Impact of COVID-19 on health services utilization in Province-2 of Nepal: A qualitative study among community members and stakeholders

Background The COVID-19 pandemic has posed unprecedented challenges and threats to the health care system, particularly affecting the effective delivery of essential health services in resource-poor countries such as Nepal. This study aimed to explore community perceptions of COVID-19 and their experiences towards health services utilization during the pandemic in Province-2 of Nepal. Methods The semi-structured qualitative interviews were conducted among purposively selected participants (n=41) from a mix of rural and urban settings in all districts (n =8) of the Province 2 of Nepal. Virtual interviews were conducted between July and August 2020 in local languages. The data were analyzed using thematic network analysis in NVivo 12 Pro. Results The findings of this research are categorized into four global themes: i) Community and stakeholders’ perceptions towards COVID-19; ii) Impact of COVID-19 and lockdown on health services delivery; iii) Community perceptions and experiences of health services during COVID-19; and iv) COVID-19: testing, isolation, and quarantine services. Most participants shared their experience of being worried and anxious about COVID-19 and reported a lack of awareness, misinformation, and stigma as major factors contributing to the spread of COVID-19. Maternity services, immunization, and supply of essential medicine were found to be the most affected areas of health care delivery during the lockdown. Participants reported that the interruptions in health services were mostly due to the closure of health services at local health care facilities, limited affordability, and involvement of private health sectors during the pandemic, fears of COVID-19 transmission among health care workers and within health centers, and disruption of transportation services. In addition, the participants expressed frustrations on poor testing, isolation, and quarantine services related to COVID-19, and poor accountability from the government at all levels towards health services continuation/management during the COVID-19 pandemic. Conclusions This study found that essential health services were severely affected during the COVID-19 pandemic in all districts of Province-2. It is critical to expand and continue the service coverage, and its quality (even more during pandemics), as well as increase public-private sector engagement to ensure the essential health services are available for the population

Monitoring of organochlorine pesticide residues from bovine milk in Patna (Bihar), INDIA

 The milk has high nutritional properties and is widely used as baby food in different forms. The present study was undertaken to evaluate pesticide contamination in bovine milk samples from Patna district of Bihar. Out of 24 samples analyzed during 2012, 18 samples (75 %) were found to be contaminated with HCH residues varying from ND-0.178 mg kg-1 (mean value 0.135 mg kg-1). Seven samples (29.2 %) had HCH exceeding MRL of 0.01 mg kg-1. DDT residues were detected in 20 samples (83.3 %) and ranged from ND-0.132 mg kg-1 (mean value 0.122 mg kg-1). Five samples (20.8 %) contained DDT residues above the prescribed MRL of 0.05 mg kg-1. Out of 24 samples of bovine milk analyzed during 2013, 16 samples (66.7 %) were found to be contaminated with HCH and 15 samples (62.5%) with DDT residues. The residues of HCH varied from ND-0.154 mg kg-1 (mean value 0.053 mg kg-1) and DDT from ND-0.120 mg kg-1 (mean value 0.122 mg kg-1). The residues of HCH and DDT were above MRL in four samples (16.7 %) and three samples (12.5 %) respectively. The management practices of animals and legal punishment on using banned pesticides are the alternatives to reduce pesticide contamination incidences in milk

Seasonal and Altitudinal Prevalence of Fascioliasis in Buffalo in Eastern Nepal

Buffalo is the most important livestock commodities for milk, meat production and several other multipurpose uses distributed densely from southern tarai to northern mid-hills in Nepal. Among several internal parasitic diseases fascioliasis is highly economic one caused by Fasciola in buffaloes. However, there are only few studies carried on prevalence of fascioliasis emphasizing buffaloes in relation to seasonal (summer and rainy, and winter) and altitudinal variations. Therefore, we examined prevalence of fascioliasis seasonally and vertically. For the purpose, we selected two districts of eastern Nepal and sampled from low altitude area known as Madhesha ranging from 175-200, Dhankuta from 800-1200 m, and Murtidhunga from 1800-2200 m elevation from the sea level, representing tarai, mid hills and high hills, respectively. Altogether from February 2013 to January 2014 at every two months interval we collected 798 fecal samples from buffaloes; 282 from Murtidhunga, 239 from Dhankuta and 277 from Madhesha. The samples were examined microscopically for the presence of Fasciola eggs using sedimentation technique. Results showed that overall prevalence of fascioliasis in buffaloes was 39.9% (319/798), ranging highest 42.6%in Madhesha followed by 39.7% in Murtidhunga and 37.2% in Dhankuta, respectively. The prevalence of fascioliasis was found to be significantly (p <0.05) high in winter (44.9%) comparing to rainy season (34.4%). The prevalence of fascioliasis in buffaloes was relatively higher in low altitude than high altitude, although it was not statistically significant (p <0.05). In our findings the female buffaloes showed higher prevalence for fascioliasis than in male. Since the fascioliasis in buffaloes is highly endemic, thus strategic deworming in high risk period is recommended along with measure to prevent pasture contamination with buffalo feces

A cross-cultural comparison of the link between modernization, anthropomorphism and attitude to wildlife

Anthropogenic pressure has significantly increased in the last decades, often enhancing conflicts at the humanndash;wildlife interface. Therefore, understanding peoplesrsquo; value orientations, attitudes and behavioural intentions towards wildlife is a crucial endeavour to reduce the occurrence of conflicts between humans and wildlife. Previous research in the USA has shown a consistent link between modernization and increased anthropomorphism (i.e., the tendency to attribute human mental or physical characteristics to other entities), leading to positive changes in value orientations, attitudes, and behavioural intentions towards wildlife. In this paper, we aimed to address whether this link is also present in other cultures, by testing participants (N = 741) in five different countries (Brazil, Indonesia, Malaysia, Mexico, and Spain). Our study shows that while the positive link between anthropomorphism, positive attitudes and behavioural intentions towards wildlife is universal, the link between modernization and anthropomorphism is culturally mediated. In some countries (Indonesia, Malaysia, Spain), modernization increased anthropomorphism, while in others modernization predicted no differences (Brazil) or even a decrease in anthropomorphism (Mexico), ultimately deteriorating individualsrsquo; attitude and behavioural intentions towards wildlife. These results call for caution when generalizing findings from western industrialized countries to inform conservation policies worldwide

fluoroscoPy guided cHeMical luMbar syMPatHectoMy for lower liMb iscHaeMic ulcers

The purpose of this study was to assess the effectiveness of chemical lumbar sympathectomy in relieving pain and healing ischaemic ulcers in patients with peripheral vascular diseases. Thirtyone consecutive patients with ischaemic/ gangrenous lower limb ulcers, referred to the BPKIHS, Pain Clinic were observed prospectively after chemical lumbar sympathectomy using modified Reid Technique with 3 ml of 70% alcohol each at L2 and L3 level under fluoroscopic guidance. Pain relief and ulcer healing were noted in the follow up. Moreover, patients’ abilities to resume at least part of their day to day work were also noted at three months follow up. Of the total 31 patients, 16 had Buerger’s disease and the remaining 15 had non-Buerger’s ischaemic ulcers of which 7 were diabetic. There was significant decrease in the pain score from mean±SD of 8.3±0.9 (pre-block) to 4.2±2.5 (post-block after 3 days) in zero to 10 Numerical Analogue Scale (NAS). By 3 months, 6 patients declined for follow up; 19(76%) of the remaining 25 patients reported pain relief, 18(72%) reported healing or decrease in the size of ulcers and 11(44%) were able to resume at least part of their usual work. Minor complications occurred in 5 patients and amputation was needed in 6 patients. Fluoroscopy- guided chemical lumbar sympathectomy is feasible, safe and effective in relieving pain and promoting ulcer healing in patients with ischaemic lower limb ulcers Key Words: Buerger’s disease; Chemical lumbar sympathectomy; Ischaemic ulcers

Optoelectronics with electrically tunable PN diodes in a monolayer dichalcogenide

One of the most fundamental devices for electronics and optoelectronics is the PN junction, which provides the functional element of diodes, bipolar transistors, photodetectors, LEDs, and solar cells, among many other devices. In conventional PN junctions, the adjacent p- and n-type regions of a semiconductor are formed by chemical doping. Materials with ambipolar conductance, however, allow for PN junctions to be configured and modified by electrostatic gating. This electrical control enables a single device to have multiple functionalities. Here we report ambipolar monolayer WSe2 devices in which two local gates are used to define a PN junction exclusively within the sheet of WSe2. With these electrically tunable PN junctions, we demonstrate both PN and NP diodes with ideality factors better than 2. Under excitation with light, the diodes show photodetection responsivity of 210 mA/W and photovoltaic power generation with a peak external quantum efficiency of 0.2%, promising numbers for a nearly transparent monolayer sheet in a lateral device geometry. Finally, we demonstrate a light-emitting diode based on monolayer WSe2. These devices provide a fundamental building block for ubiquitous, ultra-thin, flexible, and nearly transparent optoelectronic and electronic applications based on ambipolar dichalcogenide materials.Comment: 14 pages, 4 figure

Evaluating Knowledge Anchors in Data Graphs against Basic Level Objects

The growing number of available data graphs in the form of RDF Linked Da-ta enables the development of semantic exploration applications in many domains. Often, the users are not domain experts and are therefore unaware of the complex knowledge structures represented in the data graphs they in-teract with. This hinders users’ experience and effectiveness. Our research concerns intelligent support to facilitate the exploration of data graphs by us-ers who are not domain experts. We propose a new navigation support ap-proach underpinned by the subsumption theory of meaningful learning, which postulates that new concepts are grasped by starting from familiar concepts which serve as knowledge anchors from where links to new knowledge are made. Our earlier work has developed several metrics and the corresponding algorithms for identifying knowledge anchors in data graphs. In this paper, we assess the performance of these algorithms by considering the user perspective and application context. The paper address the challenge of aligning basic level objects that represent familiar concepts in human cog-nitive structures with automatically derived knowledge anchors in data graphs. We present a systematic approach that adapts experimental methods from Cognitive Science to derive basic level objects underpinned by a data graph. This is used to evaluate knowledge anchors in data graphs in two ap-plication domains - semantic browsing (Music) and semantic search (Ca-reers). The evaluation validates the algorithms, which enables their adoption over different domains and application contexts