bluuebunny/crossref_metadata_2025 huggingface dataset:
Differential gene expression of blood-based ABCA9, CNOT8, SESN1, UCP3, MAP2K1 and DDIT4 in Alzheimer’s disease
Authors: Samsudin Ainon Zahariah , Ramasamy Kalavathy , Lim Siong Meng , Chin Ai Vyrn , Tan Maw Pin , Kamaruzzaman Shahrul Bahyah , Ibrahim Baharudin , Abdul Majeed Abu Bakar
Published: December 2023

This study uncovered differential gene expression in blood to distinguish subjects with probable Alzheimer’s disease (AD) from normal elderly participants (non-demented controls, NDC). The participants were recruited via training (Phase 1) and validation cohorts (Phase 2). The changes of gene expression in blood samples from the training cohort (92 AD vs 92 NDC) were assessed using the microarray technology. The Partial Least Square Discrimination Analysis (PLSDA) was then used to develop a disease classiﬁer algorithm (accuracy = 88.3%). Six differentially expressed genes  were validated through RT-qPCR using blood samples from the validation cohort [(25 AD, 25 NDC, 12 mild cognitive impairment (MCI) and 12 vascular dementia (VaD) subjects] . The PLSDA model indicated a good separation between AD and NDC [area under the receiver operating characteristic curve (ROC AUC) = 0.88]. ABCA9, CNOT8, SESN1, UCP3, MAP2K1 and DDIT4 were found to be differentially expressed between the two groups. Validation of the panel of six genes gave an overall accuracy of 82.0% (AUC=0.86). The ABCA9 mRNA level, which was significantly (p < 0.05) lower in the AD group, correctly classified 90.9% of all subjects (AUC=0.94). This group of  genes may be responsible for dysregulation of pathways related to inflammation, mitochondrial dysfunction, oxidative injury, DNA damage, apoptosis and lipid metabolism. The disease classiﬁer algorithm discriminated probable AD from MCI and VaD at specificity of 83.3% and 75.0%, respectively. These findings warrant further validation of potential blood-based biomarkers in larger samples of clinical AD.
Some Things Take Time
Authors: Bozorova Makhzuna , Wimmer Jeffrey
Published: December 2023

Human trafficking (HT) can lead to other types of crime, such as kidnapping, smuggling, and drug trafficking. According to the 2021 Global Estimates, the number of victims is rapidly growing and in 2021 stood at 49.6 million, which is almost ten million more than in 2016. This study, a quantitative content analysis of press articles in Germany, demonstrates the dynamics of coverage during the pandemic and quarantine measures. Methodologically we rely on Entman’s (1993) four-functional classification, including portraits of victims and perpetrators, moral judgments, remedies, and calls to action. In addition, the connection between the political orientation of the newspapers and the coverage of the topic is revealed. The results show, that media construct their own reality: They create a stereotypical victim and focus on certain types of HT. The topic is given a strong political connotation, and the boundaries between HT and human smuggling are blurring.
A Percepção da Competência Interpessoal na Obtenção de Resultados
Authors: FERREIRA DA SILVA, SILVIA LETICIA Silvia Letícia Ferreira da Silva , Junior Jose Aurelio da Silva , Pontes III Pe. Joaquim Fernando , PINHO, A. P. M Ana Paula Moreno Pinho , Pitombeira Suzete Suzana Rocha
Published: December 2023

Este artigo analisa a competência interpessoal como um fator relevante para obtenção de resultados, a partir da visão de líderes e liderados de um setor jurídico de uma empresa em Fortaleza/CE. A pesquisa foi realizada com uma abordagem qualitativa, exploratório-descritiva, por meio de estudo de caso único feito mediante entrevistas semiestruturadas com 4 (quatro) líderes e 4 (quatro) liderados. Os dados foram tratados com a técnica de análise de conteúdo. Os resultados apontam que a competência interpessoal envolve habilidades de comunicação, empatia, respeito, trabalho em equipe, comprometimento, resolução de problemas, entre outras. A competência interpessoal pode contribuir para melhorar as relações entre líderes e liderados, gerar respeito e confiança entre os colaboradores, facilitar a obtenção de resultados e aumentar a credibilidade dos líderes. Contudo, foi observado divergência entre a percepção dos líderes e dos liderados sobre a qualidade do relacionamento interpessoal no setor: sendo para os líderes satisfatório, e para os liderados deficiente. Questões não abordadas na literatura, como comunicação interna e confiança na delegação, revelam fatores que impactam na resolução de problemas. Sugere-se às organizações que buscam alcançar objetivos estratégicos que invistam no desenvolvimento de competências interpessoais para superar essa lacuna, alinhar as expectativas e fortalecer as relações para otimizar os resultados.
ZAKAT PROFESI DAN PPH 21 (PEMBAHASAN KASUS-KASUS)
Authors: Bulutoding Lince
Published: December 2023

Buku ini membahas mengenai pemahaman terkait konsep kepatuhan pajak menurut islam, kasus-kasus perhitungan zakat profesi dan perhitungan Pajak Penghasilan 21 (PPh 21) yang berlaku di Indonesia yang disesuaikan dengan Rencana Pembelajaran Semester (RPS) Prodi Akuntansi UIN Alauddin Makassar. Diharapkan dengan hadirnya buku ini dapat membantu mereka yang berminat dan berkepentingan dengan konsep kepatuhan pajak, perhitungan zakat penghasilan (gaji) dan perhitungan PPh Pasal 21, mulai dari mahasiswa, dosen maupun praktisi bisnis.
KELEA Assisted Restoration of Nature’s Allostasis (KARNA)
Authors: Martin W John
Published: December 2023

Nature comprises various levels of interactive and interdependent elements, which collectively help ensure functional stability, adaptability, and predictability. The interactions between defined groupings of physical elements with various life forms are referred to as ecosystems. Allostasis refers to the adjustments within ecosystems, which maintain their functionality during development and in response to moderate disruptions. However, the intrinsic capacity for making these adjustments and self-recovery is limited to within what are called tipping points. Persisting and even worsening anomalies occur beyond the ecosystems’ tipping points. Attempts at normalizing a disordered ecosystem typically entail efforts to directly modify the levels of the identified aberrant elements. This approach often leads to secondary impairments with continuing suboptimal functioning of the ecosystem. This article describes the alternative paradigm of simply providing additional energy to a disordered ecosystem. The added energy can initiate a progressive sequence of stepwise or allostatic adaptations leading to the restoration of a normal functioning ecosystem. A readily available form of useful energy is termed KELEA, an abbreviation for Kinetic Energy Limiting Electrostatic Attraction. While the primary role of KELEA is presumably to prevent the fusion and annihilation of electrostatically attracted opposing electrical charges, it is also utilized as an energy source for all life forms. Water can become a carrier of KELEA for many of its beneficial life force activities. There are multiple ways of increasing the KELEA levels of water, including the use of soluble and insoluble electrically active components, oscillating, or fluctuating electrical devices, and being placed in the vicinity of previously activated fluids. Water with increased levels of KELEA can, therefore, potentially provide sufficient additional life-force energy to initiate a self-repairing series of allostatic adaptations in a disordered ecosystem. This has been shown with the use water-activating pellets that are comprised of volcanic material, which has been pulverized and heated to a partial melting temperature, before being cooled and pelleted. The product is termed Kiko Technology. A few Kiko pellets used in conjunction with small amounts of biochar have led to the remarkable restoration of the quality of various collections of polluted water, including areas of Spirit Lake, Iowa. The improved water quality is accompanied by the return of a normal range of aquatic, land, and flying animal-wildlife. There has also been a major die-off of zebra mussels, which is a damaging invasive species. It is postulated that the restorative process begins with a resurgence of beneficial microbes that begin to outperform pathogenic microbes. The observed continuing improvements in the treated areas around Spirit Lake and at other locations are occurring in a progressive manner consistent with KELEA assisted restoration of Nature’s allostasis (KARNA).
Artificial Intelligence in Classroom Management: A Systematic Review on Educational Purposes, Technical Implementations, and Ethical Considerations
Authors: Fütterer Tim , Goldberg Patricia , Bühler Babette , Sikimić Vlasta , Trautwein Ulrich , Gerjets Peter , Stürmer Kathleen , Kasneci Enkelejda
Published: December 2023

Rapid artificial intelligence (AI) developments signify that AI is increasingly penetrating the education sector. In this work, we conducted a systematic literature review of the application of AI in classrooms with a focus on classroom management. We examined 104 studies from 2000 to 2022 to understand the educational purposes, technical implementations, and ethical implications of AI in classroom management. Our findings reveal an increasing use of AI technologies, such as Machine Learning and Deep Learning, to monitor and enhance classroom environments. These technologies are primarily used to track attendance, monitor behavior, and assess student engagement, thus streamlining classroom management. We highlight that AI can improve the efficiency of classroom management and provide deep insights into student behavior and engagement. Alongside these opportunities, we also discuss considerable ethical concerns, especially regarding privacy, data security, and the possibility of bias in AI algorithms. Our review emphasizes the need for a balanced approach to technology adoption in educational settings, calling for strict regulations and careful implementation of AI. The study contributes to understanding AI's current state and future directions in classroom management, underlining the need for ongoing examination of its implications and advancements.
City Project
Authors: Pavel Md Eyasin Ul Islam Ul Islam
Published: December 2023

The aim of the project is to carry out research on privacy respecting methods and technologies that use the citizens’ mobile devices as sources of geo-referenced information in the context of a smart-city. The ultimate practical goal is to create the appropriate infrastructure to leverage the conscious and voluntary participation of the citizen as an agent in the maintenance and development of his city. The practical outcomes include the development of an intelligent mobility management system and a multi-functional issue reporting application. The intelligent mobility management system will use crow-sourced and openly available city data together with state of the art and newly developed urban and geospatial computing algorithms to monitor, analyse and create informative visual representations of the usage of the public transportation network and urban spaces. The analysis includes mobility modelling segmented by type of transportation with trend detection and flow predictions, as well as expert recommendations regarding the arrangement of the public transportation infrastructure (e.g. location of stops, routes, etc.). The issue reporting application will be based on successful available applications which will be enhanced and extended with privacy related and other features, like tagging, up-voting, sharing and issue managing. Privacy is a key concern in the whole project, from its conception until the last detail of its implementation. My City will be developed as an extension of MyGeoTrust, a platform for enabling transparent crowd-sourcing applications ensuring the users control over their privacy and data ownership. In addition, part of the project is dedicated to investigate ways in which geo- applications and crowd-sourced data can be used to promote the participation of the citizen as a sensor for the city.
No Free Money Theorem for Machine Learning Application in Stock Market Prediction
Authors: KUMAR CRS
Published: December 2023

The "No Free Lunch" (NFL) theorem in machine learning asserts that there is no universal algorithm or model that excels across all possible problem instances. In the context of machine learning applications for stock market prediction, this theorem implies that no single predictive model can consistently outperform others under all market conditions. The NFL theorem, introduced by David Wolpert in 1996, emphasizes the importance of considering the specific characteristics of the problem domain. In this paper, we extend the NFL Theorem as “No Free Money(NFM) Theorem for Machine learning applications in stock market predictions. The data gathered from Machine Learning competition for stock market prediction are utilized for providing experimental evidence for NFM theorem. For stock market prediction, the NFM theorem underscores the need for tailored approaches, acknowledging that the effectiveness of machine learning models is contingent on factors such as market dynamics, economic conditions, and the quality of historical data. It cautions against assuming a one-size-fits-all solution and highlights the challenge of developing models that generalize well to diverse and evolving market scenarios. The theorem prompts practitioners to approach stock market prediction with a realistic understanding of the limitations inherent in algorithmic approaches, encouraging careful consideration of the data, features, and context relevant to each specific application.
Prevalence and correlates of ICD-11-based Prolonged Grief Disorder in a Representative Slovakian Sample of Recently Bereaved Adults
Authors: Boelen Paul A. , Adamkovic Matus
Published: December 2023

Background. Prolonged Grief Disorder (PGD) has recently been included in both the ICD-11 and DSM-5-TR diagnostic manuals. Studying its prevalence and correlates across cultures is vital for more effective identification, treatment, and prevention. Objective. This study aimed to examine prevalence rates of ICD-11-based PGD, in a representative Slovakian sample in response to deaths of loved ones occurring during the previous year. Further aims were to examine the factor structure of PGD symptoms and correlates of summed PGD items scores and PGD “caseness”.Method. Self-reported data on PGD, depression, anxiety, alcohol use, and descriptive characteristics were gathered from a representative sample of the Slovak population (N = 319).Results. Data were gathered from N = 1853 people; 319 participants (17.2%) reported a loss in the past year. The prevalence of probable PGD among these bereaved participants was 1.99% for recent losses (<6 months, n = 151) and 7.75% for more distant losses (6-12 months, n = 130). The most frequently endorsed symptoms included longing/yearning for the deceased, sadness, denial/unrealness, and difficulty accepting the death. PGD symptoms had a unitary factor structure which was consistent for subsamples bereaved 1-5 and 6-12 months. The severity of PGD varied with kinship. Depression and anxiety, but not alcohol misuse, were associated with PGD severity and PGD caseness. Conclusions. These findings underscore that a significant group of people develop PGD between 6-12 months following a loss. This emphasizes the need for targeted psychological interventions.
The Cultural Lineages Project: Documenting the Evolutionary Relationships Amongst Elements of Human Culture
Authors: Gabora Liane
Published: December 2023

This short paper provides an outline of the Cultural Lineages project, the goal of which is to enable us to see precisely how each person’s actions and creative outputs, however humble or grand, fit into the grand scheme of human cultural evolution. For a given innovation it provides the 'cultural ancestors and 'cultural offspring' of that innovation, and the cognitive processes (e.g., concept combination, metaphor...) required to generate it; in other words, what it contributed above and beyond its predecessors. The project is still in its infancy; it is currently limited to technological innovation based on patent data. Eventually it will use a crowdsourcing approach, inviting people to document their cultural contributions, and see how they fit into the overall tapestry of human civilization.
Characterization, Quality Assessment and Comparison of Selected Rice Landraces (Anadi, Bhotange, and Kalo Nuniya) of Nepal
Authors: Rai Sakul , Khadka Dambar Bd , Pokhrel Bimala
Published: December 2023

This study aimed to characterize, assess and compare the milling-, physical-, cooking-, and eating qualities of brown and milled rice landraces (Kalo Nuniya, Anadi, and Bhotange). Paddysamples (~10 kg each) were cleaned, sun-dried to bring the moisture content to about 13-14%, shelled and then milled to obtain brown (unpolished) rice and milled (white/polished) rice, respectively. Milling-, physical-, cooking-, eating-, and nutritional properties of the rices were studied. The data generated were statistically analyzed using Genstat®version 12.1 for two-way ANOVA, and MS-Excel version 2019 for the Jarque-Bera test of homogeneity, correlation, and to generate graphical presentations. Bhotangehad better brown rice recovery (BRR=76.70%) and milled rice recovery (MRR=58.91%). Anadiand KaloNuniyahad poorer BRR (71.11%) and MRR (49.97%), respectively. Classifying rice samples based on the ‘grain type’, Anadi-, Bhotange-, and KaloNuniya-white were found to be of Medium-, Long-and Medium-'grain type'. Similarly, Anadi-, Bhotange-,and KaloNuniya-brown were found to be of Medium-, Medium-and Small-'grain type', respectively. In terms of size (1000-kernel weight, TKW), Anadi, Bhotangeand KaloNuniya(all white/polished) were found to be 'Small', 'Small' and 'Tiny'. Equilibrium moisture content during soaking (EMC-S) negatively (moderate degree) correlated with apparent amylose content (AAC) for both milled-(R2=0.73) and brown rices (R2=0.70). In white-rices, apparent water uptake ratio (AWUR) showed moderate degree of positive correlation (R2=0.367) with length/breadth (l/b) ratio. But for brown rices, AWUR showed high degree of positive correlation (R2=0.793) with l/b ratio. Volume expansion ratio (VER) positively (moderate degree) correlated (R2=0.63) with AAC for milled rices. This simple correlation established between 2 parameters (assuming other factors to be the same) with few data points cannot be generalized and further investigations are needed to establish solid correlations. Both Bhotangewhite and Bhotangebrown, respectively, had better cooking properties with lower solid loss (both 1.36 ± 0.11%), cooking times (17.67±1.52 and 25.33±2.51 min), higher VER (2.78±0.03 and 2.70±0.04), and l/b ratios after cooking (3.03±0.03 and 2.59±0.03). Anadiwhite had a sticky texture shown by the least VER (2.63 ± 0.13) and the lowest AAC (15.70±1.03%). Classifying rice samples based on the ‘AAC’, Anadi-, Bhotange-,and KaloNuniya-white had Low-, Low-, and Intermediate AAC. Anadi-, Bhotange-, and KaloNuniya-brown had very Low-, Low-, and Low AAC, respectively. Classifying rice samples based on the GT, Anadi-, Bhotange-, and KaloNuniya-white had Low-, Low-, and Intermediate GT. Similarly, Anadi-, Bhotange-, and KaloNuniya-white had Intermediate-, High-, and High-GT, respectively.
Phytochemical Screening and Antimicrobial Activity of Piper betle L. and Nicotiana tabacum L. across Dharan, Nepal
Authors: Chaudhary Nitesh Kumar , Chaudhary Asmita , Shakya Mejabi , Limbu Dil K. , Oli Pramod Sen
Published: December 2023

Piper betle L. and Nicotiana tabacum L., were studied to find their antibacterial properties. Water, ethanol, methanol, acetone, and petroleum ether were used as solvents for plant crude extraction for phytochemical testings. Total phenolic content and total flavonoid content. Staphylococcus aureus (ATCC 25923) and Escherichia coli (ATCC 25922) were used as test organisms to determine the antibacterial activity of the plant extracts using agar well diffusion method.

This study showed a significant antibacterial activity against both bacterial strains with a zone of inhibition ranging from 7.16 to 17.83 mm for Piper betle L. and 7.16 to 12.5 mm for Nicotiana tabacum L. against Staphylococcus aureus (ATCC 25923) and Escherichia coli (ATCC 25922). The study reveals that Nicotiana tabacum L. and Piper betle L. can be a promising source against different pathogenic bacteria if thoroughly explored.
Screening of Antibiotic producing Actinomycetes for Antibiosis from soil of Sunsari, Nepal
Authors: Limbu Dhiren Subba , Majhi Ramesh , Sah ShivNandan , Bantawa Kamana , Rai Bishan
Published: December 2023

Actinomycetes, slow-growing gram-positive bacteria, are useful in the search for bioactive compounds. A total of 24 different actinomycete strains were recovered from farming soil samples collected from the Sunsari district. The isolates were then tested against two gram-positive and three gram-negative bacteria. Results showed that 21% of all isolates are antibacterial at least, one of the test organisms, Staphylococcus aureus, Bacillus subtilis, Escherichia coli, Salmonella Typhi, and Pseudomonas spp. According to antibacterial activity and spectrum broadness, one of the isolates (S11) was selected for secondary screening. The minimum inhibitory concentration (MIC) of crude antibacterial substances extracted from the broth culture of the isolate (S11) was found to be 1.3 mg/ml against test organisms. The chromatogram in TLC showed only one spot with an Rf value of 0.87 by the isolate suggesting that the isolate produced only one compound which was utterly different from the spot with an Rf value of 0.94 paid by gentamycin. According to identification by Microscopy (1000X) and overall biochemical, and physiological characteristics, the isolate was considered Streptomyces antibioticus, a distinct taxonomic group.
Risk Factors Associated with Overweight and Obesity Among Females of Reproductive Age Residing in Damak Municipality
Authors: Pradhan Samiksha , Jaisani Pallavi Vyas
Published: December 2023

The study was intended to assess risk factors associated with overweight and obesity among females residing in Damak municipality. A cross-sectional quantitative study was performed on 202 females of reproductive age (15–49 years) with a structured questionnaire. Measurements like weight, height, and waist and hip circumference were used to determine indicators of overweight and obesity. General obesity was analyzed using the WHO BMI classification, while Waist Circumference (WC) and Waist to Hip Ratio (WHR) analyzed abdominal obesity based on International Diabetes Federation – IDF, and WHO criteria, respectively. Microsoft Office 16 and SPSS Statistics version 20 were used to analyze data. The Chi-square test was used to establish an association between the variables under study.

The study revealed that 31.7% of respondents were overweight, 8.4% were obese, 63.4% were abdominally obese by WC, and 71.8% by WHR. Here, the mean BMI was 25.36±4.56 kg/m2, and the mean WC was 89.69±12.47 cm, with a mean WHR of 0.91±0.09. Age, marital status, family size, parity, sleeping hours, eating pattern, protein intake, and consumption of dairy, eggs, and whole cereals were significantly associated (p<0.05) with overweight and obesity; while age, marital status, education, occupation, family size, parity, and contraceptive use were common factors associated with abdominal obesity (WC and WHR). However, family history, protein intake, and consumption of wheat and eggs were associated (p<0.05) only with WC. The study showed a high prevalence of increased weight among reproductive-aged females in Damak. Thus, being overweight or obese should be viewed as a critical issue. The population should be made aware of the risk factors of obesity.
Health Literacy among Diabetic Patients Visiting the Outpatient Department of a Tertiary Care Hospital: A Cross-Sectional Study
Authors: Yadav Ajay Kumar , Basnet Lila Bahadur , Budhathoki Shyam Sundar , Yadav Ashok , Shrivastav Vijay , Panthi Sagar , Acharya Rochana , Yadav Gopal Kumar , Malla Gyanendra Bahadur
Published: December 2023

Background: Diabetes Mellitus is a metabolic syndrome characterized by hyperglycemia either due to defective insulin secretion or defective insulin action or both. It is estimated to become the 7th leading cause of death by 2030. Health literacy play a significant role in self-care, adherence to medication and clinical outcomes in diseased individual. The objective of this study is to find the prevalence of poor health literacy among the diabetic patients visiting the outpatient department of a tertiary care hospital.
Methods: A descriptive cross-sectional study was conducted among 422 diabetic patients visiting the outpatient department of a tertiary care hospital from July 2020 to Jan 2021. Ethical approval was obtained from the Institutional Review Committee (Reference number: IRC/1805/020). Patients aged ≥18 years, irrespective of gender, diagnosed with Diabetes Mellitus at least 3 months before and presenting to the outpatient department for complications or follow-up were included in the study. Convenience sampling was used.
Result: Among 422 diabetic patients, poor health literacy was obtained among 165 (39.09%) (34.49-43.69 at 95% Confidence Interval). Low adherence to anti-diabetic medication was seen in 78 (47.27%) patients with majority 94 (56.97%) patients having diabetic range HbA1C level and a poor knowledge on diabetes.
Conclusion: There is poor health literacy among diabetic patients that is reflected in low adherence to anti-diabetic medication and overall diabetic self-care. Targeted intervention for health promotion of diabetic patients might be needed.
Anesthetic Management of Carcinoma Breast during Third Trimester of Pregnancy: a Case Report
Authors: Gautam Ashok , Dhakal Yogesh , Khadka Sarada
Published: December 2023

Although malignancy during pregnancy is uncommon, if occurs, it adds challenge to ensure safety of both the mother and fetus. A 36-year lady was diagnosed with carcinoma breast and scheduled for modified radical mastectomy at 29 weeks of gestation. The case was conducted under general anesthesia with intraoperative pectoralis nerve block for postoperative analgesia. Care was taken to avoid hypotension, tachycardia and hypercarbia so that the placental perfusion was not hampered. The trachea was extubated and immediate postoperative obstetrician review revealed no abnormality in the fetal heart rate and activity. Postoperative course was uneventful. Pregnancy was continued till 34 weeks of gestation when elective cesarean section was done under subarachnoid block. A healthy baby was delivered without any adverse consequences. Anesthesia during last trimester of pregnancy can be safely performed, when precautions are taken with involvement of proper teamwork, and the benefit of surgery outweighs the risk of postponing it.
Acute Kidney Injury in Methotrexate treated Leukemia
Authors: Bipesh Kumar Shah  , Seth Rachna , Sinha Aditi , Gupta Aditya Kumar , Meena Jagdish Prasad
Published: December 2023

Background: The study was performed to know the incidence of acute kidney injury within 48 hours following High dose Methotrexate administration in children with high-risk B cell Acute Lymphoblastic Leukemia along with its risk factors and toxicities. Most studies have been conducted in adults and have included non-Hodgkin lymphoma along with leukemia. There is a paucity of data regarding the burden of Acute kidney injury with Methotrexate use in the pediatric age group with B cell Acute Lymphoblastic Leukemia.
Methods: It was a prospective observational study conducted at the pediatric ward of All India Institute of Medical Sciences, New Delhi between 2019 September to 2021 June. Children between 1 to 18 years with high-risk B lineage Acute Lymphoblastic Leukemia planned for high-dose Methotrexate at 3gm/m² were enrolled. The measurement of serum creatinine was done at baseline, 24 and 42 hours while serum methotrexate at 24 and 42 hours, adverse reactions were assessed till day 14 of methotrexate administration.
Results: The incidence of Acute Kidney Injury and severe Acute Kidney Injury (stages 2 and 3) at 42 hours of High dose Methotrexate infusion was 24.3% and 12.8% respectively. Low serum albumin was associated with an increased risk of Acute Kidney Injury (p=0.004). Transaminitis and thrombocytopenia were common toxicities.
Conclusions: Acute Kidney Injury is common following High dose Methotrexate administration in B cell Acute Leukemic Leukemia. Low serum albumin level increases renal toxicity following methotrexate infusion. The measures to prevent renal toxicity should be instituted promptly in high-risk groups.
Clinical Psychopathology During Covid-19 Pandemic
Authors: Thapa Arati
Published: December 2023

The coronavirus disease 2019 (COVID-2019) pandemic and its consequences on individuals’ social, economic, and familial lives have negatively affected mental health of the general population especially in a vulnerable individual. In this case reports, we aim to highlight the role of such psychosocial stressors related to COVID pandemic resulting in development of Acute Psychosis. In the first case the stressor is associated with fear of getting infected while in the second case fear of being put into Quarantine. Thus health measures should be employed to address psychosocial stressors, particularly related to the use of isolation/quarantine, infection fear and vulnerability among the general population.
Skeletal, Dental and Soft Tissue Effects of Twin Block Appliance in Different Facial Divergence Cases
Authors: Jha Kanistika , Adhikari Manoj , Panthee Pratikshya
Published: December 2023

IntroductionClass II malocclusions refer to a discrepancy in the sagittal plane associated with either backward or upward rotation of the jaw. A backwardly positioned mandible is usually managed using a Twin block appliance which contains a bite plane to direct the occlusal forces in a more favorable direction. Our aim was to evaluate skeletal, dental, and soft tissue changes using twin-block appliance therapy in different facial divergence patients.
MethodsA cephalometric study was conducted among two groups with 15 patients in each group. Group 1 have a Frankfort Mandibular plane Angle (FMA) of 18-25 degree while Group 2 have an FMA of 28 to 33 degree with Class II Division I malocclusion. All of them were treated with twin block appliances with modifications done according to FMA. Cephalometric analysis was done using Dolphin software (Dolphin Imaging 11.95) to evaluate skeletal, dental, and soft tissue changes after twin block therapy.
ResultsAnalysis of variance and paired t-test were used to evaluate pre and post-treatment changes in cephalograms. The position of the mandible, maxillomandibular relation, and mandibular length was changed by 3.99 degrees, 5.23 degrees, and 4.04mm respectively in horizontal growers, while by 2.9 degrees, 1.74 degrees, and 1.07mm respectively in vertical growers. An increment in FMA by 4.59 degrees in horizontal growers with good vertical control and a little increment in FMA by 1.07 degrees in vertical growers were seen.
Conclusions The twin block appliance is effective in skeletal, dental, and soft tissue correction in patients with different facial divergences.
Lieno-Adrenal Shunt a Rescue for Porto-Systemic Decompression in 23-Year-Old Female
Authors: Ojha Khagendra , Yadav Prasun , Timilsina Binaya , Mallik Vipul Bhushan , Khatiwada Sagar , Belbase Narayan Prasad
Published: December 2023

Extra hepatic portal vein obstruction is one of the commonest cause of portal hypertension and upper gastrointestinal bleed in the third world. Portal vein cavernous transformation is one of the hallmarks of EHPVO. Despite various lesser invasive interventional approaches for management of EHPVO, surgical shunts still play an important role in long term treatment of patients with EHPVO. Here we present a case of 23 years old female who presented to the OPD with complains of dull aching abdominal pain for a year which was insidious on onset and gradually progressive. The pain was non-radiating, localized to the left upper quadrant of the abdomen which aggravated on lying on the left side. She underwent lieno-adrenal shunt for porto-systemic decompression and management of EHPVO. This case aims to highlight the use of leino-adrenal shunt as a feasible alternative to Linton’s shunt.
Prevalence and Associated Factors of Depression among Perimenopausal Women of Tokha Municipality, Kathmandu
Authors: Piya Sriyansu , Pradhan Bijay Lal , Upadhyay Hari Prasad
Published: December 2023

IntroductionDepression is common among all population but even more in women going through menopause. It is due to hormonal changes during that period paired with certain behavioral as well as biological factors and even certain life events that can have devastating effects on the person. The objective of this research is to find the prevalence and associated factor of perimenopausal depression along with factors associated with it.
MethodsA Cross sectional descriptive study was conducted in Ward no. 10 and 11 of Tokha Municipality among 205 perimenopausal women. Permission was taken from Research department of National Open College also from the ward offices of Tokha Municipality, Kathmandu. The collected data was entered in Microsoft excel and analyzed in SPSS version 22.
ResultsThe prevalence of depression among perimenopausal women was more than one-third (39.2%), 28.7% of respondents having mild depression, 8.3% having moderate depression, 1.1% having moderately severe and 1.1% having severe depression. Depression was found to have significant association with loss of family members or peers and help seeking intention of the respondents.
Conclusions The study identified prevalence of depression among perimenopausal women. Loss of closed ones and help seeking intentions were seen to be associated with depression during perimenopause.
Effectiveness of Structured Teaching Programme on Knowledge Regarding Arterial Blood Gas Analysis among Nursing Students in Chitwan, Nepal A Pre-experimental One Group Pretest Post-test Design
Authors: Ghimire Babita , Acharya Anjana , Upadhyay Hari Prasad
Published: December 2023

Background: Arterial blood gas (ABG) analysis measures blood pH, oxygen (O2), and carbon dioxide (CO2) levels. Normal pH is 7.35-7.45, PaO2 ranges from 70-100 mm Hg, PaCO2 is 35-45 mm Hg, and SaO2 is 93-98%. HCO3 normal value is 22-26 meq/l. This study assesses the effectiveness of a structured teaching program on arterial blood gas analysis knowledge among nursing students. Methods: A pre-experimental study with a one-group pretest-posttest design evaluated the effectiveness of a structured teaching program on Arterial Blood Gas analysis knowledge among nursing students from two Purbanchal University-affiliated colleges. Narayani Samudayik Nursing College was chosen using a probability-based simple random sampling lottery method. Enumerative sampling was employed to select respondents for the study. Results: The study found that 87% of respondents initially had an average knowledge level of arterial blood gas analysis, with 13% having adequate knowledge. After intervention, 82.6% demonstrated adequate knowledge, and 17.4% maintained an average level. Mean knowledge scores significantly increased from 67.15 to 87.7 in pretest and posttest, respectively (p<0.001). The results affirm the intervention's effectiveness in improving participants' understanding of arterial blood gas analysis..Conclusion: Most respondents had average knowledge of ABG analysis. Following the structured teaching program, the majority achieved adequate knowledge, demonstrating its significant positive impact in enhancing nursing students' unde standing of ABG analysis.
Prevalence and Associated Risk Factors of Depression among Elderly People Admitted in a Tertiary Health Care Centre of Nepal
Authors: Dhakal Bijaya , Lamichhane Rama Kumari , Sapkota Kalyan , Thapa Aasha
Published: December 2023

Background: Ageing is associated with various physiological and pathological changes including Mental Health. Mental health is a neglected health problem in Nepal which is underdiagnosed and undertreated, especially among elderly population. However, Depression among elderly people is the most common mental health problem worldwide and in Nepal, Limited research has been conducted. Thus, study aimed to assess the prevalence and associated factors of depression among elderly admitted in tertiary level hospital, Nepal. Methods: Descriptive cross-sectional study design was used where 330 patients aged 60 years and over and admitted in geriatric ward were purposively selected as sample of the study. Data were collected from September 2021 to March 2022 semi structured face to face interview schedule questionnaire to identify sociodemographic characteristics as well as factors associated with depression and Geriatric depression scale item 15 (GDS 15) to measure prevalence of depression. Data were entered in SPSS, analyzed using descriptive and inferential statistics and presented in tables. Results: This study had prevalence of depression 65.8%. Male had higher prevalence rate of depression than female. Prevalence of depression was significantly associated with gender, education status, financial support from family (P-value=0.010, 0.042 and 0.00) at 95% of confidence interval.Conclusion: The prevalence of depression among older adult was found to be high. This emphasizes the need for screening of depression among elderly, to initiate early intervention measures.
Emergence Agitation: Comparison of Paracetamol and Tramadol in Elective Surgery Patients
Authors: Thapa Ajay Singh , Shah Rakesh , Yadav Rajesh Kumar , Shrestha Ram
Published: December 2023

Background: Post-operative emergence agitation is frequent and self-limiting but at times may present with violent behavior and may result in harm to both patients and caregivers. The objective of this research is to find the incidence of emergence agitation and to compare the effects of paracetamol and tramadol on emergence agitation.Methods: A quasi experimental study was conducted in the Department of Anesthesiology, College of Medical Sciences, Bharatpur, Chitwan, Nepal over a period of three months. One hundred fifty ASA I and II patients aged 18 – 45 years old, posted for elective surgery under general anesthesia were included. Patients were assigned into two equal groups of 75 patients (n=75). At the end of the surgery, group A received inj. tramadol 1mg/kg, just when the surgeon starts skin closure and group B received 15 mg/kg Paracetamol. Time taken for extubation, shivering, Richmond agitation sedation scale (RASS) and sedation and Visual analogue scale (VAS) and need of rescue analgesics were recorded. Results: In paracetamol group, reversal to extubation time was 8.75±3.0 minutes which was higher compared to 6.21±1.84 minutes in tramadol group. Prevalence of shivering was higher in paracetamol group. VAS score in paracetamol group was 5.28±1.03 compared to 4.33±0.82 in tramadol group. Frequency of need of rescue analgesia was higher in paracetamol group. In the immediate postoperative period, agitation was more common. Conclusion: Use of tramadol before extubation reduces the incidence of postoperative emergence agitation, immediate postoperative pain and shivering.
Acute Pulmonary Embolism Following Hemorrhagic Stroke
Authors: Gupta Madhu , Prasad Maheshwar , Lal Achutanand , Mishra Jeetendra , Ali Imran , Bhatta Parash , Khadka Salina
Published: December 2023

Background: Venous thromboembolism results from extended immobilization following intracerebral hemorrhage. Massive pulmonary embolism in association with right heart failure is a life-threatening condition and requires treatment with anticoagulants or thrombolytic agents. There are no guidelines for treatment of pulmonary embolism with recent hemorrhagic stroke and these medicines are contraindicated, as they may induce farther hemorrhage.
Cardiac Arrhythmias in Ischemic Stroke Patients Admitted in a Tertiary Medical College of Central Nepal
Authors: Nepal Bikash , Mishra Rajeev , Verma Avatar , Chapagain Prativa , Chapagain Prabin , Dewan Khush Raj , Mishra Ganapati , Rana PVS
Published: December 2023

Background: Cardiac arrhythmias are known etiological agent for ischemic stroke and are also common after acute ischemic stroke. The objective of this research is to study various cardiac arrhythmias and find incidence of atrial fibrillation in acute ischemic stroke.
Methods: This hospital based cross sectional study conducted at COMS - teaching Hospital included 100 patients with diagnosis of acute ischemic stroke from October 2015 to October 2016. Arrhythmias was classified as atrial ectopic beats, atrial fibrillation, premature ventricular complex, sinus bradycardia, sinus tachycardia, sinus arrhythmias, sick sinus syndrome, atrial tachycardia and ventricular tachycardia on basis of ECG monitoring for 24 hours.
Results: Among total 56% (n=56) had abnormal rhythm. Total incidence of atrial fibrillation was 20%. Other arrhythmias observed were sinus tachycardia in 9% (n=9), premature ventricular complex in 8% (n=8), ventricular tachycardia in 5% (n=5), sinus bradycardia in 4% (n=4), sinus arrhythmias in 4% (n=4), atrial ectopic beats in 3% (n=3), sick sinus syndrome in 2% (n=2) and atrial tachycardia in 1%(n=1). Right cerebral hemisphere was more involved than left in both normal and abnormal rhythm (p =0.714). Mortality observed was 4.5% (n=2) in normal rhythm and 8.9% (n=5) in arryhthmias (p=0.461).
Conclusion: Cardiac arrhythmias are frequent in acute ischemic stroke. Atrial fibrillation is most commonly observed arrhythmia in acute ischemic stroke and mortality is higher in patient with rhythm abnormalities than with normal rhythm.
Influence of Antihypertensive Drugs on Left Ventricular Hypertrophy Regression in Hypertensive Patients
Authors: Gautam Mani Prasad , Sedhain Sabina , Gurung Puran , Paudel Sophiya , Kandel Govinda , Khatiwada Prakash
Published: December 2023

Background: Hypertension and its effect on heart in the form of left ventricular hypertrophy are the important predictors of heart failure. Hypertension treatment and left ventricular hypertrophy regression is crucial in the prevention of cardiovascular disease. However, the impact of antihypertensive treatment on left ventricular hypertrophy is less studied and which particular class of antihypertensive medicine is more effective is largely unexplored in our population. We designed this study to explore this issue in subjects taking treatment by evaluation initial and after six months echocardiography findings. Methods: One hundred fifty subjects aged 25-75 years, taking antihypertensive medicine were enrolled in the study. Along with basic demographic and epidemiological data, initial and after 6 months echocardiographic findings were analyzed for the presence of LV hypertrophy regression. Choice of medicine and necessary changes for the achievement of blood pressure targets were done on treating physician’s discretion.Results: Out of 150 subjects, data for 130 subjects were available for final analysis. Mean age was 54.4 years with standard deviation of 12.3 years. Apart from age, smoking, overweight and obesity, dyslipidemia, and diabetes were the important risk factors with a prevalence of 28%, 26%, 22% and 20% respectively. Although the decrease in rates of LV hypertrophy over the duration of 6 months were not significant in overall and in subjects treated with various antihypertensive medicines, the reductions in LV mass index (108.76+/-11.3 to 98.46+/-11.23) in overall and in different antihypertensives were significant (p<0.001). The decrease in LV mass index was statistically significant in subjects taking angiotensin converting enzyme inhibitors or angiotensin receptor blockers when compared to subjects taking calcium channel blockers (p<0.05). This decrease in LV mass index was not significant when compared between CCBs and mixed drugs.Conclusion: There was regression in LV hypertrophy among subjects taking antihypertensive treatment. It was more obvious in subjects taking angiotensin converting enzyme inhibitors/angiotensin receptor blockers when compared with subjects taking calcium channel blockers or both.
Study of Phytosociological Parameters and Carbon Stock between Two Community Forest of Different Ecological Regions of Udaypur District of Nepal
Authors: Ayer Santosh
Published: December 2023

This study compared the regeneration status, vegetation diversity, stand structure, and carbon stock of two community-managed forests located in different ecological regions of Nepal. A total of 61 concentric sample plots were investigated by using systematic random sampling with 1 % sampling intensity. The phytosociological parameters of trees and regeneration density were calculated using standard techniques. The aboveground tree carbon was estimated using a non-destructive method.  Correlation analysis was performed to assess the variation of carbon stock with biomass, stand density, tree diameter at breast height (DBH), tree height, basal area, and seedling density. Janata community forest (CF) had higher regeneration than the Hazare CF, with a bell-shaped distribution of DBH in Janata CF and an interrupted curve in Hazare CF. Both forests were dominated by Shorea robusta. Hazare CF had higher Shannon diversity index, Simpson's index, and evenness index, while Janata CF had higher carbon stock. The observed differences in the studied parameters between the two community forests can be attributed to the difference in ecological factors such as temperature, rainfall, soil nutrient availability, and management practices. Future studies focusing on investigating the underlying factors driving the observed patterns and relationships, such as the effects of disturbance, climate, and management practices on forest structure and function are also needed. These findings have important implications for forest management and conservation policies, especially in the context of climate change mitigation and biodiversity conservation.
Predictors of Institutional Delivery in Nepal: Analyzing Nepal Demographic and Health Survey 2016
Authors: Parajuli Ashya , K.C. Janak , Magar Esther Budha , Chaudhary Ranjana , Gupta Mala , Marahatta Deepak
Published: December 2023

Nepal has made remarkable progress in reducing the MMR and achieving the MMR-related goal of MDG-5A by 2015. Still, a substantial number of women deliver at home. Still, a significant number of women deliver at home. WHO estimated that 15% of women will suffer severe complications during delivery and pregnancy, leading to most maternal deaths. In Nepal, 1 out of 2 neonatal deaths and 2 out of 5 maternal deaths occur at home. Due to this, institutional delivery is considered the key and proven intervention to reduce maternal and neonatal mortality. The study aims to assess the trends in institutional delivery and its associated factors in Nepal. This study used the Nepal Demographic and Health Survey 2016 dataset to analyze a subset of 5060 women aged 15–49 who had given birth within the five years before the survey. The survey employed a three-stage cluster sampling method for the urban region and a two-stage cluster sampling method for the rural region, including the most recent birth in the study. The obtained data were weighted and analyzed using Chi-square, and the variables found to be significant in Chi-square were introduced with bivariate and multivariate logistic regression to identify the predictors. This study found that caste/ethnicity, place of residence, ecological zone, province, wealth quintile, mother’s education, occupation, birth order, ANC visit, and birth preparedness were independently associated with institutional delivery. To achieve the SDG target of 90% by 2030, we must address these factors and increase the institutional delivery rate.