Journal of Nepal Health Research Council最新文献

Background: The purpose of this study was to investigate the association of subclinical hypothyroidism with High sensitive C-reactive protein and lipid profile which can predispose to development of Cardiovascular disease.

Methods: This hospital-based comparative cross-sectional study was conducted for a period of six months. A total of 71 patients with subclinical hypothyroidism and 37 healthy control subjects were enrolled for the study. Thyroid hormones, lipid profile, hs- CRP were measured and lipid variables were used to calculate lipid indices. Student t-test were used to compare means and Spearmans correlation was done to determine the association between variables. ROC curve analysis was used to determine the diagnostic value of tests.

Results: Out of 71 cases and 37 control, majority had female preponderance (71.8% in case and 83.8% in control). The mean values between case and control groups for High sensitive C-Reactive Protein, Atherogenic index of plasma, Lipoprotein combined index and non-High Density Lipoprotein cholesterol were statistically significant. There was positive correlation between Thyroid Stimulating Hormone and High sensitive C-Reactive Protein r=0.492, p 0.001, Atherogenic index of plasma and Thyroid Stimulating Hormone r=0.430, p 0.001, Lipoprotein combined index and Thyroid Stimulating Hormone (r=0.269, p =0.005), Thyroid Stimulating Hormone and non-High Density Lipoprotein cholesterol (r=0.308, p=0.001) and Atherogenic Index and Low Density Lipoprotein r= 0.712, p 0.001 with weak correlation with statistical significance as per Spearmans correlation. Area under ROC curve for High sensitive C-Reactive Protein indicated it as a positive biomarker for cardiovascular risk assessment.

Conclusions: Our findings shows that sch patients are more at risk of cvd and hs-crp contributes as a significant marker, thus requiring timely intervention. Lipid indices and AIP must be determined even in patients with a normal lipid profile to improve atherogenic risk.

Background: Despite substantial improvements in the accessibility of safe abortion services nationwide, a noticeable underutilization of these services persists, primarily attributable to the presence of social stigma. This stigma leads to discrimination, abuse, and poor healthcare. This study aims to understand and address abortion stigma among Nepali women of reproductive age.

Methods: This cross-sectional study involved 2286 women of reproductive age across Nepal. SABAS was used to measure abortion stigma, which includes 18 questions. Quantitative data was collected through face-to-face interviews using structured questionnaires on kobo collect. Stata 15.0 software was used for data analysis.

Results: The mean SABAS score was 46.5 out of 90, indicating moderate abortion stigma in Nepal. Negative stereotypes and beliefs about abortion were more prevalent, with over 80% believing a woman's health deteriorates after abortion. Discrimination tendencies were lower, with less than 10% endorsing teasing, pointing fingers, or disgrace. Fear of contagion was also relatively low, with less than 20% agreeing that women who had abortions made others ill. Factors such as age, caste/ethnicity, education, marital status, wealth, and provinces were associated with varying levels of stigma, and women of higher age group, Madhesh, Dalit, Muslim, lower education levels, widowed, poor, Madhes province were linked to higher stigma scores. The study found that stigma levels varied among different groups.

Conclusions: The stigma level on abortion is higher in upper age group, Madheshi, Dalit, Muslim, lower education levels, widowed, poor, Madhesh province women in Nepal. Similarly, the negative stereotype and discrimination and exclusion is also high while the fear of contagion is low among Nepalese women and girls.

Background: The study aimed to assess the prevalence of internet addiction among Secondary level students in Waling Municipality, Syangja, Nepal.

Methods: A cross-sectional study was conducted among 280 students aged 15-19 from three schools in Waling Municipality in January 2022; stratified simple random sampling proportional to the size of the population was used. A self-administered structured questionnaire was used and an Internet Addiction scale was applied which includes 20 questions with a score of 1â€"5 for each question. Based on scoring subjects would be classified into normal users (0â€"30), mild (31â€"49), moderate (50â€"79), and severe (80â€"100) Internet Addiction groups. Descriptive statistics, bivariate analysis, and multivariate logistic regression analysis were computed at a 5% level of significance.

Results: of the total 30.7 had mild and 15.4 had moderate internet addiction. The likelihood of reporting internet addiction was significantly higher among those who used the internet for more than two hours (AOR, 2.91; 95% CI, 1.56-5.42), common mode to access the internet (AOR, 17.04; 95% CI, 2.09-138.61), friend's encouragements (AOR, 2.18; 95% CI, 1.17-4.05), living with family (AOR, 5.183; 95% CI, 1.55-17.30) and gender (AOR, 1.833; 95% CI, 1.04-3.22) Conclusion: The current study documents almost half of the school adolescents had internet addiction. Carrying out public awareness campaigns and establishing ways to enhance the positive effect of the internet while minimizing the negative outcomes of the associated factors may be a profitable strategy to decrease its prevalence and effect.

Background: Relief of pain is a basic need and right of all children; effective pain management requires health professionals to be able to apply several interventions to achieve optimal results. The current study aimed to discover the Effectiveness of Video-assisted Distraction Therapy on Children’s Pain Perceptions during Peripheral Venous Cannulation in Pediatric Wards of Biratnagar, Nepal.

Methods: A quasi-experimental study was conducted at Pediatric Wards of different hospitals in Biratnagar. Data collection was done from Feb 27, 2023, to April 28, 2023. Non-probability purposive sampling technique was adopted in selecting the desired sample size. Data was collected through an interview questionnaire and a standard observational checklist, the FLACC pain rating scale. The experimental group received video-assisted distraction therapy as an intervention, while the control group received routine intravenous care from the nurses.

Results: There is a significant difference between the pain perception score in the experimental and control group during peripheral venous cannulation (p= <0.001) during and after two minutes of cannulation. Similarly, the level of pain was also different in both groups, 42.5% of children in the experimental group perceived moderate pain, 37.5% perceived mild pain and 20% reported severe pain whereas 92.5% of respondents perceived severe pain and only 7.5% perceived moderate pain during peripheral venous cannulation.

Conclusions: Video-assisted Distraction Therapy was very efficient at distracting children from their pain during intravenous cannulation.

Background: The usual surgical technique for heart surgery has been median sternotomy, which provides excellent exposure of all cardiac structures and facilitates the establishment of cardiopulmonary bypass with central cannulation. A number of alternative surgical techniques, including the right anterolateral thoracotomy, posterolateral thoracotomy, and partial sternotomy, have been suggested. We want to share our experience with right anterior mini-thoracotomy versus right axillary mini-thoracotomy for closing an atrial septal defect.

Methods: The study was a retrospective cross-sectional study conducted in a hospital. The study comprised patients with atrial septal defect admitted to Green City Hospital in Kathmandu, Nepal. From May 2016 until September 2021. Data was extracted to MS excel sheet, and then transported to the STATA version 17 for analysis. First, we computed descriptive analysis which included calculation of frequency, percentage, mean and median for presentation of socio-demographic variables. Continuous data were tested for normality using Shapiro-Wilk test.

Results: A total of 25 patient were included in the study with median age 26 years (20-32). The median aortic cross clamp time was 25 minutes ranging 20-35 min. The median duration of cardiopulmonary bypass time ranging from 31to 161 minutes. The median time of Ax was 25 minutes and 26 minutes for right anterior mini-thoracotomy and right axillary mini-thoracotomy respectively. The median duration of hospital stay was 4 days ranging from 3-4 days. Nearly 36% study participants were associated with abnormal body mass index. (Either under nutrition or over nutritional status).

Conclusions: There were no significant differences between the duration of intensive care unit and hospital stays, aortic cross clamp time, and complications between the two groups. However, the possibility of less blood loss during surgery and of cosmetic appearance in axillary incision is of special importance.

Uterine leiomyomas are the most common entities encountered in routine gynaecological practice. They are usually easily identifiable on routine imaging. However, there is increasing difficulty with diagnosing leiomyoma following hyaline degeneration as it might mimic ovarian pathology. A stepwise and a multidisciplinary approach in management of these cases is preferred to achieve optimal results. We report a case of 40-year-old female presented to outpatient department with radiological diagnosis of complex adnexal mass and Ca-125 value 122 U/ml. Physical examination and radiological investigations suggested giant abdominopelvic mass, probably aggressive uterine or ovarian tumor preoperatively. Postoperative findings revealed hyaline degeneration of fibroid arising from anterior wall of uterus. Keywords: Degeneration; ovarian tumor; uterine leiomyoma.

Background: Caring is a universally accepted concept attributed to the nursing profession despite its many nebulous and elusive interpretations. Nursing is seen primarily as a feminine occupation, people get surprised when they see and hear about a male nurse. It is one of the few professions where women outnumber men greatly as it deals with care and nurture. This study aims to assess the female nurse attitude at male nurses in Nepal.

Methods: A cross-sectional study was conducted in Biratnagar, Morang from the month of March to May 2023. Ethical clearance was obtained from IRC of Nobel Medical College Teaching Hospital, Biratnagar. Web-based computerized data were collected among 200 female nurses using whats app and Messenger. Data were collected using the Likert scale (AMnQ), which is a standardized 5-point Likert scale that assesses female nurses’ attitudes toward male nurses. SPSS V 23 was used to analyze the data using descriptive and inferential statistical techniques.

Results: In this study, more than half (55.0%) of the nurses have low-level attitudes toward male nurses. Furthermore, nearly half (48.5%) disagree nursing is suitable only for females, More than one-third (36.5%) disagree nursing is considered a low-level occupation for males, half of them (50%) strongly disagree male and female nurses both are equally required in the nursing profession and (35%) agrees people do not prefer to send males for the nursing profession.

Conclusions: Thus the study concludes that majority of the female nurses have low attitude towards male nurses. Therefore, it can be considered as an initiation for having a conversation regarding making gender equality in nursing and creating awareness about the roles and their importance in this profession. Keywords Attitude; female nurse; male nurse.

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Background: Common bile duct stones is a common medical problem that are usually seen in association with gallstone disease. Endoscopic management of Common bile duct stones involves doing Endoscopic retrograde cholangiography for bile duct clearance which is the primary therapeutic modality of choice. This prospective study was done to identify the clinical characteristics and outcome of patients presenting with Common bile duct stones undergoing Endoscopic retrograde cholangiography.

Methods: A prospective observational study was conducted on all patients undergoing Endoscopic retrograde cholangiography in department of Gastroenterology, Tribhuvan University Teaching Hospital, for management of diagnosed or suspected choledocholithiasis from April 2023 to March 2024. Patient demographics, clinical characteristics, Endoscopic retrograde cholangiography findings and post procedure outcome data were collected and analysed.

Results: A total of 110 patients (61.8% male and 38.2% female) were included in the final analysis. Successful clearance of Common bile duct was obtained in 76.4% patients with overall adverse events of 18% related to the procedure. Among patients undergoing the procedure, 16.4% couldn’t be managed with Endoscopic retrograde cholangiography and were referred for surgical management.

Conclusions: Endoscopic management in form of Endoscopic retrograde cholangiography is a safe and effective method to manage patients with Common bile duct stones.