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Background: Oral cancer, which includes cancer of lips, gingiva, tongue, oropharynx, sinuses, and salivary glands, ranks fifth in its kind in Nepal. The incidence of oral cancer may differ among gender, age, and site. This study aims to address the questions regarding the incidence and trend of oral cancer occurrence. Methods: Oral cancer cases registered in the Head and Neck Oncology Department of Nepal Cancer Hospital & Research Centre, Lalitpur, Nepal from 01 Jan 2018 to 31 Dec 2019 were included in this study. The data were categorized under gender, site of a tumor, year of diagnosis, and age of patients at diagnosis and entered in RStudio version-1.3.1093 for analysis. Results: A total of 165 cases were found to be recorded where 74.5% were male and 24.5% were female. The most common site was the tongue (27.27%) followed by the mandibular alveolus (19.39%). The overall mean age was 53.71 years (95% CI: 55.73-51.68). The number of new cases was found to be increased by 35.71% from 2018 to 2019.Conclusion: A significant increase in the number of new cases indicates that there are deficiencies in handling oral cancer in Nepal. Reducing the production, import, and consumption of tobacco and related products as well as ensuring accessible health facilities for all may help control this disease.

Background. The Nepalese government announced a nationwide lockdown beginning on March 24, 2020 as an attempt to restrain the spread of COVID-19. The prohibition in flight operations and movement of vehicles, factory shutdowns and restriction in people's movement due to the lockdown led to a significant reduction in the amounts of pollutants degrading air quality in many countries. Objectives. The present study aimed to analyze changes in particulate matter (PM) emissions and the air quality index (AQI) of six cities in Nepal i.e., Damak, Simara, Kathmandu, Pokhara, Nepalgunj and Surkhet due to the nationwide lockdown in response to the COVID-19 outbreak. Methods. Daily PM concentrations of each of the six study cities from January 24 to September 21, 2020 were obtained from the World Air Quality Index project (https://aqicn.org) and analyzed using R Studio software. The drop percentage was calculated to determine the change in PM2.5 and PM10 concentration during different time periods. Independent sample Mann–Whitney U tests were performed to test the significance of differences in mean concentration for each site during the lockdown period (24 March–24 July 2020) and its corresponding period in 2019. Similarly, the significance of differences in mean concentrations between the lockdown period and the period immediately before lockdown (23 January–23 March) was also examined using the same test. Results. During the lockdown period, in overall Nepal, AQIPM2.5 and AQIPM10 were within the moderate zone for the maximum number of days. As a result of the lockdown, the highest immediate and final drop of PM2.5 was observed in Damak (26.37%) and Nepalgunj (80.86%), respectively. Similarly, the highest immediate drop of PM10 was observed in Surkhet (37.22%) and finally in Nepalgunj (81.14%). Analysis with the Mann–Whitney U test indicated that for both PM types, all sites showed a statistically significant (p < 0.05) difference in mean concentrations during lockdown and the corresponding period in 2019. Conclusions. The present study explored the positive association between vehicular movement and PM emissions, highlighting the need for alternative fuel sources to improve air quality and human health. Competing Interests. The authors declare no competing financial interests.

Background Post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP) is the most common and most serious complication of ERCP. Our aim was to estimate the nationwide incidence, temporal trends, and mortality of PEP in the United States and to establish risk factors associated with PEP development. Methods This was a retrospective cohort study analyzing Nationwide Inpatient Sample data from 2011 to 2017 using International Classification of Diseases codes. The primary outcomes were trends in PEP incidence and predictors of PEP development. Secondary outcomes were in-hospital mortality, length of hospital stay, and admission to the intensive care unit. Results Of 1 222 467 adult patients who underwent inpatient ERCP during the study period, 55 225 (4.5 %) developed PEP. The hospital admission rate of PEP increased by 15.3 %, from 7735 in 2011 to 8920 in 2017 (odds ratio [OR] 1.23, 95 % confidence interval [CI] 1.04 – 1.46; P = 0.02). The overall rate of mortality increased from 2.8 % of PEP cases in 2011 to 4.4 % in 2017 (OR 1.62, 95 %CI 1.10 – 2.38; P = 0.01). Multiple patient-related (alcohol use, cocaine use, obesity, chronic kidney disease, heart failure), procedure-related (therapeutic ERCP, sphincterotomy, pancreatic duct stent placement, sphincter of Oddi dysfunction), and hospital-related (teaching hospitals, hospitals located in the West and Midwest) factors that impact the occurrence of PEP were identified. Conclusions Our study showed rising hospital admission and mortality rates associated with PEP in the United States. This calls for a greater recognition of this life-threatening complication and amelioration of its risk factors, whenever possible.

Acute esophageal necrosis (AEN) or "black esophagus" is a rare clinical condition, endoscopically characterized by diffuse circumferential black esophageal mucosa. Etiologies include hypoperfusion, infections, and corrosive injury. Consideration of this condition as a differential diagnosis is important, as early diagnosis and treatment has implications on survival. In this article, we present four unique cases of acute esophageal necrosis who were managed conservatively.