Nepal Health Research Council Research Articles

Perceived Prevalence, Awareness and Attitude towards Counterfeit Medicines among Community Pharmacists of Kathmandu Valley: A Descriptive Cross-sectional Study

Introduction: Counterfeit medicines are a significant problem globally. In a developing country like Nepal, community pharmacists play an important role in dispensing medicines. The study was done to assess community pharmacists’ perceived prevalence, awareness and attitude towards counterfeit medicines in Kathmandu valley. Methods: A cross-sectional study design was used. Data was collected conveniently from Kathmandu, Bhaktapur, and Lalitpur districts in March 2022 after obtaining ethical clearance from Nepal Health Research Council (reference no. 2200) and taking written informed consent from Community Pharmacists. Results: Among the 343 pharmacists who participated, 250 (72.89%) were from Kathmandu, 57 (16.62%) were from Lalitpur, and 36 (10.50%) from Bhaktapur. Most 252 (73.47%) were aged between 20 to 30 years, 222 (64.72%) were male, 239 (69.68%) had done a Diploma in Pharmacy, 201 (58.60%) had working experience of more than 5 years and 342 (99.71%) had done their education in Nepal. Their median perceived prevalence of counterfeit drugs was 10.00% but only 2.30% had clear knowledge of such practice. 332 (96.79%) believed that actions should be taken against community pharmacists dispensing counterfeit drugs, 325 (94.75%) believed that pharmacists who dispense counterfeit medicines are unprofessional; 338 (98.54%) stated that there should be strong law againstcounterfeit medicine sales.Conclusions: Median perceived prevalence of counterfeit medicines was 10.00% but only 2.30% were aware of counterfeit medicine dispensing. Out of 343 pharmacists, 332 (96.79%) mentioned that action should be taken against those pharmacists knowingly dispensing counterfeit medicines and 338 (98.54%) stated that there should be strong law against counterfeit medicines.

Cervical Cancer Screening Services in Nepal: A Descriptive Crosssectional Study

Introduction: Cervical cancer, the most prevalent cancer among women, is also the primary cause of cancer-related deaths in reproductive age women in Nepal. The study aims to assess the situation of cervical cancer screening services in Nepal.Methods: This cross-sectional study used quantitative methods to understand the situation of cervical cancer screening in 572 health facilities of Nepal. The research was conducted to assess screening facilities, the allocation of separate screening rooms, the availability of screening services on a routine basis throughout the week, screening facilities that are free of charge, human resources, and the availability of treatment. It was conducted in October to December 2022. Results: The research was carried out among 572 healthcare facilities, out of which 134 (23.42%) had provision for cervical cancer screening services. Ethical approval was obtained from the Nepal Health Research Council (NHRC) under reference number 397/2022 P. Amongst those 134, 72 (53.73%) healthcare facilities had assigned separate rooms for screening intentions. One hundred andtwo (76.12%) healthcare facilities provided regular screening services throughout the week, while 112 (83.58 %) had free-of-charge screening services. Concerning trained personnel, 121 (90.30%) health facilities had personnel trained in visual inspection with Acetic acid, 9 (6.72%) had personnel trained in use of colposcopy, and 5 (3.73%) had personnel trained in use of Loop ElectrosurgicalExcision Procedure (LEEP). Lastly, 31 (23.13%) healthcare facilities offered treatment choices for cervical cancer. Conclusions: Most of the health care facilities did not have provision of cervical screening. Amongstthose who had the provision, personnel trained in loop electrosurgical excision procedure colposcopy.

A Journey Through the First to Eighteenth Issue of JKAHS

The Journal of Karnali Academy of Health Sciences (JKAHS) is an official publication of Karnali Academy of Health Sciences (KAHS), a government organization founded on October 20, 2011, by an act of the Parliament of Nepal [1]. KAHS was established with the objective of enhancing the quality of healthcare services, medical education, and research in remote and underserved areas of Nepal. The establishment of JKAHS in 2018 is a reflection of commitment of KAHS to these goals, providing a dedicated platform for the dissemination of scientific knowledge and clinical experiences in the health sciences [2].JKAHS is a peer-reviewed, international medical journal that operates under a diamond open access model, that means all its contents are freely accessible to readers without any subscription or paywall barriers [2]. This model not only broadens the journal’s audience, including researchers, students, policymakers, and the general public, but also aligns with the mission of KAHS to disseminate knowledge widely and equitably [1]. Importantly, JKAHS does not charge any fees for the submission, processing, or publication of manuscripts, thus removing financial barriers for authors and promoting inclusivity in scientific publishing. Additionally, to ensure the long-term preservation and accessibility of its content in the internet, JKAHS archives all its articles in LOCKSS (Lots of Copies Keep Stuff Safe) and CLOCKSS (Controlled Lots of Copies Keep Stuff Safe) [2]. These archiving systems safeguard the integrity and usability of the published work, ensuring that it remains available to future generations.It is triannual journal publishing three issues per year, and is available both online and in print with pISSN 2616-0064 and eISSN 2676-1327 [2]. This regular publication schedule ensures a steady flow of new research and insights, contributing to the continuous advancement of medical knowledge.Achievements and milestonesOne of our significant achievements has been in indexing of JKAHS in two national databases namely Nepal JournalOnline (NepJol) in 2019 [3] and NepalMedLine (NepMed) in 2020 [4]. The NepJol is hosted by Central Library (TUCL) and it is hosted by Ubiquity Press [3] whereas NepMed is hosted my Nepal Health Research Council (NHRC) [4]. A part from these national databases, we have been indexed in DOAJ (Directory of Open Access Journal) [5] and Hinari [6] in 2023. In the earlier days after indexing in NepJol, individual articles were assigned an unique DOI (digital object identifier) from NepJol (10.3126/jkahs). Later on we have taken our own DOI (10.61814/jkahs) directly from CrossRef under the sponsroship under GEM (Global Equitable Membership (GEM) Program from CrossRef [7]. This recognition is a testament to the quality and impact of our published research. Being indexed has enhanced the visibility and accessibility of our articles, attracted a broader readership and fostered greater academic collaboration.

Burden of tobacco-related cancers in urban, semi-urban and rural setting of Nepal: Findings from population-based cancer registries 2019.

Nepal is one of the high prevalent countries for tobacco use in Southeast Asia regions. Tobacco related cancer share the major burden since a decade, however, population-based estimates is still lacking. This study provides results from population-based cancer registries on tobacco-related cancer (TRCs) burden in Nepal. The data were collected by population-based cancer registry conducted in nine districts by Nepal Health Research Council. The districts were categorized in urban, semi-urban and rural regions on the basis of geographical locations and facilities available in the regions. Analysis was done to identify tobacco-associated cancer incidence, mortality and patterns along with cumulative risk of having cancer before the age of 75 years. Tobacco-related cancer was 35.3% in men and 17.3% in women. We found that every one in 36 men and one in 65 women developed tobacco-related cancer before age 75 in Nepal. Cancer of lung, mouth, esophagus and larynx were among the five most common tobacco-related cancers in both men and women. The incidence of tobacco-associated cancers was higher in urban region with age adjusted rate 33.6 and 17.0 per 100,000 population for men and women respectively compared to semi-urban and rural regions. Tobacco-associated cancer mortality was significantly higher compared to incidence. The prevalence of tobacco-related cancer found high in Nepal despite of enforcement of tobacco control policy and strategies including WHO framework convention on tobacco control. Concerned authorities should focus towards monitoring of implemented tobacco control policy and strategies.

Effectiveness of School-based Substance abuse Prevention Programme (SSPP) on awareness, attitude, peer pressure, and life skills among adolescents in selected public schools of Pokhara, Nepal–A cluster randomized trial protocol

ObjectiveEarly substance use has been linked to various adverse outcomes and escalates quickly during adolescence. Delaying the onset of substance use among adolescents is a primary public priority as it is associated with severe effects. The objective of the study is to develop and determine the effectiveness of a School-based Substance Abuse Prevention Programme (SSPP) on awareness, attitude, peer pressure, and life skills towards preventing substance abuse among adolescents. MethodPhase I of the study is a qualitative approach, where a focus group discussion (FGD) will be conducted among different stakeholders to explore their perceptions regarding the prevention of substance use among adolescents. The anticipated sample size is 38. Thematic analysis will be done by using ATLAS.ti software. The inputs given by the stakeholders will be incorporated in developing the intervention (SSPP). Phase II is a cluster randomized controlled trial. A minimum of 210 adolescents (105 each in the intervention and control groups) between the age group of 13 to 15 years from 8th and 9th grade will be recruited for the study. In this study, the school will be the cluster and will be randomly assigned either to an intervention or control arm. The data will be collected at pre, post, 3-month, and 6-month intervals. The ethical approval was obtained from the Nepal Health Research Council Committee, Nepal (NHRC 276/2023). The trial was also registered under the Clinical Trial Registry of USA-Clinical Trials.gov (CTRI 06004726/2023/08/22/). Descriptive and inferential statistics will be used to analyze the data. Expected resultsImplementation of the SSPP module will improve the awareness, attitude, peer pressure, and life skills of adolescents toward preventing substance use behavior. Overall, the study aims to achieve Sustainable Development Goal (SDG) 3.5- ‘Good Health and Well-being; strengthen the prevention and treatment of substance abuse, including narcotic drug abuse and harmful use of alcohol.’ ConclusionThe present study protocol will help to develop a unique training module (SSPP) focused on preventing substance use behaviour among adolescents in Nepal.

Patterns of Skin Disease among Prisoners in Central Prison in Nepal: A Descriptive Cross-sectional Study

Introduction: Skin diseases pose a significant health challenge globally, especially within prison settings where overcrowding and inadequate sanitation create a breeding ground for infections. Prisons, as part of society, exist in a dynamic equilibrium, serving as potential sources of infections that can spread beyond their confines. Despite facing similar challenges, there is a dearth of research focusing on skin diseases among inmates in Nepal. This study aims to assess patterns of skin diseases among prisoners.Methods: This was a descriptive cross-sectional study at the central prison, Kathmandu from December 2023 to March 2024. All patients with skin disease visiting the consultant Dermatologist and giving consent were included in this study. Ethical approval was obtained from the Nepal Health Research Council. Data were entered in Microsoft Excel 2010 and analysis was done by the Statistical Package for the Social Sciences software. Data were presented in the form of frequency and percentage.Results: A total of 253 patients visited the consultant Dermatologist for skin conditions. Out of which, eczema was 67 (26.50%), fungal infections 57 (22.50%), and bacterial infections 51 (20.10%). The mean age of the respondents was 34.21±12 years.Conclusions: The fungal and bacterial infections were common among the prisoners.

Job Satisfaction among Medical Doctors in Nepal: A Descriptive Cross-sectional Study

Introduction: Job satisfaction is an attitudinal variable representing the extent to which people like or dislike their jobs. It is a critical factor influencing healthcare quality, patient outcomes, and overall well-being in medical professionals. This study aimed to determine Job Satisfaction among medical doctors in Nepal. Methods: A descriptive cross-sectional study was conducted among medical doctors of Nepal between June 2023 and August 2023 after obtaining ethical approval from the Ethical Review Board of Nepal Health Research Council. A convenience sampling method was used. The point estimate was calculated at a 95% Confidence Interval. Results: Among 380 participants, 63 (16.58%) (12.84-20.32 at 95% Confidence Interval) expressed satisfaction. The number of satisfied participants above 40 years were 10 (16%) and less than 40 years were 53 (84%). Out of 63, 46 (73.02%) were male and 17 (26.98%) were females. Conclusions: Job satisfaction among doctors practicing in Nepal was found to be lower than the studies conducted in similar settings.

Experience of Mindfulness Meditations Based on Stress Reduction among Undergraduate Nursing Students, Chitwan, Nepal.

Undergraduate nursing students are frequently vulnerable to stress during their education with a high rate of attrition. Mindfulness Mediations based on Stress Reductions have been found to promote psychological well-being and mental health among nursing students. Therefore, the objective of the study was to explore the experiences of Mindfulness among undergraduate nursing students. Qualitative Hermeneutic Phenomenology research design was adopted. Data were collected from under graduate nursing students from Chitwan Medical College, Institute of Medicine who had been practicing Mindfulness Meditation for 6 weeks. The duration of data collection was January to June 2022. Data were collected after obtaining ethical approval from Nepal Health Research Council. Focused Group Discussions were conducted to collect data by the researcher using the Focused Group Discussion guide in Nepali language. A total of three Focused Group Discussions was carried out among 12 participants in each Focused Group Discussion with a total of 36 participants. Data were analyzed by thematic analysis technique based on Giorgi's qualitative data analysis technique. Five developed themes were stress managed well in daily life and during examination time, present moment awareness and positivity, self-realization of inner peace and more self-acceptance, and feeling of developed future role for advocating mindfulness meditations. Mindfulness-based mediations have been found effective strategies among undergraduate nursing for the management of stress during daily living and during examinations, development of self-realization, increase inner peace, self-acceptance and developed skills for future role for advocating mindfulness meditations.

Induction of Labour in a District Hospital of Rural Nepal: A Descriptive Cross-sectional Study

Introduction: Induction of labour, a medical intervention before spontaneous onset, is employed when the risk of continuing pregnancy is elevated. Common indications include intrauterine growth restriction, preeclampsia, gestational diabetes, placental abnormalities, prelabor rupture of membranes, post-term pregnancy, and intrauterine foetal demise. The objective of this study was to find out the prevalence of induction of labour in a rural setting in Nepal.Methods: We conducted a descriptive cross-sectional study in the District Hospital Tehrathum using patients’ record files from 14 January 2021 to 14 January 2023. Ethical approval was obtained from Nepal Health Research Council. Demographic variables were collected along with maternal outcomes which include indication of induction of labour, mode of delivery, indication of lower segment caesarean section and foetal outcomes include APGAR score at one and five minutes, birthweight and liquor colour. A total population sampling method was used in the study and 95% confidence Interval was used to calculate the point estimate. Results: Among 640 deliveries during the study period 118 (18.43%) (15.43- 21.43, 95% Confidence Interval) underwent induction of labour. Sixty-three (53.4%) of the 118 patients who underwent induction of labour were primigravida.Conclusions: The prevalence of induction of labour was comparable with previous studies. Neonatal outcome, rate of vaginal and lower segment C-section deliveries after induction of labour using misoprostol is comparable with other studies.

Knowledge, Attitude and Practice of Research Ethics among Researchers in Nepal

Introduction: The universal health research ethical principles must be adhered to ensure a balance between science and safeguarding participants' rights, safety and dignity. A cross-sectional study was conducted to assess the knowledge, attitude, and practice of research ethics among researchers in Nepal.Methods: The study was carried out among 449 researchers who submitted proposals for ethical review and approval from the Ethical Review Board of the Nepal Health Research Council between January 2017 to August 2021. Simple random sampling was done ensuring a proportional representation of researchers from all areas of health research. A structured questionnaire was administered online for data collection.Results: The participants aged between 23-80 years old consented to complete the survey questionnaire. The median age of the respondents was 35 (23-80) years. Among all the respondents, 52 (11.58%) were unaware about the National Ethical Guideline for Health Research. Similarly, 110 (24.50%) respondents strongly agreed that the ethical review process impairs research and makes it harder for researchers to conduct research; 372 (82.85%) respondents had pursued research activity only after obtaining ethical approval. Conclusions: Half of the respondents had knowledge on different aspects of research ethics.

Osteoporosis and its associated factors among patients attending Manakamana Hospital, Chitwan, Nepal.

Osteoporosis is the most common skeletal disorder that weakens bones and increases their susceptibility to fractures. It is becoming an urgent and serious global epidemic. Early diagnosis and treatment are essential to reduce morbidity and mortality associated with it. This study aimed to find out the prevalence of osteoporosis among patients attending at Manakamana Hospital, Bharatpur, Chitwan, Nepal. A cross-sectional study was adopted and 623 patients attending at orthopaedic outpatients department (OPD) of Manakamana Hospital were selected using non-probability consecutive sampling technique. Data were collected from 15th October 2021 to 15th April, 2022, by using interview schedule, chart review and Bone Mineral Density (BMD) measurement through calcaneal ultrasonography. Ethical approval was obtained from Nepal Health Research Council Ethical Review Board prior to study procedures. Obtained data were analysed using descriptive statistics. Association between the variables were measured using chi-square test. The mean age of the patients was 43.5 (±14.26) years. Nearly half (44%, n = 274) were middle aged adults, 59.7% were female and 56.0% were involved in agriculture and household chores. Nearly half of the patients (45.7%) were overweight/ obese, 7.9% were smokers and 13.5% had habit of alcohol use. Osteopenia or low bone density was detected in 58.9% patients and 19.4% had osteoporosis. The prevalence of osteoporosis was significantly associated with age group (p = <0.001) and educational status (p = 0.013) of the patients. Osteoporosis and osteopenia are prevalent in patients attending in the hospital. Hence, awareness, early screening, and treatment are necessary for the hospital attended patients to enhance their health and, minimize the risk of osteoporosis and the consequences associated with it.

Exploring community insights on antimicrobial resistance in Nepal: a formative qualitative study

BackgroundAntimicrobial resistance (AMR) is the process by which microbes evolve mechanisms to survive the medicines designed to destroy them i.e. antimicrobials (AMs). Despite being a natural process, AMR is being hastened by the abuse of AMs. In context of Nepal, there is limited information on drivers of AMR and barriers in addressing it from a community perspective. This study explores the local language and terminology used around AMs in the community, commonly used AMs and reasons for their usage, how these AMs are sourced, and the perceived barriers to addressing AMR via One Health approach.MethodsA phenomenological study design was utilized with applied qualitative research theoretically framed as pragmatism. Twelve in-depth interviews and informal discussions with a One Health focus, were purposively conducted with wide range of stakeholders and community resident of Kapilvastu municipality of Nepal during April 2022. The acquired data was analyzed manually via a thematic framework approach. The study obtained ethical approval from ethical review board of Nepal Health Research Council and University of Leeds.ResultsNepali and Awadhi languages does not have specific words for AMs or AMR, which is understandable by the community people. Rather, community use full explanatory sentences. People use AMs but have incomplete knowledge about them and they have their own local words for these medicines. The knowledge and usage of AMs across human and animal health is impacted by socio-structural factors, limited Government regulation, inadequate supply of AMs in local government health facilities and the presence of various unregulated health providers that co-exist within the health system. Novel ideas such as the use of visual and smart technology, for instance mobile phones and social media exposure, can enable access to information about AMs and AMR.ConclusionThis study shows that terminology that is understandable by the community referring to AMs and AMR in Nepali and Awadhi languages does not exist, but full explanatory sentences and colloquial names are used. Despite regular utilisation, communities have incomplete knowledge regarding AMs. Since, knowledge alone cannot improve behaviour, behavioural interventions are required to address AMR via community engagement to co-produce their own solutions.Trial registrationNot applicable.

Ethno-geographic distribution and histopathological classification of nasopharyngeal carcinoma in a single center in Nepal.

Nasopharyngeal carcinoma (NPC) shows geographic and ethnic variation with specific etiopathogenesis. This study characterized the distribution of NPC patients stratified by ethnicity, geography, and histology in a tertiary-level cancer center in Nepal. A descriptive retrospective study was designed to analyze NPC cases from different regions among patients visiting the hospital from 2016 to 2021. Demographic and clinical information was obtained from medical records. Ethical approval was granted by the Nepal Health Research Council (NHRC). Data analyses and visualization were carried out with R software. During the six-year period, a total of 65 individuals were diagnosed with NPC, comprising 42 males and 23 females. Patient median age was 43 years (range 11-85 years). A bimodal age distribution of cases was observed with peaks in patients aged 30-39 years and 50-59 years. Of the NPC patients studied, 29 were from Koshi Province, with 7 cases from Ilam district and 6 cases from Morang district. There were 18 patients in Bagmati Province, and Kathmandu district had the highest number of cases within this region, with 8 patients. The highest proportion of cases were observed among patients of Janajati ethnicity (60%), including Rai, Limbu, and Sherpa people. Histologically, undifferentiated non-keratinizing NPC was the most commonly observed subtype, accounting for 43.1% of cases, followed by 20% differentiated non-keratinizing NPC and 4.6% keratinizing NPC across the entire sample population. The majority of patients (75.3%) were diagnosed at an advanced stage (stage III or IV) with none diagnosed at stage I. In our study, most cases of NPC occurred in patients from provinces in eastern Nepal (Koshi province), and of the Janajati ethnic community. The most common histological subtype was undifferentiated non-keratinizing carcinoma. Further epidemiological studies could address differences in prevalence and the challenge of late presentation of NPC patients in Nepal.

Cancer Risk in Nepal: An Analysis from Population‐Based Cancer Registry of Urban, Suburban, and Rural Regions

Background. Cancer is one of the leading causes of death globally. The low and middle‐income countries (LMICs) cover a major share of the global cancer burden; however, most of the LMICs including Nepal still lack national cancer control and prevention strategies. Since 1st January 2018, the Nepal Health Research Council (NHRC) started the population‐based cancer registry (PBCR) in urban, suburban, and rural regions to support evidence‐based cancer control intervention in each geographical region. Methods. Data regarding incidence and mortality was collected by the PBCR in Nepal. Indirect and direct methods were used to collect data from health facilities and communities, respectively. Registered cases of incidence and mortality from 1st January 2019 to 31st December 2019 were used. Each case was verified for correctness and duplication followed by residence confirmation via phone call. Guidelines and principles of the International Association of Cancer Registry were followed for the overall registration process including data quality control. Ethical approval was taken from the Ethical Review Board of the NHRC. Result. Age‐adjusted incidence (AAR) and mortality rates in Nepal were found 65.6 and 29 per 100,000 people, respectively. Every 1 in 14 men and 1 in 13 women were at risk of getting, and 1 in 28 men and 1 in 33 women were dying of cancer before age 75 in Nepal. The highest risk was found for lung cancer (1 in 80) followed by stomach and mouth among men, and in women, breast cancer (1 in 76) was the commonest among all followed by lung and cervix. Conclusion. Cancer has been growing as one of the major public health burdens in Nepal. Screening with cost‐effective technology, awareness, and vaccination against HPV should be a government priority including revision of treatment protocols for cancers that have higher mortality to prevent further preventable life loss from malignancies.

The Role of NHRC in Regulating Health Research Ethics in Nepal: A Narrative Review

This study aims to chart Nepal's evolution of health research ethics over time and the role of the Nepal Health Research Council (NHRC) in its regulation. This narrative review article mentions the pervasiveness of contract research and the contribution of universities and international organizations in producing data and supporting pilot projects. It further highlights the structural inequalities and limitations of health research in Nepal, including lack of technology, infrastructure, funding, limited access to resources and global scientific networks. It discusses Nepal's emerging regulatory and ethical field, establishing the NHRC and developing ethical guidelines and review committees. The challenges faced by NHRC in terms of capacity and resources and the need to strengthen research ethics monitoring and compliance are also marked. This article also discusses several key challenges and areas of concern regarding research ethics and capacity building in Nepal's health research context. The conflicts arising from defining health research and determining which activities require ethical review are highlighted, especially about programmatic interventions and monitoring and evaluation exercises. The need for comprehensive mapping of health research activities is emphasized as an initial step toward understanding the research landscape. Additionally, issues related to timely ethical reviews, the co-investigator’s role, institutional research capacity, data ownership, publication practices, and the ethical considerations of health and development interventions are discussed. It emphasizes redressing these challenges and promoting responsible research practices in Nepal.

Experience and Perception of Online Education among Nursing Faculties during Covid-19 Pandemic in Nepal: A Qualitative Study

Corona virus disease - 2019 (COVID-19), the global pandemic, had jeopardized the educational institutes across the world during 2020 and 2021. The designing, preparedness and effectiveness of e-learning in nursing area were not clearly understood, particularly in a country like Nepal. Thus, the study aimed to explore experiences and perception of online education among nursing faculties during COVID-19 pandemic in Nepal. A Qualitative research design adopted where 15 nursing faculties from different University across the Nepal involved in online classes since 6 months were interviewed based on principles of data saturation using convenience sampling. Ethical approval was obtained from Nepal Health Research Council (NHRC). Written Informed consent was obtained from nursing faculties via email and in-depth interview was carried out. Confidentiality was maintained throughout the study by coding participants’ records. For the data analysis, the thematic analysis and content analysis were done for the faculties’ experiences and perception. Regarding nursing faculties’ experiences and perception on online education, despite the challenges like: technological, environmental, clinical skills and evaluation methods constraints, they had positive enthusiasm like: economical and easy, technological opportunities and competency. It was concluded online class is one of the crucial modes of teaching and learning in difficult circumstances during this pandemic of corona.

Mentorship Programme for Undergraduate Medical Students.

Mentorship is seen as a continuous journey of discovery, shared learning, and personal and professional development to achieve leadership and excellence. Medical schools can be monitored with respect to the provision of mentorships as a quality characteristic. So, the aim of our study was to know the prevalence and the impact of mentorship program in medical schools of Nepal and the need of this program in medical schools all over Nepal. A descriptive cross-sectional study was conducted among medical students in medical schools in Nepal. Ethical approval from the Nepal Health Research Council (NHRC) was obtained (Ref. 667). The cumulative data obtained nationwide was entered in computerized spreadsheet software (Microsoft Excel) and analyzed using MS Excel and SPSS 16.0. Patan Academy of Health Sciences (PAHS) 131 (50.8%) had highest prevalence of mentorship program. Out of 258 students, 110 (42.6%) knew that there was mentorship program in their medical schools. The study found the role of mentors in building rapport with faculties (61.82%), developing professional skills (81.82%) and learning evidence-based medicine (74.55%). 98.8% participants soughed for the need of this program in their medical schools. The prevalence of mentorship program among medical school in Nepal was found to be low. Individuals involved in the mentor-mentee relationship found the role of mentor not only on academics but also on their personal and social enterprises. Medical students who were familiar with the concept of this program reported its need in medical school.

Supplementation with fortified balanced energy–protein during pregnancy and lactation and its effects on birth outcomes and infant growth in southern Nepal: protocol of a 2×2 factorial randomised trial

IntroductionMany women in low and middle-income countries enter pregnancy with low nutritional reserves with increased risk of fetal growth restriction and poor birth outcomes, including small-for-gestational-age (SGA) and preterm birth....

Pregnancy among Women Undergoing Intrauterine Insemination in a Centre.

Intrauterine insemination is often performed as the first-line treatment option in many subfertility cases. Successful intrauterine insemination treatment among indicated couples helps to reduce unnecessary in-vitro fertilisation treatment. Although widely practised, the data on pregnancy after intrauterine insemination treatment is limited. The aim of this study was to find out the prevalence of pregnancy among women undergoing intrauterine insemination in a centre. A descriptive cross-sectional study was conducted at a centre among women undergoing intrauterine insemination. Data from 15 May 2017 to 15 April 2021 were collected between 16 June 2022 to 1 July 2022 from the hospital records. Ethical approval was taken from the Nepal Health Research Council. Systematic sampling technique was applied to select the appropriate sample. The point estimate was calculated at a 95% Confidence Interval. Among 225 women undergoing intrauterine insemination, pregnancy was achieved in 23 (10.22%) (6.26-14.18, 95% Confidence Interval). The mean age of pregnant women was 29.17±3.34 years and the mean duration of infertility was 3.93±2.90 years. More than half of the pregnant women 13 (56.52%) had undergone insemination with the husband's semen whereas the remaining 10 women (43.48%) had undergone insemination with donor semen. The prevalence of pregnancy among women undergoing intrauterine insemination was similar to other studies done in similar settings. artificial insemination; Nepal; pregnancy rate.

Hashimoto's Thyroiditis among Patients with Thyroid Disorders Visiting a Tertiary Care Centre.

Hashimoto's thyroiditis is a chronic autoimmune lymphocytic thyroiditis characterised by thyroid autoantibodies. Early detection and treatment of this condition help in reducing the morbidity and mortality associated with it. The aim of the study was to find out the prevalence of Hashimoto's thyroiditis among patients with thyroid disorders visiting a tertiary care centre. A descriptive cross-sectional study was conducted among patients visiting the outpatient department of a tertiary care centre. Data from 14 April 2017 to 13 April 2019 was collected between 30 June 2022 to 15 September 2022 from medical records. Ethical approval was obtained from the Nepal Health Research Council. Hashimoto's thyroiditis was diagnosed based on clinical presentation and positive antibodies to thyroid antigens. Convenience sampling method was used. The point estimate was calculated at a 95% Confidence Interval. Among 813 patients with thyroid disorders, 393 (48.33%) (44.89-51.77, 95% Confidence Interval) had Hashimoto's thyroiditis. The manifestation of the spectrum of Hashimoto's thyroiditis were euthyroid in 215 (54.70%), subclinical hypothyroidism in 102 (25.95%), subclinical hyperthyroidism in 23 (5.85%), overt hyperthyroidism in 9 (2.30%) and overt hypothyroidism in 4 (1.02%). The prevalence of Hashimoto's thyroiditis among patients with thyroid disorders was higher than in other studies done in similar settings. anti-thyroid peroxidase antibodies; Hashimoto's thyroiditis; thyroid disorders.