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  • 1
    Online Resource
    Online Resource
    Experience of Treating COVID-19 With Remdesivir and Convalescent Plasma in a Resource-Limited Setting: A Prospective, Observational Study
    Oxford University Press (OUP) ; 2021
    In:  Open Forum Infectious Diseases Vol. 8, No. 8 ( 2021-08-01)
    Details
    In: Open Forum Infectious Diseases, Oxford University Press (OUP), Vol. 8, No. 8 ( 2021-08-01)
    Abstract: Convalescent plasma therapy (CPT) and remdesivir (REM) have been approved for investigational use to treat coronavirus disease 2019 (COVID-19) in Nepal. Methods In this prospective, multicentered study, we evaluated the safety and outcomes of treatment with CPT and/or REM in 1315 hospitalized COVID-19 patients over 18 years in 31 hospitals across Nepal. REM was administered to patients with moderate, severe, or life-threatening infection. CPT was administered to patients with severe to life-threatening infections who were at high risk for progression or clinical worsening despite REM. Clinical findings and outcomes were recorded until discharge or death. Results Patients were classified as having moderate (24.2%), severe (64%), or life-threatening (11.7%) COVID-19 infection. The majority of CPT and CPT + REM recipients had severe to life-threatening infections (CPT 98.3%; CPT + REM 92.1%) and were admitted to the intensive care unit (ICU; CPT 91.8%; CPT + REM 94.6%) compared with those who received REM alone (73.3% and 57.5%, respectively). Of 1083 patients with reported outcomes, 78.4% were discharged and 21.6% died. The discharge rate was 84% for REM (n = 910), 39% for CPT (n = 59), and 54.4% for CPT + REM (n = 114) recipients. In a logistic model comparing death vs discharge and adjusted for age, gender, steroid use, and severity, the predicted margin for discharge was higher for recipients of remdesivir alone (0.82; 95% CI, 0.79–0.84) compared with CPT (0.58; 95% CI, 0.47–0.70) and CPT + REM (0.67; 95% CI, 0.60–0.74) recipients. Adverse events of remdesivir and CPT were reported in  & lt;5% of patients. Conclusions This study demonstrates a safe rollout of CPT and REM in a resource-limited setting. Remdesivir recipients had less severe infection and better outcomes. ClinicalTrials.gov identifier. NCT04570982.
    Type of Medium: Online Resource
    ISSN: 2328-8957
    URL: Article
    DOI: 10.1093/ofid/ofab391
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2021
    detail.hit.zdb_id: 2757767-3
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  • 2
    Online Resource
    Online Resource
    Cyberbullying and cyber-victimisation among higher secondary school adolescents in an urban city of Nepal: a cross-sectional study
    BMJ ; 2024
    In:  BMJ Open Vol. 14, No. 3 ( 2024-03), p. e081016-
    Details
    In: BMJ Open, BMJ, Vol. 14, No. 3 ( 2024-03), p. e081016-
    Abstract: To assess the prevalence and factors associated with cyberbullying and cyber-victimisation among high school adolescents of Pokhara Metropolitan City, Nepal. Design A cross-sectional study. Setting Pokhara Metropolitan City, Nepal. Participants We used convenient sampling to enrol 450 adolescents aged 16–19 years from four distinct higher secondary schools in Pokhara Metropolitan City. Outcome measures We administered the Cyberbullying and an Online Aggression Survey to determine the prevalence of cyberbullying and cyber-victimisation. Univariate and multivariate logistic regression analyses were performed to estimate the ORs and 95% CIs. Data were analysed using STATA V.13. Results The 30-day prevalence of cyberbullying and cyber-victimisation was 14.4% and 19.8%, and the over-the-lifetime prevalence was 24.2% and 42.2%, respectively. Posting mean or hurtful comments online was the most common form of both cyberbullying and cyber-victimisation. Compared with females, males were more likely to be involved in cyberbullying (adjusted OR (AOR)=13.52; 95% CI: 6.04 to 30.25; p value 〈 0.001) and cyber-victimised (AOR=2.22; 95% CI: 1.33 to 3.73; p value 〈 0.05). Using the internet almost every day was associated with cyberbullying (AOR=9.44; 95% CI: 1.17 to 75.79; p value 〈 0.05) and cyber-victimisation (AOR=4.96; 95% CI: 1.06 to 23.18; p value 〈 0.05). Students from urban place of residence were associated with both cyberbullying (AOR=2.45; 95% CI: 1.23 to 4.88; p value 〈 0.05) and cyber-victimisation (AOR=1.77; 95% CI: 1.02 to 3.05; p value 〈 0.05). Conclusion The study recommends the implementation of cyber-safety educational programmes, and counselling services including the rational use of internet and periodic screening for cyberbullying in educational institutions. The enforcement of strong anti-bullying policies and regulations could be helpful to combat the health-related consequences of cyberbullying.
    Type of Medium: Online Resource
    ISSN: 2044-6055 , 2044-6055
    URL: Article
    DOI: 10.1136/bmjopen-2023-081016
    Language: English
    Publisher: BMJ
    Publication Date: 2024
    detail.hit.zdb_id: 2599832-8
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  • 3
    Online Resource
    Online Resource
    Morphometric study of trachea in adult cadavers
    Institute of Medicine, Nepal ; 2018
    In:  Journal of Institute of Medicine Nepal Vol. 40, No. 1 ( 2018-04-30), p. 59-63
    Details
    In: Journal of Institute of Medicine Nepal, Institute of Medicine, Nepal, Vol. 40, No. 1 ( 2018-04-30), p. 59-63
    Abstract: Introduction: Knowledge of tracheal morphometry is essential for carrying out interventional procedures of the airway like endotracheal intubation, tracheostomy and tracheal stenting. It has been described that the length of human trachea ranges from 10 to 11 cm and the internal tracheal diameter in transverse axis is about 12 mm in adults. The main objective of this study is to evaluate the tracheal length and its internal and external diameters from adult Nepalese cadavers. Methods: A total number of 182 cadavers, 132 male and 50 female, with Nepalese nationality were studied. The study subjects were 18 years or above. Tracheal length, internal and external tracheal diameters in anteroposterior and transverse axes were measured after photographic record of the sample. Result: The mean tracheal length was 82.87 ± 8.3 mm in male and 77.59 ± 9.3 mm in female. The TEDAP were 18.95 ± 2.0 mm and 15.83 ± 2.2 mm in male and female respectively. The TEDTR were 23.73 ± 3.5 mm and 20.70 ± 3.0 mm in males and females respectively. The TIDAP in males was 9.34 ± 2.2 mm and in females was 6.88 ± 1.7 mm. The TIDTR was 13.24 ± 2.9 mm in males and 10.51 ± 2.9 mm in females. Conclusion: The tracheal dimensions of our study showed marked dissimilarity with those of the studies conducted in western population.
    Type of Medium: Online Resource
    ISSN: 1993-2987 , 1993-2979
    URL: Article
    DOI: 10.59779/jiomnepal.818
    Language: English
    Publisher: Institute of Medicine, Nepal
    Publication Date: 2018
    detail.hit.zdb_id: 2481677-2
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  • 4
    Online Resource
    Online Resource
    Drug Resistance Patterns of Commonly Used Antibiotics for the Treatment of Helicobacter pylori Infection among South Asian Countries: A Systematic Review and Meta-Analysis
    MDPI AG ; 2023
    In:  Tropical Medicine and Infectious Disease Vol. 8, No. 3 ( 2023-03-14), p. 172-
    Details
    In: Tropical Medicine and Infectious Disease, MDPI AG, Vol. 8, No. 3 ( 2023-03-14), p. 172-
    Abstract: Background: In South Asia, resistance to commonly used antibiotics for the treatment of Helicobacter pylori infection is increasing. Despite this, accurate estimates of overall antibiotic resistance are missing. Thus, this review aims to analyze the resistance rates of commonly used antibiotics for the treatment of H. pylori in South Asia. Methods: The systematic review and meta-analysis was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis statement. We searched five medical databases for relevant studies from inception to September 2022. A random effect model with a 95% confidence interval (CI) was used to calculate the pooled prevalence of antibiotic resistance. Results: This systematic review and meta-analysis included 23 articles, 6357 patients, 3294 Helicobacter pylori isolates, and 2192 samples for antibiotic resistance. The prevalences of antibiotic resistance to common antibiotics were clarithromycin: 27% (95%CI: 0.17–0.38), metronidazole: 69% (95%CI: 0.62–0.76), tetracycline: 16% (95%CI: 0.06–0.25), amoxicillin: 23% (95%CI: 0.15–0.30), ciprofloxacin: 12% (95%CI: 0.04–0.23), levofloxacin: 34% (95%CI: 0.22–0.47), and furazolidone: 14% (95%CI: 0.06–0.22). Subgroup analysis showed antibiotic resistances were more prevalent in Pakistan, India, and Bangladesh. Furthermore, a ten-year trend analysis showed the increasing resistance prevalence for clarithromycin (21% to 30%), ciprofloxacin (3% to 16%), and tetracycline (5% to 20%) from 2003 to 2022. Conclusion: This meta-analysis showed a high prevalence of resistance among the commonly used antibiotics for H. pylori in South Asian countries. Furthermore, antibiotic resistance has been increasing over the time of 20 years. In order to tackle this situation, a robust surveillance system, and strict adherence to antibiotic stewardship are required.
    Type of Medium: Online Resource
    ISSN: 2414-6366
    URL: Article
    DOI: 10.3390/tropicalmed8030172
    Language: English
    Publisher: MDPI AG
    Publication Date: 2023
    detail.hit.zdb_id: 2934690-3
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  • 5
    Online Resource
    Online Resource
    Application of Geo-information Technology in Nepal “During and Post” COVID -19
    Nepal Journals Online (JOL) ; 2020
    In:  Journal on Geoinformatics, Nepal ( 2020-07-15), p. 1-8
    Details
    In: Journal on Geoinformatics, Nepal, Nepal Journals Online (JOL), ( 2020-07-15), p. 1-8
    Abstract: At present, the world is facing the challenges to combat the pandemic situation due to outbreak of COVID-19. There is a global realization that the effects of COVID-19 will be in long term affecting various sectors of social and economic development. To support this health crisis, along with various non-pharmaceutical interventions (NPI) the application of geo-information technology have proven to be significant for delaying and containing the COVID-19 pandemic. The application of geo-information technology is one of the interventions adopted basically in the monitoring of the COVID-19 cases. This paper attempt to shade a light on the present scenario in the use of geo-information technology in Nepal and has attempted to throw lights on the need of wider application of such technologies to combat Post COVID-19 crisis. Further, the academic program like geomatics engineering currently running at Kathmandu University can be a contributor of technical human resources and can provide academic research output necessary for strengthening the domain of geo-information technology in the settings of Post Pandemic context.
    Type of Medium: Online Resource
    ISSN: 2717-5022
    URL: Article
    DOI: 10.3126/njg.v19i1.50960
    Language: Unknown
    Publisher: Nepal Journals Online (JOL)
    Publication Date: 2020
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  • 6
    Online Resource
    Online Resource
    IMPACT ASSESSMENT OF MIKANIA MICRANTHA ON LAND COVER AND MAXENT MODELING TO PREDICT ITS POTENTIAL INVASION SITES
    Copernicus GmbH ; 2017
    In:  The International Archives of the Photogrammetry, Remote Sensing and Spatial Information Sciences Vol. XLII-1/W1 ( 2017-05-31), p. 305-310
    Details
    In: The International Archives of the Photogrammetry, Remote Sensing and Spatial Information Sciences, Copernicus GmbH, Vol. XLII-1/W1 ( 2017-05-31), p. 305-310
    Abstract: Abstract. Mikania micrantha is one of the major invasive alien plant species in tropical moist forest regions of Asia including Nepal. Recently, this weed is spreading at an alarming rate in Chitwan National Park (CNP) and threatening biodiversity. This paper aims to assess the impacts of Mikania micrantha on different land cover and to predict potential invasion sites in CNP using Maxent model. Primary data for this were presence point coordinates and perceived Mikania micrantha cover collected through systematic random sampling technique. Rapideye image, Shuttle Radar Topographic Mission data and bioclimatic variables were acquired as secondary data. Mikania micrantha distribution maps were prepared by overlaying the presence points on image classified by object based image analysis. The overall accuracy of classification was 90 % with Kappa coefficient 0.848. A table depicting the number of sample points in each land cover with respective Mikania micrantha coverage was extracted from the distribution maps to show the impact. The riverine forest was found to be the most affected land cover with 85.98 % presence points and sal forest was found to be very less affected with only 17.02 % presence points. Maxent modeling predicted the areas near the river valley as the potential invasion sites with statistically significant Area Under the Receiver Operating Curve (AUC) value of 0.969. Maximum temperature of warmest month and annual precipitation were identified as the predictor variables that contribute the most to Mikania micrantha's potential distribution.
    Type of Medium: Online Resource
    ISSN: 2194-9034
    URL: Article
    DOI: 10.5194/isprs-archives-XLII-1-W1-305-2017
    Language: English
    Publisher: Copernicus GmbH
    Publication Date: 2017
    detail.hit.zdb_id: 2874092-0
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  • 7
    Online Resource
    Online Resource
    Immediate Outcome of Percutaneous Balloon Mitral Valvotomy in Shahid Gangalal National Heart Centre, Bansbari, Kathmandu, Nepal
    Nepal Journals Online (JOL) ; 2015
    In:  Nepalese Heart Journal Vol. 12, No. 1 ( 2015-03-22), p. 11-14
    Details
    In: Nepalese Heart Journal, Nepal Journals Online (JOL), Vol. 12, No. 1 ( 2015-03-22), p. 11-14
    Abstract: Background and Aim: Percutaneous balloon mitral valvotomy is well established as safe and effective procedure for patients with mitral stenosis due to Rheumatic Heart Disease. There are some retrospective studies on safety and efficacy of it in different subgroups of patients from our centre. Our study aims to assess the safety, efficacy and outcome of it in Shahid Gangalal National Heart Centre, Kathmandu, Nepal. Methods: A Single centre, prospective study was conducted from July 1st 2013 to June 31st 2014 in our centre. All the patients who underwent percutaneous balloon mitral valvotomy for moderate to severe mitral stenosis during the study period were included. Safety and efficacy of the procedure was analyzed. Results: There were 262 patients enrolled in the study among which 194 (74%) were females. Mean age of patients was 33.2±12.5 years. Seventy patients (26.7%) were in atrial fibrillation, six (2%) were pregnant, three (1%) had history of stroke, twelve (4.6%) underwent previous surgical or balloon commissurotomy. The mean left atrial pressure reduced from 26.8 ± 8.9 mmHg to 15.6 ± 7.2 mmHg (p 〈 0.05).The mean mitral valve area increased from 0.9 ± 0.17 cm2 to 1.6 ± 0.28 cm2 (p 〈 0.05). Forty nine patients (18.7%) developed moderate to severe mitral regurgitation. There was no mortality related to the procedure. The procedural success was achieved in 84% patients. Conclusion: Our study suggests that percutaneous balloon mitral valvotomy is a safe and effective procedure for symptomatic mitral stenosis patients.DOI: http://dx.doi.org/10.3126/njh.v12i1.12325 Nepalese Heart Journal Vol.12(1) 2015: 11-14 
    Type of Medium: Online Resource
    ISSN: 2382-5464 , 2091-2978
    URL: Article
    DOI: 10.3126/njh.v12i1.12325
    Language: Unknown
    Publisher: Nepal Journals Online (JOL)
    Publication Date: 2015
    detail.hit.zdb_id: 2901174-7
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  • 8
    Online Resource
    Online Resource
    A Study on the Effectiveness of Spatial Filters on Thermal Image Pre-Processing and Correlation Technique for Quantifying Defect Size
    MDPI AG ; 2022
    In:  Sensors Vol. 22, No. 22 ( 2022-11-19), p. 8965-
    Details
    In: Sensors, MDPI AG, Vol. 22, No. 22 ( 2022-11-19), p. 8965-
    Abstract: Thermal imaging plays a vital role in structural health monitoring of various materials and provides insight into the defect present due to aging, deterioration, and fault during construction. This study investigated the effectiveness of spatial filters during pre-processing of thermal images and a correlation technique in post-processing, as well as exploited its application in non-destructive testing and evaluation of defects in steel structures. Two linear filters (i.e., Gaussian and Window Averaging) and a non-linear filter (i.e., Median) were implemented during pre-processing of a pulsed thermography image sequence. The effectiveness of implemented filters was then assessed using signal to noise ratio as a quality metric. The result of pre-processing revealed that each implemented filter is capable of reducing impulse noise and producing high-quality images; additionally, when comparing the signal to noise ratio, the Gaussian filter dominated both Window Averaging and Median filters. Defect size was determined using a correlation technique on a sequence of pulsed thermography images that had been pre-processed with a Gaussian filter. Finally, it is concluded that the correlation technique could be applied to the fast measurement of defect size, even though the accuracy may depend on the detection limit of thermography and defect size to depth ratio.
    Type of Medium: Online Resource
    ISSN: 1424-8220
    URL: Article
    DOI: 10.3390/s22228965
    Language: English
    Publisher: MDPI AG
    Publication Date: 2022
    detail.hit.zdb_id: 2052857-7
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  • 9
    Online Resource
    Online Resource
    Knowledge on American Heart Association Guidelines Update for Cardiopulmonary Resuscitation among the Nurses Working at University Hospital, Kavre
    Nepal Journals Online (JOL) ; 2020
    In:  Kathmandu University Medical Journal Vol. 18, No. 2 ( 2020-12-04), p. 14-18
    Details
    In: Kathmandu University Medical Journal, Nepal Journals Online (JOL), Vol. 18, No. 2 ( 2020-12-04), p. 14-18
    Abstract: Background Cardiopulmonary resuscitation is the foundational technique for the emergency treatment of cardiac arrest and the standardized training of it has been emphasized more than ever. Competence of the nurses in this lifesaving procedure is a critical factor in patient outcome from cardiac arrest and can largely prevent sudden death. Objective Many evidences suggest lack of knowledge on proper cardiopulmonary resuscitation among nurses so the aim of this study was to assess the knowledge on 2015 American Heart Association guidelines update for cardiopulmonary resuscitation among nurses working at University hospital and to identify the relationship between the level of knowledge and selected variables. Method Two hundred and sixty nurses working in Dhulikhel hospital participated in the study. A cross-sectional descriptive study was conducted using a predesigned questionnaire based on 2015 guidelines updates for cardiopulmonary resuscitation that incorporated total of 20 questions. Result Total 260 participated in the study and all were female. Only one third of the nurses had good knowledge regarding 2015 guidelines update for cardiopulmonary resuscitation. No significant results existed between the knowledge score and age of the nurses, duration of work experience. However, significant results existed between the knowledge score and qualification, designation of the nurses and previous training on cardiopulmonary resuscitation. Conclusion One third of the nurses had good knowledge regarding 2015 guidelines update for cardiopulmonary resuscitation in this study. Thus, knowledge and practical approach has to be updated with current guidelines in cardiopulmonary resuscitation in order to improve the safety and effectiveness of patient care.
    Type of Medium: Online Resource
    ISSN: 1812-2078 , 1812-2027
    URL: Article
    DOI: 10.3126/kumj.v18i2.33220
    Language: Unknown
    Publisher: Nepal Journals Online (JOL)
    Publication Date: 2020
    detail.hit.zdb_id: 2257651-4
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  • 10
    Online Resource
    Online Resource
    Heterologous prime–boost strategies for COVID-19 vaccines
    Oxford University Press (OUP) ; 2021
    In:  Journal of Travel Medicine ( 2021-12-16)
    Details
    In: Journal of Travel Medicine, Oxford University Press (OUP), ( 2021-12-16)
    Abstract: Heterologous prime–boost doses of COVID-19 vaccines (‘mix-and-match’ approach) are being studied to test for the effectiveness of Oxford (AZD1222), Pfizer (BNT162b2), Moderna (mRNA-1273) and Novavax (NVX-CoV2373) vaccines for COVID in ‘Com-Cov2 trial’ in UK, and that of Oxford and Pfizer vaccines in ‘CombivacS trial’ in Spain. Later, other heterologous combinations of CoronaVac (DB15806), Janssen (JNJ-78436735), CanSino (AD5-nCOV) and other were also being trialled to explore their effectiveness. Previously, such a strategy was deployed for HIV, Ebola virus, malaria, tuberculosis, influenza and hepatitis B to develop the artificial acquired active immunity. The present review explores the science behind such an approach for candidate COVID-19 vaccines developed using 11 different platforms approved by the World Health Organization. Methods The candidate vaccines’ pharmaceutical parameters (e.g. platforms, number needed to vaccinate and intervals, adjuvanted status, excipients and preservatives added, efficacy and effectiveness, vaccine adverse events, and boosters), and clinical aspects must be analysed for the mix-and-match approach. Results prime–boost trials showed safety, effectiveness, higher systemic reactogenicity, well tolerability with improved immunogenicity, and flexibility profiles for future vaccinations, especially during acute and global shortages, compared to the homologous counterparts. Conclusion Still, large controlled trials are warranted to address challenging variants of concerns including Omicron and other, and to generalize the effectiveness of the approach in regular as well as emergency use during vaccine scarcity.
    Type of Medium: Online Resource
    ISSN: 1195-1982 , 1708-8305
    URL: Article
    DOI: 10.1093/jtm/taab191
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2021
    detail.hit.zdb_id: 2070527-X
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