Prevalence of Refractive Errors in Nepalese Children and Adults: A Systematic Review With Meta-Analysis

Clinical relevance: Country-specific estimates of the prevalence of refractive errors are important to formulate national eye health policies for refractive care services. Background: The purpose of this study was to systematically synthesise available literature and estimate the prevalence of refractive errors in the Nepalese population. Methods: PubMed, Scopus, and Web of Science databases were systematically searched for articles on refractive errors and presbyopia published in English language until 27 September 2022. Population and school-based quantitative, cross-sectional prevalence studies and Rapid Assessment of Avoidable Blindness survey repository data were included. The quality of the included studies was assessed using the Newcastle Ottawa scale adapted for cross-sectional studies. Data extraction was performed with consensus among the reviewers. Meta-analysis of the prevalence was performed using the Random effects model to estimate the pooled proportions. Results: A total of 38 studies with 101 701 participants were included: 18 studies in children (n = 31 596) and 20 in adults (n = 70 105). In children, the estimated pooled prevalence of overall refractive errors was 8.4% (95% CI: 4.8 to 12.9) with myopia, hypermetropia and astigmatism prevalent in 7.1% (95% CI: 3.7 to 11.4), 1.0% (95% CI: 0.7 to 1.3) and 2.2% (95% CI: 0.9 to 3.9), respectively. In adults, the prevalence of refractive errors, uncorrected refractive errors, and uncorrected presbyopia were 11.2% (95% CI: 8.0 to 14.9), 7.3% (95% CI: 5.4 to 9.5) and 78.9% (95% CI: 69.1 to 87.3), respectively. Conclusions: The pooled prevalence of refractive errors is relatively low while uncorrected refractive errors and presbyopia are high in Nepalese population suggesting a need for better access to refractive care services in the country. The paucity of quality evidence on prevalence of refractive errors, particularly in children, indicates a need for a well-designed population-based study to accurately estimate the current prevalence of refractive errors

Seroprevalence and Risk Factors of Infectious Bovine Rhinotracheitis in Dairy Cattle of Chitwan, Nawalpur and Rupandehi Districts of Nepal

The cross-sectional study from July 2018 to September 2018 was conducted to determine the seroprevalence and risk factors of Infectious Bovine Rhinotracheitis (IBR) in cattle of the Chitwan, Nawalpur, and Rupandehi districts of Nepal. The existence of antibodies against IBR was investigated in 92 serum samples obtained systematically from 55 cattle herds using Indirect-ELISA. A questionnaire interview was done to collect individual and herd-level data. The association between categorical variables and the outcome variable (seropositive) was assessed by bivariate analysis and multivariate logistic regression analysis in SPSS version 19.0. The seroprevalence of IBR was 18.48% (95% CI: 11.1-27.9), and district, breed, and herd size were identified as potential risk factors for IBR seropositivity. Significantly higher risk for IBR was found in Chitwan (Percentage-Positive “PP” = 36.37%; Odd ratio “OR” = 5.211; p = 0.008) than in Nawalpur (PP = 9.38%; OR = 0.931) and Rupandehi (PP = 10.00%). PP of IBR was significantly higher in Jersey crosses (PP = 30.00%; OR = 2.893; p = 0.048) than Holstein Friesian crosses (PP = 12.90%). Similarly, herds with more than 10 cattle (PP = 33.33%; OR = 4.167; p = 0.042) were found significantly at higher odds for seropositivity than herds having less than 10 cattle (PP = 10.71%). Due to the moderate prevalence of IBR among cattle in Nepal, this study recommends conducting additional planned research on IBR at the national level to safeguard the country's dairy businesses from potential financial losses

Visual evoked potentials’ responses in hypothyroidism and hyperthyroidism

Background: Visual Evoked Potentials (VEP) provides important diagnostic and prognostic information regarding the functional integrity of the visual system. This study, describes the effects of less or excess thyroid hormones of adults in visual conduction that helps to know the progression to neurological functional defects.Methods: The study was done in 75 consenting subjects (hypothyroid = 24, hyperthyroid = 25, euthyroid = 26). The VEP parameters N75, P100, N145 latencies and its amplitudes within different thyroid status (hypothyroidism, hyperthyroidism and euthyroidism) were compared. One way ANOVA was used to compare VEP parameters among three groups and Pearson’s correlation to find relation between thyroid hormones and VEP parameters.Results: There was positive correlation of 0.335, 0.338 and 0.301 between amplitudes of N75, P100 and N145 waves and fT3 hormone respectively. Furthermore, fT4 showed a positive correlation of 0.186 and 0.185 with the wave amplitudes of N75 and N145 waves respectively and negative correlation of TSH levels of -0.492, -0.280, -0.397 with amplitudes of N75, P100, N145 waves respectively. Hyperthyroid group had higher in VEP latency than euthyroid group in N75 (73±5.77 vs. 68.54±4.32), P100 (106.42±9.74 vs. 100.94±8.17) and N145 (153.03±16.39 vs. 144.37±7.02) waves. Similarly, hypothyroid group had higher in VEP latency than euthyroid group in N75 (72.12±6.34 vs. 68.54±4.32) wave.Conclusions: Both hypothyroidism and hyperthyroidism led to conduction delay in adults, possibly adversely affecting function of myelin. The prominent visual evoked potential abnormalities in hyperthyroidism and less change in hypothyroidism show that the visual neuropathy is more common in hyperthyroidism

Arsenic in Surface Waters: A Report from River Ganga and its Tributary Jamania at Bhagalpur, Bihar, India

An investigation has been carried out to examine the arsenic pollution status of River Ganga & its tributary Jamania during pre-monsoon period of  2017 at Bhagalpur, Bihar (India). Altogether 17 water samples from different sampling sites along with their geo co-ordinates have been investigated for the value of arsenic using FTK test as well as spectrophotometer method. Throughout the study, arsenic value ranged from 10.69 ppb to 55.92 ppb. Out of the 17 water samples, the values of arsenic in 13 samples were from 20ppb to 54.1ppb. The concentration levels of arsenic in all the 17 river water samples and 2 public water supply samples (source: river water) in the present study were found above from the permissible limit of WHO (2008) and BIS (2004-2005) standards for drinking which is 10 ppb (part per billion)

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

Collaborative Exploration of Capsicum and Cucurbitaceae Vegetable Genetic Resources in Eastern Nepal, February 2018

This report describes the third exploration for chili pepper and cucurbitaceous vegetable genetic resources in eastern Nepal, jointly conducted by the National Agriculture and Food Research Organization (NARO) of Japan and the Nepal Agricultural Research Council (NARC). We conducted a field survey in eastern Nepal from the 14th to 24th of February 2018. We collected a total of 66 samples including; Cucumis sativus (27), Cucurbita maxima (3), C. moschata (5), C. ficifolia (1), Luffa acutangula (1), Capsicum annuum (13) C. frutescens (2) and Capsicum sp. (14). The collected seed samples were stored as seeds at the National Agriculture Genetic Resources Center, NARC and will be transferred to the Genetic Resources Center, NARO.本報告は農林水産省委託プロジェクト研究「海外植物遺伝資源の収集・提供強化」の予算により実施され，国立研究開発法人農業・食品産業技術総合研究機構 遺伝資源センターとネパール国立農業遺伝資源センターとの間で締結した共同研究協定に基づいて行われたネパール東部におけるトウガラシ属およびウリ科遺伝資源の探索・収集に関わる調査報告書である．調査は2018年2月15日～24日にかけて行った．ネパール東部のイラム県，パンチタール県，ダンクタ県において探索・調査を行った．その結果，キュウリ27点，セイヨウカボチャ3点，ニホンカボチャ5点，クロダネカボチャ1点，トカドヘチマ1点，トウガラシ属29点の合計66点の野菜遺伝資源を収集した．収集された遺伝資源は，ネパール国立農業遺伝資源センターで保存するとともに，我が国の遺伝資源センターに導入される予定である

Collaborative Exploration of Legume and Amaranth Germplasm in Eastern Nepal from February 14 to 24, 2018

This is a report for the Plant Genetic Resources in Asia (PGRAsia) project and the National Agriculture and Food Research Organization (NARO) genebank project for the collaborative collection and conservation of plant genetic resources in Nepal under the agreement between the National Agriculture Genetic Resources Center (NAGRC), Nepal Agricultural Research Council (NARC), and the Genetic Resources Center, NARO, Japan.A field survey was conducted in Eastern Nepal from February 16th to February 21st, 2018, with the participants separated into teams A and B. Team A focused on cucumber and chili pepper and team B focused on legumes and amaranth. This report is the survey results from team B, with mention of some of the materials collected by team A. A total of 91 samples were collected and conserved in the gene bank at NAGRC, Nepal; these accessions consisted of 16 species from 10 genera, including Amaranthus, Coriandrum, Cyclanthera, Glycine, Lablab, Macrotyloma, Perilla, Phaseolus, Solanum and Vigna.本報告は農林水産省委託プロジェクト研究「海外植物遺伝資源の収集・提供強化」および国立研究開発法人農業・食品産業技術総合研究機構（農研機構）農業生物資源ジーンバンク事業の予算により実施され，農研機構・遺伝資源センターとネパール国立農業研究評議会との間で締結した共同研究協定に基づいて行われたネパール東部における豆類およびアマランサス遺伝資源の探索・収集に関わる調査報告書である．調査は，2018年2月14日～24日にかけてネパール東部のイラム県，パンチタール県，ダンクタ県において行った．探索は，チームA（トウガラシ属およびウリ科野菜）とチームB（豆類とアマランサス）に分かれて実施した．本報告は，チームBの報告（一部チームAの収集品を含む）である．探索の結果，10属（Amaranthus, Cariandrum, Cyclanthera, Glycine, Lablab, Macrotyloma, Perilla, Phaseolus, Solanum, Vigna），16種，91点の遺伝資源を収集し，収集品はネパール国立農業遺伝資源センターに保存した

Feasibility of implementing public-private mix approach for tuberculosis case management in Pokhara Metropolitan City of western Nepal: a qualitative study

BackgroundThe Public-Private Mix (PPM) approach is a strategic initiative that involves engaging all private and public health care providers in the fight against tuberculosis using international health care standards. For tuberculosis control in Nepal, the PPM approach could be a milestone. This study aimed to explore the barriers to a public-private mix approach in the management of tuberculosis cases in Nepal.MethodsWe conducted key informant interviews with 20 participants, 14 of whom were from private clinics, polyclinics, and hospitals where the PPM approach was used, two from government hospitals, and four from policymakers. All data were audio-recorded, transcribed, and translated into English. The transcripts of the interviews were manually organized, and themes were generated and categorized into 1. TB case detection, 2. patient-related barriers, and 3. health-system-related barriers.ResultsA total of 20 respondents participated in the study. Barriers to PPM were identified into following three themes: (1) Obstacles related to TB case detection, (2) Obstacles related to patients, and (3) Obstacles related to health-care system. PPM implementation was challenged by following sub-themes that included staff turnover, low private sector participation in workshops, a lack of trainings, poor recording and reporting, insufficient joint monitoring and supervision, poor financial benefit, lack of coordination and collaboration, and non-supportive TB-related policies and strategies.ConclusionGovernment stakeholders can significantly benefit by applying a proactive role working with the private in monitoring and supervision. The joint efforts with private sector can then enable all stakeholders to follow the government policy, practice and protocols in case finding, holding and other preventive approaches. Future research are essential in exploring how PPM could be optimized

Population and fertility by age and sex for 195 countries and territories, 1950–2017: a systematic analysis for the Global Burden of Disease Study 2017

Background: Population estimates underpin demographic and epidemiological research and are used to track progress on numerous international indicators of health and development. To date, internationally available estimates of population and fertility, although useful, have not been produced with transparent and replicable methods and do not use standardised estimates of mortality. We present single-calendar year and single-year of age estimates of fertility and population by sex with standardised and replicable methods. Methods: We estimated population in 195 locations by single year of age and single calendar year from 1950 to 2017 with standardised and replicable methods. We based the estimates on the demographic balancing equation, with inputs of fertility, mortality, population, and migration data. Fertility data came from 7817 location-years of vital registration data, 429 surveys reporting complete birth histories, and 977 surveys and censuses reporting summary birth histories. We estimated age-specific fertility rates (ASFRs; the annual number of livebirths to women of a specified age group per 1000 women in that age group) by use of spatiotemporal Gaussian process regression and used the ASFRs to estimate total fertility rates (TFRs; the average number of children a woman would bear if she survived through the end of the reproductive age span [age 10–54 years] and experienced at each age a particular set of ASFRs observed in the year of interest). Because of sparse data, fertility at ages 10–14 years and 50–54 years was estimated from data on fertility in women aged 15–19 years and 45–49 years, through use of linear regression. Age-specific mortality data came from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 estimates. Data on population came from 1257 censuses and 761 population registry location-years and were adjusted for underenumeration and age misreporting with standard demographic methods. Migration was estimated with the GBD Bayesian demographic balancing model, after incorporating information about refugee migration into the model prior. Final population estimates used the cohort-component method of population projection, with inputs of fertility, mortality, and migration data. Population uncertainty was estimated by use of out-of-sample predictive validity testing. With these data, we estimated the trends in population by age and sex and in fertility by age between 1950 and 2017 in 195 countries and territories. Findings: From 1950 to 2017, TFRs decreased by 49\ub74% (95% uncertainty interval [UI] 46\ub74–52\ub70). The TFR decreased from 4\ub77 livebirths (4\ub75–4\ub79) to 2\ub74 livebirths (2\ub72–2\ub75), and the ASFR of mothers aged 10–19 years decreased from 37 livebirths (34–40) to 22 livebirths (19–24) per 1000 women. Despite reductions in the TFR, the global population has been increasing by an average of 83\ub78 million people per year since 1985. The global population increased by 197\ub72% (193\ub73–200\ub78) since 1950, from 2\ub76 billion (2\ub75–2\ub76) to 7\ub76 billion (7\ub74–7\ub79) people in 2017; much of this increase was in the proportion of the global population in south Asia and sub-Saharan Africa. The global annual rate of population growth increased between 1950 and 1964, when it peaked at 2\ub70%; this rate then remained nearly constant until 1970 and then decreased to 1\ub71% in 2017. Population growth rates in the southeast Asia, east Asia, and Oceania GBD super-region decreased from 2\ub75% in 1963 to 0\ub77% in 2017, whereas in sub-Saharan Africa, population growth rates were almost at the highest reported levels ever in 2017, when they were at 2\ub77%. The global average age increased from 26\ub76 years in 1950 to 32\ub71 years in 2017, and the proportion of the population that is of working age (age 15–64 years) increased from 59\ub79% to 65\ub73%. At the national level, the TFR decreased in all countries and territories between 1950 and 2017; in 2017, TFRs ranged from a low of 1\ub70 livebirths (95% UI 0\ub79–1\ub72) in Cyprus to a high of 7\ub71 livebirths (6\ub78–7\ub74) in Niger. The TFR under age 25 years (TFU25; number of livebirths expected by age 25 years for a hypothetical woman who survived the age group and was exposed to current ASFRs) in 2017 ranged from 0\ub708 livebirths (0\ub707–0\ub709) in South Korea to 2\ub74 livebirths (2\ub72–2\ub76) in Niger, and the TFR over age 30 years (TFO30; number of livebirths expected for a hypothetical woman ageing from 30 to 54 years who survived the age group and was exposed to current ASFRs) ranged from a low of 0\ub73 livebirths (0\ub73–0\ub74) in Puerto Rico to a high of 3\ub71 livebirths (3\ub70–3\ub72) in Niger. TFO30 was higher than TFU25 in 145 countries and territories in 2017. 33 countries had a negative population growth rate from 2010 to 2017, most of which were located in central, eastern, and western Europe, whereas population growth rates of more than 2\ub70% were seen in 33 of 46 countries in sub-Saharan Africa. In 2017, less than 65% of the national population was of working age in 12 of 34 high-income countries, and less than 50% of the national population was of working age in Mali, Chad, and Niger. Interpretation: Population trends create demographic dividends and headwinds (ie, economic benefits and detriments) that affect national economies and determine national planning needs. Although TFRs are decreasing, the global population continues to grow as mortality declines, with diverse patterns at the national level and across age groups. To our knowledge, this is the first study to provide transparent and replicable estimates of population and fertility, which can be used to inform decision making and to monitor progress. Funding: Bill & Melinda Gates Foundation

Population and fertility by age and sex for 195 countries and territories, 1950–2017: a systematic analysis for the Global Burden of Disease Study 2017

Background: Population estimates underpin demographic and epidemiological research and are used to track progress on numerous international indicators of health and development. To date, internationally available estimates of population and fertility, although useful, have not been produced with transparent and replicable methods and do not use standardised estimates of mortality. We present single-calendar year and single-year of age estimates of fertility and population by sex with standardised and replicable methods. Methods: We estimated population in 195 locations by single year of age and single calendar year from 1950 to 2017 with standardised and replicable methods. We based the estimates on the demographic balancing equation, with inputs of fertility, mortality, population, and migration data. Fertility data came from 7817 location-years of vital registration data, 429 surveys reporting complete birth histories, and 977 surveys and censuses reporting summary birth histories. We estimated age-specific fertility rates (ASFRs; the annual number of livebirths to women of a specified age group per 1000 women in that age group) by use of spatiotemporal Gaussian process regression and used the ASFRs to estimate total fertility rates (TFRs; the average number of children a woman would bear if she survived through the end of the reproductive age span [age 10–54 years] and experienced at each age a particular set of ASFRs observed in the year of interest). Because of sparse data, fertility at ages 10–14 years and 50–54 years was estimated from data on fertility in women aged 15–19 years and 45–49 years, through use of linear regression. Age-specific mortality data came from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 estimates. Data on population came from 1257 censuses and 761 population registry location-years and were adjusted for underenumeration and age misreporting with standard demographic methods. Migration was estimated with the GBD Bayesian demographic balancing model, after incorporating information about refugee migration into the model prior. Final population estimates used the cohort-component method of population projection, with inputs of fertility, mortality, and migration data. Population uncertainty was estimated by use of out-of-sample predictive validity testing. With these data, we estimated the trends in population by age and sex and in fertility by age between 1950 and 2017 in 195 countries and territories. Findings: From 1950 to 2017, TFRs decreased by 49·4% (95% uncertainty interval [UI] 46·4–52·0). The TFR decreased from 4·7 livebirths (4·5–4·9) to 2·4 livebirths (2·2–2·5), and the ASFR of mothers aged 10–19 years decreased from 37 livebirths (34–40) to 22 livebirths (19–24) per 1000 women. Despite reductions in the TFR, the global population has been increasing by an average of 83·8 million people per year since 1985. The global population increased by 197·2% (193·3–200·8) since 1950, from 2·6 billion (2·5–2·6) to 7·6 billion (7·4–7·9) people in 2017; much of this increase was in the proportion of the global population in south Asia and sub-Saharan Africa. The global annual rate of population growth increased between 1950 and 1964, when it peaked at 2·0%; this rate then remained nearly constant until 1970 and then decreased to 1·1% in 2017. Population growth rates in the southeast Asia, east Asia, and Oceania GBD super-region decreased from 2·5% in 1963 to 0·7% in 2017, whereas in sub-Saharan Africa, population growth rates were almost at the highest reported levels ever in 2017, when they were at 2·7%. The global average age increased from 26·6 years in 1950 to 32·1 years in 2017, and the proportion of the population that is of working age (age 15–64 years) increased from 59·9% to 65·3%. At the national level, the TFR decreased in all countries and territories between 1950 and 2017; in 2017, TFRs ranged from a low of 1·0 livebirths (95% UI 0·9–1·2) in Cyprus to a high of 7·1 livebirths (6·8–7·4) in Niger. The TFR under age 25 years (TFU25; number of livebirths expected by age 25 years for a hypothetical woman who survived the age group and was exposed to current ASFRs) in 2017 ranged from 0·08 livebirths (0·07–0·09) in South Korea to 2·4 livebirths (2·2–2·6) in Niger, and the TFR over age 30 years (TFO30; number of livebirths expected for a hypothetical woman ageing from 30 to 54 years who survived the age group and was exposed to current ASFRs) ranged from a low of 0·3 livebirths (0·3–0·4) in Puerto Rico to a high of 3·1 livebirths (3·0–3·2) in Niger. TFO30 was higher than TFU25 in 145 countries and territories in 2017. 33 countries had a negative population growth rate from 2010 to 2017, most of which were located in central, eastern, and western Europe, whereas population growth rates of more than 2·0% were seen in 33 of 46 countries in sub-Saharan Africa. In 2017, less than 65% of the national population was of working age in 12 of 34 high-income countries, and less than 50% of the national population was of working age in Mali, Chad, and Niger. Interpretation: Population trends create demographic dividends and headwinds (ie, economic benefits and detriments) that affect national economies and determine national planning needs. Although TFRs are decreasing, the global population continues to grow as mortality declines, with diverse patterns at the national level and across age groups. To our knowledge, this is the first study to provide transparent and replicable estimates of population and fertility, which can be used to inform decision making and to monitor progress