Stitch in urinary bladder: A catastrophe of mesh hernioplasty.

Inguinal bladder hernia is an uncommon pathology found in less than 4% of all inguinal hernias. Pre-operative diagnosis is made in only 10% of cases and most are identified intra-operatively. The failure to diagnose bladder herniation may result in bladder injury and in rare instances are diagnosed later in post-operative period when the patient presents with peritonitis. Here we present a case of a 52-year-old male who underwent left mesh hernioplasty and presented to us after 10 days of surgery with features of peritonitis. On exploration, he was found to have a urinary bladder injury.

Immediate Fetal Outcome in Deliveries with Meconium Stained Amniotic Fluid.

BACKGROUND: Meconium-stained amniotic fluid is considered as the bad predictor of fetal outcome having significant perinatal morbidity and mortality. This study aimed to compare immediate fetal outcomes in meconium-stained amniotic fluid and clear amniotic fluid. METHODS: Hospital-based comparative observational study was conducted from a total of 204 women admitted in labour room at a tertiary level hospital. Among them, 102 were cases with meconium-stained amniotic fluid, and 102 were comparison groups with clear amniotic fluid. Fetal outcome was compared between these two groups. RESULTS: The study findings revealed that majority (74.5%) in the study group had cesarean section as compared to 14.7% in the comparative group. More than one-fourth (26.5%) of the newborns in the study group had moderate to severe birth asphyxia, needed resuscitation (25.5%) and neonatal intensive care unit admission (25.5%) as compared to 3.9% from the comparative group. Maternal age (COR=0.34, 95%CI=0.15-0.81), color of amniotic fluid (COR=0.11; 95%CI=0.04-0.33), meconium consistency (COR=0.27; 95%CI=0.17-0.43), and mode of delivery (COR=0.36; 95%CI=0.17-0.79) were associated with birth asphyxia in bivariate analysis. Maternal age (AOR=2.66; 95%CI=1.04-6.81) and color of amniotic fluid (AOR=11.50; 95%CI=2.97-44.56) were associated with birth asphyxia in the multivariate analysis. CONCLUSIONS: Meconium-stained amniotic fluid was associated with increased frequency of cesarean section and adverse fetal outcome with birth asphyxia being the major complications compared with clear amniotic fluid. Predictors of birth asphyxia were maternal age and color of amniotic fluid.

Determinants of Uptake of Cervical Cancer Screening among Women Attending Tertiary Level Hospital.

BACKGROUND: Cervical cancer, being the fourth commonest cancer in women worldwide, is also the most frequent cause of cancer deaths among women in developing and underdeveloped countries. Screening is the gold standard to control the disease yet, its uptake is still very low among Nepalese women. Thus, the objective of this study was to find out the determinants of uptake of cervical cancer screening among women. METHODS: Data were collected from a total of 220 women visiting gynecology outpatient department of Tribhuvan University Teaching Hospital, Kathmandu by using non-probability purposive sampling technique. Descriptive statistics and binary logistic regression analysis were applied. RESULTS: The study findings revealed that the prevalence of uptake of cervical cancer screening was about one third (38.6%). Educational qualification had a significant association with the uptake of cervical cancer screening (p=0.017). Women's age (COR=0.267; 95%CI=0.150-0.475), knowledge on availability of health services (COR=5.310; 95% CI=2.947-9.567), awareness on cost of screening services (COR=26.329; 95% CI=12.704-54.566), and knowledge level (COR=2.677; 95%CI= 1.385-5.173) had a significant association with the uptake of cervical cancer screening in bivariate analysis. Age (AOR=0.148; 95%CI=0.058-0.375) and awareness on cost of screening services (AOR=61.048, 95%CI=19.194-194.175) were found as major determinants of uptake of cervical cancer screening. CONCLUSIONS: The findings of this study conclude that the prevalence of uptake of cervical cancer screening was below half. Determinants of uptake of cervical cancer screening were age and awareness on the cost of screening services. So, awareness campaigns about cervical cancer screening are very necessary to increase its uptake and to reduce the morbidity and mortality associated with it.

Perception of Women regarding Respectful Maternity Care during Facility-Based Childbirth.

BACKGROUND: Respectful care during childbirth has been described as "a universal human right that encompasses the principles of ethics and respect for women's feelings, dignity, choices, and preferences." Many women experience a lack of respectful and abusive care during childbirth across the globe. OBJECTIVE: This study aimed to determine women's perception of respectful maternity care (RMC) during facility-based childbirth. METHOD: A descriptive cross-sectional study was conducted among 150 mothers admitted to the maternity ward of Nepal Medical College and Teaching Hospital using a purposive sampling technique. Data were collected through an interview technique by using a validated tool containing 15 items each measured on a scale of 5. Statistical Package for Social Science (SPSS) version 16 was used for data analysis. Frequency, percentage, mean score, standard deviation, chi-square test, and binary logistic regression were used to analyze descriptive and inferential statistics. RESULTS: In total, 84.7% of the women reported that they have experienced overall RMC services with a mean score ± SD (61.70 ± 12.12). Though the majority of the women reported that they have experienced RMC services, they also revealed that they have experienced disrespectful care in various forms such as being shouted upon (30.0%), being slapped (18.7%), delayed service provision (22.7%), and not talking positively about pain and relief during childbirth (28.0%). Likewise, length of stay, parity, and time of delivery were found as factors that influenced friendly care (COR = 0.383, 95% CI: 0.157-0.934), abuse-free care (COR = 3.663, 95% CI: 1.607-8.349), and timely care (COR = 2.050, 95% CI: 1.031-4.076) dimensions of RMC, respectively. CONCLUSION: Even though RMC emphasizes eliminating disrespectful and abusive environment from health facilities, 15.0% of participants perceived that they have not experienced overall RMC services. So, the health facility should focus on the interventions which ensure that every woman receives this basic human dignity during one of the most vulnerable times in their lives.