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Plotnik D, Sager JE, Aryal M, Fanget MC, Peter A, Schmid MA, Cebrik D, Mogalian E, Boundy K, Yeh WW, Griffin P, Reyes M. A phase 1 study in healthy volunteers to investigate the safety, tolerability, and pharmacokinetics of VIR-2482: a monoclonal antibody for the prevention of severe influenza A illness. Antimicrob Agents Chemother 2024; 68:e0127323. [PMID: 38376227 PMCID: PMC10988998 DOI: 10.1128/aac.01273-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 01/18/2024] [Indexed: 02/21/2024] Open
Abstract
The objective of this study was to evaluate the safety, tolerability, pharmacokinetics (PK), and immunogenicity of VIR-2482 in healthy adult subjects. A phase 1, first-in-human, randomized, double-blind, placebo-controlled dose-escalation study was conducted. One hundred participants were allocated to four cohorts (60 mg, 300 mg, 1,200 mg, and 1,800 mg). In each cohort, participants were randomized in a 4:1 ratio (active:placebo) to receive either VIR-2482 or volume-matched placebo by gluteal intramuscular injection. Participants remained at the investigative site under observation for 48 h, and adverse events (AEs) were collected for 56 days. PK and immunogenicity were measured up to 52 weeks post-dose. VIR-2482 was well tolerated at all doses studied. The overall incidence of AEs was comparable between VIR-2482 (68.8%) and placebo (85.0%). Nineteen VIR-2482 (23.8%) and six placebo (30.0%) recipients had Grade 1 or 2 AEs that were considered to be related to the study intervention. There were no treatment-related serious AEs. Injection-site reactions (ISRs) were reported in six (7.5%) VIR-2482 recipients, while no such reactions were reported among the placebo recipients. All ISRs were Grade 1, and there was no relationship with the dose. Median VIR-2482 serum elimination half-life ranged from 56.7 to 70.6 days across cohorts. The serum area under the curve and Cmax were dose-proportional. Nasopharyngeal VIR-2482 concentrations were approximately 2%-5% of serum levels and were less than dose-proportional. The incidence of immunogenicity across all cohorts was 1.3%. Overall, the safety, tolerability, and pharmacokinetic profile of VIR-2482 at doses up to 1,800 mg supported its further investigation as a long-acting antibody for the prevention of influenza A illness. This study has been registered at ClinicalTrials.gov under identifier NCT04033406.
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Affiliation(s)
| | | | | | | | - Alessia Peter
- Humabs BioMed, SA, Vir Biotechnology, Bellinzona, Switzerland
| | | | | | | | - Keith Boundy
- Vir Biotechnology, San Francisco, California, USA
| | - Wendy W. Yeh
- Vir Biotechnology, San Francisco, California, USA
| | - Paul Griffin
- Mater Health and University of Queensland, Queensland, Australia
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Cao Y, Aryal M, Li P, Lee C, Schipper M, You D, Jaworski E, Gharzai L, Shah J, Eisbruch A, Mierzwa M. Diffusion MRI correlation with p16 status and prediction for tumor progression in locally advanced head and neck cancer. Front Oncol 2023; 13:998186. [PMID: 38188292 PMCID: PMC10771284 DOI: 10.3389/fonc.2023.998186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 11/06/2023] [Indexed: 01/09/2024] Open
Abstract
Purpose To investigate p16 effects on diffusion image metrics and associations with tumor progression in patients with locally advanced head and neck cancers. Methods Diffusion images pretreatment and after 20 Gy (2wk) of RT were analyzed in patients with cT4/N3 p16+ oropharynx cancer (OPSCC) (N=51) and locoregionally advanced head and neck squamous cell carcinoma (LAHNSCC) (N=28), enrolled onto a prospective adaptive RT trial. Mean ADC values, subvolumes with ADC <1.2 um2/ms (TVLADC), and peak values of low (µL) and high (µH) components of ADC histograms in primary and total nodal gross tumor volumes were analyzed for prediction of freedom from local, distant, or any progression (FFLP, FFDP or FFLRDP) using multivariate Cox proportional-hazards model with clinical factors. P value with false discovery control <0.05 was considered as significant. Results With a mean follow up of 36 months, 18 of LAHNSCC patients and 16 of p16+ OPSCC patients had progression. After adjusting for p16, small µL and ADC values, and large TVLADC of primary tumors pre-RT were significantly associated with superior FFLRDP, FFLP and FFDP in the LAHNSCC (p<0.05), but no diffusion metrics were significant in p16+ oropharynx cancers. Post ad hoc analysis of the p16+ OPSCC only showed that large TVLADC of the total nodal burden pre-RT was significantly associated with inferior FFDP (p=0.05). Conclusion ADC metrics were associated with different progression patterns in the LAHNSCC and p16+ OPSCC, possibly explained by differences in cancer biology and morphology. A deep understanding of ADC metrics is warranted to establish imaging biomarkers for adaptive RT in HNSCC.
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Affiliation(s)
- Yue Cao
- Departments of Radiation Oncology, University of Michigan, Ann Arbor, MI, United States
- Department of Radiology, University of Michigan, Ann Arbor, MI, United States
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, United States
| | - M. Aryal
- Departments of Radiation Oncology, University of Michigan, Ann Arbor, MI, United States
| | - P. Li
- Department of Biostatistics, University of Michigan, Ann Arbor, MI, United States
| | - C. Lee
- Departments of Radiation Oncology, University of Michigan, Ann Arbor, MI, United States
| | - M. Schipper
- Departments of Radiation Oncology, University of Michigan, Ann Arbor, MI, United States
- Department of Biostatistics, University of Michigan, Ann Arbor, MI, United States
| | - D. You
- Departments of Radiation Oncology, University of Michigan, Ann Arbor, MI, United States
| | - E. Jaworski
- Departments of Radiation Oncology, University of Michigan, Ann Arbor, MI, United States
| | - L. Gharzai
- Departments of Radiation Oncology, University of Michigan, Ann Arbor, MI, United States
| | - J. Shah
- Departments of Radiation Oncology, University of Michigan, Ann Arbor, MI, United States
- Department of Radiation Oncology, VA Ann Arbor Healthcare System, Ann Arbor, MI, United States
| | - A. Eisbruch
- Departments of Radiation Oncology, University of Michigan, Ann Arbor, MI, United States
| | - Michelle Mierzwa
- Departments of Radiation Oncology, University of Michigan, Ann Arbor, MI, United States
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Aryal M, Lau K, Boyer R, Zhou H, Abend J, Gu K, Olbertz J, Gupta S, Zoog S, Larimore K. Achieving efficacy in subjects with sustained pegvaliase-neutralizing antibody responses. Mol Genet Metab 2021; 134:235-242. [PMID: 34716085 DOI: 10.1016/j.ymgme.2021.09.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 08/04/2021] [Accepted: 09/22/2021] [Indexed: 10/20/2022]
Abstract
Pegvaliase (Palynziq®) is an enzyme substitution therapy using PEGylated recombinant Anabaena variabilis phenylalanine ammonia lyase (PAL) to reduce blood phenylalanine (Phe) levels in adults with phenylketonuria (PKU). In Phase 3 clinical studies, all subjects treated with pegvaliase developed anti-drug antibodies. To specifically evaluate pegvaliase-neutralizing antibodies (NAbs) and assess impact on pegvaliase efficacy, a novel hybrid ligand-binding/tandem mass spectrometry NAb assay was developed. Analysis of Phase 3 study samples revealed that pegvaliase NAb titers developed during early treatment (≤6 months after treatment initiation), and then plateaued and persisted in the majority of subjects during late treatment (>6 months). Subjects with the lowest/undetectable NAb titers had relatively high plasma pegvaliase concentrations and experienced the most rapid decline in blood Phe concentrations at relatively low pegvaliase dose concentrations. In contrast, subjects with higher NAb titers generally had lower plasma pegvaliase concentrations on similar low doses, with little change in blood Phe concentrations. However, with additional time on treatment and individualized dose titration, the majority of subjects achieved substantial and sustained blood Phe reduction, including those with higher NAb titers. Moreover, after maturation of the anti-pegvaliase immune response, NAb titers were stable over time and did not rise in response to dose increases; thus, subjects did not require additional dose increases to maintain reduction in blood Phe.
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Affiliation(s)
- Madhukar Aryal
- BioMarin Pharmaceutical Inc., 105 Digital Drive, Novato, CA 94949, USA
| | - Kelly Lau
- BioMarin Pharmaceutical Inc., 105 Digital Drive, Novato, CA 94949, USA
| | - Ryan Boyer
- BioMarin Pharmaceutical Inc., 105 Digital Drive, Novato, CA 94949, USA
| | - Huiyu Zhou
- BioMarin Pharmaceutical Inc., 105 Digital Drive, Novato, CA 94949, USA
| | - Johanna Abend
- BioMarin Pharmaceutical Inc., 105 Digital Drive, Novato, CA 94949, USA
| | - Karen Gu
- BioMarin Pharmaceutical Inc., 105 Digital Drive, Novato, CA 94949, USA
| | - Joy Olbertz
- BioMarin Pharmaceutical Inc., 105 Digital Drive, Novato, CA 94949, USA
| | - Soumi Gupta
- BioMarin Pharmaceutical Inc., 105 Digital Drive, Novato, CA 94949, USA
| | - Stephen Zoog
- BioMarin Pharmaceutical Inc., 105 Digital Drive, Novato, CA 94949, USA
| | - Kevin Larimore
- BioMarin Pharmaceutical Inc., 105 Digital Drive, Novato, CA 94949, USA.
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Zhong Q, Yoon BC, Aryal M, Wang JB, Ilovitsh T, Baikoghli MA, Hosseini-Nassab N, Karthik A, Cheng RH, Ferrara KW, Airan RD. Polymeric perfluorocarbon nanoemulsions are ultrasound-activated wireless drug infusion catheters. Biomaterials 2019; 206:73-86. [PMID: 30953907 DOI: 10.1016/j.biomaterials.2019.03.021] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Revised: 03/11/2019] [Accepted: 03/15/2019] [Indexed: 01/04/2023]
Abstract
Catheter-based intra-arterial drug therapies have proven effective for a range of oncologic, neurologic, and cardiovascular applications. However, these procedures are limited by their invasiveness and relatively broad drug spatial distribution. The ideal technique for local pharmacotherapy would be noninvasive and would flexibly deliver a given drug to any region of the body with high spatial and temporal precision. Combining polymeric perfluorocarbon nanoemulsions with existent clinical focused ultrasound systems could in principle meet these needs, but it has not been clear whether these nanoparticles could provide the necessary drug loading, stability, and generalizability across a range of drugs, beyond a few niche applications. Here, we develop polymeric perfluorocarbon nanoemulsions into a generalized platform for ultrasound-targeted delivery of hydrophobic drugs with high potential for clinical translation. We demonstrate that a wide variety of drugs may be effectively uncaged with ultrasound using these nanoparticles, with drug loading increasing with hydrophobicity. We also set the stage for clinical translation by delineating production protocols that are scalable and yield sterile, stable, and optimized ultrasound-activated drug-loaded nanoemulsions. Finally, we exhibit a new potential application of these nanoemulsions for local control of vascular tone. This work establishes the power of polymeric perfluorocarbon nanoemulsions as a clinically-translatable platform for efficacious, noninvasive, and localized ultrasonic drug uncaging for myriad targets in the brain and body.
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Affiliation(s)
- Q Zhong
- Department of Radiology, Stanford University, Stanford, CA 94305, USA; David H. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA 02142, USA
| | - B C Yoon
- Department of Radiology, Stanford University, Stanford, CA 94305, USA; Department of Radiology, Massachusetts General Hospital, Boston, MA 02114, USA
| | - M Aryal
- Department of Radiology, Stanford University, Stanford, CA 94305, USA
| | - J B Wang
- Department of Radiology, Stanford University, Stanford, CA 94305, USA
| | - T Ilovitsh
- Department of Radiology, Stanford University, Stanford, CA 94305, USA; Department of Biomedical Engineering, University of California, Davis, CA 95616, USA
| | - M A Baikoghli
- Department of Molecular and Cellular Biology, University of California, Davis, CA 95616, USA
| | - N Hosseini-Nassab
- Department of Radiology, Stanford University, Stanford, CA 94305, USA
| | - A Karthik
- Department of Radiology, Stanford University, Stanford, CA 94305, USA
| | - R H Cheng
- Department of Molecular and Cellular Biology, University of California, Davis, CA 95616, USA
| | - K W Ferrara
- Department of Radiology, Stanford University, Stanford, CA 94305, USA; Department of Biomedical Engineering, University of California, Davis, CA 95616, USA
| | - R D Airan
- Department of Radiology, Stanford University, Stanford, CA 94305, USA.
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Abstract
Tomato is also known as the poor man’s apple in Nepal. China is the largest producer of tomato in the world. Tomato is grown throughout the year in recent years in Nepal with the introduction of plastic house for off season production. Secondary information is used to assess the consumption pattern and national demand of tomato in 2015/16 for Nepal. The result showed the import from India is increasing compared to previous years. The reason behind this might be increase in consumption of tomato in recent years in Nepal. The central development region is the highest consumer of tomato compared to other regions of the country. The average national consumption of tomato was found 11.97Kg/person/year in Nepal.
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Aryal M, Cao Y. SU-G-IeP1-04: Comparison of Cerebral Blood Volume Estimated by DSC- and DCEMRI. Med Phys 2016. [DOI: 10.1118/1.4956964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Aryal M, Cao Y. SU-D-303-03: Impact of Uncertainty in T1 Measurements On Quantification of Dynamic Contrast Enhanced MRI. Med Phys 2015. [DOI: 10.1118/1.4923890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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You D, Aryal M, Samuels S, Eisbruch A, Cao Y. SU-E-J-241: Wavelet-Based Temporal Feature Extraction From DCE-MRI to Identify Sub-Volumes of Low Blood Volume in Head-And-Neck Cancer. Med Phys 2015. [DOI: 10.1118/1.4924327] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Aryal M, Poudel A, Satyal B, Gyawali P, Pokharel BR, Raut BK, Adhikari RK, Koju R. Evaluation of non-HDL-c and total cholesterol: HDL-c ratio as cumulative marker of cardiovascular risk in diabetes mellitus. Kathmandu Univ Med J (KUMJ) 2012; 8:398-404. [PMID: 22610769 DOI: 10.3126/kumj.v8i4.6239] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND Cardiovascular disease (CVD), is the primary cause of morbidity and mortality in patients with diabetes and have approximately--two to four times higher CVD rate than adult without diabetes. Low density lipoprotein cholesterol (LDL-C) is primarily used as the marker of cardiovascular risk in diabetes despite its several limitations. Although several newer markers of CVD are emerging, no marker has been established in Nepal. OBJECTIVES The study was designed to evaluate the non-high-density-lipoprotein- cholesterol(Non-HDL-C) and Total Cholesterol to High density lipoprotein cholesterol (TC:HDL-C ratio) as CVD risk marker in diabetes mellitus. METHODS The study was conducted in the Department of Biochemistry, Kathmandu University School of Medical Sciences. The study comprised of 76 diabetic subjects and 60 non-diabetic subjects. The anthropometric and biochemical parameters were measured. The Non-HDL-C and TC:HDL-C ratio were also calculated employing their respective formula. RESULTS Body mass index (BMI), waist circumference (WC), blood pressure and lipid parameters were significantly different between diabetic subjects and non-diabetic subjects. There was increased non-HDL-C and TC:HDL-C ratio in subjects with diabetes mellitus. Furthermore, statistically significant correlations of non-HDL-C and TC:HDL-C ratio were obtained with BMI, WC, total cholesterol, HDL-C and LDL-C in diabetic subjects. CONCLUSIONS The present study observation revealed that the Non-HDL-C and TC: HDL-C strongly correlate with established independent risk factors such as obesity(WC), elevated blood pressure, HDL-C and LDL-C in diabetes. Thus, the evaluation of Non-HDL-C and TC: HDL-C ratio can be used as the simple, cost-effective and cumulative marker of cardiovascular risk in diabetes mellitus.
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Affiliation(s)
- M Aryal
- Department of Biochemistry, Kathmandu University School of Medical Sciences, Dhulikhel, Nepal.
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Shrestha S, Chandra L, Aryal M, Das BKL, Pandey S, Baral N. Evaluation of lipid peroxidation and antioxidants' status in metabolic syndrome. Kathmandu Univ Med J (KUMJ) 2012; 8:382-6. [PMID: 22610766 DOI: 10.3126/kumj.v8i4.6236] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND Metabolic syndrome is a constellation of physical conditions and metabolic abnormalities, commonly occurring together, that increases an individual's risk for development of type 2 diabetes mellitus and cardiovascular diseases. Oxidative stress is associated with diabetes, hypertension and other cardiovascular diseases while the role of oxidative stress in pathogenesis of MS is not clearly defined. OBJECTIVES The study aims to find out the prevalence of metabolic syndrome in faculty and staff members at BP Koirala Institute of Health Sciences, Dharan, Nepal and to evaluate oxidative stress levels in subjects with metabolic syndrome. METHODS 118 healthy participants working at B. P. Koirala Institute of Health Sciences, Dharan, Nepal were selected at random for this cross-sectional study and blood samples were collected for the estimation of the following biochemical analytes; fasting glucose; triglycerides; total cholesterol; high density lipoprotein cholesterol; Albumin; uric acid; Bilirubin; Malondialdehyde; Catalase; Glutathione peroxidase; Superoxide Dismutase; Glutathione; vitamin C; and lastly vitamin E. Results In this cross-sectional study, 39% subjects were diagnosed with metabolic syndrome , particularly in sedentary subjects. There was no difference in oxidative stress except significant rises in serum uric acid levels and catalase activity in subjects diagnosed with metabolic syndrome . CONCLUSION The prevalence of metabolic syndrome is higher without oxidative stress in this study, which suggests that oxidative stress does not contribute to the pathogenesis of MS in otherwise healthy subjects.
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Affiliation(s)
- S Shrestha
- Department of Biochemistry, BP Koirala Institute of Health Sciences, Dharan, Nepal
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Aryal M, Gyawali P, Raut B, Pokheral BR. Evaluation of Non-HDL-Cholesterol and Risk Ratio as Cumulative Marker of Cardiovascular Risk in Diabetes Mellitus. Clin Biochem 2011. [DOI: 10.1016/j.clinbiochem.2011.08.394] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Gyawali P, Lamsal N, Tamrakar S, Shrestha R, Aryal P, Raut B, Aryal M. Quality assessment and good laboratory practice in clinical chemistry laboratory at diagnostic laboratories in Nepal. Clin Biochem 2011. [DOI: 10.1016/j.clinbiochem.2011.08.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Baral N, Gautam A, Lamsal M, Paudel BH, Lal Das BK, Aryal M. Effectiveness of teachers' training in assessment techniques: participants' perception. Kathmandu Univ Med J (KUMJ) 2011; 9:189-192. [PMID: 22609505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
BACKGROUND Medical education has experienced a rapidly changing scenario especially during the past three decades. Teachers training programs have emerged in recent years as a more in depth and comprehensive mechanisms for strengthening instructional skills and formulating assessment techniques among faculty members. OBJECTIVE The present study was carried out with the aim of assessing effectiveness of teacher training workshop on assessment techniques at B.P. Koirala Institute of Health sciences (BPKIHS), Dharan, Nepal. Methods: In this prospective questionnaire based study, the 26 entry level teachers were enrolled. They were requested to fill the questionnaire before and after the workshop on the assessment techniques at BPKIHS, Dharan. METHODS Twenty six teachers majority of whom were entry level teachers comprising of medical, dental, nursing and allied sciences participated in pre- and post test analysis on the various components of written and oral examinations. A two and half days long training was conducted having 9 hours of teaching interactive sessions, 6 hours of group exercises, daily evaluation and 3 hours of presentation by participants. There was high degree of agreement with most topics of the assessment training. RESULTS There was a significant gain in knowledge (p < 0.001) by the participants. All the participants (100%) agreed upon the training being informative and learned new things about assessment. More practice session with longer duration with invited resource persons were also suggested for an effective session. CONCLUSION Thereis an immense opportunity for a better and comprehensive training in evaluation techniques in medical education..
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Affiliation(s)
- N Baral
- Department of Health Professions Education, B.P. Koirala Institute of Health Sciences, Dharan, Nepal
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Baral N, Paudel BH, Das BKL, Aryal M, Gautam A, Lamsal M. Preparing tutors for problem-based learning: an experience from B. P. Koirala Institute of Health Sciences, Nepal. Kathmandu Univ Med J (KUMJ) 2011; 8:141-5. [PMID: 21209523 DOI: 10.3126/kumj.v8i1.3237] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND Problem based learning (PBL) has made major impact on curricular designing and practice in medical education for the last forty years. Incorporation of PBL approach in medical education has been a challenge and opportunity for both educationists on how to impart change and medical teachers on how to internalise the change. OBJECTIVES This paper aimed to investigate experiences, achievement and responses of medical teachers at B. P. Koirala Institute of Health Sciences (BPKIHS), Nepal. MATERIALS AND METHODS There were 25 heterogeneous groups of teachers, majority of them were entry level. Pre- and Post-test question were taken from various topics relevant to PBL such as learning strategy and principles of adult learning, PBL practice at BPKIHS, tutorial session and role of a tutor, making resource session interactive, designing PBL problems, planning educational objectives in PBL, formulation of problem for PBL. In addition to it participants' perception on development and dissemination of PBL manual and effectiveness of workshop were also included in the questionnaire. RESULTS There was significant gain in knowledge following the workshop (p<0.001). The perception of the teacher found quite relevant and useful for adopting new role as tutor. The respondent teachers noted that skills they learned during the training will be applicable to their job situation. They stressed for an additional training for reinforcement and update with new trends and tools in PBL. CONCLUSION Therefore, such trainings for faculty development would be highly beneficial to inculcate new competencies in PBL.
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Affiliation(s)
- N Baral
- Department of Health Professions Education, B. P. Koirala Institute of Health Sciences, Dharan, Nepal.
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Abstract
No abstract available.DOI: http://dx.doi.org/10.3126/kumj.v8i4.6229 Kathmandu Univ Med J 2010;8(4):358-9
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Subedi M, Aryal M. Public perception about drinking jar water and its bacteriological analysis. Nepal Med Coll J 2010; 12:110-114. [PMID: 21222409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
The consumption of jar water has been increasing consistently in these days. To improve such water quality and supply, information is needed to assess water contamination in a variety of community, including those that rely primarily on unimproved distributed sources of drinking water. This study was done to assess the public perception on drinking jar water and assessment of drinking jar water distributed in Kathmandu Valley which was conducted in the Department of Microbiology, Amrit Science Campus, Thamel, Kathmandu during the period of Aug 2009 to Dec 2009. A total 57 water samples of different drinking jar water having different brand names were proceed using standard protocols and analyzed for the presence of total coliforms and fecal coliforms. All identified fecal coliforms isolates from different water samples were subjected to in-vitro antimicrobial susceptibility test by Kirby-Bauer disc diffusion method. In order to know the perception of people in drinking jar water, semi structured questionnaires were made and purposively selected for the study in 525 populations who were using jar water for drinking purpose. Most population rated their drinking jar water good but found to be highly concerned with the quality. Among total water samples, 91.2% (n=52) were found contaminated with total coliforms and 59.6% were with fecal coliforms. During the study, 117 isolates of enteric bacteria were isolated, of which 33.3% (n=39) were Escherichia coli followed by other gram negative bacteria. Similarly, out of 58 fecal coliforms isolates, 43.1%, 39.6%, 12.2% were E. coli, Klebsiella spp, and Enterobacter aerogens. Of those fecal coliforms, all were sensitive to antibiotic ciprofloxacin and resistant to ampicilin. The finding indicates that jar water is not safe for drinking purpose without treatment.
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Affiliation(s)
- M Subedi
- Department of Microbiology, Amrit Science Campus, Kathmandu, Nepal.
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Gelal B, Aryal M, Das BKL, Bhatta B, Lamsal M, Baral N. Assessment of iodine nutrition status among school age children of Nepal by urinary iodine assay. Southeast Asian J Trop Med Public Health 2009; 40:538-543. [PMID: 19842441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
The present study was undertaken to evaluate the iodine status of Nepalese school age children by measuring urinary iodine excretion (UIE). A population based cross-sectional study was conducted during November-December 2006 among 1,094 school age children. Spot urine samples were collected from all children and UIE was measured during February to March 2007 by an ammonium persulfate digestion microplate (APDM) method. The median UIE at the national level was 193.10 microg/l, indicating adequate iodine intake in Nepalese schoolchildren. The proportion of the population having UIE below 50 microg/l and below 100 microg/l were 4.5% and 22.0%, respectively. Determination of precision of the method was done following calculation of the inter- and intra-assay coefficient of variation (CV). At low, medium and high concentrations of urinary iodine the intra-assay CVs were 6.3, 1.8 and 1.9%, respectively. The inter-assay CVs for low, medium and high concentrations of urinary iodine were 11.9, 4.9 and 6.2%, respectively. Therefore, current iodine nutrition status is at satisfactory levels in Nepal. An effective monitoring program must be continued to ensure optimal iodine status and prevent the population from developing iodine deficiency disorder (IDD).
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Affiliation(s)
- B Gelal
- Department of Biochemistry, B.P. Koirala Institute of Health Sciences, Dharan, Nepal
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Aryal M, Pandeya A, Gautam N, Baral N, Lamsal M, Majhi S, Chandra L, Pandit R, Das BKL. Oxidative stress in benign prostate hyperplasia. Nepal Med Coll J 2007; 9:222-224. [PMID: 18298008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Benign Prostate Hyperplasia (BPH) is the common health problem in ageing male. Free radicals and reactive oxygen species (ROS) are produced more with advancement of age leads to oxidative stress. This study aims to assess Malondialdehyde (MDA), the marker of lipid peroxidation and vitaminic antioxidants e.g. alpha-Tocopherol (Toc) and Ascorbate (Asc) status in plasma of BPH patients. This is a case control study conducted in Department of Biochemistry in collaboration with Dept of Surgery, BPKIHS. Forty eight (n = 48) confirmed patients of BPH and forty six (n = 46) healthy age matched controls were enrolled. Plasma MDA, Asc and alpha-Toc were estimated. Plasma MDA level showed 4.81 +/- 1.87 nmol/ml in BPH patients compared to 3.69 +/- 1.56 nmol/ml in healthy controls (p < 0.001). There were significant decrease in plasma alpha-Toc and Asc level which were 0.85 +/- 0.12 mg/dl and 0.93 +/- 0.13 mg/dl in BPH patients compared to 1.37 +/- 0.31 mg/dl and 1.44 +/- 0.38 mg/dl in healthy controls respectively. Inverse correlation of plasma MDA with a- Toc (r = -0.09) and Asc (r = -0.51) was found in BPH patients. There was mild elevation of PSA in BPH patients compared with control but was not statistically significant. Thus, our study showed the evidence of association of oxidative stress in BPH patients.
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Affiliation(s)
- M Aryal
- Department of Biochemistry, B.P. Koirala Institute of Health Science, Dharan, Nepal.
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Baral N, Paudel BH, Das BKL, Aryal M, Das BP, Jha N, Lamsal M. An evaluation of training of teachers in medical education in four medical schools of Nepal. Nepal Med Coll J 2007; 9:157-161. [PMID: 18092430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Effective teaching is a concern of all teachers. Therefore, regular teachers' training is emphasized globally. B. P. Koirala Institute of Health Sciences (BPKIHS), a health science deemed university situated in eastern region of Nepal has an established Medical Education unit which attempts to improve teaching-learning skills by training faculty members through organizing regular medical education training programs. The aim of the present study was to assess the effectiveness of 3-day training workshop on "Teaching-learning methodology and Evaluation" held in four different medical colleges of Nepal. The workshop was targeted at middle and entry level of health profession teachers who had not been previously exposed to any teacher's training program. The various components, such as teaching-learning principles, writing educational objectives, organizing and sequencing education materials, teaching-learning methods, microteaching and assessment techniques, were incorporated in the workshop. A team of resource persons from BPKIHS were involved in all the four medical institutions. The collection data had two categories of responses: (1) a questionnaire survey of participants at the beginning and end of the workshop to determine their gain in knowledge and (2) a semi-structured questionnaire survey of participants at the end of workshop to evaluate their perception on usefulness of the workshop. The later category had items with three-point likert scale (very useful, useful and not useful) and responses to open-ended questions/ statements to document participants general views. The response was entered into a spreadsheet and analyzed using SPSS. The result showed that all participants (n = 92) improved their scores after attending the workshop (p < 0.001). Majority of respondents expressed that the teaching-learning methods, media, microteaching and evaluation techniques were useful in teaching-learning. The workshop was perceived as an acceptable way of acquiring teaching-learning skills but 39.4% participants expressed that the duration of the workshop was too short. The overall impression about trainers was very positive. Therefore, regular organization of such workshops with addition of new advances in medical education would be highly beneficial to improve teaching learning skill of medical teachers.
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Affiliation(s)
- Nirmal Baral
- Department of Health Professions Education, B. P. Koirala Institute of Health Sciences, Dharan, Nepal.
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Aryal M, Pandeya A, Bas BK, Lamsal M, Majhi S, Pandit R, Agrawal CS, Gautam N, Baral N. Oxidative stress in patients with benign prostate hyperplasia. JNMA J Nepal Med Assoc 2007; 46:103-106. [PMID: 18274564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023] Open
Abstract
Benign Prostate Hyperplasia (BPH) is a common health problem in aging male. Free radicals and Reactive Oxygen Species (ROS) are produced in overwhelming quantity with advancement of age. When in oxidative stress, these reactive species cause extensive damage to various organ in the body, may be associated with pathogenesis of BPH also. This study aimed at assessing Malondialdehyde (MDA), the marker of lipid peroxidation and anti-oxidants e.g. alpha-Tocopherol and Ascorbate status in plasma in BPH patients. Forty eight (n=48) cases of BPH and forty six (n = 46) healthy age matched controls were enrolled. Plasma MDA level showed 4.81+/-1.87 nmol/ml in cases compared to 3.69+/-1.56 nmol/ml in healthy controls (p<0.001). There were significant decrease in plasma alpha-Tocopherol and ascorbate level which were 0.85+/-0.12 mg/dl and 0.93 +/- 0.13 mg/dl in cases compared to 1.37+/-0.31 mg/dl and 1.44+/-0.38 mg/dl in healthy controls respectively. Inverse correlation of plasma MDA with alpha-Tocopherol (r = -0.09, p>0.05) and Ascorbate (r =-0.51, p=0.008) was found in BPH patients. There was mild elevation of PSA in BPH patients compared with control but was not statistically significant. Thus, our study showed the evidence of association of oxidative stress in BPH patients.
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Affiliation(s)
- M Aryal
- Department of Biochemistry, B P Koirala Institute of Health Sciences, Dharan, Nepal
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Gautam N, Aryal M, Bhatta N, Bhattacharya SK, Baral N, Lamsal M. Comparative study of cerebrospinal fluid adenosine deaminase activity in patients with meningitis. Nepal Med Coll J 2007; 9:104-6. [PMID: 17899959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
Cerebrospinal fluid (CSF) adenosine deaminase (ADA) activity in tubercular meningitis (TBM) patients (n=20), non-tubercular meningitis (NTBM) patients (n=10) and non-tubercular non-meningitis (NTBNM) cases (n=15) were measured by the method based on Berthlot's reaction. The mean CSF ADA activity in TBM (13.62 +/- 8.45 IU/L) was found to be significantly higher as compared to NTBM (6.51 +/- 2.41 IU/ L, p<0.001) and NTBNM (2.35 +/- 1.16 IU/L, p<0.0001) respectively. The sensitivity and specificity of CSF ADA activity was 85.0% and 88.0% respectively at cut-off value of 6.97 IU/L to diagnose tubercular meningitis. The specificity and sensitivity of CSF ADA for TBM was found to be 85.0% and 70.0% as compared to NTBM and 85.0% and 100.0% as compared to NTBNM. We propose that estimation of that ADA activity in CSF of TBM patients, using a cut off value 6.97 IU/L can diagnose differentially tubercular meningitis. Since, most developing countries have the dubious distinction of having higher prevalence and incidence of tubeculosis and lack of well equipped laboratory services for proper diagnosis of tubercular meningitis, measurement of CSF ADA activity can be a better and reliable approach for the rapid diagnosis and management of tubercular meningitis vis a vis other types of meningitis.
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Affiliation(s)
- Narayan Gautam
- Department of Biochemistry, Universal College of Medical Sciences Paklihawa Campus, Bhairahawa, Lumbini Zone, Nepal.
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Aryal M, Jha B. Assessment of proteinuria as a marker of nephropathy in type 2 diabetes mellitus. Nepal Med Coll J 2006; 8:250-3. [PMID: 17357643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
This is a cross sectional hospital based study carried out at Om Hospital and Research Center Kathmandu, Nepal. In the study, 200 diabetic patients attending the hospital were taken as the subjects and we evaluated the urinary albumin excretion and other biochemical parameters (such as creatinine, total cholesterol, HDL cholesterol, LDL cholesterol), blood pressure and body mass index (BMI). Among these 200 patients with type 2 diabetes mellitus (DM), 52.0% were having high blood pressure. The proteinuria was present in 23.0% of the overall subjects but when it is categorized in hypertensive and non-hypertensive group, 30.7% of the diabetic patients with hypertension were having proteinuria. It has been found that males were having higher prevalence ofproteinuria (53.8%) than female (17.6%). There was significant difference in systolic blood pressure, diastolic blood pressure in nephropathy and without nephropathy group. Thus the nephropathy or the incidence of proteinuria was associated with obesity, high diastolic blood pressure and male sex. These data suggest that control of diabetes; hypertension should decrease the risk for proteinuria thus decreasing end stage renal disease (ESRD) and mortality from ESRD.
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Affiliation(s)
- Madhukar Aryal
- Department of Biochemistry, BP. Koirala Institute of Health Science, Dharan, Nepal.
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Aryal M, Everett AE. Gravitational effects of global strings. Phys Rev D Part Fields 1986; 33:333-337. [PMID: 9956624 DOI: 10.1103/physrevd.33.333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
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