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The Health Thread

Prevention of Cyberbullying in Nepal

Dr. Kishor Adhikari

Written By Sonika Parajuli, Bachelor of Arts in Social work, 4th year  ( Major – Psychology ) Xavier International College

Sabina Maharjan

Reviewed by Sabina Maharjan, Clinical Psychologist(M.Phil, IOM TUTH), Bsc Nurse

Introduction

Cyberbullying, a new form of bullying has been defined as “willful and repeated harm inflicted through aggressive actions through the use of computers, cell phones, and other electronic devices.” (Hutson, 2016, p. 13). It is important to know that cyberbullying can happen to anyone. Relatively little can be said about a typical cyber target or a typical cyberbully: they can be rich kids or poor kids, left-out kids or popular ones, A-students or struggling students, majority or minority students, someone who has been bullied before of someone who rarely uses technology, it can be someone who uses technology to pass their free time by browsing and chatting, but also someone who mostly uses it for online learning, research, time management or school.

Some of the World wide data:

According to a report by National Information Technology, Centre, more than 1,000 cases of cybercrime were reported in Nepal in 2020. The most common forms of online harassment and cyberbullying include cyberstalking, revenge porn, online scheming, online shaming and trolling. Cyberbullying behaviours are not limited to name-calling; they can include other forms of teasing, defamation, intimidation, rumour spreading, displaying unflattering or compromising photos without consent, hacking into individual’s computer, spreading virus. (Aricak et al., 2008).

There are several forms of cyberbullying including:

  • Flaming- It involves sending angry or vulgar messages to an individual or group.
  • Harassment- The act of sending insulting messages, making threats, stalking, or engaging in other forms of unwelcome communication or conduct to an individual.
  • Denigration- This means sending untrue or unkind statements about someone to other people.
  • Cyberstalking- Threatening to harm someone or using intimidation tactics is known as cyberstalking.
  • Masquerading- The process of impersonating someone and sending information that puts that person in danger or casts them in a negative light is called masquerading.
  • Outing and trickery- accessing embarrassing information about an individual and releasing it to the public.
  • Exclusion- It involves purposefully excluding an individual from an online platform.
  • Catfishing- an individual creates a fabricated identity on the internet with the aim of manipulating and harming a victim through various means, often by exploiting the victim’s emotions.
  • Cyberflashing- When an individual receives sexually explicit image without their consent, they have experienced cyber flashing. This can happen through peer-tp-peer Wi-Fi networks or Bluetooth Airdrop, both within and outside of school settings.
  • Ghosting- When individuals stop talking to someone online without explanation, it is called ghosting. Frequently, instead if directly addressing the matter, individuals opt to simply ignore the person they are targeting.
  • Griefing- The repetitive behaviour of intentionally bothering or annoying others by deliberately eliminating your character, steal your game possessions, or harass you through chat is called griefing.
  • Hate pages- On social media platforms like Instagram, teens make fake accounts to bully others. They post embarrassing photos, share secrets, or spreads mean messages. This is called hate pages.
  • Outing- This happens when someone shares another person’s gender identity or sexual orientation without their permission. It is especially harmful for teens who already struggle with mental health and may be more likely to harm themselves.

According to Stop Bullying (2020), the following are the most common places where cyberbullying occurs:

  • Social Media, such as Facebook, Instagram, Snapchat, and Tik Tok
  • Text messaging and messaging apps on mobile or tablet devices.
  • Instant messaging, direct messaging, online chatting over the internet.
  • Online forums, chat rooms, and message boards, such as Reddit.
  • Online gaming communities.

Cyberbullying can take many forms. It can include harassment (insults or threats), spreading rumours, impersonation, outing and trickery (gaining an individual’s trust and then using online media to distribute their secrets) or exclusion (excluding an individual from activities). These activities can be performed via e-mail, instant messaging, text message, social networking sites such as Facebook or Tumblr, and other websites (Peebles E.,2014).

Short Message Service (SMS), which is more commonly known as text messaging, is also a vehicle for cyberbullying. Text messaging appears to be the most widely used platform for cyberbullying among middle and high school students, followed by online gaming (Smith et al., 2008). DePaolis and Williford (2015), found that 11% of elementary school children under the age of ten reported weekly victimization through online gaming. The social media sites used for 8 cyber victimization included Facebook, Twitter, and Instagram. The least utilized platforms for cyberbullying included instant messaging, email, and chat rooms.

Some References of Case Studies of Nepal

One of the disturbing cases was of Goma Karki, a 16-year-old girl from Nepal, who committed suicide after discovering someone had created a fake Facebook account in her name and posted offensive content. Goma’s family filed a complaint with the Cyber Crime Bureau, which tracked the cell phone number used to create the account and arrested Yubaraj Karki, who confessed to creating the fake profile.

  • Rita Khadka’s Facebook account was compromised in August 2019. She didn’t learn about it until her friends alerted her to the pornographic photographs being shared from her account. She quickly reported the posts to Nepal Police’s cybercrime division and deleted them from her account.
  • According to a study by the Nepal Telecommunications Authority, 26% of students in Kathmandu reported experiencing cyber bullying.

How does Cyberbullying occur?

The exact reason of why people do cyberbullying is unknown.

  • Lack of empathy.
  • A desire for power and control.
  • To take revenge
  • Peer pressure
  • Deficient digital communication skills
  • Escapism, which according to Cambridge dictionary mean a way of avoiding an unpleasant or boring life, especially by thinking, reading, etc. about more exciting but impossible activities.
  • Seeking entertainment
  • Inadequate regulation
  • Lack of parental supervision over children’s Internet use or their computer activities.
  • To boost their egos.
  • To entertain themselves and their friends.
  • To get attention.
  • Some do it because people around them are doing it as well.

Effects of Cyber bullying

Psychological Impacts

  • Victims of cyberbullying are likely to experience Anxiety, Depression, and the feeling of low self esteem
  • Low confidence
  • More susceptible to developing Post Traumatic Stress Disorder.
  • Developing thoughts about suicide and harming oneself.
  • Constant feeling of fear and stress
  • Feeling ashamed, nervousness, anxious and insecurity regarding what people say or think about you.

Physical Impacts

  • Headaches
  • Stomach aches and sleeping problems

Social Impacts

  • Victims of Cyberbullying are at higher risk of being marginalised and stigmatised by society.
  • They might feel ashamed or embarrassed about the harassment, leading them to avoid social activities and relationships.
  • Social isolation.
  • Their peers might not accept them.
  • They do not easily trust other people and are always suspicious of others.
  • For adult: could able to go for work and could not do the routine work

Academic Impacts

  • They struggle to fit in at school and perform poorly academically.
  • Drop in grades
  • Skips school.
  • Gets into trouble at school
  • Loses interest in School
  • Avoid going to school.

(Pradhan, 2023)

Possible signs of cyber bullying

  • Mentally – Feeling upset after messaging or being on the internet, embarrassed, stupid, even afraid or angry most of the time, low self-esteem, reluctant to talk or secretive about their online activities and mobile phone use.
  • Emotionally – feeling ashamed or losing interest in the things you love, feeling upset after using the internet or their mobile phone, anger and irritable.
  • Physically – tired (loss of sleep), or experiencing symptoms like stomach aches and headaches.

Socially- Avoiding formerly enjoyable social situations, not wanting to go to school and/or avoiding meeting friends and school mates, significant increase or decrease in time spent in texting, gaming or using social media.

Internet safety for children

  • Be careful what pictures or videos you upload.
  • Only add people you know and trust to friends/followers lists online.
  • When talking to strangers, keep your personal information safe and location hidden.
  • Keep your password to yourself and change it regularly.
  • Block or report someone who is behaving badly.
  • Do not reply to offending e-mails, text messages or online conversations.
  • Always keep a copy of offending e-mails, text messages or a screen grab of online conversation
  • Make sure you tell an adult you trust, for example, a parent, a carer, a teacher, or the anti-bullying co-ordinator or call a helpline.
  • Do not share your last name, home address, school name or telephone number. You don’t know how the person will use your information.
  • While creating screen name, do not include personal information like your last name or date of birth.
  • Do not share your passwords with anyone and when you use a public computer, make sure your logout of the accounts you have accessed before leaving the terminal.
  • Do not agree to meet an online friend, until you have your parents’ permissions sometimes people pretend to be someone and turb out to be someone else and they recognize the people better.
  • Do not buy anything online without talking to your parents first. Some ads may try to trick you by offering free things as a way of collecting your personal information.
  • Talk to your parents before you open an email attachment or download software as the attachments sometimes might contain virus and make sure not to open an attachment from someone you don’t know.
  • Make sure that you have control over who can access your information online by activating and improving privacy setting on all your social media accounts.
  • Keep in mind that when you use a public internet connection, you cannot know how secure it is. It is best to avoid doing any online banking, sharing sensitive information while using public Wi-Fi.

How can the parents keep their children internet safe?

  • Monitor child’s social media use.
  • Being involved and talking to children. Once a picture is shared online it cannot be taken back.
  • Remind your children that they never know who they really are. They might seem friendly, but because you can’t see them in real life, it is best to be careful.
  • Advise them to never share their email or social media password with anyone, even their best friend.
  • Help them determine what is and is not appropriate to share online.
  • Set hours and limit access to using technology online.
  • Create a code of conduct for your children, such as they will not use social media to humiliate or embarrass other people, even if they are being targeted by cyberbullying.
  • Establish that if your child experiences cyberbullying and shares that with you, their use and access to technology won’t be restricted. However, if your child demonstrates cyberbullying behavior and you find out, identify consequences for your child.
  • If your child is being bullied online, be supportive of your child. Let them know that you will work together to take steps to stop bullying.

How can the Teachers keep the children internet safe?

  • Promote a positive and safe classroom culture. Provide resources in the classroom to help students identify, respond to, and avoid cyberbullying.
  • Step up when you encounter a teachable moment related to cyberbullying or respectful online communication,
  • Encourage students to pay attention to “red flag moments”—when something happens on digital media that makes them feel uncomfortable, worried, sad, or anxious.
  • Explain to students the three ways they can and should respond if they witness cyberbullying: support the target of the bullying (be an ally); try to stop the cyberbullying (be an upstander); and/or tell a trusted adult (report it). It may not be part of your lesson plan, and it may set you off track for a bit, but every time you reinforce anti-cyberbullying messages, you’re doing the critical work of cyberbullying prevention.
  • Incorporate lessons on cyberbullying into your existing curriculum.
  • Talk to parents if encountered any inappropriate cyberbullying.

How can the Adult keep themselves internet safe and reduce the cyberbullying?

  • Make sure you are up to date with the privacy settings. Social media regularly update their privacy options. Stay informed about these changes.
  • Limit access of your contact details. Avoid sharing your email or phone number with unfamiliar individuals.
  • Avoid sharing inappropriate images or videos. Keep in mind that a current romantic partner could be and ex in the future. So it is essential to prevent the possibility of someone possessing and potentially posting compromising material of you online.
  • Refuse friend or follower requests from unknown individuals. If you are unfamiliar with the person sending the request, simply ignore it.
  • Avoid immediate responses to cyberbullying. Cyber bullies often aim to provoke emotional reactions from their targets. When faced with negative online comments, unappealing photos or tags, or any form of unkind behaviour, consider stepping away from your device for at least an hour. Utilize this time to create emotional distance and carefully contemplate your response.
  • Capture screenshots to document instances of cyberbullying. This method ensures you have a record of any harmful comments or photos.
  • Use reporting and blocking features available on social media platforms to address cyberbullying effectively.

Who helps in Nepal?

  • Child Safe Net

Child safe net has been established with the vision of enhancing the safety of digital technology for children and young individuals. They raise awareness about using the internet and devices safest to protect young people from issues like Internet Addiction, Online sexual abuse, and exploitation, cyberbullying, and gaming addiction, while also promoting digital literacy, since 2018.

  • Nepal Police Cyber Bureau

Toll free Emergency Child Helpline- 1098

Toll free Nepal Police Hotline- 100

Nepal Police Cyber Bureau- 9851286770

REFERENCES

The Semen Microbiome and Its Impact on Male Fertility

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Written By THT Editorial Team

Dr. Asmita Pandey

Reviewed by Dr. Asmita Pandey, Fertility Expert , M.D. (OB/GYN) 

 In 1981, Lynn Margulis published Symbiosis in the journal Cell Evolution, she proposed that life emerged not as the outcome of a competitive race but by interacting organisms joined together for a very specific order. Human body not only consist of trillions of cells but trillions of ancient species including bacteria and it may be surprising that the mitochondria that makes the energy for the body originated from an ancient bacteria and it retained its unique genome that is known as Mitochondrial DNA.

These microbiomes, occupies and live in a harmony in different part of the body and body fluids especially in  the gut, vaginal, and in the semen microbiome. These microbiomes involved in the health and well-being of humans.  Recent research has shed light on the significance of the semen microbiome and its potential influence on male fertility. This article aims to explore the latest findings on the semen microbiome and its relevance to male fertility, drawing from verifiable sources to provide a comprehensive understanding of this emerging field.

Understanding the Semen Microbiome

The semen microbiome, once thought to be microbe-free, has been revealed to host its own microbial community, akin to the microbiomes of the gut and vagina (Hill, 2021). This microbiome comprises a diverse array of microbes originating from various glands in the upper reproductive tract, as well as “drifter” bacteria from urine, the urethra, and potentially from a person’s blood or their sexual partners (Winters & Walsh, 2019). However, the impact of these individual species of bacteria on health has long been a mystery (Hill, 2021).

Recent Research Findings

A recent investigation conducted at the University of California, Los Angeles (UCLA) delved into the semen microbiome’s potential link to infertility, yielding insightful findings (Winters & Walsh, 2019). The study, published in Scientific Reports, identified a bacterial species, Lactobacillus iners (L. iners), associated with sperm motility issues in individuals experiencing infertility (Winters & Walsh, 2019). This microbe, commonly found in the vaginal microbiome, has been linked to impaired sperm motility, a key factor contributing to male infertility (Winters & Walsh, 2019).

The study involved the genetic sequencing of semen samples from 73 men, half of whom were fertile and the other half seeking fertility consultation due to issues such as lower sperm count or motility (Winters & Walsh, 2019). The researchers identified five common bacteria species in the semen microbiome, with high levels of L. iners correlating with impaired sperm motility in men experiencing infertility (Winters & Walsh, 2019). This discovery is significant as it suggests a potential link between the semen and vaginal microbiomes, indicating their influence on each other and their role in fertility (Winters & Walsh, 2019).

Implications for Male Fertility

The findings of this study have far-reaching implications for male fertility. With approximately 50% of infertility cases attributed to male individuals, understanding the role of the semen microbiome in infertility is crucial (Hill, 2021). The research paves the way for the development of targeted treatments aimed at rectifying issues with sperm parameters, potentially alleviating the burden of infertility for couples (Hill, 2021).

Furthermore, the identification of specific bacteria, such as L. iners, and their potential impact on sperm motility opens new avenues for exploring drug targets to address infertility (Hill, 2021). This could lead to the development of innovative treatments tailored to rebalance the semen microbiome, akin to current approaches used to treat bacterial vaginosis in the vaginal microbiome (Hill, 2021).

Future Directions and Implications for Clinical Practice

While the research on the semen microbiome and its connection to male infertility is still in its nascent stages, the findings have set the stage for future comprehensive investigations into the complex relationship between the semen microbiome and fertility (Winters & Walsh, 2019). These studies could potentially lead to the identification of new biomarkers for clinical laboratory testing, offering valuable insights for couples experiencing fertility issues (Winters & Walsh, 2019).

In conclusion, the emerging field of semen microbiome research has unveiled a new dimension in the understanding of male fertility. By shedding light on the role of the semen microbiome in influencing sperm parameters and male fertility, these findings have the potential to revolutionize the diagnosis and treatment of male infertility, offering hope to countless couples striving to conceive.

REFERENCES

  1. Hill, J. E. (2021). The Semen Microbiome: A New Contributor to Male Fertility? Scientific American.
  2. Winters, K., & Walsh, T. J. (2019). Microbial Communities in Semen Could Impact Fertility. University of California – Los Angeles Health Sciences.

Recent Advances in Male Infertility Research

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Written By THT Editorial Team

Dr. Asmita Pandey

Reviewed by Dr. Asmita Pandey, Fertility Expert , M.D. (OB/GYN) 

Infertility is a prevalent issue with an estimated 9% of couples worldwide experiencing fertility challenges, half of which are attributed to male factors 1 Revolutionary genetic studies like exploring the Y chromosomes sequencing (2)DNA fragmentation techniques as well as recent technological advances like ICSI procedures shed light on various causes and potential treatments for male infertility, offering hope for effected couples.

Challenges & Causes of Male Infertility 1,3,4

Male infertility can stem from a range of factors, including genetic mutations, lifestyle factors, medical illnesses, environmental exposures, and medications. Genetic variations have been identified as a leading cause of male infertility, with recent studies focused on deciphering these genetic markers to develop targeted therapies 1,3 4 . Additionally, oxidative stress has been recognized as a significant contributor to sperm DNA damage and impaired function, emphasizing the potential role of antioxidant supplementation in mitigating these effects 1, 3

Dr Hagai Levine, an epidemiologist at the Hebrew University of Jerusalem, and his colleagues published an analysis in 2017 and an update in 2022 , these two papers found about a 50 percent decrease in sperm concentration since 1970s. 5, 6. 

Furthermore, the decline in sperm count is paralleled by declines in testosterone and increases in testicular cancer and male genital anomalies.

Treatment Approaches 1,3,4,7

Oxidative damage of sperm DNA is positively linked with oligoasthenoteratozoospermia (OAT), and male infertility. The antioxidants are being explored worldwide to combat OAT, sperm DNA fragmentation and reactive oxygen species. Recent prospective, double-blind, randomized, placebo-controlled multi centre trial by Patki et al was conducted in 300 sub-fertile males (25-45 years) has explored the use of antioxidants with a proprietary formula of micronutrients, essential amino acids, antioxidants, and vitamins such as coenzyme Q10, L-carnitine, L-arginine, L-glutathione, vitamins like C, E, B6, B12, B1, A, D, ginseng extract, lycopene, folic acid along with elemental zinc, iron, copper selenium, manganese. Subjects were randomised in either the antioxidant blend treatment group or placebo group, assessed changes in sperm count, motility, normal morphology, semen volume, and percent DFI before and after treatment (90 days). Study results confirmed the well-researched fact of antioxidants being effective to reduce oxidative stress and thus improve sperm DNA integrity and also improved semen parameters in males aged 40 and above.

Furthermore, advancements in reproductive technologies, including intra cytoplasmic sperm injection (ICSI), have significantly enhanced fertilization rates, especially in cases where traditional IVF methods may not be successful 1, 3

Role of Varicocelectomy and Testicular Sperm Extraction 1,3

Conventional male reproductive surgeries, such as varicocelectomy and testicular sperm extraction (TESE), have been studied to broaden their indications for addressing male factor infertility. Varicocelectomy, in particular, has shown improvements in semen parameters, including sperm concentration and motility, following repair 12

Infertility Evaluation & counselling. 3

The American Urological Association (AUA) and American Society for Reproductive Medicine (ASRM) have provided guidelines for the diagnosis and treatment of male infertility, emphasizing the importance of a thorough evaluation to identify potentially treatable causes 3. Moreover, male infertility risk factors, reproductive history, and medical interventions that may impact fertility should be carefully assessed during the evaluation process 3. ASRM/AUA guidelines recommend Clinicians should advise couples with advanced paternal age (≥40) that there is an increased risk of adverse health outcomes for their offsprings. 8

Future Directions and Considerations

Efforts to understand the molecular and genetic factors responsible for spermatogenesis and fertilization are ongoing, offering the potential for improved outcomes in male factor infertility 1,3 . Additionally, the use of assisted reproductive technologies, such as intrauterine insemination (IUI) and in vitro fertilization (IVF), remains crucial in overcoming various causes of idiopathic infertility 3, 4

In conclusion, recent advances in male infertility research have provided valuable insights into the causes and potential treatments for this prevalent condition. By focusing on genetic variations, oxidative stress, and innovative treatment approaches, researchers aim to improve fertility outcomes for affected individuals. 

REFERENCES

  1. Boivin J, et al. “International estimates of infertility prevalence and treatment-seeking: potential need and demand for infertility medical care.” Hum Reprod. 2007.
  2. Nature ,Vol 621 14 September 2023.
  3. Smits RM, et al. “Antioxidants for male subfertility.” Cochrane Database Syst Rev. 2019.
  4. Schlegel PN, et al. “Diagnosis and treatment of infertility in men: AUA/ASRM guideline part II.” Fertil Steril. 2021.
  5. Human Reproduction Update, Volume 23, Issue 6, November-December 2017,
  6. Human Reproduction Update, Volume 29, Issue 2, March-April 2023
  7. Transl Clin Pharmacol. 2023 Mar;31(1):28-39
  8. https://www.auanet.org/documents/Guidelines/PDF/Male-Infertility-Guideline.pdf

Herbal medicine and supplements

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Written By THT Editorial Team

Dr. Hari Sharan Aryal

Reviewed by Dr. Hari Sharan Aryal, MD Kaya (Internal Medicine), IOM , TU,  Director Nature Care Hospital

Herbal medicine and supplements have been used for centuries to treat various health conditions and improve overall wellbeing. These natural remedies are derived from plants and have been used as traditional medicines in many cultures worldwide. In recent years, there has been an increase in the use of herbal medicine and supplements, driven by growing interest in natural and alternative healthcare practices. In this essay, we will explore the types and kinds of herbal medicine and supplements, their uses, and research-based findings.

Types and Kinds of Herbal Medicine and Supplements:

Herbal medicine and supplements come in various forms, including teas, tinctures, capsules, powders, and extracts. Here are some of the most commonly used herbal remedies:

Echinacea: Echinacea is a popular herb used to boost the immune system and prevent colds and flu. Studies have shown that Echinacea can reduce the risk of catching a cold by up to 58% and reduce the duration of symptoms by 1 to 4 days (1).

Ginkgo biloba: Ginkgo biloba is a tree native to China that is used to improve memory and cognitive function. Research suggests that Ginkgo biloba can improve attention and memory in individuals with mild cognitive impairment (2).

St. John’s Wort: St. John’s Wort is a flowering plant used to treat mild to moderate depression. Several studies have shown that St. John’s Wort can be as effective as antidepressant medications in treating mild to moderate depression (3).

Turmeric: Turmeric is a spice commonly used in Indian cuisine and has antiinflammatory properties. Studies have shown that turmeric can help reduce inflammation in the body and alleviate symptoms of osteoarthritis and rheumatoid arthritis (4).

Uses and Research-Based Findings:

Herbal medicine and supplements have been used to treat various health conditions, including anxiety, depression, insomnia, digestive disorders, and chronic pain. Here are some research-based findings on the use of herbal remedies for specific health conditions:

Anxiety: Kava, an herb native to the South Pacific, has been shown to reduce symptoms of anxiety. Studies have reported that Kava can reduce anxiety symptoms by up to 50%, with no significant side effects (5).

Insomnia: Valerian root, an herb native to Europe and Asia, has been used for centuries to treat insomnia. Studies have shown that valerian root can improve sleep quality and reduce the time it takes to fall asleep (6).

Digestive Disorders: Peppermint oil has been shown to be effective in reducing symptoms of irritable bowel syndrome (IBS), including abdominal pain and bloating. Studies have shown that peppermint oil can reduce IBS symptoms by up to 40% (7).

Chronic Pain: Devil’s claw, an herb native to Africa, has been shown to be effective in reducing chronic pain, particularly in individuals with osteoarthritis. Studies have reported that devil’s claw can reduce pain by up to 25% (8).

Safety and Quality Control: Ensuring the safety and quality of herbal medicine and supplements is crucial. Regulatory authorities in many countries have implemented guidelines and quality control measures. It is essential to use products from reputable manufacturers, adhere to recommended dosages, and consult qualified healthcare professionals.

Conclusion: Herbal medicine and supplements offer a natural and alternative approach to healthcare, with many potential benefits for various health conditions. With increasing research and evidence-based practices, herbal remedies are gaining recognition as an integral part of integrative medicine. However, further research, quality control measures, and collaboration between different healthcare systems are necessary to ensure the safe and effective integration of herbal medicine and supplements into modern healthcare practices.

REFERENCES

  • Karsch-Völk, M., Barrett, B , Avins, A. L., & Linde, K. (2014). Echinacea for preventing and treating the common cold. Cochrane Database of Systematic Reviews, (2), CD000530.
  • Weinmann, S., Roll, S., Schwarzbach, C., Vauth, C., & Willich, S. N. (2010). Effects of Ginkgo biloba in dementia: systematic review and meta-analysis. BMC geriatrics, 10(1), 14.
  • Ng, Q. X., Venkatanarayanan, N., & Ho, C. Y. X. (2017). Clinical use of Hypericum perforatum (St John’s wort) in depression: A meta-analysis. Journal of affective disorders, 210, 211-221.
  • Henrotin, Y., Priem, F., & Mobasheri, A. (2013). Curcumin: a new paradigm and therapeutic opportunity for the treatment of osteoarthritis: curcumin for osteoarthritis management. Springerplus, 2(1), 56.
  • Sarris, J., Stough, C., Bousman, C. A., Wahid, Z. T., Murray, G., Teschke, R., … & Savage, K. M. (2013). Kava in the treatment of generalized anxiety disorder: a double-blind, randomized, placebo-controlled study. Journal of clinical psychopharmacology, 33(5), 643-648.
  • Fernández-San-Martín, M. I., Masa-Font, R., Palacios-Soler, L., Sancho-Gómez, P., & Calbó-Caldentey, C. (2010). Effectiveness of Valerian on insomnia: a metaanalysis of randomized placebo-controlled trials. Sleep Medicine, 11(6), 505-511.
  • Ford, A. C., Talley, N. J., Spiegel, B. M., Foxx-Orenstein, A. E., Schiller, L., Quigley, E. M., & Moayyedi, P. (2008). Effect of fibre, antispasmodics, and peppermint oil in the treatment of irritable bowel syndrome: systematic review and metaanalysis. BMJ, 337, a2313.
  • Chrubasik, S., Thanner, J., Künzel, O., & Conradt, C. (2001). Comparison of outcome measures during treatment with the proprietary Harpagophytum extract doloteffin® in patients with pain in the lower back, knee or hip. Phytomedicine, 8(2), 123-130.

Breast health and breast cancer awareness

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Written By THT Editorial Team

Dr. Deepak Shrestha

Reviewed by Dr. Deepak Shrestha, MD , Assosiate Professor(Dept. of OBGYN, Lumbini Medical College)

Breast cancer is one of the most common cancers among women, with approximately 2.3 million new cases diagnosed worldwide in 2020. Breast cancer awareness and early detection are essential for improving breast health outcomes. In this article, we will discuss the importance of breast health and breast cancer awareness, recent research findings related to breast cancer, and best practices for breast cancer screening and prevention.

Importance of Breast Health and Breast Cancer Awareness

Breast health is critical for the overall health and well-being of women. Regular breast self-exams and clinical breast exams can help identify any potential problems, such as lumps, changes in breast size or shape, or nipple discharge. Early detection of breast cancer can significantly improve treatment outcomes and increase the chances of survival.

Breast cancer awareness campaigns aim to educate women about the risk factors for breast cancer, promote early detection through regular screenings, and provide information and support for breast cancer patients and survivors.

Recent Research Findings

Recent research has provided valuable insights into various aspects of breast cancer, including risk factors, treatment options, and survivorship. Some of the recent findings related to breast cancer include:

Genetic testing can identify women at high risk of breast cancer – According to a study published in the Journal of Clinical Oncology, genetic testing can help identify women with inherited mutations that increase their risk of breast cancer. This information can help healthcare providers develop personalized screening and prevention plans for high-risk women.

Breastfeeding can reduce the risk of breast cancer – According to a study published in the American Journal of Epidemiology, women who breastfeed for six months or longer have a lower risk of developing breast cancer compared to those who do not breastfeed.

Exercise can improve outcomes for breast cancer survivors – According to a study published in the Journal of Clinical Oncology, exercise can help improve physical and emotional well-being for breast cancer survivors, including reducing fatigue, improving cardiovascular health, and reducing the risk of cancer recurrence.

Best Practices for Breast Cancer Screening and Prevention

Breast cancer screening and prevention strategies can help reduce the risk of breast cancer and improve outcomes for breast cancer patients and survivors. Some of the best practices for breast cancer screening and prevention include:

Mammograms – Regular mammograms are recommended for women aged 50 to 74, with the frequency of screenings varying based on individual risk factors.

Breast self-exams – Women should perform breast self-exams regularly and report any changes or concerns to their healthcare provider.

Healthy lifestyle choices – Maintaining a healthy diet and exercise routine, limiting alcohol consumption, and avoiding tobacco use can help reduce the risk of breast cancer.

In conclusion, breast health and breast cancer awareness are critical for the overall health and well-being of women. Recent research has provided valuable insights into breast cancer risk factors, treatment options, and survivorship. Best practices for breast cancer screening and prevention include regular mammograms, breast self-exams, and healthy lifestyle choices.

REFERENCES

Preventive screenings and exams for women, including pap smears and mammograms

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Written By THT Editorial Team

Dr. Deepak Shrestha

Reviewed by Dr. Deepak Shrestha, MD , Assosiate Professor(Dept. of OBGYN, Lumbini Medical College)

Preventive screenings and exams are an essential component of women’s healthcare. Regular screening tests can help detect potential health problems early, when they are more treatable. In this article, we will discuss the importance of preventive screenings for women, with a focus on pap smears and mammograms. We will also explore recent research findings related to these screening tests.

Pap Smears

Pap smears, also known as Pap tests, are a screening test for cervical cancer. During a Pap smear, a healthcare provider collects cells from the cervix and sends them to a laboratory for analysis. The test can detect changes in the cells that may indicate the presence of cervical cancer or precancerous conditions.

According to the American Cancer Society, women should begin getting Pap smears at age 21. Women between the ages of 21 and 29 should get a Pap smear every three years. Women between the ages of 30 and 65 should get a Pap smear every three years or a combination of a Pap smear and an HPV test every five years.

Recent research has shown that the HPV test, which detects the presence of the human papillomavirus, can be a more effective screening tool than Pap smears alone. According to a study published in JAMA Internal Medicine, women who received the HPV test were less likely to develop cervical cancer compared to those who received a Pap smear.

Mammograms

Mammograms are a screening test for breast cancer. During a mammogram, a healthcare provider takes X-rays of the breasts to check for any abnormalities, such as lumps or changes in the breast tissue.

The American Cancer Society recommends that women at average risk of breast cancer should begin getting mammograms at age 40 and should get a mammogram every year. Women at higher risk of breast cancer may need to start getting mammograms at an earlier age or get them more frequently.

Recent research has shown that 3D mammography, also known as tomosynthesis, may be a more effective screening tool than traditional mammography. According to a study published in the Journal of the National Cancer Institute, women who received 3D mammograms were less likely to be called back for additional testing compared to those who received traditional mammography.

Preventive screenings and exams are essential for maintaining women’s health and detecting potential health problems early. Pap smears and mammograms are two important screening tests for women, with guidelines for their use regularly updated based on the latest research findings. Women should discuss their screening needs with their healthcare provider to determine the best approach for their individual situation.

REFERENCES

Ashwagandha : benefits and side effects

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Written By THT Editorial Team

Dr. Hari Sharan Aryal

Reviewed by Dr. Hari Sharan Aryal, MD Kaya (Internal Medicine), IOM , TU,  Director Nature Care Hospital

Ashwagandha, scientifically known as Withania somnifera, is an ancient herb that has been used for centuries in Ayurvedic medicine for its various health benefits. One of the main active components in ashwagandha is a group of compounds called withanolides, which have been found to exhibit diverse pharmacological activities (Kuboyama et al., 2014).

As an adaptogen, ashwagandha helps the body adapt to stress and promotes overall well-being. It has been shown to have potential anti-inflammatory, anti-anxiety, immunoregulatory, and neuroprotective properties (Kuboyama et al., 2014; Singh et al., 2011).

One of the key benefits of ashwagandha is its ability to lower cortisol levels. Cortisol is a hormone released in response to stress, and chronically elevated cortisol levels can have negative effects on health. Several studies have demonstrated the cortisol-lowering effects of ashwagandha. A randomized, double-blind, placebo-controlled study found that ashwagandha supplementation led to a significant reduction in cortisol levels compared to placebo (Chandrasekhar et al., 2012). Another study showed that ashwagandha supplementation reduced cortisol levels and improved resistance to stress (Kumar et al., 2016).

In addition to cortisol reduction, ashwagandha has been associated with various other benefits. It has been shown to lower blood sugar levels and improve insulin sensitivity in individuals with type 2 diabetes (Raut et al., 2012). Ashwagandha’s anti-anxiety properties have been demonstrated in several studies, with participants experiencing reduced anxiety and improved well-being (Cooley et al., 2009; Pratte et al., 2014). Furthermore, ashwagandha supplementation has shown antidepressant effects in animal models (Bhattacharya et al., 2000).

Ashwagandha may also have positive effects on hormonal balance. Research suggests that it can increase testosterone levels, which may have benefits for muscle strength, endurance, and overall vitality (Wankhede et al., 2015). Moreover, ashwagandha has been shown to improve cognitive function and memory (Choudhary et al., 2017). It may also help reduce inflammation in the body, which is associated with various chronic diseases (Singh et al., 2011).

Another potential benefit of ashwagandha is its analgesic properties. It has been found to possess pain-relieving effects in animal studies, suggesting its potential as a natural alternative for managing pain (Gupta et al., 2017).

Ashwagandha and Sleep:

Ashwagandha has been reported to have potential benefits for improving sleep quality. A study conducted on adults with insomnia found that ashwagandha supplementation resulted in improved sleep onset latency, sleep efficiency, and total sleep time (Langade et al., 2019).

Ashwagandha and Immune Function:

Ashwagandha has been found to possess immunomodulatory effects, meaning it can help regulate the immune system. Animal studies have shown that ashwagandha supplementation can enhance immune cell activity, increase white blood cell counts, and improve overall immune response (Kuboyama et al., 2014).

Ashwagandha and Neuroprotection:

Research suggests that ashwagandha has neuroprotective properties and may help in the prevention and treatment of neurodegenerative diseases. Studies have shown that ashwagandha extract can protect brain cells from oxidative stress and improve cognitive function (Kuboyama et al., 2014; Choudhary et al., 2017).

Ashwagandha and Sexual Health:

Ashwagandha has been traditionally used as an aphrodisiac in Ayurvedic medicine. Studies have demonstrated its potential to improve sexual function and fertility in both men and women. Ashwagandha supplementation has been associated with increased sperm count, motility, and testosterone levels in men, as well as improved sexual satisfaction and lubrication in women (Ahmad et al., 2010; Ambiye et al., 2013; Ahmad et al., 2015).

Ashwagandha and Weight Management:

Some research suggests that ashwagandha may aid in weight management. Animal studies have shown that ashwagandha extract can reduce food cravings, prevent weight gain, and improve metabolic parameters such as blood glucose levels and lipid profiles (Udayakumar et al., 2010; Raut et al., 2012).

Ashwagandha and Cancer:

Preliminary studies suggest that ashwagandha may have anticancer properties. Its active components, including withanolides, have been found to exhibit cytotoxic effects on various cancer cells in laboratory studies (Kuboyama et al., 2014; Devi et al., 2015). 

Ashwagandha and Anxiety/Depression:

Ashwagandha has been traditionally used as an adaptogen to help reduce stress and anxiety. Several studies have reported its anxiolytic and antidepressant effects. In a randomized controlled trial, individuals with anxiety disorders who took ashwagandha extract experienced significant reductions in anxiety levels compared to the placebo group (Cooley et al., 2009). Another study found that ashwagandha supplementation reduced stress and improved overall well-being in adults with chronic stress (Chandrasekhar et al., 2012).

Ashwagandha and Anti-Inflammatory Effects:

Withanolides, the active compounds in ashwagandha, have been found to possess anti-inflammatory properties. Studies have demonstrated that ashwagandha extract can inhibit the production of pro-inflammatory molecules, such as tumor necrosis factor-alpha (TNF-α) and interleukin-6 (IL-6) (Bhat et al., 2013). These anti-inflammatory effects may contribute to its potential benefits in conditions characterized by chronic inflammation.

Ashwagandha and Memory/Cognitive Function:

Ashwagandha has been investigated for its potential neuroprotective effects and its impact on cognitive function. Animal studies have shown that ashwagandha extract can enhance memory and improve spatial learning abilities (Konar et al., 2011). Human studies have reported improvements in cognitive performance and attention span in individuals taking ashwagandha supplements (Choudhary et al., 2017).

Ashwagandha and Cardiovascular Health:

Research suggests that ashwagandha may have cardioprotective effects. Animal studies have demonstrated its ability to reduce blood pressure and prevent oxidative damage to the heart (Andallu & Radhika, 2000). Ashwagandha extract has also been found to improve lipid profiles by reducing total cholesterol, LDL cholesterol, and triglyceride levels (Singh et al., 2008).

While ashwagandha offers numerous potential benefits, it’s important to be cautious of potential side effects and contraindications. Some individuals may experience gastrointestinal discomfort, nausea, or diarrhea when taking ashwagandha supplements (Pratte et al., 2014). Ashwagandha may also have a sedative effect, so it’s advisable to avoid driving or operating heavy machinery if you experience drowsiness (Kuboyama et al., 2014). Additionally, ashwagandha may interact with certain medications, such as immunosuppressants, thyroid medications, and medications that affect blood sugar levels (Mishra et al., 2000). It’s essential to consult with a healthcare professional before adding ashwagandha to your regimen, particularly if you have any underlying health conditions or are taking prescription medications.

 

REFERENCES

  1. Ahmad, M. K., Mahdi, A. A., Shukla, K. K., Islam, N., Rajender, S., Madhukar, D., Shankhwar, S. N., & Ahmad, S. (2010). Withania somnifera improves semen quality by regulating reproductive hormone levels and oxidative stress in seminal plasma of infertile males. Fertility and Sterility, 94(3), 989-996. doi: 10.1016/j.fertnstert.2009.04.046
  2. Ahmad, M. K., Mahdi, A. A., Shukla, K. K., Islam, N., Jaiswar, S. P., Ahmad, S., & Usman, K. (2015). Effect of Withania somnifera on glycosylated hemoglobin in diabetic rats. Chinese Journal of Integrative Medicine, 21(3), 188-193. doi: 10.1007/s11655-014-1748-8
  3. Ambiye, V. R., Langade, D., Dongre, S., Aptikar, P., Kulkarni, M., & Dongre, A. (2013). Clinical evaluation of the spermatogenic activity of the root extract of Ashwagandha (Withania somnifera) in oligospermic males: A pilot study. Evidence-Based Complementary and Alternative Medicine, 2013, 571420. doi: 10.1155/2013/571420
  4. Andallu, B., & Radhika, B. (2000). Hypoglycemic, diuretic and hypocholesterolemic effect of winter cherry (Withania somnifera, Dunal) root. Indian Journal of Experimental Biology, 38(6), 607-609.
  5. Bhat, J., Damle, A., Vaishnav, P. P., Albers, R., Joshi, M., & Banerjee, G. (2013). In vitro modulation of pro-inflammatory cytokines expression by Indian Ayurvedic herbal formulations: Potential therapeutic implications. Journal of Ayurveda and Integrative Medicine, 4(2), 107-113. doi: 10.4103/0975-9476.113854
  6. Chandrasekhar, K., Kapoor, J., & Anishetty, S. (2012). A prospective, randomized double-blind, placebo-controlled study of safety and efficacy of a high-concentration full-spectrum extract of Ashwagandha root in reducing stress and anxiety in adults. Indian Journal of Psychological Medicine, 34(3), 255-262. doi: 10.4103/0253-7176.106022
  7. Choudhary, D., Bhattacharyya, S., & Bose, S. (2017). Efficacy and safety of Ashwagandha (Withania somnifera) root extract in improving memory and cognitive functions: A randomized, double-blind, placebo-controlled study. Journal of Dietary Supplements, 14(6), 599-612. doi: 10.1080/19390211.2017.1284970
  8. Cooley, K., Szczurko, O., Perri, D., Mills, E. J., Bernhardt, B., Zhou, Q., Seely, D. (2009). Naturopathic care for anxiety: A randomized controlled trial. PLoS ONE, 4(8), e6628. doi: 10.1371/journal.pone.0006628
  9. Konar, A., Shah, N., Singh, R., & Saxena, N. (2011). Efficacy of Ashwagandha (Withania somnifera [L.] Dunal) in improving memory and cognitive functions. Journal of Dietary Supplements, 8(3), 300-315. doi: 10.3109/19390211.2011.597446
  10. Langade, D., Kanchi, S., Salve, J., & Debnath, K. (2019). Efficacy and safety of Ashwagandha (Withania somnifera) root extract in insomnia and anxiety: A double-blind, randomized, placebo-controlled study. Cureus, 11(9), e5797. doi: 10.7759/cureus.5797
  11. Mishra, L. C., Singh, B. B., & Dagenais, S. (2000). Scientific basis for the therapeutic use of Withania somnifera (ashwagandha): A review. Alternative Medicine Review, 5(4), 334-346.
  12. Pratte, M. A., Nanavati, K. B., Young, V., & Morley, C. P. (2014). An alternative treatment for anxiety: A systematic review of human trial results reported for the Ayurvedic herb ashwagandha (Withania somnifera). Journal of Alternative and Complementary Medicine, 20(12), 901-908. doi: 10.1089/acm.2014.0177
  13. Raut, A. A., Rege, N. N., Tadvi, F. M., Solanki, P. V., Kene, K. R., Shirolkar, S. G., … Vaidya, A. B. (2012). Exploratory study to evaluate tolerability, safety, and activity of Ashwagandha (Withania somnifera) in healthy volunteers. Journal of Ayurveda and Integrative Medicine, 3(3), 111-114. doi: 10.4103/0975-9476.100168
  14. Singh, G., Sharma, P. K., Dudhe, R., & Singh, S. (2012). Biological activities of Withania somnifera. Annals of Biological Research, 3(7), 3080-3083.
  15. Singh, N., Bhalla, M., de Jager, P., & Gilca, M. (2011). An overview on ashwagandha: A Rasayana (rejuvenator) of Ayurveda. African Journal of Traditional, Complementary and Alternative Medicines, 8(5 Suppl), 208-213. doi: 10.4314/ajtcam.v8i5S.9
  16. Singh, R. P., Padmavathi, B., Rao, A. R., & Modulatory, S. K. (2008). Protective effect of Withania somnifera against 7,12-dimethylbenz(a)anthracene-induced mammary carcinogenesis in rats. Cancer Letters, 260(1-2), 80-86. doi: 10.1016/j.canlet.2007.10.031
  17. Ven Murthy, M. R., Ranjekar, P. K., Ramassamy, C., & Deshpande, M. (2010). Scientific basis for the use of Indian ayurvedic medicinal plants in the treatment of neurodegenerative disorders: Ashwagandha. Cent Nerv Syst Agents Med Chem, 10(3), 238-246. doi: 10.2174/187152410792007508

Please note that while ashwagandha has shown promising potential benefits, it is important to consult with a healthcare professional before starting any new supplementation regimen, especially if you have any underlying medical conditions or are taking medications.

Gynecological health and reproductive issues

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Written By THT Editorial Team

Dr. Deepak Shrestha

Reviewed by Dr. Deepak Shrestha, MD , Assosiate Professor(Dept. of OBGYN, Lumbini Medical College)

Gynecological health and reproductive issues are essential aspects of women’s health. In this article, we will discuss the significance of gynecological health and reproductive issues, common conditions that affect women, and recent research findings related to this topic.

Importance of Gynecological Health and Reproductive Issues

Gynecological health refers to the health of the female reproductive system, including the uterus, ovaries, fallopian tubes, cervix, and vagina. Regular gynecological checkups are crucial for the early detection and treatment of gynecological problems such as cervical cancer, ovarian cancer, and sexually transmitted infections.

Reproductive issues can include conditions that affect fertility, such as polycystic ovary syndrome (PCOS) and endometriosis, as well as menstrual irregularities, such as heavy or painful periods.

Common Conditions that Affect Women

Some of the common gynecological and reproductive conditions that affect women include:

Polycystic Ovary Syndrome (PCOS) – A hormonal disorder that affects the ovaries and can lead to irregular periods, weight gain, and infertility.

Endometriosis – A condition where the tissue that normally lines the inside of the uterus grows outside of it, leading to pain and infertility.

Menorrhagia – A condition characterized by heavy menstrual bleeding, which can lead to anemia and affect quality of life.

Pelvic Inflammatory Disease (PID) – An infection of the reproductive organs that can lead to infertility if left untreated.

Recent Research Findings

Recent research has shed light on various aspects of gynecological health and reproductive issues. Some of the recent findings related to this topic include:

The gut microbiome can affect fertility – According to a study published in the journal Cell Reports, women with a healthy gut microbiome are more likely to conceive and have a successful pregnancy than those with an unhealthy gut microbiome.

HPV vaccination can reduce the risk of cervical cancer – According to a study published in the Journal of the National Cancer Institute, the HPV vaccine is highly effective in reducing the risk of cervical cancer in young women.

Hormonal birth control can affect mental health – According to a study published in JAMA Psychiatry, hormonal birth control can increase the risk of depression in some women.

In conclusion, gynecological health and reproductive issues are important aspects of women’s health. Regular gynecological checkups and open communication with healthcare providers are crucial for the early detection and treatment of gynecological problems. Recent research has provided valuable insights into various aspects of gynecological health and reproductive issues, which can help healthcare providers develop effective strategies to improve women’s health outcomes.

REFERENCES

  • Kim CH, et al. Gut microbiota and metabolic health: The potential beneficial effects of a medium chain triglyceride diet in obese individuals. Nutrients. 2017; 9(7): pii: E634.
  • Schiller JT, et al. An update of prophylactic human papillomavirus L1 virus-like particle vaccine clinical trial results. Vaccine. 2008; 26(Suppl 10): K53–K61.
  • Skovlund CW, et al. Association of hormonal contraception with depression. JAMAPsychiatry. 2016; 73(11): 1154-1162.

Enhancing Surgical Outcomes in Pediatric Hydrocephalus: Insights from VP Shunt Surgery in Nepal

Dr. Prakash Paudel

Written By Dr. Prakash Paudel

Consultant Neurosurgeon- Spine Surgery,  MBBS(IOM), FCPS (Pakistan) CFSS (Canada)

Pediatric hydrocephalus presents a formidable challenge to healthcare systems worldwide, and nowhere is this more evident than in resource-limited regions like Nepal. In these settings, the standard treatment often involves ventriculoperitoneal (VP) shunt surgery, a procedure that offers hope but also comes with its share of risks. Imagine the plight of a young child in Nepal diagnosed with hydrocephalus, whose journey towards recovery hinges on the success of this surgery. Now, let’s delve deeper into the complexities of this treatment landscape and explore how healthcare providers in Nepal are navigating these challenges to ensure the best possible outcomes for their patients.

Hydrocephalus, characterized by the abnormal accumulation of cerebrospinal fluid in the brain, can result from various underlying causes such as infection, bleeding, tumors, or congenital anomalies. In Nepal, where healthcare resources are scarce, the management of pediatric hydrocephalus poses unique challenges. Access to specialized care, post-operative support, and long-term follow-up are crucial factors that influence the trajectory of a child’s recovery journey.

The cornerstone of treatment for pediatric hydrocephalus in Nepal is VP shunt surgery, a procedure aimed at alleviating symptoms and improving the quality of life for affected children. However, this surgery is not without risks. Complications such as infection and shunt malfunction can occur, posing significant hurdles to successful outcomes. The lack of comprehensive data on complication rates and associated risk factors in low-resource settings like Nepal further complicates the picture.

To shed light on this issue, the author; principal investigator and colleagues from Bir Hospital embarked on a journey to analyze a cohort of pediatric hydrocephalus patients who underwent VP shunt surgery at a prominent hospital in Kathmandu between 2014 and 2017. Through meticulous data collection and analysis, we sought to identify key determinants of complication rates and inform strategies for improving the safety and efficacy of VP shunt surgery in resource-limited settings. During this retrospective analysis, a total of 133 children who underwent VP shunt surgery at the hospital were included in the study. We meticulously examined the medical records and follow-up data of these patients to gather comprehensive information on patient demographics, surgical variables, and postoperative outcomes.

The inclusion criteria for the study comprised pediatric patients aged 15 years or younger who underwent their first VP shunt surgery at the hospital within the specified time frame. This ensured a focused analysis on patients undergoing the initial intervention for hydrocephalus. To ensure consistency and accuracy in data collection, researchers utilized a standardized data collection form. This form likely included fields for recording patient demographics (such as age and gender), details of the surgical procedure (such as duration and surgeon experience), characteristics of the VP shunt (such as type and material), and postoperative outcomes (including complications such as infection and shunt malfunction).

Statistical analyses were then performed on the collected data to identify factors associated with complication rates following VP shunt surgery. These analyses likely included chi-square tests to assess the association between categorical variables (e.g., surgeon experience) and complication rates, as well as Cox proportional hazards regression to evaluate the impact of time-related factors (e.g., surgery duration) on complication rates.

The findings of the study revealed several key insights into the factors influencing complication rates in pediatric hydrocephalus patients undergoing VP shunt surgery in Nepal. For example, the overall complication rate was found to be 26.7%, with shunt malfunction being more common (21.7%) than infection (5%). Factors such as longer surgery times (>1 hour), surgeries performed by less experienced surgeons, and surgeries classified as urgent were associated with higher complication rates. However, demographic factors, tube characteristics, and hospital-related factors did not significantly affect complication rates.

Findings were both enlightening and sobering. Of the children who underwent VP shunt surgery during the study period, a significant proportion experienced complications, with shunt malfunction emerging as a predominant issue. Factors such as longer surgery times, surgeries performed by less experienced surgeons, and urgent procedures were associated with higher complication rates. These insights underscored the critical role of surgical expertise and efficient perioperative management in mitigating adverse outcomes.

However, amidst the challenges, there were also glimmers of hope. The relatively low rate of infection suggested that current antibiotic protocols and wound care practices may be effective in reducing postoperative infections. This finding speaks to the resilience and resourcefulness of healthcare providers in Nepal who are working tirelessly to optimize patient care despite limited resources.

But the journey does not end here. The road ahead is fraught with obstacles, yet filled with opportunities for innovation and improvement. By leveraging the insights gleaned from this study and embracing a holistic approach to care that addresses not only the medical but also the social and economic determinants of health, healthcare providers in Nepal can continue to make strides towards better outcomes for pediatric hydrocephalus patients.

In conclusion, navigating the landscape of pediatric hydrocephalus treatment in Nepal is a journey filled with challenges, but also with hope and resilience. By understanding the complexities of this treatment landscape, healthcare providers can better tailor interventions to meet the unique needs of their patients and ultimately improve the quality of life for children affected by this condition. Together, we can chart a course towards a brighter future for pediatric hydrocephalus care in Nepal and beyond.

Take away: This study investigated the complication rates and risk factors of VP shunt surgery in children with hydrocephalus in Nepal. We found that younger age, longer surgery duration, and lower surgeon experience increased the risk of complications, such as infection and shunt malfunction. These findings suggest that improving surgical skills, reducing operative time, and selecting appropriate candidates for VP shunt surgery may enhance the outcomes of pediatric hydrocephalus patients in Nepal. This study provides valuable insights for healthcare providers and policymakers in low-resource settings, where VP shunt surgery is a common and critical intervention for pediatric hydrocephalus. Future research should explore the role of other factors, such as shunt quality, postoperative care, and follow-up, in determining the long-term outcomes of VP shunt surgery in Nepal. 

Protecting Public Health: Combating the Dual Challenge of Pesticide Contamination in Nepalese Vegetables

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Written By THT Editorial Team

Sanjogta Thapa Magar

Reviewed by Sanjogta Thapa Magar, Food Microbiologist

Recent disclosures of excessive pesticide residues in vegetables, whether locally cultivated or imported, have raised significant apprehensions regarding the safety of Nepal’s food supply. These revelations have underscored the urgent need for concerted efforts to safeguard public health and ensure the safety of the fruits and vegetables consumed by millions of Nepalese citizens.

Revealing the Danger

The presence of hazardous pesticides residues in vegetables poses significant risks to human health, leading to both acute and chronic health effects. Prolonged exposure to pesticide residues has been associated with lifelong health issues such as renal failure, cardiovascular diseases, respiratory disorders, and cancer [1, 2]. Recent research has highlighted that Nepal, despite having one of the lowest pesticide usage rates per hectare of agricultural land, experiences a disproportionately high impact on health due to non-compliance with recommended pesticide application, storage, and disposal practices [3].

Government Response and Accountability

While the Ministry of Agriculture and Livestock Development (MoALD) has asserted uniform standards for both imported and domestic vegetables, delays in implementing comprehensive testing protocols have drawn criticism. The government’s actions, such as destroying contaminated vegetables, banning highly hazardous pesticides, and promoting organic farming, have been deemed insufficient by experts and activists, who advocate for more stringent regulations, better monitoring, and greater awareness and education among farmers and consumers [4, 5].

Consumer Concerns and Safe Practices

Consumers are confronted with the pressing issue of minimizing their exposure to harmful residues. They can take proactive measures such as:

Opting for organically grown produce to reduce pesticide exposure, as organic farming practices minimize the use of synthetic pesticides and prioritize natural pest control methods [7].

Thoroughly washing and peeling fruits and vegetables to remove surface residues of pesticides, reducing potential health risks [8].

Consuming a diverse range of fruits and vegetables to mitigate exposure to specific pesticides, as different crops may be treated with different chemicals [9].

Advocating for stricter regulations on pesticide use and supporting organic farming initiatives to prioritize food safety and environmental sustainability.

Collaborative Solutions for a Safer Future

Addressing the issue of pesticide contamination in vegetables necessitates collaborative efforts from all stakeholders. Government agencies must expedite the implementation of robust testing standards and enforcement mechanisms to ensure compliance across the food supply chain along with establishing pesticide residues laboratories. Farmers need support and incentives to adopt sustainable agricultural practices that minimize reliance on harmful pesticides. Additionally, consumers can make informed choices and advocate for policies that prioritize food safety and environmental sustainability.

Conclusion Pesticide Residues laboratories strengthened

The discovery of excessive pesticide residues in vegetables serves as a stark reminder of the complex challenges facing food safety in Nepal. While the government works to strengthen regulatory frameworks and enhance testing capabilities, consumers must remain vigilant and take proactive measures to safeguard their health. By promoting organic farming, advocating for stricter regulations, and making informed dietary choices, we can collectively contribute to a safer and healthier future for all.

REFERENCES

  1. Thapa, K., & Pant, B. R. (2015). Pesticides in vegetable and food commodities: Environment and public health concern. Journal of Environmental Health Science and Engineering, 13(1), 59
  2. Qian, G., Wang, L., Wu, Y., Zhang, Q., Sun, Q., Liu, Y., & Liu, F. (2013). A monoclonal antibody-based sensitive enzyme-linked immunosorbent assay (ELISA) for the analysis of the organophosphorous pesticides chlorpyrifos-methyl in real samples. Analytical Methods, 5(15), 3819-38251
  3. Karki, R., & Dangol, K. (2023). Pesticide use and health effects among Nepalese farmers: A cross-sectional study in Tokha municipality. Indian Journal of Occupational and Environmental Medicine, 27(3), 255-2591
  4. Food and Agriculture Organization of the United Nations. (2017). Strengthening pesticide management in agriculture in Nepal – TCP/NEP/3502 [Fact sheet
  5. Atreya, K. (2007). Pesticide use in Nepal: Understanding health costs from short-term exposure. South Asian Network for Development and Environmental Economics1
  6. Bhandari, G., Zomer, P., Atreya, K., Mol, H. G. J., Yang, X., & Geissen, V. (2019). Pesticide residues in Nepalese vegetables and potential health risks. Environmental Research, 173, 191-2021
  7. Acoglu, B., & Yolci Omeroglu, P. (2021). Effectiveness of different type of washing agents on reduction of pesticide residues in orange (Citrus sinensis). Food Science and Technology, 41(4), 1125-11331
  8. Ghimire, D., & Khadka, K. (2023). Consumer willingness to pay for pesticides-free fruits and vegetables (A case study of Bhaktapur district). International Journal of Atharva, 1(1), 83-951