bluuebunny/crossref_metadata_2025 huggingface dataset:
Serum Zinc in Patients with Protein-Energy Malnutrition Retrospective Assessment of Levels
Authors: ÖZEN Hasan , EMİROĞLU Halil Haldun , EMİROĞLU Melike , AKDAM Neriman , YORULMAZ Alaaddin
Published: May 2023

Aim: This study aimed to investigate the frequency of serum zinc deficiency in children with PEM and to show the relationship between the degree of PEM and serum zinc level.

Methods: Retrospective study conducted at Pediatric Gastroenterology, Hepatology, and Nutrition clinic, in a Selçuk University Hospital, 506 patients who aged between 1 and 18 years and diagnosed with PEM according to the Waterlow (YGB, BGA) classification were included in the study.

Results: The prevalence of serum zinc deficiency in PEM patients was found to be 61.1%. The mean serum zinc levels of the patients in aged 1-5 founded significantly lower than the mean serum zinc levels of the patients in aged 5-12 and aged 12-18. There was no difference between PEM grades which calculated according to BGA and YGB criteria and serum zinc level averages. Although the relationship between the PEM grade calculated according to the BGA scale and the serum zinc level averages was not statistically significant degree, contrary to the increase in PEM grade, the mean decrease in serum zinc levels was noteworthy.

Conclusion: It is important to measure serum zinc levels routinely in patients with PEM and to initiate zinc supplementation if deficiency is detected.
A New Approach To Predicting Prognosis In Sars-Cov-2 Infection: "MELD Scoring"
Authors: AFŞİN Dursun , AKSAKAL Alperen
Published: May 2023

Background/Aims: The MELD score is a scoring system used to assess the severity of end-stage liver disease. In our study, we aimed to investigate the role of MELD score in predicting the course of the disease and mortality in COVID-19 disease with multi-systemic involvement.
Methods: Our study was conducted with 96 patients over the age of 18 who were diagnosed with COVID-19 by real time PCR method by taking nasopharyngeal swabs between March 2021 and March 2022. MELD score was calculated according to the blood results of the patients at the time of hospital admission. To calculate the MELD score, the equation MELD = 11.2 x ln(international normalized ratio [INR]) + 3.78 x ln(bilirubin, mg/dL) + 9.57 x ln(creatinine, mg/dL) + 6.43 was used.
Results: We found that the MELD score was significantly higher in the moderate and severe patient group compared to the mild patient group (p<0.01). When we compared the moderate and severe patient groups between themselves, the MELD score was significantly higher in the severe patient group (p<0.01). In the evaluation of the association of MELD score with mortality, a one-unit increase in MELD score was associated with a 1.26-fold (95% confidence interval: 1.10-1.44) increased mortality risk.
Conclusions: In our study evaluating the MELD score in COVID-19 patients, it was observed that the MELD score during hospitalization was closely associated with disease severity and mortality. Therefore, the MELD score may be a guiding scoring system in the early follow-up of COVID-19 patients.
Results of Plate Osteosynthesis with Deltopectoral Approach for Proximal Humerus Fractures
Authors: ALTUNKILIÇ Tarık
Published: May 2023

ABSTRACT

Aim: The aim of this study was to evaluate the functional and radiological results of patients who underwent plate osteosynthesis with the deltopectoral approach in proximal humerus fractures, according to the intact shoulder.

Materials and Methods: Our study included 33 patients who underwent proximal humeral anatomic locking plate with deltopectoral approach due to proximal humeral fracture (PHF) between 2015 and 2017. Patients over 18 years of age, with closed humeral fractures, and with intact contralateral humerus and shoulder were included in our retrospective study. The functional results between the operated and healthy sides of the patients were evaluated by comparing the Constant-Murley score and radiological results with the full anteroposterior radiography and the collodiaphyseal angles.

Results: According to the Constant Murley scoring categorical data structure of the patients, the operated side was 6.1% (n=2) poor, 6.1% (n=2) moderate, 39.4% (n=13) good, 48.5% (n=16) excellent, while the healthy side was %. Results were 0 (n=0) poor, 3% (n=1) moderate, 30.3% (n=10) good, and 66.7% (n:22) excellent. According to the Constant Murley scoring categorical data structure, a statistical difference was found between the operated side and the healthy side (p>0.05). While the mean Constant Murley score of the operated side was 85.82 ± 7.07, the mean Constant Murley score of the healthy side was 90.67 ± 5.76. While the average of the collodiaphyseal angles of the operated side was 130.03± 4.64; the mean of the angles of the intact side is 135.64 ± 5.04. In terms of Constant Murley shoulder scores and collodiaphyseal angle values of the patients; a statistical difference was observed between the operated side and the healthy side (p
Is It Safe to Perform Laparoscopic Cholecystectomy and Transabdominal Preperitoneal Hernia Repair Simultaneously?
Authors: AKAY Tamer , ÇALTA Alparslan Fedayi
Published: May 2023

Abstract

Background/Aims: Cholecystectomy and inguinal hernia repair are the most common operations in general surgery. With the laparoscopic approach, the risk of postoperative pain and infection is lower, patients can return to their daily activities in a shorter time, and the cosmetic appearance is better. However, surgical procedures in which laparoscopic cholecystectomy and transabdominal preperitoneal hernia repair (TAPP) are performed simultaneously are limited. The safety of this procedure is questioned in this article.

Methods: The records of 38 patients who had undergone simultaneous laparoscopic cholecystectomy and TAPP were retrospectively reviewed, and patient demographic characteristics, indications for surgery, parameters associated with surgery, and postoperative complications were elicited.

Results: The mean age of the patients was 48 ± 6.7 years, the youngest patient was 32 years old, and the oldest patient was 68 years old. The average operation time of the patients was 124 ± 26 minutes, and the average postoperative hospital stay was 2.1 ± 0.4 days. As for intraoperative complications, bleeding due to a double cystic artery in one patient, and perforation of the gallbladder in one patient were observed. In the postoperative period, one patient was found to have a seroma in the hernia area (in the patient with gallbladder perforation), and one patient had a recurrence in the hernia area in the late phase.

Conclusions: Our study demonstrated that laparoscopic cholecystectomy and TAPP surgery could be safely performed simultaneously. The results of our study also include that prioritizing cholecystectomy does not increase the mesh infection rate.
Use of Complementary and Alternative Medicine Practices in Patients Admitted to The Pediatric Neurology Outpatient Clinic
Authors: CEYLAN Nesrin , CELİK Halil , ÖZDEMİR Fatih Mehmet Akif , AKSOY Erhan , ÖZTOPRAK Ülkühan , ATASOY Ergin , YÜKSEL Deniz
Published: May 2023

Introduction: Despite the developments in pharmacologic treatments, traditional and complementary therapies have recently gained popularity in our country, as well as around the world.

Aim: To question complementary and alternative medicine practices CAMP during clinical visits of pediatric neurology patients, to raise awareness of families and patients about the use of complementary and alternative medicine, and to prevent possible negative interactions.

Methods: This prospective survey study was conducted with the parents of 300 pediatric patients aged between 6 months and 18 years, who were being treated at the Child Neurology Clinic between March 1st and May 30th, 2020. For the study, 360 patients’ parents who came to the Pediatric Neurology clinic for treatment were randomly selected, and a face-to-face survey lasting 2 minutes was conducted with 300 patients’ parents who agreed to participate in the study.

This study was approved with the decision number E-20-12-62 at the meeting dated 21.12.2020 of the Clinical Research Ethics Committee of SBU Ankara Dr Sami Ulus Gynecology and Childhood Health and Diseases Training and Research Hospital.

Results: Three hundred parents (56% women) participated in the study. Just over half (55.3%) of the patients were followed up with a diagnosis of epilepsy, 56.6% of the parents stated that they had used traditional and complementary therapy methods before, 43.4% stated that they did not use it, 46.54% stated that they used prayer and 23,9% used vitamin methods, respectively.

Conclusion: In neurologic diseases, parents use traditional and complementary therapies as treatment methods, creating an alternative to modern medicine. Families and patients should be informed by investigating the reasons and frequency of using traditional and complementary therapies, raising the awareness of parents, and determining the possible harm caused by traditional and complementary therapies.
The Assessment of the Effects of Synthetic Collagen Membrane Use on the Prevention of Epidural Fibrosis Development in Patients Undergoing Lumbar Discectomy by Magnetic Resonance Imaging Findings
Authors: KAYA Mehmet
Published: May 2023

Abstract
Bacground/Aims: The aim of study to evaluate the effects of synthetic collagen membrane placed on dura mater on the prevention of arachnoiditis and fibrosis development by magnetic resonance imaging (MRI) findings in patients undergoing lumbar discectomy.
Methods: A total of 40 patients who underwent single level unilateral discectomy for lumbar disc hernia were retrospectively evaluated. Sixteen patients with collagen membranes placed on the dura and 24 patients without any material on the dura were included in the study. Postoperative MRI images of the patients with and without collagen membranes were examined and evaluated whether the material used was effective in preventing arachnoiditis and / or epidural fibrosis and granulation tissue formation.
Results: Nine female patients (37.5%) and 15 male patients (62.5%) of 24 patients were in the collagen membrane-free group. Four of the patients in the collagen membrane group were female (25%) and 12 were male (75%). The mean age of the non-membrane group was 35.47 ± 9.06, and the mean age of the membrane group was 37.40 ± 8.92 years. According to MRI findings, granulation tissue and epidural fibrosis were not observed in 8 (50%) of 16 patients with collagen membranes, whereas granulation tissue was observed in 8 (50%) patients. Granulation tissue was not observed in 10 (41.7%) of 24 patients without collagen membrane, whereas epidural fibrosis and granulation tissue formation was observed in 14 (58.3%). Based on these results, there was no statistically significant relationship between type-I collagen membrane use and granulation tissue formation. (P = 0.604 <0.05). There was no difference between the rate of granulation tissue (50%) and absence (50%) in patients with type-I collagen membranes.
Conclusion: According to these results and MRI findings, it was found that peroperative type-I collagen membrane use in lumbar discectomy did not have a statistically significant effect on granulation tissue or epidural fibrosis formation.
COVID-19 Ricochets on Kidney Transplant and Hemodialysis Patients
Authors: GÖKTEPE Mevlüt Hakan , AKAY ÇİZMECİOGLU Hilal , TUNA Ali Kürşat , CİZMECİOGLU Ahmet
Published: May 2023

Background/Aims: An impaired immune response affects Coronavirus 2019 (COVID-19) disease progression. Immunities of both hemodialysis (HD) and Kidney Transplant (KTx) patients have already been suppressed. This study evaluated the prognostic laboratory results in HD and KTx patients with COVID-19.

Methods: This retrospective, case-control study was conducted with PCR (+) COVID-19 HD and KTx patients and a control group. All patients were divided into two subgroups according to disease severity. Patients' demographic records and laboratory results were obtained from the follow-up files.

Results: A total of 30 HD, 20 KTx patients, and 40 control groups were involved in the study. Gender and hospitalization duration did not differ between the groups. There was a 10% mortality rate in the KTx group and 27% in the HD group. Lung involvement in Computed Tomography (CT) was higher in HD patients (47%) than in KTx (25%). In subgroup evaluations, the most prominent laboratory values were fibrinogen in HD patients and LDH and Ferritin in KTx patients in determining disease severity.

Conclusions: Early hospitalization and treatment implementations will be associated with a good prognosis in HD and KTx patients since CT and laboratory results are not predictive in these groups of patients during the COVID-19 pandemic.
Pediatric Forearm Fractures: TEN (Titanium Elastic Nail) versus Plate Screw Fixation for Surgical Treatment
Authors: ALTINTAŞ Mustafa , OZEL Mehmet , TATLIPARMAK Ali Cankut
Published: May 2023

Background/Aims: In pediatric forearm fractures, the choice of surgical technique and fixation method can be challenging. Surgically treated pediatric patients younger than 14 years with Titanium Elastic Nails (TEN) or Plate Screw Fixation(PSF) were compared clinically, in cost, and in terms of postoperative outcomes. Method: In the retrospective case-control study, pediatric forearm fractures operated on at a level I trauma center between 2017 and 2022 were examined. Surgically treated forearm fractures in pediatric patients under 14 years of age were included in this study group. Results: A mean age of 10.83 +- 3.28 years was found among the 109 patients. The PSF group (12.87+-2.76 years) was 3.17 (95% CI 2.02 - 4.33) years older than the TEN group (9.7+-3 years) (p
Delayed Onset of Lactation and Accompanying Perinatal Factors in Mothers Who Delivered at the End of A Normal Term Pregnancy
Authors: GÜNEŞ Bülent , YALÇIN S. Songül
Published: May 2023

ABSTRACT
Objective: This study aimed to investigate the frequency of delayed onset of lactation and accompanying perinatal factors in mothers who gave birth after a normal gestational course without any health problems.
Methods: The study sample consisted of infants and their mothers who had given birth at Şanlıurfa Şan Med Hospital and then applied to the Pediatrics Health and Diseases Polyclinic for health check-ups within 3-15 days postpartum between June 2017 and September 2017. The data were analyzed with IBM SPSS Statistics 22.0.
Results: Delayed lactation was reported by 30.6% of mothers, being more common among primiparous mothers and those who delivered by cesarean section (p<0.001 and p=0.044, respectively). The rate of delayed lactation was lower among those who had skin-to-skin contact than those who did not (p=0.010), and among those who started breastfeeding in the first hour than those who did not (p<0.001). The rate of delayed lactation was higher if water or food other than breast milk was given on the first day or in the following period (p<0.001).
Conclusion: To reduce the risk of delayed lactation, there is a need for more personalized breastfeeding counseling and interventions for mothers who have given birth for the first time. Skin-to-skin contact should be ensured in all deliveries, and unnecessary cesarean deliveries and prelacteal feeding should be avoided.
Keywords: Breastfeeding, cesarean section, delayed lactation
Structural responses of FRP sheet piles under cantilever loading
Authors:   NSF I/UCRC for Integration of Composites into Infrastructure and Constructed Facilities Center,  West Virginia University, Wilt Joshua , Liang Ruifeng ,   NSF I/UCRC for Integration of Composites into Infrastructure and Constructed Facilities Center,  West Virginia University, GangaRao Hota ,   NSF I/UCRC for Integration of Composites into Infrastructure and Constructed Facilities Center,  West Virginia University, Mostoller Jeremy ,   Creative Composites Group, Creative Pultrusions
Published: May 2023

Sheet piles are interlocked segments used for temporary or permanent soil and water retaining structures such as below-grade parking structures and sea walls. Although steel is commonly used due to its strength and ease of manufacturing, it rusts in saltwater. Fiber reinforced polymer (FRP) composite sheet piles are resistant to chlorides and have higher corrosion resistance, but their mechanical properties vary in length and width. Stress risers at corrugation corners make soil-structure interaction a challenging design issue. This research aims to develop a standardized test procedure to determine the resisting moment capacity of FRP composite sheet piles. Cantilevered FRP sheet piles fixed with a sand-concrete mixture of ~70 psi (0.48 MPa) compressive strength were tested under static loads. Strain gages and LVDTs were used to collect data on deformation response up to and beyond peak induced stress. Results suggest that the refined test procedure can assist engineers in designing efficient sheet pile structures and become a basis to develop ASTM standard.
PENGARUH KEPEMIMPINAN, DAN KOMPENSASI TERHADAP KINERJA KARYAWAN DI KANTOR POS INDONESIA SITINJAK
Authors: Rahim Kirana Agung M. , Zhafira Nabila Hilmy
Published: May 2023

This study aims to analyze partially and simultaneously between leadership in a company, and the compensation given by the company to the performance of Sitinjak POS office employees. This research method uses analysis to test the hypotheses. The respondents used in this study were 21 employees. Data collection was carried out by distributing questionnaires to the sample population using Google Forms with quantitative techniques and linear regression testing. Furthermore, the results obtained were processed using analysis using software called Statistical Product and Service Solution or abbreviated as (SPSS) version 25, and Microsoft Excel. Researchers get the result that the variables of leadership (X1) and compensation (X2) have a positive and significant effect. to the performance of the employees of the Sitinjak POS office, then simultaneously the leadership and compensation variables also have an influence on the performance of the employees of the Sitinjak POS Indonesia office with a value of 63.7 percent
Developing Teachers to Enhance Project Management Skills for Students
Authors: Nukoonkan Chawalit , Dhammapissamai Phrakru
Published: May 2023

This study is an operation within the research project of “Teachers’ Development to Enhance Their Project Management Skills for Students,” which is also one of the projects in the research plan or research project series regarding 21st-century skills. This project arose from an awareness of the opportunities from the knowledge-based society, as well as from the present digital society, and has processed different views related to project management, which have been published globally via the internet by applying the Research and Development Methodology so that an educational innovation could be created in accordance with the concept of “Knowledge and Action are power.” The aim was to empower the teachers’ learning first and then to have them apply their learning outcomes to develop their students afterwards. Furthermore, it was believed that so long as teachers are stimulated and encouraged to apply their learning outcomes, then the teaching would become more efficient. As a result, an educational innovation called an “Online Self – Training Program for Developing Teachers to Enhance the Project Management Skills of Students” has been created. It was tested by the stakeholder teachers, who used the program, and was also tested through the process of experimental field research. Thus, it was determined to be efficient as it was hypothesized by showing the possibility of disseminating the program for the useful purpose of developing the teachers and then the students in the educational opportunity extension schools under the Office of the Basic Education Commission of the Ministry of Education, which is also the target population to whom the research results will be disseminated.
Amerikan Konsolosluk Raporlarına Göre Diyarbekir Vilayeti'nde İktisadi Hayat (1900-1909)
Authors: DİLMAÇ İlksen
Published: May 2023

Amerikan Ulusal Arşivleri ve Amerika Birleşik Devletleri Ticaret ve Çalışma Bakanlığı’ndan elde edilen konsolos raporlarına dayandırılarak hazırlanan bu çalışmada, 1900-1909 yılları arasında Diyarbekir Vilayeti’nin iktisadi durumu incelenmiştir. Makalenin birinci bölümünde Diyarbekir Vilayeti’nin sosyo ekonomik durumuna yer verilmiş, ikinci bölümünde Diyarbekir’in ticaret potansiyeli ve vilayet dahilinde ithalat ile ihracata konu olan ürünler, ürünlerin miktarı ve değerlendirilmesi yapılmıştır. Son bölümünde ise Amerika Birleşik Devletleri’nin vilayetle olan iktisadi ilişkileri ele alınmaktadır. Çalışma kapsamında Diyarbekir merkezli herhangi bir Amerikan ajansının bulunmadığı, ticari faaliyetlerin Doğu Türkiye Amerikan Ajansı ve Harput Amerikan Konsolosluğu’nun çatısı altında yürütüldüğü görülmektedir. Vilayetin ihracatı tarım ve hayvancılığa dayalı ham ürünlerden oluşmakta, ithal edilen ürünler ise mâmül ve yarı mâmül mallardan meydana gelmektedir. Vilayet genelinde az Amerikan malının talep gördüğü tespit edilmiştir.
QUALITY OF LIFE OF OLDER PEOPLE RESIDING IN A RURAL COMMUNITY AT BANKE DISTRICT, NEPAL
Authors: Paudyal Kalpana , Gautam Sital
Published: May 2023

Background: The quality of life of older people reflects their health status and well-being and is an important area of concern for those involved in the care of older people. The objective of the study was to assess the quality of life of older people residing in a rural community at Banke district, Nepal.
Methods: A cross-sectional study was conducted among 368 older people aged 60 years and above in ward number-3 (Karmona, Radhaypur, and Indrapur) of Janaki rural municipality of Banke district. Purposive sampling technique was used to recruit participants. Data were collected through face-to-face interviews using World Health Organization Quality of Life Scale- BREF. T-test and ANOVA test were used to compare the mean scores of different variables and domains of quality of life. The significance level was set at p <0.05. 
Results: The mean score and standard deviation of total quality of life were 72.97±6.91. The      mean quality of life score was lowest in the psychological domain (63.39±7.11) compared to environment (71.56±7.40), social (77.68±10.49), and physical domains (79.24±12.39). A statistically significant difference was observed on total quality of life scores between age groups (p=.001), sex (p=0.047), marital status (p=.001), occupation (p=.004), educational status (p=.001), living status (p=.007), source of livelihood (p=0.001), and physical health problems (p=.001) of older people.
Conclusions: In older people, the psychological domain of quality of life necessitates particular attention along with their environment, social, and physical health.
TYMPANOPLASTY AND ITS OUTCOME IN VARIOUS AGE GROUPS USING THE MIDDLE EAR RISK INDEX SCALE AT A TERTIARY CARE CENTRE IN EASTERN NEPAL
Authors: Thakur Sanjeev , Thakur Rishikesh , Adhikari Apar , Khanal Tekendra , Yadav Rajesh Kumar , Ghimire Nisha
Published: May 2023

Background: Tympanoplasty is done in cases of chronic otitis media. Middle Ear Risk Index (MERI) Scale is used to predict the outcome of tympanoplasty, based on various risk factors like otorrhoea, perforation, ossicular chain status, cholesteatoma, smoking and middle ear granuation/effusion. The objective of the study was to report the success rate of graft uptake, postoperative gain in hearing threshold and to find out the association of success to the different categories of MERI scale.
Methods: A prospective study of 75 cases of chronic otitis media who underwent tympanoplasty, was done over one year. Convenience sampling method was done. Clinical and audiological evaluation was done pre- and post- operatively. Risk categorization based on MERI scale was done. Data were recorded and analyzed using SPSS 16.
Results: Out of 75 cases, 39 (52%) cases were male and 36 (48%) were female. The mean age was 24.55 years±11.545. Overall, 53 (70.66%) cases had successful graft uptake. MERI 1-3 group had 82.6 % (38/46), MERI 4-7 group had 64.7 % (11/17) and MERI 8-12 group had only 33.33% (4/12) graft uptake, (p-value 0.003). Above-10-year age group had higher graft uptake rate and hearing gain. Graft acceptance was seen equal in dry or wet ear, and in unilateral or bilateral perforation.
Conclusions: Tympanoplasty done in cases with lower MERI scale and more than 10 years age group was associated with higher graft acceptance. More than 10 years age group had better hearing gain. The status of middle ear, dry or wet and laterality of perforation had no association for graft acceptance.
REASONS FOR EXTRACTION OF MANDIBULAR THIRD MOLAR AT TERTIARY CARE CENTRE IN EASTERN NEPAL
Authors: Gurung Gopal , Mahat Arun Kumar , Pokharel Mona
Published: May 2023

Background: Mandibular third molar is unique as relatively large number are either malposed, impacted or underdeveloped. This characteristic often leads to higher prevalence of dental caries, periodontal diseases and pathological lesions such as cysts, tumours or space infections leading to extraction of mandibular third molars. The objective of this study was to assess the reasons for mandibular third molar extraction.
Methods: A descriptive cross-sectional study was conducted on 146 patients from 1st August 2021 to 31st July 2022 in the department of Dental surgery of Birat medical college and teaching hospital. Data were analysed by Statistical Package for Social Sciences (SPSS) version 22.
Results: Out of 146 patients 90 (61.6%) were females and 56 (38.4%) were males. Reasons for mandibular third molar extraction were dental caries (n=67; 45.9%), impaction (n=62; 42.5%), periodontitis (n=10; 6.8%) and others (n=; 4.8%) which included traumatic ulcer on the tongue (n=3; 2%), angle fracture of the mandible (n=2; 1.4%), dentigerous cyst (n=1; 0.7%) and fascial space infection (n=1; 0.7%). 
Conclusions: The most common reasons for extraction of mandibular third molar was dental caries. Most common reason for extraction in age ≤ 25 years was impaction and it gradually shifted to dental caries as age progressed. Impaction was the most common reason for extraction of mandibular third molar in males however it was dental caries in females.
PRIMARY PERCUTANEOUS CORONARY INTERVENTION IN COVID-19 PATEINTS
Authors: Dhital Bishnu Mani , Regmi Shyam Raj , Shrestha Bidhan , Thapa Sovit , Murtaza Shahid
Published: May 2023

Background: Coronavirus Disease 2019 is global pandemic having high morbidity and mortality. It is thought that COVID-19 can predispose high thrombus burden and lead to Acute Coronary Syndrome. The aim of this study was to compare the symptoms, angiographic characteristics and procedural outcome in COVID-19 positive and COVID-19 negative patient undergoing percutaneous coronary intervention for acute coronary syndrome.
Methods: All the data of 121 patients who were admitted at Chitwan Medical College on April 2020 to September 2020, suffering from acute coronary syndrome who underwent PCI were collected and compared with COVID-19 positive and negative patients using SPSS version 22. The categorical variables were presented as numbers or percentages (%) and continuous variables were presented as mean ± standard deviation.
Results: Patient suffering with acute coronary syndrome with concurrent COVID-19 infections have more symptoms of fever (27.3% Vs 0.9%) and cough (27.3% Vs 2.8%, complications (45.5% Vs 7.3%), Mortality (36.4% Vs 0.9%), multi vessels thrombosis (27.3% Vs 2.8%) glycoprotein IIb/IIIa inhibitors use (27.3% Vs 0.14%) than non-COVID infection.
Conclusions: Patient with acute coronary syndrome with concurrent COVID-19 infections have high complication rate, multivessel thrombosis and death.
SATISFACTION TOWARDS NURSING SERVICES AMONG ADMITTED PATIENTS AT A TEACHING HOSPITAL, CHITWAN, NEPAL
Authors: Sapkota Shiksha , Bajracharya Subina
Published: May 2023

Background: Patient satisfaction with nursing care is the degree of convergence between the patient’s expectation with the ideal nursing care and their perception of the nursing care they received. Patient satisfaction with nursing care is an important determinant of quality of care in healthcare facility settings. The objective of this study was to assess satisfaction towards nursing services among admitted patients in Chitwan Medical College & Teaching Hospital (CMCTH).Methods: A descriptive, cross-sectional research design was conducted among 157 patients admitted in medical and surgical units of CMCTH. Data were collected by non-probability, convenience sampling technique using structured interview schedule and analyzed using descriptive and inferential statistics.Results: The study revealed that 45.9% of patients were young adults, 51% were male, 86.6% were Hindu, 44.6% were Brahmin/ Chhetri, 61.8% were from municipality and 42% had studied up to secondary education and above. More than half (52.2%) of patients had good satisfaction towards nursing services and association between level of satisfaction towards nursing services and mode of admission was statistically significant (p=0.036).Conclusions: Considerable proportion of respondents are dissatisfied with nursing services. Therefore, effective strategies need to be planned and implemented to improve quality of nursing services so that level of satisfaction towards nursing services can be improved.
CLINICAL CHARACTERISTICS AND RESULT OF LOCAL FLAP RECONSTRUCTION FOR FINGERTIP INJURY IN ADULTS
Authors: Pandey Suresh , Bidary Suraj
Published: May 2023

Background: Fingertip injury at different levels is a common injury and management varies with variable outcomes. Local flap reconstruction techniques are the most commonly used method of treatment with satisfactory results in most. The current study aimed to analyze the clinical characteristics and results of different local flap reconstruction techniques in the treatment of fingertip injuries.
Methods: This was a retrospective observational study of 31 fingertip injuries in 24 patients treated with one of the three local flap reconstruction techniques; V-Y advancement flap, thenar flap, and Moberg flap,  performed by a single orthopedic surgeon in a tertiary care teaching hospital over 2 years period. The variables analyzed were demographic and injury characteristics, flap take-up function, and cosmesis of the finger and nail using descriptive statistics.
Results: There were a total of 31 fingertip injuries at different levels and morphology with a mean age of 35.79 years (range 18-55). Household tools or machine-related injury was the most common mode of injury. A total of 23 (74%) fingertip amputations at a different level were treated with V-Y advancement local flap, 5 cases with thenar flap, and 3 cases of thumb tip amputation and laceration with Moberg flap. All the flaps survived well with preservation of sensation, function, and acceptable cosmesis.
Conclusions: Local flap reconstruction techniques can give rise to consistently good results in the management of fingertip injury. They are technically simple, and reliable and should be practiced by all orthopedic trauma surgeons whenever it is indicated.
PREVALENCE OF REFRACTIVE ERROR IN SCHOOL GOING CHILDREN OF SUNSARI DISTRICT AND BIRATNAGAR, NEPAL
Authors: Adhikari Pankaj Ray , Chudal Grishma Shree , Karn Rajiv Ranjan , Thakur Sudhir Kumar , Panta Sitoula Rakshya , Singh Sanjay Kumar
Published: May 2023

Background: Uncorrected refractive error is the leading cause of visual impairment. The aim of this study was to find the prevalence of refractive error among school-going children of Sunsari district and Biratnagar metropolitan city, Nepal.
Methods: A retrospective study was conducted from August 2018 to January 2020. Comprehensive eye examination was performed by an experienced optometrist and ophthalmic assistant trained in Paediatric eye care. Data was entered in software, transferred to Microsoft Excel, and analyzed by using SPSS version-20.
Results: During this period a total of 186215 students were enrolled. Primary screening was done for 124993 (67%) students and Secondary screening was done for 14355(11.5%) children. The overall prevalence of refractive error was 7439 (5.9%) found mostly in male 3897 (52.4%) of 11 to 15 years of age group 4554 (61.2%) (P=0.00). The prevalence of refractive error at schools of Biratnagar was 3156 (7.9%), Dharan was 1680 (8.5%) and Itahari was 1538 (6.0%). It was mostly found in private school going children of urban areas (5.4%) (P=0.00). Myopia (53%) was the most common type of refractive error (P=0.00).
Conclusions: The prevalence of refractive error was high in private school of urban area. There is a need to conduct school screening program in both urban and rural areas to rule out the refractive error and other ocular morbidities on time for better quality of life.
IMPACT OF COVID -19 IN MENTAL HEALTH OF COMMUNITY PEOPLE
Authors: Gurung Nirmala
Published: May 2023

Background: COVID-19 has done a great impact on the life of people, till now the third wave has been reported but the magnitude of mental health impact is the same as before. This study aimed to identify depression, anxiety, and stress among community people. During COVID -19 pandemic.
Methods: A descriptive cross-sectional study carried out using convenient sampling during CO- VID-19 Pandemic. Data was collected by using a structured standard DASS 21 scale. The SPSS version 22 was used to analyze data.
Results: There were a total of 411 people who participated, among them 33.7 %, 31.7 %, and 31.7 % had mild to extremely severe levels of depression, anxiety, and stress respectively were prevalent. There was a statistically significant association between income during the lockdown and the relatives of health workers working during COVID-19 in the DASS Scale at a 95% confidence level (p value< 0.05).
Conclusions: The depression, anxiety, and stress found in the community people during the third wave of the COVID-19 pandemic suggest that the impact still persists. The psychological awareness program has to be conducted more frequently in community settings, as this manmade disaster has a greater and long-term psychological impact.
PREVALENCE OF ATROPHIC GASTRITIS IN SYMPTOMATIC PATIENTS UNDERGOING GASTRIC BIOPSY IN A TERTIARY CARE CENTER OF NEPAL
Authors: Ranjan Mukesh , Poudyal Sagar , Neupane Pradeep , Shrestha Sabir Kumar , Yadav Roshan , Sharma Asha
Published: May 2023

Background: Atrophic gastritis and intestinal metaplasia are precancerous conditions associated with Helicobacter pylori infection. The prevalence of these conditions varies among countries and even among different regions in same country. There is limited data from central Nepal regarding these entities. The primary aim of this study was to assess the prevalence of atrophic gastritis in gastric biopsy of symptomatic patients.
Methods: A prospective study which included all consecutive patients undergoing endoscopic gastric biopsy. Biopsies from body and antrum obtained as per Sydney protocol. Histopathological examination was done by a team of histopathologists and reported according to updated Sydney classification. Statistical software SPSS (version 26, SPSS Inc. Chicago, IL) and STATA 14 were used for statistical analysis.
Results: Of 113 consecutive patients, 103 were included for final analysis (female: 59.2% and mean age: 46.29 ± 16.54 years). Dyspepsia [EPS: 69 (66.9%) and PDS:19 (18.4%)] followed by GERD in 21 (20.3%) were the commonest presentations. On histology, atrophic gastritis was present in 101 (98.05%) patients with mild-, moderate-, and severe AG seen in 12 (11.8%), 87 (86.1%), and 2 (1.9%) respectively. Prevalence of AG was not different in patients with or without H. pylori infection (p=0.10). Intestinal metaplasia was present in 13 (12.62%). Helicobacter pylori were present in 58 (56.3%) with prevalence in antrum and body being 57 (55.3%) vs. 41 (39.8%), p=0.02.
Conclusions: Atrophic gastritis, IM, and H. pylori infection is highly prevalent in symptomatic patients and the prevalence in younger population is equally high compared to older population.
COVID-19 VACCINATION IN CHILDREN: AN UPDATE FOR THE NEW ERA OF COVID-19
Authors: Pailaha Aprianto Daniel
Published: May 2023

The COVID-19 pandemic is still ongoing, it is imperative to vaccinate most people, including children, to achieve herd immunity against the pandemic. Since parents are the ones who ultimately decide whether to vaccinate their children, this viewpoint was conducted to determine parents' acceptance and reluctance to vaccinate their children against COVID-19. This viewpoint aims to identify the predictors and ethical considerations of childhood vaccination. Several predictive factors contribute to the decision to accept or refuse the COVID-19 vaccine for children. Predictor factors that influence the acceptance of the COVID-19 vaccine in children are citizen trust in government, conspiratorial beliefs, intention of parents, psychological reactance, and magical beliefs. Ethical considerations must also be considered, because this is very important. Ethical considerations that may be a dilemma for vaccine acceptance such as autonomy, beneficence, non-maleficence, and justice.
HAND GRIP STRENGTH IN TYPE II DIABETIC PATIENTS VISITING OUT PATIENT DEPARTMENT OF A TERTIARY CARE CENTRE OF NEPAL
Authors: Shrestha Biju , Gurung Preetu
Published: May 2023

Background: Type 2 Diabetes Mellitus commonly affects the elderly individuals. Reduced muscle strength has been considered as one of the complication of Type 2 Diabetes Mellitus. Handgrip strength is an important parameter to evaluate the power of the hand. Hand grip strength has also proven to be an important measure to diagnose muscle degeneration at an early stage. The study aimed to compare the hand grip strength between individuals with and without type 2 diabetes mellitus.
Methods: This comparative cross-sectional study was conducted in the Outpatient Department of Medicine, Kathmandu Medical College and Teaching Hospital. In total 200 subjects who met inclusion criteria participated in the study. Handgrip strength was measured with an isometric hand dynamometer and comparisons were made between diabetic and non-diabetic groups. Independent t-test were used to analyze the significance difference in hand grip strength between the two groups (p=0.05).
Results: Total of 200 subjects (100 T2DM and 100 controls) were studied. Mean hand grip strength (kg) was significantly lower both in men and women with diabetes compared with controls (37.54±6.08 vs 45.16±4.82, p = 0.000 in men and 33.97±6.47 vs 44.54±5.42, p = 0.000 in women).
Conclusions: Hand Grip Strength was significantly lower in subjects with type 2 diabetes mellitus subjects when compared with healthy volunteers.
ASSESSMENT OF GINGIVAL HEALTH AND ORAL HYGIENE PRACTICES AMONG THE PATIENTS VISITING A DENTAL HOSPITAL IN KATHMANDU
Authors: Yadav Karnika , Poudyal Sijan , K.K Shivalingase , Pradhan Amita
Published: May 2023

Background: Good oral health plays an important role to improve the quality of life and general health of the people. Oral health depends on several factors including individual personal attitudes, behavior and perception. The aim was to assess the gingival health and oral hygiene among the population.
Methods: This cross-sectional study was conducted in outpatient department of Community Dentistry among 369 patient of age group of 18-60 years. History taking and oral health examination was done to collect the information. The questionnaire covered demographic details, ethnicity, religion, oral hygiene habits and gingival health of the participants. Statistical analysis was done by using SPSS 20 version using descriptive test like frequencies, percentage. Chi square test was done to determine the association between brushing technique and gingival index score and Fischer exact test was used to see the association between material used and gingival index.
Results: Majority of the participants were female (62.6%). Nearly 84% participants were from urban area. About 25% belong to Newar ethnicity. Most of them used horizontal method of cleaning (58.0%). About 99% of the participants used toothbrush and toothpaste. Most of the participants brushed once a day (68.6%). About 82%  used before breakfast in the morning . Nearly half of the participants (49.9) % had mild gingivitis.
Conclusions: The gingival health and oral hygiene practices play a important role. The oral hygiene practice has been adopted by majority of the participants however, more than half of the patient are suffering from any form of gingivitis which is comparatively higher than other population.
INTRA-OPERATIVE OSSICULAR CHAIN FINDINGS IN CHRONIC OTITIS MEDIA MUCOSAL INACTIVE TYPE
Authors: Mahato Rahul , Jha Amit
Published: May 2023

Background: Chronic Otitis Media is the chronic inflammation of the middle ear cleft and is broadly divided into mucosal and squamous types. Chronic otitis media often results in partial or total loss of the tympanic membrane and ossicles leading to conductive hearing loss that can be as severe as 60 decibels. The objective of this study was to find out the status of the ossicles in patients diagnosed with chronic otitis media mucosal inactive type undergoing type I tympanoplasty.
Methods: This observational study was conducted in the Department of ENT-HNS, NMCTH from September 2017 to August 2018. A total of 53 patients with chronic otitis media mucosal inactive were included in the study. All the details required were noted in an especially prepared proforma after history taking and adequate physical examination. The status of the ossicular chain was assessed during the surgery.
Results: A total of 53 patients were included in the study. There were more female patients (58.5%) than male (41.5%) patients. Hearing loss was observed in 52 (98%) of the patients. The majority of the patients had a mild degree of hearing loss (60.4%). The mean of the pre-operative air-conduction threshold and air-bone gap were 39.81 dB and 28.70 dB respectively. Intra-operative ossicular chain lesions were found in 18(34%) and the most common ossicular chain lesions was erosion of incus 8(44.4%).
Conclusions: This study shows that ossicular chain lesions are the common intraoperative finding of chronic otitis media during tympanoplasties, with an erosion of the incus being the commonest lesion.
PREVALENCE AND PREDICTORS OF DYSMENORRHOEA AND IT’S EFFECTS AMONG ADOLESCENT GIRLS IN CHITWAN, NEPAL
Authors: Sigdel Dipa , Joshi Alisha , Thapa Taniya , Koirala Pratima , Sharma Kalpana
Published: May 2023

Background: Dysmenorrhea is a common gynaecologic complaint among adolescent female. Despite of being a natural phenomenon it has severe impact on day to day activities such as school absenteeism, decreased social and physical activities. Hence, this study aimed to assess the prevalence and predictors of dysmenorrhoea and it’s effects among adolescent girls in Chitwan.
Methods: A cross-sectional study was conducted among 393 female adolescent students who were studying in secondary and higher secondary level in public schools of Bharatpur, Chitwan. Students were selected through proportionate stratified random sampling technique. Data were collected by using structured self-administered questionnaire from January 17, 2021 to February 16, 2021. Data were analysed in SPSS software version 20 for window using descriptive and inferential statistics.
Results: Prevalence of dysmenorrhoea was found to be 87.5% and 47.4% of adolescents experienced moderate level of menstrual pain. Three fourth (75%) of adolescents reported decreased in physical activity, difficulty in sleep (67.7%), unnecessary irritation (65.4%) and class absenteeism (38.1%) during menstruation. Most (89.8%) of the adolescents communicate their problem with others and 40.7% apply heat therapy. Prior health education [AOR:4.087, 95% CI: 1.980 – 8.403) and family history of dysmenorrhoea [AOR:2.786, 95% CI: 1.408– 5.495) were found to be statistically significant with dysmenorrhoea.
Conclusions: Dysmenorrhoea is the most common problem among the adolescents that affects various domains of life. Hence, the concerned authorities need to consider various factors such as health seeking behavior, educational intervention and counselling in order to mitigate the silent problems related to menstruation.
OUTCOMES AND SAFETY OF RETROGRADE INTRA RENAL SURGERY FOR RENAL STONES
Authors: Shah Rajiv , Yadav Raghvendra Vimal , Adhikari Kapil
Published: May 2023

Background: Renal stones are one of the most common urological problems requiring surgical interventions. Retrograde intra-renal surgery is a minimally invasive surgical technique with minimal complications and a good stone-free rate. In the present study we aimed to assess the outcomes and safety of retrograde intrarenal surgery.
Methods: A retrospective study was performed at Chitwan Medical College Teaching Hospital in the span of two years from Dec 2019 to Nov 2021. Patient demographics; stone burden, stone density, and location were collected from the medical records and evaluated. The data was collected in a proforma which was then entered into SPSS version 20. The data was presented in form of frequency and percentage.
Results: One hundred and seventy patients were subjected to retrograde intrarenal surgery, out of which 32 were converted to mini- percutaneous nephrolithotripsy, 12 were presented and total of 126 were subjected to retrograde intrarenal surgery. The major complications were pyrexia in 21(16.67%) patients followed by hematuria in 4(3.17%) patients, and sepsis in 2(1.58%) patients. The stone-free rate was 94.4%. 2 (1.58%) patients underwent mini- percutaneous nephrolithotripsy and5 (3.96%) of them showed stones of varying size 2-6mm, non-obstructive with none of cases planned for staged retrograde intrarenal surgery.
Conclusions: Primary Retrograde intrarenal surgery is the safe and effective treatment for the intrarenal stones.
MORBIDITY PATTERN OF SMALL FOR GESTATIONAL AGE BABIES ADMITTED IN A NEONATAL CARE UNIT
Authors: Kalakheti Balakrishna , Lamichhane Anita , Prajapati Bikesh , Upadhyay Hari Prasad
Published: May 2023

Background: The neonatal period of the small for gestational age (SGA) neonates is the most vulnerable phase; the neonatal morbid conditions along with the mortality being the major health issues in the developing countries like Nepal. The objective of this study was to assess the morbidity pattern of the SGA neonates admitted in the neonatal intensive care unit.
Methods: A hospital base cross-sectional study was carried out in 100 SGA neonates admitted in the neonatal care unit of College of Medical Sciences Teaching Hospital, Bharatpur, Nepal from May 2020 to April 2021 Small for gestational age neonates (SGA) was defined as birth weight <10th percentile for gestational age by Lubchenco’s growth chart. Infant characteristics and neonatal outcomes were assessed during the hospital stay and the data was entered in the SPSS v23.0. 
Results: Among the total 100 cases of SGA neonates, 66 % were male. The mean birth weight was 1900 ±SD 381gm (range 1000-2500 gm). Term SGA neonates accounted for 60% while preterm SGA neonates were 40%. Common morbidities seen in SGA neonates were sepsis (44%), hyperbilirubinemia (34%), perinatal depression/birth asphyxia (34%) and shock (22%). While comparing the morbidities between term and preterm neonates, a significant correlation was observed between hypothermia (p-value = 0.001), polycythemia (p-value = 0.001), NEC (p-value= 0.004) and perinatal depression/asphyxia (0.013) with the period of gestation. Mortality was observed in 8% due to various perinatal problems. 
Conclusions: From this study, we can conclude that SGA is associated with various morbidities, sepsis being the most common morbidity amongst perinatal asphyxia, hyperbilirubinemia, hypothermia and hypoglycemia.