Browsing by Author "Karki, Aruna"
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Publication Broad Ligament Leiomyomata - An Important Differential Diagnosis in Huge Abdominal Mass: A Case Report(Nepal Medical Association, 2025) Basnyat, Amogh; Dangal, Ganesh; Karki, Aruna; Pradhan, Hema; Shrestha, Ranjana; Bhattachan, KabinAbstract Leiomyomas are a common gynaecological condition affecting 20-30% of women over the age of 35, with prevalence decreasing following menopause. Leiomyomas are most commonly found within the uterus. Rarer extra-uterine locations include the broad ligament, cervix, and vagina. We present an unusual case of multiple Left Broad Ligament Leiomyomata that extended from Left Iliac Fossa and Hypogastrium to Epigastric region in a 50- year-old female. Our case highlights the importance for extra-uterine leiomyoma to be considered as a differential diagnosis in patients presenting with huge abdominal mass suspicious of adnexal tumor or malignancy.Publication Fetomaternal Outcome of Pregnant Women at Term Undergoing Cesarean Section(Nepal Health Research Council, 2024) Bharati, Sonu; Dangal, Ganesh; Tiwari, Kenusha Devi; Maharjan, Sunita; Bhandari, Srijana; Karki, Aruna; Pradhan, Hema Kumari; Shrestha, Ranjana; Bhattachan, KabinBackground: Cesarean section is one of the most common procedures performed in obstetric practice today and is a lifesaving surgery for mother and fetus. Cesarean sections are classified traditionally, as elective cesarean section or emergency cesarean. The purpose of this study is to compare the maternal and neonatal outcomes in elective and emergency cesarean section so that measures can be taken to reduce maternal and neonatal morbidity and mortality. Methods: A descriptive study including 400 pregnant women who underwent caesarean section were included in this study. Patients were subjected to elective or emergency cesarean section as per the indication and protocol of institute. were included in the study. Results: During the study period there were total 1080 deliveries. The average age of the women was 29.21±4.07 years. Of the 400 cesarean section cases, only 2.8% had wound infection, 3.8% had fever, 4.8% urinary tract infection (UTI) whereas no women had observed with post-partum hemorrhages (PPH) and maternal death. Regarding fetal outcome, neonatal intensive care unit (NICU) admission was observed in 16%, birth asphyxia was 2.3% poor Apgar score 2.5% and neonatal death was not observed. Rate of fever, UTI, wound infection, need of resuscitation and poor Apgar score was significantly high in emergency section than elective caesarean section whereas NICU admission was not statistically significant. The most common indication of emergency cesarean section were fetal dress and for previous LSCS. Conclusions: Emergency cesarean was associated with increased maternal and perinatal complications than in elective cesarean section. Keywords: Caesarean section; elective caesarean section; emergency caesarean section; neonatal morbidity and mortality.Publication Ruptured Endometrioma with Hemoperitoneum Requiring Emergency Laparotomy: A Case Report(Nepal Health Research Council, 2023) Rai, Sangam; Dangal, Ganesh; Karki, Aruna; Pradhan, Peru; Shrestha, Ranjana; Bhattachan, Kabin; Maharajan, Sunita; Bhandari, Srijana; Basnyat, AmogAbstract Endometrioma is the localization of endometriosis in ovary which often develops as cyst. The condition can be complicated with infection, torsion and rupture leading to significant hemoperitoneum and ascites. We present here a 28-year female P2 L1 presented with the features of acute abdomen and severe anemia referred from other hospital where pain management was done. She had raised Ca-125 level, negative Urine Beta HCG and USG findings of left endometrioma with degenerating subserosal fibroid. The improvement of her general condition with analgesics was misleading however a static hematocrit level despite blood transfusion raised suspicion of ongoing pathology leading to blood loss and diagnostic paracentesis confirmed the hemoperitoneum while awaiting of CT report. She underwent Emergency Laparotomy which revealed hemoperitoneum of 2000ml and right ruptured ovarian endometrioma measuring and left ovarian cyst measuring 6x6 cm was noted. The postoperative period was uneventful. Keywords: Acute abdomen; case report; endometriosis; hemoperitoneum; ruptured endometrioma.Publication Vaginoplasty with Amnion Graft: Management of Mayer-Rokitansky-Kuster-Hauser Syndrome(Nepal Health Research Council, 2023) Bhandari, Srijana; Dangal, Ganesh; Karki, Aruna; Pradhan, Hema; Shrestha, Ranjana; Bhattachan, Kabin; Tiwari, Kenusha Devi; Bharati, Sonu; Maharjan, SunitaAbstract Mayer-Rokitansky-Kuster-Hauser syndrome also known as mullerian agenesis is a rare congenital condition in which there is absence of uterus along with upper vagina. Patient usually presents with primary amenorrhea with or without cyclical lower abdominal pain but have normal secondary sexual characters. Modified McIndoe Vaginoplasty with amnion graft is the commonest surgery performed worldwide. A 23 year old girl with normal secondary sexual characters presented with primary amenorrhea with cyclical lower abdominal pain; on examination blind vagina was present. Vaginoplasty with amnion graft was done and vaginal mould was placed. Vaginal dilatation with Hegar’s dilator was done weekly until 6 weeks. She is under regular follow-up at present and advised for regular manual dilation at home. McIndoe Vaginoplasty with amnion graft is a simple yet rewarding procedure especially in low resource countries like ours, with good success rate and with minimal postoperative complications. Keywords: Amnion graft; Mayer-Rokitansky-Kuster-Hauser Syndrome; Modified McIndoe Vaginoplasty; Primary amenorrhea; Secondary sexual characters.