Browsing by Author "Pradhan, N"
Now showing 1 - 4 of 4
Results Per Page
Sort Options
Publication A Rare Case of Large Left Lateral Wall Vaginal Myoma(Kathmandu University, 2021) Shrestha, A; Mudbari, J; Tamrakar, SR; Pradhan, N; Makaju, R; Karki, SABSTRACT Vaginal leiomyomas are rare, they are uncommon benign tumor with variable clinical presentation. They usually present as a mass per vaginum or dyspareunia or pressure symptoms on the neighbouring structures. We present a case of 47 years lady with mass per vaginum and difficulty in walking and chronic pelvic pain. Her clinical findings suggested a large mass in the left vaginal wall, the mass was approximately 12 x 10 cm in size hindering the visualization of the cervix. Her ultrasonography showed bulky uterus with mass occupying the cervix. This finding was not correlating with the clinical findings. Magnetic resonance imaging (MRI) was done and it was reported as mass lesion in pelvis separate from the cervix abutting the rectum posteriorly. Ultrasonography (USG) guided biopsy was done which was reported as Leiomyoma. She underwent vaginal myomectomy and was confirmed in histopathology as Leiomyoma. A leiomyoma is a smooth muscle tumor that arises from the muscular part of the uterus and rarely seen in the vaginal wall. KEY WORDS Chronic pelvic pain, Leiomyoma, Mass per vaginumPublication Complications of warfarin in post operative heart valve surgery(Institute of Medicine, 2013) Pradhan, N; Bhandari, NR; Bharati, LAbstract Introduction: Thromboembolic complications and bleeding are the major complications of warfarin. The aim of the study was to focus on the complication of warfarin and monitoring post-valve surgery. Methods: A combined retrospective and prospective study was done in post mechanical heart valve surgery patients at Manmohan Cardiothoracic Vascular and Transplant Center. The study was carried out for 4 months by interviewing patients with self-administered structured questionnaire about any complications during their follow up in OPD and monitoring for their INR values. Results: The majority of patients studied wer male 42 and 56 were female. 55 patients underwent mitral valve replacement, 22 underwent double valve replacement and 46 underwent aortic valve replacement. There were a total of 59 cases of bleeding complications. Hemoptysis was the most common bleeding event .Pericardial bleeding was the most common major bleeding complication with 3.1%. In patients taking warfarin major bleeding complication was 10.2% and minor bleeding was 50%. Out of total INR reading 47% were out of the target INR range, with 19.5% above range and 27.5% below range. Conclusion: Minor bleeding was the most common type of bleeding. A system for proper monitoring of warfarin can bring improvement in better dose adjustment to achieve more appropriate INR values and eventually minimizing warfarin related complications. Introducing pharmacist monitored anticoagulant clinic can reduce the work load of physicians and overcome the time barrier. Keywords: Minor bleeding, Major bleeding, INR, ThromboembolismPublication Knowledge, attitude and practice of contraception among women seeking: abortion care services(Institute of Medicine, 2013) Bista, KDB; Pradhan, N; Manandhar, RAbstract Introduction: Women coming for abortion are those in whom contraceptive use is most needed. This study was therefore done to assess the knowledge, attitude and practice of family planning measures among the women who came for safe abortion services at TU Teaching Hospital Methods: A prospective, study done for a period of 9 months (17 April 2009 to 14 Jan 2010) in the Family Planning and Comprehensive Abortion Care Centre, Tribhuvan University Teaching Hospital among the women who came to seek abortion services. The women were interviewed before the procedure and then at follow up at 1 month and at 3 months. Results: A total of 125 women were interviewed. Most women belonged to age between 20- 29 yrs (57%). Of them 19% were > P3. Only 3 women had not heard about family planning methods, while >50% knew all the methods. Maximum source of information was media (65.6%). Ninety five percent women approved of practicing family planning and 81% intended to use it after the abortion. 81% needed approval from husband for using a contraceptive. Eighty percent of women had used some sort of contraceptives in the past while less than 50% of husband had ever used contraceptives in the past. Fifty seven percent women came for termination of pregnancy because of completed family. Seventy nine percent of women accepted different methods of family planning while 68% were found to continue using them at 3 months follow up. Conclusion: Long acting contraceptives were less likely to be discontinued. Husbands had an important role in giving permission and deciding the contraceptive method. Keywords: contraception, knowledge, attitude and practisePublication Reproductive Risk Factors in Uterovaginal Prolapse: A Case Control Study(Institute of Medicine, 2015) Paudyal, P; Pradhan, N; Ojha, NAbstract Introduction: Uterovaginal prolapse (UVP) is a major women’s health concern throughout the world and contributes a major bulk of reproductive health morbidity in Nepal. The cause of this disorder is likely to be multifactorial. The aim of this study was to analyze the reproductive risk factors associated with UVP. Methods: This was a hospital-based case control study, carried out in the Gynaecology Department of TUTH over one year from 1 st Baisakh 2068 to 30 th Chaitra 2068 (13th April 2011 to 12th April 2012). Cases comprised of 116 women with UVP, second degree or more and controls were women without prolapse of the same age group (± 5 years) admitted subsequently after the cases. The variables studied were; age at first childbirth, number of vaginal births, birth spacing and rest during puerperal period. P value and Odds Ratio (OR) for each risk factor were calculated. Multivariate analysis was done for those risk factors found to be significant from the univariate analysis. Results: Age at first childbirth, number of vaginal births and rest during puerperium were found to be significant risk factors from univariate analysis. Only two risk factors i.e. age at first childbirth<20years; OR 2.24(95% CI 1.18-4.25) and rest during puerperium<15 days; OR 3.87(95% CI 1.9-7.93), were found to be significant by the multivariate analysis. Conclusion: Preventing early marriage and childbirth at a young age along with imparting awareness about the importance of adequate rest during the puerperium could go a long way in reducing morbidity due to prolapse. Keywords: reproductive risk factor, uterovaginal prolapse