Background: Occupational drivers are exposed to various stressors such as ergonomic restriction, whole body vibration, vehicle exhaust and dust exposure. Drivers are reported to have higher rates of morbidities, especially of the musculoskeletal and peripheral nervous systems. Reports on drivers’ nerve functions by specific electrodiagnostic methods are lacking. Objectives: To compare electrophysiologic parameters of median and ulnar nerves in drivers with other population. Methodology: In a cross-sectional comparative study, nerve conduction study was performed in median and ulnar nerves in three groups of participants – Drivers (driving taxi/microbus for at least six months), Helpers (microbus conductors for at least six months) and Controls (college staff/students). Parameters for sensory nerve action potentials and compound motor action potentials were compared among groups by ANOVA and right versus left sides within groups by paired t test. Results: The study involved 145 male participants – 51 Drivers, 34 Helpers and 60 Controls. Compared to drivers and helpers, conduction velocity of nerves was significantly higher in controls for sensory component of all nerves (p values for right median = 0.001, left median = <0.001, right ulnar = <0.001 and left ulnar = 0.019) and motor component of right ulnar nerve (p=0.002). In right-left comparisons, conduction was slower in left median sensory than right (p=0.001) and right ulnar sensory than left (p=0.015) in the helpers but not significant in other groups. Conclusion: Electrophysiological evidences of afflictions of median and ulnar nerves are detectable in urban taxi/ microbus drivers and helpers with at least six months’ occupational duration.

Introduction: Variceal bleeding from esophageal varices has high morbidity and mortality. There are invasive and non invasive methods by which risk of bleeding can be predicted. Upper Gastro-intestinal endoscopy is invasive, uncomfortable and expensive procedure though being the gold standard to screen Esophageal Varices (EV). Aims: To know the role of non-invasive markers for prediction of esophageal varices and variceal bleed with liver cirrhosis. Methods: A prospective hospital based study was carried in the Department of Internal Medicine, Nepalgunj Medical College, Kohalpur from October  2021 to March 2022. A total of 70 patients who met the inclusion criteria were enrolled. The non invasive markers were done and correlated with endoscopy. Results: Our study included 70 patients with liver cirrhosis. The mean age in our study was 63.1±8.346 years. During upper gastrointestinal endoscopy, esophageal varices was present in 46 (65.71%) patients. Child Turcot Pugh Score C (81.43%) was found in majority. Significant association was found between score C (P<0.05), thrombocytopenia, Model for End stage Liver Disease Score (P=0.017) and low albumin level with esophageal varices and variceal bleeding. Similarly, significant alcohol intake was associated with esophageal varices and variceal bleed. However, no association was found between age and esophageal varices. Conclusion: Child Turcot Pugh score, thrombocytopenia, low albumin level and Model for End stage Liver Disease along with significant alcohol intake correlated with presence of esophageal varices and can be considered as non invasive tools for screening of esophageal varices and variceal bleeding in cirrhosis.