Introduction: High risk pregnancy is a major cause of morbidity and mortality in a developing country. These patients are recognized in the initial prenatal office visit as they have a poor obstetrical history or a well recognized medical complication however; pregnancy becomes high risk because they develop unexpected complications in the course of otherwise normal pregnancies. The objective of this study is to identify various type of high risk pregnancy and fetal outcome. Methods: This was a descriptive study conducted in Shree Birendra military hospital over a period of 9 months. Patients were recognized as high risk during antenatal visit and during admission. They were followed till delivery. The case records of all high risk pregnancy with their fetal outcome were analyzed. Statistical analysis was done using simple percentage. Results: Total deliveries during study period was 626. High risk pregnancy identified were 99 (15.81%). Previous lower segment cesarean section was the most common identified high risk pregnancy 34 (5.43%) followed by young primigravida 3.19%, breech 2.23%. There were total 13 low birth weight baby (13.13%) and 2 stillbirth (2%) as fetal outcome. Conclusion: Identification of high risk pregnancy during antenatal period will reduce adverse perinatal outcome.

Introduction:Ovarian cancer is the second most common genital tract malignancy accounting for 25% gynaecological malignancy. This study was conducted to determine the incidence, epidemiological factors and clinical presentation of different types of ovarian tumours their correlation with histopathology. Methods: This is a descriptive study conducted in Birendra Military Hospital over a period of 2 years. The case records of all the patients with ovarian tumur was analyzed. Results: Of the total of 135 adnexal masses cases 100 (74.07%) were found to be histologically proven ovarian tumour out of which 35 were non neoplastic conditions. Benign tumours comprised of 68 (68%) and 32 (32%)were malignant and borderline.Mature cystic teratoma 28 (75%) was the commonest benign tumour, whereas serous cystadenocarcinoma 13 (64.3%) were commonest malignancy. Age varying from 2.5 yrs. To 70 yrs. Smallest tumour size was 2.5 cm. largest was 40 cm. Commonest symptom was abdominal discomfort and most common sign was abdominal lump. Malignancy usually presented with ascites especially epithelial ovarian tumours. Germ cell tumour was observed in younger age group in earlier stage. Conclusion: The commonest ovarian tumor was epithelial followed by germcell. Mature cystic teratoma was the most common benign tumour and malignant was serous cyst adenocarcinoma. Epithelial ovarian tumour prevalent in perimenopausal and postmenopausal age group whereas germ cell in earlier age.

Introduction: Cardiomyopathies are diseases of heart muscle that may originate from genetic defects, cardiac myocyte injury or infiltration of myocardial tissues. Dilated cardiomyopathy is the most common phenotype and is often a final common pathway of numerous cardiac insults. Mostly it remains unknown in the absence of echocardiography, histopathology and genetic evaluation. Though common it is underdiagnosed with not much of data available in our setup.Methods: This study was analytical cross-sectional study of hospital data on Echocardiographic findings in 65 patients of DCM visiting cardiology unit for Echocardiographic evaluation from 1st of February to 31st July 2018 for the period of six months in Shree Birendra Hospital, a tertiary care military hospital at Chhauni, Kathmandu. Pediatric age group patients and those who refused to give consent were excluded. Data obtained were entered in Microsoft Excel 2010 and analyzed by IBM SPSS 21.Results: Among 65 patients enrolled 40 (61%) were male and 25 (39%) female with male to female ratio of 1.6:1. Elderly people (61-75 years) with an average age of 65 were commonly involved and they presented mostly with congestive heart failure, 32 (49%). Echocardiographic evaluation showed 36 (55%) with mildly dilated Left Ventricle (5.6-6.0cm). Majority had reduced Left ventricular systolic function with an average Ejection fraction (EF) of 39.6%. No significant difference between male and female with the average EF% (P=0.990) and there was no significant relation between age and average EF% (P=0.091).Conclusions: Dilated Cardiomyopathy is the commonest cardiomyopathy phenotype mostly presenting with congestive heart failure. It is often underdiagnosed in our part of the world, however echocardiography will easily detect the condition. Keywords: dilated cardiomyopathy; echocardiography; ejection fraction; left ventricle.

BackgroundVitiligo is a common pigmentary disorder of the skin, affecting individuals globally. Not only is this ailment psychologically incapacitating, it also has a high incidence of autoimmunity, signifying that its manifestations may be the portrayal of dysfunction of immune system. ObjectiveThe aim of this study is to find out the situations of abnormal thyroid function test (TFT) in vitiligo patients. MethodsA prospective cross sectional study was conducted at the Dhulikhel Hospital, KUTH, Dhulikhel during November 2008 to January 2011 with the objective to assess the thyroid function tests in vitiligo patients. ResultsTotal 66 vitiligo patients with male 30 (45%) and female 36 (55%). Total 26 (39.39%) vitiligo patients have been found to have abnormal thyroid function test. Among them 10 had abnormal T3, seven had abnormal T4 and 12 had abnormal TSH level. Thyroid function test were normal in other vitiligo patients. Total seven vitiligo had high level of T3 than normal value, four male and three female. Two had higher level of T4 above 2.0 ng/dl and all were male, while five had abnormally low level of T4 with three male and two female. There were seven vitiligo patient with increased T3 level and three with decreased T3 level, among them six were males and four were females, the age group was ranged from seven to 68 years old. The T4 level were found abnormal in seven vitiligo patients among which five were males and two were females with the age group ranging from 7 to 51 years. ConclusionsThere has been significant association of thyroid disorder in the patient with vitiligo. Therefore, patient with vitiligo need to undergo thyroid function test to rule out the thyroid disorder and prevent from long-term complications.DOI: http://dx.doi.org/10.3126/kumj.v9i2.6279Kathmandu Univ Med J 2011;9(2):7-10

Introduction: Obstetric Services commenced at the teaching institute where this study was conducted from Aug 2012. Hence, a review of the data of C-section in this hospital is needed for standardisation of the obstetric services in terms of the rate of C-section, its various clinical indications and maternal and fetal outcomes.Methods: This is a retrospective study carried out over a period of 5 years from Aug 13, 2012 to Aug 11, 2017. All hospital deliveries conducted during the study period were included in this study and the patients’ details obtained from hospital records. All data obtained was recorded in master charts and analysed using SPSS version 23. The caesarean rate, its indications were calculated and categorised into groups according to Robson’s 10-group classification. Results: A total number of 4892 deliveries were conducted over this 5-year study period. C-section was performed in 1104 patients, giving a C-section rate of 22.57%. The most common indications were previous C-section (25.4%), fetal distress (14.3%) and breech presentation (10.3%). Robson’s Group 1 was the highest contributors to the overall CS rate, contributing 28% of all C-sections, followed by Group 5 (26.8%) and Group 3 (15.5%).Conclusions: Nulliparous and multiparous women in term pregnancy in labor and women with previous C-section contribute to more than 70% of overall C-sections at our centre. Hence, close monitoring of these groups of patients, increasing the use of instrumental delivery and practice of vaginal birth after C-section can significantly reduce the C-section rate in our centre.