Influenza B virus: Need for heightened surveillance and epidemiologic case studies

Recent report of increased influenza B virus infection, particularly theclinical profiles and treatment challenges imposed like that of influenza A,underscores the importance of continuing influenza B virus surveillance.This is, especially in resource limited country, early detection of influenzavirus, its clinical presentation and complications would be vital in minimizingthe public heath burden imposed by this virus.Keywords: chronic obstructive pulmonary disease, influenza B, severe acutepulmonary infection

Bark Extract of Lantana camara in 1M HCl as Green Corrosion Inhibitor for Mild Steel

Lantana camara, an invasive species that adversely affects habitant, bioregions and environment has been studied as corrosion inhibitor. Methanolic extract of barks of Lantana camara in 1 M hydrochloric acid was tested as corrosion inhibitor on mild steel using potentiodynamic polarization technique. The corrosion inhibition efficiency of extract varied with concentration of extract and immersion of time. The inhibition was found to increase with increase in concentration of the extract. The polarization behavior of mild steel revealed that maximum inhibition efficiency is 97.33 % and 89.93 % respectively in the 1000 and 200 ppm concentration of the inhibitor respectively. The results showed that the extract of the barks of Lantana camara served as a mixed type inhibitor

Upper Gastrointestinal Bleeding Induced by Gastric Ulcer Secondary to Strongyloidiasis: A Case Report

Strongyloidiasis, a parasitic infestation by Strongyloides stercoralis, involves the gastrointestinal tract with a spectrum from duodenitis to enterocolitis. However, gastric involvement with the manifestation of upper gastrointestinal bleeding is an extremely rare condition due to Strongyloides stercoralis. Due to irregular excretion of larvae, unclear symptoms, paucity of effective diagnostic tools and low parasitic load, makes clinicians difficult to reach the diagnosis of strongyloidiasis. Here, we present a case of upper gastrointestinal bleeding due to a large gastric ulcer whose aetiology was identified to be Strongyloides stercoralis infection of the gastric region by the diagnosis of exclusion

Papillary Renal Cell Carcinoma: Demographics, Survival Analysis, Racial Disparities, and Genomic Landscape

Papillary renal cell carcinoma (PRCC) is the second most common histological subtype of renal cell cancer. This research aims to present a large database study highlighting the demographic, clinical, and pathological factors, racial disparities, prognosis, and survival of PRCC. The clinical and demographic data were extracted from the Surveillance, Epidemiology, and End Results (SEER) database, and molecular data was cured from the Catalogue Of Somatic Mutations in Cancer (COSMIC) database. PRCC had a median age of diagnosis at 64 years, with a higher incidence in men (77%), and Whites (68%). 70.3% of cases were Grades I–IV (13, 53, 31, and 3%, respectively). In patients with known data, 85% were localized to the kidney, and 84% of cases were 7 cm in size. No metastasis occurred in 97% of the known data. The most common treatment offered was surgical resection (9%). The 5-year overall survival was 79%, with patients undergoing surgery having a 90.6% 5-year survival. Multivariable analysis revealed age > 60 years, Black race, poor histologic differentiation, distant metastases, and tumor size > 10 cm as independent risk factors for mortality. The most common mutations identified from the COSMIC database were MET, KMT2D, KMT2C, ARID1A, and SPEN. PRCC affects male individuals in the sixth decade of life. Increased age, Black race, distant metastases, and tumors > 10 cm are associated with a worse prognosis. Surgical resection offers a favorable survival outcome. Next-generation sequencing (NGS) could identify potentially targetable alterations and future personalized therapeutic approaches

Intuition in Nursing Practice

Intuition is a rapid and unconscious source of knowledge. Its use has been documented in several fields since a long time. Although nurses use intuition in most of the nursing interventions and particularly while making clinical decisions, intuition is undervalued in comparison to evidence-based nursing. The purpose of this thesis is to introduce intuition and discuss its importance in nursing education, clinical practice and patient care, most importantly decision making. Furthermore, the thesis also emphasizes that intuition is equally important in healthcare as research-based nursing and the use of intuition should be encouraged in nursing. About 50 research articles from 2000AD-2017AD were reviewed and 9 articles were analyzed for this literature review. The databases used were: Mastofinna, CINAHL (Cumulative Index of Nursing and Allied Health Literature), SciELO, academic search elite EBSCO, PubMed and Google Scholar. Recommended areas for further study in the topic could be intuition in the context of Finnish healthcare, its relationship with cognitive processes, validating its use and finding ways to promote intuition-based nursing.Intuition on nopea ja tajuton tietolähde. Sen käyttöä on dokumentoitu useilla aloilla pitkään aikaan. Vaikka hoitajat käyttävät intuitiota useimmissa hoitotyötoimissa ja etenkin kun tehdään kliinisiä päätöksiä, intuitiota on aliarvostettu verrattuna näyttöön perustuvaan hoitotyöhön. Tämän opinnäytetyön tarkoituksena on esitellä intuitiota ja keskustella sen merkityksestä hoitotyön, kliinisen käytännön ja potilaan hoidon kannalta, mikä tärkeintä on päätöksenteko. Lisäksi opinnäytetyössä korostetaan, että intuitio on yhtä tärkeä terveydenhuollossa kuin tutkimukseen perustuva hoitotyö ja intuition käyttöä olisi kannustettava hoitotyössä. Noin 50 tutkimusartikkeleita tarkasteltiin josta 9 artikkelia analysoitiin tämän kirjallisuuskatsauksen osalta. Käytettyjä tietokantoja olivat: Mastofinna, CINAHL , SciELO, EBSCO, PubMed ja Google Scholar. Suositellut alueet jatko opintoihin aihealueella saattavat olla intuitiota suomalaisen terveydenhuollon yhteydessä, sen suhde kognitiivisiin prosesseihin, sen käytön validointi ja keinot löytää intuitioon perustuvaa hoitotyötä

Study of Serum Uric Acid Level in Acute Coronary Syndrome in Nepalese Subjects

At present, cardiovascular diseases are global health problems responsible for 17.3 million deaths per year and adding extra burden in developing countries like Nepal. Studies show that serum uric acid (SUA) can result in endothelial dysfunction which can lead to vascular disease like stroke. In this study, we determined serum uric acid levels in patients with acute coronary syndrome (ACS) and assess its risk factors. A cross sectional study was conducted in 82 patients with ACS who fulfilled the inclusion criteria included in the study and their serum uric acid level were investigated. It was found that 51 (62.2%) were males and 31 (37.8%) were females. Mean age in study population was 60.26 ± 11.34 years. Majority of the population belongs to 56-65 years age group. The mean uric acid level of our study population was 6.03 ± 1.50 mg/dl (male = 5.92 ± 1.72, female = 6.64 ± 1.53). SUA ? 7 mg/dl was maximum in 56-65 years age group and there was no association between age and SUA (P value = 0.146). Over half of the study population were hypertensive i.e. 42 (51.21%) and smoker i.e. 43 (52.43%). It showed association between SUA and ACS (P value = 0.003). Among those having diabetes, maximum have SUA ? 7 mg/dl i.e. 17 (47.22%). Among those having high cholesterol level, male have higher incidence than female with no association between T. Cholesterol and gender (P value = 0.49). The mean value of T. Cholesterol was 189.83 ± 46.81 mg/dl (male = 198.78 ± 55.19 mg/dl, female = 202.30 ± 54.92 mg/dl) with (P value = 0.52). In conclusion, the mean age of ACS patients was 60.26 years, with the peak incidence at the age of 56-65 years. The ACS had male predominance. The potential risk factors of ACS were: Age >56 years (65.83%), male sex (62.2%), dyslipidemia (35.36%, hypertension (51.2%), diabetes mellitus (43.9%), smoking (52.4%) and alcohol consumption (39%). Among these SUA significantly associated with risk factors were- Sex, Diabetes Mellitus, T. Cholesterol. There was association between serum uric acid level and ACS patients. Hypertension and smoking constitutes one of the major risk factor for ACS in study population

Trend of Antimicrobial Use in Food-Producing Animals from 2018 to 2020 in Nepal

Antimicrobial resistance is a global public health problem and is primarily driven by the widespread overuse of antibiotics. However, antimicrobial use data in animals are not readily available due to the absence of a national database in many developing countries, including Nepal. This study was conducted to estimate the quantities of antimicrobials available in Nepal as an indicator of their use in food-producing animals between 2018 and 2020. Data were collected through surveys targeting major stakeholders: (i) the Department of Drug Administration (DDA), the Government of Nepal (GoN) for the authorized antimicrobials for veterinary use in Nepal, (ii) veterinary pharmaceuticals for antimicrobials produced in Nepal, (iii) the DDA and Veterinary Importers Association for antimicrobials bought by veterinary drug importers, and (iv) the Department of Customs, GoN, for antibiotics sourced through customs. Data showed that in the 3 years, a total of 96 trade names, comprising 35 genera of antibiotics representing 10 classes, were either produced or imported in Nepal. In total, 91,088 kg, 47,694 kg, and 45,671 kg of active ingredients of antimicrobials were available in 2018, 2019, and 2020, respectively. None of the antibiotics were intended for growth promotion, but were primarily for therapeutic purposes. Oxytetracycline, tilmicosin, and sulfadimidine were among the most-used antibiotics in Nepal in 2020. Oxytetracycline was primarily intended for parenteral application, whereas tilmicosin was solely for oral use. Sulfadimidine was available for oral use, except for a small proportion for injection purposes. Aminoglycosides, fluroquinolones, nitrofurans, sulfonamides, and tetracyclines were mostly produced locally, whereas cephalosporins, macrolides and “other” classes of antimicrobials were imported. Amphenicols and penicillins were exclusively imported and nitrofurans were produced locally only. In general, except for tetracyclines, the volume of antimicrobials produced locally and/or imported in 2020 was lower than that in 2018, which corresponded to a decreasing trend in total antimicrobials available. Furthermore, the subsequent years have seen a decrease in the use of critically important antibiotics, particularly class I antibiotics. Finally, this study has firstly established a benchmark for future monitoring of antimicrobial usage in food-producing animals in Nepal. These data are useful for risk analysis, planning, interpreting resistance surveillance data, and evaluating the effectiveness of prudent use, efforts, and mitigation strategies

Drug Act 1978 of Nepal: A Critical Analysis

Background: With the enactment of the Drug Act in 1978, through the establishment of different bodies under the act, drug-related activities have been regulated and controlled in Nepal so as to provide safe and efficacious drugs of standard quality to the general public.  However, with the overgrowing use of drugs, cosmetics, biotechnological products, nutraceuticals, and veterinary products in the present market and the present act failing to include these aspects, this paper tries to critically analyze the Drug Act 1978 of Nepal which will comprise strengths, weaknesses, opportunities, and threats faced in current scenario regarding the act. The regulation of drugs in Nepal was started with the enactment of the Drugs Act in 1978 AD, which is being carried out by the Department of Drug Administration as provisioned in the section 5 of the act. To facilitate the proper implementation of the act, various rules, regulations and guidelines are framed. The objective of this study was to explore the areas to improve in the Drugs Act and help foster the use of safe, efficacious and quality drugs. Method: The Drugs Act 1978 was critically analyzed focusing on the strengths, weaknesses, opportunities, and threats of the act as of current scenario. Result: After critically analyzing the drugs act 1978 we found out that there is lack in regulations of use of cosmetics, newer biotechnology products, nutraceuticals, veterinary product, innovative pharmaceutical products as well as the online pharmacy services. Conclusion: A major amendment and periodic revision is required with the consequence of meeting timely needs and promoting the idea of safety and efficacy in drug related activities

Trace level monitoring of Cu(II) ion using CuS particles based membrane electrochemical sensor

Cu(II) monitoring is a matter of great interest to researchers due to its toxicity and adverse environmental effects. Among different methods for detecting Cu(II), ion-selective electrode (ISE) is more advantageous as they are low-cost, easy to fabricate, and highly selective. Here, we report a simple, inexpensive, and reproducible procedure for the fabrication of Cu(II) ion-selective electrodes using CuS particles and polyvinyl chloride (PVC) as a matrix. CuS particles, obtained by chemical precipitation, were characterized using X-ray diffraction (XRD), Fourier-transform infrared (FTIR) spectroscopy, ultraviolet-visible spectroscopy (UV-Vis), scanning electron microscopy (SEM), and energy-dispersive X-Ray spectroscopy (EDX). Optimization of the membrane compositions was done to get a well-behaved sensor by varying amounts of CuS, PVC, and acetophenone (AP). A membrane composition of 0.4 g CuS, 0.5 g PVC, and 1.0 mL AP in 5.0 mL tetrahydrofuran (THF) gave a Nernstian slope of 27.31 mV per decade change of Cu(II) ion over a wide range of concentration down to 64 ppb (1 × 10−6 M). The sensor gave a fast response time of 25 s, and it indicated the endpoint in a potentiometric titration of Cu(II) with standard EDTA solution. A pH-independent potential response was obtained in the pH 4.0–6.0