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  • 1
    In: Open Forum Infectious Diseases, Oxford University Press (OUP), Vol. 8, No. 8 ( 2021-08-01)
    Abstract: Convalescent plasma therapy (CPT) and remdesivir (REM) have been approved for investigational use to treat coronavirus disease 2019 (COVID-19) in Nepal. Methods In this prospective, multicentered study, we evaluated the safety and outcomes of treatment with CPT and/or REM in 1315 hospitalized COVID-19 patients over 18 years in 31 hospitals across Nepal. REM was administered to patients with moderate, severe, or life-threatening infection. CPT was administered to patients with severe to life-threatening infections who were at high risk for progression or clinical worsening despite REM. Clinical findings and outcomes were recorded until discharge or death. Results Patients were classified as having moderate (24.2%), severe (64%), or life-threatening (11.7%) COVID-19 infection. The majority of CPT and CPT + REM recipients had severe to life-threatening infections (CPT 98.3%; CPT + REM 92.1%) and were admitted to the intensive care unit (ICU; CPT 91.8%; CPT + REM 94.6%) compared with those who received REM alone (73.3% and 57.5%, respectively). Of 1083 patients with reported outcomes, 78.4% were discharged and 21.6% died. The discharge rate was 84% for REM (n = 910), 39% for CPT (n = 59), and 54.4% for CPT + REM (n = 114) recipients. In a logistic model comparing death vs discharge and adjusted for age, gender, steroid use, and severity, the predicted margin for discharge was higher for recipients of remdesivir alone (0.82; 95% CI, 0.79–0.84) compared with CPT (0.58; 95% CI, 0.47–0.70) and CPT + REM (0.67; 95% CI, 0.60–0.74) recipients. Adverse events of remdesivir and CPT were reported in  & lt;5% of patients. Conclusions This study demonstrates a safe rollout of CPT and REM in a resource-limited setting. Remdesivir recipients had less severe infection and better outcomes. ClinicalTrials.gov identifier. NCT04570982.
    Type of Medium: Online Resource
    ISSN: 2328-8957
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2021
    detail.hit.zdb_id: 2757767-3
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  • 2
    In: BMC Health Services Research, Springer Science and Business Media LLC, Vol. 21, No. 1 ( 2021-12)
    Abstract: Cardiovascular diseases (CVDs) are the leading cause of deaths and disability in Nepal. Health systems can improve CVD health outcomes even in resource-limited settings by directing efforts to meet critical system gaps. This study aimed to identify Nepal’s health systems gaps to prevent and manage CVDs. Methods We formed a task force composed of the government and non-government representatives and assessed health system performance across six building blocks: governance, service delivery, human resources, medical products, information system, and financing in terms of equity, access, coverage, efficiency, quality, safety and sustainability. We reviewed 125 national health policies, plans, strategies, guidelines, reports and websites and conducted 52 key informant interviews. We grouped notes from desk review and transcripts’ codes into equity, access, coverage, efficiency, quality, safety and sustainability of the health system. Results National health insurance covers less than 10% of the population; and more than 50% of the health spending is out of pocket. The efficiency of CVDs prevention and management programs in Nepal is affected by the shortage of human resources, weak monitoring and supervision, and inadequate engagement of stakeholders. There are policies and strategies in place to ensure quality of care, however their implementation and supervision is weak. The total budget on health has been increasing over the past five years. However, the funding on CVDs is negligible. Conclusion Governments at the federal, provincial and local levels should prioritize CVDs care and partner with non-government organizations to improve preventive and curative CVDs services.
    Type of Medium: Online Resource
    ISSN: 1472-6963
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2021
    detail.hit.zdb_id: 2050434-2
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  • 3
    Online Resource
    Online Resource
    Nepal Journals Online (JOL) ; 2022
    In:  Nepalese Journal of Ophthalmology Vol. 14, No. 1 ( 2022-05-23), p. 122-129
    In: Nepalese Journal of Ophthalmology, Nepal Journals Online (JOL), Vol. 14, No. 1 ( 2022-05-23), p. 122-129
    Abstract: Introduction: Major cause of irreversible blindness is glaucoma which is increasing as a significant global health problem. Knowledge of glaucoma burden and its clinical characteristics in this region is essential. Materials and methods: This was a cross-sectional hospital -based study conducted at Glaucoma unit in CHEERS Hospital, Bhaktapur from August 2015 to July 2019. Patients’ demographic profile, along with comprehensive eye examination findings were reviewed from the records. Data analysis was done with IBM SPSS version 24 and was presented in mean (±SD), frequency and proportions and a chi- square test was applied. P value 〈 0.05 was considered statistically significant.  Results: Total of 310 glaucoma cases were included in this study. The mean age presentation was 61.89±14.4 years, and the majority of patients (52.9%) were in the age group 60-79 years. Most patients had primary open angle glaucoma (171, 55.2%) followed by primary angle closure glaucoma (92, 29.7%). Conclusion: Primary open angle glaucoma is the most common form of glaucoma. The proportion of glaucoma increased with increasing age ( 〉 40 years). Provision of screening programs targeting persons with risk factors and opportunistic eye examinations would be beneficial in detection of glaucoma.
    Type of Medium: Online Resource
    ISSN: 2091-0320 , 2072-6805
    Language: Unknown
    Publisher: Nepal Journals Online (JOL)
    Publication Date: 2022
    detail.hit.zdb_id: 2596436-7
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  • 4
    Online Resource
    Online Resource
    MedCrave Group Kft. ; 2021
    In:  Journal of Analytical & Pharmaceutical Research Vol. 10, No. 2 ( 2021-3-29), p. 71-80
    In: Journal of Analytical & Pharmaceutical Research, MedCrave Group Kft., Vol. 10, No. 2 ( 2021-3-29), p. 71-80
    Abstract: Objective: This study aims to prepare the taste-masked granules of Mirtazapine by mass extrusion technique and formulate it into an oral dispersible tablet using different super disintegrates. Methods: Taste masked granules of mirtazapine were prepared by mass extrusion technique using Eudragit EPO in different ratios. The drug-polymer ratio was optimized based on the percent drug release in SSF and SGF. Taste masking efficacy of drug-polymer complex was determined by developing the bitterness threshold value of Mirtazapine. The selected drug-polymer complex was formulated into an oro-dispersible tablet by direct compression method. A randomized design was used to investigate individual effect of three different super disintegrates each in different concentrations. Ten formulations were developed including a controlled formulation without the addition of superdisintegrants. A comparative study was done based on various pre-compression and post-compression parameters. Results: Eudragit EPO was able to mask the bitter taste of Mirtazapine effectively in 1:2 ratio by mass extrusion method. The minimum disintegration time and wetting time was found to be 13.6±2.7 and 18.13±0.24 seconds with the formulation containing crospovidone 5% (F9). It was found that the wetting time and disintegration time followed the order SSG 〉 CCS 〉 CPV. The selected best formulation was subjected to an incompatibility study design. The IR spectrum showed that all the excipients were chemically compatible. Conclusion: Thus, in this study unpalatable taste of Mirtazapine was masked using Eudragit EPO polymer by mass extrusion technique, and superdisintegrants were added to prepare orally disintegrating tablets of Mirtazapine. This research work suggests a rapid, simple and cost effective method for formulating Mirtazapine ODT.
    Type of Medium: Online Resource
    ISSN: 2473-0831
    URL: Issue
    Language: Unknown
    Publisher: MedCrave Group Kft.
    Publication Date: 2021
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  • 5
    Online Resource
    Online Resource
    Nepal Journals Online (JOL) ; 2023
    In:  International Journal of Occupational Safety and Health Vol. 13, No. 1 ( 2023-01-01), p. 87-96
    In: International Journal of Occupational Safety and Health, Nepal Journals Online (JOL), Vol. 13, No. 1 ( 2023-01-01), p. 87-96
    Abstract: Introduction: A corneal foreign body is the most common occupational ocular injury that can cause secondary infection or scars on the visual axis, decreasing vision. The study aimed to find out practices of wearing protective eye devices in the workplace and the factors influencing the utilization of such devices among patients with corneal foreign body (CFB) injury. Methods: This cross-sectional study was conducted in a tertiary eye hospital in Bhaktapur from April 2021 to August 2021. All patients with CFB attending the hospital were included in the study. CFB was removed with ocular examination under a slit lamp biomicroscope, and face-to-face interview was conducted. Results: Among 142 patients, only one was female, and 41.5% had a previous history of CFB. The most common CFB particle was metallic (n=124, 87.3%),. Three-fourths (75.1%) of patients were not using eye-protective devices at the time of injury, and 45.1% tried physically removing the CFB in a harmful way. Nearly two in five (19.7%) had used topical antibiotics eye drops before presenting for CFB removal. Sixty-six (46.5%) reported never wearing any protective eye devices, and the main reason for not-wearing was the unavailability (48.4%) of such devices in their workplace. The awareness of the need for protective eye devices (p 〈 0.001) was significantly associated with using protective eye devices during work. Conclusion: The workers should be made aware of the consequences of harmful practices following CFB injury. The workers should wear protective eye devices to minimize the risk of ocular injury and consequent visual impairment.
    Type of Medium: Online Resource
    ISSN: 2091-0878 , 2738-9707
    Language: Unknown
    Publisher: Nepal Journals Online (JOL)
    Publication Date: 2023
    detail.hit.zdb_id: 2895042-2
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  • 6
    Online Resource
    Online Resource
    Journal of Nepal Medical Association (JNMA) ; 2021
    In:  Journal of Nepal Medical Association Vol. 59, No. 241 ( 2021-09-11), p. 858-861
    In: Journal of Nepal Medical Association, Journal of Nepal Medical Association (JNMA), Vol. 59, No. 241 ( 2021-09-11), p. 858-861
    Abstract: Introduction: Intravitreal Bevacizumab injection has now become a routine procedure for retina specialists throughout the world. Easy availability of this monoclonal antibody molecule even in Nepal has brought a revolution in the management of various retinal diseases. This study aims to find out the prevalence of the use of intravitreal Bevacizumab for retinal diseases at the tertiary eye hospital. Methods: This descriptive cross-sectional study was carried out in the retina department at a tertiary care hospital from January 2017 to December 2019 after obtaining ethical clearance from Nepal Health Research Council (Ref: 125/2020P). The sample size was calculated and the study enrolled all patients who received intravitreal Bevacizumab for retinal diseases using convenience sampling technique. Data were analyzed using Statistical Package for Social Science Version 21. Point estimate at 95% Confidence Interval was calculated, along with frequency and percentage for binary data. Results: Out of 959 total surgical retinal interventions done 296 (30.86%) at 95% Confidence Interval (27.93-33.78) patients received intravitreal Bevacizumab. Out of total intravitreal Bevacizumab injections, 143 (36.7%) injections were given to retinal vein occlusions patients, 127 (32.6%) injections were given to diabetic retinopathy patients and 66 (17%) injections was given to age-related macular degeneration patients. Males 176 (59.5%) outnumbered the females 120 (40.5%) in receiving intravitreal Bevacizumab. Mean baseline Logarithm of the Minimal Angle of Resolution visual acuity, 1.1, improved to, 0.75, after 3 months of intravitreal Bevacizumab. Conclusions: Intravitreal Bevacizumab was one of the commonest retinal interventions used. Retinal vein occlusion, diabetic retinopathy, and age-related macular degeneration were the commonest retinal diseases needing intravitreal Bevacizumab.
    Type of Medium: Online Resource
    ISSN: 1815-672X , 0028-2715
    Language: Unknown
    Publisher: Journal of Nepal Medical Association (JNMA)
    Publication Date: 2021
    detail.hit.zdb_id: 2209910-4
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  • 7
    In: Current Research in Environmental Sustainability, Elsevier BV, Vol. 3 ( 2021), p. 100031-
    Type of Medium: Online Resource
    ISSN: 2666-0490
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2021
    detail.hit.zdb_id: 3036904-6
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  • 8
    Online Resource
    Online Resource
    Nepal Journals Online (JOL) ; 2022
    In:  Nepalese Journal of Ophthalmology Vol. 14, No. 1 ( 2022-05-23), p. 82-92
    In: Nepalese Journal of Ophthalmology, Nepal Journals Online (JOL), Vol. 14, No. 1 ( 2022-05-23), p. 82-92
    Abstract: Introduction: As the number of people with diabetes mellitus is increasing because of urbanization and change in dietary habits and sedentary lifestyle, the number of diabetic retinopathy is also expected to increase in future. [1] [sa2] We aimed to find out the prevalence of diabetic retinopathy and associated risk factors among diabetic patients in the tertiary eye hospital. Materials and methods:  This is the observational cross-sectional study enrolling 420 diabetic patients visiting the multispecialty tertiary eye hospital between March 2020 and February 2021. Anthropometry measurement, laboratory risk profiles and blood pressure were recorded Results: The prevalence of any diabetic retinopathy, proliferative diabetic retinopathy, and diabetic macular edema were 30.96 %, 6.19 %, and 5.95 % respectively. The duration of DM (p=0.001), hypertension (p=0.04), high SBP (p=0.023), abdominal obesity (p=0.015), high LDL(p=0.011) cholesterol, low HDL cholesterol(p=0.012), and creatinine (p=0.001) were associated with DR in our study.  Conclusion: A holistic approach should target to control the modifiable risk factors like blood sugar, blood pressure, lipid profile, kidney function, and obesity to prevent DR. Anthropometric assessment of waist to height and waist circumference should be included in the holistic health promotion strategy in Nepal as BMI may not be risk factors for DR in Nepalese people.
    Type of Medium: Online Resource
    ISSN: 2091-0320 , 2072-6805
    Language: Unknown
    Publisher: Nepal Journals Online (JOL)
    Publication Date: 2022
    detail.hit.zdb_id: 2596436-7
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  • 9
    In: Scientific Reports, Springer Science and Business Media LLC, Vol. 7, No. 1 ( 2017-07-06)
    Abstract: We previously reported the importance of induced nuclear transglutaminase (TG) 2 activity, which results in hepatic cell death, in ethanol-induced liver injury. Here, we show that co-incubation of either human hepatic cells or mouse primary hepatocytes derived from wild-type but not TG2 −/− mice with pathogenic fungi Candida albicans and C. glabrata , but not baker’s yeast Saccharomyces cerevisiae , induced cell death in host cells by enhancing cellular, particularly nuclear, TG activity. Further pharmacological and genetic approaches demonstrated that this phenomenon was mediated partly by the production of reactive oxygen species (ROS) such as hydroxyl radicals, as detected by a fluorescent probe and electron spin resonance. A ROS scavenger, N-acetyl cysteine, blocked enhanced TG activity primarily in the nuclei and inhibited cell death. In contrast, deletion of C. glabrata nox-1 , which encodes a ROS-generating enzyme, resulted in a strain that failed to induce the same phenomena. A similar induction of hepatic ROS and TG activities was observed in C. albicans -infected mice. An antioxidant corn peptide fraction inhibited these phenomena in hepatic cells. These results address the impact of ROS-generating pathogens in inducing nuclear TG2-related liver injuries, which provides novel therapeutic targets for preventing and curing alcoholic liver disease.
    Type of Medium: Online Resource
    ISSN: 2045-2322
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2017
    detail.hit.zdb_id: 2615211-3
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  • 10
    In: Journal of Chitwan Medical College, Chitwan Medical College, Vol. 3, No. 4 ( 2014-01-11), p. 48-51
    Abstract: Free health camp is an important means to cater health services to the needy people in an underdeveloped country like Nepal with difficult geographical terrain. The objective of this study was to assess the morbidities of patients attending the free health camp in Sankhejung, Ilam. A total of 399 patients visited the health camp and 35.1% of them were males. It was observed that diseases with musculoskeletal system and gastrointestinal system were reported among 24.3% and 25.1% of the attendees respectively. Based on the findings, it was concluded that the free health camp services was utilized more by the females and more burden of disease was found among musculoskeletal and digestive system. Journal of Chitwan Medical College 2013; 3(4); 48-51 DOI: http://dx.doi.org/10.3126/jcmc.v3i4.9555
    Type of Medium: Online Resource
    ISSN: 2091-2889 , 2091-2412
    Language: Unknown
    Publisher: Chitwan Medical College
    Publication Date: 2014
    detail.hit.zdb_id: 2895123-2
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