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Suitability regarding Health proteins Content Measured by simply MilkoScan FT-Plus Dairy Analyzer to gauge Bovine along with Ovine Colostrum Quality.
Covid positive pregnant women were increasingly getting delivery in the health institution. Most of them were asymptomatic and had positive report after their obstetric event was over because of emergency nature of care. Lack of autopsy is the lacunae in determining tissue pathology. One case of sudden intrauterine fetal death in Covid positive patient had induced delivery in the hospital and the placental histopathology examination showed widespread villous infarction, decidual arteriopathy with thrombosis and chorioamnionitis. Keywords Covid positive; fetal death; placenta; thrombosis.Coronavirus disease 2019 (COVID-19) pandemic will continue affecting pregnant women with possibility of vertical transmissions. However, knowledge and evidences regarding vertical transmission of COVID-19 are just emerging. This information is very crucial in the obstetrical care of COVID-19 infected women as well as in the care of newborn born to COVID-19 positive mothers. We report a case of vertical transmission in a neonate born to asymptomatic COVID-19 infected mother. Newborn was immediately shifted to isolation nursery and formula feed was started. The nasopharyngeal swab of newborn taken at 42 hours of life tested positive for SARS-CoV-2 by RT-PCR. learn more Therefore the vertical transmission in COVID-19 is possible. Despite this, the neonatal outcome is good. Keywords Duodenal atresia; flip flop circulation; neonates; persistent pulmonary hypertension of newborn.Symptomatic imperforate hymen is very rare in infants. Here we report a neonate who presented with imperforate hymen with abdominal distension, fever and loose stool. Imaging study showed large thick walled cystic lesion extending from pelvis to abdomen upto epigastric region with bilateral mild hydroureteronephrosis and lower part in between urinary bladder and rectum suggesting hydrometrocolpos. There was spontaneous rupture leading to flow of collection. It leads to spontaneous resolution of the mass which was confirmed with pelvic ultrasound and computed tomography. Keywords Hydrometrocolpos; hydroureteronephrosis; imperforate hymen.Recently revised estimates of levels and trends of maternal mortality based on three sources are reviewed and trajectory for reaching the mortality reducing target by 2030 is assessed. According to the estimates provided by the UN Maternal Mortality Inter-agency Group (MMEIG), the maternal mortality ratio (MMR) started from a high of 901 in 1990, dropping to 258 in 2015, or a reduction of 71% over the 25 year period. Between 2000 and 2015, MMEIG estimates showed a reduction of 53%. The MMR is targeted to be reduced to at least to 70 by 2030. This implies a reduction of 73%, which is considerably higher than the reduction recorded during the earlier (2000-2015) period (which was 53%), or annualized rate of decline of 8.7% v 5.0%. Therefore, the future trajectory warrants undertaking strategic interventions more intensively than what may have been hitherto. Concurrently, more attention also needs to be given to strengthening the recording and reporting of maternal deaths. Keywords levels and trends; maternal mortality; Nepal; projections.Competency-based medical education has evolved as an alternative approach in the residency training program. It shows potential to align educational programs with health system priorities through defining the competencies of graduating doctors. Designing and implementing Competency Based Post Graduate (CBPG) training in a resource-limited setting, where most of the trainings are still run in a conventional approach, is a big challenge. Patan Academy of Health Sciences, School of Medicine has taken the competency-based approach in the postgraduate residency training. Defining core competencies and connecting those to teaching methodology and assessment system are important initial steps in implementing the competency-based approach. The institution has implemented Entrustable Professional Activity (EPA), which is a unit of professional practice and helps to measure the trainees' achievements in the form of milestones. This paper describes the process of piloting and implementing the CBPG program at this school. The school launched the CBPG training in 2018 and so far, three batches of residents have been enrolled in nine different subjects/disciplines. The first batch of trainee, having the PAHS Core competencies and the pre-defined discipline-specific EPAs certified, will be completing their training soon. The program is time and resource consuming. Continuous faculty development, commitment, supportive leadership and faculty readiness to adapt to newer approaches are the key to the program's successful implementation. Keywords Competency based medical education; Nepal; patan academy of health sciences; post graduate training; residency program.
Labial frenum is a fold of mucous membrane whose function is to attach lips and cheek to the alveolar mucosa, gingiva and underlying periosteum. The maxillary labial frenum has lot of variation in shape, size location. This study was aimed to assess the variation of maxillary labial frenum in the indigenous Chepang community of Nepal.

A descriptive cross-sectional study was conducted among the Chepang community at Madi municipality in Chitwan, Nepal. The clinical examination was done by distending the upper lip upward for viewing. The obtained data was classified according to Mirko and Sewerin classification. Data was entered into Statistical Package for the Social Sciences version 16 and descriptive statistics was performed.

All the Chepang participants 102 (100 %) had mucosal type of maxillary frenum. Among the variations normal frenum was mostly present 74 (72.5%). This type was mostly present in male participants 44 (43.1%). Apart from this frenum with nodules and appendix was also observed.

The mucosal type of frenal attachment was prevalent in Chepang Community and normal frenum was the most common type of frenal morphology.
The mucosal type of frenal attachment was prevalent in Chepang Community and normal frenum was the most common type of frenal morphology.
Hollow viscus perforation peritonitis is one of the commonest surgical emergencies with high mortality and morbidity. The objective of this study was to evaluate the effectiveness of Mannheim's peritonitis index in prediction of mortality in these patients.

This is a retrospective, observational cohort study in these patients managed in a single-center from January 1, 2013 to December 30, 2019. Total index scores were plotted in the receiver operating characteristic curves to find out the cut-off point. Sensitivity, specificity, relative risk, positive and negative predictive values were calculated. The individual risk factors were analyzed for mortality as well.

Case records of 395 cases of non-traumatic hollow viscus perforation peritonitis were available, there were 33 mortalities (8.2%), mean score was 22.96 (+7.6) points (range 10-43 points). The sensitivity and specificity with score cut-off of 25 came to be 75.8% and 56.35%; positive and negative predictive value being 13.7% and 96.2%. Risk of patients for mortality with scores >25 was 3.
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