Aim To explore the factors affecting mental health service utilization from Primary Health Care facilities of Arghakhanchi district, a western hilly district of Nepal. Background Mental health service utilization has many facilitating and hindering factors present at different socio-ecological levels. Stigma and lack of awareness in the community have been identified as the major barriers for mental health service demand and access worldwide. Methods A cross-sectional qualitative study was conducted in Arghakhanchi district of Nepal in July-August 2019 that collected information through face-to-face In-depth and Key Informant Interviews of three categories of participants selected judgmentally. Thirty-two purposively selected participants from the three categories were interviewed using validated interview guidelines. Thematic analysis was performed using RQDA package for EZR software. Validation of translated transcripts, member checking and inter-coder percent agreement were performed to maintain rigor in the study. Results Mental health stigma and inadequate awareness were identified as major factors that caused barriers for mental health service utilization at community level. They also influenced different factors at other socio-ecological levels to act as barriers. Awareness in community along with accessibility and availability of comprehensive mental health services were recommended by the participants for increasing service utilization from Primary Health Care facilities. Conclusion Individual, family and community awareness could help reduce and/or eliminate mental health stigma. Accessibility of health facilities and availability of comprehensive mental health services in Primary Health Care facilities could help increase service utilization from those facilities.

Introduction: Screening of mental disorders and psychological distress is important in clinical as well as research setting. The objective of this study is to test the reliability of mental health screening questionnaire developed by authors and see its correlation with perceived stress scale scores. Material and Method: A self-report screening instrument was designed by the authors in consultation with experts and was tested for reliability among 162 participants from general population gathered for stress management program. The correlation of the designed scale was tested with the Perceived Stress Scale score. Results: Scale reliability (Cronbach’s alpha) for the designed psychological distress scale was found to be 0.7558 which is regarded as having acceptable internal consistency. The questions of the designed scale had weak to moderate positive correlation with the score on Perceived Stress Scale. Conclusion: Despite many shortcomings of the designed scale we may be able to use it for basic screening of psychological distress and mental health problems. We recommend the validity of scale be tested in larger sample size.

This study presents a general review on four psychoacoustic properties of sound: pitch, loudness, duration and timbre. Most studies in this domain provide an extensive detail on the topic; however, this article presents a perspective to the beginner on how sounds and/or music can be influenced by these properties. This article has made an effort to provide a preliminary understanding of the domain by highlighting concepts associated closely with cognition of music. The present study is largely confined to four major psychoacoustic properties of sound and their effect on music perception and cognition. A review of existing literature was performed with the purpose of providing insight into the topic under study.

Background: Prostate cancer is one of the most common and leading cause of death among different genitourinary causes. However, screening of prostate cancer is limited to Digital Rectal Examination (DRE) and Prostate Specific Antigen (PSA) in Nepal. The aim of this study is to find out which modality is more helpful for the diagnosis of Prostate Cancer. Methods: A retrospective cross-sectional study was conducted in the department of Urology, College of Medical Sciences, Chitwan, Nepal. All patients included in this study were who presented to the OPD with Lower Urinary Tract Symptoms (LUTS). The patients were above the age of 40 with clinical suspicion prostate cancer based on either DRE or PSA.   Results: A total of 150 patients were enrolled from April 2019 to April 2020. Their mean± SD age was of 65.18±9.38 years. The accuracy of the diagnostic test for DRE and PSA were cut off at 4, PSA cut off range of 4 to 10, PSA cut off range of 10 to 30 and PSA cut off at 30 showed that all the screening indices were better for DRE (Sensitivity=100%, Specificity=59.2%, Diagnostic Accuracy=62.2%) than for PSA cut off at 4 (Sensitivity=100%, Specificity=27.6%, Diagnostic Accuracy=32.9%). Among various cut off score or ranges for PSA, cut off score at 30 provided the best screening indices with Sensitivity of 66.7%, Specificity of 97.4% and Diagnostic Accuracy of 95.1%. Conclusions: PSA has higher diagnostic accuracy then DRE. Keywords: DRE; LUTS; Prostate cancer; PSA.  

Background: Indwelling double J ureteral stents are used routinely in the resolution of ureteral obstruction caused by different etiologies. Evaluation of urinary symptoms related to double-J stent indicate that these affect 73-90% of patients. Aim of this study is to evaluate the effect of tamsulosin on the DJ related complications to improve the quality of life and render symptom free life. Material and Methods: Quasi experimental study was carried out in the department of urology in College of Medical Science, teaching hospital Chitwan, Nepal from 15th March 2017 to 15th March 2018. A total of 80 post operative patients were included in this study and were randomized into Group A and B with 40 patient in each group. Stent related symptoms, quality of life and IPSS (International prostate symptom score) were evaluated at the time of discharge and at the time of DJ removal. Pain was evaluated with the help of VAS at the time of discharge and at the time of DJ removal. Data were entered in MS-Excel and were imported to EZR software Version 3.4.1 for analysis. A p-value of less than 0.05 was considered significant. Results: Median age was 30.5 in Tamsulosingroup  and24years in placebo group. (p=0.68).At the time of discharge significant difference was noted in IPSS (p<0.001), butno significant difference wasnoted with QoL index (p=0.932) and VAS (p=0.68). At the time of DJ stent removal, significant difference was noted with IPSS (p<0.001), QoL index (p<0.001), VAS (p=0.004) in Tamsulosin group than in Placebo group. Conclusion: Tamsulosin lowers stent related symptoms, pain and improves quality of life in patientswith indwelling DJ stent. Key words: DJ stent; IPSS; Tamsulosin; VAS.