Introduction: Pre-eclampsia, one of the most common medical complication in pregnancy results in considerable maternal and fetal morbidity and mortality. Endothelial dysfunction is a central feature of pre-eclampsia. Elevated serum uric acid level may serve as a marker for early diagnosis of the disease as well as a surrogate for clinical severity of the condition. High serum values of triglycerides, total cholesterol, low- density lipoprotein and and low levels of high density lipoprotein are all significantly related to risk developing preeclampsia.  Objective: To find out the association between serum uric acid levels and lipid profile in pre-eclamptic women and compare it with the normal pregnant women.  Methodology: A case control study was conducted among 180 pregnant women (90 cases of pre-eclamptic women and 90 cases of age matched normal pregnant women) between 21-35 years who were admitted in the Gynaecology and Obstetrics ward of Nobel Medical College and Teaching Hospital, Biratnagar. Blood pressure was measured. Serum from all the patients were analyzed for the following biochemical parameters: serum uric acid, triglyceride, total cholesterol, LDL-C and HDL- C. The data were collected and entered in MS-Excel and analyzed using Statistical Package for Social Sciences (SPSS) ver. 16 software. Results: Mean serum uric acid of pre-eclamptic women was higher than those of normal pregnant women  which was found to be statistically significant with p value <0.001. Among the lipid parameters, serum triglyceride and total cholesterol was significantly higher in pre-eclamptic women whereas high density lipoprotein was significantly lower in pre-eclamptic. Also there was a positive co-relation between triglyceride and blood pressure and a negative co-relation between HDL-C in preeclamptic women. Conclusion: Development of simple and inexpensive methods to predict and prevent pre-eclampsia in early stage is very important. Thus, our study concludes the utility of measurement of serum uric acid and lipid profile for screening patients at risk of developing pre-eclampsia.

Aims: To measure the fetal kidney length in the second and third trimesters of pregnancy and correlate it with the gestational age and other routine fetal parameters. Methods: This prospective cross-sectional study includes 250 pregnant women presented in the Nobel Medical College for ultrasound examination from the period of July 2021 to June 2022. Gestational age was estimated based on the last menstrual date and ultrasonogram. Routine fetal parameters and mean fetal kidney length were measured. The correlation between gestational age, fetal kidney length, and routine fetal parameters was studied. Results: The mean gestational age according to ultrasound and last menstrual period were 35.5 ± 3.4 weeks and 35.2 ± 3.2 weeks respectively. The mean fetal kidney length was 36.8 ± 4.02mm. There was a very strong positive correlation between gestational age and fetal kidney length (r=0.921, p =0.001). Compared to the routine fetal parameters, adding fetal kidney length improved the effectiveness in predicting gestational age. (R2 =0.918 vs. R2 =0.936) Conclusion: Fetal kidney length can be added to the other standard parameters to improve the prediction of gestational age.

Introduction: Gallbladder carcinoma (GBC) is the commonest cancer of the biliary tree and the most frequent cause of death from biliary malignancies. The overall resection rates at presentation range from 10%-30% only. Therefore, a large number of patients are inoperable with overall survival of only 6-8 months. Palliation of the pain, jaundice, pruritus is a big challenge in patients with advanced disease. Methods: A prospective cross sectional study of patients with GBC during the period of October 2014 to September 2017 at Nepalgunj Medical College and Teaching Hospital, Kohalpur, department of surgery. Results: There were 216 cases of gastrointestinal malignancies with 54(25%) GBC. There was female (75.92%) preponderance with a male to female ratio of 1:3.15. The mean age was 61.41±12.18. The most common symptom at presentation was pain in a right upper abdomen (87.03%) followed by abdominal lump (41.23%) and surgical jaundice (18.51%). Fundus (70.37%) was the most common site of involvement followed by body (5.55%) and neck (24.05%). Gall stone was associated in 44 (81.48%) patients. Only 7 (12.96%) patients had localized GBC, 25 (46.29%) patients had locally advanced disease and 22 (40.74%) had metastatic disease. Liver was the commonest site of metastatis followed by peritoneum and two patients had left supraclavicular lymph node metastatis. There were two (3.72%) incidental gall bladder cancer after laparoscopic cholecystectomy. 13 (24.07%) patients were operated with intention of radical cholecystectomy but only six (46.15%) patient could undergo radical resection. Staging laparoscopy was done in all patients except for incidental gall bladder cancer. Metastatic disease was identified in 3 (23.07%) on staging laparoscopy. In eight (61.33%) among 13 patients the disease was unresectable. The most common histology was adenocarcinoma and most common stage was stage III and stage IV when both operated and non-operated groups were combined. Conclusions: GBC was the commonest gastrointestinal tract cancer with a female preponderance. A majority of patients were inoperable at presentation with pain in abdomen being the most common symptom. Surgery although is the main stay of treatment is not possible in many.