Post-Graduate Medical Journal of NAMS

Adenomyosis among Women undergoing Hysterectomy in the Department of Obstetrics and Gynaecology in a Tertiary Care Centre: A Descriptive Cross-sectional Study

Sunita Pun — 2025-07-15

Introduction: Adenomyosis is a gynecological condition that causes endometrial tissue to grow within the uterine myometrium, usually occurs in women in their late reproductive years, often presenting with menorrhagia and dysmenorrhea. There are few studies examining adenomyosis in tertiary care centre in our country. The aim of this study was to find out the prevalence of adenomyosis among women undergoing hysterectomy presenting to the Department of Obstetrics and Gynecology of a tertiary care centre.

Methods: A descriptive cross-sectional study was conducted in the Department of Obstetrics and Gynecology of a tertiary care centre, from 13 April 2016 to 14 July 2017, after obtaining ethical approval from the Institutional Review Committee (Reference number: 338/6-11-E-072-73). Women who underwent hysterectomy in the department were included in the study, while those who refused to provide consent were excluded. Convenience sampling method was used. Point estimate and 95% Confidence Interval were calculated.

Results: Among 255 women undergoing hysterectomy 85 (33.33%) (27.55-39.12, 95% Confidence Interval) were histologically confirmed to have adenomyosis. The highest prevalence was observed in women aged 41-50 years 59 (69.41%), while the lowest was found in those over 60 years, 2 (2.36%). Adenomyosis was most common among women with a parity of 3 (36.47%).

Conclusions: The prevalence of adenomyosis was found to be similar to other studies done in similar settings.

Postpartum Depression among Mothers Attending the Postnatal Ward in a Tertiary Care Centre: A Descriptive Cross-sectional Study

Smriti Poudel — 2025-07-15

Introduction: Postpartum depression remains a common and often overlooked issue, especially in low resource settings like Nepal, and should be detected to address it early to prevent deterioration of maternal mental health further. The aim of this study was to find out the prevalence of postpartum depression among mothers attending the postnatal ward in a tertiary care centre.

Methods: A descriptive cross-sectional study was conducted in the postnatal ward of a tertiary care centre from 1 March to 30 April 2020 after obtaining ethical approval from the Institutional Review Committee (CMC-IRC/078/079-036). Postnatal mothers who could read and write, were included in this study. Women who were admitted to the hospital after home delivery, had intrauterine fetal death, were severely ill, and were not willing to participate in the study were excluded. A convenience sampling method was used. The Edinburgh Postnatal Depression Scale was used to collect the data. Point estimate and 95% Confidence Interval were calculated.

Results: Among 274 postnatal mothers, the prevalence of depression was found to be 71 (25.91%) (20.72- 31.10, 95% Confidence Interval).

Conclusions: The prevalence of postpartum depression among postnatal mothers in this study was similar to similar studies done in similar settings.

Induction of Labour among Patients Admitted for Delivery in the Department of Obstetrics and Gynaecology of a Tertiary Care Centre: A Descriptive Cross-sectional Study

Dipty Shrestha — 2025-07-15

Introduction: Induction of labour is the initiation of uterine contraction in pregnant women at term with the aim of achieving a normal vaginal delivery when the benefits of doing so outweigh the risks of waiting for spontaneous labour. Induction of labour is mostly offered at 39-40 weeks after ruling out the contradictions. The most common indication for induction of labour is prolonged or “post-term” pregnancy. The aim of this study was to find out the prevalence of induction of labour among patients admitted for delivery in the Department of Obstetrics and Gynaecology of a tertiary care centre.

Methods: A descriptive cross-sectional study was conducted in the Department of Obstetrics and Gynaecology of a tertiary care centre from 1 January 2025 to 1 May 2025 after obtaining the ethical approval from the Institutional Review Committee. All the pregnant women at term admitted for delivery were enrolled. Demographic and clinical data was collected in the obstetrics ward using a standardized questionnaire. Convenience sampling method was used. Data was entered and analyzed using IBM SPSS statistics version 25. Point estimate and 95% Confidence Interval were calculated.

Results: Among 319 patients admitted for delivery, induction of labour was done in 97 (30.41%) (25.36-35.46, 95% Confidence Interval).

Conclusion: The prevalence of induction of labour was found to be similar to other studies done in similar settings.

Multisystem Inflammatory Syndrome in Children with COVID-19 in a Tertiary Care Centre: A Descriptive Cross-sectional Study

Sanjeet Kumar Shrestha — 2025-07-15

Introduction: Multisystem inflammatory syndrome in children is a rare and serious complication o COVID-19. Multisystem inflammatory syndrome in children presents with systemic inflammation, end-organ dysfunction, shock, and elevated inflammatory markers and abnormal complete blood counts requiring intensive care. Clinical features and outcomes are less well-known in children. The aim of the study was to find out the prevalence of Multisystem inflammatory syndrome in children with COVID-19.

Methods: A descriptive cross-sectional study was conducted among children diagnosed with COVID-19 in Kanti Children’s Hospital over one year from 01 January 2021 to 31 December 2021. Children aged 1 month to 14 years with COVID-19 were included in the study, and those who failed to give consent were excluded from the study. A convenience sampling method was used. An analysis was conducted on the demographics, clinical characteristics, laboratory results, treatment, and outcome of every kid diagnosed with multisystem inflammatory syndrome among children linked to COVID-19. Point estimate and 95% Confidence Interval were calculated.

Results: Among 315 COVID-19 patients, multisystem inflammatory syndrome in children was found in 57 (18.09%) (13.84-22.35, 95% Confidence Interval). Thirty seven (64.91%) of the patients with multisystem inflammatory syndrome in Children had gastrointestinal symptoms. Shock at initial presentation was also present in 25 (43.86%) patients. Most 37 (64.91%) of them were treated with intravenous immunoglobulin and steroids, and 20 (35.08%) patients died.

Conclusions: Multisystem inflammatory syndrome in children is one of the most common complications of COVID-19 in children. Most of the patients of multisystem inflammatory syndrome in children present with gastrointestinal manifestations. Other features at presentation were hyperinflammation, hypoalbuminemia, and shock. The majority of patients required pediatric intensive care unit admission and oxygen supplementation.

Lateral Epicondylitis among Police Personnel: A Descriptive Cross-sectional Study

Pawan Kumar Raya — 2025-07-15

Introduction: Lateral epicondylitis is common in occupational groups who are involved in repetitive action of the forearm. Police personnel are involved in weapon handling, handcuff and baton use. The burden of this disease among police personnel has not been studied in our country. This study aimed to determine the prevalence of lateral epicondylitis among police personnel along with association of lateral epicondylitis with weapon handling and diabetes mellitus.

Methods: This cross-sectional descriptive study was conducted between 1 January 2025 to 31 March 2025 within the orthopedic and pain Outpatient Departments of a tertiary care centre. Ethical approval for the study was obtained from the Institutional Review Committee (Reference number: 28). The sample size for the study consisted of 198 individuals, and participants were chosen using convenience sampling. Data were analyzed using descriptive statistical methods SPSS version 21. Point estimate and 95% Confidence Interval were calculated.

Results: Among 198 individuals, the prevalence of lateral epicondylitis among police personnel was found to be 51 (25.76%) (19.67-31.85, 95% Confidence Interval). The mean age of the participants was 36.065±7.99. The mean body mass index among the individuals was 24.63±0.849 kg/m2 . Majority of the participants were males, 110 (55.56%).

Conclusions: The prevalence of lateral epicondylitis among police personnel was found to be higher than other studies.

Histopathological Study of the Tissue following Early Pregnancy Failure at a Tertiary Care Center

Swati Gupta — 2025-07-15

Introduction: Early pregnancy failure accounts for approximately 10% of all recognized pregnancies. Histopathological evaluation of tissue following early pregnancy failure is critical to rule out gestational trophoblastic disease, which requires special attention. Despite its importance, the utility of routine histopathological examination remains debatable. The aim of this study was to assess the outcome of histopathological analysis of tissue following early pregnancy failure and its diagnostic value.

Methods: A descriptive cross-sectional study was conducted at a tertiary care centre from 1 April 2024 to 1 September 2024. The study included 62 women diagnosed with early pregnancy failure before 13 completed weeks of gestation, confirmed either clinically or by ultrasonography. Surgical evacuation was performed, and obtained tissue was sent for histopathological examination. Data were analyzed using IBM SPSS version 25. Binary data were expressed as n (%) and continuous data in the form of Mean±SD.

Results: The mean age of participants was 29.87±6.49 years, with most 30 (48.38%) aged 21-30 years. Early pregnancy failure was most common between 6–9 weeks of gestation 29 (46.77%). Incomplete abortion was the most prevalent ultrasonographic diagnosis 38 (61.29%), followed by missed abortion (33.87%). Histopathological findings confirmed the presence of products of conception in 57 (91.93%) of cases, while 3.22% were diagnosed with partial molar pregnancy.

Conclusions: The study highlights the significance of routine histopathological evaluation of tissue following early pregnancy failure.

Patients Undergoing Surgery for Pilonidal Sinus in the Department of Surgery in a Tertiary Care Centre: A Descriptive Cross-sectional Study

Kishor Kumar Deo — 2025-07-15

Introduction: Pilonidal sinus refers to a condition that results when hair penetrates the natal cleft skin, leading to granuloma formation and induces secondary infection and abscess formation. This study aims to find the prevalence of patients undergoing surgery for pilonidal sinus out of total surgeries performed in the Department of Surgery at a tertiary care centre.

Methods: This descriptive cross-sectional study was conducted among patients with pilonidal sinus at a tertiary care hospital from 16 July 2021 to 14 June 2022 after obtaining ethical approval from the institutional review committee and was conducted retrospectively from 01 March 2022 to 30 June 2022 using medical records. All patients who underwent surgery in the Department of Surgery during the specified period were included in the study, with entries containing missing data being excluded. A convenience sampling method was used. The point estimate was calculated at a 95% confidence interval.

Results: Among 1812 patients undergoing surgery, 30 (1.66%) (1.07-2.24, 95% Confidence Interval) patients had undergone surgery for pilonidal sinus. Among them, 26 (86.67%) were male patients, while 4 (13.33%) were female patients.

Conclusions: The prevalence of patients undergoing surgery for pilonidal sinus is found to be similar to other studies in similar settings.

Exploring Feasibility And Functionality of Rehabilitative Ultrasound in Nepal: A Narrative Review

Shree Krishna Shilpakar — 2025-07-15

Introduction: Rehabilitative ultrasound imaging is a technique commonly used by physical therapists to evaluate the structure and function of muscles and surrounding soft tissues while a patient is moving or performing exercises. This review provides an overview of diagnostic sonography, specifically focusing on rehabilitative ultrasound imaging and point-of-care ultrasound in physiotherapy. The main objective of this review is to explore the feasibility and usability of integrating rehabilitative ultrasound imaging in the Nepalese physiotherapy context, this review also shows both the opportunities and challenges, especially given its current absence from physiotherapy sections in Nepal.

Observations: Real-time ultrasound imaging has proven to be a reliable method for assessing the thickness, morphology, function, and internal architecture of various muscles, including core muscles, supraspinatus, and rectus femoris, in both healthy individuals and those with musculoskeletal conditions. It can also assess force generation and muscle activity. Furthermore, ultrasound imaging serves as a valuable biofeedback tool for enhancing diaphragm activation, contractility, and muscle contraction to improve spinal stability. While its clinical and research potential is recognized globally, its application in less resource nations like Nepal remains largely unexplored.

Conclusions and Relevance: The conclusion of this review is that rehabilitative ultrasound imaging holds significant potential for clinical application in physiotherapy, particularly for assessing muscle characteristics and providing biofeedback to improve musculoskeletal function and spinal stability. It gives real time data and objective data on muscle morphology and function, makes it relevant clinically for guiding interventions and monitoring patient progress in conditions like low back pain and various musculoskeletal impairments. In Nepal, the integration of rehabilitative ultrasound imaging into physiotherapy practice and education is a worthwhile opportunity for the improvement of diagnostic potential, improving treatment effectiveness, and possibly increasing the scope of physiotherapy practice, as per international standards of healthcare. Surmounting the challenges of implementation and training will be at the core of harnessing these gains.

Mirizzi Syndrome: A Case Report

Akanand Singh — 2025-07-15

Mirizzi syndrome is an uncommon cholelithiasis complication marked by obstructive jaundice caused by extrinsic constriction of the main hepatic duct by a gallstone impacted in the gallbladder neck or cystic duct. Diagnosis is frequently missed due to its non-specific appearance and similarity to acute cholecystitis. We discuss the case of a 73-year-old female with Mirizzi syndrome type Va, who presented with a cholecystoduodenal fistula with choledocholithiasis. A laparoscopic cholecystectomy with common bile duct exploration was planned, however due to extensive adhesions and a fistula, an open cholecystectomy was performed instead. Mirizzi syndrome remains a diagnostic and therapeutic difficulty due to its uncommon occurrence and non-specific appearance. Early detection is critical to preventing complications such as bile duct damage or fistula formation.

Instructions for Authors

pmjn — 2015-12-31

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PMJN Vol. 25 No. 2 (2025)

Post-Graduate Medical Journal of NAMS — 2025-07-15

PMJN Vol. 25 No. 2 (2025)