Journal Issue: Volume: 20, No 2, Issue 82, APRIL - JUNE, 2023
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Volume
Number
Issue Date
2023
Journal Title
Journal ISSN
1812-2027
Journal Volume
Articles
Artificial Intelligence in Medical Practice: The Promise and the Challenges
(Kathmandu University, 2023) Shrestha, BL
NA
A Qualitative Evaluation and Cross-Cultural Adaptation of the Short Form of the Sense of Coherence Scale (SOC-13) in Nepali
(Kathmandu University, 2023) Thapa, DR; Subedi, M; Ekström-Bergström, A; Areskoug Josefsson, K; Krettek, A
ABSTRACT
Background
Sense of Coherence (SOC) relates to an individual’s overall life orientation, and
stronger SOC is associated with better health, quality of life, and coping strategies.
When our research group used the SOC-13 questionnaire for the first time in Nepal,
we identified difficulties in response patterns. The findings necessitated further
evaluation of the Nepali version of the SOC-13 questionnaire.
Objective
To qualitatively evaluate the SOC-13 questionnaire in Nepali for cross-cultural
adaptation.
Method
Nineteen nurses were interviewed. We used the methodological approach of
“think aloud” to obtain a deeper understanding of the interferences of the scales.
Transcribed materials were analyzed using a deductive approach through qualitative
content analysis. The original translated version of the SOC-13 questionnaire in
Nepali was modified by replacing words that were easier to understand.
Result
Participants found the questionnaire content general and non-specific but easy
to complete. The nurses experienced that the meanings and sentences in some
of the items and response alternatives were difficult to understand. However, the
overall comprehensiveness of most items and response alternatives was perceived
as good. Nurses’ interpretation of the SOC-items in the translated version of the
SOC-13 questionnaire in Nepali matched the original English version. Items that
were experienced as difficult in the Nepali language were modified to increase their
comprehensiveness. Modified items and response alternatives had the same content
as before, but some words and meanings were substituted with easier language.
Conclusion
The current revised version of SOC-13 in Nepali is valid and useful to explore
individuals’ overall life orientation and their abilities to deal and cope with various
life events in the Nepalese context.
KEY WORDS
Health resources, Qualitative validation, Resources, Ralutogenesis, Sense of
coherence
Violence Exposed Nepalese Pregnant Women have an Accepting Attitude to Domestic Violence and Suffer from Emotional Distress
(Kathmandu University, 2023) Pun, KD; Bjørngaard, JH; Schei, B; Darj, E; The ADVANCE Study Group
ABSTRACT
Background
Violence against women and girls is frequent, a third of all women is estimated to
experience violence in their lifetime and mostly by an intimate partner. Women in
Southeast Asia are most affected, and previous studies in Nepal found that one in
five women had experiences of domestic violence, including being afraid of someone
in the family.
Objective
To investigate women’s attitudes to domestic violence and their emotional distress,
in a specific group of pregnant women.
Method
Validated questions from the WHO multi-country study on women’s health and
experiences of domestic violence, and questions from the Hopkins Symptom
Checklist (HSCL-5), measuring depression and anxiety, were used. Women could
answer anonymously by hearing questions in a headset and touching a tablet screen,
for ‘yes’ or ‘no’.
Result
In total 1011 pregnant women participated in the research and 240 women admitted
being exposed to domestic violence (23.7%). These women had a more accepting
attitude to violence compared to non-violence exposed women. They agreed more
that the husband had good reasons to hit his wife, if she does not complete the
household work to his satisfaction, she disobeys or refuses to have sex with him.
Violence exposed women also reported more emotional distress and subsequently
reduced wellbeing. They admitted worrying too much, feelings of hopelessness,
feeling blue, fearful, or nervous.
Conclusion
The present study found that the pregnant Nepali women having an accepting
attitude to violence suffer from emotional distress.
KEY WORDS
Attitudes, Domestic violence, Emotional distress, Pregnant women
Prediction of Postoperative Major Complications in Pancreaticoduodenectomy -a Prospective Comparative Analysis of Braga and WHipple-ABACUS Scores
(Kathmandu University, 2023) Sah, DN; Lakhey, PJ; Bhandari, RS
ABSTRACT
Background
Major complications following pancreaticoduodenectomy have a severely deleterious
effect on postoperative course, rather than just occurrence of pancreatic fistula.
Surgical risk stratification with Braga and WHipple-ABACUS have been proposed and
validated.
Objective
The study aimed at comparing the Braga and WHipple-ABACUS scores for prediction
of major complications following pancreaticoduodenectomies.
Method
This was a prospective observational study at the Tribhuvan University Teaching
Hospital from February 2018 to April 2019. After ethical approval, all consecutive 41
patients who underwent pancreaticoduodenectomies were included. Each patient
was graded in Braga and WHipple-ABACUS scores. Perioperative events occurring
over 30 days were graded as per Clavien -Dindo complications for pancreatic
surgery. The predictive value of the scores were assessed using a receiver operating
characteristic curve analysis. The categorical data were compared using the Pearson
χ2 test or Fisher’s exact test.
Result
Over period of 14 months, total of 41 patients (M:F=2.15:1) with median age of 58
years (range, 21-86) underwent pancreatoduodenectomy. The mean scores were
Braga (4.6±3.1) and WHipple-ABACUS (1.8±1.6). Major complications over 30 days
were developed in 11 patients with five mortality. There were significant differences
in mean values of Braga score (7.0±3.4 vs 3.7±2.6, p-value=0.02) and WHipple-
ABACUS score (3.2±1.8 vs 1.3±1.3, p-value=0.01) in patients with major complications
to those without respectively. The area under curves for Braga and WHipple-ABACUS
scores were 0.800 and 0.779 respectively.
Conclusion
Both WHipple-ABACUS and Braga scores are easy to calculate and predict
the development of major complications significantly in patients undergoing
pancreatoduodenectomy.
KEY WORDS
Braga score, Pancreaticoduodenectomy, Post-operative pancreatic fistula, WHipple-
ABACUS score
Analgesic Efficacy of Fascia Iliaca Compartment Block for Positioning During Spinal Anesthesia in Patients with Femur Fractures
(Kathmandu University, 2023) Jha, A; Khatiwada, S; Pokharel, K; Ghimire, A; Singh, SN; Prasad, JN
ABSTRACT
Background
Positioning patients with femur fractures for spinal anesthesia is associated with
excruciating pain. Fascia iliaca compartment block has the potential to block all
nerves supplying the femur and therefore may provide effective analgesia during
positioning these patients for spinal anesthesia.
Objective
To assess the analgesic efficacy of Fascia iliaca compartment block, during positioning
patients with femur fracture for spinal anesthesia. We also assessed the duration of
analgesia and the requirement for rescue analgesics in the postoperative period.
Method
Seventy adult patients with fracture femurs were randomly divided into two equal
groups (A and B). Patients in both groups received fentanyl one mcg/kg intravenously,
20 minutes before positioning them for spinal anesthesia. Patients of group B
additionally, received ultrasound-guided Fascia iliaca compartment block with 40
ml of 0.25% Ropivacaine, immediately after intravenous fentanyl. Numerical rating
score (0-10) was used for the assessment of pain at five, 10, and 20 minutes after the
block and immediately after positioning patients for spinal anesthesia.
Result
Immediately after positioning patients for spinal anesthesia, the numerical rating
score of pain was 5.06±1.5 in group A and 2.49±1.2 in group B (p<0.001). The duration
of analgesia was 799.7±62.1 minutes in group B and 314.65±118.9 minutes in group A
(p<0.001). One (2.8%) patient of group B and 18(51.4%) patients of group A required
rescue analgesics within four to twelve hours in the postoperative period (p=0.001).
In group A, seven patients were satisfied with the analgesia technique while in group
B, 17 were satisfied and eight patients were strongly satisfied (p<0.001).
Conclusion
Ultrasound-guided Fascia iliaca compartment block is effective in reducing pain
during positioning patients with femur fractures for spinal anesthesia. Patients
receiving this block had a prolonged duration of analgesia, required lesser analgesics,
and were more satisfied in the postoperative period as compared to patients not
receiving the block.
KEY WORDS
Fascia Iliaca compartment block, Positioning, Postoperative analgesia