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  • 1
    Online Resource
    Online Resource
    Rapid genomic surveillance of SARS-CoV-2 in a dense urban community of Kathmandu Valley using sewage samples
    Public Library of Science (PLoS) ; 2023
    In:  PLOS ONE Vol. 18, No. 3 ( 2023-3-30), p. e0283664-
    Details
    In: PLOS ONE, Public Library of Science (PLoS), Vol. 18, No. 3 ( 2023-3-30), p. e0283664-
    Abstract: Understanding disease burden and transmission dynamics in resource-limited, low-income countries like Nepal are often challenging due to inadequate surveillance systems. These issues are exacerbated by limited access to diagnostic and research facilities throughout the country. Nepal has one of the highest COVID-19 case rates (915 cases per 100,000 people) in South Asia, with densely-populated Kathmandu experiencing the highest number of cases. Swiftly identifying case clusters (hotspots) and introducing effective intervention programs is crucial to mounting an effective containment strategy. The rapid identification of circulating SARS-CoV-2 variants can also provide important information on viral evolution and epidemiology. Genomic-based environmental surveillance can help in the early detection of outbreaks before clinical cases are recognized and identify viral micro-diversity that can be used for designing real-time risk-based interventions. This research aimed to develop a genomic-based environmental surveillance system by detecting and characterizing SARS-CoV-2 in sewage samples of Kathmandu using portable next-generation DNA sequencing devices. Out of 22 sites in the Kathmandu Valley from June to August 2020, sewage samples from 16 (80%) sites had detectable SARS-CoV-2. A heatmap was created to visualize the presence of SARS-CoV-2 infection in the community based on viral load intensity and corresponding geospatial data. Further, 47 mutations were observed in the SARS-CoV-2 genome. Some detected mutations (n = 9, 22%) were novel at the time of data analysis and yet to be reported in the global database, with one indicating a frameshift deletion in the spike gene. SNP analysis revealed possibility of assessing circulating major/minor variant diversity on environmental samples based on key mutations. Our study demonstrated the feasibility of rapidly obtaining vital information on community transmission and disease dynamics of SARS-CoV-2 using genomic-based environmental surveillance.
    Type of Medium: Online Resource
    ISSN: 1932-6203
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    DOI: 10.1371/journal.pone.0283664
    DOI: 10.1371/journal.pone.0283664.g001
    DOI: 10.1371/journal.pone.0283664.g002
    DOI: 10.1371/journal.pone.0283664.g003
    DOI: 10.1371/journal.pone.0283664.g004
    DOI: 10.1371/journal.pone.0283664.t001
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    DOI: 10.1371/journal.pone.0283664.t003
    DOI: 10.1371/journal.pone.0283664.s001
    DOI: 10.1371/journal.pone.0283664.s002
    DOI: 10.1371/journal.pone.0283664.s003
    DOI: 10.1371/journal.pone.0283664.s004
    DOI: 10.1371/journal.pone.0283664.r001
    DOI: 10.1371/journal.pone.0283664.r002
    DOI: 10.1371/journal.pone.0283664.r003
    DOI: 10.1371/journal.pone.0283664.r004
    DOI: 10.1371/journal.pone.0283664.r005
    DOI: 10.1371/journal.pone.0283664.r006
    DOI: 10.1371/journal.pone.0283664.r007
    Language: English
    Publisher: Public Library of Science (PLoS)
    Publication Date: 2023
    detail.hit.zdb_id: 2267670-3
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  • 2
    Online Resource
    Online Resource
    Training of maternal health care providers in newer modalities of management of post-partum haemorrhage
    Medip Academy ; 2019
    In:  International Journal of Reproduction, Contraception, Obstetrics and Gynecology Vol. 8, No. 3 ( 2019-02-26), p. 1062-
    Details
    In: International Journal of Reproduction, Contraception, Obstetrics and Gynecology, Medip Academy, Vol. 8, No. 3 ( 2019-02-26), p. 1062-
    Abstract: Background: Postpartum haemorrhage (PPH) is a life-threatening complication, that occurs suddenly and unexpectedly. Institutional delivery by skilled birth attendant who are trained in active management of third stage of labour and those who can use of Uterine Balloon Tamponade and Non-pneumatic anti shock garment can reduce incidence and morbidity related to PPH. The objective of the paper was to share the experiences of the training programmes held for maternal health care workers in the newer modalities of PPH management.Methods: During one and a half year period, 32 Continuation of Medical Education (CME) programmes, with the theme of “Managing Obstetric Emergencies and Obstetric Trauma”, covering important topics related to high risk pregnancies like Hypertension, Eclampsia ,Anaemia and Haemorrhage at 32 health institutions, spread over 11 states and 2 union territories in India, were conducted .In addition,42 hands on workshops  at various health facilities were conducted with training of more than 2575 maternal health care providers.Results: The pre and post test scores revealed that 95 percent of the maternal health care providers were unaware about the use of Uterine Balloon Tamponade (Bakri balloon) in PPH and Non-pneumatic anti shock garment (NASG). Seventy percent were unaware about the proper sequence of steps of active management of third stage of labour. Training programmes helped to improve the knowledge, whereas hands on workshop, helped in skill development of the health care providers. The participants expressed great satisfaction regarding the knowledge and skills they acquired through training programme on management of post-partum haemorrhage. They gave positive feedback about the quality, contents and conduct of training programme.Conclusions: There is need for refresher training of maternal health care providers in newer modalities like AMTSL, NASG and Bakri balloon, which have potential to save lives.
    Type of Medium: Online Resource
    ISSN: 2320-1789 , 2320-1770
    URL: Article
    DOI: 10.18203/2320-1770.ijrcog20190880
    Language: Unknown
    Publisher: Medip Academy
    Publication Date: 2019
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  • 3
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    Study of incidence and outcome of acute inversion of uterus
    Medip Academy ; 2018
    In:  International Journal of Reproduction, Contraception, Obstetrics and Gynecology Vol. 7, No. 12 ( 2018-11-26), p. 5145-
    Details
    In: International Journal of Reproduction, Contraception, Obstetrics and Gynecology, Medip Academy, Vol. 7, No. 12 ( 2018-11-26), p. 5145-
    Abstract: Background: Acute inversion of uterus also called as puerperal inversion of uterus is a rare, but life-threatening complication of third stage of labour. Severe uterine atony, mismanagement of third stage of labour, adherent placenta are some of the common factors associated with the occurrence of acute inversion of uterus. Early recognition and prompt treatment are important to save life of the woman.Methods: A retrospective cross-sectional record-based study was carried out to find out the incidence, presentation and outcome of cases of acute inversion of uterus admitted to Pravara Rural Hospital Loni for a period of three years (October 2015 to September 2018).Results: During the study period, there were 27,134 deliveries including 8,834 caesarean sections. There were six cases of acute inversion of uterus in the hospital during study period. The incidence of acute inversion of uterus was 0.22 per one thousand deliveries (0.27 per thousand vaginal deliveries and 0.11per one thousand caesarean sections). Three cases were referred from outside hospital and three cases had delivered at Pravara Rural Hospital. Five cases had delivered vaginally, where as one case had undergone caesarean section. There were two maternal deaths and four survivals among six cases of inversion of uterus. Severe anaemia, irreversible hypovolemic shock and multi-organ failure were causes of maternal deaths.Conclusions: Prompt recognition of uterine inversion and its immediate reposition under anaesthesia was a key for successful management. Delay in recognition and transfer of cases resulted in haemorrhagic and neurogenic shock, leading to death of a women. Institutional deliveries with practice of principles of active management of third stage of labour (AMTSL) and improvement in emergency obstetric care services at peripheral hospitals, avoiding delays at all levels will help to reduce the incidence, morbidity and mortality associated with acute inversion of uterus.
    Type of Medium: Online Resource
    ISSN: 2320-1789 , 2320-1770
    URL: Article
    DOI: 10.18203/2320-1770.ijrcog20184982
    Language: Unknown
    Publisher: Medip Academy
    Publication Date: 2018
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