Reduction of nitrogen (N) input in cropping systems is critical to reduce environmental pollution and achieve sustainable development goals. Multi-location field trials for maize (n = 120) and rice ...(n = 84) were conducted across nine districts in Nepal during 2018 and 2019 to assess the potential of polymer coated urea (PCU) and urea briquette (UB) to increase agronomic N use efficiency (AE
N
), crop productivity and farm profits over conventional urea (CU). Nitrogen rates applied in PCU and UB treatments were 22% to 50% lower than CU (120 and 100 kg N ha
−1
for maize and rice respectively). In maize, both PCU (8.4 t ha
−1
) and UB (8.5 t ha
−1
) applied at 50% and 25% lower N rates respectively produced similar grain yields compared with CU (7.9 t ha
−1
). Similar results were observed in rice where PCU and UB applied at 22% less N led to a productivity of 5.4 and 5.5 t ha
−1
respectively over CU (5.1 t ha
−1
). Moreover, both PCU and UB increased maize and rice yields significantly compared with current farmer's practices (FP). In both maize and rice, PCU and UB significantly increased partial factor productivity of N (PFP
N
) and agronomic NUE (AE
N
) compared with CU. Furthermore, PCU and UB increased farmer's net income by US$88 and US$148 in maize and by US$10 and US$87 in rice respectively. These results suggest that PCU and UB could save N input by 22-50% while maintaining similar or even higher yield and higher benefit to farmers compared with CU.
The transmission of healthcare-associated infections (HCAIs) in healthcare settings is a serious challenge in the medical fraternity. Medical devices, such as stethoscopes used by healthcare workers ...(HCWs), are likely to harbor a considerable number of pathogenic microbes, which may result in the transmission of HCAIs. This study sought to investigate bacterial contamination of stethoscopes used by HCWs at Bharatpur Hospital, Nepal. During the study period of 3 months from December 2019 to February 2020, a total of 87 stethoscopes were examined; bacterial pathogens were isolated and identified by culture and biochemical tests, and their susceptibilities against different antibiotics were determined using standard protocols of the Clinical and Laboratory Standards Institute (CLSI). The disc diffusion method was used primarily to screen for extended-spectrum beta-lactamase (ESBL)- and metallo-beta-lactamase (MBL)-producing isolates, followed by their confirmation using cephalosporin/clavulanate combination discs and the disc potentiation methods, respectively. In addition, molecular detection of
and
genes was performed using conventional polymerase chain reaction (PCR). Of the 87 stethoscopes examined, more than a quarter (28.7%) were colonized with different pathogenic bacteria. Bacterial contamination of stethoscopes was found to be significantly associated with various factors, such as disinfecting routine, method of disinfection, and department of the hospital (
< 0.05). A higher rate of bacterial contamination was observed on the diaphragm of the stethoscope (12.64%) and among HCWs who overlooked hand hygiene practices (45.45%). The prevalence of methicillin-resistant
(MRSA) was 44.44%, and approximately half of the Gram-negative isolates (47%) were multidrug resistant (MDR). Imipenem (81.25%) and chloramphenicol (83.33%) were found to be the most effective antibiotics for Gram-negative and Gram-positive bacteria, respectively. Phenotypic screening showed that 43.75% of isolates were ESBL producers, and 18.75% were MBL producers, but
and
genes were detected in only 31.25% and 6.25% of isolates, respectively. The results of the study call for effective stethoscope disinfection practices along with the judicious use of antibiotics by HCWs in order to minimize cross-contamination, emergence of resistance, and spread of nosocomial infections in clinical settings.
Background
The Asiatic wild water buffalo (Bubalus arnee) is an endangered species that is conserved in the Koshi Tappu Wildlife Reserve (KTWR), Nepal, and was recently translocated to the Chitwan ...National Park (CNP). Gastrointestinal (GI) parasites are the cause of significant negative health and production impacts on animals worldwide.
Methods
A coprological survey of GI parasites of wild water buffalo was carried out in the CNP in 2020. Fresh dung samples (n = 25) were collected from wild water buffaloes and analysed using sedimentation and flotation techniques for morphological identification of parasite cysts, oocysts and eggs.
Results
Nine different GI parasites were recorded of which Entamoeba spp. (20 samples, 80%) were the most common. The presence of Entamoeba spp. was further validated using polymerase chain reaction (PCR) analysis and DNA sequencing. The PCR results were positive for all of the microscopically positive samples, and the species was identified as Entamoeba bovis. Three samples were sequenced and formed a cluster of E. bovis, which was separated from other Entamoeba spp. in phylogenetic analysis.
Conclusion
This is the first report for molecular detection of E. bovis from wild water buffaloes in Nepal. Future work should focus on the prevalence of such infections in water buffaloes in forest environments.
1. The Asiatic wild water buffalo is an endangered species that are present only two areas in Nepal.
2. Microscopic examination revealed 96% prevalence rate with four protozoan and five helminths’ parasites detected in wild water buffalo.
3. PCR and sequencing revealed the presence of highly prevalent species as Entamoeba bovis.
4. This is the first molecular report of E. bovis in Nepalese wild water buffaloes.
The Public-Private Mix (PPM) approach is a strategic initiative that involves engaging all private and public health care providers in the fight against tuberculosis using international health care ...standards. For tuberculosis control in Nepal, the PPM approach could be a milestone. This study aimed to explore the barriers to a public-private mix approach in the management of tuberculosis cases in Nepal.
We conducted key informant interviews with 20 participants, 14 of whom were from private clinics, polyclinics, and hospitals where the PPM approach was used, two from government hospitals, and four from policymakers. All data were audio-recorded, transcribed, and translated into English. The transcripts of the interviews were manually organized, and themes were generated and categorized into 1. TB case detection, 2. patient-related barriers, and 3. health-system-related barriers.
A total of 20 respondents participated in the study. Barriers to PPM were identified into following three themes: (1) Obstacles related to TB case detection, (2) Obstacles related to patients, and (3) Obstacles related to health-care system. PPM implementation was challenged by following sub-themes that included staff turnover, low private sector participation in workshops, a lack of trainings, poor recording and reporting, insufficient joint monitoring and supervision, poor financial benefit, lack of coordination and collaboration, and non-supportive TB-related policies and strategies.
Government stakeholders can significantly benefit by applying a proactive role working with the private in monitoring and supervision. The joint efforts with private sector can then enable all stakeholders to follow the government policy, practice and protocols in case finding, holding and other preventive approaches. Future research are essential in exploring how PPM could be optimized.
Aim. Dual coinfection of HCV and HBV in HIV-1-infected population is a leading cause of morbidity and mortality. Also, they share routes of HIV transmission; however, it might be associated with an ...independent factor like injecting drug use for HCV and unsafe sex for HBV. This case report suggests that hepatitis virus coinfection may lead to late response of antiretroviral therapy (ART) in HIV-1 patients. Patients and Methods. A 49-year-old male patient visited for the routine follow-up investigation at the National Public Health Laboratory (NPHL), Teku, Nepal. He was an HIV-1-positive injecting drug user (IDU) co-infected with HCV and HBV. The patient was under ART as per the National HIV Testing and Treatment Guidelines 2017, Nepal. Further, serological and viral load testing was performed for confirmation and monitoring therapy, respectively. Results. It is the first report that highlights the dual coinfection of HCV and HBV in an HIV-1 patient from Nepal. The follow-up investigation shows improved response to ART with an increase in CD4+ cells. However, detectable viral loads indicated for a late response might be due to effects of coinfections or viral interactions. Conclusions. Dual coinfection is rare; however, it is more serious with poorly defined epidemiology and evolution in an HIV-1-infected population. Thus, universal screening of HBV or/and HCV coinfection in HIV-1-infected population requires immediate implementation for true prevalence, proper management, and early intervention.
Electrodynamical coupling between the solar wind’s plasma and the Earth’s magnetosphere creates geomagnetic disturbances recorded on the ground. This work analyzes the
Y
-component of the geomagnetic ...field during two geomagnetic storms and compares it to the solar quiet days. The magnetogram data recorded on low latitude stations are used for the study. We investigated the correlation of the
Y
-component with geomagnetic index
SYM-H
using wavelet multiresolution analysis. We have used solar wind velocity, pressure, and interplanetary magnetic fields (
By
and
Bz
) to know the interplanetary structure for the selected duration. We found a positive correlation between
Y
-component and the
SYM-H
index for both events. The magnitude of the
Y
-component was significantly reduced during the main phase in comparison to the quiet days. Further, variation of solar wind parameters indicated geomagnetic storms are guided by the prolonged southward IMF-
Bz
component and highly fluctuated IMF-
By
component. This work connects the interplanetary plasma parameters to the storm-time geomagnetic variations.
A case of human immunodeficiency virus (HIV) infection is described from Nepal with constant maintenance of CD4 count and HIV-RNA level below the lower detection threshold for more than ten years. ...The case was diagnosed of HIV positive in the year 2008. He had his viral load estimation performed every year since then which was always below lower detection limit and remained healthy without treatment. The patient also had not any kinds of opportunistic infection till date. He is married now and has not transmitted the disease to his wife.
Tumor deposits are one of the promising factors among the different edition of Tumor, Node, Metastasis classification. Despite improvement in the treatment of various types of metastatic disease the ...source and prognostic significance of tumor deposits in staging has not been deliberating the agreeable opinion. We investigated the possibility of tumor deposit as independent prognostic factor and evaluating its prognostic value in colorectal carcinoma patients.
Author studied 313 colorectal cancer patients clinocopathological data and outcome who underwent radical resection. Data between 2011-2015 were retrospectively collected from Shanghai East Hospital, affiliated with Tongji University data information centre. The analysis was used to calculate 2 years disease free survival(DFS) and relation of tumor deposit with number of lymph node positive. Cox-regression analysis was performed to assess the prognostic factor.
Out of 313 colorectal patients included in the study, tumor deposits were detected in 17%. Tumor deposits (TDs) are relevantly associated with significant poor outcomes. The tumor deposit were significantly correlated with T-stage(P=<0.001), N-stage(P=<0.001), PLNC(P=<0.001), venous invasion(P=<0.001), TNM staging(P=<0.001), CEA(P=0.021) and CA19-9(P=0.042) of primary tumor. The Kaplan-Meier analysis revealed that disease-free survival of CRC patients with positive tumor deposit were significantly poorer that those with negative tumor deposit cohort(P=<0.001) And with multivariate analysis in different model, we found that positive tumor deposit were significantly associated with shorter DSF which is totally independent with lymph node status (P=0.001 and P=0.023 respectively). Subgroup analysis found that of 179 CRC patients with negative lymph node status, the DFS of patients with positive tumor deposit were significantly shorter that those with negative tumor deposit(P=,0.001). Of 134patients with positive lymph node status, the DFS of patients shows similar result. (P=<0.001).
We have shown that TDs are not equal to lymph node metastasis with respect to biology and outcome. Tumor deposits are an independent adverse prognostic factor in CRC patient who have undergone radical resection.
Skilled care during pregnancy, childbirth, and postpartum is essential to prevent adverse maternal health outcomes, yet utilization of care remains low in many resource-limited countries, including ...Nepal. Community health workers (CHWs) can mitigate health system challenges and geographical barriers to achieving universal health coverage. Gaps remain, however, in understanding whether evidence-based interventions delivered by CHWs, closely aligned with WHO recommendations, are effective in Nepal's context. We conducted a type II hybrid effectiveness-implementation, mixed-methods study in two rural districts in Nepal to evaluate the effectiveness and the implementation of an evidence-based integrated maternal and child health intervention delivered by CHWs, using a mobile application. The intervention was implemented stepwise over four years (2014-2018), with 65 CHWs enrolling 30,785 families. We performed a mixed-effects Poisson regression to assess institutional birth rate (IBR) pre-and post-intervention. We used the Reach, Effectiveness, Adoption, Implementation, and Maintenance framework to evaluate the implementation during and after the study completion. There was an average 30% increase in IBR post-intervention, adjusting for confounding variables (p<0.0001). Study enrollment showed 35% of families identified as dalit, janjati, or other castes. About 78-89% of postpartum women received at least one CHW-counseled home visit within 60 days of childbirth. Ten (53% of planned) municipalities adopted the intervention during the study period. Implementation fidelity, measured by median counseled home visits, improved with intervention time. The intervention was institutionalized beyond the study period and expanded to four additional hubs, albeit with adjustments in management and supervision. Mechanisms of intervention impact include increased knowledge, timely referrals, and longitudinal CHW interaction. Full-time, supervised, and trained CHWs delivering evidence-based integrated care appears to be effective in improving maternal healthcare in rural Nepal. This study contributes to the growing body of evidence on the role of community health workers in achieving universal health coverage.
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