https://hdl.handle.net/20.500.14356/1 Mon, 06 Apr 2026 02:54:04 GMT 2026-04-06T02:54:04Z https://hdl.handle.net/20.500.14356/2761 Title: Diagnostic accuracy of clinical decision support system (CDSSs) ORADIII and ORAD DDX in comparison to histopathological diagnosis of jaw lesions Authors: Bali, Harleen Dr. Abstract: Abstract: Background: With the coming age, integration of Artificial Intelligence is seen in almost all aspects of life, even medical field especially the field of radiology. Clinical Decision Support Systems (CDSSs) like ORADIII and ORAD DDx are available to help diagnose oral intra bony lesion. However, their diagnostic validity remains to be fully established and limitations need to be explored, especially when compared to gold standard of Diagnoses i.e. histopathological diagnosis. Objectives: To evaluate and compare the diagnostic performance of two CDSS tools—ORADIII and ORAD DDx—against histopathological diagnosis in identifying intra-bony jaw lesions using orthopantomograms (OPGs). Materials and Method: A cross-sectional diagnostic accuracy study was conducted on a sample comprising both lesion and non-lesion cases based on radiographic evaluation. Diagnostic outputs from ORADIII and ORAD DDx were compared with histopathology. Key performance indicators—including sensitivity, specificity, accuracy, F1 score, Positive Predictive Value (PPV), Negative Predictive Value (NPV), and likelihood ratios (LR⁺ and LR⁻)—were calculated for both systems. Concordance, partial concordance, and discordance with histopathological diagnosis were also assessed. Results: Among the 350 samples evaluated, including 175 lesion-positive and 175 non-lesion cases, ORAD DDx demonstrated superior diagnostic performance compared to ORADIII. The sensitivity, specificity, accuracy, and F1 score for ORADIII were 64.57%, 60.00%, 62.29%, and 0.6314, respectively. In contrast, ORAD DDx achieved sensitivity, specificity, accuracy, and F1 score of 70.29%, 65.71%, 68.57%, and 0.6869 respectively. The positive predictive value (PPV) and negative predictive value (NPV) for ORADIII were 61.75% and 62.87%, while for ORAD DDx, these were 67.21% and 68.86%, respectively. The positive likelihood ratio (LR+) and negative likelihood ratio (LR−) were 1.614 and 0.5905 for ORADIII, compared to 2.050 and 0.4513 for ORAD DDx. Conclusion: In this study, ORADIII and ORAD DDx demonstrated moderate diagnostic performance when compared to the gold standard of histopathological diagnosis. ORAD DDx showed slightly higher sensitivity, specificity, and diagnostic accuracy than ORADIII, with greater concordance in identifying intra-bony jaw lesions. However, both systems provide radiographic-level diagnoses and do not replace histopathological evaluation. Their utility lies in supporting clinical decision-making, and while they show promise, further refinement and validation are needed before clinical integration as reliable diagnostic tools. Keywords: artificial intelligence; clinical decision support systems; jaw diseases/diagnosis; diagnostic imaging. Wed, 01 Jan 2025 00:00:00 GMT https://hdl.handle.net/20.500.14356/2761 2025-01-01T00:00:00Z https://hdl.handle.net/20.500.14356/2681 Title: Depression, anxiety and stress among antenatal mothers in a tertiary level hospital of Kathmandu Authors: Maharjan, Radha Abstract: ABSTRACT Background: Maternal mental illness during antenatal is known as vulnerable period. Emotional aspect of pregnant women during antenatal care remains most of the time neglected, undetected and untreated. This study aimed to assess the depression, anxiety and stress among the antenatal mothers. Methods: Researcher conducted Cross-Sectional Descriptive Research Design using Depression, Anxiety and Stress Scale 21 and a structured interview questionnaire. Ethical approval taken from T.U, IOM, Institutional Review Committee and NHRC funded. Data collected via interview with 244 antenatal mothers after written informed consent within four weeks, non-probability convenient method used for sampling. Anonymity, confidentiality and privacy was maintained. Data entered into EPI DATA 3.1 and exported to the statistical package for social science 22 version for further analysis. Strength of association was determined through bivariate and multivariate logistic regression. Results: Result showed prevalence of depression, anxiety and stress were 7.8%, 13.9% and 11.1% respectively. Primigravida more prevalence of depression, anxiety and stress 8 %, 14.4% and 12%, than multigravida. Whereas, depression, anxiety and stress were more prevalent in first trimester than second trimester and third trimester which was 9.5%, 21.4% and 21.4%. The factors strongly associated with depression was facing domestic violence (AOR=23.338 95% CI: 5.034-108.199). The factors strongly associated with anxiety were facing domestic violence (AOR=21.975 95% CI: 5.826-82.882) and unable to take balance diet on daily basis were (AOR=3.420 95% CI: 1.362-8.588). The factors strongly associated with stress was facing domestic violence (AOR=67.106 95% CI: 14.439-311.883). Conclusions: Even though high prevalence of stress and anxiety were seen among antenatal mothers than depression, Depression is an alarming sign during pregnancy. Hence early detection and treatment is most crucial. Therefore, at least one routine mental and psychological screening test should be recommended as a part of routine antenatal check- up to promote maternal and child health in Nepal. Key Words: Antenatal mothers, Anxiety, Depression, Stress. Description: Thesis Report Tue, 01 Jan 2019 00:00:00 GMT https://hdl.handle.net/20.500.14356/2681 2019-01-01T00:00:00Z https://hdl.handle.net/20.500.14356/2668 Title: Nutritional status and its associated factors among pregnant women in Janakpurdham Sub-Metropolitan Authors: Mandal, Gauree Shankar Abstract: Introduction: The nutritional health of pregnant women is a crucial factor that impacts the health outcomes of both the mother and child. A nutrient-rich diet during pregnancy is a must for their nutritional well-being. However, several individuals, family, and community level factors influencing the intake of a nutrient-rich diet are worse in Nepal, particularly in the Madhesh province. This study aimed to test the association of household food security, women empowerment, and other underlying factors with the nutrition status of pregnant women. Methods: This was a community-based cross-sectional study carried out among 435 pregnant women of Janakpurdham, selected using multistage cluster sampling with probability proportionate to size method. The nutrition status was measured using MUAC tape. Pre-validated standard tools were deployed to measure diet quality, household food security, and women empowerment. The Nepalese Food Composition Table 2017 and the Indian Food Composition Table 2017 were referenced to compute the nutrient value in the recipe consumed. Data were collected using face-to-face interviews. The data were processed and analyzed in IBM SPSS. Logistic regression was carried out to evaluate the association between variables. Results: Around one-third (31.7%) of pregnant were undernourished based on MUAC. Pregnant women’s food insecurity in their households and gender-based food-eating preference orders in their families were significant predictors of their undernutrition. Only 12% of pregnant women were able to meet their recommended diet quality, with only 14.0%, 23.9%, and 13.8% meeting iron, calcium and folate intake of the daily recommended amount respectively. Conclusion: The findings indicate that undernutrition is a significant concern among pregnant women. Both food consumption behaviour and household food security could be reasons behind poor diet quality. Hence, targeted nutrition-specific and sensitive intervention programs toward food security and a blanket approach to comprehensive nutrition education are recommended to improve diet quality. Keywords: maternal nutrition, predictors, women empowerment, household food security, diet quality Description: Thesis Report. Sun, 01 Jan 2023 00:00:00 GMT https://hdl.handle.net/20.500.14356/2668 2023-01-01T00:00:00Z https://hdl.handle.net/20.500.14356/2667 Title: Prevalence of anemia and its associated factors among adolescent girls on weekly iron folic acid supplementation (WIFAS) implemented and non-implemented schools at Tokha Municipality, Kathmandu Authors: Khanal, Anita Abstract: ABSTRACT: Introduction: One of the WHO's eight primary effective actions for enhancing adolescent nutrition that is outlined in the 2018 recommendations is WIFAS (weekly iron and folic acid supplementation). There is a window of opportunity for kids to improve their nutritional status during the adolescent years. Nutritional deficiencies can have long-term effects, but if we act appropriately now, we can prevent them. In Nepal, very few studies on adolescent anemia have been conducted. Weekly iron folic acid supplementation is relatively a new program and it could be the most cost-effective intervention to break the intergenerational cycle of anemia. Several studies have shown a statistically significant link between taking folic acid and iron supplements and preventing anemia Methods: The general objective of the study was to assess the difference in the prevalence of anemia and its associated factors among adolescent girls on Weekly Iron Folic Acid Supplementation (WIFAS) implemented and non-implemented schools at Tokha Municipality, Kathmandu. A cross-sectional study was carried out among 602 adolescent girls from classes 6-10 equally divided into two groups from government schools (WIFAS implemented) and private schools (WIFAS not implemented). The (PPS) method was used to determine the number of class cluster and the students from each cluster was included. Hemoglobin estimation was done using the HemoCue method to determine the hemoglobin estimation. The validated tool was used to collect the data. The univariate, bivariate and multivariate analysis was done using SPSS version 25 to identify significant association between dependent and independent variables. Results: The overall prevalence of anemia was found to be 17.4 %. Among the total sample, 14%(42) and 20.9 % (63) of adolescent girls from government and private schools were anemic respectively whereas 86% (259) and 79.1% (238) were non anemic respectively. Bivariate analysis of the variables revealed that age, mother’s education, fathers’education, mothers’occupations, compliance, knowledge on anemia, knowledge on WIFAS, class and dietary diversity were found to be significantly associated with anemia. The factors like fathers’ education, knowledge on WIFAS and dietary diversity were only found to be associated with anemia during multivariate regression analysis. Similarly, the factors like class, type of family and provision of school health nurse were found to be associated with compliance in WIFAS implemented schools during multivariate regression analysis. According to the WHO classification on prevalence of anemia, the study site ranks as having mild public health problems of anemia among school going adolescent girls in Tokha municipality. Conclusion: In the study, the prevalence of anemia among the WIFAS implemented school was lower as compared to the not implemented school. The present study revealed that the supervision by the school teacher or supervisor increases the compliance to WIFAS which ultimately help to lower the prevalence of anemia among adolescent girls. In the study, the factors like fathers’ education, knowledge on WIFAS, and dietary diversity were found to be associated with anemia. Promotion of proper utilization of Weekly Iron and Folic Acid Supplementation (WIFS) program is recommended. The development of a peer-led strategy, or a girl-to-girl approach, is required in order to inform and counsel adolescent girls about the program advantages in order to increase the compliance and decrease the prevalence of anemia among adolescent girls. Description: Thesis Report. Sun, 01 Jan 2023 00:00:00 GMT https://hdl.handle.net/20.500.14356/2667 2023-01-01T00:00:00Z