bluuebunny/crossref_metadata_2025 huggingface dataset:
Kiến thức về lây nhiễm HIV qua quan hệ tình dục ở sinh viên nam tại Thành phố Hồ Chí Minh
Authors: Mai Thị Hiền , Võ Thị Ngọc Trà , Phạm Ngọc Hà
Published: November 2024

Đặt vấn đề: Trong những năm gần đây, tỷ lệ nhiễm HIV tại Việt Nam tăng lên đáng kể đặc biệt ở nam giới và nguyên nhân chủ yếu là do quan hệ tình dục (QHTD) không an toàn. Bên cạnh đó, việc không sử dụng bao cao su khi QHTD và thái độ dễ dãi trong QHTD ở sinh viên (SV) nam là những nguy cơ tiềm ẩn làm tăng tỷ lệ mắc HIV trên sinh viên. Chính vì vậy, nghiên cứu này được thực hiện để khảo sát kiến thức về lây nhiễm HIV qua quan hệ tình dục của sinh viên nam tại Thành phố Hồ Chí Minh (TPHCM). Từ đó, có thể cung cấp các kiến thức cần thiết góp phần giảm thiểu tối đa các ca nhiễm HIV mới trên nhóm sinh viên nam cũng như giảm thiểu số ca nhiễm HIV mới tại Việt Nam.

Mục tiêu: Xác định tỷ lệ SV nam tại TPHCM có kiến thức đúng về lây nhiễm HIV qua QHTD.

Đối tượng và phương pháp nghiên cứu: Nghiên cứu cắt ngang mô tả được thực hiện trên 283 SV nam thuộc 36 trường Đại học, Cao đẳng trên địa bàn TPHCM trong thời gian từ tháng 04/2023 – 07/2023. Sử dụng bộ câu hỏi tham khảo từ bộ câu hỏi IBBS của Bộ Y Tế. Số liệu được xử lý bằng phần mềm SPSS phiên bản 22.0. Phương pháp chọn mẫu bóng tuyết, phương pháp thu thập thông tin tự điền

Kết quả: Kiến thức về lây nhiễm HIV/AIDS qua QHTD của sinh viên nam: Tỷ lệ sinh viên nam trả lời đúng việc có thể nhiễm HIV khi QHTD với người mắc HIV mà không có biện pháp bảo vệ là 97,5%. Tỷ lệ sinh viên nam trả lời đúng việc sử dụng bao cao su đúng cách sẽ làm giảm lây nhiễm HIV là 82,3%. Tỷ lệ sinh viên nam trả lời đúng việc chỉ QHTD với một bạn tình sẽ làm giảm lây nhiễm HIV là 88,7%. Tỷ lệ sinh viên nam trả lời câu hỏi QHTD bằng đường nào sẽ có nguy cơ lây nhiễm HIV lần lượt là miệng (50,53%), hậu môn (74,45%), truyền thống (85,52%).

Kết luận: Nhìn chung tỷ lệ sinh viên có kiến thức về lây nhiễm HIV/AIDS qua QHTD tương đối cao. Cần có giải pháp tác động vào kiến thức của SV từ đó góp phần tác động vào thái độ và hành vi của SV nam nhằm nâng cao kiến thức về lây nhiễm HIV qua QHTD và giảm thiểu số ca mắc HIV trên SV nam tại địa bàn TPHCM nói riêng và Việt Nam nói chung.

Từ khóa: HIV; quan hệ tình dục; sinh viên nam
Las bases cartesianas del tratado Sobre la igualdad de los dos sexos
Authors: Estrada López Marvin
Published: November 2024

En este texto quiero ofrecer un análisis del proyecto del tratado Sobre la igualdad de los dos sexos. Un discurso físico y moral en el que se ve la importancia de deshacerse de los prejuicios, escrito por François Poulain de La Barre y publicado en 1673. El plan y los objetivos de la obra son expuesto en su prefacio. En la primera parte del prefacio, Poulain se ocupa del tema del libro: la importancia de la eliminación de los prejuicios, especialmente de aquel prejuicio que propone la inferioridad femenina.  La segunda parte contiene el plan de la obra: emplear la regla de la verdad cartesiana para refutar los argumentos en contra de las mujeres del adversario vulgar y del adversario erudito. Finalmente, la tercera parte aborda la utilidad del discurso: exhortar a las mujeres a investigar la verdad.  En este breve artículo quiero resaltar las bases cartesianas tanto del plan como de las vías que Poulain pretende seguir para alcanzar los objetivos expuestos en el prefacio del tratado Sobre la igualdad de los dos sexos.
Maturity of the country's cybersecurity system in the conditions of war: assessment trends
Authors: Dotsenko T. V , Kuzmenko M. V
Published: November 2024

Methods. The study used the following methods: an inductive approach to formulating the concept of maturity of the country's cybersecurity system in military conditions; a deductive method to derive the concept of assessing the maturity of the country's cybersecurity system during military operations; content analysis identified the key elements of assessing the maturity of the national cybersecurity system in military operations; strategic analysis identified the main vectors of assessing the problem under study, and the latest approaches to assessing the national cybersecurity system. Results. The latest trends in assessing the maturity of the country's cybersecurity system, taking into account the aspect of military conditions, are identified: the existing regulatory and legal framework at the international and national levels is indicated; the concept of maturity and assessment of the maturity of the country's cybersecurity system during military operations is formulated. The paper outlines the key elements of assessing the maturity of the national cybersecurity system in military operations: adaptability, interoperability, readiness, partnership, cyber reserves, vulnerabilities and threats, and training. The main vectors of assessment are identified: assessment of cyber threats, cyber attacks, infrastructure protection, interaction of cybersecurity actors, level of personnel training; the latest approaches to system assessment are noted. A scheme of future key challenges, trends, and recommendations for assessing the maturity of the national cybersecurity system in wartime has been formed. Novelty. The study of the specifics of assessing the maturity of the country's cybersecurity system identifies key elements, vectors, approaches, and methods for assessing the cyber defence system. Weaknesses and vulnerabilities, existing progress in the development of cyber defence of the system are identified, and the necessary activities to enhance the effectiveness of national security in times of war are identified. Practical value. The experience of previous achievements in the functioning of cybersecurity systems is summarised, the most effective practices and methods of cyber resilience are identified, recommendations for assessing the maturity of the national cybersecurity system in times of war are proposed, which will optimise existing and potential resources, and will help to create the preconditions for further development of the latest model of cyber defence assessment.
Impact of the russian-ukrainian war on the foreign economic activities of enterprises in the context of international management
Authors: Boichenko M. V , Dudnyk A. V , Boiarkin M. O , Molodan M. A
Published: November 2024

Methods. During the research, a set of general scientific methods of cognition were used, in particular methods of analysis and synthesis – to study the influence of force majeure circumstances on foreign economic activity; analysis of dynamic series – when determining the directions of changes in the structure of foreign trade by product groups and main supply markets, induction – for determining methods of managing international supply chains depending on the state of trade and payment balances. Results. The article defines the main geographical regions to which the products of Ukrainian manufacturers are exported, as well as those that serve as a source of import trade flows for Ukraine. The ratings of the countries with the largest share of imports of Ukrainian-made products, as well as the largest supplier countries that export their goods to the Ukrainian market, are presented. The most important export goods of Ukrainian enterprises have been determined, and a list of goods imported by Ukrainian enterprises from abroad has been provided. A comparison of the structure of export and import on the Ukrainian market was made, taking into account the impact of Russian aggression on the foreign economic activity of enterprises. Novelty. The nature of the impact of the Russian-Ukrainian war on the global supply chains of Ukrainian enterprises, as well as on the state of international trade, is determined. The assessments of Ukrainian and foreign experts regarding the impact of Russian aggression on the fragmentation of the world market and the strengthening of protectionist tendencies on the part of national governments are summarized. It is demonstrated how the division of countries into several camps, described in particular by the concept of a «bipolar world», will affect the management of international supply chains of Ukrainian firms. Practical value. Recommendations are offered for Ukrainian enterprises regarding the implementation of foreign economic activities taking into account the risks of martial law.
Strategic directions of policy formation of the logistics company in the context of economic security
Authors: Boichenko M. V , Bardas A. V. , Kozheltsev O. Ye
Published: November 2024

Methods. During the research, a set of general scientific methods of cognition was used, in particular, analysis – in the study of literary sources describing the specifics of the formation of the logistics services market, as well as highlighting the impact of logistics activities on the economic security of enterprises. The method of abstraction is used to determine the potential threats from the logistics market, to which a modern company is exposed, carrying out its activities in the field of logistics. On the basis of the general and specific method, the strategic directions of policy formation of the logistics firm in the context of economic security are determined. Results. The article examines the problems of economic security of enterprises and the impact on its parameters of the measures used to regulate the logistics services market, as well as modern trends in the development of logistics. Recommendations are offered regarding possible options for the formation of supply chain management policies by firms, in particular, taking into account the impact of digitization of business models. Special attention is paid to the phenomenon of the development of third-party logistics service providers and their virtual operators, taking into account the possibilities of using cloud computing technologies and artificial intelligence to process large data sets. Novelty. The strategic directions of the formation of the policy of regulation of the logistics services market, taking into account the processes of integration of our country into the European Union, have been determined. It has been proven that the regulation of the logistics services market creates risks for the economic security of enterprises, since the requirements for changing the business models of enterprises in accordance with the principles of the circular economy require additional management efforts and related costs. as well as related expenses. Practical value. The results of the research can be useful for the formation of conditions of economic security of firms that carry out their economic activities in the field of logistics.
Project teamswork efficiency management in organization
Authors: Shvets V. Ya , Shulyar R. V , Bogach K. S , Mykhieiev D. S
Published: November 2024

Methods. During the study of the specifics of managing the effectiveness of the work of project teams, a set of general scientific methods of cognition was used, in particular, general and specific methods – when establishing the specifics of the organization of the work of project teams, taking into account the influence of internal and external environmental factors; method of comparisons – to compare the advantages of using cascade and flexible methods of planning and organizing project works. Results. The article analyzes the main approaches to organizing the work of project teams. The role played by project managers in achieving its strategic goals is determined. The specifics of managing their effectiveness are singled out and the importance for the manager of constant monitoring of changes in the internal and external environment, systematic updating of information, on the basis of which key management decisions are made, is demonstrated. The expediency of using by the management of the organization those influence tools inherent in the agile methodology (flexible project management) has been updated. Variants of managerial influence to improve the efficiency of the project team are offered, and signs of its effective work are presented. Novelty. The specifics of the application of flexible methodological approaches to the organization of people's work in organizations, taking into account resource limitations, are determined. Recommendations are provided for working with stakeholders in the process of transforming the organization's business model and creating a product that has final consumer value. Practical value. The results of the research presented in the article make it possible to choose the areas of concentration of efforts of the management of the organization depending on the context of activity and the resources available in the organization.
Methodical approach to assessing the corporate responsibility of enterprises in the conditions of business innovation
Authors: Hovsieiev D. D
Published: November 2024

Methods. The theoretical-methodological approach proposed in this article involves the implementation of the procedure for assessing the corporate responsibility of an enterprise based on an infological methodical approach using a semantic network at the stage of selecting significant indicators of social responsibility. This makes it possible to simplify and logically substantiate the procedure for determining the optimal composition of the necessary indicators. Directly integrated indicator of the level of corporate responsibility was obtained based on the use of the Microsoft Excel application package. Results. It is noted that in today's dynamic environment, where technologies are developing at an incredible speed, the business environment is undergoing radical changes through the introduction of advanced technologies, which open up opportunities for enterprises for economic growth and increasing the efficiency of their operation. The implementation of the principles of corporate responsibility and innovation in business processes is associated with the need for significant investments and changes in corporate culture, which encourages enterprises to pay attention to corporate responsibility as a key factor for achieving sustainable development in conditions of innovation. An indicator of the company's corporate responsibility assessment was obtained, which is based on five group integral indicators characterizing relations with the staff and owners of enterprises, operational efficiency, financial reliability and investment attractiveness for corporate clients. Novelty. An integral indicator of the level of corporate responsibility and management decision-making regarding the use of means of increasing economic stability and further sustainable development of the enterprise in conditions of innovation has been formed. Practical value. The use of the formed integral indicator for assessing corporate responsibility is justified and corresponds to the presented approach to defining the concept of corporate responsibility as a comprehensive one, which covers all spheres of the enterprise's activity and levels of interaction with various stakeholders. This allows getting a more complete picture of its social responsibility and reflects the interests of a certain group of stakeholders (employees, owners, customers, etc.). Group integral indicators are based on the application of a system of indicators that allow you to objectively measure the components of the enterprise's corporate responsibility, establish the dynamics and relationship of general and individual trends of economic stability and sustainable development.
Economic and social factors in the formation of an industrial apiary business project
Authors: Prushkivska E. V , Krasnoshtan A. O
Published: November 2024

Methods. The theoretical and methodological basis of the study is the work of domestic and foreign scholars. The results are obtained on the basis of an integrated methodological approach, which includes an analysis of economic and social factors influencing the creation and development of an industrial apiary. To determine the main parameters of the business project, economic modelling methods, quantitative methods, in particular, calculations of the efficiency of keeping bee colonies and modelling of business processes for apiaries with 300-500 families are used. Results. This article presents beekeeping as an important sector of the national economy. The importance of honey production and exports, where Ukraine holds a leading position in the global market, is highlighted. It is substantiated that beekeeping not only ensures honey production, but also has a significant impact on agricultural crops through pollination, which increases yields. The author argues that a detailed business plan should be drawn up, which includes certain factors: seasonal costs, selection of the right equipment and technologies, and qualified personnel capable of working with the specified technologies. It is found that the main economic factors that contribute to the success of industrial apiaries are the growing demand for environmentally friendly products, the availability of subsidies and government programmes to support the agricultural sector. It is emphasised that social factors, such as the need to create jobs in rural areas and ensure food security, also play an important role in supporting this business, and the promotion and consumption of beekeeping products is the key to improving the health of the nation. Novelty. Based on the modelling of business processes, it was found that to be effective, industrial apiaries should have a minimum size of 300-500 bee colonies, and their optimal size depends on the honey base and climatic conditions. It has been determined that an important component is the proper management and organisation of processes in the apiary, where experienced professionals play a key role. Practical value of the study lies in the possibility of applying the developed recommendations for the creation and implementation of business projects of industrial apiaries, which will contribute to the development of small and medium-sized businesses in rural areas. The proposed approaches can be used to optimise costs and increase the profitability of industrial beekeeping.
Mental Health Status of Migrant Nepalese Workers Rescued By Government of Nepal During the Corona Virus disease -19 Pandemic
Authors: Kaphle Maheshor , Karmacharya Isha , Khadka Santosh , Shrestha Bikal , Adhikari Laxmi
Published: November 2024

Background: The corona virus pandemic rapidly sweeps across the world; it is inducing a considerable degree of depression, stress and anxiety concern in the population at large and among certain groups in particular, such as migrant workers. The aim of the study is to find out mental health status of migrant workers rescued by Nepal Government from different countries during corona virus disease -19 pandemic. Methods: Cross-sectional descriptive study involving 427 returned migrant workers was conducted using the depression, anxiety and stress scale –21(DASS-21). Association between socio-demographic variables to mental health status was performed using chi-square test and p-value <0.05 was considered as significant level.Results: Out of 427 participants, 4 % of respondents found to have extremely severe level of stress followed by 1.9 % extremely severe level of depression and 2.3% extremely severe level of anxiety. The association between mental health status and covariates showed that depression, anxiety and stress were associated with the place of residence, educational status of the respondents, and their perception of corona virus disease -19 risk at workplace, and test for COVID-19 after arrival to Nepal. Conclusions: The study revealed that job loss, visa and employment contract expiry were the main reasons for migrant workers to return Nepal. Nearly one fourth of the respondents had suffered from depression, nearly one third from stress and 17% from anxiety. Necessary psychosocial interventions should be formulated and implemented for addressing the mental health problems of migrant workers during the corona virus disease -19-19 pandemic.Keywords: Government of Nepal; mental health status; migrant workers
Post COVID-19 vaccine Guillain-Barré syndrome
Authors: Khadka Bikash , Khanal Kishor
Published: November 2024

Guillain-Barré syndrome is an acute generalized polyneuropathy which usually follows infection with a virus or bacteria, although rarely vaccination may be associated with it. We present a case of a 44-year-man who presented with progressive weakness of both lower limbs since 6?days, neurological examination findings were consistent with flaccid-type paraplegia and investigation findings including lumbar puncture and nerve conduction studies were consistent with the diagnosis of Guillain-Barré syndrome. He had received the Johnson and Johnson corona virus disease-19 vaccine intramuscularly 15 days before his presentation. Only potential triggering factor in this case was positive finding of Jansen Vaccine.Keywords: Guillain-Barré syndrome; immunoglobulin; jansen vaccine; polyneuropathy.
Kinetics of Severe Acute Respiratory Syndrome Corona Virus-2 Specific Antibody in Corona Virus Diease 2019
Authors: Shrestha Lilee , Karmacharya Nabin , Sharma Saroj , Bahadur Basnet Buddha , Jha Runa
Published: November 2024

Background: Severe Acute Respiratory Syndrome Corona Virus 2019, a novel coronavirus first reported from China in 2019, is the causative agent of pandemic corona virus disease 2019. Antibody response and its dynamics may provide information about natural immunity conferred upon by corona virus disease 2019. Methods: A health-center-based follow up study of confirmed Severe Acute Respiratory Syndrome Corona Virus-2 infected patients was conducted from December 2020 to June 2021. Patients were followed up to period of 28 weeks during the study. An electrochemiluminescence immunoassay was used to test antibodies elicited by Severe Acute Respiratory Syndrome Corona Virus-2. Socio-demographic and clinical information was collected from each patient.Results: A total of 40 patients (18 males and 22 females) were enrolled in the study, with 90 % seropositivity of SARS-CoV-2 antibody. Antibody level was tracked up to 28 weeks following the infection, and persistence was observed till the end. Antibody level peaked on the 3rd to 4th month, after symptom onset. The male population was found to have higher antibody levels compared to females. Age-wise trend analysis showed lower antibody levels in the younger people (15-30 years) than those older (31-60 years).Conclusions: We demonstrated that Severe Acute Respiratory Syndrome Corona Virus-2 specific antibodies in corona virus disease 2019 patients persist for at least 28 weeks, peaking at 13 to 20 weeks. Statistically, there was no correlation of antibody levels with the age and sex of individuals. Further study on a larger population is needed for determining long-term immunity.Keywords: Antibody; kinetics; SARS- CoV-2.
Live Modeling Versus Tell-Show-Do Technique Based on Children’s Heart Rates, Oxygen Saturation and Facial Image Scale
Authors: Limbu Senchhema , Dikshit Parajeeta , Malla Manisha , Parajuli Pragya , Mehata Suresh
Published: November 2024

Background: Tell-Show-Do is most popular and Live modeling is less frequently used behavior management techniques in pediatric dentistry. This study was conducted to compare the children’s response to these two techniques by measuring the objective and subjective parameters of anxiety by using pulse rate, oxygen saturation and facial-image scale.Methods: A cross-sectional study was conducted among 138 children aged 5-10 years from December 2020 - August 2021. Children were randomly divided into three groups: Group A: Live modelling technique (mother as model), Group B: Live modelling technique (father as model), Group C: Tell–Show–Do technique. All were subjected to oral examination and rotary prophylaxis on first dental visit. Pulse oximeter was used to record heart rate, oxygen saturation along with facial-image scale scores before and after the treatment period.Results: The average heart rate at the end of rotary prophylaxis session was significantly lower among children in group A than in group C (p=0.05). facial-image scale scores revealed high significance after the rotary prophylaxis treatment and it was lower in group A than group C and group B (p< 0.001). Average facial-image scale scores of fear perception by girls in group A was lower than group C and group B (p< 0.001). Oxygen saturation showed no significant differences between the three groups.Conclusions: Live modelling is equally worth practicing as Tell Show Do technique to decrease the anxiety level of children. Anxiety level increased during the procedural work than oral examination and facial image scale indicated anxiety.Keywords: Facial image scale; live modeling; oxygen saturation; pulse rate; tell-show-do.
Establishment of National Medical Registries: The Time has Arrived
Authors: Dhakal Gaurav Raj
Published: November 2024

NA
Effect of an Educational Intervention on Dietary Diversity Practices among Public School Students
Authors: Aryal Binod Kumar , Mahotra Anita , Thapa Pachya Ambika , Pahari Durga Prasad
Published: November 2024

Background: Poor dietary diversity leading to malnutrition among children and adolescents is a serious public health problem in Nepal. Though nutrition education intervention has been effective in changing the dietary intake habits of individuals in school settings, the contextual educational intervention has not been tested in our study area. This study is aimed at assessing the effect of dietary diversity education based on the Health Belief Model among secondary level students in selected schools of Siddhicharan Municipality, Okhaldhunga.Methods: Quasi-experimental study design was employed during the intervention study. Our study was conducted in 3 phases: Phase I, Baseline Study; Phase II, Education Package Development; and Phase III- Intervention Study (Implementation and evaluation of the package). The data was collected for getting baseline that was used to develop package, pre-intervention assessment and after intervention assessment, using a self-administered structured questionnaire based on constructs of Health Belief Model (HBM). Study participants were students from grade 7 and 8. The collected data was analyzed using SPSS version 21.Results: After the education intervention, dietary diversity knowledge and practice in the intervention group increased from 16.4% to 54.2% and 32.8% to 48.6% respectively. Significant association (P<0.001) was noted between knowledge of dietary diversity with intervention in post-test. Similarly, the mean score of the Health Belief Model construct was significantly improved and showed an association (P<0.001) with nutrition education after the intervention.Conclusions: Nutrition education based on the Health Belief Model showed a positive impact on knowledge and practice of dietary diversity among school students. Hence, such education intervention should be promoted by educational institutions, the Ministry of Education, Ministry of Health and Population, NGOs and INGOs.Keywords: Adolescent; dietary diversity; education intervention; health belief model school
Effect of Oral Health Promotion on Caries Experience and Oral Cleanliness of School Children in Kerung, Nepal: A Prospective 6-month Follow-Up Study
Authors: Martens Luc , Cauwels Rita , Vandenbulcke Jeroen , Joshi Kumbh Raj , Pradhan Shaili , Lambert Martijn
Published: November 2024

Background: A longitudinal oral health promotion project on caries experience and oral cleanliness was performed in a remote village in Nepal. The aim of this 6-month prospective survey was to investigate the impact of an oral health promotion project on caries experience, oral health-related behaviour, and general knowledge about oral health in Kerung, a remote village in Nepal. Methods: A prospective study was conducted in a convenience sample of children from the local school in Kerung. At baseline and after six months, dental plaque scores and caries experience scores were measured by calibrated examiners. Validated questionnaires on oral health habits and knowledge on oral health were taken. In addition, an oral health promotion program was developed. Results: At baseline, 359 children were included, of which 266 could be surveyed after six months. A statistically significant decrease in the mean plaque score was found at after six months with a higher reduction for boys. A significant decrease in caries prevalence, as well as a significant increase in knowledge about oral health, was observed. Furthermore, after six months there were significantly more children reporting that they brushed their teeth for at least two minutes.Conclusions: Dental screenings and a comprehensive educational program resulted in a significant improvement of oral health. Keywords: Caries experience; Nepal; oral cleanliness; oral health promotion
Hypocalcemia in Jaundiced Neonates Receiving Phototherapy
Authors: Shrestha Sabina , Dhungana Sangita , Shrestha Sujit Kumar , Shrestha Gentle Sunder , Kakshapati Prayash
Published: November 2024

Background: Hyperbilirubinemia is a common problem in neonates. Phototherapy and exchange transfusion are the primary treatment modalities. Less known, but one of the potential complications of phototherapy is hypocalcemia. Most of the neonates with hypocalcemia are asymptomatic. Though asymptomatic, treatment should be initiated immediately when serum calcium level is reduced. This study was conducted to detect the incidence of hypocalcemia in jaundiced neonates receiving phototherapy.Methods: It is a hospital-based cross-sectional study conducted from May 2020 to December 2020 in the neonatal intensive care unit of Nepal Medical College Teaching Hospital. A total of 128 full-term neonates with jaundice and a normal serum calcium level before initiating phototherapy were enrolled in the study. Serum calcium level was measured before starting conventional phototherapy and after 48 hours of continuous phototherapy.Results: Hyperbilirubinemia was present in 23.3% of neonates admitted to the neonatal unit. Hypocalcemia was seen in 26 (20.3%) of term jaundiced neonates receiving phototherapy. Signs of hypocalcemia were present only in 3 (2.3%) neonates.Conclusions: Hypocalcemia is a common complication of phototherapy. Serum calcium levels should be monitored in all the full-term neonates receiving phototherapy. Keywords: Hyperbilirubinemia; hypocalcemia; phototherapy
Profile of Ectopic Pregnancy Cases in a Tertiary Hospital
Authors: Singh Jitendra Kumar , Dangal Ganesh
Published: November 2024

Background: An ectopic or extra uterine pregnancy is one in which the blastocyst implants anywhere other than the endometrial lining of the uterine cavity. The objective of the study was to find incidence, risk factors, clinical presentation and mode of management of ectopic pregnancy.Methods: Observational study was conducted at Paropakar Maternity and Women’s Hospital, Thapathali, Kathmandu. All the relevant data were recorded in performa. The collected data were entered in MS Excel and exported into SPSS 26 version for statistical analysis.Results: About one third of the patients 10 (33.3%) was of 25-29 age group.The most common risk factor was pelvic infection in 23 (76.6%) cases, abortion in 11 (36.7%), and abdominal surgery in 8 (26.7%) of cases. The of classic triad of amenorrhea (100%), pain abdomen (99.7%) and per vaginal bleeding (66.7%). Ruptured ectopic seen in 26 (86.7%) cases, unruptured status in 1 (3.3%) case, tubal abortion in 1(3.3%) case and organized ectopic in 2(6.7%) cases. The most common site was found to be ampulla in 23 (76.7%) cases, fmbria 3(10%) cases, corneal in 3(10%) cases and ithmus in 1 (3.3%) case. All the cases managed surgically, of them unilateral salphingectomy, unilateral salphingo-opherectomy and wedge resection for corneal pregnancy were done in 25(83.3%), 2(6.7%) and 3(10%) cases respectively.Conclusions: Ectopic pregnancy mostly present as ruptured form in young females in our context. Pelvic infection is the commonest risk factor with ampulla being the commonest site. All cases required surgical intervention in form of unilateral salphingo-opherectomy and wedge resection.Keywords: hCG ; ectopic pregnancy; salphingectomy; ultrasonography; UPT
Prevalence of Nerve Injuries in Supracondylar Fracture of Humerus in a Tertiary Care Hospital
Authors: Panta Sunil , Thapa Sushil , Hamal Bhadra , Bhandari Pratap Babu , Paudel Krishna Prasad , Thapa Shrawan Kumar
Published: November 2024

Background: Supracondylar fracture is a common childhood injury. These fractures are often associated with neural and vascular injuries. There is discrepancy in literature about the most common nerve injured in such fractures. This study aims to study the nerve injury patterns in supracondylar fractures of humerus in Nepalese children.Methods: This descriptive cross sectional study was conducted in 152 children (aged 2 to 14 years) with supracondylar fractures of humerus attending in Bharatpur Hospital during the period of one year. All eligible patients were assessed clinically and radiologically. Neurological assessment was done for nerve injury.Results: Out of 152 children, 18(11.8%) had nerve injuries. The mean age was 7.41±2.91 years. Boys were more injured (68.4%) than girls (31.6%). It was more common on non-dominant side (57.9%). Out of 18 nerve injuries, most commonly injured nerve was median nerve 10(55.5%) followed by radial nerve 7(38.9%). Median nerve injury was common in posterolateral displacement and radial nerve injury was common in posteromedial displacement type of fracture.  Conclusions: Displaced supracondylar fractures have relatively higher prevalence of nerve injuries. Most commonly involved nerve is median nerve followed by radial nerve. So, every displaced fracture should be routinely screened for nerve injuries.Keywords: Humeral fractures; median nerve; peripheral nerve injuries; prevalence; radial nerve
Covid-19 associated Mucormycosis: A case report
Authors: Shrestha Oshan , Sharma Baral Reetu
Published: November 2024

One of the most common complication of Coronavirus disease 2019 (COVID-19) is acute respiratory distress syndrome requiring high flow oxygen, ventilator support, corticosteroids and other supportive therapies. Opportunistic aggressive fungal infection with Mucormycosis, although an uncommon entity otherwise, has been on rise in this pandemic especially in patients with chronic underlying illnesses. One such case of rhino-orbital Mucormycosis in a background of uncontrolled hyperglycaemia presented in the hospital and the histopathological examination of the tissues from ethmoidal sinus and frontal recess showed invasive necro-inflammatory infection by numerous Mucormycosis hyphae.Keywords: COVID-19; mucormycosis; rhino-orbital
Guide, Co-guide, Supervisors as Author in Publication on Student Thesis
Authors: Shah Jay N
Published: November 2024

Good research writing and publication practices are important to identify, acknowledge, and generate awareness for ethical and credible science. Academic requirement for research thesis, and ‘publish or perish’ culture of academia for career evaluation of faculties contribute to authorship misconducts. The authorship criteria have been clearly outlined by international guidelines like International Committee of Medical Journals Editors, Committee on Publication Ethics, Council of Science Editors, World Association of Medical Editors. However, the practice of guide, co-guide as authors in students’ thesis articles continues as inappropriate authorship. This is a topic which requires more debate in academia. Historical practices of academia, the power dynamics, and the guidelines of the journals vary and make this dispute even more complicated. In Nepal, we need to expand the discussion among stakeholders from academia, universities, monitoring bodies, ethical committees to journals for a consensus; to ‘put to rest’ this issue and be in line with the international guidelines.Keywords: Authorship guideline; journal article publication; research thesis guide co-guide supervisor
Influence of Household Remittance on Childhood Stunting in Nepal
Authors: Bhattarai Sanju
Published: November 2024

Background: Migration is a livelihood strategy for many poor households in Nepal. About 56% of the households receive remittances, the country also has high rates of undernutrition as 36% of children under five years of age are stunted. Remittance are known to increase household income, potentially contributing to improvements in health and nutrition of children, but few studies have examined it in the Nepalese context. Methods: We used data of 2,498 children under 5 years of age from the Nepal Living Standard Survey 2010/11 to investigate associations between childhood stunting and household remittances. Multiple logistic regression was used to evaluate the odds of child stunting by remittances received by the families in the 12 months preceding the survey. Guided by a conceptual framework, the model was adjusted for variables representing child, maternal and household level characteristics. Results: Our investigation showed that the odds of a child being stunted decreased with increased levels of remittance received by households, 67% (OR: 0.33, 95% CI: 0.16, 0.67) lower for households receiving more than Nrs.60,000 remittance per year. However, there was no difference in the risk of stunting by gender of the household head and income categories.Conclusions: An increased household income could potentially reduce the burden of chronic undernutrition in poor families in Nepal, which in turn paves a path for the expansion of cash transfer programs. Further research is indicated to understand the threshold of remittance or cash transfer needed to estimate nutritional outcomes.Keywords: Income; nutrition; remittance; stunting
Circulating Genotypes of Rotavirus Prior to Rotarix?vaccine Introduction in Kathmandu, Nepal
Authors: Shrestha Sony , Thakali Ocean , Raya Sunayana , Sherchan Samendra , Shrestha Laxman , Parajuli Keshab , Sherchand Jeevan Bahadhur
Published: November 2024

Background: In Nepal, it is estimated that about 3 million children under 5 years of age are prone to diarrhea and previous studies have shown rotavirus as the major etiological agent. Given the high burden of rotavirus, Rotarix® vaccine was introduced in the national immunization schedule in July 2020. This study was carried out in a tertiary health center from January- September 2018 to determine the burden of rotavirus diarrhea as well as genotypic variations in the circulating virus prior to vaccine introduction in Kathmandu, Nepal.Methods: Hospital based cross sectional study was conducted among children less than 5 years of age attending Kanti Children’s Hospital. Rotavirus antigen detection was performed by enzyme immunoassay using ProSpecT Rotavirus Microplate Assay. Rotavirus A positive samples were further confirmed by genotyping using Reverse-Transcription Polymerase Chain Reaction.Results: A total of 530 children that included 184 males and 346 females were enrolled in this study. Rotavirus antigen was detected in 112 (21.1%) stool samples. Of the total 112 positive EIA stool samples that were genotyped, G12P[6] (30.3%) was found to be the most common type, followed by G3P[8] (26.8%), mixed type (14.3%), and G1P[6] (13.4%). Conclusions: Continued surveillance should be carried out nationwide in Nepal to understand the effectiveness of the vaccination program and to report any new trends in the circulating genotypes.Keywords: Children under five years of age; diarrhea; Nepal; rotavirus strains; RT_PCR
Prevalence of Intimate Partner Violence and Associated Factors Among Married Nepalese Men in Kathmandu Metropolitan City
Authors: Devkota Pooja , Niraula Surya Raj , Singh Suman Bahadur , Adhikari Baikuntha Raj , Chakravartty Avaniendra
Published: November 2024

Background: Intimate Partner Violence is defined as the intentional use of physical force, or power, threatened or actual against on self/others or groups that results in injury, death, psychological harm. Methods: A community-based cross-sectional study was conducted in Kathmandu Metropolitan city in 2018. An adequate sample of 210 married men was selected from randomly selected 10 wards of Kathmandu Municipality. A semi-structured questionnaire including standard scales was used for data collection. Multivariate analysis was performed to find out the association of Intimate Partner Violence with different variables.Results: The mean age of male respondents was 40.19 years. More than half of the respondents were Janajatis. Overwhelming respondents were Hindu (religion). Intimate Partner Violence was estimated in forms of Physical violence, 31.9%, Sexual violence, 4.3%, and Psychological violence, 50.5%. Age, age at marriage, marriage type, marriage decision, spousal age gap, family income, education, smoking habit and depression were independently associated with violence. However, family income and education were found to be significant factors associated with violence even after adjusting the effects of other potential factors.Conclusions: Strong association of Intimate Partner Violence with family income, and education of male respondents was observed. More than half of the males had psychological violence and nearly one-third of the participants had Physical violence. The study concludes that Intimate Partner Violence among males could not be neglected.Keywords: Intimate partner violence; married men; Nepal
Histopathological Spectrum of Oral Mucosal Lesions in a Tertiary Care Hospital
Authors: Shrestha Bijayata , Subedi Sushil , Poudel Suman , Ranabhat Sunita , Gurung Geeta
Published: November 2024

Background: Neoplastic as well as non-neoplastic lesions commonly involve oral mucosa. It had been observed that benign lesions were more common than malignant ones. The present study was done to evaluate the pattern of distribution of various oral mucosal lesions in a tertiary care hospital.Methods: This retrospective cross-sectional study reviewed the archival records in the Department of Pathology, Gandaki Medical College, Nepal from January 2017 to December 2020. The records of patients with histopathologic diagnosis of oral mucosal lesions were obtained. The histopathological diagnosis, age, gender, and the site of involvement were collected using a prepared form. Descriptive statistics was applied using SPSS 20 software.Results: Oral mucosal lesions included 3.7% (180 out of total 4895) of cases diagnosed histopathologically. The cases were common among females (101cases/56.1%). Most of the oral mucosal lesions were diagnosed in more than 45 years old patients (75cases/41.7%). The non-neoplastic oral lesions (106cases/58.9%) were the most common lesions followed by neoplastic oral lesions (52cases/28.9%). Among non-neoplastic oral lesions, reactive hyperplastic oral lesions were the most common (50cases/27.8%). Reactive hyperplastic oral lesions frequently affected gingiva (18cases/36%). Neoplastic lesions (Benign neoplasm: 12cases/44.4%; Malignant lesions; 10cases/40%) frequently affected the tongue. Conclusions: Oral lesions were mostly non-neoplastic and reactive hyperplasia being the most commonest presentationKeywords: Neoplastic; non-neoplastic; oral mucosal lesions; reactive
Cilnidipine for Amlodipine Induced Pedal Edema and its Anti-hypertensive Effect in a Tertiary Care Teaching Hospital of Western Nepal
Authors: Kafle Ram Chandra , Sapkota Subash , Maskey Abhisek
Published: November 2024

Background: Hypertension is the most common cardiovascular disease. In Nepal, 27.3% populations are suffering from hypertension. Amlodipine is the most frequently prescribed anti-hypertensive drug. Up to 15% of patients develop pedal edema with amlodipine that may lead to discontinuation. Cilnidipine, a new calcium channel blocker, found equally effective and edema is uncommon in different studies from India. We aimed to study anti-hypertensive effect and to assess resolution of amlodipine induced Pedal edema with clinidipine.Methods: This was a prospective, single centre observational study. Study was conducted in the department of cardiology, Manipal teaching hospital from 7th May to 6th November 2020. Hypertensive Patients who were on amlodipine for at least 6 months and presented with pedal edema were enrolled for the study. Results: Total of 107 patients were enrolled for the study. The mean age of patients was 56.35 ± 12.84 years, ranged from 29 to 85 years and more than half(52.3 %) were male. Of the 107 patients, 90 (84.1%) patients received 10mg of clinidipine. On follow up, all patients except three (2.8%) had resolution of pedal edema. The blood pressure reduction with clinidipine was comparable with amlodipine (p: >0.05). Three patients who had persistent edema on follow up were on higher dose of clinidipine. Conclusions: The newer L and N type CCB, Clinidipine has comparable efficacy with amlodipine and well tolerated in our population. Though the incidence of pedal edema is low but can occur with clinidipine especially with higher doses. Keywords: Amlodipine; ankle edema; clinidipine; hypertension
Burn Care Service Training as a Public Health Intervention
Authors: Rai Shanker Man
Published: November 2024

Burn injury is more common with low economic strata requiring holistic approach and support from multiple stake holders including the government to deal with this disability. Burn injury care is the specialized surgical service to be provided by highly trained human resource which can involve multiple specialist services, special care in a specialized burn center, special transportation service and financial coverage.Keywords: burn injury; care; cost; training
Factors Associated With Utilization of Institutional Delivery Service during Covid-19 Pandemic
Authors: Dhakal Radha Devi , Nepal Shobhana , Thapa Namuna , Sapkota Sushma , KC Sita , Adhikari Prativa
Published: November 2024

Background: The utilization of institutional delivery services is pivotal to improve maternal health and reducing maternal mortality amid childbirth. But COVID-19 pandemic is posturing considerable challenges to maintain essential maternal and newborn health services. So study aims to assess the factors associated with the utilization of institutional delivery during the COVID -19 pandemic. Methods: Data was collected from the 116 mothers of Kalika Municipality, Chitwan. The total enumerative sampling technique was used to include mothers who delivered a baby during lockdown (March 21 to August 21, 2020). Collected data were analysed by using descriptive and inferential statistics like chi-square test, logistic regression analysis.Results: Out of 116 mothers, 76.6% had their delivery in the health facilities. Logistic regression analysis showed several factors associated with utilization of institutional delivery such as ethnicity, respondents education status, distance to the nearest health facility, fear of traveling, fear to visit health facility (AOR= 4.923; 95% CI =1.475-16.432, p=0.001),perception on the risk of covid-19 to mother, and intrauterine transmission of COVID-19 (AOR= 19 5.472;95% CI 1.35-22.175;p= 0.017) was found to be statistically significant with the utilization of institutional delivery during COVID-19 pandemic.Conclusions: Several factors have been associated with the utilization of institutional delivery during pandemic. Women preferred not to seek healthcare due to the fear of being infected, lack of awareness, and misperception about COVID-19 and pregnancy. Therefore, the concerned authority should need to deliver a separate message to the pregnant women for a regular check-up and deliver a baby at a hospital.Keywords: COVID-19 pandemic; institutional delivery; and utilization