In previous studies in Nepal, snakebite victims were found to either not have Pressure Immobilization Bandaging (PIB) or Local Compression Pad Immobilization (LCPI) performed for first aid, or had it performed incorrectly. The goal of this study was to evaluate training texts regarding first aid measures for snakebite and the rates of performance of both methods currently recommended, as well as ineffective or harmful practices. The study was conducted from September, 2009 to November, 2010. It evaluated the venomous snakebite first aid measures recommended in the 31 most recently published and commonly used Nepalese reference works and textbooks aimed at paramedical personnel, primary health care workers, medical undergraduates, and students of class five to bachelor´s degree. It compared the suggestions of these with those of published guidelines for the management of snakebite envenomation. Up to 100% of first aid measures advocated in these materials differed significantly from published guidelines. This included the omission of appropriate activities, misstatements and prescription of inappropriate treatments. Among appropriate recommendations that were missing was the advice to apply PIB or LCPI, and the suggestion to go to a snakebite treatment center. Fifty-five percent of the references did recommend emergency transport. Inclusion of accurate evidence-based information regarding first aid measures for venomous snakebite in commonly used texts could help to reduce the application of ineffective or harmful pre-hospital practices, their associated morbidity and mortality, and increase the use of appropriate methods.

Objectives: Tobacco smoking is considered as one of the major global public health issues, especially in developing countries. Nowadays, pregnant women are suffering from the harm from second-hand smoke (SHS) and third-hand smoke (THS) exposure due to high rates of husband smoking, which are associated with several adverse clinical outcomes of pregnant women such as spontaneous abortion and postpartum depression. Methods: A national based cross-sectional study was conducted to examine the associations between different types of tobacco exposure and health-related quality of life (HRQoL) in pregnant women from different regions in China. A web-based questionnaire was asked during participation in prenatal examination. HRQoL was measured using the EuroQoL five-dimension-five-level (EQ-5D-5L) questionnaire and demographic data were collected. Results: 16,811 pregnant women were included and 51.8% of them were in different types of tobacco exposure. Significant difference in EQ-VAS scores were detected between non-tobacco exposure and tobacco exposure groups [First-hand smoke (FHS) (p=0.002), SHS (p,0.01) and THS (p,0.01)]. Moreover, increased amounts of SHS and THS exposure could result in lower HRQoL of pregnant women (p=0.039 and p=0.007 respectively). Conclusions: Approximately half of pregnant women were under the influence of different types of tobacco exposure. Compared to non-tobacco exposure, FHS, SHS and THS had negative impact on the HRQoL of pregnant women. Deleterious effect of tobacco exposure on HRQoL of pregnant women was in dose-response relationship. Tobacco exposure is common and severe health problem causing economic burden. Government need to make more relevant policies to limit not only FHS and SHS exposure but also THS exposure, which was ignored in the past.