A rare case of functional accessory breast in the perineum presenting in labour is reported. It showed a well-formed nipple and pregnancy induced changes. The organ was completely excised postpartum. Histopathology confirmed normal breast tissue.

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Introduction: The incidence of Gestational Diabetes Mellitus (GDM) is rising globally with India no exception. The overall prevalence of GDM in our country is 16.55%. Insulin is the gold standard for the treatment of diabetes. Metformin, an Oral Hypoglycaemic Agent (OHA) is promisingly used in place of or along with Insulin. Myoinositol an insulin sensitiser may have some role in the treatment of GDM. Aim: To assess whether myoinositol in addition to metformin provides any better glycaemic control in GDM patients than those receiving metformin only. Materials and Methods: An open-label randomised clinical trial was conducted in the Department of Obstetrics and Gynaecology of Medical College and Hospital, Kolkata, West Bengal, India, in which mothers with a singleton pregnancy with 2-hour Postprandial Blood Sugar (PPBS) ≥140 mg/dL after 75 gm oral glucose {Diabetes in Pregnancy Study Group of India (DIPSI) criteria} were included and those with pregestational diabetes, on any form of anti-diabetic treatment and with other co-morbidities like renal pathology, hypertension were excluded. A total of 150 patients with GDM were given Medical Nutrition Therapy (MNT) and after two weeks, 66 patients were selected and randomly allocated into two groups. Group 1 was given Myoinositol along with metformin (n=33) and group 2 was given metformin only (n=33). Dropouts were three in each group. So, a net of 30 patients from each group was taken for the final analysis. A p-value ≤0.05 was considered statistically significant. Results: The mean change in fasting glucose levels in group 1 was 19.30±9.713 mg/dL whereas in group 2 was 20.76±13.70 mg/dL. (p=0.6343). The mean change in postprandial blood glucose was 59.4667±16.8026 mg/dL in group 1 and 54.7667±18.8674 mg/dL in group 2. Both these results were statistically not significant. Two (6.7%) patients required insulin in group 1 and in group 2, 5 (16.7%) patients had insulin added. Association was not statistically significant (p=0.2276). Conclusion: Myoinositol supplementation with metformin achieves good glycaemic control through its insulin-sensitising action and reduces the complications of GDM to a certain extent but it does not provide any extra benefits over metformin alone.

INTRODUCTIONMiscarriage is defined as any pregnancy ending spontaneously prior the fetus can survive. Recurrent miscarriage, defined as loss of 3 or more consecutive pregnancies affects 1% of couples trying to conceive. The etiology of recurrent spontaneous miscarriage includes epidemiological factors such as maternal age and number of previous miscarriages, anti-phospholipids syndrome, genetic factors, anatomical factors, endocrine factors, immune factors; inherited thrombophillic defects. 1 Women with RPL can be classified into three separate groups, as primary, secondary and tertiary aborters. Primary aborters are women with no previous live birth, secondary aborters if there was a live birth followed by pregnancy losses, and tertiary aborters are women who had pregnancy losses followed by a live birth. ABSTRACTBackground: Thyroid dysfunction and autoimmunity are relatively common in women of reproductive age group and has been associated with various adverse pregnancy outcomes such as recurrent miscarriage, preeclampsia and preterm labour. The aim of this study was to find out association between anti-tpo antibody and recurrent miscarriage and to evaluate obstetric complications such as preeclampsia and preterm labour in them. Methods: This case control observational study was carried out from July 2014 to June2015 on 110 pregnant mothers out which 55 with history of recurrent miscarriage were cases and 55 without such history were controls. Results: The mean age of the cases were 24.18 yrs. Majority of pregnancy losses occurred between 9-14wks.The prevalence of anti-tpo antibody positivity in the study population was 15.45%.out of 55 cases 12 were positive for anti-tpo antibody(21.8%).Positive anti-tpo antibody was associated with high TSH level than the negative anti tpo antibody(p<.000).The prevalence of preeclampsia and preterm labour in recurrent miscarriage patients were 9.09% and 5.45% respectively which was not significantly higher than background risk.1 out of 5 patients with preeclampsia had anti-tpo positive and none with preterm labour had anti-tpo antibody positivity. Conclusions: The prevalence of thyroid autoimmunity was higher in patients with history recurrent miscarriage history than the control population. Even in women with biochemically normal thyroid function there was relationship between recurrent miscarriage and thyroid autoimmunity. Thus anti-tpo antibody could be risk marker for RSM. Screening for subclinical hypothyroidism (TSH >2.5 but<10) and anti-tpo antibody can be suggested as these identify women with increased risk of miscarriage.