Browsing by Author "Nepal, Samata"
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Publication Evaluation of Errors on Death Certificates(Nepal Health Research Council, 2024) Atreya, Alok; Acharya, Bina; Yadav, Purushottam Prasad; Menezes, Ritesh G; Nepal, SamataBackground: Death certificates provide vital data for disease surveillance and health policy. However, errors are common globally, undermining data reliability. This study analyzed prevalence and types of errors in death certificates at a tertiary hospital in Nepal. Methods: A cross-sectional study reviewed all death certificates issued at Lumbini Medical College, Nepal from April 2020 to April 2022. Certificates were assessed for errors including improper sequencing, absent time intervals, abbreviations, illegible writing, and inaccurate immediate, antecedent, and underlying causes of death as per international guidelines. Errors were classified as major or minor. Results: Of 139 certificates, none were error-free. The most common error was incorrectly or incompletely filling the immediate cause of death (77.7%). Other errors included absent time of death (17.3%), abbreviations (57.6%), illegible writing (22.3%), and omitting the hospital stamp/medical council registration number (8.6%). Based on international criteria, 76.3% had minor errors, 23% had both major and minor errors. Conclusions: This study found a high rate of errors in death certification at a tertiary hospital in Nepal, undermining data accuracy. Regular training and monitoring with feedback are recommended to improve certification practices. Accurate cause-of-death data is vital for healthcare policy and decision-making in Nepal. Keywords: Cause of death; certification; international classification of diseases; major errors and minor errors.Publication Knowledge and Perception of Community Based Integrated Management of Neonatal and Childhood Illnesses among Medical Students at a Medical College: A Descriptive Cross-sectional Study(Nepal Medical Association, 2024) Bhandari, Swasti; Ghimire, Pranish; Lama, Tenzin Lhamo; Nepal, Samata; Joshi, LokAbstract Introduction: Community-Based Integrated Management of Neonatal and Childhood Illnesses (CBIMNCI) is the integrated approach for the management of children’s common health concerns in outpatient primary health care settings and interventions at the family and community level. This study aimed to assess the knowledge and perception regarding CB-IMNCI in medical students studying in the clinical phase of a medical college. Methods: A descriptive cross-sectional study was conducted from February to June 2023 among 218 clinical-year medical students after obtaining ethical clearance from the Institutional Review Committee (Reference number: IRC-LMC-04/M-022). A self-administered questionnaire with CB-IMNCI-related multiple-choice questions was used for data collection and the responses to knowledge-related questions were evaluated using a predefined answer key. The results were expressed in terms of the number and percentage of the participants who answered each questions correctly. Results: Of the 218 students, 111 (50.92%) were male and 107 (49.08%) were female. Among the participants, 164 (75.23%) (70-80% at 95% Confidence Interval) demonstrated basic knowledge of CB-IMNCI, successfully answering 50% or more of the questions. Among the males, 81 (72.97%), and among the females, 83 (77.57%) had basic knowledge of CBIMNCI. In terms of semester-wise distribution, 33(53.22%) in the 5th semester, 43 (82.69%) in the 7th semester, 41 (80.39%) in the 9th semester and 47 (88.67%) were able to answer 50% or more of the questions correctly. Conclusions: This study showed that one fourth of the students lack the basic knowledge about CB-IMNCI. It suggests the need for further work to enhance effectiveness of pre-service CB-IMNCI training.Publication Levonorgestrel Implant Continuation among Postpartum Women Admitted to the Department of Obstetrics and Gynecology of a Tertiary Care Centre(Nepal Medical Association, 2023) Nepal, Samata; Acharya, Shishir; Marhatta, Anu; Shrestha, SajjaAbstract Introduction: Jadelle (Levonorgestrel) implant is a long-acting reversible contraceptives which is recommended for post-partum contraceptive device due to their high efficacy, convenience, and cost-effectiveness. The continuation of Jadelle implant prevents unintended pregnancies and maintain healthy spacing between the pregnancies, thus improving maternal and child health outcomes. However, Government has endorsed the long-acting reversible contraceptives as immediate post-partum contraception, the status of Jadelle implant continuity is unknown. The aim of this study was to find out the prevalence of levonorgestrel implant continuation among postpartum women admitted to the Department of Obstetrics and Gynecology of a tertiary care centre. Methods: A descriptive cross-sectional study was conducted among women who had Jadelle implant inserted within 48 hours of delivery admitted to the Department of Obstetrics and Gynecology at a tertiary care centre. Ethical approval was taken from the Institutional Review Committee. Data from 1 July 2020 to 31 December 2020 were collected between 1 July 2022 to 31 December 2022 from the hospital records. Patients were interviewed after 2 years through phone calls. Convenience sampling method was used. The point estimate was calculated at a 95% Confidence Interval. Results: Out of 157 post-partum women, 145 (92.36%) (88.20-96.52, 95% Confidence Interval) had levonorgestrel implant in-situ. Conclusions: The prevalence of levonorgestrel implant continuation among postpartum women admitted to the Department of Obstetrics and Gynecology was similar to other studies done in similar settings.Publication Prevalence of Medical Student Syndrome among Medical Students of Nepal(Nepal Health Research Council, 2024) Nepal, Samata; Atreya, Alok; Bhandari, Swasti; Sapkota, Laxmi Prasad; Menezes, Ritesh G.; Gnawali, Laxman; Adhikari, KishorBackground: Medical student syndrome (MSS) entails the development of symptoms of the same disease as the one being studied in medical students. This study aimed to determine the prevalence of Medical student syndrome among medical students in Nepal and identify associated factors. Methods: A Cross-sectional study was conducted at Lumbini Medical College Palpa, Nepal on medical students. Google form-based questionnaire was made, and the link was distributed to the students. A cut-off score was derived for Medical student syndrome. Students whose scores exceeded this threshold were categorized as having experienced Medical student syndrome. The responses received from the consenting students were downloaded in a Microsoft Excel spreadsheet and exported to SPSS v 26 and analysed. Results: The overall prevalence of Medical student syndrome was 17.8%. There was no significant difference in Medical student syndrome scores between genders (p = 0.801). However, year of study significantly influenced Medical student syndrome scores (p = 0.001, ?² = 0.069), with final year students reporting higher scores. Conclusions: This cross-sectional study revealed a significant prevalence of Medical Student Syndrome among medical students in Nepal, with nearly 18% reporting symptoms of the condition. Keywords: Hypochondriasis; medical students; mental health; Nepal.Publication Suicidal Ideation Among Medical and Nursing Students(Nepal Health Research Council, 2022) Atreya, Alok; Nepal, Samata; Menezes, Ritesh G; Marhatta, Anu; Ghimire, Sristi; Shah, PalakAbstract Background: Suicidal ideation is a major predictor of suicide attempts. The present study was conducted to compare the prevalence of suicidal ideation and its risk factors among medical and nursing students in Nepal. Methods: An online survey was carried out among a cohort of medical and nursing students of Lumbini Medical College using questions derived from General Health Questionnaire-28 and Patient Health Questionnaire-9. Results:153 medical and 148 nursing students participated in the study. Lifetime suicidal ideation was present in 20.6%(n=62) medical and 13.95%(n=42) nursing students. Suicidal ideation in the last one year was present in 48 medical and 36 nursing students. There were higher odds of suicidal ideation in medical students who had parental neglect, psychiatric disorder, physical and sexual abuse, substance abuse, and academic performance dissatisfaction (p<0.05), whereas the odds were higher in nursing students with psychiatric disorder, parental demands, alcohol consumption, and academic performance dissatisfaction but was not statistically significant. Thematic analysis of the responses for open-ended question for reasons for previous suicide plans or attempts among four medical and eight nursing students revealed relationship issues, history of adverse childhood experiences, academics-related circumstances, and other individual problems as suicide antecedents. Conclusions: Periodic motivational speeches and counselling sessions during all the semesters of professional schooling would help decrease suicidal ideation. Mental health awareness programs for medical and nursing students should be aimed at reducing mental illness-associated stigma and promoting timely professional help-seeking behavior. Keywords: Medical students; Nepal; nursing students; suicidal ideationPublication Unintended Consequences: A Critical Analysis of Nepals Rape Law Reform and Its Impact on Juvenile Justice(Nepal Health Research Council, 2024) Atreya, Alok; Acharya, Apurba; Paudel, Sudip; Nepal, SamataThe increase of the age of consent to 18, with the Muluki Penal Code that came into effect in 2017, created an unintended burden on the juvenile justice system in Nepal. The amendment, drafted to protect minors from sexual exploitation by adults, resulted in the criminalisation of consensual relationships between adolescents. The surge of inmates aged 16 to 18 years is leading Nepal into a crisis in its juvenile correction centres, with overcrowded facilities, decrepit conditions, and increased violence. This crisis was underlined by three deaths in juvenile correction centres at Bhaktapur, Parsa, and Banke up to September 2023. This article explores the legal, social, and ethical dilemmas generated by Nepal's reforms of rape law and advocates for a more nuanced approach in safeguarding vulnerable populations without moralising normal adolescent sexual conduct. This approach is based on the consideration of pending challenges for the juvenile justice system and the development of strategies to reconcile child protection goals with the realities of adolescents' relationships. Keywords: Informed consent; juvenile delinquency; Nepal; rape.