bluuebunny/crossref_metadata_2025_split huggingface dataset:
TANGGUNG JAWAB PERLINDUNGAN HUKUM BAGI TENAGA KERJA MENGALAMI KECELAKAAN TIDAK TERDAFTAR BPJS
Authors: Yani Mohd. , Mukhlis Mukhlis , Malahayati Malahayati 
Published: January 2020

Perlindungan bagi tenaga kerja sangat penting, terutama saat menghadapi resiko-resiko yang mungkin terjadi seperti kecelakaan kerja. Untuk melindungi keselamatan tenaga kerja diselenggarakan upaya keselamatan dan kesehatan kerja, upaya tersebut dengan adanya program jaminan sosial yang diselenggarakan BPJS, meski program jaminan sosial telah dirancang sejak tahun 1992, ternyata masih ada pekerja yang tidak terdaftar dalam program BPJS salah satunya terdapat pada Hotel Lido Graha Cunda Lhokseumawe. Tujuan penelitian ini adalah menganalisis bentuk perlindungan yang diberikan terhadap tenaga kerja yang mengalami kecelakaan kerja yang belum terdaftar dalam program BPJS oleh Hotel Lido Graha Cunda Lhokseumawe dan faktor-faktor penghambat pemenuhan kewajiban terhadap tenaga kerja yang mengalami kecelakaan kerja yang belum terdaftar dalam program BPJS oleh Hotel Lido Graha Cunda Lhokseumawe serta upaya apa yang dilakukan oleh Pemerintah pada perusahaan terhadap tenaga kerja yang mengalami kecelakaan kerja yang tidak terdaftar pada BPJS. Hasil dari penelitian ini adalah bentuk perlindungan yang diberikan terhadap tenaga kerja yang mengalami kecelakaan kerja yang belum terdaftar dalam program BPJS yaitu adanya upaya perlindungan preventif dengan menyediakan klinik untuk berobat dan upaya perlindungan represif yaitu dengan memberikan santunan pengobatan bagi pekerja yang mengalami kecelakaan kerja yang belum terdaftar dalam BPJS. Faktor penghambat pemenuhan kewajiban oleh pihak hotel yaitu pekerja yang belum mengurus kembali KTP yang hilang, pekerja daily worker yang hanya dikontrak kerja tiga bulan saja dan belum tentu diperpanjang, pekerja yang tidak mau mendaftar pada program BPJS karena masa kontrak yang singkat, pekerja yang tidak mengetahui tentang BPJS. Upaya apa yang dilakukan oleh Pemerintah pada perusahaan terhadap tenaga kerja yang mengalami kecelakaan kerja yang tidak terdaftar pada BPJS? Upaya apa yang dilakukan oleh Pemerintah pada perusahaan terhadap tenaga kerja yang mengalami kecelakaan kerja yang tidak terdaftar pada BPJS yaitu Mendorong agar Memberikan Perlindungan Bagi Tenaga Kerja Pada Hotel Lido Graha dan Memberikan tanggung jawab pada Hotel Lido Graha bagi tenaga kerja yang mengalami kecelakaan kerja tidak terdaftar dalam BPJS.
Discriminating Lethal Concentrations for Transfluthrin, a Volatile Pyrethroid Compound for Mosquito Control in Thailand
Authors: Sukkanon Chutipong , Bangs Michael J. , Nararak Jirod , Hii Jeffrey , Chareonviriyaphap Theeraphap 
Published: January 2020

ABSTRACT
Pyrethroids are commonly used to control malaria and dengue vectors in Thailand. The lack of specific lethal discriminating concentrations (DCs) for specific mosquito species has possibly compromised more accurate assessments of physiological susceptibility to various chemicals over time. Previous studies have established DCs of various residual pyrethroids against specific mosquitoes in Thailand. However, DCs for transfluthrin (TFT), a highly volatile pyrethroid compound, against mosquito vectors in Thailand has been lacking. The aim of this study was to determine the DCs and susceptibility baselines of TFT against pyrethroid-susceptible laboratory strains of Aedes aegypti, Anopheles minimus, and An. dirus using the World Health Organization adult susceptibility tube method. Final DCs of TFT of each species were determined based on doubling the 99% lethal concentration at the following percentages: Ae. aegypti (0.06824%), An. minimus (0.06382%), and An. dirus (0.01508%). Subsequently, the respective TFT DCs were used to test field-collected populations of Ae. aegypti, An. harrisoni (Minimus Complex species), and An. dirus. Anopheles harrisoni and An. dirus were found completely susceptible (100% mortality), whereas Ae. aegypti from Nonthaburi Province was resistant to TFT. The suitability of the testing system and procedures is discussed. Routine assessment of insecticide susceptibility should include pyrethroids with high-vapor-pressure characteristics for informing control programs and consumers of product and chemical effectiveness.
Nymphs of Ixodes ricinus Are More Sensitive to Deet Than Adult Females
Authors: Kulma Martin , Kopecký Oldřich , Bubová Terezie 
Published: January 2020

ABSTRACT
The use of repellents is a unique measure of personal protection, which can avoid tick attachment and thus reduce the risk of tick-borne infections. In the European Union, the efficacy of the repellents coming onto the market has to be evaluated according to the guidelines published by the European Chemical Agency before registration. The United States Environmental Protection Agency has a similar role. Despite obvious differences in morphology and behavior, both these guidelines allow the use of nymph or adult female ticks for laboratory testing. Here, we provide evidence that sensitivity to diethyltoluamide (deet) (P &lt; 0.0001) of Ixodes ricinus nymphs within the in vitro trial was significantly higher than in adult females. In the experiment, we also observed that feral ticks were less sensitive to repellent than were laboratory-reared ticks (P &lt; 0.01) and that mobility decreased when the trial was repeated (P &lt; 0.05). This study showed that the results of efficacy tests could vary significantly even when the protocol was conducted in accordance with the recommended methods. To refine the results of efficacy tests, we recommend a reevaluation of the guidelines, with emphasis on the developmental stage and origin of ticks.
Management of Acute Abdomen: Acute Appendicitis
Authors: Neupane B. R. , Paudel S. R. , Shrestha A. , Bijukchhe S. `M. , Bhattarai A. , Subedi P. 
Published: January 2020

Background: Traditionally, appendectomy has been the treatment of choice for acute appendicitis but many times diagnosis can be difficult. Clinicians are looking through different ways to come to the correct diagnosis to decrease negative appendectomy. The aim of this study was to determine relation between clinical pattern, laboratory and ultrasonography findings with histopathological report of appendectomy specimen and to evaluate the Alvarado scoring regarding its usefulness in the early diagnosis in our set up.
Methods: Prospective cross-sectional study was carried out in Gandaki Medical College Teaching Hospital and Fewa City Hospital from Jan 1, 2016 to Dec 31, 2018 on consecutively admitted patients with clinical diagnosis of acute appendicitis with study variables as demography, Alvarado score, radiological/laboratory investigations, surgical management, histopathology, and clinical outcome.
Results: Among 1021 patients (48.8% men, 51.2% women), patients with Alvarado score offive and more (967, 88.8%) had abdominal USG and some (134) with score of 5-6 (13.12%) had CT scan. On the basis which 818patients (151 patients with score 5-6 and 667 with score 7 to 10) underwent emergency appendectomy; 705 (86.19%) by open and 113 (13.81%) by laparoscopic technique. Appendicitis was suggestive per-operatively in 76.2% of patients with Alvarado score of 5-6 and 97.4% of patients with the score of 7-10. Histo-pathologically diagnosis was correct in 752 (91.9%), 91.2% in open appendectomy and 96.5% in laparoscopic appendectomy cases. Only two patients had infective complication and no mortality.
Conclusion: Alvarado scoring in patients presenting with acute abdominal pain is reliable predicting tool for acute appendicitis.
A study to Assess the Knowledge Regarding Human Right of Mentally Ill Patient among Community People in Kaski, Pokhara,Nepal
Authors: Koirala D. , Silwal M , Gurung A , Gurung R. , Paudel S. 
Published: January 2020

Introduction: Mental health problems raise many human rights issues. People with mental illness are exposed to human rights violation within and outside the health care context. Because of lack of awareness, people with mental illness and their families do not exercise their rights. Psychiatric patients are most vulnerable groups in community. Incidence of violation of rights of mentally ill patients can be avoided if the community people become aware of them.
Objective: To assess knowledge regarding human rights and myth of mental illness among community people.
Method: A descriptive crosssectional study was conducted among 140 community people of Ritthepani-27, Kaski, Nepal. Non probability convenient sampling technique was adopted to collect the data. Inclusion criteria included head of the family of the selected community who were willing to participate in the study. Data was collected through face to face interview using a structured questionnaire.
Results: In the present study, it was found that 46.40% of the community people had inadequate knowledge regarding human rights of mentally ill patients. There was no significant association between demographic variables and knowledge score of the respondents. The study found that more than half of the respondents (51%) had belief that mental illness is not related to physical health. Likewise 36.4% believed mental illness is caused by supernatural power and evil and 30% believed that marriage can cure mental illness.
Conclusion: Based on findings, it is concluded that the level of knowledge regarding rights of mentally ill patient is inadequate and there is a high prevalence of myths and misconceptions related to mental illness among the adult population. So, there is need to conduct awareness raising activities in the community.
A Study on Incidence and Patterns of Acute Poisoning Cases in an Emergency Department of Western Region of Nepal
Authors: Acharya K. , Kandel I.S. , Gupta S. , Poudel S.D. 
Published: January 2020

Introduction: Poisoning is a common cause of morbidity and mortality in the Nepal. The objective of our study is to evaluate the incidence and pattern of acute poisoning cases admitted to the Gandaki Medical Teaching Hospital.
Methods: This is cross-sectional observational study carried out among acute poisoning cases attending emergency department from January 2015 to December 2017.
Results: A total of 156 poisoning cases were treated of which female patients were 71% and the highest numbers (36.5%) of patients were in the age group 21 to 30 years. Organophosphates poisoning was the commonest poison diagnosed among 28.8%, followed by rodenticide poisoning found among 27.5%. Psychiatric illnesses were present among 94.8% of our patients. The most common diagnosis were Anxiety and depression 46.6% followed by family dispute among 30.4%. Above fifty percent of our patients attended our emergency department within 2 hours our ingestion of poisons.
Conclusion: Female and young people are at greater risk of acute poisoning. Pesticides were the most common agent. The reasons for the poisoning need to be carefully evaluated and proper support and advice must be given in poisoning cases.
Maternal, Fetal and Newborn Outcome with Respect to Anemic Status of Women Admitted in Maternity Ward of BPKIHS
Authors: Upadhyaya S , Pokharel N. , Shrestha M. , Basnet P. 
Published: January 2020

Background: Anemia is a common problem in pregnancy particularly in developing countries. In Nepal, the prevalence of anemia in pregnancy is 48%. It is defined by WHO as hemoglobin level less than 11gm/dL in pregnancy. It leads to a number of threats to mother, fetus and newborn.
Objectives: The objective of the study was to assess the maternal, fetal and newborn outcome with respect to anemic status of women admitted in maternity ward of BPKIHS, Dharan, Nepal.
Methods: A descriptive cross-sectional study was conducted among the 20 to 35 years women admitted in maternity ward of BPKIHS. Total 193 respondents were included in the study by purposive sampling technique. Out of 193 respondents, 78 were anemic and 115 were non-anemic. Maternal, fetal and newborn outcome among all the respondents were assessed by interview and review of records. Pearson Chi-square test was used to find the association between two categorical variables.
Results: Maternal outcomes such as preterm delivery, mode of delivery and fetal and newborn outcomes such as abnormal fetal heart rate, IUGR, LBW, low APGAR scores at 1 minute and at 5 minutes, need for resuscitation and need for admission in ward/nursery/NICU were significantly associated with anemic status of women at p value <0.05. The prevalence of anemia among the pregnant women was 40.5%.
Conclusion: Maternal outcome such as preterm delivery, cesarean section were associated with anemia. Regarding the fetal and newborn outcome; abnormal fetal heart rate, IUGR, low birth weight, APGAR scores below 7, need for resuscitation, need for admission in ward/ nursery/NICU were associated with anemia.
Outcome of tibial diaphyseal fracture fixation with Surgical Implant Generation Network (SIGN) nail
Authors: Acharya Balakrishnan M. , Tamrakar Rojan , Devkota Pramod , Thakur Abhishek K. , Shrestha Suman K. 
Published: January 2020

Introductions: Fractures of diaphyseal region of the tibial bone are amongst the most commonly seen extremity injuries in the developing countries. The surgical implant generation network (SIGN) intramedullary (IM) nail was designed for the treatment of long bone fractures in the developing nations.
Methods: From March 2008 to December 2018, a total of 104 patients with 104 tibial diaphyseal fractures were treated with SIGN IM nail. The follow-up visits were arranged at 6, 12, 24 weeks and one-year post operatively. During follow-up visits, the signs of fracture union clinically as well as radiologically and the presence of complications any were recorded and analyzed.
Results: The mean age of the patients was 32.81 (16 – 65) years, male 74 (71.2%) and female 30 (28.8%). Majority of the patients 70 (67.3%) had fractures after road traffic accidents. The mean time of surgery was 13.58 (1 – 463) days. Six (5.8%) patients had delayed union and no non-union was detected. We had 10 cases (9.6%) of mal-alignment but were on acceptable range.
Conclusions: In the developing country like Nepal, the SIGN nail is an effective surgical implant for the management of the tibial diaphyseal fractures with good result of fracture union and low rates of nonunion, mal-alignment and manageable complications.
Clinico-histopathological analysis of orbito-ocular lesions: a hospital-based study
Authors: Kafle Santosh Upadhyaya , Singh Mrinalini , Kafle Prerna Arjyal , KC Bal Kumar , Yadav Sanjeev Kumar , KC Anadi Khatri 
Published: January 2020

Introductions: Preoperative diagnosis of orbital and ocular lesions is necessary for optimum treatment. The study aims to analyze the histomorphological spectrum of orbito-ocular lesions and to evaluate the need of ancillary techniques for confirmation of diagnosis.
Methods: A cross sectional hospital based study of orbito-ocular surgical biopsy samples obtained in the Department of Pathology, at Birat Medical College Teaching Hospital, Nepal during one-year period was analysed for clinical and histopathological findings. Demographic data, site and tissue type, benign or malignant, recommendations for special stains and immunohistochemistry panel study were analysed.
Results: Out of 185 total samples, male to female ratio of 1.1:1, age ranged from ten month to 82 years, 11-20 year age group had 39 (21.1%) orbito-ocular lesions and cornea-conjunctiva was involved in 104 (56.2%). Clinical diagnosis correlated well with histopathological diagnosis, p<0.001. The non-neoplastic, benign and malignant lesions were 36.7%, 33.5% and 29.7% respectively. Squamous cell carcinoma was seen in 28 (50.9%) of malignant lesions followed by sebaceous carcinoma 7 (12.7%). The special stains and immunohistochemistry panel was recommended in 38 (20.5% and 21 (11.3%) cases respectively.
Conclusions: Findings suggest the clinical and histopathological diagnosis correlated well in diagnosis of a wide spectrum of orbito-ocular lesions.
Efficacy of intravenous Tramadol in prevention of catheter-related bladder discomfort in upper urinary tract surgery
Authors: Manandhar Sujita , Manandhar Kishor 
Published: January 2020

Introductions: Catheter-related bladder discomfort (CRBD) is common in patients with urinary catheterization. Centrally acting intravenous opioid like Tramadol inhibits detrusor activity and incidence of CRBD. Present study aims to analyze efficacy of intravenous (IV) Tramadol in prevention of CRBD in patients undergoing upper urinary tract surgery.
Methods: Adult patients undergoing elective open upper urinary tract surgeries at Bir Hospital, National Academy of Medical Sciences (NAMS), Nepal, over a period of six months, requiring urinary catheterization were randomly divided into Control (C) and Tramadol (T) groups. After general anesthesia, patients in T-group received IV Tramadol 1.0 mg/kg and C-group received normal saline 30 minutes before extubation. In post-operative ward, CRBD was graded as mild, moderate or severe at 0, 1, 2 and 6 hours. Post-operative Ramsay sedation score and nausea vomiting were compared in two groups.
Results: There were total 70 patients, 35 in each of groups-T and C. Incidence of CRBD in T-group was significantly low compared to the C-group at all points of evaluation (p<0.05). Postoperative sedation score, analgesic requirement and nausea vomiting were not significantly different in two groups.
Conclusions: Intravenous Tramadol administered before extubation in upper urinary tract surgery reduces the incidence of CRBD.
Working mother’s awareness and practice regarding feeding of expressed breast milk
Authors: Lama Monika 
Published: January 2020

Introductions: Expressed breast milk (EBM) is a healthy feeding option as compared to formula milk for working mothers. Awareness and practice towards EBM may be helpful towards its promotion.
Methods: A cross sectional study was conducted at Patan Hospital, Patan Academy of Health Sciences, Nepal. Working mothers with breastfeeding child of less than 2 year were interviewed for and practice regarding EBM. A self-constructed open and close ended questionnaire in Nepali was used for data collection to analyze the association of mother’s age, types of family structure and number of children with EBM.
Results: Out of 178 working mothers, 121 (67.9%) had awareness about EBM and 22 had practiced it. Mother’s age, types of family structure and number of children were not statistically significant with level awareness. There was positive correlation between awareness and practice of EBM.
Conclusions: This study demonstrated 2/3rd of working mothers had awareness of EBM and 1/10th practiced EBM feeding, and there was positive correlation of awareness and practice.
Incidence of neonatal hypothermia and its association with low birth weight, preterm delivery, APGAR score and nursing care
Authors: Shrestha Shanta Dangol 
Published: January 2020

Introductions: Neonatal hypothermia increases morbidity and mortality . This study aimed to assess the incidence of neonatal hypothermia and its association with low birth weight, preterm delivery, APGAR score and nursing care practices.
Methods: A cross-sectional analytical study was carried out to assess the neonatal hypothermia in neonates born via vaginal deliveries at Maternity ward of Patan hospital, Patan Academy of Health Sciences (PAHS), Nepal, during Aug–Sept 2018. The study was approved from institutional review committee of PAHS. Axillary temperature was measured 4 times, at ten minutes and at 1,2, 4 hours after delivery by using Micro Life digital thermometer. The SPSS was used to analyse data for association of hypothermia with low birth weight, preterm delivery, APGAR score and nursing care practices. Chi square and fisher exact tests were used and p<0.05 was considered significant.
Results: Out of 153 neonates, neonatal hypothermia was seen in 61 (39.8%), 66 (43.1%), 52 (33.9%) and 41 (26.8%) at 10 minutes and 1, 2 and 4 hours after delivery. There was statistically significant association between APGAR score and hypothermia at 1 hour. There was significant association between nursing care practices after delivery and hypothermia at 4 hours.
Conclusions: In this study, the incidence of neonatal hypothermia was highoccurringin40% at 10 minutes and 25% at four hours after delivery. Low APGAR score was associated with hypothermia.
Situational judgement test: Psychometric analysis of a pilot study for selecting post graduate medical student in residency program
Authors: Shrestha Ashis , Bhandary Shital , Shrestha Shrijana 
Published: January 2020

Introductions: Selection process of post graduate medical students requires combination of knowledge, cognitive abilities and skills. Situational judgement test (SJT) is one on the important tools to measure cognitive abilities and skills. This study aims to measure the internal consistency reliability of SJT tool and item quality for local validation of the non-academic attributes. It also aims to do sub-group analysis of SJT scores based on this tool to provide further evidence for validity.
Methods: This cross-sectional study was conducted at Patan Academy of Health Sciences (PAHS) in May 2017. Two sets of SJTs were developed after iterative discussion and modification to suit the local context. Set A had five options to a given situation, students had to rank these options from most appropriate to least appropriate. Set B had seven options to a given situations, students had to pick three best options. Medical officers and interns who were working at PAHS as medical officers participated in this study.
Results: One hundred and sixteen medical officers participated in the study. Thirty-nine (33.6%) participants were interns who had graduated from PAHS and 77 (66.4%) were medical officers who had graduated from various institute inside and outside the Nepal. The overall Cronbach’s alpha for 35 questions was 0.65, that for set A (19 questions) was 0.56 and that for set B (16 questions) was 0.52. Adding SJT questions improved value of Cronbach’s alpha for SJT test as 40, 50, 60 and 70 questions gave Cronbach’s alpha of 0.68, 0.73, 0.76 and 0.79. Average percentage correct of set A was 76.3% and that of set B was 60.5%. SJT scores were statistically different for medical graduates from Nepal and different universities within Nepal.
Conclusions: Locally developed situational judgement test is found to be reliable instrument for measuring non-academic construct of post-graduate medical entrance examination.
The North Atlantic trade with Iceland, Shetland, Orkney and the Faroes and the policy of the Hanseatic Diet (1369–1535)
Authors: Hammel-Kiesow Rolf 
Published: January 2020

This paper explores the limits of the Hanseatic Diet’s ability to regulate Hanseatic trade with Iceland and the North Atlantic island groups of Shetland, Orkney and the Faroes*. It comes to the conclusion that the Hanseatic Diets prohibited direct commercial links to Shetland, Orkney and the Faroes consistently from 1416, but turned a blind eye to the Iceland trade. The reasons for this inconsistent policy were the necessity of maintaining the Bergen’s monopoly on the stockfish trade (which was also in the interest of the Danish-Norwegian crown), while at the same time keeping the door open for Hanseatic merchants who were not active in the Bergen trade to forge commercial links with Iceland, albeit at their own risk. The representatives of the Hanseatic towns often preferred to leave an issue undecided, in order to keep as many options open as possible. The huge divergence in the interests of merchants and towns forced the Diet to dissemble, pursuing policies out of the public gaze which subverted the resolutions the Diet had passed for public consumption.