Aims: This study was done to find out morbidity related with puerperal pyrexia/sepsis and its risk factors.Methods: This was retrospective study conducted from January 2011 to December 2012 at Department of Obstetrics and Gynaecology, Patan Hospital, Kathmandu, Nepal. All women who delivered in this hospital within 42 days of delivery with puerperal pyrexia/sepsis diagnosed on clinical examination and relevant investigations were included in the study. Women with malaria, typhoid fever and ??other fever were excluded. The data was recorded in predesigned proforma and analyzed.Results: During this period, there were 122 cases of puerperal pyrexia. Puerperal pyrexia accounted for 6.28% of 1945 admissions. Most of the women were aged between 20-29 years, primiparous and booked cases with absent membranes. The causes of puerperal pyrexia in our study were urinary tract infection (47.5%), wound infection (20.5%), endometritis (19.7%) retained product of conception (8.2%), pyoperitoneum (2.5%) and septicemia (1.6%). Conclusions:Puerperal pyrexia/sepsis is one of the causes of preventable maternal morbidity and mortality though in our study it was not proved to be very high in number. Optimal aseptic measures during labour can prevent most of the cases.

Introduction Oligohydramnios has increased incidence of fetal distress, meconium-stained liquor, prolonged labor, low Apgar score, low birth weight, admission to NICU, cord compression, birth asphyxia, and operative interference. The objective of the study was to determine the pregnancy outcome in amniotic fluid index 5 cm or less in term pregnancy. Materials and Methods This was a hospital-based cross-sectional study conducted at National Medical College & Teaching Hospital from June 2017 to May 2018. A total of 72 obstetric cases with AFI ≤ 5 cm and 72 cases with AFI > 5 cm with meeting the inclusion criteria were enrolled in the study after taking consent. Results Incidence of oligohydramnios was 2.2% out of 4318 deliveries and term oligohydramnios was 1.66%. AFI ≤ 5 cm was associated with increased induction of labor (p < 0.001), caesarean section (p = 0.01)), meconium stained liquor (p = 0.106), Apgar score <7 at 5 minutes (p = 0.001), NICU admission (p = 0.003), neonatal deaths (p = 0.053) were comparable with AFI >5 cm. Conclusion Amniotic fluid index ≤ 5 cm at term is an indicator of poor perinatal outcome.  Women with AFI ≤ 5 cm can expect a good outcome if they have regular ANC visits and intrapartum monitoring than the AFI > 5 cm.

Introduction: Caesarean section is one of the most common obstetric operations performed. Primary caesarean section in multiparous women means the first caesarean section done in the multiparity who had previously delivered vaginally. This study aimed to find out the prevalence of primary caesarean section among multiparous pregnant women visiting a tertiary care centre. Methods: A descriptive cross-sectional study was conducted among multiparous women in a tertiary care centre from 15 June 2020 to 14 June 2021. Ethical approval was obtained from the Institutional Review Committee (Registration number: F-NMC/420/075/076). Demographic data were collected using predesigned proforma in parous women who had a previous vaginal delivery. A convenience sampling method was used. Point estimate and 95% Confidence Interval were calculated. Results: Among 1158 multiparity, primary caesarean section was found in 155 (13.39%) (11.43-15.35, 95% Confidence Interval). Most women 62 (40%) belong to 21-25 years and the majority were second gravida 51 (32.90%). The emergency caesarean section was done in 149 (96.12%). Indications for primary caesarean section were fetal distress 63 (40.63%), non-progress of labour and breech 12 (7.74%). Post-operative complications were uneventful in 110 (70.96%) cases. Conclusions: The prevalence of primary caesarean section in multiparous women was found to be higher than the other studies done in similar settings.

This chapter aims to analyze the practice of green supply chain management and organization performance in manufacturing industries of Kathmandu valley. This study uses descriptive research design. Two hundred and seven manufacturing industries in three industrial estates (Balaju, Bhaktapur, and Patan) of Kathmandu valley were taken as a sample for the study whereas all 245 operating industries were the population of the study. The findings revealed that 33.3% of industries are highly practicing green supply management chain whereas 23.7% and 19.6% are practicing it moderately and less, respectively. It was found that industries of all scale—large, medium, and low—are equally practicing green supply management chain to a greater extent. Thus, the study concludes that manufacturing industries ought to consider the systemic interaction between the internal and external facets of the application of the GSCM and to ensure that their respective operations are integrated in order to achieve improved environmental and organizational efficiency and consequently to achieve economic benefits.

: When incisions for mesh placement are kept separate from the vaginal cuff, transvaginal mesh reconstruction can be safely performed at the time of hysterectomy.

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Nepal is one of the most seismically active countries with several seismic sources that are capable of generating moderate to high magnitude earthquakes. In this study, earthquake catalogue was developed by considering six major source zones. The completeness time period was determined by performing sensitivity analysis for various magnitude bin widths and time intervals. The seismicity parameters were computed by the least square method (LSM) and maximum likelihood method (MLM). LSM was based on Gutenberg Richter’s scale relationship, whereas for the maximum likelihood method, it was performed by a new method called cumulative slope point change method (CSPCM). The CSPCM was introduced to account the drawbacks of maximum curvature method (MCM), especially for bulk number of data. Furthermore, paper compares the LSM and the MLM for the calculation of seismicity parameters. The comparison shows that the proposed CSPCM based on MLM is reliable in terms of theoretical and analytical way as compared to LSM and MCM.

Introduction: Eclampsia is a life threatening emergency condition that remains a leading cause of maternal and perinatal mortality. It is one of the causes of preventable maternal mortality. There are specific risks for the mother as this condition lead to seizure and may cause woman to lose consciousness and if the fetus is not delivered, this condition can cause the death of the mother and or the fetus. This study was conducted to evaluate the fetomaternal outcome in eclampsia. Materials and Methods: This is a descriptive cross sectional study done at National Medical College Teaching Hospital from 1st February 2021 to 31st January 2022. Ethical approval was obtained from IRC (regd no. F-NMC/518/076-77). During the study period 1496 women delivered. Out of this, 44 patients with generalized tonic-clonic convulsions during pregnancy / labour / within 7 days of delivery were included in the study criteria. The data analyzed included various maternal parameters, fetal parameters and pregnancy outcomes. Result: Among 1496, 44 patients (2.94%) developed eclampsia, 38.63% in age group of < 20 years, 59.09% were primigravida, 84.09% unbooked, 63.63% presented with antepartum eclampsia, delivered by caesarean 63.63%. There was 2.26% maternal mortality due to cerebrovascular accident. Perinatal mortality was 11.36% which included stillbirth 6.81%nand neonatal death 4.54%. Conclusion: Regular antenatal checkup, early detection of disease, timely referral, and early initiation and treatment in patients with eclampsia improve outcomes. Treatment of these patients should be carried out in tertiary care centers where intensive care units, NICU facilities, and multidisciplinary units are available.