Potentially Inappropriate Medications and Drug-Drug Interactions in Geriatrics Cardiac Patients Visiting to Tertiary Care Central Hospital of Nepal.

Objective: Potentially Inappropriate Medications (PIMs) and Drug-Drug Interactions (DDIs) among geriatrics are a prominent issue and place a considerable burden on the quality health outcome. This study aimed to assess PIMs and DDIs particularly among geriatric cardiac elderly patients attending the outpatient department of a tertiary care hospital of Nepal.

Methodology: A prospective cross-sectional study was conducted on geriatrics patients (≥ 65 years) attending the cardiology out-patient department of Bharatpur Central Hospital, Nepal.

Rapid, low-cost colorimetric detection of Typhi bacteriophages for environmental surveillance.

Unlabelled: Typhoid fever remains a global public health challenge, especially in low- and middle-income countries where poor sanitation and limited access to clean water facilitate transmission. The lack of data on disease burden poses a significant barrier to adopting effective interventions such as vaccination programs. We developed a novel colorimetric assay for the detection of .

Exploring Potentially Inappropriate Medication Use on Elderly Patients in a General Medicine Ward Using 2023 AGS Beers Criteria.

Objectives: Potentially inappropriate medication (PIM) use is a significant concern among the elderly, a vulnerable population, due to physiological changes, and the risk of multiple comorbidities and polypharmacy. This study aimed to assess the use of PIM among elderly inpatients in tertiary care hospital in eastern Nepal.

Methods: A three-month prospective observational study was conducted, involving 200 eligible elderly patients admitted to general medicine ward.

Evaluating the accuracy of Typhi Hemolysin E and lipopolysaccharide IgA to discriminate enteric fever from other febrile illnesses in South Asia.

Existing methods to identify patients infected with Salmonella enterica Typhi (S. Typhi) or Paratyphi are inadequately accurate, affordable, and efficient. We evaluated the discriminatory power of antibodies to S.

A Systematic Review on Evaluation of WHO Core Prescribing Indicators Across Healthcare Facilities in Low Resource Asian Setting: A Case of Nepal.

Inappropriate drug use is a significant global health issue, particularly in low-resource settings. This systematic review evaluates drug utilization across healthcare facilities in Nepal, a low-resource setting, using WHO core prescribing indicators to identify areas for improvement. A systematic review was conducted by searching literature in PubMed, Embase, CINAHL, INRUD bibliography, NepJOL, NepMed, and Google Scholar.

Antibiotic resistance patterns in uropathogens: insights from a Nepalese tertiary care setting.

Background: Antimicrobial resistance in uropathogens is increasing globally, particularly in resource-limited settings such as Nepal, limiting treatment options.

Objectives: This study aimed to evaluate the antimicrobial resistance patterns of uropathogens isolated from patients with urinary tract infections (UTIs) in a tertiary care hospital in central Nepal.

Design: This study utilized a retrospective study design.

Changes in enteric fever trends during the COVID-19 pandemic from the Surveillance for Enteric Fever in Asia Project: a cross-sectional study.

Background: The Surveillance for Enteric Fever in Asia Project (SEAP) conducted blood culture surveillance for serotype Typhi (. Typhi) and Paratyphi (. Paratyphi) to provide an evidence base for prevention and control measures in Bangladesh, Nepal, and Pakistan.

Prevalence of MTHFR C677T polymorphism and its association with serum homocysteine and blood pressure among different ethnic groups: insights from a cohort study of Nepal.

Background: The risk of hypertension varies based on ethnicity, environmental factors, and genetic predispositions. Studies have reported a higher risk of cardiovascular diseases (CVD) and hypertension among the Newar ethnic groups in Nepal. However, the genetic analysis for Methylenetetrahydrofolate reductase (MTHFR C677T) gene mutations, serum homocysteine, and high-sensitivity C-reactive protein (hs-CRP) levels across different ethnicities remains unexplored.

Pharmacist interventions in optimising opioid medication therapy in pain management for palliative care patients: A systematic review.

BackgroundOpioid therapy is a critical component in managing pain in palliative care, where pharmacists' specialised expertise is crucial in ensuring quality care for patients. This systematic review aims to document available evidence on pharmacist interventions and their impact on optimising opioid therapy for pain management in palliative care patients.MethodsWe searched Medline (OVID), Embase (OVID), APA PsycINFO and Cochrane Central Register of Controlled Trials (CENTRAL) for relevant articles published from the beginning to 31 December, 2022.

Whole genome sequencing and phylogenetic analysis of dengue virus in Central Nepal from 2022 to 2023.

Background: In Nepal, dengue is an emerging disease of growing concern as outbreaks are increasing in both size and geographic reach and beginning to affect areas previously thought dengue-free. Dengue genomic surveillance has previously been limited within Nepal; however, with the increase in accessibility to sequencing technologies since the COVID-19 pandemic, it has recently become more feasible.

Methods: This hospital-based retrospective study utilized banked samples from the 2022 and 2023 dengue seasons from Dhulikhel Hospital/Kathmandu University Hospital in Central Nepal.

Opioid Accessibility for Palliative Care in Nepal: A Review of Achievement and Remaining Challenges.

This study aimed to explore current opioid availability and accessibility for palliative care (PC) practice in Nepal. A narrative review was conducted by performing literature searches in electronic databases, grey literature, policy documents, and pharmaceutical websites. This was supplemented by utilising the authors' expertise and experience in this field.

Awareness of Financial Conflicts of Interest in Selecting Clinical Practice Guidelines Among Nepalese Oncologists: A Cross-Sectional Study.

Background: Financial conflicts of interest (FCOIs) between pharmaceutical companies and clinical practice guideline (CPG) authors can influence guideline recommendations, posing challenges to patient care. Despite global concerns, limited research exists on FCOI awareness among healthcare professionals in lower-middle-income countries like Nepal.

Methods: This cross-sectional study, conducted between June 2020 and January 2021, aimed to assess FCOI awareness among Nepalese oncologists and identify associated factors.

Diagnostic Accuracy of Artificial Intelligence-Based Chest X-Ray reading for screening of Tuberculosis.

Background: Tuberculosis remains a public health challenge in Nepal and ranks as the seventh leading cause of death in the country. The END Tuberculosis strategy stresses - the screening for symptoms alone may not suffice; additional screening tools such as a chest radiograph may facilitate referral for diagnosis of tuberculosis. The study aims to evaluate the diagnostic accuracy of artificial intelligence (AI) based Chest X-ray and compare it with the human reading (radiologist), using GeneXpert-MTB RIF Assay for tuberculosis case detection.

The long-term impact of vaccine clinical research on national stakeholders involved: Experience from a low-income Country.

Clinical trials are the most rigorous scientific and regulated method to investigate the safety and efficacy of vaccines or drugs in pre-licensure stage. Clinical trial design and implementation are complex, time-consuming and involves close engagement with country's regulatory authority, clinical trial sites, investigators, and the healthcare system. Over the past few decades, a significant number of clinical trials have been conducted in low- and middle-income countries (LMICs), particularly in resource-limited settings.

Geospatial distribution of Hepatitis E seroprevalence in Nepal, 2021.

Background: Hepatitis E virus (HEV) causes acute jaundice and poses an important public health problem in low- and middle-income countries. Limited surveillance capacity and suboptimal access to diagnostics leads to under-reporting of HEV infections in affected countries, including Nepal. Serum antibodies against HEV are indicative of past infection.

Hepatitis E virus in the Kathmandu Valley: Insights from a representative longitudinal serosurvey.

Background: Hepatitis-E virus (HEV), an etiologic agent of acute inflammatory liver disease, is a significant cause of morbidity and mortality in South Asia. HEV is considered endemic in Nepal; but data on population-level infection transmission is sparse.

Methods: We conducted a longitudinal serosurvey in central Nepal to assess HEV exposure.

Isolation, Identification, and Biological Activities of a New Chlorin e6 Derivative.

Chlorin e6 is a well-known photosensitizer used in photodynamic diagnosis and therapy. A method for identifying and purifying a novel process-related impurity during the synthesis of chlorin e6 has been developed. Its structure was elucidated using NMR and HRMS.

Advancing opioid stewardship in low-middle-income countries: challenges and opportunities.

The increased utilization of opioids in low- and middle-income countries (LMICs) presents a growing threat of opioid-related abuse, misuse and diversion. Pharmacists, as integral members of healthcare teams, are responsible for dispensing and monitoring opioid use and hold a pivotal role in opioid stewardship within LMICs. This commentary describes the potential and multifaceted roles of pharmacists in opioid stewardship in resource-constrained settings and highlights appropriate strategies for promoting responsible opioid utilization.

Leaf Extract Attenuates Effects of Aging on Oxidative Stress, Neuroinflammation, and Cognitive Impairment.

Our study aimed to explore the impact and mechanism of leaf extract on age-dependent oxidative stress, neuroinflammation, and progressive memory impairments in aged mice. Twenty-four-month-old mice received EA-L3 (300 mg/kg/day) or the reference drug, donepezil (DPZ, 5 mg/kg/day), for 6 weeks, and learning and memory functions were detected using the Passive Avoidance Test (PAT). As expected, cognitive function deficits were detected in aged mice compared with young mice, and these deficits were significantly mitigated by dietary treatments with EA-L3.

Effects of a dietary intervention on cardiometabolic risk and food consumption in a workplace.

Background: Worksite-based health programs have shown positive impacts on employee health and have led to significant improvements in cardiovascular risk factor profiles. We aimed to determine the effect of cafeteria intervention on cardio-metabolic risk factors diet in a worksite setting (Dhulikhel Hospital) in Nepal.

Methods: In this one-arm pre-post intervention study, we recruited 277 non-pregnant hospital employees aged 18-60 with prediabetes or pre-hypertension.

Safety and immunogenicity of the Euvichol-S oral cholera vaccine for prevention of Vibrio cholerae O1 infection in Nepal: an observer-blind, active-controlled, randomised, non-inferiority, phase 3 trial.

Background: In October, 2017, WHO launched a strategy to eliminate cholera by 2030. A primary challenge in meeting this goal is the limited global supply capacity of oral cholera vaccine and the worsening of cholera outbreaks since 2021. To help address the current shortage of oral cholera vaccine, a WHO prequalified oral cholera vaccine, Euvichol-Plus was reformulated by reducing the number of components and inactivation methods.

Availability and Affordability of Essential Palliative Care Medicines in Nepal: A Cross-Sectional Study.

Context: The government of Nepal adopted the 2017 Nepalese National Strategy for Palliative Care (NSPC), which proposed that Essential Palliative Care Medicines (EPCMs) listed by the International Association for Hospice and Palliative Care (IAHPC) should be available at each healthcare institution. In 2017 after the issuing of NSPC, the Lancet Commission developed an EPCM list.

Objectives: To evaluate the inclusion of EPCMs recommended by both IAHPC and Lancet in national medicinal programmes, their availability, and affordability in Nepal.