Using freeze-preventive cold boxes in rural Nepal: A study of equipment performance, acceptability, system fit, and cost.

We conducted a field evaluation using qualitative and quantitative methods to assess freeze prevention of vaccines transported and stored in a recently developed, World Health Organization-prequalified freeze-preventive cold box (FPCB) as compared to currently used standard cold boxes (SCBs). The study assessed the FPCB's practical use, health worker acceptance, health system fit (including cost considerations), and challenges faced by health workers in variable conditions and geographical settings. The evaluation took place in five health facilities across hilly and plains districts of Nepal in two phases: Phase 1 involved FPCBs in simulated use alongside SCBs.

Hereditary spherocytosis in a young female in Eastern Nepal: a case report.

Introduction And Importance: Hereditary spherocytosis (HS), a rare familial extravascular haemolytic disorder, typically follows an autosomal dominant inheritance pattern with variable expressivity. Despite its classical presentation of anaemia, jaundice, and splenomegaly, HS is infrequently reported among individuals of Asian descent, contributing to its under diagnosis or delayed diagnosis. The primary objective of this case report is to underscore the pivotal role of the osmotic fragility test in diagnosing HS, emphasizing the importance of accurate and timely identification for effective clinical management and improved patient outcomes.

Social media influenced self-application of cyanoacrylate for double chin reduction in an adolescent girl: an unusual case of post-inflammatory hyperpigmentation.

Introduction: Cyanoacrylate, used as a topical adhesive for wound closure in clinical settings, can result in poor cosmetic outcome on application to skin. Lack of formal medical or dermatological training among social media influencers poses risks of improper diagnosis, incorrect treatments, ineffective home remedies, and potential self-injury or long-term skin effects, especially among adolescents.

Case Presentation: The authors present a case of a young girl with a persistent post-inflammatory hyperpigmentation after using cyanoacrylate on her chin as a home remedy to reduce her double chin problem after learning from a video on social media.

Migrated subcutaneous sharp foreign body in the anterior chest wall: An unusual presentation.

Key Clinical Message: Migration of any foreign body can cause potentially life threatening complications and should be reviewed by a multidisciplinary approach for the management. Diagnosis can be challenging; a history of foreign body injury could be suspicious.

Abstract: Foreign body injury to the chest wall can be an emergency situation and require a multidisciplinary approach for the management of the condition.

Laparoscopic transhiatal en-mass thoracic duct ligation for persistent bilateral spontaneous Chylothorax: A case report.

Chylothorax is a rare entity associated with morbidity. Surgical thoracic duct ligation (TDL) by thoracoscopic approach is the recommended choice for persistent chylothorax. However, thoracoscopy is not feasible in case of previous pleurodesis.

Asymptomatic spontaneous expulsion of a long foreign body through the gastrointestinal tract - a curious case report.

Foreign body ingestion and its natural elimination are common in children. However, this is uncommon for long foreign bodies. Here, we report the spontaneous removal of an ingested pencil in an asymptomatic child.

Over-the-counter Medication Use among Patients Presenting with Fever in the Emergency Department in a Tertiary Care Hospital.

Introduction: Over-the-counter medication use is commonly practised all over the world. However, in a developing country like Nepal, antibiotics form an essential component of OTC drugs. Fever is one of the most common clinical complaints which makes a patient go to the local pharmacy for over-the-counter medication.

Benign Breast Disease among Patients Visiting the Breast and Endocrine Clinic of a Tertiary Care Centre.

Introduction: Breast diseases encompass a wide range of conditions, including benign and malignant disorders. Given the significant burden of breast-related health issues in the community, there is a critical need to understand the prevalence. This study aimed to find the prevalence of benign breast diseases among patients visiting the breast and endocrine clinic of a tertiary care centre.

Foreign body aspiration with iatrogenic right bronchus perforation - A case report and literature review.

Introduction And Importance: Evacuation of obstructed trachea foreign body (FB) can be challenging and may have several life-threatening complications. Iatrogenic tracheobronchial injury (TBI) is a rare and devastating complication which need prompt diagnosis and management.

Case Presentation: An 11-year-old child was brought to the emergency with a history of cough and chest discomfort for the last 15 days.

Giant endometrial polyp in a post-menopausal woman: a rare case report from Nepal.

Introduction: Endometrial polyps (EPs) result from the overgrowth of endometrial glands and stroma. Giant endometrial polyps, defined as those exceeding 4 cm, are rare, and their association with phytoestrogen (PE) intake is infrequently reported.

Case Presentation: The authors present a case of a giant endometrial polyp in a 59-year-old post-menopausal woman from Nepal.

Antibiotics use among residents in Eastern Nepal: a community-based mixed method study.

Introduction: According to the WHO, more than two-thirds of all antibiotics are used in the community, of which about 30% are used inappropriately. The antimicrobial resistance (AMR) problem is a growing threat to Nepal because of indiscriminate and inappropriate use. However, exact data on the extent of inappropriate use of antibiotics in the community is scarce in Nepal.

Bednar's tumor at right shoulder in an adult male: a case report of a rare entity.

Introduction And Importance: Bednar tumor, a rare variant of dermatofibrosarcoma protuberans is a tumor with low malignant potential. Owing to limited studies, the pathogenesis and risk factor of this tumor are not clearly understood. The tumor extends from the epidermis to the dermal layers and even affects the surrounding bone.

Delayed replantation of avulsed permanent maxillary central incisor: Case report with 6-year follow-up.

Replantation should be attempted in any case of avulsion, be it immediate or delayed. Retention of the replanted tooth helps in preservation of adjacent alveolar bone. Despite the occurrence of replacement resorption, the tooth can stay healthy and functional in the arch for a longer duration.

11β Hydroxylase Deficiency in a Child with Hypothyroidism: A Case Report.

Unlabelled: Congenital adrenal hyperplasia occurs due to enzymatic defects in the adrenocortical steroidogenesis. 11β hydroxylase deficiency is the second most common cause of congenital adrenal hyperplasia which presents with hypertension and features of androgen excess. Hypertension has also been found to cause end-organ damage in children with 11β hydroxylase deficiency.

Outcome of Epidermal Growth Factor Receptor Mutated and Non Mutated Adenocarcinoma Lung to Standard Therapy.

Background: Asian patients with adenocarcinoma of lung have higher incidence of epidermal growth factor receptor mutations which predict increased response and survival in patients to oral tyrosine kinase inhibitors. This study was conducted to study the frequency of epidermal growth factor receptor mutation in patients in Nepal and compare the outcome in epidermal growth factor receptor mutated versus non-mutated patients receiving standard therapy.

Methods: This is an observational study conducted among newly diagnosed patients with stage IV adenocarcinoma of lung in Bir Hospital from April 2017 to June 2018.

Family caregiver experience of caring COVID-19 patients admitted in COVID-19 hospital of a tertiary care hospital in Nepal.

Background: Informal caregivers played a significant role in caring for COVID-19 patients during hospitalization in Nepal. This study aimed to understand the experiences of family caregivers attending to their relatives in a COVID-19 hospital in Nepal.

Methods: A descriptive phenomenological approach was adopted to understand the caregiver's experience in supporting their relatives admitted to the COVID-19 hospital of the BP Koirala Institute of Health Sciences (BPKIHS).

Foix-Chavany-Marie syndrome due to unilateral opercular infarction-A case report.

Key Clinical Message: Unilateral opercular lesions can result in Foix-Chavany-Marie syndrome, which is marked by acute anarthria, automatic-voluntary movement dissociation-most notably the absence of voluntary facial and tongue movements-and a generally better prognosis. Better patient outcomes are mostly dependent on early detection, management, and rehabilitation.

Abstract: Opercular syndrome is a rare neurological disorder caused by bilateral or unilateral lesions of the operculum that result in symptoms related to speech and swallowing difficulties with dissociation of automatic-voluntary movements in affected muscles.

Posterior reversible encephalopathy syndrome due to nonadherence to antihypertensive treatment: A case report from Nepal.

Key Clinical Message: Posterior reversible encephalopathy syndrome may occur secondary to abrupt cessation of antihypertensive therapy. A gradual reduction in blood pressure and counseling regarding medication adherence are crucial to prevent adverse consequences.

Abstract: Posterior reversible encephalopathy syndrome (PRES) is a reversible clinical radiographic syndrome with headache, hypertensive encephalopathy, seizures, and visual disturbances as common modes of presentation.

Anxiety and Depression in Pediatric-Onset Traumatic Spinal Cord Injury: A Systematic Review.

Background: Traumatic spinal cord injury (TSCI) is a debilitating neurological condition with significant long-term consequences on the mental health and well-being of affected individuals. We aimed to investigate anxiety and depression in individuals with pediatric-onset TSCI.

Methods: PubMed, Scopus, and Web of Science databases were searched from inception to December 20th, 2022 following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines, and studies were included according to the eligibility criteria.