Introduction Cervical cancer is a global leading cause of morbidity and mortality. The majority of cervical cancer deaths occur in developing countries including Nepal. Though knowledge of cervical cancer is an important determinant of women’s participation in prevention and screening for cervical cancer, little is known about this topic in Nepal. This study explores the experiences of cervical cancer survivors and assesses the attitude of family and community towards it and stigma related to this disease in Bharatpur, Nepal. Methods The study design was qualitative methods involving two focus-group discussions. A total of 17 cervical cancer survivors, who have completed two years of cancer treatment were selected purposively from Chitwan. All qualitative data were transcribed and translated into English and were thematically analyzed. Results The majority of the participants had scant knowledge about cervical cancer, its causative agent, showed less cervical cancer screening, delayed healthcare-seeking behavior despite having persistent symptoms before the diagnosis. The main reasons identified for not uptaking the cervical screening methods were an embarrassment and having no symptoms at all. Most of them endured social stigma related to cervical cancer in the form of physical isolation and verbal abuse. Conclusions There is an urgent need for interventions to make women and the public aware of cervical cancer and launch effective health education campaigns, policies for cervical cancer prevention programs. This implementation can save the lives of hundreds of women and help them avoid going through all the negative experiences related to cervical cancer. More studies are required to gain the perspectives, knowledge, experiences, and attitudes of cervical cancer survivors to add to the research.

15 Introduction 16 Cervical cancer is a global leading cause of morbidity and mortality. The majority of cervical 17 cancer deaths occur in developing countries including Nepal. Though knowledge of cervical 18 cancer is an important determinant of women's participation in prevention and screening for 19 cervical cancer, little is known about this topic in Nepal. This study explores the experiences of 20 cervical cancer survivors and assesses the attitude of family and community towards it and 21 stigma related to this disease in Bharatpur, Nepal.22 23 Methods 24The study design is qualitative methods involving two focus-group discussions. A total of 17 25 cervical cancer survivors were selected purposively from Chitwan. All qualitative data were 26 transcribed and translated into English and were thematically analyzed. 28 Results 29Majority of the participants had scant knowledge about cervical cancer, its causative agent, 30 showed less cervical cancer screening, delayed healthcare-seeking behavior despite having 31 persistent symptoms before the diagnosis. The main reasons identified for not uptaking the 32 cervical screening methods are an embarrassment and having no symptoms at all. Most of them 33 endured social stigma related to cervical cancer in the form of physical isolation and verbal 34 abuse. 35 36 Conclusions 3 37 There is an urgent need for interventions to make women and the public aware of cervical cancer 38 and launch effective health education campaigns, policies for cervical cancer prevention 39 programs. This implementation can save the lives of hundreds of women and help them avoid 40 going through all the negative experiences related to cervical cancer. More studies are required 41 to gain the perspectives, knowledge, experiences, and attitudes of cervical cancer survivors to 42 add to the research.43 44 45 46 4 47 48 Cervical cancer is the second most common cancer in females from low-to-middle-income 49 countries. Around 310,000 deaths occur annually due to cervical cancer [1]. Human 50 papillomavirus (HPV) infection is the major cause of cervical cancer. Although most cases of HPV 51 will resolve on their own, persistent infection with certain types of HPV (types 16 and 18) on the 52 cervix can lead to precancerous lesions that can progress to cervical cancer [2]. Nepal has a 53 population of 10.1 million women aged 15 years and older who are at higher risk of acquiring 54 cervical cancer. Cervical cancer is the most frequent cancer among women between 15-44 years 55 of age and it also ranks as 1 st most frequent cancer among women in Nepal. According to the latest 56 data around 1928 women die yearly out of a total of 2942 women who are diagnosed with cervical 57 cancer yearly in Nepal [3]. 58 Early detection of HPV infection through the utilization of Papanicolaou (Pap) testing has been 59 shown to decrease rates of cervical cancer. Because of restricted access to the health care facility 60 and limited knowledge about the preventive techniques for cervical malignancy, the greater part ...

Neuroleptic malignant syndrome (NMS) is a well-recognized neurologic emergency. It presents with classic features including hyperthermia, autonomic instability, muscle hypertonia, and mental status changes. The syndrome is potentially fatal and is associated with significant morbidity due to complications such as rhabdomyolysis, acute kidney injury, and ventricular arrhythmias due to the trans-cellular electrolyte shift. NMS is conventionally associated with the first-generation antipsychotic agents, however, has been described with the use of atypical and novel antipsychotics including Ziprasidone. A case of NMS with Ziprasidone use at the therapeutic dose is reported here.

Sodium nitrite is a common household product with a variety of uses such as curing meat, food additive, colouring agent, anti-freezing agent and disinfectant. We report a case of sodium nitrite intoxication for deliberate self-harm and discuss the increasing number of such cases in recent times.

ObjectiveThis study systematically reviews the data extracted from the Global Burden of Disease Study and sets out to assess the age-specific and sex-specific mortality and disability attributable to different forms of tobacco from 1990 to 2017, for Nepal.DesignThis cross-sectional study extracted data from the Institute for Health Metrics and Evaluation’s Global Burden of Disease database, then was quantitatively analysed to show the trends and patterns of prevalence of tobacco use, deaths and disability-adjusted life-years (DALYs) attributable to tobacco use from different diseases from the year 1990 to 2017 in Nepal.SettingNepal.ResultsIn between 1990 and 2015, the age-standardised prevalence of daily tobacco smoking decreased by 33% in males, 48% in females and 28% in both. By 2017, the age-standardised mortality rate and DALYs attributable to tobacco use, including any form, decreased by 34% and 41%, respectively, with tobacco smoking having the most contribution. However, the absolute number of deaths and DALYs increased by 39% and 3%, respectively. An increasing rate of deaths and DALYs attributable to tobacco was noted with an increase in age. Non-communicable diseases were responsible for most deaths and disabilities attributable to tobacco use.ConclusionThe prevalence of smoking along with the age-standardised mortality rate and DALYs shows a decreasing trend. However, attention should be made to implement a strong plan to control all forms of tobacco including secondhand exposure.