Online Learning in the Face of COVID-19 Pandemic: Assessment of Students' Satisfaction at Chitwan Medical College of Nepal.

Background Online learning can play a vital role in the process of teaching and learning during Corona Virus Disease 2019 (COVID-19) pandemic. However, learners' satisfaction is extremely important in effective implementation of the online learning, especially at institutions where it is newly adopted. Objective To assess satisfaction towards online learning and its predictors among students at Chitwan Medical College, Bharatpur. Method A web-based cross-sectional survey was undertaken among 434 undergraduate and postgraduate students from various academic programs who had participated in the online classes started during this COVID-19 pandemic. A structured questionnaire consisting of 31 items (5-point Likert scale) covering four major student satisfaction domains (learners' dimensions, technological characteristics, instructors' characteristics and course management and coordination) was distributed to the students using Google Form. Result More than half (53.5%) of the students were satisfied with the online learning, while 29.7% gave neutral views. Bivariate analyses found that all four domains scores were positively correlated with each other as well as with the students' overall satisfaction towards learning. In multivariate analysis, female gender [aOR: 2.72, p = 0.013], WiFi as internet modality for learning [aOR: 3.36, p = 0.001) and learners' dimension score [aOR: 1.27, p<0.001] were the significant predictors of students' satisfaction. Conclusion Although recently adopted, the satisfaction of the students towards online classes appears good, and prioritizing the identified predictors and working on the weak links could assist in enhancing students' satisfaction and better outcomes.

Cases of perforated duodenal ulcer treated in College of Medical Sciences, Bharatpur over a period of one year.

BACKGROUND: Eighteen patients were studied in our institution between January and December 2002. Simple closure followed by eradication of Helicobacter Pylori was used to manage the cases of perforated duodenal ulcer. METHOD: After resuscitation, laparoscopy followed by simple closure of perforation reinforced with pedicled omental patch was performed for all the patients. H- Pylori eradication using "triple regime" was done in all. Follow-up between 6 to 12 months was done, for which endoscopy and Visick's grade was used. RESULTS: All the patients were male, maximum incidence (39%) noted in 51 to 60 age group. Mean time interval between start of symptoms and surgery was 60 hours. As a result the patients were moribund with gross purulent peritonitis and poor general condition. Chest infection was the commonest complication (44%) and two patients (11%) with very poor prognosis died during post operative period. Good to excellent results using Visick's grades were obtained in 81% surviving patients. Endoscopy did not show active ulcer in any of the patients. CONCLUSION: Patients with perforated duodenal ulcer were late in presenting to the hospital, precluding the option of definitive surgery for peptic ulcer disease. Simple closure of perforated duodenal ulcer if combined with eradication of H-Pylori is an effective method of treatment of duodenal perforation and is not associated with high recurrence of symptoms of peptic ulcer disease.