Knowledge, Attitude and Practice towards COVID-19 among Dental Practitioners in Bhutan

INTRODUCTION: Corona virus disease was first reported in Wuhan city of China in 2019. The disease is caused by a highly infectious virus which can be transmitted from human to human through physical contact, droplets, or touching surfaces contaminated with the virus. AIM: The study aims to get an assessment of knowledge, attitude and practices towards COVID-19 disease among the dental practitioners in Bhutan.MATERIAL AND METHODS: An online cross- sectional study was conducted among dental practitioners working in different hospitals across the country. All dental professionals who provided their email address were included in the study. Data were collecting using a structured questionnaire shared though email. A total of 157 dental professionals were invited through e-mail to participate in the study. RESULTS: A total of 125 dental professionals participated in the study (response rate 79.6%). Over half of the participants (51.2%) were between the age group 20-30 years. Despite almost everyone (98.4%) knowing the causative agent and management of COVID-19 positive patients, only around a half of the participants (48%) had a good level of knowledge on COVID-19.CONCLUSION: The study found that less than half of the participants have a good level of knowledge on COVID-19 while a majority of them feel that there is discrimination against COVID-19 positive patients and health professionals working for COVID-19 patients. The study highlights the need to conduct sensitization, trainings or CME on COVID-19 periodically to keep all health professionals updated with latest advancements to help maintain safety in clinical practice

Rates and indications of caesarean section deliveries in Bhutan 2015-2019: a national review

BACKGROUND: Bhutan has made much efforts to provide timely access to health services during pregnancy and increase institutional deliveries. However, as specialist obstetric services became available in seven hospitals in the country, there has been a steady increase in the rates of caesarean deliveries. This article describes the national rates and indications of caesarean section deliveries in Bhutan. METHODS: This is a review of hospital records and a qualitative analysis of peer-reviewed articles on caesarean deliveries in Bhutan. Data on the volume of all deliveries that happened in the country from 2015 to 2019 were retrieved from the Annual Health Bulletins published by the Ministry of Health. The volume of deliveries and caesarean deliveries were extracted from the Annual Report of the National Referral Hospital 2015-2019 and the data were collected from hospital records of six other obstetric centres. A national rate of caesarean section was calculated as a proportion out of the total institutional deliveries at all hospitals combined. At the hospital level, the proportion of caesarean deliveries are presented as a proportion out of total institutional deliveries conducted in that hospital. RESULTS: For the period 2015-2019, the average national rate of caesarean section was 20.1% with a statistically significant increase from 18.1 to 21.5%. The average rate at the six obstetric centres was 29.9% with Phuentsholing Hospital (37.2%), Eastern Regional Referral Hospital (34.2%) and Samtse General Hospital (32.0%) reporting rates higher than that of the National Referral Hospital (28.1%). Except for the Eastern Regional Referral and Trashigang Hospitals, the other three centres showed significant increase in the proportion of caesarean deliveries during the study period. The proportion of emergency caesarean section at National Referral Hospital, Central Regional Referral Hospital and the Phuentsholing General Hospital was 58.8%. The National Referral Hospital (71.6%) and Phuentsholing General Hospital reported higher proportions of emergency caesarean sections (64.4%) while the Central Regional Referral Hospital reported higher proportions of elective sections (59.5%). The common indications were 'past caesarean section' (27.5%), foetal distress and non-reassuring cardiotocograph (14.3%), failed progress of labour (13.2%), cephalo-pelvic disproportion or shoulder dystocia (12.0%), and malpresentation including breech (8.8%). CONCLUSION: Bhutan's caesarean section rates are high and on the rise despite a shortage of obstetricians. This trend may be counterproductive to Bhutan's efforts towards 2030 Sustainable Development Goal agendas and calls for a review of obstetric standards and practices to reduce primary caesarean sections

The Weight of Schoolbags and Musculoskeletal Pain in Children of Selected Schools in Thimphu, Bhutan: A Cross-sectional Study

Background: The carriage of loads on the back in children, >10% of one’s body weight (BW), induces postural change and morbidity related to spinal pain. We studied the weight of schoolbags and the prevalence of musculoskeletal pain related to carrying schoolbags among children in Thimphu, Bhutan. Methods: This was a cross-sectional study, with a multistage cluster sampling, conducted amongst grade 8 and 10 students. Data were collected using a standardized self-administered questionnaire and weights of students and schoolbags were measured. Descriptive statistics were used to present the findings. Means were compared using t test and risk factors were identified using logistic regression. Results: There were 131 students whose schoolbags weighed >10% body weight (BW). The mean weight of schoolbags was 4.6 ±1.5 kg for grade 8 students and 4.0 ±1.5 kg for grade 10 students. Musculoskeletal pain in at least one body region was reported by 411 students. Schoolbags weighing >10% BW and carrying the bags over only one shoulder were significant risk factors for reporting musculoskeletal pain. There were 197 students whose schoolbags did not have any safety feature; students did not use them consistently even if they were present. Conclusions: The weight of school bags that were more than the recommended ?10% BW was a strong factor in reporting musculoskeletal pain. Parents and students may be educated on the use of schoolbags with safety features. Measures such as providing storage facilities in schools may reduce the weight of bags

Data from: Genetic diversity and population structure of three traditional horse breeds of Bhutan based on 29 DNA microsatellite markers

The genetic variability and population structure of three Bhutanese traditional horse breeds were assessed through genotyping of 74 horses (Boeta 25, Sharta 14 and Yuta 35) for 29 microsatellite DNA loci. Altogether, 282 alleles were detected across 29 polymorphic loci. The allelic diversity (NE) (Boeta 4.94; Sharta 4.65; Yuta 5.30) and gene diversities (HE) (Boeta 0.78; Sharta 0.77; Yuta 0.79) were high. None of the breeds deviated significantly from the Hardy-Weinberg equilibrium. There was no sign of significant population bottleneck for all the breeds. The inbreeding estimates (FIS) of the breeds were low (Boeta 0.023; Sharta 0.001; Yuta 0.021). Analysis of molecular variance showed 0.6% of the total genetic variation among breeds, 1.9% among individuals and 97.5% within individuals. The global FIT, FST, and FIS estimates for the population were 0.025, 0.006 and 0.019 respectively. The analysis of population structure failed to distinguish subpopulations in traditional horses and this was supported by a high genetic exchange among the breeds. Overall, the results of this study suggest a rich genetic diversity in the traditional horse despite a very low genetic differentiation among the breeds in Bhutan

Data from: Genetic diversity and population structure of three traditional horse breeds of Bhutan based on 29 DNA microsatellite markers

The genetic variability and population structure of three Bhutanese traditional horse breeds were assessed through genotyping of 74 horses (Boeta 25, Sharta 14 and Yuta 35) for 29 microsatellite DNA loci. Altogether, 282 alleles were detected across 29 polymorphic loci. The allelic diversity (NE) (Boeta 4.94; Sharta 4.65; Yuta 5.30) and gene diversities (HE) (Boeta 0.78; Sharta 0.77; Yuta 0.79) were high. None of the breeds deviated significantly from the Hardy-Weinberg equilibrium. There was no sign of significant population bottleneck for all the breeds. The inbreeding estimates (FIS) of the breeds were low (Boeta 0.023; Sharta 0.001; Yuta 0.021). Analysis of molecular variance showed 0.6% of the total genetic variation among breeds, 1.9% among individuals and 97.5% within individuals. The global FIT, FST, and FIS estimates for the population were 0.025, 0.006 and 0.019 respectively. The analysis of population structure failed to distinguish subpopulations in traditional horses and this was supported by a high genetic exchange among the breeds. Overall, the results of this study suggest a rich genetic diversity in the traditional horse despite a very low genetic differentiation among the breeds in Bhutan

Nei’s unbiased genetic distance (<i>D</i>_A) below diagonal and pairwise population differentiation (<i>F</i>_ST) above the diagonal among three breeds.

<p>Nei’s unbiased genetic distance (<i>D</i>_A) below diagonal and pairwise population differentiation (<i>F</i>_ST) above the diagonal among three breeds.</p

Mode-shift analysis of genetic bottleneck in Bhutanese traditional horse breeds.

<p>Mode-shift analysis of genetic bottleneck in Bhutanese traditional horse breeds.</p

Distribution of traditional horse breeds and sampling sites in Bhutan.

<p>⋆ Sharta, ♦ Yuta and Boeta.</p

The neighbor-joining tree showing the level of genetic relationships among three traditional horse breeds of Bhutan based on Nei’s genetic distances (<i>D</i>_A).

<p>The neighbor-joining tree showing the level of genetic relationships among three traditional horse breeds of Bhutan based on Nei’s genetic distances (<i>D</i>_A).</p