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"Sapkota, D."
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Rapid assessment of avoidable blindness and cataract surgery coverage among forcibly displaced Myanmar Nationals (Rohingya refugees) in Cox’s Bazar, Bangladesh
2020
To determine the prevalence and causes of blindness, vision impairment and cataract surgery coverage among Rohingya refugees aged ≥ 50 years residing in camps in Cox's Bazar, Bangladesh.
We used the Rapid Assessment of Avoidable Blindness (RAAB) methodology to select 76 clusters of 50 participants aged ≥ 50 years with probability proportionate to size. Demographic and cataract surgery data were collected using questionnaires, visual acuity was assessed per World Health Organization criteria and examinations were conducted by torch, and with direct ophthalmoscopy in eyes with pinhole-corrected vision <6/12. RAAB software was used for data entry and analysis.
We examined 3,629 of 3800 selected persons (95.5%). Age and sex adjusted prevalence of blindness (<3/60), severe visual impairment (SVI; >3/60 to ≤6/60), moderate visual impairment (MVI; >6/60 to ≤6/18), and early visual impairment (EVI; >6/18 to ≤6/12) were 2.14%, 2.35%, 9.68% and 14.7% respectively. Cataract was responsible for 75.0% of blindness and 75.8% of SVI, while refractive error caused 47.9% and 90.9% of MVI and EVI respectively. Most vision loss (95.9%) was avoidable. Cataract surgical coverage among the blind was 81.2%. Refractive error was detected in 17.1% (n = 622) of participants and 95.2% (n = 592) of these did not have spectacles. In the full Rohingya cohort of 76,692, approximately 10,000 surgeries are needed to correct all eyes impaired (<6/18) by cataract, 12,000 need distance glasses and 73,000 require presbyopic correction.
The prevalence of blindness was lower than expected for a displaced population, in part due to few Rohingya being ≥60 years and the camp's good access to cataract surgery. We suggest the United Nations High Commissioner for Refugees include eye care among recommended health services for all refugees with long-term displacement.
Journal Article
The nature of ferromagnetism in the chiral helimagnet Cr1/3NbS2
by
Vobornik, I.
,
Vilmercati, P.
,
Sapkota, D.
in
639/766/119/2793
,
639/766/119/995
,
639/766/119/997
2020
The chiral helimagnet Cr
1/3
NbS
2
hosts exotic spin textures, whose influence on the magneto-transport properties make this material an ideal candidate for future spintronic applications. To date, the interplay between macroscopic magnetic and transport degrees of freedom is believed to result from a reduction in carrier scattering following spin order. Here, we present electronic structure measurements across the helimagnetic transition temperature
T
C
that challenges this view. We show that the Fermi surface is comprised of strongly hybridized Nb- and Cr-derived electronic states, and that spectral weight close to the Fermi level increases anomalously as the temperature is lowered below
T
C
. These findings are rationalized on the basis of first principle density functional theory calculations, which reveal a large nearest-neighbor exchange energy, suggesting the interaction between local spin moments and hybridized Nb- and Cr-derived itinerant states to go beyond the perturbative interaction of Ruderman-Kittel-Kasuya-Yosida, suggesting instead a mechanism rooted in a Hund’s exchange interaction.
In the chiral helimagnet Cr
1/3
NbS
2
, spin moments localized at Cr sites are believed to play a passive role in the material’s electronic and transport properties. Here, this interpretation is challenged by experimental observation of hybridization between local magnetic moments and itinerant electrons, and changes in the electronic structure with the onset of magnetism.
Journal Article
Feasibility and Effectiveness of an Intervention to Reduce Intimate Partner Violence and Psychological Distress Among Women in Nepal: Protocol for the Domestic Violence Intervention (DeVI) Cluster-Randomized Trial
2023
Intimate partner violence (IPV) disproportionately affects people in low-and middle-income countries (LMICs), such as Nepal. Women experiencing IPV are at higher risk of developing depression, anxiety, and posttraumatic stress disorder. The shortage of trained frontline health care providers, coupled with stigma related to IPV and mental health disorders, fuels low service uptake among women experiencing IPV. The Domestic Violence Intervention (DeVI) combines the Problem Management Plus counseling program developed by the World Health Organization with a violence prevention component.
This study aims to implement and evaluate the feasibility, acceptability, and effectiveness of DeVI in addressing psychological distress and enabling the secondary prevention of violence for women experiencing IPV.
A parallel cluster-randomized trial will be conducted across 8 districts in Madhesh Province in Nepal, involving 24 health care facilities. The study will include women aged 18-49 years who are either nonpregnant or in their first trimester, have experienced IPV within the past 12 months, have a 12-item General Health Questionnaire (GHQ-12) score of 3 or more (indicating current mental health issues), and have lived with their husbands or in-laws for at least 6 months. A total sample size of 912 was estimated at 80% power and α<.05 statistical significance level to detect a 15% absolute risk reduction in the IPV frequency and a 50% reduction in the GHQ-12 score in the intervention arm. The health care facilities will be randomly assigned to either the intervention or the control arm in a 1:1 ratio. Women visiting the health care facilities in the intervention and control arms will be recruited into the respective arms. In total, 38 participants from each health care facility will be included in the trial to meet the desired sample size. Eligible participants allocated to either arm will be assessed at baseline and follow-up visits after 6, 17, and 52 weeks after baseline.
This study received funding in 2019. As of December 29, 2022, over 50% of eligible women had been recruited from both intervention and control sites. In total, 269 eligible women have been enrolled in the intervention arm and 309 eligible women in the control arm. The trial is currently in the recruitment phase. Data collection is expected to be completed by December 2023, after which data analysis will begin.
If the intervention proves effective, it will provide evidence of how nonspecialist mental health care providers can address the harmful effects of IPV in resource-constrained settings with a high burden of IPV, such as Nepal. The study findings could also contribute evidence for integrating similar services into routine health programs in LMICs to prevent IPV and manage mental health problems among women experiencing IPV.
ClinicalTrials.gov NCT05426863; https://clinicaltrials.gov/ct2/show/NCT05426863.
DERR1-10.2196/45917.
Journal Article
Population-based cancer incidence in Sikkim, India: report on ethnic variation
by
Nadayil, D
,
Nandakumar, A
,
Verma, Y
in
692/699/67/1504
,
692/699/67/2324
,
Biological and medical sciences
2012
Background:
A Population-Based Cancer Registry (PBCR) was set up in Sikkim (a state in the North Eastern India) in 2003. We examined incidence rates by ethnic groups from 2003–2008.
Methods:
Age-adjusted incidence rates (AARs) per 100 000 person-years were calculated by direct method using the world standard population, and analysed by ethnic group (Bhutia, Rai and other).
Result:
There were a total of 1148 male and 1063 female cases of cancer between 2003 and 2008 on the Sikkim PBCR. The overall AARs were 89.4 and 99.4 per 100 000 person-years in males and females, respectively. Incidence rates were highest amongst the Bhutia group (AAR=172.4 and 147.4 per 100 000 person-years in males and females, respectively), and the largest difference in rates were observed for stomach cancers with AARs being 12.6 and 4.7 times higher in the Bhutia group compared with other ethnic groups in males and females, respectively.
Conclusion:
These observations call for further epidemiological investigations and the introduction of screening programmes.
Journal Article
Blindness prevalence and cataract surgical coverage in Lumbini Zone and Chetwan District of Nepal
by
Sharma, M K
,
Bassett, K L
,
Sherchan, A
in
Age Distribution
,
Aged
,
Biological and medical sciences
2010
AimTo determine the prevalence of blindness, visual impairment and the cataract surgical coverage for people aged 50 years and older in the Lumbini Zone and the Chitwan District (Narayani Zone) of Nepal.MethodsA population-based cross-sectional study in 2006 selected subjects aged 50 years and older through a random multistage cluster sampling and door-to-door enumeration. Ophthalmic examination included visual-acuity assessment and refraction, and anterior and posterior segment examination of the eyes carried out by a trained ophthalmologist and two ophthalmic assistants at centralised locations.ResultsThe survey examined 5138 of 5196 persons enumerated (response rate of 86.8%). The mean age of the subjects was 61 (SD 9.2) years, and 2701 (52.6%) subjects were women. The age–sex-adjusted prevalence of blindness (best presenting vision <6/60) and visual impairment (better-eye presenting visual acuity of <6/18 to ≥6/60) were 4.6% (95% CI 3.4 to 5.8) and 18.9% (95% CI 16.4 to 21.4), respectively. Blindness was significantly lower in the hill (3.3%) compared with the plain (5.8%) regions (OR 0.6; 95% CI 0.4 to 0.9). The primary causes for blind eyes were cataract (n = 228, 48.1%), refractive error (n = 149, 31.4%), retinal disorders (n = 19, 4.0%) and corneal opacity (n = 18, 3.8%). The overall cataract surgical coverage was 66.6%. Cataract surgical coverage was not significantly associated with age, sex, literacy or District.ConclusionAlthough the prevalence of blindness and visual impairment is lower than 10 years ago, particularly among women, correctable blindness due to cataract and refractive error (79.5% of blind people) remains a significant population health problem in Lumbini Zone and Chitwan District.
Journal Article
Effect of electric field on exciton in high‐purity GaAs epilayer measured at room temperature
by
Wakita, K.
,
Kayastha, M.S.
,
Sapkota, D.P.
in
biexcitons
,
Condensed matter: electronic structure, electrical, magnetic, and optical properties
,
electric field effects
2013
The excitonic electroabsorption has been investigated for a high‐purity GaAs epilayer of 10 µm thickness at room temperature and clear red‐shift (≃1.44 nm) of the excitonic absorption peak has been observed. An extinction ratio over 10 dB has been obtained with an applied voltage of 11 V, which is nearly five times larger than the theoretical estimation without considering the exciton. This may be the first observation for of a surface normal structure with a polyaniline as a transparent Schottky electrode. The insertion loss is estimated to be 3 dB. This relative low driving voltage for a bulk configuration without quantum wells is due to high‐purity GaAs.
Journal Article
Rapid assessment of avoidable blindness and cataract surgery coverage among forcibly displaced Myanmar Nationals
by
Haddad, Danny
,
Khandaker, Gulam
,
Sapkota, Yuddha D
in
Blindness
,
Care and treatment
,
Cataract
2020
To determine the prevalence and causes of blindness, vision impairment and cataract surgery coverage among Rohingya refugees aged [greater than or equal to] 50 years residing in camps in Cox's Bazar, Bangladesh. We used the Rapid Assessment of Avoidable Blindness (RAAB) methodology to select 76 clusters of 50 participants aged [greater than or equal to] 50 years with probability proportionate to size. Demographic and cataract surgery data were collected using questionnaires, visual acuity was assessed per World Health Organization criteria and examinations were conducted by torch, and with direct ophthalmoscopy in eyes with pinhole-corrected vision <6/12. RAAB software was used for data entry and analysis. We examined 3,629 of 3800 selected persons (95.5%). Age and sex adjusted prevalence of blindness (3/60 to [less than or equal to]6/60), moderate visual impairment (MVI; >6/60 to [less than or equal to]6/18), and early visual impairment (EVI; >6/18 to [less than or equal to]6/12) were 2.14%, 2.35%, 9.68% and 14.7% respectively. Cataract was responsible for 75.0% of blindness and 75.8% of SVI, while refractive error caused 47.9% and 90.9% of MVI and EVI respectively. Most vision loss (95.9%) was avoidable. Cataract surgical coverage among the blind was 81.2%. Refractive error was detected in 17.1% (n = 622) of participants and 95.2% (n = 592) of these did not have spectacles. In the full Rohingya cohort of 76,692, approximately 10,000 surgeries are needed to correct all eyes impaired (<6/18) by cataract, 12,000 need distance glasses and 73,000 require presbyopic correction. The prevalence of blindness was lower than expected for a displaced population, in part due to few Rohingya being [greater than or equal to]60 years and the camp's good access to cataract surgery. We suggest the United Nations High Commissioner for Refugees include eye care among recommended health services for all refugees with long-term displacement.
Journal Article
COVID-19 salivary signature: diagnostic and research opportunities
2021
The COVID-19 (caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)) epidemic started in Wuhan (Hubei Province, China) in mid-December 2019 and quickly spread across the world as a pandemic. As a key to tracing the disease and to implement strategies aimed at breaking the chain of disease transmission, extensive testing for SARS-CoV-2 was suggested. Although nasopharyngeal/oropharyngeal swabs are the most commonly used biological samples for SARS-CoV-2 diagnosis, they have a number of limitations related to sample collection and healthcare personnel safety. In this context, saliva is emerging as a promising alternative to nasopharyngeal/oropharyngeal swabs for COVID-19 diagnosis and monitoring. Saliva collection, being a non-invasive approach with possibility for self-collection, circumvents to a great extent the limitations associated with the use of nasopharyngeal/oropharyngeal swabs. In addition, various salivary biomarkers including the salivary metabolomics offer a high promise to be useful for better understanding of COVID-19 and possibly in the identification of patients with various degrees of severity, including asymptomatic carriers. This review summarises the clinical and scientific basis for the potential use of saliva for COVID-19 diagnosis and disease monitoring. Additionally, we discuss saliva-based biomarkers and their potential clinical and research applications related to COVID-19.
Journal Article
Improving health-related quality of life in women with breast, blood, and gynaecological Cancer with an eHealth-enabled 12-week lifestyle intervention: the women’s wellness after Cancer program randomised controlled trial
by
Sapkota, Diksha
,
Seib, Charrlotte
,
McGuire, Amanda
in
Biomedical and Life Sciences
,
Biomedicine
,
Blood
2022
Background
The residual effects of cancer and its treatment can profoundly affect women’s quality of life. This paper presents results from a multisite randomized controlled trial that evaluated the clinical benefits of an e-health enabled health promotion intervention (the Women’s Wellness after Cancer Program or WWACP) on the health-related quality of life of women recovering from cancer treatment.
Methods
Overall, 351 women previously treated for breast, blood or gynaecological cancers were randomly allocated to the intervention (WWACP) or usual care arms. The WWACP comprised a structured 12-week program that included online coaching and an interactive iBook that targeted physical activity, healthy diet, stress and menopause management, sexual wellbeing, smoking cessation, alcohol intake and sleep hygiene. Data were collected via a self-completed electronic survey at baseline (t
0
), 12 weeks (post-intervention, t
1
) and 24 weeks (to assess sustained behaviour change, t
2
). The primary outcome, health-related quality of life (HRQoL), was measured using the Short Form Health Survey (SF-36).
Results
Following the 12-week lifestyle program, intervention group participants reported statistically significant improvements in general health, bodily pain, vitality, and global physical and mental health scores. Improvements were also noted in the control group across several HRQoL domains, though the magnitude of change was less.
Conclusions
The WWACP was associated with improved HRQoL in women previously treated for blood, breast, and gynaecological cancers. Given how the synergy of different lifestyle factors influence health behaviour, interventions accounting for the reciprocity of multiple health behaviours like the WWACP, have real potential for immediate and sustainable change.
Trial registration
The protocol for this randomised controlled trial was submitted to the Australian and New Zealand Clinical Trials Registry on 15/07/2014 and approved on 28/07/2014 (
ACTRN12614000800628
).
Journal Article