The Cost of Menstrual Cycle in Young Nepali Women: A Cross-Sectional Study

Introduction: Every woman must have safe access to clean water and menstrual products. They have to spend more or less money to buy menstrual products or to alleviate menstrual symptoms. The cost of a menstrual cycle is often associated with period poverty. We found a research gap on this issue. The objective of this study was to find the cost of menstrual cycle and their perceptions on menstrual cost among young Nepali women. Methods: We conducted a cross sectional study from 15 August 2019 to 15 February 2020. The total enumeration sampling technique was used to enroll 157 female medical students. Ethical clearance was obtained from institutional review committee of Birat Medical College Teaching Hospital. Open data kit (ODK) collect software was used for data collection. The collected data was extracted in Microsoft Excel 2016 and analyzed by SPSS version 23. Results: Majority (33.8%) had menarche at 13 years and 47.8% had regular menstrual cycle. The total average cost of items used in last menstrual period was NPR 480.41 (NPR 40-1850) and lifetime cost was NPR 219066.96. Sanitary pads/ tampons/menstrual cups etc. should cost less money (85.4%) and tax currently put on it should be removed by government (91.1%) were the perceptions of the participants. Conclusion: Menstrual cycle added additional cost in women's life. Participants perceived that cost is high and it should be tax free. Nepal's constitution already passed sanitation as basic fundamental right. So, the cost of sanitary items needs to be minimized by removing the government tax

Morphometric Study of Pterion in Dry Human Skull at Medical College of Eastern Nepal

Introduction: The pterion is defined as an H shaped sutural confluence present on the lateral side of the skull. This pterion junction has been used as a common extra-cranial landmark for surgeons in microsurgical and surgical approaches towards important pathologies of this region. Methods: This is an analytical cross-sectional study conducted at the Department of Anatomy, Birat Medical College & Teaching Hospital, Tankisinuwari, Morang, Nepal. Total enumeration technique was used to collect samples where 31 dry human skulls of unknown age and sex were taken. The sutural pattern and location of the pterion were determined and measured on both sides of each skull using a digital vernier caliper.  Results: Three types of sutural patterns of pterion were observed. Among them, the Sphenoparietal type was higher in frequency. The frequency was 26 (83.8%) on the right side and 24 (77.4%) on the left side. The distance between the center of pterion to the midpoint of the upper border of the zygomatic arch was 3.82±0.3 cm on the right side and 3.8±0.29 cm on the left side. The distance between the center of pterion to the postero-lateral aspect of fronto-zygomatic suture was 3.02±0.23 cm on the right side and 3.0±0.23 cm on the left side. Conclusion: The information of the sutural pattern and the location of the pterion from the different bony landmarks of our study may be useful for anthropologists and neurosurgeons.   Keywords: Frontozygomatic suture, Morphometric, Pterion, zygomatic arch DOI: https://doi.org/10.3126/jkahs.v2i3.2665

Impact of COVID 19 on Surgical Practices among Maxillofacial Surgeons of Nepal

Introduction: Oral and maxillofacial surgeons come into contact with the saliva, mucus, blood during the examination of patients. Coronavirus disease (COVID-19) is believed to spread primarily via respiratory droplets that put oral and maxillofacial surgeons at high risk of contracting the infection. COVID 19 has led to changes in maxillofacial surgical practices. There is a gap in knowledge regarding its real impact. So, we conducted this study with the objective to evaluate the impact of COVID-19 on maxillofacial surgery practices in Nepal. Methods: A web-based cross-sectional study was conducted among all the members of the Nepalese Association of oral and maxillofacial surgeons (NAOMS) practicing in Nepal. The survey was conducted from 25 June 2020 to 25 July 2020.  The total enumeration sampling was used to collect information and 46 study participants enrolled in the study. A semi-structured questionnaire was developed and sent to study participants through a google form. Ethical clearance was taken from the Institutional Review Committee of Birat Medical College and Teaching Hospital and informed web-based consent was taken from study participants. Results: Only 46 participated among 70 invitations, with a response rate of 65.71%. Among the study participants, the majority (n=35, 76.08%) used personal protective equipment (PPE) for minor procedures and in the operating room. Most surgeons (n=37, 80.43%) asked to test their patients for COVID-19 prior to shifting to the Operating room. More than half of Surgeons were doing both elective and emergency surgeries (n=24, 52.17%). Almost all surgeons (n=44, 95.65%) responded that they have minimized aerosol-generating procedures. Almost two-thirds of surgeons (n=29, 63.04%) did not feel safe while working in a hospital. Conclusion: Despite the use of PPE by the majority of Maxillofacial Surgeons and asking their patients for the COVID- 19 test, they still did not feel safe to work at the hospital

Role of Female Community Health Volunteers for Prevention and Control of COVID-19 in Nepal

Female Community Health Volunteers (FCHVs) are the pillars of community health programs in Nepal who play a pivotal role in implementing various community based preventive, promotive, and curative health programs. In the context of COVID 19 pandemic and possible outbreak in Nepal, the only way by which it can be stopped at the moment is by prevention. This paper presents the role of FCHVs for the prevention and control of COVID 19 in Nepal.

Snakebite Incidence, General Awareness and Belief of Snakebite Management at a Rural Municipality of Eastern Nepal

Background: Understanding people’s awareness on snakebite management would be highly beneficial to develop strategic program at local levels of Nepal. We aimed to identity snakebite incidence, general awareness and beliefs of people regarding snakebite management in rural communities. Materials and Methods: A community-based cross-sectional study was conducted at Budhiganga Rural Municipality from September to November 2022 among 245 households. Ethical clearance was taken from institutional review committee of Birat Medical College. Microsoft Excel 2019 and SPSS software ver. 2025 were used for data analysis. Results: Annual snakebite incidence rate was 2332 per 100000 populations. Majority (71%) could not identify biting snake and attended traditional healers (70%). Among study participants, 25% had false belief that banded krait is not poisonous. Various false beliefs on snakebite first aid management were reported such as use of tourniquet (81%), washing bite sites (53.47%), cutting bite site (52%) and so on. Further, prevalent false beliefs on food-related practices were snake drinks milk (85.31%), giving victim water following the snakebite was beneficial (47%), giving chilly to those bitten was beneficial (41.63%) and so on. Conclusion: Despite the existing burden of snakebites, people are not aware about the correct ways to manage them and were still attending traditional healers as a means of treatment. The mis beliefs about snakebite first aid management are very much prevalent

Health Seeking Behavior and Utilization of Health Care Services in Eastern Hilly Region of Nepal

noBackground &amp; Objectives: Preventive, promotive, curative, and rehabilitative health care services depend not only in availability &amp; accessibility of it but also on awareness and attitude of the people and various inter-woven social structure that determines in making choice. The objective of this study was to explore health seeking behavior and utilization of health care services in the rural places in VDCs of Ilam district of Eastern Nepal.Materials &amp; Methods: A cross sectional study was conducted in between period of March 25th 2013 to April 10th 2013 Fikkal and Pashupatinagar VDCs in Ilam district with sample of 300 people. Data was collected using a semi-structured questionnaire.Results: One fifth of the populations were found to be seeking traditional healers’ service and 80 percent among modern treatment system were relying on private treatment facility for treating sickness. People who had lived more than 20 years in that place and who felt modern health services were costly were likely to use service of traditional healers. Similarly people suffering from chronic illness, having health facility more than 30 minutes and using stretcher or walking as means of transportation were using government health centers more compared to private services.Conclusion: Significant people still use traditional healers’ service and the government health facility utilization was low as compared to private. The people living for longer period in that place and having the concept that modern health centers are costly were primary user of traditional healing system. Health facility nearby or people who could afford for automobile travel facilities were using costly private health centers.JCMS Nepal. 2015; 11(2):8-16</p

Population and conservation threats to the vulnerable Sarus crane Grus antigone in Nepal

Abstract Globally, biodiversity is declining due to habitat loss and degradation, over‐exploitation, climate change, invasive species, pollution, and infrastructure development. These threats affect the populations of large waterbird species, such as Sarus crane (Grus antigone), which inhabits agricultural–wetland ecosystems. Despite the burgeoning built‐up areas and diminishing agricultural and wetland spaces, scant research investigates the impact of these changing land uses on the globally vulnerable Sarus crane in Nepal. During the pre‐breeding season from April to June 2023, our comprehensive study meticulously scrutinized Sarus crane population status and factors associated with the occurrences and conservation challenges across 10 specific districts of Nepal. Our study documented a total of 690 individuals of Sarus cranes in five districts. The Lumbini Province has 685 individuals, occupying 11 roosting sites. Conversely, the remaining five districts have no Sarus cranes presence during this period. Wetland, farmland and built‐up areas exhibited a significantly positive influence on Sarus crane occurrences in the Lumbini Province. Additionally, we recorded 47 fatalities of Sarus cranes over the past 13 years in the Lumbini Province due to electrocution and collisions. Our study provides a baseline dataset crucial for developing conservation policies, particularly during the dry season when Sarus crane populations tend to congregate in larger flocks. The adaptation of the Sarus crane to urbanized landscapes exposes them to several anthropogenic threats in the coming days. Therefore, protecting wetlands and farmland areas and adopting transboundary conservation approaches are imperative for the long‐term conservation of the Sarus crane and its habitat

Health system gaps in cardiovascular disease prevention and management in Nepal

BACKGROUND: Cardiovascular diseases (CVDs) are the leading cause of deaths and disability in Nepal. Health systems can improve CVD health outcomes even in resource-limited settings by directing efforts to meet critical system gaps. This study aimed to identify Nepal's health systems gaps to prevent and manage CVDs. METHODS: We formed a task force composed of the government and non-government representatives and assessed health system performance across six building blocks: governance, service delivery, human resources, medical products, information system, and financing in terms of equity, access, coverage, efficiency, quality, safety and sustainability. We reviewed 125 national health policies, plans, strategies, guidelines, reports and websites and conducted 52 key informant interviews. We grouped notes from desk review and transcripts' codes into equity, access, coverage, efficiency, quality, safety and sustainability of the health system. RESULTS: National health insurance covers less than 10% of the population; and more than 50% of the health spending is out of pocket. The efficiency of CVDs prevention and management programs in Nepal is affected by the shortage of human resources, weak monitoring and supervision, and inadequate engagement of stakeholders. There are policies and strategies in place to ensure quality of care, however their implementation and supervision is weak. The total budget on health has been increasing over the past five years. However, the funding on CVDs is negligible. CONCLUSION: Governments at the federal, provincial and local levels should prioritize CVDs care and partner with non-government organizations to improve preventive and curative CVDs services.</p