One Health Journal of Nepal

Impact of Convergence of Antimicrobial Resistance (AMR) and COVID-19 on Population Health, Actions to Improve Health Outcomes

2024-02-29T15:22:24+00:00

Antimicrobial resistance (AMR) is a continuously growing and substantial threat of the twenty-first century to global health and development and its convergence with the current COVID-19 pandemic poses even a worse impact to population health. This viewpoint focuses on combined impact and determinants of AMR and Covid-19 on population health. Furthermore, it outlines potential procedures and interventions to moderate the burden of worldwide AMR in current and future pandemics.

Curious Case of a Child with Wilson Disease: A Case Report

2024-02-29T15:10:58+00:00

Wilson disease is an autosomal recessive disorder occurs due to lack or dysfunction of transmembrane copper- transporting ATPase, causing accumulation of copper in liver, the nervous system, corneas, kidneys, and heart. Patient was asymptomatic at presentation even with the sign of Kayser Fleischer ring in the eye. Asymptomatic presentation of disease can have symmetric T2 and FLAIR high signal intensities in bilateral putamina in early age and absent T1 low signal intensity in these areas of the brain. Hence MRI needs to be done early to determine the disease early without considering age and symptom.Early finding of deposition of copper in brain without neurological presentation and abnormal Liver Function Test is rare and D-Penicillamine and Zinc was enough to decrease the progression of disease.

Chondrodysplasia Punctata: A Case Report

2024-02-29T15:01:37+00:00

Chondrodysplasia Punctata (CDP) is a genetic disorder with skeletal and developmental abnormalities. This case report describes the clinical features, diagnostic evaluation, management, and genetic counselling of patients with CDP. This report aimed to increase awareness about this condition and importance of early diagnosis, multidisciplinary management care, and genetic counselling for better patient outcomes.

Lactate Dehydrogenase as a Biomarker for Assessment of COVID-19 Prognosis in Severe and Critically Ill Patients in Nepal: A Single-centered Retrospective Study

2024-02-29T12:57:13+00:00

Introduction: COVID-19 is an infectious disease caused by a corona virus. The level of serum LDH has been observed to be an important biomarker in predicting the extent of lung tissue damage. This study aimed to further investigate the predictive accuracy of LDH in estimating the prognosis of critically ill patients.

Methods: A retrospective study was conducted among COVID-19 patients, ≥ 18 years admitted to the intensive unit of Nepal APF Hospital from July 2020 to November 2021. Ethical approval was taken from NHRC and non- random sampling technique was done. The demographic, clinical and baseline LDH data was collected from the admission record files. The clinical status was investigated to look for discharge or death in the ICU. Thosepatients who were discharged or transferred to step-down were recorded as surviving patients. Data was entered in Microsoft Excel and analyzed using SPSS v16.

Results: Out of 190 patients 63% were males. The mean age noted was 56.59 ± 15.706 years. The duration of ICU stay was 9.13 ± 5.392 days. Among them 103 died and 87 of them survived. The cut-off value of LDH as a prognostic marker for mortality was observed to be 450 IU/L. On ICU admission, 164 patients had high LDH. Higher mortality was observed in the high LDH group (56%) as compared to the low LDH group (42.3%).

Conclusions: LDH is a useful biomarker for predicting in-hospital mortality in severe and critically ill COVID-19 patients and can guide the treating physicians to approach and plan the clinical management of patients with severe disease.

Knowledge and Practice on Blood Transfusion among Health Care Workers in Birtamode, Jhapa

2024-02-29T13:46:13+00:00

Introduction: Blood transfusion is the transfer of blood or blood component from donor to recipient. It is a vital and often life-saving procedure which needs proper knowledge and practice of health workers while performing. The main objective of the study was to assess knowledge and practice regarding blood transfusion procedure and its associated factors among healthcare workers working at P.T. Birta City Hospital and Research Center Pvt. Ltd.

Methods: Using a multistage sampling technique, a cross-sectional study was conducted involving 126 healthcare workers in Birtamod Municipality. A self-administered questionnaire was employed to assess their knowledge and practice of blood transfusion procedures, with data analysis conducted using SPSS version 23.

Results: The study revealed that 96% of healthcare workers exhibited satisfactory knowledge, and 79% demonstrated competent practices in blood transfusion procedures. On average, each health worker conducted 2 blood transfusions per week, with some performing up to 10. The study identified associations between compliance with unit protocol guidelines and knowledge/practices related to blood transfusion, as well as participation in training programs and the level of knowledge about blood transfusion.

Conclusions: The majority of healthcare workers exhibited satisfactory knowledge and moderate practices regarding blood transfusion, highlighting the need for targeted refresher training to enhance safe blood transfusion practices, addressing specific areas of deviation.

Nitrite and Leukocyte Esterase Activity Test for the Diagnosis of Urinary Tract Infection in Children: A Diagnostic Study

2024-02-29T13:59:19+00:00

Introduction: Urinary tract infection (UTI) is a common reason for pediatric hospital visits, often leading to misdiagnosis due to nonspecific symptoms. This study aimed to establish the diagnosis of UTI using dipstick tests in children with or without localizing signs and symptoms of UTI. Also comparison between urine culture with a dipstick test for diagnosing UTI was done.

Methods: A diagnostic study included 134 children aged 1 to 60 months presenting with fever or clinical signs of UTI. Urine samples were collected and subjected to culture, routine microscopy, and dipstick testing. The dipstick's leukocyte esterase (LE) test and nitrite test were compared to urine culture to assess their diagnostic accuracy.

Results: Among the 134 cases, 13 were culture positive, with E. coli being the most commonly isolated organism (53.8%). Fever was the most common symptom. Urine microscopy was positive in 21 cases, and 11 were culture positive. Compared to urine culture, the LE test had a sensitivity of 76.92%, specificity of 84.29%, PPV of 34.48%, and NPV of 97.14%. The nitrite test had a sensitivity of 84.61%, specificity of 92.56%, PPV of 55%, and NPV of 98.24%. Comparing either test to urine culture, the sensitivity was 92.30%, specificity was 82.64%, PPV was 36.36%, and NPV was 99.01%.

Conclusions: The combined dipstick test, including the nitrite and LE tests, showed good sensitivity, specificity, and NPV compared to urine culture. It can be reliably used for diagnosing UTI and initiating antibiotic treatment while awaiting urine culture results.

Knowledge and Preventive Practices Regarding Dengue Fever among Medical Undergraduates in Teaching Hospital in Nepal: A Descriptive Cross-sectional Study

2024-02-29T14:13:08+00:00

Introduction: Dengue Fever (DF) is a significant public health concern in Nepal, and medical undergraduates play a crucial role in disease prevention and control. This study aimed to assess the knowledge and preventive practices regarding DF among medical undergraduates at KIST Medical College and Teaching Hospital in Nepal.

Methods: A descriptive cross-sectional study was conducted among 249 medical undergraduate students, comprising 43.8% males and 56.2% females. Data were collected using a structured questionnaire, assessing participants' knowledge of Dengue symptoms, transmission, and preventive practices. The data were analyzed using SPSS version 25.

Results: Most participants correctly identified Dengue fever as a viral disease transmitted by Aedes mosquitoes (81.9%) and knew that the main cause of transmission is human to mosquito contact (96.4%). However, only 18.1% were aware of all four antigenic subtypes of Dengue prevalent in Nepal. Regarding preventive practices, 98.8% acknowledged that Dengue is preventable, and a significant proportion adopted measures such as usingmosquito bed nets (95.2%) and seeking timely medical attention when symptomatic (95.6%).

Conclusions: The study reveals that medical undergraduates at KIST Medical College and Teaching Hospital have good knowledge and positive preventive practices towards Dengue fever. However, knowledge gaps exist, particularly regarding Dengue subtypes and breeding sites. Health education programs are crucial to address these gaps and enhance preventive practices, empowering medical students to become effective advocates for Dengue control in Nepal.Dengue

Knowledge, Attitude, and Practice on Menstrual Hygiene among School going Adolescents of Tokha Municipality, Kathmandu, Nepal

2024-02-29T14:34:56+00:00

Introduction: Menstruation is a natural physiological process that starts in females usually between the ages of 11 and 15 (menarche) and ends at menopause. Menstrual hygiene, one of the crucial components for the well- being of women, has significant implications for girls' education, empowerment, and overall social development. But yet the topic remains shrouded in taboo and misconceptions. This study focuses on the knowledge, attitudes, and practices of school-going adolescents regarding menstrual hygiene in Tokha Municipality, Kathmandu.

Methods: A descriptive cross-sectional study involved 335 students in grades 8, 9, and 10 from public schools in Tokha Municipality, Kathmandu. Students were selected through random sampling, with prior ethical approval. Adolescent girls who hadn't experienced menarche were excluded. The research utilized UNICEF's Menstrual Hygiene Management (MHM) assessment tool and conducted data analysis using SPSS version 20.

Results: Out of total adolescents, more than eight out of ten males (86%) were aware that menstruation is a normal physiological process whereas the majority of females (94.5%) were aware of the same fact. The percentage of female adolescents facing restriction during menstruation was 34.7% and the percentage of adolescents having an average level of attitude towards menstruation was 60.3%. The majority of female adolescents participating in the study had above-average levels of practice on menstruation.

Conclusions: The study findings indicate a prevalent awareness of menstruation as a natural process among adolescents in Tokha Municipality, Kathmandu. However, challenges such as restrictions during menstruation and average attitudes suggest the need for targeted interventions to foster a more supportive environment for adolescent well-being.

Knowledge and Practice regarding Oral Rehydration Therapy for Diarrhea among Mothers of Under-5 Children in Buddhabhumi Municipality, Kapilvastu

2024-02-29T14:41:37+00:00

Introduction: One of the most effective and established therapies for the treatment of dehydration is oral rehydration therapy, which is convenient as it can be easily carried out in the home. Diarrhea in itself is not lethal, however, inadequate knowledge and poor practices among the primary caregiver; mothers lead to severe dehydration leading to death. The main objective of this study was to assess the mothers’ knowledge and practice regarding oral rehydration therapy for diarrhea among mothers of under-5 children.

Methods: This cross sectional study was conducted with a sample size of 216. Relevant descriptive statistics were computed for all items. A semi-structured questionnaire was used for data collection while SPSS version 20 was used for analysis. Purposive sampling technique was used, by utilizing a semi-structured questionnaire.

Results: The study highlighted that half of the mothers (52.4%) having under five aged children had fair knowledge about Oral Rehydration Solution (ORS) while one-fourth of the participants had poor (23.3%) and one-fourth of participants (24.3%) had good knowledge. More than half of the participants did not know the role of ORS in diarrhea. Half of the participants (58.2%) knew that either boiled or clean water was necessary for the preparation of ORS. Two–thirds (78.8%) of the participants knew that 1 liter of water is needed for 1 packet of ORS.

Conclusions: Despite the rampant availability of information sources, the study shows the need for awareness and knowledge dissemination sessions to be conducted at the community level to upgrade the level of knowledge.