Saree on Fireside: Fatal Burn in an Elderly Nepalese Female

As winter approaches, people in the land of rural Himalayas commonly use fire as the source of heat. Many accidents occur in the process, and mostly the victims are among unattended children and the elderlies. We present a case from rural Nepal where an elderly female sustained fatal burn injuries. Advanced age, greater surface area, and secondary infection were the complicating factors. In the present case, the victim's clad cloth (Saree) was the harbinger to death. Prevention of infection following burn and control of sepsis still remains the mainstay of treatment in burn victims.

Study on Hanging with Brief Discussion upon Ambiguity in Method of Choice and Gender Differences for Completed Suicide in Existing Literatures in Nepalese Scenario

Background Hanging is one of the common forms of violent mechanical asphyxial deaths. When compared to other forms of unnatural death all over the world this method stands on top as death is instantaneous. Death due to hanging is always suicidal until and unless otherwise specified. Objective To explore the socio-demographic characteristics in cases of death due to completed hanging in Nepal. Method This prospective study of death due to hanging was conducted during the period of July 2011 to July 2013. Meticulous autopsy of the body was done in all cases with bloodless dissection of the neck was carried out. Result During the study period medico legal autopsy of 91 cases of death due to hanging was conducted, out of which 57 (63%) were males and 34 (37%) were females. Majority of the deceased were suspended at their own house or peri-domestic settings. Based upon the circumstantial evidences 95.61% (n=87) cases attributed to suicide in nature. Conclusion Hanging undoubtedly is one of the most preferred methods to commit suicide, popular for its lethality. Lack of suicide surveillance system and national data bank in Nepal has resulted into equivocal findings. More studies should be encouraged based upon autopsy findings to get a clear picture on mortality rates.

Obligate Myiasis: A Case Series From Nepal

Although maggots are unanonymously linked to carcass or dead tissues, there are reports of its infestation into living tissues as well. Myiasis denotes maggot infestation in living tissue. There are two forms of myiasis namely obligate and facultative. Obligate myiasis denotes maggots feeding on living tissue whereas facultative myiasis represents the opportunistic behaviour of the fly taking advantage of wound or necrotic tissue, laying by eggs which hatch into maggots. Decreased physical activity and poor hygiene leads to maggot infestation. Maggot invasion of living tissues is undesirable occurrence which can best be avoided by improving hygiene. People with low living standards in the developing nations are the occasional victims for maggot infestations. We present cases of obligate myiasis for their uniqueness and rarity.

Comparision of Extramucosal Enucleation and Submucosal Excision Technique for the Treatment of Oral Mucocele at Birat Medical College & Teaching Hospital, Morang, Nepal

IntroductionMucocele is a painless swelling in the oral cavity usually confined to the lower lip. Of the various treatment techniques surgery remains the best modality.ObjectivesThe present study is aimed to observe the prevalence of mucocele in Eastern Region of Nepal and to compare the results of extramucosal enucleation and submucosal excision as the treatment of mucocele.MethodologyThis prospective study was conducted on patients diagnosed with mucocele in Birat Medical College Teaching Hospital; a tertiary centre in Eastern Nepal during the period between June 2014 to April 2017. Out of total 37 cases two groups were divided based upon size of mucocele. Patients underwent extramucosal enucleation in cases where the size of mucocele was less than 1 cm and submucosal excision was done in patients whose size of the mucocele exceeded 1 cm. The data was entered and analyzed using Statistical Package for the Social Sciences (SPSS) vs 21. Different parameters like wound infection, scar formation, recurrence, healing time, follow up were compared for both the methods.ResultThe mean age of the patient in extramucosal enucleation was 9.90±2.807 while in submucosal excision was 11.22±3.068 years. The most common location for mucocele in both the groups was the lower lip; who underwent either extramucosal enucleation (90%) or submucosal excision (70.4%). Recurrence was not observed in submucosal excision whereas one patient with extramucosal enucleation had recurrence.ConclusionMucocele in comparison to extramucosal enucleation as it usually healed within a week with fewer incidences of wound infection and without any recurrence.Birat Journal of Health Sciences Vol.2/No.1/Issue 2/ Jan - April 2017, Page: 215-218

Awareness and Perceptions of Medical Students towards Health Care Ethics - A Study from Nepal

Background Medical practitioners are the men of science who treat patients based on their knowledge and skill. Unethical and immoral conduct in the practice of medicine pertains to human right issues and litigation. Objective The present study is conducted to understand the perceptions and awareness of the moral and ethical responsibilities of future medical doctors in Nepalese scenario. Method This cross sectional study was carried out among the undergraduate medical students of Manipal College of Medical Sciences, Pokhara, Nepal who were administered a pre-tested, semi-structured questionnaire relating to various aspects of health care ethics. A total of 202 students (116 girls and 86 boys) voluntarily participated in the study. Based upon the criteria whether a student had attended forensic medicine lecture the study participants were thus divided into two groups Group I and Group II. The responses of the participants were obtained on a 5 point Likert scale and analyzed. Result The study observed that the overall awareness on issues regarding consent was proportionately higher than for issues dealing with patient's right to treatment. The awareness levels were similar among the students of both groups for most of the issues with exception of a few issues where awareness levels were higher among the Group II students when compared to the Group I students. Conclusion This present study attempts to present the assessment of students on issues relating to ethics and moral reasoning. The present study also emphasizes on the importance of ethics in the practice of medicine.

Pressure Cooker-A Potential Hazard in Domestic Setting

Pressure cooker is an integral part of Asian kitchen, and is frequently used in Nepal. Steam under pressure generated while cooking has high boiling point and great penetrating power. The use of pressure cooker in kitchen is associated with unintentional injuries that mostly include pressure cooker burns. In rare instances the pressure cooker may accidently explode and may cause serious injuries. The same mechanism is used in making explosive device for mass homicides. An unusual case of penetrating facial injury sustained in a pressure cooker explosion in a domestic setting is reported along with a brief review of literature on pressure cooker explosions.