Perceived social support, coping, and stigma on the quality of life of people living with HIV in Nepal: a moderated mediation analysis.

Perceived social support, coping strategy, and internalized stigma have been linked with the quality of life (QOL) among people living with HIV (PLHIV). However, little is known about how these psychosocial factors interact with each other and affect QOL. This study incorporated a moderated mediation model to investigate whether coping strategy mediates the relationship between perceived social support and QOL, and to examine whether this mediating effect varies with the level of internalized stigma among PLHIV. A cross-sectional study was conducted among 599 PLHIV in Nepal. The multidimensional scale of perceived social support, World Health Organization Quality of Life-BREF, Brief COPE, and AIDS-related stigma scales were used to measure perceived social support, QOL, coping strategy, and internalized stigma, respectively. Data were analyzed using structural equation modeling, and moderated mediation analysis was conducted with multi-group approach. The relationship between perceived social support and QOL was significantly and partially mediated by problem-focused coping strategy. Internalized stigma significantly moderated the mediating effect of coping strategies on the association between perceived social support and QOL. For high internalized stigma group (total stigma score > 2), the effects of perceived social support on QOL were indirect (ß = 1.48; 61.0% of total effects) through the mediating effect of coping strategy, especially problem-focused coping one. For low internalized stigma group (total stigma score ≤ 2), problem-focused coping strategy did not significantly affect the QOL, and most of the effects of perceived social support were direct (ß = 1.24; 99.2% of total effects). Internalized stigma was found to moderate the mediating effect of problem-focused coping on the relationship between perceived social support and QOL. Enhancing the problem-focused coping and social support may be helpful to improve QOL among PLHIV reporting high stigma.

Nonsteroidal Anti-inflammatory Drugs (NSAIDS) Inhibit the Growth and Reproduction of Chaetomium globosum and Other Fungi Associated with Water-Damaged Buildings.

Indoor mold due to water damage causes serious human respiratory disorders, and the remediation to homes, schools, and businesses is a major expense. Prevention of mold infestation of building materials would reduce health problems and building remediation costs. Nonsteroidal anti-inflammatory drugs (NSAIDs) inhibit yeasts and a limited number of filamentous fungi. The purpose of this research was to determine the possible inhibitory activity of nonsteroidal anti-inflammatory drugs (NSAIDs) on germination, fungal growth, and reproduction of Chaetomium globosum and other important filamentous fungi that occur in water-damaged buildings. Several NSAIDs were found to inhibit C. globosum germination, growth, and reproduction. The most effective NSAIDs inhibiting C. globosum were ibuprofen, diflunisal, and diclofenac. Fusarium oxysporum, Fusarium solani, Aspergillus niger, and Stachybotrys atra were also tested on the various media with similar results obtained. However, F. oxysporum and A. niger exhibited a higher level of resistance to aspirin and NaSAL when compared to the C. globosum isolates. The inhibition exhibited by NSAIDs was variable depending on growth media and stage of fungal development. These compounds have a great potential of inhibiting fungal growth on building materials such as gypsum board. Formulations of sprays or building materials with NSAID-like chemical treatments may hold promise in reducing mold in homes and buildings.

Phytochemical constituents from the florets of tiger grass Thysanolaena latifolia from Nepal.

Phytochemical investigation on the florets of Thysanolaena latifolia leads to the isolation of a new compound 6″-O-acetylorientin-2″-O-α-L-rhamnopyranoside (1), named amrisoside and other 34 known compounds. The chemical structures of the compounds were determined from the interpretation of spectroscopic data including NMR, MS, and IR. This is the first report of phytochemical constituents from the monotypic genus Thysanolaena.

Diterpenes from the roots of Oryza sativa L. and their inhibition activity on NO production in LPS-stimulated RAW264.7 macrophages.

Two new pimarane diterpenoids, momilactone D (3) and momilactone E (5), along with three known diterpenoids, momilactone A (1), sandaracopimaradien-3-one (2), and oryzalexin A (4) were isolated from Oryza sativa roots. The chemical structures of the compounds were determined by spectroscopic data analysis. The isolated diterpenoids were evaluated for their ability to inhibit NO production and iNOS mRNA and protein expression in LPS-stimulated RAW264.7 macrophages. Compound 4 showed strong inhibition activity on NO production, and compounds 1 and 4 decreased the expression of iNOS mRNA and protein levels.

Two new isoarylbenzofuran diglucosides from the root bark of Morus alba.

Two new arylbenzofuran diglucopyranosides, (2″R)-(-)-moracin-O-5',3″-ß-D-diglucopyranoside (1) and (2″R)-(-)-moracin-P-5',2″-ß-d-diglucopyranoside (2), along with known arylbenzofurans, moracin M 6-ß-D-glucopyranoside (3), and an isomeric mixture of R-(-)-moracin O (4) and R-(-)-moracin P (5), were isolated from the root bark of Morus alba L. The structure of the compounds was elucidated based on mass spectrometry, infrared, 1D and 2D nuclear magnetic resonance spectroscopic data.

Some Highly Potent Nepalese Medicinal Plants with Antimicrobial Properties.

In recent years, microbial infections have emerged as a serious global health problem, necessitating the search for novel and effective treatments. Medicinal plants contain phytochemicals that can be used to prevent and treat various infections. Traditional medicinal practices have long relied on the healing properties of herbs, and Nepal is particularly rich in this knowledge. Bioactive compounds found in plants possess antibacterial, antifungal, and antiviral properties, making them a valuable resource for the fight against microbial infections. This review focuses on three medicinal plants native to Nepal, Amomum subulatum, Cymbopogon jwarancusa, and Cinnamomum glaucescens, which contain potent antimicrobial phytochemicals. The traditional uses, bioactive components, and biological activities of these plants are discussed, providing valuable insights into their potential as natural remedies to combat microbial infections.

Post-Transplant Fecal Carriage of Antibiotic Resistant and B-Lactamases-Producing Enterobacteriales among Renal Transplant Recipients.

BACKGROUND: The intestinal colonization and transmission of antibiotic-resistant Enterobacteriales to renal transplant recipients may pose a threat to them because they are profoundly immunocompromised and vulnerable to infection. Hence, it is crucial to identify these antibiotic-resistant fecal Enterobacteriales harboring high-risk populations. The objective of this study was to determine antibiotic resistance as well as ß-lactamases production in fecal Enterobacteriales among renal transplant recipients. METHODS: The stool samples, one collected from each transplant recipient, were processed for isolation and identification of Enterobacteriales and were tested for their antibiotic susceptibility, extended-spectrum ß-lactamase, and metallo-ß-lactamase production by standard methods. RESULTS: A total of 103 Enterobacteriales comprising of Escherichia coli (86.4%), Klebsiella species (11.7%), and Citrobacter species (1.9%) were isolated and more than 60% of the E. coli were found resistant to ceftazidime and ciprofloxacin and around half of the Klebsiella species were resistant to ceftazidime and fluroquinolones. The extended-spectrum ß-lactamase production was seen in 3.4% and 8.3% and metallo-ß-lactamase production in 24.7% and 33.3% of E. coli and Klebsiella species, respectively. The high proportion of ß-lactamase-producers were resistant to piperacillin-tazobactam, meropenem, gentamicin, and amikacin than ß-lactamases non-producers. CONCLUSION: Since the antibiotic resistance is higher in fecal Enterobacteriales, each renal transplant recipient should be screened for these highly resistant intestinal colonizers after transplantation in order to prevent infections and to reduce the rate of transplant failure due to infections.

Potential neuroprotective flavonoid-based inhibitors of CDK5/p25 from Rhus parviflora.

Rhus parviflora (Anacardiaceae) is an indigenous medicinal shrub found in South Asia with flavonoid rich edible fruit. This study examined flavonoid derivatives of R. parviflora fruit with CDK5/p25 inhibition activity. Evaluation by in vitro assay and docking simulations for CDK5/p25 revealed that the aurones, sulfuretin (1) and aureusidin (2), the aurone glycoside, aureusidin-6-O-ß-D-glucopyranoside (3) and hovetrichoside C (4), the flavonoid glycoside, quercetin-3-O-ß-D-galactopyranoside (5), and the biflavonoid, cupressuflavone (6), had the potential to inhibit CDK5/p25, which could be useful in the treatment of neurodegenerative disorders such as Alzheimer's disease. Compound2 showed the significant in vitro inhibition capacity (IC50 value of 4.81 µM) as well as binding affinity with docking energy of -8.73 (kcal/mol) for active sites CYS83 and GLN130 of CDK5/p25 enzyme in comparison to reference compound R-roscovitine.

Neolignans from the fruits of Magnolia obovata and their inhibition effect on NO production in LPS-induced RAW 264.7 cells.

Three new neolignans, named 9-methoxyobovatol (6), magnobovatol (7), and 2-hydroxyobovaaldehyde (9), along with six known ones, magnolol (1), honokiol (2), isomagnolol (3), obovatol (4), obovatal (5), and obovaaldehyde (8), were isolated from the fruits of Magnolia obovata using silica gel and ODS column chromatography. From the results of spectroscopic data including EIMS, IR, 1H- and 13C-NMR, DEPT, and 2D-NMR (gCOSY, gHSQC, gHMBC), the chemical structures were determined. All isolated compounds were evaluated for inhibition activity on nitric oxide production in LPS-induced RAW 264.7 cells, and compounds 1-4, 6, 7, and 9 showed significant activity with IC50 values of 15.8 ± 0.3, 3.3 ± 1.2, 14.1 ± 0.9, 6.2 ± 1.2, 14.8 ± 2.3, 14.2 ± 1.2, and 14.8 ± 3.2 µM, respectively, without any visible toxic effect.

Quality evaluation of Panax ginseng roots using a rapid resolution LC-QTOF/MS-based metabolomics approach.

Korean ginseng (Panax ginseng C.A. Meyer) contains several types of ginsenosides, which are considered the major active medicinal components of ginseng. The types and quantities of ginsenosides found in ginseng may differ, depending on the location of cultivation, making it necessary to establish a reliable method for distinguishing cultivation locations of ginseng roots. P. ginseng roots produced in different regions of Korea, China, and Japan have been unintentionally confused in herbal markets owing to their complicated plant sources. PCA and PLS-DA using RRLC-QTOF/MS data was able to differentiate between ginsengs cultivated in Korea, China, and Japan. The chemical markers accountable for such variations were identified through a PCA loadings plot, tentatively identified by RRLC-QTOF/MS and partially verified by available reference standards. The classification result can be used to identify P. ginseng origin.

Dry Eyes among Visual Display Terminal Users Visiting the Outpatient Department of Ophthalmology of a Tertiary Care Centre.

Introduction: Visual display terminal usage has increased substantially in recent years across all age groups and is considered one of the major risk factors for dry eye disease. Early assesment of dry eyes and prevention is important. The aim of this study is to find the prevalence of dry eyes among visual display terminal users visiting the Outpatient Department of Ophthalmology of a tertiary care centre. Methods: A descriptive cross-sectional study was conducted among patients visiting the Department of Ophthalmology in a tertiary care centre after receiving ethical approval from the Institutional Review Committee. Data was collected from 1 October 2021 to 31 March 2022. Convenience sampling method was used. The point estimate was calculated at a 90% Confidence Interval. Results: Among 94 visual display terminal users, the prevalence of dry eyes was 55 (58.51%) (50.18-66.84, 90% Confidence Interval). Conclusions: The prevalence of dry eyes among visual display terminal users visiting the Outpatient Department of Ophthalmology was similar to other studies done in similar settings. Keywords: dry eyes; health; prevalence.

Depression, Anxiety and Stress among School-going Adolescents of a Secondary School: A Descriptive Cross-sectional Study.

Introduction: Mental health of adolescents can affect growth and development, decrease school performance, and impair social relationships with peers and families. The COVID-19 pandemic has changed the social and educational scenario and affected the psychological condition of children and adolescents. This study aimed to find out the prevalence of depression, anxiety and stress among school-going adolescents in a secondary school. Methods: A descriptive cross-sectional study was done among school-going adolescents of a school from 1 October 2021 to 31 November 2021. Ethical approval was taken from the Institutional Review Committee (Reference number: 0609202101). Data was collected using a questionnaire consisting of sociodemographic parameters and a diagnosis of depression anxiety and stress was made using a standard scale. The whole sampling method was used. Percentage and frequency were calculated for binary data. Results: Among 95 patients, the depression was found in 31 (32.63%), anxiety in 36 (37.89%), and stress in 3 (3.16%). Conclusions: The prevalence of depression, anxiety and stress was lower than in other studies done in similar settings. The mental health status of school-going adolescents should be identified and appropriate timely interventions need to be taken. Family members, teachers and the concerned authorities should give emphasis to the psychological well-being of the adolescents. Keywords: adolescent; anxiety; depression; stress.

Hypoplastic Left Heart Syndrome: A Case Report.

Hypoplastic left heart syndrome is a rare critical congenital heart defect constituting a prevalence of 1/3,500 to 1/12,500 live births in which there is obstructions to the blood flow within the left heart. Here we present a case of a full-term 38 weeks male baby with a birth weight of 3.5 kg, and no obvious physical deformity referred to our centre at 22 hours of life for respiratory distress and cyanosis. At 23 hours of life, he was diagnosed with hypoplastic left heart syndrome and kept on Prostaglandin E1 infusion till the 12th day of life. The baby had a large ventricular septal defect and atrial septal defect with a severely hypoplastic left ventricle, hypoplastic aortic root, ascending aorta and post-ductal coarctation of the aorta. The diagnosis was reconfirmed by computed tomography cardiac angiography on the 10th day of life with the same cardiac findings suggestive of hypoplastic left heart syndrome. Keywords: case reports; congenital heart disease; hypoplastic left heart syndrome.

Determinants of farmers' choice for veterinary service providers in Nepal Mountains.

This study was aimed to analyze factors that affect farmers' choice for major actors of veterinary service providers in village areas of Kaski district of Nepal, with the objective of identifying choice-specific attributes which could be addressed for improving the penetration of professional veterinary services in village areas. The information was obtained from 125 farmers using a structured questionnaire. A proportional hazard model was used for data analysis because of its ability to accommodate the attributes of both the chooser and the choice simultaneously. The results showed that village animal health workers (VAHWs) were the most preferred service providers followed by veterinarians and mid-level technicians. The farmers' age and education level had a significant but inverse relationship with the probability of choosing any of the three service providers. From our study, we found that the main choice-specific attributes with a significant impact on the choice probability was the distance to the preferred service provider. Since there was a high preference for VAHW, this suggests the possibility of poorly trained service providers dominating veterinary service market in village areas of Kaski district. Hence, the efforts put forward in the legalization of VAHW system in Nepal should first address the constraints that obstruct the accessibility of professional veterinary service providers in village areas.

Neonates Born Through Meconium-stained Amniotic Fluid among Deliveries in a Tertiary Care Centre: A Descriptive Cross-sectional Study.

Introduction: The mortality and morbidity of meconium aspiration syndrome in neonates born with meconium-stained amniotic fluid in developing countries are still high. In Nepal, few studies have estimated the prevalence of meconium-stained amniotic fluid among newborns. The study aimed to find out the prevalence of neonates born through meconium-stained amniotic fluid among deliveries in a tertiary care centre. Methods: This descriptive cross-sectional study was conducted among neonates born in a tertiary care centre from November 2021 to March 2022. Neonates born during the study period with meconium-stained amniotic fluid were studied. Ethical approval was obtained from the Institutional Review Committee. Convenience sampling method was used. With permission from the Department of the Neonatal Intensive Care Unit, the data were collected and entered in a Microsoft Excel sheet. Point estimate and 95% Confidence Interval were calculated. Results: Among 576 neonates, the prevalence of neonates born through meconium-stained amniotic fluid was 77 (13.37%) (10.59-16.15, 95% Confidence Interval). Conclusions: The prevalence of neonates born through meconium-stained amniotic fluid was found to be similar to other studies done in similar settings. Keywords: meconium; neonate; Nepal.

Feeding Intolerance among Preterm Neonates Admitted to the Neonatal Intensive Care Unit at a Tertiary Care Centre: A Descriptive Cross-sectional Study.

Introduction: Premature infants frequently suffer from feeding intolerance related to prematurity and are highly associated with morbidity and mortality. Breast milk is fundamental to the improvement of the infant's immature vulnerable framework and decreases child mortality. The aim of this study was to find out the prevalence of feeding intolerance in premature neonates admitted to the neonatal intensive care unit of a tertiary care centre. Methods: This descriptive cross-sectional study was carried out among premature infants admitted to the Neonatal Intensive Care Unit of a tertiary care hospital, from 15 December 2021 to 15 May 2022 after receiving ethical approval from the Institutional Review Committee (Reference number: 2211202103). Convenience sampling was done. Point estimate and 95% Confidence Interval were calculated. Results: Among the 55 preterm neonates, the prevalence of feeding intolerance was 21 (38.18%) (25.34-51.02, 95% Confidence Interval). Conclusions: The study showed that the prevalence of feeding intolerance among neonates was higher than in studies conducted in similar settings. Keywords: feeding patterns; food intolerance; morbidity; mortality; preterm infants.

District-Level Risk Factors for COVID-19 Incidence and Mortality in Nepal.

The recent global pandemic of the novel coronavirus disease 2019 (COVID-19) is affecting the entire population of Nepal, and the outcome of the epidemic varies from place to place. A district-level analysis was conducted to identify socio-demographic risk factors that drive the large variations in COVID-19 mortality and related health outcomes, as of 22 January 2021. Data on COVID-19 extracted from relevant reports and websites of the Ministry of Health and Population of Nepal, and the National Population and Housing Census and the Nepal Demographic and Health Survey were the main data sources for the district-level socio-demographic characteristics. We calculated the COVID-19 incidence, recovered cases, and deaths per 100,000 population, then estimated the associations with the risk factors using regression models. COVID-19 outcomes were positively associated with population density. A higher incidence of COVID-19 was associated with districts with a higher percentage of overcrowded households and without access to handwashing facilities. Adult literacy rate was negatively associated with the COVID-19 incidence. Increased mortality was significantly associated with a higher obesity prevalence in women and a higher smoking prevalence in men. Access to health care facilities reduced mortality. Population density was the most important driver behind the large variations in COVID-19 outcomes. This study identifies critical risk factors of COVID-19 outcomes, including population density, crowding, education, and hand hygiene, and these factors should be considered to address inequities in the burden of COVID-19 across districts.

Diaphragmatic Hernia in a Preterm with Congenital Heart Defects with Successful Outcome: A Case Report.

Congenital diaphragmatic hernia is an anatomical defect of the diaphragm that is often associated with serious cardiopulmonary complications. It can also be associated with many other problems like multi systemic anomalies, chromosomal aneuploidy and prematurity. Of these, cardiac defects, liver herniation and prematurity seem to have a pivotal role in affecting the outcomes of repair. We hereby present a preterm newborn with such multiple defects repaired on 15th day of life and post operatively managed in a Neonatal Intensive Care Unit with a successful outcome. The key learning objective for our team in this case was to identify the steps taken that led to a successful management of a low birth weight preemie with multiple defects in a resource limited set up. Keywords: congenital diaphragmatic hernia; preterm; surgical repair; ventricular septal defect.

Culture Positive Cases of Ophthalmia Neonatorum in a Tertiary Care Centre of Nepal: A Descriptive Cross-sectional Study.

INTRODUCTION: Ophthalmia neonatorum although runs a benign course mostly, sometimes may progress to sight threatening complications. The study was conducted to find the prevalence of culture positive cases of opthalmia neonatorum. METHODS: It was a descriptive cross-sectional study conducted at a tertiary care center from January to December 2019. Ethical clearance was obtained from institutional review committee of Kathmandu Medical College. Convenience sampling was done. All data were entered into excel and, then for analysis, exported to Statistal Package for Social Sciences version 21. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. RESULTS: The prevalence of culture positive cases of opthalmia neonaturum is 10 (55.55%) (32.61-78.49 at 95% Confidence Interval). The causative organisms were coagulase negative Staphylococcus 4 (40%), Staphylococcus aureus 3 (30%), Klebsiella 2 (20%) and Pseudomonas 1 (10%). Culture sensitivity of the isolated organisms were different according to the patient even in case of the same organism. Vancomycin 7 ( 70%) was the most sensitive antibiotic followed by Ciprofloxacin 6 (60%), Amikacin 5 (50%) and Cloxacillin 5 (50%) while Azithromycin 1 (10%), Cefixime 1 (10%) and Cotrimoxazole 1 (10%) were the least sensitive. CONCLUSIONS: Staphylococcus species was the most common organism isolated from neonates with ophthalmia neonatorum and vancomycin was the most sensitive antibiotic.

Hypocalcemia in Jaundiced Neonates Receiving Phototherapy.

BACKGROUND: Hyperbilirubinemia is a common problem in neonates. Phototherapy and exchange transfusion are the primary treatment modalities. Less known, but one of the potential complications of phototherapy is hypocalcemia. Most of the neonates with hypocalcemia are asymptomatic. Though asymptomatic, treatment should be initiated immediately when serum calcium level is reduced. This study was conducted to detect the incidence of hypocalcemia in jaundiced neonates receiving phototherapy. METHODS: It is a hospital-based cross-sectional study conducted from May 2020 to December 2020 in the neonatal intensive care unit of Nepal Medical College Teaching Hospital. A total of 128 full-term neonates with jaundice and a normal serum calcium level before initiating phototherapy were enrolled in the study. Serum calcium level was measured before starting conventional phototherapy and after 48 hours of continuous phototherapy. RESULTS: Hyperbilirubinemia was present in 23.3% of neonates admitted to the neonatal unit. Hypocalcemia was seen in 26 (20.3%) of term jaundiced neonates receiving phototherapy. Signs of hypocalcemia were present only in 3 (2.3%) neonates. CONCLUSIONS: Hypocalcemia is a common complication of phototherapy. Serum calcium levels should be monitored in all the full-term neonates receiving phototherapy.