Background Acute appendicitis is the commonest nonobstetric surgical emergency during pregnancy. The aim of the study was to compare perioperative outcomes of acute appendicitis in pregnant and nonpregnant patients. Methods A retrospective review of medical records of 56 pregnant patients between 2011 and 2016 who were compared with 164 nonpregnant women of reproductive age who underwent open appendectomy between 2014 and 2016 for acute appendicitis. The patient's demographics and perioperative data were analyzed. Results The median age of pregnant and nonpregnant patients observed was 26 years (range 19–37) and 26 years (range 18–43). There were no significant differences between the groups in negative appendectomy (21.4 and 21.3%, P = 0.52), perforated appendicitis (25 and 23.8%, P = 0.85), postoperative complications (28.6 and 26.8%, P = 0.80), and median length of hospital stay (5 and 4.5 days, P = 0.36). There were 3.6% preterm labour, no maternal mortality, and no fetal loss. In multivariate analysis, WBC >18000/mm3 and long patient time to surgery were independent risk factors for appendicular perforation and postoperative complication (P < 0.05). Conclusion Our results of appendectomy in pregnant patients are comparable with nonpregnant patients. Hence the same perioperative treatment protocol can be followed in pregnant and nonpregnant patients even in resource-poor setting.

Aims: This study was done to evaluate the effectiveness of subcutaneous injection of sterile water compared with placebo in reduction of labor pain. Methods: Two hundred and forty pregnant women at term planned for normal vaginal delivery during the first stage of labor were randomized to receive either subcutaneous injection of sterile water (study group, n=120) or normal saline as placebo (control group, n=120) at painful point in lumbosacral region. Pain score was measured before and 10, 45 and 90 minutes after the injections. Main outcome measured was reduction of low back labor pain using visual analogue scale. Results: The mean pain score was equal in both groups prior to the injection. The pain scores were significantly lower among the intervention group compared to the control group at 10, 45, 90 minutes after injection. There was no difference between the two groups with regard to rate of instrumental delivery, cesarean rate and neonatal outcome.Conclusions: The subcutaneous injection of sterile water administered at painful point in lumbosacral area was effective in reducing low back labor pain during labor. DOI: http://dx.doi.org/10.3126/njog.v8i2.9777

INTRODUCTION: Hysterectomy is the most commonly performed gynaecological surgery throughout the world. It may be life saving procedure in acute uterine hemorrhage; whereas improves the quality of life in a patient with certain uterine pathology such as fibroids, endometriosis and uterine prolapse. The objective of this study is to review the indications and complications of abdominal hysterectomy as well as to assess the correlation of preoperative clinical and ultrasonographic diagnosis with histopathology of hysterectomy specimens. MATERIAL AND METHODS: A retrospective review of medical records of patients who underwent abdominal hysterectomy between January 2010 and July 2012 in the College of Medical Sciences Teaching Hospital, Nepal was done. Various demographic and pertinent clinical informations were retrieved. Clinical presentations, indications and complications of the hysterectomy as well as the correlation between the clinical diagnosis, ultrasound findings and histopathological diagnosis of the hysterectomy specimen was studied. RESULTS: Between January 2010 and July 2012 a total of 139 patients had undergone abdominal hysterectomy for various indications. The mean age at the time of hysterectomy was 45.5 years. Abnormal vaginal bleeding and lower abdominal pain were the main presenting complaints. The median duration of symptoms was 12 months. Fourty three (40%) had hysterectomy alone and 96 (60%) had hysterectomy with salpingo oophorectomy. The most common clinical indication for hysterectomy was fibroid uterus (40.3%) followed by benign ovarian tumor (18.7%) and dysfunctional uterine bleeding (17.3%). There were no major postoperative complications. The correlation between clinical diagnosis and histopathology was significant at 0.01 level using Pearson correlations. CONCLUSION: Uterine fibroids and benign ovarian tumors are the common indications for abdominal hysterectomy. Postoperative complications are minimal and most of the time the clinical diagnosis correlates with the postoperative histopathological diagnosis.Journal of Universal College of Medical Sciences (2015) Vol.03 No.02 Issue 10Pages 16-19

Background The burden of non-communicable diseases like diabetes and hypertension is increasing worldwide including low-and middle-income countries. Good knowledge of such diseases among young people will make them adopt a healthy lifestyle from an early age, which will, in turn, prevent them from developing such non-communicable diseases. This study aimed to assess the knowledge, attitude, and practice of rural and urban school students regarding diabetes and hypertension. We also aimed to see the differences in the knowledge, attitude, and practice of students from rural vs. urban communities. Methods A school-based cross-sectional study was conducted from May 1 2021 to June 30, 2021, in four schools in Nepal (1 from a metropolitan city, 2 from an urban municipality, and 1 from a rural municipality). The study was conducted among the secondary-level students of classes 9 and 10 in each school. The data were collected from the participants via pre-tested questionnaires and analyzed in the Statistical Packages for Social Sciences (SPSS) version 20.0. Logistic regression analysis was carried out to determine the determinants of knowledge and attitude regarding diabetes and hypertension. Results Of 380 respondents, 35.5% were residents of metropolitan city, 37.4% were from the urban municipality and 27.1% were from the rural municipality. The mean age of respondents was 15.61±0.99 years and 51.1% were male. Respondents having a family history of diabetes and hypertension were 21.1% and 37.9% respectively. Respondents from the metropolitan city had significantly higher mean knowledge scores than the respondents from the urban and rural municipality (p<0.001) while there was no significant difference in mean attitude scores. There was significantly higher daily consumption of fruits and vegetables among the participants from rural municipality (p<0.01) while no significant difference was seen in salt consumption and time spent on physical activity. In univariate regression analysis, place of residence, family occupation, parental education, and family history of diabetes and hypertension were significantly associated with good knowledge level. In multivariate analysis, only a higher grade of study (grade 10 in comparison to grade 9) was an independent predictor of a student’s good attitude level. Conclusion In general, there was a good attitude towards diabetes and hypertension despite poor knowledge. The mean knowledge scores were lower in urban municipality and rural municipality compared to metropolitan city. Low knowledge scores on diabetes and hypertension among the students show an urgent need for school-based interventional programs focusing on non-communicable diseases and lifestyle modification with more emphasis on rural communities.

Background Urethral catheterization is done as a routine procedure in cesarean section. It is associated with high incidence of urinary tract infections, discomfort, delayed ambulation and longer hospital stay. Objective To determine the feasibility and safety of cesarean section without urethral catheterization. Methods A prospective, randomized controlled trial was carried out from April 2008 to March 2009, in the Department of Obstetrics and Gynecology, B. P. Koirala Institute of Health Sciences. Among 150 patients who had undergone cesarean section 75 were catheterized and 75 were uncatheterized. Results First void discomfort was significantly associated with the use of indwelling catheter (OR 6.95, CI 95 %, 3.74 to 12.95; P< 0.001).Significant number of patients with indwelling catheter had signs and symptoms of urinary tract infection (OR 6,CI 95%, 2.59 to 13. 86; P < 0.001). Positive urinalysis for urinary tract infection was high in catheterized group (P <0.001). Hospital stay was shorter in patients without catheter (p < 0.05). None of the patients had bladder injury. There were no significant differences in duration of surgery and ambulation time between two groups of patients. Conclusions Cesarean section can be done safely without urethral catheterization with reduced morbidities. Kathmandu University Medical Journal | Vol.10 | No. 2 | Issue 38 | Apr – June 2012 | Page 18-22 DOI: http://dx.doi.org/10.3126/kumj.v10i2.7337