Management of Traumatic Liver Injury in a Tertiary Care Hospital in Nepal.

BACKGROUND: The liver is most frequently injured solid organ in abdominal trauma. The non-operative management is the standard treatment for hemodynamically stable patients. This study analyse the epidemiological aspects, injury patterns, treatment modalities and outcome in patients with liver injuries only and associated injuries outside the liver. METHODS: This was a retrospective study in patients with liver injuries admitted from 1st March 2014 to 31st January 2019 at Chitwan Medical College and Hospital, Nepal. The patients were divided into two groups. Group A consisted of isolated liver injury and Group B liver injury with associated injury of other organs. Data were analysed by using descriptive statistics and Mann-Whitney U test. RESULTS: A total of 61 patients were admitted with liver injury. There were 18 (29.5 %) patients with liver injury alone (group A) and 43 (70.5 %)liver injury associated with other organs (group B). Low grade liver injuries were 48 (78.7 %) and high grade 13 (21.3 %). The operative management was done for one liver injury with biliary peritonitis in group A. In group B, 16 patients required laparotomy and operative management for associated abdomen injuries. CONCLUSIONS: Non-operative treatment modality in hemodynamically stable patients with isolated liver injuries was safe and effective.

Older people's satisfaction with and utilisation patterns of the Old Age Allowance in Nepal.

OBJECTIVE: The Old Age Allowance in Nepal aims to support the welfare of older people, to improve their social and economic status and to encourage independence. The aim of this study was to assess satisfaction with and utilisation patterns of the Old Age Allowance among older people in Nepal. METHODS: A cross-sectional, quantitative study was conducted in Chitwan, Nepal. Face-to-face interviews were carried out with 232 older people asking about demographics, and satisfaction and utilisation of Old Age Allowance. RESULTS: Seventy-two per cent of older people expressed satisfaction with the Old Age Allowance. The highest satisfaction level (81.9%) was associated with the satisfaction scale construct of contribution to religious practices. Satisfaction with the allowance was associated with family relationships and dissatisfaction with higher expectations of allowance. The allowance was predominantly utilised for personal expenditure (91.4%), followed by health and medicine (75.0%). CONCLUSION: The Old Age Allowance is a necessary and important contribution to keeping older people connected with family and community.