Introduction: Coronavirus disease pandemic has affected large number of peopleglobally and has continued to spread. Preparedness of individual nations and the hospitals isimportant to effectively deal with the surge of cases. We aimed to obtain nation wide data fromNepal, about hospital preparedness for COVID-19. Methods: Online questionnaire was prepared in accordance with the Center for Disease Controlrecommendations to assess preparedness of hospitals for COVID-19. The questionnaire wascirculated to the over 800 doctors across the nation, who are the life members of six medical societies. Results: We obtained 131 completed responses from all seven provinces. Majority of respondentshad anaesthesiology as the primary specialty. Only 52 (39.7%) participants mentioned that theirhospital had policy to receive suspected or proven cases with COVID-19. Presence of isolationward was mentioned by 83 (63.4%) respondents, with only 9 (6.9%)mentioning the presenceof airborne isolation. Supply of personal protective equipment (PPE) was inadequate as per 124(94.7%) respondents. Critical care services for COVID-19 patients were possible only in hospitals of42 (32.1%)respondents. RT-polymerase chain reaction could be performed only in the hospital of 6(4.6%) respondents. Conclusions: It is apparent that most of the hospitals are not well prepared for management ofpatients with COVID-19. Resource allocation and policy making should be aimed to enhance nationalpreparedness for the pandemic.

Introduction: Abnormal uterine bleeding is one of the most common morbidity landing women to attend medical attention in gynecology outpatient department. This study aims to evaluate the hysteroscopy finding in diagnosis of AUB and its correlation with ultrasonography finding and histopathological reports.Methods:This was a prospective comparative study in which ultrasonography was performed in fifty patients with abnormal uterine bleeding attending OPD then hysteroscopy was performed. After removing hysteroscopy dilation and curettage was done and sample sent for histopathology. At the end reports of hysteroscopy finding were compared with sonograhic and pathological results.Results:In the study women aged from 45 to 64years with the symptoms duration of 15 days to 6months. Post menopausal women seek medical attention more early then the menstruating women. Common symptoms are menorrhagia, metrorrhagia and postmenopausal bleeding. Most common abnormality was menorrhagia (32%) followed by post menopausal bleeding 28 %. Ultrasonography showed 46% of abnormal finding in which 17 (47%)menstruating women and 6 (43%) women were postmenopausal women. Among 50 women 17 (34%) had negative finding and 43 (66%) had abnormal finding in which most common finding of hyperplastic endometrium. Hysteroscopy correctly diagnose atrophic endometrium, polyp and endometrial Ca which is also confirmed by histopathology finding.Conclusions: Hysteroscopy is reliable method for evaluating cases of AUB and it can be used as first line diagnostic method for benign lesions. Hysteroscopy guided biopsy has most accurate in diagnosing pathology. Keywords: AUB; D and ; Hysteroscopy,OPD; Ultrasonography. | PubMed

The World Organization of Family Doctors (WONCA) is a not-for-profit organization and was founded in 1972 by member organizations in 18 countries. WONCA now has 118 Member Organizations in 131 countries and territories with a membership of about 500,000 family doctors and more than 90 percent of the world's population. WONCA has seven regions, each of which has its own regional Council and run their own regional activities including conferences. WONCA South Asia Region is constituted by the national academies and colleges and academic member organizations of this region namely India, Pakistan, Bangladesh, Nepal, Sri Lanka, Bhutan, and the Maldives. In the background of the ongoing COVID 19 pandemic, the office bearers, academic leaders, practitioners, and researchers of primary care from the South Asia Region have issued a solidarity statement articulating the role of primary care physicians.

Introduction: Iron deficiency anemia is the most common nutritional deficiency in pregnancy and more common in developing countries which is aggravated due to increased demand and blood loss during delivery. Though there are different methods for treating iron deficiency anemia. Iron sucrose is being used because of its minimal side effects. This study was undertaken to evaluate the response and effect of intravenous iron sucrose given to patient in antenatal and postnatal period with moderate iron deficiency anemia. Methods: A hospital based prospective study was conducted 1st Jan 2013-30th Dec 2014 in the department of obstetrics and gynecology Kathmandu Medical College, Teaching Hospital Kathmandu, Nepal. Antenatal and postnatal patients with hemoglobin between 5-9 gm% with diagnosed iron deficiency anemia were included in the study. The aim was to bring her hemoglobin level to 11gm%. Results: All together 37 patients were enrolled out of which two patient were dropped due to allergic reaction and 35 patients were included in study. Iron sucrose therapy is effective in achieving target hemoglobin of 11gm/dl in 80% of patients. It showed that intravenous iron sucrose significantly (P < 0.001) increase hemoglobin level within two weeks of therapy without any major adverse effects. Conclusions: Iron sucrose therapy is safe, effective and well tolerated for the treatment of iron deficiency anemia. Parental iron therapy was effective in increasing hemoglobin, serum ferritin and other hematological parameters in antenatal and postnatal patients with anemia. The treatment will help to reduce the risk of maternal complication during pregnancy and postpartum and its adverse effect to fetus.  Keywords: iron deficiency anemia; intravenous iron; pregnancy.

The Nepal earthquake was one of the biggest natural calamities of the year 2015. This paper attempts to explore the ethical issues involved in the humanitarian services rendered during the crisis and thereafter. The four principles of biomedical ethics - autonomy, beneficence, non-maleficence, and justice - are discussed in relation to the relief activities immediately following the disaster and the subsequent long-term activities, such as rehabilitation, wherever applicable. The discussion touches upon public health components such as vulnerable populations, environmental ethics and justice for the future. Incorporating ethical principles into the response to disasters is of vital importance to ensure that healthcare complies with professional norms and ethical standards, and is in tune with the medical needs of the local culture. Beneficence is prioritised, while non-maleficence and autonomy tend to be ignored. Justice, particularly distributive justice, deserves due attention in the context of limited resources, not only during the emergency phase but also during the phases of rehabilitation and planning for the future.