Impact of antiparasitic therapy on cardiovascular outcomes in chronic Chagas disease. A systematic review and meta-analysis.

Background: Endemic in more than 20 countries, Chagas disease affects 6.3 million people worldwide, leading to 28,000 new infections and 7700 deaths each year. Previous meta-analyses on antiparasitic treatment need updates to encompass recent studies and to assess key clinically meaningful endpoints.

Tubulin detyrosination shapes cytoskeletal architecture and virulence.

Tubulin detyrosination has been implicated in various human disorders and is important for regulating microtubule dynamics. While in most organisms this modification is restricted to α-tubulin, in trypanosomatid parasites, it occurs on both α- and β-tubulin. Here, we show that in , a single vasohibin (LmVASH) enzyme is responsible for differential kinetics of α- and β-tubulin detyrosination.

Prolonged Remission in Metastatic Ano-Rectal Malignant Melanoma With Single Agent Temozolomide.

Introduction: With the use of immune checkpoint inhibitors (ICIs) and targeted therapies, the clinical outcomes of metastatic melanoma have drastically improved. The current scenario has reduced the use of chemotherapy as a first-line treatment. We report an interesting case of a patient with stage IV ano-rectal canal malignant melanoma with an exceptional response to single-agent temozolomide.

Political parties' accountability to the public in Nepal: What factors affect it?

Political accountability is essential for maintaining trust and transparency in governance. However, the factors that influence political parties' accountability remain underexplored in Nepal. This paper examines the factors influencing citizens' perceptions of political parties' accountability in Nepal, utilizing data from the National Governance Survey 2017/18 (N = 4191).

Strategic Management of Valve Infolding in Evolut TAVR Procedures: Enhancing Outcomes and Ensuring Patient Safety.

Transcatheter aortic valve repair (TAVR) presents a minimally invasive alternative to traditional surgical valve replacement, albeit not without its own set of complications. A rare complication is the infolding of the self-expanding valve, which can precipitate cardiac arrest. The estimated incidence rate of this complication stands at 1.

Atrial Septal Defect and Percutaneous Closure: Healing the Heart From Within.

Early diagnosis and percutaneous closure of symptomatic adult atrial septal defects can enhance cardiac function and relieve symptoms. Thorough pre-procedural evaluation and diligent follow-up care are essential for achieving the best outcomes and ensuring long-term success.

Macrophage Activation Syndrome/Secondary Hemophagocytic Lymphohistiocytosis in Adult-Onset Still's Disease: An Uncommon Initial Presentation in a Young Nepalese Female: A Case Report.

Hemophagocytic lymphohistiocytosis (HLH), is a fatal systemic hyperinflammatory syndrome. HLH may be due to immunosuppression, infections, cancer, or autoimmune diseases with fever and cytopenia. HLH which occurs in adult-onset Stills disease (AOSD) is called secondary HLH, also known as macrophage activation syndrome (MAS).

Primary Tracheal Schwannoma With Extension to the Thyroid Gland: Management.

The occurrence of neurogenic tumors in the tracheobronchial tree is uncommon. We report a case of transmural tracheal schwannoma with extraluminal component extending upto the left thyroid lobe. 40-year-old male presented with scanty hemoptysis due to transmural tracheal schwannoma with extraluminal part of tumor extending till the left lobe of thyroid gland.

Caste, wealth and geographic equity in program reach and expected outcomes: an exploratory analyses of in Nepal.

Introduction: Monitoring and evaluation of maternal and child nutrition programs typically concentrates on overall population-level results. There is limited understanding, however, of how intervention reach and expected outcomes differ among sub-populations, necessary insight for addressing inequalities. These analyses aim to determine if maternal exposure to social and behavior change (SBC) interventions is associated with scales of maternal practices (antenatal care, iron and folic acid in pregnancy, diet in pregnancy, postnatal care, iron and folic acid postpartum, and maternal dietary diversity) and child practices (institutional birth, health mothers' group participation, growth monitoring and promotion, early initiation of breastfeeding and infant and young child feeding) in Nepal, overall and by wealth, caste, and geography.

Incidental imaging detection of Kartagener syndrome in a female: A case report.

Kartagener syndrome is a rare ciliopathic genetic disorder characterized by a triad of chronic sinusitis, situs inversus, and bronchiectasis. The underlying pathophysiology involves reduced ciliary motility due to defects in ciliary structure and function within the respiratory tract and fallopian tubes. Diagnosis is typically confirmed through imaging studies such as X-rays, CT scans, and echocardiograms, which reveal the abnormal orientation of the heart and other organs.

Meta-analysis of longitudinal comparison of transcatheter versus surgical aortic valve replacement in patients at low to intermediate surgical risk.

Background: Surgical aortic valve replacement (SAVR) is the commonly used approach for aortic valve replacement (AVR) in patients with aortic stenosis at low or intermediate surgical risk. However, transcatheter aortic valve replacement (TAVR) has emerged as an alternative to SAVR for AVR. This meta-analysis aims to assess the comparative efficacy and safety of TAVR versus SAVR in low-to-intermediate surgical risk patients by analyzing temporal trends in the outcomes of TAVR and SAVR at various follow-up intervals, providing a more detailed understanding.

Scope of work and contributions of female community health volunteers in Nepal's healthcare sector: a qualitative study.

Objectives: To determine the perception of female community health volunteers (FCHVs) in terms of their scope of work, impact of work on their professional experiences and their coping strategies and stakeholders' perception of FCHVs programme, their contribution to the health sector and its sustainability.

Design: A qualitative study involving in-depth interviews (IDIs) with FCHVs and key informant interviews (KIIs) with local stakeholders. All the interviews were conducted through telephone.

Half a Century's Quest for Seasonal Hyperacute Panuveitis (SHAPU): From Academic Curiosity to Public Health Concern.

For the past 50 years, significant progress has been made in understanding Seasonal Hyperacute Panuveitis (SHAPU), a mysterious blinding disease first reported in Nepal in 1975. Predominantly affecting Nepalese children, SHAPU occurs cyclically every odd year from September to December. While initially misclassified as endophthalmitis, SHAPU is set apart by its lack of trauma or surgery, failure to grow organisms in most intraocular fluid cultures, and its hallmark presentation of a "white pupil in red eye" with an association with moth exposure.

Antioxidant, Alpha-Amylase Inhibitory and Hypoglycemic Activity of Leaves from Nepal: An Integrated In Vitro, In Vivo, and In Silico Approach.

In 2019, diabetes mellitus affected 9.3% of the global population and accounted for one in nine adult deaths. Plant-based antioxidants neutralize harmful free radicals, mitigate oxidative stress, and significantly prevent diabetes and its complications.

Heart Shaped Anterior Neck Lipoma Mimicking Thyroid Mass: A Case Report.

Lipomas, one of the most common benign tumors, rarely occur in the anterior neck, often misdiagnosed as thyroid masses. This case highlights the diagnostic challenge posed by such lesions. A 58-year-old male presented with a painless slowly progressive anterior neck swelling initially mistaken for a thyroid mass.

Microsurgical Semilunar Bilaminar Technique Halts Progression of Marginal Tissue Recession by Soft Tissue Phenotypic Modification-A Case Report With 3-Year Follow-Up.

Phenotype modification therapy using the novel semilunar flap with xenogeneic collagen matrix improves gingival phenotype, root coverage and increased keratinized tissue width. It also halts the progression of recession, enhances tissue resilience and improved plaque control sustainable over 3 years. Collagen matrix avoids second site surgery and hence less morbidity.

Leprosy-Presenting as Rheumatoid Arthritis Misleading the Correct Diagnosis.

Leprosy can present with symptoms resembling rheumatoid arthritis, leading to delays in diagnosis or inappropriate treatment, potentially progressing to lepromatous forms, neuropathy, and disability. Physicians must consider leprosy as a differential for rheumatoid arthritis, especially in endemic regions. Early detection is vital to prevent chronic neuropathy, disabilities, and disfigurement.

Association of Diabetes Mellitus with Carotid Artery Stenosis Undergoing Coronary Artery Bypass Graft in Bangladesh: A Prospective Cross-Sectional Study.

Background: Atherosclerosis is a systemic vascular disease commonly affecting coronary and carotid arteries, particularly in diabetes mellitus (DM). This study assessed the association of DM with significant carotid artery stenosis (CAS) among the coronary artery disease (CAD) population undergoing isolated elective coronary artery bypass graft (CABG) surgery.

Methods: A prospective cross-sectional study evaluated 100 Bangladeshi CAD patients who underwent isolated elective CABG from January 2017 to September 2019.

Endoscopic Sphenopalatine Artery Cauterization Under Local Anesthesia for Posterior Epistaxis: A Prospective Cohort Study of its Tolerability and Efficacy.

Objective: To assess the tolerability and efficacy of endoscopic sphenopalatine artery cauterization (ESPAC) under local anesthesia (LA) in managing posterior epistaxis.

Methods: It was a prospective, cohort study, conducted in the Otorhinolaryngology Department of a tertiary-level hospital. Patients aged 18 years or above with posterior epistaxis who underwent ESPAC under LA were included.

Advocacy in Action: International Patient Group Improves Hereditary Angioedema Diagnosis and Care Across the Asia-Pacific.

This study demonstrates that patient advocacy groups significantly enhance medication availability and improve diagnosis of hereditary angioedema (HAE), particularly in emerging economies within the Asia-Pacific region. This study supports integrating patient advocacy group involvement into management guidelines, emphasising their role in improving access to diagnostics and treatment for HAE.

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.