Assessing Drug Utilization in the Emergency Medicine Department at a Tertiary Care Teaching Hospital Using WHO Drug Use Indicators.

Background Patients might need urgent care in critical cases. Limited resources and limited manpower are limitations seen in developing countries. Very few studies have been conducted on drug utilization in the emergency department in Nepal.

Ultrashort segment adult Hirschsprung disease: A case report of periodic abdominal distension and constipation spanning for more than 20 years.

The diagnosis of adult Hirschsprung disease (HD) is rare, furthermore there are only 3 or 4 cases of adult ultrashort segment HD (USHD) reported previously in English literature to our knowledge. Herein, we present a case of a 22-year-old female presented with long standing history of constipation and abdominal distension secondary to USHD. Imaging modalities included plain abdominal X-ray, ultrasound (USG) and computed tomography (CT) scan which collectively aided in establishing the diagnosis.

Overweight among Medical Students of a Medical College.

Introduction: Overweight and obesity are rapidly increasing worldwide, posing a significant global health challenge. Medical students are at a higher risk of developing obesity due to factors such as a sedentary lifestyle, inadequate physical activity, unhealthy eating patterns, elevated stress levels, and the extensive amount of information they need to learn. The aim of this study was to find out the prevalence of overweight among medical students of a medical college.

Sepsis among Neonates Admitted to a Neonatal Intensive Care Unit in a Tertiary Care Centre.

Introduction: Neonatal sepsis is a condition that carries a high risk for mortality as neonates rapidly transition to extra-uterine life and are subjected to various risk factors. Sepsis prevalence can be reduced by good antenatal care, early detection and treatment of risk factors. The study aimed to find out the prevalence of sepsis among neonates admitted to a neonatal intensive care unit in a tertiary care centre.

Non-Communicable Diseases among Women of Reproductive Age Visiting the Department of Obstetrics and Gynecology of a Tertiary Care Hospital.

Introduction: Non-communicable diseases are a significant cause of mortality worldwide, posing a substantial risk to women's health, as stated by the World Health Organization. In Nepal, a survey revealed that 10.5% of the population suffers from hypertension.

Rare case of coexisting hepatic, splenic, and vertebral hemangiomas - A case report.

Synchronous existence of hepatic, splenic, and skeletal hemangiomas has not been reported previously in the English literature to our knowledge. In this case report, we present a case of coexistence of hepatic, splenic, and skeletal hemangiomas in a 30-year-old woman with on and off bilateral lumbar region pain and no significant past medical history. Radiological investigations, including ultrasound and computed tomography and magnetic resonance imaging helped identify the synchronous existence of hepatic, splenic, and skeletal hemangiomas.

Induction of Labour among Pregnant Women in the Department of Obstetrics and Gynaecology in a Tertiary Care Centre.

Introduction: Induction of labour is the artificial initiation of uterine contraction by various means such as medical, surgical or mechanical with the aim of achieving vaginal delivery. Misoprostol, a prostaglandin E1 analogue is used popularly for the induction of labour in resource-limited health centres. The aim of the study was to find out the prevalence of induction of labour among pregnant women in the Department of Obstetrics and Gynaecology in a tertiary care centre.

Low-Birth-Weight among Term Newborns Born to Anaemic Pregnant Women Admitted to the Department of Obstetrics and Gynecology in a Tertiary Care Centre.

Introduction: Anaemia is one of the most common conditions which affects a significant proportion of pregnant women worldwide. These patients may have adverse effects on both the mother and the developing fetus. Detecting and timely treating anaemia in pregnancy help in the overall improvement of maternal and fetal health.

Neglected case of recurrent abdominal pain due to a chronically retained and broken double J (DJ) stent following percutaneous nephrolithotomy (PCNL): A case report.

Double J (DJ stent) is commonly used in urology practices. Short- and long-term complications of indwelling catheters are increasingly noted resulting in significant morbidity and at times mortality. Retained and broken DJ stent is however rare complication with few cases reported in the literature.

Chicken bone-induced ileal perforation peritonitis mimicking duodenal perforation peritonitis: a case report.

Introduction: Foreign body ingestion can lead to bowel perforation and peritonitis. We present a case of a 54-year-old male who ingested a chicken bone, resulting in ileal perforation that mimicked duodenal perforation peritonitis.

Case Presentation: The patient has a history of peptic ulcer disease and regularly used non-steroidal anti-inflammatory drugs over the counter, adding more evidence to the provisional diagnosis of duodenal perforation.

Spontaneous extradural hematoma in a Sickle cell Beta Thalassemia patient-A rare complication.

Spontaneous extradural hematoma in Sickle cell disease is rare neurological complication with few cases reported in the English literature. We report a case of a 16-year-old male patient who was previously diagnosed with Sickle Cell Beta Thalassemia and presented with severe headache and vomiting for 3 days. An emergency CT scan of the head demonstrated right-sided acute parietal extradural hematoma with mass effect.

Interaction with Patients as a Budding Doctor: An Experience.

Unlabelled: Every medical student amidst COVID-19 missed out on an integral part of medical education which is interaction with patients as all the physical classes were postponed for months. Effective interaction with patients is the heart of medicine and it provides a synergistic effect on the delivery of high-quality care to the patient. However many medical students underestimate the art of communication.

An Experience as a Medical Support during the COVID-19 Pandemic.

Unlabelled: In the midst of the COVID-19 pandemic, volunteering enabled us to support people facing difficulties in locating healthcare facilities. Working as a medical support volunteer allowed us to interact closely with patients. We assisted them by providing information on the availability of hospital beds, intensive care unit beds, ventilators and oxygen cylinders.

Attending Training Workshop of BLS/ACLS.

Unlabelled: From the beginning of day one in medical school, students are always looking for ways to do something practical and skilled based instead of just reading a textbook. Having said that, learning a skill to save a life is the most fascinating thing. Although as a student, they may not have to attend to the patient, they could be present in accidents outside of the hospital, where they should be able to perform the necessary actions to save a life.

Prevalence and Factors Associated with Tobacco Use among High School Students.

Background: Tobacco use is the leading cause of morbidity and mortality worldwide. Tobacco use among school-level students is a growing a public health problem in Nepal. A number of factors may be associated with tobacco use, but there is lack of literature showcasing an in-depth understanding of the growing prevalence of tobacco use in the Nepalese context.

GeneXpert Based Confirmed Cases among Suspected Cases of Tuberculosis in a Tertiary Care Centre: A Descriptive Cross-sectional Study.

Introduction: Tuberculosis is an infectious disease caused by Mycobacterium tuberculosis mostly affecting the lungs. Due to the low sensitivity of conventional microscopy and time-consuming culture method, Nucleic acid Amplification Assay Technique is preferred because of its rapidity and sensitivity. This test also helps in finding drug resistance to Rifampicin and also curtails the transmission of disease.

A study of Deep Neck Space Infections at Kathmandu University Dhulikhel Hospital.

Background Enhanced recovery after surgery is a multimodal strategy, used to attenuate the loss and improve the restoration of functional capacity after surgery. Now widely used in elective surgery, the implementation of all of its components is not feasible in emergency surgery. Therefore, its tailored protocol is likely to give better outcome.

Functional Outcomes of Arteriovenous Fistulas Created by Nephrologist.

Background Preoperative accurate staging of gallbladder cancer is still difficult. A number of patients with gallbladder cancer who undergo laparotomy for curative resection are ultimately found to have unresectable disease. The benifit of staging laparoscopy is its ability to find out the radilogical occult intraperitoneal metastasis and to spare from nontheraputic laparotomy.

An Unusual Case of Tetanus Masquerading as an Acute Abdomen: A Case Report.

Introduction: Tetanus is an acute onset neurological disease that is often lethal. It has a high disease burden in low and middle-income countries. Tetanus is caused by a toxin made by spores of the bacterium Clostridium tetani, which are found in soil, dust, and animal feces.

Gallbladder schistosomiasis - a rare presentation as gallbladder polyp: a case report.

Schistosomiasis is a neglected tropical disease second to malaria in prevalence with significant morbidity and mortality. Although, Schistosomiasis can affect multiple organs, gallbladder involvement is very rarely reported. We present a case of isolated gallbladder schistosomiasis in a 20-year-old female presenting as gallbladder polyp radiologically and also correlated the histopathological findings which to our knowledge has never been reported in the English literature.

Recombinant zoster vaccine (Shingrix): a new option for the prevention of herpes zoster and postherpetic neuralgia.

Postherpetic neuralgia (PHN) is a challenging condition for pain management specialists. The prevention of herpes zoster (HZ) and subsequent PHN in individuals aged 50 years and older, via the development of new vaccines, is an ongoing research project. The live zoster vaccine (LZV, Zostavax) was the first proof of concept that vaccination could prevent HZ, but LZV cannot be used in various immunecompromised patients.

Prevalence of Antiretroviral Therapy Use among HIV/AIDS Patients in a District Hospital.

Introduction: Prevention of Human Immunodeficiency Virus infection is a high priority for the government of Nepal, so the government has been scaling up Anti Retroviral Therapy centers throughout the country. The objective of our study was to find out the prevalence of people living with Human Immunodeficiency Virus infection on Anti Retroviral Therapy service.

Methods: This descriptive cross-sectional study was done in Lamjung district hospital, from May 2017 till August 2017 after taking ethical clearance from the institutional review committee.

Genital filariasis presenting as a vaginal wall cystic lesion.

Vaginal cystic lesions are rare incidental findings detected during physical examination and imaging. To our knowledge, filariasis as a cause of vaginal cystic lesions has not been previously reported in the English literature. We present vaginal cystic lesion which posed diagnostic dilemma and was confirmed on cytology to being filarial in etiology.

A case report of visceral leishmaniasis and malaria co-infection with pancytopenia and splenomegaly - a diagnostic challenge.

Background: Leishmaniasis and malaria are tropical diseases with more than half of the world population at risk of infection resulting in significant morbidity and mortality. Co-infection of Leishmaniasis and malaria pose a great challenge in the diagnosis as well as overall management.

Case Presentation: In this case report, we present a rare case of a 5 years old child hailing from non-endemic region of Nepal with history of fever for a period of 3 months who was diagnosed as co-infection of malaria due to Plasmodium vivax and visceral Leishmaniasis with pancytopenia that subsequently improved after a course of treatment.

Microvascular Decompression in Patients Aged 30 Years or Younger.

Objective: The aim of this study was to identify the etiology of hemifacial spasm (HFS) and trigeminal neuralgia (TN) in patients aged 30 years or younger and to examine the efficacy of microvascular decompression (MVD).

Patients And Methods: Between 1996 and 2012, 228 HFS and 190 TN patients underwent MVD at Atsuchi Neurosurgical Hospital. Of these, 7 patients were 30 years of age or younger at the time of treatment (HFS: n = 6, TN: n = 1).