Laxmi Subedi - Academia.edu (original) (raw)

Papers by Laxmi Subedi

Journal of Medical Physics, 2011

The purpose of this study was to evaluate the dosimetric effect of the leaf width of a multileaf ... more The purpose of this study was to evaluate the dosimetric effect of the leaf width of a multileaf collimator (MLC) in intensitymodulated radiotherapy (IMRT) delivery techniques for small-and large-volume targets. We retrospectively selected previously treated 5 intracranial and 5 head-neck patients for this study to represent small-(range, 18.37-72.75 cc; mean, 42.99 cc) and large-volume (range, 312.31-472.84 cc; mean, 361.14 cc) targets. A 6-MV photon beam data was configured for Brianlab m3 (3 mm), Varian Millennium 120 (5 mm) and Millennium 80 (10 mm) MLCs in the Eclipse treatment-planning system. Sliding window and step-shoot IMRT plans were generated for intracranial patients using all the above-mentioned MLCs; but due to the field size limitation of Brainlab MLC, we used only 5-mm and 10-mm MLCs in the head-and-neck patients. Target conformity, dose to the critical organs and dose to normal tissues were recorded and evaluated. Although the 3-mm MLC resulted in better target conformity (mean difference of 7.7% over 5-mm MLC and 12.7% over 10-mm MLC) over other MLCs for small-volume targets, it increased the total monitor units of the plans. No appreciable differences in terms of target conformity, organ at risk and normal-tissue sparing were observed between the 5-mm and 10-mm MLCs for large-volume targets. The effect of MLC leaf width was not quantifiably different in sliding window and step and shoot techniques. In addition, we observed that there was no additional benefit to the sliding-window (SW) technique when compared to the step-shoot (SS) technique as a result of reduction of MLC leaf width.

Background: The problem of HIV/AIDS among Children is common and has become a key public health c... more Background: The problem of HIV/AIDS among Children is common and has become a key public health concern for all. Objective: To find out the situation of children infected/affected from HIV. Methods: Cross-sectional descriptive study was carried out in Sunsari District of Eastern Nepal. Total 131 respondents from Sunsari District Children aged between 0-18 years and parents of these children on their behalf were visited during the study period. The analysis was done by using statistical software SPSS (statistical package for social science) version 17. Percentage and proportion was calculated where ever applicable. Result: Children between the ages of 0-6 years represented 36.4% of the sample. In 92.4% of families, father was the first to be infected. Only 9.1% of the children know about their parents HIV status. The school knew 12.1% of the children being HIV infected/affected and among them 70.4% reported of bad behavior of school. Nearly 68.2% of them were not provided any help for their education. Almost 41.7% of the respondents were taking any medicine and among them 30.3% were taking antiretroviral drug. Nearly 29% of them think when there is no discrimination they will have dignified life. Conclusion: HIV and AIDS in children is an alarming issue in Sunsari because of the increasing trend of new cases. Low economic opportunities, low literacy level, low levels of awareness usually among underprivileged and disadvantage group, and long incubation period make this infection a huge Public Health challenge to face and cope with.

Journal of Family Violence, 2007

Background: The prevalence of domestic violence (DV), men's violence against women during pregnan... more Background: The prevalence of domestic violence (DV), men's violence against women during pregnancy is very high, and is associated with significant psychological and physical impairment of mother and the fetus. Objective: The major objective of this study was to determine the prevalence of DV among expectant mothers who had attended in Iran University of Medical Sciences' (IUMS) hospitals. Design: This is a cross sectional study, in which the subjects were interviewed by using a standard questionnaire. Sample: 1800 subjects were selected, by using consecutive sampling in 6 major hospitals of IUMS. Results: The prevalence of DV was found to be 60.6%, including 3 types of physical, psychological and sexual, with the prevalence of 14.6%, 60.5% and 23.5% respectively. Severe physical DV was 43.3. Severe psychological and sexual DV were also found (24.2 and 3.5%). Conclusion: DV had a high prevalence in this study. It is recommended that all accessible pregnant women be screened for DV. Study of the prevalence of DV within the community with a larger sample size, and using cluster sampling method would be of immense value.

Kathmandu University medical journal, 2016

Background Tobacco use is still a serious public health problem in the world and represents a maj... more Background Tobacco use is still a serious public health problem in the world and represents a major cause of morbidity and mortality in most parts of the world. Objective To measure the prevalence of tobacco use and to identify the factors associated with tobacco use among the residents of Dhankuta Municipality. Method The cross-sectional study was conducted among the residents of the Dhankuta Municipality where 205 households were taken as subjects. Pretested semistructured questionnaire was used for data collection and face to face interview was conducted. Univariate and multivariate logistic regression was used to see the association between various factors and tobacco use and identify the predictor variables. Result Overall prevalence of tobacco consumption in Dhankuta Municipality was found to be 57.1%. Prevalence of tobacco consumption among the male was significantly higher (67%) than female (47.1%) (p<0.05). Most of the respondents (56.4%) started consuming tobacco due to...

Child marriage in Nepal is considered a major barrier to the nation's social and economic dev... more Child marriage in Nepal is considered a major barrier to the nation's social and economic development, as well as a major women's health concern. The objective of the study was to find out the factors associated with early age marriages in Rangeli VDC of Morang District. The cross-sectional study was conducted among the residents of Rangeli VDC of Morang District where 300 households were taken as subjects. Semi-structured questionnaire was used and face to face interview was conducted. Chi-square test was applied to find out the association between factors and age of marriages. Almost 69.3% of women were married before 18 years of age. Prevalence of child marriage was lower in Hindu (68.9%) than in Christian and Muslim women (85.7%) but the difference was not significant. Education of wife and husband, and economic status was found to be the important variables in explaining early age marriage (P<0.001). It was also seen that unplanned pregnancies was higher (70.6%) in e...

Results 13446 women responded (81% response rate). 3.4% patients admitted having symptom of conti... more Results 13446 women responded (81% response rate). 3.4% patients admitted having symptom of continuous leakage of urine. 4.2% patients had stress urinary incontinence. 4% patients had urge incontinence. 8.5% patients were having symptoms of pelvic organ prolapse. Structured questionnaire was used to assess feeling of quality of life having these symptoms and it was found that quality of life was affected in 60% of women.

Kathmandu University medical journal, 2018

Background Community Based Health Insurance (CBHI) Schemes are promising alternatives for a cost ... more Background Community Based Health Insurance (CBHI) Schemes are promising alternatives for a cost sharing health care system which hopefully leads to better utilization of health care services, reduce illness related income shocks and eventually lead to a sustainable and fully functioning universal health coverage. Objective This study focused on factors influencing the people's enrolment and hindrances for enrollment of CBHI program. Method Altogether 316 households were taken according to population proportionate sampling method.Community based cross-sectional analytical study was carried out with preformed questionnaire among members and non- member in four villages. Sample unit for enrollee were selected by using population proportionate systematic random sampling method using enrolled register and for non-enroll systematic random sampling technique was used using household list from VDC. Result For non- members 28.3% small benefit package was main reason for non membership. ...

International Journal of Scientific Reports, 2020

Background: Nepalese society is traditionally patriarchal and son-preferred with increasing numbe... more Background: Nepalese society is traditionally patriarchal and son-preferred with increasing numbers of sex-selective abortions. In this context, this study aims to assess the gender preference and associated factors among pregnant women visiting the antenatal care ward of a large public maternity hospital in Kathmandu, Nepal.Methods: A hospital-based cross-sectional study was carried out among 821 antenatal women. Data was collected via face to face interview with structured questionnaire, and gender preference was assessed using Coombs’ scale. Results: At the first instance, more than half 56.2% respondents wished to have two sons and one daughter if they were to have only three children. On asking further questions as per the Coombs’ scale, about 40% of the respondents had son preference falling in IS scale 7-5, 33% had balanced IS-4, and 27% had daughter preference (IS 3-1). The respondent characteristics significantly associated with gender preference were ecological region (p=...

Journal of Kathmandu Medical College, 2017

Background: Antenatal care has proven to be an effective way to reduce maternal mortality and sav... more Background: Antenatal care has proven to be an effective way to reduce maternal mortality and save the life of newborn. Nepal also follows the World Health Organization’s recommendations of initiation of four antenatal care visits that has helped in decreasing the maternal mortality of the country. Still, the country has to do a lot in improving the antenatal care provision.Objective: The objective of this study was to find out the antenatal care practices among the women with children less than five years of age in a district of eastern Nepal.Methods: A descriptive cross-sectional study was conducted among residents of Aurabani village of Sunsari district. Non probability convenient sampling technique was used to collect data from 15th January to 30th January, 2015. Data of 100 women having children less than five years of age were collected and analyzed in descriptive and inferential ways.Results: Women with nuclear family are more likely to have antenatal care visits (73.8%) comp...

BMJ Open, 2018

ObjectivesThe study aimed at estimating out-of-pocket (OOP) expenditure, catastrophic health expe... more ObjectivesThe study aimed at estimating out-of-pocket (OOP) expenditure, catastrophic health expenditure (CHE) and distress financing due to hospitalisation and outpatient care among industrial workers in Eastern Nepal.MethodsWe conducted a cross-sectional study involving industrial workers employed in a large-scale industry in Eastern Nepal. Those who were hospitalised in the last 1 year or availed outpatient care within the last 30 days were administered a structured questionnaire to estimate the cost of illness. CHE was defined as expenditure more than 20% of annual household income. Distress financing was defined as borrowing money/loan or selling assets to cope with OOP expenditure on health.ResultsOf 1824 workers eligible for the study, 1405 (77%) were screened, of which 85 (6%) were hospitalised last year; 223 (16%) attended outpatient department last month. The median (IQR) OOP expenditure from hospitalisation and outpatient care was US$124 (71–282) and US$36 (19–61), respec...

Journal of Chitwan Medical College, 2017

More than 1 billion people worldwide smoke. If current trends continue, 8.4 million smokers are e... more More than 1 billion people worldwide smoke. If current trends continue, 8.4 million smokers are estimated to die annually of smoking-related deaths by the year 2020. To find out awareness towards tobacco consumption and to find out association between awareness towards tobacco and status of tobacco consumption among residents of Dhankuta municipality. The cross-sectional study was conducted among residents of Dhankuta Municipality where 205 households were taken as subjects. Pretested semi-structured questionnaire was administered to the study subjects and face to face interview was conducted. Chi-square test was applied to find out the association between awareness towards tobacco and status of tobacco consumption. Almost 41% of respondents were found to be aware of the harmful consequences of tobacco consumption. The respondents who did not consume tobacco was seen more aware of tobacco consumption (85.7%) than consuming tobacco (14.3%) (P<0.001).The respondents think the problem of tobacco consumption can be control by bann the production was significantly higher among those did not consuming tobacco (57.7%) than consuming tobacco (42.3%) (<0.001). Most of the respondents think smoking can be discourage by strict low (60.5%) followed by family support (24.9%) and education (20%) and recreational activities (8.8%). Awareness towards the harmful consequences of tobacco consumption was found to be less in Dhankuta Municipality. The problem of tobacco consumption can control by bann the production, awareness program and medicine i.e. nicotine therapy.

Medical Journal of Shree Birendra Hospital, 2016

Aim: The aim of this research is to explore the effect of physical activities in treating depress... more Aim: The aim of this research is to explore the effect of physical activities in treating depression among elderly population living in an institution using different existing literature. Also, aim is to make this study useful to healthcare professionals and students while working with elderly population suffering from depression. The research question is kept in concern during the study: 1. How do physical activities promote health for elderly suffering from depression living in an institution? Methodology: The materials were acquired through qualitative research leading to deductive content analysis and literature review was also used in order to develop ideas and facts and deal with any problems during the process. Only 7 articles could be accessed due to author's copyright policy while conducting this research, which somehow created some limitations. Result: It was found that physical activities enhances functioning of the bodily systems with improvement in mental health as well in elderly people who have already lost their vibes due to different depression related disorders. The suffering age were found to be physically and psychologically benefited physical activities that increase feelings of self-esteem, self-regard and self-respect, which are important for elderly for recovery. Conclusion: Physical activities have been identified as one of the health-promoting factor on reducing depressive symptoms among elderly population. So, it has to be considered more importantly with more researches on this field.

Computational Seismology and Geodynamics, 2013

Journal of Chitwan Medical College, 2015

Retirement, change in housing, illness or death of spouse greatly affect the physical and mental ... more Retirement, change in housing, illness or death of spouse greatly affect the physical and mental well-being of the geriatric person. This study aims to find out the health status of geriatric age group in chitwan district of Nepal. A cross sectional study was carried out among 300 geriatric people where 15.7% of the geriatric were living alone, 50.3 % and 39.7% of geriatrics gave history of regular use of tobacco and alcohol respectively. Co-morbidities were found in 63% of geriatrics who suffered from 2 or more diseases. In Total 44% were found to have Ophthalmic problems, 23% were found to have ENT problems, 5.33% were found to mental disorders, 33% were found to have CVS problems, 43% were found to have GI problems, 15.67 % were found to have Metabolic disorder. The study highlighted a high prevalence of morbidity and health related problems in geriatric age groups.DOI: http://dx.doi.org/10.3126/jcmc.v5i1.12560

Journal of College of Medical Sciences-Nepal, 2015

BACKGROUND Pregnancy is a critical period for both woman and baby from a nutritional perspective.... more BACKGROUND Pregnancy is a critical period for both woman and baby from a nutritional perspective. Poor nutrition, during pregnancy is associated with adverse maternal and fetal outcomes. However, due to various factors, pregnant women do not increase the quality or quantity of diet during pregnancy. OBJECTIVE To find out the prevalence of nutritional supplementations taken during pregnancy and to find out the association between sociodemographic characteristics and nutritional supplementations taken during pregnancy. MATERIALS AND METHODS The cross-sectional study was conducted from 1st March to 14th March, 2014 among the residents of Rangeli VDC of Morang District in Eastern Nepal where 300 households were taken as subjects. Semistructured questionnaire was used and face to face interview was conducted. Chi-square test was applied to find out the association between sociodemographic characteristics and nutritional supplementations taken during pregnancy. RESULT The problem of not t...

Journal of Universal College of Medical Sciences, 2014

INTRODUCTION: Nepal has one of the worst maternal and perinatal morbidity and mortality due to th... more INTRODUCTION: Nepal has one of the worst maternal and perinatal morbidity and mortality due to the lack of antenatal care (ANC) practices of pregnant women.The objective of this study was to find out the ANC practices and to find out the association between sociodemographic characteristics and antenatal care visits. MATERIAL AND METHODS: The cross-sectional study was conducted from 1st March to 14th March, 2014 among the residents of Rangeli VDC of Morang District in Eastern Nepal where 300 households were taken as subjects. Simple random sampling technique was applied for data collection. Semi-structured questionnaire was used and face to face interview was conducted. Chi-square test was applied to find out the association between sociodemographic characteristics and antenatal care visits.RESULTS: Almost fifty five percent of respondents attended ANC visits.The findings revealed that about 55% received iron, calcium and folic acid tablets and almost 61% of the pregnant women took t...

Nepal Journal of Medical Sciences, 2014

Background: Child marriage is a substantial barrier to social and economic development in Nepal, ... more Background: Child marriage is a substantial barrier to social and economic development in Nepal, and a primary concern for women’s health. Little evidence from Nepal is available regarding the ways in which early marriage may compromise young women’s lives and their reproductive health and choices. The objectives of this study was to find out the factors associated with early age marriages in Dhankuta Municipality. Methods: The cross-sectional study was conducted among the residents of Dhankuta municipality, Nepal; where 246 households were taken as subjects. Pretested semi-structured questionnaire was administered to the study subjects and face to face interview was conducted. Chi-square test was applied to find out the association between factors and age of marriages. Results: Almost 53.3% of women were married before age 18 years. Education of wife and husband, and economic status are found to be the important variables in explaining early age marriage. Prevalence of child marria...

Janaki Medical College Journal of Medical Science, 2014

Background and objectives: Importance of maternal health has been recognized over the last decade... more Background and objectives: Importance of maternal health has been recognized over the last decade, however information about the perception of illness and health care behavior of obstetric complication is lacking. So, this study was conducted to find out the prevalence of taking care during pregnancy and delivery, and to find out the association between sociodemographic characteristics and taking care during pregnancy and delivery. Material and Methods: The study is a cross-sectional study conducted among the residents of Rangeli VDC of Morang District in Eastern Nepal where 300 households were taken as subjects. Semi-structured questionnaire was used and face to face interview was conducted. Chi-square test was applied to find out the association between sociodemographic characteristics and taking care during pregnancy and delivery. Results: Almost forty percent of pregnant women have taken care during pregnancy and delivery i.e. delivery conducted in Health Care Center (HCC). Only...