Aim: To access the knowledge, attitude, and practice (KAP) towards COVID-19 disease among chronic diseases patients visiting tertiary hospitals of Kathmandu. Methods: A cross-sectional study was conducted among chronic disease patients who visited Tribhuvan University Teaching Hospital and Manmohan Cardiothoracic Vascular and Transplant Center, Kathmandu. Semi-structured questionnaire was used to collect patients’ socio-demographic data and perspectives on COVID-19. Results: Four hundred chronic disease patients participated in the study, with 53.2% female and 46.8% male, and 56.8% of age ≥50 years. Overall, 55.5% of the participants had good knowledge, 56.2% had good practice, and 30.7% had positive attitude towards COVID-19. Younger patients, 18-34 years, were found to have higher odds of having good knowledge compared to other age groups (aOR: 2.5; 95% CI: 1.3-6.0). The patients with less than average family income and those unable to read and write had lower odds of having positive attitude towards COVID-19 (aOR: 0.6; 95% CI: 0.4-0.9 and aOR: 0.4; 95%CI: 0.2-0.9, respectively). A statistically significant correlation was found between the patients’ knowledge and practice, knowledge and attitude, and attitude and practice (p <0.001). Conclusion: Nearly half of the chronic disease patients in Nepal had poor knowledge and practice whereas more than two-third had negative attitude towards COVID-19 disease. Older age of the patient was significantly associated with poor knowledge and poor practice. These study findings could be helpful for the government and non-government stakeholders while planning COVID-19 awareness campaigns to the targeted patient groups.

Many national highways of Nepal are periodically facing the rockfall events, causing fatal accidents. The Siddhababa section of Siddhartha Highway is a lively example of an active rockfall zone where the highly steep slope geometry in combination to the unfavourable inclination of the rock joints with the road alignment primarily cause the rockfall. Recent accidents of a jeep and a bus have created much concern on rockfall in the area. But still, we do not possess any type of structural countermeasure to overcome this scenario. To address this problem, our study aims at firstly characterizing the rockfall in the area and then on proposing structural countermeasure as rockfall barriers, rock netting and rockshed, and assisted with rock bolting, based on simulation studies and analysis of the rockfall scenario in Rocscience Rocfall® program.

Background: Atrial septal defect is one of the most common congenital cardiac disorders requiring intervention. We compared a minimally invasive method for atrial septal defect closure that included total peripheral cannulation and an anterior mini-thoracotomy incision of 5 cm or less with a median sternotomy approach. Methods: This was a retrospective cross-sectional study among patients with Atrial Septal Defect. The preoperative variables, intraoperative data, and postoperative outcomes of patients undergoing minimally invasive atrial septal defect closure with total peripheral cannulation and atrial septal defect closure via median sternotomy were collected and compared.Results: Fifty-five patients underwent minimally invasive closure of the atrial septal defect with total peripheral cannulation and 55 patients that underwent surgery by median sternotomy were included for comparison. There were 61.81% (34) female and 38.18% (21) male in the mini-thoracotomy group while there were 52.72% (29) female and 47.27% (26) male in the median sternotomy group. The mean age at surgery was 23.4 and 28.6 years in mini-thoracotomy and median sternotomy groups of patients respectively. The most common symptom was exertional shortness of breath in both groups. The mean length of stay in the intensive care unit was 1.8 and 2.5 days in mini-thoracotomy and median sternotomy groups respectively, and the length of stay in the hospital was 4.5 days and 4.8 days in mini-thoracotomy and median sternotomy groups respectively. There was a significant association was found between the mini-thoracotomy and median sternotomy group in relation to mean size of the incision, average time for cardiopulmonary bypass, average cross-clamp time, and fluid drained on the first day after surgery. Conclusions: Atrial septal defect closure with a mini-invasive approach is safe and cost-effective with very few perioperative complications and good patient satisfaction. Keywords: Atrial septal defect; Nepal; sternotomy; thoracotomy; total peripheral cannulation.