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INTRODUCTION Staphylococcus aureus is one of the commonest cause of nosocomial infections. Resistant Staphylococcus aureus strain has become a matter of concern. This study was done to find out the prevalence of Staphylococcus aureus from different clinical samples. METHODS The descriptive cross-sectional study was carried out in the Clinical Microbiology laboratory from January 2019 to June 2019. Ethical approval was received from the Institutional Review Committee (Ref 28122018010). Six hundred sixty-six sample size was calculated. Convenient sampling was done. Staphylococcus aureus was identified on the basis of its microscopy and morphological characteristics followed by catalase and coagulase test. Antibiotic sensitivity test of misolated pathogens was done using Muller Hinton Agar by Kirby-Bauer method. Statistical analysis was done by Excel 2018, point estimate at 95% confidence interval was calculated along with frequency and proportion for binary data. RESULTS Out of the 666 bacteria isolated from clinical specimens, 133 (19.96%) were Staphylococcus aureus at 95% confidence interval (12.91-13.60%). Seventy nine (78.95%) of which is isolated from pus and wound infections. Out of 133 Staphylococcus aureus, 94 (70.64%) were Methicillin-Resistant Staphylococcus aureus. CONCLUSIONS This study provides valuable information regarding the high prevalence of Staphylococcus aureus from pus and wound infections. The alarming number of Methicillin-Resistant Staphylococcus aureus is worrisome finding. Antibiotics like Vancomycin and Linezolid which has not developed resistance should be cautiously used only in Methicillin-Resistant Staphylococcus aureus cases.INTRODUCTION Osteoporosis is a common metabolic bone disease characterized by increased bone fragility, yet underdiagnosed and undertreated. With the increase in longevity of the populace, it is becoming an urgent and serious global epidemic. This being a preventable disease, has no clinical manifestations until there is a fracture. Early diagnosis and treatment are of dire necessity. Hence the aim of our study is to find the prevalence of osteoporosis among adults attending a tertiary care hospital-based on calcaneal quantitative ultrasound. METHODS This descriptive cross-sectional study was done in a tertiary care hospital, from 15th July 2019 to 15th October 2019 after receiving ethical approval from the Institutional Review Committee (Registration number 2075 / 76 / 119). Convenient sampling was done. Data collection and entry was done in Microsoft excel, point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. RESULTS Out of 464 participants the overall prevalence of osteoporosis was 38 (8.2%) at a 95% confidence interval (5.7-10.7). Among the participants, 141 (30.4%) were male and 323 (69.6%) were female. The mean age of the participant was 41.02±14.96 years. Osteoporosis was more common in the older age group 11.66 (30.7%) in 60 years above Women were found to be more osteoporotic than men, 3.42 (9.0%) and 2.43 (6.4%) respectively. Bone mineral density and osteoporosis had a bimodal distribution, underweight 5.01 (13.2%) and obese group 5.32 (14.0%) were the two peaks. CONCLUSIONS The prevalence of osteoporosis in our study is high and is consistent with other South Asian studies. Early detection of osteoporosis using calcaneal quantitative ultrasound can be a good screening tool.The development of health system in Nepal dates back from ancient period to the modern period starting from ayurvedic medicine to today's modern allopathic treatment. With regard to the different rulers in different time period, the number of improvements and changes in the health system of Nepal has been made. Moreover, the health system is further strengthened by the involvement of people and better management of health information and drug supply. Keywords Bir Hospital; Community health; Health; Nepal.Congenital bands are rare causes of intestinal obstruction and often leads to diagnostic challenges. Diagnostic delays in cases of mechanical obstruction might lead to irreversible bowel ischemia and perforation. Presently described is a case of an 18 month young child with severe vomiting developed for one day. The child was initially thought to have acute viral enteritis and treated accordingly. Due to the severity, an X-Ray and computed tomography scan were sent which pointed towards the possibility of having congenital bands. He was treated operatively. The child was kept under observation for eleven days and was discharged. Although rare, intestinal obstruction due to congenital bands must be considered when treating a child with severe vomiting. Keywords case reports, congenital abnormalities, intestinal obstruction, vomiting.Congenital Adrenal Hyperplasia is a group of autosomal recessive disorders due to deficiencies of enzymes involved in steroidogenesis. The most common form is a 21-hydroxylase deficiency which can be classical or non-classical. The severe form also called Classical Congenital Adrenal Hyperplasia is usually detected after birth to infant period. If Congenital Adrenal Hyperplasia is not diagnosed and treated early, neonates are susceptible to sudden death in the early weeks of life. We report a case of thirty-five days male with a salt-wasting variant of congenital adrenal hyperplasia. The diagnosis was based on an elevated level of 17-hydroxyprogesterone. He was managed and life long oral Prednisolone and Fludrocortisone were prescribed. Keywords 21-hydroxylase, congenital adrenal hyperplasia, case report.Composite tumor of larynx, a recently included entity in the current WHO classification, is often a difficult pathological diagnosis, especially in small biopsies. We report a case of laryngeal composite tumor, initially misdiagnosed as squamous cell carcinoma, which later turned out to be composite in nature, with associated neuroendocrine (small cell carcinoma) component. This report emphasizes the need for obtaining deeper biopsies and their thorough pathological examination to improve the diagnostic accuracy. Keywords combined small cell carcinoma; composite tumor; larynx; small cell carcinoma; squamous cell carcinoma.Thyroid storm is a rare endocrine emergency that rarely presents with septic shock. It occurs in thyrotoxic patients and is manifested by decompensation of multiple organs, triggered by severe stress. The diagnosis and response to treatment is made by Burch-Wartofsky point scale or Japanese thyroid association criteria due to lack of pathophysiology of thyroid storm. We reported series of patients that presented with altered sensorium, cough, fever, palpitation, shortness of breath and shock. selleck Patient were treated initially for septic shock, later diagnosed as thyroid storm and was treated with oral carbimazole, propanolol and digoxin. From this, we want to emphasize that thyroid storm can have any presentation that should be kept in differential diagnosis of septic shock not responding to usual treatment; early diagnosis and treatment with oral medication can decrease morbidity and mortality in rural setting where intravenous form of antithyroid drug are not available for thyroid storm. Keywords sepsis; septic shock; thyroid storm.INTRODUCTION Transrectal ultrasound of prostate provides better visual for biopsy. Transrectal ultrasound guided prostate biopsy is usually performed in men with an abnormal digital rectal examination, and elevated prostate specific antigen (>4ng/ml) or prostate specific antigen velocity (rate of prostate specific antigen change) i.e., >0.4-0.75ng/ml/year. The aim of the study is to find out the complications of transrectal ultrasound guided prostatic biopsies. METHODS This descriptive cross-sectional study was done among 50 patients who transrectal ultrasound guided prostatic biopsies in a tertiary care hospital, from July 2017 to July 2019 after receiving ethical approval from the Institutional Review Committee of Kathmandu Medical College and teaching hospital. Convenient sampling was done. All patients were informed about the potential benefits and risks of the transrectal ultrasound guided prostate biopsy and patients signed an informed written consent form. Statistical analysis was done by using Statistical Package for Social Sciences version 16. RESULTS Mean prostate specific antigen was 34.571 and mean weight of prostate was 44.6gm. Moderate to severe pain was experienced by 15 (30%), 2 (4%) had hematuria with fever accounting for 3 (6%) patients. All were managed conservatively with no mortality related to the procedure and complication. Three patients was positive for malignancy on re-biopsy. CONCLUSIONS Transrectal ultrasound guided biopsy of prostate is a pioneer experience in Nepal. It has proved to be an useful tool of diagnosis of suspected carcinoma of Prostate. Use of neurovascular block may reduce the pain during the procedure.INTRODUCTION Medical students are more prone to suffer from various physiological and psychological problems but rather than seeking for formal health care, they tend to do informal consultation and often practice self medication. Thus, this study aimed to find out the health seeking behavior of medical students. METHODS This descriptive cross-sectional study was done among first and second year medical students of a teaching hospital from September to November 2019 after taking ethical approval from Institutional Review Committe. Total of 235 students were included in the study and self administered questionnaire was used. Data entry and analysis was done using Statistical Package for Social Sciences version 20.0. RESULTS Among 235 students who participated in the study, 172 (73%) reported having health problems in the last 12 months, and fever and headache were commonly reported by 21 (13%) and 18 (50%) students, respectively. Total of 112 (65%) students visited hospital/clinic for health problems and reason given for not visiting hospital/clinic was 12 (28%) thinking that the problem was minor. University hospital was the most preferred place 189 (80%) during health problem and parents were the first people for consultation 116 (49%). Mean duration of absenteeism was 2.17±4.1 days and 167 (88%) visited hospital more than five times. link2 CONCLUSIONS Health problems were common among students and most of them required multiple hospital visits. Many students seeked for health from hospital/ clinic but informal consultations were also seen.INTRODUCTION Odontophobia or dental fear is a "unique phobia with special psychosomatic components that impact on the dental health of the odontophobia persons". It is well documented that dental fear has a significant impact on dental care utilization behaviors. The objective of this study was to find out the level of dental fear among school children studying in government schools of Dharan, Nepal. METHODS A descriptive cross-sectional study was conducted from March to August 2017 among 215 school going children of Dharan of age group 6 to 15 years. Ethical approval was obtained. Children studying in six different government schools of Dharan were selected using two stage cluster sampling method. link3 The Children's Fear Survey Schedule-Dental Subscale was used to measure dental fear among the study group. Data were entered in Microsoft Excel Sheet 2007 and analyzed in Statistical Package of Social Sciences 11.5. RESULTS This study showed that among the total study population, 96 (44.7%) had high fear, 62 (28.8%) had moderate fear and 57 (26.