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This report summarizes the present status of neutrino non-standard interactions (NSI). After a brief overview, several aspects of NSIs are discussed, including connection to neutrino mass models, model-building and phenomenology of large NSI with both light and heavy mediators, NSI phenomenology in both short- and long-baseline neutrino oscillation experiments, neutrino cross-sections, complementarity of NSI with other low- and high-energy experiments, fits with neutrino oscillation and scattering data, DUNE sensitivity to NSI, effective field theory of NSI, as well as the relevance of NSI to dark matter and cosmology. We also discuss the open questions and interesting future directions that can be pursued by the community at large. This report is based on talks and discussions during the Neutrino Theory Network NSI workshop held at Washington University in St. Louis from May 29-31, 2019 (https://indico.cern.ch/event/812851/), 104 pages; minor revision

Motivated by the recently reported measurement of the $W$ boson mass $M_W = 80.4335 \pm 0.0094$ GeV by the CDF collaboration, we propose a type III seesaw extension of the minimal supersymmetric standard model (MSSM) which also includes an R-parity violating term. Without taking potential SUSY radiative corrections into account, we show that the CDF measurement of $M_W$ and the LEP measurement of the $\rho$ parameter can be simultaneously accommodated at the $2 \sigma$ level. A long-lived gravitino in a few GeV mass range is a unique viable dark matter candidate in this framework., Comment: 3 pages, typos corrected, references added, matches with published version

In this descriptive cross-sectional study, the data on the prevalence of diabetes mellitus (DM) among tuberculosis (TB) patients at the Urban Directly Observed Treatment Centers in the Kathmandu, Bhaktapur, and Lalitpur districts of Nepal were collected. The prevalence of DM was assessed in 67 previously treated TB (PTTB) and 214 new TB patients. DM was diagnosed in 8 PTTB and 20 new TB patients. Clinical interviews identified 14 patients with DM, rapid blood glucose test was used to diagnose DM in 4 patients, and oral glucose tolerance test was used to diagnose DM in another 4 patients. Impaired glucose tolerance and impaired fasting glycemia were observed in 8 and 5 patients, respectively. The 18-24-year age group had the largest number of new TB patients (82, 38.3%). However, the incidence of DM among TB patients was higher in the >35-year age group. Moreover, DM was diagnosed in 24.2% of PTTB patients and in 23.1% of new TB patients. To determine the impact of DM screening in TB patients, a larger number of samples should be analyzed. DM screening for patients with TB is expected to start in developing countries. This should be initiated by conducting clinical interviews about DM and glucose tests using rapid kits.

The scotogenic model generates Majorana neutrino masses radiatively, with dark matter particles running in the loop. We explore the parameter space in which the relic density of fermionic dark matter is generated via a conversion-driven freeze-out mechanism. The necessity for small Yukawa couplings to initiate chemical decoupling for conversion processes naturally reproduces small neutrino masses as long as the active neutrinos are hierarchical. The model can also resolve the recently reported deviation in the $W$-boson mass while satisfying constraints from direct detection, charged lepton flavor violation as well as collider bounds. Parts of the parameter space lead to long-lived particle signatures to be probed at the LHC., 8 pages and references, 5 figures; v2: Minor changes in presentation, matches published version

Experimental hints for lepton flavor universality violation in beauty-quark decay both in neutral- and charged-current transitions require an extension of the Standard Model for which scalar leptoquarks (LQs) are the prime candidates. Besides, these same LQs can resolve the long-standing tension in the muon and the recently reported deviation in the electron $g-2$ anomalies. These tantalizing flavor anomalies have discrepancies in the range of $2.5\sigma-4.2\sigma$, indicating that the Standard Model of particle physics may finally be cracking. In this Letter, we propose a resolution to all these anomalies within a unified framework that sheds light on the origin of neutrino mass. In this model, the LQs that address flavor anomalies run through the loops and generate neutrino mass at the two-loop order while satisfying all constraints from collider searches, including those from flavor physics., Comment: 6 pages+ references, added references, matches published version

Introduction: Childhood tuberculosis has always been in shadows as Nepal’s Tuberculosis Program focused mainly on adults TB resulting in under diagnose with less than 10% of total TB cases notified. Lack of political commitment; absence of guideline and working group, qualified health personnel and diagnostics tool were major implementation challenges. Methodology: Assessment of childhood TB program was done and critical gap were identified. Childhood TB was prioritized in National TB strategic plan (2016-21). Collaborate with both international and national child experts, public and private organizations to develop guideline, building capacity of health care providers and establishing national working group. Childhood TB focused interventions were implemented in 40 high burden districts since March,2017 focusing on contact tracing, diagnosis, Prevention Therapy, malnourished children in the community and major hospitals. Results : Political commitment and multi-sectoral involvement, to manage childhood TB was achieved. A total of 93 doctors were trained in the Childhood TB management training and were identified as focal persons to manage childhood TB in their respective regions. Child focused intervention from March 2018-19 resulted in the diagnosis of 521 TB cases among 38,987 malnourished children and1,764 children were enrolled under TPT after contact tracing of 59,742 family members. With political commitment, prioritization of childhood TB, collaboration of both government and non-government sectors and interventions focusing childhood TB, a significant achievement can be attained in childhood TB management. Conclusion: Nepal has shown childhood TB management program can be strengthen if NTP prioritizes it, child focused interventions are implemented and collaborate with Child health division, pediatrics association, other government and non-government organizations to increase and strengthen the program.

The aim of this study was to compare costs and socio-economic impact of tuberculosis (TB) for patients diagnosed through active (ACF) and passive case finding (PCF) in Nepal. A longitudinal costing survey was conducted in four districts of Nepal from April 2018 to October 2019. Costs were collected using the WHO TB Patient Costs Survey at three time points: intensive phase of treatment, continuation phase of treatment and at treatment completion. Direct and indirect costs and socio-economic impact (poverty headcount, employment status and coping strategies) were evaluated throughout the treatment. Prevalence of catastrophic costs was estimated using the WHO threshold. Logistic regression and generalized estimating equation were used to evaluate risk of incurring high costs, catastrophic costs and socio-economic impact of TB over time. A total of 111 ACF and 110 PCF patients were included. ACF patients were more likely to have no education (75% vs 57%, P = 0.006) and informal employment (42% vs 24%, P = 0.005) Compared with the PCF group, ACF patients incurred lower costs during the pretreatment period (mean total cost: US$55 vs US$87, P $72 vs US$101, P

The CDF collaboration at Fermilab has recently reported a new precision measurement of the $W$~boson mass showing a substantial $7\sigma$ deviation from the Standard Model prediction. Moreover, Fermilab has recently confirmed the longstanding tension in the $(g-2)_\mu$ measurement. We propose a unified solution to these deviations within the simplest radiative neutrino mass model: the Zee model. Our analysis establishes non-trivial links between the origin of neutrino mass, the $(g-2)_\mu$ anomaly, and the $W$~boson mass shift while being consistent with lepton flavor violation and all other experimental constraints. We find that the mass spectrum of the physical scalars must be hierarchical to be consistent with the $W$~boson mass shift; remarkably, this is also the key to resolving the $(g-2)_\mu$ tension. Furthermore, this mass splitting offers a unique same-sign dimuon signal through which our model can be tested at the LHC., Comment: 5 pages + references, expanded LFV, added references, matches published version

We show how trinification models based on the gauge group $SU(3)_C \times SU(3)_L \times SU(3)_R$ realized near the TeV scale can provide naturally a variety of dark matter (DM) candidates. These models contain a discrete $T$ parity which may remain unbroken even after spontaneous symmetry breaking. The lightest $T$-odd particle, which could be a fermion, a scalar, or a gauge boson, can constitute the dark matter of the universe. This framework naturally admits a doublet-singlet fermionic DM, a singlet scalar DM, or a vector boson DM. Here we develop the vector boson DM scenario wherein the DM couples off-diagonally with the usual fermions and vector-like fermions present in the theory. We show consistency of this framework with dark matter relic abundance and direct detection limits as well as LHC constraints. We derive upper limits of 900 GeV on the vector gauge boson DM mass and 4.5 TeV on the vector-like quarks and lepton masses. We also show the consistency of spontaneous gauge symmetry breaking down to Standard Model times an extra $U(1)$ while preserving the $T$-parity., 25 pages + references, 8 figures, added section 2.2 and new references

Background In the last decade, active case finding (ACF) strategies for tuberculosis (TB) have been implemented in many diverse settings, with some showing large increases in case detection and reporting at the sub-national level. There have also been several studies which seek to provide evidence for the benefits of ACF to individuals and communities in the broader context. However, there remains no quantification of the impact of ACF with regards to reducing the burden of transmission. We sought to address this knowledge gap and quantify the potential impact of active case finding on reducing transmission of TB at the national scale and further, to determine the intensification of intervention efforts required to bring the reproduction number (R0) below 1 for TB. Methods We adopt a dynamic transmission model that incorporates heterogeneity in risk to TB to assess the impact of an ACF programme (IMPACT TB) on reducing TB incidence in Vietnam and Nepal. We fit the models to country-level incidence data using a Bayesian Markov Chain Monte Carlo approach. We assess the impact of ACF using a parameter in our model, which we term the treatment success rate. Using programmatic data, we estimate how much this parameter has increased as a result of IMPACT TB in the implementation districts of Vietnam and Nepal and quantify additional efforts needed to eliminate transmission of TB in these countries by 2035. Results Extending the IMPACT TB programme to national coverage would lead to moderate decreases in TB incidence and would not be enough to interrupt transmission by 2035. Decreasing transmission sufficiently to bring the reproduction number (R0) below 1, would require a further intensification of current efforts, even at the sub-national level. Conclusions Active case finding programmes are effective in reducing TB in the short term. However, interruption of transmission in high-burden countries, like Vietnam and Nepal, will require comprehensive incremental efforts. Complementary measures to reduce progression from infection to disease, and reactivation of latent infection, are needed to meet the WHO End TB incidence targets.

Background Poisoning has become a major public health problem, with the intent in most cases being self-harm and commit suicide. This study highlights the psychological and clinical-epidemiological profile of patients visiting Scheer Memorial Adventist Hospital after poisoning. Methods This retrospective record-based study was done among poisoning patients of a hospital in Nepal from 1st January 2018 to 31st December 2020. Data were analyzed using STATA version-15. Results Out of 134 total poisoning cases, 71 had consumed organophosphate compounds. The majority of the cases were female (59.2% in organophosphate groups, 69.8% in non-organophosphate groups). The circumstances of poisoning were mostly suicidal (95.8% in organophosphate groups, 90.5% in non-organophosphate groups) and the reasons for this being mostly family disputes. Organophosphate groups had 8.41 times higher odds of having complications when compared to non-organophosphorus compounds. Conclusions The majority of the poisoning cases were suicidal in nature and family disputes being the major reason for the intake of a poisonous substance. This demands that more attention be given to psychological and family counseling to resolve any disputes, as well as psychological management of poisoning cases after medical management. Also, a strong regulatory mechanism should be imposed to control the easy access to poisonous substances.

We present a model of radiative neutrino masses which also resolves anomalies reported in $B$-meson decays, $R_{D^{(\star)}}$ and $R_{K^{(\star)}}$, as well as in muon $g-2$ measurement, $\Delta a_\mu$. Neutrino masses arise in the model through loop diagrams involving TeV-scale leptoquark (LQ) scalars $R_2$ and $S_3$. Fits to neutrino oscillation parameters are obtained satisfying all flavor constraints which also explain the anomalies in $R_{D^{(\star)}}$, $R_{K^{(\star)}}$ and $\Delta a_\mu$ within $1\, \sigma$. An isospin-3/2 Higgs quadruplet plays a crucial role in generating neutrino masses; we point out that the doubly-charged scalar contained therein can be produced in the decays of the $S_3$ LQ, which enhances its reach to 1.1 (6.2) TeV at $\sqrt s=14$ TeV high-luminosity LHC ($\sqrt s=100$ TeV FCC-hh). We also present flavor-dependent upper limits on the Yukawa couplings of the LQs to the first two family fermions, arising from non-resonant dilepton ($pp \rightarrow \ell^+ \ell^-$) processes mediated by $t$-channel LQ exchange, which for 1 TeV LQ mass, are found to be in the range $(0.15 - 0.36)$. These limits preclude any explanation of $R_{D^{(\star)}}$ through LQ-mediated $B$-meson decays involving $\nu_e$ or $\nu_\mu$ in the final state. We also find that the same Yukawa couplings responsible for the chirally-enhanced contribution to $\Delta a_\mu$ give rise to new contributions to the SM Higgs decays to muon and tau pairs, with the modifications to the corresponding branching ratios being at (2-6)% level, which could be tested at future hadron colliders, such as HL-LHC and FCC-hh., Comment: 43 pages + references, expanded $h \to \mu \mu$ discussion, added references, matches published version

We propose a pseudo-Goldstone boson dark matter (pGDM) particle in $SO(10)$ grand unified theory (GUT). Due to its Goldstone nature, this pGDM evades the direct DM detection experiments which, otherwise, severely constrain the parameter space of DM models. In $SO(10)$, the pGDM is embedded as a linear combination of the Standard Model (SM) singlet scalars in ${\bf 16_H}$ and ${\bf 126_H}$ representations. We consider two scenarios for the intermediate route of $SO(10)$ symmetry breaking (SB) to the SM: $SU(5) \times U(1)_X$ and Pati-Salam the $SU(4)_c \times SU(2)_L \times SU(2)_R$ (4-2-2) gauge groups. The vacuum expectation value of ${\bf 126_H}$, which triggers the breaking of $U(1)_X$ and 4-2-2 symmetry in the two scenarios, respectively, determines the pGDM lifetime whose astrophysical lower bound provides one of the most stringent constraints. For the 4-2-2 route to $SO(10)$, the successful SM gauge coupling unification requires the 4-2-2 breaking scale to be ${\cal O} (10^{11})$ GeV, and most of the parameter space is excluded. For the $SU(5) \times U(1)_X$ route, on the other hand, the $U(1)_X$ breaking scale can be significantly higher, and a wide range of the parameter space is allowed. Furthermore, the proton lifetime in the $SU(5)$ case is predicted to be $4.53 \times 10^{34}$ years, which lies well within the sensitivity reach of the Hyper-Kamiokande experiment. We also examine the constraints on the model parameter space from the Large Hadron Collider and the indirect DM search by Fermi-LAT and MAGIC experiments., Comment: 25 pages, 5 figures, Figures 3 revised, updated version accepted for publication in PRD

As part of a multisectoral response to gender-based violence (GBV), Nepal is testing the feasibility of having female community health volunteers (FCHVs) play a formal role in identifying GBV survivors and referring them to specialised services at health facilities. This study followed 116 FHCVs in Mangalsen municipality who attended a one-day orientation on GBV. Over the following year, data were collected from knowledge and attitude assessments of FCHVs, focus group discussions with FCHVs, and members of Mothers' Groups for Health. Most Significant Change stories were collected from FCHVs, in-depth interviews with stakeholders, and service statistics. Results show that the FCHVs' knowledge increased, attitudes changed, and confidence in addressing GBV grew. During the study period, FCHVs identified 1,253 GBV survivors and referred 221 of them to health facilities. In addition to assisting GBV survivors, FCHVs worked to prevent GBV by mediating conflicts and curbing harmful practices such as menstrual isolation. Stakeholders viewed FCHVs as a sustainable resource for identifying and referring GBV survivors to services, while women trusted them and looked to them for help. Results show that, with proper training and safety mechanisms, FCHVs can raise community awareness about GBV, facilitate support for survivors, and potentially help prevent harmful practices.

We present simple and predictive realizations of neutrino masses in theories based on the $SU(6)$ grand unifying group. At the level of the lowest-dimension operators, this class of models predicts a skew-symmetric flavor structure for the Dirac mass term of the neutrinos. In the case that neutrinos are Dirac particles, the lowest-order prediction of this construction is then one massless neutrino and two degenerate massive neutrinos. Higher-dimensional operators suppressed by the Planck scale perturb this spectrum, allowing a good fit to the observed neutrino mass matrix. A firm prediction of this construction is an inverted neutrino mass spectrum with the lightest neutrino hierarchically lighter than the other two, so that the sum of neutrino masses lies close to the lower bound for an inverted hierarchy. In the alternate case that neutrinos are Majorana particles, the mass spectrum can be either normal or inverted. However, the lightest neutrino is once again hierarchically lighter than the other two, so that the sum of neutrino masses is predicted to lie close to the corresponding lower bound for the normal or inverted hierarchy. Near future cosmological measurements will be able to test the predictions of this scenario for the sum of neutrino masses. In the case of Majorana neutrinos that exhibit an inverted hierarchy, future neutrinoless double beta experiments can provide a complementary probe.

In this work, we present a solution to the persistent tensions in the decay observables ${R}_{{D}^{(*)}}$ and ${R}_{{K}^{(*)}}$ by introducing a $SU(2{)}_{L}$ doublet and a $SU(2{)}_{L}$ triplet scalar leptoquarks (LQs) that reside at the TeV energy scale. Neutrinos that remain massless in the Standard Model receive naturally small masses at one-loop level via the propagation of the same LQs inside the loop. Such a common origin of apparently disjoint phenomenological observations is appealing, and we perform a comprehensive analysis of this setup. We identify the minimal Yukawa textures required to accommodate these flavor anomalies and to successfully incorporate neutrino oscillation data while being consistent with all experimental constraints. This scenario has the potential to be tested at the experiments by the future improved measurements in the lepton flavor violating processes. Furthermore, proper explanations of these flavor anomalies predict TeV scale LQs that are directly accessible at the LHC.

Models of radiative Majorana neutrino masses require new scalars and/or fermions to induce lepton number violating interactions. We show that these new particles also generate observable neutrino nonstandard interactions (NSI) with matter. We classify radiative models as type-I or II, with type-I models containing at least one Standard Model (SM) particle inside the loop diagram generating neutrino mass, and type-II models having no SM particle inside the loop. While type-II radiative models do not generate tree-level NSI, popular models which fall under the type-I category are shown, somewhat surprisingly, to generate observable NSI at tree-level, while being consistent with direct and indirect constraints from colliders, electroweak precision data and charged-lepton flavor violation (cLFV). We survey such models where neutrino masses arise at one, two and three loops. In the prototypical Zee model which generates neutrino masses via one-loop diagrams involving charged scalars, we find that diagonal NSI can be as large as ($8\%, 3.8\%, 9.3\%$) for ($\varepsilon_{ee},\varepsilon_{\mu \mu}, \varepsilon_{\tau \tau}$), while off-diagonal NSI can be at most ($10^{-3}\%, 0.56\%, 0.34\%$) for ($\varepsilon_{e\mu},\varepsilon_{e \tau}, \varepsilon_{\mu \tau}$). In one-loop neutrino mass models using leptoquarks (LQs), $(\varepsilon_{\mu\mu},\, \varepsilon_{\tau\tau})$ can be as large as $(21.6\%,\,51.7\%)$, while $\varepsilon_{ee}$ and $(\varepsilon_{e\mu},\, \varepsilon_{e\tau},\,\varepsilon_{\mu\tau})$ can at most be 0.6\%. The most stringent constraints on the diagonal NSI are found to come from neutrino oscillation and scattering experiments, while the off-diagonal NSI are mostly constrained by low-energy processes, such as atomic parity violation and cLFV. While our analysis is focused on radiative neutrino mass models, it essentially covers all NSI possibilities with heavy mediators., Comment: 122 pages, journal version

BackgroundThe World Health Organization (WHO) End TB Strategy has established a milestone to reduce the number of tuberculosis (TB)- affected households facing catastrophic costs to zero by 2020. The role of active case finding (ACF) in reducing patient costs has not been determined globally. This study therefore aimed to compare costs incurred by TB patients diagnosed through ACF and passive case finding (PCF), and to determine the prevalence and intensity of patient-incurred catastrophic costs in Nepal.MethodsThe study was conducted in two districts of Nepal: Bardiya and Pyuthan (Province No. 5) between June and August 2018. One hundred patients were included in this study in a 1:1 ratio (PCF: ACF, 25 consecutive ACF and 25 consecutive PCF patients in each district). The WHO TB patient costing tool was applied to collect information from patients or a member of their family regarding indirect and direct medical and non-medical costs. Catastrophic costs were calculated based on the proportion of patients with total costs exceeding 20% of their annual household income.The intensity of catastrophic costs was calculated using the positive overshoot method. The chi-square and Wilcoxon-Mann-Whitney tests were used to compare proportions and costs. Meanwhile, the Mantel Haenszel test was performed to assess the association between catastrophic costs and type of diagnosis.ResultsNinety-nine patients were interviewed (50 ACF and 49 PCF). Patients diagnosed through ACF incurred lower costs during the pre-treatment period (direct medical: USD 14 vs USD 32,P = 0.001; direct non-medical: USD 3 vs USD 10,P = 0.004; indirect, time loss: USD 4 vs USD 13,P P = 0.002) and non-medical (USD 30 vs USD 54,P = 0.022) costs among ACF patients. The prevalence of catastrophic direct costs was lower for ACF patients for all thresholds. A lower intensity of catastrophic costs was also documented for ACF patients, although the difference was not statistically significant.ConclusionsACF can reduce patient-incurred costs substantially, contributing to the End TB Strategy target. Other synergistic policies, such as social protection, will also need to be implemented to reduce catastrophic costs to zero among TB-affected households.

This study compared the yield of tuberculosis (TB) active case finding (ACF) interventions applied under TB REACH funding. Between June 2017 to November 2018, Birat Nepal Medical Trust identified presumptive cases using simple verbal screening from three interventions: door-to-door screening of social contacts of known index cases, TB camps in remote areas, and screening for hospital out-patient department (OPD) attendees. Symptomatic individuals were then tested using smear microscopy or GeneXpert MTB/RIF as first diagnostic test. Yield rates were compared for each intervention and diagnostic method. We evaluated additional cases notified from ACF interventions by comparing case notifications of the intervention and control districts using standard TB REACH methodology. The project identified 1092 TB cases. The highest yield was obtained from OPD screening at hospitals (n = 566/1092, 52%). The proportion of positive tests using GeneXpert (5.5%, n = 859/15,637) was significantly higher than from microscopy testing 2% (n = 120/6309). (OR = 1.4, 95%CI = 1.12–1.72, p = 0.0026). The project achieved 29% additionality in case notifications in the intervention districts demonstrating that GeneXpert achieved substantially higher case-finding yields. Therefore, to increase national case notification for TB, Nepal should integrate OPD screening using GeneXpert testing in every district hospital and scale up of community-based ACF of TB patient contacts nationally.

Tuberculosis (TB) is a major public health concern for Nepal like many other developing countries around the world. Economic barrier is one of the major problems in poor and marginalized population. Poor people mostly remain unaware of the treatment facilities and some find it difficult in seeking T.B treatment as they don’t trust the program and most of them don’t possess enough knowledge about the disease itself. Population residing in the remote areas of the countries can’t access the treatment facilities due to far distance of health facilities from there residence due to lack of roads and lack of transport. Thus difficult geography primarily in rural areas in the country acts as a barrier to access the health facility. TB infection faces add-on challenge with the advent of co-infection and possibility of increase in drug resistant TB. This is why detecting TB in its early stage would pose a number of advantages to the patient that would in turn help for early treatment. However, the challenges and barriers in early diagnosis remain that is being contributed by multifaceted factors. The lack of knowledge coupled with poor financial capacity to pay for the diagnosis especially in rural population prevents them from being diagnosed properly as well. Factors for not completing the treatment are when patient starts feeling better, lack of drugs, major side effects of the drugs and inadequate knowledge about advantages of completion of the drug treatment. The attitude of the hospital staff also in many cases leads to discontinuation of the treatment. Patient who have limited income and got financial support from their relatives explained about treatment going above their obtainable resources leading to early withdrawal from the treatment completion. Geography is one of the important issues for treatment completion as routine drug administration follow up in patient (farther from particular distance) is difficult and leads to exhaustion and withdrawal from the treatment.Journal of Manmohan Memorial Institute of Health Sciences Vol. 2 2016 p.76-80

Introduction: Malnutrition is a common problem in developing countries and often associated with co-morbidities. The present study was undertaken with objectives of to find out the comorbidities in children with severe acute malnutrition (SAM).Materials and Methods: This was a hospital based study carried in 77 children with SAM, diagnosed on the basis of WHO criteria.Results: The age group of children was 1- 5 years (median age 23 months) with about 39% between 1- 2 years. There were 38 males (49.3%). Low maternal education (60%), overcrowding (60%), lower- middle socioeconomic status (87%) were some of the predisposing factors observed. Pneumonia (51%), acute gastroenteritis (21%) and bacterial meningitis (8%) were common co- morbidities found. Associated abnormal laboratory parameters found were anemia (60%), leucocytosis (38%), hyboalbuminemia (36%) hyponetremia (31%), and hypokalemia (17%).Conclusion: Presence of infections and biochemical abnormalities require urgent attention in SAM cases and appropriate treatment in a hospital setting to improve their survival.J Nepal Paediatr Soc 2015;35(2):99-102

Background Healthcare centers are important sites for tuberculosis transmission, particularly in low-income settings where the burden of tuberculosis is high and infection control practices are often inadequate. This study aims to assess the knowledge, attitude, and practices of drug-resistant tuberculosis infection control among the healthcare workers under the National Tuberculosis Control Program in Nepal. Methods In this descriptive cross-sectional survey, we studied the healthcare workers from all the functioning drug-resistant tuberculosis treatment centers across Nepal between March 1, 2018 and March 15, 2018. Nepal Health Research Council provided ethical clearance. Trained enumerators obtained informed consent and conducted face-to-face interviews with a pretested questionnaire to collect data on the basic characteristics of healthcare workers, their self-reported knowledge, attitude, and practice on tuberculosis infection control. We assigned a score of one to the correct response and zero to the incorrect or no response and calculated a composite score in each of the knowledge, attitude, and practice domains. We ascertained the healthcare workers as having good knowledge, appropriate attitude, and optimal practices when the composite score was at least 50%. We summarized the numerical variables with median and interquartile range (IQR) and the categorical variables with proportions. Results A total of 95 out of 102 healthcare workers from 11 drug-resistant tuberculosis treatment centers participated in the study. There were 46 male and 49 female respondents. The median age was 33 years (IQR 26–42). The majority of them (53, 56%) were mid-level paramedics. The median work experience in drug-resistant tuberculosis was 2 years (IQR 1–5). We found 91 (96%) respondents had a good knowledge of tuberculosis infection control with the median knowledge score of 14 (IQR 12–14), 49 (52%) respondents had an appropriate attitude with the median attitude score of 5 (IQR 4–6) and 35 (37%) respondents had optimal practices with the median practice score of 5 (IQR 4–7). Conclusion Healthcare workers at the drug-resistant tuberculosis treatment centers in Nepal had good knowledge of tuberculosis infection control but it did not translate into an appropriate attitude or optimal practices. Disclosures All authors: No reported disclosures.

Aims: To study the admission patterns and outcome of children in a Pediatric Intensive Care Unit (PICU) in Nepal. Methods: Demographic profile, diagnosis, treatment, supportive measures and outcome of children admitted to the PICU of B P Koirala Institute of Health Sciences from April 2011 to March 2012 were reviewed. Results: 230 children were admitted to the PICU with male to female ratio of 1.7:1. Diagnoses included respiratory diseases (n=76, 33%), central nervous system diseases (n=43, 18.6%), infectious diseases (n=26, 11.3%), surgical problems (n=18, 7.8%), gastrointestinal diseases (n=17, 7.4%), cardiovascular diseases (n=15, 6.5%), poisonings (n=11, 4.8%), renal (n=9, 3.9%), hematological (n=3, 1.3%) and others (n=12, 5.4%). Out of 230 admitted children, 29 (12.6%) died, 19 (8.2%) left against medical advice and 5 (2%) were referred to other centers. Forty-one (17.8%) children received mechanical ventilation, among which 23 (56%) improved, 14 (34.1%) died and 4 (9.7%) children were taken away by caretakers against medical advice. Conclusion: Respiratory, central nervous system and infectious disease were the

Introduction : Neonatal period is the most susceptible period of life due to different causes, which in most cases are preventable. Every year millions of neonates are born and a large proportion of them are admitted to the neonatal intensive care unit (NICU) for various indications. One of the Millennium Development Goals is to reduce under five mortality by two thirds by 2015. Therefore, this study was conducted to identify the clinical profile, pattern of diseases and common causes of mortality and morbidity in neonates admitted to NICU. Materials and Methods : A retrospective study was conducted at level III Neonatal NICU of a tertiary -care teaching hospital from January, 2012 to December, 2012. Results : Total of 361 neonates were admitted in NICU. Eighty six neonates (23.8%) were admitted due to prematurity and 73 (20.2%) with birth asphyxia. Among birth asphyxia, 40(54.8%)were in HIE III, 27.4% and 17.8% in HIE II and HIE I, respectively. One hundred eighteen (32.6%) cases were diagnosed as sepsis. The overall mortality was 20.2% during hospital stay. Conclusions : Sepsis, prematurity and birth asphyxia were major causes for admission in NICU. All these etiologies are preventable up to some extent and, if detected earlier, can be effectively treated in order to reduce morbidity and mortality. DOI: http://dx.doi.org/10.3126/jnps.v33i3.8447 J. Nepal Paediatr. Soc. 2013;33(3):177-181

Background and objectives\ud \ud People receiving treatment for multidrug-resistant tuberculosis (MDR-TB) have high rates of depression. Psychosocial support in general, and treatments for depression in particular, form an important but neglected area of patient-centred care, and a key pillar in the global End TB strategy. We assessed the feasibility and acceptability of a psychosocial support package for people receiving treatment for MDR-TB in Nepal.\ud \ud Methods\ud \ud This feasibility study used a mixed quantitative and qualitative approach. We implemented the intervention package in two National Tuberculosis Programme (NTP) MDR-TB treatment centres and 8 sub-centres. We screened patients monthly for depression and anxiety (cut-off ≥24 and ≥17 respectively on the Hopkins Symptom Checklist) and also for low social support (cut-off ≤3 on the Multidimensional Scale of Perceived Social Support). Those who screened positive on either screening tool received the Healthy Activity Program (HAP), which uses brief counselling based on behavioural activation theory. Other aspects of the psychosocial package were information/education materials and group interactions with other patients.\ud \ud Results\ud \ud We screened 135 patients, of whom 12 (9%) received HAP counselling, 115 (85%) received information materials, 80 (59%) received an education session and 49 (36%) received at least one group session. Eight group sessions were conducted in total. All aspects of the intervention package were acceptable to patients, including the screening, information, group work and counselling. Patients particularly valued having someone to talk to about their concerns and worries. We were able to successfully train individuals with no experience of psychological counselling to deliver HAP.\ud \ud Conclusion\ud \ud This psychosocial support package is acceptable to patients. The information materials we developed are feasible to deliver in the current NTP. However, the structured psychological counselling (HAP), is not feasible in the current NTP due to time constraints. This requires additional investment of counsellors in TB clinics.

It is the hypothesis of the present study that a biocompatible material which mimics the nanometer topography of native bladder tissue will enhance cellular responses and lead to better tissue integration in vivo. Previous in vitro studies have verified the ability to successfully reduce the surface feature dimensions of poly(lactic-co-glycolic acid) (PLGA) and poly(ether urethane) (PU) films into the nanometer regime via chemical etching procedures. Results from these studies also provided the first evidence that bladder smooth muscle cell adhesion was enhanced on chemically treated nano-structured polymeric surfaces compared to their conventional counterparts. Although cell adhesion is necessary for a biomaterial's success, subsequent cell functions (such as long-term cell growth and proliferation) are also critical for tissue ingrowth and long-term implant survival. The present in vitro study, therefore, investigated the function of bladder smooth muscle cells on these novel, nano-structured polymers over the expanded periods of 1, 3 and 5 days. Results indicated that cell number was influenced by both surface roughness and surface chemistry changes; the important contributor, however, was increased nanometer surface roughness. This claim is supported by the fact that cell number was enhanced on nano-structured compared to conventional PLGA and PU once chemistry changes were eliminated using casting techniques.