Effect of different levels of nitrogen and farmyard manure on the growth and yield of spinach (Spinacia oleracea L.)

Saabunud / Received 10.05.2021 ; Aktsepteeritud / Accepted 05.09.2021 ; Avaldatud veebis / Published online 05.09.2021 ; Vastutav autor / Corresponding author: Parbati Thapa [email protected] application of nitrogen (N) and farmyard manure (FYM) greatly affects the growth and production of spinach. The objective of this study was to evaluate the effect of various levels of nitrogen and farmyard manure on the growth and yield of spinach. This study was conducted in the research field of the Institute of Agriculture and Animal Science, Lamjung, Sundarbazar, Lamjung, Nepal from November 2019 to January 2020. The treatments were: 0 kg N ha–1, 30 kg N ha–1, 60 kg N ha–1, 60 kg N ha–1 + 10 t FYM ha–1, 60 kg N ha–1 + 20 t FYM ha–1, 90 kg N ha–1 and 120 kg N ha–1. These treatments were laid out in a randomized complete block design (RCBD) with three replications. The results showed that higher N levels gave better results for all parameters studied. The increasing N fertilization rates increased the vegetative characters and yield of spinach. The maximum plant height (22.68 cm), leaf width (6.69 cm), number of leaves (12.93), fresh weight of leaves (17.07 g) and leaf length (14.94 cm) were recorded with the application of the highest level of nitrogen (120 kg N ha–1). The spinach yield (3.2 t ha–1) was the highest with the application of 120 kg N ha–1. However, the growth and yield traits were not significantly differed with the application of 60 kg N ha–1 + 20 t FYM ha–1. Therefore, this study suggests that spinach production can be maximized by the application of 60 kg N ha–1+ 20 t FYM ha–1

Identification of micronutrient-rich germplasms of barley for mid-hills and Terai region of Nepal

Zinc and iron deficiencies, common in many parts of the world, having risk factors that raise the burden of disease with high child and adult mortality. Breeding efforts for exploring barley grains with higher zinc and iron are underway. A study was conducted  during the normal barley growing season of 2017 to identify the barley genotypes with higher concentration of protein, starch, iron and zinc for the mid-hill and Terai conditions of Nepal. An augmented block design was followed, and two improved varieties i.e., Bonus and Solu Uwa were used as repeated checks. The average grain protein, starch, zinc, and iron content were 11.9%, 55.6%, 47.4 mg/kg and 41.4 mg/kg at Dailekh and 11.3%, 53.3%, 46.6 mg/kg and 39.9 mg/kg at Rampur, respectively. The grain protein content was found up to 19.8% (AM-55, AM-45, AM-88 at Dailekh) and 16.6% (AM-81, AM-77, AM-98 at Rampur). Similarly, the highest grain zinc content was found 97 mg/kg (AM-6, AM-138 and AM-125 at Dailekh) and 92  mg/kg (AM-226,  AM-99 and AM-227 mg/kg at Rampur). The highest iron content 71 mg/kg  ( AM-2, AM-43, AM-4 at Dailekh) and 63  mg/kg  (AM-90, AM-168 and AM-92 at Rampur). The identified genotypes with higher grain elements concentration are valuable resources for Nepal's barley breeding program that helps develop quality and nutritious barley varieties. &nbsp

Urinary tract infections and antibiotic susceptibility among the patients attending B & D hospital of Lalitpur, Nepal

Background: Urinary tract infection is the most common bacterial infections in humans and serious health problem in many parts of the world. It has become more complicated in treatment due to different pathogens and increasing resistant to antimicrobial agents. This study aims to investigate the prevalence of urinary tract infection and antibiotic susceptibility patterns of pathogens among the patients attending in B & B hospital Nepal. Materials and Methods: A hospital based cross sectional study was conducted in between April 2010 to March 2011. Urine samples were collected from clinically suspected patients and tested bacteriologically using standard procedures. Antimicrobial susceptibility test was performed for isolated pathogen using the Kirby-Bauer disk diffusion method according to Clinical and Laboratory Standards Institute guidelines. Results: Out of 1260 examined specimens 25.24 % were positive and majority 61.64% were females. The most common pathogens isolated were Escherichia coli (66.67%), Enterococcus (7.55%) and Staphylococcus (6.60 %). The drug resistant among the positive cases were reported. The highest resistant of positive cases was found with Cefexime (87.88%) and Enterococcus with Ampicillin (66.67%) and Staphyllococcus with Cloxacillin (66.67%). The highest susceptibility was for Vancomycin and Ampicillin i.e. 33.33% in each. Conclusion: The findings showed that E. coli isolates were the predominant pathogen and the presence of bacterial isolates with very high resistance to the commonly prescribed drugs. As drug resistance among bacterial pathogens is an evolving process and serious issue. Therefore, routine surveillance and monitoring studies should be conducted to provide physicians knowledge on the updated and most effective empirical treatment of UTIs

Impact of pharmacist services on economic, clinical, and humanistic outcome (ECHO) of South Asian patients : a systematic review

Background: Pharmacists in high-income countries routinely provide efficient pharmacy or pharmaceutical care services that are known to improve clinical, economic, and humanistic outcomes (ECHO) of patients. However, pharmacy services in low- and middle-income countries, mainly South Asia, are still evolving and limited to providing traditional pharmacy services such as dispensing prescription medicines. This systematic review aims to assess and evaluate the impact of pharmacists’ services on the ECHO of patients in South Asian countries. Methods: We searched PubMed/Medline, Scopus, EMBASE, CINAHL, and Cochrane Library for relevant articles published from inception to 20th September 2021. Original studies (only randomised controlled trials) conducted in South Asian countries (published only in the English language) and investigating the economic, clinical (therapeutic and medication safety), and humanistic impact (health-related quality of life) of pharmacists’ services, from both hospital and community settings, were included. Results: The electronic search yielded 430 studies, of which 20 relevant ones were included in this review. Most studies were conducted in India (9/20), followed by Pakistan (6/20), Nepal (4/20) and Sri Lanka (1/20). One study showed a low risk of bias (RoB), 12 studies showed some concern, and seven studies showed a high RoB. Follow-up duration ranged from 2 to 36 months. Therapeutic outcomes such as HbA1c value and blood pressure (systolic blood pressure and diastolic blood pressure) studied in fourteen studies were found to be reduced. Seventeen studies reported humanistic outcomes such as medication adherence, knowledge and health-related quality of life, which were found to be improved. One study reported safety and economic outcomes each. Most interventions delivered by the pharmacists were related to education and counselling of patients including disease monitoring, treatment optimisation, medication adherence, diet, nutrition, and lifestyle. Conclusion: This systematic review suggests that pharmacists have essential roles in improving patients’ ECHO in South Asian countries via patient education and counselling; however, further rigorous studies with appropriate study design with proper randomisation of intervention and control groups are anticipated

Anticoagulant Utilization and Cost Analysis among Cardiology Inpatients in a Tertiary Care Teaching Hospital of Western Nepal

Introduction. Anticoagulants have a wide spectrum of use and risks associated with their therapy due to their narrow therapeutic range. This study aimed to evaluate the anticoagulant utilization and cost analysis in patients admitted to the cardiology ward of a tertiary care hospital in western Nepal. Methods. A prospective cohort study was conducted in patients admitted to the cardiology ward of Manipal Teaching Hospital (MTH), Pokhara, Kaski, Nepal, from August to November 2019. All patients (n = 132) aged ≥18 years of either gender receiving anticoagulants for any indication in the cardiology ward were included in the study. Anticoagulant utilization, the average prescribed daily dose (PDD/DDD) and the cost of anticoagulant per patient were calculated. Descriptive statistics were performed using IBM-SPSS 20.0. Results. Acute coronary syndrome (66.67%) was a common indication, unfractionated heparin + enoxaparin (45.45%) and enoxaparin (27.3%) were the most frequently prescribed anticoagulants. The performance of monitoring parameters such as international normalized ratio (INR), prothrombin time (PT), activated partial thromboplastin time (aPTT), and renal function test were consistent with the American College of Chest Physician (ACCP) guidelines. The average prescribed daily dose of anticoagulants was 1.3 (unfractionated heparin), 2.25 (enoxaparin), 0.5 (warfarin), and 1.0 (dabigatran). Heparin was associated with the majority of cases of drug interactions (52 cases). Enoxaparin was the most expensive of all the anticoagulant drug classes. The median (IQR) cost of anticoagulants used per patient was US$79.92 ($46.32). Conclusion. Our study suggests that the utilization of unfractionated heparin and enoxaparin and the cost of anticoagulants per patient were higher in the patients admitted to the cardiology ward of the hospital

Pharmacist-led intervention on chronic pain management: A systematic review and meta-analysis

Aims: Pharmacists have been contributing to the management of chronic pain, ensuring the quality use of medicine. However, there is diversity in the interventions provided by pharmacists and their impact. Methods: Six electronic databases were searched from inception until June 2020 for articles published in English examining the intervention provided by the pharmacist in chronic pain management. Studies investigating the impact of pharmacist intervention individually or multidisciplinary teams including pharmacists for chronic pain management were included. Results: Fourteen studies (2365 participants) were included in the current review. Six studies were randomized controlled trials while the remainder were observational studies in which pharmacists provided intervention individually or in collaboration with other healthcare professionals. Medication review was the most common intervention provided by the pharmacist. The pooled analysis found that pharmacist-led interventions reduced the pain intensity (−0.22; 95% confidence interval [CI]: −0.35 to −0.09; moderate certainty) among participants with chronic pain. Opiate stewardship provided by pharmacists was effective; however, mixed results were noted on the impact of the intervention on physical functioning, anxiety, depression and quality of life. Pharmacist intervention was more expensive than treatment as usual. Conclusions: Pharmacists contribute substantially to chronic pain management, ensuring the quality use of medicine, resulting in reduced pain intensity. Further studies with rigorous design are needed to measure the impact of pharmacist-provided intervention individually or in a multidisciplinary team on the economic benefit and other health outcomes

Managing pain in low resource settings:healthcare professionals’ knowledge, attitude and practice regarding pain management in western Nepal

BACKGROUND: Pain is a public health problem and affects millions of people globally. Effective pain management is possible through comprehensive pain management guidelines, adequate facilities, and trained healthcare professionals. Therefore, this study aims to analyze the healthcare professionals’ knowledge, attitude, and practice regarding pain management in Western Nepal. METHODS: A cross-sectional study was carried out in hospitals of Pokhara, Nepal. Healthcare professionals, including doctors, pharmacists, and nurses, were enrolled. Tools for the study were “The Knowledge and Attitudes Survey Regarding Pain (KASRP)” and a validated practice-based questionnaire. Frequencies and descriptive statistics were used to describe the outcomes. Kruskal–Wallis H-test and Mann-Whitney U-test were used to analyze the association between the mean rank of KASRP score and sample characteristics. A p-value of <0.05 was considered significant for all statistical tests. RESULTS: A total of 336 healthcare professionals were enrolled in this study (108 medical doctors, 150 nurses, and 78 pharmacists). The mean KASRP scores (% ± SD) obtained by doctors, pharmacists, and nurses were 58.48±8.98, 53.01±7.80, and 52.26±6.39, respectively. A significant difference was found between the KASRP score and sample characteristics (p<0.001). The pain assessment tool is used by 96 (29%) healthcare professionals every time they meet the patients. Doctors and nurses used it more frequently as compared to pharmacists. Many of the pharmacists, 40 (51%), reported that they counsel the patients on the prescribed medicine (analgesics, NSAIDs, and opioids) every time. As only few participants had already attended a training on pain management, most healthcare professionals, 110 (33%), agreed and 198 (59%) strongly agreed that training related to pain management is needed in Nepal CONCLUSION: Adequate training and support are required to enhance the knowledge, attitude and ultimately better practice for healthcare professionals regarding pain management in Nepal