Effectiveness of a group-based Diabetes Prevention Education Program (DiPEP) in a population with pre-diabetes: a cluster randomised controlled trial in Nepal.

Background: Although several lifestyle intervention studies have been conducted in low/middle-income countries, there were no such studies in Nepal. Therefore, a group-based culturally tailored Diabetes Prevention Education Program (DiPEP) was conducted recently. The study aimed to evaluate the effect of DiPEP in glycated haemoglobin (HbA1c), weight, waist circumference, physical activity and diet among population with pre-diabetes.

Neostigmine and atropine as a treatment for postdural puncture headache after spinal anesthesia in cesarean section: A case report.

Key Clinical Message: Neostigmine and atropine offer a promising treatment option for postdural puncture headache (PDPH) following spinal anesthesia in cesarean section, providing effective relief with a favorable risk-benefit profile.

Abstract: Postdural puncture headache (PDPH) is a common consequence of cesarean section surgeries after spinal anesthesia. This case study describes the successful treatment of PDPH with intravenous neostigmine and atropine.

Awareness of Cervical Cancer, Risk Perception, and Practice of Pap Smear Test among Young Adult Women of Dhulikhel Municipality, Nepal.

Background: Despite being one of the most preventable forms of cancer, cervical cancer remains an important public health problem, especially in developing countries. However, there is limited evidence regarding awareness and practice of screening for cervical cancer among women in resource-poor settings like Nepal. This study is aimed at assessing the awareness of cervical cancer, risk perception, and practice of Pap smear tests among adult women of Dhulikhel municipality of Kavreplanchowk district in Nepal.

Surgical Antibiotic Prophylaxis Administration Improved after introducing Dedicated Guidelines: A Before-and-After Study from Dhulikhel Hospital in Nepal (2019-2023).

(1) : Surgical antibiotic prophylaxis (SAP) is important for reducing surgical site infections. The development of a dedicated hospital SAP guideline in the Dhulikhel Hospital was a recommendation from a baseline study on SAP compliance. Compliance with this new guideline was enhanced through the establishment of a hospital committee, the establishment of an antibiotic stewardship program and the funding and training of healthcare professionals.

Improved health-related quality of life with semaglutide in people with non-alcoholic steatohepatitis: A randomised trial.

Background: Non-alcoholic steatohepatitis (NASH) can adversely affect health-related quality of life (HRQoL).

Aims: This double-blind, placebo-controlled, phase 2 trial aimed to report the effects of the glucagon-like peptide-1 receptor agonist, semaglutide, on HRQoL in patients with NASH as a secondary endpoint.

Methods: Adults with biopsy-proven NASH and stage 1-3 fibrosis were randomised (3:3:3:1:1:1) to once-daily subcutaneous semaglutide 0.

Cyanidiales-Based Bioremediation of Heavy Metals.

With growing urbanization and ongoing development activities, the consumption of heavy metals has been increasing globally. Although heavy metals are vital for the survival of living beings, they can become hazardous when they surpass the permissible limit. The effect of heavy metals varies from normal to acute depending on the individual, so it is necessary to treat the heavy metals before releasing them into the environment.

The Cut-off Value of Great Saphenous Vein Diameter at the Level of Femoral Condyle to Predict the Sapheno-Femoral Junction Incompetence.

Background Varicose vein is one of the commonest problems that patients visit to a vascular out patient services (OPD). It causes a great deal of morbidity in today's population. Objective To see the correlation between the size of great saphenous and Saphenofemoral junction incompetence.

Pain Management Competency and its Associated Factors among Nurses.

Background: Nurses play a vital role to handle the situation in the care of the patients especially for prioritizing and managing care of pain. Nursing competency attributes personal characteristics, professional attitude, values, knowledge and skills to demonstrate professional responsibility through practices. Nursing competency helps to provide high quality essential care to the patients at a right time.

Morphological variations in Placentas among Deliveries in the Department of Obstetrics and Gynaecology in a Tertiary Care Centre: A Descriptive Cross-sectional Study.

Introduction: The full term human placenta is a flattened discoidal mass with an approximately circular or oval outline. However, variations can be present in the morphology in the form of bidiscoidal shape, lobed, diffused, fenestrated or circumvallate. The objective of the study was to find out the prevalence of morphological variations in placentas among deliveries in the Department of Obstetrics and Gynaecology in a tertiary care centre.

Performance and Cost-effectiveness of Pooling COVID-19 Samples Using Real time Polymerase Chain Reaction Test.

Background: Rapid detection of Severe Acute Respiratory Syndrome Corona Virus 2 (SARS-CoV-2) by real-time polymerase chain reaction (RT-PCR) is the most reliable method used worldwide. Although the incidence of the disease has increased globally, the limited availability of PCR kits has become the major bottleneck for the diagnosis of COVID positive patients.

Methods: Random samples were pooled for two months in group of two-five and tested for SARS-CoV-2.

The burden of non-alcoholic steatohepatitis: A systematic review of health-related quality of life and patient-reported outcomes.

Background & Aims: Non-alcoholic steatohepatitis (NASH) is associated with increased mortality and a high clinical burden. NASH adversely impacts patients' health-related quality of life (HRQoL), but published data on the humanistic burden of disease are limited. This review aimed to summarise and critically evaluate studies reporting HRQoL or patient-reported outcomes (PROs) in populations with NASH and identify key gaps for further research.

Dominance of Carrying Angle in Right-hand among Dental Students of a Teaching Hospital: A Descriptive Cross-sectional Study.

Introduction: Carrying angle is an acute angle formed between extended arm and forearm when palm is directed forward. This angle is formed due to the angulation of the articulating surfaces of the humerus with the forearm. The angle is greater in dominant hand than in non-dominant hand in both males and females.

Negative Pleural Fluid Cultures among Patients with Pleural Effusion in a Tertiary Care Hospital: A Descriptive Cross-sectional Study.

Introduction: A systematic approach to analysis of the fluid in conjunction with the clinical presentation allows clinicians to diagnose the cause of an effusion, narrow the differential diagnoses, and design a management plan. However, the number of cases where pleural fluid examination gives no proper diagnosis is depressingly high. This study aims to find out the prevalence of negative pleural fluid cultures among patients with pleural effusion in a tertiary care hospital.

Mean Canal-body Ratio among Specimens of Dried Lumbar Vertebrae in the Department of Anatomy of a Medical College: A Descriptive Cross-sectional Study.

Introduction: Lumbar spinal canal stenosis is assumed to be one of the chief causative factors for low back pain. The measurement of lumbar canal and body dimensions has thus become an important tool for the diagnosis and treatment of spinal stenosis. This study aims to find out the mean canal-body ratio among specimens of dried lumbar vertebrae in a medical college.

Lessons Learned from an HIV Pre-Exposure Prophylaxis Coordination Program in San Francisco Primary Care Clinics.

HIV pre-exposure prophylaxis (PrEP) has shown high efficacy and effectiveness for HIV prevention; however, many individuals with PrEP indications are not receiving PrEP. PrEP Coordinators work closely with patients and health care providers to increase PrEP access, and they provide unique insights into the inner workings of PrEP care and service delivery. In this study, we discuss key challenges and recommendations for improved PrEP service delivery (including training PrEP Coordinators to manage PrEP panels, making PrEP a part of routine care and optimizing electronic health records, designating a PrEP "champion" who can strengthen communication and leadership, using a proactive approach to increase PrEP retention, and training providers and PrEP Coordinators to meet youth-specific needs) from our discussions with the PrEP Coordinators who led PrEP panel management in San Francisco Department of Public Health primary care clinics.

Comparing Deep Learning and Conventional Machine Learning Models for Predicting Mental Illness from History of Present Illness Notations.

Mental illness, a serious problem across the globe, requires multi-pronged solutions including effective computational models to predict illness. Mental illness diagnosis is complicated by the pronounced sharing of symptoms and mutual pre-dispositions. Set in this context we offer a systematic comparison of seven deep learning and two conventional machine learning models for predicting mental illness from the history of present illness free-text descriptions in patient records.

Hoarseness of Voice following Left Supraclavicular Brachial Plexus Block: A Case Report.

Supraclavicular brachial plexus block is extensively used for primary regional anaesthesia as well as postoperative analgesia for the surgical procedures of the upper limb. The evidence for the use of ultrasound in supraclavicular brachial plexus is growing day by day as it has the advantage of allowing real time visualisation of the plexus, pleura and vessels along with the needle and local anaesthetics spread. Despite this, complications can even arise with ultrasound guided supraclavicular brachial plexus block.

Understanding the Situation and Effectiveness of Adolescent Focused Tobacco Control Policies in Nepal : A Qualitative Study.

Background: Tobacco use is a major risk factor for non-communicable disease that contributes two third of deaths in Nepal. Tobacco related premature deaths are estimated to rise every year if effective interventions are not implemented. In Nepal majority of smokers start using tobacco in their adolescence.

Laparoscopic Management of Dermoid Cyst of Ovary is a Safe Procedure.

Background: Dermoid cyst, a common benign neoplasm of ovary in women, needs treatment because of the risk of torsion, rupture, and malignant change. Laparoscopic surgery nowadays is the preferred treatment modality, but the only issue is its safety in case of rupture and spillage of its contents with the risk of chemical peritonitis and malignant dissemination. Aim of the study was to find out the safety of laparoscopic surgery for dermoid cyst of ovary.

Feasibility and Acceptability of Home-Collected Samples for Human Immunodeficiency Virus Preexposure Prophylaxis and Severe Acute Respiratory Syndrome Coronavirus 2 Laboratory Tests in San Francisco Primary Care Clinics.

Background: Due to the difficulty of conducting laboratory testing during the pandemic shelter-in-place orders, the objective of this study was to examine the feasibility and acceptability of conducting home-collected samples for preexposure prophylaxis (PrEP) and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) laboratory tests.

Methods: We conducted a pilot study among patients on PrEP in San Francisco primary care clinics. Individuals on PrEP provided home-collected laboratory samples using dried blood spot for fourth-generation human immunodeficiency virus antigen/antibody test, serum creatinine, syphilis antibody, and hepatitis C antibody, as needed; 3-site (oropharyngeal, rectal, and urine) swabbing for sexually transmitted infections; and nasopharyngeal swabbing for SARS-CoV-2 polymerase chain reaction.

Prevalence of Loss of Smell and/or Taste and other Otorhinolaryngology Symptoms in COVID-19 Patients.

Background Loss of smell and/or taste have been described in COVID-19 patients. Studies have not been conducted to evaluate the loss of smell and/or taste in the context of Nepal. Objective To investigate the prevalence of Ear, Nose and Throat related symptoms and assess smell and taste disorders in laboratory-confirmed SARS-CoV-2 patients.

Recurrent Pneumothorax in an Adult Male With Bilateral COVID-19 Pneumonia.

Pneumothorax is defined as the condition in which air is collected between the visceral and parietal pleura. Pneumothorax as a complication of coronavirus disease 2019 (COVID-19) infection has been reported in relatively few cases and recurrent pneumothorax is even rarer. We present a case of a 50-year-old critically ill patient who required mechanical ventilation for 55 days and developed recurrent bilateral pneumothorax.