Mixed germ cell tumors are very rare in young females. Patient survival, preservation of ovarian function and fertility are becoming an important issue. A locally advanced (III), bulky malignant mixed germ cell tumour in a 12-year-old girl presented to the Department of Radiotherapy, Regional Institute of Medical Sciences, Imphal, Manipur, in January 2011 with abdominal distension for one month. On physical examination, there was a large lower abdominal mass approximately 16x 14 cm2. Abdominal and pelvic CTs showed a lobulated 19x 15x10 cm soft tissue attenuation mass lesion in the pelvis extending superoanteriorly to supra-umbilical area. Laboratory investigations revealed increased serum LDH (4,245 IU/ L) and serum P-hCG (105.4 mIU/ml). Ultrasonography (USG)-guided fine needle aspiration cytology (FNAC) from left ovarian mass was suggestive of malignant germ cell tumour. In view of bulky and advanced stage, patient was administered four cycles of neoadjuvant chemotherapy (inj. ifosphamide 1,440 mg, inj. etoposide 90 mg, inj. cisplatin 24 mg for D1 -5, four weekly) followed by left salpingo-oophorectomy with wedge biopsy of right ovary and partial omentectomy, and another two cycles of adjuvant chemotherapy with same regimen. Biopsy tissue histopathology report also confirmed mixed germ cell tumour. Patient was kept on regular follow-up and she has been disease-free for the last four years. The present authors' treatment policy in such bulky and advanced tumor in adolescents is effective.

β-Lactam antibiotic resistance has been a big problem since the usage of these antibiotic drugs in medical practice. For reducing the side-effects of these antibiotics, the β-lactam antibiotic degrading enzymes play a major role. A thermophilic bacterial strain Geobacillus stearothermophilus “AAP7919” (NCBI accession number GU459259) isolated from oil sludge site, was found capable of producing of β-lactamase enzyme in alkaline condition (pH 10) with Benzyl-penicillin as substrate. In the present study an attempt was made to characterize and optimize the production of this enzyme by ion exchange chromatographic purification followed by SDS - PAGE and FTIR studies. Primarily the enzyme activities of extracellular and intracellular β-lactamase were detected as 33.15 U mg−1 and 15.56 U mg−1 respectively. The optimal production of β-lactamase was determined at pH 10.0 (828.73 U mg−1) at 40°C temperature and the maximum thermal stability period with enzyme activity 563.54 U mg−1 was observed at 210 min (50°C). The main functional groups which are involved in IR adsorption process were found to be alcohols, alkenes and alkyl halides. The broad intense absorption peaks at 3436 cm−1 indicated the existence of alcohol groups. The peaks located at 1135 cm−1, 1054 cm−1 and 711 cm−1 were characteristics of alkyl halide groups. The peaks located at 1633 cm−1, 997 cm−1 and 923 cm−1 were characteristics of alkenes groups. The peaks at 2083 cm and 1405 cm were characteristics of alkynes and aromatic groups respectively

International Journal of Gynecology & ObstetricsVolume 119, Issue S3 p. S289-S289 Free communication (oral) presentations O080 MATERNAL NEAR MISS: ITS TREND AND ROLE AS AN INDICATOR OF MATERNAL MORBIDITY R. Bala, R. BalaSearch for more papers by this authorK.P. Devi, K.P. DeviSearch for more papers by this authorC.M. Singh, C.M. SinghSearch for more papers by this author R. Bala, R. BalaSearch for more papers by this authorK.P. Devi, K.P. DeviSearch for more papers by this authorC.M. Singh, C.M. SinghSearch for more papers by this author First published: 22 October 2012 https://doi.org/10.1016/S0020-7292(12)60510-4AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article. Volume119, IssueS3Abstracts of XX FIGO World Congress of Gynecology and ObstetricsOctober 2012Pages S289-S289 RelatedInformation

International Journal of Gynecology & ObstetricsVolume 119, Issue S3 p. S487-S487 Free communication (oral) presentations O643 DIFFERENTIAL MATERNAL MORTALITY: A HOSPITAL BASED STUDY IN THIRTY NINE YEARS K.P. Devi, K.P. DeviSearch for more papers by this authorM.R. Singh, M.R. SinghSearch for more papers by this authorS.R. Devi, S.R. DeviSearch for more papers by this authorL.R. Singh, L.R. SinghSearch for more papers by this authorN.N. Singh, N.N. SinghSearch for more papers by this authorCh.M. Singh, Ch.M. SinghSearch for more papers by this author K.P. Devi, K.P. DeviSearch for more papers by this authorM.R. Singh, M.R. SinghSearch for more papers by this authorS.R. Devi, S.R. DeviSearch for more papers by this authorL.R. Singh, L.R. SinghSearch for more papers by this authorN.N. Singh, N.N. SinghSearch for more papers by this authorCh.M. Singh, Ch.M. SinghSearch for more papers by this author First published: 22 October 2012 https://doi.org/10.1016/S0020-7292(12)61073-XAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article. Volume119, IssueS3Abstracts of XX FIGO World Congress of Gynecology and ObstetricsOctober 2012Pages S487-S487 RelatedInformation

International Journal of Gynecology & ObstetricsVolume 119, Issue S3 p. S500-S500 Free communication (oral) presentations O681 KNOWLEDGE, ATTITUDE AND PRACTICE OF PAP SMEAR AS A SCREENING PROCEDURE AMONG NURSES IN A TERTIARY HOSPITAL IN NORTH EASTERN INDIA C. Thippeveeranna, C. ThippeveerannaSearch for more papers by this authorS.M. Surekha, S.M. SurekhaSearch for more papers by this authorK.P. Devi, K.P. DeviSearch for more papers by this authorR.S. Laiphrakpam, R.S. LaiphrakpamSearch for more papers by this authorC.M. Singh, C.M. SinghSearch for more papers by this author C. Thippeveeranna, C. ThippeveerannaSearch for more papers by this authorS.M. Surekha, S.M. SurekhaSearch for more papers by this authorK.P. Devi, K.P. DeviSearch for more papers by this authorR.S. Laiphrakpam, R.S. LaiphrakpamSearch for more papers by this authorC.M. Singh, C.M. SinghSearch for more papers by this author First published: 22 October 2012 https://doi.org/10.1016/S0020-7292(12)61111-4AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article. Volume119, IssueS3Abstracts of XX FIGO World Congress of Gynecology and ObstetricsOctober 2012Pages S500-S500 RelatedInformation

International Journal of Gynecology & ObstetricsVolume 119, Issue S3 p. S496-S496 Free communication (oral) presentations O668 ANALYSIS OF RISK FACTORS, MATERNAL AND FETAL OUTCOME OF SPONTANEOUS PRETERM PREMATURE RUPTURE OF MEMBRANES: A CROSS SECTIONAL STUDY S.M. Surekha, S.M. SurekhaSearch for more papers by this authorC. Thippeveeranna, C. ThippeveerannaSearch for more papers by this authorK.P. Devi, K.P. DeviSearch for more papers by this authorB. Devi, B. DeviSearch for more papers by this authorC.M. Singh, C.M. SinghSearch for more papers by this author S.M. Surekha, S.M. SurekhaSearch for more papers by this authorC. Thippeveeranna, C. ThippeveerannaSearch for more papers by this authorK.P. Devi, K.P. DeviSearch for more papers by this authorB. Devi, B. DeviSearch for more papers by this authorC.M. Singh, C.M. SinghSearch for more papers by this author First published: 22 October 2012 https://doi.org/10.1016/S0020-7292(12)61098-4AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article. Volume119, IssueS3Abstracts of XX FIGO World Congress of Gynecology and ObstetricsOctober 2012Pages S496-S496 RelatedInformation

Despite high efficacy of oral contraceptives, the acceptance rate is low because of side effects. In this study an attempt has been made to select the low dose steroid formulations, depending upon the endocrine profile of an individual. Majority of the side effects are related to estrogen/ progestogen imbalance of the product. The content of estrogen and progestogen of various oral contraceptive pills varies and thus affect women's own hormonal balance. Whether a woman is predominantly estrogenic or progestogenic can be assessed from her menstrual symptoms and gynaecological examination. In this study an attempt has been made to select a low dose steroid formulation depending upon endocrine profile of an individual and to assess whether the acceptability is thus increased and the number of drop-outs related to drug side effects is reduced.

The efficacy, incidence of side effects, and discontinuation were studied in 50 subjects who received intramuscular norethisterone enanthate (200 mg) in 2 treatment schedules over an 18 month period. Subjects in group A received the injection every 2 months during the study period whereas those in group B received the injection at a 2 month interval for the 1st 6 months and every 3 months thereafter for 18 months. No pregnancy occurred in either group. Longer cycles and a higher incidence of amenorrhea were noted in the group B subjects. The bleeding pattern showed an increase in spotting episodes in group A at the 4th injection, following which no apparent difference in the bleeding pattern was noted in the 2 groups. The discontinuation rate was 80% at the end of the study, 28% of the subjects having dropped out for amenorrhea, 16% for irregular bleeding, and spotting, and 6% for minor medical complaints.

The accuracy of placental localisation by radioisotopic scanning using 99mTc-labelled red blood cells has been estimated in 20 patients. The results have been correlated with the findings at delivery by direct and indirect methods. The accuracy of results regarding upper and lower segment insertion of the placenta was 90% in the present study.

Abortion was legalized in many states in India in April 1972. This study deals with 2 groups of patients admitted to P.G.I., Chadigarh, with problems of induced septic abortion. Group 1 consisted of 88 patients admitted during the 2 1/2 year period from 1 July 1969 to 31 December 1971, before the legalization of abortion. Group 2 consists of 133 patients admitted during the 2 1/2 year period from 1 July 1973 to 31 December 1975. 1 year after the new abortion law had been in force. Not only has there been an increase in the total number of patients, there has been an increase in the severity of infection. Evidently, the liberalization of the law has encouraged more patients to seek abortions and has encouraged more doctors, lacking proper qualifications, to perform them. The morbidity and mortality with induced septic abortion can only be reduced if enough public propaganda makes the people especially in rural areas conscious of the hazards of induced abortion by "dais" and unqualified personnel, simultaneously making them aware of the provision of law and facilities available at different centers. Meanwhile, the law against unskilled and untrained personnel should be rigorously enforced.

In an effort to assess foetal-placental status through an estimation of serum estrogens (estradial and estrone) and progesterone 114 high risk pregnancies were studied. Results indicated: 1) Of the 62 cases of bad obstetric history (BOH) indicated by 2 previous pregnancy losses 9 premature deliveries due to incompetent os had estrogens and progesterones within the normal range. In 50 other cases of bad obstetric history estrogen estimations predicted 46 of 49 normal deliveries and progesterone predicted all normal deliveries. 1 case of foetal loss had low levels of both hormones; 2) Normal deliveries associated with toxaemia had estrogen and progesterone levels in normal range and could thus be used as a predictor in 85% of cases. In 9 cases with abnormal births the hormonal levels were within normal range and could not be used as predictors; 3) In the diabetic pregnancy high risk group 13 of 15 cases had normal outcomes with both estrogens and progesterone within normal ranges. In the 2 abnormal outcomes estrogen was low in only 1 case while progesterone was normal in both; 4) In Rh-isoimmunized pregnancies levels of progesterone and estrogen were independent of foetal status; and 5) Higher correlations of estrogens and birth weight were evidenced at later stages of gestation while progesterone values showed no significant correlation. The authors contend that serial estimations of estrogen and progesterone in serum is important in management of BOH and toxaemia pregnancies and that normal estrogen values indicate normal function of foetal-placental unit and low progesterone can predict foetal danger.

The incidence association between genital mycoplasma isolation and copper IUD users is reported in this Indian study. The study group (IUD users) had 24.3% isolation of mycoplasma (16 of 66 subjects) compared with a figure of 11.4 in controls (non-IUD users). This was a statistically significant difference (P .001). Incidence of T-strains was more in the study group (18.2%) as compared with controls (2.2%) (P .001). Large-colony mycoplasmas (Mycoplasma hominis) had a statistically similar distribution in both study and control groups (6.1 and 9.2%, respectively) (P .005). In different categories of copper IUD users, the percentage of positivity of T-strains was higher in Copper t and Copper 7 users (33.3%) than in any other group which was statistically significant (P .001). However, M. hominis was found in the highest percentage among users of Lippes Loop (20%).

Morbidity after vaginal tubal ligation with or without medical termination of pregnancy at the same sitting is reported, based on a series of 619 vaginal tubal ligations, 422 of which were concurrent with abortion (Group 1) and 196 of which had interval sterilizations by tubal ligation. All concurrent abortion/tubal ligations were performed on pregnancies less than 13 weeks of gestation. No statistically significant difference in duration of postoperative stay of the 2 patient groups was found. 13 cases (3%) of Group 1 patients required reevacuation; 2 cases from Group 2 were readmitted with vaginal bleeding, the result of the vaginal wound. Total complication rates in the 2 groups were 12.4 and 6%, respectively. Therefore, the total immediate and late morbidity rates in the 2 groups (after correction) were 9.4 and 6%, respectively; this is not statistically significant.

The results of a study of 618 cases of vaginal tubal ligations performed in 3 years at the Postgraduate Institute of Medical Education in India are reported. 60% of the women were older than 29 years. 76% had living children. Only 1 woman had no children. Thee was a significant difference in the percentage of women with 5 or more living children between the rural and urban population (P .01). In only 9.5% of women, pregnancy had advanced beyond 10 weeks. No prophylactic antibiotics were given, and follow-ups occurred at 2 weeks, 6 weeks, 3 months, and 12 months. Only 9.5% of cases received antibiotics while in the hospital; 73 cases (11.8%) received antibiotics during follow-up because of late complications such as pelvic infection, granulation tissue, and tuboovarian disease. The total complication rate was 15%. Rectal injury occurred in 6 cases (.95%). 17 cases were labeled as vaginal route failures. 2 cases with serious complications, 1 pelvic abscess with fistula and 1 pelvic peritonitis, were noted. Pain during defecation, a common complaint at 2-week follow-up, was not encountered at the 6-week follow-up. About 5.5% did not show up for follow-up; 37.2% were followed for more than 12 months. No significant difference in morbidity was noted between rural and urban patients.

Serum levels of norethisterone (NET) progesterone and estradiol-17beta (E2-17beta) were determined at frequent intervals in a control cycle and thereafter for 32 weeks following repeated intramuscular injections of 200 mg norethisterone oenanthate at intervals of 56 days in two healthy normally menstruating women. One of them obese and sedentary in habit had high NET levels following the injections and had frequent episodes of prolonged menstrual bleeding requiring endometrial curettage. Highest levels of NET (6-13 ng/ml) were observed at 2 weeks following the injection and then declined gradually. NET could be estimated in the serum 15 weeks after the last injeciton. Serum progesterone levels suggestive of luteal cell function were recorded in one subject as early as 56 days and in both subjects after the 3rd injeciton. Endometrial biopsy showed a lack of secretory activitiy in both the cases.