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Policing is considered an extremely stressful, physically demanding, and mentally challenging occupation. The growing population with an increasing number of vehicles and the harsh working environment has made the work of traffic police even more stressful. This qualitative study aims to examine work and environment-related stressful factors among traffic police officials of Kathmandu Valley, Nepal. This qualitative study used a thematic analysis approach. Face-to-face interviews were conducted with different cadres of 15 traffic police personnel working in Kathmandu Valley, Nepal for at least six months. The study adhered to the Consolidated Criteria for Reporting Qualitative Studies (COREQ) guideline. The findings of this study are structured around five major themes- workload, work-life balance, basic amenities, work environment and occupational health problems, and possible solutions and suggestions. Most of the participants (10 out of 15) reported having work stress due to the heavy workload and hazardous working conditions that had a significant impact on their job performance and mental well-being. This study highlights the challenges faced by traffic police officers in Kathmandu Valley, Nepal. The findings suggest that efforts should be made to improve the working environment of traffic police officers to reduce the physical as well as mental burden among them. The occupational health and safety (OHS) and mental well-being of traffic enforcers' is a critical public health issue, therefore, it should be on the agenda of policymakers, organizational leaders, and stakeholders.
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Meckel's diverticulum (MD) is the most common congenital anomaly of the gastrointestinal tract. Most cases are asymptomatic and when symptomatic, preoperative diagnosis of MD is poor. Intestinal obstruction, Malena or hematochezia, and inflammation are major symptoms. We report three cases of 18-month, 2-year, and 9-year old male patients presenting with intestinal obstruction.
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Introduction: Gastrointestinal tumor (GIT) is an uncommon gastrointestinal tumor most commonly arising in the stomach. Duodenum is an uncommon site accounting for only about 3-5% of cases. Case presentation: In this case report, we present a case of high-risk duodenal GIST and review its management strategies. Discussion: An abdominal mass and gastrointestinal (GI) bleeding are its usual presentation, however it may be lost among the long list of differentials of an abdominal mass and GI bleeding, if a high index of suspicion is not maintained. Surgery, with or without tyrosine kinase inhibitors like imatinib mesylate, has been the cornerstone in management of GIST. Conclusion: This case underlined the importance of duodenal GIST as a cause of GI bleed and abdominal mass as well as shone light upon historical developments, current updates and managements of GISTs.
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Introduction: Atypical spindle cell lipomatous tumor (ASPLT), a separate entity for the group of benign/low grade adipocytic neoplasm that is characterized by adipocyte adequacy and the presence of lipoblast-like cells and spindle cells at varying degrees. Case presentation: Here, we report a rare case of 60 years old male with atypical spindle cell lipomatous tumor in the anterior abdominal wall. Discussion: Histopathology is the gold standard for establishing the diagnosis and grade of soft tissue tumor and consistent radiology-pathology correlation is essential to avoid any diagnostic pitfalls [1]. Ultrasound is preferred as an initial investigation for superficially located lesions. Conclusion: ASPLT show a wide variety of microscopic features, and differential diagnosis is important and difficult. Recognition of morphologic clues and immunohistochemistry/molecular tests to confirm the diagnosis.
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Introduction: An Inflammatory myofibroblastic tumor, a neoplasm of intermediate biological potential, of the small bowel mesentery, is a rare tumor, most commonly reported in but not confined to the pediatric age group. Case presentation: This case report underlines a case of a (small bowel) mesentery IMT in an adult female presenting with recurrent symptoms similar to acute appendicitis. Discussion: It can present with symptoms similar to acute appendicitis necessitating a high index of suspicion for its prompt diagnosis. Treatment primarily includes surgical resection with recent advances in targeted therapy with tyrosine kinase inhibitors showing promising results. Conclusion: IMTs can present as clinical as well as histopathological mimickers of a variety of diseases especially in the abdomen. Prompt diagnosis requires both imaging and histopathological examination.
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OBJECTIVE: This study aimed to assess the prevalence of depression, anxiety and stress, associated factors and stress-coping strategies among traffic police officers in Kathmandu, Nepal. DESIGN: Cross-sectional survey. SETTING: Kathmandu Valley, Nepal. PARTICIPANTS: A total of 300 traffic police officers working under the different traffic units of Kathmandu Valley for at least 6 months were recruited via a simple random sampling procedure. PRIMARY OUTCOME MEASURES: State of depression, anxiety and stress among traffic police officers based on the Depression, Anxiety and Stress Scale. SECONDARY OUTCOME MEASURES: Coping strategies under stressful conditions based on the Coping Orientation to Problems Experienced Inventory (Brief-COPE) tool. RESULTS: Altogether 124 (41.3%) traffic police officers had symptoms of depression, 141 (47%) had anxiety symptoms and 132 (44%) had symptoms of stress. Smoking was significantly associated with an increased likelihood of experiencing symptoms of depression (adjusted OR (AOR): 10.7, 95% CI: 4.8 to 23.6), anxiety (AOR: 7.1, 95% CI: 3.4 to 14.9) and stress (AOR: 6.8, 95% CI: 3.3 to 14.1). Similarly, longer working hours was significantly associated with higher odds of experiencing symptoms of depression (AOR: 3.4, 95% CI: 1.8 to 6.4), anxiety (AOR: 2.3, 95% CI: 1.3 to 3.9) and stress (AOR: 1.9, 95% CI: 1.1 to 3.4), and lack of physical exercise was associated with an increased likelihood of exhibiting depressive symptoms (AOR: 2.3, 95% CI: 1.1 to 4.7). Participants in this study used positive coping strategies more than negative coping strategies. CONCLUSION: Our study found a high prevalence of depression, anxiety and stress symptoms among traffic police officers in Kathmandu Valley, Nepal. Smoking and longer working hours were associated with an increased likelihood of experiencing symptoms of depression, anxiety and stress, and lack of physical exercise was associated with an increased likelihood of depressive symptoms.
