Introduction: Diabetes mellitus (DM) is increasing the risk of pulmonary tuberculosis (PTB) with concern over the convergence of these two diseases. Although screening for PTB among people with DM has been recommended by WHO, it has not been implemented in Bhutan yet. Objective: The aim of this study was to determine the prevalence and risk factors of PTB among people living with DM at the National Referral Hospital (NRH), Thimphu, Bhutan.
Methods: This was a cross-sectional study conducted from 1st June – 9th October 2018. All 343 consenting DM patients were screened for PTB using the WHO recommended questionnaire and those with TB positive symptoms were tested for active PTB using sputum smear microscopy and Gene-Xpert. A descriptive statistical analysis was performed using SPSS 21.
Results: The prevalence of PTB among people living with DM was 0.87% (95% CI: 0.20-2.50).The mean age was 54.95 (± 13.2 years) and all were DM type II. The median duration of diabetes was 4 years (range of 0.1-40 years), an average level of HbA1c 7.47 (± 2.6), and median duration on DM medication was 4 years (range of 0.1-40 years) with the majority (88.9%) on oral hypoglycemic drugs. Good glycemic control (HbA1c< 7) was achieved by 39.4% of individuals. PTB risk factors included PTB positive symptoms (7.0%), prior PTB history (5.5%) and recent contact with PTB patient (5.0%). Additional known PTB risk factors were smoking (7.6%), alcohol use (4.1%) and low body mass index (1.5%).
Conclusions: Although the prevalence PTB was low, health education, proper case management and risk based screening for PTB among DM is recommended.
The Gaur, Bos gaurus Smith, plays an important role in the pyramidal food chain -being an important prey for large carnivores such as tiger, common leopard, and Asiatic wild dog. Presence of Gaur in an area indicates wild and healthy ecosystem. Reduction of global distribution of Gaur by over 80% in the past 100 years, scaling in the IUCN Red List of Vulnerable category shows the species is facing serious threats. The present study assessed the distribution, activity pattern, and abundance of Gaur in the Royal Manas National Park (RMNP) through a single season occupancy modeling. The study was conducted through camera trap survey for a period of three months. Gaur was the second most abundant species among targeted sympatric species (RAI = 6.35) and its distribution was restricted mostly in the southern sub-tropical forest belts. The highest elevation that Gaur was recorded was 2256 m asl. The mean detection probability of Gaur in RMNP was 33 % ± 0.04 (0.25-0.47) and naive occupancy rate was 51.5%. The estimated Gaur occupancy with inclusion of imperfect detection showed 62.4% ± 0.15 (0.296-0.864) of 659.6 km 2 of RMNP area occupied. Core zone in RMNP was observed as most preferred habitat as Gaur tended to avoid human disturbances. Distance to saltlick and settlement was the most significant habitat parameter for Gaur's existence. Evidences of poaching inside the park call for reinforcing Spatial Monitoring Assessment and Reporting Tool (SMART) in patrolling and management of Gaur conservation in RMNP.
The Horned Lark (Eremophila alpestris) even though a widespread songbird species had not been recorded from Bhutan. The bird was observed in Jigme Khesar Strict Nature Reserve in a recent trip to Gakiling, Haa. With this new record, the number of bird species found in Bhutan has increased to 739 species.
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