Factors Associated with Intimate Partner Violence among Married Women.

BACKGROUND: Intimate partner violence refers to any behavior within an intimate relationship that causes physical, psychological or sexual harm to those in the relationship. Various factors such as alcohol or substance abuse, history of violence in family, extra marital affair, educational status, socio-economic status, decision making power, and established gender role are linked with Intimate partner violence. This study aims to identify the prevalence of different forms of intimate partner violence and its associated factors among married women in Shankharapur municipality of Kathmandu District. METHODS: A concurrent triangulation design was used. Quantitative data were collected from 602 married females while qualitative data was collected from 11 participants. Multivariate logistic regression was done using Stata MP13 version. Thematic analysis was done for qualitative data. Triangulation of both quantitative and qualitative findings waere done. RESULTS: The prevalence of Intimate partner violence was found to be 22.1%. After logistic regression, it was found that women's involvement in community groups had lower odds (AOR 0.67, 95%CI 0.6-0.7) of IPV as compared to those who were not involved in community groups. Additionally, findings from the qualitative study showed female being victims of different forms of violence. CONCLUSIONS: Still, Female are the sufferers of violence behind the closed doors and mitigation strategies should have to be adopted from different levels of government to control intimate partner violence.

Factors affecting health insurance utilization among insured population: evidence from health insurance program of Bhaktapur district of Nepal.

BACKGROUND: The Government of Nepal introduced the family-based health insurance program in 2016 to increase financial protection and improve access to health care services. The study aimed to assess factors associated with the utilization of health insurance among the insured population in an urban district of Nepal. METHODS: A cross-sectional survey using face-to-face interviews was conducted in 224 households in the Bhaktapur district of Nepal. Household heads were interviewed using a structured questionnaire. Logistic regression with weighted analysis was done to identify predictors of service utilization among the insured residents. RESULTS: The prevalence of health insurance service utilization at the household level in the Bhaktapur district was 77.2% (n = 173/224). The number of elder members in the family (AOR 2.7, 95% CI 1.09-7.07), having a family member with chronic illness (AOR 5.10, 95% CI 1.48-17.56), willingness to continue health insurance (AOR 2.18, 95% CI 1.47-3.25) and membership duration (AOR 1.14, 95% CI 1.05-1.24) were significantly associated with the utilization of the health insurance at the household level. CONCLUSION: The study identified a particular group of the population who were more likely to utilize health insurance services, including the chronically ill and elderly. Health insurance program in Nepal would benefit from strategies to increase population coverage in health insurance, improve the quality of health services, and retain members in the program.

Tambulin is a major active compound of a methanolic extract of fruits of Zanthoxylum armatum DC causing endothelium-independent relaxations in porcine coronary artery rings via the cyclic AMP and cyclic GMP relaxing pathways.

BACKGROUND: Zanthoxylum armatum DC (Z. armatum), belonging to Rutaceae family, has been traditionally used for the treatment of various diseases such as hypertension, abdominal pain, headache, fever, high altitude sickness, diarrhea, dysentery, and as a tonic, condiment, and an anthelmintic treatment. HYPOTHESIS: The present study aims to evaluate the vasorelaxant effect of a methanolic extract of the fruits of Z. armatum, isolate the active components and characterize the underlying mechanism. STUDY DESIGN: A methanolic extract of fruits of Z. armatum was prepared and its vasorelaxant effect was studied using porcine coronary artery rings. Thereafter, the methanolic extract was analyzed, and a major compound was isolated and its structure elucidated (tambulin). Different pharmacological tools were used to characterize the vasorelaxant effect of tambulin. RESULTS: The methanolic extract and the isolated tambulin caused similar endothelium-independent relaxations of porcine coronary artery rings with and without endothelium indicating a direct relaxing effect at the vascular smooth muscle. Tambulin did not affect the relaxation curves to the endothelium-dependent vasodilators, bradykinin and the calcium ionophore A23187 in rings with endothelium. Tambulin (1 µM) slightly but significantly shifted leftwards the concentration-relaxation curve to the endothelium-independent vasodilators, sodium nitroprusside (SNP), forskolin (FC) and isoproterenol but not those to soluble guanylyl cyclase activators (YC-1 and BAY 41-2272) and K+ channel openers (levcromakalim and 1-EBIO). Pretreatment with tambulin inhibited, in a concentration-dependent manner, contractions to KCl, serotonin (5-HT), CaCl2 and U46619 in coronary artery rings without endothelium. Both the protein kinase A (H-89, 10 µM) and the protein kinase G (Rp-8-br-cyclic GMPS, 30 µM) inhibitors significantly reduced relaxations to tambulin in coronary artery rings without endothelium. CONCLUSION: The present findings indicate that tambulin isolated from Z. armatum (fruits) is a major active principle inducing vasorelaxation through a direct effect at the vascular smooth muscle and involving both the cyclic AMP and/or cyclic GMP relaxing pathways.