Notes

Program work day within trophic status along with localised nutritional conditions to the Bohai Bay, The far east.
Majority of the patients were only managed in the ward without surgery.
Among the patient visiting the trauma center during the study period most common mechanism of the injury were fall and road crash with head and neck injury. Majority of the patients were only managed in the ward without surgery.
The aim of the study is the compare efficacy and safety of percutaneous nephrolithotomy in supine and prone positions. Percutaneous nephrolithotomy is conventionally performed in prone position but in recent years numbers of supine percutaneous nephrolithotomies is increasing globally.

The hospital based cross-sectional observational study was conducted in the Department of Urology, Bir Hospital from July 2018 to January 2020. A total of 81 consecutive patients undergoing percutaneous nephrolithotomy were divided into two groups, with 38 patients in Supine (Group 1) and 43 patients in Prone (Group 2) positions, respectively. Patient's demographics, access time, operative duration, stone free rate, radiation dose and duration, irrigation fluid volume, post-operative hemoglobin drop and complications were compared.

Demographic and stone characteristics were comparable in both groups. Supine Group (Group 1) had significantly shorter operative duration than Prone Group (Group 2), 44.63 ± 12.44minsvs 53.02 ±12.67mins (p< 0.04). The mean radiation duration was 99.11 ± 61.17secs in Group 1 and 108.40 ± 51.65 secs in Group 2 (p=0.46), respectively. Although the mean radiation dose was lower in Group 1 (375.1µGym2) than in Group 2 (465.7 µGym2), it was not statistically significant(p=0.24). The stone free rate at 1 month duration were comparable with 92.1% and 93.02% in Group 1 and Group 2 respectively (p=0.16). Overall complication rates were similar in both groups (15.7% in Group 1 vs 16.2% in Group 2), respectively. None of the patients in both groups had complications higher than Clavien IIIa.

PCNL in supine position has significantly shorter operative time with similar complications and stone free rates as compared to prone position.
PCNL in supine position has significantly shorter operative time with similar complications and stone free rates as compared to prone position.
Public health emergency is vulnerable time where maintaining ethical principles is obligatory while doing research, on the other hand, it is the same time when breach in ethics is much likely whenever a researcher is unaware, unprepared or hastens to do research. The aim of this study was to assess ethical issues of the coronavirus disease 2019 (COVID-19) related research proposals submitted during the early stages of pandemic in Nepal.

Retrospective analysis of COVID-19 related research proposals and their informed consent document submitted to the ethical review board at Nepal Health Research Council was done for the study. The analysis was done as per the National Ethical Guidelines, Standard Operating Procedure for Health Research in Nepal and World Health Organization guidelines for infectious disease outbreak, 2016 under ethically relevant headings. Descriptive data were analyzed in SPSS v24.

The major issues were observed in the informed consent documents where 55% were lacking principal investig relevant stakeholders at the time of health emergencies.
Equity has emerged as a cross-cutting theme in the health sector, and countries across the world are striving to ensure that all people have access to the health services they need without undue financial hardship and educational, social, cultural and geographical barriers. In this context, this analysis has attempted to analyse Nepal's progress in reducing inequalities in reproductive, maternal, newborn and child health services based on economic status and place of residence.

In this analysis, we have used data available from the web version of the Health Equity Assessment Toolkit, a data visualisation tool developed by the World Health Organisation. We have analysed the inequalities in terms of a composite coverage index which combines eight reproductive, maternal, newborn and child health interventions along the continuum of care.

Composite coverage of reproductive, maternal, newborn and child health services was 43% in 2001 which increased to 65% in 2016. The absolute difference in composite coveraed from 28-percentage points in 2001 to 8-percentage points in 2016. The difference in service coverage between the urban and rural settings reduced from 21-percentage points to six percentage points in the period. Among the eight various services, births attended by skilled birth attendants is the indicator with the highest scope for improvement. Conclusions Inequalities based on wealth quintiles and residence places have narrowed from 2001 to 2016. Additional efforts in expanding skilled birth attendants and antenatal care service coverage among the poorest quintile and rural residents could further improve the coverage of the indicators at the national level and narrow down the inequalities.
Various studies have shown that low body mass index co-relates with the severity of Chronic obstructive pulmonary disease. The reduced body mass index in these patients is thought to be due to nutritional abnormality and raised circulating inflammatory markers.The study is aimed to find the association of body mass index with respiratory failure in patient with chronic obstructive pulmunory disease.

142 patients who attended emergency /out-patient-department in Sir Sundarlal Hospital from August 2018 to July 2020 were enrolled for the study. 81 patients in one group had chronic obstructive pulmonary disease exacerbation with Type II respiratory failure. Among this group low and normal body mass index subgroup was categorized.61 patients in another group had chronic obstructive pulmonary disease. Non-invasive ventilation was applied to case group. Categorization of body mass index was done <18.5(Low BMI) and 18.5-24.9 (Normal BMI ).

The mean age of the study group was (63.53±9.021). There was a significant difference in the body mass index between the groups ( p=<0.001,t=15.40). Severity of respiratory failure was compared using ph and pco2 in the between the groups which showed no significant difference (p=1,chi square 0.000), (p=0.40,chi square=0.72) however it did affect the outcome.

Our study shows that overall respiratory failure was common in low body mass index cases compared to Control. Nevertheless there was no difference among severity of respiratory failure among low and normal body mass index subgroups and however it did affect the outcome.
Our study shows that overall respiratory failure was common in low body mass index cases compared to Control. Nevertheless there was no difference among severity of respiratory failure among low and normal body mass index subgroups and however it did affect the outcome.
Early and late introduction of complementary feeding is associated with increased morbidity and nutritional deficiencies in children. In 2016, the under 5 mortality rate of Nepal was 39 deaths per 1000 live births and around 1 million under 5 children had suffered from chronic malnutrition. The main aim of this study was to identify the level of knowledge and practice regarding complementary feeding among the mothers of children aged group 6 to 24 months in Bhanu Municipality, Tanahu District, Nepal.

A descriptive cross-sectional study was conducted with 158 mothers of children age group 6 to 24 months from ward number 1 and 2 in Bhanu Municipality, Tanahu District, Nepal. Data collection was done after taking ethical approvalby using a semi-structured questionnaire via face-to-face interviews. Collected data were entered and descriptive analysis was carriedout in Statistical Package for the Social Services version 20. Categorical variables were presented using frequency and percentage. Clopper-pearson meothers. As a result, enhancing existing strategies and developing new intervention measures including capacity building of healthworkers to improve child feeding practices must be mandatory actions for the government and policymakers.
Patellofemoral pain is the leading cause of knee pain in young adults. Magnetic resonance imaging plays an important role in early diagnosis of patellofemoral joint pathology. This study was carried out to evaluate the patellofemoral joint using magnetic imaging resonance and describe various predisposing factors for patellofemoral instability.

The study was carried in Department of Radiology, BPKIHS over a period of six months from February 2020 to August 2020. All patients with clinical diagnosis of patellar instability were included and Magnetic resonance imaging was done using standard knee protocol and findings were noted on structured proforma. Analysis was done using statistical package for the social sciences version 20 applying simple descriptive statistical methods.

A total of 60 patients who underwent MRI knee were analyzed, out of which 28(46.7%) patients were male while 32(53.3%) patients were female. 44 patients (58.3%) had various predisposing factors for patellar instability. The commonest predisposing factor was patellar subluxation (73.3%) followed by abnormal trochlear groove angle (58.3%) and patellar translation (increased tibia tubercle trochlear groove distance) (53.3%). Various MRI findings in our study were bone contusion (28 cases,46.7%), joint effusion (36 cases,60%), medial patellofemoral ligament injury (11cases ,18.3%), erosion of patellar cartilage (5 cases,8.3%), femoral cartilage erosion (3 cases,5%),loose bodies (2 cases,3.3%), subchondral edema (3 cases,5%) and meniscus injury (18 cases,30%).

Magnetic resonance imaging is not only useful in assessing lesions of the bone, cartilage and ligaments of patellofemoral joint but also enables detection of various predisposing factors for patellofemoral instability.
Magnetic resonance imaging is not only useful in assessing lesions of the bone, cartilage and ligaments of patellofemoral joint but also enables detection of various predisposing factors for patellofemoral instability.
Pregnancy has been identified as a vulnerable period for both the initiation and escalation in severity of domestic and family violence. There is a significant dearth of scholarly literature documenting the relationship of domestic and family violence with the mental health and quality of life among pregnant women of Nepal.

Baseline data of 140 women enrolled in a trial of a psychosocial intervention for abused pregnant women were analysed. Face-to-face interviews were conducted using standardised scales. Prevalence of domestic and family violence and mental health conditions were estimated and inferential statistics were used to assess the association of domestic and family violence with mental health, quality of life, social support, and use of safety behaviours.

The lifetime prevalence of domestic and family violence was found to be 27.7% (n = 173), followed by 17.1% of women (n = 107) fearing someone in their family. Domestic and family violence in the last 12 months was significantly associated with anxiety (p = 0.001), depression (p = 0.005), quality of life (p < 0.05), and perceived social support (p = 0.001). AS-703026 Use of safety behaviours (p = 0.037) was significantly low among women reporting domestic and family violence in the past year as well as during the current pregnancy (p = 0.017).

There exists a high psychological morbidity among pregnant women exposed to domestic and family violence. The findings support the need of implementing a screening and support intervention for abused women seeking antenatal services.
There exists a high psychological morbidity among pregnant women exposed to domestic and family violence. The findings support the need of implementing a screening and support intervention for abused women seeking antenatal services.
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