Background: Increasing smartphone use among adolescents in todays' world has made this handy device an indispensable electronic tool, however, it comes at a price of problematic overuse or addiction. We aim to investigate the prevalence of smartphone addiction among undergraduate medical students and explore its association with various demographic and personal factors. Methods: A pool of 250 undergraduate students completed a survey composed of socio-demographics information, smartphone-use related variables and 10-point Smartphone Addiction Scale-Short Version in February 2019. Results: Smartphone addiction among medical students was estimated at around 36.8% with higher percentage of male smartphone addicts. Phubbing was reported by 37.6% participants with more than 60% reporting overuse. Statistically significant association was observed between smartphone addiction and gender and overuse. Self-acknowledgement of addiction was found to be the biggest predictor of smartphone addiction. Conclusion: This study provides preliminary insights into smartphone use, smartphone addiction and various factors predicting smartphone addiction among early undergraduate medical students from Nepal, which should be extended in future studies. Education policymakers and educators need to develop some strategies encouraging student's smartphone utilization to enhance academic performance.

Background Pilonidal sinus is commonly seen at the sacrococcygeal region and few other sites, usually located at the midline, at areas where hairs collect or near protuberances or some adjacent rubbing surfaces. Its presence elsewhere is uncommon. We share an interesting case of a recurrent discharging sinus from the cheek bulge of a male which turned out to be a pilonidal sinus containing tuft of hairs on exploration and wide excision. Case presentation A 37 years old hirsute male presents to us with a non-healing discharging sinus at the bulge of the cheek. Exploration after a course of antibiotics showed 2 subcutaneous cavities with tuft of hairs. The area was excised along with a margin, thorough irrigation and curettage was done and the wound was closed primarily; a Z-plasty was incorporated in the central part to break the resultant suture line. Histopathological examination was done to confirm the diagnosis and rule out an off-midline dermoid cyst or an underlying/coexisting malignancy. Post-operative course was uneventful. The patient has been recurrence free for 1.5 years and is satisfied with the nature of the scar. Conclusions Pilonidal sinus of the cheek bulge is an extremely rare entity. Complete excision and clinical suspicion are important for cure of this nagging ailment, especially at unexpected areas.

Background: Hepatobiliary system has many variations. Use of cadavers, intraoperative data and various imaging modalities are the commonly employed techniques for determining the anatomy of intrahepatic bile ducts. The vivid picture of hepatobiliary system is a must for hepatobiliary surgery and identification of frequency distribution of typical and atypical pattern and different types of atypical pattern are vital. This study aimed to uncover its frequency distribution and also to recognize the variations therein. Methods: An observational study was conducted in the Department of Anatomy, Kathmandu Medical College Teaching Hospital from July 2013 to June 2014 by taking 50 complete human cadaveric livers without evidence of injuries or previous operations. Livers were dissected, duct traced, colored, photographed and the findings were entered in a proforma. Results: Out of 50 dissected livers, 32 showed typical pattern (Type A, 64%) whereas 18 liver showed atypical pattern of confluence (36%). The type B pattern was seen in 6 (12%) and type C was seen in 8 of them (16%). Of these 8 cases, subtype C1 was observed in 6 livers (12%) and subtype C2 was found in 2 livers (4%). Type D was seen in 3 livers (6%). and all of them were of the subtype D1. There were no cases of subtype D2 and of type E. Type F was observed in a single case (2%). Conclusions: An accurate knowledge of the anatomical variations of the intrahepatic biliary tree is important for a successful hepatobiliay surgery.

Background: Menarche is a milestone for adolescent girls. The age of menarche is influenced by genetic, social status, place, race, ethnicity, nutritional and physical activity. There have been many studies on age at menarche but very few in this part of the country. This study aimed to assess the age of menarche and Body mass index among school going adolescent girls in Bharatpur Metropolitan city Chitwan. Methods: Total participants of 163 adolescent girls in this cross-section study were chosen from three private schools of Bharatpur Metropolitan city during June-September 2021. A pre-tested self-administrated questionnaire for menarche and anthropometric measurements were carried out for body mass index. The data were then entered to Statistical Package for Social Science (IBM SPSS, version 20) for the analysis. Results: The study revealed that the age at menarche ranged from 10-14 years of age. BMI of students ranged from 14.68-40.26 with 47.2% of the study population being a healthy weight. Girls having the habit of exercise/yoga attained menarche at 12years or after 12 years whereas girls having no habit had their menarche before 12 years of age. Conclusions: Our finding from the present study forms a baseline to estimate the mean age of menarche. Physically, inactive adolescents were more likely to see menarche earlier than the average age. Many girls were seen overweight as well. Regular exercise and a healthy life style need to be promoted among school going adolescent.