Demographics and diagnoses at rural health camps in Nepal: cross-sectional study.

BACKGROUND: The charity 'Health Partnership Nepal' is committed to both improving global health care and providing medical training links between Nepal and the UK. This paper analyses data gathered at rural health camps. AIM: To describe the demographics, diagnoses and treatments offered to people attending three rural health camps in Nepal during 2009. Design Cross-sectional study. Setting Three free health care camps established within the Nuwakot district of Nepal during April-May 2009. Camps were staffed by doctors including GPs, nurses and medical students from London and Kathmandu. METHODS: Attendees had treatment sheets completed which recorded their demographics, diagnoses and dispensed medications. RESULTS: The mean age of the 1903 consecutive patients attending was 42.8 years (range one month to 98 years) of whom 68.6% were female and 13.7% were children. The majority, 82.3%, were agricultural workers. For adults (n = 1574), the most frequent complaints were stomach pain 20.1%, musculoskeletal pain 19.3% and visual acuity problems 6.1%. Stomach pain was significantly more common in women than men [21.2% (236/1064) versus 14.5% (65/449) P < 0.01]. For children (n = 249), the most common diagnoses were helminthiasis 10.4%, conjunctivitis 7.6% and upper respiratory tract infection 7.2%. Overall, opthalmological, gastroenterological and rheumatological diagnoses were significantly more common in Nepalese than UK general practice patients. Of 1109 recorded prescriptions, the most common were multivitamins 23%, oral analgesics 15% and oral antibiotics 14%. CONCLUSIONS: There is a considerable unmet disease burden within rural districts of Nepal particularly for stomach pain, musculoskeletal pain and visual acuity problems. When planning similar rurally based health camps, we recommend recruiting GPs and ophthalmologists.

aPKC, Crumbs3 and Lgl2 control apicobasal polarity in early vertebrate development.

In early vertebrate development, apicobasally polarised blastomeres divide to produce inner non-polarised cells and outer polarised cells that follow different fates. How the polarity of these early blastomeres is established is not known. We have examined the role of Crumbs3, Lgl2 and the apical aPKC in the polarisation of frog blastomeres. Lgl2 localises to the basolateral membrane of blastomeres, while Crumbs3 localises to the apical and basolateral membranes. Overexpression aPKC and Crumbs3 expands the apical domain at the expense of the basolateral and repositions tight junctions in the new apical-basolateral interface. Loss of aPKC function causes loss of apical markers and redirects basolateral markers ectopically to the apical membrane. Cell polarity and tight junctions, but not cell adhesion, are lost and outer polarised cells become inner-like apolar cells. Overexpression of Xenopus Lgl2 phenocopies the aPKC knockout, suggesting that Lgl2 and aPKC act antagonistically. This was confirmed by showing that aPKC and Lgl2 can inhibit the localisation of each other and that Lgl2 rescues the apicalisation caused by aPKC. We conclude that an instrumental antagonistic interaction between aPKC and Lgl2 defines apicobasal polarity in early vertebrate development.