Soil Chemical Properties Under Conservation Agriculture and Cereal-Based Cropping System in Eastern Tarai of Nepal

Field experiments were conducted for four years (2014-2017) at five locations namely Salbani, Bhokraha, Simariya, Bhaluwa and Kaptanganj of Sunsari district to assess the changes in soil chemical properties under conservation agriculture (CA)-based practices in two cropping systems namely rice-kidney bean-maize at Salbani and rice-wheat at rest of the locations. In rice-wheat cropping system, there were four treatments: (1) conventional tillage (CT) for rice transplantation and subsequent wheat sowing, (2) conventional tillage rice transplantation followed by zero tillage (ZT) wheat, (3) unpuddled rice transplantation followed by zero tillage wheat, (4) zero tillage in both rice and wheat. Similarly, in rice-kidney bean-maize cropping system, there were four treatments; (1) conventional tillage for rice transplantation and sowing of both kidney bean and maize, (2) conventional tillage rice transplantation followed by zero tillage in both kidney bean and maize, (3) unpuddled rice transplantation followed by zero tillage in both kidney bean and maize, (4) zero tillage in all three crops. Soil samples were taken at initial and every year after rice harvest.The soil samples were analyzed for total nitrogen, available phosphorus, available potassium, pH and soil organic matter.Total nitrogen (N) showed a slightly decreasing trend in the first three years and showed a slight increase at the end of experiment under ZT in all locations. The total N under ZT changed from 0.12 to 0.13%, 0.05 to 0.06%, 0.10 to 0.12%, 0.11 to 0.08% and 0.09 to 0.13% in Salbani, Bhokraha, Simariya, Bhaluwa and Kaptanganj, respectively.  All locations showed the positive values of available potassium; Salbani  revealing considerable change of 64.3 to 78.5 mg/kg in CT while 68.4 to 73.3 mg/kg in ZT condition. The treatment where rice was transplanted in unpuddled condition and zero tilled to wheat, had a mean value of available phosphorus and potassium as 87.3 and 81.9 mg/kg respectively. Soil pH ranged from 4.8 to 7.1 in CT while it was 5.2 to 6.8 in ZT across the locations. The change in soil organic matter in CT of all locations except Salbani was narrower as compared to ZT

A systematic review of current knowledge of HIV epidemiology and of sexual behaviour in Nepal

OBJECTIVE: To systematically review information on HIV epidemiology and on sexual behaviour in Nepal with a view to identifying gaps in current knowledge. METHODS: Systematic review covering electronic databases, web-based information, personal contact with experts and hand searching of key journals. RESULTS: HIV-1 seroprevalence has been rising rapidly in association with high-risk behaviours, with current levels of 40% amongst the nation's injecting drug users and approaching 20% amongst Kathmandu's female commercial sex workers (FCSWs). HIV seroprevalence remains low in the general population (0.29% of 15–49 year olds). There are significant methodological limitations in many of the seroprevalence studies identified, and these estimates need to be treated with caution. There are extensive migration patterns both within the country and internationally which provide the potential for considerable sexual networking. However, studies of sexual behaviour have focused on FCSWs and the extent of sexual networks within the general population is largely unknown. CONCLUSIONS: Whilst some of the ingredients are present for an explosive HIV epidemic in Nepal, crucial knowledge on sexual behaviour in the general population is missing. Research on sexual networking is urgently required to guide HIV control in Nepal. There is also a need for further good-quality epidemiological studies of HIV seroprevalence

Predictors of Mortality in Scrub Typhus Infection Requiring Intensive Care Admission in Tertiary Healthcare Centre of Nepal

© 2018 Shital Adhikari et al. Introduction. This study aimed to explore the predictors of mortality from scrub typhus infection in patients requiring intensive care unit (ICU) admission. Materials and Methods. A retrospective study was conducted on 120 patients with serum ELISA IgM positive for scrub typhus (optical density ≥ 0.5) admitted at the medical ICU of Chitwan Medical College Teaching Hospital between April 2016 and September 2017. Data was extracted from patient medical records and electronic database of the hospital. The outcome measurement was mortality (Yes/No) due to the infection. A multivariate binary logistic regression analysis (p 100/minute (p 1.4 mg/dl (p<0.001), acute kidney injury requiring dialysis (p=0.029), acute respiratory distress syndrome (p<0.001), and shock requiring vasopressor (p<0.001). Regression analysis showed age (odds ratio [OR] = 1.063; 95% CI = 1.010-1.118; p=0.019) and serum creatinine (OR = 1.063; 95% CI = 1.010-1.118; p=0.019) as significant predictors of poor outcome. Conclusion. Older age and high serum creatinine were found to be independent predictors of poor outcome in patients with scrub typhus admitted in medical ICU

Agro-morphological Diversity of High Altitude Bean Landraces in the Kailash Sacred Landscape of Nepal

Many varieties of bean are widely grown across diverse agro-ecological zones in Nepal. And opportunities exist for improving the crops and enhancing their resilience to various biotic and abiotic stressors. In this context, an experiment was conducted from June to October 2016 in Khar VDC of Darchula district to study the phenotypic traits of nine landraces of bean (Phaseolus vulgaris L.). The bean landraces were planted using randomized complete block design in three sites (Dhamidera, Dallekh and Sundamunda villages), with three replications in each site for their comparative analysis. The study considered the following phenotypic traits: days to emergence, days to 50% flowering, days to 90% pod maturity, number of nodes, pod length, pod width, number of pods, number of seeds per pod and weight and grain yield for 100 seeds. Kruskal-Wallis test showed significant differences in the landraces both within and among locations. KA-17-08-FB and KA-17-04-FB were late &nbsp;flowering (63 and 65 days respectively) compared to other landraces whereas KA-17-07-FB flowered earliest (within 42 days). In all three sites, three landraces namely KA-17-07-FB, KA-17-04-FB and KA-17-06-FB were found to be relatively more resistant to pest and diseases than other landraces. Eight out of nine landraces in Dhamidera and Dallekh villages and seven out of nine in Sundamunda village produced seeds greater than 1.0 t/ha. Among the nine varieties KA-17-02-FB was the highest yielding variety, with an average yield of 3.8 t/ha. This study is useful for identifying suitable landraces for future promotion based on their maturity, grain yield, diseases resistance and other qualitative and quantitative characteristics

[Accepted Manuscript] Smartphone tool to collect repeated 24 h dietary recall data in Nepal.

To outline the development of a smartphone-based tool to collect thrice-repeated 24 h dietary recall data in rural Nepal, and to describe energy intakes, common errors and researchers' experiences using the tool. We designed a novel tool to collect multi-pass 24 h dietary recalls in rural Nepal by combining the use of a CommCare questionnaire on smartphones, a paper form, a QR (quick response)-coded list of foods and a photographic atlas of portion sizes. Twenty interviewers collected dietary data on three non-consecutive days per respondent, with three respondents per household. Intakes were converted into nutrients using databases on nutritional composition of foods, recipes and portion sizes. Dhanusha and Mahottari districts, Nepal. Pregnant women, their mothers-in-law and male household heads. Energy intakes assessed in 150 households; data corrections and our experiences reported from 805 households and 6765 individual recalls. Dietary intake estimates gave plausible values, with male household heads appearing to have higher energy intakes (median (25th-75th centile): 12 079 (9293-14 108) kJ/d) than female members (8979 (7234-11 042) kJ/d for pregnant women). Manual editing of data was required when interviewers mistook portions for food codes and for coding items not on the food list. Smartphones enabled quick monitoring of data and interviewer performance, but we initially faced technical challenges with CommCare forms crashing. With sufficient time dedicated to development and pre-testing, this novel smartphone-based tool provides a useful method to collect data. Future work is needed to further validate this tool and adapt it for other contexts

Pheochromocytoma: A Rare Cause of Secondary Hypertension

&nbsp; Introduction: Pheochromocytoma is a rare tumor, originating from the chromaffin tissue. Its frequency is approximately 1/100,000. The clinical manifestation is due to catecholamine excess, which includes high blood pressure, palpitation, headache, sweating, nausea, vomiting, trembling, weakness, irritation, abdominal and chest pain, dyspnea, red warm face, constipation, polyuria, and polydipsia. &nbsp; Case Report: We present a case of 53 years old male, hospitalized for hypertensive crisis following the manipulation of left sided frozen shoulder. He had labile blood pressure ranging from 220/120 systolic- 90/60 diastolic, profuse sweating and tachycardia. Findings of Contrast enhanced CT of abdomen was consistent with right adrenal pheochromocytoma and 24 hours urinary VMA was 17 mg /24 hr (Normal &lt;13.6 mg /24hr). After the clinical, paraclinical investigations and radiological tests, it was proved to be a pheochromocytoma. The surgical intervention was planned. But due to unavailability of required antihypertensive drugs in Nepal (alpha-blockers like phentolamine and phenoxybenzamine), surgeons were reluctant to operate, although blood pressure was well controlled with use of sodium nitroprusside during hypertensive crisis and prazosin, a selective alpha blocker as maintainance therapy. The use of prazosin to control hypertension secondary to pheochromocytoma is limited to case report and case series. &nbsp; Conclusion: Although rare, pheochromocytoma is a treatable surgical cause of secondary hypertension

Ocular morbidity among children studying in private schools of Kathmandu valley: A prospective cross sectional study.

A prospective cross sectional study of students of two private schools was done and students were screened in detail. A total of 1816 students aged 5 to 16 years were evaluated, out of which 52.8% were males and 47.2 % were females. Among the total, 65.8% had no ocular abnormalities and 34.2% had some form of ocular disorders. Refractive error was the commonest problem seen accounting for 21.9% out of total, followed by infective disorders, which accounted for 7.2%, 3.5% of them were noted to have Orthoptic problem including various types of strabismus, 2.2% were color blind, 2.6% were found to have various other disorders. The prevalence of refractive error among private school children seems to be higher. Color blindness also seems to be prevalent among these children. This kind of school screening would help in detecting the eye problems timely and thus would reduce the ocular morbidity as well as prevent children from going blind unnecessarily

Persistence of Immunity Following 2-Dose Priming with a 10-Valent Pneumococcal Conjugate Vaccine at 6 and 10 Weeks or 6 and 14 Weeks of Age in Nepalese Toddlers

BACKGROUND: The pneumococcal conjugate vaccine has had a substantial impact on invasive pneumococcal disease. Previously, we compared immunity following vaccination with the 10-valent pneumococcal conjugate vaccine (PCV10) administered at 2 slightly different schedules: at 6 and 10 weeks of age, and at 6 and 14 weeks of age, both followed by a 9-month booster. In this study, we followed up those participants to evaluate the medium-term persistence of serotype-specific pneumococcal immunity at 2-3 years of age. METHOD: Children from the previous studies were contacted and after taking informed consent from their parents, blood samples and nasopharyngeal swabs were collected. Serotype-specific IgG antibody concentrations were determined by enzyme-linked immunosorbent assay, for the 10 vaccine serotypes, at a WHO pneumococcal serology reference laboratory. FINDINGS: Two hundred twenty out of the 287 children who completed the primary study returned at 2-3 years of age to provide a blood sample and nasopharyngeal swab. The nasopharyngeal carriage rate of PCV10 serotypes in the 6 + 14 group was higher than the 6 + 10 group (13.4% vs. 1.9%). Nevertheless, the proportion of toddlers with serum pneumococcal serotype-specific IgG greater than or equal to 0.35 µg/mL was comparable for all PCV10 serotypes between the 6 + 10 week and 6 + 14 week groups. Similarly, the geometric mean concentrations of serum pneumococcal serotype-specific IgG levels were similar in the 2 groups for all serotypes, except for serotype 19F which was 32% lower in the 6 + 10 group than the 6 + 14 group. CONCLUSION: Immunization with PCV10 at 6 + 10 weeks or 6 + 14 weeks, with a booster at 9 months in each case, results in similar persistence of serotype-specific antibody at 2-3 years of age. Thus, protection from pneumococcal disease is expected to be similar when either schedule is used