Preterm delivery but not intrauterine growth retardation is associated with young maternal age among primiparae in rural Nepal

Pregnancy during adolescence is associated with adverse birth outcomes, including preterm delivery and low birthweight. The nutrient availability to the fetus may be limited if the mother is still growing. This research aims to study the effects of pregnancy during adolescence in a nutritionally poor environment in rural Nepal. This study utilized data from a randomized controlled trial of micronutrient supplementation during pregnancy in south-eastern Nepal. Women of parity 0 or 1 and of age 相似文献   

Morbidity pattern of children with asthma: A prospective study

Objectives: To determine the morbidity pattern of asthma in children attending the paediatric asthma follow-up clinic. Materials and methods: Longitudinal prospective follow up of hundred and four patients, diagnosed as asthma, over a period of 2 years was done. Regular follow up by the same person during each visit and proper supervision of standard treatment along with parental education regarding the asthma, was done. Results: The mean age of children presenting with asthma was 6.7 years. Majority of children 49 (47.5%) were graded as mild persistent asthma. Fifty nine (56.7%) children were missing school more than 7 days per month. Family history was present in forty one percent of the children. Fifty seven (54.8%) children were taking significant amount of junk food and were undernourished. Significant reduction in school-missing days and Emergency Room visits was noted in these children during the follow up period. Conclusion: Awareness of disease is an important aspect of asthma management. Proper treatment and follow up with emotional support and education of the care taker, about the asthma, can reduce the morbidity pattern of asthma in children. Key words: Prospective study, longitudinal study, Asthma.     

Eating Down in Pregnancy: Exploring Food-Related Beliefs and Practices of Pregnancy in Rural Nepal

Adequate nutrition during pregnancy, vital for the health of the mother and the newborn, may be influenced by pregnancy-related food beliefs. This study explores food-related beliefs and practices specifically related to reducing food intake in pregnancy in a rural community in Nepal by combining ethnographic and quantitative data collected from pregnant Nepali women.

A large proportion (60%) of women reported reducing rice intake during pregnancy but the reduction was related to food aversions and being unwell (66%), rather than the desire to have smaller babies or other cultural beliefs (18%). Only 10–20% reported reducing intakes of other nutrient-rich foods during pregnancy. Such foods were generally consumed in inadequate amounts due to seasonal variation or because of their high cost. In a multivariate analysis, maternal characteristics that were associated with decreasing food intake during pregnancy included literacy, poor appetite, socio-economic status, and presence of night blindness, caused by vitamin A deficiency.

We conclude that eating down to prevent difficult deliveries may not be very common in rural Nepal but women may reduce food intake for reasons of aversion to food, lack of appetite, or feeling unwell. A decline in the consumption of foods rich in protein and micronutrients was not evident; such foods appear to be chronically low in the diets of poor women in this setting.     

Immunogenicity of Mannheimia haemolytica recombinant outer membrane proteins serotype 1-specific antigen, OmpA, OmpP2, and OmpD15

We previously identified Mannheimia haemolytica outer membrane proteins (OMPs) that may be important immunogens by using immunoproteomic analyses. Genes for serotype 1-specific antigen (SSA-1), OmpA, OmpP2, and OmpD15 were cloned and expressed, and recombinant proteins were purified. Objective 1 of this study was to demonstrate immunogenicity of the four recombinant OMPs in mice and cattle. Objective 2 was to determine if the addition of individual recombinant OMPs or combinations of them would modify immune responsiveness of mice to the recombinant chimeric protein SAC89, containing the main epitope from M. haemolytica outer membrane lipoprotein PlpE and the neutralizing epitope of M. haemolytica leukotoxin. Mice vaccinated with recombinant OmpA (rOmpA), rSSA-1, rOmpD15, and rOmpP2 developed significant antibody responses to M. haemolytica outer membranes and to the homologous recombinant OMP. Cattle vaccinated with rOmpA and rSSA-1 developed significant antibodies to M. haemolytica outer membranes by day 28, whereas cattle vaccinated with rOmpD15 and rOmpP2 developed only minimal responses. Sera from cattle vaccinated with each of the recombinant proteins stimulated complement-mediated killing of the bacterium. Concurrent vaccination with SAC89 plus any of the four rOMPs singly resulted in increased endpoint anti-SAC89 titers, and for the SAC89/rSSA-1 vaccinees, the response was increased significantly. In contrast, the SAC89/P2/SSA-1 and SAC89/OmpA/P2/D15/SSA-1 combination vaccines resulted in significant decreases in anti-SAC89 antibodies compared to SAC89 vaccination alone. In conclusion, under the conditions of these experiments, vaccination of mice and cattle with rOmpA and rSSA-1 stimulated high antibody responses and may have protective vaccine potential.     

Molecular analysis of isolates from influenza B outbreaks in the U.S. and Nepal, 2005

Summary. Currently circulating influenza B viruses can be divided into two antigenically and genetically distinct lineages referred to by their respective prototype strains, B/Yamagata/16/88 and B/Victoria/2/87, based on amino acid differences in the hemagglutinin surface glycoprotein. During May and July 2005, clinical specimens from two early season influenza B outbreaks in Arizona and southeastern Nepal were subjected to antigenic (hemagglutinin inhibition) and nucleotide sequence analysis of hemagglutinin (HA1), neuraminidase (NA), and NB genes. All isolates exhibited little reactivity with the B/Shanghai/361/2002 (B/Yamagata-like) vaccine strain and significantly reduced reactivity with the previous 2003/04 B/Hong Kong/330/2001 (B/Victoria-like) vaccine strain. The majority of isolates were antigenically similar to B/Hawaii/33/2004, a B/Victoria-like reference strain. Sequence analysis indicated that 33 of 34 isolates contained B/Victoria-like HA and B/Yamagata-like NA and NB proteins. Thus, these outbreak isolates are both antigenically and genetically distinct from the current Northern Hemisphere vaccine virus strain as well as the previous 2003–04 B/Hong Kong/330/2001 (B/Victoria lineage) vaccine virus strain but are genetically similar to B/Malaysia/2506/2004, the vaccine strain proposed for the coming seasons in the Northern and Southern Hemispheres. Since these influenza B outbreaks occurred in two very distant geographical locations, these viruses may continue to circulate during the 2006 season, underscoring the importance of rapid molecular monitoring of HA, NA and NB for drift and reassortment.     

Visual defects in Nepalese children with Down syndrome

Background: Down syndrome (DS) is a common chromosomal anomaly. People with this syndrome have recognisable physical characteristics and limited intellectual abilities. The aim of this study was to determine visual defects, especially refractive error and binocular anomalies, in a sample of Nepalese children with DS. Methods: Thirty‐six children with DS (19 boys and 17 girls) from the Kathmandu valley, aged from four months to 18 years, underwent detailed optometric examination. Cycloplegic refraction was performed on all subjects. Vision on presentation of all the children was assessed with preferential looking cards, the Kay picture cards, the Bailey‐Lovie logMAR chart or the Snellen chart. Binocular function was assessed with cover test, Hirschberg or Bruckner test. Results: Cycloplegic refraction of the children revealed that 80 per cent of the children had significant refractive error. Most of them had hyperopia (55 per cent), followed by astigmatism (44 per cent), myopia (25 per cent) and anisometropia (19 per cent). Only two (5.6 per cent) children were strabismic and both of them were alternating esotropes. Nystagmus was present in 10 (28 per cent). Other ocular findings were upward slanting palpebral fissures, blepharitis, congenital nasolacrimal duct obstruction, blepharoconjunctivitis, chalazion and lenticular opacities. Conclusion: Nepalese children with DS have a high prevalence of refractive error and nystagmus. Regular eye examinations are indicated for these children to enable early diagnosis and appropriate management of ocular disorders to improve their vision and quality of life.     

Pathways to forest wealth in Nepal

ABSTRACT

Nepal is one of the leading countries embracing community forestry with about 45% of households being members of community forest user groups. However, there has been a failure to deliver the full potential of forest wealth because of a lack of proper silvicultural management, a constraining policy environment and a complex socio-institutional context. Meanwhile, mid-hill agriculture has not kept pace with the changing economy and out-migration. Food insecurity is rife in a landscape of under-utilised forests and under-utilised land. Australian development assistance between 1978 and 2006 supported the establishment of 21 000 ha of community forests and significant contributions to community forest institutions. In the light of the under-performance of this sector, the Australian Centre for International Agricultural Research established the project Enhancing Food Security and Livelihoods through Agroforestry and Community Forestry in Nepal, locally known as EnLiFT, which ran from 2013 to 2018. This paper aims to explain Australia’s contribution to Nepal’s forestry, with a focus on more recent achievements supporting pathways to realise the potential wealth in Nepal’s forests. It begins with an outline of the early Australian support and origins of community forestry in Nepal via the Nepal–Australia Forestry Project, and then the current status of community forestry. It then describes the research process of the EnLiFT project starting with new conceptual models and methods such as: (1) the Pathways Approach to link forest and food security; (2) the EnLiFT Bioeconomic Model of the Farm-Forest Interface; (3) the Silvo-Institutional Model for Scientific Forest Management; (4) Active and Equitable Forest Management; (5) Rapid Silvicultural Appraisal; (6) the Strategic and Inclusive Planning process and (7) EnLiFT Policy Labs. We also highlight many significant development impacts of EnLiFT. The demonstration and training of silvicultural methods released considerable forest wealth into the community. This occurred around the time of the 2015 earthquake when timber was in need for reconstruction. It was also associated with the re-vitalisation of a defunct sawmill by facilitation of community-private partnership. It was responsible for turning the public debate from resistance to acceptance of scientific forest management. It also developed inclusive planning processes for the revision of operational plans of community forests. On privately owned land, EnLiFT demonstrated: (1) the possibility for marked and rapid changes in livelihoods from relatively simple agroforestry interventions based on horticultural commodities and tree fodders; (2) an even greater potential for livelihood enhancement through private forestry and (3) articulated the current institutional and regulatory constraints on sale of trees from private land. We conclude by highlighting the contributions of EnLiFT in policy debate which led to policy outcomes that further the improvement of community forestry, agroforestry and bringing under-utilised land back into productive use.     

Pulmonary surfactant dysfunction in pediatric cystic fibrosis: Mechanisms and reversal with a lipid-sequestering drug

Background

Airway surfactant is impaired in cystic fibrosis (CF) and associated with declines in pulmonary function. We hypothesized that surfactant dysfunction in CF is due to an excess of cholesterol with an interaction with oxidation.

Prognostic factors and long-term outcomes of hilar cholangiocarcinoma:A single-institution experience in China

AIM: To evaluate the prognostic factors of hilar cholangiocarcinoma in a large series of patients in a single institution.METHODS: Eight hundred and fourteen patients with a diagnosis of hilar cholangiocarcinoma that were evaluated and treated between 1990 and 2014, of which 381 patients underwent curative surgery, were included in this study. Potential factors associated with overall survival(OS) and disease-free survival(DFS) were evaluated by univariate and multivariate analyses.RESULTS: Curative surgery provided the best long-term survival with a median OS of 26.3 mo. The median DFS was 18.1 mo. Multivariate analysis showed that patients with tumor size > 3 cm [hazard ratio(HR) = 1.482, 95%CI: 1.127-1.949; P = 0.005], positive nodal disease(HR = 1.701, 95%CI: 1.346-2.149; P < 0.001), poor differentiation(HR = 2.535, 95%CI: 1.839-3.493; P < 0.001), vascular invasion(HR = 1.542, 95%CI: 1.082-2.197; P = 0.017), and positive margins(HR = 1.798, 95%CI: 1.314-2.461; P < 0.001) had poor OS outcome. The independent factors for DFS were positive nodal disease(HR = 3.383, 95%CI: 2.633-4.348; P < 0.001), poor differentiation(HR = 2.774, 95%CI: 2.012-3.823; P < 0.001), vascular invasion(HR = 2.136, 95%CI: 1.658-3.236; P < 0.001), and positive margins(HR = 1.835, 95%CI: 1.256-2.679; P < 0.001). Multiple logistic regression analysis showed that caudate lobectomy [odds ratio(OR) = 9.771, 95%CI: 4.672-20.433; P < 0.001], tumor diameter(OR = 3.772, 95%CI: 1.914-7.434; P < 0.001), surgical procedures(OR = 10.236, 95%CI: 4.738-22.116; P < 0.001), American Joint Committee On Cancer T stage(OR = 2.010, 95%CI: 1.043-3.870; P = 0.037), and vascular invasion(OR = 2.278, 95%CI: 0.997-5.207; P = 0.051) were independently associated with tumorfree margin, and surgical procedures could indirectly affect survival outcome by influencing the tumor resection margin. CONCLUSION: Tumor margin, tumor differentiation, vascular invasion, and lymph node status were independent factors for OS and DFS. Surgical procedures can indirectly affect survival outcome by influencing the tumor resection margin.