Background: Mandibular fractures are a major component of maxillofacial trauma due to the prominent anatomical position in facial skeleton. Their prevalence, etiology, and injury patterns vary across age groups and are influenced by environmental and geographical factors. This study aims to analyze clinical, demographic profile and pattern of mandibular fractures presenting over a period of 5 years in a tertiary institute. Methods: An observational retrospective study was conducted over a 5-year period from hospital record of National Academy of Medical Sciences, Bir Hospital, Kathmandu, Nepal. Data of all reported mandibular fracture cases were collected and analyzed based on age, gender, mechanism of injury, fracture site, and monthly variation. Results: A total of 839 mandibular fractures were recorded among 395 patients, with 331 males and 64 females. The most affected age group was 21–30 years (41.8%), while the least affected was 0–10 years (1.0%). Road traffic accidents were the leading cause (60.5%), followed by falls (24.5%), interpersonal violence (13.6%) and sports injuries (1.0%). Road traffic accidents were most common in young adults, whereas falls were more frequent at the extremes of age. Combination fractures involving multiple mandibular sites were more common (33.7 %) than single-site fractures. Among single-site fractures, Parasymphysis (25.1%) was most frequently involved, followed by condyle (13.4 %) and angle (11%). A higher incidence of cases was observed in December followed by July, and August. There was significant association between age group and etiology (p=0.001) and age group and fracture site (p=0.008).Conclusions: Road Traffic Accident are the leading cause of mandibular fracture in young adults with multiple site combination mandibular fracture being the commonest.Keywords: Mandibular fracture; maxillofacial injuries; road traffic accidents; young adults.
The Nepal Health Research Council (NHRC) and the Indian Council of Medical Research (ICMR) established a bilateral collaboration under a Memorandum of Understanding (MoU) signed (January 2021) to foster scientific exchange, capacity building, and health research ethics. NHRC officials comprising research officers, ethics administrators and journal office staff completed an exposure visits to the ICMR headquarters in New Delhi in February 2026. The visit’s sessions were centered on ethical practices of ICMR’s Bioethics Unit such as the functioning of ethics committees, clinical trial registries, quality assurance protocols, research laboratory standards, and responses to emerging bioethical challenges.This observational engagement identified operational models of potential relevance to NHRC’s mandates. Information was compiled from site visits, institutional documents, and expert presentations, and synthesized narratively into thematic lessons. This report describes observed approaches to ethical governance, digitalization, and quality assurance that may inform the strengthening of Nepal’s research governance framework. Digitalization, updated national guidelines, tiered accreditation of research institutions, public engagement, and systematic human resource development were identified as priority areas for strengthening research governance in Nepal. Keywords: Bioethics; capacity building; ethics committees; international cooperation; technology assessment.
Background: Healthcare-associated infections (HAIs) are the major cause of morbidity and mortality. This study aimed to investigate the prevalence, microbiological profile, resistance patterns, risk factors, and outcomes of HAIs in a respiratory ICU (RICU) of a tertiary care hospital in Nepal.Methods: A prospective observational study was conducted in RICU. HAIs were diagnosed according to the CDC criteria. Descriptive statistics were reported as mean (SD) and frequencies. Unpaired t-tests, chi-square tests were used for comparisons, and multivariable logistic regression was used to assess the risk factors. Results: Among 121 ICU admissions, 42 patients developed 50 episodes of HAI, yielding a prevalence of 34.7%. Ventilator-associated pneumonia was the most common HAIs. The most frequently isolated organisms were Acinetobacter baumannii in 42.0% and Klebsiella pneumonia in 18.0%. Both were resistance to Ceftriaxone. Resistance to Piperacillin–tazobactam were 85.8% and 77.8% and to carbapenems were 92% and 90% respectively. Tigecycline resistance was seen in 20% of Acinetobacter isolates and none of the Klebsiella isolates. Sensitivity to Polymyxin B was 100%. Mechanical ventilation, urinary catheters and history of prior hospitalization were the strongest predictors of HAI. Patients who developed HAI had a longer ICU stay (9.5 vs. 5.2 days, p=0.001) and higher mortality (28.6% vs. 13.9%, p=0.04).Conclusions: HAIs, particularly VAP caused by MDR organisms, were common in our ICU and there was a high resistance to beta lactams and carbapenem antibiotics. Low resistance to tigecycline and polymyxin B warrants careful stewardship.Keywords: Healthcare-associated infections; multidrug resistance; respiratory ICU.
Background: Heart failure is a major public health issue with rising hospitalizations and high mortality. This study was conducted to assess the clinical presentation, management and outcome of heart failure patients presenting to a tertiary care hospital. Methods: A prospective, observational study was conducted at a tertiary cardiac center in Nepal over a period of six months among admitted patients aged 18 years and above with heart failure. Data on demographics, etiology, treatment, and outcomes were collected via structured interviews, chart review, clinical observation, phone calls and follow-up. Etiologies were defined per standard criteria and patients were categorized according to the clinical and echocardiographic diagnosis. Results: Among 1523 patients included, the mean age of the cohort was 61.5 ± 14.9 years, and 62.0 % were male. Coronary artery disease (65.8%) was the most common etiology, followed by idiopathic dilated cardiomyopathy (15.0%) and rheumatic heart disease (7.2%). Acute coronary syndrome (39.9%) was the primary aggravating factor. Guideline-directed medical therapy use included Angiotensin-Converting Enzyme Inhibitor or Angiotensin Receptor Blocker (68.5%), Beta-blockers (66.1%), and Mineralocorticoid Receptor Antagonists (61.2%); however, the use of Sodium-Glucose Cotransporter-2 inhibitors was low (15.2%). Device therapy was rare (0.26%). The overall mortality rate was 12.7%, comprising 4.7% in-hospital mortality and 7.9% 90-day mortality.Conclusions: Coronary artery disease is the commonest etiology, with Angiotensin-Converting Enzyme Inhibitor or Angiotensin Receptor Blocker as the commonest prescription, followed by Beta-blockers and Mineralocorticoid Receptor Antagonists, with device therapy being rare, with an overall mortality of 12.7%. Keywords: Coronary artery disease; dilated cardiomyopathy; guideline-directed medical therapy; heart failure.
Background: Antimicrobial resistant Escherichia coli has been reported in Bagmati river of Kathmandu Valley; however, studies on its spatial distribution are lacking, despite being essential for effective water management. Therefore, this cross-sectional study was conducted to determine the spatial distribution of antibiotic-resistant E. coli along Bagmati river from March-September 2025.Methods: This work was conducted at Department of Microbiology Tri-Chandra Multiple Campus. Water samples collected in duplicate from fifteen sites of Bagmati river were processed for most probable number count and isolation of E.coli. BOD and DO were calculated by Winkler’s titrimetric method. Antibiotic susceptibility test was done by disk diffusion technique. Chi square test, correlation assessment, cluster and factor analysis were conducted. Results: The coliform count, E. coli isolates, Biochemical oxygen demand and dissolved oxygen levels ranged from 5–26,500 MPN/100 mL, 0–42, 1.2–418.75 mg/L, and 8.05–0.15 mg/L, respectively, from Baghdwar to Chobar. No E. coli isolates were recovered from Site 1. Cluster analysis based on these variables classified river into four distinct segments, with Sites 1 and 15 forming separate clusters. Significant differences were observed in antibiotic resistance pattern of E. coli isolates across the sampling sites. Factor analysis further grouped the river sites into five clusters, indicating spatial variation in antimicrobial resistant E. coli along the river continuum.Conclusions: Conventional water quality indicators are insufficient to capture spatial complexity of river health. Integrating fecal contamination and antibiotic resistance patterns provides a more comprehensive assessment of pollution hotspots, supporting targeted management strategies under Nepal’s Nationally Determined Contribution (NDC) 3.0.Keywords: Antimicrobial resistance; bagmati river; E. coli; spatial analysis.
