Background:Baseline stroke knowledge in a targeted population is indispensable to promote the effective stroke education. We report the baseline knowledge, attitude, and practice (KAP) of high school students with respect to stroke from Nepal.Materials and Methods:A self-structured questionnaire survey regarding KAP about stroke was conducted in high school students of 33 schools of Bharatpur, Nepal. Descriptive statistics including Chi-square test was used, and the significant variables were subjected to binary logistic regression.Results:Among 1360 participants, 71.1% had heard or read about stroke; 30.2% knew someone with stroke. 39.3% identified brain as the organ affected. Sudden onset limb/s weakness/numbness (72%) and hypertension (74%) were common warning symptom and risk factor identified. 88.9% would take stroke patients to a hospital. Almost half participants (55.5%) felt ayurvedic treatment be effective. 44.8% felt stroke as a hindrance to a happy life and 86.3% believed that family care was helpful for early recovery. Students who identified at least one risk factor were 3.924 times (P < 0.001, confidence interval [CI] = 1.867–8.247) or those who identified at least one warning symptom were 2.833 times (P ≤ 0.023, CI = 1.156–6.944) more likely to take stroke patients to a hospital.Conclusion:KAP of high school Nepalese students regarding stroke was satisfactory, and the students having knowledge about the risk factors and warning symptoms were more likely to take stroke patients to a hospital. However, a few misconceptions persisted.

Introduction: We studied the levels and severity of anxiety caused by COVID-19 amongst frontline health-care workers (HCWs) in a tertiary care neurological hospital in Nepal, not assigned to manage COVID-19 cases. Methods: A cross-sectional study was conducted on 100 frontline Health Care Workers (HCWs) using a 10-point subjective assessment tool, the Anxiety Level Index (ALI), and the Zung Self Rating Anxiety Score (SAS), to assess the level of anxiety regarding COVID-19. Results: On ALI 55% of HCWs were found to have marked severe anxiety (6-9), however, on SAS 44% of HCWs reported anxiety. The majority HCWs were female (n=78) with nurses forming 62% of the sample size. The mean age was 26.8 years (SD 8.17). Factors associated with significantly higher levels of anxiety regarding COVID-19 on ALI were age (p=0.002), sex (p=0.001), receiving regular COVID-19 updates via social media (p=0.011) and a high frequency of checking for COVID-19 information authenticity (p=0.039). Work experience (p=0.026) and frequency of checking for information authenticity (p=0.029) were factors found to increase SAS measured anxiety and were found to be associated with significantly higher levels of anxiety. Multivariate logistic regression analysis showed that respondents with work experience of less than or equal to 2 years were 0.380 (95% CI 0.158 to 0.910) times less likely to have anxiety than those with work experience of more than 2 years. Similarly, the odds of having anxiety among those who checked information authenticity less frequently was 0.377 (95% CI 0.153 to 0.931) times less than those who often did. Conclusion: The COVID-19 outbreak has caused a substantial impact on the mental health of frontline HCWs in a hospital not assigned to manage COVID-19 patients. Length of time of worked in healthcare and the frequency of checking for COVID-19-related information were significant predictors of anxiety.

Myasthenia gravis is a neuromuscular junction disorder characterised by fluctuating muscle weakness, improved by using anti-cholinesterase drugs. In addition to the autoimmune aetiology, various factors such as infections, surgery, and drugs are known to precipitate the condition. We report a case of a 15-year-old boy with D-penicillamine-induced myasthenia gravis who presented with facial diplegia, dysphagia, and drooling of saliva, 6 years after the initiation of treatment for Wilson’s disease. Therefore, clinicians should be more vigilant while prescribing patients with chelating drugs like D-penicillamine with regular monitoring of the new symptoms and keeping a very low threshold for the suspicion of myasthenia gravis.