Journal Issue: Volume: 28, No. 1 (2026)
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Volume
Number
Issue Date
2026
Journal Title
Journal ISSN
Online ISSN: 2676-1424; Print ISSN: 2676-1319
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Articles
Health expenditures in the families and its relation to non communicable diseases and multi-morbidity amongst its adult members in selected wards of Kageshwori Manohara Municipality, Kathmandu, Nepal
(Nepal Medical College Pvt. Ltd., 2026) Shrestha, Niraj; Shrestha, Binita; Shrestha, Kristina
Abstract:
Healthcare services, one of the basic necessities of life, are meant to provide social protection to the households but its rising cost has put financial burden on them. The rise in the prevalence of non-communicable disease as well as multi-morbidity as a result of increased life expectancy has added to this cost burden the households as the treatment is likely to be needed throughout the lifetime. As a part of National Health Insurance Program in an attempt to address the problem of high healthcare expenditures, the local government has recruited enrollment assistants from each ward to conduct home visit, explain families about the benefits of health insurance and enroll them in this national scheme. Hence it is very important that the data related to health expenditures incurred by family members in a year is available in the wards. Community based survey was carried out in ward 3 and 2 of Kageshwori Manohara Municipality of Kathmandu District, Nepal, in September 2023 and April 2024, respectively. Out of 848 households covered, annual health cost incurred by the family as a part of their annual income could only be obtained from 793 households (93.5%). Out of these households, health cost exceeded 10% of their annual income in 28.4% of the households and this was significantly associated with a household member having a non-communicable disease and multi-morbidity. Households living below the poverty line set at NRs. 200/person/day was seen to be significantly associated with having catastrophic health expenditure i.e. exceeding 10% of their annual income.
Exploring the effect of diversity and its impact on learning among medical students
(Nepal Medical College Pvt. Ltd., 2026) Yadav, Renu; Yadav, Subodh Kumar
Abstract:
As the world becomes increasingly diverse, it is essential for medical professionals to be adequately prepared. This project aims to explore awareness of diversity in the learning environment and perceptions of equity and inclusion in medical school. The methodology used included developing and implementing questionnaire items (23) related to diversity awareness and perception of inclusion in medical school using a 5-point Likert scale. Subsequently an awareness training workshop was conducted. Convenience and snowball sampling technique was used for total n= 247 (pre-workshop), n=210 (post-workshop) participants. A total of 247 (Female=147, Male=100) student’s pre-workshop data followed by diversity workshop training conducted for 210 (Female=125, Male=85), post workshop data was collected. A comparison of pre- and post- workshop data revealed significant differences in some questionnaire items (1, 3, 4, 7, 8, 11, 13, 15, 22, and 23) that includes awareness of diversity policies, valuing and appreciating the differences and understanding the learning perspective. These findings suggest that existing diversity policies are insufficient on their own. Implementing comprehensive awareness programs is essential to fostering understanding, respect, and a sense of belonging, thereby enhancing effective learning in diverse populations.
Therapeutic drug monitoring and adverse drug reactions of lithium in patients diagnosed with bipolar affective disorder at a tertiary care center in eastern Nepal
(Nepal Medical College Pvt. Ltd., 2026) Singh, Abhishek; Rauniar, Gajendra Prasad; Nepal, Suraj; Chaudhari, Rajendra Kumar; Sarraf, Deependra Prasad; Verma, Rakesh; Yadav, Shailendra; Chaudhary, Hemanta; Mehta, Priyanka
Abstract:
Lithium is a widely used mood stabilizer in management of bipolar affective disorder but its narrow therapeutic index (0.6–1.2 mmol/L) requires therapeutic drug monitoring to ensure both efficacy and safety. This descriptive cross-sectional study was conducted in the Psychiatry Ward of B.P. Koirala Institute of Health Sciences, Dharan, Nepal, over a period of 9 months (July 2022 to March 2023). Serum lithium concentrations and associated adverse drug reactions following lithium therapy in hospitalized patients with bipolar affective disorder was assessed, while also categorizing serum lithium levels as sub therapeutic, therapeutic, or supra-therapeutic. A total of 46 patients diagnosed with bipolar affective disorder and receiving lithium therapy were enrolled via convenience sampling. The mean age of participants was 29.13±9.25 years, with a male predominance (58.7%). Most patients (63.0%) had serum lithium levels within the therapeutic range (0.6-1.2 mmol/L), while 21.7% were sub-therapeutic (<0.6 mmol/L) and 15.2% were above the therapeutic range (>1.2 mmol/L). The most common adverse drug reaction was hand tremor (33.0%), followed by weight gain (22.7%), difficulty concentrating (16.7%), leukocytosis (7.6%), hypothyroidism (6.1%), nausea (4.5%), polyuria (4.5%) and polydipsia (4.5%). The findings highlights that although most patients achieved therapeutic lithium levels, a significant proportion had levels outside the target range. Routine monitoring of serum lithium levels, along with timely dose adjustments is therefore essential to optimize treatment outcomes and minimize adverse effect.
Effects of wearing facial masks on pulmonary function, oxygen saturation, heart rate and blood pressure during the six-minute walk test in healthy subjects
(Nepal Medical College Pvt. Ltd., 2026) Jha, Rakesh Kumar; Chaudhary, Sailesh; Sapkota, Suraksha; Gupta, Anil Kumar
Abstract:
The widespread use of surgical masks has prompted concern over their physiological effects during exercise, particularly with scarce data from South Asia; this randomized crossover study therefore evaluated 80 healthy young adults in Nepal performing six-minute walk tests with and without a surgical mask, finding that mask use significantly reduced walking distance (537.9 ± 24.9 m vs. 564.8 ± 22.3 m; p <0.001) and post-exercise oxygen saturation (95.8 ± 1.6% vs. 98.1 ± 0.8%; p <0.001), significantly decreased post-exercise pulmonary function (FVC and FEV1; both p <0.01), and led to significantly higher post-exercise heart rate and systolic blood pressure (both p <0.01), indicating a small but measurable physiological burden during light exercise which, while tolerable for healthy young adults, highlights a need for caution and further study in vulnerable populations with cardiorespiratory conditions.
Comparative study of aural packing with antibiotic and steroid cream with antibiotic and steroid ear drops in acute otitis externa
(Nepal Medical College Pvt. Ltd., 2026) Dhungana, Anup; Mishra, Sumedh; Joshi, Rupesh Raj; Shrestha, Shivani; Regmi, Sachita
Abstract:
Acute Otitis Externa (AOE) is a common inflammatory condition of the external auditory canal, typically presenting with acute pain, itching and swelling. Treatment usually involves topical antibiotic-steroid therapy, delivered either as aural packing or ear drops. However, the comparative effectiveness of these two methods in relieving pain has not been well established. This study aims to compare the effectiveness of antibiotic-steroid aural packing versus antibiotic-steroid ear drops in reducing pain among patients with AOE. A comparative prospective study was conducted at Nepal Medical College Teaching Hospital from January to June 2025. A total of 112 adults with clinically diagnosed AOE were enrolled and randomized into two groups: Group 1 received neomycin-betamethasone aural packing, and Group 2 received the same medication in ear drop form. Pain was assessed using the Numerical Rating Scale (NRS) on Day 0, Day 3, and Day 7. Both groups showed significant reductions in pain from baseline to Day 3 and Day 7 (p <0.001). Mean pain scores at Day 0, Day 3, and Day 7 were 7.91, 2.43, and 0.05 in Group 1, and 7.54, 2.29, and 0.05 in Group 2. No statistically significant differences were found between groups at any time point (p >0.05). Antibiotic-steroid aural packing and antibiotic-steroid ear drops are equally effective in relieving pain in acute otitis externa. Given the similar outcomes and greater ease of use, ear drops may be preferred as first-line therapy, while packing may be reserved for cases with severe canal edema or poor drop penetration.