Browsing by Author "Dhimal, Meghnath"
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Publication Advancing Health and Population Research and Innovations for Achieving Sustainable Development Goals in Nepal(Nepal Health Research Council, 2024) Dhimal, Meghnath; Joshi, PramodNAPublication Compliance with the Legal Provision of Tobacco Products in Nepal Authors(Nepal Health Research Council, 2024) Dhimal, Meghnath; Khatri, Bishal Dahal; Basnet, Man Bahadur; Ghimire, Sailaja; Ghimire, Namita; Acharya, Astha; Rana, Nisha; Joshi, PramodBackground: The tobacco epidemic is one of the major threats to public health, causing nearly 8 million deaths annually worldwide. In Nepal, every year, several Nepalese people die from tobacco-related diseases illnesses. Despite the implementation of several policies and strategies, tobacco use remains prevalent. This study, thus, aims to assess compliance with the legal provisions regulating tobacco products in Kathmandu Valley. Methods: A multimethod study design was adopted to explore compliance with the legal provision of tobacco products in the Kathmandu Valley. Three hundred and five public places within the Kathmandu Valley were observed using the observation checklist, and fourteen key informant interviews were conducted. The ethical approval was obtained from the Ethical Review Board of the Nepal Health Research Council. Results: Our findings show that the average adherence to the Tobacco Product Control Act in the Kathmandu Valley was merely 33.1%. Public transportation exhibited highest compliance 53.2%, whereas eateries demonstrated the lowest compliance at 15.9%. Health organizations demonstrated the highest adherence to prohibiting indoor smoking (94.7%), although the presence of “No Smoking” signage was inadequate, varying from 1.9% to 22.7% across various locations. Conclusions: In conclusion, compliance with the legal provision of tobacco products was observed owing to limited knowledge of stakeholders, inadequate multi-sectoral coordination, and lack of monitoring mechanisms in public areas. Whereas awareness initiatives through diverse communication channels are found effective in improving compliance. Keywords: Compliance; legal provision; Nepal; public places; tobacco products.Publication Genomic analysis of SARS-CoV-2 Circulating during Second and Third Wave of COVID-19 in Nepal(Nepal Health Research Council, 2023) Tamrakar, Dipesh; Katuwal, Nishan; Adhikari, Navin; Madhup, Surendra Kumar; Dhimal, Meghnath; Shrestha, RajeevAbstract Background: In Nepal, since the first detection of COVID-19 case in January 2020, the total cases have rose to almost a million with more than 12,000 deaths. Till now, WHO has classified 5 variants of SARS-Cov2 as variant of concerns at different time points causing many waves in different countries and regions at different time points. Nepal had also faced three distinct waves of COVID-19 caused by different variant of COVID 19. The objective of this study was to perform whole-genome sequencing of SARS-CoV-2 circulating in different waves of COVID-19 in Nepal and investigate its variant or lineage. Methods: In this study, samples from 49 SARS-CoV-2 infected subjects from May 2021 to January 2022, were investigated. The methodology followed RNA extraction, real-time PCR for confirmation and whole-genome sequencing. The consensus genomes were interpreted with appropriate bioinformatics tools and databases. Results: Sequence analysis of 49 genomes revealed to be of Delta (n=27) and Omicron Variant (n=22). The mutations in the consensus genomes contained the defining mutations of the respective lineages/variants. There were 20 genomes of Omicron sub-lineage BA.2, 1 of BA.1.1 and 1 of B.1.1.529. Conclusions: This study provides concise genomic evidence of presence of Delta and Omicron variant of COVID-19 in Nepal. Delta and Omicron variants were driving the second wave and the third wave of COVID-19 respectively in Nepal. Therefore, the genomic surveillance must be increased to clearly map out the pandemic and strategize vaccination approaches in the country. Keywords: COVID-19; delta, omicron; Nepal;SARS-CoV-2; whole-genome sequencingPublication Prevalence of Coronary Artery Disease among Adults in Nepal(Nepal Health Research Council, 2024) Karki, Khem Bahadur; Poudyal, Anil; Dhimal, Meghnath; Muller, Ruth; Groneberg, David ABackground: Coronary Artery Disease is a leading cause of death and a major disorder affecting the heart and blood vessels. The aim of this study is to estimate the prevalence of Coronary Artery Disease and its associated risk factors in Nepal. Methods: This population-based descriptive cross-sectional survey involved 12,557 participants aged 20 years and older, selected through a multistage stratified cluster sampling method. Data on demographics and risk factors were collected via face-to-face interviews, physical examinations, and laboratory tests. The association of different variables with Coronary Artery Disease outcomes was assessed using descriptive statistics. Results: The prevalence of definite Coronary Artery Disease among Nepalese adults aged 20 years and older was found to be 0.5% (95% CI: 0.3-0.7). Possible Coronary Artery Disease had a prevalence of 2.1% (95% CI: 1.6-3.4), and probable Coronary Artery Disease had a prevalence of 0.3% (95% CI: 0.2-0.4). Higher prevalence rates were observed among older individuals, urban residents, those with higher education levels, males, and participants with hypertension, diabetes, and elevated total cholesterol levels. Conclusion: This study represents the first comprehensive national population-based assessment of Coronary Artery Disease in Nepal. The findings indicate a significant burden of Coronary Artery Disease and its risk factors among the adult population. Addressing the high prevalence of Coronary Artery Disease and its risk factors requires both individual and population-level interventions. Keyword: Coronary arterial disease; Nepal; prevalence.