Royal University of Bhutan

A flexible ammonium ion-sensing skin patch was developed based on a three-dimensional (3D) polystyrenesulfonate:polyaniline/copper microflower (PSS:PANI/CuMF) nanoarchitecture deposited on a flexible graphene electrode. The hierarchical 3D nanostructure integrates CuMF with a PSS:PANI network, providing a high-density electroactive surface, enhanced charge-transfer pathways, and stable ion-doping sites for NH4+ detection. The transducer was fabricated via a two-step electrochemical process and characterized using SEM and FTIR, confirming the formation of nanostructured CuMF and uniform nanopolymer coating. Coupled with adsorptive stripping voltammetry (AdSV), the sensor exhibited dual linear ranges (0.01–20 mM and 20–60 mM), high sensitivity (127.9 μA mM–1 cm–2 in the low range), and a low detection limit of 3.3 μM. The nanoscale PSS:PANI framework enables reversible NH4+ doping/dedoping through fixed sulfonate sites, while CuMF enhances electron-transfer kinetics. Integration into a wearable patch platform demonstrated reliable detection of NH4+ in artificial sweat using a skin-mimicking model. This work presents a nanostructured, flexible electrochemical platform for noninvasive ammonium monitoring, with potential applications in wearable bioanalysis.

Zoonotic diseases pose an increasing threat to human, animal and environmental health, and identifying the zoonoses of greatest public health concern is key to address them effectively. Despite high ongoing risks from zoonotic diseases, Bhutan has never conducted a zoonotic disease prioritization exercise. Therefore, the present study aimed to prioritize the top 10 zoonotic diseases in Bhutan and develop action plans to support targeted resource allocation, coordinated surveillance, and strategic planning through the One Health framework. The current study used a literature review of peer-reviewed publications and grey literature, expert knowledge, followed by a workshop to prioritize zoonoses in Bhutan. The workshop was convened in April 2024, and 42 participants from 20 different organizations from human, animal, wildlife, environmental, and food safety sectors participated in the workshop. Zoonotic disease prioritization was conducted using a mixed-method approach that combined an expert consensus approach with the U.S. Centers for Disease Control and Prevention One Health Zoonotic Disease Prioritization (OHZDP) tool. The initial literature review listed 55 zoonotic diseases for prioritization in the country. The workshop prioritized the top 10 zoonotic diseases viz., Rabies; Influenza A H5N1; Leptospirosis; Brucellosis; Escherichia coli infections; Dengue; Scrub Typhus; Bovine tuberculosis; Anthrax; and Salmonellosis. Joint action areas for the top five zoonotic diseases were developed to effectively address each disease through the One Health approach in the country. The prioritized zoonoses in Bhutan should be used for strengthening One Health coordination. Key recommendations from the OHZDP workshop emphasized strengthening disease surveillance, building laboratory diagnostic capacity, enhancing intersectoral collaboration, and developing a harmonized, interoperable system for information sharing and reporting. These measures aim to improve real-time data exchange, facilitate joint outbreak investigations, and support evidence-based decision-making for the prevention and control of zoonotic diseases.

Bovine tuberculosis (bTB) is a globally neglected zoonotic disease. In several low- and middle-income countries (LMIC), limited bTB surveillance and technologies to minimise milk-borne zoonoses put dairy consumers at high risk of bTB infection. Surprisingly, LMIC consumers are seldom investigated, which represents a significant knowledge gap that undermines existing efforts to mitigate zoonotic tuberculosis. We conducted a cross-sectional study in Bhutan where bTB control measures are lacking and raw dairy is widely consumed to assess dairy consumers' awareness and their knowledge, attitudes, and practices (KAP) regarding bTB. We enrolled 347 participants at the eight milk outlets operating in the capital city to determine the level of awareness about bTB among this group and characterise their KAP towards bTB. Only 17.3 % of the participants had heard of bTB. Majority (90.1 %) of them knew there is treatment of tuberculosis (TB) in Bhutan and TB is curable (72.5 %). However, 70.1 % had misconception that infected people cannot appear healthy, and only 12 % knew bTB is zoonotic. Only 26 % and 24 % perceived milk and dairy products as high risk respectively compared to 56.5 % for meat and 85.8 % for consuming diseased animals. Over 80 % of participants reported consumption of milk and dairy products daily or weekly, 25 % consuming primarily raw or insufficiently boiled milk. Only a few consumers knew of bTB and its zoonotic potential (n = 42; 12 %, Confidence Interval 95 %: 8.9 %-16 %). Regarding health practices, 60 % had annual check-ups, 15.3 % had TB testing, 5.2 % had TB treatment, and vaccination status was uncertain. Unsupervised classification of the data using Generalised Low-Ranking Models revealed that most variability was explained by three demographic factors, a few attitudes towards bTB infection risk, and milk and dairy product consumption frequency. Our findings reveal a widespread lack of awareness and low-risk perception regarding milk-borne bTB among consumers. These results are consistent with findings in other LMICs and highlight that dairy consumers likely represent a blind spot in current efforts to mitigate the adverse effects of bTB in these settings.

The Bhutanese education system is founded on a philosophy of core cultural values. Integrating these values into Information and Communication Technology (ICT) education presents both a critical opportunity and a significant challenge in an increasingly digital world. This study explores how teachers in Bumthang District perceive and implement key Bhutanese values, Tha Damtsi (sacred commitments), Ley Jum Drey (karmic responsibility), and Driglam Namzha (discipline and etiquette) within ICT education. Using a convergent parallel mixed-methods design, survey data was collected from 30 teachers and conducted in-depth interviews with five. Thematic analysis of qualitative data and descriptive statistics of quantitative data revealed strong teacher support for value integration, which they believed enhanced learning and protected culture. However, actual implementation was weak, hindered by limited resources, time constraints, and difficulties in aligning values with technical content. A significant gap in professional development was identified, with teachers requesting structured training and localised resources. This study proposes an adapted TPACK model as a culturally sensitive framework for digital pedagogy. It emphasises the need for curriculum alignment and teacher capacity building. It also highlights the importance of promoting value-based digital citizenship in Bhutan.

Like cells are the building blocks of life on earth, classrooms are the fundamental units of education system. The kind of classroom learning environment shaped, significantly influences learners’ learning, both academic and personal development. More importantly, many studies have verified that teachers’ teaching practices in the classroom immensely affects students’ achievement. Although there has been drastic change in education system, the transformation of teachers’ teaching practices in the classroom is arguable. So, this research study is primarily conducted to examine current classroom teaching practices of Bhutanese primary science teachers of Pema Gatshel district. In this study, Convergent Parallel Mixed Methods Design was employed. A total of 36 primary science teachers who are currently teaching primary science (IV-VI) and 51 upper primary students participated in the study. The study findings revealed that primary science teachers have good understanding about science and how it works. However, they are less encouraged to embrace modern teaching strategies and approaches due to laboratory and technology facilities in the school. The mentoring system and subject related PD programs in school also accounted to driving force of their motivation level.

Osteoid osteoma is the third most common benign bone tumor, composed of osteoid and woven bone that rarely exceeds 1.5 cm in dimension. The typical presentation is intense pain that mostly worsens at night and is relieved with non-steroidal anti-inflammatory drugs. X-ray is the initial imaging modality; however, CT scan is the modality of choice as it can identify almost all cases of osteoid osteoma. Our case demonstrates that the integration of O-arm navigation with arthroscopic visualization offers a novel and effective approach for managing subchondral osteoid osteomas. Although traditional surgical excision and CT-guided radiofrequency ablation have shown long-term high success rates, they are associated with more morbidity and cosmetically undesirable scarring. Our technique combines the benefits of both approaches while minimizing their respective limitations. This dual-modality approach proved particularly valuable in our young, active patient, where preservation of joint integrity and rapid return to function were paramount. The successful outcome suggests that this technique may represent a significant advancement in the surgical management of subchondral osteoid osteomas.

Abstract Objective To evaluate the impact of non-alcoholic fatty liver disease (NAFLD) on portal and hepatic vein hemodynamics using Doppler ultrasound. Methodology This was a case-control study conducted at Radiology Department of --- for the duration of 9 months. Inclusion criteria: Patients of both genders with age group of 25–80 years were included. Patients with elevated liver enzymes. In case group patients with fatty liver disease and in control group patients with no ultrasound findings of fatty liver disease were included. Exclusion criteria: Patients with ascites, history of Hepatitis, CLD and any liver mass were excluded from this study. Results In the study involving 110 participants, the mean age was 54.8 ± 11.6 years. NAFLD patients had a significantly lower mean portal vein peak systolic velocity (PSV) 20.49 ± 35.65 compared to those without NAFLD with a significant p -value of 0.000. Hepatic artery resistive index (RI) was higher in NAFLD patients 0.82 ± 0.63 compared to non-NAFLD, indicating increased vascular resistance associated with NAFLD. The mean portal vein peak systolic velocity (PSV) for NAFLD patients decreases with increasing NAFLD severity. Similarly, the mean hepatic artery resistive index (RI) increases with NAFLD severity. Conclusion Study concluded that there is a significant correlation between portal vein PSV and hepatic artery RI with NAFLD. NAFLD patients had a significantly lower mean portal vein peak systolic velocity and hepatic artery resistive index was higher in NAFLD patients compared to non-NAFLD.