Correlations between Educational Struggle, Toxic Sites by School District and Demographic Variables, with Geographical Information System Projections.

This correlational study associated data on children enrolled in individualized educational plans in their K-12 schools (IEP) and an algorithm-calculated score of neurotoxins at contaminated sites located in each school district. The study also mapped and projected the correlations using Geographical Information System (GIS) technology. These data were populated in ArcMap 10.5 (a GIS software) for generating maps and data to conduct geospatial analysis. A total of 1 Superfund site and 39 CERCLA sites were identified as contaminated sites for this analysis. The majority of contaminants were heavy metals such as lead, arsenic, mercury, and cadmium. The mean toxic score of all contaminated sites combined was 13.4 (SD 14.4). Correlational analysis between the IEP numbers from each school district and toxic scores from the contaminated school district sites exhibited a positive relationship (F = 23.7, p < 0.0001). Correlations were also seen among higher toxics scores, IEP numbers, and children under the age of 10 (p < 0.00052) as well as higher proportions of black students in areas with high toxics scores (p = 0.0032). Black students were also far more likely to be enrolled in an IEP (p < 0.0001). Household income and poverty percentage in contaminated areas were also correlated (p = 0.0002). Individuals without college degrees were overrepresented in high toxic score school districts (p < 0.0001). The important low socio-economic status indicator of free and reduced lunch programs also correlated with increasing toxic scores (p = 0.0012) and IEP numbers (p = 0.0416). This study emphasizes the need to account for multiple exposures to wholistically appreciate environmental factors contributing to negative health outcomes.

Pregnancy intentions and its associated factors among married women in resunga, Gulmi, Nepal.

Pregnancy intention refers to a women's thinking at the time she became aware that she was pregnant. It can be categorized as intended and unintended. Identifying pregnancy intentions during prenatal periods help to employ careful monitoring of pregnancy that is at high risk for mother and children's health outcomes. Unintended pregnancy is a contributing factor for maternal and infant mortality, which is still high in Nepal. Reproductive and family planning program should incorporate pregnancy intention domains in health education and counseling with priority to design program to address and reduce unintended pregnancy. This brief research examines the pregnancy intentions and its associated factors among married women so that it could identify the intentions of pregnancy and factors influencing unintended pregnancy and could be useful to improve and maintain the health and well-being of women, family, community, and nation.

Screen time and its correlates among children aged 3-10 years during COVID-19 pandemic in Nepal: a community-based cross-sectional study.

OBJECTIVE: This study aims to determine the prevalence of high screen time among schoolchildren aged 3-10 years in Bhaktapur, its correlates and the parents' strategies to reduce screen time during the COVID-19 pandemic in Nepal. METHODS AND ANALYSIS: This cross-sectional descriptive study was conducted during March 2021. A total of 630 households were selected for the study from 21 randomly selected clusters in Bhaktapur, Nepal. Correlates of high screen time were determined using a logistic model. P<0.002 was taken as significant. RESULTS: Among all the participants, the mean (SD) age was 7.0 (2.2) years, with 50.3% male participation. Few participants had online classes (n=24, 3.8%). The prevalence of high screen time among the participants was very high (55.2%, 95% CI=51.3% to 59.1%), which is even higher in boys (61.8%, 95% CI=58.0% to 65.6%). The median screen time before the COVID-19 pandemic was 1.0 hours (mean rank=275.8) which increased to 2.2 hours (mean rank=116.6) during the pandemic (p<0.001). Participants having smartphones were about seven times (adjusted OR=6.9, 95% CI=1.5 to 31.3, p=0.013) more likely to have high screen time than those who did not have the device. Most parents used to reprimand and urge their children to play outside to limit their screen usage. CONCLUSION: During the COVID-19 pandemic, about one in two schoolchildren of 3-10 years had higher screen time than before the COVID-19 pandemic. Parents' strategies to reduce screen time were not effective. An intervention study is recommended to design and test effective strategies to reduce screen time and its negative effects on children's health.

Menopausal Symptoms among Postmenopausal Women Visiting Outpatient Department of a Tertiary Care Centre: A Descriptive Cross-sectional Study.

Introduction: Menopause is defined as the complete cessation of menstruation for consecutive 12 months which occurs due to the loss of follicular activity of ovaries from the late 40s to early 50s. The menopausal symptoms are often distressing but lack of awareness leads to failure in addressing the problem. This study aimed to find out the prevalence of menopausal symptoms among postmenopausal women visiting the outpatient department of a tertiary care centre. Methods: This descriptive cross-sectional study was done among postmenopausal women in the outpatient department of a tertiary care centre from 10 March 2021 to 10 March 2022 after taking ethical approval from the Institutional Review Committee (Reference number: MEMG/IRC/420/GA). Convenience sampling was done. Demographic data were collected using predesigned proforma and menopausal symptoms were evaluated using Rajanobritta Lakshan Mapak, the Nepali version of the menopausal rating scale. Point estimate and 95% Confidence Interval were calculated. Results: Among 424 postmenopausal women, menopausal symptom was found in 411 (96.48%) (94.73-98.23, 95% Confidence Interval). The mean age at menopause was 49±4.70 years. The most common symptom these women presented with was somatic symptoms seen in 382 (92.94%) women. Conclusions: The prevalence of menopausal symptoms is found to be higher than the other studies done in similar settings. Keywords: cross-sectional study; menopause; prevalence; somatic symptoms.

Adenosarcoma of Uterus- Rare Biphasic Malignant Tumor: A Case Report.

Uterine adenosarcoma is a rare variant of mixed Mullerian tumors comprised of neoplastic glands with the benign appearance and sarcomatous stroma. The epithelium most often consists of endometrium- like cells, while the sarcomatous component usually shows low-grade homologous uterine sarcoma. These tumors present as a pelvic mass or an enlarged uterus with abnormal vaginal bleeding. Here, we present a case of 61 years old postmenopausal female patient with chief complaints of excessive vaginal bleeding and urine retention.

Patterns of Clinically Identifiable Congenital Defects in Neonates.

BACKGROUND: The study is aimed at highlighting the pattern of congenital defect in a tertiary care hospital. Congenital anomalies are recognized as a growing cause of neonatal morbidity and mortality in developing countries and a major cause of distress to parents. METHODS: This was a prospective descriptive study conducted between September 2019 and August 2020 with the objective to determine the types of congenital anomalies among live born neonates at Manipal Teaching Hospital (MTH), Pokhara and to determine their immediate outcome. Neonatal and maternal characteristics were noted. RESULTS: Twenty four out of 2515 live births had congenital anomalies during the study period, giving an incidence rate of 9.42 congenital anomalies per 1000 live birth per year. Single system involvement was seen in 79.2 % cases, remaining 5 (20.8%) neonates had involvement of more than one system; 54.2% of these newborns were discharged, 33.3% expired, 8.3% left against medical advice and 4.2% were referred out. CONCLUSIONS: This study highlights the importance of clinical examination of neonates to detect anomalies in our setting.

Cervical Intraepithelial Lesions in Women with Persistent Inflammatory Smear on Pap Smear: A Descriptive Cross-sectional Study.

INTRODUCTION: Persistent inflammatory smear is a benign finding on pap test but is associated with premalignant lesion of the cervix. Further evaluation is therefore necessary. This study was done to determine the prevalence of cervical intraepithelial lesions in women with persistent inflammatory smear. METHODS: This is descriptive observational study conducted in Department of Obstetrics and Gynaecology of tertiary care centre of Nepal from 15th May 2020 to 14th May 2021 after obtaining ethical clearance from Institutional Review Board (Reference no MEMG/IRC/338/GA). Women with two consecutive pap smear reports showing inflammatory findings were enrolled. Colposcopy was performed and Modified Reid's colposcopic index was used to grade the lesions. Colposcopic guided biopsy was taken and tissue sent for histopathology for abnormal colposcopic lesions. Data analysis was done using Statistical Package for Social Sciences version 21 and frequency and percentages were used to present data. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. RESULTS: Among 115 women, 57 (49.5%) at 95% Confidence Interval (40.37-58.63) had Cervical Intraepithelial lesions. Among them 48 (41.7%) had low grade intraepithelial lesions and 9 (7.8%) had high grade lesions on colposcopy. CONCLUSIONS: The prevalence of cervical intraepithelial lesions in women with persistent inflammatory smear on pap was higher in our study compared to other studies.

Comparison of laparoscopy and laparotomy in the surgical management of ectopic pregnancy.

OBJECTIVE: To compare the operative findings, operative procedure and complications, postoperative complications and hospital stay in patients with ectopic pregnancy managed by laparoscopy and conventional laparotomy. STUDY DESIGN: A cross-sectional, observational study. PLACE AND DURATION OF STUDY: Department of Obstetrics and Gynaecology, Kathmandu Medical College Teaching Hospital, Kathmandu, Nepal, from October 2009 to October 2010. METHODOLOGY: All patients with ectopic pregnancy confirmed during surgery, were included in the study. Patients with preoperative diagnosis of ectopic pregnancy but confirmed not to be so during surgery were excluded. Data regarding the studied variables were collected by interviewing patients postoperatively, reviewing the charts and operative notes and by following-up the patients till discharge. RESULTS: There were a total of 32 cases of ectopic pregnancy which was 4.4% of total deliveries during the study period. Twelve patients (37.5%) were managed by laparoscopy and 20 patients (62.5%) by laparotomy. All the patients who underwent laparoscopy and 40% patients who underwent laparotomy were haemodynamically stable pre-operatively. Laparoscopy was mostly performed for tubal abortion (40%) and unruptured ectopic pregnancy (25%) whereas laparotomy mostly for ruptured ectopic pregnancy (70%). Salpingectomy was the commonest procedure in both routes of surgery. One patient in the laparoscopy group and 4 patients (20%) in laparotomy group had complications with two of the latter requiring admission in intensive care unit. CONCLUSION: Laparoscopy is feasible and safer than laparotomy in the surgical management of ectopic pregnancy.