Gender preference and fertility behavior among married women: A community based study from far western Nepal.

Gender preference often results in low use of contraceptives and parity progression, which can increase the risks of morbidity and mortality for women. This study aimed to identify gender preference and fertility behavior, including contraceptive use and the desire for additional children, among married women. A cross-sectional descriptive study was conducted using systematic random sampling to select280 household, with one respondent interviewed from each household using a semi-structured interview schedule. Descriptive and inferential statistical analysis were performed on the collected data. Of 280 respondents, 44.6% were aged 26-35 years (mean30.23±7.39 years). Most (74.3%) were literate, and 70% were paid worker. Son preference was reported by 53%, with support in old age (87.2%) being the main reason. Gender preference was 60.5% less likely among Bramhin/Chhetri ethnic groups (p = 0.033) and 71.3% less likely if husbands were literate (p = 0.002). Contraception use was 90.7%, but 31.8% desired additional children. Permanent contraceptive method use was 9.387 times more likely above age 30 years (p = <0.001), independent of respondents' and husbands' education, sex composition of children, and having a preferred child. Desire for more children was 6.813 times more likely below age 30 years (p = <0.001) and 5.875 times more likely with 1-2 living children (p = 0.001), independent of respondents' and husbands education.The study concludes that son preference persisted among the illiterate. Contraceptive use was lower among respondents below 30 years. Enhancing educational status may reduce gender bias. Targeting family planning to women below 30 years could improve contraceptive utilization in this age group.

Evaluating Antibiotic Treatment Guideline Adherence to Ongoing Antibiotic Stewardship in a Tertiary Care Setting: A Retrospective Observational Study.

Antimicrobial resistance (AMR) is widely regarded as an increasing threat to global public health. Antibiotic treatment guidelines have been increasingly recognized as an effective tool to guide appropriate prescriptions and help curtail antibiotic resistance. The present study aimed to assess physician's adherence to hospital antibiotic treatment guideline recommendations in Nepal and determine predictive variables with a significant association. This was a retrospective, monocentric observational review to investigate the adherence to endorsed guidelines using the medical records of adults admitted to the hospital with a diagnosis of urinary tract infection (UTI), pneumonia, or skin and soft tissue infection (SSTI) from January 2018 to December 2019. Of the 2,077 medical records that were reviewed (954 UTI, 754 pneumonia, and 369 SSTI), 354 (17%) met the study inclusion criteria, which included 87 UTI, 180 pneumonia, and 87 SSTI patients. Among eligible patients with antibiotic prescriptions, the following were adherent to guideline recommendations: 33 (37.9%) UTI, 78 (43.3%) pneumonia, and 23 (26.4%) SSTI. The overall extent of adherence to hospital antibiotic treatment guidelines for the use of antibiotics among adult inpatients diagnosed with these common infections was 37.9%. Patients who received ceftriaxone (OR = 2.09, 95% CI = 1.18-3.71, p=0.012) and levofloxacin (OR = 4.63, 95% CI = 1.30-16.53, p=0.018) had significantly higher adherence to treatment guidelines. This study revealed a low adherence rate despite the availability of updated guidelines for antibiotic prescriptions. The findings confer an urgent need to confront antibiotic prescription patterns in such tertiary care centers for tailored interventions to improve adherence to antibiotic guidelines.

Factors Associated with Postpartum Depressive Symptoms in Community of Central Nepal.

BACKGROUND: Pregnancy and postpartum are considered as high risk periods for the emergence of psychiatric disorder. Although postpartum depressive symptoms have been associated with tragic outcome, such as maternal suicide and infanticide, it is a neglected area of mental health care in developing countries. This study was conducted to find the prevalence and factors associated with postpartum depressive symptoms. METHOD: A community-based cross-sectional research design was carried out after selecting the three wards of Bharatpur submetropolitan by nonprobability purposive sampling method. A total of 160 mothers in their 1 month to 12 months of postpartum period were interviewed through semistructured interview schedule and Edinburgh Postnatal Depression Scale (EPDS). Collected data were entered in Epi, data 3.1, and was exported into IBM SPSS 20 version. RESULTS: The prevalence of depressive symptoms among postpartum mothers was 27.5%. The multivariate analysis identified two factors significantly associated with postpartum depression including respondents who had education level of ≤10 class (odds ratio [AOR] = 3.25, P = 0.03, confidence interval [CI] = 1.10 - 9.58), chronic disease in their family (odds ratio [AOR] = 3.25, P = 0.01, confidence interval [CI] = 1.19 - 8.16). CONCLUSION: More than one out of four mothers is suffering from depressive symptoms. The major factors associated with postpartum depressive symptoms are education of respondents and chronic disease in the family. Screening and timely management of depressive symptoms should be incorporated in routine maternal care so as to enhance maternal and child health. Likewise, concerned authority should plan and organize awareness-raising programs and provide attractive package to attract the female population for higher education.