Background: With the formulation of the National Safe Motherhood Policy in 1998, safe motherhood has forever been a priority program in Nepal. Under the safe motherhood program, every woman is provided with essential maternal health care services until now through the four-tire district health care system. There is a considerable increase in the utilization of antenatal care (ANC) by a skilled health provider from 2011 to 2016, 58 to 84%, respectively. However, inequality, exclusion, and under-utilization in health care services continue in many regions of Nepal. The present study aimed to explore the different types of socio-demographic factors associated with current ANC service utilization in Nepal. Methods: A cross-sectional study was conducted using the Nepal Demographic and Health Surveys data (DHS-7, 2016–2017). We estimated the latest pregnancy and live births in recent 5 years with the utilization of ANC services, and socio-economic differentials in these indicators under the framework of the Andersen behavioral model. Results: Two in three (69.8%) with last birth accessed at least four ANC visits. The rate of live birth was about 98.6% in the ANC4+ group, higher than that of 96.8% in the ANC4- group (χ2: 14.742, P < 0.001). In the multilevel logistic regression analysis, we found that women from province 2 (OR: 0.48; 95%CI: 0.32–0.74) and province 6 (OR: 0.46; 95%CI: 0.30–0.71) were significantly less likely to visit ANC 4 or more times. Age (OR: 0.95; 95%CI: 0.93–0.96) was also significantly associated with the frequency of ANC visits. Level of Women’s education and education of her partner were both significantly associated with the ANC visits: women (OR: 4.64; 95%CI: 3.05–7.05) and her partner (OR: 1.45; 95%CI: 1.01–2.06) having higher education were most likely to go for the recommended number of ANC visits. Moreover, women having exposure to multimedia were more likely to go for four or more ANC check-ups. Conclusions: The results highlight the need for governments and health care providers to develop special health promotion program with a focus on the vulnerable and disadvantaged and to use multi-media for maternal health literacy improvement flexibly, and maternal health system strengthening.

Background: One out of two neonatal deaths and 2 out of 5 maternal deaths occur at home in Nepal. An essential intervention in reducing maternal mortality and neonatal death is institutional delivery. The objective of this study was to find out the external environmental, predisposing, and enabling factors associated with the use of institutional delivery care in Nepal. Methods: Data from Nepal Demographic and Health Surveys (NDHS) 2016 was used to estimate socio-economic, provincial, and use of media differentials with institutional delivery under the Andersen behavioral model framework using multilevel regression analysis. Results: More than half of the women (60.9%) among 3899 women with last birth had their babies delivered in a health facility. In the multilevel logistic regression analysis, we found that women from province 2 (OR = 0.47 95%CI: 0.28-0.79) were significantly less likely to deliver in health institutions, and province 7 (OR = 1.76, 95%CI: 1.05-2.94) were significantly more likely deliver in a health institution. Age (OR = 0.94, 95%CI: 0.92-0.95) was also significantly associated with the place of delivery. Women with higher education (OR = 3.17, 95%CI: 2.09-4.81) were most likely to go for institutional delivery. The odds of women opting for institutional delivery were 3 folds more for those who had visited Antenatal Care (ANC) 4 or more times compared to those who did not. Conclusion: The results highlight the need for governments and health care providers to emphasize the promotion of institutional delivery and ANC visits as per protocol with a special focus on underprivileged communities. The use of multi-media is a vital strategy to promote the use of institutional delivery services.

Background: Diabetes mellitus (DM) is a common metabolic disorder characterized by a persistent increment of blood glucose. Type 2 DM is characterized by insulin resistance and β-cell dysfunction. Thioredoxin-interacting protein (TXNIP) is among the factors that control the produc-tion and loss of pancreatic β-cells. Objective: Recent studies have shown that high glucose can significantly up-regulate the expression of the TXNIP. Overexpression of TXNIP in β-cells not only induced apoptosis but also decreased the production of insulin. At the same time, TXNIP deficiency protected the apoptosis of β-cells, leading to increased insulin production. Therefore, finding small molecules that can modulate TXNIP expression and downstream signalling pathways is essential. Thus, the inhibition of TXNIP has beneficial effects on the cardiovascular system and other tissues such as the heart and the kid-ney in DM. Therefore, DM treatment must target small TXNIP activity, inhibit expression, and promote endogenous cell mass and insulin production. Conclusion: This review briefly describes the effect mechanism, regulatory mechanism, and crystal structure of TXNIP. In addition, we highlight how TXNIP signalling networks contribute to diabe-tes and interact with drugs that inhibit the development often and its complexes. Finally, the current status and prospects of TXNIP targeted therapy are also discussed.

Unprecedented and unforeseen highly infectious Coronavirus Disease 2019 (COVID-19) has become a significant public health concern for most of the countries worldwide, including Nepal, and it is spreading rapidly. Undoubtedly, every nation has taken maximum initiative measures to break the transmission chain of the virus. This review presents a retrospective analysis of the COVID-19 pandemic in Nepal, analyzing the actions taken by the Government of Nepal (GoN) to inform future decisions. Data used in this article were extracted from relevant reports and websites of the Ministry of Health and Population (MoHP) of Nepal and the WHO. As of January 22, 2021, the highest numbers of cases were reported in the megacity of the hilly region, Kathmandu district (population = 1,744,240), and Bagmati province. The cured and death rates of the disease among the tested population are ~98.00 and ~0.74%, respectively. Higher numbers of infected cases were observed in the age group 21–30, with an overall male to female death ratio of 2.33. With suggestions and recommendations from high-level coordination committees and experts, GoN has enacted several measures: promoting universal personal protection, physical distancing, localized lockdowns, travel restrictions, isolation, and selective quarantine. In addition, GoN formulated and distributed several guidelines/protocols for managing COVID-19 patients and vaccination programs. Despite robust preventive efforts by GoN, pandemic scenario in Nepal is, yet, to be controlled completely. This review could be helpful for the current and future effective outbreak preparedness, responses, and management of the pandemic situations and prepare necessary strategies, especially in countries with similar socio-cultural and economic status.

Background: The mammalian role of the rapamycin (mTOR) pathway is the practical nutrient-sensitive regulation of animal growth and plays a central role in physiology, metabolism, and common diseases. The mTOR is activated in response to nutrients, growth factors, and cellular energy. The mTOR pathway activates in various cellular processes and human cancer diseases. Dysfunction of mTOR signal transduction is associated with metabolic disorders, cancer for instance. Objective: In recent years, significant achievements envisaged in developing targeted drugs for cancer. The global impact of cancer continues to grow. However, the focus of disease-modifying therapies remains elusive. The mTOR is a significant target in cancer to be considered for mTOR inhibitors, even though the costs are high. Despite many mTOR inhibitors, potent, selective inhibitors for mTOR are still limited. Therefore, in this review, the mTOR structure and protein-ligand interactions of utmost importance to provide the basis for molecular modelling and structure-based drug design are discussed. Conclusion: This review introduces the mTOR, its crystal structure, and the latest research on mTOR.Besides, the role of mTOR in cancer, its function, and its regulation are reviewed. In addition, the mechanistic role of mTOR signalling networks in cancer and interaction with drugs that inhibit the development of mTOR and crystal structures of mTOR and its complexes are explored. Finally, the current status and prospects of mTOR-targeted therapy are addressed.