Bir Hospital

Early best available antibiotic therapy for multidrug-resistant gram-negative bloodstream infections: a target trial emulation

Background The effect of timely appropriate antibiotics in multidrug-resistant Gram-negative bacteria (MDR-GNB) bloodstream infections (BSIs) remains uncertain. Robust evidence is needed to inform diagnostic and treatment strategies, especially across settings with high antimicro...

Strengthening Childhood Cancer Care in Nepal (DECAN-CHILD): Protocol for Evaluating Quality, Financial Burden and Health System Readiness Through a Prospective Cohort Study

Background Strengthening health systems in low-and middle-income countries (LMICs) like Nepal is essential for equitable, high-quality diagnosis and treatment and improved survival from childhood cancer. This study aims to quantify care intervals and their determinants; assess th...

Massive Pericardial Effusion as a Manifestation of Severe Autoimmune Hypothyroidism in an Adolescent With Down Syndrome: Importance of Early Recognition and Thyroid Hormone Replacement

ABSTRACT The clinical features of severe hypothyroidism may overlap with those of Down syndrome, delaying diagnosis until complications such as myxedema crisis and massive pericardial effusion develop. Regular thyroid function screening is essential, and hypothyroidism‐associated...

Incidentalomas in Gastroenterology and Hepatology: A Narrative Review of Guideline‐Based Management, Ethical Considerations, and a Proposed Framework for Practice

ABSTRACT Background and Aim Major advancements in medical imaging have led to higher rates of detection of incidental findings unrelated to the presenting complaint, termed incidentalomas. Despite their rising prevalence in gastroenterology and hepatology, there is a paucity of u...

Rutin-magnesium complex promotes cranial bone defect repair via coordinated osteogenic and angiogenic regulation

Critical-size bone defects remain a major clinical challenge, as the current regenerative strategies such as bone grafts, biomaterials, and exogenous cells still have limitations. Emerging evidence suggests that focusing local cells and enhancing their osteogenic and angiogenic a...

Nutcracker syndrome with pelvic congestion syndrome: A case report

Nutcracker syndrome is a rare clinical entity characterized by external compression of left renal vein (LRV) disturbing the outflow of blood into inferior venacava. We present a case of a 35-year-old female who presented to gynecology outpatient department (OPD) with abdominal pa...

Potash alum-induced chemical vaginitis masquerading as vulvovaginal malignancy: a case report on the perils of digital health misinformation

Abstract Background Vaginal discharge is a common gynecological complaint among women of reproductive age in low- and middle-income countries, including Nepal. However, formal healthcare utilization remains low due to stigma and access barriers. This creates conditions favorable...

Self-reported aggressiveness does not follow facial masculinization in diverse South Asian populations

Abstract It has been suggested that sexually dimorphic facial traits are related to competitive behavior and aggression, but empirical evidence remains inconsistent and is based on a small number of populations and culturally homogeneous samples. We have combined geometric morpho...

Effects of ketone supplementation on metabolic and hormonal profiles in polycystic ovary syndrome

Background: Polycystic ovary syndrome (PCOS) is a common endocrine disorder characterized by metabolic dysfunction, hyperandrogenism, and reproductive hormone imbalance. This meta-analysis aimed to evaluate the effects of ketone supplementation on anthropometric, metabolic, and h...