Surya Raj Niraula

Tobacco use and associated factors among adolescent students in Dharan, Eastern Nepal: a cross-sectional questionnaire survey

Introduction The tobacco use among the youth, in both smoking and smokeless forms, is quite high in the South East Asian region. Tobacco use is a major proven risk factor and contributes substantially to the rising epidemic of non-communicable diseases. Objectives To estimate the prevalence of tobacco use and determine associated factors among adolescent students of Dharan municipality. Design Cross-sectional study. Setting Secondary and higher secondary schools of Dharan municipality in Sunsari district of Nepal. Participants Students in middle (14–15 years) and late adolescence (16–19 years) from grades 9, 10, 11 and 12 were included. Primary outcome measure Ever tobacco use which was defined as one who had not used any form of tobacco in the past 1 month but had tried in the past. Methodology Self-administered questionnaire adapted from Global Youth Tobacco Survey was used to assess tobacco use among the representative sample of 1312 adolescent students selected by stratified random sampling from July 2011 to July 2012. Results Out of 1454 students, 1312 students completed the questionnaires with a response rate of 90.23%. Prevalence of ever use of any tobacco product was 19.7% (95% CI 17.7 to 21.6). More than half of the tobacco users (51.9%) consumed tobacco in public places whereas almost a third (75.6%) of the consumers purchased tobacco from shops. Multivariate analysis showed that tobacco use was associated with late adolescence (OR: 1.64; 95% CI 1.17 to 2.28), male gender (OR: 12.20; 95% CI 7.78 to 19.14), type of school (OR=1.72; 95% CI 1.01 to 2.94), Janajati ethnicity (OR: 2.05; 95% CI 1.39 to 3.01) and receiving pocket money ≥Nepalese rupees 500/month (OR: 1.45; 95% CI 1.04 to 2.03). Conclusions Tobacco-focused interventions are required for school/college going students to promote cessation among users and prevent initiation, focussing on late adolescence, male gender, government schools, Janajati ethnicity and higher amount of pocket money.

Awareness of occupational hazards and use of safety measures among welders: a cross-sectional study from eastern Nepal

Objective The proper use of safety measures by welders is an important way of preventing and/or reducing a variety of health hazards that they are exposed to during welding. There is a lack of knowledge about hazards and personal protective equipments (PPEs) and the use of PPE among the welders in Nepal is limited. We designed a study to assess welders’ awareness of hazards and PPE, and the use of PPE among the welders of eastern Nepal and to find a possible correlation between awareness and use of PPE among them. Materials and methods A cross-sectional study of 300 welders selected by simple random sampling from three districts of eastern Nepal was conducted using a semistructured questionnaire. Data regarding age, education level, duration of employment, awareness of hazards, safety measures and the actual use of safety measures were recorded. Results Overall, 272 (90.7%) welders were aware of at least one hazard of welding and a similar proportion of welders were aware of at least one PPE. However, only 47.7% used one or more types of PPE. Education and duration of employment were significantly associated with the awareness of hazards and of PPE and its use. The welders who reported using PPE during welding were two times more likely to have been aware of hazards (OR=2.52, 95% CI 1.09 to 5.81) and five times more likely to have been aware of PPE compared with the welders who did not report the use of PPE (OR=5.13, 95% CI 2.34 to 11.26). Conclusions The welders using PPE were those who were aware of hazards and PPE. There is a gap between being aware of hazards and PPE (90%) and use of PPE (47%) at work. Further research is needed to identify the underlying factors leading to low utilisation of PPE despite the welders of eastern Nepal being knowledgeable of it.

Risk Factors for Drug Abuse Among Nepalese Samples Selected from a Town of Eastern Nepal

The study focuses on the serious issue related to the adolescents’ and adults’ behavior and health. It aims to identify the risk factors for drug abuse from samples taken from a town of Eastern Nepal. This is a matched case-control study. The conditional logistic regression method was adopted for data analysis. The diagnosis cut off was determined by Receiver Operating Characteristic curve. A representative sample of 150 matched pairs was recruited from Dharan in 2006. The final model after adjusting 17 possible variables each other, detected some factors like education, occupation, short temper, depression, etc that were significantly associated with drug abuse, but shy behavior was not a significant predictor for drug abuse among the study sample. The level of education, occupation and depression were the strong predictors as identified by the model. The findings of the study may have implications to aware families and schools in developing countries like Nepal.

Reliability and Validity of a Nepalese Version of the Oral Health Impact Profile for Edentulous Subjects

PURPOSE To assess the reliability and to validate the translated Nepalese version of the Oral Health Impact Profile (OHIP-EDENT-N) in Nepalese edentulous subjects. MATERIALS AND METHODS The international guidelines for translation and cross-cultural adaption of OHIP-EDENT were followed, and a Nepalese version of the questionnaire was adapted for this study. Eighty-eight completely edentulous subjects were then selected for the study and completed their responses for the questionnaire. The reliability of the OHIP-EDENT-N was evaluated using internal consistency. Validity was assessed as construct and convergent validity. Construct validity was determined using exploratory factor analysis (EFA). The correlation between OHIP-EDENT-N subscale scores and the global question was investigated to test the convergent validity. RESULTS Cronbachs alpha for the total score of OHIP-EDENT-N was 0.78. Construct validity was assessed by factor analysis: 70.196% of the variance was accountable to five factors extracted from the factor analysis. Factor loadings above 0.40 were noted for all items. In terms of convergent validity, significant correlations could be established between OHIP-EDENT-N and global questions. CONCLUSIONS This study has been able to establish the reliability and validity of the OHIP-EDENT-N, and OHIP-EDENT-N can be a considered a reliable tool to assess the oral health related quality of life in the Nepalese edentulous population.

Preferred Source and Perceived Need of More Information about Dental Implants by the Undergraduate Dental Students of Nepal: All Nepal Survey

Objectives This study was conducted to know the preferred source and perceived need of more information about dental implants by the undergraduate students of Nepal and their association with academic levels and gender. Materials and Methods It was conducted in all the dental colleges of Nepal from June 2016 to June 2017 after taking ethical clearance and approval from the research committee of BPKIHS. It included all those who were present at the time of survey. Data collection was done through a cross-sectional questionnaire survey during the academic schedule of the colleges, supervised and monitored by the investigators themselves. The collected data were coded and entered in Microsoft excel 2013, and statistical analysis was done by SPSS 20 version. Result A majority of the respondents agreed that they were not provided with sufficient information about implant treatment procedures during their BDS program (65.3%), would like more to be provided in the curriculum (95.1%), and would like to get additional reliable information from dental consultants and specialists (40.7%) and training on it from fellowship programs conducted by universities (39.2%). Significant association was seen between the responses and academic levels. Conclusion Undergraduate dental students of Nepal want more information about dental implants through various means.