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Limbu S, Nepal S, Mishra SK. Duration of untreated psychosis and its associated sociodemographic and clinical factors in first-episode psychosis: A study from Eastern Nepal. Int J Psychiatry Med 2024:912174241247611. [PMID: 38621675 DOI: 10.1177/00912174241247611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/17/2024]
Abstract
OBJECTIVE Duration of untreated psychosis (DUP) is considered an important factor in outcome. Individual, familial and illness factors may prolong DUP. Little data on this issue is available from the country of Nepal. The purpose of the present study was to assess DUP in patients with first-episode psychosis and identify associations with patients' socio-demographic and clinical factors. METHODS A cross-sectional, descriptive study was conducted in the department of psychiatry, of Tertiary Hospital in the Eastern part of Nepal. Eighty-six patients were enrolled. ICD-10 was used to make the diagnosis. Nottingham Onset Schedule-DUP version (NOS-DUP) was used to assess DUP. Positive and Negative Syndrome Scale (PANSS) was used to assess patients' clinical symptoms. RESULTS The mean (SD) DUP was 21.4 (42.1) months and median DUP was 3.0 months (IQR = 23.5). Participants from mountainous region, the unemployed, having an insidious onset of illness, and patients with a diagnosis of schizophrenia had significantly longer DUP (P < .005). Duration of untreated psychosis was also positively correlated with negative symptoms (r = .42, (P < .001) and total PANSS score (r = .42, P < .001). CONCLUSION Duration of untreated psychosis in first-episode psychotic patients was relatively long (compared to studies in other countries), and was found to be positively associated with mountainous regions of Nepal, being unemployed, having an insidious onset of illness, and having a diagnosis of schizophrenia. Programs and educational efforts are needed to ensure early treatment of patients with first-episode psychosis, especially in the mountainous rural areas of Nepal.
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Affiliation(s)
- Suren Limbu
- Department of Psychiatry, B.P. Koirala Institute of Health Sciences, Dharan, Nepal
| | - Suraj Nepal
- Department of Psychiatry, B.P. Koirala Institute of Health Sciences, Dharan, Nepal
| | - Sanjeev Kumar Mishra
- Department of Psychiatry, B.P. Koirala Institute of Health Sciences, Dharan, Nepal
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Yogi TN, Puri S, Shah B, Nepal S, Mishra A. Point prevalence and clinical profile of patients with delirium admitted in internal medicine department at tertiary care centre in eastern Nepal: a descriptive cross-sectional study. Ann Med Surg (Lond) 2024; 86:1335-1340. [PMID: 38463110 PMCID: PMC10923295 DOI: 10.1097/ms9.0000000000001761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 01/15/2024] [Indexed: 03/12/2024] Open
Abstract
Introduction Delirium, marked by acute disturbances in consciousness and cognition, remains underdiagnosed despite its significant impact on morbidity and mortality. This study investigates the point prevalence and clinical profile of delirium in patients at an eastern Nepal tertiary care centre. Methods A 1-month descriptive cross-sectional study involved 152 Internal Medicine Department patients at BPKIHS, Dharan. Data, collected through face-to-face interviews and the Confusion Assessment Method (CAM), analyzed demographic details, clinical history, and laboratory findings. Ethical clearance and informed consent were obtained. Results Among 152 participants, 13.2% exhibited delirium, with notable risk factors identified. Elderly patients (≥65 years) and those with nasogastric tubes faced higher risks. Significant associations were found with cardiovascular diseases (P=0.002), central nervous system diseases (P=0.015), and alcoholism (P=0.003). Laboratory findings revealed correlations with elevated creatinine, hyperuremia, and abnormal aspartate aminotransferase levels. The study emphasizes key contributors to delirium, providing valuable insights for clinicians in identifying, preventing, and managing delirium in a hospital setting. Conclusions This study provides critical insights into delirium prevalence and profiles in Eastern Nepal. Identified risk factors underscore the importance of routine screenings and targeted interventions for at-risk populations. Study limitations, including sample size and single-centre focus, call for further research to validate findings and enhance our understanding of delirium's management across diverse healthcare settings. Overall, the study informs clinical practices and prompts broader exploration of delirium in healthcare contexts.
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Affiliation(s)
| | | | | | - Suraj Nepal
- Psychiatry, BP Koirala Institute of Health Sciences (BPKIHS), Dharan, Nepal
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Basnet M, Thapa P, Shakya DR, Nepal S, Rai N, Shrestha KK. Knowledge, Attitude, and Practice Regarding Media Reporting on Suicide among Media Persons of a Province. JNMA J Nepal Med Assoc 2024; 62:129-135. [PMID: 38409994 PMCID: PMC10924522 DOI: 10.31729/jnma.8000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Accepted: 02/22/2024] [Indexed: 02/28/2024] Open
Abstract
Introduction Suicide is a global public health problem. Sensible media reporting on suicide could be useful in suicide prevention. This study aimed to evaluate the knowledge, attitude, and practice regarding media reporting on suicide among media persons of a province. Methods A qualitative study was done among media persons of the province after obtaining ethical approval from the Institutional Review Committee. Data was collected through online platform using Google form from 15 April 2022 and 15 January 2023. A convenience sampling method was used. Descriptive statistics were used for the data analysis. Results Among 165 media persons, 54 (32%) of the participants either agreed to or were neutral about prominently reporting suicide news, and 47 (28.48%) were undecided or agreed about mentioning the details of the event. Only 50 (30.30%) thought that it is always possible to help a person with suicidal thoughts. A total of 48 (29.09%) always reported providing information about where to seek help in case one is suicidal. Conclusions Media personnel were found to possess better knowledge about suicide reporting but exhibited inadequate practice in terms of providing method and site details and promoting support services, alongside maintaining an unfavorable attitude towards suicide. There is an urgent need to focus on coordination, standardisation, evidence generation and capacity building of media persons on suicide. Keywords attitude; cross-sectional study; knowledge; suicide.
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Affiliation(s)
- Madhur Basnet
- Department of Psychiatry, B.P. Koirala Institute of Health Sciences, Dharan, Sunsari, Nepal
| | - Prekshya Thapa
- Department of Psychiatric Nursing, College of Nursing, B.P. Koirala Institute of Health Sciences, Dharan, Sunsari, Nepal
| | - Dhana Ratna Shakya
- Department of Psychiatry, B.P. Koirala Institute of Health Sciences, Dharan, Sunsari, Nepal
| | - Suraj Nepal
- Department of Psychiatry, B.P. Koirala Institute of Health Sciences, Dharan, Sunsari, Nepal
| | - Neena Rai
- Department of Psychiatry, KIST Medical College and Teaching Hospital, Mahalaxmi, Lalitpur, Nepal
| | - Kailash Khaki Shrestha
- Department of Public Health, Edenburg International College, Purbanchal University, Biratnagar, Morang, Nepal
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Atreya A, Bashyal G, Gyawali L, Acharya J, Nepal S. Saree on Fireside: Fatal Burn in an Elderly Nepalese Female. Kathmandu Univ Med J (KUMJ) 2022; 20:114-116. [PMID: 36273304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
As winter approaches, people in the land of rural Himalayas commonly use fire as the source of heat. Many accidents occur in the process, and mostly the victims are among unattended children and the elderlies. We present a case from rural Nepal where an elderly female sustained fatal burn injuries. Advanced age, greater surface area, and secondary infection were the complicating factors. In the present case, the victim's clad cloth (Saree) was the harbinger to death. Prevention of infection following burn and control of sepsis still remains the mainstay of treatment in burn victims.
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Affiliation(s)
- A Atreya
- Department of Forensic Medicine, Lumbini Medical College Teaching Hospital, Palpa, Nepal
| | | | | | - J Acharya
- Department of Forensic Medicine, Kathmandu Medical College Teaching Hospital, Kathmandu, Nepal
| | - S Nepal
- Department of Community Medicine, Lumbini Medical College Teaching Hospital, Palpa, Nepal
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Gupta AK, Joshi S, Kafle B, Thapa R, Chapagai M, Nepal S, Niraula A, Paudyal S, Sapkota P, Poudel R, Gurung BS, Pokhrel P, Jha R, Pandit S, Thapaliya S, Shrestha S, Volpe U, Sartorius N. Pathways to mental health care in Nepal: a 14-center nationwide study. Int J Ment Health Syst 2021; 15:85. [PMID: 34930398 PMCID: PMC8685796 DOI: 10.1186/s13033-021-00509-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 12/09/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Pathways to care studies are feasible and tested means of finding the actual routes taken by patients before reaching proper care. In view of the predominance of nonprofessional service providers and the lack of previous large studies on pathways in Nepal, this multicenter study is needed. The aim of the study was to trace the various pathways and carers involved in mental health care; assess clinical variables such as the duration of untreated illness, clinical presentation and treatment; and compare geographically and culturally diverse landscapes. METHODS This was a cross-sectional, convenience sampling study performed at 14 centers where new cases were being taken. The World Health Organization Study of the Pathways-to-Care Schedule was applied. The Nepali version of the encounter form was used. The data were collected between 17 September and 16 October 2020 and were analyzed using the Statistical Package for the Social Sciences (SPSS). Additionally, perspectives from local investigators were collected and discussed. RESULTS Most of the first carers were native/religious faith healers (28.2%), followed by psychiatrists (26%). The median duration for the first psychiatric consultation was 3 weeks. The duration of untreated illness was 30.72 ± 80.34 (median: 4) weeks, and the time taken for this journey was 94.99 ± 274.58 (median: 30) min. The longest delay from the onset of illness to psychiatric care was for epilepsy {90.0 ± 199.0 (median: 25.5)} weeks, followed by neurotic illness {22.89 ± 73.45 (median: 2)} and psychotic illness {10.54 ± 18.28 (median: 2)} weeks. Overall, most patients with severe mental illnesses (SMIs) had their first contact with faithhealers (49%), then met with medical doctors (13%) or psychiatrists (28%). Marked differences in clinical presentation surfaced when hilly centers were compared with the Terai belt. CONCLUSIONS Faith healers, general practitioners and hospital doctors are major carers, and the means of educating them for proper referral can be considered. The investigators see several hindrances and opportunities in the studied pathways. The employment of more mental health professionals and better mental health advocacy, public awareness programs and school education are suggested strategies to improve proper mental health care.
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Affiliation(s)
| | - Sulochana Joshi
- Department of Psychiatry, Patan Academy of Health Sciences, Lalitpur, Nepal
| | - Bikram Kafle
- Department of Psychiatry, Devdaha Medical College, Devdaha, Nepal
| | - Ranjan Thapa
- Neuro Cardio and Multi-Specialty Hospital, Biratnagar, Nepal
| | - Manisha Chapagai
- Department of Psychiatry, Tribhuvan University Teaching Hospital, Kathmandu, Nepal
| | - Suraj Nepal
- Department of Psychiatry, B. P. Koirala Institute of Health Sciences, Dharan, Nepal
| | - Abhash Niraula
- P.T. Birta City Hospital and Research Centre, Birtamode, Nepal
| | - Sreya Paudyal
- Universal College of Medical Sciences, Siddharthanagar, Nepal
| | | | - Reet Poudel
- Department of Psychiatry, Nepalgunj Medical College, Kohalpur, Nepal
| | | | - Prabhakar Pokhrel
- Department of Psychiatry, KIST Medical College and Teaching Hospital, Imadol, Lalitpur, Nepal
| | - Robin Jha
- Department of Psychiatry, Janakpur Provincial Hospital, Janakpur, Nepal
| | - Sanjib Pandit
- Present Address: Department of Psychiatry, Rapti Academy of Health Sciences, Ghorahi, Nepal
- Department of Psychiatry, Karnali Academy of Health Sciences, Jumla, Nepal
| | - Suresh Thapaliya
- Department of Psychiatry, National Medical College, Birgunj, Nepal
- Present Address: Kent and Medway NHS and Social Care Partnership Trust, Kent, UK
| | - Shuva Shrestha
- Department of Psychiatry, National Medical College, Birgunj, Nepal
| | - Umberto Volpe
- Unit of Clinical Psychiatry, Head, Department of Clinical Neurosciences/DIMSC, School of Medicine, Università Politecnica Delle Marche, Via Tronto 10/A, 60126 Ancona, Italy
| | - Norman Sartorius
- Association for the Improvement of Mental Health Programmes (AMH), 20 chemin Colladon, 1209 Geneva, Switzerland
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Nepal S, Paudel RK, Aryal S. National lockdown poses new challenges for leprosy patients in Nepal. LEPROSY REV 2021. [DOI: 10.47276/lr.92.1.92] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Paudel L, Regmi S, Dahal P, Ghimire M, Nepal S, Manandhar N. Work-related Respiratory Symptoms and Associated Factors among Cement Factory Workers in Rupandehi District, Nepal. Kathmandu Univ Med J (KUMJ) 2021; 19:41-46. [PMID: 34812156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Background Cement factory workers are exposed to cement dust at workplace. It leads to a greater prevalence of chronic respiratory signs and symptoms. Objective To identify the prevalence of Work-related respiratory symptoms, its association with various risk factors, and to assess the outcomes like hospitalization and sickness absenteeism. Method Cross-sectional study was conducted in the Argakhanchi Cement factory among 190 workers with minimum work experience of 1 year. Census method was used for data collection. To assess the respiratory symptoms, sputum samples were collected; smears prepared by pick and smear method, and later stained by Leishman and pap stain. Smears devoid of alveolar macrophages were considered unsatisfactory for evaluation. Result The mean age of respondents with standard deviation was 35.56±11.45 years. The prevalence of Work-related respiratory symptoms was 31.6%. Age, no. of years worked, working in the raw materials department, burner and clinker department, cleaning department and wearing mask were the significant risk factors. On cytological analysis of the sputum sample, mild inflammatory cell noticed in 71.6%, moderate inflammation in 23.7%, and dense inflammation in 4.2%. Fungal spores were seen in 3.7%, fungal pseudohyphae in 0.5%, and bacterial colonies in 27% of the sputum samples. Out of 190 participants, 8(4.2%) of them had to be hospitalized and 17(8.9%) were on sick leave due to respiratory symptoms. Conclusion Pre-employment and periodic medical examination, frequent work shift, training on occupational health and safety, use of appropriate personnel protective equipment is recommended to reduce respiratory symptoms.
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Affiliation(s)
- L Paudel
- Department of Community Medicine, Nepalese Army Institute of Health Sciences, Sanobharyang, Kathmandu, Nepal
| | - S Regmi
- Department of Pathology, Manipal College of Medical Sciences, Pokhara, Nepal
| | - P Dahal
- Deaprtment of Pathology, Lumbini Medical College, Pravas, Palpa, Nepal
| | - M Ghimire
- Department of Community Medicine, Lumbini Medical College, Pravas, Palpa, Nepal
| | - S Nepal
- Department of Community Medicine, Lumbini Medical College, Pravas, Palpa, Nepal
| | - N Manandhar
- Department of Community Medicine, Kathmandu Medical college, Sinamangal, Kathmandu, Nepal
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Nepal S, Stapinski L, Newton N, Grummitt L, Lawler S, Guckel T, Lynch S, Chapman C, Teesson M. Positive Choices: Addressing the evidence-practice gap in alcohol and other drug prevention. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa165.445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Issue
Alcohol and other drug (AOD) use during adolescence puts young people at risk of juvenile offending, poor educational outcomes, school dropout, and mental health issues. Since parents and school teachers are the primary source of contact for adolescents, it is important that they are equipped with accurate and up-to-date response strategies. There are a number of effective drug prevention strategies, however, they are not widely implemented.
Description of the practice
To address this evidence-practice gap, the Positive Choices initiative was launched in 2015. Positive Choices supports implementation of evidence-based and prevention strategies through provision of training and a centralised information and resources portal for young people, their parents and teachers. The portal contains information factsheets and webinars and was developed in consultation with AOD experts and target users. Drug education resources and curriculum programs meeting pre-specified criteria for relevance, quality and evidence-base are listed in the resources database.
Results
Positive Choices has been accessed by one-million Australian and international users. The most popular resources are videos, factsheets, webinars. In 2019, 71% parents and 65% teachers said that they would continue using the website. Half (54%) of school staff were not currently implementing evidence-based prevention strategies, of these 89% intended to shift to evidence-based practice after using Positive Choices. The majority of the users have said they would recommend the website to their colleagues and friends.
Lessons
Positive Choices is effective in changing users' intentions to implement evidence-based strategies. Drug education programs need to engage parents and teachers if they are to be effective.
Key messages
Positive Choices has increased users’ awareness of evidence-based prevention strategies. Positive Choices has increased users’ intentions to implement evidence-based prevention strategies.
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Affiliation(s)
- S Nepal
- Matilda Centre for Research in Mental Health & Substance Use, University of Sydney, Darlington, Australia
| | - L Stapinski
- Matilda Centre for Research in Mental Health & Substance Use, University of Sydney, Darlington, Australia
| | - N Newton
- Matilda Centre for Research in Mental Health & Substance Use, University of Sydney, Darlington, Australia
| | - L Grummitt
- Matilda Centre for Research in Mental Health & Substance Use, University of Sydney, Darlington, Australia
| | - S Lawler
- Matilda Centre for Research in Mental Health & Substance Use, University of Sydney, Darlington, Australia
| | - T Guckel
- Matilda Centre for Research in Mental Health & Substance Use, University of Sydney, Darlington, Australia
| | - S Lynch
- Matilda Centre for Research in Mental Health & Substance Use, University of Sydney, Darlington, Australia
| | - C Chapman
- Matilda Centre for Research in Mental Health & Substance Use, University of Sydney, Darlington, Australia
| | - M Teesson
- Matilda Centre for Research in Mental Health & Substance Use, University of Sydney, Darlington, Australia
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Plaster B, Adamek E, Allgeier B, Anaya J, Back H, Bagdasarova Y, Berguno D, Blatnik M, Boissevain J, Bowles T, Broussard L, Brown MP, Carr R, Clark D, Clayton S, Cude-Woods C, Currie S, Dees E, Ding X, Du S, Filippone B, García A, Geltenbort P, Hasan S, Hawari A, Hickerson K, Hill R, Hino M, Hoagland J, Hoedl S, Hogan G, Hona B, Hong R, Holley A, Ito T, Kawai T, Kirch K, Kitagaki S, Knecht A, Lamoreaux S, Liu CY, Liu J, Makela M, Mammei R, Martin J, Meier N, Melconian D, Mendenhall M, Moore S, Morris C, Mortensen R, Nepal S, Nouri N, Pattie R, Pérez Galván A, Phillips II D, Pichlmaier A, Picker R, Pitt M, Ramsey J, Rios R, Russell R, Sabourov K, Sallaska A, Salvat D, Saunders A, Schmid R, Seestrom S, Servicky C, Sharapov E, Sjue S, Slutsky S, Smith D, Sondheim W, Sun X, Swank C, Swift G, Tatar E, Teasdale W, Terai C, Tipton B, Utsuro M, Vogelaar R, VornDick B, Wang Z, Wehring B, Wexler J, Womack T, Wrede C, Xu Y, Yan H, Young A, Yuan J, Zeck B. Final results for the neutron β-asymmetry parameter A0 from the UCNA experiment. EPJ Web Conf 2019. [DOI: 10.1051/epjconf/201921904004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
The UCNA experiment was designed to measure the neutron β-asymmetry parameter A0 using polarized ultracold neutrons (UCN). UCN produced via downscattering in solid deuterium were polarized via transport through a 7 T magnetic field, and then directed to a 1 T solenoidal electron spectrometer, where the decay electrons were detected in electron detector packages located on the two ends of the spectrometer. A value for A0 was then extracted from the asymmetry in the numbers of counts in the two detector packages. We summarize all of the results from the UCNA experiment, obtained during run periods in 2007, 2008–2009, 2010, and 2011–2013, which ultimately culminated in a 0.67% precision result for A0.
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Immerzeel WW, Lutz AF, Andrade M, Bahl A, Biemans H, Bolch T, Hyde S, Brumby S, Davies BJ, Elmore AC, Emmer A, Feng M, Fernández A, Haritashya U, Kargel JS, Koppes M, Kraaijenbrink PDA, Kulkarni AV, Mayewski PA, Nepal S, Pacheco P, Painter TH, Pellicciotti F, Rajaram H, Rupper S, Sinisalo A, Shrestha AB, Viviroli D, Wada Y, Xiao C, Yao T, Baillie JEM. Importance and vulnerability of the world’s water towers. Nature 2019; 577:364-369. [DOI: 10.1038/s41586-019-1822-y] [Citation(s) in RCA: 477] [Impact Index Per Article: 95.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Accepted: 11/11/2019] [Indexed: 11/09/2022]
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Atreya A, Nepal S, Kanchan T. Study on Hanging with Brief Discussion upon Ambiguity in Method of Choice and Gender Differences for Completed Suicide in Existing Literatures in Nepalese Scenario. Kathmandu Univ Med J (KUMJ) 2019; 17:25-29. [PMID: 31734674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Background Hanging is one of the common forms of violent mechanical asphyxial deaths. When compared to other forms of unnatural death all over the world this method stands on top as death is instantaneous. Death due to hanging is always suicidal until and unless otherwise specified. Objective To explore the socio-demographic characteristics in cases of death due to completed hanging in Nepal. Method This prospective study of death due to hanging was conducted during the period of July 2011 to July 2013. Meticulous autopsy of the body was done in all cases with bloodless dissection of the neck was carried out. Result During the study period medico legal autopsy of 91 cases of death due to hanging was conducted, out of which 57 (63%) were males and 34 (37%) were females. Majority of the deceased were suspended at their own house or peri-domestic settings. Based upon the circumstantial evidences 95.61% (n=87) cases attributed to suicide in nature. Conclusion Hanging undoubtedly is one of the most preferred methods to commit suicide, popular for its lethality. Lack of suicide surveillance system and national data bank in Nepal has resulted into equivocal findings. More studies should be encouraged based upon autopsy findings to get a clear picture on mortality rates.
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Affiliation(s)
- A Atreya
- Department of Forensic Medicine, Lumbini Medical College and Teaching Hospital, Palpa, Nepal
| | - S Nepal
- Department of Community Medicine, Lumbini Medical College and Teaching Hospital, Palpa, Nepal
| | - T Kanchan
- Department of Forensic Medicine and Toxicology, All India Institute of Medical Sciences, Jodhpur, India
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Sun X, Adamek E, Allgeier B, Blatnik M, Bowles T, Broussard L, Brown MP, Carr R, Clayton S, Cude-Woods C, Currie S, Dees E, Ding X, Filippone B, García A, Geltenbort P, Hasan S, Hickerson K, Hoagland J, Hong R, Hogan G, Holley A, Ito T, Kneckt A, Liu CY, Liu J, Makela M, Mammei R, Martin J, Melconian D, Mendenhall M, Moore S, Morris C, Nepal S, Nouri N, Pattie R, Galván A, Phillips II D, Picker R, Pitt M, Plaster B, Ramsey J, Rios R, Salvat D, Saunders A, Sondheim W, Sjue S, Slutsky S, Swank C, Swift G, Tatar E, Vogelaar R, VornDick B, Wanchun W, Wang Z, Wexler J, Womack T, Wrede C, Young A, Zeck B. Search for neutron dark decay: n → χ + e+e−. EPJ Web Conf 2019. [DOI: 10.1051/epjconf/201921905008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
In January, 2018, Fornal and Grinstein proposed that a previously unobserved neutron decay branch to a dark matter particle (χ) could account for the discrepancy in the neutron lifetime observed in two different types of experiments. One of the possible final states discussed includes a single χ along with an e+e− pair. We use data from the UCNA (Ultracold Neutron Asymmetry) experiment to set limits on this decay channel. Coincident electron-like events are detected with ∼ 4π acceptance using a pair of detectors that observe a volume of stored Ultracold Neutrons (UCNs). We use the timing information of coincidence events to select candidate dark sector particle decays by applying a timing calibration and selecting events within a physically-forbidden timing region for conventional n → p + e- + ν̅e decays. The summed kinetic energy (Ee+e−) from such events is reconstructed and used to set limits, as a function of the χ mass, on the branching fraction for this decay channel.
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Atreya A, Nepal S, Bhattarai A, Kanchan T. Obligate Myiasis: A Case Series From Nepal. Kathmandu Univ Med J (KUMJ) 2018; 16:269-271. [PMID: 31719320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Although maggots are unanonymously linked to carcass or dead tissues, there are reports of its infestation into living tissues as well. Myiasis denotes maggot infestation in living tissue. There are two forms of myiasis namely obligate and facultative. Obligate myiasis denotes maggots feeding on living tissue whereas facultative myiasis represents the opportunistic behaviour of the fly taking advantage of wound or necrotic tissue, laying by eggs which hatch into maggots. Decreased physical activity and poor hygiene leads to maggot infestation. Maggot invasion of living tissues is undesirable occurrence which can best be avoided by improving hygiene. People with low living standards in the developing nations are the occasional victims for maggot infestations. We present cases of obligate myiasis for their uniqueness and rarity.
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Affiliation(s)
- A Atreya
- Department of Forensic Medicine, Lumbini Medical College and Teaching Hospital, Palpa, Nepal
| | - S Nepal
- Department of Community Medicine, Devdaha Medical College, Rupandehi, Nepal
| | - A Bhattarai
- Department of Emergency, Manipal College of Medical Sciences, Pokhara, Nepal
| | - T Kanchan
- Department of Forensic Medicine and Toxicology, All India Institute of Medical, Sciences, Jodhpur, India
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Nepal S, Atreya A, Kanchan T. Awareness and Perceptions of Medical Students towards Health Care Ethics - A Study from Nepal. Kathmandu Univ Med J (KUMJ) 2017; 15:313-318. [PMID: 30580348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Background Medical practitioners are the men of science who treat patients based on their knowledge and skill. Unethical and immoral conduct in the practice of medicine pertains to human right issues and litigation. Objective The present study is conducted to understand the perceptions and awareness of the moral and ethical responsibilities of future medical doctors in Nepalese scenario. Method This cross sectional study was carried out among the undergraduate medical students of Manipal College of Medical Sciences, Pokhara, Nepal who were administered a pre-tested, semi-structured questionnaire relating to various aspects of health care ethics. A total of 202 students (116 girls and 86 boys) voluntarily participated in the study. Based upon the criteria whether a student had attended forensic medicine lecture the study participants were thus divided into two groups Group I and Group II. The responses of the participants were obtained on a 5 point Likert scale and analyzed. Result The study observed that the overall awareness on issues regarding consent was proportionately higher than for issues dealing with patient's right to treatment. The awareness levels were similar among the students of both groups for most of the issues with exception of a few issues where awareness levels were higher among the Group II students when compared to the Group I students. Conclusion This present study attempts to present the assessment of students on issues relating to ethics and moral reasoning. The present study also emphasizes on the importance of ethics in the practice of medicine.
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Affiliation(s)
- S Nepal
- Department of Community Medicine, Devdaha Medical College and Research Institute, Rupandehi, Nepal
| | - A Atreya
- Department of Forensic Medicine, Devdaha Medical College and Research Institute, Rupandehi, Nepal
| | - T Kanchan
- Department of Forensic Medicine and Toxicology, All India Institute of Medical Sciences, Jodhpur, India
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Atreya A, Kanchan T, Nepal S. Pressure Cooker-A Potential Hazard in Domestic Setting. Kathmandu Univ Med J (KUMJ) 2016; 14:181-183. [PMID: 28166078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Pressure cooker is an integral part of Asian kitchen, and is frequently used in Nepal. Steam under pressure generated while cooking has high boiling point and great penetrating power. The use of pressure cooker in kitchen is associated with unintentional injuries that mostly include pressure cooker burns. In rare instances the pressure cooker may accidently explode and may cause serious injuries. The same mechanism is used in making explosive device for mass homicides. An unusual case of penetrating facial injury sustained in a pressure cooker explosion in a domestic setting is reported along with a brief review of literature on pressure cooker explosions.
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Affiliation(s)
- A Atreya
- Department of Forensic Medicine, Manipal Teaching Hospital, Pokhara, Nepal
| | - T Kanchan
- Department of Forensic Medicine and Toxicology, All India Institute of Medical Sciences, Jodhpur, India
| | - S Nepal
- Department of Community Medicine, Manipal College of Medical Sciences, Pokhara, Nepal
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Gurung CK, Dahal R, Khanal P, Nepal S, Jaiswal AK. Pattern of poisoning cases in a hospital in a Terai district of central Nepal. Nepal Med Coll J 2011; 13:160-163. [PMID: 22808805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Poisoning is a major global health problem and is one of the major causes of hospitalization through emergency. The objective of this study is to evaluate the characteristics of poisoning cases admitted to emergency department over a one year period. A hospital based study was carried out in the emergency department, Mahendra Adarsha Chikitsalaya, Chitwan analyzing the data of the poisoning cases attended for one year duration by searching all the medical records. A total of 921 poisoning cases presented to emergency department in the year 2007. The female to male ratio was 1.17:1. Most of poisoning occurred in the age group 15-24 years. Snake bite was the commonest form of poisoning amongst all cases. By occupation, 46.0% cases were in farmers. Accidental poisoning prevailed over intentional poisoning. Seasonal trend revealed maximum cases being in summer (42.4%). Poisoning shows seasonal trend and hence proper intervention is required in community level.
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Affiliation(s)
- C K Gurung
- Department of Community Medicine and Family Health, Institute of Medicine, Kathmandu, Nepal
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Abstract
OBJECTIVE To evaluate the efficacy and safety of once-daily saxagliptin monotherapy in treatment-naïve patients with type 2 diabetes (T2D) and inadequate glycemic control. RESEARCH DESIGN AND METHODS This study included a main treatment cohort (MTC) with 401 patients (HbA(1c) > or = 7% and < or =10%) randomized and treated with oral saxagliptin 2.5, 5, or 10 mg once daily or placebo for 24 weeks and a separate open-label cohort (OLC) with 66 patients (HbA(1c) > 10% and < or =12%) who received saxagliptin 10 mg once daily for 24 weeks. Primary endpoint was HbA(1c) change from baseline to week 24. Secondary endpoints included change from baseline to week 24 in fasting plasma glucose (FPG), proportion of patients achieving HbA(1c) < 7%, and changes in postprandial glucose area-under-the-curve (PPG-AUC). Efficacy analyses for continuous variables were performed using an ANCOVA model with last-observation-carried-forward methodology. RESULTS In the MTC, saxagliptin demonstrated statistically significant decreases in adjusted mean HbA(1c) changes from baseline (mean, 7.9%) to week 24 (-0.43%, -0.46%, -0.54%) for saxagliptin 2.5, 5, and 10 mg, respectively, vs. +0.19% for placebo (all p < 0.0001). Adjusted mean FPG was significantly reduced from baseline (-15, -9, -17 mg/dL) for saxagliptin 2.5, 5, and 10 mg, respectively, vs. +6 mg/dL for placebo (p = 0.0002, p = 0.0074, p < 0.0001, respectively). More saxagliptin-treated patients achieved HbA(1c) < 7% at week 24 (35% [p = NS], 38% [p = 0.0443], 41% [p = 0.0133]) for saxagliptin 2.5, 5, and 10 mg, respectively, than placebo (24%). PPG-AUC was reduced for saxagliptin 2.5, 5, and 10 mg (-6868, -6896, -8084 mg x min/dL, respectively) vs. placebo (-647 mg x min/dL) with statistical significance demonstrated for saxagliptin 5 mg (p = 0.0002) and 10 mg (p < 0.0001). HbA(1c), FPG, and PPG-AUC reductions were also observed in the OLC at 24 weeks. In the MTC, adverse event frequency was similar across all study arms. No cases of confirmed hypoglycemia (symptoms, with fingerstick glucose < or =50 mg/dL) were observed in either cohort. Saxagliptin was not associated with weight gain. Study limitations included the lack of a control group for the OLC and the use of prespecified rescue criteria, which limited the exposure time during which patients could remain on their originally randomized medication without the introduction of additional antihyperglycemic rescue treatment. CONCLUSIONS Once-daily saxagliptin monotherapy for 24 weeks was generally well tolerated and demonstrated clinically meaningful reductions in key parameters of glycemic control vs. placebo. TRIAL REGISTRATION Clinical Trials NCT00121641
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Affiliation(s)
- J Rosenstock
- Dallas Diabetes and Endocrine Center at Medical City, 7777 Forest Lane, C-685, Dallas, TX 75230, USA.
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