BackgroundAdequate nutrition is essential during the lactation period for better maternal and child health outcomes. Although food insecurity and dietary monotony (defined as less diverse diet), two important determinants of undernutrition, are endemic in the rural mountains of Nepal, insufficiently examined and assessed for risk factors in mothers during lactation, a life stage of high nutritional demand. This study aimed to assess the status and factors associated with food insecurity and dietary diversity among lactating mothers residing in the mountains of Nepal. MethodsA community-based cross-sectional study was conducted in an urban municipality in the mountainous Bajhang District of far-western Nepal. The sampling frame and strategy led to 417 randomly selected lactating mothers. Household Food Insecurity Access Scale (HFIAS) and the tool "Minimum Dietary Diversity for Women" developed by the Food and Agriculture Organization were used to measure food insecurity and dietary diversity, respectively. Additional information on socio-demographics and risk factors were collected. Multivariable logistics regression assessed correlates of study outcomes. ResultsOverall, 54% of the households were food insecure, and over half (53%) of the mothers had low dietary diversity. Food insecurity status (mild food insecurity AOR = 10.12, 95% CI = 4.21-24.34; moderate food insecurity AOR = 8.17, 95% CI = 3.24-20.59, and severe food insecurity AOR = 10.56, 95% CI = 3.92-28.43) were associated with higher odds of dietary monotony. Likewise, participants with lower dietary diversity were 8.5 times more likely to be

BackgroundGlobally, neonatal deaths remain a major public health challenge and account for the majority of deaths occurring among children under five years of age. Despite Nepal’s significant achievements in meeting the maternal and child health targets of the Millennium Development Goals, an estimated 23,000 Nepalese children under five years die every year, with three out of five babies dying within the first 28 days of life. This study therefore aimed to examine the level of knowledge and practices of newborn care among Nepalese mothers in the upper Himalayas and the factors associated with these.Materials and methodsA community based cross-sectional study was conducted among 302 randomly selected mothers with children under two years of age in Tripurasundari Municipality of Dolpa district, an upper Himalayan region of Nepal. Mothers were interviewed using semi-structured questionnaires. Mean score for knowledge and Bloom’s criteria for practice were considered to categorize newborn care knowledge and practices. Multivariate logistic regression was used to identify factors associated with the newborn care knowledge and practices.ResultsIn this study, 147 (48.7%) of the mothers were found to have inadequate knowledge of newborn care, while 102 (33.8%) mothers had reported unsatisfactory newborn care practices. Mothers with at least secondary level of formal education were more likely to possess adequate newborn care knowledge compared to mothers who never attended school (AOR 4.93 at 95% CI 1.82–13.33). Mothers whose first pregnancy occurred between the ages of 20–24 years (AOR 3.89 at 95% CI 1.81–8.37) were also more likely to possess adequate newborn care knowledge, compared to mothers with a younger age at first pregnancy. Furthermore, mothers who had completed at least four ANC visits (AOR 2.89 at 95% CI 1.04–7.96), mothers who had completed three PNC visits (AOR 2.79 at 95% CI 1.16–6.72) and mothers who reported that their nearest health facility was less than one hour (30–59 minutes) walking distance (AOR 3.66 at 95% CI 1.43–9.33) had higher odds of having adequate newborn care knowledge. Similarly, mothers whose household monthly income was more than $100 (AOR 4.17 at 95% CI 1.75–9.69), mothers who had completed three PNC visits (AOR 3.27 at 95% CI 1.16–9.20) and mothers with adequate newborn care knowledge (AOR 15.35 at 95% CI 5.82–40.47) were found to be more likely to practice a satisfactory level of newborn care practices in adjusted analysis.ConclusionThe study revealed high prevalence of inadequate newborn care and knowledge amongst mothers in upper Himalayan dwellings. Approximately one third of all interviewed mothers practiced suboptimal newborn care. The results indicate an urgent need to increase awareness of neonatal services available to mothers and to prioritize investments by local governments in neonatal health services, in order to improve accessibility and quality of care for mothers and newborns.

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Objective Gestational diabetes mellitus (GDM) is associated with adverse perinatal outcomes and is an independent risk factor for vaginal dysbiosis. Understanding the vaginal microbiota in health and disease is essential to screen, detect, and manage complications of pregnancy. Therefore, the aims of the present study were to assess and compare vaginal dysbiosis in pregnancy in women with and without GDM and examine its impact on perinatal outcomes in our population. Methods The present study was a prospective cohort study recruiting pregnant women. The subjects were divided into two groups (GDM and non‐GDM) and were followed until delivery to assess fetomaternal outcomes. Vaginal samples were collected at 24–28 weeks and 34–38 weeks for Nugent scoring and determination of bacterial and fungal species. Results The study recruited 502 pregnant women, with a final assessment of 320 mother–infant pairs (GDM n = 134; non‐GDM n = 186). We found a significant association of vaginal dysbiosis with GDM and adverse perinatal outcomes. Significant differences were also seen in status of infection and its trimester‐wise changes in relation to hyperglycemia. Conclusion By defining an association of vaginal dysbiosis with GDM and its correlation with perinatal outcomes, the present study calls for exploitation of this potential association as a new target in the prevention and treatment of GDM and in alleviating their undesired maternal and infant outcomes.

Background Postpartum depression is the most common mental health problem among women of childbearing age in resource-poor countries. Poor maternal mental health is linked with both acute and chronic negative effects on the growth and development of the child. This study aimed to assess the prevalence and factors associated with depressive symptoms among postpartum mothers in the lowland region in southern Nepal. Methods A hospital-based analytical cross-sectional study was conducted from 1st July to 25th August 2019 among 415 randomly selected postpartum mothers attending the child immunization clinic at Narayani hospital. The postpartum depressive symptoms were measured using the validated Nepalese version of the Edinburg Postnatal Depression Scale (EPDS). The data were entered into EpiData software 3.1v and transferred into Stata version 14.1 (StataCorp LP, College Station, Texas) for statistical analyses. To identify the correlates, backward stepwise binary logistic regression models were performed separately for the dichotomized outcomes: the presence of postpartum depressive symptoms. The statistical significance was considered at p-value <0.05 with 95% confidence intervals (CIs). Results Among the total 415 study participants, 33.7% (95% CI: 29.2–38.5%) of postpartum mothers had depressive symptoms. Study participant’s whose family monthly income <150 USD compared to ≥150 USD (aOR = 13.76, 95% CI: 6.54–28.95), the husband had migrated for employment compared to not migrated (aOR = 8.19, 95% CI:4.11–15.87), nearest health facility located at more than 60 minutes of walking distance (aOR = 4.52, 95% CI: 2.26–9.03), delivered their last child by cesarean section compared to normal (vaginal) delivery (aOR = 2.02, 95% CI: 1.12–3.59) and received less than four recommended antenatal care (ANC) visits (aOR = 2.28, 95% CI:1.25–4.15) had higher odds of depressive symptoms. Participants who had planned pregnancy (aOR = 0.44, 95% CI: 0.25–0.77) were associated with 56% lower odds of depressive symptoms. Conclusions One-third of the mothers suffered from postpartum depressive symptoms. The participant’s husband migrated for employment, family income, distance to reach a health facility, delivery by cesarean section, not receiving recommended ANC visits, and plan of pregnancy were independent predictors for postpartum depressive symptoms. The study results warranted the urgency for clinical diagnosis of PPD and implementation of preventive package in study settings. Mental health education to pregnant women during ANC visits and proper counseling during the antepartum and postpartum period can also play a positive role in preventing postpartum depression.

Human history has witnessed various pandemics throughout, and these cause disastrous effects on human health and country’s economy. Once again, after SARS (Severe Acute Respiratory Syndrome) and MERS (Middle East Respiratory Syndrome), the world is observing a very tough time fighting an invisible enemy, the novel COVID-19 coronavirus. Initially observed in the Wuhan province of China, now, it has spread across 210 countries. Number of corona affected confirmed cases have reached > 3 million globally and death toll has reached to 258,481 as on 6th May,2020. Researchers are working round the clock, forming collaborative efforts and sharing their data to come up with a cure for this disease. The new coronavirus genome was quickly sequenced and clinical and epidemiological data are continuously being collected and analyzed. This data is crucial for forming better public health policies and developing antiviral drugs and vaccines. As there is no vaccine available in market against COVID-19, personal health, immunity, social distancing and basic protection measures are extremely important. It is critical to avoid the virus infection and to strengthen the immune system as the coronavirus can be fatal for those with weak immunity.  This article reviews the nutritional and therapeutic potential of Spirulina, which is considered as superfood and a natural supplement to strengthen the immune system. Spirulina is highly nutritious and has hypolipidemic, hypoglycemic and antihypertensive properties. Spirulina contains several bioactive compounds, such as phenols, phycobiliproteins and sulphated polysaccharides and many more with proven antioxidant, anti-inflammatory and immunostimulant/ immunomodulatory effects.

Background: Chronic kidney disease is a worldwide public health problem. It is associated with various biochemical and hematological abnormalities that leads to morbidity and mortality. The aim of this study was to evaluate the biochemical and hematological parameters in chronic kidney disease patients.Methods: This is a prospective cross sectional study conducted over a period of six months on 52 chronic kidney disease patients at Kist Medical College Teaching Hospital, Lalitpur, Nepal. Biochemical parameters such as urea, creatinine, calcium, phosphorous, sodium, potassium and hematological parameters like hemoglobin, hematocrit, red blood cell count, total leukocyte count, platelet count were measured using standard techniques in chronic kidney disease cases and the findings were compared with age and sex matched controls. Results were analyzed using SPSS 21 for Windows.Results: Hemoglobin, hematocrit, red blood cell count, total leukocyte count and platelet count were reduced and statistically significant in chronic kidney disease patients compared to controls(p <0.05).In biochemical parameters, serum urea, creatinine, phosphorous were increased and calcium was reduced which was found statistically significant as compared to controls (p <0.05). The combination of diabetes and hypertension was the lead cause of chronic kidney disease found in 38.46% followed by hypertension alone in 30.76%Conclusion: Biochemical and hematological parameters are deranged in patients with chronic kidney disease. Routine evaluation of these parameters is useful in the management of these patients.

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