Prevalence and Predictors of Incomplete Immunization among Children Residing in the Slums of Kathmandu Valley: A Community Based Door-to-Door Survey.

Background Expanded program on immunization is one of the most cost-effective and widely applied public health interventions in worldwide. It is priority program for government of Nepal. Objective To estimate the incomplete immunization and identify predictors of incomplete immunization among age of 12-60 months children residing in the slum areas of Kathmandu Valley. Method This cross sectional, community based door-to-door survey was carried out in slum areas of Kathmandu Valley in months of January to February, 2017. Among nine squatters; having more than 100 households, five were selected by using stratified random sampling. The total 505 children age of 12-60 months was included for study. The face-to-face interview with selected mothers was performed using the structured questionnaire. Mean and standard deviation was calculated for continuous variables and proportions with 95% confidence interval level for categorical variables. The chi-square analyses were used to evaluate association between selected variables with incomplete immunization. The p-value <0.05 was considered as statistically significant. Result The mean age of children was 34.7±17.8 months. Nearly half of the children (43.6%) were within age of 12-24 months. The mean age of mothers was 27.1±5.3 years and more than three quarters (82.2%) were literate. The incomplete immunization was 13.0%; it was found higher among female (14.7%) than male children (11.4%). The incomplete immunization was highly associated with poor knowledge on immunization schedule of mothers (p=0.001). Conclusion The incomplete immunization was higher than national mean. It was found association with poor knowledge on immunization schedule of mothers. So, the immunization program should be more strengthen in slum areas and need to expand the education program focusing on immunization schedule.

Migraine associated with altitude: results from a population-based study in Nepal.

BACKGROUND AND PURPOSE: A 1988 pilot study in Peru suggested an association between migraine and chronic exposure to high altitude. This study provides epidemiological evidence corroborating this. METHODS: In a cross-sectional nationwide population-based study, a representative sample of Nepali-speaking adults were recruited through stratified multistage cluster sampling. They were visited at home by trained interviewers using a culturally adapted questionnaire. The altitude of dwelling of each participant was recorded. RESULTS: Of 2100 participants, over half [1100 (52.4%)] were resident above 1000 m and almost one quarter [470 (22.4%)] at ≥2000 m. Age- and gender-standardized migraine prevalence increased from 27.9% to 45.5% with altitude between 0 and 2499 m and thereafter decreased to 37.9% at ≥2500 m. The likelihood of having migraine was greater (odds ratio, 1.5-2.2; P ≤ 0.007) at all higher altitudes compared with <500 m. In addition, all symptom indices increased with altitude across the range <500 m to 2000-2499 m, i.e. median attack frequency from 1.3 to 3.0 days/month (P < 0.001), median duration from 9 to 24 h (P < 0.001) and pain intensity [the proportion reporting 'bad pain' (highest intensity)] from 35.5% to 56.9% (P = 0.011). Each of these showed a downward trend above 2500 m. CONCLUSIONS: Dwelling at high altitudes increases not only migraine prevalence but also the severity of its symptoms.

Undertreated Hypertension and its Implications for Public Health in Nepal: Nationwide Population-Based Survey.

BACKGROUND: Hypertension (HTN), a major risk factor for cardiovascular diseases (CVDs), is a substantial global public health problem. Occasional studies indicate a high prevalence of HTN in the Nepalese population, but no nationwide population-based data exist so far. We opportunistically used a survey of major disorders of the brain in Nepal to measure blood pressure (BP) in participants selected randomly from the adult general population. OBJECTIVE: To establish the prevalence of elevated BP (eBP), and factors associated with it, regardless of any antihypertensive therapy being taken. We took this to be indicative of unmet health-care need. METHOD: This was a cross-sectional study, conducted by unannounced household visits, employing multistage random cluster sampling. To achieve representativeness, 15 districts out of 75 in the country were investigated: one district from each of the three physiographic divisions in each of the five development regions of Nepal. One adult aged 18-65 years was selected from each household and interviewed by structured questionnaire. BP was recorded in a standardised manner by digital device (Microlife 3BM1-3®). RESULT: From 2,109 eligible households, 2,100 adults (99.6%) participated. The prevalence of eBP (>140/90 mmHg on ≥2 readings) was found to be 15.1%. Multivariate logistic regression showed significant and independent associations with demographic variables (higher age, male gender), with life-style factors (daily alcohol consumption, BMI ≥25), and with living at high altitude (≥2000 m). CONCLUSION: In the context of the survey we could not collect data on antihypertensive therapy being taken but, clearly, whatever this might have been, it was failing to meet treatment needs. Almost one in six adults met criteria for hypertension, carrying risk implications for CVDs and their substantial public-health consequences. Two remediable associated factors were identified, although in a cross-sectional survey we could not prove causation.

Reliability and Validity of a Nepali-language Version of the Hospital Anxiety and Depression Scale (HADS).

BACKGROUND: In several languages and settings, the Hospital Anxiety and Depression Scale (HADS) has demonstrated reliable and valid screening properties in psychiatry. OBJECTIVE: To develop a Nepali version of HADS with acceptable reliability and construct validity for use among hospital patients and in the general population. METHOD: The original English version was translated into Nepali using a forward-backward translation protocol. Psychometric properties were tested by factor analysis and Cronbach's alpha. The translated scale was administered to three groups of adult in-patients in a university hospital in three trials, and to a sample of adults from the community in a fourth trial. Some of the 14 items were reworded reiteratively to achieve viable semantic and statistical solutions. RESULTS: The two-factor solution with anxiety and depression subscales eventually explained 40.3% of the total variance. Cronbach's alpha was 0.76 for anxiety (HADS-A) and 0.68 for depression (HADS-D). All seven HADS-A items showed at least acceptable item-to-factor correlations (range 0.44-0.74), and full construct validity was achieved for this subscale. Item-to-factor correlations for six HADS-D items were also at least acceptable (range 0.42-0.70); one item (D4) had persistently low correlations throughout all trials, although construct validity was still satisfactory. CONCLUSION: Reiterated rewording of items guided by statistical testing resulted in a Nepali version of HADS with satisfactory psychometric properties.

Measuring Neuroticism in Nepali: Reliability and Validity of the Neuroticism Subscale of the Eysenck Personality Questionnaire.

BACKGROUND: The Neuroticism subscale of the Eysenck Personality Questionnaire Revised Short Form (12 items) (EPQRS-N) has proven to be a reliable and valid measure in multiple languages. OBJECTIVE: To develop a single-factor Nepali-language version of the EPQRS-N for use in the adult population of Nepal. METHOD: The original English version of EPQRS-N was translated into Nepali using a forward-backward translation protocol. The first set of translated items was modified after testing by factor analysis with principal component extraction in an outpatient sample. Items with low factor correlations or poor semantic consistencies were reworded to fit the gist of the original items in a Nepali cultural context; the revised version was then tested in a representative random sample from the general population. Again, the same statistical procedures were applied. RESULTS: The first trial gave three factors. Based on the factor distribution of the items or their semantic quality, five were reworded. In the second trial, a two-factor solution emerged; the second factor had only one item with high correlation, which also had modest correlation with the first factor. Accordingly, a forced one-factor solution was chosen. This gave an internal consistency (Cronbach's alpha) of 0.80, with item-to-factor correlations from 0.40 to 0.73, and item-to-sum correlations from 0.31 to 0.61. CONCLUSION: The final Nepali version of EPQRS-N achieved satisfactory internal consistency. The item distribution coincided with the original English version, providing acceptable construct validity. It is psychometrically adequate for use in capturing the personality trait of neuroticism, and has broad applicability to the adult population of Nepal because of the diversity of the participant samples in which it was developed.

Prevalence and Associated Factors of Hypertension among Adults in Rural Nepal: A Community Based Study.

Background Hypertension is a major health problem throughout the world and is one of the major risk factors for cardiovascular mortality. It is important to detect and manage prehypertension and hypertension to reduce the risk of correlated complications especially cardiovascular diseases. Objective The objective of the study was to find the prevalence and risk factors of hypertension among the adults in rural Nepal. Method A community based cross-sectional study was conducted among 648 respondents. The information was obtained using pre-tested questionnaire which included demographic information of individuals and other risk factors like alcohol and tobacco use, physical activity and diet preference. Height, weight and blood pressure were recorded and hypertension was defined as per Joint National Committee (JNC) VII guidelines. Result The overall prevalence of hypertension was 20.5 % and pre-hypertension was 46.6%. The males had higher prevalence of hypertension (30.6%) compared to females (13.8%). Bivariate analysis showed male gender, smoking and non vegetarian diet have association with hypertension. Male gender [OR 2.50 (1.68 - 3.74)] and non vegetarian diet [OR 0.11 (0.01 - 0.85)] were found to be significantly associated with hypertension in multivariate analysis. Conclusion The prevalence of hypertension and prehypertension was high in the study population. In absence of life style modification and risk reduction the individuals categorized as prehypertension have great risk of developing hypertension in the future which may pose a great challenge in the future. Hence, there is a big scope for screening and primary prevention strategies to curb the epidemic of hypertension.

Is routine hospital visit after day case inguinal hernia surgery in children necessary?

BACKGROUND: To observe the prospects of day case inguinal hernia surgery in children without routine postoperative hospital visits. The aim was to access the advantages, acceptability and safety of this change in practice in low resource country like Nepal. METHODS: This was a cross-sectional study in a tertiary care general teaching hospital. Thirty children aged 6 months to 14 years who had elective day case Inguinal Hernia surgery from May 2011 to Oct 2011 were prospectively observed. Children with obstructed hernia, un-descended testis were excluded. Parents were counseled for omission of routine hospital visit after surgery. Main outcome measures were to observe unplanned hospital visit, reasons for visit, post-operative pain, wound infection and overall satisfaction of parents interviewed by telephone. Study was approved by institutional review committee. RESULTS: There were 28 boys and two girls. Average age was five years. Right Inguinal Hernia patients were 19 in number while 11 patients had left sided hernia. None of the children visited health facility for pain or wound problem. Two children were brought to outpatient because they were mistakenly given appointment slip. Mother noticed recurrence and brought one child to surgical outpatient. All 30 parents responded to telephone enquiry and were satisfied. CONCLUSIONS: Routine follow up visit after day care Inguinal Hernia surgery in children is not necessary. This practice is safe, economic and well accepted by children and parents.

Awareness regarding preventive measures of avian influenza among the adult people of Thimi Municipality, Nepal.

BACKGROUND: Avian influenza is considered as a threat to global public health. Prevention and control depends on the awareness of the general population as well as high risk-groups. The avian influenza should be viewed more seriously because it may lead to pandemic influenza when the virus mutates its strain with the common human influenza. Thus, this study aims to explore the awareness regarding preventive measures of avian influenza among the adult population of Thimi Municipality. OBJECTIVE: The objective of this study was to explore awareness regarding preventive measures of avian influenza among the adult population of Thimi Municipality. METHODS: It is a cross-sectional, population based study. It was carried out in Thimi Municipality from May 15 to June 15, 2012. Pre tested structured questionnaire was used for face to face interview with randomly selected 250 subjects. RESULTS: Out of 250 subjects, 123 (49.2 %) were males. The mean age of subjects was 36 ± 11.8 year. Among total subjects, 94.4 percent had heard about avian influenza. The main source of information was television (94.1%). Majority of subjects (84.9 %) thought that keeping infected birds and poultry as the mode of transmission followed by eating not well cooked poultry meat (82.8 %). Out of total study subjects, 165 (66.0 percent) mentioned fever and 138 (55.2 percent) thought fatigue as the signs and symptoms. As for knowledge about preventive measures, majority (85.6%) stated that cleaning the surfaces that had come in contact with the poultry could prevent the disease and 83.2 % had knowledge that the infection could be prevented by washing hands with soap and water after poultry handling. Awareness regarding preventive measures was found significantly low in females, middle adults, illiterates, and house wives. CONCLUSION: The awareness regarding avian influenza was quite satisfactory among the adult people of Thimi Municipality. However level of awareness was seen lower in female, illiterate and middle adult. So that along with large scale mass education, there should be specific health education program for the specific group of population.

Early feeding and discontinuation of intravenous fluid after laparoscopic cholecystectomy.

BACKGROUND: Common practice at most centers in the country is to continue intravenous (i.v.) fluid till morning round next day following laparoscopic cholecystectomy (LC), assess patient and gradually allow oral diet. However this seems unnecessary in view of fast recovery after minimal invasive LC. The aim of this study was to observe the prospects and assess the acceptability, safety and benefit of early oral feeding and discontinuing i.v. fluid after LC. METHODS: This cross-sectional observational study was carried out prospectively from Oct 1, 2009 to Sep 31, 2010 at Patan Hospital, a university teaching hospital. All elective LC patients were included. Oral liquid was introduced after four hours and i.v. fluid was stopped after six hr of LC. I.v. cannula was kept locked in situ. Vomiting, abdomen distension and reasons for continuation or resumption of i.v. fluids were recorded. RESULTS: During one year period 294 LC patients fulfilled study criteria. Average age was 40.8 years. Female accounted for 78.2%. Oral fluid was started in average of 5.5 hrs in 97%. In 3% (9/294) i.v. was continued. Postoperative nausea and vomiting was observed in 25.9% (76/294), of which 6.6% (5/76) required i.v.. There was no untoward affect after i.v. fluid was stopped. CONCLUSIONS: Early oral feeding and discontinuing of intravenous fluid in laparoscopic cholecystectomy is safe, economic and well accepted by patients, family and nursing staff in Patan hospital.

Prevalence and associated risk factors of hypertension among people aged 50 years and more in Banepa Municipality, Nepal.

BACKGROUND: Hypertension is a cardiovascular disorder rapidly emerging as a major public health problem in developing countries and is the most widely recognized modifiable risk factor for cardiovascular diseases. OBJECTIVE: The objective of this study was to find out the prevalence and associated risk factors with hypertension among people aged 50 years and more in Banepa Municipality, Kavre, Nepal. METHODS: It is a cross- sectional, population based study which was carried out in Banepa Municipality from May 15 to June 15, 2009. Among total 11 wards of Banepa municipally, wards number 1, 3, 5, 6, 7, and 10 were selected by using Simple Random Sampling Technique and 405 subjects of people aged 50 years and more were selected for study from the selected wards by using Cluster Sampling. The structured interview method was used for collection of data. Mercury sphygmomanometers with standard cuff were used to measure the indirect auscultatory arterial blood pressure. Two consecutive blood pressure readings were taken and average of them was calculated to determine single value of blood pressure. RESULTS: The prevalence of hypertension was 44.9 percent (47.75% in male and 42.73% in females). Among them, only 32.9 percent (60/182) were previously diagnosed as hypertension. The higher proportion of hypertensive cases were in age > 65 years (55.49%) than in the age group < 65 years (36.32%). The prevalence of hypertension was seen positively associated with non vegetarian eating habits, alcohol consumption, and > 25 Body max index. Taking green leafy vegetable at least once a week was negatively associated with the prevalence of the hypertension. CONCLUSION: These findings provide important information on the prevalence, associated factors of hypertension in Banepa Municipality. Effective public health measures and strategies are needed to improve prevention, diagnosis and access to treatment of these 50 years and above population.

Characterization of home-made silver sulphide based iodide selective electrode.

Polycrystalline silver sulphide/silver iodide ion selective electrodes (ISEs) with four different compositions, 9:1, 2:1, 1:1, 1:9 Ag(2)S-AgI mole ratios, have been fabricated in the laboratory and characterized by X-ray diffractometry (XRD), scanning electron microscopy (SEM), and electrochemical impedance spectroscopy (EIS). X-ray diffraction studies show the presence of Ag(3)SI, Ag(2)S and AgI crystalline phases in the electrode material. The electrode surfaces have been found to become smoother and lustrous with increasing percentage of silver sulphide in silver iodide. ISE 1:1, ISE 2:1 and ISE 9:1 all responded in Nernstian manner with slopes of about 60 mV/decade change in iodide ion concentration in the linear range of 1 x 10(-1) to 1 x 10(-6)M while ISE 1:9 showed sub-Nernstian behavior with slope of about 45 mV up to the concentration 1 x 10(-5)M. Two capacitive loops, one corresponding to the charge transfer process at metal electrode and the back contact and a second loop corresponding to the charge transfer process at membrane-electrolyte interface have been observed at high and low frequency ranges, respectively. Mott-Schottky analysis shows that the materials are n-type semiconductors with donor defect concentrations in the range of 5.1 x 10(14) to 2.4 x 10(19)/cm(3).

Human visceral leishmaniasis is not associated with expansion or accumulation of Foxp3+ CD4 cells in blood or spleen.

Natural regulatory T cells (CD4(+) CD25(+) Foxp3(+)), natural regulatory T cells (nTreg), play an important role in the regulation of inflammatory immune responses. However, the immunosuppressive properties of nTreg may unfavourably affect the host's ability to clear certain infections. In human visceral leishmaniasis (VL), reports on the frequency and function of nTreg are not conclusive. A limitation of our own previous studies that did not indicate a major role for Foxp3(+) nTreg in VL pathogenesis was that Foxp3 was measured by mRNA expression alone, as other tools were not available at the time. We have in this study assessed CD4(+)CD25(+)Foxp3(+) cells in splenic aspirates and peripheral blood mononuclear cells (PBMC) from an extensive series of patients with VL and endemic controls (EC) by flow cytometry (FACS). The results do not show increased frequencies of Foxp3(+) cells in patient with VL pre- and post-treatment, neither were they elevated when compared to PBMC of EC. We conclude that active VL is not associated with increased frequencies of peripheral Foxp3 Treg or accumulation at the site of infection.

Electrocardiograph and chest X-ray in prediction of left ventricular systolic dysfunction.

INTRODUCTION: Echocardiography is the definitive diagnostic tool for left ventricular systolic dysfunction. But it's expensive and requires trained manpower and thus might not be available in the primary care set up. ECG and Chest X ray, the more basic investigations, may help diagnose LVSD or at least streamline those who absolutely require echocardiography in primary care setup. METHODS: ECG, Chest X ray and Echocardiography along with clinical assessment were performed on 35 patients with some form of complaints related to heart. The inferences on systolic function obtained from ECG, Chest X ray were compared with Echocardiography findings. RESULTS: Out of 35 participants, 25 had left ventricular ejection fraction less than 45%, 28 had abnormal ECG, 30 had cardiomegaly in chest X-ray. A set of pre-selected ECG abnormalities had a sensitivity of 100% (83.4-100), specificity of 70% (35.4-91.9) and a positive predictive value of 89.3% (70.6-97.2) in diagnosing LVSD. Likewise, the figures were 92% (72.5-98.6), 30% (8.1-64.6) and 76.7% (57.3-89.4) respectively for a cardio-thoracic ratio of more than 0.5 in chest X-ray. CONCLUSIONS: Although, ECG and Chest X ray could not replace Echocardiography, they could very well give an idea of the systolic function of an individual and suggest the need or no need for an echo-study in primary care setup.

Comparative evaluation of parasitology and serological tests in the diagnosis of visceral leishmaniasis in India: a phase III diagnostic accuracy study.

In this phase III trial for diagnostics for visceral leishmaniasis (VL) in India, we compared parasitological diagnosis with several serological tests: direct agglutination test (freeze dried; DAT-FD), rK-39 strip test, rK-26 strip test and a latex agglutination test for antigen detection in urine (KAtex) in 452 subjects from the endemic regions of Bihar, India. The subjects were segregated into four categories: 230 confirmed patients, 52 probable cases, 70 non-cases and 100 healthy endemic controls. The first two groups were used for estimating sensitivity, the latter two for specificity. Sensitivity of DAT-FD was 98.9%, rK-39: 98.9%, KAtex: 67.0% and rK-26: 21.3%. Sensitivity of DAT-FD on blood taken on filter paper (DAT-FDF) was 99.3%, which was comparable with that using serum. Specificity of serological tests was comparable and high (DAT-FD and DAT-FDF: 94%, rK-39 strip test: 97%, KAtex: 99% and rK-26 strip test: 100%). The classical 'gold standard' parasitological demonstration in splenic smear performed poorly as it missed 18.4% of cases that benefited from VL treatment. Reproducibility of the serological tests between field and central laboratories was excellent (kappa = 1.0, 0.99, 0.96 and 0.94 respectively for microscopy, DAT-FD, rK-39 strip test and rK-26 strip test). A high degree of agreement was observed between DAT-FD and rK-39 strip test (kappa = 0.986). Although DAT-FD and rK-39 strip test were highly sensitive with excellent specificity, the ease of use of the latter makes it most suitable for the diagnosis of VL in the field conditions.

Morbidity pattern of children with asthma: a prospective study.

OBJECTIVES: To determine the morbidity pattern of asthma in children attending the paediatric asthma follow-up clinic. MATERIALS AND METHODS: Longitudinal prospective follow up of hundred and four patients, diagnosed as asthma, over a period of 2 years was done. Regular follow up by the same person during each visit and proper supervision of standard treatment along with parental education regarding the asthma, was done. RESULTS: The mean age of children presenting with asthma was 6.7 years. Majority of children 49 (47.5%) were graded as mild persistent asthma. Fifty nine (56.7%) children were missing school more than 7 days per month. Family history was present in forty one percent of the children. Fifty seven (54.8%) children were taking significant amount of junk food and were undernourished. Significant reduction in school-missing days and Emergency Room visits was noted in these children during the follow up period. CONCLUSION: Awareness of disease is an important aspect of asthma management. Proper treatment and follow up with emotional support and education of the care taker, about the asthma, can reduce the morbidity pattern of asthma in children.

One year follow up study of term babies born at Kathmandu medical college teaching hospital.

OBJECTIVE: To study the mean, standard deviation and centiles for anthropometry and haemoglobin in healthy term infants followed up to 12 months of age. DESIGN: Cohort study. SETTINGS: Kathmandu Medical College Teaching Hospital (KMCTH) in Kathmandu. SUBJECT: Consecutive healthy term newborns Method: 100 consecutive healthy term newborns were enrolled at birth.19 babies were lost in follow up. So, 81(45 male, 36 female) healthy, full term infants were followed up from birth to 12 months of age. Anthropometry (weight, length, and head circumference) and haemoglobin were measured at birth, 6 weeks, 6 months, 9 months and 12 months of age. Haemoglobin was estimated by Hemocue microcuvette method. The data so obtained was subjected to statistical analysis by using SPSS computer package. MAIN OUTCOMES: Mean, centile and standard deviation score values for weight (Kgs), infant length (cms), head circumference (cms) and haemoglobin (gm/dl) at birth, 6 weeks, 6 months, 9 months and 12 months of age. RESULTS: Out of 100 babies enrolled, data presented here is for the remaining 81 babies. Among 81 babies, 76 were appropriate for gestational age (AGA) and 3 were small for gestation (SFD). The mean, standard deviation and percentile values are presented for anthropometry (weight, length and head circumference) and haemoglobin at birth, 6 weeks, 6 months, 9 months and 12 months of age. The mean birth weight was 3.05 kg (SD 0.41). The mean infant length and head circumference at birth were 49 cm (2.28) and 33.8 cm (SD1.4) respectively. The mean haemoglobin at birth was 15.7 gm/dl (SD 2.29). At 12 months of age mean weight, length, head circumference and haemoglobin were 9 kg (SD 0.81), 73.5 cm (SD 2.9), 45 cm (SD 1.2 ) and 11.1 gm/dl (SD 1.41) respectively. Almost 50% of the babies at 6 weeks, 9 months and 12 months of age were found to be anaemic (Hb < 11 gm/dl). Among the babies, 49% were exclusively breast fed for 6 months of age. Other feeding practices seen were, mothers breast feed with water supplementation (25%), mothers breast feeding with formula feed (16%) and formula feeding only (5%). National and international comparisons of anthropometry and haemoglobin data are shown in table.

Prevalence of HBV infection among the healthy Nepalese males: a serological survey.

Sera from 478 healthy Nepalese male population, inhabiting various districts of five development regions of Nepal were collected from October 1996 to March 1997 and examined for the presence of HBsAg by third generation ELISA and Latex agglutination test in the laboratory of Central Department of Microbiology, Tribhuvan University, Kirtipur. The surface antigen was detected by ELISA in 4.0% (19/478) of subjects studied. However, different results were obtained in Latex agglutination test. The correlation between the results obtained from these two different tests is statistically significant (chi2=85.11, P<0.05). The results obtained from ELISA showed the probability of Nepal to fall in WHO category of intermediate endemicity zone for hepatitis B infection. The percent positivity of HBsAg was found to increase steadily from Eastern (2%) to Far Western (6.2%) development regions. Among the districts studied, Kailali district gave characteristically high prevalence followed by Rukum and Kaski. Other, districts representing for the prevalence are Sankhuwasabha, Jhapa, Ramechhap, Sarlahi, Dhanusa, Baglung, Gulmi, Palpa and Dang. None of the samples represented from Kathmandu valley were positive for HBsAg. The age groups of 16-20 years and 36-40 years were found to be associated with the hepatitis B infection. Furthermore, various percent prevalence of the infection were encountered from 16 to 40 years subjects and a single case was also observed from 63 years old man. All the samples recorded positive for HBsAg from ELISA were assayed for the amount of ALT as a liver function test. Where, 15.8% (3/19) of the infected subjects had impaired liver function, hence it showed that, the subjects with high ALT to be the possible carrier of the HBV. Conversely, the remaining 84.2% (16/19) of the total HBsAg positive subjects were concluded to have the infection either at incubation or at prodrome period.

Prevalence of hepatitis B virus infection amongst healthy Nepalese males.

Sera from 478 healthy Nepalese males, inhabiting various districts of five development regions of Nepal were collected from October 1996 to March 1997 and examined for the presence of HBsAg by third generation ELISA and latex agglutination test in the laboratory of Central Department of Microbiology, Tribhuvan University, Kirtipur. The surface antigen was detected by ELISA in 4% (19/478) of subjects studied. However, different results were obtained in Latex agglutination test. The correlation between the results obtained from these two different tests is statistically significant (X2 = 85.11, P < 0.05). The results obtained from ELISA showed the probability of Nepal to fall in WHO category of intermediate endemicity zone for hepatitis B infection. The percent positivity of HBsAg was found to increase steadily from Eastern (2%) to Far Western (6%) development regions. None of the samples represented from Kathmandu valley were positive for HBsAg. Hepatitis B infection was present in the age groups of 16-20 years and 36-40 years. The levels of ALT were assayed in all samples recorded positive for HBsAg from ELISA. Sixteen percent (3/19) of the infected subjects had raised ALT levels while 84% (16/19) had normal levels.

Determination of halide ions by cathodic stripping analysis.

The determination of halide ions in aqueous solution by cathodic stripping analysis is discussed. It is shown that a linear response is obtained over the concentration range 2 x 10(-5)-10(-3)M for solutions containing only a single halide and that mixtures of halides can usually be analysed. Other interferences are also considered.