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Jha N, Thapa B, Pathak SB, Pandey A, Pokhrel S, Shankar PR, Bhandary S, Mudvari A, Dangal G. A Point Prevalence Study of the Use of Antibiotics in Six Tertiary Care Hospitals in the Kathmandu Valley, Nepal. Kathmandu Univ Med J (KUMJ) 2022; 20:351-358. [PMID: 37042379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/13/2023]
Abstract
Background Point prevalence survey (PPS) on antibiotic use developed by the WHO has already been used in many hospitals globally. Objective To obtain information on antibiotic prescribtion using point prevalence survey methodology in six private hospitals in the Kathmandu valley. Method This descriptive cross-sectional study was completed during 20th July to 28th July 2021 using point prevalence survey methodology. The study was conducted among inpatients admitted at or before 8:00 AM on the day of survey in various wards. Data was presented as frequencies and percentages. Result Maximum number of patients were above 60 years [34 (18.7%)]. Number of male and female participants were equal [91 (50%)]. Only one antibiotic was used in 81 patients (44.5%) followed by two antibiotics in 71 (39%) patients. Duration of prophylactic antibiotic use was one day in 66 (63.7%) patients. Blood, urine, sputum, and wound swabs were the common samples for culture. Cultures were positive for 17 (24.7%) samples. The common organisms isolated were E. Coli, Pseudomonas aeruginosa and Klebsiella pneumoniae. Ceftriaxone was the most used antibiotic. Drug and therapeutics, infection control committee and pharmacovigilance activities were present in 3/6 (50%) study sites. Antimicrobial stewardship was present in 3/6 (50%) and microbiological services was present in all hospitals. Antibiotic formulary and antibiotic guideline were present in 4/6 sites and facilities to audit or review surgical antibiotic prophylaxis choice in 2/6 (33.3%) sites, facility to monitor antibiotic use in 4/6 (66.6%) and cumulative antibiotic susceptibility reports in 2/6 (33.3%) study sites. Conclusion Ceftriaxone was the most used antibiotic. E. Coli, Pseudomonas aeruginosa and Klebsiella pneumonia were the commonly isolated organisms. Not all parameters for infrastructure, policy and practice and monitoring and feedback were present at the study sites. KEY WORDS.
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Affiliation(s)
- N Jha
- Department of Clinical Pharmacology and Therapeutics, KIST Medical College and Teaching Hospital, Lalitpur, Nepal
| | - B Thapa
- Department of Emergency Medicine, Kirtipur Hospital, Kirtipur, Nepal
| | - S B Pathak
- Department of Intensive Care Unit and Critical care, Nepal Mediciti Hospital, Sainbu, Bhaisepati, Nepal
| | - A Pandey
- Department of General Surgery, Madhyapur Hospital, Bhaktapur, Nepal
| | - S Pokhrel
- Department of Emergency Medicine, Nidan Hospital, Lalitpur, Pulchowk, Nepal
| | - P R Shankar
- IMU Centre for Education, International Medical University, Kuala Lumpur, Malaysia
| | - S Bhandary
- Department of Community Health Sciences and School of Public Health, Patan Academy of Health Sciences, Lagankhel, Lalitpur, Nepal
| | - A Mudvari
- Department of Clinical Pharmacology, Maharajgunj Medical Campus, Maharajgunj, Kathmandu, Nepal
| | - G Dangal
- Kathmandu Model Hospital, Kathmandu, Nepal
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Dick MH, Abdelgadir A, Kulkarni VV, Akram H, Chatterjee A, Pokhrel S, Khan S. Comparing the Safety and Efficacy of L-Glutamine, Voxelotor, and Crizanlizumab for Reducing the Frequency of Vaso-Occlusive Crisis in Sickle Cell Disease: A Systematic Review. Cureus 2022; 14:e24920. [PMID: 35706735 PMCID: PMC9187358 DOI: 10.7759/cureus.24920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 05/11/2022] [Indexed: 11/22/2022] Open
Abstract
Sickle cell disease (SCD) is a group of inherited red blood cell disorders affecting millions worldwide. The median life expectancy of someone with SCD remains significantly low despite improvements in standards of care and the implementation of hydroxyurea therapy. Notably, a 20-year interval existed (after the implementation of hydroxyurea therapy) prior to the approval of other sickle cell medications, namely, l-glutamine, voxelotor, and crizanlizumab. In this systematic review, these new medications' impact on the occurrences of vaso-occlusive crisis (VOC) events were analyzed and the adverse events of each were noted. Further, a secondary analysis was conducted to determine the effect of combination therapies, whether synergistic, antagonistic, or additive. The systematic review was conducted following the PRISMA 2020 guidelines. The effect-based and dose-effect-based approaches were utilized to determine the combined drugs combination index based on the recommended dosage to achieve an efficacy of 50%. L-glutamine and crizanlizumab were effective in reducing the frequency of VOC (p= 0.0216 and p = 0.02). Voxelotor effect on the reduction of VOC occurrences was not significant, however, its effect on increasing hemoglobin levels was significant (p= <0.001). In all three therapies, pain was the most common adverse event reported by participants. The analysis of combination therapies revealed that voxelotor plus l-glutamine was synergistic, voxelotor plus crizanlizumab was antagonistic, and l-glutamine plus crizanlizumab was additive. Thus, voxelotor plus l-glutamine combination therapy may be more beneficial to sickle cell disease patients. As such, robust combination drug studies for approved therapies used in SCD should be initiated with a specific focus on voxelotor plus l-glutamine. Additionally, the development of medications that lessen the pain burden in sickle cell disease patients should also be prioritized.
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Ahmed NR, Kulkarni VV, Pokhrel S, Akram H, Abdelgadir A, Chatterjee A, Khan S. Comparing the Efficacy and Safety of Obeticholic Acid and Semaglutide in Patients With Non-Alcoholic Fatty Liver Disease: A Systematic Review. Cureus 2022; 14:e24829. [PMID: 35693370 PMCID: PMC9173657 DOI: 10.7759/cureus.24829] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 05/08/2022] [Indexed: 11/05/2022] Open
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Pokhrel S, Pokhrel R, Pokhrel N, Khadka N, Pardhe B. T175 MPV as an indicator of vascular complication in poor control diabetic population. Clin Chim Acta 2022. [DOI: 10.1016/j.cca.2022.04.654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Pokhrel R, Pokhrel N, Pokhrel S, Chaudhary A, Khadka N. M217 Six sigma metric evaluations of routine biochemistry parameters and glycated hemoglobin in a fully automated clinical chemistry laboratory. Clin Chim Acta 2022. [DOI: 10.1016/j.cca.2022.04.405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Asseri AH, Alam MJ, Alzahrani F, Khames A, Pathan MT, Abourehab MAS, Hosawi S, Ahmed R, Sultana SA, Alam NF, Alam NU, Alam R, Samad A, Pokhrel S, Kim JK, Ahammad F, Kim B, Tan SC. Toward the Identification of Natural Antiviral Drug Candidates against Merkel Cell Polyomavirus: Computational Drug Design Approaches. Pharmaceuticals (Basel) 2022; 15:ph15050501. [PMID: 35631328 PMCID: PMC9146542 DOI: 10.3390/ph15050501] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 04/05/2022] [Accepted: 04/12/2022] [Indexed: 12/21/2022] Open
Abstract
Merkel cell carcinoma (MCC) is a rare form of aggressive skin cancer mainly caused by Merkel cell polyomavirus (MCPyV). Most MCC tumors express MCPyV large T (LT) antigens and play an important role in the growth-promoting activities of oncoproteins. Truncated LT promotes tumorigenicity as well as host cell proliferation by activating the viral replication machinery, and inhibition of this protein in humans drastically lowers cellular growth linked to the corresponding cancer. Our study was designed with the aim of identifying small molecular-like natural antiviral candidates that are able to inhibit the proliferation of malignant tumors, especially those that are aggressive, by blocking the activity of viral LT protein. To identify potential compounds against the target protein, a computational drug design including molecular docking, ADME (absorption, distribution, metabolism, and excretion), toxicity, molecular dynamics (MD) simulation, and molecular mechanics generalized Born surface area (MM-GBSA) approaches were applied in this study. Initially, a total of 2190 phytochemicals isolated from 104 medicinal plants were screened using the molecular docking simulation method, resulting in the identification of the top five compounds having the highest binding energy, ranging between −6.5 and −7.6 kcal/mol. The effectiveness and safety of the selected compounds were evaluated based on ADME and toxicity features. A 250 ns MD simulation confirmed the stability of the selected compounds bind to the active site (AS) of the target protein. Additionally, MM-GBSA analysis was used to determine the high values of binding free energy (ΔG bind) of the compounds binding to the target protein. The five compounds identified by computational approaches, Paulownin (CID: 3084131), Actaealactone (CID: 11537736), Epigallocatechin 3-O-cinnamate (CID: 21629801), Cirsilineol (CID: 162464), and Lycoricidine (CID: 73065), can be used in therapy as lead compounds to combat MCPyV-related cancer. However, further wet laboratory investigations are required to evaluate the activity of the drugs against the virus.
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Affiliation(s)
- Amer H. Asseri
- Biochemistry Department, Faculty of Science, King Abdul-Aziz University, Jeddah 21589, Saudi Arabia; (A.H.A.); (F.A.); (S.H.)
- Centre for Artificial Intelligence in Precision Medicines, King Abdul-Aziz University, Jeddah 21589, Saudi Arabia
| | - Md. Jahidul Alam
- Department of Applied Chemistry and Chemical Engineering, Noakhali Science and Technology University, Noakhali 3814, Bangladesh;
| | - Faisal Alzahrani
- Biochemistry Department, Faculty of Science, King Abdul-Aziz University, Jeddah 21589, Saudi Arabia; (A.H.A.); (F.A.); (S.H.)
- King Fahd Medical Research Center, Embryonic Stem Cells Unit, Department of Biochemistry, Faculty of Science, King Abdul-Aziz University, Jeddah 21589, Saudi Arabia
| | - Ahmed Khames
- Department of Pharmaceutics and Industrial pharmacy, College of Pharmacy, Taif University, P.O. Box 11099, Taif 21944, Saudi Arabia;
| | - Mohammad Turhan Pathan
- Department of Biochemistry and Microbiology, North South University, Dhaka 1229, Bangladesh;
| | - Mohammed A. S. Abourehab
- Department of Pharmaceutics, Faculty of Pharmacy, Umm Al-Qura University, Makkah 21955, Saudi Arabia;
| | - Salman Hosawi
- Biochemistry Department, Faculty of Science, King Abdul-Aziz University, Jeddah 21589, Saudi Arabia; (A.H.A.); (F.A.); (S.H.)
- Centre for Artificial Intelligence in Precision Medicines, King Abdul-Aziz University, Jeddah 21589, Saudi Arabia
| | - Rubaiat Ahmed
- Department of Biochemistry and Molecular Biology, University of Dhaka, Dhaka 1000, Bangladesh; (R.A.); (N.F.A.)
| | - Sifat Ara Sultana
- Department of Pharmacy, Faculty of Pharmacy, University of Dhaka, Dhaka 1000, Bangladesh;
| | - Nazia Fairooz Alam
- Department of Biochemistry and Molecular Biology, University of Dhaka, Dhaka 1000, Bangladesh; (R.A.); (N.F.A.)
| | - Nafee-Ul Alam
- Department of Biotechnology, College of Life Science and Medicine, Zhejiang Sci-Tech University, Hangzhou 310018, China;
| | - Rahat Alam
- Department of Genetic Engineering and Biotechnology, Faculty of Biological Science and Technology, Jashore University of Science and Technology, Jashore 7408, Bangladesh; (R.A.); (A.S.)
- Laboratory of Computational Biology, Biological Solution Centre (BioSol Centre), Jashore 7408, Bangladesh
| | - Abdus Samad
- Department of Genetic Engineering and Biotechnology, Faculty of Biological Science and Technology, Jashore University of Science and Technology, Jashore 7408, Bangladesh; (R.A.); (A.S.)
- Laboratory of Computational Biology, Biological Solution Centre (BioSol Centre), Jashore 7408, Bangladesh
| | - Sushil Pokhrel
- Department of Biomedical Engineering, State University of New York (SUNY), Binghamton, NY 13902, USA;
| | - Jin Kyu Kim
- College of Korean Medicine, Kyung Hee University, Kyungheedae-ro 26, Dongdaemun-gu, Seoul 05254, Korea;
| | - Foysal Ahammad
- Laboratory of Computational Biology, Biological Solution Centre (BioSol Centre), Jashore 7408, Bangladesh
- Department of Biological Sciences, Faculty of Science, King Abdul-Aziz University (KAU), Jeddah 21589, Saudi Arabia
- Correspondence: (F.A.); (B.K.); (S.C.T.)
| | - Bonglee Kim
- College of Korean Medicine, Kyung Hee University, Kyungheedae-ro 26, Dongdaemun-gu, Seoul 05254, Korea;
- Correspondence: (F.A.); (B.K.); (S.C.T.)
| | - Shing Cheng Tan
- UKM Medical Molecular Biology Institute, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia
- Correspondence: (F.A.); (B.K.); (S.C.T.)
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Tiwari G, Thakur AK, Pokhrel S, Tiwari G, Pahari DP. Health care seeking behavior for common childhood illnesses in Birendranagar municipality, Surkhet, Nepal: 2018. PLoS One 2022; 17:e0264676. [PMID: 35353836 PMCID: PMC8967048 DOI: 10.1371/journal.pone.0264676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Accepted: 02/16/2022] [Indexed: 11/18/2022] Open
Abstract
Background Appropriate and prompt health care seeking by parents or caretakers can reduce morbidity and mortality among under-five year children. Although remarkable progress has been made in the reduction of under-five mortality, still the under-five mortality rate is high in Nepal. There are few studies on health care seeking behavior among caretakers in Nepal. Therefore, this study was conducted to determine the prevailing health care seeking behavior of caretakers on common childhood illness of under five year children and to identify the association of socio demographic, economic, illness related and health system related factors with health care seeking behavior in 2018. Methods A community based descriptive cross-sectional study was conducted from September to November 2018. Data were collected using a pretested semi-structured interview schedule. Both descriptive and inferential statistics were used to present the data. Bivariate and multivariate logistic regression analysis was used to identify the factors associated with health care seeking behavior. Results A total of 387 caretakers participated in the study. Of these, 84.8% sought any type of care and 15.2% did nothing. Amongst those who sought care 42.4% visited the pharmacy directly, 25.3% visited the health facility. Amongst those who visited a health facility, 37.2% of caretakers sought prompt health care. Common danger sign stated by caretakers was fever in children (92.4%). Secondary education(AOR = 0.357, 95%CI = 0.142–0.896), involvement in service as an occupation(AOR = 3.533, 95%CI = 1.096–11.384), distance to reach nearest health facility(0.957, 95%CI = 0.923–0.993) and perceived severity of illness; moderate severity (7.612, 95%CI = 2.127–27.242), severe severity (AOR = 15.563, 95%CI = 3.495–69.308) were found to be significantly associated with health care seeking behavior. Conclusion Strong policies and regulations should be formulated and implemented at Birendranagar municipality of Surkhet district to prevent direct purchase of medicines from pharmacies without any consultation. It is essential to conduct the health awareness program at community level on early recognition of danger signs and importance of consulting health facilities.
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Affiliation(s)
- Ganga Tiwari
- Department of Community Medicine and Public Health, Maharajgunj Medical Campus, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
- * E-mail:
| | - Ajoy Kumar Thakur
- Department of Community Medicine and Public Health, Maharajgunj Medical Campus, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
| | - Sushil Pokhrel
- Department of Orthopedics and Trauma Surgery, Maharajgunj Medical Campus, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
| | - Ganesh Tiwari
- Department of Medicine, Karnali Academy of Health Sciences, Jumla, Nepal
| | - Durga Prasad Pahari
- Central Department of Public Health, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
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Abdelgadir A, Akram H, Dick MH, Ahmed NR, Chatterjee A, Pokhrel S, Vaijaya Kulkarni V, Khan S. A Better Understanding of Moyamoya in Trisomy 21: A Systematic Review. Cureus 2022; 14:e23502. [PMID: 35494994 PMCID: PMC9036620 DOI: 10.7759/cureus.23502] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 03/25/2022] [Indexed: 11/05/2022] Open
Abstract
Moyamoya disease is defined as stenosis of the internal carotid artery or the middle, anterior or posterior cerebral arteries with considerable collateral development. This collateral vessel has a particular appearance in angiographic examinations. Moyamoya syndrome is a term used to describe when moyamoya disease occurs in conjunction with other systemic disorders. One of the associations is Down syndrome. Moyamoya syndrome is very common in patients with Down syndrome, and the cause for this is unknown. The majority of patients present in their first decade, with the clinical presentation varying with age. The cause of moyamoya syndrome in people with trisomy 21 is unknown. This research aimed to learn more about the genesis and pathology of moyamoya syndrome in people with Down syndrome. The Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines were used to conduct this systematic review. Several publications connected to this topic were searched through a comprehensive database search. They were narrowed down to a final number of ten articles after applying inclusion and exclusion criteria and analyzing the quality of each work. Several possibilities were presented in these final papers to explain the link between moyamoya syndrome and trisomy 21. Trisomy 21 patients have a genetic predisposition to vascular problems. The RNF213 gene may interact with the genes on chromosome 21 that influence vascular physiology and elasticity in patients with Down syndrome, resulting in the whole picture of moyamoya syndrome.
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Pokhrel S, Bouback TA, Samad A, Nur SM, Alam R, Abdullah-Al-Mamun M, Nain Z, Imon RR, Talukder MEK, Tareq MMI, Hossen MS, Karpiński TM, Ahammad F, Qadri I, Rahman MS. Spike protein recognizer receptor ACE2 targeted identification of potential natural antiviral drug candidates against SARS-CoV-2. Int J Biol Macromol 2021; 191:1114-1125. [PMID: 34592225 PMCID: PMC8474879 DOI: 10.1016/j.ijbiomac.2021.09.146] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Revised: 09/14/2021] [Accepted: 09/21/2021] [Indexed: 01/19/2023]
Abstract
Angiotensin-converting enzyme 2 (ACE2), also known as peptidyl-dipeptidase A, belongs to the dipeptidyl carboxydipeptidases family has emerged as a potential antiviral drug target against SARS-CoV-2. Most of the ACE2 inhibitors discovered till now are chemical synthesis; suffer from many limitations related to stability and adverse side effects. However, natural, and selective ACE2 inhibitors that possess strong stability and low side effects can be replaced instead of those chemicals' inhibitors. To envisage structurally diverse natural entities as an ACE2 inhibitor with better efficacy, a 3D structure-based-pharmacophore model (SBPM) has been developed and validated by 20 known selective inhibitors with their correspondence 1166 decoy compounds. The validated SBPM has excellent goodness of hit score and good predictive ability, which has been appointed as a query model for further screening of 11,295 natural compounds. The resultant 23 hits compounds with pharmacophore fit score 75.31 to 78.81 were optimized using in-silico ADMET and molecular docking analysis. Four potential natural inhibitory molecules namely D-DOPA (Amb17613565), L-Saccharopine (Amb6600091), D-Phenylalanine (Amb3940754), and L-Mimosine (Amb21855906) have been selected based on their binding affinity (−7.5, −7.1, −7.1, and −7.0 kcal/mol), respectively. Moreover, 250 ns molecular dynamics (MD) simulations confirmed the structural stability of the ligands within the protein. Additionally, MM/GBSA approach also used to support the stability of molecules to the binding site of the protein that also confirm the stability of the selected four natural compounds. The virtual screening strategy used in this study demonstrated four natural compounds that can be utilized for designing a future class of potential natural ACE2 inhibitor that will block the spike (S) protein dependent entry of SARS-CoV-2 into the host cell.
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Affiliation(s)
- Sushil Pokhrel
- Department of Biomedical Engineering, State University of New York (SUNY), Binghamton, NY 13902, USA
| | - Thamer A Bouback
- Department of Biological Sciences, Faculty of Science, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Abdus Samad
- Department of Genetic Engineering and Biotechnology, Faculty of Biological Science, Jashore University of Science and Technology, Jashore 7408, Bangladesh; Laboratory of Computational Biology, Biological Solution Centre (BioSol Centre), Jashore 7408, Bangladesh
| | - Suza Mohammad Nur
- Department of Biochemistry, Faculty of Science, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Rahat Alam
- Department of Genetic Engineering and Biotechnology, Faculty of Biological Science, Jashore University of Science and Technology, Jashore 7408, Bangladesh; Laboratory of Computational Biology, Biological Solution Centre (BioSol Centre), Jashore 7408, Bangladesh
| | - Md Abdullah-Al-Mamun
- Biotechnology and Genetic Engineering Discipline, Life Science School, Khulna University, Khulna 9208, Bangladesh
| | - Zulkar Nain
- Laboratory of Computational Biology, Biological Solution Centre (BioSol Centre), Jashore 7408, Bangladesh; School of Medicine, University of Utah, Salt Lake City, UT 84112, USA
| | - Raihan Rahman Imon
- Department of Genetic Engineering and Biotechnology, Faculty of Biological Science, Jashore University of Science and Technology, Jashore 7408, Bangladesh; Laboratory of Computational Biology, Biological Solution Centre (BioSol Centre), Jashore 7408, Bangladesh
| | - Md Enamul Kabir Talukder
- Department of Genetic Engineering and Biotechnology, Faculty of Biological Science, Jashore University of Science and Technology, Jashore 7408, Bangladesh; Laboratory of Computational Biology, Biological Solution Centre (BioSol Centre), Jashore 7408, Bangladesh
| | - Md Mohaimenul Islam Tareq
- Department of Genetic Engineering and Biotechnology, Faculty of Biological Science, Jashore University of Science and Technology, Jashore 7408, Bangladesh; Laboratory of Computational Biology, Biological Solution Centre (BioSol Centre), Jashore 7408, Bangladesh
| | - Md Saddam Hossen
- Laboratory of Computational Biology, Biological Solution Centre (BioSol Centre), Jashore 7408, Bangladesh; Department of Biology, School of Life Science, Zhejiang Sci-Tech University, Hangzhou 310018, China
| | - Tomasz M Karpiński
- Department of Medical Microbiology, Poznań University of Medical Sciences, Wieniawskiego 3, 61-712 Poznań, Poland
| | - Foysal Ahammad
- Department of Biological Sciences, Faculty of Science, King Abdulaziz University, Jeddah 21589, Saudi Arabia; Laboratory of Computational Biology, Biological Solution Centre (BioSol Centre), Jashore 7408, Bangladesh.
| | - Ishtiaq Qadri
- Department of Biochemistry, Faculty of Science, King Abdulaziz University, Jeddah 21589, Saudi Arabia.
| | - Md Shahedur Rahman
- Department of Genetic Engineering and Biotechnology, Faculty of Biological Science, Jashore University of Science and Technology, Jashore 7408, Bangladesh.
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Pokhrel S, Gregory A, Mellor A. Perioperative care in cardiac surgery. BJA Educ 2021; 21:396-402. [PMID: 34567795 PMCID: PMC8446225 DOI: 10.1016/j.bjae.2021.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/17/2021] [Indexed: 10/20/2022] Open
Affiliation(s)
- S. Pokhrel
- James Cook University Hospital, Middlesbrough, UK
| | | | - A. Mellor
- James Cook University Hospital, Middlesbrough, UK
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Chapgain RH, Adhikari S, Pandey A, Sharma S, Pokhrel S, Devkota N, Shrestha NJ, Upadhaya D, Acharay J, Dharel M. Knowledge and Practices of Child Protection among the School Health Nurses of Nepal. Kathmandu Univ Med J (KUMJ) 2021; 19:460-466. [PMID: 36259189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Background Child protection is burning issues in developing countries including Nepal. Child protection is one of the key works of the school health nurses. Objective To find out about the existing knowledge and practices of child protection among the school health nurses. Method This descriptive cross-sectional study was conducted among 130 school health nurses working in different schools throughout Nepal. The participants were selected using purposive sampling technique and were invited to participate via various online networks. Self-administered questionnaire was used to collect data. Duration of data collection was 20 December 2020 to 10 February 2021. Descriptive statistics was used to analyze and interpret the data. Result Among the 130 Participants, 88.5% belonged to less than 29 years age group and 67.7% had Proficiency Certificate Level in Nursing education. None of them has received training related to child protection recognition and response and 90.8% had work experience of less than 5 years. Eighty percent and 96.9% participants had knowledge regarding the meaning of child right and child abuse respectively. But 45.4% had knowledge on meaning of child neglect; 53.1% and 72.3% had the knowledge of physical abuse and noncontact sexual abuse respectively. Majority (86.9%) of the participants reported as relatives were the abuser and 63.8% replied as home is the common place for abuse. Similarly, 85.4% had received the information regarding child protection via television radio and newspaper. Only 36.1% has already been involved in child protection. The participants who went to local government (Palika), police and Non-government Organizations for coordination for child right issues were 9(19.1%), 7(14.8%) and 8(17.0%) respectively. Conclusion Most of the school health nurses are young without having experience of childhood abuse and received any child protection training before joining the job. They have good knowledge of child right, physical, sexual abuse except child neglect and existing legal arrangements. There is gap in knowledge and practice.
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Affiliation(s)
- R H Chapgain
- Kanti Children's Hospital, Kathmandu, Nepal. National Academy of Medical Sciences (NAMS), Kathmandu, Nepal
| | - S Adhikari
- KantiChildren's Hospital, Kathmandu, Nepal
| | - A Pandey
- Birgunj Nursing Campus, Institute of Medicine, Tribhuvan University, Birgunj, Parsa, Nepal
| | - S Sharma
- Scheer Memorial Hospital, Banepa, Nepal
| | - S Pokhrel
- KantiChildren's Hospital, Kathmandu, Nepal
| | - N Devkota
- KantiChildren's Hospital, Kathmandu, Nepal
| | - N J Shrestha
- KantiChildren's Hospital, Kathmandu, Nepal. National Academy of Medical Sciences (NAMS), Kathmandu, Nepal
| | - D Upadhaya
- Cumbria Partnership NHS Foundation Trust, UK
| | - J Acharay
- Alder Hey Children's Hospital, NHS Foundation Trust, UK
| | - M Dharel
- National Child Right Council, Kathmandu, Nepal
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Kane AD, Paterson J, Pokhrel S, Berry SK, Monkhouse D, Brand JW, Ingram M, Danjoux GR. Peri-operative COVID-19 infection in urgent elective surgery during a pandemic surge period: a retrospective observational cohort study. Anaesthesia 2020; 75:1596-1604. [PMID: 33090469 DOI: 10.1111/anae.15281] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/22/2020] [Indexed: 12/23/2022]
Abstract
Maintaining safe elective surgical activity during the global coronavirus disease 2019 (COVID-19) pandemic is challenging and it is not clear how COVID-19 may impact peri-operative morbidity and mortality in this population. Therefore, adaptations to normal care pathways are required. Here, we establish if implementation of a bespoke peri-operative care bundle for urgent elective surgery during a pandemic surge period can deliver a low COVID-19-associated complication profile. We present a single-centre retrospective cohort study from a tertiary care hospital of patients planned for urgent elective surgery during the initial COVID-19 surge in the UK between 29 March and 12 June 2020. Patients asymptomatic for COVID-19 were screened by oronasal swab and chest imaging (chest X-ray or computed tomography if aged ≥ 18 years), proceeding to surgery if negative. COVID-19 positive patients at screening were delayed. Postoperatively, patients transitioning to COVID-19 positive status by reverse transcriptase polymerase chain reaction testing were identified by an in-house tracking system and monitored for complications and death within 30 days of surgery. Out of 557 patients referred for surgery (230 (41.3%) women; median (IQR [range]) age 61 (48-72 [1-89])), 535 patients (96%) had COVID-19 screening, of which 13 were positive (2.4%, 95%CI 1.4-4.1%). Out of 512 patients subsequently undergoing surgery, 7 (1.4%) developed COVID-19 positive status (1.4%, 95%CI 0.7-2.8%) with one COVID-19-related death (0.2%, 95%CI 0.0-1.1%) within 30 days. Out of these seven patients, four developed pneumonia, of which two required invasive ventilation including one patient with acute respiratory distress syndrome. Low rates of COVID-19 infection and mortality in the elective surgical population can be achieved within a targeted care bundle. This should provide reassurance that elective surgery can continue, where possible, despite high community rates of COVID-19.
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Affiliation(s)
- A D Kane
- Department of Anaesthesia, James Cook University Hospital, Middlesbrough, UK
| | - J Paterson
- Department of Anaesthesia, James Cook University Hospital, Middlesbrough, UK
| | - S Pokhrel
- Department of Anaesthesia, James Cook University Hospital, Middlesbrough, UK
| | - S K Berry
- Department of Anaesthesia, James Cook University Hospital, Middlesbrough, UK
| | - D Monkhouse
- Department of Intensive Care Medicine, James Cook University Hospital, Middlesbrough, UK
| | - J W Brand
- Department of Cardiothoracic Intensive Care Medicine and Anaesthesia, James Cook University Hospital, Middlesbrough, UK
| | - M Ingram
- Department of Cardiothoracic Intensive Care Medicine and Anaesthesia, James Cook University Hospital, Middlesbrough, UK
| | - G R Danjoux
- Department of Cardiothoracic Intensive Care Medicine and Anaesthesia, James Cook University Hospital, Middlesbrough, UK.,Hull York Medical School and School of Health and Social Science, Teesside University, Middlesbrough, UK
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Fairless L, Pokhrel S, Barham N. Patient perspectives of ‘one stop shop’ preassessment. J Cardiothorac Vasc Anesth 2019. [DOI: 10.1053/j.jvca.2019.07.114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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14
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Naatz H, Hoffmann R, Hartwig A, La Mantia F, Pokhrel S, Mädler L. Verfahren zur Bestimmung des Flachbandpotenzials von Nanopartikeln in porösen Elektroden. CHEM-ING-TECH 2018. [DOI: 10.1002/cite.201855178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- H. Naatz
- Universität Bremen; Mechanische Verfahrenstechnik; Badgasteiner Straße 1 28359 Bremen Deutschland
- Leibniz-Institut für Werkstofforientierte Technologien; Badgasteiner Straße 3 28359 Bremen Deutschland
| | - R. Hoffmann
- Universität Bremen; Biologie/Chemie; Leobener Straße 3 28359 Bremen Deutschland
- Fraunhofer-Institut für Fertigungstechnik und Angewandte Materialforschung; Wiener Straße 12 28359 Bremen Deutschland
| | - A. Hartwig
- Universität Bremen; Biologie/Chemie; Leobener Straße 3 28359 Bremen Deutschland
- Fraunhofer-Institut für Fertigungstechnik und Angewandte Materialforschung; Wiener Straße 12 28359 Bremen Deutschland
| | - F. La Mantia
- Universität Bremen; Energiesysteme; Bibliothekstraße 1 28359 Bremen Deutschland
| | - S. Pokhrel
- Universität Bremen; Mechanische Verfahrenstechnik; Badgasteiner Straße 1 28359 Bremen Deutschland
- Leibniz-Institut für Werkstofforientierte Technologien; Badgasteiner Straße 3 28359 Bremen Deutschland
| | - L. Mädler
- Universität Bremen; Mechanische Verfahrenstechnik; Badgasteiner Straße 1 28359 Bremen Deutschland
- Leibniz-Institut für Werkstofforientierte Technologien; Badgasteiner Straße 3 28359 Bremen Deutschland
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Trapero-Bertran M, Muñoz C, Coyle K, Coyle D, Lester-George A, Leidl R, Bertalan N, Cheung KL, Pokhrel S, Lopez-Nicolás A. Cost-effectiveness of alternative smoking cessation scenarios in Spain: results from the EQUIPTMOD. Tob Prev Cessat 2018. [DOI: 10.18332/tpc/90419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Trapero-Bertran M, Leidl R, Muñoz C, Kulchaitanaroaj P, Coyle K, Präger M, Józwiak-Hagymásy J, Cheung KL, Hiligsmann M, Pokhrel S, EQUIPT Study Group OBOT. Estimating costs for modelling return on investment from smoking cessation interventions. Tob Prev Cessat 2018. [DOI: 10.18332/tpc/90429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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17
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Cheung K, Evers S, De Vries H, Levy P, Pokhrel S, Jones T, Danner M, Wentlandt J, Knufinke L, Mayer S, Hiligsmann M. Most important barriers and facilitators of HTA usage in decision-making in Europe. Expert Rev Pharmacoecon Outcomes Res 2018; 18:297-304. [DOI: 10.1080/14737167.2018.1421459] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- K.L. Cheung
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, Netherlands
- Department of Health Promotion, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, Netherlands
- Department of Health Economics, Center for Public Health, Medical University of Vienna, Vienna, Austria
| | - S.M.A.A. Evers
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, Netherlands
| | - H. De Vries
- Department of Health Promotion, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, Netherlands
| | - P. Levy
- Department of Economics, Paris Dauphine University, Paris, France
| | - S. Pokhrel
- Health Economics Research Group, Brunel University, London, UK
| | - T. Jones
- Health Economics Research Group, Brunel University, London, UK
| | - M. Danner
- Institute for Health Economics and Clinical Epidemiology, Cologne University Hospital, Cologne, Germany
| | - J. Wentlandt
- Institute for Health Economics and Clinical Epidemiology, Cologne University Hospital, Cologne, Germany
| | - L. Knufinke
- Institute for Health Economics and Clinical Epidemiology, Cologne University Hospital, Cologne, Germany
| | - S. Mayer
- Department of Health Economics, Center for Public Health, Medical University of Vienna, Vienna, Austria
| | - M. Hiligsmann
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, Netherlands
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Tämm K, Sikk L, Burk J, Rallo R, Pokhrel S, Mädler L, Scott-Fordsmand JJ, Burk P, Tamm T. Parametrization of nanoparticles: development of full-particle nanodescriptors. Nanoscale 2016; 8:16243-16250. [PMID: 27714136 DOI: 10.1039/c6nr04376c] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
While metal oxide nanoparticles (NPs) are one of the most commonly used nanomaterials, the theoretical models used to analyze and predict their behavior have been mostly based on just the chemical composition or the extrapolation from small metal oxide clusters' calculations. In this study, a set of novel, theoretical full-particle descriptors for modeling, grouping or read-across of metal oxide NP properties and biological activity was developed based on the force-field calculation of the potential energies of whole NPs. The capability of these nanodescriptors to group the nanomaterials acoording to their biological activity was demonstrated by Principal Component Analysis (PCA). The grouping provided by the PCA approach was found to be in good accordance with the algal growth inhibition data of well characterized nanoparticles, synthesized and measured inside the consortia of the EU 7FP framework MODERN project.
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Affiliation(s)
- K Tämm
- Institute of Chemistry, University of Tartu, Ravila 14a, Tartu 50411, Estonia.
| | - L Sikk
- Institute of Chemistry, University of Tartu, Ravila 14a, Tartu 50411, Estonia.
| | - J Burk
- Institute of Chemistry, University of Tartu, Ravila 14a, Tartu 50411, Estonia.
| | - R Rallo
- Departament d'Enginyeria Informatica i Matematiques, Universitat Rovira i Virgili, Av. Paisos Catalans 26, Tarragona 43007, Spain
| | - S Pokhrel
- Foundation Institute of Materials Science (IWT), Department of Production Engineering, University of Bremen, Germany
| | - L Mädler
- Foundation Institute of Materials Science (IWT), Department of Production Engineering, University of Bremen, Germany
| | - J J Scott-Fordsmand
- Aarhus University, Dept Bioscience, Vejlsøvej 25, PO Box 314, 8600 Silkeborg, Denmark
| | - P Burk
- Institute of Chemistry, University of Tartu, Ravila 14a, Tartu 50411, Estonia.
| | - T Tamm
- Institute of Technology, University of Tartu, Nooruse 1, Tartu 50411, Estonia
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Izaguirre E, Pokhrel S, Hedrick S, Knewtson T. TU-H-CAMPUS-TeP2-03: High Sensitivity and High Resolution Fiber Based Micro-Detector for Sub-Millimeter Preclinical Dosimetry. Med Phys 2016. [DOI: 10.1118/1.4957691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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21
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Knewtson T, Pokhrel S, Loyalka S, Izaguirre E. SU-F-T-559: High-Resolution Scintillating Fiber Array for In-Vivo Real-Time SRS and SBRT Patient QA. Med Phys 2016. [DOI: 10.1118/1.4956744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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22
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Liu Y, Yan L, Li Z, Huang WF, Pokhrel S, Liu X, Su S. Larva-mediated chalkbrood resistance-associated single nucleotide polymorphism markers in the honey bee Apis mellifera. Insect Mol Biol 2016; 25:239-250. [PMID: 26991518 DOI: 10.1111/imb.12216] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Chalkbrood is a disease affecting honey bees that seriously impairs brood growth and productivity of diseased colonies. Although honey bees can develop chalkbrood resistance naturally, the details underlying the mechanisms of resistance are not fully understood, and no easy method is currently available for selecting and breeding resistant bees. Finding the genes involved in the development of resistance and identifying single nucleotide polymorphisms (SNPs) that can be used as molecular markers of resistance is therefore a high priority. We conducted genome resequencing to compare resistant (Res) and susceptible (Sus) larvae that were selected following in vitro chalkbrood inoculation. Twelve genomic libraries, including 14.4 Gb of sequence data, were analysed using SNP-finding algorithms. Unique SNPs derived from chromosomes 2 and 11 were analysed in this study. SNPs from resistant individuals were confirmed by PCR and Sanger sequencing using in vitro reared larvae and resistant colonies. We found strong support for an association between the C allele at SNP C2587245T and chalkbrood resistance. SNP C2587245T may be useful as a genetic marker for the selection of chalkbrood resistance and high royal jelly production honey bee lines, thereby helping to minimize the negative effects of chalkbrood on managed honey bees.
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Affiliation(s)
- Y Liu
- College of Bee Science, Fujian Agriculture and Forestry University, Fuzhou, China
| | - L Yan
- College of Animal Sciences, Zhejiang University, Hangzhou, China
| | - Z Li
- College of Bee Science, Fujian Agriculture and Forestry University, Fuzhou, China
| | - W-F Huang
- College of Bee Science, Fujian Agriculture and Forestry University, Fuzhou, China
- Illinois Natural History Survey, Prairie Research Institute, University of Illinois at Urbana-Champaign, Illinois, USA
| | - S Pokhrel
- College of Bee Science, Fujian Agriculture and Forestry University, Fuzhou, China
| | - X Liu
- College of Bee Science, Fujian Agriculture and Forestry University, Fuzhou, China
| | - S Su
- College of Bee Science, Fujian Agriculture and Forestry University, Fuzhou, China
- College of Animal Sciences, Zhejiang University, Hangzhou, China
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Poudel R, Acharya A, Pokhrel S, Adhikari SK. Mucinous Cystic Borderline Tumor of the Mesentery: A Case Report. Kathmandu Univ Med J (KUMJ) 2015; 13:170-1. [PMID: 26643837 DOI: 10.3126/kumj.v13i2.16793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Mucinous cystic neoplasms are rare tumors of uncertain histogenesis. They arise from the ovaries, pancreas, and other intra-abdominal sites but more unusually from the mesentery. They can present with abdominal pain, distension, or a palpable mass but are commonly an incidental finding. We present a case of a 33-year-old female who presented with complain of pain abdomen for one-year duration. On Physical examination there was a palpable lump in right lumbar region extending to right iliac fossa. CT scan of abdomen and pelvis suggested the mass to be a Mesenteric Cyst. Enucleation of the cyst was done and histopathology report revealed Mucinous Cystic borderline tumor of the Mesentery.
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Affiliation(s)
- R Poudel
- Department of Surgery National Academy of Medical Science Bir Hospital, Kathmandu, Nepal
| | - A Acharya
- Department of Surgery National Academy of Medical Science Bir Hospital, Kathmandu, Nepal
| | - S Pokhrel
- Department of Surgery National Academy of Medical Science Bir Hospital, Kathmandu, Nepal
| | - S K Adhikari
- Department of Surgery National Academy of Medical Science Bir Hospital, Kathmandu, Nepal
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Knewtson T, Pokhrel S, Hernandez-Morales D, Price S, Loyalka S, Rangaraj D, Izaguirre E. WE-AB-BRB-09: Real Time In Vivo Scintillating Fiber Array Detector for Medical LINACS. Med Phys 2015. [DOI: 10.1118/1.4925850] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Pokhrel S, Quigley MA, Fox-Rushby J, McCormick F, Williams A, Trueman P, Dodds R, Renfrew MJ. Potential economic impacts from improving breastfeeding rates in the UK. Arch Dis Child 2015; 100:334-40. [PMID: 25477310 DOI: 10.1136/archdischild-2014-306701] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
RATIONALE Studies suggest that increased breastfeeding rates can provide substantial financial savings, but the scale of such savings in the UK is not known. OBJECTIVE To calculate potential cost savings attributable to increases in breastfeeding rates from the National Health Service perspective. DESIGN AND SETTINGS Cost savings focussed on where evidence of health benefit is strongest: reductions in gastrointestinal and lower respiratory tract infections, acute otitis media in infants, necrotising enterocolitis in preterm babies and breast cancer (BC) in women. Savings were estimated using a seven-step framework in which an incidence-based disease model determined the number of cases that could have been avoided if breastfeeding rates were increased. Point estimates of cost savings were subject to a deterministic sensitivity analysis. RESULTS Treating the four acute diseases in children costs the UK at least £89 million annually. The 2009-2010 value of lifetime costs of treating maternal BC is estimated at £959 million. Supporting mothers who are exclusively breast feeding at 1 week to continue breast feeding until 4 months can be expected to reduce the incidence of three childhood infectious diseases and save at least £11 million annually. Doubling the proportion of mothers currently breast feeding for 7-18 months in their lifetime is likely to reduce the incidence of maternal BC and save at least £31 million at 2009-2010 value. CONCLUSIONS The economic impact of low breastfeeding rates is substantial. Investing in services that support women who want to breast feed for longer is potentially cost saving.
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Affiliation(s)
- S Pokhrel
- Health Economics Research Group, Brunel University London, Uxbridge, UK
| | - M A Quigley
- National Perinatal Epidemiology Unit, University of Oxford, Oxford, UK
| | - J Fox-Rushby
- Health Economics Research Group, Brunel University London, Uxbridge, UK
| | - F McCormick
- Department of Health Sciences, University of York, York, UK
| | - A Williams
- Department of Child Health, St. George's, University of London, London, UK
| | - P Trueman
- Health Economics Research Group, Brunel University London, Uxbridge, UK
| | - R Dodds
- NCT (formerly National Childbirth Trust), London, UK
| | - M J Renfrew
- Mother and Infant Research Unit, School of Nursing and Midwifery, University of Dundee, Dundee, UK
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Pati S, Dash MK, Mukherjee CK, Dash B, Pokhrel S. Assessment of water quality using multivariate statistical techniques in the coastal region of Visakhapatnam, India. Environ Monit Assess 2014; 186:6385-6402. [PMID: 24880726 DOI: 10.1007/s10661-014-3862-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2013] [Accepted: 05/21/2014] [Indexed: 06/03/2023]
Abstract
The present study was intended to develop a Water Quality Index (WQI) for the coastal water of Visakhapatnam, India from multiple measured water quality parameters using different multivariate statistical techniques. Cluster analysis was used to classify the data set into three major groups based on similar water quality characteristics. Discriminant analysis was used to generate a discriminant function for developing a WQI. Discriminant analysis gave the best result for analyzing the seasonal variation of water quality. It helped in data reduction and found the most discriminant parameters responsible for seasonal variation of water quality. Coastal water was classified into good, average, and poor quality considering WQI and the nutrient load. The predictive capacity of WQI was proved with random samples taken from coastal areas. High concentration of ammonia in surface water during winter was attributed to nitrogen fixation by the phytoplankton bloom which resulted due to East India Coastal Current. This study brings out the fact that water quality in the coastal region not only depends on the discharge from different pollution sources but also on the presence of different current patterns. It also illustrates the usefulness of WQI for analyzing the complex nutrient data for assessing the coastal water and identifying different pollution sources, considering reasons for seasonal variation of water quality.
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Affiliation(s)
- Sangeeta Pati
- Agricultural and Food Engineering Department, Indian Institute of Technology, Kharagpur, India,
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Pokhrel S, Palaniswaamy G, Rangaraj D, Loyalka S, Izaguirre E. SU-E-T-517: Analytic Formalism to Compute in Real Time Dose Distributions Delivered by HDR Units. Med Phys 2014. [DOI: 10.1118/1.4888850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Abstract
Progress in developing novel gas sensors based on semiconducting metal oxides (SMOX) has been hindered by the cumbersome fabrication technologies currently employed. They involve time intensive synthesis procedures for gaining sensitive materials and preparation of the inks employed for realizing sensing layers. In this paper we review the opportunities offered by the relatively young method of flame spray pyrolysis, with which it is possible not only to synthesize a broad selection of SMOX in pure or doped form, but also to simultaneously deposit thick and highly porous gas sensitive films on a variety of substrates. In less than ten years the properties of nine base materials have been evaluated for all most relevant target gases and the obtained results are promising for future development.
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Affiliation(s)
- J A Kemmler
- Institute of Physical and Theoretical Chemistry, University of Tübingen, Auf der Morgenstelle 15, D-72076 Tübingen, Germany
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Großmann H, Minnermann M, Pokhrel S, Thiel K, Hagelin-Weaver H, Bäumer M, Mädler L. Doppel-Flammen-Sprüh-Pyrolyse als innovative Technik zur Synthese von hochaktiven Fischer-Tropsch-Katalysatoren. CHEM-ING-TECH 2012. [DOI: 10.1002/cite.201250356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Damoiseaux R, George S, Li M, Pokhrel S, Ji Z, France B, Xia T, Suarez E, Rallo R, Mädler L, Cohen Y, Hoek EMV, Nel A. No time to lose--high throughput screening to assess nanomaterial safety. Nanoscale 2011; 3:1345-60. [PMID: 21301704 PMCID: PMC3980675 DOI: 10.1039/c0nr00618a] [Citation(s) in RCA: 90] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Nanomaterials hold great promise for medical, technological and economical benefits. Knowledge concerning the toxicological properties of these novel materials is typically lacking. At the same time, it is becoming evident that some nanomaterials could have a toxic potential in humans and the environment. Animal based systems lack the needed capacity to cope with the abundance of novel nanomaterials being produced, and thus we have to employ in vitro methods with high throughput to manage the rush logistically and use high content readouts wherever needed in order to gain more depth of information. Towards this end, high throughput screening (HTS) and high content screening (HCS) approaches can be used to speed up the safety analysis on a scale that commensurate with the rate of expansion of new materials and new properties. The insights gained from HTS/HCS should aid in our understanding of the tenets of nanomaterial hazard at biological level as well as assist the development of safe-by-design approaches. This review aims to provide a comprehensive introduction to the HTS/HCS methodology employed for safety assessment of engineered nanomaterials (ENMs), including data analysis and prediction of potentially hazardous material properties. Given the current pace of nanomaterial development, HTS/HCS is a potentially effective means of keeping up with the rapid progress in this field--we have literally no time to lose.
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Affiliation(s)
- R Damoiseaux
- Molecular Screening Shared Resources, University of California, Los Angeles, California
- California NanoSystems Institute at University of California, Los Angeles, California
| | - S George
- Department of Medicine-Division of NanoMedicine, University of California, Los Angeles, California
- Center for Environmental Implications of Nanotechnology, University of California, Los Angeles
| | - M Li
- Center for Environmental Implications of Nanotechnology, University of California, Los Angeles
| | - S Pokhrel
- IWT Foundation Institute of Materials Science, Department of Production Engineering, University of Bremen, Germany
| | - Z Ji
- Center for Environmental Implications of Nanotechnology, University of California, Los Angeles
| | - B France
- Center for Environmental Implications of Nanotechnology, University of California, Los Angeles
| | - T Xia
- Center for Environmental Implications of Nanotechnology, University of California, Los Angeles
| | - E Suarez
- Center for Environmental Implications of Nanotechnology, University of California, Los Angeles
| | - R Rallo
- Center for Environmental Implications of Nanotechnology, University of California, Los Angeles
- Departament d’Enginyeria Informatica i Matematiques, Universitat Rovira i Virgili, Catalunya, Spain
| | - L Mädler
- California NanoSystems Institute at University of California, Los Angeles, California
- IWT Foundation Institute of Materials Science, Department of Production Engineering, University of Bremen, Germany
| | - Y Cohen
- Center for Environmental Implications of Nanotechnology, University of California, Los Angeles
| | - EMV Hoek
- Center for Environmental Implications of Nanotechnology, University of California, Los Angeles
| | - A Nel
- Department of Medicine-Division of NanoMedicine, University of California, Los Angeles, California
- California NanoSystems Institute at University of California, Los Angeles, California
- Center for Environmental Implications of Nanotechnology, University of California, Los Angeles
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Abstract
BACKGROUND Nasolacrimal duct obstruction is a common problem which can be corrected by dacryocystorhinostomy (DCR). The gold standard treatment for this is DCR operation through an external approach. Development of endoscopic sinus surgery and endoscopic DCR performed through intranasal route is a major recent development in this field. OBJECTIVES The aim of this study is to find out the success rate of endoscopic dacryocystorhinostomy without silicon stent intubation within the period of six month following surgery. MATERIALS AND METHODS A prospective study was done on 26 patients with obstruction of the nasolacrimal duct referred from eye out-patient department to ENT OPD during one year period from 2008 to 2009. All the cases had undergone endoscopic DCR operation which was regularly followed up for a period of six months. Postoperative patency of ostium was checked by sac syringing and endoscopic visualisation of ostium in the nasal cavity. The success of surgery was categorised as: complete cure, partial cure and no improvement depending upon symptomatic relief and clinical examination such as sac syringing and endoscopic examination following surgery. RESULT In six months' follow-up, 22 (84.5%) out of 26 patients had achieved the complete cure and 4 patients (15.5%) continued to have persistent epiphora. CONCLUSION Endoscopic DCR is a beneficial procedure for nasolacrimal duct obstruction with no external scar on face and less bleeding. The success rate is as good as external DCR.
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Affiliation(s)
- S Shrestha
- Department of ENT-HNS, Kathmandu Medical College, Sinamangal, Kathmandu.
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Pokhrel S, Xia T, Kovochich M, Liong M, Schowalter M, Rosenauer A, Gilbert B, Zink J, Nel A, Mädler L. Comparison of the mechanism of toxicity of binary and mixed binary metal oxide nanoparticles based on dissolution and oxidative stress properties. CHEM-ING-TECH 2009. [DOI: 10.1002/cite.200950629] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Pokhrel S, Nagaraja KS. Refinement, comparisonal study and EPR measurements on the molecular structure of NN-diethyldithiocarbamate of Zn(II) and Cd(II). Cryst Res Technol 2006. [DOI: 10.1002/crat.200610758] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Joshi AB, Banjara MR, Pokhrel S, Jimba M, Singhasivanon P, Ashford RW. Elimination of visceral leishmaniasis in Nepal: pipe-dreams and possibilities. Kathmandu Univ Med J (KUMJ) 2006; 4:488-496. [PMID: 18603960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
INTRODUCTION Visceral Leishmaniasis (VL) re-emerged in the Indian subcontinent in the mid-1970s after an almost complete absence in the previous fifteen or so years. The disease was first noted in Nepal in 1978 and, since 1980, it has been reported regularly in increasing numbers. Elimination of visceral leishmaniasis by 2015 has been identified as regional priority program in the level of high political commitment. OBJECTIVE The objectives of this study are the comprehensive assessment of information related to VL on the basis of past research studies conducted in Nepal, and an assessment of the prospects of control measures. MATERIALS AND METHODS This was time line comprehensive VL epidemiological assessment study based on the research conducted by main author during the past ten years. During the period the studies were conducted using cross sectional, case control and exploratory study design. The statistical analysis was done using qualitative and quantitative methods. RESULTS In our study in the visceral leishmaniasis endemic district, Siraha, in the population of 112,029, a total of 996 clinically suspected cases were reported (with fever of long duration and splenomegaly, with no malaria) during 1998-2002. In all, 283 subjects were found positive for visceral leishmaniasis by rK39 and 284 had positive bone marrow. There was no detectable difference in the density of Phlebotomus argentipes between high, and moderate incidence village development committees (VDC: the smallest administrative unit), but collections in the low incidence areas (in winter) were negative. P. argentipes was never numerous (maximum 4.4 females collected per man-hour), and was much less common than P. papatasi. Peaks of abundance were recorded in the March and September collections. We have found that the numbers of reported cases of visceral leishmaniasis in Nepalese villages was unaffected by indoor residual spray (IRS) indicated by parallel trends in case numbers by time series analysis in treated and untreated villages. A series of maps through ten years clearly showed that the infection can move rapidly between villages, and it is impossible to predict where transmission will occur from year to year. CONCLUSION If maximum benefit in relation to cost is the goal, it may be preferable to put all possible efforts into active case detection (ACD) with free treatment. ACD should involve the network of Village Health Workers or Female Community Health Volunteers and the rK39 dipstick test at health centre level. Surveillance of disease and vector, communication for behavioural impacts and insecticide spraying should be important component of elimination program. If IRS is to be a part of the intervention, it is essential that it is carried out effectively, both in areas where the disease has been reported and in neighbouring areas. Integrated vector management need to be monitored for its application and effectiveness for VL elimination.
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Affiliation(s)
- A B Joshi
- Research Section, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal.
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Pokhrel S, Dhakshinamoorthy A, Sundaram R, Nagaraja KS. Crystal growth and characterization of PbI2-AgI binary system. Cryst Res Technol 2005. [DOI: 10.1002/crat.200410424] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Baral N, Pokhrel S, Lamsal M, Yadav BN, Sah SP. Utility of gamma-glutamyl transpeptidase and mean corpuscular volume in alcoholic liver disease. Southeast Asian J Trop Med Public Health 2005; 36:1007-10. [PMID: 16295559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
The present study was designed to establish the role of Gamma-glutamyl transpeptidase (gamma-GT) and mean corpuscular volume (MCV) in alcoholic liver disease (ALD). Serum gamma-GT, total and direct bilirubin, albumin, total protein, AST, ALT and ALP were assayed by standard methods in a clinical chemistry autoanalyser. MCV, Hb, PCV and RBC were measured by an automated cell counter. Activity of gamma-GT and MCV levels were significantly higher in the patients with ALD compared to controls. A gamma-GT level of > or = 25 U/l was found to be significantly associated with ALD. MCV level > or = 100 fl/l showed a significant association with ALD. An AST to ALT ratio > 1 was found in 92% of the patients. None of the patients showed an ALT level > or = 300 IU/l. The degree of AST elevation in the patients with ALD was higher (3.7 times) then ALT (3.2 times). A gamma-GT level > or = 25 IU/L and an MCV level > or = 100 fl/l stand as markers of heavy alcohol consumption in this study. An AST to ALT ratio > 1 was present in most of the patients with ALD. The degree of elevation of AST was higher than ALT in the patients with ALD.
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Affiliation(s)
- N Baral
- Department of Biochemistry, BP Koirala Institute of Health Science, Dharan, Nepal.
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Pokhrel S, Nagaraja KS, Varghese B. Preparation, Characterization, and X-Ray Structure Analysis of 1,4-Diazabicyclo-2,2,2-octane (DABCO) and Ammonium Cation with Tetrathiomolybdate Anion. J STRUCT CHEM+ 2004. [DOI: 10.1007/s10947-005-0076-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Abstract
AIM A cross sectional study was carried out on 78 screened cataract patients of two screening camps in Kathmandu valley, Nepal, to assess the willingness to pay for cataract surgery. METHODS A non-probability sampling technique with open ended and close ended questionnaires was used. RESULTS The average age of patients was 68.8 years. The ratio of men and women was 0.9:1. 42.3% (33) of patients were willing to pay for cataract surgery. Among them 48.5% (16) of people were willing to pay less than dollars 13 and 51.5% (17) were willing to pay more than dollars 13. The mean was dollars 2.3 (SD dollars 15.5) per case. Patients with bilateral cataract were more willing to pay than unilateral cases. Poverty (44.4%, 20) was the main barrier for unwillingness to pay for cataract surgery. Other reasons were the lack of family support (28.9%, 13), lack of knowledge of surgery and belief that it was an unnecessary procedure (15.6%, seven), and waiting for a free surgical service (11.1%, five). CONCLUSION This study clearly indicates that although there was awareness of the availability of treatment and services provided within the reach, people are not willing to pay for the surgery and use the facility primarily because of poverty. Hence, to change patients' attitudes, a more holistic approach is needed, keeping in view the cultural, social, and economic background of the society.
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Pokhrel S, Nagaraja KS, Varghese B. Synthesis, Characterization, and X-Ray Diffraction Analysis of Triethylenetetraammonium Tetrathiomolybdate. J STRUCT CHEM+ 2003. [DOI: 10.1023/b:jory.0000017946.18501.fb] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Jha N, Pokhrel S, Sehgal R. Awareness about a national immunization day programme in the Sunsari district of Nepal. Bull World Health Organ 1999; 77:602-6. [PMID: 10444884 PMCID: PMC2557701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/13/2023] Open
Abstract
The initiative to eradicate poliomyelitis globally by the year 2000 was launched at the Forty-first World Health Assembly in May 1988, when all WHO Member States were challenged to help eradicate poliomyelitis from the world, a gift to the children of the twenty-first century. In Nepal, 100-250 children per year become disabled due to poliomyelitis. The government of Nepal is determined to eradicate the disease from the country by the year 2000 through the National Immunization Day (NID) Programme. Since 1996, about 3.3 million children under 5 years of age have been immunized each year in Nepal. In the present study, we analysed the impact of the campaign in the Sunsari district of Nepal. The study was carried out during the first NID (6 December 1996) to evaluate the local population's awareness of the programme and the impact of the media on such awareness. A total of 843 respondents were interviewed, 39% of whom were illiterate. Two important aspects of the mass campaign (whether a child previously immunized should be immunized again in the NID, and whether children should be brought to the next NID) were clearly understood by the majority of the people (93.1% and 98.8% of the respondents, respectively), although only a small proportion (24.4%) of individuals understood the purpose of the programme. Radio was the single most effective means of providing information, education, and communication about NIDs. The encouraging response, especially from a poor, illiterate rural population, augurs well for the goal of eradicating poliomyelitis from the world.
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Affiliation(s)
- N Jha
- Department of Community Medicine, B.P. Koirala Institute of Health Science, Dharan, Nepal
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