bluuebunny/crossref_metadata_2025 huggingface dataset:
Acute Myocardial Infarction in Women, a Study on Risk Factors, Angiographic Features and Outcomes
Authors: Chapagain Koirala Prabha , Sah Ram Kishor , Sherpa Kunjang , Poudyal Samir , Gautam Binayak , Koirala Richa
Published: November 2024

Background: Women with acute coronary syndrome are more likely to have cardiovascular disease risk factors and atypical symptoms as compared to men. In Nepal, there is a rising trend of Coronary Artery Disease and myocardial infarction in women. However, research on acute myocardial infarction in women is lacking. The aim of this study was to study the cardiac risk factors, clinical features, angiographic features, and outcome of acute myocardial infarction in Nepalese women admitted to Hospital. Methods: This was a cross sectional study done at Shahid Gangalal National Heart Center Kathmandu from September 2016 to March 2017. Female patients admitted with a diagnosis of acute ST-segment elevation myocardial infarction or non–ST segment elevation myocardial infarction, who fulfilled the inclusion criteria were included in the study. The details of the patients, demographic profile, major clinical symptoms, major coronary artery disease risk factors, angiographic features and outcomes were recorded and assessed during the study period. Coronary angiography was done in 112 patients out of 178 patients.Results: Out of 178 patients, 85.95 % had ST-segment elevation myocardial infarction and 14.05% had non–ST segment elevation myocardial infarction. The mean patient age was 62.53 ± 12.1. 26.4% patients were of age less than 55 years. Major risk factors were central obesity (94.61%), dyslipidemia due to low HDL (78.65%). hypertension (54.49%), smoking (54.49%) and type 2 diabetes (34.83%). The most common atypical symptoms were shortness of breath (35.39 %,) , nausea and vomiting (23. 6%) and epigastric pain (6.74%), Single vessel disease was found in 36%; double vessel disease in 26.3% and triple vessel disease in 28.9% of patients. The primary outcome of in- hospital mortality was 3.37 %. Conclusions: Our study showed that significant number of females had Coronary Artery Disease at early age. Among women with myocardial infarction in Nepal, obesity due to high waist to hip ratio was the most common risk factor followed by dyslipidemia due to low high density lipoproteins, smoking, hypertension, and diabetes. Atypical symptoms were also common findings. Single vessel disease was the most common lesion and left anterior descending artery was the most commonly involved vessel. Mortality was seen in ST-segment elevation myocardial infarction patients only.Keywords: MI in women; outcome; risk factors.
Maternal Risk Factors Associated with Preterm Birth: A Case Control Study
Authors: Gyamtsho Sonam , Tenzin Karma , Choeda Tshering
Published: November 2024

Background: Preterm birth is the child birth before 37 completed weeks .Prematurity is one of the leading causes of neonatal morbidity and mortality due to the complications associated with it. The objective of the study was to determine the maternal risk factors associated with all preterm birth in singleton pregnancy at National hospital.Methods: Hospital based unmatched case control study was conducted between March 2021 to December 2021 at National hospital, Thimphu, Bhutan. Case to control ratio was 1:2.Data were collected using interviewer –administered structured questionnaires. The collected data were entered into Epi-data and exported into SPSS for analysis. Independent variables with p-valves<0.05 in the univariate analysis were entered to multi variable logistic model to estimate the strength of association .P-valve <0.05 was considered significant.Results: Total of 107 cases and 201 controls participated with a response rate of 95.95%.Multiple logistic regression showed that mothers with ANC follow ? four[aOR 9.58(7.36-28.86) ], previous history of preterm delivery [aOR 2.99(1.5-15.77) ], previous caesarean section [aOR 5.72(2.19-14.92)], prelabour rupture of membrane [aOR 8.67(3.78-19.73)], fetal growth restriction [aOR 7.28(2.11-25.11)] , and pre-eclampsia [aOR 10.99(6.75-85.29) were the risk factors positively associated with preterm birth .Conclusions: This study highlights that preeclampsia, number of antenatal care visits ? four, prelabour rupture of membrane, fetal growth restriction, previous caesarean section and previous preterm delivery were the risk factors for preterm birth. This show the need of early screening and prevention of preeclampsia, strengthening of antenatal care follow-up, and treatment of infection to prevent prelabour rupture of membrane, reducing primary caesarean section and more attention and care with previous preterm birth .Keywords: Case control study; preeclampsia; preterm birth; risk factors.
From Rhetoric to Reality: Embracing Evidence-Based Policy for Lasting Impact
Authors: Thapa Tulsi Ram , Paudel Krishna Prasad
Published: November 2024

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Visual Field and Optical Coherence Tomography Parameters With and Without Positive Family History of Glaucoma
Authors: Bhatta Sabitri , Awasthi Suresh , Basnet Gyan Bahadur , Maharjan Indra Man
Published: November 2024

Background: To evaluate the Retinal Nerve Fiber Layer and Ganglion Cell Complex thickness using Spectral Domain Optical Coherence Tomography with and without positive family history of Primary Open Angle Glaucoma and its relation to visual field.Methods: Total 120 eyes with each subjects with positive family history of Primary Open Angle Glaucoma (Group I, n=30) and healthy subjects without positive family history of Primary Open Angle Glaucoma (Group II, n=30) undergone complete ophthalmic evaluation with Retinal Nerve Fiber Layer, Ganglion Cell Complex and VF obtained from Spectral Domain Optical Coherence Tomography RTVue-100 and Humphrey visual field respectively .The measurements were analyzed and compared among two groups using independent-t test by using SPSS version 23.The relationship of Retinal Nerve Fiber Layer with visual field were evaluated with correlation analysis.Results: The Intra Ocular Pressure and vertical Cup Disc Ratio were significantly higher in Group I with mean difference of 2.48±0.43 (p<0.001) and 0.18±0.23 (p<0.001) respectively. The average, superior, inferior, nasal, temporal RNFL and average Ganglion Cell Complex was significantly lower and thinner in Group I with mean difference of -8.53±2.30 µm (p<0.001), -7.35±3.34 µm (p<0.001), -8.52±3.58µm (p<0.001),-11.87±2.24µm (p<0.001), -5.31±1.95µm (p<0.001) and -8.05±1.52µm (p<0.001) respectively. Correlation plot with Retinal Nerve Fiber Layer thickness as predictor of Mean Deviation and Pattern Standard Deviation indicated statistically significant degree of determination in Group I (r=0.455 and r=0.623, p<0.001 and p<0.001).Conclusions: The Optical Coherence Tomography and visual field Parameters are lower in group I and used as an early predictor, diagnosis, monitoring and management.Keywords: Family history; first degree relatives; ganglion cell complex; primary open angle glaucoma; retinal nerve fiber layer.
Deaths among Women of Reproductive Age: an Explorative Case Study among Abortion Seekers
Authors: Gautam Preeti , Puri Mahesh C. , Karki Sunita , Foster Diana Greene
Published: November 2024

In Nepal, abortion was legalized in 2002. Yet many women are denied abortion services. Women denied abortion services may either continue their pregnancies or find abortion care elsewhere. However, what is not known is the consequences on women, and their children after accessing abortion services or after being denied abortion services. This comment aims to understand the cause of death of women who sought abortion services between 2019 and 2020 and were enrolled in a longitudinal nationwide study of the consequences of legal abortion access in Nepal. Women were interviewed 6 weeks and every 6 months for 3 years after seeking abortion. During the follow-up interviews, the field research assistants were informed about the death of the clients. Once the death was reported, a trained senior research staff visited the deceased persons house and interviewed family members including husbands, maternal parents or in-laws to explore the cause of death. A total of nine deaths were reported between April 2019 and December 2022. Out of nine deceased women, four received abortions while five of them were initially denial abortion services. The majority of the deaths were due to suicide followed by tuberculosis. None of the deaths were caused by abortion or birth.Keywords: Death; Nepal; reproductive ages; womens health.
Antibiotic Susceptibility and Biofilm Production among Coagulase Negative Staphylococci Isolated from Clinical Samples at Tertiary Care Hospital
Authors: Shah Pradeep Kumar , Bhandari Niru , Tamang Basanta , Joshi Rajendra D
Published: November 2024

Background: Coagulase Negative Staphylococci have been widely associated with medical device implant treatment and immune-compromised patients. Despite having increasing interest in Coagulase Negative Staphylococci, few studies from Nepal have reported the association of these organisms with urinary tract infections, conjunctivitis, high vaginal swabs, and cerebrospinal fluid. This study was carried out to determine antibiotic susceptibility pattern and biofilm production among Coagulase Negative Staphylococci isolated from clinical samples at tertiary care hospital.Methods: This study was a hospital based cross-sectional study in which 3690 clinical samples were included. Isolation and identification of isolates was done following standard microbiological protocol. Coagulase Negative Staphylococci were identified phenotypically on the basis of gram staining, slide and tube coagulase test and by various sugar fermentation tests. Antibiotic susceptibility test was done following Kirby Bauer disk diffusion method (Clinical and Laboratory Standards Institute 2020). Biofilm production was determined by Tissue Culture Plate technique. Results: A total of 113 isolates of Coagulase Negative Staphylococci were detected. Among them S. epidermidis (45.1%), S. saprophyticus (23.9%), S. haemolyticus (16.8%), S. hominis (5.3%), S. capitis (2.7%), ­­­­­S. cohini (1.8%), S. lugdunensis (1.8%) and S. sciuri (2.7%) were identified phenotypically. All isolates were found to be resistant against Ampicillin and 111 (98.2%) were sensitive against Linezolid.23.9% of CoNS were strong biofilm producers, 19.5% moderate and 56.6 % were non/weak biofilm producers.Conclusions: It requires susceptibility test for prescribing antibiotics against Coagulase Negative Staphylococci in hospital and the misuse of antibiotics should be prevented.Keywords: Clinical samples, CoNS, antibiotic susceptibility, biofilm­­­­
Improper Use of Topical Corticosteroids in Tinea Infections in a Tertiary Care Hospital
Authors: Chen Wen-Guo , Ho Wen-Tsao
Published: November 2024

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Respiratory Morbidity and Mortality of Traumatic Cervical Spinal Injury
Authors: Pokhrel Nabin , Neupane Aastha , Thapa Nabin , Yadav Rupesh Kumar , Hamal Pawan Kumar , Malla Pragya
Published: November 2024

Background: Traumatic cervical spinal injuries can severely affect respiratory function and cause significant morbidity and mortality. The typical respiratory morbidity in cervical spine injury is Atelectasis, Ventilator-associated pneumonia, acute respiratory distress syndrome and delayed weaning, etc. The study aims to see the prevalence of respiratory morbidity as well as mortality associated with cervical spine injury. Methods: Cross sectional study based on retrospective data was conducted on the X Sciences with the existing hospital record during the period of 3 years to find out the prevalence respiratory morbidity like Ventilatory Associated Pneumonia, delayed weaning, ARDS, atelectasis of traumatic cervical spine injury, determine the prevalence, type, and impact of respiratory morbidity and mortality in this population.Results: Total no 76 patients data meeting the inclusion criteria included in study. Male patients were more prone to develop traumatic cervical spinal injuries (SCI). The prevalence of respiratory morbidity in term of VAP(57.89), delayed weaning(46.05) and Atelectasis(22.36) was high. Patients with Asia A Neurology has higher association for VAP and delayed weaning, while Asia E Neurology patients had no respiratory morbidity. The study found a significant positive association between respiratory morbidity with hospital stay, and ventilator days (p-value: 0.019 and 0.048). A total of 15 patients died, 28.95% were discharged on request and 40.8% leaving the hospital against medical advice.Conclusions: The prevalence of respiratory morbidity higher in cervical spine injury. Furthermore, it has associated with prolonged ICU and ventilator days and increase in mortality. Keywords: ARDS; atelectasis; delayed weaning; respiratory morbidity; traumatic SCI.
Comparison of Sonographic Findings with Diagnostic Mammography
Authors: Joshi Birendra Raj , Paudel Bishnu , Jha Anamika
Published: November 2024

Background: Breast cancer is the leading female cancer worldwide with a high mortality rate. Early detection of the suspicious lesion is crucial for better prognosis. Higher breast density decreases the sensitivity of mammogram. Ultrasound can differentiate between cystic and solid masses and further characterize these as benign or possibly malignant. Our objective was to compare the findings of sonography with diagnostic mammography.Methods: This was a cross sectional study including 125 females who underwent diagnostic mammogram in a tertiary care center. The mammograms were evaluated and the patients were scanned by ultrasound and categorized as per ACR- BIRADS category. The findings of diagnostic mammography were compared with that of ultrasonography using SPSS version 25. Results: The heterogeneously dense breast in diagnostic mammography corresponded to the heterogenous- fibroglandular breast in ultrasonography. In majority, ultrasound increased the BIRADS category for the lesion than designated by the diagnostic mammography. It was particularly useful for category 0 and 3 lesions which were indeterminate and required further imaging.Conclusions: Ultrasound was useful in evaluation of dense breasts with ACR-BIRADS 0 and 3 in diagnostic mammogram. For category 3 and 4 in diagnostic mammogram, ultrasound showed category 1 or 2 lesions which aided to alleviate patient anxiety and avoid unnecessary biopsies. With emerging technological advances in ultrasound, it can used as a powerful tool for breast lesion detection and patient management.Keywords: Breast density; diagnostic mammogram; ultrasonography.
Chronic Cavitary Pulmonary Aspergillosis: Complication of Pulmonary Tuberculosis
Authors: Tiwari Bishal , Adhikari Sudeep , Ghimire Manoj , Singh Suraj , Kafle Amir
Published: November 2024

Pulmonary Aspergillosis is a fungal infection of the lungs that can lead to invasive disease and the formation of cavities, especially in the immunocompromised population. The most common clinical features are no symptoms at all to fever, cough, nondescript chest discomfort, trivial hemoptysis, and shortness of breath. Most patients respond well to Itraconazole therapy. Pulmonary Tuberculosis is one of the conditions that can lead to Aspergillosis, especially in cavities that are formed by Mycobacteria; both often manifest with similar clinical features and lead to diagnostic error. We present a case of a 28-year-old male diagnosed with pulmonary tuberculosis who developed symptoms of persistent cough, hemoptysis, increasing fatigue, and weight loss despite compliance with antitubercular therapy. Ultimately diagnosis of Cavitary pulmonary aspergillosis was made on clinical, laboratory, and radiological grounds. In a patient presenting with worsening symptoms of tuberculosis, there should be a suspicion of aspergillosis, necessitating the performance of standard fungal infection investigations.Keywords: Immunocompromise iosts; lung cavity; pulmonary aspergillosis; tuberculosis.
Publication Status of Theses among Post-graduate Students in Nursing from Institute of Medicine
Authors: Khatri Pratima , Chapagain Bigya , Sharma Mohan Raj
Published: November 2024

Background: Publication of the research work done during the master’s program is highly desirable. However, there is a paucity of data on the number of publications, especially from low-income countries. The objective was to find out the status of the publication of the theses of post-graduate students in Nursing from the Institute of Medicine, Tribhuvan University, Nepal from 2015-2019. Methods: Cross-sectional analytical design with a structured interview via telephone was done for data collection. Independent variables were age, marital status, current work status, current working organization, type of research, year of graduation, and facilitators and barriers to publication, whereas dependent was the publication status of the thesis.Results: Two hundred five (76.2%) out of 269 participated in the study. The age group ranged from 27 to 50 years (mean ± SD = 36.6±4.8). The majority 89.3% were married. Currently working in academic institutions was 51.7%. One hundred ninety-eight (96.6%) respondents performed a cross-sectional descriptive study. Only 2.9% of studies were cross-sectional analytical and 0.5% were qualitative. Seventy-five (36.6%) respondents published their theses. Twenty-seven (36.0%) were published in PubMed-indexed journals. The most common facilitator for publication was academic satisfaction [59 out of 75(78.7%)] followed by encouragement from supervisors 52.0% and peers 40.0%, whereas the commonest barrier to publication was lack of interest [80 out of 124 (64.5%)] followed by lack of confidence 51.6%.Conclusions: Based on the results, more than one-third of the participants published their theses in national and international journals including those indexed in PubMed. Provision of university research grants, development of publication culture among post-graduate students, and making a provision of academic publication before degree awards should be encouraged for more academic publication.Keywords: Journals; Nepal; nursing; publication status; thesis.
Barriers to Abortion among Women and Girls in Selected Districts of Nepal
Authors: Phuyal Parash Prasad , Bhattarai Tejaswee , Pant Prakash Dev , Devkota Bishnu , Devkota Jivan , Dhakal Madhav Prasad , Karki Sujan , Ghimire Jagadishwor , Moore Brittany
Published: November 2024

Background: Even after two decades of legalization of abortion in Nepal, most women and girls still do not have knowledge on abortion legality and face abortion barriers. This study will explore perceived barriers to safe abortion and the factors associated with it.Methods: A Mixed method study design was conducted in 30 wards of 20 Municipals of seven districts of Lumbini and Sudurpaschim provinces. Quantitative data was analyzed for 673 women of reproductive age of 15-49 years. For qualitative data, key informant interviews were conducted. The analysis was done on five different barriers and a composite variable was created from them. Results: Most women and girls perceived social (34.6%), followed by family (30.6%), physical (30.6%), personal (29.5%), and health facility (14.9%) barriers to access safe abortion services. The key finding was that women and girls with knowledge on abortion legality were more likely to perceive barriers to abortion (AOR:2.31, CI:1.574-3.394). Women and girls with higher educational and economic status as well as Dalit women were less likely to perceive barriers to abortion services whereas never married women and girls perceived more barriers in accessing abortion services.Conclusions: Women and girls perceived several barriers to access safe abortion services. Women who have better knowledge on abortion legality recognize more barriers regarding abortion. This highlights the importance of raising awareness of women and girls on abortion rights to empower them in recognizing and advocating for the removal of the obstacles that stop them from getting abortion services.Keywords: Barriers to abortion; caste/ethnicity; legal knowledge; women and girls.
Trends and Inequities in Use of Abortion Services in Nepal: A Nepal Demographic and Health Survey Data Analysis 1996-2022 A.D.
Authors: Gautam Manish , Mehata Suresh , Karki Sujan , Ghimire Jagadishwor , Maharjan Sanju , Dotel Bhogendra Raj
Published: November 2024

Background: Despite policy advances and public health initiatives in Nepal to improve access to reproductive healthcare, disparities persist in utilization of abortion services. Grounded in longitudinal data from the Nepal Demographic and Health Survey from 1996 to 2022, this study aims to shed light on evolving patterns in pregnancy outcomes and inequities in use of abortion services across ecological zones and wealth quintiles.Methods: Utilizing six rounds of Nepal Demographic and Health Survey data, pregnancy outcomes were categorized as abortion, delivery, miscarriage, or stillbirth. Income-related inequality in the utilization of abortion services was assessed through the concentration index, ranging from -1 to 1. Trends over time were evaluated using the annual rate of change.Results: The ARC indicated a substantial rise in induced abortion rates, surging from 0.4% in 1996 to 8.8% in 2022. In contrast, live births witnessed a decline from 92.8% to 81.2%. Significant variations were observed across ecological zones and wealth quintiles, with the Mountain zone and the Poorest group experiencing the most pronounced increases in induced abortion rates. By 2022, the concentration index reached a near-zero value, signifying a near-elimination of income-related disparities in the use of induced abortion services.Discussion: The findings suggest that while there has been significant progress in access to and use of abortion services in Nepal, particularly post-2002 policy shifts, challenges remain. Women from lower socio-economic backgrounds continue to face barriers, indicating the need for a multi-pronged approach to address residual challenges.Conclusions: Nepal has made remarkable strides in enhancing equitable access to and use of induced abortion services, but more needs to be done to guarantee equitable access for all women. Future efforts should focus on policy reforms, infrastructural improvements, and societal change to eliminate existing barriers to reproductive healthcare.Keywords: Abortion services; concentration Index; socio-economic disparities.
An Estimate of Abortion Incidence and Unintended Pregnancies
Authors: Ghimire Jagadishwor , Lal Bibek Kumar , Karki Sujan , Mehata Suresh , Dotel Bhogendra Raj , Joshi Nisha , Shrestha Pradhan Gauri , Gautam Manish , Shrestha Dangol Deeb , Phuyal Parash Prasad , Lamichhane Kritee , Bhattarai Navaraj , Lynam Anna
Published: November 2024

Background: After the legalization of abortion in Nepal, there has been remarkable changes in policies and service delivery. However, even after two decades of legalization, access to and use of safe abortion services remains limited. The objective of this study is to estimate the incidence of abortion and unintended pregnancies in Nepal.Methods: A cross sectional study was conducted in 767 health facilities using structured questionnaires to assess the availability of abortion services, and 231 key informant interviews were conducted. Information on medical abortion drugs was collected from distributors and pharmacies. Abortion estimations were segmented into categories: those performed within healthcare facilities, those conducted outside healthcare facilities, and those using other traditional methods. To estimate pregnancy outcomes, we utilized secondary data from national censuses and health surveys. Results: The total incidence of induced abortion cases in Nepal was estimated to be 333,343 for the year 2021. Only 48 percent of abortion services were provided from the listed (legal) sites and providers. The estimates showed that total facility based induced abortion in Nepal was 176,216 in 2021, more than half were medical abortions. The highest and lowest abortion cases were in Bagmati and Karnali province respectively. The result showed that more than half of the pregnancies were unintended (53.3%).Conclusions: Despite a relatively liberal legal environment, more than half of all abortions are extra-legal in Nepal. Unintended pregnancies are also common, resulting in induced abortion. This demands for increasing access to information and services on contraception and safe abortion among women and girls.Keywords: Abortion incidence; legal abortion; unintended pregnancy.
A Critical Analysis of Safe Abortion Road Map in Nepal
Authors: Ghimire Jagadishwor , Maharjan Sanju , Kattel Pratikshya , Dangol Deeb Shrestha , Lal Bibek Kumar , Joshi Nisha , Shrestha Gauri Pradhan , Suwal Archana , Bhattarai Ojasbi , Shahi Suruchi , Gautam Manish , Bhattarai Navaraj , Mehata Suresh , Dotel Bhogendra Raj , Karki Sujan
Published: November 2024

Background: Abortion was legalized by the 2002 Muluki Ain to combat the surging rates of maternal mortality and morbidity. By 2021, the Maternal Mortality Rate plummeted to 151 from 539 in 1996. The decline in the abortion-related maternal mortality attributes to the implication of progressive abortion policies that includes expanded safe abortion services introduction of medical abortion, constitutional recognition of abortion, the mandates by Safe Motherhood and Reproductive Health Rights Act, and free-of-cost abortion services in government health facilities.This review study delves into exploring the contemporary abortion policies and its implications on women’s access to safe abortion services as well as the factors that affect the access.Methods: This study incorporates findings from extensive desk review of abortion services in Nepal. Results: The 2021 safe abortion services Program Implementation Guideline aims to expand safe abortion sites; however, the Nepal’s challenging geography ensues its inequitable distribution, especially in mountainous area. Policy provisions on information and financial accessibility to abortion are well navigated by the Safe Motherhood and Reproductive Health Rights Act and regulation but consistent to sporadic gaps in its implementation were comprehended in this study. This paper further discussed the Safe Motherhood and Reproductive Health Rights Act’s regressive mandate of 28-week gestational limit at any condition and the role of gender in abortion decision-making under the pretext of factors influencing safe abortion services.Conclusions: The review study recommends strategies: improving capacity for abortion services under federalism, combating stigma, improving the private sector’s readiness, and building a resilient health system.Keywords: Accessibility; availability; legalization; quality; safe abortion.
Correlation Between Radiological Grading and Clinical Scoring in Knee Osteoarthritis Patients
Authors: Sapkota Kshitiz , Gautam Sandesh , Luitel Prajjwol , Sapkota Radhika , Pokharel Sabin
Published: November 2024

Background: Osteoarthritis is characterized by mechanical joint abnormalities, primarily involving articular cartilage and subchondral bone degradation. Diagnosis of knee osteoarthritis relies on American College of Rheumatology criteria, and severity assessment utilizes the Western Ontario and McMaster Universities Osteoarthritis Index score and Kellgren and Lawrence grading. Despite reported associations, discrepancies persist in the correlation between Western Ontario and McMaster Universities Osteoarthritis Index and Kellgren and Lawrence grade.Methods: Descriptive cross-sectional study was conducted at the National Trauma Centre, over six months with consecutive convenience sampling. Demographic and clinico-radiological data were collected. Mean, SD and correlation coefficient was calculated.Results: Consecutive convenient sampling yielded 80 participants meeting American College of Rheumatology criteria, aged 52-81 years, predominantly female (67.50%). Significant positive correlations were identified between age, Western Ontario and McMaster Universities Osteoarthritis Index score, and KL grade. Results showed most cases with Kellgren and Lawrence grade III and strong correlations (r=0.73, p=0.00) between total Western Ontario and McMaster Universities Osteoarthritis Index scores and Kellgren and Lawrence grading. Notably, pain, stiffness and physical functions individually exhibited a significant possitive correlation with Kellgren and Lawrence grading. The study affirms age-related influences on osteoarthritis, emphasizes female predilection, and underscores the importance of assessing both clinical and radiological parameters.Conclusions: In conclusion, this study supports Western Ontario and McMaster Universities Osteoarthritis Index efficacy in dynamic disease assessment and management, especially in settings where radiological examinations may be impractical, thus establishing Western Ontario and McMaster Universities Osteoarthritis Index as a versatile tool for systematic monitoring and intervention in knee osteoarthritis.Keywords: knee osteoarthritis; radiology; rheumatology; scoring; X-Ray.
Detection of Cervical Precancer Using Visual Inspection Method with Acetic Acid
Authors: Baral Gehanath , Oli Lila , Verma Sheela , Rai Snigdha , Aryal Parshuram , Tiwari Suman
Published: November 2024

Background: Cervical cancer screening is the priority activity of the government. Visual inspection with Acetic acid (VIA), Pap smear Liquid-based cytology, and HPV DNA testing are different methods of screening. VIA-based screening is the cost-effective method of screening in a resource-constrained setting like in our country as this doesn’t require cyto-histological testing, can be performed by trained paramedics too, and is as accurate as a cytological test.The aim is to explore pre-cancer cervical lesions by screening women in the community by visual inspection using acetic-acid.Methods: Community-based cross-sectional study done at a health camp setting for three months from March to June 2023. The married non-pregnant women of 30-60 years were screened. Descriptive tests as well as sub-group analysis performed by Chi-Square tests.Results: From ten community health camps, 1255 cases were screened and screen positivity was 14.3%. Positive results were proportionately distributed to all parity by 13-19%. Half of the positive results (47.2%) were in the 34-40 age group. There were no significant differences in screen positivity by parity or vaginal discharge. Menopausal women had 7.7% screen positivity.Conclusions: The prevalence of VIA positivity in the community was found double the previous facility-based prevalence; and there was no significant difference by parity, menopausal status, and vaginal discharge. The positivity was more in 30-45 years of age.Keywords: Cervical pre-cancer; screening; VIA.
Amitriptyline, Pregabalin and Duloxetine for Treatment of Painful Diabetic Peripheral Neuropathy
Authors: Nepal Richa , Bajracharya Manil Ratna , Karki Budda Bahadur , Mall Dipak , Shrestha Prajaya Shikhar , Wasti Kushal Prasad , Bisht Anjal
Published: November 2024

Background: Painful diabetic peripheral neuropathy is one of the frequent presenting complaints in diabetes and endocrine clinics. Our main objective was to compare effectiveness of three commonly prescribed drugs: amitriptyline, pregabalin and duloxetine for treatment of painful diabetic peripheral neuropathy.Methods: This was a comparative, prospective, observational study conducted among 99 diabetic patients with painful diabetic peripheral neuropathy having numeric rating pain scale ? 4. Thirty-three patients in each group were consecutively prescribed amitriptyline, pregabalin and duloxetine in lower dose (10mg/75mg/20mg) for first two weeks to gradually up titrate to higher dose (25mg/150mg/30mg) as per pain response for total duration of eight weeks.Results: At the end of eight weeks, 84.9% in amitriptyline, 78.7% in pregabalin and 60.6% in duloxetine group had adequate pain reduction in form of mild or no pain. Among total patients, 42.5% patients had severe pain at baseline that decreased to 5% by the end of our study. Out of three drugs, 45.5% patients in amitriptyline group had complete resolution of pain as compared to 24.2% in pregabalin and 18.2% in duloxetine group (p value 0.05). Drowsiness (42.4%), dizziness (21.2%) and dry mouth (21.2%) were the commonest side effects among total participants in our study. Conclusions: Amitriptyline, pregabalin and duloxetine were all associated with adequate pain reduction among patients of painful diabetic peripheral neuropathy in our study, however, amitriptyline had more favorable findings with tolerable side effects. Keywords: Amitriptyline; duloxetine; Nepal; painful diabetic peripheral neuropathy; pregabalin.
Evaluation of SARS-CoV-2 Humoral Response Following Vaccination with ChAdOx1 nCoV-19 and/or Sinopharm, BBIBP-CorV: Correspondence
Authors: Daungsupawong Hinpetch , Wiwanitkit Viroj
Published: November 2024

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Perception and Willingness Regarding Organ Transplantation/donation among Medical Students of Maharajgunj Medical Campus: A Cross-sectional Study
Authors: Bhattarai Amit Sharma , Adhikari Bidur , Joshi Deepak Raj , Yadav Alisha , Joshi Pankaj , Parajuli Bashu Dev , Koirala Megha , Karki Kushal Jung , Subedi Krishna Prasad , Shrestha Gentle Sunder , Shrestha Anil , Singh Shreejana
Published: November 2024

Background: Organ transplant is the procedure of replacing a failing or damaged organ with a functioning one. Positive attitude and awareness about donation are a must for donor organs to be available. This study explored the level of knowledge, perception and willingness regarding organ donation among medical students in Nepal.Methods: A descriptive cross-sectional study was conducted with 180 medical students using a self-administered questionnaire. Descriptive statistics were used, and Pearson correlation was applied to examine the relationship between knowledge and perception of organ transplantation. Independent samples t-test and ANOVA was used to compare scores among year of study and gender.Results: Results indicated that 86.1% of participants were aware of the need for organ donation, and 83.3% knew that both living and deceased individuals could be donors. While 93.9% believed in the need for effective laws, 72.8% perceived risks for donors. However, only 74.4% were willing to donate their organs, though 91.7% expressed willingness to promote organ donation among friends and family. Participants showed a positive perception towards organ donation.Conclusions: Despite a high level of awareness and knowledge regarding organ donation, participants exhibited a lower level of willingness to donate organs. Perceived risks for donors and a lack of robust laws and regulations presented significant barriers. Nevertheless, an inclination to promote organ donation was observed. This underlines the need for enhanced education and policy reform to increase organ donation rates.Keywords: Awareness; knowledge; organ donation; organ transplantation; perception.
Advancing Health and Population Research and Innovations for Achieving Sustainable Development Goals in Nepal
Authors: Dhimal Meghnath , Joshi Pramod
Published: November 2024

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Clinical Profile of posterior segment in high Myopia
Authors: Kaiti Raju , Bogati Birkha , Shyangbo Ranjila , Khadka Simanta , Bajgai Priya
Published: November 2024

Background: Myopia is a growing global health concern, with prevalence surging, especially in East and Southeast Asia. The World Health Organization identifies high myopia as -5.00 diopter or less, carrying an elevated risk of irreversible blindness. In 2020, an estimated 2.6 billion people had myopia, projected to reach 4.7 billion by 2050, leading to a rise in complications like myopic maculopathy. This study, conducted in Nepal, where 47.16% of the population is myopic, aims to assess fundus and optic nerve changes in high myopia, examining associations with age, gender, axial length, and mean spherical error.Methods: A prospective, cross sectional study was conducted by recruiting 98 high myopic eyes (defined as spherical equivalent of <-5.0 diopters (D) or axial length â‰¥ 26.00 mm). Colored Fundus photography was performed on viewing angle of 500 in different field of gazes following pupillary dilatation. Fundus photographs were graded by independent graders to evaluate for high myopic fundus and optic disc changes. Multinomial logistic regression was performed with axial length and mean spherical error as risk and myopic changes as dependent variable.Results: In this study, tessellated fundus (57.1%) and peripapillary atrophy (40.8%) were the most common posterior segment changes in high myopic Nepalese subjects. High myopic features were seen in 45.9% of cases. Increase in axial length and mean spherical error was established as a risk factor for development of high myopic changes in the fundus.Conclusions: In this study of the highly myopic Nepalese population visiting tertiary eye hospital, myopic changes such as tessellated fundus and peripapillary atrophy were frequent and were associated with axial length and mean spherical error. Keywords: Degenerative myopia; high myopia; pathologic myopia; peripapillary atrophy; tessellated fundus.
Knowledge, Attitude and Practice of Personal Hygiene among Grade Nine and Ten Students in Government School of Jumla
Authors: Neupane Pratima , Panta Prem Prasad , K.C Shreejana , Padhaya Ramesh Raj , Bhattarai Preeti , Lama Nishant
Published: November 2024

Background: Personal hygiene is crucial for a healthy life, especially for school children who are more susceptible to diseases due to poor hygiene. This study was design to determine the existing knowledge, attitude and practice of personal hygiene among secondary students of grade nine and ten of a government school of Jumla. Methods: A school-based cross-sectional study was conducted in a Government Secondary school situated in a rural area of Jumla. A total of 368 adolescent girls and boys from classes nine and ten were included. Data were collected using pre-tested, self-administered questionnaires and analyzed with SPSS version 16. The Chi-square test was applied to compare the proportions of quantitative variables.Results: Among the 368 students, 43.3% were male and 52.7% were female, with a mean age of 14.98 Â± 1.34 years. The study found that 94.8% had good knowledge, 82.3% had a positive attitude towards personal hygiene, and 63.6% practiced good personal hygiene. Participants with a positive attitude towards personal hygiene demonstrated a higher percentage of good hygiene practices. However, there was no statistically significant association between knowledge and attitude on personal hygiene. Conclusions: The study revealed that the majority of the students had a good level of personal hygiene knowledge. Boys appeared to be more knowledgeable than the girls; though these knowledge and attitude were not reflected in their practices. The study proposed that health education should focus on enhancing the attitude and practice to improve hygiene among rural youth.Keywords: Attitude; knowledge; personal hygiene; practices; rural government school.
Burden of Reproductive Organ Cancer of Females in the Population-based Cancer Registry in Nepal
Authors: Baral Gehanath , Marahatta Sujanbabu , Singh Sumer
Published: November 2024

Background: There are sporadic facility-based reports but an information gap in the cancer burden in the community is apparent. To address this, the Nepal Health Research Council (NHRC) started a Population-based Cancer Registry (PBCR) in 2018 in the country. Thus, this study aims to identify the cancer burden in the female population, especially in the reproductive organs.  Methods: A quantitative database analysis of the Population-based Cancer Registry for year 2018 and 2019 was performed. Data entered in the TSV (Tab-separated values) files were imported to MS Excel and SPSS data Window and variables regrouped before analysis. The national census, WHO standardized population, and registry data were used for the descriptive analysis of the registry variables. Ethical approval was taken from the Ethical Review Board of NHRC. Result: Out of 6854 cancer registries, the female population was 3590 with a male-to-female ratio of 10:11. This registry covers 10.75% of the countryâ€™s population. The crude and age-standardized cancer incidence rates were 1.24% and 66.2 per 100,000 for the female population respectively. Reproductive organs (21%) and breast (19.7%) cancers are the most common in females, and out of reproductive organs cervical (58%) and ovarian (25%) cancers are the commonest. Surgery was the main treatment modality (32.7%) with or without chemotherapy and radiotherapy.Conclusions: The burden of cancer is higher in females because of breast cancer. Reproductive organ cancers and breast cancers share an equal burden of around 20% each. The most common female genital cancer is of uterine cervix followed by the ovary. Keywords: Breast; burden of cancer; cancer registry; cervix; ovary.
Asosiasi Skandium dan Potensi Keberadaan Unsur Tanah Jarang pada Profil Laterit Nikel pada Daerah Wasile, Halmahera Timur, Maluku Utara
Authors: Fadhlurrohman Putrananda Aditya , Rosana Mega Fatimah , Yuningsih Euis Tintint
Published: November 2024

Abstrak-Skandium dan Unsur Tanah Jarang merupakan sumber daya strategis yang berharga untuk berbagai aplikasi industri sehingga menjadi perhatian untuk eksplorasi sumber daya, ekstraksi berkelanjutan, dan aplikasi pada pengembangan teknologi. Penelitian ini bertujuan untuk mengetahui karakteristik profil laterit beserta kandungan unsur skandium dan potensi UTJ yang berkembang pada profil laterit nikel yang memiliki batuan dasar ultrabasa. Daerah penelitian berada pada Daerah Wasile, Halmahera Timur. Dalam penelitian ini, metode yang digunakan adalah analisis petrologi dan analisis geokimia,yaitu XRF, ICP-MS dan XRD. Hasil dari analisis petrologi menunjukkan bahwa profil laterit terdiri atas lapisan limonit, zona transisi, saprolit dan batuan dasar. Batuan dasar yang teramati merupakan jenis lerzolite dan serpentinit. Hasil analisis geokimia menunjukkan peningkatan komposisi unsur skandium dan UTJ pada zona saprolit. Kehadiran unsur-unsur ini menjadi potensi untuk korelasi terkait dengan genesis UTJ Ion Adsorption Type dan klasifikasi deposit lebih lanjut.
Katakunci: Halmahera, profil laterit, skandium, UTJ.
Los recursos digitales empleados en la difusión y educación patrimonial: una aproximación crítica
Authors: Sánchez-Clemente Ramos Andrés
Published: November 2024

En los últimos años, especialmente desde la pandemia provocada por la COVID-19, todos los sectores han vivido procesos de transformación digital; dada la premura, en algunos casos no se pudieron definir bien los objetivos. El sector patrimonial también ha estado inmerso en procesos de transformación digital: en la difusión y educación patrimonial se han incorporado numerosas herramientas y recursos digitales, arrojando resultados muy diversos. Ante la gran cantidad de herramientas y recursos empleados en los procesos de enseñanza-aprendizaje cabe destacar que un recurso didáctico no puede ser valorado positiva o negativamente por el hecho de difundirse en una página web o presentarse en una tableta. Tomando en consideración el sexto principio de Tilden sobre interpretación del patrimonio, la clave para diseñar y desarrollar recursos didácticos eficaces y eficientes reside en su adaptación al público que lo recibirá/empleará y al contexto en el que se haga.
Hubungan Antara Pola Hidup Sehat Dengan Tingkat Kebugaran Jasmani Siswa Sekolah Menengah Pertama Negeri 1 Ujan Mas Kabupaten Kepahiang
Authors: Anggita sari Diyan , Yarmani Yarmani , Raibowo Septian , Pujianto Dian , Sugihartono Tono , Defliyanto Defliyanto
Published: November 2024

Penelitian ini bertujuan untuk mengetahui hubungan pola hidup sehat dengan tingkat kebugaran jasmani siswa Sekolah Menengah Pertama Negeri 1 Ujan Mas Kabupaten Kepahiang. Jenis penelitian ini adalah analisis korelasi dengan pendekatan kuantitatiff dengan metode survei dengan instrumen berupa tes pengukuran, instrumen pola hidup sehat dengan menggunakan kuesioner, sedangkan kebugaran jasmani menggunakan tes TKJI umur 13 – 15 tahun. Populasi dalam penelitian ini adalah seluruh siswa sekolah menegah pertama negeri 1 ujan mas kabupaten kepahiang yang berjumlah 336 siswa. Sedangkan Teknik pengambilan sampel dengan teknik random sampling yang berjumlah 36 siswa. Data dikumpulkan dengan menggunakan kuiseoner dan tes TKJI. Analisis data yang digunakan dalam penelitian ini adalah uji prasyarat analisis dan uji korelasi. Hasil penelitian menunjukan bahwa pola hidup sehat memiliki hubungan dengan hasil kebugaran jasmani siswa Sekolah Menengah Pertama Negeri 1 ujan mas kabupaten kepahiang. Berdasarkan nilai  0.62 lebih besar dari pada dalam product moment diperoleh 0.339, maka keputusan menolak hipotesis nol (Ho) dan menerima hipotesis alternatif (Ha) kesimpulannya adalah terdapat hubungan antara pola hidup sehat dan kebugaran jasmani pada siswa Sekolah Menengah Pertama Negeri 1 ujan mas kabupaten kepahiang.
Abstract
This study aims to determine the relationship between a healthy lifestyle and the level of physical fitness of students at State Junior High School 1 Ujan Mas, Kepahiang Regency. This type of research is correlation analysis with a quantitative approach using survey methodswith instruments in the form of measurement tests, and healthy lifestyle instruments using questionnaires, while physical fitness uses theTKJI test for ages 13 - 15 years. The population in this study were all students from the State 1 Ujan Mas Junior High School, Kepahiang Regency, totaling 336 students. Meanwhile, the sampling technique used a random sampling technique, totaling 36 students. Data wascollected using questionnaires and the TKJI test. The data analysis used in this research is the prerequisite analysis test and correlation test. The results of the research show that a healthy lifestyle has a relationship with the physical fitness results of students at State Junior High School 1 Ujan Mas, Kepahiang Regency. Based on the r_count value of 0.62 which is greater than r_(table) in product moment which is 0.339, so the decision is to reject the null hypothesis (Ho) and accept the alternative hypothesis (Ha ) then the conclusion is that there is arelationship between a healthy lifestyle and physical fitness (in students at State Junior High School 1 Ujan Mas, Kepahiang Regency