Civil Service Hospital

Acute pancreatitis (AP) is a gastrointestinal disorder frequently associated with gallstones, hypertriglyceridemia, and alcohol use. Drug-induced pancreatitis has been documented in the medical literature, with various medications implicated as potential triggers. We report a case of a 31-year-old man with hypertension who presented with severe upper abdominal pain and was diagnosed with AP. Extensive diagnostic evaluation excluded common causes, pointing towards losartan. Symptomatic management and cessation of losartan led to improvement. This is a rare instance of losartan-induced AP. The patient experienced symptoms after a year of use, suggesting that pancreatitis can occur at any time during therapy. The underlying mechanisms are unclear; however, they might include decreased bradykinin breakdown leading to localized pancreatic duct angioedema. This highlights the importance of differentiating drug-induced pancreatitis from idiopathic causes. This case highlights the importance of considering pancreatitis in differential diagnosis, particularly in patients lacking typical risk factors.

ABSTRACTPruritic erythroderma is not always psoriasis. Resistant cases require a broad evaluation for cutaneous lymphoma. Early, timely diagnosis prevents disease progression, improves outcomes, and enhances quality of life, highlighting the need for re‐evaluation when conventional treatments fail.

Background:Unsafe abortion is a major contributor to maternal mortality in low- and middle-income countries. Despite the legalization of abortion and expanded access to services in Nepal, data on abortion practices and patient satisfaction remain limited.Objective:This study aimed to assess abortion methods, their management, and patient satisfaction among women seeking safe abortion services at a tertiary care hospital in Kathmandu, Nepal.Design:A hospital-based cross-sectional study.Methods:The study was conducted from December 2023 to May 2024 among 285 women aged ⩾18 years with gestational age of up to 12 weeks. Data were collected through face-to-face interviews and clinical records, followed by 7-day post-abortion assessment via in-person visits or phone calls. Pearson’s chi-square test and binary logistic regression were performed at a 5% level of significance to identify factor associated with patient satisfaction.Result:Among 285 women, 76.8% underwent medical abortion with oral mifepristone followed by misoprostol via sublingual, buccal, or vaginal routes, while 23.2% received surgical abortion through vacuum aspiration after misoprostol pre-treatment and local anesthesia. Discharge medications commonly included analgesics (paracetamol and ibuprofen) and antibiotics (ciprofloxacin, and metronidazole). Post-abortion contraceptive uptake was 79.3%, with implants (28.8%) and condoms (28.4%) being the most chosen methods. Overall, 50.2% of women reported satisfaction with the abortion services received. Logistic regression analysis showed that higher education (AOR: 5.63; 95% CI: 2.40-13.16), extended family structure (AOR: 7.25; 95% CI: 3.11-16.91), and no history of live birth (AOR: 4.20; 95% CI: 1.48-11.93) were significantly associated with higher satisfaction, while age ⩾35 years was negatively associated (AOR: 0.52; 95% CI: 0.28-0.95).Conclusion:Medical abortion was the preferred method, and overall management was aligned with WHO guidelines. However, patient satisfaction was moderate. Improving infrastructure, ensuring privacy, reducing waiting times, enhancing post-abortion counseling, and providing tailored health education with regular service evaluations are needed to improve the quality of abortion care and patient satisfaction.

Anthropometric measurements of the external ear provide valuable normative data for applications in clinical practice, reconstructive surgery, forensics, and ergonomics. As ear morphology varies by population, sex, and age, population-specific reference data are essential. This study aimed to determine the normal dimensions of the outer ear among adult patients. A cross-sectional study was conducted from 8th to 28th September 2025 among 157 adult patients (82 males and 75 females) visiting the hospital with normal external ears. Standardized auricular measurements, including auricular height, auricular width, lobular height, and lobular width, were obtained bilaterally using a digital vernier caliper following established anthropometric landmarks. Data were analyzed using descriptive statistics to calculate the mean and standard deviation. The mean right and left auricular heights were 63.38 ± 6.19 mm and 63.13 ± 6.49 mm, respectively, while auricular widths were 33.81 ± 6.26 mm (right) and 33.82 ± 6.23 mm (left). Minimal bilateral asymmetry was observed. Males exhibited greater auricular height and width, whereas females showed marginally larger lobular dimensions. Lobular height demonstrated greater variability than width across both sexes. The study revealed strong bilateral symmetry in external ear measurements, with clear sexual dimorphism-males having larger auricular dimensions and females slightly larger lobules. This finding provide baseline data for Nepalese adults and hold relevance in forensic identification, prosthetic design, and reconstructive surgery. Further large-scale, multiethnic studies are recommended to validate and expand upon these findings.

Role of professional organisations is to set and promote standard, ultimately creating professional and personal excellence in supportive environment. Nepal Ophthalmic Society (NOS) plays crucial role in advancing ophthalmology in Nepal through education, research, and advocacy. Established in 1985 AD to promote professional development and enhance health care delivery, NOS has grown from handful of ophthalmologists, to 504 members and 50 associate members (2024 November 20). To assess perspectives of ophthalmologists on impact, activities, and role of NOS. To prepare framework for future to strengthen its organisation with happy members. A cross-sectional survey was conducted among ophthalmologists in Nepal from 2024 May to 2024 July using structured questionnaire. The survey assessed their perspectives on NOS's impact, activities, and role in advancing ophthalmology. Data were collected through online surveys, ensuring a representative sample of practising ophthalmologists across Nepal. The study included 309 ophthalmologists and residents. Majority were young (60.1% aged ≤40 years) and female (54%). Most participants (49.52%) believed primary function of NOS was professional development, followed by advocacy, and public awareness (34.73%). The mean satisfaction rating for NOS's role was 5.6 ± 1.85 out of 10. The major challenges faced by ophthalmologists in Nepal included low salary and financial difficulties (25.72%) as well as poor residency training and lack of surgical exposure (22.51%); 75.56% of respondents considered misuse of 'Doctor" title by non-ophthalmologists a significant issue, with most suggested solutions being press releases and public awareness campaigns (63.43%), followed by notifying regulatory bodies (39.62%) Conclusion: The NOS has been significantly contributing to professional development, advocacy, and skill enhancement in Nepal. Key challenges include low salaries, inadequate surgical training, and misuse of 'Doctor" title. Strengthening membership outreach, advocating professional rights, and addressing concerns will enhance NOS's impact and ensure its long-term sustainability in shaping Nepal's ophthalmology landscape.

Background and objectives: Penile rings are constriction devices used to enhance erection by limiting venous outflow. Here, we present a case of neglected Penile Rubber Ring in man with penile swelling following foreskin retraction. Presentation of Case: A case of a 62-year-old man who presented in our surgical OPD with sudden penile swelling and pain. Surgical intervention was done with the operative finding of a penile rubber ring inserted 14 years back, which had remained asymptomatic. It was kept for sexual enhancement. The ring was removed, and the patient had an uneventful postoperative period with full recovery. Discussion: The chronic presence of the penile rubber ring led to sebum accumulation and local inflammation, predisposing him to sudden penile swelling and pain. Early surgical intervention was critical in preventing further complications. Conclusion: This case suggests the importance of considering retained foreign bodies in patients presenting with penile swelling and the need for early surgical intervention to prevent it’s consequences.

Introduction: Low back pain (LBP) is defined as pain that occurs between the area of costal margin and gluteal fold. Low back pain is one of the common musculoskeletal health problems occuring mostly in nurses. Different research has shown that the association between low back pain and nurses is because of various factors. Disability because of pain leads to decreased quality of life for nurses and ultimately leading to decreased quality of patient care. This study was conducted to find the prevalence and associated factors of low back pain among nurses of Nepal Police Hospital. Methods: The descriptive cross-sectional study was done among nurses of various departments of Nepal Police Hospital. An email with a questionnaire was sent to the participants, and responses were recorded. Rolland Morris Disability Questionnaire (RMDQ-11 item) was used to assess disability related to low back pain. Statistical Package for Social Sciences (SPSS) 26 was used for the analysis of data. Descriptive statistics (percentage and frequency) and inferential statistics (chi-square) were used for the statistical analysis of the study. Significance level of P-value was taken as <0.05. Results: Out of 67 respondents, all were females, and the majority 41 ( 61.2 %) in the age group of 20-30 years and 37.3% were between the age group 30-40 years. Respondents were mostly from the medicine ward and ICU, accounting for 22.4 %. Mean service years was 7.9 ± 5.6 years. Low back pain prevalence was 74.6 %, and 60% of nurses had pain for less than 12 months. The mean RMDQ score was 3.6 ± 2.8. Low back pain was significantly associated with marital status, number of duty hours and working area (p<0.05). Conclusions: High prevalence of low back pain was seen among nurses of Nepal Police Hospital. It was more common among married nurses, working in the medicine department, and working > 60 hours a week. Most had a low disability as per RMDQ. Rest alleviated back pain in most of the cases. Only few had practice of doing back exercises at preventive measure.