Organophosphorus Poisoning among Acute Poisoning Cases Presenting to the Emergency Department of a Secondary Care Centre: A Descriptive Cross-sectional Study.

Introduction: Organophosphorus is an easily available compound, especially in agriculture and farming related areas. This study evaluated organophosphorus poisoning among the population in those high-risk areas. The main objective of this study is to find out the prevalence of organophosphorus poisoning among acute poisoning cases presenting to the Emergency Department of a secondary care centre. Methods: A descriptive cross-sectional study was conducted among 427 patients presenting to the Emergency Department in a secondary care centre from 17th July, 2018 to 14th January, 2022. Ethical clearance was taken from the Institutional Review Committee (Reference number: 01/2075-76). All the patients presenting to the Emergency Department were included and the patients without consent, patients with trauma, accident, severe illness and other emergency conditions were excluded. A convenience sampling was done. Data were collected and entered in Microsoft Excel version 2007 and analyzed using Statistical Package for the Social Science version 25.0. Point estimate at 95% Confidence Interval was calculated along with frequency and percentage for binary data. Results: Out of 427 patients, 203 (47.54%) (42.80-52.28 at 95% Confidence Interval) had organophosphorus poisoning. It was most commonly seen in the age group 16-30 years among 103 (50.74%). Conclusions: The prevalence of organophosphorus poisoning in our study was similar when compared to other studies conducted in similar settings. Most of the organophosphorus poisoning cases were intentional and suicidal which is similar to other studies. Keywords: acetaminophen; emergency departments; organophosphorus poisoning; prevalence.

GeneXpert Based Confirmed Cases among Suspected Cases of Tuberculosis in a Tertiary Care Centre: A Descriptive Cross-sectional Study.

Introduction: Tuberculosis is an infectious disease caused by Mycobacterium tuberculosis mostly affecting the lungs. Due to the low sensitivity of conventional microscopy and time-consuming culture method, Nucleic acid Amplification Assay Technique is preferred because of its rapidity and sensitivity. This test also helps in finding drug resistance to Rifampicin and also curtails the transmission of disease. The study is aimed to find the prevalence of GeneXpert confirmed cases among suspected cases of tuberculosis in a tertiary care centre. Methods: A descriptive cross-sectional study in 104 patients was conducted in a tertiary care centre from 30th Dec 2021 to 3rd Feb 2022. Ethical clearance was taken from the Institutional Review Committee (Reference number: 464/078/079). Sputum samples were collected from patients and were processed for GeneXpert under biological safety standards. GeneXpert Mycobacterium tuberculosis/rifampicin assay, sample processing, deoxyribonucleic acid extraction, and deoxyribonucleic acid amplification occurred in a fully automated cartridge-based real-time Polymerase chain reaction. A convenience sampling method was done. Collected data were coded as per variables and entered in Statistical Package for the Social Sciences version 25. Point estimate at 95% Confidence Interval was calculated along with frequency and percentage for binary data. Results: In all 104 patients, GeneXpert detected 10 (9.62%) (3.94-15.26 at 95% Confidence Interval) positive tuberculosis cases. Out of total positive cases, there were 6 (60%) males and 4 (40%) females and there was 1 (10%) rifampicin-resistant case. Conclusions: The prevalence of pulmonary tuberculosis among presumptive cases in our study was found to be similar to reported literature. Keywords: multidrug-resistant; nucleic acid amplification test; pulmonary tuberculosis.

Sickle Cell Anaemia among Tharu Population Visiting the Outpatient Department of General Medicine in a Secondary Care Centre: A Descriptive Cross-sectional Study.

INTRODUCTION: Sickle cell anaemia is a global health issue in which a mutation of the ß-globin gene changes normal haemoglobin in sickle-shaped red blood cells. The objective of this study was to find out the prevalence of sickle cell anaemia among the Tharu population visiting the outpatient Department of General Medicine in a secondary care centre. METHODS: A descriptive cross-sectional study was conducted among the Tharu population in the Department of General Medicine of a secondary care centre from 10 January 2020 to 10 June 2022. Ethical approval was taken from the Institutional Review Committee of the same institute (Reference number: 590/2076-077). A convenience sampling technique was used. Point estimate and 95% Confidence Interval were calculated. RESULTS: Out of 409 patients, 60 (14.67%) (11.24-18.10, 95% Confidence Interval) had sickle cell anaemia. Among them, 45 (75%) patients had sickle cell trait and 15 (25%) patients had sickle cell disease. CONCLUSIONS: The prevalence of sickle cell anaemia was higher when compared to other studies conducted in similar settings. The government needs to emphasise more effort in diagnosing cases as well as increasing the testing centre.

Evaluating financial sustainability along the sanitation value chain using a financial flow simulator (eSOSView™).

A majority of the world's population use onsite sanitation systems, which store or treat excreta close to where it is generated. Sludge from these systems needs to be managed through a series of stages, known as the sanitation value chain. There is a huge diversity of service providers, not only within each part of the chain, but also along the chain bridging the different components. These service providers are linked not only by the flow of materials, but also by the transfer of money. Therefore for this system to be considered financially sustainable all services from the toilet to reuse or disposal need to be considered. A tool has been developed (eSOSView™) to simulate, evaluate, and optimise the financial flows along and within the sanitation value chain. In this paper eSOSView™ was tested, validated (using existing data), and piloted (including data collection). This paper demonstrates how eSOSView ™ can be used to evaluate different financial flow models, to assess financial sustainability in different parts of the sanitation value chain and optimise the financial sustainability along the sanitation value chain.

Non-HIV talaromycosis: Radiological and clinical analysis.

To investigate the characteristics of spiral computed tomography (CT), positron emission tomography-computed tomography (PET/CT) and clinical manifestations of talaromycosis to improve the diagnostic level and deepen its recognition in radiology.Radiological, clinical, and pathological manifestations of 15 patients of non-HIV talaromycosis confirmed by bronchofiberscope lung biopsy and/or abscess puncture fluid culture and/or blood culture and/or sputum culture were analyzed retrospectively. All patients underwent chest CT, among them, six had a brain MRI, and six had a PET/CT scan before treatment.On plain CT scan, there were multiple patches and massive consolidation in 6 patients, multiple patchy consolidations and patchy ground-glass opacities in 3 patients, solitary or multiple nodules and masses in 3 patients, multiple cavities and small nodules in 3 patients. Multiple lymphadenectasis appeared in bilateral hila, mediastinum, and neck in 10 patients. In contrast CT scan, the parenchyma of the lesions had a slight enhancement in 10 patients, moderate enhancement in 3 patients, obvious enhancement in 2 patients. Seven cases had bone destruction and hyperplasia, cranial involvement in 1 patient and liver involvement in 3 patients, respectively. On PET/CT, five patients showed elevated standard uptake value (SUV).The radiological manifestations of non-HIV talaromycosis show multiple consolidations, ground-glass opacities, multiple nodules or masses in bilateral lungs, deep-seated enlarged lymph nodes and bone destruction in multiple systems. The final diagnosis should be based on the culture of talaromycosis.

Prevalence of Cardiovascular Risk Factors in Apparently Healthy Urban Adult Population of Kathmandu.

BACKGROUND: Cardiovascular diseases account for most deaths and major proportion of disabilities worldwide. Major cardiovascular risk factors are implicated in almost 75% of cardiovascular diseases. There has been a rapid increase in prevalence of such risk factors in apparently healthy young adults of urban population. This study aimed to find prevalence of such risk factors in order to implement preventive strategies against cardiovascular diseases in our setting. METHODS: A free heart camp was organized following wide dissemination of information through print, online, TV, radio and social media. Pretested data collection tool was used by trained enumerators using standard guidelines and calibrated devices. Demographic, anthropometric, physical examination and blood investigation data were obtained. Standard guidelines were followed to define and categorize the obtained information. Data was analyzed using SPSS V20. RESULTS: A total of 5530 participants were enrolled after carefully applying inclusion and exclusion criteria. Mean age of study population was 38.14±13.03 years. There were 3298 (59.6%) males with mean age of 37.67±12.99 years and 2232 (40.4%) females with mean age of 38.84±13.05 years. Majority of study population (29.6%) belonged to 30-39 years age group. Prevalence of tobacco and alcohol consumption was 29.3%(95%CI:28.1-30.5) and 32.7%(95%CI:31.5-34.) respectively. Prevalence of inadequate fruits and vegetables intake, low physical activity and overweight or obesity was 75.4%(95%CI:74.3-76.6), 61.1%(95%CI:59.8-62.4) and 41.3%(95%CI:40.0-42.6) respectively. Prevalence of hypertension, diabetes and dyslipidemia was 26.4%(95%CI:25.3-27.6), 5.3%(95%CI:4.7-5.9) and 86.9%(95%CI:85.9-87.7) respectively. These results were statistically significant in both age and sex based distribution. CONCLUSIONS: Prevalence of major cardiovascular risk factors in apparently healthy adult population of Kathmandu Valley was high. Dyslipidemia, unhealthy diet, physical inactivity and overweight or obesity were most prevalent cardiovascular risk factors.