Introduction: Depression is one of the major problems encountered by medical students. This maycause a negative effect on cognitive functioning and learning of students resulting in poor healthcare and service delivery in future. The presence of this major problem is necessary to be evaluated.Enough recent data regarding its prevalence is not available in our country. Thus, the main aim ofthis study is to find the prevalence of depression among medical students of a tertiary care teachinghospital. Methods: This is a descriptive cross-sectional study which was conducted among undergraduatemedical students of a tertiary teaching hospital over a four-month period (July to October 2019).Ethical clearance was received from the Institutional Review Committee of the same tertiary teachinghospital. Random sampling technique was used to collect data to meet the calculated sample size.Data analysis was done in the Statistical Package for Social Sciences. Point estimate at 95% ConfidenceInterval was calculated along with frequency and proportion for binary data. Results: The prevalence of depression among selected medical students of Kathmandu MedicalCollege and Teaching Hospital is 59 (27.2%) at 95% Confidence Interval (21.28-33.12%). Thirty (14%)of the participants were mildly depressed, 21 (10%) moderately depressed while 8 (4%) were severelydepressed according to Beck’s Depression Index II. Conclusions: Prevalence of depression among medical students is relatively significant as foundin similar studies done in other centres. Thus appropriate programs and strategies should beimplemented to avoid depression from causing a negative effect on cognitive functioning andlearning of students. Favourable environment where students are able to talk about their mentalhealth issues is a must.

Introduction: Emergency department of a hospital is responsible for providing medical and surgical care to patients arriving at the hospital in need of immediate care. Emergency department is not staffed or equipped to provide prolonged care. Duration of stay in the Emergency department directly affects the quality of patient care. Longer length of stay is associated with Emergency department overcrowding, decline in patient care, increased mortality and decreased patients satisfaction. The main aim of this study is to find the mean stay duration of patients in the emergency department of a tertiary care hospital in Nepal.Methods: This is a descriptive cross-sectional study which was conducted in a tertiary care teaching hospital from Jan 15,2019 to Jan 30, 2019. Ethical clearance was obtained from Kathmandu Medical College- Instutional Review Committee. The calculated sample size was 587. Consecutive sampling technique was used. The data thus obtained was entered in SPSS version 20 and necessary calculations were done. Results: The mean emergency stay duration was obtained to be 3.18 hours at 95% confidence interval (C.I  and standard deviation was 2.51 hours. Female had longer mean duration of stay (3.25 hours) compared to male (3.11 hours). The maximum length of stay was 15.3 hours. Most of the patients attending the emergency department were discharged right through the emergency department 398 ( 67.8%). Mean duration of stay was longest (5.06 hours) for the referral group. Conclusions: The mean stay duration in Emergency Department of tertiary care hospital in Nepal is getting shorter compared to similar study done previously.

Perinatal asphyxia is one of the major causes of neonatal morbidity and mortality. It mainly causes neurodevelopmental delay leading to hypoxic-ischemic encephalopathy. We present here the case of a preterm male baby of 1670 grams born at 31+3 weeks of gestation delivered by 25-year-old primi mother through vaginal delivery with history of umbilical cord prolapse. At birth, the baby had no heart rate and cyanosed following which he was resuscitated according to the Neonatal Advanced Life Support 2015 guidelines protocol.  After 5 minutes of neonatal resuscitation, the baby’s heart rate reappeared, but was only upto 20 beats/min and resuscitation thus continued. But heart rate did not improve despite of using all form of resuscitation procedure including intubation and drugs. After 2 hours, baby cried spontaneously and later baby was managed in Neonatal Intensive Care Unit according to the neonatal unit protocol of the hospital. 

Fecalith is a concretion of dry compact feces or hard stony mass of faeces in the intestinal tract. Thoughappendicular fecoliths are commonly encountered, caecal fecoliths are rare entities. Fecoliths areamenable to conservative management with laxatives and enemas but surgical management preventsrecurrence. We present a case of 27 years old male who was diagnosed with acute appendicitis withperitonitis. He was intraoperatively diagnosed as gangrenous and perforated retrocaecal appendixwith multiple small fecaliths and a large fecalith on cecum with perforation. Appendectomy andprimary repair of caecal perforation done. Histological examination of perforated margin confirmedas an inflammatory lesion.

Introduction: Infantile Hypertrophic Pyloric Stenosis (IHPS) is the most common surgical cause of non-bilious vomiting in infancy and in the developed world. It is more common among male infants with a peak age at presentation of 4 weeks. This study aims to review the mean age at the time of diagnosis, serum electrolyte changes, ultrasonographic pyloric dimensions and surgical outcomes in IHPS at a tertiary children’s hospital in Nepal. Methods: A retrospective chart review of patients with IHPS who presented to Kanti Children’s Hospital between June 2016 and June 2020 was performed. Data on age, sex, laboratory and ultrasonographic dimensions, treatment and outcomes of treatment were collected and analysed. Results: The clinical record of 150 infants were retrieved and analysed who were diagnosed according to the clinical manifestations, laboratory and ultrasound examination from 2016 to 2020. The mean age at presentation was 46.57 ± 27.3 days with male preponderance of 84%. The proportion of IHPS cases with hyponatremia and hypokalemia was 31.3% and 18.0% respectively. The mean pyloric muscle thickness and pyloric length was 5.4 mm and 20.28 mm respectively. All cases were managed with Ramstedt pyloromyotomy with an average length of hospital stay of 5.03 days. There was no mortality and also no significant major complications. Conclusions: This study has shown that IHPS is a common condition in our setting. More attention should be paid to diagnose early. Paediatricians and general surgeons should have high index of suspicion in infants with non-bilious vomiting to avoid delay in diagnosis.