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Objective: To evaluate the stillbirths by Root cause analysis to address the causes in-depth and ... more Objective: To evaluate the stillbirths by Root cause analysis to address the causes in-depth and understand the gaps in the accessibility to the existing health care system. Methodology: A total of hundred cases of stillbirth were studied and Root cause analysis was performed and factors contributing to stillbirths were categorized mainly into the organization, personnel, equipment, barriers at the personal/family level in accessing health care and underlying maternal and fatal causes. Results: A total of 367stillbirths delivered (out of 8157 total birth) over a period of 18 months and root cause analysis was performed successfully in a hundred cases. Common causes for stillbirth were Hypertensive disorder of pregnancy, abruption, fetal growth retardation, prematurity, and congenital malformations. Lack of recognization or seriousness at the family level (49%) ranked number one as a contributory factor, closely followed by the health care provider level like failure to follow best p...
JNMA; journal of the Nepal Medical Association, 2021
Cervical carcinoma is the most common cause of mortality due to cancer in Nepal. Carcinosarcoma i... more Cervical carcinoma is the most common cause of mortality due to cancer in Nepal. Carcinosarcoma is a very rare subtype of cervical cancer which is characterized by the presence of both epithelial and mesenchymal malignant component. It constitutes less than 1% of cervical carcinoma. Due to the low occurrence of the disease, most of the data on treatment and prognosis are based on case reports and series. Here, we report a case of 69 years, female with cervical cancer (FIGO IIA2). Histopathological and immunohistochemical analysis of cervical biopsy initially showed primary adenosarcoma of the cervix. The tumor was non-responsive to primary treatment with concurrent chemoradiation. Later she was treated with abdominal hysterectomy and bilateral salpingo-oophorectomy. The final histopathology of the resected specimen showed a sarcomatous component along with carcinomatous changes in the endocervical glands favouring the diagnosis of carcinosarcoma of the cervix.
Nepal Journal of Obstetrics and Gynaecology, 2021
Aims: To estimate 30-day surgical morbidity in patients with ovarian carcinoma and identify its a... more Aims: To estimate 30-day surgical morbidity in patients with ovarian carcinoma and identify its associated factors. Methods: This was an observational study conducted at two cancer hospitals, from October 2020 to March 2021. All women with ovarian carcinoma that underwent surgery were enrolled in the study. Incidence of surgical complications was recorded. Patients were followed up to the 30 th day post- operatively. Logistic regression analyses were used to evaluate the factors affecting surgical complications and their association was determined. Results: A total of 31 patients were analyzed in this study. The incidence rate of surgical complications was 29%. Total 11 complications occurred in nine patients (one intra-operatively and 10 post-operatively). Post-operative complications were wound infection (n=4; 12.9%), urinary tract infection (n=2; 6.4%); one each had post-op ileus, hemorrhage and deep vein thrombosis; and one mortality. Advancing age, increased Body Mass Index, pr...
Objective: To evaluate the stillbirths by Root cause analysis to address the causes in-depth and ... more Objective: To evaluate the stillbirths by Root cause analysis to address the causes in-depth and understand the gaps in the accessibility to the existing health care system. Methodology: A total of hundred cases of stillbirth were studied and Root cause analysis was performed and factors contributing to stillbirths were categorized mainly into the organization, personnel, equipment, barriers at the personal/family level in accessing health care and underlying maternal and fatal causes. Results: A total of 367stillbirths delivered (out of 8157 total birth) over a period of 18 months and root cause analysis was performed successfully in a hundred cases. Common causes for stillbirth were Hypertensive disorder of pregnancy, abruption, fetal growth retardation, prematurity, and congenital malformations. Lack of recognization or seriousness at the family level (49%) ranked number one as a contributory factor, closely followed by the health care provider level like failure to follow best p...
JNMA; journal of the Nepal Medical Association, 2021
Cervical carcinoma is the most common cause of mortality due to cancer in Nepal. Carcinosarcoma i... more Cervical carcinoma is the most common cause of mortality due to cancer in Nepal. Carcinosarcoma is a very rare subtype of cervical cancer which is characterized by the presence of both epithelial and mesenchymal malignant component. It constitutes less than 1% of cervical carcinoma. Due to the low occurrence of the disease, most of the data on treatment and prognosis are based on case reports and series. Here, we report a case of 69 years, female with cervical cancer (FIGO IIA2). Histopathological and immunohistochemical analysis of cervical biopsy initially showed primary adenosarcoma of the cervix. The tumor was non-responsive to primary treatment with concurrent chemoradiation. Later she was treated with abdominal hysterectomy and bilateral salpingo-oophorectomy. The final histopathology of the resected specimen showed a sarcomatous component along with carcinomatous changes in the endocervical glands favouring the diagnosis of carcinosarcoma of the cervix.
Nepal Journal of Obstetrics and Gynaecology, 2021
Aims: To estimate 30-day surgical morbidity in patients with ovarian carcinoma and identify its a... more Aims: To estimate 30-day surgical morbidity in patients with ovarian carcinoma and identify its associated factors. Methods: This was an observational study conducted at two cancer hospitals, from October 2020 to March 2021. All women with ovarian carcinoma that underwent surgery were enrolled in the study. Incidence of surgical complications was recorded. Patients were followed up to the 30 th day post- operatively. Logistic regression analyses were used to evaluate the factors affecting surgical complications and their association was determined. Results: A total of 31 patients were analyzed in this study. The incidence rate of surgical complications was 29%. Total 11 complications occurred in nine patients (one intra-operatively and 10 post-operatively). Post-operative complications were wound infection (n=4; 12.9%), urinary tract infection (n=2; 6.4%); one each had post-op ileus, hemorrhage and deep vein thrombosis; and one mortality. Advancing age, increased Body Mass Index, pr...