Tag: nevin manimala

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

J Nepal Health Res Counc. 2023 Mar 9;20(3):659-663. doi: 10.33314/jnhrc.v20i3.4283.

ABSTRACT

BACKGROUND: Left Ventricular Diastolic Dysfunction is considered a critical link between hypertension and heart failure, particularly in individuals with heart failure and preserved ejection fraction. The aim of this study is to assess the prevalence and factors associated with clinical parameters of left ventricular diastolic dysfunction in patients with essential hypertension.

METHODS: A hospital-based cross-sectional study was done among 68 newly diagnosed and known hypertensive patients visiting out patientdepartmentat Bir hospital. Patients who meet the inclusion criteria were chosen alternatively by referring OPD register. Patients with hypertension had undergone echocardiography to see whether left ventricular diastolic dysfunction was present and was compared to other clinical parameters like age, sex, body mass index, and dyslipidemia using the student t-test/chi-square test.

RESULTS: The prevalence of left ventricular diastolic dysfunction in essential hypertensive patients was 33.8%. About 25% patients had grade 1; 7.4% and 1.5% of patients had grade 2 and grade 3 diastolic dysfunction respectively. Patients who had a duration of hypertension of more than five years were more than nine times (OR 9.14; 2.89-28.87) more likely to have Left ventricular diastolic dysfunction. Age and Body Mass Index were found statistically significant with diastolic dysfunction (P<0.05).

CONCLUSIONS: Left ventricular diastolic dysfunction was found prevalent in hypertensive patients. Age, Body mass index, Dyslipidemia and Duration of hypertension were found to be statistically significant with diastolic dysfunction Keywords: Diastolic dysfunction; hypertension; Nepal; prevalence.

PMID:36974853 | DOI:10.33314/jnhrc.v20i3.4283

J Nepal Health Res Counc. 2023 Mar 9;20(3):653-658. doi: 10.33314/jnhrc.v20i3.3774.

ABSTRACT

BACKGROUND: We did this study to evaluate the prevalence of low birth weight among deliveries, adolescent pregnancy and advanced maternal age pregnancy. We also assessed the factors affecting the low birth weight among institutional deliveries at the level of primary hospital.

METHODS: A hospital-based retrospective cross-sectional study was done in Grahun Primary Hospital of Syangja, Nepal using data maintained in register book over last five years. We excluded all those deliveries with multiple pregnancy and incomplete records, and included 2473 participants in final analysis using convenient sampling. The relevant information was filled up in Microsoft Excel 2019 v16.0 and descriptive and inferential statistics was calculated using statistical package for social sciences, IBM SPSS® v21 (IBM, Armonk, New York).

RESULTS: The prevalence of low birth weight at Grahun Primary Hospital was 11.08%. The prevalence of adolescent pregnancy and advanced maternal age pregnancy was 18.03% and 02.18% respectively. Male newborns had significantly higher mean birth weight as compared to the female newborns (3101.48 ± 506.60 v/s 2967.53 ± 484.97, P-value <0.001). Female newborns had higher odds of low birth weight as compared to those male newborns (11.99% v/s 8.29%, AOR=1.56, 95% CI= 1.17-2.07). Pregnant women with lower gestational age (<37 weeks or preterm) had a higher odds of low birth weight as compared to pregnant women with normal gestational age (37-42 weeks) (AOR = 11.59, 95% CI 8.49-15.83).

CONCLUSIONS: The low birth weight depends upon gestational age of mother and gender of newborn. Local organizations should work to bring down low birth weight, and adolescent pregnancy and advanced maternal age pregnancy of mother.

PMID:36974852 | DOI:10.33314/jnhrc.v20i3.3774

J Nepal Health Res Counc. 2023 Mar 9;20(3):623-629. doi: 10.33314/jnhrc.v20i3.3968.

ABSTRACT

BACKGROUND: Nurses play a vital role to handle the situation in the care of the patients especially for prioritizing and managing care of pain. Nursing competency attributes personal characteristics, professional attitude, values, knowledge and skills to demonstrate professional responsibility through practices. Nursing competency helps to provide high quality essential care to the patients at a right time. This study aimed to explore pain management competency and its associated factors among nurses in a tertiary hospital, Nepal.

METHODS: A cross- sectional survey with correlational predictive design was conducted with 203 staff nurses who had work experience related to pain for more than two months at Tribhuvan University Teaching Hospital in Nepal. They were working in medical, surgical, gynecology and obstetrics, pediatric and neonatal, emergency and intensive care departments. The participants were selected from inpatient departments by convenience sampling technique from December 2020 to February 2021. SPSS 18.0 version was used for data entry and analysis using descriptive statistics, chi-square and logistic regression. Significant factors reported at P<0.05.

RESULTS: In total participants, 67.5% of nurses were competent on pain management. Work experience [OR= 0.426 (95% CI: 0.205-0.887)] could significantly predict on nurses’ competency for pain management. However, there was no significant association educational level, working unit, nurse-physician relationship, and training on nurses’ competency.

CONCLUSIONS: Based on the findings, two third (67.5%) nurses are competent on pain management and work experience is a factor contributed to the nurses’ competency for pain management, the researcher recommends nurses with lower work experience should provide pre-service training on pain management.

PMID:36974848 | DOI:10.33314/jnhrc.v20i3.3968

J Nepal Health Res Counc. 2023 Mar 9;20(3):605-610. doi: 10.33314/jnhrc.v20i3.4311.

ABSTRACT

BACKGROUND: The age estimation of the individual by the forensic experts ascertains the chronological age of an individual. The possibility that the person being examined may be younger or older than a certain age threshold makes this process crucial, as it will establish whether or not the person is an adult under the law. The aim of this study was to test the applicability of the London Atlas of tooth development and eruption in Nepalese subset population.

METHODS: The London Atlas for age estimation was tested in 350 digital panoramic radiographs from the patients between four and twenty-four years visiting Tribhuvan University Teaching Hospital, Institute of Medicine, Nepal.

RESULTS: The mean values of the estimated age were higher in both the sexes, which was statistically not significant. Both the sexes showed an excellent positive correlation, and was significant with a p value of <0.001. The age estimation upto 10 years group classification was nearly accurate with less than 1 and 2.5 years variation in males and females respectively. The accuracy was good in 16-18 years group with maximum deviation of ±2.5 years. The accuracy was poor in more than 18 years group, as the variability was more than 5 years.

CONCLUSIONS: The London Atlas method was best suited for less than 18 years of age and was not very accurate in the age group of 13-14 and 14-15 years where most of the polymorphisms were noted.

PMID:36974845 | DOI:10.33314/jnhrc.v20i3.4311