Search

A sterilization outreach program camp for minilaparotomy was established in December 1996 in Bajura one of Indias least developed rural districts. A vasectomy camp was also organized. This paper describes the reproductive behavior and morbidity among women who came to receive sterilization services. Such family planning camps can play a major role in addressing some of the burden of reproductive health problems. The camp was organized at 2 sites in the district offered services including counseling screening and surgery over a 3-day period at each site. Potential clients were identified over several months by community-based health or social workers. The main criteria for preliminary selection in the communities were that the women wanted to bear no more children and that they were currently not pregnant. The sparse distribution of villages demanded that many women walk for several hours or days to visit the camp sites. The profile of women visiting the camps and morbidities of women during the 3 months preceding their interview are presented.

Purpose: To investigate the underlying genetic variation between candidate genes and primary angle closure glaucoma (PACG) in both Nepalese and Australian populations. Methods: A total of 213 patients with PACG (106 Nepalese and 107 Australian) and 492 age and sex matched controls (204 Nepalese and 288 Australian) were included in the current study. Three candidate genes were selected; methyltetrahydrofolate reductase (MTHFR), calcitonin receptor-like receptor gene (CALCRL), and membrane frizzled-related protein (MFRP). Tag single nucleotide polymorphisms (SNPs) were selected and genotyped to capture the majority of common variation across each locus. Allele and haplotype analyses were conducted using PLINK. Results: SNPs in the nanophthalmos gene MFRP were found to be nominally associated with PACG under the allelic model. Two SNPs were associated in the Australian cohort (rs948414; p=0.02 and rs36015759; p=0.02), and a single SNP in the Nepalese cohort (rs10790289; p=0.03), however these SNPs failed to remain significant after adjustment for sex and age. A haplotype at the CALCRL gene (AATACAGAT) was associated in the Australian cohort (corrected p-value= 0.024). No association was observed in either cohort for MTHFR. Conclusions: This study implicates genetic variation at the CALCRL gene in the pathogenesis of PACG in an Australian Caucasian cohort. Additionally, the MFRP gene shows tendency to be associated with PACG in both the Australian and Nepalese cohorts. Further investigation in a larger cohort is warranted to confirm these findings. No statistically significant associations were identified between MTHFR and PACG in either population.

Introduction: In spite of legalising abortion and making safe abortion available at affordable price at accessible distance to almost everyone, unsafe abortion especially second trimester abortion is still a big health problem in Nepal. Objective: The objective of the study is to find the demographic profile, reasons for seeking abortion and to see the effectiveness of Misoprostol in preparing the cervix. Materials and methods: A prospective study was done in the two second trimester abortion trainings conducted in Maternity hospital, Kathmandu. Total 57 clients had second trimester abortion performed. Information was collected from structured questionnaire and then data was analysed. Results: Commonest reason for seeking abortion was, multiparity (61.4%). Common reasons for second trimester abortion were, completed family size with unwanted pregnancy (61.4%), unwanted pregnancy in married (10.52%) unwanted pregnancy in unmarried (5.26%). Conclusions: Second trimester abortion is one of the most common procedures performed in reproductive-aged women and when performed by a skilled provider in the appropriate setting, it is one of the safest surgeries, if it is well supported by change in policy of the country and acceptability of the people. Key words: Maternal death; Safe abortion; Second trimester abortion DOI: 10.3126/kumj.v8i2.3552 Kathmandu University Medical Journal (2010), Vol. 8, No. 2, Issue 30, 169-172

Muslims in Nepal are comprised of Indian migrants and their descendants. A large majority of them live in the southern plain areas, while a certain percentage of the Muslim population live in certain villages of the hill districts and the Kathmandu Valley. This geographic range has a profound impact on their lifestyles, cultural activities and even their religious practices. The Muslims of Nepal are categorically divided into different ethnic types, distinguishable by religious behaviours, language, beliefs, and relations with the local Hindus.

This article relies on data from the 1991 Nepal Fertility, Family Planning, and Health Survey (NFFPHS) and the 1996 Nepal Living Standards Survey (NLSS) to assess trends in fertility in Nepal. The NFFPHS shows heaping at ages 5, 8, 10, and 12 years and a larger proportion of infants. The NLSS shows a different pattern of misreporting of youth and a stronger but similar pattern of age heaping as the NFFPHS for adults. Children ever born by maternal age indicates a degree of completeness and the deletion by older women of deceased children and married children living outside the household. Findings suggest less complete reporting in the NLSS. Age-specific fertility rates are calculated based on birth histories (BH) and the own-children (OC) method based on life tables. Findings indicate that BH and OC estimates of the cumulative fertility rate (CFR) derived from the NLSS and the NFFPHS were comparable for estimating trends in the total fertility rate (TFR). The trends from the two data sets overlapped fairly well during 1983-89. Fertility trends by single years of age showed considerably annual fluctuations due to age misreporting. The CFR and TFR for aggregated time periods showed little or no decline for the earlier 5-year period, a steeper decline in the second period, and variations in trends by data set for the third period from 1983 to 1989. One curve showed no decline and the other showed fertility decline. Fitting a straight line to the trend for 1977-91 shows that CFR declined by 1.61 children from 5.29 children in 1977 to 3.68 children in 1991. TFR declined by 1.90 children from 6.68 children in 1977 to 4.78 children in 1991. The author cautions that the point of fertility decline was not determined exactly, but data suggest that decline occurred around 1980, and the rate was fast thereafter. TFR declined by 2.70 children in urban areas and 1.83 children in rural areas.

This retrospective analysis was conducted to determine whether IUD users are good candidates for laparoscopic sterilization using the tubal ring and the Filshie clip. The data set used for the analysis came from international multicenter clinical trials involving 1235 women who were sterilized by the tubal ring and 1892 women sterilized by the Filshie clip. Results indicate that former IUD use is not associated with an increased risk of surgical injuries, including uterine perforation, major complications, or postoperative infections, for either of these tubal occlusion techniques. The risk of a sterilization procedure ending in technical failure (defined as switching to laparotomy and/or a tubal occlusion technique not originally planned) among tubal ring cases was greater for former IUD users than for non-IUD users. However, this may be related to a center effect. Nine of the 10 ring cases with technical difficulties were successfully switched to electrocoagulation, and the operator did not have to resort to an unintended laparotomy. The incidence of surgical difficulties among the Filshie clip cases was also higher in former IUD users, but all of these difficulties were safely overcome without changing the tubal occlusion method. These findings lead us to believe that, in general, a woman's IUD use should not generally be a reason for an experienced service provider to hesitate in performing an interval laparoscopic sterilization using a mechanical tubal occlusion technique.