Setting: Study was performed in mortuary of B P Koirala Institute of Health Sciences (BPKIHS), Dharan. Objectives: 1. To know the various epidemiological factors related to road traffic accident cases. 2. To know the relationship of head injury in road traffic accidents with the factors like helmet use, type of vehicle involved in accident. Study design: longitudinal descriptive study. Study unit: 77 Dead bodies with fatal head injury from RTA coming to BPKIHS mortuary, a focal point in eastern Nepal Study variables: Demographic characteristics of the victims, time, day and month of accidents, type of accidents, vehicle involved in accidents etc. Statistical analysis: Proportion. Results: There were approximately 78% male and 22% female road traffic accident victims with head injury. Students were the highest (20.7%) among the victims. The highest number of accidents took place in the month of June (11.7%) and on Saturdays (24.6%). The pedestrians were the largest (45%) group of the victims. Among the motorized vehicles, two wheeler drivers were more (34%) victims in accidents. Out of 77 fatalities, 22% were found to have consumed alcohol. Conclusion: Due to bad and mismanaged roads and poor road traffic knowledge to the citizens, road traffic accidents are the most common cause of unnatural deaths in this region. Minimal use of helmet is the main cause of fatal head injury in two wheeler occupants.

Introduction: Airway management in patients with panfacial fracture remains a challenge to anesthesiologists and surgeons. Submental intubation is an effective and less invasive alternative to tracheostomy during intraoperative airway management where orotracheal and nasotracheal intubation are not appropriate options. In addition, submental intubation allows proper access to oronasal airways and occlusion during intraoperative management. Methods: The descriptive retrospective study was carried out and evaluated the outcomes of submental intubation in the management of panfacial fracture, complex maxillary or mandible fracture associated with nasal bone fracture and naso-orbito-ethmoid (NOE) fracture. The medical records of 23 patients who received submental endotracheal intubation were reviewed at UCMS College of Dental Surgery, Bhairahawa, Rupandehi, Nepal from March 2014 to December 2018. The following parameters were evaluated: mode of trauma, time required for intubation, accidental extubation, accidental perforation of the pilot balloon during its insertion, period of hospital stay, post-operative complications, such as the healing of submental scars both intraorally and extraorally. Results: The submental intubation was successfully done in all patients with minimal obvious post-operative complications. The mode of trauma for majority of cases of panfacial fracture who underwent submental intubation was road traffic accident (69.56%). The mean time required for intubation was 8.43 (±0.84) minutes. No accidental extubations occurred. Accidental perforation of the pilot balloon was seen in one patient (4.35%) during tube manipulation which was managed successfully by changing the tube. The healing of submental scars was uneventful intraorally and extraorally in almost every case. The mean period of hospital stay in patients with submental intubation was 7.95 (±1.49) days. Discussion: Submental intubation is an effective and safe method as it is not associated with complications of tracheostomy during management of panfacial fracture, NOE fracture and craniofacial fracture. In addition, it does not interfere with IMF during intraoperative period.

Despite the fact that any drug can be an impending cause of hypersensitivity reactions, Ibuprofen, an over-the-counter drug used extensively as an analgesic and antipyretic in Asia, is considered to be relatively safe. But herein we report a rare extremely 'rapid onset' occurrence of a severe case of Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) in a 22-year-old male, induced by 3 doses of 400 mg of Ibuprofen taken at 8-hour interval for eye pain, probably the first case report of rapid onset of TEN by nonsteroidal antiinflammatory drugs in Nepal. SJS and TEN are idiosyncratic, delayed hypersensitivity inflammatory adverse drug reactions that are severe adverse cutaneous drug reactions which predominantly involve the skin and mucous membranes and are linked with high morbidity and mortality. Nevertheless, removal of ibuprofen and its metabolites with plasma exchange and treatment with antibiotics and intravenous corticosteroids along with supportive therapy improved the course of the disorder. This rare case report addresses the fact that severe hypersensitivity reactions can occur with Ibuprofen, which can be potentially dangerous and life threatening. It is thus important for the clinicians to be alert to such severe hypersensitivity reactions even with drugs which are deemed to be probably safe.

Introduction: Homicide means killing of one human being as a result of conduct of another human being. This study of medico-legal and epidemiological details of homicidal cases would help in enhancement of various stakeholders in law enforcing agencies with the view to benefit the process of scientific crime detection and proper administration of justice at large. Objective: To identify the various medico-legal and epidemiological factors involved in homicide. Materials and method: A prospective cross-sectional study was conducted in fatal homicide victims brought for medico-legal autopsy in BPKIHS, during the period of 15

The vast majority of people continue to view medicinal plants as a low-cost source of medications and treatments. Numerous trees, herbs, plants, and shrubs have been used as remedies for various ailments since the dawn of time. Rubus ellipticus Smith, a weedy wild raspberry that flourishes in damp woods at high elevations, particularly those in the Himalayas and the Nilgiris area, is one of the important ethnomedicinal plants in the genus Rubus. Traditional Tibetan medicine places a great deal of importance on the plant R. ellipticus. Because of the abundance and diversity of phenolics and flavonoids in fruits or berries, which have a high concentration of both, they are generally regarded as inherently healthful foods. The roots and leaves, as well as the fruit, have traditionally been used as therapeutic agents for several illnesses including colic pain, gastrointestinal discomfort, wound healing, diarrhea, antifertility, antibacterial, analgesic, epilepsy, and others. The objective of the current review is to concentrate on the pharmacological characteristics, nutrition profile, phytoconstituents, and folkloric therapeutic applications of R. ellipticus, therefore achieving the review's overall subject.