Shishir Paudel
@cist.edu.np
Lecturer, Department of Public health
CiST College, Pokhara univeristy
RESEARCH INTERESTS
Public Health, Mental Health, Epidemiology, NCDs
Scopus Publications
Scholar Citations
Scholar h-index
Scholar i10-index
Scopus Publications
Anil Paudel, , Awijit Neupane, Santosh Khadka, Laxmi Adhikari, Shishir Paudel, Maheshor Kaphle, , , ,et al.
ASEAN Institute for Health Development
Premarital sex is considered a social taboo and an immoral act in Nepal. However, there is a widespread view that young men and women are becoming more at ease in each other's company and beginning sexual experiences prior to marriage, putting them at risk of the consequences of unsafe sex. This research aims to evaluate the factors associated with premarital sexual behavior and its consequences among Nepalese college-going adolescents and youths. This cross-sectional web-based study included 415 Nepalese students over the age of 18 who were enrolled in a bachelor's degree program in a discipline other than health science. Data was collected from students online using a self-administered structured questionnaire. Pearson's chi-square (χ2) and logistic regressions were used to examine the relationship between the independent and outcome variables. Most participants (61.7%) had dating experience and 21.2% had premarital sex. About three-fourths (76.1%) of participants had premarital sex before the age of 20 years and the ages of sexual debut ranged from 13 to 25 years. The major reasons for sexual debut were desire, curiosity, continuation of love relationship, and peer pressure. One-third of students (33.0%) reported having more than two sex partners, and 11.4% had intercourse with commercial sex workers. Among students who had premarital sex, 13.7% of participants or their sex partners, had to undergo abortions because of unintended pregnancies. Having an illiterate parent (AOR=11.0; 95% CI=2.01-60.87), high pocket money (AOR=4.2; 95% CI=1.1-16.2), increased dating culture (AOR=18.8; 95% CI=4.8-74.2), a close friend who has experienced premarital sex (AOR=5.2; 95% CI=2.21-12.21), and exposure to pornography (AOR=97.87; 95% CI= 9.5-10001.4) were predictors of premarital sex among Nepalese college students. This demonstrates the importance of sex and relationship education programs led by qualified peer educators in educating young people about safe sexual activity.
Shishir Paudel, Sujan Poudel, Dhurba Khatri, Anisha Chalise, and Sujan Babu Marahatta
Public Library of Science (PLoS)
Background The frontline health workers are the key players in the fight against the COVID-19 pandemic, however, several incidences of attacks, stigmatization, and discrimination towards them have been reported throughout the world during the peak of infection. The social impact experienced by health professionals can alter their efficiency and also lead to mental distress. This study aimed to examine the extent of social impact experienced by health professionals currently working in Gandaki Province, Nepal along with the factors associated with their depression status. Methods This was a mixed-method study where a cross-sectional online survey was executed among 418 health professionals followed by in-depth interviews with 14 health professionals of Gandaki Province. The bivariate analysis and multivariate logistic regression were performed to identify the factors associated with depression at 5% level of significance. The information collected from the in-depth interviews was clustered into themes by the researchers. Results Out of 418 health professionals, 304 (72.7%) expressed that COVID-19 has impacted their family relationships, whereas 293 (70.1%) expressed that it impacted their relationships with friends and relatives, and 282 (68.1%) expressed it impacted their relationships with community people. The prevalence of depression among health professionals was noted at 39.0%. Being a female (aOR:1.425,95% CI:1.220–2.410), job dissatisfaction (aOR:1.826, 95% CI:1.105–3.016), COVID-19 impact on family relation (aOR:2.080, 95% CI:1.081–4.002), COVID-19 impact on relationship with friends and relatives (aOR:3.765, 95% CI:1.989–7.177), being badly treated (aOR:2.169, 95% CI:1.303–3.610) and experiencing moderate (aOR:1.655, 95% CI:1.036–2.645) and severe fear (aOR:2.395, 95% CI:1.116–5.137) of COVID-19 were found to the independent predictors of depression. It was noted that the pandemic has an effect on the social relations of health professionals in multiple ways. Conclusion This study noted that there is a significant impact of COVID-19 on health professionals in terms of their social and mental health aspects. The social impact experienced by health professionals is an important predictor of their mental health. The mental health and well-being of these vital workforces can be enhanced by focusing on the social aspect during the pandemic.
Shishir Paudel, Shankar Prasad Khanal, Sujan Gautam, Anisha Chalise, Tara Nath Koirala, and Sujan Babu Marahatta
BMJ
ObjectivesTo estimate the prevalence of anxiety and depression and identify the associated factors among people with type 2 diabetes mellitus (T2DM) visiting diabetes clinics of Pokhara Metropolitan, Nepal.DesignCross-sectional study.SettingThree diabetes clinics in Pokhara Metropolitan, Nepal, from May to July 2021.Participants283 people with T2DM visiting selected diabetes centres of Pokhara Metropolitan.Outcome measuresAnxiety and depression were the outcome measures. Face-to-face interviews were conducted using a structured questionnaire comprising information related to participants’ sociodemographic profile and several factors along with Hospital Anxiety and Depression-Anxiety subscale and Patient Health Questionnaire-9 to assess the levels of anxiety and depression, respectively. Pearson’s Χ2tests and binary logistic regression were performed to examine association between dependent and independent variables at 5% level of significance.ResultsThe prevalence of anxiety and depression was 31.4% (95% CI 26.2% to 37.5%) and 36.4% (95% CI 30.8% to 42.0%), respectively. Anxiety was found to be associated with a lower level of perceived social support (adjusted OR (AOR) 2.442, 95% CI 1.020 to 5.845), multiple complications (AOR 2.758, 95% CI 1.015 to 7.334) and comorbidities (AOR 2.110, 95% CI 1.004 to 4.436), severe COVID-19 fear (AOR 2.343, 95% CI 1.123 to 4.887) and sleep dissatisfaction (AOR 1.912, 95% CI 1.073 to 3.047). Economical dependency (AOR 1.890, 95% CI 1.026 to 3.482), no insurance (AOR 2.973, 95% CI 1.134 to 7.093), lower perceived social support (AOR 2.883, 95% CI 1.158 to 7.181), multiple complications (AOR 2.308, 95% CI 1.585 to 6.422) and comorbidities (AOR 2.575, 95% CI 1.180 to 5.617), severe COVID-19 fear (AOR 2.117, 95% CI 1.009 to 4.573), alcohol use (AOR 2.401, 95% CI 1.199 to 4.806) and sleep dissatisfaction (AOR 1.995, 95% CI 1.093 to 3.644) were found to be associated with depression.ConclusionThis study showed high prevalence levels of anxiety and depression among people with T2DM. Strengthening social support and focusing on people with diabetes suffering from comorbidity and complications could help to reduce their risk of mental health problems.
Pratima Karki, Yadav Prasad Joshi, Shankar Prasad Khanal, Sujan Gautam, Shishir Paudel, Roshna Karki, and Radha Acharya
Nepal Journals Online (JOL)
Introduction: Musculoskeletal disorders (MSDs) are injuries or pain in the human musculoskeletal system which could lead to temporary or permanent impairments. The nature of nursing jobs makes nurses vulnerable to MSDs. This study aimed to assess the prevalence and potential risk factors associated with MSDs among nurses. Methods: In between March to June 2021, a cross-sectional study was conducted among 165 nurses using self-administered questionnaires. A standardized Nordic Questionnaire was used to measure MSDs. Pearson’s chi-square test and binary logistic regression at a 5% level of significance were performed to identify factors associated with upper extremities and spinal musculoskeletal disorders (UMSD) and lower extremities musculoskeletal disorders (LMSD). Variables associated with UMSD and LMSD in bivariate analysis were subjected to multiple logistic regression. Results: The prevalence of UMSD and LMSD experienced by nurses was 86.1% (95% CI: 79.4%-90.9%) and 66.1% (95% CI: 58.9%-74.3%), respectively. Among several factors, working in same position for long periods (AOR: 4.16, 95% CI: 1.2-13.4), not receiving training in injury prevention programs (AOR: 3.15, 95% CI: 1.0-9.2), not enough rest breaks during the day (AOR: 4.65, 95% CI: 1.3-15.9) and moderate to higher job stress (AOR: 3.62, 95% CI: 1.2-10.8) were found to be significantly associated with UMSD. Not having enough rest breaks during the day (AOR: 2.19, 95% CI: 1.0-4.7) was significantly associated with LMSD. Conclusion: Higher prevalence of MSDs among nurses is a serious concern that threatens individual health as well as the overall healthcare system. Sensitization and capacity enhancement programs on the issue could prevent MSDs among nurses.
Nilhari Neupane, Shishir Paudel, Regan Sapkota, Yadav Prasad Joshi, Yashoda Rijal, and Anisha Chalise
Frontiers Media SA
COPYRIGHT © 2022 Neupane, Paudel, Sapkota, Joshi, Rijal and Chalise. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. Corrigendum: Enhancing the resilience of food production systems for food and nutritional security under climate change in Nepal
Anisha Chalise, Gambhir Shrestha, Shishir Paudel, and Amod Kumar Poudyal
BMJ
ObjectivesTo estimate the prevalence of antenatal depression and identify its associated factors among pregnant women of Godawari Municipality, Lalitpur, Nepal.DesignCommunity-based cross-sectional study.SettingGodawari Municipality, Lalitpur, Nepal, between September and November 2021.Participants250 randomly selected pregnant women of Godawari Municipality, Lalitpur, Nepal.Main outcome measuresThe level of antenatal depression was assessed using Edinburgh Postnatal Depression Scale. χ2test and multivariate logistic regression analysis were applied to determine the association between antenatal depression and related variables at 95% level of confidence.ResultsThe prevalence of antenatal depression was found to be 24.8% (95% CI: 19.2 to 30.7). Multigravida (AOR: 2.219, 95% CI: 1.113 to 4.423), unintended pregnancy (AOR: 2.547, 95% CI: 1.204 to 5.388), male sex preference of child by family (AOR: 2.531, 95% CI: 1.204 to 5.321) and intimate partner violence (AOR: 2.276, 95% CI: 1.116 to 4.640) were found to be the positive predictors of antenatal depression.ConclusionThis study showed a high prevalence of depression among pregnant women. The results suggest a need for mental health assessment during pregnancy. Screening for depression should be part of routine antenatal checkups for early detection and management of mental health concerns during this vulnerable period.
Nilhari Neupane, Shishir Paudel, Regan Sapkota, Yadav Prasad Joshi, Yashoda Rijal, and Anisha Chalise
Frontiers Media SA
BackgroundClimate change in Nepal has posed a considerable challenge to agricultural productivity and has threatened food and nutritional security at multiple levels. This study aims to assess the impacts of climate change on national food production and food and nutritional security as well as document issue-based prioritized adaptation options for a resilient food production system.MethodsThis study considers temperature, precipitation, and their anomalies as the key factors affecting food production in Nepal. Nationwide precipitation trends along with their association with the annual production of major cereal crops in Nepal were assessed using data from the last three decades (1990–2018). The annual productions of the major cereal crops were summed and normalized to calculate production index scores in the districts. Scores were plotted and visualized into maps using the R programming. In three ecological regions, the distribution of flood and extreme rainfall events and cases of malnutrition from 2005 to 2018 were plotted. The effects of climate change and highest priority adaptation options at the district level were documented through a review of national policies and literature studies and qualitative research based on Focus Group Discussions (FGDs).ResultsBetween 1990 and 2018, the overall average production of major cereal crops in Nepal was increased by around 2,245 MT annually. In the district level index analysis, the highest production score was found for Jhapa and Morang while the lowest production score was found for Humla. Cases of malnutrition in some districts coincided with flood and heavy rainfall events, indicating that climate change and extreme climatic events have a role to play in food production and security. Growing drought-tolerant crops, changes in crop cycle, riverbed farming practices, and development of short-term strategies, such as contingency crop planning, changing plantation dates, plantation of short-duration varieties, and evacuation schemes. Similarly, long-term strategies, such as encouraging out-migration of population to safer locations, resettlement programs with transformative livelihood options, and sustainable agricultural practices were found to be key prioritized adaptation measures for a resilient food system.ConclusionIn Nepal, climate change and the increasing frequency and magnitude of extreme climatic events adversely affect the food production system, which has become a serious threat to food and nutritional security. The implementation of evidence-based practices to build a resilient food system specific to climate-vulnerable hotspots at the district and local levels is the nation's current need.
Anil Acharya, Naveen Shrestha, and Shishir Paudel
Nepal Journals Online (JOL)
Introduction: Glue sniffing usually refers to volatile substance abuse (VSA) for psychoactive effects. Street children are the children who live, work, and earn their livelihood through the streets of urban settlements. Street children are mostly attracted to substance abuse and more particularly towards volatile substances as they are cheap, easy to access and have psychoactive effects as alcohol intoxication. This study aimed to assess the general characteristics of street children of Pokhara Metropolitan, Nepal who are addicted to glue sniffing. Methods: A cross-sectional study was conducted among street children who were addicted to glue sniffing through the snowball sampling method in Pokhara Metropolitan, Nepal. Results: All 88 children who were addicted to glue sniffing were males. Of the total children, 59 (67%) children started glue-sniffing at the age of five to ten years of age while nine (10.2%) children started sniffing even before they were five years old. Addiction to glue (n = 33, 37.5%), pleasure (n = 18, 20.5%)), coping with hunger (n = 14, 15.9%), and being a part of street children group (n = 13, 14.8%) were the major reasons to sniff glue for these children. Conclusions: It has been observed that the majority of street children are at increased risk of getting involved in glue sniffing. It has resulted in different ill outcomes such as self-destruction and problematic behavior, fights and police arrest. There is a need to focus on the issue of glue sniffing among the street children to save and ensure the quality of life of these vulnerable children.
Deepa Bhattarai, Nisha Shrestha, and Shishir Paudel
BMJ
ObjectiveThis study examined the prevalence and factors associated with depression among adolescents attending higher secondary schools in the Pokhara Metropolitan City of Nepal.DesignA cross-sectional study design was adopted.SettingFour randomly selected higher secondary schools of Pokhara Metropolitan, Nepal.Participants312 randomly sampled higher secondary school students.MethodsThe Center for Epidemiologic Studies Depression Scale was used to assess the level of depression among students. The data collected through a self-administered questionnaire were analysed using descriptive statistical methods such as frequency and percentage. χ2 test and unadjusted OR (UOR) were calculated to assess the statistical relationship between depression and various variables at 95% CI, with level of significance at p<0.05.ResultsThe study found a high prevalence of depression among high school students, with more than two-fifths (44.2%) of students having depression. Furthermore, almost a quarter (25.3%) of the students were noted to have mild depression and 18.9% of the students expressed major depression. Students who had low perceived social support (UOR: 3.604; 95% CI 2.088 to 6.220), did not share their problems with anyone (UOR: 1.931; 95% CI 1.228 to 3.038) and had low self-esteem (UOR: 5.282; 95% CI 2.994 to 9.319) were at higher odds of being depressed.ConclusionA high prevalence of depression was observed among high school students. It was also observed that students’ level of perceived social support, self-esteem and help-seeking behaviour are somehow related to their mental well-being. Hence, improving social support and self-esteem may alleviate depression and mental distress among these adolescents.
Pradeep Paudel, Samir Chalise, Dinesh Raj Neupane, Narayan Adhikari, Shishir Paudel, and Nim Bahadur Dangi
Journal of Nepal Medical Association (JNMA)
Introduction: Hypertension is one of the leading risk factors for the global burden of disease and is of rising public health concerns in the developing world including Nepal. However, few studies have focused on awareness, treatment, and control of hypertension among people living with this condition. In this scenario, this study aimed to find out the prevalence of hypertension and its awareness, treatment, and control among hypertensive patients residing in different parts of Kaski district, Nepal.
 Methods: A descriptive cross-sectional study was performed among 977 family members of 290 households from August to December 2017. Ethical approval was taken from the Institutional Review Committee (reference number:73/074/75) of the Pokhara University Research Center. Simple random sampling was done. Hypertension screening was performed through averaging three values obtained by standardized aneroid sphygmomanometer in three observations. Primary data was collected through self-administered questionnaires and face-to-face interviews based on the participant’s preferences. Collected data were analyzed using Statistical Package for the Social Sciences version 20. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data.
 Results: Out Of total 997 family members screened, 294 (29.49%) (26.66-32.32 at 95% confidence interval) had hypertension whereas only 127 (43.2%) were completely aware of their disease condition. 279 (94.9%) were taking antihypertensive medication and 201 (68.4%) had their blood pressure controlled.
 Conclusions: We found that almost one-fourth of the adult population in the community suffered from hypertension but less than half of the hypertensive patients are aware of their conditions.
Shishir Paudel, Himlal Gautam, Chiranjivi Adhikari, and Dipendra Kumar Yadav
Nepal Health Research Council
Background: The university period is taken as a risk period for the onset of several mental disorders as this period is stressful and most of the lifetime mental disorders start typically during this young age. The present study aimed to assess the prevalence and risk factors associated with depression, anxiety, and stress among undergraduates residing at Pokhara Metropolitan, Nepal.Methods: A cross-sectional study was conducted among 681 undergraduates from different academic institutions of Pokhara Metropolitan using DASS-21 to assess the level of depression, anxiety, and stress. Results: The overall prevalence of depression, anxiety, and stress among the participants was found to be 38.2%, 46.9%, and 24.1% respectively. The level of depression and stress was not associated with the academic discipline but the higher prevalence was noted among the students from the non-technical group. The major risk factors associated with depression, anxiety and stress were parental education, family history of psychiatric disorders, self-esteem, and academic performance.Conclusions: The prevalence of mental disorders is high among the undergraduates. Further assessment of these disorders targeting students from different academic disciplines is recommended.Keywords: Anxiety; depression; risk factors; stress; undergraduates
Shishir Paudel, Ganesh Dangal, Anisha Chalise, Tulsi Ram Bhandari, and Ojash Dangal
Nepal Health Research Council
Coronavirus disease 2019 (COVID-19) is a newly emerged disease that has become a global public health concern as it rapidly spread around the world. The etiologic agent responsible for this disease has been named as severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) by the International Committee on Taxonomy of Viruses as it shows similar genomic features to that of SARS-CoV which caused a pandemic in 2002. This disease first appeared in Hubei province of China and it follows human-to-human transmission but the path this virus took to set up human infection remains a mystery. By 17 April 2020, globally there have been 2,074,529 confirmed cases with 139,378 deaths because of COVID-19. SARS-CoV-2 shows several similarities with SARS?CoV, and Middle East Respiratory Syndrome Coronavirus (MERS-CoV) with its clinical presentations. This can vary from asymptomatic infection to severe disease and mortality. Real-time reverse-transcription polymerase chain reaction (rRT-PCR) screening is considered as the standard laboratory test for the diagnosis of COVID-19. There is no proven antiviral agent against SARS-CoV-2 so the treatment for COVID-19 is symptomatic, aiming for the management of the symptoms and prevention of the complications. The outbreak of COVID-19 has led to the implementation of extraordinary public health measures throughout the world. Numerous antiviral compounds used to treat other infections are being clinically researched to find possible treatment. Similarly, the traditional public health outbreak response strategy of isolation, quarantine, social distancing and community containment has been implemented in multiple countries and has played an important role in the prevention of new outbreaks. This review aims to enhance our understanding of COVID 19.Keywords: Coronavirus disease 2019; COVID-19; SARS-CoV-2; novel coronavirus 2019; severe acute respiratory syndrome-2