Sporadic Creutzfeldt-Jakob Disease in a Patient With Multiple Sclerosis: A Case Report.

Sporadic Creutzfeldt-Jakob disease (CJD) is a rare neurodegenerative condition and a human prion disease. Rapid progressive dementia, myoclonus, visual disturbances, cerebellar signs, and pyramidal/extrapyramidal symptoms are observed in such patients. However, these are non-specific symptoms and can manifest in a variety of other conditions. The occurrence of sporadic CJD in a patient with multiple sclerosis (MS) is rare. This is the case of a 54-year-old man on natazulimab for MS who developed rapid neurocognitive changes along with visual changes, imbalance issues, and mood changes. Diagnosis of sporadic CJD (sCJD) was confirmed through clinical features, physical examination and electroencephalogram findings, cerebral spinal fluid analysis, and later magnetic resonance imaging findings. sCJD with MS being a rare phenomenon, its recognition requires a high index of suspicion, careful chronological evaluation of the patient's symptoms, and relevant investigations that can aid in reaching the diagnosis.

Association Between Internet Addiction, Depression and Sleep Quality Among Undergraduate Students of Medical and Allied Sciences.

BACKGROUND: The use of the internet is growing rapidly worldwide with easier availability and affordability in developing countries like Nepal. Apart from several benefits, it has also led to deleterious effects on certain individuals' physical and mental well-being. The present study aimed to assess the burden of internet addiction among nursing, dental and medical undergraduates at a medical school, and examine its relationship with depression and sleep quality. METHODS: A cross-sectional study among 494 students pursuing nursing, dental and medical undergraduate courses at the same medical college in Nepal was conducted. The burden of internet addiction, depression, and sleep disturbance was assessed using Young's Internet addiction test, Beck's depression inventory, and Pittsburgh Sleep Quality Index questionnaires respectively. RESULTS: The majority of respondents reported either controlled use of internet or mild problem with internet use. However, 4.7% of respondents reported significant problems due to internet use. Further, about 42.3% reported poor sleep quality, and 8.9% screened positive for depression. In both chi-square and logistic regression analyses, internet addiction was significantly associated with poor sleep quality and depression. CONCLUSION: The study shows that about half of the participants experienced at least some problems and a small but significant proportion of them reported severe problems due to internet use. This warrants the need to address the issue of internet addiction among medical and allied sciences students in Nepal. Further, internet addiction is associated with both depression and poor sleep quality, highlighting a need to develop effective interventions targeting all three problems holistically.

Knowledge of Alzheimer's Disease Among Medical Students of a Medical College.

INTRODUCTION: Dementia is a public health concern as the prevalence is increasing worldwide with significant increase being in low-middle income countries. However these countries appear to be less prepared in handling this rise in terms of diagnosis and management. METHODS: This cross-sectional study was conducted in Kathmandu medical College, from June 2017 to July 2017. Purposive sampling was done and the medical students who were in their first and final year of study were included in the study after obtaining an informed consent. RESULTS: Total 185 students were included in the study, 80 (43.24%) from first year and 105 (56.75%) from final year of medical study. The mean score of knowledge among the students was 17.44±2.46; 15.32±1.22 among first year and 19.06±1.87 among the final year students. Majority of the students said they have heard about dementia however, only 3 (3.75%) of first year and 43 (41.9%) from final year students have either attended a class or continuing medical education on dementia Conclusions: The knowledge about dementia was found to be average among medical students but better among final year medical students in comparison to first year. The knowledge was found to be better statistically among those who had either attended a class or continuing medical education on dementia or had exposure through different medias.

Pattern of abortion care in a tertiary level maternity hospital in Nepal.

INTRODUCTION: Complications from unsafe abortion are believed to account for the largest proportion of hospital admissions for gynaecological services in developing countries and not to mention the cost it imparts to the health system of a country. Therefore, it is equally important to find out the prevalence and the pattern of abortion among the women who utilize the safe abortion care services and provide a framework to target various health promotion programs including safe-motherhood and reproductive health; such that the future interventions to avoid the unintended pregnancy and unsafe abortion can be implemented accordingly. METHODS: A cross-sectional study was conducted in a tertiary care hospital in Kathmandu, Nepal. Social and demographic information of all the women seeking induced abortions from January 2011 to December 2012 were included and the result was analyzed. RESULT: Abortion contributed to about 1.68% of the total patient served in the hospital that provides both obstetrical and gynecological services. Of the total 4830 patients who underwent induced abortion in this period, the mean age was 27, 92.3% were from the Kathmandu valley and more than one-third women (35.2%) were illiterate who couldn't read and write. Majorities were more than two parity and belonged to higher caste. CONCLUSION: The socio-demographic profile of the abortion clients in Nepal has remained similar over the years. We need to address the accessibility and availability to the safe abortion care services along with other safe motherhood programs guaranteeing access to safe abortion and post-abortion care to all group of women and also, women education regarding contraception to avoid repeated abortions or unwanted pregnancy in the future.

Tuberculosis in HIV patient.

INTRODUCTION: Strict monitoring ofanti tuberculosis therapy and antiretroviral therapyis crucial for proper management of TB/HIV co-infected patients. METHODS: Between December 2006 and December 2008 a prospective observational study was conducted among 135 TB/HIV co-infected patients visiting antiretroviral therapy in Seti Zonal Hospital, Dhangadi. The diagnosed TB patients were subjected to ATT through directly observed treatment short-course (DOTS) and its response was evaluated as per WHO guidelines. RESULTS: Among 135 studied subjects, 97 (71.9%) were males and over 119 (88 %) of the patients were in the age group 21 to 50. Of the total TB cases 92 (68.1%) presented pulmonary TB and 37.20% of the Extra-pulmonary Tuberculosis cases were lymph node TB. 72 (53.33%) of them had completed ATT, 11 (8.2%) transfer out and 17 (12.6%) were default. CONCLUSIONS: Majority of the patients presented PTB, and lymph node TB was found to be the most common EPTB. Comparatively, high efficacy of ATT was found in HIV patients visiting this resource poor setting.