Peripartum cardiomyopathy (PPCM) is a rare disease of unknown etiology but serious form of cardiac failure affecting women in the last month of pregnancy or during the first 5 months post-partum. Anesthetic management of such cases is a challenge due to the increased risk of various perioperative complications. We report the successful anesthetic management of emergency lower segment caesarean section in a patient with PPCM using low dose spinal anesthesia.

Wolff-Parkinson-White syndrome, an electrophysiological disorder of heart caused by preexcitation of an abnormal accessory pathway,can either be asymptomatic or may present with palpitation or exertional dyspnea. We report a case of an asymptomatic 45-year-old male with incidental finding of Wolff-Parkinson-White syndrome posted for laparoscopic cholecystectomy under general anesthesia. The anesthetic management of these patients is challenging as they are prone to develop life-threatening tachyarrhythmia. Taking all the necessary precautions to prevent tachyarrhythmia, balanced anesthesia, rigorous monitoring and preparedness with necessary drugs and equipment to treat any complications is the cornerstone for positiveoutcome.

Introduction: The growing prevalence of diabetes mellitus (DM) is a critical threat for global health,including in Nepal, especially in Kathmandu District, where diabetic patients are increasing in hospitals catastrophically. This study tends to assess the prevalence rate of type 2 diabetes among admitted patients visiting a hospital in Kathmandu. Methods: An electronic chart review was done to assess the prevalence of type 2 diabetes in NepalPolice hospital, Kathmandu, Nepal. Ethical approval was taken from the Nepal Health ResearchCouncil. Considering eligibility criteria, 8631 cases from 4 May 2018 to 31 August 2020 wereobserved. The calculated sample size was 500. However, all diabetic cases, i.e., 576, were processedand analyzed using Python and later visualized using MS Excel. Results: The overall prevalence rate of type 2 diabetes was 6.67%. The prevalence rate was seen higher among males (7.5%). Similarly, a high prevalence rate was seen among 64-73 years, i.e., 15.10%. Conclusions: The findings showed a high prevalence rate of type 2 diabetes. Older age groups are athigh risk. Urgent public health interventions including lifestyle modification measures are requiredto reduce the extra burden of type 2 diabetes.

Spinal anaesthesia (SA) in paediatric patients was first introduced by August Bier in 1899. But this technique did not gain wide spread popularity in paediatric age group because of the introduction of various muscle relaxants and inhalational agents for general anaesthesia. SA in paediatric population has been gradually reintroduced as an alternate to general anaesthesia. The study was performed at the Nepal Medical College Teaching Hospital to evaluate the efficacy and safety of SA in paediatric age groups, compare the change in vital parameters such as heart rate, blood pressure and oxygen saturation during preoperative and intraoperative period, the complications of SA and time of demand for first rescue analgesia in postoperative ward. Sixty-seven patients aged between 3 years to 14 years of ASA I and ASA II were selected after screening for anaesthesia fitness. The duration of surgery ranged from 49.85 ± 11.55 to 56.30 ± 9.68 minutes and the blood loss was less than 10% of total blood volume, thus there was no need to transfuse during operation. The duration of analgesia ranged between 107.69 ± 7.25 to 115.00 ± 7.07 minutes in different age groups. Sixty patients (89.55%) achieved Bromage Scale Score (BSS) 3 with interpretation of complete block; seven patients (10.45 %) achieved Bromage Scale Score 2 (partial block) and were operated after supplemental intravenous sedation. None of the patients needed conversion to general anaesthesia. Successful CSF drain with placement of spinal needle in 1st attempt was achieved among 55 patients (82.1%) and in 2nd attempt among 12 patients (17.9%). No unsuccessful attempt was recorded. SA in children appears to be a relatively safe technique with few complications and may be considered as an alternative for general anaesthesia. It is cost effective in comparison to general anaesthesia as the drugs and equipment required are less and cheaper and the length of hospital stay is usually shorter.

Introduction: The possibility of undergoing anesthesia-assisted surgery can cause a great deal of anxiety in individuals. Excessive anxiety can have a number of negative consequences, including perioperative cardiac events, greater anesthetic needs, higher postoperative pain ratings, and a longer stay in the hospital. Anxiety levels during surgery might be influenced by a variety of reasons. The objective of the study was to estimate the prevalence of anxiety in adult patients scheduled for Surgery. Methods: This is Cross-sectional Descriptive Study conducted in Nepal police hospital with calculated sample size of 92 with round figure of 100, convenient sampling technique was used. Descriptive analysis was used for Analysis. Results: Prevalence of anxiety in preoperative patient was 31%. The prevalence in male patients and female patients were 21.2% and 39.5% respectively. Conclusions: When compared to many other research, the general prevalence of anxiety at Nepal Police Hospital was lower; nevertheless, the incidence was higher among female patients.