Background and Objectives: The distribution of ABO and Rh blood groups vary from population to population. With an interest of finding out rare blood group in Nepalese population, we studied the blood group distribution was studied in five different medical colleges in Nepal.

This article discuss about scientific basis of benefits of practicing slow pranayama, especially alternate nostril breathing pranayama. It explains the basis of benefit of alternate nostril breathing exercises and its probable relation with nasal cycle, cerebral dominance and autonomic nervous system. The airflow through one nostril is greater than next at any point of time which later switches to another. This is called nasal cycle. The nasal cycle lasts from 30 minutes to 2-3 hours. The nasal cycle occurs naturally. This nasal cycle is related with the cerebral dominance. When one nostril is dominant, the contra lateral hemisphere is active. The right nostril breathing leads to increased sympathetic activity while left nostril breathing decreases sympathetic activity and increases parasympathetic tone. So it has been speculated that these three phenomenon viz. nasal cycle, cerebral dominance and autonomic activities are correlated. This review also suggests that practicing alternate nostril breathing (Nadisodhan pranayma) regularly keeps the two hemispheres active and balances the sympathetic and parasympathetic activities in the body. Sympathetic or parasympathetic activity alternates automatically in our body which is important for our survival. Due to our hectic and stressful life, this naturally occurring alternate breathing cycle gets disrupted and we suffer from different ailments. These ailments are due to imbalance of autonomic nervous system which can be resolved by practicing alternate nostril breathing, the Nadisodhan pranayama. It’s just like returning back to nature. DOI: http://dx.doi.org/10.3126/jmcjms.v1i1.7885 Janaki Medical College Journal of Medical Sciences (2013) Vol. 1 (1):38-47

Background and Aims:Postspinal headache and low backache are common complaints following spinal anesthesia which regresses spontaneously but sometimes becomes very troublesome for the patient as well as for the anesthesiologists. The aim of this study was to evaluate the incidence of postspinal headache and low backache after spinal anesthesia in lower abdominal surgery.Materials and Methods:One hundred patients of 18–60 years of age group with patients physical status the American Society of Anesthesiologists Class I or II after due consent divided into equal numbers of two groups: median (M) approach and paramedian (P) approach scheduled for lower abdominal surgery. Group M (50 patients) received spinal by median approach while in Group P (50 patients) received spinal by paramedian approach. The incidence of postspinal headache and low backache was observed in each group. All the patients were observed up to 7 days postoperatively. Data collected was analyzed statistically by SPSS (IBM SPSS Statistics for Windows, Version 22.0. Armonk, NY: IBM Corp) and Chi-square test, and P < 0.05 considered as statistically significant.Results:Postspinal headache was observed to be 4% in paramedian approach and 20% in median approach group. Backache incidence recorded in both the groups was 2% and 10%, respectively. P value calculated statistically was < 0.05 and hence statistically significant in paramedian approach in respect of incidence of both postspinal headache and backache.Conclusion:Incidence of postspinal headache and low backache is less in paramedian approach than in median approach.

Background Incisional hernias cause morbidity and may require further surgery. HART (Hughes Abdominal Repair Trial) assessed the effect of an alternative suture method on the incidence of incisional hernia following colorectal cancer surgery. Methods A pragmatic multicentre single-blind RCT allocated patients undergoing midline incision for colorectal cancer to either Hughes closure (double far–near–near–far sutures of 1 nylon suture at 2-cm intervals along the fascia combined with conventional mass closure) or the surgeon’s standard closure. The primary outcome was the incidence of incisional hernia at 1 year assessed by clinical examination. An intention-to-treat analysis was performed. Results Between August 2014 and February 2018, 802 patients were randomized to either Hughes closure (401) or the standard mass closure group (401). At 1 year after surgery, 672 patients (83.7 per cent) were included in the primary outcome analysis; 50 of 339 patients (14.8 per cent) in the Hughes group and 57 of 333 (17.1 per cent) in the standard closure group had incisional hernia (OR 0.84, 95 per cent c.i. 0.55 to 1.27; P = 0.402). At 2 years, 78 patients (28.7 per cent) in the Hughes repair group and 84 (31.8 per cent) in the standard closure group had incisional hernia (OR 0.86, 0.59 to 1.25; P = 0.429). Adverse events were similar in the two groups, apart from the rate of surgical-site infection, which was higher in the Hughes group (13.2 versus 7.7 per cent; OR 1.82, 1.14 to 2.91; P = 0.011). Conclusion The incidence of incisional hernia after colorectal cancer surgery is high. There was no statistical difference in incidence between Hughes closure and mass closure at 1 or 2 years. Registration number ISRCTN25616490 (http://www.controlled-trials.com).

Introduction: Acute respiratory failure is a potential complication of chronic obstructive pulmonary disease (COPD) that severely affects the health of the patient and may require mechanical ventilation. We compared noninvasive and invasive mechanical ventilation in COPD patients with acute respiratory failure type II to validate clinical outcome based on biochemical analysis of arterial blood gases (ABGs) and pulmonary parameters in terms of duration of mechanical ventilation, period spent in intensive care unit (ICU) and mortality. Materials and Methods: After approval of institutional ethical committee 100 patients were selected for randomized prospective controlled trial and divided into two groups of 50 each according to mode of mechanical ventilation. Group-I patients managed with noninvasive ventilation (NIV) Group-ll managed with invasive ventilation. Results: Demographic data between two groups were comparable. ABG parameters were better at 2 h and 6 h interval in NIV as compared to invasive ventilation ( P < 0.05). The duration of ventilation and total time spent in ICU was 106±10 hours and 168±8 hours respectively in NIV group and 218 ± 12 and 280 ± 20 in invasive group. On intergroup comparison these were significantly less in noninvasive group ( P < 0.05). Hospital acquired pneumonia occurred in 10% of patients in invasive group whereas no incidence of pneumonia found in noninvasive group. Mortality rate was 12% in invasive groups and 2% in noninvasive groups. Conclusion: NIV leads to significant improvement in ABG and pulmonary parameters and it reduces duration of ventilation and total period of hospital stay so it can be used as an alternative to invasive ventilation as first-line treatment in COPD.