Knowledge, Attitude and Practice about Hypertension among adult Population of Letang Municipality, Morang District, Eastern Nepal

Introduction:Hypertension has been identified as one of the major public health and medical challenges with 1/4 adults worldwide estimated to have high blood pressure (BP).Objectives: To assess knowledge, attitude and practices regarding hypertension and to measure the association between socio-demographic characteristics with knowledge, attitude and practice regarding hypertension among adult population.Methods:The cross-sectional study was conducted among the 335 adult populationsin Letang Municipality of Nepal. Semi-structured questionnaire wasused for data collection. Chi-square test was applied to measure the association between socio-demographic characteristics with knowledge, attitude and practice regarding hypertension.Results:Majority of the respondents (67.2) have knowledge about the meaning of hypertension and symptoms of hypertension (52.2%). Mostof the respondents think that regular physical activity (83.9%) and reduce salt intake (84.2%) can be prevent hypertension.Almost 73.4% of respondents didn’t know their blood pressure and never checked their BP regularly(66.6%). Almost 12.8% of the study population sufferingfrom hypertension. The adult Population with age group of 41-60years (62.6%) was seen significantly good knowledge in comparison to other age groups. The study population having educational level SLC and above was seen significantly good knowledge,attitude and practice regarding prevention of hypertension in comparison to below SLC and illiterate. The study population belong to above poverty line had significantly good knowledge,attitude and practice regarding prevention of hypertensionin comparison to below poverty line.Conclusions:We conclude that majority of the study population of Letang Municipality had higher knowledge and positive attitude toward prevention of hypertension but the level of practices was poor.

Effect of Household Cooking Fuel and Breastfeeding on Infant Growth: Findings from the National Family Health Survey-4, India.

Objective: Malnutrition is a critical public health concern in India. We aimed to understand the prevalence of stunting and its association between cooking fuel type and breastfeeding among Indian infants (? 6 months of age). Methods: This study used information from a National Family Health Survey-4 (NFHS) conducted between 2015 and 2016. From all eligible infants, information on socio-demographic and clinical characteristics was obtained. Univariate and multivariable binary logistic regression was performed to examine the factors associated with stunted children. Results: Of the 15,120 infants, the median (Inter Quartile Range) age was 4 (2-5) months with a female/male ratio of 1:1.06. The prevalence of polluting fuel use and stunting was 68.10% and 20.13% respectively. Stunting among polluting fuel and clean fuel was 22.17% and 15.78%. Stunting among exclusive breastfed and not exclusive breastfed was 20.62% and 19.53%. In adjusted analysis, households using clean fuel (Adjusted Odds Ratio 0.75; 95% Confidence Interval, 0.66-0.86) had lower odds of infants being stunted compared to polluting fuel. A infant currently being breastfed (aOR 0.76; 95% CI, 0.62-0.93) had lower odds of being stunted than infants currently not being breastfed. Conclusion: The present study indicates that polluting cooking fuel and not being breastfed was associated with an increased risk of infant being stunted. A community-based randomized control trial was required to study child and maternal health risks on polluting cooking fuel. Furthermore, the study highlights the urgent need to raise awareness on the importance of exclusive breastfeeding practices.

Unusual cause of unilateral epistaxis: nasal leech infestation.

Common causes for unilateral nasal bleeding in adults are benign or malignant tumors and deviated nasal septum. Here we present two cases of recurrent unilateral nasal bleeding due to leech infestation. Though it is not a common cause for nasal bleeding, a clinician should suspect leech infestation for a recurrent nasal bleeding specially in tropical countries like Nepal.

Descending necrotizing mediastinitis: a fatal complication of neglected esophageal foreign body.

Descending necrotising mediastinitis due to a neglected esophageal foreign body is uncommon. It is a lethal disease if it develops with full blown clinical picture. A case is reported of descending necrotising mediastinitis caused by a foreign body in oesophagus which is rarely reported in world literature. It is emphasized that prompt diagnosis and aggressive surgical mediastinal drainage is very important for the survival of these patients. Delayed diagnosis and treatment in our case may have been the cause of death of the patient. Delayed diagnosis in our case is due to the unavailability proper health facility in remote area in developing countries like Nepal.

Brain abscess due to Scedosporium apiospermum in a non immunocompromised child.

Scedosporium apiospermum is a filamentous fungi that commonly causes cutaneous infection. In certain circumstances, S. apiospermum can also cause invasive disease, which can involve the central nervous system (CNS). When the CNS becomes involved, treatment is difficult, therapeutic options are limited and the prognosis is poor. Early identification and treatment can decrease the mortality rate. Here we present a case of brain abscess with chronic suppurative otitis media, caused by S. apiospermum. This is the first such case report from Nepal. We could identify the organism only post mortem. We could not save the patient, probably due to delay in diagnosis.