The prevalence and characteristics of disability in Eastern Nepal.

Background: Disability is related to poverty and development. Enough information and documentation is not available for developing countries like Nepal. Aims and Objectives: To assess the self-reported prevalence of disability in terms of age, sex, types, cause and age of onset. Methodology: A cross-sectional house to house census was carried out by means of structured questionnaires. Results: A total of 31160 individuals (4.87%) were found disabled out of a total of 640259 individuals. The three most common types of disability are physical affecting limbs, hearing and vision. The most common perceived cause of disability is inborn syndrome followed by injury/accidents. Discussion: Various publications for the prevalence of reported disability show a figure between three and ten percent, with physical disability affecting locomotion and manipulation as the leading type of disability. The prevalence rate can vary depending upon the disability indicators, methods and population surveyed and perceptions of the people. Conclusion: The self-reported prevalence of disability in Sunsari District is 4.87%, with inborn-syndrome as the leading perceived cause. Key words: Disability, types, cause, Nepal.     

Prevalence of antibodies to HTLV-I, -II, and -III in intravenous drug abusers from an AIDS endemic region

Antibody prevalences for human T-cell lymphotropic virus (HTLV) types I, II, and III were determined for 56 intravenous drug abusers from Queens, NY. While control serum samples lacked antibodies to all HTLV subgroups, seropositivity among drug users was 41% for HTLV-III, 18% for HTLV-II, and 9% for HTLV-I. Infection by HTLV-I and -II occurred independently of HTLV-III infection. Blacks had greater HTLV-III antibody prevalence than whites (54% vs 16%) and were more likely than whites to be seropositive for HTLV-I or -II (46% vs 11%). They exhibited a greater incidence than whites of double infection with HTLV-I or -II and HTLV-III (27% vs 0%), and 73% were seropositive for at least one of the viruses, compared with only 26% of the whites. The increased HTLV-I and -II infection seen in intravenous drug users suggests that once introduced into a population, these viruses may be transmitted by the same routes as HTLV-III. Transmission may have been restricted mainly to blacks in this study because of local drug use practices.     

Australian healthcare: perspectives of an immigrant from the UK

Despite it being confusing, inherently inequitable, and subject to excessive federal government control, Australia provides good healthcare.     

Tuberculosis and renal transplantation--observations from an endemic area of tuberculosis

Ninety-five renal transplant recipients from an endemic area of tuberculosis were investigated to find out the prevalence and course of tuberculosis in pre- and post-transplant periods. Eleven patients had tuberculosis in the pre-transplant period - pulmonary (2), pleural (2), miliary (1), abdominal (2), lymph node (5) and pericardial (1). They were transplanted after antituberculous therapy of 3 to 6 months with satisfactory results. The anti-tuberculous treatment was usually continued for 2 years. Only one of the above 11 patients had evidence of tuberculosis in the post-transplant period. Nine patients developed tuberculosis for the first time in the post-transplant period - pulmonary (4), pleural (1), miliary (1), lymph node (4) and pericardial (1). There was no mortality due to tuberculosis. Thorough search for tuberculosis is mandatory both during pre-transplant assessment and post-transplant follow-up in areas of endemic tuberculosis.     

Prevalence of otitis media in school going children in Eastern Nepal

Objectives: To find out the prevalence of otitis media in school going children from lower socio-economic strata. Material and methods: This study was carried out in a government school, Shree Naragram Secondary School in Morang district, eastern Nepal, and included 1050 children aged between 5-15 years. Results: Of the 1050 school children, 346 children were found to have various ENT related problems. Hearing assessment revealed a conductive hearing loss on one or both sides in 114 cases (87%). Various middle ear pathologies were detected in these children, out of which chronic suppurative otitis media "Tubotympanic type" was the most common, followed by otitis media with effusion. The prevalence of otitis media in these children was found to be13.2% and those with hearing loss comprised 12.47%. Prevalence of otitis media is found to be much higher in school going children as compared to adults, and is even higher amongst children belonging to the lower socio-economic strata. Conditions complicating otitis media are more common and severe in children as compared to adults. Conclusion: Primary ear care education to teachers, students and guardians can prevent these vulnerable children from developing hearing impairment. School based study could be one of the useful and cost-effective modality aimed at community oriented program. Key words: otitis media, Prevalence.     

Prevalence of cleft lip and cleft palate in a tertiary hospital in Eastern Nepal

The aim of this investigation was to determine the birth prevalence of cleft lip and palate in a tertiary health care centre of Dharan, Eastern Nepal and to ascertain whether the birth prevalence in this region differs significantly from birth prevalence reported in similar populations and other racial groups. A retrospective study was conducted from June 2005 to December 2010. The maternity records which included a record of the examination of the newborn child for the prescribed period were analyzed. Fifty one clefts were identified among 30,952 live births during 2005 to 2010. The total birth prevalence of cleft of the lip ± cleft of the palate (CL±P) was 1.64/1000 live births per year. There were 19 clefts of the lip alone (birth prevalence 0.61/1000 per year), 21 cleft lip and palate (0.67/1000 per year), and 11 cleft palate only (0.35/1000 per year). The birth prevalence was higher than what is reported for Caucasian and African populations. Cleft of the lip and palate (CLP) was the most common pattern followed by cleft of the lip (CL) and cleft of the palate (CP). Overall there was a male predominance whereas individually CLP and CL were more common in males while CP was more common in females.     

Complete elimination of tetanus is still elusive in developing countries: A review of adult tetanus cases from referral hospital in Eastern Nepal

Aim: To analyse demography, clinical presentation, treatment, complications and outcome of patients with tetanus over a 2-year period. Materials and methods: A retrospective analysis of medical records of all patients with tetanus admitted to the intensive care unit of B.P Koirala Institute of Health Sciences, Dharan, Nepal between July 2004 and June 2006. Results: Tetanus accounted for 1.1 % of our ICU admission. Eight tetanus patients (mean age 52 years; M: F ratio 7:1) were admitted. The tetanus prone wounds of seven patients were managed at home. The most common presenting complaints were trismus and stiffness of neck and back (87.5%). Elective intubation was followed by tracheostomy in all the patients. Overall mean duration of ventilatory support was 12.5 days. Treatments given in ICU were diazepam, magnesium sulphate, tetanus immunoglobulin, metronidazole, wound management and supportive measures. Five patients (62.5%) developed autonomic instability and three patients had ventilatory associated pneumonia (37.5%). Average ICU stay was 15.1 days while hospital stay was 20.1 days. Five patients (62.5%) survived the course of disease. Two patients (25%) left the hospital against medical advice while the other (12.5%) died in ICU. Conclusion: Tetanus is a vaccine preventable disease. Tetanus prone wounds should be managed appropriately. Respiratory compromise and autonomic instability are the main causes of morbidity and mortality. Early recognition, intense support and prompt treatment improves morbidity and mortality of patients diagnosed with tetanus.     

Primary intramuscular cold abscess in the left deltoid region: a case report

A case of primary intramuscular cold abscess in the left deltoid region is described. There was no underlying bone lesion in relation to cervical or thoracic spine, shoulder joint or upper humerus, and clavicle. It is postulated that the cold abscess might have developed as a result of reactivation of BCG lesion when the patient received a fresh dose of tubercular bacilli which produced only lymph node enlargement in the mediastinum because of the partial immunity the patient had.     

Role of rehabilitation centres in reducing drug abuse problem in a town of Eastern Nepal

Objectives: This paper focuses to describe the role and activities of Drug Rehabilitation Centres (DRCs) in reducing the drug-abuse problem in Dharan. It also offers suggestions for increasing the effectiveness of prevention programs. Materials and methods: Records of three DRCs working in Dharan for the past 9 years were analyzed using appropriate statistical tools. Results: The yearly clean rate is significantly higher in these centres. Harm reduction program was currently available only in one centre. Pharmacotherapy along with short-term rehabilitation was available at de-addiction unit of B. P. Koirala Institute of Health Sciences whereas long-term rehabilitation was at others centres. Conclusion: Thus, there should be a strong coordination and network with each other to increase the effectiveness of the treatment program for drug abuse. The treatment centres should be increased in number as well as in quality. BPKIHS should take initiation to start long-term management with repeated booster programs. Key words: Role, rehabilitation, drug abuse, BPKIHS, Dharan, Nepal.     

Tuberculosis in maintenance haemodialysis patients. Study from an endemic area.

One hundred and fifty patients requiring maintenance haemodialysis were investigated to determine the incidence and pattern of tuberculosis. Twenty patients were found to have tuberculosis, giving an incidence of 13.3 times that of the general population. The most frequent clinical presentations of tuberculosis in these patients were pyrexia, pleural effusion and lymphadenopathy. Diagnostic difficulties were encountered in 7 patients in whom therapeutic trial with anti-tubercular drugs had to be undertaken. Two patients died from tuberculosis. Five patients received renal transplants after initial treatment of tuberculosis.     

Prevalence of pelvic floor disorders in the Eastern Mediterranean region: A meta-analysis

Objectives:High prevalence of risk factors for pelvic floor disorders (PFD) in the Eastern Mediterranean may result in higher rates of prevalence of PFD in comparison to other regions. Despite individual studies, there are no clear statistics on the cumulative prevalence of PFDs in the East Mediterranean region. The aim of this study was to investigate the prevalence of PFDs in the Eastern Mediterranean region.Methods:A literature search without language restriction was conducted in PubMed, Cochrane database and Web of Science from 2016 to 01 June 2022. Cross-sectional and cohort studies that reported prevalence of urinary incontinence (UI), constipation, fecal incontinence (FI) and pelvic organ prolapse (POP) among women in the Eastern Mediterranean region were included. Study quality was assessed according to the Joanna Briggs Institute critical appraisal tool. Data were pooled and meta-analysed using a random effects model. PROSPERO: CRD42021283127Results:The search yielded 390 articles, from which 12 studies containing 9905 patients were included. Five studies were high quality and seven were low quality. The prevalence of POP (12 studies, 9905 participants), UI (5 studies, 2340 participants), constipation (4 studies, 2045 participants) and FI (1 study, 166 participants) was 39% (95% CI 21-57; I2 99.8%), 48% (95% CI 16-80; I2 99.7%), 39% (CI 17-60; I2 99.1%) and 14% (95% CI 9-20) respectively.Conclusion:In meta-analysis pooling studies of mixed quality, a high prevalence of PFDs was seen in the Eastern Mediterranean region. PROSPERO No.: CRD42021283127     

宁夏饮水型氟中毒监测点监测结果分析

目的 遵照国家卫生部的安排从１９９１年起在盐池县的沟沿村,郑记堡村,老盐池村设３个监测点,连续８年监测进行综合评价,以此了解防治效果。方法 参照《全国地方性中毒重点监测方案》的具体要求进行调查分析。结果 ３个监测点８￣１２岁儿童氟斑牙患病率由监测前的９５．５％,７２．４％,９６．０％,改水８年后分别下降为４６．１％,７．６％,６７．７％;尿氟值由监测前的２．８４ｍｇ／Ｌ,２．１３ｍｇ／Ｌ,３．８ｍ