ABSTRACT
The world population is expanding in line with the general trend. The demand for goods is currently higher than it has ever been before. This has resulted in the production of more waste than ever before. The problem of waste management is not new for humans but the complexity of the issue has increased more in present days. The research was focused on composition of solid waste and its management in Kirtipur-10. The research was conducted in ward 10 of Kirtipur municipality to know the ground reality of solid waste in households. The research aimed to understand the solid waste situation, its composition, problems and finding possible solutions to the problems. Household survey, Focused group discussion were conducted during November month of 2022 to collect data. 75 household were taken as sample for research. Wastes, collected from all of the groups of households, were segregated and weighed. Household solid waste (HSW) was comprised of seven categories of waste with organic waste being the largest component (44 %), plastic (13 %), paper (11 %), Glass (10 %), rubber (9 %), others (7 %) and Hazardous waste (6 %). Municipal authorities are usually the responsible agencies for solid waste collection and disposal, but the magnitude of the problem is well beyond the ability of any municipal government to tackle. There is strong dissatisfaction among municipal resident on waste management by local government. Looking at the composition of waste produced, composting of waste at home level can bring a sustainable solution to the problem. The solid waste management system in Kirtipur has low efficiency and needs to be improved.
ABSTRACT
There is no Food and Drug Administration-approved treatments for ocular chronic graft-versus-host disease (oGVHD) to date, and current therapeutic options are limited. Forehead application of 1% progesterone gel provides corneal antinociception in preclinical models, suggesting it may be useful in alleviating ocular irritations. This study was conducted to evaluate the efficacy and safety of 1% progesterone gel in treating moderate to severe symptomatic oGVHD. Thirty-three patients with oGVHD following allogeneic stem cell transplantation were enrolled in this single-center, sponsor-initiated, prospective exploratory randomized double-masked placebo-controlled phase II clinical trial. The inclusion criteria included a National Institutes of Health consensus score of ≥2, moderate to severe ocular discomfort level, and receipt of a stable immunosuppression regimen. Twenty-one of the 22 patients in the progesterone arm and all 11 patients in the placebo arm completed the course of twice-daily forehead drug application for 10 weeks. The changes from baseline of self-reported ocular symptom scores and physician-recorded cornea fluorescein staining scores were analyzed using mixed-model repeated-measures regression model in an intention-to-treat population. The 33 patients included 12 women and 21 men, with a median age of 66 years (range, 24 to 75 years). At 10 weeks, there was a significant reduction in ocular symptoms from baseline in the progesterone group compared with the placebo group in symptom frequency (-30.7 versus -2.2; P < .001) and severity (-19.8 versus +1.6; P = .005). At 10 weeks, there was also greater reduction of cornea fluorescein staining centrally (-1.2 versus +.1; P = .001) and inferiorly (-1.4 versus -0.2; P = .005). No difference was noted in superior cornea staining. There were no severe adverse events in the progesterone group. Forehead application of 1% progesterone gel significantly improved ocular signs and symptoms within 10 weeks. It appears to be a safe and effective new therapy for oGVHD, and a novel mechanism for neuroaxis drug delivery. A multicenter phase III clinical trial is planned for further validation.
