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so helpful in determination of Anterior Cruciate Ligament tear.

The sensitivity and specificity of Anterior Cruciate Ligament - Blumensaat line angle to detect Anterior Cruciate Ligament status was 95.83% and 95.35% respectively. Similarly, the sensitivity of Anterior Cruciate Ligament - Inclination angle was 95.83% and specificity was 95.35%. The sensitivity of Apex Anterior Cruciate Ligament - Blumensaat line angle to detect Anterior Cruciate Ligament tear on MRI was calculated to be 95.74% and a specificity of 87.5% Conclusions Anterior Cruciate Ligament - Blumensaat line angle and Anterior Cruciate Ligament - Inclination angle is highly sensitive and specific for the diagnosis of Anterior Cruciate Ligament tear. Apex of Anterior Cruciate Ligament - Blumensaat line angle is also helpful in determination of Anterior Cruciate Ligament tear.

Antiretroviral drugs are lifeline for patients living with HIV. Adverse drug reactions can compromise the compliance to antiretroviral therapy. The objectives of the study were to estimate the prevalence of adverse drug reactions and to assess its risk factors in patients living with HIV and receiving antiretroviral therapy.

A prospective cohort study was conducted among 496 patients living with HIV at B.P. Koirala Institute of Health Sciences for a period of one year. Adverse drug reactions were evaluated based upon clinical history, clinical examination and investigations.

Majority of patients were of 31-45 year age group (58.1%) and on first-line antiretroviral therapy regimen (94.3%). Total of 240 adverse drug reactions were documented. Prevalence of adverse drug reaction was 34.7%. Skin rash, anemia and nausea and vomiting were the three most common adverse drug reactions. The adverse drug reactions were more common in patients having non-communicable diseases, chronic co-infections, taking more than 3 non-HIV drugs, second and third-line antiretroviral regimen and it was statistically significant (P-value < 0.05).

Prevalence of adverse drug reaction was high in the patients living with HIV. Age, gender, co-infections, non-communicable diseases, taking more than three non-HIV drugs and second and third-line antiretroviral regimen were identified as possible risk factor for occurrence of adverse drug reactions and their prior identification is important to optimize the best suited antiretroviral regimen.

Prevalence of adverse drug reaction was high in the patients living with HIV. Age, gender, co-infections, non-communicable diseases, taking more than three non-HIV drugs and second and third-line antiretroviral regimen were identified as possible risk factor for occurrence of adverse drug reactions and their prior identification is important to optimize the best suited antiretroviral regimen.

Adolescent pregnancy is a global health problem. Early pregnancies among adolescents have major health consequences for adolescent mothers and their babies. Contraceptives can prevent early pregnancy and its consequences. However, there is a low use of contraceptives among adolescents. Global evidence has shown which programmatic approaches are effective to increase the use of contraceptives among adolescents.

This is not a systematic review. Desk review was done using Google Scholar and PubMed. Different policies, strategies, and reports published by agencies were also reviewed.

There is a low use of contraceptives and high unmet need for family planning and high adolescent fertility rate. Various studies conducted in different parts of the world have shown that there are some programmatic approaches implemented which are effective to improve the contraceptives use among adolescents. We have categorized the findings into three parts; i) delivery of services ii) increasing demand for services, and iii) creating an enabling environment.

The use of contraceptives is low among adolescents in low- and middle-income countries including Nepal. So, the current programmatic approaches should be reviewed and the evidence-based practices implemented to bring better results. Ministry of Health and Population and partner agencies in Nepal also need to review the current programmatic approaches and implement them based on the evidence-based practices to improve contraceptives use among adolescents.

The use of contraceptives is low among adolescents in low- and middle-income countries including Nepal. So, the current programmatic approaches should be reviewed and the evidence-based practices implemented to bring better results. Ministry of Health and Population and partner agencies in Nepal also need to review the current programmatic approaches and implement them based on the evidence-based practices to improve contraceptives use among adolescents.Rituximab is a chimeric monoclonal antibody directed against the CD20 expressed on B cells, originally used to treat lymphoma but is increasingly used for the treatment of autoimmune diseases. Membranous nephropathy is an autoimmune disease resulting from the deposition of IgG and complements components onto the subepithelial layer of the glomerular capillary wall and remains the leading cause of nephrotic syndrome in adults. Several prospective and retrospective studies showed rituximab induces remission and may decrease proteinuria in patients with membranous nephropathy. Considerable evidence supports the use of B-cell depletion as initial therapy in nephrotic patients with membranous nephropathy. This review focuses on the efficacy and safety of rituximab in the treatment of membranous nephropathy. Keywords Membranous nephropathy; rituximab; treatment.

Acute ischemic stroke leads to an inflammatory response and the neutrophil-to-lymphocyte ratio is an inflammatory indicator for determining prognosis in acute ischemic stroke. selleck inhibitor This meta-analysis aims to show evidence that neutrophil-to-lymphocyte can act as an independent and early prognostic marker in cases of acute ischemic stroke.

Databases of PubMed, and Embase were searched for literature. Relevant data were extracted by SSP and BT from eligible literature. Odds ratios with 95% confidence intervals were pooled and a Forest plot was used to evaluate the prognostic value of neutrophil-to-lymphocyte in acute ischemic stroke. Modified Rankin Scale ? 3 was defined as a poor functional outcome. A funnel plot is used to show the symmetric distribution and no publication bias.

According to Joanna Briggs Institute assessment for analytical observational studies, the studies included are of fair to good quality. Eight relevant studies with 3011 patients were included, one with no data on OR. The pooled OR of 6 studies with the poor functional outcome at 3 months was 1.

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