BackgroundAgriculture work is one of the most hazardous occupations across countries of all income groups. In Nepal, 74 % of people are working in the agricultural sector. This study aims to identify patterns and factors associated with injuries among farmers of rural Nepal.MethodsA community-based cross-sectional study was conducted in a rural village in eastern Nepal. House to house visit was done to collect data from the farmers. The study included 500 farmers from Shanishchare village in Morang district of Nepal. A pre-tested semi-structured questionnaire was used to collect data on socioeconomic profile, agriculture work and injury. Prevalence of injuries among farmers in the last 12 months was calculated along with factors associated with the injuries.ResultsThe overall prevalence of work- related injuries among farmers was 69 % in the last 12 months. Common injuries among the farmers were cuts (79.7 %), puncture wound (11.3 %) and laceration (7.5 %). Hand tools were responsible for most of the injuries followed by slipping at work, sharp instruments, animals and fall from height. Upper limb injury comprised of 67 % of all injuries and the most involved part was fingers (43 %). The average number of years worked in farming by the respondents was 23.6 ± 13.6 years. Age and working experience of the farmers was found to be significantly associated with the occurrence of injuries among the farmers.ConclusionsThe prevalence of injury among farmers in this study was high. Further research is needed to identify interventions to reduce the agricultural injuries in Nepal.
Kawasaki disease (KD) is a common medium vessel systemic vasculitis that usually occurs in small children. It has a predilection for the coronary arteries, but other medium sized arteries can also be involved. The etiology of this disorder remains a mystery. Though typical presentation of KD is quite characteristic, it may also present as incomplete or atypical disease in which case the diagnosis can be very challenging. As both incomplete and atypical forms of KD can be associated with serious coronary artery complications, the pediatrician can ill afford to miss these diagnoses. The American Heart Association has enunciated consensus guidelines to facilitate the clinical diagnosis and treatment of this condition. However, there are still several issues that remain controversial. Intravenous immunoglobulin remains the cornerstone of management but several other treatment modalities, especially glucocorticoids, are increasingly finding favour. We review here some of the contemporary issues, and the controversies thereon, pertaining to management of KD.
Introduction: Studies conducted amongst the inhabitants of high altitude suggested that systolic and diastolic blood pressures are lower in the high than in low altitude population. So a study was designed to look at the blood pressure values among permanent residents of high altitudes of rural Western Nepal. Methods: This is a descriptive cross sectional study conducted at two different altitudes (2670 and 2950 meters) of Humla District, Nepal, looking at the blood pressure values among the permanent inhabitants at these altitudes. Results: Total number of 137 subjects with 73 (53.3%) from 2950 meters and 64 (46.7%) from 2670 meters altitude were enrolled. Mean age of the study population was 35.29 years. Male were 57 (41.6%) and female 80 (58.4%). The difference in systolic blood pressures (118.59 and 114.66 mmHg, P=0.01) and mean arterial pressures (92.0 and 89.5 mmHg, P=0.02) at the altitudes of 2670 and 2950 meters were statistically significant whereas the difference in diastolic BP at these altitudes were not statistically significant. There was no significant correlation of BMI with blood pressure values and no difference was noted in the blood pressure values among the two different ethnic groups at the given altitudes. Conclusions: Lower rate of hypertension was observed among the inhabitants of high altitude of rural western Nepal. Blood pressure was found to decreases with increase in altitude among permanent inhabitants of high altitude. Keywords: altitude; blood pressure; high altitude inhabitants; hypertension; physiological change.
Kawasaki disease (KD) is now a common cause of acquired heart disease in children. Coronary artery involvement is the most serious complication in children with KD. Several non-coronary complications have now been identified in this condition but these are often overlooked. Myocarditis is an integral component of KD and may be more common than coronary artery abnormalities. Pericardial involvement and valvular abnormalities have also been observed in patients with KD. KD shock syndrome is now being increasingly recognized and may be difficult to differentiate clinically from toxic shock syndrome. Endothelial dysfunction has been reported both during acute stage and also on follow-up. This may be a potentially modifiable cardiovascular risk factor.
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