Knowledge on risk factors of uterine prolapse among reproductive age group women of Bajrabarahi Municipality of Lalitpur, Nepal

Background: Pelvic organ prolapse (POP) is a most common gynecological health problem contributing to maternal morbidity and mortality among women of reproductive age in developing countries. In Nepal prevalence of uterus prolapse among reproductive age women is around 17-27%. Still large numbers of rural Nepalese women are deprived of access to early diagnosis and quality treatment services related uterus prolapse. The present study was conducted with the aims to assess knowledge on risk factors on uterine prolapse among the reproductive age group of women who have at least one child below five years of age and residing at Bajrabarahi municipality of Lalitpur district.Methods: This is a cross sectional descriptive study. Total 185 individuals were randomly selected from the list of safe motherhood register book of Bajrabarahi municipality for the interview. Semi-structured questionnaire was used as tools to collect data from study participants. Data collected was entered in Epi-data and data analysis was done using SPSS 16.0 version. Bivariate analysis was done using Chi-Square test to find the association between the selected variables of the study.Results: The study results shows that out of total 46.5% of respondents have adequate knowledge and 53.5% of respondents have inadequate knowledge regarding risk factors of uterus prolapse. The study results explicitly reflects the knowledge on risk factors of uterus prolapse is significantly associated with the age of respondent (p=0.021), age at marriage of respondents (p=0.011), education status of respondents (p=0.001) and age at first child birth of respondent (p=0.001).Conclusions: Though majority of respondents have heard about uterus prolapse, very few participants have in-depth or adequate knowledge about risk factors of uterus prolapse. Still extensive efforts of government and non-government organizations are essential to improve maternal health status of rural Nepalese women

Abnormal Anatomic Variation of Pancreaticobiliary Union in Magnetic Resonance Cholangiopancreatography Department of Radiology and Imaging in a Tertiary Care Centre: A Descriptive Cross-sectional Study

Introduction: The knowledge of the variations of the abnormal anatomy of pancreaticobiliary union is of great importance for understanding various pathologies of the biliary tract, gall bladder, and pancreas as well as to avoid surgical complications and morbidity which may arise from pancreaticobiliary maljunction. Moreover, it helps in the early diagnosis and preventive treatment of pancreaticobiliary disease. The objective of this study was to find out the prevalence of abnormal anatomic variations of the pancreaticobiliary union in magnetic resonance cholangiopancreatography examinations. Methods: This descriptive cross-sectional study was done in patients referred for Magnetic resonance cholangiopancreatography examinations for various clinical indications from 1 February 2021 to 30 May 2021. Ethical approval was obtained from the Institutional Review Committee [Reference number: 306 (6-11)E 2 077/078]. The variations in the pancreaticobiliary union, length of the common channel, and angle between the common bile duct and major pancreatic duct were obtained from the 1.5T magnetic resonance scanner in 90 patients. The three‑dimensional magnetic resonance cholangiopancreaticography images were visually analyzed and classified into four categories. Convenience sampling method was used. Point estimate and 90% Confidence Interval were calculated. Results: Out of 90 patients, 73 (81.11%) (74.34-87.88, 90% Confidence Interval) patients had abnormal pancreaticobiliary union with pancreaticobiliary type as the most common occurrence seen in 33 (36.67%) patients. Conclusions: The prevalence of abnormal anatomic variation of pancreaticobiliary union was found to be higher than other studies done in similar settings

The Great Glacier and Snow-Dependent Rivers of Asia and Climate Change: Heading for Troubled Waters

The glacier- and snow-fed river basins of the Hindu Kush Himalaya (HKH) mountains provide water to 1.9 billion people in Asia. The signs of climate change in the HKH mountains are clear, with increased warming and accelerated melting of snow and glaciers. This threatens the water, food, energy and livelihood security for many in Asia. The links between mountains and plains and the differential impacts of climate change on societies upstream and downstream need to be better established to improve adaptation measures. This chapter sheds light on climate change impacts on the cryosphere and mountains, the impact on river systems and the social consequences of such changes in mountains, hills and plains. In high mountains and hills, the impact of climate change is clear, as seen in changes in agropastoral systems and the increasing occurrence of floods and droughts, with losses and damages already high. Moving downstream, the climate change signal is harder to separate from other environmental and management factors. This chapter outlines how climate change in the mountains will impact various sectors in the hills and plains, such as hydropower, irrigation, cities, industries and the environment. It discusses how climate change will potentially lead to increased disasters and out-migration of people. The chapter concludes by highlighting necessary actions, such as the need to reduce emissions globally, build regional cooperation between HKH countries, increase technical and financial support for adaptation, and more robust and interdisciplinary science to address changing policy needs

Development of a Lab Experiment for Intrusion Detection System in Wireless Body Area Networks

With the advent of sophisticated technology and associated indubitable benefits, the wireless network is gaining popularity day by day. Still there exists numerous security challenges and to overcome these, different researches are being carried on. This suggests that the wireless security is still in nascent stage and requires further development. The new wireless technologies like Wireless Body Area Network, thus provides tough challenges to security professionals. Wireless Body Area Network (WBAN) technology has been center of attraction in e-health system. In this system, data security breach might even cost lives of patients, so it alarms the need for highly reliable security system. This thesis is pivoted on security vulnerabilities in Wireless Body Area Network and mitigation tools and techniques to get rid of them. The study corresponds with security concern of Adaptive Security for Smart Internet of Things in e-Health (ASSET)project that has been launched by Norwegian Research Center. The thesis enlightens ASSET with different types of security threats that exist in wireless network, specifically on WBAN. It provides ASSET an infrastructure setup to facilitate security analysis in its network environment. ZigBee network, an instance of the WBAN is deployed as experimental platform. Experiments are performed in the OPNET network simulator and ASSET laboratory, consisting of different types of sensor devices. The study shows DoS attack and message replay attack are easily accomplished and prevalent in WBAN. However, security system to prevent them are under development. Finally, the thesis provides ASSET a platform to perform security analysis on WBAN deployment

Knowledge on risk factors of uterine prolapse among reproductive age group women of Bajrabarahi Municipality of Lalitpur, Nepal

Background: Pelvic organ prolapse (POP) is a most common gynecological health problem contributing to maternal morbidity and mortality among women of reproductive age in developing countries. In Nepal prevalence of uterus prolapse among reproductive age women is around 17-27%. Still large numbers of rural Nepalese women are deprived of access to early diagnosis and quality treatment services related uterus prolapse. The present study was conducted with the aims to assess knowledge on risk factors on uterine prolapse among the reproductive age group of women who have at least one child below five years of age and residing at Bajrabarahi municipality of Lalitpur district.Methods: This is a cross sectional descriptive study. Total 185 individuals were randomly selected from the list of safe motherhood register book of Bajrabarahi municipality for the interview. Semi-structured questionnaire was used as tools to collect data from study participants. Data collected was entered in Epi-data and data analysis was done using SPSS 16.0 version. Bivariate analysis was done using Chi-Square test to find the association between the selected variables of the study.Results: The study results shows that out of total 46.5% of respondents have adequate knowledge and 53.5% of respondents have inadequate knowledge regarding risk factors of uterus prolapse. The study results explicitly reflects the knowledge on risk factors of uterus prolapse is significantly associated with the age of respondent (p=0.021), age at marriage of respondents (p=0.011), education status of respondents (p=0.001) and age at first child birth of respondent (p=0.001).Conclusions: Though majority of respondents have heard about uterus prolapse, very few participants have in-depth or adequate knowledge about risk factors of uterus prolapse. Still extensive efforts of government and non-government organizations are essential to improve maternal health status of rural Nepalese women

A Critically Ill Child with Gangrenous Appendicitis Masquerading as Hollow Viscous Perforation

Background. Severe complications of acute appendicitis (AA) hitherto well described are less common in clinical practice nowadays. When a septic child is encountered with a short history of abdominal symptoms and disproportionate signs of peritonitis further complicated by radiological findings causing a diagnostic conundrum, management becomes exceedingly demanding. Case Presentation. A 10-year-old previously healthy boy presented to the emergency room with generalized abdominal pain associated with fever and jaundice for a day. Blood workup revealed leucopenia, hyperbilirubinemia, hyponatremia, and elevated CRP. Initial radiological evaluation suggested hollow viscous perforation. He was diagnosed to have hollow viscous perforation peritonitis in severe sepsis. At laparotomy, generalized peritoneal contamination was found, the source of which could be traced down to the gangrenous perforated appendix. Conclusion. Complicated appendicitis, in children, can present with baffling findings. Timely identification of an ill child, adequate workup, prompt resuscitation, and source control are imperative for a successful outcome

Bacteria on Medical Professionals’ White Coats in a University Hospital

The transient contamination of medical professional’s attires including white coats is one of the major vehicles for the horizontal transmission of microorganisms in the hospital environment. This study was carried out to determine the degree of contamination by bacterial agents on the white coats in a tertiary care hospital in Nepal. Sterilized uniforms with fabric patches of 10 cm × 15 cm size attached to the right and left pockets were distributed to 12 nurses of six different wards of a teaching hospital at the beginning of their work shift. Worn coats were collected at the end of the shifts and the patches were subjected for total bacterial count and identification of selected bacterial pathogens, as prioritized by the World Health Organization (WHO). Fifty percent of the sampled swatches were found to be contaminated by pathogenic bacteria. The average colony growth per square inch of the patch was 524 and 857 during first and second workdays, respectively, indicating an increase of 63.6% in colony counts. The pathogens detected on patches were Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa, and Acinetobacter sp. Additional bacteria identified included Bacillus sp., Micrococcus sp., and coagulase-negative staphylococci (CoNS). The nurses working in the maternity department had their white coats highly contaminated with bacteria. On the other hand, the least bacterial contamination was recorded from the nurses of the surgery ward. One S. aureus isolate from the maternity ward was resistant to methicillin. This study showed that pathogens belonging to the WHO list of critical priority and high priority have been isolated from white coats of nurses, thus posing the risk of transmission to patients. White coats must be worn, maintained, and washed properly to reduce bacterial contamination load and to prevent cross-contamination of potential superbugs. The practice of wearing white coats outside the healthcare zone should be strictly discouraged

Chronic Kidney Disease among COVID-19 Patients Admitted in the Department of Medicine of a Tertiary Care Centre: A Descriptive Cross-sectional Study

Introduction: Comorbidities are frequently seen in admitted COVID-19 patients most common being hypertension, diabetes, cardiovascular diseases and chronic kidney disease. Chronic kidney disease is a slowly progressive chronic illness due to the gradual loss of kidney function or structure. The available data regarding the prevalence of chronic kidney disease and COVID-19 comorbidities is still limited. The aim of this study was to find out the prevalence of chronic kidney disease among COVID-19 patients admitted to the Department of Medicine of a tertiary care centre. Methods: A descriptive cross-sectional study was done in the Department of Medicine of a tertiary care centre. Data of medical records between 1 August 2020 to 1 December 2022 were reviewed retrospectively. The data was collected from 20 January 2023 to 20 March 2023. Ethical approval was obtained from the Institutional Review Committee (Reference number: 646/2079/80). Data on chronic kidney disease patients among COVID-19 patients were collected from the hospital records. Convenience sampling method was used. Point estimate and 95% Confidence Interval were calculated. Results: Among 584 COVID-19 patients admitted, the prevalence of chronic kidney disease was 43 (7.36%) (5.24-9.48, 95% Confidence Interval). A total of 30 (69.77%) were male and 13 (30.23%) were female with a mean age of 55±16.22 years. Conclusions: The prevalence of chronic kidney disease among COVID-19 patients admitted in the department of Medicine of a tertiary care centre was found to be slightly higher than other studies done in similar settings

Phenetic and Molecular Diversity of Nitrogen Fixating Plant Growth Promoting Azotobacter Isolated from Semiarid Regions of India

In the present study, 24 Azotobacter strains were isolated from soils of different areas of southern Rajasthan and characterized at biochemical, functional, and molecular levels. The isolated Azotobacter strains were gram negative and cyst forming when viewed under the microscope. These strains were also screened for their plant growth promoting activities and the ability of these isolates to survive under abiotic stress conditions viz. salt, pH, temperature, and drought stress. All the isolates showed IAA, siderophore, HCN, and ammonia production, whereas seven Azotobacter strains showed phosphate solubilization. Amplified Ribosomal DNA Restriction Analysis (ARDRA) revealed significant diversity among Azotobacter strains and the dendrogram obtained differentiated twenty-four of the strains into two major clusters at a similarity coefficient of 0.64. Qualitative and quantitative N2 fixation abilities of these strains were also detrained, and the amounts of acetylene reduced by Azotobacter strains were in the range of 1.31 to 846.56 nmol C2H4 mg protein−1 h−1. The strains showing high nitrogen fixation ability with multiple PGP activities were selected for further pot studies, and these Azotobacter strains significantly increased the various plant growth parameters of maize plantlets. Furthermore, the best Azotobacter isolates were subjected to 16S rRNA sequencing and confirmed their identities as Azotobacter sp. The indigenous Azotobacter strains with multiple PGP activities could be further used for commercial production