Journal of Karnali Education Health Research

Chat GPT: Boon or Curse for health science research?

Gopal Pokhrel — 2025-05-24

Autonomy and Respect among Postnatal Mothers during Maternity Care in Tertiary Level Hospital

Shila Adhikari — 2025-05-18

Introduction: Lack of respectful maternity care act as more powerful deterrents to skilled birth care utilization than other more commonly recognized deterrents such as geographic and financial obstacles. Ensuring high level of respectful maternity care encourage the women to utilize facility-based care, which is essential for improving maternal and neonatal health. Thus, the objective of the study is to find out autonomy and respect during maternity care among the postnatal mothers in a tertiary level hospital.
Methods: A descriptive cross-sectional study was conducted among 214 postnatal mothers receiving child birth services from the facility were selected by using non-probability purposive sampling technique. Analysis of data was done by using descriptive statistics (number, percentage, mean, standard deviation) and chi- square test was used for association between autonomy and respect and selected socio-demographic variables.
Results: The study result indicated that (74.8%) of the respondents had high level of autonomy. Similarly, (71%) of the respondents reported that they experience high level of respect. A significant association was present between autonomy of postnatal mothers with caste (p=.027) and parity (p=.005) and a significant association was present between respect of postnatal mothers with type of delivery is with p value (.001).
Conclusion: Level of autonomy and respect tends to be high among postnatal mothers during maternity care and is associated with caste, parity and type of delivery. Continuous professional development programme for all cadres of health personnel should be conducted in respectful maternity care of maternity ward.

Knowledge and Practice on Diarrhea Management among mothers of under five year Children

Champak Kumar Singh — 2025-05-18

Introduction: Diarrhea is one of the commonest cause of morbidity in children in developing countries. In Nepal, the prevalence of diarrhea is about 15% with higher rate in rural areas. The reduction in diarrhea may be due to correct case management as per standard treatment guidelines recommended by WHO and use of oral rehydration therapy as keystone in the diarrhea management.In developing countries, Water, Sanitation and hygiene (WASH) is a crucial aspect of public health. Unfortunately, inadequate WASH leads to death of approximately 842,000 individuals each year, accounting for 58% of all deaths caused by diarrheal diseases. The objective of this study was to assess the knowledge and management practice of diarrhea among mothers of under five children in community of Balwa Municipality, Mahatori, Nepal.
Methods: A descriptive cross-sectional study was conducted in Balwa Rural Municipality targeting mothers of children under five years. Using purposive sampling, a sample size of 384 were selected based on confidence level of 95% and an acceptable error of 5%. Data were collected through structured individual interviews with a self-administered questionnaire, pretested on 10% of the sample population. Data were entered in Microsoft Excel anddescriptive analysis was performed by SPSS 16.
Results: The study revealed that most mothers in Balwa Municipality have a high awareness of diarrhea transmission and ORS preparation but exhibit varied management practices. Despite adequate knowledge of diarrhea management, many mothers demonstrate poor practices, particularly in fluid intake and dietary management during diarrhea. The analysis showed a significant discrepancy between knowledge and practice levels, with a notable portion of mothers lacking effective management practices. Socio-demographic factors such as education and income also influenced these practices.
Conclusion: The study revealed that mothersof Balwa Municipality possess substantial knowledge about diarrhea management, gaps remain in practical application. Inadequate practices influenced by socio-demographic factors undermine effective diarrhea management. Addressing these gaps through targeted education and interventions is crucial for improving child health outcomes. Enhancing practical skills alongside knowledge is essential for better management of diarrhea in the community.

Assessment of quality control parameters of aceclofenac sustained release tablets marketed in Nepal

Nanda Kishor Bhatta — 2025-05-18

Introduction: Aceclofenac has low solubility and high permeability; its dissolution is rate-limiting step for its absorption. Different brand products of same drug require analysis for their biopharmaceutical equivalence to ensure their safety and efficacy.
Methods: It was a cross-sectional study. Eight brands of Aceclofenac SR tablets were collected from various retailerstoassess for their shape, size, weight and color and also were tested for their biopharmaceuticaland physicochemical equivalence. Descriptive statistics were calculated.
Results: The weight variation of all brands ranged within the maximum limit of ±5% except brand H.All of the brands had the recommended hardness (≥4Kg/cm2). The friability values of all products were within the recommended specification (≤1%). All tablets passed the test for assay as the amount of drug in each tablet was in the range of 85% - 115%. The % drug release of all brands were in the range of 50-80% except brand E and H at 8thhrs that showed 63.88% drug release. The brand A, B and H followed Pappes release model whereas brand C followed zero order model, brand D and G followed first order model and brand E & F followed Higuchi model.
Conclusions: All brands except one were interchangeable in terms of biopharmaceutical equivalence and sustained release formulation. Further, more in-vivo bioequivalent studies in human should be conducted to correlate the findings.

Assessment of prescribing pattern of anti hypertensive therapy in diabetic patients visiting in government hospital of Dolakha

Stuti Shrestha — 2025-05-18

Introduction: Hypertension and Diabetes Mellitus are two major chronic disorders that frequently coexist progressively with age irrespective of gender. WHO has projected that about 300 million people will suffer from diabetes and 1.5 billion from Hypertension by 2025. Both Hypertension and type II Diabetes are strongly interconnected and predispose an individual to atherosclerotic cardiovascular disease. As the patients require long life treatment, it has increased the burden of patients particularly in developing country like Nepal. In hospitals, there is genuine need for drug utilization study to determine appropriate, more safe and effective patterns of drug therapy among diabetic hypertensive patients.
Methods: A single centered retrospective specify how the study is retrospective cross sectional study was conducted in Jiri Hospital, Dolakha from Feb 2022 to July 2022. A total of 148 prescriptions of the patient with hypertension and coexisting diabetes were analyzed.
Results: The age group of the patients varied from 30-99 years with dominant age interval being32.4% of 50-59 years of age. Most of the patients were male comprising of 56.08% of the total population. For the treatment of hypertension, both monotherapy and combination therapy were followed. In Monotherapy, amlodipine was most prescribed with the percentage of 66%, followed by Losartan (17%). For combination therapy, a two drug combination of Amlodipine and Losartan was projected to the most commonly prescribed combination with a percentage of 59.18% followed by Losartan and Hydrochlorthiazide (26.5%)
Conclusion: The majority of the treated patients were prescribed on monotherapy (66.21%). Antihypertensives given were consistent with JNC VIII do not use abbreviation guidelines. However, there remains potential room for improvement in drug utilization and a critical need for better blood pressure control.

Drug Utilization Pattern in Cardiovascular Diseases in a Community Cardiac Hospital

Anil Kumar Sah — 2025-05-18

Introduction: Drug utilization research is the powerful exploratory tool to ascertain the role of drug in determining the therapeutic efficacy, cost effective and minimizing the adverse effects. Cardiovascular diseases are major health problem and a common cause of premature morbidity and mortality.
Methods: A prospective cross-sectional study was carried out among in-patients diagnosed with cardiovascular diseases at acommunity cardiac hospital for a period of two months. Patients’ records forms and the medical cardexwere reviewed. The descriptive statistics were calculatedusing Microsoft Excel 2016.
Results: Out of 201, 101 (50.25%) patients were females. Seventy four (36.82%) patients were from age group of 61-80 years and 56(27.86%) had systemic hypertension. A total of 2677 drugs were prescribed in 201 patients. The average number of drug per prescription was 13.49. Out of 201, 105 (52.24%) patients were prescribed four or more drugs. Cardiovascular drugs were the most commonly prescribed (898, 33.54%) out of which diuretic drugs were the most common (189, 21.04%) followed by antiplatelet drugs (145, 16.14%) and anticoagulants (116, 12.91%). The highest percentage of cost of medication for patient were less than 1000 NPR (27.86%). The number of encounter of Aluminium hydroxide plus Aspirin was the highest (25).
Conclusion: Diuretics were the most common prescribed cardiovascular drugs in our study. Polypharmacy was practiced in majority of the patients. The highest probability of causing of drug-drug interaction was encountered with aspirin.

Practice of exclusive breastfeeding and its factors among job holder mothers of Lalitpur metropolitan city

Sarad Pudasaini — 2025-05-18

Introduction: According to WHO, first six months of a child should be fed only breast milk which is crucial for an optimal growth. During this period, an infant should not be given any type of solid, semi solid or liquid food except breast milk. It is considered to protect an infant from several chronic diseases and prevents 10% of the child death in further life. Thus, the objective of the study is to assess the practice of exclusive breastfeeding (EBF) and its associating factors among the job holder mothers of Lalitpur metropolitan city.
Methods: The study was done on job holder mother working in Lalitpur metropolitan city. Cross sectional study was done through clustered sampling technique. The total number of the sample was 165. A structured questionnaire was used as the tool. The confidentiality of the respondents were maintained and required ethical consideration was taken. Analysis of data was done by using descriptive statistics and chi- square test was used for association between knowledge and practice about EBF among the job holder mothers.
Results: About 53.3% of the respondent had good knowledge about EBF whereas 52.8% had overall good practice of EBF. Also around 37.6 % expressed milk feeding, only 20% of the respondent succeeded to breastfeedingfor at least 6 months which is the major requirement of EBF and there was no association between knowledge and practice about EBF among the job holder mothers.
Conclusions: There was no association of the knowledge and practice. Even though the study found overall good knowledge and practice among the job holderdespite of good practice the prevalence of EBF is still poor among the job holder mothers.

Women’s Experience of Birth Companion in Facility Based Birth Setting

Pariksha Sharma — 2025-05-18

Introduction: Improving maternal and newborn care is a priority globally and in Nepal, where maternal mortality remains high. Women’s experiences play a crucial role in the utilization of health facilities, and engagement with maternity services.
Methods: This phenomenological study used in-depth interviews with eight postnatal women selected through purposive sampling. Data were collected via audio recordings and field notes. The content analysis yielded four themes from 12 categories.
Results: Four themes were identified: support person, type of support, staff interactions and positive birth experiences. Husbands were the preferred companions. Birth companions offer physical, emotional, and informational support that bridges care gaps caused by staff shortages. Their presence reduces fear, pain perception, and communication barriers while fostering respect and advocacy. Companions contribute to non-pharmacological pain management, reassurance, and stronger family bonds. Women with companions reported more positive birth experiences, enhanced self-esteem, and motivation for future vaginal births, women ask for woman-centered care that respects their autonomy in choosing birth companions.
Conclusion: Companions during childbirth significantly enhance maternal well-being by addressing physical, psychological, and emotional needs, fostering positive birth experiences. Prioritizing women’s autonomy in companion choice and adopting a woman-centered approach can bridge care gaps and improve care quality.

Prescribing Pattern of Anti-depressant drugs in Anxiety and Depressive disorder in Kathmandu valley

Sharan Adhikari — 2025-05-18

Introduction: Anxiety and depression embrace a range of mental conditions occurring frequently in primary health care, usually in the form of overt disorders.
Methods: Our study site included three hospitals inside Kathmandu valley. The study was a cross sectional study review of patients attending the outpatients department of the hospital. One hundred and sixty subjects were enrolled in this study and duration of study was six months.
Results: Out of 160 patients, 81 (50.6%) were female and 79 (49.4%) were male with a mean age of 37.75±1.65. Majority of patients 100 (62.5%) were married. Majority of patient 39 (24.4%) were found to be of bachelor level, which showed prevalence of anxiety and depressive disorder more on educated groups than uneducated groups. Housewives were the highly affected group 40 (25%). Among all the antidepressant drugs prescribed, Escitalopram was highly prescribed with the frequency of 70 (48.3%). Selective serotonin reuptake inhibitors were the most common drug class with frequency 105 (65.6%). Clonazepam was the highly prescribed benzodiazepine in combination with antidepressant. Combination therapy was used in majority of cases 136 (85.0%) and Mono-therapy was used only in 24 (15.0%) cases.
Conclusion: Majority of anxiety and depressive disorder prevalence was observed in Female than in male.In anxiety disorder no mono-therapy was preferred whereas in depressive disorder both combination and mono-therapy was preferred. Combination therapy was preferred over mono-therapy.Most commonly prescribed antidepressant was Escitalopram and highly prescribed drug class was SSRI’s.Clonazepam was the highly prescribed benzodiazepine in combination with antidepressant drugs.

One Health Approach in Nepal

Sandesh Ghimire — 2025-05-18

One health is a collaborative, trans-sectional and multidisciplinary approach that interlinks holistic efforts to reduce health threats at the human-animal-ecosystem interfaceIt also emphasizes the importance of community engagement, education, and capacity building to promote sustainable health practices and reduce health disparities. Human medicine and veterinary medicine have been studied together with eco-health as a collective one health concept. Emerging, re-emerging, and endemic zoonosis, neglected tropical diseases, vector-borne diseases, antimicrobial resistance, food safety and security, environmental contamination and climate change are the issues thatcan be addressed with One Health. One Health also has great economic utilities. Concept of One Health is still in its infancy in Nepal but is growing gradually. One health (OH) approach has become limited to few funded projects only.Poor organizational structure to support One Health, absence of adequate legal framework to implement One Health, inadequate co-ordination among different governmental agencies, insufficient technical expertise, substandarddata sharing mechanism across sectors, limited budget allocation and poor understanding at political level are the major challenges in effective execution of one health approach in Nepal. It is the need of time that all concerned stakeholders and sectors in Nepal show strong commitment to execute this holistic approach.It can lay a foundation to meet targets of sustainable development goals too.