Clinicopathological profile of colorectal cancer managed at a university teaching hospital, Nepal

Introductions: Colorectal carcinoma is the third most common cancer worldwide. The incidence is increasing in developing countries including Nepal. The aim of this study is to find out the clinicopathological pattern of colorectal carcinoma locally.  Methods: Data were recorded retrospectively by reviewing the charts of the patients who were diagnosed and treated for in patients having colorectal cancer managed during three years period of 2016-9 at Patan Hospital, the university teaching hospital of Patan Academy of health sciences, Nepal. Clinicopathological profile, age, gender, surgery, histopathological findings were descriptively analised. Results:  There were 36 colorectal cancer patients, male 20 (56%) and females 16 (44%), mean age 56.9 years (range 24 to 89). Curative surgery was possible in 17 (47.2%) and adenocarcinoma of moderate differentiation was found in 25 (70%) of the resected specimen. Conclusions: Colorectal carcinoma was found in old age, slightly more in male than female, adenocarcinoma being most common histology type.  Keywords: adenocarcinoma, colorectal carcinoma (CRC), curative resectio

Outcome of gastrointestinal surgery during COVID-19 lockdown in a tertiary care hospital, Nepal

Introduction: Perioperative strategies have been changing due to the COVID-19 pandemic to prevent the risk of postoperative complications and transmission of infection. This study was aimed to assess the outcome of gastrointestinal surgery and the risk of transmission by implementing COVID-19 testing criteria and surgical strategy. Method: This was a retrospective descriptive study conducted at the department of surgery at Patan Hospital, Nepal, during COVID-19 lock-down from 24 march to 15 June 2020. All patients who underwent gastrointestinal (GI) surgery were included. High-risk patients (as defined by the Hospital Incident Command System, HICS) were tested for COVID-19 preoperatively. Surgery was performed in COVID operating room with full protective gear. Low-risk patients were not tested for COVID-19 preoperatively and performed surgery in non-COVID OR. Data from patient’s case-sheets were analyzed descriptively for age, gender, comorbidities, hospital stay, RT-PCR results, surgeries, and postoperative complications. Result: There were total 44 GI surgeries performed; 31(70.5%) were emergency, 5(11.3%) semi-emergency and 8(18.2%) oncology. There were 11(25%) patients tested for COVID-19 preoperatively and were negative. Nine HCWs tested for COVID-19 randomly were negative. Severe postoperative complications developed in 3 patients, with one mortality. Conclusion: Among GI surgeries, there was no increase in postoperative complications and transmission of COVID-19 to the patients or HCWs following the implementation of standard testing criteria and surgical strategy

Validation of the Wiedemann-Franz Law in solid and molten tungsten above 2000 K through thermal conductivity measurements via steady state temperature differential radiometry

We measure the thermal conductivity of solid and molten tungsten using Steady State Temperature Differential Radiometry. We demonstrate that the thermal conductivity can be well described by application of Wiedemann-Franz Law to electrical resistivity data, thus suggesting the validity of Wiedemann-Franz Law to capture the electronic thermal conductivity of metals in their molten phase. We further support this conclusion using ab initio molecular dynamics simulations with a machine-learned potential. Our results show that at these high temperatures, the vibrational contribution to thermal conductivity is negligible compared to the electronic component

Spectrum of paediatric surgical cases and their outcome in tertiary care hospital: Pediatric surgical cases and their outcome

Introduction: Pediatric surgical cases are operated by general surgeon due to lack of pediatric surgeons. Complex cases in neonates and infants is being referred to other centers with pediatric surgical services. This study aims to compare the spectrum of pediatric surgical cases and their outcomes before and after the availability of pediatric surgeon. Method: This retrospective study was conducted at the Patan Hospital, Nepal, over a period of 4 years. Group 1 (G1) included surgeries during 1st 2 y before and Group 2 (G2) during 2nd 2 y period after the availability of pediatric surgeon. Ethical approval was obtained. Patient age, sex, diagnosis, operative procedure, type of surgery, and outcome were analyzed.  Result: Of 1157 cases, 369 were in G1 and 788 in G2. The male to female ratio was 2.8:1. Laparotomies 270(23.2%) was the most performed inpatient surgery and herniotomies (221(19.1%) in day care. There were 52 (4.5%) neonates; 2(4%) in G1 and 50(96%) in G2. Among total cases, the mortality rate was 8(0.7%) in G2, due to preterm birth, delayed presentation, and septicemia. Conclusion: Laparotomy and incision & drainage were the most commonly performed surgeries. There was a 96% increment in neonatal cases (50 v/s 2) after the availability of pediatric surgeon. Mortality was 8(0.7%) in group-2 due to delayed presentation and septicemia. Keywords: Daycare surgery, mortality, neonatal surgery, outcome, pediatric surgical services  

Population and conservation threats to the vulnerable Sarus crane Grus antigone in Nepal

Abstract Globally, biodiversity is declining due to habitat loss and degradation, over‐exploitation, climate change, invasive species, pollution, and infrastructure development. These threats affect the populations of large waterbird species, such as Sarus crane (Grus antigone), which inhabits agricultural–wetland ecosystems. Despite the burgeoning built‐up areas and diminishing agricultural and wetland spaces, scant research investigates the impact of these changing land uses on the globally vulnerable Sarus crane in Nepal. During the pre‐breeding season from April to June 2023, our comprehensive study meticulously scrutinized Sarus crane population status and factors associated with the occurrences and conservation challenges across 10 specific districts of Nepal. Our study documented a total of 690 individuals of Sarus cranes in five districts. The Lumbini Province has 685 individuals, occupying 11 roosting sites. Conversely, the remaining five districts have no Sarus cranes presence during this period. Wetland, farmland and built‐up areas exhibited a significantly positive influence on Sarus crane occurrences in the Lumbini Province. Additionally, we recorded 47 fatalities of Sarus cranes over the past 13 years in the Lumbini Province due to electrocution and collisions. Our study provides a baseline dataset crucial for developing conservation policies, particularly during the dry season when Sarus crane populations tend to congregate in larger flocks. The adaptation of the Sarus crane to urbanized landscapes exposes them to several anthropogenic threats in the coming days. Therefore, protecting wetlands and farmland areas and adopting transboundary conservation approaches are imperative for the long‐term conservation of the Sarus crane and its habitat

Village-integrated eye workers for prevention of corneal ulcers in Nepal (VIEW study): a cluster-randomised controlled trial

BackgroundCorneal ulcers are a common cause of blindness in low-income and middle-income countries, usually resulting from traumatic corneal abrasions during agricultural work. Antimicrobial prophylaxis of corneal abrasions can help prevent corneal ulcers, but delays in the initiation of therapy are frequent. We aimed to assess whether a community-based programme for corneal ulcer prevention would reduce the incidence of corneal ulceration.MethodsA cluster-randomised trial was performed in village development committees (VDCs) in Nepal. VDCs in the catchment area of Bharatpur Eye Hospital, Nepal with less than 15 000 people were eligible for inclusion. We randomly assigned (1:1) VDCs to either an intervention group or a control group. In the intervention VDCs, existing female community health volunteers (FCHVs) were trained to diagnose corneal abrasions and provide a 3-day course of ophthalmic antimicrobials to their patients. In the control VDCs, FCHVs did not provide this intervention. Participants were not masked given the nature of the intervention. Both groups were followed up for 3 years for photographic evidence of corneal ulceration. The primary outcome was the incidence of corneal ulceration, determined by masked assessment of corneal photographs. The analysis was by intention to treat. This trial is registered with ClinicalTrials.gov, NCT01969786.FindingsWe assessed 112 VDCs, of which 24 were enrolled. The study was performed between Feb 4, 2014, and Oct 20, 2017. 12 VDCs were randomly assigned to the intervention group and 12 to the control group. 252 539 individuals were included in the study (130 579 in the intervention group and 121 960 in the control group). FCHVs diagnosed and provided antimicrobials for 4777 corneal abrasions. The census identified 289 corneal ulcers among 246 893 person-years in the intervention group (incidence 1·21 cases [95% CI 0·85-1·74] per 1000 person-years) and 262 corneal ulcers among 239 170 person-years in the control group (incidence 1·18 cases [0·82-1·70] per 1000 person-years; incidence rate ratio 1·03 [95% CI 0·63-1·67]; p=0·93). Medication allergy was self-reported in 0·2% of participants.InterpretationWe did not detect a reduction in the incidence of corneal ulceration during the first 3 years of a community-based corneal ulcer prevention programme. Further study might be warranted in more rural areas where basic eye care facilities are not available.FundingNational Eye Institute