Tag: pubmed

J Nepal Health Res Counc. 2024 Dec 20;22(3):567-573. doi: 10.33314/jnhrc.v22i03.5175.

ABSTRACT

BACKGROUND: Worldwide, Fetal growth restriction is a leading cause of stillbirth, neonatal mortality, and morbidity. Several maternal factors influence fetal growth and increases the risk of fetal growth restriction. Our study aimed to determine the risk factors and perinatal outcome of fetal growth restriction at Tribhuvan University teaching hospital, Maharajgunj, Kathmandu.

METHODS: A prospective study was conducted in the department of Obstetrics and Gynecology at Tribhuvan University teaching hospital. A total of 140 Pregnant women at > 28 weeks period of gestation clinically diagnosed as FGR and fulfilling the inclusion criteria were enrolled in this study. The data was analyzed using SPSS 23. The association between various risk factors and FGR was studied using the binary logistic regression.

RESULTS: Among the 140 FGR fetuses, 27.9 % (39) belonged to the <10th percentile (Mild Fetal growth restriction) and 72.1%(101) belonged to<5th percentile (Severe Fetal growth restriction). Maternal age more than 35 years was found to be statistically significant as a risk factor in the severe Fetal growth restriction group. Among the maternal co-morbidities, hypertensive disorder of pregnancy was found to be the most common co-morbidity followed by heart disease and thyroid disorders. The Fetal growth restriction neonates requiring neonatal intensive care unit (NICU) stay was 42 (30%) and the median neonatal intensive care unit stay was 4 days. The fetal morbidities associated with fetal growth restriction were prematurity,respiratory distress syndrome(RDS), sepsis, meconium aspiration syndrome(MAS) and neonatal jaundice (NNJ). Among the 140 FGR babies, 138 were live born and there were 2 neonatal deaths (NND).

CONCLUSIONS: In our study ,advanced maternal age is found to be a significant risk factor for Fetal growth restriction and gestational hypertension is the most common comorbidity associated with Fetal growth restriction. Therefore, identification of such women, their regular antenatal checkups, fetal surveillance and timely intervention are crucial for better perinatal outcome.

PMID:39923171 | DOI:10.33314/jnhrc.v22i03.5175

J Nepal Health Res Counc. 2024 Dec 20;22(3):562-566.

ABSTRACT

BACKGROUND: Dengue is a viral infection, commonly found in tropical and subtropical regions across the globe particularly in urban and semi-urban settings. There has been significant increase in dengue cases over past two decades. This study aims to determine the prevalence of dengue NS1 antigen, IgM, and IgG antibodies among healthy blood donors at the Nepal Medical College Blood Bank.

METHODS: The descriptive cross-sectional study was carried out at the blood bank of Nepal Medical College between August to November 2023. Ethical approval was received from the Institutional Review Committee of Nepal Medical College (Ref: -080/081). Two hundred and thirty two serum samples from the healthy blood donors were screened with Dengue RDT (SD Bioline Dengue Duo) for detection of NS1 antigen, IgM and Ig G antibodies.

RESULTS: Among the samples 18/232 (7.75%) were found IgM positive and 25/232 (10.77%) were found IgG positive. Similarly, 12/232 (5.17%) showed both IgG and IgM positive; however, all sample tested negative for NS1 Conclusions: Detection of Dengue antibodies in asymptomatic blood donors in endemic areas indicates a potential risk for recipients to contract dengue infection through blood transfusion. Implementing a screening program during dengue outbreaks could effectively mitigate this risk.

PMID:39923170

J Nepal Health Res Counc. 2024 Dec 20;22(3):549-556. doi: 10.33314/jnhrc.v22i03.5109.

ABSTRACT

BACKGROUND: Maternal mental health problems are globally considered as a major public health challenge. Postnatal stress affects mothers and children’s physical as well as mental wellbeing. The objective of the study is to assess stress and coping strategies of postnatal mothers.

METHODS: A cross-sectional descriptive study design was carried out at Immunization clinic of Lumbini Provincial Hospital. Purposive sampling technique was used to collect data among 152 mothers. Data was collected through a structured interview questionnaire using Perceived stress scale and Brief Cope. Data analysis was done through descriptive and inferential statistics.

RESULTS: Findings of the study revealed that 25.7% mothers had mild stress; 72.4% had moderate stress, and only 2% had severe stress. Regarding coping mechanism, mostly used coping strategies were problem focused coping strategies and 90.1% mother adopted adaptive coping. While there was statistically significant between stress and age (p=.016), residence (p=.022) and occupation (p=<.001). Likewise, there was statistically significant between coping and age (p=.003), residence (p=.045), occupation (p=.018), sex of the baby (p=.005) and living during postnatal periods (p=.023).

CONCLUSIONS: The majority of the postnatal mothers had some form of stress. However, most of the postnatal mothers managed their stress through adaptive and problem based coping strategies in their own ways. Thus, there was a prime need to pay attention for promotion of their coping strategies that definitely enhance the mental status of the postnatal mothers.

PMID:39923168 | DOI:10.33314/jnhrc.v22i03.5109

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