Public health data suggested a rapid rise in COVID-19-confirmed cases in Nepal along with increased deaths. There has been a wide variation in clinical outcomes of this disease. Control of this pandemic depends on the availability of vaccines or drugs for SARS-CoV-2. Thus, viral and human genetics/genomics and immunology are necessary to understand whether these factors will affect clinical trials of vaccines in Nepal.

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Introduction: Overlapping pubic symphysis dislocation (OPSD) or a locked pubic symphysis is a compression of the pelvic ring with the intact pubis trapped into the contralateral obturator foramen. Reduction can be difficult and contralateral suprapubic osteotomy is a good way to address the irreducible OPSD. The technique has only been discussed thrice in the available literature. Case Report: We report the case of a 26-year-old man who had his right pubic ramus entrapped within the contralateral obturator foramen, having an overlap of >4 cm with associated ipsilateral sacroiliac joint (SI joint) disruption and urethral injury. When all the maneuvers of closed and instrumented open reduction failed, we performed a superior pubic ramus osteotomy on the left side and unlocked the incarcerated right pubic ramus. The osteotomy site was stabilized with a 6-hole recon plate and SI joint was stabilized with a 6.5mm percutaneous sacroiliac screw. The patient underwent delayed urethral repair at 10 weeks after the index surgery. At 3-year follow-up, the patient did not report any pubic discomfort, urinary and sexual problems. Conclusion: Locked OPSD is a rare injury and is frequently associated with sacroiliac and urethral injuries. Distraction osteotomy of the contralateral superior pubic ramus is a viable option for irreducible cases. Keywords: Lateral compression injury, locked symphysis pubis, superior pubic ramus osteotomy, overlapping pubic symphysis dislocation.

Background: Fractures of the distal humerus continue to challenge surgeons due to their complex nature and the multiple options of fixation. The olecranon osteotomy approach is considered the gold standard, especially in those fractures with an intra-articular comminution, but is associated with complications. In selected cases, utilizing the triceps-on or paratricipital approach should allow adequate fixation while decreasing the incidence of complications. Methods: Patients with distal humerus fractures were treated with open reduction and internal fixation via the paratricipital approach. All patients were evaluated based on their preoperative and intraoperative parameters. Postoperative rehabilitation was implemented and the functional outcome was assessed based on the range of motion and Mayo Elbow Performance Score. Results: The current study encompassed thirty patients with a mean age of 47.5 years. AO/OTA C1 type fracture was encountered in 13 patients. The mean operative time was around 90 min. The mean elbow flexion at 2 months was 127.5°. Union was achieved in all patients, and one patient had surgical site infection. Conclusion: Metaphyseal and simple inter-articular fractures may be adequately visualized and managed with the above approach. Early rehabilitation allows faster return to normal function.