bluuebunny/crossref_metadata_2025 huggingface dataset:
Is Venous Thromboembolism Prophylaxis Needed in Patients Undergoing Knee Arthroscopy? A Prospective Observational Study
Authors: Joshi Amit , Rijal Nishchal , Gurung Subash , Basukala Bibek , Sharma Rajiv , Bista Rohit , Singh Nagmani , Pradhan Ishor
Published: November 2024

Background: Although rare, deep vein thrombosis is a potentially life-threatening complication of knee arthroscopy. There are scanty literature analysing deep vein thrombosis after arthroscopy in Nepal. This study aimed to identify the prevalence of deep vein thrombosis in patients undergoing knee arthroscopy without chemoprophylaxis postoperatively at 2 weeks and 6 weeks, respectively. The study also aimed to estimate the risk of deep vein thrombosis in these patients by using Caprini Risk Assessment Model.Methods: This prospective observational study was conducted at AKB center, B&B Hospital, Gwarko, Lalitpur, over a period of 16 months. All patients who underwent arthroscopy knee surgeries fulfilling the inclusion criteria were included in the study. The primary outcome measure was the prevalence of deep vein thrombosis as diagnosed by compression color-coded ultrasonography of the popliteal vein and calf vein at 2 weeks and 6 weeks postoperatively. The secondary outcome measure was the prevalence of deep vein thrombosis in the risk groups according to Caprini Risk Assessment Model.Results: Out of 612 patients who underwent arthroscopic knee surgeries during the study period, 2 patients (0.33%) developed deep vein thrombosis at 6 weeks follow-up as diagnosed with ultrasonography of the popliteal and calf veins. The prevalence rate in high-risk group was 0.33% (1 in 307) and in very high-risk group was 5.88% (1 in 17).Conclusions: There was a low prevalence of deep vein thrombosis without chemoprophylaxis following knee arthroscopy in our study. There was higher prevalence of deep vein thrombosis in very high-risk group patients, so close monitoring of such patients during follow-up is recommended.Keywords: Caprini Risk Assessment Model; deep vein thrombosis; knee arthroscopy; prevalence.
Diagnostic Accuracy of Fine Needle Aspiration Cytology as Compared to Histopathology in Parotid Gland Swelling
Authors: Tripathi Prashant , Acharya Kunjan , Shrivastav Shreya , Gyawali Bigyan Raj
Published: November 2024

Background: The diagnosis of parotid swelling is challenging and investigations like imaging and needle aspiration cytology are helpful. The objective of this study was to determine the diagnostic accuracy of fine needle aspiration cytology (FNAC) as compared to the histopathology in parotid gland swelling.Methods: It was a descriptive cross sectional study carried out in the Department of ENT-Head & Neck Surgery, Tribhuvan University Teaching Hospital, Institute of Medicine, Kathmandu by reviewing the medical record charts of the patients who had undergone surgery for parotid lesions during the study period of seven and half years. All patients whose fine needle aspiration cytology and histopathology reports were available were included in the study. The data were presented as mean, standard deviation, ratio and percentages. Microsoft excel was used for data analysis. Results: There were 75 patients included in the study. The age ranged from nine years to 78 years and the mean age being 38.3± 17.42 years. The male to female ratio was 1:1.78. The concordance rate between fine needle aspiration cytology and histopathology was 82.7%. The sensitivity and specificity of the fine needle aspiration cytology were 80% and 95% respectively. Similarly, the positive predictive and negative predictive values were 84% and 93% respectively. The diagnostic accuracy of the fine needle aspiration cytology was 91% for the parotid swelling in our study.Conclusions: The diagnostic accuracy of fine needle aspiration cytology for parotid swellings in our study was excellent. The result of fine needle aspiration cytology is helpful in deciding management plan for parotid lesions.Keywords: Benign; cytology; histopathology; malignant; parotid.
Knowledge and Attitude about Labor Epidural Analgesia among Pregnant Women Attending Antenatal Clinic
Authors: Parajuli Bashu Dev , Koirala Megha , Joshi Pankaj , Katuwal Neeta , Shrestha Amit , Singh Shreejana , Rawal Suniti , Shrestha Anil
Published: November 2024

Background: Labour pain is one of the most painful experiences that a woman faces in her lifetime. There are various options for labour pain management. Epidural analgesia is the gold standard method for pain management during labour. In developing and under-developed countries there are many challenges to provide this service, a very important one being knowledge about epidural analgesia among the parturients and the physicians. Methods: A prospective cross-sectional study was carried out among 384 pregnant women attending Antenatal clinic of a tertiary level teaching hospital using pretested structured questionnaire prepared by a team of anaesthesiologists and obstetricians. Non-probability purposive sampling technique was used. The data was analysed by using SPSS version 20.0. Descriptive and inferential statistical methods were used for analysis.Results: Of the 384 pregnant women, only 29.4% had knowledge about some form of labour analgesia techniques and only 16% of the participants were aware of labour epidural analgesia. Also, only 6.2% were aware that epidural service is available at our hospital. Regarding acceptance, only 42.4% were willing to use epidural analgesia in their present pregnancy.Conclusions: The present study findings revealed that a significant number of participants had very limited knowledge about labour epidural analgesia and were also unaware of the availability of the service in our hospital. Educational programs need to be provided to all the pregnant women for enhancement of knowledge and awareness about epidural labour analgesia to increase its acceptability among them. Keywords: Acceptance; awareness; knowledge; labour analgesia.
Adverse Events Following COVISHIELD and VERO CELL Vaccination Campaigns Against COVID-19
Authors: Adhikari Santosh , Maharjan Jessica , Bhattarai Sushan , Kunwar Kshitij , Agrawal Sumit , Dangal Raj Kumar , Chapagain Ram Hari , Bista Tek Bahadur , Bhattarai Srijana
Published: November 2024

Background: Vaccination against COVID-19 for Nepalese was initiated in January 2021 for various age groups. People were anxious about receiving the vaccines and were concerned about the safety profile of the vaccine they received. In this study, we have tried to observe the Adverse Events Following Immunization of two different vaccines namely COVISHIELD (ChAdOx1 nCOV-19) and VERO CELL (CZ02 strain), used in different phases of vaccination by the government of Nepal.Methods: We conducted a cross-sectional study among people who received COVID-19 vaccines in this study using a self-administered questionnaire.  Data was cleaned and then exported to IBM SPSS v.20 for analysis, Chi-square test was used to see the association between different variables and a p-value<0.05 was considered statistically significant.Results: Out of 303 respondents, all had received the first and 270 participants had received the second dose of the COVID-19 vaccine, among which, 133 (43.89%) reported at least one side effect after the first dose of vaccination while 58 (21.48%) had self-reported side effects after the second dose of vaccination. Seventeen percent of the respondents had COVID-19 infection within the past 3 months before receiving COVID-19 vaccine. Three percent of participants had re-infection with COVID-19 after receiving the first or the second dose of the COVID-19 vaccine. Among participants who experienced adverse events, 42% and 62.1% of participants experienced mild adverse events following the first dose and second dose of the vaccine, respectively. Conclusions: The adverse events following immunization for both vaccines after both doses of vaccination were quite low, with 43.89% of participants reporting side effects after the first dose and 21.48% of participants reporting side effects after the second dose. Adverse events were most frequently reported within 24 hours of vaccination and were mostly mild. There was no statistical significance of adverse events between both vaccines.Keywords: Adverse events following immunization (AEFI); COVID-19; COVISHIELD; VERO CELL.
Surgical Service Utilization and In-Patient Satisfaction in Surgical Service
Authors: Joshi Anip , Shrestha Deepa
Published: November 2024

Background: The patient satisfaction study is an important and commonly used valid indicator for service quality improvement in healthcare institutions. The aim of this study was to assess the service utilization and patient satisfaction in patients admitted under surgical service in Bir Hospital.Methods: A prospective cross sectional analytical study was conducted in Bir Hospital, National Academy of Medical Sciences from February 2021 till June 2023. The patient satisfaction data was collected using the SAPS scale after obtaining ethical clearance from the Institutional Review Board. Data were entered and analyzed in Statistical Package for the Social Sciences version 20.0. Results: There were 152 patients included in the study categorized into conservative treatment group, elective surgery group and emergency surgery group. 32.9%(50) patients were “very satisfied”, 62.5%(95) patients were “satisfied”, 2.6%(4) were “neither satisfied nor dissatisfied” and 2%(3) were “dissatisfied” with the effect of their treatment/care. The mean satisfaction score in conservative treatment group was 22.13 ±2.53 as compared to the mean satisfaction in elective surgery group which was 21.11± 2.55 (P=0.036) and the mean satisfaction score in emergency surgery group which was 21.66 ±2.68 (P=0.64).Conclusions: The mean score and proportion of patient satisfaction regarding service utilization in patients admitted under surgical service were high with satisfaction score higher in emergency surgery group among the operative groups in Bir Hospital, National Academy of Medical Sciences.Keywords: Patient satisfaction; service utilization; surgical service.
Endoscopic Drainage of Pancreatic Pseudocysts: Clinical Profile and Outcome Analysis
Authors: Gurung Ram Bahadur , Sharma Pasand , Sapkota Prakash , Shrestha Ashish , Shrestha Pramita
Published: November 2024

Background: Pancreatic pseudocyst is a complication of acute and chronic pancreatitis. Although surgery considered the gold standard, there is a rapid shift towards endoscopic treatment owing to its therapeutic outcome and minimal invasive involvement. This study aims to present the clinical profile and outcome analysis of the endoscopic drainage of pancreatic pseudocysts in Dhulikhel Hospital.Methods: This is a retrospective review of all patients who were diagnosed with pancreatic pseudocyst between January 2015 and December 2018 in Dhulikhel Hospital. The retrospective data were on patient characteristics, etiology, location of the cyst, other clinical characteristics.Results: The study included 51 patients and the average age of the patients in this study was 39 years and among them 62.7% were female. The mean size of pseudocyst was 7.89 cm, and the average days of hospital stay was 13.64. The most common etiology was idiopathic and more than half of the patient’s cyst was in head and/or body, 15 and 36 underwent conservative and therapeutic management respectively. The technical success rate was at 94% and reported increased pancreatic pseudocyst in Dhulikhel Hospital from 2015-18.Conclusions: The study findings highlight the increased trend of pancreatitis pseudocyst as a complication of acute or chronic pancreatitis. Endoscopic drainage of pseudocyst with plastic stent is an established method of managing it. However, pancreatic pseudocyst even larger than 6 cm can undergo spontaneous resolution.Hence, conservative management should be considered first. Keywords: Endoscopic ultrasound; endoscopic drainage; pancreatitis; pancreatic pseudocyst.
Prevalence of Anxiety and Depressive Symptoms among Hospitalized Patients Diagnosed with COVID-19
Authors: Sharma Sandipa , Gyawali Siddinath , K.C. Niranjan , Sapkota Subash , Shrestha Siddhartha Kumar , Bataju Pujan , K C Rumi , Lamichhane Ram Prashad
Published: November 2024

Background: A series of acute, atypical respiratory diseases was identified in Wuhan, China, which was named Coronavirus disease (COVID-19) by the World Health Organization (WHO), and the disease was later declared a pandemic. This disease has psychological effects in addition to physiological symptoms. This study aims to find out the psychological impacts of disease in the form of anxiety and depressive symptoms among hospitalized patients diagnosed with COVID-19. Methods: A multicentric descriptive cross-sectional study was conducted among patients diagnosed with COVID-19 who were admitted from July 1, 2021 to August 15, 2021 in six different hospitals. Ethical approval was obtained from the Nepal Health Research Council (reference number 284). COVID-19 was diagnosed using Reverse Transcription Polymerase Chain Reaction (RT-PCR) or COVID-19 antigen test. Data were collected from the patients using proforma containing the demographic profile and two questionnaires (Hospital Anxiety and Depression scale and Global Health Questionnaire-12) translated into the Nepali language.Results: Among 360 patients who participated in the study, 194 (53.9%) were males and 166 (46%) were females. Symptoms of anxiety and depression were seen in 161 (44.7%) and 253 (70.3%) of the participants respectively. Similarly 349 (96.9%) of them were found to have clinically significant mental distress.Conclusions: The prevalence of anxiety and depressive symptoms among hospitalized patients diagnosed with COVID-19 is significantly high compared to the general population.Keywords: Anxiety; coronavirus disease-2019; cross-sectional study; depression; psychological effect.
Feeding Practices of Infants and Young Children in Pokhara Metropolitan City
Authors: Manandhar Varsha , Upadhyaya Baidehi , Manandhar Smriti , Manandhar Alisha , Ghimire Amrita
Published: November 2024

Background: For children to grow and develop normally, appropriate feeding practices are essential, especially in the first two years of their lives. These practices can vary depending on the different sociodemographic factors. This study aims to study the feeding practices of infants and young children in different wards of Pokhara Metropolitan City.Methods: A community-based cross-sectional study was conducted and 280 mothers of infants and young children 0-23 months of age were interviewed using a semi-structured questionnaire. Data were entered and cleaned in Ms-Excel and then exported to SPSS version 21.0 for statistical analysis. Binary logistic regression analysis was used to find the association of feeding practices with different independent variables.Results: Only 32.3% of children 0-5 months of age were found to be appropriately breastfed, and 41.8% of children 6-23 months of age were found to have appropriate complementary feeding practices. Children delivered by normal vaginal delivery (AOR 18.118, p < 0.01, 95% CI 3.831 – 85.689) were more likely to have appropriate breastfeeding practices than those delivered by caesarean section. Children of birth order two or more (AOR 2.226, p = 0.016, 95% CI 1.171 – 4.620) and living in nuclear families (AOR 2.488, p = 0.013, 95% CI 1.120 – 5.116) were found to have appropriate complementary feeding practices.Conclusions: This study concludes that the feeding practices of the majority of the infants and young children in Pokhara are not adequate as per the WHO and UNICEF standards.Keywords: Breastfeeding; complementary feeding; IYCF; Pokhara.
Oral Glucose Tolerance Test for Universal screening for Gestational Diabetes Mellitus
Authors: Shrestha Abha , Shakya Rajani , Shrestha Rabina , Karki Sulata , Das Seema , Shrestha Priya , Rai Anisha , Thapa Saroj , Shrestha Abha , Karmacharya Biraj
Published: November 2024

Background: Gestational Diabetes Mellitus increased almost 30% in many countries, including underdeveloped countries and same in Nepal. Hospital-based studies in Nepal reported Gestational Diabetes Mellitus cases, with prevalence 2.48% in 2010 to 4.47% in 2019 emphasising on necessity of universal screening for Gestational Diabetes Mellitus.Methods: As part of implementation of Electronic Decision support System for Antenatal Care, in formative study clinical vignettes on Gestational Diabetes Mellitus case presented to six healthcare providers ( Incharges, Auxiliary Nurse, Midwives and Lab Assistants) from 3 primary healthcare facilities in Kavre and Dolakha districts, Nepal from October-December 2019. 19 Auxiliary Nurse, Midwives from 19 HCF of 4 districts (Kavre, Dolakha, Sindhuli, and Sindhupalchok, including where clinical vignette were applied trained to perform Oral Glucose Tolerance Test for 4 hours. In-depth Interviews conducted with 16 Auxiliary Nurse, Midwives (8 trained & 8 peer coached from selected 4 HCF to explore their perception & experiences of conducting Oral Glucose Tolerance Test and continuing it for future. Clinical vigenttes compared with PEN protocol and IDIs analyzed thematically. Results: Only 4/6 HCPs made probable diagnosis of Gestational Diabetes Mellitus. 217 Oral Glucose Tolerance Test performed, 24 found to have Gestational Diabetes Mellitus. In-depth Interviews showed Auxiliary Nurse, Midwives enthusiasts on implementing tests for Gestational Diabetes Mellitus and to continue what has been learnt in training. Some challenges; clients hesitate to stay 2 hours at facilities due to unavailability of transport and household work. Oral Glucose Tolerance Test trained Auxiliary Nurse, Midwives seem more confident in counselling and conducting Oral Glucose Tolerance Test than those peer coached. Conclusions: Administering Oral Glucose Tolerance Test seemed feasible in HCF settings despite some challenges. Training and continuing logistics supply from municipality level seems promising.Keywords: GDM: Nepal: OGTT:
Perception of Climate Change Vulnerability and its Impact on Sexual and Reproductive Health and Rights in Khutiya and Banganga River Basins
Authors: Poudel Khusbu , Karki Sujan , Lamichhane Kritee , Timilsina Amit , Dijkerman Sally , Ghimire Jagadishwor
Published: November 2024

Background: Nepal is one of the most vulnerable countries to climate change. The drivers of climate risk include its topography, ecological diversity, climatic variability, natural resource dependency, under-development, and socioeconomic vulnerabilities. Climate change affects women and girls in unique ways. Research conducted in Asia Pacific region highlight negative sexual and reproductive health outcomes from climate change-related stressors such as droughts, floods, and air pollution, factors also linked to decreased SRH services utilization, increased maternal mortality rates, and repercussions on women’s mental health.Methods: This is a mixed methods study conducted in two river basins including household surveys with 384 females ages 18-49, 12 focus group discussions, and 22 key informant interviews. We conducted descriptive and thematic analysis.Results: More than half relied on agriculture for income (66%). Despite one-third being heads of households, land ownership was low (13%). Climate change perceptions included rising temperatures (88%), increased heat wave (70%), drying water source (99%), and delayed monsoons (83%), impacting agriculture and increasing women's workload (61%) due to displacement and male migration. 64% reported disturbances in antenatal and postnatal care visits . Inaccessible healthcare facilities during the rainy season increased maternal mortality risks. Heavy river flooding hindered female community health volunteers access leading to childbirth complications. 82% of women feared being unable to protect their children post-climate events. Moreover, 21% of women faced gender-based violence during or after climate disasters. Conclusions: Our findings suggest clear impacts of climate change on women and the communities. Thus, climate adaptation efforts must be designed to address the unique impacts of the crisis on women and girls, making space for their increased participation and leadership. Keywords: Climate change; gender based violence; malnutrition; migration; sexual and reproductive health and rights.
First Trimester Abortion and Psychiatric Morbidity
Authors: Aryal Shreyashi , Basnet Rachana Sharma
Published: November 2024

Background: Early pregnancy loss is a traumatic event following which clients may experience psychological morbidities. Mental illness is associated with multiple obstetric and social factors surrounding the period of pregnancy loss. The aim of this study was to find the prevalence of depression and anxiety before and after undergoing spontaneous or induced first trimester abortion and to analyze demographic and obstetric factors associated with it.Methods: This is an observational study conducted as Kathmandu Medical College (KMC) for a duration of one year from September 2022 to August 2023. All clients with abortion were screened for psychiatric morbidity using the The Hospital Anxiety and Depression Scale (HADS). Each client was assessed at first hospital visit and then at two weeks and two months following abortion. Level of anxiety and depression was analyzed in relation to socio-demographic factors and the type of abortion.Results: 171 clients with pregnancy loss were enrolled. Pre-abortion, severe anxiety was present in 6(13%) clients with spontaneous abortion. Pre-abortion, mild to severe anxiety was present in 31 (67.3%) clients and at two weeks and two months in 11 (23.9%) and 11 (23.9%) clients respectively. In clients undergoing induced abortion, varying levels of anxiety was present in 54(43.2%) pre-abortion, and 48(38.4%) and 54(43.2%) clients at two weeks and two months. Mild to moderate depression was seen in 21 (45.6%) among spontaneous abortion and 51 (40.8%) clients among induced abortion. Mean score on HADS decreased with time. Conclusions: Anxiety and depression were common following early pregnancy loss. Rate of anxiety seems to decrease with time in spontaneous abortion but in induced abortion it remains persistent. Rate of depression tends to decrease with time for both types of abortion. Keywords: Abortion; anxiety; depression; HADS; induced.
Interconnectedness of Health and Economy in Post-COVID-19: A Systems Thinking Approach to Synergies, Trade-Offs, and Policy Responses in Nepal
Authors: Adhikari Shiva R , Pokharel Kapil , Katuwal Khagendra , Upreti Dilli Ram , Adhikari Naveen , Raut Nirmal K
Published: November 2024

Background: This study addresses the economic challenges posed by the Coronavirus Disease 2019 (COVID-19) pandemic, with a specific focus on Nepal. Employing a Systems Thinking approach, the study develops a comprehensive model that integrates macroeconomic interventions, exploring the trade-offs and synergies among various economic sectors. The interconnectedness of health, economic, and policy domains highlights the need for a holistic understanding of the pandemic's effects.Methods: An exploratory research design was used. The model introduces three primary subsystems—import, local demand, and local production—illustrating their interdependence. The causal loop diagram depicts the implications of fiscal and monetary policies on the economy, emphasizing the synergy and trade-offs resulting from policy interventions. Results: Findings reveal the significant economic impact of the pandemic on Nepal, leading to its negative growth rate in FY 2020/21, the first time Nepal has experienced this in the last two decades. The results show that both intended and unintended consequences are observed following the adoption of fiscal and monetary policy that aimed at minimizing the spread of virus suggesting a complex nature of relationship among the policy variables. The fiscal policy induced negative consequences on the increasing loan, slow revenue growth, while positive feedbacks are observed on increased investment opportunities, and boosting of local economy. The monetary measures yielded unintended consequences on the rising land prices, surge in share market. Conclusions: The study concludes by emphasizing the crucial role of informed policymaking in navigating the complex landscape, offering insights for creating a resilient and sustainable post-pandemic future.Keywords: Causal loop diagram; COVID-19; economic sectors; systems thinking approach.
Mini-thoracotomy Approach for Heart Surgery in Tertiary Care Hospital of Nepal
Authors: Bhattarai Anil , Shah Sangam , Ranabhat Kamal , Chand Swati , Thapa Sangharsha , Khakural Prabhat
Published: November 2024

Background: The usual surgical technique for heart surgery has been median sternotomy, which provides excellent exposure of all cardiac structures and facilitates the establishment of cardiopulmonary bypass with central cannulation. A number of alternative surgical techniques, including the right anterolateral thoracotomy, posterolateral thoracotomy, and partial sternotomy, have been suggested. We want to share our experience with right anterior mini-thoracotomy versus right axillary mini-thoracotomy for closing an atrial septal defect.Methods: The study was a retrospective cross-sectional study conducted in a hospital. The study comprised patients with atrial septal defect admitted to Green City Hospital in Kathmandu, Nepal. From May 2016 until September 2021. Data was extracted to MS excel sheet, and then transported to the STATA version 17 for analysis. First, we computed descriptive analysis which included calculation of frequency, percentage, mean and median for presentation of socio-demographic variables. Continuous data were tested for normality using Shapiro-Wilk test.Results: A total of 25 patient were included in the study with median age 26 years (20-32). The median aortic cross clamp time was 25 minutes ranging 20-35 min. The median duration of cardiopulmonary bypass time ranging from 31to 161 minutes. The median time of Ax was 25 minutes and 26 minutes for right anterior mini-thoracotomy and right axillary mini-thoracotomy respectively. The median duration of hospital stay was 4 days ranging from 3-4 days. Nearly 36% study participants were associated with abnormal body mass index. (Either under nutrition or over nutritional status). Conclusions: There were no significant differences between the duration of intensive care unit and hospital stays, aortic cross clamp time, and complications between the two groups. However, the possibility of less blood loss during surgery and of cosmetic appearance in axillary incision is of special importance.Keywords: Heart surgery; mini-thoracotomy; Nepal; right anterior; right axillary.
Sputum Bacteriology and Antibiotic Sensitivity Pattern of Hospitalized Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease in Kathmandu Model Hospital
Authors: Dahal Abhinav , Joshi Rajesh Dhoj , Palikhe Muna , Maskey Neelima , Sah Shyam Sundar , Onta Aastha , Shrestha Basudha
Published: November 2024

Background: Chronic obstructive pulmonary disease (COPD) is the fourth leading cause of death in the world and will become the third leading cause of death worldwide by 2020. A study was carried out with an objective to study the sputum bacteriology and antibiotic sensitivity pattern of hospitalized patients with acute exacerbation of chronic obstructive pulmonary disease.
Methods: A review study was carried out for a sputum culture isolated cases of acute exacerbation of COPD in Kathmandu Model Hospital. The discharged records from Jan 1st 2018 to December 31st, 2022. were analysed for demographic data and antibiotic susceptibility patterns. Any patient records with incomplete information were excluded from this study. An antibiotic susceptibility pattern was further confirmed from the laboratory records. Data were entered and analysed using SPSS version 21.
Results: Over the period of five years from Jan 1st 2018 to December 31st, 2022. We found that total 80  of our patients with acute exacerbation of chronic obstructive pulmonary disease had a positive routine sputum culture. Pseudomonas aeruginosa (28.7%), Kleibsella pneumonia (20%), Escherchia coli (17.6%), Acinetobacter baumani complex (13.8%) were the most common bacteria isolated. Most organisms are found to be sensitive to Polymyxin B, Colistin, Tigecycline followed by Piperacillin/Tazobactam while most of them are found to be resistant to Amoxicillin, Amoxicillin/Clavulanic Acid and Cefixime.
 
Conclusions: Pseudomonas aeruginosa, Klebsiella pneumonia and Escherchia coli accounted for most common bacteria isolated in our study. These bacteria were found to be sensitive to polymyxin B, colistin and tigecycline. Most of them were resistant to amoxicillin, amoxicillin clavulanic acid and cefixime. Our study concluded acute exacerbation of chronic obstructive pulmonary disease is associated with bacterial isolates in sputum culture and highly sensitive to broad spectrum antibiotics
 
Keywords: Bacteria, COPD, exacerbation, sputum culture, antibiotics, Nepal
High Sensitive C-Reactive Protein and Lipid Profile Alteration In Subclinical Hypothyroidism for Cardiovascular Risk Assessment
Authors: Rajkarnikar Smrity , Sharma Vijay Kumar , Baidya Sujata , Kadel Pratibha , Tuladhar Eans Tara , Niraula Apeksha , Bhattarai Aseem , Raut Mithileshwer , Dubey Raju Kumar , Parajuli Naresh
Published: November 2024

Background: The purpose of this study was to investigate the association of subclinical hypothyroidism with High sensitive C-reactive protein & lipid profile which can predispose to development of Cardiovascular disease.Methods: This hospital-based comparative cross-sectional study was conducted for a period of six months. A total of 71 patients with subclinical hypothyroidism & 37 healthy control subjects were enrolled for the study. Thyroid hormones, lipid profile, hs- CRP were measured and lipid variables were used to calculate lipid indices. Student t-test were used to compare means & Spearmanâ€™s correlation was done to determine the association between variables. ROC curve analysis was used to determine the diagnostic value of tests.Results: Out of 71 cases & 37 control, majority had female preponderance (71.8% in case & 83.8% in control). The mean values between case & control groups for hs-CRP, AIP, LCI and non-HDL cholesterol were statistically significant. There was positive correlation between TSH and hs-CRP (r=0.492, p <0.001), AIP and TSH (r=0.430, p<0.001), LCI and TSH (r=0.269, p =0.005), TSH and non-HDL cholesterol (r=0.308, p=0.001) & AI and LDL (r= 0.712, p<0.001) with weak correlation with statistical significance as per Spearmanâ€™s correlation. Area under ROC curve for hs-CRP indicated it as a positive biomarker for CVD assessment.Conclusions: Our findings shows that SCH patients are more at risk of CVD & hs-CRP contributes as a significant marker, thus requiring timely intervention. Lipid indices and AIP must be determined even in patients with a normal lipid profile to improve atherogenic risk.Keywords: Cardiovascular risk; dyslipidemia; hs-CRP; subclinical hypothyroidism.
Risk Factors for Primary Postpartum Hemorrhage in Vaginal Delivery
Authors: Rai Subash , Dangal Ganesh , Jaiswal Ekta
Published: November 2024

Background: Postpartum hemorrhage is an emergency, condition encountered in obstetric cases. It is an acute life-threatening situation and needs an immediate and rapid management. Postpartum hemorrhage is leading cause of maternal mortality and morbidity worldwide, with more commonly affecting women of developing countries. Accurate assessment of blood loss, identification of risk factors and timely recognition of postpartum hemorrhage remain major challenge in obstetrics. Different risk factors like hypertensive disorder in pregnancy, antepartum hemorrhage, anemia, big baby, polyhydramnios, multiple pregnancy, obesity, augmented/prolonged labor are risk factors for primary postpartum hemorrhage. The objective of this study was to identify the various risk factors associated with primary postpartum hemorrhage, in Paropakar Maternity and Womenâ€™s Hospital (PMWH), which is biggest institute in country for holding records of maximum number of deliveries.Methods: A cross sectional study was conducted over a period of 3 months between March 2023 to May 2023 on 72 patients. Women with term pregnancy who experienced primary PPH were analyzed for different risk factors. Similarly, incidence of postpartum hemorrhage according to age, parity, gestational age, types of labor, types of vaginal delivery and causes of postpartum hemorrhage were studied. The results were then analyzed.Results: The incidence of primary PPH during the study was 3%. Majority of cases of PPH were in age group of 20-24 (44.4%), followed by age group (25-29). Most of cases (50%) were of gravidity 2 to 3, followed by primigravida (45.8%). There was equal distribution of PPH in gestation age (37-39+6) WOG to (40-41+6) WOG. There were no risk factors associated with occurrence of PPH in 56%. Hypertensive disorder of pregnancy, anemia, APH, multiple pregnancy, fetal macrosomia, polyhydramnios and obesity are associated risk factors for PPH. Among risk factors associated with PPH, hypertensive disorder of pregnancy was most common risk factors (40.6%), followed by maternal anemia (25%), multiple pregnancy (12.5%), APH (6.3%) fetal macrosomia (6.3%), maternal obesity (6.3%), polyhydramnios (3.1%). PPH was more common in augmented labor (43%), followed by induced labor (29.2%) and spontaneous labor (27.8%). In this study most women ( 72.2%) experienced blood loss of 500-1000 ml. And most common cause of PPH was atony (83.3%) followed by genital tract injury (14%) and retained tissues (2.7%).Conclusions: In many cases, PPH canâ€™t be predicted fully as many cases of PPH occur without vivid risk factors, as in this study 56% women experiencing PPH had no associated antenatal risk factors. Antenatal risk factors like hypertensive disorder of pregnancy, maternal anemia, twin pregnancy, APH, macrosomia, obesity are common risk factors for PPH. Similarly induced and augmented labor and instrumental delivery can lead to PPH.Keywords: Postpartum haemorrhage, risk factors, vaginal delivery
Super Priority Destination Mandalika: Quality of Sport Tourism Services
Authors: Satiadji Amirosa Ria , Ali Muhtasom  , Lilik Hidayati  , Ardhana Valian Yoga Pudya , Mohammad Javed Equbal
Published: November 2024

Sports tourism is here to provide added value for the intrinsic and extrinsic elements of destinations in an area which has implications for increasing the number of visitors. In Indonesia, there are several regions that promote sports tourism to boost tourist visits and the regional economy, including NTB Province with Mandalika. Mandalika has now become a super priority destination in NTB Province and the center of attention in the development of sports tourism. To ensure this development runs well, it is necessary to understand the factors that influence the quality of service in this destination. Therefore, this research is needed to assess the quality of sport tourism services in Mandalika. The data collection technique uses scraping and crawling then creates a questionnaire and the results are analyzed using statistical tests. The results of the analysis show that event management has the most significant influence on the perception of service quality at sports event destinations with an influence of 97.7%. Besides that, the importance of event management in improving service quality, destination managers must utilize social media and online advertising as an effective marketing strategy and collaborate with sports influencers to increase tourist interest and participation.
Tolerogenic De-liver-y: Glycopolymer-mediated Approaches to Induce Antigen-specific Tolerance
Authors: McKnight Ian Christopher , Lajoie Stephane , Wilson David Scott
Published: November 2024

Numerous autoimmune diseases, which currently affect a sizable portion of the global population, are driven by aberrant autoantigen-specific T cell responses that result in tissue destruction and loss of function. Current therapeutics for autoimmunity are non-curative and rely on global immunosuppression, leaving patients vulnerable to opportunistic infections and malignancies. An ideal approach would suppress autoantigen-specific T cell responses while leaving the remainder of the immune system intact. Recently, Tremain et al. have developed a therapeutic strategy that suppresses autoantigen-specific T cell responses by targeting autoantigens to the liver’s innate tolerogenic environment. In their approach, antigens are modified with synthetic polymeric glycosylations that target internalizing C-type lectins on the surface of liver antigen presenting cells. Autoantigens targeted to liver antigen presenting cells are presented to autoantigen-specific T cells in the presence of immunosuppressive signals that drive T cells to undergo apoptosis, adopt a state of anergy, or differentiate into T regulatory cells—a subset of T cells that can provide durable suppression of autoantigen-specific T cell responses. This mini-review describes the mechanisms by which glycopolymer-mediated targeting of autoantigens to the liver establishes autoantigen-specific immunological tolerance, summarizes the various findings of the recent publications that utilize this platform, and discusses potential therapeutic applications for treating autoimmune diseases and allergies.
Український Моцарт (до двохсотріччя з дня смерті Дмитра Бортнянського)
Authors: Хорошев Олександр
Published: November 2024

Статтю присвячено дослідженню життєвого та творчого шляху видатного українського композитора, співака, диригента та музичного педагога – Дмитра Степановича Бортнянського. Метою даної роботи є всебічний розгляд постаті Дмитра Бортнянського, при чому не тільки як композитора, але й як людини на тлі історичних подій ХVІІІ століття. Встановлюються особливості творчого доробку Дмитра Бортнянського та його вплив на національну й світову музичну культуру. Наукова новизна роботи полягає в аналізі та систематизації життєвого і творчого шляху видатного українського композитора, музиканта, співака та диригента Дмитра Бортнянського; у відтворенні соціально-культурного контексту часу, який сприяв розвиткові митця, висвітленні значення його творчого доробку для актуалізації української духовної національної спадщини.
Внесок французів в освоєння та формування суспільства Північного Причорномор’я
Authors: Ходченко Олена
Published: November 2024

Статтю присвячено дослідженню внеску французьких переселенців у розвиток південноукраїнських міст Одеси, Херсона та Миколаєва, а також їх ролі у розвитку новітніх галузей промисловості, архітектури, освітньої та культурної сфер. Вивчаючи міграційні хвилі французьких переселенців, доведено, що переселення здебільшого було пов’язане з соціально-політичними та економічними процесами у Франції. Поселень колоністського типу французами не було створено, більшість поселенців з часом повернулися на Батьківщину, залишивши французьке громадянство. Водночас, завдяки новаторським ініціативам французів, було модернізовано містобудування, промисловість і садівництво, а також введено західні культурно-просвітницькі цінності.
Метою дослідження є аналіз внеску та впливу французьких мігрантів на процес розбудови північно-причорноморського регіону, а також простеження соціальних і культурних трансформацій у провінції.
Підприємці та меценати Одеси: професійна, науково-технічна та громадська діяльність Г.Е. Вейнштейна (1860-1929 рр.)
Authors: Добровольська Вікторія
Published: November 2024

Використовуючи біографічний метод, у статті досліджено одеський період життя й активної професійної, науково-організаційної, громадської діяльності інженера-технолога, відомого підприємця, одного з кращих представників науково-технічної інтелігенції промислового Півдня України Григорія Еммануїловича Вейнштейна. Розкрито діяльність Г. Вейнштейна у складі Одеського відділення Імператорського Руського технічного товариства; систематизовано інформацію про його громадську діяльність та ініціативи; актуалізовано питання необхідності дослідження самоорганізаційних процесів у технічному середовищі промислових міст Північного Причорномор’я другої половини ХІХ – початку ХХ ст.
Хворі та інваліди у таборах полонених українців зі складу царської армії в Німеччині: повсякдення, форми самоорганізації, особливості репатріації (1917 р.)
Authors: Dema Olena , Krotofil Maciej , Sribnyak Ihor
Published: November 2024

Метою дослідження є проведення системного аналізу повсякдення, форм самоорганізації й особливостей репатріації хворих та інвалідів у таборах полонених українців зі складу царської армії в Німеччині у 1917 р.
Наукова новизна роботи. Представлена проблема являє собою першу спробу цілісного представлення повсякдення хворих полонених, що потрапляли до таборових лазаретів, а також процесу репатріації інвалідів з числа полонених українців з трьох українських таборів (Раштат, Вецляр, Зальцведель) на теренах Німеччини.
Висновки. Побут інвалідів у таборах полонених українців був позначений значними складнощами, зумовленими як обмеженими фізичними можливостями цієї категорії таборян, так і недостатністю їх раціону. Остання обставина, необхідність виконання обтяжливих робіт, а також загальний дискомфорт, яким було позначено перебування полонених у таборах, призводило до розвитку у декого з таборян сухот та інших хвороб. Для поправлення їх здоров’я у кожному таборі був облаштований лазарет, проте основним його призначенням було запобігання поширенню пошесних хвороб. З метою вирішення проблеми інвалідів і тяжко хворих таборян урядами протиборчих держав (у т.ч. і між Росією та Німеччиною) було досягнуто угоду про пропорційний обмін цими двома категоріями осіб. Завдяки цьому стало можливим розпочати процес їх взаємної репатріації, але його обсяги були порівняно незначними через фактичну протидію російського уряду, який побоювався того, що у такий спосіб матиме місце посилення людського ресурсу ворога. Внаслідок цього від’їзд репатріантів хронічно затримувався, і хоча вони отримували обмежену гуманітарну допомогу від українських таборових громад, а також російських і міжнародних червонохрестних організацій, моральний стан інвалідів погіршувався. Але попри всі труднощі з трьох українських таборів додому протягом у 1917 р. виїхало понад 530 інвалідів і хворих, у т.ч. й українські активісти.
Єврейські табори примусової праці на трасі Кривий Ріг – Дніпро (Дніпропетровськ) (за матеріалами усноісторичних джерел)
Authors: Shliakhtych Roman
Published: November 2024

Мета статті – висвітлення, на основі усних свідчень, організації таборів, характеру праці у них, повсякденного життя ув’язнених євреїв, терору та репресій, які застосовувались до них охоронцями таборів, стратегій виживання в’язнів.
Новизна роботи полягає у використанні усних відеосвідчень для розкриття різних аспектів існування у таборах примусової праці. Інформація, яка міститься у цих джерелах, дала змогу відтворити історії життя та смерті в’язнів цих таборів з точки зору жертв і свідків. Такий підхід до історії таборів примусової праці, які розташовувались уздовж траси Кривий Ріг – Дніпропетровськ, застосовується вперше. Крім того проаналізовано спогади із зазначених усноісторичних колекцій про німецькі табори примусової праці на трасі Кривий Ріг – Дніпропетровськ.
Висновки. Німецькі табори примусової праці для євреїв мали важливе значення для будівництва траси між Кривим Рогом і Дніпропетровськом. Ці табори створювались протягом осені 1941 – зими 1942 років і до кінця 1943 року всі вони були ліквідовані. Головною метою таборів було вбивство євреїв важкою фізичною працею. Тому, у таборах жодним чином не забезпечувались елементарні санітарно-гігієнічні умови, не було ніякого лікування, а за найменшу провину людей могли вбити. У таких умовах деякі в’язні мешкали більше року і за цей час їх фізичний і моральний стан лише погіршувався.
Стратегії виживання в’язнів у таборах примусової праці передбачали: замкненість, адже будь-яка інформація про плани щодо втечі могла бути передана охоронцям табору; обмін продуктами й одягом, який давав можливість вижити в’язням; активний або пасивний супротив, який створював умови для втечі і, нарешті, підготована або спонтанна втеча з табору.
Крім виснажливої фізичної праці у таборах застосовувались різні форми насилля по відношенню до євреїв. В усіх випадках винуватцями цього насилля були особи, які конвоювали та охороняли євреїв. Це були німці, латиші/литовці, члени інших військових формувань, місцеві поліцаї.
Фінансування. Це дослідження було профінансоване через проект EURIZON, який фінансується Європейським Союзом за грантовою угодою № 871072. Також це дослідження було здійснено завдяки доступу до джерел із колекції Visual History and Education of the Shoa Foundation (Університет Південної Каліфорнії, США).
O ensino de história na educação básica: em busca por um ensino significativo
Authors: Almeida Adriana Sanches de , Rodrigues Adriana Aparecida
Published: November 2024

O presente estudo tem como temática o ensino de história na educação básica. Possui como objetivo, analisar a importância do uso de metodologias diversificadas no ensino de história na educação básica, em prol de desenvolver um ensino significativo. Para atender esse proposto, realizamos um estudo bibliográfico de cunho qualitativo, embasado no materialismo histórico e dialético. A pesquisa apontou que o ensino de história na educação básica é caracterizado pela presença de desafios, em consequência da estruturação da disciplina como ciência. Nesse contexto, atualmente a utilização de metodologias significativas tendem a minimizar os desafios existentes, contribuindo para o desenvolvimento do processo de ensino e aprendizagem, bem como, para o desenvolvimento humano do educando.
DNA damage-induced AIM2 pyroptosis in high glucose-induced proximal tubular epithelial cell
Authors: Li Lu’an , Zhang Li , Cai Yating , Li Jiaying , Zheng Siqi , Wang Weiteng , Chen Yinwen , Luo Jieyi , Li Ruizhao , Liang Xinling
Published: November 2024

Pyroptosis is one of the ways to cause proximal tubular epithelial cell death in diabetic nephropathy (DN), but the exact mechanism remains unclear. Absent in melanoma 2 (AIM2), a sensor for double-stranded DNA, creates an inflammasome that triggers the cleavage of gasdermin D (GSDMD), leading to a type of inflammatory cell death called pyroptosis. This study investigated the role of AIM2 in pyroptosis within proximal tubular epithelial cells in DN. We observed significantly elevated AIM2 expression in renal tubules from DN patients and db/db mice, as well as in high glucose (HG)-induced Human Kidney-2 (HK2) cells. Besides, increased AIM2 expression was accompanied by activation of the pyroptosis pathway (cleaved-caspase-1, GSDMD-FL, GSDMD-NT) in the renal cortex of db/db mice and HG-induced HK2 cells in vitro. Knocking down GSDMD can reduce HG-induced HK2 cell death, indicating that HG triggers pyroptosis in HK2 cells. Furthermore, HG-induced pyroptosis was mitigated in HK2 cells with AIM2 knockdown using siRNA. Additionally, reducing ROS levels using NAC was able to attenuate HG-induced HK2 cells DNA damage, AIM2 activation, and pyroptosis. Notably, AIM2 upregulation was observed in renal biopsies from DN patients, with expression levels positively correlating with serum creatinine and inversely with estimated glomerular filtration rate (eGFR). Collectively, DNA damage caused by HG could result in the activation of the AIM2 inflammasome, leading to the pyroptosis of proximal tubular epithelial cells, indicating that targeting AIM2 could be a potential novel approach for treating DN.