Aversive Reaction Between Disulfiram and Betel Quid Among Inpatients With Alcohol Use Disorder in Bhutan: A Preliminary Study.

Betel quid (BQ) is commonly used in the Asia-Pacific region. Disulfiram is prescribed for people with alcohol use disorders (PwAUDs) after the completion of detoxification as an alternative to rehabilitation. This prospective observational study reported the aversive reactions and common symptoms of disulfiram and BQ in PwAUDs. Participants included PwAUDs admitted to the psychiatric ward at the Jigme Dorji Wangchuck National Referral Hospital for detoxification, who were on Disulfiram and using BQ at the same time. Aversive reactions between disulfiram and BQ were observed for 100 patients over a year. Twenty participants showed aversive reactions between BQ and disulfiram. Common symptoms included sweating, diarrhea, dizziness, tremors, palpitations, shortness of breath, nausea and vomiting, and headache. Since PwAUDs in Bhutan are inducted on disulfiram after detoxification, and most use BQ simultaneously, this study will help inform health care providers to educate people about the aversive reactions of disulfiram and BQ.

Understanding How Community Wellbeing is Affected by Climate Change: Evidence From a Systematic Literature Review.

Social science studies view community wellbeing to be a cumulative construct of multiple dimensions which include social, economic, environmental, physical, political, health, education indicators and more. The study of community wellbeing is compounded by climate change as it increases the frequency of disasters affecting all dimensions of community wellbeing. It becomes crucial for communities to build community resilience and address the impact on community wellbeing in the context of Disaster Risk Reduction and sustainable development. This systematic literature aimed to understand how community wellbeing is affected by climate change. It analysed 23 papers from Scopus, Web of Science, ProQuest, and Google Scholar, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) method, to address three research questions: (i) how do climate change scholars understand community wellbeing, (ii) how community wellbeing is affected by specific climate change factors/conditions and the nature of impact, and (iii) how the impact on community wellbeing as a result of climate change is being addressed. The study found that climate change scholars hold mixed and multiple views or understanding of community wellbeing and climate change led to mental stress decreasing community wellbeing. The solutions to improve community wellbeing in the context of climate change suggests that adaptation should be the main policy instrument supplemented by mitigation strategies and recommends building a vibrant research culture in wellbeing and climate studies, among others. This review provides insights into the complex relationship between community wellbeing and climate change and identifies areas for future research and policy development.

Geographical contrasts of Y-chromosomal haplogroups from wild and domestic goats reveal ancient migrations and recent introgressions.

By their paternal transmission, Y-chromosomal haplotypes are sensitive markers of population history and male-mediated introgression. Previous studies identified biallelic single-nucleotide variants in the SRY, ZFY and DDX3Y genes, which in domestic goats identified four major Y-chromosomal haplotypes, Y1A, Y1B, Y2A and Y2B, with a marked geographical partitioning. Here, we extracted goat Y-chromosomal variants from whole-genome sequences of 386 domestic goats (75 breeds) and seven wild goat species, which were generated by the VarGoats goat genome project. Phylogenetic analyses indicated domestic haplogroups corresponding to Y1B, Y2A and Y2B, respectively, whereas Y1A is split into Y1AA and Y1AB. All five haplogroups were detected in 26 ancient DNA samples from southeast Europe or Asia. Haplotypes from present-day bezoars are not shared with domestic goats and are attached to deep nodes of the trees and networks. Haplogroup distributions for 186 domestic breeds indicate ancient paternal population bottlenecks and expansions during migrations into northern Europe, eastern and southern Asia, and Africa south of the Sahara. In addition, sharing of haplogroups indicates male-mediated introgressions, most notably an early gene flow from Asian goats into Madagascar and the crossbreeding that in the 19th century resulted in the popular Boer and Anglo-Nubian breeds. More recent introgressions are those from European goats into the native Korean goat population and from Boer goat into Uganda, Kenya, Tanzania, Malawi and Zimbabwe. This study illustrates the power of the Y-chromosomal variants for reconstructing the history of domestic species with a wide geographical range.

Knowledge, Attitude, and Practice of Infection Control and Waste Management among Traditional Medicine Practitioners in Bhutan, 2019: A Nationwide Cross-Sectional Survey.

BACKGROUND: In Bhutan, Traditional Medicine (TM) is a part of the government-sponsored free healthcare system and Traditional Medicine Units (TMUs) are colocated with allopathic hospitals. Prevention of healthcare-associated infections and patient safety must apply to all institutionalized healthcare settings including TMUs. This study assessed the knowledge, attitude, and practice of TM practitioners in Bhutan in the field of infection control and waste management practices. METHODS: This was a descriptive study among TM practitioners selected through simple random sampling. Data were collected using a structured pro forma and entered in EpiData 3.1 and analyzed in STATA 13.1. RESULTS: There were 132 respondents (response rate 98%). The majority (64%) knew the seven steps of handwashing but their knowledge of WHO's Five Moments for Handwashing was poor, especially handwashing after aseptic procedures (17%) and handwashing after touching patient surroundings (5%). Handwashing before palpation of the pulse (37%) and using gloves while dispensing medicines (9%) were poor; but the proportions of handwashing before performing moxibustion (96%), correct disposal of sharps (84%), and disinfection of cupping sets (78%) were high. The majority of participants hold a positive attitude towards the adoption of infection control and waste management practices for the benefit of patients. Only 23% had received preservice and 44% had received in-service training on infection control. CONCLUSIONS: The knowledge and practices of infection control and waste management are optimal only in select domains of practice. The practitioners hold a positive attitude towards the adoption of infection control and waste management standards.

Mithun (Bos frontalis): the neglected cattle species and their significance to ethnic communities in the Eastern Himalaya - A review.

OBJECTIVE: This review consolidates the available information on the socio-economic and ecological significance of Mithun in the lives of ethnic communities in the Eastern Himalaya. METHODS: Standard guidelines were followed for the review and data collection was carried out at three stages; literature search, literature screening, and literature review and analysis. RESULTS: Records indicate a long association of Mithun with the ethnic groups. Mithun serves as a symbol of pride and local currency for barter trade in the ethnic society. Its utilities range from being used as a bride price to settling legal disputes. Several cultural festivals and local ceremonies are celebrated around this bovine. Due to its semi-wild nature, this animal also has an ecological role to conserve broad leaf sub-tropical forests. However, it remains neglected and has not received policy attention, leading to a stagnated growth. The institutions for Mithun research and development are also weak. Furthermore, the species is under threat from new diseases and habitat alteration triggered by climate change. CONCLUSION: Founded on the current state of knowledge, there is a need for institutional development, strengthening institutional linkages, and promoting regional cooperation among Mithun rearing countries for further research and development of this unique cattle.

Genetic diversity and population structure of three traditional horse breeds of Bhutan based on 29 DNA microsatellite markers.

The genetic variability and population structure of three Bhutanese traditional horse breeds were assessed through genotyping of 74 horses (Boeta 25, Sharta 14 and Yuta 35) for 29 microsatellite DNA loci. Altogether, 282 alleles were detected across 29 polymorphic loci. The allelic diversity (NE) (Boeta 4.94; Sharta 4.65; Yuta 5.30) and gene diversities (HE) (Boeta 0.78; Sharta 0.77; Yuta 0.79) were high. None of the breeds deviated significantly from the Hardy-Weinberg equilibrium. There was no sign of significant population bottleneck for all the breeds. The inbreeding estimates (FIS) of the breeds were low (Boeta 0.023; Sharta 0.001; Yuta 0.021). Analysis of molecular variance showed 0.6% of the total genetic variation among breeds, 1.9% among individuals and 97.5% within individuals. The global FIT, FST, and FIS estimates for the population were 0.025, 0.006 and 0.019 respectively. The analysis of population structure failed to distinguish subpopulations in traditional horses and this was supported by a high genetic exchange among the breeds. Overall, the results of this study suggest a rich genetic diversity in the traditional horse despite a very low genetic differentiation among the breeds in Bhutan.

A catalyst-free growth of aluminum-doped ZnO nanorods by thermal evaporation.

The growth of Al:ZnO nanorods on a silicon substrate using a low-temperature thermal evaporation method is reported. The samples were fabricated within a horizontal quartz tube under controlled supply of O2 gas where Zn and Al powders were previously mixed and heated at 700°C. This allows the reactant vapors to deposit onto the substrate placed vertically above the source materials. Both the undoped and doped samples were characterized using scanning electron microscopy (SEM), field emission scanning electron microscopy (FESEM), energy-dispersive X-ray spectroscopy (EDX), high-resolution transmission electron microscopy (HRTEM) and photoluminescence (PL) measurements. It was observed that randomly oriented nanowires were formed with varying nanostructures as the dopant concentrations were increased from 0.6 at.% to 11.3 at.% with the appearance of 'pencil-like' shape at 2.4 at.%, measuring between 260 to 350 nm and 720 nm in diameter and length, respectively. The HRTEM images revealed nanorods fringes of 0.46 nm wide, an equivalent to the lattice constant of ZnO and correspond to the (0001) fringes with regard to the growth direction. The as-prepared Al:ZnO samples exhibited a strong UV emission band located at approximately 389 nm (E g = 3.19 eV) with multiple other low intensity peaks appeared at wavelengths greater than 400 nm contributed by oxygen vacancies. The results showed the importance of Al doping that played an important role on the morphology and optical properties of ZnO nanostructures. This may led to potential nanodevices in sensor and biological applications.

Psychoactive substance use by psychiatric patients in the National Referral Hospital, Bhutan: a retrospective analysis.

BACKGROUND: The costs to the individual and to society of psychoactive substance use is of growing concern in Bhutan. This study aimed to assess the relation between the demographic variables of patients admitted to the National Referral Hospital for first-time detoxification and the psychoactive substances used. METHODS: The demographic variables and types of psychoactive substance used by 284 substance users were reviewed. Data were collected through patients' history sheets and admission registers, and analysed through descriptive statistics, one-way analysis of variance and independent t test. RESULTS: The commonest psychoactive substance used was alcohol, followed by cannabis, nitrazepam, dextropropoxyphene, glue (inhaled) and chlorphenamine/ pseudoephedrine/codeine-containing cough syrup. Only 14% of participants were aged 45 years or older. Most patients used more than one substance; the mean number of psychoactive substances used was highest among males, individuals aged 15-24 years and those who were unemployed. CONCLUSION: Among patients admitted for first-time detoxification, harmful use of alcohol is the most common, followed by cannabis and illicit prescription drugs. Preventive measures should be prioritized on a need-based strategy. The findings of this study indicate that some of these preventive measures should be focused on males, unemployed groups and youth, and should involve raising awareness of harmful use of substances and the services available to treat substance use disorders.

Polymorphisms in the bovine hemoglobin-beta gene provide evidence for gene-flow between wild species of Bos (Bibos) and domestic cattle in Southeast Asia.

The electrophoretic variation in bovine hemoglobin-beta (HBB) is one of the most investigated genetic markers. The presence of a unique HBB variant, HBB(X), in Southeast Asian cattle has been reputed as a sign of gene-flow from wild bovine species. In this study, we analyzed the DNA sequences of HBB genes in domestic and wild bovine species to verify this belief. Isoelectric focusing of HBB chain revealed that the HBB(X) in domestic cattle had dimorphism and was separated into HBB(X1) and HBB(X2). The HBB(X1) had the same DNA sequence of the common HBB variant in gayal (Bos gaurus frontalis), while some of the HBB(X2) were identical with that of Cambodian banteng (Bos javanicus birmanicus). As a result, we confirmed that the bovine HBB variants can be a good indicator of introgression between wild and domestic cattle. The HBB(X1) was always predominant to HBB(X2) in the continental populations, suggesting that the gaur had contributed to the gene pool of domestic cattle in this region much more than the banteng. On the other hand, the mitochondrial DNA analysis could not detect gene-flow from wild species. Autosomal markers that can trace the phylogeny between alleles are suitable for the assessment of bovine interspecific introgression.

Molecular phylogeny and diversity of Myanmar and Bhutan mithun based on mtDNA sequences.

The mithun (Bos frontalis), synonymous with mithan and gayal, is considered to be a domesticated form of gaur (B. gaurus). However, there has been a controversy concerning its origin. In an effort to address this issue, the mitochondrial cytochrome b (cytb) genes of 20 mithun from Myanmar and 13 from Bhutan were sequenced to trace its maternal origin. Seven cytb haplotypes were found in the 33 mithun, and the phylogenetic tree for these haplotypes clearly showed three embranchments involving five gaur types, a B. indicus type, and a B. taurus type. Sixteen Myanmar and 12 Bhutan mithun had gaur haplotypes, while a B. indicus haplotype was found in three Myanmar and one Bhutan mithun. The B. taurus haplotype was detected in a single Myanmar animal. These results demonstrated that the principal maternal origin of mithun was gaur and suggested that it was directly domesticated from gaur. However, some introgression of domestic cattle existed in current mithun populations. The presence of cattle mtDNA raised the question of how many cattle nuclear genes might have been integrated into the gene pool of mithun.

Milk protein polymorphisms in cattle (Bos indicus), mithun (Bos frontalis) and yak (Bos grunniens) breeds and their hybrids indigenous to Bhutan.

In the current study, milk protein variation was examined in cattle (Bos indicus), mithun (Bos frontalis), yak (Bos grunniens) and their hybrid populations in Bhutan to estimate genetic variability, conduct genetic characterization and assess the possibility of gene flow between mithun and cattle. Isoelectric focusing of 372 milk samples from 11 populations detected four molecular types of ß-lactoglobulin (A, B, E and M), five molecular types of α(S1) -casein (A, B, C, E and X) and three molecular types of k-casein (A, B and X). Mithun and yak shared alleles but were found to exhibit different allele frequencies for the proteins studied. The degree of genetic variability within populations was measured by average heterozygosity and ranged from 24-40% in cattle, 26% for yak and 33% for mithun. We also resolved the traditional mithun and cattle hybridization system via principal component analysis. Our results suggested secondary introgression of mithun genes to the village Thrabum population, and a close genetic relationship between Bhutanese indigenous cattle and Indian cattle.

Sheep genetic diversity in Bhutan using microsatellite markers.

Genotype data from eight microsatellite markers were used to assess genetic diversity and relationships among five indigenous Bhutanese sheep populations, Sakten, Jakar, Sarpang, Sipsu and Tsirang. Estimates of mean observed and expected heterozygosities, mean number of alleles per locus/population were obtained. The highest observed heterozygosities were found in Jakar (0.657) and Sakten (0.647), while the lowest one was found in Tsirang (0.539). Genetic distances, pairwise proportion of different alleles, UPGMA tree, and principal component analysis indicate close relationship among Tsirang, Sipsu and Sarpang populations, while Jakar and Sakten populations are located in one cluster. These two clusters are separated geographically, and show distinct phenotypic as well as molecular characters. We therefore recommend that the Bhutanese native sheep populations be classified into at least two distinct breeds, Jakar-Sakten sheep and Sipsu sheep. Since Jakar and Sakten sheep have different morphological phenotypes, further analyses will be required to understand the genetic differences between these two sheep populations.

Phylogeny of local sheep breeds in East Asia, focusing on the Bayanbulak sheep in China and the Sipsu sheep in Bhutan.

The phylogenetic positions of the Bayanbulak sheep in China and the Sipsu sheep in Bhutan in the northern Asian sheep group were determined on the basis of allele frequency data for five informative and polymorphic loci of blood protein and nonproteins, such as transferrin (TF), arylesterase (ES), hemoglobin-beta (HB-beta), X-protein (XP), and potassium transport (KE), using different electrophoretic and ion-densitometric techniques. Based on Nei's genetic distance, clustering analysis by the UPGMA method showed that the Bayanbulak sheep is clustered in the northern Asian sheep group. Furthermore, the Bayanbulak sheep belongs to a subgroup containing the Khalkhas and Hu sheep of the Mongolian sheep group, which is distinguished from another subgroup of the small-tailed Han, Tan, Tong, and Wadi sheep. The Bayanbulak sheep was closest to the Hu sheep, despite a morphological difference in the fat deposits. In addition to these findings, the Sipsu sheep was verified to belong to the Baruwal sheep.

Phylogeography of wild musk shrew (Suncus murinus) populations in Asia based on blood protein/enzyme variation.

The musk shrew (Suncus murinus) is an insectivore species that inhabits tropical and subtropical Asia widely. To clarify the genetic relationship among wild musk shrew populations, we examined the electrophoretic variants of biparentally inherited genetic markers at 10 loci coding for eight blood proteins/enzymes in a total of 639 animals and compared the results obtained from the mitochondrial DNA data. The principal-component analysis performed using the allele frequency data revealed that the 17 populations could be divided into two major groups, a South Asian group and a Southeast Asian group that includes several island populations bound by Myanmar. The degrees of genetic divergence among populations were higher within the Southeast Asian group than within the South Asian group. This finding was incongruent with the mtDNA diversity. Analysis conducted at the individual level showed that a shrew from the central region in Myanmar that carries a South Asian type of mtDNA showed the electrophoretic variants specific to the Southeast Asian group, suggesting that this region is a contact zone between the two major groups.

Population structure of wild musk shrews (Suncus murinus) in Asia based on mitochondrial DNA variation, with research in Cambodia and Bhutan.

The musk shrew (Suncus murinus) is a small mammalian species belonging to Insectivora. It is widely distributed in Asia. To identify the genetic relationship among wild musk shrew populations and examine its migration route, we investigated the populations of Cambodia and Bhutan by using mitochondrial DNA restriction fragment length polymorphism analysis and compared them with other Asian populations previously described. Four haplotypes were detected in Cambodia and eight in Bhutan. A total of 53 haplotypes were detected in Asia and were classified largely into two groups, the Continental and Island types, based on a minimum spanning network. From the distribution of mtDNA types in wild musk shrews, three major population groups are identified in Asia: South Asia, Southeast Asia, and Malay. It is suggested that the Malay population group was a mix of South and Southeast Asian population groups and that this was a contact area of the two groups. In addition, other contact areas between the South and Southeast Asian groups exist in Myanmar, but unlike the Malay, the Myanmar area was the border of these groups.

Phylogenetic relationships among indigenous sheep populations in East Asia based on five informative blood protein and nonprotein polymorphisms.

The phylogenetic relationships among 23 local sheep breeds and varieties in East Asia were determined based on allele frequency data for five informative and polymorphic blood protein and nonprotein loci (transferrin, arylesterase, hemoglobin-beta, X-protein, and potassium transport) using electrophoresis and ion-densitometric techniques. Comparatively striking differences in the frequency distributions, especially of hemoglobin-beta and X-protein alleles, were seen between the northern population of the Khalkhas, Bhyanglung, Baruwal, Jakar, Sakten, and five Chinese breeds and the southern population of the Bengal, Kagi, Lampuchhre, Myanmar, and Sipsu breeds. Clustering analyses using UPGMA and NJ methods and principal component analysis, using the data of all populations and loci tested, clearly demonstrated the difference. The two population groups are divided by the boundary of the Himalayas, and each diverged into three subgroups: Mongolian, Tibetan, and Himalayan groups in the north and Indian groups I, II, and III in the south. It was noted that the genetic differentiation of populations was more distinct in the northern group. These findings strongly suggest the existence of at least two large and phylogenetically different gene pools of sheep in East Asia.