Result The study included 217 patients with 109 (50.2%) males and 108 (49.8%) females. The mean age of patients was 25.77±15.54. The results analyzed showed better sensitivity of Appendicitis Inflammatory Response score (96.91%) as compared to 94.30% of Alvarado score. The positive and negative predictive values of Alvarado score were 74.87% and 50%, as compared to 79.70% and 72.20% for AIR score. Furthermore, the area under receiver operating curve of the appendix inflammatory response score was better (0.701) than that of Alvarado score (0.580). Conclusion Appendicitis Inflammatory Response (AIR) scoring performed well and more accurate than Alvarado scoring system with high specificity and high negative predictive value preventing negative appendectomies.Background Preoxygenation is performed before induction of anaesthesia which increases oxygen reserve and provides delayed onset of hypoxia during period of apnea. Several techniques such as positive airway pressure and head-up tilt during preoxygenation have shown to prolong safe apnea period compared to conventional technique. However, uniform recommendations have not yet been made. Objective To find out the effect of combination of 5 cmH2 O continuous positive airway pressure (CPAP) and 25° head up position during preoxygenation on safe apnea period. Method In this comparative study 60 non-obese adult patients were divided into three equal groups; Group C receiving preoxygenation in conventional technique, Group S receiving preoxygenation with 5 cmH2 O continuous positive airway pressure in supine position and Group H receiving preoxygenation in 25° head-up position with 5 cmH2 O continuous positive airway pressure. After 3 min of preoxygenation, intubation was performed after induction of anaesthesia withcmH2O continuous positive airway pressure.Background Hearing loss among neonates is one of the important health issue in pediatric population which may remain unnoticed until the child reaches a certain age. The importance of universal early screening, diagnosis and intervention in reducing the negative impact of congenital hearing loss has been described all over the world. Objective To observe the outcome of hearing screening by Automated Auditory Brainstem Response (AABR) in newborns delivered in Dhulikhel Hospital and neonates admitted in an intensive care unit (NICU) of Dhulikhel Hospital. Method A prospective study was done in neonates who were born at Dhulikhel Hospital, Kathmandu University Hospital from February 15th, 2017 to October 30th, 2019. AABR was used for their hearing assessment within 24 hours of birth and again at about 6 weeks of age in those neonates who failed the initial test. All the neonates admitted in NICU were studied regarding the risk factors based on Joint committee on Infant Hearing. Those who failed the test for the ere possible. It should be done within one month of life and those with confirmed hearing loss should receive early appropriate intervention for better hearing in future.Background Nephrologists worldwide, after undergoing surgical training, have reported creating arteriovenous fistulas (AVFs). Objective To demonstrate the functional outcome of arteriovenous fistulas created by a trained Nepalese nephrologist. Method This was a cross sectional study. A convenient sampling method was used and all consecutive AVFs created by a single nephrologist from January 2016 to December 2018 were included to assess their functional status within 3 months of creation. Patients with incomplete data and no follow up for up to 3 months post surgery were excluded. Result One hundred sixty six (166) arteriovenous fistulas were created during the study period; mean age of the patients was 52 ± 14 years, 121 (75%) male and 65 (39%) were diabetic. The most common site of arteriovenous fistula creation was left radiocephalic (Lt RC) 69(41.5%), followed by left brachiocephalic (Lt BC) 66(39.7%). Other sites were left brachiobasilic (Lt BB) 10(6%), right brachiocephalic (Rt BC) 10(6%), right radiocephalic (Rt RC) 9(5.4%) and right brachiobasilic (Rt BB) 2(1.2%). 139 arteriovenous fistulas (83.7%) were functional within 3 months post creation. Functional outcomes of radiocephalic, brachiocephalic and brachiobasilic arteriovenous fistulas were 75.6%, 90.7% and 100% respectively at 3 months post creation. Lymphoceles developed in three Lt BC arteriovenous fistulas, thrombosis in two Lt BC arteriovenous fistulas and infection in two Lt BC arteriovenous fistulas with pseudoaneurysm formation. Conclusion The functional outcome of arteriovenous fistulas created by a trained Nepalese nephrologist is similar to that reported in the literature.Background Uncorrected refractive error is the major cause of visual impairment worldwide. There is no data on refractive error prevalence among school children in hilly region of Far West Nepal. Objective The prevalence of refractive error has been found to vary among children of different caste/ethnic groups and geographical regions. The purpose of this study is to determine the prevalence of refractive error among school children from different caste/ethnic groups in Dadeldhura district of Far West Nepal. see more Method This is a cross sectional study of refractive error among secondary school children from 2 schools in Dadeldhura district. All children underwent a vision screening consisting of visual acuity, ocular examination and refraction. Myopia was diagnosed for an eye with spherical equivalent refraction (SER) ≤ -0.5 D whereas an eye with SER ≥ +2.0 D was diagnosed as hyperopic. Ethnicity was reported through self administered questionnaire. Result Among children aged 12 to 16 years (14.07 ± 1.4) prevalence of myopia was 3.5%, hyperopia 0.33% and astigmatism 1%. All except three children had spherical equivalent refraction (SER) within ±2 D. Caste/ethnicity was not associated significantly with myopia in either eye (χ2 = 0.27, df= 2, p= 0.87). Conclusion The prevalence of refractive error among secondary school children in Dadeldhura district of Far West Nepal is very low in comparison to myopia prevalence reported in studies from other parts of the world, but slightly lower than myopia prevalence found in other, eastern parts of Nepal.