Background: The TORCH complex is a medical acronym for a set of bacterial, protozoal and viral infections (Toxoplasma, Rubella, Cytomegalovirus and Herpes simplex). Perinatal infection with TORCH can result in foetal complications depending upon the period of gestation, duration of infection, severity of infection and immune status of foetus. Objective: To determine the association of TORCH IgG and IgM antibodies in women with spontaneous abortion. Methods: It was a prospective observational study conducted in the Department of Obstetrics and Gynaecology of Tribhuvan University Teaching Hospital, IOM, Maharajgunj, Kathmandu, Nepal. The study duration was for one year - Baisakh 2067 to Chaitra 2067 (April 2010–March 2011). During the study period, 153 women with spontaneous abortion, fulfilling the inclusion criteria were taken for TORCH IgM and IgG serological study. Results: In the present study, highest occurrence of IgM only antibody was of Toxoplasma occurring in 16.3% of enrolled women. Both IgM and IgG were negative for Toxoplasma in 39.9% of enrolled women indicating risk for Toxoplama infection. IgG positivity to Cytomegalovirus was found in 124 (81%) women. Both IgM and IgG positivity for Rubella was found in 35.3% of enrolled women. Conclusion: In the present study on analysing the association of TORCH antibodies in women with spontaneous abortion, recent infection of Toxoplasma was most commonly associated. However a larger study should be carried out to confirm the finding of the present study. Health Renaissance 2014;12(2): pp: 124-129

Genital myiasis is a very rare entity associated with poor personal hygiene, restricted mobility, and immunosuppressed status and ulcerating lesions. With the reported incidence of only 0.7%, only a few cases have been published so far in literature but none from Nepal. Despite such rare occurrence, we present here two such cases which we encountered in an interval of three days; one in an unmarried teenager and another in a postmenopausal lady with fungating ulcerative growth of vulval carcinoma. Both were successfully managed.antilarval; genital; myiasis.

BACKGROUND:Caesarean section rates have been increasing worldwide over the past few decades, with most countries and regions exceeding the World Health Organization recommended rate of 15% of all deliveries.METHODS:This study was carried out with the objective of reviewing the rates of cesarean sections over five years (2005-2010) and to assess the stratified rates of cesarean sections for audit of intrapartum management in University Teaching Hospital, Institute of Medicine. Data was stratified into 10 mutually exclusive groups, by using the method presented by Michael Robson.RESULTS:A total of 5907 women had under gone caeserean section over a period of five years. The results showed a growing trend of cesarean section rate from 16.6% to 25.4%. The results of this analysis using the Robson classification has shown that group 1(Nulliparous, single cephalic ≥ 37 weeks gestation in spontaneous labour) has the largest number of cesarean deliveries followed by group 3(Multiparous, single cephalic ≥37 weeks gestation in spontaneous labor, no previous CS), although Robson classification showed that group 5 was the biggest contributor.CONCLUSIONS:The growing and uniform distribution (throughout the year) of cesarean section has been observed for five years. This analysis provides evidence-based data so we can analyze where to aim our preventive measures and focus efforts in reducing the rate of CS. We would like to suggest that all hospitals and health authorities apply this standardized classification system as to monitor their CS rates and find ways to reduce it, and improve quality care.

Primary ovarian pregnancy is a rare entity, the incidence being 1 in 25,000 to 40,000 pregnancies. The diagnosis is difficult and still continues to challenge the clinicians. A case of ovarian pregnancy is reported here. The patient underwent laparotomy with right sided oophorectomy. Histopathological examination confirmed it to be an ovarian pregnancy.

Twenty-one years old primigravida presented to emergency with amenorrhoea for 2 months and complaints of severe abdominal pain for few hours. The pain was associated with 2 episodes of fainting attacks in emergency during the period of observation. Viable intrauterine pregnancy of 8-9 weeks along with collection of fluid in the Pouch of Douglas was detected by ultrasound examination and on laparotomy ectopic pregnancy was confirmed with haemoperitoneum of 2 litres with 500gms of clots. Histopathology report confirmed the tubal ectopic pregnancy and postlaparotomy, transvaginal sonography confirmed the salvage of the intrauterine pregnancy. Despite massive haemoperitoneum, the pregnancy continued till 40+6 weeks with uneventful antenatal period. She underwent emergency caesarean section for meconium stained liquor with foetal distress and delivered of an alive healthy female of 2.5 kg with good Apgar score.

To see whether advocacy for abortion law and comprehensive abortion care (CAC) sites after legalization of abortion in Nepal is adequate among educated people (above school leaving certificate).150 participants were assigned randomly who agreed to be in the survey and were given structured questionnaires to find out their perception of abortion and CAC sites.Majority know abortion is legalized and majority have positive attitude about legalization of abortion, however majority are not aware of abortion service in CAC sites and none knew the cost of abortion service.Proper and adequate advocacy of the new abortion law and CAC service is essential.

Organic mulch (distillation waste of Citronella java with similar to 20% moisture) 5 and 7.5 t ha(-1), diuron 1.5 kg ha(-1), diuron 1.5 kg ha(-1) plus organic mulch 5t ha(-1) and intercropping of blackgram( Vigna mungo L.) were evaluated against the conventional method of weed control (three spade-hoeings year(-1)) in perennial Citronella java (Cymbopogon winterianus Jowitt) (Poaceae) during the first harvest years (planting year) in 1988-89 (July-June) and 1989-90. The residual effects were studied during the second harvest years in 1989-90 and 1990-91 at the research farm of Central Institute of Medicinal and Aromatic Plants, Lucknow. Weeds caused 48% reduction (average 2-year) in herb and oil yields in the first harvest year as against 18% in the second. Organic mulch, at both levels of application (5 and 7.5 t ha(-1)), was highly effective in arresting weed growth, producing herb and oil yields comparable with repeated manual weeding, and increased the net economic return by 560-600% and 80-85% in the first and second harvest years, respectively, over the conventional method of weed control. Diuron 1.5 kg ha(-1) was phytotoxic during 1989-90 when there was rainfall immediately after its application, suggesting a narrow range of selectivity of diuron to C. java. The conventional method of weed control and blackgram intercropping did not give the desired weed control. Weed control in the planting year had a distinct advantage in the second harvest year. Distillation waste of C. java, with no purchase cost and ready availability to the growers, is recommended for efficient weed management in C. java.

Faced with diminishing returns on resources applied to gain significant advantages in technology, cost, promotion, or sales channels in today's crowded industrial markets, industrial marketers may find the best returns on resources applied to gaining an edge in service to forge ahead of the competition. The value of a service strategy lies in its implementation. This implementation requires defining service and defining a way to control it. Service can be affected by almost anyone in the organization. Managing all the possible “moments of truth” is required for controlling service quality. This requires a commitment from top management and an internal marketing program. The objective of the internal marketing program is to focus all of the organization on the same goal. The organization's structure and technology also play a crucial role in the implementation of the service strategy. The case study of an industrial company, which succesfully used “offering the best service in the market” as its marketing strategy to significantly increase its market share and profitability, is used to illustrate the concepts developed in this paper.