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.
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.
Introduction Suicide is a global public health issue. Several environmental, psychosocial, behavioral factors along with physical, sexual, and emotional abuse have been associated with suicidal ideation and attempts. Childhood physical, sexual abuse, and health risk behaviors are also associated with suicidal attempts. The suicidal ideation prevalence varied from 1 to 20% and it varied with study population, geography, age group, gender, and other factors. The Beck suicidal ideation scale is an effective tool for assessing the major suicidal ideation with a six cut-off score. Materials and method 160 patients who met the inclusion criteria were enrolled into this cross-sectional study after random sampling among the patients visiting the Psychiatric OPD of Shree Birendra Hospital, Kathmandu, Nepal. The Semi-Structured Interview Schedule (SSIS), Beck Scale for Suicide Ideation (BSS), and Kuppuswamy’s Scale were used to collect the data from the patients enrolled in the study. The Chi-square test and binary logistic regression analyses were used to identify and differentiate the factors associated with high suicidal risk. Results Out of total 160 patients, 65% (n = 104) were female, 92.5% (n = 148) were married, 61.9% (n = 99) were residing in urban area, 93.1% (n = 148) were Hindus, 74.4% (n = 119) patients were living in the nuclear family, 5% (n = 8) patients had family history of psychiatric illness and 10.6% (n = 17) patients were using the substance of abuse. In the Beck scale for suicidal ideation questionnaire, 87.5% (n = 140) patients had moderate to strong wish to live, 89.4% (n = 143) patients responded as they would take precautions to save a life, 88.8% (n = 142) patients had such ideation/wish for brief, 96.3% (n = 154) had not considered for specificity/planning of contemplated suicidal attempt, 91.9% (n = 147) patients stated that they would not attempt active suicide because of a deterrent example from family, religion, irreversibility of the act and 98.1% (n = 157) patients had revealed ideas of deception/concealment of contemplated suicide openly. 16.9% (n = 27) of participants were categorized as high risk for suicide while 83.1% (n = 133) patients were as a low-risk category for suicide based on the Beck scale for suicidal ideation scoring. Conclusion In conclusion, this study found that most of the suicidal attempts were done as an act of impulse and it is higher among female and married individuals residing in the urban areas. This study did not establish any statistically significant association or differences among independent variables with the higher risk scoring in the Beck suicidal ideation scale.
Background Depression is a global public health problem. Studies show comorbid depression increases morbidity, mortality, and associated risk of poor adherence compared to those without depression. Materials and Method An analytical cross-sectional study was conducted among 326 patients who met the inclusion criteria. They were selected following simple random sampling from medical OPD and ward of Shree Birendra Hospital Kathmandu, Nepal. Semi-structured interview schedule (SSIS), Beck Depression Inventory-II (BDI-II), and Kuppuswamy’s Scale (KS) were used for data collection. Data analysis was done using SPSS version 26 and STATA version 15. Simple frequency distribution of attributes presented in tables and association assessed using Chi-square/ Fisher’s exact test. Further, the relation between depression and other independent factors is quantified using multivariate/ multivariable logistics regression analyses. Result Using Beck depression inventory (BDI-II) as a tool to determine depression 52.1% (n=170) had minimal or no depression, 16.9% (n=55) had mild depression, 18.7 %( n=61) had moderate depression and 12.3% (n=40) had severe depression i.e. 47.9% of population had some form of depression. Prevalence of depression among patient with single comorbidity found to be 30.9% (n=25, N=81) for hypertension, 43.3% (n=13, N=30) for diabetes mellitus, 45.6% (n=31, N=68) for chronic obstructive pulmonary disease, 77.5% (n=31, N=40) for chronic kidney disease, and 60 %( n=9, N=15) for chronic heart disease. Depression among patient with multiple comorbidities (more than one disease above mention) was found to be 51.1% (n=47, N=92). Prevalence of depression was more among patients with history of longer duration of illness; 11 years and above 52.9 % (n=36, N=68); 6-10 years 48.3 % (n=43, N=89); 1-5 years 45.6 %( n=77, N=169). Conclusion This study showed that the prevalence of depression has a significant relationship with the duration of illness. Therefore, early recognition and treatment play a crucial role in reducing the effects of depression.
Introduction: Personality disorders is comprised of deeply ingrained and enduring behavioral patterns, manifesting themselves as inflexible responses to a broad range of personal and social situations." Personality Disorders are frequently occurring among patients with substance use disorders. Co-occurrence of substance use disorders and personality disorder is associated with a greater functional impairment affecting treatment adherence. This study's objective was to find out the prevalence of personality disorders among substance use disorders from the Department of Psychiatry and Mental Health, of a tertiary care center of Nepal. Methods: A descriptive cross-sectional study was done at the Department of Psychiatry and Mental Health of Shree Birendra Hospital, Chhauni, Kathmandu, Nepal. The ethical approval was approved by the Institutional Review Committee prior to the study. The International Personality Disorder Examination ICD-10 module interview schedule was used to determine personality disorders. There were 100 patients, 86 males and 14 females of age ranging between 18-59 years, from different education levels, socioeconomic statuses, and ethnicities. Results: Of the total 100 patients, 63% of the patients with substance use disorders were found to have either single 24 (24%) or multiple 39 (39%) personality disorders. The most frequently identified disorders were Emotionally Unstable Borderline Type 34 (34%), Anxious Personality Disorder 27 (27%), Emotionally Unstable Impulsive Type 27 (27%). Conclusions: Present study indicates that personality disorders were highly comorbid with patients of substance use disorders with either single or multiple personality disorders. Personality disorders mostly found in substance use disorders are Emotional Unstable Borderline Type, Anxious Personality Disorder, and Emotional Unstable impulsive Type.
Hydroureteronephrosis is a clinical condition where the dilatation of renal calyces and ureter occur jointly due to obstruction. When two ureters arise from single kidney the situation is known as bifid ureter which may be complete orincomplete. The present study examines a congenital anomaly of bifid ureter and rare clinical presentation of calculusinduced obstructive hydroureternephrosis in a adult male aged 38 by past 48 hours. The common symptoms of thiscondition were extreme intolerable pain in the abdomen, flank pain moderate to severe radiate to loin to groin,vomiting/nausea and haematuria. Diagnosis was done by injection of intravenous dye and computed tomographyintravenous pyleogram was performed along with lab findings. In this case we found two incomplete ureters i.e. bifidnature arising from right kidney that unite as a single ureter before emptying into the urinary bladder. There was presence of single large calculus measuring approximately 8.6*8mm right at the junction of bifid ureter at the level of L3 vertebra inducing hydroureteronephrosis. Similarly marked upstream dilation of upper right ureter was found. The anomaly of bifid ureter occurs due to the untimely division of ureteric diverticulum. Unless some complication of ureter occurs, the duplication does not expose itself. Acute obstruction of ureter does not cause any significant alternation in renal function. Though the whole clinical presentation is rare itself, it further needs follow ups to avoid re-occurrence.
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