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Article ; Online: Acute Myocardial Infarction in Women, a Study on Risk Factors, Angiographic Features and Outcomes.

Chapagain Koirala, Prabha / Sah, Ram Kishor / Sherpa, Kunjang / Poudyal, Samir / Gautam, Binayak / Koirala, Richa

Journal of Nepal Health Research Council

2024 Volume 21, Issue 3, Page(s) 491–497

Abstract: Background: Women with acute coronary syndrome are more likely to have cardiovascular disease risk factors and atypical symptoms as compared to men. In Nepal, there is a rising trend of Coronary Artery Disease and myocardial infarction in women. However, ...

Abstract	Background: Women with acute coronary syndrome are more likely to have cardiovascular disease risk factors and atypical symptoms as compared to men. In Nepal, there is a rising trend of Coronary Artery Disease and myocardial infarction in women. However, research on acute myocardial infarction in women is lacking. The aim of this study was to study the cardiac risk factors, clinical features, angiographic features, and outcome of acute myocardial infarction in Nepalese women admitted to Hospital. Methods: This was a cross sectional study done at Shahid Gangalal National Heart Center Kathmandu from September 2016 to March 2017. Female patients admitted with a diagnosis of acute ST-segment elevation myocardial infarction or non-ST segment elevation myocardial infarction, who fulfilled the inclusion criteria were included in the study. The details of the patients, demographic profile, major clinical symptoms, major coronary artery disease risk factors, angiographic features and outcomes were recorded and assessed during the study period. Coronary angiography was done in 112 patients out of 178 patients. Results: Out of 178 patients, 85.95 % had ST-segment elevation myocardial infarction and 14.05% had non-ST segment elevation myocardial infarction. The mean patient age was 62.53 ± 12.1. 26.4% patients were of age less than 55 years. Major risk factors were central obesity (94.61%), dyslipidemia due to low HDL (78.65%). hypertension (54.49%), smoking (54.49%) and type 2 diabetes (34.83%). The most common atypical symptoms were shortness of breath (35.39 %,) , nausea and vomiting (23. 6%) and epigastric pain (6.74%), Single vessel disease was found in 36%; double vessel disease in 26.3% and triple vessel disease in 28.9% of patients. The primary outcome of in- hospital mortality was 3.37 %. Conclusions: Our study showed that significant number of females had Coronary Artery Disease at early age. Among women with myocardial infarction in Nepal, obesity due to high waist to hip ratio was the most common risk factor followed by dyslipidemia due to low high density lipoproteins, smoking, hypertension, and diabetes. Atypical symptoms were also common findings. Single vessel disease was the most common lesion and left anterior descending artery was the most commonly involved vessel. Mortality was seen in ST-segment elevation myocardial infarction patients only.
MeSH term(s)	Male ; Female ; Humans ; Middle Aged ; Coronary Artery Disease ; Diabetes Mellitus, Type 2 ; Cross-Sectional Studies ; Nepal/epidemiology ; Myocardial Infarction/epidemiology ; Myocardial Infarction/etiology ; Risk Factors ; Obesity ; Hypertension/complications ; Hypertension/epidemiology ; Dyslipidemias/epidemiology
Language	English
Publishing date	2024-03-22
Publishing country	Nepal
Document type	Journal Article
ZDB-ID	2551251-1
ISSN	1999-6217 ; 1999-6217
ISSN (online)	1999-6217
ISSN	1999-6217
DOI	10.33314/jnhrc.v21i3.4762
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Cadherins can dimerize via asymmetric interactions.

Priest, Andrew Vae / Koirala, Ramesh / Sivasankar, Sanjeevi

FEBS letters

2022 Volume 596, Issue 13, Page(s) 1639–1646

Abstract: Cadherins are essential cell-cell adhesion proteins that interact in two distinct conformations: X-dimers and strand-swap dimers. Both X-dimers and strand-swap dimers are thought to exclusively rely on symmetric sets of interactions between key amino ... ...

Abstract	Cadherins are essential cell-cell adhesion proteins that interact in two distinct conformations: X-dimers and strand-swap dimers. Both X-dimers and strand-swap dimers are thought to exclusively rely on symmetric sets of interactions between key amino acids on both cadherin binding partners. Here, we use single-molecule atomic force microscopy and computer simulations to show that symmetry in cadherin binding is dispensable and that cadherins can also interact in a novel conformation that asymmetrically incorporates key elements of both strand-swap dimers and X-dimers. Our results clarify the biophysical rules for cadherin binding and demonstrate that cadherins interact in a more diverse range of conformations than previously understood.
MeSH term(s)	Cadherins/genetics ; Cadherins/metabolism ; Cell Adhesion ; Dimerization ; Protein Binding ; Protein Multimerization
Chemical Substances	Cadherins
Language	English
Publishing date	2022-05-16
Publishing country	England
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	212746-5
ISSN	1873-3468 ; 0014-5793
ISSN (online)	1873-3468
ISSN	0014-5793
DOI	10.1002/1873-3468.14373
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Conference proceedings ; Online: Hydraulic and mechanical properties of fault and host rocks from the Blue Mountain Geothermal Field, Nevada

Schuster, V. / Rybacki, E. / Schleicher, A. / Cladouhos, T. / Koirala, R. / Göebel, T.

XXVIII General Assembly of the International Union of Geodesy and Geophysics (IUGG)

2023

Abstract: Several target reservoirs for Enhanced Geothermal Systems comprise hot, dry rock lithologies characterized by low matrix permeability. To improve the permeability of these formations and thus to increase the productivity of power plants, hydraulic ... ...

Abstract	Several target reservoirs for Enhanced Geothermal Systems comprise hot, dry rock lithologies characterized by low matrix permeability. To improve the permeability of these formations and thus to increase the productivity of power plants, hydraulic stimulation is a common practice. For this purpose, water is injected into the reservoir, causing a local change in the effective stress state that can potentially trigger fault slip seismicity. However, seismicity can be triggered even during normal operation, as in the case of the Blue Mountain geothermal field, Nevada, USA. Here, a significant increase in microseismic activity is observed during the annual maintenance shutdown of the power plant pumps, suggesting more complex processes, such as poroelastic stress transfer, contributing to seismicity. To better understand induced seismicity and explore the underlying mechanisms, we conducted triaxial experiments on intact and faulted reservoir rock samples from the DB2 well at the Blue Mountain geothermal site and determined the effective pressure sensitivity of flow and poroelastic properties over a range of pore (<40 MPa) and confining (<50 MPa) pressure conditions. Laboratory results are compared with permeability estimates previously determined from tidal responses in idle wells, supplemented by a seismicity catalog of continuous waveforms records from 2016 to 2019 to identify seismicity migration patterns associated with operational changes. The integration of cross-scale field and laboratory data aims to improve the characterization of the permeability structure of the fault zone at Blue Mountain and to better understand the coupling between matrix permeability, fault zone hydrology and mechanical behavior.
Subject code	550
Language	English
Publishing date	2023-07-11
Publishing country	de
Document type	Conference proceedings ; Online
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Article ; Online: Dementia Symptoms among Senior Citizens Living in Geriatric Homes of Kathmandu Valley.

Singh, D R / Parajuli, P / Hug, J / Nath, D / Koirala, R / Mandal, R

Kathmandu University medical journal (KUMJ)

2021 Volume 19, Issue 74, Page(s) 195–199

Abstract: Background With increasing age, the older population becomes more susceptible to mental disorders. It is important to recognize and develop an understanding of psychiatric morbidity particularly among the residents of geriatric homes in resource-poor ... ...

Abstract	Background With increasing age, the older population becomes more susceptible to mental disorders. It is important to recognize and develop an understanding of psychiatric morbidity particularly among the residents of geriatric homes in resource-poor settings. Objective To assess the prevalence and associated factors of dementia symptoms among Nepalese senior citizens living in geriatric homes of Kathmandu valley. Method A cross-sectional study was conducted among 304 senior citizens living in geriatric homes of Kathmandu valley. Cognitive Impairment Test (CIT), was used to assess dementia symptoms. Bivariate and multivariate logistic regressions were performed. All the variables that were significant at p < 0.05 level in the bivariate analysis were included in the multivariate regression model and statistical significance was declared at p < 0.05 with a 95.00% confidence interval (CI). Result This study showed 75.65%, of the participants, had dementia symptoms. In the multivariate logistic regression analysis, female respondents (AOR=2.94, 95% CI=1.31-6.57), respondents never received geriatric allowances (AOR=2.46, 95% CI=1.22-4.98), respondent's history of alcohol consumption habits (AOR=2.04, 95% CI=1.01-4.11) and non-vegetarian diet habits (AOR= 2.31, 95% CI=1.12-4.76) were found more likely to had higher dementia symptoms whereas, literate participants (AOR=0.19, 95% CI=0.08-0.43) were less likely to had dementia symptoms. Conclusion The high prevalence of dementia symptoms among senior citizens living in geriatric homes in the Kathmandu valley indicates an urgent need for early diagnosis and treatment of mental disorders among senior citizens to improve their quality of life and well-being.
MeSH term(s)	Aged ; Cross-Sectional Studies ; Dementia/epidemiology ; Female ; Humans ; Logistic Models ; Prevalence ; Quality of Life
Language	English
Publishing date	2021-11-24
Publishing country	Nepal
Document type	Journal Article
ZDB-ID	2257651-4
ISSN	1812-2078 ; 1812-2078
ISSN (online)	1812-2078
ISSN	1812-2078
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Role of cancer literacy in cancer screening behaviour among adults of Kaski district, Nepal.

Koirala, Reecha / Gurung, Nisha / Dhakal, Sarita / Karki, Sulata

PloS one

2021 Volume 16, Issue 7, Page(s) e0254565

Abstract: Cancer Screening is a key approach to detect cancer at an early stage and help reduce cancer mortality globally. Inadequate Cancer Literacy may pose a barrier to patient engagement in getting screened for cancer. This study assessed Cancer Screening ... ...

Abstract	Cancer Screening is a key approach to detect cancer at an early stage and help reduce cancer mortality globally. Inadequate Cancer Literacy may pose a barrier to patient engagement in getting screened for cancer. This study assessed Cancer Screening behavior and its association with Cancer Literacy and other factors among adults of Kaski district, Nepal. A cross-sectional study was carried out among 180 adults from March to August 2019, selected using a multi-stage random sampling method. Data on demographics, history of cancer, use of naturopathy, fatalism, family support, cancer literacy and cancer screening behaviour were collected using a semi-structured questionnaire, with the aid of face-to-face interviews. Cancer Literacy was measured using a cancer health literacy tool (CHLT-6), and Cancer Screening behaviour was assessed on the basis of the self reported information about having gone through any type of cancer screening in the past. Odds ratio (OR) with 95% Confidence Interval (CI) was calculated to determine the strength of association using Multivariate Logistic Regression analysis. Only 43.4% of the respondents had Cancer Literacy scores more than the median and only 11.7% had ever gone through any Cancer Screening test in the past. In this study, Cancer Screening behaviour was significantly associated with Cancer Literacy [OR = 1.43, 95% CI (1.01-2.02)]. Similarly, significant association was found between Cancer Screening behaviour and other exposure variables such as age [OR = 1.06, 95% CI (1.02-1.11)] and gender [OR = 0.06, 95% CI (0.01-0.35)]. This study showed low cancer screening and cancer literacy scores amongst the respondents. This suggests that to tackle the ever increasing burden of cancer and hence, to increase cancer screening, we need to focus on improving knowledge and awareness about cancer, as well as, on targeting efforts towards people's understanding of basic health and cancer terminologies.
MeSH term(s)	Adult ; Aged ; Cross-Sectional Studies ; Early Detection of Cancer/methods ; Female ; Health Literacy/methods ; Humans ; Male ; Middle Aged ; Neoplasms/diagnosis ; Nepal ; Surveys and Questionnaires
Language	English
Publishing date	2021-07-13
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ISSN	1932-6203
ISSN (online)	1932-6203
DOI	10.1371/journal.pone.0254565
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Edwardsiella ictaluri

Dubytska, Lidiya P / Koirala, Ranjan / Sanchez, Azhia / Thune, Ronald

Microorganisms

2022 Volume 10, Issue 7

Abstract: The type III secretion system (T3SS) effector EseN is encoded on ... ...

Abstract	The type III secretion system (T3SS) effector EseN is encoded on the
Language	English
Publishing date	2022-07-01
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2720891-6
ISSN	2076-2607
ISSN	2076-2607
DOI	10.3390/microorganisms10071334
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Article ; Online: Association of childhood trauma, and resilience, with quality of life in patients seeking treatment at a psychiatry outpatient: A cross-sectional study from Nepal.

Dhungana, Saraswati / Koirala, Rishav / Ojha, Saroj Prasad / Thapa, Suraj Bahadur

PloS one

2022 Volume 17, Issue 10, Page(s) e0275637

Abstract: Quality of life is defined by the World Health Organization as "Individuals' perception of their position in life in the context of the culture and value systems in which they live and in relation to their goals, expectations, standards and concerns". It ...

Abstract	Quality of life is defined by the World Health Organization as "Individuals' perception of their position in life in the context of the culture and value systems in which they live and in relation to their goals, expectations, standards and concerns". It is a comprehensive measure of health outcome after trauma. Childhood maltreatment is a determinant of poor mental health and quality of life. Resilience, however, is supposed to be protective. Our aim is to examine childhood trauma and resilience in patients visiting psychiatry outpatient and investigate their relations with quality of life. A descriptive cross-sectional study was conducted with a hundred patients with trauma and visiting psychiatry outpatient. Standardized tools were applied to explore childhood trauma, resilience, quality of life and clinical diagnoses and trauma categorization. Sociodemographic and relevant clinical information were obtained with a structured proforma. Bivariate followed by multivariate logistic regressions were conducted to explore the relation between childhood trauma, resilience, and quality of life. Poor quality of life was reported in almost one third of the patients. Upper socioeconomic status, emotional neglect during childhood, current depression and low resilience were the determinants of poor quality of life in bivariate analysis. Final models revealed that emotional neglect during childhood and low resilience had independent associations with poor quality of life. Efforts should be made to minimize childhood maltreatment in general; and explore strategies to build resilience suited to the cultural context to improve quality of life.
MeSH term(s)	Adverse Childhood Experiences ; Child ; Child Abuse/psychology ; Cross-Sectional Studies ; Humans ; Nepal ; Psychiatry ; Quality of Life ; Resilience, Psychological ; Surveys and Questionnaires
Language	English
Publishing date	2022-10-04
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2267670-3
ISSN	1932-6203 ; 1932-6203
ISSN (online)	1932-6203
ISSN	1932-6203
DOI	10.1371/journal.pone.0275637
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Traditional and biomedical care pathways for mental well-being in rural Nepal.

Pham, Tony V / Koirala, Rishav / Kohrt, Brandon A

International journal of mental health systems

2021 Volume 15, Issue 1, Page(s) 4

Abstract: Background: There is increasing access to mental health services in biomedical settings (e.g., primary care and specialty clinics) in low- and middle-income countries. Traditional healing continues to be widely available and used in these settings as ... ...

Abstract	Background: There is increasing access to mental health services in biomedical settings (e.g., primary care and specialty clinics) in low- and middle-income countries. Traditional healing continues to be widely available and used in these settings as well. Our goal was to explore how the general public, traditional healers, and biomedical clinicians perceive the different types of services and make decisions regarding using one or both types of care. Methods: We conducted in-depth interviews using a pilot tested semi-structured protocol around the subjects of belief, traditional healers, and seeking care. We conducted 124 interviews comprising 40 traditional healers, 79 general community members, and five physicians. We then performed qualitative analyses according to a grounded theoretical approach. Results: A majority of the participants endorsed belief in both supernatural and medical causes of illness and sought care exclusively from healers, medical practitioners, and/or both. Our findings also revealed several pathways and barriers to care that were contingent upon patient-, traditional healer-, and medical practitioner-specific attitudes. Notably, a subset of community members duplicated care across multiple, equally-qualified medical providers before seeing a traditional healer and vice versa. In view of this, the majority of our participants stressed the importance of an efficient, medically plural society. Though participants desired a more collaborative model, no consistent proposal emerged on how to bridge traditional and biomedical practices. Instead, participants offered suggestions which comprised three broad categories: (1) biomedical training of traditional healers, (2) two-way referrals between traditional and biomedical providers, and (3) open-dialogue to foster mutual understanding among traditional and biomedical providers. Conclusion: Participants offered several approaches to collaboration between medical providers and traditional healers, however if we compare it to the history of previous attempts, education and understanding between both fields may be the most viable option in low- and middle-income contexts such as Nepal. Further research should expand and investigate opportunities for collaborative learning and/or care across not only Nepal, but other countries with a history of traditional and complimentary medicine.
Language	English
Publishing date	2021-01-07
Publishing country	England
Document type	Journal Article
ZDB-ID	2382266-1
ISSN	1752-4458
ISSN	1752-4458
DOI	10.1186/s13033-020-00433-z
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: 11β Hydroxylase Deficiency in a Child with Hypothyroidism: A Case Report.

Shah, Bipesh Kumar / Koirala, Richa / Dhamala, Sumit / Bhatta, Mukesh / Khatiwada, Shekhar

JNMA; journal of the Nepal Medical Association

2023 Volume 61, Issue 268, Page(s) 956–957

Abstract: Congenital adrenal hyperplasia occurs due to enzymatic defects in the adrenocortical steroidogenesis. 11β hydroxylase deficiency is the second most common cause of congenital adrenal hyperplasia which presents with hypertension and features of androgen ... ...

Abstract	Congenital adrenal hyperplasia occurs due to enzymatic defects in the adrenocortical steroidogenesis. 11β hydroxylase deficiency is the second most common cause of congenital adrenal hyperplasia which presents with hypertension and features of androgen excess. Hypertension has also been found to cause end-organ damage in children with 11β hydroxylase deficiency. We report a case of a 10-year-old male child with hypothyroidism under thyroid replacement therapy, presenting with features of severe hypertension and androgen excess, later on, diagnosed as congenital adrenal hyperplasia due to 11β hydroxylase deficiency. Keywords: case reports; congenital adrenal hyperplasia; hypertension; hypothyroidism.
MeSH term(s)	Male ; Child ; Humans ; Adrenal Hyperplasia, Congenital/complications ; Adrenal Hyperplasia, Congenital/diagnosis ; Steroid 11-beta-Hydroxylase/genetics ; Androgens ; Mutation ; Hypertension/etiology ; Hypothyroidism/complications ; Hypothyroidism/diagnosis
Chemical Substances	Steroid 11-beta-Hydroxylase (EC 1.14.15.4) ; Androgens
Language	English
Publishing date	2023-12-01
Publishing country	Nepal
Document type	Case Reports ; Journal Article
ZDB-ID	2209910-4
ISSN	1815-672X ; 0028-2715
ISSN (online)	1815-672X
ISSN	0028-2715
DOI	10.31729/jnma.8378
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Challenges and advancements in membrane distillation crystallization for industrial applications.

Zhang, Xin / Koirala, Ravi / Pramanik, Biplob / Fan, Linhua / Date, Abhijit / Jegatheesan, Veeriah

Environmental research

2023 Volume 234, Page(s) 116577

Abstract: Membrane distillation crystallization (MDC) is an emerging hybrid thermal membrane technology that synergizes membrane distillation (MD) and crystallization, which can achieve both freshwater and minerals recovery from high concentrated solutions. Due to ...

Abstract	Membrane distillation crystallization (MDC) is an emerging hybrid thermal membrane technology that synergizes membrane distillation (MD) and crystallization, which can achieve both freshwater and minerals recovery from high concentrated solutions. Due to the outstanding hydrophobic nature of the membranes, MDC has been widely used in numerous fields such as seawater desalination, valuable minerals recovery, industrial wastewater treatment and pharmaceutical applications, where the separation of dissolved solids is required. Despite the fact that MDC has shown great promise in producing both high-purity crystals and freshwater, most studies on MDC remain limited to laboratory scale, and industrializing MDC processes is currently impractical. This paper summarizes the current state of MDC research, focusing on the mechanisms of MDC, the controls for membrane distillation (MD), and the controls for crystallization. Additionally, this paper categorizes the obstacles hindering the industrialization of MDC into various aspects, including energy consumption, membrane wetting, flux reduction, crystal yield and purity, and crystallizer design. Furthermore, this study also indicates the direction for future development of the industrialization of MDC.
MeSH term(s)	Wastewater ; Distillation ; Crystallization ; Membranes, Artificial ; Water Purification ; Minerals
Chemical Substances	Wastewater ; Membranes, Artificial ; Minerals
Language	English
Publishing date	2023-07-08
Publishing country	Netherlands
Document type	Journal Article ; Review
ZDB-ID	205699-9
ISSN	1096-0953 ; 0013-9351
ISSN (online)	1096-0953
ISSN	0013-9351
DOI	10.1016/j.envres.2023.116577
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