PREVALENCE OF HYPERTENSION IN NEPAL: RESULTS OF MAY MEASUREMENT MONTH 2020

Objective: To increase public awareness on importance of blood pressure (BP) screening for hypertension prevention and management through a national campaign in Nepal. Design: Opportunistic BP screening campaign was carried out among people 18 years or more in the year 2020, following the COVID-19 safety measures. The study used a cross-sectional survey design. Method: Systolic and diastolic BP data of the participants were obtained from three consecutive measurements of which second and third measurements were used to estimate the mean. Hypertension was defined as the systolic BP more than or equal to 140 and/or diastolic BP more than or equal to 90 mmHg or currently taking antihypertensive medicine. The screening campaign was conducted in 25 sites of the country. Measurement was done using OMRON automatic monitors. Altogether, 115 volunteer research assistants with public health background used mobilized for data collection. Logistic regression analysis was used to identify the factors associated with hypertension. Results: In total, 11,481 people participated in the BP screening campaign of which more than half were females (57%, 6568/11,481). Mean age of the participants was 45 ± 17 years. Mean systolic and diastolic BP were 125.8 ± 18 and 81.6 ± 10.5 respectively. Nearly a third (31.1%, 3592/11,481) of participants were hypertensive of which only 40% (1444/3592) were aware about their hypertension status. However, only about 80% (1146/14444) hypertensive participants were talking medicines. High age-group, high body mass index and smoking were found associated with hypertension adjusting age, sex and body mass index and smoking status of the participants. Conclusions: Blood pressure screening campaign provided an important opportunity to identify undiagnosed hypertension and raise awareness on hypertension among the general population. Awareness raising programs at the population and targeted interventions are warranted for prevention and control of hypertension in Nepal among older, overweight, and obese people and smokers.

Cloud-Based COVID-19 Analysis and Future Pandemics Prediction Using IoE

Each zone could be very well investigated and ability packages, social and financial affects, and limitations to mass rehabilitation are discussed in greater detail. It describes in element the demanding situations and opportunities for IoE framework solutions inside the post-COVID-19 generation. The COVID-19 epidemic has furnished a far-wanted check of IoE-stimulated frameworks and answers. IoE solutions together with a ways flung fitness monitoring and phone tracking have supplied the guide of authorities to successfully manage to unfold the corona contamination. The principle contribution of this compare paper is the in-intensity analysis and segmentation of vicinity-unique IoE technology, which have the potential to be remarkable applications inside the new present day. So far, privacy worries and the protection of IoE applications are thoroughly analyzed with rising standards, and the code for multitasking practices is likewise being mentioned. © 2023, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.

Time and Frequency Connectedness Among Emerging Markets and QGREEN, FinTech and Artificial Intelligence-Based Index: Lessons from the Outbreak of COVID-19

The study is about contributing to the ongoing discussion on the diversification opportunities for emerging markets with non-conventional asset class. The limited literature in the era of fourth industrial revolution motivates us to gauge diversification opportunities. This study is focusing on identifying diversification opportunities with a set of unique asset classes that are the proxies for Green Funds, FinTech and Artificial Intelligence-based index funds. The method and model applied in the study are time and frequency connectedness in a Wavelet Coherence, and for the robustness check—Network analysis has been applied. The originality of the study lies in identifying the impact of the outbreak of COVID-19. The results captured that FinTech-based asset was the most resilient asset class during the pre- and post-outbreak of COVID-19, followed by AI-based fund and finally by Green fund. Henceforth, FinTech provides superior diversification opportunities among all with MSCI Emerging Market. AI and Green funds are captured to be invested in the long term for diversification, whereas FinTech is suitable for both long- and short-term assets. The results are relevant for investors in emerging markets and for policymakers as well. © 2023 MDI.

Gaming disorder among medical college students during COVID-19 pandemic lockdown

Background The frequent lockdown in Nepal during COVID-19 pandemic had brought various kinds of complexities such as stress among college students. This situation had created uncertainty of future academic career of undergraduate students in medical colleges. Some previously published literature showed gaming as a coping mechanism against stress. Objective To assess the gaming behavior of Medical college students during lockdown in COVID-19 pandemic. Method A cross-sectional study was conducted during lockdown period of July to August 2020. A total of 412 college students were enrolled. Online Google forms were shared to all the eligible students through email, viber and messenger with the help of class representative. Collected data were analyzed in SPSS version 20.0. Result The prevalence of gaming disorder was 8.5% among 260 internet gaming users. About 69.2% of the participants reported that their gaming behavior had increased due to stress of COVID-19 pandemic. Gender and spending more time online per day showed significant associations with greater scores on the internet gaming disorder. Conclusion During lockdown period of COVID-19 pandemic, the gaming behavior of medical college students has increased. Copyright © 2020, Kathmandu University. All rights reserved.

Prediction of Customer Review's Helpfulness Based on Feature Engineering Driven Deep Learning Model

Online consumer reviews play a pivotal role in boosting online shopping. After Covid-19, the e-commerce industry has been grown exponentially. The e-commerce industry is greatly impacted by the online customer reviews, and a lot of work has been done in this regard to identify the usefulness of reviews for purchasing online products. In this proposed work, predicting helpfulness is taken as binary classification problem to identify the helpfulness of a review in context to structural, sentimental, and voting feature sets. In this study, the authors implemented various leading ML algorithms such as KNN, LR, GNB, LDA and CNN. In comparison to these algorithms and other existing state of art methods, CNN yielded better classification results, achieving highest accuracy of 95.27%. Besides, the performance of these models was also assessed in terms of precision, recall, F1 score, etc. The results shown in this paper demonstrate that proposed model will help the producers or service providers to improve and grow their business.

Clustering-Based Recommendation System for Preliminary Disease Detection

The catastrophic outbreak COVID-19 has brought threat to the society and also placed severe stress on the healthcare systems worldwide. Different segments of society are contributing to their best effort to curb the spread of COVID-19. As a part of this contribution, in this research, a clustering-based recommender system is proposed for early detection of COVID-19 based on the symptoms of an individual. For this, the suspected patient's symptoms are compared with the patient who has already contracted COVID-19 by computing similarity between symptoms. Based on this, the suspected person is classified into either of the three risk categories: high, medium, and low. This is not a confirmed test but only a mechanism to alert the suspected patient. The accuracy of the algorithm is more than 85%.

Coronavirus-associated mucormycosis: different from sinonasal mucormycosis.

OBJECTIVE: To study unusual presentations of coronavirus-associated mucormycosis that are rarely seen in sinonasal mucormycosis cases. METHOD: The data of 400 rhino-orbito-cerebral mucormycosis patients admitted to Sawai Man Singh Hospital, Jaipur, from May 2021 to June 2021, were retrospectively collected. The diagnosis of mucormycosis was made by histological examination of biopsy samples. RESULTS: Out of 400 patients, 62 had symptoms other than common symptoms of rhino-orbito-cerebral mucormycosis. Thirty-four patients had facial palsy, 19 complained of gum ulcers, 6 developed a cheek abscess, 2 complained of maggots in the nose along with common rhino-orbito-cerebral mucormycosis symptoms, and 1 had a cerebellar infarct. CONCLUSION: Mucormycosis is a disease with various presentations, and coronavirus-associated mucormycosis has added unusual presentations to the existing list of manifestations of rhino-orbito-cerebral mucormycosis. In this coronavirus disease era, mucormycosis should always be considered as a diagnosis in patients with these unusual presentations.

Transboundary sources dominated PM2.5 in Thimphu, Bhutan.

This study estimates the potential source regions contributing to PM2.5 in the capital city of Thimphu, Bhutan, during the years 2018-2020 using the ground-based data, followed by the HYSPLIT back trajectory analysis. The average PM2.5 concentration in the entire study period was 32.47 µg/m3 which is three times of the World Health Organization recommended limit of 10 µg/m3. Less than half of the days in pre-monsoon (43.47%) and post-monsoon (46.41%), and no days in winter were within the 24-h average WHO guideline of 25 µg/m3. During the COVID-19 lockdown imposed from August 11 to September 21 in Bhutan, only a marginal reduction of 4% in the PM2.5 concentrations was observed, indicating that nonlocal emissions dominate the PM2.5 concentrations in Thimphu, Bhutan. Most back trajectories in the analysis period were allocated to south or south-west sector. India was the major contributor (~ 44%), followed by Bangladesh (~ 19%), Bhutan itself (~ 19%) and China (~ 16%). This study confirms that there are significant contributions from transboundary sources to PM2.5 concentrations in Thimphu, Bhutan, and the elevated PM2.5 concentrations need to be tackled with appropriate action plans and interventions.

The effect on the T-14 paediatric throat disorders outcome score of delaying adenotonsillectomy surgery due to COVID-19.

INTRODUCTION: Adenotonsillectomy is commonly performed for recurrent tonsillitis and obstructive sleep apnoea. These conditions may improve with age. The COVID-19 pandemic led to all UK elective surgery being suspended. This study aimed to determine whether delaying surgery had any effect on a patient's symptoms using the validated T-14 paediatric throat disorders outcome test. METHODS: Patients completed a T-14 questionnaire when the child was listed for surgery; this was repeated on the revised surgery date and a paired t test was used to compare the responses. RESULTS: Questionnaires were completed by 29 patients a mean of 6.4 months apart. There was a significant improvement in scores (p<0.02) for five domains: eating habits, visits to a doctor/A&E, antibiotics for less than 2 weeks, chronic infections and school missed due to sore throats. CONCLUSIONS: This study demonstrates that following delays resulting from the COVID-19 pandemic, paediatric patients experienced an improvement in some aspects of their quality of life while awaiting tonsillectomy and/or adenoidectomy. This was most apparent in quality-of-life measures relating to recurrent tonsillitis, namely visits to a doctor/A&E, antibiotics for less than 2 weeks, chronic infections and school missed due to sore throats. Patients may experience an improvement in some of their individual symptoms, in particular their infective symptoms, during an observation period.

Management of ENT emergencies during the coronavirus disease 2019 pandemic.

BACKGROUND: Coronavirus disease 2019 imposed dramatic changes on ENT service delivery. Pre-pandemic, such changes would have been considered potentially unsafe. This study outlines the impact of lockdown on the incidence and management of ENT emergencies at a large UK centre. METHODS: After modification of pre-pandemic guidelines, ENT emergency referrals data during the UK lockdown were prospectively captured. A comparative analysis was performed with retrospective data from a corresponding period in 2019. RESULTS: An overall reduction (p < 0.001) in emergency referrals (n = 119) and admissions (n = 18) occurred during the lockdown period compared to the 2019 period (432 referrals and 290 admissions). Specifically, there were reduced admission rates for epistaxis (p < 0.0001) and tonsillar infection (p < 0.005) in the lockdown period. During lockdown, 90 per cent of patients requiring non-dissolvable nasal packing were managed as out-patients. CONCLUSIONS: Coronavirus disease 2019 compelled modifications to pre-pandemic ENT guidelines. The enforced changes to emergency care appear to be safe and successfully adopted. Arguably, the measures have both economic and patient-related implications post-coronavirus disease 2019 and during future similar pandemics and lockdowns.

Gaming Disorder among Medical College Students during COVID-19 Pandemic Lockdown.

Background The frequent lockdown in Nepal during COVID-19 pandemic had brought various kinds of complexities such as stress among college students. This situation had created uncertainty of future academic career of undergraduate students in medical colleges. Some previously published literature showed gaming as a coping mechanism against stress. Objective To assess the gaming behavior of Medical college students during lockdown in COVID-19 pandemic. Method A cross-sectional study was conducted during lockdown period of July to August 2020. A total of 412 college students were enrolled. Online Google forms were shared to all the eligible students through email, viber and messenger with the help of class representative. Collected data were analyzed in SPSS version 20.0. Result The prevalence of gaming disorder was 8.5% among 260 internet gaming users. About 69.2% of the participants reported that their gaming behavior had increased due to stress of COVID-19 pandemic. Gender and spending more time online per day showed significant associations with greater scores on the internet gaming disorder. Conclusion During lockdown period of COVID-19 pandemic, the gaming behavior of medical college students has increased.

Pulmonary thromboembolism in COVID-19: Initial experience from India

Pulmonary thromboembolic complications are increasingly being recognised in Coronavirus Disease 2019 (COVID-19) infections. Most of the cases of Pulmonary Embolism (PE) are often missed in presence of non-specific symptoms. This report is about a 90-year-old COVID-19 positive male, asymptomatic on presentation, with no prior co-morbidities who developed acute onset shortness of breath along with elevated D-dimer levels four days post admission. Subsequently, a Computed Tomography Pulmonary Angiogram (CTPA) was done which revealed segmental and sub-segmental thromboembolism in upper and middle lobar branches of right pulmonary artery along with bilateral lower lobe ground-glass opacities consistent with COVID-19 pneumonia. As the patient was haemodynamically stable, he was managed conservatively on low molecular weight heparin and subsequently discharged on oral anti-coagulants. This report highlights the need for prompt evaluation of symptoms such as dyspnoea in COVID-19 patients and to rule out thromboembolic complications in them. In resource limited countries such as India with most of the COVID-19 centres having limited access to CT scans, triaging patients based on clinical suspicion and serially rising D-dimer levels may help identify those with thromboembolic complications.

The negative impact of wearing personal protective equipment on communication during coronavirus disease 2019.

BACKGROUND: Coronavirus disease 2019 personal protective equipment has been reported to affect communication in healthcare settings. This study sought to identify those challenges experimentally. METHOD: Bamford-Kowal-Bench speech discrimination in noise performance of healthcare workers was tested under simulated background noise conditions from a variety of hospital environments. Candidates were assessed for ability to interpret speech with and without personal protective equipment, with both normal speech and raised voice. RESULTS: There was a significant difference in speech discrimination scores between normal and personal protective equipment wearing subjects in operating theatre simulated background noise levels (70 dB). CONCLUSION: Wearing personal protective equipment can impact communication in healthcare environments. Efforts should be made to remind staff about this burden and to seek alternative communication paradigms, particularly in operating theatre environments.