Advancing diabetes primary care education and knowledge in Nepal: A scoping review and case study discussion.

Aims: Diabetes mellitus (DM) is a chronic disorder of insulin and glucose metabolism. It affects more than 463 million people worldwide and is expected to reach 700 million by 2045. In the Southeast Asian region, the prevalence of DM has tripled to 115 million due to rapid urbanization, unhealthy diet, sedentary lifestyles, and genetic factors.

Treating upper limb claudication in a patient with Takayasu's arteritis with carotid-to-subclavian bypass: A case report.

Introduction And Importance: Takayasu's Arteritis (TA) is a rare form of large vessel vasculitis often being apparent late in its progression with features of artery occlusion. Studies comparing endovascular approach with bypass surgeries reveal surgery to be a better option with lesser rates of postoperative restenosis.

Clinical Presentation: A 25-year-old female patient presented with dizziness, headache, claudication and paresthesias in the right arm.

Ewing's sarcoma arising from the right sided chest wall: a case report.

Unlabelled: Ewing sarcoma (ES) is a malignant tumour prevalent in young adults with a reported 5-year survival ranging between 40 and 60% in most studies. Majority of the patients with ES are usually diagnosed late with significant chest wall mass, chest pain or respiratory distress.

Case Presentation: Here, the authors present a case of a 21-year-old female with a diagnosis of right sided chest wall ES treated with neoadjuvant chemotherapy followed by surgical resection of the mass.

Accidental gunshot injury with left-sided lung injury and D11 burst fracture: a case report.

Unlabelled: Penetrating chest injuries are mainly caused by gunshot trauma and stab injuries. These lead to damage to the vital structures, which requires a multidisciplinary approach for management.

Case Presentation: We present a case of an accidental gunshot injury (GSI) to the chest resulting in left-sided hemopneumothorax, left lung contusion, and D11 burst fracture with spinal cord injury.

Hemoperitoneum among Pediatric Abdominal Trauma Patients Visiting in Emergency Department of a Tertiary Care Centre: A Descriptive Cross-sectional study.

Introduction: Pediatric abdominal trauma presents a major challenge for first-line responders in the Emergency Department for assessment and management. The Focused assessment sonography for trauma is a readily available, easy-to-use, and affordable tool for detecting hemoperitoneum during the initial assessment of trauma in the Emergency Department for adult traumatic patients. The aim of this study was to find the prevalence of hemoperitoneum among pediatric abdominal trauma patients visiting the Emergency Department of tertiary care centre through Focused assessment with sonography for trauma examination technique.

Review of current status of cardiovascular and thoracic surgery in Nepal: An analysis from collection of institutional database.

Objective: Data collected from various institutions around the country was analyzed to assess the current status of cardiovascular and thoracic surgery in the country.

Methods: We collected data from institutions performing cardiovascular and thoracic surgery from all over the country through direct correspondence for the year 2019. Individual institution data on the number of surgeries performed for cardiac, vascular, and thoracic surgery and its outcome in terms of mortality were compiled.

High Burden of Vitamin B12 Deficiency among Adults and Elderly.

Background: Deficiency of vitamin-B12 is widespread. Adults and the elderly are particularly susceptible to vitamin-B12 deficiency. This study investigated the burden of vitamin-B12 deficiency and insufficiency among adults and the elderly attending a tertiary care hospital in Nepal.

Supraventricular tachycardia and deep vein thrombosis following Moderna vaccination: A case series.

There have been reports of deep vein thrombosis and supraventricular tachycardia following the Moderna vaccination. The timing of SVT and DVT just after vaccination in our case series could suggest possible temporal relationships to the vaccination. But further studies are needed to establish such evidence.

Anticoagulation failure in pulmonary thromboembolism in COVID-19 pneumonia despite prolonged anticoagulation: A case series.

Introduction: Moderate to severely ill patients diagnosed with Coronavirus disease 2019 (COVID-19) pneumonia develop a series of complications and less frequently, we might witness cases of Pulmonary Thromboembolism (PE)-refractory to the standard treatment with Low Molecular Weight Heparin (LMWH). The aim of this case series is to report the presentation and management of pulmonary thromboembolism secondary to COVID-19 pneumonia.

Method: We report a case series of seven cases aged 40-70 who were presented in Dhulikhel Hospital with COVID-19 symptoms in different stages.

Klippel Trenaunay syndrome in a 3-year-old: A case report.

Introduction And Importance: Klippel-Trenaunay syndrome (KTS) is characterized by a triad of port-wine stain, varicose veins and soft tissue or bony hypertrophy of lower limb. Varicose veins in Klippel Trenaunay syndrome are mostly distributed in the lateral aspect of the lower limb. The exact etiology of KTS is not known, and the treatment usually starts with conservative management- limb elevation, compression stockings and physiotherapy.

Venous pseudoaneurysm of left brachiocephalic fistula treated by excision and aneurysmorrhaphy: A case report.

Introduction And Importance: Brachiocephalic fistula, an arteriovenous fistula approach for hemodialysis in Chronic Kidney Disease patients, can cause various complications. Pseudoaneurysm in the venous end of the arteriovenous fistula is one of those unusual presentations, and can lead to the failure of vascular access.

Case Presentation: We present a case of a 38-year-old female with pseudoaneurysm in the venous end of the left brachiocephalic fistula presenting as painless swelling for one month.

Traumatic gastric laceration with injury of splenic and celiac vessel following intentional self-harm by crashing of motor vehicle: A case report.

Intra-abdominal injury due to blunt trauma accounts for 5-10% of all traumatic cases. It usually occurs secondary to motor vehicle collision, pedestrian injury, and falls. Typically these result in injury to solid abdominal organs-liver and spleen, hollow visceral organs, and rarely the abdominal vasculature.

Spontaneous Common Femoral Artery Pseudoaneurysm: A Case Report.

Unlabelled: Spontaneous femoral artery pseudoaneurysm in a young person with no comorbidity is a rare occurrence. A 30 years old gentleman presented to our hospital with complaints of painful swelling of spontaneous onset in the right inguinal region for 15 days. He had undergone incision and drainage of the contents of the swelling five days back but he suffered from a recurrence of the painful right inguinal swelling and persistent bleeding from the incision site for four days.

Klippel-Trenaunay Syndrome: Case series from a university hospital of Nepal.

Introduction: Klippel Trenaunay Syndrome (KTS) is a rare congenital malformation with capillary and venous malformations and soft tissue/bony overgrowth with or without lymphatic malformation. Cutaneous vascular stain, varicosities and tissue hypertrophy represent its main clinical features. Besides, the patient can develop thromboembolic pathologies, recurrent bouts of infection, stasis eczema, limb length discrepancy and intolerable pain typical of intraosseous involvement.

Combined vascular malformation of neck: A case report.

Vascular malformations are developmental anomalies occurring due to defective vasculogenesis. Depending on the number of vessels involved, they are subgrouped into simple or combined types. Combined vascular malformations are a rare clinical entity with two or more vascular malformations (capillary, venous, arteriovenous, lymphatic) present in one lesion.

Placement of cuffed tunnelled permanent hemodialysis catheter in patients with end stage renal disease: A cross sectional study.

Background: End-Stage Renal Disease (ESRD) is a significantly increasing condition warranting renal replacement therapy. Gaining vascular access for catheter placement for this procedure is of paramount importance. These can be done by temporary and permanent cuffed tunnelled catheters.

Peripheral Vascular Trauma among Vascular Surgery Cases Operated in a Tertiary Care Hospital: A Descriptive Cross-sectional Study.

Introduction: Peripheral vascular trauma can result in limb or life-threatening injuries. Early surgical intervention leads to a better outcome. Diagnosis is made clinically, by non-invasive and invasive imaging modalities.

Vascular Injury to the Neck by a Bamboo Stick: A Case Report.

Penetrating neck injuries causing rupture of sternocleidomastoid muscle along with transection of major vessels of the neck have significant morbidity and mortality due to the risk of severe hemorrhage and cerebral infarction. However, there are no universal guidelines for the management of penetrating neck injuries. Here, we report a case of a 67-year-old female with a lacerated wound on the left side of the neck with a complete transection of the left sternocleidomastoid muscle along with transection of internal jugular vein and two superficial branches of internal carotid artery following penetrating injury to the neck by a bamboo stick.

Cervical rib, case series from a university hospital of Nepal.

Cervical rib is a rare anatomical anomaly with an incidence of 0.2%-1% and is an important cause of thoracic outlet syndrome. We present a case series of five female patients with a mean age of 20.

Health system gaps in cardiovascular disease prevention and management in Nepal.

Background: Cardiovascular diseases (CVDs) are the leading cause of deaths and disability in Nepal. Health systems can improve CVD health outcomes even in resource-limited settings by directing efforts to meet critical system gaps. This study aimed to identify Nepal's health systems gaps to prevent and manage CVDs.

Patient literacy on varicose veins in cases presenting at university hospital of Nepal subjected for surgical management of varicose veins.

Varicose veins are prominent dilated veins usually present in the lower limbs leading to complications if not managed well. Knowledge regarding varicose vein among the patients in Nepal is not yet known. We aim to examine the knowledge regarding varicose vein diagnosis and treatment among patients to better understand the barriers to care.

Quantification of Superficial Venous Reflux by Duplex Ultrasound - Role of Peak Reflux Velocity and Reflux Time in the Assessment of Varicose Vein.

Background: The study compared the peak reflux velocity and reflux time in cases of varicose veins and non-varicose veins with a focus on quantifying the reflux parameters.

Methods: This is a hospital based observational comparative study. The limbs with CEAP Clinical classification of C2 or more were taken as diseased limbs and contra-lateral limbs with no symptoms or disease were taken as control limbs.

Management of Bile Duct Injury Following Cholecystectomy.

Background: Laparoscopic cholecystectomy is responsible for 80-85% of the bileduct injury, and twice as frequentcompared to open cholecystectomy.Injury affects the quality of life and overall survival of the patient. The management of these injuries is complex and challenging.

Worksite intervention study to prevent diabetes in Nepal: a randomised trial protocol.

Introduction: In Nepal, approximately 31% of adult industrial employees have diabetes. While the prevention of type 2 diabetes through behavioural intervention has been disseminated, worksite could be an effective platform for the translation of this knowledge into action as employed adults spend most of their workday waking hours at workplaces.

Methods And Analysis: We will conduct a randomised controlled trial to assess the effectiveness of a behavioural and a canteen intervention on diabetes risk reduction among those who are prediabetic at two worksites in eastern Nepal.

Study of Arteriovenous Fistula Cases in a Tertiary Care Hospital: A Descriptive Cross-sectional Study.

Introduction: Arteriovenous fistulas are a preferred choice for hemodialysis access in chronic kidney disease patients. There is increased adoption of arteriovenous fistula creation in Nepal. Our objective is to study various arteriovenous fistulas that have been created in our center.