Monomer unfolding of a bacterial ESCRT-III superfamily member is coupled to oligomer disassembly.

The inner membrane associated protein of 30 kDa (IM30), a member of the endosomal sorting complex required for transport (ESCRT-III) superfamily, is crucially involved in the biogenesis and maintenance of thylakoid membranes in cyanobacteria and chloroplasts. In solution, IM30 assembles into various large oligomeric barrel- or tube-like structures, whereas upon membrane binding it forms large, flat carpet structures. Dynamic localization of the protein in solution, to membranes and changes of the oligomeric states are crucial for its in vivo function.

Bouveret's syndrome: An old diagnosis. A modern multimodality approach (endoscopic and robotic surgical) of gastric outlet obstruction: Report of two cases.

Introduction And Importance: Bouveret's syndrome is an uncommon condition characterized by the impaction of a gallstone in the pylorus or duodenum via a cholecysto-enteric fistula causing gastric outlet obstruction. We report two unusual cases of Bouveret's syndrome causing gastric outlet obstruction in two elderly patients.

Case Presentation: Two elderly female patients presented to the surgical assessment unit with features of gastric outlet obstruction.

Initiation of Liver Transplant in Nepal: A Milestone.

Background: The incidence of chronic liver disease is increasing in the Nepalese population. Liver transplantation (LT) is the best option for patients with end-stage liver disease (ESLD). Nepal's first liver transplant was performed in 2016 in an international collaborative effort at Shahid Dharmabhakta National Transplant Centre (SDNTC), Bhaktapur, Nepal.

Kidney transplantation from brain-dead donors in Nepal: Report of first six cases.

Introduction: and importance: Kidney transplantation is one of the best treatment options for patients with end-stage renal disease. More than 90% of patients awaiting renal transplantation die without getting the kidney for transplantation. Brain dead donor kidney transplantation can bridge this gap proficiently.

Living donor kidney paired exchange: An observational study.

Background: Kidney transplantation is the treatment of choice for patients with end-stage renal disease (ESKD). Kidney paired donation (KPD) provides the chance to match an incompatible donor/recipient pair with another donor and recipient in a similar condition. We aimed to compare the outcomes of pair exchange kidney transplantation with traditional live donor kidney transplantation in our context.

Burnout among resident doctors: An observational study.

Background: Burnout is a syndrome of emotional exhaustion and depersonalization that reduces efficiency at work. No studies have been reported focusing only on residency burnout and risk factors from our country until now. This study aimed to find out the impact and the association of specific demographic and practice characteristics with burnout among resident doctors.

Prediction of difficult laparoscopic cholecystectomy: An observational study.

Background: Laparoscopic cholecystectomy (LC) is a gold standard treatment of symptomatic gallstone disease. Meanwhile, it is also a challenging procedure demanding excellent expertise for the best outcomes. Many times, difficult laparoscopic cholecystectomy is a nerve-wracking situation for surgeons.

A rare case report of enteric fever causing gallbladder perforation.

Introduction And Importance: Enteric fever is one of the major public health problems mainly in developing countries. Gallbladder perforation is very unusual. Enteric fever rarely causes gallbladder perforation.

Preparation and physicochemical characterization of ghee and mūrcchita ghŗ̥ta.

Background: Ghŗ̥ta mūrcchana is a process of pre-treatment recommended in Ayurveda to purify ghee before it can be used for siddha ghŗ̥ta which is claimed to improve the properties of the ghee in general and that of the prepared siddha ghŗ̥ta.

Objective: This work is aimed at studying the physiochemical properties of ghee and mūrcchita ghŗ̥ta in order to understand the impact of ghŗ̥ta mūrcchana process.

Materials And Methods: Ghee and mūrcchita ghŗ̥ta were prepared from the milk of local Pahadi, Jersey and Holstein cows.

Foreign body esophagus: Six years of silence.

Foreign body esophagus remains one of the common medical emergencies which may lead to significant morbidity and mortality. Sharp objects, batteries, and elderly with foreign body esophagus should be treated with emergent removal owing to the complications that might ensue. Endoscopic removal is the preferred choice of treatment but for large foreign body, sharp foreign body, and so on, rigid esophagoscopic removal might be more preferable.

A rare coexistence of papillary carcinoma and anaplastic carcinoma of thyroid in multinodular goitre: Case report and literature review.

Introduction: Multinodular goiter is defined as multiple discrete nodules in the thyroid gland. The incidence of Papillary carcinoma thyroid was found to be highest out of total Multinodular Goiter cases while that of Anaplastic carcinoma was the least. We report a rare coexistence of Papillary carcinoma and Anaplastic carcinoma in adult patient with a long-standing Multinodular Goiter.

Verrucous Carcinoma in a Giant Cutaneous Horn: A Case Report and Literature Review.

Background: A cutaneous horn is a common clinical entity which usually presents as a cutaneous lesion. Because of its subtle nature, patients usually tend to present late unless the lesion is big or complications develop. Because of its resemblance to animal horn, it has been given the term "horn.

Simultaneous Hydatid Cyst of the Liver and Left Iliac Fossa: An Unusual Case Report.

Hydatid disease is a significant health problem in many livestock-rearing areas especially in the developing world, mainly caused by . The liver and lung are the most common affected sites. However, hydatid disease can occur anywhere in the body.

Volvulus of sigmoid colon in a challenged adolescent: An unusual case report.

Sigmoid volvulus is very uncommon cause of intestinal obstruction in pediatrics population withhigh rate of mortality. To date, few cases of sigmoid volvulus in children and association with several condition has been reported in literature, of them very few cases are with mental disability. We report a challenged (mentally disabled) 14-year old adolescent boy presented asan emergency with feature of complete bowel obstruction.

Buccal oncocytoma: Report of a case and literature review.

Introduction: More common in major salivary glands, oncocytomas are very rare tumors. They commonly occur in the parotid gland and are painless slow growing predominantly benign tumors. The term "oncocytoma" was introduced by Jaffe to designate those tumors of the salivary glands that consist predominantly of oncocytic cells lining the salivary ducts (1) Similalry, Meza- Chavez had proposed the name "oxyphilic granular cell adenoma.

Rare giant maxillay mucocele: A rare case report and literature review.

Introduction: Mucocele is a slow growing, benign but locally aggressive cystic structure lined by true epithelium. It often results due to obstructed sinus outflow or obstruction of gland-like mucous retention cyst. It can cause bony destruction and might result in orbital symptoms like diplopia, orbital displacement, visual disturbances.

Massive encrustations as a consequence of longterm indwelling urethral catheter: A rare case report.

Longterm indwelling urethral catheter can cause several complications such as lower urinary tract infections, tissue damage, pain, hemorrhage and encrustation of catheter leading to blockage. A 55- year old male presented with suprapubic pain for three months owing to poorly draining Foley catheter. He had undergone surgery for bladder calculi two and half a years back.

Characterization and Antimicrobial Property of Some Heavy Metals Containing Ayurvedic Drugs.

Ayurvedic medicines are often used in different formulations, the heavy metals, which are generally referred to as being toxic. In this work, we report on the physicochemical characterization and biological activity of some typical Ayurvedic drugs available in the market that contain arsenic, mercury and lead with the emphasis on their antibacterial performance. Among the formulations studied, some of the drugs with 'amorphous' texture (and higher solubility) were found quite active against some bacterial strains whereas the formulations possessing crystalline texture (and low solubility) were found practically ineffective.

A rare case report of patent vitellointestinal duct causing bowel obstruction in an adult.

Introduction: Patent vitellointestinal duct occurs in about 2% of the population which unusually leads to small intestinal obstruction associated with high morbidity and mortality. Here we are reporting an unusual case of patent vitellointestinal duct causing small intestinal obstruction in an adult patient.

Presentation Of Case: A 22-year-old male without any medical illness presented as an emergency with a 3day hystory of abdominal pain, multiple episode of vomiting and abdominal distention.

Acute Appendicitis in Pregnancy and the Developing World.

Background: Acute appendicitis is the commonest nonobstetric surgical emergency during pregnancy. The aim of the study was to compare perioperative outcomes of acute appendicitis in pregnant and nonpregnant patients.

Methods: A retrospective review of medical records of 56 pregnant patients between 2011 and 2016 who were compared with 164 nonpregnant women of reproductive age who underwent open appendectomy between 2014 and 2016 for acute appendicitis.

Laparoscopic Cholecystectomy in the Elderly: An Experience at a Tertiary Care Hospital in Western Nepal.

Background: The incidence of gallstone increases with increasing age. No studies have been reported in the elderly population with laparoscopic cholecystectomy from developing nations. The aim of this study was to compare perioperative outcomes of laparoscopic cholecystectomy between the elderly (≥60 years old) and the young (<60 years old).

A Child with Severe Malaria Presenting with Acute Surgical Abdomen (Duodenal Perforation).

, the commonest cause of severe malaria in children, is an important cause of mortality in developing nations like Nepal. Duodenal perforation in a case of complicated malaria, although a rare entity, can occur in children. Early diagnosis, proper medical treatment, and early surgical repair can be a lifesaving measure in such cases.