Factors Influencing Male Participation in Maternal Health Care among Married Couples in Nepal: A Population-based Cross-sectional Study.

Background The male involvement in maternal health care is essential to reduce obstetric complications. However, there is little known about factors contributing to male participation in maternal health in Nepal. Objective To assess predisposing, enabling and reinforcing factors contributing male participation in maternal health care in Nepal. Method A population based cross-sectional study was conducted among 374 married couples. Ethical approval was obtained from Institutional Review Board of Kathmandu Medical College Teaching Hospital. The data was collected, using modified Safe Motherhood and Partnership Family Approach Model. Multivariable logistic regression was applied to account associated paternal factors. Concentration curve and concentration index were computed to measure equity gap between lowest and highest quintiles. Result While four out of ten husbands reported high level of their involvement in maternal health care practices, wives reported relatively less involvement of their husbands. Logistic regression showed that husband having low family income, knows about immunization, contact with family planning providers were more likely to participate. In contrary, according to wives, husbands' who have ever been to health facility, discuss family planning with others, contact with family planning providers and who knows about exclusive breast feeding were less likely to participate. The study also showed that socio-economic factors play a significant role. Conclusion Male involvement in maternal health care practices is low. Predisposing, enabling and reinforcing factors play a significant role; however, some contradictions among husbands' and wives' perspectives provide strong evidence on significance of communication within partners on maternal health care issues.

Smoking Susceptibility and Intention to Smoke among Secondary School Adolescents in Nepal.

BACKGROUND: Smoking Susceptibility (SS) and Intention to Smoke (IS) are important characteristics of early stages of smoking career of adolescents. Several psychosocial factors play crucial roles in prevention of smoking initiation among adolescents. This study utilized the recent Global Youth Tobacco Survey (GYTS) data of Nepal with the main aim to correlate factors associated with SS and IS. METHODS: Nationally representative data on 2,878 school going Nepalese adolescents were collected through second GYTS using two-stage cluster sampling. An anonymous and self -administrated questionnaire was used to collect information on smoking related variables. We applied multivariable logistic regression to examine relationship between risk factors (demographic, environmental, motivating and programmatic variables) and SS and IS. RESULTS: The prevalence of SS and IS among never smokers was 22.8% (95% CI: 21.2, 24.5) &11.4% (10.2, 12.6) respectively. Factors found associated with respect to different variables were as follows: SS -being a male (AOR: 1.32; 95% CI 1.04, 1.69), friend smoking (1.97; 1.53, 2.52), offered free cigarettes (1.41; 1.03, 1.93), parental smoking (1.68; 1.32, 2.12); IS -being a male (1.43; 1.04, 1.97), and parental tobacco use (1.52; 1.11, 2.08). The following factors were protective measures for SS and IS - age, and antismoking messages. CONCLUSIONS: Smoking susceptibility and intention to smoke is prevalent in Nepalese school going adolescents. Several aforementioned factors are responsible to become susceptible and intention to smoke. Therefore, an understanding of the influencing factors of adolescents provides important insight for comprehensive school based tobacco intervention programs.

A comparative study on use of 3% saline versus 0.9% saline nebulization in children with bronchiolitis.

BACKGROUND: Bronchiolitis is a common clinical problem in children below 2 years presenting with respiratory symptoms. As there is necrosis and sloughing of epithelial cells, edema, increased secretion of mucus causing obstruction of large and small airways we aim to see the clinical profile and the effect of use of hypertonic (3%) saline nebulization in these children. METHODS: A double blind randomized controlled trial was conducted at department of Pediatrics, in a hospital from July 2012 to August 2013. The computer generated random number was used to select the case and control group. All eligible patients were randomly assigned to one of two groups: receiving inhalation of 4 ml normal (0.9%) saline or hypertonic (3%) saline. Treating physicians, researchers and nurses were all blinded of the solution. Both saline were kept in two identical containers and labeled as solution A and solution B. Patients in each group will receive three treatments on each day of hospitalization and clinical score were obtained 30 minutes before each inhalation session. RESULTS: Bronchiolitis accounted 11.26% of total admissions. Their mean age (±SD) was 8.56 (±5.013) months with range from 45 days to 24 months. A total of 53 (74%) male were enrolled in the study. Fifty-seven (79%) children were less than 12 months and 15 (21%) were 12 months - 24 months. The mean (±SD) for duration of hospital stay was 44.82 (±23.15) and 43.60 (±28.25) for 3% and 0.9% group respectively (p=0.86). Likewise, mean (SD) duration of oxygen supplementation was 32.50 (±20.44) and 34.50 (±26.03) for 3% and 0.9% group respectively (p=0.85). Moreover, time required for normalization of clinical score was 36.79 (±19.53) and 38.34 (±26.67) for 3% and 0.9% group respectively (p=0.80). CONCLUSIONS: There is no advantage of hypertonic saline over normal saline nebulization in the management bronchiolitis.

Profile of children with urinary tract infection and the utility of urine dipstick as a diagnostic tool.

BACKGROUND: Urinary tract infection is a common problem in children and its early diagnosis and treatment is important to prevent long-term complications. Urine dipstick can be an important tool in this respect. The aim of this study is to look at the utility of urine dipstick as a diagnostic tool for UTI and will also see the clinical profile of children with UTI and sensitivity pattern of antibiotics among the isolates of urine culture. METHODS: Urine samples of all children below 14 years of age who were suspected of urinary tract infection were sent for routine microscopic examination and dipstick testing. Urine culture and sensitivity were sent for those samples that were tested positive for nitrite, leucocyte esterase activity or both. For every fifth sample, which is dipstick negative, a culture and sensitivity testing was done. RESULTS: Among 110 children enrolled, 32(29%) cases had significant bacteriuria. Out of 32 culture positive cases 18(56%) were female. Fever was the main complaint (62.5%)). Escherichia Coli was isolated in 81.25% of cases. Amikacin was sensitive in 93% and amoxicillinwas resistant in 82%. The sensitivity, specificity, positive predictive value, negative predictive value of nitrite test was 65%, 80%, 58%, 85% respectively; those of leucocyte esterase are 84%, 55%, 43%, 89% respectively; those for significant microscopic pyuria >10/hpf were 65%, 74%, 51%, 84% respectively. CONCLUSIONS: E. Coli is the commonest uropathogen in children with UTI. Amikacin is the most sensitive antibiotic against all the isolates. A positive dipstick both for nitrite and leucocyte esterase is associated with high sensitivity and specificity for urinary tract infection as compared to either of them positive alone. In addition, urine WBC ≥10/hpf is associated with high probability of UTI.

Education: the key to curb HIV and AIDS epidemic.

Overwhelming impact has been established among different aspects and burden of incurable HIV and AIDS is increasing day-by-day globally. The aim of this article is to discuss the potential benefits and strengths of an education system in the absence of remedy and help to develop future strategies. Education has great impact on HIV and AIDS and vice-versa. An education plays a vital role to curb the transmission of HIV and AIDS thorough capacity building, provides information, reduces vulnerability, empowerment, improve life skill, maintain equity, reduce dependence, stigma, and discrimination, where are abundance foundations for HIV infection. HIV and AIDS has role for devastation of education system and level which has great impact on productivity, economic growth, demand, supply and daily life of human being. Low and middle income countries needs to be improve recording and reporting systems related to impact of HIV and AIDS on education. By analyzing preceding evidences, policy makers or governance feels to reformulate policies relating to education and health. Evidence based policy and program will be more useful to address distressing squall of epidemic.

Hand washing practice among health care workers in a teaching hospital.

BACKGROUND: Health care associated infection has been identified as one of the major challenges of modern medicine and remains as a major health concern around the globe. Hands of the health-care workers are potential vehicle for transmission of pathogenic organisms within the healthcare environment. Hand washing is widely accepted as one of the most effective measures in prevention of health care associated infections. METHODS: A descriptive cross-sectional study was conducted to assess the hand washing practice among the doctors, intern doctors, nurses, medical students and nursing students in a multi specialty, non government tertiary care teaching hospital in Kathmandu. Summary statistics and chi-square tests were performed and the type I error was set at 0.05 for analysis. RESULTS: Out of the total 336 participants of the study, there was significant difference in hand washing practice among the participants (P<0.001). Hand washing practice both before and after the patient examination was found to be highest among the nursing students followed by the nurses. The frequency of hand washing after exposure to hospital instruments, blood or other body fluids among the participants was remarkably high (more than 90%) in all groups. Nearly 99% of the participants agreed upon the fact that hand washing could be an effective measure in preventing health care associated infections. CONCLUSIONS: The healthcare workers understand the importance of hand washing but tend to wash their hands selectively depending upon the indications. The majority of the health care workers wash their hands after the patient care than before.

Sharing the ideas of meta - science to improve quality of research.

Meta-Science is an interdisciplinary science which provides plenty of oppurtunity to cooperate on better understanding of micro-social dimension of science. It plays vital role to justify the conclusion, which helps to improve quality of research as well as to health services. There are various applications of meta-science for improving quality of research namely: applying theories of philosophy and different disciplines, the use of triangulation ,inductive and deductive reasoning ,ethical issues and finally fundamentals of scientific research.

Perceived risk of cigarette smoking among college students.

BACKGROUND: Many studies have indicated that the young adults (18-24 years) were not fully aware of health consequences of cigarette smoking. The objective of the study is to determine the prevalence of cigarette smoking among college students and to assess how they perceive the risks of cigarette smoking. METHODS: A cross-sectional study was carried out in Kathmandu valley during mid February and March 2011. This study comprises 340 students from seven private public health colleges of Kathmandu valley. The anonymous question contains information on demographic characteristics, smoking habits, and smoking related risk perception. Data was analyzed by both descriptive and inferential statistics including logistic regression with the help of Microsoft Excel 2007 and SPSS 11.5 version. RESULTS: Overall prevalence rate of ever smokers was 33% and about 16% were current smokers. Non-smokers were about 3 times more likely than smokers to report that smoking one to five cigarettes per day was harmful (aOR = 2.60; 95% CI: 1.34-5.05). Similarly, Non Smokers were 2 times more likely to belief the statement that people get addicted to tobacco as to cocaine or heroin (aOR = 2.27; 95%CI: 1.33-4.57). Nearly one fifth of smokers and non-smokers believed that smoking on a weekend or a couple of days a week was harmful, and there was no significant difference between two groups (P>0.05). CONCLUSIONS: The study reveals the smoker students were less aware of risks of cigarette smoking and its health consequences. Thus there is a need to promote effective anti-smoking messages focusing effects of each cigarette they smoke.