Journal Issue: Vol. 22 No. 04 (2024): Issue 65 Oct-Dec
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1999-6217
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Equity and Justice: An Agenda of Ethics in Health Research
(Nepal Health Research Council, 2024) Onta, Sharad
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Assessment of Skin Carotenoids among School Children
(Nepal Health Research Council, 2024) Thapa, Raba; Ruit, Sanduk; Bernstein, Paul S
Background: This study aimed to assess skin carotenoid measurement among children in the Hill region of Nepal.
Methods: School children between 3 to 7 years old from six schools were enrolled in the study. Skin carotenoid levels were assessed using the Veggie Meter® (Longevity Link Corporation, Salt Lake City, Utah, USA). Detailed eye evaluations were conducted in subjects with low skin carotenoid scores (<150 Reflectance Units(RU)) and/or those with a history of night blindness.
Results: A total of 324 school children were enrolled in the study with mean age of 5.12±1.33 years. The mean skin carotenoid score was 163±71 RU, ranging from 1 to 363 RU. The skin carotenoid level was <150 RU in 46.9% of children and between 150 and 200 RU in 23.5% of children. Low skin carotenoid scores (<150 RU) were found in 17% of 3 year olds, 28.3% each of 4 and 5 year olds, 20.4% of 6 year olds, and 11.2% of 7 year olds. In multivariate analysis, age was significantly associated with low skin carotenoid scores (p=0.003; OR; 2.02; 95% CI: 1.28- 3.19). Odds of having <150 RU was 2.02 times more among the children up to five years old as compared to those over five years of age.
Conclusions: Nearly half of the school children had low skin carotenoid scores. Skin carotenoid score was significantly lower among the lower age group. These findings emphasize the need to enhance awareness to consume plenty of green leafy vegetables and fruits in the diet.
Keywords: Children; Nepal; skin carotenoid; veggie meter; vitamin A.
Multidrug-Resistance and Biofilm Formation among Acinetobacter baumannii Isolated from Clinical Specimens
(Nepal Health Research Council, 2024) Yadav, Poonam; Mishra, Shyam Kumar; Shrestha, Sreska; Sah, Ranjit; Rai, Junu Richhinbung; Kattel, Hari Prasad; Sharma, Sangita; Willcox, Mark
Background: Acinetobacter baumannii has emerged as a problematic pathogen due to its ability to become resistant to antibiotics and form biofilms. The aim of this study was to explore antibiotic resistance and biofilm formation, and examine any correlation between these in Acinetobacter baumannii isolates.
Methods: This was a cross-sectional study conducted at the 750-bed Tribhuvan University Teaching Hospital in Nepal. Identification and antibiotic sensitivity of Acinetobacter baumannii isolates were performed following American Society for Microbiology guidelines. Different ?-lactamases were detected by standard phenotypic tests. The microtiter plate method was used to screen strains of their ability to form biofilms.
Results: Out of total 18,343 clinical samples processed, 4,249 (23.1%) showed bacterial growth. A. baumannii comprised of 4.7% of the total bacterial growth. Multidrug-resistant (MDR) was exhibited by 97.5% of Acinetobacter baumannii isolates. All multidrug-resistant Acinetobacter baumannii isolates were resistant to cephalosporins and carbapenems; however, they were sensitive to polymyxins. Only few isolates showed sensitivity to sulbactam-containing antibiotics (15.4-29.2%), fluoroquinolones (1.0-7.2%), aminoglycosides (2.6-5.6%), and cotrimoxazole (4.1%). Extended-spectrum-beta-lactamase (ESBL), metallo-beta-lactamase (MBL), Klebsiella pneumoniae carbapenemase (KPC) and AmpC production were found in 54.9%, 73.3%, 41.5% and 14.9% isolates, respectively. Among all tested isolates, 192 were able to produce biofilms, with 83.1% being classified as strong biofilm producers. Those strains that were resistant to gentamicin were more likely to produce biofilms (P<0.05). ESBL, MBL, KPC and AmpC were seen in 51.8%, 71.6%, 43.8% and 16.0% of strong biofilm producers respectively.
Conclusions: Only polymyxins were effective against Acinetobacter baumannii. Carbapenemase producers were generally strong biofilm producers, and gentamicin resistant strains were more likely to produce biofilms. The findings of this study may help to understand antibiotic-resistance mechanisms and provide valuable information in the treatment of MDR Acinetobacter baumannii infections.
Keywords: Acinetobacter baumannii, biofilm, carbapenemase; multidrug-resistant.
Sonography as an Adjunct to Digital Mammography in Patients with Dense Breasts
(Nepal Health Research Council, 2024) Jha, Anamika; Regmi, Pradeep Raj; Pradhan, Huney; Thakur, Minaxi; Joshi, Birendra Raj
Background: Dense breasts are associated with an increased risk of cancer and also mask lesions on mammograms. In our study, we evaluated the role of sonography as an adjunct to digital mammography in patients with dense breasts.
Methods: Sonography of 676 female patients with American College of Radiology category C or D mammographic density was done in this prospective cross-sectional analytical study in the Department of Radiology, Tribhuvan University Teaching Hospital. The final imaging diagnosis was classified as per the American College of Radiology Breast Imaging Reporting and Data System categories. Tissue diagnosis was obtained in patients with sonographic category 3 solid lesions larger than 3 cm, category 4 and 5 lesions. The data were tabulated and analyzed using Statistical Package for Social Service (SPSS) for Windows version 22.
Results: Additional sonography confirmed all BIRADS 1 mammograms as normal or benign, 95.7 % (112) of inconclusive, and 82.8% (n=135) of BIRADS 3 ones as benign. It had higher sensitivity and negative predictive value (100%) than mammography with similar accuracy. Most patients (479, 70.9%) had diagnostic indications. There were 540 (79.9%) cases in ACR BIRADS category c. A final diagnosis of benign (316, 46.7%) was most common, followed by normal (293, 43.4%) and malignant (67, 9.9%). The majority of the malignant lesions were Invasive Ductal Carcinoma (59, 88%).
Conclusions: Additional sonography confirmed mammography findings as normal, benign, or suspicious for malignancy, definitely described morphology and extent of mass, and also guided biopsy. It had higher sensitivity than mammography in dense breasts.
Keywords: Breast density; mammography; ultrasonography mammary.
Social Anxiety and its Associated Factors among Secondary School Adolescents of Kathmandu Metropolitan, Nepal
(Nepal Health Research Council, 2024) Tamang, Dichhen; Ram Bhandari, Tulsi
Background: Social anxiety is an intense anxiety or fear of being judged, negatively evaluated, or rejected in a social situation. It often develops in early adolescence, which eventually grows up to adulthood, mostly without being diagnosed. This study assessed the prevalence and factors associated with social anxiety in secondary school adolescents.
Methods: School-based cross-sectional study design was performed among secondary school adolescents of 10 schools in Kathmandu Metropolitan, Nepal. A total of 360 samples were obtained through multi-stage random sampling using the lottery method. A self-administered questionnaire was used as a data collection tool which included the Liebowitz social anxiety scale for children and adolescents. Data entry and analysis were done by using Epi Data and Statistical Package for Social Science (SPSS) software.
Results: The prevalence of social anxiety was 39.7% which was higher in females. The study found that 33.3% of the participants were in the high-risk category. A strong association (p<.001) was seen between self-perception and social anxiety. Similarly, a significant relationship (p<.001) was found with social experience-related variables, which included: the experience of traumatic situations, and being discriminated against bullied.
Conclusions: A high prevalence of social anxiety among adolescents was seen. One-third of the participants were in the high-risk category, clearly stating that the diagnosed cases only represented the tip of the iceberg. School-based youth-friendly entertainment and engagement interventions considering their emotional and mental health, might be beneficial in dealing with it.
Keywords: Adolescents; peer victimization; self-perception; social anxiety