Plexiform leiomyoma, a variant of epithelioid leiomyoma of the uterus is an incidental finding in hysterectomy specimens. Small plexiform leiomyomas that are detected only on microscopic examination are referred to as plexiform tumorlets. A case of plexiform tumorlets mimicking as metastatic lobular carcinoma of the breast is discussed.

Background: Globally, 500,000 new cases of cancer of the uterine cervix are recorded annually, nearly 20% are from India. Numerous clinical and experimental studies have established an association between HPV and cervical cancer. Most immune responses are important in resolution of HPV infection; hence, women with HIV are more likely to have severe, frequent HPV disease. Considering the increasing incidence of HIV in India, an increase in cervical abnormalities and cervical cancer can be expected in the near future. This study was thus carried out to study the prevalence and association of HPV and HIV co-infection in women with precancerous and cancerous lesions of cervix. Design: Cross-sectional study. Aims: To study the prevalence and correlation of HPV and HIV infection in women with cervical intraepithelial neoplasia and cervical cancer. Materials and methods: Sexually active women attending the Gynecology OPD and IPD with sign and symptoms suggestive of cervical pathology were subjected to cytology, colposcopy, and biopsy. Cervical samples for HPV detection and blood samples for HIV detection were taken. Statistical analysis: Chi-square test for statistical significance. Results: 254 women were enrolled based on signs and symptoms.143 women returned for follow-up. 129 were subjected to cervical biopsy and HPV testing of cervical tissue. HPV positivity in low-grade squamous intra-epithelial lesions (LSIL), high-grade squamous intraepithelial lesions (HSIL) and cervical cancer was 60%, 100% and 93.1% respectively. None of the women tested were reactive for HIV. Conclusion: For early detection and identification of high-risk population with precancerous lesions, there is a need for incorporation of HPV testing along with cytology to screen women. In view of the spreading HIV infection in India, we need to increase surveillance for HIV positive cases and increase awareness regarding prevention of HIV infection.

Background: Despite liberalization and legalization of abortion in India, over the counter sale and self-administration of abortion pills or do it yourself practice has shown rapid increase which at times may endanger the woman’s life. Aims: The available literature was reviewed with aim to focus on estimating the magnitude of unsafe medical abortion practice, its consequences, the profile of users, the knowledge among providers and consumers and to conclude with the interventions likely to improve the clinical scenario. Review result: The electronic media was searched for the articles on abortion pills in India; the suitable articles pertaining to our queries were selected and the data was analyzed. Review result showed that 48% of total pregnancies were unintended. 73% was the estimated incidence of unsupervised medical abortion. Most of the women were young, uneducated, multigravida residing in the rural area. The lack of awareness regarding legal status of abortion and lack of access to safe abortion facilities were the prime factors responsible for selfadministration of abortion pills. Analysis revealed that the chemists acted as service providers in 61.66% of cases. Pills were consumed by the standard protocol in 36.33% cases only and 57.66% patients reported within 10 days of pill intake. The outcome was complicated with severe anemia and shock in 15.8% and 10.6% cases respectively. Ignorance and apprehension led to increase in surgical evacuation (68%), thereby reducing the efficacy of these pills. Conclusion: It is emphasized that self administration of abortion pill in women is safe as long as the women are provided with accurate information and have easy access to health facility if need arises.

Fetal growth restriction (FGR) denotes a pathological process in which a fetus does not attain its biologically determined growth potential. It is an important cause of perinatal mortality and morbidity. Till date there is lack of consensus on the definition and management of FGR amongst different obstetrical bodies.This review aims to explore the available literature on the subject in order to help in defining FGR and discuss the latest management protocols.

Umbilical cord is an important structure for fetal survival. Any abnormality of the umbilical cord can lead to fetal distress, growth restriction and intrauterine death. A rare case of long cord with high umbilical coiling index leading to growth retardation and fetal distress is reported and importance of umbilical coiling index is discussed.

Gynecology laparoscopy surgeries have several patient related benefits. It is time to address the ergonomic challenges and consequently health impact on surgeons as a result of performing laparoscopic surgeries.

Background: Globally, 500,000 new cases of cancer of the uterine cervix are recorded annually, nearly 20% are from India. Numerous clinical and experimental studies have established an association between HPV and cervical cancer. Most immune responses are important in resolution of HPV infection; hence, women with HIV are more likely to have severe, frequent HPV disease. Considering the increasing incidence of HIV in India, an increase in cervical abnormalities and cervical cancer can be expected in the near future. This study was thus carried out to study the prevalence and association of HPV and HIV co-infection in women with precancerous and cancerous lesions of cervix

Interstitial cystitis/Bladder Pain Syndrome (IC/BPS) is a chronic debilitating condition with increasing incidence globally. Despite of regular update of guidelines by different regulatory bodies still there is a lack of consensus regarding the definition. It is still under reported in India. A single, standardised reporting method would help clinicians to understand and communicate best treatment options to these patients. The purpose of this article is give an overview of the current guidelines regarding diagnosis and management of this disease.

Background: Despite liberalization and legalization of abortion in India, over the counter sale and self-administration of abortion pills or do it yourself practice has shown rapid increase which at times may endanger the woman’s life. Aims: The available literature was reviewed with aim to focus on estimating the magnitude of unsafe medical abortion practice, its consequences, the profile of users, the knowledge among providers and consumers and to conclude with the interventions likely to improve the clinical scenario. Review result: The electronic media was searched for the articles on abortion pills in India; the suitable articles pertaining to our queries were selected and the data was analyzed. Review result showed that 48% of total pregnancies were unintended. 73% was the estimated incidence of unsupervised medical abortion. Most of the women were young, uneducated, multigravida residing in the rural area. The lack of awareness regarding legal status of abortion and lack of access to safe abortion facilities were the prime factors responsible for selfadministration of abortion pills. Analysis revealed that the chemists acted as service providers in 61.66% of cases. Pills were consumed by the standard protocol in 36.33% cases only and 57.66% patients reported within 10 days of pill intake. The outcome was complicated with severe anemia and shock in 15.8% and 10.6% cases respectively. Ignorance and apprehension led to increase in surgical evacuation (68%), thereby reducing the efficacy of these pills.

Pre-eclampsia (PE) is a globally prevalent complication of pregnancy whose prevalence in India is near the higher value of the global average. The diagnosis and prediction of PE is currently based on nonspecific clinical signs such as hypertension and proteinuria. PE is associated with significant morbidity and mortality for the mother as well as the fetus. Placental growth factor (PlGF) and soluble Fms-like tyrosine kinase 1 (sFlt-1) are key factors in the pathophysiology of PE. In PE patients, sFlt-1 levels increase and PlGF levels fall, resulting in an elevation of the sFlt-1/PlGF ratio. A recent NICE recommendation has included sFlt-1 PlGF ratio for the diagnosis of early PE. The sFlt-1/PlGF ratio appears to be an important triage tool in patients at risk of placenta-related disorders, in the second half of pregnancy, and also helps stratify those likely to develop adverse fetal outcomes from the others. The diagnostic strategy for PE is based on a dual cut-off. The suggested cut-offs between 20+0 and 33+6 weeks are =33 and =85 for rule-out and rule-in of PE respectively, and the values for 34+0 weeks and beyond are =33 and =110 respectively. A preliminary analysis of a study being conducted in India showed that the usage of sFlt-1/PlGF ratio resulted in continuation of stable pregnancies beyond 37 weeks without increase in perinatal mortality. Implementation of sFlt-1/PlGF ratio in the diagnostic process may help in optimizing care by improving management of women with suspected PE.

Dysmenorrhea is one of the most common clinical complaints in women. Magnitude of its effect on women’s life is immense. It leads to a major loss of productive life, yet it is the most under-rated condition in terms of diagnosis, treatment and patient satisfaction. It encompasses two varieties broadly—primary and secondary dysmenorrhea. This article attempts at clinical evaluation of a women with dysmenorrhea, establishing the diagnosis with the help of investigatory modalities and finally various modes of management and their relative effectiveness in terms published level of recommendations. We used Medline (1976–2017) to conduct a literature search of the systematic reviews, published clinical trials, population studies, and review articles cited in PubMed or the Cochrane database.