Warm greetings from the editorial team. The journal has evolved and grown over the last five years and is one ofthe widely accessed Indian journal. This issue has contributions from researchers and clinicians of various disciplines in medicine and Dentistry.

Optimal asthma control is essential to prevent morbidity and mortality. Several factors including demographical, psychosocial and environmental have been associated with poor control. Obesity, apart from being a risk factor for asthma has also shown to be associated with poor asthma control. Hence the present study was undertaken to correlate Body Mass Index (BMI) with control of Asthma.

An autopsy may subject the prosecutors and others to a wide variety of infectious agents, including blood borne and aerosolized pathogens such as human immunodeficiency virus, hepatitis B and C viruses, and My cobacterium tuberculosis. Several studies revealed the increased prevalence of hepatitis B, C, D, G, tuberculosis, HIV, prion diseases, hanta virus, measles, HTLV-1 or bacterial infections in mortuary workers. Safety becomes an issue, both in medical and ecological aspects regarding the protection of environment with the high seroprevalence of HIV and hepatitis viruses. The Study has been carried out to find the seroprevalence of Hepatitis B virus in 515 medico legal autopsies at our centre between April 2014 and September 2014.

The study was undertaken to address this crucial issue, in an attempt to assess the perception regarding the common oral and dental problems among the general medical practitioners in Durg district of Chhattisgarh state.

Mitral Stenosis is one of the most common manifestation of rheumatic heart disease. In pregnant women it is the most commonly seen acquired valvular lesion. It is also one of the common causes of maternal death from cardiac diseases world over. Mortality remains low in women from developed countries but there is a rise in rate of fetal morbidity as the severity of mitral stenosis worsens. Presenting a case of pregnant woman with severe mitral stenosis, successfully managed with balloon mitral valvuloplasty at mid trimester of pregnancy.

Uterine papillary serous carcinoma is a distinct subtype of endometrial carcinoma by its histological features exhibiting papillary architecture, poor differentiation and advanced stage when the patient presents initially. Uterine papillary serous carcinoma(UPSC) comprises lesser than 10% of all endometrial cancers, it is the most intrusive subtype of endometrial carcinoma. This is a case report of a 70 year old symptomatic nulliparous woman, in whom endometrial biopsy revealed uterine papillary serous carcinoma.

Malignant mixed mullerian tumor of the uterus also called carcinosarcoma is a high grade sarcoma of uterus similar to leiomyosarcoma and undifferentiated uterine sarcoma.Although it is a rare tumor which constitutes about 3-4% of uterine malignancy, it is highly aggressive and contributes to a significant percentage of mortality among uterine malignancy. This malignancy is biphasic, it has two-components both epithelial and stromal (mesenchymal differentiation).The present case is of a 62 year old post-menopausal female who had per vaginal bleeding since 5 months. Ultrasonography revealed thickened endometrium and an ill-defined heterogenous soft tissue mass.Diagnostic curettage was done, which on histopathological examination showed Malignant Mixed Mullerian Tumor with heterologous elements. Panhysterectomy was done, and the diagnosis of Malignant Mixed Mullerian Tumor of the uterus was confirmed.

Granulosa cell tumors(GCT) derive from cells of the sex cord, and produce hormones. In most of the cases they manifest through the symptoms of compressive growth. This case report discusses about a perimenopausal patient ,who was hospitalised with lower abdominal pain, without any pressure symptoms and diagnosed to have a large tumor in the abdomen. The tumor was completely removed through staging laparotomy and sent for frozen section ,followed by hysterectomy with bilateral salpingectomy and left oophorectomy.

Chorioangioma of placenta is a benign angioma of placenta . It usually does not cause any symptoms but sometimes may be associated with adverse maternal and fetal complication especially when it reaches large size. We present a case of large chorioangioma in which there were no maternal or fetal complications. The placental tumor size remained the same throughout pregnancy and an uncomplicated term delivery occurred. Placental chorioangioma got confirmed by macroscopic and histopathological examination.

Leiomyoma, commonly referred to as fibroid is a benign monoclonal tumor arising from uterine myometrial cells. The true prevalence cannot be estimated as there are a lot of asymptomatic patients in whom fibroids may be an incidental sonographic finding. Lifetime risk of a female >45 years acquiring fibroid uterus is 60% with an average of 40 to 80% incidence at 50years.1 Fibroids can be intramural, submucous or subserous depending on the location within the uterus. Rarely, we also encounter cervical, broad ligament and parasitic fibroids. There is a definite genetic predisposition for the origin of fibroids with further growth stimulated by estrogen, progesterone and growth factors like IGF 1 and IGF 2. Common symptoms include heavy menstrual bleeding, dysmenorrhea, pelvic pain, urinary disturbances and pressure symptoms.

Recurrent pregnancy loss contributes to 1% of total pregnancies.1 20% of the recurrent pregnancy loss is due to anti-phospholipid antibodies (aPL) and 6% of pregnancy morbidity is seen with aPL positivity.1 Anti-phospholipid Syndrome (APS) poses a major challenge not only to the mother and fetus, but also to the treating specialist.

Many museums have artistic paintings, jewels and old weapons. Here is the museum which has ancient specimens and surgical instruments and such a museum is at the Institute of Obstetrics and Gynecology (Gifford School Museum).

Thyroid dysfunction is a common problem encountered during pregnancy in clinical practice. There is good evidence that treatment of overt thyroid dysfunction negates risk imparted to both the mother and fetus. Clinical data on the treatment of subclinical disease is evolving and remains a topic of discussion. Various societies have published guidelines on the management of thyroid disease during pregnancy. Thyroid Stimulating Hormone (TSH) remains the most reliable test during pregnancy. Interpretation of thyroid function in pregnancy depends on the accurate knowledge of the stage of pregnancy and if available trimester specific reference ranges in that particular population. The most common cause of hypothyroidism during pregnancy is chronic autoimmune thyroiditis. Overt Hypothyroidism is associated with increased risk of several complications including preeclampsia, pre-term delivery, low birth weight, increased risk of caesarean section, peri-natal morbidity and mortality, postpartum hemorrhage and possible neuropsychological and cognitive impairment. In patients with pre - existing hypothyroidism, an increased requirement of thyroxine around 25-50 % may be needed during the first and second trimester of pregnancy.

Cardiovascular disease in pregnancy has been estimated to be 0.1-4.1%. The incidence of pregnancies in women with cardiac disease is on the rise due to an increase in the number of women with heart disease reaching childbearing age as a result of the developments in the management of cardiovascular diseases and advances in reproductive medicine, advancing maternal age with associated diabetes mellitus, hypertension, pre eclampsia and multiple fetal pregnancies. Cardiac disease has thus evolved as an important cause of non obstetric maternal mortality. Rheumatic mitral stenosis is one of the most common cardiac illnesses complicating pregnancy. Patients with severe mitral stenosis usually do not withstand the cardiovascular demands of pregnancy. Therefore, a multidisciplinary approach is required to reduce the morbidity and mortality during the antenatal and postnatal period. The role of anesthesiologist and perioperative considerations in such patients leading to prevention of complications with successful outcome of the mother and fetus are discussed.

Sir, how did you feel, when you had to leave Srilanka , where you grew up and your father was in a prominent position as Director of Jaffna Cooperative Society, to go to Singapore ? It was a difficult decision to leave. I had a desire to do academic obstetrics and gynecology. I could not get an academic position in Sri Lanka as there were only three medical schools in the country at that time. Singapore offered that possibility and hence I left.

'Look deep into Nature, and you will understand everything better' - said Albert Einstein. Nature acclimatizes itself to the various influences, both external and from within. Yet, nature has a check on these changes, to prevent the undesirable consequences that can occur. The same statement holds good for the hypothalamo-pituitary gonadal axis, which is the primary regulator of the human reproductive function.