Prevalence of Malaria among Infants and Children with febrile illness: A Hospital Based Study

Background: About half of the world’s population is at risk of malaria and the burden is particularly high in low-income countries like Nepal. Infants and children are more vulnerable to malaria. Acute febrile illness is the commonest presentation of malaria. Since it is one of the major causes of persistent febrile illnesses in Nepal, empirical antimalarial therapy is usually practiced, especially the endemic areas. A better understanding of the prevalence and clinical profile of malaria helps to tailor the treatment accordingly in cases of undifferentiated febrile illnesses and make the sue of antimalarials more rational. Methods: A cross-sectional observational study was conducted on 200 infants and children presenting with acute febrile illness in the Departments of Pediatrics, Nepalgunj Medical College, from June 2018 to May 2019.Patients were divided in two groups based on the Malarial parasite antigen status. Clinical and laboratory profile of both the groups were compared using Chi square Test. Results: Maximum number of cases in the malaria positive group were of age group 12-15 years. Palor, icterus, hepatomegaly and splenomegaly were significantly more in malaria positive cases (p-value <0.001in all cases) eosinophilia and leucopenia were common in malaria positive cases. Diagnostic accuracy of malaria was found to eb 82 % on combining serology with clinical findings. Conclusion: Prevalence of malaria was found to be more among children than the infants. Although symptoms of malaria are non-specific, clinical findings like palor, icterus, hepatomegaly and splenomegaly were found to have a significant association with malaria. Combining serology with clinical profile in the prediction of malaria helps promote rational use of antimalarial drugs

Sexual harassment in public transport and its coping strategies among bachelor students: A cross sectional study

Introduction: Sexual harassment in public transport is a common, yet little discussed form of gender-based aggression, predominantly to women. Such abuses have a significant on the mental health of the victims. It also leads them to abandon work and education due to the fear of being harassed on their route. Knowledge regarding the prevalence and coping strategies against such harassment is necessary to formulate effective plans for its mitigation. Methods: This is a cross-sectional study done among 105 bachelor students of Maiya Devi Kanya College of Bharatpur, Chitwan. Self-administered structured questionnaires were used. A Chi-square test was used to determine the significance of the association between variables. Results: Out of 105, 23 students mentioned that they had been sexually harassed in public transport. The non-verbal form was the commonest followed by verbal and physical. Almost half of the respondents mentioned that they would prefer to remain silent (47.6 %) and not react to the situation (54.3%). Self-discipline and effective law were deemed as major ways to prevent such abuses. Conclusion: When girls remain unsafe in public transport, it affects their self-esteem and ultimately hampers their personal productivity and national growth. Stricter laws, unprejudiced societies, and moral values are necessary to prevent as well as help women cope with such harassment

Non-Violent Action to Reform Medical Education in Nepal - The Fasts-unto-death of Dr Govinda KC

At present, reforms of the critically flawed system of medical education in Nepal are urgently needed. The integrity of Nepal’s medical education system is threatened by investors, including members of Nepal's parliament, political leaders, and influential businessmen who treat the creation of new for-profit medical schools as an easy way to generate profits quickly and effortlessly, while no effective, impartial central authority exists to regulate the situation. The pressure to approve new medical schools increases even when the resulting education may be substandard and debt-burdened graduates neither able to find post-graduate training opportunities nor willing to accept positions outside of the Kathmandu Valley. A major force driving efforts to reform, systematize, and improve medical education in Nepal is the series of ten non-violent fasts-unto-death campaigns of one dedicated physician, senior orthopedic surgeon Dr. Govinda KC. To put his efforts into historical context, we review medical education in Nepal from 1978, when Nepal's first medical school, the Institute of Medicine, was created. We seek to clarify whether the current trend toward for-profit medical education is compatible with the rule of law in Nepal, or whether Nepal risks becoming a failed state as it ignores the need to align the production of physicians with that of national health needs

Herpes zoster vaccination and the risk of dementia: A systematic review and meta‐analysis

Abstract Introduction Previous studies have reported a decreased risk of dementia with herpes zoster vaccination. Given this background, this systematic review and meta‐analysis aimed to investigate the association between herpes zoster vaccination and the risk of dementia. Methods We searched five databases until November 2023 for case–control, cross‐sectional, or cohort studies investigating the association of herpes zoster vaccination and dementia. Odds ratios and 95% confidence intervals (95% CIs) were pooled in the meta‐analysis. Meta‐regression, subgroup, and sensitivity analysis were also conducted. Results We evaluated a total of five studies (one cross‐sectional, one case–control, and four cohort studies) that included a total number of 103,615 patients who were vaccinated with herpes zoster vaccine. All the studies were of high quality, ranging from 7 to 9. Due to the high heterogeneity (I2 = 100%, p < .00001) observed in our study, a random effect model was used for the analysis. The pooled odds ratio was 0.84 (95% CI: 0.50, 1.43), p (overall effect) = .53), indicating that herpes zoster vaccination reduces the risk of dementia. Conclusion Herpes zoster vaccination is associated with a reduction of the risk of dementia. More epidemiological studies are needed to confirm the association