https://hdl.handle.net/20.500.14356/1336 2026-04-13T06:51:26Z https://hdl.handle.net/20.500.14356/1422 Title: Heterotopic Pregnancy: A Challenge in Early Diagnosis Authors: Karkee, Roman; Sharma, Amit; Dangal, Binod Abstract: Abstract Heterotopic pregnancy is the simultaneous existence of intrauterine and extrauterine gestation. It is usually seen in women at risk for ectopic pregnancy or those undergoing fertility treatments. The incidence has dramatically risen to 1 in 3900 of pregnancies via assisted reproductive techniques or ovulation induction, compared to 1 in 30000 of spontaneous conception. Besides this, history of pelvic inflammatory disease (PID), tubal damage, pelvic surgery and prior tubal surgery can increase its risk. Here we present a case of heterotopic pregnancy which was diagnosedafter ectopic gestation ruptured along with compromised intrauterine gestation and maternal condition. Earlier diagnosis before this life-threatening event could have saved the intrauterine fetus. Keywords: Extrauterine pregnancy; heterotopic pregnancy; ruptured ectopic. Description: Case Report 2019-01-01T00:00:00Z https://hdl.handle.net/20.500.14356/1421 Title: Morbidity Pattern among Elderly Population of Changu Narayan Municipality, Bhaktapur Authors: Manandhar, Naresh; Joshi, Sunil Kumar Abstract: Abstract Background: The Senior Citizens Acts 2063, Nepal defines the senior citizens (elderly population) as “people who are 60 years and above”. Health is the most important determinant of the quality of life of people. Ill-health becomes a major obstacle for the well-being of the elderly population. This study was conducted to assess the morbidity pattern in elderly population. Methods: A community based cross-sectional study was carried out in field practice area of the Department of Community Medicine. 124 elderly population were selected by convenient sampling technique. A structured questionnaire was used to collect the data. Data was analyzed using SPSS version 20. Chi-square was used to test the association and p<0.05 was considered as significant. Results: The mean age of elderly population was 69.85 years. Majority (47.6%) of them were in the age group of 60-69 years. Males (50.8%) were more than females (49.2%). Twelve respondents (9.7%) were not suffering from any form of morbidity. Most common morbidity was muscular skeleton problem (40.8%), followed by hypertension (36.3%), diabetes (29.8.8%), psychological (23.4%) and respiratory (18.6%). Other morbidities gastrointestinal, dental, ENT, eye and genitourinary system were found in around ten percentage of elderly population Conclusions: Majority of the elderly population were suffering from non-communicable diseases. There is a need for health care services at all level with special focus on disease prevention, early detection and treatment for elderly population. This study found high prevalence of musculoskeletal, hypertension, diabetes and psychological problem and low prevalence of respiratory, gastrointestinal, dental, ENT, genitourinary and eye problem. Keywords: Changu Narayan; diabetes; hypertension; masculo skeleton; morbidity pattern; senior citizens. Description: Short Communication 2019-01-01T00:00:00Z https://hdl.handle.net/20.500.14356/1420 Title: Job Description of Public Health Officials in Nepal Authors: Subedi, Sudarshan; MacDougall, Colin Abstract: Abstract Background: Job description of public health officials in Nepal has been prepared for assigning the definite role, responsibilities and authorities to exercise in different positions and circumstances. The purpose of this study was to analyse the job description of public health officials emphasizing the perspective of leadership and management. Methods: Document analysis method was used following the sequential process of skimming, reading and interpretation, and the themes were extracted by content analysis. Results: Job description of public health officials is mostly process and/or function oriented. Most of the officials are responsible for managing program and people rather than leading. Staff inspiration, motivation and encouragement, being one of the most important aspects of leadership, has been ignored in job description. District level officials are specifically assigned to manage programs and staff. As the position increases, the extent of practicing leadership increases and management decreases. Public health administrators have more leadership role as compared to public health officers; however, the proportion of management outweighs the leadership. Regional Directors have more leadership roles than other officials do. Conclusions: Role of public health officials vary from being a manager to a leader. Junior officials are predominantly the managers, mid-level officials are leadership-oriented managers, and top-level officials are leaders having managerial roles . In revising the job description (e.g., for the federal context), emphasis should be given to remove job duplication and role conflict, and should ensure role clarity, functions’ precision and output. Keywords: Document analysis; job description; leadership; Nepal; public health. Description: Short Communication 2019-01-01T00:00:00Z https://hdl.handle.net/20.500.14356/1419 Title: Prevalence of Selected Chronic Non-Communicable Diseases in Nepal Authors: Dhimal, Meghnath; Karki, Khem Bahadur; Aryal, Krishna Kumar; Shrestha, Namuna; Poudyal, Anil; Mahato, Namra Kumar; Karakheti, Ashwin; Sijapati, Milesh Jung; Khanal, Puspa Raj; Mehata, Suresh; Vaidya, Abhinav; Yadav, Binod Kumar; Adhikary, Krishna Prasad; Jha, Anjani Kumar Abstract: Abstract Background: The burden of non-communicable diseases has increased in the last few decades in low-and middle-income countries including in Nepal. There is limited data on population based prevalence of non-communicable diseases. Hence, this study aims to determine the nationwide prevalence of selected chronic non-communicable diseases in Nepal. Methods: A nationwide cross-sectional population-based study was conducted from 2016 to 2018. Data was collected electronically on android device inbuilt with research and monitoring software from 13200 eligible participants aged 20 years and above. Data was cleaned in SPSS version 20.0 and analyzed using Stata version 13.1. Results: The overall prevalence of selected non-communicable diseases was found to be chronic obstructive pulmonary disease 11.7% (95% CI: 10.5-12.9), diabetes mellitus 8.5% (95% CI: 7.8-9.3), chronic kidney disease 6.0% (95% CI: 5.5-6.6) and coronary artery disease 2.9% (95% CI: 2.4-3.4) in Nepal. Prevalence of non-communicable diseases varied across provinces. Higher prevalence of chronic obstructive pulmonary disease (25.1%, 95% CI: 18.1-33.8) in Karnali Province, diabetes (11.5%, 95% CI: 9.8-13.4) in Province 3, chronic kidney disease (6.8%, 95% CI: 5.6-8.1) in Gandaki Province and coronary artery disease in Gandaki (3.6%, 95% CI: 2.2-5.7) and Sudurpaschim Province (3.6%, 95% CI: 2.1-6.1) was observed. Conclusions: The study reported substantial proportion of adult population was found to have chronic non-communicable diseases in Nepal. The findings of this study may be useful for revising/updating multi-sectoral action plans on prevention and control of non-communicable diseases in Nepal. Keywords: Chronic kidney disease; chronic obstructive pulmonary disease; coronary artery disease; diabetes mellitus; non-communicable disease. Description: Original Article 2019-01-01T00:00:00Z