Eight selected wild vegetables from Nepal (Alternanthera sessilis, Basella alba, Cassia tora, Digera muricata, Ipomoea aquatica, Leucas cephalotes, Portulaca oleracea and Solanum nigrum) were investigated for their antioxidative potential using 2,2-dyphenyl-1-picrylhydrazyl (DPPH) scavenging, hydrogen peroxide (H2O2), ferric reducing antioxidant power (FRAP), and ferric thiocyanate (FTC) methods. Among the selected plant extracts C. tora displayed the highest DPPH radical scavenging activity with an IC50 value 9.898 μg/mL, whereas A. sessilis had the maximum H2O2 scavenging activity with an IC50 value 16.25 μg/mL—very close to that of ascorbic acid (16.26 μg/mL). C. tora showed the highest absorbance in the FRAP assay and the lowest lipid peroxidation in the FTC assay. A methanol extract of A. sessilis resulted in the greatest phenolic content (292.65 ± 0.42 mg gallic acid equivalent (GAE)/g) measured by the Folin–Ciocalteu reagent method, while the smallest content was recorded for B. alba (72.66 ± 0.46 GAE/g). The greatest flavonoid content was observed with extracts of P. oleracea (39.38 ± 0.57 mg quercetin equivalents (QE)/g) as measured by an aluminium chloride colorimetric method, while the least was recorded for I. aquatica (6.61 ± 0.42 QE/g). There was a strong correlation between antioxidant activity with total phenolic (DPPH, R2 = 0.75; H2O2, R2 = 0.71) and total flavonoid content (DPPH, R2 = 0.84; H2O2, R2 = 0.66). This study demonstrates that these wild edible leafy plants could be a potential source of natural antioxidants.

Coronavirus disease 2019 (COVID-19) is an infectious disease caused by a new species of β-coronavirus genus named severe acute respiratory syndrome coronavirus 2. The COVID-19 pandemic, which started in late 2019 and continues as at mid-2021, has caused enormous damage to health and lives globally. The urgent public health need has led to the development of vaccines against COVID-19 in record-breaking time. The COVID-19 vaccines have been widely rolled out for the masses by many countries following approval for emergency use by the World Health Organization and regulatory agencies in many countries. In addition, several COVID-19 vaccine candidates are undergoing clinical trials. However, myths, fears, rumors, and misconceptions persist, particularly in regard to adverse events. In this commentary, we describe the adverse events associated with COVID-19 vaccines and discuss why it is essential to have a functional adverse event monitoring system in this context.

Background: Underreporting of adverse drug reactions (ADRs) is common globally, and Nepal is not an exception to this. Health-care professionals (HCPs) play a vital role in reporting ADR during routine practice. Lack of knowledge and awareness about pharmacovigilance and reporting ADRs among HCPs may contribute to underreporting. Objective: The objective of this study was to evaluate the knowledge and perception of HCPs regarding ADR reporting and pharmacovigilance in a tertiary care teaching hospital in, Nepal. Methods: A descriptive cross-sectional study was conducted. A questionnaire was distributed to 215 HCPs (medical doctors, nurses, and pharmacists) between March and September 2018. Knowledge and perception regarding ADR reporting and pharmacovigilance were studied. Data were analyzed using IBM SPSS Statistics for Windows, Version 21.0 (IBM Corp, Armonk, New York). Results: The HCPs included 75 medical doctors, 126 nurses, and 14 pharmacists. Majority of the participants were female (67%), and the majority of participants were not aware of pharmacovigilance. Among the participants, pharmacists were found to have better knowledge regarding pharmacovigilance. However, other HCPs (doctors and nurses) strongly agreed about the necessity of having adequate knowledge about pharmacovigilance. Out of 215, 57.7% agreed that the important benefit of reporting ADR was to identify safe drugs and improve patient safety. The main reasons for not reporting were – ADR reporting was not widely promoted by relevant authorities (47%), followed by not knowing where and how to report ADR (34.9%). However, other HCPs (doctors and nurses) strongly agreed about the necessity of having adequate knowledge about pharmacovigilance. Conclusions: The knowledge of HCPs on ADR reporting and pharmacovigilance was poor. Despite a low knowledge of ADR reporting and pharmacovigilance among HCPs, there was a positive perception that ADR reporting is necessary and ADR monitoring system should be established in the hospital. This study also highlights a need for future intervention studies focusing on educating HCPs about ADR and pharmacovigilance.

Introduction: Community pharmacy services are an integral part of the healthcare system directly involved in providing safe and effective patient care services. Despite the beneficial role of the community pharmacist, limited research focusing on their roles and responsibilities have been conducted. Thus, a bibliometric study was carried out to give a bibliometric overview of publications on community pharmacy in Nepal. Method: This is a bibliometric review of published literature of articles on community pharmacy in Nepal. The extensive literature search was carried out using PubMed, Google Scholar, NepJol as the sources of data. The community-based articles published from January 1, 1992, up to December 31, 2018, were retrieved. The keywords or medical subject headings (MeSH) terms, such as “Community Pharmacy”, “Community Pharmacist”, “Community Pharmacies”, “Community Pharmaceutical Services”, “Community Pharmaceutical Service”, "Private Pharmacy" and "Retail Pharmacy" were used.  Nepal was entered as a country affiliation. Result: A total of forty-seven articles were retrieved, of which 87.5% (N=47) were based on original research papers. The maximum number of an article published in a single year was 17.02% (The majority [8 (17.02%]) of articles were published in 2016. The average number of authors per article was 4.65 with a standard deviation of 2.33. These articles were published in 38 journals, of which 10 articles were published in the journal without the impact factor or Scimago Journal and Country Rank. Conclusion: Scientific publications from community pharmacy settings are scant in Nepal. Hence, more analytical research work should be carried out to enhance the community pharmacy services and to promote the quality use of medicines in Nepalese society.

Background: Bibliometric analyses have been used previously to study the measures of quality and impact of research performed in several health-related areas such as adverse drug reactions (ADRs) and pharmacovigilance (PV), etc. This method can assess the research performance of publications quantitatively and statistically. There is no evidence of bibilometric studies analyzing ADRs and PV from Nepal. Therefore, the present study aimed to assess scientific output on ADRs and PV-related research activities in Nepal using a bibliometric analysis of publications from 2004 January to December 2018, that is, 15 years. Methods: A systematic search was conducted in PubMed, Web of Science, Google Scholar, Scopus and Nepal Journal Online (NepJOL) databases. ‘Adverse Drug Reactions‘ or ‘ADRs‘ or ‘ADR‘ or ‘Adverse drug reaction‘ or ‘AE‘ or ‘Adverse Event‘ or ‘Drug-Induced Reaction‘ or ‘Pharmacovigilance‘ or ‘PV‘ and ‘Nepal‘. The search covered 15 years (January 2004 to December 2018) of study on ADRs and PV in Nepal. Only articles retrieved from databases were included, whereas published/unpublished drug bulletins, pharmacy newsletters and thesis were excluded. The articles thus retrieved were recorded, and thereafter analyzed. Word count code was used for the analysis of keywords used in the retrieved articles. Results: A total of 124 articles were retrieved, with the highest rate of publications in 2006 and 2007, with 16 papers each. Among the articles, 10 (8.1%) were published in Kathmandu University Medical Journal (KUMJ). Single papers were published in 38 different journals. Brief reports (1.6%), case reports (31.2%), case series (0.8%), education forums (0.8%), letters to the editor (5.6%), original research articles (41.9%), review articles (9.7%), short communications and short reports (8.1%) on ADRs and PV were recorded. Out of 124 papers, 52 (41.9%) were original research publications. The majority (74.1%) of research was done in the category of ADR incidence, types, prevention, and management, followed by policy and suggestions for strengthening national and regional pharmacovigilance centers of Nepal (14.5%). Conclusions: During the study years, there was an increase in scientific publications on drug safety. A total of 124 published articles were found during bibliometric analysis of ADRs and PV research activities in Nepal.

A one-day workshop on proposal writing for research for health care professionals was organized by Hospital Research Board (HRB), Nepal Cancer Hospital and Research Center Pvt. Ltd, Harisiddhi, Lalitpur, Nepal on 2nd March 2019. The main aim of this workshop was to identify, motivate and prepare health care professionals for conducting research in their respective professional institution in collaboration. The workshop was facilitated by international and national resource persons. The deliberations of the workshop were focused on seven topics: “Turning research into impact, Essentials of the research protocol, Why proposals are rejected?, Plagiarism in medical research, Research with medical records, Grant writing workshop, Manuscript writing workshop” based on a presentation by the different resource persons. Ninety-nine persons participated in the workshop including physicians, medical oncologists, pharmacists, nurses and other allied health professionals. The interactive teaching-learning methods were utilized in all sessions of the workshop. The feedback of the participants was taken on semi-structured feedback format. Overall evaluations from the feedback forms showed that majority (90%) of the participants agreed that the workshop achieved its objectives with a major recommendation as to the allocation of short duration for the workshop and timely organize of research activities regarding scientific writing. In conclusion, the workshop on research proposal writing for health care professionals was successfully organized and the participants are looking forward for future ones.

Traditional herbal medicine is widely used globally. Despite its extensive use, there are no proper regulations on standardization and use of herbal medicinal products. Nepal has a rich biodiversity and demography comprising of different socio-ethnic groups. Herbal medicines are utilized prominently in Nepalese communities. These herbal products may cause side effects and adverse effects, such as nephrotoxicity, neurotoxicity with the heavy metal toxicity associated with their powdered dosage forms. The side effects of using herbal products have been documented, such as bleeding with use of Ginkgo biloba and increase in blood pressure with use of Ephedra. Regulation of herbal products is essential to promote their optimal and rational use. Standard tools are available for assessing adverse effects of herbal products from health authorities, like the World Health Organization. In Nepal, self-medication practice using traditional herbal medicines is common and includes the concomitant use of allopathic. There is no focal point to address the regulatory issues on herbal products currently in Nepal. The Department of Drug Administration in Nepal is nominated as a national pharmacovigilance center and there are no reports on adverse events from the use of herbal medicines so far. However, not having any reports does not ensure the absolute safety and effectiveness of herbal products, so vigilance is warranted. Herbal pharmacovigilance is needed for Nepal to ensure safe and effective use of herbal medicines as the current pharmacovigilance ecosystem does not capture those cases. In the Nepalese context, the absence of reporting mechanisms may have underreported adverse cases of herbal products. The present opinion article aims to discuss the use of herbal products in Nepal, the challenges associated with the adverse reaction due to herbal medicines, and recommendations to overcome these challenges

Background: The role of pharmacists in many developed countries has evolved from the traditional practice of dispensing medicines to contributing directly or indirectly to improve patient health outcomes. They are providing hospital services and patient care including services in the emergency department (ED). However, there is limited evidence for pharmacist involvement in the ED from resource-limited countries such as Nepal. Objective: The aim of this study is to discuss the role of pharmacists and highlight the unmet need of pharmacists in ED in Nepal. Methods: A narrative review of existing literature was conducted. Results: The status of ED services in Nepalese hospitals is not yet at a desirable level, and there is limited information about the role of pharmacists in EDs. Evidence obtained from developed nations on the role of pharmacists in EDs suggests that they help in improving patient outcomes by minimizing medication errors, adverse drug reactions, and enhance patient care. Conclusion: The study highlights the need for pharmacists in EDs in resource-limited settings. There is limited evidence of pharmacists’ role in EDs from Nepal. Therefore, this study suggests a need for further studies on the possible contribution of pharmacists to ED services in Nepal.