Browsing by Author "Adhikari, Ramesh"
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Publication Awareness of Breast Self-Examination among Female Community Health Volunteers of Pokhara(Nepal Health Research Council, 2022) Koirala, Dipti; Silwal, Muna; Pokhrel, Sushila; Adhikari, RameshAbstract Background: Breast self-examination is a simple, inexpensive and effective method of examining the breast by woman herself after 20 years of age in order to detect a breast lump in the early stage. Women should have this knowledge for early detection and treatment of breast cancer. So, the present study aimed to assess awareness of female community health volunteers regarding breast self-examination and the effect of a teaching program. Methods: One group pre-test post-test study was conducted among 145 female community health volunteers selected from eight wards of Pokhara Metropolitan using convenient sampling technique. Data was collected using a self-administered questionnaire from 27 March to 23 April 2022. Descriptive and inferential statistics were used for data analysis. Results: Before intervention, around two third of respondents (67.6%) had inadequate and only 1.4% had adequate level of awareness. But after the intervention, 68.3% had adequate level of awareness. The post-test mean awareness score (23.87 ± 4.7) was higher than pre-test mean awareness score (12.97 ± 3.93). Test of significance revealed that increment in the awareness due to a structured teaching program was highly significant (p <0 .001). This study also found that there was difference in the mean pretest awareness score according to educational level of the respondents only. Based on the mean score, the score was significantly higher among women with higher level of education (p=<.001). Conclusions: Around two thirds of female community health volunteers have inadequate level of awareness regarding breast self-examination before the intervention. Educational intervention program was found to be effective in improving their awareness. Keywords: Awareness; breast; self-examinationPublication Cervical Cancer Screening Services in Nepal: A Descriptive Crosssectional Study(Nepal Medical Association, 2024) Lal, Bibek Kumar; Bhatta, Ghanshyam Kumar; Adhikari, Ramesh; Karn, Abhishek; K.C, Ranju; Nyaupane, Sujata; Adhikari, Anuska; Shrestha, Binita; Shrestha, Merina; Bhattarai, Pankaj; Sah, Sujit; Shrestha, BijayaAbstract Introduction: Cervical cancer, the most prevalent cancer among women, is also the primary cause of cancer-related deaths in reproductive age women in Nepal. The study aims to assess the situation of cervical cancer screening services in Nepal. Methods: This cross-sectional study used quantitative methods to understand the situation of cervical cancer screening in 572 health facilities of Nepal. The research was conducted to assess screening facilities, the allocation of separate screening rooms, the availability of screening services on a routine basis throughout the week, screening facilities that are free of charge, human resources, and the availability of treatment. It was conducted in October to December 2022. Results: The research was carried out among 572 healthcare facilities, out of which 134 (23.42%) had provision for cervical cancer screening services. Ethical approval was obtained from the Nepal Health Research Council (NHRC) under reference number 397/2022 P. Amongst those 134, 72 (53.73%) healthcare facilities had assigned separate rooms for screening intentions. One hundred and two (76.12%) healthcare facilities provided regular screening services throughout the week, while 112 (83.58 %) had free-of-charge screening services. Concerning trained personnel, 121 (90.30%) health facilities had personnel trained in visual inspection with Acetic acid, 9 (6.72%) had personnel trained in use of colposcopy, and 5 (3.73%) had personnel trained in use of Loop Electrosurgical Excision Procedure (LEEP). Lastly, 31 (23.13%) healthcare facilities offered treatment choices for cervical cancer. Conclusions: Most of the health care facilities did not have provision of cervical screening. Amongst those who had the provision, personnel trained in loop electrosurgical excision procedure colposcopy.