Journal of Nepal Health Research Council最新文献

Background: Cardiovascular diseases are a leading cause of death globally, with physical inactivity as a significant risk factor. In Nepal, lifestyle-related health issues are rising, necessitating an understanding of physical activity patterns in specific groups like secondary school teachers. This study aims to assess the status of physical activity and associated factors among secondary school teachers in Pokhara, Nepal.

Methods: A cross-sectional study was conducted from December 2022 to April 2023 among 406 secondary school teachers in Pokhara. Physical activity was measured using the IPAQ-long form, and other variables were collected through self-administered questionnaires. Univariate and bivariate analyses were followed by logistic regression to calculate adjusted odds ratios (aOR) for factors associated with moderate and high physical activity.

Results: Most participants were male (53%) and Brahmins/Chhetris (69.2%), with a mean age of 38.65 years. The majority (86.3%) met WHO physical activity guidelines, with 65.3% reporting moderate and 21.5% high activity levels. Higher physical activity was associated with being male (aOR: 2.19, 95% CI: 1.11-4.35), higher education (aOR: 2.88, 95% CI: 1.45-5.73), walking while teaching (aOR: 9.13, 95% CI: 4.20-19.87), and access to walking areas (aOR: 2.28, 95% CI: 1.12-4.62).

Conclusion: Male teachers, those with higher education, and those who walked while teaching were more likely to engage in higher physical activity. Access to walking-friendly environments also positively influenced activity levels. Promoting walking friendly spaces and addressing educational and occupational factors could enhance physical activity among teachers. Keyword: Cardiovascular disease; international physical activity questionnaire; metabolic equivalents.

Background: Male involvement in family planning not only enhances the couple's uptake but also provides continuity through spousal coordination to meet the family planning need. The study aims to assess the factors associated with male involvement in family planning utilization.

Methods: A descriptive cross-sectional study design was used in Madhyabindu Municipality from14th August to 10th September 2022. After proportionately selecting from each ward, the data was collected through a systematic random sampling technique among Tharu married males who were living together with reproductive age group wives. Data was analysed by using SPSS version-16. Descriptive and inferential statistics were used for the data analysis.

Results: Of the 151 males, almost half (49.7%) of the male had completed secondary level education. The majority (80.1%) had decided together by husband and wife about the contraceptive use. The majority (67.5%) of the male had active involvement in family planning utilization, while half (51.7%) of them visited family planning clinic and users of modern family planning methods were 40.4%. Most of (95.4%) them had easy access to temporary FP services and majority (74.2%) had easy access to permanent FP services. Education (p = 0.001), prior use of contraception (p = 0.001), and easy access to permanent family planning methods (p = 0.012) were statistically significant with male involvement in family planning utilization.

Conclusions: Two-fifth of the males were users of family planning methods. Education, prior use of contraception and easy access to family planning services were the significant factors associated with male involvement in family planning utilization.

Background: Gastrointestinal (GI) epithelial cancers are a leading cause of cancer-related deaths worldwide. The objective of this study was to analyse the epidemiology, symptomatology and histopathology of gastrointestinal epithelial malignancies in a GI pathology laboratory based in Kathmandu, Nepal.

Methods: An observational study was conducted to using the data collected from biopsy specimens, pathology reports, clinical information, and endoscopic reports of patients diagnosed from March, 2017 to December, 2018 in Samyak Pathology Lab (SPL), Kathmandu. Nonepithelial tumors were excluded. Data analysis was done using Microsoft Excel 365.

Results: Of 203 GI epithelial malignancies, there were 25 (12.3%) esophageal, 81 (39.9%) gastric, 29 (14.3%) duodenal/ampullary, and 68 (33.5%) colorectal carcinomas. Gastric cancer had a mean age of 59.7 years and a male-to-female (M: F) ratio of 2.4. Common symptoms included abdominal pain, nausea/vomiting, and weight loss. The mean age for esophageal cancer was 65.8 years and the M: F ratio was 2.6. Dysphagia was the commonest symptom. Duodenal cancer had a mean age of 57.2 years and an M: F ratio of 1.2. Among these, 17 were periampullary carcinomas, and obstructive jaundice was the most common symptom. For colorectal cancer, the mean age was 54 years, and the M: F ratio was 1.6. Common symptoms included per-rectal bleeding, abdominal pain, and altered bowel habits.

Conclusions: Gastric cancer was the most common type of gastrointestinal (GI) epithelial cancer in this study, followed by colorectal, duodenal/ampullary, and esophageal cancer. There was a male predominance. The rise in colorectal carcinoma points to lifestyle changes as a contributing factor.

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.

Background: Sexual assault is one of the most traumatic crimes which leaves a deep mental and emotional scar in the victim's life. Mostly girls are the victims of sexual assault whereas boys are also victimized but are few in number. This heinous incidence hampers the normal growth and development of a growing child making them vulnerable to psychiatric disorder, drug abuse disorder and anti-social conducts in adult. This study aims at identifying the incidence of child sexual abuse in different municipal areas of Kavrepalanchok district of Nepal Methods:This is a retrospective study in which data of sexual assault victim less than 18 years presented at emergency department of Dhulikhel Hospital, KUSMS through One-stop Crisis Management Center (OCMC) by the investigating authority was studied. The data from 2076/09/01 B.S. to 2080/12/30 B.S. was included in the study. Total of 127 cases were studied.

Results: Mandandeupur rural municipality reported highest number of child victims of sexual assault i.e., 14.17%. Out of 127 victims, 4 of them were male and rests were female. Most of the victims (74.01%) were of 12-18 years age. Most of the perpetrators (51.18%) were strangers to the victim. The cases of sexual assault with children occurred mostly in the places other than house (45.66%). More than one fourth of the victims (26.77%) sustained some type of bodily injuries.

Conclusions: Sexual assault among children is predominant among females and mostly between the teenager age group with perpetrators being stranger to the victim Psychological screening of the potential pedophiles could lead to minimizing the incidence of child sexual assault and abuse. Psychosocial counseling to the victim is must to prevent the devastating psychological effects of sexual abuse.

Background: Bile duct calculi occur in a significant proportion of patients with cholelithiasis. They are usually managed by endoscopic methods, but surgical management is needed in complicated cases. The choice of a specific surgical procedure depends on various factors, such as the extent of bile duct dilation, the location of stones, and the presence of stricture or fistula. In this study, we described the different surgical procedures and their outcomes for patients with bile duct stones that could not be cleared by endoscopic methods.

Methods: This is a retrospective cross-sectional study of patients who underwent different surgical procedures for bile duct stones. Patients treated from January 2022 to December 2024 were included in the study. Demographic and clinical data were obtained from medical records and analyzed.

Results: There were 55 patients, of whom 36 were female. Pain in the abdomen and jaundice were the most common symptoms. Laparoscopic common bile duct exploration was done in 10 (18.2%) patients. Bile duct stones along with biliary fistulas, hepatolithiasis, or liver atrophy were present in 16(29.1%) cases. Besides bile duct exploration, other procedures, including choledochoduodenostomy or hepaticojejunostomy(14.5% ), choledochoplasty (5.5%), and liver resection (12.7%), were required for the management of these patients. There was no mortality, but two (3.6%) patients had residual stones, and eight (14.5%) patients developed major complications with Clavien-Dindo grade three or more.

Conclusions: Bile duct calculi that could not be cleared by endoscopic methods require surgical intervention. CBD exploration in combination of other required procedures can be performed for the management of bile duct stones and their complications with good outcomes.

Background: Asymptomatic bacteriuria in hemodialysis patients is a common problem due to their decreased immunity and renal function which often leads to development of urinary tract infection and other complications. However, there are no adequate guidelines that recommend the routine screening and management of such patients in most of the developing countries including Nepal resulting in antibiotic misuse. This study was done to find the magnitude of asymptomatic bacteriuria among hemodialysis patients along with their antibiotic susceptibility and related risk factors.

Methods: A descriptive cross-sectional study was conducted on hemodialysis patients from July 2023 to January 2024. Midstream clean catch technique was used for urine collection. Urine specimens were processed for identification of uropathogens and their antibiotic susceptibility test by Kirby Bauer disk diffusion method following standard guidelines. Statistical analysis was done by Excel 2016 and SPSS 26, the point estimate was calculated at a 95% confidence interval.

Results: The overall prevalence of asymptomatic bacteriuria was 27%. Escherichia coli (43.47%) was the most frequent isolate. Imipenem and Amikacin were the most sensitive antibiotics among Gram negative isolates while Ceftriaxone and Nitrofurantoin were the most resistant antibiotics. Pseudomonas aeruginosa was the major multidrug resistant pathogen. Hypertension and Diabetes Mellitus were commonly associated risk factors for asymptomatic bacteriuria in hemodialysis patients.

Conclusions: This study demonstrates high prevalence of asymptomatic bacteriuria among hemodialysis patients. Routine screening of asymptomatic bacteriuria aids in early detection and management of complications along with optimization of antibiotic use.

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.

Background: This study aimed to assess the antimicrobial resistance rates of Acinetobacter species and Pseudomonas species isolated from clinical samples in an Antimicrobial Resistance (AMR) surveillance site in Gandaki Province, Nepal.

Methods: A retrospective analysis of data from an AMR surveillance site was extracted and analyzed, covering the time period from January 2020 to June 2024. A total of 575 Acinetobacter species and 687 Pseudomonas species were identified, with varying numbers tested for susceptibility against different antibiotics. Resistance rates were calculated for each pathogen-antibiotic combination.

Results: Resistance in Acinetobacter species was observed in 49.9% of isolates to amikacin and 42.7% to gentamicin, whereas Pseudomonas species showed resistance rates of 21.2% and 18.5%, respectively. Resistance to piperacillin-tazobactam was identified in 54.0% of Acinetobacter species and 24.6% of Pseudomonas species. Notably, 80.3% of Acinetobacter species and 62.6% of Pseudomonas species were resistant to ceftazidime, while carbapenem resistance was observed in 59.3% of Acinetobacter species and 14.8% of Pseudomonas species. Norfloxacin resistance was observed in 38.3% of Acinetobacter species and 43.5% of Pseudomonas species, whereas only 4.0% of Acinetobacter species and 11.4% of Pseudomonas species isolates were resistance to tigecycline. Resistance rates varied across sample types, with Acinetobacter species from respiratory samples and Pseudomonas species from urine samples exhibiting the highest resistance.

Conclusions: The study underscores alarming levels of antimicrobial resistance in Acinetobacter species and Pseudomonas species. Acinetobacter species demonstrated higher resistance to most antibiotics compared to Pseudomonas species. The variation in resistance patterns across sample types highlights the need of infection site and pathogen-specific antibiotic stewardship strategies.

Congenital cystic adenomatoid pulmonary malformations are defined as the presence of a cystic mass of undifferentiated lung tissue; a third of the cases affect one of the lower lobes, and multilobar or bilateral affection is rare. The entity is a rare congenital malformation in the lungs, with an incidence of one in 11,000 to one in 35,000 live births. It is mainly discovered during the fetal period, although a low percentage of patients will be diagnosed postnatally. The disease has a wide spectrum of clinical manifestations, from asymptomatic to life-threatening respiratory symptoms. The diagnosis is made by imaging studies, and the treatment depends on the patient's clinical status. We reported the case of an infant with a rare congenital pulmonary airway malformation and a late diagnosis, which makes the case even rarer, who required open lobectomy as treatment. Keywords: Congenital abnormalities; cystic adenomatoid malformation of lung; lung diseases.