Thalassemia carrier screening in siblings of thalassemia major patients by HbA2 estimation

Objective: Thalassemia carrier screening in siblings of thalassemia major patients by HbA2 estimation. Methods: This prospective, cross-sectional study was conducted at thalassemia welfare society of JK Lon Hospital, Kota. Siblings of thalassemia major patients registered at our hospital were investigated for chemically bonded ceramics and HbA2 estimation by high performance liquid chromatography (HPLC) method. Results: A total of 121 cases were screened for carrier by HPLC method for HbA2 estimation. Total 59 (48.76%) cases had HbA2 level ≥3.5%, and considered as carrier while 62 (51.24%) cases were non-carrier. Mean HbA2 value in carrier was 5.24% ± 1.14% and in non-carrier was 2.69% ± 0.51%. Conclusion: It was concluded that β thalassemia carriers are more prevalent in siblings of thalassemia major than the normal population

Electronic Structure and Molecular Docking Studies of an anti-HIV Drug: Stavudine

337–339For anti HIV activity, Stavudine (or D4T or Zerit) is an important nucleoside reverse transcriptase inhibitor (NRTI). Molecular geometry of this compound has been optimized by DFT B3LYP/6–31G (d,p) method using Gaussian 03 software package. In order to examine global reactivity descriptors of the drug molecule, Frontier orbital analysis has been carried out. Using molecular docking inhibition activity of the drug against HIV-1 reverse transcriptase (6AN2) has been investigated. Attempts have been made to elucidate the chemical and biological properties of the drug

Knowledge and Perception of Public Towards Medico Legal Autopsy in Nepal

Introduction: Autopsy is an important tool to determine the cause of death. This study was conducted with the objectives to assess the knowledge and perception of Nepalese people towards medico legal autopsy. Methods: It was a questionnaire based cross sectional study performed among the general public of Nepal. A standard pretested questionnaire was used to collect the responses on knowledge and perception of the people about medico legal autopsy. Independent samples t-test was used to compare the mean score of knowledge among the various groups. P value of < 0.05 was considered significant. Results: Mean age of the respondents was 29.06 years (SD = 10.50) and 72.31% were male (n = 188, N = 260). Mean score of knowledge was 6.65 (SD = 1.76) out of a total ten. The score was significantly higher (p = 0.02) among the respondents whose relatives had undergone an autopsy than those whose were not. It was comparable among the educated and uneducated groups.  A total of 75.77% respondents (n = 197, N = 260) would not reject the autopsy of their relatives. Conclusion: People lack knowledge mostly in basic elements of medico legal autopsy. Most of the people showed positive perception towards autopsy and those who were negative, feared of disfigurement of the bodies after an autopsy

Electronic Structure and Molecular Docking Studies of an anti-HIV Drug: Stavudine

For anti HIV activity, Stavudine (or D4T or Zerit) is an important nucleoside reverse transcriptase inhibitor (NRTI). Molecular geometry of this compound has been optimized by DFT B3LYP/6–31G (d,p) method using Gaussian 03 software package. In order to examine global reactivity descriptors of the drug molecule, Frontier orbital analysis has been carried out. Using molecular docking inhibition activity of the drug against HIV-1 reverse transcriptase (6AN2) has been investigated. Attempts have been made to elucidate the chemical and biological properties of the drug

Design and Fabrication of Multi-finger Field Plate for Enhancement of AlGaN/GaN HEMT Breakdown Voltage

The design and fabrication of gate/source connected multi-finger field plate structures using TCAD ATLAS simulation software is presented. The designed field plate structures are fabricated on indigenous AlGaN/GaN HEMT devices. AlGaN/GaN HEMT devices with field plate structures exhibit about three times improvement in breakdown voltage of device and are in close agreement with the simulation results. Integration of field plates in device have resulted in higher VDS (drain to source voltage) operation and improvement in output power of AlGaN/GaN HEMT devices. Incorporation of field plates also decrease the reverse leakage current of HEMT devices

Efficacy of Combined Antithrombotic, Statins and Anti-Hypertensive Drugs in Acute Ischemic Stroke

Introduction: Anti-thrombotic, statins and antihypertensive drugs are commonly used for the management of acute ischemic stroke in Nepal but there is no evidence regarding their efficacy in our context. This study aims to explore the efficacy of these combined medications (anti-thrombotic, statins and antihypertensive drugs) in acute ischemic stroke patients for the first time and to assess the risk factors present in those patients. Methods: The study was conducted on 37 acute ischemic stroke patients admitted and treated at the Neurology Department of College of Medical Sciences-Teaching Hospital, Chitwan, Nepal and they were followed at three months (90±10 days). The initial stroke severity and functional disability were evaluated at admission and at 3 months using National Institute of Health Stroke Scale (NIHSS) and Modified Rankin Scale (mRS) respectively. The outcome parameters were functional independence (mRS≤2) and mortality at three months (mRS=6). Frequency distribution, Mann-Whitney U-test and χ2 test were performed for statistical analysis. Results: Out of 37 patients, 27 (73%) were Smoker, 22 (59.5%) had hypertension and 19 (51.4%) were alcohol consumer. The stroke severity on admission was statistically significant with functional independence (P=0.003) and mortality (P=0.015) at three month. Similarly, Rankin grade on admission was statistically significant with functional independence (P=0.001) and mortality (P=0.048) at three month. At three months, 20 (69%) survived patients were independent while mortality was seen in eight (21.6%) patients. Conclusions: The management of acute ischemic stroke with combined anti-thrombotic, statins and antihypertensive drugs seems promising and efficacious in mild to moderately severe ischemic stroke. Keywords: antihypertensive; anti-thrombotic; efficacy ; statins; stroke

Association of Intracellular TH1-TH2 Balance in CD4+ T-cells and MIP-1α in CD8+ T-cells with Disease Severity in Adults with Dengue

Background: We tested the hypothesis that dengue haemorrhagic fever (DHF) is associated with a TH1-skewed immune response as opposed to dengue fever (DF). Methods: We estimated intracellular (in T-cells) and serum levels of designate TH1/TH2 cytokines [interferon-γ (IFN-γ), interleukin-4 (IL-4), and tumor necrosis factor-α] and macrophage inflammatory protein-1α (MIP-1α) at admission, 48 h, and day 5 in 20 adults with dengue (DF=10, DHF=10) and 10 dengue-naive healthy controls. Results: At admission, intracellular IFN-γ/IL-4 ratio in CD4+ T-cells and proportion of MIP-1a-positive CD8+ T-cells were significantly higher in patients with DHF [7.21 (5.36 ~ 10.81) vs. 3.04 (1.75 ~ 4.02); p=0.011 and 6.2% (3.2 ~ 8.2%) vs. 2.4% (2.0 ~ 3.6%); p=0.023]. The latter showed a significant positive correlation with IFN-γ/IL-4 ratio in CD4+ T-cells (Spearman's rho=0.64; p=0.003), percentage-change in haematocrit (rho=0.47; p=0.048), and serum alanine aminotransferase level (rho=0.61; p=0.009). Conclusion: We conclude that DHF is associated with a TH1-skewed immune response. Further, MIP-1α in CD8+ T-cells is an important immunologic correlate of disease severity in dengue

COVID-19 vaccination up-take in three districts of Nepal

Vaccine hesitancy during the COVID-19 pandemic continues to be an issue in terms of global efforts to decrease transmission rates. Despite high demand for the vaccines in Nepal, the country still contends with challenges related to vaccine accessibility, equitable vaccine distribution, and vaccine hesitancy. Study objectives were to identify: 1) up-take and intention for use of COVID-19 vaccines, 2) factors associated with vaccine up-take, and 3) trusted communication strategies about COVID-19 and the vaccines. A quantitative survey was implemented in August and September 2021 through an initiative at the Nepali Ministry of Health and Population Department of Health Services, Family Welfare Division. Data were collected from 865 respondents in three provinces (Bagmati, Lumbini, and Province 1). Ordinal multivariate logistic regression was utilized to determine relationships between vaccination status and associated factors. Overall, 62% (537) respondents were fully vaccinated and 18% (159) were partially vaccinated. Those respondents with higher education (p \u3c .001) and higher household income (p \u3c .001) were more likely vaccinated. There were also significant differences in vaccine up-take across the three provinces (p \u3c .001). Respondents who were vaccinated were significantly more likely to perceive vaccines as efficacious in terms of preventing COVID-19 (p = .004) and preventing serious outcomes (p = .010). Among both vaccinated and unvaccinated individuals, there was a high level of trust in information about COVID-19 vaccines provided through local health-care workers [e.g. nurses and physicians]. These results are consistent with other findings within the South Asia region. Targeted advocacy and outreach efforts are needed to support ongoing COVID-19 vaccination campaigns throughout Nepal

Regulatory T Cells Suppress T Cell Activation at the Pathologic Site of Human Visceral Leishmaniasis

Suppression of T cell response is thought to be involved in the pathogenesis of visceral leishmaniasis (VL). Regulatory T cell (Treg) mediated immune-suppression is reported in animal models of Leishmania infection. However, their precise role among human patients still requires pathologic validation. The present study is aimed at understanding the frequency dynamics and function of Treg cells in the blood and bone marrow (BM) of VL patients. The study included 42 parasitologically confirmed patients, 17 healthy contact and 9 normal bone marrow specimens (NBM). We show i) the selective accumulation of Treg cells at one of the disease inflicted site(s), the BM, ii) their in vitro expansion in response to LD antigen and iii) persistence after successful chemotherapy. Results indicate that the Treg cells isolated from BM produces IL-10 and may inhibit T cell activation in IL-10 dependent manner. Moreover, we observed significantly higher levels of IL-10 among drug unresponsive patients, suggesting their critical role in suppression of immunity among VL patients. Our results suggest that IL-10 plays an important role in suppression of host immunity in human VL and possibly determines the efficacy of chemotherapy