bluuebunny/crossref_metadata_2025 huggingface dataset:
Capital erótico no ambiente organizacional: a sua influência no processo seletivo e na empregabilidade
Authors: Pereira Lorena Andressa Rodrigues , Dos Santos Giuliana Elisa
Published: July 2016

Beleza, habilidades físicas e sociais influenciam as relações interpessoais e são predicados superestimados social e economicamente em nossa cultura. A cientista social Catherine Hakim cunhou o conceito de capital erótico para compreender uma combinação de estética e capacidade de interação social que em nível elevado torna algumas pessoas mais atraentes que outras, inclusive profissionalmente. Buscando entender a influência deste capital no ambiente organizacional, analisaram-se os estudos da pesquisadora, bem como de outros autores e pesquisas, no processo de seleção de pessoal e empregabilidade. Esta pode ser a resposta para melhores remunerações, maior probabilidade de conquistar um emprego e promoções na carreira. Trata-se de um importante atributo para pessoas com menos acesso aos demais capitais e é possivelmente desenvolvido. O contexto do mercado moderno valoriza as competências e experiência profissional, como também aponta um novo olhar para as habilidades compositoras do capital erótico.
Um estudo no atual processo mercadológico em clínicas veterinárias do município de Dourados-MS
Authors: Costa Marcos Roberto , Turquiello Josué Paulo
Published: July 2016

A crescente oferta de médicos veterinários que chegam ao mercado de trabalho da cidade de Dourados todo ano, aliado ao interesse destes profissionais permanecerem no município após a graduação, faz com que haja grande concorrência pelos serviços oferecidos. Os antigos profissionais que permanecem até hoje no município, são oriundos de outros estados brasileiros e predominam como fundadores e principais responsáveis pela conscientização sobre os cuidados com animais de estimação, não percebendo a importância do processo mercadológico ligado ao marketing veterinário. Como metodologia se aportou a pesquisa descritiva, exploratória, qualitativa e quantitativa, através de questionário semi estruturado. Logo o referido artigo fora desenvolvido com o intuito de mostrar aos proprietários de clínicas veterinárias da área pet, que não basta somente conhecer o desfecho de uma patologia, mas oferecer aos clientes condições que o agrade e faça retornar ao seu estabelecimento, não importando o quanto se paga pelo serviço.
Marketing societal da empresa Multicoisas
Authors: Lopes Michelle Rosa
Published: July 2016

Este estudo de caso teve como fonte de pesquisa o marketing societal, onde a cada dia as empresas se enquadram em novos desenvolvimentos pela busca de sua sustentabilidade, com visão de mercado e analisando as mudanças de nosso planeta. Buscou-se mostrar a empresa cuja Responsabilidade Social se enquadra em parâmetros práticos e sociais. Tendo como preocupação, o futuro do planeta, evidenciado hoje nos mercados internacionais da globalização: há questão sobre preocupação com a água, sua pureza e fonte saudável. Em que País viveremos daqui há trinta anos, é a constante preocupação das pessoas. Assuntos que veem sendo discutidos em escolas de ensino fundamental a universidades pelo mundo à fora, buscando conscientizar a população para agravante questão. A empresa em pauta pesquisada tem como compromisso a conscientização de ajudar e fazer a sua parte na sustentação de sobrevivência do planeta.
La conversación coloquial en la enseñanza del español como lengua extranjera
Authors: Grande Alija Francisco Javier
Published: July 2016

La conversación coloquial en la enseñanza del español como lengua extranjera
La preposición desde una perspectiva funcionalista: su papel como transpositor e índice funcional
Authors: Grande Rodríguez Verónica
Published: July 2016

La preposición desde una perspectiva funcionalista: su papel como transpositor e índice funcional
El secuestro por amor: orígenes, evolución y tratamiento en el "Lancelot en prose"
Authors: Gutiérrez García Santiago
Published: July 2016

El secuestro por amor: orígenes, evolución y tratamiento en el "Lancelot en prose"
El lirismo acendrado de Gaspar Gómez (Claves de lectura)
Authors: Martínez Fernández José Enrique
Published: July 2016

El lirismo acendrado de Gaspar Gómez (Claves de lectura)
Percepciones semiológicas de los modelos de cortesía británico y español
Authors: Garrido Ardila Juan Antonio
Published: July 2016

Percepciones semiológicas de los modelos de cortesía británico y español
La rebeldía femenina durante el Renacimiento Francés: el caso de Louise Labé
Authors: Fernández Díaz María Del Carmen
Published: July 2016

La rebeldía femenina durante el Renacimiento Francés: el caso de Louise Labé
Sobre la confusión "docere" / "discere" en latín altomedieval hispano (siglos IX-XI)
Authors: Martínez Ángel Lorenzo
Published: July 2016

Sobre la confusión "docere" / "discere" en latín altomedieval hispano (siglos IX-XI)
Identifying Scientific Project-generated Data Citation from Full-text Articles: An Investigation of TCGA Data Citation
Authors: Li Jiao , Zheng Si , Kang Hongyu , Hou Zhen , Qian Qing
Published: July 2016

Purpose

In the open science era, it is typical to share project-generated scientific data by depositing it in an open and accessible database. Moreover, scientific publications are preserved in a digital library archive. It is challenging to identify the data usage that is mentioned in literature and associate it with its source. Here, we investigated the data usage of a government-funded cancer genomics project, The Cancer Genome Atlas (TCGA), via a full-text literature analysis.

Design/methodology/approach

We focused on identifying articles using the TCGA dataset and constructing linkages between the articles and the specific TCGA dataset. First, we collected 5,372 TCGA-related articles from PubMed Central (PMC). Second, we constructed a benchmark set with 25 full-text articles that truly used the TCGA data in their studies, and we summarized the key features of the benchmark set. Third, the key features were applied to the remaining PMC full-text articles that were collected from PMC.

Findings

The amount of publications that use TCGA data has increased significantly since 2011, although the TCGA project was launched in 2005. Additionally, we found that the critical areas of focus in the studies that use the TCGA data were glioblastoma multiforme, lung cancer, and breast cancer; meanwhile, data from the RNA-sequencing (RNA-seq) platform is the most preferable for use.

Research limitations

The current workflow to identify articles that truly used TCGA data is labor-intensive. An automatic method is expected to improve the performance.

Practical implications

This study will help cancer genomics researchers determine the latest advancements in cancer molecular therapy, and it will promote data sharing and data-intensive scientific discovery.

Originality/value

Few studies have been conducted to investigate data usage by government-funded projects/programs since their launch. In this preliminary study, we extracted articles that use TCGA data from PMC, and we created a link between the full-text articles and the source data.
Critical Factors for Personal Cloud Storage Adoption in China
Authors: Wang Jianya
Published: July 2016

Purpose

In order to explain and predict the adoption of personal cloud storage, this study explores the critical factors involved in the adoption of personal cloud storage and empirically validates their relationships to a user’s intentions.

Design/methodology/approach

Based on technology acceptance model (TAM), network externality, trust, and an interview survey, this study proposes a personal cloud storage adoption model. We conducted an empirical analysis by structural equation modeling based on survey data obtained with a questionnaire.

Findings

Among the adoption factors we identified, network externality has the salient influence on a user’s adoption intention, followed by perceived usefulness, individual innovation, perceived trust, perceived ease of use, and subjective norms. Cloud storage characteristics are the most important indirect factors, followed by awareness to personal cloud storage and perceived risk. However, although perceived risk is regarded as an important factor by other cloud computing researchers, we found that it has no significant influence. Also, subjective norms have no significant influence on perceived usefulness. This indicates that users are rational when they choose whether to adopt personal cloud storage.

Research limitations

This study ignores time and cost factors that might affect a user’s intention to adopt personal cloud storage.

Practical implications

Our findings might be helpful in designing and developing personal cloud storage products, and helpful to regulators crafting policies.

Originality/value

This study is one of the first research efforts that discuss Chinese users’ personal cloud storage adoption, which should help to further the understanding of personal cloud adoption behavior among Chinese users.
Knowledge Representation in Patient Safety Reporting: An Ontological Approach
Authors: Liang Chen , Gong Yang
Published: July 2016

Purpose

The current development of patient safety reporting systems is criticized for loss of information and low data quality due to the lack of a uniformed domain knowledge base and text processing functionality. To improve patient safety reporting, the present paper suggests an ontological representation of patient safety knowledge.

Design/methodology/approach

We propose a framework for constructing an ontological knowledge base of patient safety. The present paper describes our design, implementation, and evaluation of the ontology at its initial stage.

Findings

We describe the design and initial outcomes of the ontology implementation. The evaluation results demonstrate the clinical validity of the ontology by a self-developed survey measurement.

Research limitations

The proposed ontology was developed and evaluated using a small number of information sources. Presently, US data are used, but they are not essential for the ultimate structure of the ontology.

Practical implications

The goal of improving patient safety can be aided through investigating patient safety reports and providing actionable knowledge to clinical practitioners. As such, constructing a domain specific ontology for patient safety reports serves as a cornerstone in information collection and text mining methods.

Originality/value

The use of ontologies provides abstracted representation of semantic information and enables a wealth of applications in a reporting system. Therefore, constructing such a knowledge base is recognized as a high priority in health care.
Productivity of Rainfed Castor as Influenced by Plant Geometry and Nitrogen Levels
Authors: Aruna E. , Sagar G. Karuna
Published: July 2016

Field experiment was conducted at  Agricultural Research Station, Utukur,Kadapa of Acharya N G Ranga Agricultural University to study the performance of rainfed castor  hybrid PCH 111 under varied levels of nitrogen with different planting patterns during kharif seasons of  2012 and 2013.The study was laid out in a split plot design with three replications comprising of  three planting patterns, viz.,  90 cm x 30 cm (P1), 90 cm x 45 cm (P2), 90 cm x 60 cm (P3)  and three nitrogen levels viz., 60 kg ha-1 (N1), 90 kg ha-1 (N2) , and 120 kg ha-1 (N3). Number of spikes per plant and number of capsules per spike (58.84, 69.07 in 2012 and 2013 respectively) were more when castor was planted at 90 cm x 45 cm.  Hundred seed weight and seed yield were not significantly influenced by planting geometry. Application of 120 kg N ha-1 recorded higher number of spikes per plant and capsules per spike but it was on par with 90 kg N ha-1. Seed yield was higher with application of 120 kg N ha-1  in both the years but it was on par with 90 kg N  ha-1.Comparatively higher seed yield was recorded during 2013 due to the receipt of high rainfall.
Effect of Gamma Radiations on the Quality and Shelf Life of Strawberry Fruit of the Uttrakhand Region
Authors: Sharma Prianka , Rastogi Meetu
Published: July 2016

Present study was conducted to investigate the effect of gamma radiations on the quality and shelf life of strawberries. The aim of this study was to evaluate gamma radiation doses in  range of 0.3- 1.5 kGy. The irradiated strawberries were stored in ambient (temperature 25 +- 2oC, RH 70 %) and refrigerated (3 +-1oC, RH 80%) conditions. In samples treated with dose 1.2-1.5 kGy no decay was recorded up to 9 days of ambient conditions. Under refrigerated conditions, strawberry samples of unirradiated and irradiated in the range of 0.3-0.9 kGy started decaying after 14 days of storage. No decay was observed in the samples treated with 1.2-1.5 kGy up to 28 days of refrigerated storage. Dose of 1.2 kGy was significantly effective in reducing the weight loss and in maintaining the higher overall acceptability under both the storage conditions compared to the other treatments. This dose also proved effective in retention of significantly higher levels of total sugars compared to the other treatments. Thus, it was established that irradiating strawberries with dose of 1.2 kGy can prove beneficial in facilitating the marketing of the fruit to distant places other than the local markets, thereby benefiting the growers.
Swami Vivekananda – As a Poet
Authors: Tiwari Vineeta
Published: July 2016

Swami Vivekananda who, in words of Sister Nivedita (Margaret Elizabeth Noble his Irish devoted disciple), breathed India. He was a personality of multiple facets – a thinker, a philosopher, a saint, a preacher, a leader, a reformer and so on. Very few people know him as a Poet. The English poetry in India brought by the ending years of the nineteenth century has chiefly taken the form of a revival of cultural patriotism, highly necessary for a nation. It also has religious impact on it in the sense that it evolved out of the magnificent past of India. And whosoever can be the best admirer of this culture and glory of its past that is one and only Swami Vivekananda. We find a mixture of these aspects in Vivekananda’s poetry also but ratio of religion is larger than other aspects of his poetry.
To Study the Impact of Emotional Intelligence on Academic Achievement of Teacher Trainees
Authors: Sharma Poonam , Mangal Shubhra , Nagar Pooja
Published: July 2016

“All learning has an emotional base”-Plato

 

The present study was conducted to study the impact of Non cognitive factor i.e Emotional Intelligence on the academic achievement of teacher trainees.The study was conducted on 100 graduate teacher trainees pursuing B.Ed. from  Lingaya’s University . The participants consisted of male and female students in which strength of female was more than male. Average age of all participants was 24 years. Randomization method was used for selection for the participants. Emotional intelligence inventory designed by DR. S.K. Mangal (Guest faculty, Department of Education, M.D. University, Rohtak) and Ms. Shubhra Mangal (Principal C.R.S. College of Education, Noida )  was used for the measurement of  emotional intelligence of teacher trainees’ which consists four areas of Emotional Intelligence i.e  Intra-personal Awareness, Inter-personal Awareness, Intra-personal Management, Inter- personal Management respectively. The result of study reveals that  there is positive and significant correlation between Emotional Intelligence and Academic Achievement of teacher trainees.
MFIs Lending and Poverty Reduction
Authors: Reddy Vaddula V. Krishna
Published: July 2016

The paper aims to study the impact of the Microfinance lending in India as a powerful instrument for poverty Reduction.  Social businesses like microfinance, due to their sensitive client base, need to walk a fine line to balance their commercial interests with the social and moral expectations of a wide variety of stakeholders. This study attempted to investigate the effects of MFIs on poverty reduction. It intended to cover credit facilities provided by the MFI and clients perception on income improvement and/or reduced poverty levels. The study found that there is an impact of Micro Finance Institutions (MFIs) lending on income levels of beneficiaries and poverty reduction.
An Investigation of Low Volatility Anomaly in Indian Stock Market
Authors: Pandey Sitaram , Samanta Amitava
Published: July 2016

The objective of this paper is to investigate the presence of low volatility anomaly in Indian stock Market. Anomaly occurs due to the deviation in normal behavior of stocks with respect to risk-return relationship as suggested by CAPM theory. The low volatility anomaly means that portfolio of low volatility stocks provides better returns than the portfolio of high volatility stocks. The anomaly under study is one of the most common technical anomalies detected in various International markets but very few studies are there in Indian context. CAPM theory suggest that there is direct relationship between risk & return but various empirical studies finds that portfolio of low volatility stocks outperforms portfolio of high volatility stocks. In this study, returns of volatility sorted portfolios are used to analyze the low volatility anomaly. The study uses constituent stocks of S&P CNX 100 index of NSE. The data is taken from period January 2001 to December 2014.  The results of this study did not found   any significant low volatility anomaly in India rather results are supporting the CAPM model and thus found that high volatility quintile gives high returns in India and vice-versa.
Pengaruh Inokulasi Lactobacillus plantarum dan Saccharomyces cerevisiae terhadap Fermentasi dan Kecernaan In Vitro Silase Kulit Buah Kakao
Authors: Zakariah Muhammad Askari , Utomo Ristianto , Bachruddin Zaenal
Published: July 2016

The objective of this study was to identify the effect of L. plantarum and S. cerevisiae mixed culture inoculation into cocoa pods silage on chemical composition and in vitro digestibility. The four treatments were: 1 kg freshly harvested cocoa pods without inoculants as control (K); K + L. plantarum (KLp); K + S. cerevisiae (KSc); and K + L. plantarum and S. cerevisiae mixture (KLp+Sc) 0.1% dry matter, Cassava meal were added in all treatments. Each treatment was replicated 3 times, and then fermented for 21 days. Parameters observed in current study were gas test production, ruminal fermentation parameter, and in vitro digestibility. The collected data were analyzed by one-way analysis of variance and followed by Duncan’s new Multiple Range Test for data with significant differences. Result showed that the mixed culture Lp+Sc inoculation increased (P<0.05) chemical quality of cocoa pods by reducing fibre fraction and increase NFE contents, increased degradation rate, degradation theory, reduced rumen pH, and propionate acid production, without affecting acetate to propionate ratio, microbial protein synthesis, and digestibility of cocoa pod silage.
Accuracy assessment of different soil databases concerning WRB reference soil groups
Authors: Balla Dániel , Varga Orsolya , Zichar Marianna
Published: July 2016

As a result of international cooperation, the conditions of data access and data usage have been significantly improved during the last two decades. Also, the establishment of web-based geoinformatic infrastructure allowed researchers to share their results with the scientific community more efficiently on the international level. The aim of this study is to investigate the accuracy of databases with different spatial resolutions, using the reference profiles of LUCAS topsoil database. In our study, we investigated the accuracy of World Reference Base for Soil Resources (WRB) Reference Soil Groups (RSG) groups stored in freely accessible soil databases (European Soil Database (ESDB), International Soil Reference and Information Centre (ISRIC)) in Hungary. The study concluded that the continental scale database tends to be more accurate. We used the Kappa Index of Agreement (KIA) statistical index to evaluate accuracy. The European and the international databases showed a value of 0.9643 and 0.3968, respectively. Considering the results, we can conclude that the spatial resolution has a relevant impact on the accuracy of databases, however, the study should be extended to the national level and the indices should be assessed together.
Iron based metal organic framework as an effective lead ions remover from aqueous solution: Thermodynamic and kinetics studies
Authors: Shooto Ntaote , Dikio Ezekiel , Wankasi Donbebe , Sikhwivhilu Lucky
Published: July 2016

Metal organic frameworks (MOFs) based on iron as a central metal ion and 1,2,4,5-tetrabenzenecarboxylic acid as ligand was successful synthesized, characterized and studied as adsorbent for the removal of lead ions in aqueous solution. Characterization of Fe-MOF was attained by SEM, EDX, TGA and FT-IR techniques. EDX spectrum showed the presence of C, O and Fe, which may facilitate in creating charges and functionalities on the surface of the Fe-MOF for adsorption. The kinetic and thermodynamic parameters were also investigated. The results showed that Fe-MOF has a high Pb2+ adsorption affinity. The removal of Pb2+ from aqueous solutions varied with concentration, contact time and temperature. All adsorption studies were carried out in batch experiments.
Are There Clinical Implications of Racial Differences in HbA1c? Yes, to Not Consider Can Do Great Harm!
Authors: Herman William H.
Published: July 2016

Studies that have compared HbA1c levels by race have consistently demonstrated higher HbA1c levels in African Americans than in whites. These racial differences in HbA1c have not been explained by measured differences in glycemia, sociodemographic factors, clinical factors, access to care, or quality of care. Recently, a number of nonglycemic factors and several genetic polymorphisms that operate through nonglycemic mechanisms have been associated with HbA1c. Their distributions across racial groups and their impact on hemoglobin glycation need to be systematically explored. Thus, on the basis of evidence for racial differences in HbA1c, current clinical guidelines from the American Diabetes Association state: “It is important to take…race/ethnicity…into consideration when using the A1C to diagnose diabetes.” However, it is not clear from the guidelines how this recommendation might be actualized. So, the critical question is not whether racial differences in HbA1c exist between African Americans and whites; the important question is whether the observed differences in HbA1c level are clinically meaningful. Therefore, given the current controversy, we provide a Point-Counterpoint debate on this issue. In the point narrative below, Dr. Herman provides his argument that the failure to acknowledge that HbA1c might be a biased measure of average glycemia and an unwillingness to rigorously investigate this hypothesis will slow scientific progress and has the potential to do great harm. In the counterpoint narrative that follows Dr. Herman’s contribution, Dr. Selvin argues that there is no compelling evidence for racial differences in the validity of HbA1c as a measure of hyperglycemia and that race is a poor surrogate for differences in underlying causes of disease risk.

—William T. Cefalu

Editor in Chief, Diabetes Care
Role of Haptoglobin in Health and Disease: A Focus on Diabetes
Authors: MacKellar Mark , Vigerust David J.
Published: July 2016

In Brief Prospective identification of individuals with diabetes who are at greatest risk for developing complications would have considerable public health importance by allowing appropriate resources to be focused on those who would benefit most from aggressive intervention. Haptoglobin (Hp) is an acute-phase protein that is crucial for the elimination of free hemoglobin and the neutralization of oxidative damage. In the past two decades, associations have been made between polymorphisms in Hp and complications arising from diabetes. Individuals with polymorphism in Hp have been shown to have significantly higher risk of developing cardiovascular disease. This review summarizes the current literature on the role of Hp in health and disease, with a focus on diabetes.
Treatment of Fluorosis Spots Using a Resin Infiltration Technique: 14-month Follow-up
Authors: Cocco AR , Lund RG , Torre EdN , Martos J
Published: July 2016

The aim of this study was to report a clinical case of moderate fluorosis spots treated with infiltration of low-viscosity resin. A commercial resin was applied to the facial surfaces on the anterior teeth in both the maxillary and mandibular arches. The white spots of fluorosis lost their whitish appearance and appeared similar to sound enamel. This technique, which might constitute an alternative to white-masking of fluorosis spots, showed optimal esthetic results.
Bacteriological Evaluation of Tonsillar Surface and Tonsillar Core Micro Flora in Patients Undergoing Tonsillectomy
Authors: Manandhar S , Bhandary S , Chhetri S T , Khanal B , Shah S P , Sah B P , Paudel D
Published: July 2016

Background: Acute tonsillitis is the most common disease for the ENT surgeons. Effective treatment of the tonsillitis depends on knowledge of the infecting organism but there is always a dilemma whether the antibiotics prescribed for the tonsillitis is sufficient for the different organisms in the surface and core of the tonsils.Objective: To study the microorganism on the surface and in the core of the tonsil among the patients undergoing tonsillectomy and to correlate clinical profile of the patients with various microorganisms isolated.Methods: This was a cross sectional study conducted on fifty patients’ age ranging from 3 years to 45 years. The swabs obtained from the surface of the tonsil prior to tonsillectomy and core of the tonsil post tonsillectomy were sent for isolation of micro organism and microbial susceptibility technique by standard microbial method.Results: The common age group for tonsillitis was below 15 years (n= 26) and having male predominance and more common in patients from hilly region. The commonest indication for tonsillectomy was recurrent tonsillitis (n=47). There was 82% similarity in microorganisms isolated from the surface and core of the culture. Conclusion: This study highlights that the culture from the surface of the tonsil reflects the organism in the core. Staphylococcus aureus was the commonest isolated organism in the surface and core of the tonsil.Health Renaissance 2014;12(3): 149-153
Clinico-Pathological Profile of Benign Cervico-Facial Masses In Eastern Nepal
Authors: Joshi Rupesh Raj , Nepal A , Bhandary S , Chhetri S T , Karki S
Published: July 2016

Background :Head and neck region is a common site for both solid and cystic lesions. The etiology of these masses includes inflammation, congenital-developmental malformations and neoplasia. Thyroglossal cyst, branchial cyst and laryngocoele are the common congenital and acquired conditions.Objective: To assess clinicopathological profile of benign cervico-facial masses in Eastern Nepal.Methods: Patients who were admitted with cervical swellings were included for the study. Acute inflammatory and malignant conditions were excluded. This study was conducted for five years at Department of ENT and Head Neck Surgery, B.P. Koirala Institute of Health Sciences, Dharan, Nepal.Results: Out of total 499 patients included, female were 64.53% and male were 35.47%. Most patients (23%) were from between age 21-30 years. The cervical swellings were most commonly seen in upper lateral neck in 30.46%. Most of the patients (67.13%) presented within 2 years of the appearance of the swelling. Sixty-one percent of the swelling were of the size of 5 cm x 4 cm at presentation. Congenital and developmental malformations were seen in 27.65% Cysts other than developmental were found in 17.02%. The acquired benign lesions were seen in 55.31%.The swelling due to the diseases of the thyroid were found in 38.28%. The most common surgical management was thyroidectomy, done in 38.28%.Conclusion: Benign neck masses are common clinical presentation in the general population in eastern Nepal as in any head and neck clinics all over the world and present a challenge both to the clinician as well as the surgeon.Health Renaissance 2014;12(3): 162-169
Nepalese Trekking Guides: A Quantitative Study of Sexual Health Knowledge & Sexual Behaviour
Authors: Simkhada Padam , Teijlingen E Van , Regmi P , Bhatta P , Ingham R , Stone N
Published: July 2016

Background: Tourism, a global industry, brings with it a number of public health problems, one of which is the spread of sexually transmitted infections transmitted between travellers and hosts. Previous studies have largely focused on sex workers and sex tourists.Objective: To assesses sexual behaviour, knowledge and condom use among male trekking guides in Nepal.Methods: A self-administered questionnaire survey (n=324) was conducted using snowball sampling amongst men working as mountain trekking guides in Nepal. Results: Most respondents (59%) had initiated sex before the age of 18. Most (84 %) reported sexual relations with a woman other than their partner, 46% reported foreign partners, 43% had Nepalese partners, and 28% had concurrent foreign and Nepalese partners. Most (70 %) reported ever having sex with a foreign woman and two-thirds had had sexual intercourse with foreign women in the previous 12 months. Participants’ age, education status, age of first sex, smoking and drinking habits and English proficiency were significant predictors of having sex with foreign women. About 60% reported condom use during their most recent occasion of extra-martial sex. A similar proportion had used a condom during last sexual intercourse with a foreign woman. The likelihood of condom use was associated with a guide’s age, educational level, ethnicity, age of first sex and work experience.Conclusions: Most trekking guides reported sexual relations with foreign women as well as irregular use of condoms. Although sexual health knowledge about among trekking guides is high, some misconceptions still result in unsafe sex. Hence there is an urgent need to revise the existing training for trekking guides and implement appropriate health promotion programmes.Health Renaissance 2014;12(3): 180-189
Presumptive Diagnosis and Treatment of Pulmonary Tuberculosis
Authors: Chaudhary R , Bhandari R
Published: July 2016

Tuberculosis is one of the major public health problems in South-East Asian countries with immense socio-economic impacts. The advantage and disadvantage of starting anti-tubercular therapy in presumptive diagnosis of pulmonary tuberculosis is debatable in a resource constrained settings. Even in the face of high prevalence, important pitfalls warrant consideration.Health Renaissance 2014;12(3): 224-226
Minimally invasive (MIE) vs open surgery for cancer of esophagus and GE junction. Long term results
Authors: Thakur Binay , Yonghui Di , Devkota Mukti , Baral Paribartan , Regmi Yogesh , Malli Rajendra , Tiwari Upsana
Published: July 2016

Introduction: MIE is becoming a preferred approach for cancer of esophagus and GE junction, but its benefits have yet to be confirmed in randomized controlled trials. We performed a retrospective comparison between these two approaches for complications and survival results.Methods: Patients primarily going for surgery or after neoadjuvant chemo/ chemoradiation were reviewed. MIE varied from totally thoracoscopic and laparoscopic to a hybrid approach. Both MIE and Open approaches were a three, two or one incision procedures.Results: MIE and open surgery were done in 128 and 293 patients, respectively. The mean basic parameters (referred as MIE/ Open) – age (59/ 57 years), duration of dysphagia (4/ 4 months), weight loss (8/ 9 kg), postoperative stay (13/ 14 days), hospital mortality (3/ 17), anastomotic leak (17/ 32), hoarseness of voice (8/ 16), number of harvested nodes (21/ 22), and R0 resection (122/ 263) did not differ significantly (p = ns). Mean operative time (265/ 240 mins) and intraoperative blood loss (325/ 436 ml) differed significantly (p < 0.05). Postoperative pneumonia was significantly less in MIE group (p<0.001). Median and 5-year overall survival was 33 months and 21% in MIE group; and 27 months and 20% in open group (p = 0.2)Conclusion: MIE and Open surgery did not differ in major postoperative complications except postoperative pneumonia, which was less in MIE. Both the procedures were similar in achieving R0 resection, median and 5-year overall survival.
Laparoscopic cloasure of Duodenal ulcer perforation
Authors: Pangeni Anang , Shakya Vikal Chandra
Published: July 2016

Introduction and Objective: Duodenal ulcer perforation creates a peritonitis which is sometimes hard to manage, especially with minimally invasive approach. This study is about laparoscopic approach to peritonitis due to duodenal ulcer perforation.Materials and Methods: It was a prospective study in patients presenting with duodenal perforation peritonitis to emergency of Civil Service Hospital from January 2013 to November 2015.Result: There were 6 patients (4 males and 2 females). The mean duration of presentation was 16+2.32 hrs. The mean operative time was 55+17.34 minutes. One patient developed right lower zone pneumonia which resolved on conservative management. There was no conversion.Conclusion: Laparoscopic management of duodenal perforation is a feasible procedure in select young patients who present early and without any without comorbities
Endoscopic resection of the submandibular gland: a new surgical approach
Authors: Karn Sumeet , Pandit Archit
Published: July 2016

Introduction: Submandibular gland excision is traditionally performed by the transcervical approach. To avoid or reduce visible scarring and nerve injury, diverse innovative surgical trials have been reported. Here we report a patient who had an endoscopic submandibular gland resection via a hairline incision.Methods: A 36-year-old woman presented with a right submandibular gland tumor that was found on a routine check-up. The submandibular gland was resected under endoscopic assistance via a posterior hairline incision using an ultrasonic scalpel.Results: The resection was successful, causing no acute complications, such as neural injury, hematoma, or seroma formation. The incision scar healed with an excellent cosmetic result.Conclusions: Endoscopic submandibular gland resection via a hairline incision was feasible and resulted in an excellent surgical and cosmetic outcome.
Effect of cholecystectomy on fasting lipid profile and blood glucose
Authors: Karki OB
Published: July 2016

See PDF for Abstract.
Laparoscopic rectopexy for rectal prolapse
Authors: Shakya Vikal Chandra
Published: July 2016

Introduction: Rectal prolapse surgery has been considered advanced laparoscopic surgery; hence it has mostly been performed by open surgery. However, with advancement, laparoscopic rectopexy can be feasible in patients with rectal prolapse.Materials and Methods: This study was done in patients presenting to Surgery Department of Civil Service Hospital who underwent laparoscopic rectopexy from January 2013 to November 2015Results: There were 8 patients (4 females and 4 males). The mean operative time was 160+49 minutes. The mean postoperative stay was 3+1.21 days. There was no conversion. One child underwent suture rectopexy, whereas adults underwent posterior mesh rectopexy. No patients needed blood transfusion. Postoperatively one patient has constipation, and she needed occasional laxatives.  Conclusion: Laparoscopic rectopexy is a minimally invasive advanced procedure with all the advantages of laparoscopy. With further experience operative time could be reduced.
Role of postoperative antibiotics for prevention of infection after appendectomy in patients with complicated appendicitis
Authors: Poudel R
Published: July 2016

Background: Acute Appendicitis is the most common general surgical emergency. Despite improved asepsis and surgical techniques, postoperative complications are still common. The general assumption is that it is better to treat patients with complicated appendicitis (perforated or gangrenous) with antibiotics, in contrast to patients with simple appendicitis. Aim of this study was to compare outcomes of patients treated with antibiotics after appendectomy in complicated appendicitis with those of patients who were not treated with antibiotics.Methods: This was a retrospective study carried out in Universal College of Medical Sciences, Bhairawha, Nepal. Patients who underwent emergency appendectomy in 2 years period were included in the study. Patients with complicated appendicitis were analyzed on the basis of whether they received postoperative antibiotics or not. Main outcome measured were wound complications and length of hospital stay.Results: During the 2-year study period, a total of 203 patients met inclusion criteria. Complicated appendicitis was identified in 71 patients (34.97%). Postoperative antibiotics were administered to 42 (59.2%). On Univariate and multivariate analyses Postoperative antibiotics were not associated with decrease in wound infection. But it is associated with increase in length of hospital stay (p <0.01, 95% confidence interval 2.68-6.05).Conclusion: Use of Postoperative antibiotics does not decrease the rate of wound infection in patient with complicated appendicitis but result in increase length of hospital stay.
Importance of preoperative health status and intraoperative factors in predicting adverse outcomes in geriatric patients undergoing major gastrointestinal surgery
Authors: Khadka Pralaya
Published: July 2016

Introduction and objective: Perioperative management of elderly (aged 65 or older) surgical patients has become an essential component of surgical and anesthetic practice. Certain preoperative and intraoperative factors may predict adverse outcomes in such patients. The objective was to determine the prevalence and predictors of adverse postoperative outcomes in older surgical patients undergoing major gastrointestinal surgery.Materials and Methods: Prospective study of consecutive elderly patients who underwent major gastrointestinal surgery between August 2015 and November 2015 in Tribhuwan University Teaching Hospital. Patients were followed up to 1 month after surgery. Potential pre- and intra-operative risk factors were measured and evaluated for their association with the occurrence of predefined adverse outcomes. Multivariate logistic regression of predictors of postoperative outcomes were measured. Odds ratios (OR) with 95% confidence interval (CI) and two-sided p-values were reported.Results: One hundred and thirty-three consecutive patients were studied. Overall, 89 (66.9%) of patients developed one or more postoperative adverse outcomes and 6 (4.51%) died during their postoperative period. Of all the adverse outcomes, Respiratory (38.3%) were the leading cause of morbidity, followed by Gastrointestinal (32.3%) and Cardiovascular (28.8%) complications. By multivariate logistic regression analysis, presence of comorbidites (OR 1.8, CI 1.1-2.8), low albumin (OR 2.71, CI 0.1-6.6), tachycardia (OR 3.7, CI 1.2-10.8) and hypotension (OR 8.9, CI 1.1-17) were the significant predictors of postoperative adverse outcomes. The mean hospital stay was 7.4±3.8 days.Conclusion: Low albumin and presence of comorbidities, tachycardia and hypotension are significant predictors of adverse surgical outcomes. Age by itself is not associated with adverse outcomes.
Choledochal cyst: their clinical presentation, diagnosis and treatment in central Nepal: a retrospective study
Authors: Kumar Sujit , Patowary BN , Jalan Aditya
Published: July 2016

Background: Choledochal cyst is a rare congenital malformation involving the cystic dilatation of intrahepatic or extra-hepatic or both bile duct .The estimated incidence is one in 1000 live birth in Asian population with female to male ratio 3:1.Objectives: To study the clinical presentations, diagnostic modalities, treatment and outcome of choledochal cyst in College of Medical Sciences, Bharatpur, NepalMethods: A retrospective review of the records of all the patients who were diagnosed as choledochal cyst and underwent medical or operative intervention in our hospital in the period of January 2013- January 2015.Results: We have analyzed ten cases of choledochal cyst. We found most common age group of presentation of choledochal cyst was 6-10 yr with female preponderance (70%). Most common presenting symptom was pain abdomen (100%) followed by jaundice (50%). However classical triad of abdominal pain, jaundice, and an abdominal mass was not seen in any of the cases. Ultrasonography was found to be 100 % accurate in diagnosis of choledochal cyst. Todani type I cyst was the most common type. Nine out of ten cases underwent complete cyst excision with cholecystectomy and Roux-en-Y hepaticojejunostomy without any major complication. Malignancy was not seen in any patients.Conclusion: Choledochal cyst is a rare disease. Most common age group of presentation is 6-10 yrs. Pain abdomen is the most common clinical presentation. Ultrasonography is usually the first examination and is very sensitive for diagnosis of choledochal cyst. Complete cyst excision, cholecystectomy and internal drainage is the treatment of choice.
Spontaneous Gallbladdre Perforation: A case series
Authors: Kumar Sujit , Negi Sanjay , Patowary BN , Jalan Aditya , Rajbhandari Sulabh
Published: July 2016

Background: Gallbladder is rarely injured as it is embedded in the liver and well protected by ribcage. Gallbladder perforation is a rare complication of acute calculus cholecystitis. Spontaneous gallbladder perforation is even rarer.Case Series: We present our experience of 4 cases of spontaneous gallbladder perforation. The patients were mostly males (3:1) with age ranging from 42-64 years. All the patients presented with abdominal pain, distension, ileus and fever ranging from 2-5 days duration. There was no prior history of biliary colic. Examination revealed abdominal tenderness and ileus. Abdominal radiographs showed multiple air-fluid levels and no pneumoperitoneum. Sonography and CT scan of abdomen revealed pericholecystic fluid, intra-abdominal collection with no evidence of gallstones. Provisional diagnosis was peritonitis in 3 and acute pancreatitis in one case. Image guided abdominal paracentesis yielded bilious fluid. In view of lack of clinical improvement and aspiration of bilious content all the patients were subjected to laparotomy. Gallbladder perforation in fundus region without stones and intra-abdominal bile collection was noted in all the patients. Cholecystectomy with peritoneal lavage and abdominal drainage was performed in all cases. Postoperative course was uneventful except wound infection in 2 cases. Histopathology report revealed features of acute cholecystitis in 2 and acute on chronic cholecystitis in the remaining 2 patients.Conclusion: Diagnosis of spontaneous gallbladder perforation should be suspected in middle aged patients who present with acute abdomen but does not have classical signs of peritonitis and in whom paracentesis has yielded bilious fluid.
Pattern of head injuries in the recent megaearthquakes in Nepal: an audit to prepare for future!
Authors: Vaidhya Renu , Joshi Archana , Lama Karjome , KC Bidur , Shakya Bikram , Thapa Amit
Published: July 2016

Introduction and Objective: Nepal falls in very high risk zone for earthquakes. Recently in April 2015, we witnessed the worst human casualty of this century. We present an audit of the head injuries we received at KMCTH during the Mega-earthquake.Materials and Methods: We did an audit of the activities of the department of neurological surgery at KMCTH, during the megaearthquake to identify the pattern of head injuries and make disaster plan for future.Results: We served more than 150 patients in the emergency who approached with head injuries. Majority were concussion with scalp lacerations and after few hours of observations were discharged. However 34 required surgical intervention with 22 being craniotomies for skull base repair and contusions. Strokes also presented during this period possibly due to emotional stress of the happenings. We suffered a double whammy of internal and external disaster as the staff were also threatened and repeated tremors make it difficult to boost the morale and confidence of the service providers. We drafted a disaster protocol for our department in liaison with the hospital and did table top rehearsals for the same.Conclusion: A change in pattern of neurotrauma was seen during the Mega-earthquake. The health facility suffered both internal and external disaster. Better preparedness and protocol based approach with coordination at national level would help us to prepare for future.
Cost effective use of free to use apps (FAN) in neurosurgery in developing countries: from clinical decision making to educational courses, strengthening the health care delivery
Authors: Thapa Amit , KC Bidur , Shakya Bikram
Published: July 2016

Introduction and Objective: Financial limitations and scarcity of technological knowledge is a major hurdle to good communication platform, data storage and dissemination of medical knowledge in developing countries. Out of necessity we used free to use apps in our practice. We studied the applicability and cost effective aspect of a systematic use of these apps in neurosurgery.Materials and Methods: We designed Free to use apps in neurosurgery (FAN) module in 4 phases at KMCTH over the last 3 years. We used free apps like viber, dropbox, skype and vlc media player on 3G and wifi. Users were trained in ethics and measures to ensure confidentiality and privacy of patient related data. Endpoints studied were feasibility, reliability, cost effectiveness and overall satisfaction of the users.Results: In the FAN module, viber app was used to send pictures of digital imagings (DI) using smartphones within 30 minutes enabling quick decision by the consultants. Dropbox not only helped store images but also helped quick verification of discharge summaries as early as 15 minutes increasing overall efficiency. With Skype, consultants could be contacted even when they were abroad and using FAN they remain updated of their patients. Using skype and vlc, 2 operative live workshops from abroad was transmitted live with good visual and audio reception allowing question answer sessions with the faculties. Users’ satisfaction was more than 90%.Conclusion: FAN module helped in quick reliable decision making, allowing for instantaneous communication and storing data and exchange of knowledge across countries.
Tamsulosin versus Alfuzosin as medical therapy for ureteric stones
Authors: Piya B , Singh SK , Gurung R
Published: July 2016

Objectives: To evaluate and compare the efficacy of tamsulosin and alfuzosin as medical therapy in ureteric stones.Patients and Methods: A total of 87 patients with ureteral stones of size ≤10 mm were randomly divided into 3 groups. Group I patients (n-30) received 0.4 mg of tamsulosin daily, group II patients (n-29) received 10 mg of alfuzosin daily and group III patients (n-28) received no alpha blockers. All patients were given analgesia when needed. Follow up was done in weekly basis for 4 weeks.Results: The mean stone size (5.33±1.58, 5.79±1.84, 5.67±1.64) and age (29.1±6.3, 30.31±7.22, 29.4±7.63) were comparable in each groups. The stone expulsion rate was 83.3%, 79.3% and 50% in group I, II and III respectively. The drugs related side effects reported by patients were mild and transient.Conclusion: The use of tamsulosin and alfuzosin for the medical treatment of ureteric stones proved to be safe and effective and neither did have any significant benefits over the other