bluuebunny/crossref_metadata_2025 huggingface dataset:
XÁC ĐỊNH BỆNH ĐÁI THÁO ĐƯỜNG THAI KỲ BẰNG NGHIỆM PHÁP DUNG NẠP GLUCOSE ĐƯỜNG UỐNG (OGTT) Ở THAI PHỤ KHÁM THAI TẠI BỆNH VIỆN ĐA KHOA ĐỒNG NAI
Authors: HUỲNH THỊ MINH THƯ , Nguyễn Thị Phương Tuyền Nguyễn Thị Phương Tuyền , Bùi Quang Trường Bùi Quang Trường
Published: July 2024

Đặt vấn đề: Đái tháo đường thai kỳ (ĐTĐTK) là một rối loạn chuyển hóa có xu hướng ngày càng nhiều tại Việt Nam. Chẩn đoán sớm và quản lý tốt tình trạng đường huyết giúp cải thiện kết cục thai kỳ. Mục tiêu: Khảo sát giá trị về độ đúng và độ chính xác của xét nghiệm glucose trên hệ thống máy Beckman Coulter AU5800, xác định tỷ lệ đái tháo đường thai kỳ và một số yếu tố liên quan tới ĐTĐTK ở thai phụ khám thai tại Bệnh viện Đa khoa Đồng Nai. Phương pháp nghiên cứu:Tại Bệnh viện Đa khoa Đồng Nai, từ tháng 6/2023 đến tháng 11/2023, chúng tôi đã nghiên cứu cắt ngang tất cả các thai phụ có tuổi thai từ 24 - 28 tuần. Các thai phụ được làm nghiệm pháp dung nạp 75g glucose - 2 giờ theo tiêu chuẩn của ADA (2022). Kết quả: 251 thai phụ tham gia nghiên cứu, tỷ lệ ĐTĐTK là 27.9% (KTC 95%: 22.4 - 33.9). Các yếu tố độc lập liên quan với đái tháo đường thai kỳ: Sản phụ ≥ 35 tuổi tăng nguy cơ ĐTĐTK với OR = 4.16 (KTC 95% [1.54 - 1.23]; p = 0.005); tiền căn bản thân ĐTĐTK làm tăng nguy cơ ĐTĐTK với OR = 6.45 (KTC 95% [1.90 - 21.82]; p = 0.03), tiền căn sinh con to > 4,000g làm tăng nguy cơ ĐTĐTK với OR = 3.74 (KTC 95% [3.04 - 4.6]; p = 0.01). Xác định độ chính xác và độ đúng của xét nghiệm glucose đều đạt theo tiêu chuẩn chấp nhận. Kết luận: Đái tháo đường thai kỳ là bệnh lý có thể chẩn đoán sớm thông qua xét nghiệm tầm soát dung nạp glucose đường uống, giúp xử lý và can thiệp có hiệu quả, giảm thiểu nguy cơ cho mẹ và thai nhi.
THỰC TRẠNG THỪA CÂN BÉO PHÌ CỦA SINH VIÊN NĂM NHẤT TRƯỜNG ĐẠI HỌC QUỐC TẾ HỒNG BÀNG NĂM HỌC 2022-2023
Authors: Nguyễn Văn Nam , Hà Văn Toán , Phạm Đình Mai Phương
Published: July 2024

Đề tài sử dụng chỉ số BMI (Body Mass Index) hay còn gọi là chỉ số khối cơ thể, là một công cụ thường được sử dụng đánh giá mức độ gầy béo của cơ thể, để khảo sát thực trạng thừa cân, béo phì của 1.319 sinh viên năm nhất tham gia học môn Giáo dục thể chất của Trường Đại học Quốc Tế Hồng Bàng năm học 2022-2023. Qua khảo sát xác định được 323 sinh viên thừa cân, béo phì có chỉ số BMI ≥ 23, chiếm tỷ lệ 24.5%. Bằng các phương pháp nghiên cứu khoa học thường quy, thông qua các test kiểm tra thể lực, nghiên cứu đã đánh giá xếp thể lực của 323 sinh viên năm nhất thừa cân, béo phì theo tiêu chí đánh giá thể lực học sinh, sinh viên của Bộ Giáo Dục và Đào Tạo. Kết quả nghiên cứu sẽ là cơ sở để đề xuất các giải pháp nhằm giảm cân, kiểm soát cân nặng và lựa chọn các bài tập phù hợp phát triển thể lực, góp phần nâng cao chất lượng công tác giáo dục thể chất cho sinh viên của Nhà trường.
NGHIÊN CỨU ẢNH HƯỞNG CỦA QUẢNG CÁO LÊN Ý ĐỊNH MUA SẮM CỦA SINH VIÊN TẠI TRƯỜNG ĐẠI HỌC QUỐC TẾ HỒNG BÀNG
Authors: Nguyễn Minh Nguyệt Nguyễn Minh Nguyệt , Đặng Lê Đăng Khoa Đặng Lê Đăng Khoa , Nguyễn Anh Khoa Nguyễn Anh Khoa , Đặng Xuân Thanh Đặng Xuân Thanh , Tô Tuấn Kiệt Tô Tuấn Kiệt , Nguyễn Thủy Tiên Nguyễn Thủy Tiên
Published: July 2024

Nghiên cứu này được thực hiện với mục tiêu phân tích các yếu tố trong quảng cáo tác động đến ý định mua sắm của sinh viên Trường Đại học Quốc tế Hồng Bàng Thành phố Hồ Chí Minh. Sử dụng phương pháp luận định lượng, các nhà nghiên cứu đã tiến hành khảo sát online và thu thập 150 mẫu dữ liệu từ sinh viên đang theo học tại trường. Kết quả phân tích hồi quy đa biến bằng SPSS cho thấy có 5 trong 6 yếu tố nghiên cứu có tác động tích cực đến ý định mua sắm của sinh viên. Trong đó, "sự góp mặt của người nổi tiếng" và "ý kiến chuyên gia" là hai yếu tố có ảnh hưởng mạnh mẽ nhất. Dựa trên kết quả này, nghiên cứu đề xuất một số chiến lược marketing và quảng cáo hiệu quả nhằm nâng cao hiệu quả của các chiến dịch quảng cáo hướng đến đối tượng sinh viên.
Phytoremediation of Cadmium and Evaluation of Hemin-induced Tolerance Mechanism in Sorghum bicolor (L.): An Important Millet Crop of Indian Thar Desert
Authors: SHEKHAWAT ANITA SINGH AND G. S.
Published: July 2024

The current investigation assessed the impact of external hemin on cadmium (Cd)-induced toxicity regarding metal accumulation and stress tolerance in Sorghum bicolor. Two-week-old S. bicolor seedlings were treated at concentrations of 10 ?M Cd, 75 ?M Cd, 150 ?M Cd, and 1 ?M hemin individually as well as in collection with hemin within a Hoagland medium. After 120 h, the subjected plants were collected for the study of cellular homeostasis and metal tolerance mechanisms, involving the examination of growth and stress parameters as well as non-enzymatic and enzymatic antioxidants. However, augmentation of hemin under Cd-induced stress environments ameliorated plant development by augmenting biomass and chlorophyll pigments. This augmentation also encouraged antioxidant activities, including ascorbate peroxidase and guaiacol peroxidase levels, while simultaneously mitigating oxidative impairment and enhancing Cd tolerance in plants. Moreover, the utilization of hemin improves the efficacy of S. bicolor in Cd removal by enhancing the uptake of Cd. Hence, the investigation proposes that hemin holds promise for improving the Cd tolerance and accumulation capabilities of Cd-tolerant plants.. KEYWORDS :Cadmium stress, Heme oxygenase, Hemin, Phytoremediation, ROS detoxification, Sorghum bicolor
Seasonal Variations of Soil Nutrient Dynamics in Sal Forests under Two Management Regimes in Nandhaur Range, Nainital, Uttarakhand
Authors: JOSHI NEETU  AND NAMITA
Published: July 2024

This paper aimed to investigate soil physicochemical properties and concentration of nutrients released by litter in assisted natural regeneration (ANR) Sal Forest and compared with non-ANR. Soils were collected at 0?15 cm and 16?30 cm depths across each site for three seasons, that is, summer, rainy, and winter. The soil at both the study sites was sandy loam. The results indicate the maximum values of soil physicochemical characteristics during the rainy season, i.e., soil moisture (25.04%), bulk density (1.5%), pH (7.24%), carbon (2.26%), nitrogen (0.096%), phosphorus (0.006%), and potassium (0.27%) followed by summer and minimum in the winter season. The values decline with increasing depths whereas pH and bulk density have shown a reverse trend. In both the sites, the nutrient content of litter was maximum in the rainy and minimum in the winter season in the following order: N > K > P. Hence, the findings unveil that ANR Sal Forest has rich physicochemical properties of soil as well as litter nutrients compared to non-ANR sites. The present study is the first comparative research made so far on soil physicochemical properties and litter nutrient dynamics in Sal ANR and non- ANR forests of Nainital, Kumaun Himalaya, and recommends that ANR practices are good for nutrient enrichment of soil and Sal growth and regeneration. . KEYWORDS :Sal forests, Soil physicochemical properties, Litter, Kumaun Himalaya
Self-purification of Upper reaches of Yamuna River, Uttarakhand, India
Authors: BISHT POOJA , BAGRI DHIRENDRA SINGH , RANA SUDHIR KUMAR AND SUMIT SINGH
Published: July 2024

A river's ability to purify itself is a key marker of its overall health and is crucial in cases where the water is contaminated. The Yamuna River originates in Banderpoonch and travels through a number of locations along its course. Sewage, hotel garbage, and animal waste are dumped into the river, which not only contaminates the water but also impairs its ability to purify itself. Dilution, sedimentation, reaeration, adsorption, absorption, temperature, sunlight, and chemical and biological reactions, are the factors that affects self-purification capacity. Drainage density plays a major role in purifying the water, it can be clearly observed from the samples taken before and after the sub-watershed SW-2, SW-8, and Tons watershed. Samples are taken from 26 locations i.e., 23 from Yamuna River and 3 (T1 to T3) from tributaries Kedarganga, Badrigad, and Tons. 16 Physio-chemical and biological parameters i.e., pH, total dissolved solids, electrical conductivity, DO, Alkalinity, Fluoride, Chloride, Sulfate, Nitrate, Sodium, Ammonium, Potassium, Magnesium, Calcium, Total Hardness and Escherichia coli are used to calculate Water quality index (WQI). WQI ranges from 24.58 (R21) to 1258 (R5) and Ecoli from 2 (R1) to 436.6 MPN/100 mL (R5). Water quality is deteriorating at some locations from previous locations and improving at some locations, which shows that self-purification is taking place. . KEYWORDS :Hydrology, Physio-chemical, Self-purification, Water quality, Yamuna River
A Brief Comperative note about the Mechanisms of Microbial Bioremediation and Phytoremediation
Authors: BEE AKSHA , KUMAR SHIVAM , PATIL ABHIJITA KHAMARI AND ANJALI
Published: July 2024

The increasing urbanization, industrialization, and modernization of the world have made heavy metal pollution a serious issue. Toxic chemicals found in industrial wastes have made a major contribution to the current disastrous environmental pollution and have impaired the growth and metabolism of living organisms. Excessive metal pollution is the result of various ineffective treatment techniques. Bioremediation of heavy metals with plants and bacteria is simultaneously a cost-effective and environmentally friendly approach. Numerous methods, including biosorption, bioaccumulation, and efflux systems, are accessible for bacteria to mitigate the toxicity of heavy metals. Phytoremediation is a novel and promising way to speed up and enhance the rate of heavy metal detoxification. To deal with the toxicity of heavy metals, plants have a variety of defense mechanisms, including phytoextraction, rhizofiltration, phytostabilization, phytovolatilization, and phytotransformation. This study mainly focuses on the bacteria and plants that uptake and sequester toxic heavy metals and the possibilities for using them in bioremediation. . KEYWORDS :Bioremediation, Biosorption, Heavy metals, Phytoextraction, Phytoremediation
Effects on Digestive, Metabolic and Oxidative Stress Enzymes following Papaya Leaf Meal addition in the Diet of Labeo rohita (Ham.) Fingerlings
Authors: SHANTHANNA P. , MURALIDHAR TINCY VARGHESE AND ANDE PENCHALA
Published: July 2024

A 60-day feeding trial was conducted to evaluate the effect of papaya (Carica papaya) leaf meal on the physio-metabolic enzyme response of Labeo rohita fingerlings. Fingerlings were distributed in five different experimental groups with replicates. Each replicate contains 15 fishes with a mean average initial weight of 11.34 ? 0.20 g?11.61 ? 0.04 g and is fed daily twice for 60 days. Five practical iso-nitrogenous fish diets (~30% protein) were prepared with different levels of papaya leaf meal (PLM) with partial replacement of rice bran, that is T1 (0% PLM), T2 (10% PLM), T3 (15% PLM), T4 (20% PLM) and T5 (25% PLM). The digestive enzymes, such as amylase and protease varied significantly. Amylase activity was significantly higher in the T3 group, while protease activity was highest in the T4 group. The activities of metabolic enzymes, such as alanine aminotransferase, aspartate aminotransferase, lactate dehydrogenase and malate dehydrogenases were lowest in the T4 and T5 groups. The oxidative stress enzymes were also recorded for their minimum values in the T5 group. The overall results indicate that the fish fed with 20% PLM (T4 group) showed the best performance in terms of growth and physio-metabolic enzyme parameters, although some of the parameters indicated a better value at 25% inclusion. Hence, it can be concluded that PLM can be included up to 20% in the diet of L. rohita (Rohu) fingerlings for optimum production without any deleterious effect on enzyme activity, which is mostly required for fish growth and production. . KEYWORDS :Enzyme analysis, Labeo rohita fingerlings, Papaya leaf meal
Strategi dan Dampak Kenaikan Harga Kedelai Terhadap Pendapatan Pengrajin Tempe Di Tenggilis Mejoyo Surabaya
Authors: Imron Febrianto  , Iswati Iswati  , Emilia Pranata
Published: July 2024

This research aims to determine the strategies used by tempe craftsmen through the production process regarding the impact of rising soybean prices and to find out whether the income of tempe craftsmen due to the increase in soybean prices has changed in Tenggilis Mejoyo Village, Surabaya City. In conducting this research, the descriptive qualitative method was used by the researcher. The findings in this research are how the tempeh production process, the strategies used by tempeh craftsmen to overcome the increase in soybean prices and the increase in soybean prices affect the income of tempeh craftsmen. It is hoped that this research will provide benefits, especially for all elements of society, for theoretical and practical benefits. The research results show that reducing the size of tempeh sold at a fixed price is a way for tempeh craftsmen to overcome the decline in income. The increase in soybean prices not only affects the income of tempeh craftsmen but also affects the amount of tempeh production which decreases by 50%. Some of the suggestions offered by researchers include craftsmen expanding tempe marketing, for the Indonesian government to help resolve the problem of rising prices of basic commodities, especially soybeans, which are still unstable, and for researchers who can then carry out further research on the impact of rising soybean prices on the purchasing power of tempeh. community in Tenggilis Mejoyo Village, Surabaya City.
Pengaruh Gaya Kepemimpinan Transformasional, Kompetensi, dan Kerjasama Tim Terhadap Kinerja Pegawai BUMDes Gemilang Desa Ketajen Gedangan Sidoarjo
Authors: Rifanda Putri  , Tri Andjarwati
Published: July 2024

This research tries to test whether transformational leadership style, competence and teamwork partially or simultaneously have an influence on the performance of BUMDes employees in Gemilang Village Ketajen Gedangan Sidoarjo. The sample of respondents in this research was 41 people. The data collection method used was through distributing questionnaires. Multiple linear regression analysis is a technique used to analyze data. These findings explain that there is a partially significant relationship between the transformational leadership style variable and employee performance, the competency variable and employee performance, and the teamwork variable. Employee performance is influenced by the variables of transformational leadership style, competence, and teamwork simultaneously. Furthermore, looking at the analysis of the R2 coefficient of determination, the R2 value (or R square) has an influence of 49.8%, and the remaining 51.2% is influenced by other variables.
A intelectualidade entre o terreiro e a academia no século XXI: a contribuição da Iyalorixá Dalzira Maria Aparecida Iyaguña no Sul do Brasil
Authors: Silva Roselaine Dias da
Published: July 2024

Este artigo propõe pensar a intelectualidade a partir da produção de conhecimento que se organiza fora dos padrões ocidentais, um lócus sagrado de práticas e ritos de Matriz Africana no Brasil, compreendido como terreiro. A proposta metodológica de perspectiva etnográfica foi realizada por meio de entrevista aberta no terreiro Ilê Asé Ologbo Ogum, com colaboração da Iyalorixá do Candomblé Dalzira Maria Aparecida Iyaguña de Ogum, Mulher Negra retinta — como ela se identifica — que defendeu sua tese de doutorado com oitenta anos. Observou-se por meio das provocações feitas à Iyalorixá e das respostas recebidas que há um tensionamento intelectual que perpassa o trânsito entre a academia e o terreiro. Problematizou-se o conhecimento formal institucionalizado e o conhecimento adquirido por meio das concepções vivenciadas na vertente religiosa de Matriz Africana que tem a ancestralidade como esteio de compreensão do mundo. Desse modo, as narrativas foram articuladas mediante os processos de identidade e resistência, considerando a memória como vínculo para a herança ancestral que, neste artigo, constitui-se por meio do afeto e do laço familiar. Destacou-se a oralidade que preserva, por meio da linguagem oral, a memória ancestral que move o tempo e permanência das pessoas de Tradição de Matriz Africana. Evidenciou-se que a razão epistemológica que desenvolve os processos da intelectualidade produzida no campo do saber, da filosofia e do pensamento de negras/os no Brasil se alicerça em conceitos estruturados a partir da cosmologia africana que atravessa a condição de ser e estar dos sujeitos.
Surgical Management of Recurrent Herniated Lumbar Disc at TU Teaching Hospital
Authors: Shilpakar S K , Sigdel A , Sharma M R
Published: July 2024

Over the duration of eight and half years, we had performed over 158 cases of hernitated lumbar disc surgeries at Tribhuvan University Teaching Hospital. Among them, there were altogether 6 cases with recurrent herniated disc at the same or the adjacent level. The demographic profile, clinical pictures, surgical management and the outcome are presented. Our limited experience and technical recommendation for the surgical mangement of such recurrent lumbar disc pathologies are also discussed in detail.
Neuropathic Arthropathy of the Shoulder - Case report of two cases with Review of the Literature
Authors: Garg M. , Singh S.
Published: July 2024

Two cases of neuropathic arthropathy of the shouldder secondary to syringomyelia are presented.Radiographs revealed resorption of the humoral head in both patients. Magnetic resonance imagesrevealed a syrinx of the central cord in both patients.
HIV-TB Co-infection in Nepal
Authors: Suvedi B. K
Published: July 2024

Tuberculosis is considered as a major co-infection in AIDS. It is a serous challenge toNepal. The incidence of TB as the life time risk of developing TB in HIV infected person is 50%.It is estimated that in the year 2002, some 2.4% might have TB-HIV co-infection in Nepal. Themost frequently affected age group is 20-29 years. The central and western region of Nepal hashighest number of HIV-TB co-infection.
Various presentations of Meckel’s Diverticulum
Authors: Kumar S. , Singh Y.P. , Vaidya P.
Published: July 2024

Background – Meckel’s diverticulum is very difficult to diagnose. The aim of this study was to study the various presentations of Meckel’s diverticulum in TUTH in one year.Methods – Retrospective study of nine patients admitted from emergency in one year data was done.Result - In acute abdomen we have to think about Meckel’s diverticulum and its complications. The diagnosis of symptomatic Meckel’s diverticulum is difficult to make, especially in adults. The diagnosis must be considered in anyone with unexplained abdominal complaints, nausea and vomiting, or intestinal bleeding.
Cryptosporidiosis in HIV seropositive patients in Kasturba Hospital, Manipal, Karnataka, South India
Authors: Singh A. , Bairy I
Published: July 2024

Background: Cryptosporidium parvum a coccidian protozoal parasite causes a protracted lifethreatening diarrhea in HIV sero-positive patients. This study was conducted to find out distribution of cryptosporidium infection in HIV sero-positive patients (with acute or chronic diarrhea) admitted in Kasturba Hospital, Manipal, South India.Method: Freshly passed stool samples were collected and stained with modified Ziehl Neelson staining technique and examined under microscope for the detection of oocyst of Cryptosporidium.Results: Thirty out of 70 (42.85%) of HIV sero-positive patients were found to have Cryptosporidium parvum oocyst in their stool samples.Conclusion: Known prevalence of cryptosporidial in HIV positive patients can help in starting prophylaxis and can significantly reduce morbidity and mortality associated with severe diarrhea.
Can we improve university clinical examination?
Authors: Sharma Prof. Pushpa Raj
Published: July 2024

N/A
Immunization goals: Is Nepal keeping the promises?
Authors: Suvedi B.K.
Published: July 2024

Nepal committed to the global immunization goals in 1992 as expressed in the World Health Assemblyof 1989. This article examines whether Nepal has attempted to keep the promises. It is seen that thepromises are being seriously taken and fulfilled as evidenced by various activities carried out in thepast one decade.
Use of intrathecal morphine for analgesia in a surgical camp set up in Nepal
Authors: Shrestha A. , Pradhan B
Published: July 2024

Background: Pain management is often inadequately addressed, especially in a mobile surgical camp set up. We try to look at an easier and effective method, i.e. intrathecal morphine for pain relief and it’s practicability in a camp set up.Method: 89 patients under going vaginal hysterectomy under spinal anesthesia were studied. They were randomly allocated to those receiving bupivacaine and intrathecal morphine (n=61) and another group receiving bupivacaine only (n=28). Their need for post operative analgesia and untoward effects like nausea/ vomiting, pruritis and respiratory depression were compared.Results: Significant pain relief was seen with the added intrathecal morphine but it also caused increased incidence of vomiting. Other serious effects were not seen.Conclusion: Intrathecal morphine is an effective method of post operative analgesia in operations under sub arachnoid block but an effective antiemetic cover is also required and vigilance to tackle any untoward effects is needed.
Socio-demographic factors of pig farmers associated in transmission of taeniosis/cysticercosis
Authors: Sharma M.
Published: July 2024

Introduction: Pig farmers’ socio-economical and environmental conditions that comprise the risk factors for the contraction of cysticercosis in Nepal are as the socio-economic condition of pigfarmers is very poor. They are ignorant about health and hygiene. In Terai districts, 80% farmers keep pigs in the open field. Most of the families of the pig rearing communities do not have latrines. They use open field for defaecating. Free range feeding of pig is quite common all over Nepal traditionally.The unhygienic disposal of the waste helps the problem to be graver.
Method: This study was carried out in three VDCs i.e. Tindobate VDCs, Thumpokhara VDC,Jagatradevi VDC and Walling Municipality in Syangja district. Household keeping pigs farmers were randomly selected from villages in the district. About 437 households and pig farming area weresurveyed.
Results: This contamination of soil and water contributes greatly for the parasitic infestation of both pig and human. Most of the pigs are kept inside the house at night and are fed on kitchen wastes and excreta. This is the important factor that is co-related with the high prevalence of parasitic infestationslike Taeniasis in pigs and humans.
Conclusion: Pig husbandry system should be improved. Mass awareness education programmes for controlling parasitic diseases in general, and taeniasis and cysticercosis in particular should belaunched in all pig pocket production areas of the country. Social upliftment programmes like adult education, toilet construction, safe drinking water supply, gender indiscrimination in the pig husbandry as a source of poverty elimination must be carried out.
Cirsoid aneurysm-a rare congenital anomaly of arteriovenous malformation
Authors: Bilodi A.K.S , Sudharsan P. , Srinivas T.D.
Published: July 2024

Background: The aim of the present study is to report a case of arterio venous malformation thatwas observed in the scalp - Cirsoid aneurysm
Case Study: A. case of cirsoid aneurysm was seen in a male patient aged twenty two years who. Came to surgical out patient department with history of headache & a single large pulsatile swelling over left fronto parietal region. with no history of trauma or infection . Histopathological studies showed arteriovenous aneurysm. Multiple ligation with excision of sac was done. Post operative period was uneventful. This vascular malformation is rare congenital anomaly, This congenital anomaly is of profound clinical importance not only to neurosurgeons but also to vascular surgeons and gastro enterologists hence it was studied and reported.
Multifocal osteosarcoma
Authors: Pathak S.V. , Ghodke K.
Published: July 2024

Background: Osteosarcomatosis (also known as multifocal osteosarcoma or multiple sclerotic osteosarcoma) describes a condition in which there are multiple intraosseous foci of osteosarcoma at the time of presentation.
Case report: In a patient of multifocal osteosarcoma the simultaneous appearance of multiple skeletal tumors without pulmonary metastatic lesions was seen. However symptomatic lesion was large in Comparison to satellite lesions. Case is reported and general subject of multifocal osteosarcoma is reviewed.
Mullerain anomaly with a persistent cloaca and an ovarian dermoid- a rare combination
Authors: Amatya A. , Gurung G. , Rana A. , Khakurel M.P. , Singh K.P.
Published: July 2024

Background: This case concerns a 30 year old unmarried woman who was least bothered by persistent cloacal opening in the perineum from which she had been passing stool, completely being ignorant of normal female anatomy of lower gastrointestinal/urogenital tract and only attended our hospital for combined operative management of cholelithiasis and ovarian dermoid detected by an ultrasound when she presented with 2 years history of abdominal pain.
Case report: Laparotomy visualized mullerian anomaly in form of thumb sized uterus without a cervix and unilateral dermoid. Megacolon was also observed as a resultant of cloacal abnormality
Bacteriological study of upper respiratory tract infection in pediatric patients
Authors: Shrestha A. , Sherchand J.B. , Sharma P.R. , Bhatta D.R.
Published: July 2024

Background: The study was conducted with aims to identify the causative bacterial agents of upper respiratory tract infection ( URTI ) among pediatric patients and to reveal the antibiotic susceptibility pattern of the major pathogen during November 2001 to October 2002.
Methods: The throat swab samples from 192 children suspected of URTI were obtained from the outpatient department of Kanti Children’s Hospital and inoculated in the culture medium. The bacterial infection was confirmed only in 152 patients. The organisms isolated on medium were identified bytheir cultural, morphological and biochemical characteristics.
Results: The infections were found to be due to S.pyogenes, S. aureus and S. pneumoniae. Most of the infections were due to S.pyogenes. The information obtained during sample collection showed that the high rate of infection was found to be in male patients, in infants and in urban children. Antibiotic susceptibility pattern for the isolated organisms revealed that Amoxycillin and Cephalexin, Erythromycin and Cephalexin were the most effective for S.pyogenes and S. aureus respectively whereas both Amoxycillin and Cephalexin were equally and the most effective for S. pneumoniae. The effective antibiotic for overall URTI was found to be Amoxycillin
Conclusion: The study concluded that despite the existence of so many pathogens, and the susceptible antibiotics, Amoxycillin has been found to be the most effective against the pathogens causing URTI among pediatric population.
Gastric cancer: diagnosis and treatment options
Authors: Shrestha M.L
Published: July 2024

Background: Overall incidence of primary gastric cancer has steadily declined in the western countries, however it is still prevalent in northern and south Asian countries. The exact prevalence in Nepal is still to be known, however according to the hospital based statistics, it seems to be the commonest cancer in Tribhuvan university teaching hospital followed by lung carcinomas. Over all, the incidence of distal stomach tumors has greatly declined, but reported cases of proximal gastric carcinomas, including tumors at the gastroesophageal junction, have increased. Early diagnosis of gastric cancer has been very difficult because most patients are asymptomatic in the early stage. Weight loss and abdominal pain often are late signs of tumor progression. Chronic atrophic gastritis, Helicobacter pylori infection, smoking, heavy alcohol use, and several dietary factors have been incriminated to increase the risks for gastric carcinomas.
Esophagogastroduodenoscopy is the preferred diagnostic modality for evaluation of patients in whom stomach cancer is suspected. Accurate staging of gastric wall invasion and lymph node involvement is important for determining prognosis and appropriate treatment.
Endoscopic ultrasonography, in combination with computed tomography and operative lymph node dissection, may be involved in staging the tumor. Treatment with surgery alone offers a high rate of failure. Chemotherapy and radiotherapy have not improved survival rates when used as single modalities, but combined therapy has shown some promise. Primary prevention, by control of modifiable risk factors and increased surveillance of persons at increased risk, is important in decreasing morbidity and mortality
Gall bladder tuberculosis: a rare entity
Authors: Lakhey P. , Shrestha M.L. , Sayami G. , Khakurel M.P.
Published: July 2024

Background: Though tuberculosis is common in other parts of the body, gall bladder tuberculosis is rare. We report a case of gall bladder tuberculosis managed in our institution.
Case Report:A 42 year old lady presented with right upper quadrant pain associated with fatty meal intolerance for one month. The pain was relieved by antispasmodics. Her liver function test was normal. Ultrasonogram of abdomen revealed, thick wall gall bladder with solitary stone in the gall bladder. Retrograde subtotal cholecystectomy was done. The histopathology report of the gall bladder revealed granulomatous cholecystitis suggestive of tuberculosis.
An epidemiological study of Cyclospora cayetanensis in Nepalese people
Authors: Sherchand J.B. , Sherchand J.B. , Cross J.H
Published: July 2024

Background: Cyclospora cayetanensis is a coccidian parasite that causes recurrent gastroenteritis among children living under poor sanitary condition and adults from industrialized countries who lived or traveled in endemic developing countries.
Materials and Methods: A total of 1842 stool specimens from gastroenteritis patients were examined between March 2005 to February 2006 and collected various types of faecal specimens from human, animals and samples of water and green leafy vegetables.
Results: Of 1842 stool specimens collected from different areas of Nepal, 146 (7.9 %) were found to be positive for Cyclospora cayetanensis with the majority were from children 2-9 years of age. The highest rate of infections was found in the month of June; (31.6%). Cyclospora cayetanensis were found to be contaminated in green vegetables including leaves of basil, mint leaves, water sources and feces of domestic animals and these findings were presented in the paper.
Conclusion: Cyclospora-like oocysts were isolated for the first time from the leaves of basil, a holy plant of Nepal and the study indicated that vegetarian people were also found highest rate (65.1%) of Cyclosporiasis. However, to obtain more evidence on the source of infection, specimens from rodents, birds, insects and domestic animals are need for an extensive study.
Study of sensitivity and specificity of five rapid plasma reagin test kits in syphilis
Authors: Shrestha B.
Published: July 2024

Background: Syphilis caused by Treponema pallidum has been associated with humankind since ancient times.
Materials and Methods: Blood samples from 408 healthy Nepalese male population was collected and tested to find out the sensitivity and specificity of five different (a, b, c, d and e) non treponemal syphilis serological test rapid plasma reagin (RPR) as well as for the screening of the healthy target group for syphilis.
Results: Six subjects (1.47%) were found positive with the test and by Treponema pallidum Haemagglutination (TPHA) test was identified as a syphilitic subject. With the test kits a, c and d 34 false positive cases were detected. The sensitivity was 100%, and the specificity was 92% only. Whereas with test kits b and e only six true positive cases were detected thus making their sensitivity and specificity 100%.
Conclusion: Therefore, it is concluded that test kits a, c and d should only be used for the screening purpose. On the other hand, the test kits b and e can be used for the diagnostic purpose.
A retained dead fetus for eight years in a didelphys uterus
Authors: Pant P.R. , Sharma J. , Giri K. , Pradhan N. , Thapa T.P.
Published: July 2024

Case report: A case report of 32 years female with 3 childrens and a retained dead fetus for eight years in a didelphys uterus is discussed as a case report.
Is coagulation profile routinely indicated in Epistaxis?
Authors: Adhikari P. , Guragain R.P.S , Pradhananga R.B.
Published: July 2024

Background: Epistaxis is the most common ENT emergency worldwide.It is also common ENT problem in Nepal. Most cases of epistaxis don’t have an easily identifiable cause. Both local and systemic processes can play a role in it.Treatment of severe epistaxis can encompass different modalities.
Objective: To observe the significance of coagulation studies to find out a cause for epistaxis.
Materials and Methods: A retrospective chart review of coagulation studies of 124 cases(male=85, female=39) of epistaxis patients admitted in ENT-Head and Neck Surgery ward of T.U.Teaching Hospital from January 2005 to June 2006 was performed to find out the coagulation disorder in such patients.
Results: There were 124 patients with epistaxis admitted during the study period of 1 1/2 year duration with M: F ratio 2.2:1. Prothrombin Time ranged between 11-16 seconds, Bleeding Time between 2-8 minutes, Activated Partial Thrombin Time between 25-35 seconds, and International Normalized Ratio between 0.8-1.2. All those values being normal, we did not further investigate for factor assays.None of the patients with epistaxis had coagulation profile derangement.
Conclusion: From our study it seems that routine coagulation profile is not necessary in patients with epistaxis. The indications for coagulation profile testing in patients with epistaxis should be identified by a more scientific larger study. At present, the tests should be done when there is high suspicion of such disorders.
Management of acute respiratory distress syndrome
Authors: Bhattarai B.K.
Published: July 2024

Background: Managing patients with acute respiratory distress syndrome (ARDS) still remains a challenge to the intensivists despite huge accumulation of basic and clinical data and better understanding in its management. The evolution of the concept of ventilator associated lung injury (VALI) in mechanically ventilated patients with ARDS has changed the approach to ventilatory management. Survival of the patients with ARDS may be improved by modifying the mechanical ventilation such that VALI is kept to a minimum. Protective strategy in mechanical ventilation with limited volume and pressure is the only accepted treatment or supportive measure shown to affect the outcome in ARDS patients. Low tidal volume ventilation has been recommended for every patient with ARDS to be used routinely. Protective ventilatory strategy has been accepted as a new gold standard and is being used to evaluate and compare other techniques and modalities. Use of approaches such as prone position ventilation, inhaled nitric oxide and surfactant has failed to improve survival in clinical studies. But these approaches may confer benefits if used in conjunction with the protective strategy.
Patients’ perspective on informed consent in ear surgery
Authors: Adhikari P. , Guragain R.P.S
Published: July 2024

Background: Informed consent is required before any surgical procedure. This study was done to assess patient’s expectations before to signing consent forms for ear surgery.
Methods: This study was done in Department of ENT and Head and Neck Surgery, T U Teaching Hospital from August to December 2006. All patients attending to OPD for appointment of surgery were randomly selected and were explained verbally about the possible complications of surgery, by the first author. There were 100 patients and they were interviewed with a standard questionnaire just one day before surgery. Answers were written by the first author on a standard questionnaire form. All those 100 patients who were informed previously about the possible complications were included in the study. Informed consent was obtained from all patients for the study. Data analysis was done statistically using frequency and percentage.
Results: Ninety five percentages of patients were satisfied with the information given by doctors before ear surgery. There were very few patients (7.0%) who looked for further information. Only 27.0% patients could tell complication of ear surgery. Among them, 5.0% patients could list more than one complication. The common complications listed by our patients before ear surgery werebleeding (10.0%), infection (9.0%). Around 96.0% want to be informed all known complications even if the incidence was less than one percent.
Conclusion: The information given by the doctors might not meet the expectation of the patients of twenty first century as they have a high expectation. However, the doctors should give a sufficient time to explain about the surgical procedure and they should not miss a common and important complication of surgery
Analysis of tracheobronchial foreign bodies
Authors: Adhikari P. , Shrestha B.L. , Sinha B.K. , Baskota D.K. , Sharma N.R.
Published: July 2024

Background: To analyze the type and site of tracheo-bronchial foreign bodies in patients admitted in the department of ENT-Head and Neck surgery (ENT-HNS) of TU Teaching Hospital.
Methods: Medical records of 41 cases admitted in the department of ENT-HNS, TU Teaching Hospital, Kathmandu between April 2004 to October 2006 for the management of suspected foreign bodies in tracheobronchial tree were analysed retrospectively. It was found that rigid bronchoscopy was performed in all 41 cases and foreign bodies were removed from 36 cases. In the five cases where foreign body was not found, were excluded from the study.
Results: There were 83.3% children and 16.6% adults. Most common type of foreign body found in children were vegetative (63.3%) where as in adults beetle nut (50.0%) and metallic foreign bodies (50.0%) were found. Majority of foreign body was found to be lodged in the right main bronchus (56.7%) in children. Whereas, in adults foreign bodies (66.7%) were found in the left main bronchus. Radiological confirmation of the foreign body could be made only in 8 cases (22.2%). All patients had an uneventful postoperative period except two (5.5%) who died during postoperative period after removal of foreign bodies from trachea.
Conclusion: In children, foreign body is more common in right bronchus where as in adults it is more common in left bronchus. Only 22.2% foreign bodies could be seen in plain X-ray. In unresolved pneumonia high index of suspicion of foreign body in tracheobronchial tree must be made and diagnostic bronchoscopy should be performed.
My 2 Innings
Authors: Dixit Hemang
Published: July 2024

N/A
Local and systemic eosinophilia in patients with nasal polyps
Authors: Pradhan R.B. , Shrestha A. , Pradhan B. , Adhikari R.C.
Published: July 2024

Background: To determine the presence of local and systemic eosinophilia in patients with nasal polyps and to correlate between them.
Materials and Methods: Patients of all age group, presented in ENT OPD during October 2004 to May 2006, with ethmoidal polyps were studied. Patients using steroids in last one month, antrochoanal polyps and histopathological diagnosis other than nasal polyps were excluded. The local eosinophils count in nasal polyp tissue of study group and inferior turbinate mucosa of control group were evaluated and analyzed. Similarly absolute blood eosinophil counts in both study and control group were evaluated. The association between local and systemic eosinophilia were analysed.
Results: Out of 78 patients with nasal polyps systemic eosinophilia was seen in 28 patients (35.9%) and local eosinophilia was seen in 50 (64.1%) patients. Among 30 patients of control group only 2 patients (6.7%) had systemic and none had local eosinophilia. On analyzing the results, the presence of systemic and local eosinophilia in patients with polyps were statistically significant with p value 0.005 and 0.0001 respectively. The association between them was also significant (p <0.025).
Conclusion: There is significant local and systemic eosinophilia in patients with nasal polyps and also significant correlation between them.
Guillain-Barré Syndrome in Nepalese Children
Authors: Bhattarai P. , Shrestha P.N.
Published: July 2024

Background: Guillain-Barré Syndrome (GBS) is a group of autoimmune syndromes consisting of demyelinating and acute axonal degenerating forms of the disease. This study gives the profile of 30 patients who were admitted with the diagnosis of GBS in a pediatric hospital.
Methods and material: We reviewed the admitted case notes of children admitted with the diagnosis of GB syndrome from January 2005 to December 2007. The data were analyzed to find out the demographic features, preceding illness, clinical features and CSF findings.
Result: The age ranged from 3.6 years to 14 years. The mean (SD) age was 4.9 (9.7) years. The most common symptoms were inability to walk after awaking in the morning. The median evolving time from the onset of illness to nadir was 12 days. The CSF protein concentration ranged from 60 to
Rolling audit on the quality of discharge summary in TU Teaching Hospital
Authors: Guragain R.P.S , Adhikari P.
Published: July 2024

Background: Audit 2007 (December) was significant in that it was the third rolling audit on the discharge performance started in TU Teaching Hospital. The audit was started in 2005 and it intends to transfer important clinicalinformation from inpatient to outpatient settings and between hospital admissions. Materials and Methods: There were 20 discharge summary forms picked up from each of seven departments of TU Teaching Hospital between November 2007 and December 2007. All summaries were looked for the inclusion of modified Van Walraven criteria. Apart from Van Walraven eight points, admission and discharge date and follow up instructions were also checked by the second author. These summaries were compared with previous discharge summary performed 2 ½ years ago. Results: Department of ENT and HNS showed the best discharge summary as per modified Van Walraven criteria whereas Department of Orthopaedics had the least inclusion of criteria. Previous study showed best summaries in Department of Gynaecology while poor in Department of Orthopaedics. Regarding completeness of hospital discharge summary form, Department of ENT and HNS had the highest number of almost completely filled discharge summaries (>90%) while Department of Medicine had the least number of properly filled discharge summaries. Previous audit showed Department of ENT and HNS to be the best while Department of orthopaedics to be the worst. On analyzing the previous recommendations, they were not properly followed. Conclusion: Discharge summary should be filled up completely without missing necessary information. Although ENT and HNS has best discharge summary according to Van Walraven discharge criteria as well as completeness of our hospital discharge summary, it needs to follow previous recommendations. The recommendations previously given should be strictly followed and informed to the heads of all Departments concerned.
Glioblastoma multiforme or brain abscess
Authors: Shrestha P. , Pant B.
Published: July 2024

Abstract: It is not uncommon for brain abscess and glioblastoma multiforme (GBM) to be confused with one another in neuroimagings. Due to preoperative diagnostic dilemma, treatment strategy and prognosis cannot be explained in advance. In this context, we present a case of 50 year-old male patient with features of raised intracranial pressure (ICP) and left hemiparesis. His computed tomographic (CT) scan and magnetic resonance imaging (MRI) of head showed central cystic lesion with ring enhancement with significant perifocal edema. Provisional diagnosis of GBM was made. Surgery was performed with craniotomy. Intraoperative picture showed a cystic lesion with thick capsule containing pus. Histological report showed plenty of inflammatory cells without any evidence of GBM. There are various neuroimaging techniques to differentiate brain abscess from GBM. However, in Nepalese context, they are hardly applicable. By this article, we intend to emphasize that brain abscess and GBM are very difficult to differentiate and thus thorough evaluation is needed before surgery is contemplated so as to make an appropriate treatment plan.
Peutz-Jehger’s Syndrome presenting as adult intussusception
Authors: Athar Z. , Rajbhandari A. , Kansakar P. , Singh Y.P. , Vaidya P.
Published: July 2024

Abstract: Peutz- Jehger’s syndrome is an autosomal dominant disorder. It is the second most common hamartomatous syndrome with hamartomatous polyp of gastrointestinal tract and cutaneous melanin deposit. Majority of patients remain relatively asymptomatic. Some present with abdominal pain secondary to obstruction or impending obstruction owing to an intussuscepted polyp with GI bleeding. We report a case of 21 year male who presented with upper central abdominal pain, distension, vomiting and blood mixed stool. He also had black colored spots on perioral region and fingers. Ultrasound revealed mass lesion with echogenic centre suggestive of intussusception. Emergency laparotomy revealed jejunojejunal intususception with gangreneous intussusceptum and two other large polyps. Resection anastomosis of jejunum and excision of polyps was done. Peutz – Jehger’s syndrome is a rare but important cause of intussusception in adults presenting with cutaneous manifestations and features of intestinal obstruction
Multiple symmetric calculi in the duplex system ureterocoele
Authors: Bajaj A. , Hada R. , Shrestha P.M , Bajaj S.K.
Published: July 2024

Abstract: Ureterocoele is the cystic dilatation of the terminal ureter. A duplex-system ureterocoele implies one associated with the upper pole moiety of a complete ureteral duplication. These days, ureterocoeles are detected on antenatal sonograms but detection of multiple symmetric stones in an adult is infrequent. We report a rare case of bilateral duplex system ureterocoele with multiple and symmetric stones on right upper moiety in an adult.
Rare case of Parry-Romberg Syndrome (Hemi facial atrophy)
Authors: Karmacharya B.M. , Karmacharya R.M
Published: July 2024

Parry-Romberg syndrome is a rare syndrome that is more common in females. It is characterized by gradual onset and progressive atrophy of one half of face causing considerable disfigurement, blindness and orthodontic problems. The etiology and treatment has not been clarified yet 1 . We report a case of this rare syndrome.
Editorial Correction
Authors: JIOM
Published: July 2024

N/A
Prediction of surgical site infection and other adverse postoperative outcomes
Authors: Luitel B.R. , Kandel S.P , Shrestha B. , Sapkota R. , Bhandari R.S
Published: July 2024

Background: To predict surgical site infection, hospital acquired pneumonia, wound dehiscence, and mortality based on SENIC index in Nepalese perspective in surgical patients. Methods: A Retrospective study was conducted at Department of Surgery, Tribhuvan University Teaching Hospital (TUTH), Kathmandu, Nepal from October 2007 to September 2008. Surgicalinfection risk factors assessed by the traditional wound-classification system (clean, cleancontaminated, contaminated, and dirty-infected wound) and by the SENIC risk index (length of intervention more than 2 hours, more than three discharge diagnoses, abdominal surgery, and contaminated or dirty infected wound) were compared by Receiver Operating Characteristic (ROC) curve. Results: The SENIC index showed a good ability to predict SSI, Hospital Acquired pneumonia, wound dehiscence and in hospital mortality. If the index score is higher, the outcome is poorer. By using SENIC index score the area under ROC curve for SSI, pneumonia, wound dehiscence and in hospital mortality was 82.2±4.8, 90.5±2.4, 85.1 ±4.7 and 96.9±1.2 % respectively with sensitivity above 95% for all the parameters. Conclusion: This study shows that the SENIC risk index results are reproducible, and the index can be used to predict rates of SSI and other adverse postoperative complications in developing countries as well.