Clinico-epidemiology of Hymenoptera Stings in and around Kaski District, Nepal.

Introduction: In Nepal, morbidity and mortality from Hymenoptera stings is mainly from three commonly encountered insects: hornets (local: aringal), wasps (local: barulo) and honey bees (local: mahuri). The present study documents the incidence of hymenoptera sting in Western Region of Nepal and explores the cause behind such unprovoked attack upon human subjects. Methods: This hospital-based study included all the patients with history of insect sting attending the Emergency Department of Manipal Teaching Hospital, Pokhara from May 2015 till November 2015. Results: Of total 16 cases during the study period three were brought dead cases. The alleged insect happened to be bee in two cases, hornet in two cases, and wasp in eight cases with a case of unidentified insect sting. Severe burning pain with swelling, redness and itching were the common presenting symptom in all the admitted patients (n=13). Conclusion: Agricultural activity during the day was the cause of most unprovoked stings followed by deliberate destruction of the insect hive. Immediate medical attention in the nearby health care facility to the victims will save mortality. The health care facility also needs to have surplus lifesaving medication to counteract the life-threatening anaphylaxis reactions from such stings

Knowledge and awareness of the cause, prevention and control of cervical cancer amongst female undergraduates and faculty of health sciences: a cross sectional survey

Background: Carcinoma cervix is the second most common cancer in women worldwide, and the most common in India. In this study, the current knowledge of female undergraduates and faculty of health sciences regarding the various parameters like risk factors, symptoms, screening tests and vaccinations pertaining to cervical cancer was assessed.Methods: A cross-sectional, self-administered anonymous questionnaire-based survey was carried out, in a medical college in Mangalore, which included 260 staff and students. Non random sampling was done and the study was carried out only after gaining institutional Ethical community approval and written informed consent from the subjects.Results: Majority of the participants 185 (71.4%) were aware that cervical cancer is one of the most wide- spread gynecological cancers in Asia. The awareness of causative agents of cervical cancer was known to 53.9% of the undergraduates and 50% of the faculty members. 73% of the total study groups have heard of HPV and around 68% agreed that it was detectable. 71% of the study sample had heard about the Pap smear test and 42% have undergone the test. The questions pertaining to the preventive measures of cervical cancer had good faculty preponderance with 91.8% giving a positive response. 84.1% of the students and 79.5% of the faculty members knew that abnormal vaginal bleeding was a symptom.Conclusions: In this study an attempt has been made to study the correlates of knowledge of cervical cancer in a cohort which consisted of health care undergraduate and faculty. Majority of our study group was well aware of the various risk factors of cervical cancer and its preventable nature however awareness regarding the association between diets, multiple pregnancies and use of tobacco was poor

Dual Primary Malignancy: A Rare Organ Combination

A 63-year-old female smoker was evaluated for lump over the right breast, fine needle aspiration cytology of which showed infiltrating ductal carcinoma. Investigations also revealed the presence of left upper lobe mass lesion, the biopsy of which suggested small cell carcinoma. The existence of two malignancies having different histopathologies at anatomically distinct sites suggests the diagnosis of dual primary malignancy involving the breast and the lung which, being a rare combination, prompted us to report the case

Gender preferences among antenatal women: a cross-sectional study from coastal South India

Background: A balanced sex ratio is essential for a stable society. Objective: The main objective of the present research was to study the perceptions of women attending the antenatal care (ANC) facility regarding their gender preferences and family composition. Method: In this cross-sectional study 132 antenatal women were interviewed in their preferred language using a predesigned semi-structured questionnaire. The collected information was analyzed using SPSS version 11.5. Results: The mean age of the study participants was 27.2 \ub1 4.1 years. The majority of the antenatal women (60.6%, n=80) did not have any gender preferences. Among those who had a gender preference (39.4%, n=52), male and female preference was reported by 55.7% (n=29) and 44.3% (n=23) of the participants respectively. The overall son preference index was observed to be 1.3. No consistent relationship could be established between the socio-demographic factors and the preference for gender. The mean preferred family size in our study was 1.85\ub10.531 and more than half of the participants had a balanced gender preference. The majority of the participants were aware that the adverse sex ratio can lead to fall in the number of brides and that it would bring about a social imbalance. Conclusion: As a developed society we need to ensure that both the genders get equal respect and are free from any sort of preferences and prejudices. To achieve this, more and more people need to be made aware of the consequences of gender imbalance and adverse sex ratio in a society

Estimation of stature from the foot and its segments in a sub-adult female population of North India

<p>Abstract</p> <p>Background</p> <p>Establishing personal identity is one of the main concerns in forensic investigations. Estimation of stature forms a basic domain of the investigation process in unknown and co-mingled human remains in forensic anthropology case work. The objective of the present study was to set up standards for estimation of stature from the foot and its segments in a sub-adult female population.</p> <p>Methods</p> <p>The sample for the study constituted 149 young females from the Northern part of India. The participants were aged between 13 and 18 years. Besides stature, seven anthropometric measurements that included length of the foot from each toe (T1, T2, T3, T4, and T5 respectively), foot breadth at ball (BBAL) and foot breadth at heel (BHEL) were measured on both feet in each participant using standard methods and techniques.</p> <p>Results</p> <p>The results indicated that statistically significant differences (p < 0.05) between left and right feet occur in both the foot breadth measurements (BBAL and BHEL). Foot length measurements (T1 to T5 lengths) did not show any statistically significant bilateral asymmetry. The correlation between stature and all the foot measurements was found to be positive and statistically significant (<it>p-value </it>< 0.001). Linear regression models and multiple regression models were derived for estimation of stature from the measurements of the foot. The present study indicates that anthropometric measurements of foot and its segments are valuable in the estimation of stature. Foot length measurements estimate stature with greater accuracy when compared to foot breadth measurements.</p> <p>Conclusions</p> <p>The present study concluded that foot measurements have a strong relationship with stature in the sub-adult female population of North India. Hence, the stature of an individual can be successfully estimated from the foot and its segments using different regression models derived in the study. The regression models derived in the study may be applied successfully for the estimation of stature in sub-adult females, whenever foot remains are brought for forensic examination. Stepwise multiple regression models tend to estimate stature more accurately than linear regression models in female sub-adults.</p

The burden of unintentional drowning : global, regional and national estimates of mortality from the Global Burden of Disease 2017 Study

Background Drowning is a leading cause of injury-related mortality globally. Unintentional drowning (International Classification of Diseases (ICD) 10 codes W65-74 and ICD9 E910) is one of the 30 mutually exclusive and collectively exhaustive causes of injury-related mortality in the Global Burden of Disease (GBD) study. This study's objective is to describe unintentional drowning using GBD estimates from 1990 to 2017. Methods Unintentional drowning from GBD 2017 was estimated for cause-specific mortality and years of life lost (YLLs), age, sex, country, region, Socio-demographic Index (SDI) quintile, and trends from 1990 to 2017. GBD 2017 used standard GBD methods for estimating mortality from drowning. Results Globally, unintentional drowning mortality decreased by 44.5% between 1990 and 2017, from 531 956 (uncertainty interval (UI): 484 107 to 572 854) to 295 210 (284 493 to 306 187) deaths. Global age-standardised mortality rates decreased 57.4%, from 9.3 (8.5 to 10.0) in 1990 to 4.0 (3.8 to 4.1) per 100 000 per annum in 2017. Unintentional drowning-associated mortality was generally higher in children, males and in low-SDI to middle-SDI countries. China, India, Pakistan and Bangladesh accounted for 51.2% of all drowning deaths in 2017. Oceania was the region with the highest rate of age-standardised YLLs in 2017, with 45 434 (40 850 to 50 539) YLLs per 100 000 across both sexes. Conclusions There has been a decline in global drowning rates. This study shows that the decline was not consistent across countries. The results reinforce the need for continued and improved policy, prevention and research efforts, with a focus on low- and middle-income countries.Peer reviewe

The burden of unintentional drowning: Global, regional and national estimates of mortality from the Global Burden of Disease 2017 Study

__Background:__ Drowning is a leading cause of injury-related mortality globally. Unintentional drowning (International Classification of Diseases (ICD) 10 codes W65-74 and ICD9 E910) is one of the 30 mutually exclusive and collectively exhaustive causes of injury-related mortality in the Global Burden of Disease (GBD) study. This study's objective is to describe unintentional drowning using GBD estimates from 1990 to 2017. __Methods:__ Unintentional drowning from GBD 2017 was estimated for cause-specific mortality and years of life lost (YLLs), age, sex, country, region, Socio-demographic Index (SDI) quintile, and trends from 1990 to 2017. GBD 2017 used standard GBD methods for estimating mortality from drowning. __Results:__ Globally, unintentional drowning mortality decreased by 44.5% between 1990 and 2017, from 531 956 (uncertainty interval (UI): 484 107 to 572 854) to 295 210 (284 493 to 306 187) deaths. Global age-standardised mortality rates decreased 57.4%, from 9.3 (8.5 to 10.0) in 1990 to 4.0 (3.8 to 4.1) per 100 000 per annum in 2017. Unintentional drowning-associated mortality was generally higher in children, males and in low-SDI to middle-SDI countries. China, India, Pakistan and Bangladesh accounted for 51.2% of all drowning deaths in 2017. Oceania was the region with the highest rate of age-standardised YLLs in 2017, with 45 434 (40 850 to 50 539) YLLs per 100 000 across both sexes. __Conclusions:__ There has been a decline in global drowning rates. This study shows that the decline was not consistent across countries. The results reinforce the need for continued and improved policy, prevention and research efforts, with a focus on low-and middle-income countries

Subnational mapping of HIV incidence and mortality among individuals aged 15–49 years in sub-Saharan Africa, 2000–18 : a modelling study

Background: High-resolution estimates of HIV burden across space and time provide an important tool for tracking and monitoring the progress of prevention and control efforts and assist with improving the precision and efficiency of targeting efforts. We aimed to assess HIV incidence and HIV mortality for all second-level administrative units across sub-Saharan Africa. Methods: In this modelling study, we developed a framework that used the geographically specific HIV prevalence data collected in seroprevalence surveys and antenatal care clinics to train a model that estimates HIV incidence and mortality among individuals aged 15–49 years. We used a model-based geostatistical framework to estimate HIV prevalence at the second administrative level in 44 countries in sub-Saharan Africa for 2000–18 and sought data on the number of individuals on antiretroviral therapy (ART) by second-level administrative unit. We then modified the Estimation and Projection Package (EPP) to use these HIV prevalence and treatment estimates to estimate HIV incidence and mortality by second-level administrative unit. Findings: The estimates suggest substantial variation in HIV incidence and mortality rates both between and within countries in sub-Saharan Africa, with 15 countries having a ten-times or greater difference in estimated HIV incidence between the second-level administrative units with the lowest and highest estimated incidence levels. Across all 44 countries in 2018, HIV incidence ranged from 2 ·8 (95% uncertainty interval 2·1–3·8) in Mauritania to 1585·9 (1369·4–1824·8) cases per 100 000 people in Lesotho and HIV mortality ranged from 0·8 (0·7–0·9) in Mauritania to 676· 5 (513· 6–888·0) deaths per 100 000 people in Lesotho. Variation in both incidence and mortality was substantially greater at the subnational level than at the national level and the highest estimated rates were accordingly higher. Among second-level administrative units, Guijá District, Gaza Province, Mozambique, had the highest estimated HIV incidence (4661·7 [2544·8–8120·3]) cases per 100000 people in 2018 and Inhassunge District, Zambezia Province, Mozambique, had the highest estimated HIV mortality rate (1163·0 [679·0–1866·8]) deaths per 100 000 people. Further, the rate of reduction in HIV incidence and mortality from 2000 to 2018, as well as the ratio of new infections to the number of people living with HIV was highly variable. Although most second-level administrative units had declines in the number of new cases (3316 [81· 1%] of 4087 units) and number of deaths (3325 [81·4%]), nearly all appeared well short of the targeted 75% reduction in new cases and deaths between 2010 and 2020. Interpretation: Our estimates suggest that most second-level administrative units in sub-Saharan Africa are falling short of the targeted 75% reduction in new cases and deaths by 2020, which is further compounded by substantial within-country variability. These estimates will help decision makers and programme implementers expand access to ART and better target health resources to higher burden subnational areas