Effect of Group Psycho-Educational Interventions on Child birth fear and Child birth Self-efficacy among Primiparous women.

BACKGROUND: Child birth related fear and low self-efficacy for child birth found common among primiparous women. Antenatal group psycho-educational interventions have been used as important strategies to address child birth fear and self-efficacy. Thus, this study aimed to find out the status of child birth fear among antenatal women and effect of group psycho-educational interventions among primiparous women. METHODS: One group pretest-posttest design was adopted. Total 307 primigravida women attending antenatal outpatient department of two hospitals within Kathmandu valley were selected through purposive sampling technique. Data was collected from March to July 2020. Child birth fear was assessed by using validated tool i.e.Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ) and Child birth self-efficacy was assessed by using childbirth self- efficacy tool. Primigravida women with moderate level of child-birth fear, were intervened for group psycho-education based on PRIME Model by nurses who were research team members. Paired t-test was used to compare differences in mean scores on child birth fear and child birth self-efficacy before and after intervention. RESULTS: Moderate level of child birth fear was found among 24.8% of participants. Low child-birth self-efficacy was found among 42.0% participants. The overall mean score before providing group psycho-educational interventions to experimental group on child-birth fear was 54.0±2.09 and on child birth self-efficacy was 78.0±28.64 with p<0.001 and after providing group psycho-educational interventions child-birth fear was reduced to 47.8±2.44 and child birth self-efficacy was 105.2±19.6 with p<0.001. CONCLUSIONS: Group psycho-educational interventions based on PRIME approach led by nurses have significant effects in reducing child-birth fear and increasing child-birth self-efficacy. Therefore, provision of group psycho-educational interventions along with routine antenatal service need to be considered in clinical settings in Nepalese context.

Comparative genomic analyses of multi-drug resistant Mycobacterium tuberculosis from Nepal and other geographical locations.

Nepal exhibits a tuberculosis (TB) incidence rate that is comparable to neighbouring high TB incidence countries. In addition, it records >500 cases of multi-drug resistant (MDR) TB each year. The objective of this study was to perform whole-genome bioinformatic analysis on MDR-TB isolates from Nepal (n = 19) to identify the specific mutations underlying their phenotypic resistance. In addition, we examined the dominant genotype among the Nepal MDR-TB isolates, the East-Asian Beijing sub-lineage, to determine its relatedness to a panel of 1274 genomes of international strains available from public databases. These analyses provided evidence that the XDR-TB isolates in our collection were not derived from importation of primary XDR-TB to Nepal but were more likely the result of acquisition of second-line drug resistance in Nepal. Resistance to fluoroquinolones was detected among a high proportion of the Nepal isolates. This has implications for the management of TB, including appropriate antimicrobial stewardship and susceptibility testing for fluoroquinolones and other second-line TB drugs, to minimise the development of XDR-TB among Nepal TB cases.

Draft Genome Sequence of an Isolate of Extensively Drug-Resistant Mycobacterium tuberculosis from Nepal.

Extensively drug-resistant (XDR) Mycobacterium tuberculosis has become a challenge to the treatment of tuberculosis (TB) in several countries, including Nepal. Here, we report for the first time the draft genome sequence of an isolate of XDR-TB collected in Nepal and describe single-nucleotide variations associated with its extensively drug-resistant phenotype.

Iodine Status among Subclinical and Overt Hypothyroid Patients by Urinary Iodine Assay: A Case-Control Study.

OBJECTIVES: The objective of the study was to assess the differences of iodine status as measured by urinary iodine excretion (UIE) between cases of hypothyroidism and healthy controls. MATERIALS AND METHODS: The study was conducted in cases with subclinical hypothyroidism (n = 58) and overt hypothyroidism (n = 41) and compared with age- and sex-matched healthy euthyroid controls (n = 52) attending Universal College of Medical Sciences Teaching Hospital, Bhairahawa, Nepal. Serum free triiodothyronine (fT3), free thyroxine (fT4), and thyroid-stimulating hormone (TSH) were estimated by competitive ELISA and sandwich ELISA, respectively (Diametra, Italy). The urinary iodine concentration (UIC) in urine samples was estimated by ammonium persulfate digestion method recommended by the WHO. RESULTS: A significantly higher median UIC was observed among cases of subclinical hypothyroidism (224.90 µg/l) and overt hypothyroidism (281.0 µg/l) as compared to the controls (189.90 µg/l) (P = 0.0001, P = 0.001). Serum TSH in the cases of subclinical hypothyroid was higher, whereas fT3 was lower as compared to controls (P = 0.028, P = 0.0001), respectively. Similarly, serum TSH in the cases of overt hypothyroid was higher and fT3 and fT4 were lower as compared to controls (P = 0.0001, P = 0.0001, P = 0.015), respectively. There was positive correlation of UIC with TSH (r = 0.269, P = 0.0001), whereas negative correlation was seen with fT3 (r = -0.328, P = 0.0001) and fT4 (r = -0.145, P = 0.076). The test of multiple regression has shown that fT3 (ß = -0.262, P = 0.012) as an independent predictor in association with UIE in cases. CONCLUSION: Excessive iodine intake was found in hypothyroid patients as assessed by UIE concluding that it may trigger the thyroid hypofunction. Cohort studies to generate further evidence should be done to explore potential mechanism of hypothyroidism in excess iodine intake.