Descriptions of adults of Simulium (Gomphostilbia) sachini Takaoka & Henry and S. (G.) williei Takaoka & Thapa in the S. (G.) gombakense species-group (Diptera: Simuliidae) from India

@#The Simulium gombakense species-group, one of the 15 species-groups of the subgenus Gomphostilbia Enderlein, is small, being represented by only 12 species, all of which are distributed in the Oriental Region. It is characterized by the pupal gill composed of an inflated structure and eight or ten slender filaments. Among the 12 species, S. sachini Takaoka & Henry, and S. williei Takaoka & Thapa were originally described from two pupae, and one pupa and two larvae, respectively, from Darjeeling, India. In the present paper, the adult females and males of these species are described for the first time from specimens reared from pupae collected at the type locality. Simulium sachini is distinctive in the female by the claw with a medium-sized basal tooth, and in the male by the somewhat enlarged, spindleshaped hind basitarsus and ventral plate with its ventral margin much depressed medially, while S. williei is characterized by the small number of male upper-eye (large) facets in 12 vertical columns and 13 or 14 horizontal rows and ventral plate much produced posteroventrally. Taxonomic notes are given to separate these two species in the adult stage from their related species.

Hazardous alcohol use in rural southern India: Nature, prevalence and risk factors.

Background. There is a dearth of data on the hazardous use of alcohol in rural India. Methods. We examined the nature, prevalence and factors associated with hazardous use of alcohol among men in a rural community in southern India. We used stratified sampling to select subjects from the Kaniyambadi block and employed ‘AUDIT’, a standard instrument, to assess the use of alcohol. Results. The prevalence of life-time use, use in the past year and hazardous use of alcohol was 46.7%, 34.8% and 14.2%, respectively. Using Indian made foreign liquor (OR 20.51; 95% CI 8.81–47.75) and living in a village which brewed illicit alcohol (OR 2.82; 95% CI 1.39–5.72) were risk factors for hazardous use while education (OR 0.39; 95% CI 0.21–0.72) was protective. These factors remained significantly associated with hazardous use after adjusting for age and education using logistic regression. Conclusion. The relationship between the availability of illicit and commercial alcohol and its hazardous use suggests the need for an alcohol policy which takes into account health and economic issues and also implements the law to prevent the negative impact of problem drinking.

Pattern of poisoning cases in Emergency Department of Kathmandu Medical College Teaching Hospital.

OBJECTIVE: This study was conducted to determine the pattern and severity of poisoning cases in Emergency Department of Kathmandu Medical College Teaching Hospital, Kathmandu, Nepal (KMCTH). DESIGN: Retrospective observational study. MATERIALS AND METHODS: Hospital records of all admissions to the Emergency Department of Kathmandu Medical College Teaching Hospital (KMCTH) following acute poisoning were revised and all data from February 2007 to February 2008 were analyzed retrospectively. RESULTS: This retrospective observational study was performed on 148 cases of poisoning who attended Emergency Department of KMCTH over a period of one year. The overall male to female ratio was 1.05:1. Poisoning was most common in the age group 21-30 years (40.5%). The most common causes of poisoning in adults were organophosphorous compounds and in children was kerosene oil. Oral route (79.05%) was the most common route of administration. 66.2% of cases were intentional poisoning for suicidal attempt. Students (43.9%) and service holders (18.9%) were commonly involved in poisoning. CONCLUSION: It was seen that adult between 21-30 years of age were more prone to suicidal poisoning with organophosphorous compounds and children of 1-10 years of age were more susceptible to accidental poisoning with kerosene oil.

Topiramate induced bilateral angle-closure glaucoma.

Topiramate is a sulfamate-substituted monosaccharide and is used as an antiepileptic medication. It can also be used as a prophylactic agent for headache from migraine. The main purpose of this article is to create awareness among medical colleagues regarding severe ophthalmic side effect of topiramate. This is the first reported case of topiramate induced bilateral angle-closure glaucoma in Nepal. This case was managed successfully by discontinuing topiramate and by starting anti-glaucoma medication along with atropine eye drops which were tapered and eventually discontinued.

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.

HIV / AIDS in Nepal: an update.

HIV/AIDS is a growing problem in Nepal. There has been a 15-fold increase in the number of HIV-infected cases during the period 1990-93. By 1993, 195 cases had been reported to the Ministry of Health. Among the total cases reported, approximately equal numbers of male and female HIV cases are represented. The current estimate of HIV-infected individuals is 5000; however, the number is projected to reach cumulatively 100,000 by the year 2000 if effective preventive measures are not taken. Commercial sex workers and their clients remain the most affected groups. The majority of HIV-infected cases belong to the 20-29 age group. HIV surveillance data indicate that the overall positivity rate increased from 0.20 to 0.70 over the 12-month period, 1991-92. Of the total 195 HIV-infected cases, 24 (12.3%) are reported to be AIDS cases. The AIDS cases doubled between 1991 and 1993. There are three times as many AIDS cases among females than males. Of the total 24 AIDS cases, 11 have died. Case studies illustrate the multi-faceted context in which HIV/AIDS is spreading in Nepal.

Commercial sex workers in Kathmandu Valley: profile and prevalence of sexually transmitted diseases.

This paper presents a socioeconomic profile and the prevalence of sexually transmitted diseases (STDs), including human immunodeficiency virus (HIV), among 341 female commercial sex workers (CSWs) in Kathmandu Valley. Most of the CSWs are from outside the valley, but from within Nepal. Over 50% of the CSWs have a secondary or higher level of education. The average age of the CSWs is 21 years. The average age of first sexual intercourse was 16 years; and, at entering the sex trade, 18 years. The most frequently reported type of sexual activity is vaginal intercourse followed by anal intercourse. Although a large proportion of CSWs are aware of condoms, only one-fifth of them reported using condoms most of the time they had intercourse. The majority of the CSWs are aware of general types of STDs. Slightly over 60% are aware of AIDS, and the majority of them know of at least one mode of AIDS transmission. Gynecological examination based on symptoms revealed that 72% of the CSWs were infected with some type of STD. About 47% had vaginal discharges, 36% had pelvic inflammatory disease, 24% had ulcerative disease, and 4% had urethritis. Blood tests of the CSWs revealed that 28% had VDRL (a test for syphilis), hepatitis B, or HIV. The prevalence of VDRL was the most common, followed by hepatitis B. Of the 341 CSWs, 3 (0.9%) were HIV-positive.