Implementing Reflective Writing at a Newly Established Health Science Academy of Nepal: Exploring a Novel Practice, Overcoming Obstacles and Recommendations.

Establishing new institutions for health professions provides the opportunity to implement innovative approaches catering to the current health needs and also allows to address the inadequacies of well-established institutions. Grabbing this opportunity, we initiated the implementation of reflective practices at Madan Bhandari Academy of Health Sciences, a new provincial university in Nepal. Though literature shows that reflection is a helpful tool to reflect on choices, experiences, and failures and obtain knowledge for the students, the adoption of reflective writing in health professions education in Nepal is limited. Therefore, we looked into the practices from other countries to adopt them in our settings and integrated them into our curriculum. But, we came across many impediments during the process-particularly those related to limited resources. We found innovative solutions like using technology and peer mentoring to overcome these challenges and integrated these practices to initiate reflective writing at the institution. The introspective "talking to oneself" has been a valuable strategy for implementing the reflective practices at our institution. Based on our experiences, we highly recommend educators in Nepal or similar settings embrace team-based writing practices that are contextually appropriate. But, we also recognize the benefits of team-based reflective writing that considers the cultural context. We hope this review will inspire educators, particularly those who lack the resources to initiate such practices at their institution. Our firsthand experience is detailed in this perspective article.

Electro-physiological Changes in the Central Nervous System by Visual Evoked Potential in Diabetic Patients.

BACKGROUND: Increasing sedentary lifestyle in today's world has increased the prevalence of Diabetes Mellitus. Loss of vision due to diabetic retinopathy is a major public health burden. Visual evoked potential identifies the neuronal degenerative changes in chronic metabolic disorders specially Diabetes Mellitus. The study aimed at evaluating changes in visual evoked potential waves in diabetic patients. METHODS: This is a cross sectional comparative study consisting of 90 participants, out of which 60 were diabetic patients and 30 were non-diabetic control group. Among diabetic patients, 30 were without retinopathy, 10 with mild non-proliferative retinopathy, 10 with moderate non-proliferative retinopathy and 10 with severe non-proliferative retinopathy. Visually evoked potential latencies and amplitudes were compared among diabetic patients and the control group and also among individuals with different grades of retinopathy. RESULTS: Delay in P100 latency and decrease in its amplitude were statistically significant in diabetic patients. The changes in P100 latency, P100 amplitude and N75 latency were also significant in different grades of retinopathy. CONCLUSIONS: There are statistically significant changes in visually evoked potential in diabetes patients. Visual evoked potential is a useful, non-invasive investigation which can establish the central nervous system neuropathy in diabetes at an early stage of the disease. So Diabetic retinopathy can be prevented due to early detection of neuropathy by visual evoked potential test Keywords: Diabetes mellitus; diabetic retinopathy; visual evoked potential.

Association of ABO blood group with susceptibility to SARS-CoV-2 infection in Rupandehi district of Nepal.

Objectives: Recent studies after the outbreak of coronavirus disease 2019 have shown an association of the ABO blood group to the susceptibility of severe acute respiratory syndrome coronavirus 2 infection. Anti-A and anti-B antibodies, carbohydrate clustering, interleukin-6 levels and host transmembrane protease serine subtype 2 were suggested to cause the variable susceptibility of severe acute respiratory syndrome coronavirus 2 infection to the ABO blood groups. This study aims to find the association of the ABO blood group with severe acute respiratory syndrome coronavirus 2 infection susceptibility in Nepal. Methods: Population-based matched case-control study was conducted from October 2021 to February 2022 in Rupandehi district of Nepal. A total of 1091 reverse transcription-polymerase chain reaction confirmed coronavirus disease 2019 cases and 2182 controls were included in the study by convenient sampling method. Results: A statistically significant association of severe acute respiratory syndrome coronavirus 2 infection was observed for the blood group AB between cases and controls (11.5% vs 8.5%; odds ratio = 1.4, 95% confidence interval = 1.10-1.78). However, there was no association of severe acute respiratory syndrome coronavirus 2 infection for blood group A (26.7% vs 28.23%; odds ratio = 0.93, 95% confidence interval = 0.79-1.09), B (26.9% vs 29.84%; odds ratio = 0.86, 95% confidence interval = 0.73-1.02) and O (34.9% vs 33.41%; odds ratio = 1.07, 95% confidence interval = 0.92-1.25). Conclusion: This study reported slightly more susceptibility to severe acute respiratory syndrome coronavirus 2 infection among individuals with blood group AB.

Prevalence of occult hepatitis B among HIV-positive individuals in Africa: A systematic review and meta-analysis.

The prevalence of hepatitis B virus among HIV-seropositive individuals is believed to be high, and yet the disease remains neglected in many areas of the continent. Little is known about occult hepatitis in HIV individuals. This review assessed occult hepatitis B infection and its prevalence in the different regions of the African continent. It also determines its prevalence in the HIV population which is endemic in the region. Studies were searched from the Cochrane, google scholar, PubMed/Medline, and African Journals online. Authors included cross-sectional studies, case controls, and cohorts, from 2010 to January 2021, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses and Participants, Interventions, Comparisons, Outcomes, and Study design frameworks to develop the search strategy. All studies had participants who were HIV-positive, covering different regions of the continent. Risk ratio was used to measure effect size, and Stata 14 software was used for analysis. Eleven studies met the eligibility criteria, with 2567 participants. Overall prevalence of occult hepatitis B was 11.2%. Regional prevalence was 26.5% for the south, 11% for the north, 9.1% for the east, and 8.5% for the western region. Approximately 10% of HIV-seropositive individuals were co-infected with occult hepatitis B virus. Regionally, the prevalence was highest in the southern region and lowest in the west. The prevalence of occult HBV infection was compared between the southern region and the other regions. It was higher in the south compared to the east (risk ratio = 0.87, 95% confidence interval (0.83-0.91)). It was also higher in the south compared to the north (risk ratio = 0.82, 95% confidence interval (0.79-0.85)), and it was also higher in the south compared to the west (risk ratio = 0.85, 95% confidence interval (0.82-0.87)). Public health measures and interventions are required to raise awareness, increase prevention, and reduce spread of the disease. More evidence-based studies need to be carried out.