Ebola Hemorrhagic Fever: Recent Update On Disease Status, Current Therapies And Advances In Treatment

Swiftly growing viruses are a major intimidation to human health. Such viruses are extremely pathogenic like Ebola virus, influenza virus, HIV virus, Zika virus etc . Ebola virus, a type of Filovirus, is an extremely infectious, single-stranded ribonucleic acid virus that infects both humans and apes, prompting acute fever with hemorrhagic syndrome. The high infectivity, severity and mortality of Ebola has plagued the world for the past fifty years with its first outbreak in 1976 in Marburg, Germany, and Frankfurt along with Belgrade and Serbia. The world has perceived about 28,000 cases and over 11,000 losses. The high lethality of Ebola makes it a candidate for use in bioterrorism thereby arising more concern. New guidelines have been framed for providing best possible care to the patients suffering from Ebola virus i.e Grading of Recommendation Assessment, Development And Evaluation (GRADE) methodology to develop evidence-based strategy for the treatment in future outbreak of Ebola virus. No drugs have been approved, while many potent drugs like rVSV-EBOV, Favipiravir, ZMapp are on clinical test for human safety. In this review we will discover and discuss perspective aspects that lead to the evolution of different Ebola variants as well as advances in various drugs and vaccines for treatment of the disease

ENERGY USE EFFICIENCY (EUE) FOR HYBRID MAIZE UNDER DIFFERENT TILLAGE SYSTEMS AND PLANT DENSITY IN CHITWAN, NEPAL

To assess energy use efficiency of hybrids maize as influenced by tillage methods and plant density. A field experiment was carried out at research field of National Maize Research Program (NMRP), Rampur, Chitwan, Nepal during winter season of 2015/16. The experiment was laid out in strip-split plot design comprising two hybrids as horizontal factor (Rampur hybrid 4 and Rampur hybrid 6), two tillage methods as vertical factors (zero and conventional tillage) and four plant populations as sub-sub plot factors (55,555, 69,444, 85,470 and 1,01,010 plants ha-1). Zero tillage recorded significantly higher energy output and net energy balance (238.98 and 217.48 MJ ha-1) as compared to conventional tillage (193.65 and 172.22 MJ ha-1, respectively). Similarly, the plant population of 85 thousand plants ha-1 recorded significantly higher energy output and net energy balance (233.98 and 212.45 thousand MJ ha-1) than 55 (184.10 and 162.87 thousand MJ ha-1) but remained at par with 69 (206.63 and 185.24 thousand MJ ha-1) and 101 thousand plants ha-1 (240.55 and 218.83 thousand MJ ha-1).To assess energy use efficiency of hybrids maize as influenced by tillage methods and plant density. A field experiment was carried out at research field of National Maize Research Program (NMRP), Rampur, Chitwan, Nepal during winter season of 2015/16. The experiment was laid out in strip-split plot design comprising two hybrids as horizontal factor (Rampur hybrid 4 and Rampur hybrid 6), two tillage methods as vertical factors (zero and conventional tillage) and four plant populations as sub-sub plot factors (55,555, 69,444, 85,470 and 1,01,010 plants ha-1). Zero tillage recorded significantly higher energy output and net energy balance (238.98 and 217.48 MJ ha-1) as compared to conventional tillage (193.65 and 172.22 MJ ha-1, respectively). Similarly, the plant population of 85 thousand plants ha-1 recorded significantly higher energy output and net energy balance (233.98 and 212.45 thousand MJ ha-1) than 55 (184.10 and 162.87 thousand MJ ha-1) but remained at par with 69 (206.63 and 185.24 thousand MJ ha-1) and 101 thousand plants ha-1 (240.55 and 218.83 thousand MJ ha-1)

Assessing the prospects of transboundary multihazard dynamics:The case of Bhotekoshi—Sunkoshi watershed in Sino—Nepal border region

The impacts of multihazards have become more pronounced over the past few decades globally. Multiple hazards and their cascading impacts claim enormous losses of lives, livelihoods, and built environment. This paradigm prompts integrated and multidisciplinary perspectives to identify, characterize, and assess the occurrence of multihazards and subsequently design counter-measures considering impending multihazard scenarios at the local level. To this end, we considered one of the most egregious transboundary watersheds, which is regarded as a multihazard hotspot of Nepal, to analyze the underlying causes and cascade scenarios of multihazards, and their associated impacts. In this paper, geophysical, hydrometeorological, and socioeconomic perspectives are formulated to characterize the watershed from the dimension of susceptibility to multihaz-ard occurrence. To characterize the complex dynamics of transboundary multihazard occurrence, insights have been presented from both the Nepali and the Chinese sides. Individual case studies and the interrelation matrix between various natural hazards are also presented so as to depict mul-tihazard consequences in the transboundary region. The sum of the observations highlights that the watershed is highly vulnerable to a single as well as multiple natural hazards that often switch to disasters

The durability of long-lasting insecticidal nets distributed to the households between 2009 and 2013 in Nepal

Background: Understanding and improving the durability of long-lasting insecticidal nets (LLINs) in the field are critical for planning future implementation strategies including behavioral change for care and maintenance. LLIN distribution at high coverage is considered to be one of the adjunctive transmission reduction strategies in Nepal’s Malaria Strategic Plan 2014–2025. The main objective of this study was to assess the durability through assessment of community usage, physical integrity, residual bio-efficacy, and chemical retention in LLINs: Interceptor®, Yorkool®, and PermaNet ®2.0 which were used in Nepal during 2009 through 2013. Methods: Assessments were conducted on random samples (n = 440) of LLINs from the eleven districts representing four ecological zones: Terai plain region (Kailali and Kanchanpur districts), outer Terai fluvial ecosystem (Surkhet, Dang, and Rupandhei districts), inner Terai forest ecosystem (Mahhothari, Dhanusa, and Illam districts), and Hills and river valley (Kavrepalanchock and Sindhupalchok districts). For each LLIN, fabric integrity in terms of proportionate hole index (pHI) and residual bio-efficacy were assessed. However, for chemical retention, a representative sample of 44 nets (15 Yorkool®, 10 Permanet®2.0, and 19 Interceptor®) was evaluated. Data were analyzed using descriptive statistics stratified by LLINs brand, districts, and duration of exposure. Results: On average, duration of use of LLINs was shortest for the Yorkool® samples, followed by PermaNet® 2.0 and Interceptor® with median ages of 8.9 (IQR = 0.4), 23.8 (IQR = 3.2), and 50.1 (IQR = 3.2) months, respectively. Over 80% of field distributed Yorkool® and PermaNet® 2.0 nets were in good condition (pHI< 25) compared to Interceptor® (66%). Bio-efficacy analysis showed that average mortality rates of Interceptor and Yorkool were below World Health Organization (WHO) optimal effectiveness of ≥ 80% compared to 2-year-old PermaNet 2.0 which attained 80%. Chemical retention analysis was consistent with bio-efficacy results. Conclusion: This study shows that distribution of LLINs is effective for malaria control; however, serviceable life of LLINs should be considered in terms of waning residual bio-efficacy that warrants replacement. As an adjunctive malaria control tool, National Malaria Control Program of Nepal can benefit by renewing the distribution of LLINs in an appropriate time frame in addition to utilizing durable and effective LLINs

Multi-Hazard Risk Assessment of Kathmandu Valley, Nepal

Natural hazards are complex phenomena that can occur independently, simultaneously, or in a series as cascading events. For any particular region, numerous single hazard maps may not necessarily provide all information regarding impending hazards to the stakeholders for preparedness and planning. A multi-hazard map furnishes composite illustration of the natural hazards of varying magnitude, frequency, and spatial distribution. Thus, multi-hazard risk assessment is performed to depict the holistic natural hazards scenario of any particular region. To the best of the authors’ knowledge, multi-hazard risk assessments are rarely conducted in Nepal although multiple natural hazards strike the country almost every year. In this study, floods, landslides, earthquakes, and urban fire hazards are used to assess multi-hazard risk in Kathmandu Valley, Nepal, using the Analytical Hierarchy Process (AHP), which is then integrated with the Geographical Information System (GIS). First, flood, landslide, earthquake, and urban fire hazard assessments are performed individually and then superimposed to obtain multi-hazard risk. Multi-hazard risk assessment of Kathmandu Valley is performed by pair-wise comparison of the four natural hazards. The sum of observations concludes that densely populated areas, old settlements, and the central valley have high to very high level of multi-hazard risk

Unzipping flood vulnerability and functionality loss:tale of struggle for existence of riparian buildings

Floods pose significant risk to riparian buildings as evidenced during many historical events. Although structural resilience to tsunami flooding is well studied in the literature, high-velocity and debris-laden floods in steep terrains are not considered adequately so far. Historical floods in steep terrains necessitate the need for flood vulnerability analysis of buildings. To this end, we report vulnerability of riparian-reinforced concrete buildings using forensic damage interpretations and empirical/analytical vulnerability analyses. Furthermore, we propose the concept and implications of functionality loss due to flooding in residential reinforced concrete (RC) buildings using empirical data. Fragility functions using inundation depth and momentum flux are presented for RC buildings considering a recent flooding event in Nepal. The results show that flow velocity and sediment load, rather than hydrostatic load, govern the damages in riparian RC buildings. However, at larger inundation depth, hydrostatic force alone may collapse some of the RC buildings

Antioxidant Properties of Honey from Different Altitudes of Nepal Himalayas

Twenty two multifloral honey samples representing central western parts of Nepal were examined spectrophotometrically for their antioxidant properties and total phenol content. The modified Folin-Ciocalteu method was used to determine total phenol content and 2,2-diphenyl-1-picrylhydrazyl radicals (DPPH•) assay for antiradical activity. In all samples, physicochemical parameters like moisture, reducing sugar, sucrose, ash, free acidity and water insoluble matter were also measured according to harmonized methods of the International Honey Commission (IHC). The results of physicochemical analysis showed that all the values, except for moisture of a small number of high altitude honey samples, are in good agreement with the current Nepalese standard. The total phenolic contents of honey, collected from high and low altitude, ranged from 154.87 to 41.90 mg gallic acid equivalent (GAE/100 g) respectively, at corresponding antiradical activity using DPPH• expressed as percent inhibition of 76.66% and 25.69%. The IC50 values of selected high altitude honey samples ranged from 56 to 72 mg/mL. The total antioxidant properties were correlated (P<0.01) between total phenol content and antiradical activity (r=0.992). The obtained results demonstrate that the Nepalese honey collected from high altitude region contained more antioxidants than honey of low altitude region

Genotypically Confirmed Vancomycin-Resistant With Gene Among Clinical Isolates in Kathmandu

Purpose: Methicillin-resistant Staphylococcus aureus , a common bacterial pathogen causes various infections. The acquisition of various antimicrobial-resistant genes in S. aureus has led to the transformation of this bacterium into a superbug. Vancomycin resistance among MRSA isolates is an emerging threat in empirical therapy of various infections. The study was hence aimed to find out the susceptibility status of S. aureus isolates toward vancomycin and detect mecA, vanA , and vanB genes among the isolates. Methods: A total of 1245 clinical samples from the participants attending a tertiary care hospital in Kathmandu were processed. S. aureus isolated from the samples were subjected to antibiotic susceptibility patterns using the modified Kirby-Bauer disk diffusion method. Agar dilution method was used to determine the minimum inhibitory concentration of vancomycin. The antibiotic-resistant genes such as mecA, vanA , and vanB among S. aureus isolates were screened by a conventional polymerase chain reaction. Results: Of 1245 samples, 80 S. aureus were identified. Out of which, 47.5% (38/80) were phenotypically confirmed MRSA isolates. mec A gene was detected in 84.2% (32/38) of MRSA isolates. 10.5% (4/38) were confirmed as vancomycin-intermediate S. aureus (VISA) by MIC determination. None of the isolates was positive for the vanA gene; however, 2 isolates were found to possess the vanB gene. The 2 isolates have vancomycin MIC breakpoints of 4 to 8 μg/mL. Conclusion: There might be a spreading of vancomycin resistance among S. aureus , creating serious public health problems. Therefore, measures to limit vancomycin resistance should be considered in healthcare facilities as immediately as possible

Multidrug-resistant bacteria with ESBL genes: a growing threat among people living with HIV/AIDS in Nepal

BACKGROUND: Bacterial opportunistic infections are common in people living with HIV/AIDS (PLHA). Besides HIV-TB co-infection, lower respiratory tract infections (LRTIs) due to multidrug-resistant (MDR) bacteria cause significant morbidity and mortality among PLHA. This study identified bacterial co-infection of the lower respiratory tract and detected plasmid-mediated blaTEM and blaCTX-M genes among Extended-Spectrum β-Lactamase (ESBL) producing isolates from sputum samples in PLHA. METHODS: A total of 263 PLHA with LRTIs were enrolled in this study, out of which, 50 were smokers, 70 had previous pulmonary tuberculosis, and 21 had CD4 count &lt; 200 cells/µl. Sputum samples collected from PLHA were processed with standard microbiological methods to identify the possible bacterial pathogens. The identified bacterial isolates were assessed for antibiotic susceptibility pattern using modified Kirby Bauer disk diffusion method following Clinical Laboratory Standard Institute (CLSI) guidelines. In addition, plasmid DNA was extracted from MDR and ESBL producers for screening of ESBL genes; blaCTX-M and blaTEM by conventional PCR method using specific primers. RESULTS: Of 263 sputum samples, 67 (25.48%) showed bacterial growth. Among different bacterial pathogens, Klebsiella pneumoniae, (17; 25.37%) was the most predominant, followed by Haemophillus influenzae, (14; 20.90%) and Escherichia coli, (12; 17.91%). A higher infection rate (4/8; 50%) was observed among people aged 61–70 years, whereas no infection was observed below 20 years. About 30.0% (15/50) of smokers, 32.86% (23/70) cases with previous pulmonary tuberculosis, and 52.38% (11/21) with CD4 count &lt; 200 cells/µl had bacterial LRTIs. Among 53 bacterial isolates excluding H. influenzae, 28 isolates were MDR and 23 were ESBL producers. All ESBL producers were sensitive to colistin and polymyxin B. Among ESBL producers, 47.83% (11/23) possessed blaCTX-M, 8.6% (2/23) were positive for blaTEM gene, and 43.48% (10/23) possessed both ESBL genes. CONCLUSION: The increasing rate of MDR bacterial infections, mainly ESBL producers of LRTIs causes difficulty in disease management, leading to high morbidity and mortality of PLHA. Hence, it is crucial to know the antibiogram pattern of the isolates to recommend effective antimicrobial therapy to treat LRTIs in PLHA

Antibiotic Susceptibility, Biofilm Production, and Detection of mecA Gene among Staphylococcus aureus Isolates from Different Clinical Specimens

The increasing incidence of methicillin-resistant and biofilm-forming S. aureus isolates in hospital settings is a gruesome concern today. The main objectives of this study were to determine the burden of S. aureus in clinical samples, assess their antibiotic susceptibility pattern and detect biofilm formation and mecA gene in them. A total of 1968 different clinical specimens were processed to isolate S. aureus following standard microbiological procedures. Antibiotic susceptibility test of the isolates was performed by Kirby–Bauer disc-diffusion method following CLSI guidelines. Biofilm was detected through tissue culture plate method. Methicillin-resistant S. aureus (MRSA) isolates were screened using cefoxitin (30 µg) discs and mecA gene was amplified by conventional polymerase chain reaction (PCR). Of 177 bacterial growth, the prevalence of S. aureus was 15.3% (n = 27). MRSA were 55.6% (15/27) and 44% (12/27) exhibited multidrug resistance (MDR). There was no significant association between methicillin resistance and MDR (p &gt; 0.05). Both MRSA and MSSA were least sensitive to penicillin (100%, 75%) followed by erythromycin (86.6%, 66.6%). Most of the MRSA (93.4%) were susceptible to tetracycline. All S. aureus isolates were biofilm producers—19 (70%) were weak and only one (4%) was a strong biofilm producer. The strong biofilm-producing MSSA was resistant to most of the antibiotics except cefoxitin and clindamycin. None of the MSSA possessed mecA gene while 8 (53.3%) MRSA had it. More than half of S. aureus isolated were MRSA. High incidence of multidrug resistance along with capacity to form biofilm among clinical isolates of S.aureus is a matter of apprehension and prompt adoption of biosafety measures is suggested to curb their dissemination in the hospital environments