Association of Previous Smoking Habit and Perceived Social Discrimination with the Risk of Multi-Drug Resistant Tuberculosis in Central Nepal

BACKGROUND

Multidrug-resistant tuberculosis (MDR TB) caused by Mycobacterium tuberculosis resistant to both Isoniazid and Rifampicin with or without resistant to other drug, is among the most alarming pandemic problem. The objectives of this study was to assess the risk factors of MDR TB in Central Nepal.

METHODS

A matched case control study was conducted among 186 cases of MDR TB and 372 non-MDR TB controls from central region of Nepal. Pretested questionnaires containing socio-economic, cultural & behavioral; environmental, biological and health service factors were used. Variables significant in bivariate analysis were entered in multiple regression models for further analysis.

RESULTS

After adjusting for confounders, previous smoking habit (aOR= 4.5,(95%CI(1.24-16.2)) (p=0.04), and perceived social discrimination (aOR=5.83,95%CI (1.77-19.71)) (P=0.021) independently predicted greater MDR TB risk.

CONCLUSIONS

Encouraging MDR TB cases for smoking cessation through awareness activities should be a priority. Stigma reduction programs should include the empowerment of patients and communities while promoting TBrelated research for further exploration into the risk factors of TB and associated stigma.

A study of assessment of partial edentulous patients based on Kennedy's classification at Dhulikhel Hospital Kathmandu University Hospital

BACKGROUND

Oral health contributes significantly towards quality of life(QOL). Edentulousness falls in a special category among the various conditions of dental origin. Dietary intake and nutritional status is affected by poor oral health and loss of teeth. This will ultimately compromise general health.

OBJECTIVE

To identify the frequency of Kennedy's classification among partial edentulous patients and to compare occurrence among gender and between upper and lower arches and also to compare edentulousness among employed and unemployed population.

METHODS

This study was carried out at Dhulikhel Hospital Dental Department. The study was conducted randomly among 194 patients in dental OPD who were partially edentulous. A structured pro forma was used to find out the edentulousness based on Kennedy,s classification.

RESULTS

Among the Kennedy's classification ClassIII was found to be most common. Among them females and unemployed group were found to have more edentulousness and upper arch was more common. It was also found that females were more conscious and get the replacement of missing teeth among which those having Class IV missing were replaced most often.

CONCLUSION

The Kennedy Class III partial edentulousness type is most commonly found in this study.

Depression among undergraduate medical students

BACKGROUND

Psychological stress is common in medical school and associated with depression. Medical education is grooming in Nepal, but only few studies are done concerning mental health of medical students.

OBJECTIVE

To assess the prevalence of depression among medical students at different levels of education and find about their stressors.

METHODS

A cross sectional, questionnaire-based survey was carried out among the undergraduate medical students of B.P.Koirala Institute of Health Sciences, Nepal. 50 students each from Bachelor of Medicine and Bachelor of Surgery (MBBS) first and third year were enrolled in the study conducted between November 2008 to January 2009. The depression levels were assessed using Zung depression scale. Students were asked to complete the questionnaire and then the depression levels calculated .The stress inducing factors during their course of medical education were also assessed.

RESULTS

The overall prevalence of depression among the students was 29.78 percent. The prevalence of depression in first and third year was 36.74and 22.22 percent respectively. The prevalence of depression was 32.43 percent among female students versus 28.07 percent in male students. Both first and third year students gave high ratings to academic stress and hectic lifestyle as the main stress inducing factors.

CONCLUSION

The prevalence of depression is seen especially in the first year medical students. So, attempts should be made to alleviate the stressors right from the time they join medical school. Since academic stress proved to be one of the major factors, measures to make the academic curriculum more student-friendly are suggested.

Community attitudes towards leprosy affected persons in Pokhara municipality of western Nepal

BACKGROUND

Stigma is a social process of interpretation of an attribute. Leprosy has been seen as the epitome of stigmatization. The psychosocial impact a person has to bear in a society after the diagnosis weighs heavier than the physical afflictions it causes, which does not get cured with the mere medical treatment. There are various factors which construct the perception of stigma in both leprosy affected persons and unaffected persons. The main purpose of this study was to determine the level of perceived stigma and the risk factors contributing to it among community people living in ward 15, Pokhara municipality.

METHODS

Cross-sectional descriptive study among 281 community people above the age of 18 years was conducted. Two sets of questionnaire form with additional Explanatory Model Interview Catalogue (EMIC) for each individual were used.

RESULTS

Among 281 community people, the median score of perceived stigma was 12 while it ranged from 0-30. Ethnic groups, Brahmins, Dalits and minorities had highest perceived stigma score of 15 and above compared to the rest (p=0.001), community people living at the distance more than 2 km had highest perceived stigma score of 15 compared to those living closer to the hospital (p=0.019) and nuclear family had highest perceived stigma score of 15 compared to the joint family (p=0.014). People who lacked information on leprosy had higher score of perceived stigma compared to those who had information on leprosy (p=0.002).Similarly, those who perceived leprosy to be difficult to treat (p<0.001) and a severe disease (p<0.001) had highest score of perceived stigma.

CONCLUSIONS

Stigma in leprosy was found highly associated with the lack of information about leprosy and their perception in treatment and disease severity. Stigma reduction strategies should focus on health education, targeting to alleviate their perception about the disease with their active participation.

The inactivation kinetics of polyphenol oxidase in mushroom (Agaricus bisporus) during thermal and thermosonic treatments

The effect of thermal and thermosonic treatments on the inactivation kinetics of polyphenol oxidase (PPO) in mushroom (Agaricus bisporus) was studied in 55-75°C temperature range. In both the processes, the inactivation kinetics of PPO followed a first-order kinetics (R(2)=0.941-0.989). The D values during thermal inactivation varied from 112±8.4min to 1.2±0.07min while they varied from 57.8±6.1min to 0.88±0.05min during thermosonic inactivation at the same temperature range. The activation energy during thermal inactivation was found to be 214±17kJ/mol, while it was 183±32kJ/mol during thermosonic inactivation. The inactivating effect of combined ultrasound and heat was found to synergistically enhance the inactivation kinetics of PPO. The D values of PPO decreased by 1.3-3 times during thermosonic inactivation compared to the D values of PPO during thermal inactivation at the temperature range. Therefore, thermosonication can be further developed as an alternative to "hot break" process of mushroom.

Physicochemical and functional characteristics of lentil starch

The physicochemical properties of lentil starch were measured and linked up with its functional properties and compared with those of corn and potato starches. The amylose content of lentil starch was the highest among these starches. The crystallinity and gelatinization enthalpy of lentil starch were the lowest among these starches. The high amylose: amylopectin ratio in lentil starch resulted into low crystallinity and gelatinization enthalpy. Gelatinization and pasting temperatures of lentil starch were in between those of corn and potato starches. Lentil starch gels showed the highest storage modulus, gel strength and pasting viscosity than corn and potato starch gels. Peleg's model was able to predict the stress relaxation data of these starches well (R(2)>0.98). The elastic modulus of lentil starch gel was less frequency dependent and higher in magnitude at high temperature (60 °C) than at lower temperature (10 °C). Lentil starch is suitable where higher gel strengthened pasting viscosity are desired.

Composition analysis and material characterization of an emulsifying extracellular polysaccharide (EPS) produced by Bacillus megaterium RB-05: a hydrodynamic sediment-attached isolate of freshwater origin

AIMS

This work was aimed to isolate, purify and characterize an extracellular polysaccharide (EPS) produced by a freshwater dynamic sediment-attached micro-organism, Bacillus megaterium RB-05, and study its emulsifying potential in different hydrocarbon media.

METHODS AND RESULTS

Bacillus megaterium RB-05 was found to produce EPSs in glucose mineral salts medium, and maximum yield (0.864 g l(-1) ) was achieved after 24-h incubation. The recovery rates of the polysaccharide material by ion-exchange and gel filtration chromatography were around 67 and 93%, respectively. As evident from HPLC and FT-IR analyses, the polysaccharide was found to be a heteropolymer-containing glucose, galactose, mannose, arabinose, fucose and N-acetyl glucosamine. Different oligosaccharide combinations namely hexose(3), hexose(4), hexose(5) deoxyhexose(1) and hexose(5) deoxyhexose(1) pentose(3) were obtained after partial hydrolysis of the polymer using MALDI-ToF-MS. The polysaccharide with an average molecular weight of 170 kDa and thermal stability up to 180°C showed pseudoplastic rheology and significant emulsifying activity in hydrocarbon media.

CONCLUSIONS

Isolated polysaccharide was found to be of high molecular weight and thermally stable. The purified EPS fraction was composed of hexose, pentose and deoxyhexose sugar residues, which is a rare combination for bacterial polysaccharides. Emulsifying property was either better or comparable to that of other commercially available natural gums and polysaccharides.

SIGNIFICANCE AND IMPACT OF THE STUDY

This is probably one of the few reports about characterizing an emulsifying EPS produced by a freshwater sediment-attached bacterium. The results of this study contribute to understand the influence of chemical composition and material properties of a new microbial polysaccharide on its application in industrial biotechnology. Furthermore, this work reconfirms freshwater dynamic sediment as a potential habitat for bioprospecting extracellular polymer-producing bacteria. This study will improve our knowledge on the exploitation of a nonconventional renewable resource, which also seems to be ecologically significant.

Arsenate exposure affects amino acids, mineral nutrient status and antioxidants in rice (Oryza sativa L.) genotypes

Simulated pot experiments were conducted on four rice (Oryza sativa L.) genotypes (Triguna, IR-36, PNR-519, and IET-4786) to examine the effects of As(V) on amino acids and mineral nutrient status in grain along with antioxidant response to arsenic exposure. Rice genotypes responded differentially to As(V) exposure in terms of amino acids and antioxidant profiles. Total amino acid content in grains of all rice genotypes was positively correlated with arsenic accumulation. While, most of the essential amino acids increased in all cultivars except IR-36, glutamic acid and glycine increased in IET-4786 and PNR-519. The level of nonprotein thiols (NPTs) and the activities of superoxide dismutase (SOD; EC 1.15.1.1), glutathione reductase (GR; EC 1.6.4.2) and ascorbate peroxidase (APX; EC 1.11.1.11) increased in all rice cultivars except IET-4786. A significant genotypic variation was also observed in specific arsenic uptake (SAU; mg kg(-1)dw), which was in the order of Triguna (134) > IR-36 (71) > PNR-519 (53) > IET-4786 (29). Further, application of As(V) at lower doses (4 and 8 mg L(-1) As) enhanced the accumulation of selenium (Se) and other nutrients (Fe, P, Zn, and S), however, higher dose (12 mg L(-1) As) limits the nutrient uptake in rice. In conclusion, low As accumulating genotype, IET-4786, which also had significantly induced level of essential amino acids, seems suitable for cultivation in moderately As contaminated soil and would be safe for human consumption.

Arsenic affects mineral nutrients in grains of various Indian rice (Oryza sativa L.) genotypes grown on arsenic-contaminated soils of West Bengal

The exposure of paddy fields to arsenic (As) through groundwater irrigation is a serious concern that may not only lead to As accumulation to unacceptable levels but also interfere with mineral nutrients in rice grains. In the present field study, profiling of the mineral nutrients (iron (Fe), phosphorous, zinc, and selenium (Se)) was done in various rice genotypes with respect to As accumulation. A significant genotypic variation was observed in elemental retention on root Fe plaque and their accumulation in various plant parts including grains, specific As uptake (29-167 mg kg(-1) dw), as well as As transfer factor (4-45%). Grains retained the least level of As (0.7-3%) with inorganic As species being the dominant forms, while organic As species, viz., dimethylarsinic acid and monomethylarsonic acid, were non-detectable. In all tested varieties, the level of Se was low (0.05-0.12 mg kg(-1) dw), whereas that of As was high (0.4-1.68 mg kg(-1) dw), considering their safe/recommended daily intake limits, which may not warrant their human consumption. Hence, their utilization may increase the risk of arsenicosis, when grown in As-contaminated areas.

Fair and sustainable irrigation water management in the Babai basin, Nepal

This paper attempts to find a strategy to provide year-round irrigation for cultivating three crops per year in the southern plains of the country taking a case study of the Babai basin. Despite having enough flows during the summer for growing rice in total 27,000 ha area, the dry season flows of the Babai river can irrigate only 6,300 ha in winter and 4,000 ha in spring limiting the cropping intensity to 138.50%. It is proposed to irrigate the 7,500 ha southern dry area at the right bank bringing water from a large snow-fed river: the Karnali. Water balance study of the three irrigation regions to be irrigated from the Babai source preserving their existing water rights showed that the year-round irrigation at the west with the proposed arrangement will fall short of only 13.9 million m(3) water volume. At the east side, the head reach area and the tail portion will fall short of 19.4 and 66.4 million m(3) of water to insure a cropping intensity of 250%. The deficits can be fulfilled by means of capturing the excess river water of rainy season in local reservoirs and by making conjunctive use of groundwater. The proposed solution is financially, environmentally and socially viable being a cost effective, user friendly and should be the linchpin towards attaining a sustainable year-round irrigation in the region.

Appropriate rehabilitation strategy for a traditional irrigation supply system: a case from the Babai area in Nepal

This paper studies primary canals of three traditional irrigation systems in the southern plains of Nepal. It offers a scientific interpretation of the indigenous technology applied to the systems, which facilitates to use the same channel network for irrigation, drainage and flood management. The flood management technology of the farmers by diverting as much discharge as possible to the field channels results in the reduction of discharge towards the downstream part of the main channel. It is depicted in the simulation study that uses the river analysis program HEC-RAS 4.0. A cascade of weirs is found to be the most cost effective and user-friendly option to upgrade these systems preserving the existing irrigation, drainage as well as flood management functions. This study suggests that the conventional irrigation design principles should be applied very cautiously with full knowledge of the existing socio-institutional setting, hydro-ecological regime and indigenous technology for upgrading any traditional irrigation system successfully. The indigenous flood management technology strengthens the emerging concept that the floods in the Ganges plain are to be managed, not controlled.

Prevalence and clonal diversity of Campylobacter jejuni from dairy farms and urban sources

AIM

To investigate the role of free-living animals such as sparrows, rodents and flies as potential reservoirs of Campylobacter spp on a dairy farm, and to assess the genetic diversity among Campylobacter isolates from the farm and an urban source.

METHODS

A total of 290 samples (bovine, passerine and rodent faeces, and whole flies) were collected from a large commercial dairy farm in the Manawatu district in New Zealand, and from faeces from urban sparrows in a nearby city. Other samples collected from the dairy farm included five from silage, two from aprons worn by workers during milking, two from workers' boots and two from water in troughs in a paddock. Isolates of thermophilic Campylobacter spp were identified morphologically and phenotypically and further characterised molecularly using pulsed-field gel electrophoresis (PFGE) and the restriction enzyme SmaI.

RESULTS

Campylobacter jejuni was the only Campylobacter species isolated from all samples. The highest prevalence was found in faeces from dairy cows (54%), followed by faeces from sparrows from the urban area (40%) and the farm (38%), and from rodents (11%) and whole flies (9%). Other samples from the farm environment such as silage, trough water, and workers' aprons and boots were also positive for C. jejuni. Of the 22 restriction patterns obtained, seven were common to more than one source.

CONCLUSIONS

Cattle, sparrows, rodents and flies are potential reservoirs of C. jejuni on dairy farms. Identical clones of C. jejuni carried by cattle, sparrows, flies and rodents probably indicate a common source of infection. The high level of asymptomatic carriage of C. jejuni by healthy dairy cows could be sufficient to maintain infections within the dairy farm surroundings via environmental contamination.