bluuebunny/crossref_metadata_2025 huggingface dataset:
Perceptions Towards Behavioral Finance Among Investors in Banking Industry: Evidence from Nepal Bank Limited
Authors: Amgain Pushpa Nidhi
Published: December 2024

The purpose of this article is to investigate the attitudes that investors in the banking industry have towards behavioural finance for the purpose of gathering evidence from Nepal Bank Limited. In collaboration with Nepal Bank Limited, the purpose of this study is to investigate the implications of behavioural biases on investment decisions in the banking business. In the context of rational investment decision making on the stock market, the investigation of cognitive biases and emotional biases is measured. After careful consideration, the ontological research philosophy that employs interpretivism research philosophy has been chosen. The researcher has been hired with a semi-structured interview with three investors in the banking business with reference to the Nepal Bank Limited. The data analysis has been done qualitatively using theme analysis. This article presents the findings of the interview. All of the codes were arranged into categories, and themes were discovered. According to the findings of the study, the most common types of behavioural biases that investors in the banking business exhibit are cognitive biases and emotional biases. The evidence for this was obtained from Nepal Bank Limited. Both fundamental and technical analysis were utilised to determine how the outcomes of the study influenced the NBL stock market. In doing so, it brought to light arbitrage possibilities that arise from the psychological and behavioural flaws of investors. These biases include representativeness, availability biases, optimism, overconfidence, and herding behaviour. Because of these biases, individual investors in Nepal Bank Limited were impacted in both their opinions and their behaviour. When it comes to the emotional biases, investors are impacted by psychological and mental accounting, ambiguity aversion, and self[1]control when it comes to making investment decisions in the banking business, as evidenced by Nepal Bank Limited (NBL). The focus of this study is on individual investors; however, it is possible that future research paths may concentrate on institutional investors in the banking industry, supported by evidence from Nepal Bank Limited.
Green Practices on Bank’s Environmental Performance
Authors: Chhetri Ashmita Dahal , Chhetri Guna Raj
Published: December 2024

The study examines the adoption of green banking practices among commercial banks in Chitwan and its impact on environmental performance. The researcher aims to assess the green banking practices employed by commercial banks, examining the relationship between these practices and bank performance, and analyse the impact of green banking on the perceived performance of commercial banks. The study employs an analytical research design to analyze the variables associated with green banking practices. The population comprises bankers from financial institutions across Chitwan, with a sample of 189 respondents selected through purposive sampling. Statistical tools were used to analyze the relationships between independent variables (employee-related practices, daily operation practices, customer-related practices, and bank policy-related practices) and the dependent variable (bank's environmental performance). The results showed that commercial banks in Chitwan generally have a positive view of their sustainability practices, with bank policy-relatedpractices showing the highest positive perception among employees. The study also found a positive correlation between green banking practices and environmental performance, with bank policy-related practices having the strongest relationship and customer-related practices the weakest. The study underscores the importance ofstrategic policy implementation and employee involvement in promoting sustainability within the banking sector.
Impact of Working Capital Management on Profitability of Bottler’s Nepal (Terai) Limited
Authors: Gupta Rajan Kumar
Published: December 2024

Working capital management (WCM) is a key part of figuring out how profitable a business is because it makes sure that present assets and expenses are used efficiently. Effective WCM is important for Bottler's Nepal Terai Limited to keep their cash on hand, make the best use of their goods, and keep track of their receivables and payables. All of these things have a direct effect on their business efficiency and profit margins. How well a company balances its working capital has a big impact on its profitability, which is a key measure of its financial health. The point of this study is to look into how WCM affects earnings at Bottler's Nepal Terai Limited. This will help us understand how good financial management can improve business performance. Nine (9) years of data (from 2015 to 2023) were used for this study. They looked at data from BOTTLER'S NEPAL (TERAI) LIMITED. The data came from yearly reports and was studied with statistical tools like mean, descriptive statistics, Pearson correlation, regression analysis, multicollinearity, and F-test. SPSS 21.0 versions were used to compute and handle all of the data that was gathered. Cash conversion period (CCP), Inventor Conversion period (ICP), Receivable conversion period (RCP), and Payable delayed period (PDP) are the independent factors that make up working capital. Return on assets (ROA) is the dependent variable. The number of R-square is 0.166, which can be seen in the model report. In other words, the four independent factors can explain around 16.6% of the changes in the dependent variable. But these independent factors still can't explain 83.4% of the changes that were looked at in this study. It seems that there is a strong connection between revenue (ROA) and PDP. On the other hand, it is clear that revenue and ICP, RCP, and CCP are not significantly linked.
Influence of Liquidity Management of Commercial Banks in Nepal Mini Chaurasia
Authors: Chaurasia Mini
Published: December 2024

The purpose of paper is impact of liquidity management and commercial banks' profitability in Nepal is examined in this study. Descriptive statistics, Pearson correlation, regression analysis, and the t-test were used to analyse the data. Three (3) samples that were used for the analysis covered the commercial banks in Nepal from 2014 to 2023. The factors of the Credit Deposit Ratio (CDR), Capital Adequacy Ratio (CAR), Current Reserve Ratio (CRR), and profitability, including Return on Assets (ROA), are all represented by liquidity management. With a R square value of 0.628, the study's results demonstrate a strong positive correlation between the dependent variable and the set of independent variables, with the independent variables accounting for 62.8% of the variation in the dependent variable and other variables outside the model for 37.2%. The findings indicated that while CAR had a little effect on the return on assets (ROA) of Nepal's commercial banks, CDR and CRR had a considerable influence.
Artificial Intelligence (AI) Role in Financial Literacy in the Banking Channels: Mobile Apps and Physical Branches
Authors: Rahman Abdul
Published: December 2024

The integration of Artificial Intelligence (AI) in the banking sector is transforming financial literacy initiatives by offering personalized, accessible, and interactive learning experiences. This study examines the impact of AI interventions on financial literacy improvement through a two[1]way ANOVA analysis, considering two independent variables: demographics (age groups) and banking channels (mobile apps vs. physical branches). Findings indicate significant improvements in financial literacy among younger users (18–35) and higher effectiveness of AI-driven tools in mobile apps compared to physical branches. Additionally, the interaction effect reveals that demographic-specific strategies are essential for maximizing AI's impact. This research underscores AI’s potential to bridge knowledge gaps and promote financial inclusion by tailoring educational tools to diverse customer needs.
Assessment of Dividend Payout Ratios in Nepalese Commercial Banks: A Buddhism Perspective
Authors: Bista Purushotam
Published: December 2024

Buddhism ethics in investment and profit distribution emphasize compassion, non-harm, ethical conduct, generosity, and avoidance of greed, guiding Nepalese banks toward balanced, sustainable, and ethical operations. The dividend payout ratio shows how much of a company's earnings after tax are distributed to shareholders, indicating profitability and boosting shareholder trust. The board of directors sets the dividend policy, including payment frequency and amount, based on company performance. The study titled, assessment of dividend payout ratios in Nepalese commercial banks from a Buddhist perspective analyzes three prominent banks (NBL, RBB, and ADB) from 2012/13 to 2021/22. These banks were chosen for their strong fundamentals and popularity among investors. The study used secondary data from annual reports and employed statistical and financial tools like descriptive statistics, correlation, and regression analysis to evaluate their performance and investment appeal. From a Buddhism perspective, the investment and dividend mechanisms should align with ethical considerations. The analysis shows that banks with higher growth and earnings per share tend to have higher dividend payouts, but the overall complexity and variability suggest that mindful and ethical financial decisions are crucial.
Relationship Between Money Supply and Economic Growth of Nepal: VECM Approach
Authors: Sigdel Sahadev
Published: December 2024

Several theories elucidate the correlation between money supply and gross domestic product (GDP). Money supply refers to the total amount of money in circulation within an economy, encompassing currency, printed notes, funds in deposit accounts, and other liquid assets. Assessing the valuation of money supply assists analysts and policymakers in formulating or adjusting monetary policies, whether to increase or decrease the money supply. This valuation is crucial as it directly influences the business cycle, thus impacting the overall economy. This study delves into the relationship between money supply and economic growth in Nepal from 1975 to 2021 using co-integration, VECM, and causality tests. ADF tests reveal non-stationarity at the level but stationarity at the first difference, affirming long-run equilibrium with a single error correction term. VECM analysis unveils a notable ECT coefficient (-1.095592, p-value: 0.0042), indicating adjustments from past year deviations at a rate of 0.42%. Short-term dynamics demonstrate varying significance levels, with money supply (M2) leading to GDP, GDP leading to private investment (PI), private consumption (PC) leading to GDP, money supply (M2) leading to private investment (PI), money supply (M2) leading to private consumption (PC), and private investment (PI) leading to private consumption (PC), all showing significant unidirectional causal relationships at the 5% level. The study proposes increasing the money supply as a means to attain higher and swifter economic growth in Nepal.
Enhancing Sequential Sentence Classification of Biomedical Abstracts Using Multilevel Embedding Approach Based on Deep Learning Methods
Authors: Karn Avijit , Sah Anand Kumar
Published: December 2024

Sequential sentence classification in natural language processing tasks has witnessed significant advancements with the integration of deep learning and transfer learning techniques. In this research, we study a deep learning model and investigate different components to study details on word-embedding adjustments, complexity challenges, and also misclassifications in abstract sectioning. We also propose a multilevel embedding approach with some modifications done in the model that addresses the contribution of additional layers present in the studied model. Multiple deep learning architectures based on character, token, and positional level embeddings are used to learn and obtain the final classification of sentences for a particular context in an abstract sequence. These models are trained on large-scale biomedical Randomized Controlled Clinical Trials (RCT) datasets to learn representations that capture domain-specific features. On validating and testing with the PubMed 20k dataset for all deep models, the Tribrid model performs significantly well with accuracy and precision of 0.856 and 0.854 respectively, which is also marginally good when compared to other baseline models. Experimental results demonstrate that the integration of multiple levels of embeddings leads to improved sequential classification performance as compared to using either embedding approach individually
Subaltern Voice and the Politics of Representation
Authors: Saradar Satya Narayan
Published: December 2024

Subaltern is a term coined after to discuss the state of marginalized and suppressed people existing in our society. They have been far away from the main stream discourse. They are fully controlled and suppressed by the elites. On the other hand, the subaltern has been the issued of various people to bring forward and create a ground for discussion. This term has come in existence since the postcolonial era. The wide discussion on subaltern has given a big platform to understand the underprivileged group. The society consists the subaltern but their voice is suppressed or they are totally ignored in mainstream discussion. Subalterns have been the stairs for the elites to grow and gain in the society. In the name of representation, again subalterns are dominated and others get benefitted.
Measurement of GPS Derived Precipitable Water Vapour (PWV) in Low and High Altitudes in Nepal
Authors: Saud Kuber , Sah Nabin , Ghimire Basu Dev , Khadka Balaram , Nagarkoti Shreeram , Pokheral Aakash , Chapagain Narayan Prasad
Published: December 2024

The study of Precipitable Water Vapour (PWV) using satellite data and ground-based observation is crucial for understanding hydrological processes, atmospheric circulation, and weather systems. It is considered the most prominent greenhouse gas in the Earth’s atmosphere. It is highly variable in both space and time across the Earth. Precipitable Water Vapor is a measure of the total amount of water vapour present in a vertical column of the atmosphere from the Earth’s surface to the top of it. This study investigates the potential atmospheric water vapour column at high (JMSM)and low(GRHI) to understand water vapour dynamics. To investigate precipitable water vapour, GNSS/GPS data were downloaded from UNAVCO SAGE. The downloaded data were processed and analyzed using GAMIT/GLOBK software which is a comprehensive GPS analysis package developed at the Massachusetts Institute of Technology (MIT), the Harvard-Smithsonian Center for Astrophysics (CfA), and the Scripps Institution of Oceanography (SIO). The main purpose of this software is to process data for Atmospheric science. This paper’s findings investigate the PWV amount in high and low altitudes over a year. Our finding shows that there is a significant difference in PWV levels between the two stations, with low-altitude areas exhibiting higher humidity and precipitation during the monsoon season, while high altitudes show reduced water vapour concentrations influenced by surrounding climatic variation.
Portraying my Research Journey from Positivist to Post-Modernist
Authors: Aryal Rameshower
Published: December 2024

This paper delves into the philosophical underpinnings of various educational research paradigms, spanning from Positivism to Post-Modernism. Through an exploration of the researcher's pedagogical journey, it aims to elucidate the interconnections between epistemology, ontology, axiology, and methodology within each paradigm. Beginning with Positivism, characterized by its emphasis on empirical observation and objective truths, the paper navigates through the evolution towards Post-Positivism, which acknowledges the role of subjectivity and context in knowledge production. Interpretivism is examined next, highlighting its focus on understanding the subjective meanings and interpretations individuals attach to their experiences. Criticalism emerges as a paradigm that critiques power structures and seeks to empower marginalized voices in research. Finally, the paper delves into Post-Modernism, which challenges grand narratives and embraces pluralistic perspectives. Each paradigm is illustrated with examples from the researcher's own experiences, demonstrating how research within each framework is justified and legitimized. Through this exploration, the paper contributes to a deeper understanding of the diverse philosophical perspectives that inform educational research methodologies.
Adherence to Antihypertensive Medications among Nepalese Hypertensive Patients at A Tertiary Care Hospital of Nepal
Authors: Palikhey Anjan , Jaisi Sandeep , Sharma Banjade Dilip , Thapaliya Ishwor , Shrestha Laxmi , Kumar Shrivastava Amit , Kandel Kamal
Published: December 2024

Background: Hypertension remains a significant public health concern globally, contributing to the burden of cardiovascular disease and associated morbidity and mortality. Effective management of hypertension often relies on adherence to antihypertensive medication regimens. However, non-adherence to prescribed medications presents a formidable challenge in achieving optimal blood pressure control and preventing complications. The main objective of this study was to find out the adherence to antihypertensive medication among Nepalese hypertensive patients at a tertiary care hospital. Methods: This analytical cross-sectional study was conducted at the outpatient department of medicine of UCMS-TH. A total of 384 participants were involved in the study, where the adherence rate to anti-hypertensive medication was collected using Morisky Medication Adherence Scale (MMAS-8). SPSS version 22 was used to record and analyze the data, and the descriptive results were presented as numbers and percentages. Chi-square test was used to determine the association between adherence and other variables at 95% confidence interval. Results: The study found a very high percentage (85.70%) of adherence to antihypertensive drugs. Forgetfulness was the major reason for the non-adherence 30(54.50%). Age group and educational status of the participants were significantly associated with adherence rate (p<0.05). Conclusion: The study revealed greater number of participants were adherent to antihypertensive medications which helps to better control blood pressure and reduce the risk of complications. Proper counseling can significantly increase the adherence rate.
Correlation of Ultrasonographic Findings with Estimated Glomerular Filtration Rate in Chronic Kidney Disease
Authors: Kharel Amrit , Shrestha Shreejana , Karki Dan Bahadur
Published: December 2024

Background: Chronic Kidney Disease (CKD) is a condition characterized by kidney damage for three or more months or Glomerular Filtration Rate (GFR) less than 60ml/minute/1.73m2 for three or more months with or without kidney damage. Ultrasonography is the noninvasive imaging modality to determine the renal morphology. The aim of this study was to find the correlation of ultrasonographic parameters with estimated Glomerular Filtration Rate (eGFR) in CKD patients visiting a tertiary hospital.Methods: This observational cross-sectional study was carried at Patan Hospital in thirty-five CKD diagnosed cases above the age of 18 years. Renal sonographic parameters like renal length, width, parenchymal thickness, and cortical echogenecity grade were obtained during ultrasonography. eGFR was calculated from CKD-EPI formula after obtaining serum creatinine. Ultrasonographic parameters were compared with eGFR using Spearman correlation test and Kruskal Wallis test was used to check difference in median eGFR among different echogenicity grades.Results: Statistically significant moderate positive correlation was seen between eGFR and parenchymal thickness (rs = 0.51, p<0.05) and eGFR and length (rs = 0.46, p<0.05) but weak positive correlation was seen between eGFR and width (rs = 0.3, p<0.05). A statistically significant relationship was also seen between eGFR and renal cortical echogenecity grade (p<0.05).Conclusion: Renal parenchymal thickness has maximum positive correlation with eGFR than other parameters to measure renal dimensions like renal length and width. Hence, renal parenchymal thickness is a better parameter to measure renal dimension in patients with CKD.
Understanding Physician Barriers in the Management of Lung Cancer in Nepal. Can Educational Intervention Make a Difference?
Authors: Shilpakar Ramila , Pandey Shama , Gurung Jasmine , Acharya Bibek
Published: December 2024

Background: Lung cancer is the leading cause of cancer morbidity and mortality in Nepal. A majority of patients present with advanced stage and some patients are never referred to an oncologist. Many factors contribute to this, including lack of oncology training and exposure. Herein, we evaluated the physician related factors contributing to the current scenario of lung cancer treatment in Nepal.Methods: A prospective survey in Internal Medicine programs across Nepal was performed. A structured, self-administered questionnaire focusing on physician’s behavior, practice, and attitude towards lung cancer was used. Results: Total 74 participants responded to the survey questionnaire. Only 3 out of 10 Internal Medicine programs had a compulsory oncology rotation. Multiple factors contributed to delay in diagnosis of lung cancer. 66 participants (91.6%) responded that they gave empirical anti-tubercular drugs (ATT) to patients with a non-resolving consolidative mass before they began evaluation for lung cancer; 22 % deferred CT scan before ATT. Multiple courses of antibiotics was a common practice in 62.5% participants. Misattribution of existing symptoms was common. 83.3% agreed that they treated smokers with respiratory symptoms initially as COPD with no consideration of lung cancer while 72.2% did not consider lung carcinoma in a middle-aged, never-smoker female with non-resolving consolidative mass. We also discovered that 36.1% of participants don’t refer elderly patients with lung cancer to an oncologist.Conclusion: Lung cancer remains a neglected disease in Nepal. There is an urgent need to overcome physician related barriers by oncology education for physicians and in training programs.
Clinico-Demographic Profile of Patients with Acute Coronary Syndrome Presenting to Emergency Department in a Tertiary Care Setting in Nepal
Authors: Mishra Deepak Kumar , Adhikari Sushil
Published: December 2024

Background: ACS patients in South Asia present approximately a decade earlier than their counterparts in developed nations due to the high prevalence of modifiable risk factors like hypertension, diabetes, and smoking. This study aimed to find the clinico-demographic profile of ACS patients in a tertiary care hospital in Nepal. Methods: A descriptive cross-sectional study was conducted retrospectively at Patan Hospital from July 2022 to July 2024. Data from 375 patients with ACS were reviewed, including age, sex, comorbidities, and coronary angiogram findings. The data were analyzed using descriptive statistics.Results: The mean age of patients was 60.81 ± 10.75 years, with 54.13% being male. Hypertension (30.67%) and diabetes (21.07%) were the most prevalent comorbidities. Coronary angiograms revealed normal arteries in 51.20% of patients, while 22.93%, 12%, and 9.97% had single-vessel disease (SVD), double-vessel disease (DVD), and triple-vessel disease (TVD), respectively. Management strategies included medical management for 57.87% of patients, while 39.47% underwent percutaneous coronary intervention (PCI).Conclusion: The majority of the subjects with acute coronary syndrome were middle-aged males. The burden of ACS was exacerbated by prevalent risk factors such as hypertension, diabetes, and smoking. Timely diagnosis and management of ACS, including early initiation of medical management and appropriate use of interventions like percutaneous coronary intervention (PCI).
Correlation of Serum Lipase Level and APACHE II Score in Predicting Outcomes in Patients with Acute Pancreatitis in Western Nepal
Authors: Timilsina Bishowdeep , Timilsina Babita subedi
Published: December 2024

Background: Acute pancreatitis (AP) is a disease with highly variable outcomes and high mortality rate. There are various sets of scoring systems and biomarkers to make prediction of its outcomes, but they have some drawbacks. This encouraged us to study on simple tests which would help in making diagnosis as well as act as an indicator of the outcomes in a patient with AP. The aim of this study is to correlate noble scoring system like Acute physiology and chronic health evaluation II (APACHE II) with serum lipase level in predicting outcomes in a patient with AP.Methods: Hospital based prospective descriptive study was done. The comparison of APACHE II score and Serum lipase level to predict the outcomes in terms of complications, length of hospital stay and in hospital mortality in AP was done using Pearson’s correlation, chi square test, Fischer’s exact test.Results: Of 90 patients, 37.78% had severe disease and 4.4 % died. APACHE II score had statistically significant correlation and association with length of hospital stay, complication and in hospital mortality (i. e. p<0.05). Serum lipase had no statistically significant correlation and association with Length of hospital stay (p=0.792), complications(p=0.379) and in hospital mortality(p=0.597).Conclusion: APACHE II can be used to predict the outcomes in the patients with AP. Serum lipase level cannot be used as a predictor of outcomes in AP although it is one of the noble biomarkers and for the diagnosis of AP and easily available in most of the health care centers.
A Knowledge on Non-Communicable Disease among Patient Visitors Attending to a Tertiary Level Hospital of Chitwan, Nepal
Authors: Dhakal Bijaya , Shrestha Laxmi , Paudel Madhumaya
Published: December 2024

Background: Non communicable diseases are a major contributor to the burden of disease in developed countries and are increasing rapidly in developing countries. This is mainly due to demographic transitions and changing lifestyle of population associated with urbanization. The impact of NCDs is devastating in term of premature morbidity, mortality, and economic loss. This study aimed to ware to find out the knowledge on non-communicable disease among patient visitors attending tertiary level hospital.Methods: A descriptive Cross sectional study design was used where122 patient visitors aged 24-44 years were purposively selected and enrolled in the study. Data were collected using face to face Interview questionnaire. Obtained data was analyzed in SPSS version 27 for window using descriptive and inferential statistics.Results: The finding of the study revealed that 59.8% respondents were from 24-44 years where 80.9% of the respondents were female. All most all (92.6%) of respondents were married,96.7% of respondents were literate. Regarding heard about NCDs, all most all (99.2%) of respondent were heard. Regarding family history of NCDs, more than half (59.8%) of respondent had present. This study showed 87.7% had good knowledge where 3.3% has poor Knowledge on overall Non-Communicable Disease.Conclusion: This study concluded that majority of respondents have good knowledge on overall non communicable disease so further studied should focus on identifying practices whether they are implementing their knowledge on day-to-day life or not.
ASD Device Closure in Dextrocardia with Situs Inversus Totalis
Authors: Adhikari Chandra Mani , Bogati Amrit , Kharel Sushant , Ghimire Vijay , Thapa Pratik , Yadav Rahul , Timalsena Birat , Saffi Sajjad , Prajapati Dipanker
Published: December 2024

Device closure of the atrial septal defect in dextrocardia with situs inversus totalis has been reported previously. Dextrocardia with situs Inversus totalis in ASD makes the procedure complex.With proper imaging ASD device closure can be done in such cases. We present a case of a 19 years old female, who underwent successful ASD device closure for the second time in our center.
Pattern of Dyslipidemia in Patients with Acute Coronary Syndrome in a Cardiac hospital in Nepal
Authors: Laudari Shankar , Poudel Kiran , Bhurtyal Sujal , Upadhyay Hari Prasad
Published: December 2024

Background: Dyslipidemia is defined as an abnormal concentration of lipids in the blood and is a critical modifiable risk factor for the development of cardiovascular diseases, including acute coronary syndrome (ACS). The aim of the study was to determine the pattern of dyslipidemia among patients with Acute Coronary Syndrome admitted to a cardiac hospital. 
Methodology: This is a cross-sectional study including consequent 143 patients admitted to Chitwan Mutu Aspatal with a diagnosis of acute coronary syndrome. The study was conducted from July 2021 to Jan 2024 over a period of 2.5years. The patient’s lipid levels were taken within 24 hours from the onset of Acute Coronary Syndrome.
Results: Out of total of 143 patients, dyslipidemia was found in majority of patients with low HDL in 92(64.30%) in our study. 53 (37.1%) were females and 90 (62.9%) were males. The mean age of the patients was 62.3013.03 SD (in years). Patients with STEMI had maximum elevation of LDL (52.9%) compared with those having NSTEMI in 44.4% and 31% in Unstable angina patients. Also, low HDL level was detected in the majority of the patients across all spectrum of ACS patients which was statistically significant (p<0.05).
Conclusion: There is a higher prevalence of low HDL-C and high prevalence of LDL-C among the Nepalese population presenting with acute coronary syndrome (ACS) in the hospital
Histopathological Spectrum among Patients Presenting with Adult Onset Nephrotic Syndrome
Authors: Sharma Deepak , Bhusal Pramod , Maharjan Chunumila , Ghimire Madhav
Published: December 2024

Background: Adult nephrotic syndrome is caused by glomerulopathy that manifests differently in Nepal and other nations. Examining the range of glomerulopathy in individuals over 15 with biopsy-proven nephrotic syndrome, estimating its prevalence and age distribution, and connecting its clinical-pathological features using electron microscopy and immunofluorescence are our objectives. Methods: In our tertiary care hospital, we retrospectively reviewed and analysed 157 renal biopsies of adults with nephrotic syndrome that were performed between January 2021 and August 2024, a period of 3.7 years.Results: There were 157 patients with nephrotic syndrome, 92 of whom were men and 65 of whom were women (1.4 :1). Nephrotic syndrome was most common in the 15–25 age group (24.84%), and it was least common in the 76–85 age group (3.18%). Minimal change disease was the most frequent histological finding among people with nephrotic syndrome (n = 34), followed by MGN (21.01%; n = 33), FSGS (17.19%) (n = 27), IgA Nephropathy (9.55%; n = 15), and amyloidosis (7%; n = 11). MPGN and SLE were similar in 6.30% (n=10), diabetic nephropathy was similar in 5.09% (n=8), and collageno-proliferative glomerulonephritis, tubulointerstitial nephritis, and fibrillary glomerulonephritis were similar in 0.35% (n=1) of histological findings. MGN and MPGN had the highest male predominances (2.3:1 and 2.3:1, respectively), even though fewer patients had the histological diagnostic of MPGN. In SLE, the female predominance was highest (1:9) (M:F). Primary glomerular disease were 78.34%, and secondary glomerular disease were 21.65%. Conclusion: Primary glomerular disease, histologically MCD followed by MGN are the most common cause of NS in adults.
Pattern of Anemia in Patients with Heart Failure in Ischemic Heart Disease
Authors: Dhungel Sachin , Gautam Samir , K.C Bishal , Khan Mazhar , Shakya Abhishesh , Bhattrai Prayantna , Yadav Manisha , Khadka Bishal , Shrestha Munal
Published: December 2024

Background: Anemia is common health problem encountered in patients with heart failure which in turn is is one of the common presenting feature of ischemic heart disease.This study aims to study the patterns and types of anemia in patients admitted with heart failurein ischemic heart disease. Methods: A cross sectional hospital based study for one year in eligible patients as ischemic heart disease in clinical heart failure. Blood parameters especially RBC indices, biochemical parameters including iron profile, serum ferritin, vitamin B12,folic acid were studied. Results: Out of 77 patients with mean age 67±7 years, anemia was common in female (63.6%) and elderly (66.2%). Other most common precipitants of heart failure in anemia were recent MI (<1 month) 55.8% and renal disease (55.8%), hypertension (49.4%) and diabetes (42.9%). Most common pattern of anemia according to RBC indices were normocytic (60.3%), hypochromic (79.3%), normocytic hypochromic anemia (48.2%) Iron deficiency was found in 25 (33.7%) of which absolute iron deficiency was in 12 (16.2%) and relative iron deficiency 13 ( 17.5%). Anemia of chronic disease were in 24 (32.4%), vitamin B12 deficiency 15 (20.2%) and Folic acid deficiency in 2 (2.7%). Conclusion: In heart failure with ischemic heart disease patient, anemia is common precipitating factor. Normocytic and hypochromic pattern are the commonest pattern. Iron deficiency is the commonest. Timely detection and management of iron deficiency may prevent heart failure even in ischemic heart disease.
Post Appendectomy Complication Analysis at Karnali Academy of Health Sciences Teaching Hospital, Jumla
Authors: Thapaliya Narad Prasad , Menyengbo Suryaman , Rain Abdullah , Thapa Nabin , Bista Binamra
Published: December 2024

Background: Acute Appendicitis is common surgical disease throughout the world and Appendectomy is common surgical Emergency operation.The Aims of this study is to analyse post appendectomy complications at Karnali Teaching Hospital, Jumla, Nepal.Methods: This is Retrospective study conducted at the Karnali Teaching Hospital over a periods of Two years (2021-2023) under the Department of Surgery,Karnali Academy of Health Sciences,Jumla-which is Rural community based Hospital.The Datas were analysed by appropriate statistical tools.Results: A Total of 70 Appendectomy performed over that periods and amongs them 36(51.5%) were Females and 34 (48.5%) were males. Main post surgical complications were postoperative Ileus (7%), SSI (4.3%) and seroma (2.8%). Anaesthesia related complications were found more significant in our study,in compare to other studies. Conclusion: Post Appendectomy surgical complications were relatively low in our study,its may be due to high altitude but post- anesthetic complications were relatively high.
Medication Adherence and Health related Quality of life among Patients with Chronic Obstructive Pulmonary Disease in Pokhara
Authors: Acharya Chandra Prasad , Yadav Alok , Paudel Kalpana , Thapaliya Rekha , Duwadi Vijaya
Published: December 2024

Background: Chronic obstructive pulmonary disease (COPD) is a common preventable and treatable chronic disease. Patients have to consume medicine for longer duration which usually leads to non adherent to medicine in long term due to various socio-economic factors such as financial status, economical status of patients. This study focuses on nature of medicine adherence among COPD patients, factors affecting medicine adherence of the patients and influence of medicine adherence on Health related Quality Of Life.Methods: A descriptive analysis study was done among known case of COPD cases after obtaining approval from ethical review board of NHRC. A written consent was obtained from all the participants. Morrisky Medication adherence scale was used to access medication adherence among patient where as st. George ’s Respiratory Questionnaire for COPD was used to evaluate Health related Quality of life of the patients. Results: Among 350 cases analyzed, majority (n= 217; 63%) of the cases were poorly adherence to medicine. There was significant association between rural residence of patients, poor financial status, low education status, longer disease duration, lack of financial support, nuclear family type and poor adherent to medicine (p< 0.05). There was also significant association between poor medicine adherent and poor Health related Quality of Life. (P < 0.05).Conclusion: These patients experienced a severe impact on their symptoms, considerable limitations in daily activities, a higher burden of disease, and an overall reduction in their quality of life.
Lemierre’s Syndrome: The Forgotten Disease is on the Rise
Authors: Kasarla Rajeshwar Reddy
Published: December 2024

No Abstract Available
Clinical Probability Assessment using Modified Wells Criteria and D-Dimer for Diagnosis of Lower Limb DVT
Authors: Shah Santosh , Poudel Rajesh , Miya Sabir
Published: December 2024

Background Deep vein thrombosis (DVT) is a frequent problem in ambulatory and hospitalized patients. It is linked to considerable illness and death related to post-thrombotic syndrome, pulmonary embolism (PE), and pulmonary hypertension secondary to chronic PE. The comparitively low prevalence of DVT leads to a significant number of negative initial ultrasound (US) examinations. A combination of clinical pretest probability assessment using Modified Wells Score (MWS) and D-Dimer testing and subsequent venous US is a good diagnostic approach.
Methods This study is a drescriptive cross-sectional analysis on patients attending UCMS hospital with suspected DVT from September 2021 to March 2023 in order to evaluate the reliability of a combined approach of clinical assessment score (Modified Wells Score) followed by D-dimer test to exclude deep vein thrombosis. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of Modified Wells Score and D-Dimer individually and in combination were noted as outcomes.
Results The study was undertaken in 79 patients. Among the patients, 31 out of 79 (39.24%) were confirmed to have DVT (group one), while 48 patients (60.76%) were ruled out for DVT (group two). In individual Modified Wells Score both the sensitivity and PPV were found to be 77.4%, and both the specificity and NPV were found to be 85.4%. The individual D-dimer test sensitivity was 93.5% with a specificity of 87.5%, while PPV and NPV were 82.9% and 95.5%, respectively. In combined strategy the sensitivity, specificity, PPV and NPV for the likely group combined with D-dimer test results were 100%, 42.9%, 85.7% and 100% respectively. The sensitivity, specificity, PPV and NPV for unlikely group combined with D-dimer test results were 71.4%, 95.1%, 71.4% and 95.1% respectively.
Conclusion Combination of Modified Well’s Criteria along with D-dimer level increases the sensitivity and Negative Predictive Value in DVT diagnosis in suspected cases.
A Study of Vitamin B12 Deficiency in Type-II Diabetic Patients on Metformin Therapy in Eastern Region of Nepal
Authors: Mishra Gopal , Das Pawan Kumar Lal , Karki Dipesh
Published: December 2024

Background Diabetes mellitus, a metabolic disorder marked by elevated blood glucose level, requires effective management to prevent complications. Metformin, a common frontline treatment for type -II diabetes, is linked to Vitamin B12 deficiency, which may trigger severe health disorders like anemia and neurological problems if remain undiagnosed for a longer duration.
This study aims to assess the prevalence of Vitamin B12 deficiency among type 2 diabetic patients on metformin therapy. The objective is to assess the distribution of patients affected by this deficiency and understand how metformin therapy influences B12 levels among these patients. The Study was conducted at B&C Medical College Teaching Hospital and Research Center, Birtamod, Jhapa, Nepal.
Methods A total of 200 diabetes patients on metformin were included in the study. Patients were included if they were diagnosed with type -II diabetes, were currently undergoing metformin therapy, and had been on the medication for at least 6 months.
Data collected comprised patient age, gender, duration of metformin use, and serum vitamin B12 levels measured using chemiluminescence immunoassay (CLIA). Vitamin B12 deficiency was defined as serum levels <200 pg/mL, insufficiency as 200-300 pg/mL, and sufficiency as >300 pg/mL. Statistical analysis involved descriptive statistics and Chi-square tests.
Results Out of the 200 diabetic patients taking metformin, 45% exhibited Vitamin B12 deficiency based on serum levels (<200 pg/mL), 30% had insufficient Vitamin B12 levels (200–300 pg/mL), and 25% had sufficient levels (>300 pg/mL) Deficiency rates were similar across genders but higher in patients over 47 years. A significant correlation was observed between longer metformin use and lower Vitamin B12 levels.
Conclusion The results highlight a prominent rate of Vitamin B12 deficiency among diabetes patients prescribed metformin, especially in older patients and those on long-term therapy. Routine monitoring of vitamin B12 levels is recommended for these patients to prevent serious complications and improve health outcomes
Editorial Vol.29(1)
Authors: Giri Ram Ashish
Published: December 2024

No abstract available.
Benefits, challenges, and recommendations of cultural instruction in second language learning
Authors: Salam Md Abdus
Published: December 2024

In the fast-growing globalized and culturally diverse society today, multiculturalism, i.e. knowledge of variegated culture, is considered to be an essential individual resource. This study examines the views of international postgraduate students on the benefits and challenges of incorporating cultural instruction into second language learning within an English-speaking higher education context in the UK. The objectives are to identify the advantages of cultural instruction, the barriers to its implementation in academic settings, and strategies to overcome these barriers. To achieve this, surveys and face-to-face discussions were conducted with a group of multiracial postgraduate language learners at Westminster University in London. The findings reveal that cultural instruction enhances learners’ understanding and engagement by providing contextually relevant information. The findings also show that there is a significant lack of institutional curricula and standards for integrating cultural materials into language learning, along with limited awareness among students and educators. The study recommends that academic stakeholders—including students, educators, and institutions—collaborate to incorporate cultural education into second language programs to enhance learning outcomes.
Exploring Teachers’ Perspectives and Strategies for Enhancing Workplace Wellbeing
Authors: Panta Chet Nath
Published: December 2024

Well being is perceived as a contested, relational, interdependent, and multifaceted concept. The study explored teachers’ perceptions on well being and their efforts and organizational efforts and commitment to maintain holistic teacher well being. Underpinned by the interpretive paradigm, the study employed the PERMA model, a theory of well being and resilience. The model represents positive emotions, engagement, relationships, meaning and accomplishments to cultivate well being. Another theory employed is appreciative inquiry as a transformative approach to maintaining teacher well being. Teachers need to cultivate a sense of hope, nurturing their agency and resilience, as deficit views appear to be hurdles for maintain and flourishing well being. A sense of optimism in teachers appears to be a compass to navigate challenges and foster teacher well being. Teacher well being is a collective concern. Teachers’ awareness of cross-cutting issues of pedagogical innovations and professional sensibilities and commitments play a crucial role in maintaining their well being. Efforts and strategies adopted by teachers align with the intent of appreciative inquiry and positive psychology. The study calls for taking teacher well being as a collective commitment and an indispensable aspect to enhance team culture, thereby contributing to quality education. It requires emotional commitment and holistic understanding of the stakeholders to reduce the stress and burnout of teachers so that they can remain engaged wholeheartedly in their profession to makea difference.
English Language Teachers’ Experiences of Emotional Well-being During COVID-19 Pandemic
Authors: Maharjan Jeena , Neupane Bharat Prasad , Shrestha Narayan , Bhatt Surendra Prasad
Published: December 2024

The COVID-19 pandemic brought unprecedented challenges, starting in early 2020 and leading to the extensive shutdown of schools around the globe, necessitating a rapid transition to an alternative mode of teaching and learning. Amidst the digital divide regarding access and skills, shifting to virtual teaching-learning was a challenge in Nepal that caused a lot of stress for teachers. This study explores the emotional experiences of basic-level English language teachers in private schools as they adapted to this unforeseen shift. The study investigates the experiences of the English language teachers elicited through in-depth interviews and informal conversation particularly the impact of COVID-19, the sudden shift to virtual instruction on teachers’ emotional well-being and how they adapted to this new normal. The research result revealed that they felt unprecedented psychological needs and fear, underwent loneliness and social isolation, experienced teaching challenges, uncertainty and anxiety, and frustration and helplessness. Despite these challenges, they also showed emotional resilience through peer support and collaboration, family support and work-life balance, and adaptation of new technology and innovation in teaching and learning. This article informs teachers, policymakers, and practitioners about the emotional upheavals teachers experienced during the crises and the resilience displayed, implying policy formulation and teacher support mechanisms.
Navigating English as a Medium of Instruction Practices in a Public School
Authors: Mishra Dipak
Published: December 2024

The Implementation of English as a Medium of Instruction (EMI) in public schools has been connected with teachers’ competence, teachers’ professional development and teacher learning processes. The study adopts the qualitative case study to explore EMI practices in a classroom of a public school through the lenses of Vygotsky’s (1978)social interactional theory. The study looks into the experiences and practices of teachers, students, and other stakeholders in EMI classrooms. The research findings show that teachers are unable to make their pedagogy meaningful as the textbooks of private publications are entirely designed for commercial purposes; as a result, the students are quiet and passive due to the fear of EMI in the classroom. The study also reveals that newly appointed teachers have a zeal to enhance professional development and network among the teacher community to uplift students’ levels. Lastly, the paper paves the way for in-depth debate on EMI policy and practices in public schools.
Blended Learning Approaches in English Language Teaching Pedagogy
Authors: Aryal Muna
Published: December 2024

This paper presents the impact and eff ectiveness of blended learning strategies in English language teaching (ELT). The study delves into how blended learning, a combination of traditional face-to-face and online learning platforms, enhances student engagement, motivation, and communication. The study utilizes a qualitative research design, employing semi-structured interviews with three experienced English language teachers. The findings reveal that blended learning provides flexible and individual learning opportunities to learners which significantly enhances their engagement and learning outcomes. However, teacher’s flexibility and continued professional development are essential for the successful implementation of blended learning. The study highlights the need for institutional support to address the challenges of integrating blended learning into ELT, ultimately contributing to a more dynamic and effective teaching methodology.