IntroductionThe COVID-19 pandemic has caused discrimination and social stigma among healthcare workers (HCW) causing psychological problems due to prolonged work shifts, uncertain pay, lack of personal protective equipment (PPE), added fear of infection to self or family, and so on. This online survey is directed towards the determination of anxiety, depression, and stigma among healthcare providers in Nepal during the later phase of the first wave of the COVID-19 pandemic.

Background Good sleep quality is associated with a diverse range of positive outcomes such as better health, less daytime sleepiness, well-being and proper psychological functioning. Sleep deprivation or poor sleep quality leads to many metabolic, endocrine, and immune changes. Many studies have shown changes in sleep schedule along with worsening of sleep quality during the COVID-19 pandemic. Methods This cross-sectional study was conducted among students of a medical college in Kathmandu, Nepal from January 13, 2021 to February 15, 2021. A stratified random sampling technique was used. Data were collected using the Pittsburgh Sleep Quality Index (PSQI). Questionnaires that were completely filled were included and analyzed using STATA vs. 15. Results 168(n=190) medical students filled out the questionnaires with a response rate of 88.42%. Around 30% (n=51) of respondents had poor sleep quality (PSQI total score of > 5) with an average PSQI score of 4.24±2.19. Unadjusted logistic regression analysis showed significantly higher odds of poor sleep quality among females (OR, 2.25; CI, 1.14-4.43) compared with male and the relation persists even after adjusting with age and year in medical school (aOR, 2.81; CI, 1.35-5.86).  Adjusting with age and gender, 4 th-year MBBS students had 82% lesser odds of having poor sleep quality compared to 2 nd-year MBBS students (aOR, 0.18; CI, 0.04-0.76). Our study is suggestive of poor sleep quality common among medical students. Conclusions More than a quarter of medical students have a poor sleep quality as per our study. So, education and awareness should be raised among medical students regarding the detrimental effects of poor quality sleep on daily activities, physical and mental well-being, and the overall quality of life.

Background Good sleep quality is associated with a diverse range of positive outcomes such as better health, less daytime sleepiness, well-being, and proper psychological functioning. Sleep deprivation or poor sleep quality leads to many metabolic, endocrine, and immune changes. Many studies have shown changes in sleep schedule along with worsening of sleep quality during the COVID-19 pandemic. Methods This cross-sectional study was conducted among students of a medical college in Kathmandu, Nepal from January 13, 2021, to February 15, 2021. A stratified random sampling technique was used. Data were collected using the Pittsburgh Sleep Quality Index (PSQI). Questionnaires that were completely filled were included and analyzed using STATA vs. 15. Results 168 medical students filled out the questionnaires with a response rate of 88.42%. 30.36% (n=51) of respondents were having poor quality of sleep (PSQI total score of > 5) with an average PSQI score of 4.24±2.19. Unadjusted logistic regression analysis showed significantly higher odds of poor quality of sleep among females (OR, 2.25; CI, 1.14-4.43) comparing to male and the relation persists even adjusting with age and year in medical school (aOR, 2.81; CI, 1.35-5.86)  Adjusting with age and gender 4th-year MBBS students were 82% less likely to have a poor quality of sleep compared to 2nd-year MBBS students (aOR, 0.18; CI, 0.04-0.76). Poor quality of sleep is common among medical students. Conclusions More than a quarter of medical students have a poor quality of sleep as per our study. So, education and awareness should be aroused among medical students regarding the detrimental effects of poor quality sleep on daily activities, physical and mental well-being, and the overall quality of life.

Introduction: Mental illness is major global public health problem affecting over 450 million people, most of whom live in developing countries. Nepal just overcame ten years long conflict situation. Post-traumatic stress disorder (PTSD) and depression is most prevalent in conflict inflicted areas as per most literatures. Much is not known about the psychological effects of the conflict situation, even after six years of peace process in Nepalese context.Material and Method: This is a cross sectional descriptive study carried out to explore the prevalence of Post-traumatic stress disorder and Depression in Nepalese army combatants involved during the armed insurgency period and its relationship with different. It was conducted in two randomly selected battalions of tenth brigade in Kathmandu. The PTSD was assessed using Post traumatic stress disorder checklist - military version (PCL-M), depression was assessed using the Beck depression inventory (BDI) and degree of combat exposure was assessed using Combat exposure scale (CES). The quantitative assessment was done using appropriate methods and tools.Results The degree of combat exposure showed 48.8% exposed to moderate and above degree of combat exposure. PTSD was found in 21.9% of the combats and 20.5% were found to have depression. Both PTSD and depression were found to be associated with degree of combat exposure. There was statistically significant association between degree of combat exposure and PTSD (p= 0.001, 95% CI (1.567-6.303)) and depression (p=0.011, 95% CI (1.209-4.830)).Conclusion: PTSD and depression exists even six years after the peace process in Nepalese army and is related to the degree of combat exposure regardless of other attributes like age, sex, rank, marital status.J Psychiatrists’ Association of Nepal Vol .6(1), 2017, p.24-28

Introduction: Vitamin B-12 deficiency is a frequent condition in the elderly population. High homocysteine levels, which can contribute to arterial damage and blood clots in blood vessels, usually indicate a deficiency in vitamin B-12. Different studies have shown an association of raised total homocysteine with incident Alzheimer’s disease. This study aimed to evaluate the association between vitamin B-12 levels and the risk of Alzheimer’s disease (AD). Methods: A case-control study with a sample size of 90 was conducted at Tertiary hospital, Kathmandu. The participants who visited the psychiatric outpatient department from 2019 onward at Tertiary hospital, Kathmandu, were recruited. The Mini-Mental State Examination (MMSE) was administered to the participants by a trained medical doctor. The medical doctor used the MMSE scores to classify the participants into two groups: the healthy control group and the AD group. Results: The AD group had higher percentages of hypertension (20.9%), diabetes (13.6%), smoking habit (27.3%), vitamin B-12 deficiency (22.7%), and alcohol consumption (13.8%) relative to the control group. Among these features, a significant association was found between alcohol and vitamin B-12 status and between systolic blood pressure and MMSE score. Conclusion: This study concluded that there is an association between low levels of vitamin B-12 and the risk of AD. Further studies are needed to determine the cause-effect.

Globally, mental health problems constitute a serious public health problem, contributing 14 % to the global burden of disease. The aim of this epidemiological study was to identify prevalence rates of post-traumatic stress disorder (PTSD), factors associated and its relationship with combat exposure in a post-insurgency period in Nepali army personnel and Veterans. This cross-sectional study was conducted among 300 adults in 2021. In the study both quantitative and qualitative mixed approach with descriptive design was followed. The outcome measures used in the study were locally validated with PCL-M and combat exposure scale. Of the sample, 9 % met threshold for PTSD. The association of variable in reference to age, rank, education and service years with PTSD showed that Age group and Education in current study did not show significant association. However, PTSD with years of service and rank showed significant association. The study also showed a significant relationship between combat exposure and PTSD. There is a significant association between different level of education and combat exposure as well. Overall, the prevalence rates of PTSD in the sample are comparable to other studies conducted with populations affected by conflict and with refugees. However, the findings underscore the need to address the current mental health care awareness and resources in combatants who were exposed to traumatic events during combat in insurgency period. Traumatic exposure predicted increase in PTSD.

Background: Suicide and Parasuicide are the serious public health problem, which is higher in females, younger people and among unemployed males. Parasuicide being common include mental disorders such as mood disorder, personality disorders, and substance abuse. Para-suicides among military personnels and their families have not been studied yet in Nepal. This study is carried out to understand the demography of parasuicide and its mode.Methodology: This is a hospital record based study including data of last fi ve years (2011-2016 AD) where individuals with history of parasucide were assessed after they were referred to the neuropsychiatry department of military hospital. Their personal detail records and mode of parasuicide were retrieved using simple data retrieval sheet and entered and analysed after approval from local institutional review committee.Results: Among 65 cases attempting suicide, 52.3% were males and 47.7% were females. Median age of individuals attempting suicide was 29 years. Most of the cases (32, 49.2%) attempted suicide were family member of the soldiers then followed by serving and retired soldiers. Among the suicide attempters, organo-phosphorous (OP) poisoning was the commonest mode of suicide attempt (25, 43.1%), followed by drug overdose/ hanging each 11 (16.9%) cases.Conclusion: The study showed that among the soldiers and their family, the commonest mode of parasuicide is OPpoisoning and seen in young males.Journal of Kathmandu Medical CollegeVol. 7, No. 2, Issue 24, Apr.-Jun., 2018, page: 47-49

Objectives: Psychiatric consequences are very common following RTA. The study is sought to identify the prevalence of psychiatric morbidity (e.g. depressive symptoms, anxiety symptoms and symptoms related to PTSD(Post Traumatic Stress Disorder) following injury sustained victims and psychiatric symptoms. Methods: The 102 (male=83,female=19) patients were interviewed using a questionnaire to collect the socio-demographic data, the Self Rating Questionnaire (SRQ) -Beck Depression Inventory(BDI),Beck Anxiety Inventory(BAI) and the Impact of Event Scale -Revised (IES-R). Patients were prospectively followed up for 1 month. Patients were aged between 20-69 years. The impact of injury was assessed by ISS (Injury Severity Scale) and ABI (Abbreviated injury Scale). Results:The mean age was 33.93 years (range 20-69). Overall, the prevalence rate o of Anxiety symptoms-19.6%, depressive symptoms-21.6% and PTSD symptoms-35.3%. Females had a higher rate of PTSD symptoms 52.6% (n = 10), compared to the males 31.3% (n=26). The majority of those with PTSD (47.2%) were young, 20 -29 years. symptoms 51% and then anxiety symptoms30.4%. The symptoms gradually reduced in the fourth week to PTSD -35.3%, depression-21.6% and anxiety-19.6%. The study also showed higher scales of psychiatric symptoms in major injuries in comparison to minor injuries showing direct correlation of psychiatric morbidity with severity of injury. Conclusion: Psychiatric symptoms are frequent and severe after major injuries and less severe after minor RTA. Psychopathology following injury is a frequent and persistent occurrence. Early information and advice might reduce psychological distress and symptoms.