Awareness and Knowledge of Glaucoma and their Associated Factors among People Visiting a Tertiary Level Hospital in Central Nepal.

Background Glaucoma is one of the major causes of irreversible blindness globally. Almost 60 million people globally are affected by glaucoma making it the second leading cause of blindness worldwide. Diagnosis of glaucoma early on is vital for timely management and prevention of blindness. However, it is challenging to diagnose it early because it is asymptomatic in the initial stage, and there is also the dearth of appropriate screening tools. Awareness, knowledge, and beliefs are believed to influence the treatment-seeking behavior of people as well as their uptake of services. Objective To assess the awareness and knowledge about glaucoma among general patients and patient attendants visiting Dhulikhel Hospital. Method We conducted a cross sectional quantitative study among general patients visiting Dhulikhel Hospital. We collected data using face-to-face interviews with semistructured questionnaires. We analyzed data in R version 4.0.3 (2020-10-10). We presented numerical variables as mean and standard deviation whereas categorical variables as frequency and percentage. We determined factors associated with awareness and knowledge of glaucoma using logistic regression analysis and estimated adjusted odds ratio (AOR) with 95% confidence interval. Result Of 379 participants, a total of 214 (56.5%) participants had heard about glaucoma. Out of the participants who heard about glaucoma, the mean knowledge score was 48.3±21.7 and 53.3% had good knowledge on glaucoma. The odds of having heard about glaucoma were two percent lower (AOR=0.98; 95%CI: 0.97-0.99; p-value 0.036) in the older participants compared to one year younger participant, 1.98 (95%CI:1.01-3.86; p-value 0.046) times higher among literates and 2.79 (95%CI: 1.76- 4.41; p-value < 0.001) times among participants with previous ocular examination. The odds of having good knowledge was 1.94 (95%CI: 1.10-3.42; p value 0.021) times among participants with previous ocular examinations. Conclusion The knowledge and awareness regarding glaucoma in a hospital-visiting population in central Nepal was low. Half of the participants were unaware of the disease glaucoma and half of the participants who heard of the glaucoma had poor knowledge on glaucoma.

Awareness and Knowledge of Glaucoma and their Associated Factors among Staffs in a Tertiary-level Hospital in Central Nepal.

Background Since glaucoma-related blindness may only be prevented with early identification and treatment, finding asymptomatic individuals in the target population is critical. It is thus important to determine the awareness and knowledge on glaucoma. Objective To determine the knowledge and awareness on glaucoma among the staff of a tertiary level hospital in central Nepal. Method This was a cross sectional study among the staffs of Dhulikhel Hospital who participated voluntarily in the study. The data was collected through the administration of semi-structured questionnaires. R version 4.0.3 (2020-10-10) was used for the data analysis. Categorical variables are presented as frequency (percentages) and the numerical ones are presented as mean (standard deviation). Adjusted odds ratio (AOR) with 95% confidence interval were estimated through logistic regression analysis for determining factors associated with awareness and knowledge of glaucoma. Result A total of 107 (89.2%) participants had heard about glaucoma of which 93 (86.9%) had good knowledge and 14(13.1%) had poor knowledge on glaucoma. The mean score of knowledge was 64.1±16.9. Only 47.7% of the participants said that glaucoma also has an asymptomatic course. We could not find an association of awareness and knowledge of glaucoma with any of the selected sociodemographic variables. Conclusion Although there was a fairly good glaucoma related awareness and knowledge among hospital staff, we found lack of understanding on some critical issues on glaucoma, mainly related to its asymptomatic nature. There is thus room for improvement in educating about glaucoma even in healthcare settings. Given the necessity of expanding glaucoma awareness in the public, hospital staff might potentially serve as messengers to the communities.

Demographics and Awareness of Diabetic Retinopathy among Diabetic Patients Attending Department of Ophthalmology at Dhulikhel Hospital.

Background Diabetes mellitus is considered as a major public health concern globally. Poor management of diabetes may lead to several serious complications including endstage renal disease, diabetic retinopathy, diabetic neuropathy, and cardiovascular complications. Among them diabetic retinopathy is one of the leading causes of visual impairment and blindness in Nepal. Objective To assess the demographics and level of awareness among individuals with diabetes about diabetic retinopathy during their visit to Department of Ophthalmology at Dhulikhel Hospital. Method A descriptive cross-sectional study was conducted involving all consecutive cases of diabetes mellitus who attended eye clinic with the principal investigator and co-investigator from March 2021 to August 2021. Detailed demographics of the participants, their level of awareness regarding diabetic retinopathy and associated complications were documented. This was followed by a detailed ocular examination intending to screen for the presence of features of diabetic retinopathy. Result A total of 260 patients with a mean age of 54 years ± 12.20 (range of 24 - 85 years) were included. The male to female ratio was 2.2:1. Among them, 65.4% of the patients had diabetes mellitus for less than 5 years duration. Diabetic retinopathy was found in 18.46% of the cases. Awareness of diabetic ocular complications was significantly higher among literate population (p = 0.054), among those who have positive family history of diabetes mellitus (p = 0.529) and those who had undergone prior fundus evaluation (p = 0.000). Conclusion From result of this study, we can emphasize that there is a necessity for health education in order to increase the awareness and knowledge about diabetic retinopathy to lower the burden of sight threatening complications related with the issue.

Online Education Status at Dental Colleges During COVID-19 Pandemic in Nepal.

Background The COVID-19 pandemic has caused lockdown situation impeding all educational institutions including dental colleges. The circumstance demanded online classes as the alternative strategy for continuation of education. Objective To assess current practice and perception about online education among faculties of dental colleges in Nepal. Method A cross-sectional study was conducted among 208 faculties of all dental colleges in Nepal. Data collection was done through structured online questionnaire comprising demographic information, practice and perception of the respondents towards online education. Descriptive statistics surveyed the frequency distribution and Chisquare test assessed the difference in perception among the faculties of different universities. Result The response rate was 74.3%. Faculties commonly used PowerPoint presentation (96.6%) on Zoom platform (83.3%) using laptop (94.7%) with Wi-Fi connection (91.8%). Majority of faculties had good or satisfactory access to internet (94.8%). The faculties believed that the online class environment was interactive (95.2%); but it was not effective (86.5%) as live classroom. Majority of the faculties (79.4%) felt tracking of students' presence was difficult. There was no significant difference on perception towards online class among the faculties of Kathmandu University, Tribhuvan University and BP Koirala Institute Health Sciences at p < 0.05. Conclusion The COVID-19 pandemic has paved the way for e-learning in dental education in Nepal. Faculties agree to complete the theory syllabus and conduct sessional exams as an alternative during the lockdown period. However, they show strong reservations in carrying out practical/clinical simulations and university exams online. Training on e-learning and institutional strategy for online education is recommended.

Correlation Between Oral Health and Body Mass Index among Nepalese Teachers.

Background Health problems like high body weight and oral diseases have the same essential risk factors as the inflammatory nature of obesity and periodontal disease are widely recognized. Body Mass Index and oral health indices are correlated and may be a confounder of disease status. Objective To assess oral health status and Body Mass Index of school teachers of Kathmandu valley and to find the correlation between them. Method A cross sectional study with purposive sampling was done on 100 Nepalese teachers to assess Body Mass Index, Community Periodontal Index and Decayed Missing Filled Teeth index. Mann-Whitney U-test, crude and adjusted odds ratio were used to analyze the difference between periodontal status based on Community Periodontal Indexscores in relation to age, Body Mass Index, Decayed Missing Filled Teeth. Result The prevalence of periodontal disease according to Community Periodontal Index score was: bleeding on probing 14%, calculus 34%, pocket depth 4-5 mm 35%, pocket depth ≥ 6 mm 12%. The mean Decayed Missing Filled Teeth index was 4.41, and mean number of teeth present was 29.22. According to Body Mass Index score; 10% were underweight, 38% overweight and 2% obese. There were significant differences in age, Body Mass Index and number of teeth present between the control and periodontitis groups. Logistic regression analysis revealed that the risk of periodontal disease increased with age, and there is an increased risk of periodontitis by 39% for each 1 kg/m2 Body Mass Index increase. Conclusion There is increased risk of periodontitis with gain in Body Mass Index in teachers of Kathmandu valley.

Herders' perceptions of and responses to climate change in northern Pakistan.

Migratory pastoralism is an adaptation to a harsh and unstable environment, and pastoral herders have traditionally adapted to environmental and climatic change by building on their in-depth knowledge of this environment. In the Hindu Kush Himalayan region, and particularly in the arid and semiarid areas of northern Pakistan, pastoralism, the main livelihood, is vulnerable to climate change. Little detailed information is available about climate trends and impacts in remote mountain regions; herders' perceptions of climate change can provide the information needed by policy makers to address problems and make decisions on adaptive strategies in high pastoral areas. A survey was conducted in Gilgit-Baltistan province of Pakistan to assess herders' perceptions of, and adaptation strategies to climate change. Herders' perceptions were gathered in individual interviews and focus group discussions. The herders perceived a change in climate over the past 10-15 years with longer and more intense droughts in summer, more frequent and heavier snowfall in winter, and prolonged summers and relatively shorter winters. These perceptions were validated by published scientific evidence. The herders considered that the change in climate had directly impacted pastures and then livestock by changing vegetation composition and reducing forage yield. They had adopted some adaptive strategies in response to the change such as altering the migration pattern and diversifying livelihoods. The findings show that the herder communities have practical lessons and indigenous knowledge related to rangeland management and adaptation to climate change that should be shared with the scientific community and integrated into development planning.

Ruptured primary ovarian pregnancy: a rare case report.

Ovarian pregnancy is an uncommon presentation of ectopic gestation and usually, it ends with rupture before the end of the first trimester. Its presentation often is difficult to distinguish from that of tubal ectopic pregnancy and hemorrhagic ovarian cyst. We report a rare primary ruptured ovarian pregnancy in a 26 years lady.

Tweeds analysis of Nepalese people.

The aim of the present study was to establish the Tweed's norms for Nepalese people, compare the values between the Nepalese male and female samples as well as to compare with the Caucasians. One hundred lateral cephalogram was taken by the same x- ray technician and later traced by manually and all three angular parameters Frankfort Mandibular plane Angle (FMA), Frankfort Mandibular Incisal Angle (FMIA), Inciso Mandibular Plane Angle (IMPA) were measured and found to be 28 degrees, 56 degrees and 96 degrees respectively. There was no clinical significant different between Nepalese male and female but there is highly significant among Nepalese and Caucasian.

Causative agents of urinary tract infections in children and their antibiotic sensitivity pattern: a hospital based study.

A retrospective study was conducted to find out the causative agents of urinary tract infection (UTI) in children and their antibiotic sensitivity pattern among Nepalese children. This was done at Kanti Children's Hospital in Kathmandu (Nepal) by analyzing the records of urine samples collected for culture and sensitivity tests over a period of six months (April to November, 2007). Of the total 1878 mid-stream urine samples collected from suspected cases of UTI, 538 (28.6%) were positive for pathogenic organisms. There was no significant difference in growth positive rate in two genders (M: 51.7% and F: 48.3%). Of the various pathogenic organisms isolated, Escherichia coli constituted for 93.3% followed by Proteus sp, Klebsiella sp, Citrobacter sp, Staphylococcus aureus and others. E. coli was found to be most sensitive to amikacin, chloramphenicol, nitrofurantoin and ofloxacin and least sensitive to most commonly used drugs like cephalexin, nalidixic acid, cotrimoxazole and norfloxacin.

Prevalence of Salmonella typhi and paratyphi infection in children: a hospital based study.

The purpose of this study was to find out the prevalence and antibiotic sensitivity pattern of Salmonella typhi and paratyphi isolated from children presenting with fever at Kanti Children's Hospital in Kathmandu, Nepal. A total of 9,856 blood samples collected for culture during one year period (April 2007 to March 2008) were included in the study. Out of total, 235 (2.0%) were positive for S. typhi and paratyphi A. Of the total positive, 195 (83.0%) were S. typhi and 40 (17.0%) were S. paratyphi A. The growth positive rate in two genders (M: 53.2% and F: 46.8%) was not significant (P > 0.05). Over two-third of cases were clustered in the age-group of 1-10 years. The occurrence of infections was common in summer months (rainy season). S. typhi was found to be most sensitive to cefotaxime (100.0%) followed by ceftriaxone (98.9%), ofloxacin (93.5%), cotrimoxazole (93.5%) and chloramphenicol (93.2%) and was least sensitive to amoxyccilin (66.7%) followed by ciprofloxacin (86.6%). S. paratyphi also was found to be most sensitive to cefotaxime (100.0%), followed by ceftriaxone (97.4%), cotrimoxazole (97.1%) and chloramphenicol (92.5%) and was least sensitive to amoxycillin (15.0%) followed by ciprofloxacin (51.3%) and ofloxacin (70.3%).

A review of foot and mouth disease in Nepal.

Foot and mouth disease (FMD) causes substantial economic losses to the predominantly agricultural community of the Kingdom of Nepal. FMD is endemic in the country and four of the seven serotypes of FMD virus have been isolated (O, A, C and Asia 1). The epidemiology of FMD and the factors which play a role in its prevalence and spread are outlined. The National Epidemiological Laboratory for FMD has been established in Kathmandu and its diagnostic capabilities and activities are described. The important points to be considered in the formulation of any future regional or national control programme for FMD in Nepal are discussed.

Association between weight for age and mid-upper arm circumference measurement: findings from Malawi.

Anthropometric methods involving measurement of weight-for-height, height-for-age, weight-for-age, and mid-upper arm circumference have been extensively researched to identify an appropriate method of monitoring infant and child growth. Many countries have adopted weight for age as the main practical method. The Malawi Ministry of Health introduced weight for age based upon WHO recommended standards as a growth indicator in 1973. There are, however, difficulties in making the practice widely used at community level. In the present study, confined to the four urban areas of Malawi, a comparison was made between the weight-for-age (W/A) and mid-upper arm circumference (MUAC) measurements. A very good correlation was observed between the two methods of screening for identification of undernourished children from 4 months of age onwards. Correct use of MUAC was found to be as effective as W/A in detecting undernutrition.

Association between weight for age and mid-upper arm circumference measurement: findings from Malawi

Anthropometric methods involving measurement of weight-for-height; height-for-age; weight-for-age; and mid-upper arm circumference have been extensively researched to identify an appropriate method of monitoring infant and child growth. Many countries have adopted weight for age as the main practical method. The Malawi Ministry of Health introduced weight for age based upon WHO recommended standards as a growth indicator in 1973. There are; however; difficulties in making the practice widely used at community level. In the present study; confined to the four urban areas of Malawi; a comparison was made between the weight-for-age (W/A) and mid-upper arm circumference (MUAC) measurements. A very good correlation was observed between the two methods of screening for identification of undernourished children from 4 months of age onwards. Correct use of MUAC was found to be as effective as W/A in detecting undernutrition. Author.90.Z1-542-363-300901107

Interim evaluation by WFP/FAO/WHO/UNICEF mission of project Malawi 525 expansion III supplementary feeding of vulnerable groups and appraisal of the expansion request: conclusions and recommendations of the mission

The mission concludes that further support for the supplementary feeding programme is fully warranted in view of the high levels of malnutrition

Breast-feeding and weaning practices in urban areas of Malawi

This study assesses the existing situation of breast feeding and weaning practices in urban areas of Malawi with the intention of establishing programmes to promote breast feeding and better weaning