Introduction: Studies among health care workers from different part of world during the coronavirus disease 19 pandemic have reported substantial impact on their physical, mental and emotional well-being. This study measured the impact of coronavirus disease 2019 on the mental health of Nepali healthcare workers in different parts of the world during the pandemic. Methods: This cross-sectional survey was carried out from December 25, 2020 to Jan 25, 2021. Ethical approval was taken from the Institutional Review Committee (reference number: 372). Online questionnaire including demographic profiles and Depression, Anxiety, and Stress Scales-21 instrument were sent to Nepali healthcare workers around the world through social media apps using convenience sampling. Data were entered into Microsoft Excel for Mac version 16.49 and analysed. Results: Among 208 who participated in the study, 62 (30%) participants were positive for anxiety, 47 (22.5%) for depression and 25 (12%) for stress. Higher prevalence of depression 18 (30%) and stress 10 (17%) was found in nurses compared to paramedics, among whom depression was seen in 5 (20%) and stress in 4 (16%). Among doctors, depression was found in 24 (19%) and stress in 11 (9%). Conclusions: This study demonstrated that a high proportion of healthcare workers were suffering from depression, anxiety and stress. Our findings are similar to the data from other national and international studies.

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Posterior reversible encephalopathy syndrome is a condition presenting with non-specific symptoms like nausea, vomiting and headache along with neurological manifestations like altered mental status, seizure, visual impairment and even coma. These symptoms are coupled with characteristic radiological findings of vasogenic edema in the bilateral parieto-occipital lobe which is usually reversible. We present here, a young 30 years old male, with dizziness, vomiting, generalized weakness, altered mental status with cortical blindness and focal and generalized tonic-clonic seizures in the background of first presentation of type 2 diabetes mellitus with ketonuria. Characteristic findings in Magnetic Resonance Imaging and reversal of the symptoms helped to reach the diagnosis of posterior reversible encephalopathy syndrome in our patient. The patient was discharged in stable condition after reversal of the symptoms and treatment of type 2 diabetes mellitus.

Introduction Overweight and obesity with their surrogate anthropometric markers like body mass index (BMI), waist circumference (WC) and waist hip ratio (WHR) have been shown to be strongly associated with Type 2 diabetes mellitus. Neck circumference (NC) though less used can be an equally effective alternative to diagnose overweight and obesity in patients with Type 2 diabetes mellitus in a resource limited setting. MethodsPatients who had Type 2 Diabetes Mellitus for 5 years or more and above 35 years underwent simple random sampling. Weight, height, WC and NC were measured. BMI was calculated and patients were graded into overweight and obesity based on the Asian cutoffs for BMI and abdominal obesity. ResultsAmong 100 patients enrolled in this study, 45% were men and the mean age was 53.05. Mean neck circumference was 36.55 ± 1.28 cm and 35.27 ± 1.78 cm for male and female respectively. NC was positively correlated with WC and BMI in both men and women (p ˂ 0.001). In the ROC curves, NC presented the largest area under the curve (AUC) for overweight in males (p ˂ 0.001), while NC presented a large AUC for central obesity in both genders. Furthermore, the cut off value of neck circumference for overweight was 35.6 cm in males vs 35.2 cm in females and for central obesity was 36.75 cm in males vs 34.75 cm in females. ConclusionNeck circumference was positively associated with overweight and central obesity in patients with type 2 diabetes mellitus.

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