Assessment of Anxiety and Depression among Patients with Substance Use Disorder Attending at a selected Rehabilitation Center Kathmandu, Nepal

Background: Anxiety and depression are two important contributors to the global burden of disease. Both conditions are frequently found as comorbidity among patients with substance use disorder and play a major role in its prognosis and relapse. If ignored such psychiatric illness by a mental health professional, can create a gap in the overall treatment outcome of substance use disorder.   Methods: A descriptive cross-sectional research design was adopted to assess the level of depression and anxiety among patients with substance use disorder attending a selected rehabilitation center, Kathmandu from March 2019 to May 2019. Data collection was done from 115 respondents using the purposive sampling technique. A Semi-structured interview scheduled and Hospital Anxiety and Depression Scale was used. Collected data were analyzed by using both descriptive as well as inferential statistics. Results: The study findings showed that among 71.3% of respondents, 41.7% had boarder line anxiety and 29.6% of them had anxiety. Similarly, among 48.7 % of respondents, 29.6% had borderline depression and 19.1% of them had depression. The study concluded that there was a significant association between the level of anxiety and type of family (p=0.035). There was a significant positive relationship (p=0.001, r=.328) between anxiety and depression scores. Conclusion: Most of the patients with substance use disorder had borderline anxiety and depression. Likewise, level of anxiety was significantly associated with type of family. It was also concluded that there was significant positive relationship between anxiety and depression scores. So early identification and management of such psychiatric co-morbid conditions is noteworthy. This action would help to reduce severity in future. Keywords: Anxiety, Depression, Substance use disorder, Rehabilitation cente

Factors Associated with Postpartum Care during the Fourth Stage of Labor in Nepal: A Hospital-based Cross-sectional Study

Postnatal care is an important part of maternal and neonatal care, and life-threatening complications can occur during the postpartum period. Empirical information on the level of postpartum care services is generally scarce in Nepal. Key elements of postpartum care during the fourth stage of labor include providing proper nutrition, promoting breastfeeding, and helping the mother manage any physical discomforts or challenges that may arise. This study investigated the level of postpartum care services delivered during the fourth stage of labor in a tertiary-level hospital in the Chitwan district of Nepal. A descriptive cross-sectional hospital-based study was conducted among 148 women admitted for vaginal delivery. A set of structured observation checklists was developed and finalized based on the WHO Recommended Interventions for Improving Maternal and Newborn Health: Integrated Management of Pregnancy and Childbirth. The structured observation checklist had twenty-two items, including twelve critical steps. A good level of care was valid with a score of ≥ 90% based on total items, including all twelve critical steps of care, and a poor level of care was valid with a score \u3c90%. The purpose of the study was explained to and written informed consent was obtained from all respondents. Ethical approval was received from the Institutional Review Committee of Chitwan Medical College. One third (33.8%) of the women received a good level of postpartum care services. Women’s residence (p = .021), number of pregnancies (p =.002), and number of antenatal visits (p =.029) were significantly associated with the level of postpartum care during the fourth stage of labor. Going forward, it will be important for Nepal to enhance the capacity of clinicians or nurses to provide postpartum care as per WHO guidelines

Postpartum Care Services during the Fourth Stage of Labour in Bharatpur Hospital of Nepal

Background: Postnatal care is an important part of maternal care, as serious and life-threatening complications can occur in the postpartum period. So, this study was conducted to assess the level of postpartum care services during the fourth stage of labour in the maternity ward of Bharatpur hospital in the Chitwan district of Nepal. Methods: Cross-sectional hospital-based study was done among women admitted in the maternity ward for vaginal delivery in Bhartapur hospital in Chitwan. Total 218 sample size derived by using the formula; n= N/1+N (e²). A set of data collection tool was developed, pretested and finalized. Part-1 of the tool was related to socio-demographic features of respondents, Part-2 and 3 of the tool was used as a checklist to assess institutional characteristics and level of postpartum care services respectively. The structured checklist had twenty-two items including twelve critical steps. The purpose of the study explained to the respondents; verbal informed consent obtained from respondents and ethical approval from the Institutional review committee of Chitwan Medical College. Results: The significant association observed between postpartum care during the fourth stage of labour and residence of mothers (p=0.021). Conclusions: Postpartum care in Bharatpur hospital is poor and there is an urgent need to develop plans and programs to enhance the capacity of staffs and health institutions to provide postpartum care according to the WHO recommendation guideline.  

Child Trafficking and Associated Factors in Earthquake Affected Area of Nepal

Background: Recruitment, transportation, transfers, harboring, and/or receipt kidnapping of under 18 yrs child for the purpose of slavery, forced labor and exploitation is Child Trafficking. To assess the knowledge about child trafficking and factors associated with child trafficking in Gorkha district of Nepal Methods: Cross sectional study conducted to determine the knowledge and factors related to child trafficking in Gorkha district. Two urban municipalities selected purposively and other three rural municipalities were randomly selected.  Out of 160,772 households, total 300 households for survey was calculated by using Yamane formula (n) = N/ (1+Ne2). Wards of the municipalities were Primary Sampling Unit. Based on Population Proportionate Sampling technique; required number of households of each Wards was identified.  In Wards, households for survey were selected by using simple random method.  Head of the selected household were the respondent for household survey. Ten Key Informant Interviews were done with policemen, teachers, social workers, community leaders, stakeholders and six Focus Group Discussions were done with Youths (15-25 yrs), Parents and Social worker/teacher/community leader groups. Results: Remarkable proportions of respondents have correct knowledge about the child trafficking. Near relatives, unknown person, pears group, parents/family members and neighbor were common traffickers. During and after disaster is the most vulnerable time/event for child trafficking. False marriage, assuring lucrative job, asking for adoption and proposing good education were tricks of traffickers for child trafficking.  Homeless children, children travelling without parents, socially isolated children, children travelling at night, unprotected girl child like orphan, separated from family or without parent are most vulnerable for child Trafficking. Conclusions: Family, social groups, government officials and stakeholders should jointly initiate for anti child trafficking movement. School teacher and management committee should also take initiation to make fully aware to school going children about different dimension/aspect of Child Right and Child Trafficking

Sexual harassment in public transport and its coping strategies among bachelor students: A cross sectional study

Introduction: Sexual harassment in public transport is a common, yet little discussed form of gender-based aggression, predominantly to women. Such abuses have a significant on the mental health of the victims. It also leads them to abandon work and education due to the fear of being harassed on their route. Knowledge regarding the prevalence and coping strategies against such harassment is necessary to formulate effective plans for its mitigation. Methods: This is a cross-sectional study done among 105 bachelor students of Maiya Devi Kanya College of Bharatpur, Chitwan. Self-administered structured questionnaires were used. A Chi-square test was used to determine the significance of the association between variables. Results: Out of 105, 23 students mentioned that they had been sexually harassed in public transport. The non-verbal form was the commonest followed by verbal and physical. Almost half of the respondents mentioned that they would prefer to remain silent (47.6 %) and not react to the situation (54.3%). Self-discipline and effective law were deemed as major ways to prevent such abuses. Conclusion: When girls remain unsafe in public transport, it affects their self-esteem and ultimately hampers their personal productivity and national growth. Stricter laws, unprejudiced societies, and moral values are necessary to prevent as well as help women cope with such harassment