Nevin Manimala

J Nepal Health Res Counc. 2024 Mar 22;21(3):514-522. doi: 10.33314/jnhrc.v21i3.4991.

ABSTRACT

BACKGROUND: Sexual dysfunctions including erectile dysfunction among men, a widespread sexual health issue, pose challenges to sexual satisfaction. This cross-sectional study aimed to assess the prevalence and determinants of sexual dysfunctions in both diabetic and non-diabetic individuals aged 30-70.

METHODS: A study at Tribhuvan University Teaching Hospital in Kathmandu, Nepal, surveyed 350 participants (176 men, 174 women), aged 30-70, with 52.6% having diabetes. The structured interviews and validated questionnaires like IIEF-5 for men and FSFI-6 for women to assess the prevalence and factors associated with erectile dysfunction were used. Statistical tools were employed to measure the associations of different variables with Sexual dysfunctions.

RESULTS: Overall, the prevalence of sexual dysfunction was 73.7% (95% CI: 72.4- 73.7) with higher rates in men 83.9% (95% CI: 83.1- 84.7) than women 63.6% (95% CI: 62.0 – 65.2). Individuals with diabetes experienced an 81.5% prevalence of sexual dysfunction (95% CI: 80.6-82.4), whereas non-diabetic individuals exhibited a 65.1% prevalence (95% CI: 63.5-66.7). In the diabetic male population, the prevalence of sexual dysfunction was 97.5% (95% CI: 97.4-97.6), while diabetic females had a prevalence of 68.9% (95% CI: 67.5-70.3). Among non-diabetic men, the percentage of erectile dysfunction was 72% (95% CI: 70.7-73.3), and among non-diabetic women, sexual dysfunction remained 56.2% (95% CI: 54.4-58.0). Among individuals with diabetes, those who used tobacco exhibited a sexual dysfunction prevalence of 93.8% (95% CI: 93.5-94.1), while non-tobacco users had a prevalence of 74.8% (95% CI: 73.6-76.0). In non-diabetic individuals, obesity was associated with a higher prevalence of sexual dysfunctions, reaching 84.6% (95% CI: 83.8-84.6). High blood pressure showed a strong association with sexual dysfunctions in both diabetic (83% with 95% CI: 81.9-83.4) and non-diabetic (70% with 95% CI: 67.7-70.1) groups. Individuals with diabetes for more than five years had a higher rate of sexual dysfunction as 87.8% (95% CI: 86.6-89.0) with 100% in men and 79% in women. However, there was no significant difference in the prevalence of sexual dysfunctions related to obesity and alcohol consumption between diabetics and non-diabetics.

CONCLUSIONS: The research highlights a noteworthy association of sexual dysfunctions with individuals with diabetes, male sex, tobacco use, and hypertension. The observed high prevalence of sexual dysfunctions in both diabetic and non diabetic people is a public health concern, emphasizing the need for culturally tailored approaches to address the sexual health of the affected individuals.

PMID:38615226 | DOI:10.33314/jnhrc.v21i3.4991

J Nepal Health Res Counc. 2024 Mar 22;21(3):498-504. doi: 10.33314/jnhrc.v21i3.4797.

ABSTRACT

BACKGROUND: Health Promotion and maintenance are fundamental prerequisites to achieve optimum health in an individual and limit the illness. The objective of the study was to assess the health promoting behaviors among adolescents at selected schools.

METHODS: A descriptive cross-sectional study was conducted among 238 adolescents age 14-18 years of age studying in three different government schools of Bharatpur-10 Chitwan. Probability simple random method was used for selecting the required respondent. Data were collected using Adolescents Health Promoting Scale questionnaire through self-administered technique. Obtained data were analyzed using descriptive and inferential statistics.

RESULTS: The study revealed that 47.5% had high level of health promoting behaviors whereas 52.5% had low level of health promoting behavior. Regarding, the subscale, the highest score was obtained in the area of exercise (median percentage=72.5%) and lowest score was obtained in the area of stress management (median percentage=48%). Moreover, statistically significant variables for health promoting behavior were respondents age, availability of school health nurse, educational status of both the parents and and occupation of father (p<0.05).

CONCLUSIONS: More than half of the adolescents in schools have low health promoting behavior, particularly in the area of stress management and nutrition. Adolescence is the period when most of the healthy and unhealthy habits are developed. Hence, it is necessary to focus on developing efficient health promotion and disease prevention strategies in collaboration with school teachers and school health nurse.

PMID:38615224 | DOI:10.33314/jnhrc.v21i3.4797

J Nepal Health Res Counc. 2024 Mar 22;21(3):486-490. doi: 10.33314/jnhrc.v21i3.4752.

ABSTRACT

BACKGROUND: Facial growth and development is necessary for proper orthodontic diagnosis and treatment planning. Growth of cranial base is linked to the overall growth of facial bones, especially the maxilla and mandible. Any change in the amount and direction of growth of the cranial base can have direct or indirect effects on the developing maxilla and mandible. Thus the aim of this study was to determine the linear and angular cranial base measurements in different skeletal malocclusion in Nepalese population.

METHODS: Pretreatment lateral cephalograms of 225 patients aged between 17-30 years were collected. Linear measurements Sella-Nasion (S-N), Sella-Articulare (S-Ar), Articulare-Gonion (Ar-Go), Gonion-Gnathion (Go-Gn) and angular measurements Saddle angle (N-S-Ar), Articular angle (S-Ar-Go) and Gonial angle (Ar-Go-Gn) were measured.

RESULTS: In angular measurements statistically significant differences were found in the saddle and gonial angles between class I, II, and III skeletal pattern. In linear measurements, anterior and posterior cranial base lengths were not significantly different among groups however, ramal height and mandibular body length were significantly different among groups with a P value < 0.05.

CONCLUSIONS: Skeletal class III has a larger gonial angle, ramal height and mandibular length. Males have larger linear measurements and females have larger angular measurements.

PMID:38615222 | DOI:10.33314/jnhrc.v21i3.4752

J Nepal Health Res Counc. 2024 Mar 22;21(3):463-466. doi: 10.33314/jnhrc.v21i3.4707.

ABSTRACT

BACKGROUND: Mandibular canines are recognized as usually having one root and one root canal in most cases. However, many investigators have reported the anatomical variations associated with mandibular canines. Thus; the objective of this study is to determine the number of roots and morphology of the root canal system of permanent mandibular canine in a Nepalese population.

METHODS: Cone Beam Computerized Tomography images of 390 patients in a Nepalese population were selected, and a total of 780 mandibular canines were analyzed. The number of root and the canal configurations were investigated. Data were analyzed with descriptive analysis and Chi-square tests using the Statistical Package for the Social Sciences (SPSS) software version 20 (SPSS Inc, Chicago, IL, USA).

RESULTS: Out of the 780 mandibular canines, 741(95%) were single-rooted canines while only 39 (5%) were double-rooted canines. The most common type of Vertucci in single-rooted canines was Type I (1-1) in the percentage of 85.6% and the least type was Type IV (1-2) in the percentage of (2.5%). The Chi-square tests showed no significant association between gender and number of roots (P = 0.87) and gender and root canal configuration in single-rooted canine (P = 0.52).

CONCLUSIONS: All mandibular permanent canines were single rooted but 5.2% of the permanent mandibular canines had two roots.

PMID:38615218 | DOI:10.33314/jnhrc.v21i3.4707

J Nepal Health Res Counc. 2024 Mar 22;21(3):458-462.

ABSTRACT

BACKGROUND: Dacryocystorhinostomy surgery aims to treat nasolacrimal duct obstruction and are often performed by general ophthalmologists in developing countries. The aim of this study is to estimate the clinical burden, surgeon’s experience, and outcome of dacryocystorhinostomy surgery.

METHODS: A cross-sectional survey of Nepalese Ophthalmologists registered with the Nepal Ophthalmic Society was conducted after ethical clearance from Nepal Health Research Council. The survey form consisted of a single mail-shot questionnaire information including the age and experience, average case per month, and participant-reported post-operative complications and failures. Data were entered onto Microsoft excel (Microsoft Corp) and analyzed using SPSS 22.0. The data were presented in graphical and tabular format and appropriate statistical tools were employed for the analysis.

RESULTS: Out of 300 practicing ophthalmologist, 135 (45%) comprising male 60 (44.4%) and female 75(55.6%) responded to the survey. Majority of respondents were general ophthalmologists (37 ,41.6%) followed by oculoplastic surgeons (27,30.3%) and other subspecialties (25,28.1%). More than 70% respondents perform 1-10 surgeries /month and only 3% perform >50 surgeries /month. The success rate of 75-90% was reported by 45(50%) respondents whereas > 90% success rate by 41 (46.1%). More than 80% surgeons experienced an infection rate of <1% regardless of the intubation status.

CONCLUSIONS: This survey revealed huge differences in surgery practice patterns among ophthalmologists in Nepal. The surgical success rate and post-operative infection rate depends upon surgeon experience. Moreover, uniform surgery protocols and training budding ophthalmologists/ young Oculoplastic surgeons in the best modern dacryocystorhinostomy surgery are required.

PMID:38615217

J Nepal Health Res Counc. 2024 Mar 22;21(3):445-449.

ABSTRACT

BACKGROUND: Suicide is an emerging public health problem accounting for over 700,000 annual deaths globally. It is also the fourth leading cause of death among the age group 15-29 years in the world. In Nepal, on average 14 people commit suicide every day. Our study explores the factors associated with suicidal and self-harm behaviours among young adults in the Kathmandu district, Nepal.

METHODS: A descriptive cross-sectional study was conducted among a total of 242 young adults of the Kathmandu district. Data were collected through interview using a developed semi-structured questionnaire. Descriptive statistics and odds ratios were used for data analysis.

RESULTS: The mean age for initial suicidal and self-harm behaviour was found to be 14 and 15 years respectively, with 28.51% reporting suicidal behaviours including making a plan or suicidal ideation or attempts, and 18.5% with self-harm behaviours. Avoidance and emotional discharge were found as common coping strategies adopted by participants. Belief, family functioning, depression status and self-harm behaviour were found statistically associated with suicidal behaviour.

CONCLUSIONS: Various factors including belief, family functioning, and depression were found to influence individual suicidal behaviour. Hence, an integrated approach addressing these factors is crucial for the prevention and control of suicide among young adults at risk.

PMID:38615215

J Nepal Health Res Counc. 2024 Mar 22;21(3):417-427. doi: 10.33314/jnhrc.v21i3.4538.

ABSTRACT

BACKGROUND: Tumour budding Tuberculosis is a new prognostic marker whose role in breast cancer is still under evaluation. Our aim was to study Tuberculosis in breast carcinoma and correlate it with other prognostic markers.

METHODS: A descriptive cross-sectional study was conducted over 2 years on 75 invasive breast carcinoma specimens and biopsies. Hematoxylin and Eosin sections were examined for tumour grade, stage, molecular subtype, necrosis, lymphovascular invasion inflammation and counting of Tuberculosis. Lymph node metastasis was studied only in mastectomies. TB was defined as a cluster of 1-5 tumour cells and counted in 10 consecutive 400X fields. The cut-off for high grade TB was taken as ?10 per 10 HPFs. Immunohistochemical staining was done for molecular subtyping and differentiating Tuberculosis from mimickers. Statistical analysis was done using chi square test and Fischer’s exact test.

RESULTS: Tuberculosis was present in 66/75 cases; 53% (n=35) were high grade. Among these, majority were of T2 (74%, n= 26), grade 2 (52%, n= 18), luminal A (34%, n= 12), had 3+ inflammation (46%, n= 16) and peripheral tumour buds (54%). Necrosis and lymphovascular invasion were absent in 77% and 71%, respectively. Lymph node metastasis was seen in 63% (n= 25/28) cases. Statistically significant association (p= 0.016) was observed between degree of inflammation and Tuberculosis grade. However, no significant association was observed between TB and other prognostic markers of breast carcinoma.

CONCLUSIONS: In our study, association of Tuberculosis with different prognostic markers was appreciated but was not statistically significant. However, it highlights need for standardization of Tuberculosis reporting.

PMID:38615212 | DOI:10.33314/jnhrc.v21i3.4538

J Nepal Health Res Counc. 2024 Mar 22;21(3):400-409. doi: 10.33314/jnhrc.v21i3.4471.

ABSTRACT

BACKGROUND: Video-demonstrated action-observation-execution is an effective intervention for motor re-learning in stroke rehabilitation. But customization of video for each task repeatedly questions its feasibility within limited resources, particularly for daily routine practice and in community settings. Physiotherapist-demonstrated action-observation-execution is a practical intervention based on the principle of observation and consecutive repetitions of observed real, live movements. The main objective of this study was to investigate the immediate effect of Physiotherapist-demonstrated action-observation-execution in upper extremity motor training in stroke.

METHODS: Individuals with stroke were screened and 5 eligible participants were recruited. The research was a pre-post. A single session of Physiotherapist-demonstrated action-observation-execution was administered. A functional “Drinking” task was subdivided into simpler acts and trained. Pre and post intervention assessment of movement time using five hand-and-arm items of Nepali Wolf Motor Function Test were carried out. Global recovery was assessed in the form of Visual Analogue Scale.

RESULTS: Paired t-test provided statistically significant difference in total movement time (mean difference=5.04 seconds, standard deviation=1.92, p=0.004) with larger effect size (0.95) indicating impressive improvement in movement time with the training. Substantial difference in global recovery score was noted (mean difference=17.40, standard deviation=3.65, p<0.0001, effect size=1.00) signifying the increased confidence and improved performance of upper extremity post treatment.

CONCLUSIONS: The findings indicated that Physiotherapist-demonstrated action-observation-execution could be a feasible intervention to train motor functions in participants with stroke. Large-scale studies are recommended to establish the effectiveness of the intervention.

PMID:38615210 | DOI:10.33314/jnhrc.v21i3.4471

J Nepal Health Res Counc. 2024 Mar 22;21(3):393-399. doi: 10.33314/jnhrc.v21i3.4447.

ABSTRACT

BACKGROUND: Understanding spirituality and spiritual care is a prerequisite for holistic care in nursing. Spirituality is an important dimension of human existence with a crucial role in health promotion. The objective of this study was to assess the level of attitude towards spirituality and spiritual care among nurses.

METHODS: A cross-sectional analytical study design was used among 208 nurses to assess attitude toward spirituality and spiritual care among nurses of Bharatpur Hospital. A pretested semi-structured, self-administered questionnaire was used to collect data from the respondents. The instrument spirituality and spiritual care rating scales were used. Collected data were coded and entered in Microsoft office excel and SPSS version 22 was used for analysis.

RESULTS: The finding of the study revealed that, out of 208 respondents, the majority (74.0%) of respondents were of age 20-29 years with a mean and SD of 28.2±5.510. Among all, 125(60.1%) respondents had a moderate attitude score of 32-62, 83(39.9%) had a high level of attitude score of 63-92, whereas 0.5% had a low level of attitude towards spirituality and spiritual care score (0-31).There is no statistically significant relationship between the level of attitude and socio-demographic variables.

CONCLUSIONS: It is concluded that most of the respondents had a moderate level of attitude. In-service education and awareness on providing spiritual care among nurses needs to be focused.

PMID:38615209 | DOI:10.33314/jnhrc.v21i3.4447

J Nepal Health Res Counc. 2024 Mar 22;21(3):366-372. doi: 10.33314/jnhrc.v21i3.4073.

ABSTRACT

BACKGROUND: While the advanced health care settings are struggling hard to handle the sudden surge of COVID-19 cases, resource poor settings in developing countries like Nepal can barely stand to fight the increasing number of severe cases. Easily available cost effective interventions would be great blessing for such settings. This study aimed to study if awake prone positioning can be used as such intervention in COVID 19.

METHODS: The retrospective study involved 150 patients admitted between November 2020 and January 2021 at Nepal Armed Police Force Hospital and met specific inclusion criteria. Data was obtained at four different time points in relation to prone position and was analysed using International Business Machines Statistical Package for the Social Sciences (SPSS) version 23.

RESULTS: It was found that among 150 patients, majority (109; 72.7%) were males and 60(40%) had some comorbidities. The mean oxygen saturation was found to increase significantly from 87.18 %(SD 3.531) to 91.08(SD 2.206) after fifteen minutes of prone positioning. One way ANOVA test showed that there was significant difference in oxygen saturation between at least two time points. (F (3,596) = [180.005], p=0.000). Games Howell Post Hoc test for multiple comparisons showed that the mean value of SPO-2 was significantly different across all four time points, at significance level 0.05.

CONCLUSIONS: This study found Awake Prone positioning as a promising cost effective and feasible intervention for improving oxygenation in COVID 19 and thus could be a blessing to the resource poor health care settings.

PMID:38615205 | DOI:10.33314/jnhrc.v21i3.4073