bluuebunny/crossref_metadata_2025 huggingface dataset:
Estudo dos processos hidrológicos causadores de desastres que ocorrem nos municípios de Estrela e Lajeado, Vale do Taquari/RS
Authors: Borges Caroline Maria Cadore , Robaina Luís Eduardo de Souza , Sccoti Anderson Augusto Volpato
Published: July 2024

O aumento dos desastres naturais vem sendo intensificados pelas mudanças climáticas. Isso pode levar a uma aceleração do ciclo hidrológico, aumentando a intensidade e a frequência de eventos extremos. O presente artigo tem como temática os processos hidrológicos causadores de desastres no baixo curso da bacia hidrográfica do rio Taquari-Antas, nos municípios de Lajeado e Estrela, localizados no Vale do Taquari, RS. Este estudo apresenta o inventário de registro dos eventos de inundação nos municípios de Estrela e Lajeado, em um intervalo temporal de 20 anos com objetivo de identificar e espacializar os desastres naturais associados a processos hidrológicos. No período entre 2002 e 2022 ocorreram 43 eventos de origem hidrológica que ocasionaram danos. Para abordar a lacuna de dados esta pesquisa apresenta um levantamento de informações que resultou no inventário e juntamente com o auxílio da defesa civil foi possível determinar os níveis de suscetibilidade nos bairros, como forma de analisar a espacialização através da suscetibilidade a inundações. A partir das informações cartográficas e dos dados coletados foi possível categorizar a suscetibilidade por bairro em cada um dos municípios. Os resultados apresentam uma análise temporal e espacial das ocorrências de eventos originados por processos hidrológicos nos municípios, o que poderá ser empregado nas ações de gerenciamento de risco.
Inovasi Rumah Dan Lingkungan Sehat Guna Menghindari Stunting
Authors: Lestari Kiki , Shindi Indira Sri , Prapsetyo Agung , Silitonga Franky
Published: July 2024

Hasil survey status gizi indonesia (SSGI) tahun 2022, angka stunting di Kabupaten Langkat sebesar 18,32 persen, dimana pada tahun sebelumnya 31,61 persen pada tahun 2018. Keberhasilan Langkat menekan angka stunting tersebut, dikarenakan pencegahannya dilaksanakan secara terintegrasi dan bekerja sama serta melibatkan pihak terkait seperti Bappeda, Dinkes, Dinsos, PMD, Tokoh Mayarakat, Stake Holder dan Dunia Pendidikan. Semua instansi dan pihak terkait berkontribusi sesuai dengan tugas pokoknya. Pencegahan stunting dapat dilaksanakan dengan makanan yang sehat, vitamin dan kecukupan asupan gizi yang akan mudah dilaksanakan pada masyarakat yang berpendidikan dan berpenghasilan cukup. Bila pada masyarakat dengan ekonomi yang di bawah standar, maka pencegahan stunting diawali dari rumah dan keluarga itu sendiri. Penelitian diangkat sebagai bentuk Pengabdian kepada Masyarakat guna mensosialisasikan dan mengetahui pendapat masyarakat terhadap Inovasi Rumah Dan Lingkungan Yang Sehat Guna Menghindari Stunting Pada Masyarakat Desa Tanjung Mulia Kecamatan Hinai Kabupaten Langkat.
            Metode penelitian menggunakan metode kualitatif dengan pendekatan deskriptif analisis dan sosialisasi serta aplikatif inovasi rumah sehat dan pemanfaatan lingkungan sekitarnya guna meningkatkan derajat ekonomi keluarga sehingga tercukupinya kebutuhan akan gizi keluarga, dengan mereduksi hasil wawancara serta hasil observasi lapangan. Hasil penelitian menunjukan bahwa keberadaan rumah sehat dan lingkungan yang sehat serta pemanfaatan pekarangan sekitar rumah meningkatkan motivasi masyarakat untuk hidup sehat dan termotifikasi untuk berkebun guna mencukupi kebutuhan sayur dan buah yang akhirnya dapat meningkatkan kesehatan dan ekonomi keluarga secara terbatas
Pelatihan Pengembangan Usaha Barista Dan Mixologi Untuk Siswa-Siswi Di SMK Al-Azhar Batam
Authors: Dailami  , Moh. Thandzir  , Haufi Sukmamedian  , Syailendra Reza I. R  , Natal Olotua Sipayung
Published: July 2024

Barista training is an important investment in the development of the coffee industry to improve the quality of their products and services. A good barista, apart from being able to mix delicious coffee, must be able to make customers feel satisfied with their service. That way, customers will be more loyal to your coffee shop. The more satisfied they are, the more often they will visit your coffee shop. That way, your coffee shop's turnover and income will increase. However, in general mixology is considered a comprehensive and in-depth study of the art and skill of mixing drinks. More specifically, Bar School states that mixologist refers to a profession involved in making cocktails, creating new drinks and techniques based on extensive knowledge of all existing ingredients as well as a deep understanding of the history of drinks. Meanwhile, the term bartender refers to individuals who are able to translate and realize these techniques and concepts practically. Usually a bartender plays a direct role at the bar, serving and interacting with customers, and if necessary, interpreting customer needs regarding the desired drink.
Sosialisasi Edukasi Masyarakat Dalam Penerapan Hygiene Sanitasi Dan Keamanan Makanan Produk Catering Di PT. Mitra Jaya Harmoni
Authors: Supardi  , Wibowo Andri , Lubis Arina Luthfini , Fatimah Zahara
Published: July 2024

Pengabdian Sosialisasi Edukasi Masyarakat Dalam Penerapan Hygiene Sanitasi dan Keamanan Makanan Produk Catering di PT Mitra Jaya Harmoni sangat dibutuhkan dan bermanfaat bagi karyawan MJH dan pengabdi, maka harus memanfaatkan pelatihan ini. Pengabdian ini dilaksanakan mendatangi tempat yang dituju dimana metode analisa dan menyelesaikan masalahnya dengan memberikan pengarahan theorikal practek yang bertempat di PT. Mitra Jaya Harmoni dengan alamat Kompleks Ruko Greenland Blok V, No. 02 Batam Center 29431 pada Jum’at 19 April 2024. Dalam pengabdian ini para supervisor setempat sebagai pendamping pekerjanya yang mandapat arahan dari team pengabdi. Para pengabdi dari Politeknik Pariwisata Batam  yang unggul, terkemuka, berkualitas yang menjadi pusat pendidikan dan pengembangan pariwisata teruma bidang perhotelan sebagai pengarah tidak perlu diragukan lagi dimana para pengabdi berlokasi di jalan Gajah Mada the Vitka City Complek, Tiban Batam Propinsi Kepulauan Riau, dimana memiliki 4 jurusan yaitu Manajemen Devisi Kamar, Manajemen Devisi Tata Hidang, Manajemen Devisi Kulinar dan Manajemen Perencanaan Pariwisata.
Scientific computing needs deterministic programming paradigms
Authors: Hinsen Konrad
Published: July 2024

Programmers, scientific and otherwise, spend a lot of time discussing which programming languages, libraries, and development tools to use. In such discussions, the notion of a programming paradigm is rarely mentioned, and yet it is a very fundamental one. It becomes particularly important for parallel and concurrent programming, where the most popular languages and libraries do not necessarily provide the best programming paradigm.
Executable Papers
Authors: Hinsen Konrad
Published: July 2024

The last two days I participated in the "Executable Papers workshop" at this year's ICCS conference. It was not just another workshop among the many ICCS workshops. The participants had all submitted a proposal to the "Executable Paper Grand Challenge" run by Elsevier, one of the biggest scientific publishers. On the first day, the nine finalists presented their work, and on the second day, the remaining accepted proposals were presented.
EuroSciPy 2011
Authors: Hinsen Konrad
Published: July 2024

Another EuroSciPy conference is over, and like last year it was very interesting. Here is my personal list of highlights and comments. The two keynote talks were particularly inspiring. On Saturday, Marian Petre reported on her studies of how people in general and scientists in particular develop software.
A critical view of altmetrics
Authors: Hinsen Konrad
Published: July 2024

Altmetrics is one of the hotly debated topics in the Open Science movement today. In summary, the idea is that traditional bibliometric measures (citation counts, impact factors, h factors, ...) are too limited because they miss all the scientific activity that happens outside of the traditional journals.
How to prepare for an avian influenza H5N1 pandemic outbreak: Lessons learned from the influenza H1N1 pandemic of 1918
Authors: Sudhir Bhatia
Published: July 2024

In this paper, we highlight the significant challenges encountered during the influenza H1N1 pandemic of 1918. These lessons are being utilized to prepare for potential avian influenza H5N1 pandemic outbreaks, as this virus will impact both humans and food-serving animals. Preparation for this threat is crucial because H5N1 infections are already affecting the United States and many other countries
Factors influencing instructional practices of grade-12 mathematics teachers in Tigray: Lessons from content analysis and socio-economic perspectives of teachers
Authors: Weldeslassie Abreha Tesfay , Haile Tesfay
Published: July 2024

Content analysis is a research tool used to determine the presence of certain words, themes, or concepts within, for example, textbooks. Mathematics textbooks have a significant impact on students’ learning due to their role during the instructional processes. Both quantitative and qualitative data from primary and secondary sources were employed using content analysis of grade-12 mathematics textbooks and responses from 23 teachers from schools in three randomly selected zones out of seven. The objective is to identify strengths and/or weaknesses of the textbook and challenges affecting teachers’ instructional practices, thereby recommending corrective measures to be taken by stakeholders and policymakers. The nine units/sub-topics of the textbook have been analyzed in terms of coverage, vertical-horizontal relationships, integration, continuity, sequence, and the application of higher-level cognitive objectives. Results from responses to closed-and open-ended questions revealed that major problems with the instructional practices include low interest of students (Mean = 4.22, SD = 1.06) resulting in a high rate of migration, bulky content (Mean = 4.0, SD = 1.14), lack of support from parents (Mean = 3.78, SD = 0.98), shortage of time/period allotment (Mean = 3.65, SD = 1.05), and insufficient training (Mean = 3.35, SD = 1.05). The identified themes/patterns are narrated, sequenced, and interpreted using different perspectives. Findings indicated that there are no conceptual problems throughout, but there are weaknesses in the textbook, such as the problem of horizontal articulation with other subjects like physics. There is a need to address the imbalance on the cognitive objectives, and teachers focus on lecturing to cover the voluminous content. This requires due attention through the participatory approach model (PAM), including awareness creation to reduce migration and providing continuous short-term trainings for teachers as per set national and/or international standards at all levels to improve the quality of education.
ANTI-INFLAMMATORY AND ANTIMICROBIAL ACTIVITIES OF THE LEAVES OF ACALYPHA WILKESIANA MUELL. ARG. (EUPHORBIACEAE) FORMULATED AS HERBAL CREAM
Authors: ABERE TAVS ATAVWODA , OFFOR AMARACHI CHUKWUMA , ABERE ONOHWEKAROMA , ENIAYEKAN FAVOUR IREOLUWA , ISHIMA WILSON OBADU
Published: July 2024

The use of some traditional creams in Nigeria is associated with negative outcomes. In order to tackle this problem, we conducted a study on the antibacterial and anti-inflammatory characteristics of Acalypha wilkesiana leaves, which were utilized in the creation of a herbal cream. Standard methods were employed to conduct analytical procedures for the analysis of the phytochemical and chromatographic content of A. wilkesiana leaves. The anti-inflammatory efficacy of the unrefined ethanol extract was assessed using the egg albumin technique, throughout a dosage range of 15.6 to 500 mg/ml. The effectiveness of the herbal cream and the raw ethanol extract of A. wilkesiana in killing specific bacteria were evaluated. A comprehensive evaluation was carried out to determine the physicochemical characteristics of the herbal cream formulation using appropriate methodologies. The phytochemical examination of A. wilkesiana which gave a yield of 12.6 % indicated the existence of alkaloids, tannins, and saponins. The anti-inflammatory properties of the crude extract derived from A. wilkesiana had a comparable effect to that of aspirin, a commonly prescribed medicine at doses of 125, 250 and 500 mg/kg. The herbal cream (25.5 ± 0.22) and crude extract (19.5 ± 0.01) had the greatest antibacterial effectiveness against Candida albicans at 200 mg/ml. The physicochemical examination of the cream that was created: pH (5.6 ± 0.64); consistency (5 mm); viscosity (22 x 106 cps); spreadability (36 g.cm/sec); Extrudability (510 gm) showed similarities to the commercially available Gentamycin cream. The herbal cream containing A. wilkesiana has demonstrated substantial promise and could function as a practical alternative to traditional creams for treating skin infections.
DIFFERENCES IN PARENTS' ATTITUDES TOWARDS THE CAUSES OF NEURODEVELOPMENTAL DISORDERS
Authors: Ćirić Sanela
Published: July 2024

Neurodevelopmental disorders are a heterogeneous group of clinical conditions characterized by deficits in one or more aspects of development, with the most prevalent subgroups being autism spectrum disorders and intellectual developmental disorders. Longitudinal studies have shown a significant increase in the number of children with autism spectrum disorders over the past few decades compared to the stable prevalence of intellectual developmental disorders. The aim of this study was to examine and compare the attitudes of parents of children with autism spectrum disorders and parents of children with intellectual developmental disorders regarding genetics, vaccination, and stress as causes of these disorders. The sample consisted of 80 parents, with 40 parents of children with intellectual developmental disorders and 40 parents of children with autism spectrum disorders. The study used a survey as the instrument, employing content analysis, interviewing, and scaling techniques. Data were statistically analyzed using quantitative methods in the JASP program. The results showed that parents' attitudes towards genetics as a cause did not statistically differ, with the most of parents not considering genetics as a cause of neurodevelopmental disorders (40%). There was a notable difference between these two subgroups of neurodevelopmental disorders in the number of children who had undergone genetic testing. A third of the participants expressed a negative attitude towards genetic testing in the future. A statistically significant difference was confirmed in attitudes towards vaccination as a cause of disorders. While most parents did not believe that stress caused their child's disorder, a higher number of parents with children who have intellectual developmental disorders cited stress as a contributing factor. Well-informed parents about the origins of neurodevelopmental disorders influence the lives of entire families, reducing the risk of unnecessary exposure of children to various interventions and treatments.
SUSTAINABLE FINANCING OF THE BUSINESS ENVIRONMENT IN THE REPUBLIC OF MOLDOVA: CHALLENGES AND SOLUTIONS
Authors: Iordachi Victoria
Published: July 2024

In a rapidly changing world, sustainable financing has become a necessity for economic and social development. With limited natural resources and growing environmental impact, the imperative for sustainable economic growth is globally recognized. Despite increased interest and initiatives in sustainability, significant challenges persist, including climate change, energy security, and natural resource depletion. This paper explores the landscape of sustainable financing in the Republic of Moldova, analyzing current practices, challenges, and opportunities. Drawing on fact-finding, comparative analysis, and correlation studies, the research methodology assesses the state of sustainable financing in Moldova. The literature review encompasses legislative acts, monographs, articles, and reports from international financial institutions. Findings reveal limited access to international funds through local banking institutions, hindering the development of green lending activities. To address this, increased cooperation with international investment funds is recommended, alongside the promotion of green lending products by local banks. Furthermore, there is a call for mandatory environmental management reporting by commercial banks to enhance transparency and accountability. Given the significant role of Small and Medium-sized Enterprises (SMEs) in Moldova's economy, the imperative arises to make their operations more environmentally sustainable. This entails reducing their environmental footprint and opening up avenues to international markets. Moreover, transitioning towards renewable energy sources and adopting energy-efficient technologies is underscored as vital for decreasing reliance on fossil fuels and addressing climate change. In essence, cultivating a culture of green financing in Moldova requires collaborative efforts, cooperation, and responsible investment practices. These measures are essential to safeguard environmental sustainability while promoting economic growth.
THE POSSIBILITIES OF APPLYING ARTIFICIAL INTELLIGENCE FOR THE PURPOSE OF DEVELOPING INTERNAL CORPORATE CONTROL
Authors: Caprian Iulia , Zaharia Virginia , Balan Tatiana
Published: July 2024

Internal corporate control is one of the important components of effective corporate governance. Its mechanisms are designed to serve the internal objectives of the company and its internal stakeholders. As a general rule, internal corporate control should contribute to safeguarding the company's assets by preventing errors and inappropriate actions through the appropriate promotion of policies, procedures and technical safeguards. Artificial intelligence has become a natural attribute of the post-industrial age and its application in the area of internal corporate control has become welcome. These include data analytics, predictive analytics, automation of routine tasks, fraud detection, artificial intelligence processing, continuous monitoring and customisable alerts. Harnessing them tends to substantially elevate the corporate governance process. Corporate governance is an attempt to implement systems of risk analysis, verification, evaluation and control that contribute to the effective management of their operation. Therefore, the concept of corporate governance will need to be addressed in conjunction with risk management throughout the organisation and the evolution of the financial management and internal control system. The purpose of the research is to investigate the mechanisms of internal corporate control efficiency in the Republic of Moldova, to substantiate the directions and strategies for organizing internal control of corporate financial resources.
Ética judicial en la resolución de conflictos en Pueblo Libre, Huancavelica, Perú
Authors: Montero-Yaranga Isaac Wilmer , Gavidia-Anticona Juber Amilcar , Flores-Apaza Esteban Eustaquio , Hurtado-Valencia Saúl Manuel , Alcos-Flores Karen Michel
Published: July 2024

En Perú, la resolución de conflictos se basa en tradiciones y mecanismos ancestrales para restaurar la armonía social. El objetivo del estudio es determinar la influencia de la ética de los jueces de paz en la resolución de conflictos en la comunidad campesina de Pueblo Libre - Huancavelica. El enfoque es cuantitativo, tipo descriptivo, explicativo, diseño no experimental, retrospectivo, observacional y transversal. Se seleccionó la muestra mediante un muestreo no probabilístico por conveniencia, conformado por 30 ciudadanos. Los resultados indicaron que influye en la resolución de conflictos la ética de los jueces de paz, sus principios éticos, su capacidad de discernimiento, el debido proceso del juzgado de paz, su ideal ético en el comportamiento ético y el ordenamiento de los valores, entre otros factores. Se concluye con la necesidad de que se tomen medidas para la construcción de un sistema de justicia de paz más ético, confiable, transparente y equitativo.
Percepción docente sobre el pensamiento crítico de los alumnos de educación primaria
Authors: Rojas Ramos Johanann Andrea , Holguin-Alvarez Jhon
Published: July 2024

El artículo describe la percepción de los docentes sobre el pensamiento crítico en los alumnos del Colegio Bruning de La Molina, Lima, Perú. La problemática radica en la importancia de fomentar la capacidad crítica desde la enseñanza primaria. Las variables de estudio incluyen la opinión de los docentes, razonamiento, resolución de problemas y la toma de decisiones. El objetivo es describir la percepción docente sobre el pensamiento crítico de los alumnos. Se utiliza una metodología cualitativa exploratoria y diseño fenomenológico con once maestros que conforman la muestra. Se aplica una guía de entrevista etnográfica para obtener una comprensión más profunda y detallada del desempeño y las competencias de los docentes relacionados con la percepción. Los resultados demuestran que los profesores consideran fundamental fomentar el pensamiento crítico para el enfrentamiento a situaciones cotidianas. En conclusión, se destaca la importancia del pensamiento crítico en la formación integral de los alumnos.
CATÁLOGO DE OBJETOS DIGITAIS DE APRENDIZAGEM: CONTRIBUIÇÕES PARA AS PRÁTICAS DOCENTES NO ENSINO DE CIÊNCIAS
Authors: Batistella Jefferson , Leão Marcelo Franco
Published: July 2024

Os Objetos Digitais de Aprendizagem (ODA) têm contribuído com professores nas práticas pedagógicas desenvolvidas em sala de aula, por meio de uma linguagem envolvente e atual. A utilização desses recursos foi recorrente no período da pandemia da Covid-19. Desse modo, este estudo objetivou catalogar os ODA disponíveis para serem utilizados no Ensino de Ciências, mediante pesquisa descritiva e exploratória, de abordagem qualitativa, do tipo estado do conhecimento. Para tanto, o levantamento da produção científica recorreu aos repositórios Periódicos CAPES, SciELO e PubMed com filtro dos anos de 2017 a 2021 e catalogou 22 ODA, contendo a descrição de aspectos técnicos e aspectos pedagógicos. Em síntese, evidenciou-se que a utilização de ODA por professores de Ciências nas práticas pedagógicas contribuem para o processo educativo na construção de aulas dinâmicas e atrativas.
Analisis Penggunaan Media Pop-Up Book dalam Menumbuhkan Motivasi Belajar Siswa Kelas II SDN Karanganyar Gunung 02 Semarang
Authors: Pujilestari Desi , Kartinah Kartinah , Kusniati Siti , Miyono Noor
Published: July 2024

Salah satu faktor yang mempengaruhi rendahnya pemahaman materi pada siswa adalah motivasi belajar. Penelitian ini bertujuan untuk menggambarkan penggunaan media buku pop-up dalam meningkatkan motivasi belajar siswa. Metode yang digunakan adalah deskriptif kualitatif dengan melibatkan tiga siswa kelas II A yang dipilih melalui teknik purposive sampling. Data diperoleh melalui observasi dan wawancara, dan untuk menjamin keabsahan data digunakan teknik triangulasi. Hasil penelitian menunjukkan bahwa media buku pop-up dapat memberikan dampak positif dalam meningkatkan motivasi belajar siswa. Selama proses pembelajaran, siswa tampak antusias, aktif, dan fokus. Disarankan agar guru lebih inovatif dan kreatif dalam menggunakan media pembelajaran, karena media seperti buku pop-up dapat menarik minat siswa dan meningkatkan motivasi belajar, yang pada akhirnya dapat memaksimalkan hasil pembelajaran.
Meningkatkan Hasil Belajar Siswa melalui Metode Project Based Learning Materi Cuaca, Musim dan Iklim di Sekolah Dasar
Authors: Nurjanah Gina , Rokhman Nissa Mawarda , Rijal Akmal
Published: July 2024

Penelitian ini dilatarbelakangi oleh rendahnya hasil belajar siswa kelas 3 SDN Biru 01 dalam pembelajaran Bahasa Indonesia pada materi cuaca, musim, serta iklim. Siswa kurang aktif dan termotivasi dalam mengikuti pelajaran. Oleh karena itu, dilakukan Penelitian Tindakan Kelas dengan menggunakan metode project based learning. Tujuan penelitian ini adalah untuk mengetahui apakah metode project based learning dapat meningkatkan hasil belajar siswa kelas 3 SDN Biru 01 Kecamatan Majalaya Kabupaten Bandung tahun ajaran 2024/2025 pada pembelajaran IPA terkait materi cuaca, musim, serta iklim. Subjek penelitian ini adalah 35 siswa kelas 3 yang terdiri dari 23 siswi dan 12 siswa. Penelitian Tindakan Kelas dilakukan selama dua siklus dengan membandingkan hasil belajar pada prasiklus, siklus I, dan siklus II. Data penelitian dikumpulkan melalui lembar tes dan lembar observasi, kemudian dianalisis menggunakan teknik analisis kuantitatif dan kualitatif. Analisis kuantitatif mencakup perhitungan rata-rata dan persentase hasil belajar siswa, sedangkan data kualitatif diperoleh melalui observasi selama proses pembelajaran pada setiap siklus dan dianalisis dengan mereduksi data, menyajikan data, dan menarik kesimpulan. Temuan penelitian menunjukkan bahwa hasil belajar pada tahap prasiklus adalah 20% dengan nilai rata-rata 51. Pada siklus I meningkat menjadi 62% dengan nilai rata-rata 70, dan pada siklus II meningkat lagi menjadi 85% dengan nilai rata-rata 77. Penelitian ini menyimpulkan bahwa penggunaan metode project based learning dapat meningkatkan hasil belajar siswa kelas 3 SDN Biru 01 dalam pembelajaran IPA materi cuaca, musim, dan iklim. Disarankan agar metode ini digunakan secara berkesinambungan untuk meningkatkan hasil belajar siswa di sekolah dasar lainnya.
Verbotene Vereinsmedien
Authors: Gusy Christoph
Published: July 2024

In der Auseinandersetzung mit den Gegnern der Verfassung beweist und bewährt sich der demokratische Rechtsstaat. Auch dort, wo der Kampf gegen die freiheitliche demokratische Grundordnung zweifelsfrei festgestellt ist, sind die Voraussetzungen und Grenzen des Grundgesetzes selbst und der Gesetze zum Schutz der Verfassung einzuhalten. Wenig kann den Verfassungsschutz stärker delegitimieren als administrative Maßnahmen, welche rechtswidrig ergehen und später von den Gerichten beanstandet werden.
Clinical and Etiological Profile of Patients with Optic Disc Edema in Tertiary Care Centre of Nepal
Authors: Shah Ritesh K
Published: July 2024

Introduction: sible in most cases using tests like visual acuity, color vision, visual field and suitable radiological imaging. Study in Nepalese population with regard to optic disc edema is scarce. Hence this study aims to act as a guideline for evaluation of such cases and help in further studies in this regard.
Methods: A descriptive, cross-sectional study was conducted in all cases of optic disc edema presenting to neuro-ophthalmology clinic of B.P. Koirala Lions Centre for Ophthalmic Studies from January 2011 to June 2012. A ophthalmologist and neuro-physician. Assessment of visual acuity, color vision, contrast sensitivity and visual field along with radiological tests were done in all possible cases.
Results: Out of all the cases evaluated, 38 cases where causes of optic disc edema could be established were included in the study. The commonly affected age group was 31 to 40 years (26.3%) and most of them were males. The commonest cause observed was optic neuritis (36.8%). Others were papilledema, idiopathic intracranial hypertension, toxic optic neuropathy, non-arteritic anterior ischemic optic neuropathy (NA-AION), compressive and traumatic optic neuropathy.
Conclusion: Optic neuritis and papilledema should be considered as common differential diagnosis in patients with optic disc edema. NA-AION is a relatively uncommon disease among Nepalese population.
Life Satisfaction and Insomnia among Elderly Community Dwellers of Lalitpur, Nepal
Authors: Khagi Bina R , Timalsina Rekha , Chhantya Anita , Shiwakoti Shrijana , Maharjan Manju
Published: July 2024

Introduction: Life satisfaction during elderly is essential in ageing process. Globally, insomnia is a problem that degrades the health of elderly people, which also interferes with the quality of life.
Methods: A descriptive cross-sectional study was conducted to identify life satisfaction and insomnia among 501 community dwellers elderly of Lalitpur by using structured interview schedule on socio-demographic information, Satisfaction with Life Scale (SWLS) to measure a life satisfaction and Pittsburgh Insomnia Rating Scale (PIRS) to identify the prevalence of insomnia.
Results: Data was edited, classified, and coded manually. Then, data entry and data cleaning were done using Epi data software and data analysis was done using SPSS software version 16. Descriptive and inferential statistics were used to analyze data. The study showed that 31.9% and 35.7% of respondents were highly satisfied and satisfied with their life respectively. However, 6% and 0.6% of respondents were dissatisfied and extremely dissatisfied with their life respectively. Study reveals that 50.5% of respondents had insomnia. Ethnicity, current job status, and health problems during night sleep were significantly associated with life satisfaction. Similarly, age, marital status, educational status, current job status, current physical health problems, presence of disease, taking medication at present and health problems during night sleep were significantly associated with insomnia.
Conclusion: Most elderly people were satisfied with their life, but majority of them suffered from insomnia. Therefore, it is necessary to plan awareness program regarding life satisfaction and insomnia by concerned authority to help elderly to stay healthy and improve their quality of life.
Clinico-etiological Profile of Seizure Disorder among Adults Admitted to Tertiary Care Hospital of Nepal
Authors: Rayamahji Parash , Karn Ragesh , Gajurel Bikram P , Rajbhandari Reema , Ojha Rajeev , Agrawal Jagadish P
Published: July 2024

Introduction: Seizures beginning in the adult life require special attention as regards to their etiology because these are likely to be due to an identifiable cause. Understanding the trend in prevalence of various etiology of seizure will help in formulation of diagnostic protocol and might help to reduce the cost of investigations. In this retrospective study, we, therefore, aimed to assess etiology and clinical profile of adult onset seizures.
Methods: This was a retrospective study done at Tribhuvan University Teaching Hospital (TUTH), Kathmandu, Nepal. We included patients of both sexes and age > 18 years old admitted to neurology ward with seizure disorder and excluded the patients who suffered from unprovoked seizure and epilepsy. Our study variables included demographic profile of patients, co-morbidities, clinical features, laboratory investigation, neuro-imaging, EEG and drugs.
Results: Among 26 patients, 3 (11.5%) had hyponatremia, 2(7.7%) had intra-cranial space occupying lesion, 12(46.2%) had neurocysticercosis (NCC), 1 (3.8%) had opioid withdrawal, 1 (3.8%) had alcohol withdrawal, 1 (3.8%) had stroke, 1 (3.8%) tuberculoma and in 5 (19.2%) patients no underlying cause was found.
Conclusion: NCC was the most common cause of seizure disorders among adults. Even after huge development in laboratory, neuroimaging and neurophysiology testing, in as much as 19.2% patients, no etiology could be found.
Awake Throughout Craniotomy: Initial Experience and the Anaesthetic Challenges
Authors: Shakya Bigen M , Acharya Binita , Shrestha Gentle S , Shrestha Anil , Sedain Gopal , Shrestha Ninadini
Published: July 2024

Awake throughout technique for craniotomy demands very careful titration of drugs for sedation. It does not utilize any airway devices. The success depends on experience of anesthesiologist, good team work and meticulous planning. This is the first case of awake throughout craniotomy in our institute.
Prevalence of Laryngopharyngeal Reflux in Patients with Gastroesophageal Reflux Disease Undergoing Upper Esophagogastroduodenoscopy
Authors: Chalise Sangita R , Khadka Subash , Mukhia Rupesh , Thapa Abishek , Gautam Santosh , Sah Mukesh , Ranjan Rashmi
Published: July 2024

Introduction: Gastroesophageal reflux disease (GERD) has been defined as the retrograde flow of gastric contents into the esophagus. Laryngopharyngeal reflux (LPR) is one of the manifestations of GERD which can be diagnosed clinically by Reflux Symptom Index (RSI) and Reflux Finding Score (RFS). The aim of this study was to find the prevalence of laryngopharyngeal reflux in patients with GERD undergoing upper esophagogastroduodenoscopy.
Methods: This was a prospective cross sectional study and all the patients visiting author’s institute with GERD undergoing upper esophagogastroduodenoscopy were included. All the relevant data on history, examination, RSI scores, RFS scores and upper esophagogastroduodenoscopy findings were recorded in the standard proforma and data were analysed.
Results: A total of 205 patients with GERD and undergoing upper esophagogastroduodenoscopy were included whose mean age was 46.1 years. The female to male ratio was 1.3:1. The most common presenting symptoms in our study was hoarseness (97%) followed by coughing (90.7%). The mean RSI score was 11.6. The symptom prevalence of LPR was 23.4%. The prevalence in between age groups and gender was not significantly different. The mean RFS score was 9.5. The prevalence of LPR by RFS assessment was 64.4%, which is significantly more than the prevalence assessed by RSI (23.4%).
Conclusion: The prevalence of LPR in patients with GERD by RSI was less than the prevalence by RFS. So both the tools need to be used simultaneously to make the diagnosis and not recommendable to use independently.
Antimicrobial Susceptibility Pattern of Acinetobacter calcoaceticus-Acinetobacter baumannii Complex Isolated from Sputum in a Tertiary Care Hospital
Authors: Sapkota Jyotshna , Sharma Manisha , Shrestha Deepti , Jha Beena
Published: July 2024

Introduction: Acinetobacter calcoaceticus-Acinetobacter baumanni (ACB) complex is one of the commonest cause of hospital acquired and ventilator associated pneumonia. Multidrug resistant Acinetobacter species have become a matter of huge concern. This study was done to find out the antibiotic susceptibility pattern of Acinetobacter calcoaceticus-Acinetobacter baumanii complex from sputum samples.
Methods: This descriptive cross-sectional study was carried out in Clinical Microbiology laboratory from July 2018 to Jan 2019 after ethical approval. Acinetobacter calcoaceticus-Acinetobacter baumannii complex was identified on the basis of its microscopy and morphological characteristics followed by biochemical tests. Antibiotic sensitivity test of isolated pathogens was done using Muller Hinton Agar by Kirby-Bauer method.
Results: Of the 384 culture positive sputum specimen, 76 (19.80%) were Acinetobacter calcoaceticus-Acinetobacter baumannii complex. Most of the isolates were resistant to commonly used antibiotics, 72.36% of the isolates were multidrug resistance and 3.95% isolates were resistant to tigecycline.
Conclusion: This study provides valuable information regarding prevalence of Acinetobacter calcoaceticus-Acinetobacter baumannii complex from sputum specimen. The alarming number of multidrug resistance isolates is worrisome finding. Antibiotics like Tigecycline and Colistin which is still sensitive to isolates should be cautiously used only in MDR cases.
Blood Groups and their Association with Academic Performance among Medical Students in a Nepalese Medical College
Authors: Mahat Barun , Shrestha Lava , Adhikari Shailesh , Thapa Bikalp , Limbu Prakesh , Banstola Dinesh , Dhungel Sunil
Published: July 2024

Introduction: Knowing a person’s blood type is not only important in transfusion medicine and forensic medicine but is also useful for predicting a person’s characteristics including intelligence, knowledge, skill and behavior. It is recognized that intelligence, knowledge and skill are assessed by performance in examination. The objective of this study was to determine distribution of blood groups among students and its association with their academic performance.
Methods: This was an analytical study that was conducted among the medical students of Nepalese Army Institutes of Health Sciences (NAIHS) in Department of Clinical Physiology from June 2014 to April 2019. This study was conducted among 738 students by using convenient sampling method. Blood group was determine on the basis of agglutination reaction. Academic performance of students was assessed by the marks obtained by them in annual final examination.
Results: Blood group O was the most prevalent at 33.5%, followed by B at 29.5%, A at 29% and AB at 8%. Distribution of Rh positive and Rh negative were 96.6% and 3.4% respectively. The mean scores obtained in final university examination were highest in blood group A (62.9%) and lowest in blood group AB (60.3%) but the difference between different blood groups was not statistically significant.
Conclusion: Blood group O was the most common blood group. Rh positive was present in 96.6%. Though mean score was highest in blood group A, significant association between blood groups and academic performance was not seen in our study.
Drug Induced Sleep Endoscopy for Obstructive Sleep Apnea Syndrome: An Initial Experience in a Tertiary Level Centre
Authors: Parajuli Bashu D , Mandal Lokendra , Koirala Megha , Bhattarai Amit S , Neupane Yogesh , Shrestha Anil
Published: July 2024

Drug induced sleep endoscopy (DISE) is a technique of performing endoscopy of the upper airway after inducing sleep by the use of anaesthetic agents in patients suffering from obstructive sleep apnea syndrome (OSAS). The main purpose of DISE is to detect the obstruction or collapse at one or more location in the upper airway, both for the successful diagnosis and management of OSAS. Here we discuss a case of OSAS who underwent DISE under novel anaesthetic agents midazolam and dexmedetomidine.
Case Report on Pseudoaneurysm of Brachial Artery: A Rare Complication of Paediatric Supracondylar Humerus Fracture Pinning
Authors: Bhandari Prawesh S , Bastola Priska , Gurung Dinesh
Published: July 2024

Pseudoaneurysm (PA) of the brachial artery in pediatric supracondylar humerus fracture who have undergone closed reduction and percutaneous pinning is a rare complication. A few cases have been reported in medical literature. This case report sheds some insight into early identification and management outcome of such complication. Rapidly progressive swelling in antecubital fossa in cases of supracondylar fracture who have undergone pinning should arouse suspicion of vascular lesion. It should be timely intervened. Surgical intervention of pseudoaneurysm with reversed saphenous venous graft has shown to have no early vascular complication.
Lancet Commission on Global Surgery - A Public Health Initiative
Authors: Kurlberg Göran
Published: July 2024

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Japan: What to Do with Dead Bodies? A Burning Issue
Authors: Crump Andy
Published: July 2024

Death, the passing of a loved one, friend, colleague or just someone we may have known, is virtually always sad and often traumatic. However, it is a part of life and has to be coped with. Each year around 60 million people worldwide die from a wide and diverse number of causes. The problem of what to do with all those dead bodies is becoming a major conundrum for the families involved as well as for policy makers and governments. Natural and anthropogenic disasters, together with increasing incidence of major pandemics of infectious diseases is making finding a solution ever more difficult. A problem which is made worse by ever-increasing draconian rules about what can and cannot be done when disposing of a body. Currently, there are two basic choices, either bury the body in the ground where such action is permitted or cremate it and dispose of the ashes in a culturally and legally acceptable fashion. Generally, both options are becoming prohibitively expensive. The cost of land and the burgeoning demand for land to be used for industry, agriculture, urbanised centres or leisure activities is making burial no longer an option for most people. Japan has long led the world in incineration technology and it has also led the world for many years in cremating its dead. Virtually all Japanese are now cremated, the funeral process involving a mixture of high technology and unique routines steeped in history. Despite widespread concerns that cremation can cause environmental pollution and may damage public health as a result, it is still deemed less polluting than burial. It is likely that countries around the globe will increasingly adopt a policy of cremating their deceased citizens and would do well to follow the lead in this respect being shown by Japan.
Fracture Nasal Bone: Causes, Presentation and Management in a Tertiary Care Center in Nepal
Authors: Mahaseth Rajeev K , Gurung Urmila , Thapa Narmaya , Pradhan Bibhu , Kharel Bijaya
Published: July 2024

Introduction: Fracture of nasal bone, the commonest facial fracture is frequently encountered in ENT practice. This study was conducted to assess the causes, presentation and management of fracture nasal bone in a tertiary care center.
Methods: A retrospective chart review was done of patients admitted from August 2017 to July 2019 for management of isolated nasal bone fracture in the department of ENT and Head and Neck Surgery, Tribhuvan University Teaching Hospital.
Results: Thirty-five patients (31 males and 4 females) of 13 to 86 years (mean age 26 years) underwent closed reduction of fracture nasal bone. The injury was sustained following physical assault in 13/35 (37%), fall from height in 10/35 (29%), road traffic accident in 8/35 (23%) and sports injury in 4/35 (11%). Pain, epistaxis, swelling over nasal dorsum, nasal deformity and wound were the presenting symptoms which most often occurred in combination. Close reduction was done under local anesthesia in 28/35 (80 %) and under general anesthesia in 7/35 (20%). The time between trauma and closed reduction ranged from 1 to 16 days with a mean of 6.2 days.
Conclusion: Nasal bone fracture needing reduction was common following physical assault in males predominantly of 21 to 30 years. A combination of pain, epistaxis and nasal deformity was the commonest presentation. Closed reduction of fracture under local anesthesia within 16 days of trauma was the usual practice.
Palliative Care Services at a Cancer Center in Janakpur Nepal
Authors: Gupta Sanjay , Thakur Anshu K , Mishra Reecha , Jha Pamesh
Published: July 2024

Introduction: Palliative care is one of the essential components of cancer care in Nepal. Most of our cancer patients present to the hospital quite late. In our everyday practice, we encounter many progressive incurable cancer patients who need palliative care. The goal of the palliative care is to relieve the pertinent symptoms or to improve quality of life (QoL) for patients with advanced cancer. We reviewed the palliative care services to the cancer patients at our center.
Methods: Retrospective analysis of the cancer patients who received palliative care alone or in adjunct to curative treatment in Binayatara Cancer Center since its establishment in December 2018 was done.
Results: A total of 108 patients received palliative care of which most were at advanced stage of disease (Stage IV). The male to female ratio was 1:1.45. The most common complaints for their visit was pain (62%) followed by nause and vomiting (32%), constipation (28%), anorexia (22%), shortness of breath, abdominal distension, seizure. Most of the patients with pain needed morphine (65%) for pain management followed by tramadol (25%) and NSAIDs (10%). Few of them were also supplemented with TCAs and anticonvulsants. Abdominal distension due to ascites was managed by ascitic tapping, Albumin supplementation while shortness of breath due to pleural effusion was managed by pleural fluid tapping. In one patient with pleural effusion, chest tube was inserted. Three patients with seizure due to brain metastasis were managed with anticonvulsant. A patient of prostate cancer with bony metastasis was managed with surgical orchidectomy.
Conclusion: While considering the appropriate and effective use of palliative care, a palliative care physician is often confronted with a full range of multidisciplinary treatment options, and technical considerations that could potentially relieve some symptoms of advanced cancer in our settings.
Separate Consent for Anesthetic Practice: Need of the Moment
Authors: Shrestha Anil , Shrestha Gentle S , Pradhan Saurabh , Joshi Pankaj
Published: July 2024

Decades of refinement and modifications have led the modern anaesthetic practice to be conducted so smoothly and safely, that sometimes we take for granted the enormous amount of risks involved with it. Furthermore, with the evolution of monitoring techniques, and discovery of safer drugs, anesthesia has facilitated the conduction of complex surgeries on sicker patients, and older patients. The expansion to critical care and pain management services has added another dimension to this field, with anesthesiologists not just working as facilitators for another procedure, but acting as primary physicians. Anesthesiologists are among the few clinicians, who are involved in patient morbidity and mortality in their daily routine. With the ever-changing ethical and legal background, the significance of obtaining a separate consent for anesthesia needs to be timely evaluated. In this review, we have discussed the significance of a separate consent for anesthesia and highlight its various aspects.
Short Term Outcome of Acute ST Elevation Myocardial Infarction in a Tertiary Care Cardiac Center
Authors: Shrestha Hemant , Gajurel Ratna M , Poudel Chandra M , Thapa Sanjeev , Sayami Arun
Published: July 2024

Introduction: Acute ST Elevation Myocardial infarction (STEMI) is a cardiovascular emergency and is associated with significant adverse short and long-term outcome. The objective of this study was to determine the short-term outcome in terms of heart failure, myocardial reinfarction, stroke, hospital readmission and mortality in patients admitted with STEMI
Methods: It was a prospective observational study conducted at Manmohan Cardiothoracic Vascular and Transplant Center, Kathmandu from May 2014 to April 2015. All patients admitted with diagnosis of STEMI during study period were enrolled. Patients were treated on the basis of existing guidelines. Mode of management, adverse outcomes and mortality of patients during the study period were evaluated. The discharged patients were followed up for 30 days. Statistical analysis was performed with SPSS version 20. Ethical approval was taken from the Institutional Review Committee of Institute of Medicine.
Results: The median duration of presentation was 20 hours, and only 40% of the patients presented within 12 hours of symptom onset. Primary PCI was performed in 50 (33%), thrombolysis was performed in 29(19%) and conservative medical management was done in 72 (48%) patients. Overall outcome occurred in 52 (37.7%) patients. In hospital and 30 day mortality was 14 (9.2%) and 17 (11%) respectively. Heart failure was present in 28(18.5%), myocardial reinfarction 8 (5%), stroke 4 (2.6%), and hospital readmission was 18 (12%). Conservatively treated patients had significantly more adverse outcomes (p=0.02). More patients in conservatively managed group had hospital readmission. (p=0.04)
Conclusion: There were more overall adverse outcomes in conservatively managed group which is mainly due to more hospital readmission.
Ectopic Thyroid Tissue in Submandibular Region in Pediatric Patient: A Case Report
Authors: Bajracharya Rohita , Dutta Heempali
Published: July 2024

Normal anatomical location of thyroid gland is anterior to trachea and larynx. Ectopic thyroid is rare presentation. Ectopic thyroid tissue in submandibular region is even more rare. This article reports a case of five-year-old child who presented with swelling in left submandibular region which was later diagnosed to be an ectopic thyroid gland with no thyroid tissue in thyroid bed. Although rare, physician should consider possibility of ectopic thyroid in patient presenting with submandibular mass. Ultrasonography should always be performed to confirm presence of normal thyroid gland if surgical excision is planned.