Deepak Shrestha

Lumbini Medical Collage & Teaching Hospial · Department of Obstetrics and Gynaecology

Introduction: Maternal obesity is an established risk factor for various adverse pregnancy outcomes. For instance, increased chances of labour induction, prolonged labour, instrumental and cesarean deliveries, medical disorders of pregnancy, post partum haemorrhage, preterm deliveries, macrosomia, and low Apgar score are well recognised risks of ma...

Introduction: Abnormal uterine bleeding accounts for more than 70% of complaints in peri- and post-menopausal women. The main purpose of investigating them is to rule out premalignant and malignant endometrial lesions. This study aimed to find out the prevalence of abnormal uterine bleeding among out-patients visiting the gynecology department of a...

Background: Patient satisfaction is an individual's positive evaluation of a distinct dimension of health care. This study aimed to assess client satisfaction with maternity care in a tertiary hospital in the western region of Nepal. Methods: This cross-sectional study was conducted among 405 delivered women. A structured questionnaire of 21 ite...

Although cases of sexual offenses are not uncommon in children, they present to the Emergency Department seeking treatment for a medical cause. Sometimes the history of abuse is missed by the treating clinicians who are only focused upon the presenting complaint and not upon the underlying cause. Furthermore, the lack of reporting of sexual abuse i...

Hair tourniquet syndrome is the strangulation of body appendages by a thread of hair. If neglected, it results in lymphatic obliteration, venous congestion, and arterial obstruction. A 25 years lady with a history of insect bite presented with intense itching and painful swelling in the left labia minora for three days. She had tied the swollen par...

Is it humane to attack healthcare workers for no fault of theirs? Is humanity really on sale? In a small country like Nepal with limited healthcare resources, the government needs to do more to protect healthcare workers from such untoward incidents being repeated. The emergence and spread of the virus has created chaos and anxiety in the general p...

Introduction: Operative delivery at full cervical dilatation can be either a caesarean section or instrumental deliveries. Instrumental deliveries are well debated options for reducing caesarean section rates but they have their own set of maternal and fetal morbidities. CS at full dilatation of cervix is also demanding due to impacted fetal head....

In Nepal, following allegations of sexual assault, the survivor is taken by the police to a Government Hospital for medical examination and sample collection. To provide an integrated service to survivors of gender-based violence, a One–Stop Crisis Management Centre (OCMC) is established in many Government Hospitals. However, paediatric survivors o...

COVID 19 and pregnancy.

Aims: To find the preference of career in Obstetrics and Gynecology among interns at the end of internship and factors influencing this choice. Methods: A semistructured questionnaire was distributed to interns at the end of a one year rotatory internship. Demographic factors and clinical exposure in Obstetrics and Gynecology (ObGyn) were assessed...

Background: Young Nepalese men have been forced to migrate to other countries in search of better opportunities. Wives of these migrant workers are in a vulnerable state and face various problems. The aim of this study wasto assess the prevalence of reproductive health problems and depression in this sub-population and to compare it with women liv...

p> Background: With the legalization of medical abortion in Nepal, mifepristone-misoprostol combination via different routes has been widely used for early abortion. This study aims to evaluate the efficacy and acceptability of 200 milligrams mifepristone orally followed by 800 micrograms sublingual misoprostol in outpatient setting. Methods: It w...

Background:With the legalization of medical abortion in Nepal, mifepristone-misoprostol combination via different routes has been widely used for early abortion. This study aims to evaluate the efficacy and acceptability of 200 milligrams mifepristone orally followed by 800 micrograms sublingual misoprostol in outpatient setting. Methods: It was an...

Introduction: The need for critical care support and admission to intensive care unit (ICU) in obstetric population is infrequent. The proportion ranges from 0.1 to 8.5%. Yet, obstetric admissions to ICU and mortality continue to have a significant impact on overall maternal health care. The study of epidemiology and predictors of obstetric admissi...

Introduction: Tubal sterilization is a highly effective method of permanent contraception. However, pregnancy can still occur following a successful procedure. Published literatures report a failure rate of 0.13-1.3% and 15-33% of such pregnancies are likely to be ectopic. Case report: A 33 years para three lady with prior history of tubal ligation...

Fetal ascites has been diagnosed more frequently these days because of routine ultrasound scanning in pregnancy. However as a cause of dystocia in labour, it is very rare. Twenty four years second gravida of 28 weeks 6 days of gestation presented to labour room with preterm obstructed labour. Abdominal examination revealed less readily palpable fet...

Introduction: Blood transfusion is an essential part of perioperative care in surgeries in obstetrics and gynecology. A tendency of over ordering of blood imposes additional workload to the blood bank and extra cost to the laboratory and patients. Maximum surgical blood ordering schedule (MSBOS) is a guide which helps in the decision of ordering an...

Introduction: When more than two fetuses simultaneously develop in the uterus, it is called higher order multiple pregnancy. The incidence of such pregnancies ranges from 0.01% to 0.07%. Case report: We report a case of 26-year-old G2P1L0D2 with previous history of preterm vaginal twin delivery, diagnosed to have quadruplet pregnancy. She was admi...