Introduction: Cancer patients are at higher risk of COVID-19 infection as they are highly immunocompromised. The patients' adherence to control measures is affected by their knowledge, attitudes, and practices (KAP) towards COVID-19. This study assesses the KAP towards COVID-19 among the admitted cancer patients in Nepal and is first of its kind. Patients and Methods: A cross-sectional study was conducted among the 224 admitted cancer patients in B.P. Koirala Memorial Cancer Hospital, Chitwan, Nepal, between April 20 and May 20, 2020, which was the early phase of the lockdown due to COVID-19. The study was conducted via face-to-face interviews taking optimum precautions. The research used a semi-structured questionnaire consisting of demographic characteristics, cancer-related information, 14 knowledge items, 4 attitude items, and 10 practice items. Independent sample t-tests and one-way analysis of variance were used to assess the association of knowledge with demographic characteristics. Results: The overall correct response rate of the knowledge component of the questionnaire was 79.4%. Most of the participants (89.7%) had a positive attitude towards accepting isolation if they had the COVID-19 infection. Only 4.5% reported that they had visited the crowded places recently. More than 98% of the patients were found to be compliant with the recommended preventive behaviors such as using the face mask, avoiding touching the eyes, nose, and mouth, washing the hands more than usual, and avoiding close contact with other patients or the caretakers not using the face masks. A total of 21.9% of respondents were using the same face mask for more than 3 days. Male gender, younger age group, and higher education were the positive predictors of knowledge regarding COVID-19. Conclusion: The overwhelming majority of the cancer patients had a good knowledge of COVID-19 and maintained positive attitudes and practice towards it. When tailored health education programs are planned, age, gender, and educational status should be taken into a consideration.

Background The novel beta-coronavirus disease (COVID-19) has infected millions of people globally with high risk among males than females. However, the effect of COVID-19 andrology is still a subject of dispute. We planned to analyze the overall consequences of COVID-19 on semen parameters and male sex hormones. Main text Systematic search was performed on MEDLINE and Scopus database until 11 June 2021. We included observational studies, which reported mean ± standard deviation of the semen parameters and serum sex hormones of those reproductive-aged males recovered from COVID-19 and controls who did not suffered from COVID-19. We used Random-effect model to pool the studies, as heterogeneity was present. The Q test and I2 evaluated heterogeneity. All articles were assessed with their quality and publication bias. We assessed 966 articles for eligibility and found seven eligible studies. These 7 studies included 934 participants with mean age 37.34 ± 10.5 years. Random-effect model meta-analysis showed that men who recovered from COVID-19 had semen parameters less than those who had not suffered from COVID-19. The overall mean difference (MD) [95% confidence interval (CI)] in semen volume, sperm concentration, sperm number, and progressive sperm motility was − 0.20 (− 0.45, 0.05) ml, − 16.59 (− 34.82, 1.65) millions/ml, − 45.44 (− 84.56, − 6.31) millions per ejaculate, − 1.73 (− 8.20, 4.75) percentage respectively. Considering sex hormones, luteinizing hormone and prolactin levels were higher among those recovered with a significant MD (95% CI) of 3.47 (1.59, 5.35)U l−1 and 3.21 (1.71, 4.72)ng ml−1 respectively. Conclusion We found that COVID-19 affects both semen parameters and sexual hormones. However, the mechanism for testicular involvement remains doubtful. Trial registration PROSPERO CRD42021259445

Background: The novel beta-coronavirus disease (COVID-19) has infected millions of people globally with high risk among male then female. However, the effect of COVID-19 andrology is still a subject of dispute. We planned to analyze the overall consequences of COVID-19 on semen parameters and male sex hormones.Main text: Systematic search was performed on MEDLINE and Scopus database until June 11 2021. We included observational studies, which reported mean ± standard deviation of the semen parameters and serum sex hormones of those reproductive-aged male recovered from COVID-19 and controls who did not suffered from COVID-19. We used Random-effect model to pool the studies, as heterogeneity was present. Heterogeneity was evaluated by Q test and I2. All studies were assessed with their quality and publication bias.We assessed 966 articles for eligibility and found 7 eligible studies meeting PICO criteria. This include 934 participants with mean age 37.34 ± 10.5. Random-effect model meta-analysis showed that men recovered form COVID-19 had semen parameters less than those who had not suffered from COVID-19. The overall mean difference (MD) [95% confidence interval (CI)] in semen volume, sperm concentration, sperm number, and progressive sperm motility was -0.20 (-0.45, 0.05), -16.59 (-34.82, 1.65), -45.44 (-84.56, -6.31), -1.73(-8.20, 4.75) respectively. Considering sex hormones; Luteinizing hormone and prolactin was found more among those recovered with the significant MD (95% CI) of 3.47 (1.59, 5.35) and 3.21 (1.71, 4.72) respectively.Conclusion: Both the semen parameters and sexual hormones were found to be affected after infected with COVID-19. However, the mechanism for testicular involvement remains doubtful.This systematic review and meta-analysis has been registered in PROSPERO (ID: CRD42021259445)

Introduction: Global burden of cancer is witnessing an exponential increase. Nepal is no exception. In the recent years, cancer care has seen a focus shift towards holistic healing. This includes screening and assessing for psychosocial distress, allowing health care providers to deliver timely psychological interventions. The goal of this study was to find the prevalence of psychosocial and functional impact of cancer diagnoses in Nepal. Methods: A descriptive cross-sectional study was carried out on 169 cancer patients attending out-patient department, day-care and in-patient department at B.P. Koirala Memorial Cancer Hospital, Nepal. National Comprehensive Cancer Network Distress Thermometer was used to evaluate spiritual/religious concerns, practical, family, emotional and physical issues and the distress score of these patients. Results: One-hundred and thirty eight (81.7%) of respondents had a Distress Thermometer score of ≥4. Distress Thermometer score of 7 was reported by the largest number of patients. Highest average Distress Thermometer scores were found in patients with hepatobiliary, head & neck and lung cancers. More than 50% of the patients reported to experience spiritual or religious concerns, fatigue, pain, worry and insurance or financial related concerns. Pain, sadness, worry and spiritual/religious concerns were significantly associated with distress levels. Sixty-two (36.7%) of respondents were in stage IV of cancer. Average Distress Thermometer score for patients in stage IV cancer was 5.69, the highest among all cancer stages. Ninety-six (56.8%) of the respondents were females, 73 (43.2%) were males. Gynaecological, haematological, gastrointestinal, head & neck and breast cancers were the top 5 cancer types. Conclusions: Cancer patients in Nepal have clinically significant psychosocial issues that directly impact on their distress.

Introduction: Uterine cervical carcinoma is the commonest form of gynecological malignancy in Bangladesh as well as in South Asia. Outcome of weekly versus three weekly Cisplatin concurrent with External beam radiotherapy followed by intracavitary radiotherapy in locally advanced cervical carcinoma was compared in this study. Methods: A quasi experimental study was carried out from April 2016 to September 2017. Total eighty patients of uterine cervical cancer were included and received External beam radiotherapy concurrent with either weekly or three weekly Cisplatin followed by High dose rate intracavitary brachytherapy. External beam radiotherapy was given with a dose of 50 Gray (Gy) in conventional fractionation over 5 weeks. Cisplatin 40 mg/m2, weekly was given along with radiotherapy to the patients of Arm A (n=40) while the patients of Arm B (n=40) received cisplatin 75 mg/m2, 3 weekly along with the radiotherapy. Patients were evaluated weekly during treatment and afterwards up to 6 months. Results: The mean age of patients were 48±9 years for Arm A and 42±9 years for Arm B. Complete response at 6 months of follow up was observed in 30 (75%) and 36 (90%) patients of Arm A and B respectively.Overall complete response was observed in 66 (82.5%)patients. Common toxicities were nephrological, hematological, skin and bowel related and were managed accordingly. Grade III-IV neutropenia was more in patients of Arm A (42.5%) than B (20%). Conclusions: This study showed that the radiotherapy concurrent with three weekly Cisplatin is effective and less toxic than weekly Cisplatin in locally advanced cervical