Introduction: Adrenal tumors are very common, affecting 3–10% of the human population, and most are small, benign, nonfunctional adrenocortical adenomas. Adrenocortical carcinoma (ACC), in contrast, is a very rare disease. The median age of diagnosis is in the fifth to sixth decade. There is a predilection for the female gender (the ratio of female to male ranges from 1.5 to 2.5 : 1) the adult. Case presentation: A 28-year-old man who had no prior history of systemic hypertension or diabetes mellitus presented with bilateral limb swelling for 2 months and facial puffiness for 1 month. He had an episode of hypertensive emergencies. A radiological and hormonal work-up established the diagnosis of primary ACC. One cycle of chemotherapy was given until he lost follow-up and succumbed to death due to financial constraints. Conclusions: Adrenocortical carcinoma is an extremely uncommon tumor of the adrenal gland, and it is even more uncommon when it manifests without any symptoms. If patients exhibit signs of rapid and multiple adrenocortical hormone excess, such as weakness, hypokalaemia, or hypertension, ACC may be suspected. Recently developed gynecomastia in men may be brought on by an ACC producing too much sex hormone. To accurately diagnose the condition and give the patient a fair prognosis, a multidisciplinary approach involving endocrine surgeons, oncologists, radiologists, and internists is advised. Proper genetic counseling is recommended. It is critical to know whether the adrenal mass is malignant or not, and to get this ascertained by a computed tomography finding and biopsy.

Introduction: Physical activity is defined as any bodily movement produced by skeletal muscles that requires energy expenditure. Nerve conduction studies and surface EMG provides a comprehensive evaluation of nerve, muscle or neuromuscular impairment. However, such studies are mostly done on professional athletes. Methods: Healthy physically active (n=17) and non-active (n=17) medical undergraduate students from B.P. Koirala Institute of Health Sciences (BPKIHS), Nepal were enrolled in the study using convenient sampling technique. Anthropometric and motor nerve conduction parameters of common peroneal nerves and surface EMG of gastrocnemius muscle were recorded using standard technique in Neurophysiology Lab II, BPKIHS. Descriptive analysis was done. Unpaired t-test was applied for comparing the nerve conduction and surface EMG variables between the groups. Pearson’s correlation was applied between anthropometric and nerve conduction & surface EMG variables. Objectives: To compare nerve conduction parameters of common peroneal nerve and surface EMG of Gastrocnemius muscle between active and non-active individuals. Results: The distal and proximal amplitudes of left common peroneal nerve were significantly higher in physically active compared to non-active individuals (LCPDA-p value: 0.026, LCPPA-p value: 0.009). Anthropometric parameters showed significant correlation with nerve conduction parameters. Conclusion: Nerve conduction parameters are affected in the physically active individuals. Anthropometric variables showed significant relation with the nerve conduction parameters. Keywords: Nerve Conduction Velocity, Surface Electromyography, Peroneal Nerve, Gastrocnemius.

Cleft lip and palate (CLP) are one of the most frequently occurring craniofacial congenital anomalies. A syndromic association is frequently seen in such cases. A feeding obturator is a prosthetic aid that assists a patient in obturating a cleft until surgery is performed.

Cleft lip and palate (CLP) are one of the most frequently occurring craniofacial congenital anomalies. A syndromic association is frequently seen in such cases. A feeding obturator is a prosthetic aid that assists a patient in obturating a cleft until surgery is performed. Cleft lip surgery or cheiloplasty is often performed three months after birth, while palate surgery or palatoplasty is typically performed between the ages of six and fourteen months. A 2-day-old newborn presented to the Pediatric Emergency with a complaint of difficulty in feeding. On examination, bilateral cleft of the lip and unilateral cleft of the palate was present. The ultrasonography of the fetus before the birth had revealed non-visualized left kidney, so an ultrasonography (USG) of the abdomen and pelvis was advised which confirmed the finding i.e., left renal agenesis. Electrocardiography (ECG) revealed an arterial septal defect (ASD) of 4.5 mm. Such presentation is commonly seen in cases of isolated gonadotropin-releasing hormone (GnRH) deficiency (IGD). A custom-made feeding obturator was fabricated and delivered to help the baby overcome feeding difficulties. Parents were instructed and well-taught to feed the child with the appliance in place. Apart from giving appropriate instructions regarding feeding and maintenance of the appliance, parents were also informed about the surgical procedures that would be followed at a later date. Also, considering the exceptional psychological situation of the family and the need for a long-standing relationship between the cleft team for a successful outcome, appropriate counseling with reassurance was rendered to the family members.