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Objectives: In Nepal, where increasing numbers of married couples live apart due tomigration, progress in reducing unmet need for family planning (UMN) is stagnant. This study aims to identify spatial patterns of UMN of married women and spousal separation in Nepal and explore associations between UMN and spousal separation at individual- and district-levels. Methods: We used 2016 Nepal Demographic and Health Surveys data to conduct spatial and multilevel logistic analyses. Results: This study shows evidence of similar geographical patterns in UMN of married women and spousal separation. At the individual level, women living with their spouses had 88% (aOR = 0.12, 95% CI 0.11-0.13) decreased odds of experiencing UMN compared to those living apart from their spouses. While not statistically significant, increasing odds of UMN were observed with higher prevalence of spousal separation at the district level. Conclusion: This study contributes to the existing literature by showing similar geographical patterns of UMN and spousal separation across Nepal and demonstrating both individual and contextual effects of spousal separation on UMN among married women. Theoretical and policy implications are discussed. [ABSTRACT FROM AUTHOR]

Background: Most common cardio vascular disease events after COVID-19 were hypertension, pulmonary embolism, acute coronary syndrome, myocarditis, stress-Cardiomyopathy, arrhythmias, carcinogenic shock, and cardiac arrest. Aim: To evaluate cardio vascular disease events in patients recovered from COVID-19 in central Indian population Methods: This retrospective observational study was carried out in the department of medicine in a tertiary care hospital, central India. Asses all the participants for post covid cardio vascular events, detailed history, clinical examination and all necessary investigation was done Results: in our study Post COVID 19 cardio vascular events was occur in 17.6%. Majority of the patient was male (69.3%), most common age group were 51-60 years. Higher incidence of cardio vascular disease was reported in obese person. Common cardio vascular diseases found after COVID 19 infection were, hypertension (35.3%), pulmonary embolism (23.5%), Myocarditis (20.6%), myocardial infection (11.8%) and Arrhythmias were in 8.8% cases. Conclusion: Overall observations indicate an increased incidence of hypertension and CVDs post recovery from COVID-19. A dual therapy of ARBs was the preferred choice for management of hypertension. Regular follow-up and close monitoring of symptoms to prevent further CV complications in COVID-19 recovered patients is recommended. [ABSTRACT FROM AUTHOR]

Introduction: Magnesium sulphate and dexmedetomidine can decrease the duration and intensity of postoperative pain due to their antinociceptive effects. Magnesium sulphate blocks N-methyl-D-aspartate receptor (NMDA) channel in a voltage dependant way, while dexmedetomidine acts on dorsal root neurons. Aim: To compare the analgesic efficacy and duration of postoperative analgesia after intraperitoneal instillation of magnesium sulphate and dexmedetomidine in laparoscopic cholecystectomy. Materials and Methods: The present study was a randomised clinical study, in which 90 patients of age 18-60 years, belonging to American Society of Anaesthesiologists (ASA) grade I or II were randomly selected and divided in three groups. Group M received magnesium sulphate 50 mg/kg with 0.25% bupivacaine 30 mL, group D received dexmedetomidine 1 µg/kg with 0.25% bupivacaine 30 mL, and group B received 0.25% of plain bupivacaine 30 mL. Pain was assessed using Visual Analog Scale (VAS) score as primary outcome, recorded at 0, 2, 4, 6, 8, 10, 12 and 24 hours after surgery. Time to rescue analgesia (VAS =4 or on demand) and patients satisfaction score were the secondary outcomes. All recorded data were analysed by statistical test (Analysis of Variance (ANOVA), post-hoc Tukey's HSD (Honest Significant Difference) test and Chi-square test). Results: The mean VAS score was 2.40±0.84, 2.57±0.78 and 2.88±0.92 in group M, group D and group B, respectively (p<0.05). The total analgesic requirement (Paracetamol) in first 24 hours postoperatively was lower in group M (1.73±0.58 gm), and group D (2.17±0.53 gm), than group B (2.70±0.47 gm). Highly satisfied patients in group M were 10, group D were 03, and none in group C. There were 14 highly dissatisfied patients in group B. The difference in the patient satisfaction score between groups was statistically significant (p=0.0002). Time to first rescue analgesia was highest in group M then group D. Conclusion: Intraperitoneal instillation of magnesium sulphate was found to be superior for postoperative analgesia in first 24 hours after laparoscopic cholecystectomy as reflected by a lower VAS score and longer duration of analgesia. [ABSTRACT FROM AUTHOR]

Nepalese migrant workers are at heightened risk of adverse mental health problems. However, the social mechanisms by which experiences of labor migration create such vulnerabilities are not well understood. Moreover, limited attention has been paid to the experiences of left-behind spouses. This study explores how migrant fathers and left-behind mothers experience labor migration and how migration affects mental health across migrant household members, paying special attention to the role of gender. We conducted 29 in-depth interviews with Nepalese migrant fathers (N = 18) in South Korea and left-behind mothers (N = 11) in Nepal. Labor migration imposes substantial stress on the entire family. Migrant fathers discussed their feelings of guilt and worry regarding their relationships with their children due to physical and emotional distance. Left-behind mothers indicated loneliness and caregiver stress due to additional responsibilities as a single parent. Migrant fathers reported that they felt respected by their communities for their work, while left-behind mothers felt heavily scrutinized. Our findings highlight how labor migration reinforces gender inequalities in domestic responsibilities and norms regarding the expected roles of migrating men and left-behind women. These findings suggest that psychosocial services must be tailored to the unique needs of migrant workers and left-behind families. [ABSTRACT FROM AUTHOR]