Otomycosis and its Predisposing Factors in Out-Patient Department of Otorhinolaryngology in a Tertiary Care Center

Introduction: Otomycosis is a fungal infection of external auditory canal frequently encountered by otorhinolaryngologists. It causes discomfort to patients with varied symptoms of pruritus, otorrhea, aural fullness and earache. People with a habit of using unnecessary ear drops, cleaning ear with unsterilized objects and those who use mustard oil are all prone to otomycosis. This study aims to find out the association between otomycosis and its predisposing factors. Methods: This study was undertaken in the Department of Otorhinolaryngology of a tertiary hospital from March 2018 to February 2019 and a total of 300 clinically diagnosed cases of otomycosis were enrolled for the study. Results: The mean age ±SD of the patients was 37.7 ± 18.8 years. Females (n=172, 57.3%) were more prone to otomycosis than males (n=128, 42.7%). The most common presenting symptom was pruritus only (n=95, 31.7%) with unilateral involvement being more common. The most common predisposing factor was mustard oil instillation (n=124, 41.3%). Aspergillus niger  was the most common fungus causing otomycosis in this study (n=104, 34.7%). Positive fungal cultures were observed in 285 specimens (95%). The fungal growth (n=285) was high in patients with the history of instilling mustard oil (42.8%) into the ear, 34.0% in topical steroid containing ear drops and 23.2% in self-cleaning group. Conclusion: Otomycosis is common in people using unnecessary steroid containing ear drops, cleaning ear with unsterilized objects and instillation of mustard oil

An Advanced LMI-Based-LQR Design for Load Frequency Control of an Autonomous Hybrid Generation System

Part 13: Energy GenerationInternational audienceThis paper proposes a load frequency control scheme for an autonomous hybrid generation system consisting of wind turbine generator (WTG), diesel engine generator (DEG), fuel cell (FC), aquaelectrolyzer (AE) and battery energy storage system (BESS). In wind power generation systems, operating conditions are changing continually due to wind speed and load changes, having an effect on system frequency. Therefore, a robust controller is required for load frequency control. The control scheme is based on Linear Matrix Inequality (LMI)-Linear Quadratic Regulator (LQR). The control optimization problem is obtained in terms of a system of LMI constraints and matrix equations that are simultaneously solved. The proposed load frequency control scheme with the advanced LMI-based-LQR (ALQR) design is applied for the autonomous hybrid generation system. The effectiveness and robustness of the proposed controller is demonstrated for different load and wind power perturbations. The results suggest superior performance of the proposed ALQR controller against an optimal output state feedback controller. The integrated control could be realized though the web by applying Internet of Things technologies within the future smart grid

High anisotropy hcp CoPt media for perpendicular magnetic recording

Ph.DDOCTOR OF PHILOSOPH

Unique hemoglobin dynamics in female Tibetan highlanders

Background: Tibetan highlanders have adapted to hypoxic environments through the development of unique mechanisms that suppress an increase in hemoglobin (Hb) concentration even in high-altitude areas. Hb concentrations generally decrease with increasing age. However, in the highlands, chronic altitude sickness is known to occur in the elderly population. To investigate how aging in a hypoxic environment affects Hb levels in Tibetan highlanders, we focused on the Mustang people, who live above 3500 m. We tried to clarify the pure relationship between aging and Hb levels in a hypoxic environment.Results: We found that the Hb concentration increased with increasing age in females but not in males. Multivariate analysis showed that age, pulse pressure, the poverty index, and vascular diameter were strongly correlated with the Hb concentration. Conclusions: We found unique Hb dynamics among female Tibetan highlanders. As seen in these Hb dynamics, there may be sex-based differences in the adaptive mechanism in Tibetan highlanders

A Doctor’s Training in COVID Era

Doctors have severely been impacted by COVID19 not only by overburden but also by a shift in training programmes. With objective to identify the impact of COVID19 on the present training programme of doctors and delineate the possible future impact and find ways to reduce it, a literature review was carried on. Various impacts and adaptations were found. These could be different for different individuals, specialities, and regions based on available resources and the direct impact of COVID19. Although long-term effects are yet to be seen, it has raised several brows, especially questioning the traditional way of training and competency of individuals trained in specialities. We recommend a hybrid model—a mixture of virtual and real training and assessment—for medical education even in the post-COVID era to reap the benefits of both

Has COVID-19 suppressed dengue transmission in Nepal?

Following the report of the first COVID-19 case in Nepal on 23 January 2020, three major waves were documented between 2020 and 2021. By the end of July 2022, 986 596 cases of confirmed COVID-19 and 11 967 deaths had been reported and 70.5% of the population had received at least two doses of a COVID-19 vaccine. Prior to the pandemic, a large dengue virus (DENV) epidemic affected 68 out of 77 districts, with 17 932 cases and six deaths recorded in 2019. In contrast, the country's Epidemiology and Disease Control Division reported 530 and 540 dengue cases in the pandemic period (2020 and 2021), respectively. Furthermore, Kathmandu reported just 63 dengue cases during 2020 and 2021, significantly lower than the 1463 cases reported in 2019. Serological assay showed 3.2% positivity rates for anti-dengue immunoglobulin M antibodies during the pandemic period, contrasting with 26.9-40% prior to it. Real-time polymerase chain reaction for DENV showed a 0.5% positive rate during the COVID-19 pandemic which is far lower than the 57.0% recorded in 2019. Continuing analyses of dengue incidence and further strengthening of surveillance and collaboration at the regional and international levels are required to fully understand whether the reduction in dengue incidence/transmission were caused by movement restrictions during the COVID-19 pandemic

Diagnosis of visceral leishmaniasis by polymerase chain reaction of DNA extracted from Giemsa\u27s solution-stained slides.

Visceral leishmaniasis (VL) is caused by the protozoan parasite Leishmania donovani and is a potentially fatal disease in endemic areas of the world. Nepal is an endemic area in which VL causes major public health problems in the lowland areas of the southeast regions. The aim of the present study was to evaluate the sensitivity of polymerase chain reaction (PCR) amplification for the detection of Leishmania DNA from Giemsa\u27s solution-stained bone marrow slides. Bone marrow samples were aspirated from a total of 115 VL suspected patients and used to prepare smears on glass slides and for the initiation of in vitro culture. Bone marrow slides were used for microscopic observation, DNA extraction, and subsequent PCR amplification. PCR analysis showed that all the positive samples were of Leishmania parasites. The PCR assay also showed a higher sensitivity (69%) than microscopic examination (57%) and culture (21%). In addition, PCR was able to detect VL in 12% of samples which were negative by microscopy. PCR of DNA extracted from Giemsa\u27s solution-stained bone marrow slides is a suitable tool for confirming diagnosis in patients with VL and may also be useful in the diagnosis of difficult cases. Bone marrow smears are easily stored and can be easily sent to research centers where PCR is available. This makes PCR a good option for diagnosis in the field

Molecular detection of Leishmania parasites from whole bodies of sandflies collected in Nepal.

Visceral leishmaniasis is endemic in the southern part of the Terai region of Nepal. Natural infections of Phlebotomus species with Leishmania parasites in these endemic areas were analyzed by a polymerase chain reaction (PCR) amplification-based assay. A total of 401 Phlebotomus argentipes and 202 P. papatasi female sandflies were captured in the Dhanusa district from 2004 to 2006 and analyzed. It was found that 6.7% of P. argentipes, but no P. papatasi, were positive for Leishmania parasites, suggesting that P. argentipes is a major vector in these areas. The infectivity of P. argentipes with Leishmania was consistent with the infection rates reported from other areas of the world. This is the first report of naturally infected Leishmania parasites in sandflies collected from Nepal

High prevalence of rheumatoid arthritis and its risk factors among Tibetan highlanders living in Tsarang, Mustang district of Nepal

Background: In Tsarang (at 3560 m), which is located in Mustang, 62.7% of the residents answered that they had a subjective medical history of arthritis, and 41.1% of the residents answered that their families had a subjective medical history of arthritis on a survey conducted in 2017. The expression of hypoxia-inducible factor (HIF) and its efects are deeply involved in hypoxic adaptation in Tibetan highlanders. At the same time, HIF is also related to the onset of rheumatoid arthritis. Therefore, the adaptive mechanism acquired by Tibetan highlanders may promote the development of rheumatoid arthritis. The prevalence of rheumatoid arthritis is estimated to be approximately 0.5–1.0% worldwide. The objective of this study was to estimate the prevalence of rheumatoid arthritis in Tsarang residents using existing diagnostic criteria and to explore its risk factors. Methods: An epidemiological survey was conducted in Tsarang in 2019. Data obtained from anthropometry and questionnaires were statistically analyzed. Biochemical measurements using blood samples were also performed, and the results were used to assess arthritis status. Residents’ joint status was scored, and arthritis was assessed based on the clinical disease activity index and ACR/EULAR 2010 criteria.Results: Twenty-seven males and 50 females participated in this survey. In Tsarang, ACR/EULAR 2010 classifed 4.3% of males and 7.1% of females as having rheumatoid arthritis, indicating a very high estimated prevalence. We also performed a multivariate analysis to explore its risk factors, and two factors, older age (standardized parameter estimate= 4.84E−01, 95% CI = [9.19E−02, 8.76E−01], p = 0.0170) and a history of living in urban areas (standardized parameter estimate = − 5.49E−01, 95% CI = [− 9.21E−01, 1.77E−01], p = 0.0050), signifcantly contributed to the higher ACR/EULAR 2010 score in females. In addition, three factors, having no spouse (standardized parameter estimate = 3.17E−01, 95% CI = [5.74E−02, 5.77E−01], p = 0.0179), having a smoking habit (standardized parameter estimate = 2.88E−01, 95% CI = [1.71E−02, 5.59E−01], p = 0.0377), and a history of living in urban areas (standardized parameter estimate = − 3.69E−01, 95% CI = [− 6.83E−01, − 5.60E−02], p = 0.0219), resulted in signifcantly higher clinical disease activity index scores in females. Furthermore, smoking habits were found to signifcantly increase blood hyaluronic acid in both males (standardized parameter estimate = 6.03E−01, 95% CI = [3.06E−01, 9.01E−01], p = 0.0020) and females (standardized parameter estimate = 4.87E−01, 95% CI = [5.63E−02, 9.18E−01], p = 0.0291)

COVID-19-related knowledge, attitudes, and practices among adolescents and young people in Bihar and Uttar Pradesh, India: Study description

To control the spread of COVID-19 in India and to aid the efforts of the Ministry of Health and Family Welfare (MOHFW), the Population Council and other non-governmental organizations are conducting research to assess residents’ ability to follow sanitation and social distancing precautions under a countrywide lockdown. The Population Council COVID-19 study team is implementing rapid phone-based surveys to collect information on knowledge, attitudes and practices, as well as needs, among 2,041 young people (ages 19-23 years) and/or an adult household member, sampled from an existing prospective cohort study with a total sample size of 20,574 in Bihar (n=10,433) and Uttar Pradesh (n=10,141). Baseline was conducted from April 3-22; subsequent iterations of the survey are planned to be conducted on a monthly basis. Baseline findings on awareness of COVID-19 symptoms, perceived risk, awareness of and ability to carry out preventive behaviors, misconceptions, and fears will inform the development of government and other stakeholders’ interventions and/or strategies. We are committed to openly sharing the latest versions of the study description, questionnaires, deidentified or aggregated datasets, and preliminary results. Data and findings can also be shared with partners working in COVID-19 response