Outcome of surgical decompression in resistant de Quervain tenosynovitis

Introductions: De Quervain tenosynovitis is a common cause of functional impairment. Steroid injection has good result but significant numbers of cases develop resistance requiring surgical decompression. This study assesses the outcome of surgery. Methods: Symptomatic de Quervaint tenosynovitis cases resistant to conservative treatment that underwent surgical decompression and postoperative thumb immobilization using thumb spica splint cast during four and half years were analyzed. They were followed for at least three months for clinical and functional outcome. Patient demography, visual analogue score (VAS) and complications were analyzed descriptively. Results: There were 34 cases of de Quervaint tenosynovitis, mean age 42±16 years, and female 88.2%. Treatment was successful in all cases. The mean VAS score reduced to 0.5 from 6.82, p-value <0.01. Complication occurred in one case. Conclusions: Surgical decompression of de Quervain tenosynovitis was safe and effective in cases resistant to conservative treatment. Keywords: corticosteroid injection CSI, resistant de Quervain tenosynovitis, surgical decompression, thumb spica splint cas

Factors associated with co-occurrence of large carnivores in a human-dominated landscape

We investigated the factors facilitating co-occurrence of two large carnivores, tigers (Panthera tigris) and common leopards (Panthera pardus), within a human-dominated landscape. We estimated their density and population size using camera-trap photographs and examined spatial segregation of habitats, temporal activity pattern, and diets in Chitwan National Park, Nepal. A Bayesian spatially-explicit capture-recapture model estimated densities of 3.2–4.6 (3.94 ± 0.37) tigers and 2.6–4.1 (3.31 ± 0.4) leopards per 100 km2 with abundance of 70–102 tigers and 66–105 leopards. Tigers occupied the prime habitats (grasslands and riverine forests) in alluvial floodplains of the Park whereas leopards appeared in Sal forests and marginal areas where livestock are present. Both tigers and leopards showed crepuscular activity patterns with a high overlap but tigers were less active during the day compared to leopards. Leopards’ activity in the day increased in the presence of tigers. Tiger and leopard diet overlapped considerably (90%). Compared to leopards, tigers consumed a higher proportion of the large prey and a smaller proportion of livestock. Our study demonstrates that sympatric large carnivores can coexist in high densities in prey-rich areas that contain a mosaics of habitats. To increase the resilience and size of the Chitwan carnivore population, strategies are needed to increase prey biomass and prevent livestock depredation in adjacent forests. Long-term monitoring is also required to obtain a detailed understanding of the interaction between the large carnivores and their effects on local communities living in forest fringes within the landscape.Global Challenges (FSW

Predicting the potential distribution and habitat variables associated with pangolins in Nepal

Pangolins are highly-threatened due to illegal hunting and poaching, and by the loss, degradation, and fragmentation of their habitats. In Nepal, effective conservation actions for pangolins are scarce due to limited information on the distribution of pangolins in many areas of the country. To identify the nationwide distribution of pangolins in Nepal, and assess the environmental variables associated with their habitat, we conducted an extensive literature review to collate data from previous studies, canvassed information from key informant interviews and expert opinion, and conducted transect surveys and sign surveys. The occurrence of pangolins was recorded based on sightings and indirect signs (such as burrows, digs, tracks, and scats) along 115 belt transects of 500-m length with a fixed width of 50-m, and habitat parameters were surveyed using 347 quadrats of 10 m*10 m. Pangolin presence was confirmed from 61 out of 75 districts from the eastern to the far western parts of the country. The highest frequency of burrows (74%) was observed in the forested habitat constituting brown soil with medium texture (0.02–2 mm) within an elevation range of 500–1500 m above sea level. Logistic regression suggested that the occurrence of pangolin was highly influenced by ground cover and canopy cover of 50–75%, litter depth, and the distance to termite mounds and roads. We used 4136 occurrence GPS points of pangolin burrows that were compiled and collected from the literature review and field surveys in order to predict the potential habitat distribution of pangolin using maximum entropy algorithm (MaxEnt 3.4.1). The model predicted 15.2% (22,393 km2) of the total land of Nepal as potentially suitable habitat for pangolin, with 38.3% (8574 km2) of potential habitat in the eastern region, followed by 37.6% (8432 km2) in the central and 24.1% (5,387 km2) in the western regions. The results of this study present a national baseline for pangolin distribution and serve as an important document for developing and executing conservation actions and management plans for the long-term conservation of pangolins in Nepal

Data from: Caregivers' attitude towards people with mental illness and perceived stigma: a cross-sectional study in a tertiary hospital in Nepal

Background: Mental illness is stigmatized in most of the communities and people with such illness are often subjected to defame. Stigma impairs an individual’s and their caregiver’s physical, social and emotional wellbeing, and health-seeking behavior. Sufficient literature on how often the caregivers of people with mental illness from low and middle-income countries are stigmatized and how they perceive people with mental illness is unavailable. In this study, we examined caregivers’ attitude towards people with mental illness and perceived stigma. Methods: We conducted face-to-face interviews with 170 caregivers in an outpatient clinic of a hospital in Nepal using a structured questionnaire. We calculated median and inter-quartile range of the attitude and perceived stigma scores. To assess the correlates, Kruskal Wallis H test and Mann Whitney U test were carried out. Results: Overall median score for the domains: attitude (score range: 18–90) and perceived stigma (score range: 12–60) were 42 and 28 respectively, inter-quartile range being 8 each. Attitude score differed significantly by the sex of caregiver (p<0.05), educational status of caregiver (p<0.001), sex of patient (p<0.05) and type of mental illness (p<0.05). Perceived stigma score varied significantly by caregiver’s sex (p<0.05), marital status (p<0.001), educational status (p<0.001), occupation (p<0.05), relation with the patient (p<0.005) and use of alternative treatment modalities (p<0.05). Conclusion: Sex of participant, educational status, sex of patient and type of mental illness were the correlates of attitude towards mental illness. Similarly, sex of participant, marital status, educational status, occupation, caregiver’s relation with patient and use of alternative treatment modalities were correlates of perceived stigma. Findings of this study suggest that interventions targeting these high-risk populations might be beneficial to help build a positive attitude and overcome the perceived social stigma

Dataset- Caregivers' Stigma

This file contains the data form the study "Caregivers’ Attitude towards People with Mental Illness and Perceived Stigma: A Cross-Sectional Study in A Tertiary Hospital in Nepal

Caregivers’ Attitude towards People with Mental Illness and Perceived Stigma: A Cross-Sectional Study in a Tertiary Hospital in Nepal

<div><p>Background</p><p>Mental illness is stigmatized in most of the communities and people with such illness are often subjected to defame. Stigma impairs an individual’s and their caregiver’s physical, social and emotional wellbeing, and health-seeking behavior. Sufficient literature on how often the caregivers of people with mental illness from low and middle-income countries are stigmatized and how they perceive people with mental illness is unavailable. In this study, we examined caregivers’ attitude towards people with mental illness and perceived stigma.</p><p>Methods</p><p>We conducted face-to-face interviews with 170 caregivers in an outpatient clinic of a hospital in Nepal using a structured questionnaire. We calculated median and inter-quartile range of the attitude and perceived stigma scores. To assess the correlates, Kruskal Wallis H test and Mann Whitney U test were carried out.</p><p>Results</p><p>Overall median score for the domains: attitude (score range: 18–90) and perceived stigma (score range: 12–60) were 42 and 28 respectively, inter-quartile range being 8 each. Attitude score differed significantly by the sex of caregiver (p<0.05), educational status of caregiver (p<0.001), sex of patient (p<0.05) and type of mental illness (p<0.05). Perceived stigma score varied significantly by caregiver’s sex (p<0.05), marital status (p<0.001), educational status (p<0.001), occupation (p<0.05), relation with the patient (p<0.005) and use of alternative treatment modalities (p<0.05).</p><p>Conclusion</p><p>Sex of participant, educational status, sex of patient and type of mental illness were the correlates of attitude towards mental illness. Similarly, sex of participant, marital status, educational status, occupation, caregiver’s relation with patient and use of alternative treatment modalities were correlates of perceived stigma. Findings of this study suggest that interventions targeting these high-risk populations might be beneficial to help build a positive attitude and overcome the perceived social stigma.</p></div

Median score of items measuring perceived stigma.

<p>Median score of items measuring perceived stigma.</p

Median score of items measuring attitude towards PWMI.

<p>Median score of items measuring attitude towards PWMI.</p

Socio-demographic characteristics in relation to attitude towards PWMI and perceived stigma.

<p>Socio-demographic characteristics in relation to attitude towards PWMI and perceived stigma.</p