Chronic obstructive pulmonary disease is a major cause of morbidity and mortality worldwide and global health concern. COPD self care knowledge is a cornerstone for self-management of chronic illness. The objective of this study was to find out the level of knowledge on self care among COPD patients. A descriptive, cross sectional design and purposive sampling was applied in which 182 patients were interviewed by using semi-structure interviews schedule at Chitwan Medical College, Teaching Hospital, Bharatpur. Data was analyzed by using SPSS and descriptive and inferential test was applied. The study findings revealed that 36.8% of the respondents were between age group 61-70 years, 54.4% respondents were male, 59.9% were from Chitwan district, majority of the respondents (62.1%) were outpatient, 48.4% had a history of COPD more than 5 years, 83.2%were hospitalized 1-2 times in last year, 63.2% had no history of COPD in family members and all respondents got information from health personnel. Highest percentage (75) of mean score on smoking cessation and lowest (10) on weight monitoring. Most of all respondents (90.7%) had poor level of knowledge on self care of COPD. The respondents’ level of knowledge on self care is statistically significant with family history (p=0.048), educational status (p=0.000), and types of patient (p=0.017).So, there should be need of health education program for COPD patients about self care to improve knowledge. DOI: http://dx.doi.org/10.3126/jcmc.v4i3.11938Journal of Chitwan Medical College 2014; 4(3):34-37

Maternity incentive schemes were to encourage mothers to use skilled birth attendance for the best prevention of maternal and child death where as the pregnant women should have access to high quality prenatal care which, they can afford and where, they are treated with respect. The objective of the study was to determine the knowledge and utilization of maternal incentives scheme on delivery services at rural area of Nepal. This study was cross-sectional descriptive in nature and Study was conducted in Panchkhal VDC, Kavre district of Nepal.The numbers of married women of reproductive age group were the study population. The sample size was taken as 96. Most of the respondent had primary education (38.5%) and illiterate (15.6%). Highest mobilization of sources which provided throughout the health institute disseminates the MIS information During the study seventy nine mothers went to hospital for treatment. Utilization of incentive helps to change the delivery behavior (practice) of women (78%) within the hospital services by the skilled birth attendants. The 54.2% were not getting money (private hospital) for delivery and 13.5% respondents used money in nutrition and transport, 11.5% used in medicine and 1.0% respondent didn't spend money. Low income and poor women (63%) have been more benefited from the incentive scheme followed by Janajati (12.5%), Dalit (12.5%) and rural women (9.4%) respectively. Importance of maternity incentive scheme (MIS) on safe delivery services (SDS) needs to be disseminated in rural community through integrated health education program. Most of the respondents reported that only incentive is not the matter of utilization of hospital services, but the issue of mother and child health.

Background Metabolic syndrome (MetS) is associated with an increased incidence of chronic complications and mortality of diabetes patients. Prevention and treatment of MetS is important means of lowering the risk of cardiovascular diseases and mortality. Objective This study aimed to find out metabolic syndrome and life style factors among diabetes patients. Methods A cross-sectional survey was carried out among 296 patients with type 2 diabetes mellitus attending Chitwan Medical College Teaching Hospital. Consecutive sampling technique was used to select sample. Data were collected from 15th December 2021 to 15th March, 2022 using Interview Schedule, bio-physiological measurement and record review. Obtained data were analysed in SPSS version 20 for window using descriptive and inferential statistics. Chi-square test was applied to measure the association between the variables. Logistic regression analysis was performed to identify the factors associated with metabolic syndrome. Result Findings revealed that the prevalence of MetS was 66.2% and 58.4% in patients according to International Diabetes Federation (IDF) and National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) criteria respectively. The most common MetS parameters were raised fasting plasma glucose (94.6%) and abnormal waist circumference (78.4% in IDF criteria) while the least prevalent parameter was reduced HDL level (43.2%). Majorities of the patients were non-vegetarian (85.5%), had poor dietary compliance (poor-46.3%, very poor-32.1%), overweight/obese (65.5%), and suffered from moderate stress (90.1%). Bivariate analysis showed that MetS as per NCEP ATP criteria was significantly associated with gender (p = 0.006), occupation (p = 0.007), presence of other co-morbid condition (<0.001) and sleep problem (p = <0.001). However, MetS as per IDF criteria was significantly associated with age (p = <0.028), duration of diabetes (p = <0.001), follow-up visit (p = <0.030), blood sugar monitoring (p = <0.009) and physical activity of diabetes patients (p = <0.001). Further logistic regression analysis revealed that sleep problem (AOR = 21.812;95%CI = 8.512,55.894) and presence of other comorbidities (AOR = 4.024;95%CI = 2.220,7.295) were the significant factors of metabolic syndrome. Conclusion and recommendation Metabolic syndrome is high in patients with type 2 diabetes mellitus. Therefore, treating physicians and other health workers need to monitor MetS parameters regularly to reduce the risk of cardiovascular diseases, stroke and premature death.

Background: The family member is an important support system in the care of patient with chronic mental illness. The caregivers experience from a number of significant stresses and burden and need concern from the mental health professionals. The objective of the study was to assess the extent of burden and coping strategies among caregivers of mentally-ill patients. Methods: Descriptive cross-sectional study design was used among 102 caregivers of mentally ill patients admitted in Psychiatric ward of Chitwan Medical College, Teaching Hospital. Non-probability consecutive sampling technique was used to select the sample. Ethical approval was taken from the Institutional Review Committee. Data were collected from 27 January 2020 to 29 May 2020 using a structured interview schedule and record review. Data was analyzed using Statistical Package for Social Sciences version 20 and analyzed by using descriptive statistics and inferential statistics. Results: Among 102 caregivers, it was found that 47.1% caregivers perceived moderate to severe burden, 41.2% of the caregivers experienced mild to moderate and 11.8% experienced minimal burden. The highest median percentage of caregivers reported financial burden (50%) where 41.66% reported burden in the relationship. The most frequently used strategies were use of informational support (62.5%), venting (62.5%), positive reframing (62.5%), acceptance (62.5%), and religion (62.5%). Conclusions: The highest percentage of caregivers experienced moderate to severe burden. So, mental health professionals should develop training programs that include counseling to support both patients and family caregivers to reduce the family burden and improving coping skills.