Bir Hospital (बीर अस्पताल) is the oldest and one of the busiest hospitals in Nepal. It is located at the center of Kathmandu city. The hospital is run by the National Academy of Medical Sciences, a government agency since 2003.The hospital provides medical and surgical treatments. It current has a capacity of 535 beds.[citation needed]It provides some post graduate medical training e.g. general surgery, internal medicine, orthopedic surgery, pathology etc.
Multiple sclerosis (MS) is the most common demyelinating disease of the CNS and disproportionately affects younger individuals, yet it remains underdiagnosed and undertreated in many low and middle-income countries. We describe key barriers to timely diagnosis and effective management of MS in Nepal, including limited public and clinician awareness; restricted access to neurologic care, MRI, and essential laboratory testing; and the high cost of long-term treatment. We also outline practical, context-specific adaptations such as simplified diagnostic pathways, use of affordable immunosuppressive therapies, and sustained advocacy by the Multiple Sclerosis Society of Nepal to improve access and affordability. Our experience illustrates pragmatic, low-cost strategies that may support more equitable MS care in resource-constrained settings.
Cytopathology in Nepal has expanded considerably over recent decades, playing a key role in the diagnosis of both malignancies and infectious diseases. This article reviews the historical evolution, current practices, specimen types, processing techniques, and reporting systems in Nepal. It also outlines cytopathology training, workforce development, and cervical cancer screening initiatives. Despite this progress, access to advanced ancillary techniques such as immunocytochemistry and molecular testing remains limited, with reliance on referral laboratories. Ongoing challenges include resource constraints, uneven infrastructure, and limited subspecialty training opportunities. Strengthening diagnostic capacity through expanded infrastructure, quality assurance, and targeted training will be essential for future growth. Due to limited published data, some observations are based on the authors' experience.
Background: Diaphyseal fractures of the femur constitute approximately 1.6% of skeletal trauma encountered in the pediatric population. While historical management emphasized prolonged immobilization via traction and spica casting, contemporary practice increasingly favors operative stabilization to accelerate functional recovery and mitigate complications associated with extended recumbency. Among children aged 6–14 years, treatment options include secondary spica application, elastic stable intramedullary nailing (ESIN), submuscular plating, or external fixation for open injuries. This investigation assesses clinical and radiographic outcomes following stainless steel flexible intramedullary nailing for displaced femoral shaft fractures within this age cohort. Methods: This is a retrospective study of 30 patients in the age group of 6-14 years with displaced femoral shaft fractures that were fixed with stainless steel flexible intramedullary nail under fluoroscopy at Narayani hospital Birgunj. Patients were followed clinically and radiologically for six months. The results were evaluated using Flynn’s criteria. Technical difficulties and complications associated with the procedure were also analyzed. Results: Excellent outcomes were achieved in 18 cases (60%) and satisfactory results in 12 (40%), with no poor outcomes. The mean patient age was 9.5 years. Road traffic accidents were the predominant injury mechanism (60%), and middle-third fractures were most common (66.7%). The mean hospital stay was 10 days, and all fractures achieved radiographic union at an average of 10 weeks. Entry-site soft tissue irritation occurred in 5 patients. Three cases demonstrated mild malalignment with an average limb length discrepancy of 0.5 cm; all remained asymptomatic and required no revision surgery Conclusion: Flexible intramedullary nailing provides a minimally invasive, growth-sparing fixation method with a high rate of excellent outcomes and a low complication profile in children aged 6–14 years. Larger multicenter studies with extended follow-up are recommended to further validate long-term functional results.
Background: Breast cancer considered as most common, is a leading cause of cancer related death among women worldwide. Early diagnosis and appropriate surgical management are important to improve patient outcomes. There are two primary surgical approaches for early breast cancer treatment: modified radical mastectomy and breast-conserving surgery. This study was conducted with the objectives of assessing and comparing the efficacy and oncological outcomes of breast-conserving surgery and modified radical mastectomy in patients with breast cancer at a tertiary cancer centre in Nepal. Methods: A retrospective cross-sectional study was designed including data from patients who underwent breast conserving surgery and modified radical mastectomy at Bhaktapur Cancer Hospital, Nepal, from year 2012 to 2018, with the follow up period of at least 5 years postoperatively. Results: A total of 200 patients were included in the study, with the mean age of 44.1 ± 10.3 years in breast conserving surgery group and 50.1 ± 12.6 years in modified radical mastectomy group. The operation time (69.65 ± 9.05 vs 115.5 ± 20.81) min, incision length (49.5 ± 7.05 vs 108.6 ± 14.07) mm, intraoperative blood loss (37.5 ± 14.96 vs 45.6 ± 8.44) ml, and complication rate (5% vs 20%) were significantly less in BCS group than in MRM group. Furthermore, significant difference was not observed in the local recurrence rate, distant recurrence rate, disease-free survival, and overall survival at 1 and 5 years postoperatively between the BCS and MRM groups. Conclusion: BCS is as effective in the treatment of early breast cancer as MRM; however, it offers less operation time, incision length, blood loss, and complication rate than MRM. Keywords: breast cancer; breast conserving surgery; modified radical mastectomy.
Multiple sclerosis (MS) is the most common demyelinating disease of the CNS and disproportionately affects younger individuals, yet it remains underdiagnosed and undertreated in many low and middle-income countries. We describe key barriers to timely diagnosis and effective management of MS in Nepal, including limited public and clinician awareness; restricted access to neurologic care, MRI, and essential laboratory testing; and the high cost of long-term treatment. We also outline practical, context-specific adaptations such as simplified diagnostic pathways, use of affordable immunosuppressive therapies, and sustained advocacy by the Multiple Sclerosis Society of Nepal to improve access and affordability. Our experience illustrates pragmatic, low-cost strategies that may support more equitable MS care in resource-constrained settings.
