PubMed Health⌕ Search

Biomedical subjects

S Thapa

Publications and source records attributed to S Thapa.

At least 19 recordsLinked to original sources
PubMed2005

Caring for victims of sexual abuse.

Recognizing sexual abuse to be universal, in stable as well as disordered societies and directed predominantly but not only against younger women, this article first considers legal definitions of sexual abuse and the forensic evidence health care providers may be expected to gather. It explores the impact on victims of historic definitions of rape, and legal reforms to dispense with proof of sexual penetration. The WHO 2003 guidelines for medico-legal care for victims of sexual violence are noted, which emphasize the need for physical and psychological care of victims. The guidelines show that goals of treating victims and retaining forensic evidence can create a clinical dilemma. Ethical issues concern management of this dilemma, probing whether patients' psychological disturbance may have roots in past sexual abuse, and the conduct of appropriate research. It concludes that much sexual abuse is symptomatic of women's sexual subordination and disregard of their human rights.

Caregivers↗
PubMed2001

One and a half centuries of demographic transition in Nepal.

This paper examines the past and prospective demographic transition in Nepal. Sparse data from the pre-1961 censuses suggest that mortality decline began during 1930s and allow rough estimates of fertility and mortality levels prior to 1961. Fertility decline began sometime between 1961 and early 1980s, with the total fertility rate declining from about 6 to 5 children per woman by early 1990s. The four scenarios of future fertility decline and population growth presented in the paper help draw several conclusions. A continuation of the recent slow pace of fertility decline would result in a total population of slightly over 100 million by the end of the next century (Scenario I). More rapid decline, similar to the median experience of Asian countries, would reduce this growth to below 60 million (Scenario III). Still more rapid decline, close to the limit of what has been observed in countries that have experienced the most rapid declines, could reduce the growth to 40 million (Scenario IV). It is possible, if not at present particularly plausible, that very rapid decline might be achieved by a combination of smaller family sizes and rising age of childbearing. An approach to reaching zero population growth rapidly--and anything less than a doubling of current population--may be ruled out with a high degree of certainty (Scenario II and IV). A doubling of population to 40 million is the least possible growth that can be expected. At the current rate of fertility decline, population will increase to 100 million during this century. If a smaller population in this range is considered to be in the national interest, it is as important to work for more rapid fertility decline as it is to work for accommodation of a much larger population.

Age Distribution↗
PubMed1999

Conditions in rural Nepal for which depot-medroxyprogesterone acetate initiation is not recommended: implications for community-based service delivery.

The presence of medical conditions that might affect the use of depot-medroxyprogesterone acetate (DMPA) as a contraceptive method was assessed in a rural district in Nepal. A general health survey was conducted in nonpregnant and noncontracepting women aged 15-44 years to determine the presence of any health problems. The survey included a general assessment interview by nonphysicians, followed by formal medical histories and physical exams by female gynecologists. Possible pregnancy (nine cases) and abnormal uterine bleeding (one case) were the only conditions identified in which DMPA should not be used, based on the World Health Organization (WHO) Medical Eligibility Criteria for Contraceptive Use. Five additional cases of cardiovascular problems, in which DMPA initiation is not usually recommended, were also detected. Recently developed checklists based on the WHO criteria for DMPA use would have identified all of these health conditions. This checklist would allow the safe delivery of DMPA at the community health worker level, and increase the availability and accessibility of DMPA in rural Nepal.

Adolescent↗
PubMed1997

Timing of family formation in ethnic mosaic Nepal: a district-level analysis.

"The purpose of this paper is to extend...previous research in order to analyse the district-level variations in the timing of family formation in Nepal. The main hypothesis examined is that the district-level variations in the timing of family formation are determined principally by ethnicity, independent of socio-economic factors. It is surmised, therefore, that the district-level variations are not randomly distributed among sub-populations but are differentiated by ethnic characteristics in the districts." The full text of this article is available electronically through www.undp.org/popin.

Asia↗
PubMed1994

Mechanical devices for interval laparoscopic tubal sterilization in previous IUD users.

This retrospective analysis was conducted to determine whether IUD users are good candidates for laparoscopic sterilization using the tubal ring and the Filshie clip. The data set used for the analysis came from international multicenter clinical trials involving 1235 women who were sterilized by the tubal ring and 1892 women sterilized by the Filshie clip. Results indicate that former IUD use is not associated with an increased risk of surgical injuries, including uterine perforation, major complications, or postoperative infections, for either of these tubal occlusion techniques. The risk of a sterilization procedure ending in technical failure (defined as switching to laparotomy and/or a tubal occlusion technique not originally planned) among tubal ring cases was greater for former IUD users than for non-IUD users. However, this may be related to a center effect. Nine of the 10 ring cases with technical difficulties were successfully switched to electrocoagulation, and the operator did not have to resort to an unintended laparotomy. The incidence of surgical difficulties among the Filshie clip cases was also higher in former IUD users, but all of these difficulties were safely overcome without changing the tubal occlusion method. These findings lead us to believe that, in general, a woman's IUD use should not generally be a reason for an experienced service provider to hesitate in performing an interval laparoscopic sterilization using a mechanical tubal occlusion technique.

Adult↗