Background The patients suffering from tuberculosis are receiving shame and unfair treatment from the people living around them within their own society attending DOTS clinic of Dharan municipality. Objective To assess the stigma experienced by tuberculosis patients and to find out the association between stigma experienced by Tuberculosis patient and the selected variables (socio-demographic characteristics, clinical profile and illness experience). Methods Descriptive Cross Sectional study was done among sixty tuberculosis patients. Stratified random sampling was used to select the main center and sub center of Tuberculosis treatment and population proportionate simple random sampling using lottery method was done. Data was collected using predesigned, pretested performa from Explanatory Model Interview Catalogue developed by World Health Organization. Results The study revealed that 63.3% of the subjects were stigmatized. There was association between stigma and variables such as occupation, monthly family income and past history of Tuberculosis. There was also association of stigma with treatment phase, category of the patient and past outcome of illness. Conclusion Due to lack of knowledge and awareness about Tuberculosis, many patients were stigmatized. Efforts should be made to educate the public about Tuberculosis to reduce stigma experienced by Tuberculosis patients and improve the compliance of the patient. KATHMANDU UNIVERSITY MEDICAL JOURNAL  VOL.10 | NO. 1 | ISSUE 37 | JAN - MAR 2012 | 48-52 DOI: http://dx.doi.org/10.3126/kumj.v10i1.6914

among 48 women who were admitted with abortion complications and also gave history of self-administration of abortion pills.Results: During the study period, 48 women with history of self-medication with abortion pills were admitted with various abortion complications. There were 60% of women who had consumed abortion pills within approved nine weeks gestation while 19% had consumed after nine weeks and 21% after twelve weeks. Majority (60%) were admitted with incomplete abortion, 4% with missed abortion, 13% with continued live pregnancy, 6.5% with septic abortion and 6.5% with ectopic pregnancy. Anemia was present in 79% of patient. More than one third of the patient had severe anemia and blood transfusion was needed in 52%. Surgical evacuation was required in 71% of patient; medical abortion with repeat doses of mifepristone and misoprostol was done in was done 13% and 6.5% needed laparotomy for ectopic pregnancy. Conclusions:Though medical abortion is considered to be highly effective and safe procedure, unsupervised selfadministration of medical abortion pills was associated with serious maternal morbidities. There should be some policy to restrict over the counter sale of this medicine.

Introduction: The complications of cesarean section are seen more commonly in emergency than in elective cases. The aim of this study was to find out the incidence of cesarean section in Nepal Medical College Teaching Hospital and to compare the maternal and fetal outcome in elective and emergency cesarean section. Methods: A prospective study of all the cases undergoing cesarean section in Nepal Medical College Teaching Hospital was carried out during the period of six months from Asar 2069 to Mangsir 2069. Results: The incidence of cesarean section was 254 (22.30%) out of which emergency cesarean section accounted for 167 (65.7%) and elective cesarean section for 87 (34.3%). The usual indications of emergency cesarean section were fetal distress, previous cesarean section in labour, non progress of labour and prolonged second stage of labour. The usual indications of elective cesarean section were previous cesarean section, breech, cephalopelvic disproportion and cesarean section on demand. There was found to be no significant difference in age, period of gestation, blood loss and blood transfusion in emergency vs. elective cesarean section. There was significant difference seen in the length of hospital stay, fever, urinary tract infection, wound infection and low APGAR in five minutes indicating that these were more common in emergency cesarean section. Significant difference was also seen in the incidence of postpartum haemorrhage indicating that it was seen more in elective cesarean section. Conclusions: The incidence of cesarean section in Nepal Medical College Teaching Hospital is high and the overall complication rate is higher in emergency cesarean section than in elective cesarean section.Keywords: cesarean section; fetal and maternal outcome.

This is an analysis of the incidence of molar pregnancies and those of complete and partial molar pregnancies across the reproductive age range for BP Koirala Institute of Health Sciences (BPKIHS) in the period 2010-2011.Patients with molar pregnancies registered with BPKIHS from January 2008 to January 2010 were identified. The overall number of molar pregnancies registered was compared to the number of maternities (live births and still births) and total viable conceptions for this year. A retrospective study of 64 cases of molar pregnancies recorded at BPKIHS during the two year time was done. Medical records were reviewed. Incidence, clinical presentation and methods of diagnosis were studied.During the study period, there were 37 complete moles, 23 partial moles, 1 persistent gestational trophoblastic tumor, 1 choriocarcinoma, and 2 invasive moles. The incidence of molarpregnancy was 3.94 per 1000 deliveries. Median distribution was at 22 years of age, and majority (67%) presented during early second trimester. Twenty one (32.8%) women were of blood group A positive and ten (15.6%) presented with severe form of anemia.This study provides detailed data regarding the incidence of partial and complete molar pregnancies with increasing maternal age. It confirms the relation of molar pregnancy with age, and blood group. Complete mole had the highest incidence, affecting mostly younger age group, and usually in the first half of their pregnancy. KEY WORDS gestational trophoblastic disease, hyaditiform mole, persistant gestational tumorsThis study presents the incidence of molar pregnancy, including its signs and symptoms in Terai belt of Nepal which constitute a sub-tropical climate and rural to suburban living standard. METHODSThis was a retrospective descriptive study conducted at

BackgroundThe World Health Organization (WHO) defines obesity as a 'global epidemic. Overweight and obese children are at higher risk for developing long-term chronic diseases like hypertension. With globalization bringing more lifestyle modifications, adolescents are exposed to multiple risk factors including obesity, diet, academic stress, lack of physical work apart from hereditary risk factors. Early diagnosis of obesity and hypertension is an important strategy in its control, effective treatment and prevention of complications. The aim of the study is to assess the prevalence of and the factors associated with childhood overweight/obesity among school children Material and Methods It is a school based cross sectional study done in schools of Biratnagar. School going children aged 6 to 16 years from 10 different schools of Biratnagar were taken as study population. Five were private schools and five were government schools. All the school going children aged 6 to 16 years were included in the study. Children with any chronic illness were excluded from the study. Results A total of 1900 students were included between age group of 6 to 16 years. The prevalence of overweight, obesity and hypertension were 2.9%, 1.8% and 6.1%. Conclusion Overweight, obesity was significantly associated with hypertension. Students studying in private schools and family income > Rs.10,000 were strongly associated with overweight, obesity and hypertension. Family history of hypertension was also associated with overweight/obesity.

Aims: This study was conducted to evaluate maternal characteristics and obstetric outcomes among women with hyperemesis gravidarum during pregnancy. Methods: A prospective hospital based study was conducted at Nepal medical college and teaching hospital over the period of two years where all the women admitted with history of hyperemesis gravidarum were evaluated. Hyperemesis gravidarum was defined as intractable nausea/vomiting in pregnancy that leads to dehydration, nutritional deficiency, electrolyte and metabolic disturbances and considerable ketonuria that may require hospitalization. The age of women, parity, gestational age, method of treatment and duration of hospital stay were analysed.The fetal outcome evaluated were incidence of preterm birth, apgar score <7 at 5 mins of birth, low birth weight, perinatal deaths and congenital anomalies in baby. Results: There were 52 women admitted with hyperemesis gravidarum among all obstetric admission (N= 2080). The incidence of hyperemesis gravidarum was 2.5% of all pregnancy. The condition was seen more commonly in nulliparous (61.5%) than in multiparous women. It was less common in women of parity 3 or more. The problem was identified maximum (50%) in gestational age of 5-7 weeks though one case was seen in gestational age of 20 weeks also. The mainstay of treatment was supportive. The range of hospital stay was 1-10 days with mean hospital stay 2.26 days. The preterm delivery rate was 4.8% and none of the babies were low birth weight. All the babies had apgar score >7 at 5 mins of birth. There were no congenital anomalies and no perinatal deaths were noted. Conclusions: Women with hyperemesis gravidarum did not have adverse obstetric outcome in this study. NJOG 2011 Nov-Dec; 6 (2): 24-26 DOI: http://dx.doi.org/10.3126/njog.v6i2.6752

Introduction: Urinary tract infection is one of the commonest causes of childhood morbidity. Earlydiagnosis and appropriate choice of antimicrobials is essential. Hence, this study aims to identify theprevalence of Escherichia coli in childhood urinary tract infections. Methods: This was a hospital based descriptive cross-sectional study conducted in Nobel MedicalCollege, Biratnagar over a period of one year. A total of 163 cases aged 1-15 years were included andclinical profile, laboratory reports including bacterial isolates in urine cultures and their sensitivitypatterns were documented. Results: The prevalence of Escherichia coli is 45 (53.57%) C.I. Escherichia coli was the most commonorganism isolated in bacterial cultures followed by Klebsiella 12 (14.29%), Enterococcus 10 (11.90%).Urinary tract infection was common among females with male: female ratio of 1:2.3. Fever 152(93.2%) and abdominal pain 113 (69.3%) were the most common presenting symptoms. Escherichiacoli was found most sensitive to Nitrofurantoin 43 (95.5%) followed by Ciprofloxacin 41 (91.1%) andAmikacin 40 (88.8%). Conclusions: Urinary tract infections in childhood require prompt attention and treatment to preventsignificant morbidity and mortality. From this study it can be concluded that Escherichia coli is oneof the most common isolates in urine culture and Aminoglycosides and Fluoroquinolones can beaccepted as empirical treatment regimens for childhood Urinary tract infections.

Introduction: Hand hygiene is a very simple and cost-effective procedure to prevent cross-transmission of microorganisms. The compliance of residents and nursing staffs with hand hygiene guidelines seems to be vital in preventing disease transmission among patients. The objective of the study was to assess the knowledge of residents and nursing staffs with regard to hand hygiene. Material and Methods: This was an institution based descriptive cross-sectional study conducted among 55 respondents (29 nursing staffs and 26 resident doctors) of department of paediatrics, Nobel Medical College in Biratnagar, Nepal. Knowledge was assessed using WHO hand hygiene questionnaire for health care workers. Chi square test was used to compare the percentage of correct responses between resident doctors and nursing staffs. A p value of <0.05 was considered significant. Results: Among 26 resident doctors and 29 nursing staffs who participated in the study, 30.7% of resident doctors and 55.1% of nursing staffs had received formal training in hand hygiene in the last three years. Only 9% of participants (5 out of 55) had good knowledge regarding hand hygiene. Conclusions: The knowledge regarding hand hygiene is limited among the study population. The study recommends the need for emphasizing hand hygiene component in the preservice as well as in-service training programs of doctors and nurses.