bluuebunny/crossref_metadata_2025 huggingface dataset:
Manajemen Pemeliharaan dan Pola Pemasaran Kelinci di Kecamatan Kabawetan Kabupaten Kepahiang
Authors: Desmiarti Jessi , Sutriyono Sutriyono , Brata Bieng
Published: June 2021

Penelitian ini bertujuan untuk mengkaji manjemen pemeliharaan dan pola pemasaran ternak kelinci pada peternakan rakyat di Kecamatan Kabawetan Kabupaten Kepahiang. Variabel yang diamati; identitas responden, manajemen pemeliharaan ternak kelinci (pemilihan bibit, reproduksi, kandang dan fasilitasnya, pemberian pakan, dan pemberantasan penyakit), populasi ternak, dan pola pemasaran. Data yang diperoleh ditabulasi dan disajikan dalam bentuk tabel lalu di bahas secara deskriptif. Responden kelinci yang ada di Kecamatan Kabawetan sebanyak 17 orang. Hasil penelitian memnunjukkan bahwa peternak memilih bibit yang berasal dari indukan (47,01% ) dan anakan (52,95%). Kelinci dikawinkan dengan cara alami dengan rasio jantan betina rata rata 1 : 6. Kandang adalah kandang baterai, beratap seng, berdinding bambu (82,35%), dan lantai kandang, berbahan bambu (94,12%). Pakan kelinci diberikan sebanyak dua kali dalam sehari. Jenis pakan yang diberikan; rumput lapang, wortel, daun singkong, kubis, daun sawi dan buncis. Sanitasi kandang dan pencegahan penyakit selalu dilakukan. Populasi ternak kelinci dalam 1 tahun terakhir sebanyak 4527 ekor; 304 indukan dan penjantan, 3220 dijual, 621 mati, 372 anakan, dan 10 ekor kelinci dipotong. Pola pemasaran ternak kelinci, semua peternak menjual hasil ternak mereka ke pedagang pengumpul. Kriteria penentuan harga dan waktu penjualan bibit ditentukan sendiri oleh peternak. Dapat disimpulkan bahwa sistem manajemen pemeliharaan ternak kelinci masih tradisional, peternak menjual langsung ke pedagang pengumpul. Kriteria penentuan harga dan waktu penjualan ternak ditentukan oleh peternak.
Pengaruh Pemberian Level Protein Pakan Berbeda terhadap Performa Ayam Merawang Umur 2 – 12 Minggu
Authors: Dewati Rekno , Hidayat Hidayat , Kususiyah Kususiyah
Published: June 2021

Penelitian ini menggunakan Rancangan Acak Lengkap (RAL) dengan 3 perlakuan level protein yaitu : P1=17%, P2 = 18%, dan P3 = 19% dengan 10 ulangan, dan setiap ulangan menggunakan 2 ekor ayam umur 2 minggu (14 hari). Hasil penelitian menunjukkan bahwa perbedaan level protein pakan berpengaruh tidak nyata (P>0,05) terhadap konsumsi pakan kumulatif (umur 2 -12 minggu), sedangkan berat badan, pertambahan berat badan dan konversi pakan berpengaruh nyata (P<0,05). Berdasarkan data konsumsi pakan, berat badan, dan konversi pakan, dapat disimpulkan bahwa pemberian pakan ayam Merawang umur 2 – 12 pada level protein pakan 18% merupakan level protein pakan yang optimal.
Hubungan Karakteristik Peternak dengan Skala Kepemilikan Sapi Perah di Kecamatan Kabawetan Kabupaten Kepahiang
Authors: Nurdiyansah Irwan , Suherman Dadang , Putranto Heri Dwi
Published: June 2021

Penelitian ini bertujuan untuk mengetahui karakteristik peternak dan menganalisis hubungan antara karakteristik peternak dengan skala kepemilikan sapi perah di Kecamatan Kabawetan Kabupaten Kepahiang. Penelitian dilaksanakan di Kecamatan Kabawetan Kabupaten Kepahiang pada tanggal 5 Juni sampai 31 Juli 2017. Materi yang digunakan dalam penelitian adalah peternak sapi perah sebanyak 15 responden. Tahapan Penelitian dilakukan Survey terlebih dahulu untuk menentukan lokasi penelitian, surat izin penelitian dibuat oleh Fakultas Pertanian dan kemudian surat izin dikeluarkan oleh Kantor Pelayanan Perizinan Terpadu Provinsi Bengkulu, dan pengambilan data yang digunakan dalam penelitian ini berupa data primer dan data sekunder. Variabel yang diamati meliputi umur, pendidikan, lama pengalaman beternak, jumlah tanggungan keluarga, luas lahan dan kepemilikan. Data yang diperoleh dianalisis secara deskriptif berupa tabel. Analisa data yang digunakan statistik regresi linear berganda. Dari hasil dan pembahasan bahwa luas lahan berpengaruh terhadap kepemilikan ternak sapi perah, semakin luas lahan hijauan pakan ternak maka semakin meningkatkan kepemilikan ternak sapi perah, sebaliknya makin sempit lahan pertanian maka semakin rendah kepemilikan ternak sapi perah. Berdasarkan hasil penelitian dan pembahasan dapat disimpulkan bahwa antara kepemilikan ternak sapi perah dengan faktor umur, pendidikan, lama pengalaman beternak, jumlah tanggungan keluarga dan luas lahan diperoleh persamaan regresi Y = -4,091 + 0,029X1 + 0,196X2 – 0,395X3 + 0,105X4 + 1,251X5*.
Karakteristik Organoleptik dan Total Mikroba Telur Ayam Ras yang Direndam dalam Air Rebusan Daun Melinjo (Gnetum gnemon L.)
Authors: Novitanti Linda , Suharyanto Suharyanto , Soetrisno Edi , Warnoto Warnoto
Published: June 2021

Penelitian ini bertujuan untuk mengetahui pengaruh perendaman telur ayam ras dalam air rebusan daun melinjo terhadap karakteristik organoleptik, warna kuning, pH dan total mikroba telur ayam ras. Penelitian ini menggunakan 180 butir telur ayam ras. Rancangan percobaan yang digunakan adalah Rancangan Acak Lengkap (RAL) sebanyak 4 perlakuan dan 4 ulangan dengan lama penyimpanan 14 dan 21 hari. Perlakuan terdiri atas P0 = 0%, P1 = 15%, P2 = 30%, P3 = 45% air rebusan daun melinjo (Gnetum gnemon L). Variabel yang diamati yaitu organoleptik meliputi bau, tekstur dan rasa, warna kuning; pH dan total mikroba isi telur. Data organoleptik dianalisis secara deskiptif. Data warna kuning telur, pH dan total mikroba dianalisis menggunakan ANOVA dilanjutkan dengan uji DMRT jika terdapat perbedaan. Hasil pengujian mutu hedonik dan hedonik bau menunjukkan bahwa perlakuan P2 dan P3 penyimpanan 21 hari mempengaruhi nilai dan kesukaan bau telur mentah maupun masak. Hasil pengujian mutu hedonik dan hedonik tekstur menunjukkan bahwa semua perlakuan pada penyimpanan 14 dan 21 hari tidak meningkatkan nilai dan kesukaan tekstur putih telur maupun kuning telur. Hasil pengujian mutu hedonik dan hedonik rasa menunjukkan bahwa perlakuan perlakuan P3 penyimpanan 14 hari dan semua perlakuan pada penyimpanan 21 hari mempengaruhi nilai dan kesukaan rasa putih telur maupun kuning telur. Hasil pengujian warna menunjukkan bahwa perlakuan P2 dan P3 penyimpanan 14 hari serta perlakuan P1, P2 dan P3 penyimpanan 21 hari dapat meningkatkan warna kuning telur. Hasil pengukuran pH menunjukkan bahwa lama penyimpanan menyebabkan terjadinya peningkatan nilai pH. Hasil pengukuran TPC menunjukkan bahwa lama penyimpanan menyebabkan terjadinya kenaikan nilai TPC.
Mind Map Value Proposition Design
Authors: Jaya Aprillia Dwi
Published: June 2021

Mind Map Value Proposition Design
Over-expression of mucin 1, cell surface associated in human endometrial cancer.
Authors: Mamoor Shahan
Published: June 2021

Gynecologic cancers including cancers of the endometrium are a clinical problem (1-4). We mined published microarray data (5, 6) to discover genes associated with endometrial cancers by comparing transcriptomes of the normal endometrium and endometrial tumors from humans. We identified mucin 1, cell surface associated, encoded by MUC1, as among the most differentially expressed genes, transcriptome-wide, in cancers of the endometrium. MUC1 was expressed at significantly higher levels in endometrial tumor tissues as compared to the endometrium. Importantly, in human endometrial cancer, primary tumor expression of MUC1 was correlated with overall survival in white patients with low mutational burden. MUC1 may be a molecule of interest in understanding the etiology or progression of human endometrial cancer.
Mind Map Value Proposition Design
Authors: Taner Juan Heinricko
Published: June 2021

This is a Value Propositon Design Mind Map
KONSEP DASAR ILMU GIZI
Authors: Darwis Dian Yuliawati
Published: June 2021

Pengertian dari Ilmu Gizi (nutrition science) adalah Ilmu yang mempelajari segala sesuatu tentang makanan dalam hubungannya dengan kesehatan optimal. Sedangkan yang disebut sebagai Makanan adalah bahan selain obat yang mengandung zat-zat gizi dan atau unsur-unsur/ikatan kimia yang dapat di ubah menjadi zat gizi oleh tubuh, yang berguna bila dimasukkan dalam tubuh. Makanan dan semua suplemen yang mengandung zat gizi bisa kita kategorikan sebagai makanan. Artinya yang dikatakan gizi adalah aspek yang berhubungan dengan fungsi dasar zat gizi tersebut yaitu menghasilkan energi, pertumbuhan dan pemeliharaan jaringan, serta mengatur proses metabolisme dalam tubuh.
Sattva: The General Factor of Personality from Indian tradition
Authors: Nedungottil Chandana , Agrawal Jyotsna , Murthy Pratima , Sharma Mehandra Prakash
Published: June 2021

The current study aimed to explore the relationship of Triguna model of Indian psychology, and Anasakti with respect to meta traits of personality as well as affect.A cross sectional survey method was adopted for the current study and it was conducted after approval by the institute ethics committee. A total of 84 males between the age of 18-50 years with a minimum of 10 years of formal education were selected from colleges and various organizations. The study was approved by the Institute ethics committee.Vedic personality Inventory, Big five aspect scale, Positive and negative affect schedule, and Non- attachment scale were used in the study. A quantitative statistical analysis was carried out using SPSS. An integration of the Indian model of personality with the western concept of general factor of personality (GFP) was carried out here and Sattva was found to be positively correlated with the general factor of personality. Anasakti was also moderately correlated with the general factor of personality.
Integration of ASEAN Economic Community - Perspectives from Singapore logistics and logistic development of transportation business in Vietnam
Authors: Trinh Minh Thong
Published: June 2021

Ngày 31 tháng 12 năm 2015, cộng đồng kinh tế ASEAN (ASEAN Economic Community – AEC) chính thức được thành lập - đánh dấu sự hội nhập khu vực một cách toàn diện của các nền kinh tế Đông Nam Á trong đó có Việt Nam. Điều này đặt ra nhiều cơ hội và thách thức lớn đối với nền kinh tế Việt Nam, trong đó lĩnh vực Logistics là một trong những nhóm ngành được kỳ vọng sẽ tăng trưởng tốt trong những năm tới. Phát triển dịch vụ logistics một cách hiệu quả sẽ góp phần tăng năng lực cạnh tranh của nền kinh tế và quốc gia. Trong xu thế toàn cầu hóa mạnh mẽ hiện nay, cạnh tranh kinh tế giữa các quốc gia trên thế giới ngày càng trở nên gay gắt và khốc liệt hơn. Điều này đã làm cho dịch vụ logistics trở thành một trong các lợi thế cạnh tranh của quốc gia. Bài viết này nhằm phân tích thực trạng hoạt động của ngành dịch vụ Logistics tại Singapore trong quá trình xây dựng AEC và vận dụng kinh nghiệm phát triển ngành Logistics tại Việt Nam.
The Impact of the Southern Initiative of the Algebra Project (SIAP) Training on Mentor Self-Regulation, Mindfulness, Efficacy, and Mentee Relations
Authors: JohnFinn Shana E , Hopkins Reginald , Talley Cheryl P.
Published: June 2021

This dissertation is an evaluation of the (SIAP) Southern Initiative of the Algebra Project's mentor training program. Through the use of culturally relevant pedagogical approaches, mentors were trained on fundamentals of mentoring, various mathematical models, and topics of social justice. The study assessed changes in mentors' cognitive characteristics of self-regulation, mindfulness, and sense of efficacy before and after mentor training.
MIND MAP Value Proposition Design
Authors: Arzetta Arveandro
Published: June 2021

Mind Map Value Proposition Design
Quadruple or triple action creams for insect venom treatments
Authors: Tabaee Damavandi Pardis
Published: June 2021

Editorial (no abstract required). Author's opinion.
PENYELESAIAN KASUS PELANGGARAN HAK ASASI MANUSIA BERAT TERHADAP ETNIS ROHINGYA DI MYANMAR BERDASARKAN HUKUM INTERNASIONAL
Authors: Nugroho Fahry
Published: June 2021

This paper aims to described and analyse rules of international law with respect to protection against ethnic rohingya, and find out and analyse the efforts that can be made in resolving the cases of severe Human rights violations against the ethnic rohingya in Myanmar based on international law. The Research is conducted through normative. The materials used are the primary, secondary, and tertiary studies of librarianship. It is found that Myanmar government has commited international wrongfull act by neglecting its international obligations in protecting international community’s interest toward international peace and security. For such human rights violation, Myanmar has an obligation to resolve it under article 33 of the UN Charter throught diplomacy before bringing to judicial institution. The diplomacy can be done through mediation system and if it fails, then such violation can be brought before the ICC (International Criminal Court) and should be sentenced based on international law.
Konsep Dasar Ilmu Gizi
Authors: Hadza Roza Qoni
Published: June 2021

Kata “gizi” berasal dari bahasa Arab ghidza, yg berarti “makanan”. Ilmu gizi bisa berkaitan dengan makanan dan tubuh manusia. Dalam bahasa Inggris, food menyatakan makanan, pangan dan bahan makanan. Secara Klasik : gizi hanya dihubungkan dengan kesehatan tubuh (menyediakan energi, membangun, memelihara jaringan tubuh, mengatur proses-proses kehidupan dalam tubuh).Sekarang : selain untuk kesehatan, juga dikaitkan dengan potensi ekonomi seseorang karena gizi berkaitan dengan perkembangan otak, kemampuan belajar, produktivitas kerja. Oleh karena itu, ilmu gizi memiliki peranan penting dalam kehidupan.
Breadth, Polarity, and Emergence of Character Strengths and their Relevance for Assessment
Authors: Arbenz Gian Carlo , Gander Fabian , Ruch Willibald
Published: June 2021

Research activity on correlates of character strengths has been steadily increasing in the past years. However, very little is known about basic properties of character strengths, such as their conceptual breadth (narrow versus broader strengths), polarity (unipolar versus bipolar strengths), and emergence (phasic versus tonic strengths). These properties are relevant to the operationalization of character strengths and likely also for related interventions. We therefore asked a sample of N = 249 psychologists to rate the breadth, polarity, and emergence of the 24 character strengths. The results provide a first account of these properties and suggest a considerable variety in them. Our analysis suggests that the content validity of the VIA-IS and VIA-IS-R may be limited as these variety was apparently not sufficiently accounted for in these instruments. We call for further research on such basic properties and propose that these findings are considered for the future assessment of character strengths.
Connecting research and teaching through the creation of a staff research lab: A case history
Authors: Vallée-Tourangeau Gaëlle
Published: June 2021

In this article, I share my experience and my attempt to meet the teaching-research nexus challenge through the creation of a “staff research lab,” to engage my students with my research activities. I do this by presenting a short case history recounting the creation of the lab, its impact on students’ experience and my own.
autoFC: An R Package for Automatic Item Pairing in Forced-Choice Test Construction
Authors: Li Mengtong , Sun Tianjun , Zhang Bo
Published: June 2021

Recently, there has been increasing interest in adopting the forced-choice (FC) test format in non-cognitive assessments, as it demonstrates faking resistance when well-designed. However, traditional or manual pairing approaches to FC test construction are time- and effort- intensive, and often involves insufficient considerations. To address these issues, we developed the new open-source autoFC R package to facilitate automated and optimized item pairing strategies. The autoFC package is intended as a practical tool for FC test constructions. Users can easily obtain automatically optimized FC tests by simply inputting the item characteristics of interest. Customizations are also available for considerations on matching indices and the behaviors of the optimization process. The autoFC package should be of interest to researchers and practitioners constructing FC scales with potentially many metrics to match on and/or many items to pair, essentially exempting users from the burden of manual item pairing and reducing the computational costs and biases induced by simple ranking methods.
Laws of Concentration and Centralization of Capital: A Modern Review
Authors: Dutta Sourish
Published: June 2021

Though the basic (the late 1860s) Marxian model, under the capitalist mode of production, assumes (more or less) perfect competitive or contestable ambience within the market by means of a large number of trivial firms in each industry, Marx was cognizant of the growing size of firms, the subsequent dwindling of competition, and the evolution of monopolistic or anti-competitive power. Hence, the capital has the inclination for concentration and centralization in the hands of the richest and big capitalists. Actually, the concentration and centralization of capital are two capital accumulation (or self-expansion of capital) techniques. Such concentration and centralization of capital can be clearly detected at this modern time, especially in the USA, in the enormous occurrences of mergers, acquisitions and conglomerates. In this assignment, henceforth, I will be trying to cultivate an analytical discussion about these two interlinked concepts and their implications and repercussions in this modern world of capitalism.
Book Review : The Philosophy of Education Management "Filsafat Manajemen Pendidikan"
Authors: Manurung Jonathan , Pandin Moses Glorino Rumambo
Published: June 2021

This book's purpose is to discuss several matters related to education management to regulate the education system in the face of the current era of globalization. As a result of that purpose, this book discusses the philosophy of educational management. This educational management philosophy explains in detail the philosophy itself and explains its relation to education. Philosophy itself is related to education because education is a vital field for human life in the future. A good education will create good human resources too, so that good management is needed to produce quality education. This is inseparable from philosophy which is the source of knowledge, of course this knowledge must be used in conducting any policy or research. Therefore, writing this book aims to explain the philosophy of educational management, which aims to organize all the structures contained in education for the better.
Understanding Indian Public Opinion Toward China: Evidence from Seven Decades of Survey Data
Authors: Milliff Aidan , Staniland Paul
Published: June 2021

India is increasingly important in world politics, yet we know little about how Indians view international affairs. This paper analyzes a unique collection of Indian public opinion data about China spanning seven decades, The paper compares evidence from India to theories in the existing OECD-focused literature, making an empirical contribution to the study of India in IR and identifying where India aligns with/diverges from existing conventional wisdom. We find that India’s “foreign policy public” is broadly similar to that of OECD countries, and nonrepresentative of broader public. More surprisingly, we show that domestic political cleavages shaping public opinion are quite different in India, depending more on region, and less on partisanship. We provide tentative evidence that Indians who offer survey responses have sophisticated, coherent opinions, that do not seem to mechanistically reflect elite priorities. Our findings have implications for research on India, and IR more broadly.
Monitoring the aerosol solids deposited in snow in the area affected by the technological road of the Gorlov anthracite mining pit (Novosibirsk region, Russia)
Authors: Sokolov Denis A. , Usoltsev Nikilai V. , Gossen Igor N. , Morozov Sergei V.
Published: June 2021

The aim of the study. To monitor and assess the chemical composition of the solid aerosols deposited in the snow in the area affected by the technological road of the Gorlov anthracite mining site.

Location and time of the study. The study was conducted in the Iskitim district of the Novosibirsk region (54.58o N, 83.57o E) in 2018–2020.

Methodology. The content of total solids in snow was measured by gravimetric method after filtering the melted snow sample through the filter with 0.22 µm mesh size. Micromorphology of the solids was studied by using scanning electron microscope Hitachi TM-3000 (Japan) with attached EDS detector console Bruker Quantax 70 for the element analysis of the surface. The carbon content, С/Н and C/N ratios were determined by dry combustion using the СHN-analyzer (Perkin Elmer 2400 Series II, USA). The content and composition of polycyclic aromatic hydrocarbons (PAH) were determined by gas chromatography using Agilent Technologies АТ 6890N with AT 5975N mass-selective detector and AT 7683B autosampler.

Main results. The article presents the results of the three-years long study of the solids accumulated in snow along the technological road in the north of the Gorlov anthracite basin. The influence of the automobile road used for the anthracite transportation was shown to reach as far as 2000 m in all directions. The snow cover was found to accumulate from 1.4 to 1131.6 g/m2 of deposited aerosol solids. Those solids were mostly represented by coal particles, the carbon content ranging 26.5–64.1% and increasing with the distance from the road. The aerosol solids, accumulated in snow, were found to contain significant amounts of PAH, including the carcinogenic ones. In the snow samples collected at 25–2000 m off the road, carcinogenic PAH content was found to be 9–13000 times higher than at the control site remoted from the road.

Conclusion. The presented study helped to elucidate the factors, contributing to decreasing the spread of the anthracite solids during automobile transportation. Such spread can be attained by a) establishing wide multi-storeyed forested protective belts along technological automobile roads; b) compulsory covering of the loads in the coal-transporting vehicles; c) decreasing the speed limit of the vehicles; and d) taking into consideration a wind rose while projecting locations new automobile roads and coal mining spoils.
Implementation of WHO Surgical Safety Checklist and its Outcome in South Asia
Authors: Kurlberg Göran
Published: June 2021

Introduction Surgery plays an essential role in any health care system. In 2009, WHO introduced the safe surgery checklist, to improve patient outcome following surgical procedures. The purpose of this trial was to elucidate the effects of the checklist on perioperative complications and checklist implementation at different hospitals in South Asia.

MethodsOnline databases were searched to find relevant publications at centres in the South Asian Association for Regional Cooperation (SAARC) area. They were characterised regarding type of study, publication details, study population as well as type of intervention, by the use of the WHO checklist.

ResultsFollowing the search process, seven full text publications were included in the review. They emanated from five medical centres in India and two from Pakistan. All of these reports found a clear improvement in surgical outcomes and the implementation approached 90-96%.

ConclusionThe WHO checklist is a valuable tool to reduce surgical complications, especially in resource-limited settings, where it should be more commonly used.
Changes in the Quality of Life of Outpatients in Methadone Maintenance Treatment Clinics in Kathmandu Valley
Authors: Sapkota Basanta , Tulachan Pratikchya , Ojha Saroj P , Chapagai Manisha , Dhungana Saraswati
Published: June 2021

Introduction Methadone maintenance treatment (MMT) is widely accepted treatment option for the opioid dependent individuals. The evaluation of the quality of life represents the assessment of the effectiveness of the treatment program. The study aimed to explore the impact of MMT program on clients’ quality of life in the first 6 months of treatment.

MethodsA total of 63 patients were recruited from the 5 different methadone clinics of Kathmandu valley. A prospective follow-up design was used. The semi-structured pro forma was filled up. To assess quality of life, WHO Quality of Life questionnaire (WHOQOL-BREF, 26-item version) was used. The tool was used to assess the quality of life at the baseline and after 6 months of enrollment in MMT program.

ResultsFollowing 6 months of methadone maintenance treatment of opioid dependent individuals, significant improvements (P<0.001) were observed in all measured domains of quality of life i.e. physical, psychological, environmental and social. The least improvement was noted in the social domain.

ConclusionMethadone maintenance treatment is helpful in improving the quality of the life of the opioid dependent individuals in MMT clinics.
Awareness Regarding Child Abuse among Mothers Attending a Pediatric Clinic of a Tertiary Level Hospital, Kathmandu
Authors: Adhikari Mishra Tulashi , Bhattarai Tilarupa
Published: June 2021

Introduction Child abuse constitutes all forms of physical as well as emotional maltreatment resulting in harm to the child’s health and overall development. Parental awareness plays a significant role in the prevention of child abuse. The objective of this study was to find out the awareness of mothers regarding child abuse.

MethodsThis descriptive cross sectional study was carried out among mothers attending a Pediatric Outpatient Department of Tribhuvan University Teaching Hospital Kathmandu, Nepal. A total of 162 mothers having their children of aged one to 16 years were selected as a sample using non-probability convenient sampling technique. Data was collected by face to face interview using semi-structured interview schedule.

ResultsFindings of the study revealed that majority of mothers could state different types of abuse as physical abuse (72.8%), psychological abuse (78.4%), sexual abuse (71.6%), but 53.1% of mothers were aware about neglect, 48.8% of mothers considered that relatives could abuse their child. In total, 49.1% of mothers had moderately adequate, 26.4% had inadequate and 23.9% had adequate level of awareness regarding child abuse. No significant association was noted between the level of awareness and mothers’ age, ethnicity, religion and occupation. The level of awareness of mothers was significantly associated with nuclear family type (p=0.03).

ConclusionThe mothers are aware of child abuse at moderate level. Conducting awareness programmes in community, regarding child abuse focusing on child neglect is recommended.
Antimicrobial Susceptibility Pattern of Acinetobacter calcoaceticus-Acinetobacter baumannii Complex Isolated from Sputum in a Tertiary Care Hospital
Authors: Sapkota Jyotshna , Sharma Manisha , Shrestha Deepti , Jha Beena
Published: June 2021

Introduction Acinetobacter calcoaceticus-Acinetobacter baumanni (ACB) complex is one of the commonest cause of hospital acquired and ventilator associated pneumonia. Multidrug resistant Acinetobacter species have become a matter of huge concern. This study was done to find out the antibiotic susceptibility pattern of Acinetobacter calcoaceticus-Acinetobacter baumanii complex from sputum samples.

MethodsThis descriptive cross-sectional study was carried out in Clinical Microbiology laboratory from July 2018 to Jan 2019 after ethical approval. Acinetobacter calcoaceticus-Acinetobacter baumannii complex was identified on the basis of its microscopy and morphological characteristics followed by biochemical tests. Antibiotic sensitivity test of isolated pathogens was done using Muller Hinton Agar by Kirby-Bauer method.

ResultsOf the 384 culture positive sputum specimen, 76 (19.80%) were Acinetobacter calcoaceticus-Acinetobacter baumannii complex. Most of the isolates were resistant to commonly used antibiotics, 72.36% of the isolates were multidrug resistance and 3.95% isolates were resistant to tigecycline.

ConclusionThis study provides valuable information regarding prevalence of Acinetobacter calcoaceticus-Acinetobacter baumannii complex from sputum specimen. The alarming number of Multidrug resistance isolates is worrisome finding. Antibiotics like Tigecycline and Colistin which is still sensitive to isolates should be cautiously used only in MDR cases.
Role of Preoperative CEA, CA 19-9, NLR and PLR as Predictors of Adverse Prognostic Pathological Features of Gastric Carcinoma Patients in a Tertiary Centre of Nepal
Authors: Mandal Rajesh K , Bhandari Ramesh S , Joshi Lakhey Paleswan , Singh Yogendra P , Vaidya Pradeep , Kansakar Prasan BS , Ghimire Bikal , Kandel Bishnu P
Published: June 2021

Introduction According to GLOBOCAN 2018, gastric carcinoma is the fifth most common cancer (5.7%) and third most common cause of cancer related death (8.2%) worldwide. Delayed presentation and advanced disease at diagnosis, owing to the overlapping symptoms, can be attributed to its high mortality. Gastrectomy is one of the most commonly performed surgery at our centre. This study aims to study the role of pre-operative serum carcinoembryonic antigen (CEA), carbohydrate antigen 19-9 (CA 19-9), neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) as predictors of adverse prognostic pathological features of gastric carcinoma patients who were considered for surgery at our centre.

MethodsThis is a retrospective analysis of prospectively maintained database of all operated gastric carcinoma patients since June 2016 to January 2019. Various pre-operative variables including serum CEA level, serum CA 19-9 level, NLR and PLR were collected. Intra-operative surgical procedures performed and post-operative pathologic variables like tumor size, stage, grade, lymph node ratio (LNR), lymphovascular invasion (LVI) and perineural invasion (PNI) were collected.

ResultsA total 60 patients were planned for surgical intervention over this duration. Mean age of the population was 56.8±12.5 years with slight male predominance (i.e. 55%). Mean CEA level was 6.17 ng/ml and CA 19-9 level was 72.1 U/ml. The mean NLR and PLR of the study population was 3.4 and 200 respectively. Fifty four patients had distal tumors and six had proximal tumors. Curative surgery was performed in 40 patients out of which 37 underwent subtotal gastrectomy and three underwent total gastrectomy. D2 gastrectomy was performed in 55% patients treated with curative intention. Advanced disease (T2 and above) was seen in 86.7% of patients. Preoperative CEA, CA 19-9, NLR, PLR were evaluated for association with pathologic features like tumor size, T stage, grade of tumor, LNR, LVI, and PNI but statistical analysis failed to show any significant association.

ConclusionAdvanced disease at presentation is common in gastric carcinoma. Preoperative clinical parameters including tumor markers CEA, CA 19-9, NLR and PLR may not be useful to diagnose the advanced disease in gastric carcinoma patients.
Knowledge Regarding Antibiotic Use, its Resistance and Consequences among Higher Secondary Students in Private Schools of Kathmandu Valley
Authors: Deo Satish K , Gautam Naveen , Gyawali Siddinath , Shrestha Deepti , Yadav Shikha
Published: June 2021

Introduction The lack of awareness on the appropriate use of antibiotics, its dose and duration is one of the leading causes of global antimicrobial resistance (AMR). AMR poses a growing threat to public health, as infections from resistant strains of microbes become increasingly difficult to treat, resulting in prolonged illness and greater risk of death. Hence, this study would be an important reference for determining the scope of the problem which will be essential for formulating and monitoring an effective response to antibiotic use and its problem of resistance.

MethodsA descriptive cross-sectional study was done among higher secondary level students from selected schools in Kathmandu valley. Baseline data was collected after a tutorial session through semi-structured questionnaires which was based on past researches and verified using expert consultation. Ethical consideration was maintained throughout the study. Descriptive statistics was used to find out the KAP level including knowledge score and attitude-practice score of the selected population.

ResultsAmong 465 participants conducted in our research, the overall average knowledge score of the participants was found to be 73.3% while the attitude-practice score was 60.53%. It was found that 80.86% of the participants had heard the term “antibiotic resistance”. The knowledge score percentage among the students of grade 10 and 11 had no significant difference (p value= 0.592).

ConclusionOur study concludes that if topics like antibiotics and their judicial use is well covered in school curriculum, it can produce measurable change in knowledge, attitude and practice level of the students.
Comparison of Graft Uptake and Postoperative Hearing Results between Butterfly-Cartilage and Temporalis-Fascia Myringoplasty
Authors: Sah Amiya K , Rayamajhi Pabina , Bhattarai Hari
Published: June 2021

Introduction Myringoplasty is one of the commonest surgeries done in Otology for chronic otitis media- mucosal type (COM-mucosal type). The objective of this study was to compare the graft uptake and post-operative hearing status between butterfly-cartilage and temporalis-fascia myringoplasty.

MethodsPatients of age ≥15 years with COM-mucosal type with dry, small to medium sized central perforation of pars tensa with clearly visible perforation margin were randomized into two groups of butterfly-cartilage myringoplasty and temporalis-fascia myringoplasty. Graft uptake and hearing results were assessed after six weeks and results were compared within and between the groups.

ResultsThirty-one patients in butterfly cartilage group and twenty-nine patients in temporalis fascia group were analysed. Graft uptake rate was 93.5% (29/31) in butterfly group and it was 86.2% (25/29) in temporalis fascia group with no statistically significant difference (p= 0.34) between the two groups. The mean pre and post-operative air bone gap in butterfly cartilage group were 20.65dB±8.35 dB; 12.86dB±7.39dB and that in the temporalis fascia group were 19.72±6.14dB, 13.16dB±6.26dB respectively. The difference of preoperative and postoperative hearing status, obtained within the two groups was statistically highly significant (p< 0.001). However, there was no statistically significant difference in hearing results between the two groups (p= 0.54).

ConclusionThe graft uptake rate and hearing results of butterfly-cartilage group and temporalis-fascia group were statistically significant within the group after myringoplasty but there was no statistically significant difference in between the two methods.
Effect of Preoperative Nebulized Ketamine on Incidence and Severity of Postoperative Sore Throat in Patient Undergoing General Anaesthesia with Endotracheal Intubation
Authors: Bhatta Prajjwol D , Shakya Bigen M , Bista Navindra R , Marhatta Moda N , Shrestha Ninadini
Published: June 2021

Introduction Postoperative sore throat (POST) has a reported incidence of up to 62% following general anaesthesia. POST was rated by patients as the eighth most undesirable outcome in the postoperative period. The objective of this study was to compare the incidence and severity of postoperative sore throat after saline and ketamine nebulization in patients undergoing general anaesthesia with endotracheal intubation.

MethodsThe study was prospective double blinded randomized controlled trial . One hundred patients belonging to American Society of Anesthesiologists physical status I–II undergoing surgery under general anaesthesia with endotracheal intubation were randomized into two groups; group Saline (S) received nebulization with 5 ml of normal saline and group Ketamine (K) received nebulization with 1 ml of ketamine of concentration 50 mg/ml mixed with 4 ml saline. POST was assessed at zero hour, two hour, four hour, six hour, eight hour and 24 hour.

ResultsThe overall incidence of POST was 28%. Twenty two (44%) patients in group S and six (12%) patients in group K had postoperative sore throat at some point of the study. The POST was significantly reduced in group K at zero hour 3(6%), two hour 3(6%), four hour 4(8%), six hour 5(10%) and eight hour 3(6%) with p value <0.05 . The severity of POST was also significantly decreased in group K at zero hour, two hour, four hour, six hour, eight hour with p value <0.05.

ConclusionPreoperative nebulization with ketamine reduces the incidence and severity of POST after general anaesthesia with endotracheal intubation.
Variation of Arteries Forming Circle of Willis in Adult Human Cadavers
Authors: Gautam Jyoti , Adhikari Bidur , Bhandari Rosha , Shrestha Anusuya , Ranjit Nirju
Published: June 2021

Introduction Circle of Willis is a large arterial anastomosis between internal carotid and vertebrobasilar arterial system. It is the principal collateral channel for constant blood flow to brain. Any changes in its morphology may cause vascular insufficiency of variable severity. Knowledge about its anomalies may elucidate occurrence of cerebrovascular disorders, its presentation, treatment, prognosis and prevention.

MethodsAn observational study on 107 fresh cadavers was conducted at Maharajgunj Medical Campus from September 2016 to August 2017. After dissection of the scalp and removal of the vault and dura mater, the brain was obtained. Then the Circle of Willis was identified and observed for its completeness, symmetry, presence, origin and number of arteries forming it and the obtained data were documented, photographed and analyzed.

ResultsOut of 107 cadavers, variations were noted among 15 (14%): out of which 10 were male and 5 female. Twelve cadavers had single variation while 3 had two variations. Accessory anterior cerebral artery was found in 7 (38.90%), fetal origin of right posterior communicating artery in 2 (11.10%), fetal origin of left posterior communicating artery in 4 (22.20%), early bifurcation of left posterior cerebral artery in 1 (5.60%), variant anterior communicating artery in 2 (11.10%), fused anterior cerebral artery in 1 (5.60%) and aneurysm in 1(5.60%) subjects were found.

ConclusionVariations were noted among 15 cadavers (14%), 12 cadavers had single variation while 3 had two variations. The most common variation seen was accessory anterior cerebral artery found in 7 cadavers (38.90%). Most of the variations were found in midline anteriorly followed by right side.
Comparison of Outcomes of Open versus Laparoscopic Living Donor Nephrectomy in Nepal
Authors: Sigdel Prem R , Gnyawali Diwas , Rai Bipendra DK , Dhital Pawan , Parajuli Purushottam , Chudal Sampanna , Dhakal Niraj , Pradhan Manish , Poudyal Sujeet , Poudyal Sujeet , Chapagain Suman , Luitel Bhoj R , Chalise Pawan R , Sharma Uttam K , Gyawali Prem R
Published: June 2021

Introduction Laparoscopic donor nephrectomy is the gold standard for kidney retrieval in live donors. Until recently, donor nephrectomies were performed only by open technique in Nepal. There is no information on the experience and outcomes of laparoscopic donor nephrectomy in Nepal. The study was done to compare the outcomes among donors undergoing open and laparoscopic nephrectomies, and to compare the graft related outcomes between the two groups receiving these kidneys.

MethodsIn this retrospective study, 44 kidney donors from March 2019 to October 2019 were analyzed. Donors were divided into 2 groups: open donor nephrectomy (ODN) and laparoscopic donor nephrectomy (LDN). Parameters for analysis included demographic data, warm ischemia time, surgery time and length of hospital stay. Data on early graft function and complications in recipients till 30th post-operative day were compared.

ResultsThere were 22 donors each in the ODN and LDN groups. Baseline characteristics of the donors were comparable between two groups. Mean surgery duration (183.55±43.31 minutes vs 117.73±18.75 minutes) and first warm ischemia time (11.22±4.34 minutes vs 2.3±0.8 minutes) was significantly high in LDN. Hemoglobin drop, post-operative complications in donors, creatinine of donors at discharge, mean hospital stay, graft function at one month and complications in recipients were comparable among ODN and LDN. Pain score in 1st post-operative day was comparable between two groups, however, pain was significantly less in second post-operative day in LDN.

ConclusionLaparoscopic donor nephrectomy is feasible in Nepal and associated with acceptable morbidity and graft function when compared to ODN.
Diagnostic Evaluation of Patients Presenting with Rectal Bleeding by Colonoscopy
Authors: Malla Bala R , Simkhada Suyog
Published: June 2021

Introduction Rectal bleeding indicates the bleeding from lower gastro-intestinal tract occurring distal to ligaments of Treitz. Annual incidence of per rectal bleeding has been estimated to be 20% . Colonoscopy is the examination of choice for investigation. The objective of this study is to know the diagnostic yield of colonoscopy in cases with per rectal bleeding and to know the common causes of per rectal bleeding in adults

MethodsOne hundred and twenty-nine adult patients, age more than 18years, who presented to Surgical OPD and ward of Dhulikhel Hospital during the year 2018 and 2019 were taken for the study irrespective of their sex. All the patients were subjected to fibre-optic colonoscopy after necessary preparation and the findings were recorded. Diagnosis was based on colonoscopic and histopathologic findings.

ResultsA total of 129 (77 male and 52 female )patients with per rectal bleeding were evaluated with colonoscopy. The age ranged from 18 years to 79 years with the mean age 42.25 (SD+/- 15.29). Colonoscopy showed abnormalities in 102 patients (79.06%). The most common finding was hemorrhoids in 36 patients (27.90%) followed by colorectal malignant mass in 20 patients (15.50%). Polyps were diagnosed as the cause of rectal bleeding in 14 patients (10.84%).

ConclusionColonoscopy has good diagnostic yield at evaluating cases with per rectal bleeding. Hemorrhoids, colorectal malignant mass and polyps are the common causes producing PR bleeding in Nepalese adult population.
Clinicopathological Review of Resectable Gastric Cancer at a Tertiary Level Teaching Hospital of Nepal
Authors: Kansakar Prasan , Vaidya Pradeep
Published: June 2021

Introduction According to available data, gastric carcinoma is the most common malignancy arising from the gastrointestinal tract in Nepal. Our objective was to analyze the pathological features of gastric carcinoma in patients undergoing curative resection.

MethodsRetrospective analysis of histopathological reports of patients who underwent curative surgery for gastric cancer was performed at Department of Surgery, Tribhuvan University Teaching Hospital for a period of two years. Demographic characteristics, symptoms, site of tumor, type of surgery performed, macroscopic and microscopic characteristics including number of harvested lymph nodes, number of positive lymph nodes and tumor stage were analyzed.

ResultsA total of 36 patients underwent curative resection. Mean age of the patients was 61.6 years with range of 21-82 years. Male:female ratio was 7:4. Pain abdomen was the predominant presenting symptom. Vomiting, hematemesis and malena were the other frequent symptoms. Endoscopy Borrmann type II tumor was seen in 27 (75%) of patients. Most patients underwent subtotal gastrectomy. In 25 patients, tumor was located in antrum. Lymphovascular and perineural invasion was seen in 21 and 20 patients respectively. Sixteen patients had poorly differentiated tumors. All but two patients had microscopic negative distal margin whereas proximal margin was negative in all patients. A mean of 15 lymph nodes were harvested. Twenty three patients had node positive disease. Pathological staging revealed Stage IA in 3 patients, Stage IB in in 5 patients , stage IIA in 4 patients stage IIB in 6 patients, stage IIIA in 6 patients, stage IIIB in 8 patients and IIIC in 4 patients.

ConclusionGastric carcinoma was common in seventh and eighth decade of life with male preponderance. Most of the patients presented with locally advanced gastric cancer. Tumors located in antrum requiring subtotal gastrectomy was the predominant finding.
Palliative Care Services at a Cancer Center in Janakpur Nepal
Authors: Gupta Sanjay , Thakur Anshu K , Mishra Reecha , Jha Pamesh
Published: June 2021

Introduction Palliative care is one of the essential components of cancer care in Nepal. Most of our cancer patients present to the hospital quite late. In our everyday practice, we encounter many progressive incurable cancer patients who need palliative care. The goal of the palliative care is to relieve the pertinent symptoms or to improve quality of life (QoL) for patients with advanced cancer. We reviewed the palliative care services to the cancer patients at our center.

MethodsRetrospective analysis of the cancer patients who received palliative care alone or in adjunct to curative treatment in Binayatara Cancer Center since its establishment in December 2018 was done.

ResultsA total of 108 patients received palliative care of which most were at advanced stage of disease (Stage IV). The male to female ratio was 1:1.45. The most common complaints for their visit was pain (62%) followed by nause and vomiting (32%), constipation (28%), anorexia (22%), shortness of breath, abdominal distension, seizure. Most of the patients with pain needed morphine (65%) for pain management followed by tramadol (25%) and NSAIDs (10%). Few of them were also supplemented with TCAs and anticonvulsants.Abdominal distension due to ascites was managed by ascitic tapping, Albumin supplementation while shortness of breath due to pleural effusion was managed by pleural fluid tapping. In one patient with pleural effusion, chest tube was inserted. Three patients with seizure due to brain metastasis were managed with anticonvulsant. A patient of prostate cancer with bony metastasis was managed with surgical orchidectomy.

ConclusionWhile considering the appropriate and effective use of palliative care, a palliative care physician is often confronted with a full range of multidisciplinary treatment options, and technical considerations that could potentially relieve some symptoms of advanced cancer in our settings.Keywords: ,
Cesarean Section or Instrumental Delivery: The Best Choice for Mode of Delivery during Second Stage of Labor
Authors: Rawal Suniti , Katuwal Neeta , Shrestha Sajana
Published: June 2021

Introduction Managing second stage of labour is very crucial. Emergency Cesarean Section (CS) or Instrumental Delivery (ID) is the only choices although complications might occur in both modes of deliveries. The rate of CS is at rise and the fear of failed ID followed by emergency CS with added complications makes the choice more difficult amongst the obstetricians.

MethodsA retrospective study done to assess the maternal and fetal outcome in second stage of labour following ID and emergency CS from April 2018 to March 2019 among the pregnant women having completed 34 weeks of gestations and beyond.

ResultsOf 4761 deliveries, 2537 (53.2%) were vaginal and 2224 (46.7%) CS, and amongst all, 133 (2.7%) were second stage interventions. Out of 133, 78 had ID, 76 were successful and 2 failed. Fifty seven (2.6%) were second stage CS. Nulliparas (65.8%) needed more ID, teenage pregnancy (6.5%) (p=0.04) and heart disease (18.4%) (p=0.002) were high risk for ID. Complications were more in CS, uterine extensions, (29.8%) (p<0.001), urinary complications, (43.9%) (p<0.001) and blood loss (p<0.001). Neonatal admission too was higher in CS (n=29) and more so due to respiratory distress (16/29).

ConclusionDespite of few failed attempted ID, it still proved to be better choice for delivery during second stage, as both maternal and neonatal complications were higher following the second stage CS. Hence, the correct and timely decision for ID addressing the associated risk factors could lead to favorable outcome.