Background:Induction of labour is the process of initiating the labour by artificial means from 24 weeks of gestation. The main aim of this study is to find out the maternal and foetal outcomes after induction of labour with misoprostol and oxytocin beyond 37 weeks of gestation.Methods:This was a hospital-based observational study carried out at Paropakar Maternity and Women’s Hospital, Nepal. Misoprostol of 25 µg was inserted in posterior fornix of vagina or oxytocin infusion was started from 2.5 units on whom induction was decided. Maternal and foetal/neonatal outcomes were observed. Collected data were analysed using SPSS and MS Excel.Results:General induction rate was found to be 7.2%. In this study, post-term pregnancy was found to be the most common reason for induction of labour. Analysis of onset of labour led to the finding that mean onset of labour was much rapid in oxytocin (6.6 h) than misoprostol (13.6 h). However, there is similarity in induction–delivery interval in both groups. Overall, the rate of normal delivery and caesarean section was found to be 64.9% and 33.2%, respectively. Similarly, normal delivery within 12 h was seen in 18.4% of the patients given with misoprostol and 43.5% in oxytocin group. Foetal distress was found as the most common reason for caesarean section. The overall occurrence of maternal complication was found to be similar in misoprostol and oxytocin groups, nausea/vomiting being the most common (36.7%) complication followed by fever (24.1%). Besides this, the most common neonatal complication found in overall cases was meconium stained liquor (49.2%).Conclusion:It was found that misoprostol was used most frequently for induction of labour compared to oxytocin. The onset of labour was found to be rapid in oxytocin than misoprostol. However, the occurrence of side effects was found to be similar in both misoprostol and oxytocin groups.
Background & Objectives:Prevention of Mother to child Transmission (PMTCT) is a global intervention which aims at preventing mother to child transmission of Human Immunodeficiency Virus (HIV). The study aims to find out knowledge of pregnant women on Mother to child Transmission (MTCT) of HIV/AIDS (Acquired Immune Deficiency Syndrome).Materials & Methods:A cross-sectional study was carried out at Paropakar Maternity and Women’s Hospital, Kathmandu, Nepal among the pregnant women who came to visit Antenatal Clinic. Data was collected using non-probability purposive sampling technique. Face to face interview was done and a structured questionnaire was developed for data collection. Data analysis and interpretation were done in SPSS and MS Excel.Results:The total number of respondents was 80 with a mean age of 27.4 years. 90% (n=72) respondents were found to be literate. 86.3% (n=69) were well aware of the knowledge on PMTCT. Majority of the respondents (40%) mentioned that radio, TV/Media were the main sources of information about HIV/AIDS. Out of 32.5% (26) who had heard about the window period, only 26.9% (n=7) gave the correct answer. 93.8% (n=75) were well known about the routes of transmission of HIV but only 10.1% (n=7) gave the correct answer about it. Further, 54% (n=43) respondents knew about the availability of drugs to reduce MTCT of HIV/AIDS.Conclusion:The level of awareness about PMTCT among antenatal mothers was satisfactory. However, knowledge was inadequate which imparts for the need of health education about MTCT of HIV/AIDS in every health facilities of Nepal.
Hypertension is an important public health-challenge in the developing and the developed world alike. However, hospital-based studies on cardiovascular diseases including hypertension in a developing country like Nepal have been limited. Objective: The objective of the present study was to determine the life style of patients before and after diagnosis of hypertension. Methods: A total of 100 adult hypertensive patients over 30 years of age who were attending in medical out patients department within 6 month to 2 years after first diagnosis of hypertension in Shahid Gangalal National Heart Centre and Tribhuvan University Teaching Hospital, in Kathmandu, Nepal, in April 2009, using a descriptive research design. The data was collected by interview using a questionnaire consisting of a combination of structured and semistructured questions. The data was analyzed by using SPSS 11.5 version. Results: This study found the respondents’ knowledge regarding hypertension was poor. Regarding life style of hypertensive patients, majorities (90%) of them were non-vegetarian before diagnosis but after diagnosis of hypertension the percentage of non-vegetarian was reduced by 10%. Similarly, the reduction in consumption of meat, eggs, ghee and oil (mustard, sunflower) by hypertensive patients was statistically significant difference (p = 0.000) after the diagnosis of hypertension. Regarding soyabean oil consumption, additional salty food and amount of salt intake there was no statistical significant difference before and after the diagnosis of hypertension. Likewise, physical exercise and stress reduction activities performed by hypertensive patients and change in drinking alcohol and smoking was found to be statistically significant difference (p = 0.000) after the diagnosis of hypertension. Conclusion: The adverse consequences of hypertension can be reduced by modifying the life style. Therefore more focus should be given in increasing the awareness about hypertension by developing information, education and communication materials on hypertension and setting up hypertensive counseling clinic in each hospitals
Despite the growing recognition of the importance of evidence-based practice (EBP) and Evidence Based Nursing (EBN), there remain barriers to the implementation of EBP and EBN in many countries including lack of knowledge as well as time and resources for full EBP implementation. The International Council of Nursing, recognizing the need to prepare nurses and midwives in EBP, has published a toolkit to help nurses better understand EBP so that they can make optimal contributions to global health care. This paper is based on a presentation made at the first International Nursing Conference on "Enhancing Evidence Based Nursing Practice, held at Dhulikhel Hospital, Kathmandu University in Nepal in November 2014. The purpose of this paper is to review the history of the EBP movement in nursing and health care, compare concepts of EBP with the concepts of translational science, implementation science, and improvement science, and describe the process of Evidence Based Nursing (EBN) practice. The paper concludes with a discussion of barriers to EBP, recommendations for strategies to address these barriers, and implications for improving EBN in Nepal and other Asian countries.
Background: Hypertension is currently a common and serious health issue that leads to cardiovascular disease and premature death around the world. Self-care practice is essential for blood pressure control and reduction of hypertension complications of cardiovascular and renal diseases. The objective of this study is to assess the level of self-care management and its associated factors among patients with hypertension. Methods: The cross-sectional study was conducted at the Internal medicine and Cardiac outpatient department of Kathmandu University Hospital, Dhulikhel on 386 participants diagnosed with hypertension with six months of diagnosis and age of 30-80 years. The participants were recruited conveniently in the study. Face to face interviews with participants using Hypertension Self-Care Profile (HTN-SCP) and Multidimensional Scale of Perceived Social Support (MSPSS) were used to assess self-care management and perceived social support. Descriptive and inferential statistics were performed using SPSS version 23. Results: The mean age of the participants was 57.39 years. Half of the participants (52.3 %) had poor self-care practice. There is significant association between level of self-care practice with religion (p= <0.001), educational level (p= <0.001), area of residence (p= 0.001), income (p=<0.001) and perceived social support (p= 0.001). Conclusions: The present study revealed that half of the participants had poor self-care practice. Based on the results, the study concluded that good self-care practices and social support influence better self-care practice among hypertensive patients which may eventually help to prevent complications in the coming future.
Introduction: Musculoskeletal disorders (MSDs) are injuries or pain in the human musculoskeletal system which could lead to temporary or permanent impairments. The nature of nursing jobs makes nurses vulnerable to MSDs. This study aimed to assess the prevalence and potential risk factors associated with MSDs among nurses. Methods: In between March to June 2021, a cross-sectional study was conducted among 165 nurses using self-administered questionnaires. A standardized Nordic Questionnaire was used to measure MSDs. Pearson’s chi-square test and binary logistic regression at a 5% level of significance were performed to identify factors associated with upper extremities and spinal musculoskeletal disorders (UMSD) and lower extremities musculoskeletal disorders (LMSD). Variables associated with UMSD and LMSD in bivariate analysis were subjected to multiple logistic regression. Results: The prevalence of UMSD and LMSD experienced by nurses was 86.1% (95% CI: 79.4%-90.9%) and 66.1% (95% CI: 58.9%-74.3%), respectively. Among several factors, working in same position for long periods (AOR: 4.16, 95% CI: 1.2-13.4), not receiving training in injury prevention programs (AOR: 3.15, 95% CI: 1.0-9.2), not enough rest breaks during the day (AOR: 4.65, 95% CI: 1.3-15.9) and moderate to higher job stress (AOR: 3.62, 95% CI: 1.2-10.8) were found to be significantly associated with UMSD. Not having enough rest breaks during the day (AOR: 2.19, 95% CI: 1.0-4.7) was significantly associated with LMSD. Conclusion: Higher prevalence of MSDs among nurses is a serious concern that threatens individual health as well as the overall healthcare system. Sensitization and capacity enhancement programs on the issue could prevent MSDs among nurses.
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