Introduction: The field of minimal invasive surgery has flowered explosively in the recent past. Modern endoscopy has changed the approach to diagnosis as well as the operative procedure. This study was done with the aim of sharing the experiences of gynecological laparoscopic procedures done at Nobel Medical College and Teaching Hospital, Nepal. Methods: A descriptive study was done in the department of Obstetrics and Gynecology, Nobel Medical College from 1st April 2015 to 30th March 2016. All the patients undergoing laparoscopic procedures were analyzed for the indication, type of procedures and their complications. Results: During the study period, 100 patients underwent laparoscopic procedures including 25 cases of diagnostic and 75 cases of therapeutic procedures. Fiftythree patients with an ovarian mass underwent laparoscopic cystectomy. Laparoscopic salpingectomy was done in 11 patients with ectopic pregnancy. Laparoscopy assisted vaginal hysterectomy (LAVH) was done in eight cases and laparoscopic sterilization in two cases. One patient underwent successful myomectomy. One patient undergoing laparoscopic cystectomy and one case of LAVH had conversion to laparotomy because of dense adhesion and vault bleeding respectively. No other major complication noted apart from port side bleeding, infection and vault hematoma. Conclusion: Laparoscopy is a safe and feasible alternative to open gynecological surgeries though it has a longlearning curve and a lot of expertise is necessary.
INTRODUCTION Urinary tract of female undergoes tremendous changes during pregnancy which increases their risk of acquiring infection. Asymptomatic bacteriuria is a common entity among pregnant women which refers to significant bacteriuria (>105 bacteria per ml of urine) without any typical symptoms of urinary tract infection. Asymptomatic bacteriuria can lead to various maternal and fetal complications if not detected and treated on time. MATERIAL AND METHODS Total 280 urine samples were collected in sterile universal containers from pregnant women not showing typical symptoms of urinary tract infection at the time of sample collection. Urine samples were inoculated in both MacConkey agar and Blood agar by semi quantitative culture method. Culture plates were reported after 24 hours of incubation at 370C. Bacteria isolated were subjected to antibacterial susceptibility testing by modified Kirby-Bauer disc diffusion method. RESULTS Out of 280 urine cultures, 213 samples were sterile. Significant bacteriuria was seen in 25 cases (8.9%) followed by insignificant bacteriuria (20, 7.14%) and contamination (17, 6.10%). Highest number of cultures positive were in age group 21-30 years (19, 9.1%,). Out of 25 cases of significant bacteriuria, 60% were primigravida and 40% were multigravida. The most common organism isolated was Escherichia coli (10, 60%) followed by Klebsiella pneumoniae (5, 40%). CONCLUSION Screening of all pregnant women for asymptomatic bacteriuria is essential during their antenatal checkup. Escherichia coli is the commonest organism that cause asymptomatic bacteriuria. Appropriate antibiotic therapy is absolutely necessary for positive cases on the basis of antimicrobial susceptibility result to prevent unwanted obstetric complications.
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