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Background: Multiple pregnancies are associated with an increased risk of obstetric complications as well as perinatal morbidity and mortality especially in developing countries. The present study aims to identify socio-demographic, obstetric, and maternal complications associated with any adverse perinatal outcome in singleton and twin deliveries in the department of obstetrics and gynaecology at the R. D. Gardi Medical College in Ujjain between September 1, 2021 and December 31, 2022.. Methods: This comparative prospective study was conducted in the department of obstetrics and gynecology, R. D. Gardi Medical College in Ujjain between September 1, 2021 and December 31, 2022. Consecutive sampling was done till the sample size of 142 was reached for both twin and singleton pregnancies. It included all women admitted in antenatal ward and labor room with clinical or ultrasound diagnosis of twin pregnancy after 28 weeks of gestation. Results: The incidence of twins in this study was 1.85%. Mean maternal age was 24.08±2.73 years for twin pregnancies and 24.08±3.56 for singleton pregnancies. Twins were seen more in multigravida as compared to primigravida. Preterm labor (40%), anemia (26.5%) and hypertensive disorders (14.3%) and PPH (6%) were the most common complication in twin pregnancies. Significantly higher rate of LSCS were seen in twin pregnancies (30.6%) as compared to singletons 17%. There was higher incidence of moderate to severe asphyxia, IUGR and higher rate of NICU admissions in twins as compared to singletons. Conclusions: Early diagnosis, good antenatal care with early recognition of complications and their timely referral and management at a tertiary care with level 3 neonatal care can help reduce maternal and perinatal mortality and morbidity. Prompt ANC care and timely intervention is required to avoid these complications. [ABSTRACT FROM AUTHOR]

Ashish Pathak1,2, Yogyata Marothi3, Vandana Kekre4, Kalpana Mahadik5, Ragini Macaden6, Cecilia Stålsby Lundborg11Division of Global Health, Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden; 2Department of Pediatrics, 3Department of Microbiology, 4Department of Medicine, 5Department of Obstetrics and Gynecology, RD Gardi Medical College, Ujjain, India; 6St Johns Research Institute, Bangalore, IndiaBackground: Recent reports of the rapid evolution of bacterial resistance in India require urgent antibiotic stewardship programs. This study aimed to define the magnitude and pattern of resistance of bacterial pathogens to guide empirical therapy.Methods: We prospectively collected consecutive, clinically significant, and nonduplicate bacterial isolates from each patient from two hospitals in Ujjain, India. The antibiotic susceptibility of the bacteria was tested using a disc diffusion method as recommended by the Clinical and Laboratory Standards Institute.Results: A total of 716 pathogens were isolated from 2568 patients (median age, 25 years; range, 0 days to 92 years). Gram-negative infections were predominant (62%). The isolated pathogens included Staphylococcus aureus (n = 221; 31%), Escherichia coli (n = 149; 21%), Pseudomonas aeruginosa (n = 127; 18%), and Klebsiella pneumoniae (n = 107; 15%). Common diagnoses included abscesses (56%), urinary tract infections (14%), blood stream infections (10%), pneumonia (10%), and vaginal infections (10%). In E. coli isolates, 69% (95% confidence interval [CI] 61.6–76.6) were extended-spectrum β-lactamase (ESBL) producers and 41% (95% CI 31.6–50.5) of K. pneumoniae isolates were ESBL producers. These isolates had a high resistance to fluoroquinolones and β-lactams, except for imipenem and piperacillin-tazobactam. Salmonella typhi remained sensitive to third-generation cephalosporins. Methicillin-resistant S. aureus (MRSA) constituted 30% of all S. aureus isolates and showed resistance to ciprofloxacin (81%), cotrimoxazole (76%), and levofloxacin (60%).Conclusion: Our results showed a high prevalence of ESBL among Gram-negative bacterial isolates and a high prevalence of MRSA among S. aureus isolates. Carbapenems provided the broadest coverage for Gram-negative bacteria, while glycopeptides were the most effective against MRSA; however, both classes of drugs need to be used judiciously. This study will help in planning future antibiotic stewardship programs.Keywords: antibiotic susceptibility, surveillance, extended-spectrum β-lactamases, India

Background: Hydatid cyst in pelvic region is very rare. A patient was admitted in Gynaec ward with complaints of, lump and pain in lower abdomen and, constipation since, five months. General examination was normal. Abdominal and gynaecological examination lead to diagnoses as ovarian cyst? Multiple uterine subserous fibroids? Ultra sonography diagnosis was Hydatid cysts abdomen / Mucininious cystadenoma ovaries. CT Scan abdomen and pelvis confirmed USG findings of Hydatid cysts. On Laprotomy multiple hydatid removed from pelvic region, omentum, ileocaecal junction and liver. Patient put on chemotherapy and follow up was satisfactory [ABSTRACT FROM AUTHOR]

To find out whether Hysterosalpigography (HSG), can be used as initial method for assessing tubal factor of infertility, instead of more invasive method like diagnostic laparoscopy. Methods: Retrospective analysis of 75 cases, who had attended infertility Clinic at Medical College, Ujjain, and underwent HSG as initial test followed by Laparoscopy from November 2005 to December 2010. Results: Primary infertility was the major cause of tubal factor of infertility (75%) and majority of women were between 20-25 years (60%). In comparison to laparoscopy, HSG has 80.8% sensitivity & 100% specificity for determination of tubal patency. HSG also has a high sensitivity (100%) for determination of unilateral or bilateral blockage with specificity of 100% & 85.3% respectively. HSG can detect only endo-tubal and intrauterine pathology, whereas laparoscopy can detect pelvic pathology. Conclusion: HSG should be used as initial test to assess tubal patency whereas laparoscopy should be limited to selected cases. [ABSTRACT FROM AUTHOR]