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I am extremely delighted to write the Editor's Desk for this issue of IOG with great pleasure and satisfaction due to smooth functioning of previous issues and great appreciation received by obstetricians and gynecologists, all across India and the neighboring countries. We expect continuous extensive support to the journal from our readers and as usual, we invite your suggestions and contributions to enrich the journal.
I feel extremely happy to present this new issue to our esteemed readers. I offer thanks to the contributors of articles and case report.
In this issue we have an original study on 'Leiomyomas in Pregnancy - clinical implications' by Dr. Mandira Dasgupta and co-authors from Kolkata which will be very useful for our readers in their day to day practice, as leiomyoma's are very common and can complicate pregnancy. They may be asymptomatic and may not influence maternal and perinatal outcome in most cases but large fibroids can adversely affect outcome. A cervical fibroid or large fibroid in lower segment can cause malpresentations and may necessitate caesarean section. As a general principle myomectomy is avoided during caesarean section due to increased risk of haemorrhage and rare need of hysterectomy however, a fibroid coming in the wall of caesarean section or a subserous fibroid may be removed at the time of caesarean section.
We have an interesting and clinically relevant review article, 'Micronutrients in Pregnancy' by Dr. Gunjan Bhatnagar and Dr. Ashok Kumar from MAMC, Delhi. Lot of studies all over the world has confirmed the importance of micronutrients in pregnancy. Micronutrients include nutrient required in smaller quantity and include metals and some vitamins often in our daily practice, we are more concerned for iron, folic acid and calcium and often ignore other micronutrients. We should be aware that there are others like Iodine, zinc, and other micronutrients, which can influence maternal and perinatal outcome during pregnancy. For instance iodine can be responsible for optimal neurocognition and IQ for the child. Hence, clinicians should be aware of appropriate prescription of micronutrients during pregnancy for optimum maternal and perinatal outcome. The article by Dr. Bhatnagar and Dr. Ashok Kumar should help and guide the clinicians in beô€†©er prescription writing during pregnancy.
We have interesting case reports on 'Takayasus Aorto- Arteritis with Pregnancy' by Dr. Namrata Seth and Dr. Anita Kant from Asian Institute of Medical Sciences, Faridabad and on 'Twin pregnancy with Complete Hydatidiform Mole and Coexisting Live Foetus' by Dr. Sabina Shrestha, Dr. Bhola Rijal, Dr. Suphatra Koirala, Dr. Hari Kishor Shrestha from Kathmandu, Nepal. Our esteemed readers will find it interesting and useful in their day to day practice.
There have been great advancements in early diagnosis and management of ectopic pregnancy in recent years. Serum Î² hCG levels and transvaginal ultrasound have revolutionized the early and accurate diagnosis of ectopic pregnancy. There has been significant advances in the management of this disease. Traditional treatment comprised of laparotomy and salpingectomy with resuscitation and blood transfusion. However, conservative treatment and medical management are oô€…Œen practiced successfully especially in early and small unruptured ectopic pregnancies even when surgery is indicated, laparoscopic surgery is usually sufficient in majority of cases. Laparotomy is only indicated in haemodynamically unstable ruptured ectopic pregnancies in smaller hospitals where a facility for laparoscopic surgery is not available. However, for medical management strict criteria needs to be fulfilled and proper follow up is needed with serial serum Î² hCG levels for optimum outcome. We have an interesting and clinically useful review of cases titled 'A Review of Medical Treatment of Ectopic Pregnancy with Systemic Methotrexate' by Dr. Vandita Patil and co-authors from Oman which will benefit our esteemed reader
We have an interesting review article titled 'Reproductive Hormones in Pathophysiology of Fibromyalgia Syndrome' by Ms. Suman Tanwar and co-authors from AIIMS, New Delhi, which will be useful for our esteem readers. Fibromyalgia syndrome affects many women and adversely affects their health and quality of life. Traditionally analgesics and antispasmodic are prescribed to severe patients. However, various reproductive hormones may play a role in its etiology. Hence, basic science research will ultimately unravel the exact etiology of the condition and will have a way for its new treatment.
We have two interesting case reports on 'Invasive Mole of the Uterus' by Dr. Nupur Assudani and Dr. Anita Assudani from New Delhi and 'Para Ovarian Benign Multicystic Mesothelioma' by Dr. Wills G Sheela, Dr. A Gowri Bai from Puducherry for our esteemed readers.I am delighted that two articles in the current issue are from abroad (Nepal and Oman) highlighting that Indian Obstetrics and Gynecology is slowly but surely making an impact all over the world. We expect support by our esteemed editorial board members, external reviewers, authors and readers to make IOG a truly International Journal.
Dr J B Sharma