Publications by authors named "Silwal P"

Introduction: Neuromyelitis optica (NMO) is an idiopathic demyelinating disorder characterized mainly by optic neuritis and myelitis, causing gradual loss of vision and deterioration of neurological function. The underlying pathogenesis mainly involves antibodies against aquaporin 4. The effectiveness of therapeutic plasma exchange (TPE) has been shown by many studies across the globe but are only a few from India.

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There is growing interest in using outcome-based measures in sub-national level health system performance management, particularly in high-income countries. Increasingly, population health indicators used for making international comparisons are being applied at a sub-national level. This study aims to understand whether and under what circumstances population health outcome-based measures can be used for performance measurement and management at the sub-national level health systems.

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Hypertrophy of the ligamentum flavum (HLF) is a common contributor to lumbar spinal stenosis (LSS). Fibrosis is a core pathological factor of HLF resulting in degenerative LSS and associated low back pain. Although progress has been made in HLF research, the specific molecular mechanisms that promote HLF remain to be defined.

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Article Synopsis
  • The Herlyn-Werner-Wunderlich (HWW) syndrome is a rare congenital disorder characterized by a double uterus, obstruction of one side of the vagina, and absence of a kidney, usually affecting the right side, with symptoms often starting at puberty.
  • Common issues experienced by individuals include pelvic pain, heavy menstrual bleeding, and infertility due to complications such as hematocolpos or hematometra, with potential long-term problems like endometriosis and increased risk of miscarriage.
  • Diagnosis typically begins with an ultrasound, but MRI is preferred for confirming the syndrome and identifying associated anomalies; treatment often involves surgically removing the obstructed vaginal septum, as demonstrated in a case study of a 43-year
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Background: An effective airway management education program is a crucial part of the undergraduate medical education curriculum. Theoretical instructions and practical demonstrations are the major modalities of medical education in Nepal. Simulation-based education (SBE) programs have not yet been implemented effectively.

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Objective: To describe antibiotic prescription patterns in the emergency department (ED) of a tertiary healthcare center in Nepal.

Methods: This was a descriptive cross-sectional study of hospital records of patients who visited the ED.

Results: Of the 758 ED patients included in the study, 384 (50.

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Spontaneous and isolated necrosis of the falciform ligament is a rare condition. A 55-year-old lady presented with sudden onset of epigastric pain, fever and vomiting. Laboratory studies revealed less than three-fold increase in serum amylase and lipase levels.

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Background: We aimed to summarise the extent and nature of published research about eye health and eye health services in Pacific Island Countries and Territories since 1980.

Methods: We searched Medline, EMBASE, Global Health and Cochrane Library to identify publications about eye health and eye health services in 22 Pacific Island Countries and Territories from 1 January 1980 to 26 January 2024. Study selection and data extraction were conducted by two reviewers independently.

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Introduction And Importance: Malignancy can lead to colo-enteric fistulas. A malignant fistula between the rectum and the jejunum is a rare occurrence.

Case Presentation: A 60-year-old female suffered from diarrhea, vomiting, and epigastric pain for 4 months.

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  • Vector-borne parasite infections are common in both domestic and wild animals, often asymptomatic but potentially fatal, particularly under stress.
  • This study focused on the detection and characterization of such parasites in rescued greater one-horned rhinoceroses in Chitwan National Park, Nepal, using advanced molecular techniques on blood samples.
  • Results revealed a 75% prevalence of Theileria bicornis, two new haplotypes, and the presence of Wolbachia and filarial nematodes, indicating a need for enhanced parasite surveillance and further research on wildlife diseases in the region.
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Background: Sexually dimorphic spinal motoneurons (MNs) in the dorsomedial nucleus (DMN) and dorsolateral nucleus (DLN) as well as those in the cremaster nucleus are involved in reproductive behaviours, and the cremaster nucleus additionally contributes to testicular thermoregulation. It has been reported that MNs in DMN and DLN are extensively linked by gap junctions forming electrical synapses composed of connexin36 (Cx36) and there is evidence that subpopulation of MNs in the cremaster nucleus are also electrically coupled by these synapses.

Methodology: We used immunofluorescence methods to detect enhanced green fluorescent protein (eGFP) reporter for Cx36 expression in these motor nuclei.

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Objectives: In pursuit of health equity, the World Health Organization has recently called for more extensive monitoring of inequalities in eye health. Population-based eye health surveys can provide this information, but whether underserved groups are considered in the design, implementation, and reporting of surveys is unknown. We conducted a systematic methodological review of surveys published since 2000 to examine how many population-based eye health surveys have considered underserved groups in their design, implementation, or reporting.

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Introduction Within primary health care policy, there is an increasing focus on enhancing involvement with secondary health care, social care services and communities. Yet, translating these expectations into tangible changes frequently encounters significant obstacles. As part of an investigation into the progress made in achieving primary health care reform in Aotearoa New Zealand, realist research was undertaken with those charged with responsibility for national and local policies.

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Background: Colonoscopy is widely used as a tool for diagnosis, screening and treatment of various pathologies in the rectum, colon, and terminal ileum. The aim of this study is to evaluate the demographic, clinical, and histological parameters of the records of patients undergoing colonoscopy at a tertiary care hospital in Nepal.

Materials And Methods: This retrospective cross-sectional study included the hospital records of all patients who underwent colonoscopy from 2015 to 2019 in a tertiary care centre in Nepal.

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Introduction: The global population is ageing, and by 2050, there will be almost 2.1 billion people over the age of 60 years. This ageing population means conditions such as diabetes are on the increase, as well as other conditions associated with ageing (and/or diabetes), including those that cause vision impairment, hearing impairment or foot problems.

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Introduction: Diabetic retinopathy is a leading cause of vision impairment globally. Vision loss from diabetic retinopathy can generally be prevented by early detection and timely treatment. The WHO included a measure of service access for diabetic retinopathy as a core indicator in the Eye Care Indicator Menu launched in 2022: .

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Background: Intervertebral disc degeneration (IDD) is a leading contributor to low back pain (LBP). Autophagy, strongly activated by hypoxia and nutrient starvation, is a vital intracellular quality control process that removes damaged proteins and organelles to recycle them for cellular biosynthesis and energy production. While well-established as a major driver of many age-related diseases, autophagy dysregulation or deficiency has yet been confirmed to cause IDD.

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Background: Low back pain is a global health problem that originated mainly from intervertebral disc degeneration (IDD). Autophagy, negatively regulated by the phosphatidylinositol 3-kinase (PI3K)/Akt/mammalian target of rapamycin (mTOR) signaling pathway, prevents metabolic and degenerative diseases by removing and recycling damaged cellular components. Despite growing evidence that autophagy occurs in the intervertebral disc, the regulation of disc cellular autophagy is still poorly understood.

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Article Synopsis
  • The 'G' antigen, part of the Rh blood group system, was first identified in 1958 by researchers Allen and Tippet.
  • It’s crucial to rule out anti-D antibodies in RhD-negative pregnant women before giving RhIg prophylaxis to avoid hemolytic disease of the fetus and newborn (HDFN).
  • The report highlights the importance of identifying anti-G antibodies and utilizing a multidisciplinary team approach to manage HDFN through methods like intrauterine and exchange transfusions during the perinatal period.
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  • * The study analyzed enrollment data from 2016 to 2023, noting that Māori, young people, and the most deprived groups had lower enrollment rates, while young people's enrollment increased during the pandemic, contrasting with declining rates for Māori and Pacific peoples.
  • * The findings indicate significant disparities in enrollment across different sociodemographic groups, suggesting that changes in enrollment patterns due to the COVID-19 pandemic could adversely impact overall population health.
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Purpose: The study aims to estimate the prevalence of workplace bullying, personal and work-related impacts, reporting practices for bullying, and the reasons for not reporting bullying incidents in the New Zealand pharmacy sector.

Design/methodology/approach: An online survey was conducted among registered pharmacists and pharmacist interns in New Zealand from June to August 2020. The questionnaire comprises both close-ended and semi-structured free-text questions.

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Objective: To assess diabetes eye service use in New Zealand among people aged ≥15 years by estimating service attendance, biennial screening rate, and disparities in the use of screening and treatment services.

Methods: We obtained Ministry of Health data from the National Non-Admitted Patient Collection on diabetes eye service events between 1 July 2006 and 31 December 2019 and sociodemographic and mortality data from the Virtual Diabetes Register and linked these using a unique patient identifier (encrypted National Health Index). We 1) summarized attendance at retinal screening and ophthalmology services, 2) calculated biennial and triennial screening rate, 3) summarized treatment with laser and anti-VEGF and used log-binomial regression to examine associations of all of these with age group, ethnicity, and area-level deprivation.

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Closely associated with aging and age-related disorders, cellular senescence (CS) is the inability of cells to proliferate due to accumulated unrepaired cellular damage and irreversible cell cycle arrest. Senescent cells are characterized by their senescence-associated secretory phenotype that overproduces inflammatory and catabolic factors that hamper normal tissue homeostasis. Chronic accumulation of senescent cells is thought to be associated with intervertebral disc degeneration (IDD) in an aging population.

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