Input properties of four populations of spinocerebellar tract neurons in the cat and the rat thoraco-lumbar spinal cord

The cerebellum receives information from the hindlimbs through several populations of spinocerebellar tract neurons. Although the role of these neurons has been established in electrophysiological experiments, the relative contribution of afferent fibres and central neurons to their input, their organization and mechanisms of control of transmission has only been estimated approximately so far. The present study aimed to investigate the input properties of four populations of spinocerebellar tract neurons: dorsal spinocerebellar tract neurons located in Clarke´s column (ccDSCT) and in the dorsal horn (dhDSCT) and ventral spinocerebellar tract (VSCT) neurons including spinal border (SB) neurons. There were three major aims: (1) to investigate the excitatory inputs to four types of spinocerebellar tract neurons in the cat and rat thoraco-lumbar spinal cord; (2) to analyze the inhibitory inputs to four types of spinocerebellar tract neurons in the cat and rat thoraco-lumbar spinal cord; (3) to determine the origin of excitatory and inhibitory inputs to four types of spinocerebellar tract neurons in the cat and rat thoraco-lumbar spinal cord. Two series of experiments were carried out. In the first series of experiments in cats, spinocerebellar tract neurons were identified electrophysiologically and labelled intracellularly with rhodamine-dextran and Neurobiotin. In the second series of experiments in rats, cells were labelled by retrograde transport of b-subunit of Cholera toxin (CTb) from the cerebellum. In addition, to address the third aim, reticulospinal (RetS) and corticospinal (CS) terminals were identified by anterograde transport of CTb from the caudal medulla and hindlimb sensory motor cortex respectively in rats along with labelling of spinocerebellar tract neurons by retrograde injection of Fluorogold in the cerebellum. Following this, immunohistochemistry was carried out. The first aim was achieved by utilizing the difference in the immunohistochemistry of glutamatergic terminals of peripheral afferents and of central neurons with vesicular glutamate transporters, VGLUT1 or VGLUT2, respectively. All SB neurons with dominating inhibitory input from the periphery possessed very few VGLUT1 contacts and remarkably higher numbers of VGLUT2 contacts. In VSCT neurons with excitatory primary afferent input, the number of VGLUT1 contacts was relatively high although VGLUT2 contacts likewise dominated. In contrast, DSCT neurons were associated with numerous VGLUT1 contacts; ccDSCT neurons with strong input from group I afferents had higher density of VGLUT1 contacts than dhDSCT neurons with major input from group II and cutaneous afferents. In order to fulfill the second aim, quantification of contacts formed by inhibitory axon terminals on spinocerebellar tract neurons along with excitatory terminals was carried out. Inhibitory axon terminals were characterised as either GABAergic, glycinergic or both GABAergic/glycinergic by using antibodies against vesicular GABA transporter (VGAT), glutamic acid decarboxylase (GAD) and gephyrin. Similarly, excitatory terminals were characterised by using combination of VGLUT1 and 2. The comparison revealed the presence of much higher proportions of inhibitory than excitatory contacts on SB neurons but similar proportions were found on VSCT, ccDSCT and dhDSCT neurons. In all types of cell, the majority of inhibitory terminals were glycinergic. The density of contacts was higher on somata and proximal in comparison with distal dendrites of SB and VSCT neurons but more evenly distributed in ccDSCT and dhDSCT neurons. To achieve the third aim, a series of immunohistochemical reactions was performed to characterize contacts that originate from proprioceptors, different types of interneurons and descending RetS and CS pathways. Among the four populations of spinocerebellar tract neurons, ccDSCT neurons had the highest proportion of contacts formed by VGLUT1 terminals double labeled with parvalbumin (PV) which indicated that majority of direct excitatory sensory inputs to ccDSCT neurons are derived from proprioceptors. A small proportion of excitatory and inhibitory contacts on these neurons originated from Calbindin/ Calretinin/ PV expressing neurons. Quantitative analysis revealed that SB and VSCT neurons have significantly higher numbers of appositions from VGLUT2 expressing RetS axon terminals than DSCT neurons. A small proportion of the RetS contacts on these neurons were VGAT positive. In contrast, DSCT neurons had higher numbers of appositions made by CS axon terminals in comparison to SB and VSCT neurons. The present findings provide a new basis for understanding the organization and functional connectivity of four populations of spinocerebellar tract neurons and strengthen previous indications of their functional differentiation. SB and VSCT neurons principally receive inputs from spinal and supraspinal neurons although direct input from primary afferents is also stronger in VSCT neurons. DSCT neurons have major direct input from primary afferents and also to some extent from the CS pathway but monosynaptic inputs from proprioceptors dominated in ccDSCT neurons and dhDSCT neurons have mixed proprioceptive and low threshold cutaneous afferent input

Self-medication in Primary Dysmenorrhea among Undergraduate Students in a Medical College: A Descriptive Cross-sectional Study

Introduction: Primary dysmenorrhea is painful menstruation in women with normal pelvic anatomy, usually beginning during adolescence, primarily associated with a normal ovulatory cycle. There is an increased likelihood of self-medication among medical students. The aim of this study is to find out the prevalence of self-medication in primary dysmenorrhea among undergraduate students in a medical college. Methods: A descriptive cross-sectional study was conducted in a medical college among undergraduate female students with primary dysmenorrhea from 1 February 2022 to 31 May 2022. Ethical approval was obtained from the Institutional Review Committee of the same institute (Reference number: 254/2021). Convenience sampling was done. Data were collected through a self-administered questionnaire. Point estimate and 95% Confidence Interval were calculated. Results: Among 213 students with primary dysmenorrhea, self-medication was found to be in 78 (36.62%) (30.15-43.09, 95% Confidence Interval)). Among all the self-medications used, mefenamic acid was most common, used by 45 (57.69%) students, followed by paracetamol 11 (14.10%). Conclusions: The prevalence of self-medication practice in primary dysmenorrhea among undergraduate students was lower when compared to similar studies done in similar settings

A perspective on nanomedicine: focus on cardiovascular medicine

Background: Nanomedicine refers to the application of nanotechnology to improve the diagnosis, monitoring and treatment of diseases. Although the primary application was originally in oncology, nanomedicine has witnessed substantial scientific interest and growth beyond chemotherapeutic drug development. Approach: Despite the widespread prevalence of cardiovascular diseases (CVDs), limitations remain in their clinical management regardless of the major technological advancement in diagnostic and therapeutic modalities available. In the present context, flourishing research in cardiovascular nanomedicine is expected to address the current challenges and bring about much sought for solutions to the identification and management of the progression of CVDs. Practical Implications: As the research portfolio of nanomedicine expands, it can have a significant impact on the management of CVDs, particularly atherosclerosis. Nanotechnology presents an opportunity to address the components of atherosclerotic plaque and enhance the therapeutic approaches to atherogenesis

Neonatal Septicemia in Nepal: Early-Onset versus Late-Onset

Introduction. Neonatal septicemia is defined as infection in the first 28 days of life. Early-onset neonatal septicemia and late-onset neonatal septicemia are defined as illnesses appearing from birth to three days and from four to twenty-eight days postnatally, respectively. Methods. In this cross-sectional study, blood samples from the suspected infants were collected and processed in the bacteriology laboratory. The growth was identified by standard microbiological protocol and the antibiotic sensitivity testing was carried out by modified Kirby-Bauer disk diffusion method. Results. Among total suspected cases, the septicemia was confirmed in 116 (12.6%) neonates. Early-onset septicemia (EOS) was observed in 82 infants and late-onset septicemia (LOS) in 34 infants. Coagulase-negative staphylococcus (CoNS) (46.6%) was the predominant Gram-positive organism isolated from EOS as well as from LOS cases followed by Staphylococcus aureus (14.6%). Acinetobacter species (9.5%) was the predominant Gram-negative organism followed by Klebsiella pneumoniae (7.7%). Conclusions. The result of our study reveals that the CoNS, Staphylococcus aureus, Acinetobacter spp., and Klebsiella pneumoniae are the most common etiological agents of neonatal septicemia. In particular, since rate of CoNS causing sepsis is alarming, prompting concern to curb the excess burden of CoNS infection is necessary

Stakeholder perspectives on the effectiveness of governance in red panda conservation programmes in Nepal: a comparative analysis

This paper investigates the views of multi-stakeholders on the governance quality of existing forest management strategies for red panda (Ailurus fulgens) protection in Nepal, focusing on forest governance in general, red panda conservation programmes and natural habitat protection in particular. The study deployed two surveys in August and September 2020. The first survey was conducted online for the stakeholders with internet access; for those without, it was conducted over the phone. While the results reveal almost similar perspectives among the stakeholders regarding the effectiveness of the red panda management approaches, they differ significantly between the online survey and telephonic survey, in terms of the relative scores given to these initiatives. In depth, follow-up interviews revealed that marginalised groups had little access to income generation from conservation activities and few capacity-building opportunities. These findings indicate that while management strategies for red panda conservation were generally considered effective by online survey participants which are generally more privileged, this is less effective for marginalised people. Local people, who are typically resource-poor and reliant on the forest, continue to endure inequitable resource distribution and benefit sharing. Consequently, greater attention should be paid to balancing the conservation needs and basic needs of forest-dependent communities through capacity building, income generation and alternative sources of livelihood

Childhood Septicemia in Nepal: Documenting the Bacterial Etiology and Its Susceptibility to Antibiotics

Introduction. Children are among the most vulnerable population groups to contract illnesses. The varying microbiological pattern of septicemia warrants the need for an ongoing review of the causative organisms and their antimicrobial susceptibility pattern. Therefore, the objective of this study was to document the bacterial etiology of childhood septicemia and its antibiotic susceptibility profile. Methods. Cross-sectional type of study in 1630 suspected patients was conducted at CMCTH from January 2012 to December 2013. Blood samples were collected aseptically for culture. The organisms grown were identified by standard microbiological methods recommended by American Society for Microbiology (ASM) and subjected to antibiotic susceptibility testing by modified Kirby-Bauer disk diffusion method. Methicillin resistance was confirmed using cefoxitin and oxacillin disks methods. Results. Septicemia was detected in 172 (10.6%) cases. Among Gram-positive organisms, coagulase negative staphylococci (CoNS) were leading pathogen and Acinetobacter spp. were leading pathogen among Gram-negative isolates. Vancomycin, teicoplanin, and clindamycin were the most effective antibiotics against Gram-positive isolates while amikacin was effective against Gram-positive as well as Gram-negative isolates. Methicillin resistance was detected in 44.4% of Staphylococcus aureus. Conclusions. This study has highlighted the burden of bacterial etiology for septicemia among children in a tertiary care center of central Nepal

Feasibility of implementing public-private mix approach for tuberculosis case management in Pokhara Metropolitan City of western Nepal: a qualitative study

BackgroundThe Public-Private Mix (PPM) approach is a strategic initiative that involves engaging all private and public health care providers in the fight against tuberculosis using international health care standards. For tuberculosis control in Nepal, the PPM approach could be a milestone. This study aimed to explore the barriers to a public-private mix approach in the management of tuberculosis cases in Nepal.MethodsWe conducted key informant interviews with 20 participants, 14 of whom were from private clinics, polyclinics, and hospitals where the PPM approach was used, two from government hospitals, and four from policymakers. All data were audio-recorded, transcribed, and translated into English. The transcripts of the interviews were manually organized, and themes were generated and categorized into 1. TB case detection, 2. patient-related barriers, and 3. health-system-related barriers.ResultsA total of 20 respondents participated in the study. Barriers to PPM were identified into following three themes: (1) Obstacles related to TB case detection, (2) Obstacles related to patients, and (3) Obstacles related to health-care system. PPM implementation was challenged by following sub-themes that included staff turnover, low private sector participation in workshops, a lack of trainings, poor recording and reporting, insufficient joint monitoring and supervision, poor financial benefit, lack of coordination and collaboration, and non-supportive TB-related policies and strategies.ConclusionGovernment stakeholders can significantly benefit by applying a proactive role working with the private in monitoring and supervision. The joint efforts with private sector can then enable all stakeholders to follow the government policy, practice and protocols in case finding, holding and other preventive approaches. Future research are essential in exploring how PPM could be optimized