Browsing by Author "Sharma, Jyotshna"
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Publication Down Syndrome Screening among Pregnant Women Visiting the Department of Obstetrics and Gynaecology of a Tertiary Care Centre(Nepal Medical Association, 2023) Sharma, Jyotshna; Thapa, Meena; Yadav, Ranjana; Shrestha, DiptyAbstract Introduction: The screening of Down’s syndrome by the measurement of serum markers using dual and quadruple tests in the second trimester is done among obstetric patients between 13 to 22 weeks of gestation. The test readings are signified in terms of low-risk or high-risk. The aim of this study was to find out the prevalence of Downs syndrome screening among pregnant women visiting the Department of Obstetrics and Gynaecology of a tertiary care centre. Methods: A descriptive cross-sectional study was conducted from 15 April 2022 to 15 December 2022 among patients visiting the Department of Obstetrics and Gynecology of a tertiary care centre. Ethical approval was taken from the Institutional Review Committee. Women with a singleton pregnancy who underwent dual and quadruple screening tests at 11 to 22 weeks of gestation were taken and analysed as per reports. Convenience sampling method was used. The point estimate was calculated at a 95% Confidence Interval. Results: Among 268 women, Down syndrome screening was done in 200 (74.63%) (69.42-79.84, 95% Confidence Interval). Among them, 168 (84%) had a low risk for Down syndrome, and 32 (16%) had a high risk for Down syndrome. Conclusions: The prevalence of Downs syndrome screening among pregnant women visiting the Department of Obstetrics and Gynecology of a tertiary care centre was found to be similar to other studies done in similar settings.Publication Intra-abdominal Adhesions among Patients Undergoing Repeat Caesarean Section in Department of Obstetrics and Gynaecology of a Tertiary Care Centre: A Descriptive Cross-sectional Study(Nepal Medical Association, 2022) Pokhrel, Manoj; Sherpa, Lakpa Dolma; Thapa, Meena; Sharma, JyotshnaAbstract Introduction: Adhesions are one of the common complications encountered after caesarean section whose risk increases with the number of caesarean deliveries. This study aimed to find out the prevalence of intra-abdominal adhesions among patients undergoing repeat caesarean section in a tertiary care centre. Methods: A descriptive cross-sectional study was conducted on 74 pregnant women undergoing repeat caesarean section in the Department of Obstetrics and Gynaecology of a tertiary care centre from July, 2021 to December, 2021 after receiving the ethical approval from the Institutional Review Committee (Reference number: 2107202103). Pregnant women who met the eligibility criteria were included in the study. Convenience sampling was done. The severity of the adhesions was classified using the Tulandi and Lyell classification. Data were analysed using the Statistical Package for the Social Sciences version 26.0 software. Point estimate at 90% Confidence Interval was calculated along with frequency and percentage for binary data along with mean and standard deviation for continuous data. Results: Out of 74 women undergoing repeat caesarean section, 55 (74.32%) (65.99-82.65 at 90% Confidence Interval) had developed intra-abdominal adhesions. Conclusions: Our study showed that the prevalence of intra-abdominal adhesions among patients undergoing repeat caesarean section was higher when compared to similar studies conducted in similar settings.Publication Prevalence of Thyroid Disorders in Women of Reproductive Age Group with Abnormal Uterine Bleeding(Rapti Academy of Health Sciences (RAHS), 2025) Yadav, Ranjana; Shrestha, Usha; Pathak, Punam; Sharma, Jyotshna; Thapa, DurgaAbstract: Introduction: Abnormal uterine bleeding (AUB) is one of the most common presentations in the outpatient gynecological department. Numerous mechanisms, including thyroid hormone, controls the physiology of menstruation. Assessing thyroid function is essential for definitive management. Objective of study is to analyse and find thyroid dysfunction among patient of AUB. Methods: This study is hospital based descriptive cross sectional conducted at Kathmandu Medical College, Kathmandu, a tertiary centre. Study period was 14 months from December 1st, 2021 to January 2nd, 2023. Study include 126 patients meeting inclusion criteria. TFT was done in eligible under inclusion criteria. Prevalence of thyroid disorder and pattern of AUB associated with specific type of thyroid disorder was noted. Results: 126 patients presented with AUB. Women over 40 years had highest prevalence of AUB (41.26%; 52 out of 126). In multipara, prevalence was 60.31% (76 out of 126 cases). Most prevalent pattern in AUB was Menorrhagia i.e 53.17% of cases (67 out of 126). 35 out of 126 cases (27.77%) had thyroid dysfunction. Of them, hypothyroidism was most prevalent occurring in 26.08% cases (34 out of 126). 1 out of 126 cases (0.79%) had hyperthyroidism. Majority of subclinical hypothyroidism (48.3%) was discovered in menorrhagia.Thyroid dysfunction was caused by non-structural causes AUB in 65.71% patients (23 out of 35). Types of thyroid disorders and causes of bleeding were shown significantly correlated (p=0.048). Conclusion: TFT can be routine test during evaluation of AUB to avoid unnecessary hormonal exposure and surgeries.Publication Thyroid Disorders in Patients with Polycystic Ovarian Syndrome in a Tertiary Care Center: An Observational study(Nepal Medical Association, 2024) Sharma, Jyotshna; Mahat, Bimita; Tiwari, Sanjeeb; Singh, Niraj Kumar; Thapa, Durga; Yadav, RanjanaAbstract Introduction: Polycystic ovarian syndrome is the most common endocrine and metabolic disorder in women of childbearing age, affecting 3–15% of women worldwide, leading to reproductive, metabolic, and psychological issues. Patients with polycystic ovarian syndrome require rigorous thyroid function detection, monitoring, and correction over time. In this study, we aimed to evaluate the clinical presentations and thyroid dysfunction in patients with polycystic ovarian syndrome. Methods: An observational study was done in patients with polycystic ovarian disease presenting to a tertiary care centre over six months, from December 2023 to May 2024 Total population sampling was done. All the women during the study period diagnosed with polycystic ovarian disease based on Rotterdam criteria were included in the study after getting ethical approval from the institutional review board. (Reference number: 20102023/03). Results: The mean age of women in the study was 24.74±5.01 years. A total of 28 (31.46%) patients of polycystic ovarian disease had hyperthyriodism, hypothyroidism was found in 13 (14.60%) and subclinical hypothyroidism was found in 6 (6.74%) patients. All the women had menstrual irregularities. Regarding androgenic characteristics, 53 (59.55%) of patients presented with hirsutism, 43 (48.51%) presented with acne, 13 (14.61%) women had alopecia, and 4 (4.49%) women had acanthosis. Conclusions: Hyperthyroidism, hypothyroidism and subclinical hypothyroidism were prevalent in polycystic ovarian disease patients, emphasizing the need for thorough thyroid evaluation in polycystic ovarian disease patients due to its impact on metabolic and reproductive health. High rates of menstrual irregularities, androgenic symptoms like hirsutism and acne, and fertility challenges were also prevalent, aligning with findings from similar studies.Publication Vaginal Microflora in High Vaginal Swab in Prelabour Rupture of Membrane: A Descriptive Cross-sectional Study(Nepal Medical Association, 2024) Sharma, Jyotshna; Tiwari, Sanjeeb; Thapa, Durga; Yadav, RanjanaAbstract Introduction: Premature rupture of membrane (PROM) refers to the disruption of the fetal membrane before the beginning of labor, resulting in spontaneous leakage of amniotic fluid. Cervicovaginal infection is an important risk factor of PROM and can lead to complications to mother and the child. This study aimed to delineate the bacterial patterns found in PROM so that the ideal appropriate responsive antibiotics can be chosen. Methods: A descriptive cross-sectional was done during the period of 6 months from December of 2023 to May 2023, to characterize the microorganisms in the vaginal fluid found in antenatal women presenting with premature rupture of membraneafter obtaining ethical approval (IRC number: 20102023/02). A total of 117 antenatal women diagnosed with premature rupture of membrane were included in the study. High vaginal swabs were collected for microbial culture and sensitivity. Data were entered using Microsoft Excel 2000 (v9.0) and Statistical Package for the Social Sciences (SPSS) software version 26.0 was used for analysis. Results: Out of 117 samples, culture growth was present in the culture of high vaginal swabs of 23 (19.66%) women. The high vaginal swab cultures from the samples collected in women presenting with PROM reported 9 different types of pathogens E. coli in 12 (52.17%), Klebsiella in 4 (17.39%) and Pseudomonas in 2 (8.70%) cultures. Conclusions: This study reveals diverse microorganisms in premature rupture of membrane cases, with E. coli being the most common. Identifying these bacterial patterns is essential for selecting effective antibiotics, improving maternal and neonatal outcomes, and reducing morbidity and mortality by early detection and treatment of vaginal infections.