Introduction: Cervical cancer remains a major cause of morbidity and mortality in Nepal. Human Papillomavirus (HPV) infection is the primary etiological factor. This study aimed to determine the frequency of HPV infection among women attending a tertiary care gynecological outpatient department in Kathmandu. Methods: A cross-sectional study was conducted at Paropakar Maternity and Women’s Hospital over three months. A total of 185 married or sexually active women aged 30–60 years were enrolled. Cervical samples were collected and tested for HPV DNA, including high-risk genotypes HPV-16 and HPV-18. Sociodemographic and clinical data were collected. Data analysis was performed using SPSS v26, applying chi-square and ANOVA tests, with p < 0.05 considered significant. Results: Of 185 women, 172 (93.0%) were HPV negative. Thirteen (7.0%) tested positive: HPV-16 in 7 (3.8%), HPV-18 in 3 (1.6%), and other types in 3 (1.6%). HPV positivity was more frequent in women aged 50–59 years. We found that postmenopausal women were significantly more likely to have HPV infection than premenopausal women. No significant associations were found with parity, smoking, or age at marriage. Conclusions: HPV was detected in 7%, with HPV-16 being the most common genotype. These findings underscore the importance of strengthening screening and vaccination programs in Nepal.
Background: Esophageal Foreign Body (EFB) ingestion is a frequent emergency, particularly in children and neurologicallyimpaired adults. In resource-limited settings like Eastern Nepal, optimal anaesthetic management remains challenging due toinfrastructure constraints and lack of standardized protocols.Methods: This observational study at a Nepalese tertiary hospital analysed 40 EFB cases (ages 1 to 75 years) over two months.Using convenience sampling, we documented anaesthetic techniques, airway management and outcomes through structuredinterviews and medical records.Results: Paediatric cases comprised 55% of presentations. Coins (27.5%), chicken bones (17.5%) and fish bones (15%) weremost common, primarily lodged in upper esophagus (37.5%). Intravenous anaesthesia (60%) surpassed general anaesthesia(40%), with nasopharyngeal tubes (65%) preferred over endotracheal intubation (35%). Propofol (75%) and fentanyl (55%) weremainstay medications. Mean procedure duration was 15 to 20 minutes with Para oxygenation in 67.5% cases. Complication ratewas 17.5% (desaturation 10%, laryngospasm 5%).Conclusion: Resource-adapted anaesthetic approaches demonstrated safety in EFB removal, though technique variabilityhighlights need for standardized protocols. Findings support context-specific guideline development for low-resource settings.
ABSTRACT Keloids are fibroproliferative scars extending beyond the original wound margin and are more common in individuals with darker skin types. Eruptive keloids represent a rare clinical presentation characterized by the sudden development of multiple lesions. Only a few cases have been reported following varicella infection. We report a 15‐year‐old immunocompetent female who developed five painful and pruritic keloids over the jaw, chest, abdomen, and flank within 2 months of primary varicella infection. All lesions corresponded to healed varicella scars. Diagnosis was made clinically based on classical morphology. The patient was managed conservatively due to financial constraints, and lesions remained stable during follow‐up. Varicella‐induced inflammatory and profibrotic cytokine responses may contribute to aberrant wound healing. Clinicians should recognize this rare temporal association to ensure early counseling and appropriate management.
Background: Peptic ulcer perforation is a life-threatening surgical emergency traditionally associated with older adults, but its occurrence in young patients is increasingly recognized. Young adults may have distinct risk factors, clinical characteristics, and outcomes. Early diagnosis and prompt surgical intervention are essential to reduce morbidity and mortality. Aim: To evaluate the demographic characteristics, etiological factors, clinical presentation, surgical management, postoperative outcomes, and follow-up of patients younger than 30 years presenting with peptic ulcer perforation. Materials and Methods: This planned observational cohort study was conducted in the Department of General Surgery, Narayana Medical College and Hospital, Nellore, from June 2024 to December 2025. Thirty patients younger than 30 years with clinically and radiologically diagnosed peptic ulcer perforation, confirmed intraoperatively, were included. Demographic details, risk factors, clinical findings, investigations, site and size of perforation, degree of contamination, operative procedure, postoperative complications, hospital stay, ulcer healing, recurrence, and mortality were assessed. Results: Among 30 patients, 21 (70%) were males and 9 (30%) were females. The majority belonged to the 25–30-year age group (46.67%). Smoking was the most common risk factor, reported in 70% of patients, followed by alcohol use (40%), H. pylori positivity (36.67%), and NSAID use (23.33%). Abdominal pain and abdominal rigidity were present in all patients, while vomiting occurred in 63.33%. Preoperative shock was present in 10%, and free gas on X-ray was detected in all patients. Duodenal perforation was predominant (76.67%), while gastric perforation accounted for 23.33%. All patients underwent Graham’s omental patch repair, with a mean operative duration of 73.5 ± 15.15 minutes. Postoperative pain showed significant improvement from a mean VAS score of 7 ± 1.74 on postoperative day 1 to 3.47 ± 1.25 on day 7 (p<0.001). Surgical site infection occurred in 6.67%, wound dehiscence in 6.67% during the first week, and 36.67% required ICU admission. The mean hospital stay was 7 ± 1.74 days. Ulcer healing was achieved in 96.67%, with no recurrence or incisional hernia during follow-up. Overall mortality was 3.33%. Conclusion: Peptic ulcer perforation in young adults predominantly affects males and is commonly associated with lifestyle-related factors, particularly smoking and alcohol use. Duodenal perforation was the predominant anatomical presentation. Early recognition, prompt surgical intervention, and Graham’s omental patch repair resulted in favorable postoperative outcomes, high ulcer-healing rates, low complication rates, and minimal mortality. Preventive strategies addressing modifiable risk factors may help reduce the burden of peptic ulcer perforation among young adults. Keywords: Peptic ulcer perforation; Young adults; Graham’s patch repair; Helicobacter pylori; Surgical outcomes
Introduction:Hydatid cyst of the liver is a zoonotic disease caused by the larvae of Echinococcus granulosus. It is endemic in countries like South America, Africa, Asia, and China. Giant hepatic hydatid cysts are rare in children and carry a higher risk of complications. We report a similar case of a giant hepatic hydatid cyst in an 8-year-old child managed successfully with laparoscopic surgery. Case presentation:An 8-year-old boy from a remote village of Nepal presented with fever, upper abdominal pain, and a sensation of heaviness in the abdomen for 6 months. Imaging revealed a giant hepatic hydatid cyst measuring 12.6 cm × 11.3 cm × 10.7 cm on the right lobe of the liver. The child underwent laparoscopic partial pericystectomy and recovered well. Postoperative albendazole therapy was continued, and there was no evidence of recurrence at 3 months of follow-up. Discussion:Hydatid disease commonly affects the liver in adults and lungs in children, with giant cysts posing a high risk of rupture, infection, and other complications. Imaging with ultrasonography and computed tomography is essential for diagnosis. Surgery remains the mainstay of treatment, with laparoscopic techniques offering faster recovery, smaller incisions, and fewer complications. Postoperative albendazole therapy and regular follow-up are crucial. This case highlights the effectiveness and safety of laparoscopic partial pericystectomy in a child, even in resource-limited settings. Conclusion:Laparoscopic surgery is a safe and effective option for managing giant hepatic hydatid cysts in children, even in resource-limited settings. Early diagnosis and intervention are crucial to reduce morbidity, mortality, and recurrence.
