bluuebunny/crossref_metadata_2025 huggingface dataset:
Kajian Stilistika Semantik pada Ungkapan Bahasa Jawa Postingan Instagram @Gojekgentho
Authors: Ristiningrum Arliva , Sawardi FX. , Supana Supana
Published: January 2023

Language style is one aspect that beautifies a language. The aims of this study are (1) to describe the forms of expression contained in uploads to the Instagram account @gojekgentho, (2) to describe the stylistics or language style of expressions in uploads to the Instagram account @gojekgentho. The object of this research is the expression uploaded by the Instagram account @gojekgentho. The source of the data in this research is the utterances in the Black and White television program on Trans7 in August 2011. This research uses library and note-taking techniques. The results of this study indicate (1) the form of expression in the Instagram account @gojekgentho, namely found 58 data, (2) of the 58 data found there were 13 data entered from several styles of language or figure of speech, namely (a) figure of speech assonance, (b) figure of speech pleonasm , (c) simile, (d) hyperbole. From all the expressions uploaded to the account, there is the same form in the rhyme
Pengembangan Profesi Guru dalam Meningkatkan Kinerja Guru SDN 007 Sei Beduk Kota Batam
Authors: Kartawinata Kartawinata
Published: January 2023

Study this aim for know description about development teaching profession , for know description level teacher performance, and for know influence development teaching profession to teacher performance The essence of the study focused on influencing factors teacher performance , as for factors studied in study this is development teacher profession . Method research used is survey method . Data collection techniques performed in study this use questionnaire . Respondents in study this are teachers at SDN 007 Sei Beduk in Batam City , with a total of 18 teachers. Data analysis techniques using regression simple. Research results this show : (1) development the teaching profession is in category enough effective, and teacher performance is in the category enough height ; (2) development influential teaching profession positive to performance
Pengembangan Pembelajaran Matematika Diskrit Menggunakan Google Classroom pada Mahasiswa Pendidikan Matematika
Authors: Djafar Suarti , Hafsyah Hafsyah , Rustiani Rustiani
Published: January 2023

Google Classroom is a platform in the form of an LMS (learning management system) which is provided free or unpaid by Google. Google classroom is integrated with email, so it's easy to use (user friendly). Google classroom makes it easy for teachers and lecturers to do distance learning, so that learning becomes efficient, effective and interactive. This study uses a quantitative descriptive research method (Maolani & Cahyana, 2016). The quantitative approach used is in the form of questionnaires and interviews. The purpose of this study is to describe student learning using the Google Classroom Application in Discrete Mathematics courses during the Covid-19 pandemic. This research carried out from the odd semester of the 2021/2022 academic year to 10 students in the fifth semester of the Discrete Mathematics course, the Mathematics Education Study Program. useful for helping plan events, send surveys, give students or others quizzes, or gather simple information in an efficient way. Interviews were conducted at the end of online teaching and learning activities. Data analysis was performed using excel to calculate the percentage and average value. Based on the indicators of the application of the Google Classroom Application, it shows that the average student answer is 75.5% agree and 25.5% disagree. These results show that the application of Google Classroom gets good responses from students, so that it can be used for learning in Discrete Mathematics courses.
THE SEARCH FOR THE PALEOLITHIC AND THEIR PROSPECTS IN THE UKRAINIAN PART OF THE BASIN OF SEIM
Authors:   Інститут археології НАН України, Ступак Дмитро
Published: January 2023

The study of the Paleolithic of the Desna basin has been going on for more than a hundred years. During this time, a significant number of points of different periods of the Paleolithic time were discovered. A significant number of them are concentrated in the basin of the Middle Desna (Fig. 1). The overwhelming majority of Paleolithic sites of the Middle Desna are concentrated within the loess islands on the right bank of the river. Another significant concentration of sites is located in the eastern part of the Seim basin, on the territory of Russia (Fig. 2). The concentrations of points on the right bank of the Middle Desna and the eastern part of the Seimas basin contrast significantly with the western, Ukrainian part of the Seimas basin (Fig. 1). At present, not a single Paleolithic site with a recorded presence of a cultural layer is known in this territory. What is the reason for this situation and the prospects for the discovery of Paleolithic sites here? A good saturation with Paleolithic sites, as a rule, is noted in territories that were well provided with food resources in the Paleolithic time, which in modern times is expressed in the presence in such regions of frequent finds of the Pleistocene fauna and also have favorable conditions for the arrangement of sites and equipped with flint or other stone raw materials for to produce of tools. An example of such a territory is the right bank of the middle reaches of the Desna. The territory of the eastern part of the Seim basin was also well provided with food resources and places for sites. The sites of the region demonstrate the availability of various types of flint raw materials to their inhabitants. The presence of finds of the Pleistocene fauna, the existence of convenient places for arranging sites, the availability of quartzite raw materials convincingly indicate that there are all prerequisites for identifying new Paleolithic sites in the western, Ukrainian part of the Seim basin. And such a disappointing situation with the discovery of Paleolithic sites is the result of the lack of targeted work to search for them. The most promising for prospecting are the right bank of the Seim and the basin of its right tributary, the Kleven River.
INFORMATION ON THE REPRESSIVE POLICY OF THE USSR AGAINST GERMAN PEASANT COLONISTS DURING THE HOLODOMOR 1932-1933 (FROM THE MATERIALS OF SECRET OBSERVATIONS OF THE ODPU BY EMPLOYEES OF THE GERMAN CONSULATES)
Authors:   Сумський державний педагогічний університет імені А.С. Макаренка, Ювко Єгор
Published: January 2023

The article examines the repressive policy of the USSR in relation to national minorities during the Holodomor of 1932–1933, in particular the testimony about the consequences of collectivization and famine in German colonial villages, which ethnic Germans gave to employees of the German consulate in the USSR. The article analyzes archival materials, namely detailed notes of employees of the ODPU, who were engaged in secret surveillance of representatives of German consulates, as well as their own detailed notes of consulate workers. Considerable attention in the article is devoted to the establishment of the consequences of the policy of collectivization, which in the period of the late 1920s and early 1930s became one of the causes of the Holodomor, in particular, the state of agriculture of the colonist peasants in southern and central Ukraine was established precisely at the beginning of the famine and during its greatest spread. The article attempts to analyze archival sources that serve as documentary evidence of the genocide not only of the Ukrainian people, but also of national minorities living on the territory of the USSR. The article also attempts to determine the actions of the German consulate aimed at saving and easing the lives of ethnic Germans who suffered from collectivization and hunger. In particular, about the efforts of the consulates to organize the departure of colonist peasants to Germany. The scientific novelty of the article lies in the fact that, for the first time, an attempt was made to summarize the materials of the archives regarding information on the situation of German colonies during the Holodomor of 1932–1933, which are an important source for the general study of the Holodomor as a policy that was directed not only against Ukrainians, but also against national minorities.
SOCIAL AND RELIGIOUS REACTION TO ELECTION OF METROPOLITAN SERGIUS (STRAGORODSKY) PATRIARCH OF THE RUSSIAN ORTHODOX CHURCH IN 1943
Authors:   Сумський державний педагогічний університет імені А.С. Макаренка, Ходун Едуард
Published: January 2023

The article analyses the reaction of Orthodox churches and churches of the Anglican Commonwealth, as well as secular society to the election of Metropolitan Sergius (Stragorodsky) as Patriarch of Moscow. This event was the first vivid fact of changing the course of the religious policy of Soviet power and caused a certain resonance in the world community, both religious and secular. The study of the spectrum of points of view about the mentioned local fact in their systematic presentation will allow to establish general trends of contemporaries in their attitude to the election of a new Moscow Patriarch in 1943. The dramatic circumstances preceding the patriarchal election of Metropolitan Sergius (Stragorodsky) did not prevent the world community, primarily religious, from receiving him as the Primate of the Russian Orthodox Church. This event was the initial step in the general process of renewal of state and religious relations in the USSR and the use of church resources in the international interests of Soviet power. The foreign policy effect of the election of Patriarch Sergius was significant and perceived as a certain indicator of religious freedom in the USSR, and therefore influenced the position of the Allies preparing to meet in Tehran to discuss the opening of the Second Front.
The Impact of Science: Issues with NIH Oversight of Grant Funding for Bat Virus Research in China
Authors: Han YouAI
Published: January 2023

The Impact of Science: Issues with NIH Oversight of Grant Funding for Bat Virus Research in China
The Value of Philanthropy in Scientific Research
Authors: Han YouAI
Published: January 2023

The Value of Philanthropy in Scientific Research
Experiment ended
Authors: Zhang Wei
Published: January 2023

The Impact of Science on Society: An Analysis of NIH Oversight Failures in China
The Impact of Philanthropy on Scientific Research
Authors: Han YouAI
Published: January 2023

The Impact of Philanthropy on Scientific Research
FILSAFAT HUKUM MENEMUKAN MASALAH-MASALAH HUKUM DALAM MASYARAKAT
Authors: P. ABRAR HADY
Published: January 2023

Filsafat hukum dalam menemukan masalah-masalah hukum dimasyarakat tidak dimasukkan sebagai cabang dari filsafat hukum tetapisebagai bagian dari teori hukum (legal theory) atau disiplin hukum. Teorihukum dengan demikian tidak sama dengan filsafat hukum, satu mencakuplainnya. Satjipto Rahardjo menyatakan bahwa teori hukumu boleh disebutsebagai kelanjutan dari usaha mempelajari hukum positif, setidak-tidaknyadalam urutan yang demikian itulah kita mengkonstruksikan kehadiran teorihukum secara jelas. Teori hukum memang berbicara tentang banyak halyang dapat masuk ke dalam lapangan politik hukum, filsafat hukum, ilmuhukum atau kombinasi ketiga bidang itu. Karena itulah teori hukum dapatsaja pada suatu ketika membicarakan sesuatu yang bersifat universal,tetapi tidak tertutup kemungkinan ia berbicara mengenai hal-hal yangsangat khas menurut tempat tertentu.
Modul ETIKA DAN HUKUM KESEHATAN
Authors: Rajab Muhammad Al
Published: January 2023

Didalam buku ini dijelaskan secara singkat tentang gambaran umum hukum dalam bidang kesehatan yang dapat menjadi modal dasar bagi pihak akademisi maupun praktisi dibidang hukum dalam memahami dan menyelesaikan masalah hukum yang ada ditengah-tengah masyarakat.Sebagai calon akademisi dan praktisi dibidang hukum tidak akan terlepas pada masalah pengaduan maupun pelanggaran hukum dalam praktek kesehatan yang dialami baik oleh pasien sebagai penerima pelayanan kesehatan maupun oleh tenaga kesehatan sebagai pihak yang memberikan pelayanan medis. Unutk itu dengan adanya modul ini diharapkan dapat memberikan pemahaman atau pengetahuan tenang bagaimana ketentuan perundang-undangan yang mengatur tentang pelaksnaan pelayanan kesehatan.
Experiment ended
Authors: Evans Isabelle
Published: January 2023

The Funding of Ukrainian Science A Global Issue
FILSAFAT HUKUM SEBAGAI DASAR PELAKSANAAN HUKUM
Authors: jeriherman
Published: January 2023

FILSAFAT HUKUM SEBAGAI DASAR PELAKSANAAN HUKUM
Filsafat hukum dalam pandangan ilmu hukum
Authors: aulia Chindy
Published: January 2023

Dalam beberapa dekale terakhir, fer polis shop marak Tindikan pengadilan wongkali tidak Nik kaks pa masyarakat. Hakim blk lagi menkin peso al pals wag jenis y Nejalan karena tak melalui peale vang Na Pekan diputan deng undang yang telah dipesan dengan kerasama antar peut ding using pelaku kejahatan yang kelasnya mang membolottan mati pe dengan pendapat hakim sehingga berkenalan (Bir Seg, 78 Produk Nokum telah dikelabui oleh pelanoma sio kewiba Manusia lepas dari joratan bekum karena bekum yang dipakai selih d sistematik sehingga perkara tidak dapat dia secara u kan ju kop dan akhinya lenyap tertimbun masalah Air yang calKeadaan dan kenyataan hukum dewasa ini samp peraturan perundang-undangan hanya menja tal es posit persoalan pokoknya, tetapi berkembang, men dengan as the sep yang sidak sampai pada kebenaran, keadilan dan kejujumn Hingst dokun skola karena adanya kesan tafiran tanpa Natas yang do olh kekuatan pek yang Skemas dengan tujuan tertentu. Hukum hanya menjal sanction pent unik me juan, padahal politik sult ditemukan arahnya. Politik instiger sesuai dengan garis partai yang mampu menerobos hukum dar sucht man asal sampa pada tujuan dai target yang dikehendaki
Net Assets Value and its Determinants of Mutual Funds in Nepal: An Analysis of Monthly Returns
Authors: Niraula Damodar , Ghimire Purushottam , Tamang Kharga Bahadur
Published: January 2023

The research work has been conducted to examine the impact of age, total expense, total investment, and turnover ratio on financial performance of mutual funds in Nepal. Out of 29 mutual funds reported by Nepal Stock Exchange Ltd (as on 15 January, 2022), a total of 10 mutual funds following judgmental sampling technique have been selected as sample of the study. Samples are selected with the objective of getting 32 months data (from 12-Feb 2019 to 16-Sep 2021) resulted 320 observations. The required balanced panel data have been extracted from the monthly reports published on respective websites. Based on the regression result, it has been found that the age, total investment and turnover ratio have significant positive impact on net asset value but the magnitude of turnover ratio is negligible. However, impact of total expense on net asset value is positive but not found significant. The result can give mutual fund managers an insight on improving funds performance. On the other hand, the result can be helpful to investors in deciding their investment on mutual funds. Analysis with adding more variables will be beneficial in increasing the generalizability of the findings.
Enterprise Risk Management and Institutional Performance of Life Insurance Companies in Nepal
Authors: Mahat Nishwarth , Pandey Surendra , Thapa Bharat Singh
Published: January 2023

The paper aims at determining the performance of insurance companies in Nepal from the perspectives of enterprise risk management. Risk identification, risk evaluation, risk mitigation, risk implementation and management are predictors of performance of insurance firms. A full fledge structured questionnaire survey was conducted among conveniently selected 100 respondents representing key employees from different branches of insurance firms within the Kathmandu valley. Analysis was made using correlation and step-wise regression. The major finding of the study implies that risk identification, risk assessments and risk mitigation affect positively to insurance firms’ performance whereas, risk management and implementation have negative impact on company’s performance. However, only effect of risk mitigation was found statistically significant. Thus, the insurance companies are suggested to focus on risk mitigation to enhance their performance. Finally, the study also recommends that the firms need to pursue enterprise risk management in line with international best practices to ensure productivity and competitiveness at par with global benchmark.
Reduplication in Newar Language: An Empirical Study
Authors: Paudyal Rishi Ram
Published: January 2023

This research paper aims to explore the reduplication practices in Newar language and its linguistic relations with other languages. A field survey was conducted among Newar community in Patan. Data was collected through interviews. The collected qualitative data were analyzed using transcription, reinterviews, and re-field visits. The study found that Newar language is very rich in language reduplication. Newar people use reduplication for a number of purposes: plural marking, expressing frustration, expressing unknown and unwilling states, expressing difficult situations, emphasizing dislikes and refusals, expressing urgency, asking somebody to hold on, politely inviting somebody to come, persuading somebody to go, expressing empathy, asking somebody to remain longer and many more. The intention differs from situation to situation, person to person and as per time. The findings of this research may be helpful for those future researchers who want to study reduplication in other languages. Inclusion of impact of other languages on Newar language in terms of reduplication may enrich the findings.
Cultural Displacement in V.S. Naipaul's A House for Mr. Biswas
Authors: Prasai Surya Bahadur
Published: January 2023

This paper examines the literary text A House for Mr. Biswas in order to explore psychological, geographical, cultural and social alienation and displacement of the migrant people. It makes exploration of how the central character, Mohan Biswas makes the search for identity based on cultural root. Displacement gives birth to the feeling of rootness. Biswas is displaced again and again exclusively as well as inclusively. The people who migrate to other countries for any reason feel the nostalgia for their homeland left behind and a feeling of fear on the strange land that gives birth to the feeling of homelessness. The text explains the difficulties and psychological anguish which create the feeling of alienation and fragmentation within a person in the colonial world. The novel attempts to reveal the hardships of the postcolonial people, endure in their search for self- identity and self-esteem in Caribbean society. V.S. Naipaul presents his experience of dislocation through the central character, who struggles for survival and feels alienated, fragmented, dislocated, and rootless. So, this research paper explores Naipaul's experience of displacement and the struggle of the protagonist in the postcolonial milieu.
Destination Management for Sustainable Tourism: A Case Study of Bungamati and Khokana
Authors: Ghimire Ananda , Baral Deep Kumar
Published: January 2023

Development is a peaceful transformation of all round betterment. Tourism is one of the best means to attain development at the local level. To be sustainable, it must be accepted by the local people. The local people need to be aware of tourism, involve in tourism activities, realize its benefit, and impacts to be sustainable. Nepal, as a destination, includes many destinations within it such as Everest region, Annapurna region, Pokhara, Chitwan, and so on. Kathmandu Valley as a destination contains seven World Heritage Sites, which is a world record by itself. Among several local heritage sites, culturally rich Newar villages of Bungamati and Khokana have all the basic elements to be a tourism destination. The comparative analysis of these two destinations analyze the local perception about tourism, sustainable tourism, impacts and benefits of tourism and identifies the variables and factors needed to be studied to be a sustainable tourism destination.
The L2 Motivational Self System among Nepalese College Level Learners of English
Authors: Timilsina Santosh
Published: January 2023

The main purpose of the study is to validate Dörnyei’s L2 Motivational Self System (2005; 2009) among Nepalese college level learners in a rural district of Nepal named Solukhumbu. In particular, the study aims to find out which among the three dimensions (Ideal L2 self; the- Ought to L2 self; L2 learning experience) of Dörnyei’s L2 motivational self-system impact the learners motivation in learning second language. The study employed 50 survey questions along with six background questions to the data. Correlation analysis of the data provides considerable empirical support for the validity of the L2 motivational self- system and its relevance in Nepalese context, with Ideal L2 self as the strongest predictor among the three dimensions of Dörnyei’s L2 motivational self-system along with some relation to L2 learning experience while comparing Ought to L2 self. However, Instrumentality prevention came to be the strongest contributor to the criterion measure, whereas instrumentality promotion contributes more to the ideal L2 self, highlighting the need to understand the association of English targeting future goals to become successful and to find better job.
Subversive Humanism in Manto’s Partition Fiction
Authors: Gautam Bimal
Published: January 2023

Ironizing the violence to convey the political message about minority, Saadat Hasan Monto uses humanistic radical irony as a vehicle for political commentary by demystifying the politics of the representation of violence in official texts of both modern India and Pakistan. Partition affected every sector of human affairs badly. So, partition stories depict the irreplaceable loss displacement, dispossession, abduction, rape, painful death and other forms of violence that common people suffered from all three communities: Hindu, Sikh and Muslim. Manto counts the prime position who dealt with reality of the existing violence by showing it at various levels as familial, social, economic, political, religious others. In that course Manto also subverts the limited and biased notion of partition, which took partition of India as only the partition of territory and people. In the light of Hutcheon’s notion of ‘radical use of irony’, I argue that Manto’s use of irony in “Cold Meat” and “Open it” shows the utter cruelty of the people in power and authority at the time of partition violence and humanity shown by the marginalized section of society. His writing encapsulates his empathy for the victims and his belief in the essential goodness of humanity. The humanity that shines through in his writings about the down-trodden people living in the fringes of society, and the victims of partition violence of 1947 are an integral part of his stories.
Indeterminacy of Meaning in William Blake’s “The Sick Rose”
Authors: Dhungel Nabaraj
Published: January 2023

This study attempts to make deconstructive reading of William Blake’s poem “The Sick Rose”. It also shows how the literary text can be interpreted from multiple perspectives deriving infinite meanings from the same text. The major motive of this research is to demonstrate potentiality of every text to be creatively misread generating various possible meanings. The paper also projects the fact that deconstruction is not destruction, rather it is reconstruction. It displays how the use of language in the text creates contradiction, un-decidability and multiplicity opening up possibility for new meanings. To justify the argument, deconstructive ideas of the philosophers Jacques Derrida and Roland Barthes have been used. The four steps of deconstructive reading- a. Reading the Text b. Finding the Binaries c. Hierarchizing the Binaries and d. Creative Misreading-have been followed for the study of the poem “The Sick Rose”. This research can be a contributing source for promotion of deconstructive reading of anything prevailing in the society and thereby decentering the center and re-centering the margin opening up possibilities for new perspectives, meanings and truths.
Passengers’ Satisfaction towards Service Quality with Public Transportation in Kathmandu Valley
Authors: Manandhar Raju Bhai
Published: January 2023

The operation of public transportation is a public service. Nepal's only cooperative public transportation system is Sajha Yatayat. Additionally, many public transportation options are operated by private companies. Kathmandu is the capital of Nepal; hence the population and public transportation are under significant strain. Therefore, this location was chosen for the research on passengers' satisfaction with the service quality of public transportation. The survey issued 80 questionnaires to riders of public transportation. 52 surveys were returned. Forty of the samples were valid for analysis. 26 passengers (65%) said that evening and nighttime access to public transportation was extremely limited. In addition, 16 (40%) of respondents felt uneasy riding in public transportation. Similarly, 27 (67.5%) respondents noted poor hygiene, and 22 (55%), dangerous public transportation. However, the majority of passengers are dissatisfied with the accessibility, comfort, cleanliness, and safety of public transportation. Only the transportation fare provides satisfaction to passengers. In order to increase passenger happiness, the relevant authority should be accountable for enhancing the service quality of public transportation.
Comparative Study of Physico-Chemical Parameters of Karra, Rapti and Samari River Water of Hetauda
Authors: Pahadi Prakash , Adhikari Solar , Kharel Dipak , Lamichhane Chiranjivi , Chaube Srijesh , Shrestha Madhusudan
Published: January 2023

The genesis of civilization was directly linked with the quality of water and its resource. Any degradation in the water quality will hamper the development of the society because of its direct impact on human health. Therefore the physical and chemical parameters of the water have to be measured time to time to ensure its standard limit. This research aimed to find out the chemical and physical status of the three rivers located inside as well as at the periphery of Hetauda sub-metropolitan city in Makawanpur district. During the mid-week of January 2023, water sample from Karra, Rapti and Samari Rivers were collected in order to compare and study their Physico-Chemical Parameters. The physical parameters like odour, color, pH value and temperature were measured on site while other physical values such as conductivity, and Total Dissolved Solids (TDS) along with the corresponding chemical parameters like hardness, alkalinity and chemical oxygen demand (COD) were measured at chemistry laboratory in Makawanpur Multiple Campus. The test suggested that the water from these rivers were unfit for direct drinking.
Identifying the Trends and Consequences of Retention Rates among Bachelor Students in Makawanpur Multiple Campus
Authors: Chhatkuli Shyam Bahadur , Aryal Uttam , Shrestha Suresh , Nyaupane Ramji Prasad
Published: January 2023

The prime purpose of this study was to successfully examine the trends of drop out in Makawanpur Multiple Campus students studying in bachelor and the consequential effects that would spoil the academic progress of the campus. The data collected from the campus were analysed descriptively from the sample size that included the drop out students of the Makawanpur Multiple Campus in three years. The research method used was analytical which typically use the correlation and regression due to its suitability to determine the strength and direction of the relationship between the variables being studied. The results of this study provide valuable insights into exploring the trend of leaving study among bachelor students and may be used to reflect the consequence which may occur in the near future. It also suggests the strategies for improving retention rates in the different programs of the campus. Overall, this study contributes to overcome the issues that influence student retention and the effectiveness of interventions aimed at improving retention in higher education.
Impact of Bank-Specific Variables on Financial Performance of Joint Venture Banks in Nepal
Authors: Pathak Hari Prasad , Gurung Jas Bahadur , Thapa Magar Gupta Bahadur
Published: January 2023

Banks play an important role not only in the growth of the financial system but also in the development of the overall economy of a nation. Therefore, the determinants of bank performance have attracted the interest of academic research, bank management, and financial markets as well as of bank regulatory bodies. This paper examines the impact of bank-specific variables on the financial performance of joint venture banks in Nepal. The data are collected from the supervision report of Nepal Rastra Bank and annual reports of the sample banks for 10 years from the fiscal year 2009/10 to 2018/19. Based on the results of the Breusch-Pagan LM test and Hausman Test, fixed effects regression models are applied to examine the effects of bank-specific variables on the financial performance of Nepalese joint venture banks. The result shows that there is a significant positive impact of size and employee expenses on the performance of banks measured in terms of return on assets, return on equity and net interest margin. Management efficiency has also a positive impact on the performance of banks but it is significant only on net interest margin. Similarly, there is a significant negative impact of liquidity on return on equity and net interest margin and a significant negative impact of operating expenses on the net interest margin of the banks.
Comparative Study of Temporalis Fascia Graft versus Cartilage Shield Tympanoplasty in Chronic Otitis Media - Mucosal Type
Authors: Shrestha Kumar , Paduel Dhundi Raj , Bhandari Shama , Mahaseth Subhash Chandra
Published: January 2023

Introduction: Tympanoplasty is the procedure of choice for surgical correction of tympanic membrane perforation triggered by either chronic otitis media or trauma. Various types of autologous grafts have been used to close tympanic membrane perforations among which temporalis fascia and tragal cartilage are preferred, due to their anatomic proximity, ease of harvesting and suppleness.

Aims: To compare clinical and audiological outcomes of type 1 tympanoplasty where temporalis fascia and tragal cartilage were used as the graft material.

Methods: A prospective study was conducted on 50 patients of ages ranging from 10 to 50 years with Chronic Otitis Media - Mucosal. All the patients underwent type 1 tympanoplasty and were categorized into Group-A (Temporalis fascia graft) and Group-B (Cartilage graft), each group comprising of 25 patients. Graft uptake rate, hearing gain and air bone gap closure were compared between the groups in 4 and 8 weeks after surgery.

Results: Out of total 50 patients, 20 were male and 30 were female. The average age of the patients was 28.20 years. The total hearing gain in the whole series was 14.94 dB while the total air bone gap closure was 14.78 dB respectively. The difference between pre and post-operative hearing was statistically significant for both air bone gap and air conduction, (P<0.05) in the whole series. There was 15.56 dB improvement in mean hearing threshold and 15.64 dB mean air bone gap closure in the fascia group, compared to 14.32 dB improvement in mean hearing and 13.92 dB mean air bone gap closure in the cartilage group. Graft uptake rate in the temporalis fascia group was 84% and the cartilage group was 92 % with significant difference in the graft uptake rate between the groups.

Conclusion: The graft uptake rate and hearing results of tragal cartilage are comparable to those of temporalis fascia. Cartilage tympanoplasty has a higher graft uptake rate with low failure rate and also shows a high degree of reliability in high risk cases. Both cartilage and fascia tympanoplasty provided similar improvements in the hearing outcome post-operatively. Thus, cartilage tympanoplasty is recommended as an alternative option.
Comparative Study of Opioid Free versus Opioid Anaesthesia in Patients Undergoing Laparoscopic Cholecystectomy
Authors: Shakya Shailendra , Vaidya Preeti , Paudel Bibek
Published: January 2023

Introduction: Opioids have been used as a part of balanced anaesthesia and have known side effects. Opioid Free Analgesia is an emerging technique, based on avoiding intraoperative opioids.

Aims: To compare the effectiveness of opioid-free versus opioid based anaesthesia.

Methods: This comparative study involved 100 patients undergoing elective laparoscopic cholecystectomy under general anaesthesia with American Society of Anaesthesiologists I or II physical status. Out of 100 patients, 50 received Fentanyl (Group A) while another 50 (Group B) received Ketamine and Lignocaine. Parameters measured and compared were the gender, age, weight, ASA physical status, hemodynamic stability, postoperative pain intensity (VAS) and opioid requirements, as well as side effects.

Results: Both groups were comparable with regards to age, gender, weight, American Society of Anaesthesiologists I or II physical status, mean duration of surgery. There was no significant difference between groups hemodynamics at all assessed times (p>0.05) intraoperatively. Visual Analogue Scale pain score in the first 24 hours postoperatively showed that patients in Group A, at all analyzed time points had higher Visual Analogue Scale scores than Group B, but statistically significant difference was confirmed during the first hour (p = 0.001). Seven(14%) in Group A and 5(10%) patients in Group B got intravenous tramadol only once while 5(10%) patients in Group A required twice, which was statistically significant (p=0.05). Intraoperatively, 2 patients (4%) in group A had bradycardia while none in group B, which was statistically insignificant (p=0.153). Postoperatively, nausea was more in group A than Group B i.e. 8% vs 4% (p=0.4).

Conclusion: Opioid Free anaesthesia has a better benefit over Opioid anaesthesia with regard to postoperative pain score, opioid consumption and its side effects.
Rouviere’s Sulcus: An Important Anatomical Landmark in Laparoscopic Cholecystectomy
Authors: Bhattarai Suraj Raj , Acharya Poonam , Yadav Prabin Kumar , Rajbhandari Paras
Published: January 2023

Introduction: Though laparoscopic cholecystectomy is a gold standard treatment for symptomatic cholelithiasis, safe dissection of Calot's triangle is important to avoid major complications like injury to bile duct, vessels and nearby organs.

Aims: This study was designed to determine the frequency, description of Rouviere’s sulcus and its role in safe laparoscopic cholecystectomy.

Methods:This prospective cross-sectional study was conducted at the Department of Surgery, Karuna Hospital, Nepal from January 2022 to September 2022. Patients who underwent laparoscopic cholecystectomy, presence of Rouviere’s sulcus were identified and classified, kept in Group A and absent in Group B. If the common bile duct outline visualized, its relation with Rouviere’s sulcus was noted and used as reference point for gall bladder dissection. The perioperative complications, conversion to open procedure, operative time and hospital stay were recorded.

Results: Among 100 patients, the Rouviere’s sulcus was present in 79% and absent in 21%. Type I is the most common (65.82%). It was found above the level of common bile duct line in 84.81%. Cystic artery injury was present in 1.26% (Group A) and 14.28% (Group B). Bile/stone spillage 1.26% (Group A) and 9.52% (Group B), port hematoma 2.52% (Group A) and 9.52% (Group B), operative time 43.17±8.57 minutes (Group A) and 61.29±12.07 minutes (Group B), conversion to open procedure was none in Group A and 9.52% (Group B) and hospital stay 1.23±0.59 days in group A and 3.16±1.16 days in Group B.

Conclusion: Rouviere’s sulcus is an important extrabiliary anatomical landmark, seen in majority of patients for safe laparoscopic cholecystectomy.
Functional Outcome of Isolated Middle to Distal Third Ulnar Shaft Fracture in Adults with Square Nail Fixation
Authors: KC Dipendra , Shrestha Dinesh Kumar , Karki Prateek , Shrestha Sabin , Yogi Sushil
Published: January 2023

Introduction: Isolated ulnar shaft are uncommon injuries with most of the fractures occurring following direct trauma.  Open reduction and internal fixation with plating is the gold standard treatment but is associated with complications. Treatment with square nail provides rotational stability, is cheaper, safer with minimum complications of plating.

Aims: To evaluate the functional outcome of isolated fracture of middle third to distal third ulna treated with square nail.

Methods: This prospective observational study was conducted in the Department of Orthopedics at Nepalgunj Medical College Teaching Hospital Kohalpur from September 2018 to August 2022. Patients aged above 18 and below 60 years who had displaced isolated fracture of middle third or distal third of ulna were evaluated for demographic details, union, functional outcome and associated complications. All of the fractures of ulna were treated by square nail and outcomes were evaluated using disability of arm, shoulder and hand (DASH) score and Grace and Eversmann scoring system.

Results: In this study of 39 patients with the mean age of 30.84±8.12 years, 56.4% of the patients were in age group 18-30 years, 27 (69.2%) were males and 12 (30.8%) were females.  The right limb was fractured in majority, distal third was more commonly involved, physical assault was the most common mode of injury, transverse was the most common fracture pattern. The average time to union was 11.61±2.74 weeks. Most (74.4%) of the patients had good result in DASH score and most (94.9%) had good to excellent result in Grace and Eversmannscoring at final follow-up. The most common complication noted was olecranon bursitis (17.94%) followed by skin irritation (12.82%).

Conclusion: Square nail fixation of isolated middle third to distal third ulna is safe procedure with few complications, produces excellent to good results.
Knowledge and Prevalence of Emergency Contraceptive Pills among the General Population Visiting a Tertiary Care Centre
Authors: Bist Aayush , Jha Rajshree , Singh Meeta , Devkota Kanchan , Das Divya , Das Neha
Published: January 2023

Introduction: Emergency contraception is a contraceptive method used to prevent unwanted pregnancy in the first few days after unprotected sexual intercourse or contraceptive failure/accident. Many women are unaware of the existence of emergency contraception, misunderstand its use and safety, or do not use it when needed. Especially, residents of the rural regions of Nepal are deprived of family planning services and measures, which cover a major percent of our hospital patients.

Aims: To assess the knowledge regarding emergency contraceptive pills, family planning and their prevalence.

Methods: A descriptive cross-sectional study with a population size of 392 was performed at Nepalgunj medical college teaching hospital, Kohalpur, starting from January to April 2022. A pre-tested questionnaire containing structural, semi-structural, and open-ended questions in printed form was made as a data collection tool. All the people in this study were interviewed after receiving their consent.

Results: 363 out of 392(92.6%) people in our study have known about contraceptives. Only 74.93% responded to having used some sort of contraceptive measure. Oral contraceptive pills were found to be the most used measure in 265 (73%). 222(61.6%) of 363 have heard about emergency contraceptive pills but only 71(31.98%) of them have ever used them. Out of 222 respondents who were aware of emergency contraceptive pills, only 129(58.10%)correctly identified 72 hours as the time limit for the methods to be used. Nineteen respondents (8.56%) believed that emergency contraceptive pills could be used as regular pills. None of them were aware of the use of the intrauterine contraceptive device as an emergency contraception.

Conclusion: Despite having knowledge, only two-third population was found using any of the contraceptive measures. Among those having knowledge about emergency contraceptive pills, more than a half people preferred emergency contraceptive pills for any unplanned event. Emergency contraception awareness is essential to prevent unwanted pregnancy.
Correlation of Mastoid Pneumatization with Middle Ear Pathology in Unilateral Squamous Type of Chronic Otitis Media
Authors: Bhandari Shama , Paudel Dhundi Raj , Mahaseth Subhash Chandra
Published: January 2023

Introduction: Chronic otitis media is chronic inflammation of middle ear cleft followed by permanent abnormality of tympanic membrane. As mastoid a part of temporal bone is in close relation to middle ear; its pneumatization plays an important role in pathogenesis and prognosis of chronic otitis media.

Aims: To study the pneumatization pattern of mastoid in unilateral chronic otitis media and its relationship with contralateral mastoid, diseased side tympanic membrane and ossicular status.

Methods: Forty patients of 10-65 year of age diagnosed as unilateral chronic otitis media squamous type were selected. They were otoscopically evaluated for retraction and perforation of tympanic membrane and were subjected to high-resolution computed tomography of temporal bone. High resolution computed tomographies were analyzed for mastoid status of bilateral ear and ossicular involvement. During mastoidectomy ossicular status was noted and correlated with high resolution computed tomography.

Results: Forty cases were enrolled in the study. Age ranged from10-65 years. On radiological analysis of temporal bones, 21(52.5%) mastoids were sclerotic, 15(37.5 %) mastoid diploic and 4(10%) were pneumatized in the diseased sides. Contralateral side showed pneumatization in 23(57.5%), diploic in 11(27.5%) and sclerotic in 6(15%) Amongst 21 sclerotic mastoid, 11(52.3%) patient had retraction in pars tensa and 9(42.8 %) had retraction of pars flaccida. In total 15 diploic mastoids retraction of pars tensa was in 8(53.3%) and pars flaccid retraction in 8(53.3%) All three ossicles were involved in 8(38%), Malleus and incus were eroded in 3(14%), incus were eroded in 7(33.3%), malleus were eroded in 3(14%) and ossicles were intact in 3(14%)of 21 sclerosed mastoids on high resolution computed tomography. In remaining 19 non sclerotic mastoids all 3 ossicles were eroded in 4 (21%), malleus plus incus eroded in 8 (16%), incus were eroded in 5(26.3%) andossicular chain was intact  in 2(10%).

Conclusion: Mastoid pneumatization pattern not only effect to the pressure of middle ear leading to chronic otitis media but also alter the pathogenesis and outcome of chronicotitismedia. Contralateral mastoid pneumatization is not altered in unilateral Chronic otitis media.
The Role of E-learning in Studying English Language: Teachers’ and Students’ Perspectives
Authors: Tiwari Hari Prasad
Published: January 2023

The substantial increase in technological innovation over the past few decades has had a significant impact in the field of English Language Teaching (ELT). Governments throughout the world are investing a lot of resources to keep up with this technological innovation as a result. Considering this, many local levels of Nepal recently committed to implement e-learning to teach English and other subjects in schools and colleges. Keeping this in mind, the present descriptive phenomenological study tries to explore English Language (EL) teachers’ and students’ perceptions regarding the role of E-learning in studying English.  A total of 24 participants including eight EL teachers and 16 students studying English Education at master’s level participated in the study. I employed convenience technique to collect the study area and purposive sampling technique to select the sample. Similarly, I employed the Single Focused Group Disunion (SFGD) technique to collect the data. As per the choice of the participants, the discussions were conducted in the Nepali language in face-to-face mode. FGDs were audio recorded, transcribed and thematized. The findings of the study were presented and discussed in terms of themes using descriptive methods for analyzing qualitative data. The findings are presented and explored in four themes. They are promoting fundamental learning skills, independence, adaptability, and interaction.
Does women empowerment affect in Timing of Antenatal Care Initiation in Nepal?
Authors: Shrestha Bidhya
Published: January 2023

Background: Many pregnant women who are in their first trimester of pregnancy are still being left behind and do not attend antenatal care (ANC) visits on time, which is unfortunately a dreadful condition. This paper explores the dimensions of women empowerment and their relationship to the timely initiation of ANC.

Methods: The study is based on the 2016 Nepal Demographic and Health Survey. Currently married women aged 15-49 years (n=1,973) who had live births 2 years before the survey were the main target population. The study used binary logistic regression to examine the causal relationship between women empowerment and the timing of ANC service.

Results: The findings reveal that more than two-thirds of the respondents who had a live birth two years prior to the survey made their first antenatal visit during the first trimester. Eight out of 10 highly empowered women are more likely to visit in the first trimester than low empowered women. Furthermore, according to the study, the level of women empowerment affects the timing of ANC service. Furthermore, except for control over sexual relations, indicators-wise empowerment level indicates a positive impact on the timing of ANC services.

Conclusions: Women, especially young women, should be empowered in order to meet the SDG target. There should not be any maternal deaths during pregnancy as well as childbirth and after birth.
Innovative monitoring mechanism: Evidence from rural drinking water sector in Nepal
Authors: Yadav Maheshwar Prasad
Published: January 2023

The paper aims at determining innovative monitoring mechanism in the context of rural drinking water sector of Nepal. This study is based on both primary and secondary data. The necessary primary data were collected through telephone interview using semi-structured questionnaire while the secondary data were collected through database and publications. The collected data were analysed through simple statistical tools to derived results leading to major findings of the study. The study shows that the innovative monitoring mechanism such as, letter monitoring, hello monitoring, sensor monitoring, and toll-free monitoring are useful tools for efficient and effective monitoring of rural drinking water system in the context of developing countries like Nepal. Considering the innovative monitoring ladders and on-site monitoring, the study further concludes that a combination of two or more innovative monitoring mechanisms will make more sense for effective and efficient monitoring mechanism to keep the projects functional and sustainable. This study may be useful for development actor in the sector, academia, and policy makers. The study can be further extended by capturing learning from the implementation for these innovative monitoring mechanism in the context of rural and urban drinking water sector in Nepal.