ABSTRACT
Background: Over the time the caesarean delivery rate has significantly increase worldwide from 18.2% in 2002 to 30.3% in 2012. In parous women, previous caesarean section has been found to be the most common indication for caesarean delivery in as high as 67% cases. Unsecure prediction of the integrity of the scarred LUS during labor appears to be one of the reasons for high repeat caesarean rates. The purpose of this study was to assess the usefulness of sonographic measurement of the lower uterine segment scar before labour for deciding whether it is a reliable safeguard for trial of labour or not in a woman having previous one caesarean delivery.Methods: This study was a prospective observational study, carried out on 108 pregnant women having previous one CS, gestational age >37, singleton pregnancy, cephalic presentation. Trans-abdominal USG was done to measure scar thickness. Trial of labour was given to each patient irrespective of scar thickness. Pregnancy outcome were noted in terms of successful VBAC or emergency LSCS and compared with scar thickness. Correlation between sonographic and intra-operative finding of scar were noted.Results: Result shows strong correlation between scar thickness and successful trial of labour. Scar thickness increases chances of successful vaginal deliveries.Conclusions: Sonographic assessment of previous scar has a practical application to predict the thickness and thinness of previous scar and can be taken as a reliable safeguard for trial of labour after previous cesarean but cut off value above which vaginal delivery could be considered safe is yet to be identified.
ABSTRACT
The incidence of unilateral live twin ectopic pregnancy is approximately 1:1,25,000 but increased in last few decades due to increased use of fertility drugs for ovulation induction, superovulation and assisted reproductive technology. It is also associated with increased incidence of pelvic inflammatory diseases. Patient was 30 years old G3P2L2 who presented to OPD of this LLRM medical college, Meerut with complain of amenorrhoea of two and half months. Pelvic examination revealed tenderness in lower abdomen, left adnexal fullness and tenderness without any bleeding. On USG, left adnexal monochorionic monoamniotic ectopic twins with normal cardiac activity. Exploratory laparotomy followed by left sided salpingectomy was done and patient was discharged with satisfactory condition. This is a very rare case and PID is also among risk factors and may also cause twin ectopic pregnancy.
ABSTRACT
Background: Carcinoma of cervix is one of the most common cause of cancer related deaths among women in developing countries. Adoptions of healthy life style and extensive screening by Conventional Pap smear followed by early intervention have resulted in decline in death rates by cervical cancer. Aims: The aim of this study was to know the incidence of preneoplastic and neoplastic lesions of cervix in various age groups by using Conventional Pap smear. Methods: A retrospective observational study carried out in the Department of Pathology, Chirayu Medical College & Hospital, Bhopal from January to April 2018. All the cases (n= 268), from May 2015 to April 2018, reported in Conventional Pap smear as preneoplastic lesions and invasive malignancies were retrieved from hospital medical record and Lab Information System (LIS). Results: Highest number of cases 93 (34.7%) of both preneoplastic and neoplastic lesions were found in the age range of 41-50 years. We had 19 cases (7%) of preneoplastic lesions and zero cases of invasive malignancy in the age range of 21-30 years, 31 cases (11.5%) of both preneoplastic and invasive malignancy in >60 years of age. Conclusion: Conventional Pap smear is cost effective, simple and easily applicable method which can be performed on OPD basis. It should start at a younger age so that preneoplastic and neoplastic lesions can be diagnosed in an early stage.
ABSTRACT
Langerhans cell histiocytosis (LCH) is a rare proliferative histiocytic disorder of unknown etiopathogenesis. The clinical presentations range from unifocal or multifocal bony lesions to disseminated form of the disease with multiorgan involvement. The unifocal bony lesion (Solitary eosinophilic granuloma) carries a good prognosis. We report such a case of unifocal bony lesion of LCH involving tibia in a 8 years old female child. The clinical and radiological manifestations were non specific, enlightening the suspicion of osteomyelitis. A curettage excision biopsy was performed which on microscopy revealed sheets of eosinophils in milieu of Langerhans cells, giant cells, lymphocytes and plasma cells. Langerhans cells showed strong immunoreactivity for S-100 and CD1a antigen thus establishing the diagnosis of LCH. LCH of long bones may be a rare entity but it must be kept in mind as a differential diagnosis whenever a child presents with features of osteomyelitis.