Background: Hypertension (HTN) is a major risk factor for cardiovascular and renal diseases. The prevalence of hypertension has substantially increased during the past four decades. Information on prevalence as well as awareness regarding treatment and prevention of hypertension is scarce particularly in rural settings. The levels of awareness, treatment, and control of HTN vary between different countries and population groups. Objectives: The objective of this study was to find out the awareness of hypertensive patients about their own disease and self care. Methodology: Descriptive cross sectional study was conducted among 50 hypertensive patients who were admitted to Tribhuvan University Teaching Hospital (TUTH) and attended to medical OPD. Data was collected by using interview schedule by face to face interview method. Results: Among 50 hypertensive patients, 56% were aware about meaning of hypertension, 68% symptoms, 34% cause, 62% prognosis, and 62% complication of HTN. Likewise regarding self care, 70% were doing regular follow up, 92% using regular medication, most of them (80%) were not smoker and 84% were non alcoholic, and 74% taking low fat and low salt diet. Conclusion: Study finding reflects many of them (56%) had more than 50% of knowledge about the hypertension and more than half (54%) were giving more than 50% emphasis about their own self care.

A Prospective study of 30 cases of type III open fractures of tibia is conducted at Nepal Medical College, Kathmandu and Nobel Medical College, Biratnagar from 2009 to 2011. All cases included in the study were initially managed by wound debridement and external fixation, and followed-up regularly for 10 months for outcome. Five cases developed deep infection and 10 had superficial infection, which subsided with prolonged use of antibiotics. Union was obtained in 7 to 8 months for 28 cases. Two cases resulted in non- union which had been managed by bone grafting. Open Type III fractures of tibia are still a difficult and challenging problem for orthopedic surgeons. Almost all cases are required for twice surgery including secondary closure, skin grafting and readjustment.

Anger as an emotional reaction involves both physical and psychological changes in our health. Despite of common emotional reactions, it can create many physical and psychological disturbances and diseases as well. So, information regarding its management is helpful to learn some of the simple skills to control it. There cannot be a single cause of the anger. Heredity factors, home environment, social learning and cultural factors are important factors for its emergence. Behavioral techniques and cognitive restructuring techniques are found to be effective methods in controlling anger reaction if practiced properly and systematically. They are effective only if practicing therapist or psychologist is equipped with these skills. It cannot be done jus reading an article in the books. Key Words: , ,

Background: The symptoms of anxiety are widely prevalent among the former opioid addicts in methadone maintenance treatment (MMT). It is clinically important to be aware of the severity of the co-morbidity as it plays a crucial role in the methadone dosage, length of time in treatment and the relapse rate and the co-existence of co-morbidity has been described as the factor which worsens the prognosis. Aim: to study the prevalence of the symptoms of anxiety among MMT clients Methods: a descriptive, survey and a cross- sectional study, 60 MMT clients were selected who had been attending the MMTP for more than 2 months and were given with semistructured proforma specifically designed for this study only. Then after, they were evaluated for the anxiety symptoms with Beck Anxiety Inventory (BAI). Finally, the information obtained from the demographic profile and the rating scale were analyzed with the help of computer program SPSS. Results: The study showed around 41.7 % of the patients had symptoms of anxiety with varying severity. Correlates of presence of anxiety symptom among MMT client in the present study showed higher prevalence among age group 20-29(88%), 66% were separated and 64% were unmarried, 50% were Buddhist, majority of the case were chhetri (70%), 75% had primary level education, 67% were unemployed, and 65% from middle class socioeconomic status. Limitation: The study was a cross sectional, which showed only the symptoms of anxiety not the disorder and the drug use, withdrawals itself, could distort evaluation and lead to misdiagnosis of anxiety. Conclusion: The major risk factor for was male gender, separated, primary education level, students and middle socio-economic status.

Phytochemicals, that is, chemicals present in various plants and herbs , are now becoming important candidates for development of drugs.Wide range of medicinals plants {Plants from which potential photochemicals are isolated for development of drugs for treatment of diseases}present in South Asian countries have now been increasingly utilized for development of phytomedicines. Treatment with ethanol extract of leaf of Cajanus indicus Spreng at a dose of 50 mg /kg body weight for 20 days, after induction of hepatotoxic damage by CCl4, produce significant elevation of the hepatic injury. The liver marker enzymes like(Aspartate Transaminate) AST, GGT(Gamma Glutamyl Transferase), ALT(Alanine Transaminase) and ALP(Alkaline Phosphatase) decreased significantly at the above dose showing the optimum effect against hepatic damage. The liver antioxidant enzymes SOD, catalase, glutathione peroxidase, glutathione reductase and glutathione transferase and the membrane damaging indicators TBARS(Thiobarbituric Acis Reactive Species), conjugate diene and marker of glutathione status indicate the mechanism of healing action to be due to scavenging of free radicals or ROS. The results thus gives a confirmatory proof that the healing action of ethanol extract of leaf of Cajanus indicus Spreng is for shifting of equilibrium from the peroxidant to antioxidant side and the leaf acts as a natural antioxidant and healer of CCl4 induced hepatotoxicity.

Schizophrenia is a serious, disabling, often lifetime condition, which can produce severe functional impairment in patients. The life time morbidity risk for schizophrenia is estimated to be 1% and account for 2.8% of the total global YLDs. The World Health Organization Assessment Instrument for Mental Health Systems report of 2006 done in Nepal states in Nepal states that 12% of the patients are diagnosed as schizophrenia in out-patient mental facilities, 14% in community based psychiatry inpatient units and 34 % in mental hospital . Atypical antipsychotics are the first line agents recommended for the treatment of schizophrenia considering better efficacy at least in the negative symptoms and better side-effect profile compared with typical antipsychotic. Haloperidol has been used as a standard comparator in numerous trials and new drugs have been compared to it to establish their efficacy, and safety profile. As the authors could not find out any such study which had compared the safety profile of quetipine against conventional antipsychotic, hence this present study is purposed to carry as an attempt to address this issue among Nepalease population.

Background: Capsule endoscopy (CE), is a superior non-invasive tool in the diagnosis of suspected small bowel lesions to conventional modalities. This study has been carried out with the aim to share the experience and to evaluate the efficacy of OMOM CE. The objectives have been set to find out and compare the diagnostic yields of the CE for obscure gastrointestinal bleeding (OGB) and unexplained abdominal pain and/or diarrhea and also to see the cost effectiveness and quality of the CE. Methods: OMOM CE examination was conducted in consecutive 46 admitted patients presented with suspected small intestinal lesions over a period of one year. The indications were OGB, unexplained abdominal pain and diarrhea. Results: Abnormal findings were revealed in 42 out of which 36 subjects revealed significant abnormal findings in small bowel. Overall diagnostic efficacy of the CE was 80% and Diagnostic yield was significantly higher for OGB (26/27) in comparison to unexplained abdominal pain and/or diarrhea (96.30% vs 55.55%, P < 0.001). Angioectasia was the major finding for OGB cases. No complications were observed with the CE examination. Conclusion: OMOM CE has high diagnostic yield for OGB and unexplained abdominal pain or diarrhea and effectiveness is comparable with Pillcam CE.

A baby girl was born with severe deformity of left knee. Clinically and radiologically she was diagnosed as congenital dislocation of left knee. Gentle manipulation followed by above knee POP slab corrected the deformity in three weeks. A follow up at the age of 6 months showed normal position and range of motion of the knee. We are reporting this case for its rarity. Early recognition requires simple intervention only.

Objective: To assess the efficacy, safety and cost effectiveness of Misoprostol (Prostaglandin E1 analogue) as a single dose of 800μg in first trimester abortion Methods: A descriptive study was conducted in Nobel Medical College and Teaching Hospital from June 2010-June 2011 where 110 patients were enrolled for first trimester abortions including incomplete, missed, blighted ovum. Each woman received a single dose of 800μg of Misoprostol intravaginally and the the process of abortion was monitored to assess the outcome measures. Results: Successful abortion was seen in 102 patients (92.7%) with induction to delivery interval of < 24 hours and the remaining 8 (7.2%) of them had to undergo surgical evacuation. Side effects noted were lower abdominal pain, fever, nausea, vomiting, and diarrhoea. Mean hospital stay of the patients was 48 hours. Conclusion: Misoprostol is a safe, cost effective and efficacious drug for first trimester abortion even as a single dosage.

A baby girl was born with severe deformity of left knee. Clinically and radiologically she was diagnosed as congenital dislocation of left knee. Gentle manipulation followed by above knee POP slab corrected the deformity in three weeks. A follow up at the age of 6 months showed normal position and range of motion of the knee. We are reporting this case for its rarity. Early recognition requires simple intervention only.

Background: Hypertension (HTN) is a major risk factor for cardiovascular and renal diseases. The prevalence of hypertension has substantially increased during the past four decades. Information on prevalence as well as awareness regarding treatment and prevention of hypertension is scarce particularly in rural settings. The levels of awareness, treatment, and control of HTN vary between different countries and population groups. Objectives: The objective of this study was to find out the awareness of hypertensive patients about their own disease and self care. Methodology: Descriptive cross sectional study was conducted among 50 hypertensive patients who were admitted to Tribhuvan University Teaching Hospital (TUTH) and attended to medical OPD. Data was collected by using interview schedule by face to face interview method. Results: Among 50 hypertensive patients, 56% were aware about meaning of hypertension, 68% symptoms, 34% cause, 62% prognosis, and 62% complication of HTN. Likewise regarding self care, 70% were doing regular follow up, 92% using regular medication, most of them (80%) were not smoker and 84% were non alcoholic, and 74% taking low fat and low salt diet. Conclusion: Study finding reflects many of them (56%) had more than 50% of knowledge about the hypertension and more than half (54%) were giving more than 50% emphasis about their own self care.

Patients with diabetes mellitus have 2 to 4 times increased risk for cardiovascular disease than non-diabetic patients. However this excess risk is not fully explained by the traditional cardiovascular risk factors (Hypertension, Hypercholesterolaemia, Smoking and Obesity) which are also associated with diabetes. Fibrinogen has been identified as an independent risk factor for cardiovascular disease and it is associated with traditional cardiovascular risk factors. Studies done in the Caucasians have shown fibrinogen to be higher in diabetic than the non-diabetic patients. Elevated fibrinogen in diabetic patients may be responsible for the increased cardiovascular risk in those patients. Elevated fibrinogen is also associated with increased mortality in general population. Key word: Fibrinogen ,

Background: The study aimed to study knowledge, attitude and practice of husband and factors affecting in supporting activities during pregnancy, delivery and postpartum period at Khairahani VDC of Chitwan district. The general objective of the study was to identify husband’s involvement in making safe pregnancy, delivery and postpartum period. Methods: A cross sectional, descriptive and non-experimental study design was conducted using quantitative methods. Sampling method was purposive and study population was father of fewer than one year age group children. Data was collected using structured questionnaire by interview method. Results: Majority of husbands had low knowledge about support during pregnancy, delivery and postpartum period while activities did for support was very negligible regardless of knowledge. Most of the husbands don’t know about danger signs during pregnancy. Very low level of knowledge was found about birth preparedness, emergency obstetric conditions during delivery period. Husbands took decision regarding place of delivery in majority. Half of the respondent’s don’t know about complications during postpartum period. Education level was found to be non-supporting factor for knowledge of support during pregnancy. Education of husband increased the knowledge of birth preparedness during pregnancy. Family size has influence the support during postpartum period. There was no association between income of husband and support provided during delivery. Conclusion: The knowledge level of support was found to be low during pregnancy, delivery & postpartum period along with supporting activities. Similarly there was low knowledge of emergency obstetric condition; danger signs during pregnancy and post-partum period. The practice of birth preparedness was found to be unsatisfactory regardless of knowledge.

Background: Appropriate utilization of maternal health care services is very important to reduce the maternal morbidity and mortality rate in the country and healthful practices while caring mother is needed to improve the health condition of both mother and child. Objectives: Main objectives of this study is to assess the utilization of Maternal health care services and know the cultural practices about care of mother and children of under one year of children. Methodology: Descriptive cross sectional study was conducted among 248 mothers of less than one year children on Belbari VDC of Morang district. Data was collected by using quantitative (house hold survey) and qualitative (focus group discussions and key informant interview) methods. Results: Among 248 mothers, 84% utilized the antenatal care services, 91% received TT vaccine during pregnancy. Most of them 80% had done delivery in health institutions. Conclusion: Based on proposed objectives of study, Utilization of maternal health care services should be encouraged in Belbari VDC of Morang District and healthful practices should be reinforced in areas where corrections are needed.

Iron deficiency anaemia is one of the most dangerous and devastating causative form of malnutrition in developing countries, where special care should be taken from the health community to address the problem in South East Asian countries, 1.3-2.2 billion population is affected according to world health organization. Fifty percent of women and children and 60% of gross anemic women of developing nations have been adversely affected till date. The most common cause of iron deficiency anaemia is due to inadequate intake of iron in diet, physiologic demands of pregnancy and rapid growth and loss due to parasitic infections. Other prevalent causes of anaemia include malaria, chronic infections and nutritional deficiencies of vitamin A, folic acid and Vitamin b-12. The study reveals that 25.57 % of patients have been suffering from iron deficient anemia.