Background

ObjectivesThe primary objective of the study was to estimate the prevalence of depression among female sex workers (FSWs) of eastern Nepal. The secondary objective was to search for an association between depression, violence and HIV risk behaviour.DesignCross-sectional/observational study.Study settingThis study was carried out in five cities of eastern Nepal (Dharan, Itahari, Biratnagar, Damak and Birtamode). Both restaurant-based and street-based FSWs were recruited in the study.ParticipantsWomen who had been involved in commercial sex activity in the past 6 months and gave informed consent were included in the study.Primary outcome measureA score of more than or equal to 16 on the Centre for Epidemiological Studies Depression (CESD) scale was considered as depression.MethodologyFace-to-face interviews were conducted with respondents who were sought through a snowball sampling technique. Information regarding their depression status, HIV high-risk behaviour and violence was recorded. The estimated sample size was 210.ResultsWe interviewed 210 FSWs (both restaurant-based and street-based). The prevalence of depression among respondents was 82.4%. FSWs who had experienced violence were five times more likely to be depressed than those who were not victims of violence. The odds of depression were six times higher among respondents who were involved in any HIV risk behaviour compared with those who were not involved.ConclusionsThe present study reports a high prevalence of depression, HIV risk behaviours and violence among FSWs of eastern Nepal. The mental health of FSWs should also be regarded as an important aspect of HIV prevention efforts which can help to promote the overall health of this population.

Background/Aim:Alcohol is the most common substance abused in Nepal. Liver disease caused by alcohol abuse, including its end stage, cirrhosis, is a major health care problem, which is difficult to treat.Objectives:To study the demographic profile, laboratory parameters, complications and their prognostic implications among patients of alcoholic liver disease (ALD).Materials and Methods:Records of all patients of ALD admitted from January 1' 2005 to December 31' 2006 were studied and followed up to December 31, 2007. A total of 181 patients were analyzed. Their clinical profile and laboratory parameters were noted and analyzed using SPSS-10.0 software.Results:Among the 181 patients, 80.7% were male, 30.9% were army/ex-army and 65.2% were documented smokers. The mean age of presentation was 52.08 years. Jaundice (57.5%) was the most common presentation followed by hepatomegaly (51.4%). Hypoalbuminemia (50.3) followed by ascites (48.1) were common complications. Death occurred in 19.1% of the patients, the most common cause being hepatic encephalopathy (72.2%) followed by variceal bleeding and hepatorenal syndrome. Jaundice, ascites and hepatic encephalopathy at presentation and female sex were significantly associated with increased mortality along with discriminant score >32, aspartate aminotransferase (AST): Alanine aminotranferase (ALT) ≥ 2, ultrasonography (USG)-proven cirrhosis, rise in prothrombin time ≥5 s, total bilirubin ≥ 4mg/dL and ESR ≥34.Conclusion:ALD was predominantly seen among the productive age group with a high morbidity and mortality. Jaundice, ascites, hepatic encephalopathy at presentation and female sex are poor prognostic indicators along with discriminant score > 32, AST:ALT ≥ 2, USG-proven cirrhosis, coagulopathy, hyperbilirubenemia and high ESR.

Introduction. Alopecia areata is one of the commonest causes of nonscarring alopecia. Since hair is a vital part with very high cosmetic concern, hair loss might have a significant negative impact on patient’s life. Hence, we aimed this to investigate depression and anxiety in patients with alopecia areata. Methods. In this cross-sectional study, a total of 75 consecutive eligible patients of alopecia areata were interviewed over one-year period in the dermatology outpatient department. We recorded the relevant history and examination details in the present proforma. Nepali versions of Beck Depression Inventory and Beck Anxiety Inventory were used for the assessment of depression and anxiety, respectively. Data analysis was done with Statistical Package for the Social Sciences version 11.5. Results. Among 75 patients, the prevalence of depression and anxiety were 66.7% and 73.3%, respectively, with median depression score = 5 (IQR = 0.0–10.0) and median anxiety score = 5 (IQR = 0.0–11.0). Out of all depressed patients, 82.0% had minimal and 18.0% had moderate depression. However, none of them had severe depression. Likewise, out of all patients with anxiety, 89.0% had mild and 11.0% had moderate anxiety, but none of them had severe anxiety. Conclusion. Anxiety and depression are common psychological problems in patients with alopecia areata. Because of their direct impact on treatment outcome, we, treating dermatologist, must be aware of them, and we should counsel our patients for consultation with the psychiatrist on time for their maximum benefit.

Introduction: Mental health problem is common and ubiquitous. Mental illness cuts across all sections of society, irrespective of socio-economic status. Recent international survey showed a varying prevalence rates ranged (4.7%- 12.0%). The Community study in Nepal yielded prevalence rate of mental illness at 14.0%. Methods: descriptive, epidemiologic study with systematic randomization sampling. Results: Of 911 respondents majority was married (76.1%), of age group 20-59 yrs. Overall, 113 (12.4%) respondents had at least one psychiatric disorder and the commonest were: Depression, Anxiety disorders, Alcohol use disorders with 1.9% had seizure/epilepsy. Conclusions: Community prevalence rate of some common psychiatric disorders is high which calls for special attention to address depressive and alcohol related disorder from all quarters of society particularly from government.  Keywords: community survey; mental illness; psychiatric morbidity.

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INTRODUCTION: Cholera is one of the most common diarrhoeal diseases in Nepal. Etiological agent of cholera is Vibrio cholerae which removes essential body fluids, salts and vital nutrients, which are necessary for life causing dehydration and malnutrition. Emerging antimicrobial resistant is common. The aim of the present study was to determine the antibiotic susceptibility pattern of cholera patients in Nepal. METHODS: All the laboratory works were conducted in the bacteriology section of National Public Health Laboratory, Teku from March to September 2005. During this period a total of 340 stool samples from diarrhoeal patients were collected and processed according to the standard laboratory methods. Each patient suffering from diarrhoea was directly interviewed for his or her clinical history during sample collection. RESULTS: A total of 340 stool samples were processed and studied from both sex including all ages of patients. Among the processed sample 53 Vibrio cholerae cases were found. All isolated Vibrio cholerae O1 were El Tor, Inaba. All isolated (100%) Vibrio cholerae O1 were sensitive to Ampicillin, Ciprofloxacin, Erythromycin and Tetracycline whereas all were resistant to Nalidixic acid and Cotrimoxazole. Only 15.1% cases were sensitive to Furazolidone whereas 84.9% were resistant. CONCLUSION: All V. cholerae strains isolated in this study were found resistant to Multi Drug Resistant (resistant to at least two antibiotics of different group). Ampicillin, Ciprofloxacin, Erythromycin and Tetracycline were found still more potent antibiotics against Vibrio cholerae isolated during the study. Keywords: antibiotics, susceptibility, Vibrio cholera.