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Introduction: One of the most important aspect of postoperative care is pain management which plays an important role in early recovery and improves patient’s general condition. Paracetamol and diclofenac have an excellent safety profile when compared to opioids. Aim: To assess and compare the analgesic efficacy and safety of individual use of Intravenous (IV) paracetamol, diclofenac suppository and in combination. Materials and Methods: This hospital-based cross-sectional study was conducted from October 2018 to June 2020 at Department of Obstetrics and Gynaecology. A total of 90 women who underwent caesarean section were recruited for the study and were randomly allocated (lottery method) into three groups with 30 participants in each group. The patients underwent Lower Segment Caesarean Section (LSCS) under spinal anaesthesia with the same technique and medicine, (Bupivacaine 0.5%) without receiving any sedation. Group A patients received diclofenac suppository 50 mg every eight hourly, Group B received paracetamol infusion 1000 mg every eight hourly and Group C received 50 mg diclofenac suppository and 500 mg IV paracetamol every eight hourly. Pain severity (Visual Analogue Scale (VAS) score), Heart Rate (HR), Blood Pressure (BP) and side-effects were evaluated at 2,4,6,8,12 and 24 hours postoperatively. Patient satisfaction score was evaluated 24 hours after caesarean section. Results: Age range of participants was 19 to 28 years. Mean duration of surgery (minutes) in each group were- Group A-56.5±7.49, Group B-58.27±8.06 and Group C-56.97±6.78, respectively. There was a significant reduction of pain in patients receiving paracetamol and diclofenac suppository combination group. The satisfaction score was categorised as excellent by 80% patients in Group C. In Group A 30% and in Group B 16.6% categorised as excellent patient satisfaction score. The adverse effects such as nausea and epigastric discomfort was higher (7.7%) with diclofenac suppository group followed by Paracetamol (2.2% side-effects) and minimal with combination (1%). Conclusion: Paracetamol infusion is as effective as diclofenac suppository in reducing postoperative pain following caesarean section. Diclofenac suppository and IV paracetamol combination provides more effective postoperative analgesia compared with individual usage of IV paracetamol or diclofenac suppository in patients following caesarean section. The combined use of paracetamol and diclofenac suppository has fewer side-effects compared with individual use of either IV paracetamol or diclofenac suppository

Molluscum Contagiosum (MC) is a common viral infection of skin caused by a double stranded DNA Pox virus affecting both adults and children. MC is primarily an infection of school-going children (one to five years), occasionally it affects adults and immunocompromised individuals. Transmission of virus occurs by direct contact with infected person or contaminated objects. Most common sites are skin of face, trunk and extremities in children, genitals in adults and rarely palms, soles and mucous membranes. The occurrence of MC in genitals is lowest (3%). We present a case report of Molluscum Contagiosum of cervix which is a rare site; only one case has been reported in medical literature till date.

Purpose: There is significant prevalence of overt and subclinical hypothyroidism in pregnant women in rural areas. Maternal hypothyroidism is known to cause congenital hypothyroidism resulting in sensorineural hearing loss. Anti-Thyroperoxidase antibodies are known to cross placental barrier. There is no literature on hearing assessment in infants born to women whose hypothyroidism was corrected during pregnancy. Do these infants suffer hearing loss? Our study addresses this question., Methods: 140 infants born to women on treatment for hypothyroidism during pregnancy and 140 infants born to euthyroid women were evaluated for hearing by Brainstem Evoked Response Audiometrry at 1 and 4 months age. Anti-TPO antibodies were estimated at 4 months of age., Results: There was no clinical hearing deficit or delay in neurological development in infants born to women undergoing treatment for hypothyroidism during pregnancy. However wave V latency on BERA was slightly prolonged in them compared to infants born to euthyroid women. There was absence of wave V when maternal subclinical hypothyroidism persisted till parturition. However within 6-8months of age the wave V latencies corrected to normal. Anti-TPO antibodies were within normal range at 4months age., Conclusion: Maternal hypothyroidism when corrected before parturition does not affect hearing in the infants clinically. The mild delay in wave V on BERA corrects within first year of life. However larger studies to assess hearing in infants born to women having overt hypothyroidism during first trimester of pregnancy may be desirable to assess whether hearing is adversely affected in them., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Objectives: Placental hypoxia is a hallmark of preeclampsia. SNP rs479200 in the EGLN1 gene is associated with reduced responsiveness to hypoxia. Whether this translates into an association between SNP rs479200 and preeclampsia is not known. We evaluated the association of SNP rs479200 (T>C) with the risk of preeclampsia., Methods: This case-control study involved 600 pregnant women of whom 300 were preeclamptic and 300 were normotensive. SNP rs479200 was genotyped by PCR-RFLP method., Result: Minor allele frequency was 44% in preeclamptic women and 53% in normotensive pregnant women (P = 1.8 × 10 -3 ; odds ratio = 1.43). The odds ratio was heterogeneous when compared after categorization of the preeclamptic group into clinical sub-groups. The association was significant with both mild (P = 6.2 × 10 -5 ) and severe (3.8 × 10 -3 ) preeclampsia. However, the odds ratio was 0.52 for mild preeclampsia and 1.43 for severe preeclampsia., Conclusion: The minor allele of SNP rs479200 is associated with the predisposition to preeclampsia. This association underlines the importance of oxygen sensing in the pathogenesis of preeclampsia., (Copyright © 2019. Published by Elsevier B.V.)

Objectives: SNP rs2200733 located near PITX2 gene is associated with the risk of atrial fibrillation. Preeclamptic women are at increased risk of developing cardiovascular disease like atrial fibrillation. Whether this translates into an association between SNP rs2200733 and preeclampsia is not known. Therefore, we determined the association of SNP rs2200733 (C/T) with the risk of preeclampsia., Study Design: A hospital based prospective case-control study involving 585 pregnant women of whom 285 were preeclamptic and 300 were normotensive. SNP rs2200733 was genotyped by PCR-RFLP method., Main Outcome Measures: Statistical significance of the difference in the minor allele frequency between case and control groups was determined by Fisher's exact test., Results: Minor allele frequency was 21.4% among preeclamptic pregnant women and 13.7% among normotensive pregnant women (P = 0.00064; odds ratio = 1.72 (0.95 CI: 1.23-2.41). The measures of association were heterogeneous when compared after categorisation of the preeclamptic group into clinical sub-groups. The association was not significant with the eclampsia sub-group (P = 0.39) but relatively higher with the sub-group not superimposed by eclampsia (P = 0.0000048; odds ratio = 2.10 [0.95CI: 1.50-2.92]). Furthermore, the association was relatively higher with the sub-group involving intrauterine growth retardation and intrauterine death (P = 0.00017; odds ratio = 2.89 (0.95CI: 1.65-4.94)]., Conclusions: Minor allele of SNP rs2200733 is associated with the risk of preeclampsia. SNP rs220073 may represent a common risk factor that predispose women to develop both preeclampsia during pregnancy and cardiovascular disease later on., (Copyright © 2018 International Society for the Study of Hypertension in Pregnancy. Published by Elsevier B.V. All rights reserved.)