B.P. Koirala Institute of Health Sciences, Dharan, Nepal, is the only tertiary care referral centre in the eastern region of Nepal. This paper discusses the author's experience of starting a plastic surgery unit in eastern Nepal regarding need and present status of plastic surgery care in Nepal. Methods. We analyzed the data of patients treated in Plastic surgery unit from July 2007 to February 2009. We did evaluation regarding type of patients, procedures, and their outcome. We also evaluated the limitations and their possible solutions to overcome the barriers to establish effective plastic surgical centers in developing countries. Results. Plastic surgery services were started as a unit in general surgery by single plastic surgeon and one general surgery resident on rotation. Total 848 patients were treated for different plastic-surgery-related conditions, which included 307 acute burn patients 541 general plastic surgery patients. Trauma constituted the major bulk 22%, followed by tumors 20%, while aesthetic surgery operations were only 10.1%. Conclusions. In developing countries, aesthetic procedures constitute very small part of plastic surgery interventions and plastic surgery units are primarily required for reconstructive needs for optimum management of patients.

Background:The malar bone represents a strong bone on fragile support and its processes - frontal, orbital, maxillary and zygomatic are frequently the site of fracture. Current study was done to compare the stability of zygomatic complex fracture using Biodegradable plates and titanium miniplates with one point fixation.Materials and Methods:Twenty patients of zygomatic complex fracture were randomly selected and divided in two groups which were further divided into two subgroups (A, B). Group I patients were treated with titanium miniplate at zygomatic buttress and Group II was treated by bio-resorbable plates. One point fixation was done either at zygomatic buttress or at frontozygomatic suture and it was observed that both the site have been the most favored site of rigid internal fixation in terms of stability, aesthetics and prevention of rotation of the fracture segment in either vertical or horizontal axis.Conclusion:There is no significant difference in post operative outcomes between two groups, but still bioresorbable system has some advantage over titanium system as these plates resorbs over a period of time and does not cause any interference with growth and post operative radiotherapy. However application of biodegradable system demands highly précised technique.

Background: There is an increasing trend in prevalence of hypertension worldwide. Studies have shown that tribal populations in India are also experiencing this transition. Objective: To know the prevalence of hypertension in tribal population of India. Method: A literature search PubMed, Google scholar databases from January 1980-December 2019 using the MeSH (Medical Subject Heading)-prevalence, hypertension, tribal, adult population, India, cross-sectional studies was conducted. Out of the total 96 published studies which reported the prevalence of hypertension in Indian tribal population, 21 were included in the review. Data Extraction: All the data were extracted by the investigators using a standardized protocol and data collection form. Result: Total twenty-one studies with sample size varying from 154 to 47,401 were included in the review. The reported prevalence of hypertension in tribal populations varied from 10% to 55.5% in different regions and states of India. The prevalence of hypertension in males was higher than females. Increasing age, body mass index, smoking, diabetes and extra salt intake were common risk factors. Conclusion: The prevalence of hypertension in Indian tribal population is as high as other urban and rural populations and needs preventive measures to control the problem.

Even though many studies tested and found Hawan altering biome by killing pathogenic bacteria, fungus, and viruses. Studies are required to further validate its effect on load of viruses, its infectivity and if it can reduce occurrence of flu-like illnesses and their complications. In view of SARS-CoV-2 pandemic and its potential of community spread, one of the measure to curtail community spread may be Indian traditional mass fumigation technique of Hawan, which is considered as cultural practice for health and well being by offering ingredients of medicinal values in to fire. Such processing of specific ingredients through fire is considered turning them to nano-particles and act to alter biome. This paper reviews existing research evidences and suggests future mode of studies on viruses. This also highlights dearth of research capacity for estimation of virus content from the open air samples and the need to strengthen it through potential/ proposed technologies

Background: Increasing aggression and violent behaviors in adolescents present serious challenges for public health. Children with persistent high levels of aggressiveness are often associated with developing conduct disorders later in life. Objectives: (1) To identify aggression among school adolescents. (2). To find out the association of aggression with different socio-demographic characteristics among these students. Methods: It was a school based cross sectional study conducted in one of the private schools in Raipur, Chhattisgarh. Study population comprised of 319 adolescents studying in classes 9 th-12 th. A pre-tested, semi-structured, self-administered questionnaire was distributed to the study subjects. For assessing aggression, a modified version of Direct and Indirect Aggression Scale (DIAS) was used. Data was analyzed by using frequency tables and significant association was established by chi-square test. Result: A large proportion of adolescents scored high on each item of aggression scale. Males adolescents displayed significantly higher levels of aggressiveness as compared to female. Younger age showed higher level of aggressive scores than older age groups. Adolescents who were Hindus and had nuclear families with educated parents were found to have high aggressive scores as compared to other religion and joint families. However, these differences were not statistically significant. Conclusions: There is high aggression level among school adolescents which needs effective preventive and management strategy.

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Prevention of risk factors and management of Noncommunicable diseases are possible and their complications can be prevented by early diagnosis but due to unavailability of diagnostic facilities at cheaper rates most of the patients remains undiagnosed in rural setting. However, validity of such device is important before its use in these areas.Objective: To generate validation data using Mobile Lab (Labike & Suitcase model) to check its sensitivity and specificity against gold standard methods. Material and Methods:A cross-sectional comparative study was conducted among 824 participants, aged 18 years and above in rural catchment area of the department. Pre-tested questionnaires were used. For the Biochemical investigations blood samples were collected and were divided into two parts for each parameter. One part of the blood sample was kept for the Mobile lab investigations whereas another part was transported to a tertiary care teaching institution for the estimation. The comparison of the results was done through the CLIP range of total Allowable error to define the acceptable limits. Bland and Altman plots are also used for describing the agreement between two quantitative measurements.Result: Biochemical estimation were done for total 18 parameters in which Uric Acid, Creatinine (-9.39%), Total Bilirubin (19.8%) SGOT (16.3%), SGPT (-17.6%), ALP (-14.7%), HDL (16.7%), Triglycerides (-16.8%) and Phosphorus (-10.3%) were within allowable limits. Conclusion:Mobile lab is acceptable for most of the any biochemical parameters and can be used as the point of care device for diagnostic purpose with certain correction required for the measurement of Electrolyte panel and Direct Bilirubin test.