Karnali Academy of Health Sciences is an autonomous medical institution of Government of Nepal established by an Act of parliament of Nepal on 20 October 2011. The main purpose of the academy is to provide medical service in the Karnali Province which is considered to be lagging behind in health facilities. It runs the government owned Karnali Zonal hospital in Jumla district.In December 2021, a post graduate course was started by the academy. The teaching facility has capacity of 50 students per year. As per the government rules, 45% of the seats is reserved for the students from Jumla, Humla, Dolpa, Kalikot, Mugu, Jajarkot, Bajura, Bajhang and Achham districts. The 300 beded teaching hospital at Jumla was completed in 2017 but remained closed due to lack of equipment and medical professionals.
Background Menstrual disorders are common among adolescents and may affect physical, psychological, and academic well-being. Body mass index (BMI) may influence menstrual patterns, but evidence remains inconsistent. This study aimed to assess the prevalence of menstrual disorders and their association with BMI among adolescent nursing students in Kathmandu, Nepal. Methods A descriptive cross-sectional study was conducted from October to November 2020 among 230 first- and second-year PCL nursing students from four CTEVT-affiliated campuses in Kathmandu. Cluster sampling was used. Data were collected using a self-administered questionnaire, and menstrual disorders were assessed based on self-reported history using predefined operational definitions. Height and weight were measured to calculate BMI using WHO Asian criteria. Data were analysed using SPSS version 23 using descriptive statistics and Pearson’s Chi-square test; p < 0.05 was considered significant. Results The mean age of participants was 17.06 ± 1.15 years, and the mean age at menarche was 12.84 ± 1.25 years. Most students (76.5%) had regular cycles. Dysmenorrhea was most common (76.1%), followed by menorrhagia (31.3%), irregular menstruation (23.5%), oligomenorrhea (21.3%), and metrorrhagia (13.5%). Common premenstrual symptoms were anger/irritability (62.2%) and difficulty sleeping (52.2%). Most participants had normal BMI (67.4%), while 21.7% were underweight and 10.9% overweight. No significant association was observed between BMI and menstrual interval, dysmenorrhea, pain severity, metrorrhagia, or oligomenorrhea (p > 0.05). Conclusions Menstrual disorders, particularly dysmenorrhea, were highly prevalent. However, BMI was not significantly associated with menstrual characteristics. These findings highlight the need for menstrual health education and awareness programs in educational institutions.
Introduction: Gender-based violence (GBV) is a burden throughout Nepal. This study aims to assess the sociodemographic profile of GBV cases and shed light on factors associated with these incidents in the Jumla district of rural Nepal. Methods: A retrospective observational study involving all the GBV cases brought for clinical medico-legal examination at the Department of Forensic Medicine and Toxicology, Karnali Academy of Health Sciences, Jumla, Nepal, from 1st January 2022–31st December 2023. The study variables included various socio-demographic profiles of these cases. These variables were entered and analyzed using Microsoft Excel (version 16.16.27-- 201012) and SPSS 23.0. Results: Among the total clinical forensic medicine cases, GBV was present in 83 (41.92%). All the females were survivors, 53 (63.85%), and all the males were perpetrators, 30 (36.14%). The median ages of the females and males were 20 years (Range: 11–73) and 19 years (Range: 13–52), respectively. Among these cases, 20 (24.10%) were associated with physical assault, and 63 (75.90%) were related to sexual assault, with all male examinees presenting with sexual assault. Conclusion: GBV is common among females in Jumla and is primarily inflicted by males due to various sociocultural factors.
Introduction:Acute abdomen refers to sudden, spontaneous, non-traumatic abdominal pain of less than a week. It is one of the common causes of emergency room visits and abdominal surgery. Therefore, it is critical for healthcare professionals to be familiar with the presentations of the common causes of acute abdomen, as well as the strength and validity of the investigative tools. Methodology:In this hospital-based observational study (September 2023 to August 2024), a total of 81 patients with acute abdomen who underwent emergency surgery were enrolled. Data were collected using a proforma, and statistical analysis was performed using IBM SPSS v28 (P value < 0.05 considered significant). Results:Among 81 patients included in this study, acute abdomen was most common in males and the 16-25-year age group. Common symptoms of acute abdomen were abdominal pain, nausea/vomiting, anorexia, constipation/obstipation, and fever, while common signs were tenderness, rebound tenderness, guarding/rigidity, tachycardia, and abdominal distention. The most common postoperative diagnosis was acute appendicitis (33.33%), and including its sequelae, it accounted for 51.85%. The next most common pathologies were perforation peritonitis (22.2%) and bowel obstruction (21%). Ultrasonography (USG) was the most specific tool in the diagnosis of appendicular pathologies (Sn = 73.81%, Sp = 96.87%, and accuracy = 83.78%). In cases of perforation peritonitis, clinical signs of generalized peritonitis were an equally effective method, with sensitivity comparable to an X-ray. The most sensitive tool in bowel obstruction was plain abdominal X-ray (sensitivity [Sn] = 88.24%), while USG had the highest specificity (Sp) of 94.74%. The diagnostic accuracy of acute abdomen was 88.89%, and the negative laparotomy rate was nil. Conclusion:This study highlights the critical nature of accurate preoperative diagnosis in acute abdomen cases and the potential for improved patient outcomes through enhanced investigative strategies. For better outcomes in patients with acute abdomen, early diagnosis based on clinical findings, supported by laboratory and radiological correlation, followed by timely decision-making regarding operative management, is of utmost importance.
Social media has become an integrated part of our daily lives, offering spaces for communication, creativity, learning, and social support. However, the same platform also comes with emotional and psychological challenges. Constant exposure to glorified lifestyles, pressure for online validation, fear of missing out, and unhealthy comparison can negatively affect self-esteem, sleep, concentration at work, and overall mental health. These reflections aim to encourage youths, parents, and society to visualize the opportunities and hazards of the digital world, so that social media becomes a tool for growth rather than self-harm.
Introduction: Pregnant woman’s knowledge and attitude towards folic acid directly impacts its consumption, which influences the rate of birth defects. The rate of neural tube defects in Nepal has significantly decreased with increased consumption of folic acid before and during early pregnancy, offering a ray of hope for improved maternal and neonatal health. Methods: This was a cross-sectional observational study conducted in the Karnali Academy of Health Sciences (KAHS) among 422 participants attending antenatal checkup and admitted to maternity ward using systematic random sampling. Data were collected using self structured customized, pretested questionnaire and KAP tool for assessing knowledge, attitude and consumption of folic acid. Descriptive statistics were used to summarize the data, while Chi-square test, Fisher’s exact test, and odds ratios were applied to determine associations between socio-demographic and obstetric variables with knowledge, attitude, and folic acid consumption using SPSS 16. Results: Among 422 participants, 17.8% had adequate knowledge, 55.5% demonstrated positive attitude and 20.6% consumed folic acid. Knowledge and attitude of the participants were significantly associated with folic acid consumption (p<0.001). Marital age, pregnancy planning, first ANC visit and occupation were significantly associated with knowledge, attitude, and folic acid consumption (p<0.001). The main barriers to folic acid consumption were lack of first trimester ANC visit (75.1%) and lack of awareness (73.9%). Only 35.1% had an anomaly scan, with 1.4% anencephaly. Conclusion: The study’s findings underscore a significant lack of knowledge and consumption of folic acid among pregnant women in Jumla. Despite a positive attitude the critical need for targeted awareness programs to boost folic acid intake and reduce birth defects is evident. These findings can serve as a catalyst for our efforts in improving maternal and child health.
