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Cervical cancer (CC) is acknowledged as the most ubiquitous carcinoma among females along with the utmost prevalence in developing nations. The major cause of CC is HPV exposure, especially HPV16 and 18. Inflammation is linked to the carcinogenesis of CC in addition to HPV infection. Although the precise cause of CC is yet unknown, using oral contraceptives, being immunosuppressed, and smoking may enhance the risk of the disease. Oxidative stress (OS), in addition to HPV, is linked to cervical cancer. Across several clinical and preclinical research, the dysfunctional redox system and the impact of oxidative stress throughout the aetiology of CC have been examined. Redox homeostasis must therefore be maintained, which calls for both enzymatic and nonenzymatic redox regulators. In this study, we explored the therapeutic strategies used to preserve redox balance, lower cervical cancer mortality, and illustrate the contribution of oxidative stress in the aetiology of the disease.

Background and Objective: LEAD, an environmental toxicant, accounts for 0.6% of the global burden of disease, with the highest burden in developing countries. It can permeate through the foetus blood-brain barrier causing a negative impact on foetal growth and the developing brain. Literacy and awareness related to its impact are low and the clinical establishment for biological monitoring of Blood LEAD Level is low, costly, and time-consuming.Methods: We propose a novel approach to build a low-cost point-of-care analytical device, a screening app that can predict LEAD toxicity levels in maternal blood. A computational model is built that learns from maternal data comprising of blood LEAD level and a set of sociodemographic features, and then predicts the LEAD toxicity level based on the set of input features.Results: Following feature selection methods, the 11-feature set obtained from Boruta algorithm gave the best prediction results. The k-Nearest Neighbour-based model gave 94.00% accuracy whereas the Neural Network-based model gave 92.50% accuracy when tested on 200 participants.Conclusion: The range of features identified in the built models can estimate the underlying function and can accurately model LEAD toxicity prediction and provide an understanding of toxicity level. Early identification and intervention of LEAD-exposed pregnant women will reduce LEAD poisoning in infants and thus, prevent harmful effects on health throughout childhood and adulthood. The built prediction model is beneficial in improving the point of care and hence reducing the cost and the risk involved. It is envisaged that the app will become a part of a screening process to assist healthcare experts at the point of evaluating the LEAD toxicity level in pregnant women. Women screened positive could be given a range of facilities including preliminary counselling to being referred to the health centre for further diagnosis. Steps could be taken to reduce maternal exposure and hence, it could also be possible to mitigate infant’s LEAD exposure by reducing transfer from the pregnant woman.

AIM:To compare cerebroplacental and cerebrouterine ratio as predictors of perinatal outcome in hypertensive disorders of pregnancy. METHODS: A prospective cohort study was done at a tertiary hospital in Northern India. Singleton pregnancies of gestational age >28 weeks, having BP>140/90mm of Hg with/without proteinuria >30mg/dL(+1 dipstick)were included. Doppler indices were measured, and perinatal outcomes studied. RESULTS:Cerebrouterine(CU) and cerebroplacental(CP) ratios had a better negative predictive value for adverse perinatal outcomes(except Apgar and preterm birth). CP ratio had highest sensitivity and specicity for outcomes perinatal death (100% and 95.9%), ventilatory support (100% and 97.2%) and hypoglycemia (100% and 95.9%). CU ratio had maximum sensitivity and specicity for the outcome hypoglycemia (100% and 95.9%). CONCLUSIONS:CP ratiohas a higher efcacy than CU ratio, however CU ratio compliments its predictive ability. Higher negative predictive values indicate that these ratios correctly ruled out unfavourable perinatal outcomes. Further studies to derive more sensitive values of CU ratio with normotensive patients and a larger sample size would be benecial.

Introduction Gestational diabetes mellitus (GDM) is a public health problem that currently affects a large part of the female population and has short- and long-term consequences for the fetus and the mother. It has been reported that GDM affects 1%-14% of all pregnancies, and that its incidence has been steadily rising. In recent years while exploring the etiological factors responsible for the emergence of insulin resistance particularly that of transient nature, vitamin D has emerged as one of the possible factors. Although systematic review and metaanalysis of observational studies show that low blood vitamin D level during pregnancy is associated with 1.8 times higher odds of GDM as compared to those having normal blood vitamin D levels; however, individual observational studies about maternal vitamin D status and risk of GDM are conflicting, The aim of this study is to compare the levels of 25(OH) vitamin D in women with gestational diabetes mellitus and normoglycemic pregnant women to assess the pathogenic role of vitamin D in the causation of GDM. Materials and methods This study was conducted in the Department of Obstetrics and Gynecology, Era's Lucknow Medical College and Hospital (ELMCH), Lucknow from December 2018 to November 2020 The present study was an analytical case-control study, in which a total of 30 pregnant women in 24-28 weeks of gestation diagnosed as GDM using Diabetes in Pregnancy Study Group criteria were enrolled as cases while another 30 pregnant women in same gestational age range with normoglycemic profile were enrolled as controls. The 25(OH)D levels were assessed by the chemiluminecence immunoassay. The statistical analysis was performed using SPSS (Statistical Package for Social Sciences) Version 21.0. Results On multivariate analysis, vegetarian diet and GDM were found to be significantly associated with vitamin D deficiency. The present study endorsed the relationship between vitamin D deficiency and GDM and showed a high prevalence of vitamin D deficiency, and that too at severe level could result in GDM. Appropriate awareness and intervention strategies are warranted on a larger sample.

Aim The aim of the present study was to assess the role of hemoglobin A1c (HbA1c) in screening of gestational diabetes mellitus (GDM) and to compare its efficacy with 75 g oral glucose tolerance test (OGTT) (World Health Organization [WHO]) screening criteria. Methods A prospective observational study was performed on a total of 260 women attending antenatal outpatient department of our hospital at 24-28 weeks of gestation. All women underwent 75-g OGTT testing, and WHO 1999 criteria was used for diagnosis of GDM. Also, a HbA1c test was performed for the same women. Results Prevalence of GDM was found to be 19.6% by OGTT. Mean HbA1c values in GDM was significantly higher than non-GDM. HbA1c correlated well with both fasting and 2 h postprandial levels but there was better correlation with 2-h postprandial level. Conclusion The incidence of gestational diabetes is rising in South-East Asian countries, especially in India. HBA1c could be a potential screening test for GDM.

Modified Reid index helps to objectively differentiate between low-grade and high-grade lesions during colposcopy; however, its differentiating ability is often debated. Swede score is a relatively newer score for the purpose. In the present study, we compared the efficacy of modified Reid index and Swede score in evaluation of visual inspection by acetic acid (VIA) positive women. A total of 57 VIA-positive women underwent colposcopic evaluation followed by histopathological confirmation. Women with obvious growth, previous procedures on the cervix, pregnancy, nulliparity and history of pelvic irradiation were excluded. Colposcopic findings were scored using modified Reid index and Swede score, respectively. The diagnostic efficacy of modified Reid index and Swede score was done using sensitivity, specificity, positive and negative predictive values. Mean age of women was 37.53 ± 8.98 years. On colposcopy, according to modified Reid index, a total of 26 (45.6%) were likely to be CIN I, 29 (50.9%) were CIN I/II, and 2 (3.5%) were CIN II/III. According to Swede score, 38 (66.7%) were low grade (normal/CIN I), 11 (19.3%) were high grade (non-invasive CIN II or above) and 8 (14%) were high grade (suspected invasive/CIN II or above). On histopathology, 34 (59.6%) were diagnosed as cervicitis, 10 (17.5%) were low grade (CIN I/mild dysplasia), 5 (8.8%) high grade (CIN II/moderate dysplasia), 2 high grade (CIN III/severe dysplasia) and 6 (10.5%) carcinoma cervix, respectively. For high-grade lesions/carcinoma at a cut-off value 8 or above modified Reid index had sensitivity, specificity, PPV and NPV of 33.3%, 100%, 100% and 92.7%, respectively, as compared to 61.5%, 100%, 100% and 88.6%, respectively, for Swede score at a cut-off > 7. For high-grade lesions, Swede score was found to be more sensitive as compared to modified Reid index in VIA-positive women.

Vaginal fibroids rarely exist as a primary vaginal tumor. Approximately 300 cases have been reported in the literature. Here we are reporting a rare case of giant vaginal fibromyoma. It was diagnosed as cervical fibroid polyp preoperatively but found to be vaginal fibromyoma peroperatively.

About 4-5 % of ovarian tumours are metastatic from other organs, most frequently from the female genital tract, the breast, or the gastrointestinal tract. Ovarian metastases constitute 76% of genital tract metastases from extragenital primary tumours, of which 78% arise in the gastrointestinal tract. Metastatic ovarian tumours, often mistaken as primary ovarian carcinomas. A 37 year old P2+0 presented with c/o - Abdominal distension since last 6 months. It was associated with anorexia, constipation and generalised weakness. Not having any menstrual complaint. P/A: moderate ascitis was there. A mass of 8x10 cm felt through right fornix extending up to right iliac fossa. Mass was firm in consistency with restricted mobility. Uterus felt separately from the mass. Left fornix clear. A right sided ovarian mass of approx. 10x15 cm of variegated consistency identified. Bladder wall was thickened. Small nodules of approximately 1 cm present over dome of bladder under visceral peritoneum. Omentum, ascending colon, transverse colon, descending colon, caecum, greater curvature and lesser curvature were thickened. Liver and spleen were normal. Total abdominal hysterectomy with bilateral Salpingo oophorectomy with partial omentectomy was done. Histopathology Revealed metastatic adenocarcinoma of the genital tract and B/L ovaries. So it was concluded that secondaries from intestinal malignancy can present as primary ovarian malignancy.

The Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome occurs in one of 4,000 to 5,000 female births and is characterized by normal development of secondary sexual, congenital aplasia of uterus and upper part (2/3) of vagina, and normal fallopian tubes and ovaries. Therefore, individuals with MRKH syndrome are at normal risk of developing ovarian neoplasms. We report a case of 19 years old unmarried female who was admitted to the hospital with pain in lower abdomen for 7 months. She was having primary amenorrhea. Gynecological examination revealed a blind vaginal pouch. Rectal examination revealed a large left-sided 8 cm cystic mass which was mobile with a smooth surface. Uterus was not palpable. Phenotypic sex was female. Breast development, axillar and pubic hair development were normal. Abdominopelvic ultrasonography showed left-sided crossed fused renal ectopia and a heterogeneous hypoechoic cystic mass with dense internal echoes on left-side. Uterus was not visualized. Intravenous pyelography also confirmed the finding of left-sided crossed fused renal ectopia. At laparotomy, a 10 × 8 cm cystic hemorrhagic ovarian mass with a single twist of pedicle was found, with a normal right ovary and bilateral tubes. A small hypoplastic unicornuate uterus was present. Cervix was absent. Left-sided Salpingo-oophorectomy was done and tissue was sent for histopathology, which revealed ovarian serous cyst adenoma. All patients with vaginal agenesis must be regarded primarily as a MRKH syndrome and they must be investigated to establish whether there were any associated congenital anomalies. How to cite this article Asnani M, Srivastava K, Inam L, Kunwar S. Mayer-Rokitansky-Küster-Hauser Syndrome with Rare Findings of Crossed Fused Renal Ectopia and Ovarian Serous Cystadenoma. J South Asian Feder Obst Gynae 2015;7(3):220-222.

Abdominal pregnancy is an extremely rare form of ectopic pregnancy, mostly occurring secondarily after tubal rupture or abortion with secondary implantation anywhere in the peritoneal cavity. Massive intra-abdominal hemorrhage is a life threatening complication associated with secondary abdominal pregnancy. Various methods and techniques have been reported in the literature for controlling hemorrhage. Here, we report a case of massive intraperitoneal haemorrhage following placental removal controlled by abdominal packing and review the literature for diagnostic and management challenges.

Vaginal stenosis (gynatresia) is commonly congenital, occurring as a part of Mayer-Kustner-Hauser syndrome. Those occurring postabortal or postpartum are rarely seen nowadays. Here, we report two cases, one in which there was complete stenosis postpartum following a retained gauze and another case, with chemical vaginal burns following attempted abortion by a local untrained midwife.

The present study was designed to evaluate the efficacy and safety of misoprostol (400 μg) given intravaginally repeated at 6 hourly intervals for a maximum of 6 doses for second-trimester pregnancy terminations. The study was conducted on women who had to undergo pregnancy termination between 13 and 26 weeks of gestation for various indications but mainly intrauterine death over a period of 2 years. A standard regime of 400 μg of misoprostol 6 hourly intravaginally was given until a maximum of 6 doses. Sixty women underwent second trimester terminations. The mean induction abortion interval was 11.8 h. The success rate at the end of 48 h was 96.6%. Side-effects were in the form of incomplete abortion, excessive blood loss, and fever. No patient had a uterus rupture. Intravaginal misoprostol 400 μg given 6 hourly seems to be an effective, safe, and acceptable method for second trimester pregnancy terminations.

Molar pregnancy is associated with very high levels of hCG in serum as well as in urine and therefore is an important marker in its diagnosis and follow-up. However, at times very high levels of hCG may be associated with falsely low or negative hCG levels because of Hook effect. Here, we report two cases molar associated with Hook effect.How to cite this articleKunwar S, Gupta H, Bagchi S, Mittal A. Hook Effect in Molar Pregnancy: A Report of Two Cases. J South Asian Feder Obst Gynae 2014;6(1):49-50.

The present study aims to determine the patterns of breast feeding, return of menstruation, and contraceptive practices in the first six months postpartum in women visiting the outpatient department at a teaching hospital in Lucknow, Northern India. Mothers of infants between six to eight months of age visiting the outpatient department of Era's Lucknow Medical College were interviewed regarding breast feeding practices, return of menstruation, sexual activity, and contraceptive practices within the first six months postpartum using a structured questionnaire. Of all women interviewed only 75.8% practiced exclusive breast feeding with the mean duration of exclusive breast feeding (EBF) being 3.5 months with only 41% practicing EBF for six months, 28% were sexually active within six weeks postpartum, 64.5% women had a return of menstruation within six months. Contraception was practiced by only 54.4% women with a barrier method such as a condom, being the most common. Better education was the only factor significantly affecting EBF (p0.004) and use of contraception (p0.027). There were a total of 10 pregnancies within six months postpartum. In conclusion, optimal breast feeding practices are poor in this part of the country and lactational amenorrhoea cannot be effectively and reliably used as a method of contraception. Therefore, optimal breast feeding practices, timely introduction of contraception and institutional delivery need to be encouraged.