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Background: Acute appendicitis is a common surgical emergency amongst the paediatric population. Available diagnostic tools are focussed to make a diagnosis of acute appendicitis. A definitive predictive factor for the diagnosis of complicated appendicitis is lacking. Thus, this aims to analyse hyperbilirubinaemia as a predictor of complicated appendicitis amongst the paediatric population.Materials and Methods: A prospective observational study was conducted in a tertiary hospital from November 2018 to October 2019. All children undergoing emergency appendectomy were included in the study. Preoperatively, patients were evaluated clinically, and routine investigations including total and direct serum bilirubin were sent. All patients were grouped as 'simple appendicitis' or 'complicated appendicitis' based on intra-operative and histological findings. Bilirubin level was compared between these groups and analysed.Results: A total of 52 children fulfilling the inclusion criteria were included. The mean age was 13.2 ± 4.2 years, and the male: female ratio was 2.1:1. Thirty-four (65.4%) had simple appendicitis and 18 (34.6%) had complicated appendicitis. Total bilirubin was 23.83 ± 5.94 mmol/L in the complicated appendicitis group and 13.15 ± 3.29 mmol/L in the simple appendicitis group. Direct bilirubin was 5.28 ± 2.22 mmol/L in complicated appendicitis and 2.62 ± 0.83 mmol/L in simple one. Both total and direct bilirubin were significantly high in the complicated group (P < 0.001) compared to the simple appendicitis group. On the Receiver operating curve (ROC), the best cutoff value for total and direct bilirubin was 21 and 5.5 mmol/L, respectively. The sensitivity and specificity of total and direct bilirubin were 72.2%, 100%, and 61.1%, and 85.3%, respectively.Conclusion: It is concluded that hyperbilirubinaemia is a good predictor for paediatric complicated appendicitis. [ABSTRACT FROM AUTHOR]

Introduction: COVID-19 is an emerging global health pandemic causing tremendous morbidity and mortality worldwide. Chronic symptoms progressing to poor functional status have been reported in a substantial proportion of COVID-19 patients worldwide. This study aimed to determine the prevalence of functional limitation in COVID-19 recovered patients using the post-COVID-19 functional status scale., Methods: A descriptive cross-sectional study was conducted at Tribhuvan University Teaching Hospital. COVID-19 recovered patients with reverse transcription-polymerase chain reaction negative status were included and assessed using the post-COVID-19 functional status scale. Data entry and analysis was done in Statistical Package for the Social Sciences version 20.0. Descriptive statistics were performed., Results: A total of 106 patients were included for the final analysis. More than half of the patients (56.6%) reported having no functional limitation (grade 0), while the prevalence of some degree of functional limitation was observed in 46 (43.4%) patients (grade 1 to 4)., Conclusions: Some form of functional limitation should be anticipated after COVID-19 infection. Post-COVID-19 functional status scale can be a valuable tool in determining the prevalence of functional limitation in COVID-19 recovered patients in acute health care settings. It can potentially guide in planning rehabilitative measures in post-acute care management of COVID-19 survivors.

Introduction: Respiratory diseases are a leading cause of morbidity and mortality worldwide imposing a significant global health burden. The admission rate of patients is the indication of the overall workload in the ward. The aim of this study was to find the prevalence of admission of patients in the pulmonology ward among patients visiting the pulmonology department of a tertiary care hospital., Methods: A descriptive cross-sectional study was conducted at Tribhuvan University Teaching Hospital. Medical records of all patients visiting the pulmonology department and admitted to the pulmonology ward from May 2018 to April 2020 were retrospectively reviewed. Data entry and analysis was done in SPSS version 20.0. Descriptive statistics were performed., Results: A total of 30,480 patients visited the pulmonology department in the two-year study period. Out of them, 1296 (4.25%) patients were admitted to the pulmonology ward. Eleven respiratory diseases were identified as primary causes for admission. Acute exacerbation of chronic obstructive pulmonary disease (44.5%), pneumonia (26.3%), tuberculosis (11%), lung cancer (5%), and bronchiectasis (3.9%) ranked the top five causes for admission., Conclusions: Respiratory diseases impose a tremendous burden in the health care setting. Acute exacerbation of the chronic obstructive pulmonary disease, pneumonia, and tuberculosis remains an important cause of respiratory admissions in our study.