Browsing by Author "Thapa, Durga"
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Publication Clinical Profile of Patients with Infertility Presenting to Tertiary Care Center: An Observational Study(Nepal Medical Association, 2025) Tiwari, Jyotshna; Shrestha, Dipty; Thapa, Durga; Rawal, Sirjana; Kafle, RijanAbstract Introduction: Infertility, defined as the inability to conceive after a year of regular unprotected sexual activity, is a significant global health concern. It affects couples across the world, with prevalence rates varying between 3.5-16.7% in developed countries and 6.9-9.3% in developing nations. This study aims to explore the sociodemographic profiles and contributing factors in both men and women among infertility patients at a tertiary care center. Methods: An observational cross-section study was conducted at a tertiary care center and participants were between 18 and 42 years old with infertility for one year or longer, excluding those who had received treatment or were pregnant. The data was collected from December 2023 to May 2024. Ethical approval and informed consent were obtained. Data were collected using a structure proforma through in-person interviews or telephone calls and analyzed using Statistical Package for the Social Sciences with descriptive statistics. Results: Among 170 couples with infertility, primary infertility was observed in 124 (72.94%) and secondary infertility in 46 (27.06%). The median duration of marriage was 5 years (IQR: 4–7). Among women, 37 (21.76%) had tubal blockages, 16 (9.41%) had polycystic ovarian disease, and 6 (3.53%) had fibroids. Among men, 58 (34.12%) had semen abnormalities, with oligospermia being the most common in 25 (14.71%). Hormonal analysis revealed that 68 (40%) of women had elevated anti-Müllerian hormone levels, frequently linked to polycystic ovarian syndrome. Conclusions: These findings show that infertility is rarely due to a single cause. It commonly involves both partners and requires a comprehensive approach to diagnosis and treatment.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.