Hopelessness and Suicidal Ideation among Patients with Depression and Neurotic Disorders Attending a Tertiary Care Centre at Eastern Nepal.

BACKGROUND: Hopelessness is thought to result from a negative appraisal system and interacts with, and worsens, appraisals of defeat and trap which in turn interact with suicide schema and lead to suicidal behaviour. This study was intended to assess hopelessness and suicidal ideation among patients with depression and neurotic disorders at tertiary care centre of eastern Nepal. METHODS: A cross sectional design included 70 respondents by purposive sampling technique. Beck Hopelessness Scale and Scale of Suicidal Ideation were used to measure hopelessness and suicidal ideation, respectively. Data were analyzed using SPSS statistical software. Pearson chi-square, binary logistic regression and Spearmans' rho, test were applied at 95% confidence interval. RESULTS: Mean ± SD age was 32.8 ± 13.5 years. Most (62.8%) of the patients were female and with the diagnosis of depression. Majority (66%) of the patients had hopelessness. There was no significant difference in hopelessness among patients with depression and neurotic disorders. About 17% respondents had suicidal ideation, among them 82.4% were female. There was no significant difference of suicidal ideation among patients with depression and neurotic disorders (p=0.013). Significant positive correlation between hopelessness and suicidal ideation was found (p=0.001). Binary logistic regression revealed hopelessness was independently related to income and family history of mental illness. Similarly, suicidal ideation was independently related to depression and family history of mental illness. CONCLUSIONS: Female respondents, people living under poverty and positive family history of mental illness had more hopelessness and suicidal ideation.

Understanding socio economic contexts of female sex workers in eastern Nepal.

The present focus is mostly laid on high risk behavior of commercial sex workers without any consideration of their location, educational status and other socio-cultural norms. Thus, we designed a study to understand socio demographic characteristics, lifestyle of female sex workers and search for driving factors for prostitution in eastern Nepal. A descriptive study was conducted in three districts of Eastern Nepal in 2012 over the period of six months. The data regarding their socio demographic characteristics, income, reason for joining sex trade and future choice regarding the profession were recorded from 210 female sex workers through face-to-face interviews. Majority (53.3%) of respondents belonged to the productive age group of 20-29 years, more than one thirds (43.3%) had not received any form of formal education and were unmarried. More than half (53.80%) were presently living alone and about one thirds of the women (31.90%) were minors when they joined this profession. Major portion of the sample (94.80%) worked more than three days a week with median income of 15 thousand per month and 41 percent had sex with more than or equal to ten clients per week. Poor economic condition was the most frequent (47.6%) factor leading to joining of sex trade however, more than two thirds, (72.80%) wanted to quit the profession. Given low level of education, relatively low income, and young age among this population, empowerment and alternative employment/education opportunities should be created to develop this part of Nepalese society.

Community Based Survey on Psychiatric Morbidity in Eastern Nepal.

INTRODUCTION: Mental health problem is common and ubiquitous. Mental illness cuts across all sections of society, irrespective of socio-economic status. Recent international survey showed a varying prevalence rates ranged (4.7%- 12.0%). The Community study in Nepal yielded prevalence rate of mental illness at 14.0%. METHODS: This is a descriptive, epidemiologic study with systematic randomization sampling. RESULTS: Of 911 respondents majority was married (76.1%), of age group 20-59 yrs. Overall, 113 (12.4%) respondents had at least one psychiatric disorder and the commonest were: Depression, Anxiety disorders, Alcohol use disorders with 1.9% had seizure/epilepsy. CONCLUSIONS: Community prevalence rate of some common psychiatric disorders is high which calls for special attention to address depressive and alcohol related disorder from all quarters of society particularly from government.

Antibiotic susceptibility patterns of Vibrio cholerae isolates.

INTRODUCTION: Cholera is one of the most common diarrhoeal diseases in Nepal. Etiological agent of cholera is Vibrio cholerae which removes essential body fluids, salts and vital nutrients, which are necessary for life causing dehydration and malnutrition. Emerging antimicrobial resistant is common. The aim of the present study was to determine the antibiotic susceptibility pattern of cholera patients in Nepal. METHODS: All the laboratory works were conducted in the bacteriology section of National Public Health Laboratory, Teku from March to September 2005. During this period a total of 340 stool samples from diarrhoeal patients were collected and processed according to the standard laboratory methods. Each patient suffering from diarrhoea was directly interviewed for his or her clinical history during sample collection. RESULTS: A total of 340 stool samples were processed and studied from both sex including all ages of patients. Among the processed sample 53 Vibrio cholerae cases were found. All isolated Vibrio cholerae O1 were El Tor, Inaba. All isolated (100%) Vibrio cholerae O1 were sensitive to Ampicillin, Ciprofloxacin, Erythromycin and Tetracycline whereas all were resistant to Nalidixic acid and Cotrimoxazole. Only 15.1% cases were sensitive to Furazolidone whereas 84.9% were resistant. CONCLUSION: All V. cholerae strains isolated in this study were found resistant to Multi Drug Resistant (resistant to at least two antibiotics of different group). Ampicillin, Ciprofloxacin, Erythromycin and Tetracycline were found still more potent antibiotics against Vibrio cholerae isolated during the study.

Mini-open reduction and intramedullary interlocking nailing of fracture shaft of tibia without an image intensifier.

Intramedullary interlocking tibial nailing is usually performed using an image intensifier. But being expensive, it is not available in the most of the hospitals of resource-poor countries of the world. The purpose of this study is to analyze the results of interlocking nailing without the use of an image intensifier. This is the retrospective study of 55 diaphyseal tibial fractures treated with minimally open reduction and internal fixation with interlocked intramedullary nail fixation. The proximal locking of the nail with the screws was made using external jig and for the distal locking direct visualization of the hole was carried out. There were 15 females and 40 males. The average age in years was 32 with a range of 18 to 64 years. The surgical approach was medial parapatellar. The average follow up period was 4 months. This period ranged from 3 months to 14 months. The union time in an average was 4 months. The complication mainly was distal screw loosening leading to valgus deformity and shortening in 1 case. It is, therefore, concluded that interlocking intramedullary nailing can be performed with proximal and distal locking accurately without the use of an image intensifier.