In recent years there has been a growing appreciation of the issues of quality of life and stresses involved medical training as this may affect their learning and academic performance. However, such studies are lacking in medical schools of Nepal. Therefore, we carried out this study to assess the prevalence of psychological morbidity, sources and severity of stress and coping strategies among medical students in our integrated problem-stimulated undergraduate medical curriculum.

Self-medication and non-doctor prescribing of drugs is common in developing countries. Complementary and alternative medications, especially herbs, are also commonly used. There are few studies on the use of these medications in Pokhara Valley, Western Nepal. Previously briefed seventh semester medical students, using a semi-structured questionnaire, carried out the study on 142 respondents. Demographic information and information on drugs used for self-medication or prescribed by a non-allopathic doctor were collected. Seventy-six respondents (54%) were aged between 20 to 39 years. The majority of the respondents (72 %) stayed within 30 minutes walking distance of a health post/medical store. 59% of these respondents had taken some form of self-medication in the 6-month period preceding the study. The common reasons given for self-medication were mild illness, previous experience of treating a similar illness, and non-availability of health personnel. 70% of respondents were prescribed allopathic drugs by a non-allopathic doctor. The compounder and health assistant were common sources of medicines. Paracetamol and antimicrobials were the drugs most commonly prescribed. A significantly higher proportion of young (<40 years) male respondents had used self-medication than other groups. Self-medication and non-doctor prescribing are common in the Pokhara valley. In addition to allopathic drugs, herbal remedies were also commonly used for self-medication. Drugs, especially antimicrobials, were not taken for the proper duration. Education to help patients decide on the appropriateness of self-medication is required.

Arch Pharma Pract, Official publication of Archives of Global Professionals,Saudi Arabia

Purpose: Artificial intelligence (AI) is playing an increasingly important role in healthcare and health professions education. This study explored medical students’ and interns’ knowledge of artificial intelligence (AI), perceptions of the role of AI in medicine, and preferences around the teaching of AI competencies. Methods: In this cross-sectional study, the authors used a previously validated Canadian questionnaire and gathered responses from students and interns at KIST Medical College, Nepal. Face validity and reliability of the tool were assessed by administering the questionnaire to 20 alumni as a pilot sample (Cronbach alpha = 0.6). Survey results were analyzed quantitatively (p-value = 0.05). Results: In total 216 students (37% response rate) participated. The median AI knowledge score was 11 (interquartile range 4), and the maximum possible score was 25. The score was higher among final year students (p = 0.006) and among those with additional training in AI (p = 0.040). Over 49% strongly agreed or agreed that AI will reduce the number of jobs for doctors. Many expect AI to impact their specialty choice, felt the Nepalese health-care system is ill-equipped to deal with the challenges of AI, and opined every student of medicine should receive training on AI competencies. Conclusion: The lack of coverage of AI and machine learning in Nepalese medical schools has resulted in students being unaware of AI’s impact on individual patients and the healthcare system. A high perceived willingness among respondents to learn about AI is a positive sign and a strong indicator of futuristic successful curricula changes. Systematic implementation of AI in the Nepalese healthcare system can be a potential tool in addressing health-care challenges related to resource and manpower constraints. Incorporating topics related to AI and machine learning in medical curricula can be a useful first step.

Background: The World Health Organization estimates that seeking prompt and appropriate care could reduce child deaths due to acute respiratory infections by 20%. The purpose of our study was to assess care seeking behaviour of the mothers during childhood illness and to determine the predictors of mother's care seeking behaviour. Methods: A cross-sectional survey was conducted in the immunization clinics of Pokhara city, Kaski district, western Nepal. A trained health worker interviewed the mothers of children suffering from illness during the preceding 15 days. Results: A total of 292 mothers were interviewed. Pharmacies (46.2%) were the most common facilities where care was sought followed by allopathic medical practitioners (26.4%). No care was sought for 8 (2.7%) children and 26 (8.9%) children received traditional/home remedies. 'Appropriate', 'prompt' and 'appropriate and prompt' care was sought by 77 (26.4%), 166 (56.8%) and 33 (11.3%) mothers respectively. The mothers were aware of fever (51%), child becoming sicker (45.2%) and drinking poorly (42.5%) as the danger signs of childhood illness. By multiple logistic regression analysis total family income, number of symptoms, mothers' education and perceived severity of illness were the predictors of care seeking behaviour. Conclusion: The results of the present study show that the mothers were more likely to seek care when they perceived the illness as 'serious'. Poor maternal knowledge of danger signs of childhood illness warrants the need for a complementary introduction of community-based Integrated Management of Childhood Illness programmes to improve family's care seeking behaviour and their ability to recognize danger signs of childhood illness. Socioeconomic development of the urban poor may overcome their financial constraints to seek 'appropriate' and 'prompt' care during the childhood illness.

Objective: To assess rates of initiation of breast-feeding and exclusive breast-feeding within 2 months after delivery and to determine the factors influencing exclusive breast-feeding.Design: A health worker-administered questionnaire survey was carried out during the time period 1 August–30 September 2005.Setting: Immunisation clinics of Pokhara, a submetropolitan city in western Nepal.Subjects: Three hundred and eighty-five mothers who had delivered a child within the previous 2 months.Results: The rates of initiation within 1 h and within 24 h of delivery were 72.7 and 84.4%, respectively. Within 2 months after delivery, exclusive breast-feeding was practised by 82.3% of the mothers. Breast milk/colostrum was given as the first feed to 332 (86.2%) babies but 17.2% of them were either given expressed breast milk or were put to the breast of another lactating mother. Pre-lacteal feeds were given to 14% of the babies. The common pre-lacteal feeds given were formula feeds (6.2%), sugar water (5.9%) and cow's milk (2.8%). Complementary feeds were introduced by 12.7% of the mothers. By logistic regression analysis, friends' feeding practices, type of delivery and baby's first feed were the factors influencing exclusive breast-feeding practice of the mothers.Conclusions: Despite the higher rates of initiation and exclusive breast-feeding, practices such as pre-lacteal feeds and premature introduction of complementary feeds are of great concern in this urban population. There is a need for promotion of good breast-feeding practices among expectant mothers and also the community, especially the families, taking into account the local traditions and customs.