bluuebunny/crossref_metadata_2025 huggingface dataset:
To cringe or not to cringe: the role of individual variability in the perception of Covid-19 humor
Authors: Bischetti Luca
Published: August 2024

Humans share a laugh in response to comic uses of language and tend to find the fun side of events also when facing misfortunes. This is the case of cringe humor, in which others suffer while eliciting some awkwardness in the perceiver. At the emotional level, cringe humor pairs with reduced appreciation and increased discomfort, an ensemble of mixed emotions close to disgust. Accordingly, cringe humor matches other comic genres causing a cascade of emotions, like Covid-19 humor. Characterized by a bittersweet taste, the pandemic-inspired humor is akin to cringe humor in emotional/appraisal terms. Despite the large use of Covid-19 and cringe humor, little is known about the mixture of emotions they trigger and, to what extent, Covid-19 humor is as hard-to-watch as cringe humor. Overall, this chapter sought to push the experimental turn into cringe humor research, putting together insights from the linguistics and psychology of humor. To do so, we (re-)analyzed data collected from two large-scale studies in Italy and the US during 2020, the first year of the Covid-19 pandemic. By applying the k-means bottom-up clustering technique, here we analyzed to what extent judgments of funniness and aversiveness encapsulate cringe instances related to the pandemic. Moreover, we sketched on the role of individual and cultural variability in cringe humor appraisal. The semi-automatic classification showed that a cringe space of appreciation exists, and comic elements belonging to the cringe constellation share specific features. These features are described according to pragmatic categories introduced in the General Theory of Verbal Humor. In addition, our findings delineated a complex pattern of relationship between age and the cringe experience, largely faced by young adults, yet also found for more mature and older adults. In sum, all cringe, but what makes people cringe depends on how they position themselves in the cringe space.
Exploring Challenges and Impacts: Insights from School Teachers in Virtual Learning Environments
Authors: Journal Arab World English
Published: August 2024

As Virtual Learning Environments become increasingly integral to educational practices, this study delves into the often-neglected realm of challenges faced by teachers in the implementation of virtual teaching and learning. This study aims to explore the challenges and impacts faced by teachers in implementing virtual learning environments. Next is to identify the best features in addressing the challenges and impact of virtual learning implementation among teachers. Employing a qualitative case study design, the research conducted semi-structured interviews and observations involving primary school teachers from level 1 (years 1 to 3) and level 2 (years 3–6). The findings illuminate multifaceted challenges and constraints encountered by teachers, resonating across the realms of teacher dynamics, school infrastructure, and student engagement. Efforts to surmount these challenges revolve around recognizing teachers as crucial exemplars and elucidating the responsibilities they shoulder. Moreover, the study underscores the pivotal role of the learning environment and atmosphere during virtual teaching and learning implementations. In essence, teachers emerge as driving agents shaping the practical construction of the curriculum, necessitating a supportive environment and comprehensive infrastructure. The implications of this research extend towards fostering effective teaching and learning practices, ensuring a more conducive educational landscape for both educators and students in the era of virtual pedagogy.
Using Artificial Intelligence in English As A Foreign Language Classrooms: Ethical Concerns and Future Prospects
Authors: Journal Arab World English
Published: August 2024

This qualitative study aimed to explore how teachers of English perceive the advantages and disadvantages of using artificial intelligence by Saudi students who study English as a Foreign Language. The study used semi-structured interviews to delve into teachers’ pedagogical beliefs, ethical concerns, and expectations regarding using artificial intelligence tools by Saudi students, using the College of Languages and Translation at Al-Imam Mohammed Bin Saud Islamic University as a case study. The main research question focused on examining the positive and negative impacts of artificial intelligence on students’ language performance. The study findings revealed several themes from teachers’ interviews, including strategies for implementing artificial intelligence in the classroom, the impacts of artificial intelligence on students’ language proficiency, and the importance of guiding students to effectively use artificial intelligence applications. The findings also highlighted teachers’ expectations for expanding open-source language learning online channels and the widespread use of robots in English classrooms. The study recommends aligning professional development programs with language curricula to equip teachers with the necessary skills for effectively integrating artificial intelligence technologies into the classroom. The significance of this study stems from its contribution to the current debate on using artificial intelligence in education, presenting empirical evidence on its impacts on students’ language performance.
Relationship between macro- and micronutrient intakes with undernutrition among toddlers aged 12-23 months in Aceh, Indonesia
Authors:   Department of Community Nutrition, Faculty of Human Ecology, IPB University, Bogor, West Java, Indonesia, Suryana  ,   Department of Nutrition, Health Polytechnic of Aceh, Ministry of Health, Aceh Besar, Aceh, Indonesia, Marliyati Sri Anna ,   Department of Community Nutrition, Faculty of Human Ecology, IPB University, Bogor, West Java, Indonesia, Khomsan Ali ,   Department of Community Nutrition, Faculty of Human Ecology, IPB University, Bogor, West Java, Indonesia, Cesilia Meti Dwiriani Cesilia Meti ,   Department of Community Nutrition, Faculty of Human Ecology, IPB University, Bogor, West Java, Indonesia
Published: August 2024

Introduction: Foods consumed contain macro- and micronutrients necessary for the growth and development of children. This study aimed to analyse the relationship between macronutrient and micronutrient intakes with undernutrition in toddlers aged 12-23 months. Methods: This cross-sectional study was conducted in 18 Integrated Healthcare Centres (Posyandu) in Simpang Tiga, Aceh Besar Regency. A total of 138 toddlers were selected using simple random sampling technique. Data collected included family demographics, characteristics, nutritional status of children, and food consumption for macro- and micronutrient intake analyses. Results: Prevalence of malnutrition in toddlers was relatively high – severe underweight and underweight totaled 23.2%, severe wasting and wasting 18.1%, and severe stunting and stunting 27.5%. Significant associations (p<0.05) were found between underweight and intakes of energy, protein, carbohydrates, fat, calcium, phosphorus, zinc, thiamin, and niacin. Wasting was significantly associated (p<0.05) with intakes of energy, protein, and vitamin A. Stunting was significantly associated (p<0.05) with intakes of energy, protein, carbohydrates, fat, calcium, phosphorus, iron, calcium, zinc, vitamin A, thiamine, riboflavin, niacin, and vitamin C. Conclusion: Certain macro- and micronutrient intakes were correlated with undernutrition in toddlers. The results of this study can be used as a reference for planning the development of supplementary feeding programmes for children aged 12-23 months, considering that the critical period of child growth and development is in the first 1000 days of life.
The clinical, hematological, and biochemical profiles of patients with complications due to Plasmodium vivax malaria: A case series
Authors: Amrita Jha  , Sanjay Kumar Mandal  , Ranjan Mondal  , Sadhan Barman  , Golam Muztaba  , Krishnendu Das
Published: August 2024

Malaria, a protozoal infection caused by the six species of the genus Plasmodium, is one of the most important diseases known to humankind, with most infections caused by either of the two species – Plasmodium vivax and Plasmodium falciparum. Previously, it was held that falciparum malaria was responsible for causing severe, life-threatening disease, with vivax malaria causing mild or uncomplicated infections. In this case series, the clinical, hematological, and biochemical profiles of eight patients with features of complications due to P. vivax malaria, along with their clinical course, response to treatment, and clinical outcomes have been described. Among these, the most common clinical features were fever, headache, and myalgias. Five patients had altered mental status, two were prostrated, two were hypotensive, and one had recurrent generalized seizures. Three patients had pancytopenia, two had both anemia and thrombocytopenia, and one had evidence of disseminated intravascular coagulation. Six patients had clinical jaundice, four had elevated transaminases, and four had acute kidney injury. All cases showed excellent response to anti-malarial therapy. Hence, this case series revealed that P. vivax is capable of causing severe, life-threatening organ dysfunction akin to those seen in P. falciparum malaria and that early diagnosis and treatment initiation are associated with positive patient end outcomes.
A fascinating case of complex congenital heart disease
Authors: Divvela Soumya , Jensy Jaison  , Rajoo Ramachandran
Published: August 2024

Complex congenital heart disease (CHD) constitutes a significant non-infectious contributor to childhood morbidity and mortality, particularly prevalent in developing countries with an estimated incidence of nearly 1/100 births. The spectrum of CHD spans from isolated atrial septal defects that necessitate no immediate intervention to intricate structural cardiovascular abnormalities demanding multiple interventions early in the neonatal period. Patients afflicted with complex CHD often manifest symptoms such as respiratory distress, cyanosis of the skin, feeding difficulties, and failure to thrive, becoming evident within the initial 48 h post-birth. In this context, we present an intriguing case of a male child with complex CHD. This case study is accompanied by a concise exploration of the embryology of the heart, shedding light on the intricate developmental processes that may underlie such congenital anomalies.
Endometriosis and adenomyosis in a Mullerian agenesis patient: A delayed presentation
Authors: Gautam Monika , Meenakshi Chauhan  , Vani Malhotra  , Sushila Chaudhary  , Sarika Gautam  , Menka Verma
Published: August 2024

Mullerian duct anomalies are developmental anomalies resulting from failure in organogenesis, fusion, or the reabsorption of the paired Mullerian ducts. Endometriosis and Mullerian anomalies have a high coincidence rate. Obstructive uterine malformations with functioning endometrium have higher chances of co-incident endometriosis. Continuous bleeding into functional uterine remnants can lead to the formation of hematometra, endometriosis, and adenomyosis. We report a case of primary amenorrhea who reported 18 years after vaginoplasty with pain abdomen due to the presence of endometriosis in bilateral ovaries and adenomyosis in the rudimentary uterine horn.
Graham’s patch omentopexy versus modified Graham’s patch omentopexy in duodenal perforation – A comparative study
Authors: Atul Kumar Khare  , Kuldip Pratap Patel  , Ashok Kumar Chopra  , Pankaj Goyal  , Ashish Paliwal  , Aditya J Baindur  , Kirti Singh  , Ravi Pratap Singh
Published: August 2024

Background: Peptic ulcer perforation is a serious complication which affects 2–10% of peptic ulcer patients. Peptic ulcer perforation presents with an overall mortality of 10% although various authors had reported incidence between 1.3% and 20%. Being a life-threatening complication of peptic ulcer disease, it needs special attention with prompt resuscitation and appropriate surgical management if morbidity and mortality are to be contained.
Aims and Objectives: The aim of the study was to the comparative study of Graham’s omentopexy versus modified Graham’s omentopexy in duodenal perforation.
Materials and Methods: This prospective and single-center study was done in Birsa Munda, GMC Shahdol Madhya Pradesh from 2021 to 2023 for 2 years of periods. A total of 160 patients divided into two groups-Graham’s omentopexy 80 cases group “A” and modified Graham’s omentopexy 80 cases group “B.”
Results: One hundred and forty-six (91%) were male and 14 (9%) were female with M:F Ratio 10:1. Most of the patients were 20–78 years of age in both groups. Post-operative leakage was 7.5% and 1.25%, respectively. Mortality rate in Group A (3.75%) and in Group B (1.25%). The overall mortality rate was 7.14%. In this study, average hospital stay was 12.4 days in Group A and 9.0 days in Group B.
Conclusion: This study showed that modified Graham’s patch repair is as effective as Graham’s patch repair in terms of the mean operative time period, the timing of oral feed allow, and mean hospital stay timing.
A comparative evaluation of 0.25% bupivacaine and 0.25% levobupivacaine in peritubal infiltration in percutaneous nephrolithotomy
Authors: Devendra Singh  , Neelima Tandon  , Kushal Jethani  , Tripathy Anusha
Published: August 2024

Background: Percutaneous nephrolithotomy (PCNL) is a routine endourologic procedure in patients with renal calculi. Although it is less painful than open surgery, pain around the nephrostomy tube is a clinical problem; therefore, good post-operative analgesia is required to alleviate pain. Peritubal infiltration can be one of the choices to alleviate pain around the nephrostomy tube.
Aims and Objectives: The aim of this study was to evaluate the efficacy of peritubal infiltration of local anesthetics for post-operative pain following PCNL.
Materials and Methods: A total of 60 patients with American Society of Anesthesiologists Grade I/II scheduled for elective PCNL surgeries were randomly allocated into two groups. Group L received levobupivacaine 0.25% (30 mL) and Group B received bupivacaine 0.25% (30 mL). The duration of rescue analgesia, total dose of tramadol consumption in 24 h, hemodynamic parameters, and adverse events during the post-operative period were noted.
Results: The mean duration of rescue analgesia in Group L was 274.50±24.89 min and in Group B was 275.33±23.04 min which was not significant (P>0.05).
Conclusion: Peritubal infiltration of 0.25% levobupivacaine and 0.25% bupivacaine is efficient in alleviating post-operative pain after PCNL. Both drugs can be used for infiltration around nephrostomy tubes in PCNL surgeries safely and are associated with minimal side effects.
Immunohistochemical expression of CD44 in invasive breast carcinoma
Authors: Kapil Kumar Swami  , Renuka Verma  , Sunita Singh  , Sanjay Marwah  , Rachana Yadav  , Pooja Rathee  , Vibhuti Thukral
Published: August 2024

Background: In India, breast cancer forms the most common malignancy, accounting for 28.2% of all female cancers. Breast cancer consists of phenotypically diverse group of diseases. Due to different relapse abilities, doubling times, and different infiltrative capacities, it is important to identify potential biomarkers that could be used to screen high-risk patient and predict breast cancer prognosis in conjunction with classical pathological parameters.
Aims and Objectives: The present study was conducted to evaluate immunohistochemical expression of CD44 in breast carcinoma and to correlate CD44 expression with other clinicopathological parameters and molecular classification of carcinoma breast.
Materials and Methods: The present study was a prospective descriptive study conducted on 100 cases of carcinoma breast diagnosed on modified radical mastectomy specimens that were submitted to the Department of Pathology, Pt. B. D. Sharma, PGIMS, Rohtak, Haryana, over the period of 2 years.
Results: Out of 100, 64 cases (64%) were CD44 positive. Out of these 64 cases, 9 (9%) cases were 1+, 34 (34%) cases were 2+, and 21 (21%) cases showed 3+ positive expression of CD44 in tumor cells. Loss of CD44 expression was seen in 36 (36%) cases. A statistically significant association of CD44 was seen with multifocality of the tumor, negative estrogen receptor/progesterone receptor (ER/PR) expression, and molecular subtypes. No statistically significant association of CD44 was seen with age, side of tumor, lymph node metastasis, lymphovascular invasion, ductal carcinoma in situ and Ki67, and HER2neu expression.
Conclusion: A high CD44 expression in breast carcinoma correlates with aggressive tumor characteristics such as multifocality, negative ER/PR expression, and belonging to the basal subtype which is associated with poor prognosis. Conversely, low CD44 expression is linked to Luminal A and Luminal B subtypes which have good prognosis. These indicate the role of CD44 as a prognostic biomarker in the carcinoma breast.
Assessment of seasonal variations in dry eye syndrome prevalence among office workers
Authors: Prameela R  , Vijaya Sree S  , Ramya Bhukya
Published: August 2024

Background: Dry eye syndrome (DES) is prevalent among office workers and influenced by various environmental and individual factors. This study assesses the prevalence, seasonal variations, symptom severity, and environmental influences on DES among office workers.
Aims and Objectives: The study aimed to assess the prevalence of DES among office workers in Warangal, Telangana, India, and to evaluate the impact of seasonal variations, symptom severity, and environmental factors on DES.
Materials and Methods: A cross-sectional study was conducted with 100 office workers aged 25–55 years old. Data were collected through questionnaires on DES symptoms, environmental conditions, and demographics. The prevalence of DES was calculated, and seasonal variations were analyzed. Symptom severity was recorded on a scale from 1 to 10. Environmental factors such as humidity, air-conditioning use, screen time, and indoor air quality were examined for their correlation with DES prevalence.
Results: The overall prevalence of DES was 45%, with females showing a higher prevalence (50%) compared to males (37.5%). Seasonal variations showed the highest DES prevalence in winter (40%) and the lowest in summer (16%). Symptom severity scores were highest in winter (6.5 overall) and lowest in summer (3.8 overall). Low humidity in winter was associated with a 55% prevalence of DES, especially among females (65%). High air-conditioning use in summer correlated with a lower DES prevalence (12.5%). Increased screen time (>6 h/day) resulted in a 60% prevalence of DES, with seasonal peaks in winter (65%). Poor indoor air quality was reported by 70% of participants and linked to a 50% prevalence of DES.
Conclusion: The study highlights significant gender differences, seasonal variations, and environmental factors impacting DES prevalence and severity among office workers. Interventions focusing on improving workplace conditions, managing screen time, and enhancing indoor air quality may mitigate DES symptoms.
A computerized tomography-based study of anatomical variations of the ethmoidal uncinate process
Authors: Rakesh Sharma  , Puneet Gupta
Published: August 2024

Background: The uncinate process is very relevant with respect to the ventilation and drainage of the frontal, maxillary and anterior ethmoid sinuses in the osteomeatal complex.
Aims and Objectives: The study was conducted with the aim to examine and assess various patterns of upper attachment of the ethmoidal uncinate process. The secondary objective of the study was to study the incidence of pneumatization of the uncinate process.
Materials and Methods: With the objective to study the various patterns of upper attachment of the uncinate process, the study was conducted at the Department of Ear, Nose, and Throat (ENT) Head and Neck Surgery, at Government Medical College, Doda, J and K, India. The period of study was from November 2020 up to November 2021. The study involved 100 patients who had presented to the ENT outpatient with nasal and or sinus-related complaints.
Results: The study included 58 males and 42 females. Among the various patterns, it was the type-2 pattern of the uncinate attachment that was the most prevalent (42%). This was followed by a type-1 pattern (attached to the lamina papyracea) (16%) and then a type-6 pattern (14%). Type-3 in 4%, type-4 in 3%, and type-5 in 7%. In 14% of the cases, there was no upper attachment of the uncinate process. The pneumatization of the uncinate process was noted among 42 of the uncinate processes that we studied. The pneumatization was unilateral in 41% and bilateral in 59% of the uncinate process. The patients with a pneumatized uncinate process had more severe clinical presentation.
Conclusions: A thorough computerized tomography scan assessment of the attachments of the uncinate process and its variations aids in minimizing damage to the related landmarks during the surgery and helps minimizing the chances of iatrogenic trauma to the nasolacrimal duct, medial orbital wall, and other surrounding structures. It can also assist in figuring out the likely cause of refractory sinusitis.
A comparative study to evaluate the efficacy of cisatracurium and rocuronium for endotracheal intubation in pediatric patients: A prospective randomized study
Authors: Deepak R  , Seema Shende  , Namrata Jain  , Sanyukta Paul
Published: August 2024

Background: Cisatracurium and rocuronium are non-depolarizing neuromuscular blockers with an intermediate duration of action and are used safely in short and intermediate-duration surgical procedures in the pediatric population.
Aims and Objectives: A prospective randomized study is to assess the efficacy of cisatracurium compared to rocuronium in terms of intubating conditions, clinical duration of action, hemodynamic parameters, and side effects in pediatric patients undergoing surgeries under general anesthesia.
Materials and Methods: In this study, 50 patients aged 2–12 years with the American Society of Anesthesiologists grades I and II were randomly allocated into two groups: Group I received injection cisatracurium 0.15 mg/kg IV and Group II received injection rocuronium 0.6 mg/kg IV for intubation. Intubating conditions by Cooper et al., score, TOF count, hemodynamic parameters, signs of histamine release, and complications if any were noted.
Results: According to the Cooper et al., score, intubating conditions were excellent in 100% of patients in Group II and 84% of patients in Group I, which was statistically significant. The time required for the first maintenance dose was shorter in Group II (14.04±2.95 min) compared to Group I (20.08±3.68 min). Hemodynamic parameters and demographic profiles were comparable between the two groups. No associated signs of histamine release or any other complications were noted in either group.
Conclusion: We concluded that rocuronium 0.6 mg/kg provides better intubating conditions and a shorter duration of action compared to cisatracurium 0.15 mg/kg without any signs of histamine release in pediatric patients.
Nature-Young Adult Relationship in Anderson’s Speak: An Ecofeminist Reading
Authors: Thapa Hukum
Published: August 2024

This paper explores ecofeminism through a connection to the nature and a sexually assaulted young adult girl in Laurie Halse Anderson’s novel Speak. This study argues that adolescents suffer from the effects of rape. It also contends that aside from abusing teenagers, sexual assaulters also damage the victim’s ability to interact with the outside world. The rapists prevent the female protagonist from having healthy relationship with the nature.  Therefore, it is crucial to re-establish connections with oneself, other people, and the natural environment in order to escape the horrible act of physical violation. For that purpose, this research paper employs the perspectives of Roberta S. Trites about young adults; and opinions of Carlos J. Adams and Greta Gaard about ecofeminism. In conclusion, this study hopes to pave the path for future research into the comprehensive interaction between a young adult’s (female) body and nature.
Osteoporotic vertebral fracture: Our Experience and update
Authors: Sharma Krishna , Bhattachan Maya , Bhatta Raj Kumar , Singh Praveen Kumar
Published: August 2024

Introduction: Osteoporotic vertebral fracture is a fragility fracture due to osteoporosis and is a growing public health problem. It mainly affects postmenopausal women and men > 50 years. It significantly affects morbidity, financial condition, quality of life and mortality of patients. It presents mainly with back pain, which is mostly manageable with conservative measures. Those with unrelieved pain, severe spinal deformity or neurological impairment would require intervention. The quality of bone and surgical fitness along with associated co-morbidities of these elderly people, require special consideration, indications and appropriate modification of technique and instruments for surgical intervention. Materials and methodology: This prospective study summarizes the management of osteoporotic vertebral fractures from September 2015 to September 2021 in Nepal Medical College, Kathmandu, Nepal. The study included patients with back pain of more than 50 years old age. The backpain was evaluated clinically using visual analogue scale and Oswestry Disability Index, neurological deficits using Frankel grading system and deformity using X-ray. Other investigations included MRI, Dexa scan, Serum calcium and Vitamin D3. Risk factors for developing osteoporosis and OVF were also assessed. Results: Out of the 630 patients of more than 50 years age, presenting in neurosurgical OPD with backache from September 2015 to September 2020, 158 cases were later diagnosed to have osteoporotic spine fractures. There were 122 (77.2%) postmenopausal ladies and 36 (22.8%) gentlemen. All had backpain, with 36% having VAS score of < 3 and 64% had ODI of mild to moderate disability. The neurological deficits were present in 16.4% and mostly were Frankel grade C and D. Significant kyphoscoliosis (Cobb angle more than 20 degrees) in X-ray was present in 18 (11.3%) patients. 88 (55.7%) patients had Dexa scan and T score was less than -2.5 in 88 (56%). Serum calcium was low in (41) 26% and Vitamin D3 was low in (107) 67.7% of the patients. For backpain, all were started on non-operative management.  Vertebral augmentation procedure was not available in our institute. Thus, surgery was offered in 44 (28%) of the patients but only 18 (11.4%) agreed for surgery and underwent decompression with long segment fixation. Only 48 patients remained in follow up for more than 2 years and all had satisfactory control of pain with no deterioration in deformity or neurological deficit. There were no significant short or long-term complications or mortality. Conclusion: Osteoporotic vertebral fracture is a very common reason for back pain in people of more than 50 years old affecting their livelihood. The majority responded to conservative treatment.  Those indicated for surgery need special consideration in preparation, technique and devices. Preventive measures can help reduce the problem load.
Intracranial Empyemas: Experience of the Neurosurgery Department of Conakry University Hospital
Authors: Louncény Fatoumata Barry , Ibrahima S Souare , Hugues G ATAKLA , HAMANI Abdoul B DJIBO , Alpha Y CONDE , Mamadi CAMARA , Fodé A CISSE , A CISSE
Published: August 2024

Introduction: Intracranial empyemas are rare intracranial suppurations but carry serious and potentially fatal prognosis In the absence of adequate treatment. The objective of our study was to determine the epidemiological, clinical features, therapeutic and evolutionary characteristics of these suppurations in our department. Materials and methods: It was a descriptive retrospective study of 88 intracranial empyemas files collected over a period of 5 years (January 2014-December 2018) in the archives of the neurosurgery department of Conakry University Hospital. Results: The frequency was 43.1% for all intracranial suppurations. The mean age was 14.6 years (2-42 years) with a sex ratio of 1.8 (57 males/31 females). The port of infection was dominated by otorhinolaryngological infections, 76.5% and unknown in 19%. The clinical manifestations were dominated by fever (90%), intracranial hypertension (66%) and focal signs (45%). The site was subdural in 59 cases and extradural in 29 cases. Surgical treatment involved 91% of patients and 9%were treated with antibiotic therapy alone. The evolution was favorable in 68.1% of cases with a mortality rate of 13.6%. Conclusion: Intracranial empyemas are medical and surgical emergency. The forms of otorhinolaryngology origin are more frequent. Despite the therapeutic difficulties, the prognosis remains acceptable in our study with 13.6% of deaths.
Introduction of Endovascular Thrombectomy to The Island Nation — The Maldives
Authors: Niyaf Ali , Niraula Kiran , Haaish Hashmath Mohamed , Reeath Hameed Mariyam , Bhattarai Robin
Published: August 2024

Over the years multiple treatment trials were researched up on for acute management of ischemic stroke to reduce mortality risk and morbidity rate among adults who suffered. Here, we report a case of 63 years Muslim diabetic female with multiple co-morbidities of coronary heart disease, pulmonary disease, and internal carotid artery aneurysm presented with thrombotic occlusion of left middle cerebral artery who underwent Maldives first ever endovascular thrombectomy using combined technique.
Dyke –Davidoff – Masson Syndrome in a 28 years old pregnant woman – A rare case report
Authors: Yadav Ashmita , Kumar Chaudhary Pramod , Kafle Prakash , Jonathan Edmond , Jung Shah Sabin
Published: August 2024

Dyke -Davidoff- Masson (DDM) Syndrome is rare neurological disorder commonly affecting the children but is rarely reported in adults as well. It mostly presents with seizure, hemiparesis followed by mental retardation and facial asymmetry. We here in report a case of 28 years old female (G3P2A0) with 34+ weeks of pregnancy who presented with generalized tonic clonic seizures and was incidentally diagnosed as DDM. She was managed with an External ventricular drain and antiepileptic medication. This case report aims to draw the attention of health care professionals to keep DDM as a differential in a patient with seizure.
The Jajarkot Earthquake: Revealed the Vulnerability of Load Bearing Structures in Western Nepal
Authors: Poudel Hemanta Raj , Chaulagain Hemchandra
Published: August 2024

The Jajarkot Earthquake, which occurred on 3rd November, 2023 of magnitude 5.7 (Mw) exposed Nepal’s longstanding vulnerability to seismic activity. This paper presents damage assessments derived from both on-site field observations and secondary resources to evaluate the damages sustained by load bearing masonry structures. In the region, 95% of the building structures are based on masonry construction. The damage status of structures in Jajarkot and Rukum East highlighted that about 50% of the building structures were partially and complete damage. The evaluation encompassed various aspects, including the types, mechanisms, and underlying causes of the damage incurred by structures. The observed damage was categorized using an established catalogue originally developed for the identification of failure mechanisms and vulnerability assessment. The common types of damage encompassed features like cracks in the load bearing external walls and corners, diagonal cracks originating from door and window corners, vertical out-of-plane displacement of external walls, collapse of external walls, and partial collapse of load bearing internal walls, fracturing of window and door lintels and complete collapse of structure. Some special forms of damage which was of new nature and distinct from those observed in prior seismic events such as the Gorkha earthquake included ruptures in the outer surfaces of loadbearing external walls, partial roof structure collapses, out-of-plane fragmentation or disintegration as well as rupture. The causes underlying this general damage were attributed to irregular bonding systems, weak mortar, stone block formation, size of stone blocks, absence of tie beams, weakly connected corners, insufficient connections of wall-roof and wall-floor systems, and differing internal wall systems. The mechanisms of damage varied based on the number and specifics of these causative factors, as well as certain structural attributes.
Quackery: A Major Persisting Issue in the Dental Profession of Nepal
Authors: Poudel Priyanka , Roshan kumar Roy  , Mahato Lalan Kumar , Panday Purushottam , Sharah Mehnaz Meghla
Published: August 2024

Background: Quackery in the dental profession is a significant and persistent issue in Nepal, particularly in urban areas like Hetauda city. This practice involves the provision of dental services by individuals lacking formal education, training, or licensing, posing serious risks to patient health and safety. Objective: This study aims to assess the prevalence of quackery in Hetauda city, Nepal, and its implications for dental care quality and patient safety. It also seeks to understand the reasons behind patients’ continued use of unlicensed dental practitioners and to provide recommendations for addressing this issue. Methods: A cross-sectional study was conducted in 25 dental clinics across Hetauda city. Data collection included structured interviews with licensed dental practitioners, patient surveys, and observational assessments of clinic operations and infection control practices. Quantitative data were analyzed using descriptive statistics, while qualitative data from interviews were thematically analyzed. Results: The study found that 28% of the surveyed clinics employed unlicensed practitioners. Clinics with quacks exhibited significantly lower standards of care, including inadequate infection control and improper procedures. Only 30% of patients were aware of their dental care providers' qualifications, with many opting for quacks due to affordability and accessibility. A higher incidence of complications and adverse outcomes were reported among patients treated by unlicensed practitioners. Qualitative findings highlighted patient trust in quacks, frustrations of licensed practitioners, and regulatory gaps. Conclusion: Quackery remains a major issue in the dental profession in Hetauda city, Nepal. Addressing this problem requires a multifaceted approach, including improved regulation, increased public awareness, and stringent enforcement of licensing standards. Ensuring that all dental practitioners are properly qualified and licensed is essential for protecting patient safety and maintaining the credibility of the dental profession in Nepal.
Health Promoting Behaviour among School Going Adolescents of Government School in Gaidakot, Nawalparasi
Authors: Ghimire Babita , Aryal Barsha , Upadhyay Hari Prasad
Published: August 2024

Background: A health-promoting behavior is an endpoint or action-outcome directed toward attaining positive healthoutcomes such as optimal wellbeing, personal fulfillment, and productive living. Adolescents make up as much as a quarterof the population and the number of adolescents is expected to rise through 2050. Adolescents are vulnerable to the riskfactors contributing to Noncommunicable diseases, whether from unhealthy diets, physical inactivity, exposure to tobaccosmoke or the harmful use of alcohol.Method: A cross sectional analytical study design was used among 89 adolescents of grade 9 and 10 was selected throughenumerative sampling technique. Data was collected using a self–administered questionnaire from Adolescent HealthPromoting – Short Form scale and entered in excel and analyzed by Statistical Package for Social Science (SPSS) version20.0 using Descriptive statistics (Frequency, percentage, mean, standard deviation) and interferential statistics (chi-square).Result: Findings revealed that 48.3% respondents obtained below average mean score on health promoting behaviour.The overall mean ± S.D of status of health promoting behaviour was 68.12±8.847. Among 6 subscales, life appreciationobtained the highest mean score (with standard deviation) i.e. 15.35±3.72, whereas exercise obtained least mean score (withstandard deviation) i.e. 7.80±2.66 and there is statistically significant association with health promoting behaviours amongadolescents and educational status of mother (p=0.033).Conclusion: Overall health promoting behaviours among adolescents is below average so it is necessary to improve in areaslike nutrition and exercise. There is significant association between parental education and health promoting behavioursof the adolescents, so parental education should be improved by school committee, should introduce educational session,awareness program, physical activity program and nutrition exhibition program regarding health promoting behaviourssince early grade.
From Fields to Futures: Examining the Socioeconomic Shifts from Cardamom Cultivation in Eastern Nepal
Authors: Budhathoki Drona
Published: August 2024

Large-scale cardamom cultivation in Eastern Nepal is primarily concentrated in six districts, namely Dhankuta, Taplejung, Panchthar, Ilam, Terhathum and Sankhuwasabha, contributing over 80% of the national production and engaging approximately 60,000–70,000 families. The study aims to investigate how cardamom farming has impacted farmers' livelihoods compared to traditional farming methods and how the volatility of cardamom prices underscores the complex dynamics of capitalist market structures. This study focused on Ward No. 2 of Mahalaxmi Municipality in Dhankuta District and spans a five-year period from 2019 to February 18, 2024. Through census-based data collection from 27 households using interviews and observations, the research examined the impact of cardamom production on local livelihoods. The analysis incorporates insights from Marx's Mode of Production, along with perspectives from Jagannath Adhikari, Mark Liechty, and Ian Carlos Fitzpatrick. The findings reveal that earnings from cardamom cultivation did not only elevate living standards but also encouraged self-sufficiency and reduced reliance on foreign employment through borrowing, highlighting changing economic opportunities, self-esteem, and job prospects within the community. The study reveals that cardamom farming has the potential to significantly influence farmers' economic stability and highlights the need for better market strategies and government policies to address price volatility and enhance cardamom productivity.
Mechanical and Structural Characterization of Resole Resin Composites Reinforced with Sabai Grass-Derived Cellulose Fibers
Authors: Puri Aabha , Adhikari Rameshwar , Pandit Rajesh
Published: August 2024

Cellulose fibers were extracted from Sabai grass (Eulaliopsis binata) using mechanical and chemical treatments. The grass was ground to ~250 µm powder and bleached with hydrogen peroxide and acetic acid. The bleached fibers were treated with 6% sodium hydroxide solution and incorporated into resole resin at various weight percentages to prepare the composites. The prepared samples were characterized by X-ray Diffraction (XRD), Fourier Transform Infra-Red (FTIR) spectroscopy, Scanning Electron Microscopy (SEM), and compressive strength tests. The XRD and FTIR showed a nanometric crystallite size of 3.84 nm and effective removal of non-cellulosic compounds, respectively, leading to a compressive strength increase from 15.60 MPa to 25.26 MPa at 3 wt.-% cellulose fiber. The compressive strength improved up to 3 wt.-% cellulose fiber, which however declined upon adding more filler. SEM revealed modified surface morphology in the composites with cellulose fibers.
Synthesis and Characterization of Janus fenugreek Seed Gum-based Film for Food Packaging and Wound Dressing Applications
Authors: Bhattarai Susmita , Khanal Kalpana , Karki Nirmal , Shahi Dikpal Kumar , GC Rajendra Bahadur , Bhatt Lok Ranjan , Bhattarai Narayan , Joshi Mahesh Kumar
Published: August 2024

The use of plant-derived natural gum polysaccharides in food packaging and biomedicine is growing due to their biocompatibility, biodegradability, film-forming ability, abundant functional groups, and potential for chemical or physical modification to develop novel materials. In this study, fenugreek (Trigonella foenum-graecum) seed gum (FSG)-based Janus films with glycerol (GLY) as a plasticizer in varying concentrations (2%, 5%, 7%, and 10% w/w) were synthesized for potential food packaging and biomedical applications. The glycerol concentration significantly affected the stability, microstructure, moisture content, and solubility of the film, with 5% GLY yielding the most stable films. The water solubility was gradually increased with increasing the GLY content in the film sample. The film exhibited strong radical scavenging activity against DPPH assays, with an IC50 value of 158.73±0.013 µg/mL. The total phenolic content (TPC) and total flavonoid content (TFC) of the film were found to be 88.21±0.012 mg/g in gallic acid equivalents (GAE) and 9.36±0.018 mg/g in quercetin equivalents (QE), respectively. The pristine FSG film exhibited antibacterial activity against Staphylococcus aureus, Escherichia coli, and the fungal strain Candida albicans, which was significantly enhanced by incorporating the antibacterial drug penicillin. Additionally, we examined the impact of different films on chicken meat and cheese by monitoring changes in weight loss, color, pH, total aerobic mesophilic counts (TAMC), and psychrotrophic bacterial counts (PBC) during storage. Our results demonstrated that the samples packaged with pristine FSG film exhibited significantly lower TAMC and PBC values and slowed down the increase in pH values compared to the control samples, which further decreased by incorporating antimicrobial drug. These findings indicated that the Janus pristine FSG film is suitable for food packaging. Further, antimicrobial drugs incorporated into FSG film could be potential candidates for wound dressing applications.
Medication Adherence and its Determinants among Type 2 Diabetic Patient in Tertiary Care Hospital
Authors: Shah Pammi , K.C Nyamika , Dhami Kabita , Shah Nisha Kumari , K.c Mamta , Pokhrel Khushi
Published: August 2024

Background: Diabetes mellitus imposes vast social, health, and economic impacts on individuals and countries in the long term.Inadequate medication adherence is a major factor leading to poor and suboptimal glycemic control among patients with DM, which catalyzes the magnitude of this problem and leads to the development of diabetic-related complications.
Materials and Methods: A descriptive cross-sectional study was conducted in medicine and endocrine OPD of Nobel Medical College Teaching Hospital.A convenience sampling technique was deployed using a structured interview schedule consisting of a medication adherence scale having a 4 Likert scale. Data was analyzed by SPSS version 20.0. Descriptive statistics including, frequencies, percentages, mean, and standard deviation were demonstrated by using tables and pie charts. Inferential statistics were used to find out the association between the level of adherence and selected variablesand also determinants associated with non-adherence.
Results: From a total of 228 study respondents, more than half (59.65%) of them were non-adherent to their anti-diabetic medication. Glycemic control and the type of drug taken were found to be significantly associated with the level of medication adherence. Patients with tend to forgetfulness, far distance from health facilities, fear of dependency on drugs, and symptoms of hypoglycemia will likely have greater odds to be non-adhered to medications.
Conclusion: Medication adherence among diabetic patients in the present study is non-adherent. Glycemic control and the type of drug taken were associated with level of adherence
Stress and Coping among Nursing Students
Authors: Shah Nisha Kumari , Dhami Kabita , Pokhrel Khushi , Shah Pammi , K.C Nyamika , K.C Mamta
Published: August 2024

Background: Student at the university level experience high level of stress, related to worry about successes, availability of time and engagement in patient care. Coping mechanisms are essential when trying to deal with the stress and anxiety that nursing students face on a daily basis. The objectives of this study was to find out the level of stress and coping among nursing students and to find out the association between level of stress and coping with selected socio demographic variables.
Materials and Methods: A descriptive cross sectional research design was adopted for the study. Non probability total enumerative sampling technique was used in the study. A structured questionnaire consisting of 5 points Likert scale was used for assessing the stress whereas Brief cope scale was used for assessing the coping among nursing students. Data was analyzed by using descriptive and inferential statistics.
Results: The result depicts that out 107 respondents, more than two third (68.2%) of the respondents had high level of stress whereas more than half (60.7%) of the respondents had average coping. There was statically significant association between the age of the respondents with the level of stress whereas there was no statically significant association between coping with the socio demographic characteristics of respondents.
Conclusion: The study concluded that, more than two third respondents had high level of stress with average coping. So, there is further need of nursing educators to provide stress management technique educational program to nursing students.
Determinants of Investment Decisions of Mutual Fund in Nepal
Authors: Bhandari Dilli Ram , Subedi Dhruba Prasad
Published: August 2024

Mutual funds in Nepal are financial vehicles that pool money from multiple investors to invest in diversified portfolios of securities, managed by professional fund managers. They play a crucial role in mobilizing savings and providing access to diversified investment opportunities for Nepalese investors. This study examines the factors influencing investment decisions in mutual funds in Nepal, focusing particularly on financial literacy, risk perception, investment behavior, and peer group influence. To achieve the stated objective, data were collected from the primary source using a structured questionnaire administered through convenience sampling technique. The respondents comprised 204 individual investors of mutual funds inside the Kathmandu Valley. The Smart PLS 4.0 was used to analyze the structural relationships within the proposed theoretical model. The findings of this study validated the set hypotheses that financial literacy, risk perception and investment behaviour have positive and significant effect on investment decisions among the investors in Nepalese mutual funds but the peer group has no any effect on investment decision. These results underscore the importance of targeted financial education programs and tailored investment strategies that enhance individual investor knowledge and understanding, thereby fostering more informed and independent investment decisions in Nepal's mutual fund market. The results may encourage to promote financial literacy through educational programs and integrating it into national curricula can empower investors to make informed decisions in Nepalese context.