Tag: nevin manimala

J Nepal Health Res Counc. 2023 Mar 10;20(3):779-785. doi: 10.33314/jnhrc.v20i3.3952.

ABSTRACT

BACKGROUND: Antenatal care is medical supervision and care given to pregnant women to ensure, support and maintain maternal and fetal well-being throughout the pregnancy. Therefore, this study was done to find out the utilization of antenatal services among postnatal mothers.

METHODS: The descriptive cross sectional study design was used to identify the utilization of antenatal services among postnatal mothers who came in Maternal and Child Health Clinic for the immunization of baby. Total 367 postnatal mothers within one year of childbirth were recruited by simple random sampling technique, and data was collected with face-to-face interview by using semi structured interview schedule. Analysis was done by using descriptive and inferential statistics.

RESULTS: All postnatal mothers consumed iron and folic acid during pregnancy, 96.2% consumed until the childbirth, 94.0% got freely, 97.0% taken anti helminths drug, 98.1% did urine test, 98.1% did blood test, 97.8% got ultrasound service, and 96.5% received Td vaccine. Likewise, higher proportion had checked weight 98.6% and lower proportion had checked height 86.9%. Similarly, majority 90.2% received counselling on danger signs and only 26.2% received the counselling on preparation of items safe delivery and care of newborns. There is significant association of antenatal care service utilization with postnatal mothers’ educational level and her husband’s occupation (P<0.05 level).

CONCLUSIONS: Although most of the postnatal mothers utilized antenatal care services, some aspect of antenatal education and counselling need to be improved such as preparation of item for delivery and new born care, finance, and blood donors.

PMID:36974874 | DOI:10.33314/jnhrc.v20i3.3952

J Nepal Health Res Counc. 2023 Mar 10;20(3):750-754. doi: 10.33314/jnhrc.v20i3.4366.

ABSTRACT

BACKGROUND: Solefinacin and Tolterodine are new generation antimuscarinics claimed to have bladder specific action and less adverse effect like dry mouth. The objective of the study was to compare the improvement in urinary symptoms among patients using solefinacin and tolterodine with overactive bladder symptoms.

METHODS: A hospital based cross-sectional comparative study was done for one year duration. All patients with overactive bladder symptoms were included and in every alternate patient’s solefinacin and tolterodine were given after taking note of baseline OAB symptoms, PPBC score and UPS score. Participants were followed up after one month and noted improvement in endpoint OAB symptoms. Comparison of baseline to end-point symptoms changes among each group of participants were analyzed for statistical significance.

RESULTS: Among 101 participants included in the study, 49 participants were in solefinacin group and 52 participants were in tolterodine group. The end-point comparison of urgency symptoms were improved by 20.1±6.76 (mean ± SD) units in solefinacin group and by 17.0 ± 9.18 units in tolterodine group. Urgency perception score improved to 2.1±0.66 for patients under solefinacin and 2±0.73 for tolterodine. Patient perception of bladder condition (PPBC) showed improvement in solefinacin group by 3.2±1.26 units and in tolteradine by 2.8±1.54 units (p = 0.165). Comparing the patient’s perception of treatment outcome, massive improvement was reported by 81.6% of those receiving Solefinacinand 65.4% receiving tolterodine, though not statistically significant ( p = 0.131).

CONCLUSIONS: Solefinacin and Tolterodine showed improvement in urinary symptoms, UPS and PPBC. Both showed comparable efficacy without significant superiority over one another.

PMID:36974869 | DOI:10.33314/jnhrc.v20i3.4366

J Nepal Health Res Counc. 2023 Mar 10;20(3):746-749. doi: 10.33314/jnhrc.v20i3.4408.

ABSTRACT

BACKGROUND: Alopecia Areata is a common non scarring alopecia with autoimmune etiology. In several previous studies, an insufficient level of 25 hydroxyvitamin D had been correlated with various autoimmune diseases. The current study aimed to determine the level of serum 25 hydroxyvitamin D in patients with alopecia areata.

METHODS: A cross-sectional study was conducted on 35 patients with alopecia areata who visited the outpatient department of Dermatology of KIST Medical College and Teaching Hospital, Nepal. A prior approval of the institute review committee was taken. Convenience sampling technique period for 3 months (March 2022-May 2022) was used to include the participants (informed consent was taken; in minors parental consent was prepared). The serum levels of 25 hydroxyvitamin D was estimated using Abbott Architect i1000 SR analyser.

RESULT: In this study, Alopecia Areata was common in the age group of 16-30 years (Mean age: 31.65 ± 11.92 Years). The average duration of the disease in Alopecia Areata patients was close to 1 year. This study indicated a lower concentration of 25 hydroxyvitamin D in half of the studied AA patients (51.4%).The number of patches, Severity of Alopecia Tool scoring, serum 25 hydroxyvitamin D level, and age were found to be statistically insignificant with the disease activity. However, a significant positive correlation was found between the Severity of Alopecia Tool score and the number of patches.

CONCLUSIONS: Although low levels of serum 25 hydroxyvitamin D may be seen among subjects with alopecia areata; No statistical correlation was observed. Hence, a larger study of similar nature is needed in the future to elucidate the exact correlation.

PMID:36974868 | DOI:10.33314/jnhrc.v20i3.4408

J Nepal Health Res Counc. 2023 Mar 10;20(3):739-745. doi: 10.33314/jnhrc.v20i3.4388.

ABSTRACT

BACKGROUND: The skill, accessibility, and knowledge of community pharmacists have been paramount in managing pandemics. This study was conducted to assess the knowledge, attitude, and practice of community pharmacy personnel towards tackling COVID-19 pandemic which might help concerned authorities to take effective actions to eliminate the gaps for the management of such pandemic in an efficient way.

METHODS: A cross-sectional study was conducted among 428 community pharmacy personnel from different community pharmacies in Kathmandu, Nepal from December 2021 to February 2022. Statistical analysis was done through SPSS® v21 and MedCalc for Windows v12.3.0.

RESULTS: Most of the participants (42.76%) had certificate-level degrees in their respective fields and one to five years of working experience (48.84%). Only 29.67% of the respondents had good knowledge towards tackling COVID-19, whereas good attitude and practice were demonstrated by 59.11% and 42.29% respectively. The participants with higher degrees and more working experience had better knowledge, attitude, and practice. Education level bachelor and above was independent predictor of good knowledge (OR 20.69, 95% CI 11.30-37.90). Knowledge and practice (Spearman’s rho: 0.135; P ≤0.005) and attitude and practice (Spearman’s rho: 0.095; P = 0.049) scores were positively correlated.

CONCLUSIONS: The significant association of community pharmacy personnel’s educational level with knowledge, attitude, and practices demands the necessity of policy-making bodies’ involvement for the mandatory presence of well-qualified pharmacists and regular training at the community pharmacy level. Furthermore, it is high time to reinforce the drug regulatory acts, regulations, and codes all over the nation.

PMID:36974867 | DOI:10.33314/jnhrc.v20i3.4388

J Nepal Health Res Counc. 2023 Mar 10;20(3):726-730. doi: 10.33314/jnhrc.v20i3.4275.

ABSTRACT

BACKGROUND: Digital devices have been an integral part of our daily lives. With the emergence of COVID-19 pandemic we have gone through strict lockdowns. Most educational institutions conducted classes virtually. This increased the symptoms of digital eye strain. This study aims to assess the prevalence, symptoms, and level of awareness regarding digital eye strain in medical undergraduate students following the COVID-19 pandemic.

METHODS: Our study was a questionnaire-based cross-sectional study with a duration of 3 months. All the undergraduate medical students studying at Kathmandu Medical College Teaching Hospital were included in the study. A self-administered questionnaire was sent to each student electronically via google forms. Descriptive statistics, frequency tables, and percentages were calculated.

RESULTS: A total of 208 students were included in the study. The mean age of participants was 22.7±1.6 years (Mean ± SD) with a mean duration of online classes being11.39 ± 5.2 months (Mean ± SD) . The average screen time of students before the start of online classes was 4.14 (SD=2.13) hours. The average screen time after the start of online classes was 7.93 (SD=2.44) hours, an increase of 91.54%. The overall prevalence of digital eye strain among the respondents was 90.8% (n=189).

CONCLUSIONS: The prevalence of digital eye strain in our study was high. The average screen time increased significantly following COVID-19. Therefore, it is important to create awareness regarding digital eye strain and practices that decrease the symptoms of digital eye strain.

PMID:36974864 | DOI:10.33314/jnhrc.v20i3.4275

J Nepal Health Res Counc. 2023 Mar 10;20(3):712-719. doi: 10.33314/jnhrc.v20i3.4269.

ABSTRACT

BACKGROUND: Pregnant women and their fetuses represent a high-risk population during coronavirus disease 2019 (COVID-19) pandemic. During pregnancy, body undergoes significant physiologic, mechanical, and immunologic alterations which increases susceptibility to infections. Thus pregnant women are at an increased risk for severe illness from COVID-19. This study explored the clinical profile, disease severity, and perinatal outcomes of pregnant women with COVID-19.

METHODS: A retro-prospective cross-sectional study was conducted at KIST Medical College after ethical approval. All women (1227) who delivered from 15 April 2020 to 15 October 2021 and underwent the COVID-19 screening by Reverse Transcriptase Polymerase Chain Reaction were studied. COVID-19 positive women (44) were further analyzed and classified as asymptomatic, mild, moderate, severe, and critical diseases. Data was collected in proforma by reviewing patients’ records. The data analysis were done in SPSS version 26. A descriptive statistical test and chi-square test were done.

RESULTS: The prevalence of COVID-19 among delivering pregnant women was 3.6% (44/1227). Majority were asymptomatic 79.5% (35). About 16% (7) had mild illness and 4.5% (2) had moderate illness. The caesarean rate was 34.1% (15/44) among COVID-19 positive women. Stillbirth and preterm birth was observed in 2.3% (1) and 4.5% (2) respectively. The COVID-19 infection rate in a neonate was 4.5%.

CONCLUSIONS: The severity of COVID-19 among delivering pregnant women was less. The perinatal outcome was also favourable. The overall prognosis of COVID-19 among mothers and newborns was good. Further research is needed to understand the true magnitude of risks and management, more so with the emergence of new variants.

PMID:36974862 | DOI:10.33314/jnhrc.v20i3.4269

J Nepal Health Res Counc. 2023 Mar 10;20(3):708-711. doi: 10.33314/jnhrc.v20i3.4112.

ABSTRACT

BACKGROUND: The rapid growth of older population has enhanced the number of people at lifetime risk of enduring from chronic diseases. Successful aging is a significant phenomenon for achieving a healthy and happy life for all elderly and aging society.

METHODS: A descriptive cross sectional study was carried out with the objective of assessing the factors influencing successful aging. Structured interview questionnaire using Successful aging scale and Self-esteem scale was used for data collection and obtained data was analyzed using descriptive statistics and inferential statistics at 0.05 level of significance. Participants of the research were considered in this study using purposive sampling technique.

RESULTS: The findings revealed that majority of elderly respondents (73.8%) had successful aging. Successful aging was significantly associated with marital status (p-value= 0.040), family type (p-value=0.002), family annual income (p-value=0.009), presence of children as support system (p-value=0.034), negative life events in last 12 months (p-value<0.001), subjective perception of health (p-value=0.001) and ability to remember things without difficulties (p-value<0.001).

CONCLUSIONS: Thus, it can be concluded that successful aging is associated with several factors. So, individual factors must be taken into consideration while implementing intervention programs in order to bring about positive aging experience among elderly.

PMID:36974861 | DOI:10.33314/jnhrc.v20i3.4112

J Nepal Health Res Counc. 2023 Mar 9;20(3):697-701. doi: 10.33314/jnhrc.v20i3.4282.

ABSTRACT

BACKGROUND: Mal-positioning of cervical screws risks neurovascular injury so, it is necessary to understand cervical pedicle morphology for pedicle screw fixation in the region. The risks of pedicle screw insertion in the cervical spine can be mitigated by a three-dimensional appreciation of pedicle anatomy. The study aims to determine the morphology of the sub axial cervical spine pedicles in Nepalese Population based on computerized tomography.

METHODS: A cross-sectional study using computerized tomography scans of the spine was made among the randomly selected 87 patients who had visited National Trauma center, Kathmandu, Nepal with vertebral fracture other than cervical vertebrae. Patient was examined as per Advanced Trauma Life support protocol and neurological assessment. Measurement was done from the third cervical vertebra down to the seventh cervical vertebra in computer with standard software in the department of radiology from where all the computerized tomography scan reporting are done.

RESULTS: The mean pedicle length ranged from 4.41 mm at C3 to 4.96 mm at C7 where mean pedicle height ranged from 4.64 at C3 to 5.12 at C7. Pedicle length, pedicle height and pedicle width were observed to be statistically significant with gender. The pedicle axial length of C3 and C7 vertebra were found significant with gender. All parameters were found to be greater in male compared to female.

CONCLUSIONS: The study revealed that pedicle length, pedicle height, pedicle width, pedicle axial length increased from third to seventh cervical however, transverse angulation increased up to fifth vertebra and decreased to seventh vertebra.

PMID:36974859 | DOI:10.33314/jnhrc.v20i3.4282

J Nepal Health Res Counc. 2023 Mar 9;20(3):689-696. doi: 10.33314/jnhrc.v20i3.3992.

ABSTRACT

BACKGROUND: Antimicrobial resistance is an important global problem resulting in an improper response of infections to antimicrobials and an increase in the duration and cost of treatment. Healthcare professionals play an important role in addressing Antimicrobial resistance and positive perception is important for involvement in antimicrobial stewardship policies. Hence the perception of key Healthcare professionals, including physicians, nurses, and hospital pharmacists, towards Antimicrobial resistance antimicrobial stewardship policies was studied.

METHODS: A cross-sectional study was conducted in a tertiary care hospital at Lalitpur, from January to March 2021 using stratified random sampling. An online questionnaire was circulated to the selected Healthcare professionals. Median Antimicrobial resistance and antimicrobial stewardship policy scores were calculated and compared among different subgroups. Previous engagement with Antimicrobial resistance and antimicrobial stewardship policies programs was also noted. Descriptive statistics, Mann Whitney, and Kruskal Wallis tests were used for data analysis.

RESULTS: The response rate was 89.3% (202/226). Antimicrobial resistance was regarded as a serious problem in the Nepali community by participants with work experience of 1-5 years, 87 (75.6%, p=0.029), and female participants, 62 (45.5%, p<0.001). Most physicians, females, and participants with working experience 1-5 years believed inappropriate use of antibiotics can harm patients and is professionally unethical. Physicians supported the availability of local antimicrobial guidelines and protocols. The median scores for Antimicrobial resistance (p<0.001) and Antimicrobial resistance eradication (p=0.048) differed according to age groups.

CONCLUSIONS: Healthcare professionals believed Antimicrobial resistance was an important issue. Antibiotic guidelines developed should be strictly implemented. Healthcare professionals also believed inappropriate use of antibiotics can harm patients and is professionally unethical.

PMID:36974858 | DOI:10.33314/jnhrc.v20i3.3992

J Nepal Health Res Counc. 2023 Mar 9;20(3):672-676. doi: 10.33314/jnhrc.v20i3.4070.

ABSTRACT

BACKGROUND: Acne causes significant impairment in the quality of life of patients, but clinicians in Nepal lack a simple validated tool to measure the psychological side of acne. We planned to translate and validate Cardiff Acne Disability Index, a five item questionnaire into Nepali language to address this need.

METHODS: A linguistic translation with semantic equivalence to the original English language Cardiff Acne Disability Index was achieved through standard forward and backward translation into Nepali language. All eligible patients were requested to fill the Nepali translated version of both Cardiff Acne Disability Index and Dermatology Life Quality Index questionnaires. Reliability and validity of the newly translated questionnaire were established, based on statistical analyses of factor structure, item correlations and concurrent correlations.

RESULTS: This validity study included 94 patients with male: female ratio of 1:3.27 and mean age 21.29 (±3.92) years. Reliability analysis revealed a Cronbach’s alpha of .72 and mean inter item correlation coefficient of .337. A single factor was extracted on Principal Component Analysis explaining 48.40% of variance. A strong correlation of Cardiff Acne Disability Index scores to the Dermatology Life quality Index score (rs>.7) indicated good concurrent validity.

CONCLUSIONS: The newly translated Nepali Cardiff Acne Disability Index is a valid tool to measure the impact of acne in Nepalese patients. This short and simple assessment tool will help clinicians understand the patient’s perspective of her acne.

PMID:36974855 | DOI:10.33314/jnhrc.v20i3.4070