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1.
PLoS One ; 17(5): e0265993, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35536839

RESUMO

BACKGROUND: Nepal has implemented the social health security program in certain health facilities to improve access to quality health services. The aim of the study is to understand the utilization pattern of social health security schemes and community's perception of the social health security program. METHOD: A descriptive cross-sectional mixed-method study was conducted among 300 households of Illam district who had enrolled in the social health security scheme. A multi-stage random sampling method was used. A semi-structured questionnaire was used to collect quantitative data whereas focus group discussions (FGDs) were conducted for qualitative data. Descriptive analysis, bivariate and multivariate analysis was done. FGDs were transcribed and thematic analysis was done. FINDINGS: The utilization rate of social health security scheme was 88.7%. Factors associated with the utilization of program included: presence of under-five children and chronic illness in households, sex and age group. Focus group discussion revealed that people were aware of social health insurance and pleased with program implemented by government. However, the hospitals under the social health insurance were not able to meet their expectations. CONCLUSION: Although the utilization of social health security scheme was high, people were dissatisfied with the service provided by the hospital under the social health security scheme. Therefore, the social health insurance board should closely monitor the hospitals and develop a feedback mechanism from the users.


Assuntos
Características da Família , Seguro Saúde , Criança , Estudos Transversais , Humanos , Renda , Nepal
3.
BMC Infect Dis ; 22(1): 422, 2022 May 03.
Artigo em Inglês | MEDLINE | ID: mdl-35505278

RESUMO

BACKGROUND: Vaccination is the most effective method to prevent the spread of infectious diseases and helps reduce mortality rate and economic costs associated with the pandemic. Despite these advantages, misinformation on vaccine safety and efficacy can lead to increased hesitation towards vaccination. This study reports the incidence of adverse events following Covishield vaccination, their associated factors, medication used for their management, and attitudes about vaccine safety. METHODS: A cross-sectional study was conducted from the sample of Covishield-vaccinated individuals from a secondary hospital, two primary health centres, and 36 health posts in eastern Nepal. Individuals (n = 602) were randomly sampled from a population (n = 1013) who had received the first dose of Covishield, namely frontline workers and other high-risk populations. The second-round follow-up had 516 participants. Association of incidence and severity of post-vaccination events with socio-demographic variables, comorbidity status, and medication use were estimated. RESULTS: Among the 79.9% of participants who reported adverse events after receiving the first dose, two-thirds of complaints were mild (67.4%, 95% CI 63.2-71.6) with the most common complaint being pain at the injection site (86.5%). Paracetamol or its combination with NSAIDs were used in the majority of cases (95.2%). After the second dose, only 31.2% (95% CI 27.2-35.2) reported adverse events, the overwhelming majority of which were mild (95.7%) and required a lower frequency of medication (7.5% vs. 26.0%). Adverse event following immunization were significantly associated with being 18-30 years old (χ2 = 16.9, df = 3, p < 0.001) and female gender (χ2 = 5.2, df = 1, p < 0.05). Prior to the first dose, 86.0% of participants (95% CI 83.3-88.8%) perceived the vaccine to be safe, and 96.0% recommended the vaccine post-vaccination, while 96.8% were interested in receiving the second dose. AEFI severity was negatively associated with vaccine recommendation to the peers (odds-ratio 0.062, p < 0.05) following the first dose, whereas, the optimistic pre-vaccination perception was associated with positive vaccine recommendation post-vaccination (odds-ratio 28.658, p < 0.01). CONCLUSIONS: Overall, vaccination-associated events were mild and majority were managed with paracetamol or its combination. Effective counselling about adverse events before vaccination should be prioritized to reduce hesitation and fear.


Assuntos
Vacinas contra Influenza , Influenza Humana , Acetaminofen , Adolescente , Adulto , Estudos Transversais , Feminino , Humanos , Influenza Humana/epidemiologia , Nepal/epidemiologia , Vacinação/efeitos adversos , Adulto Jovem
4.
BMJ Open ; 12(5): e057062, 2022 May 09.
Artigo em Inglês | MEDLINE | ID: mdl-35534057

RESUMO

OBJECTIVES: To assess the attitude of medical students towards cultural diversity aiming to elucidate our current status in understanding cultural awareness and sensitivity. DESIGN, SETTING AND PARTICIPANTS: A web-based cross-sectional study was carried out among 601 undergraduate health science students (medical and dental courses) at a health sciences university in eastern Nepal via various modes of social-media platforms like WhatsApp, Messenger, Gmail, etc. OUTCOME MEASURES: Medical students' attitude towards cultural diversity and its association with the sociodemographic profile of the students. RESULTS: A total of 601 students participated in the study, out of which, 64.2% were men with a sex ratio of 1.8:1 and a mean age of 22.3±1.9 years. More than two-thirds (77.2%) of the students had an excellent to good attitude towards cultural diversity. The proportion of students reporting 'excellent' attitude towards cultural diversity was higher among male students compared with female students (37.8% vs 20.5%) and students aged >22 years compared with younger students (37.1% vs 26.7%). Gender (p<0.001) and age (p=0.009) were significantly associated with the attitude towards cultural diversity. CONCLUSIONS: Medical students, in general, are aware of the impacts of a cross-cultural society on the delivery of quality healthcare and also about the need to be aware of prejudices doctors may have towards certain cultures. Majority suggest the inclusion of concepts of multicultural awareness and sensitivity in the medical curriculum itself.


Assuntos
Estudantes de Medicina , Adulto , Atitude do Pessoal de Saúde , Estudos Transversais , Diversidade Cultural , Currículo , Feminino , Humanos , Masculino , Nepal , Inquéritos e Questionários , Universidades , Adulto Jovem
5.
Biomed Res Int ; 2022: 6840409, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35601142

RESUMO

This study is aimed at isolating and identifying a thermophilic cellulolytic bacterium from hot spring water and characterizing thermostable cellulase produced by the isolate. Enrichment and culture of water sample was used for isolation of bacterial strains and an isolate with highest cellulase activity was chosen for the production, partial purification, and biochemical characterization of the enzyme. Different staining techniques, enzymatic tests, and 16s ribosomal DNA (16s rDNA) gene sequencing were used for the identification of the isolate. The cellulase producing isolate was Gram positive, motile, and sporulated rod-shaped bacterium growing optimally between 55°C and 65°C. Based on partial 16s rDNA sequence analysis, the isolate was identified as Geobacillus sp. and was designated as Geobacillus sp. KP43. The cellulase enzyme production condition was optimized, and the product was partially purified and biochemically characterized. Optimum cellulase production was observed in 1% carboxymethyl cellulose (CMC) at 55°C. The molecular weight of the enzyme was found to be approximately 66 kDa on 12% SDS-PAGE analysis. Biochemical characterization of partially purified enzyme revealed the temperature optimum of 70°C and activity over a wide pH range. Further, cellulase activity was markedly stimulated by metal ion Fe2+. Apart from cellulases, the isolate also depicted good xylanase, cellobiase, and amylase activities. Thermophilic growth with a variety of extracellular enzyme activities at elevated temperature as well as in a wide pH range showed that the isolated bacteria, Geobacillus sp. KP43, can withstand the harsh environmental condition, which makes this organism suitable for enzyme production for various biotechnological and industrial applications.


Assuntos
Celulase , Geobacillus , Fontes Termais , Celulase/química , DNA Ribossômico , Estabilidade Enzimática , Geobacillus/genética , Fontes Termais/microbiologia , Temperatura Alta , Concentração de Íons de Hidrogênio , Nepal , Filogenia , Temperatura , Água
6.
Global Health ; 18(1): 42, 2022 04 20.
Artigo em Inglês | MEDLINE | ID: mdl-35443701

RESUMO

BACKGROUND: Child undernutrition continues to be a major public health problem in many countries, including Nepal. The repercussions of undernutrition are not only limited to the affected children and families but also transcend to the national and global economy. Earlier studies from Nepal have predominantly used either ordinary least squares (OLS) regression or binary regression to analyse the socioeconomic and demographic correlates of the nutritional outcome. In this study, quantile regression was used to understand a complete and more precise estimate of the effects of the covariates on the child nutritional status. METHODS: This study was based on the most recent nationally representative Nepal Multiple Indicator Cluster Survey (MICS) 2019. Height-for-age z scores (HAZ) were used as an indicator for assessing the nutritional status of under-five children. Quantile regression was used to examine the heterogeneous association of covariates with conditional HAZ distribution across the different quantiles (0.10, 0.30, 0.50, 0.85). As a comparison, the effects of covariates at conditional mean of HAZ using OLS regression was also analysed. The graphs were plotted to visualize the changes in the coefficients for each regressor across the entire conditional HAZ distribution. RESULTS: Age of children, sex of children, province and wealth had a consistent and statistically significant association with HAZ in both OLS and quantile regression. Improved toilet facility was positively correlated with HAZ at the lower tails (tenth and thirtieth percentiles). Ethnicity (Janajati and Newer) was positively correlated with HAZ at the lower tail (thirtieth percentile) and mean (OLS regression). Maternal education was a significant predictor of improved height-for-age across conditional quantiles, except at the tenth percentile. Maternal age, number of under-five children in household, number of household members, and improved source of drinking water showed heterogeneous effects across different quantiles of conditional HAZ distribution. CONCLUSION: Use of quantile regression approach showed that the effect of different factors differed across the conditional distribution of HAZ. Policymakers should consider the heterogeneous effect of different factors on HAZ so that the targeted intervention could be implemented to maximize the nutritional benefits to children.


Assuntos
Desnutrição , Estado Nutricional , Criança , Características da Família , Transtornos do Crescimento , Humanos , Lactente , Nepal/epidemiologia , Fatores Socioeconômicos
7.
BMJ Open ; 12(4): e059942, 2022 Apr 22.
Artigo em Inglês | MEDLINE | ID: mdl-35459678

RESUMO

OBJECTIVES: Rheumatic fever (RF) and rheumatic heart disease (RHD) remain among the major heart problems among children in Nepal. Although these conditions are preventable and treatable, the lack of proper knowledge and resources to diagnose and manage these conditions in rural health centres is a key concern. This study assessed the impact of educational sessions to improve the knowledge of healthcare workers in the early recognition, diagnosis, and management of RF and RHD in rural far-western Nepal. DESIGN, SETTING AND PARTICIPANTS: This study used a pretest and post-test interventional design and was conducted among 64 healthcare workers in two primary healthcare centres and a peripheral district-level hospital in Achham district in the far-western region of Nepal. A self-administered questionnaire was used before and after the educational sessions. Data were analysed using SPSS V.21. RESULTS: The overall test scores increased from 10 (SD=2.4) pre-intervention to 13.8 (SD=1.9) post-intervention (p<0.001). Similarly, participant confidence (graded 1-5) in differentiating bacterial from viral sore throat rose from 3.6 (SD=1.08) pre-intervention to 3.98 (SD=1.09) post-intervention (p<0.05). Confidence in managing RF increased from 3.9 (SD=0.88) pre-intervention to 4.30 (SD=0.8) post-intervention (p<0.001). CONCLUSION: The findings suggest that the investigated educational sessions are promising with respect to improving the knowledge and confidence of healthcare workers in the early recognition, diagnosis, and management of RF and RHD at the primary healthcare level. Further studies with a larger sample size and conducted in different parts of the country are warranted to assess the effectiveness and impact of scaling up such educational interventions in Nepal.


Assuntos
Faringite , Febre Reumática , Cardiopatia Reumática , Criança , Pessoal de Saúde , Humanos , Nepal , Febre Reumática/diagnóstico , Febre Reumática/prevenção & controle , Cardiopatia Reumática/diagnóstico , Cardiopatia Reumática/terapia
8.
PLoS One ; 17(4): e0266662, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35413065

RESUMO

BACKGROUND: High dietary salt intake is recognized as a risk factor for several non-communicable diseases (NCDs), in particular cardiovascular diseases (CVDs), including heart attack and stroke. Accurate measurement of population level salt intake is essential for setting targeted goals and plans for salt reduction strategies. We used a spot urine sample to estimate the mean population salt intake in Nepal and evaluated the association of salt intake with excess weight, hypertension, raised blood sugar and hypercholesterolemia, and a number of socio-demographic characteristics. METHODS: A population-based cross-sectional study was carried out from February to May 2019 using a WHO STEPwise approach to surveillance. Spot urine was collected from 4361 participants aged 15-69 years for the analysis of salt intake. We then used the INTERSALT equation to calculate population salt intake. Student's 't' test, one-way ANOVA and multivariable linear regression were used to assess the association between salt intake and a number of factors. Statistical significance was accepted at P < .05. RESULTS: The average (±SD) age of participants was 40 (14.1) years. Mean salt intake, derived from spot urine samples, was estimated to be 9.1g/d. A total of 70.8% of the population consumed more than the WHO's recommended amount of 5g salt per day, with almost one third of the population (29%) consuming more than 10g of salt per day. Higher salt intake was significantly associated with male gender (ß for male = 0.98g; 95%CI:0.87,1.1) and younger age groups (ß25-39 years = 0.08; 95%CI:-0.08,0.23) and higher BMI (ß = 0.19; 95%CI:0.18,0.21). Participants who were hypertensive and had raised blood cholesterol consumed less salt than people who had normal blood pressure and cholesterol levels (P<0.001). CONCLUSIONS: Salt consumption in Nepal is high, with a total of 70.8% of the population having a mean salt intake >5g/d, well above the World Health Organization recommendation. High salt intake was found to be associated with sex, age group, education, province, BMI, and raised cholesterol level of participants These findings build a strong case for action to reduce salt consumption in Nepal in order to achieve the global target of 30% reduction in population salt intake by 2025.


Assuntos
Hipercolesterolemia , Hipertensão , Glicemia , Índice de Massa Corporal , Colesterol , Estudos Transversais , Humanos , Hipercolesterolemia/epidemiologia , Hipertensão/epidemiologia , Masculino , Nepal/epidemiologia , Cloreto de Sódio , Cloreto de Sódio na Dieta/urina
9.
Artigo em Inglês | MEDLINE | ID: mdl-35457618

RESUMO

Individuals' perceived fairness or justice beliefs are related to health in numerous ways. However, environment justice research to date has given little attention to perceived fairness of environmental exposures as experienced by individuals. This study explored the feasibility of a bottom-up digital participatory (via mobile phones) approach using ecological momentary assessment (EMA) to capture individuals' subjective experience of environmental exposures and the subjective evaluation of fairness by those affected in the context of Nepal. In total, 22 individuals participated in the study for 28 days. The results show high rates of study retention and adherence. Individuals' justice perception was found to vary within and between individuals, but also substantially depending on the types of environmental exposures. Nevertheless, the study indicates that uncertainties are inevitable as study design and timing may conflict participants' daily lives and priorities. The method allows us to consider multiple geographic contexts of individuals' everyday lives beyond residential environment. This pilot study proved the possibility to assess perceptions of environmental justice issues and demonstrated the necessary steps to using digital participatory method for assessing subjective perception of fairness of individuals.


Assuntos
Avaliação Momentânea Ecológica , Humanos , Nepal , Projetos Piloto , Projetos de Pesquisa
10.
BMC Oral Health ; 22(1): 107, 2022 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-35365151

RESUMO

BACKGROUND: During the coronavirus disease (COVID-19) pandemic, ordinary dental services were sustained in Nepal. Because a dental practice is considered to involve a high risk of infection, the needs of dentists should be identified, and demand-driven support should be provided. The purpose of this study was to investigate the situation and needs of dentists during the COVID-19 pandemic in order to guide demand-driven support. First, we investigated how the situation of Nepali dentists differed according to their types of practices between private clinics and university/government hospitals. Second, we assessed the characteristics of dentists demanding four types of support: financial, material, technical, and guidelines/guidance support. METHODS: A cross-sectional online questionnaire survey was conducted between July 28th and August 7th 2020. Closed-ended questions were prepared regarding behavior, material availability, economic and psychological impacts, training, and the main support dentists wanted to receive. The situation of dentists between private clinics and university/government hospitals was determined using a chi-squared test for each variable. To examine the association between the characteristics of dentists and four types of support, multivariable logistic regression analyses were used to estimate adjusted odds ratios (ORs) with a 95% confidence interval (CI) for each variable. RESULTS: There were 352 dentists (137 males and 215 females) included in the analysis. Private clinic dentists experienced a bigger economic impact and demanded financial support that 45.5% of them did not receive a salary, compared to 18.9% in university/government hospitals. On the contrary, university/government hospitals experienced lack of PPE and demanded material support that 79.8% had personal protective equipment, compared to 92.5% in private clinics. Financial support was demanded significantly more by male than female dentists (ORs = 5.56; 95% CI = 2.96-10.45). Material support was demanded significantly more by dentists who received training regarding COVID-19 management (ORs = 1.96; 95% CI = 1.01-3.81). Technical support was demanded significantly less by male dentists (ORs = 0.44; 95% CI = 0.23-0.83). Guideline/guidance support was demanded significantly more by dentists who answered that Nepal Dental Association provided appropriate support (ORs = 2.21; 95% CI = 1.25-3.91). CONCLUSION: This study articulated the diverse needs of Nepali dentists during the COVID-19 pandemic. Demand-driven support should be provided in the future.


Assuntos
COVID-19 , Pandemias , COVID-19/epidemiologia , Estudos Transversais , Odontólogos/psicologia , Feminino , Humanos , Masculino , Nepal/epidemiologia , Inquéritos e Questionários
11.
Parasit Vectors ; 15(1): 145, 2022 Apr 24.
Artigo em Inglês | MEDLINE | ID: mdl-35462529

RESUMO

BACKGROUND: Vector-borne diseases are on the rise on a global scale, which is anticipated to further accelerate because of anthropogenic climate change. Resource-limited regions are especially hard hit by this increment with the currently implemented surveillance programs being inadequate for the observed expansion of potential vector species. Cost-effective methods that can be easily implemented in resource-limited settings, e.g. under field conditions, are thus urgently needed to function as an early warning system for vector-borne disease epidemics. Our aim was to enhance entomological capacity in Nepal, a country with endemicity of numerous vector-borne diseases and with frequent outbreaks of dengue fever. METHODS: We used a field barcoding pipeline based on DNA nanopore sequencing (Oxford Nanopore Technologies) and verified its use for different mosquito life stages and storage methods. We furthermore hosted an online workshop to facilitate knowledge transfer to Nepalese scientific experts from different disciplines. RESULTS: The use of the barcoding pipeline could be verified for adult mosquitos and eggs, as well as for homogenized samples, dried specimens, samples that were stored in ethanol and frozen tissue. The transfer of knowledge was successful, as reflected by feedback from the participants and their wish to implement the method. CONCLUSIONS: Cost effective strategies are urgently needed to assess the likelihood of disease outbreaks. We were able to show that field sequencing provides a solution that is cost-effective, undemanding in its implementation and easy to learn. The knowledge transfer to Nepalese scientific experts from different disciplines provides an opportunity for sustainable implementation of low-cost portable sequencing solutions in Nepal.


Assuntos
Aedes , Dengue , Adulto , Animais , Dengue/epidemiologia , Dengue/prevenção & controle , Entomologia , Humanos , Mosquitos Vetores , Nepal/epidemiologia
12.
BMC Pregnancy Childbirth ; 22(1): 319, 2022 Apr 14.
Artigo em Inglês | MEDLINE | ID: mdl-35421934

RESUMO

INTRODUCTION: Trust of women and families toward health institutions has led to increased use of their services for childbirth. Whilst unpleasant experience of care during childbirth will halt this achievement and have adverse consequences. We examined the experience of women regarding the care received during childbirth in health institutions in Nepal. METHOD: A prospective cohort study conducted in 11 hospitals in Nepal for a period of 18 months. Using a semi-structured questionnaire based on the typology of mistreatment during childbirth, information on childbirth experience was gathered from women (n = 62,926) at the time of discharge. Using those variables, principal component analysis was conducted to create a single mistreatment index. Bivariate and multivariate linear regression analyses were conducted to assess the association of the mistreatment index with sociodemographic, obstetric and newborn characteristics. RESULT: A total of 62,926 women were consented and enrolled in the study. Of those women, 84.3% had no opportunity to discuss any concerns, 80.4% were not adequately informed before providing care, and 1.5% of them were refused for care due to inability to pay. According to multivariate regression analysis, women 35 years or older (ß, - 0.3587; p-value, 0.000) or 30-34 years old (ß,- 0.38013; p-value, 0.000) were less likely to be mistreated compared to women aged 18 years or younger. Women from a relatively disadvantaged (Dalit) ethnic group were more likely to be mistreated (ß, 0.29596; p-value, 0.000) compared to a relatively advantaged (Chettri) ethnic group. Newborns who were born preterm (ß, - 0.05988; p-value, 0.000) were less likely to be mistreated than those born at term. CONCLUSION: The study reports high rate of some categories of mistreatment of women during childbirth. Women from disadvantaged ethnic group, young women, and term newborns are at higher risk of mistreatment. Strengthening health system and improving health workers' readiness and response will be key in experience respectful care during childbirth.


Assuntos
Serviços de Saúde Materna , Qualidade da Assistência à Saúde , Adulto , Atitude do Pessoal de Saúde , Estudos Transversais , Parto Obstétrico , Feminino , Humanos , Recém-Nascido , Masculino , Nepal/epidemiologia , Parto , Gravidez , Estudos Prospectivos
13.
J Infect Dev Ctries ; 16(3): 469-477, 2022 Mar 31.
Artigo em Inglês | MEDLINE | ID: mdl-35404852

RESUMO

INTRODUCTION: There is limited data on clinical course and outcomes of hospitalized adults with COVID-19 in Nepal. Thus, it is imperative to characterize the features of this disease in the domestic context. METHODOLOGY: We identified all adult patients with laboratory-confirmed COVID-19 admitted to five different hospitals in Nepal from June 15 to July 15, 2020. We collected epidemiological, socio-cultural and clinicopathologic data, and stratified the patients based on their symptom status. RESULTS: The study included 220 patients with an overall median age of 31.5 (25-37) years, and 181 (82.3%) were males. 159 (72.3%) were asymptomatic, and 163 (74.1%) were imported cases. Of 217 patients with the available data, 110 (50.7%) reported their annual household income less than 2000 US dollars, and 122 (56.2%) practiced Pranayama (yogic rhythmic breathing techniques) regularly. Eight patients (3.6%) required supplemental oxygen and two patients (0.9%) died. None of the patients who practiced Pranayama regularly required supplemental oxygen. Compared to asymptomatic patients, symptomatic patients had greater proportion of females (31.1% vs. 12.6%, p = 0.001), imported cases (85.2% vs. 69.8%, p = 0.02), illiterates (26.8% vs. 12.1%, p = 0.01), alcohol users (43.3% vs. 24.5%, p = 0.01), and had higher platelet count (253×109/L vs. 185×109/L, p = 0.02). CONCLUSIONS: Most cases were imported, asymptomatic young males, with very few deaths. Pranayama practice was associated with protection against severe COVID-19, but more data is needed to substantiate this. The association of platelets count with symptom status in the Nepalese population needs further exploration.


Assuntos
COVID-19 , Adulto , COVID-19/epidemiologia , Feminino , Hospitalização , Humanos , Masculino , Nepal/epidemiologia , Oxigênio , Estudos Prospectivos
14.
PLoS One ; 17(4): e0266661, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35395045

RESUMO

INTRODUCTION: Nicotine dependence is an addiction to tobacco products caused by the chemical nicotine present in tobacco. 80% of premature deaths due to nicotine dependence come from low-and middle-income countries. Since most of the public health studies have focused solely on psychological and behavioral factors associated with tobacco smoking, this study aims to assess the nicotine dependence and stages of change of quitting smoking. METHODOLOGY: A community based quantitative cross-sectional study was conducted among 280 smokers aged 15-69 years in Bharatpur metropolitan, Nepal. A semi-structured and validated questionnaire was used during the face-to-face interviews. Nicotine dependence among participants was assessed using the six-item Fagerstrom Test for Nicotine Dependence (FTND). Chi-square test and multivariate logistic regression analysis were performed to assess the associations between variables at the significance level α = 0.05. RESULT: In the study population, the mean score of FTND was 5.15 ± 2.34. 33.9% participants had a high level of nicotine dependence and nearly half of the participants felt difficulty to refrain smoking even in No-smoking areas. Almost three out of ten respondents were prepared for smoking cessation. It was found that age group 20-39 years were more likely to have nicotine dependence (AOR 3.308, 95% CI = 1.039-10.534), those who initiated smoking before age of 15 were associated with a greater risk of nicotine dependence (AOR 3.68, 95% CI = 1.826-7.446), participants spending more on tobacco products (more than Rs 2400 monthly) were associated with an increased risk of nicotine dependence (AOR 4.47, 95% CI = 2.225-8.991), those who initiated smoking due to mental stress were more likely to have nicotine addiction (AOR 2.522, 95% CI = 1.004-6.028), and those who had no thought of quitting smoking were more associated with nicotine dependence (AOR 4.935, 95% CI = 1.458-16.699). CONCLUSION: Our study showed that high level of nicotine dependence is a major public health problem in low-and middle-income countries like Nepal. It also highlights that effective smoking cessation programs should be developed considering the level of nicotine dependence with more focus on early interventions of its associated factors.


Assuntos
Abandono do Hábito de Fumar , Tabagismo , Estudos Transversais , Humanos , Nepal/epidemiologia , Fumantes , Abandono do Hábito de Fumar/psicologia , Tabagismo/epidemiologia
15.
Sci Rep ; 12(1): 6266, 2022 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-35428776

RESUMO

In the days to weeks following an earthquake, landslides can display specific post-seismic motions, including delayed initiations and post-seismic relaxations. These motions have an uncertain origin, sometimes attributed to specificities of the landslide basal interface or to fluid transports in the landslide basal shear zone. Here we address this question, by documenting the co- and post-seismic motions of slow-moving landslides accelerated by the Gorkha earthquake (Mw 7.8, 25/04/2015, Nepal). We detect 11 slow-moving landslides over an area of 750 km[Formula: see text] in the near field of the earthquake, and monitor their motions thanks to a time-series of Pléiades optical satellite images and SAR Sentinel-1 images. The post-seismic landslide motions are much larger than the co-seismic ones, reaching up to [Formula: see text] m accommodated over 2 months. A delayed initiation of several days (> 4 days) is also measured for at least two of the landslides. We analyze our findings in regards with all the previous observations on slow-moving landslides accelerated by earthquakes, and propose that the post-seismic motions are caused by diffusion of groundwater from co-seismic material contraction up to the landslide basal shear zone or from internal landslide reconfiguration. Our observations strongly suggest the main control of the hydrology in the landslide processes under seismic forcings.


Assuntos
Terremotos , Deslizamentos de Terra , Hidrologia , Nepal
16.
Medicine (Baltimore) ; 101(16): e29192, 2022 Apr 22.
Artigo em Inglês | MEDLINE | ID: mdl-35482989

RESUMO

ABSTRACT: The medication therapy management (MTM) pharmacists follow the philosophy of pharmaceutical care to address individualistic medication therapy requirements in their practice settings.The present study aimed to introduce the pharmacist-delivered MTM services among type 2 diabetes mellitus patients at a tertiary care hospital in Nepal.Cross-sectional study was conducted at Patan Hospital, Lalitpur, Nepal, among 200 patients with type 2 diabetes mellitus from July to December 2019. The intervention included maintenance of medication profile for individual patients, and then MTM service was proposed based on 5 core elements of MTM services proposed by the American Pharmacists Association. Both antidiabetic and non-antidiabetic medicines were coded as per the anatomic, therapeutic, and chemical classification and defined daily dose assignment 2020 for documentation. The Charlson Comorbidity Index was used to index comorbidities. The drug interaction profile was checked with the Medscape Drug Interaction Checker.Both fasting and postprandial blood sugar levels were significantly associated with age (P-values <.000 for both), baseline symptom (P-values .012 and .003 respectively), and diet plan proposed (P-values .049 and .011 respectively). Maximum cases of drug interactions requiring close monitoring were between metformin and insulin regular (i.e., 11, 5.5%).This was a novel initiative of the MTM services in a resource constraint country like Nepal and can show a clue for the pharmacists targeting such services in other similar settings.


Assuntos
Diabetes Mellitus Tipo 2 , Conduta do Tratamento Medicamentoso , Estudos Transversais , Diabetes Mellitus Tipo 2/tratamento farmacológico , Humanos , Hipoglicemiantes/uso terapêutico , Nepal , Farmacêuticos , Centros de Atenção Terciária , Estados Unidos
17.
Zootaxa ; 5104(1): 143-148, 2022 Feb 24.
Artigo em Inglês | MEDLINE | ID: mdl-35391044

RESUMO

Two new species of the genus Amphichroum Kraatz, 1857 are described and illustrated: A. brachypterum sp. n. (central Nepal) and A. cuccodoroi sp. n. (China: Yunnan). Faunistic records of A. altivagans Cameron, 1941 from India (Kashmir) and A. pindarense Champion, 1920 from Nepal are provided.


Assuntos
Besouros , Distribuição Animal , Animais , China , Índia , Nepal
18.
Zootaxa ; 5100(4): 573-584, 2022 Feb 22.
Artigo em Inglês | MEDLINE | ID: mdl-35391058

RESUMO

Six species of Elachistinae are newly reported from Nepal, four of which are described as new: Elachista conspecta sp. nov., E. marginata sp. nov., E. minor sp. nov. and E. simulans sp. nov. The new species are diagnosed and illustrated with photographs of the adults and genitalia. E. siamensis Sruoga Kaila, 2019 and E. kurokoi Parenti, 1983 are recorded for the first time in Nepal.


Assuntos
Lepidópteros , Mariposas , Distribuição Animal , Animais , Genitália , Nepal
19.
BMC Vet Res ; 18(1): 132, 2022 Apr 06.
Artigo em Inglês | MEDLINE | ID: mdl-35387664

RESUMO

BACKGROUND: Glanders is a transmissible zoonotic disease caused by Burkholderia mallei that infects equids and humans. No glanders cases in equids were reported so far in Nepal. CASE PRESENTATION: Following suspected glanders in animals with clinical signs in different regions in Nepal, serum samples were tested by CFT, ELISA and Luminex® tests. Two horses and a mule tested positive for glanders by all tests, while two other equids only tested positive by ELISA and Luminex®. Analysis of swabs and pus samples by a PCR system targeting B. mallei confirmed the presence of the bacterium in the samples collected from the 3 equids that yielded positive results in all serological tests. Genotyping of the three PCR positive samples with a SNP-based method identified a genotype closely related to the B. mallei strains circulating in India. CONCLUSION: Confirmation of glanders cases underscores the need of implementing a surveillance program in Nepal and a strict control of the animal movement across the borders.


Assuntos
Burkholderia mallei , Mormo , Doenças dos Cavalos , Animais , Ensaio de Imunoadsorção Enzimática/veterinária , Equidae , Mormo/diagnóstico , Mormo/epidemiologia , Mormo/microbiologia , Cavalos , Nepal/epidemiologia
20.
J Physiol Anthropol ; 41(1): 12, 2022 Apr 02.
Artigo em Inglês | MEDLINE | ID: mdl-35366946

RESUMO

BACKGROUND: In Tsarang (at 3560 m), which is located in Mustang, 62.7% of the residents answered that they had a subjective medical history of arthritis, and 41.1% of the residents answered that their families had a subjective medical history of arthritis on a survey conducted in 2017. The expression of hypoxia-inducible factor (HIF) and its effects are deeply involved in hypoxic adaptation in Tibetan highlanders. At the same time, HIF is also related to the onset of rheumatoid arthritis. Therefore, the adaptive mechanism acquired by Tibetan highlanders may promote the development of rheumatoid arthritis. The prevalence of rheumatoid arthritis is estimated to be approximately 0.5-1.0% worldwide. The objective of this study was to estimate the prevalence of rheumatoid arthritis in Tsarang residents using existing diagnostic criteria and to explore its risk factors. METHODS: An epidemiological survey was conducted in Tsarang in 2019. Data obtained from anthropometry and questionnaires were statistically analyzed. Biochemical measurements using blood samples were also performed, and the results were used to assess arthritis status. Residents' joint status was scored, and arthritis was assessed based on the clinical disease activity index and ACR/EULAR 2010 criteria. RESULTS: Twenty-seven males and 50 females participated in this survey. In Tsarang, ACR/EULAR 2010 classified 4.3% of males and 7.1% of females as having rheumatoid arthritis, indicating a very high estimated prevalence. We also performed a multivariate analysis to explore its risk factors, and two factors, older age (standardized parameter estimate = 4.84E-01, 95% CI = [9.19E-02, 8.76E-01], p = 0.0170) and a history of living in urban areas (standardized parameter estimate = - 5.49E-01, 95% CI = [- 9.21E-01, 1.77E-01], p = 0.0050), significantly contributed to the higher ACR/EULAR 2010 score in females. In addition, three factors, having no spouse (standardized parameter estimate = 3.17E-01, 95% CI = [5.74E-02, 5.77E-01], p = 0.0179), having a smoking habit (standardized parameter estimate = 2.88E-01, 95% CI = [1.71E-02, 5.59E-01], p = 0.0377), and a history of living in urban areas (standardized parameter estimate = - 3.69E-01, 95% CI = [- 6.83E-01, - 5.60E-02], p = 0.0219), resulted in significantly higher clinical disease activity index scores in females. Furthermore, smoking habits were found to significantly increase blood hyaluronic acid in both males (standardized parameter estimate = 6.03E-01, 95% CI = [3.06E-01, 9.01E-01], p = 0.0020) and females (standardized parameter estimate = 4.87E-01, 95% CI = [5.63E-02, 9.18E-01], p = 0.0291). CONCLUSIONS: In this study, we evaluated the symptoms of arthritis and estimated the prevalence of rheumatoid arthritis using classification criteria for Tibetan highlanders who have adapted to the hypoxic environment and fostered their own culture. The high prevalence of rheumatoid arthritis among Tsarang residents suggests that the hypoxic adaptation mechanism involving HIF in Tibetan highlanders may promote the onset or exacerbation of rheumatoid arthritis. The high prevalence of rheumatoid arthritis among Tibetan highlanders may be related not only to the environmental factors analyzed in this study but also to hypoxic adaptation genes. Further investigation is needed to clarify the genetic factors involved.


Assuntos
Artrite Reumatoide , Artrite Reumatoide/diagnóstico , Artrite Reumatoide/epidemiologia , Feminino , Humanos , Masculino , Nepal , Prevalência , Fatores de Risco , Tibet/epidemiologia
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