Background: Placenta previa is an obstetric life-threatening condition with several maternal and fetal complications. The objective of this study is to compare the maternal and fetal outcome of placenta previa in scarred and unscarred uterus.Methods: A retrospective case control study was carried out on 85 cases of placenta previa in the department of obstetrics and gynecology, Paropakar Maternity and Womens Hospital (PMWH) Kathmandu from April 2019 to May 2020 of which 46 had scarred uterus and 39 cases had unscarred uterus.Results: Sixty-one of patients were less than 30 years of age, 62% presented with gestational age 28 to 37 weeks and 67% had parity between 1 to 5. Frequency of placenta previa in scarred uterus was 54% and that in unscarred uterus was 46%. Eighty percent cases with scarred uterus had anterior placenta compared to 33% of cases of unscarred uterus with p value of 0.009. 42% had grade 4 placenta previa on ultrasonography. 45 percent of patient with scarred uterus had PPH compared to 23% in unscarred group with p value of 0.03. Malpresentation was found in 7 cases in scarred group and in one case in unscarred. Cesarean hysterectomy was performed in 6 cases in scarred category compared to 2 in unscarred. Low birth weight was present in 28 cases in scarred category compared to 15 cases in unscarred category with p value 0.03.Conclusions: This study concluded that fetal and maternal outcome is adverse for cases of placenta previa with scarred uterus compared to unscarred uterus.
Introduction: Knowledge, attitude, and practice (KAP) survey provides a suitable format to evaluate existing programs and to identify effective strategies for behavior change in society. This study aimed to investigate and compare KAP concerning COVID-19 among Health Care Professionals (HCPs) at Paropakar Maternity and Women’s Hospital (PMWH). Method: This was a cross sectional descriptive study conducted in HCPs (doctors and nurses) of PMWH, Nepal, from May to June 2020. A pre-validated questionnaire was used to access the objectives where knowledge and attitude score was 10 each and practice score was 20. Collected data was entered in Microsoft excel spreadsheet and analyzed using IBM SPSS software and p-value < 0.05 was taken as statistically significant. Result: A total of 168 doctors and nurses responded to the survey, of which 112 (66.6%) were in 25-34 years of age group, 87.5% females, and 61.9% nurses. Mean score for knowledge, attitude and practice score was 5.8 (out of 10), 8.1 (out of 10) and 17.4 (out of 20) respectively. The score was significantly different among doctors and nurses in ‘knowledge’ (p=0.000) and ‘attitude’ categories (p = 0.006). There was no significant difference in ‘practice’ scores (p = 0.664). Conclusion: Doctors and nurses of PMWH have positive attitude and good practice towards COVID-19. This characteristic can prove handy in bringing about useful behavioural changes and promoting safe practices while managing maternity patients in this hospital.
Background: Subacute Thyroiditis is a self-limiting thyroidal illness caused by viral infection with clinical course divided into three phases: hyperthyroidism, hypothyroidism followed by euthyroidism. Several viral infections have been linked to be associated with subacute thyroiditis but often no etiology can be found. Objective: The aim of this study is to explore a possible link between subacute thyroiditis and Coronavirus disease (COVID-19) infection. Method: Here we describe a case of subacute thyroiditis which occurred during the recovery phase of initial flu like illness. The initial illness was mild and was treated symptomatically. Later, the patient presented with features of hyperthyroidism and neck pain during recovery of initial flu like illness. Result: Two weeks after the onset of initial illness, the patient presented with neck pain, palpitation, sweating, and weight loss along with mid-line tenderness in neck. Thyroid function test revealed suppressed TSH and elevated free T4 along with reduced uptake on radionuclide thyroid scan. He was treated with NSAIDs and B-blocker which resulted in dramatic improvement in neck pain. Conclusion: Since Subacute thyroiditis is a self limiting disorder, it is often under reported. But It is important to recognize the disorder as it can directly impact on the morbidity and mortality related to other associated primary disorder like respiratory illness. Clinician must be aware about the possibility of thyroiditis in patient developing fever and neck pain and look for it.
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