In Vitro Antioxidant and Antibacterial Activities of Medicinal Flower Laligurans Rhododendron arboreum Collected from Kathmandu Valley, Nepal.

Rhododendron arboreum, known as Nepal's national flower and belonging to the Ericaceae family, thrives throughout the Himalayan region. This study investigates the antioxidant and antimicrobial potential of Rhododendron arboreum flowers. Three different extracts were prepared at concentrations ranging from 10 to 640 µg/mL and assessed for their total phenolic content (TPC), total flavonoid content (TFC), and DPPH radical scavenging activity. Results showed significant accumulation of antioxidant compounds (P < 0.05), with TPC levels of 37.78, 67.29, and 53.46 mg GAE/g and TFC values of 49.46, 67.46, and 65.71 mg QE/g for LGP, LGE, and LGA at 640 µg/mL, respectively. DPPH activity was highest in LGE (96.33%), followed by LGA (87.11%) and LGP (76.59%), compared to the standard (77.38%). The antibacterial properties were significant against Aeromonas hydrophila, Staphylococcus aureus, and Escherichia coli at 100% concentration, with inhibition rates of 15%, 16%, and 17% for LGP, LGE, and LGA, respectively. These findings indicate that Rhododendron arboreum petals, rich in bioactive compounds, possess strong antioxidant and antibacterial properties, making them potential candidates for developing cost-effective therapeutic formulations. Further research should focus on isolating specific bioactive compounds and understanding their molecular mechanisms to enhance therapeutic efficacy.

Thirty-day readmission in patients with heart failure with preserved ejection fraction: Insights from the nationwide readmission database.

BACKGROUND: There are rising numbers of patients who have heart failure with preserved ejection fraction (HFpEF). Poorly understood pathophysiology of heart failure with preserved and reduced ejection fraction and due to a sparsity of studies, the management of HFpEF is challenging. AIM: To determine the hospital readmission rate within 30 d of acute or acute on chronic heart failure with preserved ejection fraction and its effect on mortality and burden on health care in the United States. METHODS: We performed a retrospective study using the Agency for Health-care Research and Quality Health-care Cost and Utilization Project, Nationwide Readmissions Database for the year 2017. We collected data on hospital readmissions of 60514 adults hospitalized for acute or acute on chronic HFpEF. The primary outcome was the rate of all-cause readmission within 30 d of discharge. Secondary outcomes were cause of readmission, mortality rate in readmitted and index patients, length of stay, total hospitalization costs and charges. Independent risk factors for readmission were identified using Cox regression analysis. RESULTS: The thirty day readmission rate was 21%. Approximately 9.17% of readmissions were in the setting of acute on chronic diastolic heart failure. Hypertensive chronic kidney disease with heart failure (1245; 9.7%) was the most common readmission diagnosis. Readmitted patients had higher in-hospital mortality (7.9% vs 2.9%, P = 0.000). Our study showed that Medicaid insurance, higher Charlson co-morbidity score, patient admitted to a teaching hospital and longer hospital stay were significant variables associated with higher readmission rates. Lower readmission rate was found in residents of small metropolitan or micropolitan areas, older age, female gender, and private insurance or no insurance were associated with lower risk of readmission. CONCLUSION: We found that patients hospitalized for acute or acute on chronic HFpEF, the thirty day readmission rate was 21%. Readmission cases had a higher mortality rate and increased healthcare resource utilization. The most common cause of readmission was cardio-renal syndrome.

Telemedicine and Community Health Projects in Asia.

Telemedicine has the potential to deliver high-quality, affordable health care to underserved populations that otherwise would not have adequate access to care. The authors provide a snapshot of several telemedicine initiatives that have used information and communication technologies to connect patients with health care providers across various Asian countries with differing socioeconomic statuses. They highlight several factors thought to contribute to the success of telemedicine programs, such as financial sustainability, ease of use, and utilization of existing resources. Challenges these programs have faced include lack of technological infrastructure, limitations in funding, and conflicting health system priorities.

Frequency of different types of facial melanoses referring to the Department of Dermatology and Venereology, Nepal Medical College and Teaching Hospital in 2019, and assessment of their effect on health-related quality of life.

BACKGROUND: Abnormalities of facial pigmentation, or facial melanoses, are a common presenting complaint in Nepal and are the result of a diverse range of conditions. OBJECTIVES: The objective of this study was to determine the frequency, underlying cause and impact on quality of life of facial pigmentary disorders among patients visiting the Department of Dermatology and Venereology, Nepal Medical College and Teaching Hospital (NMCTH) over the course of one year. METHODS: This was a cross-sectional study conducted at the Department of Dermatology and Venereology, NMCTH. We recruited patients with facial melanoses above 16 years of age who presented to the outpatient department. Clinical and demographic data were collected and all the enrolled participants completed the validated Nepali version of the Dermatology Life Quality Index (DLQI). RESULTS: Between January 5, 2019 to January 4, 2020, a total of 485 patients were recruited in the study. The most common diagnoses were melasma (166 patients) and post acne hyperpigmentation (71 patients). Quality of life impairment was highest in patients having melasma with steroid induced rosacea-like dermatitis (DLQI = 13.54 ± 1.30), while it was lowest in participants with ephelides (2.45 ± 1.23). CONCLUSION: Facial melanoses are a common presenting complaint and lead to substantial impacts on quality of life. Accurate diagnosis and management can prevent or treat many facial melanoses, including those that lead to substantial loss of quality of life, such as melasma with steroid induced rosacea-like dermatitis. Health care systems in low and middle-income countries should dedicate resources to the identification, prevention and treatment of these conditions to improve quality of life.

Mobile learning in resource-constrained environments: a case study of medical education.

BACKGROUND: The achievement of the millennium development goals may be facilitated by the use of information and communication technology in medical and health education. AIMS: This study intended to explore the use and impact of educational technology in medical education in resource-constrained environments. METHODS: A multiple case study was conducted in two Nepalese teaching hospitals. The data were analysed using activity theory as an analytical basis. RESULTS: There was little evidence for formal e-learning, but the findings indicate that students and residents adopted mobile technologies, such as mobile phones and small laptops, as cultural tools for surprisingly rich 'informal' learning in a very short time. These tools allowed learners to enhance (a) situated learning, by immediately connecting virtual information sources to their situated experiences; (b) cross-contextual learning by documenting situated experiences in the form of images and videos and re-using the material for later reflection and discussion and (c) engagement with educational content in social network communities. CONCLUSION: By placing the students and residents at the centre of the new learning activities, this development has begun to affect the overall educational system. Leveraging these tools is closely linked to the development of broad media literacy, including awareness of ethical and privacy issues.

Microorganisms present in discharging otitis media in a group of patients in Kathmandu.

Discharge from the ear is one of the commonest symptoms of infections of the ear. To study the major strains of bacteria encountered in ear discharges, this study was conducted from July 1999, to June 2001 in the microbiology laboratory of Om Hospital. A total of 115 patients, of 6-35 years of age clinically diagnosed as discharging otitis media were studied. In 60.9% single organism and in 26.08% two organisms were isolated. Results revealed that, Staphylococcus aureus (34.3%), Klebsiella pneumoniae (24.3%), Pseudomons aeruginosa (22.8%), Enterobacter sps (7.1%), Esch coli (4.3%), Citrobacter sps (1.4%), Proteus sps (1.4%), Acinetobacter sps (1.4%) and Pneumococci (1.4%) were the common organisms in the discharge. Candida albicans (2.8%) was the pathogen in two cases. In 27.8% of cases the causative agent was not demonstrated. About sixty percent (65.9%), 64.8% and 56.0% of the isolates were sensitive to amikacin, ciprofloxacin and gentamycin respectively.

Lasers in dermatology.

Laser technology, since its inception, has grown to find it's in varied fields, and medical science has been no exception. Dermatological surgery is in itself an emerging field in medical science, and the evolution of laser technology has further widened its scope, with various therapeutic well as diagnostic applications. Though the use of this technology is rapidly evolving, controlled studies to compare the efficacy of different types of lasers in specific skin conditions, or its effect on different skin types, is lacking. This study presents the observations of the response to the Carbon-di-oxide laser used to treat various skin conditions, in the Nepali skin phenotype. Lasers are being used to treat a wide variety of dermatological conditions, many of which did not have satisfactory treatment in the past. Further studies are required to study the effect of lasers in the Nepali skin phenotype, so as to standardize the wavelengths, doses and exposure times that would be suitable to treat specific skin conditions.

Seasonal variation of skin diseases in Nepal: a hospital based annual study of out-patient visits.

The aim of this study was to determine whether there was seasonal variation in skin diseases amongst dermatology out-patients in Nepal. A retrospective study was done of all new out-patients visiting a single dermatologist, at the Om Hospital and Research Center, Kathmandu, Nepal. The study population comprised all new patients visiting the dermatology out-patient department, between January and December, 1999. Data were obtained from the hospital out-patient records and analyzed. The total number of patients with skin diseases was 1746 (Males-793; Females-953). Majority (28.6%) of the visits was in spring and the three most common diagnoses included fungal infections, acne and melasma. All skin diseases showed statistically significant seasonal variation. It is clear that occurrence of certain skin diseases in Nepal show a significant seasonal trend.

Study on head and neck tumours presented in ENT OPD of Nepal Medical College Teaching Hospital.

This retrospective study was carried out to analyze the types of head and neck tumours on the basis of site and histopathological type. A total of 35 patients with head and neck tumours (M: 19 and F: 16; aged 15 to 68 years) were included. Thyroid neoplasm was the commonest (20.0%) patients followed by tumour of larynx (17.1%), oropharyngeal tumour and (14.3%), oral cavity tumour ranked number one (14.3%) followed by tumours of nose (11.4%) and others. All thyroid neoplasms were follicular type whereas all laryngeal tumours were squamous cell carcinoma.