BackgroundThe incidence of molar pregnancy has demonstrated marked geographic and ethnic differences. The reported data in Nepal is inconsistent with minimal published literature. Thus, we designed a study to determine prevalence of molar pregnancies and demonstrate clinical and epidemiological characteristics of the patients attending a tertiary care center in eastern Nepal.MethodsA retrospective review of medical records was conducted to determine the prevalence of molar pregnancies at the B.P. Koirala Institute of Health Sciences (BPKIHS) from the year 2008 to 2012. Secondary data from the medical records were analyzed. Annual and 5-year prevalence of molar pregnancy per 1000 live births was calculated. Demographic characteristics, clinical presentation, management methods and complications of molar pregnancy were studied.ResultsThe 5- year prevalence of molar pregnancy at BPKIHS is 4.17 per 1000 live births with annual prevalence ranging 3.8–4.5 per 1000 live births. More than one third of the patients were in the age group of 20–35 years and majority of them were of Hindu religion. For more than one third (41.7 %) of the patients, it was their first pregnancy while about 10 % gave a positive past history of molar pregnancy. Abnormal uterine bleeding (86.3 %) was the most frequent complaint, suction evacuation was the most common method of treatment and more than half of the patients required prolonged care after initial management.ConclusionThere is a need for studies at country level which will give us a national figure on molar pregnancies. Thus, a standardized clinic-epidemiological profile of molar pregnancy in Nepal can be created.

Ovarian pregnancy is a very rare form of ectopic pregnancy. (1) It was first described in 17 th century by Dr. Saint Monnissey. Incidence has been estimated around 0.5-3% of all ectopic pregnancies. (2) Incidence has increased in recent years due to increase in diagnosis which can be attributed to availability of USG facility, more sensitive β-hCG assay, diagnostic laparoscopy and risk factors associated with overall ectopic pregnancies. Use of IUCD has been disproportionately associated with primary ovarian pregnancy with incidence range being 57-90%. (3-7) Diagnosis is done by both surgical and histopathological observations. (8) Usually, it ends in rupture in early stage. (9) Classical management is surgicalwedge resection or oophorectomy. Medical management has been reported to be successful in few cases.

Aim:Dynamics of faecal egg count (FEC) in Haemonchus spp. infected goats of two Indian goat breeds, Jamunapari and Sirohi, in natural conditions was studied and effects of genetic and non-genetic factors were determined.Materials and Methods:A total of 1399 faecal samples of goats of Jamunapari and Sirohi breeds, maintained at CIRG, Makhdoom, Mathura, India and naturally infected with Haemonchus spp., were processed and FEC was performed. Raw data generated on FEC were transformed by loge (FEC+100) and transformed data (least squares mean of FEC [LFEC]) were analyzed using a mixed model least squares analysis for fitting constant. Fixed effects such as breed, physiological status, season and year of sampling and breed × physiological states interaction were used.Result:The incidence of Haemomchus spp. infection in Jamunapari and Sirohi does was 63.01 and 47.06%, respectively. The mean LFEC of both Jamunapari and Sirohi (does) at different physiological stages, namely dry, early pregnant, late pregnant early lactating and late lactating stages were compared. Breed, season and year of sampling had a significant effect on FEC in Haemomchus spp. infection. Effect of breed × physiological interaction was also significant. The late pregnant does of both breeds had higher FEC when compared to does in other stages.Conclusion:Breed difference in FEC was more pronounced at the time of post kidding (early lactation) when sharp change in FEC was observed.

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Obstucted hemivagina with ipsilateral renal anomaly (OHVIRA) syndrome or Herlyn-Werner-Wunderlich syndrome (HWW) is a rare congenital anomaly consist of uterus didelphys, obstructed hemivagina, and ipsilateral renal agenesis. We are reporting an adolescent girl with orofacial defect who presented with lower abdominal pain. She attained menarche 3 months earlier and had a regular menstrual cycle with cyclical abdominal pain. On abdominal examination a firm, mobile tender mass extending from left iliac fossa up to umbilicus (24 weeks size) was found.  Lower border of mass could not be approached. Further evaluation with ultrasound showed enlarged uterus with collection with internal echoes and non-visualization of the left kidney. CECT showed absent left kidney and didelphys uterus with large left hematocolpometra with left complex adenexal cyst. Patient was posted for hematocolpos drainage and vaginoplasty. An unusual presentation of regular menstruation and nonspecific abdominal pain delays the diagnosis, which can lead to severe complications such as endometriosis and infertility.