Background: The aim of the study was to share the experience of laparoscopic gynecologic surgery in a government hospital outside Kathmandu valley Method: A descriptive  cross-sectional study was carried out in Bharatpur Hospital from 15 Dec, 2018 to 15 June, 2019. Fifty consecutive patients who underwent laparoscopic gynecological procedures were included in the study and analyzed demographics, indication, hospital stay and complications. Results: The mean age of the patients (n = 50) was 34.6 ± 12.5 years (Range: 17 – 66 years). More than athird of the total patients (n = 18, 36.0%) were between 26 – 35 years. Majority (n = 26, 56.0 %) of the patients were multipara (≥ 2 child). Hasson type was more frequently utilized type of primary port incision in the surgeries performed (52.0%, n = 26). The median duration of surgery was 2.08 hours (Range: 0.83 – 3.25 hours). The commonest post-operative diagnosis was dermoid cyst (n = 14, 28.0%). Complications were observed in eight patients (16.0 %). The median duration of post-operative hospital stay was 3 days.  Conclusions: LGS has evolved greatly advantageous as it reduces hospital stay, surgical site infection, and better aesthetic results. It is essential to extend services outside the Kathmandu Valley

Background: Although 24-hour urine total protein (UTP) measurement is the gold standard method for detecting proteinuria in preeclamptic women, the procedure is lengthy and time consuming that might result in delay in diagnosis of the condition. This study aimed at deter­mining the correlation between these 2 parameters. Methods: This was a cross-sectional study done on 50 pregnant women with preeclamp­sia admitted at Bharatpur Hospital from September 2018 - January 2019. Patient with pre­eclampsia and having albumin ≥1 on urine dipstick, the sample was collected in every 12 hours interval on two separate well labeled container with the assistance of nursing staff. Total urine protein at 12-hour and 24-hour were measured by spectrophotometric method. The data were analyzed using SPSS version 21. Correlation between the 2 measurements was analyzed using Spearman’s rank correlation coefficient. p<0.01 was considered to be statistically significant. Results: The age of participants ranged between 20-38 years (Mean age: 26.6 years). The maximum occurrence of preeclampsia was observed in primigravid women and younger age group (between 20-25 years), 72% had mild preeclampsia and 28% developed severe preeclampsia. There was a significant correlation between 12-hour and 24-hour UTP (Spear­man’s r = 0.99, p<0.001). Conclusions: There is a strong correlation between 12- and 24-hour urine total protein mea­surements in women with preeclampsia. 12-hour UTP can be used as an alternative for the assessment of proteinuria in these women, with benefits such as early diagnosis and better patient compliance.

Abstract: Background: Cervical cancer is the fourth most common cancer in women with high mortality. Since it is a preventable cancer, screening for cervical cancer with Papanicolaou test (Pap Test) is considered as the stepping stone in its cure by detecting  at its premalignant state. The two methods of acquiring the sample for cytology are Conventional method and liquid based cytology. Methods:  The Pap test  results of the patients who visited the outpatient clinic of the Gynecologic Department of Gandaki Medical College and Teaching Hospital from January 2012 to December 2017 were reviewed and analyzed from the medical records. The findings of Pap test results were tabulated and categorized as per Bethesda system of classification (2001). Results:  A total of 2004 Pap tests were taken. All of the patients in the study were married with mean age of 39.7±10.3 years. A total of 1291(64.42%) Pap tests were normal or negative for intraepithelial lesion whereas 578(28.84%) were inflammatory smears while 37(1.85%) were inadequate for evaluation. There was a presence of low grade intraepithelial lesion in 4(0.2%)  and high grade intraepithelial lesion in 15(0.75%). Atypical squamous cell of undetermined significance (ASCUS) was noted in 11(0.55%) and frank malignancy was noted in 1(0.05%) of total Pap test samples. Conclusion: In a developing country like Nepal, Pap test is still the preferred cervical cancer screening tool. All women should undergo the screening test for cervical cancer with any feasible available test. Key words: Bethesda system; cervical cancer; HPV; Pap Test.

Background: The corona virus disease 19 pandemic has affected the whole world with pregnant ladies being more vulnerable population. This study aimed to evaluate characteristics of corona virus disease 19 infection in pregnancy and neonates and whether close proximity to the mother increases the incidence of corona virus disease infection in neonates..Methods: This is a hospital based prospective cross sectional observational study done among pregnant women presenting to Paropakar maternity and womens hospital from 1st September 2020 to 31st march 2021 with confirmed corona virus disease 19 infection. Results: The total 160 cases were included in study. Most of the women (33.8%) were of 20- 25 years of age, 55 % were multigravida and 77.6 % were full term. Around 74 % of cases were symptomatic with predominant symptoms being cough, fever and sore throat present in 33.1 %, 18% and 14% respectively. Out of 125 deliveries 71 % of cases underwent cesarean section of which fetal distress was most common indication. Six newborns were positive for corona virus disease 19 infection within 48 hours of life. Mortality was seen in four mothers and three neonates. Conclusions: The clinical presentation of corona virus disease infection in pregnant ladies is similar to general population. There is no increased risk of vertical transmission to the baby. Keywords: corona virus disease 19; pregnancy outcome; vertical transmission.

Introduction: Isolated Oligohydramnios complicates 3 to 5% of pregnancy at term both in terms of fetal outcome and mode of delivery. Aims: To study the perinatal outcome in isolated oligohydramnios (Amniotic Fluid Index≤8) and compare the outcome between Borderline (Amniotic Fluid Index=5.1-8 cm) and Severe (<5 cm) oligohydramnios. Methods: Retrospective observational study of pregnancy outcome with isolated oligohydramnios (Amniotic Fluid Index≤8 cm) at term was carried out in Gandaki Medical College Teaching Hospital, Pokhara for one year from January 2019 to December 2019. Patients were divided into Borderline Oligohydramnios (Amniotic Fluid Index=5.1 to 8 cm) and Severe Oligohydramnios (Amniotic Fluid Index ≤5 cm). The two groups were compared in terms of fetal outcome like: meconium passage, low birth weight, low APGAR (Appearance, Pulse, Grimace, Activity and Respiration) score at 1 and 5 min, Neonatal Intensive Care Unit (NICU) admission and neonatal death. Similarly mode of delivery was also compared. Results: There were total of 100 patients with isolated oligohydramnios. Of which 51(51%) were with Borderline Oligohydramnios and 49(49%) with Severe Oligohydramnios. The incidence of adverse perinatal outcome and caesarean delivery was high in patients with isolated oligohydramnios. When compared with the two groups there was significant difference in terms of meconium passage (11% vs 48.9%), low birth weight (5.8% vs 18%), low APGAR (Appearance, Pulse, Grimace, Activity and Respiration) score at 1 min (1.9% vs 14%), NICU (Neonatal Intensive Care Unit) admission (11% vs 67%) and Caesarean delivery (39% vs 79.5%). Conclusion: Isolated oligohydramnios at term has been associated with an increased risk for caesarean delivery for fetal distress and adverse perinatal outcomes. Severe oligohydramnios is a sensitive predictor for the adverse perinatal outcome both in terms of fetal outcome and termination of pregnancy.