Journal Issue: Vol. 21 No. 03 (2023): Issue 60 July-Sep
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1999-6217
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From Rhetoric to Reality: Embracing Evidence-Based Policy for Lasting Impact
(Nepal Health Research Council, 2023) Thapa, Tulsi Ram; Paudel, Krishna Prasad
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Awake Prone Positioning In COVID Positive Patients: A Retrospective Study
(Nepal Health Research Council, 2023) Dangol, Shova; Poudel, Dipesh; Shrestha, Surendra Man; Rawal, Prabhat; Shrestha, Kundu
Abstract
Background: While the advanced health care settings are struggling hard to handle the sudden surge of COVID-19 cases, resource poor settings in developing countries like Nepal can barely stand to fight the increasing number of severe cases. Easily available cost effective interventions would be great blessing for such settings. This study aimed to study if awake prone positioning can be used as such intervention in COVID 19.
Methods: The retrospective study involved 150 patients admitted between November 2020 and January 2021 at Nepal Armed Police Force Hospital and met specific inclusion criteria. Data was obtained at four different time points in relation to prone position and was analysed using International Business Machines Statistical Package for the Social Sciences (SPSS) version 23.
Results: It was found that among 150 patients, majority (109; 72.7%) were males and 60(40%) had some comorbidities. The mean oxygen saturation was found to increase significantly from 87.18 %(SD 3.531) to 91.08(SD 2.206) after fifteen minutes of prone positioning. One way ANOVA test showed that there was significant difference in oxygen saturation between at least two time points. (F (3,596) = [180.005], p=0.000). Games Howell Post Hoc test for multiple comparisons showed that the mean value of SPO2 was significantly different across all four time points, at significance level 0.05.
Conclusions: This study found Awake Prone positioning as a promising cost effective and feasible intervention for improving oxygenation in COVID 19 and thus could be a blessing to the resource poor health care settings.
Keywords: Awake prone; COVID-19; oxygen saturation; resource-poor.
Morbidity and Mortality Profile of Neonates Admitted in Neonatal Intensive Care Unit
(Nepal Health Research Council, 2023) Paudel, Pradip Kumar; Bhandari, Prakreeti; KC, Nawaraj; Devkota, Bibek
Abstract
Background: The neonatal period faces the greatest risk of death as they are vulnerable to sepsis, birth asphyxia, hypoxic injuries etc. A substantial disparity exists in NMR between Nepal and other developed countries and among different provinces of Nepal as well. This study was conducted to describe the pattern of neonatal admission, and immediate hospital outcomes from NICU located in a remote part of Nepal.
Methods: This prospective study was conducted in The Province Hospital, Karnali, Nepal over a period of six months (June 2021 to Dec 2021 AD). The variables used were neonatal age, sex, gestation, birth weight, maternal age, mode and place of delivery. Neonatal morbidities and final outcomes at discharge were recorded in a predesigned proforma.
Results: A total of 396 neonates included, the majority were inborn 283(71%), male 241(61%), term 301(76%) and had normal birth weight 279 (70.4%). Neonatal sepsis 188(37.2%), prematurity 95(24%), and birth asphyxia 55(15.2%) were main indications for hospitalization. The majority 337(85%) improved after treatment, while 33(8.3%) died, 12 (3%) left against medical advice and 14(3.5%) cases were referred. Preterm neonates had thrice the risk of mortality than term neonates (OR =3.27). Low birth weight (< 2500 grams) had higher odds of poor outcomes (OR =3.5). Low maternal age (<20 years), prematurity, LBW, mechanical ventilation and inotrope use were predictors of poor outcomes.
Conclusions: Neonatal sepsis, prematurity and perinatal asphyxia were the most common causes of NICU admissions. Mechanical ventilation, inotropes use, extreme prematurity, low birth weight and younger age of the mother were predictors of poor outcome.
Keywords: Karnali; morbidity; mortality; neonates.
Translation and validation of Bristol Female lower urinary tract symptoms (BFLUTS) questionnaire for Nepali speaking women
(Nepal Health Research Council, 2023) Thapa, Baburam Dixit; Regmi, Mohan Chandra; Basnet, Tulasa
Abstract
Title: Translation and validation of Bristol Female lower urinary tract symptoms (BFLUTS) questionnaire for Nepali speaking women
Introduction: Bristol female lower urinary tract symptoms questionnaire (BFLUTS) was designed to identify the lower urinary tract symptoms (LUTS) in women. It aids in determining the severity of lower urinary tract symptoms and how they affect sexual function and quality of life.It can be employed in research and therapeutic practice. It is not available in Nepali version. As a result, our goal is to translate and validate the BFLUTS questionnaire in Nepali.
Methods: The BFLUTS questionnaire has been translated into Nepali. From March 1, 2020 to February 28, 2021, 225 Nepalese patients with lower urinary tract symptoms were evaluated using a Nepali version of the BFLUTS questionnaire adapted from the English version. Internal consistency, test-retest reliability, validity, and change responsiveness were all assessed.
Results: A total of 225 patients were enrolled in the study. The missing data was less than 2%. The Nepali version of the BFLUTS questionnaire showed good reliability (? = 0.76; ICC= 0.934). Test-retest reliability was assessed with weighted kappa (?) ranging from 0.71 to 0.83.It showed good sensitive to change before and after the treatment. Mean BFLUTS scores correlated strongly with the symptomsof lower urinary tract symptoms reported in the bladder diary with ? ranging from 0.689to 0.859.
Conclusions: The Nepali version of BFLUTS questionnaire is a reliable, valid and consistent for measuring lower urinary tract symptoms and their effect on sexual function and quality of life.
Keywords: BFLUTS; LUTS; Nepali; Reliability; Validity.
Immediate Effect of Physiotherapist-demonstrated Action Observation with Execution for Improving Upper Extremity Motor Function in Stroke: a Pre-post Pilot Study
(Nepal Health Research Council, 2023) Shrestha, Shaj; Shrestha, Nistha; Shrestha, Abhishek Dhalachhe; Adhikari, Shambhu Prasad
Abstract
Background: Video-demonstrated action-observation-execution is an effective intervention for motor re-learning in stroke rehabilitation. But customization of video for each task repeatedly questions its feasibility within limited resources, particularly for daily routine practice and in community settings. Physiotherapist-demonstrated action-observation-execution is a practical intervention based on the principle of observation and consecutive repetitions of observed real, live movements. The main objective of this study was to investigate the immediate effect of Physiotherapist-demonstrated action-observation-execution in upper extremity motor training in stroke.
Methods: Individuals with stroke were screened and 5 eligible participants were recruited. The research was a pre-post. A single session of Physiotherapist-demonstrated action-observation-execution was administered. A functional “Drinking” task was subdivided into simpler acts and trained. Pre and post intervention assessment of movement time using five hand-and-arm items of Nepali Wolf Motor Function Test were carried out. Global recovery was assessed in the form of Visual Analogue Scale.
Results: Paired t-test provided statistically significant difference in total movement time (mean difference=5.04 seconds, standard deviation=1.92, p=0.004) with larger effect size (0.95) indicating impressive improvement in movement time with the training. Substantial difference in global recovery score was noted (mean difference=17.40, standard deviation=3.65, p<0.0001, effect size=1.00) signifying the increased confidence and improved performance of upper extremity post treatment.
Conclusions: The findings indicated that Physiotherapist-demonstrated action-observation-execution could be a feasible intervention to train motor functions in participants with stroke. Large-scale studies are recommended to establish the effectiveness of the intervention.
Keywords: Action-observation; action-execution; hand function; mirror neuron; stroke.