Seroprevalence of SARS-CoV-2 infection in the general population of Nepal during the first and second generalized waves of the COVID-19 pandemic-2020-2021.

Few seroprevalence studies have been conducted on coronavirus disease (COVID-19) in Nepal. Here, we aimed to estimate seroprevalence and assess risk factors for infection in the general population of Nepal by conducting two rounds of sampling. The first round was in October 2020, at the peak of the first generalized wave of COVID-19, and the second round in July-August 2021, following the peak of the wave caused by the delta variant of SARS-CoV-2. We used cross-sectional probability-to-size (PPS)-based multistage cluster sampling to estimate the seroprevalence in the general population of Nepal at the national and provincial levels. We tested for anti-SARS-CoV-2 total antibody using the WANTAI SARS-CoV-2 Ab ELISA kit. In Round 1, the overall national seroprevalence was 14.4%, with provincial estimates ranging from 5.3% in Sudurpaschim to 27.3% in Madhesh Province. In Round 2, the estimated national seroprevalence was 70.7%, with the highest in the Madhesh Province (84.8%) and the lowest in the Gandaki Province (62.9%). Seroprevalence was comparable between males and females (Round 1, 15.8% vs. 12.2% and Round 2, 72.3% vs. 68.7%). The seroprevalence in the ecozones-Terai, hills, and mountains-was 76.3%, 65.3%, and 60.5% in Round 2 and 17.7%, 11.7%, and 4.6% in Round 1, respectively. In Nepal, COVID-19 vaccination was introduced in January 2021. At the peak of the first generalized wave of COVID-19, most of the population of Nepal remained unexposed to SARS-CoV-2. Towards the end of the second generalized wave in April 2021, two thirds of the population was exposed.

Capillary Hemangioma of the Maxillary Sinus: A Rare Cause of Massive Life-Threatening Epistaxis.

Hemangioma of the paranasal sinus is an infrequent condition. Two types of hemangioma are present at the nose; cavernous and capillary. Capillary hemangioma is rare in the sinonasal tract. Patients presented with massive epistaxis should think of nasal hemangioma. Resuscitation of patients is important and urgent Computerized Tomography scans should be performed which will help character and extension of any mass present at the nasal cavity. Initial nasal packing may help to prevent bleeding. We report a case of capillary hemangioma of a 30-year lady present with massive epistaxis initially controlled by Nasal packing. Her CT scan shows a homogenous mass at left maxillary sinuses and underwent left endoscopic sphenopalatine artery ligation and removal of the mass. Supplementary Information: The online version contains supplementary material available at 10.1007/s12070-023-04046-z.

Estimating yield-contributing physiological parameters of cotton using UAV-based imagery.

Lint yield in cotton is governed by light intercepted by the canopy (IPAR), radiation use efficiency (RUE), and harvest index (HI). However, the conventional methods of measuring these yield-governing physiological parameters are labor-intensive, time-consuming and requires destructive sampling. This study aimed to explore the use of low-cost and high-resolution UAV-based RGB and multispectral imagery 1) to estimate fraction of IPAR (IPARf), RUE, and biomass throughout the season, 2) to estimate lint yield using the cotton fiber index (CFI), and 3) to determine the potential use of biomass and lint yield models for estimating cotton HI. An experiment was conducted during the 2021 and 2022 growing seasons in Tifton, Georgia, USA in randomized complete block design with five different nitrogen treatments. Different nitrogen treatments were applied to generate substantial variability in canopy development and yield. UAV imagery was collected bi-weekly along with light interception and biomass measurements throughout the season, and 20 different vegetation indices (VIs) were computed from the imagery. Generalized linear regression was performed to develop models using VIs and growing degree days (GDDs). The IPARf models had R2 values ranging from 0.66 to 0.90, and models based on RVI and RECI explained the highest variation (93%) in IPARf during cross-validation. Similarly, cotton above-ground biomass was best estimated by models from MSAVI and OSAVI. Estimation of RUE using actual biomass measurement and RVI-based IPARf model was able to explain 84% of variation in RUE. CFI from UAV-based RGB imagery had strong relationship (R2 = 0.69) with machine harvested lint yield. The estimated HI from CFI-based lint yield and MSAVI-based biomass models was able to explain 40 to 49% of variation in measured HI for the 2022 growing season. The models developed to estimate the yield-contributing physiological parameters in cotton showed low to strong performance, with IPARf and above-ground biomass having greater prediction accuracy. Future studies on accurate estimation of lint yield is suggested for precise cotton HI prediction. This study is the first attempt of its kind and the results can be used to expand and improve research on predicting functional yield drivers of cotton.

Photosensitized O2 enables intermolecular alkene cyclopropanation by active methylene compounds.

Cyclopropanes are key features in many preclinical, clinical, and commercial drugs, as well as natural products. The most prolific technique for their synthesis is the metal-catalyzed reaction of an alkene with a diazoalkane, a highly energetic reagent requiring stringent safety precautions. Discovery of alternative innocuous reagents remains an ongoing challenge. Herein, we report a simple photoredox-catalyzed intermolecular cyclopropanation of unactivated alkenes with active methylene compounds. The reaction proceeds in neutral solvent under air or dioxygen (O2) with a photoredox catalyst excited by blue light-emitting diode light and an iodine co-catalyst that is either added as molecular iodine or generated in situ from alkyl iodides. Mechanistic investigations indicate that photosensitized O2 plays a vital role in the generation of carbon-centered radicals for both the addition of active methylene compounds to alkenes and the ring closure.

Promoting Healthy Sexual Behaviours through Comprehensive Sexuality Education.

Comprehensive sexuality education is a scientifically accurate global program that encompasses the variable aspects necessary for achieving healthy sexual and reproductive health in children of schoolgoing age. It provides a holistic approach to developing sound knowledge and a positive attitude in a manner that does not blatantly refute the established sociocultural norms but rather delicately treads around them to bust unhealthy practices through age-appropriate measures. It is deemed necessary for health professionals to be appropriately trained to better convey sensitive information regarding sexual and reproductive well-being in a manner that is acceptable and effective, especially in the context of orthodox communities. Keywords: adolescent; medical students; sexual health; sexuality education.

Differential sensitivities of photosynthetic processes and carbon loss mechanisms govern N-induced variation in net carbon assimilation rate for field-grown cotton.

Nitrogen (N) deficiency limits the net carbon assimilation rate (AN), but the relative N sensitivities of photosynthetic component processes and carbon loss mechanisms remain relatively unexplored for field-grown cotton. Therefore, the objective of the current study was to define the relative sensitivity of individual physiological processes driving N deficiency-induced declines in AN for field-grown cotton. Among the potential diffusional limitations evaluated, mesophyll conductance was the only parameter substantially reduced by N deficiency, but this did not affect CO2 availability in the chloroplast. A number of metabolic processes were negatively impacted by N deficiency, and these effects were more pronounced at lower leaf positions in the cotton canopy. Ribulose bisphosphate (RuBP) regeneration and carboxylation, AN, and gross photosynthesis were the most sensitive metabolic processes to N deficiency, whereas photosynthetic electron transport processes, electron flux to photorespiration, and dark respiration exhibited intermediate sensitivity to N deficiency. Among thylakoid-specific processes, the quantum yield of PSI end electron acceptor reduction was the most sensitive process to N deficiency. It was concluded that AN is primarily limited by Rubisco carboxylation and RuBP regeneration under N deficiency in field-grown cotton, and the differential N sensitivities of the photosynthetic process and carbon loss mechanisms contributed significantly to photosynthetic declines.

High-altitude illness: Menace in Himalayas of Nepal.

Nepal is a country of Himalayas including Mt Everest, the tallest mountain in the world, where a lot of people travel to high altitudes. Significant number of people develop high-altitude illness which includes acute mountain sickness (AMS), high altitude pulmonary edema (HAPE) and high-altitude cerebral edema (HACE) leading even to death. Addressing this issue demands more efforts on both the preventive and treatment aspects to decrease the sufferings of people in this modern time of advanced healthcare and technology.

Microscopic assisted excision of a rare posterior triangle branchial cyst.

Branchial cyst is a painless mass commonly located in the anterior triangle of the neck. It is rarely found in the posterior triangle of the neck. A computed tomography scan of the neck is important to see the extent of the anomaly and its relationship with the major vessel.

Pseudoaneurysm of the proximal superficial femoral artery following blunt trauma in a footballer: A rare case report.

Pseudoaneurysm of superficial femoral artery without any femoral fracture following blunt trauma is a rare clinical entity. Most cases of pseudoaneurysm of superficial femoral artery present to the hospital following penetrating injury, femoral fracture, and surgical procedures. Failure of management of pain despite taking analgesics should lead to suspicion of pseudoaneurysm.

Giant multinodular goiter for 24 years; hidden in a village in Western Nepal.

Here, we present the case of a giant multinodular goiter with retrosternal extension in an old lady with dyspnea for 3 months. The patient was treated with microscopic-assisted total thyroidectomy without any postoperative complications.

Operational Gaps in Implementing the COVID-19 Case Investigation and Contact Tracing in Madhesh Province of Nepal, May-July 2021.

In Nepal, case investigation and contact tracing (CICT) was adopted as an important public health measure to reduce COVID-19 transmission. In this study, we assessed the performance of CICT in Madhesh Province of Nepal against national benchmarks, using routine programmatic data reported by district CICT teams. Between May and July 2021, 17,943 COVID-19 cases were declared in the province, among which case investigation was performed for 30% (95% CI: 29.6-31.0%) within 24 h (against 80% benchmark). As a result of case investigations, 6067 contacts were identified (3 contacts per 10 cases), of which 40% were traced and tested for SARS-CoV-2 infection (against 100% benchmark). About 60% of the contacts tested positive. At most 14% (95% CI: 13.1% to 14.9%) of traced contacts underwent a 14-day follow-up assessment (against 100% benchmark). We found the performance of the CICT program in Madhesh Province to be sub-optimal and call for corrective measures to strengthen CICT in the province and the country at large. Similar studies with wider geographical scope and longer time frames are needed to identify and address deficiencies in data recording and reporting systems for COVID-19, in low- and middle-income countries like Nepal and others.

COVID-19 Amongst Travelers at Points of Entry in Nepal: Screening, Testing, Diagnosis and Isolation Practices.

WHO recommends surveillance for COVID-19 among travelers at Points of Entry (POE) to countries. At 13 selected POE at the Nepal-India border, between March 2021 and July 2021, we describe the screening, testing, diagnosis and isolation practices of COVID-19 amongst travelers. Those who stayed in India or elsewhere for > one day and those who did not have a negative RT-PCR result within the last 72 h of travel were tested for COVID-19 with rapid antigen diagnostic tests. Daily surveillance reports maintained at POE were used for analysis. Of 337,338 travelers screened, 69,886 (21%) were tested and 3907 (6%) were diagnosed with COVID-19. The proportions tested averaged 15% during April-May when screened numbers were high and increased to 35% in July when screened numbers had decreased. The proportions diagnosed positive peaked at 10% in April-May, but decreased to below 1% in June and July. Testing coverage varied from 0−99% in the different POE. Most COVID-19 cases were Nepalese, male, <60 years of age, migrant workers and presented with fever. Of COVID-19 cases, 32% had home-based isolation, 64% underwent community-based isolation and the remainder either went to hospital or returned to India. In conclusion, about one fifth of travelers overall were tested, with coverage varying considerably over time and among different POE. Strengthening surveillance processes at POE is needed.

Endoscopic management of huge pleomorphic adenoma of the nasal septum; a case report.

Introduction: and Importance: Pleomorphic adenoma (PA) is one of the most common benign tumors of the salivary glands. They can develop in all the salivary glands, but it most commonly occurs in the parotid gland, followed minor salivary gland. It may occurs at the hard and soft palate, lips, cheeks, gingiva, and nasal septum. PA of the nasal septum is a rare tumor. Case presentation: 72-year-old female was diagnosed with pleomorphic adenoma of the nasal septum which was successfully treated by endoscopic endonasal surgical excision. Clinical discussion: Pleomorphic adenoma of the nasal septum was rare tumor may mimic with hemangioma of nose. Diagnostic nasal endoscopy, Computerized tomography and Magnetic resonance imaging are diagnostic to see extent and vascularity of tumor. Endoscopic endonasal approach with microdebrider can help removal of tumor. Conclusion: Pleomorphic adenoma of nasal septum is a rare diagnosis may mimic hemangioma. Endoscopic endonasal approach with microdebrider can be performed in highly vascular masses of the nose in selected cases.