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Fulltext Intraradicular rehabilitation of a necrotic immature permanent maxillary incisor

Unni A, Mayya A, Bhandary S, Mayya A

BMJ Case Rep, 2021 Jul 22;14(7).
PMID: 34301705 DOI: 10.1136/bcr-2021-243703
Fulltext Management of necrotic immature permanent maxillary incisors using a modified technique of revascularisation

Mayya A, Bhandary S, Kolakemar A, George AM

BMJ Case Rep, 2021 Mar 17;14(3).
PMID: 33731387 DOI: 10.1136/bcr-2020-240203

The management of necrotic immature permanent teeth has always been a challenge to endodontists. Various treatment modalities have been tried and tested for achieving a successful outcome. Revascularisation is one among these treatment options, which is gaining widespread attention among endodontists. The growing body of evidence demonstrating the success of revascularisation has led to different variations of this treatment option. Clinicians have over time used different scaffolds such as blood clot, collagen, platelet-rich fibrin (PRF) and platelet-rich plasma for revascularisation. This case report outlines the management of immature maxillary central incisors with pulp necrosis and large periapical lesions in a 19-year-old female patient with a modified technique of revascularisation by combining PRF and blood clot. At the end of 12 months, the patient was completely asymptomatic along with regression of the periapical lesions.
Perceived Prevalence, Awareness and Attitude towards Counterfeit Medicines among Community Pharmacists of Kathmandu Valley: A Descriptive Cross-sectional Study

Kafle S, Jha N, Bhandary S, Ravi Shankar P

JNMA J Nepal Med Assoc, 2024 Jun 30;62(275):427-432.
PMID: 39369416 DOI: 10.31729/jnma.8651

INTRODUCTION: Counterfeit medicines are a significant problem globally. In a developing country like Nepal, community pharmacists play an important role in dispensing medicines. The study was done to assess community pharmacists' perceived prevalence, awareness and attitude towards counterfeit medicines in Kathmandu valley. Methods: A cross-sectional study design was used. Data was collected conveniently from Kathmandu, Bhaktapur, and Lalitpur districts in March 2022 after obtaining ethical clearance from Nepal Health Research Council (reference no. 2200) and taking written informed consent from Community Pharmacists. Results: Among the 343 pharmacists who participated, 250 (72.89%) were from Kathmandu, 57 (16.62%) were from Lalitpur, and 36 (10.50%) from Bhaktapur. Most 252 (73.47%) were aged between 20 to 30 years, 222 (64.72%) were male, 239 (69.68%) had done a Diploma in Pharmacy, 201 (58.60%) had working experience of more than 5 years and 342 (99.71%) had done their education in Nepal. Their median perceived prevalence of counterfeit drugs was 10.00% but only 2.30% had clear knowledge of such practice. 332 (96.79%) believed that actions should be taken against community pharmacists dispensing counterfeit drugs, 325 (94.75%) believed that pharmacists who dispense counterfeit medicines are unprofessional; 338 (98.54%) stated that there should be strong law against counterfeit medicine sales.
CONCLUSIONS: Median perceived prevalence of counterfeit medicines was 10.00% but only 2.30% were aware of counterfeit medicine dispensing. Out of 343 pharmacists, 332 (96.79%) mentioned that action should be taken against those pharmacists knowingly dispensing counterfeit medicines and 338 (98.54%) stated that there should be strong law against counterfeit medicines.
Eye donation - awareness and willingness among attendants of patients at various clinics in Melaka, Malaysia

Bhandary S, Khanna R, Rao KA, Rao LG, Lingam KD, Binu V

Indian J Ophthalmol, 2010 12 16;59(1):41-5.
PMID: 21157071

AIM: Corneal blindness accounts for 3.42% of blindness in Malaysia; the rate of eye donation is low. The aim of the study was to assess the awareness about eye donation and willingness to donate eyes among attendants of patients at various clinics in Melaka, Malaysia.
MATERIALS AND METHODS: This observational study was conducted on attendants who accompanied patients (n = 400) visiting various outpatient departments of the General Hospital and two peripheral clinics in Melaka between August and October 2007. The participants answered a questionnaire (Malay and English versions) which included demographic profile, awareness of eye donation, knowledge regarding facts of eye donation, and willingness to donate eyes. Univariate and multivariate logistic regression was performed at 5% level of significance.
RESULTS: Awareness of eye donation was observed in 276 (69%) participants. Multivariate analysis showed that awareness was more among females when compared to males (P = 0.009). Of the 276 participants who were aware of eye donation, only 34.42% were willing to donate eyes. Willingness was more among the Indian race (P = 0.02) and males (P = 0.02). Educational status did not influence the willingness to donate eyes.
CONCLUSIONS: Although majority of participants were aware of eye donation, willingness to donate eyes was poor.
A Point Prevalence Study of the Use of Antibiotics in Six Tertiary Care Hospitals in the Kathmandu Valley, Nepal

Jha N, Thapa B, Pathak SB, Pandey A, Pokhrel S, Shankar PR, et al.

Kathmandu Univ Med J (KUMJ), 2022;20(79):351-358.
PMID: 37042379

Background Point prevalence survey (PPS) on antibiotic use developed by the WHO has already been used in many hospitals globally. Objective To obtain information on antibiotic prescribtion using point prevalence survey methodology in six private hospitals in the Kathmandu valley. Method This descriptive cross-sectional study was completed during 20th July to 28th July 2021 using point prevalence survey methodology. The study was conducted among inpatients admitted at or before 8:00 AM on the day of survey in various wards. Data was presented as frequencies and percentages. Result Maximum number of patients were above 60 years [34 (18.7%)]. Number of male and female participants were equal [91 (50%)]. Only one antibiotic was used in 81 patients (44.5%) followed by two antibiotics in 71 (39%) patients. Duration of prophylactic antibiotic use was one day in 66 (63.7%) patients. Blood, urine, sputum, and wound swabs were the common samples for culture. Cultures were positive for 17 (24.7%) samples. The common organisms isolated were E. Coli, Pseudomonas aeruginosa and Klebsiella pneumoniae. Ceftriaxone was the most used antibiotic. Drug and therapeutics, infection control committee and pharmacovigilance activities were present in 3/6 (50%) study sites. Antimicrobial stewardship was present in 3/6 (50%) and microbiological services was present in all hospitals. Antibiotic formulary and antibiotic guideline were present in 4/6 sites and facilities to audit or review surgical antibiotic prophylaxis choice in 2/6 (33.3%) sites, facility to monitor antibiotic use in 4/6 (66.6%) and cumulative antibiotic susceptibility reports in 2/6 (33.3%) study sites. Conclusion Ceftriaxone was the most used antibiotic. E. Coli, Pseudomonas aeruginosa and Klebsiella pneumonia were the commonly isolated organisms. Not all parameters for infrastructure, policy and practice and monitoring and feedback were present at the study sites. KEY WORDS.
Fulltext Baseline assessment of knowledge, attitude, practice, and adherence toward antimicrobials among women living in two urban municipalities in Lalitpur district, Nepal

Jha N, Kafle S, Joshi M, Pandey A, Koirala P, Bhandary S, et al.

PLoS One, 2025;20(1):e0317092.
PMID: 39787140 DOI: 10.1371/journal.pone.0317092

INTRODUCTION: Antimicrobial resistance (AMR) is a significant problem in developing, low- and middle-income countries like Nepal. Community engagement can be an important means to address the problem. Knowledge, attitude, practice, and adherence of women regarding antibiotics and AMR was studied.
METHODS: This baseline study was conducted in two urban municipalities of Lalitpur district as preparation for a larger intervention study (Mahalaxmi municipality will be the intervention and Godawari the comparison/control area). The study population was women belonging to the mother's groups of 45 female community health volunteers (FCHVs) from each municipality. The study was done from September 2023 to January 2024. A total of 1207 individuals (580 in Mahalaxmi and 627 in Godawari) were involved. Data on demographics, knowledge, attitude, practice, and adherence was collected using a pre-validated structured questionnaire.
RESULTS: The average age, educational status, monthly income, occupation, presence of respiratory disease, chronic diseases and communicable diseases were found to be not different among the two municipalities. Work experience, presence of respiratory disease and of health worker in the household was different in the baseline survey among the two locations. Knowledge was higher in Mahalaxmi municipality, but adherence was higher in Godawari municipality (p <0.0001). No significant difference was seen in attitude and practice scales. Knowledge, attitude, practice and adherence scores among different subgroups of respondents in the two municipalities were found to be significantly different for occupation (p <0.0001), and education (p <0.0001). The attitude scores were also significantly different according to presence/absence of respiratory disease in the household (p = 0.027).
CONCLUSION: At baseline the two study sites were broadly comparable in terms of participants' demographic characteristics. There was higher knowledge and lower adherence in Mahalaxmi municipality. An educational intervention to improve KAP and adherence is required and will be conducted.
Knowledge, Attitudes, and Practices Regarding Coronavirus Disease Among Patients Visiting Eye Hospitals of Province Number 2, Nepal

Shah R, Mishra SK, Jha N, Shankar PR, Bhandary S, Kunwar MB, et al.

Asia Pac J Public Health, 2021 07;33(5):608-612.
PMID: 33980075 DOI: 10.1177/10105395211014647
Fulltext Computational, crystallographic studies, cytotoxicity and anti-tubercular activity of substituted 7-methoxy-indolizine analogues

Venugopala KN, Chandrashekharappa S, Pillay M, Abdallah HH, Mahomoodally FM, Bhandary S, et al.

PLoS One, 2019;14(6):e0217270.
PMID: 31163040 DOI: 10.1371/journal.pone.0217270

Indolizines are heteroaromatic compounds, and their synthetic analogues have reportedly showed promising pharmacological properties. In this study, a series of synthetic 7-methoxy-indolizine derivatives were synthesised, characterised and evaluated for in vitro whole-cell anti-tuberculosis (TB) screening against susceptible (H37Rv) and multi-drug-resistant (MDR) strains of Mycobacterium tuberculosis (MTB) using the resazurin microplate assay method. The cytotoxicity was evaluated using the MTT assay. In silico molecular-docking study was conducted for compounds 5a-j against enoyl-[acyl-carrier] protein reductase, a key enzyme of the type II fatty acid synthesis that has attracted much interest for the development of novel anti-TB compounds. Thereafter, molecular dynamic (MD) simulation was undertaken for the most active inhibitors. Compounds 5i and 5j with the methoxy functional group at the meta position of the benzoyl group, which was at the third position of the indolizine nucleus, demonstrated encouraging anti-TB activity against MDR strains of MTB at 16 μg/mL. In silico studies showed binding affinity within the range of 7.07-8.57 kcal/mol, with 5i showing the highest binding affinity. Hydrogen bonding, π-π- interactions, and electrostatic interactions were common with the active site. Most of these interactions occurred with the catalytic amino acids (Pro193, Tyr158, Phe149, and Lys165). MD simulation showed that 5j possessed the highest binding affinity toward the enzyme, according to the two calculation methods (MM/PBSA and MM/GBSA). The single-crystal X-ray studies of compounds 5c and 5d revealed that the molecular arrangements in these two structures were mostly guided by C-H···O hydrogen-bonded dimeric motifs and C-H···N hydrogen bonds, while various secondary interactions (such as π···π and C-H···F) also contributed to crystal formation. Compounds 5a, 5c, 5i, and 5j exhibited no toxicity up to 500 μg/mL. In conclusion, 5i and 5j are promising anti-TB compounds that have shown high affinity based on docking and MD simulation results.