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Heterotopic pregnancy is a rare occurrence in naturally conceived pregnancy and is difficult to assess as pain and bleeding may be due to abortion. We report a case of spontaneous heterotopic pregnancy which was missed in initial transabdominal scan and was reported to be intrauterine pregnancy and was later identified as heterotopic pregnancy with serial beta-human chorionic gonadotropin levels and clinical features. If assisted reproductive treatment procedures are not involved, it is likely to be missed and may lead to serious and delayed consequences. [ABSTRACT FROM AUTHOR]

Cervical esophageal perforation is rare and associated with a high morbidity and mortality >20% if misdiagnosed. At least half of the perforations are iatrogenic, mostly related to endoscopic instrumentation used in the upper gastrointestinal tract. We describe two cases of cervical esophageal perforations during negotiating the cricopharynx. Both patients had malignant stricture in mid and lower esophagus, respectively, and developed iatrogenic perforation during palliative metallic stenting – one of the two by a pediatric gastroscope. Both the patients were diagnosed as having esophageal perforation in the first 6 h after procedure and successfully managed with medical management. Patients with small perforations and minimal extraesophageal involvement may be managed with nonoperative treatment. [ABSTRACT FROM AUTHOR]

Abstract: The hallmark of ovarian cancer treatment, over decades, is accurate diagnosis, precise surgical staging, and optimal cytoreduction, followed by chemotherapy in the majority of cases. However, it is distressing to see the development of disease recurrence, resistance, and poor prognosis. Ovarian cancer cells express gene signatures, which pose significant challenges for cancer drug development. The aim of this review is to discuss the recent developments in terms of screening, surgical management, newer chemotherapeutic agents and molecular targeted therapies to improve the overall prognosis of ovarian cancer. [Copyright &y& Elsevier]

Several epidemiological studies have confirmed an increased incidence of lymphoproliferative diseases post renal transplantation, with the highest incidence in the second decade post transplantation. This report describes a case of primary non Hodgkins lymphoma of the lower oesophagus in a young man nine years post renal transplantation. This is an extremely rare disease with less than fifteen case reports in the literature. His disease had a very aggressive course, was refractory to chemotherapy and radiotherapy and the patient died within ten weeks of being diagnosed. [Copyright &y& Elsevier]

A 24-year-old female was admitted in Apollo Hospitals, Ahmedabad with history of caesarian section 24 hrs ago for PET and triplet pregnancy. Her condition deteriorated after caesarian section. A clinical diagnosis of HELLP syndrome was made, supported by laboratory investigations. She stayed in hospital for 14 days with close monitoring in high dependency unit with supportive and symptomatic care and blood products. She also developed peripartum cardiomyopathy but a multidisciplinary team approach in the hospital saved the life of the patient which was a near miss mortality. [Copyright &y& Elsevier]