Journal of Karnali Academy of Health Sciences最新文献

{"title":"Clinical Spectrum of Herpes Simplex Keratitis in a Tertiary Eye Hospital, Nepal","authors":"Poonam Shrestha, Santosh Paudel","doi":"10.61814/jkahs.v6i2.822","DOIUrl":"https://doi.org/10.61814/jkahs.v6i2.822","url":null,"abstract":"Background: Ocular manifestations of herpes simplex virus infection range from benign blepharitis, conjunctivitis, and epithelial keratitis to vision-threatening stromal keratitis and uveitis. This study aims to find out the demographic profile, clinical manifestations of herpes simplex virus keratitis and to assess associated visual impairment in Nepalese population. Method: The retrospective study was conducted from January 2020 – February 2022. The medical records were reviewed where visual acuity at presentation and at one month follow-up, clinical details on examination and, diagnosis of the stage of disease were noted. Results:  Of 112 herpes simplex keratitis patients, mean age was 47.19±19.14 years. Patients of herpes simplex keratiris presented with different types of clinical manifestations namely 25 (22.31%) cases were dendritic and 13 (11.6%) geographic ulcers, 38 (33.9%) cases presented with purely stromal lesions, 19 (16.9%) cases with epithelial plus stromal lesions, 11 (9.8%) cases with stromal plus endothelial lesions and six (5.3%) cases with endothelitis. At presentation, 33 (29.4) had visual acuity of 6/6–6/18, 50 (44.6%) had 6/18–6/60, 6 (5.3%) had 6/60–3/60 and 23 (20.5%) had <3/60. At one month follow up 71 (63.3%) had visual acuity of 6/6–6/18, 30 (26.7%) had 6/18–6/60, 5 (4.4%) had <6/60–3/60 and 6 (5.35%) had <3/60. Conclusion: Herpes simplex keratitis has diverse presentation and can cause significant vision impairment. Early clinical diagnosis and management may prevent disease progression and visual impairment.","PeriodicalId":111957,"journal":{"name":"Journal of Karnali Academy of Health Sciences","volume":"93 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139347733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nursing Students’ Intention to Work in Rural Areas after Graduation: A Mixed Approach Study","authors":"Selina Siwakoti, Nandaram Gahatraj, Niranjan Shrestha","doi":"10.61814/jkahs.v6i2.767","DOIUrl":"https://doi.org/10.61814/jkahs.v6i2.767","url":null,"abstract":"Introduction: A key issue of Human Resources for Health and constraint to Universal Health Coverage is a disparity between the number of healthcare providers in urban and rural areas. The accessibility to health services has been found difficult in rural areas due to shortage of health workers. As final-year nursing students are the prospective human resource for health, this study aimed to assess the intention of nursing students to work in rural areas and identify the motivating and discouraging factors associated with their intention. Methods: Cross-sectional research design with mixed methods was conducted among final-year bachelor-level nursing students of Pokhara, Nepal from December 2019 to July 2020. A census method using a self-administered questionnaire was used for the quantitative method and in-depth interviews were conducted for the qualitative method. For quantitative method, descriptive and inferential statistics were used while content analysis for the qualitative method was carried out. Results: About one-third (33.3%) participants intended to work in rural areas. The motivating factors were an opportunity for career advancement (AOR: 3.8; 95% CI: 1.35-10.77), locating near to family (AOR: 3.58, 95% CI: 1.36-9.45),  high salary/incentives, and high healthcare needs in rural areas; whereas discouraging factors were separation from family and friends (AOR 4.10, 95% CI 1.34-12.52), less availability of recreational facilities (AOR 3.68, 95% CI 1.11-12.21), inadequate salary/incentives, lack of equipment and resources, low utilization of skills and knowledge and low self-perceived competency. Conclusions: Only one-third of the participants had the intention to have the job placement in rural areas. The participants preferred to work staying with or nearby their family. The enrollment of students of rural origin/residence or background in a nursing program should be ensured. Various motivating factors like training, attractive incentives, infrastructures, and facilities should be offered to make rural jobs more attractive.","PeriodicalId":111957,"journal":{"name":"Journal of Karnali Academy of Health Sciences","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139347246","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endocrinologic Outcome Following Endonasal Transphenoidal Excision of Growth Hormone Secreting Pituitary Adenomas","authors":"Ali Aafee, B. Khambu, R. Jha, P. Bista","doi":"10.61814/jkahs.v6i2.576","DOIUrl":"https://doi.org/10.61814/jkahs.v6i2.576","url":null,"abstract":"Background: Endonasal Transphenoidal Approach for excision of pituitary adenomas has been gaining popularity over the traditional microsurgical approach. The objective of this study is to assess the rate of hormonal recovery following endonasal transphenoidal excision of growth hormone secreting pituitary macroadenoma in out center. Methods: In this prospective observational study all cases subjected to endonasal transphenoidal excision of growth hormone secreting pituitary adenoma, during the study period from January 2019 to December 2020 at National Neurosurgical Referral Center, Bir Hospital, Kathmandu were included in this study. Preoperative and postoperative patient characteristics were recorded. Hormonal remission was defined as normal insulin-like growth factor-1 level at 3 months follow-up. Results: A total of 24 cases were included. The mean age of acromegaly cases was 39.42±10.41 years (24-56 years), with male to female ratio of 0.71:1. Majority (9) of cases had a Knosp grade 1.Thirteen cases had a Wilson-Hardy Extension Grade 0. Majority (11) of cases had a Wilson-Hardy Invasion Grade I. Three cases developed post-operative CSF leak, which recovered after lumbar drainage with no sequel. Five cases developed epistaxis which resolved with nasal packing. Sixty three percent (15 cases) had normal IGF-1 levels at 3 months follow up. Conclusion: Endoscopic endonasal transphenoidal approach to excision of growth hormone secreting pituitary adenomas is a safe and effective modality at achieving hormonal control in our setting.","PeriodicalId":111957,"journal":{"name":"Journal of Karnali Academy of Health Sciences","volume":"19 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139347701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Major Factors Influencing the Utilization of Maternal Health Services in Nepal","authors":"Kaitlyn Alessi, Michael Ierardi, N. Anderson, S. Marahatta, Cyril Blavo","doi":"10.61814/jkahs.v6i2.747","DOIUrl":"https://doi.org/10.61814/jkahs.v6i2.747","url":null,"abstract":"Background: According to the World Health Organization, maternal health services (MHS) include antenatal care, perinatal care, and postnatal care.  MHS have been underutilized in Nepal and are contributing to an increased morbidity and mortality in the region leading to various adverse outcomes for both mothers and their newborns.  Many of these adverse outcomes can be avoided with increased use of antenatal, perinatal, and postnatal checkups. Methods: Literature reviews of existing information about MHS in Nepal presents an opportunity to identify the source of underutilization and by understanding the source, plans can be proposed to improve MHS. Search for the data was achieved through Medline, Springerlink, and Nepal journals online; with additional articles found by branching off the references of those articles.  Publications were limited to those written or translated into English, and those related to Nepal demography.  Articles were excluded if the report was not referring specifically to Nepal. In this study, all three natal periods are addressed. Results: Cultural aspects, educational aspects and accessibility have been determined to be the leading causes of the underutilization of MHS.  Conclusion: Using this new understanding, interventions focused on improving and providing education about these barriers should lead to reduced morbidity and mortality among mothers and their newborns in Nepal.","PeriodicalId":111957,"journal":{"name":"Journal of Karnali Academy of Health Sciences","volume":"27 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139347807","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Knowledge on Malaria and Health Seeking Behavior among the People of Belauri Municipality of Nepal: A Cross-Sectional Study","authors":"Ashok Kumar Paudel, M. Chhetri, P. P. Panta, Rashmi Luintel, Sandhya Bc","doi":"10.61814/jkahs.v6i2.790","DOIUrl":"https://doi.org/10.61814/jkahs.v6i2.790","url":null,"abstract":"Background: Malaria infection is transmitted to humans through the bite of infected female Anopheles mosquitoes and 247 million cases of malaria in 2021, an increase from 245 million cases in 2020. The objective of the study was to assess the level of knowledge and health seeking behavior on malaria among the people of Belauri Municipality of Nepal. Method: A Cross-sectional descriptive study was done among randomly selected 387 households. Head of the households were the respondents for face to face interview.  Pretested and validated tool was used for data collection. Statistical Package for Social Sciences version 20 used for data analysis. Percentages, frequency, bivariate and multivariate analysis has been to measure the distribution and level of association. Results: Overall knowledge about symptoms of malaria was good among 57.9% and who possessed a good understanding of malaria symptoms tended to seek treatment from modern health facilities during a malaria fever. Of these individuals, 43.8% sought treatment from public health facilities, while 32.7% sought treatment from private health facilities, resulting in a total of 76.5% seeking treatment from modern health facilities. However, the analysis found that the level of knowledge regarding malaria symptoms was not statistically significant (p=0.13) in relation to health-seeking behavior. Conclusions: For success of malaria prevention, programs should be designed to increase level of knowledge and also the translation of knowledge domain into appropriate health care seeking behavior in malaria fever.","PeriodicalId":111957,"journal":{"name":"Journal of Karnali Academy of Health Sciences","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139347223","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Social Health Insurance a Key for Universal Health Coverage in Nepal","authors":"Sujan Poudel, Anusha Parajuli, Shishir Paudel","doi":"10.61814/jkahs.v6i2.819","DOIUrl":"https://doi.org/10.61814/jkahs.v6i2.819","url":null,"abstract":"Social health insurance, which offers financial security and risk sharing for health care expenses, could be the key to achieving Universal Health Coverage (UHC) in Nepal. The social health insurance program in Nepal has advanced significantly, but many adjustments in the insurance mechanism are needed to make it truly a key to UHC.","PeriodicalId":111957,"journal":{"name":"Journal of Karnali Academy of Health Sciences","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139347309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Awareness Regarding Diabetes Mellitus among Clients Attending a Diabetes, Thyroid & Endocrinology Care Centre, Kupandole, Kathmandu","authors":"Pragya Shrestha, G. Neupane, Priti Shakya","doi":"10.61814/jkahs.v6i2.786","DOIUrl":"https://doi.org/10.61814/jkahs.v6i2.786","url":null,"abstract":"Background: Diabetes mellitus is the most common non-communicable disease and has emerged as a major health issue globally. It is a group of metabolic disorders caused by high blood sugar in the blood. The awareness of patients about their illness is considered as an important factor in controlling blood sugar and preventing complications through self-care management. The objective of the study was to find out the level of awareness regarding diabetes mellitus among clients. Methods: A descriptive cross-sectional study was conducted among 80 diabetic clients. The clients were selected by non-probability sampling technique. A semi-structured interview schedule was used to collect the data. It included the components of diabetes such as its meaning, risk factors, causes, clinical features, blood tests, complications, management, and preventive measures. Data were analyzed by using descriptive statistics with Statistical Package for Social Science (SPSS) version 20.0. Results: Majority (76.25%) of the clients were in the age group of 55–79 years, and 51.25% were female. Most of the clients (81.25%) had a history of diabetes for 1–15 years since the diagnosis. Sixty percent had adequate awareness regarding diabetes mellitus. Conclusion: Based on the findings, it is concluded that the awareness regarding diabetes among clients is inadequate. They have inadequate awareness of the causes of diabetes in terms of smoking, alcohol consumption, and advancing age. Unawareness of the causes leads to ignorance of preventive measures for diabetes and low quality of life among diabetic clients. So, an improved and well-structured continuing educational program for raising awareness of diabetes among diabetic clients is needed.","PeriodicalId":111957,"journal":{"name":"Journal of Karnali Academy of Health Sciences","volume":"2015 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139347352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Orthodontic Management of Anterior and Unilateral Posterior Crossbite: A Case Report","authors":"N. Chaudhary","doi":"10.61814/jkahs.v6i2.716","DOIUrl":"https://doi.org/10.61814/jkahs.v6i2.716","url":null,"abstract":"Crossbite refers to abnormal labiolingual and buccolingual relations between the opposing teeth. This results in the imbalanced facial appearance of the patient causing varied degrees of distress based on the individual's values and self-esteem. The management of skeletal class III malocclusion with anterior and posterior crossbite can be challenging. This case report describes a case of skeletal class III malocclusion complicated with an anterior, and unilateral posterior crossbite, and severe crowding which was managed satisfactorily with a fixed orthodontic appliance. The proper clinical examination, diagnosis, problem list, and formulation of the treatment plan are of utmost importance for the proper management of the case. The diagnosis can be done through proper history, clinical examination, an orthopantomogram, and a lateral cephalogram. The patient's grin was transformed from a non-consonant to a consonant smile, and the profile was transformed from slightly concave to straight.","PeriodicalId":111957,"journal":{"name":"Journal of Karnali Academy of Health Sciences","volume":"84 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139347230","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Readmission for Morbidities among Postpartum Women in a Tertiary Hospital of Kathmandu","authors":"Bijaya M. Ojha, Sunil Mani Pokharel, A. Silwal","doi":"10.61814/jkahs.v6i2.785","DOIUrl":"https://doi.org/10.61814/jkahs.v6i2.785","url":null,"abstract":"Background: Postpartum period is a critical stage where the majority of the maternal mortality occurs. Major obstetric morbidities during this period include postpartum haemorrhage, puerperal pyrexia, and sepsis, and pregnancy induced hypertension. The objective of this study was to find out the morbidities in postpartum women readmitted following discharge from the hospital after delivery. Methods: It was conducted as a hospital-based descriptive study at Paropakar Maternity and Women’s Hospital (PMWH), Thapathali, Kathmandu. Ethical clearance was obtained from Institutional Review Board (IRB) of National Academy of Medical Sciences (NAMS). The total population enumeration technique was used to collect the data for a period of three months.  A Standard Performa containing socio demographic characteristics, causes of readmission, complications during pregnancy, time interval of readmission and outcome of readmission was prepared which include relevant points according to the objective of the study. Data analysis was done using the Statistical Package for Social Sciences 16. Descriptive statistics (frequency, percent, mean, standard deviation and range) were used to analyse the data. Results: The incidence of postpartum readmission was 1.0% of total deliveries with 58 women being readmitted. More than two-fifth (29, 43.9%) were readmitted due to abdominal and perineal wound infections followed by urinary tract infections (8, 12.1%). Hypertension, puerperal pyrexia, secondary postpartum haemorrhage were other conditions requiring readmission in postpartum period. Conclusion: The study concluded that the women were readmitted during their postpartum period for multiple causes, wound infection being the most common. The quality of postnatal care including proper examination before discharge is necessary to ensure reduction in the readmission rate.","PeriodicalId":111957,"journal":{"name":"Journal of Karnali Academy of Health Sciences","volume":"90 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139347560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Problematic Internet Use in Undergraduate Health Science Students at a Remote Place of Nepal: a Cross-Sectional Study","authors":"Jayshree Jha, D. B. Pun, K. Amgain, Hiramani Prasad Chaudhary","doi":"10.61814/jkahs.v6i2.836","DOIUrl":"https://doi.org/10.61814/jkahs.v6i2.836","url":null,"abstract":"Background: Problematic internet use (PIU) is a growing concern among teenage and college students. Excessive internet use has detrimental effects on physical and mental health. This study aims to assess the computer usage pattern and calculate the frequency of PIU in undergraduate health science students at Karnali Academy of Health Sciences, Jumla, a remote place of Nepal. Methods: A cross-sectional questionnaire-based study was conducted from October to November 2022. Data were collected from all the undergraduate students who consented to participate. The questionnaire included students’ computer-related behaviours. PIU was defined as a score of 42 or above on the PIU questionnaire. Data were analyzed by descriptive and analytical statistics, keeping p value <0.05 as significant. Results: Among 127 students, majority used smartphones and laptops, primarily for social media. The mean duration of internet use was 6.09±2.63 years, with an average daily use of 2.54±2.05 hours on weekdays and 3.88±2.2 hours on weekends. The prevalence of PIU among the participants was 43.3%, which was not significantly different by gender (p=0.094). The PIU score was positively correlated with annual income of family, years of internet use, and daily screen and internet use time (p<0.05). Conclusion: PIU is prevalent among undergraduate health science students at Karnali Academy. The findings emphasize the need for awareness, guidance, and proper planning to promote healthy internet usage habits among students. Educational institutions should play an active role in implementing strategies to address PIU and support students for a healthy internet use.","PeriodicalId":111957,"journal":{"name":"Journal of Karnali Academy of Health Sciences","volume":"15 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139347154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}