BackgroundDespite the substantial impact on child and maternal health, breastfeeding practices for infants remain at the suboptimum level in Bangladesh. Yet the understanding of why these practices are suboptimal, especially surrounding urban slum dwelling mothers, is unclear. The purpose of this study was to assess early infant feeding practices, examine associations with maternal factors, and uncover the facilitators and barriers to early feeding practices in selected slums of Dhaka, Bangladesh.MethodsA mixed method study was conducted from June to September 2016 using both quantitative and qualitative methods among mothers with children under the age of 6 months. The survey included 342 mother-infant pairs and 18 in-depth interviews were conducted. Univariate and multiple logistic regression was used to determine status of early infant feeding practices and factors associated with exclusive breastfeeding (EBF) within the previous 24 h. Transcripts were coded to uncover the facilitators and barriers surrounding early infant feeding practices.ResultsSixty four percent (220/342) of mothers initiated breastfeeding within 1 h, 96.5% (330/342) reported feeding colostrum, and 36.3% (124/342) infants were EBF in the last 24 h. After adjusting for child gender, maternal age, education, diet and household income; infant’s age (adjusted odds ratio (AOR) for 61–120 days 6.42; 95% CI 3.42, 12.1; AOR for 121–180 days 45.6; 95% CI 18.33, 113.45), prelacteal feeding (AOR 2.53; 95% CI 1.14, 4.58), lack of planning for EBF during pregnancy (AOR 4.06; 95% CI 1.09, 15.12) and infants delivered by cesarean section (AOR 2.76; 95% CI 1.34, 5.67) were negatively associated with EBF. During the 18 interviews, eight mothers reported a cesarean delivery and none of these mothers initiated breastfeeding within 1 h or exclusively breastfed. Moreover, all eight mothers gave their infants prelacteal feeds.ConclusionsThe status of early infant feeding practices in Dhaka’s slums was poor. The negative impact of cesarean section on all early infant feeding practices was evident in both quantitative and qualitative analysis.

Background: Foreign body (FB) impaction in the esophagus is a common emergency in all age groups. In the children coins are the commonest foreign bodies while bones have been found as the commonest in adults. Methods: This is a retrospective study comparing FB in the esophagus in adult and pediatric population between June 2007 and May 2010 in Manipal Teaching Hospital, Pokhara, Nepal. Most of the patients underwent rigid esophagoscopy and FB removal; few were removed under anesthesia by the anesthesiologists. Comparison was done in terms of pattern of FB, their site of impaction and relative ease of removal. Data were collected from the case file available from the medical record department and analysed using SPSS 11.6. Results: A total of 63 cases were included in this study. Out of which 28 (44.4%) patients were children and 35 (55.5%) were adults. Coin was the most common foreign body in the pediatric population (82.1%) whereas bones were the commonest ones (91.4%) in adults. In the pediatric population the commonest site of impaction was upper esophagus (92.8%) whereas mid esophagus was the commonest site (65.7%) in adults. Conclusion:There are differences in various aspects of impacted foreign bodies in esophagus in adult and pediatric populations. Coins being the commonest foreign bodies in children are relatively easier to remove due to their higher location and less chances of trauma. Contrary in the adults, bones being the commonest foreign body are difficult to remove due to the lower location and chances of trauma. Keywords: Foreign body; esophagus; rigid bronchoscopy DOI: http://dx.doi.org/10.3126/njms.v1i1.5797   Nepal Journal of Medical Sciences. 2012; 1(1): 42-44

Introduction: Children in developing countries are prone to infectious diseases due to insufficient and inappropriate feeding practices. Socio-demographic and socio-economic factors directly and indirectly play a role in influencing infant feeding practices. This study was conducted to assess the sociodemographic and economic factors associated with initiation of breastfeeding, complimentary feeding, and the various prelacteal feeds practiced in Kaski, Pokhara. Materials and Methods: In this prospective study, interviews were conducted to 500 mothers at Manipal Teaching Hospital who brought their child for treatment. The interviews were conducted in a questionnaire format relating to their demographic and financial statuses. Results: A total of 500 mothers were questioned, out of which 86.6% gave their child breastmilk as its first food. 47% initiated breastfeeding within half an hour of child's birth. 86% gave Jaulo as the first complementary food to their children. About 26% of the mothers gave complementary feeding to their children before the recommended time of 6 months. Conclusion: Initiation of breastfeeding after life and complementary feeding practices overall has improved from previous studies. There is still need of making awareness campaigns and such in order to further improve this trend.

The patuka is a special piece of cloth worn around the waist by heavy workers and mountain porters in Nepal. An investigation was carried out to study its role in preventing pain in the back. Observations of intra-abdominal pressure and the lumbosacral compression force confirmed that the patuka might be responsible for the low incidence of back pain in those wearing it.

No abstract

No abstract

Like the world over, Nepal was also hard hit by the second wave of COVID-19. We audited the clinical care provided to COVID-19 patients admitted from April to June 2021 in a tertiary care hospital of Nepal. This was a cohort study using routinely collected hospital data. There were 620 patients, and most (458, 74%) had severe illness. The majority (600, 97%) of the patients were eligible for admission as per national guidelines. Laboratory tests helping to predict the outcome of COVID-19, such as D-dimer and C-reactive protein, were missing in about 25% of patients. Nearly all (>95%) patients with severe disease received corticosteroids, anticoagulants and oxygen. The use of remdesivir was low (22%). About 70% of the patients received antibiotics. Hospital exit outcomes of most (>95%) patients with mild and moderate illness were favorable (alive and discharged). Among patients with severe illness, about 25% died and 4% were critically ill, needing further referral. This is the first study from Nepal to audit and document COVID-19 clinical care provision in a tertiary care hospital, thus filling the evidence gap in this area from resource-limited settings. Adherence to admission guidelines was excellent. Laboratory testing, access to essential drugs and data management needs to be improved.

Background: In Nepal pesticide poisoning is a common problem and organophosphorus poisoning (OP) is the most common form of acute poisoning responsible for majority of deaths. However, sufficient data is still lacking from Western region of Nepal. The present study analysed the sociodemographic factors of OP poisoning cases, the association of severity based on admission clinical score (POP scale) and lag time with mortality.Methods: This is a cross-sectional study conducted in patients of organophosphorus poisoning, admitted to our casualty ward during a period of one-year June 2015 to 2016.Results: In this study incidence of OP poisoning was more in females 51 (65.38%) compared to males 27 (34.46%). The commonest age group involved in poisoning was 21-30 years 30 (38.4%). Housewives 32 (41.02%) were the commonest victims of poisoning. Incidence was high during rainy season 34 (43.58%) and mainly during late hours 27 (34.61%) of the day. Majority 24 (30.76%) cases reached hospital within 2 hours of poison intake. Methyl parathion (Metacid) 24 (30.76%) was the commonest OP compound consumed by the victims. Suicide 62 (79.48%) was the main motive of poison intake and financial problem (37.17%) was the main reason behind poison ingestion. In majority of the cases the sign and symptoms were mild (80.76%) in severity. In this study majority of the victims survived (9.30%) with prompt and appropriate treatment.Conclusions: The numbers of OP poisoning cases are increasing every year and poisoning is seen commonly in younger age groups. Therefore, strict legislature on the availability of OP compounds, preventive measures and appropriate health education should be introduced to decrease the incidence.