Normal or Arthritic: Is 25-hydroxy Vitamin D status significant?

Background: Vitamin D is required for proper skeletal development and function. However, the status of vitamin D in healthy subjects and those suffering from arthritis in Nepal is largely unknown. Objective: This study measured vitamin D level in healthy and arthritic individuals of Western Nepal. Methods: Vitamin D level in healthy and arthritic subjects were measured by using LIASION 25-hydroxy Vitamin D assay, a direct competitive chemiluminescence immunoassay (CLIA). Results: Our result suggested that most of the subjects, irrespective of age and disease condition, have subnormal/normal level of vitamin D (≥16ng/mL). Also, the data suggested that serum vitamin D level is significantly higher in males than in females. Moreover, the vitamin D level is higher in healthy individuals when compared with those suffering from arthritis. However, vitamin D level in normal subjects and arthritic patients could not be correlated. Conclusion: Vitamin D level is higher in normal subjects compared to arthritic individuals. However, the level could not be correlated suggesting need of a pilot study to determine vitamin D level and its association with arthritis in Nepalese. Journal of Gandaki Medical College Vol. 10, No. 1, 2017, Page: 21-2

Intellectual Property Right on Basmati Rice: Current Scenario and Evidences of Origin, Diversity, Cultivation and Use Values of Basmati Rice in Nepal

Basmati rice, also called the king/prince of rice landraces has very special values in Nepalese society as well as in other countries of Indian Subcontinent. With the objectives of collecting, analyzing and documenting Basmati related information in Nepal, we visited different sites; carried out key informant surveys; organized focus group discussions, online interaction and discussion meetings; requested all relevant offices/ persons/ stakeholders through phone, website, and letter to share information; organized high level official meeting, and Basmati rice expert meeting; documented video documentary and did online as well as library search. Because of its high market value at global level, many countries and organizations have been attempting to get intellectual property rights (mainly patent and geographical indication tag) on Basmati rice. India applied for GI tag to Basmati rice in the European Union (EU) in July 2018, and Nepal submitted opposition letter along with proofs and evidences of origin, diversity, cultivation and use values of Basmati rice on 9 December 2020. A total 133 Basmati type rice landraces are grown in 60 districts of Nepal. Basmati rice is traditionally grown, sold, and consumed in geographically localized areas of Nepal since ancient time. International and national scientists have defined lower altitude of Nepal as one of the centers of origin of Basmati rice. Many Nepalese basmati rice landraces have been characterized and evaluated using morphological traits, isozymes and DNA markers. Four basmati type of rice landraces have been registered in National Seed Board. Many community seed banks have maintained different types of Basmati rice landraces. National Agriculture Genetic Resources Center and International genebanks have collected more than 80 and conserved 68 basmati landraces. Basmati rice landraces have geo-linked traits. The historical culture of production, consumption and marketing of native basmati rice in Nepal should always be favored by both national and international rules and regulations. Nepal has ample and valid evidences to get geographical indication (GI) right on Basmati rice

Functional outcome of the treatment of AO-ASIF type C distal humerus fracture using Lambda plate

Introduction: Although the use of two plates for the treatment of type-C distal humerus fracture is popular, site of plate placement still is under debate. Use of Lambda plate for the fracture treatment can be easier and settle the dispute. This study aims to evaluate the functional outcome of the surgery using Lambda Plate. This can be a reference for surgeons and helps them make the decision about choice of implant for type C distal humerus fracture treatment among Nepalese people. Methods: This interventional study used Lambda plate for the treatment of type C fracture of distal humerus. Patients were examined at 4, 12, and 24 weeks respectively for the measurement of the outcome. Visual analogous scale was used for assessment of pain, range of motion for functional recovery and Mayo Elbow Performance Score was used for the assessment of functional outcome. Paired-samples t-test and linear regression was used to for data analysis. Results: Functional outcome at the last follow-up was excellent in 24(53.33%) patients, good in 18(40%) patients and fair in 3(6.67%) patients. Range of motion of elbow increased significantly with every follow-up (p-value <0.001). Average angle of flexion at last follow-up was 117.53°±11.74 while loss of extension was 7.53°±4.86. Average number of patients had their fracture union at 19.84±2.38 weeks. There was no association of age, sex and union weeks with functional outcome when measured with MEPS. Conclusion: Fixation of distal humerus fracture by using Lambda plate gave excellent and satisfying outcome in terms of pain, range of motion and objective functional outcome

Factors associated with chronic obstructive pulmonary diseases in Nepal: evidence from a nationally representative population-based study

Background: The Global Burden of Diseases Study 2017 predicted that chronic obstructive pulmonary disease (COPD) is the second leading cause of death, the fourth leading cause of premature death, and the third cause for DALYs lost in Nepal. However, data on the population-based prevalence of COPD in Nepal are very limited. This study aims to assess the prevalence of COPD and factors associated with the occurrence of COPD in Nepal. Methods: From a nationally representative, population-based cross-sectional study on chronic non-communicable diseases, the prevalence of COPD and its associated factors was determined. Of 12,557 participants aged over 20 years, 8945 participants completed a questionnaire and spirometry. Eligible participants were also asked to answer a COPD diagnostic questionnaire for screening COPD cases, and if needed underwent pre-bronchodilator and post-bronchodilator spirometry. COPD was defined as a post-bronchodilator FEV1/FVC (forced expiratory volume in 1 s/forced vital capacity) ratio of < 0.70. Multivariate logistic regression was performed to identify factors associated with COPD. Sampling weights were used for all data analyses. Results: The prevalence of COPD in Nepal was 11.7% (95% CI: 10.5% to 12.9 %), which increased with age, and higher in those with a low educational level, those who had smoked ≥ 50 pack-years, persons having a low body mass index (BMI), and residents of Karnali province. Multivariate analysis revealed that being aged 60 years and above, having a low BMI, low educational status, having smoked more than 50 pack-years, provincial distribution, and ethnicity were independent predictors of COPD. Conclusion: COPD is a growing and serious public health issue in Nepal. Factor such as old age, cigarette smoking, low educational attainment, low BMI, ethnicity, and locality of residence (province-level variation) plays a vital role in the occurrence of COPD. Strategies aimed at targeting these risk factors through health promotion and education interventions are needed to decrease the burden of COPD

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