Journal Issue: Volume: 37, No. 1 (2015) April
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Volume
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Issue Date
2015
Journal Title
Journal ISSN
ISSN (Print) : 1993-2979 | ISSN (Online) : 1993-2987
Journal Volume
Articles
Earthquake disaster-associated health effects and the need for improved preventive measures
(Institute of Medicine, 2015) Sherchand, JB
NA.
Health - related Quality of Life of Patients with Coronary Heart Disease Attending a Cardiac Care Centre in Kathmandu
(Institute of Medicine, 2015) Shrestha, R; Shrestha, S
Abstract
Introduction: Coronary heart disease (CHD) is gradually emerging as a major public health problem in many developing countries including Nepal. Consequences of CHD are that it often results in depletion of the health related quality of life (HRQL) of patients. The aim of this study was to assess the HRQL of CHD patients.
Methods: A descriptive cross sectional design was used to assess HRQL of 254 CHD patients attending out-patient department of Shahid Gangalal National Heart Centre (SGNHC), Bansbari, Kathmandu, Nepal. Purposive sampling technique was used for data collection by face to face interview technique using the MacNew Health - related Quality of Life tool.
Results: The results of the study showed that mean ± SD for emotional domain was 3.87 ± 1.01, for physical domain was 3.81 ± 0.88 and social domain was 3.82 ± 0.88 and global score of HRQL was 3.83 ± 0.87 on 7- point likert scale. The different domains of HRQL was significantly correlated with each others. The descriptive statistics of individual domain scores according to level of HRQL was found to be greater in below average group in each domain including global HRQL score.
Conclusions: The HRQL score of CHD patients attending a cardiac centre are below average. Hence, Self-Instructional Module (SIM) on “Living well with CHD” was developed to enhanced quality of life.
Keywords: coronary heart disease, health- related quality of life, cross sectional study, Nepal
Assessment of Health Systems in Relation to Interface Between Malaria Control Programs and Health System Strengthening: Comparative Study Between Nepal and Viet Nam
(Institute of Medicine, 2015) Oraha, H; Sherchan, JB; Pokhrel, BM; Hirayama, T; Huy Nam, Vu; Sherchand, JB
Abstract
Introduction: Malaria control has been a major health issue with high priority in endemic countries and various efforts have been made with the support of foreign assistant partners. In order to implement efficient and sustainable control, integration of the control program into general health system or effective interactions between them is one of the important strategies.
Methods: Studies were conducted in Nepal and Viet Nam. Information obtained from document reviews, interviews, and field surveys were analyzed from the viewpoint of interface between malaria control program and the health system in accordance with six building blocks of a health system, with special emphasis on good practices and challenges in the implementation of the malaria control program.
Results: Among good practices, strong government commitment towards the control programs to strengthen facilities and capacity of health workers at the primary level, utilization of health volunteers, setting up mobile team and intensified education for residents were noteworthy. Key challenges mainly involved remote areas. Introduction of malaria due to population movement and the emergence of new endemic areas have become growing issues. While strengthening of the vertical health program appeared to have some impact on the general health system, particularly at the primary level, dissociation between the vertical control program and horizontal general health system still remains.
Conclusion: It is crucial to implement an effective and equitable malaria control program that responds to these existing challenges and can create a sustainable health system. Addressing these issues will lead to further strengthening of the health system there and eventually lead to the effective implementation of various health programs.
Keywords: malaria control, health system, Nepal, Veit Nam
Frequency and pattern of Skin Disorders in Adolescents in a School of Kathmandu
(Institute of Medicine, 2015) Shrestha, DP; Baral, S; Shrestha, R; Gupta, S; Bhattarai, S; Shrestha, S; Rosdahl, I
Abstract
Introduction: Skin disorders are one of the major causes of morbidity in Nepal. The objectives of this study are to determine the relative frequency and pattern of skin disorders in a cohort of adolescents 9-18 years of age.
Methods: The study was conducted in a residential school of Kathmandu. A detailed information about the study was given to the student members of a school club and they in turn, informed all the other students of the dermatologic health camp, which was conducted subsequently. All students appearing at the camp were examined by a dermatologist and information regarding age, gender, school grade and diagnosis were recorded in a pre-validated format.
Results: In the school there were a total of 950 students (627 m, 323 f). Of them 242 (116 m, 126 f) had skin disorder with a point prevalence of 25.5%. Female students had significantly higher prevalence (29%) than male (18.5%). The most common skin disorders were acne, eczemas and urticaria, and the 10 most frequent diagnoses comprised 87% of all skin conditions.
Conclusion: This study demonstrates that 1/4 of the students had one or more identifiable skin disorders. Despite the wide range of dermatoses, only a few of them accounted for a major proportion of the skin disorders. This study provides data for targeting health care programs for prevention and treatment of skin disorders in this age group.
Keywords: skin disorrders, adolscents, frequency, patttern
Impact of iron and zinc supplementation on child disability screening using the Ten Questions Plus tool in rural Sarlahi District, southern Nepal
(Institute of Medicine, 2015) Wu, LA; Katz, J; Mullany, LC; Khatry, SK; Darmstadt, GL; LeClerq, SC; Tielsch, JM
Abstract
Introduction: The Ten Questions tool was developed in 1984 as a low-cost tool to screen for child disability prior to referral for definitive diagnosis. Iron and zinc contribute to child growth and development, but few studies examine the relationship between supplementation and longer-term neuro-developmental outcomes.
Methods: The Ten Questions Plus tool was administered to caregivers of 1410 children between 1-9 years of age from August 2007 to March 2008 in rural Sarlahi, southern Nepal. Participants had been previously enrolled in a randomized 2x2 factorial trial of daily iron and zinc supplementation between October 2001 and January 2006.
Results: Nearly 30% of the sample screened positive for disability. The most common problems were learning disability (12.3%) and motor milestone delay (11.3%). Children supplemented with zinc were less likely to screen positive overall, and for motor and learning problems. Children supplemented with smaller doses of iron were more likely to screen positive overall, and for physical, and cognitive problems, but these differences were not statistically significant. There were no differences in children dually supplemented with iron and zinc compared with placebo.
Conclusions: The Ten Questions Plus tool can be used in this rural Nepali setting to identify children at increased risk for physical and cognitive disability who should be referred for clinical examination, diagnosis and enrollment in intervention services. We found evidence for a beneficial effect of zinc supplementation in reducing the likelihood of screening positive for disability.
Keywords: micronutrient supplement, zinc, iron, disabiity, children, Nepal, screening