Women and Irrigation in Nepal: Context, Issues and Prospects

Occasional Papers in Sociology and Anthropology - Volume 9, 200

Barriers to Utilisation of Sexual Health Services by Female Sex Workers in Nepal

Sexual health services are relatively rare in Nepal. Female sex workers (FSWs) do not use health services as much as would be desirable. A study was conducted to identify barriers to access of sexual health services by FSWs in Nepal. A mixed-method approach consisting of a 425 questionnaire-based survey and 15 in-depth interviews were conducted in 2007. One fifth of the FSWs had never visited health facilities. FSWs turned to private clinics followed by clinics belonging to non-governmental organisations and pharmacies for treatment. A combination of personal and service-related factors acted as critical barriers in accessing health services. Lack of confidentiality, discrimination and negative attitudes held by health care providers, poor communication between service providers and fear of exposure to the public as a sex worker were the major barriers to seeking sexual health services. These barriers should be taken into account while planning for sexual health services

A study of the adaptive immune system in coronary thromboaspirate during human acute myocardial infarction

Introduction: This thesis aims to characterize the biology of solid and liquid phase coronary thromboaspirate obtained during therapeutic aspiration at primary angioplasty for ST elevation myocardial infarction (STEMI). Methods: We studied coronary thromboaspirate obtained from the coronary artery (CA) in STEMI and focussed on three lines of investigation: • Intracoronary solid phase thrombus was subjected to immunohistochemistry for characterization and quantification of the different leukocyte types and proteins involved in the thrombus. • Resident cell populations in the liquid phase filtrate from the aspirate including platelets and leukocytes along with their subpopulations were analysed by flow cytometry for phenotypic and activation markers. Comparison was made with cells in the peripheral femoral artery (FA) blood. • Paired plasma/serum from the CA filtrate and FA blood were analysed for the presence of autoreactive antibodies and cytotoxic potential. Results: • Leukocytes were heterogeneously distributed in the ex-vivo thrombus. The granulocyte population was predominant and strongly expressed CD11b and vimentin. • The CA aspirate filtrate when compared to the paired FA blood contained significantly more leukocyte-platelet conjugates, more activated platelets, and more Vimentin. • More of the CD4+ T cells in the CA than FA had lost the co-stimulatory molecule CD28 (p<0.00001) and they often expressed effector phenotype marker. • Conversely, the immune-regulatory T cells expressing the FoxP3 were more attenuated in the CA than FA (p<0.00001). • Whilst IgG and IgM antivimentin antibody titres in the CA sera were consistently lower than the titres in FA sera (p<0.001), auto-reactive non-HLA IgM were more prevalent in CA sera. The CA sera had increased potential to induce apoptosis than FA sera when incubated with endothelial cells (p<0.001). Conclusions: • Aspirated intracoronary clot contained granulocytes as the predominant leukocyte component. This investigation of the immune system in the CA during AMI therefore moved on to the adaptive system in the coronary filtrate. • Increased concentrations of pro-inflammatory immune cells and reduced concentrations of immune-modulating cells were observed in the aspirate from the culprit site of CA occlusion when compared with the FA. The presence of T memory cells implies that this subset may have been released from the ruptured coronary plaque and this phenotypic analysis may help clarify the role of the immune system in the pathogenesis of coronary plaque instability. • The higher titres of auto-reactive IGM in the CA than FA sera have the potential to activate the complement system and may contribute to myocardial injury following therapeutic restoration of coronary flow in STEMI

Menarche and Its Determinants in Adolescent Girls

Introduction: Biological, psychosocial, cognitive, emotional and social changes begin during puberty and continue throughout adolescence. The age at which a female reaches sexual maturity is critical in determining her future reproductive health and success. The aim of the study was to assess the average age of sexual feeling and menarche among the adolescent girls and its determinants. Methods: Three hundred fifty five respondents were selected through simple random sampling from three secondary schools (namely Sunrise Boarding School, Swaraswati Secondary School and Gyanjyoti Samudayak Bidhyalaya) in Palpa for the cross-sectional study. Structured interview schedule was used to collect information. Data was tabulated in Microsoft Excel spreadsheet and analyzed with SPSS-16. Results: Most of the girls (44.8%) attained menarche at 12 years (M = 12.4, SD = 1.11). Age at menarche was more likely before 13 years of age when the age of onset of sexual feeling was earlier than 12 years of age, in students than in domestic workers and if they are living with parents than in those not living with parents. Conclusion: The average age of menarche among the adolescent girls was 12.40 years and it could be influenced by age of sexual feeling, occupation and living status of girls

Prevalence of Low Calorie Intake by Rural Families in Palpa District of Nepal

Background: Healthy population is indispensable for national development. Adequate food intake by people is the key determinant to keep up their health. Malnutrition nevertheless remains pervasive in developing countries, undermining people’s health, productivity, and often their survival. Food insecurity and hunger remain persistent in Nepal. Prevalence of low calories intake by rural family is widespread throughout the country population. Mainly marginalized communities, ethnic group with poor economic status, traditional societies and lower cast people are exposed to food defi cit. Objective: to investigate the prevalence of low calories intake by rural families and its associated determinants in Palpa district. Materials and methods: The cross-sectional study was designed to achieve objective of the research. A random sample of 339 families was selected from rural areas (DUMRE, DAMKADA, GORKHEKOT and TELGHA villages) of this district. Data were analyzed by using the SPSS software for Windows (version 16.0). Results: The existence of inadequate food calorie intake among rural families was most common. Most of them were malnourished. Conclusion: low calorie intake by ethnic group was considerably higher than other groups in community