bluuebunny/crossref_metadata_2025 huggingface dataset:
Qualidade físico-química entre sistema de tratamento de água e áreas de vulnerabilidade
Authors: Rafael Clélio Rodrigo Paiva , Fonseca Ronald Assis , Marinho Renata de Oliveira , Sila Bárbara Letícia da , Silva Gil Amaro da , Teixeira Débora Rith Costa , Bessa Levi Damasceno , Pereira Vítor Manoel de Souza , Louback Geisa Correa , Cartaxo Aparecida Evangelista , Cardozo Larissa Guilhermina Campos , Cordeiro Anelita Nunes
Published: April 2024

A qualidade da água é fundamental para a saúde pública, influenciando diretamente a ocorrência de doenças, sejam elas infecciosas ou não. Assim, a garantia da segurança da água potável surge como uma preocupação mundial, exigindo práticas para prevenir riscos à saúde das populações. Este estudo visou analisar a qualidade físico-química da água coletadas em dois municípios distintos do Rio Grande do Norte e em diferentes condições. Foi realizada uma comparação das propriedades físico-químicas de amostras de água tratada do sistema de abastecimento de Caraúbas e amostras vulneráveis à contaminação em Almino Afonso, próximo a áreas de lixão a céu aberto. Os resultados mostraram que em Caraúbas, o sistema de abastecimento assegura a potabilidade e segurança da água, em conformidade com a Portaria nº 2.914/2011 do Ministério da Saúde e a Resolução CONAMA nº 357/2005. A análise físico-química confirmou a conformidade da água tratada com os padrões de potabilidade, destacando a eficiência dos processos de tratamento e distribuição. Em Almino Afonso, a proximidade de áreas de lixão a céu aberto introduz riscos de contaminação, evidenciados por altos níveis de condutividade elétrica, sódio e cloreto, apontando para a necessidade urgente de tratamento adequado para garantir a segurança hídrica. A comparação entre as amostras coletadas revela um claro contraste na qualidade da água, ressaltando a importância dos sistemas de tratamento e abastecimento para a manutenção da saúde pública e sustentabilidade ambiental. Os resultados também mostram o impacto negativo da gestão inadequada de resíduos sólidos e efluentes na qualidade da água, enfatizando a necessidade de práticas sustentáveis de gestão de resíduos e sistemas eficientes de tratamento de água. Portanto, os resultados reforçam a importância da implementação de estratégias integradas de gestão de recursos hídricos, que incluam tanto o tratamento e distribuição de água quanto a gestão ambientalmente sustentável de resíduos, para proteger as fontes de água da contaminação e assegurar sua potabilidade e segurança para o consumo humano.
“Mendacia, deliria, scurrilitates erat sperandum.” Realtà e aspettative di una donna di fronte ai tribunali dello Stato Pontificio dell'Ottocento
Authors: Delmedico Sara
Published: April 2024

Attraverso l'analisi di un contenzioso che vede per protagonisti una donna, Umbellina, e la sua famiglia, il presente articolo mostra la condizione giuridica femminile nello Stato Pontificio di metà Ottocento per quanto concerne la dote. La donna dello Stato Pontificio è in posizione giuridicamente ed economicamente subalterna e, alla morte del padre, ha diritto esclusivamente a una dote “congrua” sull'asse ereditario, in caso non sia ancora sposata; se già sposata e dotata, invece, non le spettano ulteriori beni mobili o immobili. Tuttavia, le donne dell'Ottocento, come dimostra il caso descritto nel presente lavoro, non sembrano più accettare passivamente come in passato la loro condizione e non esitano a far valere con forza i loro diritti, sfidando non solo la famiglia ma la società stessa, che ha ancora in sé le peculiarità dell'Ancien Régime, è ancora statica, basata sull'immobilismo, su un sistema gerarchico e sull'obbedienza.
Sanctioned by Law: Post-Patriarchal Narratives of Gender-Based Violence
Authors: Aiello Lucia
Published: April 2024

Italian women writers such as Anna Banti, Elsa Morante, and Elena Ferrante have challenged the patriarchal discourse on female subjectivity through their narrative articulations of gender-based violence. Drawing on Walter Benjamin's analysis of violence in relation to natural and positive law, this article argues that these authors’ representations of violence against women not only provide a powerful critique of patriarchal models but also reveal the contradictory nature of law and justice within a patriarchal power structure. By positioning gender-based violence at the intersection of sanctioned (i.e., legal) and unsanctioned (i.e., illegal) violence, the patriarchal structure of power ensures its continuity. The article concludes that by weaving the pervasiveness of violence experienced by women into their narrative textures, these writers modify their relationship to language from one of displacement to one of cautious proximity, thus opening the possibility for the emergence of a post-patriarchal notion of the human.
“Puoi stare perfettamente tranquilla.” Dubbi, timori e autorappresentazioni del corpo femminile nelle rubriche di “Posta del cuore” (Italia, anni Sessanta e Settanta)
Authors: Niri Virginia
Published: April 2024

Tra i pochi spazi espressivi a disposizione delle giovani donne dell'Italia del boom economico, le riviste femminili—e in particolare le rubriche della posta del cuore—sono un terreno di indagine prolifico per analizzare l'immagine di sé e della propria “femminilità” delle ragazze di allora. La natura dicotomica di queste riviste (Di Franco, 2018) permetteva infatti la formulazione di dubbi e timori legati al proprio corpo—e in particolare alla propria intimità—che non trovavano spazio espressivo altrove, né in famiglia né in contesti di socializzazione; dall'altra parte silenziava ogni possibile spunto di confronto con quelle che i responsabili della “posta del cuore” chiamavano “risposte in maschera”: una serie generica di rassicurazioni che non permetteva il confronto tra le lettrici, riportando ogni angoscia a livello personale. L'articolo si interroga sulla potenziale utilità “didattica” di queste rubriche, sottolineando la forte spinta sistemica che caratterizza la maggior parte delle risposte alle lettere. Ne risulta un ritratto spezzettato del corpo femminile, diviso tra parti dicibili e indicibili, ma che nel “senso della socializzazione dei problemi” (Del Bo Boffino, 1997) trova uno dei suoi primi tentativi di nominazione—un processo che sarà poi fondamentale nel lavoro sul corpo e sulla rappresentazione di sé proprio del femminismo autocoscienziale.
A Hidden Landscape: Interpreting Buried Archaeological Site Potential in the White River Valley, Indiana
Authors: Trader Patrick D.
Published: April 2024

A model for buried site potential has been developed and presented here following extensive geoarchaeological investigations conducted along the White River valley in Indiana. Backhoe-trenching efforts identified 35 buried archaeological sites dating from the Late Archaic through postcontact periods. Buried archaeological sites were found primarily in soils classified as inceptisols, with fewer found in soils classified as mollisols and entisols. Geochronological dating and artifact analysis suggest that after 3000 BP the White River valley transitioned from lateral to vertical accretion, providing landforms suitable for precontact occupation.
دور إستراتيجية المحيط الأخضر بتوسيط تحفيز الإبداع المستمر لتحقيق النصر الاستراتيجي: دراسة استطلاعية في الشركة العامة للصناعات الجلدية
Authors: غالب الاء عبد الكريم
Published: April 2024

تجابه إدارة الشركة العامة للصناعات الجلدية في عملها بالسوق المحلي حالة مستمرة من المنافسة سواء كانت من شركات منافسة أو منتجات مستوردة من مختلف الدول ، بالإضافة إلى التغيرات في أذواق الزبائن وتسارع وتيرة التصاميم والمتغيرات البيئية مما يتطلب تبني استراتيجية المحيط الأخضر لتساعد الشركة على مواجهة تلك التحديات، ومن هنا تتبلور مشكلة البحث حول كيف يمكن لاستراتيجية المحيط الأخضر التي يمكن توظيفها لتحقيق النصر الاستراتيجي عبر اعتماد تحفيز الإبداع المستمر في الشركة العامة للصناعات الجلدية ، كما تكمن أهمية البحث في تسليط الضوء على ماهية مضامين متغيرات جوهر المشكلة لاعتمادها من قبل إدارات الشركة العامة للصناعات الجلدية لبلوغ المرامي التي تسعى إليها وهو ما يؤشر إلى أهداف البحث. وتم اعتماد استمارة استبيان وزعت على (84) عينة من العاملين في الشركة العامة للصناعات الجلدية في مدينة بغداد، لقياس نتائج العلاقة التأثيرية. وخلص البحث إلى النتيجة بوجود علاقة تأثيرية لاستراتيجية المحيط الأخضر على النصر الاستراتيجي  وبوجود تأثير إيجابي لتحفيز الإبداع المستمر . ويوصي البحث بضرورة اعتماد استراتيجية المحيط الأخضر كمنهج تتبعة إدارة الشركة العامة للصناعات الجلدية لزيادة الأفكار الإبداعية التي تساعدها للوصول والحفاظ على النصر الاستراتيجي .
اثر الاحتواء الاستراتيجي في تحقيق الميزة الرائدة للعلامة دراسة تطبيقية في شركة الجود لتكنولوجيا الصناعة الحديثة
Authors: الخاقاني ضرغام محمد
Published: April 2024

تمثلت مشكلة البحث في إن القطاع الصناعي بصورة عامة والمنظمات الانتاجية بصورة خاصة في العراق في حالة تدهور ولظهور هذا الشركات في السوق عليها اولا الاهتمام بصورة رئيسة بعلامتها التجارية الخاصة بمنتجاتها. ومن هنا فقد تم صياغة المشكلة في التساؤل الرئيسي " هل يوجد تأثير موجب ذات دلالة معنوية للاحتواء الاستراتيجي في تحقيق الميزة الرائدة للعلامة ".

وهدفت الدراسة الحالية بصورة رئيسة إلى اختبار تأثير الاحتواء الاستراتيجي ودورها في تحقيق الميزة الرائدة للعلامة, وذلك كمحاولة جادة لردم الفجوة المعرفية في تفسير طبيعة العلاقة بين هذه المتغيرات عبر تحليل طبيعة العلاقات بينها من خلال استطلاع آراء مجموعة من الافراد العاملين في شركة الجود لتكنولوجيا الصناعة والزراعة الحديثة.

ولتحقيق هذا الهدف, فقد تم استخدام الاستبانة الالكترونية بوصفها أداة رئيسة لجمع البيانات المطلوبة من خلال توزيعها بأسلوب الحصر الشامل للمجتمع, وبعد قيام الباحث بأرسال الاستبانة الالكترونية على العاملين في المنظمة قيد الدراسة, تم استرجاع (156) استبانة من الشركة المبحوثة، تم تحليلها باستخدام عددٍ من الاختبارات الإحصائية المتوافرة ضمن البرنامجين الاحصائيين SPSS  وSmsrtPLS.

توصلت الدراسة بعد ذلك إلى مجموعة من النتائج الإحصائية التي اثبتت الدراسة من خلال هذه النتائج التي تم التوصل اليها وجود تاثير معنوي موجب للاحتواء الاستراتيجي في تحقيق الميزة الرائدة للعلامة.

اما اهم التوصيات التي يوصي بها الباحث, ضرورة اعتماد المنظمة المبحوثة ان تهتم وتجاري كل التطورات والحداثة في تكنولوجيا الصناعة من خلال اعتماد الاحتواء الاستراتيجي في تقليل الوقت والجهد والموارد والطاقة من جانب وجذب الزبون من خلال الاهتمام باحتياجات وتفضيلات الزبائن من جانب اخر لتحقيق الميزة الرائدة لعلامة المنظمة.
فاعلية استخدام التعليم عن بعد في المرحلة الأساسية
Authors: الرشدان مهند أحمد حسن
Published: April 2024

هدفت الدراسة التعرف إلى فاعلية استخدام التعليم عن بعد في المرحلة الأساسية. استخدمت الدراسة المنهج شبه التجريبي، ولتحقيق هدف الدراسة حاول الباحث الإجابة  عما إذا كان هناك فروق ذات دلالة إحصائية عند مستوى الدلالة  (α≤0.05) في درجة اكتساب مفاهيم الوراثة لطلبة الصف الثامن في محافظة إربد تعزى لطريقة التدريس (التقليدية والتعليم عن بعد). تكونت عينة الدراسة من أربع مجموعات تم اختيارها بطريقة عشوائية، وتم توزيعها على النحو الآتي،  مجموعتان تجريبيتان بلغ عدد أفرادها (28) طالبا و(30) وطالبة،  ومجموعتان ضابطتان بلغ عدد أفرادها ( 30) طالبا و ( 30) طالبة ، من طلاب الصف الثامن الأساسي في مدرسة كفر الماء الأساسية الثانية  للذكور، وطالبات الصف الثامن الأساسي في مدرسة كفرالماء الثانوية الشاملة  للإناث. تكونت أدوات الدراسة من الوحدة الدراسية المحوسبة التي تم إعدادها لغايات التعليم عن بعد، واختبار تم إعداده أيضا لغايات الدراسة من قبل الباحث. وقد خلصت الدراسة إلى وجود فروق ذات دلالة إحصائية عند مستوى الدلالة تعزى إلى طريقة التدريس لصالح المجموعة التعليم عن بعد.
الحاكمية المؤسسية المصرفية الإسلامية وعلاقتها بالامتثال
Authors: Alhajaj Zaid , الحوراني ياسر
Published: April 2024

هدفت الدراسة التعرف على الحاكمية المؤسسية المصرفية الإسلامية وعلاقتها بالامتثال، وقد تناولت الدراسة في أجزائها على ماهية الحاكمية المؤسسية المصرفية الإسلامية، وكذلك التعرف على الحاكمية المؤسسية المصرفية الإسلامية وعلاقتها بالامتثال المصرفي الإسلامي، واعتمدت الدراسة الحالية في سبيل تحقيق هدفها الرئيس والوصول إلى غايتها على المنهج التحليلي الاستنباطي، وتوصلت الدراسة إلى أنه تختلف المصارف التقليدية عن المصارف الإسلامية في توافر الحوكمة الشرعية فـي المصارف الإسلامية يساعدها على مراقبة جميع المعاملات التي تتم داخلها؛ وبالتالي يضمن صحة عملياتها المصرفية الإسلامية، كما أن تطبيق الحوكمة في المصارف الإسلامية يعد أمراً ضرورياً لإيجاد نظام رقابي محكم وموحد يمكن أن يسهم في تحسين أداء المصرف الإسلامي، ومن أهم توصيات الدراسة تسهيل حصول المساهمين على المعلومات المتعلقة بالمصرف الإسلامي بصفة دورية ومنتظمة وبسهولة، وإجراء المزيد من الدراسات فيما يتعلق بالحاكمية المؤسسية في دولة الأردن وخصوصًا فيما يتعلق بالامتثال المصرفي الإسلامي.
Perspectives of Winding Up of a Company: Comparative Analysis of UK, USA and EU
Authors: Almuhaidb Yasser
Published: April 2024

Companies across the globe are often started and, at the end of their operations, undergo a legal process identified as winding up. The legal process of starting a business or company differs greatly from the ending or winding-up process. Some common practices identified with closing a business entail compulsory winding up and voluntary winding up based on their jurisdictions. An investigation of some of the nations to be applied in the study include the European Union, the United States, and the United Kingdom of Great Britain. The research will also examine the efficacies associated with the legal processes in these three jurisdictions. The study will explore the legal provisions associated with the Insolvency & Bankruptcy Code and the Companies Act practiced in the European Union. An emphasis on the challenges companies faces when in the winding-up process or insolvency will be highlighted. It will offer an opportunity to navigate the intricacies of insolvency laws alongside their historical evolution. The underlying provisions and principles governing the operations of winding up a company in these three nations will be discussed to offer valuable information for the study. Lastly, the article will tabulate the variations and similarities in the three regimes.
أثر الجاهزية البشرية لتطبيق المعيار الدولي لإعداد التقارير المالية رقم (17) "عقود التأمين" في تحسين الميزة التنافسية لشركات التأمين الأردنية
Authors: Al-Masri Rami
Published: April 2024

تهدف الدراسة إلى تحديد أثر الجاهزية البشرية لتطبيق المعيار الدولي لإعداد التقارير المالية رقم (17) "عقود التأمين" في تحسين الميزة التنافسية لشركات التأمين الأردنية بأبعادها (الجودة, والتسعير, والتكلفة, والمرونة). تقوم هذه الدراسة على استخدام المنهج الوصفي الارتباطي، تم تطوير استبيان وتوزيعه على عينة مختارة بالطريقة العشوائية من العاملين في الدوائر المالية ودوائر التدقيق الداخلي والمختصين في شركات التأمين الأردنية, و تمثلت العينة النهائية بـ 136 مفردة. تشير النتائج إلى أن شركات التأمين الأردنية لديها مستوى مرتفع من الاستعداد لتمويل البنية التحتية، وإعادة تأهيل الموارد البشرية استعدادا لتطبيق المعيار الدولي لإعداد التقارير المالية رقم 17, كما أن التأثير المتوقع لتطبيق المعيار 17 في الجودة مرتفع, وهناك ضرورة لاتباع النظم الحديثة في التسعير بما يحقق العدالة لكل من شركة التأمين وحامل وثيقة التأمين. توصي الدراسة بإجراء المزيد من الدراسات التي تخص تطبيق المعيار الدولي لإعداد التقارير المالية رقم 17, وإعداد النشرات التعليمية لزيادة الوعي بمتطلبات تطبيق المعيار 17 لدى مستخدمي البيانات المالية.
مستوى التميز التعليمي لدى المعلمين المتقدمين لجائزة الملكة رانيا في مدارس لواء المفرق
Authors: الخزاعلة شادي
Published: April 2024

هدفت الدراسة التعرف إلى مستوى التميز التعليمي لدى المعلمين المتقدمين لجائزة الملكة رانيا من وجهة نظر مديري ومديرات مدارس لواء قصبة المفرق، تم استخدام المنهج الوصفي المسحي، تكونت عينة الدراسة من (145) مدديراً ومديرة، تم استخدام (الإستبانة إلكترونية) كأداة للدراسة مكونه من (23) فقرة، وأظهرت نتائج الدراسة مستوى التميز التعليمي لدى المعلمين المتقدمين لجائزة الملكة رانيا من وجهة نظر مديري ومديرات مدارس لواء قصبة المفرق جاءت بدرجة (مرتفعه) ، كما كشفت النتائج بالنسبة للفروق الإحصائية بوجود فروق احصائية تعزى لأثر متغير الجنس وجاء لصالح الإناث، وعدم وجود فروق تعزى لأثر متغير سنوات الخبرة، والمؤهل العلمي، والمؤهل العلمي.
THICKNESS MAPPING OF NEPALESE CALVARIA USING COMPUTERIZED TOMOGRAPHY
Authors: Shrestha Amit , Khan Gulam Anwer , Bhusal Deepak , Gautam Ajeevan , Shakya Shuvecchya
Published: April 2024

Background: The bony skeleton of the head is termed skull. Skull composed of cranial vault and base. Cranial vault is known as Calvaria. Cranial vault (Calvaria) is the superior view of skull (Norma Verticalis). Calvarium consists of frontal, parietal, temporal and occipital bones. Total thickness of calvarial bones includes outer table, diploe and inner table. Diploe is made up of spongy bone. Outer and inner table made up of compact bone. This study aims to measure the image assisted measurement of thickness of Calvaria and to observe the variation in thickness with age, gender and ethnicity.
Methods: This was a descriptive cross-sectional study conducted at Department of Radiology, Chitwan Medical College Teaching Hospital Bharatpur-13, Chitwan. Patient of age 15 to 50 years with normal CT finding were included in the study. Using the axial view of brain CT, the thickness of Calvaria was measured and recorded in millimeter.
Results: Hundred calvarial thickness was measured using computerized tomography scan. Thickness of frontal bone; parietal bone and occipital bone ranges from 0.37 mm to 0.97mm with mean value 0.6991±0.311mm;0.36mm to 0.99 with mean 0.6772±0.15058 mm and 0.30 to 0.95mm with mean 0.68±0.15236 respectively. No significant correlation between thickness of frontal, parietal and occipital bone is observed using Pearson coefficient.
Conclusions: There is slight variation of calvarial thickness of frontal, parietal and occipital bone. The frontal, parietal and occipital bone thickness are not significantly correlated with each other.
KNOWLEDGE, PRACTICE AND ATTITUDE REGARDING CERVICAL CANCER SCREENING AMONG FEMALE TEACHERS OF GOVERNMENT SCHOOL, BHARATPUR, CHITWAN
Authors: Ranabhat Mina , Neupane Sarmila , Thapa Basanta
Published: April 2024

Background: In Nepal, cervical cancer ranks second highest after lung cancer among both sexes and stands as the leading cause of female cancer deaths. Preventative measures include Human Papilloma Virus vaccination and regular screening. This study aimed to assess the knowledge, attitudes, and practices regarding cervical cancer screening among female teachers in government schools in Nepal.
Methods: A cross-sectional study design was employed with a sample of 362 female teachers from selected government schools in Bharatpur Chitwan. A non-probability purposive sampling technique was used for sample selection. Data were collected between 2079/3/21 to 2079/6/20 using a structured self-administered questionnaire and were subsequently entered into IBM SPSS version 22 for analysis.
Results: Of the 362 respondents, only 16.3% demonstrated a good level of knowledge, and 36.1% displayed a good level of attitudes towards cervical cancer screening. However, only 38.3% had utilized cervical cancer screening services. Regarding the reasons for not using these services, 87.86% of respondents indicated the absence of any uterine problems, and 16.99% cited a lack of time for screening. The utilization of cervical cancer screening services showed a statistically significant association with respondents’ level of education (p=0.03), family type (p=0.003), shyness (p=0.016), and the absence of any uterine problems (p=0.04).
Conclusions: The findings indicate that a substantial percentage of respondents possess a good level of knowledge and attitude towards cervical cancer screening, yet only slightly more than one-third have utilized these services. Therefore, the need for awareness programs concerning cervical cancer screening is evident.
GRAFT UPTAKE AND HEARING AFTER ENDOSCOPIC PALISADE CARTILAGE MYRINGOPLASTY AT NEPAL MEDICAL COLLEGE TEACHING HOSPITAL
Authors: Rijal Anupama Shah , Joshi Rupesh Raj , Shrestha Kundan Kumar , Dhungana Anup
Published: April 2024

Background: Chronic otitis media mucosal type is commonly encountered in otorhinolaryngology. Myringoplasty is a common surgery performed to repair the tympanic membrane (TM). Management of subtotal perforation of the TM has become better with the use of endoscopes. The use of cartilage as palisade for repair of the TM has become popular. The aim of the study was to assess graft uptake and hearing after endoscopic palisade myringoplasty.
Methods: A prospective study was conducted in the otorhinolaryngology department from April, 2022 to January, 2023. The study included 65 patients, aged 21 years and above diagnosed as chronic otitis media mucosal type, inactive with subtotal perforation and conductive hearing loss. History, clinical examination, otoscopy, tuning fork tests, examination under microscope (EUM) were conducted preoperatively. All patients underwent endoscopic palisade cartilage myringoplasty. Pre-operative and post-operative pure tone audiograms of the patients were done to record the air conduction threshold (ACT), bone conduction threshold (BCT) and air bone gap (ABG). SPSS 16 software was used for analysis of results. The statistical tests used for analysis was paired t-test, level of statistical signiﬁcance was set at the P < 0.05.
Results: The mean age of the patients was 28.51±7.20 years with a female preponderance (57.9%). Graft uptake following surgery was 91.9%. There was significant reduction (p<0.001) in the air bone gap postoperatively that suggested improvement in hearing. The mean hearing gain was 13.91±6.79 dB.
Conclusions: The use of endoscopic palisade cartilage myringoplasty to correct subtotal perforation has good results in terms of graft uptake and hearing improvement.
ADDRESSING DEATH AND DYING THROUGH A MEDICAL HUMANITIES MODULE
Authors: Shankar Pathiyil Ravi
Published: April 2024

Death and dying are less addressed in the undergraduate medical curriculum. These issues are explored during a health/medical humanities module offered to undergraduate medical students. The screening of the movie ‘wit’ followed by group activities also explores this topic. A study exploring how this topic is addressed in Nepalese medical schools may be required.
PREVALENCE OF TWO VARIANTS OF MANDIBULAR SECOND PREMOLAR AT A TERTIARY CARE CENTER OF NEPAL
Authors: Poudel Pratibha , Adhikari Bhoj Raj , Bali Harleen
Published: April 2024

Background: Mandibular second premolar has two different types depending on the number of cusp present and each type has different groove patterns. There is difference in opinion regarding the influence on ethnicity in tooth morphology. This study aimed to determine the frequency of different type traits of mandibular second premolar in Nepalese population.
Methods: A descriptive cross-sectional study was carried out in the Department of Oral and Maxillofacial Pathology, Dhulikhel Hospital, Kavre from December 2022 to February 2023. A total of 418 participants were included in the study. Mandibular second premolars of both right and left sides were examined and number of cusps and groove patterns were noted. The data were entered in Microsoft Excel Sheet and descriptive statistical analysis were done using SPSS version 23.
Results: The frequency of two cusp type and three cusps type mandibular second premolar was noted to be 67% and 33% respectively. The predominant groove pattern in two cusp variant was H type in both males (32.8%) and females (38.1%). All the three-cusp variant showed Y shape groove in both males and females.
Conclusions: The frequency of different types of mandibular second premolar varies depending upon the population. Two cusps type mandibular second premolar with H shape occlusal groove is more common than three cusp type in Nepalese subjects.
UNVEILING REALITY: AN ENGAGING REVIEW OF CLIMATE CHANGE’S IMPACTS ON HUMAN HEALTH
Authors: Yong Kun Hing , Gautam Ajeevan , Chaulagain Rajib , Chu Cordia
Published: April 2024

Background: The phenomenon of global climate change has been observed worldwide. Scientists have determined that the Earth’s average temperature has increased by 1°C since the late 19th century. This change is attributed to the increase in greenhouse gas emissions from anthropogenic activities. Aside from rising temperatures, climate change also changes weather patterns and increases the frequency and magnitude of extreme events. This global issue has created long-term anxiety for the public due to negative impacts on ecosystems and human health. Climate change exacerbates health disparities, especially among vulnerable populations. This study aimed to review the current direct and indirect impact of climate change on human health in line with recent developments across the globe.
Methods: A comprehensive literature review was conducted in 2023, identifying and retrieving all related articles published between 2010 and 2023 from electronic databases. Additionally, grey literature from world organisations’ websites was also studied.
Results: This review found that climate change directly affects human health through climate extremes, excessive temperatures, and rising sea levels. Climate change also indirectly impacts health through food, clean water, infectious diseases, and migration.
Conclusions: Climate change needs to be addressed urgently, and collective action is needed to mitigate its impact. World leaders and policymakers should find ways to reduce greenhouse gas emissions, transition to clean energy investments and protect the health of vulnerable populations. Lastly, a heatwave is one of the climate-related extreme events that has become more frequent and intense but remains relatively understudied compared to other extreme events. Future climate change research should consider heatwaves and adaptation strategies.
REVOLUTIONIZING CRITICAL CARE NURSING: DEFEATING CHALLENGES AND UNLEASHING THE POTENTIAL OF ADVANCED HOSPITAL TACTICS
Authors: Kalia Raman , Charan Gopal Singh , Joshi Ujala
Published: April 2024

Critical care nurses face numerous challenges including ethical dilemmas, moral distress, high patient-to-nurse ratios, and emotional strain. Novel hospital strategies empower nursing excellence by optimizing workload distribution, establishing a positive work environment and culture, fostering emotional and mental well-being support systems, empowering Intensive care Unit (ICU) nurses with tech-driven training, embracing evidence-based nursing practices, collaborative solutions for ICU nursing shortages, promoting continuous process improvement, strengthening leadership and nursing advocacy efforts, and cultivating joy and connection through celebrating special occasions and offering additional incentives.
PROGNOSTIC VALUE OF THE NEUTROPHIL-TO-LYMPHOCYTE RATIO IN ACUTE PESTICIDE POISONING
Authors: Gauli Basanta , Adhikari Shital , Pandey Bikash , Karna Vikram , Timalsina Santosh
Published: April 2024

Background: Neutrophil to Lymphocyte ratio is a marker of oxidative stress and inflammation. It has gained increased attention in last few years for its prognostic value in several disease subsets. However, there is limited data about its potential role in setting of pesticide poisoning. This study aimed to explore the predictive value of NLR for severe clinical outcome in patients with acute pesticide poisoning.
Methods: An observational study was done at medical ICU of Chitwan Medical College from October 2022 to March 2023 among 62 patients of acute pesticide poisoning. The primary endpoint was severe clinical outcome which was defined as a composite of requirement of mechanical ventilation, need for vasopressors, new renal replacement therapy, or in- hospital mortality. The study patients were divided based on patients with severe clinical outcome(n=13) and those without (n=49) for analysis.
Results: The NLR ratio at hospital admission in patients with severe clinical outcome and those without were 2.8(1.9-5.9) and 3.3(2.6-11.6) respectively, higher in severe clinical outcome group but the difference was not statistically significant. The NLR had an area under receiver operating characteristics curve of 0.631 (95% confidence interval [CI], 0.472 to 0.790). NLR at hospital admission with a cut-off value ≥ 2.68 predicted severe clinical outcome with 76.9% sensitivity and 55% specificity.
Conclusions: The NLR at hospital admission had sub-optimal prediction ability for severe clinical outcome in this study setting. Thus, this cannot be used solely for early identification of patients at risk of severe clinical outcome in acute pesticide poisoning.
MUSCULOSKELETAL DISORDERS AMONG THE ORAL HEALTH PROFESSIONALS OF A DISTRICT IN NEPAL
Authors: Adhikari Santosh , Amgain Kapil , Humagain Manoj , Sanjel Sangita
Published: April 2024

Background: Musculoskeletal disorder is a potential occupational danger in dental profession. The study aimed to determine the current status of musculoskeletal disorders and the factors affecting the status of musculoskeletal disorders among the oral health professionals of a district in Nepal.
Methods: A cross-sectional, quantitative study was carried out among 102 oral health professionals working in different clinics/hospitals of Chitwan. Data were collected from 10th July to 5th August, 2021 and, analyzed with SPSS version 17. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Chi-square test and Fisher’s exact test were carried out to find out the association between various variables. Binary logistic regression analyses were done for the associated variables. Significance was set at p < 0.05.
Results: The study showed that 54.9% (44.7-64.8 at 95% Confidence Interval) of the oral health professionals had some form of musculoskeletal disorders, with the most common sites being neck (22.3%) and lower back (21.9%). Compared to the oral health professionals working in dentist-owned clinics, the odds of getting musculoskeletal disorders was 3.07 times higher among those working in non-dentist owned clinics, and 7.23 times higher among those working in government hospitals.
Conclusions: The study finds that neck and lower back are the most common areas of MSDs among the OHPs. It also demands further researches in order to probe into the reasons behind the higher susceptibility of MSDs among the OHPs working in non-dentist owned clinics and government hospitals as compared to those working in dentist-owned private clinics and hospitals.
RISK OF EATING DISORDER AND BODY SHAPE CONCERN AMONG UNDERGRADUATE NURSING STUDENTS
Authors: Shrestha Ashmita , Maharjan Sapana Kumari , Mehta Mamata , Pradhan Rita , Dhungana Sudarshan , Joshi Puspal
Published: April 2024

Background: Eating disorders (anorexia nervosa, bulimia nervosa and binge eating) are mental illness associated with severe disturbances in people’s eating behavior which results in both psychological and social impairments. Body image dissatisfaction might be an important predictor of increased incidence of eating disorder. This study aimed to assess the risk of eating disorder and body shape concern among undergraduate students at selected nursing colleges, Morang.
Methods: A descriptive cross-sectional design was conducted among 288 undergraduate nursing students selected by non-probability convenient sampling technique. Data was collected through self-administered method using EAT-26 and BSQ-34 standard tool. The obtained data were analyzed by descriptive and inferential statistics using SPSS version 16 software.
Results: Among 288 nursing students, majority (83%) of them had no risk while (17%) had risk of eating disorder. Similarly, majority (62.2%) of them had no concern with body shape, (19.8%) had mild concern, (12.2%) had moderate concern and (5.9%) had marked concern. There is a statistically significant association between the risk level and selected socio demographic variables like religion (P= 0.01*), weight (P=0.009*), BMI (P= 0.001*).
Conclusions: Majority of the students had no risk while very few students had risk of eating disorder. Almost half of the nursing students had mild to marked concern about body shape which can entice eating disorder.
STATUS OF TONGUE COATING AND PERCEIVED HALITOSIS AMONG THE PATIENTS SEEKING ORAL TREATMENT
Authors: Poudyal Sijan , Acharya Lochana , Yadav Karnika , Pradhan Amita , Chaulagain Rajib
Published: April 2024

Background: Tongue coating is accountable for various oral and systemic diseases. It is the prime cause of intraoral halitosis. Oral cleaning has primarily been focused on tooth cleaning, leaving the tongue neglected. Studies on tongue coating status have not been conducted in Nepal. Therefore, this study aimed to assess the tongue coating status and perceived halitosis among the patients seeking oral treatment in a tertiary care centre of Lalitpur, Nepal.
Methods: A cross-sectional study was conducted among 392 randomly selected patients above 18 years of age attending the Oral Medicine and Radiology department of KIST Medical College and Teaching Hospital. Demographic details, tooth brushing, tongue cleaning, and tobacco consumption habits and self perception of halitosis were recorded. Amount of tongue coating and plaque was assessed using Winkel tongue coating index and Silness and Loe plaque index respectively.
Results: The mean value of tongue coating was 5.06±3.35. Tongue cleaning was performed by 240(61.2%) participants and daily tongue cleaning was practiced by 142(36.2%) participants. Prevalence of oral malodor was 65.8%(n=258). Twenty three (5.9%) participants suffered from halitosis on a regular basis. Tongue coating was related with gender (p=.03) and tongue cleaning frequency (p=0.02). No relationship was observed between tongue coating and perceived halitosis.
Conclusions: Mean value of tongue coating was lower but higher percentage of people suffered from halitosis. Halitosis reduction and other health benefits can be motivating factors for people to clean their tongue. Oral health professionals should raise the awareness of tongue cleaning among general population.
PREVALENCE AND ASSOCIATED FACTORS OF OLDER ADULTS MISTREATMENT IN BHARATPUR, CHITWAN
Authors: Subba Hem Kumari , Subba Ramesh , Poudyal Sunita , Thapa Sara , Maskey Sreeja
Published: April 2024

Background: Older adults mistreatment is an important public health issue in both developed and developing countries. It has a significant impact on the physical and mental health of the older population. Hence, this study aimed to find out the prevalence and associated factors of older adults mistreatment in Bharatpur, Chitwan.
Methods: A cross-sectional study was used among 160 older adults aged 60 years and above admitted in medical and surgical wards of Chitwan Medical College Teaching Hospital. A non-probability purposive sampling technique was used to select the desired sample. The data were collected using a structured interview schedule. The collected data were analyzed using IBM SPSS version 23 and interpreted in terms of descriptive statistics (frequency, percentage, and median) and inferential statistics (chi-square test).
Results: Findings revealed that the median age of the older adult was 70 years where 57.5% were male, Brahmin (45%), and Hindu (79.4%). The prevalence of older adults mistreatment was 41.3%; among them, the most common types of self-reported mistreatment were psychological mistreatment (74.2%), financial mistreatment (59.1%), and neglect (59.1%), respectively. Educational status, occupation, depression, dependency level, old age allowance, chronic illness, and hearing abuse had statistically significant association with older adults mistreatment.
Conclusions: This study shows that older adults mistreatment is quite high, with psychological, neglect, and financial mistreatment being the most common. Thus, an awareness program for the elderly and caregivers is necessary for the prevention and management of older adults mistreatment and the wellbeing of the elderly by concerned authorities.
CHRONIC URTICARIA ASSOCIATED WITH DENTAL INFECTION: AN OVERLOOKED CAUSE
Authors: Kalwar Mahalaxmi Shah , Sundas Sunanada , Dhakal Neha , Rai Amita , Poudel Bishnu
Published: April 2024

Urticaria is a dermatological disease caused by various aetiologies namely infection, stress and allergy. Chronic urticaria can persist for long duration despite having proper medications. The most common reason for persistent urticaria can be attributed to undetected focus of infection in the body like untreated dental infection. This case report highlights the association of dental infection and persistent urticaria, in which the urticaria lesions persisting since three years got completely cured following the treatment of dental infection in a nine-year-old boy.
AMYAND'S HERNIA, UNVEILING A UNIQUE PRESENTATION IN HERNIA SURGERY: A CASE REPORT
Authors: Paudyal Nabin Paudya; , Hassan Seema , Emaan Abdulla , Devkota Yogendra
Published: April 2024

Amyand’s hernia, characterized by the appendix within a hernial sac, is rare. We present a unique case in a 66-year-old deaf, non-verbal male with bilateral groin swelling initially suggestive of bilateral inguinal hernias. Intraoperatively, we discovered a right-sided Amyand’s hernia concurrent with bilateral pantaloon hernias. Treatment involved bilateral inguinal hernioplasty and appendectomy, tailored to the patient’s needs. The postoperative period was uneventful. Our report significantly enriches Amyand’s hernia literature, addressing diagnostic and treatment complexities. Our case is noteworthy due to the exceptional occurrence of bilateral hernias in a deaf-mute Amyand’s hernia patient, posing ethical challenges during consent and necessitating the involvement of the patient’s elder son. Documenting these intricate ethical and surgical issues in this rare case provides valuable insights for surgeons encountering similar scenarios, thereby advancing the field.
OUTCOME OF THERAPEUTIC PENETRATING KERATOPLASTY IN A TERTIARY EYE HOSPITAL IN NEPAL
Authors: Pandey Manish , Luitel Pragya , Singh Sanjay Kumar , Sitoula Rakshya Panta , Karn Rajiv Ranjan
Published: April 2024

Background: Therapeutic penetrating keratoplasty is the most common variety of keratoplasty performed in the developing countries. The objective of this study was to assess the outcome of therapeutic penetrating keratoplasty in infective keratitis.
Methods: This was a hospital based retrospective study where medical records of patients who underwent therapeutic penetrating keratoplasty between July 2021 and December 2022 were analyzed. Data collected included demographic parameters, indications for surgery, microbiology of the ulcers, donor details. Success was evaluated in terms of eradication of the disease, anatomical stability, graft clarity and visual acuity. SPSS software version 20.0 was used for statistical analysis. The mean, standard deviation, frequency and percentage were calculated
Results: Sixty-seven patients of therapeutic penetrating keratoplasty who completed 2 months of follow-up after surgery were included in the study. Corneal scrapings and corneal buttons were positive for organisms in 19 cases (90.47%) and 20 cases (29.85%) respectively. In all,out of 67 eyes, 30 (44.77%) were positive for organisms in smear or culture or both, of which 27 cases showed pure fungus and 3 cases showed pure bacteria. Aspergillus (8, 29.62%) was the commonest fungus isolated. Eradication of infection after the primary procedure was seen in 48 cases (71.64%). Anatomical success was seen in 60 eyes (89.50%), clear grafts were seen in 23 eyes (34.32%). Visual acuity of ≥6/60 was seen in 14 eyes (20.89%).
Conclusions: Therapeutic penetrating keratoplasty provided good success in terms of maintaining anatomical integrity and helps in eradication of infection while giving satisfactory functional outcome.
POSTNATAL MOTHERS’ EXPERIENCE OF DOMESTIC VIOLENCE AGAINST WOMEN DURING PREGNANCY
Authors: Acharya Tara Kumari , Bhattarai Sanju , Adhikari Bijaya , Ghimire Ambika , Bajracharya Karuna
Published: April 2024

Background: Violence against women is a social problem that has serious consequences on women’s physical, and psychosocial well-being. The violence against women ultimately also affects children, families, and society as a whole. This study aimed to identify the experience of domestic violence against women during pregnancy.
Methods: A descriptive cross-sectional study was conducted among purposively selected 302 postnatal mothers of postpartum A, B and Gynae ward of Patan Hospital. Data were collected through face-to-face interviews using a structured interview schedule. Data were analyzed in IBM SPSS Statistics version 20.0 using descriptive statistics.
Results: Postnatal mothers experienced sexual violence by their husbands (8.9%), physical violence (12.9%), and emotional violence (43%) from their husbands and or family members. Regarding other forms of violence, mothers experienced not being given nutritious food during pregnancy (38.4%) and violence by their mother-in-law (45.4%). Likewise, few number of mothers have reported the violence (17.2%). Among them, 76.9% reported the incident of violence to the maternal side.
Conclusions: The findings suggest a concerning prevalence of various forms of violence against postnatal mothers like sexual, physical, and emotional. Among those form of violence, existence of emotional violence was high and often perpetrated by husbands or family members. Moreover, the low reporting rates highlight the urgent need for enhanced support structures and interventions to empower victims and address the underlying issues contributing to this pervasive problem.
LAPAROSCOPIC DISTAL PANCREATECTOMY FOR ISOLATED PANCREATIC INJURY IN BLUNT ABDOMINAL TRAUMA – A CASE REPORT
Authors: Bhujel Sushim , Khatiwada Sagar , Yadav Prasun , Koirala Nishnata , Belbase Narayan Prasad , Shrestha Nischal
Published: April 2024

Pancreatic injury presenting as an isolated injury in the pediatric population is rare. Unlike other solid organ injuries, these injuries may be subtle and difficult to diagnose. The management options vary from conservative management for low-grade injuries to surgical management for high-grade injuries; The optimal course of treatment is best determined by the severity of the injury and its clinical presentation. Laparoscopic distal pancreatectomy has increasingly been described as a feasible procedure for the surgical management of such injuries.Here we present our experience with a twelve-year-old boy with epigastric pain for eighteen hours following a road traffic accident. He was hemodynamically stable with no external signs of injury, and investigations were initially normal, but later he developed leukocytosis and hyperamylasemia; a repeat contrast-enhanced computed tomography (CECT) diagnosed an isolated grade III pancreatic injury. The case was initially managed non-operatively, but a laparoscopic distal pancreatectomy was later performed due to an acute abdomen caused by generalized peritonitis.Laparoscopic distal pancreatectomy can be a safe and valuable surgical option when the surgical approach is considered for pancreatic injury. Laparoscopic distal pancreatectomy has been associated with an overall decrease in morbidity.
COMPUTED TOMOGRAPHY STUDY OF THE THYMUS AT A TERTIARY CARE CENTRE OF NEPAL
Authors: Basnet Prabhat , Upadhyay Hari Prasad , Chaulagain Rajib
Published: April 2024

Background: Thymus is a small, irregular shaped gland mainly concerned with immune function. Studies have shown that in different age groups and in genders, the morphology of thymus is variable. Hence this study was aimed to access the different shapes, size of thymus gland using Computed tomography scan.
Methods: The study was a descriptive cross-sectional study conducted in Department of Radiology and Imaging, College of medical sciences, Bharatpur, Nepal.  This study was conducted for a period of three months among 104 patients. Computed tomography examination was conducted by the Toshiba 160 slice CT scanner with slice thickness of 1.5mm. Statistical analysis was done with Statistical Package for the Social Sciences (SPSS) version 16. Only descriptive statistics were employed and the results were presented in tabular format.
Results: In total 104 patients participated in this study. The frequency of male was 39 (37.5%) and female 65 (62.5%). The mean age of patients was 55±15.1 years. The mean anteroposterior diameter in the male was 17.62±5.98 mm and in female it was 16.02±5.78 mm, similarly the transverse diameter in male was 30.85±11.85 and in female it was 28.80±10.23 mm. Triangular morphology was most common among both male and female with frequency of 31(79.5%) and 34(52.3%) respectively.
Conclusions: Thymus gland is slightly larger in males than females. From this study we can conclude that triangular thymic shape was most frequently observed morphological shape in both male and female.
KNOWLEDGE, AWARENESS AND PRACTICE REGARDING ORAL CANCER AMONG UNDERGRADUATE STUDENTS AND INTERNS IN A DENTAL HOSPITAL
Authors: Gupta Abhishek , Singh Harender , Poudyal Sijan
Published: April 2024

Background: Oral cancer is one of the three most common types of cancer and 2nd most common cancer in males in Nepal. The main causes of oral cancer are the consumption of tobacco, areca nuts, alcohol, betel nuts etc Very few studies have been done in Nepal regarding awareness of Oral Cancer among college-going students. Since future doctors will also be responsible for the prevention and management of Oral cancer, it prompted us to conduct a study to evaluate the awareness, knowledge and practice regarding Oral cancer.
Methods: This cross-sectional study was done after the clearance from the Institutional Review Committee. The study sample was among the 700 BDS and MBBS Students and Interns who responded through the Google Forms questionnaire online, within 1 month. The questionnaire consisted of 10 validated questions, related to Oral cancer. The results were tabulated in Microsoft Excel/ spreadsheet by Google. Descriptive statistics were obtained and frequency and percentages were calculated.
Results: Among the 405 participants, only 15.5% routinely examined the oral mucosa, 98.51% are going to advised the patients regarding the risk factors of oral cancer, 79.25% felt they had not been sufficiently taught to diagnose oral cancer, 82.71% felt that they were inadequately informed about clinical appearance of oral cancer, 86.91% felt that they have inadequate knowledge concerning prevention and detection of oral cancer and 60% said they are going to refer a patient with suspected oral lesion to oral medicine.
Conclusions: There is an overall lack of awareness among the participants regarding the requirement to routinely examine the oral cavity. The participants do not have adequate knowledge and awareness regarding oral cancer prevention and early detection.
AN UNUSUAL CAUSE OF ACUTE SMALL BOWEL OBSTRUCTION
Authors: Giri Barsha , Mandal Rajesh Kumar , Tamrakar Kishor Kumar , Acharya Bishal , Dhungana Saroj
Published: April 2024

Up to 20% of admissions with severe acute abdomen are due to intestinal obstruction, a common surgical emergency. Paraduodenal hernia is a rare entity of congenital internal hernia which is an unusual cause of small bowel obstruction. This case report describes the case of a 29-year-old woman with acute pain abdomen and vomiting without other significant past history. Radiological investigations revealed mechanical bowel obstruction and gangrenous bowel loops was evident on surgical exploration. Non-viable small bowel loop was resected and peritoneal defect was sutured. Left paraduodenal hernia is a rare cause of acute abdomen and high index of suspicion is required for early diagnosis and management.