INTRODUCTION Since the declaration of COVID-19 as a pandemic there has been many public health strategies implemented to decrease it's extraordinarily adverse consequences. On March 18 2020, an estimated 107 countries around the world implemented national school closures and the Government of Nepal followed sooth on March 19. Children across European countries felt isolated due to the lockdown according to Save the Children, with increasing levels of feeling psychological distress. The effects of COVID-19 may be assumed to exert more negative life outcomes (depression, anxiety, domestic violence and loneliness) for children as it was more severe, unknown and fatal. This study is designed with a to assess the perspective of the child's mental health condition. METHODOLOGY A descriptive cross-sectional online survey was done among children from two selected schools of Kathmandu, Nepal. Emails were sent to the children via the parents, following permission taken from schools, which contained a semi-structured pro-forma and Revised Child Anxiety and Depression Scale 25, along with and informed assent form. RESULT In the study 29.3% of the respondents were of age 14 years, maximum age of 18 (1.1%) and minimum age 12 (8.7%) with mean age of 14.4 and sd ±1.41. More than half 58.7% of respondents were girls. Similarly, most of the respondents (35.3%) were studying in grade 10. Likewise,73.4% of respondents were living in nuclear family. Moreover, less than half 48.9 of the respondents belong to the Lower Middle Class and only 1.1% belong to the upper class of socio-economic status. The maximum number of respondents have scored between 0-64 which means that majority of the respondents were in low severity in respect to depression and anxiety. CONCLUSIONS We found an increase in the levels of anxiety and depression in Nepali children and adolescent compared to pre-pandemic study. Policy makers should be alerted to this fact and judicious use of technology and strength of existing communities should be used to mitigate this in the future.

Introduction: Somatoform disorder (SD)is group of psychiatric disorders that disrupt multiple physical symptoms, accompanied by disturbance in thoughts, impairing activities of daily living due to muscle and joint pain, low back pain, headache, chronic tiredness, palpitation, stomach upset, dizziness and sleeplessness which may cause occupational and social dysfunction. Objective: Evaluation of patients by Numeric Pain Rating Scale (NPRS), Pain Disability Scale (PDS) and complications duloxetine medication during treating of patients with somatoform disorder at Koshi Zonal Hospital. Methodology: A total of 50 patients with first time diagnosis of SD were selected by in this cross sectional study on the basis of diagnostic and statistical manual (DSM-5), pain and other symptoms, were treated with Duloxetine medication in early stage of Somatoform Disorder and results were evaluated at 2nd week, 6th week and 12th  week. The study was conducted from March 2016 to July 2017 at Koshi Zonal Hospital. Results: Out of 50 early SD patients, total mean age was 41.38 years (range 20-60), 21 patients recovered at 6th week and 22 patients recovered at 12th week but 7 patients needed other medications after 12 weeks. Duloxetine was well tolerated with nausea and headache being the most common complaint following use of duloxeting. Conclusion: Duloxetine can be both effective and well tolerated in the treatment of early stage of somatoform disorder.

Introduction: Delirium is underdiagnosed especially in ICU. In a study done in the Netherlands investigators found not only ICU nurses but also intensivists had difficulty in diagnosing delirium. With the impact that delirium has on patients’ health, its monitoring and detection should be considered an integral part of patient care in critical care medicine, Knowledge and attitude are one of the primary unmet needs regarding early detection and treatment of delirium. Since nurses are the first line assessors in any ward we would like to carry out this cross-sectional survey on a group of nurses. Objective: To assess the nurses’ knowledge about delirium & to compare the knowledge between those that have worked in ICU or critical care to those who haven’t. Methodology: This was a cross-sectional survey carried out at Birat medical college and teaching hospital. Here all nurses were requested to fill a questionnaire that consisted of 15 questions. A time-frame of 1 week was taken to gather the data. Results: We collected data from 124 nurses, who had varying educational degrees, Eighty-four were currently working in an ICU and 32.5% of those not working had previously worked in an ICU. Over all knowledge level for nurses was poor where 94 of 124 nurses had less than 50% scores. About 27% of those who had worked in an ICU setting had good knowledge compared to 17.5% of those who had not.   Conclusion: Training regarding delirium is required to increase identification and adequate management to decrease morbidity due to delirium.