The facilitators of and barriers to antimicrobial use and misuse in Lalitpur, Nepal: a qualitative study.

Background: Antimicrobial resistance (AMR) is a pressing global health concern driven by inappropriate antibiotic use, which is in turn influenced by various social, systemic, and individual factors. This study, nested within FIND's AMR Diagnostic Use Accelerator clinical trial in Nepal, aimed to (i) explore the perspectives of patients, caregivers, and healthcare workers (HCWs) on antibiotic prescription adherence and (ii) assess the impact of a training and communication (T&C) intervention on adherence to antibiotic prescriptions.

Methods: Using qualitative, semi-structured interviews, pre-intervention and Day 7 follow-up components, and the Behaviour Change Wheel process, we investigated the facilitators of and barriers to the use and misuse of antibiotic prescriptions.

Prevalence of non-convulsive seizures and electroencephalographic abnormalities in critically ill patients-A retrospective observational study.

Objective: Electroencephalographic (EEG) abnormalities especially non-convulsive status epilepticus (NCSE) have been found to be associated with worse outcomes in critically ill patients. We aimed to assess the prevalence of non-convulsive seizures and electroencephalographic abnormalities in critically ill patients. Furthermore, we aimed to investigate any association between the type of EEG abnormality and outcomes including ICU mortality and successful ICU discharge.

Liver injury in COVID-19: prevalence and its associated factors in Nepal - A retrospective cross-sectional study.

Unlabelled: Liver impairment has been reported as a common clinical manifestation in patients with Severe Acute Respiratory Syndrome Coronavirus 2 infection, with varying degrees of severity ranging from a mild elevation of liver enzymes to acute liver failure. However, the prevalence and clinical significance of liver injury in Coronavirus Disease 2019 (COVID-19) patients, particularly in low- and middle-income countries such as Nepal, remains poorly understood. To investigate the hepatic injury related to this disease and its clinical significance, the authors conducted a retrospective study that included adult patients with COVID-19 infection in security hospitals of Nepal.

Emergency unit assessment of seven tertiary hospitals in Nepal using the WHO tool: a cross-sectional study.

Background: In 2021, the Nepal national emergency care system's assessment (ECSA) identified 39 activities and 11 facility-specific goals to improve care. To support implementation of the ECSA facility-based goals, this pilot study used the World Health Organization's (WHO) Hospital Emergency Unit Assessment Tool (HEAT) to evaluate key functions of emergency care at tertiary hospitals in Kathmandu, Nepal.

Methods: This cross-sectional study used the standardized HEAT assessment tool.

Successful management of delayed presentation of massive paracetamol overdose in a resource-limited setting: A case report from Nepal.

We present a case of self-poisoning with a massive dose of paracetamol by a young Nepalese female patient who presented late to our emergency department. This report highlights the successful management of the patient with the extended use of N-acetylcysteine over 4 days and continuous supportive therapy as required. The case is an example of the management of delayed presentation of a massive paracetamol poisoning in a resource-limited setting, where intensive care units and hemodialysis facilities are not easily available.

The Impact of Basic Police Training and Scale Diet on Body Composition and Aerobic Performance of Nepal Police Officers Trainees.

Introduction: Executing their daily duties, police officers are expected to perform complex, physically demanding activities, often at maximal levels of exertion. Given these criteria, training must be rigorous enough to ensure that when trainees graduate, they are competent in their response to crisis and flexible enough to sustain this for the span of their career. The present study aimed to determine the impact of scale diet and physical training (SDPT) on body composition and aerobic performance among Nepal police officer trainees.

COVID Stress among Nepal Police Officers.

Background: In Nepal, the stress factor is exacerbated by a large number of police officers working away from home with less family contact, a hectic work schedule in a pandemic situation, companions suffering from illness and updates on additional cases with rising mortality rates, and a lack of access to Personal Protection Equipment. The main aim of this study was to identify the prevalence of COVID stress among Nepal police officers working during pandemic.

Methods: We conducted a cross-sectional study among police officers (n=1526) working during pandemic in Province X Nepal.

Suspicious Case of a Body packer "Mule" in a Low Resource Country: A Case Report.

Body packing is the process of smuggling illicit drugs in the form of packages concealed within the gastrointestinal tract via ingestion or inserting into body orifices. These individuals are described as "body packers", "stuffers", "mules" or "swallowers" and resort to carrying drugs like heroin, cocaine and cannabis. They present to the hospital following the development of complications or brought dead due to the rupture of packets or directly from detention for further investigations.

Cypermethrin poisoning manifesting with prolonged bradycardia: A case report.

Pyrethrins and their synthetic derivatives known as pyrethroids are highly effective insecticides used worldwide in the agricultural fields and households. Cypermethrin is a type II pyrethroid which acts primarily by delaying the closure of voltage-sensitive sodium channels at higher concentrations. Its toxicity in humans occur due to accidental or intentional exposure through inhalation, skin contact or via ingestion.

Pretilachlor poisoning: A rare case of a herbicide masquerading as organophosphate toxicity.

Acute oral intoxication of pretilachlor, a chloroacetanilide herbicide, in humans can present with similar clinical manifestations of organophosphate toxicity. Clinicians should be aware of such mimickers for proper management of the patient.

Multiple Organ Dysfunction and Acute Pancreatitis Following Wasp Stings.

Wasp stings are common in our part of the world and may cause complications ranging from mild local reactions to fatal anaphylaxis. Severe cases may present with multisystem involvement causing acute kidney injury, hepatic dysfunction, clotting abnormalities, rhabdomyolysis or even death. However, cases with acute pancreatitis as a complication of wasp sting is not usual and have been very rarely reported.

Variation at HLA-DRB1 is associated with resistance to enteric fever.

Enteric fever affects more than 25 million people annually and results from systemic infection with Salmonella enterica serovar Typhi or Paratyphi pathovars A, B or C(1). We conducted a genome-wide association study of 432 individuals with blood culture-confirmed enteric fever and 2,011 controls from Vietnam. We observed strong association at rs7765379 (odds ratio (OR) for the minor allele = 0.

Gatifloxacin versus ofloxacin for the treatment of uncomplicated enteric fever in Nepal: an open-label, randomized, controlled trial.

Background: Fluoroquinolones are the most commonly used group of antimicrobials for the treatment of enteric fever, but no direct comparison between two fluoroquinolones has been performed in a large randomised trial. An open-label randomized trial was conducted to investigate whether gatifloxacin is more effective than ofloxacin in the treatment of uncomplicated enteric fever caused by nalidixic acid-resistant Salmonella enterica serovars Typhi and Paratyphi A.

Methodology And Principal Findings: Adults and children clinically diagnosed with uncomplicated enteric fever were enrolled in the study to receive gatifloxacin (10 mg/kg/day) in a single dose or ofloxacin (20 mg/kg/day) in two divided doses for 7 days.

Aetiologies of central nervous system infections in adults in Kathmandu, Nepal: a prospective hospital-based study.

We conducted a prospective hospital based study from February 2009-April 2011 to identify the possible pathogens of central nervous system (CNS) infections in adults admitted to a tertiary referral hospital (Patan Hospital) in Kathmandu, Nepal. The pathogens of CNS infections were confirmed in cerebrospinal fluid (CSF) using molecular diagnostics, culture (bacteria) and serology. 87 patients were recruited for the study and the etiological diagnosis was established in 38% (n = 33).