Aim. Neuropathic pain affects 710 of the population, with most of the patients receiving inadequate and incomplete treatment. Owing to the high financial burden and the poor quality of life of the patients and their caretakers, there is a dire need to address the challenges in diagnosing and treating chronic neuropathic pain. Methods. This literature review was conducted to review novel treatments and related challenges through a systematic search from sources such as PubMed, Google Scholar with the combination of MESH words such as neuropathic pain, management of neuropathic pain. Articles from non-English literature, reports without human subjects, animal studies, and abstracts/posters were excluded. However, human studies and studies published in English were included. Result. This review article discusses novel treatment modalities while acknowledging the challenges medical workers face while encountering neuropathic pain. Despite the recent advances in diagnosis and treatment modalities, several challenges still exist. Hence, there is still a need to explore the various treatment modalities, emphasizing the cause and underlying pathophysiology of neuropathic pain. Conclusion. We recommend integrated multimodal treatment with the current treatment facility, including various medical disciplines. However, a personalized approach would work the best depending on the patients medical history. Therefore, this article recommends an integrated, cause-specific, cost-effective approach to address this problem of chronic neuropathic pain.

Background: The use of computers and other Visual Display Terminal (VDT) screens is increasing in Nepal. However, there is a paucity of evidence on the prevalence of Computer Vision Syndrome (CVS) and other occupational health concerns among employees working in front of VDT screens in the Nepalese population. Objectives: This study aims to estimate the prevalence of CVS, musculoskeletal and work-related stress among VDT screen users in the office, as well as their understanding and usage of preventive measures. Methods: The study was a cross-sectional descriptive study among 319 VDT users in office settings in Kathmandu Metropolitan City, Nepal, using a semi-structured self-administered questionnaire. Multivariate logistic regression analysis was conducted to identify the associated factors at 95% CI. P-value <0.05 was considered as statistically significant. Results: The prevalence of CVS was 89.4%. More than eight out of ten study participants reported at least one visual and musculoskeletal symptom. Work-related stress, which was moderate-difficult to handle, was present in 36.7% of the study population. The mean±SD computer usage per day was 7.9±1.9 hours. Tired eye (63.3%), feeling of dry eye (57.8%), headache (56.9%) were the common visual symptoms of CVS reported. Total computer use/day > = 8 hours OR 2.6, improper viewing distance OR 3.2, Not using an anti-glare screen OR 2.6, not using eye-drops, and not wearing protective goggles OR 3.1 were significantly associated with the presence of CVS. There was no statistically significant association between visual symptoms of CVS, musculoskeletal symptoms, and stress with gender. Conclusion: CVS was substantially related to not employing preventive measures, working longer hours, and having an incorrect viewing distance. With more hours per day spent in front of a VDT screen, work-related stress and musculoskeletal complaints were also found to be important correlates. Similarly, work-related stress was found more among those who had less than five years of job.

Introduction: Previous studies have reported a decreased risk of dementia with herpes zoster vaccination. Given this background, this systematic review and meta‐analysis aimed to investigate the association between herpes zoster vaccination and the risk of dementia.Methods: We searched five databases until November 2023 for case–control, cross‐sectional, or cohort studies investigating the association of herpes zoster vaccination and dementia. Odds ratios and 95% confidence intervals (95% CIs) were pooled in the meta‐analysis. Meta‐regression, subgroup, and sensitivity analysis were also conducted.Results: We evaluated a total of five studies (one cross‐sectional, one case–control, and four cohort studies) that included a total number of 103,615 patients who were vaccinated with herpes zoster vaccine. All the studies were of high quality, ranging from 7 to 9. Due to the high heterogeneity (I² = 100%, p < .00001) observed in our study, a random effect model was used for the analysis. The pooled odds ratio was 0.84 (95% CI: 0.50, 1.43), p (overall effect) = .53), indicating that herpes zoster vaccination reduces the risk of dementia.Conclusion: Herpes zoster vaccination is associated with a reduction of the risk of dementia. More epidemiological studies are needed to confirm the association.

Introduction. Cooccurrence of hypertension and depression/anxiety increases the chance of cardiovascular mortality and morbidity. Therefore, this study is aimed at assessing the prevalence of anxiety and depression and their association with hypertension among hypertensive adults in a tertiary care hospital in Kathmandu, Nepal. Methods. A descriptive cross-sectional study was conducted using a semistructured self-administered questionnaire based on Hamilton Anxiety and Hamilton Depression Rating Scale. The data was entered in EPI Data and analyzed using descriptive and inferential statistics in SPSS version 22. value < 0.05 was considered statistically significant. Results. A total of 260 individuals participated in the study, with a mean age of 42.6 years. About 46% of patients did not have any symptoms of depressed mood, and 73 (28.1%) of the participants experienced feelings of depressed mood only on questioning. Similarly, (151) 58.1% did not have feelings of guilt, and 48 (18.5%) participants who had the feeling of guilt had let people down. Among 260 respondents, most participants ((102) 39.2%) had mild symptoms of anxious mood, followed by (86) 33.1% participants with moderate symptoms. Only (4) 1.5% of participants had severe symptoms. Similarly, the majority of participants ((114) 43.8%) had a mild form of mental and emotional strain, followed by (72) 27.7% with moderate mental and emotional strain while (43) 16.5% had no mental and emotional strain. The occupation and marital status of the hypertensive individual was associated with anxiety and depression ( ). Conclusion. In conclusion, anxiety and depression were common among patients with hypertension. Anxiety and depression were linked to some of the patients’ sociodemographic and clinical features. This study demonstrates that treating hypertension alone is not enough to improve patients’ quality of life; mental illness screening among chronically ill individuals is also required.

Endemic in more than 20 countries, Chagas disease affects 6.3 million people worldwide, leading to 28,000 new infections and 7700 deaths each year. Previous meta-analyses on antiparasitic treatment need updates to encompass recent studies and to assess key clinically meaningful endpoints. This study aims to evaluate the impact of antitrypanosomal therapy in preventing or reducing disease progression and mortality in chronic Chagas disease. We performed a systematic review and meta-analysis of studies reporting the cardiovascular outcomes of antitrypanosomal therapy in patients with chronic Chagas disease. We searched Ovid Embase, Ovid MEDLINE, Ovid Global Health, Scopus, Web of Science Core Collection, Cochrane Library, PubMed, Google Scholar, and Virtual Health Library databases from inception to May 18, 2024. We included aggregated data from randomized controlled studies and observational reports (full articles and abstracts) featuring antiparasitic interventions with benznidazole or nifurtimox compared to a control group. Primary outcomes were electrocardiogram (ECG) changes, disease progression, cardiovascular death, and overall mortality. A customized risk of bias scale assessed the methodological quality of studies, and a random-effects model estimated the pooled risk ratios. This investigation was registered in PROSPERO (CRD42023495755). Out of 4666 reports screened, 23 met the pre-specified inclusion criteria (8972 participants). Compared to no treatment or placebo, antiparasitic treatment led to a reduction in i) ECG changes (17 studies, 4994 participants: risk ratio (RR): 0.48, 95% CI 0.36–0.66, p < 0.001; I² = 76.4%) with a number needed to treat (NNT) of 5; ii) disease progression (12 studies, 5722 participants: RR: 0.35, 95% CI 0.23–0.51, p < 0.001; I² = 72.4%) NNT of 6; iii) cardiovascular death (7 studies, 5662 participants: RR: 0.44, 95% CI 0.21–0.95, p = 0.04; I² = 50.5%) NNT of 22; and iv) overall mortality (10 studies, 7694 participants: RR: 0.54, 95% CI 0.34–0.87, p < 0.001; I² = 60%) NNT of 23. We found compelling evidence that antiparasitic treatment significantly reduces the risk of ECG changes, disease progression, cardiovascular death, and overall mortality in chronic Chagas disease. Although the quality of evidence ranges from low to intermediate, with considerable heterogeneity across studies, the potential benefits are substantial. These findings support the broader use of trypanocidal therapy in the management of Chagas disease, though further research remains necessary. This study had no funding source.

Introduction: The post-coronavirus disease 2019 (COVID-19) syndrome is defined as the persistence of symptoms after viral clearance and the emergence of new symptoms after a few months following recovery from COVID-19. This study aimed to assess the prevalence of post-COVID-19 syndrome and the risk factors that contribute to its development. Methods: This study was conducted prospectively in Tribhuvan University Teaching Hospital (TUTH), located in Maharajgunj, Kathmandu. The patients were followed up for three months. Results: The post-COVID status of 300 patients admitted to the COVID emergency of TUTH was studied. The mean age of the patients was 46.6±15.7 years, and the proportion of male (56%) was slightly higher than female (44%). Most of the patients (81.7%) had fever on their presentation to the emergency which was followed by fatigue (81.3%) and cough (78.3%). During the post-COVID phase, fatigue was the most common persistent symptom, with 34% experiencing fatigue after 60 days and 28.3% even after 90 days from the onset of symptoms. Univariate logistic regression showed sore throat (OR 4.6; 95% CI (2.8–7.6)), rhinitis (OR 3.6; 95% CI (2.1–5.9)), fatigue (OR 3.7; 95% CI (1.8–7.6)), diarrhea (OR 4.1; 95% CI (2.4–6.9)), anosmia (OR 6.7; 95% CI (3.9–11.3)), ageusia (OR 7.8; 95% CI (4.5–13.4)) and shortness of breath (OR 14.9; 95% CI (1.8–119.6)) at admission were all predictors of post-COVID syndrome after three months. Conclusion: Even after recovering from COVID-19, people with COVID-19 may develop symptoms. As a result, COVID-19’s long-term consequences should not be neglected, as they may lead to increased morbidity among patients, consumption of financial resources, and added burden on the health system.