Raj K Subedi | Pokhara University (original) (raw)

Papers by Raj K Subedi

Occupational safety and health is a neglected area in small scale cottage factories in Nepal. A c... more Occupational safety and health is a neglected area in small scale cottage factories in Nepal. A cross-sectional study was conducted in 10 small scale carpet factories in Bhaktapur district of Nepal among 100 workers to find out their occupational health and safety status. The study revealed that majority of the workers were females (57%) and more than half (52%) of the workers were aged 20 - 30 years. The duration of work in a day ranged from 8 to 12 hours and majority were weavers (58%). About three in four (77%) worked outside the factory as well. None of them received health education at work and none of the factories had medical treatment facilities and had only basic first aid treatment. Similarly, 80% were not found to be using any personal protective equipment (PPE) during work. A total of 90% workers regarded the dust control measures in their factory as poor; 90% regarded ventilation as poor, 60% reported fire management preparedness as poor; and 30% perceived the first aid treatment services as poor. Majority of them (84%) said they had experienced some health problems at work. The most commonly reported health problems were backache/joint ache (63.1%), eye irritations (40.48%), prolonged headache (40.48%), chest pain (38.1%), and skin irritation (23.81%). Only 27.38% of them informed the authority after experiencing problems; 65.22% of those who reported their problems received treatment. Interestingly, 10% said it was not big deal to have health problems while working in the carpet factory. Further comparative and analytical studies are recommended to explore the occupational health status in small scale factories in Nepal.

Tweetable abstract: Students support government's effort to ban smoking in public places but say ... more Tweetable abstract: Students support government's effort to ban smoking in public places but say it hasn't been effectively implemented.

At current era of globalization, media is the double edged sword that is important both for healt... more At current era of globalization, media is the double edged sword that is important both for health education as well as the stimulation of unhealthy behaviour. In Nepal, though there is ban on most forms of advertising, it is not clear about placement of tobacco advertisement in TV, films and other forms of media. Studies about cigarette smoking and its association with media are inadequate in Nepal. The objective of this study was to explore the role of media in cigarette smoking habit of adolescents in Nepal.
A cross-sectional study was conducted among 394 adolescent students by using questionnaire method in 3 randomly selected colleges of Kathmandu district, Nepal. Data were analysed by using bivariate and multinomial logistic regression analysis.
Statistically significant relationship at 95% CI was found between cigarette smoking status and media related variables like: seeing cigarette advertisement, reading fashion magazine, attending musical program sponsored by cigarette companies, watching movies in cinema hall, liking heavy metal/hard rock music, television watching time and desire to smoke if favourite artist smokes. Multinomial logistic regression showed that those with high receptivity to cigarette advertisement were likely to be current smokers (OR = 71.416, CI: 8.796 - 579.823) and ever smokers (OR = 9.582, CI: 2.201 - 41.714) compared to never smokers. About 79% of respondents agreed that media teaches different ways of smoking to its audiences.
Different forms of media including cinema, music, magazines, television, games and music sponsorship are found to be important predictors for smoking status of college students in urban Nepal. Thus smoking prevention activities should consider role of media in smoking provocation among adolescents.
Keywords: Adolescents, Cigarette Advertisement, Media, Provocation, Smoking

The advent of sensitive diagnostic techniques along with widespread treatment of Cerebral Venous ... more The advent of sensitive diagnostic techniques along with widespread treatment of Cerebral Venous Sinus Thrombosis (CVST) with anticoagulation has transformed this once dreaded disease to a benign entity. Prompt diagnosis on hospital visit and effective therapeutic interventions are likely to improve the outcome of the CVST patients and we employed this good clinical practice in our study.
From 2007 to 2011, 32 adult patients with CVST confirmed by radiography and investigated for prothrombotic states were retrospectively studied. All patients were followed up for 6 months after hospitalization and the outcome at last follow- up visit was assessed by modified Rankin Scale (mRS). Primary outcome was mRS <=2 at the end of follow-up signifying good outcome.
Of the 32 patients, 18(56.3%) were men and the mean age was 37.8 years (range 18-66). The most common symptoms were headaches (84.4%), vomiting (37.5%) and seizures (21.9%). Papilledema (31.3%) and isolated intracranial hypertension (IIH) (31.3%) were the most common sign and clinical syndrome respectively. The most common risk factors were oral contraceptive pills (28.1%) and dehydration (18.7%). Good outcome (mRS<=2) and poor outcome (mRS 3-6) at the end of follow-up were observed in 28(87.5%) and 4(12.5%) patients respectively with mortality (mRS=6) of 3(9.4%) patients.
We had higher prevalence of CVST in men than previously reported. We had excellent prognosis with 87.5% of patients exhibiting good outcome (mRS<=2) at the final follow-up. We attribute this remarkable patient’s outcome to increased awareness of this entity, prompt diagnosis on hospital visit and timely intervention with effective therapies.

Key Words: cerebral venous sinus thrombosis, diagnosis, effective therapies, patient’s outcome

Family planning services in Nepal are provided by government and non-government health facilities... more Family planning services in Nepal are provided by government and non-government health facilities. A descriptive cross sectional study was done by secondary data review of eight months from Institutional clinic, District Health Office (DHO) Ilam district. Use of different family planning methods through government health facility was studied in relation to different variables like age, sex, ethnicity, and, number of children. Around 53% of the female users of spacing method and around 47% of female users of permanent method were in age group 20-29 years and 25-29 years respectively. The major reasons for removal of IUCD were husband's migration and experienced physical problems. Most of the females doing sterilization were from Disadvantaged Janajati group whereas most of the males doing sterilization were from Upper caste ethnic group. Among females doing sterilization, 70% already had their second live birth baby. Out of the total sterilization performed in 8 months, only 15.15% was done among males. So, there is need of increasing male involvement in Family planning. There is also need of programs to encourage spacing methods among the target population.

Insomnia is one of the major and unsolved problems in older people. Most of the sleep studies rep... more Insomnia is one of the major and unsolved problems in older people. Most of the sleep studies report that the different forms of insomnia like Difficulty Initiating Sleep (DIS), Difficulty Maintaining Sleep (DMS) and Non-Restorative Sleep (NRS) are common among the elderly that are associated to many factors. The objective of the study was to measure the prevalence of insomnia and the factors associated to it among the elderly people.A cross-sectional study was conducted among 142 elderly people of and above 60 years of age in Sarangdanda VDC of Panchthar District of Eastern Nepal. The presence or absence of insomnia and the associated factors were assessed on them by the help of interview schedule. The results were analyzed using chisquare test in SPSS (version 11.5). DMS was the most common reported form of insomnia among the elderly followed by DIS and NRS. Association between insomnia and each of factors like use of tobacco before sleeping hours, eating too close to bedtime, use of tea/coffee before sleeping hours and use of alcohol before sleeping hours were statistically significant at 95% level of confidence. Insomnia affects a large proportion of elderly and is triggered by many factors like use of tobacco before sleeping hours, use of tea/coffee before sleeping hours, eating too close to bedtime and use of alcohol before sleeping hours.

Occupational safety and health is a neglected area in small scale cottage factories in Nepal. A c... more Occupational safety and health is a neglected area in small scale cottage factories in Nepal. A cross-sectional study was conducted in 10 small scale carpet factories in Bhaktapur district of Nepal among 100 workers to find out their occupational health and safety status. The study revealed that majority of the workers were females (57%) and more than half (52%) of the workers were aged 20 - 30 years. The duration of work in a day ranged from 8 to 12 hours and majority were weavers (58%). About three in four (77%) worked outside the factory as well. None of them received health education at work and none of the factories had medical treatment facilities and had only basic first aid treatment. Similarly, 80% were not found to be using any personal protective equipment (PPE) during work. A total of 90% workers regarded the dust control measures in their factory as poor; 90% regarded ventilation as poor, 60% reported fire management preparedness as poor; and 30% perceived the first aid treatment services as poor. Majority of them (84%) said they had experienced some health problems at work. The most commonly reported health problems were backache/joint ache (63.1%), eye irritations (40.48%), prolonged headache (40.48%), chest pain (38.1%), and skin irritation (23.81%). Only 27.38% of them informed the authority after experiencing problems; 65.22% of those who reported their problems received treatment. Interestingly, 10% said it was not big deal to have health problems while working in the carpet factory. Further comparative and analytical studies are recommended to explore the occupational health status in small scale factories in Nepal.

Tweetable abstract: Students support government's effort to ban smoking in public places but say ... more Tweetable abstract: Students support government's effort to ban smoking in public places but say it hasn't been effectively implemented.

At current era of globalization, media is the double edged sword that is important both for healt... more At current era of globalization, media is the double edged sword that is important both for health education as well as the stimulation of unhealthy behaviour. In Nepal, though there is ban on most forms of advertising, it is not clear about placement of tobacco advertisement in TV, films and other forms of media. Studies about cigarette smoking and its association with media are inadequate in Nepal. The objective of this study was to explore the role of media in cigarette smoking habit of adolescents in Nepal.
A cross-sectional study was conducted among 394 adolescent students by using questionnaire method in 3 randomly selected colleges of Kathmandu district, Nepal. Data were analysed by using bivariate and multinomial logistic regression analysis.
Statistically significant relationship at 95% CI was found between cigarette smoking status and media related variables like: seeing cigarette advertisement, reading fashion magazine, attending musical program sponsored by cigarette companies, watching movies in cinema hall, liking heavy metal/hard rock music, television watching time and desire to smoke if favourite artist smokes. Multinomial logistic regression showed that those with high receptivity to cigarette advertisement were likely to be current smokers (OR = 71.416, CI: 8.796 - 579.823) and ever smokers (OR = 9.582, CI: 2.201 - 41.714) compared to never smokers. About 79% of respondents agreed that media teaches different ways of smoking to its audiences.
Different forms of media including cinema, music, magazines, television, games and music sponsorship are found to be important predictors for smoking status of college students in urban Nepal. Thus smoking prevention activities should consider role of media in smoking provocation among adolescents.
Keywords: Adolescents, Cigarette Advertisement, Media, Provocation, Smoking

The advent of sensitive diagnostic techniques along with widespread treatment of Cerebral Venous ... more The advent of sensitive diagnostic techniques along with widespread treatment of Cerebral Venous Sinus Thrombosis (CVST) with anticoagulation has transformed this once dreaded disease to a benign entity. Prompt diagnosis on hospital visit and effective therapeutic interventions are likely to improve the outcome of the CVST patients and we employed this good clinical practice in our study.
From 2007 to 2011, 32 adult patients with CVST confirmed by radiography and investigated for prothrombotic states were retrospectively studied. All patients were followed up for 6 months after hospitalization and the outcome at last follow- up visit was assessed by modified Rankin Scale (mRS). Primary outcome was mRS <=2 at the end of follow-up signifying good outcome.
Of the 32 patients, 18(56.3%) were men and the mean age was 37.8 years (range 18-66). The most common symptoms were headaches (84.4%), vomiting (37.5%) and seizures (21.9%). Papilledema (31.3%) and isolated intracranial hypertension (IIH) (31.3%) were the most common sign and clinical syndrome respectively. The most common risk factors were oral contraceptive pills (28.1%) and dehydration (18.7%). Good outcome (mRS<=2) and poor outcome (mRS 3-6) at the end of follow-up were observed in 28(87.5%) and 4(12.5%) patients respectively with mortality (mRS=6) of 3(9.4%) patients.
We had higher prevalence of CVST in men than previously reported. We had excellent prognosis with 87.5% of patients exhibiting good outcome (mRS<=2) at the final follow-up. We attribute this remarkable patient’s outcome to increased awareness of this entity, prompt diagnosis on hospital visit and timely intervention with effective therapies.

Key Words: cerebral venous sinus thrombosis, diagnosis, effective therapies, patient’s outcome

Family planning services in Nepal are provided by government and non-government health facilities... more Family planning services in Nepal are provided by government and non-government health facilities. A descriptive cross sectional study was done by secondary data review of eight months from Institutional clinic, District Health Office (DHO) Ilam district. Use of different family planning methods through government health facility was studied in relation to different variables like age, sex, ethnicity, and, number of children. Around 53% of the female users of spacing method and around 47% of female users of permanent method were in age group 20-29 years and 25-29 years respectively. The major reasons for removal of IUCD were husband's migration and experienced physical problems. Most of the females doing sterilization were from Disadvantaged Janajati group whereas most of the males doing sterilization were from Upper caste ethnic group. Among females doing sterilization, 70% already had their second live birth baby. Out of the total sterilization performed in 8 months, only 15.15% was done among males. So, there is need of increasing male involvement in Family planning. There is also need of programs to encourage spacing methods among the target population.

Insomnia is one of the major and unsolved problems in older people. Most of the sleep studies rep... more Insomnia is one of the major and unsolved problems in older people. Most of the sleep studies report that the different forms of insomnia like Difficulty Initiating Sleep (DIS), Difficulty Maintaining Sleep (DMS) and Non-Restorative Sleep (NRS) are common among the elderly that are associated to many factors. The objective of the study was to measure the prevalence of insomnia and the factors associated to it among the elderly people.A cross-sectional study was conducted among 142 elderly people of and above 60 years of age in Sarangdanda VDC of Panchthar District of Eastern Nepal. The presence or absence of insomnia and the associated factors were assessed on them by the help of interview schedule. The results were analyzed using chisquare test in SPSS (version 11.5). DMS was the most common reported form of insomnia among the elderly followed by DIS and NRS. Association between insomnia and each of factors like use of tobacco before sleeping hours, eating too close to bedtime, use of tea/coffee before sleeping hours and use of alcohol before sleeping hours were statistically significant at 95% level of confidence. Insomnia affects a large proportion of elderly and is triggered by many factors like use of tobacco before sleeping hours, use of tea/coffee before sleeping hours, eating too close to bedtime and use of alcohol before sleeping hours.