Marked improvement was noticed in this new paradigm and more multicentric trial is needed to check the increasing trend of CD.

No abstract

Objectives To study the present status and effect of paradigm shift in the epidemiology of HIV amongst pregnant women in urban set up. Aims The purpose of the study is to evaluate the paradigm shift in overall screening and management strategy of HIV in antenatal women for last four and half years in an urban medical college. Methods The study was conducted from 1st January 2004 to 30th June 2008 and all registered and unregistered pregnant women who attended ICTC clinic and also for emergency admission (unregistered) were counseled and blood samples were tested as per NACO guidelines with cafeteria choice of opt in and opt out strategy. Reactive women in antenatal period were counseled and discussed about anti-retroviral therapy (ART) and universal treatment regime. Seroprevalent women were counseled about their spouse, personal habits and demographic status. Marked improvement was seen in the use of contraceptive and drug abuse. During labor mother and baby were given nevirapine as per NACO guidelines. Results The seroprevalence of HIV reactive women in our Centre was 0.23, 0.19, 0.14 and 0.12% in the year

Background: Laparoscopic surgery is the method of choice for treating women with benign adnexal masses. The aim of the current study is to assess the feasibility and surgical outcome of laparoscopic surgery among women with large benign ovarian cysts with a minimum risk of converting the operation to a laparotomy. Materials and methods: Symptomatic women (abdominal pain or mass) with a clinical or ultrasound diagnosis of an adnexal mass were offered a detailed transvaginal ultrasound scan in order to assess the feasibility of laparoscopic cystectomy=oophorectomy. The following patient information was abstracted: age, menopausal status, body-mass index, preoperative imaging studies, cyst dimensions, preoperative CA-125, date of surgery, surgical procedures, estimated amount of blood loss (EBL), conversion to laparotomy and its causes, operative time, operative and postoperative complications, length of hospital stay, and long-term follow-up. Results: All patients had transvaginal and transabdominal ultrasounds and 18 patients had computed tomography of the abdomen and pelvis. The mean and range of maximum diameter of the ovarian cysts were 16 (10-22 cm). Twenty-seven (27) cysts (51.5%) were unilocular and 16 (27.3%) had one to five septa. Fourteen (14) cysts (21.2%) had an echogenic area thought to be consistent with dermoids. None of the patients had ascites, omental cake, or lymphadenopathy in preoperative imaging studies. Fifty-two (84.8%) patients had preoperative CA-125 values within the normal range (<35 IU=mL). Five (5; 15.5%) patients had elevated 43, 53, 57, and 67 IU=mL, respectively). None of the patients had operative or postoperative complications or had to be converted to laparotomy. The mean (range) operative time, EBL, and hospital stay were 32 (20-45 minutes), 27 (5-55 mL), 8 (4-12 hours), respectively. The pathologic findings included endometriosis (n ¼ 14), dermoid (n ¼ 13), para-ovarian cyst (n ¼ 9), serous cyst adenoma (n ¼ 9), benign epithelial-lined cyst (simple cyst) (n ¼ 5), mucinous cystadenoma (n ¼ 4), borderline ovarian tumors (n ¼ 2), and peritoneal pseudocyst (n ¼ 1) Conclusions: Laparoscopic surgery among women with large benign ovarian cyst is feasible with a minimum risk of converting the operation to a laparotomy. ( J GYNECOL SURG 27:83)