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1.
Kathmandu Univ Med J (KUMJ) ; 17(68): 322-328, 2019.
Article in English | MEDLINE | ID: mdl-33311043

ABSTRACT

Background Thyroid disorders are emerging public health issues. Clients' awareness is crucial for prevention, early diagnosis, and treatment of the thyroid disorders. Studies, assessing knowledge on thyroid disorders among Nepalese population, is lacking. Objective To assess the awareness of thyroid disorders among women, a susceptible subgroup, and find the correlates of poor knowledge. Method A cross-sectional study was conducted among 423 women at the gynecological outpatient department of Tribhuvan University Teaching Hospital. Eighteen-item scale, with a Cronbach's Alpha of 0.913, was developed to assess participant's knowledge on various constructs of thyroid disorder. A linear regression model with Bootstrap approach was used to identify the predictors of the total knowledge score. Result The mean (±SD) age of the participant was 29.2 ± 7.0 years. About 49% of the women had inadequate knowledge, defined at or below the mean cumulative knowledge score. In linear regression, the total knowledge score was significantly lower among participants who were Janajati (ß=-2.87, BCa 95%CI=-4.61, -1.11), illiterate (ß=- 6.37, BCa 95%CI =-9.14, -3.21), and low income (ß=-3.76, BCa 95%CI=-5.68, -1.83). Likewise, a university education (ß=5.94, BCa 95%CI=3.50, 8.26), working status (ß=4.04, BCa 95%CI=2.19, 5.81), urban residence (ß=2.06, BCa 95%CI=0.02, 3.96) and family history (ß=2.20, BCa 95%CI=0.71, 3.63) of thyroid disorder predicted higher knowledge score. Conclusion This study identified a poor level of knowledge on thyroid disorders among Nepali women and thus proposes them to be an important subgroup for an intervention or policy aimed at promoting awarenessof thyroid disorders. The findings also warrant increased awareness among these population through hospital and communitybased behavior change communication campaigns.


Subject(s)
Thyroid Diseases , Women , Cross-Sectional Studies , Female , Health Knowledge, Attitudes, Practice , Humans
2.
J Nepal Health Res Counc ; 15(1): 7-11, 2017 Jan.
Article in English | MEDLINE | ID: mdl-28714485

ABSTRACT

BACKGROUND: Medical waste is considered as a major public health hazard. In a developing country like Nepal, there is much concern about the management practice of medical waste. This study aimed to assess Health Care Waste Management practice among Health Care Institutions in Nepal. METHODS: A cross sectional study was carried out between July 2012 to June 2013 in 62 different Health Care Institutions, selected from stratified proportionate random sampling technique from all administrative regions of Nepal. A structured questionnaire and observation checklist were used for data collection. RESULTS: The waste generation rate is found significantly correlated with bed capacity, patient flow rate and annual budget spent in the hospital. It is found significantly higher in Teaching hospital than other Health Care Institutions of Nepal. An average of 3.3 kg/day/patient of medical waste (2.0 kg/day/patient non-hazardous and 1.0 kg/day/patient hazardous waste) was generated during the study period. Further, it was found that most of the Health care wastes were not disinfected before transportation to waste disposal sites. Very limited number of Health Care Institutions had conducted Environmental Assessment. Similarly, some of the Health Care Institutions had not followed Health care waste management guideline 2009 of Nepal Government. CONCLUSIONS: We found poor compliance of medical waste management practice as per existing legislation of Government of Nepal. Hence, additional effort is needed for improvement of Health care waste management practice at Health Care Institutions of Nepal.


Subject(s)
Health Facilities/statistics & numerical data , Medical Waste Disposal/methods , Medical Waste Disposal/standards , Budgets/statistics & numerical data , Cross-Sectional Studies , Hospital Bed Capacity/statistics & numerical data , Hospitals, Teaching/statistics & numerical data , Humans , Nepal , Ownership , Residence Characteristics
4.
J Nepal Health Res Counc ; 14(33): 99-103, 2016 May.
Article in English | MEDLINE | ID: mdl-27885291

ABSTRACT

BACKGROUND: The immunization card is revised with addition of general information about child health and is later called as child health card. This card is a tool used by Health Management Information System in Nepal. It is important for tracking the records of immunization. Aim is to identify the factors determining the availability, utilization and retention of the child health card in Western Nepal. METHODS: A cross sectional study was conducted among mothers having children < 24 months old from Gorkha (Western Hill) and Nawalparasi (Western Terai) districts. The sample size for the study was 600 and systematic random sampling was used to select the mothers having less than 24 months old children. Data entry and analysis was done by using SPSS. Qualitative data was analyzed by making matrix. RESULTS: The average age of respondents was 24 years. The majority of respondents have gained higher level education. Retention of the card was found to be 82.2%. 90.3% retention was seen among 0-12 months children age group whereas it was 74 % among12 to 24 months age group. The reasons for less retention were torn by the child/played by child (54.6%) followed by lack of proper place,unaware about importance and poor quality of card.The new child health cards were insufficient, compelling use of both new and old cards which created problem in consistency. Regarding utilization of child health card, it was found to be used for birth registration and for further studies in abroad. CONCLUSIONS: The areas of utilization of child health card should be broadened so that the retention of card can be increased. The main reasons for less retention of the card are torn by children and lack of the proper place.


Subject(s)
Documentation , Immunization/statistics & numerical data , Adult , Child , Cross-Sectional Studies , Documentation/statistics & numerical data , Educational Status , Female , Humans , Infant , Infant, Newborn , Male , Maternal Age , Middle Aged , Mothers/statistics & numerical data , Nepal , Young Adult
5.
J Nepal Health Res Counc ; 14(34): 165-172, 2016 Sep.
Article in English | MEDLINE | ID: mdl-28327681

ABSTRACT

BACKGROUND: Over the past decade in Nepal, a large number of studies have been carried in a variety of health areas; however whether evidence derived from these studies has been used to inform health policy has not been explored. This study aims to assess the utilization of recommendations from health research in health policy and plans, and to identify the factors that influence utilization of research findings by policy makers' in Nepal. METHODS: Qualitative study incorporating literature review and semi-structured interviews was used. Research reports and health related policies were collected from governmental and non-governmental bodies. Documents were reviewed to identify the utilization of research-based recommendations in health policy and plan formulation. In-depth interviews were conducted with key policy makers and researchers to identify factors that hinder the utilization of research recommendations. RESULTS: A total of 83 health related research reports were identified, of which 48 had recommendations. Four policies and three plans, from total 21 identified plans and policies, were found to have incorporated recommendations from research. Of the 48 studies that had recommendations, 35 were found to be used in the policy making process. Lack of appropriate communication mechanisms, and concerns related to the quality of research conducted, were the main factors hindering the translation of evidence into policy. CONCLUSIONS: Communication gaps exist between researchers and policy makers, which seem to have impeded the utilization of research-based information and recommendations in decision-making process. Establishing a unit responsible for synthesizing evidences and producing actionable messages for policy makers can improve utilization of research findings.


Subject(s)
Health Policy , Policy Making , Research , Decision Making , Humans , Nepal , Qualitative Research
6.
J Nepal Health Res Counc ; 13(29): 1-6, 2015.
Article in English | MEDLINE | ID: mdl-26411705

ABSTRACT

BACKGROUND: Over the centuries, the world has witnessed alcohol use as a common phenomenon among the male population. Owing to the vulnerability of women towards alcohol and its possible consequences on women as well as children when pregnant or lactating mothers drink alcohol, there is utmost need to know the alcohol use among this population. The study sought to assess alcohol use among the Nepalese women aged 15-69 years. METHODS: It was a sub-set analysis of 2807 women aged 15-69 years, extracted from a data of national cross-sectional study, NCD Risk Factors: STEPS Survey Nepal 2013 carried out among 4200 adults in 2013 using a multistage cluster sampling. Data collected in personal digital assistants using WHO NCD STEPS instrument version 2.2 were transferred to Microsoft Excel, cleaned in SPSS 16.0, and analyzed in STATA 13.0. RESULTS: We reported 11.7% (95% CI: 9.5-14.3) ever users of alcohol, 9.4% (95% CI: 7.4-11.7) last 12 months alcohol users, 7.1% (95% CI: 5.2-9.0) current drinkers, and 0.9% (95% CI: 0.5-1.6) with harmful use of alcohol. As compared to 15-29 years women, 30-44 and 45-69 years women were 1.61 (95% CI: 1.02-2.55) and 1.58 (95% CI: 1.03-2.43) times more likely to be drinkers in the last 12 months, respectively. Likewise, 45-69 years women were 2.84 (95% CI: 1.05-7.63) times more likely to indulge into harmful use of alcohol than their younger counterparts (15-29 years). Women from the Terai belt had lower odds of any drinking pattern than the women from hills: ever use (0.43, 95% CI: 0.27-0.70), alcohol use in the last 12 months (0.44, 95% CI: 0.26-0.75), current drinking (0.38, 95% CI: 0.22-0.65), and harmful use of alcohol (0.11, 95% CI: 0.03-0.37). Primary education holders were found to have 0.64 times (95% CI: 0.43-0.95) chances of current drinking than those without formal education. CONCLUSIONS: Women from upper age groups, hills, and with no formal education were found likely to be consuming alcohol. Contextual and culture friendly anti alcohol behaviour change communication interventions on community settings of hills and mountains, promoting active participation of relatively older women (45-69 years) and illiterate women are of great importance.


Subject(s)
Alcohol Drinking/epidemiology , Adolescent , Adult , Age Factors , Aged , Alcohol Drinking/ethnology , Cross-Sectional Studies , Culture , Female , Health Surveys , Humans , Middle Aged , Nepal/epidemiology , Residence Characteristics , Risk Factors , Socioeconomic Factors , Young Adult
7.
J Nepal Health Res Counc ; 13(29): 14-9, 2015.
Article in English | MEDLINE | ID: mdl-26411707

ABSTRACT

BACKGROUND: Globally, tobacco use is most common public health problem. Similar is the situation of Nepal where thousands of lives are lost annually. Both sexes are affected by tobacco use but women share different and unique problems. Hence, in this paper we made an attempt to understand socio-demographic predictors of tobacco use among women of Nepal. METHODS: A cross-sectional study was carried out with a sample of 2797 women (15-69 years) recruited through multistage cluster sampling technique. This study used sub-set of data of non-Communicable diseases risk factors survey 2013 of Nepal. Bivariate and multivariable regression analyses were carried out to determine predictors of tobacco use among women of Nepal. RESULTS: Among total women, 14% were having at least one form and pattern of tobacco use. Furthermore, 10 % were smoker and 4 percent were using any form of chewing tobacco user. As compared to 15-29 years women, 45-69 years age group were 5 times (OR=4.7, 95% CI =2.7-8.0) more likely to be tobacco user. Similarly, urban women were 40% (OR=0.6, 95% CI=0.38-0.95) less vulnerable than rural women. In addition, higher educated women were found to be at 1% (OR=0.01, 95% CI=0.01-0.01) less risk of being tobacco user. CONCLUSIONS: Age, area of residence, and education level were found to be significant socio-demographic predictors for tobacco use among women in Nepal. Therefore, tobacco control programme should target these groups for interventions.


Subject(s)
Tobacco Use/epidemiology , Adolescent , Adult , Age Distribution , Aged , Cross-Sectional Studies , Female , Health Surveys , Humans , Middle Aged , Nepal/epidemiology , Residence Characteristics , Risk Factors , Smoking/epidemiology , Socioeconomic Factors , Young Adult
8.
J Nepal Health Res Counc ; 13(29): 20-5, 2015.
Article in English | MEDLINE | ID: mdl-26411708

ABSTRACT

BACKGROUND: Despite being preventable disease, diabetes and hypertension fall among top 10 leading causes of death globally. Diabetes and hypertension are independent risk factor for cardiovascular disease, and the risk is markedly increased by their co-occurrence.This study attempted to find out the prevalence of comorbid diabetes and hypertension in Nepal. METHODS: A cross-sectional survey was conducted among 4,200 Nepalese adults selected through multistage cluster sampling.Out of 4,200 respondents of larger study, this article includes the analysis of 3,772respondents who granted permission for physical and biochemical measurement. Nepali version of WHO NCD STEPS instrument version 2.2 was used for data collection. In order to obtain national estimates sample weight was used. Chi-square test and multivariable binary logistic regression were used to assess the association of socio-economic predictors with comorbid conditions after adjusting effect of clusters and strata. RESULTS: The overall prevalence of comorbid diabetes and hypertension was found to be 2% in Nepal.Considering age group 15 to 29 years as reference, people in age group 45-69 and 30 to 44 years were found to have 33 folds (AOR=33.06, 95%CI=5.90-185.35) and 6 folds(AOR=6.36, 95%CI=1.08-37.43) higher odds of developing comorbid condition of diabetes and hypertension. CONCLUSIONS: Prevalence of comorbid diabetes and hypertension seem to be high in people of 45-69 years of age. Age and level of education seem to be associated with comorbid diabetes and hypertension.


Subject(s)
Diabetes Mellitus/epidemiology , Hypertension/epidemiology , Adolescent , Adult , Age Distribution , Aged , Cross-Sectional Studies , Diabetes Mellitus/ethnology , Female , Humans , Hypertension/ethnology , Logistic Models , Male , Middle Aged , Nepal/epidemiology , Prevalence , Residence Characteristics , Risk Factors , Sex Distribution , Socioeconomic Factors , Young Adult
9.
J Nepal Health Res Counc ; 13(29): 7-13, 2015.
Article in English | MEDLINE | ID: mdl-26411706

ABSTRACT

BACKGROUND: Oral diseases and feeding habits are inextricably linked. Significance of assessing oral health conditions among the school children therefore exists. The current study investigated the oral health condition among 5-6 years and 12-13 years children in Nawalparasi district, Nepal. METHODS: Recruiting 1,000 school children aged (5-6) and (12-13) years in Nawalparasi district, a cross-sectional study was carried out from November to December, 2014. Data assembled from standard instrument was entered in Epi-Data 3.1, cleaned in SPSS version 16.0, and analyzed in Epi Info 3.5.4. RESULTS: Of 12-13 years children, three out of ten (32.0%, 95% CI: 27.8-36.4) suffered from occasional dental discomfort and pain, and 8.1% (95% CI: 5.9-11.0) often experienced dental discomfort and pain during the last 12 months. It was 73.6% (95% CI: 69.3-77.4) who brushed teeth at least once a day, while another 20.7% (95% CI: 17.2-24.7) brushed twice a day. Among all children, 86.1% (95% CI: 82.6-89.1) used toothpaste to brush the teeth. A three-fourth (73.8%, 95% CI: 69.5-77.7) drank tea with sugar daily. Dental caries was visible on 42.2% (95% CI: 37.7-46.8) (mean DMFT score 2.3 ± 1.5). Likewise, a quarter (24.1%, 95% CI: 20.3-28.3) had gingival bleeding, 10.9% (95% CI: 8.3-14.1) questionable enamel fluorosis, 4.5% (95% CI: 2.9-6.9) dental trauma, and 1.7% (95% CI: 0.8-3.5) oral mucosal lesion. Referral for preventive/routine treatment was observed in 40.5% (95% CI: 36.145.1). Among 5-6 years old children, a remarkable proportion of dental caries (64.4%, 95% CI: 59.2-69.4 and mean DMFT score 4.4 ± 3.0) was noted. Statistics of enamel fluorosis, dental trauma, and oral mucosal lesions in this age group were: 3.1% (95% CI: 1.6-5.6), 1.7% (95% CI: 0.7-3.8), and 1.1% (95% CI: 0.4-3.0) respectively. About 40.1% (95% CI: 35.0-45.4) were referred for preventive treatment, and the rest for prompt treatment. CONCLUSIONS: Oral health of the children was poor, chiefly dental carries remained widespread. Dental hygiene awareness should be promoted in schools in active coordination and collaboration with education authorities.


Subject(s)
Dental Caries/epidemiology , Oral Health/statistics & numerical data , Oral Hygiene/statistics & numerical data , Adolescent , Child , Child, Preschool , Cross-Sectional Studies , DMF Index , Dental Caries/ethnology , Female , Glucose/administration & dosage , Humans , Male , Nepal/epidemiology , Oral Hygiene/methods , Pain/epidemiology , Prevalence , Toothpastes/administration & dosage
10.
J Nepal Health Res Counc ; 13(31): 182-7, 2015.
Article in English | MEDLINE | ID: mdl-27005709

ABSTRACT

BACKGROUND: Women face numerous health problems in their post-reproductive and menopausal years, including issues such as pelvic pain, incontinence and obstetric fistula. In Nepal, the importance of these health issues is increasing with the aging of the population, yet women are often unable to access adequate health care due to entrenched gender structures and misconceptions regarding menopause. This study aimed to describe the prevalence of menopause, the associated health problems and their severity amongst women aged 40-60 years in Kapilvastu. METHODS: A descriptive study was conducted in Kapilvastu district. Multi stage cluster sampling technique was adopted: Illakas of Kapilvastu were identified, then one Village Development Committee (VDC) from each Illaka of the district, and two wards from each of these VDCs, were selected randomly. RESULTS: The median age of onset of menopause was 47 years (25 th and 75 percentiles = 43 and 50 years), and >90% of women had entered menopause by 54. All symptoms in the Menopause Rating Scale were experienced to some extent by at least 30% of women, even amongst the premenopausal group. The most common problems experienced by menopausal women were: sexual problems (81.7%, 95%CI: 78.0-85.4), physical and mental exhaustion (81.5%, 95%CI: 77.8-85.2) and joint and muscular discomfort (78.5%, 95%CI: 74.6-82.4). The symptoms most frequently deemed "severe" or "very severe" were: sexual problems (40.5%), joint and muscular discomfort (27.4%), and sleep problems (21.0%). th CONCLUSIONS: Middle-aged women in Kapilvastu experienced menopausal symptoms to a substantial degree. The prevalence and severity of these symptoms increased with the menopausal transition, and with increasing age. Menopause itself did not appear to be the primary risk factor for typical "menopausal" symptoms.


Subject(s)
Health Status , Menopause/physiology , Adult , Cluster Analysis , Female , Humans , Middle Aged , Nepal
11.
J Nepal Health Res Counc ; 13(31): 233-40, 2015.
Article in English | MEDLINE | ID: mdl-27005718

ABSTRACT

BACKGROUND: Many countries are having problem of substandard and counterfeit drugs which results in life threatening issues, financial loss of consumers and loss in trust on health system. This study is concerned with the assessment of drugs quality available in the Nepalese market. METHODS: A cross sectional survey was carried out in Kathmandu valley. Five different brands from each eight molecules of drugs (Paracetamol tablet, Cloxacillin capsule, Amlodipine tablet, Metformin tablet, Losartan tablet, Cefixime tablet, Ofloxacin tablet, Carbamazepine tablet) were purposively selected. Registration compliance was verified from Department of Drug Administration (DDA) and laboratorial analysis was done in two different laboratories. RESULTS: Out of 40 drug samples, 90% did not comply with the existing regulatory requirement on labeling and 42.5% brands did not mention about the pharmacopoeial standard. There was no uniformity in mentioning the selflife. Similarly, large variation was seen on price of same generic drugs. Laboratory analysis showed that 40% samples failed to meet the standard among domestic companies and 28% among imported brands. Altogether 32.5% samples were found to be of substandard quality. Only the result of one sample matched with both laboratories. This indicates that there was variation in the selected two laboratories. CONCLUSIONS: The result of this survey indicates that, substandard medicines are available in Nepalese market. Moreover, there is weak regulation and no uniformity in similar pharmaceutical products. A larger study is required to access the quality of pharmaceutical products in the Nepalese market with testing of products in more than two independent laboratories.


Subject(s)
Counterfeit Drugs , Pharmaceutical Preparations/standards , Product Surveillance, Postmarketing , Consumer Product Safety , Cross-Sectional Studies , Drug and Narcotic Control , Humans , Nepal
12.
J Nepal Health Res Counc ; 13(31): 248-51, 2015.
Article in English | MEDLINE | ID: mdl-27005721

ABSTRACT

Zika virus (ZIKV) is a flavivirus with single stranded RNA related to yellow fever, dengue, West Nile, and Japanese encephalitis viruses and is transmitted by Aedes mosquitoes primarily by Aedes aegipti which is widely distributed in Nepal. ZIKV was first identified incidentally in Rhesus monkey in Uganda in 1947 and human infection in 1952; and by now outbreaks of ZIKV disease have been recorded in Africa, the Americas, Asia and the Pacific. The World Health Organization (WHO) has recently declared the ZIKV an international public health emergency. The aim of this paper is to briefly summarize origin, signs, symptoms, transmission, diagnosis, preventions and management of ZIKV and possible threat to Nepal in light of endemicity of other arbovirus infections and common mosquito vector species in Nepal. Keyword: Aedes aegypti; aedes albopictus; zika virus; microcephaly; birth defect; Nepal.


Subject(s)
Disease Outbreaks/prevention & control , Zika Virus Infection/prevention & control , Aedes , Animals , Disease Outbreaks/statistics & numerical data , Humans , Nepal/epidemiology , Zika Virus Infection/epidemiology
14.
J Nepal Health Res Counc ; 11(24): 126-32, 2013 May.
Article in English | MEDLINE | ID: mdl-24362599

ABSTRACT

BACKGROUND: Distribution and skill mix of health workforce has always been a challenge in rural Nepal. Workforce surpluses or shortages and inappropriate skill mix, decrease productivity and efficiency, deplete scarce resources and squander worker capabilities. This study was aimed at generating evidences on the current distribution and skill mix of health workforce in Nepal. METHODS: A cross-sectional study was conducted using both qualitative and quantitative methods.Fifteen districts representing three eco-developmental regions of Nepal were selected using multi-stage cluster sampling method. Out of 404 sampled health institutions, 747 health workers from 375 health institutions were interviewed. Observation was carried out in 256 health facilities. RESULTS: Currently, the vacant positions are mostly of doctors 74(38%) technicians 28 (21%) nurses 50 (10%) and paramedics 26 (6%)with respect to sanctioned positions. Variations of fulfilled positions occurred in all three ecological belts, with the Hill belt having the highest proportion of vacant posts 116 (16%).On the basis of types of health facilities, ayurvedic centres have the highest fulfilled positions 55 (95%) and the lowest in primary healthcare centres (PHCCs) 162 (81%). Proper skill mix was observed in 6 (43%) of hospitals and 3(18%) of PHCCs.Only 132 (17.7%) of health workers have taken part in orientation on non-communicable diseases (NCDs) despite the increasing trend of NCDs. CONCLUSIONS: There is scarcity of health workforce with appropriate skills, particularly in rural Nepal. Sanctioned positions and categories of health workers need to be revised on the basis of population growth and epidemiological shifts.


Subject(s)
Clinical Competence , Health Personnel , Clinical Competence/statistics & numerical data , Cost of Illness , Cross-Sectional Studies , Humans , Nepal , Qualitative Research , Rural Health Services
15.
J Nepal Health Res Counc ; 11(24): 138-43, 2013 May.
Article in English | MEDLINE | ID: mdl-24362601

ABSTRACT

BACKGROUND: The policy document of Nepal has spelled out commitment to involving civil society organisations (CSOs) in improving human resources for health (HRH). However, lack of empirical evidences, it is very hard to figure out exact situation about the roles and engagement of CSOs in HRH management. METHODS: A cross-sectional descriptive study was conducted using both quantitative and qualitative methods. Out of 404 sample health institutions, 747 health workforce from 375 health institutions were interviewed (<10% non-response rate) using the probability proportionate to size method as per World Health Organization (WHO) guidelines. RESULTS: Nearly 75% respondents had opined that the political parties were supporting the health institutions in the grassroots. It was found that the support from the CSO was better in Hill (54.9%) compared to Terai (46.9%) and Mountain (46.7%). The support was significantly different between rural (CI: 0.5063-0.591) and urban (CI: 0.3055-0.4363) (p <0.05, CI 95%). Mean index score of effectiveness of CSOs was found highest in Hills (0.3036) followed by Mountains (0.2669) and Terai (0.2589). Effectiveness of CSOs was found positively correlated with feeling of security by health workers and social prestige. CONCLUSIONS: The roles of civil society in HRH management still need to be recognized and well documented ensuring their active participation in formulation and implementation of policies, strategies and planning related to HRH for effective and quality healthcare services in Nepal.


Subject(s)
Community Networks , Health Workforce , Private Sector , Role , Adult , Confidence Intervals , Cross-Sectional Studies , Female , Humans , Male , Middle Aged , Nepal , Qualitative Research , Surveys and Questionnaires , World Health Organization
16.
J Nepal Health Res Counc ; 11(24): 153-7, 2013 May.
Article in English | MEDLINE | ID: mdl-24362604

ABSTRACT

BACKGROUND: In Nepal, the relationship of health worker and patient or community people is now deteriorating and the security and safety of health worker is becoming emerging issues. The poor relationship between community people and health worker is hampering the health service especially in rural setting. This study was aimed at finding the security perception and situation of health workforce in Nepal. METHODS: A cross-sectional descriptive study was conducted using both quantitative and qualitative methods. Out of 404 sample health institutions, 747 health workforce from 375 health institutions were interviewed (<10% non-response rate) using the probability proportionate to size method as per World Health Organization (WHO) guidelines. RESULTS: Nearly 168 (23%) of health workers felt some level of insecurity at their workplace. Mostly, doctors felt insecure at their workplace 24 (30%) and argued with service users , 26 (32.50%). Feeling of security was highest in central region 160 (83.30%). Nationwide, 121 (16%) of health workers faced some level of arguments with service users, which was highest in Tarai 64 (18.08%). Of the total harassment, both gender based and sexual harassment was higher among female health workers [20 (62.5%) and 13 (56.5%) respectively]. Only, 230 (30.7%) of health workers who suffered from workplace accidents got compensation and treatment. CONCLUSIONS: Higher proportions of health workers feel insecurity at workplace whereas provision of compensation was minimal. There is a need of strict implementation of Security of the Health Workers and Health Organizations Act, 2066 (2009) for effective health service delivery.


Subject(s)
Health Knowledge, Attitudes, Practice , Health Personnel/psychology , Safety Management , Security Measures , Community-Institutional Relations , Cross-Sectional Studies , Female , Health Facilities , Humans , Male , Nepal , Qualitative Research , Security Measures/statistics & numerical data , Violence/statistics & numerical data , Workplace
17.
Nepal J Ophthalmol ; 5(2): 230-4, 2013.
Article in English | MEDLINE | ID: mdl-24172560

ABSTRACT

INTRODUCTION: Corneal edema delays early visual recovery after phacoemulsification surgery in diabetes mellitus. OBJECTIVE: To compare corneal edema of eyes in patients with type II diabetes mellitus and in non-diabetics after phacoemusification surgery. MATERIALS AND METHODS: A hospital-based, retrospective study involving 96 eyes that underwent phacoemulsification surgery for immature cataract at the Department of Ophthalmology, Kathmandu Medical College Teaching Hospital, Kathmandu, Nepal was carried out. Evaluation was performed of 33 eyes in patients with diabetes mellitus (diabetic group) and of 63 eyes in patients without diabetes mellitus (non-diabetic group). All diabetic patients had controlled blood glucose for at least one week prior to the surgery. The operated eye was examined before surgery and on one day, one week, and one month after surgery. Intraocular pressure was measured on each visit. MAIN OUTCOME MEASURES: The findings of post-operative corneal edema and visual acuity between the diabetic and non-diabetic groups were studied and compared. RESULTS: There was no difference clinically in any pre-operative corneal examination between the diabetic and non-diabetic groups. The corneal edema after surgery was significantly higher in the diabetic group than in the non-diabetic group (p less than 0.001). The number of patients with corneal edema one day and one week after surgery was significantly higher in the diabetic group than in the non-diabetic group (after 1 day, OR = 62.5; 95 % CI = 15.31 - 255.11, p less than 0.000) and after 1 week, OR = 6.77; 95 % CI = 1.28 - 35.76, p less than 0.006). CONCLUSION: Corneal edema following phacoemusification surgery in diabetic eyes is likely to be more frequent than in non-diabetic eyes.


Subject(s)
Cataract/etiology , Corneal Edema/diagnosis , Corneal Edema/etiology , Diabetes Mellitus, Type 2/complications , Diabetic Retinopathy/complications , Phacoemulsification/adverse effects , Adult , Aged , Aged, 80 and over , Follow-Up Studies , Humans , Intraocular Pressure , Middle Aged , Retrospective Studies , Tonometry, Ocular , Visual Acuity
18.
JNMA J Nepal Med Assoc ; 52(186): 79-81, 2012.
Article in English | MEDLINE | ID: mdl-23478735

ABSTRACT

Retroperitoneal hamartoma in adult is an extremely rare entity. Here we report a case of 23-years-old lady who presented with a large retroperitoneal mass and abdominal pain. The mass was surgically removed and the diagnosis of hamartoma was made on histological findings.


Subject(s)
Hamartoma/pathology , Retroperitoneal Space , Abdominal Pain/etiology , Female , Hamartoma/complications , Hamartoma/surgery , Humans , Retroperitoneal Space/pathology , Young Adult
19.
Environ Pollut ; 155(1): 157-63, 2008 Sep.
Article in English | MEDLINE | ID: mdl-18068879

ABSTRACT

This study monitored the influence of arsenic-contaminated irrigation water on alkaline soils and arsenic uptake in agricultural plants at field level. The arsenic concentrations in irrigation water ranges from <0.005 to 1.014 mg L(-1) where the arsenic concentrations in the soils were measured from 6.1 to 16.7 mg As kg(-1). The arsenic content in different parts of plants are found in the order of roots>shoots>leaves>edible parts. The mean arsenic content of edible plant material (dry weight) were found in the order of onion leaves (0.55 mg As kg(-1))>onion bulb (0.45 mg As kg(-1))>cauliflower (0.33 mg As kg(-1))>rice (0.18 mg As kg(-1))>brinjal (0.09 mg As kg(-1))>potato (<0.01 mg As kg(-1)).


Subject(s)
Arsenic/analysis , Crops, Agricultural , Food Contamination/analysis , Soil Pollutants/analysis , Soil/analysis , Environmental Monitoring/methods , Nepal , Oryza , Plant Leaves/chemistry , Plant Roots/chemistry , Plant Shoots/chemistry , Vegetables , Water Pollutants, Chemical/analysis , Water Supply
20.
Kathmandu Univ Med J (KUMJ) ; 4(4): 470-3, 2006.
Article in English | MEDLINE | ID: mdl-18603956

ABSTRACT

OBJECTIVE: To find out prevalence of amblyopia in ametropias in a clinical set-up. MATERIALS AND METHODS: In this retrospective clinical study children from 4-5 years age group to the young adults who attended the eye clinic in one year period were included after taking history, VA test by Snellen's Vision Chart, cycloplegic refraction by streak retinoscope in children and wet or dry retinospcopy in young adults; and a thorough anterior and posterior segment eye examinations by slit lamp biomicroscope and ophthalmoscope to exclude structural abnormality of the eye or the posterior visual pathway defects. A total of 970 eye patients having diminution of vision with ametropias were identified and patients having reduction of visual acuity of greater than two lines between the eyes or an absolute reduction in acuity below 6/9 either eye in snellen's vision chart which cannot be corrected by refraction were enrolled to find out prevalence of amblyopia. RESULTS: Out of 970 ametropic eye patients amblyopia was present in 56 patients (5.97%) with anisometropias and high bilateral ametropias. The prevalence of amblyopia according to types of ametropias are: hyperopia 6 (10.71%), myopia 2 (3.57%), myopic astigmatism 31 (55.36%), hyperopic astigmatism 11 (19.64%) and mixed astigmatism 6 (10.71%). Sex distribution of amblyopia is male 32 (57.14%) and female 24 (42.86%). Laterality of amblyopia shows: monocular 40 (71.43%) and binocular 16 (28.57%). CONCLUSION: Out of 970 ametropic eye patients a total of 56 (5.97%) patients have amblyopia. A preschool and school screening program in children in critical period of development of amblyopia must be conducted to find out the ametropias and amblyopia in time; and treat them earlier, by optical correction and amblyopia therapy, effectively and adequately.


Subject(s)
Amblyopia/epidemiology , Refractive Errors/epidemiology , Amblyopia/complications , Amblyopia/diagnosis , Child, Preschool , Female , Humans , Male , Prevalence , Refractive Errors/classification , Refractive Errors/complications , Retrospective Studies , Vision Tests
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