Handwashing stations in Nepal: Role of wealth status in establishing handwashing stations at home

Handwashing has been proven to be effective at preventing several infectious diseases. This study aims to find out the role of wealth status in establishing handwashing stations in the households of Nepal. This study used secondary data from Nepal Demographic Health Survey in 2016 to assess the association between households' wealth status and handwashing stations. The findings displayed a significant association between the age of the household head, residence place, ecological zone, province, wealth status, having a mosquito net, having a radio and TV in the respondent's household, and fixed handwashing stations at their households at p < 0.001 level. Wealth status has significant effect on fixed handwashing stations (adjusted odds ratio [aOR] = 12.699;95% confidence interval [CI] = 10.120–15.935;p < 0.001) in the households. The households with the poorest wealth status (aOR = 9.718;95% CI = 7.387–12.785;p < 0.001), mountain ecological zone (aOR = 1.325;95% CI = 1.098–1.599;p < 0.01), Madhesh province (aOR = 2.967;95% CI = 2.405–3.658;p < 0.001) were significant predictors for not having fixed handwashing stations even after inclusion of socio‐covariates. Correspondingly, the presence of mosquito net (aOR = 0.795;95% CI = 0.692–0.913; p < 0.01), presence of a radio (aOR = 0.758;95% CI = 0.671–0.857;p < 0.001), and presence of a TV (aOR = 0.762;95% CI = 0.667–0.871;p < 0.001) had a significant effect on fixed handwashing stations at their households even after inclusion of socio‐covariates. The study found households with the poorest wealth quintiles, mountain ecological zone, and Madhesh and Karnali provinces had low fixed handwashing stations. The study suggests more leading interventions to improve public health in this region.Alternate :洗手能有效预防多种传染病。本研究旨在分析财富状况对尼泊尔家庭建立洗手台一事产生的作用。本研究使用2016年尼泊尔人口统计健康调查(NDHS)数据，评估家庭财富状况与洗手台之间的关联。研究结果显示，受访家庭户主的年龄、居住地、生态区、省份、财富状况、拥有蚊帐、收音机和电视机，这些因素与家庭拥有固定洗手台之间存在显著相关性，p=<0.001。财富状况对家庭拥有固定洗手台一事产生显著效果，调整后比值比（aOR）=12.699；95%置信区间 (CI) =10.120‐15.935，p=<0.001。财富状况最差的家庭（aOR=9.718；95% CI=7.387‐12.785，p=<0.001）、山地生态区（aOR=1.325，95% CI=1.098‐1.599，p=<0.01）、摩提舍省（aOR=2.967, 95% CI= 2.405‐3.658, p=<0.001) 是家庭没有固定洗手台的重要预测物，即使在包含社会协变量后也是如此。相应地，拥有蚊帐 (aOR=.795;95% CI=.692‐.913, p=<0.01)、收音机 (aOR=.758;95% CI=.671‐.857, p= <0.001) 和电视 (aOR=.762;95% CI=.667‐.871, p=<0.001) 对家庭拥有固定洗手台一事产生显著效果，即使在包含社会协变量后也是如此。研究发现，最贫困的财富五分位家庭、山地生态区、摩提舍省和卡尔纳利省的固定洗手台位置较低。本研究建议采取更多重要的干预措施来改善该地区的公共卫生。Alternate :El lavado de manos es efectivo para prevenir varias enfermedades infecciosas. El estudio tiene como objetivo averiguar el papel del estado de riqueza en el establecimiento de estaciones de lavado de manos en los hogares de Nepal. Este estudio utilizó datos secundarios de la Encuesta de salud demográfica de Nepal (NDHS) de 2016 para evaluar la asociación entre el estado de riqueza de los hogares y las estaciones de lavado de manos. Los hallazgos mostraron una asociación significativa entre la edad del jefe de hogar, el lugar de residencia, la zona ecológica, la provincia, el nivel de riqueza, tener mosquitero, tener radio y televisión en los hogares de los encuestados con estaciones fijas de lavado de manos en sus hogares a un ivel de p = <0,001. El estado de riqueza tiene un efecto significativo en las estaciones fijas de lavado de manos cociente de probabilidades ajustado (aOR) = 12,699;Intervalo de confianza (IC) del 95% =10.120‐15.935, p = <0.001, en los hogares. Los hogares con el estado de riqueza más pobre (aOR = 9.718;95% IC = 7.387‐12.785, p = <0.001), zona ecológica de montaña (aOR = 1.325, 95% IC = 1.098‐1.599, p = <0.01), provincia de Madhesh (aOR = 2.967, IC 95%= 2.405‐3.658, p = <0.001), fueron predictores significativos de no tener estaciones fijas de lavado de manos aún después de la inclusión de socio‐covariables. Así mismo, presencia de mosquitera (ORa = .795;IC 95%=.692‐.913, p = <0.01), presencia de radio (ORa = .758;IC 95%=.671‐.857, p = <0.001) y la presencia de un televisor (aOR = .762;95% IC = .667‐.871, p = <0.001) tuvieron un efecto significativo en las estaciones fijas de lavado de manos en sus hogares incluso después de la inclusión de socio‐covariables. El estudio encontró que los hogares con los quintiles de riqueza más pobres, la zona ecológica montañosa, Madhesh y la provincia de Karnali tenían estaciones de lavado de manos fijas bajas. El estudio sugiere más intervenciones líderes para mejorar la salud pública en esta región.Alternate :Key PointsHandwashing effectively reduces the spread of several infectious diseases, including COVID‐19.This paper uses secondary data from Nepal's Demographic Health Survey in 2016 to assess the association between households' wealth status and having handwashing stations.There exists a significant association between the age of the household head, place of residence, ecological zone, province, wealth status, and having a mosquito net/radio/TV in the house, and the likelihood of having fixed handwashing stations.The lowest proportions of fixed handwashing stations were found in the poorest households, in the mountains, among the Madheshi ethnicity, and based in Karnali province.Promoting handwashing stations may need additional public health interventions to overcome underlying inequalities at a population level.

A Systematic Review on the Emergence of Omicron Variant and Recent Advancement in Therapies.

With the ongoing COVID-19 pandemic, the emergence of the novel Omicron variant in November 2021 has created chaos around the world. Despite mass vaccination, Omicron has spread rapidly, raising concerns around the globe. The Omicron variant has a vast array of mutations, as compared to another variant of concern, with a total of 50 mutations, 30 of which are present on its spike protein alone. These mutations have led to immune escape and more transmissibility compared to other variants, including the Delta variant. A cluster of mutations (H655Y, N679K, and P681H) present in the Omicron spike protein could aid in transmission. Currently, no virus-specific data are available to predict the efficacy of the anti-viral and mAbs drugs. However, two monoclonal antibody drugs, Sotrovimab and Evusheld, are authorized for emergency use in COVID-19 patients. This virus is not fading away soon. The easiest solution and least expensive measure to fight against this pandemic are to follow the appropriate COVID-19 protocols. There is a need to strengthen the level of research for the development of potential vaccines and anti-viral drugs. It is also important to monitor and expand the genomic surveillance to keep track of the emergence of new variants, thus avoiding the spread of new diseases worldwide. This article highlights the emergence of the new SARS-CoV-2 variant of concern, Omicron (B.1.1.529), and the vast number of mutations in its protein. In addition, recent advancements in drugs approved by FDA to treat COVID patients have been listed and focused in this paper.

Major Spinal Surgery Between Two Documented COVID-19 Infections in an Elderly Female: A Case Report.

Documented re-infection of COVID-19 is uncommon and doing a major spinal surgery in an elderly patient right after the recovery from the first event is itself a major undertaking. Re-infection after successful surgery points to the possibility of COVID-19 infection being a post-surgical complication. Here, we report a case of a 72-years-old elderly female who had presented to us with features of COVID-19 infection confirmed by reverse transcription polymerase chain reaction assay and unstable spinal fracture who underwent a pedicle screw fixation for the fracture of the third and fourth thoracic vertebrae after two consecutive negative serology assays. A month after discharge from the hospital, she presented with severe symptoms of COVID-19 again confirmed by two consecutive polymerase chain reaction assays. She was managed conservatively and was discharged without significant respiratory and neurological complications. We described this case in detail in addition to reviewing the pertinent literature.

The Pedagogical Shift during COVID-19 Pandemic: Emergency Remote Learning Practices in Nursing and Its Effectiveness

COVID-19 pandemic has adversely affected the education system worldwide;consequently, education has been shifted to remote learning mode. There is still confusion regarding the effectiveness of remote learning compared to in-person education. Therefore, this study aimed to assess the perceived effectiveness and factors affecting emergency remote learning practices by administering online questionnaires. The study selected 254 participants (200 nursing students and 54 faculty) randomly from the five constituent nursing campuses of Tribhuvan University. A structured online questionnaire was developed in a google doc and an electronic link was shared to each of the participants. A self-generated excel sheet was transferred to SPSS Version 20 for the analysis. The result indicates that 46.2% of students used smartphones and almost all faculty used laptops for classes during COVID 19 pandemic. Students and faculty spent 11.45 ±8.43 and 4.26 ±2.05 hours respectively per week in class and >80% of respondents felt that the sessions were overloaded. PowerPoint slides, document sharing, chat, emails, and video conferences were the tools used for class. Most of them faced internet and electricity problems in between. Almost all respondents preferred live classes over recorded classes;71% students and 59% of faculty were not interested in online classes. The remote learning method of teaching was less effective than face-to-face learning for 33.5% of students and 59.2% of faculty. To conclude, although there has been increased student-teacher communication, cooperation between students and active learning, the overall effectiveness of remote learning is decreased. Hence, there is a crucial need for a strategy to enhance effectiveness.

Virtual High Throughput Screening to find Suitable Inhibitors for SARSCoV- 2 Main Protease

Background: COVID-19 caused by SARS-CoV-2 virus which originated in Wuhan and quickly spread across various countries has taken the form of a pandemic. It is now a major health concern worldwide and finding a solution to this problem is of utmost importance. Understanding its origin, transmission, and interaction with different compounds is essential to find probable inhibitors. Objective: The objective of our study was to search for potential inhibitors of the main protease of SARS-CoV-2 and to assess their drug-like properties. Methods: In our study, 1909 ligands were filtered through the Lipinski filter and their ADMET properties along with mutagenic nature were analyzed. They were screened for inhibitory activity against the Main Protease of SARS-CoV-2 using BIOVIA Discovery studio. Results: After virtual high throughput screening, two compounds- apigenin and N-(4-bromophenyl)- 7-hydroxy-2-iminochromene-3-carboxamide were found to have promising binding energies as well as –CDOCKER energy scores compared to the reported inhibitor. Conclusion: Apigenin seems to be a potential candidate against the main protease of SARS-CoV-2 and must be considered for further experiments.