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Background: Tuberculosis (TB) is a global public health issue, particularly in resource-constrained countries like Nepal. This case report highlights the consequences of prolonged self-treatment and non-compliance with TB management protocols, emphasizing the need for increased awareness and intervention. Case Presentation: A 50-year-old male from Nepal self-medicated with anti-tubercular drugs for 13 years after completing the recommended course of treatment. He experienced worsening symptoms, including respiratory distress and visual impairment. Upon evaluation, he was diagnosed with chronic cavitary pulmonary aspergillosis. The patient received comprehensive treatment, including antifungal therapy, steroids, antibiotics, and respiratory support, resulting in significant improvement. Conclusions: This case highlights the dangers of self-treatment and non-compliance with TB management protocols. It emphasizes the importance of patient education, awareness programs, and regular follow-up to ensure treatment adherence and detect complications. The case also reveals gaps in the DOTS (Directly Observed Treatment, Short Course) program, including the need for improved surveillance, and a multidisciplinary approach. The ease of over-the-counter purchase of anti-tubercular drugs in Nepal contributed to the patient's prolonged self-medication, highlighting a concerning. The complications arising from prolonged self-medication underscore the need for increased awareness, intervention, and patient education in TB management. Improving patient education, raising awareness about the risks of self-medication, and integrating ophthalmologic evaluations into standard management are essential for better TB control in Nepal. [ABSTRACT FROM AUTHOR]

Key Clinical Message: This case report highlights the importance of considering scrub typhus as a differential diagnosis for acute encephalitis with cranial nerve palsy in the region of the tsutsugamushi triangle. Scrub typhus is a zoonotic rickettsiosis caused by the bacterium Orientia tsutsugamushi. This disease is endemic to a region called the tsutsugamushi triangle that extends from Southeast Asia to the Pacific Ocean. We report a 17‐year‐old girl from western Nepal who presented with fever, headache, vomiting, and altered sensorium, as well as bilateral lateral rectus palsy, dysphagia, regurgitation of food, dysarthria, and left‐sided upper motor neuron type facial palsy. Following laboratory and imaging tests, the patient was diagnosed with scrub typhus and was treated successfully with high‐dose dexamethasone and doxycycline. This case highlights the importance of considering scrub typhus in the differential diagnosis of encephalitis with cranial nerve palsy, especially in the region of the tsutsugamushi triangle. It also emphasizes the need for timely diagnosis and treatment of scrub typhus to prevent the development of various complications and ensure earlier recovery of patients. [ABSTRACT FROM AUTHOR]

This paper reports on the presence of one generic and six specific new records of Cyperaceous species for the flora of Nepal. Amongst the new discoveries are the genus Machaerina, alongside species: Eleocharis ochrostachys, Fimbristylis acuminata, F. ferruginea, F. nutans, F. thomsonii and Scleria rugosa. The taxonomy and distribution of Actinoscirpus grossus, Fimbristylis salbundia and Fuirena umbellata in Nepal are clarified through notes on nomenclature, description, distribution, specimen examination, identification keys and photographs. [ABSTRACT FROM AUTHOR]