Introduction: In developing countries, urinary tract infections (UTIs) are one of the most commonly diagnosed diseases among the patient seeking medical service and are treated with empirical antibiotics which does not provides cure and causes resistance.Objective: To find out the incidence of urinary tract infections and antibiotics sensitivity pattern among bacterial pathogens isolated in patients attending Nepalgunj Medical College and Teaching Hospital, Kohalpur.Methodology: All patients (both male and female) were included in the study with the clinical suspicion of UTI . They had their urine culture done. Incidence of UTI and spectrum of pathogens with their sensitivity were recorded.Result: A total number of 1445 patients were clinically suspected for UT. They had their urine cultura and sensitivity done Total number of patients with culture positive was 391(27.05%). The majority of isolates were from female patients comprising of 314(80.3%) patients. The most common pathogenic microorganism isolated was E.coli (73.65%). Second most common organism was Klebsiella (19.9%), it was followed by Acinetobacter (3.5%), Enterobacter (3.06%), Pseudmonas and Proteus (0.76%) each, Staphylococcus (0.05%) salmonella (0.02%). The isolated microorganisms showed maximum sensitivity to Nitrofurantin and Amikacin. The isolated microorganism demonstrated resistance to cefpodoxime and Cefotaxime.Conclusion: Urinary tract infections is a commonly encountered case in general practice Females are more commonly affected than men. The microbial profile and the antibiotic sensitivity pattern must be taken into account while planning for the management. Regular supervision of the sensitivity pattern of pathogenic microorganism is mandatory for effective treatment.JNGMC, Vol. 14 No. 2 December 2016, Page: 34-37

Introduction: Vaginal discharge syndrome consists of abnormal vaginal discharge, vaginal itching, painful urination and painful sexual intercourse, among them abnormal vaginal discharge is one of the most common clinical symptoms for which most of the female seek care for management in gynaecology and obstetrics outpatient department. Abnormal vaginal discharge in the women of reproductive age can lead to subfertility, ectopic pregnancy, early rupture of membrane, chronic pelvic pain and increases susceptibility for HIV virus and oncogenic virus. Objective: To identify aerobic microflora associated with vaginal discharge and find out most useful drugs for it. Material and Methods: A Hospital based cross sectional study was carried out at Nepalgunj Medical College Teaching Hospital, Kohalpur in November 2016 to November 2017. Ninety- five women who were at reproductive age group with vaginal discharge and met inclusion criteria participated in the study. Samples were taken from posterior fornix of vagina with the help of cotton swab following the confirmation of vaginal discharge by per speculum examination, culture and sensitivity was done. Result: The mean age of participants was 32.7±8.1. Out of 95 participant's samples, aerobic vaginal microfloras were grown in 18 (18.94%) participants and 77 (74.73%) samples was found to be sterile. E. coli and staphylococcus aureus (predominant aerobic vaginal flora) was grown in 7(38.88%). E. coli was sensitive with all available antibiotics in majority of samples showed sensitive to ciprofloxacin, ceftriaxone, tobramycin and meropenam i.e 6 (85.71%) each followed by cefixime and cefpodoxime 5(71.42%), least sensitive with doxycycline 4(57.14%). Similarly, in majority of the samples Staphylococcus aureus was also found to be sensitive with doxycycline, ceftriaxone and meropenam 7(100%) each followed by tobramycin in 6(85.71%), ciprofloxacin and cefixime 2 (28.58%), least sensitive with cefpodoxime 1(14.29%). Meanwhile Ciprofloxacin and tobramycin 2(100%) found to be more effective for klebsiella pneumoniae and doxycycline, meropenam, cefixime and cefpodoxime was found to least effective 1(50%). Chloramphenicol was the only drug sensitive to streptococcus in total collected samples. However Acinetobacter was sensitive with ceftriaxone, ciprofloxacin and doxycycline 1(100%) each but resistant with rest of the antibiotics like meropenam, tobramycin, cefixime and cefpodoxime 1(100%). Most microorganisms were found to be sensitive with ceftriaxone, tobramycin and meropenam 14 (77.77%) and was followed by doxycycline 13 (72.22%) and ciprofloxacin in 11 (61.11%). Cefpodoxime 11(61.11%) and cefixime10 (55.55%), they found poorly in sensitivity test. Conclusion: Bacterial culture and its sensitivity in vaginal discharge should be done not only because of its troublesome symptoms but for its complications like subfertility, preterm delivery, ectopic pregnancy and it's increased susceptibility for HIV and oncogenic virus. E. coli and staphylococcus were the predominant bacteria found in present study and were followed by klebsiella pneumoniae, streptococcus and acinetobacter. In this study, Ceftriaxone (85.7%) and meropenam (100%) were found to be more effective for E.coli and staphylococcus aureus respectively, ciprofloxacin could be used as a choice of drugs for E.coli (sensitivity 85.7%). However for staphylococcus, doxycycline was a better option with 100 % sensitivity.

Background: Hysterectomy is a common surgery performed by gynecologist worldwide. It can be done either by vaginal, abdominal or laparoscopic route. Non decent vaginal hysterectomy (NDVH) is less invasive, less time consuming and scar less surgery. The blood loss during surgery, intra-operative and post-operative complications are less in NDVH compare to TAH (total abdominal hysterectomy). Aim and objective: to compare the clinical outcome between NDVH and TAH. Method: A hospital based prospective study was done at Nepalgunj medical collage Kolhapur between March 2018–March 2019, 60 cases fulfilling selection criteria were selected, 30 cases underwent NDVH next 30 cases underwent TAH. Outcome is measured on the basis of operating time, blood loss during surgery, hospital stay and post-operative complications. Result: The most common indication for hysterectomy was fibroid uterus in both the groups (NDVH and TAH). The operating time, blood loss, hospital stay and post-operative complications were less in NDVH as compare to TAH. Conclusion: NDVH is a choice of surgery over TAH for freely mobile uterus with benign pathology and uterus size less than twelve weeks and without adenexal pathology.

Background: Globally, Preterm delivery is a major contributory factor for early neonatal death. Till date definite causative factor for preterm labour has not been proven. However, the genital tract infection is considered to be the contributory factors for PPROM. Method: This case control study was conducted at Nepalgunj Medical College Teaching Hospital, Kohalpur. 100 cases enrolled in the study were divided into two groups; group A consisted of 50 cases with PPROM; and in group B 50 cases were included cases without PPROM who came to routine antenatal check-up in ANC (antenatal care) clinic. The high vaginal swab was taken from the upper one-third of the posterior wall of the vagina and sent for culture and sensitivity in all cases. Results: In group A (with PPROM)74% of cases were culture positive and the commonest organism was E. coli which was isolated in 40% (20/50). In group B (without PROM) 28% of cases had culture positive, and again the commonest organism was E. coli isolated in 14 % cases (7/50). This present study showed that E. coli was most sensitive to amoxyclav and staphylococcus epidermis was most sensitive to nitrofurantoin. Ceftriaxone was found to be most effective in mixed infections. Conclusions: The genital tract infections in PPROM group was very high (+ve) culture in 74% in comparison to the non PPROM group where genital tract swab showed growth in only 28% (p-value 0.001). The lower genital tract infection has been considered as one of the potent cause of PPROM, so it is advised that a vaginal swab should be routinely obtained in the ANC clinic for culture and sensitivity. An appropriate antibiotic should be started in culture positive cases.

Introduction: Foetal death at any stage of pregnancy is not just a tragic event but also a more traumatic for the mental well-being of a mother. It is one of the most wrenching events in the field of obstetrics. Aims: The study was done to determine the probable risk factors of intrauterine foetal death and role of antenatal care in its prevention. Methods: The study was conducted  in Obstetrics and Gynecology department at Nepalgunj Medical college from July 2018 to July 2020 .Inclusion criteria were  intrauterine fetal death  of >28 weeks of gestation and baby weighing  1000 grams or more . An exclusion criterion was molar pregnancy. Results: There were 115(3.52%) intrauterine fetal death during the study period, making it 35 per 1000 cases. In 17(14.78%) the cause of intrauterine fetal death was not known. The other common associated risk factors were prematurity in 14(12.17%) and hypertension in 13(11.30%). Similarly anemia and antepartum hemorrhage were seen in 13(11.30%) each. 11(9.56%) patients had oligohydramnios. Mal presentation was found in 8(6.95%) patients while polyhydromnios in 6(5.21%).The commonest age range in whom intrauterine fetal death was seen was 20-30 (73.90%). 28 (24.34%) patients were at preterm pregnancy ranging between 28-30 weeks whereas 17(14.78) intrauterine fetal death occured at  32-34 weeks. 77 foetuses were preterm and their birth weight was between 1 - 1.5 kg  with the mean wt of  1175.73 gms. Conclusion: Intrauterine fetal death is still common inspite of the improving awareness in importance of regular antenatal care. In majority, the cause of intrauterine fetal death is still unknown. However, where the cause was known prematurity was the commonest.