Explore the vast range of titles available.

Diabetes Mellitus is a significant global public health burden. Although medication adherence is an inevitable consideration in managing and curing the disease, medication price is the major barrier to patients in Nepal, like any other low- and middle-income countries. Prescribing in brand-name inhibits the possibility of accessing cost-effective generic alternatives in Nepal. This study aimed to explore and examine price variations among the oral hypoglycaemic medicines (OHMs) available in the country and their distribution in various medicine-related characteristics. A cross-sectional study was conducted using a convenient sample of five tertiary care hospital pharmacies in Kathmandu, publicly accessible online pharmacy websites, and a government database to list the OHMs available in Nepal. The study determined price variations and statistically tested the association between these variations and the characteristics of the medicines. Fourteen OHMs were available as 57 generic medicine items with different formulations in Nepal. The maximum of 484.82% of price variation was found. Fourteen, fifteen and eighteen OHMs have variations of over 100%, more than 10 rupees and no price change, respectively. Except for Dipeptidyl Peptidase-IV (DPP-4) Inhibitors and Thiazolidinediones (TZDs), all other categories of OHMs have >100% of price variation in medicine items. Although Nepal itself produces most of the available OHMs, the available OHMs have price variations. Most fixed dose combinations showed no reduction in cost compared to their component medicine’s mean price. This study presented and discussed the price variation scenario of OHMs with their medicine-related characteristics to develop and implement effective drug policies and programs that can address medication price-related issues to ensure access to OHMs without placing an economic burden on patients.

Several pharmacy standards exist within high-income countries for measuring standards of practice in clinical and hospital settings. Following the implementation of diverse hospital pharmacy standards in low- and middle-income countries (LMICs) like Nepal such as the hospital pharmacy service guideline 2015, minimum service standards, this study aims to assess compliance with Good Pharmacy Practice (GPP) standards as per the codes for sales and distribution of drugs (CSDD) 2024 guideline in one of the provincial hospital of Nepal, as a quality improvement project. A cross-sectional study design was conducted within the Hetauda Hospital pharmacy section to check the compliance nature of hospital pharmacy practice standards using the 16 components and 121 indicators mentioned in the CSDD, implemented by the National Drug Regulatory Authority of Nepal, Department of Drug Administration. CSDD is a publicly available guideline consisting of 5 chapters and 20 sections, where the codes specifically focus on structural, human resources, storage and documentation, pharmacovigilance, GPP, good storage and distribution practice license-related provisions. Following the checklist provided in the CSDD, data were collected and entered into the MS Excel and analyzed in terms of frequency and percentage compliance. If the indicators were found to be 100% compliant, it was categorized as fully compliant, if the indicators were scored from (>50%-99.9%), it was categorized as partially compliant whereas if it was in between (0.0%-≤50%), it was categorized as poorly compliant. Out of a total of 121 indicators mentioned in the CSDD, only 74 (61.2%) were compliant. Only 6 domains were fully compliant (100%), whereas 7 domains were partially compliant (≥50%-99.9%) and 10 domains were poorly compliant (<50%-0.0%). Following the CSDD guidelines, it was found that the hospital pharmacy lacked in domains such as quality policy, service strategy, training, client complaints, product recalls, counseling services, medication records, client follow-up and referral, and self-inspection process, underscoring the need for prompt attention and an action plan from the Drug and Therapeutic Committee and the executives.

Despite declining smoking prevalence globally, South Asia faces a rising burden. In Nepal, existing tobacco control laws haven't curbed use, with 28.9% of young adults engaging in tobacco use. This study investigates tobacco use and associated factors among medical, dental, and nursing students at a Nepalese tertiary care center. We aimed to assess tobacco use prevalence and identify factors associated with it among future healthcare professionals, considering their distinct roles in tobacco control. Medical students can contribute through clinical counseling and public health advocacy, dental students through oral health education, and nursing students through patient education and community outreach. A cross-sectional study involving 427 medical, dental, and nursing students was conducted. Data was collected using online questionnaires distributed via email and social media. Descriptive statistics and Chi-square tests were used for analysis. The study found that 45% of participants were aged 22-25, with females comprising the majority (53.2%). Nearly half (49.2%) belonged to the medical faculty, and 24.4% were in their first year. Furthermore, among those who smoke, 53% reported smoking less than 5 cigarettes daily. The analysis revealed significant associations between smoking with age (p = 0.01), year of study (p = 0.001), parental smoking history (p = 0.001), and having friends who smoke (p = 0.001). Our findings highlight the moderate prevalence of cigarette smoking among medical students, with family and friends emerging as major influences. Stress relief was a common reason, particularly among young females and first-year students. These results emphasize the urgent need for comprehensive tobacco control programs within medical institutions to equip future healthcare professionals to effectively address smoking issues.

Literatures shows that poor air quality index (AQI) is associated with several adverse health impacts, such as asthma, chronic obstructive pulmonary disease, diabetes mellitus, tuberculosis, cancer, pneumonia, cataracts, heart diseases, and mental health disorders. Nepal, one of the lower-middle-income countries, has become vulnerable to adverse health impacts due to poor AQI over time. The capital city of Nepal, Kathmandu, is frequently placed as one of the most polluted cities by IQAir. As such, this statement marks a caution for policymakers and the public to be aware of the future effects of prolonged exposure to air pollution and highlights its causative factors. To solve this burgeoning issue, because of the significant rise in urbanization and population growth, mitigation strategies such as creating awareness, reducing vehicular emission, reducing forest fires, creating and identifying vulnerability maps risk zones for forest fires, switching to electronic vehicles and personal interventions such as staying indoors and reducing physical outdoor activity, wearing face masks must be focused and given priority. Although our study is limited in its methodology and findings, it helps establish a policy base to underscore the need for longitudinal cohort studies to generate further evidences pertaining to not up to par air quality levels and their subsequent health impacts in the Nepalese population.

ABSTRACT Autoimmune pulmonary alveolar proteinosis (PAP) is characterized by antibodies to granulocyte–macrophage colony‐stimulating factor (GM‐CSF), alveolar macrophage dysfunction, and surfactant accumulation. Whole lung lavage (WLL) is the treatment of choice in patients with PAP and severe hypoxemia. In resource‐limited settings, WLL can be performed in the intubated, anesthetized patient who is being one lung ventilated using a Y‐type bladder irrigation catheter for saline instillation and drainage.

The unique historical and cultural background of Nepal has shaped its perspective on cannabis usage. Narcotic Drugs Control Act 1976 of Nepal prohibits the cultivation, production, manufacture, sales, and distribution of narcotic drugs, which also include various forms of cannabis. With proponents for cannabis legalization increasing in the country, it is equally crucial to analyze context and practices in countries already adopting legalization. As such, this article contextualizes the current debates in Nepal with global policies and practices and talks about the possible impacts of changing the laws on society, the economy, and public health. Policymakers in Nepal must make decisions based on evidence and facts when deciding how to regulate cannabis.

ABSTRACT Moyamoya disease (MMD) is a rare progressive cerebrovascular disorder characterized by stenosis of the terminal internal carotid arteries with fragile collateral vessel formation. It is common in East Asia but underreported in Nepal. Pediatric cases typically present with ischemic symptoms such as transient ischemic attacks, stroke, or seizures. We report a 7‐year‐old Nepali boy with 11 days of fever followed by recurrent tonic–clonic seizures, progressive right‐sided weakness, and impaired fine motor function. Examination showed right hemiparesis with an upgoing plantar reflex. MRI and MR angiography revealed multiple acute infarcts with supraclinoid internal carotid artery stenosis and extensive collateral vessels, confirming MMD. Cerebrospinal fluid and autoimmune workup were unremarkable. The child was managed conservatively with aspirin and levetiracetam, leading to partial recovery. Surgery was deferred due to financial limitations and initial improvement. This case underscores the importance of considering MMD in pediatric strokes in non‐endemic regions. In resource‐limited settings like Nepal, conservative treatment offers symptomatic relief, but long‐term follow‐up is essential to monitor progression and surgical needs.