Showing papers by "Bishal Gyawali published in 2015"

Prevalence of type 2 diabetes in Nepal: a systematic review and meta-analysis from 2000 to 2014

Abstract: BackgroundUnderstanding the prevalence of type 2 diabetes in Nepal can help in planning for health services and recognising risk factors. This review aims to systematically identify and collate studies describing the prevalence of type 2 diabetes, to summarise the findings, and to explore selected factors that may influence prevalence estimates.DesignThis systematic review was conducted in adherence to the MOOSE Guidelines for Meta-Analysis and Systematic Reviews of Observational Studies. Medical Literature Analysis and Retrieval System (MEDLINE) database from 1 January 2000 to 31 December 2014 was searched for the prevalence of type 2 diabetes among Nepalese populations with a combination of search terms. We exploded the search terms to include all possible synonyms and spellings obtained in the search strategy. Additionally, we performed a manual search for other articles and references of published articles.ResultsWe found 65 articles; 10 studies fulfilled the inclusion criteria and were included in th...

Opioid-induced constipation.

Abstract: Opioid-induced constipation (OIC) is a very troublesome, difficult to manage and a nearly universal complication of chronic opioid use to control pain associated with advanced illness. Some studies have reported that OIC is so intolerable in some patients that they skip their opioid medications and bear pain instead of OIC. Laxatives have commonly been used as a prophylaxis and treatment of OIC but they are frequently ineffective because the commonly available laxatives do not target the underlying mechanism of OIC, which is the blockade of peripheral mu-receptors. Recently, there have been a number of advances in the treatment of OIC, which any physician involved with opioid-prescribing discipline should be aware of. This review will update the new options and strategies available for treating OIC along with the relevant clinical trials. Finally, this review also provides a recommendation on the preferred way to approach a patient with OIC in the modern era as well as highlight on the importance ...

Cervical cancer screening in Nepal: Ethical considerations

Abstract: Cervical cancer is the leading cause of cancer deaths for women worldwide. Cervical screening and early treatment can help to prevent cervical cancers. Cervical screening programs in Nepal are often associated with a number of socioeconomic, cultural, and ethical challenges. This paper discusses some central ethical challenges in providing cervical cancer screening in the Nepalese context and culture. It is necessary to address these challenges for successful implementation of such screening programs.

Pazopanib monotherapy in a patient with a malignant granular cell tumor originating from the right orbit: A case report.

Abstract: Granular cell tumors are uncommon, usually benign tumors of Schwann cell origin. The malignant variant is extremely rare, representing <2% of all granular cell tumors. Therefore, standard systemic chemotherapy for this disease does not exist. The present study reports the case of a 40-year-old female with a malignant granular cell tumor that originally arose in the right orbit and subsequently relapsed. The patient was started on pazopanib monotherapy following treatment with two investigational drugs, a smoothened inhibitor and then a phosphatidylinositol 3-kinase inhibitor, as part of a clinical trial. Although additional radiotherapy for local control was necessary, the lung metastases remained stable during the pazopanib monotherapy, which lasted for 7 months, following which a clinically stable disease state was determined. This case suggests that pazopanib can be a treatment option for the stabilization of disease progression in metastatic malignant granular cell tumor.

Prophylactic Use of Antiemetics for Prevention of Opioid-Induced Nausea and Vomiting: A Questionnaire Survey among Japanese Physicians.

Abstract: Background: Antiemetics are being used both for the treatment and prophylaxis of opioid-induced nausea and vomiting (OINV) in clinical practice, despite the lack of evidence for the prophylactic benefit. Data regarding the actual status of prophylactic antiemetic use for OINV remain to be elucidated. Objective: The objective of this study was to evaluate the practice among Japanese physicians of the prophylactic use of antiemetics when starting opioids prescription for the prevention of opioid-induced nausea and vomiting. Methods: This questionnaire survey was targeted among physicians experienced in cancer pain treatment at two institutions of Japan (Nagoya University Hospital and Ichinomiya City Municipal Hospital). The questionnaire assessed the physicians' practice and beliefs regarding the prophylactic antiemetics prescription when they start opioids in patients with cancer pain. Results: Questionnaires were filled in and received from 112 physicians from two institutions. Eighty-two percent...

Effective approaches to improve the psychosocial work environment

Abstract: There has been a growing recognition that the experience of psychosocial hazards at work has detrimental effects on the health and well-being of employees, as well as on the workplace productivity and profits. Issues such as work-related stress, bullying, and stress due to harassment have grown in prominence in recent years in response to a number of factors such as overwork, job insecurity, low levels of job satisfaction, and lack of autonomy. These hazards are highly underestimated in most of the workplaces because of the difficulties involved with their detection and management and eventually represent risks to physical and psychological health. Reducing this huge burden from unhealthy workplaces is a formidable challenge for national governments, health policy makers, and practitioners. The growing burden of psychosocial hazards at workplace has guided to review the literature on the effective approaches to improve psychosocial work environment. It is concluded that adapting the systems and structured approach to psychosocial health risk management will be effective to prevent hazards and manage psychosocial work environment.