Food insecurity during COVID-19 pandemic: A genuine concern for people from disadvantaged community and low-income families in Province 2 of Nepal.

Background: Food insecurity is a serious social and public health problem which is exacerbated by the COVID-19 pandemic especially in resource-poor countries such as Nepal. However, there is a paucity of evidence at local levels. This study aims to explore food insecurity among people from the disadvantaged community and low-income families during the COVID-19 pandemic in Province-2 of Nepal. Methods: The semi-structured qualitative interviews were conducted virtually among purposively selected participants (n = 41) from both urban and rural areas in eight districts of Province 2 in Nepal. All the interviews were conducted in the local language between July and August 2020. The data analysis was performed using thematic network analysis in Nvivo 12 Pro software.ResultsThe results of this study are grouped into four global themes: i) Impact of COVID-19 on food security; ii) Food insecurity and coping strategies during the COVID-19 pandemic, iii) Food relief and emergency support during the COVID-19 pandemic, and iv) Impact of COVID-19 and food insecurity on health and wellbeing. Most participants in the study expressed that families from low socioeconomic backgrounds and disadvantaged communities such as those working on daily wages and who rely on remittance had experienced increased food insecurity during the COVID-19 pandemic. Participants used different forms of coping strategies to meet their food requirements during the pandemic. Community members experienced favouritism, nepotism, and partiality from local politicians and authorities during the distribution of food relief. The food insecurity among low-income and disadvantaged families has affected their health and wellbeing making them increasingly vulnerable to the COVID-19 infection.ConclusionFood insecurity among low-income and disadvantaged families was found to be a serious problem during the COVID-19 pandemic. The study suggests that the relief support plan and policies should be focused on the implementation of immediate sustainable food security strategies to prevent hunger, malnutrition, and mental health problems among the most vulnerable groups in the community

Impact of COVID-19 on health services utilization in Province-2 of Nepal: a qualitative study among community members and stakeholders

Background The COVID-19 pandemic has posed unprecedented challenges and threats to the health care system, particularly affecting the effective delivery of essential health services in resource-poor countries such as Nepal. This study aimed to explore community perceptions of COVID-19 and their experiences towards health services utilization during the pandemic in Province-2 of Nepal. Methods The semi-structured qualitative interviews were conducted among purposively selected participants (n = 41) from a mix of rural and urban settings in all districts (n = 8) of the Province 2 of Nepal. Virtual interviews were conducted between July and August 2020 in local languages. The data were analyzed using thematic network analysis in NVivo 12 Pro. Results The findings of this research are categorized into four global themes: i) Community and stakeholders’ perceptions towards COVID-19; ii) Impact of COVID-19 and lockdown on health services delivery; iii) Community perceptions and experiences of health services during COVID-19; and iv) COVID-19: testing, isolation, and quarantine services. Most participants shared their experience of being worried and anxious about COVID-19 and reported a lack of awareness, misinformation, and stigma as major factors contributing to the spread of COVID-19. Maternity services, immunization, and supply of essential medicine were found to be the most affected areas of health care delivery during the lockdown. Participants reported that the interruptions in health services were mostly due to the closure of health services at local health care facilities, limited affordability, and involvement of private health sectors during the pandemic, fears of COVID-19 transmission among health care workers and within health centers, and disruption of transportation services. In addition, the participants expressed frustrations on poor testing, isolation, and quarantine services related to COVID-19, and poor accountability from the government at all levels towards health services continuation/management during the COVID-19 pandemic. Conclusions This study found that essential health services were severely affected during the COVID-19 pandemic in all districts of Province-2. It is critical to expand and continue the service coverage, and its quality (even more during pandemics), as well as increase public-private sector engagement to ensure the essential health services are available for the population

PROTECTIVE EFFECT OF SAPONIN OF MOMORDICA CYMBALARIA FENZL ON HIGH-GLUCOSE INDUCED NEUROPATHY IN NB-41A3 MOUSE NEUROBLASTOMA CELLS

Objective: The natural product Momordica cymbalaria Fenzl has been in use considerably because of its antidiabetic activity. In this work, we have investigated the protective action of one of its phytoconstituent, a saponin, in peripheral neuropathy–a diabetic complication.Methods: The saponin was isolated and identified by preparative high-performance liquid chromatography (preparative HPLC) and thin layer chromatography TLC). High glucose (56 mM)-mediated neuropathy was induced in NB-41A3 mouse neuroblastoma cells and the neuroprotective activity of the saponin was assessed by evaluating its effect on the two polyol pathway enzymes–aldose reductase (AR) and sorbitol dehydrogenase (SDH). The accumulation of intracellular sorbitol, activity of Na+K+-ATPase and production of pro-inflammatory cytokines IL-6, IL-1β and TNF-α were also investigated.Results: The results showed a significant reduction in AR activity and intracellular accumulation of sorbitol on saponin treatment. Improvement in Na+K+-ATPase activity was evident with a noteworthy reduction in IL-6, IL-1β and TNF-α production.Conclusion: These results suggest that the saponin possesses neuroprotective activity in diabetic peripheral neuropathy.Keywords: Diabetic peripheral neuropathy (DPN), Saponin of Momordica cymbalaria (SMC), Neuroblastoma cells, Aldose reductase, Sorbitol dehydrogenase, Na+K+-ATPas

A comparative study of oral clonidine and oral pregabalin as premedication for the control of haemodynamic surge in patients undergoing elective laparoscopic cholecystectomy

Background: Pregabalin, a gabapentinoid compound, which exhibits potent analgesic, anticonvulsant, and anxiolytic activity, is now additionally being used in the preoperative period to reduce stress responses to direct laryngoscopy and tracheal intubation as well as to reduce the opioid requirement perioperatively. Clonidine is also being used for amelioration of hemodynamic surge response both during laryngoscopy with endotracheal intubation as well as during various time points of pneumoperitoneum. Aims and Objectives: The study was designed with an aim to compare the role of oral clonidine (200 mcg) and oral Pregabalin (150 mg) as premedications in controlling the hemodynamic surge response to direct laryngoscopy, endotracheal intubation, and pneumoperitoneum in patients posted for elective laparoscopic cholecystectomy under general anesthesia (GA). Materials and Methods: Sixty-six adult patients aged between 20 and 60 years of age, American Society of Anesthesiologists physical status 1 and 2, undergoing elective laparoscopic cholecystectomy under GA with endotracheal intubation, were randomly allocated to two equal groups (n=33 in each group) to receive either single dose oral 200 mcg clonidine or single dose oral 150 mg pregabalin 2 h before induction of GA. Heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP) and mean arterial blood pressure (MAP), and arrhythmia if any, were recorded at different points of time perioperatively and compared. Oxygen saturation (SpO2), end-tidal CO2 (EtCO2) were also compared at different points of time. Postoperative adverse effects like nausea and vomiting, shivering, and dry mouth were also noted and compared. Sedation was assessed in the immediate postoperative period using Ramsay Sedation Scale and was compared between the two groups. Results: HRs were significantly lower in the clonidine group at 1, 2, 3, 4, and 5 min after laryngoscopy and 15 min after pneumoperitonium. MAP and SBP were significantly lower in the clonidine group at 3, 4, and 5 min after laryngoscopy and intubation. There was no significant difference in DBP between the two groups at different points of time. SpO2 and EtCO2 at different points of time and adverse effects like nausea and vomiting, shivering, and dry mouth were comparable between the two groups. Postoperative sedation score was also comparable between the two groups. Conclusion: Oral clonidine (200 mcg) was found to be superior to oral pregabalin (150 mg) as a premedicant, in attenuating the hemodynamic surge during direct laryngoscopy, endotracheal intubation and during pneumoperitoneum in patients undergoing elective laparoscopic cholecystectomy under GA

Pattern of Cancer in Nepal from 2003 to 2011

Correction: On 15th January 2017, the authors Sunil Kumar Sah and Naval Kishor Yadav were added to the author list.Cancer is global burden of disease in developed and developing countries. It is one of the main causes of death. The environmental factor and life styles are major causes of cancer.This hospital based retrospective study was carried out using data retrieved from the register maintained at seven cancer centers. The most common basis of diagnosis were microscopic (histopathological and cytopathological examination). The diagnosis was also based on clinical examination, radiological examination, endoscopy, biochemical and immunological tests.Most of the cancer cases were diagnosed at BPKMCH (23908) followed by BPKIHS (9668) and BH (5959) and few cases from KCH (518) in 2003 to 2011. The total number of cancer cases were increasing from 2003 to 2011 and it become double in 2011. Out of 75 district of Nepal, more number of cancer cases was found in Kathmandu, Sunsari, Morang, Chitwan, Lalitpur, Jhapa, Kaski, Nawalparasi, Rupendehi and Kavrepalchowk in 2010. Similarly, in 2011 more number of cancer cases was found in Kathmandu, Morang, Jhapa, Sunsari, Chitwan, Lalitpur, Rupendehi, Kaski, Saptari, Bhaktapur. Lung cancer was the common cancer and similarly, other prevalent cancers were cervical, breast, stomach, ovarian and colo-rectum cancer in 2003 to 2011. The common cancers were lung, cervical, breast, stomach, ovarian and colo-rectum. The number of patients is increasing, which may be due to change in life style and lack of education

Current Understanding to Accelerate Wound Healing: Mechanism and Clinical Importance

Wound mending is a complex organic cycle that brings about the reclamation of tissue honesty. Physiologically, it very well may be separated into four particular periods of hemostasis, inflammation, proliferation, and tissue remodeling (redesigning). This chapter portrays the cellular premise of wound mending and extracellular flagging cycles, which is responsible to control them. The capacity of fibroblasts, neutrophils, platelets, and macrophages is contemplated exhaustively. The idea of mending by essential and optional expectation is talked about. Numerous components are known to unfavorably influence mending including undernourishment, hypoxia, immunosuppression, ongoing sickness, and medical procedure. It is fundamental that specialists comprehend the key physiological cycles associated with mending to limit patient illness from postponed recuperating

Factors Influencing COVID-19 Vaccine Uptake among Nepali People in the UK: A Qualitative Study

From MDPI via Jisc Publications RouterHistory: accepted 2022-05-11, pub-electronic 2022-05-14Publication status: PublishedVaccination saves lives and can be an effective strategy for preventing the spread of the COVID-19, but negative attitudes towards vaccines lead to vaccine hesitancy. This study aimed to explore the factors influencing the uptake of the COVID-19 vaccine in the Nepali community in the United Kingdom (UK). This qualitative study included in-depth interviews with 20 people from Nepal living in the UK. Interviews were conducted by a native-Nepali speaker and all interviews were audio-recorded, transcribed, and translated into English before being analysed thematically. Our study found that attitudes towards COVID-19 are generally positive. Nine overlapping themes around barriers to COVID-19 vaccination were identified: (a) rumours and mis/disinformation; (b) prefer home remedies and yoga; (c) religion restriction; (d) concern towards vaccine eligibility; (e) difficulty with online vaccine booking system; (f) doubts of vaccine effectiveness after changing the second dose timeline; (g) lack of confidence in the vaccine; (h) past bad experience with the influenza vaccine; and i) worried about side-effects. Understanding barriers to the uptake of the COVID-19 vaccine can help in the design of better targeted interventions. Public health messages including favourable policy should be tailored to address those barriers and make this vaccination programme more viable and acceptable to the ethnic minority communities in the UK

Factors Influencing COVID-19 Vaccine Uptake among Nepali People in the UK: A Qualitative Study

Vaccination saves lives and can be an effective strategy for preventing the spread of the COVID-19, but negative attitudes towards vaccines lead to vaccine hesitancy. This study aimed to explore the factors influencing the uptake of the COVID-19 vaccine in the Nepali community in the United Kingdom (UK). This qualitative study included in-depth interviews with 20 people from Nepal living in the UK. Interviews were conducted by a native-Nepali speaker and all interviews were audio-recorded, transcribed, and translated into English before being analysed thematically. Our study found that attitudes towards COVID-19 are generally positive. Nine overlapping themes around barriers to COVID-19 vaccination were identified: (a) rumours and mis/disinformation; (b) prefer home remedies and yoga; (c) religion restriction; (d) concern towards vaccine eligibility; (e) difficulty with online vaccine booking system; (f) doubts of vaccine effectiveness after changing the second dose timeline; (g) lack of confidence in the vaccine; (h) past bad experience with the influenza vaccine; and (i) worried about side-effects. Understanding barriers to the uptake of the COVID-19 vaccine can help in the design of better targeted interventions. Public health messages including favourable policy should be tailored to address those barriers and make this vaccination programme more viable and acceptable to the ethnic minority communities in the U

Unzipping flood vulnerability and functionality loss:tale of struggle for existence of riparian buildings

Floods pose significant risk to riparian buildings as evidenced during many historical events. Although structural resilience to tsunami flooding is well studied in the literature, high-velocity and debris-laden floods in steep terrains are not considered adequately so far. Historical floods in steep terrains necessitate the need for flood vulnerability analysis of buildings. To this end, we report vulnerability of riparian-reinforced concrete buildings using forensic damage interpretations and empirical/analytical vulnerability analyses. Furthermore, we propose the concept and implications of functionality loss due to flooding in residential reinforced concrete (RC) buildings using empirical data. Fragility functions using inundation depth and momentum flux are presented for RC buildings considering a recent flooding event in Nepal. The results show that flow velocity and sediment load, rather than hydrostatic load, govern the damages in riparian RC buildings. However, at larger inundation depth, hydrostatic force alone may collapse some of the RC buildings