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Background Skin problems are the commonest reason for people accessing healthcare services in Nepal but there is little information about the prevalence of skin disease. Objectives To perform a point prevalence study of skin disease in the Terai region of Nepal. Methods Five villages were randomly selected in Bara District in the Terai region of Nepal, and 878 people were examined. Results The number of individuals identified as having a skin disease was 546. The point prevalence of identifiable skin abnormalities was 62·2% (546 of 878) (with 95% exact confidence intervals 58·9–65·4%). A wide range of dermatoses was identified. The six most prevalent were dermatophyte infections (11·4%), followed by pityriasis versicolor (8·9%), acne (7·7%), melasma (6·8%), eczema (5·6%) and pityriasis alba (5·2%). Overall, treatable skin infections and infestations were by far the commonest skin diseases identified. Conclusions Our study has demonstrated a very high point prevalence (62·2%) of skin disease in rural Nepal. This study represents the first formal survey of skin disease in Nepal and demonstrates a large burden of disease, in particular treatable infections. [ABSTRACT FROM AUTHOR]

Mayer-Rokitansky-Kuster-Hauser syndrome also known as mullerian agenesis is a rare congenital condition in which there is absence of uterus along with upper vagina. Patient usually presents with primary amenorrhea with or without cyclical lower abdominal pain but have normal secondary sexual characters. Modified McIndoe Vaginoplasty with amnion graft is the commonest surgery performed worldwide. A 23 year old girl with normal secondary sexual characters presented with primary amenorrhea with cyclical lower abdominal pain; on examination blind vagina was present. Vaginoplasty with amnion graft was done and vaginal mould was placed. Vaginal dilatation with Hegar's dilator was done weekly until 6 weeks. She is under regular follow-up at present and advised for regular manual dilation at home. McIndoe Vaginoplasty with amnion graft is a simple yet rewarding procedure especially in low resource countries like ours, with good success rate and with minimal postoperative complications. Keywords: Amnion graft; Mayer-Rokitansky-Kuster-Hauser Syndrome; Modified McIndoe Vaginoplasty; Primary amenorrhea; Secondary sexual characters.

Successful pregnancy along with prevention of obstetric fistula in a subsequent pregnancy is possible if proper antenatal care and timely elective caesarean delivery are ensured. Keywords: Fistula recurrence; obstetric fistula.

Medical induction is an alternative to dilatation and evacuation (D and E) in second trimester abortion, though it has higher risk of minor complications compared to D and E. Combination of mifepristone and misoprostol is commonly used for the medical abortion. A 32 years G3P2L2 with previous two cesarean delivery was referred to our center at sixteen weeks of gestation for termination of her pregnancy. After 63 doses of misoprostol, she had to undergo unintended major intra-abdominal surgery for partial uterine rupture. Keywords: Dilatation and evacuation; medical induction; second trimester abortion; uterine rupture.

Obstetric fistula is a hidden tragedy in the developing world, prevention is important and treatment is by surgical repair. However, failure, broken fistula, stress incontinence often demoralizes surgeons and patients. Keywords: Fistula repair; Obstetric fistula; Obstructed delivery.