Tag: nevin manimala

J Nepal Health Res Counc. 2024 Dec 20;22(3):543-548. doi: 10.33314/jnhrc.v22i03.5055.

ABSTRACT

BACKGROUNDS: Eye donation is an act of donating, one’s eyes, mostly the cornea after his/her death. According to World Health Organization (WHO) estimates every 5 second, someone goes blind. There are currently about 45 million blind people in the world which increases by 1 to 2 million every year. The study aimed to identify and explore the awareness of eye donation among university students in Morang, Nepal.

METHODS: A descriptive cross-sectional study was conducted on Undergraduate Students of Purbanchal University School of Health Sciences a constituent college of Purbanchal University situated in Sundarharaicha Municipality of Morang District of Nepal. Population proportionate simple random sampling technique was applied to allocate the sample size.

RESULTS: Among the total of 177 respondents, 22.0% are from the Pharmacy faculty, 22.6% from Public Health, and 55.4% from Nursing. Out of the total respondents, 98.9% were aware of eye donation, while only 1.1% had no awareness. About 86.9%, of the respondents correctly identified the cornea as a donatable part. However, a smaller percentage mentioned the retina (4.0%), eye ball (6.9%), and lens (2.3%).

CONCLUSIONS: The findings of the study on awareness of eye donation suggest the need for targeted educational interventions to enhance understanding the parts of eye for donation and avoiding the misconceptions about various aspects of eye donation among Health Sciences students.

PMID:39923167 | DOI:10.33314/jnhrc.v22i03.5055

J Nepal Health Res Counc. 2024 Dec 20;22(3):527-536. doi: 10.33314/jnhrc.v22i03.4937.

ABSTRACT

BACKGROUND: Self-management behaviour is crucial for halting the progression of the disease and preventing exacerbations and hospitalizations in patients with chronic obstructive pulmonary diseases. Hence, this study aimed to assess self-care practice among patients with chronic obstructive pulmonary diseases attending at a teaching hospital.

METHODS: Cross-sectional study was carried out among 106 patients who were diagnosed to have Chronic Obstructive Pulmonary Diseases and attending at respiratory and critical care medicine department of Chitwan Medical College Teaching Hospital. Convenience sampling technique was used to select 106 samples for the study. Structured interview schedule and observation checklist were used to collect the data. Data analysis was performed in SPSS version 23 for window using descriptive and inferential statistics.

RESULTS: The finding of this study revealed that 50.0% of patients with Chronic Obstructive Pulmonary Diseases had high and 50.0% had low self-care practice. Only 5.7% were using inhaler correctly whereas 94.3% of patients were using inhaler incorrectly, Furthermore, marital status, ethnicity and level of depression were found to be the significant factors associated with self-care practice of the patients.

CONCLUSIONS: Half of the patients with chronic obstructive pulmonary diseases have low self-care practice whereas almost all are using inhaler incorrectly. Hence, self-management intervention program is needed for the patients with chronic obstructive pulmonary diseases to enhance their knowledge and skill on self-care practice including inhaler use.

PMID:39923165 | DOI:10.33314/jnhrc.v22i03.4937

J Nepal Health Res Counc. 2024 Dec 19;22(3):484-493. doi: 10.33314/jnhrc.v22i03.4744.

ABSTRACT

BACKGROUND: Consumption of junk food degrades the health status of people and is associated with low consumption of nutritious foods, which are essential for physical and mental growth. This study was carried out to find out the junk food consumption and its associated factors among young children.

METHODS: A cross-sectional study was conducted among 352 school going children aged 5 to 9 years in Pokhara Metropolitan. Face to face interviews were done with one of the parents of the selected children with the help of a structured questionnaire. The study was done from March to October, 2020. Three or more consumption per week was categorized as high consumption of junk food. A descriptive and multivariate statistical analysis was performed. All inferential analyses were conducted at a 5% level of significance. Ethical approval was taken from the Nepal Health Research Council.

RESULTS: Among the study participants, 70.7% consumed junk food three or more times per week; 66.5% energy dense food, 20.7% consumed noodles; and 9.7% sugary drinks. Consumption of junk food was associated with presence of conventional shop near home,ways type of food provision at school and, food at home after school. Consumption of junk food was found higher among those who got money for food at school (AOR, 2.31), and those who took snacks at home after school (AOR, 12.86).

CONCLUSIONS: Consumption of junk food among young children was remarkably high in the study area; concerned authorities should pay attention to dissociating such foods through policies and programs.

PMID:39923160 | DOI:10.33314/jnhrc.v22i03.4744

J Nepal Health Res Counc. 2024 Dec 19;22(3):470-476. doi: 10.33314/jnhrc.v22i03.4616.

ABSTRACT

BACKGROUND: Acute kidney Injury associated with Coronavirus disease COVID-19 appeared to negatively influence clinical outcomes and is found to be associated with significant risk of death. This retrospective study aimed to describe the incidence of Acute Kidney Injury, its associations with clinical characteristics and outcomes among COVID-19 patients in Sukraraj Tropical and Infectious Disease Hospital, a tertiary infectious disease hospital in Nepal.

METHODS: A cross-sectional study was done where. Medical and lab records of reverse transcriptase Polymerase chain reaction positive COVID-19 inpatients, admitted between April 2021 to July 2021 were reviewed. It represented the second wave of wave of coronavirus pandemic caused by the delta strain. Patients aged less than 18 years, pregnant females and patients with known chronic kidney disease were excluded Results: Of 393 admissions, 83 (21.1%) patients developed Acute Kidney Injury. Characteristics found to have significant association with development of AKI was age (p <0.001), multiple co morbidities (2 or more) (p <0.001), use of mechanical ventilation (p <0.001), lymphopenia (p<0.001), Neutrophil to Lymphocyte Ratio (p =0.001) and d-dimer levels (p <0.001). Mortality was found to be significantly higher in COVID-19 patients with AKI compared to COVID-19 patients without AKI ((36.14% vs 15.8%, p value <0.01)). The median duration of hospital stay for patients with AKI was higher than for patients without AKI (10 days vs 6 days,p <0.01).

CONCLUSIONS: AKI develops in a sizeable percentage of patients with COVID-19 and is significantly associated with increasing age, multiple comorbidities, increased biomarkers, use of mechanical ventilation and is associated with poor outcome in terms of mortality and morbidity.

PMID:39923158 | DOI:10.33314/jnhrc.v22i03.4616

J Nepal Health Res Counc. 2024 Dec 19;22(3):464-469. doi: 10.33314/jnhrc.v22i03.4604.

ABSTRACT

BACKGROUND: The fear of childbirth is the feeling of fearfulness, anxiety or worry among women in relation to pregnancy and childbirth process which influence their experience of childbirth which is the subjective feeling of sadness or joyfulness regarding childbirth. The main objective of the study was to identify the relationship between fear and experience of childbirth among primiparous women.

METHODS: A descriptive cross-sectional study was done where non probability, purposive sampling technique was used to select a sample of 133 primiparous women attending Paropakar Maternity and Woman’s Hospital having term pregnancy (37-42 weeks of gestation) without any complications and willing to participate in the study. Data were collected through interview technique. Fear of childbirth was assessed by using standard Wijma Delivery Expectancy/ Experience Questionnaire (WDEQ) and experience of childbirth was assessed by using Childbirth Experiences Questionnaire (CEQ). Data analysis was done by using descriptive statistics like frequency, mean, percentage and standard deviation and inferential statistics i.e. Pearson’s correlation and chi square test in Statistical Package for Social Sciences version 16.

RESULTS: The study revealed that fear and experience of childbirth were negatively correlated (r= -0.254). The majority of the respondents (64.7%) had a moderate level of fear of childbirth. Most of the respondents (80.5%) had a positive experience of childbirth.

CONCLUSIONS: This study concludes that there is negative relationship between the fear of childbirth and its experience. Women having higher fear of childbirth have less positive experience of childbirth.

PMID:39923157 | DOI:10.33314/jnhrc.v22i03.4604

Eur J Pain. 2025 Mar;29(3):e4795. doi: 10.1002/ejp.4795.

ABSTRACT

BACKGROUND: Observer pain scales are commonly used to assess pain in individuals with impaired cognition. However, nursing staff have highlighted that extremely tight time schedules and increasing workload demands prevent regular use. With the development of a short version of the Pain Assessment in Impaired Cognition (PAIC15), we aimed to reduce implementation barriers in everyday clinical practice.

METHODS: We developed a new 6-item short version (PAIC6) in a first sample (N = 59) and validated its psychometric properties in a second sample (N = 250) of older individuals with cognitive impairments. The item reduction and evaluation involved four steps. First, we used Sample 1 to exclude items based on item quality statistics (e.g., difficulty, reliability). Second, the Partial Credit Model (PCM) was utilised for further reduction using again Sample 1. Third, an expert panel evaluated the preceding steps and suggested a draft short version with six items (PAIC6). Fourth, psychometric properties of the short version were evaluated in the independent Sample 2. Thereafter, the final short version was approved.

RESULTS: The new PAIC6 showed a high correlation with the total scale PAIC15 (r = 0.870), good reliability (Cronbach’s α = 0.684), and high convergent construct validity, as observed by a high correlation with the established Pain Assessment in Advanced Dementia (r = 0.602).

CONCLUSIONS: Overall, we developed a valid, reliable, and clinically valuable PAIC6 that allows a more time-efficient pain assessment, by reducing the assessment time from 5 min to approximately 2 min (60% time saving).

SIGNIFICANCE: Observer pain scales are commonly used to assess pain in individuals with impaired cognition. However, nursing staff have highlighted that extremely tight time schedules and increasing workload demands prevent regular use. To address this, we developed PAIC6, a short version of the Pain Assessment in Impaired Cognition 15 (PAIC15). PAIC6 includes six items and takes 2 min for completion after training, realising a 60%-time reduction compared to the original scale while keeping the psychometric quality high.

PMID:39923123 | DOI:10.1002/ejp.4795

J Clin Anesth. 2025 Feb 7;102:111770. doi: 10.1016/j.jclinane.2025.111770. Online ahead of print.

ABSTRACT

BACKGROUND: Electroencephalogram oscillations during general anesthesia may change as a function of cognitive and physical health. This study aimed to characterize associations between anesthesia-induced oscillations and postoperative outcomes in cardiac surgery patients over 60 years.

METHODS: This was a prespecified secondary data analysis from the Minimizing Intensive Care Unit Dysfunction with Dexmedetomidine-induced Sleep (MINDDS) study. Participants were admitted from home for elective cardiac surgery with cardiopulmonary bypass. The primary outcome was postoperative delirium obtained using the Confusion Assessment Method. Secondary outcomes were non-home discharge and 30-day readmission. The exposure of interest was alpha power measured during the maintenance phase of isoflurane-general anesthesia. Confounding cognitive and physical health variables were collected.

RESULTS: Of 394 participants in the MINDDS study, 302 had analyzable electroencephalograms. The incidence of postoperative delirium was 11.1 %. Odds of postoperative delirium decreased by 14 % for every decibel increase in alpha power (OR 0.86, 95 % CI: 0.78 to 0.95; P = 0.004). This finding was not significant in adjusted analysis (OR_adj 0.92, 95 % CI: 0.81 to 1.03; P = 0.154). Non-home discharge setting findings were not associated with alpha power. The odds of 30-day readmission decreased by 20 % for every decibel increase in alpha power (OR_adj 0.80, 95 % CI: 0.71 to 0.91; P < 0.001). Findings were conserved in exploratory and sensitivity analyses.

CONCLUSIONS: In this study anesthesia-induced oscillations were associated with postoperative outcomes; however, these were not independently associated with delirium or discharge disposition after considering preoperative cognitive and physical health. These oscillations were robustly associated with 30-day readmission however, which may help anesthesiologists identify high-risk patients, offering benefits beyond the operating room.

CLINICAL TRIAL REGISTRATION: Registration Number: NCT02856594.

PMID:39921932 | DOI:10.1016/j.jclinane.2025.111770

Comput Med Imaging Graph. 2025 Feb 1;121:102508. doi: 10.1016/j.compmedimag.2025.102508. Online ahead of print.

ABSTRACT

This study proposes a deep learning framework, DLPVI, which integrates projection, view-by-view backprojection (VVBP), and image domains to improve the quality of high-sparse-view and ultra-sparse-view cone-beam computed tomography (CBCT) images. The DLPVI comprises a projection domain sub-framework, a VVBP domain sub-framework, and a Transformer-based image domain model. First, full-view projections were restored from sparse-view projections via the projection domain sub-framework, then filtered and view-by-view backprojected to generate VVBP raw data. Next, the VVBP raw data was processed by the VVBP domain sub-framework to suppress residual noise and artifacts, and produce CBCT axial images. Finally, the axial images were further refined using the image domain model. The DLPVI was trained, validated, and tested on CBCT data from 163, 30, and 30 real patients respectively. Quantitative metrics including root-mean-square error (RMSE), peak signal-to-noise ratio (PSNR), structural similarity (SSIM), and feature similarity (FSIM) were calculated to evaluate the method performance. The DLPVI was compared with 15 state-of-the-art (SOTA) methods, including 2 projection domain models, 10 image domain models, and 3 projection-image dual-domain frameworks, on 1/8 high-sparse-view and 1/16 ultra-sparse-view reconstruction tasks. Statistical analysis was conducted using the Kruskal-Wallis test, followed by the post-hoc Dunn’s test. Experimental results demonstrated that the DLPVI outperformed all 15 SOTA methods for both tasks, with statistically significant improvements (p < 0.05 in Kruskal-Wallis test and p < 0.05/15 in Dunn’s test). The proposed DLPVI effectively improves the quality of high- and ultra-sparse-view CBCT images.

PMID:39921927 | DOI:10.1016/j.compmedimag.2025.102508

Leuk Res. 2025 Feb 4;150:107662. doi: 10.1016/j.leukres.2025.107662. Online ahead of print.

ABSTRACT

CMML is a heterogenous myelodysplastic/myeloproliferative neoplasm (MDS/MPN) sharing both diseases’ molecular and clinical phenotypes. Several models are used to risk-stratify patients diagnosed with CMML. Inflammation plays a pivotal role in developing the disease or its progression and has been linked to worse outcomes. Serum albumin (SA) is an inflammatory marker and/or surrogate for co-morbidities. While the role of SA has been investigated in myelodysplastic syndrome (MDS), acute myeloid leukemia (AML), multiple myeloma, and other cancers, its prognostic value in CMML remains unclear. We identified 919 patients diagnosed with CMML with known SA levels at the time of diagnosis or prior to any therapy. We divided patients into three groups based on SA levels: < 3.5 g/dL, 3.5-4.0 g/dL and > 4.0 g/dL. We then compared the baseline characteristics and outcomes of these three groups. Patients with SA < 3.5 g/dL had higher risk disease according to the CPSS-Molecular model, WHO 2022 classification, and FAB classification. Additionally, patients with SA < 3.5 g/dL had a higher median blast percentage, ferritin levels, WBC, and monocyte count (P < 0.001). These patients were also more likely to be cytopenic and RBC transfusion-dependent (RBC-TD) (P < 0.001). In multivariable Cox regression analysis, SA was independently significant for predicting overall survival (OS) after adjusting for CPSS-Molecular risk, WHO 2022 subtype, proliferative CMML (FAB classification), RBC-TD, and bi/pancytopenia. Therefore, SA is an independent prognostic factor for OS among patients with CMML. Low SA may reflect inflammatory disease status or a surrogate for co-morbidities. Risk stratification models should incorporate serum albumin levels to refine their prognostic value.

PMID:39921921 | DOI:10.1016/j.leukres.2025.107662

J Health Popul Nutr. 2025 Feb 8;44(1):36. doi: 10.1186/s41043-025-00759-9.

ABSTRACT

BACKGROUND: Hemoglobin, albumin, lymphocyte and platelet (HALP) score is derived from the counts of hemoglobin, albumin, lymphocytes, and platelets. It serves as a valuable tool for assessing both inflammation and nutritional status in critically ill patients. However, there hasn’t been a specific study exploring the role of the HALP score in critically ill patients. Additionally, whether the HALP score exhibits an incremental effect on the Sequential Organ Failure Assessment (SOFA) score remains unknown.

METHODS: In this study, we used the Medical Information Mart for Intensive Care (MIMIC-IV) version 2.2 database to evaluate the predictive value of HALP score for critically ill patients. The primary outcome investigated was intensive care unit (ICU) death, and the secondary outcomes included in-hospital mortality, ICU length of stay (LOS), hospital LOS, and 28-day mortality.

RESULTS: We analyzed 20,083 critically ill patients. In logistic regression, a low HALP score (HALP score < 3.56) showed higher risk of ICU death (adjusted odds ratio: 1.41, 95% confidence interval [CI]: 1.25 to 1.59). Additionally, the HALP score improved the predictive ability of the SOFA score (∆Area under curve: 0.009, p < 0.001). In Cox proportional hazards models, a low HALP score (HALP score < 3.2) was also associated with a higher risk of 28-day mortality (adjusted hazard ratio: 1.52, 95% CI: 1.33 to 1.74).

CONCLUSION: HALP score is associated with short-term mortality. Additionally, HALP score showed an incremental effect on SOFA score in predicting short-term mortality.

PMID:39923110 | DOI:10.1186/s41043-025-00759-9