Entrepreneurial Design Thinking Course at Secondary School in Nepal: Contextual Prospects and Challenges

The glorification of entrepreneurship in Nepal has led to various stakeholders being interested in the entrepreneurship ecosystem of the country including the educational stakeholders. A surge is being observed in the number of educational institutions that now offer entrepreneurship courses to their students. However, little has been done to investigate the impact of such courses. A secondary school in Nepal used the design thinking approach strategy to conduct entrepreneurship classes for its secondary level students. This paper attempts to assess the effectiveness of the entrepreneurship classes conducted at the school by using the mixed method strategy. Our paper found that the year-long entrepreneurship course helped shift the mindset of students from a fixed mindset to a growth mindset by giving them a solution-seeking lens and the emotional engagement of the students with the course was also seen as high. Similarly, an emotional growth was also seen in the side of the educator. However, owing to the time boundaries and less support from school administration, the entrepreneurship course was not seen as successful in leading meaningful development of 21st-century skills like collaboration, creativity, curiosity, experimentalism in students. Keywords: entrepreneurship, design thinking, entrepreneurship education, emotional engagement DOI: 10.7176/JEP/12-1-04 Publication date: January 31st 2021

Overcoming Barriers as a Nepali Woman through Emotional Intelligence: My Emotional Literacy Journey into my Ph.D. in Educational Leadership

This article explores my process of being emotionally literate, realizing my personal power through it and deciding to move ahead with my Ph.D. to explore further as my contribution in the flourishing of humanity. In this qualitative reflective self-study, I have used my detailed personal, professional, and academic reflective journal and audio-visual narratives that I had kept over seven years as data to explore the process of learning. The article reveals my process of learning from my experiences as a confused Nepali girl to my experience of working as a journalist, to an aspiring educational leader and a researcher. The results are discussed using a microscopic lens into my childhood and understanding how the social settings were playing a major role in my learning and how emotional intelligence played an instrumental role in deconstructing that and helped me understand myself better and urging me to explore further through my Ph.D. research as an educational leader

VAGINAL DELIVERY OF MULTIVALENT ANTI-SPERM ANTIBODIES FOR EFFECTIVE NON-HORMONAL CONTRACEPTION

Nearly half of all pregnancies in the United States are unintended, due to poor adoption of existing methods of contraception, the majority of which are hormonal methods. Naturally occurring sperm-binding antibodies prevents fertilization in immune infertile women by trapping motile sperm in mucus through agglutination and mucin-crosslinking, thereby preventing sperm from reaching the egg. Indeed, vaginal delivery of sperm agglutinating IgM in the highly fertile rabbit model reduced embryo formation by 95%. This led us to explore the direct vaginal delivery of sperm-binding monoclonal antibodies as a strategy for effective non-hormonal contraception. In this dissertation, I worked to 1) Engineer a panel of multivalent IgGs possessing 4-10 Fabs against a unique surface antigen universally present on human sperm, 2) Assess the agglutination and trapping potency of all multivalent IgGs in vitro and in vivo, 3) Develop self-dissolving intravaginal film comprising of hexavalent sperm-binding IgG (6 Fabs per molecule; termed as “FIF”) produced in cGMP-compliant Nicotiana-expression system and 4) Evaluate the potency of FIF-Film in reducing progressively motile sperm in the sheep vagina. Our results indicated that all multivalent IgGs produced at comparable yields and possessed identical thermal stability and homogeneity to the parent IgG. All multivalent IgGs were markedly more potent and faster at agglutinating sperm than the parent IgG, while preserving Fc-mediated crosslinking of individual spermatozoa in mucus. Especially, the highly multivalent IgGs (HM-IgGs; 6-10 Fabs per molecule) were at least 10- to 16-fold more potent and faster at agglutinating sperm than the parent IgG. The increased potencies translated to effective (>99.9%) reduction of progressively motile sperm in the sheep vagina using just 33 micrograms of the 10-Fab HM-IgG per sheep. Similarly, the polyvinyl alcohol-based water-soluble contraceptive film formulated with Nicotiana-expressed 6-Fab HM-IgG enabled complete agglutination of all progressively motile sperm within 2 mins in the sheep vagina. These results not only underscore the potential of multivalent contraceptive antibodies to provide safe, effective, on-demand non-hormonal contraception but also represent a promising platform for generating potent agglutinating mAb for diverse medical applications such as anti-bacterial therapeutics.Doctor of Philosoph

Prevalence of Malnutrition in a Rural Residential Sanskrit School in Baglung, Nepal

Introduction: Under-nutrition is a condition in which there is inadequate consumption, poor absorption or excessive loss of nutrients. Nepal still faces high chronic as well as acute under‐nutrition in children. The following study was conducted a Sanskrit school in rural Baglung to find the prevalence of malnutrition among the children which could reflect the nutritional status of the community. Methods: Out of 60 students admitted to the school, only 43 were present at the time when we collected our data. Weight was measured with a standard weighing scale and standing height with a measuring tape attached to the wall. Data were filled up in proforma, entered in Microsoft Excel 2013 and were analyzed and indicators calculated with SPSS version 20 using WHO Child Growth Reference data for 5-19 years and macros. Results: Stunting (Z score < -2) was found in 53.5 % of the study group and severe stunting (Z score < -3) was found in 25.6%. 12.5% of the 8 children under 10 years in our study had weight for age < -2 Z score which indicates underweight. No one was severely underweight. In our study, 2.3% had severe thinness (Z-score < -3), 14% had thinness (Z-score < -2). No one was overweight or obese. Conclusions: The prevalence of malnutrition was high among the students of the rural Sanskrit school where the study was conducted.   Keywords: anthropometry; Baglung; malnutrition; Nepal; prevalence

Appropriateness of perioperative antibiotics in thyroid surgery

Background: Most of the guidelines do not recommend routine antibiotics prophylaxis in clean head and neck surgery like thyroidectomy. In contrary to the recommendation, antibiotics are being routinely prescribed in perioperative period for various duration in many centers of Nepal. This study was aimed to find out the need of postoperative antibiotics in surgeries for thyroid related problems. Methods: Records of all patients who had undergone surgery for thyroid related problems from Jan, 2019 to Sept, 2022 were retrospectively reviewed for patterns of antibiotic use, apart from preincision antibiotic, in postoperative period which was classified as group A – no antibiotics, group B – shorter course of antibiotics (≤3 days) and group C – longer course of antibiotics (&gt;3 days). The occurrence of surgical site infection (SSI) was recorded. Results: During the study period, 77 patients underwent surgery for thyroid related problems, out of which five were excluded (records not found in four cases and one patient was ASA III). Two out of 72 (2.77 %) patients developed superficial incisional SSI which was managed conservatively. One patient in each group A (50) and group B (8) developed SSI. Conclusion: Postoperative antibiotics can be avoided safely even in our setup in clean head and neck surgeries like thyroidectomy without increase in the risk of SSI thus reducing the cost to the patients. &nbsp

A study of the prevalence and risk factors leading to HIV infection among a sample of street children and youth of Kathmandu

Background: The true prevalence of HIV and other sexually transmitted diseases among street children in Nepal is virtually unknown while information on related behavioural risk factors in this population is non-existent. The risk of HIV infection among street children and adolescents may be especially high due to their marginalized social and economic conditions. This study was conducted to determine the prevalence of HIV infection among a sample of street children and youth of Kathmandu and to identify risk factors associated with HIV infection in this group. A sample of street children and youth was recruited based on the purposive sampling of ten streets in Kathmandu, Nepal, known to have a high density of street children and youth. A total of 251 street children (aged 11–16 years) and youth (aged 17–24 years) were enrolled, with informed consent, from November, 2008 through June, 2009. Most of the participants (95%) were male. Case status was determined by serological assessment of HIV status; data on risk factors were obtained using structured survey interviews. HIV prevalence and rates of a number of behavioural risk factors suspected to play a role in HIV transmission among street children and youth were determined, including unprotected sex, intravenous drug use, and other risky sex and substance use behaviours. Results: Among the 251 children and youth, we found an overall HIV prevalence of 7.6%. As the sample size of females was small (n = 13) and the behavioural risk factors are likely to be quite different for boys and girls, we conducted separate analyses by gender. As our small sample of females is unlikely to be representative and lacks power for statistical testing, our report focuses on the results for the males surveyed.The strongest behavioural risk factor to emerge from this study was intravenous drug use; 30% of the male subjects were injecting drug users and 20% of those were HIV positive. Furthermore, frequency of drug injection was a highly significant predictor with a dose–response relationship; males reporting occasional injection drug use were nearly 9 times more likely to be HIV positive than never users, while weekly drug injectors had over 46 times the risk of non-users, controlling for exposure to group sex, the only other significant risk factor in the multivariate model. Conclusions: This sample of street children and youth of Kathmandu has a nearly 20-fold higher prevalence of HIV infection than the general population of Nepal (0.39%). The children and youth engage in number of high risk behaviours, including intravenous drug use, putting them at significant risk of contracting HIV and other sexually transmitted infections

First insights into the phylogenetic diversity of Mycobacterium tuberculosis in Nepal

BACKGROUND: Tuberculosis (TB) is a major public health problem in Nepal. Strain variation in Mycobacterium tuberculosis may influence the outcome of TB infection and disease. To date, the phylogenetic diversity of M. tuberculosis in Nepal is unknown. METHODS AND FINDINGS: We analyzed 261 M. tuberculosis isolates recovered from pulmonary TB patients recruited between August 2009 and August 2010 in Nepal. M. tuberculosis lineages were determined by single nucleotide polymorphisms (SNP) typing and spoligotyping. Drug resistance was determined by sequencing the hot spot regions of the relevant target genes. Overall, 164 (62.8%) TB patients were new, and 97 (37.2%) were previously treated. Any drug resistance was detected in 50 (19.2%) isolates, and 16 (6.1%) were multidrug-resistant. The most frequent M. tuberculosis lineage was Lineage 3 (CAS/Delhi) with 106 isolates (40.6%), followed by Lineage 2 (East-Asian lineage, includes Beijing genotype) with 84 isolates (32.2%), Lineage 4 (Euro-American lineage) with 41 (15.7%) isolates, and Lineage 1 (Indo-Oceanic lineage) with 30 isolates (11.5%). Based on spoligotyping, we found 45 different spoligotyping patterns that were previously described. The Beijing (83 isolates, 31.8%) and CAS spoligotype (52, 19.9%) were the dominant spoligotypes. A total of 36 (13.8%) isolates could not be assigned to any known spoligotyping pattern. Lineage 2 was associated with female sex (adjusted odds ratio [aOR] 2.58, 95% confidence interval [95% CI] 1.42-4.67, p = 0.002), and any drug resistance (aOR 2.79; 95% CI 1.43-5.45; p = 0.002). We found no evidence for an association of Lineage 2 with age or BCG vaccination status. CONCLUSIONS: We found a large genetic diversity of M. tuberculosis in Nepal with representation of all four major lineages. Lineages 3 and 2 were dominating. Lineage 2 was associated with clinical characteristics. This study fills an important gap on the map of the M. tuberculosis genetic diversity in the Asian reg

Cost of wastewater-based environmental surveillance for SARS-CoV-2: evidence from pilot sites in Blantyre, Malawi and Kathmandu, Nepal

Environmental surveillance of rivers and wastewater for SARS-CoV-2 detection has been explored as an innovative way to surveil the pandemic. This study estimated the economic costs of conducting wastewater-based environmental surveillance for SARS-CoV-2 to inform decision making if countries consider continuing these efforts. We estimated the cost of two SARS-CoV-2 environmental surveillance pilot studies conducted in Blantyre, Malawi, and Kathmandu, Nepal. The cost estimation accounted for the consumables, equipment, and human resource time costs used for environmental surveillance from sample selection until pathogen detection and overhead costs for the projects. Costs are reported in 2021 US$and reported as costs per month, per sample and person per year. The estimated costs for environmental surveillance range from$6,175 to $8,272 per month (Blantyre site) and$16,756 to $30,050 (Kathmandu site). The number of samples processed per month ranged from 84 to 336 at the Blantyre site and 96 to 250 at the Kathmandu site. Consumables costs are variable costs influenced by the number of samples processed and are a large share of the monthly costs for ES (ranging from 39$25 to $74 (Blantyre) and$120 to $175 (Kathmandu). There were associated economies of scale for human resources and equipment costs with increased sample processing and sharing of resources with other activities. The cost per person in the catchment area per year ranged from$0.07 to $0.10 in Blantyre and$0.07 to $0.13 in Kathmandu. Environmental surveillance may be a low-cost early warning signal for SARS-CoV-2 that can complement other SARS-CoV2 monitoring efforts

Tuberculosis in Staff and Students of Patan Hospital.

BACKGROUND There is a high risk of occupational exposure to tuberculosis among healthcare workers in endemic countries. Regular screening for tuberculosis among healthcare workers is not carried out in Nepal. Infection control measures are also not routinely implemented. The aim of this study was to determine the prevalence of active tuberculosis among staff/students at Patan Hospital. METHODS Participants were given a self-administered questionnaire and invited to undergo chest radiography. Cases were scored and reviewed based on predetermined criteria, and presumptive tuberculosis cases were invited to undergo sputum smear and culture. Participants were categorized according to the extent of patient contact and asked about history of tuberculosis medication. RESULTS Among 560 participants, 76.8% had direct contact with patients. Fifty-eight (10.4%) gave history of cough >2 weeks. Based on symptom history and chest radiography, 20.0% (n=112) cases were reviewed, and 12.5% (n=14) of those reviewed had sputum tested for acid-fast bacilli. One participant had culture-positive tuberculosis. Fifty participants (8.9%) reported tuberculosis in the past, among which 42.0% (n=21) occurred after employment at Patan Hospital and 42.0% before joining Patan Hospital. Security staff, radiology technicians and ward cleaning staff had the highest proportion of cases with a history of tuberculosis.History of tuberculosis medication had no relation with age, sex, education, body mass index and smoking.The incidence rate of tuberculosis at Patan Hospital was 3.6 per 1000 person-years. CONCLUSIONS Overall incidence of tuberculosis among healthcare workers is noteworthy. However, this study suggests when symptomatic tuberculosis occurs in healthcare worker at Patan Hospital, it is diagnosed and there is not a large pool of undiagnosed tuberculosis