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I am pleased to write the editor's desk for this issue of Indian Obstetrics and Gynaecology.
Emergency obstetric hysterectomy is the last resort in the obstetrician's armamentarium to save the life of mother. The main indications include postpartum haemorrhage and morbidly adherent placenta. The epidemic of caesarean sections throughout the world has increased the incidence of morbidly adherent placenta which may require obstetric hysterectomy. We have an interesting and clinically useful article on 'Role of Emergency Obstetric Hysterectomy to Reduce Maternal Death' by Dr. Nibedita and co-authors.
Dr. Reddi Rani, our esteemed editorial board member & regular contributor from Pondicherry, and co-author have enlightened us by an interesting review article on 'Infectious Morbidity after Caesarean Section- Analysis of Risk Factors and Strategies to Reduce Risk'. Caesarean delivery remains the single most important risk factor for postpartum infection. This review article analyses the risk factors and discusses prevention strategies to reduce the incidence of postoperative infections. Given the short duration of hospital stay, post caesarean delivery infections may often be detected after discharge from hospital.
Locked twins should be anticipated in twin gestations when the after-coming head of first breech foetus gets locked with the head of second cephalic foetus. We have an interesting case report on 'Interlocking in Diamniotic Twin Pregnancy' by Dr. Pushplata and co-authors. Prenatally diagnosed isolated enlarged hyperechogenic kidney poses a great diagnostic dilemma due to varied underlying aetiologies. Family members should be screened as parental kidneys are likely to be informative in accurate prenatal diagnosis and prognostication. A case report by Dr. Gupta and co-authors on 'Autosomal Dominant Polycystic Kidney Disease in Foetus' may be of interest to our esteemed readers.
Misoprostol, originally introduced as a therapy for gastric ulcers, is now widely used in reproductive health. The optimal dose varies widely. Dr. Praveen Kumar and co-authors present 'A Randomized Controlled Study to Compare Three Time Regimen of Misoprostol after Oral Mifepristone in Medical Abortion' which will be useful for the readers. This method of abortion using misoprostol is highly successful in termination of pregnancies up to 56 days of gestation.
Endometriosis is considered to be an enigmatic disorder with various aetiologies, pathogenesis and management. It is associated with significant morbidity like chronic pelvic pain and infertility. We have a review article on 'Recent Advances in Medical Management of Endometriosis' by Dr. Bandyopadhyay and Dr. Pal to enlighten our readers. Progestins remain a proven mode of treatment. Prolonged administration of norethisterone yields good results.
There is also an interesting case report in the Gynaecology section on 'Single Vulval Mass with Coexisting Labial Fibroid and Gartner's Duct Cyst' by Dr. Mukhopadhyay and co-authors. This case is discussed here because of its rarity. All vulval lesions require prompt diagnosis and treatment. Brigadier Dr. Bhatnagar and co-authors present here a case of 'Multiple Vesicovaginal Fistulae with Vesicle Calculus following Abdominal Hysterectomy'. VVF is a devastating condition and a social & surgical problem. Quick and accurate diagnosis will improve the outcome and limit the clinical insult & distress.
We are introducing a new section to our journal, 'Letters to Editor'. We invite our revered readers to send their comments on the published articles. Letter topics may include critiques on methodology or module used in articles to alternative views on subjects. Letters selected for publication will undergo scrutiny by our peer reviewers.
We wish our esteemed readers a happy reading and welcome their valuable comments.