Vesicovaginal fistula at tertiary care center in eastern Nepal.

Vesicovaginal fistula is physically, socially and psychologically devastating to the women who suffer from it. The aim of this study is to create some awareness about VVF, to describe the profile of the patients, etiology, and success rate of surgery in our institute. A retrospective analysis of a total of 23 cases of vesicovaginal fistula admitted to the Department of Gynecology and Obstetrics, BPKIHS over a period of three years were included in the study. The cause of VVF in all was obstructed labor except in one, which followed abdominal hysterectomy. Twenty-three subjects underwent VVF repair, of which 14 (56.5%) had successful outcome.

Spontaneous bacterial peritonitis (SBP) in cirrhotic ascites: a prospective study in a tertiary care hospital, Nepal.

BACKGROUND: Spontaneous bacterial peritonitis (SBP) is one of the potentially lethal complications of cirrhosis and is defined as infected ascites in the absence of any recognizable secondary cause of infection. Objective was to study the occurrence of SBP, clinical and laboratory characteristics and the response to antibiotics. METHODS: We had prospectively evaluated 81 cirrhotic patients with ascites during one-year period. All SBP patients were treated with cefotaxime, 2gm IV, every 12h for 5days. RESULTS: Of these 81 patients, 24.67% of patients (n=20) had SBP and its variants (classical SBP n= 4, CNNA n=13 and bacterascites n=3). There were thirteen males and 7 females in the study.85% of the cases had Child;s class C cirrhosis. UGI bleeding and abdominal pain were the most common presenting symptoms of SBP. Culture positives were 35% (n=7). The most frequent organisms were Escherichia coli (n=3) and Streptococcus pneumoniae (n=2). 94% of the patients responded to therapy after 48 hours of treatment. Total resolution after 5 days of therapy was 73% and in-hospital mortality was 15% (n=3). CONCLUSION: SBP, if diagnosed early can be treated with very good success rate up to 73%. Appropriate treatment of SBP with cefotaxime can help in reducing mortality and morbidity in patients with chronic liver disease.