Tag: nevin manimala

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

Br J Educ Psychol. 2025 Nov 30. doi: 10.1111/bjep.70050. Online ahead of print.

ABSTRACT

BACKGROUND: Youth with neurodevelopmental disorders are at risk for school failure, but little is known about the contextual factors influencing academic achievement.

AIMS: Drawing on a bioecological system framework, we examined how ADHD and autism, parental educational attainment and aspects of the parent-child relationship influence educational achievement at the end of primary school, and to what extent these factors have independent as opposed to interactive effects on educational achievement.

SAMPLE: A total of 12,477 twins born 1994-2005 from Sweden.

METHODS: ADHD and autism were assessed at age nine with a structured telephone interview with parents. Among participants, n = 996 and n = 249 met screening criteria for ADHD and autism, respectively. At age 15, data on parent-child relationships and parental educational attainment were gathered. Children’s school grades and eligibility for upper secondary school were obtained from a register, and used as main outcome measures. Multiple regression models with interaction terms were used to explore if the effects of family-related factors differed in students with or without ADHD or autism.

RESULTS: ADHD or autism was associated with low academic achievement, as were all the family-related variables in multiple regression models (all p < .005). However, there was no statistical evidence (all p > .005) that the influence of family-related variables differed (i.e., were either less or more important in the prediction of educational achievement) in students with or without ADHD or autism.

CONCLUSIONS: Results were in keeping with a bioecological model of non-interacting multiple risks for educational underachievement in students with ADHD and/or autism.

PMID:41319052 | DOI:10.1111/bjep.70050

Brief Bioinform. 2025 Nov 1;26(6):bbaf634. doi: 10.1093/bib/bbaf634.

ABSTRACT

Enhancer-enhancer interactions (EEIs) are critical regulatory components in transcriptional networks but remain computationally challenging to predict. While enhancer-promoter interactions have been extensively studied, EEIs remain comparatively underexplored. We developed ETNet (Enhancer-enhancer Interaction Explainable Transformer Network), a deep learning architecture integrating convolutional neural networks with Transformer modules to predict EEIs from DNA sequences. Evaluation across three cell lines (GM12878, K562, MCF-7) demonstrated superior performance compared to existing methods including EnContact, with statistical significance confirmed through DeLong tests across six cell lines. Rigorous validation through cross-validation and enhancer-level data partitioning confirmed robust generalization. ETNet exhibited effective cross-cell type transfer learning and showed transferability to enhancer-promoter interaction tasks, providing exploratory evidence for shared chromatin interaction principles. Feature attribution analysis recovered cell-type-specific regulatory motifs consistent with known transcription factors and revealed computational evidence for super-additive cooperative mechanisms, with cooperativity negatively correlating with sequence similarity-patterns representing hypothesis-generating observations requiring experimental validation. Proof-of-concept analysis demonstrated how single-nucleotide polymorphisms in JAK-STAT pathway genes may influence predicted interactions through motif alterations. ETNet advances computational approaches for studying enhancer interactions and provides a framework combining predictive capability with exploratory interpretability.

PMID:41319043 | DOI:10.1093/bib/bbaf634

Clin Transl Allergy. 2025 Dec;15(12):e70130. doi: 10.1002/clt2.70130.

ABSTRACT

BACKGROUND: Chat Generative Pre-Trained Transformer 4 (ChatGPT-4) represents an advancing large language model (LLM) with potential applications in medical education and patient care. While Allergen Immunotherapy (AIT) can change the course of allergic diseases, it can also bring uncertainty to patients, who turn to readily available resources such as ChatGPT-4 to address these doubts. This study aimed to use validated tools to evaluate the information provided by ChatGPT-4 regarding AIT in terms of quality, reliability, and readability.

METHODS: In accordance with EAACI clinical guidelines about AIT, 24 questions were selected and introduced in ChatGPT-4. Independent reviewers evaluated ChatGPT-4 responses using three validated tools: the DISCERN instrument (quality), JAMA Benchmark criteria (reliability), and Flesch-Kincaid Readability Tests (readability). Descriptive statistics summarized findings across categories.

RESULTS: ChatGPT-4 responses were generally rated as “fair quality” on DISCERN, with strengths in classification/formulations and special populations. Notably, the tool provided good-quality responses on the preventive effects of AIT in children and premedication to reduce adverse reactions. However, JAMA Benchmark scores consistently indicated “insufficient information” (median = 0-1), primarily due to absent authorship, attribution, disclosure, and currency. Readability analyses revealed a college graduate-level requirement, with most responses classified as “very difficult” to understand. Overall, ChatGPT-4 demonstrated fair quality, insufficient reliability, and difficult readability for patients.

CONCLUSIONS: ChatGPT-4 provides generally well-structured responses on AIT but lacks reliability and readability for clinical or patient-directed use. Until specialized, reference-based models are developed, healthcare professionals should supervise its use, particularly in sensitive areas such as dosing and safety.

PMID:41319041 | DOI:10.1002/clt2.70130