Journal of Nepal Health Research Council最新文献

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Background: The prevalence of gender discrimination and sexual harassment/ violence among children is alarmingly high in Nepal. This study aimed to measure aggregate changes in knowledge, attitude, and skills among school adolescents on gender discrimination; sexual harassment, mindfulness of breathing; and self-defense skills, with application of an integrative experiential learning modules.

Methods: A quasi-experimental study was carried out among 3661 students from 8-9 grades (1880 intervention and 1781 control) in 52 community schools across the seven provinces. Pre- and post-intervention self-reported surveys were conducted among the intervention and control groups before and after intervention of 24 learning hours. We used a mixed two-way effects model to measure the changes in composite indices between pretest and posttest among both the groups.

Results: We found statistically significant increment (P<0.0001) in knowledge, attitude and skills on gender norms, gender discrimination, sexual harassment, self-defense, reporting sexual harassment, legal measures and mindfulness of breathing technique among the intervention group compared to that in the control group.

Conclusions: These findings, though measured immediately after the intervention, offer initial evidence that school adolescents could be empowered to prevent the risks of gender discrimination and sexual harassment.

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Background: The tobacco epidemic is one of the major threats to public health, causing nearly 8 million deaths annually worldwide. In Nepal, every year, several Nepalese people die from tobacco-related diseases illnesses. Despite the implementation of several policies and strategies, tobacco use remains prevalent. This study, thus, aims to assess compliance with the legal provisions regulating tobacco products in Kathmandu Valley.

Methods: A multimethod study design was adopted to explore compliance with the legal provision of tobacco products in the Kathmandu Valley. Three hundred and five public places within the Kathmandu Valley were observed using the observation checklist, and fourteen key informant interviews were conducted. The ethical approval was obtained from the Ethical Review Board of the Nepal Health Research Council.

Results: Our findings show that the average adherence to the Tobacco Product Control Act in the Kathmandu Valley was merely 33.1%. Public transportation exhibited highest compliance 53.2%, whereas eateries demonstrated the lowest compliance at 15.9%. Health organizations demonstrated the highest adherence to prohibiting indoor smoking (94.7%), although the presence of "No Smoking" signage was inadequate, varying from 1.9% to 22.7% across various locations.

Conclusions: In conclusion, compliance with the legal provision of tobacco products was observed owing to limited knowledge of stakeholders, inadequate multi-sectoral coordination, and lack of monitoring mechanisms in public areas. Whereas awareness initiatives through diverse communication channels are found effective in improving compliance.

Background: Blood transfusions are lifesaving, but resource limitations and inadequate utilization patterns pose challenges in low- and middle-income countries. In Nepal, detailed analyses of blood use practices, are needed to inform resource allocation and policy decisions. The objective of this study was to study the overall and component-specific use, explore temporal trends in utilization of blood and blood products.

Methods: We conducted an observational study analyzing data from Blood Bank of Tribhuvan University Teaching Hospital (TUTH), a tertiary hospital (January 1st - December 31st, 2019). Data included patient demographics, blood groups, blood products requested and transfused, and facility type. Data analysis was conducted with SPSS v20.

Results: Patients from TUTH had substantially higher blood product requests, requesting 25,716 units compared to only 1855 units across other centers combined. Blood groups A positive (8089, 31.4%) and and O positive (7851, 30.6%) were the most requested blood groups. Whole blood (11358, 44.2%) and packed red blood cells (9565, 37.2%) were most frequently requested. We observed monthly fluctuations in demand with peak of 2742 requests in December with a trough in June (1947 units). Notably, only approximately 46% of blood products requested from patients admitted to TUTH were ultimately transfused.

Conclusions: Whole blood and packed red blood cells were the most frequently requested blood products. Eventhough whole blood was the most frequently requested blood product, the most transfused one was packed red cells. Peak demand was observed in December. Our study provides valuable insights into blood utilization patterns, underscoring the need for specific strategies to improve blood transfusion management practices.

This case report highlights the severity of dowry-related intimate partner violence in Terai, Nepal. A 24-year-old married female presented with multiple stab injuries to the abdomen and a cut-throat injury inflicted by her husband under the influence of alcohol due to dissatisfaction with dowry demands. Successful management involved exploratory laparotomy, anterior abdominal wall repair, cholecystectomy, and neck injury repair. However, on the third postoperative day, due to persistent pain and feeding difficulties, the patient was referred to a tertiary care center, where a re-exploratory laparotomy revealed missed diaphragmatic injury and bowel herniation requiring further repair. This case underscores the need for high clinical suspicion and early specialist referral in complex trauma scenarios. It also highlights the role of cultural and societal factors in intimate partner violence and the need for a multidimensional approach involving healthcare, legal, and social services. Keywords: Abdominal trauma; dowry; intimate partner violence; Nepal; stab injury.

Background: Olfactory fossa is a depression in anterior cranial cavity whose floor is formed by cribriform plate of ethmoid bone and is susceptible to injury during functional endoscopic sinus surgery (FESS), especially when fossa is deep. Understanding of patient's ethmoid roof anatomy and its possible variations is crucial for countering possible complications during functional endoscopic sinus surgery. So, objective of this study was to evaluate olfactory fossa depth.

Methods: In this descriptive cross sectional study, olfactory fossa depth was measured on Computed Tomographic images of 280 patients in the Department of Radiology, Tribhuvan University Teaching Hospital. The data were grouped according to Keros classification and their distributions were analyzed according to side and gender. Association between olfactory fossa depth with different parameters were evaluated with descriptive statistics, independent t-test, ANOVA and Chi-square test.

Results: Among 280 participants, 144 were male and 136 female. The mean depth of right and left olfactory fossa was found 5.10 ± 1.58 mm and 5.28 ± 1.62 mm respectively. Keros type II was the most common, found in 209 cases (74.60%) on left side and 194 (69.30%) on right side while type III was the least common. The difference between left and right olfactory fossa depth was significant though it was insignificant between male and female. No significant association was found between Keros type with sides and with gender.

Conclusions: Variation in olfactory fossa depth was common. Thus, preoperative assessment of ethmoid roof and Keros type is cruicial for warning the surgeon to minimize the critical complications.

Key words: Computed Tomography; olfactory fossa depth; para nasal sinus.

Background: Chronic obstructive pulmonary disease is defined as a preventable and treatable disease characterized by persistent respiratory symptoms and airflow limitation attributable to airway accompanied by alveolar abnormalities elicited by significant exposure to noxious particles or gases. Stress hormone is involved in proclivity towards causation of hyperglycemia and hyponatremia in COPD.

Methods: This study is an analytical cross sectional single center study that was carried out in Tribhuvan University Teaching Hospital. Specimens were processed as per the guidelines of Standard Operating Procedure (SOP) of Biochemistry laboratory of Tribhuvan University Teaching Hospital.

Results: In this study of 138 patients with acute exacerbation of COPD, the mean age was (71.88±9.771) years with higher prevalence in the age group between 70-80 years of age. Females (65.2%) outnumbered males and 71.7% came from outside the Kathmandu valley. Hyponatremia was observed in sodium levels with 51.4% below normal with majority of patient's possessing mixed acid-base disorders (58.7%). Most of thepatients 76.5% received general care with a mean hospital stay of 8.7 days. Statistical analysis revealed significant associations between care type, geographical distribution (p=0.026) and duration of stay with care type (p=0.0001). No significant associations were found regarding gender, glucose, sodium, potassium levels and age with duration of stay.

Conclusions: Factors such as age, gender, and glycemic status did not significantly affect the type of care or duration of hospital stay, geographical location emerged as a significant determinant, with patients from outside the Kathmandu valley more likely to receive general care. Despite the prevalence of electrolyte imbalances and acid-base disorders, these biochemical factors showed no substantial impact on clinical outcomes, suggesting that other factors may play a more significant role in duration of stay.

Background: Dense breasts are associated with an increased risk of cancer and also mask lesions on mammograms. In our study, we evaluated the role of sonography as an adjunct to digital mammography in patients with dense breasts.

Methods: Sonography of 676 female patients with American College of Radiology category C or D mammographic density was done in this prospective cross-sectional analytical study in the Department of Radiology, Tribhuvan University Teaching Hospital. The final imaging diagnosis was classified as per the American College of Radiology Breast Imaging Reporting and Data System categories. Tissue diagnosis was obtained in patients with sonographic category 3 solid lesions larger than 3 cm, category 4 and 5 lesions. The data were tabulated and analyzed using Statistical Package for Social Service (SPSS) for Windows version 22.

Results: Additional sonography confirmed all BIRADS 1 mammograms as normal or benign, 95.7 % (112) of inconclusive, and 82.8% (n=135) of BIRADS 3 ones as benign. It had higher sensitivity and negative predictive value (100%) than mammography with similar accuracy. Most patients (479, 70.9%) had diagnostic indications. There were 540 (79.9%) cases in ACR BIRADS category c. A final diagnosis of benign (316, 46.7%) was most common, followed by normal (293, 43.4%) and malignant (67, 9.9%). The majority of the malignant lesions were Invasive Ductal Carcinoma (59, 88%).

Conclusions: Additional sonography confirmed mammography findings as normal, benign, or suspicious for malignancy, definitely described morphology and extent of mass, and also guided biopsy. It had higher sensitivity than mammography in dense breasts.

Background: Urban areas are occupied with dense population and green spaces are hard to find. Urban agriculture solves food security problems as well as has important positive health outcomes. The aim of this study is to determine health and wellbeing Benefits of Urban Agricultural Practice.

Methods: A cross-sectional study was conducted from December 2022 to June 2023. Random selection of three study sites from Kathmandu valley was done. The total sample size was 230 which was grouped into involved in agriculture (115) and non- Involved in agriculture (115). Those groups were recruited from different wards of Kathmandu, Lalitpur and Bhaktapur. Questionnaire regarding socio-demographic variables, SF-12 health survey, perceived stress scale, satisfaction with life scale were used. KoBo Toolbox was used for data collection.

Results: The involved in agriculture groups differed from non-involved in terms of gender, ethnicity, occupation, marital status, education and ownership of the house (p<0.05). Participants engaged in urban agriculture reported significantly lower levels of perceived stress compared to those not involved in urban agriculture. Similarly, the data shows that life satisfaction was significantly higher among the group involved in urban agriculture.

Conclusions: Urban agriculture was associated with lower perceived stress and higher life satisfaction among the study participants who were involved in urban agriculture compared to the group not involved as compared to the group of study participants not involved in urban agriculture.