Background The aim of this study was to determine the knowledge, attitude and practice (KAP) regarding the COVID-19 among frontline healthcare workers (F-HCWs) working at different hospitals in Nepal and to identify the factors significantly associated with KAP. Methods We used a web-based survey, and a convenience sampling method was adopted to collect data from 603 F-HCWs working at different hospitals in Nepal during the first week of June 2020. A self-administered questionnaire was utilized to assess the KAP perceived by the F-HCWs. It was divided into 4-parts consisting of 30-items, demographic characteristics (10-items), knowledge (10-items), attitude (5-items), and practice (5-items). It consisted of both multiple-choice questions and Likert scale items questionnaire. Results Among the participants, 76% reported adequate knowledge, 54.7% reported positive attitude, and 78.9% reported appropriate practice. Statistically significant differences regarding the perceived level of knowledge among F-HCWs were observed among independent variables, including age, gender, level of education, marital status, profession, work experience, source of information, infection prevention and control (IPC) training, and online course(p < 0.05). Similarly, statistically significant differences regarding the attitude among F-HCWs were observed among independent variables, including age, gender, level of education, profession, and online course(p < 0.05). Moreover, only 2-independent variables, including the profession and online course, showed statistically significant differences with practice(p < 0.05). Pearson correlation analysis showed a significant association between knowledge, attitude and practice at the level of p = 0.01. The factors significantly associated with adequate knowledge were male gender, nurse and doctor, websites and IPC training. Similarly, factors significantly associated with positive attitude were online course related to COVID-19 only. Moreover, factors significantly associated with appropriate practice were master’s degree or above and online course related to COVID-19. Conclusions F-HCWs reported adequate overall knowledge with a positive attitude and adopted the appropriate practice. The experienced F-HCWs with higher education and who received IPC training and online course regarding COVID-19 had better KAP. So, the stakeholders must arrange the educational programs and training for F-HCWs for better preparedness tackling with COVID-19.

Background: The primary aim of this national survey was to determine the knowledge, attitude and practice(KAP) regarding the COVID-19 among frontline healthcare workers(F-HCWs) working at different hospitals in Nepal, and the secondary aim was to find the factors associated with KAP. Methods: We used a web-based survey to collect data from 603 F-HCWs working at different hospitals in Nepal during the first week of June 2020. A self-administered questionnaire was utilized to assess the KAP perceived by the F-HCWs. It was divided into 4-parts consisting of 30-items, demographic characteristics (10-items), knowledge (10-items), attitude (5-items), and practice (5-items). It consisted of both multiple-choice questions and Likert scale items questionnaire. Results: Among the participants, 76% reported adequate knowledge, 54.7% reported positive attitude, and 78.9% reported appropriate practice. Statistically significant differences regarding the perceived level of knowledge among F-HCWs were observed among independent variables, including age, gender, level of education, marital status, profession, work experience, source of information, infection prevention and control (IPC) training, and online course(p<0.05). Similarly, statistically significant differences regarding the attitude among F-HCWs were observed among independent variables, including age, gender, level of education, profession, and online course(p<0.05). Moreover, only 2-independent variables, including the profession and online course, showed statistically significant differences with practice(p<0.05). Pearson correlation analysis showed a significant association between knowledge, attitude and practice at the level of p=0.01. The factors significantly associated with adequate knowledge were male gender (aOR: 3.66; 95%CI: 1.97-6.82), nurse and doctor (aOR: 2.10; 95%CI: 1.18-3.72), websites (aOR: 1.83; 95%CI: 1.83 (1.13-2.97) and IPC training (aOR: 1.53; 95%CI: 1.02-2.31). Similarly, factors significantly associated with positive attitude were online course related to COVID-19 (aOR: 1.49; 95%CI: 1.02-2.17) only. Moreover, factors significantly associated with appropriate practice were master’s degree or above (aOR: 0.56; 95%CI: 0.31-1.00) and online course related to COVID-19 (aOR: 2.43; 95%CI: 1.44-4.09) Conclusions: F-HCWs reported adequate overall knowledge with a positive attitude and adopted the appropriate practice.The experienced F-HCWs with higher education and who received IPC training and online course regarding COVID-19 had better KAP. So, the stakeholders must arrange the educational programs and training for F-HCWs for better preparedness tackling with COVID-19.

Introduction:Stroke is the second most common cause of mortality worldwide. Data regarding the predictors of mortality of acute ischemic stroke are widely discordant. Identifying the predictors and providing the utmost care to a high-risk patient is still an unmet need in middle- to low-income countries. We did this study to identify the predictor of in-hospital mortality of acute ischemic stroke.Materials and Methods:We conducted a retrospective study of patients with acute ischemic stroke presented to the tertiary care center in eastern Nepal from January 2012 to December 2016. We enrolled patients of age 18 years and older with acute ischemic stroke in this study. The primary outcome of the study was in-hospital mortality of enrolled patients. Predictors of mortality were analyzed by comparing the patients with acute ischemic stroke who had mortality with those who survived.Results:The mean age of enrolled patients was 66 years. Among 257, the in-hospital mortality rate was 20.5%. The patients with in-hospital mortality had lower Glasgow coma scale (GCS) score (9 vs. 12, P < 0.001) compared to those who survived. During admission, a patient with in-hospital mortality had significantly lower arterial oxygen saturation (92 vs. 95, P < 0.001), higher pulse rate (91 vs. 83, P = 0.009), and higher respiratory rate (24 vs. 21, P < 0.001) than those patients with acute ischemic stroke who survived.Conclusion:Lower GCS score, baseline higher pulse rate, higher respiratory rate, and lower arterial oxygen saturation are the predictors of in-hospital mortality of adult with acute ischemic stroke.

Background: Smoking is one of the global problems causing different disease. Smoking cause variation in different parameters of blood among which hemoglobin is believed to be increased due to smoking. Objective: To compare the effect of cigarette smoking on hemoglobin levels between smokers and non smokers. Materials and methods: A cross-sectional comparative study was conducted in Department of Pathology, Hematology Laboratory, B.P. Koirala Institute of Health Sciences, Dharan, Nepal. Total of 100 sample size which compromised of 50 smokers and 50 non smokers were included the study. Hemoglobin was estimated by Cyanmethemoglobin method. Student ‘t’ test was applied for parametric data and Chi- Square test was applied for categorical data. A p-value less than 0.05 was considered statistically significant. Results: Mean±SD of hemoglobin for smokers was 14.14±1.3 g/dl and for non smokers was 12.37±2.36 g/dl. The awareness about smoking effect in both smokers and non smokers group was not significantly different (p=0.15). Similarly the mean±SD age was 32.78±9.27 years for smokers and 35.68±11.11 years for non smokers, and was not significantly different (p=0.18). Conclusion: The present study showed that the hemoglobin level of smoker group was higher than the non-smoker group. Further substantial studies in large population should be conducted to generalize this findings.DOI: http://dx.doi.org/10.3126/stcj.v1i1.7985 Sunsari Technical College Journal Vol.1(1) 2012 42-44

Background Worldwide, it is estimated that snakes bite 4.5–5.4 million people annually, 2.7 million of which are envenomed, and 81,000–138,000 die. The World Health Organization reported these estimates and recognized the scarcity of large-scale, community-based, epidemiological data. In this context, we developed the “Snake-Byte” project that aims at (i) quantifying and mapping the impact of snakebite on human and animal health, and on livelihoods, (ii) developing predictive models for medical, ecological and economic indicators, and (iii) analyzing geographic accessibility to healthcare. This paper exclusively describes the methodology we developed to collect large-scale primary data on snakebite in humans and animals in two hyper-endemic countries, Cameroon and Nepal. Methodology/Principal findings We compared available methods on snakebite epidemiology and on multi-cluster survey development. Then, in line with those findings, we developed an original study methodology based on a multi-cluster random survey, enhanced by geospatial, One Health, and health economics components. Using a minimum hypothesized snakebite national incidence of 100/100,000/year and optimizing design effect, confidence level, and non-response margin, we calculated a sample of 61,000 people per country. This represented 11,700 households in Cameroon and 13,800 in Nepal. The random selection with probability proportional to size generated 250 clusters from all Cameroonian regions and all Nepalese Terai districts. Our household selection methodology combined spatial randomization and selection via high-resolution satellite images. After ethical approval in Switerland (CCER), Nepal (BPKIHS), and Cameroon (CNERSH), and informed written consent, our e-questionnaires included geolocated baseline demographic and socio-economic characteristics, snakebite clinical features and outcomes, healthcare expenditure, animal ownership, animal outcomes, snake identification, and service accessibility. Conclusions/Significance This novel transdisciplinary survey methodology was subsequently used to collect countrywide snakebite envenoming data in Nepal and Cameroon. District-level incidence data should help health authorities to channel antivenom and healthcare allocation. This methodology, or parts thereof, could be easily adapted to other countries and to other Neglected Tropical Diseases.