Browsing by Author "Bista, Kesang Diki"
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Publication B-Lynch Suture Management among Patients with Postpartum Hemorrhage in a Tertiary Care Centre: A Descriptive Cross-sectional Study(Nepal Medical Association, 2023) Koirala, Poonam; Ghimire, Asmita; Bista, Kesang DikiAbstract Introduction: Postpartum haemorrhage is the most life-threatening complication during pregnancy and atonic postpartum haemorrhage being the commonest one, often poses difficulties in management. B-Lynch suture with a high success rate has emerged as a life-saving measure in uncontrolled atonic postpartum haemorrhage refractory to uterotonics. The objective of this study was to find out the prevalence of B-Lynch suture management among patients with post-partum haemorrhage in a tertiary care centre. Methods: This descriptive cross-sectional study was conducted in the Department of Obstetrics and Gynecology of a tertiary care centre from 1 April 2017 to 1 April 2021 after taking ethical approval from the Institutional Review Committee of the same institution [Reference number: 497(6-11)C-2077/078]. All patients with post-partum haemorrhage during the study period were included in the study. Patients with traumatic post-partum haemorrhage, congenital malformations, complete placenta previa/accreta, bleeding disorders, disseminated intravascular coagulation, and retained bits of placenta were excluded from the study. A convenience sampling method was used. Point estimate and 90% Confidence Interval were calculated. Results: Out of 72 patients, 19 (26.39%) (17.85-34.93, 90% Confidence Interval) underwent B-Lynch suture management for atonic post-partum haemorrhage. Uterus salvage was done in 18 (94.74%) whereas 1 (5.26%) underwent a cesarean hysterectomy. Conclusions: The prevalence of the use of B-Lynch suture was similar to other studies done in similar settings. B-Lynch suture is a valuable addition for controlling intractable atonic primary postpartum haemorrhage refractory to uterotonics, thus saving the life as well as preserving the future fertility of the woman.Publication B-Lynch Suture Management among Patients with Postpartum Hemorrhage in a Tertiary Care Centre: A Descriptive Cross-sectional Study(Nepal Medical Association, 2023) Koirala, Poonam; Ghimire, Asmita; Bista, Kesang DikiAbstract Introduction: Postpartum haemorrhage is the most life-threatening complication during pregnancy and atonic postpartum haemorrhage being the commonest one, often poses difficulties in management. B-Lynch suture with a high success rate has emerged as a life-saving measure in uncontrolled atonic postpartum haemorrhage refractory to uterotonics. The objective of this study was to find out the prevalence of B-Lynch suture management among patients with post-partum haemorrhage in a tertiary care centre. Methods: This descriptive cross-sectional study was conducted in the Department of Obstetrics and Gynecology of a tertiary care centre from 1 April 2017 to 1 April 2021 after taking ethical approval from the Institutional Review Committee of the same institution [Reference number: 497(6-11)C-2077/078]. All patients with post-partum haemorrhage during the study period were included in the study. Patients with traumatic post-partum haemorrhage, congenital malformations, complete placenta previa/accreta, bleeding disorders, disseminated intravascular coagulation, and retained bits of placenta were excluded from the study. A convenience sampling method was used. Point estimate and 90% Confidence Interval were calculated. Results: Out of 72 patients, 19 (26.39%) (17.85-34.93, 90% Confidence Interval) underwent B-Lynch suture management for atonic post-partum haemorrhage. Uterus salvage was done in 18 (94.74%) whereas 1 (5.26%) underwent a cesarean hysterectomy. Conclusions: The prevalence of the use of B-Lynch suture was similar to other studies done in similar settings. B-Lynch suture is a valuable addition for controlling intractable atonic primary postpartum haemorrhage refractory to uterotonics, thus saving the life as well as preserving the future fertility of the woman.Publication Clinical and Endometrial Histopathological Profile of Women with Perimenopausal and Postmenopausal Bleeding(Institute of Medicine, Tribhuvan University, 2025) Bhardwaj, Manisha; Bista, Kesang Diki; Ojha, Neebha; Khaniya, BishalAbstract: Introduction: Abnormal uterine bleeding (AUB) in perimenopausal and postmenopausal women is common and clinically important concern, as it may indicate anything from hormonal imbalance to serious pathologies like endometrial hyperplasia or carcinoma . The objective of this study was to assess clinical and endometrial histopathological characteristics in women with perimenopausal and postmenopausal bleeding in TUTH. Methods: This was a descriptive study carried out in the Department of Obstetrics and Gynecology at Maharajgunj Medical Campus, Tribhuvan University Teaching Hospital, Kathmandu from April 2018 to April 2019. All women > 40 years with abnormal uterine bleeding attending gynecology OPD were taken. Endometrial biopsy was done and histopathological examination findings were studied. Results: Among 328 women, 218 were with perimenopausal bleeding and those with postmenopausal bleeding were 110. The most frequent bleeding in ladies with perimenopausal bleeding was menorrhagia in 93(42.9%) and spotting accounting 68 (71%) in postmenopausal bleeding. Out of total 328 cases, 317(96.6%) had benign endometrial findings and 11 cases (3.4%) had malignant endometrial findings. The most frequent histopathological finding in women with perimenopausal bleeding was secretary endometrium. Among postmenopausal bleeding 110 (91%) were benign and 9( 8.2%) had malignant histopathology. Conclusion: The most frequent bleeding pattern in perimenopausal bleeding was menorrhagia and spotting in those with postmenopausal bleeding. Malignant histopathological was found more in postmenopausal bleeding than perimenopausal bleeding.Publication Primary Solitary Uterine Hydatid Cyst Mimicking an Intramyometrial Cyst: A Case Report(Nepal Medical Association, 2024) Rajbhandary, Sanyukta; Bista, Kesang Diki; Bajracharya, Sunita; Shrestha, Prezma; Mallik, PrernaAbstract Like many agricultural countries, cystic echinococcal zoonotic disease is endemic in Nepal. Incidence of hydatid cyst in liver and lungs are common among the adult population but hydatid cyst of the uterus is an extremely rare entity. We report a case of a 76-year-old menopausal lady who presented with lower abdominal pain for 4 months and underwent laparotomy for provisional diagnosis of myometrial cyst, as shown by MRI scan, however the cyst was found to be primary hydatid cyst of uterus. Postoperatively serological test for hydatid cyst was positive for echinococcus granulosus, further confirmed by histopathological diagnosis. Hence in endemic areas like ours, there should be high index of suspicion of the possibility of hydatid cyst as a differential for cystic pelvic masses.