Reviewing the science on 50 years of conservation: Knowledge production biases and lessons for practice.

Drawing on 662 studies from 102 countries, we present a systematic review of published empirical studies about site-level biodiversity conservation initiated between 1970 and 2019. Within this sample, we find that knowledge production about the Global South is largely produced by researchers in the Global North, implying a neocolonial power dynamic. We also find evidence of bias in reported ecological outcomes linked to lack of independence in scientific studies, serving to uphold narratives about who should lead conservation. We explore relationships in the sample studies between conservation initiative types, the extent of Indigenous Peoples' and local communities' influence in governance, and reported social and ecological outcomes. Findings reveal positive ecological and social outcomes are strongly associated with higher levels of influence of Indigenous Peoples and local communities and their institutions, implying equity in conservation practice should be advanced not only for moral reasons, but because it can enhance conservation effectiveness.

Risk of Cardiac Arrhythmias Among Climbers on Mount Everest.

Importance: Arterial hypoxemia, electrolyte imbalances, and periodic breathing increase the vulnerability to cardiac arrhythmia at altitude. Objective: To explore the incidence of tachyarrhythmias and bradyarrhythmias in healthy individuals at high altitudes. Design, Setting, and Participants: This prospective cohort study involved healthy individuals at altitude (8849 m) on Mount Everest, Nepal. Recruitment occurred from January 25 to May 9, 2023, and data analysis took place from June to July 2023. Exposure: All study participants underwent 12-lead electrocardiogram, transthoracic echocardiography, and exercise stress testing before and ambulatory rhythm recording both before and during the expedition. Main Outcome: The incidence of a composite of supraventricular (>30 seconds) and ventricular (>3 beats) tachyarrhythmia and bradyarrhythmia (sinoatrial arrest, second- or third-degree atrioventricular block). Results: Of the 41 individuals recruited, 100% were male, and the mean (SD) age was 33.6 (8.9) years. On baseline investigations, there were no signs of exertional ischemia, wall motion abnormality, or cardiac arrhythmia in any of the participants. Among 34 individuals reaching basecamp at 5300 m, 32 participants climbed to 7900 m or higher, and 14 reached the summit of Mount Everest. A total of 45 primary end point-relevant events were recorded in 13 individuals (38.2%). Forty-three bradyarrhythmic events were documented in 13 individuals (38.2%) and 2 ventricular tachycardias in 2 individuals (5.9%). Nine arrhythmias (20%) in 5 participants occurred when climbers were using supplemental bottled oxygen, whereas 36 events (80%) in 11 participants occurred at lower altitudes when no supplemental bottled oxygen was used. The proportion of individuals with arrhythmia remained stable across levels of increasing altitude, while event rates per 24 hours numerically increased between 5300 m (0.16 per 24 hours) and 7300 m (0.37 per 24 hours) before decreasing again at higher altitudes, where supplemental oxygen was used. None of the study participants reported dizziness or syncope. Conclusion and Relevance: In this study, more than 1 in 3 healthy individuals experienced cardiac arrhythmia during the climb of Mount Everest, thereby confirming the association between exposure to high altitude and incidence of cardiac arrhythmia. Future studies should explore the potential implications of these rhythm disturbances.

Recurrent Tolosa-Hunt syndrome: a case report.

Introduction and importance: Tolosa-Hunt syndrome is a rare condition with unknown aetiology that manifests clinically as unilateral orbital pain and ophthalmoplegia. It is a diagnosis of exclusion that resolves spontaneously but can recur and respond dramatically to systemic steroids. Case presentation: The authors herein report a case of a 38-year-old male who presented with horizontal diplopia, limited outward movement of the right eye, and blurry vision for two days which was managed with oral Prednisolone. The patient visited 3 months later with progressive ptosis and vertical diplopia with periorbital pain over the right eye. It was eventually diagnosed via magnetic imaging resonance studies and successfully treated for Tolosa-Hunt syndrome with IV methylprednisolone followed by oral prednisolone. Clinical discussion: Hence, the typical clinical presentation of the case with significant response to steroids, exclusion of other conditions from investigation and imaging, and subsequent recurrence of similar symptoms were crucial for making the diagnosis of Tolosa-Hunt syndrome. Conclusion: Tolosa-Hunt syndrome is a syndrome of painful ophthalmoplegia which responds well to steroid therapy but has a tendency to recur. Hence, patients must be adequately informed about the reoccurrence and kept under follow-up.

Cap Polyposis: A Case Report.

Cap polyposis is a gastrointestinal disease with multiple inflammatory polyps between the distal colon and rectum. Its symptoms overlap with inflammatory bowel disease with typical endoscopic features of multiple sessile polyps in the rectum and sigmoid colon, located at the apices of transverse folds. Microscopically, the polyps consist of elongated, tortuous, and distended crypts covered by a "cap" of inflammatory granulation tissue. In this report, we present a case of a 18-year-old male patient who underwent polypectomy for polyposis in multiple settings. He presented with one year of painless rectal bleeding and polyposis in a recto-sigmoid area on colonoscopy, with a single polyp in the sigmoid area and multiple polyps in the rectum. He was managed with immediate and interval polypectomy. Though cap polyposis is rare, it can be cured as it is laparoscopically resectable. Keywords: case reports; granulation tissue; inflammatory bowel diseases; polyps.

A Study to Assess Tyrosine Kinase Inhibitors Induced Thyroid Dysfunction in Newly Diagnosed Chronic Myeloid Leukemia Patients.

INTRODUCTION: The use of TKIs has dramatically improved the prognosis of CML. The aim of this study was to evaluate the effects of TKIs on thyroid function in a prospective manner. MATERIALS: In this prospective study, 55 newly diagnosed adult subjects with positive Philadelphia chromosome in chronic phase of CML without any other apparent underlying diseases were enrolled. Total T3, Free T4, TSH and Anti TPO antibodies were measured at starting and after 12 & 24 weeks of treatment respectively. The study also included a same number control group of sex- and age-matched healthy individuals. RESULT: Approximately 10% of the patients were having subclinical hypothyroidism while the rest were normal regarding thyroid function. There were statistically significant changes within reference ranges in serum concentration of TSH (p = 0.022 and 0.011) 12 weeks and 24 weeks after TKIs initiation, respectively. CONCLUSION: This study showed some significant changes on thyroid function tests.However, without any clinical abnormalities in the course of treatment we didn't initiate replacement. We recommend other studies with larger sample size and longer duration of follow-up. References Singha H, Chakrabarty SK, Sherpa PL, et al. Tyrosine kinase inhibitors induced thyroid dysfunction in newly diagnosed chronic myeloid leukemia patients. Singha H, et al. Thyroid dysfunction caused by tyrosine kinase inhibitors in Philadelphia chromosome-positive chronic myeloid leukemia.

Placing diverse knowledge systems at the core of transformative climate research.

We argue that solutions-based research must avoid treating climate change as a merely technical problem, recognizing instead that it is symptomatic of the history of European and North American colonialism. It must therefore be addressed by decolonizing the research process and transforming relations between scientific expertise and the knowledge systems of Indigenous Peoples and of local communities. Partnership across diverse knowledge systems can be a path to transformative change only if those systems are respected in their entirety, as indivisible cultural wholes of knowledge, practices, values, and worldviews. This argument grounds our specific recommendations for governance at the local, national, and international scales. As concrete mechanisms to guide collaboration across knowledge systems, we propose a set of instruments based on the principles of consent, intellectual and cultural autonomy, and justice. We recommend these instruments as tools to ensure that collaborations across knowledge systems embody just partnerships in support of a decolonial transformation of relations between human communities and between humanity and the more-than-human world.

A qualitative study of coping strategies in persons with spinal cord injury during the COVID-19 pandemic.

PURPOSE/OBJECTIVE: The objective of this study was to identify strategies that persons with spinal cord injury (PwSCI) used to cope with COVID-19 pandemic-related challenges. RESEARCH METHOD/DESIGN: This qualitative phenomenological study utilized focus group discussions (FGDs) to collect participants' responses. Two virtual FGDs using Zoom were conducted in June and July, 2021. Each FGD consisted of seven participants with spinal cord injury (SCI) living in communities in Nepal. A thematic analysis approach was used to analyze and interpret the data. RESULTS: Four major themes related to coping strategies PwSCI used during the pandemic were identified: (a) use of social support, (b) serving others, (c) engagement in self-care activities, and (d) positive thinking and creativity. CONCLUSIONS/IMPLICATIONS: Findings suggest that many participants used healthy coping strategies to cope with COVID-19 pandemic-related stress and challenges. Identification and reinforcement of healthy coping strategies in PwSCI are essential for health professionals to help these individuals navigate the psychosocial adaptation process during the pandemic. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Chronic Obstructive Pulmonary Disease among Patients Admitted to the Department of Medicine in a Tertiary Care Centre.

Introduction: Chronic obstructive pulmonary disease is a prevalent respiratory condition with permanent and progressively decreasing airflow limitation. Chronic obstructive pulmonary disease causes more than 3 million deaths per year globally, making it the third leading cause of death globally. The aim of this study was to find out the prevalence of chronic obstructive pulmonary disease among patients admitted to the Department of Medicine in a tertiary care centre. Methods: A descriptive cross-sectional study was done in the Department of Medicine of a tertiary care centre. Data from 1 January 2022 to 30 December 2022 were collected between 15 June 2023 to 30 June 2023 from the hospital records and reviewed. Ethical approval was taken from the Institutional Review Committee. All the patients admitted to the Department of Medicine during the study period were included in the study. The patients with incomplete medical records were excluded from the study. Convenience sampling method was used. The point estimate was calculated at a 95% Confidence Interval. Results: Among 280 patients, chronic obstructive pulmonary disease was found in 68 (24.29%) (19.27-29.31, 95% Confidence Interval) with a mean age of 70.62±10.39 years and a mean pack year of 16.72±7.67. Conclusions: The prevalence of chronic obstructive pulmonary disease among patients admitted to the Department of Medicine was similar to the other studies done in similar settings. Keywords: COPD; inpatients; prevalence; tertiary hospital.

Dyslipidemia among Patients with Ischemic Stroke Admitted to the Department of Medicine of a Tertiary Care Centre.

Introduction: Sudden neurological deficits due to an acute focal vascular injury of the central nervous system is stroke. It is a major cause of morbidity and mortality. Dyslipidemia is any abnormality in the parameter of the lipid profile which has been associated with stroke. The aim of this study was to find out the prevalence of dyslipidemia among patients with ischemic stroke in the Department of Medicine of a tertiary care centre. Methods: A descriptive cross-sectional study was conducted in a tertiary care centre among admitted ischemic stroke patients from 5 August 2022 to 14 March 2023 after obtaining ethical approval from the Institutional Review Committee. Overnight fasting blood samples were collected for lipid profile. Convenience sampling method was used. The point estimate was calculated at a 95% Confidence Interval. Results: Among 79 ischemic stroke patients, 42 (53.16%) (42.09-64.23, at 95% Confidence Interval) had dyslipidemia where high cholesterol was seen in 21 (50%), high triglyceride in 22 (52.38%), high low-density lipoprotein 14 (33.33%) and low high-density lipoprotein in 20 (47.61%). Conclusions: The prevalence of dyslipidemia among ischemic stroke patients was lower than the similar studies done in similar settings. Keywords: cross-sectional studies; dyslipidemia; hyperlipidemias; ischemic stroke.

Living with spinal cord injury during COVID-19: a qualitative study of impacts of the pandemic in Nepal.

STUDY DESIGN: A qualitative study using focus group discussion. OBJECTIVE: To explore the impacts of COVID-19 on multiple aspects of the lives of individuals living with spinal cord injury (SCI) in Nepal. SETTING: Community settings in Nepal. METHODS: A qualitative phenomenological study was conducted using two virtual focus group discussions. Fourteen individuals with SCI residing in different parts of Nepal participated. A thematic analysis approach was used to analyze and interpret the participants' responses. RESULTS: The four key themes for the impacts of COVID-19 on individuals with SCI were: (1) physical health with subthemes of (a) difficulty due to the presence of COVID-19 symptoms and (b) deterioration in secondary conditions; (2) mental health with subthemes of (c) constant fear of COVID-19 and (d) psychological distress; (3) social life with subthemes of (e) social stigma and (f) social isolation, and (4) economic problems with subthemes of (g) financial burden and (i) inadequate resources. CONCLUSIONS: The pandemic has tremendously impacted the physical, mental, social, and economic aspects of the lives of individuals with SCI. These, in turn, could impede the functioning and well-being of this population. The utilization of telehealth to provide education, psychosocial support, social awareness programs, and the provision of essential medical supplies appear necessary to maintain and improve the well-being of individuals with SCI during this pandemic. Future studies using an in-depth interview approach and psychosocial interventions are recommended.

From climate adaptation to climate justice: Critical reflections on the IPCC and Himalayan climate knowledges.

The IPCC reports represent a powerful discursive and institutional undertaking. However, the IPCC has faced criticism for its different organizational and functional biases which include a geographical bias favoring experts from the global north, a gender bias in favor of men, a disciplinary bias in favor of the natural sciences over the social sciences and humanities, and finally, a cosmological bias favoring western science over indigenous knowledges. In recent years, scholars have noted changes in the IPCC, pointing at the inclusion of social science/humanities perspectives and a growing engagement with plural worldviews. Despite such forays, all aspects of knowledge production within the IPCC still echo the aspirations of nation states and quantitative models of attribution and detection. Climate knowledge production in the Himalayan region reflects this reality. In this essay, we focus on our personal experiences with local communities from the Himalayas and bring it in dialogue with our experiences with the IPCC knowledge production process. In doing so, we have two objectives: first, to highlight marginalized stories of climate-society relationships that challenge normative climate science/policy and, second, in light of these stories, suggest some salient considerations required to foreground justice and equity in futureengagements with the IPCC, which explores the production of democratic knowledge and how such knowledge can be wielded to achieve regional climate justice.

Predicting quality of life among family caregivers of people with spinal cord injury having chronic low back pain in Nepal: a cross-sectional pilot study.

STUDY DESIGN: Descriptive cross-sectional study. OBJECTIVE: This study aims to determine the factors predicting quality of life among Nepalese family caregivers of people with spinal cord injury (SCI) having low back pain. SETTING: Eight districts of the Bagmati Zone of Nepal. METHODS: Sixty-five family caregivers of people with SCI having chronic low back pain were recruited from January to March 2017. The factors examined as independent variables included monthly household income, daily caregiving hours, functional independence of people with SCI, low back pain intensity, and functional disability of family caregivers. The measures were the Family Caregivers' and Spinal Cord Injury Patients' Demographic Form, the Modified Barthel Index, the Pain Intensity Scale, the Oswestry Disability Index, and the World Health Organization Quality of Life-BREF Nepali version. A hierarchical multiple regression analysis was used to predict quality of life. RESULTS: Functional independence of people with SCI, monthly household income, and functional disability of family caregivers with chronic low back pain could significantly predict quality of life at 41% (adjusted R2 = 0.41, Fchange (3,59) = 11.02, p < 0.01). The functional dependence of persons with SCI was the most powerful factor contributing to QoL of caregivers (ß = 0.36, p < 0.01) followed by monthly household income (ß = 0.30, p < 0.01) and caregivers' functional disability (ß = -0.28, p < 0.01). CONCLUSION: The findings suggested that in order to improve the quality of life of family caregivers who have chronic low back pain while providing care for people with SCI during a long period, health professionals should strengthen the functional independence of the patients after discharge to reduce the functional disability of the caregivers. Financial support is needed for caregivers who have a low income.

Perceived HIV Related Stigma among Patients Attending ART Center of a Tertiary Care Center in Rural West Bengal, India.

INTRODUCTION: Despite the advent of modern technologies, India is still grappling with the HIV/AIDS pandemic. Stigma is one of the key aspects which can interfere with HIV test-seeking behaviour, care-seeking behaviour upon diagnosis, quality of care given to HIV-positive patients and perception and treatment of People Living with HIV/AIDS (PLHA) by communities, families, and partners. AIM: To determine the perceived stigma associated with HIV/AIDS and its correlates among PLHAs attending the Anti Retroviral Therapy (ART) centre of North Bengal Medical College, Darjeeling, West Bengal, India. MATERIALS AND METHODS: An observational cross-sectional study was conducted over a period of four months among 454 patients aged ≥18years attending ART centre of North Bengal Medical College. Perceived stigma among the study subjects were assessed using a face and content validated version of Berger's HIV stigma scale. Linear regression analysis was used for statistical analysis of the predictors of perceived stigma. Data were analysed using SPSS version 16 software. RESULTS: The majority of the study population had moderate to low stigma. Regression analysis showed that being on treatment with ART had the highest contribution towards stigma followed by gender and HIV serostatus of the patients. CONCLUSION: The patients attending ART centre of North Bengal Medical College had moderate to low level of stigma. In absence of any efficacious stigma reduction programs in this region, more work needs to be done to assist PLHA in coping with stigma.

Tuberous Sclerosis and Polycystic Kidney Disease: A Rare Association.

Tuberous sclerosis complex (TSC) and autosomal dominant polycystic kidney disease (ADPKD) are two different genetic diseases. Although these two diseases are associated very rarely, the association is well recognized. This occurs due to a large deletion involving both PKD-1 and TSC-2 genes on chromosome 16. This is also known as TSC-2/PKD-1 contiguous gene syndrome. We report a 26-year-old female patient with TSC who presented with severe metabolic acidosis due to renal failure. She had palpable enlarged kidneys bilaterally. CT scan of abdomen revealed bilateral enlarged lobulated kidneys studded with multiple cysts which was consistent with the diagnosis of ADPKD.

Sweet's syndrome: a very rare association with pulmonary tuberculosis.

Mycobacterium tuberculosis infection is a common infection in developing countries, including India. It can induce several cutaneous reactions such as erythema nodosum, and erythema induratum; however, association of tuberculosis with Sweet's syndrome (also known as acute febrile neutrophilic dermatosis) is extremely rare. Here we present an interesting case of sputum-positive pulmonary tuberculosis with Sweet's syndrome. A 55-year-old female who was receiving a regimen of four antitubercular drugs (isoniazid, rifampicin, pyrazinamide, ethambutol- HRZE) for six weeks for sputum-positive pulmonary tuberculosis developed new onset high-grade fever for 15 days along with multiple reddish brown plaques and nodules involving the face as well as all four limbs of the body. Histopathology of the skin lesion was suggestive of Sweet's syndrome. The patient responded well to immunosuppressive steroid therapy.