RESUMEN
Age-related macular degeneration (AMD) severely affects central vision due to progressive macular degeneration and its staggering prevalence is rising globally, especially in the elderly population above 55 years. Increased oxidative stress with aging is considered an important contributor to AMD pathogenesis despite multifaceted risk factors including genetic predisposition and environmental agents. Wet AMD can be managed with routine intra-vitreal injection of angiogenesis inhibitors, but no satisfactory medicine has been approved for the successful management of the dry form. The toxic carbonyls due to photo-oxidative degradation of accumulated bisretinoids within lysosomes initiate a series of events including protein adduct formation, impaired autophagy flux, complement activation, and chronic inflammation, which is implicated in dry AMD. Therapy based on antioxidants has been extensively studied for its promising effect in reducing the impact of oxidative stress. This paper reviews the dry AMD pathogenesis, delineates the effectiveness of dietary and nutrition supplements in clinical studies, and explores pre-clinical studies of antioxidant molecules, extracts, and formulations with their mechanistic insights.
RESUMEN
Within the history of mathematics and mathematics education in Nepal, Tikaram and Chandrakala Dhananjaya are relatively well-known figures for their two books Sisubodha Tarangini and Lilavati. This is despite there being almost no archival or manuscript materials offering a window into their lives: we have no letters, notebooks, diaries, or school records. Rather than focusing on either individual in isolation, in this article we present an argument for considering the Dhananjayas as an analytically indivisible collaborative couple in mathematics. Of the two aforementioned books, one is attributed to Chandrakala and the other to Tikaram; but in fact, both are translations of the same Sanskrit source text, Lilavati, into Nepali. By comparing the mathematical contents of these two works, which were published within a few years of each other, we explore what it means to be an author or translator of a mathematical text and propose different models of spousal collaboration which could plausibly have been adopted by the Dhananjayas. In the absence of documentary evidence, the impossibility of delineating each individual's contributions removes the temptation to focus exclusively on apportioning credit. Instead, we offer the alternative perspective of considering what labour must have been undertaken to bring their books to publication.
RESUMEN
OBJECTIVE: We sought to determine the prevalence and antimicrobial susceptibility pattern of methicillin-resistant Staphylococcus aureus (MRSA) isolated from the clinical samples at a tertiary care hospital in Nepal. METHODS: Cross-sectional, observational study design. STUDY SETTING: The study was carried out at a tertiary care facility, the largest public hospital, Tribhuvan University Teaching Hospital (TUTH), Nepal. PARTICIPANTS: A total of 7433 clinical samples from hospital inpatients and outpatients available in the TUTH microbiology laboratory were examined. The study included clinical samples from the patients of either sex and across all age groups that had been clinically determined to have S. aureus infections. RESULTS: Of 7433 clinical samples analysed, S. aureus was recovered from 499 (6.71%). The prevalence of MRSA was discovered to be 26.4% (95% CI 21.6% to 30.4%). The major sources of MRSA were pus, 71 (18.5%). MRSA isolates encountered 100% resistance to penicillin and cloxacillin, followed by ciprofloxacin (80.5%), erythromycin (79.8%), cephalexin (64.9%), cotrimoxazole (61.1%) and clindamycin (58.5%). Chloramphenicol (17.9%), and gentamicin (27.4%), on the other hand, exhibited minimal resistance. None of the isolates were resistant to vancomycin (0.0%). Prevalence of multidrug resistance (MDR) was markedly higher in MRSA, 94.05% (95% CI 89.4% to 98.6%), compared with methicillin-sensitive S. aureus, 52.12% (95% CI 46.2% to 57.8%). CONCLUSION: Our study indicated a high rate of MRSA and MDR-SA (Multidrug-resistant Staphylococcus aureus) prevalence in a Nepalese tertiary care hospital. Therefore, given the widespread burden of MRSA and the threat of the emergence of resistance to commonly used antibiotics, there is a need for the development, adoption and enforcement of appropriate control policies in these hospital settings. Regular surveillance, reporting mechanism as well as prudent use of antimicrobial agents are crucial to combating the progression of MDR-MRSA prevalence and antibiotic resistance.