Small vessel cerebrovascular disease is associated with cognition in prospective Alzheimer's clinical trial participants.

Background: Secondary prevention clinical trials for Alzheimer's disease (AD) target amyloid accumulation in asymptomatic, amyloid-positive individuals, but it is unclear to what extent other pathophysiological processes, such as small vessel cerebrovascular disease, account for participant performance on the primary cognitive outcomes in those trials. White matter hyperintensities are areas of increased signal on T2-weighted magnetic resonance imaging (MRI) that reflect small vessel cerebrovascular disease. They are associated with cognitive functioning in older adults and with clinical presentation and course of AD, particularly when distributed in posterior brain regions.

Disseminated Nocardia Brain Abscess Presenting as Primary Lung Cancer With Brain Metastasis.

We present a challenging case of disseminated infection manifesting as brain and skin abscesses. is an important potential pathogen to consider in patients with a relevant travel history to endemic regions or atypical presentations, such as brain and skin abscesses. About one-third of patients with infections are immunocompetent, and their symptoms are nonspecific.

Nonparaneoplastic anti-NMDA receptor encephalitis in an adolescent girl: a case report.

Unlabelled: Anti--methyl D-aspartate (NMDA) receptor encephalitis is an autoimmune neurologic disorder that classically presents with psychiatric, neurologic, and autonomic symptoms, often with a viral prodrome.

Case Presentation: A 17-year-old female presented to the hospital with an 11-day history of fever, altered behavior, abnormal body movements, and altered sensorium. Upon examination, she was found to be febrile, tachycardic, and tachypneic, with a Glasgow Coma Scale score of 8.

B-Lynch Suture Management among Patients with Postpartum Hemorrhage in a Tertiary Care Centre: A Descriptive Cross-sectional Study.

Introduction: Postpartum haemorrhage is the most life-threatening complication during pregnancy and atonic postpartum haemorrhage being the commonest one, often poses difficulties in management. B-Lynch suture with a high success rate has emerged as a life-saving measure in uncontrolled atonic postpartum haemorrhage refractory to uterotonics. The objective of this study was to find out the prevalence of B-Lynch suture management among patients with post-partum haemorrhage in a tertiary care centre.

Severe hepatitis E infection in pregnancy: a case report.

Unlabelled: Hepatitis E virus causes self limiting hepatitis most of the times but, during pregnancy it can lead to severe hepatitis along with various complications thereby increasing the mortality.

Case Presentation: A 27-year-old woman gravida two, para one at 38 weeks and 6 days of gestation presented with multiple episodes of nonbilious vomiting, severe dehydration, and later developed right upper quadrant abdominal pain. The patient had a positive serological test for the hepatitis E virus, and liver enzymes were severely elevated.

Public Health Approach to Developing Palliative Care.

Unlabelled: Nepal has witnessed demographic and epidemiological transition resulting in the shift from infectious diseases to non-communicable diseases as the major disease burden. Around 60% of mortalities and morbidities are attributable to non-communicable diseases of which the majority end with the need for palliative care services. The current palliative care services in Nepal are in the infancy stage compared with other services.

Genitourinary Syndrome of Menopause among Postmenopausal Women in a Tertiary Care Centre: A Descriptive Cross-sectional Study.

Introduction: Genitourinary syndrome of menopause incorporates vulvovaginal and lower urinary tract symptoms related to estrogen deficiency which affects more than half of postmenopausal women. This study aimed to find out the prevalence of genitourinary syndrome of menopause among postmenopausal women attending a tertiary care center.

Methods: A descriptive cross-sectional study was conducted at the Department of Obstetrics and Gynaecology of tertiary care hospital from October 2019 to April 2021 after obtaining ethical approval from the Institutional Review Committee (Reference number: 452 6-11).

Case of Late Recurrence in Early Stage Epithelial Ovarian Cancer.

Epithelial ovarian canceris usually diagnosed in late stage with high recurrence rate and fatality. Long term survival in late recurrence is not very common. We present a case of 66 year woman who had come in early stage of epithelial ovarian cancer.

Comparative study of Amsel's criteria and Nugent scoring for diagnosis of bacterial vaginosis in a tertiary care hospital, Nepal.

Background: The most common pathological cause of abnormal vaginal discharge in reproductive-aged women is bacterial vaginosis (BV). Amsel's criteria and Nugent scoring systems are commonly employed approaches for the diagnosis of BV. Despite the Nugent scoring system being the gold standard method for diagnosing BV, Amsel's criteria are generally preferred in clinical setup owing to the fact Nugent scoring requires considerable time and expert microscopist.

Kawasaki Disease like Multisystem Inflammatory Syndrome in a Toddler during SARS-CoV-2 Pandemic in Nepal.

Multisystem inflammatory syndrome in children is a new childhood inflammatory disorder associated with respiratory syndrome coronavirus 2 (SARS-CoV-2). This illness of elevated inflammatory markers and multiple organ involvement similar to Kawasaki disease is not commonly reported from Asia. A 17-month-old boy presented with acute onset fever, rash, non-exudative conjunctivitis and swellings of hands and legs.

An Unusual Case of Acute Abdomen: Ovarian Vein Thrombosis.

Ovarian vein thrombosis is one of the rare causes for acute abdomen. Occult presentation of this disease may lead to diagnostic dilemma. A sixteen years female who was operated as a case of ectopic pregnancy was finally diagnosed as having ovarian vein thrombosis.

Partial Invasive Mole with Bilateral Torsion of Theca Lutein Cysts.

Gestational trophoblastic neoplasia is extremely rare entity accounting 1% of all gynecological malignancies. Invasive mole is a form of Gestational trophoblastic neoplasia which is locally invasive with propensity of metastasis. Association of partial mole with invasive mole and/or theca lutein cysts is a rare occurrence.

Kinetics of organic matter and ammonia removal in horizontal reed beds treating wastewater in Nepal.

In Nepal, both horizontal bed and vertical bed subsurface flow constructed wetlands have been used for wastewater treatment. However, these units were designed based on the empirical findings from other countries. The rational design criteria developed so far has some limitations as the performance of the units is sensitive to the behaviour of the microorganisms, climatic conditions and other attributes pertaining to the local contexts.

A preliminary randomized double blind placebo-controlled trial of intravenous immunoglobulin for Japanese encephalitis in Nepal.

Background: Japanese encephalitis (JE) virus (JEV) is a mosquito-borne flavivirus found across Asia that is closely related to West Nile virus. There is no known antiviral treatment for any flavivirus. Results from in vitro studies and animal models suggest intravenous immunoglobulin (IVIG) containing virus-specific neutralizing antibody may be effective in improving outcome in viral encephalitis.

Human genital myiasisin extremes of age.

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.

Intra-Spinal Bone Marrow Mononuclear Cells Transplantation Inhibits the Expression of Nuclear Factor-κB in Acute Transection Spinal Cord Injury in Rats.

Objective: To assess the effect of bone marrow mononuclear cells (BMMNCs) transplantation in the expression of nuclear factor-κB (NF-κB) in spinal cord injury (SCI) in rats.

Methods: BMMNCs were isolated from tibia and femur by a density gradient centrifugation. After establishment of acute transection SCI, rats were divided into experiment (BMMNCs), experiment control (0.

Situation analysis of patients attending TU Teaching Hospital after medical abortion with problems and complications.

Introduction: In Nepal medical abortion has been approved for use since 2009. There were many cases coming to Tribhuvan University Teaching Hospital coming with problems and complications following medical abortion. Thus the objective of this study was to analyze the cases that came to TUTH following medical abortion with problems and complications.

Clinical and prognostic features among children with acute encephalitis syndrome in Nepal; a retrospective study.

Background: Acute encephalitis syndrome (AES) is commonly seen among hospitalized Nepali children. Japanese Encephalitis (JE) accounts for approximately one-quarter of cases. Although poor prognostic features for JE have been identified, and guide management, relatively little is reported on the remaining three-quarters of AES cases.

Myths and misconceptions about abortion among marginalized underserved community.

Introduction: Unsafe abortion remains a huge problem in Nepal even after legalization of abortion. Various myths and misconceptions persist which prompt women towards unsafe abortive practices.

Methods: A qualitative study was conducted among different groups of women using focus group discussions and in depth interviews.

Surviving 27 weeks fetus expelled out of the ruptured rudimentary horn and detected a month later as a secondary abdominal pregnancy.

A pregnant woman, gravida 3 with two living children, who frequently experienced syncope from 23(+5) weeks of pregnancy onwards and recurring every week for a period of 3 weeks, was repeatedly treated in line for a case of acid peptic disease/appendicitis in various peripheral hospitals of Nepal, until ultrasonogram/magnetic resonance imaging diagnosis of an (undisturbed) live 27(+5) weeks abdominal pregnancy was made at our hospital. On laparotomy, this materialized to be secondary to the rupture of a left rudimentary horn pregnancy (evidenced from its sealed margin) which still retained a complete placenta, from where an umbilical cord was seen, traversing across towards the right side of the abdominal cavity just below the liver, securing its attachment to the surviving fetus and enclosed in an intact amniotic sac. Excision of the rudimentary horn containing the placenta was accomplished, after the delivery of a live baby weighing 650 g who unfortunately died on the third day of life.