bluuebunny/crossref_metadata_2025 huggingface dataset:
Risk Management and Value Creation: Empirical Findings from Government Linked Companies in Malaysia
Authors: Said Jamaliah , Alam Md. Mahmudul , Abdullah Nik Herda Nik , Zulkarnain Nur Nadiah
Published: February 2019

This study is an attempt to assess the status of current level of value creation among the Government Linked Companies (GLCs) in Malaysia. This study collected primary data based on a set of questionnaire survey among 134 executives and managers of GLCs in Malaysia. The data were collected based on opinions of the ten factors of value creation practices by using the five-point Likert scale. The data were analysed using descriptive statistics. Further, the reliability of the data was tested using Cronbach’s alpha test, the validity of the data was tested by checking the normality test through skewness and kurtosis, and the consistency of the data was tested using factor analysis. On an average, 80.6% of the respondents agreed that they focus on these factors of value creation. Overall, the federal owned GLCs place more emphasis on certain elements of value creation than the state owned GLCs. Among the elements of value creation, the state owned GLCs emphasize the most on quality development and brand value creation, where the federal owned GLCs emphasized the most on reputation. The GLCs engaged in service sector emphasized the most on brand value and the GLCs engaged in manufacturing sector emphasized the most on customer satisfaction and quality development. This study suggest that GLCs in Malaysia improve the overall value creation by emphasizing on responsiveness, average return on investment, sales growth, profit growth and average return on sales.
Food Security and Low-Income Households in the Malaysian East Coast Economic Region: An Empirical Analysis
Authors: Alam Md. Mahmudul , Siwar Chamhuri , Abu N.M. Wahid  , Talib Basri
Published: February 2019

This research aims at analyzing the level of food security among some selected poor and low-income households in Malaysia. The study area is located in the East Coast Economic Region of the country. It uses primary data collected during the July-October months of 2012 and 460 sample families were chosen from the E-Kasih poor households database based on cluster random sampling technique. In this sample survey, households’ food security has been measured by the USAID-HFIA model. The findings of the study indicate that 52.8% of the households are food secure, that of 23.3% are mildly food insecure, 14.3% are moderately food insecure, and 9.6% are severely food insecure. The findings on the current situation of household food security among different economic groups is very important for the policy makers to achieve Vision 2020 and the targets of Malaysian National Plans regarding food security, socioeconomic development and poverty alleviation. In order to ensure food security in Malaysia, especial focuses are needed for those who are severely food insecured and those who are food insecured but marginally above the poverty line. Here the involvement of private sector and community based organizations are also important to combat the short run, seasonal, and event related risk of food insecurity as well as for the development of appropriate mitigation and adaptation options to ensure sustainable food security at household level in Malaysia.
Lo público en la antigüedad, un retorno al ágora
Authors: Aguilar Juan Fernando
Published: February 2019

Hace 50 años, cuando se forjaba la era de los discursos revolucionarios, intelectuales y estudiantes se tomaron las calles de París para protestar contra la injusticia y la desigualdad que aún anidaba, no solo en Francia, sino en toda Europa. La historia recordaría aquella época de marchas y huelgas como Mayo del 68, el momento en que la política se hizo en la calle, en que la juventud decidió no callar más y en el que pensadores como Jean-Paul Sartre y Michel Foucault abandonaron las aulas universitarias para debatir en las calles, en las plazas públicas, en medio del sudor, la represión estatal y los gritos libertarios que convocarían nuevos movimientos alrededor del mundo.
Editorial Note: Vol.2(1)
Authors: Risal Nischal
Published: February 2019

No abstract available.
Message from the Principal
Authors: Joshi Puran Bahadur
Published: February 2019

No abstract available.
Online Recruitment: A Cognitive Perspective of Job Seekers in Nepal
Authors: Poudel Bishwash Raj
Published: February 2019

IT adoption is more than just technology deployment; it requires careful consideration of social-cognitive factors. With this premise, in this paper, the behavioral intention of job seekers to use online recruitment services in Nepalese context has been examined on the basis of five determinants: Performance expectancy, Effort expectancy, Subjective Norms, Objective Norms and Facilitating conditions. The impact of predictor on outcome variable is examined using multiple regression analysis. The unified theory of acceptance and use of technology (UTAUT) has been used as basic foundation of the study.
A Conceptual Review On Strategic Human Resources Management And Planning In Non Profit Motive Organization
Authors: Shah Gyanendra Bikram
Published: February 2019

The nonprofit and public sectors are facing significant numbers of impending retirements from the traditionalists and baby boomers in their workforces. In an effort to retain the knowledge base of an agency or to better serve its clients, some organizations have developed creative ways to encourage retirement-eligible employees to remain on the job. Public and nonprofit organizations are driven by the knowledge and skills their employees possess. It is shortsighted for elected officials, board members, funders, executives, and other agency leaders to dismiss the importance of SHRM. As important, organizations must reinforce the importance of human capital and the contribution that knowledge management makes to the effective delivery of services.
Personnel Control Practices in Insurance Companies of Nepal
Authors: Upadhyay Jitendra Pd
Published: February 2019

Background - Personnel controlling is used to achieve best possible use of employees and their development to get the maximum benefit for the company. It will be present not only in the human resource planning and staff assessment, but also in selection, professional development, health and safety

Purpose – The purpose of the study is to analyze the practices of personnel control in Insurance Companies of Nepal

Methodology – Due to the specific nature of the research objectives, descriptive cum analytical research design has been used.

Findings – All the insurance companies have applied the personnel control approaches in their company.
Domestic Violence in Province 3: An Empirical Reference to Case of Women in Pharping, Kathmandu
Authors: Poudel Muna
Published: February 2019

The aim of the research is to explore the domestic violence in woman of Pharping, Kathmandu. The descriptive and exploratory research designs have been adopted in the study. The sample has been taken from Sheshnarayan Mahila Bidhyalaya, Pharping, Kathmandu. The study has been focused only on women. The purposive sampling method has been used to collect the information. The descriptive analysis concluded that women in city are still victims of discrimination and domestic violence. There is a great need for the commitment of all people including social workers, organizations, and political institutions to bring an end to all forms of violence against woman.
Measuring Green Banking Practices on Bank’s Environmental Performance: Empirical Evidence from Kathmandu valley
Authors: Risal Nischal , Joshi Sanjeev Kumar
Published: February 2019

The research paper aims to analyze the impact of green banking practices on bank’s environmental performance in Nepal. The casual relational research design has been adopted in the study. The simple and stepwise multiple regression analysis have been performed to accomplish the objective of the research. The research paper follows cross-sectional qualitative research with descriptive outcome. The Chronbach’s Alpha has been used to analyze the reliability of instruments and data. The 189 samples have been collected from the banks using convenience sampling method. The SPSS software has been used to tabulate and analyze the data. The research paper concluded the energy efficient equipment and green policy posed the significant impact on bank’s environmental performance; green loan and green project as not. Similarly, the environmental training contributed mild to bank’s environmental performance. The findings of the paper suggested the role of banks and government in encouraging environmentally sustainable technologies as highly important for increasing bank’s reputation and awareness among customers.
A Study on Investor's Attitude towards Government Securities in Nepal
Authors: Shrestha Pitambar
Published: February 2019

The research paper sought to analyze the interest and awareness of Nepali people on government securities with one specific objectives of to examine the investor's interest and awareness towards government securities. The descriptive and analytical research design has been adopted in the study. The target population was the all investors of government securities in Nepal. The judgmental sampling method has been used to select the investor and 200 respondents were taken as its sample size. The data were collected using structured questionnaire. Chi-square test was done to examine the investor's interest and awareness towards government securities. It can be concluded that both educated and uneducated people are interested in government security. Thus, the research paper draws the conclusion that both poor and rich people are interested in government security. The income is the major factor of investment on government security.
Macroeconomics And Bank-Specific Factors Affecting Liquidity: A Study Of Nepali Commercial Banks
Authors: Ojha Pushpa Raj
Published: February 2019

This paper aims to examine the form and pattern of liquidity, NPL, return on assets, CAR, return on equity, GDP, inflation and interbank rate in Nepalese commercial banks. The study is intended to analyze the relationship between liquidity and bank specific variables in Nepalese commercial banks. The key findings stated that there is significant relation between numbers of variables that impacts on the liquidity performance of Nepalese commercial banks. The panel data of commercial banks from 2010/11 to 2016/17 has been taken for the purpose of the research. Mean, standard deviation, correlation and multiple regression analysis have been used to diagnose date to meet the specific objectives of research. The results reveal that there is significant influence of ROA, ROE, NPL, GDP and IBR on LIQ.
Work Life Balance in Nepalese Commercial Banks
Authors: Pathak Resham Raj
Published: February 2019

Work life balance has always been an important issue in social sciences due to its significant influence on career choice, time management, stress management and other important aspects of day to day life of human beings. Moreover, it is universal phenomena. With this context, the study tries to explore and analyze the link between Working hour, income level and organizational support with work-life balance of employees working in selected commercial banks of Nepal. Moreover, the study seeks the necessity to formulate an apparent and specific organization policy to address work life balance in Nepalese Commercial banks.
Impact of Educational Intervention in Knowledge of Infection Prevention and Control among healthcare professionals in Nepal
Authors: Pradhan Sait Kumar , Shrestha Sweta
Published: February 2019

Background: Health care-associated infection (HCAI) affects the mortality and morbidity of inpatients worldwide. Nepal is a developing country in which HCAI pose a major problem in terms of patient safety. Improper and inadequate knowledge about HCAI among health care workers is responsible for majority of nosocomial infections resulting in prolonged illness. Thus this study was designed to assess the level of knowledge of infection control among nurses and pharmacists.

Methods: A pre and post interventional study was conducted in 22 participants using a self-administered questionnaire which included queries on hand hygiene strategies, cross contamination sources and aseptic services. Each correct answer was scored as 1 and an incorrect answer was scored as zero. The total score for each individual was calculated before and after the intervention which was compared using the Paired t test at 95% confidence interval.

Result: 81.8% of the participants possessed a good knowledge on infection prevention and control practices which increased to 100% after intervention. The difference in knowledge score before and after the workshop was found to be statistically significant (p=0.034). Previous training and duration of work experience was found to be correlated with the knowledge score whereas the other independent variables had no association with the knowledge score.

Conclusion: Educational intervention has a positive impact in the knowledge level of the healthcare professionals in infection and prevention control.
Status Of Child Labour In Hotels Of Hetauda Sub-Metropolitian City
Authors: Sapkota Tika
Published: February 2019

The problem of child labour, as faced by the developing economics today, has indeed taken on serious dimensions. The exploitative socio-economic structures resulting in the marginalization of the poor have left them with no option but compel them to adopt child labour as a survival strategy. In the study, efforts are made to understand the societal facts about child labour and the root causes of the problem in the context of the socio-economic dynamics prevailing in the country. Child labour is a serious and wide spread problem in Nepal. Hotel, teashop and restaurant work are the most visible and hazardous forms of child labour, which is mostly common in the urban areas of Nepal. Moreover, they are among the most neglected, abused and exploited segments of the population. The study gathered information on hotel, child laborers socio-economic condition, their working condition, root cause of being laborers and problems faced by them. The child laborers come from almost all parts of the country and they are from different castes and ethnic groups. The majority of children are of age group with the average age being 14.5 years. Most of child laborers have their poor condition, step mother scenario, and illiterate family background. The children were found marginally illiterate. The household poverty is the leading cause of being child laborer in general. However, other factors like social injustice, unequal access to resources, large family size, death of earning family members, illiteracy, etc. contribute to enter into labour market from early age. The communicable diseases were prone in child laborers.
Halting Forest Encroachment in Terai: What Role for Community Forestry?
Authors: Bhusal Prabin , Paudel Naya Sharma , Adhikary Anukram , Karki Jisan , Bhandari Kamal
Published: February 2019

This paper highlights the lessons of using adaptive learning in community forestry that effectively help to resolve forest based conflicts in Terai region of Nepal. The paper is based on a three-year action research carried out in Terai. Qualitative methods including participatory rural appraisal tools and documentation of engaged action and reflections were used. Methods and tools that largely fall under adaptive learning were deployed. The field data was complemented by review of secondary data and literature on environmental history of Terai. We found that policies on land and forest in Terai for the last fifty years have induced and aggravated conflicts over access and control between state and communities and also within diverse groups of local communities. These conflicts have had serious negative impacts on sustainable management of forests and on local people’s livelihoods, particularly resource poor and landless people. Centralised and bureaucratic approaches to control forest and encroachment have largely failed. Despite investing millions of Rupees in maintaining law and order in forestlands, the problem continues to worsen often at the cost of forests and local communities. We found that transferring management rights to local communities like landless and land poor in the form of community forestry (CF) has induced strong local level collective action in forest management and supported local livelihoods. Moreover, adding adaptive learning, as a methodological tool to improve governance and enhance local level collective action significantly improves the benefit of CF. It implies that a major rethinking is needed in the current policies that have often led to hostile relationships with the local inhabitants- particularly the illegal settlers. Instead, transferring forest rights to local communities and supporting them through technical aspects of forest management will strengthen local initiatives towards sustainable management of forests.
Multiple Choice Questions (How valid as a tool of assessment)
Authors: Mishra S. M.
Published: February 2019

Not available.
Gallbladder Cancer: A Hospital Based Study
Authors: Sharma Anup , Thapa P , Dhakal A
Published: February 2019

Introduction: Gallbladder carcinoma (GBC) is the commonest cancer of the biliary tree and the most frequent cause of death from biliary malignancies. The overall resection rates at presentation range from 10%-30% only. Therefore, a large number of patients are inoperable with overall survival of only 6-8 months. Palliation of the pain, jaundice, pruritus is a big challenge in patients with advanced disease.

Methods: A prospective cross sectional study of patients with GBC during the period of October 2014 to September 2017 at Nepalgunj Medical College and Teaching Hospital, Kohalpur, department of surgery.

Results: There were 216 cases of gastrointestinal malignancies with 54(25%) GBC. There was female (75.92%) preponderance with a male to female ratio of 1:3.15. The mean age was 61.41±12.18. The most common symptom at presentation was pain in a right upper abdomen (87.03%) followed by abdominal lump (41.23%) and surgical jaundice (18.51%). Fundus (70.37%) was the most common site of involvement followed by body (5.55%) and neck (24.05%). Gall stone was associated in 44 (81.48%) patients. Only 7 (12.96%) patients had localized GBC, 25 (46.29%) patients had locally advanced disease and 22 (40.74%) had metastatic disease. Liver was the commonest site of metastatis followed by peritoneum and two patients had left supraclavicular lymph node metastatis. There were two (3.72%) incidental gall bladder cancer after laparoscopic cholecystectomy. 13 (24.07%) patients were operated with intention of radical cholecystectomy but only six (46.15%) patient could undergo radical resection. Staging laparoscopy was done in all patients except for incidental gall bladder cancer. Metastatic disease was identified in 3 (23.07%) on staging laparoscopy. In eight (61.33%) among 13 patients the disease was unresectable. The most common histology was adenocarcinoma and most common stage was stage III and stage IV when both operated and non-operated groups were combined.

Conclusions: GBC was the commonest gastrointestinal tract cancer with a female preponderance. A majority of patients were inoperable at presentation with pain in abdomen being the most common symptom. Surgery although is the main stay of treatment is not possible in many.
Maternal and Fetal Outcome in Eclampsia: A Study From Tertiary Care Hospital
Authors: Haque Husneyara , Thapa Kalpana Kumari
Published: February 2019

Introduction: Eclampsia is an acute and life-threatening complication of pregnancy associated with elevated maternal and fetal morbidity and mortality. This study was done with the aim to evaluate the maternal and fetal outcome in eclampsia patients and to observe various factors affecting its occurrence and outcome.

Methods: A retrospective cross-sectional hospital based study carried out in Nepalgunj Medical College, Nepalgunj from January 2015 to December 2016. Details and data obtained from maternity register were analysed. All patients with eclampsia were included and fetomaternal outcomes measured in terms of complications. Simple descriptive statistical method was applied for analysis. Result: Out of 6056 pregnant women, 46 had eclampsia with the incidence of 7.59 per 1000 deliveries. 58.7% of study population belonged to age group of 21-30 years followed by 36.96% from age less than 20 years. 78.26% cases were unbooked. 73.91% eclamptic patients were primi gravida and 60.87% had gestational age less than 37 weeks. Half of pregnancies with eclampsia underwent ceasarian for delivery and 30.44% required ICU care. One third women developed eclampsia related complications and 2(4.35%) died. Common complications were atonic postpartum heamorrhage (15.21%), psychosis (8.71%) acute renal failure (4.35%). 60.86% newborn were preterm and 56.52% were low birth weight. In 50% newborn, Apgar score at 5 minutes was less than 7. Fetal death was 10.85%.

Conclusion: Eclampsia continues to be one of the prime etiological factors for maternal and fetal morbidity and mortality. Therefore early recognition and proper management are vital to tackle this challenge.
Assessment of Patch Test in Predicting Ossicular Status in Chronic Otitis Media
Authors: Bhandari Shama , Parajuli S. , Saxena R. K.
Published: February 2019

Objectives: To assess the reliability of paper-patch test in predicting the intra-operative ossicular status of patients with tympanic th membrane perforation from small to medium size.

Methods: This is a hospital based prospective study conducted from 30 April, st 2016 to 1 May, 2017 in the Department of Otorhinolaryngology of Nepalgunj Medical College Teaching Hospital. The patients of chronic otitis media with small to medium sized central perforation were subjected to complete history taking and thorough examination. Audiological evaluation was done before patching, then after patching the perforation with cigarette paper. The result was recorded to predict the ossicular status.

Result: The most common age group affected by the disease was 20-30 years with 21(42%) patients. Most of them were females 28(56%). Left ear was affected more 19(38%) than right ear 16(32%) and bilateral 15(30%). All the patients had conductive type of hearing loss out of which moderate degree of hearing loss was present in 36(72%) and mild degree of hearing was present in 14(28%). Following patch test, the hearing improved and in 7(14%) of patients the hearing came to normalcy. Majority of patients had mild degree of hearing loss, i.e., 36(72%) and moderate degree of hearing loss was seen in 7(14%). It was found that in those patients in whom there was less improvement in hearing that i.e. less than 10 dB, the mobility of the ossicles was restricted intra-operatively.

Conclusion: The type of hearing loss was conductive hearing loss out of which most common was moderate degree of hearing loss in 36(72%) followed by mild degree of hearing present in 14(28%). Following patch test, it was found that in those patients in whom there was less improvement in hearing i.e., less than 10 dB,ossicular discontinuity was noted intra-operatively and thus ossicular reconstruction by tympanoplasty procedures had to be undertaken.
Prevalence of Candida Albicans in Genital Tract of Pregnant Women Attending Antenatal Clinic of Nepalgunj Medical College Hospital
Authors: Rai Maya , Poudel T. P. , Gurung K. , Neupane G. P. , B.C. Durga
Published: February 2019

Introduction: Pregnancy is one of the important risk factor for occurrence of vaginal candidiasis which may lead to pregnancy complications like abortions, premature birth, low birth weight and other morbidities. It is essential to know pattern of distribution of the species of Candida that are pathogenic.

Aim and Objective: To identify prevalence of Candida albicans in the genital tract of pregnant women.

Materials and Methods: Total of 100 vaginal swabs were collected from 100 pregnant women attending at antenatal clinic of Gynaecology and Obstetrics department for a period of six months from March 2017 to August 2017. Gram's staining and inoculation onto Sabouraud dextrose agar (SDA) medium were done for general identification of yeast and to isolate the positive cases. The specifications of Candida species was done on the basis of sugar fermentation, carbohydrate assimilation, production of germ tube in fresh human serum, formation of chlamydospore on Cornmeal agar and colour of colony on CHRO Magar.

Results: Out of 100 high vaginal swabs 40(40%) samples were positive for Candida. Of these positive samples, Candida albicans was isolated in 52.5% of pregnant women. Candida albicans was most commonly isolated in the age group of 25-29(38.09%), in third trimester of pregnancy and in the multigravidae.

Conclusions: High prevalence of Candida albicans species among pregnant women were documented in this study. Our results indicate that gravidity, as the risk factor for occurrence of infection, has the significant role in the occurrence of vaginal candidiasis.
Autonomic Function test in person with Obesity aAmong Mid-Western Population of Nepal
Authors: Neupane Pant Bhawana , Goit Rajesh Kumar , Panta Manoj , Neupane Ashish , Bhargava Pushpa
Published: February 2019

Objective: Autonomic dysfunction qualifies a major public health problems owing to their high prevalence and incidence globally. Among many predisposing factor of autonomic neuropathy such as age, gender, genetic, diabetes etc, obesity also has significant . impact Although a lot of progress has been achieved in past decade on accessibility and awareness about health, the obesity remains impending and burgeoning health concern in Nepal. With this trend, we can foresee that the Body Mass Index (BMI) one of the commonly used indirect measure of obesity, might potentially turn out to be one of the leading factor of autonomic dysfunction.

Methods: 100 healthy subjects were screened and divided into 2 groups- Group I (BMI>30) and Group II (BMI< 30). Height & weight were measured & BMI was calculated. Resting heart rate (RHR) was recorded with Lead II of ECG. Blood pressure (BP) and Heart Rate (HR) were recorded in supine position and on immediate standing. Cold pressure test (CPT): Resting BP was recorded in sitting position. Then the subjects were asked to immerse the hand in cold water, and the BP was measured from other hand. Data was analyzed using SPSS 16 (Statistical Package for Social Science).

Result: Our result showed that RHR of Group I (79.32±4.22) was higher than that of Group II (74.38±7.26). However, on student –T test, BP and HR response to immediate standing (P=0.34 &P=0.23 respectively) were non-significant between group I and group II person. When the correlation was done for the change in BP in response to CPT in between obese and non-obese person it was found to be significant (P=0.04).

Conclusion: Our data suggests that the BMI can be a predictor of autonomic dysfunction.
Clinical Spectrum and Outcome of Snake Bite Cases in Western Nepal
Authors: Bajracharya Sujeeta , Joshi R. , Shrestha D. B.
Published: February 2019

Background: Prevalence of snake bite is high in Nepal. However, there is no exact figure of mortality and morbidity associated with snake-bite probably due to poor reporting.

Objectives: To study demographic characters of snake bite victims, to see clinical symptoms of the bite, outcome of snake bite, use of ASVS and its associated anaphylactic reaction.

Methods: A retrospective observational hospital based study carried out through July- October 2017 of the patients with the history of snake bite and visited to secondary level hospital (Army Hospital) at Nepalganj.

Result: Among 169 cases of snake bite between 6 months to 83 years, 49.70% was between 20-54 years. Highest number of cases (n=110) came from local areas of Nepalganj like Manikapur, Alanagar, Fulltegra, Daduwa, Gayatrinagar and Samsherganj. Male victims were 61.53% (n=104) and 38.46% (n=65) were female. Commonest site of bite was in lower limb (n=116), followed by upper limb (n=47), head, neck and trunk. Maximum number of cases came to the center within 90 minutes of bite while only n= 28 came after 180 minutes of bite. Use of tourniquet as first aid was seen in 68% (n=115) and 3 cases came in with incised wound and sucked wound. A total of 97.04% (n=164) were dry bite with 26.62% (n=45) only had suspicion of snake bite (snake not seen due to invisibility or bite other than snake). A majority of cases presented without any other symptoms (with only history of bite), 45.56% had bite marks, 17.16% had pain and swelling at the bite site, 6.7% had bleeding from the site and burning and tingling sensation. A total of 2.95% (n=5) of snake bite cases needed ASVS and one developed ASVS complication.

Conclusion: Snake bite is more common in adult male between 20-54 years and the commonest site is lower limb. Maximum number of cases presented within in 90 minutes of bite using tourniquet on the affected limb as first aid. Only small percentage of snake bite required anti-snake venom treatment and its complication rate is high.
Percutaneous Tibial Length Measurement for Estimation and Correlation of Stature in Nepalese Males
Authors: Poudel Abhishek , Satyal Biswas
Published: February 2019

Introduction: Estimation of stature is an important step in identification of an individual, which often is required in medio-legal practice. It provides a valuable indicator for unknown individual in a population. Through the remains of human skeletal or body parts stature of an individual can be estimated.

Methods and Materials: Percutaneous tibial length (PCTL) is measured in present study to estimate the stature by formulating simple regression equation. The PCTL was measured by the surface anatomical landmarks that is between most prominent part of medial condyle of tibia and tip of medial malleolus.

Result: Positive correlation was found between the length of tibia and estimated height. A linear regression formula was derived for estimation of height from the length of right and left tibia.

 Conclusion: Estimated height and observed height were closely related within the range of error. Differences in length of right and left tibia showed statistically non-significant.
Platelet Count/Spleen Diameter Ratio as a Predictor of Esophageal Varices in Patients with Liver Cirrhosis
Authors: Khadka Dipendra , KC Sudhamshu , Khadka Sandip , Regmi Kiran , KC Pooja
Published: February 2019

Introduction: Upper gastro-intestinal endoscopy still remains the gold standard for screening of patients suspected to have esophageal varices but not without limitations. So, this study was conducted to access the diagnostic validity and correlation between non-invasive parameters like platelet count, spleen diameter and their ratio with esophageal varices (EV) in patients with liver cirrhosis.

Methods: A hospital based descriptive cross-sectional study was carried out in Liver unit of National Academy of Medical Sciences, Bir Hospital, from October 2016 to September 2017. Complete blood count, liver function tests, liver ultrasound and UGI endoscopy were done for all patients included in the study to detect esophageal varices and the platelet count/spleen diameter (PC/SD) ratio was calculated and analyzed to determine whether it can predict the presence of esophageal varices or not.

Results: Total patients of liver cirrhosis studied after exclusion were 191 EV was present in 125 patients (65.4%). The platelet count/spleen diameter ratio using a cutoff value of ≤ 909 to detect EV independent of the grade had 93% sensitivity and 100% specificity and positive and negative predictive values of 100% and 91% respectively.

Conclusions: PC/SD ratio now can be used as a predictor of presence of esophageal varices in liver cirrhosis.
A Study of Neonatal Hyperbilirubinemia in Mid-Western Part of Nepal
Authors: Roma K.M. , Kanodia Piush , Pyakurel Manita , Gupta Veena
Published: February 2019

Introduction: Neonatal hyperbilirubinemia is a common cause of hospital admissions. Serum Bilirubin depends on birth weight and gestational age. Common causes of neonatal jaundice are physiological jaundice, breast feeding/milk jaundice, prematurity and pathological causes. Surmount total serum bilirubin over critical level, crosses the blood brain barrier leading to kernicterus. Prompt identification and proper management is of great importance otherwise there is a risk of bilirubin encephalopathy.

Objectives: To find out the prevalence and causes of neonatal jaundice in our setting and treatment modalities undertaken.

Materials and methods: A hospital based descriptive study was done among total newborns including both inborn and out born admitted in NICU, NGMC over the period of one year. A total 288 newborns with jaundice were enrolled in the study .Data were entered in excel and th analyzed in SPSS 18 version. Descriptive data were presented through pie, bar graph, and table with frequency and percentage.

Results: Prevalence of neonatal jaundice was 31%. Causes of neonatal jaundice were physiological and pathological in 56% and 44% cases respectively. Among the pathological causes ABO incompatibility was the most common cause seen in 11.4% cases followed by sepsis seen in 8.7% cases.

Conclusions: Phototherapy is very effective treatment modality to reduce the serum bilirubin in most of the cases neonatal hyperbilirubinemia and if the bilirubin crosses the cut off limit according to Bhutani's chart then we have to consider exchange transfusion. Appropriate management in time leads to satisfactory outcome.
Gender Based Violence Among Pregnant Women: A Hospital Based Study
Authors: Chaudhary Shrawan Kumar , Chaudhary Pushpa
Published: February 2019

Introduction: Gender Based Violence (GBV) is prevalent and exists to some extent in virtually all societies throughout the world. Evidence shows consistent negative effect of violence on health of women particularly. This hidden disease is perceived as a social issue and not a health issue and is often overlooked by health care providers.

Methodology: This study was a Cross Sectional descriptive study conducted at national Academy of Medical Science affiliated Paropaker Women's and Maternity Hospital, Kathmandu enrolling 950 pregnant women from the emergency admission room who were interviewed using structured questionnaire from mid march to the end August in the year 2007.

Result and discussion: Among 950 women suffered from gender based violence (33.36%). One hundred and fifty women faced psychological violence (47.31%), seventy two clients faced physical violence (22.71%), and forty two women faced sexual violence (13.24%) and rest of them faced all types of violence. Violence was reported during the current pregnancy (41.32%). Husbands were perpetrator of violence for almost on third of women (34.06%), followed by mother in low (18.29%). Joint violence by family members was quit common (28.1%). Perpetrator outside family was responsible for approximately 20% of cases. Domestic violence was extremely common accounting for more than four fifty of cases (81.38%). Among sexual violence, (45.45%) women were victim of marital rape. Alcoholism as one of the common reason for wife battering, observed in this study in Maternity Hospital which is still prevalent in Nepal. Often, verbal abuse is an excuse for imposing discipline in the family. Women's economic and emotional dependence on husband could be responsible for the vulnerable status in family. Health seeking behavior following violence was found to be extremely low in this study suggestion gender based violence as a privet matter.
Anthropometric Study of External Ear: A Comparative Study in Medical Students of Nepalgunj Medical College in Nepal
Authors: Gupta Anil Kumar , Ambekar M. N.
Published: February 2019

Background: Anthropometry is the measurements of the body parts in the living or dead persons with the help of instruments. Many studies in the past are done for various purposes such as: adding data to statistical data bank, to estimate stature, age differences. The study on the measurement of ear is also helpful to forensic expert for individual identity, to cosmetic surgeon to correct shape and size or reconstruct the auricle, to electronic companies to prepare hearing aids and lastly to prosthetic makers who required average measurement of the auricle to prepare prosthesis.

Aim and objective of the study: The aim of the study was to determine the normal anthropometric measurement of external ear in male and female Nepalese and Indian medical students.

Material and methods: This study was conducted on 200 medical students (Nepalese students 134 and Indian student 66). The study was conducted during October 2017 to November 2017. All the important parameters were obtained using vernier caliper.

Results: In Indian male auricular height and lobular height was found more than Nepalese. Auricular width was equal in both. Lobular width was more in left auricle and equal in right auricle in female. All parameters are more in Indian than Nepalese.

Conclusion: These measurements are helpful for forensic expert in individual identity, for cosmetic surgeries, correction of anomalies of auricle, for designing hearing aids and prepare prosthesis.
Ocular Biometry and Corneal Astigmatism in Patients Undergoing Cataract Surgery in Bheri Zone of Nepal
Authors: Thapa Bikram Bahadur , Dhakal Y. , Verma J. K. , Manandhar P.
Published: February 2019

Introduction: Accurate measurement of ocular axial length, keratometry and anterior chamber depth before cataract surgery is crucial for calculating the power of intraocular lens (IOL) to be implanted. Corneal astigmatism is one of the major thefts to have best postoperative unaided visual acuity. Thus, knowing it preoperatively and taking appropriate intervention during surgery provides best postoperative visual outcome. But there are no studies on corneal astigmatism and biometric parameters in the population of Bheri Zone.

MATERIAL AND METHOD: The medical records of the patients who had  ndergone cataract surgery between January 2017 and November 2017 at Nepalgunj medical college were retrospectively reviewed and analyzed. Patient's demographic parameter, keratometric value, anterior chamber depth, lens thickness and axial length data were collected and analyzed.

RESULTS: This study evaluated the data in 65 eyes of 65 patients who had undergone cataract surgery. The mean age of patients was 59.3 ± 15.71 years. The mean corneal astigmatism was 1.37 D ±1.4D (range 0.00-6.75D). Corneal astigmatism was higher than 1.00 D in 32.3% of cases. The mean average keratometry was 44.54±1.83D. The magnitude of corneal astigmatism was positively correlated with age (p<0. 001) and there was a tendency for corneal astigmatism to increase with age above 50 years. Against-the-rule regular astigmatism was the most common type (46.2%) of astigmatism observed in this study.

CONCLUSION: The present report showed the pattern of corneal astigmatism before cataract surgery in the patients at Nepalgunj Medical College Teaching Hospital. One third of cataract patients had corneal astigmatism of more than 1.0D. This finding provide the important normative reference and help ophthalmologists to plan and manage the cost-effective correction of preexisting corneal astigmatism in cataract patients to achieve the best visual outcome.
Challenges of shaft excavation in Nepal Himalaya: case study from hydropower projects
Authors: Sunuwar Subas Chandra
Published: February 2019

The excavation of the long blind shaft is one of the most difficult and risky in Nepal Himalaya for hydropower development. Excavation of the shaft greater than 200 m length is a challenge due to vertical or inclined orientation, limited space, available technology and changing geological conditions. Amongst Alimak raise climber, shaft sinking and raise boring excavation methods, Alimak raise climber is most commonly used in Nepal. Selection of excavation method depends on geological conditions, size, length of shaft, access and of course the cost. Pressure shaft of Jhimruk, Khimti I, Chilime, Kaligandagi, Kulekhani, Khani Khola, Upper Tamakoshi and other hydroelectric projects were excavated with the help of conventional Alimak raise climber method. Severe overbreak problems were faced in Khimti I hydropower project during construction of upper inclined pressure shaft whereas recently 214 m vertical pressure shaft of Upper Tamakoshi and 280 m vertical pressure shaft of Khani Khola hydroelectric projects in Dolakha have been constructed successfully. Raise boring method was tried in Upper Tamakoshi Project but could not succeed due to deviation of pilot hole and hence shaft sinking and Alimak raise climber were used.
Delineation of groundwater potential zones in rocky aquifers in the mountainous area of Central Nepal
Authors: Pathak Dinesh , Shrestha Surendra Raj
Published: February 2019

Groundwater is the lifeline for the people residing in the mountainous regions of Nepal as they are dependent in this natural resource for drinking and other domestic purposes. The springs and seepages are reported to be drying in many places in Nepalese mountains in the recent time. Such problem is expected to be much more severe in view of climate change condition in the future. In this regard, it is important to establish a methodology to explore groundwater in the mountainous terrain for better planning. In order to delineate groundwater potential zones of rocky aquifers in the mountainous terrain, study has been carried out in Melamchi watershed, lying in the Sindhupalchowk district, Nepal. Various thematic layers have been prepared in GIS and the satellite imageries have been used to extract relevant information. Ranks and weights have been assigned to each thematic layer and its classes, respectively. The rasterized layers have been combined and classifi ed and the resulting map is crossed with the existing springs. It is found that the moderate and high potential classes of the groundwater potential map are represented by the existing springs. This method is expected to be useful at the preliminary watershed level study of groundwater potential in the mountainous terrain of central Nepal.
Rock mass property evaluation based on the borehole wall images taken by using an ultrasonic scanner (USS)
Authors: Ootsuka Yasunori , Ishikawa Takanori , Tajima Katsuhiro , Wada Testu , Aydan Omer , Tokashiki Naohiko , Sato Tshinori , Aoyagi Kazuhei
Published: February 2019

Discontinuities, such as faults and fractures exist even in Neogene soft sedimentary rocks. These discontinuities play an important role for determination of physical, mechanical and hydraulic properties of rock mass. For geological disposal of high-level radioactive waste, these data should be obtained for designs of the layout of repository, engineered barrier system and safety assessment. Rock mass properties are important information for quantitative rock mass classification as well as for design and construction of underground facilities and assessment of safe waste disposal. Ultrasonic wave reflection intensity of the wall of the borehole drilled from bottom of East Access Shaft in Horonobe Underground Research Laboratory Center, Hokkaido, Japan, was obtained by using the ultrasonic scanner (USS). In this paper, we compared results of USS observation with core logging data including the core observation, the optical digital scanner (ODS) observation, and result of Needle Penetration Index (NPI) tests. These results indicated that ultrasonic wave reflection intensity had a good correlation with other observation results, and USS observation and NPI test are useful techniques for the determination of the detailed rock mass classification.
Sediment dynamics of mountain streams as a function of variation in sediment deposition
Authors: Nakanishi Ryunosuke , Okajima Yuki , Baba Akira , Mitani Yasuhiro , Ikemi Hiro
Published: February 2019

In Japan, the management of sediment in dam reservoirs has become challenging owing to heavy rain. Unexpected increase of sediment volume in dam reservoirs can increase flood risk owing to a rise in the level of the riverbed. It is therefore necessary to conduct sediment management to clarify the area of sediment production to control the amount of sediment transported and the timing of its movement. Sediment discharge from tributaries is often calculated based on catchment area and the deposited sediment volume already present in the dam reservoir. However, our preliminary surveys have implied that it is also necessary to consider regional geology in the evaluation of sediment transport. Moreover, variations in sediment deposition should be evaluated for each site where the geology changes.

In this study, we observe in detail changes in the riverbed in two tributaries with different regional geologies. Changes in the shape of the riverbed were analyzed from unmanned aerial vehicle observation data, following which the effects of erosion and sedimentation on the riverbed were quantitatively evaluated. Finally, sediment discharge was calculated by a one-dimensional numerical model of sediment transport. These results indicate that the tributary that is mostly composed of mudstone produced considerably more sediment than the tributary composed mainly of sandstone. This suggests that an understanding of regional geology is necessary in the evaluation of sediment dynamics and should be considered in addition to the catchment area.
Study on gross streambank sediment erosion from the Godavari Khola, southeast Kathmandu Valley, Central Nepal
Authors: Maskey Ujwal Kumar , Tamrakar Naresh Kazi
Published: February 2019

The fifth order Godavari Khola is flowing from the South to the North direction and is one of the major tributaries from the southern part of the Kathmandu Valley. As the urbanization is growing in the Kathmandu Valley the banks of the streams are being targeted for the housing and roads, therefore it is important to know the characteristic of the river behavior, nature of erosion and sediment production along its banks. This study accesses the stream bank erosion characteristics and sediment production by erosion along the Godavari Khola. It was conducted by surveying and accessing hydraulic parameters, Bank Erosion and Lateral Instability status, streambank recession rates and gross sediment erosion from the bank.

The Godavari Khola has high bank erodibility and lateral instability as the hazard level of Bank Erosion and Lateral Instability (BELI) and width/depth ratio are quite high. Since the slope and the bankfull depth exceed the critical slope and critical depth values, respectively, the Godavari Khola is competent enough to mobilize its sediments. The apparent recession rate of the banks of the Godavari Khola is 0.66 m per year yielding 85 m3 volume of the displaced material which weighs 141 tonnes. The estimated bank erosion rate is in between 0.02 to 0.235 m/y and the gross erosion is estimated to be 320 tonnes per year. Similar to the other river of the Kathmandu Valley, the Godavari Khola is very disturbed by the anthropogenic activities. Riparian vegetation clearing and bad agricultural practice is one of the major causes for the high bank erosion and instability of the Godavari Khola.