A systematic review of current knowledge of HIV epidemiology and of sexual behaviour in Nepal

OBJECTIVE: To systematically review information on HIV epidemiology and on sexual behaviour in Nepal with a view to identifying gaps in current knowledge. METHODS: Systematic review covering electronic databases, web-based information, personal contact with experts and hand searching of key journals. RESULTS: HIV-1 seroprevalence has been rising rapidly in association with high-risk behaviours, with current levels of 40% amongst the nation's injecting drug users and approaching 20% amongst Kathmandu's female commercial sex workers (FCSWs). HIV seroprevalence remains low in the general population (0.29% of 15–49 year olds). There are significant methodological limitations in many of the seroprevalence studies identified, and these estimates need to be treated with caution. There are extensive migration patterns both within the country and internationally which provide the potential for considerable sexual networking. However, studies of sexual behaviour have focused on FCSWs and the extent of sexual networks within the general population is largely unknown. CONCLUSIONS: Whilst some of the ingredients are present for an explosive HIV epidemic in Nepal, crucial knowledge on sexual behaviour in the general population is missing. Research on sexual networking is urgently required to guide HIV control in Nepal. There is also a need for further good-quality epidemiological studies of HIV seroprevalence

Surgical interventions in chronic osteomyelitis

Abstract Chronic osteomyelitis is a leading cause of morbidity in orthopaedic practice in Nepal. Various factors like health service inaccessibility, inadequate treatment, malnutrition, poverty, and to some extent antibiotic resistance contribute to disease progression from acute osteomyelitis to chronic osteomyelitis in this region of the world. This paper presents our experience of managing ninety patients with chronic osteomyelitis over a period of four years

Glial Heterotopia of the orbit: A rare presentation

<p>Abstract</p> <p>Background</p> <p>Glial heterotopias are rare, benign, congenital, midline, non-teratomatous extracranial glial tissue. They may masquerade as encephalocoele or dermoid cyst and mostly present in nose. Herein, we present an unusual case of glial heterotopia of the orbit with unilateral blindness.</p> <p>Case presentation</p> <p>A 6 year-old-boy presented with a progressive painless mass over the nose and medial aspect of the left eye noticed since birth. On examination, the globe was displaced laterally by a firm, regular, mobile, non-pulsatile and non-tender medial mass. The affected eye had profound loss of vision. Computed tomography scan showed a large hypodense mass in the extraconal space with no intracranial connectivity and bony erosion. The child underwent total surgical excision of the mass and histopathological examination confirmed glial heterotopia of the orbit.</p> <p>Conclusion</p> <p>Though the incidence of this condition is rare, the need of appropriate diagnosis and management of such mass to prevent the visual and cosmetic deterioration is warranted. To our knowledge this is the first reported case of Glial heterotopia of orbit causing unilateral blindness.</p

A preliminary assessment of PM10 and TSP concentrations in Tuticorin, India

The respirable particulate matter (RPM; PM10) and total suspended particulate matter (TSP) concentrations in ambient air in Tuticorin, India, were preliminarily estimated. Statistical analyses on so-generated database were performed to infer frequency distributions and to identify dominant meteorological factor affecting the pollution levels. Both the RPM and TSP levels were well below the permissible limits set by the US Environmental Protection Agency. As expected, lognormal distribution always fit the data during the study period. However, fit with the normal was also acceptable except for very few seasons. The RPM concentrations ranged between 20.9 and 198.2 μg/m3, while the TSP concentrations varied from 51.5 to 333.3 μg/m3 during the study period. There was a better correlation between PM10–100 and TSP concentrations than that of PM10 (RPM) and TSP concentrations, but the correlation of RPM fraction was also acceptable. It was found that wind speed was the most important meteorological factor affecting the concentrations of the pollutants of present interest. Significant seasonal variations in the pollutant concentrations of present interest were found at 5% significance level except for TSP concentrations in the year 2006

Prevalence and risk factors associated with chronic kidney disease in Nepal: evidence from a nationally representative population-based cross-sectional study.

OBJECTIVE: This study aimed to determine population-based prevalence of chronic kidney disease (CKD) and its associated factors in Nepal. STUDY DESIGN: The study was a nationwide population-based cross-sectional study. SETTING AND PARTICIPANTS: Cross-sectional survey conducted in a nationally representative sample of 12 109 Nepalese adult from 2016 to 2018 on selected chronic non-communicable diseases was examined. Multistage cluster sampling with a mix of probability proportionate to size and systematic random sampling was used for the selection of individuals aged 20 years and above. PRIMARY AND SECONDARY OUTCOME MEASURES: Primary outcome in this study was population-based prevalence of CKD in Nepal. A participant was considered to have CKD if the urine albumin-to-creatinine ratio was greater than or equal to 30 mg/g and/or estimated glomerular filtration rate is less than 60 mL/min/1.73 m2 at baseline and in follow-up using modification of diet in renal disease study equations. The secondary outcome measure was factors associated with CKD in Nepal. The covariate adjusted association of risk factors and CKD was calculated using multivariable binary logistic regression. RESULTS: The overall prevalence of CKD in Nepal was 6.0% (95% CI 5.5 to 6.6). Factors independently associated with CKD included older age (adjusted OR (AOR) 2.6, 95% CI 1.9 to 3.6), Dalit caste (AOR 1.6, 95% CI 1.1 to 2.3), hypertension (AOR 2.4, 95% CI 2.0 to 3.0), diabetes mellitus (AOR 3.2, 95% CI 2.5 to 4.1), raised total cholesterol (AOR 1.3, 95% CI 1.0 to 1.6) and increased waist-to-hip ratio (AOR 1.6, 95% CI 1.2 to 2.3). CONCLUSION: This nationally representative study shows that the prevalence of CKD in the adult population of Nepal is substantial, and it is independently associated with several cardiometabolic traits. These findings warrant longitudinal studies to identify the causes of CKD in Nepal and effective strategies to prevent it

A role for core planar polarity proteins in cell contact-mediated orientation of planar cell division across the mammalian embryonic skin

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/. © The Author(s) 2017. Supplementary information accompanies this paper at doi:10.1038/s41598-017-01971-2.The question of how cell division orientation is determined is fundamentally important for understanding tissue and organ shape in both healthy or disease conditions. Here we provide evidence for cell contact-dependent orientation of planar cell division in the mammalian embryonic skin. We propose a model where the core planar polarity proteins Celsr1 and Frizzled-6 (Fz6) communicate the long axis orientation of interphase basal cells to neighbouring basal mitoses so that they align their horizontal division plane along the same axis. The underlying mechanism requires a direct, cell surface, planar polarised cue, which we posit depends upon variant post-translational forms of Celsr1 protein coupled to Fz6. Our hypothesis has parallels with contact-mediated division orientation in early C. elegans embryos suggesting functional conservation between the adhesion-GPCRs Celsr1 and Latrophilin-1. We propose that linking planar cell division plane with interphase neighbour long axis geometry reinforces axial bias in skin spreading around the mouse embryo body.Peer reviewe

What motivates open defecation? A qualitative study from a rural setting in Nepal

Introduction Open defecation is ongoing in Nepal despite the rise in efforts for increasing latrine coverage and its use. Understanding the reasons for open defecation would complement the ongoing efforts to achieve the ‘open defecation free’ status in Nepal. This study aimed at exploring different motivations of people who practice open defecation in a village in Nepal. Methods This study was conducted among the people from the Hattimudha village in Morang district of eastern Nepal, who practiced open defecation. Maximum variation sampling method was used to recruit participants for 20 in-depth interviews and 2 focus group discussions. We adopted a content analysis approach to analyze the data. Results We categorized different reasons for open defecation as motivation by choice and motivation by compulsion. Open defecation by choice as is expressed as a medium for socializing, a habit and an enjoyable outdoor activity that complies with spiritual and religious norms. Open defecation by compulsion include reasons such as not having a latrine at home or having an alternative use for the latrine structures. Despite having a private latrine at home or access to a public latrine, people were compelled to practice open defecation due to constraints of norms restricting latrine use and hygiene issues in general. For women the issues with privacy and issues refraining women to use the same latrine as men compelled women to look for open defecation places. Conclusion Open defecation is either a voluntary choice or a compulsion. This choice is closely linked with personal preferences, cultural and traditional norms with special concerns for privacy for women and girls in different communities. The ongoing campaigns to promote latrine construction and its use needs to carefully consider these factors in order to reduce the open defecation practices and increase the use of sanitary latrines

Morphological and Electrochemical Properties of Crystalline Praseodymium Oxide Nanorods

Highly crystalline Pr6O11 nanorods were prepared by a simple precipitation method of triethylamine complex at 500°C. Synthesized Pr6O11 nanorods were uniformly grown with the diameter of 12–15 nm and the length of 100–150 nm without any impurities of unstable PrO2 phase. The Pr6O11 nanorod electrodes attained a high electrical conductivity of 0.954 Scm−1 with low activation energy of 0.594 eV at 850°C. The electrochemical impedance study showed that the resistance of electrode was significantly decreased at high temperature, which resulted from its high conductivity and low activation energy. The reduced impedance and high electrical conductivity of Pr6O11 nanorod electrodes are attributed to the reduction of grain boundaries and high space charge width

Clustering and forecasting of dissolved oxygen concentration on a river basin

The aim of this contribution is to combine statistical methodologies to geographically classify homogeneous groups of water quality monitoring sites based on similarities in the temporal dynamics of the dissolved oxygen (DO) concentration, in order to obtain accurate forecasts of this quality variable. Our methodology intends to classify the water quality monitoring sites into spatial homogeneous groups, based on the DO concentration, which has been selected and considered relevant to characterize the water quality. We apply clustering techniques based on Kullback Information, measures that are obtained in the state space modelling process. For each homogeneous group of water quality monitoring sites we model the DO concentration using linear and state space models, which incorporate tendency and seasonality components in different ways. Both approaches are compared by the mean squared error (MSE) of forecasts

River water quality assessment using environmentric techniques : case study of Jakara River Basin.

akara River Basin has been extensively studied to assess the overall water quality and to identify the major variables responsible for water quality variations in the basin. A total of 27 sampling points were selected in the riverine network of the Upper Jakara River Basin. Water samples were collected in triplicate and analyzed for physicochemical variables. Pearson product-moment correlation analysis was conducted to evaluate the relationship of water quality parameters and revealed a significant relationship between salinity, conductivity with dissolved solids (DS) and 5-day biochemical oxygen demand (BOD5), chemical oxygen demand (COD), and nitrogen in form of ammonia (NH4). Partial correlation analysis (r p) results showed that there is a strong relationship between salinity and turbidity (r p = 0.930, p = 0.001) and BOD5 and COD (r p = 0.839, p = 0.001) controlling for the linear effects of conductivity and NH4, respectively. Principal component analysis and or factor analysis was used to investigate the origin of each water quality parameter in the Jakara Basin and identified three major factors explaining 68.11 % of the total variance in water quality. The major variations are related to anthropogenic activities (irrigation agricultural, construction activities, clearing of land, and domestic waste disposal) and natural processes (erosion of river bank and runoff). Discriminant analysis (DA) was applied on the dataset to maximize the similarities between group relative to within-group variance of the parameters. DA provided better results with great discriminatory ability using eight variables (DO, BOD5, COD, SS, NH4, conductivity, salinity, and DS) as the most statistically significantly responsible for surface water quality variation in the area. The present study, however, makes several noteworthy contributions to the existing knowledge on the spatial variations of surface water quality and is believed to serve as a baseline data for further studies. Future research should therefore concentrate on the investigation of temporal variations of water quality in the basin