Nairobi Eye: A Clinico-epidemiological Study from A Tertiary Care Center of Central Nepal

Introduction: Periocular paederus dermatitis (Nairobi eye) is characterized by erythematous vesiculobullouslinear plaque with stinging sensation. It commonly occurs during rainy season. It has been describedin people living near agricultural fields due to the potential toxin pederin. This study aims to evaluate thedemographic profile and clinical presentation of patients with periocular paederus dermatitis in a tertiary carecenter. Methods: This was a descriptive, cross-sectional study evaluating patients attending dermatologyand/or ophthalmology department with features consistent with paederus dermatitis involving perioculararea from June to August, 2019. Relevant demographic and clinical data were obtained; clinical photographswere taken and histopathology performed among selected patients. Results: A total of 24 (14.8%) patients hadfeatures of Nairobi eye among 162 patients of paederus dermatitis. Majority of the patients were males (1.4:1)with mean age 29.08±13.38 years. The peak time of presentation was the first week of July (37.5%). Meantime period between onset of symptoms and presentation was 3.41±2.01 days. The lesions were unilateral inall cases, with predominant involvement of the right eye (62%). Burning sensation (80%) and itching (60%)were the predominant symptoms while conjunctival hyperemia (41.6%), seropurulent discharge (20.8%)and chemosis (16.6%) were the ocular findings. Most of the patients (n=17, 70.8%) noticed the lesion whilewaking up in the morning. Conclusion: The finding of the present study has shown that Nairobi eye isa common presentation during rainy season. Periocular findings with significant intraocular signs weredocumented to be presenting features among patients with periocular paederus dermatitis

The Cost of Menstrual Cycle in Young Nepali Women: A Cross-Sectional Study

Introduction: Every woman must have safe access to clean water and menstrual products. They have to spend more or less money to buy menstrual products or to alleviate menstrual symptoms. The cost of a menstrual cycle is often associated with period poverty. We found a research gap on this issue. The objective of this study was to find the cost of menstrual cycle and their perceptions on menstrual cost among young Nepali women. Methods: We conducted a cross sectional study from 15 August 2019 to 15 February 2020. The total enumeration sampling technique was used to enroll 157 female medical students. Ethical clearance was obtained from institutional review committee of Birat Medical College Teaching Hospital. Open data kit (ODK) collect software was used for data collection. The collected data was extracted in Microsoft Excel 2016 and analyzed by SPSS version 23. Results: Majority (33.8%) had menarche at 13 years and 47.8% had regular menstrual cycle. The total average cost of items used in last menstrual period was NPR 480.41 (NPR 40-1850) and lifetime cost was NPR 219066.96. Sanitary pads/ tampons/menstrual cups etc. should cost less money (85.4%) and tax currently put on it should be removed by government (91.1%) were the perceptions of the participants. Conclusion: Menstrual cycle added additional cost in women's life. Participants perceived that cost is high and it should be tax free. Nepal's constitution already passed sanitation as basic fundamental right. So, the cost of sanitary items needs to be minimized by removing the government tax

Fermentation process for alcoholic beverage production from mahua (Madhuca indica J. F. Mel.) flowers

Mahua flowers are rich in sugar (68-72%), in addition to a number of minerals and one of the most important raw materials for alcohol fermentation. The present investigation was for the development of a non-distilled alcoholic beverage from Mahua flowers. Eighteen (18) treatment combinations consisting of two temperatures (25 and 30°C), three pH (4.0, 4.5 and 5.0) and three period of fermentation (7, 14 and 21 days) were used in the fermentation conditions. The maximum yield of ethanol (9.51 %) occurred at 25°C with pH 4.5 after 14 days of  fermentation of Mahua flower juice. The fermented non-distilled alcoholic beverage contained total sugar (8.83 mg/ml), reducing sugar (0.82 mg/ml), total soluble solids (6.37°Brix) titrable acidity (0.65 %), and volatile acidity (0.086%). Methanol was not detected at any stage of fermentation. The developed fermented alcoholic beverage had characteristic flavor and aroma of Mahua flowers with about 7 to 9% alcohol.Keywords: Madhuca indica, ethanol, reducing sugar, fermentation.African Journal of Biotechnology Vol. 12(39), pp. 5771-577

Quality of life of elderly people living with family and in old age home in Morang District, Nepal

Introduction: Nepal like many other developing countries in the world is witnessing the rapid ageing of population. Quality of life (QOL) of elderly people is becoming even more relevant towards an ageing society. In Nepal, less is known regarding special needs and quality of life of elderly people either in familial situations or in old age residences. Objectives: The present study was undertaken to assess and compare the quality of life of elderly living with the family and in old age home. Methodology: A Cross sectional descriptive study was conducted from October 2016 to April 2017 among elderly population aged 60 years and above. A total of 50 elderly people were enrolled from old age home (OAH) using total enumeration sampling technique and equal number of sample was selected from the family setting. QOL of elderly was assessed using WHOQOL-BRIEF questionnaire after taking informed consent from the participants. Data was analyzed using SPSS. Results: The mean scores of QOL domains were better among the age group 60-70 years, males, married, literates and who had children. The mean scores of QOL in physical, psychological and environmental domains were better in elderly living with the family than living in OAH. Low scores were found on social domain among elderly compared to other domain irrespective of their residence. Conclusion: QOL score among elderly is average, while social relationship domain of QOL scores was found to be low. Social activities should be expanded for these residents in order to promote social health. The QOL which each individual possesses is very important in all aspects be it physical, psychological, social &amp; environmental. Furthermore, programs that help elderly people live in their own homes and social environments should be promoted.BIBECHANA 16 (2019) 221-227</p

Interventions to promote cost-effectiveness in adult Intensive care units: consensus statement and considerations for best practice from a multidisciplinary and multinational eDelphi study

Background There is limited evidence to guide interventions that promote cost-effectiveness in adult intensive care units (ICU). The aim of this consensus statement is to identify globally applicable interventions for best ICU practice and provide guidance for judicious use of resources. Methods A three-round modified online Delphi process, using a web-based platform, sought consensus from 61 multidisciplinary ICU experts (physicians, nurses, allied health, administrators) from 21 countries. Round 1 was qualitative to ascertain opinions on cost-effectiveness criteria based on four key domains of high-value healthcare (foundational elements; infrastructure fundamentals; care delivery priorities; reliability and feedback). Round 2 was qualitative and quantitative, while round 3 was quantitative to reiterate and establish criteria. Both rounds 2 and 3 utilized a five-point Likert scale for voting. Consensus was considered when > 70% of the experts voted for a proposed intervention. Thereafter, the steering committee endorsed interventions that were identified as ‘critical’ by more than 50% of steering committee members. These interventions and experts’ comments were summarized as final considerations for best practice. Results At the conclusion of round 3, consensus was obtained on 50 best practice considerations for cost-effectiveness in adult ICU. Finally, the steering committee endorsed 9 ‘critical’ best practice considerations. This included adoption of a multidisciplinary ICU model of care, focus on staff training and competency assessment, ongoing quality audits, thus ensuring high quality of critical care services whether within or outside the four walls of ICUs, implementation of a dynamic staff roster, multidisciplinary approach to implementing end-of-life care, early mobilization and promoting international consensus efforts on the Green ICU concept. Conclusions This Delphi study with international experts resulted in 9 consensus statements and best practice considerations promoting cost-effectiveness in adult ICUs. Stakeholders (government bodies, professional societies) must lead the efforts to identify locally applicable specifics while working within these best practice considerations with the available resources

Lessons to be learnt from Leishmania studies

Leishmaniasis is a disease caused by infection with the protozoan parasite Leishmania, which is responsible for three main types of disease: cutaneous leishmaniasis, visceral leishmaniasis and mucocutaneous leishmaniasis based to the site of infection for the particular species. This presents a major challenge to successful drug treatment, as a drug must not only reach antileishmanial concentrations in infected macrophages, the parasites' host cell, but also reach infected cells in locations specific to the type of disease. In this paper we discuss how studies using Leishmania have contributed to our knowledge on how drug delivery systems can be used to improve drug efficacy and delivery

Poor Thermal Care Practices among Home Births in Nepal: Further Analysis of Nepal Demographic and Health Survey 2011

Introduction - Hypothermia is a major factor associated with neonatal mortality in low and middle income countries. Thermal care protection of newborn through a series of measures taken at birth and during the initial days of life is recommended to reduce the hypothermia and associated neonatal mortality. This study aimed to identify the prevalence of and the factors associated with receiving ‘optimum thermal care’ among home born newborns of Nepal. Methods - Data from the Nepal Demographic and Health Surveys (NDHS) 2011 were used for this study. Women who reported a home birth for their most recent childbirth was included in the study. Factors associated with optimum thermal care were examined using Chi-square test followed by logistic regression. Results - A total of 2464 newborns were included in the study. A total of 57.6 % were dried before the placenta was delivered; 60.3% were wrapped; 24.5% had not bathing during the first 24 hours, and 63.9% were breastfed within one hour of birth. Overall, only 248 (10.7%; 95% CI (8.8 %, 12.9%)) newborns received optimum thermal care. Newborns whose mothers had achieved higher education (OR 2.810; 95% CI (1.132, 6.976)), attended four or more antenatal care visits (OR 2.563; 95% CI (1.309, 5.017)), and those whose birth were attended by skilled attendants (OR 2.178; 95% CI (1.428, 3.323)) were likely to receive optimum thermal care. Conclusion - The current study showed that only one in ten newborns in Nepal received optimum thermal care. Future newborn survival programs should focus on those mothers who are uneducated; who do not attend the recommended four or more attend antenatal care visits; and those who deliver without the assistance of skilled birth attendants to reduce the risk of neonatal hypothermia in Nepal

Piperidinols that show anti-tubercular activity as inhibitors of arylamine N-acetyltransferase: an essential enzyme for mycobacterial survival inside macrophages

Latent M. tuberculosis infection presents one of the major obstacles in the global eradication of tuberculosis (TB). Cholesterol plays a critical role in the persistence of M. tuberculosis within the macrophage during latent infection. Catabolism of cholesterol contributes to the pool of propionyl-CoA, a precursor that is incorporated into cell-wall lipids. Arylamine N-acetyltransferase (NAT) is encoded within a gene cluster that is involved in the cholesterol sterol-ring degradation and is essential for intracellular survival. The ability of the NAT from M. tuberculosis (TBNAT) to utilise propionyl-CoA links it to the cholesterol-catabolism pathway. Deleting the nat gene or inhibiting the NAT enzyme prevents intracellular survival and results in depletion of cell-wall lipids. TBNAT has been investigated as a potential target for TB therapies. From a previous high-throughput screen, 3-benzoyl-4-phenyl-1-methylpiperidinol was identified as a selective inhibitor of prokaryotic NAT that exhibited antimycobacterial activity. The compound resulted in time-dependent irreversible inhibition of the NAT activity when tested against NAT from M. marinum (MMNAT). To further evaluate the antimycobacterial activity and the NAT inhibition of this compound, four piperidinol analogues were tested. All five compounds exert potent antimycobacterial activity against M. tuberculosis with MIC values of 2.3-16.9 µM. Treatment of the MMNAT enzyme with this set of inhibitors resulted in an irreversible time-dependent inhibition of NAT activity. Here we investigate the mechanism of NAT inhibition by studying protein-ligand interactions using mass spectrometry in combination with enzyme analysis and structure determination. We propose a covalent mechanism of NAT inhibition that involves the formation of a reactive intermediate and selective cysteine residue modification. These piperidinols present a unique class of antimycobacterial compounds that have a novel mode of action different from known anti-tubercular drugs

In Vitro Contraction of Cytokinetic Ring Depends on Myosin II but not on Actin Dynamics

10.1038/ncb2781Nature Cell Biology157853-859NCBI

Development of a biosensor for urea assay based on amidase inhibition, using an ion-selective electrode

A biosensor for urea has been developed based on the observation that urea is a powerful active-site inhibitor of amidase, which catalyzes the hydrolysis of amides such as acetamide to produce ammonia and the corresponding organic acid. Cell-free extract from Pseudomonas aeruginosa was the source of amidase (acylamide hydrolase, EC 3.5.1.4) which was immobilized on a polyethersulfone membrane in the presence of glutaraldehyde; anion-selective electrode for ammonium ions was used for biosensor development. Analysis of variance was used for optimization of the biosensorresponse and showed that 30 mu L of cell-free extract containing 7.47 mg protein mL(-1), 2 mu L of glutaraldehyde (5%, v/v) and 10 mu L of gelatin (15%, w/v) exhibited the highest response. Optimization of other parameters showed that pH 7.2 and 30 min incubation time were optimum for incubation ofmembranes in urea. The biosensor exhibited a linear response in the range of 4.0-10.0 mu M urea, a detection limit of 2.0 mu M for urea, a response timeof 20 s, a sensitivity of 58.245 % per mu M urea and a storage stability of over 4 months. It was successfully used for quantification of urea in samples such as wine and milk; recovery experiments were carried out which revealed an average substrate recovery of 94.9%. The urea analogs hydroxyurea, methylurea and thiourea inhibited amidase activity by about 90%, 10% and 0%, respectively, compared with urea inhibition