Varicella Pneumonia in an Immunocompetent Middle-aged Adult Male: A Case Report.

Varicella pneumonia is uncommon among adults and can present as potentially life-threatening complications of varicella. Here we report a case of a 43-year-old man with no known history of chronic disease and no allergic history who presented to our hospital emergency department with widespread skin eruptions over the entire body and hemoptysis. Varicella pneumonia was diagnosed based on the patient being in contact with his 6-year-old son who had contracted chickenpox 10 days back, typical cutaneous lesions, pulmonary symptoms and radiographic findings. The patient was treated with oral acyclovir and was admitted to the intensive care unit for monitoring. The patient recovered completely after 10 days of treatment. Keywords: chickenpox; pneumonia; skin eruptions.

Higher Termination of Brachial Artery in Cadavers in the Department of Anatomy of a Medical College: A Descriptive Cross-sectional Study.

INTRODUCTION: The main blood supply for arm is provided by the brachial artery. It shows variation in branching and termination patterns in some individuals. Variation in brachial artery may cause difficulties during various clinical and surgical procedures. The present study aims to find out the prevalence of higher termination of brachial artery in cadavers in the department of anatomy of a medical college. METHODS: A descriptive cross-sectional study was carried out from 10th January 2020 to 20th April 2021 after the ethical approval was taken from the Institutional Review Committee of Nobel Medical College (reference number: IRC-NMCTH 280/2020). The study was done in 58 upper limbs of 29 properly embalmed cadavers. Convenient sampling was done. They were carefully dissected. The level of termination of brachial artery was noted. The length of the brachial artery and the distance between its termination and the intercondylar line of humerus was recorded. RESULTS: Higher termination of brachial artery was observed in 3 (5.17%) extremities; one (1.72%) at middle third of arm and two (3.45%) at lower third of arm. In 52 (89.66%) extremities, the site of termination was at the level of neck of radius. The brachial artery terminated a few centimeters below its usual site at the level of upper part of shaft of the radius in 3 (5.17%) extremities. CONCLUSIONS: The prevalence of higher termination of brachial artery in cadavers is slightly lower than the studies performed in similar settings. It is not an uncommon finding. It may have impact on clinical and surgical procedures.

Pes Planus Foot among the First and Second Year Medical Students of a Medical College: A Descriptive Cross-sectional Study.

INTRODUCTION: Foot is a complex segmented structure formed by the articulation of 26 different bones which are held together by multiple ligaments, extrinsic tendons and the intrinsic muscles of the feet. The assessment of median longitudinal arch serves as an important reference in determining the degree of pes planus or pes cavus. This study aims to find the prevalence of pes planus among the undergraduate medical students of a medical college. METHODS: A descriptive cross-sectional study was carried out in the first- and second-year undergraduate medical students of a teaching hospital after taking ethical approval from Institutional Review Committee. The study was conducted from 15th November 2019 to 14th November 2020. Eighty-seven participants were involved in study using the random sampling technique. Foot prints were collected from the participants in the A4 size paper after applying ink over plantar surface of the foot. Measurements were done using the Autodesk Autocad software. Statistical Package for the Social Sciences was used. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. RESULTS: Out of the total subjects, 14 (8.04%) (5.14-10.94 at 95% Confidence Interval) presented with flat foot. Similarly, high arched foot was seen in 29 (16.67%) of subjects whereas normal arched foot was seen in 131 (75.29%) subjects. CONCLUSIONS: From the current study we conclude that the prevalence of pes planus was slightly higher than that compared with the similar studies.

Prevalence of Retrocaecal Appendix among Patients with Appendicitis in A Tertiary Care Hospital of Nepal.

INTRODUCTION: Appendicitis is one of the most common causes of acute abdomen. The clinical presentation of appendicitis and its susceptibility to acute inflammation may be affected by the length and position of vermiform appendix. Length and position of appendix are variable. The aim of the study was to find the prevalence of retrocaecal appendix among patients undergoing appendectomy for appendicitis. METHODS: A descriptive cross-sectional study was performed in 264 patients undergoing appendectomy in Department of Surgery, Nobel Medical College, Biratnagar, Nepal from 1st May, 2018 to 15th May, 2019. Ethical approval was taken. Simple random sampling was done. The position of appendix was noted before appendectomy. Subgroup analysis was done on the basis of gender and length of appendix recorded in centimeters with a measuring scale immediately after removal of appendix. Data was collected in excel and was analyzed in SPSS version 16. RESULTS: Prevalence of retrocaecal appendix among patients with appendicitis was 95 (35.98%). Similarly, other positions noted were pelvic in 67 (25.37%), post-ileal in 61 (23.10%), pre-ileal in 11 (4.16%) and subcaecal in 30 (11.36%) individuals. The length of appendix ranged from 1.7 cm to 14.7 cm. The mean length was 8.67±2.44 cm. CONCLUSIONS: The most common position of appendix in patients with appendicitis is retrocaecal position followed by pelvic position in both males and females.

Cephalic Index in Indigenous Tharu Community.

INTRODUCTION: Cephalic index is an important parameter for differentiation of race and sex which varies significantly on the basis of hereditary, geographical, racial, sexual and other factors. It is a morphometric expression of different forms of head. The objective of this research was to evaluate the cephalic index of people of indigenous Tharu community of Biratnagar, Nepal and to determine different head types. METHODS: A cross-sectional study was conducted in which maximum head length and breadth of 100 adult Tharu people living in Biratnagar were measured using spreading caliper and scale. The cephalic index was obtained from these values using Hrdlicka's method. RESULTS: The mean cephalic index of the study population was 75.99±4.97. The mean cephalic indices of males and females were 76.22±5.14 and 75.78±4.85 respectively. The most common head type observed was dolichocephalic type 47 (47%). It was followed by mesocephalic type 37 (37%), brachycephalic type 13 (13%) was less common and least common was hyperbrachycephalic type 3 (3%). CONCLUSIONS: Long head (dolichocephalic) type is more common in Tharu population in both the genders, whereas, broad head (brachycephalic and hyperbrachycephalic) type is present in very few people.