Factors influencing the knowledge, attitude, and practices of police personnel toward dengue fever in Kathmandu, Nepal.

OBJECTIVE: Dengue fever is a significant public health problem in Nepal, and police personnel are considered to play a crucial role in preventing and controlling dengue fever. This study aimed to assess the factors that influence the knowledge, attitudes, and practices of police personnel toward dengue in Kathmandu, Nepal. METHODS: The study design was a descriptive cross-sectional study among 422 police personnel, where data were collected using self-administered questionnaires. Bi-variate analysis and multivariate analysis were used to examine the association between sociodemographic factors and environmental factors with knowledge, attitude, and practices of dengue. RESULTS: The study found that the knowledge, attitude, and practice toward dengue prevention was 58%, 46%, and 75%, respectively. The study found that family history of dengue (AOR = 2.78, 95% CI = 1.38-5.6), owning bed nets (AOR = 2.13, 95% CI = 1.04-4.35) and having covered water storage containers (AOR = 2.99, 95% CI = 1.74-5.13) were associated with higher odds of knowledge on dengue. Having family history of dengue (AOR = 2.45, 95% CI = 1.24-4.87) and the presence of broken glasses or discarded plastic bottles in the house (AOR = 2.07, 95% CI = 1.93-5.36) were associated with attitude on dengue. Knowledge on dengue was associated with higher odds of attitude (AOR = 3.3, 95% CI = 2.09-5.36) and practices (AOR = 3.21, 95% CI = 1.93, 5.36). CONCLUSION: The study identified specific factors associated with knowledge, attitude, and practices toward dengue prevention. The study concluded that regular training and awareness-raising activities are needed to improve their knowledge, attitudes, and practices toward dengue.

Building a 'Virtual Library': continuing a global collaboration to strengthen research capacity within Nepal and other low- and middle-income countries.

To fill the gap in health research capacity-building efforts, we created the 'Virtual Library' (VL) - a web-based repository of context-relevant resources for health researchers in low- and middle-income countries (LMICs). This paper describes the participatory process used to systematically develop the VL, and describes how our interprofessional team - representing both an LMIC (Nepal) and a high-income country (HIC) (USA, US) - engaged in shared meaning-making. A team of researchers and clinicians representing a range of subdisciplines from Nepal and the US created a replicable search strategy and standardized Resource Screening Guide (RSG) to systematically assess resources to be included within the VL. Descriptive methods were used to summarize findings from the RSG and lessons learned from the collaborative process. Collectively, 14 team members reviewed 564 potential resources (mean = 40, SD = 22.7). Mean RSG score was 7.02/10 (SD = 2). More than 76% of resources met each of the four quality criteria (relevant; reputable, accessible; understandable). Within the published VL, 298 resources were included, organized by 15 topics and 45 sub-topics. Of these, 223 resources were evaluated by the RSG; 75 were identified by team member expertise. The collaborative process involved regular meetings, iterative document revisions, and peer review. Resource quality was better than expected, perhaps because best practices/principles related to health research are universally relevant, regardless of context. While the RSG was essential to systematize our search and ensure reproducibility, team member expertise was valuable. Pairing team members during peer-review led to bi-directional knowledge sharing and was particularly successful. This work reflects a highly collaborative global partnership and offers a model for future health research capacity-building efforts. We invite engagement with the Virtual Library as one supportive pillar of infrastructure to develop individual and institutional research capacity.

Extra-pulmonary Tuberculosis among Tuberculosis Patients Visiting a Tertiary Care Centre: A Descriptive Cross-sectional Study.

Introduction: Tuberculosis outside of the lung is extrapulmonary tuberculosis. The diagnosis of extrapulmonary tuberculosis is not easy in a community setting even in district hospitals. Clinical symptoms and radiological diagnosis are effective for the diagnosis of pulmonary and extra-pulmonary cases. The aim of the study is to find out the prevalence of extra-pulmonary tuberculosis among tuberculosis patients visiting a tertiary care centre. Methods: This was a descriptive cross-sectional study conducted among the patient visiting a tertiary care centre from August 2019 to January 2020 after taking ethical approval from Institutional Review Committe (Reference number: 86) which observed different clinicoradiological and laboratory features in patients with extrapulmonary tuberculosis to address their respective accuracy and usability in measuring the burden of tuberculosis. The interview was taken for the symptoms, and then radiological and laboratory data were collected. Convenience sampling was used. Point estimate and 95% confidence interval were calculated. Results: Out of 60 patients with tuberculosis, 39 (65%) (62.83-67.17, 95% Confidence Interval) were diagnosed with extrapulmonary tuberculosis. Among them, 30 (76.9%) were with pleural effusions followed by lymphadenopathy in 9 (23.07%). Conclusions: The prevalence of extra-pulmonary tuberculosis was found to be higher as compared to the study done in similar settings. Keywords: extrapulmonary; pulmonary; tuberculosis.

A Study of Surgical Cases During Earthquake Disaster in A Medical College.

INTRODUCTION: An earthquake is an intense shaking of earth's surface which is caused by movements in earth's outermost layer. The earthquake of 25th April 2015, with a magnitude of 7.8 richter scale with its major aftershock on 12th May 2015 of 7.3 richter scale claimed around 8,962 lives across several districts of Nepal with 22,302 injuries. In this study we tried to figure out various surgical cases and the surgical procedures performed in a tertiary care hospital during an earthquake disaster. METHODS: This study was a descriptive cross-sectional study of hospital data on all admitted surgical cases during an earthquake disaster. A total of 238 earthquake victims brought to emergency department of Kathmandu Medical College Teaching Hospital , a tertiary care center, from 26th April 2015 to 7th Jun 2015, for the period of 42 days were included. Those brought dead and discharged after primary treatments were excluded. Data obtained were entered and analysed in Microsoft Excel 2010. RESULTS: Among 238 patients enrolled, 122 (51%) were male and 116 (49%) female with male to female ratio of 1.05:1. Age group (31-60 years) with an average age of 45 years were encountered most frequently 110 (46%) with the maximum number of patient burden from Sindhupalchowk district 80 (33.6%). Orthopedic surgery 185 (76%) appeared to be the most frequent followed by neurosurgery, plastic surgery, general surgery and dental surgery. CONCLUSIONS: In natural disaster like earthquakes, traumatic injuries are very common and thereby various surgical procedures especially ortho-plastic are the domain of treatment modalities. Disaster preparedness and combined surgical team effort needs to be focused to reduce both mortality and morbidity.

Intestinal parasitic infestation in combatants and their families: a hospital-based study in Mid-Western Regional Police Hospital, Nepal.

OBJECTIVE: To find out the scenario of intestinal parasitic infestation in combatants and their families in the setting of Mid-Western Regional Police Hospital (MWRPH), Nepal. STUDY DESIGN: Cross-sectional study. METHODS: All 2005 patients presented with the complaint of abdominal pain, diarrhoea, frequent defecation, blood in stool, or black stool from August 2007 to February 2011 were offered a stool examination. About 10g of fresh stool was collected in a clean, dry bottle. Two slides from each specimen were examined applying light microscope in 10 and 40 uvf at Banke, Nepalgunj hospital laboratory. RESULT: Among 2005 patients, 928 (46.28%) were infested with either helminths and/or protozoa. 96% were single infestation. The most common infestation was Ascaris lumbricoides (48.06%) and the second was hook worm (18.97%). Most common protozoal infestations were Entamoeba histolytica (12.92%) and Giardia lamblia (9.49%). Helminthic infestations peaked in cool months and protozoal infestations were rather steady throughout the year. CONCLUSION: Very high parasitic infestation in least developed mid- western Nepal may need urgent public health intervention.

Global evidence directing regional preventive strategies in Southeast Asia for fighting TB/HIV.

Tuberculosis (TB) and human immunodeficiency virus (HIV) co-epidemics form a huge burden of disease in the Southeast Asia region. Five out of eleven nations in this region are high TB/HIV burden countries: Myanmar, Thailand, India, Indonesia and Nepal. The trends of TB incidence in these countries have been rising in recent years, in contrast to a falling global trend. Experts in the field of TB control and health service providers have been perplexed by the association of TB and HIV infections which causes a mosaic clinical presentation, a unique course with poor treatment outcomes including death. We conducted a review of contemporary evidence relating to TB/HIV control with the aims of assisting integrated health system responses in Southeast Asia and demystifying current evidence to facilitate translating it into practice.

Comparison of real-time SYBR green dengue assay with real-time taqman RT-PCR dengue assay and the conventional nested PCR for diagnosis of primary and secondary dengue infection.

BACKGROUND: Dengue fever and dengue hemorrhagic fever are caused by dengue virus. Dengue infection remains a burning problem of many countries. To diagnose acute dengue in the early phase we improve the low cost, rapid SYBR green real time assay and compared the sensitivity and specificity with real time Taqman(®) assay and conventional nested PCR assay. AIMS: To develop low cost, rapid and reliable real time SYBR green diagnostic dengue assay and compare with Taqman real-time assay and conventional nested PCR (modified Lanciotti). MATERIALS AND METHODS: Eight cultured virus strains were diluted in tenth dilution down to undetectable level by the PCR to optimize the primer, temperature (annealing, and extension and to detect the limit of detection of the assay. Hundred and ninety three ELISA and PCR proved dengue clinical samples were tested with real time SYBR(®) Green assay, real time Taqman(®) assay to compare the sensitivity and specificity. RESULTS: Sensitivity and specificity of real time SYBR® green dengue assay (84% and 66%, respectively) was almost comparable to those (81% and 74%) of Taqman real time PCR dengue assay. Real time SYBR(®) green RT-PCR was equally sensitive in primary and secondary infection while real time Taqman was less sensitive in the secondary infection. Sensitivity of real time Taqman on DENV3 (87%) was equal to SYBR green real time PCR dengue assay. CONCLUSION: We developed low cost rapid diagnostic SYBR green dengue assay. Further study is needed to make duplex primer assay for the serotyping of dengue virus.