Kathmandu, Nepal
Kathmandu, Nepal

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Khan G.M.,Pokhara University | Alam K.,Manipal Teaching Hospital | Regmi A.,Tribhuvan University | Sapkota B.,Nobel College
BMC Pregnancy and Childbirth | Year: 2016

Background: Drugs used during pregnancy can adversely affect the health and life of the mother and unborn child. However, the fact that drugs are needed to mitigate complications during pregnancy cannot be avoided. The present study was designed to identify the common complications during pregnancy and assess the medications that have been used to mitigate those complications in an attempt to improve drug prescribing during pregnancy. Methods: A hospital based cross sectional study was conducted at Manipal Teaching Hospital, Nepal in 275 pregnant women presenting with at least one complication and the drugs prescribed for the management of those complications were analyzed. Results: Majority of the patients in this study were in the age group 20-24 (44 %) and in the third trimester (53.8 %). Maximum patients complained pain (back, abdominal, lower abdominal, neck, pelvic) as primary complication (24.3 %) which was followed by nausea/vomiting, upper respiratory tract complications, acid reflux disease and others. Of the total prescriptions eighty six (86) did not have any medicines prescribed to the patients except multivitamins and nutritional supplements. The average drugs prescribed per patient was 2.78 in outpatient setting and 5.41 in in-patients. Ranitidine, hyoscine butylbromide, paracetamol were the most frequently prescribed medications. Antimicrobials comprised 12.8 % of total drugs prescribed and 18 % of total drugs were fixed dose combinations. Two hundred and thirty four (234) prescriptions out of 275 were prescribed by brand names. Most of the prescribed drugs were from FDA pregnancy category B and C. Conclusion: The present finding showed that pregnant patients were prescribed medications almost only when necessary and those considered safe during pregnancy were chosen to a large extent. However, few teratogenic drugs (2.49 % of total drugs prescribed) were also found to be prescribed which might need further assessments. © 2016 The Author(s).


Neupane D.,University of Aarhus | Panthi B.,Nobel College | McLachlan C.S.,University of New South Wales | Mishra S.R.,Nepal Development Society | And 2 more authors.
PLoS ONE | Year: 2015

Background: Despite an increasing number of studies exploring prevalence of depression among hypertensive patients in high income countries, limited data is available from low and middle income countries, particularly Nepal. Our aim was to investigate the prevalence of undiagnosed (sub clinical) depression and associated risk factors among hypertensive patients attending a tertiary health care clinic in Nepal. Methods: The study was based on a cross-sectional study design, with 321 hypertensive patients attending the Out-Patient Department of a central hospital in Nepal. Blood measure was recorded via a mercury column sphygmomanometer. Depression levels were assessed using the Beck Depression Inventory-Ia (BDI) scale. Demographics and risk factors were assessed. Result: The proportion of participants with undiagnosed depression was 15%. Multivariable analyses demonstrated an increase in BDI scores with increased aging. Approximately a 1 point increase in the BDI score was observed for each additional decade of aging in hypertensive patients. Additional factors associated with increased risk of depression included being female (4.28 point BDI score increase), smoking (5.61 point BDI score increase), being hypertensive with no hypertensive medication (4.46 point BDI score increase) and being illiterate (4.46 point BDI score increase). Conclusions: Among persons with hypertension in outpatient settings in Nepal, demographic (age, sex, education), behavioural (smoking,) and adherence factors (anti-hypertensive medication) were associated with undiagnosed depression. Screening programs in Nepal may assist early intervention in hypertensive patients with sub clinical depression. © 2015 Neupane et al.


PubMed | Nobel College, Tribhuvan University, Manipal Teaching Hospital and Pokhara University
Type: | Journal: BMC pregnancy and childbirth | Year: 2016

Drugs used during pregnancy can adversely affect the health and life of the mother and unborn child. However, the fact that drugs are needed to mitigate complications during pregnancy cannot be avoided. The present study was designed to identify the common complications during pregnancy and assess the medications that have been used to mitigate those complications in an attempt to improve drug prescribing during pregnancy.A hospital based cross sectional study was conducted at Manipal Teaching Hospital, Nepal in 275 pregnant women presenting with at least one complication and the drugs prescribed for the management of those complications were analyzed.Majority of the patients in this study were in the age group 20-24 (44%) and in the third trimester (53.8%). Maximum patients complained pain (back, abdominal, lower abdominal, neck, pelvic) as primary complication (24.3%) which was followed by nausea/vomiting, upper respiratory tract complications, acid reflux disease and others. Of the total prescriptions eighty six (86) did not have any medicines prescribed to the patients except multivitamins and nutritional supplements. The average drugs prescribed per patient was 2.78 in outpatient setting and 5.41 in in-patients. Ranitidine, hyoscine butylbromide, paracetamol were the most frequently prescribed medications. Antimicrobials comprised 12.8% of total drugs prescribed and 18% of total drugs were fixed dose combinations. Two hundred and thirty four (234) prescriptions out of 275 were prescribed by brand names. Most of the prescribed drugs were from FDA pregnancy category B and C.The present finding showed that pregnant patients were prescribed medications almost only when necessary and those considered safe during pregnancy were chosen to a large extent. However, few teratogenic drugs (2.49% of total drugs prescribed) were also found to be prescribed which might need further assessments.


Shrestha R.,University of Connecticut Health Center | Shrestha R.,University of Connecticut | Karki P.,Nobel College | Karki P.,University of Connecticut | And 2 more authors.
PLoS ONE | Year: 2015

Background: Sex trafficking has been a long-standing concern in Nepal. Very little has been achieved, however, in terms of actual reduction in the number of victims despite numerous anti-sex trafficking programs. This situation may be attributable to a lack of empirical evidence upon which to formulate anti-sexual trafficking interventions. This study aimed to assess sex trafficking- related knowledge, awareness and attitudes, and factors associated with sex trafficking awareness and attitudes towards the victims of sex trafficking and/or anti-sex trafficking campaigns among adolescent female students in Nepal. Methods: A cross-sectional study was conducted between August-September 2013 among 292 adolescent female students (>10 years old) using systematic random sampling from three high schools in Sindhupalchowk district, Nepal. As an initial step, descriptive analyses were employed to characterize the data and multivariate logistic regression analyses were used to explore factors associated with sex trafficking awareness and related attitudes. Results: Seventy-six percent of sampled students reported that they were aware of sex trafficking and 94.6% indicated media (i.e., radio or television) as the primary sources of their knowledge. Fifty-one percent mentioned relatives/friends as mediators of sex trafficking, 60.4% reported promise for better jobs as the primary attraction behind sex trafficking, and 48.6% mentioned adolescent females as the most vulnerable group for sex trafficking. Over half (56.8%) of the respondents had positive attitudes towards the victims of sex trafficking and/or anti-sex trafficking campaigns. Age (OR = 3.38, 95% CI:2.51-4.55), parents' occupation (OR = 3.89, 95% CI:1.58-9.58), and having a radio/TV at home (OR = 6.67, 95% CI:3.99-9.54) were significantly associated with awareness, whereas being younger (OR = 0.67, 95% CI:0.55-0.79) and having joint-family (OR = 2.67, 95% CI:1.49-4.80) were significantly associated with having a positive attitudes towards the victims of sex trafficking and/ or anti-sex trafficking campaigns. Conclusion: Findings presented have important implications for anti-trafficking programs, in particular those designed to educate the adolescent females who are at most-risk of sex trafficking. Educational programs need to include specific interventions to improve knowledge and attitudes towards sex trafficking among adolescent females in Nepal. © 2015 Shrestha et al.


PubMed | University of Aarhus, Duke University, University of New South Wales, Nobel College and Shiva Raj Mishra
Type: Journal Article | Journal: PloS one | Year: 2015

Despite an increasing number of studies exploring prevalence of depression among hypertensive patients in high income countries, limited data is available from low and middle income countries, particularly Nepal. Our aim was to investigate the prevalence of undiagnosed (sub clinical) depression and associated risk factors among hypertensive patients attending a tertiary health care clinic in Nepal.The study was based on a cross-sectional study design, with 321 hypertensive patients attending the Out-Patient Department of a central hospital in Nepal. Blood measure was recorded via a mercury column sphygmomanometer. Depression levels were assessed using the Beck Depression Inventory-Ia (BDI) scale. Demographics and risk factors were assessed.The proportion of participants with undiagnosed depression was 15%. Multivariable analyses demonstrated an increase in BDI scores with increased aging. Approximately a 1 point increase in the BDI score was observed for each additional decade of aging in hypertensive patients. Additional factors associated with increased risk of depression included being female (4.28 point BDI score increase), smoking (5.61 point BDI score increase), being hypertensive with no hypertensive medication (4.46 point BDI score increase) and being illiterate (4.46 point BDI score increase).Among persons with hypertension in outpatient settings in Nepal, demographic (age, sex, education), behavioural (smoking,) and adherence factors (anti-hypertensive medication) were associated with undiagnosed depression. Screening programs in Nepal may assist early intervention in hypertensive patients with sub clinical depression.


PubMed | Jhamsikhel, Nobel College, Rural Environment Development Center, Duke University and 2 more.
Type: | Journal: The International journal on drug policy | Year: 2016

In Nepal, prevalence of Hepatitis C (HCV) among injecting drug users (IDUs) has been measured at 50% and knowledge of the virus is low. Rehabilitation and harm reduction attendees constitute populations to whom health care providers can deliver services. As such, characterizing their drug use and risk profiles is important for developing targeted service delivery. We measured drug use and risk patterns of IDUs participating in residential rehabilitation as well as those contacted through needle exchanges to identify correlates of drug use frequency, risky injection practices as well as HCV testing, knowledge and perceived risk.We collected cross-sectional data from one-on-one structured interviews of IDUs contacted through needle-exchange outreach workers (n=202) and those attending rehabilitation centres (behaviour immediately prior to joining rehabilitation) (n=167).Roughly half of participants reported injecting at least 30 times in the past 30 days and individuals with previous residential rehabilitation experience reported frequent injection far more than those without it. About one in fourteen respondents reported past week risky injection practices. Participants were over three times as likely to report risky injection if they consumed alcohol daily (17.2%) than if they did not (5.0%) (p=0.002). Those who reported injecting daily reported risky injection practices (11.9%) significantly more than non-daily injectors (1.8%) (p<0.001). Respondents reported high HCV infection rates, low perceived risk, testing history and knowledge. HCV knowledge was not associated with differences in risky injecting.Treatment centres should highlight the link between heavy drinking, frequent injection and risky injecting practices. The link between rehabilitation attendance and frequent injection may suggest IDUs with more severe use patterns are more likely to attend rehabilitation. Rehabilitation centres and needle exchanges should provide testing and education for HCV. Education alone may not be sufficient to initiate change since knowledge did not predict lower risk.


Gurung T.R.,SANN Institute of Nursing | Vl N.G.,Nobel College
JNMA; journal of the Nepal Medical Association | Year: 2014

METHODS: A sample size of 300 adolescent students was taken to do a cross-sectional study. Body weight and height were recorded and body mass index was categorized based on age-and sex-specific cut-off values as per International Obesity Task Force reference growth charts. Proportions of obese, overweight and underweight children were calculated and subjected to chi-square and logistic regression tests at the p < 0.05 significance level.RESULTS: The overall prevalence of overweight and obesity in the present study were 12% and 3.3% respectively. The highest prevalence was among those aged 15 years i.e. 36.7%. The prevalence of overweight and obesity was higher among the subject who did not practice physical activity and whose family income was more than 10,000 per month.CONCLUSIONS: Prevalence of overweight and obesity among adolescents student in Belgaum city was high which is statistically associated with less physically activity and monthly income of parent.INTRODUCTION: The World Health Organization defines obesity as a 'global epidemic'. An overweight adolescent has a 70% chance of becoming obese. Overweight and obese adolescents are at higher risk for developing long-term chronic diseases. So the present study objective is to estimate the prevalence of overweight and obesity among adolescent school students


Gurung T.R.,KLE University | Gurung V.N.,Nobel College
Journal of the Nepal Medical Association | Year: 2014

Introduction: The World Health Organization defines obesity as a ‘global epidemic’. An overweight adolescent has a 70% chance of becoming obese. Overweight and obese adolescents are at higher risk for developing long-term chronic diseases. So the present study objective is to estimate the prevalence of overweight and obesity among adolescent school students.Methods: A sample size of 300 adolescent students was taken to conduct a cross-sectional study. Body weight and height were recorded and body mass index was categorized based on age-and sex-specific cut-off values as per International Obesity Task Force reference growth charts. Proportions of obese, overweight and underweight children were calculated and subjected to chi-square and logistic regression tests at the P<0.05 significance level.Results: The overall prevalence of overweight and obesity in the present study were 12% and 3.3% respectively. The highest prevalence was among those aged 15 years i.e. 36.7%. The prevalence of overweight and obesity was higher among the subject who did not practice physical activity and whose family income was more than Rs. 10,000 per month.Conclusions: Prevalence of overweight and obesity among adolescents student in Belgaum city was high which is statistically associated with less physical activity and monthly income of parent. © 2014, Nepal Medical Association. All rights reserved.


PubMed | Nobel College
Type: Review | Journal: Journal of clinical and diagnostic research : JCDR | Year: 2017

S-1 is a novel oral fluoropyrimidine derivative, widely used for treating gastric, pancreatic, lung, head, neck and breast carcinomas. It is designed to enhance the clinical utility of an oral fluoropyrimidine and is associated with low gastrointestinal toxicity. S-1 consists of three pharmacological agents (at a molar ratio of 1:0.4:1)-Tegafur (FT), a prodrug of 5-Fluorouracil (5-FU), 5-Chloro-2-4-Dihydroxypyridine (CDHP), which inhibits the activity of Dihydropyrimidine Dehydrogenase (DPD) and Oxonic Acid (Oxo), which reduces Gastrointestinal (GI) toxicity of 5-FU. The present article reviews the current development of clinical study of S-1.


PubMed | SANN Institute of Nursing and Nobel College
Type: Journal Article | Journal: JNMA; journal of the Nepal Medical Association | Year: 2016

The World Health Organization defines obesity as a global epidemic. An overweight adolescent has a 70% chance of becoming obese. Overweight and obese adolescents are at higher risk for developing long-term chronic diseases. So the present study objective is to estimate the prevalence of overweight and obesity among adolescent school studentsA sample size of 300 adolescent students was taken to do a cross-sectional study. Body weight and height were recorded and body mass index was categorized based on age-and sex-specific cut-off values as per International Obesity Task Force reference growth charts. Proportions of obese, overweight and underweight children were calculated and subjected to chi-square and logistic regression tests at the p < 0.05 significance level.The overall prevalence of overweight and obesity in the present study were 12% and 3.3% respectively. The highest prevalence was among those aged 15 years i.e. 36.7%. The prevalence of overweight and obesity was higher among the subject who did not practice physical activity and whose family income was more than 10,000 per month.Prevalence of overweight and obesity among adolescents student in Belgaum city was high which is statistically associated with less physically activity and monthly income of parent.

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