B.P. Koirala Institute of Health Sciences (BPKIHS) (Nepali: वी. पी. कोइराला स्वास्थ्य विज्ञान प्रतिष्ठान), is a Nepalese autonomous health sciences university. It is located in the sub-metropolitan city of Dharan in Sunsari District. The Institute is a Nepal-India cooperation. The Institute serves the health education needs of the eastern region of Nepal at primary, secondary and tertiary levels.The Institute comprises four colleges: the Faculty of Medicine, the College of Dental Surgery, the College of Nursing, and the School of Public Health and Community Medicine. The Institute also operates a 700-bed Teaching Hospital, offering postgraduate, undergraduate and university certificate programs. The Institute grants Bachelor's, Master's, Doctoral degrees, and several other certificates. The MBBS program began on March 10, 1994, while the postgraduate programs began in 1999.
PURPOSE:To provide evidence-based recommendations for patients with stage IV non-small cell lung cancer with driver alterations. METHODS:This ASCO living guideline offers continually updated recommendations based on an ongoing systematic review of randomized controlled trials (RCTs), with the latest time frame spanning March-October 2025. An Expert Panel of medical oncology, pulmonary, community oncology, research methodology, and advocacy experts was convened. The literature search included systematic reviews, meta-analyses, and RCTs. Outcomes of interest include efficacy and safety. Expert Panel members used available evidence and informal consensus to develop evidence-based guideline recommendations. RESULTS:This guideline consolidates all previous updates and reflects the body of evidence informing this guideline topic. Thirteen studies were identified in the latest search of literature to date. RECOMMENDATIONS:Evidence-based recommendations were updated to address first, second, and subsequent treatment options for patients with driver alterations.Additional information is available at www.asco.org/thoracic-cancer-guidelines.
Introduction:In this retrospective study, a cohort from a Tertiary level Institute at Eastern Nepal was examined for clinicodemographic features of oral squamous cell carcinoma (OSCC). Materials and Methods:From 2014 to 2023, a total of 523 OSCC patients with histological confirmation were included. Descriptive statistics and chi-square tests were used to assess socio-demographic, habitual and clinicopathological data that were gathered from archival records. Results:The age group of 51-60 years old had the largest incidence of male patients (72.27%). Geographically, the Sunsari district accounted for most cases. Chewing smokeless tobacco (49.71%) was the most prevalent habit, lasting 10-20 years on average. The labial vestibule (37.2%) and the buccal vestibule (34.9%) were the most common main locations. Most lesions measured 2-4 cm and presented clinically as ulceroproliferative growths. At presentation, most lesions (68.45%) were painless. Conclusion:As per this study, in Eastern Nepal, OSCC primarily affects older men who have used smokeless tobacco in the past. It frequently manifests as painless ulceroproliferative lesions, which delays diagnosis. This hospital-based study shows that OSCC frequently manifests as painless ulceroproliferative lesions and typically affects older males with long-standing smokeless tobacco usage in Eastern Nepal. The results offer valuable regional clinicodemographic information that could help with tobacco control efforts, awareness campaigns and early clinical detection of suspicious oral lesions.
BACKGROUND:Respiratory syncytial virus (RSV) is the leading cause of pneumonia-related mortality in infants younger than 6 months, with the majority of deaths occurring in low- and middle-income countries (LMICs). Two RSV preventive products-a maternal vaccine and a long-acting monoclonal antibody (mAb) for infants-were recently recommended by the World Health Organization. Understanding the acceptability and programmatic feasibility of delivering these products is essential for policy and implementation planning in LMICs. METHODS:PATH conducted a formative study in Kenya, Nepal, and Peru (June-September 2024). Semi-structured interviews were held with 69 stakeholders at national, district, and health center levels, selected for their experience in maternal health and/or immunization programs. Interviews explored perceptions of operational feasibility and acceptability of maternal and infant RSV immunization options, and stakeholder preferences for implementation. RESULTS:Stakeholders across all three countries broadly supported the feasibility and acceptability of both maternal RSV vaccination and infant mAb immunization. Stakeholders in Nepal favored maternal vaccination, citing reduced burden on infants and the ability to reach babies born outside health facilities. Views in Kenya and Peru were mixed: maternal vaccination was seen as acceptable by most, but stakeholders raised concerns regarding vaccine hesitancy and limited antenatal care access, particularly in rural areas. Infant mAbs were viewed as compatible with existing at-birth immunization platforms, but concerns included injection burden, cost, and misconceptions regarding use being limited to high-risk populations. Stakeholders expressed a strong preference for year-round immunization over seasonal campaigns. CONCLUSIONS:Both maternal and infant RSV immunization options were viewed as acceptable and feasible if integrated into existing public health programs. Introduction decisions will require additional country-specific considerations, including community acceptability of option(s), health system/workforce capacity, availability of relevant epidemiology data, and product affordability. These findings can guide policymakers as they prepare for potential RSV prevention product introduction and scale-up.
