81 results on '"Thapa, L."'
Search Results
2. Do winter and summer cohorts of the invasive weed Parthenium hysterophorus differ in seed germination and seedling growth?
- Author
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Shrestha, A., Dangol, A., Airi, H., Kharel, N., Thapa, L. B., Devkota, A., and Shrestha, B. B.
- Subjects
PARTHENIUM hysterophorus ,NOXIOUS weeds ,GERMINATION ,SUMMER ,SEEDLINGS ,WEEDS - Abstract
The highly invasive weed Parthenium hysterophorus flowers during both hot, humid summers and cold, dry winters in Nepal, yet it remains unknown if there are differences in seed germination and seedling growth during these contrasting seasons. We analysed seed germination and seedling growth of summer and winter cohorts of P. hysterophorus in Kathmandu Valley. Seeds were germinated at low (25/15°C) and high (30/20°C) temperatures, 12/12 h photoperiod and complete dark, and at different levels of water stress. Seedlings were grown in a greenhouse to determine biomass allocation and relative growth rate (RGR). Winter seeds had higher seed biomass than summer seeds, and both seed types germinated under complete dark and 12/12 h photoperiod. Summer seeds germinated at significantly lower rates and percentage than winter seeds at the low temperature, but this difference in germination was not present when summer and winter seeds were incubated at the high temperature. Winter seeds had higher germination (percentage and rate) and took a longer time to reach maximum germination than summer seeds at different levels of water stress. Seedling emergence of both seed types declined with increasing soil depth. Seedling RGRs were nearly equal (summer: 73 mg g−1 day−1, winter: 77 mg g−1 day−1). Biomass allocation to stem and leaves were similar in both cohorts but root biomass allocation was higher in the winter than in the summer cohort. Overall, the maternal environmental effect was moderate on seed germination, and weak on seedling growth. Lack of a pronounced difference in the germination and seedling growth of summer and winter cohorts of P. hysterophorus suggests a wide environmental tolerance of the species, and this could be one of the reasons for the species' ability to invade diverse climatic and geographic regions globally. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
3. Pragmatic solutions to reduce the global burden of stroke: a World Stroke Organization–Lancet Neurology Commission
- Author
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Feigin, V, Owolabi, M, Abd-Allah, F, Akinyemi, R, Bhattacharjee, N, Brainin, M, Cao, J, Caso, V, Dalton, B, Davis, A, Dempsey, R, Duprey, J, Feng, W, Ford, G, Gall, S, Gandhi, D, Good, D, Hachinski, V, Hacke, W, Hankey, G, Ishida, M, Johnson, W, Kim, J, Lavados, P, Lindsay, P, Mahal, A, Martins, S, Murray, C, Nguyen, T, Norrving, B, Olaiya, M, Olalusi, O, Pandian, J, Phan, H, Platz, T, Ranta, A, Rehman, S, Roth, G, Sebastian, I, Smith, A, Suwanwela, N, Sylaja, P, Thapa, R, Thrift, A, Uvere, E, Vollset, S, Yavagal, D, Yaria, J, Abera, S, Ibrahim, N, Liu, L, Ovbiagele, B, Piradov, M, Abanto, C, Addissie, A, Adeleye, A, Adilbekov, Y, Adilbekova, B, Adoukonou, T, Aguiar de Sousa, D, Akhmetzhanova, Z, Akpalu, A, El Alaoui-Faris, M, Ameriso, S, Andonova, S, Arsovska, A, Awoniyi, F, Bakhiet, M, Barboza, M, Basri, H, Bath, P, Bereczki, D, Beretta, S, Berkowitz, A, Bernhardt, J, Berzina, G, Bhavsar, B, Bisharyan, M, Bohara, M, Bovet, P, Budincevic, H, Cadilhac, D, Cerimagic, D, Charway-Felli, A, Chen, C, Chin, J, Christensen, H, Chwojnicki, K, Conforto, A, Correia, M, Mora Cuervo, D, Czlonkowska, A, D'Amelio, M, Danielyan, K, Davis, S, Demarin, V, Demchuk, A, Dichgans, M, Dokova, K, Donnan, G, Duran, J, Ekeng, G, Elkind, M, Endres, M, Fischer, U, Flomin, Y, Gankpe, F, Gavidia, M, Gaye Saavedra, A, Gebreyohanns, M, George, M, Gierlotka, M, Giroud, M, Gnedovskaya, E, Goncalves, I, Gongora-Rivera, F, Gunaratne, P, Hamadeh, R, Hamzat, T, Heldner, M, Ibrahim, E, Ihle-Hansen, H, Jee, S, Jiann-Shing, J, Johnston, S, Jovanovic, D, Jurjans, K, Kalani, R, Kalkonde, Y, Kamenova, S, Karaszewski, B, Kelly, P, Kiechl, S, Kondybayeva, A, Korv, J, Kozera, G, Kravchenko, M, Krespi, Y, Krishnamurthi, R, Kruja, J, Kutluk, K, Langhorne, P, Law, Z, Lebedynets, D, Lee, T, Leung, T, Liebeskind, D, Lopez-Jaramillo, P, Lotufo, P, Machline-Carrion, M, Maia, L, Malojcic, B, Markus, H, Marquez-Romero, J, Medina, M, Medukhanova, S, Mehndiratta, M, Miglane, E, Mihejeva, I, Mikulik, R, Mirrakhimov, E, Mohl, S, Munakomi, S, Murphy, S, Musa, K, Nasreldein, A, Nogueira, R, Nolte, C, Noubiap, J, Novarro-Escudero, N, Ocampo, C, O'Donnell, M, Ogun, Y, Ogunniyi, A, Oraby, M, Orken, D, Ozdemir, A, Ozturk, S, Paccot, M, Pereira, T, Peeters, A, Potpara, T, Proios, H, Rathore, F, Sacco, R, Sahathevan, R, Sandset, E, Renato Santos, I, Saposnik, G, Sarfo, F, Sargento-Freitas, J, Sharma, M, Shaw, L, Sheth, K, Shin, Y, Shobhana, A, Silva, S, Tedim Cruz, V, Thakur, K, Thapa, L, Toni, D, Topcuoglu, M, Torales, J, Towfighi, A, Truelsen, T, Tsiskaridze, A, Tulloch-Reid, M, Useche, J, Vanacker, P, Vassilopoulou, S, Vukorepa, G, Vuletic, V, Wahab, K, Wang, W, Wijeratne, T, Wojtyniak, B, Wolfe, C, Yacouba, M, Yang, J, Yifru, Y, Yock-Corrales, A, Yonemoto, N, Yperzeele, L, Zagozdzon, P, Feigin V. L., Owolabi M. O., Abd-Allah F., Akinyemi R. O., Bhattacharjee N. V., Brainin M., Cao J., Caso V., Dalton B., Davis A., Dempsey R., Duprey J., Feng W., Ford G. A., Gall S., Gandhi D., Good D. C., Hachinski V., Hacke W., Hankey G. J., Ishida M., Johnson W., Kim J., Lavados P., Lindsay P., Mahal A., Martins S., Murray C., Nguyen T. P., Norrving B., Olaiya M. T., Olalusi O. V., Pandian J., Phan H., Platz T., Ranta A., Rehman S., Roth G., Sebastian I. A., Smith A. E., Suwanwela N. C., Sylaja P. N., Thapa R., Thrift A. G., Uvere E., Vollset S. E., Yavagal D., Yaria J., Abera S. F., Akinyemi R., Dempsey R. J., Ibrahim N. M., Liu L., Ovbiagele B., Piradov M., Suwanwela N., Abanto C., Addissie A., Adeleye A. O., Adilbekov Y., Adilbekova B., Adoukonou T. A., Aguiar de Sousa D., Akhmetzhanova Z., Akpalu A., El Alaoui-Faris M., Ameriso S. F., Andonova S., Arsovska A., Awoniyi F. E., Bakhiet M., Barboza M. A., Basri H., Bath P. M., Bereczki D., Beretta S., Berkowitz A. L., Bernhardt J., Berzina G., Bhavsar B., Bisharyan M. S., Bohara M., Bovet P., Budincevic H., Cadilhac D. A., Cerimagic D., Charway-Felli A., Chen C., Chin J. H., Christensen H., Chwojnicki K., Conforto A. B., Correia M., Mora Cuervo D. L., Czlonkowska A., D'Amelio M., Danielyan K. E., Davis S., Demarin V., Demchuk A. M., Dichgans M., Dokova K., Donnan G., Duran J. C., Ekeng G., Elkind M. S., Endres M., Fischer U., Flomin Y., Gankpe F., Gavidia M., Gaye Saavedra A., Gebreyohanns M., George M., Gierlotka M., Giroud M., Gnedovskaya E. V., Goncalves I. P., Gongora-Rivera F., Gunaratne P. S., Hamadeh R. R., Hamzat T. -H. K., Heldner M. R., Ibrahim E., Ihle-Hansen H., Jee S., Jiann-Shing J., Johnston S. C., Jovanovic D., Jurjans K., Kalani R., Kalkonde Y., Kamenova S., Karaszewski B., Kelly P., Kiechl S., Kondybayeva A., Korv J., Kozera G., Kravchenko M., Krespi Y., Krishnamurthi R., Kruja J., Kutluk K., Langhorne P., Law Z. K., Lebedynets D., Lee T. -H., Leung T. W., Liebeskind D. S., Lopez-Jaramillo P., Lotufo P. A., Machline-Carrion M. J., Maia L. F., Malojcic B., Markus H. S., Marquez-Romero J. M., Medina M. T., Medukhanova S., Mehndiratta M. M., Miglane E., Mihejeva I., Mikulik R., Mirrakhimov E., Mohl S., Munakomi S., Murphy S., Musa K. I., Nasreldein A., Nogueira R. G., Nolte C. H., Noubiap J. J., Novarro-Escudero N., Ocampo C., O'Donnell M., Ogun Y., Ogunniyi A., Oraby M. I., Orken D. N., Ozdemir A. O., Ozturk S., Paccot M., Pereira T., Peeters A., Potpara T., Proios H., Rathore F. A., Sacco R. L., Sahathevan R., Sandset E. S., Renato Santos I., Saposnik G., Sarfo F. S., Sargento-Freitas J., Sharma M., Shaw L., Sheth K. N., Shin Y. -I., Shobhana A., Silva S. N., Tedim Cruz V., Thakur K., Thapa L. J., Toni D., Topcuoglu M. A., Torales J., Towfighi A., Truelsen T., Tsiskaridze A., Tulloch-Reid M., Useche J. N., Vanacker P., Vassilopoulou S., Vukorepa G., Vuletic V., Wahab K. W., Wang W., Wijeratne T., Wojtyniak B., Wolfe C., Yacouba M. N., Yang J., Yifru Y. M., Yock-Corrales A., Yonemoto N., Yperzeele L., Zagozdzon P., Feigin, V, Owolabi, M, Abd-Allah, F, Akinyemi, R, Bhattacharjee, N, Brainin, M, Cao, J, Caso, V, Dalton, B, Davis, A, Dempsey, R, Duprey, J, Feng, W, Ford, G, Gall, S, Gandhi, D, Good, D, Hachinski, V, Hacke, W, Hankey, G, Ishida, M, Johnson, W, Kim, J, Lavados, P, Lindsay, P, Mahal, A, Martins, S, Murray, C, Nguyen, T, Norrving, B, Olaiya, M, Olalusi, O, Pandian, J, Phan, H, Platz, T, Ranta, A, Rehman, S, Roth, G, Sebastian, I, Smith, A, Suwanwela, N, Sylaja, P, Thapa, R, Thrift, A, Uvere, E, Vollset, S, Yavagal, D, Yaria, J, Abera, S, Ibrahim, N, Liu, L, Ovbiagele, B, Piradov, M, Abanto, C, Addissie, A, Adeleye, A, Adilbekov, Y, Adilbekova, B, Adoukonou, T, Aguiar de Sousa, D, Akhmetzhanova, Z, Akpalu, A, El Alaoui-Faris, M, Ameriso, S, Andonova, S, Arsovska, A, Awoniyi, F, Bakhiet, M, Barboza, M, Basri, H, Bath, P, Bereczki, D, Beretta, S, Berkowitz, A, Bernhardt, J, Berzina, G, Bhavsar, B, Bisharyan, M, Bohara, M, Bovet, P, Budincevic, H, Cadilhac, D, Cerimagic, D, Charway-Felli, A, Chen, C, Chin, J, Christensen, H, Chwojnicki, K, Conforto, A, Correia, M, Mora Cuervo, D, Czlonkowska, A, D'Amelio, M, Danielyan, K, Davis, S, Demarin, V, Demchuk, A, Dichgans, M, Dokova, K, Donnan, G, Duran, J, Ekeng, G, Elkind, M, Endres, M, Fischer, U, Flomin, Y, Gankpe, F, Gavidia, M, Gaye Saavedra, A, Gebreyohanns, M, George, M, Gierlotka, M, Giroud, M, Gnedovskaya, E, Goncalves, I, Gongora-Rivera, F, Gunaratne, P, Hamadeh, R, Hamzat, T, Heldner, M, Ibrahim, E, Ihle-Hansen, H, Jee, S, Jiann-Shing, J, Johnston, S, Jovanovic, D, Jurjans, K, Kalani, R, Kalkonde, Y, Kamenova, S, Karaszewski, B, Kelly, P, Kiechl, S, Kondybayeva, A, Korv, J, Kozera, G, Kravchenko, M, Krespi, Y, Krishnamurthi, R, Kruja, J, Kutluk, K, Langhorne, P, Law, Z, Lebedynets, D, Lee, T, Leung, T, Liebeskind, D, Lopez-Jaramillo, P, Lotufo, P, Machline-Carrion, M, Maia, L, Malojcic, B, Markus, H, Marquez-Romero, J, Medina, M, Medukhanova, S, Mehndiratta, M, Miglane, E, Mihejeva, I, Mikulik, R, Mirrakhimov, E, Mohl, S, Munakomi, S, Murphy, S, Musa, K, Nasreldein, A, Nogueira, R, Nolte, C, Noubiap, J, Novarro-Escudero, N, Ocampo, C, O'Donnell, M, Ogun, Y, Ogunniyi, A, Oraby, M, Orken, D, Ozdemir, A, Ozturk, S, Paccot, M, Pereira, T, Peeters, A, Potpara, T, Proios, H, Rathore, F, Sacco, R, Sahathevan, R, Sandset, E, Renato Santos, I, Saposnik, G, Sarfo, F, Sargento-Freitas, J, Sharma, M, Shaw, L, Sheth, K, Shin, Y, Shobhana, A, Silva, S, Tedim Cruz, V, Thakur, K, Thapa, L, Toni, D, Topcuoglu, M, Torales, J, Towfighi, A, Truelsen, T, Tsiskaridze, A, Tulloch-Reid, M, Useche, J, Vanacker, P, Vassilopoulou, S, Vukorepa, G, Vuletic, V, Wahab, K, Wang, W, Wijeratne, T, Wojtyniak, B, Wolfe, C, Yacouba, M, Yang, J, Yifru, Y, Yock-Corrales, A, Yonemoto, N, Yperzeele, L, Zagozdzon, P, Feigin V. L., Owolabi M. O., Abd-Allah F., Akinyemi R. O., Bhattacharjee N. V., Brainin M., Cao J., Caso V., Dalton B., Davis A., Dempsey R., Duprey J., Feng W., Ford G. A., Gall S., Gandhi D., Good D. C., Hachinski V., Hacke W., Hankey G. J., Ishida M., Johnson W., Kim J., Lavados P., Lindsay P., Mahal A., Martins S., Murray C., Nguyen T. P., Norrving B., Olaiya M. T., Olalusi O. V., Pandian J., Phan H., Platz T., Ranta A., Rehman S., Roth G., Sebastian I. A., Smith A. E., Suwanwela N. C., Sylaja P. N., Thapa R., Thrift A. G., Uvere E., Vollset S. E., Yavagal D., Yaria J., Abera S. F., Akinyemi R., Dempsey R. J., Ibrahim N. M., Liu L., Ovbiagele B., Piradov M., Suwanwela N., Abanto C., Addissie A., Adeleye A. O., Adilbekov Y., Adilbekova B., Adoukonou T. A., Aguiar de Sousa D., Akhmetzhanova Z., Akpalu A., El Alaoui-Faris M., Ameriso S. F., Andonova S., Arsovska A., Awoniyi F. E., Bakhiet M., Barboza M. A., Basri H., Bath P. M., Bereczki D., Beretta S., Berkowitz A. L., Bernhardt J., Berzina G., Bhavsar B., Bisharyan M. S., Bohara M., Bovet P., Budincevic H., Cadilhac D. A., Cerimagic D., Charway-Felli A., Chen C., Chin J. H., Christensen H., Chwojnicki K., Conforto A. B., Correia M., Mora Cuervo D. L., Czlonkowska A., D'Amelio M., Danielyan K. E., Davis S., Demarin V., Demchuk A. M., Dichgans M., Dokova K., Donnan G., Duran J. C., Ekeng G., Elkind M. S., Endres M., Fischer U., Flomin Y., Gankpe F., Gavidia M., Gaye Saavedra A., Gebreyohanns M., George M., Gierlotka M., Giroud M., Gnedovskaya E. V., Goncalves I. P., Gongora-Rivera F., Gunaratne P. S., Hamadeh R. R., Hamzat T. -H. K., Heldner M. R., Ibrahim E., Ihle-Hansen H., Jee S., Jiann-Shing J., Johnston S. C., Jovanovic D., Jurjans K., Kalani R., Kalkonde Y., Kamenova S., Karaszewski B., Kelly P., Kiechl S., Kondybayeva A., Korv J., Kozera G., Kravchenko M., Krespi Y., Krishnamurthi R., Kruja J., Kutluk K., Langhorne P., Law Z. K., Lebedynets D., Lee T. -H., Leung T. W., Liebeskind D. S., Lopez-Jaramillo P., Lotufo P. A., Machline-Carrion M. J., Maia L. F., Malojcic B., Markus H. S., Marquez-Romero J. M., Medina M. T., Medukhanova S., Mehndiratta M. M., Miglane E., Mihejeva I., Mikulik R., Mirrakhimov E., Mohl S., Munakomi S., Murphy S., Musa K. I., Nasreldein A., Nogueira R. G., Nolte C. H., Noubiap J. J., Novarro-Escudero N., Ocampo C., O'Donnell M., Ogun Y., Ogunniyi A., Oraby M. I., Orken D. N., Ozdemir A. O., Ozturk S., Paccot M., Pereira T., Peeters A., Potpara T., Proios H., Rathore F. A., Sacco R. L., Sahathevan R., Sandset E. S., Renato Santos I., Saposnik G., Sarfo F. S., Sargento-Freitas J., Sharma M., Shaw L., Sheth K. N., Shin Y. -I., Shobhana A., Silva S. N., Tedim Cruz V., Thakur K., Thapa L. J., Toni D., Topcuoglu M. A., Torales J., Towfighi A., Truelsen T., Tsiskaridze A., Tulloch-Reid M., Useche J. N., Vanacker P., Vassilopoulou S., Vukorepa G., Vuletic V., Wahab K. W., Wang W., Wijeratne T., Wojtyniak B., Wolfe C., Yacouba M. N., Yang J., Yifru Y. M., Yock-Corrales A., Yonemoto N., Yperzeele L., and Zagozdzon P.
- Published
- 2023
4. Estimating Fire Radiative Power Using Weather Radar Products for Wildfires.
- Author
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Saide, P. E., Krishna, M., Ye, X., Thapa, L. H., Turney, F., Howes, C., and Schmidt, C. C.
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WILDFIRES ,RADAR meteorology ,MACHINE learning ,SMOKE plumes ,BIOMASS burning ,WILDFIRE prevention ,CLOUDINESS ,RAINFALL - Abstract
Satellite‐based Fire radiative power (FRP) retrievals are used to track wildfire activity but are sometimes not possible or have large uncertainties. Here, we show that weather radar products including composite and base reflectivity and equivalent rainfall integrated in the vicinity of the fires show strong correlation with hourly FRP for multiple fires during 2019–2020. Correlation decreases when radar beams are blocked by topography and when there is significant ground clutter (GC) and anomalous propagation (AP). GC/AP can be effectively removed using a machine learning classifier trained with radar retrieved correlation coefficient, velocity, and spectrum width. We find a power‐law best describes the relationship between radar products and FRP for multiple fires combined (0.67–0.76 R2). Radar‐based FRP estimates can be used to fill gaps in satellite FRP created by cloud cover and show great potential to overcome satellite FRP biases occurring during extreme fire events. Plain Language Summary: The radiant energy emitted by wildfires (FRP) is an important variable that controls many aspects of the smoke plume including the amount of emission released into the atmosphere and how high it travels. Biomass burning debris, which are large particles generated by combustion, can be suspended in the atmosphere along with smoke. Weather radars can detect and retrieve information from these large particles, which can be used for a variety of applications. In this work, we show that retrievals from weather radars can be used to estimate FRP with reasonable results. Echoes associated with ground artifacts affect these results but can be effectively screened using machine learning algorithms trained on manually selected data of representative plume and non‐plume cases. Satellite FRP can often be missing or underpredicted especially for extreme fire events, and thus this technique offers an alternative way to provide a more accurate depiction of fire evolution that can be used to predict smoke impacts. Key Points: Weather radar products integrated in the vicinity of fires can be used to estimate Fire radiative power (FRP) through a power‐law relationshipThe relationships between FRP and radar products are skillful only after removing artifacts using a machine learning classifierRadar‐based FRP has potential to fill gaps and overcome satellite FRP biases occurring during extreme fire events [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
5. IDF2022-0525 Cost of illness of diabetes mellitus among patients visiting a tertiary diabetes center in Kathmandu, Nepal
- Author
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Sharma, T., primary, Paudel, K., additional, Joshi, A., additional, Karmacharya, S., additional, Thapa, L., additional, and Dahal, P., additional
- Published
- 2023
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6. IDF2022-0562 Self-care practice of patients with diabetes mellitus visiting a tertiary diabetes center in Kathmandu, Nepal
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Dahal, P., primary, Joshi, A., additional, Thapa, L., additional, and Sharma, T., additional
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- 2023
- Full Text
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7. Plant communities in Shivapuri-Nagarjun National Park, Central Nepal.
- Author
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Dhakall, T. M., Thapa, L. B., Yadav, R. K. P., and Pokhrel, C. P.
- Published
- 2023
- Full Text
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8. Chorea-acanthocytosis: a case report
- Author
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Thapa L, Bhattarai S, Shrestha MP, Panth R, Gongal DN, and Devkota UP
- Subjects
acanthocytes ,lip-biting ,neuroacanthocytosis ,orofacial dyskinesia ,Medicine (General) ,R5-920 - Abstract
Lekhjung Thapa,1 Suman Bhattarai,1 Milan P Shrestha,1 Rajesh Panth,2 Dinesh Nath Gongal,3 Upendra Prasad Devkota,31Department of Neurology, 2Department of Pathology, 3Department of Neurosurgery, National Institute of Neurological and Allied Sciences, Kathmandu, Nepal Abstract: Neuroacanthocytosis is a group of rare disorders. We report a 36-year-old right-handed female who presented with gradually progressive abnormal facial movements, generalized weakness, and lower-lip biting starting 4 years ago. On examination, she had lower-lip ulcer, orofacial dyskinesias, and peripheral neuropathy. Her peripheral blood smears showed acanthocytosis and magnetic resonance imaging revealed atrophied head of caudate nuclei and putaminal hyperintensities on T2-weighted and fluid attenuated inversion recovery images. Work-up for autoimmune and metabolic causes was negative. She was diagnosed with chorea-acanthocytosis, an entity under neuroacanthocytosis syndrome and the patient was offered symptomatic treatment. Keywords: acanthocytes, lip-biting, neuroacanthocytosis, orofacial dyskinesia, movement disorder
- Published
- 2016
9. Stroke subtype, age, and baseline NIHSS score predict ischemic stroke outcomes at 3 months: a preliminary study from Central Nepal
- Author
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Shrestha S, Poudel RS, Khatiwada D, and Thapa L
- Subjects
Medicine (General) ,R5-920 - Abstract
Shakti Shrestha,1 Ramesh Sharma Poudel,2 Dipendra Khatiwada,3 Lekhjung Thapa4 1Department of Pharmacy, Shree Medical and Technical College, 2Department of Pharmacy, 3Department of Community Medicine, 4Department of Neurology, College of Medical Sciences-Teaching Hospital, Chitwan, Nepal Background: The combined medications practice of using antithrombotic agents and statins with or without antihypertensive agents is common in the treatment of acute ischemic stroke in Nepal. Short-term outcomes of the current practice have been studied. We aim to explore the predictors of ischemic stroke outcomes at 3 months, with the current combined medications practice. Methods: The study population (N=56) included acute ischemic stroke patients treated at the Neurology Department of the College of Medical Sciences-Teaching Hospital, Chitwan, Nepal, from May 2014 to August 2014 and followed up at 3 months. Death or disability (modified Rankin scale >2) was defined as poor outcomes. Multivariate logistic regression analysis (P
- Published
- 2015
10. Comparative analysis of hydrochemical variables of two Ramsar-listed lakes in Pokhara Valley, Nepal
- Author
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Pant, R. R., primary, Bishwakarma, K., additional, Pal, K. B., additional, Thapa, L. B., additional, Shrestha, R. G., additional, Karuppannan, S., additional, Garu, L., additional, Bista, S., additional, and Singh, V. B., additional
- Published
- 2022
- Full Text
- View/download PDF
11. Impact of Albendazole Therapy on Clinical and Radiological Outcomes at One Month in Patients with Active Solitary Neurocysticercosis Patients
- Author
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Bhattarai, S., primary, Thapa, L., additional, Maharjan, A. M. S., additional, Shrestha, A. M., additional, Shrestha, S., additional, Ghimire, M. R., additional, Upadhyaya, S., additional, and Thapa, M., additional
- Published
- 2022
- Full Text
- View/download PDF
12. REVISITING THE CURRENT UAV REGULATIONS IN NEPAL: A STEP TOWARDS LEGAL DIMENSION FOR UAVS EFFICIENT APPLICATION
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Shrestha, R., Zevenbergen, J.A., Panday, U.S., Awasthi, B., Karki, S., McDougall, K., Bhatta, G.P., Paudyal, D.R., Upadhyaya, P.S., Dahal, T.P., Ranjit, B., Shrestha, S., Thapa, L., Department of Urban and Regional Planning and Geo-Information Management, UT-I-ITC-PLUS, and Faculty of Geo-Information Science and Earth Observation
- Subjects
lcsh:Applied optics. Photonics ,010504 meteorology & atmospheric sciences ,lcsh:T ,business.industry ,Computer science ,Geomatics ,0211 other engineering and technologies ,lcsh:TA1501-1820 ,ComputerApplications_COMPUTERSINOTHERSYSTEMS ,02 engineering and technology ,lcsh:Technology ,01 natural sciences ,Drone ,Systematic review ,Risk analysis (engineering) ,lcsh:TA1-2040 ,Precision agriculture ,Dimension (data warehouse) ,lcsh:Engineering (General). Civil engineering (General) ,Human resources ,business ,Spatial analysis ,021101 geological & geomatics engineering ,0105 earth and related environmental sciences - Abstract
UAVs-Unmanned Aerial Vehicles- also known as drones, are an emerging geospatial technology that can facilitate data acquisition at various temporal and spatial scales. Notwithstanding, the wide application of UAVs globally, its wider application is found to be growing in Nepal as well. For instance, precision agriculture, forestry, topographical surveying, etc. It seems that there is a correlation between efficient use of UAVs in these sectors and the legal frameworks that regulate the use of UAVs. Therefore, it seems necessary to obtain holistic national view of UAVs regulations. Aligning with this necessity, this paper provides insight on existing legal provisions for UAVs in Nepal by highlighting the importance, impact, and limitations of UAV regulations. The criteria used in the framework to capture the present holistic legal dimension from literature in the web of science database are a) applicability b) technical requirements c) operational requirements/ limitations d) administration procedure e) human resource requirements and f) implementation of ethical constraints. The adopted methodological approach consists of exploratory case studies, systematic reviews of the concerned literature on UAVs regulations and the workshop on “Flight 4 Purpose” in which various UAVs application were discussed. The results show that the existing legal framework has both strengths and weaknesses for its use to capture the spatial data. The way forward is to harmonize the soft and hard regulations so that such geospatial technology can be applied for overall development and ultimately for the societal benefits.
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- 2019
13. Leveraging citizen science to advance interactive spatial decision support technology
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Shrestha, R., Flacke, J., McDougall, K., Bhatta, G.P., Paudyal, D.R., Upadhyaya, P.S., Dahal, D.P., Ranjit, B., Shrestha, S., Thapa, L., Department of Urban and Regional Planning and Geo-Information Management, UT-I-ITC-PLUS, and Faculty of Geo-Information Science and Earth Observation
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lcsh:Applied optics. Photonics ,0106 biological sciences ,Decision support system ,Participatory planning ,Knowledge management ,Planning support system citizen science ,lcsh:Technology ,010603 evolutionary biology ,01 natural sciences ,Spatial decision support system ,Political science ,Citizen science ,Decision-making ,SWOT analysis ,lcsh:T ,business.industry ,010604 marine biology & hydrobiology ,Participation ,lcsh:TA1501-1820 ,Information technology ,SWOT ,lcsh:TA1-2040 ,Public participation ,lcsh:Engineering (General). Civil engineering (General) ,business - Abstract
Over three decades, the Spatial Decision Support System (SDSS) concept has evolved significantly exploiting information technology to assist decision maker in a variety of fields of research, development, and practice. With the communicative turn in planning, which emphasizes public participation in all levels of planning and decision making, these technologies have further matured to support participatory planning by means of supporting diverse stakeholders in the decision making process. However, for multiple reasons, SDSS are still in the domain of expert, largely failing to incorporate general citizens in its use and applications. On the same note, citizen science as a method of inquiry is gaining much attention in recent years to engage general citizens in the scientific research, thereby also empowering them to participate in the decisions of the issues affecting them. As such, it seems likely that citizen science shows great promise for advancing SDSS for achieving broad citizen engagement in planning and decision-making. This paper discusses the strengths, weaknesses, opportunities, threats (SWOT) of integrating citizen science with SDSS by analyzing existing literature on SDSS and citizen science. In particular, we explore the integration of aspects of citizen science in Interactive Planning Support System (PSS), as one form of SDSS to support wider citizen engagement.
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- 2019
14. MEASURING GROWTH CONDITIONS OF SALAD PLANTS USING SENSORS: A HIGH SCHOOL PROJECT
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Thapa, L., primary, Naseer, H., additional, El-Kaiy, S., additional, and Bartoschek, T., additional
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- 2018
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15. FATE OF AGRICULTURAL AREAS OF KAILALI DISTRICT OF NEPAL: A TEMPORAL LAND USE LAND COVER CHANGE (LUCC) ANALYSIS.
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Niraj K.C., Thapa, L., and Shukla, D. P.
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LAND use ,NATURAL disasters ,LAND resource ,LANDSAT satellites ,FARMS ,LAND cover ,CARTOGRAPHY software - Abstract
Changes of agricultural land into non-agricultural land is the main issue of increasing population and urbanization. The objective of this paper is to identify the various land resources and its changes into other Land Use Land Cover (LULC) type. LANDSAT satellite data for 1990, 2000, 2010 and 2018 years of Kailali district Nepal was acquired for supervised LULC mapping and change analysis using ENVI 5.4 software. Sentinel-2 and Google earth satellite data were used for the accuracy assessment of the LULC map. The time-series data analysis from 1990–2000–2010–2018 shows major changes in vegetation and agriculture. The changes in LULC show that settlement and bare land is continuously increasing throughout these years. The change in land use and land cover during the period of 1990–2018 shows that the settlement area is increased by 204%; and agriculture is decreased by 57%. The fluctuating behavior of vegetation, agriculture and water bodies in which the areas decrease and increase over the selected periods is due to natural calamities and migration of the local population. This shows that human influence on the land resources is accelerating and leading to a deterioration of agricultural land. Thus effective agricultural management practices and policies should be carried out at the government level for minimizing land resources degradation by the human-induced impact. [ABSTRACT FROM AUTHOR]
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- 2020
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16. Knowledge, Beliefs, and Practices on Epilepsy among High School Students of Central Nepal.
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Thapa, L, Bhandari, TR, Shrestha, S, Poudel, RS, Thapa, L, Bhandari, TR, Shrestha, S, and Poudel, RS
- Abstract
Introduction. Epilepsy continues to increase worldwide but, unfortunately, many high school students have inadequate knowledge of and negative beliefs towards the disease. We aimed to assess the knowledge, beliefs, and practices of epilepsy among high school students of Central Nepal. Materials and Methods. A cross-sectional study was performed involving 1360 high school students from 33 private schools across Bharatpur, from June 2013 to July 2013, to assess their knowledge, beliefs, and practices (KBP) on epilepsy using a standardized questionnaire. The differences in mean KBP scores between different sexes, religions, and those personally knowing versus not knowing someone with epilepsy were assessed using independent t-tests; a Pearson correlation was calculated to assess the relationship between KBP scores and age. Results. Of 1360 participants, 79 (5.8%) students had never heard or read about epilepsy and were consequently excluded from statistical analysis. Only 261 out of 1360 (19.2%) had personally known someone with epilepsy. The mean KBP scores were 5.0/8, 7.4/12, and 1.7/3, respectively. Statistically significant differences were only observed in the knowledge component of the KBP score; female scored higher than males (p < 0.001) and, interestingly, students who had personally known a person with epilepsy actually knew less than those who had not known one (p = 0.018). We also found a significant negative correlation between knowledge and age (p = 0.003). Conclusions. The overall knowledge, beliefs, and practices appear to be inadequate, emphasizing the need for further educational intervention.
- Published
- 2017
17. Cerebral Venous Sinus Thrombosis during Everest Expedition: A Case Report and Review of the Literature
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Khanal, P., Thapa, L., Shrestha, A. M., Bhattarai, S., Sapkota, D., Sharma, N., and Devkota, U. P.
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Article Subject ,human activities - Abstract
Cerebral venous sinus thrombosis (CVST) is a rare but serious disorder that is associated with a poor clinical outcome. We report a 35-year-old man who had a severe headache and diplopia while climbing Mount Everest. His MR venography showed right transverse and right sigmoid sinus thrombosis. He improved on anticoagulant and symptomatic measures. Cerebral venous sinus thrombosis at high altitude is discussed.
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- 2016
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18. FEASIBILITY STUDY OF LOW-COST IMAGE-BASED HERITAGE DOCUMENTATION IN NEPAL
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Dhonju, H. K., primary, Xiao, W., additional, Sarhosis, V., additional, Mills, J. P., additional, Wilkinson, S., additional, Wang, Z., additional, Thapa, L., additional, and Panday, U. S., additional
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- 2017
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19. Plant invasiveness and target plant density: high densities of nativeSchima wallichiiseedlings reduce negative effects of invasiveAgeratina adenophora
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Thapa, L B, primary, Kaewchumnong, K, additional, Sinkkonen, A, additional, and Sridith, K, additional
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- 2016
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20. SPATIAL-TEMPORAL ANALYSIS OF SOCIAL MEDIA DATA RELATED TO NEPAL EARTHQUAKE 2015
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Thapa, L., primary
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- 2016
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21. Plant invasiveness and target plant density: high densities of native Schima wallichii seedlings reduce negative effects of invasive Ageratina adenophora.
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Thapa, L B, Kaewchumnong, K, Sinkkonen, A, Sridith, K, and Freckleton, Rob
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- *
PLANT spacing , *INVASIVE plants , *SEEDLINGS , *PLANT biomass , *INTRODUCED plants , *FOREST litter - Abstract
Economically feasible strategies to cope with invasive species are urgently needed. Plant density can be increased to reduce competitive effects on target plants. This study indicates that increasing native plant density can be used to reduce the effect of invasive Ageratina adenophora. Seedlings of an indigenous tree species, Schima wallichii, were grown in pots containing uninvaded or invaded soil, with or without A. adenophora leaf litter on the soil surface. Schima wallichii seedlings were also grown at four densities under four levels of A. adenophora leaf litter. Root and shoot biomass and length were measured as response parameters in both bioassays. Schima wallichii growth was inhibited by A. adenophora leaf litter and invaded soil. High litter levels reduced S. wallichii root length and dry weight at low plant densities. The inhibition disappeared at high S. wallichii plant densities. As A. adenophora did not inhibit S. wallichii growth at high plant densities, adjustments of seedling density should be studied as a possible management strategy for invasion by A. adenophora and potentially by other exotic plant species. As density-dependent growth inhibition is the key characteristic of chemical interference, we propose that phytotoxins contribute to A. adenophora invasion particularly at low densities of native seedlings. [ABSTRACT FROM AUTHOR]
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- 2017
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22. Cheiro-Oral Syndrome.
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Thapa L., Amatya R., Maharjan S., Gaurishankar N., Shrestha A. M., Bhattarai S., Singh S. N., Gongal D. N., and Devkota U. P.
- Published
- 2018
23. Vitamin D and Other Risk Factors among Stroke Patients.
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Pokharel, B. R., Kharel, G., Thapa, L. J., and Rana, P. V. S.
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- 2015
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24. Estimation methodology for forest biomass in Mongolia using remote sensing
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T. Altanchimeg, T. Renchin, P. De Maeyer, E. Natsagdorj, B. Tseveen, B. Norov, McDougall, K., Bhatta, G. P., Paudyal, D. R., Shrestha, R., Upadhyaya, P. S., Dahal, T. P., Ranjit, B., Shrestha, S., and Thapa, L.
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lcsh:Applied optics. Photonics ,0106 biological sciences ,Estimation ,Ground truth ,Biomass (ecology) ,Backscatter ,lcsh:T ,lcsh:TA1501-1820 ,lcsh:Technology ,010603 evolutionary biology ,01 natural sciences ,lcsh:TA1-2040 ,Remote sensing (archaeology) ,Co2 concentration ,Earth and Environmental Sciences ,Environmental science ,General Earth and Planetary Sciences ,Leaf area index ,lcsh:Engineering (General). Civil engineering (General) ,Water content ,010606 plant biology & botany ,Remote sensing ,General Environmental Science - Abstract
The forest biomass is one of the most important parameters for the global carbon stock. Information on the forest volume, coverage and biomass are important to develop the global perspective on the CO2 concentration changes. Objective of this research is to estimate forest biomass in the study area. The study area is Hangal sum, Bulgan province, Mongolia. Backscatter coefficients for vertical transmit and vertical receive (VV), for vertical transmit and horizontal receive (VH) from Sentinel data and Leaf Area Index (LAI) from Landsat data were used in the study area. We developed biomass estimation approach using ground truth data which is DBH, height and soil moisture. The coefficient α, β, δ, γ were found from the approach. The output map from the approach was compared with VV and VH, LAI data. The relationship between output map and VH data shows a positive result R2 = 0.61. This study suggests that the biomass estimation using Remote sensing data can be applied in forest region in the North.
- Published
- 2019
25. Association between gallstone disease and carotid intima-media thickness: a prospective observational cross-sectional study in a tertiary care center.
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Thapa L, Katwal S, and Thapa BR
- Abstract
Background and Objectives: Gallstone disease (GD) is a prevalent health issue globally, particularly in developed nations, and has notable associations with cardiovascular disease (CVD). This prospective observational cross-sectional study aimed to investigate the association between gallstone disease and carotid intima-media thickness (CIMT), a marker of carotid atherosclerosis, in a tertiary care setting., Method: Conducted at a tertiary care center, the study included 96 participants (48 with gallstone disease and 48 age and sex-matched controls). Data collection involved demographic information, BMI calculation, abdominal ultrasonography for gallstone detection, and carotid ultrasonography for CIMT measurement. Statistical analysis was performed using SPSS version 26., Results: The study revealed higher CIMT values in GD patients compared to controls ( P <0.001). Additionally, a positive correlation was observed between CIMT and age (r=0.450, P <0.001) and BMI (r=0.550, P <0.001). The Cohen's d-test indicated a clinically significant difference in CIMT between GD patients and controls (d=1.47)., Conclusion: This study revealed a significant association between gallstone disease and elevated CIMT, correlating with higher BMI indicating a potential link between gallstone disease and increased risk of carotid atherosclerosis. These findings highlight the importance of assessing cardiovascular risk in patients with gallstone disease, highlighting the potential utility of carotid ultrasonography as a non-invasive screening tool. Early intervention strategies may be warranted to mitigate cardiovascular risks associated with gallstone disease., Competing Interests: All the authors declare no competing interest., (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.)
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- 2024
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26. Ataxia telangiectasia: a rare case report from Nepal.
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Upreti A, Mandal P, Upreti A, Sapkota S, Acharya S, Yogi A, Gauchan B, Bhattarai S, and Thapa L
- Abstract
Introduction and Importance: Ataxia telangiectasia (A-T) is a rare autosomal recessive neurodegenerative disorder with early childhood onset. It is characterized by ataxia, oculocutaneous telangiectasia, immunodeficiency, and lymphoid-origin cancer predisposition due to ataxia telangiectasia mutated gene mutations., Case Presentation: The authors present a 19-year-old girl with spastic movements since 18 months, leading to wheelchair dependence. Ocular telangiectasia, dystonic posture, and slurred speech were evident. Diagnosis involved elevated alpha-fetoprotein levels and typical brain imaging., Clinical Discussion: A-T due to ataxia telangiectasia mutated gene mutations located on chromosome 11q22-23. It has varied presentations categorized by age and features. Timely diagnosis relies on characteristic symptoms, lab findings, and imaging. Radiation sensitivity and increased cancer risk underscore cautious radiation use., Conclusion: A-T is a complex disorder with no cure. Genetic counseling for parents is vital. Its poor prognosis due to infection susceptibility and cancer risk necessitates supportive care. Comprehensive management, including genetic counseling and careful surveillance, is imperative., Competing Interests: Authors have no conflict of interest to declare.Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article., (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.)
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- 2024
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27. Thrombolysis with Tenecteplase for Basilar Artery Occlusion in Neuro and Allied Clinic: Importance of Clinical Assessment and Drip and Ship Model in Nepal.
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Thapa L, Ghimire MR, Bhattarai S, Shrestha AM, Rai N, and Paudel R
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- Humans, Nepal, Tissue Plasminogen Activator therapeutic use, Tissue Plasminogen Activator administration & dosage, Male, Basilar Artery, Ischemic Stroke drug therapy, Middle Aged, Tenecteplase therapeutic use, Fibrinolytic Agents therapeutic use, Fibrinolytic Agents administration & dosage, Thrombolytic Therapy methods
- Abstract
Tenecteplase, a new thrombolytic drug, is now widely recommended and used for treating acute ischemic stroke, and timely thrombolysis within 4.5 hours is crucial for better outcomes. However, due to limited stroke awareness, transportation difficulties, and inadequate access to experts and comprehensive stroke care centers, fewer than 15% of stroke patients in Nepal receive thrombolytic therapy. The "drip and ship" model, which involves starting thrombolysis at a noncomprehensive stroke care center and transferring the patient to another center for further care, can effectively overcome these obstacles, provided trained personnel are available at non-comprehensive stroke care centers. We report a case of acute ischemic stroke treated with thrombolysis within 4.5 hours of symptom onset at a non-comprehensive stroke care center, followed by transfer to another center for ongoing care, demonstrating the feasibility and potential benefits of the drip and ship model in resource-limited settings.
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- 2024
28. Rosacea and Its Association With Malignancy: Systematic Review.
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Thapa L, Xia J, Guo W, Usmani H, Miller D, and Lozeau D
- Abstract
Background: Rosacea is a chronic inflammatory skin condition that predominantly manifests as facial flushing, irritation, and acne. Rosacea and cancer are thought to be linked by the commonality of inflammatory and immune response dysfunction. Studies that have looked into this possible association have reported mixed results., Objective: Given the conflicting literature on this topic, our study sought to evaluate the overall association between rosacea and several cancers commonly investigated in the literature., Methods: A systematic review was conducted using the Cochrane, PubMed, Embase, and Ovid databases. Studies were screened independently for inclusion of rosacea and glioma and breast, thyroid, hepatic, or skin cancers. Using information from the articles, rosacea and each cancer were categorized as having a positive, negative, or unclear association., Results: Our systematic review included 39 full-text studies that investigated the association between rosacea and various malignancies. Among the malignancies of concern, 41% (16/39) of the studies reported an association with basal cell carcinoma, with 2 cohorts revealing an adjusted risk ratio (RR) of 1.50 (95% CI 1.35-1.67) and 0.72 (95% CI 0.56-0.93). In total, 33% (13/39) of the studies reported an association with squamous cell carcinoma, with 2 cohorts revealing an adjusted RR of 1.4 (95% CI 1.02-1.93) and 1.30 (95% CI 0.90-1.88). A total of 8% (3/39) of the studies reported an association between breast cancer and melanoma, with breast cancer cohorts revealing an adjusted RR of 8.453 (95% CI 1.638-43.606), 1.03 (95% CI 0.89-1.20), and 1.36 (95% CI 1.18-1.58) and melanoma cohorts revealing an adjusted RR of 1.10 (95% CI 0.95-1.27), 0.63 (95% CI 0.47-0.85), and 0.96 (95% CI 0.57-1.62). A total of 5% (2/39) of the studies reported an association among nonmelanoma skin cancers, hepatic cancer, and thyroid carcinomas, with nonmelanoma skin cancer cohorts revealing an adjusted RR of 1.36 (95% CI 1.26-1.47) and 2.66 (95% CI 1.53-4.61), hepatic cancer cohorts revealing an adjusted RR of 1.42 (95% CI 1.06-1.90) and 1.32 (95% CI 0.89-1.95), and thyroid carcinoma cohorts revealing an adjusted RR of 1.06 (95% CI 0.68-1.65) and 1.59 (95% CI 1.07-2.36). Only 1 cohort reported an association with glioma, revealing an adjusted RR of 1.36 (95% CI 1.18-1.58). According to our review, patients with rosacea were statistically more likely to have nonmelanoma skin cancers, breast cancer, and glioma. Rosacea was not found to be substantially associated with melanoma. The associations between rosacea and hepatic and thyroid cancers were unclear because of conflicting results., Conclusions: The current literature shows that rosacea is significantly associated with increased odds of nonmelanoma skin cancers, glioma, and breast cancer. Rosacea does not appear to be associated with melanoma. Further studies should be conducted to clarify the association between thyroid and hepatic cancers and rosacea., (©Luna Thapa, Joyce Xia, William Guo, Hunya Usmani, Devin Miller, Daniel Lozeau. Originally published in JMIR Dermatology (http://derma.jmir.org), 08.11.2023.)
- Published
- 2023
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29. Rare case of duplicated middle cerebral artery and acute ischaemic stroke managed successfully with mechanical thrombectomy.
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Phuyal S, Thapa L, Mishra BM, and Nayak MK
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- Humans, Male, Infarction, Middle Cerebral Artery diagnostic imaging, Infarction, Middle Cerebral Artery surgery, Middle Cerebral Artery diagnostic imaging, Middle Cerebral Artery surgery, Thrombectomy, Aged, 80 and over, Brain Ischemia, Ischemic Stroke, Stroke diagnostic imaging, Stroke surgery
- Abstract
A man in his early 80s presented with acute onset aphasia and right-sided weakness with an NIH Stroke Scale (NIHSS) of 17. He was last seen normal 9 hours before the presentation. MRI of the brain showed acute infarcts in the left caudate, lentiform nucleus and corona radiata. MRI angiogram (MRA) revealed an occluded left main middle cerebral artery (MCA) and an associated ipsilateral patent duplicated middle cerebral artery (DMCA). Mechanical thrombectomy (MT) was performed, and he was discharged with an NIHSS of 8. In this report, we review and discuss the challenges during the intervention of MCA occlusion in the presence of duplicated MCA, a rare anomaly., Competing Interests: Competing interests: None declared., (© BMJ Publishing Group Limited 2023. No commercial re-use. See rights and permissions. Published by BMJ.)
- Published
- 2023
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30. Implementing stroke care in a lower-middle-income country: results and recommendations based on an implementation study within the Nepal Stroke Project.
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Tunkl C, Paudel R, Bajaj S, Thapa L, Tunkl P, Chandra A, Shah B, Karmacharya B, Subedi A, Jalan P, Ghimire P, Ghimire MR, Dorje G, Begli NH, Golenia J, Gajurel BP, Shreyan S, Sharma N, Krauss A, Pandian J, Fischer T, van der Merwe J, Wick W, Hacke W, and Gumbinger C
- Abstract
Background: Globally, the majority of strokes affect people residing in lower- and lower-middle-income countries (LMICs), but translating evidence-based knowledge into clinical practice in regions with limited healthcare resources remains challenging. As an LMIC in South Asia, stroke care has remained a healthcare problem previously unaddressed at a national scale in Nepal. The Nepal Stroke Project (NSP) aims to improve acute stroke care in the tertiary healthcare sector of Nepal. We hereby describe the methods applied and analyze the barriers and facilitators of the NSP after 18 months., Methods: The NSP follows a four-tier strategy: (1) quality improvement by training healthcare professionals in tertiary care centers; (2) implementation of in-hospital stroke surveillance and quality monitoring system; (3) raising public awareness of strokes; and (4) collaborating with political stakeholders to facilitate public funding for stroke care. We performed a qualitative, iterative analysis of observational data to analyze the output indicators and identify best practices., Results: Both offline and online initiatives were undertaken to address quality improvement and public awareness. More than 1,000 healthcare professionals across nine tertiary care hospitals attended 26 stroke-related workshops conducted by Nepalese and international stroke experts. Monthly webinars were organized, and chat groups were made for better networking and cross-institutional case sharing. Social media-based public awareness campaigns reached more than 3 million individuals. Moreover, live events and other mass media campaigns were instituted. For quality monitoring, the Registry of Stroke Care Quality (RES-Q) was introduced. Collaboration with stakeholders (both national and international) has been initiated., Discussion: We identified six actions that may support the development of tertiary care centers into essential stroke centers in a resource-limited setting. We believe that our experiences will contribute to the body of knowledge on translating evidence into practice in LMICs, although the impact of our results must be verified with process indicators of stroke care., Competing Interests: TF and JM were employed by Boehringer Ingelheim International GmbH. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision., (Copyright © 2023 Tunkl, Paudel, Bajaj, Thapa, Tunkl, Chandra, Shah, Karmacharya, Subedi, Jalan, Ghimire, Ghimire, Dorje, Begli, Golenia, Gajurel, Shreyan, Sharma, Krauss, Pandian, Fischer, van der Merwe, Wick, Hacke and Gumbinger.)
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- 2023
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31. Nitrogen Electrocatalysis: Electrolyte Engineering Strategies to Boost Faradaic Efficiency.
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Thapa L and Retna Raj C
- Abstract
The electrochemical activation of dinitrogen at ambient temperature and pressure for the synthesis of ammonia has drawn increasing attention. The faradaic efficiency (FE) as well as ammonia yield in the electrochemical synthesis is far from reaching the requirement of industrial-scale production. In aqueous electrolytes, the competing electron-consuming hydrogen evolution reaction (HER) and poor solubility of nitrogen are the two major bottlenecks. As the electrochemical reduction of nitrogen involves proton-coupled electron transfer reaction, rationally engineered electrolytes are required to boost FE and ammonia yield. In this Review, we comprehensively summarize various electrolyte engineering strategies to boost the FE in aqueous and non-aqueous medium and suggest possible approaches to further improve the performance. In aqueous medium, the performance can be improved by altering the electrolyte pH, transport velocity of protons, and water activity. Other strategies involve the use of hybrid and water-in-salt electrolytes, ionic liquids, and non-aqueous electrolytes. Existing aqueous electrolytes are not ideal for industrial-scale production. Suppression of HER and enhanced nitrogen solubility have been observed with hybrid and non-aqueous electrolytes. The engineered electrolytes are very promising though the electrochemical activation has several challenges. The outcome of lithium-mediated nitrogen reduction reaction with engineered non-aqueous electrolyte is highly encouraging., (© 2023 Wiley-VCH GmbH.)
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- 2023
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32. Stroke epidemiology and outcomes of stroke patients in Nepal: a systematic review and meta-analysis.
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Paudel R, Tunkl C, Shrestha S, Subedi RC, Adhikari A, Thapa L, Gajurel BP, Chandra A, Kharel G, Jalan P, Phuyal S, Pokharel BR, Acharya S, Bogati K, Jha P, Kharbuja N, and Gumbinger C
- Subjects
- Humans, Nepal epidemiology, Databases, Factual, Hospitals, Stroke epidemiology, Stroke therapy, Ischemic Stroke
- Abstract
Background: With an increasing burden of stroke, it is essential to minimize the incidence of stroke and improve stroke care by emphasizing areas that bring out the maximum impact. The care situation remains unclear in the absence of a national stroke care registry and a lack of structured hospital-based data monitoring. We conducted this systematic review and meta-analysis to assess the status of stroke care in Nepal and identify areas that need dedicated improvement in stroke care., Methods: A systematic literature review was conducted to identify all studies on stroke epidemiology or stroke care published between 2000 and 2020 in Nepal. Data analysis was done with Statistical Package for Social Sciences (SPSS) and Comprehensive Meta-analysis (CMA-3)., Results: We identified 2533 studies after database searching, and 55 were included in quantitative and narrative synthesis. All analyses were done in tertiary care settings in densely populated central parts of Nepal. Ischemic stroke was more frequent (70.87%) than hemorrhagic (26.79%), and the mean age of stroke patients was 62,9 years. Mortality occurred in 16.9% (13-21.7%), thrombolysis was performed in 2.39% of patients, and no studies described thrombectomy or stroke unit care., Conclusion: The provision of stroke care in Nepal needs to catch up to international standards, and our systematic review demonstrated the need to improve access to quality stroke care. Dedicated studies on establishing stroke care units, prevention, rehabilitation, and studies on lower levels of care or remote regions are required., (© 2023. BioMed Central Ltd., part of Springer Nature.)
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- 2023
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33. Are digital social media campaigns the key to raise stroke awareness in low-and middle-income countries? A study of feasibility and cost-effectiveness in Nepal.
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Tunkl C, Paudel R, Thapa L, Tunkl P, Jalan P, Chandra A, Belson S, Prasad Gajurel B, Haji-Begli N, Bajaj S, Golenia J, Wick W, Hacke W, and Gumbinger C
- Subjects
- Humans, Cost-Benefit Analysis, Nepal epidemiology, Developing Countries, Feasibility Studies, Social Media, Stroke epidemiology, Stroke therapy
- Abstract
Background: Stroke is a major global health problem and was the second leading cause of death worldwide in 2020. However, the lack of public stroke awareness especially in low- and middle-income countries (LMICs) such as Nepal severely hinders the effective provision of stroke care. Efficient and cost-effective strategies to raise stroke awareness in LMICs are still lacking. This study aims to (a) explore the feasibility of a social media-based stroke awareness campaign in Nepal using a cost-benefit analysis and (b) identify best practices for social media health education campaigns., Methods: We performed a stroke awareness campaign over a period of 6 months as part of a Stroke Project in Nepal on four social media platforms (Facebook, Instagram, Twitter, TikTok) with organic traffic and paid advertisements. Adapted material based on the World Stroke Day Campaign and specifically created videos for TikTok were used. Performance of the campaign was analyzed with established quantitative social media metrics (impressions, reach, engagement, costs)., Results: Campaign posts were displayed 7.5 million times to users in Nepal. 2.5 million individual social media users in Nepal were exposed to the campaign on average three times, which equals 8.6% of Nepal's total population. Of those, 250,000 users actively engaged with the posts. Paid advertisement on Facebook and Instagram proved to be more effective in terms of reach and cost than organic traffic. The total campaign cost was low with a "Cost to reach 1,000 users" of 0.24 EUR and a "Cost Per Click" of 0.01 EUR., Discussion: Social media-based campaigns using paid advertisement provide a feasible and, compared to classical mass medias, a very cost-effective approach to inform large parts of the population about stroke awareness in LMICs. Future research needs to further analyze the impact of social media campaigns on stroke knowledge., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Tunkl et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
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- 2023
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34. Screening of Peripheral Arterial Disease in Patients with Diabetes.
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Ghimire MR, Acharya S, Pandey S, Aryal D, Shah P, Soti B, Ghimire S, and Thapa L
- Subjects
- Humans, Female, Male, Aged, Middle Aged, Glycated Hemoglobin, Nepal epidemiology, Ethanol, Diabetes Mellitus, Type 2 complications, Diabetes Mellitus, Type 2 epidemiology, Peripheral Arterial Disease diagnosis, Peripheral Arterial Disease epidemiology
- Abstract
Background: Out of many atherosclerotic complications, peripheral arterial disease (PAD) is also important one. To prevent morbidity and mortality related with PAD, early detection is must, and is possible by duplex screening. This study aims at screening for PAD in patients with type 2 Diabetes mellitus., Methods: This study is single centered cross- sectional, observational study conducted in department of internal medicine of DMCRI- a tertiary care hospital. A total of 140, type 2 diabetes patients were screened for peripheral arterial disease by duplex ultrasound after taking informed consent and fulfilling inclusion and exclusion criteria., Results: In our study among 140 Participants, 50% are male and 50% are female with mean age of 57.6 ± 10.4 years standard deviation (SD) and mean duration of diabetes was 8.31± 5.9 SD years with 13.6% were alcohol consumer; 1.4% were smokers; 59.3% of them had high blood pressure; (28.6%) had dyslipidaemia and 11.4% had hypothyroidism. The prevalence of PAD in type 2 diabetes was 27.1% in our study. The mean of glycated hemoglobin (HBA1c) was 7.23 ± 1.75% and while performing analytical test {chi-square (χ)}, we found there was no association between HBA1c level and presence of peripheral arterial disease., Conclusions: The prevalence of peripheral arterial disease is high almost more than one quarter (27.1%). Screening of diabetic patients is must especially those aged and high glycated hemoglobin for early detection and effective management of PAD.
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- 2023
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35. Mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes syndrome: a case report from Nepal.
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Subedi RC, Paudel R, Paudel S, Thapa L, Phuyal S, Kharbuja N, and Adhikari A
- Abstract
Mitochondrial encephalomyopathy, lactic acidosis, and stroke-like syndrome (MELAS) is a rare neurodegenerative inherited disorder that is characterized by stroke-like episodes, seizures, endocrine, and multiple system involvement. It is important to consider it as a differential diagnosis in a young patient with stroke-like episodes as it is progressive and has multiple complications., Case Presentation: A 28-year-old male presented with slurring of speech and drowsiness for 7 h. He was a diagnosed case of type 2 diabetes mellitus, Wolf-Parkinson-White syndrome, and bilateral hearing loss., Clinical Findings and Investigations: The patient had expressive aphasia with impaired fluency, repetition, and naming. After being discharged, he represented with loss of consciousness and involuntary movements of the whole body. MRI and MRS showed extension of hyperintense lesions to parieto-occipital regions from temporal regions not limited by vascular territories. MELAS was considered, which was confirmed by molecular genetic analysis. Coenzyme Q10 was used for MELAS. Insulin, Linagliptin, and levetiracetam were used for diabetes and seizures. Regular follow-up was advised to the patient.MELAS is an important syndrome to consider in any young patient presenting with unexplained stroke disorders. A high index of suspicion is needed in an appropriate clinical setting to avoid misdiagnosis., Competing Interests: No conflict of interest., (Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.)
- Published
- 2023
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36. Report on Rare Complication Post Silent Myocardial Infarction: Ventricular Septal Rupture.
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Thapa L and Lemons L
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The advent of primary reperfusion therapy for the treatment of myocardial infarction (MI) has made mechanical complications rare. Mechanical complications include free wall rupture, papillary muscle rupture, left ventricular septal rupture, and more. In this case, we describe a 53-year-old patient who presented to the emergency department with complaints of shortness of breath, abdominal pain, urinary retention, and constipation. On exam, he was in mild distress and presented with jugular venous distension (JVD), bibasilar crackles, and diffuse abdominal pain with guarding. After a rapid hemodynamic decline and a transthoracic echocardiogram that displayed a new onset ventricular septal defect (VSD), it was determined that the patient had a ventricular septal rupture (VSR). Septal rupture is a cardiac emergency causing cardiogenic shock and carries a high mortality risk despite prompt surgical treatment; hence a high suspicion is warranted. Our patient presented with generalized symptoms, no previous cardiovascular history, and no reported myocardial infarctions or risk factors, leading to a low clinical index of suspicion for a VSR. This case highlights the importance of high clinical suspicion of ventricular septal rupture in a patient presenting with similar symptoms so prompt management can occur., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Thapa et al.)
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- 2023
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37. Clinical Profile and Knowledge, Attitude and Practice of Patients Presenting with Headache.
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Ghimire MR, Thapa M, Shrestha AM, Bhattrai S, Ghimire S, Sharma N, Soti B, Dutta A, Shrestha S, Pokhare M, Poudel R, and Thapa LJ
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- Middle Aged, Female, Humans, Male, Cross-Sectional Studies, Headache therapy, Headache etiology, Surveys and Questionnaires, Health Knowledge, Attitudes, Practice, Migraine Disorders etiology
- Abstract
Background Headache disorders are among the most prevalent and disabling conditions worldwide. People, however, do not seek early advice in developing countries. Objective To study clinical profile of patients with headache and their existing knowledge, attitude, and practice regarding primary headaches. Method Descriptive cross-sectional study conducted among 196 patients. Patients were selected using purposive sampling technique fulfilling inclusion criteria. Patients were interviewed based on semi-structural headache questionnaire and data was collected from 4th October to 21st December 2021. Descriptive statistics was used for analysis and interpretation. Result Among 196 participants, 74% were females, 29.6% of patients were between (31 to 40) years of age. The majority were Hindu and belongs to province 3; 36.7% were homemakers, and 32.2% were literate. Migraine headache was the most common type with 14.3% reporting aura. Most reported headache within 1 to 5 years. The commonest triggers were sunlight 64.8%, crowd 54.7%, stress 39.8%, fasting state 31.7%, cold 26.3%. Almost 39% believed that headache could be a chronic neurologic disorder. Majority had knowledge of the causes, triggers, and the relieving factors. Fifty-five percent seek help of a doctor for first time, and the rest seek help of a pharmacist or self-medication. Only 19% tried to manage the headache triggers; 66.8% felt that lifestyle modification is the best treatment for headache comparing drugs. Conclusion Migraine headache was the commonest headache occurring at middle age group with sunlight being the most common trigger factor. Lifestyle modification was perceived to be the best for headache management.
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- 2023
38. Initial Results of a Direct Aspiration First-Pass Technique to Treat Acute Ischemic Stroke Patients in Nepal.
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Phuyal S, Paudel R, Lamsal R, Thapa L, Maharjan AMS, and Gajurel BP
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Objective Endovascular therapy has become the mainstay of treatment of acute ischemic stroke (AIS) due to large vessel occlusion. A direct aspiration first-pass technique (ADAPT) using large bore aspiration catheters has been introduced as a rapid, simple method for achieving good revascularization and good clinical outcomes. The aim of this study was to assess the safety and efficacy of ADAPT in the treatment of AIS due to large-vessel occlusion in the Nepali patient population. Materials and Methods Retrospective data were collected for all consecutive patients treated for AIS with ADAPT from March 2019 through January 2021 at two hospitals. Outcomes were successful revascularization (modified thrombolysis in cerebral infarction score of 2b-3), time to revascularization, procedural complications, and good clinical outcome (modified Rankin Scale score of 0 to 2) and mortality at 90 days. Statistical Analysis Retrospective data were collected and descriptive statistics were calculated. Results Sixty-eight patients treated for AIS with ADAPT were included. The median National Institutes of Health Stroke Scale score at presentation was 13 (IQR 10-13.25). The median time from arterial puncture to revascularization was 40 minutes (IQR 30-45). Successful revascularization was achieved in 54 patients (79.4%). No cases of symptomatic intracranial hemorrhage occurred. At 90-day follow-up, good clinical outcome was achieved in 57 patients (83.8%), and 4 patients died (5.9%). Conclusion A direct aspiration first pass technique appears to be a fast, simple, safe, and effective method for the management of AIS in the Nepali patient population., Competing Interests: Conflict of Interest None declared., (Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. ( https://creativecommons.org/licenses/by-nc-nd/4.0/ ).)
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- 2023
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39. D-penicillamine Induced Myasthenia Gravis in Wilson's Disease: A Case Report.
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Thapa L, Thapa M, Bhattarai S, Shrestha AM, Sharma N, Rai N, Pokharel M, and Paudel R
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- Male, Humans, Adolescent, Penicillamine adverse effects, Hepatolenticular Degeneration complications, Hepatolenticular Degeneration diagnosis, Hepatolenticular Degeneration drug therapy, Myasthenia Gravis chemically induced, Myasthenia Gravis diagnosis
- Abstract
Myasthenia gravis is a neuromuscular junction disorder characterised by fluctuating muscle weakness, improved by using anti-cholinesterase drugs. In addition to the autoimmune aetiology, various factors such as infections, surgery, and drugs are known to precipitate the condition. We report a case of a 15-year-old boy with D-penicillamine-induced myasthenia gravis who presented with facial diplegia, dysphagia, and drooling of saliva, 6 years after the initiation of treatment for Wilson's disease. Therefore, clinicians should be more vigilant while prescribing patients with chelating drugs like D-penicillamine with regular monitoring of the new symptoms and keeping a very low threshold for the suspicion of myasthenia gravis., Keywords: d-penicillamine; myasthenia gravis; pyridostigmine; Wilson's disease.
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- 2022
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40. Adverse Events Following the First Dose of Immunization of COVID-19 Vaccine.
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Bhandari B, Jha N, Khan IH, Rayamajhi G, Thapa L, and Bista B
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- ChAdOx1 nCoV-19, Cross-Sectional Studies, Humans, Immunization, Nepal epidemiology, Pandemics prevention & control, Vaccination adverse effects, Vaccines adverse effects, COVID-19 epidemiology, COVID-19 prevention & control, COVID-19 Vaccines adverse effects
- Abstract
Background: The COVID-19 pandemic has challenged the entire globe and the need for a vaccine is supreme. Since many vaccines along with Covishield have been granted emergency use authorization, the evaluation and monitoring of safety are crucial. Covishield was rolled out in Nepal on January 27, 2021. So through this study, we aim to identify the prevalence of Adverse Events Following Immunization in general with the first dose of Covishield vaccine, compare Adverse Events Following Immunization in prior COVID-19 positive cases and Adverse Events Following Immunization in co-morbid individuals., Methods: This was a descriptive cross-sectional study conducted in 440 sample from May 2021 till July 2021 in a provincial government hospital of western Nepal. Ethical approval was received from Ethical Review Board, Nepal Health Research Council (Registration no: 279/2021 P). Simple random sampling was used. Point estimate was done at 95% confidence interval and descriptive analysis was done to identify the prevalence of Adverse Events Following Immunization within one week after Covishield vaccination in the studied population., Results: 79.77% of the study population complaint at least one or more Adverse Events Following Immunization. Fever, myalgia, headache, pain at the injection site, arthralgia, chills, and fever are the most common Adverse Events Following Immunization. 42.73% of the study population self-medicated to manage Adverse Events Following Immunization, 7.89% took leave from work while 0.28% needed medical attention. No major Adverse Events Following Immunization relevance with prior-COVID history or co-morbidity was seen., Conclusions: Majority of the vaccinated participants had minor adverse effects on the first-day post-vaccination while most of the Adverse Events Following Immunization subsided within seven days.
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- 2022
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41. Prevalence of Stroke and Stroke Risk Factors in a South-Western Community of Nepal.
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Thapa L, Shrestha S, Kandu R, Ghimire MR, Ghimire S, Chaudhary NK, Pahari B, Bhattarai S, Kharel G, Paudel R, Jalan P, Chandra A, Phuyal S, Adhikari B, Aryal N, and Kurmi OP
- Subjects
- Adolescent, Adult, Age Distribution, Age Factors, Aged, Aged, 80 and over, Cross-Sectional Studies, Female, Healthy Lifestyle, Humans, Life Style, Male, Middle Aged, Nepal epidemiology, Prevalence, Risk Assessment, Risk Factors, Risk Reduction Behavior, Stroke diagnosis, Stroke prevention & control, Young Adult, Stroke epidemiology
- Abstract
Background: Stroke related studies in Nepal are primarily hospital-based and mainly from the capital city., Objectives: We aimed to estimate the prevalence of stroke and stroke risk factors in the South-Western community of Nepal., Methods: A cross-sectional study was conducted from May to August 2018 among 549 randomly selected Nepalese participants from diverse ethnicity, aged ≥15 years, in a region with the availability of neurological support facilities. Data were collected using a stroke questionnaire designed for the purpose. Stroke was identified by enumerators using the Balance-Eyes-Face-Arms-Speech-Time (BEFAST) scale, and a senior neurologist confirmed it. We assessed the presence of major risk factors associated with stroke., Results: The crude and age-standardised prevalence of stroke were 2368 and 2967 per 100,000 respectively. Of all the surveyed participants, 61% (n=335) reported consumption of full-fat dairy products >3 days per week, 87.6% (n=481) reported a high intake of salt (>5 g/day), 83.6% (n=459) with a low intake of fruits and vegetables (<400 g/day), 45.2% (n=248) with perceived stress related to work or home, 51.6% (n=283) with financial stress (283, 51.6%), 86.7% (n=457) with low high-density lipoprotein, 96.2% (n=507) with high blood urea nitrogen, 47.1% (n=356) were either overweight or obese 20.4% (n=112) with hypertension and 6.2% (n=34) with diabetes., Conclusions: The prevalence of stroke in the community of the South-Western part of Nepal is relatively higher than that estimated in South-Asia and global context. Our findings suggest an urgent community intervention, particularly with healthy lifestyles changes for future stroke prevention in the high-risk group., Competing Interests: Declaration of Competing Interest The authors declared no conflict of interest concerning the research, authorship, and/or publication of this article, (Copyright © 2021 Elsevier Inc. All rights reserved.)
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- 2021
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42. Management of Stroke During COVID-19 Pandemic: The Challenges in Nepal.
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Phuyal S, Lamsal R, Shrestha GS, Paudel R, and Thapa L
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- Humans, Nepal epidemiology, Pandemics, SARS-CoV-2, COVID-19 complications, COVID-19 epidemiology, Stroke therapy, Stroke virology
- Abstract
The COVID-19 pandemic has significantly affected health care delivery globally. COVID-19 is associated with varied neurological manifestations including acute ischemic stroke. In densely populated South Asian nations like Nepal that have suboptimal baseline health care systems, we foresee unique challenges during this pandemic to ensure effective stroke management as well as the safety of health care workers involved in the management of stroke patients. Keywords: COVID-19; health care workers; safety; stroke management.
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- 2021
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43. Endovascular management of acute ischaemic stroke in Nepal.
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Phuyal S, Poudel R, Shrestha GS, Dawadi K, Rauniyar VK, Thapa L, Adhikari RB, Thapa A, Sedain G, Acharya SP, Jalan P, and Pandey CR
- Subjects
- Humans, Nepal epidemiology, Treatment Outcome, Brain Ischemia surgery, Endovascular Procedures, Ischemic Stroke, Stroke surgery
- Published
- 2020
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44. Seesaw-Pattern Ocular Bobbing in a Patient With Pontine Bleed.
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Munakomi S and Thapa L
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- Adult, Humans, Magnetic Resonance Imaging, Male, Ocular Motility Disorders etiology, Pons diagnostic imaging, Intracranial Hemorrhages complications, Intracranial Hemorrhages diagnosis, Intracranial Hemorrhages pathology, Intracranial Hemorrhages physiopathology, Ocular Motility Disorders physiopathology, Pons pathology
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- 2019
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45. Resilience Among Nepali Widows After the Death of a Spouse: "That Was My Past and Now I Have to See My Present".
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Hendrickson ZM, Kim J, Tol WA, Shrestha A, Kafle HM, Luitel NP, Thapa L, and Surkan PJ
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- Adult, Attitude to Death ethnology, Grief, Humans, Interviews as Topic, Middle Aged, Nepal, Qualitative Research, Social Participation psychology, Social Support, Resilience, Psychological, Widowhood psychology
- Abstract
Responses to the death of a spouse vary; although some are at increased risk of poorer physical and mental health outcomes, others have more resilient responses. In light of the limited scope of research on widows' experiences in Nepal, a setting where widows are often marginalized, we explore themes of resilience in Nepali widows' lives. Drawing from a larger qualitative study of grief and widowhood, a thematic narrative analysis was performed on narratives from four widows that reflected resilient outcomes. Individual assets and social resources contributed to these widows' resilient outcomes. Forgetting, acceptance, and moving forward were complemented by confidence and strength. Social support and social participation were key to widows' resilient outcomes. These four narratives reflect the sociocultural context that shape widows' resilient outcomes in Nepal. Future studies on the emergent themes from this exploratory study will help identify how best to encourage resilient outcomes among widows.
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- 2018
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46. Renal impairment in stroke patients: A comparison between the haemorrhagic and ischemic variants.
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Shrestha P, Thapa S, Shrestha S, Lohani S, Bk S, MacCormac O, Thapa L, and Devkota UP
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Background: Renal impairment is regularly seen in hospitalized stroke patients, affecting the outcome of patients, as well as causing difficulties in their management. A prospective cohort study was conducted to assess the trend of renal function in hospitalized ischemic and haemorrhagic stroke patients. The incidence of renal impairment in these subgroups, the contributing factors and the need for renal replacement in renal impaired patients was evaluated. Methods: Alternate day renal function testing was performed in hospitalized stroke patients. Estimated glomerular filtration rate (e-GFR) was calculated and the trend of renal function in the two stroke subgroups (haemorrhagic and ischemic) was assessed, with renal impairment defined as e-GFR < 60mL/ minute per 1.73m
2 . Results: Among 52 patients, 25 had haemorrhagic stroke (mean age 59.81 ± 14.67) and 27 had ischemic stroke (mean age 56.12 ± 13.08). The mean e-GFR (mL/minute per 1.732m2 ) at admission in the haemorrhagic stroke subgroup was 64.79 ± 25.85 compared to 86.04 ± 26.09 in the ischemic stroke subgroup (p=0.005). Sixteen out of 25 (64%) patients in the haemorrhagic stroke subgroup and 9 out of 27 (33.3%) patients in the ischemic subgroup developed renal impairment (p=0.27). The location of the bleed (p=0.8), volume of hematoma (p=0.966) and surgical intervention (p=0.4) did not predispose the patients to renal impairment. One out of 16 patients with haemorrhagic stroke (who eventually died), and 2 out of 9 patients with ischemic stroke required renal replacement. Conclusion : Renal impairment is commonly seen in stroke patients, more so in patients who suffered haemorrhagic strokes. The impairment, however, is transient and rarely requires renal replacement therapy., Competing Interests: Competing interests: No competing interests were disclosed.- Published
- 2017
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47. Persistent Complex Bereavement Disorder and Culture: Early and Prolonged Grief in Nepali Widows.
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Kim J, Tol WA, Shrestha A, Kafle HM, Rayamajhi R, Luitel NP, Thapa L, and Surkan PJ
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- Adult, Female, Grief, Humans, Middle Aged, Nepal ethnology, Young Adult, Bereavement, Mental Disorders classification, Suicide ethnology, Widowhood ethnology
- Abstract
Objective: Persistent complex bereavement disorder (PCBD) in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), has not been well studied in socioculturally diverse populations. Thus, this qualitative study examined (a) how widows in Nepal understand grief, (b) whether a local construct of PCBD exists, and (c) its comparability with the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), terminology., Methods: Using an adapted Explanatory Model Interview Catalogue (EMIC) framework, semistructured interviews with 25 widows and 12 key informants, as well as three focus-group discussions (n = 20), were conducted between October 2014 and April 2015. Through an inductive grounded theory-based approach, we used the constant comparative method, iteratively coding transcripts to identify themes and patterns in the data. Also, we created two lists of grief responses, one of early reactions and another all reactions to grief, based on the frequency of mention., Results: No single term for grief was reported. Widows reported a local construct of PCBD, which was broadly compatible with DSM-5 terminology but with important variation reflecting societal influence. Surviving torture during conflict, economic and family stressors, and discrimination were mentioned as important determinants that prolong and complicate grief. Suicidal ideation was common, with about 31% and 62% of widows reporting past-year and lifetime suicidality, respectively. Findings may not be generalizable to all Nepali widows; participants were recruited from a non-governmental organization, from Kathmandu and its neighboring districts, and were primarily of reproductive age., Conclusions: While PCBD symptoms proposed in DSM-5 were mentioned as relevant by study participants, some components may need adaptation for use in non-Western settings, such as Nepal.
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- 2017
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48. Knowledge, Beliefs, and Practices on Epilepsy among High School Students of Central Nepal.
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Thapa L, Bhandari TR, Shrestha S, and Poudel RS
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Introduction . Epilepsy continues to increase worldwide but, unfortunately, many high school students have inadequate knowledge of and negative beliefs towards the disease. We aimed to assess the knowledge, beliefs, and practices of epilepsy among high school students of Central Nepal. Materials and Methods . A cross-sectional study was performed involving 1360 high school students from 33 private schools across Bharatpur, from June 2013 to July 2013, to assess their knowledge, beliefs, and practices (KBP) on epilepsy using a standardized questionnaire. The differences in mean KBP scores between different sexes, religions, and those personally knowing versus not knowing someone with epilepsy were assessed using independent t -tests; a Pearson correlation was calculated to assess the relationship between KBP scores and age. Results . Of 1360 participants, 79 (5.8%) students had never heard or read about epilepsy and were consequently excluded from statistical analysis. Only 261 out of 1360 (19.2%) had personally known someone with epilepsy. The mean KBP scores were 5.0/8, 7.4/12, and 1.7/3, respectively. Statistically significant differences were only observed in the knowledge component of the KBP score; female scored higher than males ( p < 0.001) and, interestingly, students who had personally known a person with epilepsy actually knew less than those who had not known one ( p = 0.018). We also found a significant negative correlation between knowledge and age ( p = 0.003). Conclusions . The overall knowledge, beliefs, and practices appear to be inadequate, emphasizing the need for further educational intervention., Competing Interests: The authors declare that there are no competing interests.
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- 2017
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49. Social isolation and health in widowhood: A qualitative study of Nepali widows' experiences.
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Houston KT, Shrestha A, Kafle HM, Singh S, Mullany L, Thapa L, and Surkan PJ
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- Adaptation, Psychological, Adult, Aged, Emotions, Female, Humans, Interviews as Topic, Middle Aged, Nepal, Qualitative Research, Socioeconomic Factors, Health Status, Social Isolation, Social Support, Widowhood psychology
- Abstract
Little research exists on social isolation and health among widows despite their marginalization in South Asia. Using a conceptual framework that delineates distinct forms of social support, our results provide a preliminary analysis of the role social support plays in the well-being of Nepali widows. Between 2011 and 2012, we conducted 42 in-depth interviews in the Kathmandu valley and Surkhet district. Low social support was a common theme, principally lacking in the domains of emotional and instrumental support and was described as increasing women's vulnerability to mistreatment and economic insecurity. Policies and programs that foster these types of support may have positive effects on widows' well-being.
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- 2016
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50. Knowledge, attitude, and practice of stroke among high school students in Nepal.
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Thapa L, Sharma N, Poudel RS, Bhandari TR, Bhagat R, Shrestha A, Shrestha S, Khatiwada D, and Caplan LR
- Abstract
Background: Baseline stroke knowledge in a targeted population is indispensable to promote the effective stroke education. We report the baseline knowledge, attitude, and practice (KAP) of high school students with respect to stroke from Nepal., Materials and Methods: A self-structured questionnaire survey regarding KAP about stroke was conducted in high school students of 33 schools of Bharatpur, Nepal. Descriptive statistics including Chi-square test was used, and the significant variables were subjected to binary logistic regression., Results: Among 1360 participants, 71.1% had heard or read about stroke; 30.2% knew someone with stroke. 39.3% identified brain as the organ affected. Sudden onset limb/s weakness/numbness (72%) and hypertension (74%) were common warning symptom and risk factor identified. 88.9% would take stroke patients to a hospital. Almost half participants (55.5%) felt ayurvedic treatment be effective. 44.8% felt stroke as a hindrance to a happy life and 86.3% believed that family care was helpful for early recovery. Students who identified at least one risk factor were 3.924 times ( P < 0.001, confidence interval [CI] = 1.867-8.247) or those who identified at least one warning symptom were 2.833 times ( P ≤ 0.023, CI = 1.156-6.944) more likely to take stroke patients to a hospital., Conclusion: KAP of high school Nepalese students regarding stroke was satisfactory, and the students having knowledge about the risk factors and warning symptoms were more likely to take stroke patients to a hospital. However, a few misconceptions persisted.
- Published
- 2016
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