Nepal Journal of Epidemiology最新文献

Background: Worldwide, tobacco smoking is a major risk factor for morbidity and early mortality among adult population. The present study aimed to find out the association between current smoking and suicidal ideation among young people in Nepal.

Materials and methods: A cross-sectional questionnaire-based survey was carried out among 452 youths from Pokhara, Nepal. The present study included both genders (age 18-24 years) who were smokers as well as non-smokers.

Results: Across the study period, 452 participants were identified after matching for age, and sex (226 in the smoking group and 226 in the non-smoking group). The mean age of participants was 21.6±1.2 years and 58.8% were males. The overall rate of suicidal ideation in our cohort was 8.9%. Smokers were slightly more likely to report suicidal ideation than non-smokers (aOR 1.12). The risk of developing suicidal ideation was 3.56 (95% CI 1.26-10.09) times more in individuals who smoked greater than 3.5 cigarettes per week (p=0.01).

Conclusion: The rate of suicidal ideation was slightly higher among smokers and a dose-response relationship was identified with the number of cigarettes smoked per week. Being aware of the link between smoking and suicidal ideation may help health care professionals working with young people to address more effectively the issues of mental well-being and thoughts about suicide.

Background: Breast cancer (BC) is reported to be the most common malignancies affecting women worldwide. There is a sharp increase in the BC incidence rate over the past three decades as previously low risk countries are moving towards high -calorie western diets. Few epidemiologic studies along with animal experiments have ascertained the role of dietary fat in developing BC. This study aimed to determine the correlation between per capita dietary fat consumption and incidence of BC.

Methods: Three major data bases were used to conduct this correlational study. The data regarding consumption of fat and breast cancer incidence from 88 countries across five continents were extracted. The correlation coefficients between the incidence of BC and the fat consumption from the year 1990 to 2007 were calculated.

Results: A statistically significant (P<0.001) correlation between the average fat consumption and the crude BC incidence rate was observed and was more than 0.6, clearly indicating that there is a moderate to strong correlation with fat consumption and incidence of breast cancer (P<0.001).

Conclusions: Our observation indicated that increased total fat consumption increases the risk of developing BC. Consumption of dietary fat increases obesity thereby, increasing the risk of BC development. Dietary fat gets stored in the body since they undergo minimum oxidation as compared to carbohydrates and protein thereby, contributing to obesity a known risk factors for BC. Current study strengthens the evidence to support the hypothesis that non-genetic factors contribute to the occurrence of this disease.

Background: Calcium requirement increases during pregnancy, thereby increasing the chances of developing hypocalcaemia. Hypocalcaemia may be associated with pregnancy-related complications. Therefore, we planned this study to estimate the prevalence of hypocalcaemia among pregnant women attending secondary care hospital, and to study the association between hypocalcaemia and pregnancy outcomes.

Materials and methods: This study was conducted in a secondary level hospital at Ballabgarh, district Faridabad, Haryana, India. Consecutive pregnant women with gestation period more than 28 weeks were enrolled. Dietary calcium intake was ascertained using 24-hour dietary recall method. Serum calcium estimation was done by Biolis 24i auto analyser. Outcome of pregnancy (preterm delivery, low birth weight (LBW) babies, and neonatal mortality) was assessed telephonically 3 months after the enrolment.

Results: A total of 696 pregnant women were enrolled in the study. Mean (SD) dietary calcium intake and serum calcium level was 796.4 (360.4) mg/day and 9.56 (0.94) mg/dl respectively. Prevalence (95% CI) of hypocalcaemia was 23.9% (20.8 - 27.2%). Serum total calcium level was not associated with dietary calcium intake (p-value = 0.36). Mean serum calcium level was significantly lower in mothers who had LBW babies. Pre-eclampsia, preterm delivery, and neonatal mortality were not associated with serum calcium level.

Conclusion: Serum calcium level may not be related to dietary calcium level. Hence, the current recommendation of calcium supplementation during antenatal period appears to be inconclusive among our study population.

Background: Infections caused by Acinetobacter species and Pseudomonas species, especially multidrug-resistant (MDR) strains pose a serious management challenge with a public health threat.

Materials and methods: A hospital-based retrospective study of patients who were infected with Acinetobacter spp or Pseudomonas aeruginosa was carried out at Manipal Teaching Hospital from 2014 to 2016.

Results: A total of 170 cases of infections with Acinetobacter spp. and 313 cases with Pseudomonas aeruginosa were studied. The rate of nosocomial infections was higher than non-nosocomial infections. ICU was found as the major hub for both the organisms; (53.5% of cases due to Acinetobacter spp. and 39.6% due to Pseudomonas aeruginosa). Most isolates were of respiratory tract origin (Acinetobacter 74.7% and Pseudomonas aeruginosa 65.8%). Percentage resistance of Acinetobacter spp. towards polymyxin B was found to be quite low (18.8%). Similarly, resistance rates of Pseudomonas aeruginosa against amikacin were also found to be low, i.e., 17.4%. A higher prevalence of multidrug resistance was seen among Acinetobacter spp than among Pseudomonas aeruginosa (75.9% vs. 60.1%). The hospital stay was longer for patients infected with MDR isolate (p=0.001 for Acinetobacter spp. and p=0.003 for Pseudomonas aeruginosa). The mortality rate was higher in infections due to Acinetobacter spp (15.9%) as compared to Pseudomonas aeruginosa (8.3%).

Conclusion: This study reveals that infections caused by Acinetobacter species and Pseudomonas aeruginosa are associated with prolonged hospital stay and high in-hospital mortality. These emphasize the need for prudent use of antibiotics and aggressive infection control strategies.

Background: Screening interventions for the early diagnosis of breast cancer are associated with better clinical outcomes. Developing nations such as Nepal reportedly have lesser frequency of female university graduates (UGs) and therefore public awareness and education remains central in the early diagnosis of breast cancer. The current meta-analysis was aimed to assess the knowledge about breast self-examination (BSE) among women of Nepal.

Materials and methods: We have conducted the literature search using electronic databases such as PubMed, MEDLINE, Cochrane library and Google scholar. The search terms utilized were "breast self-examination"; "knowledge", "awareness"; and "attitude" in various combinations AND "Nepal" in the title or abstract. Additional searches were conducted with the help of cross references quoted in the selected studies and review articles. Data were retrieved using excel sheets which were pilot tested. Data were independently abstracted by the four authors using a standardized data collection form. Findings from the various studies were pooled together for the sake of analysis, if appropriate.

Results: The search yielded 36 articles; 27 duplicates and review articles were excluded and a further 4 articles not relevant were excluded. Finally, 5 original studies met the inclusion criteria. Total pooled sample size for assessing knowledge was 1910. The overall pooled knowledge about breast self-examination was found to be 27% with a 95% CI [23-31].

Conclusion: The pooled estimates demonstrated that the overall knowledge of breast self-examination was inadequate among women in Nepal. Therefore, prompt capacity building measures are warranted to enhance the public awareness towards BSE.

Globally, frequent flooding causes higher magnitude of disaster among the developing and developed nations. Particularly, the Indian subcontinent is considered as highly vulnerable area for natural disaster and is affected most because of limited resources and coping strategies for post-disaster rehabilitation. Apart from the great impact on human health, floods have considerable impact on mental health. The most frequently diagnosed psychological illness in flood affected population is post-traumatic stress disorder (PTSD). In India, the incidence of PTSD in major natural disasters varies considerably depending upon the magnitude of event, with the highest rates reported of around 70%. Studies conducted during initial few months post-disaster, showed a higher occurrence of psychiatric manifestations. On the other hand, some reports suggested contrary results under similar circumstances. Notably, extreme age (children and elderly), female gender, socioeconomic status, pre-existing mental health issues and financial crisis post-disaster are the potential predisposing factors influencing the vulnerability of PTSD. In Indian context, the variability in the magnitude of psychiatric illness is mainly attributed to the ethnic diversity (vulnerable population), severity and type of flood event and social support. Still there is more to explore regarding the long-term sequelae of catastrophic floods on physical and mental trauma on disaster-affected populations.