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Miniature fluorescence microscopes (miniscopes) are one of the most powerful and versatile tools for recording large scale neural activity in freely moving rodents with single cell resolution. Recent advances in the design of genetically encoded calcium indicators (GECIs) allow to target distinct neuronal populations with non-overlapping emission spectral profiles. However, conventional miniscopes are limited to a single excitation, single focal plane imaging, which does not allow to compensate for chromatic aberration and image from two spectrally distinct calcium indicators. In this paper we present an open-source dual channel miniscope capable of simultaneous imaging of genetically or functionally distinct neuronal populations. Chromatic aberrations are corrected using an electrowetting lens (EWL), which allows fast focal plane change between frames. To demonstrate the capabilities of the dual channel miniscope, we labeled layer specific excitatory neurons or inhibitory interneurons in the medial prefrontal cortex (mPFC) with a red fluorescence protein, and simultaneously imaged neural activity of distinct neuronal populations of freely moving mice via a green GECI.

Background: Kathmandu Valley experiences over 5,500 road traffic accidents annually, causing significant fatalities. Despite taxis being a safer transport option, they are still involved in accidents that is attributed to compromised knowledge related to road traffic accidents (RTAs). This study investigates taxi drivers' knowledge on road traffic accident prevention in Kathmandu Valley. Methods: The study used a cross-sectional design and was conducted across various junctions in Kathmandu Valley. A sample of 322 taxi drivers was selected using a purposive method. Data were collected through semi-structured interviews, with pre-testing conducted beforehand. Data were entered into Epi- Data and analyzed using SPSS version 16, with all ethical considerations strictly adhered. Results: The study found that 98% of the drivers were male, with a mean age of 37 years. Most were married, and over half identified as Janajatis. About half had secondary education, and 80% earned less than 50,000 per month. Despite 86% being satisfied with their income, knowledge gaps were evident. On average, 42% had poor knowledge of human-related factors, 62% lacked understanding of vehicular factors, and 20% were incorrect about environmental factors affecting RTAs. Conclusions: The study highlights significant gaps in taxi drivers' knowledge about factors contributing to RTAs. The findings suggest that targeted education programs and stricter regulations could help improve drivers' understanding and potentially reduce RTAs in the future.

Introduction: Acid peptic disease is caused by excessive acid secretion or weakened mucosal defense. Symptoms include epigastric pain, bloating, and nausea. Factors like gastric acid, Helicobacter pylori infection, alcohol consumption, smoking, and stress contribute to peptic ulcers. Imbalances between offensive and defensive factors can lead to ulcers. Acid-related disorders impact the quality of life and mortality. Accurate diagnosis and prompt treatment are vital. This study aimed to find out the prevalence of acid peptic disease among patients with acute abdomen in the Department of Emergency Medicine in a tertiary care centre. Methods: A descriptive cross-sectional study was conducted from 2 April 2022 and 2 April 2023 among the patients presented in the Department of Emergency Medicine in a tertiary care centre. Ethical approval was obtained from the Institutional Review Committee. All patients presenting with acute abdominal pain in the Emergency Department were included in the study. Patients not giving consent were excluded from the study. Convenience sampling method was used. The point estimate was calculated at a 95% Confidence Interval. Results: Out of the 400 patients with acute abdomen, the prevalence of acid peptic disease was found to be 87 (21.75%) (17.71-25.79, 95% Confidence Interval). Conclusions: The prevalence of acid peptic disease among patients with acute abdomen was found to be lower than in other studies performed in similar settings.

Background: An increase in the number of natural disasters and consequently the rate of disability has been also increased. So, purpose of this study is to assess the knowledge, attitude and practice about disaster preparedness among health care workers at a tertiary care center of a disaster-prone developing country like Nepal. Methods: This is a descriptive cross-sectional study. A total of 135 participants were included. Self-administered multiple sets of questionnaires with four sections i.e., Demographic information, Knowledge Questionnaire, Aptitude Checklist, and Practice based questionnaire were used for study. The study was conducted in Kathmandu Medical College Teaching Hospital and the study period was two months, from December to February 2021. The respondents were the staffs working in Kathmandu medical college teaching hospital with or without formal training and work-related experiences of disaster preparedness and management in the past. The data was entered into the Microsoft Excel software and analyzed using the statistical package for social studies (SPSS) software 23.0 version and P-value was set at 0.5 with 95% CI. Results: Among 135 participants, female participants were 90 (66.7 %). There were 41 Doctors (37.0%) and 45 nurses (37.8%). Equal participation from every department was ensured. Their overall knowledge, attitude, and practice in disaster preparedness were good. 80.7% of the participants had knowledge of the disaster, and 7.0% agreed with the necessity to have a disaster plan. Conclusions: Health Care professionals have a significant level of knowledge. Attitude is a significant predictor of readiness to practice. Educators and health policymakers should build a robust curriculum in disaster medicine management and preparedness for the future of competent health care professionals in our country Nepal.

Background: Nurses professionals experience an overwhelming level of depression and anxiety; which remain taboo, despite the prevalence of these mental health conditions within the field. This cross-sectional hospital-based study was conducted to identify the prevalence of anxiety, depression and associated factors among nightshift working nurses of hospitals in Kathmandu Valley of Nepal. Methods: Cross-sectional hospital-based study was done among randomly sampled nightshift working nurses. Total 206 samples derived by using the formula; n=z²pq/e2. Hospital Anxiety and Depression Scale used to assess the level of anxiety, depression and associated factors. The self-administered Hospital Anxiety and Depression Scale was pretested and finalized before data collection. Nightshift working nurses were respondents and the purpose of the study explained to the respondents before data collection. Verbal informed consent was obtained from nurses and ethical approval from Nepal Health Research Council was taken. Scientific Package for Social Science version-20 used for data analysis and relevant statistical test applied. Results: Mean age of nurses was 24.46 ± 3.7 SD. years Forty-one percent of the nurses were between 22-26 years and 70.9% of them were unmarried. Three in four (75.0%) of nightshift working nurses had anxiety and nearly half (49.5%) of them had depression. Age of the nurses and level of anxiety (p= 0.032); working duration of the nurses and level of depression (p= 0.02) was found significantly associated with the depression. Conclusions: Remarkable proportion of hospital working nurses of Kathmandu Valley has anxiety and depression. Age and working duration of nurses were the factors associated with anxiety and depression respectively. So, there is an insistent need to develop policies, plans and programs to resolve the issues related to the prevalence of anxiety and depression among the hospital working nurses in Kathmandu Valley.

Background: Cardiac arrest is a substantial public health problem estimated to account for 15-20% of all death. Cardiac arrest is one of the most common emergencies within the emergency department leading to serious and life threatening results which can be managed if medical and paramedical personnel working in the emergency department have adequate knowledge about cardiopulmonary resuscitation (CPR) and if they are well trained to administer it effectively. Objective: To assess the knowledge, attitude and practice regarding CPR amongst interns in tertiary medical center of Nepal and comprehend the depth of knowledge about CPR and practice regarding defibrillation used during CPR. Methodology: This is a cross-sectional study carried out in Kathmandu Medical College Teaching Hospital using a semi structured pretested questionnaire. We requested interns to answer the questionnaire, which included 25 questions to assess the knowledge of BLS. Similarly, subjects were inquired about the attitude level questionnaire by the researcher and scoring was done accordingly. We analyzed the statistics through frequency, percentage, mean and mean percentw. Results: Out of 150 interns , regarding knowledge, on an average 11.71 questions were correctly answered. Highest score of 22 was scored by five participants and lowest of 5 scored by seven participants. Eleven questions were rightly answered by more than 50%. All the participants agreed that resuscitation training need to be added in the curriculum . . Conclusion: The present study identified the attitude score was good however, knowledge score of BLS was poor among medical interns. BLS training should be the part of the MBBS curriculum to solve this very critical issue. The unconsolidated knowledge about resuscitation among the interns is not adequate. This study emphasizes the necessity for standardized systemic resuscitation program in the undergraduate curriculum and effort should be made to introduce an appropriate, efficient and effective course design.

Background: Bacteriological aetiology and its culture sensitivity pattern is an important parameter for evaluating antibiotic use in Emergency Department. Blood-stream infections cause significant morbidity and mortality, increase in length of hospital stay and increased cost of care. Frequent inappropriate antibiotic use contributes to emergence of drug-resistant bacteria pathogens. Objectives: The objective of this study was to identify likely etiologic agents’ and antibiotic sensitivity profile of bacteria from blood stream infection in Emergency Department of Patan Hospital. Methodology: The study was conducted at tertiary care hospital from July to August 2014 blood culture was done and antibiotic susceptibility test was performed following Kirby Bauer disc diffusion technique and growth and sensitivity pattern of organisms isolated were analyzed. Results: There were 282 blood culture sent from the Emergency Department. The most common bacterial isolates were Enterobacter species. Second most common bacteria were Streptococcus pneumoniae. Enterobacter species was more sensitive to Chloramphenicol, Amikacin and Gentamycin. While Streptococcus pneumoniae was sensitive to most of the antibiotics, we also found that 65.3% bacterial isolates were resistant to Cephalosporin. Conclusion: Contaminated blood samples were found higher therefore, emphasis should be given in reducing the contamination. Proper cleaning of skin with antiseptic and guidelines to draw blood for culture should be familiarized and strictly followed while drawing the blood and others from Emergency Department of Patan Hospital.

Obstructed Hemivagina and Ipsilateral Renal Anomaly syndrome is a rare obstructive uterovaginal anomaly involving both mesonephric and paramesonephric ducts. It usually presents after menarche with non-specific symptoms like pelvic pain, dysmenorrhea, or paravaginal mass and examination findings of paravaginal or pelvic mass. Because of non-specific symptoms and signs, the diagnosis is usually overlooked, which leads to complications like endometriosis, tubo-ovarian abscess compromising patient’s fertility, and quality of life. Therefore, in presence of these nonspecific clinical features along with imaging findings of uterine didelphys and unilateral renal agenesis, this syndrome should be considered in the diagnosis. We present a case of a 17-year-old lady with Obstructed Hemivagina and Ipsilateral Renal Anomaly syndrome, diagnosed by finding of paravaginal mass on examination and uterine didelphys with ipsilateral renal agenesis in USG and managed successfully by resection of vaginal septum.

Background: Cholesterol management guidelines from the American College of Cardiology/American Heart Association (ACC/AHA-2013) recommend fixed statin dosing (dose depends on age ≤ or >75 years) compared to the earlier adult treatment panel III (ATPIII) guidelines which recommended specific low-density lipoprotein-cholesterol (LDL-C) targets. Clinical implications of this recommendation are not known. Methods: We retrospectively compared cholesterol levels and statin utilization across cohorts with coronary artery disease (CAD) (n = 9563), peripheral arterial disease (PAD) (n = 596) and CAD + PAD (n = 975) by applying both guidelines. The percentage of patients who achieved guideline-specific targets using 2013 ACC/AHA (use of moderate/high intensity statins) or ATPIII guidelines (LDL-C 100 mg/dl. Conclusions: Application of the ACC/AHA guidelines results in a higher percentage of patients considered to be ‘at goal’ when compared to the ATP III guidelines without changes in clinical practice. This is due to patients ≤75 years old on adequate statin doses but still have LDL-C levels >100 mg/dl, thereby raising concerns that physicians may not pursue alternate LDL reduction strategies since they are now considered at goal despite LDL-C >100 mg/dl. Lipid management of PAD patients remains sub-optimal as compared to CAD and CAD + PAD.

Introduction: Basic life support is foundation to save lives. In contrast to the developed countries, there is still no national standard BLS training module in Nepal. Basic life support training is being provided by various institutions but lack in consistency and coordination. The Nepal basic life support Course is the video based training in Nepali language with reference to recent advances which was intended for all health care personnel of Nepal in urban as well as rural setting. We aimed to describe the features of this video based training module in local language, to analyse the differences of knowledge and find out the participants perception and satisfaction with this course. Methods: This is a descriptive cross-sectional study based on data of trainings conducted over the study period. Ethical approval was taken. The post-test score was recorded and compared with the occupational using ANOVA. On the spot and delayed feedbacks from the participants were collected voluntarily and summarized. Results: Total of 576 participants (435 clinical doctors, 92 nurses/paramedics, 18 non-clinical doctors and 41 intern doctors) successfully completed the training. The difference in post test scores (mean = 12.9±1.8) among the different occupational background was not significant (P=0.159). The feedbacks from the participants were mostly positive and encouraging. Conclusions: The knowledge of basic life support improved significantly irrespective of the occupation of the participants. A universal, nationwide video based training module in Nepali language should be developed focusing all health care personnel of urban as well rural Nepal.

Background: Medicinal plants are being used by the majority of the population throughout the world for their primary health care needs. The reliance is also prevalent in Nepal, aided by its ethnic and biological diversity. This study aimed to catalogue the ethnomedicinal knowledge of plants used by local people of Machhapuchchhre Rural Municipality of Kaski district. Methods: Data were collected between February 2017 and April 2018 from eight different villages of the Kaski district by using semi-structured interviews, guided field works, focus group discussions, and in-depth interviews. The reported traditional uses were supported by local assistants, cataloguing vernacular names and crosschecking with the earlier published and gray literature. Results: A total of 105 medicinal plants, belonging to 58 families and 99 genera were documented to treat 70 different diseases and ailments. The highest numbers of plants (37) were used for gastrointestinal disorders and the lowest (4) were used for female genital disorders. Commonly used parts were underground portions (28 species) followed by fruits and seeds (25 species each). The most preferred dosage form was juice, used for 50 ailments, and the oral route was the most favored route of administration (77 species). The medicinal properties of 22 plant species were found hitherto unreported in the district. Conclusions: The study area was found to be rich in plant resources and the people have ample knowledge on the use of medicinal plants. Due to a lack of proper documentation, conservation, and cultivation practices, valuable plant species are at risk of extinction. Thus, appropriate conservation measures and scientific assessment of plant-lore in the district is immediately required.

Background: More than 700 plants are reported to be used for medicinal purposes in Nepal; however, many of them are not studied for their scientific evidences. The aims of the present study were the estimation of the total phenolic and flavonoid contents, and the evaluation of the free radical scavenging and α-amylase inhibitory activities of five selected medicinal plants from western Nepal: Aeschynanthus parviflorus Wall. (Gesneriaceae), Buddleja asiatica Lour. (Loganiaceae), Carica papaya L. (Caricaceae), Drepanostachyum falcatum (Nees) Keng f. (Gramineae) and Spondias pinnata (L. f.) Kurz (Anacardiaceae). Methods: The total phenolic content (TPC) and total flavonoid content (TFC) were measured using Folin-Ciocalteu’s phenol reagent and aluminium chloride methods, respectively. A 1,1−diphenyl−2−picrylhydrazyl (DPPH) free radical scavenging assay was used to evaluate the free radical scavenging activity and an α-amylase inhibitory assay was carried out to determine the in vitro antidiabetic activity. Results: The phytochemical screening of five hydroalcoholic plant extracts revealed the presence of various secondary metabolites, including alkaloids, flavonoids, reducing sugars, saponins, terpenoids and tannins. The amounts of total phenolics and flavonoids were found to be the highest in B. asiatica leaf extract, which also showed the most potent free radical scavenging activity. Extract of C. papaya fruits showed the highest α-amylase inhibitory activity, whereas the extracts of B. asiatica leaves and S. pinnata leaves exhibited moderate activity. Conclusions: Some of the medicinal plants selected in this study showed high TPC and TFC values and potent bioactivities. These results may provide the scientific evidences of the traditional uses of these plants. However, further detailed studies on bioactive compounds isolation and identification and evaluation of in vivo pharmacological activities should be performed in future.

This survey of 502 U.S. residents explored how people practiced wearing facemasks and maintaining social distancing during the COVID-19 pandemic. Using Health Benefit Model (HBM), the study found that perceived susceptibility, perceived severity, perceived self-efficacy, perceived benefit, and perceived barrier were significant predictors of wearing facemasks while perceived severity, perceived self-Efficacy, and perceived benefit were significant predictors for maintaining social distancing. While women and people with higher education and higher income were more likely to wear facemasks than others, people of 40 years of age and above and those with higher income tended to maintain social distancing more than others. Participants did not have COVID-19 were more likely to wear facemask and maintain social distancing than those who already had the disease.

Background: The prevalence of heart disease has increased and is a leading cause of death in the U.S. Despite the importance of physical activity, only one-third of adults in the United States meet the amount of physical activity recommended by the Centers for Disease Control and Prevention (CDC). The purpose of this study was to extend the extended parallel process model (EPPM) by adding a ‘barrier’ (a construct from Health Belief Model) and exploring the roles of threat, efficacy, and barrier on participants’ self-efficacy, attitudes, and intentions toward exercise. Methods: A between-subject experimental design was conducted online in 2018 in the U.S. A total of 446 participants were recruited from the Amazon Mechanical Turk age 18 or above. The participants were first provided with stimuli messages about physical activity behaviors. Then participants’ responses to self-efficacy, intention, and attitudes toward exercise were assessed. Results: The results found an interaction between efficacy and barrier to participants’ attitudes toward exercise [F(1,435)=4.35, P=0.038, η2 part=0.01]. The results also showed that there was a statistically significant effect of barriers on participants’ self-efficacy regarding exercise behavior [F(1,442)=4.21, P=0.04, η2 part=0.009]. However, three-way interactions of threat, efficacy, and barrier were not found in attitudes or intentions to exercise. Conclusion: The findings suggested that addressing an individual’s perceived barrier regarding a health behavior may lead to an increase in self-confidence ensuing in higher physical activity. Future studies should further explore how addressing barriers may influence other health behaviors to design unique and effective health messages.