Postnatal period is considered as an important part in reproductive life of women. Even though the antenatal phase and labour are utmost important, puerperal phase of pregnancy cannot be overlooked. Puerperal complication can sometime lead to diabilities for lifelong of women. For the prevention of postnatal complication, antenatal prepadareness is needed. The objective of this study was to find out the incidence of puerperal complications and associated risk factors. This is a retrospective, descriptive study conducted at Tribhuvan University Teaching Hospital, Department of Obstetrics and Gynaecology from April 2019 to March 2020. The cases of puerperal complications were noted from the record book from ward. The individual files were collected from record section. Data was collected from record files and analysed. Total number of deliveries were 4932 in one year. Out of which, 84 cases (1.7%) were admitted due to various puerperal complications. Majority of the women admitted with puerperal complications were between 21-29 years, 59.5%. Sixty-four percent (n=54) were primipara and 35.7%(n=30) were multipara. Seventy-six (90.5%) were term deliveries, 6(7%) were preterm and 2(2.4%) were post term deliveries. Sixty-two (74%) had emergency cesarean section as mode of delivery. Major indication of emergency cesarean section was fetal distress (29.8%, n=25). Surgical site infection (53/84,63%) was the commonest puerperal complication followed by puerperal sepsis (8/84,9.5%). Fifty- three cases of surgical site infection (SSI) were observed in patients who had undergone emergency cesarean section. Associated medical condition like hypertension, diabeties, anemia, obesity was seen in 33.5% (n=33) of the cases. Surgical Site Infection is the most common puerperal complication and commonly seen in women who had undergone emergency cesarean section.

Introduction: Infertility has been rising steeply as the prime health issue among women around the world these days. This study aims to investigate the causes, hormonal profi le, and clinical spectrum of infertility.Materials and Methods: This is a descriptive cross-sectional study conducted throughout a one year duration in an infertility clinic. The couples meeting the inclusion criteria were included and a pre-formed proforma was used to collect the data regarding history, examination, and investigations.Results: A total of 118 infertile couples were analyzed. The mean age of the females was 28.3±4.5 years. There were 72.1 %cases of primary infertility and 27.9 %of secondary infertility. Regarding obesity status,35.5% were overweight and 15.2 % were obese. Thirty-one (26.2%) males were smokers, 41 (34.7%) used to consume alcohol, and 14 (11.8%) had a habit of chewing tobacco. Among the different fi ndings of semen analysis, 21.1% asthenozoospermia, 9.3% oligoasthenozospermia,7.6% oligospermia, 1.6% azoospermia. Female factor accounted for 45.3%, the malefactor for 28% and in 19.3% the defi nite factor was not determined. The ovulatory disorder was diagnosed in 38.6% of females and hysterosalpingography (HSG) revealed that around 10% had a unilateral block and 1.7% had a bilateral block.Conclusions: Infertility is becoming a global issue affecting a signifi cant number of young couples. About forty-six percent were female aging more than thirty years. The female factor for infertility was more common than the male factor among which ovulatory disorder was the commonest one. Asthenozoospermiawas the commonest abnormal fi nding on semen analysis in a male partner.

Introduction Thyroid dysfunction has profound effects on menstrual function and female fertility. Hypothyroidism is often associated with increased prolactin level which again worsens the problem. This study was done to evaluate the prevalence of thyroid disorders in infertile women attending infertility outpatient department (OPD) in Tribhuvan University Teaching Hospital (TUTH) and to determine the association of hypothyroidism and hyperprolactenemia with obesity which is not well studied in our population. MethodsA hospital-based cross-sectional study was conducted in infertility OPD of TUTH reviewing women’s records who underwent infertility workup and relevant history, clinical finding and results of investigations including thyroid function test (TFT) and serum prolactin (PRL) level were documented. Descriptive and inferential statistical analyses were used to identify the prevalence and associations of predictors and outcome variables. ResultsOut of 213 participants, the majority of the participants were obese (90; 42.3%) with mean (±SD) body mass index (BMI) being 24.8 ± 4.5 kg/m2. The prevalence of thyroid disorder was 18.4% including hypothyroidism 13.6% and hyperthyroidism 4.8%. There was no significant association of BMI and hyperprolactinemia with thyroid disorder as well as of BMI with hyperprolactinemia however the thyroid stimulating hormone (TSH) had significant positive correlation with prolactin (r=0.23, p<0.001). ConclusionThyroid disorders and hyperprolactinemia are commonly observed in infertile women, so they should be routinely screened during initial evaluation of infertility. As majority of the study population were obese, despite no significant association of BMI with thyroid disorder and hyperprolactinemia, the effect of weight gain on infertility cannot be overlooked.

Background: Studies done to determine relation of increase in Body mass index and semen parameters have shown conflicting results, some showing negative correlation others showing none. This study aimed to find out if there is any association between them in our population. Methods: A cross-sectional study was performed in an infertility clinic in 2018/19 reviewing records from which Body mass index of male partner and results of semen analysis noted. Participants were grouped according to Body mass index; normal: 18.5–24.99 kg/m2, overweight: 25–29.99 kg/m2 and obese: >30 kg/m2. Different semen parameters such as volume, total count, concentration and motility were compared between different Body mass index groups to determine if there is any association between them. Results: Total 249 participants enrolled with mean Body mass index of 25.1 + 3.4 years. Semen volume decreased with increase in Body mass index (p value 0.063) and sperm count was lower in overweight and obese group compared to normal Body mass index group (p value 0.449) suggesting insignificant negative correlation of Body mass index with semen volume and sperm count. However there was insignificant weak positive correlation of Body mass index with sperm concentration and progressive motility (p value 0.668 and 0.973 respectively). Overweight persons were 3.14 times likely to have hypovolemia (OR:3.14; 95%CI: 1.51-6.53) and obese persons were 1.19 times likely to have oligospermia (OR:1.19 95% CI: 0.42-3.36) compared to persons with normal Body mass index.Conclusions: Body mass index has insignificant negative correlation with semen volume and total sperm count and persons with higher Body mass index were more likely to have hypovolemia and oligospermia compared to person with normal Body mass index. Keywords: Asthenospermia; body mass index; hypovolemeia; oligospermia; semen parameters.

A case of 28 years primigravida with refractory tachycardia at term is reported. She was refractory to medical cardioversion. Electrical cardioversion was applied before and after the delivery of baby. With several cycles of variable joules of electrical cardioversion, the normal rhythm was not obtained. However, patient’s rhythm reverted to sinus with anti-arrhythmic medication after third week of cesearean delivery.