bluuebunny/crossref_metadata_2025 huggingface dataset:
RUPIAH CURRENCY INTRODUCTION PROGRAM FOR CHILDREN OF MIGRANT WORKERS IN MALAYSIA
Authors: Gymnastiar Iman Ahmad , Roisah Roisah , Azizah Siti Nur , Shahla Nazwa Khaira , Azhahra Almahira Putri , Nelson Feby , Simorangkir Prita Laura Angelica , Nugroho Septian Widyo , Maulidah Syarofina Izna , Syifa Nurul Mustika , Nugraha Aditya Setya , K Intan Duta Swara , Bachri Sagita Nur , Pratama Alga
Published: July 2024

This program's goal is to enhance the understanding and skills of the children of Indonesian migrant workers in Malaysia in recognizing and understanding the Rupiah currency. Through an interactive and creative approach, this program combines information technology, mock money, and hands-on teaching to 32 children in Malaysia.. The results of this program include children's ability to demonstrate methods of distinguishing between natural and imitation currency, an understanding of how to care for money properly, the ability to compare the value of Ringgit and Rupiah currency, and the ability to recognize, sort and count the amount of Rupiah currency. This program provides practical knowledge of currency and engages children in activities supporting essential financial skills development. With the involvement of the Indonesian Young Spirit, this program is a form of positive contribution in equipping the children of migrant workers with relevant knowledge to face life in Malaysian society.
PELATIHAN PENGGUNAAN APPSHEET UNTUK PENGELOLAAN ARSIP DIGITAL ORGANISASI DI JPRMI DKI
Authors: Oktaviana R Shinta , Kurniawati Laela , Putri Sukmawati Anggraeni , Utami Lilyani Asri
Published: July 2024

Jaringan Pemuda Remaja Muslim Indonesia (JPRMI) Jakarta merupakan organisasi yang sudah cukup sering menjadi mitra pengabdian masyarakat dengan Universitas Nusa Mandiri. Organisasi ini merupakan organisasi sosial yang berangotakan remaja masjid se Jakarta. Di era teknologi digital, JPRMI Jakarta mulai mengganti arsip manual (hardcopy) menjadi arsip digital. Arsip digital menjadi salah satu elemen penting dalam pengelolaan organisasi modern. Appsheet merupakan salah satu aplikasi google yang menyediakan fitur-fitur untuk membuat suatu aplikasi tanpa harus mengerti dan melakukan pemrograman. Appsheet mampu mengotomisasi proses bisnis organisasi dengan menghubungkan semua dokumen digital yang tersedia pada aplikasi google. Untuk itu, kegiatan ini diharapkan dapat memberikan pengetahuan dan keterampilan bagi pengurus untuk pembuatan web organisasi dengan menggunakan data-data ditigal organisasi yang ada di spredsheet dan google drive menggunakan appsheet. Kegiatan ini dilakukan dalam bentuk pelatihan langsung kepada pengurus. Sehingga para pengurus mendapat keterampilan dalam menggunakan aplikasi appsheet. Hasil pelatihan diharapkan membantu meningkatkan kinerja oraganisasi dalam melakukan adaptasi teknologi informasi.
ALAT PERAGA DISPLAY UNTUK PRODUK USAHA KECIL MENENGAH
Authors: Darajat Teddy Mohamad , Murtiharso Yosaphat Danis , Hulu Dalizanolo
Published: July 2024

Tujuan jangka Panjang dari alat ini bagi penggunaanya adalah lebih mengutamakan standar visual hasil photography yang selama ini masih dianggap mahal. Dengan teknik sederhana tetapi bisa menghasilkan kualitas yang baik karena pada prinsipnya mengolah cahaya yang dirubah menghasilkan efek visual yang baik terlihat mata. Alat ini jika nanti diproduksi masal bisa menghasilkan nilai peningkatan ekonomi yang signifikan. Dapat juga digunakan untuk program pelatihan photography di kalangan UKM yang ingin mendapatkan hasil yang baik untuk tampilan brosur atau pamflet produknya. Target khususnya adalah selain memberikan ilmu kepakaran dalam bidang photography produk juga menggunakan manajemen bisnis sebagai modal perluasan penjualan dan distribusi. Kelimuan komunikasi bisa menjadi alat menyampaikan konsep visual bagi panca inder yang menerimanya yaitu: visual display adalah display yang dapat dilihat dengan menggunakan indera penglihatan. Metode yang dipakai adalah menggunakan prinsip desain visual display yang dikategorikan menjadi yaitu: Pertama, proximity (kedekatan elemen) elemen-elemen diatur/ diorganisasikan sedemikian rupa berdasarkan kedekatan posisinya sehingga akan lebih mudah dalam memberikan suatu perkiraan. Alat display sebagai mesin yang menangkap detail visual yang akan di presentasikan oleh manusia sebagai operator. Kedua, Display berfungsi sebagai suatu “sistem komunikasi” yang menghubungkan antara fasilitas kerja maupun alat kepada manusia. Adapun yang bertindak sebagai mesin dalam hal ini adalah alat pemutar. manusia disini berfungsi sebagai operator yang dapat diharapkan untuk melakukan suatu respon yang diinginkan. Penggunaan data statistik yang berasal dari calon konsumen sebagai acuan untuk mendapatkan informasi yang akurat tentang kebutuhan alat yang dimaksud.
CORPORATE BOND MARKET IN INDIA: A REVIEW OF FACTORS LIMITING THE DEVELOPMENT
Authors: NADAF ALLAUDDIN , Dr.Shivappa
Published: July 2024

The corporate bond market helps the companies raise long-term finance, which is essential external source of capital. The Indian corporate bond market is still in its early stages of development, and as a result, it lacks the depth found in more mature markets. This paper aims to understand the factors that have limited the development of the corporate bond market in India. In addition, the paper examines the requirements for corporate bond market development, where the government bond market is doing quite well. This paper is designed as a literature review previously attempted to elaborate on the current state of corporate bond markets. The research is limited to previous studies and secondary data. Based on the literature review from previous studies and recently available market statistics, the main factors that constrain the development of Indian corporate bond markets are performance metrics, corporate governance, opacity to information and credit rating mechanism, financial infrastructure, and cost associated with issuance influence the corporate bond markets. The Indian government and Reserve bank have simultaneously tried to develop the corporate bond market.
A COMPREHENSIVE STUDY ON THE ROLE OF FORENSIC ACCOUNTING IN DETECTING FINANCIAL FRAUDS WITH REFERENCE TO KARNATAKA
Authors: Dr. Abhinandan N  , Karthika Ravi
Published: July 2024

This study investigates the role of forensic accounting in spotting financial frauds and the efficiency of forensic accounting in dealing with problems involving financial statement manipulation in Karnataka and also understand the standards issued by ICAI.  This study seeks to analyze the services provided by forensic accountants in Karnataka as well as the future of forensic accounting in the state in light of increasing numbers of fraud. The questionnaire approach is one of the quantitative research techniques used in this study. Investigating, spotting, and proving the legal case against such crimes through the use of accounting knowledge is known as forensic accounting. The major goals of forensic accounting include presenting the results of an inquiry in a style that allows for interrogation in court and to give proof that financial fraud has occurred.
SYNERGIZING ACADEMIC ANIMATION AND AI INTEGRATION FOR ENRICHED LIBRARY EXPERIENCE
Authors: Inamdar Saba
Published: July 2024

Libraries must maintain a harmonic balance between technology and the human aspect to ensure patrons receive the best possible service. This conceptual paper combines academic animation and artificial intelligence to create a library experience. This study proposes using animation to enhance patrons' library experience. Using artificial intelligence and machine learning in a natural language can enrich the library experience.
Handbook Of Data Structures And Algorithms (Implementations Through CPP, Java And Python)
Authors: Rajasekaran Mrs. Vidya ,   Assistant Professor  Department of Computer Science and Engineering (Artificial Intelligence and Machine Learning)  St. Peter’s Engineering College, UGC Autonomous, Telangana, India., Deepan Dr. P. , Arul Mr. N. , Shaik Dr. Amjan ,   Associate Professor and Head   Department of Computer Science and Engineering (AIML) St. Peter’s Engineering College, UGC Autonomous, Telangana, India.,   Assistant Professor  Department of Computer Science and Engineering (Artificial Intelligence and Machine Learning)  St. Peter’s Engineering College, UGC Autonomous, Telangana, India.,   Professor and Dean (Research & Development) Department of Computer Science and Engineering St. Peter’s Engineering College, UGC Autonomous, Telangana, India.
Published: July 2024

To solve difficult problems with data structures and algorithms, one might refer to the “Handbook of Data Structures and Algorithms (Implementations Through CPP, Java and Python)”. Written in C, C++, Java, and Python, with several answers provided for each issue, this book is perfect for computer science interviews and exams. People working in computer science could find it useful as a reference book. Interviews, tests, and campus work may all be better prepared for with the help of this book. To sum up, this book provides answers to a wide range of algorithmic and data structure challenges.
Fundamentals Of Big Data Analytics
Authors: Grace Dr. J. Sylvia ,   Assistant Professor  Department of Computer Science and Engineering Sathyabama Institute of science and technology Chennai, Tamil Nadu
Published: July 2024

By shedding light on the qualities and benefits that such an asset brings to every prosperous economic firm, this book provides a comprehension of Big Data and what it implies to use a foundation of Big Data. The topic is explored by means of a case study that puts the reader in the shoes of a made-up company, Serif Industries, which has formally begun a Big Data program in an effort to get an edge over its competitors.
IMPLEMENTASI PENDEKATAN TEACHING AT THE RIGHT LEVEL (TARL) TERINTEGRASI KONSEP UNDERSTANDING BY DESIGN (UBD) UNTUK MENINGKATKAN MOTIVASI BELAJAR SISWA SMA PADA PEMBELAJARAN BIOLOGI
Authors: Ni Nyoman Serma Adi  , Dewa Nyoman Oka  , I Ketut Surata
Published: July 2024

Teaching at the right level (Tarl) is a student-centered learning approach where students are grouped into groups with certain cognitive levels. Meanwhile, Understanding by Design (Ubd) is a reverse learning design or backward design where the process consists of determining objectives, then assessing and compiling learning activities which, if integrated, will be able to achieve optimal learning objectives and increase learning motivation. This research aims to determine whether the implementation of teaching at the right level (Tarl) integrated with the concept of Understanding by design (Ubd) can increase students' learning motivation at Surya Wisata Kediri Tabanan Senior High School. This type of research is classroom action research (PTK), using a cycle design from Kemmis & Mc Taggard. The location of this research is at Surya Wisata Kediri High School in class X MIPA 1 with research subjects of 32 students. Based on the research, the results obtained are that the implementation of the Teaching at the Right Level (TaRL) approach integrated with the Understanding by Design (UBD) concept can increase students' learning motivation, where in the pre-cycle the percentage of students was in the low category, in the first cycle the percentage was 24.21%. Student motivation increased to 59.24% in the medium category and in cycle II it increased to 80.56% in the high category. So it can be concluded that the implementation of the Teaching at the Right Level (TaRL) approach integrated with the concept of Understanding by Design (UbD) can increase high school students' learning motivation in learning biology.
FILSAFAT TARI DALAM KEBUDAYAAN BALI
Authors: Ni Made Pira Erawati
Published: July 2024

Balinese dance is an ethnic Balinese dance that is imbued with Balinese Hindu cultural values, as an embodiment of Balinese cultural character. The characteristics of Balinese culture are socio-religious which contains its own philosophy which can be categorized as sacred art and profane art. With the categories sacred and profane, Balinese dance is classified into wali, bebali and balih-balihan arts. As a sacred art, Balinese dance is a treat of beauty to the forces of nature, and as a profane art, it is a treat of beauty to society. This article aims to understand the philosophy of dance in relation to Balinese culture which is based on Hindu religious teachings. The problem that is the main subject of the study to explain this goal is, what is meant by Balinese dance, and what is its relationship with Balinese culture. The study of the problems above is based on the results of observations of Balinese dance which were analyzed using the approach of art philosophy and aesthetic theory which is divided into morphological aesthetics and psychological aesthetics. The results of this study show that Balinese dance contains a philosophy of life that is imbued with the teachings of Balinese Hinduism in realizing truth and purity aesthetically
Pengaruh Progressive Muscle Relaxation terhadap Tingkat Insomnia pada Lansia di Panti Wredha Maria Sudarsih
Authors: Badriyani Ayu , Nurhidayah Ninik
Published: July 2024

Abstract
Background: The elderly experience many changes that cause sleep pattern disturbances, namely insomnia. The technique used to treat insomnia nonpharmacologically is progressive muscle relaxation. Objectives: This study aims to determine the effect of progressive muscle relaxation on insomnia level of the elderly at Panti Wredha Maria Sudarsih. This study is quantitative research using pre-experimental design with one group pretest-posttest. The study was conducted in Panti Wredha Maria Sudarsih. The time of the study was conducted in April 2023-March 2024. Methods: Data collection methods are using interview, questionnaire, observation, and documentation. The number of samples was 27 respondents. The instrument used to measure insomnia level is the insomnia severity index. Progressive muscle relaxation is carried out for 20-30 minutes per session with a frequency of 3 times a week for 8 therapy sessions. The data analysis technique used paired sample t-test. The majority of the sample is old elderly with an age range of 75-90 years (63,0%), don’t have comorbidities (51,9%), and have educational levels, namely no school, junior high school graduate, and high school graduate (25,9%). Results: The results of data analysis obtained t=13,454, p=0,000. Conclusion: There is an effect of providing progressive muscle relaxation on insomnia level of the elderly at Panti Wredha Maria Sudarsih. Therefore, progressive muscle relaxation techniques are recommended in the elderly to reduce the level of insomnia.
Keywords: Progressive Muscle Relaxation, Insomnia Level, Elderly
Urethral prolapse in a 4-year-old girl: A case report
Authors: Opar Tonny O , Koigi Mary K , Ojukwu Idyoro J , Mwangi Robert I , Kimemia Martin M , Mukui Kelvin  K , Abukar Maryan A , Ngoigo Moses M
Published: July 2024

Background: Urethral prolapse is a rare cause of vaginal bleeding in prepubertal females and occursmore commonly in black girls. It is characterized by protrusion of the distal urethral mucosa at orbeyond the level of the urethral meatus. It is often mistaken for sexual abuse in children because itpresents with vaginal bleeding, creating anxiety among parents and confusion among clinicians.Case presentation: A 4-year-old girl presented to the outpatient department with a 2-day history ofvaginal bleeding. However, no lower abdominal pain was reported. Sexual abuse was initiallysuspected. A diagnosis of urethral prolapse was made during examination under anesthesia.Surgical excision and postoperative care were performed.Conclusion: Urethral prolapse, although rare, can occur in prepubertal black girls and is managedeither surgically or through conservative approaches.
Prevalence of Rhesus D negativity and barriers to immuno- prophylaxis among obstetric patients in Kitengela Sub- county Hospital: A cross-sectional study
Authors: Njiru James , Omar Muhamed , Esiromo Marian , Kandie Edith , Silla Montella , Were Francis , Ogombe Samuel , Koigi Paul
Published: July 2024

Background: Rhesus (Rh) alloimmunization is a serious but preventable disease that develops in women who are Rh(D)-negative. This disease contributes significantly to perinatal morbidity and mortality. Prevalence data of Rh(D)-negative blood type among pregnant women in Kenya are scarce. This study aimed to determine the prevalence of Rh(D)-negative blood type, barriers to immunoprophylaxis, and ABO blood type patterns among the obstetric population in Kitengela Subcounty Hospital, Kajiado, Kenya.
Methods: A cross-sectional study design was employed in which medical records of Rh-negative women as documented at the first antenatal visit were retrieved. Data were collected, extracted into a data collection tool, and analyzed using the Statistical Package for Social Scientists Software (SPSS version 23). 
Results: Of the 7141 women screened, 1.2 % (85) were Rh-negative. Among these, blood group O was the most common (48.2%), followed by blood groups B (24.7%), A (23.5%), and AB (3.5%). Most Rh-negative women (45.9%) were aged 15-23 years. Following delivery, only half of the women received anti-D immunoglobulin. Among those who did not receive anti-D postnatally, 80.8% lacked a documented reason, whereas 12.2% and 4.9% of the patients lacked access and did not know their Rh status, respectively. None of these patients had fetal blood grouping conducted before anti-D administration.
Conclusion: Rh(D) negativity remains prevalent in the Kenyan population. However, access restrictions at both diagnostic and therapeutic levels remain. In addition, there is an overt hiatus in neonatal blood grouping.
Biting More Than It Can Chew
Authors: Sznajder Marta
Published: July 2024

Among (too) many other things, the recently adopted European Media Freedom Act (EMFA) introduced an assessment of the impact of media market concentration on media pluralism and editorial independence. It thereby aims to address the growing economic threats media pluralism and freedom have been facing all across Europe. However, when considering recent media merger cases in Poland as well as the substantive and institutional competition law framework, it is uncertain whether the Act will provide efficient solutions.
Development of a scale for assessing academic stress: a preliminary report
Authors: Sinha Uday K , Sharma Vibha , Nepal Mahendra K.
Published: July 2024

This article describes the process of development and standardization of the Scalefor Assessing Academic Stress (SAAS) on a sample of 400 high school and college students of different grades. Thirty item scale prepared based on 'yes' and 'no' format was found to have high test -retest and split-half reliability, adequate internal consistency, adequate validity against Academic Anxiety Scale for Children (AASC) and Beck Depression Inventory (BDI), and ability to yield normally distributed data on academic stress. Separate norms for boys and girls of different grades (grade VIII tograde XII) were developed. Clinical, research, educational and other implications ofthe scale is discussed along with the need for further studies on different population.
Sepsis: a private hospital experience in Nepal
Authors: Lakhey S. , KARKI B. , SAKYA S. , Pandey S.B.
Published: July 2024

Introduction: Sepsis, severe sepsis and septic shock are associated with high mortality. Data about patient profile and outcome of sepsis in ICU of Nepal is lacking. This study was conducted to investigate the source of infection leading to sepsis, its complications and eventual outcome.
Material and Methods: It is a prospective study carried out fromAugust 2004 to July 2005 in the ICU of B & B Hospital. The patients admitted in the ICU with the diagnosis of sepsis in accordance to the criteria laid down byAmerican College of chest physician and Society of Critical Care Medicine were analysed and followed up. Age, sex, source of infection, duration of stay in the ICU, co-morbidities (Mc Cabe’s score), associated severe sepsis, septic shock, acute respiratory distress syndrome (ARDS), multiple organ dysfunction syndrome (MODS), disseminated intravascular coagulation (DIC) and the eventual outcome of sepsis were taken into account. The cause of death was also studied. Infection was diagnosed on the basis of clinical, radiological and microbiological parameters.
Results: Of the 28 patients included in the study, 53.6% were male and 46.4% were female, the youngest was 15 years old and the oldest was 93 years old. More than half of the patients were more than 60 years old (53.6%)the average stay in the ICU was 6 days and the main source of infection was lung/respiratory tract (57.14%). 10.7% had sepsis, 89.3% had severe sepsis, 82% had septic shock, 42.9% had MODS, 32.1% hadARDS and 7.1% had DIC. The overall mortality was 39.3%. In elderly the mortality rate was higher (46.7%). The mortality rate was highest in patients with MODS. The mortality rate of sepsis, severe sepsis and septic shock increased progressively from 0%, 39.3% and 47.8% respectively. The mortality rate in patients with ARDS was 55.6%. The most commonly failing organ was circulatory system (82.1%). The mortality was 100% in patients with 3 or more organ failure.
Concluction: Sepsis with its complications has high mortality in our hospital that is similar to the recent findings in Brazil, Norway and USA. Awareness of sepsis and its appropriate treatment as per Surviving Sepsis Campaign Guidelines has become mandatory to reduce its mortality.
Increase use of contact lenses for optical correction
Authors: Poudel P. , Khadka J. , SAKYA S. , Shrestha J.K. , Shah D.N.
Published: July 2024

Introduction: Contact lenses (CL) are considered as a widely accepted modality of refractive correction in the last few decades, though their history is nearly about 100 years old. Millions of people are wearing contact lenses all over the world. Every year the number of CL wearers has increased significantly. No definite statistics are available regarding the number of people wearing contact lenses in Nepal. Contact lenses are not used only for refractive correction but also for therapeutic and cosmetic use.
Methods: The main purpose of the study was to find the popularity of contact lenses irrespective to other optical correction. A hospital based retrospective study was conducted evaluating the medical records of 848 CL patients attended in CL clinic at B. P. Koirala Lions Centre for Ophthalmic Studies.
Results: In this study, the number of CL wearers was found to increase significantly every year. The number of contact lens wearers in the year 2002-2003 was 158 where as in the later years the number reached up to 326 and 364 respectively. Similarly, the numbers of RGP wearers and bandage CL wearers also increased significantly in comparison to previous years. Almost 90 percent wearers were using soft contact lens. It was found to be more popular among the age group of 21yrs to 30 yrs. The number of female wearers was predominant than the male wearers. The contact lens wear ocular complications were found to be very rare.
Conclusion: In Nepal, contact lenses are being considered as suitable alternatives for optical correction due to better cosmesis than the conventional mode of optical correction.
All drugs are poisons at a higher dose - acute paracetamol poisoning
Authors: Palaian S. , Shankar P.R. , Poudel R. , Mishra P.
Published: July 2024

Paracetamol is considered to be a safe and effective drug and is available over the counter in many countries including Nepal. Though it is considered safe at its therapeutic dose, it may be toxic at higher dose. It is recognized as a major drug leading to poisoning in the United States of America,United Kingdom and even in Nepal. Several factors such as age of the patients, sex, alcohol intake, disease conditions, concomitant drug intake etc are known to be important factors affecting the severity and outcome of the poisoning. The signs and symptoms are exhibited in a sequentialmanner and may start with mild nausea and may end with fulminant hepatic failure. Though paracetamolpoisoning is associated with many complications and may affect the cardiovascular, respiratory and renal systems, hepatotoxicity is the major complication leading to death. Since paracetamol may beavailable in combination with other drugs, on many occasions the patient may not present with classical symptoms of paracetamol poisoning. Several laboratory investigations along with the patients’ signs and symptoms help in diagnosis. The management involves symptomatic treatmentand a specific antidote mainly N-acetyl cysteine. The estimation of plasma paracetamol concentrationis beneficial in diagnosing as well as monitoring the poisoned patient. The pattern and management of paracetamol poisoning varies with the patient populations such as pregnant women, pediatricpatients etc. Several strategies including restriction of pack size have been implemented worldwide to prevent the occurrence of paracetamol poisoning. Availability of unbiased drug information isvery much essential in management.
Recent advances in hormonal replacement therapy
Authors: Singh Meeta , Jha Rajshree
Published: July 2024

There are various methods of hormonal replacement therapy (HRT). The oral route has been used for over 3 decades. Despite its proven efficacy by this route, dose related adverse effects is a major drawback due to hepatic first pass metabolism. In recent years, a number of non oral-routes which avoid hepatic first pass metabolism, have been used in hormonal replacement therapy (H.R.T.). These include intramuscular depot injections, subcutaneous implants, vaginal creams and pessaries. Recently transdermal patches known as the transdermal therapeutic system (T.T.S.) contains estradiol known as Estraderm and Systen; this contains micronized 17ß estradiol, which is an outgrowth of the ongoing evolution of transdermal delivery system.
Cataract surgery in Mechi Eye Care Centre, Nepal
Authors: Singh Sanjay Kumar , Dahal Tulasi , Sharma Divya
Published: July 2024

Since the establishment of Mechi Eye Care Centre, 783 patients have had cataract surgeries with the implantation of intraocular lens in their eyes in the period between 1 December 1996 and 15 May 1998. Ninety-one percent of the patients regained vision better than 6/18 with minor refractive correction. There was no sight threatening and eye threatening complications noted in the intraoperative and postoperative period.
Hypertensive patients in eye OPD, TUTH
Authors: Badhu BP , Shrestha JK
Published: July 2024

A retrospective hospital-based analysis of cases with systemic hypertension attending the eye out-patient department (OPD), TU Teaching Hospital (TUTH) was done. Out of 56 cases, 30 had hypertensive fundus changes. Twenty per cent of hypertensive patients of less than 6 months duration had fundus changes. Among them 26.6% were not aware that they were hypertensives. More females (40%) had severe grade of hypertensive fundus changes and more of them (43.3%) had uncontrolled hypertension than males. Branch retinal vein occlusion (23.3%) was the most commonly encountered ocular complication of hypertension. Diminution of visual acuity (40%) and a headache (36.7%) were common presenting features of hypertensive patients with fundus changes.
Tribhuvan University certificate nursing curriculum
Authors: Regmi K. , Regmi S. , Shahi M.
Published: July 2024

Introduction: A Nepalese certificate of nursing curriculum was developed in 1977 and has been used since with a few revisions. There has been open debate about continuing gaps between theory, as expressed in the curriculum, and practice. The purpose of this study was to evaluate this 3-year undergraduate curriculum, and to draw general lessons, which might help to develop appropriate strategies to improve nursing education in Nepal.
Methods: A mixed evaluation method was used consisting of reviews of current curriculum theories/models, and interviews with nursing students (15) and nursing tutors (10).
Results: Both students and tutors were generally positive about the curriculum and its intended learning outcomes. While reviewing the existing curriculum, analysis revealed that there was limited use of curriculum theories and models.
Conclusions: There is a need to focus more on the development of abilities related to evidence based learning. Selection of appropriate teaching-learning methodologies in response to the growing needs of students and professionals, development of learning strategies to reduce the gap between educational theories and nursing practice, in line with a humanistic paradigm in nursing education is important.
Prevalence of PSA in suspected cases at TUTH
Authors: Jha Bharat , Gurung Chitra Kumar , Mishra Dr. Parashuram , Bist Pushpa
Published: July 2024

Blood samples of suspected cases of prostate carcinoma were analysed by Enzyme Immunoassay. The objective of this study was to find out the percentage of PSA positivity in under or above 50 years of age. We found that positivity percentage was higher in under or 50 years age group.
Hypertension, as an iceberg disease in the high hilly areas of Nepa
Authors: Lamsal KS , Kafle MP
Published: July 2024

Introduction: Hypertension simply is usual blood pressure of 140/90 mm Hg or higher in otherwise normal individuals and even lower for certain high-risk patients. Its a common medical condition worldwide. It is the most important, commonest and correctible cardiovascular risk factor and one of the leading causes of death. Many factors like dietary, behavioral, psychological, environmental, genetic etc. have direct or indirect influence on hypertension. In this study we have analyzed the prevalence and different stages of hypertension in a remote and high hilly area of Nepal.
Methods: The study was conducted in high hilly area adjoined to Solukhumbu and Dolakha districts. Altogether 600 participants were enrolled in the study. Participants having age more 18 years, regardless of symptoms, willing to give consent were involved. Demograghic data and blood pressure was recorded twice. The 1st reading was taken by trained nursing staff using standard Riva Rocci Sphygnomanometer after five minutes rest. The 2nd reading was taken by Physician and mean was calculated from both readings.
Results: Among 600 patients involved in the study, the mean age was 48 years. Among them, 92 patients were having prehypertension including 53 male and 39 female. The stage I hypertension was found in 130 cases, out of them 77 were male and 53 were female. Whereas stage II hypertension was found in 84 cases, including 40 males and 44 females. Prehypertension was commonest among 40-49 years of age, stage I and stage II hypertension was commonest among 50-59 years. Systolic hypertension was more common in younger and elderly participants whereas diastolic hypertension was more common in middle age adults.
Conclusion: In the study, the incidence of hypertension increases whose age was found between 50-59 with age till 50-59 years age group. Systolic hypertension was more common than diastolic hypertension in less than 30 years age group where as between 30-59 years diastolic blood pressure was more commonly found than systolic blood pressure. In the elderly of more than 60 years, again systolic hypertension is more predominant than diastolic hypertension.
Acute tuberculous mastoiditis
Authors: Baskota DK , Sinha BK
Published: July 2024

Tuberculosis is one of the commonest infectious diseases of developing countries including Nepal, affecting almost all the vital organs of human body. Here an unusual case of tuberculosis of temporal bone has been presented. A 26-year old lady presenting with features of acute mastoiditis was managed surgically. All the investigations including histopathological examination were negative for tuberculosis, but in the end she responded only to anti tuberculous therapy (ATT) with complete resolution of her symptoms.
Neurocysticercosis presenting with hypersexuality
Authors: Sharma Vidya Dev , Khalid Abdul
Published: July 2024

Neurological disorders can produce paraphilic behaviour and alterations in sexual drive. Lesions of the temporal lobe have been classically associated with sexual disorders. We are reporting a 20-year old girl who presented with marked hypersexuality for five years and had history of generalized tonic-clonic seizures about seven years back. EEG record showed localised spike discharges with phase reversal in the leads corresponding to left parietal lobe. MRI scan revealed calsifications with no perifocal oedema in both parietal lobes and right occipital lobe, suggestive of healed neurocysticercosis. The patient showed significant improvement with carbamazepine.
Successful hymenectomy in a young girl in imperforate hymen
Authors: Singh Meeta , Rana Asma , Jha Rajshree , Gurung Geeta , Thapa Bimal
Published: July 2024

An imperforate hymen may exist at the lower end of the vagina. This is due to failure in breakdown of the partition between the mullerian and sinovaginal bulb, contributing to the formation of vagina. We are presenting a case of a fourteen-year girl who was diagnosed as haematocolpus with imperforate hymen from history and clinical examination. Diagnosis was reconfirmed with abdominal ultrasonogram after evacuation of bladder, who had urgent surgical treatment (incision and excision) and relief of symptoms of lower abdominal pain and inability to pass urine.
Availability and Use of Oxytocin in Health Facilities in Nepal
Authors: Poudyal AK , Shrestha B , Onta SR
Published: July 2024

Introduction: Although maternal mortality is declining over the past 15 years, it is still high in Nepal. Postpartum haemorrhage is the leading cause of maternal deaths in Nepal. Oxytocin is one of the emergency drugs, which prevent and manage postpartum haemeorrhage, listed in essential drug list, and supplied to hospitals and Primary Health Care centers in Nepal. The study aimed to assess availability, storage condition, prescriber’s knowledge and practice of Oxytocin in Nepal.
Methods: A descriptive cross-sectional explorative study was conducted in 40 health facilities of 10districts. Multiple methods–observation, interviews, store records and delivery charts analysis-were used to collect data. The respondents of the study (health facility in-charges, service providers and storekeepers) were interviewed with semi-structured questionnaire. The collected data was entered into MS-Excel and analyzed using SPSS version 17.
Results: Oxytocin was available throughout the year in 35.5% of health facilities among them only 8.3% of health facilities stored Oxytocin in refrigerator. In-charges, service providers, were not aware of recommended temperature for Oxytocin storage. Similarly, 40.7% of the service providers used Oxytocin for prevention and management of postpartum haemorrhage, 31.9% and 27.4% of service providers used Oxytocin for augmentation and induction respectively.
Conclusion: In some districts, the medicine was not available throughout the year. Majority of service providers were not aware of recommended indications to induction and augmentation. There should be a serious effort to orient the service providers about rational use of Oxytocin and store to maintain the efficacy of the drug.
The National Institute of Health Stroke Scale Score and Outcome in acute Ischemic Stroke
Authors: Gajurel BP , Dhungana K , Parajuli P , Karn R , Rajbhandari R , Kafle D , Oli KK
Published: July 2024

Introduction: Stroke is a focal neurological deficit of sudden onset which lasts for more than 24 hours and has a vascular cause. Various prognostic indices derived from clinical features or patient characteristics and ancillary tests have been used to predict the prognosis of patients with acute ischemic stroke. The aim of this study was to find out the significance of the National Institute of Health Stroke Scale (NIHSS) score on admission in predicting the prognosis of patients with acute ischemic stroke.
Method: This is a prospective observational study done in a tertiary care hospital with two hundred patients with acute ischemic stroke
Result: Themean NIHSS score in patients with better outcome was 4.6 (± 2.2) and the mean NIHSS score in patients with poor outcome was 14.16(± 7.96). The difference was statistically significant (p=0.000).
Conclusion: The baseline neurological status as measured by the National Institute of Health Stroke Scale score predicts the functional status at one month after acute ischemic stroke.
Functional Outcome in Patients with Chronic Plantar Fasciitis Treated with Plantar Fascia Stetching vs Tendoachilles Stretching Exercises
Authors: Jha R K , Uprety S , Shah L L
Published: July 2024

Introduction: Approximately ten percentage of patients with plantar fasciitis have development of persistent and often disabling symptoms. A poor response to treatment may be due, in part, to inappropriate and nonspecific stretching techniques. We hypothesized that patients with chromic plantar fasciitis who are managed with the structure-specific planter fascia-stretching program for eight weeks have a better functional outcome than do patients managed with a standard Achilles tendon-stretching protocol.
Methods: Sixty five patients who had chronic proximal planter fasciitis for duration of at least ten  months were randomized into one of two treatment groups. All patients received prefabricated soft insoles and a three-week course of naproxen. The patients received instructions for either a plantar fascia tissue-stretching program (Group A) or an Achilles tendon-stretching program (Group B). All patients completed the pain subscale of the Foot Function Index and a subject-relevant outcome survey that incorporated generic and condition-specific outcome measures related to pain, function, and satisfaction with treatment outcome. The patients were reevaluated after eight weeks.
Results: sixty one patients returned for follow-up evaluation (78 total feet). Covariates for baseline measures revealed no significant differences between the groups. The pain subscale scores of the Foot Function Index showed significantly better results for the patients managed with the plantar fascia stretching program with respect to item 1 (worst pain; p = 0.002), item 2 (first steps in the morning; p=0.018) and combined items 1 to 7(p=0.033). Analysis of the response rates to the outcome measures also revealed significant differences with respect to pain, activity limitations, and patient satisfaction, with greater improvement seen in the group managed with the plantar fascia-stretching program.
Conclusions: A program of non-weight-bearing stretching exercises specific to the planter fascia is superior to the standard program of weight-bearing Achilles tendon-stretching exercises for the treatment of symptoms of proximal planter fasciitis. These findings provide an alternative option to the present standard of care in the non-operative treatment of patients with chronic, disabling plantar heel pain.
Systemic Lupus Erythematosus with antiphospholipid Syndrome Presenting as Seizure Disorder and Retinopathy
Authors: Sharma AK , Sitaula S , Thapa M , Gautam P , Shrestha GS , Gajurel BP , Sigdel MR
Published: July 2024

N\A
Safe Zones for Miniscrew Insertion among Nepalese Population: A cadaveric study
Authors: Shrestha BK
Published: July 2024

Introduction: Anchorage plays very important role in executing orthodontic treatment planning and achieving ideal goal. With the use of mini-implant, the job of orthodontists to control anchorage has been easier. Several radiographic, cone beam CT and histopathological studies have been performed to assess the safe locations in the interradicular spaces for miniscrew placement, the so-called ‘‘safe zones.’ The aim of the study is to determine safe zones for miniscrew placement among Nepalese population.
Methods: Cross sections of adult cadaver jaws were analyzed in 16 mandibles and 16 maxillae after decalcification. Direct measurements were done both in mesio-distal and bucco-lingual directions with the use of digital vernier caliper at 2 mm, 5 mm, 8 mm and 11 mm cut levels from the cervical line in posterior regions of the jaws.
Results: Generally interradicular distance measured greater than 3mm at all levels except at 2mm where the measurement varied considerably in both jaws. All the bucco-lingual measurements in maxilla were above 7 mm except at 2 mm level where the measurements varied. The average bucco-lingual distance measured between 6.52 mm to 9.63 mm in mandible. Generally, all the dimensions measured increased upon moving apically and distally except at 11 mm level between first and second premolar region.
Conclusion: At the buccal aspect of the posterior region of both jaws, the optimal sites are between the second premolar and the first molar and between the first and second in agreement with most of the studies done earlier.
PAIR for Hepatic Hydatid Cyst: A study in tertiary care hospital in Nepal
Authors: Lohani B , Gurung G , Paudel S
Published: July 2024

Introduction: The purpose of this study was to assess the outcome of PAIR in patients with hepatic hydatid cysts.
Methods: A total of 17 hepatic hydatid cysts were treated by PAIR in a tertiary care teaching hospital in Nepal from June 2007- May 2009. In all cases, local anesthesia was applied. All the patients were kept in supine except 1 where the patient was kept in left lateral position due to location of the cyst. A spinal needle of 18G was used to puncture the cyst. A connecting tube was attached at the hub of the needle to facilitate the aspiration & to prevent the accidental dislodgement of the needle. 95% alcohol was used as scolecidal agent in 12 cysts & 20% hypertonic saline in 5 cysts. The process was repeated in when the aspirated fluid was > 100 ml.
Results: A total of 17 hydatid cysts of liver were treated with PAIR under ultrasound guidance. The age of the patient ranged from 10-76 years. All patients had signs & symptoms of a hepatic mass caused by the cysts. All the cysts had prominent fluid component which was anechoic or hypoechoic with marked enhancement of back wall echoes on USG. A few patients had CT scans owing to the location of the cysts. Majority of the cysts were in right lobe (12) & rest were in the left lobe (5, one patient had two cysts). The maximum amount of fluid aspirated was 1000 ml. The volume of alcohol / hypertonic saline was 1/3rd of the aspirated fluid. No major complication was found in any of the patients. Following aspiration all the patients were relieved of their symptoms. Follow up ultrasonogram showed decrease in diameter of the cyst.
Conclusion: Among the treatment modalities of hydatid disease though surgery is the first choice treatment, it is associated with considerable morbidity. Chemotherapy with benzimidazoles carbamates is palliative as it is poorly absorbed by the intestine & is unable to diffuse across the cyst wall. PAIR has the benefits of minimal invasiveness, less morbidity & hospital stay as compared to surgery along with confirmation of diagnosis (parasitological examination of the fluid) and cost-effectiveness among others.
A Histopathological Study of Gastrointestinal Polyps in Tertiary Care Hospital, Nepal
Authors: Gurung P , Hirachand S , Pradhanang S , Lama S
Published: July 2024

Introduction: Gastrointestinal polyps may be non-neoplastic or neoplastic lesions. They are mostly asymptomatic and are common in the colon but may occur anywhere in the gastrointestinal tract. Some polyps have an increased risk for malignancy, so it is important to determine the histologic type and characteristics for treatment. This study was undertaken to determine the histomorphological spectrum of polyps, their potential risk for malignancy, and frequency in our center.
Methods: This is a descriptive study which was carried out at Kathmandu Medical College Teaching Hospital for a period of three years from 1st January 2011 to 31st December 2013. A total of 67 polypectomy specimens were received and processed in the Pathology Department. Hematoxylin and Eosin stained slides were examined.
Results: 47 (70.1%) gastrointestinal polyps were non-neoplastic, 19 (28.3%) were neoplastic and 1 (1.6%) was an infarcted polyp. Most of the patients presented with rectal bleeding. The age of patients for non-neoplastic and neoplastic polyps ranged from 3-74 and 23-78 years, respectively. Amongst the non-neoplastic polyps, 21 (44.7%) were retention polyps, 14 (29.8%) were inflammatory polyps, 10 (21.3%) were hyperplastic polyps, 1 (2.1%) benign gastric polyp and 1 (2.1%) non-categorized polyp. The neoplastic polyps had 16 (84.1%) adenomatous polyps, 1 (5.3%) mixed polyp, 1 (5.3%) fundic gland polyp, and 1 (5.3%) moderately differentiated adenocarcinoma. 11 (68.8%) adenomatous polyps had mild dysplasia, 2 (12.5%) moderate dysplasia, and 3 (18.7%) severe dysplasia. Size of the non-neoplastic polyps ranged from 0.2-5.0 cm and size of neoplastic polyps ranged from 0.3-6.0 cm in diameter. Some patients presented with more than one polyp.
Conclusion: Polyps have a diverse histomorphology and there is a risk of malignancy in the adenomatous polyps so it is important to screen patients for treatment and cancer prevention.
Phenotypic characterization of multidrug-resistant Acinetobacter baumannii with special reference to metallo-β-lactamase production from the hospitalized patients in a tertiary care hospital in Nepal.
Authors: Shrestha S , Tada T , Shrestha B , Ohara H , Kirikae T , Rijal BP , Pokhrel BM , Sherchand JB
Published: July 2024

Introduction: Acinetobacter baumanniiis an important cause of nosocomial infection and has been associated with a wide variety of illnesses in hospitalized patients, especially patients in the intensive care units. The emergence of carbapenem-resistant clones of A. baumannii has been the most serious problem worldwide. After the carbapenem resistant clones have emerged, leaving the hope of treatment of A. baumannii infection is by the last resort of antibiotics such as tigecycline, polymyxin-B and colistin. The purpose of this study is to determine the antibiotic resistance patterns of A. baumannil isolates, prevalence of multidrug resistance, extended spectrum beta lactamase production and metallo-beta lactamase production.
Methods: This is a prospective study conducted at the department of Clinical Microbiology. Tribhuvan University Teaching Hospital, from December 2013 to September 2014. Ethical approval was taken from the Institutional Review Board of Institute of Medicine. Two hundred and forty six Acinetobacterisolates were identified by standard microbiological testing. Antimicrobial susceptibility testing was performed by Kirby Bauer method as per the CLSI guidelines. Multidrug resistance was determined. ESBL production was detected by combination disc method and confirmed by Clinical and Laboratory Standerd Institute confirmatory test. MBL production was detected by using imipenem and imipenem/EDTA disc.
Result: All 122 Multidrug-resistant A. baumannii isolateswere resistant to majority of the drugs used. All the isolates were completely sensitive to polymyxin B, colistin and tigecycline only. Fifteen (12.29%) isolates of A. baumannii were extended spectrum beta-lactamase producers and 50 (40.98%) were metallo-beta-lactamase producers. Multidrug resistance was common in A. baumannii
Conclusion: Multidrug resistance in A. baumannii is becoming more common ESBL and MBL production should be promptly detected and reported to control the spread of resistant phenotypes to other individuals.