Laparoscopic Approach for Management of Hydatid Cyst of Liver

BACKGROUND

Laparoscopy surgery trials are small and unconvincing at present and are limited to higher centers. The objective of the study is to determine the clinical features, prevalence of site of hydatid cyst and complications of this modality of this treatment.

METHODS

A cross sectional study was carried out in all patients with one or two hepatic hydatid cyst who underwent laparoscopic management in KMCTH from January 2013 to March 2015 were included in the study. Aspiration, deroofing and evacuation of the hydatid cyst were done.

RESULTS

Twenty six patients underwent laparoscopic management for liver hydatid cysts. Males were seven (65.38%) and females were 9(34.61%).The mean age was 35.5±13.1 years (range 21-55years.) The commonest complaint was pain and discomfort in 13(50%) patients and lump in 6(13.06%) patients. Twenty four (92.3%) patients were successfully treated with laparoscopic approach. Two (7.69%) patients had to be converted to laparotomy because of dense adhesions and bleeding. Mean operation time was 43.6±10.6 minutes. Two (7.69%) patients had port site infection. One (3.84%) patient had bile leak and no recurrence and mortality in our series.

CONCLUSIONS

Laparoscopic management of liver hydatid cyst was safe and effective in selective group of patients in equipped hospital.

Utilization of services for institutional deliveries in Gorkha District

BACKGROUND

Adequate health services for improving maternal and neonatal health is an important global health issues. Institutional delivery is most important component to address maternal and neonatal issue. Institutional delivery service utilization assures safe birth and minimizes the maternal morbidity and mortality. This study was aimed to assess the utilization of institutional delivery service among the mothers of Gorkha district.

METHODS

A cross sectional study of 180 mothers having child below 2 years residing in Palungtar municipality was done between March to July 2015. Information was collected by using an interviewer administered semi-structured questionnaire. Chi-square test was used to for data analysis.

RESULTS

Of total, 93.3% of the mother gave birth to their current child at health institution. The study variables like age at marriage, knowledge on delivery incentive, long waiting hours at health facility, Information on maternal health before current pregnancy, age at first pregnancy, gestational age at first ANC visit and women knowing differences between home and institutional delivery were independent factors influencing utilization of institutional delivery service.

CONCLUSIONS

Promotion of information, education and communication on maternal health services and delivery incentives could result in utilization of institutional delivery services.