Background: Pregnant and breastfeeding women are more susceptible to viral infection and in the year 2020 they have to face the COVID-19 pandemic. Since, no successful treatment and vaccine has been developed so far, efforts to enhance the knowledge, attitudes, and practice of the public, especially the high-risk groups like pregnancy and postpartum period are crucial to manage COVID-19 pandemic. Objective To analyze the knowledge, attitude, practice and hospital experience regarding COVID-19 among post-partum mothers at a tertiary care center of Nepal Method The data collection was based on direct interview after receiving written consent from the research participants, using a semi-structured questionnaire. The questionnaire consisted of 4 major domains- knowledge (8 questions), attitude (6 questions), practice (5 questions) and experience (5 questions). Standard descriptive statistics were used for the data, mean and standard deviation for continuous variables whereas frequencies and percentages for categorical variables. Result A total of 203 post-partum women participated in the study. Almost all the participants had heard about COVID-19 (96.6%). A majority of them were aware about how COVID-19 gets transmitted and its preventive measures. Most of the participants (88.2%) knew that COVID-19 has effects on pregnancy. Almost all of participants (97%) wore mask during hospital stay. All of the women washed their hands with soap water or alcohol based sanitizer. A majority of the mothers (79.3%) wore mask while breastfeeding their baby. Conclusion The post-partum mothers have good knowledge, attitude, practice and experiences regarding the COVID-19 pandemic.

Introduction: The lack of knowledge among health care professionals leads to diagnostic delays,further spread of disease, and poor infection control practices. Health care professionals must beupdated knowledge regarding COVID-19. This study aims to assess the knowledge of health careprofessionals regarding COVID -19 in a medical college in Chitwan. Methods: A Knowledge, Attitude and Practice Study was carried out in a tertiary care hospitalin Chitwan, Nepal from April 22, 2020, to April 28, 2020. The institutional review committee ofChitwan Medical College provided ethical approval for the research. Data were collected with anonline questionnaire using Google forms. The questionnaire was sent out to 724 potential responderswho included health care professionals from medical, dental, nursing, and allied health sciences inChitwan Medical College. A convenient sampling method was used for data collection. Data wereanalyzed using Statistical Package of Social Sciences. Results: A total of 181 respondents completed the web survey. Overall, a total of 35 (19.3%)respondents were found to have “Good” knowledge; 105 (58%) respondents had “Fair” knowledgeand 41 (22.7%) respondents had “Poor” knowledge regarding various aspects of COVID-19. Therewas no significant difference among the various health professional groups in their knowledgescores under the four knowledge domains. Conclusions: The study of knowledge of health care professionals could act as a reference for theprevention and better management of COVID-19. This study shows that there is a need to implementperiodic educational interventions and training programs on infection control practices for COVID-19across all healthcare professions.

Introduction Proper insulin injection practice is essential for better diabetic control. This study aims to assess the insulin injection practice of patients with diabetes. Materials and Methods A cross-sectional study was conducted at Chitwan Medical College Teaching Hospital, Bharatpur, Nepal, from February 2017 to May 2017. Patients injecting insulin through insulin pens (n = 43) for a minimum of 4 weeks were consecutively recruited. Patients' baseline characteristics, current insulin injection technique, insulin transportation practice, complications of insulin injection, disposal practice of used needle, and acceptability of insulin were recorded. Descriptive statistics were performed using IBM-SPSS 20.0. Results The insulin injection technique of patients and their relatives was inadequate. The majority of patients and their relatives (25, 58.1%) mentioned that they transport their insulin cartridge without maintaining cold chain. Thirteen patients (30.2%, n = 43) reported complications of insulin injection and the most common complication among those patients was bruising (10, 76.9%, n = 13). Almost all patients disposed the used needle improperly, and the common method was disposing the needle in a dustbin and then transferring to municipal waste disposal vehicle. Insulin was accepted by just 16 (37.2%) patients. Conclusion There was a significant gap between the insulin delivery recommendation through insulin pen and current insulin injection practice.

Introduction Sound knowledge and good practice on insulin injection technique are essential for nurses in order to administer insulin correctly and to educate patients or their relatives adequately. This study aimed to assess the insulin injection practice through the use of insulin pen among nurses working in a tertiary healthcare center of Nepal. Materials and Methods A cross-sectional descriptive study was conducted among 67 nurses working in one of the tertiary healthcare centers of Nepal. Demographic information and insulin injection practice of nurses through the use of insulin pen were assessed using self-administered questionnaire. Each correct practice was scored “1” and incorrect practice was scored “0.” Results. The median (IQR) insulin injection practice score of nurses was 11 (9-12) out of 16. Thirty-seven (55.2%) nurses store insulin pen filled with insulin cartridge at room temperature while 57 (85.1%) nurses store unopened cartridge at refrigerator (2-8°C). The practice of hand washing and injection site cleaning was mentioned by 92.5% and 82.1% of the nurses, respectively. However, just over half of the nurses mix the premix (cloudy) insulin and prime insulin pen before each injection. Thirty-four (50.7%) nurses do not lift skin during injection and more than half of the nurses keep needle beneath the skin for less than 5 seconds after completely injecting the required dose of insulin. One out of ten nurses massage injection site after injecting insulin. Most of the nurses (86.6%) use single needle more than once and the median (IQR) frequency of needle reuse was 6 (3-12). Similarly, systematic site rotation was performed by 59 (88.1%) nurses and twenty (29.9%) nurses claim that they use single insulin pen for two different cartridges. Conclusion The insulin injection practice of nurses assessed through the use of insulin pen was suboptimal and highlights the need for urgent educational intervention.

Introduction This study aimed to explore the predictors of mortality from scrub typhus infection in patients requiring intensive care unit (ICU) admission. Materials and Methods A retrospective study was conducted on 120 patients with serum ELISA IgM positive for scrub typhus (optical density ≥ 0.5) admitted at the medical ICU of Chitwan Medical College Teaching Hospital between April 2016 and September 2017. Data was extracted from patient medical records and electronic database of the hospital. The outcome measurement was mortality (Yes/No) due to the infection. A multivariate binary logistic regression analysis (p < 0.10) using potential variables from bivariate analysis (p < 0.25) was adjusted to predict the mortality. Results The mortality rate was 20% (24/120). Factors associated with mortality, as found using bivariate analysis, were heart rate > 100/minute (p < 0.001), systolic blood pressure < 90 mmHg (p = 0.025), diastolic blood pressure < 60 mmHg (p = 0.032), serum creatinine > 1.4 mg/dl (p < 0.001), acute kidney injury requiring dialysis (p = 0.029), acute respiratory distress syndrome (p < 0.001), and shock requiring vasopressor (p < 0.001). Regression analysis showed age (odds ratio [OR] = 1.063; 95% CI = 1.010–1.118; p = 0.019) and serum creatinine (OR = 1.063; 95% CI = 1.010–1.118; p = 0.019) as significant predictors of poor outcome. Conclusion Older age and high serum creatinine were found to be independent predictors of poor outcome in patients with scrub typhus admitted in medical ICU.