INTRODUCTION:The present study was performed to assess the safety and feasibility of a new laparoscopic entry site in cases suspected of adhesions due to previous surgery.MATERIALS AND METHODS:It is a retrospective study undertaken at a tertiary care referral center for advanced gynecological laparoscopic surgery from January 2011 to December 2014.RESULTS:In 624 patients with a history of previous abdominal surgeries, the laparoscopic entry site was through a newly devised point. It is a point in the left paraumbilical region at the level of umbilicus, in a straight line drawn vertically upward from a point 2.5 cm medial to anterior superior iliac spine. Intra-abdominal adhesions were found in 487 (78.0%) patients, and umbilical adhesions in 404 (64.7%) patients with past abdominal surgeries.CONCLUSION:There were no significant entry-related, intra-operative, or postoperative complications with the use of this entry point. It is also suitable as a main working port during the course of surgery.
Objectives (1) To compare the efficacy of Pap smear and HPV PCR for detection of CIN; and (2) To study the distribution of HPV genotypes. Methods One hundred women presenting at the female Outpatient Department with unhealthy cervices were subjected to a detailed history, clinical examination, Pap smear, HPV DNA PCR test, and colposcopic-directed biopsy (where indicated). Results This study has shown that there is a strong association of HPV infection with higher grades of CIN (100 % in patients with CIN 2, CIN 3, and CIS). The detection of CIN by HPV PCR was more accurate than by Pap smear. The most prevalent HPV genotype found in our study was HPV 16. Conclusion The advent of HPV testing has opened the doors for more accurate cervical cancer surveillance strategies than Pap smear. Early detection and treatment of CIN will considerably reduce the incidence of cervical cancer.
Labor induction in women with unfavorable cervices results in high caesarean section rates. However, the use of misoprostol significantly reduces the induction to delivery interval, without adversely affecting the caesarean section rates and neonatal outcomes. Hence it may become a cost-effective alternative to dinoprostone gel in resource-poor settings like India.
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