Antibiotic Resistance Pattern of Shigella spp. Among Gastroenteritis Patients at Tertiary Care Hospital in Pokhara, Nepal

Shigellosis, a disease caused by Shigella species. It is a major public health problem in developing nations like Nepal, where communities having poverty; poor sanitation, personal hygiene, and water supplies. The main aim of our study is to isolate and identify Shigella spp. from gastroenteritis patients and to find out its drug resistance pattern.A cross-sectional study was carried out based on routinely attending outpatients and inpatients.  A total of 225 stool samples collected from gastroenteritis patients were processed from 20 April to 24 September 2014 in Western Regional Hospital, Pokhara, Nepal. Standard microbiological procedures were followed for the isolation of Shigella spp. After that slide agglutination kit method was used for identification of Shigella spp.  Finally, Kirby-Bauer disc diffusion method was done for an antimicrobial resistance test.Of the total 225 gastroenteritis patients, 133 were detected as bacterial positive cases.  Among positive cases, Shigella spp. was identified in 10.5%.  Age wise, an infection rate of Shigella in patients <15-years old was found higher i.e. 7.3% than in patients ≥ 15 years old i.e. 4.5% with the (p = 0.432) at 95% CI. The infection rate of S. dysenteriae, S. flexneri, and S. sonnei was detected in 28.6%, 57.1%, and 14.3% respectively. For the antimicrobial test, eight types of antibiotics were used.  The most resistance pattern of isolated Shigella spp. was found in nalidixic acid, and co-trimoxazole 92.8% followed by ampicillin 64.3% and ciprofloxacin 42.8% etc.Our study reported that endemicity of Shigellosis with S. flexneri is the predominant group in gastroenteritis patients. This finding suggests that co-trimoxazole, nalidixic acid, ciprofloxacin and ampicillin should not be used experimentally as first-line drugs for shigellosis treatment

STUDY OF IN VITRO ANTI-OXIDANT AND ANTI-DIABETIC ACTIVITY BY MUSSAENDA MACROPHYLLA ROOT EXTRACTS

Objective: The systematic study of effective alternative anti-diabetic drugs has great importance to manage diabetes as well as other oxidative stress-related diseases. According to previous research, root and bark of Mussaenda macrophylla plant has anti-microbial, anti-coagulant, anti-inflammatory, and hepatoprotective activity. Ethnomedicinal data shows that Mussaenda macrophylla is used to treat diabetes as well as oxidative stress. The objective of this research is to investigate in vitro anti-diabetic and anti-oxidant activity of root extract of Mussaenda macrophylla. Methods: DPPH free radical scavenging assay was used to detect anti-oxidant potency of ethanol and methanol root extract of the plant and expressed as % of radicle inhibition. Anti-diabetic activity was determined by the glucose diffusion method using a glucose oxidase kit and results were expressed as mean±SD. Results: The ethanol root extract at the concentration of 50 mg/ml and 100 mg/ml showed better glucose diffusion inhibition than that of methanol extract at the same concentration on increasing time interval. Ethanol extract at the concentration 100 µg/ml displayed better DPPH scavenging activity (89.83±0.19 %) than that of methanol extract (86.61±0.75%). Conclusion: This study concluded that ethanol and methanol root extract of Mussenda macrophylla have potent anti-diabetic as well as anti-oxidant activity but further advance research is necessary in the animal model

ANALGESIC ACTIVITY OF BARK AND LEAVES OF FICUS RELIGIOSA L. FROM NEPAL

Objective: Because of adverse side effects, caused by NSAIDs, tolerance, and dependence induced by opiates, the use of these analgesic agents has not been successful in all cases. Therefore, alternative analgesic drugs from plant sources are the new target now days. The objective of this study was to evaluate the analgesic activity of ethanolic extracts of stem barks and leaves of Ficus religiosa. Methods: The analgesic activity of ethanolic extract of stem barks and leaves was evaluated in the Swiss albino mice model using acetic acid-induced writing response and Eddy’s hot plate method. Analgesic activity was demonstrated with the percentage inhibition of acetic acid induced writings and the percentage increased in latency time of paw licking. The potency of test extracts was compared with standard drug, Diclofenac. Results: Ethanolic extract of leaves and bark of F. religiosa showed potential analgesic activity from both methods. From Eddy’s hot plate model, it was observed that the percentage of increased latency time at 90 min by ethanolic extract of leaves and stem bark was found to be 70.81 % (8.54 min) and 70.78 % (8.53 min) respectively at a dose of 400 mg/kg. Both of these results are statistically significant (p<0.05) as compared to the test group. Furthermore, both of these extracts showed the dose-dependent and time-dependent increased in latency time and these results are compared to that of standard drug Diclofenac. Similarly, ethanolic extract of leaves and stem at 400 mg/kg significantly inhibited the number of writhings induced by acetic acid. The percentage inhibition of writhings by ethanolic extract of leaves at a dose of 400 mg/kg was 68.47 % which was similar to that of standard drug Diclofenac (68.47 %). However, ethanolic extract of bark showed relatively lower percentage inhibition (60.79 %) as compared to leaf extract and standard, but the result was significant as compared to that of the test group (p<0.05). Conclusion: Ethanolic extracts of F. religiosa stem bark and leaf possess both central and peripheral analgesic properties and these effects may be beneficial for the management of pain

Association of RT-qPCR Ct Values and Disease Severity among COVID-19 Patients Visiting a Tertiary Care Hospital in Nepal

COVID-19 pandemic due to SARS-CoV-2 has been one of the major global health issues of this aeon. The aim of this study was to evaluate the association of SARS-CoV-2 cycle threshold (Ct) values with multiple factors among COVID-19 patients visiting a tertiary care hospital in Sudurpashchim province of Nepal. A retrospective analysis was performed on the data of randomly selected COVID-19 cases among the total RT-qPCR tested patients from March 2020 to April 2022. The Ct values at the time of patient admission and their clinical outcomes (discharge or death) were compared. Among the COVID-19 patients, survivor group had significantly higher initial Ct value compared to non-survivors [median Ct values 23.21 and 24.39 (P < 0.0001)]. Selected haematological parameters; white blood cells (P<001), neutrophils (P<001), and monocytes (P<0.0001), and all the biochemical parameters were significantly different between these two groups (p < 0.005). Furthermore, significantly increased CRP (61.54±63.00, P<0.0017), D-dimer levels (0.8979± 1.480, P<0.0001), creatinine (0.7931±0.2551, P<0.0001), monocytes (0.6782±0.7981, P<0.0001), and random blood sugar (152.4±34.32, P<0.0001) were observed among non-survivors indicating as cause of disease severity in COVID-19. The findings of this study imply that the Ct value, CRP and D-dimer levels could be a crucial marker for the early detection of severe COVID-19 patients or those at higher risk of developing severe disease. This will eventually help to identify cases requiring immediate and critical medical care and reduce mortality

The system of crop intensification: Agroecological innovations for improving agricultural production, food security, and resilience to climate change

There is growing consensus that to meet global food-security requirements, agricultural sectors will need to pursue appropriate strategies for sustainable intensification of production. This volume reports on current ‘work in progress’ to achieve this via an approach known as System of Crop Intensification (SCI). Collated from the contributors’ work with farmers in their respective countries – and illustrated throughout with case studies, data, pictures and feedback – it presents a set of ideas and experiences to encourage people to think ‘outside the box’ of current practices

The COVID‐19 Pandemic Not Only Poses Challenges, but Also Opens Opportunities for Sustainable Transformation

The COVID-19 pandemic has impacted social, economic, and environmental systems worldwide, slowing down and reversing the progress made in achieving the Sustainable Development Goals (SDGs). SDGs belong to the 2030 Agenda to transform our world by tackling humankind's challenges to ensure well-being, economic prosperity, and environmental protection. We explore the potential impacts of the pandemic on SDGs for Nepal. We followed a knowledge co-creation process with experts from various professional backgrounds, involving five steps: online survey, online workshop, assessment of expert's opinions, review and validation, and revision and synthesis. The pandemic has negatively impacted most SDGs in the short term. Particularly, the targets of SDG 1, 4, 5, 8, 9, 10, 11, and 13 have and will continue to have weakly to moderately restricting impacts. However, a few targets of SDG 2, 3, 6, and 11 could also have weakly promoting impacts. The negative impacts have resulted from impeding factors linked to the pandemic. Many of the negative impacts may subside in the medium and long terms. The key five impeding factors are lockdowns, underemployment and unemployment, closure of institutions and facilities, diluted focus and funds for non-COVID-19-related issues, and anticipated reduction in support from development partners. The pandemic has also opened a window of opportunity for sustainable transformation, which is short-lived and narrow. These opportunities are lessons learned for planning and action, socio-economic recovery plan, use of information and communication technologies and the digital economy, reverse migration and “brain gain,” and local governments' exercising authorities

Applicability of UAV in crop health monitoring using machine learning techniques

Food demands are increasing globally. Various issues such as urbanization, climate change, and desertification increasingly favour crop pests and diseases that limit crop productivity. Elaborating and discussing the pragmatic knowledge and information on recent advances in tools and techniques for crop monitoring developed in recent decades might help agronomists make more informed decisions. This chapter discusses the progress and development of new techniques equipped with recent sensors and platforms such as drones that have revolutionized the way of understanding plant physiology and stresses. It begins with the introduction to various tools available for crop stress estimation, mainly based on optical imaging such as multispectral, thermal, and hyperspectral imaging. An overview of unmanned aerial vehicle (UAV) -based image processing pipeline is presented and shed light on the possible avenues of UAV-based remote sensing for crop health monitoring using machine learning approaches

Epidemiology and Pathogenesis of Coronavirus Disease (COVID-19)

An acute respiratory syndrome (ARDS) episode was first identified in Wuhan, China, and later officially designated as COVID-19 by the WHO. It is caused by SARS-CoV-2 that is likely associated with zoonotic transmission. Based on the live data from live reference website Worldometer which provides counters and realtime statistics for diverse topics data, COVID-19 has influenced 186 nations. China reported 25% of cases, while 75% of the remaining cases were reported in other nations. The clinical and genetic characteristics of SARSCoV-2 support the similar pathogenesis pattern between SARS-CoV and MERS-CoV. The elevated level of cytokine release during the infection caused the failure of multiple organs leading to the patient death. Treatment of patients depends on the clinical course and symptoms associated with the COVID-19. Several prevention and control measures including; active surveillance, use of masks, and hand sanitizers are recommended to stop the spread of this virus. Besides, COVID-19 was sampled using a throat swab to detect the viral nucleic acid using Real Time Polymerase Chain Reaction (RT-PCR), for early detection and treatments evaluation. In this review, we comprehensively summarized the COVID-19 epidemiology, pathogenesis and diagnosis, using suitable literatures obtained from reliable sources

Successful health promotion, its challenges and the way forward in Nepal

Health promotion is the most favorable approach and process to achieve a positive health outcome of the population. Several countries across the world are committed to achieving positive health for their people with the best health promotion strategies. Health promotion, in fact, shares a large portion of health care economy and resources in many countries. A low-income country like Nepal, however, lacks the implementation of rigorous health care strategies on a large scale and is deficient in evidence of the potential scope of health promotion. Nepal has adopted the global health promotion declaration on paper; however, health care providers and authorities are still working in a traditional way using existing health policies and strategies. This paper aims to explore some of the global best practices of health promotion, including the challenges and opportunities by adopting such practices in Nepal, and provides some recommendations as a way forward

Dengue: Rapid Diagnostic Testing in a Tertiary Care Setting in Butwal, Nepal

Dengue virus (DENV) is spread mostly by biting by the infected female mosquitoes of the species Aedes aegypti, that are commonly found in tropical and subtropical zones of globe. Some studies have shown that nearly fifty percent of the globe are susceptible to DENV. Most infections by DENV are asymptomatic. Clinical infections vary from mild fever to serious diseases including hemorrhagic fever and shock syndrome. The main objective of this study was to estimate DENV infection by rapid diagnostic (RDTs) kit methods in a tertiary care setting. This retrospective study was done at Crimson Hospital, Butwal, Nepal from June to November 2019. Serum samples of all dengue fever suspected patients were tested for DENV antigen as Dengue nonstructural protein 1(NS1) and DENV specific antibodies as IgM and IgG by using World Health Organization Good Manufacturing Practices (GMP) certified rapid solid phase immunochromatographic method. All laboratory test results were tabulated by using MS-Excel and analyzed by statistical package for the Social Sciences software version 20. Out of 821 samples tested, 518 were positive, including 322 (62.16%) reactive for dengue NS1 Protein, 121 (23.35%) for IgM, 62 (11.96%) for IgG and 13 (2.50%) were positive for both IgG and IgM antibodies. Our study showed high prevalence of dengue infection during monsoon to post-monsoon and the infection rate was higher in males (71.72%) than in females (53.36%). According to our findings, DENV infection is prevalent in Butwal, Nepal. Early diagnosis, better case management, faster public health response and effective health policy towards the control of mosquito vectors may reduce the dengue burden and must be implemented in Nepal