Journal of Gandaki Medical College-Nepal 2021-07-04T15:10:27+00:00 Dr. Nuwadatta Subedi Open Journal Systems <p>An official publication of the Gandaki Medical College Teaching Hospital &amp; Research Centre Pvt. Ltd.</p> COVID-19 Vaccines for the low-income Countries; challenges and the way forward 2021-07-03T15:17:33+00:00 Purushottam Adhikari Sangeeta Poudel Asmita Itani Swotantra Gautam Saroj Adhkari Yadav <p>The vaccine rollout has started for the health workers as well as common people all around the world. The production has been going on rapidly, but the poor and low income countries are still lagging behind to get in the vaccine race and have their people vaccinated. A group of several international non-governmental organizations have warned about 90% of people in 67 low-income countries to have a low chance of being vaccinated in 2021 due to more than a necessary number of vaccines reserved by developed countries. COVAX program, co-led by Gavi, the Vaccine Alliance, along with the World Health Organization (WHO) and the Coalition for Epidemic Preparedness Innovations (CEPI) has raised rays of hope but it’s still long way to go. Vaccine hesitancy among the public, logistics and storage difficulty and emergence of new variants has emerged as potential challenges for COVID-19 vaccination in developing countries.</p> 2021-07-03T00:00:00+00:00 Copyright (c) 2021 Purushottam Adhikari, Sangeeta Poudel, Asmita Itani, Swotantra Gautam, Saroj Adhkari Yadav Assessment of arch width changes in Class I and Class II Division 1 patients treated with fixed orthodontics 2021-07-04T15:10:27+00:00 Umesh Parajuli Manish Bajracharya Manju Pandey Ima Gurung Sapna Laxmi Tuladhar <p><strong>Background: </strong>The orthodontic treatment should aim to maintain the inter-canine and inter-molar width to that of the pre-treatment values. The study was conducted with objective to evaluate arch width changes in Class I and Class II patients treated with fixed orthodontics.</p> <p><strong>Methods:</strong> This was a hospital-based cross-sectional study with two study groups. The first group included patients with Class I malocclusion, treated with four first premolar extractions and the second group included patients with Class II Div 1 malocclusion, treated with upper two first premolar extractions. The inter-canine and inter-molar width of the pre and post-treatment study model were measured. To compare the changes observed amongst two groups, independent samples t-test was performed. A paired sample t-test was used to evaluate the treatment changes within each group.</p> <p><strong>Results:</strong> There was significant increase in inter-canine width in both maxillary and mandibular arches in both the groups. In Class I extraction group there was significant decrease in the inter-molar width in both maxillary and mandibular arches. The Class II Div1 maxillary extraction group also showed significant increase in inter-canine width in both maxillary and mandibular arches. In the same group there was decrease in post treatment</p> <p><strong>Methods:</strong> This was a hospital-based cross-sectional study with two study groups. The first group included patients with Class I malocclusion, treated with four first premolar extractions and the second group included patients with Class II Div 1 malocclusion, treated with upper two first premolar extractions. The inter-canine and inter-molar width of the pre and post-treatment study model were measured. To compare the changes observed amongst two groups, independent samples <em>t</em>-test was performed.&nbsp; A paired sample <em>t</em>-test was used to evaluate the treatment changes within each group.</p> <p><strong>Results:</strong> There was significant increase in inter-canine width in both maxillary and mandibular arches in both the groups. In Class I extraction group there was significant decrease in the inter-molar width in both maxillary and mandibular arches. The Class II Div1 maxillary extraction group also showed significant increase in inter-canine width in both maxillary and mandibular arches. In the same group there was decrease in post-treatment inter-molar width in both arches with significant decrease in the maxillary inter-molar width.</p> <p><strong>Conclusion:</strong> There was increase in inter-canine width in both Class I extraction group and Class II Div 1 maxillary extraction group with decrease in inter-molar width in both the groups.</p> <p>&nbsp;</p> 2021-06-13T00:00:00+00:00 Copyright (c) 2021 Umesh Parajuli, Manish Bajracharya, Manju Pandey, Ima Gurung, Sapna Laxmi Tuladhar Role of parents on screen time of young children in Pokhara metropolitan, Nepal- a cross sectional study 2021-07-03T15:17:13+00:00 Sharad Koirala Sanju Banstola Nirmala Shrestha Nisha Gurung Saurabh Kishor Sah Bimala Sharma <p><strong>Background: </strong>Sedentary lifestyle is a major modifiable risk factor that usually starts from childhood. High screen time is associated with sedentary lifestyle in children; and parents might have played a role in screen time among the children. This study aims to assess the role of parents in the screen time of young children aged five to nine years in Pokhara metropolitan city in Nepal.</p> <p><strong>Methods: </strong>A cross sectional study was done among 360 children where respondents were one of the parents of those children. Face to face interview was done using a semi structured questionnaire between March 8 and September 4, 2020. A daily screen time &lt;2 hours was taken as a normal value. Descriptive and inferential analyses were done with the data. Chi square test at 5% level of significance was computed for the inferential analysis. The ethical approval was taken from the Nepal Health Research Council.</p> <p><strong>Results: </strong>Of the total 360 children, 54.7% were male and 35.6% were aged 9 years. Screen time &gt;2 hours was found among 48.6% children. The screen time of &gt;2 hours children was significantly associated with the educational qualification of parents, parental worry and parental permission to watch the screen for tasks like eating, doing homework, not going out or making free time for parents. The screen time of children was not associated with socioeconomic characteristics like parental occupation.</p> <p><strong>Conclusion: </strong>Parental characteristics have role in the screen time of children. Parental factors must also be considered while implementing programs to reduce children’s screen time. </p> 2021-07-03T00:00:00+00:00 Copyright (c) 2021 Sharad Koirala, Sanju Banstola, Nirmala Shrestha, Nisha Gurung, Saurabh Kishor Sah, Bimala Sharma Clinicopathological profile of colorectal carcinoma in a tertiary care teaching hospital in Pokhara, Nepal 2021-07-03T15:17:15+00:00 Subash Bhattarai Om Bahadur Karki Merina Gyawali Sudeep Regmi <p><strong>Introduction: </strong>Colorectal cancer is the most common malignancy of the gastrointestinal tract. They are common after 50 years of age and present with bleeding per rectum, altered bowel habits, anemia, pain abdomen, and weight loss. The objective of this study was to evaluate the demographic profile, clinical presentation, colonoscopy and histopathology findings of colorectal cancer.</p> <p><strong>Methods: </strong>A descriptive cross-sectional study was conducted. Cases were studied from the departmental records. Clinical presentation, CT abdomen, colonoscopy, and histopathology findings of colorectal carcinoma were studied. Data entry was done in SPSS version 20.</p> <p><strong>Results: </strong>The mean age of subjects was 56 ± 11.42 years (range of 34 – 80 years) with male predominance (M: F=3:2). Changes in bowel habits (92.3%), chronic abdominal pain (84.6%), generalized weakness (80.7%), rectal bleeding (46.2%), and significant weight loss (42.3%) were the most common presenting symptoms. Rectal carcinoma was the most common (35%) followed by carcinomas of ascending colon (14%) and descending colon (10 %). The most common morphology was proliferative growth (61.5%). All colorectal carcinomas were adenocarcinoma, and the majority was moderately differentiated (51.9%).</p> <p><strong>Conclusion: </strong>Colorectal cancers are seen above 50 years of age and common in males. Changes in bowel habits, chronic abdominal pain, generalized weakness, rectal bleeding, and weight loss are the most common form of presentations. These patients usually present late with advanced disease and unfavorable histopathology. Screening colonoscopy &gt;50 years is strongly recommended.</p> 2021-07-03T00:00:00+00:00 Copyright (c) 2021 Subash Bhattarai, Om Bahadur Karki, Merina Gyawali, Sudeep Regmi A study of variations in formation of superficial palmar arch in Nepalese cadavers 2021-07-03T15:17:16+00:00 Prakash Baral Rami Shrestha Subash Sapkota Supana Koju Binod Chaudhary <p><strong>Introduction: </strong>The superficial palmar arch (SPA) is the main source of arterial supply to the palm. It is an arterial arcade formed mainly by the ulnar artery and is completed by the superficial palmar branch of the radial artery. The study was conducted with objective to study the variations in formation of superficial palmar arch in Nepalese cadaveric hands.</p> <p><strong>Methodology: </strong>Two horizontal incisions were made, one at the wrist joint and another incision along the root of fingers. A vertical incision was made from the middle of the wrist to the 3rd metacarpo-phalangeal joint. The skin of the palm and the palmar aponeurosis was reflected. The surrounding adipose tissue was removed to view the superficial palmar arch and its branches.</p> <p><strong>Result: </strong>In present study, out of 50 specimens of hands, 64% of superficial palmar arch was formed as normal pattern and in 36% cases it was formed by ulnar artery alone. Normal SPA pattern was seen 63% in male and 66.7% in female i.e. higher percentage in female than in male but it was statistically insignificant (P&lt;0.05). SPA-ulnar artery alone pattern was seen 37% in male and 33.3% in female i.e. higher percentage in male than in female, however it was also statistically insignificant (P&lt;0.05).</p> <p><strong>Conclusion: </strong>Normal pattern of SPA observed in Sixty-four percent of Nepalese hands and in thirty-six percent cases it was formed by ulnar artery alone. There was no statistically significant difference in SPA pattern distribution between Nepalese male and female. &nbsp;</p> 2021-07-03T00:00:00+00:00 Copyright (c) 2021 prakash baral Pattern of morbidity and mortality among neonates admitted to neonatal intensive care unit in tertiary care centre, western Nepal 2021-07-03T15:17:18+00:00 Namrata K.C. Bandana Shrestha Arjun Bhattarai Shankar Paudel Nabraj Subedi <p><strong>Background:</strong> The objective of this study was to determine the disease pattern and outcome of diseases in neonatal intensive care unit (NICU) as the common causes of mortality and morbidity in our region are preventable.</p> <p><strong>Methods:</strong> The retrospective study was carried out in 1041 newborns admitted from 1st August 2019 to 30th July 2020 in Gandaki Medical College Teaching Hospital in Western Nepal. Age, sex, gestational age, diagnosis at admission, outcome of admitted newborns were the main variables under study. Data was entered and analyzed using SPSS 20 version.</p> <p><strong>Result: </strong>Among 1041 newborns, 599 (57.54%) were male and 442(42.46%) were female. 1028(98.75%) were born in hospital while 8(0.77%) were born at home and 5(0.48%) in ambulance. The majority 610 newborns were admitted during the first 24 hours of life. Infection and hyperbilirubinemia were the main reasons for admission (44.96% and 23.15 % respectively), followed by prematurity (9.51%) and Birth Asphyxia (9.13%). A total of 831patients (79.83%) were improved and discharged, 79(7.59%) were discharged on request, 61(7.59%) left against medical advice, 34 (3.26) were referred and 36 (3.46%) expired. The major causes for neonatal mortality were prematurity (44.45%), Sepsis (27.78%), and Birth Asphyxia (13.89%) respectively. Among the expired neonates, 24(66.67%) were outborns and 12(33.33%) were inborns and majority 27(75%) expired at the age between 24-48 hours of life.</p> <p><strong>Conclusions: </strong>Infection was the leading cause of morbidity and prematurity the leading cause of mortality in the neonatal care unit. This is preventable with antenatal care, training of manpower and procurement of necessary equipments.</p> 2021-07-03T00:00:00+00:00 Copyright (c) 2021 Namrata K.C., Bandana Shrestha, Arjun Bhattarai, Shankar Paudel, Nabraj Subedi Association between emotional intelligence and academic performance among students in Gandaki Medical College, Pokhara 2021-07-03T15:17:19+00:00 Rami Shrestha Nirmala Shrestha Sapana Koju Ratna Keshari Tako <p><strong>Introduction: </strong>Recent studies in last few decades are revealing that Intelligence Quotient (IQ) alone is not a reliable factor of students’ academic achievement. It has been claimed that only 20% of a person’s success can be attributed to IQ and rest 80% to Emotional Quotient. Since, many researchers had claimed the influence of emotional intelligence on academic performance; the aims of this study were to find out the level of emotional intelligence and its relation with academic performance among Nepali undergraduate students.</p> <p><strong>Methods: </strong>A cross sectional study was carried out in 280 medical students (120 male, 160 female). The data of this research was obtained through the use of a questionnaire which elicits information about their Emotional Intelligence level and academic performance. The obtained data was analyzed by SPSS. The degree of relationship between marks obtained and emotional intelligence were established by Correlation coefficient and Fischer exact test. The level of significance was set at p-value less than 0.05.</p> <p><strong>Results: </strong>The mean level of emotional intelligence was high (5.055±0.798) among Nepalese medical students. The respondents were reported to have high level of emotional intelligence with (5.544±0.929) for Self- awareness, (5.035±1.01) for Social awareness, (5.394±1.11) for Social skill and moderate level of emotional intelligence (4.24±1.37) for Self-management.</p> <p><strong>Conclusion: </strong>There was a positive and strong relationship between the respondents’ overall emotional intelligence and their academic achievement which means that the higher their level of emotional intelligence, the better they perform academically.</p> 2021-07-03T00:00:00+00:00 Copyright (c) 2021 Rami Shrestha, Nirmala Shrestha, Sapana Koju, Ratna Keshari Tako Bacteriological profile of surgical site infections in a tertiary care hospital of western Nepal 2021-07-03T15:17:20+00:00 Dharm Raj Bhatta Abhijit Adhikari Jampa Lhamo Gurung Niroj Man Amatya Niranjan Nayak Shishir Gokhale <p><strong>Introduction: </strong>Surgical site infections are one of the most commonly reported nosocomial infections resulting into significant morbidity and mortality. Hospital admission and surgical procedures increase the risk of infection with multidrug resistant pathogens. This study was aimed to determine the bacterial agents associated with surgical site infections and antibiotic resistance patterns of the isolates.</p> <p><strong>Methods: </strong>A total of 161 specimens from patients with surgical site infections were included in this study. Isolation, identification and antibiotic susceptibility testing of the isolates was performed by standard microbiological techniques.</p> <p><strong>Results: </strong>Out of 161 samples, 94 bacterial isolates were recovered. Gram positive bacteria were isolated in 57.4% (54/94) cases and <em>Staphylococcus aureus </em>was the most common organism (49/54) with 65.3% (32/49) methicillin resistant <em>Staphylococcus aureus </em>isolates. All <em>S. aureus </em>isolates were susceptible to vancomycin. Gram negative bacteria constituted 42.6% (40/94) of total isolates and <em>Escherichia coli </em>was the commonest organism (13/40). Majority of Gram negative isolates were susceptible to amikacin, imipenem and piperacillin-tazobactam. Resistance to imipenem was detected among isolates of <em>E coli, Pseudomonas </em>and <em>Acinetobacter species. </em></p> <p><strong>Conclusion: </strong>Gram positive isolates were more commonly associated with surgical site infections. High percentage of MRSA was detected among the <em>S. aureus </em>isolates but no vancomycin resistant <em>S. aureus</em>. High percentage of Gram negative isolates was susceptible to imipenem, piperacillin-tazobactam, amikacin and gentimicin.</p> 2021-07-03T00:00:00+00:00 Copyright (c) 2021 dharm raj bhatta, Abhijit Adhikari, Jampa Lhamo Gurung, Niroj Man Amatya, Niranjan Nayak, Shishir Gokhale Disrespect and abuse during facility-based childbirth in Pokhara metropolitan city 2021-07-03T15:17:22+00:00 Rekha Thapaliya Kalpana Paudel Saphalta Shrestha <p><strong>Introduction: </strong>Respectful maternity care is the universal right of every childbearing woman, which promotes the practices that recognize women’s preferences and women’s and newborns’ needs. The objective of the study was to assess disrespect and abuse during facility-based childbirth in Pokhara.</p> <p><strong>Methods: </strong>Postnatal mothers having vaginal institutional delivery were included in the study. Non-probability purposive sampling technique was done to select 231 samples. Face to face interview technique with structured interview schedule was used. Descriptive and inferential statistics were used for data analysis.</p> <p><strong>Results: </strong>Most (88.3%) of the mothers were between the age of 20 and 34 years with the mean age of 25.39±4.799 years. More than half of them had spontaneous vaginal delivery with episiotomy and (87%) of mothers had no any complications during childbirth. The overall disrespect and abuse during facility-based childbirth was (70.1%) and only (29.9%) of the postnatal mothers received respectful and non-abusive care. Regarding types of disrespect and abuse, (34.6%) of them were suffered from physical abuse, (68%) received non-consented care, (22.5%) of them received non-confidential and non-dignified care, (1.3%) experienced discrimination based on specific attributes and (26%) suffered from abandonment or neglect of care. There was no significant association between the prevalence of disrespect and abuse with socio-demographic and obstetric characteristics of the mothers. The association was found with place of delivery.</p> <p><strong>Conclusion: </strong>It is concluded that near to three fourth of the postnatal mothers suffer from disrespect and abuse during facility based child birth in Pokhara. Thus, to increase respectful and non-abusive care during facility based childbirth, practice of respectful maternity care should be promoted including development of clinical guidelines and protocols.</p> 2021-07-03T00:00:00+00:00 Copyright (c) 2021 Rekha Thapaliya, Kalpana Paudel, Saphalta Shrestha Factors influencing job retention and satisfaction among nurses in tertiary level hospital 2021-07-03T15:17:23+00:00 Mana Maya Rana Nona Shakya <p><strong>Introduction: </strong>Retention of nurses in any health care facilities is essential for maintaining quality nursing care. Nurses’ job satisfaction is an important issue to retain nurse in same organization. The study aimed to assess factors influencing job retention and satisfaction among nurses.</p> <p><strong>Methods: </strong>The descriptive cross-sectional study was done among 125 nurses working in Manipal Teaching Hospital. Purposive sampling technique was used to select the sample. The semi structured self-administered questionnaire was used to collect data. The collected data was analysed by using descriptive and inferential statistic.</p> <p><strong>Results: </strong>Majority (90.4%) of nurses were in age group 21 to 39 years, 78.4% of nurses wanted to continue their job in current organization. All the nurses agreed on timely payment of salary followed by good working relationship with colleagues (93.6%), feeling proud to tell name of organization (89.6%), adequate supplies and equipment (83.2%), safe working environment (80.6%), opportunity to develop many job skill (81.6%), supportive matron (75.2%), the financial incentives such as bonus and allowance (67.2%), higher salary compared to similar organization (64.8%) are important factors to motivate nurses to retain in current organization. Only half of the nurses (50.4%) were satisfied with their job. The significant correlation was seen between factors influencing job retention and their satisfaction level.</p> <p><strong>Conclusion: </strong>The study concluded that timely payment of salary, image of organization, safe working environment and adequate equipment and supplies are important factors to retain in this organization. &nbsp;</p> 2021-07-03T00:00:00+00:00 Copyright (c) 2021 Mana Maya Rana, Nona Shakya Demographic and autopsy characteristics of drowning deaths in a major autopsy center of Gandaki province of Nepal 2021-07-03T15:17:24+00:00 Madan Prasad Baral Nuwadatta Subedi <p><strong>Background: </strong>Autopsy examination is mandatory in all unnatural deaths as per law of Nepal and thus all deaths due to drowning are undergone medico legal autopsy. This study aims to analyze the demographic and autopsy characteristics of drowning deaths in cases brought for medico legal autopsy at a major autopsy center of Gandaki province of Nepal.</p> <p><strong>Methods: </strong>This study was conducted based on review of database in a period of two years among 53 corpses of drowning related deaths. The demographic data and relevant information from the inquest and autopsy report of such cases were collected and presented.</p> <p><strong>Result: </strong>The commonest age group involved in drowning deaths was &lt;20 years, attributing to 22 (41.5%) cases, and with males (41, 77.4%) more common than females. Suicidal drowning (34, 64.2%) was the commonest manner. Maximum (19, 35.8%) deaths occurred in the rainy season and on lakes (34, 64.1%).</p> <p><strong>Conclusion: </strong>Drowning deaths were more common among males of young age groups. Most of the drownings occurred during the rainy season, lakes were the common sites of drowning, and the commonest manner was suicidal.</p> 2021-07-03T00:00:00+00:00 Copyright (c) 2021 Madan Prasad Baral, Nuwadatta Subedi Impact of COVID-19 awareness on health-related behavior among adolescents in Nepal 2021-07-03T15:17:26+00:00 Bidhya Banstola Durga Dhungana <p><strong>Introduction: </strong>With occurrence of COVID-19, many countries have initiated lockdown in an effort to control the pandemic. These measures can only be effective when the people co-operate. The awareness and health-related behavior have a major role in determining society’s response. Meanwhile adolescents are at the risk of deviating from disciplined health-related behaviors due to turbulence arising from their hormones despite of their awareness. This study aims to study COVID-19 awareness and its impact on health-related behavior of adolescents.</p> <p><strong>Methods: </strong>A descriptive cross-sectional web-based online study of 299 adolescents enrolled in various educational programs, between ages 13 to 19 years was conducted between June 18, 2020 and July 11, 2020 in Nepal. The questionnaire consisted of demographic characteristics, 16 items on knowledge and 40 items on behavior. Descriptive statistics, chi-square tests and binary logistic regression were conducted in Statistical Package for the Social Sciences.</p> <p><strong>Results: </strong>A total of 299 adolescents were enrolled in the study. Majority (92.6%) of the adolescents had adequate awareness. Positive health-related behavior was seen in 72% of the adolescents. Spiritual behavior was the most affected in comparison to physical, social and psychological behavior. Adolescents with adequate awareness on COVID-19 were 10.67 times more likely to perform positive health related behavior (P=0.005; 95% CI=2.01-56.47).</p> <p><strong>Conclusion: </strong>Majority of the adolescents had adequate awareness. Significant percentage of adolescents had positive health-related behavior. Positive behaviour was not proportionately in level with adequate awareness. Effective health programs and policies are needed to transform adequate awareness into positive health-related behaviour for effective control of disease.</p> 2021-07-03T00:00:00+00:00 Copyright (c) 2021 Bidhya Banstola, Durga Dhungana Perceived psychological stress among undergraduate students: role of academic factors of a medical college of Kathmandu 2021-07-03T15:17:27+00:00 Jyoti Badan Tuladhar <p><strong>Introduction: </strong>Stress refers to a dynamic interaction between the individual and the environment, which described as external demands (physical or mental) on an individual’s physical and psychological well-being. The objective of this study was to assess the perceived psychological stress and perception of academic stress among undergraduate students.</p> <p><strong>Methods: </strong>A cross-sectional, questionnaire- based survey was carried out among 853 undergraduate students (medical, dental and nursing) of Kathmandu Medical College, Kathmandu Nepal during August 2017 to July 2018. Perceived stress was assessed using Perceived Stress Scale-14 and perception of academic stress 18-item questionnaire was used to assess the academic factors of stress using self-administered technique.</p> <p><strong>Result: </strong>The overall mean perceived stress score was 45.23 ±4.96, 99.6% of participants were in the group of more stressed and overall mean score of perception of academic stress was 54.68 ±9.10, and 56.3% of participants were in the group of academic stress. The correlation between perceived psychological stress and academic stress was 0.070 with P value of 0.040.</p> <p><strong>Conclusion: </strong>Higher level of perceived stress and academic stress were reported by the students and there was weak significantly positive correlation between perceived psychological stress and academic stress.</p> 2021-07-03T00:00:00+00:00 Copyright (c) 2021 Jyoti Badan Tuladhar Epidemiology and visual outcome of severe eye injuries in a tertiary center of Gandaki Province of Nepal 2021-07-03T15:26:04+00:00 Kripa Joshi Khem Raj Kaini Kirti Nath Jha Niraj Man Shrestha Srijana Thapa Godar <p><strong>Introduction: </strong>Ocular trauma is an important worldwide preventable public health problem which may lead to permanent visual impairment. This study aims to determine the demographics, clinical profile and visual outcome of severe eye injuries.</p> <p><strong>Methods: </strong>This study was conducted at a tertiary centre from January 2013 to August 2014. Cases of severe eye injuries hospitalized at or presenting to emergency/OPD were included in the study. All cases underwent detailed examination and necessary intervention. Cases were followed upto 3 months and final visual outcome was evaluated.</p> <p><strong>Results: </strong>The study comprised of 60 individuals (65 eyes); 76.7% males and 23.3% females. Out of 60 cases, the age group 1-9 years had the highest occurrence with 23.33% followed by 20-29 years with 20% and majority were students 45%. Impact with stone was the commonest cause of injury reported on 21.7% followed by road traffic accident (RTA) 20%. Closed-globe injuries accounted for 36.6% and open-globe injuries for 33.3%. At the time of presentation, visual acuity of less than 6/18 was seen in 71.6% and at follow up was seen in 45%. Among total cases, 63.3% eyes were managed conservatively, 30% eyes underwent surgery and 6.7% were referred to higher centre for vitreoretinal surgeries.</p> <p><strong>Conclusions: </strong>Severe eye injuries were seen in 0.13% of total eye injuries. Paediatric and young adult males formed the majority of victims. Stone and road traffic accidents were the common causes. One fourth of the eyes were blind. Primary prevention and management of the affected cases is the clear need.</p> 2021-07-03T00:00:00+00:00 Copyright (c) 2021 Kripa Joshi, Kaini Raj Khem, Jha Kirti Nath, Niraj Man Shrestha, Srijana Thapa Godar Embracing electronic learning in medical education during COVID-19 pandemic 2021-07-03T15:17:30+00:00 Soni Bista Rupesh Shingh Basnyat Rebicca Ranjit Nuwadatta Subedi <p>Medical education is considered as a very significant strategy ensuring good quality in academics and health care. Currently, medical education across the world has been experiencing a major obstruction as a consequence of the novel coronavirus disease pandemic. At the same time, the rapid use of emergent technologies to maintain effective teaching and learning has become an essential component for transformative changes and the future of medical education. In this paper, we discuss the role of e-learning in medical education by outlining its components, effectiveness, barriers, all the pros and cons and future of implementation of such technology. The intention of this article is to inform all medical educators and students across the world on how the technological changes even after the pandemic can have a positive impact on medical education. &nbsp;</p> 2021-07-03T00:00:00+00:00 Copyright (c) 2021 Soni Bista, Rupesh Shingh Basnyat, Rebicca Ranjit, Nuwadatta Subedi The ugly, the bad and the good facets of COVID 19 in Nepal 2021-07-03T15:17:11+00:00 Suman Baral Nuwadatta Subedi <p>Not Available</p> 2021-07-03T00:00:00+00:00 Copyright (c) 2021 Suman Baral, Nuwadatta Subedi HIV-Associated benign lymphoepithelial parotid cysts: a rare case report 2021-07-03T15:17:31+00:00 Brihaspati Sigdel Priti Acharya Rajesh Maharjan Kusheswar Sah <p>Approximately one to 10% of patients with Human Immunodeficiency virus (HIV) infection associated with salivary gland disease. The presence of Benign lymphoepithelial cyst (BLEC) in the parotid gland is an indicator of HIV Infection. The diagnosis is usually based on a clinical course and HIV confirmatory blood testing. We have reported a case of a 35 years old Nepalese male patient with swelling of the bilateral parotid glands and HIV associated BLEC confirmed by Rapid diagnostic test kit (Determine unigold stat pack).</p> 2021-07-03T00:00:00+00:00 Copyright (c) 2021 Brihaspati Sigdel, Priti Acharya, Rajesh Maharjan, Kusheswar Sah Unique case series of tubercular neck abscess at a primary care centre in the Eastern part of Nepal. 2021-07-03T15:17:32+00:00 Pradeep Kumar Pyakurel <p>Cervical tubercular lymphadenopathy(CTL) is a common extra-Pulmonary manifestation of tuberculosis. CTL can masquerade many other diseases. A high index of suspicion must be maintained in any cases presenting with neck swelling especially in TB endemic region like Nepal. Here we present a varied presentation of CTL at a primary care level community hospital.</p> 2021-07-03T00:00:00+00:00 Copyright (c) 2021 Pradeep Kumar Pyakurel