Incidental left paraaortic mass in a patient with gall bladder adenocarcinoma: A diagnostic challenge.

Incidental adrenal masses are frequently detected due to the extensive use of cross-sectional imaging, with about 3% to 7% of adults estimated to have them. Paragangliomas and pheochromocytomas (PPGL), rare tumors originating from paraganglia tissues, including the adrenal medulla, continue to be imaging mimics, necessitating a multimodal approach for accurate diagnosis. We report a case of 72-years male presenting with intermittent pain abdomen for the past 1 year.

Gall bladder duplication: A rare biliary malformation.

Gallbladder duplication is a rare anatomical variation with an incidence of approximately 1 in 3800 to 4000 live births, resulting from aberrant biliary organogenesis. This case report discusses a 35-year-old female who presented with intermittent lower abdominal pain, with initial imaging revealing a complex left adnexal cyst. Follow-up CT and ultrasound examinations revealed 2 distinct gallbladder-like structures in the gallbladder fossa, each with a cystic duct draining into the common bile duct.

Health care systems and policies for older adults in Nepal: new challenges for a low-middle income country.

Background: Nepal, like other low- and middle-income countries, is experiencing a rapid increase in the number of older adults and the rate of aging in the population. This has increased the number of older adults with age-associated chronic illnesses, which in turn will escalate the demand for specialized healthcare and long-term care in Nepal. However, very little is known regarding the current healthcare system and health policies for older adults in Nepal.

Mentorship advances antimicrobial use surveillance systems in low- and middle-income countries.

A shortage of trained personnel poses significant challenges to implementing antimicrobial use (AMU) surveillance systems in low- and middle-income countries (LMICs). Traditional training models, such as workshops, seminars and online courses, often lack the sustained engagement and support necessary for deep learning and skill mastery. This article advocates for mentorship as an effective training method for AMU professionals in LMICs.

Assessing flexible ureteroscopy outcomes for lower Pole versus non lower Pole stones using the flexible and navigable suction ureteric access sheath: a prospective multicenter study by EAU Endourology and PEARLS group.

Purpose: Use of suction in flexible ureteroscopy is increasing lately. The introduction of flexible and navigable suction access sheath (FANS) has shown improved stone free rate (SFR). However, its efficacy in lower pole stone (LPS) in terms of SFR and complications is yet to be studied.

Challenges and Progress in Neurosurgery: A Comprehensive Assessment of the Landscape in Nepal.

A large portion of the global population lacks access to essential surgical care, despite surgical conditions contributing significantly to the overall burden of disease worldwide. This burden is heaviest in developing countries like Nepal, where disparities in access to surgery for neurosurgical disorders stem from health system failures including an inadequate neurosurgical workforce, lack of requisite neurosurgical equipment, and challenges in perioperative care. By bibliometric analysis of neurosurgery-related publications in Nepal through PubMed search using the search terms "Neurosurg* AND Nepal", we have found a total of 528 articles with a notable increase in the number of such publications from 14 to 25 between 2015 and 2016, with over 300 published in 2021, 2022, and 2023.

A rare case of left transverse testicular ectopia in an adult.

Introduction And Importance: Transverse testicular ectopia (TTE) is a rare congenital anomaly in which both testes descend into the same inguinal canal and are located in the same hemiscrotum. Diagnosing TTE can be challenging due to its rarity and unusual presentation.

Case Presentation: The authors present a case of a male in his 50s who was diagnosed with left transverse testicular ectopia after presenting with an empty right hemiscrotum and two testes-like masses in the left hemiscrotum.

Comparison of Surgical Outcomes Following Percutaneous Pedicle Screw Fixation and Traditional Open Pedicle Screw Fixation for Thoracolumbar Fractures Without Neurological Deficit.

Background: Traumatic thoracolumbar fractures are frequently encountered in blunt trauma patients. The Open pedicle screw fixation has been proven to be effective in stabilizing fractures, deformity correction, early mobilization and improving long term quality of life of patients with thoracolumbar fracture. Percutaneous pedicle screw fixation is a minimally invasive approach that minimizes the tissue injury, enhances early recovery and facilitates rehabilitation program.

A Case Report of a Rare Mesenteric Schwannoma: A Diagnostic Challenge.

Schwannomas, also known as neurilemmomas, are neurogenic, benign tumors of Schwann cells arising from peripheral nerve sheaths that may be present at almost any anatomical site. A primary mesenteric schwannoma is an extremely rare tumor, with only 12 cases reported in the literature to date. Preoperative diagnosis of mesenteric schwannomas is almost impossible because of the rarity of the case and their nonspecific symptoms.

Medication Adherence among Patients with Non-Communicable Diseases in a Tertiary Hospital: A Descriptive Cross-sectional Study.

Introduction: Non-communicable diseases (NCDs) are a leading cause of mortality, with a projected rise from 38 million in 2012 to 52 million by 2030. Among NCDs, hypertension, diabetes and Chronic Obstructive Pulmonary Disease are the major burdens in healthcare today, requiring long-term therapies and a significant effort in maintaining treatment adherence.

Methods: A descriptive cross-sectional study design was adopted to determine medication adherence among patients with non-communicable diseases using non-probability, consecutive sampling techniques after ethical approval from same institute (Reference number: 524).

Consensus recommendations for acute trauma care & outcomes in LMICs from the transdisciplinary research, advocacy & implementation network for trauma in India.

Background & objectives Injuries profoundly impact global health, with substantial deaths and disabilities, especially in low- and middle-income countries (LMICs). This paper presents strategic consensus from the Transdisciplinary Research, Advocacy, and Implementation Network for Trauma in India (TRAIN Trauma India) symposium, advocating for enhanced, system-level trauma care to address this challenge. Methods Five working groups conducted separate literature reviews on pre-hospital trauma care, in-hospital trauma resuscitation and training, trauma systems, trauma registries, and India's Towards Improving Trauma Care Outcomes (TITCO) registry.

Practicing Medicine Wisely: Routine Use of Urine Legionella in Suspicious Pneumonia - Are we Overdoing?

Legionella spp. is an underreported cause of Community Acquired pneumonia that affects significant population specially in urban areas and its prevalence is on an increasing trend. The routine practice of testing for urinary antigen of Legionella in all suspected cases of pneumonia is prevalent is resource rich western countries.

Elderly Patients at Risk of Malnutrition Presenting to a Tertiary Hospital in Nepal: A Descriptive Cross-sectional Study.

Introduction: The nutritional status of elderly people is crucial for healthy aging, enabling them to maintain productive lives and reduce the progression of chronic diseases. Given that the quality of life tends to decline with age, it becomes particularly crucial for elderly individuals. Therefore, this study was aimed to find out the prevalence of elderly patients at risk of malnutrition in a tertiary hospital.