A greater prevalence of S. enterica serotype Paratyphi A with higher rates of multidrug resistance and ESBL production is concerning for natives as well as travelers in Nepal since the current typhoid vaccines do not provide protection against this serotype.

BackgroundAlthough antiretroviral therapy has limited efficiency, patients should take multiple drugs in combination in prescribed time for lifelong and they should also require specific food and fluid restriction. Due to these and other factors patients may discontinue their medication and therefore face significant challenges in adherence.

Objectives: The main objective of this study was to translate and validate the short form 36 (SF-36) health survey questionnaire into the Nepali language using a standard protocol to determine health-related quality of life (HRQoL) in patients with chronic liver disease (CLD).Methods: We conducted a cross-sectional study among 40 patients with CLD. A formal translation of SF-36 from English into the Nepali language was performed. Patients with CLD without other known co-morbidities were administered the Nepali version of SF-36. Cronbach's alpha and test-retest were performed for reliability analysis.Results: Cronbach's alpha of overall SF-36 score was 0.85, and the test-retest correlation coefficient was 0.78 (p <0.05).Conclusion: The Nepali language version of SF-36 is valid and reliable.

Introduction: Malnutrition is one of the most common complications of liver cirrhosis. Yet, little attention is paid in evaluating nutrition in this group of patients. This study aims to assess malnutrition among cirrhotic patients using a nutrition screening tool and anthropometry. Methods: This was a prospective, observational study of admitted patients with liver cirrhosis. In the study duration of 3months, 50 patients met the inclusion criteria and were included. Nutritional assessment was performed using the Royal Free Hospital Nutritional Prioritizing Tool (RFH-NPT), BMI and standard anthropometry including TSF,MUAC and MAMC. Results: The mean age was 51.56 ± 11.50 with a Male to Female ratio of 3:2. Chronic alcohol consumption (72%) was the most common etiology while management of tense as cites (40%) was the most common reason for hospital admission. 58% had Child Pugh Class C cirrhosis while the remaining 42% were Class B. The average MELD Nascore was 19.64 ± 6. Significant differences in anthropometric measurements including BMI, MUAC, TSF and MAMC were found between Child B and C cirrhosis. Similarly, those patients who had low, moderate and high-risk of malnutrition by the RFH-NPT had significant differences in anthropometric measurements between them. Conclusion: A significant number of patients had moderate to severe risk of malnutrition that correlated well with anthropometric measurements. The degree of malnutrition is parallel with the severity of liver disease among these patients. Both the RFH-NPT and anthropometry are relatively easy to perform and effective. Hence, they can be used as a practical means for identifying malnutrition among cirrhotic patients in routine clinical practice.

The objective was to know the prevalence of coccidian parasites, their clinical manifestation, treatment and prophylaxis in HIV infected patients in Tribhuvan University Teaching Hospital, Nepal.A total of 300 stool samples from 128 (64.00%) HIV patient without previous history of treatment with antiretroviral therapy (ART), 72 (36.00%) under ART treatment and 100 HIV seronegative control samples were collected and examined by wet mount, Kinyoun modified Ziehl Neelsen staining, Sheather's sucrose flotation and modified formalin-ethyl acetate sedimentation methods.The coccidian parasites were detected in 22 (11.0%) of the 200 HIV infected patients, 18 (9.0%) without ART and 4 (2.0%) with ART undertaking patients. Those without ART had majority of 11 (8.5%) Cryptosporidium spp and those with ART had equal percentage of 2 (0.03%) Cryptosporidium spp and 2 (0.03%) Cyclospora spp. The prevalence of coccidian parasites was significantly higher in patients with diarrhea (20/22) than in those without diarrhea (2/22) (P value < 0.05). The drug therapy indices of the antibiotic, Cotrimoxazole given for 30 days in combination with ART for treatment and/or prophylaxis for opportunistic infections showed that long term treatment was needed for the clearance of coccidian parasites. Among 8 Cyclospora identified, 7.6% cleared from stool anlaysis after 30th days of treatment likewise 15.3% of Cryptosporidium cleared after 45th days of treatment.In conclusion, Cryptosporidium followed by Cyclospora appeared to be the predominant coccidian parasite associated with diarrhea among HIV patients. Clinicians are requested to query for coccidian parasites to evaluate diarrhea in HIV patients. Cotrimoxazole is the drug of choice in curing coccidian parasites. So, it should be given along with ART as a treatment and/ or prophylaxis that act against both opportunistic infections as well as coccidian parasites. However its side effects should be evaluated for its long term prophylaxis. Key words: AIDS; Coccidian; Diarrhea; HIV; ART; OIs. DOI: 10.3126/sw.v8i8.3849 Scientific World Vol.8(8) 2010 pp.51-55