Intracranial lipomas are rare benign tumour that is slow growing, generally asymptomatic, most frequently located in the midline areas and are usually an incidental finding on imaging and therefore cases are not frequently reported. This study reports a case of a patient with quadrigeminal plate lipoma presenting with obstructive hydrocephalous and the 6th cranial nerve palsy that was successfully treated with ventriculo-peritoneal shunting without addressing the lesion. Key words: Lipoma, quadrigeminal plate, the 6th cranial nerve palsy, hydrocephalus ABSTRACTArticle history:

Introduction: The issues of sexual and reproductive health (SRH) remain the leading cause of ill health among adolescents worldwide and are of growing concern in Nepal. The correct knowledge of condoms is integral part of SRH. The present study was carried out to assess and compare the knowledge about condoms among adolescents in the Kathmandu valley of Nepal. Aim: To study, assess and compare the knowledge about condoms among adolescents in the Kathmandu valley of Nepal. Methods: The study was a cross-sectional questionnaire-based survey. The sample was derived through cluster sampling of the secondary schools in the Kathmandu valley. Schools were selected randomly and two hundred and fifty adolescents were taken from each government and non-government high schools. Result: Altogether 500 adolescents were recruited for this study. A total of 298 (53.0%) participants said that condoms reduced pleasure. Most women don't like to use condoms was agreed by 291 (55.6%) people and it was statistically significant (p value < 0.05) when compared between males and females. Using condoms with new partner is a good idea was agreed upon by 448 (81.0%) participants. Women should ask their partners to use condoms was answered by 480 (88.1%) and discussing condom use with prospective partner is easy was agreed by 417(79.0%) and both the issues were also statistically significant (p value < 0.05). Conclusion: It was found that the knowledge about condoms was not adequate and the knowledge among male participants was in general better than females. Key words: Adolescents, Condom, Sexual and reproductive Health DOI: 10.3126/jnps.v30i1.2455 Journal of Nepal Paediatric Society Vol.30(1) 2010 18-22

INTRODUCTION: Access to hemodialysis is limited in Nepal due to geographical terrain and hemodialysis centers being mostly limited to major city. Therefore, continuous ambulatory peritoneal dialysis is likely to be a better option in Nepal. In 1998, CAPD was initiated in Nepal without success. High rate of peritonitis was cited for failure. Hot tropical climate and poor sense of hygiene among patients was thought to be responsible for the high rate of peritonitis. A new CPD program was started in 2002 in our institute. We reviewed the incidence of peritonitis and factors predisposing. METHODS: All chronic renal failure patients on CAPD since 2002 to 2007 were included in the study. They were followed up for complications and treatment outcome. Patients complicated with peritonitis (N=19) and patients without peritonitis (N=31) were compared. RESULTS: A total of 50 patients were enrolled and mean duration of dialysis was 12 month per patients (Total patients month=600). Twenty six episodes of peritonitis in 19 patients were recorded during this period. Fourteen episode of peritonitis were culture positive. Culture sterile peritonitis was recorded in 12 episodes. Low serum albumin was predisposing factors for peritonitis and peritonitis rate was higher in end stage disease related due to diabetes mellitus. CONCLUSION: Peritonitis rate was comparable in our new program. Thus peritonitis is not a limiting factor for growth of CAPD in Nepal. Hypoalbuminemic and diabetic patients are prone for CAPD related peritonitis.  KEYWORDS: continuous ambulatory peritoneal dialysis, Peritonitis, Peritonitis rate.

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Introduction: Accidental mushroom poisoning is constantly seen and regularly reported from all over world. Exact magnitude of problem and its clinical profile in Nepal is not well known. This study was done to evaluate clinical profile and treatment outcome of patients presenting with mushroom poisoning in the department of internal medicine, BPKIHS, Dharan. Methods: It is a prospective observational study conducted in department of internal medicine, BPKIHS, Dharan from 1st January 2008 to 31st December 2009. Informed consent was taken. All the patients were subjected to necessary laboratory investigation. They were followed up at 1 week and 1 month after discharge. Results: All together 60 patients were analyzed. Majority of subjects 56 (93.3%) were from rural areas. Vomiting and diarrhea were the two most common presentations seen in 56 (93.3%) subjects. The latent period for the symptoms were > 6 hours in 4 (6.7%) and < 6 hours in 56 (93.3%) subjects. Fulminant hepatic failure was seen in 6 (10%) subjects and among them 4 (66.7%) expired. After admission 3 (5%) subjects developed GI bleeding. Average duration of hospital stay was 4.6 days. In follow up recovery was complete in all subjects who survived the acute phase of poisoning. Conclusions: Especially in patients coming during rainy season mushroom poisoning should be considered in the differential diagnosis of acute gastroenteritis. Mortality is high in subjects with FHF whereas recovery is complete in subjects who survived the acute phase. Keywords: fulminant hepatic failure; gastroenteritis; mushroom poisoning; wild mushrooms.

Cough is one of the most common symptom for which patients seek medical attention from primary care physicians and pulmonologists. Although tuberculosis and other lung infections are common throughout the developing world, they are not among the most common causes of chronic cough. We report a case of a 23 years old male who presenting to the outpatient clinic with chronic cough not responding to regular and symptomatic treatment that was diagnosed to have thymoma. After all the common causes for chronic cough have been ruled out, unusual causes should also be considered in the differential diagnosis. KEYWORDS: Chronic cough, Thymoma, Anterior Mediastinum.

Introduction: Accurate determination of donor kidney function has important long-term implications for both donor health and recipient outcome. Many centers use 24 hour urinary creatinine clearance or creatinine-based GFR estimations to assess kidney function but their performance when compared with GFR measurements by isotope clearance remains inconclusive. We assessed the performance of creatinine based equations against DTPA GFR for evaluating Nepalese kidney donors.Methods: All kidney donors who had undergone both DTPA GFR estimation and 24 hour urine CrCl were included. The performance of the urine-CrCl, CG-CrCl, modified MDRD GFR against DTPA GFR was evaluated by analyzing global bias, precision (R2),Pearson correlation and accuracy percentage within 30% and 15%. The sensitivity and specificity of each predictive equation in selecting donor with GFR of ≥80 mL/min/1.73 m2 was also calculated.Results: Of 51 donors analysed, only 18 (35.29%) were male. The mean measured GFR was 102.752±16.71 mL/min/1.73 m2. Of all prediction equations, urine-CrCL has most precision (R2=0.207) with the highest pearson correlation (0.455) and highest accuracy percentage within 30% and 15%. However, predictive performance was poor for all the equations. The urine CrCl had highest sensitivity of 100% for detecting donor with measured GFR>80 mL/min/1.73 m2 with positive predictive value of 92.1%.Conclusions: The performance of all equations was disappointing and even the best performing equation urine-CrCl was suboptimal for donor selection. So considering the potential risk of living kidney donation, other more accurate methods of GFR estimation should be used._________________________________________________________Keywords: Cockcroft-Gault equation; creatinine clearance; glomerular filtration rate; modification of diet in enal disease formula; 99mTc-Diethylene-Triamine Pentaacetic Acid.