A Case Report of Fahr's Disease and Its Clinical Heterogeneity.

Fahr's disease is an exceptionally rare and complex neurological disorder characterized by abnormal calcium deposition in the basal ganglia and cerebral cortex. This case report presents a 27-year-old female with Fahr's disease, showcasing the striking clinical diversity and challenging diagnostic landscape associated with this condition. Despite its rarity, Fahr's disease can have a profound impact on patients, manifesting as a spectrum of neurological symptoms, cognitive deficits, and motor impairment. Recent advancements in research have illuminated genetic aspects, offering potential avenues for enhanced diagnostic accuracy and therapeutic interventions. Treatment for Fahr's disease remains primarily supportive, targeting neuropsychiatric symptoms and seizure prophylaxis. Our case highlights the unique presentation of a young female patient with Fahr's disease, challenging conventional demographic profiles and emphasizing the need for individualized patient assessments. The utilization of non-contrast CT scans in diagnosis underscores the importance of appropriate imaging techniques, given the diverse clinical manifestations of this condition. This case adds to the growing understanding of Fahr's disease, emphasizing its clinical heterogeneity and advancing the quest for tailored approaches to diagnosis and intervention.

Health Services Utilization among Older Adults in Pokhara Metropolitan City.

The Government of Nepal provides a range of welfare schemes to senior citizens, but little is known about the use of public benefits by older adults. This community-based cross-sectional survey thus aims to assess the utilization and correlates of health services (through both private and public health facilities), free essential health services (provided by the government through public health facilities), and other welfare schemes - discounts in health treatment for certain diseases, monthly senior citizen allowance, reservation and concession in transportation, and the government-run health insurance program - among 201 Nepali older adults. Notably, a sizable proportion of the participants (22.4%) did not visit a health facility despite having a health problem. Females and those with higher co-morbidity had higher odds of health facility visits. Only 8% utilized the free essential health services, and 47% one or more of the other welfare schemes. Lack of awareness of free health services and welfare schemes were associated with lower odds of their utilization, respectively.

Level of Exercise Participation in Individuals with Traumatic Spinal Cord Injury During Inpatient Rehabilitation: A Cross-sectional Study.

BACKGROUND: The outcome of exercises depends on participants' level of exercise participation. We aimed to investigate the level of exercise participation in individuals with traumatic spinal cord injury during inpatient rehabilitation. METHODS: All participants with traumatic spinal cord injury undergoing inpatient physiotherapy at a rehabilitation center were recruited. Participants with hearing/visual problems were excluded. Hopkins Rehabilitation Engagement Rating Scale and Pittsburgh Rehabilitation Participation Scale were used to evaluate exercise participation levels. One-way ANOVA and unpaired t-test were used to compare level of participation between groups. Pearson's correlation and Chi-square tests were used to evaluate correlation and association. RESULTS: Thirty-five participants with mean age 37.1 ± 11.7 years completed the study. Hopkins Rehabilitation Engagement Rating Scale and Pittsburgh Rehabilitation Participation Scale demonstrated a low level of exercise participation in 31.4 % and 42.9 % participants respectively. Participants with an incomplete injury had high exercise participation levels compared to complete injuries. There were significant group differences (p < 0.001, effect size = 0.8) between complete and incomplete injuries and among various levels of injuries. The level of exercise participation was significantly associated with injury levels and type (p < 0.001, Phi = 0.7 to 0.9). CONCLUSIONS: The exercise participation level was high for incomplete compared to complete injuries in Nepalese individuals with traumatic spinal cord injury. The demographic and socio-economical factors were not associated with level of exercise participation.

Determining factors for the prevalence of depressive symptoms among postpartum mothers in lowland region in southern Nepal.

BACKGROUND: Postpartum depression is the most common mental health problem among women of childbearing age in resource-poor countries. Poor maternal mental health is linked with both acute and chronic negative effects on the growth and development of the child. This study aimed to assess the prevalence and factors associated with depressive symptoms among postpartum mothers in the lowland region in southern Nepal. METHODS: A hospital-based analytical cross-sectional study was conducted from 1st July to 25th August 2019 among 415 randomly selected postpartum mothers attending the child immunization clinic at Narayani hospital. The postpartum depressive symptoms were measured using the validated Nepalese version of the Edinburg Postnatal Depression Scale (EPDS). The data were entered into EpiData software 3.1v and transferred into Stata version 14.1 (StataCorp LP, College Station, Texas) for statistical analyses. To identify the correlates, backward stepwise binary logistic regression models were performed separately for the dichotomized outcomes: the presence of postpartum depressive symptoms. The statistical significance was considered at p-value <0.05 with 95% confidence intervals (CIs). RESULTS: Among the total 415 study participants, 33.7% (95% CI: 29.2-38.5%) of postpartum mothers had depressive symptoms. Study participant's whose family monthly income <150 USD compared to ≥150 USD (aOR = 13.76, 95% CI: 6.54-28.95), the husband had migrated for employment compared to not migrated (aOR = 8.19, 95% CI:4.11-15.87), nearest health facility located at more than 60 minutes of walking distance (aOR = 4.52, 95% CI: 2.26-9.03), delivered their last child by cesarean section compared to normal (vaginal) delivery (aOR = 2.02, 95% CI: 1.12-3.59) and received less than four recommended antenatal care (ANC) visits (aOR = 2.28, 95% CI:1.25-4.15) had higher odds of depressive symptoms. Participants who had planned pregnancy (aOR = 0.44, 95% CI: 0.25-0.77) were associated with 56% lower odds of depressive symptoms. CONCLUSIONS: One-third of the mothers suffered from postpartum depressive symptoms. The participant's husband migrated for employment, family income, distance to reach a health facility, delivery by cesarean section, not receiving recommended ANC visits, and plan of pregnancy were independent predictors for postpartum depressive symptoms. The study results warranted the urgency for clinical diagnosis of PPD and implementation of preventive package in study settings. Mental health education to pregnant women during ANC visits and proper counseling during the antepartum and postpartum period can also play a positive role in preventing postpartum depression.

Investigation of Mycobacterium avium complex (MAC) in Australian commercial milk using qPCR.

This technical research communication describes the first study to use quantitative polymerase chain reaction (qPCR) to investigate the presence of Mycobacterium avium complex (MAC) in Australian pasteurised milk. MAC is the most common NTM responsible for human illnesses and includes M. avium subspecies paratuberculosis (MAP). MAC is a causative agent of lymphadenitis in children, with contaminated food and water considered as a likely source. As such the presence of MAC in milk would have public health significance. MAP has been linked to Crohn's disease and is also the causative agent of Johne's disease in cattle. Previous studies have detected MAP in pasteurised milk from Brazil, India, Czech Republic, USA, Argentina, UK, Iran, Ireland and the United Kingdom. This study investigated a total of 180 commercially available Australian pasteurised milk samples which were tested for MAC DNA in triplicate using PCR. All samples were negative for MAC DNA. An additional 14 milk samples were tested, incubated for 3 weeks at 37 °C to potentially increase the concentration of any viable MAC that may be present and then retested. All samples were again negative for MAC DNA. This could be due to concentrations below the limit of detection, limited sample size or could be reflective of the Australian biosecurity control protocols and surveillance of Johne's disease in ruminant animals.