Price variation among different brands of anticancer medicines available in hospital pharmacies of Nepal.

Objective:To assess the variation in price among different brands of anticancer medicines available in hospital pharmacies at Nepalese cancer hospitals. Methods:The price of different brands of the same anticancer medicines available in the hospital pharmacies of two cancer hospitals was assessed. Prices of different dosage forms such as a single tablet, capsule and vial were calculated. The difference in the maximum and minimum price of the same drug manufactured by different pharmaceutical industries was determined, and the percentage variation in price was calculated. The prices of medicines (brands) were also compared with the price determined by the government where available. Results:Price variation was assessed for 31 anticancer medicines belonging to six broad categories. Prices were found to vary maximally among the following medicines, each belonging to separate categories: among alkylating agents, the price of temozolomide 100 mg capsule varied 308%; among antimetabolite agents, the price of pemetrexed 500 mg injection varied 134%; among hormonal drugs, the price of letrozole 2.5 mg tablet varied 200%; among antibody class, the price of trastuzumab 440 mg injection varied 73%; among natural products, the price of irinotecan 100 mg injection varied 590%; and among miscellaneous agents, the price of bortezomib 2 mg injection varied 241%. There was a significant difference in the mean MRP of the alkylating agents with the antimetabolites (p-value 0.006) and the monoclonal antibody (p-value <.001). Antimetabolites, natural products, hormonal therapy all had significant mean differences in their MRPs with the monoclonal antibodies. (p-value <.001) and the monoclonal antibodies had a significant mean difference in the MRP with the miscellaneous agents. (p-value <.001). Conclusions:There was a considerable variation in the price of different brands of anticancer medicines available in the Nepalese market. The Government of Nepal has regulated the prices of some medicines, including anticancer medicine. However, it is not enough as prices of the majority of anticancer medicines are still not regulated. Therefore, further strategies are needed to address the variation in the prices of anticancer medicines available in the Nepalese market

Social Determinants of Child Trafficking addressed by Government and Non-Government Strategies in South and Southeast Asia: An Integrate Review

Aims: Child trafficking in South and Southeast Asia is widespread and deeply troubling. While several agencies have initiated anti-child trafficking interventions, it is unknown if they address the 21 social determinants of child trafficking identified by Perry and McEwing (2103). The aim of this integrative review was to explore the anti-child trafficking strategies employed by governments and non-government organizations (NGOs) that target the social determinants of child trafficking in South and Southeast Asia, and identify which levels of the Socio-Ecological Model (SEM) they address. Methods: The authors performed a literature search for journal articles and reports by researchers, local or national governments, and international organizations on the prevention of child trafficking in eight South Asian and eight Southeast Asian nations. Identified manuscripts were analyzed to determine which social determinants and socio-ecological levels were addressed by the programs described. Results: 16 journals articles and 31 reports from the grey literature were identified. The government and NGO anti-child trafficking strategies in 16 South and Southeast Asian nations addressed 15 and 12 of the 21 social determinants, respectively. Social determinants at the intrapersonal, interpersonal, community, and policy levels of SEM were addressed, but failed to address the organizational level. Conclusion: The gravity of child trafficking necessitates that interventions address all of the 21 social determinants of child trafficking at all levels of the SEM. The authors found no account on any anti-child trafficking intervention from four South Asian and five Southeast Asian nations. Dissemination and continuous evaluation of anti-trafficking interventions are warranted

Predictors of Mortality in Scrub Typhus Infection Requiring Intensive Care Admission in Tertiary Healthcare Centre of Nepal

© 2018 Shital Adhikari et al. Introduction. This study aimed to explore the predictors of mortality from scrub typhus infection in patients requiring intensive care unit (ICU) admission. Materials and Methods. A retrospective study was conducted on 120 patients with serum ELISA IgM positive for scrub typhus (optical density ≥ 0.5) admitted at the medical ICU of Chitwan Medical College Teaching Hospital between April 2016 and September 2017. Data was extracted from patient medical records and electronic database of the hospital. The outcome measurement was mortality (Yes/No) due to the infection. A multivariate binary logistic regression analysis (p 100/minute (p 1.4 mg/dl (p<0.001), acute kidney injury requiring dialysis (p=0.029), acute respiratory distress syndrome (p<0.001), and shock requiring vasopressor (p<0.001). Regression analysis showed age (odds ratio [OR] = 1.063; 95% CI = 1.010-1.118; p=0.019) and serum creatinine (OR = 1.063; 95% CI = 1.010-1.118; p=0.019) as significant predictors of poor outcome. Conclusion. Older age and high serum creatinine were found to be independent predictors of poor outcome in patients with scrub typhus admitted in medical ICU

Profile of Ocular Trauma in a Tertiary Centre in Western Nepal

Introduction: Ocular trauma is an important cause of blindness and ocular morbidity throughout the world. The present study was done to establish the common causes of ocular trauma in a Tertiary Care Hospital of Western Nepal. Methods: In this prospective study, all the patients with ocular trauma visiting eye Out Patient Department (OPD) and Emergency Department of Gandaki Medical College Teaching Hospital (GMCTH) from June 2015 to June 2016 were included. A complete history and detailed ophthalmological evaluation was done. Results: Over a period of one year, 226 patients attended to the OPD and Emergency Department of GMCTH. Mean age of patients was 30.41 ±15.7 years. Males were 70.8% and females 29.2%. About 82.5% patients had visual acuity better than 6/18 while 17.7% had visual acuity <3/60. Road traffic accident (RTA) was the most common cause followed by foreign bodies. Conclusions: Males are more prone to ocular trauma than females and majority of ocular trauma occurred at workplace. RTA is the commonest cause of ocular trauma. Very few patients used protective device. Public awareness and strict legislation for the use of personal protective devices can also help reduce the occurrence of ocular injury. J-GMC-N | Volume 11 | Issue 01 | January-June 2018, Page: 6-1

Prevalence of Postpartum Family Planning Service Coverage in Selected Referral Facilities of Nepal

Introduction: Nepal Society of Obstetricians and Gynecologists jointly with the Nepalese government and with the support from the International Federation of Obstetrics and Gynecology has implemented an initiative to institutionalize postpartum family planning services in selected major referral facilities of Nepal to address the gap of low uptake of postpartum family planning in Nepal. The aim of the study is to find the prevalence of the service coverage of postpartum contraception in the selected facilities. Methods: A descriptive cross-sectional study was conducted in seven major referral facilities across Nepal. Data were collected from the hospital records of all women who delivered in these facilities between October 2018 and March 2019. Ethical approval for this study was obtained from Nepal Health Research Council. Data analysis was done with SPSS version 23. Results: Among the 29,072 deliveries from all the facilities, postpartum family planning counseling coverage was 27,301 (93.9%). The prevalence of uptake of Postpartum Intrauterine Device is 1581 (5.4%) and female sterilization is 1830 (6.3%). In total 11387 mothers (52.2%) had the intention to choose a postpartum family planning method. However, 36% of mothers neither used nor had the intention to choose a postpartum family planning method. Conclusions: The coverage of Postpartum Intrauterine Device counseling service coverage in Nepal is higher in 2018 as compared to 2016-2017 and in other countries implementing Postpartum Intrauterine Device initiatives. However, the prevalence of service coverage of immediate Postpartum Family Planning methods, mainly Postpartum Intrauterine Device in 2018 is lower in Nepal as compared to 2016-2017, and other countries implementing Postpartum Intrauterine Device initiative. More efforts are needed to encourage mothers delivering in the facilities to use the postpartum family planning method

Agro-morphological Diversity of High Altitude Bean Landraces in the Kailash Sacred Landscape of Nepal

Many varieties of bean are widely grown across diverse agro-ecological zones in Nepal. And opportunities exist for improving the crops and enhancing their resilience to various biotic and abiotic stressors. In this context, an experiment was conducted from June to October 2016 in Khar VDC of Darchula district to study the phenotypic traits of nine landraces of bean (Phaseolus vulgaris L.). The bean landraces were planted using randomized complete block design in three sites (Dhamidera, Dallekh and Sundamunda villages), with three replications in each site for their comparative analysis. The study considered the following phenotypic traits: days to emergence, days to 50% flowering, days to 90% pod maturity, number of nodes, pod length, pod width, number of pods, number of seeds per pod and weight and grain yield for 100 seeds. Kruskal-Wallis test showed significant differences in the landraces both within and among locations. KA-17-08-FB and KA-17-04-FB were late &nbsp;flowering (63 and 65 days respectively) compared to other landraces whereas KA-17-07-FB flowered earliest (within 42 days). In all three sites, three landraces namely KA-17-07-FB, KA-17-04-FB and KA-17-06-FB were found to be relatively more resistant to pest and diseases than other landraces. Eight out of nine landraces in Dhamidera and Dallekh villages and seven out of nine in Sundamunda village produced seeds greater than 1.0 t/ha. Among the nine varieties KA-17-02-FB was the highest yielding variety, with an average yield of 3.8 t/ha. This study is useful for identifying suitable landraces for future promotion based on their maturity, grain yield, diseases resistance and other qualitative and quantitative characteristics

The Curation of Genetic Variants: Difficulties and Possible Solutions

The curation of genetic variants from biomedical articles is required for various clinical and research purposes. Nowadays, establishment of variant databases that include overall information about variants is becoming quite popular. These databases have immense utility, serving as a user-friendly information storehouse of variants for information seekers. While manual curation is the gold standard method for curation of variants, it can turn out to be time-consuming on a large scale thus necessitating the need for automation. Curation of variants described in biomedical literature may not be straightforward mainly due to various nomenclature and expression issues. Though current trends in paper writing on variants is inclined to the standard nomenclature such that variants can easily be retrieved, we have a massive store of variants in the literature that are present as non-standard names and the online search engines that are predominantly used may not be capable of finding them. For effective curation of variants, knowledge about the overall process of curation, nature and types of difficulties in curation, and ways to tackle the difficulties during the task are crucial. Only by effective curation, can variants be correctly interpreted. This paper presents the process and difficulties of curation of genetic variants with possible solutions and suggestions from our work experience in the field including literature support. The paper also highlights aspects of interpretation of genetic variants and the importance of writing papers on variants following standard and retrievable methods. © 2012 Beijing Institute of Genomics, Chinese Academy of Sciences and Genetics Society of China