Internally Displaced Persons in Nepal

Occasional Papers in Sociology and Anthropology - Peace and Democracy in South Asia, Volume 1, Issue 2, 200

Ear Nose Throat (ENT) disorders in Government Schools of Far-Western Nepal

Background: ENT disorders specially hearing impairment negatively impacts students’ development of academic, language and social skills. If left undiagnosed, these conditions may result in significant irreversible damage such as varying degree of hearing loss that can affect the social or professional performance of the individuals in later stages of life. Students going to government school in our country generally come from under privileged society. We investigated the occurrence of ENT diseases among various government school students in Kailali district. Methods: Nine government school of Kailai district were chosen at random. All students of those school present on the day of examination went routine ENT examinations. Brief history, if any, was recorded and findings were noted. The study was done throughout the month of September, 2013. Results: There were a total of 2256 students enrolled in the study. There were 1126 male and 1130 female students. Mean age of the students was 9.88 years. Forty One percent of students had ENT problems. Ear wax was the most common (17%) findings followed by suppurative ear diseases, otittis media with effusion as so on in decreasing frequency. Conclusions: ENT diseases and specially ear diseases are important health problems among school children of Nepal. Regular school health services, screening program, public awareness, improvement of socioeconomic status, timely referral to a specialist doctor can help to reduce the disease-related burden

Burden and Life Satisfaction among Caregivers of Hemodialysis Patients Residing in Kathmandu

Introduction: The patients undergoing hemodialysis need long-term care. Caregivers of hemodialysis patients can suffer from physical and psychological stress that can affect the level of burden and life satisfaction among them. The objective of the study was to assess burden and the life satisfaction among caregivers of hemodialysis patients. Methods: A cross-sectional study was conducted among 167 caregivers of hemodialysis patients in Bir Hospital and National Kidney Center from December 2019 to March 2020 by using a proportionate sampling technique. Zarit Burden Interview-22 (ZBI) was used to assess the level of caregiver burden and the Life Satisfaction Questionnaire (LiSat-11) was used to assess life satisfaction among caregivers. Data analysis was done in the Statistical Package for the Social Sciences version 16.0. Results: Out of 167 participants, 89 (53.3%) had a mild to moderate level of burden. Only 6 (3.6%) of them had a severe burden. The overall life satisfaction score was 36.89±7.03. Marital status, the number of children, and annual income had a statistically significant association with the level of burden. A negative correlation was found between burden and life satisfaction which was statistically significant (r = -0.403, p value=0.000<0.05). Conclusion: The majority of caregivers were satisfied in terms of life as a whole, leisure situation, contacts, sexual life, activities, family life, partner relationships, physical and psychological health. However, the level of burden was found to be high among caregivers of hemodialysis patients. Necessary support interventions should be carried out to improve their caring roles and coping strategies

Embracing Diversity, Equity, and Inclusion in the Scientific Community-Viewpoints of the Diversity, Equity, and Inclusion Committee of the North American Vascular Biology Organization

Recent increased visibility on racial issues in the United States elicited public outcry and a collective call for action. The social justice movement has facilitated energetic discussions about race, sexual orientation, and various issues of diversity, equity, and inclusion. This article discusses issues faced by people of color that we as scientists can address, as well as challenges faced by women and internationally trained scientists in the scientific community that need immediate attention. Moreover, we highlight various ways to resolve such issues at both institutional and individual levels. Silence and incremental solutions are no longer acceptable to achieving lasting social justice and ensure prosperous societies that work for all

Challenges and opportunities for nurses during COVID-19 pandemic

Background: Pandemic of COVID-19 coincided with the year of Nurses and Midwives 2020. In war against invisible that has been ongoing during this pandemic, nurses play crucial role. As of June 2020, more than 600 nurses have lost their lives due to COVID-19. Nursing practice takes patients’ safety at paramount through continuum of testing, quarantine and isolation. Thus, there is need to review challenges that pandemic has posed as well as the avenues of opportunities that it has opened for nurses. Method: Review of existing literature on nurses, their challenges and opportunities during COVID-19 was done using electronic database. Freely accessible literatures in English language that clearly mentioned on challenges and opportunities of nurses during COVID-19 were included in the study. Result: One of thechallenges that nurses face during COVID-19 is workforce shortage. With increasing number of people infected with COVID-19, it outstretches the existing nursing health workforce, and disproportionately in the low and middle incomes countries. They are at risk of infection and have high job demand. The incidents of suicide among nurses are representation of physical distress and psychological trauma. Role of nurses in patients care during COVID-19 can be under-rated and stigmatized. Internationally trained nurses and minorities nurses are at increased risk of discrimination. Despite these challenges, COVID-19 puts forward opportunities for nurses on implementing humanistic theory in practice, self-esteem and sharing of real time stories, contingency management and creativity. It opens platform for leading infection prevention measures and advocacy of profession. Conclusion: Being the pertinent stakeholders in patient care, nurses’ faces different challenges as well as some opportunities. COVID-19 has opened avenues for advocacy of nursing profession to get acknowledged for their dedication, perseverance, high morale and contribution during the pandemic management

Visualizing Sustainability of Selective Mountain Farming Systems from Far-eastern Himalayas to Support Decision Making

Mountain farming systems rely on both empirical and academic knowledge. Their sustainability depends on how effectively diverse knowledge is used for solution-oriented decision making. For mountains, decisions must be conducive to rural farmers whose livelihoods depend on agriculture and related activities. Adopting transdisciplinary research approach, we define a composite Sustainability Space indicator that will help decision makers better understand the ingredients for sustainability, and formulate policy and management decisions to reinforce on-the-ground sustainability. Sustainability Space was derived through analysis of the positive and negative impact factors co-defined by community and disciplinary experts, and visualized through a radar diagram. We used Principal Component Analysis to understand relationships between factors. The results on Sustainability Spaces for eight cases of farming systems from the far-Eastern Himalayas indicated that the sustainability of farming systems is strengthened if decisions holistically cater to (i) geophysical pre-requisites, (ii) ecological foundations, (iii) integrated processes and practices, (iv) resources, knowledge, and value systems, (v) stakeholders’ development and economic aspirations, (vi) well-being of farming communities, and (vii) government support mechanisms. More equitable the attention to these seven components, the higher the sustainability of farming systems in this region could be

Ascending CNS Progression of EAE: Linkage of Events at the Choroid Plexus and Spinal Cord

Dysfunction of the blood brain barrier (BBB), the specialized complex of cells situated at the central nervous system (CNS) microvasculature has been associated with numerous neuroinflammatory disorders like multiple sclerosis (MS) and its animal model, experimental autoimmune encephalomyelitis (EAE). BBB known to restrict passage of soluble and cellular elements between the blood and CNS is breached. The mechanism by which auto-reactive T cells cross the normally “impermeable” BBB, invade the initially naive CNS, and cause neuroinflammation, remains unclear. Recent studies suggest an initial route by which these cells first gain entry from circulating blood through the choroid plexus (CP). The permeable fenestrated capillaries of CP allow these sentinal T cells into the cerebrospinal fluid (CSF) across the surrounding tight junction expressing choroidal epithelium also known as the blood-CSF-barrier (BCSFB). Once into the CSF, these cells travel to the subarachnoid space (SAS) that surrounds the CNS parenchyma. Here, T cells are known to encounter their cognate antigen and set off a cytokine storm that propagates inflammation. The effects are first observed within the SAS in the meningeal vessels followed by activation of parenchymal inflammation. However, several critical questions in this scenario remain. First, how do these T cells cross the epithelium of the CP to enter the CSF? Does this involve changes in the tight junctional integrity between adjacent epithelial cells to allow leukocyte diapedesis? Second, once they enter the CSF, do these cells select a segment within the SAS to ignite the inflammatory sequence? Given the ascending inflammation within spinal cord segments in developing EAE (caudal to rostral), regional blood vessels in meninges and parenchyma might display unique vulnerabilities depending upon the segment of the spinal column in which they reside. Third, what links the inflammatory signals in the SAS to neuroinflammation in the parenchyma? Results obtained from this work show evidence towards the hypothesis that the ascending course of EAE is due to initial penetration of sentinal T cells through a structurally compromised CP choroidal epithelium, followed by a spinal segment-dependent relay of inflammatory signals between meningeal and parenchymal vessels

Clinico-radiological Aspects of Neurocysticercosis in Pediatric Population in a Tertiary Hospital

Introduction: Neurocysticercosis (NCC) is common in developing countries including Nepal. Clinical presentations vary depending on the CT scan findings of head. Adequate information of NCC in children from Western Nepal is lacking. This study was conducted with an objective of evaluating the most common clinical and radiological picture in children suffering from NCC at a tertiary care teaching hospital in Western Nepal. Methods: Hospital records of all pediatric inpatients, admitted from 16th June 2010 to 15th December 2012, consistent with the diagnosis of Neurocysticercosis were reviewed. Results: Among the 217 patients that either presented seizure or other neurological deficit, 49 were diagnosed as Neurocysticercosis. Their age varied between 2.6 years and 14 years with the mean age of 10.6 years and the peak age of 12 years among diagnosed inpatients. It also showed slight male predominance with the ratio of male and female being 1.22:1. Sorted based on geographical distribution, the maximum of 14 (28.6%) patients were from Kaski district, closely followed by Tanahun district with 13 (26.5%). 38 (77.5%) of the presentations were seizures, partial seizures being most common. 44 (89.8%) of the lesions were single, with 20 (40.8%) predominantly residing in the parietal region, 30 (61.22%) were in transitional stage. However, number of lesions discovered from CT scan of head showed no significance in association with seizure types (p=0.84). In addition, perilesional edema and scolex within the lesion were noted in 67.34% and 18.36% of the cases respectively. _______________________________________________________________________________________ Keywords: clinico-radiological profile; neurocysticercosis; pediatric population. ______________________________________________________________________________________

Bio-fortified maize: Cornerstone in plant breeding to combat hidden hunger in developing countries

Malnutrition has been one of the major global health problems mainly in underdeveloped and developing world causing massive economic damage as well as distressing human life. Deficiency of useful micronutrients like vitamins and minerals including low level of availability of better quality protein causes hidden hunger which can be alleviate with the help of genetic bio-fortification of crops. Besides all the challenges, biofortified maize crops like quality protein maize along with the provitamin A and Zn hold a great future to address the malnutrition challenge combating the deficiency of malnutrtients. This is the most sustainable, cost-effective and potentially wide-reaching approach which can bridge the gap between agriculture and nutrition. Biofortification can be achieved both by agronomic and genetic approaches. The Importance, genetics and potential of bio-fotification is thoroughly reviewed to provide useful findings for new readers and researchers

Clinico-radiological Aspects of Neurocysticercosis in Pediatric Population in a Tertiary Hospital

Introduction: Neurocysticercosis (NCC) is common in developing countries including Nepal. Clinical presentations vary depending on the CT scan findings of head. Adequate information of NCC in children from Western Nepal is lacking. This study was conducted with an objective of evaluating the most common clinical and radiological picture in children suffering from NCC at a tertiary care teaching hospital in Western Nepal.  Methods: Hospital records of all pediatric inpatients, admitted from 16th June 2010 to 15th December 2012, consistent with the diagnosis of Neurocysticercosis were reviewed. Results: Among the 217 patients that either presented seizure or other neurological deficit, 49 were diagnosed as Neurocysticercosis. Their age varied between 2.6 years and 14 years with the mean age of 10.6 years and the peak age of 12 years among diagnosed inpatients. It also showed slight male predominance with the ratio of male and female being 1.22:1. Sorted based on geographical distribution, the maximum of 14 (28.6%) patients were from Kaski district, closely followed by Tanahun district with 13 (26.5%). 38 (77.5%) of the presentations were seizures, partial seizures being most common. 44 (89.8%) of the lesions were single, with 20 (40.8%) predominantly residing in the parietal region, 30 (61.22%) were in transitional stage. However, number of lesions discovered from CT scan of head showed no significance in association with seizure types (p=0.84). In addition, perilesional edema and scolex within the lesion were noted in 67.34% and 18.36% of the cases respectively. _______________________________________________________________________________________ Keywords: clinico-radiological profile; neurocysticercosis; pediatric population. ______________________________________________________________________________________