MedS Alliance Journal of Medicine and Medical Sciences <p>The MedS Alliance Journal of Medicine and Medical Sciences is the official peer-reviewed journal of Centre for Clinical Research and Community Health (CC-REACH), MedSpirit Alliance Inc.</p> en-US (Dr. Jitendra K. Singh) (Sioux Cumming) Wed, 12 Jun 2024 09:48:10 +0000 OJS 60 Striving for Equity in Nepalese Healthcare: Challenges, Progress, and Future Directions Kishor Adhikari Copyright (c) 2024 Sun, 31 Dec 2023 00:00:00 +0000 Government Health Expenditure and Policy for Public Health Outcomes: A Systematic Literature Review <p><strong>INTRODUCTION:</strong> The level of good governance, the efficiency of the healthcare system, and socioeconomic vulnerabilities all affect public health outcomes. Despite potential gains in terms of health outcomes, public healthcare investment has been extremely low in low-income countries. By improving the consolidation of healthcare system performance, this study helps the government and policymakers improve the quality of life in developing countries.</p> <p><strong>MATERIALS AND METHODS:</strong> This study aims to assess the government health expenditure and policy for public health outcomes. The research is based on a review of empirical studies and reports. The PubMed search engine was used to locate research publications on government health expenditure and policy for public health outcomes. The PubMed Open Database was applied to find the publications using the keywords “health expenditure” and “health policy”. All papers that were published from January 1, 2013, to January 31, 2024, were checked for the study. 121 research papers were discovered during the initial inquiry; five duplicate articles were eliminated, and 84 were irrelevant to the study. Finally, 25 research papers and reports were selected for evaluation with the study titled “ Government Health Expenditure and Policy for Public Health Outcomes: A Systematic Literature Review”. </p> <p><strong>RESULTS:</strong> Raising the nation’s social health insurance (SHI) coverage does not guarantee universal health care (UHC) or improved financial security. Extremely few people in poverty have health insurance and attempts to give them coverage through exemptions and waivers have not had the intended effect. To prevent families from being ruined due to family health problems, an innovative insurance plan needs to be created. Supply-side strategies, or health infrastructure, are needed to expand access to high-quality medical treatment.</p> <p><strong>CONCLUSIONS:</strong> The quality of life in developing nations is directly improved by the consolidation of healthcare system performance, suggesting that policymakers should step in and offer financial and political help through a variety of policy options. Curative and preventive care are provided by health systems, which can greatly enhance people’s health. Developing a robust health finance system has been a primary objective for numerous countries worldwide, as increased public spending on healthcare leads to better health outcomes and more effective healthcare services. Financial limitations are one of the largest barriers to obtaining high-quality healthcare. A national health insurance program increased public financing for healthcare, and the construction of community-based clinics in rural areas could all contribute to the nation’s transition to universal health care. Policymakers ought to pay greater attention to the quality of care since it significantly affects the amount of money that patients must pay out-of-pocket. Governments must develop new internal financing sources and devise strategies to refocus on health promotion and prevention.</p> Bharat Ram Dhungana Copyright (c) 2023 Sun, 31 Dec 2023 00:00:00 +0000 The Relationship of Plasma Glucose Level and HbA1c among Diabetic Patients attending Chitwan Medical College <p><strong>INTRODUCTION:</strong> Type 2 diabetes mellitus is a complex heterogeneous group of metabolic conditions characterized by an increased level of blood glucose, due to impairment in insulin action and/or insulin secretion. Normally the level of HbA1c is less than 6%. HbA1c level reveals the mean glucose level over the previous 10-12 weeks. HbA1c has become a very important part of the management of patients with diabetes mellitus. In addition, the HbA1c is a better indicator of chronic glycemic levels and has a better index to determine the risk for long-term complications as well. So for the screening or diagnosing DM by using glycated hemoglobin (HbA1c) level is very important. The aim of the study was to correlate the plasma glucose level and HbA1c in diabetic patients attending in Chitwan Medical College and Teaching Hospital.</p> <p><strong>MATERIALS AND METHODS:</strong> The study was a cross sectional study carried out in Department of Biochemistry in collaboration with Department of Medicine, Chitwan Medical College, Nepal. The standard screening procedures such as fasting blood sugar (FBS), post prandial blood sugar (PPBS) and HbA1c were the parameters taken into account for the research work.</p> <p><strong>RESULTS:</strong> It was found that both FBS and PPBG strongly correlated significantly with HbA1c values (r = 0.79, p &lt;0.001 and r = 0.75, p &lt;0.001).</p> <p><strong>CONCLUSIONS:</strong> The results suggest that both fasting and postprandial blood glucose significantly correlated with HbA1c. However, our data suggest that HbA1c values may be a weak parameter to identify pre-diabetes cases. HbA1c threshold of ≥ 6.8% can be considered a relatively sensitive marker for the diagnosis of diabetes in the study population.</p> Brihaspati Rimal, Fuleshwar Mandal, Deepak Kafle, Pashupati Ranabhat Copyright (c) 2023 The Author(s) Sun, 31 Dec 2023 00:00:00 +0000 Predicting Length of Hospital Stay Following Adult Cardiac Surgery: A Prospective Observational Study <p><strong>INTRODUCTION:</strong> Despite life-saving benefits, adult cardiac surgery presents challenges due to potential for extended hospital stays and resource strain. Accurately predicting length of stay (LOS) is crucial for efficient resource allocation and patient discharge planning. The study aims to assess factors associated with LOS following adult cardiac surgery and proposed a model for predicting LOS after adult cardiac surgery.</p> <p><strong>MATERIALS AND METHODS:</strong> A prospective observational study was conducted at Manmohan Cardiothoracic Vascular and Transplant Center from September 2019 to May 2021, enrolling 249 adults undergoing cardiac surgery. A prospective observational study was conducted at Manmohan Cardiothoracic Vascular and Transplant Center from September 2019 to May 2021, enrolling 249 adults undergoing cardiac surgery. Non-probability consecutive sampling was employed and a standardized data collection form was used to record patient-related, cardiacrelated, operation-related, and postoperative characteristics including LOS. Descriptive statistics and multivariate analysis were employed to meet the objectives.</p> <p><strong>RESULTS:</strong> The study reported a median length of hospital stay as 10 days with interquartile range 6 days. Patients who experienced prolonged LOS (&gt;13 days) after cardiac surgery accounted for 21.70% of the total sample. In an adjusted relationships, only female sex (AOR= 1.957; 95% CI: 1.022 - 3.745), previous cardiac surgery (AOR: 2.684, 95% CI: 1.314 - 7.885), active IE (AOR: 23.187, 95% CI: 2.467 - 217.969), and ECA (AOR: 3.891, 95% CI: 1.135 - 13.332) were identified as significant predictors of prolonged postoperative LOS.</p> <p><strong>CONCLUSIONS:</strong> By understanding the factors influencing LOS following cardiac surgery, clinicians can optimize care plans and resource allocation, ultimately improving patient outcomes.</p> Krishnaprasad Bashyal, Ravi Kumar Baral, Prabhat Khakural, Prashiddha B. Kadel, Arjun Gurung, Anil Bhattarai Copyright (c) 2023 Sat, 30 Dec 2023 00:00:00 +0000 Knowledge Regarding Intravenous Therapy among Health Workers of a Teaching Hospital Birgunj, Parsa, Nepal <p><strong>INTRODUCTION:</strong> Intravenous fluid is a continuous process of administration of large amount of fluid into the vein by a drip apparatus. The main purpose of intravenous therapy is to supply fluid and electrolyte to prevent or treat fluid and electrolyte imbalance in the body. The intravenous drug injected through vein into the body for quick action. At the time of infusion the nurse check or observe the flow rate of fluid for any adverse affect and also for others complication. Globally more than 330 million people receive invasive procedure of intravenous catheter placement annually. 60% to 90% patients require an intravenous catheter during hospitalization in US and studies said that 35%-50% patient is in fail intravenous catheters in hospitalization and arise complication. The objective of the study was to find out the knowledge regarding intravenous therapy among health workers of Teaching Hospital Birgunj, Parsa.</p> <p><strong>MATERIALS AND METHODS:</strong> A descriptive cross sectional study design was adopted for the study. This carried out in national medical college teaching hospital is a tertiary level Hospital, Birgunj, Nepal, with the sample size of 139. The instruments used for the study was a structured knowledge questionnaire was used in the study, after reviewing related literatures, which consists of 28 items and data were collected within 2 weeks.</p> <p><strong>RESULTS:</strong> Among 139 health workers, 43.2% had moderate level of knowledge, 33.1% had low level of knowledge and 23.7% had adequate level of knowledge.</p> <p><strong>CONCLUSION:</strong> From the study finding it can be concluded that knowledge regarding intravenous therapy among respondents had moderate level of knowledge. Hence, various educational programmes for health workers should be focused on enhancing their knowledge regarding intravenous therapy which enables them to provide quality care for patients.</p> Rinku Yadav Copyright (c) 2023 Sun, 31 Dec 2023 00:00:00 +0000 Relationship Between the Height of the Person with the Length of the Radius in Undergraduate Students of Gandaki Medical College Pokhara <p><strong>INTRODUCTION:</strong> Stature estimation from skeletal remains is a critical component in forensic anthropology and medical examinations. Traditional methods often require a nearly complete skeleton, which may not be available in cases of dismembered or decomposed bodies. This study explores the connotation between the height of individuals and the radius’ length as a potentially practical and accessible method for stature estimation.</p> <p><strong>MATERIALS AND METHODS:</strong> The study involved 125 asymptomatic, healthy undergraduate medical students, aged 18-25 years, from Gandaki Medical College. Height measurements were obtained using a stadiometer, while radius length was measured by marking two specific points on the radius and measuring the distance between them with a spreading caliper. Statistical exploration was carried out with p&lt;0.05 significance rate.</p> <p><strong>RESULTS:</strong> The investigation revealed a strong and statistically significant positive correlation between height and radius length for all participants (p &lt; 0.001). Gender-specific analyses showed a slightly higher correlation for males compared to females. These findings suggest that radius length can be a reliable predictor of stature, with potential gender-specific equations.</p> <p><strong>CONCLUSION:</strong> The study highlights the potential utility of radius length as a practical and accessible method for stature estimation in forensic anthropology and medical assessments. The strong correlation observed between height and radius length, along with gender-specific differences, supports the development of genderspecific regression equations for more accurate predictions of stature. This research contributes to the development of simplified and efficient tools for estimating stature from skeletal measurements, reducing reliance on complete skeletons and complex mathematical models.</p> Bijendra Prasad Yadav, Prakash Baral, Binod Kumar Chaudhary, Sudeep Kumar Yadav, Sanjay Kumar Yadav, Ripti Shrestha Copyright (c) 2023 The Author(s) Tue, 31 Dec 2013 00:00:00 +0000 Prescribing Pattern of Antibiotics in Paediatric Inpatients of Bakulahar Ratnanagar Hospital, Chitwan <p><strong>INTRODUCTION:</strong> The rational use of antibiotics is crucial in paediatric healthcare settings to mitigate the risk of antimicrobial resistance. This study aimed to assess the prescription patterns of antibiotics among paediatric inpatients at Bakulahar Ratnanagar Hospital, Ratnanagar, Chitwan.</p> <p><strong>MATERIALS AND METHODS: </strong> A cross-sectional study conducted over a 2-month period in May-June 2023 involved the analysis of 160 patient case sheets from the paediatric inpatient department. Patients with various infections were included, and data were analyzed using SPSS.</p> <p><strong>RESULTS:</strong> The mean age of paediatric patients was 2.83 years. Each encounter involved an average of 3.4 drugs, with 1.86 antibiotics per patient. Pneumonia emerged as the most prevalent disease. Among antibiotics, the Cephalosporin group, particularly Ceftriaxone and Cefotaxime, were frequently prescribed. The combination antibiotic Ceftriaxone plus Tazobactam was widely used.</p> <p><strong>CONCLUSIONS:</strong> Strict adherence to antibiotic prescription policies can significantly curb overuse and reduce antibiotic resistance development.</p> Roshan Kumar Chaurasiya, Ajit Kumar Sah Copyright (c) 2023 Sun, 31 Dec 2023 00:00:00 +0000 Adverse Maternal and Fetal Outcomes in Teenage Pregnancy <p><strong>INTRODUCTION:</strong> Teenage pregnancy is a major public health issue these days and is associated with adverse maternal and fetal outcomes. This study was conducted to determine the adverse maternal and fetal outcomes in teenage pregnancy.</p> <p><strong>MATERIALS AND METHODS:</strong> This was a hospital based descriptive cross-sectional study. All the teenage pregnant women (15-19 years of age) with a singleton pregnancy coming to antenatal ward of Birat Medical College Teaching Hospital from 22nd December 2022 to 21th December 2023 were enrolled in the study, irrespective of their APGAR score at birth, NICU admission and early neonatal death and intrauterine fetal death were noted after delivery.</p> <p><strong>RESULTS:</strong> The incidence of teenage pregnancy was 1.7%, and the mean age was 18.36±.83 years. Majority (53.3 %) of the women had normal vaginal delivery. The most common maternal complication was preterm labor (26.7%), while the most common fetal complication was low birth weight (38.7%). 29.3% were admitted to NICU, 25.3% had low APGAR score, 2.7% had stillbirth, 1.3% had early neonatal death.</p> <p><strong>CONCLUSION:</strong> Teenage pregnancy was associated with a high rate of adverse maternal and fetal outcomes like premature delivery, anemia, pregnancy induced hypertension, instrumental deliveries, lower segment cesarean section (LSCS), low birth weight, low APGAR score at birth and NICU admission. </p> <p> </p> Amit Deo, Raj Deb Mahato, Siddhartha Kumar Yadav, Jibanath Dhamala, Tarun Pradhan Copyright (c) 2023 Sun, 31 Dec 2023 00:00:00 +0000 Socio-Emotional Development Among Adolescents Raised in Families With or Without Grandparents in Dharan, Nepal: A Comparative Study <p><strong>Introduction:</strong> Socio-emotional development can be defined by convergence of social and emotional growth. Adolescence, transitional phase of growth and development between childhood and adulthood. Grandparents are often highly involved as secondary caregivers for their grandchildren and may influence children’s psychological and physical health outcomes.</p> <p><strong>Materials and Methods:</strong> A comparative cross- sessional study was conducted in a Dharan 17 and samples were selected using the purposive sampling method. A total of 156 adolescents (78 in each group) with an age range of 15 to 17 years were interviewed using the self- rated version of Strength and Difficulty Questionnaire (SDQ) .Data was analyzed using SPSS version 11.6. Questions were in the Likert scale 0 (not true), 1 (somewhat true) and 2 (certainly true). Descriptive statistics were used to describe socio-demographic data. Pearson Chi-square test was used to compare the socio-emotional development among adolescents raised in families with or without grandparents and to find out the association between dependent and independent variables.</p> <p><strong>Results:</strong> Pearson chi-square depicts significant difference in socio-emotional development raised in families with or without grandparents in Dharan 17 (p- value&lt;0.05).There was significant association of socio-development with Ethinicity, Per capita income and Occupational status of fathers. By observing the mean values of total difficulties SDQ score, mean for adolescents raised in families with grandparents was 1.33 and for adolescents raised in families without grandparents was 1.56 from which it is concluded that adolescents raised in families without grandparents had more difficulties in compare to adolescents raised in families with grandparents.</p> <p><strong>Conclusion:</strong> In this study the findings revealed that adolescents raised in families with grandparents had better socio-emotional development as compare to the adolescents raised in families without grandparents.</p> Smita Pandey, Angur Badhu, Tara Shah, Surya Niraula Copyright (c) 2023 Sun, 31 Dec 2023 00:00:00 +0000 Comparison of Aloe Vera versus Petroleum Jelly in Reduction of Diaper Dermatitis among Infants admitted in BPKIHS <p><strong>INTRODUCTION:</strong> Diaper dermatitis is one of the most common inflammatory skin reactions during infancy caused by high humidity, maceration and friction due to contact with urine and faeces. Application of a suitable barrier preparation can easily treat diaper dermatitis. This study aims to compare effectiveness of Aloe Vera and Petroleum Jelly in reduction of diaper dermatitis among infants admitted in BPKIHS.</p> <p><strong>MATERIALS AND METHODS:</strong> A quasi- experimental study design was adopted. Fifty infants meeting eligible criteria were selected by consecutive sampling technique. Data was collected using semi structured interview questionnaire and observation Proforma for skin grading. Descriptive and inferential statistic (Chi square test) was used to analyse the data.</p> <p><strong>RESULTS:</strong> The severity of diaper dermatitis was reduced in both groups although the reduction rate was not statistically significant. After application of aloevera jelly the mean intensity of Diaper Dermatitis was reduced from 2.04 to 1.4 and after application of petroleum jelly it was reduced from 2.21 to 1.2. Frequency of diaper change has significant association with development of Diaper Dermatitis (p=0.04).</p> <p><strong>CONCLUSIONS:</strong></p> <p>The study concludes petroleum jelly to be more effective than Aloe Vera Jelly for reduction of infantile diaper dermatitis.</p> Laxmi Dahal, Ramanand Chaudhary, Upendra Yadav, Basant Rai, Sanju Parajuli Copyright (c) 2023 The Author(s) Sun, 31 Dec 2023 00:00:00 +0000 Pharmacoeconomic evaluation of Levothyroxine in the treatment of Hypothyroidism in Nepal <p><strong>INTRODUCTION:</strong> Hypothyroidism, is an endocrine disorder, wherein the thyroid gland does not make enough thyroid hormones to meet the body’s needs. Levothyroxine is the mainstay of hormone replacement therapy for hypothyroidism. This study was aimed to evaluate the cost ratio and percentage cost variation, of different brands of levothyroxine, available in the Nepali market.</p> <p><strong>MATERIALS AND METHODS:</strong> This observational pharmacoeconomic study was carried out at Department of Pharmacology of Janaki Medical College, Janakpurdham, Nepal from 5 April to 30 May, 2023. Maximum retail price (Cost) in Nepalese currency (NRs), of various brands of levothyroxine available in Nepali market, of same dosage form, strength and number was reviewed for calculating the cost ratio and the percentage cost variation of levothyroxine manufactured by Nepali and Indian Pharmaceutical companies.</p> <p><strong>RESULTS:</strong> For 120 tablets of levothyroxine, maximum cost ratio of 1.37 and percentage cost variation of 37.14% was observed with 50 mcg of levothyroxine. For 100 tablets of levothyroxine, maximum cost ratio of 1.65 and percentage cost variation of 65.44% was observed with 50 mcg of levothyroxine.</p> <p><strong>CONCLUSIONS:</strong> The findings of this study can be used by a treating physician for prescribing an alternative cheaper brand of levothyroxine for better compliance and for reducing the total health-care cost. Continuous pharmacoeconomic analysis, if carried out at government level, can greatly minimize the cost variation as well as reduce the overall treatment cost for hypothyroid patients in Nepal.</p> <p> </p> Lokeshwar Chaurasia, Ragni Sinha, Ram Chandra Shah, Sushma Deo, Rajesh Shah Copyright (c) 2023 Sun, 31 Dec 2023 00:00:00 +0000 Nutritional Disparities in Urban Aging: Ethnicity as culprit for Malnutrition in Ratnanagar Municipality <p><strong>INTRODUCTION:</strong> Nutritional disparities in urban aging have emerged as a critical concern globally. As the aging population grows and urbanization accelerates, understanding the drivers of malnutrition among older adults in urban areas, especially across diverse ethnic groups becomes increasingly urgent. The study addresses the critical concern of malnutrition among older adults in urban areas, focusing on the influence of ethnicity on nutritional disparities.</p> <p><strong>MATERIALS AND METHODS:</strong> An analytical cross- sectional study was conducted among 341 elderly people aged above 60 years from March 2023 to August 2023 in Ratnanagar municipality of Chitwan. A systematic random sampling technique was employed to select participants from each ward. Face to face interview technique and anthropometric assessment was used in collecting data using semi-structured questionnaire comprising socio-demographic characteristics including ethnicity, life-style factors, dietary factors, functional status and nutritional status. Data analysis was performed using the Statistical Program for Social Sciences version 26.</p> <p><strong>RESULTS:</strong> The mean age of the participants was 69.86 years (SD = 7.72), with a range from 61 to 99 years. Of 317 participating elderly people, the prevalence of malnutrition and risk of malnutrition was 27.44% and 55.84% respectively. Dalit (50% malnourished, 50% at risk); Janajatis (31.50% malnourished, 57.48% at risk); Madeshi (33.33% malnourished, 50% at risk) and Muslim (20% malnourished, 60% at risk) respondents, categorized as disadvantaged, showed higher proportions of malnutrition or at-risk status; while Brahmin/Chhetri respondents considered advantaged, exhibited comparatively lesser proportion of malnutrition [1.79 (95% CI: 1.06-3.03)]. Likewise, disadvantaged ethnic group exhibited a significant AOR of 1.46 (95% CI: 1.05-2.89) for being at risk, compared to advantaged group.</p> <p><strong>CONCLUSIONS:</strong> There were significant disparities in nutritional status among older adults in Ratnanagar Municipality, with disadvantaged ethnic groups being particularly vulnerable to malnutrition. The findings of this study have important implications for public health policy and practice in Nepal. </p> Sunita Subedi, Ashesh Malla, Bibek Giri, Kishor Adhikari, Shankar Nand Subedi, Ramesh Sigdel Copyright (c) 2023 Sun, 31 Dec 2023 00:00:00 +0000 Assessment of Attitude and Practices towards COVID-19 among Paramedical Students <p><strong>INTRODUCTION:</strong> The country’s response to a potential outbreak may benefit greatly from the practical knowledge, experience and skills of paramedical students in a number of ways. Thus, this study was conducted to evaluate attitude and practices regarding COVID-19 among paramedical students studying in different colleges of Janakpurdham, Nepal.</p> <p><strong>MATERIALS AND METHODS:</strong> A structured questionnaire was used in a descriptive cross-sectional study to collect information on COVID-19 attitude and practices among HA students enrolled in different selected colleges affiliated to Council for Technical Education and Vocational Training (CTEVT), Nepal in April and May of 2022. Statistical Package for the Social Sciences was used to analyse the data. Significant results were defined as a p-value of less than 0.05.</p> <p><strong>RESULTS:</strong> Majority of girls from NHRDA and MTA (53.7% and 50.58%) respectively, believed that COVID-19 infection is a global problem than CMC girls (35.08%). Of 63.5% and 49.35% girls from NHRDA and MTA agreed that the public is crucial for infection control. More than 60% of girls from NHRDA and MTA suffered from mild fever after immunization fall down by 52.17% girls from CMC’s while 52.3%, 30.6% and 42.42% girls from each college respectively felt 4healthy after immunization and one fourth of total suffered from high fever after immunization. The significant association between the COVID-19 immunization among the students of different colleges (p = 0.00).</p> <p><strong>CONCLUSIONS:</strong> Most of the girl students had positive attitude and optimistic practice, while the boys followed appropriate safety measures to avoid contracting COVID-19. A significant correlation has been found between students from various colleges and the COVID-19 vaccine.</p> Khushbu Yadav, Satyam Prakash, Basant Kumar Yadav, Bishal Pokhrel Copyright (c) 2023 Sun, 31 Dec 2023 00:00:00 +0000 Awareness and Attitude of Teenage Girls Towards Adolescent Pregnancy: A Quantitative Study <p><strong>INTRODUCTION:</strong> Adolescent pregnancy poses serious challenges to public health, especially in developing nations. However, despite the significant adverse outcomes associated with early pregnancy, there exists a dearth of studies investigating the extent of knowledge and perspective of adolescent pregnancy among teenage girls. Therefore, this study aimed to assess the awareness and attitude of teenage girl students about adolescent pregnancy.</p> <p><strong>MATERIALS AND METHODS:</strong> A cross-sectional descriptive study design was employed using simple random sampling of 145 adolescent girls in a public school located in Pokhara, Nepal. Data were collected using a self-administered questionnaire consisting of socio-demographic information, level of awareness and attitudes towards adolescent pregnancy. Descriptive and inferential analysis were conducted using SPSS version 21.0.</p> <p><strong>RESULTS:</strong> More than half, 81 (55.9%), showed a moderate level of knowledge about adolescent pregnancy. Similarly, a statistically significant relationship was revealed between the level of awareness and sociodemographic variables, including ethnicity (p = 0.003), and family income (p = 0.006). Likewise, the results indicated that a significant proportion of the participants 117 (80.7%) had favourable attitudes towards adolescent pregnancy. In addition, statistical significance was demonstrated in the relationship between religion (p = 0.005), ethnicity (p = 0.007), and grade level (p = 0.001) and the level of attitude towards adolescent pregnancy.</p> <p><strong>CONCLUSION:</strong> The study posits that the majority of adolescents had a favourable attitude towards adolescent pregnancy. However, there is still a misconception in their overall knowledge and attitude towards adolescent pregnancy. The study, therefore, emphasized the need to implement awareness programs on adolescent pregnancy within educational institutions and the broader society.</p> Alisha Gurung, Pooja Bhandari, Santosh Kumar Gurung Copyright (c) 2023 Sun, 31 Dec 2023 00:00:00 +0000 Prevalence of Malocclusion among Adolescent Children Visiting Dental Department in a Tertiary Care Centre <p><strong>INTRODUCTION:</strong> Malocclusion is defined as an irregularity concerning teeth alighnment and/ or their relationship during dental occlusion beyond the range of what is accepted as normal.The study was conducted in order to identify prevalence of malocclusion in adolescents visiting dental department of a tertiary care centre at Dhanusha district of Madhesh Pradesh.</p> <p><strong>MATERIALS AND METHODS:</strong> A descriptive cross-sectional study was conducted at Out-Patient Department of dental department of Janaki Medical College and Teaching Hospital (JMCTH) with participants aged 13-19 years irrespective of gender. Total of 600 adolescents were examined for malocclusion like overjet,overbite,spacing,crowding,rotation and missing tooth. Angle’s Classification was used to define malocclusion in participants.</p> <p><strong>RESULTS:</strong> 93.8% of participants had some sort of malocclusion. Highest prevalence of Angle’s Class I(68%) followed by Class II(21.3%) and Class III(4.5%) was found.40.5% had increased overjet, 33.5% have deep overbite and 31.2% have crowding. 37.25% of participant had rotation of tooth.</p> <p><strong>CONCLUSIONS:</strong> The study concludes with the fact that Angle’s Class I Malocclusion is the major malocclusion presenting in OPD of JMCTH. High percentage of adolescents with permanent dentition having some sort of malocclusion also seems to be concern which can affect future self confidence and much more expenditure on treatment and maintenance.</p> Rajan Singh, Kshitiz Shrestha, Mukesh Pandey, Bashu Raj Pandey Copyright (c) 2023 Sun, 31 Dec 2023 00:00:00 +0000 Correlations of hepatorenal functions among Diabetes patients attending tertiary care centers at Janakpurdham <p><strong>INTRODUCTION:</strong> Diabetes mellitus (DM) has multiple long-term consequences linked to hepatorenal pathophysiology. The long-term DM is associated with evidences of abnormal liver and renal function. However, this yet to be clearly established, especially in rural low to mid-income countries like Nepal. Thus, we aimed to assess correlations of hepatorenal functions among diabetes patients attending tertiary care centers at Janakpurdham, Nepal.</p> <p><strong>MATERIALS AND METHODS:</strong> A total of 227 diabetes patients attending medicine OPD of Janaki Medical College teaching hospital, Ramdiaya and Ram Janaki Hospital, Janakpur were enrolled. Under aseptic conditions, blood samples were collected. Semi-automatic analyzers were used for all biochemical investigations. Pearson correlation test was used to observe correlation between the various hepatorenal functions in diabetic patients. A p-value less than 0.005 was considered to be significant.</p> <p><strong>RESULTS:</strong> Out of total 227 diabetes patients, 132 (58.1%) were male and 95 (41.9%) were female. Significant results were obtained regarding the correlation between the hepatic and renal profile with SGOT [SGPT (p=0.000); Urea (p=0.049)]. Significant correlations were found between the liver and renal profile with SGPT [Albumin (p=0.050); Creatinine (p=0.020)] and with urea [Creatinine (p=0.000)]. Similarly, there was a significant correlation between the renal profile and liver with urea [Creatinine (p=0.000)] and for creatinine [Sodium (p=0.000)].</p> <p><strong>CONCLUSIONS:</strong> Among diabetic patients, there was a substantial correlation between the liver and renal profiles. The etiology of various forms of diabetes mellitus is significantly influenced by hepatorenal factors among diabetics.</p> Satyam Prakash, Manohar Kumar Sah, Vijay Kumar Sah, Om Prakash Yadav, Ramesh Nayak, Buddharam Yadav Copyright (c) 2023 Sun, 31 Dec 2023 00:00:00 +0000 Fostering Community Resilience: A Multi-dimensional Community Health Analysis and Evaluation in Aurahi Rural Municipality, Nepal <p><strong>INTRODUCTION:</strong> Community health diagnosis is a crucial process for assessing the health status, identifying problems, available resources, and setting priorities for interventions within a community. This comprehensive assessment serves as a valuable data repository, guides program evaluation, policy formulation, and ensures community participation. The specific objectives of this study were to define health problems, identify resources, set planning priorities, implement and evaluate health actions, identify vulnerabilities, and explore social and environmental linkages to health in Aurahi Rural Municipality.</p> <p><strong>MATERIALS AND METHODS:</strong> A cross-sectional study using quantitative and qualitative methods was conducted in May-June 2022 by medical students across Aurahi’s 6 wards. Systematic random sampling selected 835 households. Data tools included questionnaires, checklists, anthropometry, and guides for interviews/focus groups. Primary data came from household surveys, interviews, focus groups, and observations.</p> <p><strong>RESULTS:</strong> The population exhibited an expansive age structure with the largest 20-24 year group. Agriculture was the main occupation (43%). Major health problems were diarrhoea (92%), pneumonia (54%), tuberculosis (80%), hypertension (57%), anaemia (41%), scabies (67%), COVID-19 (98% knowledge). Maternal health challenges included adolescent marriages (50% at 15-18 years), home deliveries (46%), low antenatal care visits (&lt;4 times, 33%), inadequate breastfeeding practices (45% not providing colostrum). Child malnutrition was 6% moderately malnourished, 3% severely malnourished. Family planning awareness was 60%, utilization 37%.</p> <p><strong>CONCLUSION:</strong> Aurahi Municipality confronts critical sanitation, nutrition, maternal/child health, and family planning challenges necessitating community-focused, multi- sectoral actions. Initiatives promoting handwashing/ORS, school health education, and adolescent health awareness were initial steps, but sustained efforts through engagement and collaboration are crucial for lasting improvements in this rural population’s well-being.</p> Hem Shankar Yadav, Community Health Diagnosis Study Group Copyright (c) 2023 Sun, 31 Dec 2023 00:00:00 +0000