Effectiveness of a Neurocritical Care Course with Problem-Based Learning and Discussion Format in Asia.

Numerous barriers hinder the effective delivery of neurologic care as well as the education of health care professionals in the low-income and middle-income countries (LMICs). This study assessed the knowledge of the participants after Comprehensive Neurocritical Care Course (CN3C) in the LMICs. Data from 177 participants were collected and analyzed.

Impact of Country Income Level on Outcomes in Patients with Acute Brain Injury Requiring Invasive Mechanical Ventilation: A Secondary Analysis of the ENIO Study.

Background: Invasive mechanical ventilation can present complex challenges for patients with acute brain injury (ABI) in middle-income countries (MICs). We characterized the impact of country income level on weaning strategies and outcomes in patients with ABI.

Methods: A secondary analysis was performed on a registry of critically ill patients with ABI admitted to 73 intensive care units (ICUs) in 18 countries from 2018 to 2020.

Evaluation of the Effects of a Combination of Vitamin C, Thiamine and Hydrocortisone vs Hydrocortisone Alone on ICU Outcome in Patients with Septic Shock: A Randomized Controlled Trial.

Aims And Background: Glucocorticoids, vitamin C and thiamine have important biological effects in patients with sepsis and septic shock. Multiple studies have demonstrated the beneficial role of a combination therapy of vitamin C, hydrocortisone and thiamine in patients with sepsis and septic shock in terms of mortality reduction, and increase in the number of days free of ventilators and vasopressors.

Materials And Methods: Patients who had septic shock were assessed for eligibility after intensive care unit (ICU) admission.

Assessing the drivers of sexual behavior among youth and its social determinants in Nepal.

Introduction: Sexual behavior among youth is a public health concern, particularly in contexts where cultural norms, socio-economic factors, and access to comprehensive sexual education play pivotal roles. This paper aims to examine the determinants of sexual behavior among Nepali youths.

Methods: This study analyzed data from 7,122 individuals aged 15-24 years from the Nepal Demographic and Health Survey (NDHS) 2022, focusing on a nationally representative sample.

Management of adult sepsis in resource-limited settings: global expert consensus statements using a Delphi method.

Purpose: To generate consensus and provide expert clinical practice statements for the management of adult sepsis in resource-limited settings.

Methods: An international multidisciplinary Steering Committee with expertise in sepsis management and including a Delphi methodologist was convened by the Asia Pacific Sepsis Alliance (APSA). The committee selected an international panel of clinicians and researchers with expertise in sepsis management.

International cross-sectional survey on current and updated definitions of intra-abdominal hypertension and abdominal compartment syndrome.

Background: The Abdominal Compartment Society (WSACS) established consensus definitions and recommendations for the management of intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) in 2006, and they were last updated in 2013. The WSACS conducted an international survey between 2022 and 2023 to seek the agreement of healthcare practitioners (HCPs) worldwide on current and new candidate statements that may be used for future guidelines.

Methods: A self-administered, online cross-sectional survey was conducted under the auspices of the WSACS to assess the level of agreement among HCPs over current and new candidate statements.

Symptomatic vigabatrin-associated MRI toxicity is associated with simultaneous hormonal therapy among patients with infantile spasms.

Vigabatrin-associated brain abnormalities on MRI (VABAM) are observed in approximately 20% of children who receive vigabatrin for treatment of infantile epileptic spasms syndrome. Although usually reversible and asymptomatic, VABAM is occasionally symptomatic. Whereas asymptomatic VABAM appears to be dose-dependent, symptomatic VABAM is possibly associated with co-administration of vigabatrin and hormonal therapy (i.

A case of postpartum dermatomyositis with onset at three months: expanding the clinical spectrum.

Introduction And Importance: Dermatomyositis (DM) is an autoimmune disorder affecting all age groups, with a higher prevalence in women. Diagnosis typically occurs around age 40. Manifestation can be acute or chronic.

Prediction of the outcome of intracerebral hemorrhage by blood neutrophil to lymphocyte ratio: a prospective observational study.

Introduction: Intracerebral haemorrhage (ICH) is defined as bleeding within the brain parenchyma. Neutrophil lymphocyte ratio (NLR) is a dynamic parameter that can be affected by an underlying condition like microangiopathy (e.g.

Intimate partner violence in Nepal: Analysis of Nepal Demographic and Health Survey 2022.

Introduction: Intimate partner violence (IPV) is a major public health issue in Nepal. IPV has social and economic impacts on women, family, and the wider society. In this study, we aimed to determine factors associated with IPV among currently partnered women aged 15-49.

A Critical Analysis of Safe Abortion Road Map in Nepal.

Background: Abortion was legalized by the 2002 Muluki Ain to combat the surging rates of maternal mortality and morbidity. By 2021, the Maternal Mortality Rate plummeted to 151 from 539 in 1996. The decline in the abortion-related maternal mortality attributes to the implication of progressive abortion policies that includes expanded safe abortion services introduction of medical abortion, constitutional recognition of abortion, the mandates by Safe Motherhood and Reproductive Health Rights Act, and free-of-cost abortion services in government health facilities.

Perception and Willingness Regarding Organ Transplantation/donation among Medical Students of Maharajgunj Medical Campus: A Cross-sectional Study.

Background: Organ transplant is the procedure of replacing a failing or damaged organ with a functioning one. Positive attitude and awareness about donation are a must for donor organs to be available. This study explored the level of knowledge, perception and willingness regarding organ donation among medical students in Nepal.

Medical Triage: Ethical Implications and Management Strategies.

Natural or man-made medical disasters have repeatedly affected human communities. The impact on health care resources may vary depending on the magnitude of each crisis, catastrophe or pandemic, and the resources available. Medical triage protocols serve as invaluable tools to address clinical needs, particularly when resources, including supplies, equipment, and personnel, are limited.

Centering Communities in Global Health: Using Human-Centered Design to Facilitate Collaboration and Intervention Development.

Background: Utilizing iterative and collaborative tools, Human-centered Design (HCD) facilitates the creation of tailored solutions for multifaceted issues by fostering empathy and a deep understanding of human behaviors. This paper presents insights gleaned from employing HCD tools to center communities in global health intervention development.

Purpose: The study team collaborated with community members in Dailekh, Nepal to co-design interventions to address harms associated with menstrual seclusion, known as .

Modified Graham patch repair for cecal perforation: A case report.

Introduction And Importance: Acute appendicitis is a common cause of acute abdomen worldwide. The complications associated with it can sometimes be unpredictable and pose a dilemma in the management of such complications.

Case Presentation: A case of 18 year female with complaints of right iliac fossa pain and vomiting was diagnosed clinically as acute appendicitis and underwent emergency open appendectomy where a cecal perforation was encountered intra-operatively for which a Modified Graham's Patch Repair was done.

A Case Report on Unilateral Non-axial Proptosis of a Young Female: Lacrimal Gland Tumour.

Background: Lacrimal gland adenoma is a benign tumour of the lacrimal gland mostly involving the orbital part of the gland and composed of epithelial and myoepithelial components. It involves the third and fourth decade of life as a gradual painless enlargement of the lacrimal gland.

Case: This is a case report of a 30-year-old female presenting with the forward bulging of the right eye causing the eye to be displaced medio-inferiorly over the course of one year.

From stigma to solutions: harnessing local wisdom to tackle harms associated with menstrual seclusion () in Nepal.

In Nepal, menstrual practices, and particularly , impose restrictive norms affecting women's daily lives. Chhaupadi is a tradition that involves isolating women and girls during menstruation and after childbirth, along with following other restrictions, which have physical and mental health implications. To date, interventions have yet to fully and sustainably address harms associated with chhaupadi across the country.

Use of ketamine in Super Refractory Status Epilepticus: a systematic review.

Objective: This review specifically investigates ketamine's role in SRSE management.

Methods: PubMed, EMBASE, and Google Scholar databases were searched from inception to May 1st, 2023, for English-language literature. Inclusion criteria encompassed studies on SRSE in humans of all ages and genders treated with ketamine.

Equity in Clinical Care and Research Involving Persons with Disorders of Consciousness.

People with disorders of consciousness (DoC) are characteristically unable to synchronously participate in decision-making about clinical care or research. The inability to self-advocate exacerbates preexisting socioeconomic and geographic disparities, which include the wide variability observed across individuals, hospitals, and countries in access to acute care, expertise, and sophisticated diagnostic, prognostic, and therapeutic interventions. Concerns about equity for people with DoC are particularly notable when they lack a surrogate decision-maker (legally referred to as "unrepresented" or "unbefriended").

SFox imidates as versatile glycosyl donors for chemical glycosylation.

Described herein is a continuation of our studies dedicated to the development of novel classes of leaving groups based on - and -imidates. The main focus of the study presented herein is the synthesis of novel 3,3-difluoro-3-indol-2-ylthio (SFox) imidates and their application as glycosyl donors in chemical glycosylation. Being thioimidates, these compounds are more stable than -imidates albeit much more reactive than conventional alkyl/arylthio glycosides.

BCLA CLEAR Presbyopia: Epidemiology and impact.

The global all-ages prevalence of epidemiologically-measured 'functional' presbyopia was estimated at 24.9% in 2015, affecting 1.8 billion people.

A Case of Cotyledonoid Dissecting Leiomyoma With Associated Disseminated Peritoneal Leiomyomatosis: The Significance of Frozen Section in Identification of This Unusual Entity.

Cotyledonoid dissecting leiomyoma (CDL) is a rare variant of uterine leiomyoma. The tumor is benign, but the appearance and growth pattern are unusual and alarming. Disseminated peritoneal leiomyomatosis (DPL) is another rare tumor that can mimic malignancy.