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The novel coronavirus (COVID-19) cause various symptoms such as pneumonia, fever, breathing difficult and lung infection. Till now, total 9 cases are reported in Nepal and 4 cases from this province. This case series is to describe the initial clinical features of COVID-19 among the patients admitted in isolation ward of Seti Provincial Hospital. Oropharyngeal swab was taken from all four patients and sample was transfer to national reference laboratory. Three patients were coming from infected country and one is local transmission. Age of patients was range from 20 to 40 years of age with male preponderance. The patient coming from United Arab Emirate was presented with mild symptoms and others were asymptomatic. More tests, contact tracing and keeping them in quarantine are the necessitated action need to be taken by government of Nepal. Keywords COVID-19; local transmission; oropharyngeal swab.Nepal is a landlocked country bordering two most populous countries, India and China. Nepal shares open border with India from three sides, east, south and west. [https://www.selleckchem.com/products/pf-2545920.html PF-2545920 mouse] And, in north with China, where the novel coronavirus infection (CVOVID-19) began in late December 2019. The first confirmed imported case in Nepal was reported in 2nd week of January 2020. The initial response of Nepal to COVID-19 were comparably slow but country geared efforts after it was declared a 'global pandemic' by WHO on 11 March, 2020. Government of Nepal's steps from 18 March, 2020 led to partial lock down and countrywide lockdown imposed on 24 March, 2020. Government devised comprehensive plan on 27 March, 2020 for quarantine for peoples who arrived in Nepal from COVID-19 affected countries. This article covers summary of global status, South Asian Association of Regional Cooperation (SAARC) status, and Nepal's response to contain COVID-19 infection discussed under three headings Steps taken before and after WHO declared COVID-19 a global pandemic and lab services regarding detection of COVID-19. Nepal has documented five confirmed cases of COVID-19 till the end of March 2020, first in second week of 15 January, 2020 and 2nd case 8-weeks thereafter and 3rd case two days later, 4th on 27 March and 5th on 28 March. Four more cases detected during first week of April. Non-Pharmacological interventions like social distancing and excellent personal habits are widely practiced. Country has to enhance testing and strengthen tracing, isolation and quarantine mechanism and care of COVID-19 patients as Nepal is in risk zone because of comparably weak health system and porous borders with India. The time will tell regarding further outbreak and how it will be tackled. Keywords COVID-19; lockdown; Nepal; pandemic; response.The novel coronavirus COVID-19 (SARS-CoV-2) was first reported in 31 December 2019 in Wuhan City, China. The first case of COVID-19 was officially announced on 24 January, 2020, in Nepal. Nine COVID-19 cases have been reported in Nepal. We aim to describe our experiences of COVID-19 patients in Nepal. Keywords COVID-19; experience; Nepal.Emergency medicine, globally, is a developing specialty. The President of International Federation for Emergency Medicine penned down in a 2007 editorial that emergency medicine is rapidly becoming a global specialty. There are an increasing number of countries which are exploring ways to further build emergency medicine. The Hybrid International Emergency Medicine Training Program is the first collaborative international Emergency Medicine training developed in the UK. A Memorandum of Understanding has been signed among Doncaster and Bassetlaw Teaching Hospital, UK, International Centre for Emergency Medicine UK, International Academy of Medical Leadership, UK and Chitwan Medical College, Nepal.The HIEM program has been executed by CMC from November 15, 2018. As per the MOU, the International Training Registrars of HIEM Program will undergo 1st and 4rth Year of training at CMC, Nepal and the 2nd year and 3rd year of training at DBTH, UK. The HIEM Training Program is the first of its kind in the country; HIEM is the first post graduate emergency medicine program in Nepal which also has an international recognition and is unique in the sense that the programme is integrated with training in leadership and management.The HIEM Training Program is recognized by Royal College of Emergency Medicine, UK. CMC has committed to improving emergency care in Nepal by pioneering the HIEM Training Program. We are committed to fulfilling our moral and social responsibility to improve emergency care systems in the country through building up of a cadre of adequately trained Emergency Physicians. Keywords Emergencies; emergency care; emergency medicine; Nepal.BACKGROUND Nepal government has legalized abortion and approved both medical abortion and manual vacuum aspiration for first trimester pregnancy. However, there is inadequate evidence in our setup to comment on the acceptability and complications of medical abortion and manual vacuum aspiration for termination of pregnancy up to nine weeks of gestation. The objective of this study is to compare the reasons for termination of pregnancy, effectiveness and complications between medical abortion and manual vacuum aspiration in termination of pregnancy up to nine weeks. METHODS A comparative study was conducted among women requesting termination of pregnancy up to nine weeks of gestation in Comprehensive Abortion Care unit of Paropakar Maternity and Women's Hospital. Women were kept in medical abortion and manual vacuum aspiration groups after they chose the method. They were advised for follow up in two weeks. Reasons for termination, effectiveness and complications of medical abortion and manual vacuum aspiration were compared using Chi square test. RESULTS In a total of 160 women, the most common reason for termination of pregnancy was completion of the family. In manual vacuum aspiration group 43 (58.9%) women had minimal per vaginal bleeding while 30 (40.54%) women in medical abortion group had per vaginal bleeding for 6-10 days(p less than 0.001). Rate of complete abortion in medical abortion group was 85.14% (n=63) and in manual vacuum aspiration group was 93.15% (n=68). CONCLUSIONS The complications following medical abortion were higher than manual vacuum aspiration in termination of pregnancy up to nine weeks. Rate of completeness of abortion following manual vacuum aspiration is superior over medical abortion.BACKGROUND The aim of the study is to find out the age and sex distribution, modes of head injury and correlate Glasgow Coma Scale with Computed Tomography in patients with head trauma in our center. METHODS A cross-sectional study was performed among 113 patients of acute head trauma presenting to Emergency department of our hospital for three months. The severity of the head injury was assessed on admission by the Glasgow Coma Scale score and categorized as mild, moderate, or severe head injury. Non contrast head computed tomography was obtained. RESULTS The mean age of patients studied in this study was 35.53 year in males and 32.1 year in female with male to female ratio being 1.861. The most common causes of head injury were road-traffic accident 58 (51%), falls 42 (37%) and physical assault 13 (12%). In our present study, 67 (59.3%) of patients had mild head injury, 27 (23.9%) had moderate head injury and 19(16.8%) had severe head injury. Our study shows presence of multiple lesions with depressed bone fracture of skull bone was associated with lower Glasgow Coma Scale. Significant association between Glasgow Coma Scale and computed tomography finding was seen(p less than 0.001). CONCLUSIONS Glasgow Coma Scale is strongly associated with computed tomography in patients with head injury. Road traffic accident is the commonest mode of injury. Most present with mild head injury.BACKGROUND The interval between stimulus and response is called reaction time. It measures the sensorimotor function and performance of an individual. It involves stimulus processing, decision making and response programming. Many factors such as age, gender, handedness, physical fitness, sleep, fatigue, distraction, personality type and type of stimulus have been shown to affect reaction time. Thus the aim of this study was to assess the effect of body mass index, handedness and gender on reaction time. METHODS A cross-sectional study was conducted in the Department of Physiology, Kathmandu University School of Medical Sciences, from October 2019 to December 2019, among 113 student volunteers. Height and weight were recorded and body mass index was then calculated. In ruler drop method, the students were made to sit with their forearm resting on a flat horizontal table surface, with their open hand at the edge of the surface. When the examiner suspended and released the ruler vertically the students were instructed to catch it as quickly as possible. RESULTS Females had a faster reaction time than males when testing either hand (178.46±17.56 Vs 195.99±15.67; right hand) and (184.25±17.02 Vs 199.57±15.91; left hand). In females, right hand responded faster than left hand. In both gender, reaction time was faster in normal weight compared to overweight individuals but it was statistically insignificant. CONCLUSIONS Females responded faster than males. Right hand had shorter reaction time than left hand in females. Reaction time was insignificantly prolonged in overweight individuals.BACKGROUND Vitamin D deficiency is a common problem in many countries throughout the world. This study aimed at understanding the status of vitamin D deficiency in relation to age, gender, geography and season among relatively bigger numbers of population residing in central and western regions of Nepal. METHODS This retrospective cross-sectional study was carried out by reviewing the records of vitamin D tests in two centers of Nepal- namely united reference laboratories at Pokhara and Chitwan Medical College at Chitwan. A total of 3320 individuals who were tested for clinical suspicion of vitamin D deficiency over a period of one year were included in the study. RESULTS Mean vitamin D level was 18.7 ng/mL. Majority of subjects tested for vitamin D were females (71.36 %) with female to male ratio of 2.491. Hypovitaminosis D (≤ 30 ng/mL) was found in 84.5% subjects and was moderate to severely deficit (less than 10 ng/mL) in 25.9% of subjects. Status of hypovitaminosis D was found to be less in ≥50 years (79.9%) than the younger subjects (89.9% in ≤18 years and 87.0% in 19-49 years age group). Vitamin D deficiency was found lower in hills districts (80.8% vs 89.7% in the plains), which was found to be more pronounced during winter through summer seasons as compared to fall season. CONCLUSIONS Population residing in plain areas and summer, spring and winter season are found to have increased problem of Hypovitaminosis D. It is also found to be common among younger children and female of reproductive age group. We have also found out the increased problem of hypovitaminosis D among population residing in the plain areas than in the hills especially in the summer, spring and winter season.BACKGROUND Sepsis has been defined as life-threatening organ dysfunction caused by dysregulated host response to infection. Sepsis is an important cause of mortality in intensive care unit worldwide. The study aims to identify the outcome of sepsis patient admitted at tertiary care hospital. METHODS This is a descriptive cross-sectional hospital based study on 76 adult patients admitted at intensive care unit of Nobel Medical College with diagnosis of sepsis with an objective of estimating mortality of sepsis and identifying associated symptoms with it. Baseline demographics, clinical and laboratory data were collected and analyzed. RESULTS Out of 76 patients with sepsis, mean age of the patients was 50.07±18.15 years. Majority of patients 31.6% with sepsis were above age groups &gt;60 years. The most common symptoms among the patients were fever, which was seen in 69 (90.8%) patients. The most common source of infection in those patients was found to be unknown, which was seen in 36.8% of patients. While analyzing the outcome, it was noted that 25 patients with sepsis (32.