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1.
J Popul Ageing ; 10(4): 343-361, 2017.
Article in English | MEDLINE | ID: mdl-29104702

ABSTRACT

People's life expectancy is increasing throughout the world as a result of improved living standards and medical advances. The natural ageing process is accompanied by physiological changes which can have significant consequences for mobility. As a consequence, older people tend to make fewer journeys than other adults and may change their transport mode. Access to public transport can help older people to avail themselves of goods, services, employment and other activities. With the current generation of older people being more active than previous generations of equivalent age, public transport will play a crucial role in maintaining their active life style even when they are unable to drive. Hence, public transport is important to older people's quality of life, their sense of freedom and independence. Within the European Commission funded GOAL (Growing Older and staying mobile) project, the requirements of older people using public transport were studied in terms of four main issues: Affordability, availability, accessibility and acceptability. These requirements were then analysed in terms of five different profiles of older people defined within the GOAL project - 'Fit as a Fiddle', 'Hole in the Heart', 'Happily Connected', An 'Oldie but a Goodie' and 'Care-Full'. On the basis of the analysis the paper brings out some areas of knowledge gaps and research needed to make public transport much more attractive and used by older people in the 21st century.

2.
Rural Remote Health ; 14(1): 2508, 2014.
Article in English | MEDLINE | ID: mdl-24724713

ABSTRACT

INTRODCTION: Low birth weight (LBW) is a major risk factor for neonatal death. However, most neonates in low-income countries are not weighed at birth. This results in many LBW infants being overlooked. Female community health volunteers (FCHVs) in Nepal are non-health professionals who are living in local communities and have already worked in a field of reproductive and child health under the government of Nepal for more than 20 years. The effectiveness of involving FCHVs to detect LBW infants and to initiate prompt action for their care was studied in rural areas of Nepal. METHODS: FCHVs were tasked with weighing all neonates born in selected areas using color-coded spring scales. Supervisors repeated each weighing using electronic scales as the gold standard comparator. Data on the relative birth sizes of the infants, as assessed by their mothers, were also collected and compared with the measured weights. Each of the 205 FCHVs involved in the study was asked about the steps that she would take when she came across a LBW infant, and knowledge of zeroing a spring scale was also assessed through individual interviews. The effect of the background social characteristics of the FCHVs on their performance was examined by logistic regression. This study was nested within a community-based neonatal sepsis-management intervention surveillance system, which facilitated an assessment of the performance of the FCHVs in weighing neonates, coverage of FCHVs' visits, and weighing of babies through maternal interviews. RESULTS: A total of 462 babies were weighed, using both spring scales and electronic scales, within 72 hours of birth. The prevalence of LBW, as assessed by the gold standard method, was 28%. The sensitivity of detection of LBW by FCHVs was 89%, whereas the sensitivity of the mothers' perception of size at birth was only 40%. Of the 205 FCHVs participating in the study, 70% of FCHVs understood what they should do when they identified LBW and very low birth weight (VLBW) infants. Ninety-six per cent could describe how to zero a scale and approximately 50% could do it correctly. Seventy-seven per cent of FCHVs weighed infants at least once during the study period, and 19 of them (12%) miscategorized infant weights. Differences were not detected between the background social characteristics of FCHVs who miscategorized infants and those who did not. On the basis of maternal reporting, 67% of FCHVs who visited infants had weighed them. CONCLUSIONS: FCHVs are able to correctly identify LBW and VLBW infants using spring scales and describe the correct steps to take after identification of these infants. Use of FCHVs as newborn care providers allows for utilization of their logistical, geographical, and cultural strengths, particularly a high level of access to neonates, that can complement the Nepalese healthcare system. Providing additional training to and increasing supervision of local FCHVs regarding birth weight measurement will increase the identification of high-risk neonates in resource-limited settings.


Subject(s)
Body Weights and Measures/instrumentation , Community Health Workers/standards , Infant, Low Birth Weight , Infant, Newborn, Diseases/prevention & control , Mothers/psychology , Adult , Body Weights and Measures/methods , Body Weights and Measures/standards , Community Health Workers/education , Community Health Workers/statistics & numerical data , Cross-Sectional Studies , Dimensional Measurement Accuracy , Female , Humans , Infant, Newborn , Infant, Newborn, Diseases/diagnosis , Logistic Models , Middle Aged , Nepal/epidemiology , Perception , Prevalence , Program Evaluation
3.
J Child Orthop ; 4(3): 233-7, 2010 Jun.
Article in English | MEDLINE | ID: mdl-21629372

ABSTRACT

PURPOSE: Long arm cast is the method of immobilization after closed reduction of the fracture of the distal third of the forearm, although short arm cast has been used to immobilize the forearm by some orthopedic surgeons. We conducted this study to evaluate the rate of displacement, union time, complication, and cost of treatment between the above-elbow and below-elbow plaster cast groups. METHODS: We designed a prospective randomized controlled trial to compare above- and below-elbow casts for patients of distal forearm fracture aged 4-12 years. One hundred and one patients were presented to our institution during the period from 1st June 2007 to 31st May 2008. Twelve patients were excluded from the study. Eighty-nine patients were randomized into two groups. Four patients were lost to follow up. Hence, 85 patients, 42 in the above-elbow group and 43 in the below-elbow group, were analyzed. Informed consent was obtained prior to participation in the trial. The parameters to be studied were defined before treatment and noted in the pilot-tested pro forma and follow up was done. RESULTS: Among the 85 patients analyzed, randomization was successful. Pain and swelling on the next day and at one week following cast application was significantly higher (P = 0.000) in the above-elbow group. Three cases in the above-elbow group needed slitting of the plaster cast. Remanipulation was needed more often in the above-elbow group (9.5%). Although the cast index was not statistically significant (P = 0.054) between the groups, those who needed remanipulation had a larger cast index (0.80). The total cost of the treatment and the number of school days lost was significantly higher (P = 0.000) in the above-elbow group. CONCLUSION: Below-elbow cast treatment was comparable in terms of redisplacement, union time, and movement of the wrist to the above-elbow treatment. The complications rate and total cost was higher in the above-elbow plaster group, which could be a cost benefit if a below-elbow cast is used.

4.
Trop Doct ; 39(1): 1-3, 2009 Jan.
Article in English | MEDLINE | ID: mdl-19211408

ABSTRACT

We conducted a randomized controlled trial comparing EUSOL (Edinburgh University Solution of Lime) and sugar as dressing agents in the treatment of traumatic wounds. Patients in both groups were matched for age and gender. We found EUSOL did better than sugar in terms of contraction of size of wound, presence of discharge, floor area covered with slough, formation of healthy granulation and early possibility of wound coverage.


Subject(s)
Anti-Infective Agents , Borates , Carbohydrates , Sodium Hypochlorite , Wounds and Injuries/therapy , Adolescent , Adult , Anti-Infective Agents/administration & dosage , Anti-Infective Agents/therapeutic use , Bandages , Borates/administration & dosage , Borates/therapeutic use , Carbohydrates/administration & dosage , Carbohydrates/therapeutic use , Female , Humans , Male , Middle Aged , Sodium Hypochlorite/administration & dosage , Sodium Hypochlorite/therapeutic use , Treatment Outcome , Wound Healing/drug effects , Young Adult
5.
JNMA J Nepal Med Assoc ; 47(170): 77-81, 2008.
Article in English | MEDLINE | ID: mdl-18709036

ABSTRACT

The objective of this study was to describe the occurrence of neck pain, shoulder pain and back pain among dentists and to assess the risk factors affecting them. Sixty-eight dentists from Dharan and Biratnagar were interviewed using pretested questionnaires in January 2006. Back pain was the most common complaint affecting almost 80% of the study population, followed by neck pain (58.8%) and shoulder pain (47%). The frequency of shoulder pain among female dentists was nearly double that of males (P=0.009). The mean days of neck pain among males was significantly higher as compared to females (P=0.048). The study suggests that musculoskeletal complaints are common among dentists, though they are not of severe nature. There is a scope for further decreasing the prevalence and severity of these disorders by performing regular specific exercises.


Subject(s)
Dentists/psychology , Dentists/statistics & numerical data , Job Satisfaction , Occupational Diseases/epidemiology , Adult , Back Pain/epidemiology , Cross-Sectional Studies , Female , Humans , Male , Neck Pain/epidemiology , Nepal/epidemiology , Prevalence , Sex Factors , Shoulder Pain/epidemiology , Surveys and Questionnaires , Young Adult
6.
Nepal Med Coll J ; 10(4): 278-80, 2008 Dec.
Article in English | MEDLINE | ID: mdl-19558072

ABSTRACT

The pathophysiological mechanism and clinical course of complex regional pain syndrome (CRPS) type-I still remain ill defined. Both the treatment and the prediction of the outcome of the treatment are difficult. Abnormal neurohumoral and inflammatory mechanisms have been implicated in its causation usually following trivial noxious event in an extremity. However, to the best of our knowledge CRPS type-1 following snakebite has not been reported yet in the literature. We here report a case of an aggressive CRPS type-1 following a mountain pit viper bite, locally known as Gurube (Ovophis monticola monticola) in a 55-year-old lady. The clinical condition responded well to the therapy with serial sympathetic blockade of the limb with local anaesthetics, non-steroidal antiinflammatory analgesic, antiepileptic, antidepressant and physiotherapy. Our experience in managing this patient and associated pathophysiology in development of CRPS type-1 are discussed.


Subject(s)
Complex Regional Pain Syndromes/etiology , Snake Bites/complications , Animals , Combined Modality Therapy , Complex Regional Pain Syndromes/therapy , Crotalid Venoms/adverse effects , Female , Humans , Middle Aged
7.
Trop Doct ; 35(4): 231-3, 2005 Oct.
Article in English | MEDLINE | ID: mdl-16354480

ABSTRACT

This is a retrospective case series of 233 spinal injury patients admitted to the orthopaedic ward of BPKIHS from May 1997 to April 2001. The inpatient records were analysed. In all, 40.3% of spinal injuries resulted from falls from trees while cutting leaves for fodder, and 27.9% resulted from falls from first/second floors. More than 75% of total spinal injuries are largely preventable. Overall, 46.8% of our spinal injury patients had complete cord transection at the level of injury. All adolescents and adults, irrespective of age or sex, should be the target groups for community education and intervention programmes for prevention of spinal injury.


Subject(s)
Spinal Cord Injuries/epidemiology , Spinal Cord Injuries/etiology , Spinal Injuries/epidemiology , Spinal Injuries/etiology , Accidental Falls , Adolescent , Adult , Humans , Middle Aged , Nepal/epidemiology , Prevalence , Retrospective Studies , Severity of Illness Index , Spinal Cord Injuries/prevention & control , Spinal Injuries/prevention & control
8.
JNMA J Nepal Med Assoc ; 44(159): 84-6, 2005.
Article in English | MEDLINE | ID: mdl-16554860

ABSTRACT

Cortico-Cancellous bone graft harvested from the anterior iliac crest by the conventional open method is associated with more morbidity and is more time consuming as compared to the percutaneous method using trephine biopsy needle. The aim of the study was to determine whether cancellous bone graft harvested from anterior iliac crest using trephine biopsy needle consistently achieved bone union in comminuted fractures and fractures of more than 3 weeks duration of radius and ulna and also to determine the morbidity at the donor site. Autogenous cancellous bone graft was harvested percutaneously from 28 iliac crests in 16 patients and applied at fracture sites of 30 forearm bones using a 4mm trephine biopsy needle after the fractures had been fixed with plate and screws. The patients were followed up regularly upto 6 to 9 months post - operatively in the OPD to determine the union status of the fractured bones and the morbidity at the donor site. 29 of the 30 fractures of the forearm bones united without any problems. The shaft of a trephine got bent during the harvesting procedure at the beginning of the study due to improper technique. Cancellous bone graft harvested from the anterior iliac crest results in predictable good union results in comminuted fractures of forearm bones and also fractures presenting after 3 weeks of injury. It is also an easier and quicker way of harvesting bone graft and is associated with lesser morbidity and earlier recovery as compared to conventional open method.


Subject(s)
Bone Transplantation/methods , Fracture Fixation, Internal/methods , Radius Fractures/surgery , Tissue and Organ Harvesting/methods , Ulna Fractures/surgery , Biopsy, Needle , Cohort Studies , Combined Modality Therapy , Female , Fracture Healing/physiology , Graft Survival , Humans , Ilium , Injury Severity Score , Male , Prospective Studies , Radiography , Radius Fractures/diagnostic imaging , Risk Factors , Sensitivity and Specificity , Transplantation, Autologous , Ulna Fractures/diagnostic imaging
9.
Dev Econ ; 2(1-2): 46-68, 1980.
Article in English | MEDLINE | ID: mdl-12265460

ABSTRACT

PIP: The relationship between natural resources and population in Nepal is first considered, with particular reference to the impact of projected population growth on available agricultural resources. Ways to increase employment opportunities in both rural and urban areas are also discussed.^ieng


Subject(s)
Agriculture , Conservation of Natural Resources , Population Growth , Asia , Demography , Developing Countries , Economics , Employment , Environment , Nepal , Population , Population Dynamics
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