Objectives
The main objective of the study was to ascertain the prevalence of chronic otitis media and determine the corresponding hearing loss in children from Nepal’s Himalayan region now residing in Buddhist Monastic schools of Nepal.
Methods
The study was conducted among children at Buddhist monastic school in different parts of Nepal. A total of 3174 children aged between 5 and 15 years, who were originally from the Himalayan region of Nepal and were currently residing in monastic schools, were screened for ear problems and hearing loss. They were examined by otoscope to diagnose chronic otitis media. Hearing was evaluated by pure tone audiometer, and 0.5–4 kHz air conduction hearing threshold was measured and documented.
Results
Of the total of 3174 children who were screened for ear diseases and hearing loss, monks constituted 76.21% (n = 2419) and Nuns 23.78% (n = 755). Chronic otitis media was the most common otoscopic finding during the screening, and it affected a total of 344 (10.83%) children. Out of these 344, hearing loss of varying degrees was observed in 5.42% (n = 172) children.
Conclusion
There is high prevalence of chronic otitis media in children belonging to the Himalayan region of Nepal, and it is the main cause of avoidable hearing loss. Timely diagnosis and treatment of chronic otitis media could prevent unnecessary hearing loss in these children.
Uterine prolapse is a significant public health problem in Nepal. The aim of this study was to determine the prevalence of uterine prolapse and to identify the possible risk factors for this. This is a cross sectional study conducted at semi urban area in Kathmadu district. A total of 168 women of age 25 – 34 years were surveyed, and nearly half of them were of 25-29 years. Maximum respondents (38.1%) were Chhettri, and least was Dalit (13.1%). Regarding occupation, two –third of the participants had agriculture and house maker as their main source of living. Among the interviewed population, the prevalence of uterine prolapse was found to be 11.9%. Among them, 15.3% were farmers, 29.4 % were daily wagers, 18.2% were Dalit and 16.7% were of age more than 28 years. This study showed that the income has a vital role in the occurrence of the uterine prolapse, the odds ratio was found to be 13.6 (CI: 4.6-38.5). The pregnancy below the age of 20 was found to be the second major cause (OR: 12.6, CI: 3.5 - 45). Similarly, other factors like parity, gravid, child spacing, lack of rest during pregnancy, heavy weight lifting were the significant factors to uterine prolapse (p<0.05). However, the type of delivery was not associated to the occurrence of uterine prolapse.
Refractory status epilepticus, with persistence of seizures despite initial intravenous benzodiazepine and one secondline intravenous antiepileptic drug occurs in nine percent to 44% of the patients with status epilepticus. Aggressive treatment is needed to control such seizures with drug refractoriness. A case of a 2-year-old boy treated with intravenous levetiracetam with cessation of seizures, averting the need for general anesthesia is reported. Option of using levetiracetam in refractory status epilepticus is suggested.
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