Background Coronavirus disease-19 (COVID-19) is an infectious respiratory disease caused by Severe Acute Respiratory Syndrome Corona Virus 2 (SARS-CoV-2). Respiratory symptoms and flu-like presentation are the most defined clinical manifestations. However, gastrointestinal symptoms with acute abdomen have been reported in a small percentage, occasionally mimicking acute appendicitis. Hence, the diagnosis of COVID-19 should be suspected and investigated in every case of acute abdomen in the present situation. Case presentation We report a case of a 25-year-old male who presented with features of acute appendicitis. Despite the equivocal ultrasound results, he was scheduled for an emergency appendectomy for Alvarado's score 7 out of 10, who underwent a successful appendectomy. The patient had initially tested negative on an upper respiratory COVID-19 reverse transcription-polymerase chain reaction (RT-PCR) with normal chest X-ray but few hours after the surgery patient developed a high-grade fever. An RT-PCR for COVID-19 was resent following a suspicion that came out to be positive. Clinical discussion Several case reports have suggested a probable association between COVID-19 and appendicitis. This case shows the limited effectiveness of clinical diagnosis for the surgical abdomen in COVID-19 patients as these two conditions share similar symptoms often needing a clinical vigilance. Conclusion This case reports acute appendicitis in a patient who tested positive for SARS-CoV-2 subsequently following emergency appendectomy highlighting the acute gastrointestinal presentation of COVID-19. This case exemplifies the necessity to be familiar with the gastrointestinal symptoms of COVID-19 and maintain a high level of suspicion for COVID-19 infection in cases of abdominal pain.

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Background: Hypertension, a key determinant of cardiovascular disease, is one of the major public health burdens worldwide. Family history is a known nonmodifiable risk factor for hypertension. This study aims to identify the family history of hypertension in terms of its prevalence and its association with various risk factors. Methods: A descriptive cross-sectional study was conducted among 423 hypertensive patients visiting the general outpatient department of Shree Birendra Hospital using a simple random sampling method. The data were collected using a preformed questionnaire through a face-to-face interview approach. Data were entered into Microsoft Excel 2019 v16.0 and were analyzed using Statistical Packages for Social Sciences version 21. Results: Out of 423 hypertensive individuals, 131 (30.97%) had a family history of hypertension, with grandparents having the greatest frequency (56.49%). In the multivariable model, the participants with age 60 years or older [adjusted odds ratio (AOR): 2.54, 95% CI: 1.60–4.02, P < 0.001], female (AOR: 2.11, 95% CI: 1.35–3.29, P = 0.001), and participants with government or private jobs, including farming (AOR: 2.63, 95% CI: 1.59–4.35, P <0.001), were significantly associated with a family history of hypertension. Conclusions: Family history is an influencing factor in hypertension. Thus, it is possible to target people who have a family history of hypertension to identify undiagnosed hypertension cases in the community, as well as to modify risk factors and provide necessary interventions.

Introduction: Upper gastrointestinal bleeding is a common medical emergency with significant morbidity and mortality. Its causes can be classified under variceal bleeding or non-variceal bleeding. Peptic ulcer and variceal bleeding are common causes. Thus, this study aims to find the prevalence of upper gastrointestinal bleeding among patients attending the Department of Emergency in a tertiary care centre. Methods: This was a descriptive cross-sectional study conducted on patients admitted to the Department of Emergency a tertiary care centre from September 2020 to August 2021 among 3375 patients. The ethical approval was obtained from the Institutional Review Committee of the hospital (Reference number: 328). Patients presenting with the clinical features of upper gastrointestinal bleeding in the form of hematemesis or melena were enrolled after written informed consent. Data entry was done in Statistical Packages for the Social Sciences version 20.0. for descriptive analysis. Point estimate at 95% Confidence Interval was calculated along with frequency and percentage for binary data. Results: Out of 3375 admissions in the Department of Emergency, 85 (2.52%) (1.99-3.05 at 95% Confidence Interval) patients presented with upper gastrointestinal bleeding. Conclusions: The prevalence of upper gastrointestinal bleeding is lower in comparison to other studies done in similar settings.

This a preprint and has not been peer reviewed. Data may be preliminary.

Wilson's disease can have varied clinical manifestations and initial presentation can be misleading as in our case. Our case depicts the necessity of suspicion of WD in variable presentation of liver disorders, especially in pediatrics population.