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  • 1
    Online Resource
    Online Resource
    Birat Medical College and Teaching Hospital ; 2022
    In:  Birat Journal of Health Sciences Vol. 7, No. 3 ( 2022-12-31), p. 1845-1850
    In: Birat Journal of Health Sciences, Birat Medical College and Teaching Hospital, Vol. 7, No. 3 ( 2022-12-31), p. 1845-1850
    Abstract: Introduction: Infertility is a disorder of the reproductive system defined by failure to achieve a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse. Globally, about 10-15% married couples are sub-fertile. 20-40% of female factors for infertility include ovarian cause. Ovarian reserve refers to the size of resting primordial follicle in the ovaries which determines the capacity of the ovary to provide egg cells for fertilization resulting in a successful pregnancy. Ovarian reserve is one of the most reliable investigations to determine ovarian regression, which regresses with age. Follicular Stimulating Hormone (FSH), Estradiol (E2), Antral Follicular Count (AFC) and Anti-Mullerian Hormone (AMH) are investigations to determine ovarian reserve. Objective: To determine the correlation of antral follicular count and follicular stimulating hormone with anti-mullerian hormone in determining ovarian reserve among infertile women attending infertility clinic of Tribhuvan University Teaching Hospital (TUTH). Methodology: This was a prospective, hospital based study conducted among 78 patients attending infertility clinic in the Department of Obstetrics and Gynecology at TUTH, Kathmandu from 14th April 2017 to 13th April 2018. After taking history and examination, routine infertility investigation was sent. On the Day 2 or Day 3 of the cycle, serum FSH and AMH were sent. On the 3-5 day of the cycle, trans-vaginal scan was done for antral follicular count. Follicular monitoring was done every alternate day from day 9 of natural cycle till the follicle became 18 to 22 mm. If no follicle developed even after day 20 of menstruation, monitoring was stopped and development of follicle or failure was noted. This monitoring was done in single cycle. Early follicular phase serum FSH, AMH and AFC were correlated in relation to follicular development. Result: Among 78 patients included, mean age was 27.6 ± 3.14 years. The mean FSH, AMH and total AFC were 6.46 ± 1.90 IU/ml, 5.01 ± 3.46 ng/ml and 15.88 ± 5.21 respectively. A strong positive linear correlation between AFC and AMH (p 〈 0.001, r=0.811) and weakly negative correlation between FSH and AMH (p=0.182, r= -0.153) was found. Conclusion: Serum AFC level showed a strong positive correlation with AMH and could be used as an alternative to AMH to assess ovarian reserve.
    Type of Medium: Online Resource
    ISSN: 2542-2804 , 2542-2758
    Language: Unknown
    Publisher: Birat Medical College and Teaching Hospital
    Publication Date: 2022
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  • 2
    Online Resource
    Online Resource
    Nepal Health Research Council ; 2018
    In:  Journal of Nepal Health Research Council Vol. 15, No. 3 ( 2018-01-01), p. 298-300
    In: Journal of Nepal Health Research Council, Nepal Health Research Council, Vol. 15, No. 3 ( 2018-01-01), p. 298-300
    Abstract: Gestational trophoblastic neoplasia is extremely rare entity accounting 1% of all gynecological malignancies. Invasive mole is a form of Gestational trophoblastic neoplasia which is locally invasive with propensity of metastasis. Association of partial mole with invasive mole and/or theca lutein cysts is a rare occurrence. Large cysts may present with complications. A case with these rare combinations presented at 15+3 weeks period of gestation as acute abdomen due to torsion of bilateral theca lutein cysts is reported. Right salpingo-ophorectomy with untwisting of left cyst was done. Six cycles of chemotherapy was given with regular βhCG monitoring. First trimester dating scan would have helped in early diagnosis, treatment and prevention of complications. Keywords: Invasive mole; theca lutein cysts; torsion.
    Type of Medium: Online Resource
    ISSN: 1999-6217 , 1727-5482
    Language: Unknown
    Publisher: Nepal Health Research Council
    Publication Date: 2018
    detail.hit.zdb_id: 2551251-1
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  • 3
    Online Resource
    Online Resource
    Nepal Journals Online (JOL) ; 2023
    In:  Nepalese Heart Journal Vol. 20, No. 1 ( 2023-06-10), p. 29-33
    In: Nepalese Heart Journal, Nepal Journals Online (JOL), Vol. 20, No. 1 ( 2023-06-10), p. 29-33
    Abstract: Background and Aims: Rheumatic heart disease is still one of the most common heart lesion in developing countries. The maternal and fetal hazards increase with the severity of Mitral stenosis. This study was aimed to determine the fetomaternal outcome in women with mitral stenosis during pregnancy. Methods: This was descriptive cross-sectional study which included all pregnant patients with isolated rheumatic mitral valve stenosis. Major adverse outcomes studied were cardiac failure, thromboembolic event, admission in cardiac care or intensive care unit, atrial fibrillation, endocarditis, pulmonary hypertension and cardiac death. Results: Out of 3194 pregnant women, 31 had mitral stenosis. Their mean age was 27 years, mean mitral valve area 1.43cm2 and majority were primigravida (61.29%). Among them, symptomatic cardiac failure was present in 6.66%, 30% and 66.66% of mild, moderate and severe mitral stenosis respectively. The chances of cardiac failure, atrial fibrillation, preterm delivery and small for gestational age babies was high in all patients without having percutaneous trans-luminal mitral commissurotomy than those who underwent the procedure for moderate to severe mitral stenosis during pregnancy. Conclusion: There were high chances of adverse fetomaternal outcome in pregnant women with mitral stenosis. Cardiac failure was found to be increased with the severity of mitral stenosis. PTMC during pregnancy resulted in decreased cardiac failure, atrial fibrillation, preterm delivery and small for gestational age babies.
    Type of Medium: Online Resource
    ISSN: 2382-5464 , 2091-2978
    Language: Unknown
    Publisher: Nepal Journals Online (JOL)
    Publication Date: 2023
    detail.hit.zdb_id: 2901174-7
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  • 4
    Online Resource
    Online Resource
    Nepal Journals Online (JOL) ; 2018
    In:  Nepal Journal of Obstetrics and Gynaecology Vol. 12, No. 2 ( 2018-11-01), p. 44-47
    In: Nepal Journal of Obstetrics and Gynaecology, Nepal Journals Online (JOL), Vol. 12, No. 2 ( 2018-11-01), p. 44-47
    Abstract: Aims: This study aims to find out histopathological diagnosis and stage at presentation during the diagnosis of female genital tumors.Methodology: This is hospital based prospective observational study of histopathologically confirmed gynecological malignancies conducted in the Department of Obstetrics and Gynecology, TUTH, Maharajgunj, Kathmandu for one year from 2014 to 2015Results: Among 102 cases enrolled in the study, the most common gynecological malignancy was of ovary (48%) followed by cervix (31%), endometrium (11%), vulval (6%), gestational trophoblastic neoplasia (3%) and fallopian tube (1%). Patients presented in early stage in 66.6% of cases. Seventy-nine percent of ovarian cancer, 96.8% cases of cervical carcinoma, 66.6% cases of gestational trophoblastic neoplasia and all the cases of the endometrial, vulval fallopian tube carcinoma presented in early stage of the disease. The most common histopathological diagnosis of ovarian cancer was serous cyst adenocarcinoma (49.4%), cervical cancer was squamous cell nonkeratinising type (72%), endometrial carcinoma was endometroid adenocarcinoma (82%), vulval carcinoma were squamous cell carcinoma (100%) and fallopian tube carcinoma was adenocarcinoma (100%). The mean age of gynecological malignancy was 49.6±14.5 years.Conclusions: Screening of gynecological malignancy in women with suggestive symptoms is necessary to identify this disease in early stage and decrease the incidence, morbidity and mortality from this common public health problem.
    Type of Medium: Online Resource
    ISSN: 1999-8546 , 1999-9623
    Language: Unknown
    Publisher: Nepal Journals Online (JOL)
    Publication Date: 2018
    detail.hit.zdb_id: 2430134-6
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  • 5
    Online Resource
    Online Resource
    Journal of Nepal Medical Association (JNMA) ; 2015
    In:  Journal of Nepal Medical Association Vol. 53, No. 200 ( 2015-12-31), p. 250-255
    In: Journal of Nepal Medical Association, Journal of Nepal Medical Association (JNMA), Vol. 53, No. 200 ( 2015-12-31), p. 250-255
    Abstract: Introduction: Low birth weight and preterm birth are the major community health problems in developing countries. They are the major determinants of perinatal survival and infant morbidity and mortality.  The aim of this study was to determine the proportion and the maternal risk factors for low birth weight and preterm birth among hospital deliveries in Tribhuvan University Teaching Hospital. Methods: A cross sectional retrospective study was carried out in the Department of Obstetrics and Gynecology of TUTH. Maternal risk factors like age, parity, ethnicity, history of previous abortion, history of previous cesarean section, antepartum hemorrhage and medical disorders were studied. Information on all births that occurred was extracted from maternity case notes and delivery registers. Results: During the study period, there were 685 singleton live births.  Among these 78(11.4%) were low birth weight and 47(6.9%) were preterm birth. The mean birth weight was 2950 ± 488 gm. The mean weight of female was statistically less compared to male babies (p=0.032). The significant risk factors for LBW were primiparity (OR 2.12; 95%CI 1.25-3.58), Indo-Aryan ethnicity (OR 1.97; 95%CI 1.12-3.45) and history of medical disorder (OR 3.08; 95%CI 1.17-8.12). As for PTB antepartum hemorrhage (OR 8.63; 95%CI 1.99-37.30) and history of medical disorder (OR 3.20; 95%CI 1.04-9.89) were significant risk factors. Conclusions: Parity, ethnicity, and medical disorders were the main risk factors for low birth weight. Antepartum hemorrhage and medical disorders were significant risk factors for preterm birth. Keywords: low birth weight; preterm birth; risk factors.
    Type of Medium: Online Resource
    ISSN: 1815-672X , 0028-2715
    Language: Unknown
    Publisher: Journal of Nepal Medical Association (JNMA)
    Publication Date: 2015
    detail.hit.zdb_id: 2209910-4
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  • 6
    Online Resource
    Online Resource
    Nepal Journals Online (JOL) ; 1970
    In:  Nepal Journal of Obstetrics and Gynaecology Vol. 2, No. 1 ( 1970-01-01), p. 13-16
    In: Nepal Journal of Obstetrics and Gynaecology, Nepal Journals Online (JOL), Vol. 2, No. 1 ( 1970-01-01), p. 13-16
    Abstract: Aim: To compare oxytocin used via intraumbilical or intramuscular route in the active management of third stage of labour with respect to duration and amount of bleeding. Methods: Prospective comparative study conducted in Maternity Hospital, Thapathali, Kathmandu for three months 29th April - July 28th 2004 (061/1/16 to 061/4/12 BS ). After immediate umbilical cord clamping following vaginal delivery, 120 women were divided into 2 groups administering 10 units of oxytocin; in Group I: which was diluted mixing with 10 ml of normal saline before it was infused intraumbilical and Group II: injected intramuscularly. Results: There was no difference in the duration of third stage of labour (3.6 vs. 3.7min) between the two groups. There was significant blood loss in the intraumblical group as compared to intramuscular group (242ml vs.168ml, p. 0.004). The need for additional oxytocic to control the uterine bleeding was more in intraumbilical group as compared to intramuscular group (28.3% vs 6.7%, p 0.005). There was more postpartum haemorrhage (PPH) in intraumbilical group (8.3% vs 3.3%, p 0.439). The injection delivery interval was significantly longer in the intraumbilical group as compared to intramuscular group (46.9 vs. 30.7 sec). Conclusion: Intraumbilical oxytocin is technically more difficult to administer without having any added benefit either in decreasing the duration of third stage of labour or reducing the blood loss. Key words: Intraumbilical oxytocin, intramuscular oxytocin, third stage of labour. doi:10.3126/njog.v2i1.1469 N. J. Obstet. Gynaecol Vol. 2, No. 1, p. 13 - 16 May -June 2007
    Type of Medium: Online Resource
    ISSN: 1999-8546 , 1999-9623
    Language: Unknown
    Publisher: Nepal Journals Online (JOL)
    Publication Date: 1970
    detail.hit.zdb_id: 2430134-6
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  • 7
    Online Resource
    Online Resource
    Hindawi Limited ; 2022
    In:  International Journal of Reproductive Medicine Vol. 2022 ( 2022-5-16), p. 1-11
    In: International Journal of Reproductive Medicine, Hindawi Limited, Vol. 2022 ( 2022-5-16), p. 1-11
    Abstract: Background. Cesarean section (CS) is one of the most performed surgeries in obstetrics. Surgical site infection is the major cause of morbidity and mortality causing an increase in the duration of hospitalization as well as the cost of admission for the patient. Objective. To determine incidence of surgical site infection following cesarean section, classify them according to CDC criteria, and identify the different risk factors. Methodology. This is a case-control study conducted at the Department of Obstetrics and Gynecology at Tribhuvan University Teaching Hospital (TUTH), main campus of Institute of Medicine (IOM), Kathmandu, Nepal. Surgical site infections (SSI) in patients who underwent cesarean sections from February 2019 to August 2019 were taken as cases, while the patients who underwent cesarean section before or after the procedure and did not develop SSI comprised the controls. Visual inspection during ward rounds, reports from laboratory, and postprocedure follow-ups for up to 30 days formed the basis of identifying infections on the patients. Risk factors were identified by bivariate and multivariate logistic regression. Results. Out of 1135 cases of cesarean sections, 97 of them developed SSI with incidence rate of 8.54%. Among them, 94.85% were superficial incisional and 5.15% were deep incisional type of SSI with no organ space type. Cases had higher mean age 26.88 ± 4.38 years compared to 24.81 ± 5.08 years in controls. Host-related risk factors which led to higher odds of developing surgical site infection (SSI) were obesity with adjusted odds ratio (AOR) 15.72 (confidence interval (CI): 4.60-53.67), diabetes/hypertension in pregnancy with AOR 4.75(CI 1.69-13.32), and other medical diseases with AOR 9.38 (CI 2.89-30.46). Duration of the rupture of membrane for more than 18 hours with AOR 8.38 (CI 1.48-47.35), more than five per vaginal (PV) examination with AOR 1.93 (95% CI 1.03-3.64), and in labor status with AOR 6.52 (CI 1.17-36.38) were some procedure-related factors resulting into higher odds of infection. Conclusion. Multiple risk factors like age, obesity, medical complications during pregnancy, occurrence of labor status during cesarean section, prolonged duration of rupture of membrane for more than 18 hours, and more than five vaginal examinations before the procedure increases the chance of surgical site infection (SSI) following cesarean section.
    Type of Medium: Online Resource
    ISSN: 2314-5757 , 2356-7104
    Language: English
    Publisher: Hindawi Limited
    Publication Date: 2022
    detail.hit.zdb_id: 2710782-6
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  • 8
    Online Resource
    Online Resource
    Nepal Journals Online (JOL) ; 2021
    In:  Journal of Patan Academy of Health Sciences Vol. 8, No. 2 ( 2021-05-03), p. 131-135
    In: Journal of Patan Academy of Health Sciences, Nepal Journals Online (JOL), Vol. 8, No. 2 ( 2021-05-03), p. 131-135
    Abstract: Uterine carcinosarcoma is a rare aggressive tumor also known as Malignant Mixed MullerianTumor.  Prognosis is poor with 30-40% having extrauterine involvement at the first presentation and over 10% with distant metastasis. The primary treatment is surgery, along with radio-chemotherapy. We report a case of uterine carcinosarcoma in a 65 y para four lady who presented with blood mixed discharge per vagina for one month and polypoidal mass protruding through the cervical os. Endometrial biopsy showed carcinosarcoma. She was managed with surgery. She received adjuvant chemotherapy paclitaxel and carboplatin. There was no recurrence at six months follow-ups.
    Type of Medium: Online Resource
    ISSN: 2091-2757 , 2091-2749
    Language: Unknown
    Publisher: Nepal Journals Online (JOL)
    Publication Date: 2021
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  • 9
    Online Resource
    Online Resource
    Wiley ; 2022
    In:  Clinical Case Reports Vol. 10, No. 11 ( 2022-11)
    In: Clinical Case Reports, Wiley, Vol. 10, No. 11 ( 2022-11)
    Abstract: Rete ovarii giving rise to cysts, and benign and malignant tumors is a rare entity. Radiological and histopathological examinations can be used to make the diagnosis of rete cyst and differentiate it from cystic tumor of ovarian origin, with surgery being the treatment of choice.
    Type of Medium: Online Resource
    ISSN: 2050-0904 , 2050-0904
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2022
    detail.hit.zdb_id: 2740234-4
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  • 10
    Online Resource
    Online Resource
    Journal of Nepal Medical Association (JNMA) ; 2022
    In:  Journal of Nepal Medical Association Vol. 60, No. 246 ( 2022-02-15), p. 126-131
    In: Journal of Nepal Medical Association, Journal of Nepal Medical Association (JNMA), Vol. 60, No. 246 ( 2022-02-15), p. 126-131
    Abstract: Introduction: Genitourinary syndrome of menopause incorporates vulvovaginal and lower urinary tract symptoms related to estrogen deficiency which affects more than half of postmenopausal women. This study aimed to find out the prevalence of genitourinary syndrome of menopause among postmenopausal women attending a tertiary care center. Methods: A descriptive cross-sectional study was conducted at the Department of Obstetrics and Gynaecology of tertiary care hospital from October 2019 to April 2021 after obtaining ethical approval from the Institutional Review Committee (Reference number: 452 6-11). A convenience sampling method was used among postmenopausal women aged 40-75 years attending gynaecology outpatient departments. The information was obtained by interview and examination. Analysis was done using the Statistical Package for the Social Sciences version 20. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Results: Among the 385 postmenopausal women, 285 (74.02%) (69.63-78.40 at 95% Confidence Interval) had a diagnosis of genitourinary syndrome of menopause. The mean age of menopause was 48.2±3.6years. The most common symptom and sign were vaginal dryness in 223 (78.2%) and decreased moisture 200 (70.2%). Regarding the impact of genitourinary syndrome of menopause on quality of life, it least affected the activities of daily living and mostly on sexual functioning. Conclusions: The study showed three-fourth of postmenopausal women suffered from genitourinary syndrome of menopause which is similar to the previous studies done in other countries, in postmenopausal women. Therefore, understanding genitourinary syndrome of menopause is vital, and assuring women those treatments are available to relieve symptoms may improve their quality of life.
    Type of Medium: Online Resource
    ISSN: 1815-672X , 0028-2715
    Language: Unknown
    Publisher: Journal of Nepal Medical Association (JNMA)
    Publication Date: 2022
    detail.hit.zdb_id: 2209910-4
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