bluuebunny/crossref_metadata_2025 huggingface dataset:
Penatalaksanaan Miksoma Odontogenik Periferal Maksila Sinistra pada Penderita Geriatri Pasca Stroke Non Hemoragik dengan Anestesi Umum
Authors: Khoiriyah Anik , Widastuti Maria Goreti , Hasan Cahya Yustisia
Published: December 2016

Miksoma odontogenik tipe periferal adalah miksoma yang berlokasi pada jaringan lunak, tumbuh lambat, kurang agresif dan mempunyai tingkat rekurensi yang rendah dibandingkan dengan miksoma odontogenik tipe sentral. Miksoma odontogenik periferal bisa terjadi pada setiap dekade kehidupan, paling banyak terjadi pada dekade keempat. Tujuan penulisan studi kasus ini adalah melaporkan keberhasilan eksisi miksoma odontogenik periferal yang terjadi pada pasien geriatri pasca stroke non hemoragik. Seorang pasien wanita usia 74 tahun, terdapat benjolan di gingiva rahang atas kiri, timbul sejak 3 bulan yang lalu, tidak sakit, tidak mudah berdarah, tetapi mengganggu pengunyahan. Pasien memiliki riwayat stroke non hemoragik yang terkontrol. Eksisi lesi dan kuretase tulang dilakukan dengan anestesi umum. Hasil pasca operasi, setelah dilakukan follow-up selama 6 bulan, tidak ada keluhan pasien terkait dengan penyakit yang diderita, tidak dehisensi, tidak kambuh dan prognosis baik. Eksisi miksoma odontogenik periferal yang terjadi pada pasien geriatri pasca stroke non hemoragik bisa dilakukan, tetapi harus dengan persiapan perioperatif yang optimal, meliputi konsultasi ke bagian neurologi, kardiologi dan rawat bersama dengan bagian penyakit dalam sub bagian geriatri, untuk meminimalkan interaksi obat-obatan yang diberikan dan mencegah komplikasi pasca operasi.   ABSTRACT: Excision Peripheral Odontogenic Myxoma of the Maxillary Sinistra on Post Stroke Non-Hemorrhagic Patients under General Anesthesia. Peripheral odontogenic myxoma is a myxoma located on soft tissue, growing slowly, less aggressive and owning low recurrency rate compared to central odontogenic myxoma. Peripheral odontogenic myxoma may occur in every decade of life, mostly in the fourth decade. The aim of this report is to expose the successful excision of peripheral odontogenic myxoma on post non-hemorrhagic stroke of geriatric patient. A seventy-four-year-old woman had a pedunculated mass on the left maxillary gingivitis. It had been growing for 3 months, non-tender, non-bleeding but causing chewing inconvenience. She had a controlled non-hemorrhage stroke. An excision of lesion and bone curettage was conducted under general anesthesia. Six months after the operation, the follow-up showed no further complaints concerning her disease, no dehiscence, no recurrence, and the prognosis was good. It can be concluded that the excision of peripheral odontogenic myxoma on post non-hemorrhagic stroke of geriatric patients was feasible. However, it must be conducted under adequate perioperative preparation, which consists of neurology and cardiology consultation and joint treatment between internal department and geriatric sub-department to minimize drug interaction and to prevent post-operative complication.
Pornographic Confessions? Sex Work and Scientia Sexualis in Foucault and Linda Williams
Authors: Taylor Chloë
Published: December 2016

In the first volume of the History of Sexuality, Michel Foucault states in passing that prostitution and pornography, like the sexual sciences of medicine and psychiatry, are involved in the proliferation of sexualities and the perverse implantation. Against an influential misinterpretation of this passage on the part of film studies scholar Linda Williams, this paper takes up Foucault’s claim and attempts to explain the mechanism through which the sex industry, and pornography in particular, functions analogously to the sexual sciences in terms of the normalizing form of power that Foucault describes. Whereas Williams sets the question of prostitution aside, and argues that pornography must be a confessional discourse for Foucault, this paper argues that consumption rather than confession is the mechanism through which both prostitution and pornography deploy sexualities within a disciplinary system of power.
Normativity and Normalization
Authors: Taylor Dianna
Published: December 2016

This article illustrates ways in which the concepts of the norm and normativity are implicated in relations of power. Specifically, I argue that these concepts have come to function in a normalizing manner. I outline Michel Foucault’s thinking on the norm and normalization and then provide an overview of Jürgen Habermas’s thinking on the norm and normativity in order to show that Habermas’s conceptualizations of the norm and normativity are not, as he posits, necessary foundations for ethics and politics, but in fact simply one philosophical approach among many. Uncritically accepting a Habermasian framework therefore produces normalizing effects and inhibits alternative and potentially emancipatory thinking about ethics and politics. Having problematized the requirement of normative foundations as it is currently articulated, I conclude by examining the emancipatory potential of a particular aspect of Foucault’s work for the practice of philosophy.
Excavating Government: Giorgio Agamben’s Archaeological Dig
Authors: Fuggle Sophie
Published: December 2016

This paper looks at the development of certain Foucauldian concepts and themes within the work of the Italian philosopher, Giorgio Agamben. Where Agamben is well-known for his critique of biopower in Homo Sacer, his recent work a more complex engagement with Foucault both in terms of his subject matter, governmentality and economy (oikonomia), and his critical methodology, most notably, his reaffirmation of the value of Foucault’s archaeological method. Focusing on three of Agamben’s recent publications, Signatura Rerum: Sul Metodo, Il regno e la gloria. Per una genealogia teologica dell'economia e del governo and What is an Apparatus?, the article looks first at Agamben’s development of Foucault’s archaeological method within his own concept of the signature. It then goes on to consider Agamben’s identification of an economic theology in contradistinction to Schmitt’s political theology and how Agamben’s discussion of collateral damage might be related to Foucault’s notion of security as developed in Security, Territory, Population. Finally, the article considers how Agamben links Foucault’s notion of ‘dispositif’ [apparatus] to an economic theology of government, calling for the development of counter-apparatuses in a similar way to Foucault’s call for ‘resistances.’ The article concludes by considering both the benefits and the limitations of Agamben’s engagement with Foucault.
Pattern of Acute Poisoning Attending a Tertiary Care Hospital of Western Nepal
Authors: Shakya Raju Prasad , Adhikary Suraj , Bajracharya Rohit
Published: December 2016

Introduction: Poisoning with various substances is a major public health problem and a reason for significant morbidity and mortality throughout the globe. It is one of the most common presentation in an emergency department. This study was conducted to determine the sociodemographic, poisoning types, and mode of poisoning in cases attending a tertiary hospital of Western Nepal.

 

Methods: A retrospective observational study of two years was conducted from July 2014 to June 2016. Demography details, name of poisonous substance, and reasons for poisoning were reviewed and analyzed using descriptive statistics.

 

Results: A total of 65 cases of poisoning were recorded. The occurrence was more common in female (n=44, 67.7%) than in male (n=21, 32.3%) with a F:M ratio of 2.1:1.  Poisoning  was most  common in the age group of 11-20 years (32.3%). Most of the cases were students (37%) followed by farmers (26%). The most commonly abused poisoning substance were organophosphorous compounds, zinc-phosphate,  and  kerosene in adults, adolescents, and children respectively. Oral route was the most common (99%) route of administration. Suicidal attempt, as a mode of poisoning, accounted for 70.8% of total poisoning cases.

 

Conclusion: Female and young people are at greater risk of acute poisoning. Insecticide was the most common agent and self administer poisoning was the most common mode of poisoning. The occurrence of poisoning and its morbidity and mortality can be reduced by developing and implementation of effective prevention strategies like restricting easy poison sales, establishing drug and poison information centers,  and community awareness programs.
Risk Factors of Diarrhea in Children Under Five Years in Urban Slums
Authors: Kalakheti Balakrishna , Panthee Kiran , Jain Kastur Chand
Published: December 2016

Introduction: Diarrhea is a leading cause of mortality in children in developing countries and the condition is worse in slums. In order to provide effective preventive and management strategies, it is important to identify factors associated with the disease. This study was carried out to investigate the risk factors of diarrhea in  children under five years of age in urban slums.

 

Methods: Parents of all children under five years from the urban slums of Tansen municipality, Palpa, Nepal were interviewed using a standardized pretested questionnaire and proforma. Parental variables, environmental factors, and presence of diarrhea in those children in past three months were collected by trained enumerators and the data were analyzed with statistical software SPSS-10.

 

Results: A total of 450 under five years children were enrolled in the study. There were 216 (48%) male and 234 (52%) female children with F:M ratio of 1.08:1. Occurrence of diarrhea was lower if the children were breast-fed for more than six months, well-nourished, used fountain water for drinking, or used boiled or treated water. Similarly, diarrhea prevalence was lower if father had a regular job, daily income in the family was more than one US dollar, there was a toilet in the house, practice of hand washing was followed before feeding or preparing food, or there was no child suffering from diarrhea in the neighborhood.

 

Conclusion: There are a few variables that are significantly related to diarrhea in children under five years of age. In order to decrease the diarrheal episodes in children in the slums of the developing countries, priority could be given in the improvement of those variables.
Generalized ensemble model for document ranking in information retrieval
Authors: Wang Yanshan , Choi In-Chan , Liu Hongfang
Published: December 2016

A generalized ensemble model (gEnM) for document ranking is proposed in this
paper. The gEnM linearly combines the document retrieval models and tries to
retrieve relevant documents at high positions. In order to obtain the
optimal linear combination of multiple document retrieval models or rankers,
an optimization program is formulated by directly maximizing the mean
average precision. Both supervised and unsupervised learning algorithms are
presented to solve this program. For the supervised scheme, two approaches
are considered based on the data setting, namely batch and online setting.
In the batch setting, we propose a revised Newton?s algorithm, gEnM.BAT, by
approximating the derivative and Hessian matrix. In the online setting, we
advocate a stochastic gradient descent (SGD) based algorithm-gEnM.ON. As for
the unsupervised scheme, an unsupervised ensemble model (UnsEnM) by
iteratively co-learning from each constituent ranker is presented.
Experimental study on benchmark data sets verifies the effectiveness of the
proposed algorithms. Therefore, with appropriate algorithms, the gEnM is a
viable option in diverse practical information retrieval applications.
Floodplain rehabilitation projects in Hungary: Case studies from the Danube, Tisza, Körös and Drava rivers
Authors: Lóczy Dénes , Dezső József , Ronczyk Levente
Published: December 2016

Floodplains along regulated rivers often suffer from serious environmental
degradation. River and floodplain rehabilitation measures along the major
rivers of Hungary are motivated by two objectives: to inrease the floodwater
retention capacity of floodplains (also beyond the dykes) and to improve the
ecological conditions of floodplain habitats (with special regard to oxbow
lakes). In this paper reports and documents mostly written in Hungarian are
presented for the international public on river and floodplain rehabilitation
efforts. Examples for the water management objective are cited from the Tisza
and K?r?s Rivers, while interventions promoting the second, nature
conservation (and also forestry and agriculture), aim are mentioned from the
Danube and Drava Rivers. A common characteristic of the case studies is that
they apply ?hard engineering? solutions to environmental problems. Although
water availability in the Szigetk?z floodplain has substantially improved
after the building of the bottom weir, the efficiency of the recently
implemented engineering measures (the emergency reservoirs along the Tisza
and water replenishment structures along the Drava) is too early to judge.
The analysis of the occurrence of tropical nights in Knjazevac (Eastern Serbia)
Authors: Tasic Ana
Published: December 2016

Tropical nights are, as defined, days when the minimum temperature does not
fall below 20?C. Apart from being of interest for climate scientist, these
days also impact the comfort of life of the local population. The paper
analyzes the occurrence of tropical nights in Knjazevac, situated at the
foothill of the mountain in Eastern Serbia. The research is based on the
time series from the measuring station of the Republic Hydrometeorological
Service of Serbia and it covers the period of 60 years, from 1955 to 2014,
with 50 years of observations. Data were analyzed using standard statistical
methods and modelled using simple linear regression. Quantitative data are
given in Histogram, showing the frequency of the occurrence of tropical
nights both for the whole period and the sub-periods of ten annual
observations. Analysis shows that the number of tropical nights in the
observed period has a trend of slight increase. In total, 33 days with
tropical night were recorded, which occurred in June, July, August and
September. Year 2007 is identified as a peak of data sequence, reaching 11
occurrences of tropical nights. In this year the highest ever temperature in
Serbia was recorded - of 44.9?C in Smederevska Palanka, whereas maximum
temperature in Knjazevac reached 43.5?C, which also represents the record.
Environmental cohesion across the Hungarian-Croatian border
Authors: Varjú Viktor
Published: December 2016

Environmental cohesion (as a new EU paradigm for a place-based interpretation
of environmental justice) has a clear connection to territorial cohesion.
Based on this idea, advantages for people can include an equitable
distribution of environmental protection and access to environmental
services. In non-EU countries regional environmental cohesion is used as an
instrument to accelerate accession to the EU and it may be manifested as a
declaration of environmental diplomacy. Environmental cohesion across a
border can be identified as soon as two regions - alongside the border -
start to cooperate in order to improve environmental conditions and to
ensure equal access to natural resources and environmental services. After a
literature review environmental cohesion is evaluated in multidimensional
way, using empirical quantitative and qualitative data and a two-pillar
based methodological approach. The Croatian-Hungarian border area was closed
for a long time. As a result, developments avoided the area, on the other,
natural resources remained mainly untouched. However, the two countries have
had different approaches towards the area, while, Croatia made efforts to
build another water power plant, Hungary intended to preserve and extend a
Natural Park. This contradiction remained until the accession process of
Croatia. Finally the disagreement between the two countries was moderated by
a UNESCO Biosphere Reserve that was created alongside the border in 2015.
The post-2010 period has been characterised by an increasing number of
environmental-related cooperations.
Naked-eye astronomy in mass tourism
Authors: Tadic Milutin
Published: December 2016

This paper considers the possibility of developing astro-tourism in small
countries such as Serbia and other Balkan countries, with "discreet"
astro-tourism reduced to naked-eye astronomy as part of mass tourism rather
than elite tourism that is realized through specialized programs with
spacecraft and space stations, spectacular planetariums and observatories
with giant telescopes. The specific relationship between the virtual and the
real world is highlighted in this paper especially when considering younger
generations. Furthermore, the differences in the way stars are perceived by
astronomers and "ordinary" tourists or non-astronomers is also emphasized.
Tourists are not enchanted by celestial bodies themselves, but by a complete
scene, which consists of integrated skyscapes and landscapes, as a complex
stage where in various combinations and forms these celestial bodies are
observed, and of their own experience. These complex sky-earth landscapes,
astro-landscapes, present astro-tourism resources of the small countries
like Serbia, provided that a tourist can "read" their astronomical text. In
this regard, Belgrade was used as the example for drafting a "package" of
astronomical information that can be easily prepared and adapted according
to the needs of a particular group, so that every tourist may know what can
be seen, where and when. With the help of a rotating star map (planisphere),
visitors may observe the sky with the naked eye.
Production, Marketing and Value Chain Mapping of 'Srijana' Tomato Hybrid Seed in Nepal
Authors: Magar Dinesh Babu Thapa , Gauchan Devendra
Published: December 2016

A tomato variety known as ‘Srijana’ developed by Nepal Agricultural Research Council (NARC) has been substantially popular among Nepalese farmers and entrepreneurs. To understand the seed value chain of the Srijana hybrid tomato, a survey was conducted in 2014/15 with public research and extension institutions, private seed companies/firms, non-governmental organization and community group including individual farmers, involved in Srijana tomato seed production. The survey covered random selection of 30 agro-vets and 30 farmers in Kathmandu valley, Kavre, Nuwakot, Dolakha and Kaski districts, Nepal where production of Srijana tomato seed is mostly concentrated. A focus group discussion was also conducted with commercial tomato farmers in each of the study districts. The study showed a total production of 293 kg Srijana seed having a value of around 47 million Nepalese Rupees (US $ 470 thousands) in year 2013/14. Private sector was the dominant actor sharing about 85% of the total Srijana seed production followed by non-governmental organization (10%), farmers group (3%) and governmental station/farm/centers (2%), respectively. Out of the total Srijana seed produced, about 95% was consumed in domestic market while 5% was exported to India. The study revealed increasing trend of production, supply and price of Srijana tomato seed. About 0.3 million NRs (US $ 3,000) profit was estimated through the production of Srijana tomato seed in 0.05 hectares (500 m2) of land. Agro-vets (private sector seed dealers) were the major actors for supplying the seed from the producers to farms and received a higher profit margins. The farmers producing and selling the seed in technical assistance of public agencies received higher producer`s share (66.6%) than farmers producing and selling seed through own group (60%), technical assistance of non-governmental organization (53.3%), and in contract with private seed companies (26.7%). Majority of commercial tomato farmers had complaints on supply of poor quality seed in the market. As a result, there was declining faith on the quality of Srijana tomato seed. Limited access to parental lines and poor availability of skilled human resources were the key constraints to produce the quality Srijana seed. Therefore, it is recommended that there should be a provision of efficient quality control mechanisms, and development of human resources including public private partnerships for maintaining the genetic purity of parental lines and also improving the capacities of seed value chain actors for sustainable Srijana seed production in Nepal.
Diversity Analysis and Physico-Morphlogical Characteritics of Indigenous Germplasm of Lablab Bean
Authors: KC Ram Bahadur , Joshi Bal Krishna , Dahal Surya Prasad
Published: December 2016

Germplasm characterization is an important component of crop breeding program.  In characterizing indigenous beans lablab which is used for vegetables as well pulses in Nepal. Twenty three lablab beans germplasm were evaluated for different qualitative and quantitive physico-morphological charecteristics for two years during 2011 and 2012 at Horticulture Research Station, Malepatan, Pokhara. The germplasm showed considerable variations in most of the qualitative and quantitative traits. Leaf size, vine color, flower color, pod color, pod shape, pod type and seed color varied among the genotypes. Variation was also observed in yield attributing characters eg, pod length and width, 10 fresh pod weight, seeds per pod and 100-seed weight.  Days to 50% flowering ranged from 81 to 130 days indicating the presence of early varieties. Fresh pod weight of 10 pods was ranged from 45.0 g to 162.5 g. Multivariate analysis indicated four groups in these genotypes, among with ML-02 and ML-10 were distinct in comparioson with other genotypes. Simple selection may be considered to develop high yielding, early type varieties from these gentopypes.
Cluster Analysis of Maize Inbred Lines
Authors: Shrestha Jiban
Published: December 2016

The determination of diversity among inbred lines is important for heterosis breeding. Sixty maize inbred lines were evaluated for their eight agro morphological traits during winter season of 2011 to analyze their genetic diversity. Clustering was done by average linkage method. The inbred lines were grouped into six clusters. Inbred lines grouped into Clusters II had taller plants with maximum number of leaves. The cluster III was characterized with shorter plants with minimum number of leaves. The inbred lines categorized into cluster V had early flowering whereas the group into cluster VI had late flowering time. The inbred lines grouped into the cluster III were characterized by higher value of anthesis silking interval (ASI) and those of cluster VI had lower value of ASI. These results showed that the inbred lines having widely divergent clusters can be utilized in hybrid breeding programme.
Prevalence of Stunting and Thinness Among Adolescent Girls Belonging to the Rajbanshi Population of West Bengal, India
Authors: Roy Susmita , Barman Sweeta , Mondal Nitish , Sen Jaydip
Published: December 2016

Introduction: In India majority of the individuals remain undernourished. The primary causes of undernutrition are its large population, socio-economic differences and inadequate access to health facilities. Assessment of nutritional status among adolescents is very important as they are the future parents and constitute a potentially vulnerable segment of the population. The present school-based cross-sectional study evaluates the prevalence of stunting and thinness among adolescent girls from North Bengal.Materials and Methods: The present study was carried out among 500 Rajbanshi adolescent girls aged 9 to 18 years and residing in the districts of Darjeeling and Jalpaiguri in West Bengal, India. Anthropometric measurements of height and weight were recorded and body mass index (BMI) calculated. The prevalence of undernutrition was assessed using recommended anthropometric indices of stunting (low height-for-age) and thinness (low BMI-for-age), along with a comparison with the WHO reference population.Results: The overall prevalence of stunting and thinness was observed to be 39.60% and 26.00% respectively. The prevalence of age-specific stunting was higher and lower among girls aged 17 years (70.21%) and 10 years (24.00%), respectively. The age-specific prevalence of thinness was observed to be higher among those aged 10 years (66.00%) and lower among those aged 17 years (8.51%).Conclusion: There is a need for appropriate nutritional intervention programmes to address their nutritional needs. The results of the present study will also help policy makers to formulate various developmental and health care programmes.J Nepal Paediatr Soc 2016;36(2):147-155.
The Use of PELOD Score in Predicting Acute Kidney Injury in Critically Ill Children
Authors: Prasetyo Risky Vitria , Saraswati Putu Dian , Kurniawan Muhammad Riza , Kushartono Hari , Soemyarso Ninik Asmaningsih , Azis Abdul Latief , Noer Mohammad Sjaifullah
Published: December 2016

Introduction: Acute kidney injury (AKI) significantly increases morbidity and mortality in critically ill children. Prognostic indicators such as Pediatric Logistic Organ Dysfunction (PELOD) score is associated with factors related to renal dysfunction. The aim of this study was to study the AKI incidence and correlate the PELOD score with AKI in critically ill children admitted to PICU at Dr. Soetomo Hospital Surabaya Indonesia.Material and Methods: A prospective study was conducted to all children admitted to PICU during 15 January-14 April 2014. Demographic data (age, sex, PICU indications, PELOD scores, AKI staging by pRIFLE at admission) and outcome after 7 days at PICU were recorded. All data were analyzed descriptively (p<0.05).Results: A total of 56 (47.1%) out of 119 children were studied. The rest was excluded for being <3 months old, had end-stage kidney disease or complex cardiac problem, and cardiac catheterization. Mean age of subjects was 49.7 (SD 46.2) months, male-to-female ratio of 1.2:1. PICU indication was dominated by shock (35.7%), followed by CNS dysfunction in 13 (23.2%) and respiratory failure in 12 (21.4%) children. AKI was noted in 15 (26.8%) children, mostly (10.7%) in Injury stage with 5 (8.9%) in Risk and 4 (7.1%) in Failure stages. PELOD scores at admission ranged from 0 to 20 (mean 4.34, SD 5.87), higher scores in AKI group (7.8±6.64 vs 3.1±5.09, P=0.013). Twelve (21.4%) children died, 7 (58.3%) had AKI with 3 (25.0%) each in Risk and Failure while 1(8.3%) in Injury (p<0.05).Conclusion: PELOD score can be used as a predictor for AKI in critically ill children.J Nepal Paediatr Soc 2016;36(2):165-169.
Neonatal Bartter Syndrome
Authors: Roy Amrita , Chakraborty Debalina Sarkar , Dogra Shivani , Sengupta Sudip
Published: December 2016

The neonatal form of Bartter syndrome is characterized by intrauterine onset of polyuria leading to severe polyhydramnios. We report a case of a 31 weeks, male baby was born by emergency Caesarean Section due to severe polyhydramnios (AFI 54). Postnatally, baby had polyuria, dehydration, hyponatremia, hypokalemia and hypochloremic metabolic alkalosis. Possibility of neonatal Bartter syndrome was supported by high serum renin and aldosterone levels. Correction of electrolytes and dehydration along with indomethacin constituted the treatment. This syndrome is reported to make paediatricians aware about the severe neonatal form of the disease.J Nepal Paediatr Soc 2016;36(2):204-207.
Incidence of G6PD Deficiency in a Tertiary Care Hospital in South India
Authors: Chandrashekhar Chenna , Bandaru Kasi
Published: December 2016

Glucose-6-phosphate dehydrogenase (G6PD) deficiency is the commonest red cell enzymopathy affecting red cell metabolism. Its presentation can vary from drug induced haemolysis to neonatal jaundice with a prevalence ranging from 0-27% in India. The objective of this study was to find out the incidence of G6PD deficiency in babies delivered in our hospital and to assess its contribution in causing neonatal jaundice. 500 babies were screened for G6PD deficiency by Fluorescent spot test method. All the babies were found to have normal enzyme activity. Hence we concluded the burden of G6PD deficiency causing neonatal jaundice is less in our setup.J Nepal Paediatr Soc 2016;36(2):141-142.
Hypervitaminosis D Following Overdose in a Patient with SLE
Authors: Roy Kakali , Basu Surupa , Kundu Ritabrata , Das Joydeep
Published: December 2016

Vitamin D supplementation has come under lime light and is being prescribed randomly. Often physicians prescribe high doses of Vitamin D. Overdosing may be dangerous if not supervised or followed up. We are presenting one child with all features of hypercalcemia due to hypervitaminosis D following overdose. Doctors should be cautious during prescribing high dose of Vitamin D.J Nepal Paediatr Soc 2016;36(2):196-197.
Update on Changing Terminologies in Sepsis
Authors: Simalti Ashish Kumar , Ghuliani Ranjit , Nair Bindu T.
Published: December 2016

Definitions of sepsis and septic shock were last revised in 2001. Since then there have been considerable advances in our understanding of pathophysiology, management, and epidemiology of sepsis, suggesting the need for reexamination. The European Society of Intensive Care Medicine and the Society of Critical Care Medicine convened a task force in January 2014 with objective to evaluate and, as needed, update definitions for sepsis and septic shock. Recommendations of this task force were published recently as “The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3)”. The aim of this article is to generate awareness and discussion regarding this new important development.
Clinical Utility of Serum Neutrophil Gelatinase Associated Lipocalin(NGAL) as an Early Marker of Acute Kidney Injury in Asphyxiated Neonates
Authors: Chandrashekar Chenna , Venkatkrishnan Akila
Published: December 2016

Introduction: Acute Kidney Injury (AKI) is a common devastating problem in the NICU. Since the kidney is the second most affected organ in asphyxiated neonates (after the brain), a marker to determine kidney injury becomes important. Serum Neutrophil Gelatinase Associated Lipocalin (NGAL) determines acute kidney injury even before Blood Urea Nitrogen (BUN) or serum creatinine values rise. The aim of this study was to determine the clinical utility of NGAL as an early marker of acute kidney injury in asphyxiated neonates.Materials and Methods: This was a cohort study performed at a Level III NICU at JSS Hospital, Mysore, Karnataka, India over a period of two years. The study was conducted on30 term asphyxiated neonates and 30 term control neonates. Serum NGAL was measured within 6 hours after birth in an asphyxiated neonate using fluorescence immunoassay.Results: A highly significant increase in serum NGAL in cases group with a median of 323ng/ml as compared to control group with median of 64ng/ml was observed. Of the 30 asphyxiated neonates, 23 were positive for NGAL, and of these 3 had AKI.A cutoff value of 155 ng/ml for Serum NGAL could detect AKI in asphyxiated neonates with a sensitivity of 75% and a specificity of 23%.Conclusion: NGAL is raised in Asphyxiated neonates both with and without kidney injury. Therefore, it is not a specific marker for acute kidney injury in asphyxiated neonates.  J Nepal Paediatr Soc 2016;36(2):121-125.
White Cerebellum Sign
Authors: Gopalakrishnan Shridhar , Uddandam Rajesh , Sodhi Kirandeep
Published: December 2016

The white cerebellum sign is an unusual but striking radiological sign of global hypoxia ischemia of the brain. Recognition helps in diagnosis and prognosis as this sign is usually associated with a uniformly poor outcome.
Clinico-aetiological Profile of Congenital Hypothyroidism
Authors: Karki Subhana Thapa , Rai Ganesh Kumar , Karki Buddha Bdr , Gurung Roshma
Published: December 2016

Introduction: Thyroid hormone is critical for normal brain development in the early postnatal months. Biochemical diagnosis must be made soon after birth and effective treatment must be initiated promptly to prevent irreversible brain damage. Early diagnosis and adequate treatment from the first weeks of life result in normal linear growth and development. This study was conducted to find out the clinical features suggestive of congenital hypothyroidism and also its causation. Materials and Methods: This was a hospital based retrospective study of 40 congenital hypothyroid children conducted at endocrine unit of Kanti Children’s hospital from 2067 to 2072. All congenital hypothyroid children were reviewed in detail and frequency of signs/symptoms was calculated and also the possible causes were established using ultrasonography and scintigraphy.Results: Out of 40 congenital hypothyroid children 55% were male and 45% were female with M: F ratio of 1.23:1.Common age of presentation of congenital hypothyroidism was 6 to 12 months. The most frequent symptoms were decreased activity/ lethargy (78.9%) followed by stunted height (68.4%) and hypotonia (65.8%).Technetium thyroid scan was performed in 19 cases among which thyroid agenesis was the most common cause of congenital hypothyroidism (42.1%) followed by dyshormonogenesis (31.6%) and ectopic thyroid (26.3%).Conclusion: Early diagnosis of congenital hypothyroidism is possible in some children based on clinical features followed by biomedical investigation soon after birth.J Nepal Paediatr Soc 2016; 36(2):126-130
Ellis Van-Creveld Syndrome in an Ethnic Group in Nepal: Case Report with Review of Literature
Authors: Gauchan Eva , Sharma Prakash
Published: December 2016

Ellis van-Creveld syndrome is a rare autosomal recessive disorder characterized by acromesomelic dwarfism, postaxial polydactyly, oro-dental abnormalities and congenital heart disease. We are reporting three cases in two families of the same ethnic group from Western Nepal. Genetic testing should be done in this population in order to identify the mutation in the gene causing the syndrome.J Nepal Paediatr Soc 2016;36(2):188-192.
Reference Ranges for Hematological Values in Umbilical Cord Blood in Pokhara, Nepal
Authors: Basnet Sahisnuta , Singh Sandip Kumar , Sathian Brijesh , Mishra Rajnish
Published: December 2016

Correction: Due to an error in loading the metadata, the author Sahisnuta Basnet was omitted. Sahisnuta Basnet was therefore added to the metadata on 9th January 2017. The PDF was correct.Introduction: Reference hematological values in newborns are informative in evaluation of newborns to determine state of health or disease. For a given population, reference values may differ in accordance with various factors such as age, sex, race, diet, drug intake, altitude, socio-economic status and also the method employed for determination of the values. The aim of this study was to establish reference ranges of complete blood count using umbilical cord blood of normal, healthy, full term neonates born in Manipal Teaching Hospital (MTH), Pokhara, Nepal.Material and Method: The study was conducted in 210 full term, healthy newborns delivered in MTH between Jan 2014 to Feb 2015. Cord blood was collected and a complete blood count was obtained using an automated hematology analyzer.Result: Mean hemoglobin was 15.24 ± 1.96 gm/dl and mean red blood cell count was 4.30 ± 0.63 (range 3.05 – 6.36) X 1012/L. Mean white blood cell count was 14.93 ± 4.44 (range 6.10 ± 31.7) X 109/L and platelet count was 226.88 ± 61.28 (range 105 ± 392) X 109/L. There was no significant difference found in hemoglobin, red cell, white cell and platelet counts between males and females in this study.Conclusion: The values obtained from our study provide ranges for some hematological values in healthy newborns of Pokhara Nepal. However, the hematological reference values for Nepalese cord blood needs to be confirmed by larger numbers of samples from different centers of Nepal.J Nepal Paediatr Soc 2016;36(2):160-164.
Assessing the Role of Potential Biomarkers in Antimony Susceptible and Resistant Clinical Isolates of L. donovani from India
Authors: Maharjan Mahendra , Mandal Swati , Madhubala Rentala
Published: December 2016

Failure of antimonial drugs, the mainstay therapy for leishmaniasis has become an escalating problem in the treatment of Indian leishmaniasis. Using 14 clinical isolates from both visceral (VL) and post-kala-azar dermal leismaniasis (PKDL) patients, we have examined the role of ATP-binding cassette transporter (ABC transporter) gene, multidrug resistant protein A (MRPA) and two building blocks of the major thiol, trypanothione namely, ornithine decarboxylase gene (ODC) (a rate limiting enzyme in the polyamine biosynthesis) and γ-glutamylcysteine synthetase (γ-GCS) (a rate limiting enzyme in glutathione biosynthesis) in antimony resistance. Amplification of these three genes was observed in some but not all clinical isolates. Increased expression of the three RNAs as determined by real-time PCR was observed in all SAG-R clinical isolates. Significant increase in cysteine and glutathione levels was observed in the resistant isolates. Our studies report the underlying mechanism of antimony resistance in the clinical isolates.
Characterization of Nepalese Barley Gene Pool for Leaf Rust Resistance
Authors: Amgai Resham Babu , Pantha Sumitra , Bhatta Madan Raj
Published: December 2016

Barley (Hordeum vulagare L) is the major crop for the people living in the high hills and mountainous region of Nepal. Leaf rust (caused by Puccinia hordei) is one of the major production threats for barley cultivation. A lot of variation can be observed on Nepalese barley accessions with respect to leaf rust resistance characteristics. Two hundred and forty one barley accessions were screened for leaf rust resistance characteristics on heading stage at Khumaltar, Lalitpur, Nepal. Among them, one hundred and nine Nepalese barley accessions showing promising for disease resistance were screened using six SSR markers linked to leaf rust resistance genes. Bonus and Local Jau was used as the resistant and susceptible check respectively. Leaf rust resistance genes Rph1, Rph2, Rph3, Rph7, QBLR-P and QTL on chromosome 5HS were detected on Nepalese barley accessions using respective SSR markers. Eight Nepalese barley accessions showed presence of three and more leaf rust resistant genes. The poor relationship between the field disease resistance and molecular markers linked with specific leaf rust resistance gene proved that Nepalese barley gene pool contains other leaf resistance genes.
Detection of Latent HIV-1 Infection and Drug Resistant Mutation Testing in Nepal: HIV-1 env V3 DNA Sequence and RT Gene (M184V) Mutation
Authors: Shrestha Rupendra , Khadka Sundar , Wagle Susbin Raj , Sapkota Alisha
Published: December 2016

HIV-1 resistance to antiretroviral therapy (ART) is a crucial issue, despite various effective drugs are available for the treatment. Although the viral RNA is suppressed below the detection limit (<50 copies/ml) with the use of potent antiviral drugs, the mutation can be archived in the cellular reservoir as proviral DNA. The detection of proviral DNA and mutation screening in HIV 1 RNA for genotypic resistance is the sole basis for monitoring the effectiveness of ART. Our study aim to access the extent of latent HIV infections by detecting env V3 DNA and also testing of M184V (meth184val; ATG - GTG substitution at 184th codon) specific mutations in HIV-1 RT gene to monitor the effectiveness of ART. The HIV-1 env V3 DNA sequence was amplified using multiple upstream and downstream primes to show the latent HIV infections, whereas polymerase chain reaction- restriction fragment digestion assay (PCR-RFDA) was used for testing M184V mutation in HIV-1 RT gene. In the study, out of 15 HIV infected patient blood samples, 12 shows amplification of env V3 DNA, confirming the latent HIV infections while 3 were negative for env V3 DNA. HIV-1 RT gene tested for M184V mutation in all 15 samples showed wild type after analysis using PCR-RFDA. After digestion with CviAII, three bands were observed in wild type whereas in mutant only two bands. Although the study shows negative for the M184V resistance mutation, screening of various panels of drug resistance mutations should be performed in recently infected HIV-1 patients for planning the effective ART strategy. The data is not enough to compare the overall scenario of the Nepal thus warrant urgency for large scale study with standard genotypic tools.
Hormonal Effect on Mandarin Orange (Citrus reticulata Blanco) Micro-propagation
Authors: Amgai Resham Babu , Prasai Hari Kumar , Pandey Yama Raj
Published: December 2016

Tissue culture is the best option to produce disease free seedling of the fruit crop rapidly. Micro-propagation and use of the in-vitro grafting (micro-grafting) is very helpful for production of virus free planting materials in mandarin. Different levels of the in-vitro hormone affect the success of callusing, shooting and plant regeneration in mandarin. Shoot bud, flower bud and in-vitro seedling epicotyl was used as explants to study the hormonal effect on mandarin micro-propagation. Similarly, 10 levels of BAP and IAA combination on MS media for mandarin tissue culture were used. Observation was done for 100 test tubes per treatment combination after 4, 8 and 12 weeks of culture. Data was arc sine transformed for analysis. Shooting from explants was significantly higher (71.72%) on medium level of the BAP (0.5 mg/L) and IAA (0.2 mg/L) using in-vitro seedling stem as explant, however, it was 27.91% for stem bud as explant. Stem bud showed higher level of callusing (6.15%, p<0.001) in mandarin orange. However, flower bud didn’t develop shoot in mandarin tissue culture. Increment of the in-vitro regeneration of the shooting and callusing was observed by the increment of the in-vitro incubation duration in mandarin orange tissue culture.
Study of Phytochemical, Antioxidant and Antimicrobial Activity of Artocarpus heterophyllus
Authors: Thapa Nita , Thapa Pratiksha , Bhandari Jay , Niraula Prasodhan , Shrestha Nikita , Shrestha Bhupal G
Published: December 2016

In today’s world, search for natural medicines is increasing as a result of drug resistance of pathogens and also due to negative consequences of antibiotic. Presence of phytochemicals, antioxidant potential and antimicrobial activity of Artocarpus heterophyllus was carried out in this study. Leaf of this plant was subjected to warm extraction with three different solvents namely methanol, aqueous methanol and ethyl acetate. Leaf extract showed the presence of coumarin, alkaloid, terpenoid in methanol solvent; tannin, coumarin, saponin in aqueous methanol extract and coumarin, terpenoids in ethyl acetate solvent. Further, antimicrobial activity was assessed through disc diffusion method with six pathological bacteria and two fungi strains in four different concentrations of plant extract. Largest ZOI of 16mm was obtained against B. subtilis in 200mg/ml concentration for ethyl acetate extract. Antioxidant potential was measured by DPPH (Diphenyl-2-picrylhydrazyl) assay. DPPH free radical Scavenging Activity was expressed in % inhibition with L Ascorbic acid as standard and leaf extract in methanol showed the best activity.
Novel Bio-Markers for Prediction of Preeclampsia
Authors: Garg Ruchika , Singh S , Dhiman S , Agrawal P , Prakash P
Published: December 2016

Pre-eclampsia (PE) is a pregnancy related disorder. It is an important cause of maternal and perinatal morbidity and mortality worldwide. Two to eight percent of pregnancies were affected by PE. It is characterized by de novo hypertension and proteinuria after 20 weeks of gestation. The etiology and pathogenesis of the disease is unknown, but recent studies have revealed that placenta is the place of origin of this disorder and widespread maternal endothelial dysfunction is the characteristic feature of the disease. Some biochemical molecules are identified recently which are involved in the pathogenesis of the disease, which may help in early identification of patients at risk and help in providing proper prenatal care. Several promising biomarkers have been proposed, alone or in combination. Maternal serum concentrations of these biomarkers either increase or decrease in PE during gestation. This review focuses on the various biomarkers available and their utility in prediction and diagnosis of pre-eclampsia.
Assessment of Risk Factors, Feasibility and Acceptability of VIA for Cervical Cancer Screening and Prevention
Authors: Rijal Pappu , Pradhan Tarun , Agrawal A , Rai R , Bhatta R , Chhetri S
Published: December 2016

Aims – To assess feasibility of visual inspection with acetic acid and treatment with cryotherapy for cervical cancer screening and prevention and assess risk factors for cervical cancer in the screened population.Methods – A prospective analysis of all patients enrolled for cervical cancer screening by visual inspection, meeting the eligibility criteria for screening and treatment as per national guidelines 2011 was analyzed form March 2012 to April 2013.Results – A total of 4138 met the eligibility criteria and were counseled for screening, 33 rejected for screening. Out of 4105 screened 241 were visual inspection with acetic acid positive, 211 were treated with cryotherapy, 25 treated with LEEP, 5 rejected to  treatment.  Mean age of patient in year’s ± SD 41.48 ± 9.72. The visual inspection with acetic acidpositivity rate was 5.9 %Conclusion – Single visit approach is a feasible and acceptable form of cervical cancer screening strategy in our population.
French manufacturing firms’ reorganizational performance
Authors: Mtar Kais , Bannour Ep Sfar Souad , Richet Xavier
Published: December 2016

This article sheds some light on the economics field. It establishes a link between French manufacturing firms’ reorganization and performance by using the matching method, which Donald B. Rubin first introduced. Through matching the 2006 COI survey and the DIANE database, the available data show that reorganization improves French manufacturing companies’ added value, turnover, labor productivity and the productivity of financial capital.
Determining the optimal working capital to enhance firms’ profitability
Authors: Habib Ashfaq , Huang Xiaoxia
Published: December 2016

Seeking the optimal level of cement firms’ working capital in Pakistan, this study examines the impact of working capital on their operating profit. By employing panel least squares estimation, panel fixed effect and panel generalized method of movement, the research finds a significant curvilinear relation between working capital and profitability. Further, it confirms that a positive working capital yields negative profitability, while a negative working capital affects profitability positively. In each method, the optimal level of working capital is derived as the partial derivative of the Working Capital Rate (WCR), with respect to sales. The research also investigates cement firms’ cash level, an important contributor to working capital management efficiency.
Moral knowledge for human systems
Authors: Singer Alan E.
Published: December 2016

Some stated information, such as “1+1 = 2” or “force = mass×acceleration” can be assessed as true or false in a sense that is enduring and independent of politics. Such statements are subject to merely minor objections or caveats that for almost-all practical purposes amount to nit-picking. The same can be said about many natural-language (NL) evaluative statements that refer to (i) the human-goods, (ii) the limitations of markets (with respect to those goods), and the (iii) general qualities of human intentions. However, the only available true statements about these things are imprecise, containing words like “frequently” or “complicated”. In future, the knowledge-based economy should be fully in-formed by what is known: that is, statements about humans and markets that are true in the above sense.