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IntrOductIOnAs the field of assisted reproductive techniques are making a continual progress it raises hopes for childless couples. Alongside, it also increases nightmares for the obstetrician due to the increased numbers of multi-fetal pregnancies [1,2]. These multi-fetal pregnancies are accompanied by their own set of adverse perinatal outcomes compared to singleton pregnancies, where the second twin is at a higher risk than the first one [3][4][5]. While caesarean section is the preferred mode of delivery for triplets and high order pregnancies, the course for term twin pregnancies is not so well-defined. Yang et al., highlighted that, the previously followed guideline of planned caesarean delivery for all twin pregnancies is flawed because it was based on expert opinion rather than clinical trials [6].There is a definite rise in rates of elective caesarean delivery for twins' inspite of a lack of substantial evidence. Hence, it is important to identify the various factors which influence the decision regarding the mode of delivery of twins, in order to address this increasing rate of caesarean section.In this study, we analysed the trend of twin delivery and perinatal outcome of second twin with respect to mode of delivery, in a tertiary care center in Mumbai. MAterIAls And MethOdsA prospective observational study was carried out at Nowrosjee Wadia Maternity Hospital for a period of 1 year from June 2013 to May 2014. Total of 93 pregnant women carrying twins were studied.Inclusion criteria: Pregnant women carrying twins with gestational age >28 weeks, conceived spontaneously or with treatment.exclusion criteria: Pregnancies with triplets and higher order multi-fetal pregnancies or pregnancies with amnio-reduction and selective fetal termination done in early pregnancy.After Institutional Review Board approval, all twin pregnancies presenting for delivery, were enrolled for the study. Data was collected from hospital birth records regarding maternal age, parity, whether spontaneous or assisted conception, gestational age whether full term or preterm. History and examination was done to confirm any obstetric risk factors like pregnancy induced hypertension/ chronic hypertension, overt or gestational diabetes mellitus, hypothyroidism and obstetric history, preterm pre-mature rupture of membranes and anaemia. Presence of fetal high risk conditions like intrauterine growth restriction, twin growth discordance, fetal anomaly, abnormal colour doppler flows, cord prolapse, fetal distress and meconium stained liquor was also noted. Presentation of both twins was noted. Mode of delivery of the twin pair, i.e., whether vaginal or caesarean delivery was noted. Perinatal outcome in terms of 5minute APGAR score <7, morbidity like asphyxia, sepsis, fracture, respiratory distress syndrome and mortality was noted. Mode of delivery was compared with presentation of twins, presence of risk factors (obstetric or fetal), 5 minute APGAR score <7, morbidity like asphyxia, sepsis, fracture, respiratory distress syndrome and mortali...

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A 52-year-old patient presented with complaints of menorrhagia. Endometrial biopsy revealed simple hyperplasia of the endometrium. Total abdominal hysterectomy with bilateral oophorectomy was carried out. The ovaries looked grossly normal, but histopathology reported granulosa cell tumor of the right ovary. Granulosa cell tumors belong to the sexcord stromal category and account for approximately 2% of all ovarian tumors. We review the features and treatment of granulosa cell tumors and the importance of screening for ovarian tumors in a case of endometrial hyperplasia and delayed menopause.

Introduction:The COVID-19 pandemic is the first of its kind that doctors have encountered in their clinical practice, offering several challenges in all aspects of their lives. The aim of this study was to look into the impact of the COVID-19 pandemic on the personal and professional lives of doctors. Methods: 264 anonymous voluntary responses received within one week of sending 805 requests to Indian doctors in July 2020, through Google forms were included in the study. Results: Of the 264 respondents, 72.3% continued to stay at home with their families as before, 22% practiced self-isolation at home and a small proportion of mainly young doctors stayed in a hostel or other accommodation. Majority of the respondents reported an improvement in family life and interpersonal relationships, eating habits, volume of daily exercise and fitness levels. Regarding the financial situation, more than 70% of doctors were negatively impacted during the pandemic. While a majority of doctors appreciated technological aid in the form of teleconsultation and webinars, most of them questioned their application post COVID-19. Over 40% of doctors experienced some form of discrimination against them during the pandemic. Conclusion: While healthcare professionals face a unique set of obstacles and dilemmas that require special attention, many have also experienced a silver lining amidst this chaos in the form of family life and lifestyle changes. Regardless, COVID-19 has been a game changer for everyone!.