A rare case of ruptured mediastinal echinococcal cyst causing diagnostic challenge: A case report.

Introduction: Echinococcus is a common infection in an endemic country like Bhutan. Mediastinal echinococcosis is rare. Although presentation due to a mediastinal echinococcal cyst is variable according to the cyst's location, a reaction due to rupture of the cyst and simultaneous reaction to an administration of antibiotics such as ceftriaxone can cause a diagnostic challenge.

Knowledge, attitude, and practice of One Health and zoonotic diseases among multisectoral collaborators in Bhutan: Results from a nationwide survey.

The One Health concept is increasingly employed to combat zoonotic diseases. This study assessed the knowledge, attitudes, and practices regarding One Health and zoonotic diseases among key sector professionals to identify gaps and opportunities for enhancing One Health strategies in Bhutan. A cross-sectional, facility-based study was used to conduct a nationwide online questionnaire survey using a validated and pre-tested questionnaire among professionals from the Ministry of Health, the Ministry of Agriculture and Livestock, and universities.

Aetiological, seasonal and antibiotic susceptibility patterns of diarrhoeal diseases in Bhutan (2016-2022): a retrospective study of surveillance data.

Objectives: This study aimed to identify the aetiological spectrum, seasonal distribution and antimicrobial resistance patterns of diarrhoeal diseases in Bhutan.

Study Design And Setting: The study used a cross-sectional, retrospective analysis of secondary data gathered through a passive, hospital-based sentinel surveillance for diarrhoeal disease across 12 hospitals, representing Bhutan's demographically diverse regions.

Participants: A total of 3429 participants' data of all age groups who presented with diarrhoea at sentinel hospitals between 1 January 1 2016 and 31 December 2022 were analysed.

Assessment of performance feedback as a teaching-learning tool in the operating room at the National Referral Hospital, Bhutan: a prospective pre-post interventional study.

Background: Effective, efficient, and enduring feedback on performance improves and accelerates learning in medical education. Basic teaching methods like providing constructive feedback would enhance educational quality. However, briefing and debriefing culture is almost absent in our operating room.

The ClinGen Syndromic Disorders Gene Curation Expert Panel: Assessing the Clinical Validity of 111 Gene-Disease Relationships.

Purpose: The Clinical Genome Resource (ClinGen) Gene Curation Expert Panels (GCEPs) have historically focused on specific organ systems or phenotypes; thus, the ClinGen Syndromic Disorders GCEP (SD-GCEP) was formed to address an unmet need.

Methods: The SD-GCEP applied ClinGen's framework to evaluate the clinical validity of genes associated with rare syndromic disorders. 111 Gene-Disease Relationships (GDRs) associated with 100 genes spanning the clinical spectrum of syndromic disorders were curated.

Clinical Profile and Risk Factors for Complication of Type 2 Diabetes Mellitus at the National Referral Hospital, Bhutan: A Descriptive Cross-Sectional Study.

Background And Aim: Globally, diabetes mellitus is a major public health concern affecting 10.5% of the population. Nearly 90% of these people have Type 2 diabetes mellitus (T2DM).

Testate amoebae from the wetlands of the Phobjikha Valley of Bhutan, the Eastern Himalayas.

The Kingdom of Bhutan in the Eastern Himalayas harbors a rich biodiversity. However, its detailed documentation still needs to be created, including not only macroorganisms but also protists. In the present study, as many as 105 taxa of testate amoebae were identified and directly counted in soil suspension samples collected from the wetlands of the Gangtey-Phobji Valley (generally Phobjikha), Wangdue Phodrang district.

High incidence of multidrug-resistant tuberculosis in Bhutan: A cohort study based on national TB surveillance data.

Objectives: The emergence of multidrug-resistant tuberculosis (MDR-TB) has made the elimination of TB difficult. Currently, there are limited data on MDR-TB and other drug-resistant TB in Bhutan. We aimed to estimate the incidence and explore the potential risk factors associated with MDR/pre-extensively drug-resistant (pre-XDR)-TB using comprehensive national TB data.

The Egg Hub Model: A Sustainable and Replicable Approach to Address Food Security and Improve Livelihoods.

Background: Despite progress in improving living standards and reduced poverty, food insecurity and malnutrition remain a significant issue worldwide. Childhood is a critical time for the intake of protein to support physical and cognitive growth, including animal-source foods like eggs which can effectively mitigate stunting in low- and middle-income countries. In Malawi, high malnutrition rates among women and children represent a significant public health challenge, but high-quality sources such as eggs remain costly, scarce, and rarely consumed by children in Malawi.

Sources and pathways of spring flow and climate change effects in the Dungju Ri & Yude Ri catchments, Bhutan Himalaya.

Springs and streams are vital water sources for supporting the livelihood of Himalayan residents. Escalating climate change, population growth, and economic development strain the region's freshwater resources. A national survey reveals declining spring and stream flows in Bhutan, necessitating an improved understanding of their generation.

Trends in Active Surveillance for Men With Intermediate-Risk Prostate Cancer.

Importance: Initial management of intermediate-risk prostate cancer is evolving, with no clear recommendation for treatment. Data on utilization of active surveillance for patients with newly diagnosed intermediate-risk prostate cancer may help clarify emerging trends.

Objective: To further characterize US national trends of initial management of intermediate-risk prostate cancer.

Factors associated with postoperative nausea and vomiting after laparoscopic cholecystectomy at the National Referral Hospital, Bhutan: a cross-sectional study.

Introduction: Postoperative nausea and vomiting (PONV) are common distressing symptoms experienced after laparoscopic cholecystectomy. We report the rate, and the factors associated with postoperative nausea and vomiting, the patterns of prophylactic antiemetic prescription, and the anesthetic techniques used among patients who underwent laparoscopic cholecystectomy at the Jigme Dorji Wangchuck (JDW) National Referral Hospital, Bhutan.

Methods: A cross-sectional study was conducted at the JDW National Referral Hospital, from January to December 2018.

Massive ascites following spontaneous vaginal delivery in a woman with preeclampsia-a diagnostic and management challenges in a low resource country: A case report.

Introduction And Importance: Hypertensive disorders of pregnancy, including preeclampsia, causes major pregnancy associated morbidity and mortality. Massive ascites is a rare complication in a severe preeclampsia. This case report high lights the importance of obstetrician being aware of such complications of severe preeclampsia, and avoid non-therapeutic interventions such as exploratory laparotomy.

Efficacy and safety of topical capsaicin in the treatment of osteoarthritis pain: A systematic review and meta-analysis.

Osteoarthritis (OA) affects hundreds of millions of people worldwide. The objective was to critically appraise the efficacy and safety of topical capsaicin in reducing pain in OA. MEDLINE (PubMed) and Embase (Ebsco) were searched from inceptions until February 2023.

Mapping recommendations towards an Asian Code Against Cancer (ACAC) as part of the World Code Against Cancer Framework: an Asian National Cancer Centers Alliance (ANCCA) initiative.

This paper outlines the process undertaken by Asian National Cancer Centers Alliance (ANCCA) members in working towards an Asian Code Against Cancer (ACAC). The process involves: (i) identification of the criteria for selecting the existing set of national recommendations for ACAC (ii) compilation of existing national codes or recommendations on cancer prevention (iii) reviewing the scientific evidence on cancer risk factors in Asia and (iv) establishment of one or more ACAC under the World Code Against Cancer Framework. A matrix of national codes or key recommendations against cancer in ANCCA member countries is presented.

Factors impacting clinical data and documentation quality in Australian aged care and disability services: a user-centred perspective.

Background: Research has highlighted a need to improve the quality of clinical documentation and data within aged care and disability services in Australia to support improved regulatory reporting and ensure quality and safety of services. However, the specific causes of data quality issues within aged care and disability services and solutions for optimisation are not well understood.

Objectives: This study explored aged care and disability workforce (referred to as 'data-users') experiences and perceived root causes of clinical data quality issues at a large aged care and disability services provider in Western Australia, to inform optimisation solutions.

Rate and risk factors of inadequate endometrial tissues after endometrial sampling among Bhutanese women at the national referral hospital of Bhutan: a cross-sectional study.

Introduction: Women presenting with abnormal uterine bleeding needs careful and thorough assessment including ultrasound examination of endometrium and histopathological assessment of the endometrial tissues. The objective of this cross-sectional study was to determine the rate and the factors associated with inadequate endometrial tissues after endometrial sampling using MedGyn® pipette among Bhutanese women at the colposcopy clinic, Jigme Dorji Wangchuck National Referral Hospital (JDWNRH), Bhutan.

Methods: This cross-sectional study was conducted at the colposcopy clinic, JDWNRH, Thimphu between October, 2021 and March, 2022.

Special Sensory Function Deficit among Patients with Post-COVID-19 Visiting a Tertiary Care Centre.

Introduction: Several patients who recover from COVID-19 infection continue to have persistent symptoms even after recovery from the disease. The special sensory functions such as taste, smell and hearing are affected by COVID-19 infection even after recovery from the illness. The aim of the study was to find out the prevalence of special sensory deficits among patients with post-COVID-19 visiting a tertiary care centre.

History of emergency medicine in Bhutan.

Emergency medicine in Bhutan has made significant progress in the past few decades and continues to evolve. In this article, we provide valuable insights into the history of emergency medicine at Jigme Dorji Wangchuck National Referral Hospital (JDWNRH) and in Bhutan and highlight some of the future challenges we face as we move forward to meet the demands of increased patient volume and complexity.

Challenges in the management of high-altitude illnesses and emergencies in Bhutan and Nepal.

Many popular tourist attractions and trekking routes in Bhutan and Nepal are situated between 3000 and 6000 m in elevation. High-altitude emergencies are becoming more common and medical providers must be aware of the practical and medical issues in managing these disorders. We reflect on the challenges in providing high-altitude emergency medical services in Bhutan and Nepal.