IMJH: September 2020

Maternal health care services utilization amidst Covid-19 lockdown: retrospective study


Objective: The objective was to find the changes in maternal health care utilization.

Design: Retrospective design was adopted.

Setting: Study was conducted in Damak, Nepal.

Methods: Data from four hospitals was retrieved for fiscal year 2076/77 (July 14,2019 – June 14 2020). Trend analysis was done.

Results : Study showed a decline in utilization of overall maternal health care during the months of Lockdown The utilization of antenatal care services has declined in the beginning of Lockdown but shows an increasing trend in the month of May-June. The number of Normal deliveries has declining trend since the beginning of Lockdown. The number of Caeserean Section declined during (March 14-April 12) and slightly increased in Bhaishak (April 13-May 13), but reduced again in the month of Jestha (may13-June14). The number of permanent family planning service use reduced in Chaitra (March 14-April 12), increased very slightly in Bhaishak(April 13-May 13), and declined again in the month of Jestha(may13-June14). The utilization of temporary family planning method and immunization has increased in the later month of Lockdown.

Conclusion: This decline in utilization may increase the maternal morbidity and mortality rates.

Keywords: Maternal health services, COVID-19 lockdown, Nepal.

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Perceived Economic Crisis due to COVID-19 and its Impact on Health

Abstract A mixed research design was adopted to explore the perceived economic impact of COVID-19 and its impact on health. Quantitative data was used to find out the status of microeconomic parameters and FGD was done to find out the perceived economic impact and its impact on health. The quantitative data was retrieved from the Nepal Rastriya Bank’s database. FGD was conducted among experts in the field of economics and health. The quantitative analysis showed decline in remittance and economic growth. The thematic analysis of the FGD revealed that remittance will decrease further and will have a negative economic growth. The participants predicted that the population falling under poverty line will also increase. They also predicted that mental health problems like depression, anxiety, PTSD, substance and alcohol use and sleep problems are likely to increase. They also predicted that the after effects of this pandemic will bring a huge burden on public health and the non-communicable disease is likely to increase. This study recommends that employment opportunities needs to be created and the health service points need to be strengthened. Mental health assessment should be made a part of health assessment in quarantine. This study emphasizes on maintaining physical distance while being socially connected.

Keywords— Covid-19, Economic Crisis, FDP, Economy in Covid-19.

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Physical Therapy A Critical Component in Breast Cancer and Secondary Lymphedema: A Rehabilitation Perspective


Purpose: The main purpose of the methodical review is to obtain the importance of Physiotherapy Rehabilitation in breast cancer-related lymphedema in order to elucidate the role of Physiotherapy in these patients.

Methods: A systematic data search was performed using Google scholar, PubMed (from February 2001 till August 2020) and is focused on the rehabilitative aspect of breast cancer related secondary lymphedema and undertaken according to the PRISMA statement with Levels of Evidence (LoE) assessed.

Results: 14 randomized controlled trials that included 158 women with breast cancer in after care were included. The included for articles studies of effect different types of physiotherapy regimens like exercises that consisted of lymph training, swimming, resistance exercise, gravity-resistive exercise and aerobic exercises. The mentioned articles were thoroughly analyzed and included in the review.

Conclusion: The evidence indicates that Physiotherapy can improve subjective and objective parameters in BCRL patients although it is found to be helpful in improving the quality of life of these patients.

Keywords— Breast cancer, Lymphedema, Physiotherapy, Rehabilitation.

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