Nevin Manimala

J Nepal Health Res Counc. 2025 Oct 17;23(2):320-328. doi: 10.33314/jnhrc.v23i02.4762.

ABSTRACT

BACKGROUND: Cardiovascular diseases are a leading cause of death globally, with physical inactivity as a significant risk factor. In Nepal, lifestyle-related health issues are rising, necessitating an understanding of physical activity patterns in specific groups like secondary school teachers. This study aims to assess the status of physical activity and associated factors among secondary school teachers in Pokhara, Nepal.

METHODS: A cross-sectional study was conducted from December 2022 to April 2023 among 406 secondary school teachers in Pokhara. Physical activity was measured using the IPAQ-long form, and other variables were collected through self-administered questionnaires. Univariate and bivariate analyses were followed by logistic regression to calculate adjusted odds ratios (aOR) for factors associated with moderate and high physical activity.

RESULTS: Most participants were male (53%) and Brahmins/Chhetris (69.2%), with a mean age of 38.65 years. The majority (86.3%) met WHO physical activity guidelines, with 65.3% reporting moderate and 21.5% high activity levels. Higher physical activity was associated with being male (aOR: 2.19, 95% CI: 1.11-4.35), higher education (aOR: 2.88, 95% CI: 1.45-5.73), walking while teaching (aOR: 9.13, 95% CI: 4.20-19.87), and access to walking areas (aOR: 2.28, 95% CI: 1.12-4.62).

CONCLUSION: Male teachers, those with higher education, and those who walked while teaching were more likely to engage in higher physical activity. Access to walking-friendly environments also positively influenced activity levels. Promoting walking friendly spaces and addressing educational and occupational factors could enhance physical activity among teachers. Keyword: Cardiovascular disease; international physical activity questionnaire; metabolic equivalents.

PMID:41319075 | DOI:10.33314/jnhrc.v23i02.4762

J Nepal Health Res Counc. 2025 Oct 17;23(2):243-246. doi: 10.33314/jnhrc.v23i02.4753.

ABSTRACT

BACKGROUND: Sexual assault is one of the most traumatic crimes which leaves a deep mental and emotional scar in the victim’s life. Mostly girls are the victims of sexual assault whereas boys are also victimized but are few in number. This heinous incidence hampers the normal growth and development of a growing child making them vulnerable to psychiatric disorder, drug abuse disorder and anti-social conducts in adult. This study aims at identifying the incidence of child sexual abuse in different municipal areas of Kavrepalanchok district of Nepal Methods:This is a retrospective study in which data of sexual assault victim less than 18 years presented at emergency department of Dhulikhel Hospital, KUSMS through One-stop Crisis Management Center (OCMC) by the investigating authority was studied. The data from 2076/09/01 B.S. to 2080/12/30 B.S. was included in the study. Total of 127 cases were studied.

RESULTS: Mandandeupur rural municipality reported highest number of child victims of sexual assault i.e., 14.17%. Out of 127 victims, 4 of them were male and rests were female. Most of the victims (74.01%) were of 12-18 years age. Most of the perpetrators (51.18%) were strangers to the victim. The cases of sexual assault with children occurred mostly in the places other than house (45.66%). More than one fourth of the victims (26.77%) sustained some type of bodily injuries.

CONCLUSIONS: Sexual assault among children is predominant among females and mostly between the teenager age group with perpetrators being stranger to the victim Psychological screening of the potential pedophiles could lead to minimizing the incidence of child sexual assault and abuse. Psychosocial counseling to the victim is must to prevent the devastating psychological effects of sexual abuse.

PMID:41319074 | DOI:10.33314/jnhrc.v23i02.4753

J Nepal Health Res Counc. 2025 Oct 17;23(2):329-334. doi: 10.33314/jnhrc.v23i02.4752.

ABSTRACT

BACKGROUND: Asymptomatic bacteriuria in hemodialysis patients is a common problem due to their decreased immunity and renal function which often leads to development of urinary tract infection and other complications. However, there are no adequate guidelines that recommend the routine screening and management of such patients in most of the developing countries including Nepal resulting in antibiotic misuse. This study was done to find the magnitude of asymptomatic bacteriuria among hemodialysis patients along with their antibiotic susceptibility and related risk factors.

METHODS: A descriptive cross-sectional study was conducted on hemodialysis patients from July 2023 to January 2024. Midstream clean catch technique was used for urine collection. Urine specimens were processed for identification of uropathogens and their antibiotic susceptibility test by Kirby Bauer disk diffusion method following standard guidelines. Statistical analysis was done by Excel 2016 and SPSS 26, the point estimate was calculated at a 95% confidence interval.

RESULTS: The overall prevalence of asymptomatic bacteriuria was 27%. Escherichia coli (43.47%) was the most frequent isolate. Imipenem and Amikacin were the most sensitive antibiotics among Gram negative isolates while Ceftriaxone and Nitrofurantoin were the most resistant antibiotics. Pseudomonas aeruginosa was the major multidrug resistant pathogen. Hypertension and Diabetes Mellitus were commonly associated risk factors for asymptomatic bacteriuria in hemodialysis patients.

CONCLUSIONS: This study demonstrates high prevalence of asymptomatic bacteriuria among hemodialysis patients. Routine screening of asymptomatic bacteriuria aids in early detection and management of complications along with optimization of antibiotic use.

PMID:41319073 | DOI:10.33314/jnhrc.v23i02.4752

J Nepal Health Res Counc. 2025 Oct 17;23(2):343-350. doi: 10.33314/jnhrc.v23i02.4724.

ABSTRACT

BACKGROUND: Adequate nutrition during pregnancy is crucial for maternal and fetal health. This study aims to assess the nutritional status, food insecurity, and socio-demographic factors affecting the nutritional status of pregnant women in this region.

METHODS: A cross-sectional study was conducted among 903 pregnant women in Kailali district. Data were collected using structured questionnaires covering socio-demographic characteristics, food insecurity and knowledge of nutrition. Nutritional status was assessed using Mid-Upper Arm Circumference (MUAC). Statistical analysis was performed to identify associations between nutritional status and various factors.

RESULTS: The majority of women (68.6%) had normal nutritional status (MUAC >23 cm), while 31.4% were either had severe or moderate malnutrition. Approximately 10% to 12% of participants reported food insecurity. A significant association was found between higher MUAC and factors such as sufficient nutrition knowledge, regular antenatal care visits, increased dietary intake, and a higher pre-pregnancy BMI. Ethnic disparities were also noted, with Dalit, Janjati, and Brahmin women having higher MUAC compared to Madeshi and Muslim women.

CONCLUSIONS: Nutritional deficiencies and food insecurity remain significant challenges for pregnant women in Kailali district. Strengthening nutrition education, improving food security, and promoting antenatal care can improve maternal nutrition and health outcomes.

PMID:41319071 | DOI:10.33314/jnhrc.v23i02.4724

J Nepal Health Res Counc. 2025 Oct 17;23(2):351-360. doi: 10.33314/jnhrc.v23i02.4723.

ABSTRACT

BACKGROUND: The burden of hypertension is increasing, especially in low- and middle-income countries like Nepal. Occupation is one of the risk factors correlated with hypertension, among others. There is limited evidence about its prevalence among school teachers in Nepal. Therefore, the study aims to identify the prevalence of hypertension and its associated factors among school teachers.

METHODS: A school-based cross-sectional study was conducted from September 1st to October 12th, 2023, at Amargadhi Municipality among two hundred twenty-three (223) school teachers using a two-stage stratified random sampling technique. Data on socio-demographic profiles and behavioral factors, including a history of diabetes and hypertension, as well as blood pressure, were collected using a standardized method.

RESULTS: The overall prevalence of hypertension was 14.7% and 8.9% were taking antihypertensive medication. After excluding medication (n=203), 41% of participants had pre-hypertension systolic, and 3.9% had Systolic hypertension. Diastolic blood pressure followed a similar pattern: 53.7% had pre-hypertension, and 6.4% had hypertension. About 96% of them had controlled systolic blood pressure, and nearly 90% had controlled diastolic blood pressure. The mean diastolic and systolic blood pressures were 76.98 (8.72) mmHg and 115 (11.93) mmHg, respectively. The Stepwise regression showed that both diastolic and systolic blood pressure were significantly associated with sex and body mass index.

CONCLUSIONS: There is a high prevalence of hypertension and pre-hypertension among study participants. To effectively prevent and control hypertension, it is essential to prioritize school teachers in public health initiatives. As respected role models within their communities, teachers can influence the adoption of healthy lifestyles and behaviors.

PMID:41319070 | DOI:10.33314/jnhrc.v23i02.4723

J Nepal Health Res Counc. 2025 Oct 17;23(2):216-235. doi: 10.33314/jnhrc.v23i02.4708.

ABSTRACT

BACKGROUND: Curcumin, the primary bioactive compound in turmeric (Curcuma longa Linn.), has demonstrated potential benefits in managing type 2 diabetes mellitus (T2DM) and hyperglycemia. This systematic meta-review aimed to evaluate the effectiveness of turmeric in improving glycemic control, lipid profiles, and other metabolic markers in the patients with T2DM or hyperglycemia.

METHODS: A comprehensive literature search was conducted across seven electronic databases to identify relevant studies published up to December 2023. Inclusion criteria focused on randomized controlled trials included in systematic reviews or meta-analyses assessing curcumin’s effects on metabolic markers. Data were extracted systematically, and the methodological quality of included reviews was assessed using AMSTAR-2. Meta-analyses were performed using STATA 17 to synthesize outcomes for fasting blood glucose (FBG), glycated hemoglobin (HbA1c), lipid profiles, and other markers, employing random-effects models to account for heterogeneity.

RESULTS: Thirteen systematic reviews and meta-analyses of 63 unique randomized controlled trials involving 3706 human participants met the inclusion criteria. The pooled analysis revealed that curcumin significantly reduced FBG (mean difference [MD] = – 6.30 mg/dL; 95% CI: – 9.33, – 3.27), HbA1c (MD = – 0.31%; 95% CI: – 0.57, – 0.05), low – density lipoprotein (LDL) cholesterol (MD = – 5.95 mg/dL; 95% CI: – 9.43, – 2.47), and triglycerides (TG) (MD = -12.88 mg/dL; 95% CI: – 20.09, – 5.67) while increasing high-density lipoprotein (HDL) cholesterol (MD = 1.46 mg/dL; 95% CI: 0.37, 2.56). No significant effects were observed on total cholesterol, blood pressure, body mass index, blood urea nitrogen, or creatinine levels. Heterogeneity across studies was high but consistent with meta-analytical expectations for diverse populations and interventions.

CONCLUSIONS: Curcumin supplementation shows statistically significant improvements in glycemic control and lipid profiles in individuals with T2DM or hyperglycemia, supporting its potential as an adjunct therapy. However, its effects on renal markers, blood pressure, and body weight remain inconclusive. Moreover the efficacy of the crude powder of turmeric remain unexplored. Future trials should address long-term efficacy and safety to optimize the therapeutic role of curcumin and turmeric powder in diabetes management.

PMID:41319069 | DOI:10.33314/jnhrc.v23i02.4708

J Nepal Health Res Counc. 2025 Oct 17;23(2):369-376. doi: 10.33314/jnhrc.v23i02.4703.

ABSTRACT

BACKGROUND: Hospitals play a crucial role in disaster response, but they often face resource challenges. Hospital disaster preparedness, involving plans and procedures, is vital to ensure they can handle emergencies effectively. Nepal has identified 25 Hub Hospitals to coordinate disaster response, highlighting the importance of organized disaster management planning in saving lives. This study assesses disaster preparedness in these designated hospitals.

METHODS: This observational study conducted in December 2023 is a secondary analysis of data from a workshop held in 25 designated hub hospitals in Nepal. The workshop aimed to develop disaster preparedness plans. The study evaluates physical facilities, triage, planning, and available resources in these hospitals, categorizing variables related to beds, human resources, disaster plans, and more. Ethical approval was obtained.

RESULTS: Average hospital bed occupancy in ward was 80% and that of emergency was 92%. The average bed per province was 1272, nurses were 833, doctors were 521, paramedics were 181. Disaster plan was available in 21(84%) of the hospital. Out of 21 hospitals that had disaster plan, surge capacity activation plan was included in 18(86%), infectious disease outbreak plan in 14(67%) and fire safety plan in 7(33%) of the disaster plan. Blood bank was available in 16(64%) of the hospitals. One stop crisis management Centre was available in in 24(96%) hub hospitals, birthing and facility for caesarean section was available in all hospitals.

CONCLUSIONS: The study findings reveal varying levels of hospital preparedness in Nepal, including bed occupancy, staff, disaster plans, structural assessments, and available services.

PMID:41319068 | DOI:10.33314/jnhrc.v23i02.4703

J Nepal Health Res Counc. 2025 Oct 17;23(2):385-396. doi: 10.33314/jnhrc.v23i02.4692.

ABSTRACT

BACKGROUND: Neonatal mortality refers to the risk of death within the first month of life. This study investigates the key factors influencing neonatal mortality in Nepal between 2011 and 2016, focusing on changes over this period.

METHODS: Data for this research were sourced from the Nepal Demographic and Health Survey (NDHS) for the years 2011 and 2016. Neonatal mortality was the primary outcome variable. Key determinants examined included community-level factors (residence), socio-economic factors (maternal and paternal education, wealth index), maternal characteristics (age, pregnancy duration, antenatal care visits), infant characteristics (sex, birth order, birth interval, birth weight), delivery factors (assistance and location of delivery), and post-delivery factors (breastfeeding status, postnatal check-ups).

RESULTS: Statistical analysis utilized the Chi-squared test to identify significant relationships between determinants and outcomes, alongside a full logistic model based on treatment contrasts. Findings indicated that in 2011, the significant factors included pregnancy duration, postnatal checks, antenatal visits, and having twins. By 2016, important determinants shifted to the mother’s age, breastfeeding status, pregnancy duration, postnatal checks, and antenatal visits.

CONCLUSIONS: The study highlights that pregnancy duration, postnatal check-ups, and antenatal visits consistently influenced neonatal mortality across both surveys. Given the rarity of studies addressing program impacts on neonatal mortality, this research suggests conducting panel studies to better understand the slow decline of neonatal mortality in Nepal.

PMID:41319065 | DOI:10.33314/jnhrc.v23i02.4692

J Nepal Health Res Counc. 2025 Oct 17;23(2):397-403. doi: 10.33314/jnhrc.v23i02.4689.

ABSTRACT

BACKGROUND: Accurate mortality data is vital for public health planning and policy. In Nepal, non-standardized death certificates, often missing structured causal sequences and critical details, compromise data quality in the Civil Registration and Vital Statistics (CRVS) systems. Implementing the World Health Organization’s (WHO) Medical Certificate of Cause of Death (MCCoD) could enhance accuracy, strengthen mortality statistics, and facilitate evidence-based public health interventions.

METHODS: This retrospective study analyzed inpatient deaths occurring between 13 April 2024 to 15 December 2024. Demographic and clinical data were extracted from medical records. The leading causes of death were identified by analyzing International Classification of Diseases Eleventh Revision (ICD-11) coded data using the Digital Open Rule Integrated cause of death Selection (DORIS) tool. Additionally, the study assessed documentation errors, predominant causes of in-hospital mortality, and evaluated the accuracy of cause-of-death reporting in the Health Management Information System (HMIS).

RESULTS: The study analyzed 564 death certificates and corresponding medical records. Chronic liver disease was the leading underlying cause of death (UCOD) accounting 11.17% of total deaths. No certificate was entirely error-free, with nearly all (99.9%) failing to document the time interval between symptom onset and death. Approximately 59% contained unclear abbreviations, while 99.7% listed multiple causes in a single line without proper sequencing. Only 2% followed a causal sequence as: immediate, antecedent, and UCOD. Additionally, inaccurately reported cardiopulmonary arrest as the UCOD in HMIS.

CONCLUSIONS: Hospital death certification remains critically substandard, undermining mortality data quality. Prioritizing WHO’s MCCoD implementation and clinician training would significantly improve accuracy, supporting SDG targets for reliable cause of death reporting.

PMID:41319064 | DOI:10.33314/jnhrc.v23i02.4689

J Nepal Health Res Counc. 2025 Oct 17;23(2):274-281. doi: 10.33314/jnhrc.v23i02.4905.

ABSTRACT

BACKGROUND: Maternal satisfaction is higher in the midwife-led model than in other models of maternity care. The objective of this study was to compare maternal satisfaction with childbirth services, receiving care in the birthing center, and the labor room.

METHODS: A cross-sectional descriptive comparative research design was used for the study to compare the satisfaction of 70 postnatal mothers delivered in the birthing center (midwifery-led model) with 70 postnatal mothers delivered in the labor room (obstetrician-led model) of Paropakar Maternity and Women’s Hospital. The study population comprised postnatal mothers with normal deliveries, selected using non-probability purposive sampling technique. Data were collected using a pretested structured interview.

RESULTS: The median satisfaction score of the respondents delivered in the birthing center is higher (96.88%) than in the labor room (77.66%) with a statistical significant (p-value <0.001).

CONCLUSIONS: Almost all the mothers who delivered their newborns at the birthing center were more satisfied with the childbirth services provided by midwives compared with the services provided in the labor room led by other healthcare providers. Therefore, the midwifery-led model should be expanded to improve maternal satisfaction with the childbirth service.

PMID:41319061 | DOI:10.33314/jnhrc.v23i02.4905