Hand hygiene compliance among rural healthcare workers of Nepal

Introductions: Transmission of healthcare associated infections through contaminated hands of healthcare workers are common. This study was designed to explore the existing compliance of hand hygiene among the healthcare workers workings in different level of health care centers of Makwanpur district of Nepal. Methods: This was a cross sectional observational study conducted in Makwanpur district, Nepal, during 2015. Healthcare workers from nine healthcare centers were selected randomly for the study. Standard observation checklists and World Health Organization guidelines on hand hygiene were used to assess the compliance of hand hygiene during patient care. Results: There were 74 participants. Overall compliance for hand washing was 24.25% (range 19.63 to 45.56). Complete steps of hand washing were performed by 38.3% of health care workers. The factors associated for noncompliance were lack of time (29.3%), example set by seniors (20%), absence or inadequate institution protocol (20%) and unfavourable health care setting (> 20%).Conclusions: Overall hand washing compliance rate amongst the healthcare workers in rural health facilities of Nepal were low (24.25%).  Keywords: hand hygiene, healthcare worker, rural health facilitie

Self Assessment of Dental students’ Perception of Learning Environment in Croatia, India and Nepal

Cilj: Željela se procijeniti percepcija studenata dentalne medicine iz različitih okolina za učenje u Hrvatskoj, Indiji i Nepalu. Postupci: Istraživanje je provedeno tijekom akademske godine 2016./17. Ukupno je sudjelovalo 849 studenata dentalne medicine – 188 iz Hrvatske, 373 iz Indije i 288 iz Nepala. Oni koji nisu ispunili upitnik nisu uzeti u obzir. Primijenjen je Upitnik za studente dentalne medicine o okolini za učenje (engl. Dental Student Learning Environment Survey – DSLES) koji se sastojao od 55 pitanja svrstanih u 7 kategorija. Njima su se mjerile percepcije fleksibilnosti, interakcija među studentima, emocionalno ozračje, potpora, stečeno iskustvo, organizacija i širina interesa. U statističkoj analizi podataka korišten je Kolmogorov-Smirnovljev test. Kruskal-Wallisova neparametrijska ANOVA također je upotrijebljena u testiranju razlika između zemalja. Post hoc analiza obavljena je s pomoću Ranksovih tablica i medijanskoga testa. Rezultati: Odgovorilo je 26,9 % studenata. Značajne razlike između zemalja nađene su za sve varijable DSLES upitnika (Kruskal-Wallis, p < 0,01). Medijanski test također je pokazao značajne razlike za sve varijable DSLES-a (p < 0,01). Kategorije s najvišim srednjim vrijednostima ocjena su interakcije među studentima u Indiji i Nepalu te emocionalno ozračje u Hrvatskoj. Zaključak: Studenti u Hrvatskoj ocijenili su svoj fakultet samo ocjenama odličan i dobar, a njihovi kolege u Indiji i Nepalu bili su kritičniji. Unatoč različitim okolnostima u trima zemljama, fleksibilnost je identificirana kao područje slabosti u svim tim sustavima obrazovanja.Aim: The aim of this study was to assess dental students’ perception of different learning environment in India, Nepal and Croatia. Methods: The study was conducted during a period of academic year 2016/17. A total of 849 dental students participated in the study. There were 188 respondents from Croatia, 373 from India, and 288 from Nepal. Non-responders were not followed up. The Dental Student Learning Environment Survey (DSLES) was used which consisted of 55 items subdivided into seven scales. The scales measured the following perceptions: Flexibility, ‘Student-to-Student Interactions, Emotional Climate, Supportiveness, Meaningful Experience, Organization and Breadth of Interest. Statistical analysis of the data utilised the Kolmogorov Smirnov test. The Kruskal-Wallis “non-parametric ANOVA” was also used to test the differences between the countries. A post hoc analysis was performed using Ranks tables and the Median test. Results: The response rate was 26.9%. Significant differences between the countries were found for all DSLES variables (Kruskal-Wallis, p<0.01). The Median test also showed significant differences between the countries for all DSLES variables (p<0.01). The scales with the highest mean values were ‘Student-to-student interactions’ in India and Nepal, and the ‘Emotional Climate’ in Croatia. Conclusions: Students in Croatia rated their school only with grades excellent and good, while their colleagues in India and Nepal were more critical. Despite the different settings in three countries, ‘Flexibility’ was identified as the area of weakness in all three educational systems

Menstrual hygiene management among women and adolescent girls in the aftermath of the earthquake in Nepal.

BACKGROUND: Menstrual hygiene management (MHM) is an essential aspect of hygiene for women and adolescent girls between menarche and menopause. Despite being an important issue concerning women and girls in the menstruating age group MHM is often overlooked in post-disaster responses. Further, there is limited evidence of menstrual hygiene management in humanitarian settings. This study aims to describe the experiences and perceptions of women and adolescent girls on menstrual hygiene management in post-earthquake Nepal. METHODS: A mixed methods study was carried out among the earthquake affected women and adolescent girls in three villages of Sindhupalchowk district of Nepal. Data was collected using a semi-structured questionnaire that captured experiences and perceptions of respondents on menstrual hygiene management in the aftermath of the Nepal earthquake. Quantitative data were triangulated with in-depth interview regarding respondent's personal experiences of menstrual hygiene management. RESULTS: Menstrual hygiene was rated as the sixth highest overall need and perceived as an immediate need by 18.8% of the respondents. There were 42.8% women & girls who menstruated within first week of the earthquake. Reusable sanitary cloth were used by about 66.7% of the respondents before the earthquake and remained a popular method (76.1%) post-earthquake. None of the respondents reported receiving menstrual adsorbents as relief materials in the first month following the earthquake. Disposable pads (77.8%) were preferred by respondents as they were perceived to be clean and convenient to use. Most respondents (73.5%) felt that reusable sanitary pads were a sustainable choice. Women who were in the age group of 15-34 years (OR = 3.14; CI = (1.07-9.20), did not go to school (OR = 9.68; CI = 2.16-43.33), married (OR = 2.99; CI = 1.22-7.31) and previously used reusable sanitary cloth (OR = 5.82; CI = 2.33-14.55) were more likely to use the reusable sanitary cloth. CONCLUSIONS: In the immediate aftermath of the earthquake, women and girls completely depended on the use of locally available resources as adsorbents during menstruation. Immediate relief activities by humanitarian agencies, lacked MHM activities. Understanding the previous practice and using local resources, the reusable sanitary cloth is a way to address the menstrual hygiene needs in the post-disaster situations in Nepal

Smoking and Quality of Life - Is there really an association? Evidence from a Nepalese sample.

Tobacco smoking has a negative impact on human health. Thus, it seems plausible for it to affect perceived quality of life as well. Information in this regard is lacking in Nepalese context. Thus, a comparative study was designed to assess association of cigarette smoking with Health Related Quality of Life (HRQoL). This study was conducted among 125 current and never cigarette smokers who attended a teaching hospital in peri-urban area of Capital city of Nepal from December 2015 to June 2016. The data regarding their socio-demographic characteristic, tobacco history and HRQoL was collected using a self administered questionnaire. QoL assessment was made with the help of valid, translated version of WHO QOL-BREF. Results showed current smokers on an average used 4 sticks of cigarettes per day. Significant proportions of current smokers also consumed alcohol compared to never smokers (p <0.05). Mean difference of both overall QoL score and domain scores among both study groups were relatively small and thus, failed to reach statistical significance. On the other hand, the socio-demographic characteristics like male gender, currently earning and attaining more than higher secondary education were predictors of better HRQoL scores. According to study results, relationship between smoking status and self reported QoL is unclear. Thus, the policy makers should also focus on wider determinants of ill health and well being and not just smoking status. Further research is still needed to understand the effect of tobacco on self perceived health related quality of life

Coronectomy - A viable alternative to prevent inferior alveolar nerve injury

Background and Objectives: Coronectomy is a relatively new method to prevent the risk of Inferior Alveolar Nerve (IAN) injury during removal of lower third molars with limited scientific literature among Nepalese patients. Thus, a study was designed to evaluate coronectomy regarding its use, outcomes and complications.Materials and Methods: A descriptive study was conducted from December 2012 to December 2013 among patients attending Department of Oral and Maxillofacial Surgery, College of Dental Sciences, BP Koirala Institute of Health Sciences, Dharan, Nepal for removal of mandibular third molars. After reviewing the radiograph for proximity of third molar to the IAN, coronectomy was advised. A written informed consent was obtained from the patients and coronectomy was performed. Patients were recalled after one week. The outcome measures in the follow-up visit were primary healing, pain, infection, dry socket, root exposure and IAN injury. The prevalence of IAN proximity of lower third molars and incidence of complications were calculated.Results: A total 300 mandibular third molars were extracted in 278 patients during the study period. Out of 300 impacted mandibular third molar, 41 (13.7%) showed close proximity to inferior alveolar nerve . The incidence of complications and failed procedure was 7.4% among the patients who underwent coronectomy. During the follow up visit, persistent pain and root exposure was reported while other complications like inferior alveolar nerve injury, dry socket and infection was not experienced by the study patients.Conclusion: With a success rate of 92.6% among the 41 patients, coronectomy is a viable alternative to conventional total extraction for mandibular third molars who have a higher risk for damage to the inferior alveolar nerve.JCMS Nepal. 2015;11(3):1-5.</p

Knowledge and Awareness Regarding Dental Implants among Patients Attending a Tertiary Care Center

Introduction: Loss of natural teeth is a debilitating and irreversible process, which leads to functional, cosmetic and psychological morbidities. Dental implant serves as one of the options of tooth replacement, which are stronger, functionally effective and more durable. However, public awareness regarding it has been found to be low in Asian countries. This study was designed to know the status of knowledge and awareness of dental implant. Methods: Seventy nine patients visiting dental department of Patan Academy of Health Sciences were included in this study through non-probability sampling. Data on knowledge and awareness regarding dental implants were collected through a survey after ethical approval from Institutional Review committee of Patan Academy of Health Sciences. Data entry was done in Epidata and analyzed with the help of Statistical Package of Social Sciences version 20. Results: Total 33 (41.8%) of study populations choose dental implant as alternative for replacing teeth, 22 (30.4%) choose fixed dental prosthesis. 36 (45.6%) and 32 (40.5%) of population stated that long treatment time and high cost respectively as the disadvantages of dental implants. Only 12 (15.2%) were aware that dental implants are anchored in jaw bone. The source of information about dental implants was dentists for 48 (60.8%) of the patients followed by friends, media and medical doctors. Conclusions: Within the limitations of this study, we conclude that awareness of patients attending tertiary care center of Kathmandu valley is low. Hence, there is a need of organizing dental education programs to create awareness about dental implants

Socio economic challenges and coping strategies against COVID-19 among dentists of Nepal: Challenges and coping strategies against COVID-19 among dentists

Introduction: COVID-19 has posed various challenges to health care professionals including dentists. We aimed to study financial impact, socio- economic challenges, coping strategies and areas where dentists of Nepal require support during the current pandemic. Method: A descriptive study was conducted among registered dentists currently involved in clinical practice in Nepal. Data was collected via semi-structured online google form during the period of August – October 2020 through non-probability sampling. The online responses from google forms were transformed to datasheets which were analyzed using Microsoft Excel and summarized using descriptive statistics. Result: More than a quarter (127, 29.8%) of the dentists were not able to practice dentistry during the pandemic. Among the salaried dentists, 113 (34.2%) of them did not receive any salary and 67 (15.7%) lost their jobs. More than 50% percent of decline in monthly income was experienced by 80 (18.7%). The most common challenge faced by the dentists was reduced income (95.2%) followed by access to PPE and sanitizers (72.9%). Social distancing was the most common (87.2%) coping strategy followed by strict use of PPE (86.9%), acquiring correct information regarding prevention of COVID-19 (76.8%). Provision of PPE was the area where 147 dentists needed the most support (36.4%) followed by cash allowance (31.7%) and rent waiver (28.4%). Conclusion: The study showed that dentists in Nepal are facing serious financial challenges due to the current pandemic. The current study highlights a need to create a support system for dentists to sustain their clinical practice during the pandemic

Self Assessment of Dental students’ Perception of Learning Environment in Croatia, India and Nepal

Aim: The aim of this study was to assess dental students’ perception of different learning environment in India, Nepal and Croatia. Methods: The study was conducted during a period of academic year 2016/17. A total of 849 dental students participated in the study. There were 188 respondents from Croatia, 373 from India, and 288 from Nepal. Non-responders were not followed up. The Dental Student Learning Environment Survey (DSLES) was used which consisted of 55 items subdivided into seven scales. The scales measured the following perceptions: Flexibility, ‘Student-to-Student Interactions, Emotional Climate, Supportiveness, Meaningful Experience, Organization and Breadth of Interest. Statistical analysis of the data utilised the Kolmogorov Smirnov test. The Kruskal-Wallis “non-parametric ANOVA” was also used to test the differences between the countries. A post hoc analysis was performed using Ranks tables and the Median test. Results: The response rate was 26.9%. Significant differences between the countries were found for all DSLES variables (Kruskal-Wallis, p<0.01). The Median test also showed significant differences between the countries for all DSLES variables (p<0.01). The scales with the highest mean values were ‘Student-to-student interactions’ in India and Nepal, and the ‘Emotional Climate’ in Croatia. Conclusions: Students in Croatia rated their school only with grades excellent and good, while their colleagues in India and Nepal were more critical. Despite the different settings in three countries, ‘Flexibility’ was identified as the area of weakness in all three educational systems