Background: Stroke is one of the most common cause of morbidity and mortality worldwide. Approximately 50-85 percent of strokes are due to ischemic cerebral infarction and 7-27 percent to intracerebral hemorrhage. Since the incidence of stroke is increasing in our country, the study aims to identify various factors associated with stroke. Materials and Methods: This is a retrospective study of 86 patients admitted in A & B International Hospital, which is a private hospital located in Pokhara ,Nepal from 1st January 2018 to 31st December 2019.The case notes were taken from hospital record section and relevant data extracted and analyzed. Approval from the hospital management was taken prior to collecting the case notes. Patients below 18 years of age, stroke due to trauma were excluded. The data were collected, and were analyzed using SPSS version 20.0 software Results: Of the total 86 patients studied, the age range was from 36 years to 94 years with mean age of 64.3 years. Mean age in ischemic stroke was 66.7 years and in hemorrhagic stroke was 54.8 years. Stroke is more common in men than female (2.3:1 ratio) .Ischemic stroke accounted for 80.2 percent of cases and hemorrhagic stroke for 19.2 percent. Most common presentation included limb weakness, facial deviation and speech abnormality. Most common vascular territory involved was MCA territory infarction and small vessel strokes. Conclusion: Stroke is prevalent in our country and the incidence rises with age. Ischemic stroke is more prevalent than hemorrhagic stroke. Mean age of hemorrhagic stroke is lower than that of ischemic stroke and hypertension is most commonly associated risk factor for both types of stroke.

Background: Obesity, a chronic disease that is increasing in prevalence in adults, adolescents and children, is now considered a global epidemic. Thyroid dysfunction contributes to the pathogenesis of obesity. Many clinical studies raise the questions of whether thyroid-stimulating hormone (TSH) changes in physiological limits is associated with obesity and whether there is a link between adipose tissue and hypothalamo-thyroidal axis. Materials and Method: This was a cross-sectional study. All clinically euthyroid patients and healthy volunteer adults of age 18 to 60 years of either gender were included in the study. Fasting blood sample was taken for thyroid function evaluation, which included Free T3, Free T4 and thyroid stimulating hormone. Height, weight, waist circumference and hip circumference were measured. The results were compared with calculated Body Mass Index (BMI). Results: 61 patients who met the inclusion criteria were studied. Among 61 patients 16 had subclinical hypothyroidism, 2 patients had hypothyroidism and 43 were euthyroid. Similarly, 2 underweight patients were observed, 7 had normal weight, 13 were over weight and 39 were obese. The mean TSH according to BMI were 3.8, 4.04, 3.88 and 6.19 respectively. Conclusion: The result in this study showed that the mean TSH increased as BMI increased with significant relationship between serum TSH and BMI (p <0.001). Thus thyroid dysfunction mainly subclinical hypothyroidism and hypothyroidism could be found in association with increased body weight.

Introduction: Acute poisoning, irrespective of the etiology, is a medical emergency which requires prompt diagnosis and treatment. Such cases require ICU set up for better management. Central level hospitals in Nepal have ICU facilities to manage such cases. Materials and Methods: Current study is a retrospective type hospital based study conducted in Western Regional Hospital, Pokhara. Data collected from ICU department of Hospital in a period of one year from 2073 Ashad 16 to 2074 Ashad 16. It was analyzed and presented. Results: In this study it is observed that total 90 cases admitted in ICU department of WRH in a period of one year. Female patients outnumbered the male patients. Age group of 10-20 years is predominance in present study. Most of the patients were from Kaski district as the hospital belongs to Kaski district and one of the renowned tertiary care centers in the Gandaki province. Maximum number of patients consumed the OP compound. Outcome was better as out of 90 cases 80 were discharged and only 10 were died during the course of treatment. Conclusion: Early identification of the cause and type of poisoning, close monitoring and standard management, preferably in the ICU for at least a first few days, reduces the complication and improves the survival. The commonly available insecticides and rodenticides are the most common cause of acute poisoning.

Introduction: The pituitary gland is the master endocrine gland that secretes important hormones and controls other glands. Its size, shape and volume vary with age and sex and also in various pathological conditions. This study was conducted to identify the size, shape and volume of the normal pituitary gland in different age groups of both genders using Magnetic Resonance Imaging (MRI).Methods: A retrospective study of the brain MRI Images of 203 patients was done in the Radiology and Imaging department of Pokhara Academy of Health Sciences, Nepal. Anterior-posterior dimension, transverse dimension, height and shape of the pituitary gland were noted and volume was calculated. Descriptive analysis and relationship of pituitary parameters with age and sex were assessed using ANOVA and Chi-square tests.Results: The pituitary height and volume was maximum in the 11-20years age group. Similarly, the mean height and volume of the pituitary gland in female patients of each age group were greater than that of male patients in the same age group. The inferential analysis revealed significant differences for mean pituitary height and volume with age but not with gender. The upper surface convexity was maximum in the age group 11-20years.Conclusion: The study has shown a clear trend with regards to the morphology of the pituitary gland with the age and sex of the individual highlighting the size, shape and volume of the pituitary gland should be taken into consideration while evaluating the glands for any neuroendocrine disorders.

Background: One of the major causes of morbidity and mortality in Nepal is portal hypertension due to liver cirrhosis. In rural areas where a lot of cases of cirrhosis of liver are prevalent and endoscopic expertise and facilities are not available, predicting the presence of esophageal varices through non-invasive means may reduce a large number of unnecessary endoscopies. This study is to identify the relationship of platelet count /splenic bipolar diameter ratio with the presence of esophageal varices in portal hypertension. Materials and methods: Eighty patients were included in this study between Jestha 2072 to Baisakh 2073 with the diagnosis of portal hypertension admitted in Bir hospital, Kathmandu which is a tertiary hospital of government of Nepal, which were mostly due to liver cirrhosis. The patients fulfilling the inclusion criteria underwent lab investigations, ultra sonogram and UGI endoscopy. The data were assessed for descriptive studies and means were compared using t-test. The cut off value of platelet count to spleen diameter ratio of 1150 was used to predict the presence or absence of oesophageal varices. Statistical analysis was done using SPSS 20 software Results: Platelet count to splenic diameter ratio with a cut off value of 1150 has sensitivity of 89.7%, specificity of 83.3%, positive predictive value of 96.8% and negative predictive value of 58.8% (p= 0.002, CI=95%) with 89.5 % accuracy. Conclusion: Platelet count to splenic bipolar diameter ratio can be a good predictor of presence of esophageal varices in patients with portal hypertension in the resource poor settings.