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Introduction: Hypertensive disorder of pregnancy is a mysterious condition. Even after extensive research, it is associated with high maternal as well as perinatal mortality and morbidity. The origin of hypertension in pregnancy is thought to be lying in the placenta. β -hCG and PAPP-A are glycoproteins produced from placenta. Therefore, these values are reported to be altered in hypertensive disorders of pregnancy., Aim and Objective: To determine the predictive value of early trimester serum β-hCG and PAPP-A levels for the development of hypertensive disorders of pregnancy., Materials and Methods: This is a prospective cohort study conducted at IMS and SUM Hospital, Bhubaneswar. Maternal serum β -hCG and PAPP-A levels were measured in all the singleton pregnant women at 11 + 0-13 + 6 weeks. All these women were followed up till delivery to find out the development of hypertension. The outcome was matched with their respective biochemical markers and analyzed., Results: Mean value for maternal serum β -hCG of the study population was found to be 48.95 ng/ml with a range of 2-210 ng/ml. Hence, maternal serum β -hCG value during 11-13 weeks of pregnancy shows no correlation with the development of HDP later in pregnancy. The mean value of maternal serum β -hCG for women who developed HDP and those who did not develop the pathology was 48.13 ng/ml and 49.78 ng/ml, respectively ( p  = 0.61). Mean value of serum PAPP-A for the normotensive group was found to be 5.12 mIU/ml and 3.76 mIU/ml for women who developed HDP ( p  < 0.01)., Conclusion: Low maternal serum PAPP-A determined at 11 + 0-13 + 6 weeks has a better predictive value for the development of hypertensive disorders in pregnancy than β -hCG., Competing Interests: Conflict of InterestAuthors declare no conflict of interest., (© Federation of Obstetric & Gynecological Societies of India 2024. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.)

Introduction: Internet access, smartphones, and televisions have significantly boosted over-the-top (OTT) movies and web series viewing in India, especially among youths. Despite restrictions, OTT platforms continue to promote tobacco products. India has recently enforced the revised OTT Rules 2023 effective September 1, 2023, to counter tobacco promotion in OTT shows. This study explores compliance with the OTT Rules 2023 in popular movies and web series on select OTT platforms in India., Methods: About 29 movies and 31 web series from seven popular OTT platforms as of September 26, 2023, were analyzed in this study. The incidence of tobacco imagery and compliance with the OTT Rules 2023 were assessed using a standardized format with the help of seven trained coders. Descriptive statistics were used to describe instances of tobacco imagery and violations of the provisions of Indian law., Results: The average incidence of tobacco imagery per included show was 3.95. None of the movies and web series fully complied with the provisions of health spots and audio-visual warnings. Only 35.7% of the shows (movies: 57.1%, web series: 14.3%) fully complied with the anti-tobacco static message provisions. The foreign-origin movies had zero compliance with static messages, though they had fewer tobacco images. Half of the shows for children up to 12 years old had tobacco imagery but fully complied with the static warning message provisions., Conclusion: The portrayal of tobacco imagery in OTT shows is prevalent, and their poor compliance with the OTT Rules 2023 is a concern. Therefore, monitoring and stricter enforcement of the OTT Rules should be given priority to protect viewers from tobacco promotion in OTT shows., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Jena et al.)

Aims: This study is aimed at finding out a logical solution for perimenopausal menorrhagia in normal or bulky uterus., Settings and Design: The study is carried out at a tertiary care hospital at Odisha. In our setup, nearly 900 hysterectomies are done per year out of which 60% are for menorrhagia with bulky uterus., Subjects and Methods: There were sixty cases of menorrhagia between the ages of 40 and 55 years who completed child bearing treated with ormeloxifene. Their endometrial thickness (ET) and hemoglobin (Hb) level were determined at the start of the study and also at 6 months and compared. At 1 year from the start of treatment, patients' satisfaction and status of menstrual cycle were reassessed., Statistical Analysis Used: Age and parity variables were expressed as mean ± standard deviation and range. We used the paired samples t -test to estimate the mean, median, range, P and t value. All statistical analyses were performed using SPSS software version 11.5 (IBM Corp) and tests of statistical significance were two-sided and differences were taken as significant when P < 0.05., Results: After 1 year of follow-up, 90% of patients found to be amenorrhoic and only two out of them presented with mild irritability and vasomotor complaints which resolved with counseling and placebo therapy. There was a significant reduction ( P < 0.0001) in ET and rise in Hb level ( P < 0.0001)., Conclusions: Ormeloxifene is a safe drug which can be used to treatment of perimenopausal bleeding with minimal focal pathology., Competing Interests: There are no conflicts of interest.

Unlabelled: Doppler measurement provides information on the hemodynamics in the hepatic artery and the portal venous system., Aim: To study the hepatic artery hemodynamics in children with extra hepatic portal vein obstruction., Materials and Methods: Hepatic artery indices were studied using Doppler indices in 15 children (<12 years) with extra hepatic portal hypertension (EHPVO) and obliterated esophageal varices. The hepatic artery resistive index, the arterial acceleration time and the acceleration index were used to determine the flow pattern within the hepatic artery. Controls were 15 healthy age-sex matched children, belonging to the same socioeconomic strata in absence of liver disease., Results: The mean age of the children was 8.43 ± 3.2 years and male female ratio was 4:1. All the children had obliterated esophageal varices. The hepatic artery resistive index in the children with EHPVO was normal and similar to controls. The hepatic arterial early systolic acceleration index was significantly higher in cases compared to controls (436 ± 290 vs 214 ± 100; P value <0.004). The hepatic arterial acceleration time though low in the cases (86 ± 35 cm/s) was not statistically different from the controls (128 ± 14 cm/s)., Conclusion: There was a significant increase in hepatic arterial early systolic acceleration in children with chronic EHPVO. The latter may be responsible for an increase in hepatic arterial in flow velocity in a slow flow system despite a normal resistive index.