Menopausal Symptoms in Premenopausal Women Among the Cohort of Gynecological Patients Attending Outpatient Department of Dhulikhel Hospital.

Introduction: Perimenopause is the time when ovaries gradually produce less estrogen. The menopausal symptoms in perimenopausal women cause severe disturbance in the women’s life. This study aimed to identify menopausal symptoms in perimenopausal women. Methods: This was a hospital-based descriptive, cross-sectional study conducted among 243 women aged between 45 to 55 years. The categorical variables were presented as frequency and percentage. The associations between categorical variables were tested using Chi-square or Fisher exact test. Result: The total prevalence of menopausal symptoms was 91.8%. Physical symptoms were identified to be prevailing symptom(n=184, 75.7%) followed by psychological (n=167, 69.5%). There were 136 (55.5%) women experiencing poor memory and 148 (60.9%) women having genitourinary symptoms. Stress urinary incontinence (n=73, 30.04%) was predominant over urge (n=58, 23.8%), mixed (n=43, 17.6%) and prolapse (n=49, 20.1%) symptoms. Vasomotor symptoms were experienced by123 (50.6%). Excessive sweating (n=114, 46.9%) was leading over hot flush(n=113, 46.5%), night sweat (n=107, 44.03%) and palpitation (n=96, 39.5%).  A total of 114 (46.9%) women were facing sexual symptoms. The common sexual symptom was dyspareunia 68 (27.9%). The Menopausal Rating Scale (MRS) rating of overall symptoms showed women mostly suffer from mild symptoms during the perimenopausal period. Conclusion: Physical symptoms were identified to be predominating followed by psychological, genitourinary, vasomotor, and sexual. However rating of symptoms using MRS showed the majority of symptoms were mild. This study signifies the need to use the tool for the assessment of the severity of menopausal symptoms from the perimenopausal group

Adverse events following immunization with ChAdOx1 nCoV-19 and BBIBP-CorV vaccine: A comparative study among healthcare professionals of Nepal.

BackgroundAdverse events following immunization (AEFI) against SARS-CoV-2 are common as reported by clinical trials and contemporary evidence. The objective of the present study was to evaluate the local and systemic adverse events following vaccination with ChAdOx1 nCoV-19 and BBIBP-CorV among the healthcare professionals (HCPs) of Nepal.MethodsThis cross-sectional study was conducted among 606 vaccinated HCPs of Kathmandu, Nepal. Data was collected from June 15 to 30, 2021 using a self-administered online survey tool. Multiple binary logistic regression models were used to predict the adverse events according to the vaccine types and doses after adjusting for age, sex, comorbidity and previous SARS-CoV-2 infection.ResultsThe mean (SD) age of the participants was 35.6 (13.2) years and 52% of them were female. Almost 59% of participants were vaccinated with two doses and around 54% of total of them took the ChAdOx1 nCoV-19 vaccine. At least one local and systemic adverse event was reported by 54% and 62% of participants after the first dose and 37% and 49% after the second dose of ChAdOx1 nCoV-19 and by 37% and 43% after the first dose and 42% and 36% after the second dose of BBIBP-CorV vaccine respectively. Injection site pain, swelling and tenderness at the injection site were the most frequently reported local AEFI while, fatigue, headache, fever and myalgia were the most frequently reported systemic AEFI. The logistic model demonstrated that the risk of both local and systemic adverse events was higher among the ChAdOx1 nCoV-19 vaccine recipients compared to the BBIBP-CorV vaccine. Almost 10% of individuals reported a post-vaccination SARS-CoV-2 infection and most of them occurred after taking the first dose of vaccine.ConclusionsRecipients of both the ChAdOx1 nCoV-19 and BBIBP-CorV vaccine among the HCPs of Nepal reported only mild and constitutional symptoms including injection site pain and tenderness, headache, fever, fatigue, etc. after vaccination

Engaging husbands in a digital mental health intervention to provide tailored counseling for women experiencing postpartum depression: A mixed methods study in Nepal

Background: Postpartum depression (PPD) is a common experience among mothers worldwide. Family members, especially husbands, can play an integral role in supporting and helping mothers recover from PPD. However, husbands are typically not included in interventions to address postpartum depression among women. This study explored husbands’ perspectives on engaging in a counseling intervention augmented with a digital health component for the treatment of PPD. Methods: A convergent mixed methods design was used to evaluate husbands’ attitudes and involvement in a counseling and digital intervention for mothers in a semi-urban region of Nepal.Thematic analysis of semi-structured interviews was used to derive emergent themes. A joint display examined differences in themes for husbands whose wives experienced a significant decline in PPD symptoms as measured by the Patient Health Questionnaire-9 pre and post intervention, as compared to husbands of women whose symptoms stayed the same or worsened. Results: Thirteen husbands were interviewed. Three primary themes emerged: the impact of gender norms and attitudes on engagement in the intervention, involvement and support in the intervention, and suggestions for future interventions for PPD. Among wives who experienced a reduction in depression symptoms, their husbands were more likely to endorse gender-equitable norms and attitudes and the husbands provided emotional support, as well as participating in household chores and childcare. Conclusion: When husbands are living in the same household, providing support and being involved in their wives’ PPD treatment can help them recover. Husbands describe time at home and work as barriers to being able to help their wives. PPD interventions that involve husbands might need to educate husbands about how they can provide emotional support to their partner