HEALTH SEEKING BEHAVIOUR OF WOMEN & CHILDREN LESS THAN FIVE YEARS AMONG THARU ETHNIC COMMUNITY IN TRIYUGA MUNICIPALITY, NEPAL

Background: Under 5yrs mortality rates among male child is 30 and among female is 26 and overall infant mortality rate 24 per thousand respectively; these are the most vulnerable groups to different morbidity and mortality, and they ought to be fully dependent on parental knowledge and awareness to meet their health needs. Health seeking behavior (HSB) has become a tool for understanding the approach of people towards the health care systems in their respective socio-economic, cultural and demographic circumstances. A Community based Methods: descriptive study among “Tharu” ethnic women with children less than ?ve years of age in Triyuga Municipality, Nepal. Semi- structured questionnaire was used to collect socio-demographic information,, knowledge and current practice regarding health seeking behavior, including awareness and accessibility of health services. Among 406 respondents, 388 of Results: their children were reported ill within last 1 year, with fever accounting for 70%, followed by ARI (65%), diarrhea (6%) and others. Where 52.8% of respondents had appropriate HSB, taking their ill children to hospitals. More than 52% of respondents had hospitals as the ?rst preference for treatment for every morbidity. Except for access to health care facility, there was no signi?cant association of HSB was seen with parent's literacy,income, gender preference. With satisfactory Conclusion: awareness, literacy, and accessibility of health care centers, the HSB among tharu women, for the children morbidity seemed to be satisfactory in comparison to national scenario and other marginalized groups

Spectrofluorimetric-based Approach to Screen Urine Contamination in Drinking Water: A Step Toward the Development of Screening Method for Leptospirosis

Hygiene hypothesis and sanitization are two important pivots of modern civilization. The drinking water should be free from urine and stool contamination. Coliform test is popular for understanding feces contamination. However, understanding urine contamination in drinking water is a difficult task. On the other hand, urine contamination can cause disease like leptospirosis. It occurs mainly in animals and infects humans through contaminated water, food, and soil and causes serious consequences. Rat urine is the most common source of such disease outbreaks. Further, sophisticated laboratories with high-end technologies may not be present at the site of disease outbreaks. In this context, we have proposed a spectrofluorimetric approach to screen urine contamination in water. The screening method can sense up to 156 nl/ml of rat urine

Screening beyond conventional serological markers for hepatitis B and C viruses in cirrhosis: an entity overlooked

We aimed to emphasise the role of screening beyond conventional serological markers (HBsAg and Anti HCV antibodies for chronic viral hepatitis B and C respectively) in patients with cirrhosis. Patients with cirrhosis of liver are often labelled as having cryptogenic cirrhosis (CC), if no etiology is found. In chronic viral hepatitis B and C (CHB and CHC) induced cirrhosis, HBsAg and Anti HCV antibodies respectively are usually done to rule out the viral infections however their absence have been documented in subset of patients having these infections. In this regard, we hereby present a case labelled as CC and developed HCC; later on, further evaluation turned out to be having both CHB and CHC. A 51-year-old male with diabetes presented with index episode of hemetemesis. On further evaluation he was diagnosed to have cirrhosis of liver. No etiology was found and he was labeled as cirrhosis secondary to Non-alcoholic steatohepatitis (NASH)/cryptogenic cirrhosis. Later on, he developed hepatocellular carcinoma (HCC). We evaluated the patient with HBV DNA and HCV RNA levels keeping possibility of occult hepatitis B (OBI)/ seronegative hepatitis C infection despite HBsAg and Anti HCV antibodies being negative. Both levels were found to be raised and we attributed cirrhosis to dual hit by CHB and CHC. Patient was managed with antiviral drugs successfully with no recurrence of HCC and control of blood sugar levels.  We hereby stress that screening beyond the HBsAg and Anti HCV antibodies should be done in all cases of liver cirrhosis in which etiology is not found on initial screening.

Changes in visual evoked potentials on acute induction to high altitude.

BACKGROUND & OBJECTIVES: Induction to high altitude leads to altered central nervous system (CNS) functions induced by hypobaric hypoxia. The sensory systems like visual and auditory systems are reported to be affected by hypoxia. The present study was undertaken to assess the effects of hypobaric hypoxia on visual evoked potentials (VEPs) at 3200 m and 4300 m. METHODS: The VEP of 30 human volunteers were recorded at sea level (SL) and then at high altitude (HA) of 3200 m (HA I) and 4300 m (HA II) in eastern Himalayas and on return to sea level (RSL). The absolute latencies and amplitude of positive and negative waves were recorded. RESULTS: High altitude of 3200 m did not alter the latency of major wave N1, P1 and N2 of the VEPs. At HA II (4300 m), there was a statistically significant increase (P < 0.01) in the latency of NI wave as compared to the SL value and HA I (3200 m) in both left and right eye. There was a slight increase in latenty of P1 wave in both left and right eye at HA II. INTERPRETATION & CONCLUSION: From these results it may be concluded that induction to HA causes increase in latency of N1 wave at 4300 m which is still within physiological limits. This increase in wave latency of N1 wave in both eyes may be due to synaptic delay and/or altered neuronal processing at HA.

Effect of chronic hypobaric hypoxia on components of the human event related potential.

BACKGROUND & OBJECTIVES: Induction to high altitude (HA) leads to deterioration in cognitive functions. The event related potentials (ERPs) like P300 are reported to be affected by hypoxia and bring about impairments in cognitive performance. The aim of the study was to investigate the effect of hypobaric hypoxia on event related potentials at two different altitudes i.e., 3200 m (HA I) and 4300 m (HA II) in ascending order to see how ERPs change with increasing altitude. METHODS: The study was carried out on 20 healthy male volunteers at sea level (SL) and thereafter at high altitude (HA) in Eastern Himalayas and on return to sea level (RSL). The P300 was recorded by using standard auditory odd ball paradigm with compact -4 (Nicolet, USA). RESULTS: The N1, N2 and P2 latencies were not significantly affected at HA I and HA II in comparison with SL indicating no effect of hypobaric hypoxia on sensory conduction. However, at HA II, most of the subjects showed an increase in latency of P3 component reflecting sensory discrimination and delay in evaluation process at 4300 m. At HA I, only 10 out of 20 subjects showed an increase in P3 wave latency and 3 did not show any change in N2-P3 components. INTERPRETATION & CONCLUSION: The results of the present study showed an increase in P300 wave latency at 3200 and 4300 m of high altitude. The observations suggest that hypoxia causes slowing of the signal processing at 4300 m, and magnitudes of the effects are altitude dependent with higher level of decline observed with increasing altitude.

Effect of high altitude on human auditory brainstem responses.

The effect of hypobaric hypoxia on Brain Stem Auditory evoked potentials (BAERs) were studied. BAERs were recorded in 30 volunteers at sea level (SL) and then at high altitude (HA) of 3200 m (HA I) and 4300 m (HA II) in Eastern Himalayas and on return to sea level (RSL). The BAERs were recorded using Nicolet Compact - 4 (USA) in response to monaural auditory stimuli consisting of clicks of 100 ps square pulse at a rate of 15/sec. The BAERs were recorded on day 4 of their stay at 3200 m and 4300 m respectively. Findings indicated an increase in absolute peak latencies of wave V at 3200 m, which was statistically significant. On further ascent to 4300 m there was an increase in absolute peak latencies of wave I and III indicating delay in sensory conduction at the medullo-pontine auditory pathways.

Effect of high altitude (HA) on event related brain potentials.

Event Related brain potentials (ERPs) were recorded in 15 subjects using standard auditory odd ball paradigm, in which subjects were presented a sequence of two distinguishable sound stimuli of that occurred frequently (frequently (frequent stimulus-non target) and the other infrequently (rare stimulus-target). These recordings were made at sea level (SL) and then the subjects were air lifted to 3500 m altitude (HA), where they stayed for 3 weeks. Their ERPs were recorded during the first and third week of stay at HA and on return to sea level (RSL). Data indicated impairment in cognitive function as a result of exposure to HA as depicted by increase in the latency of P3 which was significant during the 1st week of stay at HA compared to sea level. The P3 wave latency during the 3rd week of stay at HA showed an increase compared to SL but was not statistically significant. From the results it may be concluded that high altitude hypoxia induced slow processing of stimulus evaluation, may be responsible for increase in P3 latency. The difference in the latent period of P3 waves during the first and third week of stay at HA may be due to continuous stay at HA which might lead to the time dependent adaptive processes occurring with increasing duration of exposure to HA which may induce learning effects.