Feasibility of a randomized controlled trial of enteral vs intravenous resuscitation for adults with major burn injuries in Nepal.

Introduction: Enterally-based resuscitation (EResus) is safe, efficacious, and has operational advantages, particularly in low-resource settings. However, there is a lack of real-world effectiveness studies and evidence-based protocols, which hinders implementation. To address this gap, we conducted a feasibility study ahead of a randomized controlled trial (RCT) of enterally based versus usual resuscitation at a tertiary burn center in Nepal which had no prior clinical trial experience.

CAR-T cell therapy in developing countries: how long should we wait?

Low- and middle-income countries (LMICs) face a significant burden of cancer prevalence and incidence. However, the survival rates for patients with cancer in these regions are notably lower than those in high-income countries, primarily due to late diagnosis and limited access to advanced treatments. Chimeric antigen receptor (CAR) T-cell therapy has demonstrated promising outcomes in certain terminally ill patients with cancer, yet access to this treatment remains limited in LMICs, including Nepal.

Microvascular decompression: a contemporary update.

Background: Microvascular decompression (MVD) is the gold-standard surgical treatment for cranial nerve compression disorders, including trigeminal neuralgia (TN), hemifacial spasm (HFS), and glossopharyngeal neuralgia (GPN). This review synthesizes historical milestones, recent advances, and evolving techniques in MVD, with a primary focus on these conditions.

Methods: A comprehensive literature review was conducted using databases such as PubMed, SpringerLink, Google Scholar, BioMed Central, Scopus, and ScienceDirect.

Comparing integrative ventilatory and renal acid-base acclimatization in lowlanders and Tibetan highlanders during ascent to 4,300 m.

With over 14 million people living above 3,500 m, the study of acclimatization and adaptation to high altitude in human populations is of increasing importance, where exposure to high altitude (HA) imposes a blood oxygenation and acid-base challenge. A sustained and augmented hypoxic ventilatory response protects oxygenation through ventilatory acclimatization, but elicits hypocapnia and respiratory alkalosis. A subsequent renally mediated compensatory metabolic acidosis corrects pH toward baseline values, with a high degree of interindividual variability.

Are we ready for self-sampling for cervical cancer screening? Insights from service providers and policy makers in Nepal.

Cervical cancer is the leading cancer among women in Nepal, but the country has very low screening rate, with only 8.2% of women being screened. In recent years, a self-sampling kit for testing for the human papillomavirus (HPV) has been developed to allow self-sampling and enable early detection of cervical abnormalities.

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.

Assessing health systems' capacities to provide post-abortion care: insights from seven low- and middle-income countries.

Background: Abortion-related complications significantly contribute to maternal morbidity and mortality globally. Post-abortion care (PAC) services are essential to safeguarding women's rights by substantially mitigating the health risks associated with abortions - a step which is fundamental to achieving reproductive and maternal health-related Sustainable Development Goals.

Methods: We conducted a secondary analysis of data from the nationally representative Service Provision Assessment (SPA) surveys conducted between 2015 and 2024 across three regions in seven low- and middle-income countries: Afghanistan, Bangladesh, Nepal, the Democratic Republic of Congo (DRC), Ethiopia, Senegal, and Haiti.

The genetic demographic history of the last hunter-gatherer population of the Himalayas.

Nepal, largely covered by the Himalayan mountains, hosts indigenous populations with distinct linguistic, cultural, and genetic characteristics. Among these populations, the Raute, Nepal's last nomadic hunter-gatherers, offer a unique insight into the genetic and demographic history of Himalayan foragers. Despite strong cultural connections to other regional foragers, the genetic history of this population remains understudied.

A Novel Approach to Assessing the Potential of Electronic Decision Support Systems to Improve the Quality of Antenatal Care in Nepal.

Introduction: Electronic decision-support systems (EDSSs) aim to improve the quality of antenatal care (ANC) through adherence to evidence-based guidelines. We assessed the potential of the mHealth integrated model of hypertension, diabetes, and ANC EDSS and the World Health Organization EDSS to improve the quality of ANC in primary-level health care facilities in Nepal.

Methods: From December 2021 to January 2023, we conducted a mixed-methods evaluation in 19 primary-level ANC facilities in Bagmati Province, Nepal.

Compassion Fatigue Among Australian Oncology Nurses Caring for Adult Cancer Patients: Antecedents, Impact and Mediators.

Aims: To explore how Australian oncology nurses perceive and experience compassion fatigue when caring for adult cancer patients, how they mitigate compassion fatigue and identify potential interventions to address compassion fatigue.

Design: A qualitative, descriptive study.

Methods: Twenty Australian oncology nurses caring for adult cancer patients were interviewed between August and September 2023.

Hydrology and water quality evaluation for potential HABs under future climate scenarios.

Harmful algal blooms (HABs) are increasingly a global concern and the issue of all fifty states in the U.S as it poses a threat to human health and aquatic ecosystem. This study aimed to investigate the relationship of HABs with streamflow and water quality parameters and assess the hydrology-based potential future HABs in the Ohio River Basin at Ironton (ORBI) using the Soil and Water Assessment Tool (SWAT).

Characterizing thyroid follicles histogenesis in the human fetuses: A morphological approach.

Thyroid gland which is responsible for the maintenance of metabolism and growth is derived from thyroglossal duct, an outpocketing of foregut. The microscopic study of thyroid gland during development in first, second and third trimesters has utmost significance to understand the several developmental thyroid disorders metabolically and structurally. This study is descriptive observational study carried in tissue sections taken from thyroid gland of still birth and spontaneously aborted human fetuses of first, second and third trimester.

High Prevalence of Malnutrition in Geriatric Patients With Solid Organ Cancer-An Institutional Study.

Purpose: The demographic transition toward aging heralds an increase in the number of geriatric patients with cancer in India. Comprehensive geriatric assessment (CGA) is a sine qua non for treatment planning and shared decision making in these patients. We aimed to study the prevalence of malnutrition and the associated risk factors in geriatric patients with solid organ cancer.

Baseline assessment of knowledge, attitude, practice, and adherence toward antimicrobials among women living in two urban municipalities in Lalitpur district, Nepal.

Introduction: Antimicrobial resistance (AMR) is a significant problem in developing, low- and middle-income countries like Nepal. Community engagement can be an important means to address the problem. Knowledge, attitude, practice, and adherence of women regarding antibiotics and AMR was studied.

Stroke Epidemiology in Asia.

Background Stroke is a major cause of death and disability globally, with different stroke burdens in different regions. This paper reviews the epidemiology of stroke in Asia. Summary There is a wide range in age and sex-standardised stroke incidence, highest in China, lowest in Bhutan.

The impacts of alien species on river bioassessment.

The extent of alien taxa impacts on river ecosystem health is unclear, but their frequency continues to rise. We investigated 1) the prevalence of including alien taxa in common bioindicators used in river bioassessment, 2) the effect of alien taxa on the richness and abundance of natives, and 3) whether including alien taxa in bioassessment tools increased their sensitivity to river degradation. In the 17 countries analyzed fish represented the greatest number of alien species (1726), followed by macrophytes (925), macroinvertebrates (556), and diatoms (7).

Intracranial ependymoma: A retrospective analysis of clinical features, treatment modalities, and long-term outcome.

Objective: Ependymomas, rare neuroglial tumors originating from ependymal cells, can occur in the CNS and typically affect the brain's ventricles or spinal cord. Prognosis is influenced by tumor grade, location, resection extent, and preoperative Karnofsky Performance Status Scale (KPSS) scores. This study evaluates clinical features, treatment outcomes, and factors affecting prognosis in patients with intracranial ependymomas.

No prediction without prevention: A global qualitative study of attitudes toward using a prediction tool for risk of developing depression during adolescence.

Given the rate of advancement in predictive psychiatry, there is a threat that it outpaces public and professional willingness for use in clinical care and public health. Prediction tools in psychiatry estimate the risk of future development of mental health conditions. Prediction tools used with young populations have the potential to reduce the worldwide burden of depression.

Tracking the Ghosts of the Himalayas: Snow Leopard Conservation Insights From Satellite Collar Data.

This study presents the first movement analysis of snow leopards () using satellite telemetry data, focusing on the northeastern Himalayas of Nepal. By examining GPS-based satellite collar data between 2013 and 2017 from five collared snow leopards (effectively three individuals), the research uncovered distinct movement patterns, activity budgeting and home range utilisation from one adult male and two sub adult females. Hidden Markov models (HMMs) revealed three behavioural states based on the movement patterns-slow (indicative of resting), moderate and fast (associated with travelling) and demonstrated that the time of day influenced their behavioural state.

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.

Effectiveness of menstrual hygiene management training to enhance knowledge, attitude, and practice among adolescents in Sindhupalchowk, Nepal.

Background: Menstrual Health (MH) knowledge, attitude and practice (KAP) are highly affected by access to information regarding menstruation. Despite being included in the school curriculum, Sexual and Reproductive Health (SRH) education is often not delivered in practice. School-based educational interventions have been shown to be effective in promoting MH.

Food habit, physical activity and nutritional status of adolescents in selected schools of Madhyapur Thimi municipality, Nepal: A cross-sectional study.

A dramatic rise in obesity is caused by unhealthy eating habits combined with lower levels of physical activity, and the under nutrition problem is still unresolved. Focusing on the nutritional needs of adolescents could be a significant step toward breaking the vicious cycle of malnutrition, chronic diseases, and poverty. This study aims to assess food habit, levels of physical activity and nutritional status of adolescents in Madhyapur Thimi Municipality, Bhaktapur.

Exosomal NEDD4L derived from HG+oxLDL-induced vascular endothelial cells accelerates macrophage M1 polarization and oxLDL uptake by ubiquitinating IκBα and PPARγ.

Background: Vascular endothelial cell-derived exosomes are thought to mediate disease progression by regulating macrophage polarization. However, its mechanism in diabetes mellitus (DM)-related atherosclerosis (AS) progress is unclear.

Methods: High-glucose (HG) and oxLDL were used to induce human cardiac microvascular endothelial cells (HCMECs) to mimic DM-related AS model.