Developing and validating the Nepalese Abuse Assessment Screen (N-AAS) for identifying domestic violence among pregnant women in Nepal.

This study culturally adapted and validated a Nepalese version of the Abuse Assessment Screen (AAS) tool for identifying domestic violence among pregnant women in Nepal, creating the Nepalese Abuse Assessment Screen (N-AAS). International and national topic experts reviewed the initial N-AAS version using the Delphi method, and pregnant women participated in cognitive interviews, providing feedback on the N-AAS as user experts. Subsequent pre-testing of a comprehensive questionnaire, which included the translated version of the N-AAS, occurred in two tertiary care hospitals using an electronic format known as Color-Coded Audio Computer-Assisted Self-Interview (C-ACASI). The study assessed the content validity index, compared the concurrent validity of the N-AAS with the gold standard interview, estimated the prevalence of domestic violence from two hospitals, and calculated the Kappa coefficient. The reliability of the entire questionnaire was also evaluated through a test-retest analysis, with content validity rated as "good to excellent" by topic and user experts and high test-retest reliability (91.2-98.9%), indicating consistency across questionnaires completed at two different time points, with 12% of participants reporting any form of violence. The N-AAS demonstrated ≥91.7% specificity for all forms of abuse, accurately identifying non-abuse cases. In addition, moderate to excellent sensitivity was observed for emotional abuse (52.5%) and physical abuse since marriage (50%), while sensitivity for physical abuse in the past 12 months was 100%. Thus, the N-AAS demonstrated reliable test-retest results with a good Kappa coefficient and specificity, as well as showing excellent sensitivity for detecting recent physical abuse and moderate sensitivity for detecting emotional abuse and physical abuse since marriage. Because cultural context often leads women to normalize and tolerate abuse from spouses and family members and women are thus reluctant to report abuse, the results imply that the N-AAS can serve as a valuable screening tool for domestic abuse in antenatal care settings in Nepal.

Knowledge of Vitamin D among First-year Medical Undergraduate Students of a Medical College: A Descriptive Cross-sectional Study.

INTRODUCTION: Vitamin D also known as the sunshine vitamin, helps in bone metabolism and calcium homeostasis. It is estimated that one billion people in the world have vitamin D deficiency making it a public health problem. The objective of this study is to find out the knowledge regarding vitamin D among first-year medical undergraduate students of a medical college. METHODS: This is a descriptive cross-sectional study carried out from 2nd February 2020 to 15th February 2020 at Kathmandu Medical College Teaching Hospital, Duwakot among medical undergraduate students of a medical college. Ethical clearance was received from the Institutional Review Committee of Kathmandu Medical College Teaching Hospital (Reference Number: 2812201809). A structured self-designed multiple-choice questionnaire on vitamin D knowledge was used. Convenient sampling method was applied and statistical analysis was done with Statistical Package for the Social Sciences 20 version. RESULTS: Out of total 157 undergraduate medical students, 21 (13.3%) exhibited good knowledge, 116 (73.9.8%) had average, and 20 (12.8%) had poor knowledge. There were 83 (52.9%) Bachelor of Medicine and Bachelor of Surgery students, 39 (24.8%) were Bachelor of Dental Surgery and 35 (22.3%) were Nursing students. CONCLUSIONS: We found a satisfactory level of knowledge of vitamin D among first-year undergraduate medical students of a medical college when compared to similar studies. The majority of students from all three disciplines had average knowledge of vitamin D.

Knowledge, Attitude and Practice about Vitamin D among Pregnant Women at a Municipality of Bhaktapur.

INTRODUCTION: Almost a billion people in the world are affected by Vitamin D deficiency. During pregnancy, the deficiency of Vitamin D can manifest as gestational diabetes, pre-eclampsia, preterm birth, or miscarriage in the early stages of pregnancy. The objective of this study was to assess the knowledge, attitude, and practice, and importance of Vitamin D among pregnant women via a focus group. METHODS: A qualitative study was carried out at Changu Narayan Municipality, Duwakot ward no. two, Bhaktapur district from November to December 2019 after approval from the Institutional Review Committee of Kathmandu Medical College (Ref. 181020192). Participants were selected via the Female Community Health Volunteer's pregnant women list by purposive sampling method. Focus group discussion was conducted among pregnant women. The interview questions were open-ended and the data were analyzed using thematic analysis. RESULTS: Study participants showed limited knowledge on vitamin D. Few participants had information regarding sun exposure for vitamin D. But many participants had negative attitudes towards sun exposure and lack of knowledge on sun exposure requirements. The participants have a huge knowledge gap between Vitamin D and its importance in pregnancy. CONCLUSIONS: Increasing awareness of the importance of Vitamin D among pregnant women is required.

Practice of Breastfeeding and its Barriers among Women Working in Tertiary Level Hospitals.

INTRODUCTION: Breastfeeding provides ideal food for newborns and prevents recurrent infection and malnutrition in infants. In Nepal, breastfeeding is a universal practice but exclusive breastfeeding is low. As there is increased involvement of women in workforce, practice of breastfeeding may have been compromised. The main objective of the study was to examine the practice and barriers of breastfeeding among women working in tertiary level hospitals of Nepal. METHODS: This was a hospital based descriptive cross-sectional study. Study participants were women working in Dhulikhel Hospital and Kathmandu Medical College and Teaching Hospital and was conducted from December 2017 to June 2018. Ethical approval was taken from institutional review committee of both institutions. Total of 208 women were included in the study and face to face interview was conducted. Data entry and analysis was done using statistical package of social sciences. RESULTS: Breastfeeding practice was universal and colostrum was fed by 195 (94%) women. Pre-lacteal feeding was given by 14 (7%) women and 119 (57%) initiated breastfeeding within one hour of birth. Total of 93 (45%) children were exclusively breastfed for any duration while 10 (11%) were exclusively breastfed for six months. The mean duration of breastfeeding was 14.57 months and 90 (43%) started complementary feeding before six months. Total of 97 (51%) women and 42 (47%) women stated work as barrier for not exclusively breastfeeding and early complementary feeding respectively. CONCLUSIONS: Exclusive breastfeeding was very low and children were breastfed for less than two years. Complementary feeding was also started earlier and work was stated as the main barrier for poor breastfeeding practice.

Preservative effects of some selected spice oleoresins to stabilize the sunflower oil in comparison to tertiary butylhydroquinone.

DPPH (1, 1-Diphenyl-2-Picrylhydrazyl) radical scavenging activity was performed to find out the antioxidant activity (AA) of all the antioxidants used at a concentration of 5, 10, and 15 µl/ml. Effect of spice oleoresins (clove, black pepper, and ginger) (200 ppm) and TBHQ (200 ppm) were incorporated in stabilizing refined, bleached, and deodorized (RBD) sunflower oil heating at frying temperature (170°C) and during accelerated oxidation storage (70°C) was studied in comparison to Tert-Butylhydroquinone (TBHQ). Antioxidant activity (AA) was found to be in the order TBHQ > clove > ginger > pepper at a concentration of 5; 10; 15 µl/ml. A direct correlation was found between AA and the effectiveness of oleoresins and TBHQ in controlling AV and PV of the sunflower oil. During both heating and storage, TBHQ was found most effective to control AV and PV followed by clove, pepper, and ginger.