Background & Objectives: The most common etiology of neck pain is degenerative disc disease, however non-degenerative disease can be important cause of neck pain. This study aims to study the non-degenerative findings in cervical MRI in symptomatic patients with neck and radicular pain.Materials & Methods: The study was a institutional record based retrospective study performed for the duration of 3 years. MRI performed for patients with neck pain and/ or radiculopathy were reviewed. Patients with post operative findings were excluded from the study. Statistical analysis was done using SPSS 21.0.Results: A total of 721 MRI were performed for neck pain and radiculopathy, among which 91 (12.13%) cases had non-degenerative changes. Most common non degenerative change was traumatic lesions followed by neoplastic lesions and syrinx. Traumatic lesions were more common in males as compared to females. Infection was more common in females as compared to males. C5 and C6 vertebrae were most common vertebra involved in trauma and infection. Some cases like signal change in spinal cord, and syrinx were also noted in our study.Conclusion: Non degenerative cause of neck pain were less common but important cause of neck pain. Traumatic lesions were the most common cause of non degenerative neck pain.Journal of College of Medical Sciences-Nepal, Vol.11(4) 2015: 20-23

Background: Inadequate fruit and vegetable intake and other adverse dietary habits -along with tobacco and alcohol abuse and sub-optimal physical activity -make up the four most important behavioural risk factors of non-communicable diseases. Low fruit and vegetable intake is particularly associated with burden of high cardiovascular disease. It has received more attention in the last decade, with studies that explore disparities and determinants in their intake, as well as interventions that attempt to improve the intake. Objectives: Our study aimed to determine fruit and vegetable consumption in a peri-urban community of Nepal and to compare this intake in relation to various socio-demographic variables. Methods: This cross-sectional study was conducted as a part of the HARDIC (Heart-Health Associated Research and Dissemination in the Community) study in the Jhaukhel-Duwakot Health Demographic Surveillance Site in the Bhaktapur district of Nepal during September-December 2011. Adults from six randomly selected clusters were interviewed by 12 trained interviewers after taking informed consent. WHO-STEPS questions were used to elicit information on fruit and vegetable intake. Results: Fruit and vegetable intake in the community was low with 2.1 percent of the study population consuming the WHO-recommended fi ve servings per day. There were differences in the intake according to the various sociodemographic factors. Conclusions: Our study reaffi rms low fruit and vegetable intake as a public health problem in the Nepalese context. Health-promotional activities aimed at specifi c target groups are essential. Multi-sectoral coordination of health and other health-related sectors is therefore vital in addressing the issue.

Nepal is also affected by Corona Virus Disease (COVID-19) pandemic which is likely to last for several months. The Reverse Transcriptase-Polymerase Chain Reaction is the current gold standard diagnostic test. Chest X-ray or Computed Tomography scan is considered inappropriate according to most society recommendations for screening though are emerging as frontline diagnostic modalities in conjunction with clinical history and laboratory parameters.Multiple guidelines have been released by prominent radiological societies worldwide to facilitate preparedness of radiology department in the war against COVID-19. Based on these, the Nepal Radiologists’ Association has proposed its guidelines, endorsed by the Nepal Medical Council, practical in our context, with the aim to limit exposure to the infection while ensuring best use of imaging, protection of health care personnel and other patients and maintenance of uninterrupted radiology department operations.This review article aims to summarize the highlights from various guidelines focusing on role of chest X-ray and Computed Tomography including the indications, specific findings, reporting format and important differentials and also addresses the safety issues.

Introduction: Laparoscopic cholecystectomy is one of the most common operation performed. Though LC have become safer and easier at times it can be difficult. Difficult cases can result in prolonged operative time, bleeding, bile spillage, conversion to open technique and bile duct injury resulting in unplanned prolonged hospital stay, increase in estimated cost to the patients and for the surgeon it leads to increased stress during operation and time pressure to complete the operative list. . Identification of difficult cases has potential advantages for surgeons, patients and their relatives. We aim to develop and validate a scoring system to predict difficult LC preoperatively. Methods: Prospective study. History, physical examination, abdominal ultrasound and biochemical parameters were included to develop a scoring system. Hundred patients undergoing LC were included and preoperative scores were calculated preoperatively to predict difficult LC which was compared with operative assessment. Results: Sensitivity and specificity of the preoperative scoring for difficult case was 53.8 % and 89.2 % respectively with PPV of 63.64 % and NPV of 84.62%. Only three parameters (history of acute cholecystitis, gall bladder wall thickness and contracted gall bladder) were statistically significant to predict difficult LC individually. Area under ROC curve was 0.779 (95 % CI, 0.657-0.883). Conclusions: Preoperative scoring system can be used to predict difficult LC. Surgeons can plan operation based on predicted difficulty. Patients and relatives can be counselled preoperatively for the possibility of difficult operation, prolonged hospital stay and increased cost in predicted difficult case. Keywords: difficult cholecystectomy; laparoscopic cholecystectomy; symptomatic cholelithiasis.

Background: There is a high risk of occupational exposure to tuberculosis among healthcare workers in endemic countries. Regular screening for tuberculosis among healthcare workers is not carried out in Nepal. Infection control measures are also not routinely implemented. The aim of this study was to determine the prevalence of active tuberculosis among staff/students at Patan Hospital.Methods: Participants were given a self-administered questionnaire and invited to undergo chest radiography. Cases were scored and reviewed based on predetermined criteria, and presumptive tuberculosis cases were invited to undergo sputum smear and culture. Participants were categorized according to the extent of patient contact and asked about history of tuberculosis medication. Results: Among 560 participants, 76.8% had direct contact with patients. Fifty-eight (10.4%) gave history of cough >2 weeks. Based on symptom history and chest radiography, 20.0% (n=112) cases were reviewed, and 12.5% (n=14) of those reviewed had sputum tested for acid-fast bacilli. One participant had culture-positive tuberculosis. Fifty participants (8.9%) reported tuberculosis in the past, among which 42.0% (n=21) occurred after employment at Patan Hospital and 42.0% before joining Patan Hospital. Security staff, radiology technicians and ward cleaning staff had the highest proportion of cases with a history of tuberculosis.History of tuberculosis medication had no relation with age, sex, education, body mass index and smoking.The incidence rate of tuberculosis at Patan Hospital was 3.6 per 1000 person-years.Conclusions: Overall incidence of tuberculosis among healthcare workers is noteworthy. However, this study suggests when symptomatic tuberculosis occurs in healthcare worker at Patan Hospital, it is diagnosed and there is not a large pool of undiagnosed tuberculosis.