Background COVID-19 pandemic has created unprecedented health and economic impact. Psychological stress, anxiety and depression are affecting not only COVID-19 patients but also health professionals, and general population. Fear of contracting COVID-19, forced restrictive social measures, and economic hardship are causing mental trauma. Nepal is a developing country from South Asia where the COVID-19 pandemic is still evolving. This online survey has been carried out to understand impact of COVID- 19 on mental health of Nepalese community dwellers. Methods The COVID-19 Peritraumatic Distress Index (CPDI) questionnaire adapted from the Shanghai Mental Health Centre was used for online data collection from 11 April-17 May 2020. Collected data were extracted to Microsoft excel-13 and imported and analyzed using SPSS (Statistical Package for Social Sciences) version-22. An initial univariate analysis was conducted for all variables to assess the distribution. Logistic regression analyses were done to estimate the odds ratios of relevant predicting variables. Results A total of 410 participants completed the self-rated questionnaires. Mean age of study participants was 34.8 ± 11.7 years with male preponderance. 88.5% of the respondents were not in distress (score less than 28) while, 11% had mild to moderate distress and 0.5% had severe distress. The prevalence of distress is higher among age group > 45 years, female gender, and post-secondary education group. Health professional were more likely to get distressed. Respondents with post-secondary education had higher odds (OR = 3.32; p = 0.020) of developing distress as compared to respondents with secondary education or lower. Conclusion There is lower rate of psychological distress in city dwellers and people with low education. Adequate intervention and evaluation into mental health awareness, and psychosocial support focused primarily on health care workers, female and elderly individuals is necessary.

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Background Headache is a common neurological disorder, with a global prevalence of around 50%. It may affect people of any age, gender, education, socioeconomic status and occupation. Tension headache, migraine headache and cluster headache are commonly encountered headache types. The prevalence of headache problems is higher among medical students. This could potentially affect their academic performance and quality of life. The objective of this study is to find out the prevalence of headaches and their clinical characteristics among students of a medical college. Materials and methods An online, single-centre, cross-sectional study was conducted among undergraduate medical students in Nepal. Stratified sampling followed by a simple random sampling technique was adopted depending upon the academic years of students. For data collection, pre-tested semi-structured questionnaire was used. The data entry and analysis were done by using Statistical Package for the Social Sciences (IBM-SPSS), version-23. The prevalence of headache and its subtypes were calculated. All the clinical characteristics associated with headaches were also studied. Results The prevalence of headache disorder was 65 (26.86%), with tension headache (69.23%) being the commonest one. It was highest among fourth-year students (37.84%) followed by first-year students (33.33%). Anxiety/stress (75.40%) was the most common precipitating factor. This problem stopped most of the students (63.09%) from doing daily activities. More than half of them (53.85%) practised self-medication in case of non-resolution of pain, and non-steroidal anti-inflammatory drugs (NSAIDs) were frequently used. Conclusion Headache was fairly prevalent among medical students. Anxiety/stress in medical life has led to headaches in the majority of students. The headache disturbed their daily activities and promoted self-medication practice. So, this problem should be properly looked into and addressed in time by the concerned authority.

Background: Pulmonary Tuberculosis (PTB) is a major public health problem in Nepal. Diag­nosis of pulmonary tuberculosis is done by bacteriological confirmation of respiratory speci­men however Negative smear needs clinical and radiological evaluation for the diagnosis in suspected patient. This study focuses on radiological findings in both Pulmonary bacterio­logically confirmed (PBC) and pulmonary clinically diagnosed (PCD) Tuberculosis. Methods: This observational study was conducted at Chitwan Medical College between Feb 2019 to July 2019. 45 Patient diagnosed with PTB were enrolled. Chest X-ray (CXR) and High Resolution Computed Tomography (HRCT) chest reports were analysed for the presence of findings that suggest active infection like cavity, consolidation, tree in bud, etc in PBC and PCD. Results: A total of 45 PTB patients with mean age: 54.60 ± 19 years were included. 53.3 % were PBC and 46.7 % were PCD tuberculosis, CXR findings in PBC and PCD tuberculosis was nodular infiltrate 45.8% versus 2.4%, consolidation 45% versus 42.9%, cavity 8.3% versus 14.3% respectively however 12.5% PBC tuberculosis patient had a normal chest x-ray. HRCT chest in PBC and PCD showed cavity in 45.8% versus 23%, tree in bud 25% versus 52.4%, con­solidation 62.5 versus 57.1%, ground glass opacity 29.2% versus 23.8% respectively and none of the HRCT chest was normal. In comparison to the CXR, HRCT chest shows more cavitary lesions in PBC and tree in bud was more common in PCD. Conclusions: This study has found that radiological findings suggestive of active PTB was more obvious in HRCT than CXR. Presence of cavity, lobar consolidation and tree in bud lesion in HRCT chest were more frequently observed in both PBC and PCD Tuberculosis.

Breast cancer is the most common cancer among women in the world, with a rising incidence. 1 It is a heterogeneous disease with a varied morphologic appearance, molecular features, behavior, and response to treatment. Currently, clinical management of breast carcinoma patients depends on pathologic prognostic and predictive factors that enable decision making among various treatment options for these patients. 2 Breast cancer patients are subcategorized into hormone receptor (estrogen receptor [ER]/progesterone receptor [PR]) positive, human epidermal growth factor receptor 2 (HER2) positive, or both hormone receptor and HER2 negative. The treatment offered varies accordingly; the patients who are ER/PR positive show good response to hormonal therapy, whereas HER2positive patients show good response to trastuzumab (Herceptin). Triple-negative breast cancer (TNBC) is a subcategory that lacks expression of all three receptors, that is, ER, PR, and HER2. This group of tumors is associated with a poorer prognosis. They usually present at a younger age, exhibit higher histologic grade, have larger size, have higher chances of distant metastasis, and have higher recurrence rates as compared with non-TNBC. 3,4 Therefore, early identification of the receptor type of breast cancer has important prognostic relevance and management implications. In recent years, some studies have focused on the imaging of breast carcinoma with modalities like 721663J DMXXX10.