Introduction: Airway manipulation during endotracheal intubation is associated with hemodynamic and cardiovascular responses. Different agents have been used to obtund the pressure response. Objectives: To evaluate the place of Dexmedetomidine for routine use during induction of anesthesia to blunt pressure response to laryngoscopy and intubation. Methodology: One hundred patients of ASA I and II were randomly divided into two groups. Group A received Midazolam (0.05 mg/kg) a n d Fentanyl (2 mcg/Kg) and group B received Dexmedetomidine (0.6 mcg/kg) 10 minutes before induction of anesthesia. Both groups were induced with Propofol (1.5 mg/Kg). In all patients after induction (loss of eye lashes reflex) tracheal intubation was facilitated using Rocuronium 1mg/kg. Baseline heart rate was noted and hemodynamic response to intubation was observed 3, 6 and 9 minutes after intubation. Results: In group A, time for loss of eyelashes reflex was 17.45±2.19 seconds and in group B it was 11.33±2.64 seconds. In group A, after intubation heart rate increased by 11.22±2.37, 5.71±1.68, 2.34±1.73 in3, 6 and 9 minutes respectively. In group A, after intubation MAP increased by 6.49±1.37, 3.30±1.15, and 1.24±1.50 from baseline in 3,6, and 9 minutes respectively. In group B after intubation heart rate increased by 2.49±0.89 from baseline at third minutes, however decreased by 2.85±1.58 and 4.73±1.86 at sixth and ninth minute respectively. In group B, MAP increased from baseline by 3.44±1.06 in third minute however decreased by 2.22±1.38 and 4.24±3.40 at sixth and ninth minutes respectively. Conclusion: Both the agents were observed to obtund pressure response to laryngoscopy and intubation however Dexmedetomidine proved to be better option compared to Fentanyl.

Introduction: Urinary tract infection (UTI) is among the common bacterial infections worldwide and approximately 80% are associated with a urinary catheter. Catheter-associated UTI (CAUTI) has been associated with increased mortality, morbidity, length of hospital stay and the best way of CAUTI prevention is to adhere to recommended guidelines on infection control in the use of a urinary catheter. Methods: A cross-sectional analytical study was conducted among the nurses of college of medical sciences. A total of 160 staff nurses were selected using a probability simple random sampling technique. Data was collected using a self-administered questionnaire for knowledge, Likert scale for attitude, and checklist for practice regarding the prevention of CAUTI. The data gathered was analyzed using both descriptive and inferential statistics in SPSS software. Results: Among the total of 160 participants, most of the nurses 59.37% had moderate knowledge and 16.25% had adequate knowledge towards the prevention of CAUTI. The positive attitude of nurses was 41.88% and the majority of nurses 64.38% had a good level of practice. Also, age (p=0.022), professional qualification (p=0.001), designation (p=0.001), current area of practice (p=0.030) and previous information towards CAUTI prevention (p=0.003) among all the socio-demographic variables were statistically significant with the level of knowledge regarding the prevention of CAUTI. Conclusion: Majority of nurses level of knowledge was not satisfactory and had a negative attitude regarding CAUTI prevention. This indicates that the implementation of an educational program is needed to enhance nurses' knowledge regarding catheter management to improve quality care. Keywords: attitude; catheter-associated urinary tract infections; CAUTI; practice; UTI

IntroductionKnowing breastfeeding is one of the easiest and cost-effective ways to maintain a good childhealth, majority infants are not exclusively breastfed for the recommended 6 months of age.Thus, the aim of the study was to find out the factors associated with discontinuing exclusivebreastfeeding (EBF) among mothers of infants’ aged 0-6 months. MethodsA analytical study design was used to find out the factors associated with discontinuing EBFamong mothers of infants’ aged 0-6 months in Nepal. A total of 380 mothers of infants whosechild were 0-6 months old were selected using non-probability purposive sampling techniquethrough online survey as people are advised to stay at home during the Covid-19 outbreak. Datawas collected using structured questionnaire with interview technique. ResultsStudy findings revealed that half (50.5%) of the mothers exclusive breastfed their infants withmother’s mean age being 27.39 ± 3.64 years. Discontinuation of EBF varied with mothers age,ethnicity, mother’s educational level, initiation of breastfeeding and sources of informationregarding EBF as newspaper/articles and relatives/friends/neighbors (p=<0.005). The factorsrelated to mother that are associated with discontinuation of EBF were found to be perceivedinsufficient milk, cesarean section delivery, jobholder mother (p= <0.001) respectively. ConclusionsOnly half of respondents exclusively breastfed their infants for the recommended age in whichonly factors related to mother were significant with discontinuation of EBF rather than infants’.Findings of the study emphasizes on counselling the mothers regarding the benefits of EBF toboth child and mother during hospital visits. Keywords: exclusive breastfeeding; factors; under 6 months; EBF.

Background: Adolescence is a critical period and is associated with physical and psycho-social changes induced by puberty, which builds personality, behaviour, and future health of the adolescents. Thus, the aim of the study was to find out the knowledge and attitude regarding pubertal health of adolescence girls.Methods: A descriptive cross sectional study was conducted in Bharatpur Metropolitan City’s secondary level schools. A total of 183 adolescent girls were selected using probability simple random sampling from 5 schools out of total 43 schools which were also selected by simple random sampling technique. Data was collected by using structured self-administered questionnaire for knowledge and likert’s scale was used for attitude regarding pubertal health. Results: Study findings revealed that 61.4% of the students belonged to early adolescence (11-14) age group with the mean age 14.27±1.33 years. Majority (80.3%) had moderate level of knowledge and around half (48.6%) had positive attitude. Knowledge and attitude varied with the respondents’ level of education (p=0.001), relation to sibling (p=0.013) and source of information by elder sister (p=0.022), teachers/school (p=0.001).Moderately positive correlation was found between knowledge and attitude which was highly significant (r=0.395, p<0.001).Conclusions: Majority of respondents had moderate level of knowledge and half of the respondent had positive attitude regarding pubertal health. Findings of the study emphasizes on improvement in education of adolescent girls which can help uplift health status and minimize vulnerability to health issues of pubertal health. Keywords: Adolescents; attitude; knowledge; pubertal health; puberty.

Introduction: Immobility is a condition in which a person is unable to move freely or movement is restricted for medical reasons. Prolonged bed rest and immobilization inevitably leads to complications. Caregivers play a vital role in preventing the complications of immobilization and avoiding discomfort for the patient. This study aims to assess awareness on prevention of complications of immobility among caregivers of bedridden patients admitted in tertiary health care center. Methods: A descriptive cross-sectional research design was used to assess 66 caregivers of college of medical sciences by using non-probability convenience sampling technique. Data was collected by using self-administered questionnaire to assess awareness through face-to-face interview method. Obtained data were analyzed by using descriptive and inferential statistics using IBM SPSS 16. Results: Study findings revealed that the mean age of the respondents was 18 years with mean age 18 ± 11.87 and majority (54.5%) were female with higher percentage of respondents’ involvement in agriculture (28.3%). Majority (68.2%) of the respondents stayed in hospitals for 1 to 5 days and 51.5% respondents had no previous experience of hospital stays. Among the total respondents, majority (83.3%) had inadequate awareness on prevention of complication related to immobility which varied with respondent’s gender (p=0.047), educational level (p=0.001), occupation (p=0.0026) and information from television (p=0.005). Conclusions: Majority of the respondents had inadequate awareness on prevention of complication related to immobility. Findings emphasize that awareness programs should be implemented time to time in hospital settings to update the caregivers in relation to preventive measures of complications of immobilization.