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Introduction: The COVID 19 pandemic has adversely impacted all aspects of health care throughout the world. Burn care in lower and middle income countries has suffered the most. We aimed to compare burn care at Kirtipur Hospital before and during the pandemic and explore psychological issues and practice behaviour among burn care worker (BCW). Methods: Retrospective data analysis of burn patients admitted during April to August of 2019 and 2020 was done. Internet based survey of BCW was done. Results: Burn admissions, demographics and characteristics did not change. Fewer surgeries were undertaken in 2020. Almost half of the BCW worked 12 hours shift or longer. Most were working on half pay. Nearly everyone was using hand sanitizers, hand washing and masks. Few had access to level II personal protective equipments (PPE) to see suspected patients; fewer had access to face shield, KN 95 masks and boot. Even gloves and caps were scarce. Many feared getting themselves or family members infected. Majority realized the need of clear hospital policy on how they would be managed when infected. Conclusion: Number, types, severity and mortality did not change. Number of surgeries decreased. Issues like pay cuts, longer working hours and lack of PPEs were reported by majority. [ABSTRACT FROM AUTHOR]

Three labdane-type diterpenes, namely coronalactoside I, hedychilactone A, and ( E )-labda-8(17),12-dien-15(16)-olide, along with the flavonoid glycoside Isolinariin A, were isolated from Heydichium coronarium . Structural elucidation employed spectroscopic techniques (IR, MS, NMR, and DEPT) and comparison with literature data. Pesticidal and antimicrobial activities were assessed. Isolinariin A exhibited potent nematicidal activity (71.33% mortality) against Meloidogyne incognita , while Coronalactoside I demonstrated strong inhibition of nematode egg hatchability (26.00% at 1 µg/mL). In insecticidal activity against Spodoptera litura , ( E )-labda-8(17),12-dien-15(16)-olide displayed significant mortality (93.66% at 100 µg/mL). Molecular docking studies indicated favourable interactions with target proteins, suggesting potential in pest management. These findings propose the application of these compounds to mitigate the ecological impact of synthetic pesticides.

The present study aimed to identify the bioactive constituents in the chloroform extract of H. spicatum rhizomes (HS-RCLE), further evaluated for its in-vitro pesticidal activities validating via molecular docking techniques. GC/MS analysis of HS-RCLE identified 14 compounds contributing 84.1 % of the total composition. The extract was dominated by oxygenated sesquiterpenes (43.1 %) with curcumenone (25.2 %) and coronarin E (14.8 %) as the major compounds. The extract recorded 89.4 % egg hatchability inhibition and 82.6 % immobility of Meloidogyne incognita, 66.7 % insecticidal activity on Spodoptera litura, 100 % phytotoxic activity on Raphanus raphanistrum seeds, and 74.7 % anti-fungal activity on Curvularia lunata at the respective highest dose studied. The biological activities were furthermore validated by using docking studies on certain proteins/enzymes namely acetylcholinesterase (PBD ID: IC2O), carboxylesterase (PDB ID: 1CI8), acetohydroxyacid synthase (PBD ID: 1YHZ) and trihydroxy naphthalene reductase (PBD ID: 3HNR). The bioactivity of the major constituents of the extract was predicted with the help of in silico PASS studies. HS-RCLE was observed to be a viable alternative source of natural pesticidal agents and paves the way for further studies on its mechanistic approaches and field trials to ascertain its pesticidal studies.

Introduction: Timely repair of cleft lip and palate maximises the benefits of surgery. Developing countries have large number of adults with unrepaired clefts. The impact of a cleft program can be determined by observing the trends of lower age at surgery. Public Health Concern Trust, Nepal has been providing a comprehensive nationwide cleft service since 1999. This study was conducted to see any change in the age at surgery., Methods: A retrospective cross sectional study was conducted to analyse the data of all the individuals' age at primary cleft surgery from July 1999 to June 2010. Mean and median age of individuals as well as the proportion of individuals operated on at the right age in different years were calculated and compared., Results: The median age for cleft lip surgery decreased from 100 to 24 months. Similarly the median age for cleft palate surgery decreased from 70 to 28 months. Proportion of surgeries carried out in the recommended age also increased. A change in the policy of the program reaching out to more remote areas and removing the age barrier for surgery resulted in older adults receiving surgery and increased median age especially for cleft palate repairs., Conclusions: A nationwide cleft program for a decade had a small impact on age at surgery. There are still many individuals who are missing the ideal age for surgery. The program needs to reach more remote areas. This information will be useful for governmental as well as non-governmental organizations working in the area of clefts.

Background: Routine practice after major GI surgery has been to keep patient nil per oral till the return of bowel sound with a belief that this will prevent post operative nausea and vomiting and protect the anastomotic site where as the trend has been changing to encourage enteral feeding as soon as possible as various studies has shown early enteral feeding to be beneficial in terms of nutritional, immunological aspect and for faster recovery of patient., Methods: Patients undergoing major elective GI surgery in department of Surgery, Kathmandu Medical college Teaching Hospital who were given early enteral feeding (within 24 hrs of operation) were studied prospectively and were compared retrospectively with historical control who underwent similar procedure., Results: Early enteral feeding in patient undergoing major G.I surgery showed early return of bowel movement, decreased ICU and hospital stay with a significant reduction in postoperative cost., Conclusions: Early enteral feeding promotes faster recovery while reducing hospital stay and treatment cost in patient undergoing major GI surgery.