Background: Infertility is defined as a couple’s inability to conceive after a period of twelve months of regular unprotected intercourse. Infertility globally affects approximately 10-15% of couples. This study was carried out to find out the determinants of infertility among infertile couples.Methods: This is a retrospective review of records of 3231 infertile couples in the Department of Obstetrics and Gynecology, Dhulikhel Hospital from January 1, 2008 to June 30, 2018. A total of 3231 infertile couples were evaluated by reviewing their case history including demographic parameters and investigations performed.Results: Mean age of female cases seeking infertility treatment was 26.85 (±4.78) years and that of male cases was 29.81±3.18 years. About three quarter (74.7%) of the cases was of primary type. Almost half of infertility cases (48.8%) were having only female factor. Of the female contributory factors, half of them (52.12%) had ovulatory cause. Male factors contributed 23.9% of cases and 22.7% cases had abnormality in semen analysis while 1.2% had other sexual dysfunction. Mixed type of infertility was seen in 26.6% and unexplained factors had contribution of 14.4%. Conclusions: Primary infertility cases are three times more common in Dhulikhel hospital.Ovulatory cause was the most common contributory factors among female infertile cases while abnormality in semen parameter was the commonest problem among male infertile cases. Thorough evaluation and repeated visits were required to find out the apparent determinants of infertility problem.Keywords: Female factor; hysterosalpingography; infertility; ovulatory dysfunction; semen analysis.

Uterovesical fistula is an abnormal communication between uterine cavity and the bladder. It is a rare type of fistula accounting for four percent of all cases of urogenital fistula. However the incidence of uterovesical fistula has been rising due to increasing incidence of lower segment caesarean section. Uterovesical fistula is seen more after repeated caesarean section rather than primary section. This is a case report of a primipara with uterovesical fistula following primary emergency Caesarean section on her 12th postoperative day for foetal distress. She was managed conservatively using IV antibiotics and catheterization for six weeks.DOI: http://dx.doi.org/10.3126/jkmc.v2i4.11799Journal of Kathmandu Medical CollegeVol. 2, No. 4, Issue 6, Oct.-Dec., 2013Page: 211-213

Background Pre-eclampsia is described as a pregnancy-specific syndrome that can affect virtually every organ system. The appearance of proteinuria remains an important diagnostic criterion. Proteinuria is an objective marker and reflects system-wide endothelial leak, which characterizes the pre-eclampsia syndrome. Objective To determine protein values using the spot urinary albumin/creatinine ratio amongst the pregnant women and to identify whether this test can be used as the investigation of choice for predicting pre-eclampsia in near future. Method A hospital based observational cross-sectional study conducted from February 2016 to August 2017. The study included pregnant women from 20-28 weeks of gestation. They were tested for spot urinary albumin and creatinine. They were all followed up till term, delivery and post partum. Result The mean age of the study patients was 28 years (N+335), the most common age group being 25 to 29 years (43.6%). Pregnant women with higher values of urinary albumin/creatinine ratio were found to develop hypertension compared to women with normal values of urinary albumin/creatinine ratio in the third trimester with insignificant difference (p < 0.283) statistically. Conclusion Microalbuminuria is one of the predictor of pre-eclampsia however it cannot be used as routine investigation for predicting pre-eclampsia in future; further studies in large scales are needed to prove whether urinary albumin/creatinine ratio can be utilized as predictor for pre-eclampsia or not.