Background: There can be multiple hand problems with which patients can present. Such hand problems can be because of any kind of trauma, birth defects, tumours, infection or other conditions. Hand surgery is a special field of plastic surgery, which deals with these hand problems. The Department of Burns, Plastic & Reconstructive Surgery of Kirtipur Hospital run by Public Health Concern Trust-Nepal has been providing hand surgery service to the patients with these hand problems.Aim of Study: To analyse the various types of surgical hand problems in patients attending Kirtipur Hospital.Material and Methods: It is a cross sectional retrospective  observational study of the patients with different hand problems done at the Department of Burns, Plastic & Reconstructive surgery of Kirtipur Hospital from January to December 2016.Results: There were 124 patients who presented with various hand problems. There was male preponderance and the most common age group affected was between 15-60 years. Hand trauma was the most common cause of hand problems followed by post burn contractures.Conclusion: Hand is a complicated organ which can give rise to various problems. Hand surgery is an essential component of reconstructive surgery to deal with these problems. JNGMC,  Vol. 14 No. 2 December 2016, Page: 41-43

Pyrexia of unknown origin refers to a fever of over 38.3°C on multiple occasions for at least three weeks without a known aetiology, even after a week of hospitalization. Adult-onset Still’s disease is a rare systemic auto-inflammatory disorder with a prevalence of 0.6/100,000 population characterized by spiking fever, arthralgia or arthritis and maculopapular rash. Here, we present a case of 19 years-old female with pyrexia of unknown origin. With no identifiable cause and fulfilled criteria of Yamaguchi, a diagnosis of adult-onset Still’s disease was made. She was treated with IV steroid therapy followed by oral steroids and non-steroidal anti-inflammatory drugs. This case highlights the awareness of the possible adult-onset Still’s disease patients with pyrexia of unknown origin. However, one should remain cautious and exclude all other differentials before making this diagnosis, as the actual disease may masquerade as adult-onset Still’s disease criteria.