International Journal of Reproduction, Contraception, Obstetrics and Gynecology
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Low recto-vaginal fistula cured by Kshar Sutra (a medicated seton) treatment: a case report
Get PDFRectovaginal fistulas (RVFs) are challenging to treat, primarily due to their high recurrence rate and the risk of faecal incontinence following surgical intervention. A 30-year-old woman was suffering from low RVF. An herbal medicated seton, known as 'Kshar Sutra,' was used to treat the patient. The local anaesthesia was used in and around the fistula track. Weekly thread changes were done on an outpatient basis for four weeks. There were no complications such as severe bleeding, secondary infection, severe pain, and incontinence. The patient has been fistula-free for the last 5 years. Low RVF can be treated safely by an herbal Kshar Sutra seton without any complications.
Evaluating a synergistic nutritional strategy in women with polycystic ovary syndrome: a multicentric retrospective analysis
Get PDFBackground: The objective of this study was to review clinical outcomes in women with polycystic ovary syndrome (PCOS) following 3-6 months of treatment with the marketed formulations containing insulin sensitizers, minerals, herbal extracts, amino acids, antioxidants, and vitamins.
Methods: An observational study was conducted to retrospectively review clinical records of women diagnosed with PCOS (age 15-42 years; n=211) at 14 fertility clinics in India between April 2024 and February 2025. From the day of PCOS diagnosis, patients received marketed formulations containing (1) insulin-sensitizing agents, antioxidants, and vitamins and (2) fertility blend containing herbal extracts, amino acids and minerals administered as two tablets daily for 3 to 6 months. The primary outcomes assessed were improvements in PCOS symptoms such as (menstrual cyclicity, acne, and hirsutism), body mass index (BMI), waist-to-hip ratio, ovarian cyst count, hormonal profile, and clinical pregnancy rates.
Results: Combination therapy significantly improved menstrual cyclicity in both obese (40% at 3 months; 80.56% at six months) and lean (42.30% at three months; 69.23% at 6 months) PCOS women. Significant reductions in acne, hirsutism, and ovarian cysts were observed across both the groups. Additionally, metabolic parameters and hormonal profiles improved significantly. The clinical pregnancy rate increased to 36.78% at three months and 65.16% at six months in obese women, while lean women showed rates of 38.46% and 53.84% respectively.
Conclusions: The combination of inositols, antioxidants, herbal extracts, amino acids, minerals, and vitamins offer a promising and clinically relevant treatment option for PCOS management, demonstrating significant benefits in metabolic, hormonal, and reproductive health
A case report on ovarian dermoid cyst
Get PDFOvarian dermoid cyst, also known as a mature cystic teratoma, is a benign embryonal tumor. Dermoid cysts account for approximately 10-25% of all ovarian tumors and comprise about 60% of all benign ovarian neoplasms. They are common in adolescent and young age and carry minimal risk of malignant transformation. A case of 14 year old adolescent girl presented to OBG outpatient department at Navodaya medical college, Raichur with compliant of abdominal pain since 1 month. Ultrasonography features suggestive of right dermoid cyst, further evaluated with tumour markers. Managed with laparotomy and proceed. Understanding the epidemiology, clinical features and imaging characteristics of dermoid cysts is essential for accurate diagnosis, to prevent complications and treatment planning
The prevalence of depression among diabetic patients in Sub-Saharan Africa and its impact on their glycaemic control: a systematic review
Get PDFType 2 diabetes poses a major global health challenge, especially in Sub-Saharan Africa, where healthcare systems are often weak and the condition's prevalence is increasing. A common but frequently overlooked complication in Sub-Saharan Africa is depression, which often goes undiagnosed and untreated. Depression is often associated with poor adherence to medication and self-care routines, leading to adverse outcomes like poor glycaemic control. Recognising how common depression is among diabetes patients and understanding the factors affecting glycaemic management in this region are crucial steps toward creating targeted interventions to improve type 2 diabetes mellitus treatment and enhance patients' quality of life. The study aimed to determine how common depression is among patients with type 2 diabetes mellitus in Sub-Saharan Africa and to examine the impact of depression on their glycaemic control. We conducted a comprehensive search of PubMed, PsycINFO, Scopus, ScienceDirect, Cochrane Library, Embase, Medline, and Google Scholar for studies on depression in individuals with type 2 diabetes mellitus in Sub-Saharan Africa and its impact on glycaemic control. Only peer-reviewed, English-language primary research articles published from January 2014 to January 2024 were eligible. Two reviewers independently selected and evaluated the articles using the Critical Appraisal Programme Tool and extracted data in accordance with preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. The review analysed 12 studies involving 3,709 participants across eight Sub-Saharan African countries. The reported rates of co-morbid depression varied, likely due to differences in sample size rather than regional factors. Five studies included gender data, showing a significant association between depression and being female. Glycaemic control rates ranged from 11.9% to 89.7%. Overall, the results demonstrated a strong link between depression among type 2 diabetes mellitus patients and poor glycaemic control (HbA1c >7%), although some studies found no such connection. The study revealed a high overall rate of comorbid depression among patients with type 2 diabetes in Sub-Saharan Africa. It also highlighted that diagnosing depression in these patients is usually associated with poor glycaemic control. Therefore, public health policymakers in the region should develop targeted strategies for screening, diagnosing, and treating depression in individuals with type 2 diabetes
Spindle cell variant of leiomyoma exhibiting myxoid change and calcification: a rare case report
Get PDFUterine leiomyomas, commonly referred to as fibroids, are the most prevalent benign tumors found in women of reproductive age, characterised by the proliferation of smooth muscle cells within the uterus. While the vast majority of leiomyomas are benign, a small percentage (approximately 1%) can undergo malignant transformation into leiomyosarcoma, complicating management and prognosis. Here we report a case of 51-year-old P1L1 presented to the outpatient department (OPD) with complaints of heavy menstrual bleeding for two years. Patient was examined and investigated. On clinical examination, a palpable pelvic mass of approximately 20×15 cm noted measuring about 24 weeks in size. On radiological examination, revealed a heterogeneously hyperechoic solid-cystic lesion measuring 12.5×10.5×7.6 cm with features suggestive of endometrial carcinoma. Total abdominal hysterectomy with bilateral salpingo - oophorectomy. Histopathological examination (HPE) report revealed endometrial hyperplasia without atypia. The myometrium reveals features of adenomyosis and leiomyoma. The subserosal fibroid consists of spindle cells in interlacing fascicles, with areas of calcification and focal myxoid change
A rare case of coexistence of bicornuate and septate uterine malformation
Get PDFCongenital uterine anomalies result from defects in the formation, fusion, or resorption of the Müllerian ducts during embryogenesis. Patients commonly present with infertility, recurrent pregnancy loss, preterm labor, or abnormal fetal presentation, though some anomalies are detected incidentally on imaging. The most frequent congenital anomaly is septate uterus. We report an unusual case of coexistence of septate uterus with bicornuate morphology in a woman presenting with primary infertility
Management of cervical atresia and vaginal aplasia leading to hematometra and endometriosis in a young patient: a case report
Get PDFCervicovaginal atresia is a rare congenital anomaly of the female reproductive system where there is a complete absence or severe underdevelopment of the cervix and /or vagina usually presenting in adolescence with severe abdominal pain and primary amenorrhoea which can further lead to endometriosis and pelvic mass. Hereby, we are reporting such a rare case of cervicovaginal atresia in 24 years female who was managed with hysterectomy. Surgery is not strictly required during menstruation, but if there is hematometra, the surgery should be performed as soon as possible to relieve the obstruction. This case reporting aims to offer insights and recommendations for future research on cervicovaginal atresia, ultimately striving to enhance the quality of life for affected individuals.
Impact of cigarette smoking on semen quality and sperm DNA fragmentation in infertile men of Chhattisgarh, India
Get PDFBackground: Cigarette smoking is a major risk factor for male infertility, primarily by reducing sperm count and motility, thereby impairing spermatogenesis and overall reproductive function. This study aimed to evaluate the effects of smoking on semen parameters and sperm DNA integrity in infertile men.
Methods: A total of 200 male partners of infertile couples attending an infertility clinic in Raipur, Chhattisgarh, from 2022 to 2024 were included. Detailed smoking histories were obtained, followed by semen analysis. Statistical comparisons between smokers and non-smokers were performed using appropriate software.
Results: Smokers had significantly lower semen volume (2.08±0.78 versus 2.45±0.79 ml), total sperm count (59.22±60.39 versus 94.12±91.12 million), total motility (44.82±24.66 versus 57.03±20.33%), progressive motility (24.67±24.19 versus 33.07±24.14%), vitality (46.46±20.18 versus 56.81±22.15%), and normal morphology (3.25±1.27 versus 3.84±1.42%), with higher DNA fragmentation index (21.33±10.52 versus 15.05±6.63%) compared with non-smokers. Moderate or occasional smokers exhibited intermediate values. Sperm concentration did not differ significantly. Normozoospermia was most frequent in non-smokers (46%), whereas daily smokers showed higher prevalence of asthenozoospermia, teratozoospermia, and combined abnormalities, suggesting a dose-dependent negative effect of smoking.
Conclusion: Cigarette smoking significantly impairs semen quality and increases sperm DNA fragmentation, contributing to male infertility. Even intermittent smoking adversely affects semen parameters, highlighting the importance of smoking cessation for fertility preservation.
Recurrent ovarian cancer with BRCA reversion: a case study and comprehensive literature review
Get PDFHerein, this report presents the case of a 48-year-old female with a history of breast cancer (2013) and subsequent high-grade epithelial ovarian cancer (2020), illustrating the complex evolution of therapeutic resistance in BRCA1-mutated malignancies. Following initial response to paclitaxel-carboplatin chemotherapy and complete surgical debulking, the patient experienced multiple disease relapses transitioning from platinum-sensitive to platinum-resistant states. Comprehensive molecular profiling via Tempus xF+ next-generation sequencing revealed a pathogenic BRCA1 mutation alongside a secondary BRCA1 reversion mutation, conferring partial restoration of homologous recombination repair and resistance to both platinum-based chemotherapy and PARP inhibitors. Subsequent therapies, including pemetrexed and liposomal irinotecan, were employed with limited success. This case underscores the dynamic molecular evolution of recurrent ovarian cancer under therapeutic pressure and highlights the critical role of serial genomic profiling in guiding personalized treatment strategies. Emerging approaches targeting alternative DNA repair mechanisms and novel antibody–drug conjugates may hold promise for overcoming resistance in BRCA-mutated, therapy-refractory ovarian cancer.
Maternal and fetal outcomes in pregnancies complicated by renal disease: a single-centre observational study
Get PDFBackground: Renal disease in pregnancy poses significant risks for both mother and fetus, with increased rates of maternal morbidity, fetal growth restriction, preterm delivery, and adverse neonatal outcomes. In India, women comprise nearly half the renal disease burden, and 3-5% of them conceive. This study evaluates the clinical profile, maternal, and fetal outcomes of pregnancies complicated by renal disease.
Methods: A retrospective observational study was conducted at a tertiary care hospital in Western India between February 2020 and July 2023. All pregnant women with documented renal disease or renal abnormalities were included. Data on demographics, comorbidities, renal parameters, obstetric outcomes, and complications were analysed.Results: Of 44 screened women, 36 met inclusion criteria. Mean age was 29.2±4.7 years; 58.3% were multigravida. Hypertension (27.8%) and proteinuria >1000 mg/day (16.7%) were significant predictors of adverse fetal outcome (p<0.05). Maternal age >30 years and multigravida status were significantly associated with caesarean delivery (p<0.05). Preterm delivery occurred in 41.7%, and intrauterine growth restriction in 25%.
Conclusions: Pregnancies complicated by renal disease represent a high-risk group requiring multidisciplinary management. Preconception counselling, optimal blood pressure control, and close antenatal surveillance can improve outcomes. Larger multicentric studies are needed for more definitive guidance.