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.

Abstract

Background: Birth asphyxia is one of the important causes of neonatal morbidity and mortality, accounting up to 30% of neonatal death in Nepal. It is also an important cause of long term neurological disability and impairment. Thompson encephalopathy score is a clinical score which can be used to assess the newborn with hypoxic ischemic encephalopathy for the prognosis and their neurodevelopmental outcome. The aim of the study was to assess the role of Thompson score in predicting the early outcome of neonates with birth asphyxia. Methods: A prospective study was conducted from May 2019 to April 2020 in Nepal Medical College. All the term babies during the period with Apgar score of less than seven at five minutes were considered to have birth asphyxia and included in the study. Neurological examination was done on first, second and third day using HIE score proposed by Thompson and severity of hypoxic ischemic encephalopathy was classified accordingly. Outcome was measured as normal, morbidity with encephalopathy, seizure, organ dysfunction and death. Results: Out of 391 newborn admitted to neonatal unit, 84 (21.4%) had birth asphyxia. Mild Thompson score on day 1,2,3 were 49(58.3%), 49 (58.3%), 51(60.7%); moderate Thompson score on day 1,2,3 were 21 (25%), 21 (25%), 18(21.4%) and severe Thompson score on day 1, 2, 3 were 14 (16.7%), 14 (16.7%), 15(17.9%) respectively. Out of 14 babies who had severe Thompson score on day 1, 11(91.7%) expired and 3 (16.7%) developed encephalopathy. Conclusions: There was strong correlation of severity of Thompson score with the outcome. Keywords: Birth asphyxia; hypoxic ischemic encephalopathy; thompson score

FNO levels were higher in bronchial asthma (despite disease control) than in normal non-smoking adults and subjects with stable chronic obstructive pulmonary disease. Levels of FNO were similar between the chronic obstructive airway disease and normal groups.