No abstract

Background: Early cognitive changes in people at risk of developing dementia may be detected using behavioral tests that examine the performance of typically affected brain areas, such as the hippocampi. An important cognitive function supported by the hippocampi is memory binding, in which object features are associated to create a unified percept. Aim: To compare visual short-term memory (VSTM) binding performance for object names, locations, and identities between a participant group known to be at higher risk of developing dementia (mild cognitive impairment [MCI]) and healthily aging controls. Methods: Ten MCI and 10 control participants completed five VSTM tests that differed in their requirement of remembering bound or unbound object names, locations, and identities, along with a standard neuropsychological test (Addenbrooke’s Cognitive Examination [ACE]-III). Results: The performance of the MCI participants was selectively and significantly lower than that of the healthily aging controls for memory tasks that required object-location or name-location binding. Conclusion: Tasks that measure unimodal (object-location) and crossmodal (name-location) binding performance appear to be particularly effective for the detection of early cognitive changes in those at higher risk of developing dementia due to Alzheimer’s disease.

Cancer patients are at high risk of antibiotic resistant bacterial urinary tract infections (UTIs). In this study, we assessed the bacterial profile and antibiotic resistance among cancer patients suspected of UTI in B.P. Koirala Memorial Cancer Hospital in Nepal through a cross-sectional study with routinely collected data. All cancer patients who had a recorded urine culture between July 2018–June 2019 were included in the study. Out of 308 patients who had undergone culture, 73 (24%) of samples had bacterial growth. The most common organisms isolated were E. coli (58%), Staphylococcus (11%) and Klebsiella (10%). These bacteria had undergone susceptibility testing to 27 different antibiotics in various proportions. Of the limited antibiotic testing levels, nitrofurantoin (54/66, 82%) and amikacin (30/51, 59%) were the most common. Among those tested, there were high levels of resistance to antibiotics in the “Access” and “Watch” groups of antibiotics (2019 WHO classification). In the “Reserve” group, both antibiotics showed resistance (polymyxin 15%, tigecycline 8%). Multidrug resistance was seen among 89% of the positive culture samples. This calls for urgent measures to optimize the use of antibiotics in UTI care at policy and health facility levels through stewardship to prevent further augmentation of antibiotic resistance among cancer patients.

Background: Cancer is an major public health problem in the world. This study aims to present a three-year trend of cancer incidence in Nepal. Methods: This study used the three-year data of National Cancer Registry Program (NCRP) from January 2013 to December 2015. NCRP currently includes 12 major hospitals where diagnostic treatment facilities are available and represent the majority of the cases in Nepal. Descriptive analysis was used to present the demographic profile of the participants and the incidence of different topography of cancer. Age-specific and age-adjusted cancer incidence per 100,000 population were presented. Results: A total of 27,483 new cancer cases were included in the study. The age-adjusted incidence rates were 39.1, 39.8 and 41.8 per 100,000 population in the year 2013, 2014 and 2015 respectively. The most common cancer in Nepal was lung followed by cervical, breast, stomach and colorectal cancer. Among males, lung cancer was the most common followed by lip and oral cavity, stomach, colorectal cancer and leukemia and among females, cervical cancer followed by breast, lung, ovary and stomach. Conclusion: Cancer incidence is rising in Nepal and thus comprehensive policies targeting prevention, early detection, and treatment programs should be carried out.

The burden of cancer is estimated to be increasing in Nepal, whilst the country lacks national established guidelines or protocols for referral of cancer cases. Cancer patients are presenting many different health facilities throughout the country. In rural areas almost all cancer patients have their first diagnosis when visiting a health assistant or nurse at their nearest primary health care delivery service.  If cancer is suspected, health care assistants or nurses will refer the patient to a medical doctor at the primary health centre, or refer the patient directly to the cancer treatment centre or oncology department of the closest hospital.  Patients from urban areas will usually be seen for the first time by a medical doctor initially and then referred to either the cancer treatment centre or oncology department of the hospital.  Both in rural and urban areas the referral for treatment is determined by both the patients’ capacity to pay for treatment own healthcare, as well as their geographical location (i.e. availability and accessibility of cancer treatment services.