Potable water production through a low-cost single chamber solar still in north India.

The main aim of this study is to evaluate the performance of a single slope solar still and to assess the effect of nanofluid on its performance. A single basin single slope solar still was designed and fabricated at the Department of Chemical Engineering, IET Lucknow. Its performance was assessed in terms of the yield of potable water. The effect of various climatic parameters was also studied. Al2O3 nanofluid was used to enhance the yield of the solar still. In the presence of nanofluid, the total yield of the solar still improved by 16.6%. Its economic feasibility was analyzed and reported. The portability of the small size of solar stills, its better economics, easy fabrication, and good performance make them very useful for industrial as well as household purposes.

How dominant the load of bioaerosols in PM2.5 and PM10: a comprehensive study in the IGP during winter.

The winter period is most ideal for studying near-surface aerosols in the Indo-Gangetic plains (IGP) of India, since this period is inundated with significantly higher concentrations of aerosols across the unique geographical domain because of shallow atmospheric boundary layer. This study focuses on analysing the concentration of the biotic component of aerosols (bioaerosols) in a central location of the IGP and estimating their dominance in ambient particulate matter (PM) from 2021 to 2023. Observations showed that bioaerosol concentrations also increased significantly with the increasing concentrations of PM2.5 and PM10, suggesting that bioaerosols are a dominant component of the total aerosol load in the atmosphere. The total microbe's concentration (collectively fungi and bacteria) was found to be 94 to 226 cfu m-3 in PM2.5 and 167 to 375 cfu m-3 in PM10 where bacteria contributed 81.12 and 79.99%, respectively. The contribution of fungal spores in PM2.5 and PM10 remained as 18.88 and 20.01%, respectively, in the total microbes in the respective particulate matter. In the bioaerosols, fungi, namely Aspergillus, Cladosporium, and Penicillium, were dominant, and bacteria, namely E. coli, Mammaliicoccus and Enterobacter, were prevalent in both the PM size regimes. The most prominent microbial presence was observed when the temperature ranged between 16 and 20°C and relative humidity between 80 and 85%. The outcomes of the present study will be useful for further research on the health effect of the bioaerosols in the IGP.

A synergistic approach combining Adsorption and Biodegradation for effective treatment of Acid Blue 113 dye by Klebsiella grimontii entrapped Graphene Oxide-Calcium Alginate Hydrogel Beads.

This study investigated the degradation of Acid Blue 113 (AB 113) dye using Klebsiella grimontii entrapped Graphene Oxide-Calcium Alginate Hydrogel beads (KG-GO-CA) in a Fluidized Bed Bioreactor (FBBR) under varying inlet loading rates. The minimum fluidization velocity of the KG-GO-CA hydrogel beads in FBBR was found to be 0.15 mm/s. The KG-GO-CA beads showed a maximum removal efficiency of 94.6% at an inlet flow rate of 20 mL/h over 15 days. Reusability studies indicated a removal efficiency of 70.6 ± 2.5% for AB 113 after the 12th cycle. Langmuir adsorption isotherm showed the best fit (R2 = 0.98724) with model parameters of Qm (203.83 mg/g) and Ki (0.0101 L/g). The study also confirmed that treated wastewater was more environmentally safe for domestic and commercial uses than untreated wastewater. The research highlights the potential use of KG-GO-CA hydrogel beads for removing dyes from wastewater.

Construction and performance assessment of Recirculating packed bed biofilm reactor (RPBBR) for effective biodegradation of p-cresol from wastewater.

Wastewater containing excess phenolic compounds is considered a major environmental concern due to its adverse impacts on the ecosystem. In this work, an effort has been given to treat the p-cresol from wastewater using Recirculating Packed Bed Biofilm Reactor (RPBBR). The process parameters, namely inoculum dose, pH, and NaCl (w/v) concentration were optimized to enhance the specific growth and obtained to be 14 ml, 7.0, and 1% NaCl (w/100 ml), respectively. Maximum p-cresol removal efficiency of 99.36±0.2% was achieved at 100 mg L-1 of p-cresol. First-order rate constants were found to be 0.70 day-1 and 0.96 day-1 for batch and continuous mode, respectively. The intermediates were analysed using FT-IR and GC-MS analysis. Pseudomonas fluorescens was used to assess bacterial toxicity and observed that the toxicity was reduced in case of treated wastewater. Finally, the performance of continuous RPBBR was better than the batch mode.

Clinical manifestations of delayed reaction following mass hornet envenomation: a case report.

Delayed reaction following mass hornet envenomation is associated with various clinical manifestations. Case Presentation: The authors present a case of a 24-year-old male from eastern Nepal, who presented following mass envenomation by hornet stings. He had progressive yellowish discoloration of skin and sclera, myalgia, fever, and dizziness. He had passage of tea-coloured urine followed by anuria. Laboratory investigations suggested acute kidney injury, rhabdomyolysis, and acute liver injury. The authors managed the patient with supportive measures and haemodialysis. There was complete recovery of liver and renal function in the patient. Discussion: The findings in this patient were similar to other cases reported in the literature. These patients must be managed supportively, with few requiring renal replacement therapy. Most of these patients recover completely. In low-middle-income countries like Nepal, delay in seeking care and delay in reaching care is associated with severe clinical manifestations. Delayed presentation can lead to renal shutdown and mortality; hence, early intervention is simple, and, crucial. Conclusion: This case highlights the occurrence of delayed reaction following mass envenomation by hornets. Also, the authors show an approach to managing such patients, similar to managing any other case with acute kidney injury. In these cases, an early simple intervention can prevent mortality. It is crucial to train healthcare workers regarding toxin induced acute kidney injury and the importance of early identification and intervention.

Assessment of biodegradation kinetics and mass transfer aspects in attached growth bioreactor for effective treatment of brilliant green dye from wastewater.

In this study, Bacillus licheniformis immobilized with low-density polyethylene (LDPE) was employed to degrade Brilliant Green (BG) dye from wastewater in a packed bed bioreactor (PBBR). Bacterial growth and extracellular polymeric substance (EPS) secretion were also assessed under different concentrations of BG dye. The impacts of external mass transfer resistance on BG biodegradation were also evaluated at different flow rates (0.3-1.2 L/h). A new mass transfer correlation [Formula: see text] was proposed to study the mass transfer aspects in attached-growth bioreactor. The intermediates, namely 3- dimethylamino phenol, benzoic acid, 1-4 benzenediol, and acetaldehyde were identified during the biodegradation of BG and, subsequently degradation pathway was proposed. Han - Levenspiel kinetics parameters µmax and Ks were found to be 0.185 per day and 115 mg/L, respectively. The new insight into mass transfer and kinetics support the design of efficiently attached growth bioreactor to treat a wide range of pollutants.

Health and wellbeing of Nepalese migrant workers in Gulf Cooperation Council (GCC) countries: A mixed-methods study.

Introduction: Migrant workers support low- and middle-income economies through remittances, often bearing considerable health risks with long-term consequences. This study aims to understand the health and wellbeing issues of Nepalese migrant workers in Gulf Cooperation Council (GCC) countries, a major destination for low-skilled Nepalese workers. Methodology: We conducted a mixed-methods study in Dhading district of Nepal. A pilot survey was carried out with returnee migrants from GCC countries to understand key health and wellbeing issues faced by workers. In addition, in-depth interviews were conducted with a subset of these returnee migrants and their families, and related stakeholders. These aimed to understand broader societal and policy implications in relation to labour migration. Quantitative data from the survey were analysed using descriptive statistics and thematic analysis was used for qualitative interviews. Results: 60 returnee migrants (58 males, 2 females) took part in the survey (response rate, 100%). Median age of the survey participants was 34 (IQR, 9) years and 68% had completed school level education. Returnee migrants reported suffering from various physical and mental health issues during their stay in GCC countries including cold/fever (42%), mental health problems (25%) and verbal abuse (35%). 20 participants took part in the qualitative study:10 returnee migrants (8 males, 2 females), four family members (female spouses) and six key stakeholders working in organizations related to international migration. Interview participants reported severe weather conditions resulting in physical health problems (e.g. pneumonia, dehydration and kidney disease) as well as mental health issues (including anxiety, loneliness and depression). Participants raised concerns about the usefulness and appropriateness of pre-departure training, and the authenticity of medical tests and reports in Nepal. Female migrants reported facing stigma after returning home from abroad. Language difficulties, alongside issues related to payment, insurance and support at work were cited as barriers to accessing healthcare in destination countries. Conclusion: Our study shows that Nepalese migrant workers experience severe weather conditions and suffer from various physical and mental health issues, including workplace abuse and exploitation. The study highlights an urgent need for strategies to enforce compulsory relevant pre-departure orientation and appropriate medical screening in Nepal, and fair employment terms and full health insurance coverage in destination countries. Greater collaboration between the Nepalese government and GCC countries is needed to ensure necessary legislation and regulatory frameworks are in place to safeguard the health and wellbeing of migrant workers.

Biodegradation of Congo Red Dye Using Lysinibacillus Species in a Moving Bed Biofilm Reactor: Continuous Study and Kinetic Evaluation.

The objective of this work was to develop a low-cost and efficient biocarrier for biodegradation of azo dye (i.e., Congo red (CR) dye). The potential bacterial species, i.e., Lysinibacillus fusiformis KLM1 and Lysinibacillus macrolides KLM2, were isolated from the dye-contaminated site. These bacterial species were immobilized onto the polypropylene-polyurethane foam (PP-PUF) and employed in a moving bed biofilm reactor (MBBR) for the treatment of CR dye. The effectiveness of the MBBR was investigated by operating the bioreactor in a continuous mode at various initial CR dye concentrations (50-250 mg/L) for 113 days. The removal efficiency was found in the range of 88.4-64.6% when the initial dye concentration was varied from 50 to 250 mg/L. The maximum elimination capacity (EC) of 213.18 mg/L.d was found at 250 mg/L of CR dye concentration. In addition, the CR dye utilization rate in the MBBR was studied by using two kinetics, namely, first-order and second-order (Grau) models. The high regression coefficients (R2 > 0.97) and the satisfactory root mean square (RMSE) values (0.00096-0.02610) indicated the reasonable prediction of CR dye degradation rate by the Grau model.

Comparative study for sorption of arsenic on peanut shell biochar and modified peanut shell biochar.

In this study, arsenite [As(III)] and arsenate [As(V)] removal efficiency of peanut shell biochar (PSB) and modified peanut shell biochar (MPSB) was compared in aqueous solutions. The modification was carried out with KMnO4 and KOH. Sorption efficiency of MPSB was relatively higher than PSB at pH 6 for As(III) (86%) and for As(V) (91.26%) for initial concentration of 1 mg/L, adsorbent dose of 0.5 g/L and 240 min equilibrium time at 100 rpm. Freundlich isotherm and pseudo-second order kinetic model suggested possible multilayer chemisorption. Fourier transform infrared spectroscopy showed that -OH, C-C, CC and C-O-C groups contributed significantly in adsorption for both PSB and MPSB. Thermodynamic study showed that the adsorption process was spontaneous and endothermic. Regeneration studies revealed that PSB and MPSB can be successfully used for three cycles. This study established that peanut shell is a low-cost, environment friendly and efficient biochar for removal of arsenic from water.

Interaction of Antioxidant Trace Minerals Affecting Blood Picture Including Antioxidant Profile of Healthy Buffalo (Bubalus bubalis) Calves.

Copper (Cu) and selenium (Se) are antioxidants and essential trace elements that have mutual interaction and are reported to have beneficial effects at supranutritional levels. The experiment was executed to evaluate the individual impact of supranutritional levels of targeted elements with the effect of their interactions in buffalo calves. Twenty male Murrah buffalo calves of about 8-9 months (bodyweight 112.1 ± 7.69 kg) were distributed into four groups of five calves in each group and fed either a control (C) diet or supplemented with supranutritional levels of Cu (T1), Se (T2), or combination of both (T3) for 120 days. Higher (P = 0.015) values of packed cell volume were observed in group T2 at day 120; otherwise, all other hematological parameters remained comparable among groups. Over the period (day 120 vs. day 0), an enhancement in the percentage of lymphocytes (P = 0.006) with a reduction in neutrophils (P = 0.028) and hemoglobin (P = 0.024) values was observed in the control group. An enhancement in the percentage of monocytes (P = 0.031), with a reduced percentage of neutrophils (P = 0.022), was reported in groups T2 and T3, respectively. Interaction of Cu and Se at supranutritional level (T3) dramatically reduced plasma Cu (P = 0.008) level against the control values, with an improvement in Se markers (i.e., plasma Se, P = 0.041 and enzyme glutathione peroxidase, P = 0.057) over the values in calves fed supplemental Se alone (T2). Additionally, Cu (T1 and T3) was forced to decline (P < 0.05) Zn level in the plasma of buffalo calves. Cu (T1, P < 0.05) and Se (T2 and T3, P ≤ 0.01) supplementation was able to improve their respective plasma levels. The interaction of two trace elements at the supranutritional level further helped in reducing the lipid peroxidation (P = 0.01) values as well. Though antioxidant vitamins and cell-mediated immunity remained unaffected, humoral immunity against antigen P. multocida was high (P = 0.005) in the group T2. The conclusion may be drawn that supranutritional Cu and Se were capable to influence certain blood parameters with an additional interaction effect due to simultaneous supplementation in buffalo calves.

Imidacloprid biodegradation using novel bacteria Tepidibacillus decaturensis strain ST1 in batch and in situ microcosm study.

Imidacloprid is one of the frequently used insecticides. Indiscriminate use of imidacloprid makes it perilous to non-target organisms as well as the environment, including soil and water sources, thus, making its elimination from the environment an irresistible concern. Bioremediation is a technique that uses the degrading capabilities of bacteria to create an economical and reliable method of pesticide abatement. In an attempt to solve the problem arising due to imidacloprid contamination, bacterial strains possessing the ability to degrade imidacloprid were isolated from contaminated agricultural soil samples in the present study. Imidacloprid-degrading isolate, identified as Tepidibacillus decaturensis strain ST1, could effectively degrade imidacloprid in liquid media, slurry, and soil microcosms. The microcosm studies using the isolate resulted in the degradation of around 77.5% and 85% of imidacloprid (200 ppm) in sterile and unsterile soils within 45 days. In addition to biodegradation, sorption of insecticide by the plants and natural reduction of insecticide over time has also been reported. The degradation in soil follows first-order kinetics. Hydrazinecarboxamide and hydroxyurea were identified as metabolites on conducting GC-MS analysis of the degraded samples.

Increasing and sustaining diabetic retinopathy screening in Fiji by leveraging community health workers (CHWs) services: A qualitative study.

Introduction: Inequities in access to diabetic retinopathy (DR) services particularly in rural and remote Fiji is concerning. This is because DR when left undiagnosed and untreated for long, can lead to vision loss and permanent blindness. Appropriate channels must be explored to strengthen services and ensure equitable access to healthcare for everyone. This study describes the development and implementation of DR awareness training for community health workers (CHWs) and their subsequent engagement to raise awareness and scale-up DR screening for communities throughout Fiji. Materials and method: As part of a programme to reduce the incidence of avoidable blindness due to diabetes amongst people living in the Pacific, DR training for primary level nurses was developed and implemented. As these primary level nurses were already inundated by clinical duties and competing health priorities, a shifting of the task was proposed to engage the CHWs who would instead educate communities on diabetes and DR and make referrals for DR screening. A one-day DR awareness training was developed and implemented by the Pacific Eye Institute with funding from the Fred Hollows Foundation New Zealand. Results: At the end of the DR programme in 2019, the team had achieved their target and trained a total of 823 CHWs giving an 81.32% coverage of the total 1012 registered CHW in the MHMS register. Anecdotal evidence showed a spike in DR referrals and screenings recorded at health facilities. Three key themes emerged related to the involvement of CHWs which include engagement of CHWs, benefits of the engagement, and health system-related challenges. Conclusion: The use of CHWs who are already integrated into the health system was considered a sustainable intervention to strengthen diabetes and DR services at the primary level of care, particularly if it involves community awareness, health education, and health services facilitation The future of the CHWs will depend on their being integrated more systematically into local health services with strengthened management and supervision.

Biodegradation and detoxification study of triphenylmethane dye (Brilliant green) in a recirculating packed-bed bioreactor by bacterial consortium.

In the last few decades, Brilliant green (BG) dye is widely employed to colour the fabric materials in various industries (e.g. textile, pulp and paper, etc.). The wastewater containing BG dye emerges as a major challenge among the researchers due to its toxic, mutagenic, and carcinogenic effects on human beings and marine life. In this context, the present study is mainly focused on the biodegradation of BG dye present in wastewater. The biodegradation of BG dye was performed in an indigenously designed recirculating packed bed bioreactor (RPBBR). Modified Polypropylene-Polyurethane foam (PP-PUF), a support packing material, was immobilised with a newly isolated bacterial consortium of Enterobacter asburiae strain SG43 (BGT1) and Alcaligenes sp. SY1 (BGT2). The bioreactor was operated under various organic loading rates (OLRs) of 2.7, 1.27, 0.93, 0.71, and 0.53 kg COD/m3.d-1 with a hydraulic retention time (HRT) of 4 days. The bioreactor exhibited the maximum BG dye removal efficiency of 91%. Proton Nuclear Magnetic Resonance (1H NMR), UV-Vis spectroscopy, Gas chromatography-mass spectrometry (GC-MS), and Fourier Transform Infrared Spectroscopy (FTIR) depicted the biodegradation of BG dye. Phaseolus mungo seeds germinated in BG dye biodegraded wastewater was significantly high (83.56%) than the untreated wastewater (32.4%), which was reasonably subjected to the detoxification of treated wastewater.

A comprehensive evaluation of the integrated photocatalytic-fixed bed bioreactor system for the treatment of Acid Blue 113 dye.

This work investigated the performance of the integrated system (i.e., a Photocatalytic reactor followed by a Fixed bed bioreactor (PC-FBR)) for the degradation of complex Acid Blue 113 from wastewater. Initially, a Photocatalytic reactor was employed to improve the biodegradability index (i.e., BOD/COD) of wastewater from 0.21 ± 0.0062 to 0.395 ± 0.0058. The preliminary photocatalytic oxidation study revealed a maximum of 86.42 ± 0.33 % dye removal at TiO2 loading of 1.5 g/L and an initial concentration of 50 mg/L of AB 113. An integrated reactor system significantly achieved a maximum of 92 ± 2.6 % of dye removal efficiency under a retention time of 120 hr. The stand-alone FBR dye shock loading study suggested that the reactor system was reasonably able to further restore its degradation efficiency. Langmuir-Hinshelwood kinetic model, Monod model, and Andrew-Haldane model were fitted. The bacterial toxicity assessment was carried out using the Pseudomonas fluorescens.

Impact of diabetic retinopathy awareness training on community health workers' knowledge and referral practices in Fiji: a qualitative study.

INTRODUCTION: Community health workers (CHWs) are effective in raising awareness about diabetes mellitus and diabetic retinopathy (DR). In Fiji, CHWs were trained in a 1-day diabetic retinopathy (DR) awareness to provide communities with adequate basic knowledge about diabetes and DR to improve awareness and enhance referrals for DR screening and treatment. This study aimed to explore the impact of this training on CHWs' knowledge of DR and their referral practices related to DR screening in Fiji 2 years post-training. METHODS: This qualitative study was conducted in 2021 across three out of the four administrative divisions of Fiji, namely the Western, Northern and Central divisions. A total of 14 CHWs from the three divisions of Fiji participated in this study. All participants had attended a 1-day DR awareness training 2 years before this study. Participants were chosen purposively and were invited to participate in focus group discussion (FGD). The FGDs were audio-recorded and transcribed verbatim, and thematic analysis was conducted to identify and classify recurrent themes. RESULTS: CHWs indicated that their knowledge about both diabetes and DR improved significantly after the training. This boosted their confidence in talking about these issues and providing clarity regarding referrals for DR screening in their respective communities. Consequently, they have referred a significantly higher number of people for screening both in outreach and to health facilities. Challenges in referral included poverty, high transportation cost and social support needs, which hindered screening. Further, although CHWs felt some degree of integration within the health system, they thought more was needed. CONCLUSION: Investing in scalable models such as training CHWs is an important first step in tackling diabetes and DR in communities, particularly at the grassroots level in low-resource settings by increasing the community's knowledge of DR and improving access to screening, diagnosis and treatment.

Highly efficient bio-adsorption of Malachite green using Chinese Fan-Palm Biochar (Livistona chinensis).

The discharge of effluents from the textile industry is a multidimensional problem that affects the ecosystem in many ways. Though many new technologies are being developed, it remains to be seen which of those can be practiced in a real scenario. The current investigation attempts to absorb the Malachite Green, an effluent from textile dye using Chinese Fan Palm Seed Biochar. Accordingly, biochar was prepared using fruits of Chinese Fan Palm (Livistona chinensis) tree. The fruit also yielded a significant amount of biochar and bio-oil. 1.346 kg of fresh and cleaned fruit was fast pyrolyzed at 500 °C in a laboratory-scale Pyrolyzer resulting in 0.487 kg of biochar and 0.803 L of bio-oil. The remaining fruit matter was converted to gaseous products. The kinetics of dye removal were studied and the parameters were determined. The study advocates that the Langmuir isotherm model simulates the adsorption experiment, to a good extent. From the plot, the maximum (monolayer) adsorption capacity, Qm was determined to be 21.4 mg/g. The suitability of the Langmuir isotherm model onto biochar was established by the high correlation coefficient, R2 that was higher than 0.97.

Factors affecting utilization of sexual and reproductive health services among women with disabilities- a mixed-method cross-sectional study from Ilam district, Nepal.

BACKGROUND: Persons with disabilities can have physical, mental, intellectual, or sensory impairments which can hinder their social participation. Despite Sustainable Development Goals call for "universal access to sexual and reproductive health (SRH)", women with disabilities (WwDs) continue to experience barriers to access SRH services in Nepal. This study evaluated factors affecting the utilization of SRH services among WwDs in Ilam district, Nepal. METHODS: A mixed-method study with 384 WwDs of reproductive age was conducted in Ilam district, eastern Nepal. Quantitative data were collected using a structured questionnaire. Relationships between utilization of SRH services and associated factors were explored using multivariate logistic regression analysis. Qualitative data were collected from focus groups with female community health volunteers and interviews with WwDs, health workers and local political leaders. They were audio-recorded, translated and transcribed into English and were thematically analyzed. RESULTS: Among 384 respondents (31% physical; 7% vision,16% hearing, 7% voice&speech,12% mental/psychosocial, 9% intellectual, 18% multiple disabilities), only 15% of them had ever utilized any SRH services. No requirement (57%) and unaware of SRH services (24%) were the major reasons for not utilizing SRH services. A majority (81%) of them reported that the nearest health facility was not disability-inclusive (73%), specifically referring to the inaccessible road (48%). Multivariate analysis showed that being married (AOR = 121.7, 95% CI: 12.206-1214.338), having perceived need for SRH services (AOR = 5.5; 95% CI: 1.419-21.357) and perceived susceptibility to SRH related disease/condition (AOR = 6.0; 95% CI:1.978-18.370) were positively associated with the utilization of SRH services. Qualitative findings revealed that illiteracy, poor socioeconomic status, and lack of information hindered the utilization of SRH services. WwDs faced socioeconomic (lack of empowerment, lack of family support), structural (distant health facility, inaccessible-infrastructure), and attitudinal (stigmatization, bad behaviour of health care providers, perception that SRH is needed only for married) barriers to access SRH services. CONCLUSIONS: Utilization of SRH services among WwDs was very low in Ilam district, Nepal. The findings of this study warrant a need to promote awareness-raising programs to WwDs and their family members, sensitization programs to health service providers, and ensure the provision of disability-inclusive SRH services in all health facilities.

Construction of biotreatment platforms for aromatic hydrocarbons and their future perspectives.

Aromatic hydrocarbons (AHCs) are one of the major environmental pollutants introduced from both natural and anthropogenic sources. Many AHCs are well known for their toxic, carcinogenic, and mutagenic impact on human health and ecological systems. Biodegradation is an eco-friendly and cost-effective option as microorganisms (e.g., bacteria, fungi, and algae) can efficiently breakdown or transform such pollutants into less harmful and simple metabolites (e.g., carbon dioxide (aerobic), methane (anaerobic), water, and inorganic salts). This paper is organized to offer a state-of-the-art review on the biodegradation of AHCs (monocyclic aromatic hydrocarbons (MAHs) and polycyclic aromatic hydrocarbons (PAHs)) and associated mechanisms. The recent progress in biological treatment using suspended and attached growth bioreactors for the biodegradation of AHCs is also discussed. In addition, various substrate growth and inhibition models are introduced along with the key factors governing their biodegradation kinetics. The growth and inhibition models have helped gain a better understanding of substrate inhibition in biodegradation. Techno-economic analysis (TEA) and life cycle assessment (LCA) aspects are also described to assess the technical, economical, and environmental impacts of the biological treatment system.

Prevalence of Diabetes in Tuberculosis Patients in Kathmandu Valley, Nepal.

In this descriptive cross-sectional study, the data on the prevalence of diabetes mellitus (DM) among tuberculosis (TB) patients at the Urban Directly Observed Treatment Centers in the Kathmandu, Bhaktapur, and Lalitpur districts of Nepal were collected. The prevalence of DM was assessed in 67 previously treated TB (PTTB) and 214 new TB patients. DM was diagnosed in 8 PTTB and 20 new TB patients. Clinical interviews identified 14 patients with DM, rapid blood glucose test was used to diagnose DM in 4 patients, and oral glucose tolerance test was used to diagnose DM in another 4 patients. Impaired glucose tolerance and impaired fasting glycemia were observed in 8 and 5 patients, respectively. The 18-24-year age group had the largest number of new TB patients (82, 38.3%). However, the incidence of DM among TB patients was higher in the >35-year age group. Moreover, DM was diagnosed in 24.2% of PTTB patients and in 23.1% of new TB patients. To determine the impact of DM screening in TB patients, a larger number of samples should be analyzed. DM screening for patients with TB is expected to start in developing countries. This should be initiated by conducting clinical interviews about DM and glucose tests using rapid kits.

A scoping review on climate change and tuberculosis.

Climate change is a global public health challenge. The changes in climatic factors affect the pattern and burden of tuberculosis, which is a worldwide public health problem affecting low and middle-income countries. However, the evidence related to the impact of climate change on tuberculosis is few and far between. This study is a scoping review following a five-stage version of Arksey and O'Malley's method. We searched the literature using the keywords and their combination in Google scholar, and PubMed. Climate change affects tuberculosis through diverse pathways: changes in climatic factors like temperature, humidity, and precipitation influence host response through alterations in vitamin D distribution, ultraviolet radiation, malnutrition, and other risk factors. The rise in extreme climatic events induces population displacement resulting in a greater number of vulnerable and risk populations of tuberculosis. It creates a conducive environment of tuberculosis transmission and development of active tuberculosis and disrupts tuberculosis diagnosis and treatment services. Therefore, it stands to reasons that climate change affects tuberculosis, particularly in highly vulnerable countries and areas. However, further studies and novel methodologies are required to address such a complex relationship and better understand the occurrence of tuberculosis attributable to climate change.