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ABSTRACT: The purpose of this study was to assess the attitudes of undergraduate medical students towards the objective structured practical examination (OSPE) in Forensic Medicine, in a medical college in Nepal. Participants included 59 undergraduate medical students of the 7th semester. Findings indicated that the OSPE was an acceptable tool considering the conduct of practical examination in Forensic Medicine at the undergraduate level. The overall mean attitude score was towards the favourable side. Students strongly agreed that the OSPE tested a wide range of skills. They also strongly agreed that it was a good form of examination as well as a learning experience. The introduction of the OSPE replacing the conventional method of practical examination in Forensic Medicine is a step in the right direction taken to objectively assess undergraduate medical students.
Journal of forensic and legal medicine 11/2011; 18(8):347-9.
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ABSTRACT: Smokeless tobacco is found to be as addictive and harmful as smoking but have not been explored into, especially among youth.
This study was conducted to find the prevalence of tobacco chewing among college students in Nepal and the factors that have influence over their use.
A cross-sectional study with a self-administered questionnaire.
Five colleges of different streams in Pokhara city were selected for the study. A total of 816 students participated. The study was conducted during the period of May 2006-February 2007, using a semi-structured, self-administered questionnaire.
Overall prevalence of ever tobacco chewing was 21.3% (males 30.2% and females 10.9%) among the youth with average age of initiation 15.7 years. Pan masala and gutka were used by 63.6% and frequency of use varied widely and only 5.7% said they were daily users. Reasons cited for chewing were most commonly 'just like it' or 'friends chew'. Multiple logistic regression analysis showed age, ever smoking status, being ever alcoholic, and having friends or family members who chewed were significantly associated with students' tobacco chewing. Almost one-tenth of the students believed they were addicted to chewing tobacco and 42.5% of them had tried to quit the habit.
The study shows a high prevalence of tobacco chewing by Nepali youth. Important factors that influenced the habit were having chewer friends, their own smoking and alcohol status and having family members who chewed. It is pertinent to consider these when formulating cessation and prevention programs.
Indian Journal of Community Medicine 04/2011; 36(2):128-32.
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ABSTRACT: Introduction: Refractive errors are a major cause of visual impairment in the population. Purpose: To find the pattern of refractive errors among patients evaluated in a tertiary care hospital in the western region of Nepal. Materials and methods: The present hospital-based retrospective study was conducted in the Department of Ophthalmology of the Manipal Teaching Hospital, situated in Pokhara, Nepal. Patients who had refractive error of at least 0.5 D (dioptre) were included for the study. Results: During the study period, 15,410 patients attended the outpatient department and 10.8% of the patients were identified as having refractive error. The age of the patients in the present study ranged between 5 - 90 years. Myopia was the commonest refractive error followed by hypermetropia. There was no difference in the frequency of the type of refractive errors when they were defined using right the eye, the left eye or both the eyes. Males predominated among myopics and females predominated among hypermetropics. The majority of spherical errors was less than or equal to 2 D. Astigmatic power above 1D was rarely seen with hypermetropic astigmatism and was seen in around 13 % with myopic astigmatism. "Astigmatism against the rule" was more common than "astigmatism with the rule", irrespective of age. Conclusion: Refractive errors progressively shift along myopia up to the third decade and change to hypermetropia till the seventh decade. Hyperopic shift in the refractive error in young adults should be well noted while planning any refractive surgery in younger patients with myopia. Keywords: myopia; hypermetropia; astigmatism; ethnicities; age.
Nepalese journal of ophthalmology : a biannual peer-reviewed academic journal of the Nepal Ophthalmic Society : NEPJOPH. 07/2010; 2(4):87-96.
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ABSTRACT: The study was carried out to study the pattern of injuries and epidemiological factors in Nepal where there is no systematic surveillance system for injuries.
A hospital based, retrospective study conducted by extracting data from the medico-legal register of the Emergency Department of a Regional Hospital for 3 years.
Regional Hospital in Pokhara, Western Nepal.
A total of 1100 cases of physical assault had been reported. Male to female ratio was 3.6:1 and most commonly involved age group in males was 16-25 and in females was 26-35 years. Contusion (28.7%) was the commonest type of injury followed by incised wounds (25.7%). Most commonly used weapon was wooden stick and clubs (21.5%) followed by kicks and punches (20.6%). The most frequently affected anatomical site involved was the head and neck (57.06%), followed by the upper limbs (17.74%) and the lower limbs (10.5%). Assailants for females were most commonly spouse (40%) and in-laws (14%) and for males it was unspecified known individuals (18%) followed by neighbours (11%). Maximum number of physical assault injuries occurred between evening and midnight (59.59%).
Injuries from physical assault occurred in all age groups but most commonly affecting the young males and majority of them were in the productive age group. Commonest type of injury was contusion and weapon used wooden sticks and clubs. Assailants were spouses in females and known but unspecified individuals in men.
Journal of forensic and legal medicine 05/2010; 17(4):203-8.
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ABSTRACT: Tobacco is the single largest risk factor for various diseases and its presence in the young heralds more serious problems as they may be exposed for longer periods. Prevalence and predictors of smoking among youth will aid in formulating effective preventive and control measures. A cross-sectional study was therefore conducted among 816 students selected from five colleges of Western Nepal using a self-administered questionnaire. Prevalence of ever smoking was 34.2% (males 47.6% and females 18.4%) and for current smoking was 17%. It was higher among youth belonging to 21 years or older as compared to younger age groups. Mean age of initiation was 16.8 years (standard deviation 2.8 years) and the most common reasons cited for smoking were; like it, to feel more relaxed, out of boredom and to look more mature. Proportion of youth who said they felt they were addicted was 43.1% and 64.7% said that they had tried to quit the habit. Most important predictors having independent effects on youth being ever smokers were having three or more smoker friends (OR=18), their own chewing (OR=4.8) or alcohol use (OR=4.2), male gender (OR=3.7) and the type of course they were pursuing, with professional course students having higher risk. With almost one fifth of college-going youth smoking and a higher prevalence in older age groups within them, smoking is a serious concern for young people in Western Nepal.
Asian Pacific journal of cancer prevention: APJCP 01/2010; 11(1):221-6. · 0.66 Impact Factor
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ABSTRACT: Determination of sex from human skeletal remains is an imperative element of any medicolegal investigation. Length of manubrium, length of mesosternum, and combined length of manubrium and mesosternum were measured in 115 sternums of confirmed sex (75 male and 40 female) for sexual dimorphism. Application of "the 50 rule" for the manubrium confirmed sex in 77.3% male and 77.5% female bones, while application of "the 81 rule" for the mesosternum confirmed sex in 73.3% male and 75% female bones accurately. Application of "the 131 rule" derived from the study for combined length of manubrium and mesosternum confirmed sex in 85.3% male and 77.5% female sternums correctly. This study confined to the Maharashtra region of western India is useful to determine the sex of the sternum when it is subjected for medicolegal skeletal examination.
Legal Medicine 02/2008; 10(1):6-10.
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ABSTRACT: In recent years there has been a growing appreciation of the issues of quality of life and stresses involved medical training as this may affect their learning and academic performance. However, such studies are lacking in medical schools of Nepal. Therefore, we carried out this study to assess the prevalence of psychological morbidity, sources and severity of stress and coping strategies among medical students in our integrated problem-stimulated undergraduate medical curriculum.
A cross-sectional, questionnaire-based survey was carried out among the undergraduate medical students of Manipal College of Medical Sciences, Pokhara, Nepal during the time period August, 2005 to December, 2006. The psychological morbidity was assessed using General Health Questionnaire. A 24-item questionnaire was used to assess sources of stress and their severity. Coping strategies adopted was assessed using brief COPE inventory.
The overall response rate was 75.8% (407 out of 525 students). The overall prevalence of psychological morbidity was 20.9% and was higher among students of basic sciences, Indian nationality and whose parents were medical doctors. By logistic regression analysis, GHQ-caseness was associated with occurrence of academic and health-related stressors. The most common sources of stress were related to academic and psychosocial concerns. The most important and severe sources of stress were staying in hostel, high parental expectations, vastness of syllabus, tests/exams, lack of time and facilities for entertainment. The students generally used active coping strategies and alcohol/drug was a least used coping strategy. The coping strategies commonly used by students in our institution were positive reframing, planning, acceptance, active coping, self-distraction and emotional support. The coping strategies showed variation by GHQ-caseness, year of study, gender and parents' occupation.
The higher level of psychological morbidity warrants need for interventions like social and psychological support to improve the quality of life for these medical students. Student advisors and counselors may train students about stress management. There is also need to bring about academic changes in quality of teaching and evaluation system. A prospective study is necessary to study the association of psychological morbidity with demographic variables, sources of stress and coping strategies.
BMC Medical Education 02/2007; 7:26. · 1.15 Impact Factor
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ABSTRACT: Information on cancer patterns is an important basis for determining the priorities for cancer control in different countries worldwide. There is no reliable information about the incidence or pattern of cancer in Nepal and hence an attempt was made to assess the situation based on hospital data which is the only source in the western region of Nepal. Cancer cases diagnosed by all methods or treated in Manipal Teaching Hospital, affiliated to Manipal College of Medical Sciences, Pokhara, during 1st January 2003 to 30th May 2005 were used for the present study. A total of 957 cancer cases were identified with a male to female ratio of 1.1:1. The median age of male and female patients was 63 and 60 years, respectively. The proportion of microscopically confirmed cases, both from primary and metastatic sites was 87.5% and tobacco-related cancers constituted 48% of all cancers among males and 28% among females. For males the leading cancer sites were lung (22.2%), larynx (9.8%) and stomach (9%) and that for females was lung (20%), cervix (19.7%) and breast (7.8%). Among males, 33.1% of all cancers were in the respiratory system followed by digestive organ cancers (23.2%). Among females, 28.4% cancers were related to the reproductive system, 22.8% to the respiratory system and 14.1% to digestive organs. The cancer pattern revealed by the present study provides valuable leads to cancer epidemiology in Nepal, particularly in the western region, and provides useful information for health planning and future research.
Asian Pacific journal of cancer prevention: APJCP 8(2):183-6. · 0.66 Impact Factor
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ABSTRACT: Child health in developing countries including Nepal is a matter of serious concern as the prevalence of malnutrition among children continues to be high with 48.6% of children under five in Nepal being underweight. Since infant feeding practices adopted by mothers play a major role in influencing health of these children, there is a need to study the infant feeding practices prevalent in different areas in order to have pragmatic approaches to solve this problem.
A cross sectional study was conducted among mothers who attended the immunization clinics of 18 wards of Pokhara municipality area. They were interviewed with a semi-structured questionnaire on various aspects of infant feeding.
A total of 168 mothers were interviewed and prevalence of breastfeeding was 99.4% (167). Only 43.5% of the mothers initiated breastfeeding within one hour of birth and 60.5% were practicing exclusive breastfeeding at 5 months. Almost 40% of the mothers started complementary feeding before the recommended age of 6 months and 22.5 % delayed introduction of complementary feeding beyond the recommended age.
Breast feeding practices adopted by mothers of Pokhara urban area are still lacking in terms of late initiation of and early starting of complementary feeding. There is a need to educate the mothers regarding proper infant feeding practices.
Kathmandu University Medical Journal 5(1):42-7.
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ABSTRACT: Information on the learning styles of medical students are lacking in medical colleges in Nepal. Learning styles may be associated with student understanding and may predict success in examination. The present study was carried out to obtain information on learning styles and preferences for teaching of fourth semester medical students and note the association, if any, between respondents' personal characteristics and preferences for learning styles and types of teaching. The correlation between preferences for learning styles and types of teaching and performance in the second year university examination was also explored.
The study was carried out during October 2003 at the Manipal College of Medical Sciences, Pokhara, Nepal using the Approaches and Study Skills Inventory (ASSIST) instrument. Information on the respondents' personal characteristics was collected. Respondents had to indicate their degree of agreement with a set of statements using a modified Likert-type scale. The statements were grouped into three main learning styles and two types of teaching. The median scores among different subgroups of respondents were compared using appropriate non-parametric tests (p<0.05).
Ninety-two students (92%) participated; fifty-six were male. Thirty-one respondents were Nepalese, 48 were Indians. Majority were educated in English medium schools. The median scores for deep and surface learning styles were 64 and 49 respectively (maximum score=80). The scores for strategic learning was 75.5 (maximum score=100). There was no clear preference for any particular type of teaching. Indian students used more surface apathetic learning strategies compared to others. There was a negative correlation between surface learning and marks obtained in the final examination.
The students mainly used deep and strategic learning styles. Differences in preference for learning styles and types of teaching were noted according the respondents' personal characteristics. This was a preliminary study and further studies are required.
Kathmandu University Medical Journal 4(3):390-5.
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ABSTRACT: ObjectiveThe study was carried out to study the pattern of injuries and epidemiological factors in Nepal where there is no systematic surveillance system for injuries.DesignA hospital based, retrospective study conducted by extracting data from the medico-legal register of the Emergency Department of a Regional Hospital for 3 years.SettingRegional Hospital in Pokhara, Western Nepal.ResultsA total of 1100 cases of physical assault had been reported. Male to female ratio was 3.6:1 and most commonly involved age group in males was 16–25 and in females was 26–35 years. Contusion (28.7%) was the commonest type of injury followed by incised wounds (25.7%). Most commonly used weapon was wooden stick and clubs (21.5%) followed by kicks and punches (20.6%). The most frequently affected anatomical site involved was the head and neck (57.06%), followed by the upper limbs (17.74%) and the lower limbs (10.5%). Assailants for females were most commonly spouse (40%) and in-laws (14%) and for males it was unspecified known individuals (18%) followed by neighbours (11%). Maximum number of physical assault injuries occurred between evening and midnight (59.59%).ConclusionInjuries from physical assault occurred in all age groups but most commonly affecting the young males and majority of them were in the productive age group. Commonest type of injury was contusion and weapon used wooden sticks and clubs. Assailants were spouses in females and known but unspecified individuals in men.
Journal of Forensic and Legal Medicine.
