Communicative Competence of Secondary School Students of Bhutan

This study on communicative competence of secondary school students of Bhutan was conducted with the lower, middle and higher secondary school students under four districts Chukha, Samtse, Paro and Thimphu. The study aimed to explore why communicative proficiency was generally perceived low as reported by LaPrarie (2014). Random sampling survey questionnaire was administered to 864 students and purposive sampling interviews conducted with 24 teacher and 2 curriculum developers from Royal Education Council. Other data collection methods included classroom lesson observation and documentary analysis. Simple descriptive analysis for quantitative data and thematic analysis for qualitative data analysis were employed. The study found that majority of the students had low proficiency level in both English and Dzongkha with a few who had higher level. The low communicative competence in both English and Dzongkha has been attributed to the negative influence of social media in which students showed more interested than engaging in academic reading and writing activities. However, the study found the schools organised relevant activities such as literary fest, debates, and speeches, speaking and writing activities to enhance the communication skills. The research recommends activities such as reviewing the curriculum standards, enhancing teachers’ skills to focus on the communicative skills to improve students’ proficiency in communication

Malaria elimination in Bhutan: asymptomatic malaria cases in the Bhutanese population living in malaria-risk areas and in migrant workers from India

In 2018, Bhutan reported 54 cases of malaria, of which six were indigenous, 14 introduced and 34 imported. Considering the continuous reduction in the number of indigenous cases, Bhutan plans to eliminate malaria by 2025 under the Bhutan Malaria Elimination Strategy. The study was conducted to assess the presence of asymptomatic plasmodial infection in both, Bhutanese population living in malaria-risk areas and in migrant workers to guide the elimination strategies. A cross-sectional study was conducted from April to May 2016 in 750 Bhutanese people and 473 migrant workers. Plasmodium falciparum and Plasmodium vivax infections were investigated by using a rapid diagnostic test (RDT) and the polymerase chain reaction (PCR). Prevalence of asymptomatic plasmodial infection based on PCR was 0.27% (95% CI: 0.05–1.07%) among Bhutanese people with a mean age of 43 years old. The proportions of males and females were 45% and 55%, respectively. Among migrant workers, the prevalence of asymptomatic plasmodial infection was 0.42% (95% CI: 0.07– 1.69%) with a mean age of 30 years old. The majority of migrant workers were from the neighboring Indian State of West Bengal (57.51%), followed by Assam (12.26%). RDT in both study groups did not detect any plasmodial infection. The presence of a low prevalence of asymptomatic plasmodial infection indicates that the current elimination strategies and interventions are effective

An Evaluation of the National Malaria Surveillance System of Bhutan, 2006-2012, as it Approaches the Goal of Malaria Elimination

Introduction: Bhutan is progressing towards malaria elimination. The purpose of this evaluation was to assess the ability of the surveillance system from 2006-2012 to meet the objectives of the Bhutan Vector-borne Disease Control Programme (VDCP) and to highlight priorities requiring attention as the nation transitions to elimination.Methods: The evaluation was conducted using the Center for Disease Control guidelines for evaluating public health surveillance systems. Data sources included a search of publically available literature, VDCP program data, and interviews with malaria surveillance personnel. Blood slide quality assurance and control through formal assessment of slide preparation and measures of between reader correlation was performed. Results: Total malaria cases declined from 2006-2012. The average slide positivity rate decreased from 3.4% in 2006 to 0.2% in 2012. The proportion of non-residents in all cases increased to its highest value of 22.6% in 2012, and significant clustering in the border regions of India was noted, with Sarpang accounting for more cases than any other district from 2009 onward. Case detection was almost exclusively passive, but flexibility and sensitivity was demonstrated by the later addition of active case detection and specification of imported and locally-acquired cases. Spatial data was limited to the village level, not allowing identification of transmission hotspots. For blood smears, statistical measures of between reader agreement and predictive value were not computed. Blood smear quality was suboptimal by at least one criteria in over half of evaluated smears. Timeliness in reporting of cases was on a weekly to monthly basis, and did not meet the WHO goal of immediate notification.Conclusions: As of 2012, the national malaria surveillance system demonstrated flexibility, representativeness, simplicity, and stability. The full potential for data analysis was not yet realized. Attaining the goal of malaria elimination will require system function enhancement through increased and more accurate case detection and rapid investigation, improved health worker training and accountability, focally-targeted response measures, and, in particular, the challenge of finding re-introductions of infections from India. Many such measure have been undertaken or planned as part of the next phase of the Bhutan’s National Strategic Plan

Assignment Computations Based on Cexp Average in Various Ladder Graphs

This study introduces the Cexp average assignments and investigates its properties using various ladder graphs. The ladder graphs can be found in every communication networks. Ladder networks are increasingly being used in everyday life for monitoring and environmental applications such as domestic, military, surveillance, industrial, medical applications, and traffic management. These datasets are afflicted by the average representation of the graph structure. It aids in the visualisation and comprehension of data analysis. The Cexp labeling is used in sensor networks, adhoc networks, and other applications. It also efficiently creates a communication network after using noise reduction methods to remove salt and pepper noise

The First Record of Horned Lark from Jigme Khesar Strict Nature Reserve - A new Record for Bhutan

The Horned Lark (Eremophila alpestris) even though a widespread songbird species had not been recorded from Bhutan. The bird was observed in Jigme Khesar Strict Nature Reserve in a recent trip to Gakiling, Haa. With this new record, the number of bird species found in Bhutan has increased to 739 species

Knowledge, Attitude, and Practice of Infection Control and Waste Management among Traditional Medicine Practitioners in Bhutan, 2019: A Nationwide Cross-Sectional Survey

Background. In Bhutan, Traditional Medicine (TM) is a part of the government-sponsored free healthcare system and Traditional Medicine Units (TMUs) are colocated with allopathic hospitals. Prevention of healthcare-associated infections and patient safety must apply to all institutionalized healthcare settings including TMUs. This study assessed the knowledge, attitude, and practice of TM practitioners in Bhutan in the field of infection control and waste management practices. Methods. This was a descriptive study among TM practitioners selected through simple random sampling. Data were collected using a structured pro forma and entered in EpiData 3.1 and analyzed in STATA 13.1. Results. There were 132 respondents (response rate 98%). The majority (64%) knew the seven steps of handwashing but their knowledge of WHO’s Five Moments for Handwashing was poor, especially handwashing after aseptic procedures (17%) and handwashing after touching patient surroundings (5%). Handwashing before palpation of the pulse (37%) and using gloves while dispensing medicines (9%) were poor; but the proportions of handwashing before performing moxibustion (96%), correct disposal of sharps (84%), and disinfection of cupping sets (78%) were high. The majority of participants hold a positive attitude towards the adoption of infection control and waste management practices for the benefit of patients. Only 23% had received preservice and 44% had received in-service training on infection control. Conclusions. The knowledge and practices of infection control and waste management are optimal only in select domains of practice. The practitioners hold a positive attitude towards the adoption of infection control and waste management standards

Influence of Temperature Gradients and Heat Source in a Combined Layer on Double Component-Magneto-Marangoni-Convection

The present paper has enormous applications including fields of crystal growth, material processing, spacecraft, underground spread of chemical contaminants, petroleum reservoirs, waste dispersal and fertilizer migration in saturated soil, alloy solidification, and many more. The importance of double-diffusive convection has been recognized in various engineering applications, and it has thoroughly been investigated theoretically. In the presence of a constant heat source/sink on both layers, the double component-magneto-Marangoni-convection in a composite layer is examined. Due to heat, this combined layer is enclosed by adiabatic boundaries and exposed to basic temperature gradients. For the system of ordinary differential equations, the thermal surface-tension-driven (Marangoni) number, which also happens to be the Eigenvalue, is solved in closed form. For basic temperature gradients, the eigenvalues, or thermal Marangoni numbers are determined in closed form for lower rigid and higher free boundaries with surface tension, depending on both temperature and concentration. The effect of several parameters on the eigenvalue against depth ratio was studied. It is observed that the inverted parabolic temperature gradient on double component magneto-Marangoni-convection in a combined layer is the most stable of the three temperature gradients and for larger values of depth ratios, all physical parameters are nominal for the porous region dominant combined system

Cardiotoxic effects of poisoning from aconite root in a middle-aged man in Bhutan: a case report

Introduction: Poisoning is a major global health concern and a preventable cause of death. Aconite, an alkaloid found in the aconitum genus frequently leads to poisoning in Asian countries including Bhutan owing to its use in traditional medicine and religious items. Case presentation: A 47-year-old male consumed a tincture of aconite plant root and experienced vomiting, blurred vision, paraesthesia, and light headedness. On presentation to the emergency department, his vitals were normal but on subsequent close monitoring, he had premature ventricular contractions and sinus bradycardia leading to hypotension and shock. He was admitted to the intensive care unit for continuous cardiac monitoring and supportive treatment including atropine and noradrenaline. He reported subjective improvement, his vital signs improved and ECG returned to normal, enabling discharge after 5 days of admission. Conclusion: There is no specific antidote to aconite toxicity so the treatment is mainly supportive. It is imperative to implement proactive measures such as public awareness programs and dedicated research efforts to mitigate the risk of inadvertent toxicity resulting from aconite use

PSYCHOLOGICAL STATUS DURING COVID-19 PANDEMIC AMONG THE GENERAL POPULATION IN BHUTAN

Background: Since the outbreak of the novel coronavirus disease-19 (COVID-19) on 31 December 2019 in Wuhan (Hubei, China), an increasing amount of information, concern, and restrictive public health measures put on to contain the spread of infection have impacted the mental health of the people. The psychological status of the Bhutanese population during this novel coronavirus disease-19 (COVID-19) pandemic is unknown.Aim: To measure the levels of stress, anxiety, and depression in Bhutanese population during the COVID-19 pandemic. The study also aimed to explore the potential differences in psychological status between the demographic variables.Methods and material: A cross-sectional web-based survey was done using a non-probabilistic snowball sampling methodology. Data were collected using the socio-demographic data questionnaire and the Depression Anxiety and Stress scale-21 (DASS-21). Descriptive statistics were used to describe the data, and independent t-tests and analyses of variance (ANOVAs) were used to compare the psychological status among different groups.Results: A total of 663 respondents were recruited. Of them, 21.27% of the participants reported mild to severe levels of depression, 25.04% reported mild to severe levels of anxiety, and 10.56% were stressed. Young and those unemployed during the pandemic showed greater negative psychological symptoms.Conclusion: The results show that psychological problems are prevalent during the COVID-19 pandemic. The findings can help government and health professionals safeguard the psychological wellbeing of the community in the face of COVID-19 outbreak in Bhutan and worldwide

Malaria elimination in Bhutan: asymptomatic malaria cases in the Bhutanese population living in malaria-risk areas and in migrant workers from India

ABSTRACT In 2018, Bhutan reported 54 cases of malaria, of which six were indigenous, 14 introduced and 34 imported. Considering the continuous reduction in the number of indigenous cases, Bhutan plans to eliminate malaria by 2025 under the Bhutan Malaria Elimination Strategy. The study was conducted to assess the presence of asymptomatic plasmodial infection in both, Bhutanese population living in malaria-risk areas and in migrant workers to guide the elimination strategies. A cross-sectional study was conducted from April to May 2016 in 750 Bhutanese people and 473 migrant workers. Plasmodium falciparum and Plasmodium vivax infections were investigated by using a rapid diagnostic test (RDT) and the polymerase chain reaction (PCR). Prevalence of asymptomatic plasmodial infection based on PCR was 0.27% (95% CI: 0.05–1.07%) among Bhutanese people with a mean age of 43 years old. The proportions of males and females were 45% and 55%, respectively. Among migrant workers, the prevalence of asymptomatic plasmodial infection was 0.42% (95% CI: 0.07–1.69%) with a mean age of 30 years old. The majority of migrant workers were from the neighboring Indian State of West Bengal (57.51%), followed by Assam (12.26%). RDT in both study groups did not detect any plasmodial infection. The presence of a low prevalence of asymptomatic plasmodial infection indicates that the current elimination strategies and interventions are effective