Introduction: Menstruation, a normal physiological process in reproductive life of female still has many misconceptions. Knowledge of menstrual hygiene and menstrual sanitation practices affects the health of female. Lack of awareness on menstrual care practice is a challenge for community health. Objective: The objective of this study was to find knowledge and practice on menstrual hygiene; and perspective of Chaupadi (menstrual shed) among the reproductive age group female. Methodology: A community based mixed method study having cross sectional study as quantitative domain and phenomenological study as qualitative domain was conducted in Maranthana community of Pyuthan district of mid-western Nepal from April 2016-September 2016. Using convenient sampling techniques, 109 participants were included for cross sectional study and five of them who experienced Chaupadi were enrolled for phenomenological study. One eligible participant form each household was taken after getting informed voluntary consent. Collected data was entered in Microsoft excel and analysed by SPSS and NVivo software. Results: Regarding knowledge, 73.7% were aware on the right age of menarche. Almost 93% were aware on possible pregnancy after initiation of menstruation. Many of them (34.9%) were informed on menstruation by friends. Almost half (45.9%) had negative belief of use of old clean cloth during menstrual flow. Regarding practice, only 40.4% used sanitary pad during their menstrual flow. Most (65.1%) of them did not dispose,16.5% bury in nearby ground and 18.4% burn. More than half (60.6%) used soap-water to clean genitalia. Remedial measures adopted during menstruation were taking adequate rest (44%), seeking medical advice (22.9%) and drinking plenty of fluid (13.8%). Different traditional practice followed were use of separate utensils (64.2%), not allowed to see sun (75.8%), restriction to- go outside (71.6%), cook food (56%), usual food intake (56.9%), worship (74.3%), eat with others (27.5%), sleep in usual bedroom (27.5%) and  touch male members (28.4%). Most (94.5%) of them experienced Chaupadi (Menstrual Shed) during their menarche. The phenomenological approach found that Chaupadi was common. They had various infections and ill health. Mother groups were advocating to eliminate Chaupadi in their locality. Conclusion: The know-do gap on menstruation was evident. Despite increasing awareness, people were still following traditional cultural practices. BIBECHANA 16 (2019) 228-235

Introduction: Prisoners are one of the most vulnerable groups for having high prevalence of mental illness. There is a dearth of major studies conducted amongst prisoners in Nepal. The basic objective of this study is to study prevalence and nature of psychiatric morbidity in prisoners attending general OPD of Central jail Hospital, Kathmandu. Material and Method: This was a descriptive, cross-sectional study carried out in prisoners attending OPD of central jail for a period of six months. Initial screening was done with self- reporting questionnaire (SRQ) and those having distress on SRQ were interviewed and diagnosis was made based on ICD-10 DCR and data analysis was done using SPSS version 16. Results: A total of 121 prisoners out of 300 prisoners attending OPD of central jail hospital during a period of six months had been diagnosed to suffer from psychiatric morbidity. Majority of cases were within age group 26-30 years (20.7%) with male preponderance (76.9%), married (69.4%), educated up to higher secondary level (38%), doing occupation as labor work (24%), Hindus (62.8%) with janajatis (32.2%), having low socioeconomic status (51.2%), belonging to joint family (50.4%) and were from rural areas (45.4%). Murder was the most common offence committed (33.9%) followed by drug trafficking (28.1%). Most common primary diagnosis belong to Neurotic, stress related and somatoform disorder (57%) followed by mood disorder (32.2%). Most common psychiatric morbidity among prisoners was generalized anxiety disorder (36.4%) followed by Moderate depressive episode (23.1%) and somatoform disorder (9.1%). The overall prevalence of psychiatric morbidity in prisoners attending OPD of central jail hospital was found to be 40.33%. Conclusion: A substantial burden of psychiatric morbidity exists in prison population of Nepal. Prompt recognition and treatment of mental illness in prison lead to decrease in functional disability and better quality of life.

Introduction: Mental disorders are common and major source of disability around the world. Though Nepal lacks national data on the prevalence of mental disorders, many studies have been conducted in specific groups of people. The Thakali community is one of the indigenous communities of Nepal. We aim to look at the prevalence of mental disorders in this group. Materials and Methods: This is a cross-sectional study with multiphasic sampling conducted in the Thakali community in six distinct geographical regions of Nepal. The first stage was a household survey done by field researchers using screening questionnaires to detect a probable diagnosis of mental disorders. The second stage was detailed clinical assessment and diagnosis (ICD-10) by two independent psychiatrists. Results: Among the 917 participants, after the first phase, a probable diagnosis (as per the screening questionnaire) was found to be 12.5%. After the psychiatrists' assessment and addition of already diagnosed cases, the prevalence was 6.1%. In both the cases, prevalence of alcohol use disorder was comparatively higher (34.8% and 31.9%, respectively). Conclusion: Despite many shortcomings, this study has provided an estimate of the prevalence and pattern of mental disorders among an indigenous Nepalese community. We emphasize the need of validation of tools for Nepal and estimation of prevalence at the national level.

Background and Objectives: Delirium is one of the most important neuro-psychiatric disorders in Consultation liaison psychiatry. There is a dearth of studies in this subject in Nepalese context. The objective of this study was to find out the demographic profile, source of referral, reason for referral and possible risk factors for delirium and association between risk factors and subtypes of delirium.Material and Methods: This is a descriptive cross-sectional study carried out in a tertiary care center over a period of six months. Delirium was diagnosed by psychiatrist based on International Classification of Disease, 10th revision, Diagnostic Criteria for Research (ICD-10 DCR) and was classified into subtypes using the Liptzin and Levkoff criteria. Data analysis was done using SPSS version 16 and chi- square test was applied to find the association between risk factors and subtypes of delirium.Results: A total of 52 cases of delirium were included in the study. Majority of cases were aged 65 years and above with male preponderance. The most common cause for referral was disturbed behavior and disorientation. Hyperactive delirium was the most common subtype of delirium. Most of the referred cases of delirium were from Medical ward and Intensive Care Unit/Critical Care Unit (ICU/CCU). Infection / Inflammation, Drug/alcohol intoxication or withdrawal and those with multiple etiologies were the most common possible causes of delirium. There was no significant difference in terms of associated risk factors between the clinical subtype (p = 0.8023).Conclusion: The presence of delirium warrants prompt intervention to identify and treat the underlying causes and consultation liaison psychiatric services should be enhanced to achieve this goal.Janaki Medical College Journal of Medical Sciences (2017) Vol. 5(2): 19-26

Introduction: Medical education can lead to anxiety and depression in medical students which may have negative academic and professional consequences on them. The objective of this study was to find out the prevalence of study related anxiety, its severity and frequency of different symptoms related to anxiety among medical students. Results: Study-related anxiety was found in 73.33% of students. Anxiety was more common amongst final year medical students (83.33%) followed by 1st/2nd year students (76.67%). Prevalence of anxiety was found to be less among 4th-year medical students (63.33%). The majority of the students experienced a mild to moderate level of anxiety. i.e.44.31 % and 36.37 % respectively. The most common symptoms of study related anxiety were recurrent fearful thoughts about studies, constant tension about studies and panic feeling about exam in varying degree of severity. Conclusion: There is a high prevalence of study related anxiety among medical students in the current study. Early identification and timely intervention of study related anxiety symptoms in medical students will prevent mental distress and negative effect on their academic pursuits.

Background: The diagnostic category of “acute and transient psychotic disorders” (ATPD) comprises of psychotic disorders with features of acute onset (within 2 weeks), presence of typical syndromes that are either polymorphic or schizophrenic or persistently delusional, evidence for associated acute stress and complete recovery in most cases within 2–3 months. Studies of diagnostic stability among patients with the initial diagnosis of ATPD at their first admission have reported modest stabilities spanning over different periods of time, with higher levels of stability reported in samples from the developing countries. This study aimed at investigating the diagnostic stability of cases of ATPD at the Mental Hospital, Lagankhel over a period of 3 months from the first diagnosis. Methods: ASeventy-five drug naïve patients with the initial diagnosis of first episode ATPD admitted at the in-patient unit of Mental Hospital, Lagankhel were followed up longitudinally and their diagnosis was assessed independently by two consultant psychiatrists over a period of 3 months. Results: Average age of the sample was 30.71 years. 66.7% of the cases retained their index diagnosis of ATPD at 3 months, while the remaining required diagnostic revision. A higher number of patients had their diagnosis revised to Affective Disorders including Mania and Severe depression with psychotic features (13.88%) when compared to Schizophrenia (6.94%). Conclusion: ATPD is a relatively stable diagnostic category in the Nepalese Scenario as well with more than two third of the patients retaining the initial diagnosis at 3 months.