Age of the patients' ranges from 18 to 45 years with the mean age of 24.7 years. 73.5% of the cases in present study were belonged to rural society while 26.5% cases belonged to urban society. The most common cause for referral of the patients in present study was history of previous LSCS (31%) followed by anaemia (16%), hypertensive disorder of the pregnancy (9%) and bad obstetric history (9%).44.5% of the study participants had normal delivery while 54% had caesarean sections and the rest 1.5% had instrumental delivery (vacuum or forceps delivery). 200 study participants gave birth to 203 neonates (included 3 twin births). 97% were the live birth while 3% had intrauterine death and the rest 1.5% were stillborn. Conclusion: Early detection of high risk pregnancies at primary health care level with proper antenatal services and referral system is advisable to improve fetomaternal outcome.

Objectives: The present study was performed to assess the role of NASG (non pneumatic anti shock garment) in the management of postpartum haemorrhage. Material and Methods: The present study is a retrospective study carried out in the department of Obstetrics & Gynaecology of a tertiary care institute of southern Rajasthan during the period of six years from July 2009 to June 2015. 100 patients of postpartum haemorrhage (PPH) with gestational age ≥28 weeks were included in the study. All the patients delivered at our institute and BMI ~18.5-24.9 kg/m 2 so that NASG was meticulously applied. Results: 100 patients of PPH were included in present study and NASG were applied to them. Age of the patients ranged from 18 to 45 years with the mean age of 25.99 years. 13% of the patients were grand multipara while 20% patients were primi and remaining 63% were multipara. The most common cause of PPH was atonic uterus (77%), of which commonest etiology was maternal anaemia (37.6%). Next common cause was trauma of genital tract (19%) out of which vaginal injuries were the most common (47.36%). Other rare causes were tissue factor (3%) and coagulopathies (1%).67% of the study participants had normal delivery while 29% patients had caesarian sections and remaining(4%) had instrumental delivery. After NASG application, 53% patients responded to medical management, 32% were managed surgically and rests 15% were stabilized by manoeuvres. 57% patients stayed for three days in the hospital while 29% stayed for five days. Only 3% patients had a hospital stay of ≥ six days. Conclusion: The present study concluded that majority of patients suffering from PPH were multigravidas in the reproductive age group of 21-30 years. The major cause of PPH was uterine atony followed by genital tract injuries. Use of NASG in these patients significantly reduced any major surgical intervention. Most of these patients were successfully managed by uterotonics, blood components and supportive care. Even a substantial decrease in theduration of stay in hospital and ICU stay was noted.