Rojana Dhakal | Pokhara University (original) (raw)

Papers by Rojana Dhakal

International Journal of Medical and Health Sciences, Jan 14, 2015

Introduction: Globally, there is decline trend of breastfeeding reasons for declining breastfeedi... more Introduction: Globally, there is decline trend of breastfeeding reasons for declining breastfeeding includes lack of knowledge and confidence regarding breastfeeding techniques. The current study is designed to determine the effectiveness of educational package on knowledge and practices regarding breastfeeding techniques. Methods: An evaluative research approach was used for this study. The study was carried out among 60 postnatal mothers in selected maternity hospital, Mangalore Via structured interview schedule and observation checklist. Results: The overall mean percentage of pre-test level of knowledge and practice is 37.33 and 47.79. The calculated "t" value is 29.34 and 20.21 for knowledge and practice respectively. The mean percentage of post-test is 74.5 and 80.55for knowledge and practice. The present study reveals that the computed "r" value is 0.83 which is significant at 0.05 level of significance. Conclusion: Educational package on knowledge and practices regarding breastfeeding techniques among postnatal mothers was found effective.

Journal of Health and Allied Sciences, Nov 8, 2022

Introduction: Breast carcinoma is the most prevalent cancer in both industrialized and developing... more Introduction: Breast carcinoma is the most prevalent cancer in both industrialized and developing nations among women. Early screening play a vital role in cancer identification and prevention, potentially decreasing mortality due to breast cancer. The study's primary goal was to find out breast cancer screening behavior and factors related to it among women of Pokhara. Methods: A survey was carried out among the 269 women residing in ward number 33, Pokhara using systematic sampling. Pokhara University Institutional Review Committee provided approval for the the study. Data were gathered through the use of validated questionnaire. Chi-square test has been applied to analyze the relationship between variables. Results: Out of 269 women, only 15.6% ever heard of breast cancer screening measures. Among those who are informed about breast cancer screening only 12.3% of women screened at least once in their life for carcinoma of breast. Breast selfexamination, clinical breast exam, mammography, and breast ultrasound were practiced once in a life by 1.9%, 6.8%, 3.3% and 0.3% of women, respectively. Women educational level, ever heard of breast cancer screening programs, institutional factors, pain, concern of cost, availability of female doctor were associated with breast cancer screening. Conclusion: Overall, cancer screening behavior was poor in women of this location. Educational level, breast cancer screening information and health professional recommendation were identified as important factors for breast carcinoma screening behavior.

Journal of Health and Allied Sciences, Aug 17, 2020

Introduction: Cesarean section (CS) was introduced in clinical practice as a life-saving procedur... more Introduction: Cesarean section (CS) was introduced in clinical practice as a life-saving procedure for both the mother and baby. The World Health Organization (WHO) has set a 15 percent minimum threshold for cesarean delivery to save the life of the mother and fetus. The rates of cesarean delivery have been increasing worldwide, leading to emerging public health issues affecting both developed and developing countries. This study examined the maternal and fetal outcomes of cesarean section at a tertiary-level hospital. Methods: This study was based on secondary data retrieved from the record information of the registry of Maternity, Gynecological, Operation Theater, and Neonatal Intensive Care Unit (NICU) ward of the regional hospital in western Nepal. A total of 5802 women delivered by cesarean section, those record had complete information of year 2013 to 2016 were analyzed. Data were collected through review guidelines developed by the researcher. Frequency and percentage were used to analyze the socio-demographic and obstetric information, indication of cesarean section, maternal and neonatal outcomes, and the obtained results presented in tables, graphs, and narratives. The chi-square test was used to find out the association of cesarean section and its outcomes with demographic and obstetrics variables. Results: The mean age of mothers was 25.25 ± 4.7 years,with the minimum and maximum age being 14 and 48 years respectively. Of the 5802 mothers, 17.1 percent of mothers had poor outcomes having some maternal complications. Regarding neonatal outcomes of 5872 neonates, 11.8 percent of new born had poor outcomes having some complications like low birth weight, asphyxia, etc. There was statistically significant association of age, ethnicity, and type of cesarean section with maternal outcomes. Similarly, weeks of gestation and mode of cesarean section were significantly associated with neonatal outcomes. Conclusion: A large number of cesarean sections were emergency. Of the mothers who delivered by cesarean section majority of them and newborns had good outcomes. Mothers and neonates actual needs, contributory factors and outcomes following cesarean section need to be extensive evaluation before performing it.

Journal of Health and Allied Sciences, Nov 21, 2019

Cervical cancer is the second most common cancer in women worldwide. Close to half a million new ... more Cervical cancer is the second most common cancer in women worldwide. Close to half a million new cases are diagnosed each year and over 2.5 lakhs of women die due to cervical cancer annually. Current estimates indicate that every year 2332 women are diagnosed with cervical cancer and 1367 die from the disease. It is one of the leading causes of morbidity and mortality amongst the gynecological cancers worldwide. A cross-sectional descriptive design was used to assess the awareness and practice of cervical cancer screening among the married women of Syangja district. Proportionate stratified sampling was used to select the total 207 representative sample. Data was collected by using semi structured interview schedules and collected data were entered in Ms-Exel and analyzed using SPSS. The study result showed that majority 96% of the respondents had poor awareness and whereas none of the respondents had good awareness regarding the cervical cancer and its screening tests. The highest awareness was in the area of cervical cancer screening with mean percentage 61.11% whereas the least awareness was in the area of general aspects of cervical cancer with mean percentage 41.55%. Regarding practice of cervical cancer screening test 25.6% had performed it within 5 years, among them 50.93% of the respondents had undergone pap smear test. There was no association exists between the selected demographic variables and the level of awareness. Similarly there was no correlation exists between the level of awareness on cervical cancer and practice of cervical cancer screening. Majority of the women had poor awareness regarding the cervical cancer screening tests and significantly low practice of cervical cancer screening test.

International Journal of Health Sciences and Research, 2015

Background: Urinary tract infection (UTI) is the most common complications of pregnancy together ... more Background: Urinary tract infection (UTI) is the most common complications of pregnancy together with many complications like hypertension, anemia, and pyelonephritis. It occurs approximately 5 to 10 % of all pregnancy. Educating the pregnant women about the urinary tract infection during pregnancy helps to prevent from UTI and preventive measures for development of complication. Methodology: A descriptive research design was employed for the study and data was collected through direct face to face interview schedule. Non probability purposive sampling technique was used to select the sample of the study. Two hundred and forty six primigravida women were interviewed between May to June 2015. Results: Most of the respondents 102 (41.46%) were in between the age group of 22-25 years and the mean age was 23.5 years. Most of respondents 174 (70.73%) were lived in urban region. Majority of respondents 201(81.70%) follows the Hindu religion. Majority of respondents 221(89.84%) had got formal education .One hundred and fifty nine (64.63%) of women had no information about Urinary tract infection. Regarding knowledge on urinary tract infection 60 (24.39%) had poor knowledge, 160 (65.05%) had average knowledge and 26 (10.56%) of respondents had good level of knowledge. Statistically significant relationship was found on level of knowledge with age of women (χ 2 = 8.53). Conclusion: The study shows that most knowledgeable area was management and treatment of urinary tract infection and least knowledgeable area was on the area of incidence and causes of the urinary tract infection. Awareness program is required to improve the knowledge on UTI.

Journal of Health and Allied Sciences, 2018

Birth spacing is the interval that the couples maintain between two successive children. World He... more Birth spacing is the interval that the couples maintain between two successive children. World Health Organization (WHO) and other international organizations recommend that individuals and couples should wait for at least 3-5 years between births in order to reduce the risk of adverse maternal and child health outcomes. Having children too close together has long been associated with increased risk of various adverse health outcomes, including mortality, for infants, children and mothers. But in developing countries women are giving birth to children in short gap which is causing infant, child and maternal mortality. The main objective of the study is to assess the determinants of birth spacing. A cross sectional study was carried out in Deurali VDC of Kaski. The study population comprised of married women of reproductive age having at least one child. The data was collected by using semi structured interview schedules and collected data were entered in Epi-data and analyzed using SPSS. The total sample was 262, among them most of the 130 (49.6%) respondents were >30 years old while 13 (5%) of respondents were <20 years old. The minimum age was 15 and maximum age was 45 years. The mean ± SD of age of the respondents was 31.65±7.144 years. Majority 231 (88.2%) of respondents were Hindu and 123 (48%) were of upper caste. Majority of 151 (57.6%) respondents lived in joint family and 158 (60.3%) of respondents were house wives. Educational status of respondents shows that 79 (30.2%) had primary education. Only 69 (26.3%) of respondents were found using temporary family planning methods 91 (34.7%) and unwanted pregnancy. Depo-Provera and implant were found common among family planning users. The main reason for inadequate birth spacing was hope for male child 184 (70.2%), however, 212 (20.9%) respondents also said that adequate birth spacing is determined to maintain health of the mother and child.

PLOS ONE, 2023

Breast malignancy is the most frequent carcinoma among females across the world and third-most in... more Breast malignancy is the most frequent carcinoma among females across the world and third-most in Nepal. Early diagnosis of breast cancer through breast health awareness and self-examination, in addition to mammography screening, is a highly feasible and useful technique in poorly resourced settings. However, their intentions, whether to modify behaviors or actions, remain debatable and less explained in the literature. So, we aimed to assess how long an educational intervention affects women's intention to do a breast selfexamination (BSE) and mammography screening. After assessing feasibility, one ward was assigned to the intervention (IG; ward number 30) and control group (CG; ward number 33), and then with inclusion criteria, a total of 360 females (180 each in IG and CG) aged 40-75 years enrolled in the study. After the baseline assessment, participants in the IG were delivered an hour-long breast cancer screening-related lecture-discussion-demonstration session that included BSE and mammography, aided with a silicone dummy. The session was carried out by the female trained nurses. Outcome data were obtained at the baseline, 4, 8, and 12 months following the intervention. Attitudes, perceived behavioral controls (PBCs) and behavioral intents (BIs) of both mammography and BSE at baseline were similar in both IG and CG except in case of subjective norms (SNs). Intents of BSE remained effective for 4 months, whereas for mammography, it was effective only at 4 and 12 months. Moreover, attitudes toward both tests remained intact for 4, 8, and 12 months (p = < .05) consistently. With regards to PBCs, women having good control remained only for 4 months in both screening tests. Further, regarding SN, significant mean changes were observed at 4 and 12 months in BSE, and only at 4 months in mammography screening. The session was effective in sustaining BSE and mammography intentions for at least 4 months. To retain

Journal of Health and Allied Sciences, Nov 8, 2022

Breast cancer, Aug 1, 2022

This study aimed to provide updated evidence on the status of female breast cancer and cancer tre... more This study aimed to provide updated evidence on the status of female breast cancer and cancer treatment facilities in Asia, with a special focus on Nepal. This review used search phrases that included, breast neoplasm or cancer, health status, epidemiology, breast cancer survivors, cancer care facilities, Asia, Nepal. Researchers examined databases from January 2011 to December 2020 (PubMed, PMC, Google Scholar, and the reference lists of included papers). Studies of any design and reviews, were included in the study, except for qualitative studies. The study findings are presented in a narrative synthesis format using Preferred Reporting Items for Systematic Reviews and Meta-analyses Extension for Scoping Reviews. An initial search resulted in 974 papers, and 896 were reviewed after being checked for duplication using the Zotero software. Accordingly, utilizing the inclusion and exclusion criteria, 188 publications were selected, and after review of titles and abstracts, an additional 98 papers were removed for different reasons. Finally, the study looked at 90 female breast cancer papers. Results showed that the number of cases of breast cancer is growing all around the world, including in Asia and Nepal. Age, early menarche, late menopause, nulliparity, positive family history, excessive fat consumption, alcohol, and smoking are all frequent risk factors for breast cancer found in Asian women. Breast self-examination, clinical breast examination, and mammography screening are common methods for detecting breast carcinoma. Chemotherapy, radiation, and modified mastectomy are commonly used options for treatment. The number of breast cancer survivors is growing throughout the world, indicating better clinical care. There is a paucity of survival data in many Asian countries, including Nepal. There is also a scarcity of health workforce specialized in cancer care and treatment, as well as a few health facilities that are available to treat cancer cases in many Asian countries, including Nepal.

Frontiers in Cardiovascular Medicine

ObjectiveHealth Technology Assessment (HTA) is a comprehensive and important tool for assessment ... more ObjectiveHealth Technology Assessment (HTA) is a comprehensive and important tool for assessment and decision-making in public health and healthcare practice. It is recommended by the WHO and has been applied in practice in many countries, mostly the developed ones. HTA might be an important tool to achieve universal health coverage (UHC), especially beneficial to low-and-middle-income countries (LMIC). Even though the Package for Essential Non-communicable Diseases (PEN) has already been initiated, there is a clear policy gap in the HTA of any health device, service, or procedure, including the assessment of cardiovascular risk factors (CVRFs) in Nepal. Hence, we carried out the review to document the HTA supported evidence of hypertension and diabetes screening, as CVRFs in Nepal.Materials and methodsWe searched in PubMed, Cochrane, and Google Scholar, along with some gray literature published in the last 6 years (2016–2021) in a systematic way with a controlled vocabulary using a...

Annals of Epidemiology, 2010

A random sample of 585 Kuwaiti college women was studied in 1997 for factors associated with over... more A random sample of 585 Kuwaiti college women was studied in 1997 for factors associated with overweight and obesity. Weight and height were measured. The index of adiposity used was the body mass index (BMI), which is the weight in kilograms divided by the height squared (W/H 2). The women were classified as overweight or obese (BMI >25 or >30 Kg/m 2). The associated factors obtained through questionnaires included age, marital status, area of residence, number of siblings, (brothers, sisters, total), suffering from a chronic disease, obesity among parents, parents' education and occupation, number of major meals eaten, eating between meals, family income, number of servants, number of people living at home, exercising, last dental and physical checkup, dieting, year of study, highest desired degree, countries prefer visiting, and socioeconomic status (SES). The results of the study revealed that 27.2 and 7.2% of the students were overweight (BMI >25 Kg/m 2) and obese (BMI >30 Kg/m 2), respectively. Factors that were found to be significantly associated with overweight and obesity among the women included number of brothers, having a chronic disease, obesity among parents, dieting and countries prefer visiting. Logistic regression analysis of significant associated factors revealed that the same factors contributed to the development of overweight and obesity except number of brothers and having a chronic disease.

Preconception care is any intervention provided to women and couples of childbearing age, regardl... more Preconception care is any intervention provided to women and couples of childbearing age, regardless of pregnancy status or desire, before pregnancy, to improve health outcomes for women, newborns and children. Preconception care mainly focuses on health promotion, screening and interventions for women of reproductive age to reduce risk factors that might affect future pregnancies. A descriptive research design was used for this study. Non- probability purposive sampling technique was used to select the respondents. Two hundred twenty-seven reproductive age women were interviewed face to face using structured questionnaires. Most of the respondents 99 (43.61%) were in between the age group of 21-25 years. Majority of respondents 218(96.03%) belonged to Hindu religion. Most of the respondents 152(66.96%) belonged to nuclear family. Only 65(28.63%) had information regarding preconception care. Majority of respondents 192(84.58%) had average level of knowledge. Highest knowledge score ...

International Journal of Health Sciences and Research, 2015

Background: Children are the future of any nation. Care of the children had always traditionally ... more Background: Children are the future of any nation. Care of the children had always traditionally been the forte of mothers irrespective of education, income and social class differences. Educating mothers to create awareness about essential obstetric and neonatal care are the key steps in achieving the goals of reproductive and child health programme. Methodology: A descriptive cross-sectional study was carried out using face to face interview schedule on different aspects of newborn care questionnaire. Non-probability purposive sampling technique was used to select sample of the study. Two hundred forty five (245) postnatal mothers were interviewed between November-December 2014. Results: Most of the respondents 88(35.9%) belong to 18-21 age groups and the mean age was 23.5 years. Majority of respondents 222(90.6%) were Hindu and 242(98.7%) were literate. One hundred and fifty one (61.6%) have average knowledge while 94(38.4%) have good level of knowledge regarding knowledge on new...

International Journal of Health Sciences and Research, 2015

Background: Exclusive breastfeeding is defined as a practice where by the infants receive only br... more Background: Exclusive breastfeeding is defined as a practice where by the infants receive only breast milk and not even water, other liquids, tea, herbal preparation, or food during the first six months of life, with the exception of vitamins, minerals supplements, or medicines. Exclusive breastfeeding is the best nutrition which fulfills the physical needs of the child and also is the psychotic complementary for the mother and child. Methodology: A cross sectional descriptive research design was carried out using direct interview schedule. The non-probability purposive sampling technique was used to select the sample of the study. Respondents were 245 mothers who were attending Maternal and Child Health Clinic, Pediatric OPD and Pediatric Ward of Western Regional Hospital Pokhara Nepal. Structured interview schedule was used to collect the data. Results: Most of the respondents 91 (37.1%) belonged to age group 22-25 years and the mean age was 25.93 ± 4.139. Overall 191 (78.0%) of r...

International Journal of Health Sciences and Research, 2015

Mothers and newborns are vulnerable to illness and deaths during the postnatal period. Postnatal ... more Mothers and newborns are vulnerable to illness and deaths during the postnatal period. Postnatal period is the important part of maternal health care as the serious and life threatening complications can occur in postnatal period. The health of the mother is regarded as the indicator of health of the society so postnatal care is important for the health of mother and newborn as well. A descriptive research design was used in this study. Non probability purposive sampling technique was used to select the postnatal mothers. One hundred ninety six postnatal mothers were interviewed face to face using structured questionnaires. Most of the respondents 79(40.31%) belongs to 22-25 age groups and the mean age was 24.12 years. Majority of the respondents 182(92.86%) were Hindu. All the respondents were literate. Out of 196, 146(74.48%) of the respondents, got information from friends and family. Most of the respondents 123(62.76%) had average level of knowledge on postnatal care. Highest kn...

Reproductive rights are the rights of individuals to decide whether to reproduce and have reprodu... more Reproductive rights are the rights of individuals to decide whether to reproduce and have reproductive health. It includes an individual’s right to plan a family, terminate a pregnancy, use contraceptives, learn about sex education in public school, and gain access to reproductive health services. The method was a descriptive research design was used for this study. Proportionate stratified sampling technique and systematic random sampling technique was used to select the respondents. Three hundred seventeen undergraduate students were participated in the study and data was collected through structured self administered questionnaire between May to June 2015. The results were most of the respondents 224 (70.66%) were in between the age group of 15-20 years and 221 (69.38%) were female. Majority of respondents 294(92.74%) belonged to Hindu religion. Most of the respondents 199(62.78%) belonged to nuclear family. Majority of respondents 235(74.1%) were unmarried. Majority of the respo...

Preconception care is any intervention provided to women and couples of childbearing age, regardl... more Preconception care is any intervention provided to women and couples of childbearing age, regardless of pregnancy status or desire, before pregnancy, to improve health outcomes for women, newborns and children. Preconception care mainly focuses on health promotion, screening and interventions for women of reproductive age to reduce risk factors that might affect future pregnancies. A descriptive research design was used for this study. Nonprobability purposive sampling technique was used to select the respondents. Two hundred twenty-seven reproductive age women were interviewed face to face using structured questionnaires. Most of the respondents 99 (43.61%) were in between the age group of 21-25 years. Majority of respondents 218(96.03%) belonged to Hindu religion. Most of the respondents 152(66.96%) belonged to nuclear family. Only 65(28.63%) had information regarding preconception care. Majority of respondents 192(84.58%) had average level of knowledge. Highest knowledge score wa...

International Journal of Medical and Health Sciences, Jan 14, 2015

Journal of Health and Allied Sciences, Nov 8, 2022

Journal of Health and Allied Sciences, Aug 17, 2020

Journal of Health and Allied Sciences, Nov 21, 2019

International Journal of Health Sciences and Research, 2015

Journal of Health and Allied Sciences, 2018

PLOS ONE, 2023

Journal of Health and Allied Sciences, Nov 8, 2022

Breast cancer, Aug 1, 2022

Frontiers in Cardiovascular Medicine

Annals of Epidemiology, 2010

International Journal of Health Sciences and Research, 2015

Preconception care is any intervention provided to women and couples of childbearing age, regardl... more Preconception care is any intervention provided to women and couples of childbearing age, regardless of pregnancy status or desire, before pregnancy, to improve health outcomes for women, newborns and children. Preconception care mainly focuses on health promotion, screening and interventions for women of reproductive age to reduce risk factors that might affect future pregnancies. A descriptive research design was used for this study. Nonprobability purposive sampling technique was used to select the respondents. Two hundred twenty-seven reproductive age women were interviewed face to face using structured questionnaires. Most of the respondents 99 (43.61%) were in between the age group of 21-25 years. Majority of respondents 218(96.03%) belonged to Hindu religion. Most of the respondents 152(66.96%) belonged to nuclear family. Only 65(28.63%) had information regarding preconception care. Majority of respondents 192(84.58%) had average level of knowledge. Highest knowledge score wa...