bluuebunny/crossref_metadata_2025 huggingface dataset:
The Role of Environmentally Responsible Interior Design in Healthcare for Enhanced Patient Well-being
Authors: Bayır Esra
Published: April 2024

While the healthcare industry is struggling with environmental impacts, it is also trying to bring together holistic design practices to create sustainable, patient-centered and ecologically responsible, energy-efficient healthcare areas. With the increase in studies focusing on the positive effects of the ecological design approach on the well-being and recovery processes of patients, the integration of green elements into healthcare structures becomes even more important. Integration of environmentally responsible design (ERD) principles into hospital interior design; It contributes significantly to reducing carbon emissions, resource consumption and environmental waste. At the same time; by optimizing energy-efficient systems, adopting sustainable materials, and creating patient-centered healing spaces by utilizing natural light and natural ventilation, it can be both contributed to the treatment process and reduce carbon footprints. This study proposes a new approach that integrates ERD elements with healthcare interior design. Recognizing that the built environment and human health are interconnected, the research examines innovative design strategies to promote healing through environmentally responsible interior design (ERID). The focus of this approach is on combining ERD strategies such as healing design, patient-centered design, evidence-based design and the use of sustainable materials, daylight, natural ventilation, energy-efficient design, sustainable design, biophilic design. As a result of this integration, by drawing attention to the role that patient-centered green interior designs play in improving the health and well-being of patients and the efforts to minimize the negative effects of hospitals on the environment. Also, it is aimed to encourage the health and construction sectors in this sense and proposed a path towards a green future.
Beneficios, efectos negativos y rol del profesional de enfermería en la cirugía bariátrica
Authors: Fuentealba Leyton Roberto Antonio , Noack Segovia Jessica Pamela , Chávez Vergara Viviana Andrea , Galeano Méndez Antonia Alejandra
Published: April 2024

Objetivo: Describir evidencias de los beneficios, efectos negativos y rol del profesional de enfermería en la cirugía bariátrica. Desarrollo: La obesidad ha alcanzado niveles preocupantes en Chile, siendo un desafío de salud pública. La cirugía bariátrica emerge como una intervención crucial para pacientes con obesidad que no obtienen resultados con enfoques convencionales. Aunque se evidencian beneficios notables en personas que optan por este procedimiento quirúrgico, también existen riesgos y efectos negativos en aspectos físicos, psicológicos y sociales. La relación inicialmente positiva entre la cirugía bariátrica y la calidad de vida puede volverse desfavorable debido a la falta de adherencia a recomendaciones postoperatorias. Los profesionales de enfermería juegan un importante rol en la preparación y seguimiento de los pacientes sometidos a cirugía bariátrica, proporcionando educación y apoyo emocional. La evaluación exhaustiva pre y postoperatoria es crucial, reconociendo la contribución de estos profesionales en el cuidado integral de estos pacientes. Conclusiones: La cirugía bariátrica no debe considerarse como una solución aislada, sino como parte de un enfoque multidisciplinario que incluya cambios en el estilo de vida. Es fundamental promover la colaboración entre profesionales de la salud, destacando el rol significativo de los profesionales de enfermería en mejorar los resultados y la calidad de vida de pacientes con obesidad sometidos a esta intervención.
ASPIRATION PICTURE AND CLIMATE ADAPTATION: HOUSEHOLDS’ INCREMENTAL STRATEGIES IN CLIMATE-RESILIENT HOUSING IN RURAL COASTAL BANGLADESH
Authors: Mallick Jati , Shahriar Abu Towab Md. , Rashid A.K. M. Mamunur , Munira Sirazoom
Published: April 2024

While housing is a critical component of incremental climate change adaptation, identified by the Intergovernmental Panel on Climate Change (IPCC), climate resilient housing implementation is widely focused on the module's safety and modularity, ignoring the beneficiaries' social adaption process underscored by incremental housing ideas. The study explores the incremental adaptation strategies employed by households in climate-vulnerable rural coastal Bangladesh to understand the complex adaptation attitudes of households in social or climate adaptation. The study uses a case study approach with qualitative methods encompassing household interviews, focus group discussions, and in-depth observation on 10 self-built homesteads, 10 Government of Bangladesh (GoB) provided, and 10 United Nations Development Program (UNDP) provided housing modules at Koyra, Khulna. The study observes that households adopt distinct adaptation strategies depending on sittings, roofs, walls, foundations, bedrooms, kitchens, and toilets of modules, which are prone to climate exposure and sensitivity. Therefore, households tackle the delicate complexity of the aspiration picture and social and climate adaptation when the residential situation is coupled with climate vulnerabilities. The study finds that the incomplete nature of a module allows for more aspiration achievement, while a more complete module leads to aspiration adjustments by changing attitudes toward the aspiration picture. This study underscores that in the design of climate-resilient housing modules, it is essential to consider a minimalist approach that can produce more robust climate-resilient homesteads while offering better opportunities for household engagement to enhance knowledge for building back better and safer.
Circular Mounds and Sweat Lodges in the Greater Cahokia Region
Authors: Pauketat Timothy R. , McCullough Robert G. , Alt Susan M. , Kruchten Jeffery D. , Wilson Carrie V. , Farkas Michael G. , Bandy Brandon “Everett” , Malouchos Elizabeth Watts , Buchanan Meghan E.
Published: April 2024

New archaeological and geophysical evidence from the Greater Cahokia region affirms that so-called conical mounds of the Mississippian era were, in fact, flat-topped circular platforms. Historical accounts indicate that such mounds were numerous across the region and were topped by or associated with circular sweat lodges and rotundas and paired with rectangular structures and mounds built in rows or connected by earthen causeways. Our geophysical results include detecting the foundation of a rebuilt circular structure on the southeastern extension of Monks Mound in alignment with the Rattlesnake Causeway and an actual conical Woodland mound on the river bluffs to the south. Additional circular mounds and submound or mound-summit architecture are confirmed elsewhere at Cahokia and at the Pfeffer and Emerald sites.
Evaluation of the Wound-Healing Activity and Apoptotic Induction of New Quinazolinone Derivatives
Authors: Oleiwi Mohammed Abdulameer , Zalzala Munaf Hashim , Khudhair Alaa Radhi , Hadi Mohammed Kamil , Abdulazeez Zahraa Duraid
Published: April 2024

Background: Chemotherapeutic medication treatment for cancer is typically used in conjunction with other techniques as part of a routine regimen. It is well established that the capacity of different chemotherapeutic drugs to induce apoptosis is correlated with their anticancer efficacy. Quinazolinone-based drugs have demonstrated excellent responses from several cancer cell types. These substances have a lot of potential for use as building blocks in the creation of apoptosis inducers. Objective: To assess the new quinazolinone derivatives (M1 and M2) that were recently synthesized for their potential to halt wound healing and to use the acridine orange/propidium iodide (AO/PI) double stain to assess their capacity to induce apoptosis in the chosen cancer cell lines. Methods: Using the breast carcinoma cell line (MCF-7) and the lung adenocarcinoma cell line (A549), two quinazolinone derivatives (M1 and M2) were investigated for their capacity to inhibit wound healing and induce apoptosis. Results: In both cell lines, the chemicals were found to be effective inducers of apoptosis and to considerably limit wound healing. Conclusions: In cancer cell lines (MCF-7 and A549), compounds M1 and M2 efficiently inhibited wound repair and triggered apoptosis.
أفعل الفضيل في اللغات: السامية والعربية دراسة مقارنة. السور المكية في القران الكريم أنموذجا
Authors: الطــوالبــة علي أحمــد عيفان , الخمايسة وعلي زعل محمود
Published: April 2024

يهدفُ البحثُ إلى دراسةِ " أفعل التّفضيل" دراسةً صرفيّةً دلالية في أشهر اللغات السّاميّة واللغة العربيّة، من حيث: تعريفه، وشروط صياغته، والأنماط التي يأتي عليها، ثُمَّ الوقوف على المعاني الدِّلاليَّة له في سِياق الآياتِ المكّيّة؛ حيثُ استنتجَ الباحثان بعضَ المعاني الدِّلاليّة متبعين المنهجِ الاستقصائي المبني على أدلّةٍ مستنبطةٍ من مظان كتب التّفسير وشروحها. كما تمّت الإشارةُ إلى صيغة التّفضيل في بعض اللغات الساميّة، في محاولةٍ لإيجاد مقاربة بين اللغات السامية والعربية؛ حيثُ قام الباحثان بدارسةِ صيغة "أفعل التَّفضيل" في بعضِ اللغات السَّاميَّة من حيث: اهتمام علماء اللغة العربية، والمستعربين الأوائل بربط بعض موضوعات الصَّرف العربي بموضوعات الصَّرف في اللغات السّاميّة، ويتضّمنُ البحثُ – أيضًا - دراسة الصياغة الاشتقاقيّة لأفعل التَّفضيل، ودلالاته،  ووظيفته النّحويّة في سياقات من اللغات السَّاميَّة. يعرضَ البحثُ بإيجازٍ نماذجَ من الدّراسات السّابقة، التي اعتنتْ بدراسةِ بعض الموضوعات الصّرفيّةِ في القرآنِ الكريم: كاسمِ الفاعلِ، وصِيَغِ الجموع، وصيغ المبالغة، واسم التفضيل..، ويُختتم البحث بالنتائج، لعلّ أهمَّها تفسيرُ سببِ كثرةِ دوران "أفعل التفضيل" في السِّياقِ القرآني المكّي.
The impact of the compulsory cash reserve on generating money in Jordanian conventional and Islamic banks on the money supply, an analytical study from the period (2011-2020)
Authors: Bani Salman "Mohammad Amin" , ALsaad Ahmad
Published: April 2024

The study objectives are to know the concept of the compulsory cash reserve and the money supply, and to clarify the concept of conventional and Islamic banks and their reality in Jordan and the extent of their ability to generate money, and to show the impact of the compulsory cash reserve in generating money and money supply, this is through a presentation of the statistical analysis models for the independent study variables represented in the cash reserve and the factors affecting it, and the extent of its impact on the dependent variable represented in the money supply.
The study included three sections, the first section dealt with the cash reserve and the money supply and the relationship between them, the second topic dealt with the role of the cash reserve in generating money in Islamic and conventional banks, and the third topic: the study methodology and statistical analysis.
The study concluded that the compulsory cash reserve policy works to limit the ability of Islamic banks to generate money compared to usurious banks, and this is due to the commodity nature of the financing formulas practiced by Islamic banks, which makes the amount of money creation and credit expansion linked to production, which helps them to achieve The balance between the commodity current and the monetary current. While the study concluded that the policy of the compulsory reserve works to reduce the money supply in the event of an increase in the percentage of the compulsory reserve and to increase the money supply in the event of a decrease in the percentage of the compulsory reserve.
The study recommended a set of recommendations, the most important of which is that an alternative monetary policy must be found to the monetary reserve policy, especially in Islamic banks, because it is completely different for commercial banks.
القدس في فكر الملك الحسين بن طلال 1952-1998 "دراسة من خلال كتاب النطق السامي"
Authors: خصاونه أسماء
Published: April 2024

حظيت مدينة القدس الشريف باهتمام ورعاية الهاشمين منذ عهد الشريف الحسين بن علي ، وقد أولى الملك الحسين بن طلال عناية خاصة للقدس والمقدسات الإسلامية منذ تسلمه سلطاته الدستورية عام 1953م، واحتلت القدس مكانة خاصة في قلب ووجدان الحسين، وكان الحسين الأكثر حديثاً عن القدس والمقدسات الإسلامية في كل من خطاباته وأحاديثه ومقالاته ومقابلاته الصحيفة والرسائل سواء كانت داخلية موجهة للشعب الأردني او خارجية على المستوى العربي او الدولي بشكل عام ، والتي تم جمعها في كتاب " النطق السامي 1952-1988 لجلالة الملك الحسين بن طلال المعظم حول شؤون القدس الشريف والمقدسات، وتأتي أهمية هذا الكتاب انه اختص فقط بالقدس والمقدسات الإسلامية  في فكر الملك الحسين طوال فترة حكمه لان القدس من أهم محاور تاريخ الصراع العربي الاسرائيلي . في حين نجد أن غالبية الكتب الأخرى تحدثت عن القدس من ضمن الحديث القضية الفلسطينية كاملة
Honorary Doctorate Prof. Dr. Karl-Henrik Robèrt
Authors: Robère Karl-Henrik , van Krieken Han
Published: April 2024

On 15 October 2020, in the middle of the COVID-19 pandemic, Prof. Dr. Karl-Henrik Robèrt received a Radboud honorary doctorate in recognition of his work on strategic sustainable development. This edition includes honorary promotor Han van Krieken’s laudatio, Karl-Henrik Robèrt’s acceptance speech, and a detailed recollection of his professional history. Trained as an oncologist, Dr. Karl-Henrik Robèrt became aware in the last decades of the twentieth century that air and water pollution in the environment were responsible for several types of cancer. It became his goal to make people aware of the environmental problems and to achieve a more sustainable society. In 1989, he founded 'The Natural Step', an organisation that developed the Framework for Strategic Sustainable Development, for which Robèrt received in 2000 the Blue Planet Prize - the 'Nobel Prize' for sustainability. Honorary promotor Han van Krieken: “It is for a variety of reasons that Radboud University wants to honour Professor Karl-Henrik Robèrt. Our university’s new Strategic Plan defines explicitly our ‘responsibility for the world in which we live’. It states as one of our goals that ‘we want to be in the vanguard when it comes to achieving the United Nations’ sustainable development goals and to make our own contribution to the changes needed in the world in the coming decades’. Professor Robèrt can show us ways in which we can translate these goals more effectively.”
Help-Seeking Behavior among Older Adults with Urinary Incontinence in Intensive Care Unit
Authors: Mehboob Attia , Shafi Muhammad Tariq , Anwar Sahreen , Asim Hafiz Muhammad , Zahra Syeda Anum
Published: April 2024

Urinary incontinence is one of the disabling conditions that may cause discomfort and social avoidance and interfere with daily life, general health, and the overall quality of life. Urinary Incontinence affects people of all ages but is particularly common among older adults. Objective: To find out the tendency of old age people to seek help for Urinary Incontinence and the factors affecting the decision. Methods: A descriptive cross-sectional study was conducted in which 164 participants were selected using non-probability convenience sampling. Older adults of both genders between 60 to 85 years with incontinence and admitted to the intensive care unit were included in the study. Result: Out of 164 patients, N=61(37.20%) of the older adults had sought treatment and N=103 (62.80%) had not sought treatment for urinary incontinence. Conclusion: The frequency of older adults in Pakistan who seek help for Urinary Incontinence in Intensive Care Units is low. The most common reason for not seeking help is a lack of knowledge about the available treatment.
SERUM VITAMIN D LEVELS IN EUTHYROID AND HYPOTHYROID FEMALES VISITING A TERTIARY CARE CENTER OF WESTERN NEPAL
Authors: Tamang Binaya , Pokhrel Buddhi Raj , Shrestha Jharana , Gautam Narayan , Shahi Aakash , Pandey Alok , K.C Samjhana , Gharti Sakar Babu
Published: April 2024

Background: Thyroid function and vitamin D levels may be intricately related. The purpose of the current study was to investigate the relationship between thyroid hormones and vitamin D levels in females attending a tertiary care center in western Nepal.
Methods: This hospital-based cross-sectional study enrolled 300 women advised to get a thyroid function test (TFT) were included in the study population. They were grouped as euthyroid and hypothyroid based on the TFT status and their serum vitamin D concentrations were measured. Vitamin D levels were classified as normal, deficient, and insufficient using the standard criteria. Statistical tests like Chi-square analysis, Mann-Whitney U test, Kruskal Wallis test, and Spearman’s correlation analysis were performed. Finally, a multiple linear regression analysis was done to adjust for the effects of confounding variables.
Results: Majority of the study population (n=214, 71%) had insufficient serum vitamin D levels. The median Vitamin D levels were significantly lower in hypothyroid group as compared to the euthyroid group (16.88 vs. 25.01 ng/ml, p <0.001). Similarly, serum Vitamin D levels were negatively associated with obesity, winter and spring seasons, and vegetarian diet. After adjustment for the confounders, the Vitamin D levels were significantly lower in hypothyroid population than the euthyroid group (P<0.001).
Conclusions: In conclusion, majority of our study participants had insufficient vitamin D, whose concentration further dropped with decreasing thyroid hormone levels. This could have potentially adverse clinical implications.
ASSOCIATION BETWEEN SOCIAL MEDIA AND PSYCHOLOGICAL EFFECTS AMONG ADOLESCENTS: SCHOOL-BASED CROSS-SECTIONAL STUDY IN KATHMANDU CITY OF NEPAL
Authors: Paudel Ashok Kumar , Chhetri Muni Raj , Baidya Prinisha
Published: April 2024

Background: Social media are comprised of websites and software applications that enable users to create and share content or to participate in social networking. Inappropriate use of social media may lead to negative psychological effects. This study was designed to assess the psychological effects of social media among adolescent students of Grade 9 and 10 in Kathmandu city of Nepal
Methods: A cross-sectional school-based study was done among randomly sampled adolescent students (10-19 yrs) of Grade 9 and 10.  Total 318 sample size derived using the formula: n=z²pq/e2. Social Media Addiction Scale Student Form and Short Mood and Feelings Questionnaire were self-administered data collection tools.  The purpose of the study was explained to respondents. Ethical approval was obtained through the Ethical Review Board of Nepal Health Research Council. Data were analyzed on Scientific Package for Social Science version-20.
Results: About sixty-two percent of the adolescents had their cell phones and 88.1 percent had internet facilities in their houses. Forty-six percent of adolescents were possibly addicted to social media and 68.2 percent were probably depressed. Out of depressed adolescents, 64.4 percent of them had possibility of social media addiction. A significant association was observed between adolescents with their cell phone and social media addiction (p=0.037); social media addiction and depression (p <0.001).
Conclusions: Adolescents with their cell phones are associated with social media addiction and social media addiction is associated with depression, suggesting an urgent need to develop policies and programs to mitigate the negative psychological effects social media addiction.
HISTOMORPHOLOGICAL PATTERNS OF VARIOUS KIDNEY LESIONS IN NEPHRECTOMY SPECIMENS: A FIVE YEARS EXPERIENCE IN A TERTIARY CARE HOSPITAL
Authors: Sedhain Mamata , Shrestha Akshunna Rup , Joshi Zannat , Pun Chin Bahadur
Published: April 2024

Background: A variety of non-neoplastic diseases and both benign and malignant neoplasms occur in the kidney. Radiological studies like ultrasound, CT and MRI are useful to provide a preoperative diagnosis, but histopathological study still remains the gold standard for definite diagnosis. This study aimed to explore the histomorphological patterns of various kidney lesions in nephrectomy specimens.
Methods: This was a retrospective study conducted in the department of Pathology at College of Medical Sciences, Bharatpur, Chitwan from the period of 1st August 2017 to 31st July 2022. 57 samples of nephrectomy specimens were received during the study period of five years and were included in the study.
Results: Maximum number of patients undergoing nephrectomy were in the age group of 40 to 49 years. Non neoplastic lesions constituted 87.72% of the nephrectomy specimens while the remaining were neoplastic cases. Chronic pyelonephritis was the commonest non neoplastic lesion. The commonest neoplastic lesion was renal cell carcinoma followed by transitional cell carcinoma and squamous cell carcinoma.
Conclusions: Chronic pyelonephritis is a preventable cause of nephrectomy which could be avoided with early diagnosis and no operative management. The  commonest malignant neoplasm was renal cell carcinoma.
URINARY CARCINOMA IN YOUNG PATIENTS: A RARE CASE SERIES AND LITERATURE REVIEW
Authors: Shah Rajiv , Khanal Sandeep , Kumar jha Ashish , Adhikari Kapil
Published: April 2024

Urinary bladder carcinoma is mostly prevalent above the age of 40. It is more common in males. Here, we report a case series of young males with urinary bladder carcinoma. Urinary bladder mass was confirmed by ultrasonogram. Cystoscopic evaluation was done followed by endoscopic resection in the same setting. On histopathology it was found to be low grade noninvasive urothelial carcinoma.
IRON COMPLIANCE DURING ANTEPARTUM AND POSTPARTUM PERIOD AMONG WOMEN ATTENDING MATERNAL AND CHILD HEALTH CLINIC OF A TERTIARY HOSPITAL
Authors: Adhikari Jamuna , Ranjitkar Sharmila , Manandhar Mamata , Timalsina Punjita , Gachhadar Rashmi
Published: April 2024

Background: Daily oral iron supplementation, beginning from second trimester of pregnancy till 45 days postpartum, is recommended by national protocol to reduce risk of low birth weight, maternal anaemia and iron deficiency. The aim of the study was to assess iron compliance during antepartum and postpartum period among women attending maternal and child health clinic.
Methods: A descriptive cross-sectional study was carried out among women visiting maternal and child health clinic of Tribhuvan University Teaching Hospital for first dose of infant’s pentavalent vaccine. Non-probability consecutive sampling technique was used to select 426 sample for the study. Data were collected through interview schedule using structured and semi-structured questionnaire. Data were analyzed using descriptive statistics (mean, standard deviation, etc.), and inferential statistics (simple binary logistic and multiple logistic regression).
Results: Overall compliance during both pregnancy and postpartum was 61.0%. The common reason for compliance included doctors’ prescription (53.8%) followed by self-awareness (41.1%). For non-compliance, negligence or forgetfulness (16.2%) was commonest reason followed by improper information provided during pregnancy and postpartum (15.3%). Significant association was found between number of ANC visits [p=0.017,OR=0.269(0.091-0.792)], self-awareness on iron supplementation [p=<0.001, OR=0.319(0.198-0.515)] and buying tablets from pharmacy rather than free supply [p=0.001, OR=0.437(0.274-0.698)].
Conclusions: Iron compliance during antenatal and postnatal period is low among women. Enhancing self-awareness on iron supplementation through education and counseling among women during antenatal and postnatal visits and regular prescription could improve iron compliance during pregnancy and postpartum period.
MAGNITUDE OF FRACTURE NECK OF FEMUR IN PATIENTS WITH IPSILATERAL FRACTURE SHAFT OF FEMUR IN ADULT
Authors: Das Manoj , Pandey Suresh , Gupta Hemant Kumar , Bidary Suraj
Published: April 2024

Background: Magnitude of fracture neck of femur associated with ipsilateral fracture shaft of femur is rare and challenging in terms of diagnosis and management. Fracture neck of femur is associated with 0.8-9 % of ipsilateral fracture shaft of femur. Fracture neck of femur is often missed preoperatively with incidence ranging from 20-50%. This study was done with an objective of assessing the magnitude of fracture neck of femur in patients with ipsilateral fracture shaft of femur.
Methods: This was descriptive study of retrospective data of 187 fracture shaft of femur. Data from all the patients with fracture shaft of femur in the age group of 17 to 70 years admitted and operated between September 2018 to September 2022 were analyzed with magnitude of ipsilateral fracture neck of femur diagnosed preoperatively or postoperatively as main variable. Descriptive statistics was used to calculate frequency and percentage.
Results: Out of 187 fracture shaft of femur, 8.02% (n=15) cases were associated with ipsilateral fracture neck of femur. 73.33% (n=11) cases of fracture neck of femur were identified preoperatively on plain radiograph whereas diagnosis of 26.66% (n=4) cases of fracture neck of femur was missed on initial evaluation and diagnosed on postoperative plain radiograph.
Conclusions: Current study showed the magnitude of fracture neck of femur as 8.02% associated with ipsilateral fracture shaft of femur. Careful clinical evaluation, proper radiography of hip, possible CT scan in doubtful cases and intraoperative fluoroscopic evaluation of hip may decrease the incidence of missed diagnosis.
A RARE CASE OF SCAR ENDOMETRIOSIS WITH UTEROCUTANEOUS FISTULA
Authors: Bhattarai Aliza , Dangal Ganesh , Karki Auna , Bhattachan Kabin , Maharjan Sunita , Ghimire Nitesh
Published: April 2024

Utero-cutaneous fistula is a rare condition which is characterized by an abnormal communication between the anterior wall of the uterus and the abdominal wall. The causes are multiple caesarean sections, abortions, uterine cavity revision, retention of placental material after delivery, endometriosis, use of drains, post-operative infections, or injuries. Blood discharge from the caesarean scar during menstruation is a prominent feature as in our case. Here we present a case of para 2 living 1 lady, with previous 2 caesarean section presented to our Gynecology outpatient department with bleeding from the classical caesarean scar site cyclically during menses. Elective laparotomy with excision of uterocutaneous tract was done. Histopathology showed scar endometriosis.
SHORT VERSUS LONG PROXIMAL FEMUR NAIL FOR TREATMENT OF INTERTROCHANTERIC FEMUR FRACTURES
Authors: Acharya Devendra , Neupane Gaurav , Dawadi Tej Praksah , Rijal Sanjeeb , Bhandari Pratap Babu
Published: April 2024

Background: Intertrochanteric fractures are commonly encountered hip fractures worldwide. Nowadays proximal femur nails are increasingly being used to treat intertrochanteric fractures. The current study aimed to evaluate the outcome of short proximal femoral nail compared to long proximal femoral nail for managing intertrochanteric fractures.
Methods: This prospective observational study was done at a tertiary hospital from December 2020 to June 2023. Among 63 cases of intertrochanteric femur fractures (AO/OTA type 31A1 and 31A2), 30 were treated with short PFN while the remaining 33 cases were operated with long PFN. Demographic data, various intraoperative parameters, complications, union time and functional outcomes in terms of Harris hip score (HHS) were noted. Student t- test was used to compare continuous data whereas categorical data was compared using Chi-square or Fischer’s exact test (SPSS 20.0 software). 
Results: The average estimated blood loss (EBL) (83.2 ± 11.1 ml) and duration of surgery (69.0 ±9.4 min) for short PFN group were found to be significantly lesser than the EBL (163.3 ± 21.3 ml) and duration of surgery (86.2 ±11.4 min) for long PFN group. However, similar results were found with regard to age, sex, fracture type, union time, complications and HHS (at 6 months).
Conclusions: Use of PFN either short or long for intertrochanteric fractures (31A1 and 31A2) provides good results. Statistically significant lesser operative time and EBL found among the patients treated with short PFN makes it preferable especially in cases of sick and polytrauma patients where shorter operative time with minimal blood loss is desirable.
URINARY INCONTINENCE AMONG PERI AND POSTMENOPAUSAL WOMEN
Authors: Adhikari Anjana , Poudel Atit
Published: April 2024

Background: Urinary incontinence is a common problem in peri and post-menopausal age. The aim of this study was to find the prevalence of urinary incontinence in peri and post-menopausal women attending Gynecology clinic in a tertiary care centre.
Methods: This descriptive study was conducted among women over 40 years of age attending gynaecologic outpatient department of Paropakar Maternity and Women’s Hospital, from March 2023 to June 2023. Ethical approval was obtained from the Institutional Review Board. Convenience sampling method was used for data collection. General characteristics were recorded in preformed Performa and incontinence symptoms were recorded on the Questionnaire for Urinary Incontinence Diagnosis. The data collected using Microsoft excel, recorded and analysed using Statistical Package for Social Sciences version 29 and Mean was calculated.
Results: Total of 375 women were included in the study out of which 244 (65%) had incontinence. Stress urinary incontinence was the most common type of incontinence in this age group. Education status, parity, pelvic organ prolapse stage 2 and above, smoking have significant effect on urinary incontinence.
Conclusions: Our study showed that urinary incontinence is a common condition in peri and post-menopausal women and prevalence is higher when specifically enquired.
PREVALENCE OF THYROID EYE DISEASE IN PATIENTS WITH THYROID DYSFUNCTION IN A TERTIARY CARE HOSPITAL OF CENTRAL NEPAL
Authors: Dahal Polina , Khatiwada Saurav , Lamichhane Kripesh , Suvedi Anil , Khanal Niharika , Adhikari Rishikanta
Published: April 2024

Background: Thyroid eye disease is the most common extra thyroidal manifestation of Graves’ disease. The pattern and prevalence of thyroid eye disease vary widely from a mild disorder characterized by dry eye symptoms and ocular irritation to a severe disfiguring form of orbitopathy. Thyroid eye disease is a frequently encountered Ophthalmological morbidity in Nepal and across the globe. The aim of this study was to ascertain the prevalence of thyroid eye disease in subjects with thyroid dysfunction in a tertiary care hospital in central Nepal..
Methods: This was a prospective cross-sectional study, conducted in Chitwan medical college Teaching hospital (CMCTH), department of Ophthalmology. Subjects presenting to Ophthalmology department or referred patients from different departments with thyroid dysfunction were enrolled in the study. The data thus collected was analyzed using SPSS version 26 and the data was presented as frequency and percentage.
Results: Among 320 subjects screened for Thyroid eye disease prevalence, 106 (33.3%) were hyperthyroid, 207 (64.7%) were hypothyroid whereas, 7 (2.2%) were euthyroid. The prevalence of Thyroid eye disease was 40% and this was more prevalent among hypothyroid. Among the 320 patients with thyroid eye disease, 126 (39.4%), 95 (29.7%), 53 (16.6%), 24 (7.5%), 15 (4.7%), 5 (1.6%) and 2 (0.6%) had CAS score of 1,2,3,4,5,6 and 7 respectively. Similarly, NOSPECS score (American Thyroid Association) 243 (75.9%), 57 (17.8%), 1 (0.3%), 7 (2.2%), 8 (2.5%), 3(0.9%) and 1 (0.3%) were graded from 0-6 accordingly respectively.
Conclusions: Thyroid eye disease was more prevalent in hypothyroid middle-aged females and the overall prevalence of Thyroid Eye disease was more in hypothyroid patients. Though sight threatening complications didn’t exist in our study, close workup by endocrinologist and ophthalmologist can decrease ocular morbidity.
ACUTE POISONING AND ENVENOMATION IN CHILDREN: CLINICO-EPIDEMIOLOGICAL PROFILE AND OUTCOME IN CENTRAL NEPAL
Authors: Parajuli Biraj , Pandit Aakash Kumar , Sah Ritesh Ranjan , Soni Prakash Kumar , Adhikari Sonu
Published: April 2024

Background: Acute poisoning and envenomation are significant concerns among children, demanding specialized approaches. This study aimed to assess the current scenario, clinico-etiological profile and outcome of acute poisoning and envenomation in children within Bagmati province, excluding the valley area.
Methods: A retrospective observational analysis was conducted involving children aged 28 days and above to 18 years admitted to Chitwan Medical College’s Pediatric department between July 2020 to January 2023. Cases involving poison exposure or envenomation regardless of signs and symptoms, were included. Demographics, triage, interventions and outcomes were collected in predesigned data proforma and descriptive analysis was performed using SPSS 20.
Results: Results revealed, 179 admissions (3.49% of total) with most cases being accidental (87.3%), frequently among boys (64.8%) and age group 1-5 years old (53.1%) and median (IQR) age of 3 (2-8) years. Common presenting symptoms included vomiting (48%) and altered sensorium (21.2%). The median (IQR) time to hospital presentation post exposure was 3.75(2-7) hours. Organophosphorus (17.3%) and kerosene poisoning (8.4%) were the commonest poison, along with 11 cases of envenomation. Treatment included supportive care with antidote used in 17.9%. A majority (58.88%) only required 24- hour observation. There were a total of 5 deaths (2.79%) and 6 (3.35%) left against medical advice.
Conclusions: Our results align with previous similar studies conducted in Nepal and across Asia. Accidental cases predominated, particularly among young children. Organophosphorus remained a significant poison, while cypermethrin and alcohol poisoning were new observations. Basic supportive care saves more lives than all the antidotes put together.
ACADEMIC PROCRASTINATION AMONG UNDERGRADUATE STUDENTS OF A MEDICAL INSTITUTION
Authors: Thapa Kriti , Rimal Surya Prasad
Published: April 2024

Background: Academic procrastination is a universal phenomenon. It affects various aspects of student’s personal and academic life and also has been associated with numerous undesirable and irreversible consequences. The objective of the study was to assess the level of academic procrastination among the undergraduate students.
Methods: A descriptive cross-sectional study was conducted among 454 undergraduate students of a medical institute using convenience sampling technique. Students were requested to complete a self-administered questionnaire which comprised their socio-demographic characteristics and Academic Procrastination scale. Descriptive studies i.e. mean, percentage, frequency, standard deviation and inferential statistics i.e. Chi-square was used to analyse the data.
Results: High level of academic procrastination was seen among 40.1% of the undergraduate students. Academic procrastination was also found to be significantly associated with age, sex and academic year of the undergraduate students.
Conclusions: The finding of this study reveal that a considerable number of undergraduate students have high level of academic procrastination.
CLINICO-RADIOLOGICAL OUTCOMES IN SHORT SEGMENT FIXATION INCLUDING FRACTURE LEVEL FOR UNSTABLE THORACOLUMBAR JUNCTION FRACTURES (T10-L2)
Authors: Sitaula Jyoti , Basel Suman Kumar , Rijal Sanjeeb , Sharma Bishnu Dev , Dawadi Tej Prakash , Thapa Bibechan
Published: April 2024

Background: Thoracolumbar region being a transition zone is frequently injured during trauma. Treatment aims to achieve stable fixation while preserving mobility, prevent deformity, and improve neurology. Short-segment fixation, with fracture level pedicle screw fixation, is popular for preserving motion. This study assesses the clinico-radiological outcomes for short segment fixation including fracture level for unstable thoracolumbar fractures.
Methods: This was an observational study conducted at a tertiary care center from December 2020 to November 2022 after receiving ethical approval among single level burst fractures (AO type A3 & A4) at the thoracolumbar junction. Patients with AO type B and C fractures, osteoporotic burst fractures, lack of surgical consent, and multi-level vertebral fractures were excluded from the study. The study utilized ASIA impairment scale, Visual Analogue Score(VAS), and radiological parameters (Kyphotic angle and Loss of vertebral body height) to assess patients immediately, postoperatively and at 6 weeks, 3 months, and 6 months follow-up.
Results: Out of 20 patients,70% of the fractures were AO type A3, while the remaining 30% were type A4. The injury resulted in a 56.25 ± 13.75% loss of vertebral height. The mean kyphotic angle improved significantly from 24.38 ± 3.77 degrees preoperatively to 5.92 ± 1.91 degrees at 6 months post-operatively. The VAS scores showed significant improvement from 7.85 ± 0.67 preoperatively to 0.65 ± 0.81 at 6 months postoperatively.
Conclusions: Use of pedicle screw in the fractured vertebra can result in significant improvement in post-operative pain and kyphosis correction utilizing fewer motion segment with satisfactory clinic-radiological outcome.
CAN MATHEMATICS STRENGTHEN EDUCATIONAL THEORIES?
Authors: Shankar Pathiyil Ravi , Wilson Ian
Published: April 2024

Quantifying educational theories will provide us with a better understanding of the relationship between variables. They will also make educational theories stronger and the level of uncertainty in the relationship can also be quantified.
PSYCHOSOCIAL BURDEN OF PARENTS HAVING CHILDREN WITH HAEMOPHILIA IN NEPAL
Authors: Shakya Milashree , Banstola Ratna Shila , Shrestha Romina
Published: April 2024

Background: Parenting a child with haemophilia, a hereditary bleeding disorder, causes more stress than parenting a normal child. The main aim of this study was to find out the psychosocial burden faced by parents having children with haemophilia in Nepal.
Methods: In this cross-sectional study, 76 parents having children with haemophilia were recruited from Nepal Haemophilia Society using a non-probability purposive sampling technique. The Zarit Burden Interview scale was used. Chi-square test and odds ratio at 95% confidence interval were used to assess an association between parents’ psychosocial burden with the parents and child-related variables using SPSS version 16.
Results: A moderate level of psychosocial burden was prevalent among 60.5% of the parents. There was a significant association between parents’ psychosocial burden with parents’ education (p = 0.037), income (p = 0.03), type of Haemophilia among children (p = 0.03) and type of treatment received by children (p = 0.01). Further, the odds ratio predicted that psychosocial burden was 3.0 times higher (95% CI = 1.1 – 8.3, p = 0.04) among those parents with insufficient income and 4.2 times higher (95% CI = 1.3 – 13.4, p = 0.02) for the parents whose children were under factor VIII and associated treatment.
Conclusions: Psychosocial burden, particularly of moderate intensity was higher in parents having children with haemophilia. Those parents with low education level, with less income and whose children are diagnosed with Haemophilia A and under factor VIII and associated treatment should be more considered in reducing their psychosocial burden.
PREVALENCE OF DENTAL CARIES ON PERMANENT FIRST MOLARS AMONG CHILDREN OF AGE GROUP 6-14 YEARS
Authors: Thapaliya Bidhya , Gautam Shailesh , Chaudhari Sudeep Madhusudan , Shrestha Dristhi , Paudel Subani , Lamichhane Puja , Chaudhary Govind Kumar
Published: April 2024

Background: Dental caries currently represents the most common chronic disease among children. Early detection of caries is very important as it helps in the prevention and control of carious diseases. This study was aimed to assess the prevalence of dental caries on permanent first molars among children of age group 6-14 years.        
Methods: This descriptive cross–sectional study was conducted among 270 children coming to Department of Pedodontics of Chitwan Medical College. The children of age 6-14 years were included in the study. Caries status was noted using DMFT index and the data was presented using descriptive statistical tool. This was analysed using SPSS version 26.
Results: A total of 270 children of age group 6-14 years (Mean ± SD: 9.84 ± 2.24 years, median 10 years) participated in the study. The prevalence of dental caries of left mandibular first permanent molar was high 108 (40%) among the studied teeth. The prevalence of dental caries was high in mandibular arch.
Conclusions: Among the permanent first molars, prevalence of dental caries was higher in mandibular arch than maxillary arch.
HEMATOCRIT AS AN EARLY PREDICTOR OF SEVERE ACUTE PANCREATITIS: A PROSPECTIVE OBSERVATIONAL STUDY IN TERTIARY CARE CENTRE OF NEPAL
Authors: Acharya Bishal , Neupane Harish Chandra , Tamrakar Kishor Kumar , Ghimire Iswar Chandra , Mandal Rajesh Kumar , Mishra Rohit Kumar , Raut Birendra , Vimal Raghavendra , Bastola Nimish Raj , Kandel Akarsh , Timalsina Ekanta , Shrestha Ajit
Published: April 2024

Background: The predictor system for acute severe pancreatitis is complex and takes up to 48 hours to complete. This study aimed to investigate the role of admission hematocrit in predicting acute pancreatitis severity.
Methods: This was an observational study, conducted at Chitwan Medical College where 112 patients who met the inclusion criteria and were diagnosed with acute pancreatitis were examined. The patients were followed for 48 hours by evaluating the admission hematocrit and were categorized to have mild to moderately severe pancreatitis or severe pancreatitis according to the modified Atlanta criteria. All analyzes were performed using SPSS statistical software, version 26. Descriptive and inferential statics, sensitivity and specificity were calculated.
Results: The mean age was 44.72 ± 14.5 years and 70.5% were male. The most common etiology was ethanol (52.2%), followed by gallstone disease (26.5%). The prevalence of severe pancreatitis in patients in the high-risk group was 88.89%, and the incidence of severe pancreatitis in patients in the low-risk group was 10.59%. The detection sensitivity of hematocrit level  >/= 44% for severe acute pancreatitis was 72.73%, the specificity of 96.2%, the positive predictive value of 88.89%, the negative predictive value of 89.41%, the accuracy of 89.3%, likelihood ratio for positive test result of 19.14 and likelihood ratio for negative test result of 0.283.
Conclusions: Patients with high hematocrit on admission were associated with the occurrence of severe acute pancreatitis, so these patients should be considered as a high-risk group for development of severe acute pancreatitis and monitored meticulously.
FREQUENCY OF SECOND MESIOBUCCAL CANAL IN PERMANENT MAXILLARY SECOND MOLARS AT A TERTIARY CARE CENTRE OF NEPAL
Authors: Ahmed Sageer , Shubham Snigdha , Shrestha Kriti , Gautam Vanita , Chaudhary Govind Kumar
Published: April 2024

Background: The success of endodontic treatment relies on the precise identification of root canals followed by cleaning, shaping, and obturating the canals. Mesiobuccal root of maxillary second molar teeth present wide variations with regard to the number and type of root canals. The complexity of the root canal varies widely in different ethnic groups. The study aimed to determine the prevalence of second mesiobuccal canal (MB2 canal) in maxillary second molar.
Methods: A descriptive cross-sectional study was conducted at Department of Conservative Dentistry and Endodontics, Universal College of Medical Sciences, Bhairahawa. A total of 100 permanent maxillary second molar undergoing endodontic treatments were studied. After access cavity preparation ultrasonic tips and magnification loupes were used to open the subpulpal groove in a direction from first mesiobuccal (MB1) canal towards the palatal canal to locate the second mesiobuccal (MB2) canal. Radiovisiography (RVG) was taken to confirm the presence of MB2 canals.
Results: MB2 canals were detected in 52 teeth out of 100 teeth that were studied. It was found that the younger adult (18-35 years) tends to have a higher proportion of MB2 canals (65.6%) as compared to the middle-aged elderly (36-55years) in whom it could be identified only 33.4% of the time.
Conclusions: Based on this study, it can be concluded that the prevalence of MB2 canal in mesiobuccal root of the permanent maxillary second molar is high.
A Two-Phase Survey of Psychiatric Morbidity among Females with Infertility in a Tertiary Hospital in North-Western Nigeria
Authors: ABIOLA T , UDOFIA O , AGHUKWA N , YUSSUF A , MOJEED M , DOKU V , MORAKINY O
Published: April 2024

ABSTRACT
Background: The inability of couples to conceive or infertility has been identified as a major source of psychiatric morbidity. In several studies in sub-Saharan Africa, the psychological burden, often higher among females, is mostly assessed through screening measures and hardly by diagnostic instruments. This study evaluated the prevalence and clinical pattern of psychiatric morbidity among adult female patients attending Aminu Kano Teaching Hospital (AKTH) infertility clinic using the two-phase survey method.
Methods: In the first phase, 281 respondents were assessed using sociodemographic, clinical, and the 12-item General Health Questionnaire (GHQ-12). The second phase was by using the World Health Organization Schedule for Clinical Assessment in Neuropsychiatry (SCAN) to interview all probable cases on the GHI-12 with a score of 3 or more, and 10% of non-cases. Psychiatric diagnosis was made in accordance with the diagnostic criteria of the 10th edition of the International Classification of Diseases (ICD-10).
Results: The point prevalence of psychiatric morbidity in this study was 29.2% with a weighted prevalence rate of 64.8% projected onto the infertile population seeking medical help within the 3-month study period. Depression (21%) was the most occurring diagnosis. Generalized Anxiety Disorder and Somatisation were diagnosed in 6% and 2% respectively. There was a significant relationship between psychiatric morbidity and age, educational status, religion, and the duration of marriage (p<0.05).
Conclusion: About one-third of infertile women in this study had psychiatric morbidity with depression being the most prevalent diagnosis. Psychiatric morbidity was significantly associated with increasing age, high educational attainment, religion and longer duration of marriage. The study demonstrated the need to include Consultation-Liaison Mental Health Practitioners in the management of women with infertility in order to meet their unmet mental health needs.
GENÇLERİN GİRİŞİMCİLİĞE BAKIŞ AÇILARI VE GİRİŞİMCİ OLMA ARZULARI ÜZERİNE NİTEL BİR ARAŞTIRMA
Authors: Okan Yusuf Taha , Çakır Ahmet
Published: April 2024

Bu çalışmanın amacı, gençlerin girişimciliğe yönelik bakış açılarını ve girişimci olma arzularını ortaya çıkarmaktır. Çalışma, gençlerin girişimcilikle ilgili algılarını araştıran fenomenolojik bir desen kullanılarak gerçekleştirilmiştir. Araştırma verileri, 18-24 yaş arasındaki 20 katılımcıyla yüz yüze yapılan yarı yapılandırılmış görüşmelerle elde edilmiştir. Katılımcılara araştırmanın amacını ortaya çıkaracak sorular yöneltilmiş ve veriler elde edilmiştir. Elde edilen veriler, Maxqda 20 Paket Programı kullanılarak içerik analizine tabi tutulmuş ve araştırma sonuçları elde edilmiştir. Analiz sonuçlarına göre, gençlerin genel kanısı toplumun girişimciliğe olumlu baktığı ve girişimcilerin toplum nezdinde olumlu bir imaja sahip olduğu yönündedir. Katılımcılar, insanların maddi kazanç elde etme ve yaşam standartlarını yükseltme gibi nedenlerle girişimci olmayı tercih ettiğini ifade etmişlerdir. Ayrıca, nitelikli girişimci sayısının artırılması için girişimcilik eğitimlerinin ve devlet desteğinin önemli olduğu vurgulanmıştır. Katılımcılar tarafından belirtilen birçok girişimcilik özelliği bulunmakta ve bu özelliklere sahip olmanın girişimci olma isteği üzerinde olumlu bir etkisi olduğu belirtilmiştir.