Introduction and Objectives: Chronic kidney disease is an increasing health problem worldwide and the burden of such patients is increasing in developing countries like Nepal as well. The final treatment for End Stage Renal Disease is only renal replacement therapy. The objective was to study the demographic and clinical profile of patients with End Stage Renal Disease undergoing haemodialysis. Methods: This was a prospective, observational study carried out in a tertiary hospital after obtaining ethical consent from the Institutional Review Board. The study period was from June 1st to August 31st, 2019. Thirty seven patients, older than 15 years who were on maintenance haemodialysis on regular basis in the hospital for at least 3 months were selected for the study. Patient’s records were used for the data collection as well as direct questionnaire to the patients on follow up for routine haemodialysis. Data were entered into Statistical Package for the Social Sciences 21 and descriptive analysis was done. Results: Twenty-six patients were under 50 years with male: female ratio of 1.64:1. Mean duration of haemodialysis of patients was 3.82 years. Most common cause for end stage renal disease was hypertension followed by idiopathic cause. Anaemia and hypocalcaemia were found to be the common complications associated with the patients. Conclusions: Prevention and early treatment may be the key to decrease the incidence of chronic kidney disease patients and also halt the progression to End stage renal disease.

Introduction: Animal bite is a common public health problem and dog bites are most common among them in Nepal. Rabies infection is of most significant concern following animal-bites’ injuries. This study aimed to assess the epidemiological variation in terms of demographic variables, type of animal, circumstances of bite, type and site of wound and outcome of the animal bite. Methods: It was a descriptive cross-sectional study conducted at emergency department of Gandaki Medical College Teaching Hospital and Research Centre among animal-bite cases from October 1, 2020 to September 30, 2021 using a pre-designed questionnaire. Results: Out of total 217 cases of animal-bite included in the study, 65 (29.95%) were of 21 to 30 years and 129 (59.46%) were males, 120 (55.23%) cases hailed from rural area and 63 (29.03%) were farmers. Most cases 168 (77.42%) were bitten by dog among which 93 (55.35%) were owned dogs and only 22 dogs were vaccinated. A total of 127 (58.53%) were unprovoked and lower limb 130 (59.91%) was the commonest site. World Health Organization (WHO) Category II wound were the most commonly encountered 122 (56.22%). Majority 99 (45.62%) came to hospital within 25 to 48 hours of bite and after cleaning the wound site 115 (52.99%). Only 81 (37.78%) animals were observed for 10 days after the bite out of which 5 (6.09%) developed signs of rabies. Conclusions: Animal bite was common in males and source was owned dogs. Majority of the owned dogs were not vaccinated and most of the cases visited hospital without following first-aid measures.

Introduction: Dengue, the arthropod borne viral disease is serious public health problem in Nepal. The clinical diagnosis of dengue has become challenging in children as it is presented with nonspecific symptoms. The objective of present study was to assess different clinical presentations and outcomes of dengue fever in tertiary care centre. Methods: A record based observational cross-sectional study was carried out on all dengue positive patients of aged 11 months to 15 years presented in Gandaki Medical College from July to November 2019. Total 74 patients with history of fever with dengue seropositive were included in the study. All the clinical and haematological findings were recorded in semi-structured questionnaire form. Results: Of 74 patients 40 (54.1%) males and 34 (45.9%) were females. Fiftyone (68.9%) were cases of dengue without warning sign, 18 (24.3%) were dengue with warning signs and 5(6.8%) cases had severe dengue symptoms. Most of the patients (78.38%) were from Kaski district. Fever (100%) was the most common clinical presentation followed by headache (36.5%), vomiting (25.7%), and retro orbital pain (20.3%). Common laboratory findings included thrombocytopenia (59.4%) and leukopenia (35.1%). Among 74 cases, 68 were in stable condition and treated in OPD or in ward, and 6 were admitted in ICU of which one developed warning signs and other 5 had severe dengue. All the enrolled children recovered well and there was no mortality during this period. Conclusions: Fever, headache, vomiting, thrombocytopenia and leukopenia were most common presentation of dengue fever among children. Appropriate clinico-laboratory diagnosis and management is relatively simple, inexpensive and very effective in saving lives as long as correct and timely interventions are instituted.

Background: Diabetes mellitus is a multisystem disease. It has multiple complications like retinopathy, neuropathy, nephropathy, diabetes ketoacidosis, and stroke. Diabetes retinopathy (DR) is one of the blinding complications of diabetes. This study was done to find out the prevalence of diabetic retinopathy among diabetic patients attending in the outpatient department (OPD) of internal medicine, Gandaki Medical College and Teaching Hospital (GMCTHRC), Pokhara, Nepal. Materials and Methods: A hospital based cross-sectional study was performed among the 200 diabetes mellitus patients attending in the medicine OPD from 15th December 2017 to 15thDecember 2018. They were referred to eye OPD of GMC. The detailed eye examination including fundus evaluation under mydriasis was done to all the patients. The diagnosis of DR was graded using the Early Treatment Diabetic Retinopathy Study classification (ETDRS). Patients having hypertension and other retinal diseases were excluded from the study. Data analysis was done using statistical package for social sciences (SPPS) version 11.20. Results: The mean age of the patients was 63.02 ±11.8 years. In our study 60.5% of the patients were male and 39.5% were female. Diabetes retinopathy was seen in 29.5% patients, of which non proliferative diabetes retinopathy (NPDR) was present in 19.5%, proliferative diabetes retinopathy (PDR) in 9.5% and 0.5% had diabetes maculopathy. Conclusion: The prevalence of DR is quite significant in the people with diabetes. Early diagnosis and management of retinopathy will help to avoid blindness due to the diabetic retinopathy.

Objectives COVID disease started in the late 2019 and within a short time became a pandemic disease. With the increasing morbidity and mortality all over the world and the therapeutics not doing wonders, scientists were in the attempt to develop vaccines as a mitigating measure. With continuous efforts and developments, different vaccines were developed and rolled out gradually in different countries. Concerns were notable for occurrence of side effects. Hence this study was done to assess the side effects following Covishield vaccination in Nepal at the initial stage. Methods This was a cross-sectional study done via snowball sampling method among healthcare workers at a tertiary medical college hospital in Pokhara, Nepal after obtaining ethical consent from the institutional review committee of the concerned hospital. The proforma was sent via online means through different social media platforms and also printed forms were also given to the respondents. A total of 139 respondents were obtained after removing duplications. The data were entered into SPSS and analyzed using descriptive and inferential statistics. P-value of less than or equal to 0.05 was considered statistically significant. Results Majority (64.7%) were female healthcare workers. More than half (52.3%) used premedication in an attempt to avoid the side effects of vaccine. Most (90.6%) reported at least one side effect-local or systemic to the first dose and approximately three-quarter (74.3%) reported side effect to the second dose. Common side effects were pain at injection site, muscle pain, headache, fatigue and weakness. Most of the side effects were higher with the first dose as compared to the second dose. Conclusion Side effects are common with Covishield vaccination, significantly more with the first dose as compared to the second dose. Female gender, younger age and past covid infection were associated with slightly more occurrence of side effects; however were not found to be statistically significant.