Successful endoscopic endonasal trans-sphenoidal resection for pituitary macro adenoma with apoplexy in a twin pregnancy: A case report.

Key Clinical Message: Pituitary apoplexy is a medical and surgical emergency requiring prompt diagnosis and often urgent treatment to manage symptoms and prevent further complications. Abstract: This report describes the successful management of a 37-year-old pregnant woman with a history of pituitary macroadenoma and apoplexy during a twin pregnancy. Presenting with bitemporal vision loss, a common pituitary adenoma symptom, she showed no other alarming signs despite a twin pregnancy. Successful endoscopic resection improved her vision, and postoperative recovery was uneventful. The discussion underscores significance of the diagnostic utility of contrast MRI. The patient's favorable outcome supports endoscopic resection feasibility in pregnant individuals with pituitary apoplexy.

Newspaper reporting of suicide in Nepal: Quality assessment against World Health Organization media guidelines.

Background: Sensible media reporting of suicide is a population-based suicide prevention strategy. However, the quality of media reporting of suicide has not been assessed in Nepal. Objectives: We aimed to assess the newspaper reporting status of suicide in Nepal with reference to World Health Organization (WHO) media guidelines for suicide reporting. Method: We retrospectively searched eight major newspapers in Nepal between January 2020 and May 2021 and assessed 167 news reports against WHO suicide reporting guidelines. Results: Potentially harmful characteristics were found to be reported in both the title and main text of the reports. About half of them mentioned sex (48.5%) and 38.3% mentioned the location of suicide in the title. Of the 167 reports, 74.3%, 95.2%, 34.7%, 92.2%, 98.8%, and 52.7% mentioned the name, sex, occupation, method of suicide, the location of suicide, and life events, respectively, in their main content. On the other hand, only 6% and 2.4% of reports mentioned linkage of suicides with mental illness and substance abuse, respectively. While lesser than 1% of reports narrated educative information regarding suicide prevention, none mentioned contact information for help-seeking for the vulnerable. Conclusion: Newspaper reporting of suicide in Nepal poorly adheres to WHO guidelines, substantiated by the high presence of potentially harmful characteristics and negligible presence of potentially helpful characteristics.

History of psychiatry in Nepal.

The history of psychiatry as a discipline in Nepal has been poorly studied. We have attempted to summarise historical landmarks to explore how it began and its evolution over time in relation to contemporary political events. Although Nepal has achieved several milestones, from establishing a psychiatric out-patient department with one psychiatrist in 1961 to having more than 500 psychiatric in-patient beds with 200 psychiatrists by 2020, the pace, commitment and dedication seem to be slower than necessary: the current national mental health policy dates back to 1996 and has not been updated since; there is no Mental Health Act; the number of psychiatric nurses and in-patient psychiatric beds has increased only slowly; and there is a dearth of professional supervision in rehabilitation centres. Thus, despite making significant progress, much more is required, at greater intensity and speed, and with wide collaboration and political commitment in order to improve the mental health of all Nepali citizens, including those living in rural areas and or in deprived conditions.

Medical Students Volunteering during COVID-19 Pandemic: Synopsis of Some Student-led Initiatives in Nepal.

The efforts shown by healthcare professionals, security personnel and the general public in fighting Coronavirus Disease 2019 pandemic is highly appreciable. Medical students are future healthcare professionals and have the opportunity to volunteer and help their seniors fight Coronavirus Disease 2019 pandemic. In Nepal, we as medical students are contributing by raising awareness about Coronavirus Disease 2019 along with some innovative initiatives which are Project Personal Protective Equipment, Project Telemedicine and the ″Donate Plasma, Help Defeat COVID-19″ Campaign. Since we were able to support thousands of frontline healthcare workers with personal protective equipment and reduce burden in hospitals by providing telemedicine service, we believe such volunteering and initiations from medical students can be an inspiration for all students for future crises.

Occupational stress among tunnel workers in Sikkim.

BACKGROUND: Job stress has been linked to a wide range of adverse effects on mental, physical and organizational health. OBJECTIVE: The objective of this study was to determine the impact of job stress on mental, physical and social health of the underground construction workers in Sikkim. MATERIALS AND METHODS: The study population comprised of tunnel workers and a comparable group of controls. Using the interview technique, data was collected using the SF-36 General Health Survey Questionnaire. RESULTS: The study population comprised of individuals of whom more than half were below 40 years of age and was comparable to the group of controls. Majority reported good health, while poor health was reported by 22 % of the subjects under study Compared to their health status last year, 52% rated their health as somewhat worse. Majority reported that their physical health problems limited them in activities of daily life, viz., running, lifting heavy objects, participation in strenuous sports, climbing several flights of stairs, bending, stooping or kneeling and walking more than a mile, during the past four weeks. More than half of them had severe body ache in the past four weeks that interfered with both work outside home and housework. This was true for emotional problems also, which interfered with their normal social activities involving family, friends, neighbors or groups. The associations of occupational stress with physical, emotional and social life and with limitation of day-to-day activities among tunnel workers were found to be statistically significant. CONCLUSION: The results emphasize the importance of assessment of the effects of job stress and of fulfilling the need of underground workers for optimum preventive measures.