Activation of the Anti-Oxidative Stress Response Reactivates Latent HIV-1 Through the Mitochondrial Antiviral Signaling Protein Isoform MiniMAVS

The mitochondrial antiviral signaling protein (MAVS) is part of the cell's innate immune mechanism of defense. MAVS mRNA is bicistronic and can give rise to a full length-MAVS and a shorter isoform termed miniMAVS. In response to viral infections, viral RNA can be sensed by the cytosolic RNA sensors retinoic acid-inducible gene I (RIG-I) and/or melanoma differentiation-associated protein 5 (MDA5) and activate NF-κB through interaction with MAVS. MAVS can also sense cellular stress and activate an anti-oxidative stress (AOS) response through the activation of NF-κB. Because NF-κB is a main cellular transcription factor for HIV-1, we wanted to address what role MAVS plays in HIV-1 reactivation from latency in CD4 T cells. Our results indicate that RIG-I agonists required full length-MAVS whereas the AOS response induced by Dynasore through its catechol group can reactivate latent HIV-1 in a MAVS dependent manner through miniMAVS isoform. Furthermore, we uncover that PKC agonists, a class of latency-reversing agents, induce an AOS response in CD4 T cells and require miniMAVS to fully reactivate latent HIV-1. Our results indicate that the AOS response, through miniMAVS, can induce HIV-1 transcription in response to cellular stress and targeting this pathway adds to the repertoire of approaches to reactivate latent HIV-1 in 'shock-and-kill' strategies.

Recognition of nuclear export signals by CRM1 carrying the oncogenic E571K mutation

The E571K mutation of CRM1 is highly prevalent in some cancers, but its mechanism of tumorigenesis is unclear. Glu571 of CRM1 is located in its nuclear export signal (NES)-binding groove, suggesting that binding of select NESs may be altered. We generated HEK 293 cells with either monoallelic CRM1WT/E571K or biallelic CRM1E571K/E571K using CRISPR/Cas9. We also combined analysis of binding affinities and structures of 27 diverse NESs for wild-type and E571K CRM1 with structure-based bioinformatics. While most NESs bind the two CRM1 similarly, NESs from Mek1, eIF4E-transporter, and RPS2 showed >10-fold affinity differences. These NESs have multiple charged side chains binding close to CRM1 position 571, but this feature alone was not sufficient to predict different binding to CRM1(E571K). Consistent with eIF4E-transporter NES binding weaker to CRM1(E571K), eIF4E-transporter was mislocalized in tumor cells carrying CRM1(E571K). This serves as proof of concept that understanding how CRM1(E571K) affects NES binding provides a platform for identifying cargoes that are mislocalized in cancer upon CRM1 mutation. Finally, we showed that large affinity changes seen with some NES peptides (of Mek1 and RPS2) do not always translate to the full-length cargoes, suggesting limitations with current NES prediction methods. Therefore, comprehensive studies like ours are imperative to identify CRM1 cargoes with real pathogenic potential.

Patient Satisfaction with Outpatient Physiotherapy Services in Dhulikhel Hospital, Kathmandu University Hospital, Nepal

Background The quality of care provided to recipients of health services is measured by the satisfaction of patient. Patient satisfaction is the extent to which patient feels that their needs and expectations have been met on behalf of their expenses made to get quality health services. Satisfied patients adhere to the treatment plan, seek for further services and provide feedback. Therefore, such study in Nepal would be important and first of its kind to assess the quality of physiotherapy services. Objective To evaluate the level of satisfaction of patient receiving outpatient Physiotherapy services and the relationship between the items within the questionnaire. Method The MedRisk Instrument for Measuring Patient Satisfaction (MRPS) with Physical Therapy Care was administered to 256 patients to identify the level of patient satisfaction. Result There was a high level of satisfaction of patient receiving Outpatient physiotherapy services using MRPS (Mean = 4.18; SD = 0.39). The relationships between individual item scores and Global satisfaction (Item 11) were explored with bivariate correlation analysis. The Internal factors correlated most strongly with the global satisfaction whereas the external factors had the lowest correlation with the global satisfaction. Conclusion Patient satisfaction is an important aspect of the measurement of quality of care. Thus, it must be evaluated timely to provide quality services to the patients. There was high level of satisfaction reported by patient receiving outpatient physiotherapy services in the Dhulikhel Hospital.

Cornual Ectopic Pregnancy: Case Series

Three cases of cornual pregnancies encountered within three weeks at Paropakar Maternity and Women’s Hospital had diverse presentations. Fortunately, in all three case series, cornual resection was performed successfully. Cornual pregnancy is difficult to diagnose preoperatively with low ultrasonographic sensitivity and is easily confused with tubal ectopic pregnancy or a normal intrauterine pregnancy. Diagnosis before rupture is essential to prevent mortality and potential loss of fertility. The surgical management of diagnosed cornual pregnancy consists of hemostasis, resection, repair and reconstruction. 

Binding of Substrates to the Central Pore of the Vps4 ATPase Is Autoinhibited by the Microtubule Interacting and Trafficking (MIT) Domain and Activated by MIT Interacting Motifs (MIMs)

The endosomal sorting complexes required for transport (ESCRT) pathway drives reverse topology membrane fission events within multiple cellular pathways, including cytokinesis, multivesicular body biogenesis, repair of the plasma membrane, nuclear membrane vesicle formation, and HIV budding. The AAA ATPase Vps4 is recruited to membrane necks shortly before fission, where it catalyzes disassembly of the ESCRT-III lattice. The N-terminal Vps4 microtubule-interacting and trafficking (MIT) domains initially bind the C-terminal MIT-interacting motifs (MIMs) of ESCRT-III subunits, but it is unclear how the enzyme then remodels these substrates in response to ATP hydrolysis. Here, we report quantitative binding studies that demonstrate that residues from helix 5 of the Vps2p subunit of ESCRT-III bind to the central pore of an asymmetric Vps4p hexamer in a manner that is dependent upon the presence of flexible nucleotide analogs that can mimic multiple states in the ATP hydrolysis cycle. We also find that substrate engagement is autoinhibited by the Vps4p MIT domain and that this inhibition is relieved by binding of either Type 1 or Type 2 MIM elements, which bind the Vps4p MIT domain through different interfaces. These observations support the model that Vps4 substrates are initially recruited by an MIM-MIT interaction that activates the Vps4 central pore to engage substrates and generate force, thereby triggering ESCRT-III disassembly.

Androblastoma of the Ovary

 Androblastoma of the ovary occurs most frequently in the 3rd to 4th decades of life and about 75% of the lesions are seen in women younger than 40 years. This tumor produces androgen and virilization is present in more than 70% of the patients. Due to the early diagnosis and treatment of such type of tumor, the prognosis is very good. This was a case report of an 18 years’ unmarried girl who presented with signs of virilization and amenorrhea for two years. On abdominal examination mass was up to epigastric reason, after all investigation we planned for laparotomy. Histopathology report revealed androblastoma of the ovary. After a month of operation, she had regular menstruation. DOI: http://dx.doi.org/10.3126/njog.v9i2.11765

Profile of Obstetric Morbidity Among Maternal Intensive Care Unit Patients

Aims: The objective of the study was to determine the outcome of the obstetric admissions to Maternal Intensive Care Unit in the setting of a tertiary care hospital. Methods: This was a cross-sectional study undertaken at Paropakar Maternity and Women’s Hospital from April 1, 2012 to March 31, 2013. Patient characteristics, gestational age, booking status, indication for intensive care unit admission, intervention, length of stay and outcome were analyzed. Results: During the study period, 19,247 deliveries occurred and 247 women were admitted to maternal intensive care unit. This accounts for 1.28% of all deliveries. The most common indication of admission to intensive care unit was hypertensive disorders in pregnancy (45.3%) followed by obstetric hemorrhage (39.27%). Sepsis was the cause in ten (4.04%) cases. Ten cases (4.04%) of postpartum hemorrhage were managed by balloon tamponade, seven (2.83%) by B-Lynch compression sutures and three (1.21%) necessitated cesarean hysterectomy. Among 18 cases of ruptured uterus, 13 (5.26%) were repaired while five (2.02%) required hysterectomy. Maternal mortality occurred in four (1.61%) of the cases. One was a case of severe preeclampsia who died on 4th post-operative day due to pulmonary embolism, another due to anesthetic complication and the other two died of septic shock and multiorgan failure. Conclusions: Hypertensive disorders of pregnancy and obstetric hemorrhage appeared as the major risk factors for admission to an intensive care unit thereby influencing maternal outcomes in obstetric patients. DOI: http://dx.doi.org/10.3126/njog.v9i2.11762 

Instrumentation in cervical spine injury: neurological outcome measurement using ASIA impairment scale

Cervical spinal cord injuries make up more than half of all spinal cord injuries. It affects 2-3% of all trauma patients and accounts for 8.2% of all trauma related deaths. Cervical spine surgery has been evolving in terms of surgical technique, equipment, and instrumentation. We have analyzed a series of patients with cervical spine injuries stabilized with various instrumentation techniques. The objective of the study was to evaluate the outcome of instrumentation in cervical spine injury measured on ASIA Impairment Scale. We present prospective observational descriptive analysis, for 36 patients, looking at the clinical and neurological outcomes following instrumentation for cervical spine injuries from Jun 2011 to July 2013. All 36 patients underwent various instrumentation techniques for stabilization and decompression of the cervical spinal cord. The outcome was compared by the ASIA impairment scale. There were 27 (75%) males and 9 (25%) females. The mean age at presentation was 46 years (17-74 years). The most common mode of injury was fall (62%), with ASIA grade C and D, 31% each. C5/6 level was the most common level (26.2%) of injury. The timing of surgery ranged between 8 - 270 days from injury. Out of thirty-six, thirty-two patients were available for follow-up. Eighteen of these patients had spinal cord injury and improved by at least one ASIA grade. It is concluded that instrumentation in cervical spine injury is an effective surgical procedure with minimal post-operative morbidity for the management of cervical injury, allowing an improved physiologic environment for maximal neurologic improvement. The post-operative outcome measured on ASIA impairment scale was comparable to international study.

Intra-amniotic Digoxin for Fetal Anomaly in Second and Early Third Trimester

Aims: Carrying a baby with major anomaly is emotional trauma for mother and her family. If born alive, these babies would either not survive or would have significant disability. The objective of this study was to induce fetal demise by instillation of digoxin intra-amniotically for fetal anomaly before termination of pregnancy. Methods: This was a cross-sectional study undertaken at Paropakar Maternity and Women’s Hospital from April 13, 2012 to October 13, 2013. Patient characteristics, gestational age, types of fetal anomaly and its time of detection were recorded in 32 cases with fetal anomaly in second and early third trimester. One milligram digoxin was instilled intra-amniotically under ultrasound guidance and after 24 hours, ultrasonography was done to check fetal cardiac activity. Induction of labour using misoprostol as per FIGO guideline and augmentation with oxytocin was done if already in labour. Induction to delivery interval, effectiveness and side effects of digoxin were recorded. Results: Among 32 cases of fetal anomaly, majority occurred in primigravida (n=17, 53.12%). The mean age was 25 years and mean gestational age was 26.5 weeks’. Majority of them were anencephaly (n=16, 50%) followed by multiple anomaly (n=6, 18.75%). Thirty one (96.87%) cases visited out-patient department, 25% of them had presented late at 30-34 weeks’. Following 24 hours of intra-amniotic digoxin, cardiac activity was absent in all cases and there was no side effect of digoxin. Spontaneous expulsion occurred in 9.37%, oxytocin augmentation (n=6, 18.75%) and misoprostol induction (n=23, 71.87%). The mean induction to delivery interval was 47.3 hours. Conclusions: Intra-amniotic digoxin instillation appeared safe and effective in inducing fetal demise for fetal anomaly in second and early third trimester. DOI: http://dx.doi.org/10.3126/njog.v9i1.11188 NJOG 2014 Jan-Jun; 2(1):48-51

Overview of Eclampsia at a Tertiary Care Hospital

Aims: The aim was to study about the morbidity and mortality of eclampsia cases at Paropakar Maternity and Women’s Hospital, Kathmandu, Nepal. Methods: This is a retrospective study undertaken at Paropakar Maternity and Women’s Hospital, Kathmandu, Nepal on 45 eclampsia cases between14 April 2010 to 16 July 2011. Results: Out of 31,674 obstetric admissions, 45 (0.14%) were eclampsia cases of which 42.2% belonged to 20 - <25 years and 28.8% in 17- <20 years age group occurring mostly in primipara (71.1%). Antepartum and postpartum eclampsia were 77.7% and 22.2% respectively. Majority of them presented at 36-40 weeks’(46.6%), unbooked cases being 80% and 20% had antenatal check-up at this hospital. The diastolic blood pressure on admission recorded was 110-130 mmHg (55.5%), headache being the most common symptom(53.3%), blurred vision (22.2%), HELLP syndrome (4.4%) and urine albumin 3+ (46.6%) at the time of admission. Magnesium sulphate was used as anticonvulsant, loading and maintenance dose (40%) and only as loading dose (33.3%). Though fetal outcome was normal in 44.4% cases, rest were premature (24.4%), intrauterine growth restriction (17.7%) and intrauterine fetal demise (13.3%). Three (6.6%) cases were referred to multidisciplinary center. Maternal mortality occurred in two (4.4%) cases (cardiopulmonary arrest and prolonged hypoxia). Conclusions: When patients with eclampsia presented late, significant morbidity like HELLP syndrome, renal failure and central nervous disorder occurred and muti-organ damage leading to maternal mortality.Nepal Journal of Obstetrics and Gynaecology / Vol 8 / No. 2 / Issue 16 / July-Dec, 2013 / 46-49 DOI: http://dx.doi.org/10.3126/njog.v8i2.9770

Efficacy of Misoprostol as a Post Abortion Care

Aims: This study was done to find the efficacy of Misoprostol as a post-abortion care in our setting. Methods: Women with incomplete abortion of gestational age ≤ 12 weeks or uterine size ≤ 12 weeks with open cervical os, haemoglobin ≥ 9 gm% and stable physical condition; were given 600 microgram Misoprostol orally and were observed for 24 hours for complete expulsion. If the patient failed to expel within 24 hours of Misoprostol administration manual vacuum aspiration or suction evacuation was done. Results: One hundred and twenty-two women were enrolled in the study. Among them, 41% had complete expulsion within 24 hours of administration of misoprostol and 49% had incomplete expulsions. The success rate was high in the group of < 8 weeks of pregnancy. Among 50 (41%) successful cases, 38 (76%) belonged to 8 weeks of gestation by bimanual examination (p = 0.02). Conclusions: Single dose of oral Misoprostol was effective, safe and alternative method to the management of incomplete abortion compared to the manual vacuum aspiration or suction evacuation in case of early pregnancy abortion.Nepal Journal of Obstetrics and Gynaecology / Vol 8 / No. 2 / Issue 16 / July-Dec, 2013 / 71-74 DOI: http://dx.doi.org/10.3126/njog.v8i2.9778

Intestinal type borderline mucinous ovarian tumour

A 26 years old para 4 lady presented with abdominal distension following a home delivery 18 months back and lactational amenorrhoea following since. Examination and investigation findings revealed a large ovarian tumour (28X28 cm) occupying the whole of the abdomen. Tumour markers were normal except for a slightly raised lactate dehydrogenase enzyme. Patient underwent staging laparotomy- left salpingoophorectomy, right tubal ligation with omental biopsy and peritoneal fluid cytology. Histopathology report revealed borderline mucinous ovarian tumour of intestinal type. Her postoperative period was uneventful and she was advised for follow-up. Borderline ovarian tumours are uncommon tumours. In the younger age with stage I, fertility sparing surgery is enough and has excellent prognosis, but follow up is important.

Occupational Exposure and Pulmonary Function of Workers of Carpet Industries and Sawmills, Lalitpur, Nepal

Background: Most workers of carpet factory and sawmills suffer from non-specific lung diseases and ventilatory disorders. There is so many such industries operative in Lalitpur district and so far not many studies have been reported on pulmonary function in these workers. Method: A brief clinical sheet regarding age, occupational particulars, smoking habits and presence or absence of major complaints was recorded for each worker. Spirometric parameters were recorded using an electronic (MEDSPIROR) spirometer. The groups consisted of control subjects not exposed to industrial dusts (n=50) for each group of workers (carpet factory, n=50 and saw mill, n=50). Result: This study indicated an overall reduction in pulmonary function parameters; in particular FVC, FEV1 and FEV1/FVC % in carpet factory workers and FEV1 and FEV1/FVC % in saw mill workers. Comparison of pulmonary function parameters between carpet factories workers and sawmill workers revealed a significant reduction in FEV1 and MVV in carpet workers. Conclusion: Exposure to cotton dust and wood dust leads to combined type of spirometric deficit revealing obstructive or restrictive lung diseases. Workers exposed to industrial dusts also suffer from various upper or lower respiratory symptoms. DOI: http://dx.doi.org/10.3126/ajms.v5i2.8951   Asian Journal of Medical Science, Volume-5(2) 2014: 54-58

Mutagenesis of isopentenyl phosphate kinase to enhance geranyl phosphate kinase activity

Isopentenyl phosphate kinase (IPK) catalyzes the ATP-dependent phosphorylation of isopentenyl phosphate (IP) to form isopentenyl diphosphate (IPP) during biosynthesis of isoprenoid metabolites in Archaea. The structure of IPK from the archeaon Thermoplasma acidophilum (THA) was recently reported and guided the reconstruction of the IP binding site to accommodate the longer chain isoprenoid monophosphates geranyl phosphate (GP) and farnesyl phosphate (FP). We created four mutants of THA IPK with different combinations of alanine substitutions for Tyr70, Val73, Val130, and Ile140, amino acids with bulky side chains that limited the size of the side chain of the isoprenoid phosphate substrate that could be accommodated in the active site. The mutants had substantially increased GP kinase activity, with 20-200-fold increases in k(cat)(GP) and 30-130-fold increases in k(cat)(GP)/K(M)(GP) relative to those of wild-type THA IPK. The mutations also resulted in a 10(6)-fold decrease in k(cat)(IP)/K(M)(IP) compared to that of wild-type IPK. No significant change in the kinetic parameters for the cosubstrate ATP was observed, signifying that binding between the nucleotide binding site and the IP binding site was not cooperative. The shift in substrate selectivity from IP to GP, and to a lesser extent, FP, in the mutants could act as a starting point for the creation of more efficient GP or FP kinases whose products could be exploited for the chemoenzymatic synthesis of radiolabeled isoprenoid diphosphates.

Intestinal parasitic infection among school children

BACKGROUND

Intestinal parasitosis is a major public health problem of developing countries, children being major victims. Higher prevalence has been reported among school children, mostly in hilly regions of Nepal. This study aims at assessing prevalence of intestinal parasitosis among school children of a school in a border town of Nepal and the associated factors.

METHODS

Fecal samples from the students were examined by direct smear technique and result was correlated with their socioeconomic status and hygienic behavior. The chi-square test was used for analytical assessment.

RESULTS

The prevalence rate was 13.9%, girls being highly infected (19.1%) than boys (10.3%) (P>0.05). Entamoeba histolytica (36.0%) was the commonest parasite followed by A. lumbricoides (28.0%). The highest positive rate was found among children of 5 years and less age (29.2%) and least among those above 12 years (5.3%) (P>0.05). Those from family size 5 and less than 5 were least infected (10.5%). Children of illiterate parents (16.7%) and farmers (17.1%) were more infected than literate ones and non-farmers (P>0.05). 8.7% of positive children had multi-parasitic infection. Children drinking untreated water (15.0%) were more infected than those drinking treated water (5.5%) (P>0.05).

CONCLUSIONS

Intestinal parasitic infection was found among 17% school children. Awareness on infectious diseases, improving hygiene, and application of supportive programs for parents to elevate socioeconomic conditions may reduce the burden of infection.

Nasal carriage rate of methicillin resistant Staphylococcus aureus among at National Medical College Teaching Hospital, Birgunj, Nepal

Present study was conducted to assess the nasal carriage rate of methicilin resistant Staphylococcus aureus (MRSA) among patients, visitors/patient attendants and healthcare personnel at National Medical College Teaching Hospital, Birgunj, Nepal. A total of 112 nasal swabs (patients: 31, visitors/patient attendants: 61, and healthcare personnel: 20) were subjected to bacteriological investigation following standard protocol. S. aureus isolates were identified by mannitol fermentation and coagulase positivity. Antimicrobial susceptibility test was performed by Kirby-Bauer's disc diffusion method on Muller-Hinton agar medium. S. aureus was isolated in 14 (12.5%) of participants (M: 11.3%, F: 13.6%). Highest nasal colonization rate was found among healthcare personnel (25.0%) followed by the visitors/patient attendants (13.1%) and the patients (3.2%) (P>0.05). Highest positive rate was observed in the age group d"14 years (33.3%), followed by 15 to 50 years (13.2%) and >50 years (5.6%) (P>0.05). Out of 14 S. aureus isolates, 57.1% were methicillin resistant, prevalence rate of MRSA among total subjects being 7.1%. MRSA prevalence rate were 5.6% and 8.5% in total male and female participants, respectively (P>0.05). Highest MRSA prevalence rate was among health-care personnel (10.0%), followed by visitors/patient attendants (8.2%) and the patients (3.2%) (P>0.05). All MRSA isolates were resistant to Ampicillin, followed by Cephalexin (37.5%), Ciprofloxacin (37.5%), Tetracycline (37.5%), Gentamycin (25.0%), Erythromycin (0.0%) and Vancomycin (0.0%). High rate of nasal MRSA carriage rate found in this study indicates the need for standard infection control to prevent MRSA transmission.

Prophylactic low dose ketamine and ondansetron for prevention of shivering during spinal anaesthesia

BACKGROUND

Perioperative shivering is a common problem during anaesthesia. Apart from physical warming many drugs have also been used for prevention of shivering. Ketamine has been used for preventing shivering during anaesthesia in doses of 0.5 to 0.75mg kg(-1), but even these doses causes too much sedation and hallucination. Ondansetron (8 mg) has been recently evaluated for its perioperative antishivering effect in patients under anaethesia. Present study was conducted to evaluate the efficacy and safety of low dose Ketamine (0.25mg kg(-1)) and Ondansetron (4 mg) for prevention of shivering during spinal anaesthesia. PATIENTS #ENTITYSTARTX00026;

METHODS

Total 120 patients undergoing lower abdominal surgery under spinal anaesthesia were included. 3ml of hyperbaric bupivacaine 0.5% was used for spinal anaesthesia. After intrathecal injection, the patients were randomly divided in 3 groups of 40 each who received Ketamine 0.25mg kg(-1)or Ondansetron 4mg IV or Saline. Vitals, temperature and shivering scores were recorded every 5 minutes. Side effects i.e. hypotension, nausea and vomiting, sedation and hallucinations were also recorded.

RESULTS

Fall in temperature was more significant in saline and ondansetron group (gp) than in ketamine group at all time interval. Out of 40 patients, shivering was maximum & seen in 17 patients (42.50%) in saline gp, 4 patients (10%) in ondansetron gp and in only 1patient (2.5%) in ketamine gp. Odd ratio of ketamine, ondansetron and saline are 1, 4.33 and 28.33 respectively which means that shivering in saline gp was 28.83 times higher than ketamine gp and 6.65 times higher than in ondansetron .Shivering rate was 4.33 times higher in ondansetron gp than in ketamine gp. Hypotension was lowest in ketamine gp (10%) in comparison to ondansetron gp (22.5%) and saline gp. (20%). Mild sedation was seen in almost all (95%) patients in ketamine gp,

CONCLUSION

Prophylactic low dose ketamine (0.25mg kg(-1)) and Ondansetron (4mg) significantly decreased shivering in patients undergoing spinal anaesthesia without significant side effects.

Intestinal parasitosis among subjects undergoing cataract surgery at the eye camps in rural hilly areas of Nepal

Present study investigated the intestinal parasitosis among 221 subjects undergoing cataract surgery (M: 129 and F: 92; aged 13-86 years) at the eye camps in three rural hilly districts (Ramechhap, Sindhupalchok and Dhading) in 2006. Stool samples collected in clean, dry, screw capped plastic containers were examined locally by direct smear technique and anti-parasitic drugs were distributed to parasite positive subjects. The remaining stool samples were fixed with 10% formal-saline, transported to Shi-Gan Health Foundation/Nat'l Inst of Trop Med and Public Health Research, Kathmandu and re-examined by formal-ether sedimentation technique. A total of 148 samples (66.9%) were positive for some kind of intestinal parasites (F: 68.5% and M: 65.9%; P > 0.05). Ramechhap (Manthali) and Sindhupalchok (Chautara) had higher positive rate (71.8% and 70.7%, respectively) than in Dhading (Salyantar) (60.0%) (P > 0.05). Tibeto-Burman (indigenous nationalities) ethnic group had highest positive rate (70.1%) compared with Indo-Aryan (64.7%) and Dalits (57.7%). Subjects without toilet (latrine) had marginally higher positive rate (69.7%) than those having toilet at their home (65.5) (P> 0 .05). Age was independent of positive rate. Vegetarians had marginally higher parasitic infection rate compared to their non-vegetarian counterparts. Helminths were more common than protozoa. Overall, hookworm was the commonest parasite detected. However, Ascaris was common in Dhading District. Entamoeba histolytica was most common among protozoa and was followed by Cyclospora and others.