A PROSPECTIVE COHORT STUDY ON INCIDENCE AND RISK FACTORS FOR LOW BIRTH WEIGHT AMONG INSTITUTIONAL DELIVERIES IN KATHMANDU, NEPAL

Background: Low birth weight (LBW) in developing countries are mainly due to preterm delivery and intrauterine growth retardation. Among other causes of low birth weight, maternal factors are predominant. Aim: This study aimed to identify how strongly maternal risk factors associated to low birth weight. Method and Materials: The study used cohort prospective design among 700 pregnant women attended in antenatal care outdoor patient in Paropakar Maternity Women's hospital with 6 months follow up. Results: Among 700 respondents, 23 (3%) were lost in follow up. Out of 677 mothers, 151 (22%) gave birth of LBW. The mean birth weight was 2724gm. The mean maternal weight was 48kg, height was150cm and BMI was 21.2kg/m2. The cumulative incidence of LBW in the cohort was 22%. Mothers with weight <45kg had 11 times higher risk of giving of LBW babies (RR=10.92, CI:7.90-15.08); BMI <18.5kg/m2 had 3 times higher risk of giving LBW babies (RR=3.08, CI: 2.30 - 4.12). Mothers without having past history of LBW, and preterm delivery were 0.3 times, and 0.44 times chances of giving LBW babies respectively. There are positive association of LBW with primigravida (RR=1.09), and primiparity (RR=1.41), however, it could not reach statistically significant. Conclusion: The study concluded that maternal weight <45kg is the strongest risk factor for LBW. Other maternal risk factors were weight <45kg, BMI<18.5kg/m2, mothers without past history of LBW, and preterm are also statistically significant to LBW. KEYWORDS: Low birth weight; Cohort; Hospital-based; Maternal anthropometry

KEY FACTORS ASSOCIATED WITH LOW BIRTH WEIGHT AT TERM IN NEPAL: A CASE CONTROL STUDY

Background:Low Birth Weight (LBW) is a major public health problem in developing countries including Nepal. Nepal has a prevalence of LBW of 21%. There are various factors associated to high prevalence of LBW. This study aimed to identify specific factors associated to LBW at term in hospital settings in Nepal. Methodology: This study used a hospital based case control design. Hospital nurses interviewed mothers aged 15-45 years who had delivered a full term, single and live baby. Results: A total of 1533 respondents (511 cases and 1022 controls) were taken which is slightly more than the estimated sample size. The mean weight of newborns among case group was 2215 gm (SD:203); and among control group was 3012gm (SD:367). This study revealed that factors such as mothers under 20 years old (OR=1.436, 95% CI:1.074-1.920); height below 145cm (OR=1.504, 95% CI:1.087 -2.083); primigravida (OR=1.423, 95% CI:1.132-1.788); illiterate (OR=1.407 95% CI:1.011-1.957); <4 ANC visits (OR=1.534, 95% CI:1.202-1.957); and iron supplement <180 tabs (OR=1.434, 95% CI:1.152-1.786) were associated with LBW. However, variables like <20 years at the first pregnancy (OR=1.139, 95% CI: 0.904-1.433), disadvantaged ethnicity (OR=1.077, 95% CI: 0.861-1.347) were not associated with LBW in this study.Conclusion: Maternal height, education, number of ANC visits, and iron consumption were strong predictors for LBW in Nepal. It would benefit the country to develop effective strategies on maternal nutrition, female education, and quality ANC to overcome LBW.KEYWORDS: Low Birth Weight; Socio-demographic and antenatal care, Case control design

KEY FACTORS ASSOCIATED WITH LOW BIRTH WEIGHT AT TERM IN NEPAL: A CASE CONTROL STUDY

Background:Low Birth Weight (LBW) is a major public health problem in developing countries including Nepal. Nepal has a prevalence of LBW of 21%. There are various factors associated to high prevalence of LBW. This study aimed to identify specific factors associated to LBW at term in hospital settings in Nepal. Methodology: This study used a hospital based case control design. Hospital nurses interviewed mothers aged 15-45 years who had delivered a full term, single and live baby. Results: A total of 1533 respondents (511 cases and 1022 controls) were taken which is slightly more than the estimated sample size. The mean weight of newborns among case group was 2215 gm (SD:203); and among control group was 3012gm (SD:367). This study revealed that factors such as mothers under 20 years old (OR=1.436, 95% CI:1.074-1.920); height below 145cm (OR=1.504, 95% CI:1.087 -2.083); primigravida (OR=1.423, 95% CI:1.132-1.788); illiterate (OR=1.407 95% CI:1.011-1.957); <4 ANC visits (OR=1.534, 95% CI:1.202-1.957); and iron supplement <180 tabs (OR=1.434, 95% CI:1.152-1.786) were associated with LBW. However, variables like <20 years at the first pregnancy (OR=1.139, 95% CI: 0.904-1.433), disadvantaged ethnicity (OR=1.077, 95% CI: 0.861-1.347) were not associated with LBW in this study.Conclusion: Maternal height, education, number of ANC visits, and iron consumption were strong predictors for LBW in Nepal. It would benefit the country to develop effective strategies on maternal nutrition, female education, and quality ANC to overcome LBW.KEYWORDS: Low Birth Weight; Socio-demographic and antenatal care, Case control design

Penerapan Model Pembelajaran Team Assisted Individualization Untuk Meningkatkan Aktivitas dan Hasil Belajar Ekonomi Siswa Kelas XI IPS 2 SMA Negeri 1 Banjarangkan Tahun Pelajaran 2018/2019

Penelitian ini bertujuan untuk mengetahui hasil belajar ekonomi siswa kelas XI IPS 2 SMA Negeri 1 Banjarangkan melalui penerapan model pembelajaran Team Assisted Individualization tahun pelajaran 2018/2019. Subjek penelitian ini adalah Kelas XI IPS 2 SMA Negeri 1 Banjarangkan tahun pelajaran 2018/2019 yang berjumlah 33 siswa. Objek penelitian ini adalah penerapan model pembelajaran Team Assisted Individualization untuk meningkatkan aktivitas dan hasil belajar ekonomi siswa kelas XI IPS 2 SMA Negeri 1 Banjarangkan. Hasil penelitian siklus I dimana jumlah siswa yang tuntas 19 siswa (57,58%) dan yang tidak tuntas sebanyak 14 siswa (42,42%). Aktivitas belajar siswa pada siklus I adalah 49,61% dengan nilai rata-rata hasil belajar siswa sebesar 74,57, daya serap 74,57% dan ketuntasan klasikal yang mrncapai 57,58%. Pada siklus II jumlah siswa yang tuntas sebanyak 29 siswa (87,88%) dan yang tidak tuntas sebanyak 4 orang siswa (12,12%), dimana untuk siswa yang tidak tuntas diberikan tugas tambahan berupa tugas individu untuk melengkapi nilai siswa yang tidak tuntas. Rata-rata aktivitas belajar siswa pada siklus II mencapai 79,53% dengan nilai rata-rata hasil belajar 79,54, daya serap 79,54% dan ketuntasan klasikalnya adalah 87,88

Penerapan Model Pembelajaran Team Assisted Individualization Untuk Meningkatkan Aktivitas dan Hasil Belajar Ekonomi Siswa Kelas XI IPS 2 SMA Negeri 1 Banjarangkan Tahun Pelajaran 2018/2019

Penelitian ini bertujuan untuk mengetahui hasil belajar ekonomi siswa kelas XI IPS 2 SMA Negeri 1 Banjarangkan melalui penerapan model pembelajaran Team Assisted Individualization tahun pelajaran 2018/2019. Subjek penelitian ini adalah Kelas XI IPS 2 SMA Negeri 1 Banjarangkan tahun pelajaran 2018/2019 yang berjumlah 33 siswa. Objek penelitian ini adalah penerapan model pembelajaran Team Assisted Individualization untuk meningkatkan aktivitas dan hasil belajar ekonomi siswa kelas XI IPS 2 SMA Negeri 1 Banjarangkan. Hasil penelitian siklus I dimana jumlah siswa yang tuntas 19 siswa (57,58%) dan yang tidak tuntas sebanyak 14 siswa (42,42%). Aktivitas belajar siswa pada siklus I adalah 49,61% dengan nilai rata-rata hasil belajar siswa sebesar 74,57, daya serap 74,57% dan ketuntasan klasikal yang mrncapai 57,58%. Pada siklus II jumlah siswa yang tuntas sebanyak 29 siswa (87,88%) dan yang tidak tuntas sebanyak 4 orang siswa (12,12%), dimana untuk siswa yang tidak tuntas diberikan tugas tambahan berupa tugas individu untuk melengkapi nilai siswa yang tidak tuntas. Rata-rata aktivitas belajar siswa pada siklus II mencapai 79,53% dengan nilai rata-rata hasil belajar 79,54, daya serap 79,54% dan ketuntasan klasikalnya adalah 87,88%

Language of evaluation: How PLA evaluators write about student learning

Very few studies (e.g., Arnold, 1998; Joosten-ten Brinke, et al., 2009) have examined the ways in which evaluators assess students’ prior learning. This investigation explored the ways that evaluators described students’ prior learning in final assessment reports at a single, multiple-location institution. Results found four themes; audience, voice, presentation of the learning, and evaluation language. Within each theme, further sub-themes are defined. These results are significant for training evaluators on how to discuss student learning and for institutions to consider in relationship to the purpose behind the evaluations. Further research and implications are discussed

Revealing What is Dear: the post-earthquake iconisation of the Dharahara, Kathmandu

On 25 April 2015 central Nepal was struck by a magnitude 7.8 earthquake which killed over 9000 people and displaced 2.8 million. The image of the Dharahara, a nineteenth century minaret which collapsed during the quake, quickly became for many Nepalis an iconic representation not only of the disaster but also of a national determination to recover and rebuild. Edward Simpson has argued that the aftermath of a disaster is ‘a product of the longer history of a locality’ and it is the aftermath ‘that may reveal what is dear’ (Simpson 2013: 53, 50). Drawing upon media and literary discourse in the Nepali language, this article asks why the Dharahara tower loomed so large in the Nepali imagination in the immediate aftermath of the April 2015 earthquake, rather than the country’s severely damaged World Heritage sites, and why it became a rallying point for a resurgence of Nepali hill nationalism

The outcome of cannulated cancellous screw fixation for treatment of base of fifth metatarsal fractures

Background: The fracture of the base of the fifth metatarsal is one of the common fractures that occur in 5th decade of life in the foot. Stable fixation with the cannulated cancellous screw provided early healing and patients can return to their work early. Aims and Objectives: The aim of the study is to find the functional outcome of closed reduction and internal fixation with cannulated cancellous screw fixation for the displaced base of fifth metatarsal fractures, to evaluate the clinical and radiological union of fifth metatarsal fractures, and to study the complications of treatment of fifth metatarsal fractures. Materials and Methods: This prospective study was conducted in the Department of Orthopaedics Manipal teaching hospital Pokhara, Nepal, from February 2022 to January 2023. A total of 35 patients with the fractured fifth metatarsal base were included in the study. The patient was kept in a supine position with a pillow under the knee so that the knee was flexed to 90° and the foot was plantigrade. A cannulated cancellous screw of the appropriate size was inserted along with a washer to fix the fracture. Results: There were a total of 35 patients with the base of 5th metatarsal fractures. The mean age of the patient was 36.94±8.04 years, with males 22 (62.9%) and females 13 (37.1%). The left side commonly involves 22 (62.9%). The history twisting injury is the most common mode of injury. All patients had a union of fracture by 7.09±1.07 weeks ranging from 6 to 9 weeks. There were no cases of sural nerve injuries in our study. Conclusion: The base of fifth metatarsal fractures is commonly seen in athletes and patients around 40 years of age. Closed reduction under image guidance and stable fixation with cannulated cancellous screw fixation provides early healing of fractures. Patients can return to work early