BackgroundCarcinoma of gall bladder is the most common malignancy of the billiary tract. Most of the cases are diagnosed as an incidental case among patients undergoing cholecystectomy. ObjectivesTo establish the rate of incidental carcinoma of gall bladder in patients undergoing routine cholecystectomy to study the demographic profile and prognosis of these patients. MethodsA retrospective study was carried out in Fishtail Hospital and Research Center, Pokhara during 1998-2009. The surgical notes, hospital records and histopathology reports of 783 patients undergoing routine cholecystectomy were studied. ResultsOut of 783 cases, gall bladder cancer was detected in 10(1.28%) of cases and was more common in females (M:F ratio 1:2.3) and the mean age of occurrence was 63.8 years. Most of the cases diagnosed were at their early stages and none of them were in T3 and T4 stages. Six of these patients have survived till a mean follow up duration of 23.7 months. ConclusionThe rate of incidental carcinoma of gall bladder is 1.28%.DOI: http://dx.doi.org/10.3126/kumj.v9i2.6278Kathmandu Univ Med J 2011;9(2):3-6

Introduction: Cutaneous Leishmaniasis is a vector borne disease caused by the bite of an infected sandfly. The disease is rare in Nepal with only few cases reported till date. We report the largest collection of patients over six years.Objective: To describe the clinical, epidemiological and pathological aspect of Cutaneous Leishmaniasis in Midwestern region of Nepal Materials and Methods: Thirty-three patients referred to the department of Pathology for fine needle aspiration were diagnosed as Cutaneous leishmaniasis based on detection of Leishmania donovani in the fine needle aspiration smears. Demographic data and clinical details including site, size, and duration of disease onset were recorded on a printed proforma. Statistical analysis was done using SPSS version 16.0 for windows. Results:A total of 33 patients with age ranging from 11 years to 65 years were included in the study. Mean age was 26.5±11.5 years. Most patients were in the age group 21-40 years. Male: Female ratio was 1.7:1. Mean duration of disease was 5.3±4.4 months. Thirty patients had single lesion. Lesions were either of plaque type (84.9 %) or papulonodular type (15.1%). Conclusion:Cutaneous leishmaniasis is uncommon in Nepal. So, it is often neglected. It is in an increasing trend. Cutaneous leishmaniasis should be included in the differential diagnosis of a non-healing ulcer.

Background: Extracorporeal shock wave lithotripsy (ESWL) is an effective non-invasive method for management of urinary tract stones. It was introduced for the first time in Pokhara 1 year back. This study aims to study the efficacy of ESWL in removal of renal and ureteric calculus in relation to the stone size and location and potential adverse effect of the procedure. Methods:It is a prospective observational study carried out in 112 cases undergoing elective ESWL for solitary urolithiasis during a period of 1 year (August 2010-August 2011). Number of sessions required for successful fragmentation and clearance of stones were studied according to their size and position along with the complications encountered. Results:The success rate of ESWL was found to be 91.1% for solitary urolithiasis. The mean number of sessions required for success was found to increase according to increase in size of the stones whereas it was almost similar for various locations. Complications were encountered in 25% of cases. Conclusion:Stone size was found to be the most important predictor in successful outcome of ESWL and the procedure is quite favorable for stones less than 20 mm.

Background:Head injury is one of the common surgical condition which causes increased morbidity and mortality worldwide. The aim of the study is to study the epidemiology, incidence and pattern of head injury, and their outcome in a general Management of Head Injury by General Surgeons in a General Hospital

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