Waldmann's disease, or primary intestinal lymphangiectasia, is an unusual cause of protein-losing enteropathy primarily characterized by lymphopenia, hypoalbuminemia, and hypogammaglobulinemia. However, variable clinical presentations result dilemmas in diagnosis and effective management. We present a toddler diagnosed with Waldmann's disease managed with a high-protein diet and medium-chain triglyceride supplementation.

The Gharial (Gavialis gangeticus), also known as the gavial or fish-eating crocodile, is a member of the family Gavialidae, is the most threatened of the two species of crocodilians found in Nepal. However, sufficient information on its habitat characteristics influencing population status, distribution, and threats to its existence are lacking. We studied the gharial population in the Narayani River that was carried out in the winter season during December 2019 to April of 2020. During our surveys, a total of 117 gharials were recorded, including an adult male, 56 adult females, 19 sub-adults, 32 immature and nine were unidentified. The gharial census recorded 57 gharials in Sikrauli-Amaltari (Chitwan branch) river section followed by 14 in Sikrauli-Amaltari (Nawalparasi branch), 16 in Amaltari-Baguwan and 30 in the Baguwan-Tribeni River sections. Of 117 individuals, the number of gharials sighted under the direct observation category was 112. The majority of respondents (129 of 140) during our questionnaire, considered gharial as an important species and displayed a favorable attitude towards gharial conservation. This study concludes that the population of gharial in the Narayani River has increased, as the present population is larger than recorded during previous surveys. Finally, regular surveys and monitoring of gharial in the area are recommended to investigate the status of gharial, the prevalence of any threats and disturbance along the habitat of this important species.

Every year, more than 200 million surgeries are performed around the world, and recent statistics show that adverse event rates for surgical pathologies remain unacceptably high, despite several national and global patient safety initiatives over the last decade. Patient safety is diverse and highly complicated in nature, with several critical components. Although concern for patient safety is fundamental in health care practice, its transition into knowledge is comparatively recent, and hence patient safety may be deemed a "new" field. Current surgical safety guidelines and checklists are generic and not adapted to specific patient concerns and risk factors in surgical subspecialties. All surgical practitioners and health care organizations must therefore become better aware of the fundamental context of patient safety, actively participate in endeavors to integrate patient safety measures in daily practice, and foster a patient safety culture. The purpose of this review article is to outline patient safety in surgical techniques that should be adopted and implemented.

Ciprofloxacin, among the many Fluoroquinolones, has been widely used as a broad‐spectrum antibiotic due to its wide range of action and relatively safe adverse effect profile. However, among the cutaneous adverse drug reactions due to Ciprofloxacin, toxic epidermal necrolysis occurring along with cholestatic hepatitis is a rare one. Here, we present a case of a 22‐year‐old male patient who was diagnosed with toxic epidermal necrolysis with cholestatic hepatitis secondary to Ciprofloxacin. Naranjo adverse drug reaction probability scale was used for the causal association.

Background: This study aimed to investigate the demographic characteristics, anatomical distribution, and histopathological features of hydatidosis and cysticercosis in a Nepalese population presenting to a tertiary care hospital. The study also aimed to provide a better understanding of the clinical and pathological aspects of these diseases in the local context. Methods: This retrospective study analyzed all cases of hydatidosis and cysticercosis reported in the Department of Pathology at Tribhuvan University Teaching Hospital between January 2013 and December 2019. Demographic, clinical, radiological, and histopathological data were collected and analyzed from hospital charts. Results: During the 7-year study period, the authors identified 112 cases of hydatid cysts and 26 cases of cysticercosis. The mean age of patients with hydatidosis was 33.86 years (range: 5–74 years), while the mean age of patients with cysticercosis was 25.39 years (range: 4–63 years). Females were more commonly affected with hydatidosis (68, 61.7%) than males (44, 39.3%), resulting in a male-to-female ratio of 0.6:1. In contrast, there was no significant sex difference in cysticercosis cases, with 14 (53.85%) males and 12 (46.15%) females affected. The most commonly affected site for hydatid cysts was the lung (47 cases, 42%), followed by the liver (41 cases, 36.6%). The study identified three cases of neurocysticercosis. The average diameter of hydatid cysts and cysticercosis was 8.7 cm and 1.7 cm, respectively. Conclusion: In conclusion, our study provides important insights into the clinical and pathological features of hydatidosis and cysticercosis in a Nepalese population. These zoonotic diseases pose a significant health burden, particularly among the poor and marginalized populations. Our findings highlight the need to integrate prevention and control measures into the healthcare system to decrease the overall burden of these diseases.