Introduction: Liver cirrhosis is a common problem faced by physicians worldwide and is also responsible for 11th most common cause of death globally. Data regarding prevalence of esophageal varices and other upper gastrointestinal changes in patients with liver cirrhosis is scare in Nepal. So this study was carried out to find clinical profile and upper gastrointestinal endoscopic findings of patients presenting with liver cirrhosis with portal hypertension. Methods: This was a cross-sectional observational hospital based study conducted in the department of internal medicine and endoscopy unit of the Universal College of Medical Sciences, Bhairahawa, Nepal. The study was done from 21 February 2019 to 20 November 2019 in the patients presented with liver cirrhosis with portal hypertension. Sample size of 80±10 was calculated based on the statistics of previous data. The upper gastrointestinal endoscopy was done in all the patients. The data was collected using the predesigned pro-forma. Results: Total 89 patients with liver cirrhosis were enrolled with mean age of 51.84±12.26 years and male: female ratio of 3.68:1. As per Child Pugh classification (CTP) 45 patients (51%) were in Class C, 33 patients (37%) were in Class B and 11 patients (12%) were in Class A. Esophageal varices were present in 51 (57.3%) patients. According to Westaby classification grade I esophageal varices were seen in 17 (19.1%), grade II esophageal varices were seen in 26 (29.2%), grade III esophageal varices were seen in 8 (8.9%) patients. Portal hypertensive gastropathy (PHG) was seen in 64 (71%) patients. The association between esophageal varices and PHG grade was found statistically significant (P= <0.001). Conclusions: Liver cirrhosis was more commonly seen in middle age males. Esophageal varices and portal hypertensive gastropathy were common endoscopic findings present in patients with liver cirrhosis. There was statistically significant association between esophageal varices and PHG.

INTRODUCTION: Dengue fever (DF) is highly prevalent in tropical and subtropical countries all over the world. This study was done to study the clinico-laboratory profile of DF patients and their outcomes in a tertiary care hospital of western Nepal.MATERIAL & METHODS:  A prospective observational cross-sectional study conducted over 6 months (October 2016 to March 2017) in patients admitted to medical inpatient ward of a tertiary care referral hospital located at south west Nepal. All febrile patients underwent dengue antibody (IgM) testing. Patient details, clinical manifestations and laboratory parameters were recorded. Descriptive analysis was done as mean and percentage.RESULTS: Out of total 2653 hospital admissions, 1274 patients (male: 780, female: 494) presented with fever. Forty patients between 17 years to 84 years (Mean age ± SD: 40.3±17 years) were diagnosed as DF. All the age groups were almost equally affected. The average duration of hospital stay was 5.4±3.2 days. Fever (n=40, 100%), body ache (n=29, 74.4%) and headache (n=28, 70%) were three leading complaints in dengue patients. Only 22.5% (n=9) of the patients had thrombocytopenia (mild and moderate). Severe thrombocytopenia was not noticed. Only 10% of total dengue cases received platelet transfusion. The mean platelet count increased from day one to day seven gradually. All the patients recovered.CONCLUSION: DF is a well-established vector-borne disease in south west Nepal; may be due to rapid urbanization and poor hygiene facility. Appropriate disease control programme emphasizing on vector surveillance and control, early clinical diagnosis and treatment reduces the dengue-related deaths.Journal of Universal College of Medical Sciences (2017)Vol.05 No.02 Issue 16, page: 3-7

Introduction: Accidental mushroom poisoning is constantly seen and regularly reported from all over world. Exact magnitude of problem and its clinical profile in Nepal is not well known. This study was done to evaluate clinical profile and treatment outcome of patients presenting with mushroom poisoning in the department of internal medicine, BPKIHS, Dharan. Methods: It is a prospective observational study conducted in department of internal medicine, BPKIHS, Dharan from 1st January 2008 to 31st December 2009. Informed consent was taken. All the patients were subjected to necessary laboratory investigation. They were followed up at 1 week and 1 month after discharge. Results: All together 60 patients were analyzed. Majority of subjects 56 (93.3%) were from rural areas. Vomiting and diarrhea were the two most common presentations seen in 56 (93.3%) subjects. The latent period for the symptoms were > 6 hours in 4 (6.7%) and < 6 hours in 56 (93.3%) subjects. Fulminant hepatic failure was seen in 6 (10%) subjects and among them 4 (66.7%) expired. After admission 3 (5%) subjects developed GI bleeding. Average duration of hospital stay was 4.6 days. In follow up recovery was complete in all subjects who survived the acute phase of poisoning. Conclusions: Especially in patients coming during rainy season mushroom poisoning should be considered in the differential diagnosis of acute gastroenteritis. Mortality is high in subjects with FHF whereas recovery is complete in subjects who survived the acute phase. Keywords: fulminant hepatic failure; gastroenteritis; mushroom poisoning; wild mushrooms.

Introduction: Helicobacter pylori (H. pylori) is a microaerophile gram-negative bacillus which is found mainly on the surface of mucous membrane of the prepyloric part of the stomach. It is found to be infecting approximately 50% of world population. In patients with liver cirrhosis, the prevalence of H. pylori is variable. A high incidence of H. pylori colonization has been found in portal hypertension; especially in those with gastric erosion. This study was done to find out the prevalence of H. pylori infection in patients with portal hypertension at Universal College of Medical Sciences Teaching Hospital, Nepal.  Materials and methods: It was a hospital based cross sectional observational study. All the consecutive patients aged more than 16 years, presented with portal hypertension who fulfilled the inclusion criteria were included in the study. The study period was from 1st  September 2015 to 31st August 2016. The upper gastrointestinal endoscopy was done in all cases and mucosal biopsy was taken. H. pylori infection was diagnosed by using rapid urease test.  Results: During the study period, 71 patients fulfilled the inclusion criteria and were included in the analysis. The majority of the patients 21 (29.6%) were between 51-60 years age group. There were more male (78.9%) then female (21.1%). The mean age of study population was 50.85 ± 12.47 years. Among the study population, rapid urease test was positive in 70.4% (n=50) patients.  Conclusion: The prevalence of H. pylori infection was seen in 70.4% of the patients suffering with portal hypertension.