Browsing by Author "Aryal, Shreyashi"
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Publication Abnormal Uterine Bleeding among Women Visiting Gynecology Out- patient Department of a Tertiary Care Hospital: A Descriptive Cross- sectional Study(Nepal Medical Association, 2022) Shrestha, Deepak; Aryal, Shreyashi; Tiwari, Archana; Sharma, RupeshAbstract: Introduction: Abnormal uterine bleeding accounts for more than 70% of complaints in peri- and post-menopausal women. The main purpose of investigating them is to rule out premalignant and malignant endometrial lesions. This study aimed to find out the prevalence of abnormal uterine bleeding among out-patients visiting the gynecology department of a tertiary care hospital. Methods: This descriptive cross-sectional study was conducted in the Department of Obstetrics and Gynecology of a tertiary care center from August 1, 2020 to April 23, 2021. Ethical approval was obtained from the Institutional Review Committee of the same institution (IRC-LMC 07-C/020). A total of 2680 women visiting gynecology outpatient departments were included by convenience sampling technique. Women with abnormal uterine bleeding were evaluated by endometrial thickness measurement and endometrial biopsies. Statistical Package for the Social Sciences version 16 was used for data analysis. Point estimate at 95% Confidence Interval was calculated along with frequency, percentage, mean and standard deviation. Results: Among 2680 women visiting the gynecology outpatient department, the prevalence of abnormal uterine bleeding was 240 (8.9%) (7.82-9.98 at 95% Confidence Interval). The mean endometrial thickness was 10.15±6.63mm. Majority of patients 104 (43.3%) had endometrial thickness >10mm. Sixty-six (27.8%) patients had disordered proliferative endometrium while endometrial carcinoma was noted in three (1.2%) patients. Atrophic endometrium was observed in 17 (7.2%) and endometrial hyperplasia in nine (3.8%) patients. Conclusions: The prevalence of abnormal uterine bleeding was found to be higher in comparison to other studies. Disordered proliferative endometrium was the most common histopathological finding followed by secretory phase endometrium.Publication First Trimester Abortion and Psychiatric Morbidity(Nepal Health Research Council, 2024) Basnet, Rachana Sharma; Aryal, ShreyashiBackground: Early pregnancy loss is a traumatic event following which clients may experience psychological morbidities. Mental illness is associated with multiple obstetric and social factors surrounding the period of pregnancy loss. The aim of this study was to find the prevalence of depression and anxiety before and after undergoing spontaneous or induced first trimester abortion and to analyze demographic and obstetric factors associated with it. Methods: This is an observational study conducted as Kathmandu Medical College (KMC) for a duration of one year from September 2022 to August 2023. All clients with abortion were screened for psychiatric morbidity using the The Hospital Anxiety and Depression Scale (HADS). Each client was assessed at first hospital visit and then at two weeks and two months following abortion. Level of anxiety and depression was analyzed in relation to socio-demographic factors and the type of abortion. Results: 171 clients with pregnancy loss were enrolled. Pre-abortion, severe anxiety was present in 6(13%) clients with spontaneous abortion. Pre-abortion, mild to severe anxiety was present in 31 (67.3%) clients and at two weeks and two months in 11 (23.9%) and 11 (23.9%) clients respectively. In clients undergoing induced abortion, varying levels of anxiety was present in 54(43.2%) pre-abortion, and 48(38.4%) and 54(43.2%) clients at two weeks and two months. Mild to moderate depression was seen in 21 (45.6%) among spontaneous abortion and 51 (40.8%) clients among induced abortion. Mean score on HADS decreased with time. Conclusions: Anxiety and depression were common following early pregnancy loss. Rate of anxiety seems to decrease with time in spontaneous abortion but in induced abortion it remains persistent. Rate of depression tends to decrease with time for both types of abortion. Keywords: Abortion; anxiety; depression; HADS; induced.Publication Sex ratio at Birth in a Tertiary Care Hospital in Western Nepal are the Trends Changing?(Nepal Paediatric Society (JNPS), 2016) Aryal, Shreyashi; Kalakheti, BalkrishnaAbstract: Introduction: Sex ratio at birth remains unchanged in absence of human intervention. A tendency of skewing towards males is seen in Asian population attributable to various reasons, foremost being abortions. The decreasing number of female population is a form of gender discrimination and has serious implications for both sexes in the future. The purpose of this study was to analyze the trends of sex ratio at birth among deliveries at Lumbini Medical College Teaching Hospital, Palpa, Nepal over the past eight years. Materials and Methods: A retrospective audit of deliveries from 1st January 2008 to 31st December 2015 was carried out. Sex ratio at birth was calculated and its relationship with maternal age, birth order and number of previous abortions was analyzed. Results: The total number of live-births during the study period was 9394 consisting of 5008 male and 4350 female with an overall sex ratio at birth of 112.6. Every year, there was an increasing trend in total number of live births and sex ratio at birth. The number of male births increased with increase in parity but there was no statistical difference seen between maternal age, parity and number of abortions for male and female births. Conclusion: The sex ratio at birth in hospital deliveries is unbalanced with inclination towards male, more so in women with high parity. Additional research exploring the reason for increase in male births is needed, so that potential programs which can reverse this trend can be implemented.