Cultural heritage and community engagement : exploring participatory approaches in Nepal

Community engagement in Cultural Heritage Management is not a popular practice in Nepal. However, recent political transformations that emphasize inclusive participation in development projects have started to allow local communities to enter into the heritage management process. Within this new relationship, there appear to be two key concerns for local communities: the distribution of revenue generated from heritage; and an ability to participate more fully in the design and management of such enterprises. Using semi-structured interviews with community stakeholders and heritage management authorities at two case study sites in Kathmandu – Boudhanath Stupa and Rani-Pokhari – this research aims to explore whether or not decentralized grassroots engagements with cultural heritage in Nepal provides a more effective and sustainable management strategy. This research is an evaluative study of contemporary policy on cultural heritage management in Kathmandu, and ultimately aims to contribute to heritage debates by offering a new perspective on community engagement specific to the post-disaster, post-development Nepalese context

Infectious sources of Histoplasmosis and molecular techniques for its identification

Histoplasmosis, a fungal infection caused by Histoplasma capsulatum (H. capsulatum), acquired from contaminated soil with droppings of chicken or birds and found to be distributed in many parts of the world. The prevalence of histoplasmosis has not well studied in Nepal. The common symptoms of acute and epidemic histoplasmosis include high fever, cough, and asthenia and weight loss. Most of the infections associated with histoplasmosis are asymptomatic. People with compromised immune systems such as HIV/AIDS (PLWHA), cancer, and organ transplant recipients are at risk of developing this disease. In this review, we have summarised the current status of histoplasmosis in Nepal and molecular techniques available for its identification. To date, the significant outbreak is not reported in Nepal, but the risk of infection for the vulnerable population cannot be undermined. Appropriate preventive measures and treatment on time can reduce the burden of this fungal disease. Further, this review is also focused on molecular identification of H. capsulatum. Hence, careful considerations by concerned stakeholders for national surveillance programs and the treatment of patients on time after proper diagnosis is highly recommended

Evaluation of Phytochemical, Antioxidant and Antibacterial Activities of Selected Medicinal Plants

Medicinal plants are important reservoirs of bioactive compounds that need to be explored systematically. Because of their chemical diversity, natural products provide limitless possibilities for new drug discovery. This study aimed to investigate the biochemical properties of crude extracts from fifteen Nepalese medicinal plants. The total phenolic contents (TPC), total flavonoid contents (TFC), and antioxidant activity were evaluated through a colorimetric approach while the antibacterial activities were studied through the measurement of the zone of inhibition (ZoI) by agar well diffusion method along with minimum inhibitory concentrations (MIC) by broth dilution method. The methanolic extracts of Acacia catechu and Eupoterium adenophorum showed the highest TPC (55.21 ± 11.09 mg GAE/gm) and TFC (10.23 ± 1.07 mg QE/gm) among the studied plant extracts. Acacia catechu showed effective antioxidant properties with an IC50 value of 1.3 μg/mL, followed by extracts of Myrica esculenta, Syzygium cumini, and Mangifera indica. Morus australis exhibited antibacterial activity against Klebsiella pneumoniae (ZoI: 25mm, MIC: 0.012 mg/mL), Staphylococcus aureus ATCC 25923 (ZoI: 22 mm, MIC: 0.012 mg/mL), Pseudomonas aeruginosa (ZoI; 20 mm, MIC: 0.05 mg/mL), and methicillin-resistant Staphylococcus aureus (MRSA) (ZoI: 19 mm, MIC: 0.19 mg/mL). Morus australis extract showed a broad-spectrum antibacterial activity, followed by Eclipta prostrata, and Hypericum cordifolium. Future study is recommended to explore secondary metabolites of those medicinal plants to uncover further clinical efficacy

Digital learning Initiatives, Challenges and Achievement in Higher Education in Nepal Amidst COVID-19

The COVID-19 pandemic has affected higher education institutions (HEIs) worldwide and reshaped the existing educational system. Due to travel constraints and physical separation, there has been a global shift toward distance learning, and Nepal is no exception. This research intends to assess the practicality of online education by evaluating learners' experiences amidst COVID-19. A cross-sectional study was directed among HEIs students in Nepal using self-structured questionnaires. Our study revealed that 64.6% of the respondents were unsatisfied with online classes. More than half of the respondents (53.4%) use cell phones for online studies. Online education was reported to be unappealing to 28.8% of respondents. Variables such as age group (p = 0.05), enjoying class (p < 0.001), hours spent for an online class in a day (p = 0.05), and period for educational work using an electronic device (p = 0.1) were found significant with satisfaction level using both bivariate test and inferential test of univariate binary logistics regression. The challenges and opportunities encountered among students and faculties are highlighted along with the recommendations for fortifying communication in online-based teaching/learning

Biochemical, Antimicrobial, and Antioxidant activities of some wild Mushrooms from Nepal

Wild mushrooms represent a crucial dietary staple for many tribal groups throughout the world since they consist of a significant source of bioactive constituents such as phenolic compounds, tocopherol, and act as anti-cancer, anti-allergic, anti-obesity, anti-inflammatory compounds, etc. Wild mushrooms including Scleroderma citrinum, Heterobasidion annosum, Coriolus hirsutus, Cavimalum indicum, Russula sanguinea, and Suillus punctatipes were studied to evaluate their phytochemical constituents, antimicrobial activity, antioxidant activity, toxicity and its importance as a source of food along with safety concerns. Initially, the total flavonoid content (TFC), total phenolic content (TPC), and total tannin content (TTC) along with antioxidant, and antimicrobial activity were assessed using ethanolic extracts of fungus. Furthermore, a Brine shrimp bioassay was performed, the correlation of which with antioxidant activity, TPC, TFC, TTC, and lethal concentration (LC50) value was shown by principal component analysis (PCA). Secondary metabolites like glucosides, flavonoids, polyphenols, alkaloids, terpenoids, saponins, and quinones were identified using phytochemical investigations. The TPC ranged from 45.98 to 102.3 mg GAE/g for the extracts, TFC from 100 to 225 mg QE/g, and the TTC was found to vary between 80 to 180 mg GAE/g. The findings of the antioxidant studies demonstrated that S. punctatipes exhibited the highest antioxidant activity (IC50 = 16.95 µg/mL), followed by C. indicum (IC50 = 22.5 µg/mL), and C. hirsutus (IC50 = 35.34 µg/mL). Likewise, S. punctatipes exhibited strong antimicrobial activity as compared to other extracts. The larvicidal efficacy against brine shrimp tests revealed that three mushrooms; C. hirsutus, C. indicum, and S. punctatipes—contain highly toxic substances while the other three are non-toxic and when properly examined can be consumed to some extent

Acute milk-alkali syndrome

A 74-year-old woman presented with progressive lethargy, confusion, poor appetite and abdominal pain. She was found to have non-PTH-mediated severe hypercalcemia with renal failure and metabolic alkalosis. Extensive workup for hypercalcemia to rule out alternate etiology was unrevealing. Upon further questioning, she was taking excess calcium carbonate (Tums) for her worsening heartburn. She was diagnosed with milk-alkali syndrome (MAS). Her hypercalcemia and alkalosis recovered completely with aggressive hydration along with improvement in her renal function. High index of suspicion should be maintained and history of drug and supplements, especially calcium ingestion, should be routinely asked in patients presenting with hypercalcemia to timely diagnose MAS and prevent unnecessary tests and treatments

In vitro Antileishmanial and Antimalarial Activity of Selected Plants of Nepal

Ethnopharmacological relevance: Nepal is rich in biodiversity and no extensive effort has yet been carried out to screen plants that are used by traditional healers against parasitic diseases. The aim of this study was to evaluate the in vitro antileishmanial and antimalarial activity of crude methanolic or ethanolic extracts of 30 selected plant species. Materials and methods: Crude extracts of leaves, twigs, aerial parts and/or roots were evaluated for in vitro inhibitory activity against intracellular amastigotes of Leishmania infantum and against erythrocytic stages of Plasmodium falciparum. To determine the selectivity index (SI), cytotoxicity was assessed on MRC5 cells in parallel. Results: Three plant species revealed antiprotozoal activity, namely Phragmites vallatoria, Ampelocissus tomentosa for which no antiprotozoal activity has previously been reported, and Terminalia chebula. The extract of A. tomentosa exhibited moderate activity against L. infantum with an IC50 of 13.2 ± 4.3 µg/ml and SI >3 while T. chebula exhibited fairly good antiplasmodial activity with IC50 values of 4.5 ± 2.4 µg/ml and SI values >5. Conclusion: In countries like Nepal where the current health system is unable to combat the burden of endemic parasitic diseases, evaluation of local plants as a potential source of drug will help in expanding the treatment options. The extent of untapped resources available in these countries provides an opportunity for future bioprospecting. Keywords: Leishmania, Plasmodium, crude plant extracts, in vitro, Nepal [J Complement Med Res 2016; 5(4.000): 383-389

Statin-Induced Necrotizing Autoimmune Myopathy: An Extremely Rare Side Effect from Statin Use

Case Presentation: A 71-year-old-male presented with recurrent falls due to extreme bilateral lower extremity weakness following revision surgery for infected right knee prosthesis. He denied any pain or sensory changes in his extremities. He denied fever, chills, rash, joint pain, recent infection or medication changes. He had history of coronary artery disease, diabetes mellitus and hyperlipidemia. He was taking atorvastatin 80 mg daily for over ten years. Physical exam revealed significant muscle wasting on right deltoid with decreased power in proximal muscles of all extremities and areflexia in bilateral lower extremities. Systemic examination was otherwise unremarkable. Pertinent labs included elevated creatinine kinase (CK: 3334IU/L; Ref: 30-223 IU/L), aldolase, sedimentation rate, CRP and transaminases. Anti-3-hydroxy-3-methylglutaryl-coenzyme A reductase (anti-HMGCR) antibody was elevated at \u3e200 U (Ref: 0-19 U). TSH, serum protein electrophoresis and rapid plasma reagin were unremarkable. ANA, Anti-Jo-1, anti-Mi2, anti-SRP, anti-ds-DNA, anti-SSA and anti-SSB antibodies were negative. MRI thigh revealed diffuse myositis. Electromyogram was consistent with acute myopathic process. Muscle biopsy showed muscle necrosis and C5b-9 sarcolemmal deposits on non-necrotic fibers without rimmed vacuoles. He was diagnosed with SINAM. Statin was discontinued and he was started on steroid, immunoglobulins and azathioprine. CK decreased to 195 IU/L and muscle weakness improved gradually. Discussion: Statins are widely prescribed medications to prevent cardiovascular events. While self-limited statin myopathy is relatively common, statin-induced necrotizing autoimmune myopathy (SINAM) is extremely uncommon, with incidence of 2 cases per million per year. SINAM is a relatively newly-described statin myotoxicity. Unlike the self-limiting statin myopathy, SINAM is more severe and is associated with significant proximal muscle weakness, markedly elevated CK and persistent symptoms despite statin discontinuation. Anti-HMGCR antibodies are present in 100% cases. Immunosuppressants are the mainstay of treatment and statin rechallenge should never be done in these cases. Conclusions: Although relatively rare, physicians should be cognizant of SINAM and maintain a high index of suspicion in patients on statin presenting with myopathy, as early immunosuppressive therapy can significantly improve clinical outcomes

LC-HRMS-Based Profiling: Antibacterial and Lipase Inhibitory Activities of Some Medicinal Plants for the Remedy of Obesity

Globally, obesity is a serious health concern that causes numerous diseases, including type 2 diabetes, hypertension, cardiovascular diseases, etc. Medicinal plants have been used to aid in weight loss since ancient times. Thus, this research is focused on the exploration of pancreatic lipase inhibitory activity and secondary metabolite profiling of Bergenia ciliata, Mimosa pudica, and Phyllanthus emblica, selected based on an ethnobotanical survey. The lipase inhibition was investigated using 4-nitrophenyl butyrate (p-NPB) as a substrate. To uncover further therapeutic potentials of these medicinal plants, antimicrobial activity and minimum inhibitory concentration (MIC) of the extracts were also determined. The ethyl acetate plant extracts showed higher antimicrobial activity against Staphylococcus aureus, Escherichia coli, Salmonella typhi, and Shigella sonnei. The MIC of ethyl acetate extracts of medicinal plants considered in this study ranges from 1.56 to 6.25 mg/mL. The hexane fraction of Mimosa pudica and Phyllanthus emblica showed a higher lipase inhibitory activity as compared to others, with IC50 values of 0.49 ± 0.02 and 2.45 ± 0.003 mg/mL, respectively. In the case of Bergenia ciliata, the methanolic extract inhibited lipase more effectively than others, with an IC50 value of 1.55 ± 0.02 mg/mL (IC50 value of orlistat was 179.70 ± 3.60 µg/mL). A mass spectrometry analysis of various solvent/solvent partition fractions (extracts) revealed 29 major secondary metabolites. The research offers a multitude of evidence for using medicinal plants as antiobesity and antimicrobial agents