Examining social vulnerability to multi-hazards in North-Western Himalayas, India.

The enhancing risk from human action and multi-hazard interaction has substantially complicated the hazard-society relationship. The underlying vulnerabilities are crucial in predicting the probable impact to be caused by multi-hazards. Thus, the evaluation of social vulnerability is decisive in inferring the driving factor and preparing for mitigation strategies. The Himalayan landscape is prone to multiple hazards as well as possesses a multitude of vulnerabilities owing to changing human landscape. Thus, an attempt has been made to inquire into the underlying socioeconomic factors enhancing the susceptibility of the region to multi-hazards. The social vulnerability index (SVIent) has been introduced, consisting of 13 indicators and 33 variables. The variables have been standardized using the maximum and minimum normalization method and the relative importance for each indicator has been determined using Shannon entropy methods to compute SVIent. The findings revealed that female population, population above 60 years old, net irrigated area, migrant population, dilapidated house, nonworkers, bank, and nonworkers seeking jobs were found to be relatively significant contributors to the vulnerability. The western part of the study area was classified as the highly vulnerable category (SVI > 0.40628), attributed to high dependence, and higher share of unemployed workers and high poverty. The SVIent was shown to have positive correlation between unemployment, socioeconomic status, migration, dependency, and household structure significant at two-tailed test. The study's impact can be found in influencing the decision of policymakers and stakeholders in framing the mitigation strategies and policy documents.

Unusual non-infectious cause of meningitis.

Meningitis, though commonly caused by various infectious agents, may also have non-infectious aetiologies. The clinical presentation, however may be identical to infectious meningitis. We present a case of a female in her 50s who presented with fever, headache, vomiting and neck rigidity. She had features of inflammatory polyarthritis, cold sensitivity, puffy digits, alopecia and easy fatigability. No evidence of infection was found, and serological features consistent with mixed connective tissue disease (MCTD) were revealed, which led to the diagnosis of MCTD-related aseptic meningitis.

Dermatomyositis with positive anti-TIF1 gamma antibodies in an adult female: A case report.

Dermatomyositis is an uncommon autoimmune disease with only few cases reported from Nepal. Presence of anti TIF-1 gamma antibodies in DM are the strongest predictor of malignancy. Timely screening of malignancies for early detection and management remains the mainstay of this report.

Mechanoluminescence, thermoluminescence, optically stimulated luminescence and photoluminescence in SrAl2O4:Eu micro- and nanophosphors: effect of particle size and annealing in different atmospheres.

SrAl2O4:Eu in microcrystalline form was prepared by a combustion method. The formation of the material in a single phase was confirmed by XRD analysis. The material was crushed and sieved to get particles with different particle size ranges. It was further ball milled for 1-7 days to get particles in the nanosize ranges. The broadening of the XRD peaks of the phosphor material in nanocrystalline form was used to determine average particle sizes. The shapes and sizes of these particles could also be seen in FESEM images. The materials thus obtained were annealed in reducing (10% H2 in Ar) and oxidizing (in air) atmospheres at different temperatures for 1.0 h. The increase in the mechanoluminescence (ML) intensity on annealing in a reducing atmosphere at different temperatures and decrease on annealing in an oxidizing atmosphere could be attributed to redox reactions. This was further confirmed by PL measurements. Mechanoluminescence (ML), thermoluminescence (TL), and optically stimulated luminescence (OSL) of the materials were studied. In all three cases (i.e., ML, TL, and OSL), the intensities are found to decrease with the particle size. A large shift of approximately 20 °C in the main peak of TL glow curves of micro- and nanocrystalline materials shows a widening of the band gap due to the particle size effect. A decrease in piezoelectric constant (d33) and field (F V m-1) with particle size was also observed. The present systematic study of particle size effect (over a wide range of particle sizes) on ML has great importance from a technological and application point of view for developing stress sensors.

Groundwater potential mapping of Tawi River basin of Jammu District, India, using geospatial techniques.

The demand for water is increasing around the world due to population growth, urbanization, industrialization, etc., which is making groundwater a vital natural resource for meeting the growing demand for water. According to the central groundwater report, Jammu district has adequate groundwater potential (GWP) and comes under the safe category. However, the GWP has not been fully utilized, thereby leading to a water shortage in the district. Therefore, this study has been designed to examine the GWP zones in the Tawi River basin of Jammu district using geospatial techniques. For this, several GWP conditioning parameters, such as elevation, slope, geology, geomorphology, rainfall, soil, land use/land cover, topographic wetness index (TWI), drainage density, lineament density, roughness, and curvature, were utilized. The analytical hierarchy process (AHP) technique was used to evaluate the weights of the selected criteria after a pair-wise comparison of each criterion with the rest of the criteria. The result showed that the high GWP zone accounts for 21.98% of the area, the moderate zone covers an area of 40.54%, the low GWP area accounts for about 34.91%, and only 2.57% of the area lies under the very low GWP zone. The validation of GWP zones using 25 monitoring wells showed an accuracy of 80% in GWP modeling. The findings of this study may be utilized in meeting the rising demand for water in the region.

Spondyloarthropathy - Is sacroiliac joint imaging sufficient? A study of 431 patients.

BACKGROUND: Sacroiliac (SI) joint involvement (sacroiliitis) is considered as major criteria for diagnosing Spondyloarthropathy (SpA), although involvement of spine and hip can also occur. The aim of our study was to assess the utility of including sagittal short-tau inversion recovery (STIR) sequence of dorsolumbar spine and coronal STIR/proton density (PD) fat saturated sequence through both hips, to routine SI joint magnetic resonance (MR) imaging protocol, in patients clinically suspected to have SpA. MATERIAL AND METHODS: A retrospective observational study was conducted between February 2013 and February 2018 on clinically suspected SpA patients referred to our department for imaging. The images obtained using this new SI joint protocol were evaluated for findings suggesting SpA diagnosis as per the Assessment of SpondyloArthritis international Society criteria. Other differentials for similar symptoms were also looked for. RESULTS: Of the 431 patients (313 M and 118 F), 255 had features confirming the diagnosis of SpA and 176 had no radiological manifestations of SpA (56 were normal and 120 had other findings to suggest clinical symptoms; e.g., degenerative SpA, Pott's spine, skeletal metastases, early AVN of hip, cysticercus, iliofemoral impingement). 19/255 patients had normal SI joints but other findings to suggest diagnosis of SpA, e.g. romanus lesions, costovertebritis/costotransversitis, pubic symphysitis, inflammatory hip arthropathy, enthesitis, iliofemoral/trochanteric bursitis. 33/61 patients with chronic sacroiliitis had disease activity in spine or hip. CONCLUSION: Inclusion of sections through dorsolumbar spine and both hips to routine SI joint protocol, helped in identifying: (a) early disease in 19 patients, who had normal SI joints and may have otherwise been missed with routine only SI joint imaging, (b) additional findings in SpA-related sacroiliitis, (c) disease activity in chronic sacroiliitis, and (d) other causes of low back pain and thus helped in further patient management.

Relationship between total serum immunoglobulin E levels, fractional exhaled breath nitric oxide levels and absolute blood eosinophil counts in atopic and non-atopic asthma: a controlled comparative study.

OBJECTIVE: Asthma is a prevalent non-communicable disease both in low- and high-income countries, including Nepal. Total serum immunoglobulin E levels and peripheral blood absolute eosinophil counts are known inflammatory markers of asthma. Fractional exhaled nitric oxide measurement in breath has also been proposed as a non-invasive biomarker to assess eosinophilic airway inflammation. This study explores the correlation between these three variables with the intent that one may replace the other in resource-limited setups. APPROACH: This prospective controlled trial evaluated 314 subjects with and without asthma, with the asthma group sub-divided into atopic and non-atopic categories. Total serum immunoglobulin E level, absolute eosinophil count in peripheral blood and fractional exhaled nitric oxide level were measured in all categories. RESULTS: The geometric mean of immunoglobulin E levels, absolute eosinophil count and fractional exhaled nitric oxide were 221.07 ± 774.55 IU/mL, 214 ± 360/uL and 37 ± 49 ppb in the asthma group and 59.13 ± 174.32 IU/mL, 164 ± 137/uL and 12 ± 21 ppb in the control group, respectively. Significantly higher levels were seen in the asthma group for total serum immunoglobulin E (p < 0.001), AEC (p = 0.002) and FENO (p < 0.001) levels. Total serum immunoglobulin E levels, absolute eosinophil count and fractional exhaled nitric oxide were 436.79 ± 822.40 IU/mL, 269 ± 395/uL and 76 ± 52 ppb in atopic asthma group. Similarly, total serum immunoglobulin E levels, absolute eosinophil count and fractional exhaled nitric oxide were 131.17 ± 692.96 IU/mL, 182 ± 328/uL and 23 ± 22.5 ppb in non-atopic asthma group. Significantly higher levels were seen in all three variables: tIgE (p < 0.001), AEC (p =  0.008) and FENO (p < 0.001). A moderate degree of positive correlation was identified between tIgE and FENO50 (Spearman's rho = 0.461) and tIgE and AEC (Spearman's rho = 0.315) with only small correlation between FENO50 and AEC (Spearman's rho = 0.299). SIGNIFICANCE: tIgE levels, FENO50 and AEC levels are higher in asthma, specifically in the atopic phenotype, as compared to normal. Total serum IgE levels have moderate correlation with FENO50 and AEC but FENO50 and AEC are weakly correlated.

Comparison of fractional exhaled nitric oxide levels in chronic obstructive pulmonary disease, bronchial asthma and healthy subjects of Nepal.

INTRODUCTION: Fractional exhaled nitric oxide levels in exhaled breath can indicate ongoing eosinophilic airway inflammation, specifically in asthma. But its utility is being explored for central airway inflammations, including chronic obstructive pulmonary disease. Normal levels of fractional exhaled nitric oxide (FENO50) have been defined in different studies but not in Nepal. This study compares FENO50 levels in normal subjects, asthma and chronic obstructive pulmonary disease. METHODS: Single breath estimation of FENO50 was measured by a handheld electrochemical sensor-based device in normal non-smoking adults (n = 106), clinically controlled asthma (n = 106) and stable chronic obstructive pulmonary disease (n = 106). RESULTS: The geometric mean for FENO50 was 14 parts per billion (ppb) with a median of 16 ppb, first quartile at 11 ppb and third quartile at 20 ppb in normal non-smoking adults. The values were 31 ppb (geometric mean), 34 ppb (median), 17 ppb (first quartile) and 79 ppb (third quartile) in clinically controlled asthma. Similarly the values were 10 ppb (geometric mean), 11 ppb (median), 6 ppb (first quartile) and 17 ppb (third quartile) in stable chronic obstructive airway disease. The log-transformed data showed significantly higher FENO50 levels in the asthma group compared with the normal (p < 0.001) and chronic obstructive airway disease (p < 0.001). However, levels were similar between healthy and chronic obstructive airway disease groups (p = 0.08). CONCLUSIONS: FENO50 levels were higher in bronchial asthma (despite disease control) than in normal non-smoking adults and subjects with stable chronic obstructive pulmonary disease. Levels of FENO50 were similar between the chronic obstructive airway disease and normal groups.