Publications by authors named "K N Paudel"

158 Publications

Effectiveness of community-based health education and home support program to reduce blood pressure among patients with uncontrolled hypertension in Nepal: A cluster-randomized trial.

PLoS One 2021 12;16(10):e0258406. Epub 2021 Oct 12.

Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia.

Background: Hypertension is a major global public health problem. Elevated blood pressure can cause cardiovascular and kidney diseases. We assessed the effectiveness of health education sessions and home support programs in reducing blood pressure among patients with uncontrolled hypertension in a suburban community of Nepal.

Methods: We conducted a community-based, open-level, parallel-group, cluster randomized controlled trial in Birendranagar municipality of Surkhet, Nepal. We randomly assigned four clusters (wards) into intervention and control arms. We provided four health education sessions, frequent home and usual care for intervention groups over six months. The participants of the control arm received only usual care from health facilities. The primary outcome of this study was the proportion of controlled systolic blood pressure (SBP). The analysis included all participants who completed follow-up at six months.

Results: 125 participants were assigned to either the intervention (n = 63) or the control (n = 62) group. Of them, 60 participants in each group completed six months follow-up. The proportion of controlled SBP was significantly higher among the intervention participants compared to the control (58.3% vs. 40%). Odds ratio of this was 2.1 with 95% CI: 1.01-4.35 (p = 0.046) and that of controlled diastolic blood pressure (DBP) was 1.31 (0.63-2.72) (p = 0.600). The mean change (follow-up minus baseline) in SBP was significantly higher in the intervention than in the usual care (-18.7 mmHg vs. -11.2 mmHg, p = 0.041). Such mean change of DBP was also higher in the intervention (-10.95 mmHg vs. -5.53 mmHg, p = 0.065). The knowledge score on hypertension improved by 2.38 (SD 2.4) in the intervention arm, which was significantly different from that of the control group, 0.13 (1.8) (p<0.001).

Conclusions: Multiple health education sessions complemented by frequent household visits by health volunteers can effectively improve knowledge on hypertension and reduce blood pressure among uncontrolled hypertensive patients at the community level in Nepal.

Trial Registration: ClinicalTrial.gov: NCT02981251.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0258406PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8509872PMC
October 2021

Nutraceuticals: unlocking newer paradigms in the mitigation of inflammatory lung diseases.

Crit Rev Food Sci Nutr 2021 Oct 6:1-31. Epub 2021 Oct 6.

Department of Biotechnology, School of Engineering & Technology (SET), Sharda University, Greater Noida, Uttar Pradesh, India.

Persistent respiratory tract inflammation contributes to the pathogenesis of various chronic respiratory diseases, such as asthma, chronic obstructive pulmonary disease, and pulmonary fibrosis. These inflammatory respiratory diseases have been a major public health concern as they are the leading causes of worldwide mortality and morbidity, resulting in heavy burden on socioeconomic growth throughout these years. Although various therapeutic agents are currently available, the clinical applications of these agents are found to be futile due to their adverse effects, and most patients remained poorly controlled with a low quality of life. These drawbacks have necessitated the development of novel, alternative therapeutic agents that can effectively improve therapeutic outcomes. Recently, nutraceuticals such as probiotics, vitamins, and phytochemicals have gained increasing attention due to their nutritional properties and therapeutic potential in modulating the pathological mechanisms underlying inflammatory respiratory diseases, which could ultimately result in improved disease control and overall health outcomes. As such, nutraceuticals have been held in high regard as the possible alternatives to address the limitations of conventional therapeutics, where intensive research are being performed to identify novel nutraceuticals that can positively impact various inflammatory respiratory diseases. This review provides an insight into the utilization of nutraceuticals with respect to their molecular mechanisms targeting multiple signaling pathways involved in the pathogenesis of inflammatory respiratory diseases.
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http://dx.doi.org/10.1080/10408398.2021.1986467DOI Listing
October 2021

Berberine loaded liquid crystalline nanostructure inhibits cancer progression in adenocarcinomic human alveolar basal epithelial cells in vitro.

J Food Biochem 2021 Oct 5:e13954. Epub 2021 Oct 5.

Discipline of Pharmacy, Graduate School of Health, University of Technology Sydney, Sydney, New South Wales, Australia.

Metastasis represents the leading cause of death in lung cancer patients. C-X-C Motif Chemokine Ligand 8 (CXCL-8), Chemokine (C-C motif) ligand 20 (CCL-20) and heme oxygenase -1 (HO-1) play an important role in cancer cell proliferation and migration. Berberine is an isoquinoline alkaloid isolated from several herbs in the Papaveraceae family that exhibits anti-inflammatory, anticancer and antidiabetic properties. Therefore, the aim of present study is to investigate the inhibitory potential of berberine monoolein loaded liquid crystalline nanoparticles (berberine-LCNs) against cancer progression. Berberine-LCNs were prepared by mixing berberine, monoolein and poloxamer 407 (P407) using ultrasonication method. A549 cells were treated with or without 5 µM dose of berberine LCNs for 24 hr and total cellular protein was extracted and further analyzed for the protein expression of CCl-20, CXCL-8 and HO-1 using human oncology array kit. Our results showed that berberine-LCNs significantly reduced the expression of CCl-20, CXCL-8 and HO-1 at dose of 5µM. Collectively, our findings suggest that berberine-LCNs have inhibitory effect on inflammation/oxidative stress related cytokines i.e. CCL20, CXCL-8, and HO-1 which could be a novel therapeutic target for the management of lung cancer. PRACTICAL APPLICATIONS: Berberine is an isoquinoline alkaloid extracted from various plants of Papaveraceae family. CXCL-8, CCL-20 and HO-1 play an important role in cancer progression. Our study showed that Berberine LCNs significantly downregulate the expression of CXCL-8, CCL-20 and HO-1 which suggests that Berberine loaded nanoparticles could be a promising therapeutic alternative for the management of lung cancer.
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http://dx.doi.org/10.1111/jfbc.13954DOI Listing
October 2021

Prevalence of Nerve Injuries in Supracondylar Fracture of Humerus in a Tertiary Care Hospital.

J Nepal Health Res Counc 2021 Sep 6;19(2):367-371. Epub 2021 Sep 6.

Department of Orthopaedics, Bharatpur Hospital, Chitwan, Nepal.

Background: Supracondylar fracture is a common childhood injury. These fractures are often associated with neural and vascular injuries. There is discrepancy in literature about the most common nerve injured in such fractures. This study aims to study the nerve injury patterns in supracondylar fractures of humerus in Nepalese children.

Methods: This descriptive cross sectional study was conducted in 152 children (aged 2 to 14 years) with supracondylar fractures of humerus attending in Bharatpur Hospital during the period of one year. All eligible patients were assessed clinically and radiologically. Neurological assessment was done for nerve injury.

Results: Out of 152 children, 18(11.8%) had nerve injuries. The mean age was 7.41±2.91 years. Boys were more injured (68.4%) than girls (31.6%). It was more common on non-dominant side (57.9%). Out of 18 nerve injuries, most commonly injured nerve was median nerve 10(55.5%) followed by radial nerve 7(38.9%). Median nerve injury was common in posterolateral displacement and radial nerve injury was common in posteromedial displacement type of fracture.   Conclusions: Displaced supracondylar fractures have relatively higher prevalence of nerve injuries. Most commonly involved nerve is median nerve followed by radial nerve. So, every displaced fracture should be routinely screened for nerve injuries.
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http://dx.doi.org/10.33314/jnhrc.v19i2.3637DOI Listing
September 2021

Hoffa Osteochondroma - Para-articular Extrasynovial Infrapatellar Fat Pad Osteochondroma: A Case Report.

JNMA J Nepal Med Assoc 2021 Aug 12;59(240):799-801. Epub 2021 Aug 12.

Department of Orthopedics, Bharatpur Hospital, Chitwan, Nepal.

Osteochondroma usually arises from the metaphyseal region of growing bones. The occurrence of extraskeletal osteochondroma is rare with very few case reports. Para-articular osteochondroma is a type of extraskeletal osteochondroma. It frequently occurs around the knee, usually at infrapatellar Hoffa's fat pad. It is usually intracapsular but extrasynovial and arises from the capsule and connective tissues due to osteocartilaginous metaplasia. We present a case of 19-years male with anterior knee pain for 3 years, swelling, and deformity of the knee with flexion limitation for one year. Radiography revealed ovoid, corticated lesion free from adjoining bones. Mass interpreted as benign, so planned for excision. Well circumscribed nodule excised from the medial parapatellar approach. Histology revealed cartilaginous tissues surrounded by fibrous tissues with scattered enchondral ossification. Postoperatively and subsequent follow-up resulted in pain-free joint, complete recovery of range of motion with no clinicoradiological evidence of recurrence.
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http://dx.doi.org/10.31729/jnma.6625DOI Listing
August 2021
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