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Article ; Online: An unusual case of Brown-Sequard syndrome associated with Horner’s syndrome after a penetrating injury with a (Bhutanese dart) to the neck

Kuenzang Wangdi

SAGE Open Medical Case Reports, Vol

A case report

2022 Volume 10

Abstract: The occurrence of Brown-Sequard syndrome with Horner’s syndrome in a child with spinal trauma is a very rare and unusual entity. Brown-Sequard syndrome results from hemisection injury of the spinal cord, mostly in the cervical cord region. The Horner’s ... ...

Abstract	The occurrence of Brown-Sequard syndrome with Horner’s syndrome in a child with spinal trauma is a very rare and unusual entity. Brown-Sequard syndrome results from hemisection injury of the spinal cord, mostly in the cervical cord region. The Horner’s syndrome presents when the injury is in the cervical region involving the sympathetic pathway. We present you with the case of a 12-year-old boy who was referred from a local hospital with weakness on the left half of his body after sustaining a penetrating injury to his neck by a khuru (Bhutanese dart). Clinical examination was consistent with the diagnosis of Brown-Sequard syndrome with ipsilateral Horner’s syndrome. Although cervical spine plain radiographs showed no fracture, computed tomography and magnetic resonance imaging showed a C2 lamina fracture at the left side of the spinous process with indentation to the cord. He was managed conservatively with a soft cervical collar, intravenous antibiotics, and physiotherapy. He had complete resolution of Brown-Sequard syndrome and Horner’s syndrome after 1 year. Patients with Brown-Sequard syndrome associated with Horner’s syndrome usually have a good prognosis and full recovery rate with regular physiotherapy and rehabilitation. Early diagnosis and treatment will have a better chance of recovery and return to pre-injury status.
Keywords	Medicine (General) ; R5-920
Subject code	610
Language	English
Publishing date	2022-08-01T00:00:00Z
Publisher	SAGE Publishing
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article: An unusual case of Brown-Sequard syndrome associated with Horner's syndrome after a penetrating injury with a

Wangdi, Kuenzang

SAGE open medical case reports

2022 Volume 10, Page(s) 2050313X221116945

Abstract: The occurrence of Brown-Sequard syndrome with Horner's syndrome in a child with spinal trauma is a very rare and unusual entity. Brown-Sequard syndrome results from hemisection injury of the spinal cord, mostly in the cervical cord region. The Horner's ... ...

Abstract	The occurrence of Brown-Sequard syndrome with Horner's syndrome in a child with spinal trauma is a very rare and unusual entity. Brown-Sequard syndrome results from hemisection injury of the spinal cord, mostly in the cervical cord region. The Horner's syndrome presents when the injury is in the cervical region involving the sympathetic pathway. We present you with the case of a 12-year-old boy who was referred from a local hospital with weakness on the left half of his body after sustaining a penetrating injury to his neck by a
Language	English
Publishing date	2022-08-17
Publishing country	England
Document type	Case Reports
ZDB-ID	2736953-5
ISSN	2050-313X
ISSN	2050-313X
DOI	10.1177/2050313X221116945
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Groundwater Potential Mapping at Highly Populated Sub-districts of Thimphu District Using Fuzzy Analytic Hierarchy Process

Thongley Thongley / Tshering Choki / Kuenzang Choden

Applied Environmental Research, Vol 45, Iss

2023 Volume 2

Abstract: Groundwater is important when there is an insufficient spring water supply for daily needs. The population growth and expansion of the cities demand more water. Thimphu is the capital city of Bhutan and facing water shortage in recent times due to urban ... ...

Abstract	Groundwater is important when there is an insufficient spring water supply for daily needs. The population growth and expansion of the cities demand more water. Thimphu is the capital city of Bhutan and facing water shortage in recent times due to urban expansion and population growth. This study aims to find the potential area for groundwater using the Fuzzy Analytic Hierarchy Process. The factors used for this study are elevation, slope, curvature, topographic wetness index, drainage density, normalized difference vegetation index, distance from fault density, rainfall distribution map, soil texture map, and drainage density. The rating for the factors and classes of the factors were carried out with the help of field experts. As per the fuzzy weight, the highest contributing factor for the groundwater is rainfall with a fuzzy weight of 0.215. Only 1.19% of the study area falls under very high potential zone for groundwater and the area under the curve of the groundwater potential map is 70.37%. The groundwater potential map will help concerned officials to explore the subsurface groundwater using geophysical investigation using test drilling and borehole geophysical logging techniques.
Keywords	Fuzzy Analytic Hierarchy Process ; Groundwater potential mapping ; Geographic Information System ; Area Under Curve ; Environmental sciences ; GE1-350 ; Environmental technology. Sanitary engineering ; TD1-1066
Subject code	550
Language	English
Publishing date	2023-06-01T00:00:00Z
Publisher	Environmental Research Institute, Chulalongkorn University
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article: The trend of tuberculosis case notification and predictors of unsuccessful treatment outcomes in Samdrup Jongkhar district, Bhutan: A fourteen-year retrospective study.

Penjor, Kinley / Kuenzang / Tshokey, Tshokey / Wangdi, Kinley

Heliyon

2021 Volume 7, Issue 3, Page(s) e06573

Abstract: Tuberculosis (TB) continues to be an important public health issue in Bhutan. This study aims to describe the trend of tuberculosis and investigate factors associated with a unsuccessful treatment outcome in Samdrup Jongkhar District in Bhutan. A ... ...

Abstract	Tuberculosis (TB) continues to be an important public health issue in Bhutan. This study aims to describe the trend of tuberculosis and investigate factors associated with a unsuccessful treatment outcome in Samdrup Jongkhar District in Bhutan. A fourteen-year (2004-2017) case records in two TB centres of Dewathang and Samdrup Jongkhar Hospitals were reviewed and analyzed to examine trends in case notification and treatment outcomes. Univariable and multivariable logistic regression analysis was undertaken to identify covariates of unsuccessful TB treatment. Of the total of 820 TB cases registered in surveillance record, 729 cases were analysed. Males made up 53.8% (397) of total cases and the median age was 29 years (range: 2-87 years). A gradual downward trend in TB case notification was noticed in the district with overall case notification rate of 139/100,000 during the study period. The annual treatment success rate was over 90% except for years 2013-2015 with overall treatment success rate for the study period at 93%. A re-treatment TB patient, sputum-positive at the second month of treatment and being of Indian nationality were significant correlates of unsuccessful treatment outcomes. The overall TB inclidence has declined and TB treatment success rate was above WHO recommended 90% in Samdrup Jongkhar District during the study period. A special attention should be paid to the poor treatment outcome predictors including re-treatment cases and failed sputum conversion at the second month of treatment.
Language	English
Publishing date	2021-03-25
Publishing country	England
Document type	Journal Article
ZDB-ID	2835763-2
ISSN	2405-8440
ISSN	2405-8440
DOI	10.1016/j.heliyon.2021.e06573
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Comparison of Laboratory and Non-Laboratory-Based 2019 World Health Organization Cardiovascular Risk Charts in the Bhutanese Population.

Chhezom, Kuenzang / Gurung, Mongal Singh / Wangdi, Kinley

Asia-Pacific journal of public health

2023 Volume 36, Issue 1, Page(s) 29–35

Abstract: The World Health Organization (WHO) recommends the use of color-coded cardiovascular disease (CVD) risk charts for CVD management. This study evaluated the agreement between the laboratory and non-laboratory 10-year CVD risks based on 2019 WHO CVD risk- ... ...

Abstract	The World Health Organization (WHO) recommends the use of color-coded cardiovascular disease (CVD) risk charts for CVD management. This study evaluated the agreement between the laboratory and non-laboratory 10-year CVD risks based on 2019 WHO CVD risk-prediction charts. The agreement of CVD risk scores among 40- to 69-year-old Bhutanese population stratified by gender and age groups (<60 and ≥60 years) was determined via weighted kappa statistics. In the general population, there was substantial agreement between the two CVD risk score charts for all ages and <60 years but a moderate agreement for participants aged ≥60 years. In males, substantial agreement was observed in all ages and in <60 years and moderate agreement in ≥60 years. In females, both the predictions showed substantial agreement in all ages and <60, but a moderate agreement for ≥60 years. The non-laboratory-based risk charts can be used interchangeably with laboratory-based charts for predicting 10-year CVD risk in resource-constrained countries like Bhutan.
MeSH term(s)	Male ; Female ; Humans ; Adult ; Middle Aged ; Aged ; Cardiovascular Diseases/diagnosis ; Cardiovascular Diseases/epidemiology ; Risk Factors ; Bhutan/epidemiology ; Risk Assessment ; World Health Organization ; Heart Disease Risk Factors
Language	English
Publishing date	2023-11-21
Publishing country	China
Document type	Journal Article
ZDB-ID	1025444-4
ISSN	1941-2479 ; 1010-5395
ISSN (online)	1941-2479
ISSN	1010-5395
DOI	10.1177/10105395231211997
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Article ; Online: The trend of tuberculosis case notification and predictors of unsuccessful treatment outcomes in Samdrup Jongkhar district, Bhutan

Kinley Penjor / Kuenzang / Tshokey Tshokey / Kinley Wangdi

Heliyon, Vol 7, Iss 3, Pp e06573- (2021)

A fourteen-year retrospective study

2021

Abstract	Tuberculosis (TB) continues to be an important public health issue in Bhutan. This study aims to describe the trend of tuberculosis and investigate factors associated with a unsuccessful treatment outcome in Samdrup Jongkhar District in Bhutan.A fourteen-year (2004–2017) case records in two TB centres of Dewathang and Samdrup Jongkhar Hospitals were reviewed and analyzed to examine trends in case notification and treatment outcomes. Univariable and multivariable logistic regression analysis was undertaken to identify covariates of unsuccessful TB treatment.Of the total of 820 TB cases registered in surveillance record, 729 cases were analysed. Males made up 53.8% (397) of total cases and the median age was 29 years (range: 2–87 years). A gradual downward trend in TB case notification was noticed in the district with overall case notification rate of 139/100,000 during the study period. The annual treatment success rate was over 90% except for years 2013–2015 with overall treatment success rate for the study period at 93%. A re-treatment TB patient, sputum-positive at the second month of treatment and being of Indian nationality were significant correlates of unsuccessful treatment outcomes. The overall TB inclidence has declined and TB treatment success rate was above WHO recommended 90% in Samdrup Jongkhar District during the study period. A special attention should be paid to the poor treatment outcome predictors including re-treatment cases and failed sputum conversion at the second month of treatment.
Keywords	Bhutan ; Tuberculosis ; Infection ; Risk factors ; Modelling ; Science (General) ; Q1-390 ; Social sciences (General) ; H1-99
Subject code	616
Language	English
Publishing date	2021-03-01T00:00:00Z
Publisher	Elsevier
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Simulated temperatures of forest fires affect water solubility in soil and litter

Miotliński, Konrad / Kuenzang Tshering / Boyce, Mary C. / Blake, David / Horwitz, Pierre

Ecological Indicators. 2023, p.110236-

2023 , Page(s) 110236–

Abstract: As wildfires are of increasing concern in a warming world, there is a need to understand how fire temperatures affect solute concentrations of forest litter and soils in drinking water catchments. In addition, the concentrations are expected to be ... ...

Abstract	As wildfires are of increasing concern in a warming world, there is a need to understand how fire temperatures affect solute concentrations of forest litter and soils in drinking water catchments. In addition, the concentrations are expected to be affected by time since the previous fire. We sampled soil and litter from recently (2 months) and less recently (4.5 years) burnt sites from jarrah forest in SW Australia. The samples were heated at 250°C, 350°C, and 500°C for 30min followed by leaching to determine solute compositions at these temperatures and in unburnt samples. At 250°C-350°C, we found increased concentrations of manganese (Mn), arsenic (As), total phosphorus (TP), phosphate (PO43-), ammonia (NH4+), potassium (K), calcium (Ca), mangesium (Mg), cobalt (Co), barium (Ba), sulphate (SO42-), alkalinity and dissolved organic carbon in soils, as well as of zinc (Zn), As, Ca, Ba, alkalinity, aluminium (Al) and chromium (Cr) in litter. At 350°C-500°C, divalent cations and organic carbon declined, while soils generated very high Al and Cr concentrations. The time following the fire was important, with the more recent fire generating higher concentrations. The elevated concentrations in 250°C-350°C were attributed to a decomposition of organic matter and mineral transformations, including CaCO₃ formation. Based on thermodynamics, we propose a couple of burn severity indicators: activities of calcium and carbonates that are calculated from pH, alkalinity and Ca concentration. The indicators do not only show the degree of post-fire transformations, but they also inform on CaCO₃ formation. Further studies include: (1) application to field data, (2) association with organic contaminants, and (3) validation in other geographical locations.
Keywords	Eucalyptus marginata ; alkalinity ; aluminum ; ammonia ; arsenic ; barium ; burn severity ; calcium ; chromium ; cobalt ; forest litter ; forests ; manganese ; organic carbon ; pH ; phosphates ; potassium ; solutes ; sulfates ; thermodynamics ; total phosphorus ; water solubility ; zinc ; Australia ; wildfire ; biogeochemical cycle ; metal contamination ; nutrient contamination ; carbonate formation
Language	English
Publishing place	Elsevier Ltd
Document type	Article ; Online
Note	Pre-press version ; Use and reproduction
ZDB-ID	2036774-0
ISSN	1872-7034 ; 1470-160X
ISSN (online)	1872-7034
ISSN	1470-160X
DOI	10.1016/j.ecolind.2023.110236
Database	NAL-Catalogue (AGRICOLA)

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Article ; Online: Stream macro-invertebrate diversity of the Phobjikha Valley, Bhutan

Jigme Wangchuk / Kuenzang Dorji

Journal of Threatened Taxa, Vol 10, Iss 1, Pp 11126-

2018 Volume 11146

Abstract: Macro-invertebrates form an integral part of aquatic systems, and assessment of macro-invertebrate communities is one of the best ways to monitor the health of a stream. Despite this, stream monitoring of macro-invertebrates has been extremely limited in ...

Abstract	Macro-invertebrates form an integral part of aquatic systems, and assessment of macro-invertebrate communities is one of the best ways to monitor the health of a stream. Despite this, stream monitoring of macro-invertebrates has been extremely limited in Bhutan. A study was conducted to generate baseline information on macro-invertebrate diversity in the Phobjikha valley, covering community composition and seasonal variation in diversity during post and pre-monsoon seasons. From a total of 244 units sampled in streams, 50 families from 13 orders were recorded. The dominant order overall was Ephemeroptera (31%), which also dominated the pre-monsoon assessment (33%), while Trichoptera (39%) dominated the post-monsoon assessment. The pre-monsoon assessment recorded two additional orders, Caenogastropoda and Veneroida. There was no significant difference in diversity between the post-monsoon and pre-monsoon assessments (p˃0.3), but a significant difference in species diversity between seasons was observed in pools and riffles. Physicochemical parameters indicated that pH, electrical conductivity and salinity were within favorable ranges for macro-invertebrates. Further studies of other habitats in different seasons will produce a more comprehensive understanding of macro-invertebrate diversity.
Keywords	environmental variables ; macroinvertebrate diversity ; post and pre-monsoon ; freshwater ecosystem ; pool and riffle ; core wetland ; Ecology ; QH540-549.5 ; General. Including nature conservation ; geographical distribution ; QH1-199.5
Language	English
Publishing date	2018-01-01T00:00:00Z
Publisher	Wildlife Information Liaison Development Society
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Perspectives on chronic musculoskeletal pain management among healthcare professionals in Bhutan: A qualitative study.

Tamang, Monu / Dorji, Nidup / Wangdi, Kuenzang / Letho, Zimba / Lhaki, Karma / Dorji, Thinley

Musculoskeletal care

2023 Volume 21, Issue 4, Page(s) 1401–1411

Abstract: Introduction: Musculoskeletal pain disorders continue to be one of the leading causes of disability worldwide. Best practice care recommends patient-centred biopsychosocial models of care. Little is known about the chronic musculoskeletal pain ... ...

Abstract	Introduction: Musculoskeletal pain disorders continue to be one of the leading causes of disability worldwide. Best practice care recommends patient-centred biopsychosocial models of care. Little is known about the chronic musculoskeletal pain management in low- and middle-income countries. Objectives: To explore the management of chronic musculoskeletal pain by healthcare professionals in Bhutan. Methods: This study employed a qualitative design involving 19 Bhutanese healthcare professionals managing chronic musculoskeletal pain in Bhutan. We collected data using a semi-structured interview guide. Thematic analysis was done manually. Results: Healthcare professionals reported that patients rely on a combination of home remedies and seek help from local healers and hospitals for chronic musculoskeletal pain management. While healthcare professionals understand chronic musculoskeletal pain as multi-dimensional phenomenon, the primary focus was on identifying and treating structural anomalies. Time constraints, inadequate knowledge and skills, lack of confidence, facilities and expertise were reported as barriers to the effective management of chronic musculoskeletal pain. They proposed a need for clinical guidelines, relevant skills training and creating awareness of chronic musculoskeletal pain. Conclusion: The management of chronic musculoskeletal pain in Bhutan is focused on identifying and treating physical abnormalities. Healthcare professionals consider psychosocial dimensions important but lack any form of actionable interventions in this domain.
MeSH term(s)	Humans ; Bhutan ; Musculoskeletal Pain/therapy ; Chronic Pain/therapy ; Chronic Pain/psychology ; Qualitative Research ; Attitude of Health Personnel
Language	English
Publishing date	2023-09-14
Publishing country	England
Document type	Journal Article
ZDB-ID	2171452-6
ISSN	1557-0681 ; 1478-2189
ISSN (online)	1557-0681
ISSN	1478-2189
DOI	10.1002/msc.1821
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Article ; Online: The trend of tuberculosis case notification and predictors of unsuccessful treatment outcomes in Samdrup Jongkhar district, Bhutan: A fourteen-year retrospective study

Penjor, Kinley / Kuenzang / Tshokey, Tshokey / Kinley Wangdi

Heliyon. 2021 Mar., v. 7, no. 3 p.e06573-

2021

Abstract	Tuberculosis (TB) continues to be an important public health issue in Bhutan. This study aims to describe the trend of tuberculosis and investigate factors associated with a unsuccessful treatment outcome in Samdrup Jongkhar District in Bhutan.A fourteen-year (2004–2017) case records in two TB centres of Dewathang and Samdrup Jongkhar Hospitals were reviewed and analyzed to examine trends in case notification and treatment outcomes. Univariable and multivariable logistic regression analysis was undertaken to identify covariates of unsuccessful TB treatment.Of the total of 820 TB cases registered in surveillance record, 729 cases were analysed. Males made up 53.8% (397) of total cases and the median age was 29 years (range: 2–87 years). A gradual downward trend in TB case notification was noticed in the district with overall case notification rate of 139/100,000 during the study period. The annual treatment success rate was over 90% except for years 2013–2015 with overall treatment success rate for the study period at 93%. A re-treatment TB patient, sputum-positive at the second month of treatment and being of Indian nationality were significant correlates of unsuccessful treatment outcomes. The overall TB inclidence has declined and TB treatment success rate was above WHO recommended 90% in Samdrup Jongkhar District during the study period. A special attention should be paid to the poor treatment outcome predictors including re-treatment cases and failed sputum conversion at the second month of treatment.
Keywords	monitoring ; nationalities and ethnic groups ; patients ; public health ; regression analysis ; retrospective studies ; tuberculosis ; Bhutan ; Tuberculosis ; Infection ; Risk factors ; Modelling
Language	English
Dates of publication	2021-03
Publishing place	Elsevier Ltd
Document type	Article ; Online
ZDB-ID	2835763-2
ISSN	2405-8440
ISSN	2405-8440
DOI	10.1016/j.heliyon.2021.e06573
Database	NAL-Catalogue (AGRICOLA)

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