To Compare the Outcome of Minor Anorectal Surgeries Under Local Anesthesia Versus Spinal Anesthesia.

The purpose of study is to analyze the feasibility, utility, and advantage of using alternate methods of anesthesia in patients undergoing surgeries for minor anorectal ailments. A total of 60 cases with proctoscopic findings of low fistula in ano, fissure in ano, hemorrhoids grade II and grade III, were operated between October 2005 and April 2007. Patients were randomized and divided into two groups of 30 each. Group A underwent surgeries under local anesthesia while group B under spinal anesthesia. There was no significant difference in operating time and patient satisfaction score. Postoperative urinary retention was significantly higher in group B-30 % patients in group B versus 6.7 % in group A. Hospital stay was significantly decreased in group A, with 93.3 % patients discharged on day 1 as compared to 70 % in group B (P = 0.02). Surgeries under local anesthesia were beneficial in terms of hospital stay and postoperative complications like urinary retention. No significant difference in patient satisfaction was observed. Hence, compared to spinal anesthesia, local anesthesia is a safe and advantageous technique in performing minor anorectal surgeries.

Smoking among Nepali youth--prevalence and predictors.

Tobacco is the single largest risk factor for various diseases and its presence in the young heralds more serious problems as they may be exposed for longer periods. Prevalence and predictors of smoking among youth will aid in formulating effective preventive and control measures. A cross-sectional study was therefore conducted among 816 students selected from five colleges of Western Nepal using a self-administered questionnaire. Prevalence of ever smoking was 34.2% (males 47.6% and females 18.4%) and for current smoking was 17%. It was higher among youth belonging to 21 years or older as compared to younger age groups. Mean age of initiation was 16.8 years (standard deviation 2.8 years) and the most common reasons cited for smoking were; like it, to feel more relaxed, out of boredom and to look more mature. Proportion of youth who said they felt they were addicted was 43.1% and 64.7% said that they had tried to quit the habit. Most important predictors having independent effects on youth being ever smokers were having three or more smoker friends (OR=18), their own chewing (OR=4.8) or alcohol use (OR=4.2), male gender (OR=3.7) and the type of course they were pursuing, with professional course students having higher risk. With almost one fifth of college-going youth smoking and a higher prevalence in older age groups within them, smoking is a serious concern for young people in Western Nepal.