Journal Issue: Volume: 59, No. 239, July (2021)
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Volume
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Issue Date
2021
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Journal ISSN
JNMA Print ISSN: 0028-2715; Online ISSN: 1815-672X
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Articles
Ureteric Injuries after Hysterectomy in a Tertiary Care Center of Nepal: A Descriptive Cross-sectional Study
(Nepal Medical Association, 2021) Khatri, Ratna Adhikari; Chand, Arju; Thapa, Sumana; Khadka, Shailaja; Thapa, Manish
Abstract:
Introduction: Pelvic surgery is the most common cause of iatrogenic ureteral injury. The incidence of ureteric injuries varies between skilled and inexperienced surgeons. The study aims to determine the prevalence of ureteric injuries sustained during hysterectomy in a tertiary care center of Nepal.
Methods: A descriptive cross-sectional study involving the women attending the gynecological outpatient department of a tertiary care center of Nepal, for various benign and malignant conditions and later on underwent hysterectomy from June 2019 to June 2020 was done after obtaining ethical clearence from the Institutional Review Committee (Reference No. 245). Convenient sampling method was used. The data were entered in Excel and analyzed using Statistical Package for Social Sciences version 17. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data.
Results: Altogether, 1 (0.63%) (0.55-0.71 at 95% Confidence Interval) out of 159 patients sustained the ureteric injury during hysterectomy in a tertiary care center of Nepal. The injury was seen during the exploratory laparotomy for adnexal mass. The injury was recognized intraoperatively and was repaired with double J stenting. A total of 159 patients were enrolled in the study that had undergone hysterectomy over one year for various benign and malignant conditions. Out of which 21 (13.2%) had undergone surgeries for malignant conditions and 138 (86.79%) for benign conditions.
Conclusions: Iatrogenic ureteric is still a major cause of harm and concern in hysterectomy. Patients with ureteric injury should be evaluated and intervened at the earliest.
Study of Vitamin-D Deficiency among Pregnant Women in their First Trimester Visiting a Tertiary Care Hospital: A Descriptive Cross-sectional Study Authors
(Nepal Medical Association, 2021) Shrestha, Dipty; Saha, Rachana; Karki, Chandrima; Mahato, Shilpi
Abstract:
Introduction: Vitamin-D deficient pregnant women are more likely to have pregnancy complications like pre-eclampsia, intrauterine growth restriction, diabetes, preterm birth, etc. Associated factors include ethnicity, skin coverall, use of sun protection, overweight, vitamin-D intake, and smoking. The objective of this study is to determine the prevalence of Vitamin-D deficiency among pregnant women in a tertiary level hospital.
Methods: This study descriptive cross-sectional study was conducted at a tertiary care hospital from September 15th, 2020 to November 15th, 2020 where the pregnant women visiting for an antenatal checkup in the first trimester were enrolled. Ethical clearance was taken from the Institutional Review Committee of Kathmandu Medical College (reference no. 1808202003). A convenience sampling method was used. All the data were entered in the Statistical Package of the Social Sciences version 20.0 and analyzed. Point estimate at 90% Confidence Interval was calculated along with frequency and percentage for binary data.
Results: Among a total of 47 cases, vitamin-D deficiency was seen in 21 (44.6%) (32.67-56.52 at 90% Confidence Interval).
Conclusions: The prevalence of vitamin-D deficiency was similar to other studies done in similar settings.
Late Stage Cervical Cancer among Confirmed Cervical Cancer Cases in a Tertiary Care Centre: A Descriptive Cross-sectional Study
(Nepal Medical Association, 2021) Ojha, Neebha; Jha, Meena; Shrestha, Eliza; Dangal, Ganesh
Abstract:
Introduction: Cervical cancer is the leading gynaecological cancer in Nepal. Most of the time, it is diagnosed in the late stage with its associated morbidity and mortality. This study aimed to find out the prevalence of late-stage presentation of cervical cancer among confirmed cases of cervical cancer in a tertiary care centre.
Methods: A descriptive cross-sectional study was conducted at a tertiary care centre of Nepal from March 2021 to May 2021 after obtaining ethical clearance from the Institutional Review Board (Reference no.805). A convenient sampling method was used. A descriptive analysis was done of all cases of cervical cancer who were diagnosed within the last 36 months and attended hospital during the study period. The information was collected by interview and hospital record was checked. Analysis was done using Statistical Package for Social Sciences version 20. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data.
Results: Among the 142 confirmed cervical cancer cases, the prevalence of late-stage presentation of cervical cancer was 93 (65.5%) (57.7-73.3 at 95% Confidence Interval). The mean age at diagnosis was 50.6±10.9 years. More than two-thirds of the women were from outside Kathmandu valley 102 (71.8%) and came from >50km distance. The majority of the women 83 (58.5%) were illiterate.
Conclusions: The study showed that two-thirds of the women presented in advanced stage and the factors leading to the late stage. This highlights the fact, that the focus should be on the provision of organized screening programs and early diagnosis and treatment of cervical cancer.
Thyroid Dysfunction in Patient with Abnormal Uterine Bleeding in a Tertiary Hospital of Eastern Nepal: A Descriptive Cross-sectional Study Authors
(Nepal Medical Association, 2021) Joshi, Bishal Raj; Rizal, Shikha; Subedi, Shanti
Abstract:
Introduction: Thyroid hormone is known to affect reproductive biology. Abnormal uterine bleeding is one of the common presentations in gynaecology outpatient departments and thyroid dysfunction is known to affect its progression. This study aims to find the prevalence of thyroid dysfunction in diagnosed cases of abnormal uterine bleeding in patients in a tertiary hospital of eastern Nepal.
Methods: A descriptive cross-sectional study was conducted in patients diagnosed with abnormal uterine bleeding in a tertiary care hospital of eastern Nepal from April 2019-March 2020 after taking ethical clearance from the Institutional Review Committee. On basis of inclusion and exclusion criteria, 95 cases of abnormal uterine bleeding were included in the study. A blood sample was taken and a thyroid function test was done by chemiluminescence assay on an automated analyzer. Convenient sampling method was used for sample collection. Statistical analysis was done using Statistical Package for the Social Sciences version 16. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data.
Results: Out of the total cases of abnormal uterine bleeding, 15 (15.79%) (8.46-23.12 at 95% Confidence Interval) had thyroid dysfunction. Among total cases, 80 (84.21%) were euthyroid. The mean age of the patients was 33±8 years. Among thyroid dysfunction, 9 (60.0%) were hypothyroid, 4 (26.66 %) were subclinical hypothyroid, and 2 (13.33 %) were hyperthyroid.
Conclusions: Thyroid dysfunction was common among patients with abnormal uterine bleeding, with hypothyroidism being the most common type.
Use of Contraceptive among Postpartum Women of a Municipality: A Descriptive Cross-sectional Study
(Nepal Medical Association, 2021) Bhandari, Mukta Singh; Kayastha, Suresh
Abstract:
Introduction: Contraception plays a key role in preventing unwanted births. It also decreases pregnancy and childbirth-related morbidities and mortalities, but many women don't use contraception particularly in the postpartum period. The main objective of this study was to find out the prevalence of contraception use among postpartum women in a municipality.
Methods: A descriptive cross-sectional study was conducted among married women of reproductive age in Dhulikhel municipality of Kavrepalanchok from January to September 2019. Ethical approval was obtained from Institutional Review Committee and permission was taken from Dhulikhel Municipality before the study. The sample size was 332. A convenience sampling method was used. A semi-structured questionnaire pre-tested in Panauti municipality was used. Data entry and analysis were done using Statistical Package for Social Sciences version 20. Point estimate at 95% Confidence Interval was calculated for descriptive analysis.
Results: Out of total 332 women, 146 (40%) (34.73-45.26 at 95% Confidence Interval) used postpartum contraception. Injectable/Depot was used by 61 (42%) women. Total 97 (52%) of the non-users intended to use contraception in the future. The most common reason for contraception use was women not wanting the next child soon 91 (62%) and reason for non-use was feeling contraception as unnecessary 73 (39%).
Conclusions: The use of postpartum contraception was poor, and only half of the non-users intended to use contraception in the future. Thus, contraception use should be encouraged during all possible contact times, and counselling should be made universal to improve postpartum contraception services' uptake.