Objective To explore the risk of adverse maternal and perinatal outcomes in women with antepartum bleeding of unknown origin (ABUO).Design Cohort study based on data extracted from the Aberdeen Maternity and Neonatal Databank. Exposure was antepartum haemorrhage occurring after the first trimester not attributable to placenta praevia or placental abruption.Setting Aberdeen Maternity Hospital, Aberdeen, Scotland, UK.Population All primigravidae delivering between 1976 and 2010.Methods Data were analysed using univariate and multivariate statistical methods.Main outcome measures Pre-eclampsia, induced labour, mode of delivery, preterm delivery, postpartum haemorrhage, admission to neonatal unit, perinatal death.Results Between 1976 and 2010, there were 7517 women with ABUO and 68 423 women without ABUO in the cohort. Women with ABUO were more likely to be non-smokers, belong to a lower social class, and have a higher body mass index. ABUO was a significant risk factor for induced labour (adjusted odds ratio, aOR, 1.23; 95% CI 1.16-1.31), preterm delivery at <37 weeks of gestation (aOR 2.30; 95% CI 2.11-2.50), and postpartum haemorrhage (aOR 1.15; 95% CI 1.06-1.25). There was no significant association detected with pre-eclampsia (aOR 0.93; 95% CI 0.83-1.05). Whereas there was an increased risk of low birthweight (aOR 0.90; 95% CI 0.79-1.03) and stillbirth (aOR 0.92; 95% CI 0.66-1.30) with ABUO on univariate analysis, once adjusted for confounding factors this risk was non-significant.Conclusion Pregnancies complicated by ABUO are at a greater risk of preterm delivery and induced labour. There was no increase seen in perinatal mortality after adjusting for preterm birth.

Introduction: Cesarean section is a surgical procedure performed to deliver fetus through abdominal route. Increasing rate of cesarean section worldwide is an alarming concern for public health and obstetricians due to increase in financial burden and risk to health of the mother in comparison to vaginal delivery. The aim of the study was to find the prevalence of cesarean section and its most common indication in a tertiary care hospital. Methods: This descriptive cross-sectional study was done in a tertiary care hospital, from July 2016 to June 2018 after taking ethical clearance from institutional review board. Convenience sampling was done to reach the sample size. Data was collected and entry was done in microsoft excel, point estimate at 95% CI was calculated along with frequency and proportion for binary data and analysis was done. Results: Out of total deliveries conducted, 862 (36.8%) were CS deliveries, 1477 (63.1%) were vaginal deliveries, and 12 (0.51%) were instrumental deliveries. Prevalence of CS is 862 (36.8%) at 95% CI (34.82%-38.78%). Mean age±S.D of delivering mother was found to be 26.1±0.25 years. Primi cesarean section was more than repeat cesarean section. Most common indication of cesarean section was fetal distress 243 (28%) followed by previous cesarean section 165 (18%), non-progress of labour 106 (12%), oligohydramnios 59 (7%), malpresentation 59 (7%), cephalo pelvic disorders 52 (6.5%), and hypertensive disorder in pregnancy 33 (4%). Conclusions: Prevalence of cesarean section in a tertiary care hospital is high compared to WHO data. The most common indication of cesarean section are fetal distress and previous cesarean section.

The Kathmandu Valley offers the best archive to study the Late Pleistocene climate in Nepal. The Gokarna Formation, constituting the middle part of the sedimentary sequence of the Kathmandu Valley comprises alternating layers of carbonaceous clay, silt, massive to parallel and large scale cross stratified, fine to coarse grained sands and occasional gravel layers, deposited at fluvio-deltaic and lacustrine environment. The organic rich layers of clay, silt, silty-sand and micaceous fine sand consists of abundant plant macro-fossils (fruit, seed and leaves). Plant macrofossils assemblage from the Gokarna Formation (thickness 28.5 m, Dhapasi section) in the northern part of the valley consists of 56 taxa from 35 families. Depending upon the available plant, seven macrofossil assemblages, DS-I to DS-VII in ascending order were established. The common tree and shrubs discovered from this section were Eurya, Ficus, Carpinus, Quercus, Alnus, Rubus, Pyracantha, Zizyphus, Carpinus, Boehmeria etc. Carex, Scirpus triqueter, Scirpus, Polygonum, Euphorbia, Oxalis, Mosla, Viola etc. were the common herbaceous taxa. The constant occurrence of subtropical and warm temperate taxa including Eurya, Ficus, Pyracantha and Zizyphus indicated that subtropical and warm temperate climate continued during the deposition of those macrofossil assemblages. However change in the constituents of those taxa and occurrence of taxa indicating cooler climatic condition like conifers and Betula may indicate minor fluctuation of climate during the deposition of the Gokarna Formation.   doi: 10.3126/bdg.v12i0.2252 Bulletin of the Department of Geology, Vol. 12, 2009, pp. 75-88

Introduction: Abnormal uterine bleeding is a common gynecological presentation, accounting forat least 20% of all new outpatient visits. It has been recognized that thyroid dysfunction may haveprofound effects on the female reproductive system. Both hypothyroidism and hyperthyroidism areassociated with a variety of changes, including delayed onset of puberty, anovulatory cycles, andabnormally high fetal wastage. Hence, this study was conducted to know the thyroid status of thepatient with abnormal uterine bleeding. Methods: A descriptive cross-sectional study was conducted in all the patients with abnormaluterine bleeding in a tertiary care hospital from 2 August 2019 to 2 February 2020. Ethical clearancewas received from the institutional review committee of KIST Medical College. Convenient samplingwas done. Data was collected using a questionnaire which includes patients profile, the pattern ofabnormal uterine bleeding, and thyroid profile. Statistical analysis was done using Statistical Packagefor the Social Sciences version 23. Results: Out of 79 patients, it was found that 67 (84.8%) were euthyroid, 11 (13.9%) were hypothyroid,and 1 (1.2%) was hyperthyroidism. The most common type of abnormal uterine bleeding wasmenorrhagia 34 (43%), followed by polymenorrhoea 23 (29%), oligomenorrhoea 13 (16.5%),menometrorrhagia 6 (7.6%), metrorrhagia 2 (2.5%), and hypomenorrhea 1 (1.3%). The maximumnumber of patients was between 20-25 years with the mean age of 31 years. Among hypothyroid, 7(8.8%) had subclinical hypothyroidism and 4 (5%) had frank hypothyroidism. Conclusions: Most females with abnormal uterine bleeding were euthyroid. Menorrhagia was themost common pattern of abnormal uterine bleeding.

BACKGROUNDUterine leiomyoma is the most common benign neoplasm in women of reproductive age group. Hysterectomy is a mode of therapy in uterine Leiomyoma. The objective of this study was to evaluate the histopathological changes in hysterectomy specimens with uterine leiomyomas.