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Background: Chronic otitis media is usually complicated due to perforation of tympanic membrane and ultimately leading to hearing loss. The objective of this study was to compare the results of myringoplasty alone with myringoplasty with cortical mastoidectomy in COM (Chronic Otitis Media) mucosal inactive type in terms of graft uptake. Methods: This was a descriptive, prospective, qualitative type of study. A total of thirty patients of COM mucosal inactive type were included in the study of which 15 patients were selected alternatively for myringoplasty alone while another 15 patients were selected for myringoplasty with cortical mastoidectomy. Pure tone audiometry was done within 1 week prior to surgery. Graft uptake was assessed after 6 weeks and results were compared within and between the groups using Chi-square test. Results: Graft uptake rate of myringoplasty alone and myringoplasty with cortical mastoidectomy done using temporalis fascia graft and underlay technique was same 86.66% (n=26) and failure rate was 13.33% (n=4).The graft take was higher 88.9%(n=8) in small perforation worsened in medium (85 %) and then in subtotal perforation (79%). Graft uptake rate was highest in central perforation (86.9%) followed by posterior perforation (84.6%) and least in anterior perforation (77.7%). Mean age of presentation was 27.7 years, ranging from 15 to 60 years. Most common approach was permeatal in myringoplasty and postaural in case of myringoplasty with cortical mastoidectomy. Conclusions: The graft uptake rate myringoplasty alone are comparable to those of myringoplasty with cortical mastoidectomy. The choice of surgery is based on surgeon’s preference.

Introduction: The vaccine has a positive impact on reducing the severity of COIVD-19 disease-course and studies have projected 50-90% protection against severe disease. Our study aimed to find the difference in disease severity outcomes between RT-PCR positive vaccinated and unvaccinated individuals. Method: This cross-sectional study was carried out among 417 COVID-19 cases who were admitted from June 2021 to August 2021. Collected data were fed into Microsoft-excel and analyzed using SPSS software, version- 16.0. Frequency, percentage, mean and standard deviation were calculated for descriptive analysis. To find out the association of categorical variables, Chi-square test or Fisher’s Exact test was used where appropriate. P-value

Introduction: Informed consent gives patient assurance and faith by providing information on diagnostic and therapeutic methods, risks, cost, complications, and alternative treatment options. This study aims to determine the adequacy of information provided in preoperative informed consent in everyday practice. Method: A cross sectional study was conducted among 388 patients undergoing surgery at Patan Hospital from November, 2016 to April, 2017. Respondents’ characteristics with Adequacy of information scale (AOI scale) were evaluated. Frequency, percentage, mean and standard deviation were calculated for descriptive study while Student t-test and ANOVA test was applied for assessing association between categorical variables. P value less than 0.05 was considered statistically significant. Result: Among participants 52.6% were females and 47.4% males with mean age of 40.69 years. Most of the patients were literate and with higher education. Male patients, exhibit a statistically significant higher AOI scale (p value

To evaluate the hearing status of COVID-19 patients and compare with control group. Prospective study carried out in 9 institutes. The pure tone audiogram and impedance audiometry of COVID-19 patients performed initially and at 3 months follow up. The control group consisted COVID-19 negative individuals with no history of ear related diseases. The average of air and bone conduction threshold (AC and BC) were compared between the COVID-19 patients and control group using independent t-test with a p value of less than 0.05 considered significant. Total of 331 patients, age 32 ± 4.3 years, 66.7% males and 33.3% females were included in the study. There were 80 individuals in the control group. Aural symptoms were, tinnitus in 1.8%, aural fullness in 1.4%, hearing loss in 3. 9%, and ear ache in 1.8% were present initially, resolved at 3 months follow up. The impedance audiometry demonstrated type B and type C curve in 5.1% and 1.15% ears, and out of these 64.7% and 40% improved at 3 months follow up respectively. No significant difference observed between the average AC and BC of the COVID-19 patients and control group. The COVID-19 infection may present with aural symptoms; however, it was concluded that there was no significant difference in the hearing status of the COVID-19 positive patients in comparison to the control group. The presence of some changes in the normal functioning of the eustachian tube and middle ear in the COVID-19 infection was also highlighted.

In social media, Information is present in enormous amount. Extracting data from processed information from social media gives us diverse usages in various fields. In the field of Business Analytics, HealthCare, Technologies and Trending Topics in Social Media posted by the user. Extracting information from social media is providing number of benefits such as knowledge about the latest Technology, Medical field, Business Decisions, etc. Twitter is solitary of the social media which allows the user post tweets of limited number of characters and share the tweet to their followers. Twitter allows application developer to access the tweets for their motive. In the implemented methodology, Tweets are collected, and sentiment analysis is performed on them. Based on the results of sentimental analysis of Trending Topics in Twitter, suggestions can be provided to the user. In this way, the implemented system can help in improving the growth of business, healthcare, technologies and alsoNegative or Positive mentions of a product or service can be determined.

Background The services rendered by hospitals during the pandemic may not be efficient. This might impact the satisfaction of patients seeking healthcare. The aim of this study is to assess the satisfaction level of patients other than those with COVID-19 during the pandemic with different services provided by the hospital. Method A quantitative, analytical and cross-sectional study was carried out in a multidisciplinary hospital. Valid questionnaire, derived from PSQ III and PSQ 18, was used for data collection from 250 outpatients. Ethical approval was obtained. Systematic random sampling was done to enrol patients into the study after taking their consent. Descriptive analysis was performed using frequency, proportion, median and inter-quartile range. Mann–Whitney U test and Kruskal–Wallis test were carried out to find the association between overall satisfaction and different socio-demographic and other variables. Statistical significance was set at p-value < 0.05. Result Almost two-thirds of the respondents visiting the hospital during the pandemic were female (male: 35.6% and female: 64.4%). More than half (50.4%) of the patients reported that access to the hospital was feasible. Of the patients reporting dissatisfaction, most of them (86.4%) considered the establishment of separate COVID-19 hospitals as the best option. The median satisfaction score for the overall satisfaction of patients towards different service domains was 54.0 (45–60). Almost all respondents (95.6%) found that services were easily available. Patient satisfaction score was significantly associated with expenditure ( p < 0.001). Satisfaction score was also significantly associated with the time spent in the hospital by the patients ( p < 0.001). Conclusion Majority of the patients reporting to the multidisciplinary hospital were satisfied with the provisioning of treatment and different services during the COVID-19 pandemic. Relatively lesser satisfaction was reported for the provision of maintenance of social distance, availability of hand washing/sanitisation, overall hospital cleanliness and cost of treatment. Moreover, satisfaction among patients was associated with their perceived fear of the pandemic.

Introduction: Since the WHO declared COVID-19 as a global pandemic, nearly 80% of the global population has come under stay-home orders, lockdowns, and quarantines, inflicting increasingly severe direct and indirect economic impacts. Transmission of SARS-CoV-2 can occur through direct, indirect, or close-contact. The duration of RT-PCR positivity ranges from 1-3 weeks or more in some cases. The number of COVID-19 infections may be attributable to the late identification of sources-of-infection and the ability of the host to shed the infection while asymptomatic. The COVID-19 pandemic is wreaking havoc on the global economy, unleashing the worst economic downturn since the great depression. Managing the human resource in such a situation, keeping most of the workforce in quarantine is challenging. The idea of the Worker’s Distribution Model(WDM) of management is innovated. There is a global economic crisis during this pandemic. This WDM is justifiable to sustain the economic crisis of the country and stands aside to raise the economy of a country or community.

Homicidal cut throat is an injury over the front of neck by sharp instruments with an intent of murder. The neck contains vital structures (nerves, blood vessels, airway and pharyngeal conduit) in a compact fashion that may be difficult to access for physical examination or surgical exploration in a limited time. That is why these cases create panic and pose great challenges in the management. Here is a case of an attempted homicidal cut throat injury that highlights some of the challenges encountered in the management along with discussion on the evolving knowledge of the optimal management practice.

Background Many scientists across the world got involved in the race to develop successful anti-SARS-CoV-2 vaccines to overcome COVID-19 pandemic. Among the different vaccines developed against SARS-CoV-2, Covishield was the first vaccine approved for emergency use in Nepal. We report two cases of Superficial Vein Thrombosis (SVT) for the first time in the literature after vaccination with the Chimpanzee Adenovirus-vectored Vaccine (ChAdOx1 nCoV-19 vaccine). Cases presentation Two cases, a 24-year-old young Chhetri male and a 62-year-old Chhetri female who have received Covishield (ChAdOx1 nCoV-19) vaccine, developed pain in left calf after 2 weeks and 10 weeks of vaccination, respectively. Both the case belongs to the Chhetri ethnic group of Nepal. The pain became severe on the fourth week of immunization in the first case while the pain was acute and severe on the 10th week of vaccination in the second case. The first presented to emergency room and second case was referred to the emergency room from Orthopedic Clinic. On evaluation the first patient had normal vitals with no history of fever and swelling yet displayed non-radiating mild to moderate intensity pain localized to left leg below the knee which became aggravated by movements. In the second case however pain was more intense with other characteristics as first case. Both cases had low wells score ( Conclusion These cases reporting Superficial Vein Thrombosis may be an additional adverse effect to the list of adverse events associated with ChAdOx1 nCoV-19, Covishield, vaccine. However, the benefits of the vaccine in breaking the chain of COVID 19 spread are certainly greater than the risk of thromboses.

Background COVID-19 is an emerging respiratory disease caused by a novel coronavirus. There is not much evidence assessing the knowledge of dental surgeons regarding COVID-19. This study was conducted to assess the knowledge of COVID-19 among dental surgeons of Nepal. Methods A web-based cross-sectional study was conducted among registered dental surgeons of Nepal. Ethical approval was obtained. Consent was taken, and knowledge on COVID-19 was assessed via a pre-tested structured questionnaire using Google form. The form was emailed to the participants. Descriptive analysis was performed using frequency, percentage, median and inter-quartile range. Man-Whitney test and Kruskal-Wallis tests were carried out to see the difference in knowledge score. P-value Results Total 227 dental surgeons responded to the questionnaire (male: 46.4%; female: 53.7%). Almost two-third (65.2%) of the respondents were B.D.S. (Bachelor of Dental Surgery) graduates. Only 29.1% worked in the government hospitals. 17.6% were currently involved in COVID-19 management. Of the participants, 87.7% knew about the condition of the requirement of Personal Protective Equipment (PPE) but only 29.1% could correctly answer the framed question for PPE. The median knowledge score calculated was 14.0 (8.0–18.0). The bivariate analysis showed a statistically significant difference in knowledge score among the age group ≥30 years and p = 0.013); M.D.S. (Master of Dental Surgery) graduate and B.D.S. graduate (0.041); dental surgeons of government healthcare facilities and other healthcare facilities (p Conclusion The dental surgeons of Nepal have a good knowledge of COVID-19, and they can be utilized for assisting in the management of COVID-19 cases in Nepal.

Introduction Depressive disorder is the most common psychiatric comorbidity in individuals with epilepsy (IWE) and is associated with a significant negative impact with increased morbidity and mortality rate. However, the magnitude of comorbid depression in such patients in the Nepalese setting is still poorly understood. Therefore, we aimed to determine the magnitude of depression in individuals diagnosed as having epilepsy and further examine the influencing factors associated with it. Methods This cross-sectional observational study was conducted from April 2018 to September 2018 at Nepal Epilepsy Center, Lazimpat, Kathmandu, Nepal. One hundred and forty-two eligible subjects were enrolled for analysis. The core outcome variable evaluated in this study was depressive disorder, whereas age, gender, types of epilepsy, frequency of seizures, duration of epilepsy, and drug use were evaluated as covariates. The mean ages of the patients were 31.45 ± 12.05 years, and 87 (61.3%) were male. The prevalence of depression was found to be 31% (95% confidence interval [CI]; lower limit: 23.39% and upper limit: 38.60%), with majority subjects had a mild type of depression, and 63.63% (95% CI; lower limit: 55.05% and upper limit: 70.94%). The frequency of drug use remained a significant predictor for depression in individuals with epilepsy (P = 0.002), and the odds of having depression in individuals receiving polytherapy were 3.82 higher than in those receiving monotherapy (95%: 1.61–9.05, P = 0.002). Conclusion Our study indicated a high rate of depression in a substantial number of IWE in the Nepalese setting. Polytherapy emerged as an independent predictor for depression. The high coexistence of depression in this vulnerable population and an increased risk for comorbid in polytherapy necessitate incorporating depression screening and proper treatment into the existing epilepsy program. Furthermore, revising treatment guidelines on comorbid depression to reduce polytherapy and encouraging health education on epilepsy to reduce stigma may also be warranted.

Background: Intraoperative bleeding and postoperative pain are two commonest concerns for both patient and surgeon in tonsillectomy. This study was aimed to compare intraoperative blood loss and early postoperative pain between ultrasonic device and bipolar diathermy tonsillectomy in children.Methods: Prospective, interventional, single blinded, comparative study was carried out from September 2016 to September 2017 including children up to age 15 years who underwent tonsillectomy either by bipolar diathermy or ultrasonic device. Intraoperative blood loss was recorded using standard sized gauge technique. Post-tonsillectomy pain on first five postoperative days (early postoperative pain) was assessed using Visual analog scale for children older than 5 years and FLACC score for children up to 5 years respectively.Means were compared.Results: 38 children (76 tonsils) were included in the study out of which 31 were boys (62 tonsils) and 7 were girls (14 tonsils). The mean intraoperative blood loss in ultrasonic dissection group was 13.94 ml and 13.91 ml in bipolar diathermy group. This difference was not statistically significant (p=0.974). Post-operative pain on 1st, 2nd, 3rd and 4th days were significantly less (p

Background: Though government of every country has their own health delivery system, private sector in the delivery of health service is undeniable and same is true for Nepal. Private healthcare services in Nepal are making better efforts as compared to public health care services. The aim of the study was to compare the performance of private and public healthcare systems in Nepal.Methods: A hospital based cross sectional study was conducted in which five hospitals each from private and public healthcare systems were chosen purposively from five developmental regions of Nepal. The patients visiting the healthcare systems were randomly chosen for the study from the admission registers of the hospitals. This study was approved from the Annamalai University, Tamil Nadu (India). Before data collection, permission was taken from corresponding hospital administration and written consent was taken from respondents of the study. Bivariate analysis was performed to compare the performance of the private and public hospitals.Results: Most of the patients visiting the private hospitals were patients with higher education and income. Public hospitals were more accessible and transparent than the private hospital. Doctors’ punctuality and responsibility were higher in public healthcare systems. Overall patient satisfaction and quality of services provided were significantly higher in the private healthcare systems. Fairness, responsiveness and behavior of the health personnel were almost equally satisfactory in both public and private healthcare systems.Conclusions: The overall services quality and patient satisfaction is higher in private healthcare systems so Government of Nepal should focus on improving services quality, facilities of public healthcare systems so that patient can get easily accessible quality health services with better patient satisfaction.