BackgroundNonadherence to diet and physical activity is a major problem in the management of diabetes mellitus and its complications. This study was undertaken to measure the factors associated with nonadherence to diet and physical activity advice among Nepalese type 2 diabetic patients.MethodsAn analytical cross-sectional study was conducted among type 2 diabetic patients (age, M ± SD, 54.4 ± 11.5 yrs) and interviewed using three days recall method for dietary history and Compendium of Physical Activity for physical activity. Data were analysed by univariate and multivariate statistics.ResultsOut of 385 patients, 87.5% were nonadherent and 12.5% poorly adherent to dietary advice. 42.1% were nonadherent, 36.6% partially adherent while 21.3% good adherent to physical activity. Adherence to dietary advice was higher in males than females (M ± SD, 33 ± 16.7 vs 27 ± 15.5, p = 0.001), those staying nearer to hospital than farther (M ± SD, 32 ± 18.6 vs 28 ± 13.5, p = 0.013), those advice by physician than others (p = 0.001) and from nuclear family than joint and extended (p = 0.001). With increasing age, dietary advice adherence decreased (p = 0.06) and was positively correlated with the knowledge about diabetes mellitus (r = 0.115, p = 0.024). Physical activity adherence was higher in those with positive family history of diabetes than others (M ± SD, 74 ± 24.2 vs 65 ± 23.6, p = 0.001), upper middle socioeconomic class respondents than lower ones (p = 0.047) and from extended family than nuclear or joint ones (p = 0.041). Divorced were more nonadherent to physical activity than married and widowed patients (p = 0.021).ConclusionsDeterminants of nonadherence to dietary advice: Female gender, increasing age, joint or extended family members, farther distance from hospital, poor knowledge about diabetes mellitus and advice by others than physicians. Determinants for nonadherence to physical activity: negative family history of DM, divorced status, lower socioeconomic class.

The novel coronavirus (COVID-19) cause various symptoms such as pneumonia, fever, breathing difficult and lung infection. Till now, total 9 cases are reported in Nepal and 4 cases from this province. This case series is to describe the initial clinical features of COVID-19 among the patients admitted in isolation ward of Seti Provincial Hospital. Oropharyngeal swab was taken from all four patients and sample was transfer to national reference laboratory. Three patients were coming from infected country and one is local transmission. Age of patients was range from 20 to 40 years of age with male preponderance. The patient coming from United Arab Emirate was presented with mild symptoms and others were asymptomatic. More tests, contact tracing and keeping them in quarantine are the necessitated action need to be taken by government of Nepal.Keywords: COVID-19; local transmission; oropharyngeal swab

Background: Health care workers are at greater risk of infection during COVID 19 pandemic.  This study was carried out to assess the knowledge and attitude toward COVID-19 among healthcare workers at working at Seti Zonal Hospital. Methods: A cross-sectional study was performed between April and May 2020 at Seti Zonal Hospital with purposive sampling technique and self-administered questionnaire of the knowledge and attitude of healthcare workers regarding COVID-19. The demographic characteristics mean knowledge and attitude score of healthcare workers were identified and inferential statistics t-test, ANOVA and Spearman’s correlation were used to show the relationship between variables. Results: A total of 230 healthcare workers (92% response rate) had a mean score of knowledge and attitude of 8±0.88 and 7.88±1.32, respectively with good knowledge and a low positive attitude. Majority (94.7%) were familiar with the sign and symptoms, agreed that chronic diseases patients and HCWs are at a higher risk (97%) and (87.8%) respectively while knowledge related to COVID 19 vaccination, isolation period and treatment by antibiotics was poor with low positive attitude towards information availability about COVID 19 (41%), government ability to control the epidemic (49%), and the family members might get infection (60%). There was a positive correlation between knowledge scores and attitude scores (r=0.28, p<0.0001). Conclusions: We identified a significant gap in information source, sufficient knowledge and low positive attitude about COVID 19 among health care workers. Greater educational efforts about prevention should be directed to different level of health workers. Keywords: Attitude; COVID-19; health care worker; knowledge.

Background: Breastfeeding has been accepted as the most vital intervention for reducing infant mortality and ensuring optimal growth and development of children. The current study aimed to assess the knowledge and practice regarding breastfeeding among mothers attending immunization clinic. Methods: A cross sectional study was mothers having children under 1 year of age, who attended their children for vaccination and for the treatment of other minor illnesses. The purposive sampling technique was used for selecting the study subjects. Information regarding patients' demographics, knowledge and practice towards breastfeeding were collected from these mothers on a pre-designed and pretested questionnaire. Results: A total of 208 women with children between 6 months and 12 months were included in the study. Their age ranged between 18 and 37 years with the mean of 24.9±4.1. Overall mother's breastfeeding knowledge was good among 35% and excellent among 22% of them while it was unsatisfactory among 43% of the mothers. Breastfeeding in the first 6 months was practiced by 42% of the participated mothers. Only 23% practiced exclusive breast feeding. Among those who breastfed their babies, 51% initiated breastfeeding in the first hour of birth, 21% between 2-4 hours and only 20% initiated it after 24 hours. Only 73% of mother had not given any prelacteal feeding to their babies. No enough breast milk (47.9%), crying hungry (31.5%), work-related problems (13.7%) & mothers' illness (6.8%) were the commonly reported barriers against exclusive breastfeeding. Conclusion: The prevalence of EBF for up to 6 months of age was still low as per WHO recommendations. The mother's perception of "insufficient breast milk" was also the main reason for introducing other foods. Optimal breastfeeding promotion campaigns need to be carried out within the existing health care system such as the antenatal, after delivery and vaccination clinics.

Background: Obesity and type 2 diabetes constitute major public health issues in modern societies worldwide. These two forms frequently coexist, and statistics show that 60–90% of all patients with type 2 diabetes are or have been obese. Obesity is generally considered to be a strong risk factor for the development of type 2 diabetes mellitus in future.Objectives: This study aims to assess the prevalence of obesity among type 2 diabetes patients attending diabetic clinic in Nepalgunj Medical College Teaching Hospital.Methods: An analytical cross-sectional study was conducted at NGMCTH, kohalpur, Nepal during the period from October 2013 to March 2014. The present study comprised of a total of 385 type 2 diabetic subjects whose BMI was measured during the visit to the diabetic clinic. Respondents' height, weight, age, sex and duration of diabetes were taken as the study variable.Results: Out of total, 51.4% were female and 48.6% were male who attended the clinic. The mean age of the study population was 56.20±11.95 (95% CI; 54.47-57.92) of which 38% were overweight, 4.2% were obese and 55.8% had normal BMI. The proportion of overweight in total population is 37.1% where female type 2 diabetes proportion (41.4%) was comparatively higher than male(32.6%). 4.2 % of the total type 2 diabetes were obese and above(p=0.014).Conclusions: High prevalence of overweight and obesity in type 2 diabetics is associated with other serious complications. Ways to control prevent obesity and overweight should be stressed and made known to people of all ages in the population.Journal of Nepalgunj Medical College Vol.12(1) 2014: 25-28

Background: Pneumonia is the single largest cause of death in children worldwide. Malnutrition increases the incidence and severity of ALRI and similarly it contributes to malnutrition. By identifying and treating the cases of malnutrition will decrease disease burden.  Objective: To identify malnutrition as a risk factor of lower respiratory tract infection among children of under five years.Methods and Materials: A case control study was conducted at Nepalgunj Medical College, Kohalpur Teaching Hospital, Kohalpur, Nepal from June 2014 to November 2014. All diagnosed case of ALRI as per WHO were selected for case group. The controls were healthy children presented in OPD, pediatric ward and immunization clinic. The predesigned case performa with check list was the tool to identifying risk factor of ALRI. All data were entered in SPSS version 19. Descriptive and analytic statistics were used for analysis of data with level of significance at p value <0.05.Results: 107 cases and 107 controls were enrolled with age and sex matched. Male to female ratio was 1.6:1 vs 1.8:1 and the proportion of infants, 70.1% vs 68.3% in cases and controls respectively. Moderate wasting was present on 36.4% (39) of case group and 16.8% (18) of control group and It was significantly associated with ALRI (p=0.003). 10.3% (11) of case group children were moderately stunted while 6.5% (7) of control group. It was not statistical associated with ALRI (p=0.325).Conclusions: Wasted children were more prone to suffer from ALRI as compare to stunted children. As it is modifiable risk factor, we should focus on effective community education and public health measures to prevent malnutrition.JNGMC Vol. 12 No. 2 December 2014. Page : 2-5