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Background: Nepal is known for its exquisite natural beauty, with the iconic Himalayas running across the northern and western part of the country. Kathmandu valley, which is the capital of the country and the main hub for trade, commerce, education and administration, is considered as one of the earthquake prone areas. It is a highly populated area with an estimated population of about 2 million. After 82 years on April 25 th at 11:56 am local time, an earthquake of magnitude 7.8 struck Nepal, with an epicenter 77 kilometers northwest of Nepal's capital Kathmandu in the Gorkha district. As of May 15 th , 8,316 people had been reported killed and 17,866 people injured. A study was carried out to assess psychological distress among the adult survivors of Kathmandu valley from Nepal's 2015 earthquake. Methodology: A cross sectional study was conducted among 304 adult survivors with an objective to identify the psychological distress among the adult survivors of Kathmandu valley from Nepal's 2015 earthquake. This study was carried out in Kathmandu valley; there are three districts in Kathmandu valley which are Kathmandu, Bhaktapur and Lalitpur. Among the three districts, Kathmandu district and Kathmandu metropolitan city was selected purposively. There are 35 wards in Kathmandu metropolitan city. Results: Among the total of 304 respondents interviewed for the study, nearly half of them were female (54.6%) and males (45.4%). Considering the age group 30.6% of them belonged to age group of 26 to 35 years. Out of the total 304 respondents, 18.1 % were suffering from moderate anxiety and 21.7 % were having moderate depression, 16.1 % had mild anxiety and 21 .1% had mild depression, 12.5% were having severe anxiety and 13.5 % were suffering from severe depression. Depression was seen significantly higher in businessmen, middle income family, patients with behavior changes, injured people and in those people who lost their family members in the earthquake (p=<0.05). Those who live in second floor, who had changed personal habits, injured during earthquake and those who lost their family members in the earthquake were found significantly associated with anxiety (p=<0.05). The analysis shows person aged above 55 years had 2.3 times higher chance to have anxiety than those below aged 55 years (adj. OR=2.3, 95% CI: 0.458-12.039). Conclusion: This suggests that to reduce negative health impacts of the earthquake adequate psychological counseling is needed for those who survived the tragedy.

IntroductionLyme disease is a tick-borne illness caused by the spirochete Borrelia burgdorferi and is widely reported in the USA, Central Europe, South East Asia and Latin America. Until recently, no scientific report regarding Lyme disease in Nepal had been published.Case presentationA 32-year-old, previously healthy female visited the hospital with a history of joint pains, fatigue, neck stiffness, tingling sensation and headache. She was initially treated for typhoid fever, brucellosis and malaria, but did not show significant improvement. Doxycycline was prescribed empirically for 3 weeks for the treatment of suspected tick-borne illness. A two-tiered immunoglobulin laboratory testing confirmed Borrelia burgdorferi. She developed post-treatment Lyme disease syndrome after completion of antibiotic therapy.ConclusionTo the best of our knowledge, this is the first report of Lyme disease in Nepal and probably the first documented case of post-treatment Lyme disease syndrome in Asia. Lyme disease might have been overlooked in Nepal and, therefore, patients having clinical signs and symptoms similar to Lyme disease should not be disregarded in differential diagnosis.