Background: Pregnant and breastfeeding women are more susceptible to viral infection and in the year 2020 they have to face the COVID-19 pandemic. Since, no successful treatment and vaccine has been developed so far, efforts to enhance the knowledge, attitudes, and practice of the public, especially the high-risk groups like pregnancy and postpartum period are crucial to manage COVID-19 pandemic. Objective To analyze the knowledge, attitude, practice and hospital experience regarding COVID-19 among post-partum mothers at a tertiary care center of Nepal Method The data collection was based on direct interview after receiving written consent from the research participants, using a semi-structured questionnaire. The questionnaire consisted of 4 major domains- knowledge (8 questions), attitude (6 questions), practice (5 questions) and experience (5 questions). Standard descriptive statistics were used for the data, mean and standard deviation for continuous variables whereas frequencies and percentages for categorical variables. Result A total of 203 post-partum women participated in the study. Almost all the participants had heard about COVID-19 (96.6%). A majority of them were aware about how COVID-19 gets transmitted and its preventive measures. Most of the participants (88.2%) knew that COVID-19 has effects on pregnancy. Almost all of participants (97%) wore mask during hospital stay. All of the women washed their hands with soap water or alcohol based sanitizer. A majority of the mothers (79.3%) wore mask while breastfeeding their baby. Conclusion The post-partum mothers have good knowledge, attitude, practice and experiences regarding the COVID-19 pandemic.

Background: Although 24-hour urine total protein (UTP) measurement is the gold standard method for detecting proteinuria in preeclamptic women, the procedure is lengthy and time consuming that might result in delay in diagnosis of the condition. This study aimed at deter­mining the correlation between these 2 parameters. Methods: This was a cross-sectional study done on 50 pregnant women with preeclamp­sia admitted at Bharatpur Hospital from September 2018 - January 2019. Patient with pre­eclampsia and having albumin ≥1 on urine dipstick, the sample was collected in every 12 hours interval on two separate well labeled container with the assistance of nursing staff. Total urine protein at 12-hour and 24-hour were measured by spectrophotometric method. The data were analyzed using SPSS version 21. Correlation between the 2 measurements was analyzed using Spearman’s rank correlation coefficient. p<0.01 was considered to be statistically significant. Results: The age of participants ranged between 20-38 years (Mean age: 26.6 years). The maximum occurrence of preeclampsia was observed in primigravid women and younger age group (between 20-25 years), 72% had mild preeclampsia and 28% developed severe preeclampsia. There was a significant correlation between 12-hour and 24-hour UTP (Spear­man’s r = 0.99, p<0.001). Conclusions: There is a strong correlation between 12- and 24-hour urine total protein mea­surements in women with preeclampsia. 12-hour UTP can be used as an alternative for the assessment of proteinuria in these women, with benefits such as early diagnosis and better patient compliance.

Background: The aim of the study was to share the experience of laparoscopic gynecologic surgery in a government hospital outside Kathmandu valley Method: A descriptive  cross-sectional study was carried out in Bharatpur Hospital from 15 Dec, 2018 to 15 June, 2019. Fifty consecutive patients who underwent laparoscopic gynecological procedures were included in the study and analyzed demographics, indication, hospital stay and complications. Results: The mean age of the patients (n = 50) was 34.6 ± 12.5 years (Range: 17 – 66 years). More than athird of the total patients (n = 18, 36.0%) were between 26 – 35 years. Majority (n = 26, 56.0 %) of the patients were multipara (≥ 2 child). Hasson type was more frequently utilized type of primary port incision in the surgeries performed (52.0%, n = 26). The median duration of surgery was 2.08 hours (Range: 0.83 – 3.25 hours). The commonest post-operative diagnosis was dermoid cyst (n = 14, 28.0%). Complications were observed in eight patients (16.0 %). The median duration of post-operative hospital stay was 3 days.  Conclusions: LGS has evolved greatly advantageous as it reduces hospital stay, surgical site infection, and better aesthetic results. It is essential to extend services outside the Kathmandu Valley

Background: Endoscopic retrograde cholangiopancreatography is carried out under moderate sedation mostly by use of propofol, opioids and benzodizepines. The aim of study is to assess difficulty in cannulation of ampulla of vater with the use of fentanyl.Methods: A prospective randomized double blind comparative study was conducted at Bharatpur Hospital from August 2019 to August 2020 among patients undergoing Endoscopic retrograde cholangiopancreatography. Total 100 patients were enrolled in study and were divided in two groups – Group P (propofol and midazolam) and Group FP (propofol, midazolam and fentanyl). Ease of cannulation was determined using Freeman scale. Independent sample t-test was used to compare mean between two groups and Chi Square test was used to compare categorical variables.Results: Mean age (51.36±17.750 years versus 56.74±16.995 years), weight (58.88±8.151 kg versus 57.32±8.431 kg) and gender distribution (14 versus 12 male patients and 36 versus 38 female patients) were comparable in both groups-Group P and Group FP. There were 34 patients in Group P and 37 patients in Group FP with easy cannulation and 16 patients in Group P and 13 patients in Group FP with difficult cannulation, which was comparable (p value=0.509) Conclusions: Cannulation of ampulla of vater is not affected by the use of fentanyl in combination with propofol when compared to propofol alone and can be routinely used during endoscopic retrograde cholangiopancreatography.Keywords: Ampulla of vater; endoscopic retrograde cholangiopancreatography; fentanyl; propofol

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