Addressing Domestic Violence in Antenatal Care Environments in Nepal (ADVANCE) - study protocol for a randomized controlled trial evaluating a video intervention on domestic violence among pregnant women.

BACKGROUND: Domestic violence (DV) prior to, and during pregnancy is associated with increased risks for morbidity and mortality. As pregnant women routinely attend antenatal care this environment can be used to offer support to women experiencing DV. We have developed a video intervention that focuses on the use of behavioral coping strategies, particularly regarding disclosure of DV experiences. The effectiveness of this intervention will be evaluated through a randomized controlled trial (RCT) and a concurrent process evaluation. METHODS: All pregnant women between 12-22 weeks of gestation attending routine antenatal care at two tertiary level hospitals in Nepal are invited to participate. DV is measured using the Nepalese version of the Abuse Assessment Screen (N-AAS). Additionally, we measure participants' mental health, use of coping strategies, physical activity, and food security through a Color-coded Audio Computer Assisted Self Interview (C-ACASI). Irrespective of DV status, women are randomized into the intervention or control arm using a computer-generated randomization program. The intervention arm views a short video providing information on DV, safety improving actions women can take with an emphasis on disclosing the violence to a trusted person along with utilizing helplines available in Nepal. The control group watches a video on maintaining a healthy pregnancy and when to seek healthcare. The primary outcome is the proportion of women disclosing their DV status to someone. Secondary outcomes are symptoms of anxiety and depression, coping strategies, the use of safety measures and attitudes towards acceptance of abuse. Follow-up is conducted after 32 weeks of gestation, where both the intervention and control group participants view the intervention video after completing the follow-up questionnaire. Additionally, a mixed methods process evaluation of the intervention will be carried out to explore factors influencing the acceptability of the intervention and the disclosure of DV, including a review of project documents, individual interviews, and focus group discussions with members of the research team, healthcare providers, and participants. DISCUSSION: This study will provide evidence on whether pregnant women attending regular antenatal visits can enhance their safety by disclosing their experiences of violence to a trusted person after receiving a video intervention. TRIAL REGISTRATION: The study is registered in ClinicalTrial.gov with identifier NCT05199935.

Awareness Regarding Cervical Cancer among Reproductive Age Women Residing in Nuwakot District.

Background Cervical cancer is the most common malignancy among Nepalese women and it is main cause of death among reproductive age women in Nepal. Objective The objective of this study was to find out awareness regarding cervical cancer among reproductive age women residing in Nuwakot district. Method A descriptive cross-sectional study was conducted to assess the awareness about cervical cancer among reproductive age women of Nuwakot district from April to May 2021. A total of 190 respondents were interviewed using structured questionnaire. Descriptive and inferential analysis were conducted using SPSS version 23 not licenced but trail version. Result Among 190 reproductive age women, the mean age was 33.37±8.39 (Mean±SD). Nearly 10% of respondents answered the meaning of cervical cancer correctly. Among them 30% of respondents did not know about the cause. Similarly, only 7.4% of respondents answered that HPV Infection was risk factor, 2.6% of respondents knew about appropriate age for HPV vaccine. However, nearly 19% of respondents answered that cervical cancer screening was needed for sexually exposed women. There was a significant difference in mean of awareness among different ethnicity (p=0.014), educational level (p=0.001) and there was no significant difference in mean of awareness among different age group, marital status, occupation, family history of cervical cancer and smoking habit. Conclusion Most of the reproductive age women were unaware about meaning, causes, risk factors and preventive measures of cervical cancer. So, there is a need for the implementation of awareness programs on cervical cancer and its preventive measures in this community.

Perception Regarding Care of Attempted Suicide Patients among Nursing Students in Kathmandu University School of Medical Sciences.

Background Suicide is an act of deliberately killing oneself. It is a global health problem and is the second leading cause of death in 15 to 29 years. Thus, studying nursing students' perception towards suicide attempters has paramount importance in understanding and addressing the existing gaps in healthcare delivery system. Objective To assess the nursing students' perception towards attempted suicide and to find out the association between perception and selected variables. Method A descriptive, cross sectional design was carried out to assess the nursing students' perception towards suicide attempters in Kathmandu University School of Medical Sciences. The respondents were 193 nursing students. A structured questionnaire was used in order to collect data. Descriptive statistics including frequency, percentage, mean and standard deviation were calculated to summarize the data and inferential statistics, Mann Whitney-U test was used for the association between perception and selected variables. Result A total 193 nursing students participated in this study. The scores between 1 and 2.4 were considered 'positive', 'unsure' or 'uncertain', between 2.5 and 3.4 and negative for 3.5 and above' over all nurses showed relatively negative perception towards suicide attempters. According to results from eight domains of perception, those who did not attend the courses on psychiatry nursing presented higher score, which was found to have significant association with permissiveness, unpredictability and incomprehensibility. A younger nursing student shows significant association with incomprehensibility. Younger nursing student showed statistically significant association with duration of suicide process. Conclusion Nursing students are frequently encountered with attempted suicide patients. Therefore, they must be aware of their attitudes toward this group of patients as part of their professional and therapeutic role. Thus a nurse's positive perception towards attempted suicide can play a key role in communicating and preventing a future suicide attempt.

Association of Subjective Sleep Quality and Glycemic Level in Patients with Type 2 Diabetes Mellitus: A cross sectional study.

Background Sleep disorders are considered as one of the important risk factor which have a great impact on patients with type 2 diabetes mellitus. Objective The objectives of this study was to determine the effect of sleep quality on the glycemic level among type 2 diabetic patients. Method This was a cross sectional study done in 208 type 2 diabetic patients visiting Kathmandu Medical College Public Limited from July 2019 to December 2019. Data regarding sleep quality was collected by using Pittsburgh Sleep Quality Index taking global cut off score ≥ 8 as poor sleeper. Glycated hemoglobin level ≥ 7 was considered as poor glycemic control. Chi square test was used to compare parameters between good sleeper and poor sleeper. Independent sample t test compared the means of Pittsburgh Sleep Quality Index factors and glycemic contol. A logistic regression analysis of Pittsburgh Sleep Quality Index factors and glycated hemoglobin was done. Values of p ≤ 0.05 were considered statistically significant. Result The study findings revealed that 62 % had poor glycemic control and 58.7 % were poor quality sleeper. There was a significant association of sleep quality with glycemic control and duration of diabetes. Logistic regression analyses showed that subjective sleep quality was risk factor for poor glycemic control. The odds ratio for subjective sleep quality was found to be 4.59 (2.13-9.91). Conclusion Poor sleep quality was common in type 2 diabetic patients. This study showed that the risk factors for poor subjective sleep quality include poor glycemic control and longer duration of diabetes mellitus.

Risk-based Management of Non-muscle Invasive Bladder Cancer: Experience from Tribhuvan University Teaching Hospital.

Background Most of the recent evidences suggest for risk-based management of non muscle invasive bladder cancer (NMIBC) to reduce the risk of recurrence and progression. Objective This study was conducted to assess the recurrence and progression of non muscle invasive bladder cancer in Nepalese patients using European Organization for Research and Treatment of Cancer (EORTC) risk tables and to assess the effectiveness of intravesical therapy to reduce the risk of recurrence. Method A prospective observational single centre study was conducted at Tribhuvan University Teaching Hospital from January 2010- December 2012. Forty six patients with non muscle invasive bladder cancer who underwent transurethral resection of bladder tumor and completed two years follow up were included. According to the European Organization for Research and Treatment of Cancer (EORTC) risk table, the patients were divided into low, intermediate and high risk groups. The patients received postoperative adjuvant therapy and surveillance as per the European Association of Urology guidelines. Result Among the 46 patients, the overall two year recurrence and progression rate was 8 (17%) and 1 (2%) respectively. Out of seven patients in low risk category, none of them developed recurrence or progression of disease. Out of 15 patients in intermediate risk category the one year and two year recurrence rate was 13% and 20% respectively. Out of 24 patients in high risk category the one and two year recurrence rate was 17% and 21% respectively. The risk reduction by use of intravesical Bacillus Calmette Guerin (BCG) for recurrence in high risk category was 58% and 60% in first and second year respectively. In our study, the overall and individual risk group, the one and two year recurrence rate was lower than that predicted by European Organization for Research and Treatment of Cancer risk table. Conclusion Risk-based management of non muscle invasive bladder cancer by using the European Organization for Research and Treatment of Cancer risk table is a useful method of management, though its prediction rates are lower in Nepalese population.

Perceptions and Attitudes towards Evidence Based Practice among Nurses and Nursing Students in Nepal.

Background As the evidence based practice (EBP) movement expands, there is a need for health leaders and educators in each country to assess the extent to which health professional students and practitioners are prepared to locate, evaluate, and apply evidence to guide their practice. Objective The study objective was to explore nurses' and nursing students' perceptions and attitudes towards EBP. Method This was a descriptive cross-sectional survey administered to all 273 nurses and nursing students from Nepal who attended an EBP conference. The survey instrument that was used by Majid in Singapore was adapted for use in this study with permission from the author. Result In total, 121 nurses participated in the study. The majority (93%) of respondents reported that they had no previous training in EBP. The respondents' perceptions of their EBP knowledge and skills were variable, but most of them demonstrated positive attitudes toward EBP. Respondents identified a number of barriers that limit the implementation of EBP in Nepal. The greatest barriers were lack of time and resources, difficulty understanding research articles and translating the findings to practice, and limited autonomy to change practice based on evidence. Conclusion Although respondents had positive attitudes towards EBP, their knowledge and skills were limited and barriers to implementation existed. Nursing faculty can use the findings to guide implementation of EBP into curricula, and nursing administrators and clinicians can use the findings to guide practice to promote EBP.

Phaeochromocytoma in Nepal--a single centre experience.

BACKGROUND: Phaeochromocytomas are rare tumors of chromaffin cells of neural crest that classically present with symptoms of catecholamine excess such as palpitations, headache and sweating. They are diagnosed by measuring plasma or urinary levels of catecholamines or their metabolites. Anatomic localization is done by computed tomographic scan or magnetic resonance imaging, or meta-iodobenzyl guanidine scan in certain cases. Adequate preoperative catecholamine blockade prevents perioperative hemodynamic instability. OBJECTIVES: To study the clinical spectrum and management of phaeochromocytomas in a tertiary care centre, Tribhuvan University Teaching Hospital, in Nepal. METHODS: Retrospective review of case records of histologically proven cases of phaeochromocytomas from 2008 -2011 was done, and data collected on clinical spectrum, diagnostic modalities, perioperative management and follow-up. RESULTS: Twelve cases of phaeochromocytomas were operated. The mean age was 36.41+/-14.07 years. There were 2 bilateral phaeochromocytomas and 1 extraadrenal paraganglioma. Apart from the common symptoms of catecholamine excess, patients had atypical presentations like psychiatric manifestations and blurred vision. A combination of urinary Vanillyl Mandelic Acid and computed tomographic scan was used for diagnosis, and open surgery was done in all cases. Pre-operative blood pressure control was achieved by prazocin or calcium channel blockers. Ten patients had intraoperative surge in blood pressure. There were no major morbidity or mortality. Three patients had high blood pressure postoperatively, but were effectively managed with antihypertensives. CONCLUSION: Phaeochromocytomas can have variable presentation. Good preoperative preparation and perioperative management can result in an excellent outcome.

Pattern of renal cell carcinoma - a single center experience in Nepal.

BACKGROUND: Renal tumor is the 13th most common malignancy in the world and more than 90% of renal tumors are renal cell carcinomas. As there is no data available on renal cell carcinoma in Nepal, hence this study was undertaken to analyze the patterns of renal cell carcinoma in patients with renal mass at a tertiary level hospital in Nepal. OBJECTIVES: To analyze the patterns of renal cell carcinoma in patients with renal mass at a tertiary level hospital in Nepal. METHODS: The case records of 50 consecutive patients with renal cell carcinoma presenting at the Tribhuvan University Teaching Hospital, Kathmandu from July 2006 to June 2011 were retrospectively evaluated for presenting symptoms, physical finding, investigation and histopathology report. RESULTS: Out of 50 patients, 64% were male and 36% were female. The age ranged between 11 to 78 years (mean ± SD: 55 ± 15 years). Fifty four percent of patients were smokers. Incidentally tumor was detected in 40% cases by ultrasonography and the typical triad was present in only 4%. The tumor was occupying upper pole in 40% of cases. The tumor size ranged from 3 to 15 cm (mean ± SD: 7.3 ± 2.9 cm). Histopathologically, 76% of the patient had organ confined renal cell carcinoma (T1- 2 N0 M0). Clear cell was the most common type seen in 86%. Fuhrman nuclear grade 2 was found in 50%. CONCLUSION: Many of the renal cell carcinoma are detected incidentally, at an early stage and are of clear cell subtype.

Urological complication after kidney transplantation.

BACKGROUND: Renal transplantation is a regular service at Tribhuvan University Teaching Hospital and complications have been known to occur after it. This study was conducted to assess complications after transplantation. OBJECTIVES: To determine the incidence of urological complications after living related renal transplantation at Tribhuvan University Teaching Hospital. METHODS: A clinical study was performed (from August 2008 to July 2010) which included 50 living-related renal transplantations at Tribhuvan University Teaching Hospital. All the donors and recipients were evaluated preoperatively with necessary investigations and followed up postoperatively with standard hospital transplant protocol. The incidence of urological complications were documented and analyzed. RESULTS: Fifty living-related, renal transplantations were carried out during the study period. Seven doors had minor post operative complications; three had post operative fever, two had chest infections and each one had superficial surgical site infections and severe pain at incision site. Ureteroneocystostomy was performed with double J stent in all recipients. Urological complications were noted in 12 (24%) recipients. Clinical significant hematuria occurred in four cases. One patient had ureteric necrosis and urinary leak which required re-exploration post operatively. Two patients developed delayed ureteric stricture which were managed by antegrade Double J stenting and ureteric reimplantation. Peri-graft abscess occurred in two cases, which were drained percutaneously. surgical site infections was seen in one case. CONCLUSIONS: Urological complications are inevitable in renal transplantation and our complications rate appears similar to that reported in literature.

Retrospective analysis of management of patients presenting with acute urinary retention due to benign prostatic hyperplasia: a hospital based study.

OBJECTIVES: To analyze current practice of management of acute urinary retention (AUR) in men above 40 years of age at B.P.Koirala Institute of Health Sciences, Nepal. MATERIALS AND METHODS: A total of 68 patients (aged 50-91 years) presenting with indwelling catheter for AUR were included in the study. Because of lack of clear guideline and limited health care facility in our setup trial without catheter (TWOC) was given selectively depending mainly on preexisting symptoms. AUR presumed to be due to urinary tract infection received only antibiotic and others diagnosed of benign prostatic hyperplasia (BPH) received alpha 1 blocker prior to TWOC. TWOC was given 3-15 days after such treatment. Those satisfied without catheter for at least a week were considered successful TWOC. RESULTS: The data was available for 68 patients (mean age 66.1 years). Of 15 patients treated with antibiotic alone, 11 (73.3 %) had successful TWOC. Of 57 with presumptive diagnosis of BPH, 68.9% (31 of 45) had successful TWOC. Mean age, symptom score and prostate volume were higher for patients with unsuccessful TWOC. CONCLUSION: Selective TWOC may be imperative to minimize unnecessary suffering from AUR in less easily accessible health care facilities like ours. It may also reduce total cost of treatment.

Bacterial cells exposed to nanosecond pulsed electric fields show lethal and sublethal effects.

Cell suspensions of Escherichia coli K12 and Salmonella typhimurium were exposed to electrical pulses of 32 ns duration at a field intensity of 100 kV/cm and a repetition rate of 30 pulses per second for a total of 300 s. Treated cells were plated onto Tryptone Soya Agar (TSA) and TSA supplemented with NaCl, and cell counts were monitored daily for 3 days. The concentrations of NaCl used were 3 and 4% (w/v) for E. coli and 4 and 5% (w/v) for S. typhimurium. Treatment under these conditions resulted in a 2 log(10) reduction for E. coli and approximately a single log(10) reduction for S. typhimurium. For both species of bacteria it was discovered that the surviving population was composed of only 1% of uninjured cells. Moreover, the proportion of sublethally injured cells increased more rapidly than the total recoverable population suggesting a process of injury accumulation culminating in death rather than an 'all or nothing' mechanism. Sublethal injury manifested itself in a proportion of the injured population of both species by an extended lag phase at longer treatment times. Finally, possible mechanisms by which nanosecond electric pulses inactivate bacteria are discussed.

Marker-Negative Pheochromocytoma Associated with Inferior Vena Cava Thrombosis.

Pheochromocytoma associated with inferior vena cava (IVC) thrombosis is very rare. A 27-year-old female presented with right flank pain and hypertensive urgency. Contrast-enhanced CT abdomen and gadolinium-contrast MRI abdomen revealed right adrenal mass suspicious of malignancy with invasion and compression to the right IVC wall along with IVC thrombus extending from the level of renal veins to the level of confluence with hepatic veins. Her routine laboratory investigations including 24-hour urine fractionated metanephrines, vanillylmandelic acid, and cortisol were normal. Right adrenalectomy with IVC thrombectomy was done. Perioperative period was uneventful. Histopathology of the mass turned out to be pheochromocytoma with thrombus revealing fibroadipose tissue with fibrin. Pheochromocytoma may present with IVC thrombus as well as normal serum and urinary markers. Thus, clinical suspicion is imperative in perioperative management of adrenal mass.

Folie a Deux.

Shared psychotic disorder is a rare psychiatric disorder. It is defined when a primary psychotic person imposes his/her delusional beliefs to the other person usually in a close relationship. Occurrence of this disorder among family members and close friends has been described. However, its exact incidence and prevalence is not known. Since such case has not been reported in Nepal to best of our knowledge, we present a case of shared delusional disorder along with brief review of literature. This case report describes a case of common shared persecutory delusion in husband and wife.

Clinicopathological Pattern of Penile Cancer in a Tertiary Care Centre in Nepal.

INTRODUCTION: Carcinoma of penis is an uncommon entity. The higher incidence in developing country may be because of poor hygiene, less common practice of circumcision and unsafe sexual practice. Timely diagnosis and intervention gives the patient a chance of cure. Data on penile cancer is sparse from Nepal so treatment of penile cancer in our centre is presented here. METHODS: This was a retrospective cross-sectional study done at Urology unit of Department of Surgery of Tribhuvan University Teaching Hospital, Nepal from November, 2007 to December, 2013. Data was retrieved from case records and those with penile carcinoma were included. Patient demographics, lesion characteristics, mode of treatment with outcome measures were noted and analyzed. RESULTS: Total 17 patients underwent treatment for primary penile lesion. Mean age of the patients was 51.5 years. Penile growth was the most frequent presentation with five patients coming with more than one symptom. The most common site was over glans of penis (n=13) with the mean size of 3.55 cm. Partial penectomy was offered in 16 with one patient undergoing circumcision only. Inguinal lymph node dissection was done in four patients. Squamous cell carcinoma was the histological diagnosis in 15 patients. CONCLUSIONS: Penile carcinoma is primarily a disease of old. Growth over glans penis is the most common presentation and partial penectomy is feasible in most of the patients to allow oncological cure while preserving the organ for its native function.

Nephron sparing surgery in a tertiary care center in Nepal--an initial experience.

BACKGROUND: Malignant renal mass accounts for 2 to 3% of all malignant diseases in adults. Radical surgery used to be the treatment of choice with high propensity to develop chronic kidney disease in the compromised contralateral kidney. Currently, nephron sparing surgery is considered to be the standard of care with equivalent oncological outcome. METHODS: This was a retrospective chart review of patients with renal mass less than seven cm in size who had open nephron sparing surgery from July 2012 to Sep 2013 at Tribhuvan university teaching hospital, Nepal. Latest follow up either from record or over telephone was documented. RESULTS: Eight patients (mean age 45 years, male: female ratio1:1.6) underwent nephron sparing surgery over the specified period. Mean size of tumor was 4.75 cm. Mean ischemia time was 16.37 min. Histopathological diagnosis was benign in two and renal cell carcinoma in six patients. CONCLUSIONS: Nephron sparing surgery is safe in low stage renal tumors. It also prevents unnecessary nephrectomy in benign lesions and prevents negative sequelae of long term chronic renal impairment in remaining contralateral kidney.

Outcome of treatment of nonunion tibial shaft fracture by intramedullary interlocking nail augmentated with autogenous cancellous bone graft.

To assess results of operative treatment of non union fracture shaft of Tibia by intramedullary interlocking nail augmented with autogenous cancellous bone graft in our setup. A total of 25 nonunion tibial shaft fractures were evaluated among which 20 cases were male and 5 female with the mean age 31.84 years. Hypertrophic non-union were 14 and atrophic non union were 11. Upper one third of tibial diaphysis was involved in 4 cases, middle one third in 14 cases and lower one third in 7 cases. In all cases open reduction, interlocking nailing and autogenous cancellous bone graft was applied. The mean follow up was one year. Mean time for healing was 8.08 months. Mean operation time was 110 minutes (range 70 to 160 minutes). Satisfactory results (excellent and good) were achieved in 88% cases and unsatisfactory (fair and poor) results in 12% cases. This operative treatment option appears to have a high success rate and should be considered in nonunion of tibial diaphysis.

Comparative study in surgical outcome of intracapsular fracture neck of femur in active elderly patients treated with hemiarthroplasty with Austin Moore's and bipolar prosthesis.

Fracture neck of femur is most commonly encountered fractures in elderly population. Hemiarthroplasty is generally considered to be the treatment of choice in most active elderly patients. However, there is inadequate evidence to support the choice between unipolar or bipolar prosthesis. This study was conducted to analyze the outcome regarding pain, hip function, complication and acetabular erosion in patients randomly selected and treated with Austin Moore's or Bipolar hemiarthroplasty in our setup. The study included total of 40 patients (17 males and 23 females) with intracapsular neck of femur fractures with mean age of 67 years (55-85 years). 20 patients each were treated with Hemiarthroplasty using Austin Moore's and Bipolar prosthesis. The patients were followed up at intervals of 2 weeks, 6 weeks, 24 weeks and 1 year after the operation and evaluated clinically and radiologically. There were no significant differences between the groups regarding complication. The Harris hip score were 81.95% (SD - 2.99) in Austin Moore's hemiarthroplasty and 79.15% (SD - 2.94) in Bipolar hemiarthroplasty (p = 0.812), whereas acetabular erosion was 20.05% in Austin Moore's hemiarthroplasty and 5% in Bipolar hemiarthroplasty (p = 0.758) with no mortality seen during lyear follow up. The intracapsular neck of femur fracture in active elderly patients treated with Austin Moore's hemiarthroplasty had better outcome regarding pain and hip function whereas high acetabular erosion compared to patients treated with Bipolar hemiarthroplasty though the difference is statistically insignificant.

Diaphyseal femoral fractures in children treated with titanium elastic nail system.

Femur fractures are common long bone injuries in children which account for less than 2% of all paediatric fractures. Although these fractures are dramatic and disabling injuries for the child and parent, the good part is that they unite rapidly with minimal complications if aligned well. Various methods have been used successfully to treat these fractures, but they differ in their stability and potential for complications. The aim of our study was to see the outcome of titanium elastic nailing system in diaphyseal femoral fracture in children. The study included total of 30 children's (19 boys and 11 girls) of diaphyseal femoral fracture treated with titanium elastic nailing system and they were followed up at 2, 6, 12 and 24 weeks. The average duration of callus formation was 3.5 weeks with radiological union mean time of 9.5 weeks. Full weight bearing was possible in a mean time of 10 weeks. According to flynn's scoring criteria, excellent and good results were in 24 cases (80%) and 6 cases (20%) respectively. The nail irritation was present in 3 childrens and there was no post operative infection, physeal injury and implant failure. Titanium elastic nail is a safe and satisfactory mode of treatment and is relatively easy to perform in disphyseal fracture of femur in children. It avoids the chances of physeal injury, infection and offers rapid healing.

The treatment of trigger thumb in children: conservative or surgical?

The trigger thumb is an uncommon condition in infants and children which occurs due to pathology of flexor pollicis longus or A1 pulley. The objectives in our study were to determine the treatment outcome of trigger thumb. The study included total of 45 patients (24 males and 21 females) with trigger thumb. The mean age of onset was 28.5 months (3 months -7 years). There was overall success rate of 72.41% following conservative treatment and the success rate appears to be higher in the younger age group. The outcome of children who underwent surgery was 91.66% with recurrence rate of 8.33% and superficial wound infection rate of 4.16%. Our study suggests that surgery is not urgent, postponing surgery does not interfere with the result, trying conservative methods to get a higher chance of recovery is reasonable before the elective surgery. So conservative approach should be adopted in treating trigger thumb.

Outcome of pertrochantric fracture of the femur treated with proximal femoral locking compression plate.

Pertrochantric femoral fractures are one of the most common fracture in old patients with variety of complications. However fixing Pertrochantric femoral fractures properly is clinically challenging. We report the outcome of pertrochantric femoral fractures treated with Proximal Femoral Locking Compression Plate (PFLCP) using Minimal Invasive Percutaneous Plate Osteosynthesis (MIPPO) techniques which were evaluated clinically by Harris hip score and radiologically for a union at fracture site and implant related complication. The study included total of 33 patients (20 males and 13 females) with Pertrochantric femoral fractures. The mean ages of the patients were 57 years (23-88 years). Pertrochantric femoral fractures included both Intertrochantric and Subtrochantric femoral fractures. Patients were followed up at 2 weeks, 6 weeks, 3 months, 6 months and 1 year after the operation. Among the 33 patients, the union rate was 95% (31 patients). However there were 1 case of implant breakage and 1 case of non union. According to Harris Hip score the excellent and good results were 87.87% with no mortality during 1 year follow up period. The PFLCP can be feasible alternative to the treatment of Pertrochantric femoral fractures by providing biological healing and mechanical stability with limited occurrence of complications.