Climate-driven dengue fever outbreaks in Nepal: Trends, challenges, and strategies.

Dengue fever (DF) has become a major public health concern in Nepal, with increasing outbreaks in recent years. Transmitted by Aedes mosquitoes, this climate-sensitive viral disease presents a significant challenge for healthcare providers and policymakers. Since 2004, Nepal has experienced a sharp increase in DF cases, peaking in 2022 with 54784 cases and 88 deaths.

A Decade-Long Analysis of Trends in Antimicrobial Resistance in a Neurosurgical Hospital in Kathmandu, Nepal.

Multidrug-resistant (MDR) bacteria cause infections with higher risks of morbidity, mortality, and financial burden. Understanding the antimicrobial resistance patterns of these pathogens is crucial for effective treatment and managing resistance. Therefore, this retrospective study examined the prevalence, causes, and trends in antimicrobial resistance in bacterial infections at a neurosurgical hospital in Nepal.

Unusual presentation of ruptured non coronary sinus of valsalva with new onset heart failure.

Rupture of sinus of Valsalva is a rare cardiac condition which is associated with severe left to right shunting. Symptoms may include breathlessness, chest pain and fatigue or even cardiogenic shock and when untreated, this condition carries a grave prognosis. We report a case of a 57-year-old gentleman without any past comorbidities who presented to our hospital with features of acute heart failure due to rupture of sinus of Valsalva which was diagnosed by echocardiogram and further confirmed by cardiac computed tomography scan.

The Significance of Diffusion-Weighted Imaging and Apparent Diffusion Coefficient in the Diagnosis of Early Acute Interstitial Edematous Pancreatitis.

The study assessed the diagnostic value of diffusion-weighted imaging (DWI) and mean apparent diffusion coefficient (ADC) in early acute interstitial edematous pancreatitis (AIEP). Fifty-six AIEP patients and 60 healthy controls underwent an upper abdominal magnetic resonance (MR) examination. The pancreas diameter and ADC values were measured and analyzed across age and gender groups.

Surgical excision of recurrent renal angiomyolipoma after previous embolization and nephron-sparing surgery - A case report.

Introduction: Renal angiomyolipoma is the most common benign kidney tumor, representing 1-3 % of solid renal tumors. Despite its benign nature, it can be associated with lethal hemorrhage, and can also show signs of local extension mimicking malignant tumors. The cornerstone of treatment remains angioembolization and nephron sparing surgery.

Cholecystocutaneous fistula after cholecystectomy.

Cholecystocutaneous fistula is an exceedingly rare type of external biliary fistula, where an abnormal connection forms between the gallbladder and the skin. Cholecystocutaneous fistula commonly develops in the setting of chronic calculus cholecystitis or following a previous surgical intervention involving the biliary tract. Patients with cholecystocutaneous fistula often present with systemic symptoms, such as fever, nausea, and vomiting, as well as localized symptoms in the right upper quadrant of the abdomen, where the external opening of the fistula is typically found.

Isolated visceral manifestation of Buerger's disease presenting as intestinal obstruction: a case report.

Introduction And Importance: Buerger's disease is an uncommon segmental nonatherosclerotic vasculitis essentially affecting small to medium-sized arteries and veins of upper and lower extremities and can lead to limb amputation. Visceral vessel involvement is quite rare accounting for 2% of cases presenting with acute abdomen due to mesenteric ischemia. Moreover, isolated visceral involvement is even rare.

Hypothermic Cardiac Arrest: A Case Report of an Unexpected Survivor Using Air Medical Transportation in Nepal.

This is a case of a 34-year-old man surviving hypothermic cardiac arrest with excellent neurologic recovery in Nepal. After 3 days without communication at an altitude of approximately 6,000 m, the patient was located in a crevasse and retrieved by a helicopter-supported search and rescue team. At first contact, he was reported to be breathing and shivering with appropriate pupillary response.

Jejunovesical Fistula Diagnosis After Normal Vaginal Delivery: A Case Report.

Unlabelled: Enterovesical fistula represents an abnormal communication between the intestine and bladder. The causes are diverticulitis (56.3%), malignant tumours, which are located mainly in the intestine (20.

Mean Intracranial Volume of Brain among Patients with Normal Magnetic Resonance Imaging Referred to the Department of Radiology and Imaging of a Tertiary Care Centre.

Introduction: The measurement of brain volume is an important aspect of the assessment of brain structure and function. However, limited data is available on brain volumetry in the Nepalese population. The study aimed to find the mean intracranial volume of the brain among patients with normal magnetic resonance imaging referred to the Department of Radiology and Imaging of a tertiary care centre.

Stumbling blocks on the path to measles-free Nepal: impact of the COVID-19 pandemic.

Measles poses a significant global health threat, exacerbated by the COVID-19 pandemic. Despite the efficacy of two vaccine doses, under-5 mortality rates persist, with over 61 million delayed measles vaccinations worldwide. Nepal, striving to eliminate measles by 2023, faces a resurgence, attributing 1013 cases to inadequate vaccination and healthcare accessibility issues.

Translation and Cross-Cultural Adaptation of Nepali Version of the Montreal Cognitive Assessment.

Background: Montreal Cognitive Assessment is widely used in stroke to detect cognitive impairment. The superiority of it over other outcome measures has been well established. It has been cross-culturally translated and has shown excellent psychometric properties.

Factors Affecting the Outcome after Surgical Clipping of Ruptured Distal Anterior Cerebral Artery (DACA) Aneurysms.

 The purpose of this study is to assess demographic, clinical, and unique morphological characteristics of distal anterior cerebral artery (DACA) aneurysm. The relation of outcome included Glasgow Outcome Scale (GOS) using various independent variables, Hunt and Hess clinical grade (H&H), Miller Fischer grade, intraoperative rupture, and comparison of outcomes at discharge and last follow-up.  Demographic data, aneurysm characteristics, and treatment outcomes were evaluated in 28 ruptured DACA aneurysms operated over a period of 13 years.

Effectiveness of a dietician-led intervention in reducing glycated haemoglobin among people with type 2 diabetes in Nepal: a single centre, open-label, randomised controlled trial.

Background: Nutrition education and counselling are considered a cornerstone for the management of type 2 diabetes (T2D). However, there is limited research related to the management of T2D through dietary approach, particularly in low-income and middle-income countries (LMICs) like Nepal. This study assessed the effectiveness of a dietician-led dietary intervention in reducing glycated haemoglobin (HbA1c) levels among people with T2D.

Diabetic foot problem in Nepal.

Introduction: Nepal is a developing country where diabetes is becoming a major health challenge due to its high prevalence of 8.5% affecting around 2 million people. Due to limited resources, there are many barriers to providing affordable and convenient diabetes care or regular screening for complications.

Availability of access, watch, and reserve (AWaRe) group of antibiotics in community pharmacies located close to a tertiary care hospital in Lalitpur, Nepal.

Introduction: The access, watch, and reserve (AWaRe) classification of antibiotics was developed in 2019 by the WHO Expert Committee on the Selection and Use of Essential Medicines as a tool to support antibiotic stewardship efforts at local, national, and global levels. The objectives of this study were to assess the availability of antibiotics as per WHO AWaRe classification at community pharmacies located around a tertiary care hospital in Lalitpur and to compare these antibiotics with the national essential medicine list of Nepal.

Method: The cross-sectional study was conducted at community pharmacies located within a two-kilometer radius of a teaching hospital from August to November 2022.

Correlation of Imaging Findings with Molecular Subtypes of Breast Cancer.

Background: Ultrasound and Mammography are first-line imaging in breast cancer. The management of malignant breast lesions depends on molecular biomarkers in the tumor cells. This study aims to correlate different imaging findings in breast carcinoma with immune-histology subtypes.

Practice of dialysis access interventional nephrology procedures in the Asia-Pacific region: Getting lay of the land.

Aim: This cross-sectional survey aimed to determine the prevalence of Interventional Nephrology (IN) practice amongst nephrologists in the Asia-Pacific Region (APR), specifically related to dialysis access (DA).

Methods: The Association of VA and intervenTionAl Renal physicians (AVATAR) Foundation from India conducted a multinational online survey amongst nephrologists from the Asia-Pacific to determine the practice of IN in the planning, creation, and management of dialysis access. The treatment modalities, manpower and equipment availability, monthly cost of treatment, specifics of dialysis access interventions, and challenges in the training and practice of IN by nephrologists were included in the survey.