ObjectiveTo investigate whether benchtop auto-analyzers (AAs) and arterial blood gas (ABG) analyzers, for measuring electrolyte levels of patients admitted to intensive care units (ICU), are equal and whether they can be used interchangeably.Materials and methodThis study was conducted on 98 patients admitted to the ICU of the Institute of Medicine, Kathmandu, Nepal between 15 October and 15 December 2016. The sample for AA was collected from the peripheral vein through venipuncture, and that for ABG analyzer was collected from radial artery simultaneously. Electrolyte levels were measured with ABG analyzer in the ICU itself, and with benchtop AA in the central clinical biochemistry laboratory.ResultsThe mean value for sodium by AA was 144.6 (standard deviation [SD] 7.63) and by ABG analyzer 140.1 (SD 7.58), which was significant (p-value <0.001). The mean value for potassium by AA was 3.6 (SD 0.52) and by ABG analyzer 3.58 (SD 0.66). The Bland-Altman analysis with the 95% limit of agreement between methods were −4.45 to 13.11 mmol/L for sodium and the mean difference was 4.3 mmol/L and −1.15 to 1.24 mmol/L for potassium and the mean difference was 0.04 mmol/L. The United States Clinical Laboratory Improvement Amendments accepts a 0.5 mmol/L difference in measured potassium levels and a 4 mmol/L difference in measured sodium levels, in the gold standard measure of the standard calibration solution. The passing and Bablok regression with 95% confidence interval has an intercept of zero and slope one for both sodium and potassium, and the 95% of random difference is −6.32 to 6.32 for sodium and −0.84 to 0.84 for potassium, showing no significant deviation from linearity.ConclusionIt can be concluded that AA and ABG analyzers may be used interchangeably for measurement of potassium in the Institute of Medicine, while the same cannot be concluded for the measurement of sodium, because of the significant difference in sodium measurement by the two instruments.

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Introduction: Cervical cancer is one of the most common cancers among women worldwide. It is preventable by early detection of precancerous lesions by various screening techniques. Considering the importance of the perceptions and practices of the women about the disease and its screening, this study was conducted with an aim to determine the knowledge, attitude and practice of women towards cervical cancer and its screening among Nepalese women visiting a tertiary care institute in Kathmandu. Methods: A cross-sectional descriptive study was conducted among 390 outpatients in the gynaecological outpatient department of Tribhuwan University Teaching Hospital for a span of six months. Data were collected after obtaining ethical clearance from the institutional review board. A structured questionnaire covering the socio-demographic characteristics and knowledge, attitude and practice on cervical cancer and its screening was used. Results: Among the 390 women who were interviewed, the mean age was 41.9 years, 37% of the respondents had an average knowledge and 16.5% had a good knowledge about cervical cancer and its screening. There was a positive attitude among 70% of the respondents, however the uptake of screening among them was less than 25% only. Embarrassment (72%), pain (71%) and lack of privacy (65.9%) were the main barriers of screening. Conclusions: Knowledge regarding cervical cancer screening was found to be good and the attitude to undergo screening was positive. However, a significant number of barriers refrain women from seeking this service which is shown by the poor practice for screening.

Peripheral route for administration of vasopressors is often opted due to resource limitations or as a rescue until central venous access is established. This, however, is not devoid of complications, the most common being extravasation and tissue injury. Phentolamine is the only drug approved for management of vasopressor extravasation; however, successful use of other agents has been reported. Here we report a case of peripheral extravasation of vasopressors, successfully managed with topical nitroglycerin in intensive care unit in Kathmandu. To our knowledge, this is the first report of such kind from Nepal.