Metabolic Syndrome among Patients with Polycystic Ovarian Syndrome Presenting to a Tertiary Care Hospital: A Descriptive Cross-Sectional Study.

INTRODUCTION: Metabolic syndrome in polycystic ovarian syndrome is associated with a long-term risk of developing type 2 diabetes mellitus and cardiovascular disease. This study aims to find the prevalence of metabolic syndrome among patients with polycystic ovarian syndrome presenting to a tertiary care hospital. METHODS: A descriptive cross-sectional study was done on women attending the obstetrics and gynecology outpatient department of a tertiary care hospital from June 2020 to May 2021. A total of 106 women diagnosed with polycystic ovarian syndrome using Rotterdam criteria 2003 were recruited for the study and cases of metabolic syndrome was defined according to the modified American Heart Association/National Heart Lung and Blood Institute. Ethical approval was taken from the Institutional Review Committee of Nepal Medical College and Teaching Hospital (Reference number: 001-077/078). Convenience sampling was done. The collected data was entered and analyzed in Statistical Package for the Social Sciences version 21. Calculation of point estimate at 95% confidence interval was done along with frequency and proportion for binary data. RESULTS: Among 106 women with polycystic ovarian syndrome, 50 (47.1%) had metabolic syndrome (37.59-56.60 at 95% Confidence Interval). The most common component of metabolic syndrome was low high-density lipoprotein cholesterol in 90 (84.9%) followed by central obesity in 60 (56.6%), hypertriglyceridemia in 47 (44.33%), high fasting sugar in 34 (32.07%), and high blood pressure in 14 (13.2%). CONCLUSIONS: The prevalence of metabolic syndrome among patients with the polycystic ovarian syndrome was similar to other studies done in similar settings.

Primary High Grade Serous Carcinoma of the Fallopian Tube: A Case Report.

A 49-year-old, perimenopausal nulliparous woman with lower abdominal pain and abnormal uterine bleeding. Clinical and radiological findings suggested a right adnexal tumor.  CA-125 level was moderately elevated. Total abdominal hysterectomy with bilateral salpingo-oophorectomy was done. Peroperative findings revealed a soft to friable growth arising from right fallopian tube with no involvement of ovaries. Histopathologic examination confirmed it to be a high grade serous carcinoma, FIGO stage IA. The histomorphology resembled high grade serous carcinoma of ovary, however ovaries on both sides appeared unremarkable. Surgery was uneventful and the patient was discharged after seven days of hospital stay. She did not receive postoperative chemotherapy or radiotherapy and is under follow-up. The case is reported for its occurrence in an uncommon anatomic site and preoperative dilemma with relevant review of literature.

Maternal and fetal outcome in elective versus emergency cesarean section.

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.

Mucocolpos due to complete transverse septum in middle third of vagina in a 17-year-old girl.

A 17-year-old girl had a large abdominopelvic mass (12 x 8cm) extending from vagina, due to the presence of a complete transverse vaginal septum in its middle third which on resection facilitated the drainage and disappearance of the mass finally diagnosed as a case of mucocolpos.