Background: Severe sepsis and septic shock are major causes of morbidity and mortality worldwide and need immediate medical attention. Early recognition, fluid resuscitation and early antimicrobials are the mainstays of sepsis therapy. This study analyzed the management strategies of severe sepsis and septic shock and evaluated its impact.Methods: A prospective study was conducted on patients admitted through emergency department of Tribhuvan University Teaching Hospital of Nepal, who were diagnosed with severe sepsis and septic shock.Results: A total of 85 patients were diagnosed as severe sepsis and septic shock with 45 female patients and mean age 47.69 years ranging from 18 to 83 years. Pneumonia (45.9%) was found to be the major source of infection. The most commonly prescribed antibiotics and vassopressor at emergency department were ceftriaxone (24.7%) and norepinephrine (44.7%) respectively. The mean length of stay in Emergency department was 13.01 ± 7.03 h, while it was 11.27 ± 5.26 days in hospital. A total of 31 (36.5%) septic patients died. Deceased patients were found to have greater age, higher Acute Physiology and Chronic Health Evaluation II (APACHE II) score and presence of co-morbid conditions.Conclusions: This study looked in-depth on management and outcome of patients with severe sepsis and septic shock. Mortality from severe sepsis and septic shock were high, but similar to other studies. Keywords:

This study aims to establish qualitative as well as quantitative phytochemical profiles and determine the free radical scavenging activity of phytochemical constituents of the entire plant of Achyranthes aspera Linn. The extraction of dried plant material was carried out by cold maceration with    methanol followed by partitioning with ethyl acetate. Preliminary phytochemical screening of the plant was carried out by performing various chemical tests. Phenolic and flavonoid contents were determined by Folin-Ciocalteu and Aluminum chloride methods, respectively.  Antioxidant activity was studied using the 2,2-diphenyl-1-picrylhydrazyl (DPPH) radical scavenging method.  The result of study revealed the presence of flavonoids, alkaloids, terpenoids, phytosterols, tannins, saponins, phenolic compounds, and carbohydrates. Total phenolic content, total flavonoids content, and antioxidant activity of the extract were found as 209.007 µg GA/mg, 17.59 µg QE/mg, and 25.12% (100 µg/mL), respectively. The study showed that plant could be a source of antioxidant compounds.

Background: Severe sepsis and septic shock are major causes of morbidity and mortality worldwide and need immediate medical attention. Early recognition, fluid resuscitation and early antimicrobials are the mainstays of sepsis therapy. This study analyzed the management strategies of severe sepsis and septic shock and evaluated its impact.Methods: A prospective study was conducted on patients admitted through emergency department of Tribhuvan University Teaching Hospital of Nepal, who were diagnosed with severe sepsis and septic shock.Results: A total of 85 patients were diagnosed as severe sepsis and septic shock with 45 female patients and mean age 47.69 years ranging from 18 to 83 years. Pneumonia (45.9%) was found to be the major source of infection. The most commonly prescribed antibiotics and vassopressor at emergency department were ceftriaxone (24.7%) and norepinephrine (44.7%) respectively. The mean length of stay in Emergency department was 13.01 ± 7.03 h, while it was 11.27 ± 5.26 days in hospital. A total of 31 (36.5%) septic patients died. Deceased patients were found to have greater age, higher Acute Physiology and Chronic Health Evaluation II (APACHE II) score and presence of co-morbid conditions.Conclusions: This study looked in-depth on management and outcome of patients with severe sepsis and septic shock. Mortality from severe sepsis and septic shock were high, but similar to other studies.Keywords: Antimicrobial therapy; emergency department; mortality; septic shock; severe sepsis.

Neopicrorrhiza srophulariiflora (NS), locally known as "kutki / katuki" in nepali is available in 3500-4800 m of Nepal. The present study was carried out to evaluate the antidiabetic property of NS in streptozotocin (STZ) induced type 2 diabetic model rats. NS dried rhizomes, was extracted with 80% ethanol and water by cold percolation method. The extracts were administered at a dose of 1.25gkg -1 body weight for 21 consecutive days to type 2 diabetic male Long-Evans rats, bred at BIRDEM animal house. Serum glucose was estimated by GOD PAP method. Ethanol extract of N. srophulariiflora significantly (p<0.05) improved oral glucose tolerance in type 2 rats in comparison to control group. The water extract and ethanol extracts significantly lowered serum glucose level of type 2 diabetic rats in both prandial states (simultaneously with oral glucose load p<0.05; at 75min and 30 minutes prior to oral glucose load p<0.05; at 105min) compared to control group. N. srophulariiflora is beneficial for treating Type 2 diabetes and therefore needs further exploration and researches, both chemically and biologically to identify the active principle(s) and mechanism of action.

To assess the different types of health disorders that are more frequent during the pregnancy and drugs prescribed for the management of those disorders are of the safest category and in practice considering the risk to benefit ratio. Also, to find out the extent to which the drugs prescribed are adhered to WHO prescribing indicators. It was an observational cross-sectional study. Data collection sheets were filled by the direct questionnaire and the prescription paper. The drugs were evaluated from WHO core prescribing indicators. Among the total of 141 pregnant women, the maximum number were from the age group 20-25 years. The average number of drugs received during pregnancy is 3.25 per prescription. Whereas the percentage of the drug prescribed by generic name and essential drug list were found to be 26.1 and 56.64, respectively. The most frequently prescribed drug was from the USFDA safe category i.e. category B (53%) and only 2% of drugs were prescribed from category X. Most of the medicine was prescribed listed in the National essential drug list. Deviation was observed in terms of prescription of injection and drugs with a generic name. Contraindicated medicines during pregnancy were almost absent in this study. Pregnant women who appeared during the duration of the study with the health disorder were treated with the appropriate drugs considering the risk to the benefit ratio. However, to assure the rational drug prescription the prescription audit should be carried out at regular intervals.