Browsing by Author "Joshi, B"
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Publication Burden of Stroke in Nepal: Findings from Global Burden of Disease Dataset 2017(Kathmandu University, 2021) Pyakurel, M; Bhattarai, S; Joshi, B; Koju, RP; Shrestha, AABSTRACT Background Stroke is the second leading cause of death and disability worldwide including Asian countries, surpassing ischemic heart disease. Stroke accounts for 10% of global death, of which more than three fourth occur in low- and middle-income countries. An exact estimate of the burden of stroke in Nepal is not available. Objective To assess the burden of stroke including disability and death over time in Nepal and compare it with other South Asian countries. Method We retrieved data from the Institute of Health Metrics and Evaluation’s Global Burden of Diseases database of 2017 on stroke deaths, disability-adjusted life years, incidence, and prevalence rates, for both genders from Nepal, Bangladesh, Pakistan, Bhutan, and India by year. We assessed the trend of deaths and Disability-Adjusted Life Years (DALYs) due to stroke from 1990 to 2017; and the contribution of major risk factors to stroke burden in 2017. Result Stroke contributed 7.6% of total deaths and 3.5% of total DALYs in Nepal, with a higher burden among the male and old age population. Intracerebral hemorrhage was the dominant type of stroke in Nepal with the highest proportion of deaths and DALYs. Among the South Asian countries, incidence, prevalence, and burden of stroke were highest in Bangladesh. Intracerebral hemorrhage contributed the highest DALYs in South Asian countries. High systolic blood pressure was contributing the maximum DALYs due to stroke in Nepal. Conclusion Hemorrhagic stroke causes high mortality and DALYs in Nepal. Most of the burden of stroke is attributed to high blood pressure in Nepal. KEY WORDS Global burden of disease (GBD), Nepal, Prevalence, Risk factor, StrokePublication Neurophysiology of Mindfulness Meditation: A Narrative Review Based on Buddhist Perspective(Kathmandu University, 2025) Joshi, B; Jha, JP; Karn, A; Shrestha, LABSTRACT Meditation, an inward journey to explore profound levels of consciousness rooted in Buddhism, has significant physical and psychological benefits, including enhanced well-being, improved concentration, emotional stability, and positive cognitive shifts. This narrative review consolidates past two decades of research on the neurophysiological effects of Buddhist mindfulness meditation based on neuroimaging findings, and aims to examine the Buddhist view of mindfulness meditation in relation to the structural and functional changes in the brain areas in health and diseases. Meditation practices, such as Vipassana in Buddhism, emphasize mindfulness and non-judgmental awareness of oneself and surrounding. Neuroimaging studies have revealed its significant impact on brain regions including structural changes involving anterior cingulate cortex (ACC), temporal lobe, insula, hippocampus, amygdala, thalamus and other areas. Four fundamental mechanisms summarize the mindfulness meditation: attention regulation, body awareness, emotion regulation, and a transformed self- perspective. The scientific explanation of effects of meditation is challenging, and we are only beginning to understand in neurophysiological terms. Previous research on mindfulness meditation has employed diverse methodological approaches, including self-reported measures, behavioral tasks and neuroimaging techniques; but there lacks a standardization, making it difficult to compare the findings. However, the cognitive processes are thought to underlie the potential benefits of mindfulness meditation in promoting mental well-being on an individual and societal level. This review highlights the mechanisms of mindfulness meditation to improve cognitive flexibility and promote mental well-being, in relation to Buddhist philosophy, with implications for individual and societal benefits. KEY WORDS Buddhism, Cognition, Consciousness, Meditation, Mindfulness, Neurophysiology