Clinical Profile and Endoscopic Management in Patients with Choledocholithiasis.

Background: Common bile duct stones is a common medical problem that are usually seen in association with gallstone disease. Endoscopic management of Common bile duct stones involves doing Endoscopic retrograde cholangiography for bile duct clearance which is the primary therapeutic modality of choice. This prospective study was done to identify the clinical characteristics and outcome of patients presenting with Common bile duct stones undergoing Endoscopic retrograde cholangiography.

Feasibility and acceptability of outpatient medical induction at 13-18 weeks' gestation in public sector hospitals in Nepal: a prospective cohort study.

Purpose: To evaluate the feasibility and acceptability of outpatient medical induction at 13-18 weeks' gestation to limit overnight hospital stays.

Methods: In this prospective cohort study, participants with 13-18-week pregnancies seeking abortions at two government hospitals swallowed mifepristone 200 mg and self-administered misoprostol 400 mcg buccally 24-48 h later, 1-2 h before returning to the outpatient clinic (OPD). Repeat misoprostol was dosed every 3 h until expulsion.

Neurotoxicity and acute renal injury secondary to Russell's viper bite in an individual: a case report from Nepal.

Introduction And Importance: Owing to the high number of envenomation and fatalities, the Russell's viper holds greater medicinal significance than any other Asian serpent. South East Asia is one of the most snakebite-prone regions in the world. Dense population, extensive agricultural practices, the abundance of venomous snake species, and an overall lack of knowledge about primary treatment (first aid) are the major culprits associated with snake bite-related morbidity and mortality.

Goat milk as the connecting link in dengue and brucella coinfection.

In areas with widespread prevalence of myth of goat milk as a platelet booster, the goat milk can be connecting link in dengue and brucella coinfection.

Vasculitis, an Early Unusual Presentation of Rheumatoid Arthritis: A Case Report.

Rheumatoid arthritis (RA) is a chronic inflammatory disease, with rheumatoid vasculitis (RV) being its most threatening complication. We report a case of a 70-year-old female presenting with gangrene of the tips of fingers and toes early in the course of RA, which is a rare manifestation. The skin is the most commonly affected organ in RV, followed by the peripheral nerves.

A decisive lifesaving tool in submassive pulmonary embolism: Bedside echocardiography.

Key Clinical Message: Immediate thrombolysis in submassive pulmonary embolism on the basis of bedside echocardiography can be a lifesaving decision in areas where computed tomography (CT) pulmonary angiogram is not readily available.

Abstract: Bedside echocardiography can be a rapid diagnostic and decision-making tool for immediate thrombolysis in submassive pulmonary embolism with evidence of progressively failing ventricles. We report a case of submassive pulmonary embolism in a 26-year-old male under testosterone replacement therapy, who was successfully thrombolyzed based on bedside echocardiography findings.

Natural killer cell T-cell lymphoma (nasal type), a rare and aggressive type of non-Hodgkin's lymphoma: Case report.

In the sinonasal tract, diffuse large B-cell lymphomas are the predominant type non-Hodgkin's lymphoma while natural killer (NK) cell T-cell lymphoma, the nasal type, constitute only 3%-12% of NHLs in this region and is the more aggressive subtype. NK cell T-cell lymphoma mostly occurs in male at the median age of 50 years and has got a poor prognosis with a 3-years overall survival (OS) of 46.3% and a 5-years OS of 42%.

Road Traffic Accidents among Patients Visiting Department of Emergency of a Tertiary Care Centre: A Descriptive Cross-sectional Study.

Introduction: Road Traffic Accidents, are one of the major neglected global health burdens which are predicted to be the 7th leading cause of global deaths by 2030 as per the World Health Organization hence, seem to be one of the major global threats in near future. Most road traffic accidents affect the most vulnerable age groups in developing countries. The aim of this study was to find out the prevalence of road traffic accidents among patients visiting the Department of Emergency of a tertiary care centre.

Diabetic Ketoacidosis among Diabetic Patients Admitted in the Department of Medicine of a Tertiary Care Centre: A Descriptive Cross-sectional Study.

Introduction: Diabetic ketoacidosis is one of the most severe acute complications of diabetes mellitus characterised by hyperglycemia, hyperketonemia, and metabolic acidosis. Prompt diagnosis and treatment of diabetic ketoacidosis can decrease severity, hospital stay, and possible mortality. This study aimed to find out the prevalence of diabetic ketoacidosis among diabetic patients admitted to the department of medicine of a tertiary care centre.

Counterfeit Healthcare Products: Nepal at a Vulnerable Position.

Unlabelled: Nepal stands in a vulnerable position when it comes to counterfeit medicines as two of its major trade partners countries are leading producers of falsified healthcare products. The impacts that it can lead to are a lower standard of healthcare delivery to the public, increased cost of treatment, antibiotic resistance, and even fatality. The time of crisis as the Coronavirus disease 2019 pandemic is often seen as an opportunity to endorse substandard products in greater amounts.

Acquired Lymphangiectasia of the Scrotum Successfully Treated with Radiofrequency Ablation: A Case Report with Dermoscopic Review.

Lymphangiectasia is dilatation of normal superficial lymphatic vessels due to damage or obstruction of deep lymphatic vessels leading to increased lymphatic pressure and engorgement of dermal lymphatics due to varying causes. Lymphangiectasia clinically presents as thick-walled, translucent vesicles and papules with chronic lymphedema rarely involving the scrotum. Here we report a patient with acquired lymphangiectasia of the scrotum secondary to surgery for hydrocele successfully treated with radiofrequency ablation.

Pattern of Deaths among Women of Reproductive Age in Major Autopsy Centres of Capital Cities of the Seven Provinces of Nepal.

Background: The females in the reproductive age group are vulnerable to injuries and diseases. There is no reliable evidence of the pattern of deaths in reproductive age group females from Nepal. This study was conducted to explore the patterns of deaths of females of the reproductive age group in Nepal.

Successful management of delayed presentation of massive paracetamol overdose in a resource-limited setting: A case report from Nepal.

We present a case of self-poisoning with a massive dose of paracetamol by a young Nepalese female patient who presented late to our emergency department. This report highlights the successful management of the patient with the extended use of N-acetylcysteine over 4 days and continuous supportive therapy as required. The case is an example of the management of delayed presentation of a massive paracetamol poisoning in a resource-limited setting, where intensive care units and hemodialysis facilities are not easily available.

Prevalence and clinical characteristics of headache among medical students of Nepal: A cross-sectional study.

Background: Headache is a common neurological disorder, with a global prevalence of around 50%. It may affect people of any age, gender, education, socioeconomic status and occupation. Tension headache, migraine headache and cluster headache are commonly encountered headache types.

Mayer-Rokitansky-Kuster-Hauser Syndrome: A rare case report from Nepal.

Introduction: Mayer-Rokitansky-Kuster-Hauser Syndrome (MRKHS) is a rare congenital disorder with an incidence of 1 in 5000 females. It is characterized by uterovaginal aplasia with normal secondary sexual characteristics and genetic karyotype 46XX. The exact etiology of MRKH syndrome is not known.

Filariasis diagnosed by real-time ultrasound scanning as filarial dance sign - A case report.

Introduction: Lymphatic filariasis (LF) is a vector-borne illness caused due to Wuchereria bancrofti. Genital abnormalities may result from chronic inflammation of the lymphatic vessels and obstruction of the afferent vessels in Bancroftian filariasis. Doxycycline, albendazole, diethylcarbamazine, and ivermectin are among the treatments available.

Adverse Events following Immunization with COVID-19 Vaccines: A Narrative Review.

Numerous COVID-19 vaccines are being administered to people around the world. Adverse events following immunization (AEFI) with COVID-19 vaccines have been reported by health care workers as well as surveillance bodies. A wealth of information on the efficacy and safety of vaccines exists in the literature, and the knowledge in this sector is growing exponentially.

Adverse Events Following the First Dose of Immunization of COVID-19 Vaccine.

Background: The COVID-19 pandemic has challenged the entire globe and the need for a vaccine is supreme. Since many vaccines along with Covishield have been granted emergency use authorization, the evaluation and monitoring of safety are crucial. Covishield was rolled out in Nepal on January 27, 2021.

Intestinal Obstruction among Patients Admitted in the Department of Surgery of a Tertiary Care Centre: A Descriptive Cross-sectional Study.

Introduction: Although intestinal obstruction is a very common surgical emergency, there is a dearth of evidence regarding its prevalence at our institute. The objective of this study is to find out the prevalence of intestinal obstruction among patients admitted to the Department of Surgery of a tertiary care centre.

Methods: A descriptive cross-sectional study on a total of 6735 admitted patients' in Department of Surgery a tertiary care centre was conducted from 1st January, 2014 to 31st March, 2015.

Prevalence of rheumatic heart disease in South Asia: A systematic review and meta-analysis.

Introduction: Most countries in South Asia are endemic for rheumatic heart disease (RHD). We aimed to estimate the pooled prevalence of RHD in South Asia from population-based screening studies.

Methods: A systematic strategy was developed and used to search online databases for articles which described the prevalence of RHD in the South Asia region.

Case Report: Medicolegal evaluation in a pediatric case of fatal scald injury from rural Nepal.

Thermal injuries in young children involving the buttocks, perineum, and lower limbs raise suspicion of child abuse. Determining the manner of death and ruling out homicide in a fatal case of scalding remains a challenge for forensic practitioners. In the present article, the medicolegal evaluation in a case of fatal scald injury involving a two-year-old child from rural Nepal is discussed.

Isolated Gall Bladder Perforation in a Tertiary Care Hospital in Eastern Nepal: A Descriptive Cross-sectional Study.

Introduction: Cholelithiasisis is a common surgical problem worldwide. Gall bladder perforation is a rare life-threatening complication with considerable mortality. This study aims to find the etiology, demography, type of perforation, and outcome of gall bladder perforation.

Outcome of treatment of MDR-TB or drug-resistant patients treated with bedaquiline and delamanid: Results from a large global cohort.

The World Health Organization (WHO) recommends countries introduce new anti-TB drugs in the treatment of multidrug-resistant tuberculosis. The aim of the study is to prospectively evaluate the effectiveness of bedaquiline (and/or delamanid)- containing regimens in a large cohort of consecutive TB patients treated globally. This observational, prospective study is based on data collected and provided by Global Tuberculosis Network (GTN) centres and analysed twice a year.