Appendicitis among Patients Admitted to the Department of Surgery of a Tertiary Care Centre: A Descriptive Cross-sectional Study.

Introduction: The prevalence of appendicitis is widespread among both adult and pediatric populations. Despite being so common, its diagnosis remains difficult. Initially, acute appendicitis is managed conservatively. To reduce morbidity and mortality, surgery must be performed promptly. The main objective of the study is to find out the prevalence of appendicitis among patients admitted to the department of surgery of a tertiary care centre. Methods: A descriptive cross-sectional study was conducted among patients admitted to the Department of Surgery of a tertiary care centre from 1 July 2021 to 1 July 2022. Ethical approval was obtained from the Institutional Review Committee (Reference number: 202/2079/80). Convenience sampling was done. The patient admitted to the Department of Surgery during the study period was included. Point estimate and 95% Confidence Interval were calculated. Results: Out of 2452 patients, the prevalence of appendicitis was 321 (13.09%) (11.75-14.43, 95% Confidence Interval). The mean age of the patients with appendicitis was 31.57±14.14 years and among them, males were 176 (54.83%). Conclusions: The prevalence of appendicitis among patients admitted to the department of surgery of a tertiary care centre was lower compared to other studies conducted in similar settings. Keywords: appendectomy; appendicitis; prevalence; surgery.

Anaemia among Pregnant Women Visiting Obstetric Department of a Tertiary Care Centre: A Descriptive Cross-sectional Study.

Introduction: Anaemia is one of the common health problems of pregnant women and children in developing countries. Anaemia in pregnancy is related to poor foetal and maternal outcomes contributing to significant morbidity and mortality. Anaemia is a treatable and preventable condition. The objective of this study was to find out the prevalence of anaemia in pregnant women visiting the Obstetric Department of a tertiary care centre. Methods: A descriptive cross-sectional study was conducted among the pregnant women visiting the Department of Obstetrics and Gynecology of a tertiary care centre for their antenatal checkup. The study was conducted from 2 November 2022 to 11 November 2022 after obtaining ethical approval from the Institutional Review Committee (Reference number: 11(6-11)E2/079/080). Pregnant women with a history of blood transfusion, anaemia of chronic disease like chronic kidney disease, history of recurrent bleeding, and referral cases from other centres were excluded from the study. Serum haemoglobin was used for diagnosing anaemia according to criteria given by the World Health Organization. Convenience sampling was used. Point estimate and 95% Confidence Interval were calculated. Results: Among 442 pregnant women, the prevalence of anaemia was 24 (5.43%) (3.32-7.54, 95% Confidence Interval). Conclusions: The prevalence of anaemia among pregnant women was lower in comparison to other studies done in similar settings. Keywords: anemia; maternal-child health services; prevalence.

Chronic Liver Disease among Patients Admitted in the Department of Internal Medicine of a Tertiary Care Centre: A Descriptive Cross-sectional Study.

Introduction: Chronic liver disease with cirrhosis is a significant cause of morbidity and mortality not only in developed but also in developing countries. Many patients already develop complications before hospital admission and require intensive medical care during hospital treatment. The main objective of the study was to find out the prevalence of the chronic liver disease among patients admitted in the Department of Internal Medicine of a tertiary care centre. Methods: A descriptive cross-sectional study was conducted among patients admitted to the Department of Internal Medicine of a tertiary care centre from 1 January 2022 to 31 March 2022. Ethical approval was obtained from the Ethical Review Board (Reference number: 2211202105). The patient admitted in the Department during the study period was included and those who do not gave consent were excluded. Convenience sampling method was used. Point estimate and 95% Confidence Interval were calculated. Results: Out of 447 patients, the prevalence of chronic liver disease was 93 (20.8%) (17.04-24.56, 95% Confidence Interval). The mean age of the patients was 49.69±10.94 years and among them, males were 64 (68.82%). Conclusions: The prevalence of the chronic liver disease among patients admitted to the Department of Internal Medicine of a tertiary care centre was lower than in other studies conducted in similar settings. Keywords: alcoholic liver diseases; liver diseases; prevalence.

Hernia among Patients Admitted to the Department of Surgery of a Tertiary Care Centre: A Descriptive Cross-sectional Study.

Introduction: Hernia is one of the most common surgery-requiring conditions. Despite this, hernia still needs to be studied in more detail. The main objective of the study was to find out the prevalence of hernia among patients admitted to the Department of Surgery of a tertiary care centre. Methods: A descriptive cross-sectional study was conducted among patients admitted to the Department of Surgery of a tertiary care centre from 1 July 2021 to 31 December 2022. Ethical approval was obtained from the Institutional Review Committee (Reference number: 202/2079/80). The patient admitted to the Department of Surgery during the study period was included and those with incomplete data were excluded. A convenience sampling method was used. Point estimate and 95% Confidence Interval were calculated. Results: Among 3236 patients, the prevalence of hernia was 749 (23.14%) (21.69-24.59, 95% Confidence Interval). The inguinal hernia was the most common type found in 574 (77.25%), followed by an umbilical hernia in 64 (8.61%). A total of 79 (10.55%) had comorbidity among patients with hernia. Conclusions: The prevalence of hernia in our study was found to be higher than in other studies done in similar setting. Easily accessible health facilities, competent primary surgical care and health education should be taken into account by the policymakers to reduce the morbidity and mortality of this condition. Keywords: hernia; inguinal hernia; prevalence; surgery; umbilical hernia.

Spontaneous Heterotopic Pregnancy: A Case Report.

Spontaneous heterotopic pregnancy is a rare clinical condition which is a potentially dangerous condition where at least two pregnancies are present simultaneously at different implantation sites and only one is located in the intrauterine cavity. It is a life-threatening condition with an incidence estimated as 1 in 30,000 natural conceptions. Being rare it's challenging to diagnose such conditions due to complex clinical and laboratory findings. In view of the survival of maternal as well as intrauterine pregnancy, a high index of suspicion leading to timely diagnosis and appropriate intervention is needed. We are reporting a case of a 28-year-old female with heterotopic pregnancy at 8 weeks of gestation following natural conception diagnosed by ultrasound and managed successfully by laparoscopic salpingectomy. Intrauterine pregnancy was continued normally till term with no complications. Hence, with timely diagnosis and early intervention, maternal and fetal survival is possible. Keywords: case reports; ectopic pregnancy; laparoscopy; ultrasound.

Postpartum Symphysis Pubis Diastasis: A Case Report.

The pubic symphysis is a midline, non-synovial joint connecting the right and left superior pubic rami. The joint allows very limited movement of approximately 0.5-1 mm. Under hormonal stimulation during pregnancy, the widening of the symphysis pubis and sacroiliac joints occurs. Pubic symphysis diastasis is defined as the widening of the pubic joint of >10 mm. It is a rare complication of vaginal childbirth for which no gold standard treatment has been defined. Most cases are treated conservatively. A case of pubic diastasis in a 24-year-old G5P2A2L1 following vaginal delivery is reported. Management consisted of simple conservative treatment, which was sufficient in achieving symptomatic relief. Keywords: case reports; pelvic pain; pubic symphysis diastasis.

Nulligravida with Large Uterine Leiomyoma: A Case Report.

Uterine leiomyoma is the most common benign tumour of the female reproductive tract originating from the uterine smooth muscle causing morbidity and impairing their quality of life. It is common among women in the age group 30 to 50 years of age. Women are usually asymptomatic or may present with various symptoms such as abnormal uterine bleeding, pelvic pain, dysmenorrhea, and change in bowel and bladder habits due to pressure symptoms. It is one of the leading causes of hysterectomy. Women with uterine leiomyoma can be managed medically and surgically. Gonadotropin-releasing hormone analogue is one of the modalities used preoperatively to reduce the size of large uterine fibroid. We present the case report of a 36-year-old nulligravida who underwent total abdominal hysterectomy with bilateral salpingectomy for large uterine leiomyoma weighing 5.61 kg without compression symptoms. She received a gonadotropin-releasing hormone agonist (injection leuprolide) preoperatively for reduction of the size of uterine myoma. Keywords: case reports; gonadotropin-releasing hormone; hysterectomy; leiomyoma.

Abruptio Placenta among Pregnant Women Admitted to the Department of Obstetrics and Gynaecology in a Tertiary Care Centre: A Descriptive Cross-sectional Study.

Introduction: Abruptio placenta is the complete or partial separation of the normally implanted placenta before delivery of the foetus. It is one of the commonest causes of antepartum haemorrhage affecting maternal and foetal outcomes. Early detection and timely intervention of abruptio placenta in daily clinical practice are important to improve maternal and perinatal outcomes. The objective of the study was to find out the prevalence of abruptio placenta among the pregnant women admitted to the Department of Obstetrics and Gynaecology in a tertiary care centre. Methods: A descriptive cross-sectional study was done among the pregnant women admitted to the Department of Obstetrics and Gynaecology in a tertiary care centre where data from medical records was taken from 1 January, 2021 to 31 December, 2021 after taking ethical approval from the Institutional Review Committee (Reference number: 1102202208). Demographic details of the patients including age and parity were recorded. Convenience sampling was done. Point estimate and 95% Confidence Interval were calculated. Results: Out of 1514 deliveries, abruptio placenta was seen in 10 (0.66%) (0.25-1.07, 95% Confidence Interval) cases. Conclusions: The prevalence of abruptio placenta among pregnancies was similar to the studies done in similar settings. Keywords: abruptio placenta; epidemiology; fetal outcome; incidence; maternal outcome.

Experience Sharing: Final Year MBBS Journey.

Studying medicine is tough. The saying: It is hard to enter medical school but easier later is a myth. All the semesters and years have their trials and tribulations but the final year is known among students to be a terror. Here we share our experience of the final year hoping it could give insight to the medical students about what to expect in the ultimate year and prepare themselves mentally as well as academically beforehand.