Understanding Global Health: An Experience from International Professional Exchange Program.

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Favipiravir versus other antiviral or standard of care for COVID-19 treatment: a rapid systematic review and meta-analysis.

Background: The COVID-19 causing coronavirus is an enveloped RNA virus that utilizes an enzyme RNA dependent RNA polymerase for its replication. Favipiravir (FVP) triphosphate, a purine nucleoside analog, inhibits that enzyme. We have conducted this systematic review and meta-analysis on efficacy and safety of the drug FVP as a treatment for COVID-19.

Anterior Tooth Width Measurements among Patients in a Tertiary Hospital of Nepal: A Descriptive Cross-sectional Study.

Introduction: The knowledge of anterior tooth width and their relationships with each other is essential for any esthetic and prosthodontic rehabilitation. The objective of this study is to measure the width of the anterior teeth of patients coming to a teritary hospital of Nepal.

Methods: This descriptive cross-sectional study was conducted at a tertiary care hospital from 30th September 2019 to 30th October 2019 after receiving ethical clearance from the institutional review committee (reference number: 2076/77/20).

Prevalence of Perforated Graft in Underlay and Pop-in Technique Myringoplasty.

Introduction: The radial artery is commonly originated from the brachial artery in the cubital fossa at the level of the neck of the radius. It is the artery of choice for coronary artery angiography, percutaneous coronary artery intervention, cannulation, and others. Radial artery anomalies like high origin, tortuosity, and accessory branches are associated with the failure of such procedures.

Prevalence of Osteoporosis among Adults in a Tertiary Care Hospital: A Descriptive Cross-sectional Study.

Introduction: Osteoporosis is a common metabolic bone disease characterized by increased bone fragility, yet underdiagnosed and undertreated. With the increase in longevity of the populace, it is becoming an urgent and serious global epidemic. This being a preventable disease, has no clinical manifestations until there is a fracture.

Bacteriology of Sputum Samples: A Descriptive Cross-sectional Study in a Tertiary Care Hospital.

Introduction: Lower respiratory tract infection is a common infection and accounts for a greater burden of disease worldwide. It is a great challenge to the clinician and still more, with increasing antimicrobial resistance. Its empirical treatment may vary according to the type of causative organisms.

The Coronavirus Pandemic: What Does the Evidence Show?

Coronavirus disease 2019 (COVID-19) is a newly emerged disease that has become a global public health concern as it rapidly spread around the world. The etiologic agent responsible for this disease has been named as severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) by the International Committee on Taxonomy of Viruses as it shows similar genomic features to that of SARS-CoV which caused a pandemic in 2002. This disease first appeared in Hubei province of China and it follows human-to-human transmission but the path this virus took to set up human infection remains a mystery.

Prevalence of Cesarean Section and Its Indications in A Tertiary Care Hospital.

Introduction: Cesarean section is a surgical procedure performed to deliver fetus through abdominal route. Increasing rate of cesarean section worldwide is an alarming concern for public health and obstetricians due to increase in financial burden and risk to health of the mother in comparison to vaginal delivery. The aim of the study was to find the prevalence of cesarean section and its most common indication in a tertiary care hospital.

Vancomycin-Induced Leukocytoclastic Vasculitis: A Rare Case Report.

Vancomycin causes different types of hypersensitivity reactions, ranging from localized skin reactions to generalized cardiovascular collapse. However, cases of vancomycin-induced leukocytoclastic vasculitis are rare. In this article, we present a case where the patient developed palpable purpura on his bilateral lower limbs following treatment with vancomycin.

Good Quality Research in Sepsis: A Need of Low and Middle-income Countries.

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An Experience of Video Based Training on Basic Life Support.

Introduction: Basic life support is foundation to save lives. In contrast to the developed countries, there is still no national standard BLS training module in Nepal. Basic life support training is being provided by various institutions but lack in consistency and coordination.

Predisposing Factors and Outcome of Malpresentations in an Institute.

Introduction: This study was done to find out the incidence of malpresentation among all deliveries with various types of Malpresentations, its mode of delivery , maternal and fetal predisposing factors with outcome.

Methods: This was a cross sectional descriptive study done at KIST Medical College and Teaching Hospital. Review cases of women admitted in labor after 22 weeks with malpresentation was done.

A Case of Pseudoinfarction Pattern in Diabetic Ketoacidosis: A Diagnostic and Therapeutic Dilemma.

Diabetic ketoacidosis (DKA) is regularly associated with hyperkalemia that results in well-described changes on the electrocardiogram (EKG). However, ST-segment elevations on EKG mimicking acute myocardial infarction have rarely been described in the setting of DKA. Here we present a case of a 43-year-old male with DKA who had pseudoinfarction pattern of ST-segment elevation on EKG that resolved with treatment of DKA and discuss the diagnostic and therapeutic dilemma around the condition.

Intramuscular Epinephrine-Induced Transient ST-Elevation Myocardial Infarction.

Myocardial infarction in the setting of anaphylaxis may result from the anaphylaxis itself or from the epinephrine used to treat the anaphylaxis. While cases of myocardial infarction due to large doses of intravenous epinephrine have previously been reported, myocardial infarction after therapeutic doses of intramuscular epinephrine is rarely reported. A 23-year-old male presented with sudden onset of difficulty in swallowing and speech after eating takeout food.

Fibrodysplasia Ossificans Progressiva: A Case Report.

Fibrodysplasia ossificans progressiva is a genetic disorder of the connective tissue differentiation characterized by congenital malformation of the big toes and progressive heterotopic ossification in the extra skeletal tissues like tendons, ligaments, fascia and skeletal muscles leading to permanent disability. The prevalence is one in two million people. During childhood, it may be asymptomatic but in later life, progressive stiffness of major joints renders movement of the individual impossible.

The Characteristics and Trends in Adrenocortical Carcinoma: A United States Population Based Study.

Background: Adrenocortical carcinoma (ACC) is a rare malignancy with poor prognosis. Data on the incidence of ACC, however, are scarce and not recent. The purpose of this study was to characterize the tumor and the patients developing ACC over the last four decades using a large population based database.

Secondary Salivary Gland Malignancy in Thyroid Cancer: A United States Population Based Study.

Background: There is an increased risk of second primary malignancies with thyroid cancer. However, the risk and characters of secondary salivary gland malignancy (sSGM) in patients with thyroid cancer have not been evaluated before.

Methods: We used the Surveillance Epidemiology and End Results (SEER) 18 registry to identify thyroid cancer patients from 1973 to 2014.

Myocardial Infarction as an Early Presentation in Thrombotic Thrombocytopenic Purpura: A Rare Case Series.

Renal and neurological involvements are frequently seen in thrombotic thrombocytopenic purpura (TTP). Cardiac involvement, however, has been rarely reported. In this article, we present 2 cases of myocardial infarction in patients with TTP.

Acquired Amegakaryocytic Thrombocytopenia and Pure Red Cell Aplasia in Thymoma.

Association of thymoma with myasthenia gravis, pure red cell aplasia, and aplastic anemia is well documented. However, thymoma complicated by acquired amegakaryocytic thrombocytopenia (AAMT) is rarely reported. Here, we present a case of a 60-year-old male with past medical history of recurrent invasive thymoma who presented with cough and blood in sputum.

Sickle Cell Beta-Plus Thalassemia with Subcapsular Hematoma of the Spleen.

While splenic complications like hypersplenism, sequestration crisis, and infarction are commonly reported in sickle cell variants like sickle cell beta-plus thalassemia, splenic rupture with hematoma is rare. We present a case of a 32-year-old young male who presented with dull left upper quadrant pain who was found to have multiple subcapsular splenic lacerations and hematoma on abdominal imaging. Hemoglobin electrophoresis confirmed sickle cell beta-plus thalassemia in the patient.

Prevalence of poor mental health among medical students in Nepal: a cross-sectional study.

Background: Poor mental health among medical students is widely acknowledged. Studies on mental health among medical students of Nepal are lacking. Therefore, we conducted a study to determine the prevalence of mental disorders.

Use of 90% ethanol to decontaminate stethoscopes in resource limited settings.

Background: In developing countries like Nepal, 90% ethanol is cheap and is available in most hospitals. The unavailability of isopropyl alcohol (IPA) in these settings led us to compare the efficacy between 90% ethanol and isopropyl alcohol pads in reducing the bacterial contamination of diaphragm of stethoscope.

Methods: A randomized blinded experimental study was carried out to determine the difference between cleaning stethoscopes with 90% ethanol and IPA.

Recent developments in the detection and management of acute kidney injury.

Acute kidney injury (AKI) is a common condition in children admitted to hospital and existing serum and urine biomarkers are insensitive. There have been significant developments in stratifying the risk of AKI in children and also in the identification of new AKI biomarkers. Risk stratification coupled with a panel of AKI biomarkers will improve future detection of AKI, however, paediatric validation studies in mixed patient cohorts are required.

Minimum inhibitory concentration of vancomycin to methicillin resistant Staphylococcus aureus isolated from different clinical samples at a tertiary care hospital in Nepal.

Background: Methicillin resistant Staphylococcus aureus (MRSA) has evolved as a serious threat to public health. It has capability to cause infections not only in health care settings but also in community. Due to the multidrug resistance shown by MRSA, there are limited treatment options for the infections caused by this superbug.

Iodized Salt Use and Salt Iodine Content among Household Salts from Six Districts of Eastern Nepal.

Background: Universal salt iodization is considered the best strategy for controlling iodine deficiency disorders in Nepal. This study was done to find iodized salt use among Nepalese population and the iodine content of household salts.

Methods: Six districts (Siraha, Saptari, Jhapa, Udayapur, Ilam and Panchthar) were chosen randomly from 16 districts of eastern Nepal for the study.