Introduction: Over the past decades fertility rate have surprisingly been stagnated demanding further research on the ways it reduces rate to a level appropriate for healthy population. Considering the status of male in developing countries like Nepal, it is believed that men play vital role in achieving success in this sector. Therefore this study was done to find out the knowledge and practice of contraceptives among married males of Makwanpur, Nepal.Methods: This is a cross-sectional descriptive study. Data were collected from the 387 respondents by personal interview using semi-structured questionnaire.Results: Mean age of the respondents was 34.48 years. Most of the respondents knew at least four contraceptive methods. There is a strong relationship between knowledge and the use of contraceptives with the level of education and economic status having a direct impact. The attitude of male respondents to share responsibility for promotion of contraceptive was found to be positive.Conclusions:Almost majority agree that the responsibility for contraception should shared by both partner, but use of contraceptive methods among men is still low. This study recommended in depth action research to promote male contraceptive methods and priority for service delivery program in Nepal.Keywords: Contraceptives; Family planning; Knowledge and practice of contraceptivesDOI: 10.3126/joim.v31i3.2972Journal of Institute of Medicine Vol. 31, Issue 3, 2009, December Page: 3-9

INTRODUCTION: Complete Hydatidiform mole is one of the most frequent abnormal pregnancies. This review studies the trend of complete mole in Paropakar Maternity and Women's hospital and clinical ability to detect it. METHODS: This is a retrospective study of 504 cases of complete hydatidiform mole recorded at Paropakar maternity and women's hospital, Kathmandu, during 2058-2065 B.S. Medical records were reviewed and incidence, clinical presentation and method of diagnosis were studied. RESULTS: During the study period, there were 13,9117 births and 504 complete moles, 12 partial moles, 48 persistent gestational tumours, six choriocarcinoma and four invasive moles recorded in the hospital. The incidence of complete mole was one per 276 births. It was prevalent among women younger than 29 years (80%) and among the primigravidae (36.7%). More than 90% women presented in the first half of their pregnancy and vaginal bleeding was the main complaint (68.3%). Suction evacuation, dilation and evacuation followed by sharp curettage and abdominal hysterectomy were performed in 80.6%, 17.6% and 1.2% of the women respectively. Persistent mole and choriocarcinoma developed in 9.5% and 0.4% respectively. CONCLUSIONS: Complete mole has the highest incidence. It affects mostly younger women and presents with vaginal bleeding most of the time, usually in the first half of their pregnancy. Keywords: complete hydatidiform mole, gestational trophoblastic disease, persistent gestational tumours.

Background: MTP Act no 34 of 1971 has been defined as Legal termination of pregnancy before the age of viability of fetus that is 20 weeks of gestation. There is a need to find a medical agent which can help in the process of abortion by speeding it up, with minimal side effects. The objective of this study was to compare the efficacy of I.M carboprost and intravaginal Misoprostol and to evaluate the safety profile of I.M carboprost and Intravaginal Misoprostol. To compare the cervical dilatation caused by I.M carboprost and intravaginal Misoprostol and to compare the blood loss and adverse effects of I.M carboprost and Intravaginal Misoprostol.Methods: Prospective randomized experimental study including pregnant women up to 12 weeks of gestation opting for M.T.P. Study conducted on 200 patients selected from patients admitted in MGM Medical College and M.Y. Hospital, Indore and Kalyanmal Hospital, Indore during the period July 2014 to March 2015. They were randomly divided into 2 groups. Group A who received intramuscular injection of 250 mcg of caboprost or Group B,which received 400 mcg of vaginal Misoprostol 4 hours prior to suction evacuation.Results: Intravaginal misoprostol achieves better cervical dilatation compared I.M carboprost which is statistically significant. Misoprostol is associated with higher blood loss as compared to I.M carboprost which is associated with nausea/vomiting & more likelihood of loose stools and abdominal cramps which is proved statistically.Conclusions: Intravaginal misoprostol is associated with higher blood loss as compared to I.M carboprost which is significant but intravaginal misoprostol achieves more cervical dilatation and causes less adverse events than I.M carboprost which is statistically more significant and therefore intravaginal misoprostol is the drug of choice for cervical priming prior to surgical abortion in terms of both efficacy and safety.

Tracheostomy still remains a life-saving procedure to secure a patent airway in emergency situations. Anaesthetic management of tracheostomy in paediatric patients with bilateral vocal cord immobility and acute respiratory distress in emergency has always been a great challenge to the anaesthesiologists. Administering general anaesthesia in a child for recannulation of tracheostomy in emergency is far more challenging. We report a case of a 4-year-old male child in whom tracheostomy tube was accidentally removed 2 months back and the wound got stenosed gradually leading to acute respiratory distress. Emergency dilatation and recannulation of tracheostomy wound was planned under general anaesthesia and the case was managed successfully.