bluuebunny/crossref_metadata_2025 huggingface dataset:
Validation of Nepalese Version of Utrecht Work Engagement Scale
Authors: Panthee Bimala , Shimazu Akihito , Kawakami Norito
Published: September 2014

Validation of Nepalese Version of Utrecht Work Engagement Scale: Bimala PANTHEE, et al. Department of Psychiatric Nursing, Graduate School of Medicine, The University of Tokyo—

Objective

The objective of the current study was to examine the psychometric properties of the Nepalese version of the Utrecht Work Engagement Scale (UWES‐N) in a sample of hospital nurses.

Method

Registered nurses from three hospitals in Nepal (total N=438) voluntarily completed a self‐administered paper‐ and‐pencil questionnaire.

Results

Confirmatory factor analysis revealed that the hypothesized three‐factor model of the 9‐item version of the UWES‐N (UWES‐N‐9) fitted the data best. The internal consistency of the scale was acceptable. Work engagement was positively related to job satisfaction, job performance, happiness and health, and it was negatively related to psychological distress, confirming its construct validity.

Conclusions

In conclusion, the findings of our study indicated that the UWES‐N‐9 has satisfactory psychometric properties and provided supportive evidence for use of the UWESN‐9 in the Nepalese context.
Validation of a 15‐item Care‐related Regret Coping Scale for Health‐care Professionals (RCS‐HCP)
Authors: Courvoisier Delphine Sophie , Cullati Stephane , Ouchi Rieko , Schmidt Ralph Eric , Haller Guy , Chopard Pierre , Agoritsas Thomas , Perneger Thomas V.
Published: September 2014

Validation of a 15‐item Care‐related Regret Coping Scale for Health‐care Professionals (RCS‐HCP): Delphine Sophie COURVOISIER, et al. Department of Psychology, Harvard University, USA—

Objectives

Coping with difficult care‐related situations is a common challenge for health‐care professionals. How these professionals deal with the regrets they may experience following one of the many decisions and interventions they must make every day can have an impact on their own health and quality of life, and also on their patient care practices. To identify professionals most at need for extra support, development and validation of a tool measuring coping style are needed.

Methods

We performed a survey of physicians and nurses of a French‐speaking University hospital; 469 healthcare professionals responded to the survey, and 175 responded to the same survey one‐month later. Regret was assessed with the regret coping scale developed for this study, self‐report questions on the frequency of regretted situations and the intensity of regret. Construct validity was assessed using measures of health‐care professionals' quality of life (including job and life satisfaction, and self‐reported health) as well as sleep problems and depression.

Results

Based on factor analysis and item response analysis, the initial 31‐item scale was shortened to 15 items, which measured three types of strategies: problem‐focused strategies (i.e., trying to find solutions, talking to colleagues) and two types of emotion‐focused strategies, A (i.e., self‐blame, rumination) and B (e.g., acceptance, emotional distance). All subscales showed high internal consistency (α>0.85). Overall, as expected, problem‐focused and emotion‐focused B strategies correlated with higher quality of life, fewer sleep problems and less depression, and emotion‐focused A strategies showed the opposite pattern.

Conclusions

The regret coping scale (RCS‐HCP) is a valid and reliable measure of coping abilities of hospital‐based health‐care professionals.
Sb2S3/SnSe thin film solar cells by thermal evaporation
Authors: Escorcia-García José , Barrios-Salgado Enue , Nair M.T.S. , Nair P.K.
Published: September 2014

We report a stable CdS/Sb2S3/SnSe heterojunction thin film solar cell deposited on SnO2:F (FTO) – coated glass substrates. Thermal evaporation at 10-5 Torr with substrate temperature of 400 °C was used to deposit Sb2S3 and SnSe thin films of 450 nm and 160 nm, respectively. Thin film Sb2S3 has an optical band gap (Eg) of 1.48 eV and photoconductivity (σp) of 4x10-7 Ω-1 cm-1 and thin film SnSe has an Eg of 1.28 eV and σp of 2 Ω-1 cm-1. The chemically deposited CdS thin film heated at 400 °C shows an Eg of 2.34 eV and σp of 0.1 Ω-1 cm-1. Stabilized solar cell structures with these thin films, FTO/CdS/Sb2S3/SnSe/C-Ag, showed open circuit voltage (Voc) of 0.60 V, short circuit current density (Jsc) of 5.51 mA/cm2 and power conversion efficiency (η) of 0.96% with a fill factor FF of 0.29. In the absence of the SnSe layer, Jsc decreases to 4.77 mA/cm2.
Silver antimony sulfide-selenide for thin film solar cells
Authors: Capistrán-Martínez Jesús , Nair M.T.S , Nair P.K.
Published: September 2014

Thin films of AgSbS2 (150 nm) are prepared (75 min at 40 °C) via chemical deposition using a solution mixture containing SbCl3, Na2S2O3 and AgNO3. As-deposited films are amorphous. When they are heated in nitrogen at 180-320 °C, crystalline cubic-AgSbS2 films are formed. They show an optical band gap 1.89 eV and photoconductivity 1.8x10-5 Ω-1cm-1. Silver antimony sulfide-selenide film, AgSb(SxSe1-x)2, is produced from the initial amorphous film when it is heated in presence of Se-vapor. XRD analysis confirms the formation of solid solution AgSbS1.25Se0.75 or AgSbSe2 depending on the extent of Se-vapor available during heating. SnO2:F/CdS/AgSbS2/C solar cell shows Voc 610 mV, Jsc 0.88 mA/cm2,FF 0.53 and η 0.28%. In SnO2:F/CdS/Sb2S3/AgSb(SxSe1-x)2/C solar cell, Voc is 582 mV, Jsc 0.99 mA/cm2, FF 0.51 and η 0.29%.
Effects of Annealing on Structural and Optical Properties of ZnO Nanowires
Authors: Mazady Anas , Rivera Abdiel , Anwar Mehdi
Published: September 2014

We report, for the first time, effects of annealing of ZnO NWs grown on p-Si substrates. ZnO NWs are grown using metalorganic chemical vapor deposition (MOCVD) and thermal annealing was performed in situ under nitrogen ambient at different stages of the growth process. Increasing the annealing temperature of the ZnO seed epi-layer from 635 °C to 800 °C does not affect the morphology of the grown NWs. In contrast, annealing the NWs themselves at 800 °C results in a 48% decrease of the surface area to volume ratio of the grown NWs. The optical quality can be improved by annealing the seed layer at a higher temperature of 800 °C, although annealing the NWs themselves does not affect the defect density.
Cobalt oxide-tungsten oxide nanowire heterostructures: Fabrication and characterization
Authors: Chopra Nitin , Li Yuan , Kumar Kuldeep
Published: September 2014

Nanowire heterostructures comprised of cobalt oxide and tungsten oxide were fabricated in a core/shell configuration. This was achieved by sputter coating tungsten oxide shells on standing cobalt oxide nanowires on a substrate. To ensure the polycrystallinity of tungsten oxide shell, the nanowire heterostructures were subjected to post-sputtering annealing process. The cobalt oxide nanowires for this study were grown employing a thermal method via vapor-solid growth mechanism. The crystal structures, morphologies, dimensions, and phases at various growth stages of nanowire heterostructures were studied using high resolution electron microscopy, energy dispersive spectroscopy, and X-ray diffraction methods. The interfaces of these nanowire heterostructures were also studied and showed variation in the lattice spacing across the heterostructure diameter. Results indicated that the cobalt oxide nanowires survived multiple processing steps and resulted in stable heterostructure configurations. The investigation shows, for the first time, a dry processing route for the formation of such novel nanowire heterostructures.
Photoactivated Metal-Oxide Gas Sensing Nanomesh by Using Nanosphere Lithography
Authors: Ho Yu-Hsuan , Lin Tsu-Hung , Chen Yi-Wen , Tian Wei-Cheng , Wei Pei-Kuen , Sheen Horn-Jiunn
Published: September 2014

A photoactivated ZnO nanomesh with precisely controlled dimensions and geometries is fabricated by using nanosphere lithography process. The nanomesh structures effectively increase the surface-to-volume ratio to improve the sensing response under the same testing gas. And the periodical nanostructures also increase the effective light path and lead to more efficient light activation for gas sensing. With the increase of the photoinduced oxygen ions by UV illumination, a distinguished sensing response is observed at room temperature. In the optimized case, the sensing response (△R/R0) of the ZnO nanomesh at the butanol concentration of 500 ppm is 97.5%, which is 4.54 times higher than the unpatterned one.
Synthesis of Imprinted Polysiloxanes for Immobilization of Metal ions
Authors: Mujahid Adnan , Amin Faisal , Hussain Tajamal , Iqbal Naseer , Shah Asma Tufail , Afzal Adeel
Published: September 2014

Imprinting is a well-established technique to induce recognition features in both organic and inorganic materials for a variety of target analytes. In this study, ion imprinted polysiloxanes with varying percentage of coupling agent i.e. 3-chloro propyl trimethoxy silane (CPTM) were synthesized by sol-gel method for imprinting of Cr3+. The imprinting of Cr3+ in cross-linked siloxane network was investigated by FT-IR which indicates the metal ion is coordinated with oxygen atoms of polysiloxanes. SEM images revealed that imprinted polysiloxanes possess uniform particles of submicron size. It was experienced that by increasing the concentration of CPTM up to 10% (v/v) substantially improves the binding capacity of polysiloxanes which allows us to recognized Cr3+ down to 50µg/L. Furthermore, the selectivity of Cr3+-imprinted polysiloxanes was evaluated by treating them with other competing metal ions of same concentration i.e. Cr6+, Pb2+ and Ni2+. In this regard, polysiloxanes showed much higher binding for imprint ion i.e. Cr3+ in comparison to above mentioned metal ions. Finally, the regenerated polysiloxanes were studied in order to reuse them thus, developing cost effective biomimetic sensor coatings.
An Analytic Toolbox for Simulated Filament Networks
Authors: Pandolfi Ronald J. , Edwards Lauren , Hirst Linda S.
Published: September 2014

Semi-flexible polymer networks generate a diverse family of structures. The network generating behaviors of specific semi-flexible biological filaments are well known (i.e. F-actin, microtubules, DNA etc.), however recent developments in tunable synthetic filaments extend the range of accessible structures. A similarly tunable model was developed using the molecular dynamics platform NAMD to provide a guide for generating synthetic filament networks. Structural characteristics of simulated networks may be quantitatively examined using connectivity analysis, radial pair distribution functions and scaling analysis. These methods provide a basis to calculate morphological properties, including mesh size, packing order, network connectivity, avg. cluster size, filaments per bundle, and space-filling dimensionality. An analytic toolset for describing the structure of filament networks is thus provided by detailing these methods.
Ion-Beam Modification of Colloidal Silica Particle Masks to Tailor the Size of Ordered Arrays of Ag Nanostructures Produced by Nanosphere Lithography
Authors: Reséndiz Eder , Morales Ulises , Salinas Cecilia , Graniel Octavio , López L.M. , Cheang-Wong Juan-Carlos
Published: September 2014

Spherical submicrometer-sized silica particles were prepared by the sol-gel method and deposited as a monolayer onto silicon wafers, in order to use them as a mask to create regular arrays of nanoscale surface features. Thus, by e-gun evaporation of a 50 nm thick Ag film through the silica mask, Ag nanostructures were obtained after removal of the silica monolayer. In order to tailor the mask characteristics (size and interparticle spacing), the silica masks were irradiated at room temperature with 4 and 6 MeV Si ions at different fluences up to 5×1015 ion/cm2, perpendicularly to the sample surface. After the irradiation the silica particles turned into oblate particles, as a result of the increase of the particle dimension perpendicular to the ion beam and the decrease in the parallel direction. By this way, the mask openings of the silica particle monolayer were modified as a function of the irradiation parameters, and the subsequent Ag e-gun evaporation allowed the formation of ordered arrays of Ag features. The size, shape and interparticle spacing of both the silica particles and the Ag deposits were determined by scanning electron microscopy.
Ventriculolumbar Perfusion Chemotherapy With Methotrexate for Treating Leptomeningeal Carcinomatosis: A Phase II Study
Authors: Gwak Ho-Shin , Joo Jungnam , Shin Sang-Hoon , Yoo Heon , Han Ji-Youn , Kim Heung Tae , Yun Tak , Ro Jungsil , Lee Jin Soo , Lee Seung Hoon
Published: September 2014

Background.

The efficacy of ventriculolumbar perfusion (VLP) chemotherapy with methotrexate (MTX) was evaluated for treatment of leptomeningeal carcinomatosis (LMC).

Methods.

The primary outcome was the response rate of increased intracranial pressure (ICP), which was available for comparison from historical data on conventional intraventricular chemotherapy. Secondary endpoints were response rates of other LMC symptoms and overall survival of patients. Artificial cerebrospinal fluid (CSF) premixed with MTX was continuously perfused intraventricularly through a preinstalled intraventricular reservoir and drained via lumbar catheter for 72 hours. The VLP was repeated twice at 3-day intervals for each cycle.

Results.

Forty-five of 65 patients had increased ICP, and 32 patients (71%) showed response after VLP chemotherapy, including 31 patients with normalization of ICP. Altered mentation improved in 7 of 21 patients (33%). Cauda equina symptoms responded in 5 of 27 patients (19%), including 4 patients who became ambulatory from a bedridden state. Median overall survival was 187 days, and the 1-year survival rate was 27%. All side effects, including nausea, vomiting, confusion, and sleep disturbance, were tolerable and transient except for two cases of CSF infection.

Conclusion.

VLP chemotherapy with MTX provided better control of increased ICP, improved symptom response, and prolonged survival at a cost of acceptable toxicity in patients with LMC.
Preoperative Chemotherapy in Patients With Intermediate-Risk Rectal Adenocarcinoma Selected by High-Resolution Magnetic Resonance Imaging: The GEMCAD 0801 Phase II Multicenter Trial
Authors: Fernandez-Martos Carlos , Brown Gina , Estevan Rafael , Salud Antonieta , Montagut Clara , Maurel Joan , Safont Maria Jose , Aparicio Jorge , Feliu Jaime , Vera Ruth , Alonso Vicente , Gallego Javier , Martin Marta , Pera Miguel , Sierra Enrique , Serra Javier , Delgado Salvadora , Roig Jose V. , Santos Jesus , Pericay Carles
Published: September 2014

Background.

The need for preoperative chemoradiation or short-course radiation in all T3 rectal tumors is a controversial issue. A multicenter phase II trial was undertaken to evaluate the efficacy and safety of neoadjuvant capecitabine and oxaliplatin combined with bevacizumab in patients with intermediate-risk rectal adenocarcinoma.

Methods.

We recruited 46 patients with T3 rectal adenocarcinoma selected by magnetic resonance imaging (MRI) who were candidates for (R0) resection located in the middle third with clear mesorectal fascia and who were selected by pelvic MRI. Patients received four cycles of neoadjuvant capecitabine and oxaliplatin combined with bevacizumab (final cycle without bevacizumab) before total mesorectal excision (TME). In case of progression, preoperative chemoradiation was planned. The primary endpoint was overall response rate (ORR).

Results.

On an intent-to-treat analysis, the ORR was 78% (n = 36; 95% confidence interval [CI]: 63%–89%) and no progression was detected. Pathologic complete response was observed in nine patients (20%; 95% CI: 9–33), and T downstaging was observed in 48%. Forty-four patients proceeded to TME, and all had R0 resection. During preoperative therapy, two deaths occurred as a result of pulmonary embolism and diarrhea, respectively, and one patient died after surgery as a result of peritonitis secondary to an anastomotic leak (AL). A 13% rate of AL was higher than expected. The 24-month disease-free survival rate was 75% (95% CI: 60%–85%), and the 2-year local relapse rate was 2% (95% CI: 0%–11%).

Conclusion.

In this selected population, initial chemotherapy results in promising activity, but the observed toxicity does not support further investigation of this specific regimen. Nevertheless, these early results warrant further testing of this strategy in an enriched population and in randomized trials.
My Father's Final Lesson
Authors: Dizon Don S.
Published: September 2014

Studies have shown that during residency and training, less than half of clinicians are comfortable with, let alone knowledgeable about, delivering bad news. As attendings, we should not rob our patients of the time at the end of life, the opportunity for closure, and the chance to say what needs to be said.
Curvature-relevant analysis of eccentrically loaded circular concrete-filled steel tube columns
Authors: Ouyang Yi , Ho Johnny Ching Ming
Published: September 2014

The existence of curvature can reduce the effective confining pressure within concrete-filled steel tube (CFST) columns under eccentric compression. The existing analysis method ignores such an effect and still treats the confining pressure as constant across the whole section as if it is under axial compression. In this paper, the authors have made significant improvements on the existing model, so that the curvature effect can be taken into account to properly interpret the non-linear behaviour of eccentrically loaded CFST columns. Meanwhile, shortening between two hinges is an important data output in test programmes of this type, which has been completely neglected by the existing analysis method. This improved method also provides calculation steps to track the value of shortening for each load increment. Unknown parameters in this new method are determined on the basis of data fitting of 87 specimens from previous researchers' test programmes. The following parameters are incorporated in this study: effective tube length (660–4670 mm), diameter of tube (76–600 mm), tube thickness (1·52–8·81 mm), yield strength of tube (256·4–517·0 MPa), cylinder strength of concrete (26·42–112·70 MPa) and eccentricity (9·4–300 mm). The load–axial displacement, load–deflection and moment–curvature curves predicted by the new method agree well with their measured counterparts in the tests.
Experiments on RC Y-shaped connections in diagonal grid structures
Authors: Zhou Wei , Zhang Jianxin , Cao Zhenggang
Published: September 2014

In high-rise diagonal grid structures, the Y-shaped connections play a key role in transferring the diagonal members of upper stories to the lower columns. Four reinforced concrete Y-shaped specimens were designed based on two factors: the volumetric ratio of stirrups in the joint zone and the material strength of the inclined members. They were then tested from loading to failure. The reduction coefficient of stirrups was defined and determined, leading to proposed design recommendations and expressions for determining the load-bearing capacity of reinforced concrete Y-shaped connections.
Changing dynamic of bridge aerodynamics
Authors: Kareem Ahsan , Wu Teng
Published: September 2014

The assurance of safety and reliability of long-span bridges under winds requires the accurate modelling of wind-induced effects. In this study, the existing conventional linear and non-linear models of bridge aerodynamics are first systematically reviewed with a focus on the study of the relationships among them. After highlighting the shortcomings of conventional models, three advanced non-linear models, based on artificial neural networks, non-linear moving average (within the framework of Volterra theory) and Volterra series, are introduced. Example applications of linear and non-linear analysis schemes are presented, underscoring the changing dynamic of bridge aerodynamics under smooth and turbulent wind conditions.
Making Each Other’s Daily Life: Nurse Assistants’ Experiences and Knowledge on Developing a Meaningful Daily Life in Nursing Homes
Authors: James Inger , Fredriksson Carin , Wahlström Catrin , Kihlgren Annica , Blomberg Karin
Published: September 2014

Background

In a larger action research project, guidelines were generated for how a meaningful daily life could be developed for older persons. In this study, we focused on the nurse assistants’ (NAs) perspectives, as their knowledge is essential for a well-functioning team and quality of care. The aim was to learn from NAs’ experiences and knowledge about how to develop a meaningful daily life for older persons in nursing homes and the meaning NAs ascribe to their work.

Methods

The project is based on Participatory and Appreciative Action and Reflection. Data were generated through interviews, participating observations and informal conversations with 27 NAs working in nursing homes in Sweden, and a thematic analysis was used.

Result

NAs developed a meaningful daily life by sensing and finding the “right” way of being (Theme 1). They sense and read the older person in order to judge how the person was feeling (Theme 2). They adapt to the older person (Theme 3) and share their daily life (Theme 4). NAs use emotional involvement to develop a meaningful daily life for the older person and meaning in their own work (Theme 5), ultimately making each other’s daily lives meaningful.

Conclusion

It was obvious that NAs based the development of a meaningful daily life on different forms of knowledge: theoretical and practical knowledge, and practical wisdom, all of which are intertwined. These results could be used within the team to constitute a meaningful daily life for older persons in nursing homes.
Comparison of sources of urban ambient particle bound PAHs between non-heating seasons 2009 and 2012 in Belgrade, Serbia
Authors: Cvetkovic Anka , Jovasevic-Stojanovic M. , Matic-Besarabic S. , Markovic D.A. , Bartoňová A.
Published: September 2014

Exposure to increased cconcentrations of polycyclic aromatic hydrocarbons
(PAHs) is associated with adverse health problems and specifically with
carcinogenic and mutagenic effects. The major PAH sources outdoors are:
stationary sources from industry (power plants, incineration, local industry)
and domestic sources as the residential heating, burning and pyrolysis of
coal, oil, gas, garbage, wood, or other organic substances mobile emissions
(diesel and petrol engines), biomass burning and agricultural activities
(e.g., open burning of brushwood, straw, stubble). The aim of this study was
to assess potential differences in particle-bound PAH levels and source
contribution between summer 2009 and 2012 sampling campaigns done at same
location in Belgrade urban area. The sampling location is considered
representative for a mix of residential, business and industrial areas of New
Belgrade, an urban area that has been under rapid development. The average
concentrations of PM10 are slightly higher in summer 2012 than in 2009.
PM-bound PAH follow the same trend as the PM indicating an increasing
strength of PAH sources relative to all PM sources. Appling Positive Matrix
Factorization, three potential sources of PAHs in the atmosphere were
distinguished: (1) stationary sources, (2) traffic (diesel and gasoline
vehicle exhaust) and (3) local open burning sources (OBS). The analysis
confirmed higher contribution of traffic and lower of OBS in summer 2012 than
in 2009, reflecting higher traffic volumes and absence of or lower local OBS
emissions due to burning wood, grass and domestic waste in 2012.
Ethics in Undergraduate Medical Courses in Nepal
Authors: Adhikari RK
Published: September 2014

No Abstract AvailableDOI: http://dx.doi.org/10.3126/kumj.v11i1.11014 Kathmandu University Medical Journal Vol.11(1) 2013: 1-3
Benign Sinonasal Masses: A Clinicopathological and Radiological Profile
Authors: Nepal A , Chettri ST , Joshi RR , Karki S
Published: September 2014

Background Benign nasal and paranasal sinus masses are commonly encountered in clinical practice. Though benign, certain nasal polyps, fungal sinusitis, hemangiomas and fibro-osseous tumors can present with locally destructive features and deformities, mimicking malignancies at once. Objective This study was carried out to recognize the great variety of benign nasal lesions and their frequency in our region. Methods A retrospective chart analysis of cases presenting as mass in nose and paranasal sinus that underwent surgery over three years duration at our institute was done. A provisional diagnosis was made after clinical assessment and radiological investigations, but the final diagnosis was established after histopathological examination. Results A total 331 cases presented as masses in nose and paranasal sinus presented during the period. The clinicopathological examination aided by endoscopic and imaging studies revealed the non neoplastic benign masses in 293 and neoplastic masses in 38. Polyps were the commonest lesions constituting 70% cases followed by rhinosporidiosis in 10%. Fungal sinusitis, squamous papillomas, hemangiomas and inverted papillomas were found to be in order of 4.5%, 4%, 3.5% and 3% respectively. Rare cases like “rhino-oto-cereberal” form of mucormycosis, angiomyoma, and psammomatoid ossifying fibroma were also observed in the study. Conclusion Most of the nasal polyps/fungal sinusitis can be diagnosed clinically. However many a times Computer tomography (CT) scan and biopsy are necessary to differentiate them from each other and treatment plan. Certain benign tumors have high potential for malignant transformation while others can present with locally destructive features and deformities. DOI: http://dx.doi.org/10.3126/kumj.v11i1.11015 Kathmandu University Medical Journal Vol.11(1) 2013: 4-8
Thyroid Hormone levels in Highlanders- A Comparison Between Residents of Two Altitudes in Nepal
Authors: Nepal O , Pokharel BR , Khanal K , Gyawali P , Malik SL , Koju R , Kapoor BK
Published: September 2014

Background The endocrine changes related to altitude adaptation in human have attracted physiologists around the globe for long. A number of high altitude studies to detect the physiological changes have been performed now and then. But, the study to see the hormonal changes to compare populations residing at different high altitudes is a scarce. Hence, we have performed a study in native populations of different high altitude comparing changes in thyroid hormones in western Nepal. The Jharkot population included in this study is at altitude of 3760m and Jomsom population at 2800m height from sea bed. Objective The study is to compare changes in thyroid hormones at two different high altitude natives. Methods To compare thyroid status between high altitude natives at two different altitudes a cross sectional study is performed by random sampling method. The blood sample was collected in a vacutainer from fifty eight individuals after obtaining the informed consent of participants. The blood collected from antecubital vein was centrifuged in an hour and the serum obtained was used for biochemical analysis of free triiodothyronine, free thyroxine and thyroid stimulating hormone. Results Mean free thyroxine (fT4) of Jharkot population is significantly larger (p = 0.001) than Jomsom population. Mean thyroid stimulating hormone (TSH) with p = 0.597, does not indicate the difference between this two population. There is no significant difference between mean free triiodothyronine (fT3) of Jharkot and Jomsom population (p = 0.345). Conclusion The rise in free thyroid hormone at high altitude is not dependent on the thyroid stimulating hormone released from anterior pituitary. The rise in free thyroxine is found at higher altitude and no difference in fT3 level is detected in population studied at high altitudes. DOI: http://dx.doi.org/10.3126/kumj.v11i1.11017 Kathmandu University Medical Journal Vol.11(1) 2013: 18-21
Inter-Relationship Between Rheumatoid Arthritis and Periodontitis
Authors: Rajkarnikar J , Thomas BS , Rao SK
Published: September 2014

Background Periodontal medicine defines a rapidly emerging branch of Periodontology focusing on establishing a strong relationship between periodontal health and systemic health. It is speculated that the major common dysregulation which links Periodontitis with Rheumatoid arthritis (RA) is being played by the mediators of immune inflammatory response. Objectives To determine whether there is any relationship between periodontal disease and Rheumatoid arthritis. Methods A total of 100 patients were included for the present study which was divided into two groups: one group (cases) included 50 patients attending the Department of Orthopedics, Kasturba Medical College, Manipal who were diagnosed of Rheumatoid arthritis. Another subject population included 50 patients as controls attending the Department of Oral Medicine, Manipal College of Dental Sciences, Manipal with age and gender matched with those of rheumatoid arthritis group. Specific measures for periodontitis included plaque index, gingival index, number of missing teeth, and radiographic alveolar bone loss scores. Measures of rheumatoid arthritis included health assessment questionaires, levels of C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR). Various periodontal parameters were compared between the cases and controls. Results The average alveolar bone loss was statistically more severe in Rheumatoid arthritis (RA) group than in the controls although there were similar plaque index in both the groups. The gingival index was statistically higher in the RA group. The Erythrocyte Sedimentation Rate (ESR) and C- Reactive Protein (CRP) levels of RA patients were also significantly associated with the severity of periodontal disease. Conclusion There was a significant association between Rheumatoid arthritis and Periodontitis which may be due to a common underlying deregulation of the inflammatory response in these individuals. DOI: http://dx.doi.org/10.3126/kumj.v11i1.11018 Kathmandu University Medical Journal Vol.11(1) 2013: 22-26
Premarital Sex Behaviors Among College Youths of Kathmandu, Nepal
Authors: BC GB , Basel PL
Published: September 2014

Backgroud Unhealthy premarital sex behavior leads to several health problems namely; sexually transmitted diseases (STDs), Human Immune Virus and Acquired Immune Deficiency Syndrome (HIV/AIDS), unwanted pregnancies, abortions and maternal deaths. Unwanted pregnancies and unsafe abortions are rampant in Nepal despite introduction of legal provision for safe abortion since 2003. Lately, unsafe sex and sex without condoms and drinking before sex is increasing in trend in youth population. The primary aim of this study was to explore the factors associated with premarital sex behaviors. Objectives The main objective of the study was to identify the premarital sex behaviors and related factors among college youths in Kathmandu, Nepal. Methods Descriptive and explorative study of size 230 college youths aged between 18- 24 years. Data were collected by self-administered questionnaire from February 26 to March 15, 2012. The reliability of the questionnaire was ensured by using Cronbach’s alpha. Results Late youths of age 20-24 were more likely to experience premarital sex than early youths of age 18-19 years old. Urban youths were less involved in premarital sex behavior than rural youth. Youths having negative attitudes towards premarital sex were more likely to experience premarital sex than a positive attitude. Youths who had good relationship with their parents had less premarital sex experience than youths having poor relationship with their parents. Conclusion One fifth of college youth had premarital sex experience where alcohol drinker had higher premarital sex experience than non-drinker. Youths having good peer norms were significantly less likely to experience premarital sex behaviors than youths having poor peer norms. DOI: http://dx.doi.org/10.3126/kumj.v11i1.11019 Kathmandu University Medical Journal Vol.11(1) 2013: 27-31
Smoking Habit among Male Medical and Dental Students of B.P.Koirala Institute of Health Sciences, Nepal
Authors: Sharma A , Sharma B , Niraula SR , Devkota S , Pradhan PMS
Published: September 2014

Background Smoking and health are intimately related and thus, smoking among future health care personnel is an important issue. As future physicians and dentists who will witness the continued burden of smoking-related diseases among their patients, represent a primary target for smoking prevention programs. Objectives To explore the magnitude of smoking problem and assess the major causes aggravating the burden of smoking among medical and dental students. Methods A cross sectional study was conducted between June and July 2009 among 345 medical and dental students. Pre-tested self-administered questionnaire containing questions regarding smoking and its various correlates were used to collect the data. Chi square test was used for testing hypothesis. Results Prevalence of smoking was estimated as 38.4%, among whom majority started smoking during 15 to 19 years of life. Peer pressure was the major cause behind smoking (29.5%). Nearly one third of the participants used to consume alcohol along with smoking. Presence of parental smoking and use of other drugs were significantly associated with smoking among the students. Conclusion Tobacco smoking is a significant health problem among the male medical and dental students. Medical and dental students were approached as they are the treatment providers for smoking and disease related to it in the future. The results in our study are discouraging and reveal that the medical knowledge regarding ill effects of smoking has not been able to check its use. DOI: http://dx.doi.org/10.3126/kumj.v11i1.11020 Kathmandu University Medical Journal Vol.11(1) 2013: 32-36
Gnathic Osteosarcoma: A Retrospective Analysis over a 20 Year Period
Authors: Prabhu S , Jose M , Iyengar S
Published: September 2014

Background Osteosarcomas are very rare malignant mesenchymal neoplasms affecting jaw bones. Only few studies are reported about this lesion in this particular region. Objective We wanted to assess the demography and tumor behaviour and histopathological pattern, retrospectively in the available cases. Methods A retrospective analysis of hospital records for 20 years was carried out. Clinical features, radiographic findings, histopathological details and treatment aspect of each of the lesions was considered. Results Findings of this study revealed only 13 cases of gnathic osteosarcomas, usually occurring in middle age, with equal sex predilection and predominantly seen in maxilla. Histopathologically, most of them belonged to osteogenic variant. Conclusion Only few cases of gnathic osteosarcomas are reported in this region mainly in the young males. Interestingly many of them has history of dental extraction before the onset of disease. DOI: http://dx.doi.org/10.3126/kumj.v11i1.11024 Kathmandu University Medical Journal Vol.11(1) 2013: 37-40
Awareness Regarding Preventive Measures of Avian Influenza Among the Adult People of Thimi Municipality, Nepal
Authors: Manandhar K , Chataut J , Khanal K , Shrestha A , Shrestha S , Shrestha S
Published: September 2014

Background Avian influenza is considered as a threat to global public health. Prevention and control depends on the awareness of the general population as well as high risk-groups. The avian influenza should be viewed more seriously because it may lead to pandemic influenza when the virus mutates its strain with the common human influenza. Thus, this study aims to explore the awareness regarding preventive measures of avian influenza among the adult population of Thimi Municipality. Objective The objective of this study was to explore awareness regarding preventive measures of avian influenza among the adult population of Thimi Municipality. Methods It is a cross-sectional, population based study. It was carried out in Thimi Municipality from May 15 to June 15, 2012. Pre tested structured questionnaire was used for face to face interview with randomly selected 250 subjects. Results Out of 250 subjects, 123 (49.2 %) were males. The mean age of subjects was 36 ± 11.8 year. Among total subjects, 94.4 percent had heard about avian influenza. The main source of information was television (94.1%). Majority of subjects (84.9 %) thought that keeping infected birds and poultry as the mode of transmission followed by eating not well cooked poultry meat (82.8 %). Out of total study subjects, 165 (66.0 percent) mentioned fever and 138 (55.2 percent) thought fatigue as the signs and symptoms. As for knowledge about preventive measures, majority (85.6%) stated that cleaning the surfaces that had come in contact with the poultry could prevent the disease and 83.2 % had knowledge that the infection could be prevented by washing hands with soap and water after poultry handling. Awareness regarding preventive measures was found significantly low in females, middle adults, illiterates, and house wives. Conclusion The awareness regarding avian influenza was quite satisfactory among the adult people of Thimi Municipality. However level of awareness was seen lower in female, illiterate and middle adult. So that along with large scale mass education, there should be specific health education program for the specific group of population. DOI: http://dx.doi.org/10.3126/kumj.v11i1.11026 Kathmandu University Medical Journal Vol.11(1) 2013: 45-49
Medication Adherence to Antiretroviral Therapy Among Patients Visiting Antiretroviral Therapy Center at Tribhuvan University Teaching Hospital, Kathmandu, Nepal
Authors: Sharma S , Khadga P , Dhungana GP , Chitrakar U
Published: September 2014

Background Although antiretroviral therapy has limited efficiency, patients should take multiple drugs in combination in prescribed time for lifelong and they should also require specific food and fluid restriction. Due to these and other factors patients may discontinue their medication and therefore face significant challenges in adherence. Objectives To assess factors associated with non-adherence among people living with HIV receiving the antiretroviral therapy. Methods Between July 2011 to January 2012, a cross sectional survey was conducted among patients visiting HIV/AIDS unit, Tribhuvan University Teaching Hospital for therapy. After taking informed consent, a pre-structured questionnaire was filled up and data were entered into SPSS 11.5 system and analyzed. Results Of the 100 studied subjects, 61 (61.0%) were male and 39 (39%) were female. Adherence was found to be 79%. The major barrier to adherence was reported to be simply forgetfulness (33.3% of those non adherents). Non adherence was significantly associated with types of family (X2 value, 7.11), smoking (X2 value, 5.44) and alcoholic habit (X2 value, 5.69) but not with gender (X2 value, 2.57). Besides this, poor economic status, and attendance to religious ceremony were reported to be major obstacles to adherence. Conclusion Adherence at this center was found to be only satisfactory. Forgetfulness was reported to be the major cause of non adherence. Persons living in joint family and those with alcoholic and /or smoking habit were more likely to miss the pills. It can be recommended that effective counseling, moral/financial support for HIV/AIDS patients may increase their adherence. DOI: http://dx.doi.org/10.3126/kumj.v11i1.11027 Kathmandu University Medical Journal Vol.11(1) 2013: 50-53
Factors Contributing to Antenatal Care and Delivery Practices in Village Development Committees of Ilam District, Nepal
Authors: Pradhan PMS , Bhattarai S , Paudel IS , Gaurav K , Pokharel PK
Published: September 2014

Background Proper antenatal care and good delivery practice helps to prevent the complications of childbirth and ensures a wholesome maternal and child health in the future. Almost half of the births in the developing countries take place without a skilled birth attendant. Objectives To assess the antenatal care (ANC) and delivery practices in the Village Development Committees (VDC) of Ilam district, Nepal and to identify the relationship with the socio-demographic factors. Method Cross sectional study of 262 mothers of reproductive age group having at least one child of less than five years of age, selected by simple random sampling, was carried out over different VDCs of Ilam by face to face interview using semi-structured questionnaire. Results Among 262 mothers, 34.7% were married before the age of 18 years. 69.5% of the mothers had attended four antenatal care visits. Nearly 47% of the deliveries were conducted at home out of which only 33.6% were conducted by skilled birth attendant. Number of children and maternal education were found to significantly affect the ANC visit and place of delivery. Age at marriage and age at first pregnancy were significantly associated with the place of delivery. Conclusion Large proportion of mothers still do not have adequate antenatal visits and this is supported by the fact that nearly half of the deliveries were conducted at home. Motivation and incentives are required for pregnant mothers especially in rural areas regarding importance of adequate antenatal visits and delivery in health institutions. Population policies should be aimed at reducing proportion of women marrying and giving birth in their teens. DOI: http://dx.doi.org/10.3126/kumj.v11i1.11029 Kathmandu University Medical Journal Vol.11(1) 2013: 60-65
Bacterial Isolates and its Antibiotic Susceptibility Pattern in NICU
Authors: Shrestha S , Shrestha NC , Dongol Singh S , Shrestha RPB , Kayestha S , Shrestha M , Thakur NK
Published: September 2014

Background Neonatal sepsis is one of the major causes of morbidity and mortality among the newborns in the developing world. Objectives To determine the common bacterial isolates causing sepsis in neonatal intensive care unit and its antibiotic susceptibility pattern. Methods A one year discriptive prospective study was conducted in neonatal intensive care unit to analyse the results of blood culture and to look into the sensitivity of the commonly used antibiotics. Results The blood culture yield by conventional method was 44.13% with nosocomial sepsis accounting for 10.79%. 84.08% were culture proven early onset sepsis and 15.95% were late onset sepsis. Klebsiella infection was the commonest organism isolated in early, late and nosocomial sepsis but statistically not significant. Gram positive organisms were 39.36% in which Staphylococcus aureus was the leading microorganism followed by coagulase negative staphylococcus areus. Gram negative organisms were 60.64% amongst them Klebsiella was the most often encountered followed by Pseudomonas. The most common organism Klebsiella was 87.5% and 78.3% resistance to ampicillin and gentamycin respectively. Among gram negative isolates 87.5% and 77.2% were resistance to ampicillin and gentamycin respectively. Among gram positive isolates 58.5% and 31.5% resistance were noted to ampicillin and gentamycin respectively. Resistance to cefotaxim to gram negative and gram positive isolates were 87.34% and 59.35% respectively. Conclusion Klebsiella is most common organism which is almost resistance to first line antibiotics. Resistance to both gram negative and gram positive isolates among firstline antibiotics and even with cefotaxim is emerging and is a major concern in neonatal intensive care unit. DOI: http://dx.doi.org/10.3126/kumj.v11i1.11030 Kathmandu University Medical Journal Vol.11(1) 2013: 66-70
Renal Impairment Among Patients With Pelvic Organ Prolapse in a Tertiary Care Center
Authors: Dongol A , Joshi KS , KC S
Published: September 2014

Background Pelvic organ prolapse is a multidimensional phenomenon. The manifestations of renal involvement following pelvic organ prolapse ranges from acute to chronic renal failure and may also lead to end stage renal failure. Prolonged duration and its severity in pelvic organ prolapse are responsible for renal impairment. Objectives This study will find out the incidence of renal impairment among women with pelvic organ prolapse undergoing surgical management. It will also help to establish the association of renal impairment with degree and duration of pelvic organ prolapse. Methods This prospective study includes cases of pelvic organ prolapse who underwent surgical management from the year 2009-2012 in Dhulikhel hospital. Total 140 cases were assessed with age, duration and different symptoms. Clinical examination was done to find out the degree of prolapse and graded according to Baden Walker classification. Urine routine and microscopic examination, renal function test and abdominopelvic sonography were performed routinely. Renal impairment was assessed using hydronephrosis and creatinine clearance. Creatinine clearance was calculated using patient’s weight and serum creatinine value by Cockcroft and Gault formula. Results Among 140 cases, 8 (5.7%) patients had procedentia, 106 (75.7%) had third degree, 22 (15.7%) had second degree, and four (2.8%) patients had first degree uterine prolapse. The mean duration of prolapse was found to be 11.47 years. Total 5 (3.57%) patients had hydronephrosis. Four had moderate and one had severe hydronephrosis. Total 49 (34.1%) patients had moderate to severe renal failure. Forty six (32%) in stage III moderate reduction in creatinine clearance, 2 (1.4%) with severe reduction and 1(0.7%) in end stage renal failure. Conclusion Renal impairment is a common entity among women with pelvic organ prolapse. Both hydronephrosis and degree renal impairment correlates correspondingly with the duration and severity of prolapse. DOI: http://dx.doi.org/10.3126/kumj.v11i1.11031 Kathmandu University Medical Journal Vol.11(1) 2013: 71-74
Basic Sciences: An Alternative career?
Authors: Khatri R
Published: September 2014

Career selection is a crucial and a complex process which is also true in the medical profession as well. In the context of our country, due to the limited opportunity and proper guidance, migration of medical graduates to foreign countries is increasing. Though, clinical subjects have a huge attraction, basic science field has failed to impress our medical graduates. In current scenario, basic science field seems to be a dumping site for the incompetent as the candidates who have failed trying their luck elsewhere stumble upon basic science careers though it is not true for all. Moreover, a very few medical graduates are interested in developing their career as a basic scientist. Therefore, to motivate today’s young medical graduates, there is a need of a good mentor along with a proper career guidance which can help them to understand the basic science field as an alternative career. DOI: http://dx.doi.org/10.3126/kumj.v11i1.11033 Kathmandu University Medical Journal Vol.11(1) 2013: 78-80
Cold Abscess of the Thigh in an Infant
Authors: Mishra D , Mohta A , Arora P
Published: September 2014

Local and minor adverse reactions to diphtheria–pertussis–tetanus (DPT) vaccination are usually mild and appear within 48 hours of vaccination. We herein report a rare association with intramuscular DPT injection and discuss pertinent issues. Primary tuberculous abscess was the final diagnosis. DOI: http://dx.doi.org/10.3126/kumj.v11i1.11035 Kathmandu University Medical Journal Vol.11(1) 2013: 86-87
Anterior Neck Lipoma with Anterior Mediastinal Extention – A Rare Case Report
Authors: Sharma BK , Khanna SK , Bharati M , Gupta A
Published: September 2014

Lipomas are the most common benign mesenchymal tumour. Thirteen percent of lipomas are seen in head and neck region. Anterior neck lipoma is a rare one. Anterior neck lipoma with mediastinal extension is extremely rare. We are presenting a case of 52 years old male reported to Central Referral Hospital, Sikkim Manipal Institute of Medical Sciences, Gangtok, Sikkim with complains of swelling in left side of neck for last 18 months along with occasional history of dyspnoea. Physical examination, ultrasound, computed tomography and fine needle aspiration cytology are in favor of lipoma. Due to its location up to the anterior mediastinum, the surgery could not be done in this hospital and patient was referred to higher center having cardio-thoracic surgical back up. DOI: http://dx.doi.org/10.3126/kumj.v11i1.11048 Kathmandu University Medical Journal Vol.11(1) 2013: 88-90