21 research outputs found

    Sero-prevalance of Cryptococcal Antigenemia in HIV Positive Individual having CD4 Counts

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    Cryptococcus neoformans is one of the foremost common opportunistic infectious agents in people living with Acquired Immuno Deficiency Syndrome (AIDS). It has been reported to cause about 1 million cases of cryptococcal meningitis per year among HIV/AIDS and 600,000 deaths annually. This study was done to find the prevalence of Cryptococcal antigenemia among HIV positive individuals having CD4counts <100 cells/mm3. A cross-sectional study was conducted in the HIV Reference unit, National public health laboratory from July to December 2015. The study comprised of 99 HIV positive individuals having CD4counts <100 cells/mm3. CD4 T cell count was performed by flow cytometry (BD Biosciences, San Jose, CA, USA) and Cryptococcal antigen test by Latex agglutination assay. The overall prevalence of cryptococcal antigenemia was found to be 18.2%. Of the total ninety-nine subjects enrolled in the study, 72 (72.8%) were males and 27 (27.2%) were females. The mean age of the patients was 38 years ranging from 13 to 69 years. Higher percentage of female (22.2%) showed Cryptococcal infection in our study as compared to male (16.7%). The study concludes higher prevalence of Cryptococcal antigenemia among HIV infected individuals and recommends Cryptococcal antigen screening to be made mandatory in HIV positive patients having CD4 T cells count below 100/μl

    Low cost sustainable agriculture kits (SAKs) as an agronomic strategy to improve farmer livelihoods in Nepal

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    This work was carried out with the aid of a grant from Canada’s International Development Research Centre (IDRC), and with financial support from the Government of Canada, provided through Global Affairs Canada (GAC)A sustainable agriculture kit (SAK) consists of 3 components: locally approved seeds; low cost tools and technologies (focused on reducing female drudgery); and an agricultural extension picture book to communicate best agronomic practices (indigenous and scientific) to empower illiterate farmers. The picture book is open access and will be available online at www.SAKNepal.org. Local vendors/ distributors have been identified, and the scaling up process has begun. The poster depicts components of the project so that interrelationships between aspects of the research and its implementation can be made and shared for training purposes

    Vaginoplasty in vaginal agenesis associated with MRKH syndrome with tabularized peritoneal pull-through

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    In this paper, a 16 year old girl who was  diagnosed as a case of Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome, underwent a combined laparotomy-peritoneal approach to create a neovagina by using tubularized peritoneal graft with uneventful postoperative period. Vaginal dilation was maintained with a vaginal mould daily for six months and three to four times weekly thereafter. She was followed-up after 2 and 4 weeks in the first month and three monthly for a duration of six months. On second follow-up, adequate vaginal length of 6-7 cm and width of 2.5-3 cm were achieved with healthy vaginal tissue. Hence, the laparotomy-peritoneal approach of using a peritoneal graft for creations of a neovagina can be  an effective approach  with  minimal  surgical morbidity to  create  a passageway for satisfactory intercourse

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

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    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

    The impact of blockchain technology in banking : How can blockchain revolutionize the banking industry?

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    A blockchain is an ordered, decentralized, immutable ledger that allows a recording of transactions in a network. Over recent years, blockchain has emerged to be a technology that can be applied in various sectors. It has promised to be the technology that will allow transactions simply, effectively, safely, and cheaply. The main aim of this thesis was to study the possible impacts of blockchain in the banking industry along with its challenges and limitations. The outcome would include a good explanation of blockchain technology, how it works, future bank implementation, and its challenges. To answer the research questions, a literature review was conducted. The articles were selected from evidence-based scientific databases such as ABI Inform, Academic Search Elite, Emerald, Sage Premier, ScienceDirect, Springer Open, and Google Scholar. Six scholarly articles were selected by using inclusion and exclusion criteria and screening the relevant articles. Data were systematically extracted and grouped into five main categories. The result shows that blockchain technology could enhance the efficiency of various sectors of the banking industry. It has the potential to upgrade and transform the cross-border payment, trade finance, capital markets, and financial reporting and compliance. It also makes the process of knowing your customer straightforward. So, the implementation of blockchain is projected to disrupt the banking and finance system by facilitating a new way of payment, faster trade execution, secured ledger, smart contracts, and many other innovations. However, there are some obstacles such as regulation and technological challenges to be solved for efficient implementation in the banking sector

    Diversity of methane and short chain hydrocarbon degrading bacteria with an emphasis on methane biofilter systems

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    Methanotrophs house enzymes capable of methane oxidation, act as a sink for atmospheric methane and play a key role in the global carbon cycle. This study conducted multiple studies on methanotrophs, including: examination of the evolutionary history of copper membrane monooxygenases (CuMMOs), application of methanotrophic communities in protocol design for monitoring methane biofilter systems, and the analyses of single cell genomes containing new CuMMO-encoding genes. CuMMOs are encoded by three genes, usually in an operon of xmoCAB, and oxidize ammonia, methane, and short chain alkanes and alkenes. To examine the evolutionary history of CuMMOs, phylogenetic inferences and compositional genome analyses were applied to a set of 66 genomes. Individual phylogeny of all genes xmoA, xmoB, and xmoC closely matched in almost all genomes, indicating this operon evolved as a unit. However in Verrucomicrobia pmoB has a distinct phylogeny from pmoA and pmoC. The gammaproteobacteria AMO (Nitrosococcus spp.), the gammaproteobacterial Pxm, the thaumarcheotal AMO and the NC10 pMMO showed little or no compositional bias in the xmo operon indicating similar compositional biases to its genome. Based on the analysis, possible lateral gene transfer events of xmoCAB genes were predicted. The nitrifying bacterium Nitrosococcus postulated as the donor of pmoCAB to both the alpha- and gammaproteobacterial methanotrophs. To design a monitoring protocol that would allow a simple, cost effective and accurate estimation of whether a methane biofilter is operating efficiently, microcosms using compost as a biofilter material were tested via growth and starvation experiments for long periods. Analysis of 16S rRNA gene sequences suggested that non-methanotrophic methylotrophic bacteria belonging the family Methylophilaceae showed a rapid response to biofilter methane oxidation activity and may be a good monitoring target. A monitoring system based on these “methanotroph-associated methylotrophs” is proposed and a ratio of Methylophilaceae to Methylococcaceae of 0.35 was related to high methane activity and 0.1 to low activity. Novel copper membrane monooxygenase encoding operons (xmoCAB) were detected while screening metagenomes obtained from oil sands environments. Quantitative PCR assays were developed for detection of xmoCAB genes in methane, ethane and propane enrichment cultures from environmental samples. Single cell genomes were sequenced from the xmoCAB positive sorted cells of a propane enrichment culture. Screening the genomes identified Polaromonas and Rhodoferax as containing multiple xmoCAB operons. Potential propane oxidation pathways were predicted based on enzymes present in single cell genomes of these two genera

    Sustained Viremic Control in HIV-Infected Patient: Case Report from Nepal

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    A case of human immunodeficiency virus (HIV) infection is described from Nepal with constant maintenance of CD4 count and HIV-RNA level below the lower detection threshold for more than ten years. The case was diagnosed of HIV positive in the year 2008. He had his viral load estimation performed every year since then which was always below lower detection limit and remained healthy without treatment. The patient also had not any kinds of opportunistic infection till date. He is married now and has not transmitted the disease to his wife
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