INTRODUCTION:Viral infections during pregnancy carry a risk for intrauterine transmission which may result in fetal damage. Bad obstetric history implies for previous unfavorable foetal outcome in terms of two or more consecutive spontaneous abortions, history of intrauterine foetal death, intrauterine growth retardation, still birth, early neonatal death and congenital anomalies. Cytomegalovirus, a ubiquitous virus belonging to the herpes family, is known to cause abnormal fetal outcome. We aim to determine the possible involvement of CMV infection among pregnant women with bad obstetric history MATERIALS AND METHODS: A cross sectional study was carried out among 136 women with bad obstetric outcome attending Dhulikhel HospitalKathmandu University Hospital. The cytomegalovirus specific IgG and IgM antibodies were determined by ELISA test. Data were analyzed using SPSS, version 17.0 and interpreted according to frequency distribution and percentage. The data was considered significant if the p-value was <0.05. RESULTS:The results revealed that 87 (63.9%) out of 136 patients were positive for CMV IgG antibodies and only one (0.007%) patient was positive for CMV IgM. The majority of the patients were of the age between 20 and 29 years (99/136) and it was observed that most of the positive CMV IgG were participants of the same age group (63/ 99). There was no significant association of CMV seropositivity with the age of participants (p value 0.9).CONCLUSION: CMV infection could be the risk factor for BOH and may play a vital role in determining the foetal outcome. Thus we recommend routine serological testing to all pregnant women with or without BOH attending the antenatal clinics for both CMV specific IgG and IgM.

Introduction: Changes in the lifestyle, food habits, lack of nutritious diet, stress, physical inactivity increases the body mass index among adults. Excess weight gain is an important risk factor for non-communicable diseases such as heart disease, stroke, diabetes, and some cancers (endometrial, breast, colon). Thus, this study aims to find out body mass index of medical students of a medical college in Nepal. Methods: This descriptive cross-sectional study was conducted in the department of physiology of a tertiary care center from August 2019 to February 2020 after taking ethical clearence from Institutional Review Committee (Reference number 192/19). Height and weight were recorded and body mass index was then being calculated. Data entry was done in Microsoft Excel and analyzed using Statistical Package for the Social Sciences version 22. Results: Out of 266 medical students, 39 (15%) were overweight and 32 (12%) were underweight with mean body mass index 26.60±1.99kg/m2 and 17.13±1.19kg/m2 respectively. Mean body mass index of males was 21.76±3.06kg/m2 and that of females was 21.70±2.96 kg/m2. Conclusions: Comparing with a similar study done in Nepal previously, we found a higher prevalence of overweight in medical students whereas majority of medical students had normal weight. Factors affecting body mass index in medical students should be explored further.

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Cervical rib is a rare anatomical anomaly with an incidence of 0.2%–1% and is an important cause of thoracic outlet syndrome. We present a case series of five female patients with a mean age of 20.6 (15–26) years, symptoms present were neck pain, neck mass, tingling sensation and weakness in the affected side. Symptoms develop in adolescence probably due to sagging of the shoulders and a disproportion between chest and neck growth at this age. X-rays of cervical spine was a common mode of diagnosis and showed bilateral cervical rib in three cases and unilateral in two cases. They were managed by performing surgeries under supraclavicular approach with resection of cervical rib of affected side. There was improvement of symptoms with restoration of limb function with a mean time of recovery of 9 weeks. Early diagnosis is important as differential diagnosis of such symptoms may be cervical stenosis and myelopathy which differ in management and have a greater risk of morbidity. In absence of intervention, cervical ribs can lead to compression of neurovascular structures leading to worsening of symptoms, thrombosis of subclavian artery or cerebral emboli.

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