AIM: To revealed the prevalence of Helicobacter pylori (H. pylori ) infection in the Bhutanese population. METHODS: We recruited a total of 372 volunteers (214 females and 158 males; mean age of 39.6 ± 14.9 years...AIM: To revealed the prevalence of Helicobacter pylori (H. pylori ) infection in the Bhutanese population. METHODS: We recruited a total of 372 volunteers (214 females and 158 males; mean age of 39.6 ± 14.9 years) from three Bhutanese cities (Thimphu, Punaka, and Wangdue). The status of H. pylori infection was determined based on five different tests: the rapid urease test (CLO test), culture, histology, immunohistochemistry (IHC), and serum anti H. pylori -antibody. RESULTS: The serological test showed a significantly higher positive rate compared with the CLO test, culture, histology and IHC (P < 0.001, P < 0.001, P=0.01, and P=0.01, respectively). When the subjects were considered to be H. pylori positive in the case of at least one test showing a positive result, the overall prevalence of H. pylori infection in Bhutan was 73.4%. The prevalence of H. pylori infection significantly decreased with age (P < 0.01). The prevalence of H. pylori infection was lower in Thimphu than in Punakha and Wangdue (P=0.001 and 0.06, respectively). The prevalence of H. pylori infection was significantly higher in patients with peptic ulcers than in those with gastritis (91.4% vs 71.3%, P=0.003). CONCLUSION: The high incidence of gastric cancer in Bhutan may be attributed to the high prevalence of H. pylori infection.展开更多
AIM:To survey the antibiotic resistance pattern of Helicobacter pylori(H.pylori)strains isolated from Bhutanese population.METHODS:We isolated 111 H.pylori strains from the gastric mucosa of H.pylori-infected patients...AIM:To survey the antibiotic resistance pattern of Helicobacter pylori(H.pylori)strains isolated from Bhutanese population.METHODS:We isolated 111 H.pylori strains from the gastric mucosa of H.pylori-infected patients in Bhutan in 2010.The Epsilometer test was used to determine the minimum inhibitory concentrations(MICs)of amoxicillin(AMX),clarithromycin(CLR),metronidazole(MNZ),levofloxacin(LVX),ciprofloxacin(CIP),and tetracycline(TET).RESULTS:Nineteen of the isolated H.pylori strains were susceptible to all antibiotics tested.The isolated strains showed the highest rate of antibiotic resistance to MNZ(92/111,82.9%).Among the 92 MNZresistant strains,74 strains(80.4%)showed high-level resistance(MIC≥256 g/mL).Three strains were resistance to LVX(2.7%).These strains were also resistance to CIP.None of the strains showed resistance to CLR,AMX and TET.CONCLUSION:CLR-based triple therapy is a more effective treatment approach over MNZ-based triple therapy for H.pylori infection in Bhutan.展开更多
AIM: To estimate the prevalence of gastric cancer(GC) in a cohort of patients diagnosed with GC and to compare it with patients diagnosed with all other types of gastro-intestinal(GI) cancer during the same period.MET...AIM: To estimate the prevalence of gastric cancer(GC) in a cohort of patients diagnosed with GC and to compare it with patients diagnosed with all other types of gastro-intestinal(GI) cancer during the same period.METHODS: Between 2008 and 2013,five-year period,the medical records of all GI cancer patients who underwent medical care and confirm diagnosis of cancer were reviewed at the National Referral Hospital,Thimphu which is the only hospital in the country where surgical and cancer diagnosis can be made. Demographic information,type of cancer,and the year of diagnosis were collected.RESULTS: There were a total of 767 GI related cancer records reviewed during the study period of which 354(46%) patients were diagnosed with GC. There were 413 patients with other GI cancer including; esophagus,colon,liver,rectum,pancreas,gall bladder,cholangiocarcinoma and other GI tract cancers. The GC incidence rate is approximately 0.9/10000 per year(367 cases/5years per 800000 people). The geographic distribution of GC was the lowest in the south region of Bhutan 0.3/10000 per year compared to the central region 1.4/10000 per year,Eastern region 1.2/10000 per year,and the Western region 1.1/10000 per year. Moreover,GC in the South part was significantly lower than the other GI cancer in the same region(8% vs 15%; OR = 1.8,95%CI: 1.3-3.1,P = 0.05). Among GC patients,38% were under the age of 60 years,mean age at diagnosis was 62.3(± 12.1) years with male-to-female ratio 1:0.5. The mean age among patients with all other type GI cancer was 60 years(± 13.2) and male-tofemale ratio of 1:0.7. At time of diagnosis of GC,342(93%) were at stage 3 and 4 of and by the year 2013; 80(23%) GC patients died compared to 31% death among patients with the all other GI cancer(P = 0.08).CONCLUSION: The incidence rate of GC in Bhutan is twice as high in the United States but is likely an underestimate rate because of unreported and undiagnosed cases in the villages. The high incidence of GC in Bhutan could be attributed to the high prevalence of Helicobacter pylori infection that we previously reported. The lowest incidence of GC in Southern part of the country could be due to the difference in the ethnicity as most of its population is of Indian and Nepal origin. Our current study emphasizes on the importance for developing surveillance and prevention strategies for GC in Bhutan.展开更多
The regional distribution of landslide dams can provide valuable insights into the interactions among various factors,including lithology,topography,climate,and fluvial landforms in tectonically active mountains.Himal...The regional distribution of landslide dams can provide valuable insights into the interactions among various factors,including lithology,topography,climate,and fluvial landforms in tectonically active mountains.Himalayan rivers are frequently impacted by large-scale landslide damming,which profoundly influence fluvial geomorphology.In this study,we identified 1652 landslide dams in four major rivers of Bhutan and its surrounding area by remote sensing interpretation.Notably,approximately 71%of these landslide dams are found in regions composed of quartzite or gneiss.Fault-related tectonic activity plays a significant role in governing the distribution of these landslide dams,as approximately 83%of the mapped landslide dams are found within a 10 km radius of the nearest fault.The majority of the identified landslide dams are situated in areas with relatively modest local relief,ranging from 227 m to 327 m.These dams tend to cluster in the tributaries,and the stream power of almost 95%of them is typically below 1×10^(6) kg m^(2) s^(-3).Our data,combining the erosion rate and kernel density map of the landslide dams,reveals that regions with high erosion rates do not consistently align with the major high-density distribution of landslide dams.It is shown that the distribution of landslide dams is strongly influenced by the valley form.In comparison to U-shaped valleys,V-shaped valleys exhibit a higher density of landslide dams.Intriguingly,we also find a positive correlation between the landslide-dam distribution density and the erosion rate only in relatively arid regions with mean annual rainfall less than 500 mm.Moreover,the length of the upstream reach protected by the knickpoint associated with both lithology and landslide damming is about three times longer than that protected by the knickpoint associated only with landslide damming.展开更多
Bhutan has reported a total of 2596 COVID-19 cases and three deaths as of September 15,2021.With support from India,the United States,Denmark,the People’s Republic of China,Croatia and other countries,Bhutan was able...Bhutan has reported a total of 2596 COVID-19 cases and three deaths as of September 15,2021.With support from India,the United States,Denmark,the People’s Republic of China,Croatia and other countries,Bhutan was able to conduct two rounds of nationwide vaccination campaign.While many countries struggle to overcome vaccine refusal or hesitancy due to complacency,a lack of trust,inconvenience and fear,escalated in some countries by anti-vaccine groups,Bhutan managed to inoculate more than 95%of its eligible populations in two rounds of vaccination campaign.Enabling factors of this successful vaccination campaign were strong national leadership,a well-coordinated national preparedness plan,and high acceptability of vaccine due to effective mass communication and social engagement led by religious figures,volunteers and local leaders.In this short report,we described the national strategic plan and enabling factors that led to the success of this historical vaccination campaign.展开更多
基金Supported by A Grant from the grants-in-Aid for Scientific Research from the Ministry of Education, Culture, Sports, Science and Technology of Japan, No. 23790798A Grant from the National Research University Project of the Thailand Office of Higher Education Commission+1 种基金The National Institutes of Health(DK62813)the grants-in-Aid for Scientific Research from the Ministry of Education, Culture, Sports, Science and Technology of Japan, No. 22390085 and No. 22659087
文摘AIM: To revealed the prevalence of Helicobacter pylori (H. pylori ) infection in the Bhutanese population. METHODS: We recruited a total of 372 volunteers (214 females and 158 males; mean age of 39.6 ± 14.9 years) from three Bhutanese cities (Thimphu, Punaka, and Wangdue). The status of H. pylori infection was determined based on five different tests: the rapid urease test (CLO test), culture, histology, immunohistochemistry (IHC), and serum anti H. pylori -antibody. RESULTS: The serological test showed a significantly higher positive rate compared with the CLO test, culture, histology and IHC (P < 0.001, P < 0.001, P=0.01, and P=0.01, respectively). When the subjects were considered to be H. pylori positive in the case of at least one test showing a positive result, the overall prevalence of H. pylori infection in Bhutan was 73.4%. The prevalence of H. pylori infection significantly decreased with age (P < 0.01). The prevalence of H. pylori infection was lower in Thimphu than in Punakha and Wangdue (P=0.001 and 0.06, respectively). The prevalence of H. pylori infection was significantly higher in patients with peptic ulcers than in those with gastritis (91.4% vs 71.3%, P=0.003). CONCLUSION: The high incidence of gastric cancer in Bhutan may be attributed to the high prevalence of H. pylori infection.
基金Supported by Grants from the National Institutes of HealthDK62813 to Yamaoka Y+12 种基金National Research University Project of Thailand Office of Higher Education Commission to Vilaichone RMahachai VGrants-in-Aid for Scientific Research from the Ministry of EducationCultureSportsScience and Technology of JapanNo.223900852265908724406015 and 24659200 to Yamaoka YThe Japan Society for the Promotion of Science Institutional Program for Young Researcher Overseas Visits to Fujioka TYamaoka YThe Strategic Funds for the Promotion of Science and Technology from Japan Science and Technology Agency to Fujioka TYamaoka Y
文摘AIM:To survey the antibiotic resistance pattern of Helicobacter pylori(H.pylori)strains isolated from Bhutanese population.METHODS:We isolated 111 H.pylori strains from the gastric mucosa of H.pylori-infected patients in Bhutan in 2010.The Epsilometer test was used to determine the minimum inhibitory concentrations(MICs)of amoxicillin(AMX),clarithromycin(CLR),metronidazole(MNZ),levofloxacin(LVX),ciprofloxacin(CIP),and tetracycline(TET).RESULTS:Nineteen of the isolated H.pylori strains were susceptible to all antibiotics tested.The isolated strains showed the highest rate of antibiotic resistance to MNZ(92/111,82.9%).Among the 92 MNZresistant strains,74 strains(80.4%)showed high-level resistance(MIC≥256 g/mL).Three strains were resistance to LVX(2.7%).These strains were also resistance to CIP.None of the strains showed resistance to CLR,AMX and TET.CONCLUSION:CLR-based triple therapy is a more effective treatment approach over MNZ-based triple therapy for H.pylori infection in Bhutan.
基金Supported by The Center for Eye Research and Education,Boston Massachusetts(partly)
文摘AIM: To estimate the prevalence of gastric cancer(GC) in a cohort of patients diagnosed with GC and to compare it with patients diagnosed with all other types of gastro-intestinal(GI) cancer during the same period.METHODS: Between 2008 and 2013,five-year period,the medical records of all GI cancer patients who underwent medical care and confirm diagnosis of cancer were reviewed at the National Referral Hospital,Thimphu which is the only hospital in the country where surgical and cancer diagnosis can be made. Demographic information,type of cancer,and the year of diagnosis were collected.RESULTS: There were a total of 767 GI related cancer records reviewed during the study period of which 354(46%) patients were diagnosed with GC. There were 413 patients with other GI cancer including; esophagus,colon,liver,rectum,pancreas,gall bladder,cholangiocarcinoma and other GI tract cancers. The GC incidence rate is approximately 0.9/10000 per year(367 cases/5years per 800000 people). The geographic distribution of GC was the lowest in the south region of Bhutan 0.3/10000 per year compared to the central region 1.4/10000 per year,Eastern region 1.2/10000 per year,and the Western region 1.1/10000 per year. Moreover,GC in the South part was significantly lower than the other GI cancer in the same region(8% vs 15%; OR = 1.8,95%CI: 1.3-3.1,P = 0.05). Among GC patients,38% were under the age of 60 years,mean age at diagnosis was 62.3(± 12.1) years with male-to-female ratio 1:0.5. The mean age among patients with all other type GI cancer was 60 years(± 13.2) and male-tofemale ratio of 1:0.7. At time of diagnosis of GC,342(93%) were at stage 3 and 4 of and by the year 2013; 80(23%) GC patients died compared to 31% death among patients with the all other GI cancer(P = 0.08).CONCLUSION: The incidence rate of GC in Bhutan is twice as high in the United States but is likely an underestimate rate because of unreported and undiagnosed cases in the villages. The high incidence of GC in Bhutan could be attributed to the high prevalence of Helicobacter pylori infection that we previously reported. The lowest incidence of GC in Southern part of the country could be due to the difference in the ethnicity as most of its population is of Indian and Nepal origin. Our current study emphasizes on the importance for developing surveillance and prevention strategies for GC in Bhutan.
基金supported by the National Natural Science Foundation of China(Grant No.91747207)the National Key R&D Program of China(Grant No.2018YFC1505205)the National Natural Science Foundation of China(Grant No.41790434)。
文摘The regional distribution of landslide dams can provide valuable insights into the interactions among various factors,including lithology,topography,climate,and fluvial landforms in tectonically active mountains.Himalayan rivers are frequently impacted by large-scale landslide damming,which profoundly influence fluvial geomorphology.In this study,we identified 1652 landslide dams in four major rivers of Bhutan and its surrounding area by remote sensing interpretation.Notably,approximately 71%of these landslide dams are found in regions composed of quartzite or gneiss.Fault-related tectonic activity plays a significant role in governing the distribution of these landslide dams,as approximately 83%of the mapped landslide dams are found within a 10 km radius of the nearest fault.The majority of the identified landslide dams are situated in areas with relatively modest local relief,ranging from 227 m to 327 m.These dams tend to cluster in the tributaries,and the stream power of almost 95%of them is typically below 1×10^(6) kg m^(2) s^(-3).Our data,combining the erosion rate and kernel density map of the landslide dams,reveals that regions with high erosion rates do not consistently align with the major high-density distribution of landslide dams.It is shown that the distribution of landslide dams is strongly influenced by the valley form.In comparison to U-shaped valleys,V-shaped valleys exhibit a higher density of landslide dams.Intriguingly,we also find a positive correlation between the landslide-dam distribution density and the erosion rate only in relatively arid regions with mean annual rainfall less than 500 mm.Moreover,the length of the upstream reach protected by the knickpoint associated with both lithology and landslide damming is about three times longer than that protected by the knickpoint associated only with landslide damming.
文摘Bhutan has reported a total of 2596 COVID-19 cases and three deaths as of September 15,2021.With support from India,the United States,Denmark,the People’s Republic of China,Croatia and other countries,Bhutan was able to conduct two rounds of nationwide vaccination campaign.While many countries struggle to overcome vaccine refusal or hesitancy due to complacency,a lack of trust,inconvenience and fear,escalated in some countries by anti-vaccine groups,Bhutan managed to inoculate more than 95%of its eligible populations in two rounds of vaccination campaign.Enabling factors of this successful vaccination campaign were strong national leadership,a well-coordinated national preparedness plan,and high acceptability of vaccine due to effective mass communication and social engagement led by religious figures,volunteers and local leaders.In this short report,we described the national strategic plan and enabling factors that led to the success of this historical vaccination campaign.
