Factors associated with uptake of breast and cervical cancer screening among Nepalese women: Evidence from Nepal Demographic and Health Survey 2022.

Breast cancer screening (BCS) and cervical cancer screening (CCS) are integral parts of initiatives to reduce the burden associated with these diseases. In this context, we aimed to determine factors associated with BCS and CCS uptake among Nepalese women aged 30 to 49 years using data from the Nepal Demographic Health Survey (NDHS) 2022. We performed a weighted analysis to account complex survey design of the NDHS 2022. We employed univariable and multivariable logistic regression to determine factors associated with the uptake of BCS and CCS and results were presented as crude odds ratio and adjusted odds ratio (AOR) along with 95% confidence interval (CI). The uptake of BCS and CCS among Nepalese women aged 30 to 49 years were 6.5% and 11.4% respectively. Women from Terai compared to mountain region (AOR = 0.54, 95%CI: 0.31, 0.93) and those engaged in agriculture compared to non-working (AOR = 0.59, 95%CI: 0.42, 0.82) women had lower odds of BCS uptake. Conversely, Dalit women compared to Brahmin/Chhetri (AOR = 2.08, 95%CI: 1.37, 3.16), and women with basic (AOR = 1.49, 95%CI: 1.04, 2.13), secondary (AOR = 1.96, 95%CI: 1.33, 2.88), and higher education (AOR = 2.80, 95% CI: 1.51, 5.19) compared to those with no education had higher odds of BCS uptake. Women from rural areas (AOR = 0.76, 95%CI: 0.61, 0.96), and those living in Bagmati (AOR = 2.16, 95% CI: 1.44, 3.23) and Gandaki (AOR = 2.09, 95%CI: 1.40, 3.14) provinces had higher odds of CCS uptake compared to their urban counterparts and those living in Koshi province, respectively. The odds of CCS increased with age (AOR = 1.06, 95%CI: 1.04, 1.08). Women with secondary education (AOR = 1.47, 95%CI: 1.06, 2.04) had higher odds of CCS uptake compared to those without education. Similarly, married women (AOR = 8.24, 95%CI: 1.03, 66.21), and those with health insurance (AOR = 1.41, 95%CI: 1.08, 1.83) had higher odds of CCS. In conclusion, the uptake of both BCS and CCS was relatively poor among Nepalese women indicating a need for targeted and tailored intervention to increase BCS and CCS uptake.

Academic Stress among Adolescents of Rural Nepal: A Community-based Cross-Sectional Study.

BACKGROUND: Adolescents are in the transition phase between childhood and adulthood. Their mental health influences many aspects in their life as they go through many physical and emotional changes. Adolescent mental health is harmed by changes in emotional and physical state, as well as increased academic pressure. This study aimed to assess academic stress and its associated factors among adolescents in rural Nepal. METHODS: A community-based cross-sectional survey was conducted among 424 adolescents residing in Karnali Province, Nepal. Academic stress was measured using Student Assessing Academic Stress. Multivariate logistic regression analysis was used to examine associated factors at the significance level of 0.05. RESULTS: Of the total students, 19.8% had moderate academic stress and 2.4% of them had high academic stress. Female students had thrice higher odds of having academic stress as compared to male students (Adjusted Odds Ratio:3.47; 95% Confidence Interval:1.91to 6.31, p-value:<0.001). Grade 10 students had higher odds of having academic stress as compared to grade 9 (Adjusted Odds Ratio:2.02; 95% Confidence Interval:1.13 to 3.61, p-value:0.017). Students of literate mothers were more likely to experience academic stress than those with illiterate mothers (Adjusted Odds Ratio:0.53; 95% Confidence Interval:0.29 to 0.96, p-value:0.036). Students with unsatisfactory academic performance had thrice higher odds of having academic stress as compared to students with satisfactory academic performance (Adjusted Odds Ratio:3.12; 95% Confidence Interval:1.46 to 6.67, p-value:<0.003). CONCLUSIONS: The findings of the study showed that high school students have academic stress, which is related to many factors at home and school. Understanding academic stress and parents and teachers providing the best support to the students could help lessen the burden.

Prevalence and factors associated with depression, anxiety and stress symptoms among construction workers in Nepal.

INTRODUCTION: The construction industry in Nepal, which employs a significant proportion of the population, ranks as one of the largest industries in the country. Construction work is physically demanding and can be risky due to the use of heavy machinery and the presence of intense physical labor. However, the physical and mental health of construction workers in Nepal is often neglected. This study aimed to assess psychological distress (depression, anxiety, and stress symptoms) and its association with socio-demographic, lifestyle, and occupational factors among construction workers in Kavre district, Nepal. METHODS: We conducted a cross-sectional study from 1st October 2019 to 15th January 2020 among 402 construction workers in Banepa, and Panauti municipalities of Kavre district, Nepal. We collected data with face-to-face interviews using a structured questionnaire consisting of a) socio-demographic characteristics; b) lifestyle and occupational characteristics; and c) depression, anxiety and stress symptoms. We collected data using electronic forms in KoboToolbox and imported them into R version 3.6.2 for statistical analysis. We present parametric numerical variables as mean and standard deviation, and categorical variables as percentage and frequency. The confidence interval around proportion was estimated with the Clopper-Pearson method. We applied univariate and multivariable logistic regression to determine factors associated with depression symptoms, anxiety, and stress. The result of logistic regression was presented as crude odds ratio, adjusted odds ratio (AOR), and their 95% confidence interval (CI). RESULTS: The prevalence of depression, anxiety and stress symptoms were 17.1% (95%CI: 13.6-21.2), 19.2% (95%CI: 15.5-23.4) and 16.4% (95%CI: 12.9-20.4), respectively. In multivariable logistic regression analysis, depression symptom was positively associated with poor sleep quality (AOR = 3.51; 95%CI: 1.5-8.19; p-value: 0.004); stress symptom was positively associated with Brahmin ethnicity (AOR = 3.76; 95%CI:1.34-10.58; p-value: 0.012) and current smoking (AOR = 2.0; 95%CI: 1.11-3.82 p-value: 0.022). But anxiety symptoms were not associated with any of the variables. CONCLUSIONS: The prevalence of depression, anxiety, and stress symptoms were high among construction workers. Developing evidence-based and appropriate community-based mental health prevention programs among laborers and construction workers is recommended.

Management of health information of nepalese labour migrants.

INTRODUCTION: The monitoring and improvement of the health of labour migrants (LMs) require sufficient health data to be recorded and managed. In this context, this study was conducted to explore the management of health information of Nepalese labour migrants (NLMs). METHODS: This is an explorative qualitative study. Stakeholders involved directly or indirectly in maintaining the health profile of NLMs were first mapped, physically visited, and any documents or information were collected. Then, sixteen key informant interviews were conducted among these stakeholders related to labour migrants' health information management and challenges. A checklist extracted information from the interviews, and a thematic analysis was carried out to summarize the challenges. RESULTS: Government agencies, non-governmental organizations, and government approved private medical centers are involved in generating and maintaining the health data of NLMs. The Foreign Employment Board (FEB) records deaths and disabilities of NLMs while at work abroad and these health records are also maintained in an online portal called Foreign Employment Information Management System (FEIMS) under the Department of Foreign Employment (DoFE). Health assessment of NLMs is a mandatory procedure before departure, which is done through the government-approved pre-departure private medical assessment centers. The health records from these assessment centers are first recorded in paper-based form and then entered into an online electronic form to be stored by the DoFE. The filled-up paper forms are sent to District Health Offices, which further report the data to the Department of Health Services (DoHS), Ministry of Health and Population (MoHP) and associated governmental infectious diseases centers. However, there is no formal health assessment of NLMs upon arrival to Nepal. Key informants raised various issues and concerns in maintaining health records of NLMs, which were grouped into three themes: lack of interest to develop a unified online system; need of competent human resources and equipment; and developing a set of health indicators for migrant health assessment. CONCLUSION: The FEB and government-approved private assessment centers are the main stakeholders in keeping the health records of outgoing NLMs. The current migrant health record keeping procedure in Nepal is fragmented. The national Health Information Management Systems does not effectively capture and categorize the health record of NLMs. There is a need to effectively link national health information system with premigration health assessment centers; and potentially develop a migrant health information management system by systematically keeping health records electronically with relevant health indicators on departing and arriving NLMs.

Prevalence and factors associated with depression, anxiety, and stress symptoms among home isolated COVID-19 patients in Western Nepal.

Introduction: Globally, COVID-19 pandemic has a significant impact on mental health. In Nepal, COVID-19 positive cases have to self-isolate at home in multi-generational and multi-family households. This could be strongly associated with depression, anxiety, and stress-related health outcomes. Additionally, COVID-19 related stigma and fear of transmission may intensify depression, anxiety, and stress symptoms. This study determined the prevalence of depression, anxiety, and stress symptoms and their association with presence of COVID-19 symptoms and comorbid conditions among home isolated COVID-19 positives in the Karnali province, Nepal. Methods: We conducted a cross-sectional study to assess depression, anxiety, and stress symptoms among 402 home isolated COVID-19 patients of Karnali province from January to May 2021 using "Depression, Anxiety and Stress Scale-21 (DASS-21)". We interviewed patients to collect socio-demographic, DASS-21, COVID-19 symptoms, comorbid conditions, and self-treatment. We conducted a telephonic interview using a standardized questionnaire using Kobotoolbox. We calculated the prevalence of depression, anxiety, and stress symptoms. We utilized univariate and multivariate logistic regression to determine their association with the presence of COVID-19 symptoms and comorbid conditions. In multivariate logistic regression, we adjusted sociodemographic factors (age, gender, ethnicity, marital status, monthly family income, education level), smoking status and history of self-treatment. We reported adjusted odds ratios (aOR) with 95% confidence intervals. All analyses were conducted in R (version: 4.0.3). Results: The prevalence of depression, anxiety and stress symptoms among home isolated COVID-19 patients were 8.0% (95% CI: 5.5 to 11.1), 11.2% (95% CI: 8.3 to 14.7), and 4.0% (95% CI: 2.3 to 6.4) respectively. Higher odds of depression symptoms (aOR: 2.86; 95% CI: 1.10-7.44, p = 0.03), anxiety symptoms (aOR: 3.81; 95% CI: 1.62 to 8.93; p = <0.01) and stress symptoms (aOR: 7.78; 95% CI: 1.43 to 42.28; p = 0.02) were associated significantly with presence of COVID-19 symptoms in past week. Higher odds of anxiety symptoms were associated with the presence of comorbid conditions (aOR = 2.92; 95% CI: 1.09 to 7.80; p = 0.03). Conclusion: Depression, anxiety, and stress symptoms were present in a significant proportion of home isolated COVID-19 patients in western Nepal and positively associated with the presence of COVID-19 symptoms. In this global COVID-19 pandemic, it is important to provide timely counseling to high-risk groups like those with comorbidities and COVID-19 symptoms to maintain a high level of mental health among home isolated COVID-19 patients.

Validation of the Cancer Stigma Scale in Nepalese Women.

BACKGROUND: Cancer stigma is known to have an adverse impact on cancer patients as well as vulnerable groups who are at risk of developing cancer. In Nepal, there is no validated instrument for assessing cancer stigma and there has been relatively little research examining the stigmatization of cancer among the Nepalese population. OBJECTIVE: We aimed to validate the Cancer Stigma Scale (CASS) among apparently healthy Nepali women. METHODS: We interviewed 426 Nepali women after the translation, back-translation, and cross-cultural adaptation of the CASS into Nepali. We assessed internal consistency using Cronbach's alpha and assessed model fit using confirmatory component analysis. RESULTS: The Nepali CASS had satisfactory internal reliability, Cronbach's alpha of the overall scale and six components was 0.88 and 0.70-0.89, respectively. Confirmatory factor analysis confirmed the six-factor structure (RMSEA = 0.074, GFI = 0.864, AGFI = 0.825, CFI = 0.901, NFI = 0.866, χ2/df=3.341). Having no formal education was associated with higher levels of stigma related to avoiding cancer patients and attributing cancer to personal responsibility. CONCLUSIONS: The Nepali CASS demonstrated sufficient internal consistency, reliability, and model fit indices, making it suitable for assessing cancer stigma among Nepali people.

Impact of yoga and physical exercise on psychological wellbeing among substance abusers: a randomized controlled trial.

OBJECTIVES: Substance use disorder is a pattern of recurrent use of illicit substances that leads to severe psychosocial imbalance and recurrent relapse. The study was to evaluate the efficacy of a yoga-based intervention as an add-on in enhancing psychological wellbeing, compared with physical exercise among substance abusers. METHODS: In this randomized controlled study, 96 male participants with substance use disorder from a residential rehabilitation treatment center, Kathmandu, Nepal, were randomly allocated into two groups namely the yoga group (n=48, mean age ± SD=25.18 ± 6.43) and the physical exercise group (n=48, mean age ± SD=25.02 ± 5.02). The participants in the yoga group attended the 90 min yoga sessions for 12 weeks (six days per week) whereas the physical exercise group attended exercise sessions for the same duration. Above mentioned interventions were in addition to standard rehabilitation treatment. The study measured the Self-Control, Anxiety, Depression, Sleep parameters, and Mindfulness at the baseline and after 12 weeks of intervention. RESULTS: A significant enhancement in self-control was observed in both the yoga (p<0.033, d=0.33) and the exercise group (p<0.038, d=0.32). Yoga group showed significant improvement in mindfulness score (p<0.017, d=0.37), whereas exercise group did not show any significant changes in mindfulness (p<0.169, d=0.21). The depression and anxiety scores reduced significantly in both yoga (p<0.044, d=0.31; p<0.025, d=0.35 resp.) and exercise (p<0.032, d=0.34. p<0.039, d=0.32. resp.) group. Furthermore, significant reduction was seen in sleep disturbance after yoga (p<0.001, d=0.52) and exercise (p<0.001, d=0.78) intervention. The sleep - somnolence score reduced significantly only in yoga group (p<0.020, d=0.36). The magnitude of improvement was higher in the yoga group than physical exercise group on self-control, mindfulness, depression, anxiety and some sleep parameters, however the between group differences could not reach to the level of significance. CONCLUSIONS: The 12 week yoga intervention did not appear to be significantly more effective than the 12 week physical exercise program on psychological wellbeing in male participants with substance use disorder. However, greater improvement in psychological wellbeing was observed within the yoga group. In future, a multi-centric study with robust design, larger sample size and longer follow-up is required to conform the present results and to find out the difference between the impacts of yoga and physical exercise on psychological wellbeing in substance abusers.

The Impact of Basic Police Training and Scale Diet on Body Composition and Aerobic Performance of Nepal Police Officers Trainees.

INTRODUCTION: Executing their daily duties, police officers are expected to perform complex, physically demanding activities, often at maximal levels of exertion. Given these criteria, training must be rigorous enough to ensure that when trainees graduate, they are competent in their response to crisis and flexible enough to sustain this for the span of their career. The present study aimed to determine the impact of scale diet and physical training (SDPT) on body composition and aerobic performance among Nepal police officer trainees. METHOD: We conducted a cross-sectional analytic study among 570 Nepal Police recruits from Nepal Police Academy of Butwal and Kathmandu. Null hypothesis was created followed by an alternative hypothesis. Alpha (1 - ?) for the above-mentioned study design were set. Parametric statistical analysis was done with criteria set for acceptance or rejection of the null hypothesis. We collected the data from the field as per Nepal police basic exercise and diet  protocol to determine the effect of physical training and scale diet on body composition and aerobic performance. We enrolled all the recruits  from March to May, 2019 who met the eligibility criteria in the study. We used Microsoft Excel 2013 for data entry and R program (version: 4.0.3) for statistical analysis.  Results:There was a significant rise in aerobic performance (4.51 ± 3.39 ml/kg/min) and remarkable reduction in body fat (-4.49 ± 2.33 %) and Body Mass Index (-0.433 ± 1.00 kg/m2) after SDPT among participants with normal BMI at the time of recruitment. Body fat was significantly reduced (-4.36 ± 2.3%) and aerobic performance was significantly increased (6.93±4.70 ml/kg/min) among overweight participants at the time of recruitment. CONCLUSIONS: The methodology adopted in the physical training of Nepal Police was effective in reducing body mass index and fat, improving the physical capacity. .   Key words: Scale Diet; Physical Training, Body Fat; Aerobic Performance; VO2max, Body Mass Index.

Health problems of nepalese labor migrants: A scoping review.

Labor migrants (LMs) often work in precarious work environments and are exposed to various health risks. There is a lack of information on the health of international Nepalese LMs (NLMs). This scoping study was conducted to assess the health problems of international NLMs based on the six-stage scoping review process of Arksey and O'Malley. A literature review and stakeholders consultation related to NLMs' health information were conducted. A total of 455 studies were identified of which 38 studies were potentially relevant based on title and/or abstract screening, and a total of 16 studies were finally included and assessed. The literature showed that the health problems incurred by NLMs are mainly mental health problems; accidents, injuries, and infectious diseases. The Foreign Employment Board is the main public stakeholder which records deaths and disabilities of NLMs. The record showed that there were a total of 3,752,811 labor permits approval, a total of 7467 deaths, and a total of 1512 disabilities among NLMs during the 11 years from 2008-2018. There is a need to have a better investigation of causes of death and disability among NLMs to assign scientific causes of death. Predeparture orientation on mental health coping strategies, labor rights, health-care accessibility options in destination countries, traffic safety, and infectious diseases should be instituted.

COVID Stress among Nepal Police Officers.

BACKGROUND: In Nepal, the stress factor is exacerbated by a large number of police officers working away from home with less family contact, a hectic work schedule in a pandemic situation, companions suffering from illness and updates on additional cases with rising mortality rates, and a lack of access to Personal Protection Equipment. The main aim of this study was to identify the prevalence of COVID stress among Nepal police officers working during pandemic. METHODS: We conducted a cross-sectional study among police officers (n=1526) working during pandemic in Province X Nepal. Semi-structured questionnaire was administered using google form. COVID Stress Scale -36 (CSS-36) was used to assess the stress in officers. Data collection was done after obtaining ethical approval. Data cleaning was done using a python script and then was exported to Ms. Excel for graph analysis. RESULTS: The highest percentage was seen in the xenophobia subscale (24.63%), followed by contamination (20.10 %) and compulsive checking (19.21%). Comparing socio-demographic variables, 18-27 aged groups including male officers and unmarried groups had experienced high COVID stress. CONCLUSIONS: Most of the officers feared from the foreigners perceiving them the main source of COVID-19. Fears about getting contaminated related to COVID-19 was also seen high. There is a need to assess psychological issues and provide social support to police officers during this pandemic situation.

Prevalence of Type 2 Diabetes among Patients Visiting Nepal Police Hospital in Kathmandu: A Descriptive Cross-sectional Study.

INTRODUCTION: The growing prevalence of diabetes mellitus (DM) is a critical threat for global health, including in Nepal, especially in Kathmandu District, where diabetic patients are increasing in hospitals catastrophically. This study tends to assess the prevalence rate of type 2 diabetes among admitted patients visiting a hospital in Kathmandu. METHODS: An electronic chart review was done to assess the prevalence of type 2 diabetes in Nepal Police hospital, Kathmandu, Nepal. Ethical approval was taken from the Nepal Health Research Council. Considering eligibility criteria, 8631 cases from 4 May 2018 to 31 August 2020 were observed. The calculated sample size was 500. However, all diabetic cases, i.e., 576, were processed and analyzed using Python and later visualized using MS Excel. RESULTS: The overall prevalence rate of type 2 diabetes was 6.67%. The prevalence rate was seen higher among males (7.5%). Similarly, a high prevalence rate was seen among 64-73 years, i.e., 15.10%. CONCLUSIONS: The findings showed a high prevalence rate of type 2 diabetes. Older age groups are at high risk. Urgent public health interventions including lifestyle modification measures are required to reduce the extra burden of type 2 diabetes.

Child Sexual Abuse among School Children of a Municipality: A Descriptive Cross-sectional Study.

INTRODUCTION: Sexual abuse remains a hidden and underreported form of violence against children and a serious public health concern. Although it results in severe mental, physical, and psychological risks with consequences such as depression, fear, and low self-esteem, it is still an unexplored and less prioritized area in Nepal. The objective of this study was to determine the prevalence of Child Sexual Abuse among school children of a municipality. METHODS: This was a descriptive cross-sectional study, conducted among 405 students, aged below 18 of Mandan-Deupur Municipality, Kavrepalanchowk from April to May 2018. Ethical clearance was taken from Nepal Health Research Council (Ref no 2506). A simple random sampling technique was used to select the schools. Collected data were then entered and analyzed using Statistical Package for Social Sciences version 16. Point estimate at 95% Confidence Interval was calculated along with frequency and percentage. RESULTS: In overall, 64 (15.8%) (12.4-19.7 at 95% Confidence Interval) were found to be sexually abused, where a high prevalence of Child Sexual Abuse was reported for boys 46 (73.43%). CONCLUSIONS: According to the findings of this study, child sexual abuse is seen as a significant issue in the place studied. Awareness programs on child sexual abuse should be organized targeting children along with parents and community people.

Knowledge and Practice of Complementary Feeding among the Mothers of the Child Aged Group 6-24 Months, Tanahu Distirct, Nepal.

BACKGROUND: Early and late introduction of complementary feeding is associated with increased morbidity and nutritional deficiencies in children. In 2016, the under 5 mortality rate of Nepal was 39 deaths per 1000 live births and around 1 million under 5 children had suffered from chronic malnutrition. The main aim of this study was to identify the level of knowledge and practice regarding complementary feeding among the mothers of children aged group 6 to 24 months in Bhanu Municipality, Tanahu District, Nepal. METHODS: A descriptive cross-sectional study was conducted with 158 mothers of children age group 6 to 24 months from ward number 1 and 2 in Bhanu Municipality, Tanahu District, Nepal. Data collection was done after taking ethical approvalby using a semi-structured questionnaire via face-to-face interviews. Collected data were entered and descriptive analysis was carriedout in Statistical Package for the Social Services version 20. Categorical variables were presented using frequency and percentage. Clopper-pearson method was used to determine 95% confidence interval. RESULTS: Out of 158 respondents, 26.6% (95%CI:19.9,34.2) had inadequate knowledge, whereas 73.4% (95%CI:65.8, 80.1) had adequate knowledge on complementary feeding. Likewise, the study revealed that 51.9%(95%CI: 43.8, 59.9) did the right practice, while 48.1%(95%CI: 40.1,56.2) were involved in the wrong practice on complementary feeding. Only 39 % mothers gained the knowledge about complementary feeding from the health workers. 2.5% of mother had exclusively breastfed their child up to just 3 months. CONCLUSIONS: Despite the good level of knowledge about complementary feeding, the wrong practice was prevalent in about half of the mothers. As a result, enhancing existing strategies and developing new intervention measures including capacity building of healthworkers to improve child feeding practices must be mandatory actions for the government and policymakers.

Prevalence of Overweight Among Adult Women of A Metropolitan.

INTRODUCTION: Globally, Overweight has reached epidemic proportions. It is an excessive accumulation of fat that may impair health. Overweight and obesity area major contributor to the global burden of non-communicable disease. The prevalence of overweight is commonly assessed by using Body Mass Index (BMI), where overweight is indicated by BMI greater or equal to 25. Overall, about 13% of the world's adult population was obese in 2016, among them women were more affected than men. Overall,female population is higher than male in Nepal and concentrating on Kaski district female population are significantly more than that of male as per population census of 2011. The objective of this study was to find out the prevalence of overweight among adult women. METHODS: This was a cross-sectional descriptive study, conducted among calculated sample size of 185 adult women of Lekhnath Metropolitian of Kaski district, over six months' period. Sampling technique was proportionate random sampling. Ethical approval was taken from Institutional Review Board (Ref no. 40/74/75). Anthropometric measurement was taken to calculate BMI. Collected data was entered in Epi data, which was then exported to SPSS version 20 for further analysis. Descriptive statistics was reported for demographic, socio-economic and various overweight related factors of the respondents as frequencies and percentage. RESULTS: Out of 185 adult women, 69 (37.3%) of them were overweight, 30 (16.2%) of them were obese, and central obesity was seen among 97 (52.4%) women at 95% C.I. CONCLUSIONS: The finding of this study shows prevalence of overweight and obesity was high. Regular Physical exercise and balanced diet should be followed to prevent overweight and noncommunicable diseases.

Patient Satisfaction in Out-patient Services at a Tertiary Care Center: A Descriptive Cross-sectional Study.

INTRODUCTION: Patient satisfaction is an important and commonly used valid indicator for the measurement of service quality. Patient responses to healthcare services are one of the best ways to obtain information about patient views regarding the quality of healthcare. The main aim of the study was to find out the patient's satisfaction level in the tertiary care center. METHODS: A descriptive cross-sectional study was conducted among 94 outpatients at a tertiary care center. Data were collected after obtaining ethical clearance from the institutional review committee. Patients were selected conveniently who visited any four of the major department. We collected demographic data and the patient satisfaction towards outpatient clinic experience was studied. We used the Patient Satisfaction Questionnaire-18 to assess patient satisfaction. Data were entered and analyzed in Statistical Package for the Social Sciences version 23. The mean score and the standard deviation were calculated. RESULTS: Overall satisfaction was 74.78% with a mean value of 3.7394±0.40128. The highest satisfaction score was found in regards to the interpersonal manner of health personnel (4.2872±0.61561) followed by communication (3.9628±0.40982) and the lowest was seen in accessibility and convenience (3.2394±0.81478). CONCLUSIONS: The mean score and percentage of patient satisfaction were high in the hospital. However, the accessibility and availability of medical personnel were only a matter of concern.

Probable Exit Strategy Against COVID-19 of Low Resource Country like Nepal: Open Floor Discussion.

Lockdown is essential for containing the spread of SARS-CoV-2. It is the best measure to maintain extreme social distancing which has been effective in controlling the infection and saving lives. But they are causing huge loss economically, disrupting social life and causing distress around the world. Reopening too quickly or too boldly without a goal-oriented strategy could mean a second wave of infection as fierce or even worse as the first. The fundamentals of the virus remain the same - one infected person will, without a lockdown pass it onto three others on average. The consequences of lifting the lockdown are unforeseeable and the stakes are high. Due to the different spectrum of severity with same strain of virus and uncertainty of post lockdown era, lifting the lockdown will be a trial and error approach. Nevertheless, at some point the lockdown has to be lifted. The strategic approach would be innumerable testing, investigations, strong contact tracing, isolation and follow-up. In a low-income country like Nepal, this will mean negotiating a tricky balance between terminating the spread of SARS-CoV-2, and allowing people to recover their livelihoods before they slip into extreme poverty and anguish.

Prevalence of Postpartum Depression in a Tertiary Health Care.

INTRODUCTION: Postpartum Depression is an important public health problem in developing country like Nepal.Although prevalence of postpartum depression is high in our setting, it is most neglected area of mental health. These have negative consequences not only to mother but also to infant. Data related to postpartum depression in Nepal are limited, research in this particular field will contribute in knowing the gravity of the situation and helps to formulate the factor association to upcoming researchers. This research is done in order to find out the prevalence of postpartum depression. METHODS: A descriptive cross-sectional study was carried out in Paropakar Maternity and Women's Hospital, among total 348 postnatal mothers who were selected through convenient sampling technique. Validated Nepalese version of Edinburg Postnatal Depression Scale was used to screen depressive symptoms. Data was collected after receiving ethical approval letter. Data entry was done using SPSS version 20. RESULTS: Out of total mothers, the prevalence of Postpartum Depression (PPD) was seen among 51 (14.7%) mothers. CONCLUSIONS: Postpartum Depression being a common yet neglected area of maternal health in Nepal, should be detected in early stage. As the study showed that about one sixth of mothers had postpartum depression, more focus should be given to maternal mental health.