Chronic morbidity and health seeking behaviour among post-menopausal women of Itahari Sub-Metropolitan City, Nepal

Introduction: The prevalence of morbidity increases in postmenopausal period. Usually co-morbid chronic conditions and symptoms of menopause are underestimated due to low awareness thereby affecting the health seeking behaviour. This study aims to find out the chronic morbidity and health seeking behaviour among post-menopausal women of Itahari sub metropolitan city of Nepal. Method: This is a community based cross-sectional study conducted in 5 wards of Itahari sub metropolitan city, of Nepal over a period of one year (February 2018 to January 2019) among 490 post-menopausal women of 45 and above age. Ethical approval was obtained. The frequency and percentage of women with chronic morbidity and their health seeking in general was calculated. Also, percentage of health seeking for the each morbidly and postmenopausal symptoms were calculated using MS-Excel. Result: Among the 490 participants 69.4% were having chronic diseases in which diabetes mellitus and hypertension had highest prevalence. Up to 98% of the women having chronic morbidity sought help from professionals. There was lowest professional health seeking for psychological symptoms and highest for somatic symptoms. Conclusion: Our study shows high chronic morbidity in post-menopausal period and good health seeking behaviour for them. There is less professional heath seeking for vasomotor and psychological symptoms of post menstrual period

Predictors of cardiac self-efficacy among patients diagnosed with coronary artery disease in tertiary hospitals in Nepal

Background: Cardiac self-efficacy determines how people feel, think, motivate themselves and behave with regards to improving their cardiac health subsequently preventing complications of coronary artery disease (CAD). Given almost one-third of global death is contributed by CAD with 10% of disability adjusted life years lost in low- and middle-income countries (including Nepal), it is important to identify factors that can promote cardiac self-efficacy. There are no studies in Nepal focusing on predictors of self-efficacy. Therefore, we aim to determine the predictors of cardiac self-efficacy of CAD patients in Nepal.Design and Methods: This is a cross-sectional study where we recruited 170 patients (≥30 years) diagnosed with CAD from two tertiary level hospitals. Multiple linear regression model was used to identify the predictors of cardiac self-efficacy.Results: The mean age of the participants was 60.45±10.39 years (range, 31-83). Most of the participants were diagnosed as myocardial infarction (91.2%), rest with unstable angina (6.5%) and stable angina (2.4%). The multivariate analysis shows age (p<0.001), health behaviors (p<0.001) and knowledge of the disease (p<0.001) were statistically significant predictors to cardiac self-efficacy. Every 1-year increase in age was associated with 0.23 units increase in cardiac self-efficacy score. Similarly, every unit increase in health behavior score and knowledge of disease score was associated with 0.432 units and 0.475 units increase in cardiac self-efficacy score, respectively.Conclusion: Age and health behaviors were the strongest predictors of cardiac self-efficacy followed by knowledge of the disease. We conclude that those with poor health behavior are at a greater risk of poorer cardiac self-efficacy compared to those with relatively good level of self-efficacy. Public health interventions such as awareness raising about cardiac disease and health behavior modification along with early screening, diagnosis and appropriate care are essential to improving self-efficacy and cardiac care outcomes

Health literacy Knowledge and understanding of registered nurses in tertiary care teaching hospital of eastern Nepal: two important dimensions for better health results

Background: Difference in health literacy skills among peoples is a cause of health inequality and has a profound effect on health care system. Correlation between health literacy and health outcome of patient subsequently demands identification of patient’s health literacy level by health professionals. Objective: The study aims to assess the health literacy knowledge and understanding of registered nurses working in tertiary care teaching hospital. Methods: A cross-sectional method was employed among 125 registered nurses. Health Literacy Knowledge and Experience Survey (HLKES-2) was used to gather knowledge related data. Descriptive statistical tools, t Mann-Whitney U test and Kruskal-Wallis H were used to analyze the data. A focus group discussion (N=10) was conducted to obtain nurses' understanding of health literacy. Results: Majority of nurses had not heard the term health literacy before. Finding suggest gap in health literacy knowledge among nurses. Knowledge scarcity was in almost all areas but noticeably in the area of evaluation of healthcare teaching. Half of the respondent scored less than 50% of the total score. Analysis demonstrated that Health literacy knowledge was independent of nurses' characteristics. Conclusion: limited knowledge of health literacy among nurses stresses for integration of health literacy education in nursing curriculum and continuing education

Prevalence of Depressive Disorder among Patients with Epilepsy: a cross-sectional study

Background: Epilepsy is the most common neurological disease in the general population. Depression when comorbid in individuals with epilepsy contributes to low quality of life. As the epilepsy clinics do not routinely assess for major depression substantial opportunity exists to improve the quality of care for many people with epilepsy. The objective of the study was to study the prevalence of depressive disorder and associated factors in individuals with epilepsy.            Methods: A cross-sectional study was conducted at the teaching hospital of Karnali Academy of Health Sciences, Jumla. Sixty patients with epilepsy meeting the inclusion criteria of the study were enrolled in the study.  Data was collected using Patient Health Questionnaire-9 (PHQ-9) via face-to-face interview.    Descriptive statistics was presented as frequency and percentages. Association between variables was assessed with Chi-square test. P-value of <0.05 was considered as statistically significant. Results: The mean age of the participants in years was 32.45 (± SD 10.39). Majority of the participants were married (80%) and between 25-34 years of age (33.3%). Among the participants, 33.3% were farmers and 8.3% were housewives by occupation. The majority of the participants were literate (38.3%) and male (65%). The prevalence of depression was 55%. Various variables like age, sex, caste, education and occupation showed no association with depression. Conclusion: The prevalence of depression was more than half in individuals with epilepsy. The study recommends for screening of depressive disorder among individuals with epilepsy by attending clinicians on a regular basis

A case study of medicinal plants and their usage by the local community of Dilasaini Gaunpalika, Baitadi district, Nepal

An Ethnomedicinal survey study was conducted to get information about the usage of medicinal plants and the diversity of species found around the village. The main objective of the study was to document the plants for their medicinal and other uses. Ethnomedicinal plants are locally available used by tribal communities and local inhabitants for various medicinal purposes. Random sampling survey was conducted by selecting 50 households to access the medicinal plants and document their usage in Gokuleshwor, Baitadi. A total of 33 species of medicinal plants to treat 40 ailments was reported with their multipurpose use. During the survey, an equal proportion of males and females aged 14 to 78 were selected randomly. The literacy rate of the study area was 80% and 94% of the people were found to be involved in the collection of medicinal plants. The majority of the respondents (92%) used medicinal plants for minor diseases like cuts, wounds whereas few were found to use the medicinal plant for a long time to treat major diseases like cancer, tumor. The use of medicinal plants for skin infections, cuts and wounds, fever was found to be high followed by diarrhea, common cold, ulcer, asthma, jaundice, burns, piles, and eye inflammation. Most of the plants were found to be used for more than one disease. The conservation of Indigenous knowledge on the Ethnomedicinal plant should be promoted as most of the respondents were unaware of the conservation of medicinal plants

Effect of gender preference on fertility: cross-sectional study among women of Tharu community from rural area of eastern region of Nepal

BACKGROUND: Son preference is predominant in developing countries especially South Asian countries and its effect is most visible when the fertility is on transition. Nepal is a country in South Asia where the fertility has declined and son is valued highly. This study examines the parent’s gender preference for children and its effect on fertility and reproductive behaviors. METHODS: Study was conducted in Sonapur village development committee of Sunsari district among women of Tharu community of reproductive age (15–49) currently in union and having at least one child. Data was collected by house to house survey. Data was analyzed with IBM SPSS 20 version. Multinomial and binary logistic regression were used to analyze the relationship among variables. RESULTS: Three hundred women of reproductive age were included in the study. Current average age of the respondents was 31.97 years and mean age at marriage was 18.87 (SD +/-2.615). Child Sex ratio (male: female) of the respondents who didn’t want any more children was 1.41. The birth spacing following male baby was 3.09 years whereas the average birth spacing following female baby was 2.71 years. Age of the respondents and education status of the respondents were also significantly associated with contraceptive practice. Presence of only female children in family significantly increased the desire of other children (AOR = 10.153, 95% CI = 2.357-43.732). CONCLUSION: This study finds that the gender preference affects the fertility and reproductive behavior of the respondents and it is necessary to reduce son preference for the health and well being of children and women

Impact study of temperature on the time series electricity demand of urban Nepal for short-term load forecasting

Short-term electricity demand forecasting is one of the best ways to understand the changing characteristics of demand that helps to make important decisions regarding load flow analysis, preventing imbalance in generation planning, demand management, and load scheduling, all of which are actions for the reliability and quality of that power system. The variation in electricity demand depends upon various parameters, such as the effect of the temperature, social activities, holidays, the working environment, and so on. The selection of improper forecasting methods and data can lead to huge variations and mislead the power system operators. This paper presents a study of electricity demand and its relation to the previous day’s lags and temperature by examining the case of a consumer distribution center in urban Nepal. The effect of the temperature on load, load variation on weekends and weekdays, and the effect of load lags on the load demand are thoroughly discussed. Based on the analysis conducted on the data, short-term load forecasting is conducted for weekdays and weekends by using the previous day’s demand and temperature data for the whole year. Using the conventional time series model as a benchmark, an ANN model is developed to track the effect of the temperature and similar day patterns. The results show that the time series models with feedforward neural networks (FF-ANNs), in terms of the mean absolute percentage error (MAPE), performed better by 0.34% on a weekday and by 8.04% on a weekend

Removing knotted or stuck epidural catheters: a systematic review of case reports

Background The knotting or in vivo entrapment of epidural catheters is an uncommon but challenging issue for anesthesiologists. This study aimed to identify the possible causes behind entrapped epidural catheters and the effective methods for their removal. Methods A systematic review of relevant case reports and series was conducted using the patient/population, intervention, comparison and outcome framework and keywords such as “epidural,” “catheter,” “knotting,” “stuck,” “entrapped,” and “entrapment.” The Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement was followed, and the review protocol was registered with International Prospective Register for Systematic Reviews (CRD42021291266). Results The analysis included 59 cases with a mean depth of catheter insertion from the skin of 11.825 cm and an average duration of 8.17 h for the detection of non-functioning catheters. In 27 cases (45.8%), a radiological knot was found, with an average length of 2.59 cm from the tip. The chi-squared test revealed a significant difference between the initial and final positions of catheter insertion (P = 0.049). Conclusions Deep insertion was the primary cause of epidural catheter entrapment. To remove the entrapped catheters, the lateral decubitus position should be attempted first, followed by the position used during insertion. Based on these findings, recommendations for the prevention and removal of entrapped catheters have been formulated

Giant Sacrococcygeal Teratoma in a Neonate: A Case Report

Sacrococcygeal teratomas are common tumours in neonates and infants, primarily affecting females. A 35-year-old primigravida presented with a large sacrococcygeal teratoma that was detected during the 30th week of gestation in the fetus. The baby was delivered via elective caesarean section at 36+3 weeks, and surgical excision of the 10x10x5 cm3 mass was performed successfully on the third day of life. Despite a surgical site infection, the patient had a favourable outcome with normal vital signs, bowel, bladder, and lower extremity functions upon discharge. Early diagnosis and prompt management of sacrococcygeal teratoma in newborns is vital for optimal outcomes, providing valuable insights and guidance to medical practitioners