Background

BackgroundHypertension is a cardiovascular disorder rapidly emerging as a major public health problem in developing countries and is the most widely recognized modifiable risk factor for cardiovascular diseases. ObjectiveThe objective of this study was to find out the prevalence and associated risk factors with hypertension among people aged 50 years and more in Banepa Municipality, Kavre, Nepal. MethodsIt is a cross-sectional, population based study which was carried out in Banepa Municipality from May 15 to June 15, 2009. Among total 11 wards of Banepa municipally, wards number 1, 3, 5, 6, 7, and 10 were selected by using Simple Random Sampling Technique and 405 subjects of people aged 50 years and more were selected for study from the selected wards by using Cluster Sampling. The structured interview method was used for collection of data. Mercury sphygmomanometers with standard cuff were used to measure the indirect auscultatory arterial blood pressure. Two consecutive blood pressure readings were taken and average of them was calculated to determine single value of blood pressure. ResultsThe prevalence of hypertension was 44.9 percent (47.75% in male and 42.73% in females). Among them, only 32.9 percent (60/182) were previously diagnosed as hypertension. The higher proportion of hypertensive cases were in age > 65 years (55.49%) than in the age group < 65 years (36.32%). The prevalence of hypertension was seen positively associated with non vegetarian eating habits, alcohol consumption, and > 25 Body max index. Taking green leafy vegetable at least once a week was negatively associated with the prevalence of the hypertension. ConclusionThese findings provide important information on the prevalence, associated factors of hypertension in Banepa Municipality. Effective public health measures and strategies are needed to improve prevention, diagnosis and access to treatment of these 50 years and above population.

Background Pesticide poisoning is very common in Nepal. Hospital based studies from various parts of Nepal have shown that poisoning with organophosphorus compounds is the most common type of poisoning. Current study is undertaken to see the pattern of organophosphorus poisoning and to identify the common risk factors among the cases. If the risk factors are modifiable, attempts in addressing the risk factors and decreasing the likelihood of poisoning will certainly be fruitful in reducing the morbidity and mortality associated with organophosphorus poisoning. Objectives To assess the risk factors of organophosphorus poisoning which is major public health problem in Nepal. Methods A community based retrospective study of 75 cases of organophosphate poisoning who were brought to the emergency department of Dhulikhel hospital over the period of 3 years. Basic information was collected from hospital records and home visits were made to study the risk factors. Data were collected through interviews of the study population and their family members using a pre-designed questionnaire. Results In this study 75 cases and their families were interviewed of which there were 59% males and 42% females (M/F ratio of 1:1.4). The majority (40%) of the poisoning cases were in the age group 25-34 years. Lower literacy level showed positive association with the incidence of poisoning. Occupation wise vast majority (80%) of the cases were engaged in agricultural work. Suicidal attempts by ingesting organophosphate compounds were high in farmers and females. Conclusion In this study, majority of the poisoning were attempts of intentional self harm. Agriculture workers and females are high risk groups and may be associated with the fact that they have easy access to the poison. Interventions directed towards health education, counseling, and enforcement of laws restricting the availability and use of harmful pesticides may help in reducing such events in future. DOI: http://dx.doi.org/10.3126/kumj.v9i2.6284Kathmandu Univ Med J 2011;9(2):31-4

Background: A revolution in health care is occurring as a result of changes in the practice of medicine and in society. Medical education, if it is to keep up with the times, needs to adapt to society's changing attitudes. Presently medical education has been criticised for its orientation and insensitivity to people's need. The MBBS curriculum of medical institutions of Nepal has been focusing on community-based approaches and is still guided by the same notion. The question put forward is whether it has been appropriate to nurture the present health needs and aspiration of people. Objective: The objective of the present study is to review the existing community based medical education in health institutions of Nepal to strengthen the components of community care. Materials and methods: Qualitative study was done by reviewing the curricula and existing community medicine courses/activities in MBBS curriculum Findings and Discussion: The curriculum of all the health institutions have addressed signifi cantly on community medicine practice. As per Institute of Medicine, the community medicine practice is achieved through community based learning experiences like community diagnosis, concurrent fi eld with families of sick members and district health system management practice. In BP Koirala Institute of Health Sciences, community medicine practice is undertaken through exposure to community diagnosis program, health care delivery system, family health exercise, applied epidemiology and educational research methodology, management skills for health services and Community Oriented Compulsory Residential Rotatory Internship Program (COCRRIP). In KUSMS, community medicine module is carried out as-community diagnosis program, community health intervention project, school health project, occupational health project, health delivery system functioning, family health care activities and Compulsory Residential Rotatory Internship Program in outreach clinics. In the practice the practical aspects are largely unstructured that waste too much time in non-educational activities and rely on learning and doing. Meanwhile, expectation of the community is increasing and the challenge of nurturing their demands has come in forefront. Community has perceived that the medical schools are concentrating on fulfi lling the demand of their curriculum rather directing on their health care need. Conclusion: Health institutions need to be accountable to take the responsibility of strengthening the health status of the community of their catchments areas. The practice of community medicine need to be done in an innovative way and these schools should execute continual intervention activities and complement other institutions working in their areas.

Introduction: Indicators of health are extensively based on the age-sex data and thus warrants a detailed assessment of data. The main purpose of this study is to assess and then adjust the various types of bias and error that can occur during any census or survey. Method: This study is based on a cross-sectional de jure census of Ugrachandi Nala VDC, Kavre, Nepal, which was conducted during August 30 – September 5, 2005. Digit and gender preference is analysed using Whipple Index Myers Index and, Age-Sex Accuracy Indices. The data is adjusted using Beer’s Method and Hill Technique. Microsoft Excel 2003 and SPSS 11.5 programs were used for data entry and analysis respectively. Result: The Whipple Indices revealed that the single year data as rough and Myers Index confirmed that 0 and 5 are the most preferred digits. Age-Sex Accuracy Indices disclosed the quniquennial age data as highly inaccurate. Single-year age data adjusted using Beer’s Method and quinquennial age data adjusted using Hills Technique are found to be an ideal age-sex structure. Conclusion: Although the reported age shows serious problems of digit preference and age displacement in Ugrachandi Nala VDC, its data quality is better than the Nepal and Kavre district. This study shows that bias and errors related to the reported age and gender in a census and survey can be identified and adjusted using various demographic tools. Thus, it is suggested to use adjusted age-sex structure for calculating demographic, epidemiological and other health indicators.