MOF-based nanocomposites as transduction matrices for optical and electrochemical sensing

Metal Organic Frameworks (MOFs), a class of crystalline microporous materials have been into research limelight lately due to their commendable physio-chemical properties and easy fabrication methods. They have enormous surface area which can be a working ground for innumerable molecule adhesions and site for potential sensor matrices. Their biocompatibility makes them valuable for in vitro detection systems but a compromised conductivity requires a lot of surface engineering of these molecules for their usage in electrochemical biosensors. However, they are not just restricted to a single type of transduction system rather can also be modified to achieve feat as optical (colorimetry, luminescence) and electro-luminescent biosensors. This review emphasizes on recent advancements in the area of MOF-based biosensors with focus on various MOF synthesis methods and their general properties along with selective attention to electrochemical, optical and opto-electrochemical hybrid biosensors. It also summarizes MOF-based biosensors for monitoring free radicals, metal ions, small molecules, macromolecules and cells in a wide range of real matrices. Extensive tables have been included for understanding recent trends in the field of MOF-composite probe fabrication. The article sums up the future scope of these materials in the field of biosensors and enlightens the reader with recent trends for future research scope.

Effect of rheological models on pulsatile hemodynamics in a multiply afflicted descending human aortic network

In the cardiovascular diseased (CVD) conditions, it is essential to choose a suitable rheological model for capturing the correct physics behind the hemodynamic in the multiply afflicted diseased arterial network. This study investigates the effect of blood rheology on hemodynamics in a blood vessel with abdominal aortic aneurysm (AAA) and right internal iliac stenosis (RIIAS). A model with AAA and RIIAS is reconstructed from a human subject's computed tomography (CT) data. Localized mesh generation and pulsatile inflow condition are considered. Non-Newtonian models such as the Power-law, Carreau, Cross, and Herschel Berkley models are used in simulations. The outcome from a validated computational model is compared with the Newtonian model to identify the suitable model for dealing with pathological complications under consideration. The capabilities and significance of various rheological models are also examined via Wall Pressure (WP), Wall Shear Stress (WSS), velocity, Global non-Newtonian importance factor (IG), Vorticity Streamlines, and Swirling Strength. It is noted that during the entire cardiac cycle, the IG factor of the cross model is found to be relatively more significant. Power Law depicts larger IG factor during peak systole and early diastole. Also, the cross model depicts larger WSS, WPS, swirling strength distribution and vorticity during the peak systolic and diastolic phases It is noted that IG ∼0.02 is an appropriate non-Newtonian blood activity cut-off value in the descending abdominal artery having AAA and RIIAS. The critical important WSS values are in the range of 0-9 Pa which is stated in WSS contour plot.

Process temperature-dependent interface quality and Maxwell-Wagner interfacial polarization in atomic layer deposited Al2O3/TiO2 nanolaminates for energy storage applications

Considering the excellent tunability of electrical and dielectric properties in binary metal oxide based multi-layered nanolaminate structures, a thermal atomic layer deposition system is carefully optimized for the synthesis of device grade Al₂O₃/TiO₂ nanolaminates with well-defined artificial periodicity and distinct interfaces, and the role of process temperature in the structural, interfacial, dielectric and electrical properties is systematically investigated. A marginal increase in interfacial interdiffusion in these nanolaminates, at elevated temperatures, is validated using X-ray reflectivity and secondary ion mass spectrometry studies. With an increase in deposition temperature from 150 to 300 °C, the impedance spectroscopy measurements of these nanolaminates exhibited a monotonic increment in dielectric constant from ∼95 to 186, and a decrement in dielectric loss from ∼0.48 to 0.21, while the current-voltage measurements revealed a subsequent reduction in leakage current density from ∼2.24 × 10^-5 to 3.45 × 10^-7 A cm^-2 at 1 V applied bias and an improvement in nanobattery polarization voltage from 100 mV to 700 mV, respectively. This improvement in dielectric and electrical properties at elevated processing temperature is attributed to the reduction in impurity content along with the significant enhancement in sublayer densities and the conductivity contrast driven Maxwell-Wagner interfacial polarisation. Additionally, the devices fabricated at 300 °C exhibited a higher capacitance density of ∼22.87 fF μm^-2, a low equivalent oxide thickness of ∼1.51 nm, and a low leakage current density of ∼10^-7 A cm^-2 (at 1 V bias), making this nanolaminate a promising material for high-density energy storage applications. These findings highlight the ALD process temperature assisted growth chemistry of Al₂O₃/TiO₂ nanolaminates for superior dielectric performance and multifaceted applications.

Retrospective analysis and risk of progression of partial anterior cruciate ligament injuries in a young population

BACKGROUND

The anterior cruciate ligament (ACL) is a common knee ligament injury. Partial ACL tears are common, and at least 10-27% of isolated ACL tears are diagnosed as partial tears. Patients with partial tears have high risk of progression of tears to complete tears, which may require surgical reconstruction. The risk factors associated with the progression to a complete tear are poorly understood.

METHODS

The present case-control study assessed the incidence and risk factors for the progression of conservatively treated partial ACL tears to complete tears in 351 patients younger than 45 years. The diagnosis of partial ACL tears was based on clinical evaluation, side-to-side difference on Rolimeter, and magnetic resonance imaging. These patients were managed conservatively and followed up for a mean of 17.5 months or until the progression of the tear into a complete tear, requiring surgery. The patients in whom the tear progressed to complete tear (group P) were compared with those in whom the tear remained stable for a minimum of 18-month follow-up period (group S).

RESULTS

Of the 351 partial ACL tear patients, 166 (47.3%) patients progressed to a complete tear at a mean duration of 17.5 months, whereas the tear in 185 (52.7%) patients remained stable and did not progress to a complete tear. Group P had mean international knee documentation committee (IKDC) scores and Tegner scores of 95.7 ± 3.7 and 7.6 ± 1.6, respectively, before the injury, and scores decreased to 52.4 ± 4.1 and 5.7 ± 2.2, respectively, at the 24-month follow-up.

CONCLUSION

Partial ACL tear progressed to a complete tear in 47.3% of evaluated patients. The associated risk factors were age less than 35 years, rigorous physical activities, high ACL-Return to Sport after Injury score during early rehabilitation days, early return to activity, and pivoting contact sports.

First-Generation SARS-CoV-2 Vaccines: A Comparative Analysis between Vaccinated and Unvaccinated Hospitalized Patients Infected with SARS-CoV-2

Background Severe acute respiratory syndrome corona virus-2 (SARS-CoV-2) variants, which have emerged due to several mutations in spike protein, have a potential to escape immune protection provided by the first-generation vaccines, thereby resulting in breakthrough infections. Objective To identify the socio-demographic factors, clinical features, and outcomes in both vaccinated and unvaccinated hospitalized patients infected with SARS-CoV-2. Method Socio-demographic details, clinical features, and the outcomes among fully vaccinated (double for Covishield/AstraZeneca and BBIBP-CorV and single for Janssen), partially vaccinated, and unvaccinated hospitalized patients with coronavirus disease of 2019 (COVID-19) were collected and analyzed using SPSS version 17. Result Among the hospitalized COVID-19 patients (n=299), 175 (58.5%) patients received a single-dose, 82 (27.4%) double-dose, and 124 (41.5%) did not receive any dose of the COVID-19 vaccines. The risk of SARS-CoV-2 infection when compared between vaccinated and unvaccinated patients was found to be associated among professional degree holders (23.4% versus 9.7%) (p<0.05), professional workers (43.4% vs. 25.0%) (p<0.05), hospitalization to general ward (76.6% vs. 72.6%) (p<0.05), and presence of multiple symptoms (> or equel 3) (86.8% vs. 75.0%) (p>0.05) and comorbidities (> or equal 2) (15.5% vs. 13.7%) (p>0.05). Despite such approximate incidences, the risk of in-hospital mortality among the vaccinated patients was reduced (0.6% vs. 3.2%) (p>0.05), when compared to the unvaccinated patients. The risk of in-hospital mortality was associated with the older age and the presence of multiple comorbidities including bronchial asthma, diabetes, and hypertension. Conclusion Full or partial vaccination against the SARS-CoV-2 variants of concerns might be effective in preventing in-hospital mortality among COVID-19 patients.

The pulsatile 3D-Hemodynamics in a doubly afflicted human descending abdominal artery with iliac branching

The study of patient-specific human arterial flow dynamics is well known to face challenges like a) apt geometric modelling, b) bifurcation zone meshing, and c) capturing the hemodynamic prone to variations with multiple disease complications. Due to aneurysms and stenosis in the same arterial network, the blood flow dynamics get affected, which needs to be explored. This study develops a new protocol for accurate geometric modelling, bifurcation zone meshing and numerically investigates the arterial network with abdominal aortic aneurysms (AAA) and right internal iliac stenosis (RIIAS). A realistic arterial model is reconstructed from the computed tomography (CT) data of a human subject. To understand the combined effect of the aneurysm and aortoiliac occlusive diseases in a patient, an arterial network with AAA, RIIAS, multiple branches tapering, and curvature has been considered. Clinically significant pulsatile blood flow simulations have been carried out to trace the alteration in the flow dynamics with multiple pathological complications under consideration. The transient blood flow dynamics are investigated via wall shear stress, wall pressure, velocity contour, streamlines, vorticity, and swirling strength. During the systolic deceleration phase, the rhythmic nested rapid secondary oscillatory WSS, adverse pressure gradients, high WSS, and high WP bands are noticed. Also, the above studies will help researchers, clinicians, and doctors understand the influence of morphological changes on hemodynamics in cardiovascular studies.

Hypoplastic femur with pathologic femoral shaft fracture associated with extensive arteriovenous malformations. A series of five cases

Introduction:

Extremities arteriovenous malformations are uncommon vascular lesions that usually go unnoticed until a fracture occurs or imaged for other medical problems. The lesion is invariably quiescent, infiltrative in nature, and leads to the destruction of soft tissue and bone. Worldwide 20-30 % incidence of arteriovenous malformations has been noted in bones. This arteriovenous malformation greatly affects bone growth as compared to the normal side and leads to pathological fracture. However, few reports on the management of such pathologic fractures associated with AVM have been published in the literature.

The main problem is to decide the types of implants and whether open or closed reduction. Here, we present a case series of pathologic femoral shaft fracture associated with multiple hemangiomas in the thigh that was treated successfully by minimally invasive distal femoral locking plate fixation and teriparatide.

Case Presentation:

We are describing our one index case. A 39-year-old woman, otherwise healthy, sustained a fall and developed a left femoral shaft fracture. At the time of admission, she had swelling and venous varicosities and non-itchy, blanchable violet patches over the left thigh. Plain radiography of the left thigh revealed Hypoplastic femoral shaft with a markedly obliterated medullary canal with distal 1/3 rd fracture with calcification of soft tissue. We planned open reduction and distal locking femoral plating because medullary canal was very small to accommodate intramedullary nail following embolization of the feeding artery. While performing open reduction, a considerable amount of bleeding (1300 ml) after incision of subcutaneous tissue occurred. After successful fracture fixation, union was achieved with administration of teriparatide 12 months postoperatively. At present patient is able to walk using elbow support.

Conclusion:

We present the five cases of pathologic fracture associated with large AVMs that achieved fracture union using minimally invasive distal femoral locking plate fixation and teriparatide.

Natural infection of Delta mutant of SARS-CoV-2 in Asiatic lions of India

The current pandemic caused by a novel coronavirus (SARS‐CoV‐2) has underlined the importance of emerging diseases of zoonotic importance. Along with human beings, several species of wild and pet animals have been demonstrated to be infected by SARS‐CoV‐2, both naturally and experimentally. In addition, with constant emergence of new variants, the species susceptibility might further change which warrants intensified screening efforts. India is a vast and second most populated country, with a habitat of a very diverse range of animal species. In this study we place on record of SARS‐CoV‐2 infections in three captive Asiatic lions. Detailed genomic characterization revealed involvement of Delta mutant (Pango lineage B.1.617.2) of SARS‐CoV‐2 at two different locations. Interestingly, no other feline species enclosed in the zoo/park were found infected. The epidemiological and molecular analysis will contribute to the understanding of the emerging mutants of SARS‐CoV‐2 in wild and domestic animals.

BL-02: a versatile X-ray scattering and diffraction beamline for engineering applications at Indus-2 synchrotron source

A hard X-ray engineering applications beamline (BL-02) was commissioned recently and started operation in March 2019 at the Indian synchrotron source, Indus-2. This bending-magnet-based beamline is capable of operating in various beam modes, viz. white, pink and monochromatic beam. The beamline utilizes the X-ray diffraction technique in energy-dispersive and angle-dispersive modes to carry out experiments mainly focused on engineering problems, viz. stress measurement, texture measurement and determination of elastic constants in a variety of bulk as well as thin-film samples. An open-cradle six-circle diffractometer with ∼12 kg load capacity allows accommodation of a wide variety of engineering samples and qualifies the beamline as a unique facility at Indus-2. The high-resolution mode of this beamline is suitably designed so as to carry out line profile analysis for characterization of micro- and nano-structures. In the present article the beamline is described starting from the beamline design, layout, optics involved, various operational modes and experimental stations. Experiments executed to validate the beamline design parameters and to demonstrate the capabilities of the beamline are also described. The future facilities to be incorporated to enhance the capabilities of the beamline are also discussed.

Anteromedial Surface Plating for Midshaft Fracture Humerus Through an Anterolateral Approach - A Better Option than Anterolateral Plating

Introduction

Osteosynthesis by plate fixation of humeral shaft fractures as a gold standard for fracture fixation has been proven beyond doubt. However, during conventional anterolateral plating Radial nerve injury may occur which can be avoided by applying plate on the medial flat surface. The aim of this study was to evaluate the results of application of plate on the flat medial surface of humerus rather than the conventional anterolateral surface.

Materials and Methods

This study was conducted between Oct 2010 to Dec 2015. One-hundred-fifty fracture shafts of the humerus were treated with the anteromedial plating through the anterolateral approach.

Results

One-hundred-fifty patients with a fracture shaft of the humerus were treated with anteromedial plating. Twenty were female (mean ±SD,28 years±4.5) and 130 were male (mean ± SD, 38 years±5.6). One hundred and forty-eight out of 150 (98.6%) patients achieved union at 12 months. Two of three patients developed a superficial infection, both of which were treated successfully by antibiotics and one developed a deep infection, which was treated by wound debridement, prolonged antibiotics with the removal of the plate and subsequently by delayed plating and bone grafting.

Conclusion

In the present study, we applied plate on the anteromedial flat surface of humerus using the anterolateral approach. It is an easier and quicker fixation as compared to anterolateral plating because later involved much more dissection than a medial application of the plate and this application of plate on a medial flat surface, does not required Radial nerve exposure and palsy post-operatively. The significant improvement in elbow flexion without brachialis dissection is also a potential benefit of this approach. Based on our results, we recommend the application of an anteromedial plate for treatment of midshaft fractures humerus.

COVID-19 pandemic-Environmental perspective of COVID-19 and a primer for all of us

Coronavirus Disease (COVID-19) spread worldwide has created a global pandemic. To reduce the transmission of the virus, the Indian government had imposed a countrywide lockdown on 24 Mar 2020 by suspending all public transport and industries temporarily resulting in loss of jobs in multiple sectors and looming threats to the nation economy. Lockdown on the opposite hand has removed pollutants from the air and thus improved air quality in many cities across the globe. The near-total shutdown of all economic activities except related to essential commodities like medicine and food was only allowed which resulted in the lowering of carbon emission and improvement in global warming and air pollution. This review article indented to bring important features of how the COVID-19 pandemic affects human civilization and the global environment. However, its epidemiology, symptom, possible prevention, and management will briefly describe. Authors have collected data from, PubMed, Embase, Scopus, WHO, and CDC (USA). Severe Acute Respiratory Syndrome is a result of COVID- 19 infection. This virus is transmitted through close contact by respiratory droplets from one person to another. The majority of symptoms of COVID-19 are very much similar to any viral upper respiratory tract infection ( Common Coryza). Any person with the slightest suspicion or has respiratory symptoms related to COVID-19 infection should wear a facemask, keep safe social distancing, observe cough/sneeze etiquettes. The COVID-19 pandemic has taught us a lesson to introspect the way humans are destroying the environment for their benefit. Whatever be the origin or cause, the occurrence of COVID-19 has made a foreground for us to improve the symbiotic relationship between humans, wildlife, and nature.

Epidemiology and outcome of trauma victims admitted in trauma centers of tertiary care hospitals - A multicentric study in India

Background:

Roadside trauma in India is an increasingly significant problem, particularly because of bad roads, irregular road signs, overcrowding, overspeeding, and bad traffic etiquettes. Adequate information on the characteristics of victims, causes of accidents, frequency, vehicles involved, alcohol intake, and outcome of management is essential for understanding and planning for better management.

Aim:

This study aimed to determine the characteristics of trauma (roadside accidents) victims admitted to various trauma centers in India. The purpose of this study is to examine the epidemiology of trauma within a local community in India through data gained from the different emergency centers and to analyze trauma patients to find the predictors that led to the deaths of trauma patients.

Materials and Methods:

The present observational study involved trauma victims over 1-year period in three centers. Demographical details recorded were age, sex, alcohol intake, systolic blood pressure on arrival, respiratory rate, Glasgow Coma Scale (GCS) score, the interval between injury and admission, Injury Severity Score (ISS) risk factors, hospital stay, and outcome.

Results:

A total of 2650 injuries were recorded in 2466 patients. The mean age was 42.45 ± 15.7 years, the mean ISS was 13.82 ± 6.2, and the mean GCS was 12.20 ± 4.1. The mean time to admission at different trauma centres was 48.41 ± 172.8 h. The head injury was the most common (29.52%).

Conclusion:

Road side accidents due to overspeeding was the most common cause whereas driving under the effect of alcohol was the second most common cause. Accidents are common because of bad traffic etiquette on Indian roads.

Moonlighting matrix metalloproteinase substrates: Enhancement of proinflammatory functions of extracellular tyrosyl-tRNA synthetase upon cleavage

Tyrosyl-tRNA synthetase ligates tyrosine to its cognate tRNA in the cytoplasm, but it can also be secreted through a noncanonical pathway. We found that extracellular tyrosyl-tRNA synthetase (YRS) exhibited proinflammatory activities. In addition to acting as a monocyte/macrophage chemoattractant, YRS initiated signaling through Toll-like receptor 2 (TLR2) resulting in NF-κB activation and release of tumor necrosis factor α (TNFα) and multiple chemokines, including MIP-1α/β, CXCL8 (IL8), and CXCL1 (KC) from THP1 monocyte and peripheral blood mononuclear cell–derived macrophages. Furthermore, YRS up-regulated matrix metalloproteinase (MMP) activity in a TNFα-dependent manner in M0 macrophages. Because MMPs process a variety of intracellular proteins that also exhibit extracellular moonlighting functions, we profiled 10 MMPs for YRS cleavage and identified 55 cleavage sites by amino-terminal oriented mass spectrometry of substrates (ATOMS) positional proteomics and Edman degradation. Stable proteoforms resulted from cleavages near the start of the YRS C-terminal EMAPII domain. All of the MMPs tested cleaved at ADS³⁸⁶↓³⁸⁷LYV and VSG⁴⁰⁵↓⁴⁰⁶LVQ, generating 43- and 45-kDa fragments. The highest catalytic efficiency for YRS was demonstrated by MMP7, which is highly expressed by monocytes and macrophages, and by neutrophil-specific MMP8. MMP-cleaved YRS enhanced TLR2 signaling, increased TNFα secretion from macrophages, and amplified monocyte/macrophage chemotaxis compared with unprocessed YRS. The cleavage of YRS by MMP8, but not MMP7, was inhibited by tyrosine, a substrate of the YRS aminoacylation reaction. Overall, the proinflammatory activity of YRS is enhanced by MMP cleavage, which we suggest forms a feed-forward mechanism to promote inflammation.

Depth-resolved compositional analysis of W/B4C multilayers using resonant soft X-ray reflectivity

W/B₄C multilayers (MLs) consisting of ten layer pairs with varying boron carbide layer thicknesses have been investigated. The ML structures were characterized using grazing-incidence hard X-ray reflectivity (GIXR), resonant soft X-ray reflectivity (RSXR), hard X-ray photoelectron spectroscopy (HAXPES) and X-ray absorption near-edge spectroscopy (XANES). Depth-resolved spectroscopic information on the boron carbide layer in W/B₄C MLs was extracted with sub-nanometre resolution using reflectivity performed in the vicinity of the B K-edge. Interestingly, these results show that the composition of boron carbide films is strongly dependent on layer thicknesses. HAXPES measurements suggest that most of the boron is in the chemical state of B₄C in the multilayer structures. XANES measurements suggest an increase in boron content and C-B-C bonding with increase in boron carbide layer thickness.

A compact nanosecond pulse generator for DBD tube characterization

High voltage pulses of very short duration and fast rise time are required for generating uniform and diffuse plasma under various operating conditions. Dielectric Barrier Discharge (DBD) has been generated by high voltage pulses of short duration and fast rise time to produce diffuse plasma in the discharge gap. The high voltage pulse power generators have been chosen according to the requirement for the DBD applications. In this paper, a compact solid-state unipolar pulse generator has been constructed for characterization of DBD plasma. This pulsar is designed to provide repetitive pulses of 315 ns pulse width, pulse amplitude up to 5 kV, and frequency variation up to 10 kHz. The amplitude of the output pulse depends on the dc input voltage. The output frequency has been varied by changing the trigger pulse frequency. The pulsar is capable of generating pulses of positive or negative polarity by changing the polarity of pulse transformer's secondary. Uniform and stable homogeneous dielectric barrier discharge plasma has been produced successfully in a xenon DBD tube at 400-mbar pressure using the developed high voltage pulse generator.

Clinicopathological Profile of Anaplastic Lymphoma Kinase-positive Nonsmall Cell Lung Cancer: An Indian Perspective

Background: A novel fusion gene of echinoderm microtubule-associated protein-like 4 (EML4) and anaplastic lymphoma kinase (ALK) has been identified in a subset of non-small-cell lung cancers (NSCLCs). Patients with the ALK-EML4 fusion gene demonstrate unique clinicopathological and physiological characteristics. Here we present an analysis of clinicopathological profile of patients of metastatic adenocarcinoma harboring the ALK-EML4 fusion gene. Methods: A retrospective analysis of advanced ALK positive NSCLC, who presented at this tertiary care hospital of armed forces from September 2014 to December 2016 was conducted. The primary goal was to evaluate demographic and clinicopathological profile of ALK positive advanced NSCLC. Detection of ALK fusion was done by IHC on formalin fixed paraffin embedded cell blocks. Results: Out of 270 patients of NSCLC, 15 (7.4%) tested positive for ALK-EML4 fusion. Rate of positivity was higher in females (13.7%) than in males (5%). The correlation of the ALK-EML4 fusion gene and clinicopathological characteristics of NSCLC patients demonstrated a significant difference in smoking status, histological types, stage, and metastatic pattern. Conclusion: Our analysis indicated that ALK-EML4 positive NSCLC comprised a unique subgroup of adenocarcinomas with distinct clinicopathological and radiological characteristics. Incidence of ALK positivity was found to be higher in females and never smokers. These patients have distinct pathological and radiological characteristics.

Does time of surgery and complication have any correlation in the management of hip fracture in elderly and can early surgery affect the outcome?

OBJECTIVE

Hip fractures in the elderly are usually associated with a high rate of morbidity and mortality and affect quality of life. On review of published data, the current guidelines in the literature indicate that early surgery should be performed within 24 h of injury because it is associated with better functional outcomes and lower rates of perioperative complications and mortality. The aim of this study was to evaluate whether any correlation exists between early surgical intervention and functional outcomes.

METHODS

In a retrospective study, we analyzed the records between January 2010 and December 2016 and 550 elderly patients between the age group of 65-95 were included.

RESULTS

The results of early surgery were promising, 451 (82%) patients did not have any complication, 42 (7.6%) has developed bed sore, 23 (4%) developed a hospital-acquired infection, 13 (2.3%) developed wound infection, 08 (1.4%) developed DVT, 04 (0.7%) developed implant failure, and 09 (01%) died of some or other complications.

CONCLUSION

Still, there is conflicting evidence in the published data that early surgery would improve mortality and function. However, early surgery definitively improves outcome and reduces morbidity, bed sores, infection, and the length of hospital stay could be improved by reducing the waiting time of hip surgery following fracture. We concluded that it is beneficial to the elderly patients to receive surgical treatment as early as possible.

Influence of alcohol on condom use pattern during non-spousal sexual encounter in male migrant workers in north India

CONTEXT

Migrant workers constitute an important risk group for Human Immunodeficiency Virus/Acquired Immuno-Deficiency Syndrome transmission in India. Alcohol consumption before sexual intercourse has been postulated to influence condom use practices. This study aimed to assess this association with regard to non-spousal sexual encounters among male migrant workers in northern India.

MATERIALS AND METHODS

A cross-sectional facility-based survey was conducted in 2011. Male migrant workers aged ≥18 years, who were born outside Haryana, who had moved to the current location after 15 years of age,had worked in the current factory for at least 1 year, who were willing to participate and were able to give written, informed consent were included in the study. A consecutive sampling was performed. Descriptive, bivariate and multiple logistic regression analyses were carried out.

RESULTS

A total of 162 participants reported having experienced non-spousal sexual encounters in the last 1 year. The proportion of men who reported not having used a condom at their last non-spousal sexual encounter was 59.3%, and 78.4% of the men reported having consumed alcohol in the last 1 year. About 48.1% of men reported having consumed alcohol before their last non-spousal sexual encounter. Men who consumed alcohol were three times more likely to not use a condom at their last non-spousal sexual encounter (OR = 3.1, 95% CI: 1.5-6.4). This association persisted even after adjusting for relevant confounders.

CONCLUSION

Alcohol consumption had a negative influence on condom use during non-spousal sexual encounter among male migrant workers. An integrated approach to promote condom use and reduce alcohol consumption among migrant men needs to be undertaken through targeted intervention strategies.

Re-evaluation of the formalin-ether sedimentation method for the improvement of parasite egg recovery efficiency

The formalin-ether sedimentation (FES) method is considered as reliable method of fecal examination for the detection of parasites. In this study, we re-evaluated several aspects of FES such as (i) pretreatment of feces; (ii) filtration of fecal suspensions; (iii) test-tube material and (iv) substitution of ether by other organic solvents as to see an improvement in parasite egg recovery. The egg count was represented by the number of ova detected per 100 μg of sediment. Pre-treatment of feces with formalin (pH 7) increased egg detection rate remarkably compared with original FES method. Use of three layers of gauze dramatically reduced the sediment in the final product, and led to an increase in the number of ova detected. Use of polypropylene test tubes instead of glass test tubes also increased the number of egg detection. None of the organic solvents used to replace the ether produced better results. Based on these findings, we proposed a modified FES procedure. Further, we also compared the parasite positive rate and the number of ova recovered by using original FES and the modified FES procedures by examining 112 fecal samples collected from school children of parasite endemic area in Nepal. Feces collected from Nepal had many parasite ova, and these fecal samples barely displayed false-negative results even by method with low sensitivity. When the mean number of Hemenolepis nana, hookworm, T. trichiura, and A. lumbricoides ova recovered by original FES and the modified FES methods was compared, the values obtained by modified FES were superior (higher). This result suggested that the modified FES is effective and better for the recovery of parasite ova in areas of low-intensity parasitic infection.

Teaching community medicine to medical undergraduates-learning by doing: our experience of rural posting at All India Institute of Medical Sciences, New Delhi, India

BACKGROUND

The goal of medical education is to ensure that the medical graduate has acquired broad public health competencies needed to solve the health problems of the community. We present the current teaching of community medicine to medical students of the All India Institute of Medical Sciences (AIIMS), New Delhi during their 5-week posting at the rural centre at Ballabgarh, Haryana.

METHODS

The teaching activities consist of field visits to different levels of health facilities and meeting with health workers, epidemiological exercises, a community-based exercise, posting in inpatient and outpatient departments of a secondary hospital, and domiciliary visits to families of patients. These are spread over 80 sessions of about 200 hours. There is very little didactic teaching and the assessment is broad-based. The evaluation of the posting was based on comparison of blinded pre- and post-posting assessments as well as anonymous feedback of the posting by the students.

RESULTS

There was a significant increase in the mean scores of all components of the posting-epidemiology (5.1 to 8.4), health systems (6.8 to 9.3) and clinical (8.0 to 10.8). The posting did not result in a better understanding of a public health approach as compared to a clinical approach. The feedback provided by students was generally positive for all activities with 94% of them rating it as good or very good.

CONCLUSION

The teaching of community medicine can be made more practical and interesting without compromising on learning. However, despite such a programme, getting medical students to develop a public health approach is a daunting task.

Stability and normal incidence reflectivity of W/B4C multilayer mirror near the boron K absorption edge

A multilayer structure consisting of alternate layers of W and B4C has been deposited using a magnetron sputtering system. The structure of the as-deposited and vacuum-annealed W/B4C multilayer sample has been characterized using grazing incidence x-ray reflectivity, grazing incidence diffraction, and the normal incidence reflectivity has been measured using synchrotron radiation. A two-layer model consisting of tungsten and boron carbide is presented. The multilayer structure was found to be stable after 800°C annealing. Grazing incidence x-ray diffraction measurements suggested that W is polycrystalline with small grain size. No signature of tungsten carbide or tungsten boride formation could be observed during the annealing treatments. A near normal incidence soft x-ray reflectivity (SXRR) of ~8.3% was obtained at 6.8 nm wavelength. A little drop (~1%) in SXRR after 800°C annealing suggested that there were no compositional changes within the layers during the annealing treatments.

Bacteriological study of neonatal sepsis and antibiotic susceptibility pattern of isolates in Kathmandu, Nepal

Bloodstream infections in neonates are life-threatening emergencies. Identification of the common bacteria causing such infections and their susceptibility patterns will provide necessary information for timely intervention. This study was done to determine the prevalence of neonatal septicaemia, identify the bacterial isolates and study their antimicrobial susceptibility pattern in neonates admitted to the neonatal intensive care unit of Nepal Medical College Teaching Hospital (NMCTH), Kathmandu, Nepal. This descriptive-analytical study was conducted in NMCTH from July 2011 to January 2012. Blood culture of all neonates who were suspected for neonatal sepsis was performed. Bacterial isolation, identification and antimicrobial susceptibility testing were done by standard microbiological method. Out of 120 neonates suspected of having neonatal sepsis, 30.8% (37/120) were blood culture positive (i.e. prevalence = 30.8%). The most common causative agents of neonatal sepsis was Staphylococcus aureus (56.8%; 21/37) followed by Klebsiella pneumoniae (21.7%; 8/37), Pseudomonas aeruginosa (13.4%; 5/37) and others. Neonatal sepsis was more frequent in male neonates (32.5%) while (26.5%) in female neonates in the ratio of 1.2:1 (p > 0.05). Neonatal sepsis was significantly higher (58.3%) in low birth weight (LBW) (< 2.5kg) neonates compared with good birth weight (GBW) (23.9%) (< 0.05). Prevalence was higher in preterm neonates (57.8%; 11/19) as compared with term-babies (25.7%) (P = 0.05). Generally, all of the isolates were sensitive to most of the antibiotics used as the first line drugs like amikacin, gentamicin, cefotaxime and ampicillin except Acinetobacter baumannii. This organisms was only sensitive towards cotrimoxazole, azithromicin, cefotaxime and ceftazidime.

The health system in Nepal-An introduction

We present here a study on the health system in Nepal. Approximately two-thirds of the health problems in Nepal are infectious diseases. Epidemics occur frequently with a high rate of morbidity and mortality and there are occasional outbreaks of infectious diseases of unknown etiology. In addition, the rapid rate of HIV infection in the Indian sub-continent is likely to add a new dimension of opportunistic infections. Until now, the Health System introduced as the General Health Plan in 1956 has been expanded by focusing on primary health care, and a comprehensive network-like Health System has been developed; the most basic unit is a Sub-Health Post or Health Post in each Village Development Committee area. However, the expansion of the Health System has not been matched by an expansion in the domestive resources, workers and supplies, and the available resources are not efficiently distributed. In addition, insufficient resources available for preventive and promotive medicine and the occurrence of non-infectious diseases such as cancer and cardiovascular diseases has been increasing. The Government recently introduced a Health Policy encouraging the private sector to invest in the production of health workers and in providing quality health services. As a result, several private health institutions have been founded and are expected to contribute to the development of the human resources required by Nepal.

Intestinal protozoan parasitic infection among school children

BACKGROUND

Intestinal protozoan parasitosis is highly prevalent among general population, majority of them are children. The objective of the study is to find out the prevalence of intestinal protozoan infection in school children of Sindhuli.

METHODS

Stool samples were collected from school children of Sindhuli in June 2011 and investigated in National Institute of Tropical Medicine and Public Health Research, Laboratory by using formal-ether concentration method. Statistical significance was analyzed by using Chi-Square test.

RESULTS

A total of 342 stool samples were collected and 68 (19.8%) protozoan parasites were identified. The prevalence rate of protozoa in boys and girls were 16.9% and 22.0% respectively. Altogether 5 species of protozoan parasites were detected. Of them Entamoeba coli was most common followed by Giardia lamblia, Entamoeba histolytica, Blastocystis hominis and Endolimax nana. Positive rate was highest in Dalit (20.3%), and least in Indo-Aryan (19.6%).

CONCLUSIONS

There is a low prevalence of intestinal protozoan parasitosis among children even though this study emphasizes the need for improved environmental hygiene i.e. clean water supplies and enhanced sanitation.

A large-scale study of bacterial contamination of drinking water and its public health impact in Nepal

Bacterial contamination of drinking water is a major public health in Nepal. A large scale study on contamination of drinking water was done covering all three ecological belts (mountain, hill and Terai) in all five (eastern, central, western, mid-western and far-western) development regions of Nepal during 2009-2011. Of the total 506 water samples studied, one-forth (25.1%; 127/506) were visually turbid. Bacteriologically, 88.5% (448/506) samples were positive for total coliform (TC) whereas 56.5% (286/506) were positive for fecal coliform (FC) (Esch. coli). The TC positive rate ranged from 53.8% in Damak (Jhapa) to 100.0% in different districts. The FC positive rate varied more widely ranging from 10.0% in Bharatpur City (Chitawan) to 100.0% in Baglung Township (Baglung) with over 50.0% in most of the districts (over 75.0% in eight districts). Both TC and FC positive rate were highest in Far-western Development Region (DR). High TC positive rate (96.7%) in Far-western DR was followed by Western DR (93.9%), Eastern DR (89.2%), Central DR (87.0%) and Mid-western DR (74.6%). Highest FC positive rate (65.5%) in Far-western DR was followed by Med-western DR (63.5%), Western DR (55.9%), Central DR (53.2%) and Eastern DR (52.0%). TC positive was highest (90.7%) in hills followed by mountain (89.7%) and Terai (plain) (84.1%) belt. In contrast, FC positive rate was highest (66.2%) in mountain, followed by hills (58.0%) and Terai (49.7%). Of the total 506, 335 were piped tap water, 129 were boring water, 16 natural tap (spout), 16 were well (sallow/deep well) and 10 were mineral/uroguard treated water. TC positive rate was very high (81.2% to 100.0%) in different type water samples (piped tap: 90.1%; boring water: 85.2%; natural spout/tap: 81.2%; well water 100.0% and mineral water/uroguard treated water: 80.0%). FC positive rate ranged from 0.0% in mineral water/uroguard treated water to 93.7% in well water samples. These findings are of serious public health concern with regard to both endemicity and outbreak of waterborne diseases in the country.

Study of medically important Vibrios in the sewage of Katmandu Valley, Nepal

A total of 42 samples were collected from the different sites of sewer system of Kathmandu Valley during rainy summer season (June to September 2008) using Moore's technique. Samples (on Moore's swabs) were submersed in alkaline peptone water (pH 8.6) and transported to Research Laboratory of National Institute of Tropical Medicine and Public Health Research, Kathmandu in cold condition (ice chest) followed by incubation at 37 degrees C for 8 hours. After incubation, culture was done on thiosulfate-citrate-bile salt-sucrose (TCBS) agar and incubated at 37 degrees C for overnight (15 hrs). Both yellow and green colonies measuring from 2 to 9 mm in diameter on TCBS agar were subjected for gram staining, biochemical testing as well as sero-typing using antisera (poly O1, Ogawa and Inaba) (Denka Seiken Co. Ltd, Japan). Altogether 46 medically important Vibrios were isolated from 42 samples studied. The isolates were identified as V. cholerae (n = 20; 43.5%), V. vulnificus (n = 11; 23.9%), V. parahaemolyticus (n = 5; 10.9%), V. furnissi (n = 5; 10.9%), V. fluvialis (n = 3; 6.5%) and V. alginolyticus (n = 2; 4.3%). Of the 20 V. cholerae isolates, 13 (65.0%) and 7 (35.0%) isolates were V. cholerae O1 and non-O1, respectively. Among the V. cholerae O1 (n = 13), classical Hikojima strain was most frequently isolated (n = 10) followed by V. cholerae O1 Ogawa (El Tor = 2 and classical = 1). High frequency of V. cholerae isolation from sewer system of Kathmandu Valley is an indication of possible outbreak of cholera anytime in future and, therefore, demands improvement in sanitary condition, supply/consumption of safe drinking water and personal hygiene.

Study on carrier rate of Streptococcus pyogenes among the school children and antimicrobial susceptibility pattern of isolates

This study was done to investigate the rate of Streptococcus pyogenes or Group A streptococcus (GAS) and antimicrobial susceptibility pattern of isolates in asymptomatic school children in Kathmandu and Sindhuli districts. Pharyngeal swabs were collected and subjected to crystal violet blood agar (CVBA). A total of 468 asymptomatic school aged children were included and 51 (10.8%) were found to be GAS carrier. Among the isolates 23 (12.0%) were from boys where 28 (10.1%) were from girls. The GAS colonization rate was statistically insignificant (P > 0.05) with sex and age sub-group, although the rate was slightly higher among the boys and age sub group 10-12 years. GAS was significantly higher in large family size (p < 0.05). Out of 51 isolates, 100.0% isolates were sensitive to antibiotic penicillin where as 7.8% and 5.8% isolates were resistant to antibiotic ampicillin and erythromycin respectively.

Private rural health providers in Haryana, India: profile and practices

INTRODUCTION

Despite a widespread public health system, the private healthcare sector is the major provider of health care in rural India. This study describes the profile and medical practices of private rural health providers (PRHPs) in rural Haryana, India.

METHODS

A cross-sectional study was conducted among PRHPs practicing in the villages of Comprehensive Rural Health Services Project (CRHSP) at Ballabgarh block located in the Faridabad district of Haryana State. The CRHSP is an Intensive Field Practice Area (IFPA) of the Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi.

RESULTS

Eighty PRHPs participated in this study (response rate 93%). The majority (96%) did not possess a qualification in any formal system of medicine. Half of the PRHPs had a separate space (private area) for the examination of patients. Almost all had stethoscopes, thermometers and blood pressure apparatus. The PRHPs were involved in a wide range of practices, such as dispensing medicines (98.7%), providing injections (98.7%) and intravenous fluids (98.7%), and conducting minor surgery (78.5%). Dumping biomedical waste was a common practice among these practitioners. Some PRHPs (8.7%) were involved in national health programs.

CONCLUSIONS

Unqualified PRHPs provide substantial outpatient healthcare services in rural Ballabgarh, India. Their biomedical waste disposal practices are inadequate. There is a need for training in waste disposal practices and monitoring of safe injection techniques among PRHPs. Consideration should be given to utilising PRHPs in important public health programs such as disease surveillance.

NbC/Si multilayer mirror for next generation EUV light sources

In the present study we report a new multilayer combination comprised of refracting layers of niobium carbide and spacer layers of silicon as a more stable and high reflecting combination for the 10 - 20 nm wavelength region. The reflectivity of the new combination is comparable to Mo/Si conventional mirrors. Annealing experiments carried out with NbC/Si multilayer at 600°C temperature showed a ~2.5% drop in the soft x-ray reflectivity along with a marginal contraction in the multilayer period length. The multilayer structure is found stable after the heat treatment. Crystallization of the niobium carbide and silicon layers is responsible for the compaction in the period length as revealed by the grazing incidence x-ray diffraction measurements. No signature of silicide formation or any other chemical species could be detected. The multilayer structures were grown by ion beam sputtering technique using a compound target of niobium carbide. Soft x-ray reflectivity measurements performed at the Indus-1 and BESSY-II synchrotron radiation sources are found in good agreement with the simulations.

Intestinal parasitic infections among patients attending Nepal Medical College Teaching Hospital, Kathmandu, Nepal

This study was conducted to find out the prevalence of intestinal parasitic infection among patients attending Nepal Medical College Teaching Hospital, Kathmandu from July 2011 to February 2012. A total of 312 stool samples collected in a clean, dry screw capped plastic container were examined using the formal-ether concentration and sucrose-flotation techniques. Overall parasite positivity rate was 30.1% with significant difference between males (34.2%) and Female (26.3%) (p < 0.05). Out of total positive, 90.4% had single parasitism whereas 9.6% had multiple parasitism. Children aged < or = 5 years were found to be highly infected (35.8%), followed by 6-15 years (32.1%) and > 15 years old (26.9%). Rate of infection was significantly higher among patients from inside Kathmandu Valley (31.1%) than outside valley (17.4%) (p < 0.05). E. histolytica (38.5%) and Hookworm (10.6%) were the commonest protozoa and helminthes respectively. Other parasites detected were G. lamblia (26.0%), E. coli (1.0%), T. trichiura (7.7%), A. lumbricoides (6.7%), H. nana (5.8%) and Taenia species (3.8%). Out of total parasites detected, 65.4% were protozoa and 34.6% were helminthes. Positive rate was higher in Dalit (37.5%) and Aadibasi-Janjati (34.3%) than Brahman-Chhetri (22.6%) (p < 0.05).

Prevalence of intestinal worm infestations among school children in Kathmandu, Nepal

Intestinal worm infestation is one of the major childhood health problem in Nepal. This study was done to assess the prevalence of intestinal worm infestations among school children aged 6-16 years in a public high school in Kathmandu Nepal. A total of 142 stool samples from healthy students were collected and reported following formol-ether concentration technique. The overall prevalence of intestinal worm infestation was found to be 17.6% (Boys = 22.0% vs girls = 13.5%). Children aged 6-8 years were found to be highly infected with intestinal worms (21.4%) followed by 9-12 years old (18.6%). Those between 13-16 years of age were significantly less infected (10.7%) compared to others (p < 0.05). Ova/cysts of intestinal parasites detected include Trichuris trichiura (32.0%), Ascaris lumbricoides (20.0%), Hymenolepis nana (16.0%), hookworm (8.0%) and 24.0% cases showed mixed parasitic infections.

Study of rifampicin and isoniazid resistance mutation genes of M. tuberculosis isolates in Nepal

We studied the rifampicin (RIF) and isoniazid (INH) resistant genes in Mycobacterium tuberculosis isolated from sputum samples of re-treated TB cases using phenotypic drug susceptibility test (DST) and rapid molecular method (Genotype; MTBDR plus, Hains Life Science, Nehren, Germany). Of the total 207 isolates included in this study, 90 (42.0%) were RIF resistant, 107 (50.7%) were INH resistant whereas 86 (41.5%) were multidrug resistant (MDR) by DST. According to genotypic analysis, 37.0% (77/207) were RIF resistant, 50.2% (105/207) INH resistant and 70 (33.8%) were MDR. Among the total 90 RIF resistant isolates, 85.5% (77/90) showed mutation in 81 bp of rpoB gene and the mutation locus were distributed as follows; MUT1 Asp516Val (16.7%; 15/90), MUT2A His526Tyr (6.6%; 6/90), MUT2B His526Asp (5.5%; 5/90) and MUT3 Ser531Lue (56.7%; 51/90). Among the total 107 INH resistant isolates, the mutation located in katG gene was 98.1% (105/107) and in inhA MUT1 gene was (16.8%; 18/107). The mutation locus were distributed as follows; MUT1 Ser315Thr (77.6%; 83/107), MUT2 Ser315Ile (3.7%; 4/107) in katG and in inhA MUT1Cys15Thr (16.8%; 18/107). The highest frequency of mutations in rpoB gene was found at the region of codon Ser531Leu (56.7%) while the frequency of mutation in katG and inhA gene were found at the region of codon Ser315Thr (77.6%) and Cyst15Thr (17.1%), respectively. The rapid molecular test kit used in this study was found to be sensitive as well as specific for detection of RIF and INH resistant gene and also helpful in early detection of MDR-TB.

Status of intestinal parasitosis among hospital visiting patients in Deukhury Valley, Dang, Nepal

Intestinal parasitosis is highly prevalent among the general population in Nepal. This study aimed to assess the status of intestinal parasitosis among patients attending Deukhury Community Hospital, Lamahi, Dang, situated in the mid western region of Nepal. A total of 210 stool samples examined by direct smear technique were reported. The overall prevalence of intestinal parasitic infection was found to be 21.4% (M = 23.5% vs F = 19.3%). Children < 15 yrs age were infected more often as compared to > 60 yrs and 15-60 yrs aged people. Among adults, Entamoeba histolytica infection was found to be very high compared to high helminthic infection found among children. Finding showed that, the prevalence was significantly high (68.8%) among people having low socio-economic status compared to others (31.1%) (p < 0.05). Among various parasites detected, E. histolytica was the most common parasite (48.8%) followed by helminths, mainly Ascaris lumbricoides (31.1%), hookworm (13.3%), Trichuris trichiura (4.4%) and Taenia species (2.2%) respectively in the locality.

Asymptomatic bacteriurea among pregnant women visiting Nepal Medical College Teaching Hospital, Kathmandu, Nepal

Urinary tract infection is the commonest bacterial infection in pregnancy. The overall incidence is 5.0-10.0% of all pregnancy. During pregnancy bacterial growth is favoured by increased urinary content of glucose, aminoacids and other nutrients. Other factors responsible for infection are basically related to hormonal effect and mechanical factors. Prolonged stasis of urine in urinary bladder favours growth of micro organism, relaxation of vesico-ureteric junction leads to reflux of urine from bladder to ureter and later up to renal pelvis and later can affect the renal parenchyma affecting the function of kidneys. In addition, some maternal defense mechanism are less effective during pregnancy. Bacteriuria either asymptomatic (5.0%) or symptomatic is common in pregnancy, if left untreated, asymptomatic bacteriuria will lead to acute pyelonephritis in 20.0-30.0%. This may result in abortion, premature delivery, low birth baby and even still birth. About 12.0% of antenatal admission are sepsis due to pyelonephritis. Keeping in mind that UTI in pregnancy leads to increase in maternal morbidity as well as neonatal morbidity and mortality. In this prospective study all asymptomatic consecutive antenatal women were included 200 from each trimester with total of 600 in number to see the incidence in different trimester, most prevalent organisms and it's sensitivity. They were followed up till delivery to see the incidence of asymptomatic bacteriurea in different trimester and its outcome in terms of type of delivery, baby weight, apgar score given at the time of birth and hospital admission for morbidity.

Study of parasitic infection among children of Sukumbasi Basti in Kathmandu valley

Keeping in view of heavy burden of intestinal parasitosis, present study was done to find out the prevalence of intestinal parasitic infection in children (aged <16 years) of Sukumbasi (people living without land ownership) Basti (community) in Kathmandu Valley. A total of 279 stool samples collected in clean, dry and screw capped plastic container were firstly examined for the presence of adult worm and/or segments of worms. Samples fixed in 10% formal-saline were then examined microscopically after concentration by formal-ether sedimentation technique. Overall parasite positive rate was 43.3% (121/279) with no significant difference in two genders (Boys: 48.3%, 73/151; Girls: 37.5%, 48/128) (p=0.07). Altogether 11 species of parasites were detected. Of them Giardia lamblia was most common followed by Entamoeba histolytica, Trichuris trichiura and others. Positive rate was higher in Tibeto-Burman (55.0%, 77/140) and the least in Indo-Aryan (25.4%, 27/ 106) (p=0.01) ethnic groups. Children taking anti-parasitic drug in last six months had significantly low positive rate (25.4%, 15/59) than others (48.2%, 106/220) (p=0.002). Results of this study suggestive of periodic administration of anti-parastic drugs and need for improvement of sanitary/hygienic practice.

First case of congenital toxoplasmosis from Nepal

Reportedly, nearly half of the Nepalese are Toxoplasma seropositive. However, neither the prevalence of congenital toxoplasmosis (CT) nor the confirmed case to CT is reported from Nepal yet. In this case report, we report the first case of CT in a 53 days old full term male baby (weight: 2,600 grams) delivered by caesarean section. The baby had hepatosplenomegaly and optic nerve coloboma with large scar in the right eye. The TORCH panel test showed significantly high Toxoplasma IgM antibody level (5.77 OD Ratio) compared with IgM antibody level against other agents. The baby was diagnosed as a case of CT and treatment was started accordingly. The baby, however, did not improve with the treatment and died after six days. The immediate cause of death was cardiorespiratory failure with antecedent cause of liver failure, renal insufficiency with thrombocytopenia.

Status of drinking water contamination in Mountain Region, Nepal

Status of drinking water contamination was studied in three mountainous districts in Nepal. A total of 43 water samples (Sankhuwasabha: 11, Rasuwa: 12 and Dolpa: 20) were tested for the presence of total coliform (TC) and Escherichia coli as fecal coliform bacilli using commercially available test system called Colilert (Japan). Of the total, 85.7% (36/43) were positive for TC whereas 67.4% (29/43) were positive for Esch. coli. The fecal contamination rates (as indicated by the growth of Esch. coli) in Sankhuwasabha, Rasuwa and Dolpa Districts were 81.8% (9/11), 75.0% (9/12) and 65.0% (13/20), respectively. Most of the water samples collected in district headquarter towns namely Khandbari, Dhunche and Dunai, respectively) showed Esch. coli compared with those collected in remote villages areas.

Study of enteric fever and antibiogram of Salmonella isolates at a teaching hospital in Kathmandu Valley

Enteric fever is one of the common public health problems in Nepal. This study was carried out at Nepal Medical College Teaching Hospital located at peri-urban area in Kathmandu Valley to find out the prevalence of enteric fever and the sensitivity pattern of the Salmonella isolates. A total of 479 patients with fever were included in the study. Venous blood samples collected aseptically were subjected to culture and were studied following the standard bacteriological procedure. The overall prevalence of enteric fever was 5.4% (26/479). Of them more than half (65.4%) were caused by S. paratryphi A whereas remaining (34.6%) by S. typhi. The positive rate was higher in children aged 1-15 years (8.9%) followed by 15-30 years of age (4.3%) and others (1.9%). Gender wise, females to male ratio was 1.4:1. The occurrence of infections was higher in Dalit (7.1%), Khas (Brahmin and Chhetri) (5.9%) and Madeshi (5.9%) whereas lowest was in Adibasi Janajati (4.8%). Prevalence rate of enteric fever among different sex, age and ethnic group was not significant (p > 0.05). Isolates were highly sensitive to Amikacin (100.0%) and Ciprofloxacin (96.1%) whereas least sensitive to Gentamycin (68.7%).

Study on health-related quality of life perception among Nepalese

Perception about the health status of an individual is important for the quality of life (QOL) and day-to-day productive functioning. Present study was carried out on the perception status QOL of Nepalese (aged 10 to 80 years) using SF-36v2 questionnaire. A total of 788 Nepalese (322; 40.9% were males and 466; 59.1% were females) living in Kathmandu Valley were included. More than half were Bahun/Chhetri (Hindu upper caste people) (n=437; 55.5%) followed by Adibashi Janajati (Indigenous nationalities) and Dalits (Hindu lower caste people). Males had significantly higher scores for physical functioning (t = 5.277, df = 780, p = 0.00), bodily pain (t = 2.811, df = 780, p = 0.05) and vitality (t = 3.78, df = 780, p = 0.00) but not with regard to mental health (t = 1.43, df = 780, p = 0.153). This was true for all age groups. No significant difference was observed in role physical, general health, social functioning and role emotional. Dalits had significantly low score regarding physical functioning compared with Bahun/Chhetri and Adibashi Janajati (f = 9.005, P = 0.000). However, they had positive perceptions regarding the general health (f = 8.408, P = 0.000) and social functioning (f = 13.216, P = 0.000). Genderwise difference was observed in physical, mental and social perception and activities compared with their male counterparts, and were found to be significantly decreasing with the increase of age (p = 0.05-0.00). These findings suggested that there are significant differences in the perceptions of different groups of people in Nepal.

Parasite egg contamination of vegetables from a suburban market in Hanoi, Vietnam

Helminth egg contamination of vegetables purchased at suburban market in Hanoi, Vietnam was examined. A total of 317 vegetables were examined and 82 (26%) were revealed to be positive for parasite eggs. Of the 15 varieties, 13 were positive except for horseradish and cucumber. Contamination was highest in leafy vegetables (31%), followed by root vegetables (17%) and fruit vegetables (3%). Throughout the survey, five species of parasite eggs were found: Ascaris sp., Trichuris sp., Toxocara sp., Taenia sp. and Ascaridia galli. In the interview with the villagers, 121 (81%) of 149 adult villagers stated that they usually use not only animal feces but also human feces as a fertilizer. Throughout the survey, a total of 453 eggs were recovered. Number of eggs recovered from vegetables was higher in the dry season (355 eggs) than in the rainy season (98 eggs). The study revealed that vegetables purchased at a market in suburban Hanoi (Vietnam) were highly contaminated with parasite eggs excreted by humans and animals. Considering the eating habits of the Vietnamese and the 17% embryonation rate of detected parasites, vegetables seem to play an important role in soil-transmitted helminth infection in this country.

Method for detecting circulating Toxocara canis antigen and its application in human serum samples

Diagnosis of larval migrans (LM) is usually done by immunodiagnostic methods. These methods, however, simply show the presence or absence of antibody but not the active infection of the patients. Therefore, we aimed to establish a diagnostic method for detecting circulating Toxocara canis antigen using a sandwich, ELISA. Monoclonal antibodies (MAb) were produced against the excretory-secretory (ES) antigen of second-stage T canis larvae. Among the MAbs obtained, we selected one MAb (TCMAb12; molecular weight, 30-80 kDa, IgG) for use in the sandwich ELISA. The cross-reactivity of the sandwich-ELISA against thirteen different kinds of parasite antigens were examined. The results revealed that the antibody reacted with T canis ES antigen, T. canis female antigen, and T. canis second-stage larvae antigen, but did not react with any other antigens. From results obtained using an ES antigen concentration standard curve, we confirmed that the detection limit of the sandwich-ELISA was 5 ng/ml, which provides sufficient sensitivity for the diagnosis of toxocariasis (LM). We applied the method to suspected toxocariasis patients and examined the circulating antigen in their sera. We used nine serum samples collected from patients with suspected toxocariasis based on both their clinical symptoms and high antibody titers. Overall, five sera showed antigen-positive reactions, while the remaining four were negative. These results indicated that about 44.0% of the antibody-positive patients were antigen-negative, not ongoing active infection. The results obtained using this technique would provide us for understanding toxocariasis.

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%).

Study on maternal consciousness among Nepalese mothers in Kathmandu, Nepal

Present study was carried out to study the status of maternal consciousness among Nepalese women living in Kathmandu. Of the total 360 mothers of different ethnic groups included in this study, only 55.5% mothers were found to have a positive feeling regarding their pregnancy (pregnancy is a wonderful event for women) (strongly positive 16.6%; positive 39.2%). Over one-forth of the mothers (27.7%) had negative feelings (strongly negative 8.8%; negative = 19.0%) and 14.4% had neither positive nor negative feeling. Among the different ethnic groups, Launa (Tamang/Sherpa) ethnic had highest rate (nearly two-third) of positive feeling towards pregnancy. However, the positive feeling towards born baby was very high (77.9%). The level of feeling of love to their baby was different in different ethnic groups. Compared with other population groups, Dalits had higher level of positive feelings about giving a child birth, childcare and self-sacrifice for the shake of children.