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Introduction: Primary focal segmental glomerulosclerosis is a form of glomerular disease that needs immunosuppressive therapy, which, if untreated, can lead to end-stage renal disease. Ultrastructural analysis by electron microscopy is essential to distinguish primary from other forms of focal segmental glomerulosclerosis. This study aimed to find out the prevalence of primary focal segmental glomerulosclerosis among patients with glomerular diseases undergoing kidney biopsy in a tertiary care centre. Methods: A descriptive cross-sectional study was done in the Department of Nephrology from 1 January 2022 to 31 December 2022. Data were collected after obtaining ethical approval from the Institutional Review Committee (Reference number: 473/2079/80). The data from clinical and laboratory records of patients with the glomerular disease who underwent kidney biopsy were obtained. Data was collected by using convenience sampling. Point estimate and 95% Confidence Interval were calculated. Results: Among 213 patients with glomerular disease undergoing kidney biopsy, 22 (10.33%) (6.24-14.42, 95% Confidence Interval) were diagnosed with primary focal segmental glomerulosclerosis. All patients had nephrotic range proteinuria, but 2 (9.09%) patients had no features of nephrotic syndrome. Microscopic hematuria was found in 4 (18.18%) patients. Conclusions: The prevalence of primary focal segmental glomerulosclerosis was lower than in other studies done in similar settings.

Introduction: A corneal foreign body is the most common occupational ocular injury that can cause secondary infection or scars on the visual axis, decreasing vision. The study aimed to find out practices of wearing protective eye devices in the workplace and the factors influencing the utilization of such devices among patients with corneal foreign body (CFB) injury. Methods: This cross-sectional study was conducted in a tertiary eye hospital in Bhaktapur from April 2021 to August 2021. All patients with CFB attending the hospital were included in the study. CFB was removed with ocular examination under a slit lamp biomicroscope, and face-to-face interview was conducted. Results: Among 142 patients, only one was female, and 41.5% had a previous history of CFB. The most common CFB particle was metallic (n=124, 87.3%),. Three-fourths (75.1%) of patients were not using eye-protective devices at the time of injury, and 45.1% tried physically removing the CFB in a harmful way. Nearly two in five (19.7%) had used topical antibiotics eye drops before presenting for CFB removal. Sixty-six (46.5%) reported never wearing any protective eye devices, and the main reason for not-wearing was the unavailability (48.4%) of such devices in their workplace. The awareness of the need for protective eye devices (p

Background: Active tuberculosis in transplant recipients can result from latent infection with Mycobacterium Tuberculosis in the transplant recipients, donor tissue, or de novo post-transplant infection. This study aimed to determine the prevalence of latent tuberculosis infection in potential renal transplant recipients and live donors at a tertiary-level transplant center. Materials and Methods: This observational study was conducted from July to October 2020 among 72 potential kidney transplant recipients and their potential donors from the Department of Nephrology, Tribhuvan University Teaching Hospital. The biochemical parameters and health behaviors were measured to find the association with latent tuberculosis infection. Results: The prevalence of latent tuberculosis infection according to Mycobacterium tuberculosis-specific interferon-gamma release assays was 20.8% in potential recipients and 16.6% in potential donors, whereas the prevalence with tuberculin skin test was 9.7% in potential recipients and 33.3% in potential donors. Low levels of hemoglobin, calcium, albumin, vitamin D and history of smoking were associated with the development of latent tuberculosis infection among potential recipients. Alcohol drinking was significantly associated with the development of latent tuberculosis infection among donors. Conclusion: Potential renal transplant recipients and donors have a significant burden of latent tuberculosis in the pre-transplantation phase. Diagnosis and treatment of latent tuberculosis before transplantation can prevent ominous complications.

Introduction: Amblyopia is defined as a reduction in visual acuity unilaterally or bilaterally without any detectable cause. It is a major public health issue in developing and underdeveloped countries. Its prevalence is usually underestimated because of proper study and lack of awareness. The aim of the study was to find out the prevalence of amblyopia among patients attending the Outpatient Department of Ophthalmology of a tertiary care centre. Methods: This descriptive cross-sectional study was conducted among outpatients visiting a tertiary care centre in the Outpatient Department of Ophthalmology between 1 January 2017 to 31 December 2019. Ethical approval was obtained from the Institutional Review Board (Registration number: 407/2020 P). All patients had gone through a comprehensive eye examination. Convenience sampling was used. Point estimate and 99% Confidence Interval were calculated. Results: Among 82972 patients, prevalence of amblyopia was 344 (0.41%) (0.37-0.46, 99% Confidence Interval). Amblyopia was more common in anisometropia 263 (63.50%). A total of 117 (34%) patients had no history of eye examination and were newly diagnosed with amblyopia. Astigmatism was the most common type of refractive error among 224 (56.70%) amblyopic patients. Conclusions: The prevalence of amblyopia was found to be lower than in previous studies conducted in similar settings. Early detection and diagnosis of amblyopia can help to design more effective plans and treatments to reduce amblyopia through optical correction and amblyopia therapy.

INTRODUCTION: Tele-otology is one of the least explored areas of telehealth in Nepal. The objective image findings and live virtual specialist consultation using synchronous data exchange can address the different barriers to basic otological care in low-resource settings like Nepal. This study was conducted to explore the acceptability and feasibility of community management of ear patients through tele-otology. MATERIALS AND METHODS: It was a cross-sectional descriptive study conducted at a tertiary level ENT hospital in Bhaktapur and three outreach clinics of the hospital in the periphery of Kathmandu valley from 1st April to 31st May 2021. Trained community ear health workers (CEHWs) used mobile data in fields and communicated with ENT consultants at the base hospital with fiber-to-the-home internet connection for teleconsultation. The satisfaction was measured using a 5-point Likert scale. RESULTS: This study has shown satisfactory acceptance among beneficiaries and service providers. The sound quality rating was 4.5±0.8 at field-site and 4.5±0.9 at base hospital. The video quality ratings were 4.4±0.8 and 4.0±1.1 at field-site and base hospital, respectively; this difference was statistically significant (p=0.017). CONCLUSIONS: With trained grassroots level workers and quality internet connections, tele-otology can play a significant role in the early identification and diagnosis of ear diseases, including middle ear pathologies, as well as bridging the ear care service gap in resource constraints settings like Nepal.

Introduction: Diabetes mellitus is a chronic metabolic disease characterised by elevated blood sugar levels and is a pandemic of public health importance. Screening programs can help reduce morbidity and mortality by preventing or delaying complications. This study aimed to find out the prevalence of diabetes mellitus among adult outpatients visiting a tertiary care centre. Methods: This descriptive cross-sectional study was conducted among outpatients visiting a tertiary care centre between 1 January 2019 to 31 December 2019. Ethical approval was obtained from the Ethical Review Board (Registration number: 408/2020 P). Patients with unknown history of diabetes participating in free random blood sugar examinations were included in the study. Systematic random sampling was used. Point estimate and 95% Confidence Interval were calculated. Results: Among 385 adult outpatients, 17 (4.42%) (2.37–6.47, 95% Confidence Interval) had diabetes. The mean random blood sugar level of the diabetic patients was 281.41±57.49 mg/dl. Conclusions: The prevalence of diabetes mellitus among adult outpatients was similar to previous studies conducted in similar settings. Random blood sugar test in hospital outpatient settings is feasible to identify people with diabetes mellitus.

Background and Objectives: The priority after the outbreak of COVID-19 pandemic has been treating cases and counting the number of fatalities. But mental health impact has been neglected, even though evidence show that frontline health care workers are at risk of mental health issues in such situations. This study aimed to determine the status of anxiety among ENT-HNS doctors and the associated factors in Nepal during the second wave of COVID-19 havoc in Nepal. Material and Methods: This is a web-based cross-sectional study carried out from 1st May to 31st May 2021. The study participants: ENT-HNS consultants and residents, were approached for the study through different social media, and data was collected through an app-based self-administered questionnaire. The anxiety level was measured using the GAD-7 scale, and the chi-square test was applied to study the factors associated with anxiety. Results: Among sixty-two participating ENT-HNS doctors, 33.9% already had contracted COVID-19, and 77.4% had mild to severe anxiety. Just below half (45.2%) of the participants worked in COVID-dedicated hospitals and treated patients every working day. None of the respondents could comply with social distance at their workplace, and 75.8% believed they lacked sufficient personal protection equipment (PPE). The potential aerosol-generating procedures like epistaxis management, tracheostomy, and flexible endoscopy were regarded as the highest risk of viral transmission by 35.5%, 30.6%, and 21.0% of respondents, respectively. The young doctors, female doctors, and residents were more likely to be anxious than their counterparts. The ENT-HNS doctors who had lost a family member, close relatives, or colleague were seven times more likely to have anxiety. Conclusion: The ENT-HNS doctors are neither immune to the COVID-19 infection nor the anxiety. They must have access to required PPE as well as psychosocial support to prevent anxiety. Early identification and timely intervention at the institutional level are vital to maintaining a well-staffed workforce during a pandemic like COVID-19.

PURPOSE To find out clinical characteristics, therapeutic options, and visual outcome in symptomatic retinal artery macroaneurysm (RAMA) patients. METHOD Newly diagnosed cases of symptomatic RAMA from January 2015 to December 2019 were included. Fifteen eyes of 15 patients with mean age 62.46 years ± 14.89 (SD) fulfilled the inclusion criteria. RESULT Hypertension was present in 66.6% of the patients, and the commonest site was superotemporal (12 eyes, 80%). The most commonly employed treatment was Nd: Yag laser hyaloidotomy in 4 eyes (26.6%). Other treatments were intravitreal bevacizumab in 3 eyes (20%), focal laser with intravitreal bevacizumab in 3 eyes (20%), PPV with focal laser (13.3%) in 2, focal laser only in one (6.6%), PPV with focal and intravitreal bevacizumab in one (6.6%). The mean best-corrected visual acuity (BCVA) at baseline was 1.35 ± 0.84 LogMAR, which improved to 0.39 ± 0.53 LogMAR at the last follow-up. Presenting VA 0.77 (±0.40) improved to 0.20 (±0.17) p value (0.180) in intravitreal bevacizumab only group, 1.29 (±0.35) to 0.75 (±0.15) p value 0.66 in Nd: Yag laser group, 2.67 (±0.58) to 0.46 (±0.28) p value 0.019 in PPV group and did not improve in combined anti-VEGF and focal laser group due to dense hard exudates at the fovea in one and persistent cystoid macular edema in another case. CONCLUSION With regard to its presentation, which can vary tremendously, there are no approved guidelines for its treatment. The present study reinforces the need for a treatment guideline development. Customization of treatment should be considered depending on the clinical presentation of each case.

Background COVID-19 is an infectious disease caused by a newly discovered coronavirus. The number of cases and dramatic loss of human life worldwide created psychological problems among general public, including health care workers. Objective To determine the burden of anxiety, depression, and functional impairment among health care workers in the early days of lockdown during the first wave of COVID-19 outbreak in Nepal. Method A hospital-based cross-sectional study was carried out among all the employees of Hospital for Children Eye ENT and Rehabilitation Services, Bhaktapur during the COVID-19 pandemic lockdown from April 3, 2020 to May 2, 2020 using an online questionnaire. The tools used were adopted from Nepali version of Hospital Anxiety and Depression scale (HADS) and Nepali version of WHO Disability Assessment Schedule (WHODAS 2.0). Result The mean age (SD) of the participants (n=86) was 32.53 (7.92) years. Male and female participants were equal in number. The point prevalence of anxiety and depression was 25.6% and 14.0%, respectively. Females had a higher prevalence of both anxiety (39.5% vs 11.6%, p < 0.01) and depression (18.6% vs 9.3%, p=0.351). Clinical and nonclinical staff both had a higher prevalence of both anxiety (31.0% and 20.5%, p=0.265) and depression (16.7% and 11.4%, p=0.478). The mean functional impairment score (WHODAS 2.0) among all participants and participants with anxiety and depression was 19.47 (95% CI: 18.13-20.80), 21.27 (95% CI: 18.08-24.46), and 19.92 (95% CI: 15.28- 24.56), respectively. Conclusion Anxiety and depression during the first lockdown due to COVID-19 pandemic were highly prevalent in clinical and non-clinical employees. Besides controlling the outbreak, special consideration should be given to mental health.

Introduction: The World Health Organization recommends mass vaccination campaigns in children under 15 years before introducing the Japanese Encephalitis (JE) vaccine into the routine immunization program as the most effective immunization strategy in JE disease-endemic countries. The study was conducted to assess the JE vaccine coverage during the recent mass vaccination campaign in five districts of Nepal in 2016. Methods: A stratified three-stage cluster design was used for this cross-sectional sample survey. The JE mass vaccination campaign of 2016 targeted children aged between 1-14 years, and the interview was conducted among systematically sampled households’ mothers and guardians of children aged between 2-15 years in 2017. Results: The coverage of the JE mass vaccination campaign in the year 2016 was 96.9%; the males had slightly higher coverage (97.4%) than females (96.6%). The vaccine utilization increased with an increase in age, 94.0%, 98.1%, and 99.1% coverage among children aged 2-5 years, 6-10 years, and 10-15 years, respectively. The school enrolled children were four-times (OR: 4.016, CI: 2.595–6.216) likely to be vaccinated than out-of-school children and association was statistically significant. Among 86 children who were not vaccinated, 45.3% were ill during the campaign. Besides, 6.6% of out of school children also didn’t get the vaccination. Only three in ten (30.4%) respondents knew that the JE vaccine was given to protect against JE disease or brain fever. More than one-third (36.3%) of respondents reported that the recommendation from the health workers was main reason for vaccinating their children. Only 1.1% of vaccinated children had minor issues following vaccination. Conclusion: Despite low awareness about the specific protection of the JE vaccine, the vaccination coverage was high during the JE mass vaccination campaign. Increasing awareness about the particular vaccine and including activities to vaccinate out-of-school children could help achieve universal coverage in future mass vaccination campaigns

Any bodily movement produced by skeletal muscle which requires energy expenditure is known as physical activity (PA). WHO has recommended that at least 150 minutes of moderate or 75 minutes of vigorous-intensity PA or a combination of both per week is required for health benefits. Physical inactivity is one of the strongest risk factors for noncommunicable diseases (NCDs) and other conditions and is attributable to 6% of global premature death. However, data on the PA of teachers are unavailable in Nepal. They are considered one of the risk groups for NCDs because of the less active nature of their job. So, we aimed to evaluate the effect of the educational intervention based on the theory of planned behaviour on PA intention among secondary school teachers in Bhaktapur district, Nepal. For this study, we recruited 126 teachers from 6 schools. Each intervention and control group contained three randomly selected secondary schools. All the teachers from the selected schools were enrolled in the respective groups. A quasiexperimental (pretest-posttest control group) study design was used to test the effectiveness of the intervention on attitude, behaviour control, subjective norms, and intention for engaging in regular PA. Both groups underwent baseline and follow-up assessments at four weeks using the self-administered questionnaire developed for this study. The intervention group delivered a one-hour lecture session supported by audio-video materials for PA promotion. The effect was analysed by comparing the changes in the theory of planned behaviour (TPB) constructs within and between intervention and control groups. The difference in scores between and within the groups was tested using Student’s t -test. Adjusted difference-in-difference scores were calculated through linear regression. Data analysis was done using Statistical Package for Social Science version 26.0. The adjusted mean score increase in TPB constructs due to the interaction of time and intervention increased from 0.641 to 1.381. The highest gain ( beta = 1.381 ) was seen in the intention score, while a minor improvement was seen in perceived behavioural control ( beta = 0.641 ). After the intervention, the net increase in PA intention score was 9.35% compared to the control group. Thus, the promotion package was effective in increasing PA intention. The findings of this study and educational package could be helpful in encouraging teachers to engage in PA in other schools.

Adolescent friendly health services (AFHS) are designed to make health services accommodate the unique needs of adolescents. AFHS are characterized by three basic characteristics (programmatic, health facilities and health service providers) that should be applied. However, limited is known about the use of AFHS in the context of Nepal. This study aimed to assess the extent of AFHS utilization and associated factors among higher secondary students in the Jumla district of Nepal. A cross-sectional quantitative study was conducted in October-November 2017. Data were collected from a random sample of 528 aged 16–19 years old using a self-administered survey in their classroom. Adjusted Odds Ratios (AOR) and a 95% confidence level were estimated to measure the strength of association between the outcome variable (utilization of AFHS) and independent variable using multivariable logistic regression. Knowledge related to AFHS, measured by a seven-item scale, was based on information about the availability of AFHS. More than two-thirds (67.05%) of adolescents had utilized AFHS at least once in the last twelve months before the survey. In multivariable logistic regression analysis, knowledge level [AOR = 14.796, 95%CI (5.326–41.099)], cost of services [AOR = 2.971, 95%CI (1.764–5.003)], satisfaction from services [AOR = 1.817, 95%CI (1.037–3.185)] and availability of waiting room [AOR = 1.897, 95%CI (1.096–3.283)] were significantly associated with the utilization of AFHS. The utilization of AFHS was less than the country’s target of universal utilization in this study. Adolescents’ knowledge level about AFHS was importantly associated with its utilization. Utilization increases with lower service costs, client satisfaction, and availability of waiting rooms in the health facility. The health planners should make efforts to create a conducive environment for the adolescent by training the AFHS providers, particularly those who work in government institutions, and strengthening the awareness creation strategies among adolescents to increase the utilization of the services.

ObjectiveThis study aims to determine the prevalence of high screen time among schoolchildren aged 3–10 years in Bhaktapur, its correlates and the parents’ strategies to reduce screen time during the COVID-19 pandemic in Nepal.Methods and analysisThis cross-sectional descriptive study was conducted during March 2021. A total of 630 households were selected for the study from 21 randomly selected clusters in Bhaktapur, Nepal. Correlates of high screen time were determined using a logistic model. PResultsAmong all the participants, the mean (SD) age was 7.0 (2.2) years, with 50.3% male participation. Few participants had online classes (n=24, 3.8%). The prevalence of high screen time among the participants was very high (55.2%, 95% CI=51.3% to 59.1%), which is even higher in boys (61.8%, 95% CI=58.0% to 65.6%). The median screen time before the COVID-19 pandemic was 1.0 hours (mean rank=275.8) which increased to 2.2 hours (mean rank=116.6) during the pandemic (pConclusionDuring the COVID-19 pandemic, about one in two schoolchildren of 3–10 years had higher screen time than before the COVID-19 pandemic. Parents’ strategies to reduce screen time were not effective. An intervention study is recommended to design and test effective strategies to reduce screen time and its negative effects on children’s health.

Background: Undernutrition is highly prevalent in Nepal, which interferes with physical and mental development among children. It is one of the severe health problems contributing to the significant portion of the disease burden. This study aimed to explore socio-demographic and healthcare-seeking related predictors of undernutrition among children under five years old in Dang, Nepal. Methods: This was a descriptive cross-sectional study. A sample of 426 children was participated through stratified proportionate random sampling to identify socio-demographics and healthcare-seeking predictors of undernutrition. Multivariable regression was applied to identify the independent predictors of undernutrition. Results: This study found that children below 24 months of age were more likely to be undernourished than children aged 24-36 months. Female children (OR=2.32, 95% CI: 1.19-4.54), illiterate or non-formally educated women (OR=4.09, 95% CI: 1.84-9.08), mother’s occupation other than a housewife (OR=13.05, 95% CI: 4.19-40.68), labor work of father (OR=2.40, 95% CI: 1.04-5.57) had increased risk of undernutrition among children. Similarly, food insufficiency from their land, antenatal care visit, postnatal care visit, and delivery place were significantly associated with childhood undernutrition among children. Conclusions: The study showed that undernutrition among children is associated with age and gender of children, educational attainment of the mother, food sufficiency, health-seeking practices of the mother during pregnancy, delivery, and postnatal. Socio-demographics and health-seeking practices related predictors must be explicitly considered to address undernutrition among children under the age of five years. Keywords: Children; health care seeking; Nepal; socio-demographic factors; undernutrition.

Background Recently, the number of retinal patients is increasing in Nepal. The retinal problems are the second common cause of blindness in Nepal. Retinal diseases are challenging to manage due to the lack of simple and cost-effective screening methods, limited human resources, poverty, and lack of awareness in Nepal. Hospital for Children, Eye, ENT & Rehabilitation Services (CHEERS), Nepal conducted retina screening camps and education in communities through Retina Eye Care of Nepal project (RECON) in the years 2017 and 2018. Materials and Methods We screened retinal patients with an indirect ophthalmoscope coupled with plus 20 Dioptre lens and portable fundus camera. We referred the patients needing interventions to the base hospital (CHEERS) using a screening algorithm, where they received retinal laser and surgery. Besides, we also provided on-site educational programs for retinal disease awareness to the community. Results Retinal problems found from two static outreach clinics (SORC) and a day screening and treatment service (DSTS) were 18.3%, 20%, and 20%, respectively, while from a remote rural health camp (RRHC) was 2.61%. Likewise, patients referred to CHEERS for retinal laser or other retinal interventions were 15%, 16.6%, 16%, and 1.96% from 2 SORCs, 1 DSTS, and 1 RRHC, respectively. Conclusion Retina camp is a cost-effective approach to early detection and referral for retinal-related vision impairment patients. It is also one opportunity to educate the community. The purpose of the project was to provide retina care to the community who otherwise could not afford it. We recommend a similar screening model on a large scale in a low-resource setting for the maximum benefits to the rural community.

The gunshot neck injury is an emergency and must be addressed immediately. However, as our case report, a long-standing retained foreign body (firearm) in the deep neck is rare. Surgical removal of a long-standing foreign body is challenging for the operating surgeon. A 36-year-old male with a history of a firearm injury to the neck dating 16 years back with complaints of recent onset of pain was evaluated. A computed tomography scan of the neck showed a metallic foreign body located in close proximity to the right common carotid artery. Neck exploration was performed under general anaesthesia, and the foreign body was removed without complications. The patient has recovered following the intervention and has resumed his normal activities. The use of methylene blue helps to locate the foreign body during surgery. However, the choice of intervention for a stable patient with a penetrating neck injury remains based on cases.case reports; firearms; foreign body; neck.

Introduction: Abdominal obesity, as abnormal fat accumulation that presents a risk to health, is a global epidemic. There is evidence to support a trait of abdominal adipose deposition despite normal body mass index in south asian populations with greater cardiometabolic risks. Thus, this study aimed to find out the prevalence of abdominal obesity using the waist to height ratio among outpatients in a tertiary level hospital. Methods: This descriptive cross-sectional study was conducted among outpatients at a tertiary level hospital in Nepal from January 2016 to December 2018. Ethical approval was taken from the Ethical Review Board of Nepal Health Research Council (Reference no. 207/2019). Convenience sampling was done. The data were entered into excel and analyzed using Statistical Package for Social Sciences version 24. Point estimate at 99% confidence interval was calculated along with frequency and proportion for binary data. Results: Among 25,511 participants, 21,834 (85.6%) (85.0- 86.2 at 99% Confidence Interval) participants had abdominal obesity using Waist-to-Height Ratio, higher in women 12,397 (86.4%) than men 9,437 (84.5%). The mean age of the participants was 53.37±13.15 years and more than half 17,075 (55.7%) of all participants were female. Conclusions: The prevalence of abdominal obesity among hospital outpatients is higher than in other community-based studies. As hospitals attract large crowds and provide excellent opportunities for screening patients, their attendants, as well as providing opportunities for health promotion, we recommend the introduction of opportunistic obesity screening in all health facilities using weight to height ratio in a phased manner.

Barsha Suwal,1 Deepak Khadka,1 Arjun Shrestha,1 Sangeeta Shrestha,1 Nirsara Shrestha,1 Bijay Khatri2 1Department of Ophthalmology, BP Eye Foundation, Hospital for Children, Eye, ENT and Rehabilitation Services (CHEERS), Lokanthali, Bhaktapur, Nepal; 2Department of Academics and Research, Hospital for Children, Eye, ENT, Rehabilitation Services (CHEERS), Lokanthali, Bhaktapur, NepalCorrespondence: Barsha SuwalDepartment of Ophthalmology, BP Eye Foundation, Hospital for Children, Eye, ENT and Rehabilitation Services (CHEERS), Lokanthali, Bhaktapur, NepalTel +977-9803056313Fax +977-16639735 Email suwal.barsha@gmail.comBackground: To determine the influence of spectral domain optical coherence tomography (OCT) changes on visual outcome and persistence of subretinal fluid (SRF) in patients with idiopathic central serous chorioretinopathy (CSCR).Materials and methods: In a retrospective study done in 48 eyes of 45 patients diagnosed as CSCR, all eyes were subjected to fundus photography, spectral domain OCT, and fluorescein angiography (FA) in selected cases.Results: Retinal pigment epithelium detachment was present in 22.91% of the cases at presentation. The logMar best corrected visual acuity improved from 0.46±0.29 at presentation to 0.18±0.22 at 3 months (P-value0.3 logMar) were disruption in the inner segment (IS)/outer segment (OS) junction or external limiting membrane (ELM) line and hyper-reflective dots in the intra/subretinal layer (P-value

BackgroundCOVID-19 is an infectious disease caused by a newly discovered, with more than 24 million cases worldwide. Geometrically increasing numbers of cases and deaths from COVID 19 in the world, both medical staff and the public have been experiencing psychological problems, which can cause disability and functional impairment of the individual. This study aimed to determine the burden of stress anxiety and depression among health care workers.MethodologyA hospital-based cross-sectional study was carried out among all the employees of Hospital for Children Eye ENT and Rehabilitation Services Bhaktapur during the COVID-19 pandemic lockdown using an online questionnaire. The tools used were adopted from Hospital Anxiety and Depression scale (HADS) Nepali version and WHO Disability Assessment Schedule (WHODAS2.0).ResultsThe mean age (SD) of the participants (n=86) was 32.53 (7.92) years. Male and female participants were equal in number. The point prevalence of anxiety and depression was 25.6% and 14.0%, respectively. Females had a higher prevalence of both anxiety (39.5% vs 11.6%, pConclusionAnxiety and depression during COVID-19 pandemic lockdown were highly prevalent both in clinical and non-clinical employees, without causing significant functional impairment among health care workers.

BackgroundCOVID-19 is an infectious disease caused by a newly discovered coronavirus that is pandemic, with more than 338 thousand cases worldwide. Geometrically increasing numbers of cases and deaths from COVID 19 in the world, both medical staff and the public have been experiencing psychological problems, including anxiety, depression, and stress, which can cause disability and functional impairment of the individual. One of the most stressful situations is the unpredictability of the situation and the uncertainty of when to control the disease and the seriousness of the risk. These challenges and stress can trigger a common mental disorder. This study aimed to determine the burden of stress anxiety and depression among all employees of Eye and ENT hospitals.MethodologyA hospital-based cross-sectional study was carried out among all the employees of Hospital for Children Eye ENT and Rehabilitation Services Bhaktapur during the COVID-19 pandemic lockdown using an online self-administered questionnaire through Google forms. The tools were adopted from Hospital Anxiety and Depression scale (HADS) Nepali version on a Likert's scale of 0 to 3 validated by Risal A. et al. and WHO Disability Assessment Schedule (WHODAS S2.0) on a Likert's scale of 1 to 5 to assess functional impairment.ResultsThe mean age (SD) of the participants (n=86) was 32.53 (7.92) years. Male and female participants was equal in number. The point prevalence of anxiety and depression was 25.6% and 14.0%, respectively. Females had a higher prevalence of both anxiety (39.5% vs 11.6%, pConclusionAnxiety and depression during COVID-19 pandemic lockdown were highly prevalent both in clinical and non-clinical employees, causing mild to moderate functional impairment.

Background: Obesity has become a global epidemic with a rise in noncommunicable diseases. It is now becoming the problem of low- and middle-income countries such as Nepal. Conventional risk factors are present in a high proportion in the Nepalese population. As a routine surveillance or registry system is absent, the actual burden and trend of obesity and hypertension in Nepal are unknown. Hypertension and other cardiovascular diseases can be prevented by detecting risk factors such as obesity and high blood pressure. A simple anthropometric measurement could be used to determine the risk of hypertension. However, the best predictor of hypertension remains contentious and controversial. We aimed to determine the burden of obesity and hypertension and test the ability to determine hypertension through different anthropometric measurements in hospital outpatients in a low-income setting.Methods: This hospital-based cross-sectional descriptive study was conducted from June to December 2019 among 40-69 year outpatients in a tertiary eye and ENT hospital in a semi-urban area of Nepal among a randomly selected sample of 2,256 participants from 6,769 outpatients visited in Health Promotion and risked factor screening service. We performed a correlation analysis to determine the relationship between anthropometric measurements and blood pressure. The area under the receiver operating characteristic (ROC) curve of body mass index (BMI), waist to height ratio (WHtR) and waist circumference (WC) was calculated and compared.Results: The mean (SD) age of the participants was 51.75 (8.47) years. The overall prevalence of obesity and overweight by BMI was 16.09% and 42.20%, respectively. The overall prevalence of abdominal obesity by waist-to-height ratio was 32.76%, which is higher than obesity by BMI. High waist circumference was observed among 66.76% participants, whereas female participants had a very higher prevalence of high waist circumference (77.46%) and male participants (53.73%) (pBMI≥25 kg/m2, WHtR≥0.5 and WC≥ cutoff values was 45.97%, 42.52% and 45.28%, respectively. The overall prevalence of hypertension and prehypertension was 40.67% and 36.77%, respectively. Male participants had a slightly higher prevalence of hypertension (42.72%) than female participants (39.00%). The areas under the curve (AUCs) were significantly higher than 0.5 for BMI (0.570, 95% CI: 0.548-0.592), WC (0.585, 95% CI: 0.563-0.607) and WHtR (0.586, 95% CI: 0.564-0.608). In both genders, the area under the curve was significantly higher than 0.5 (PConclusion: Waist circumference was both correlated as well as had higher predictive capacity amongst WHtR and BMI and may play a major role in the future diagnosis of HTN in Nepali adults. Regardless of the anthropometric metrics used to measure overweight and obesity, the hospital setting is an opportunity centre to screen for overweight, obesity and hypertension, which are major risk factors for NCDs.