Delivery site preferences and associated factors among married women of Panauti Municipality, Kavrepalanchok district, Nepal

Introduction: Maternal mortality is a top global developmental agenda. The main cause of being underutilization of available delivery services especially in a developing country like Nepal. Various socio-demographic, socio-cultural and health service-related factors affect the utilization of these services. Thus, the study aims to identify the delivery site preferences and its associated factors among the married women of Panauti municipality of Kavrepalanchok district. Method: A cross-sectional study was conducted among the married women between the ages of 15-49 y residing in Panauti municipality. The face-to-face interviews were conducted using semi-structured questionnaires. The statistical analysis was done using Statistical Package for Social Sciences (SPSS) version 21. Result: A total of 106 women of 15-49 y were included in the study. The proportion of institutional delivery among the participants was 68%. 90.6% of total participants would prefer health facility for their future deliveries; 7.5% were not sure about their preferences and very few (1.9%) preferred to deliver at home. The factors like knowledge regarding safe-motherhood program and age at marriage were found to be significantly associated with their delivery site preference (p<0.05). Conclusion: In a country like Nepal, home delivery is still in practice and pregnancy and childbirth are regarded as normal life events. Thus, efforts should be made to change that perception, increasing utilization of available services and improving maternal and child health. This in turn will help to achieve the Sustainable Development Goal target in reducing the Maternal Mortality Rate

Outcome of Respiratory distress in Neonates with Bubble CPAP at Neonatal Intensive Care Unit of a Tertiary Hospital

Introduction: Respiratory distress is one of the commonest problem seen in neonates during admission in Neonatal Intensive Care Unit. Hyaline Membrane disease, Meconium Aspiration Syndrome, septicemia, congenital pneumonia, Transient Tachypnea of Newborn are the major causes of respiratory distress in neonates. Bubble Continuous Positive Airway Pressure is a non-invasive respiratory support delivered to a spontaneously breathing newborn to maintain lung volume during expiration. The main objective of this study was to observe the outcome of respiratory distress in neonates with Bubble Continuous Positive Airway Pressure. Methods: This was a descriptive cross-sectional study conducted at Kathmandu Medical College Teaching Hospital over six months (October 2018 – March 2019) period. All preterm, term and post term babies with respiratory distress were included. Ethical clearance was received from Institutional Review Committee of Kathmandu Medical College and statistical analysis was done with SPSS 19 version. Results: Sixty three babies with respiratory distress were included in this study with 45 (71%) male predominance. The mean birth weight receiving Bubble Continuous Positive Airway Pressure was 2661.75±84 gms and gestational age was 36.67±3.4 wks. The Bubble Continuous Positive Airway Pressure was started at 8.05±2 hr of life and duration of Bubble Continuous Positive Airway Pressure required for settling respiratory distress was 95.71±3 hrs. Out of 63 babies, improvement of respiratory distress in neonates with Bubble Continuous Positive Airway Pressure was 39 (61%) with confidence interval of (38-62) whereas 24 (39%) babies required mechanical ventilation and other modalities. Conclusions: This study concludes usefulness of Bubble Continuous Positive Airway Pressure in neonates with respiratory distress

Establishing injury surveillance in emergency departments in Nepal: Protocol for mixed methods prospective study

Background: Globally, injuries cause more than 5 million deaths annually, a similar number to those from HIV, Tuberculosis and Malaria combined. In people aged between 5 and 44 years of age trauma is the leading cause of death and disability and the burden is highest in low- and middle-income countries (LMICs). Like other LMICs, injuries represent a significant burden in Nepal and data suggest that the number is increasing with high morbidity and mortality. In the last 20 years there have been significant improvements in injury outcomes in high income countries as a result of organised systems for collecting injury data and using this surveillance to inform developments in policy and practice. Meanwhile, in most LMICs, including Nepal, systems for routinely collecting injury data are limited and the establishment of injury surveillance systems and trauma registries have been proposed as ways to improve data quality and availability. Methods: This study will implement an injury surveillance system for use in emergency departments in Nepal to collect data on patients presenting with injuries. The surveillance system will be introduced in two hospitals and data collection will take place 24 h a day over a 12-month period using trained data collectors. Prospective data collection will enable the description of the epidemiology of hospital injury presentations and associated risk factors. Qualitative interviews with stakeholders will inform understanding of the perceived benefits of the data and the barriers and facilitators to embedding a sustainable hospital-based injury surveillance system into routine practice. Discussion: The effective use of injury surveillance data in Nepal could support the reduction in morbidity and mortality from adult and childhood injury through improved prevention, care and policy development, as well as providing evidence to inform health resource allocation. This study seeks to test a model of injury surveillance based in emergency departments and explore factors that have the potential to influence extension to additional settings

Epidemiology of paediatric injuries in Nepal: Evidence from emergency department injury surveillance

BACKGROUND: Globally, injuries cause >5 million deaths annually and children and young people are particularly vulnerable. Injuries are the leading cause of death in people aged 5-24 years and a leading cause of disability. In most low-income and middle-income countries where the majority of global child injury burden occurs, systems for routinely collecting injury data are limited. METHODS: A new model of injury surveillance for use in emergency departments in Nepal was designed and piloted. Data from patients presenting with injuries were collected prospectively over 12 months and used to describe the epidemiology of paediatric injury presentations. RESULTS: The total number of childre

ACMiner: Extraction and Analysis of Authorization Checks inAndroid’s Middleware

Billions of users rely on the security of the Android platform to protect phones, tablets, and many different types of consumer electronics. While Android’s permission model is well studied, the enforcementof the protection policy has received relatively little attention. Much of this enforcement is spread across system services,taking the form of hard-coded checks within their implementations.In this paper, we propose Authorization Check Miner (ACMiner),a framework for evaluating the correctness of Android’s access control enforcement through consistency analysis of authorization checks. ACMiner combines program and text analysis techniques to generate a rich set of authorization checks, mines the corresponding protection policy for each service entry point, and uses association rule mining at a service granularity to identify inconsistencies that may correspond to vulnerabilities. We used ACMiner to study the AOSP version of Android 7.1.1 to identify 28 vulnerabilities relating to missing authorization checks. In doing so, we demonstrate ACMiner’s ability to help domain experts process thousands of authorization checks scattered across millions of lines of code

Pattern of Cancer in Nepal from 2003 to 2011

Correction: On 15th January 2017, the authors Sunil Kumar Sah and Naval Kishor Yadav were added to the author list.Cancer is global burden of disease in developed and developing countries. It is one of the main causes of death. The environmental factor and life styles are major causes of cancer.This hospital based retrospective study was carried out using data retrieved from the register maintained at seven cancer centers. The most common basis of diagnosis were microscopic (histopathological and cytopathological examination). The diagnosis was also based on clinical examination, radiological examination, endoscopy, biochemical and immunological tests.Most of the cancer cases were diagnosed at BPKMCH (23908) followed by BPKIHS (9668) and BH (5959) and few cases from KCH (518) in 2003 to 2011. The total number of cancer cases were increasing from 2003 to 2011 and it become double in 2011. Out of 75 district of Nepal, more number of cancer cases was found in Kathmandu, Sunsari, Morang, Chitwan, Lalitpur, Jhapa, Kaski, Nawalparasi, Rupendehi and Kavrepalchowk in 2010. Similarly, in 2011 more number of cancer cases was found in Kathmandu, Morang, Jhapa, Sunsari, Chitwan, Lalitpur, Rupendehi, Kaski, Saptari, Bhaktapur. Lung cancer was the common cancer and similarly, other prevalent cancers were cervical, breast, stomach, ovarian and colo-rectum cancer in 2003 to 2011. The common cancers were lung, cervical, breast, stomach, ovarian and colo-rectum. The number of patients is increasing, which may be due to change in life style and lack of education

The epidemiology of injuries in adults in nepal: Findings from a hospital-based injury surveillance study

This study aimed to develop and evaluate a model of hospital-based injury surveillance and describe the epidemiology of injuries in adults. One-year prospective surveillance was conducted in two hospitals in Hetauda, Nepal. Data were collected electronically for patients presenting to emergency departments (EDs) with injuries between April 2019 and March 2020. To evaluate the model's sustainability, clinical leaders, senior managers, data collectors, and study coordinators were interviewed. The total number of patients with injuries over one year was 10154, representing 30.7% of all patients visiting the EDs. Of patients with injuries, 7458 (73.4%) were adults 18 years and over. Most injuries (6434, 86%) were unintentional, with smaller proportions due to assault (616, 8.2%) and self-harm (408, 5.5%). The median age of adult patients was 33 years (IQR 25-47). Males had twice the rate of ED presentation compared with females (40.4 vs 20.9/1000). The most common causes were road traffic (32.8%), falls (25.4%), and animal/insect related (20.1%). Most injured patients were discharged after treatment (80%) with 9.1% admitted to hospital, 8.1% transferred to other hospitals and 2.1% died. In Nepal, hospital-based injury surveillance is feasible, and rich injury data can be obtained by embedding data collectors in EDs

Home-related and work-related injuries in Makwanpur district, Nepal: A household survey

© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY. Published by BMJ. Objective: To describe the epidemiology of home-related and work-related injuries, their mechanisms, inequalities and costs associated with these injuries. Methods: A household survey was undertaken in three palikas of Makwanpur district between April and June 2019. Data were collected electronically on non-fatal injuries that occurred in the previous 3 months and fatal injuries that occurred in the previous 5 years. Findings: 17 593 individuals were surveyed from 3327 households. Injury rates were 8.0 per 1000 population for home injuries and 6.4 per 1000 for work-related injuries; 61.0% of home injuries were among women and 69.9% of work-related injuries among men. Falls were the cause of 48% home injuries, affecting 50.9% of men and 46.5% of women. Burns/scalds were higher in women than men, affecting 17.4% of women reporting home injuries. Cuts and piercings accounted for 39.8% of all work-related injuries and 36.3% were falls. Injury incidence varied by ethnic group: home injuries were highest in Brahmin (12.0 per 1000) and work-related injuries highest in Rai groups (21.0 per 1000). The total mean costs (transport and treatment) of work-related injury was US$143.3 (SD 276.7), higher than for home injuries (US$130.4, SD 347.6). The number of home (n=74, 64.9%) and work-related (n=67, 77.9%) injuries were higher in families below the poverty line than families in the next income bracket (home: n=22, 19.3%; work: n=11, 12.8%). Conclusions: Home-related and work-related fall injuries are common. The inequalities in injury identified in our study by rurality, age, sex, income level and ethnic group can help target injury prevention interventions for vulnerable groups