Background: Vitamin D is an essential prohormone for the normal skeletal and extraskeletal health. Vitamin D deficiency/ insufficiency is an unrecognized epidemic among children and adults worldwide. There are growing data from studies of young children and adolescents in other countries, but a limited information are available regarding the prevalence of this nutritional deficiency/insufficiency among the Nepalese children and adolescents. Thus this study was aimed to find out the prevalence of vitamin D deficiency/insufficiency among children and adolescents, who has attended in Chitwan Medical College (CMC). Methods: This was a retrospective hospital based study in children between 2 months and 19 years of age, conducted in CMC from April 2015 to December 2016. Results: Among 108 total studied, overall 74.1% (80) patients had 25(OH) D levels lower than 30 ng/ml with 27.8% having severe deficiency (< 10 ng/ml), 28.7% deficiency (10-19 ng/ml) and 17.6% insufficiency (20-29 ng/ml) category . The prevalence was found higher in females (95.2%), though the difference in prevalence between sexes was not statistically significant (P -value 0.243). Conclusion: Our study concluded that a high prevalence of low Vitamin D status (deficiency/insufficiency) found among the paediatric population (all paediatric age groups) indicates a need for further national level study to find out the actual prevalence of this nutritional deficiency, as well as the need for vitamin D supplementation to all children and adolescents.
Summary: The micromechanical behaviour of various thermoplastics based nanocomposites was investigated with the aid of the microindentation technique. The materials studied were microphase separated styrene‐butadiene block copolymer systems and several thermoplastics reinforced with nano‐sized fillers having variable dimensionality. It was found that the microhardness behaviour of the nanocomposites studied was strongly influenced by the dimensionalities of the filler. Due to large surface to volume‐ratio one‐ and two‐dimensional fillers exhibit a far better reinforcing behaviour than the three dimensional ones. In case of nanostructured block copolymers, the microhardness is not determined by the total polystyrene (PS)/polybutadiene (PB) composition alone but diminishes gradually in presence of freely standing dangling polybutadiene chains even if the morphology of the systems remains unaltered.
Background: Scrub typhus, an important cause of undifferentiated fever, is grossly neglected and often misdiagnosed in low and middle income countries like Nepal. The main aim of this study was to describe the clinico-laboratory profile, drug used in treatment, predictor of PICU admission and therapeutic outcome of serologically confirmed scrub typhus among Nepalese children.Methods: A prospective observational study was carried out in children aged up to 14 years with serologically (IgM ELISA) diagnosed Scrub typhus, admitted in a tertiary care hospital of central Nepal between Jan 2019 to Dec 2019.Results: All 100 children with scrub typhus presented with fever. Other symptoms and sign were cough (29%), abdominal distension (22%) hepatomegaly (45%), splenomegaly (28%), crepitation (10%) and eschar (6%). Similarly, thrombocytopenia (72%), and increased liver enzymes SGPT (51%) and SGOT (62%) were found. Co-infection with dengue (5%) brucella (5%) and UTI (5%) were seen. Thirty six percent has some form of complication. Fifty eight percent of children were treated with azithromycin and 25% treated with doxycycline. The mean length of hospital stay was 6.68 ±2.97 days with a mean duration of defervescence being 30.07 ± 26.65 hours. The increased risk of PICU admission was found in those children with crepitation in chest (OR: 15.17, 95% CI: 3.4-66.8) during presentation and those children not getting azithromycin as treatment (OR: 3.8, 95% CI: 1.2-11.7)Conclusions: Scrub typhus should be considered as a differential diagnosis in any community acquired acute undifferentiated febrile illness regardless of the presence of an eschar. Sepsis, meningitis and pneumonia are important complications. Child having crepitation on presentation has an increased chance admission in critical care unit. The child receiving azithromycin has less chance to land in PICU.Keywords: Clinico-laboratory profile; complications; fever; scrub typhus.
Recently published guidelines on Psychosocial Management of Diabetes in India provide evidence-based recommendations for the whole nation. However, they do not fully address the myriad socio-cultural issues prevalent in the North Eastern states. The eight North Eastern states of India house 45 million people, belonging to 220 ethnic groups who speak an equal number of dialects, and follow distinctly unique cultures, which impact health-related behavior. Such diversity is difficult to cover in any national guideline. This lacuna makes it necessary to have a document, which addresses the specific needs and requirements of diabetes care professionals in the North-east of India. This consensus statement aims to highlight evidence- and experience-based strategies for psychosocial management of diabetes, based upon the unique ethnographic constitution of this part of the country. It is based upon the results of a daylong focused group discussion, held at Sonapur, Assam, on 9th February 2013, involving key opinion leaders from most North-eastern states, including all geographical divisions of Assam. Recommendations are classified into three domains: General, psychological, and socio-cultural, and graded by the weight they should have in clinical practice. Eighteen recommendations of varying strength are made, to help professionals identify the psycho-socio-cultural determinants of diabetes, and to explore the role of psycho-socio-cultural interventions in devising support strategies for people with diabetes and their families. They also aid in developing core skills needed for effective diabetes management. These recommendations provide practical guidelines to fulfill unmet needs in diabetes management in the North-east and help achieve a qualitative improvement in diabetes care. The guidelines may also be useful for diabetes care professionals working with other indigenous groups across the world.
ZusammenfassungDie gewonnen geologischen, geomorphologischen und geotechnischen Grundlagenerkenntnisse an der im Kristallin weltweit gewaltigsten und einzigartigen Großmassenbewegung des Tsergo Ri im Langthangtal des zentralen Nepal Himalaya entschlüsselten nicht nur den chronologischen Ablauf der Paläo-Ereignisse vor Ort, sondern können auch direkt auf eine Einstufung des rezenten Gefahrenpotentials dieser Gegend und ähnlich geotektonisch-lithologisch positionierter Bereiche des Himalaya und der Erde angewendet werden. Dies konnte vorerst am Beispiel weiterer, kleinerer Bergstürze im Langthangtal selbst, im Kristallin des Annapurna Massivs und mit einem Vergleich zu einer Felslawine in Zentralchina bestätigt werden.
Due to the inherent complex nature of clinical trials, individual’s willingness to participate and hence, enrollment in a clinical trial maybe challenging. When it comes to vaccine clinical trial in children, informed consent needs to be secured from the parents or legally acceptable representatives (LARs). Some of the factors which contribute to hesitancy in taking part in clinical trials are based on the level of education, living standards, part of the world they live, associated burden of disease, fear of different procedures in clinical trial, side effects, limited understanding, limited time, and mistrust with Investigational product. This study included 201 parents/LARs, who approached Kanti Children Hospital site in Kathmandu with the interest to get their children enrolled in a vaccine clinical trial with objectives of describing the reasons for agreeing or disagreeing to participate in the vaccine clinical trial, factors affecting decision making, and finding the major concerns of parents/LARs. The acceptance for the study vaccine was 136 (67.7%) whereas denial was 65 (32.3%). This study showed that age, education level, family structure, advice from family and friends, and medical guidance play important roles in willingness of parents to get their child enrolled in the trial. If a proper counseling is done, fear of blood sampling is not a big factor which is contrary to the belief among clinical researchers. Safety of vaccine, frequency of injections, and cost of vaccine were the main concerns of the parents, which need to be addressed extensively while planning for any clinical trial in children.
Tomato is highly perishable in nature and incurred high post-harvest losses due to unsuitable packaging method. Experimentation was undertaken to find the effect of different polymeric film packaging on postharvest quality of tomato var. Manisha in a completely randomized block design (CRD). There was five treatment viz. open, ordinary plastic, Polypropylene (PP38,) Low-Density Polyethylene (LDPE38) and 25) which was replicated four times. Destructive and non-destructive samples were prepared for each treatment, nondestructive samples were sealed completely and used for weight loss observation and destructive samples were tied with a rubber band and used for observation of Titratable Acidity (TA), Total Soluble Solid (TSS), pH and firmness every four days after packaging. Among the different packaging treatments, no packaging (open) showed the highest percentage of weight loss (13.25%), lowest firmness (3.35 kg), and highest TSS (4.33) at the final day of storage as compared to another plastic packaging. The plastic packaging creates a modified atmosphere for the packed tomatoes which slows down the physiological processes and delay ripening, causes minimum weight loss, delays a change in color, and lower TSS content of the tomato fruit. So, packing tomatoes in any type of plastic packs is suitable for increasing shelf life.
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