Knowledge and Perception of Community Based Integrated Management of Neonatal and Childhood Illnesses among Medical Students at a Medical College: A Descriptive Cross-sectional Study.

INTRODUCTION: Community-Based Integrated Management of Neonatal and Childhood Illnesses (CBIMNCI) is the integrated approach for the management of children's common health concerns in outpatient primary health care settings and interventions at the family and community level. This study aimed to assess the knowledge and perception regarding CB-IMNCI in medical students studying in the clinical phase of a medical college. METHODS: A descriptive cross-sectional study was conducted from February to June 2023 among 218 clinical-year medical students after obtaining ethical clearance from the Institutional Review Committee (Reference number: IRC-LMC-04/M-022). A self-administered questionnaire with CB-IMNCI-related multiple-choice questions was used for data collection and the responses to knowledge-related questions were evaluated using a predefined answer key. The results were expressed in terms of the number and percentage of the participants who answered each questions correctly. RESULTS: Of the 218 students, 111 (50.92%) were male and 107 (49.08%) were female. Among the participants, 164 (75.23%) (70-80% at 95% Confidence Interval) demonstrated basic knowledge of CB-IMNCI, successfully answering 50% or more of the questions. Among the males, 81 (72.97%), and among the females, 83 (77.57%) had basic knowledge of CBIMNCI. In terms of semester-wise distribution, 33(53.22%) in the 5th semester, 43 (82.69%) in the 7th semester, 41 (80.39%) in the 9th semester and 47 (88.67%) were able to answer 50% or more of the questions correctly. CONCLUSIONS: This study showed that one fourth of the students lack the basic knowledge about CB-IMNCI. It suggests the need for further work to enhance effectiveness of pre-service CB-IMNCI training.

Brain Death and Organ Transplantation in Nepal: Navigating Cultural, Legal, and Ethical Landscapes.

Organ transplantation after brain death is challenging in Nepal due to cultural beliefs, legal frameworks, and ethical considerations. The Human Body Organ Transplantation (Regulation and Prohibition) Act (HBOTA) has not met with substantial success after its amendment. This review critically appraises the current state of brain death and organ transplantation in Nepal. It explores challenges, evaluates progress, and provides recommendations. Literature review of databases was conducted to find articles on brain death, organ donation, and transplantation in Nepal. Analysis of cultural, legal, ethical, and practical factors influencing implementation. Key challenges include limited awareness, religious beliefs, infrastructure gaps, and family consent barriers. HBOTA amendments in 2016 enabled brain death donations, however, donation rates remain low. Strategies are needed to improve public education, resources, personnel training, and collaboration. Cultural sensitivity and stakeholder engagement are crucial. A multifaceted approach addressing cultural, legal, ethical and practical dimensions is essential to improve organ donation rates in Nepal. Despite progress, substantial challenges persist requiring evidence-based strategies focused on awareness, capacity building, policy improvements, and culturally appropriate community engagement.