bluuebunny/crossref_metadata_2025_split huggingface dataset:
اقتراب لغة الغزل الأموي من لغة الحياة اليومية واقترابها من اللغة النثرية
Authors: جبارة زينب مديح 
Published: May 2020

خلاصة البحث
يعدّ هذا البحث جزءا من دراسة موسعة عن لغة الغزل في العصر الاموي ، اذ وجدت ان من سمات التطور في لغة الغزل الاموي هو اقترابها من لغة الحياة اليومية ، وجنوحها نحو النثرية ، وهذا ما غيّر لغة الشعر العربي الذي يتميز بالجزالة والسبك والرصانة .والنماذج الشعرية التي تناولها البحث هي لشعراء من البادية والحاضرة على حد سواء ، وقد تجلت فيها لغة الحياة اليومية التي تستعملها النسوة وذلك حينما ينقل الشاعر احاديث صاحباته . كما يلجأ الى استعمال الجمل الاعتراضية الطويلة مما يحول النص الى النثرية ويبتعد عن الشعر .كما لابد من الاشارة الى ان الخطأ النحوي قد تسلل الى لغة الشعراء الامويين وذلك في أمثلة موثقة من شعر عمر بن أبي ربيعة وجميل بثينة. وقد أدى ذلك كله الى اقتراب النص الشعري من لغة الحياة اليومية وجنوحه نحو النثرية
Study of Correlation of Left Atrial Size and Atrial Fibrillation in Rheumatic Mitral Valve Disease
Authors: Shrestha Anil , Shrestha Richa 
Published: May 2020

Aim: To study the correlation between Atrial Fibrillation (AF) and left atrial size in Rheumatic Mitral valve disease (RMVD).
Background: AF is the most common sustained cardiac arrhythmia which is associated with increased cardiovascular morbidity, mortality and preventable stroke. AF is common in rheumatic heart disease (RHD) particularly mitral stenosis (MS). LA dilatation is the predisposing factor for the development of AF in RMVD.
Methodology: This is a hospital based cross sectional descriptive study conducted in 52 patients who were diagnosed as RMVD clinically and echocardiographically in NGMCTH, Kohalpur between December 2018 to November 2019. Detailed history and complete clinical examination were performed. Standard 12 lead ECG and 2-D echocardiography were done. Left atrial size was measured and compared with patients in AF and with sinus rhythm.
Result: The age of patients ranged from 20-76 years with the mean age of 40.33 years. Out of 52 patients 30 were in AF and 23 in sinus rhythm. Among 30 patients in AF, 27 (90%) had LA size ≥ 4 cm with mean LA size of 4.6 cm whereas among 22 patients in sinus rhythm, 14 (63.64%) had LA Size <4 cm with a mean of 3.83 cm.
Conclusion: Left atrial size ≥ 4 cm is the predisposing factor for the development of AF in rheumatic mitral valve disease. Therefore, if patients in sinus rhythm who are at high risk of developing AF are identified, prophylactic anticoagulation and antiarrythmic drug might prevent AF induced embolism and exacerbation of symptoms in rheumatic mitral valve disease.
A Comparative Study of Interscalene Block Vs. Interscalene Block with Superficial Cervical Plexus Block for Clavicular Plating
Authors: Regmi Nabin Kumar , Pokhrel Kapil 
Published: May 2020

Background: Regional anaesthesia for fixation of clavicle fracture is a new concept. Various techniques of regional anaesthesia are being tried to find the optimal type. Combined interscalene and superficial cervical plexus block is widely accepted.
Aim of Study: This study aims to compare the efficacy of interscalene block (ISB) with combined interscalene block and superficial cervical plexus block (ISB+ SCPB) for clavicular plating.
Material and Methods: This prospective, hospital based comparative study was conducted from March 2019 to October 2019, in the department of anaesthesiology, Nepalgunj Medical College. 60 ASA category I and II patients undergoing clavicular plating and belonging to age group 16-65 years were enrolled. Patients were divided into two groups: Group I: ISB (n=30), Group II: ISB+ SCPB (n=30). Blocks were given using landmark technique. Primary outcome measures were conversion to general anesthesia (GA), requirement of supplemental analgesia and patient satisfaction. Secondary outcome measures were sensory and motor block, duration of analgesia and complications. These outcome measures were compared between the groups.
Results: No patient required conversion to GA. The number of patient requiring supplemental analgesia was significantly higher in ISB group in comparison to ISB+ SCPB. Patient satisfaction was excellent in both groups. No statistically significant complications were seen in either group.
Conclusion: Interscalene block combined with Superficial Cervical Plexus Block (ISB + SCPB) has better efficacy than Interscalene block (ISB) alone for clavicular plating. Nevertheless, both techniques avoid GA and provide excellent patient satisfaction level.
Risk Factors in Patients with Intrauterine Fetal Death at Tertiary Referral Centre
Authors: Sinha Kavita , Pandey Subhash 
Published: May 2020

Background: Among various community health indicators available for measurement of quality and impact of health services in developing countries, perinatal mortality accounts one of the top most single indicators even today. Documentation and evaluation of the etiology and the associated risk factors for stillbirth is required in order to decrease the fetal mortality rate and to devise plan in maternal health sector.
Objective: To find out common risk factors in patient and its association with intrauterine fetal death.
Methods: A hospital based cross-sectional study carried out in the Department of OBSGYN, Nepalgunj Medical College, Kohalpur from Jan 2018 to September 2019.Cases of multiple pregnancies, intrapartum death and fetal death diagnosed before 28th weeks of gestation were excluded. After exclusion, 65 cases of intrauterine fetal death were studied.
Results: Majority (78.4%) of the patients with IUFD belonged to the reproductive age group(20-35yrs) and (15.4%) belong to <19yrs (p=0.008) associated with illiteracy (84.6%). More than half (58.5%) had at least one ANC visit and were primigravida (17%) with preterm (63.07%). Hypertensive disorder was the commonest obstetric complication in these mothers (36.92%) followed by unexplained (26.15%), anaemia (18.46%), PROM (15.4%), APH (13.8%). Most of the babies were low birth weight (63.69%) and majority were males (63.1%).
Conclusion: Majority of the risk factors found in the present study were preventable. Stillbirth rate can be reduced by proper management of these risk factors during antenatal care and intrapartum care.
Outcome of Lateral Condyle Fracture of Humerus in Children Treated with Open Reduction and Internal Fixation
Authors: K.C. Dipendra , Mishra S.M. , Yogi Sushil , Shrestha Dinesh , Karki Prateek , Shrestha Sabin 
Published: May 2020

Introduction: Lateral condyle fracture is one of the commonest injuries encountered in pediatric age group. There is no unanimity regarding the method of treatment, however closed reduction is not applicable to all cases and have failure rates making open reduction and internal fixation (ORIF) as the treatment of choice at least in displaced fractures. There are a number of options during surgical management of these fractures; Kirschner-wire (K-wire) is the most commonly used implant for fixation. The purpose of our study was to evaluate the results of lateral condyle fractures of humerus in children treated by ORIF by K-wires based on Hardacre criteria.
Materials: This prospective study was conducted in the department of orthopedics in Nepalgunj Medical College Teaching Hospital, Kohalpur from May 2016 to October 2018. All of the fractures in this study were treated by ORIF with unburied K-wires. It included 37 children of age group upto 14 years. Children were evaluated for age, sex, side of arm involved, mechanism of injury, type of fracture, presence of additional injuries, implant removal time, outcome and accompanying complications. K-wires were removed after clinico-radiological union of the fractures. Patients were evaluated using the Hardacre criteria in follow up till 6 months.
Result: In this study of 37 children, 28 (75.7%) were males and 9 (24.3%) were females. All of them were 14 years of age or less with mean age of 6.7 ± 0.316. Majority of fractures (67.6%) were observed between six to ten years of age. Left side was predominantly involved (62.2%). Milch type I fracture was found in 5 (13.5%) children while Milch type II fracture were observed in 32 (86.5%) children. The final outcome and functions were evaluated using Hardacre criteria in which 27 (73%) cases had excellent result and all cases had good result as per Hardacre criteria. The complications were 10 (27%) cases of lateral spur; eight (21.6%) cases of hypertrophied scar and four (10.8%) cases of pin track infection and 2 (5.4%) of cubitus varus.
Conclusion: The treatment of displaced lateral condyle fracture of humerus by open reduction and unburied K-wire fixation is safe, easy and cost effective procedure with good results. This modality of treatment provides good results among pediatric population without the need for second admission for implant removal.
Assessment of Liver Function Tests in Children with Typhoid Fever: A Hospital Based Study
Authors: Ahmad Shakil 
Published: May 2020

Background: Typhoid fever is among the most endemic diseases in the tropics and which causes significant morbidity and mortality. It can lead to liver damage if not properly treated. Therefore, the liver function test assessment was conducted in children with typhoid fever. Our study aimed to evaluate the liver function test abnormalities in typhoid fever.
Material and methods: This was a prospective observational study conducted at the department of paediatrics, Nepalgunj Medical College and Teaching hospital, Nepalgunj for a period of one year August 2018-July 2019.In the present study total 60 children of Typhoid fever were included on the basis of inclusion and exclusion criteria. On admission a detailed history and complete physical examination was carried out. Routine investigations were also carried out. The diagnosis was confirmed by serum Widal test. Liver function tests were performed i.e. Serum glutamic oxaloacetic transaminase [SGOT] and serum glutamic pyruvic transaminase [SGPT] estimation.
Result: In the present study total children were 60 in which 43.33% were boys and 56.66% were girls. Fever was present in all the cases loss of appetite, cough, vomiting was present in majority of cases. On admission, SGOT and SGPT levels were found > 35 IU/L in 26 cases (43.33%) and 34 cases (56.66%) respectively. On discharge after 7 days of antibiotic, majority of patients had SGOT and SGPT levels < 35 IU/L.
Conclusion: Our study concluded that on admission of children SGOT and SGPT levels were found > 35 IU/L in 43.33% and 56.66% respectively. On discharge after 7 days of antibiotic, majority of patients had SGOT and SGPT levels < 35 IU/L.
Practice of “Defensive Medicine” Among Doctors at a Tertiary Care Hospital
Authors: Bhandari Binus , Khadka Dipendra , Saxena Prem , Mishra S.M. 
Published: May 2020

Introduction: Defensive medicine is the short term coined for a defensive medical decision making.It means advising diagnostic tests, prescribing more drugs than required or avoids treating and operating high risk patients. These may not be the best options for the patient but the practice among doctors is currently adopted to avoid litigation. A situation aggravated by the promulgation of tough consumer laws and other criminal laws applicable to health care providers. This study was conducted to assess the frequency of defensive medicine practice among doctors at the teaching medical college hospital of NGMC.
Methods: A cross sectional study was conducted at Nepalgunj Medical College, Teaching Hospital, Kohalpur, a tertiary care center in between January to December 2018. A questionnaire was developed to assess the various aspects of defensive medicine practice. In this study, a total of 75 doctors participated.
Results: Practice of defensive medicine was common in age between 30-40 years. Fear of caring high risk patients (76%)), ordering un-necessary tests (56%)) followed by avoiding high risk procedures (46%) were common forms of defensive medicine practices observed in sampled doctors. Senior faculties were found practicing more defensive medicine than juniors (69.4% versus 30.6%) and more in surgical field as compared to non-surgical 61% vs. 39%.
Conclusion: Defensive medical practice in various ways is common among the doctors. This has produced a positive impact in the form of greater communications with the patients and awareness to have a good medical record keeping. However, the negative impacts on the doctors have been more in the form of prescribing more investigations, drugs, more referral and reluctance to accept high risk patients if there is choice.
Correlation of Serum Prolactin and Thyroid Hormone in Female Infertility
Authors: Banu Fahat 
Published: May 2020

Background: Infertility is a growing problem with adverse medical, social and psychological consequences globally. Apart from several causes of infertility, hormonal imbalance especially thyroid dysfunction and hyperprolactinemia can lead to female infertility. Both these conditions are treatable so Proper management of hormonal imbalance can result in restoration of normal fertility.
Aims and objectives: Correlation of serum Prolactin and Thyroid hormone in female infertility.
Materials and methods: Descriptive hospital based study was conducted at Nepalgunj medical college and teaching hospital, Nepalgunj, Banke, Nepal. The data was collected from September 2018 to August 2019. Total 30 cases of females of primary and secondary infertility attending outpatient department of gynecology department of Nepalgunj medical college were included in the study. A detailed history and clinical evaluation was done along with estimation of serum Prolactin and Thyroid hormone profile.
Result: Hormonal status of subjects showed 15 i.e. 50% participants were thyroid whereas 11 (36.33%) were hypothyroid and 4 (13.33%) were hyperthyroid. Serum Prolactin was raised in 17 (57%) and normal in 13 (43%). Serum TSH and prolactin were found to be significantly positively correlated in female infertility (r=0.507, p =0.004).
Conclusion: There is a high incidence of hyperprolactinaemia and thyroid dysfunction in female infertility.
Perinatal Outcomes of Hypertensive Pregnancy: A Case Control Study
Authors: Acharya Niraj , Dhungana Diwas , Gupta Veena 
Published: May 2020

Background: Hypertensive disorders of pregnancy (HDP) are one of the maternal diseases that cause the most detrimental effects to the mother and the fetus.
Objective: This study was conducted to compare the perinatal outcomes of neonates delivered by hypertensive mothers and normal mothers.
Methods: This comparative hospital based study was conducted in Nepalgunj Medical College Teaching Hospital, Kohalpur from December 2014 to December 2015. Fifty mothers fulfilling the inclusion criteria and their fetal outcome in form of still birth and newborn babies were taken for the study and 50 healthy mothers with normotensive pregnancies and their newborn babies or fetal outcome were taken as control. They were followed up till their hospital stay in NICU or postnatal ward and final outcomes were noted.
Results: The prevalence of HDP in our hospital was 2.16%. Among neonates, 27(54%) in case group and 9(18%) in control group were low birth weight which is statistically significant. It was found that 18(36%) neonates in case group and 7(14%) neonates in control group were IUGR(Intrauterine growth retardation). Seventeen (34%) neonates in case group were preterm as compared to 2(4%) neonates in control group (p value < 0.001).
Conclusion: Pregnancies complicated by hypertension were characterized by an increase in the rate of preterm delivery and low birth weight infants compared with normal pregnancies.
COVID-19: Cardiovascular perspective
Authors: Acharya Kiran Prasad , Poudel Pratima , Sherpa Kunjang , Adhikari Chandra Mani 
Published: May 2020

Introduction: Recently the outbreak of COVID-19 has created a nuisance in the health care system throughout the world. There are multiple early reports covering the cardiovascular perspective of COVID-19. However, there are limited guidelines/protocols addressing the issue. With the emerging pandemic, data is ever-changing and so is our understanding of the cardiovascular implication of COVID-19.
Shahid Gangalal National Heart Centre-ST-elevation Myocardial infarction Registry (SGNHC-STEMI-Registry), Nepal
Authors: Adhikari Chandra Mani , Acharya Kiran Prasad , Manandhar Reeju , Sherpa Kunjang , Tamrakar Rikesh , Bogati Amrit , Singh Satish Kumar , Kansakar Subodh , Yadav Dharma Nath , Dhungana Murari , Dhungel Sachin , Baniya Bibek , Joshi Surakshya , Rajbhandari Sujeeb , Pandey Rabindra , Raut Roshan , Prajapati Dipanker , KC Sanjay Singh , Adhikari Jagat , Adhikari Ajay , Gautam Binayak , Najmy Shaneez , Poudel Rajan , Timalsina Birat Krishna , Karki Parag , Poudel Samir , Thakur Kartikesh Kumar , Limbu Deepak , Nepal Himanshu Prasad , Sharma Mukunda , Rauniyar Binay Kumar , Rajbhandari Rajib , Limbu Yuba Raj , Maskey Arun , Malla Rabi , Sharma Deewakar , KC Man Bahadur 
Published: May 2020

Background and Aims: Incidence of ST-elevation myocardial infarction (STEMI) is increasing in Nepal. We aim to describe the presentation, management, complications, and outcomes of patients admitted with a diagnosis of STEMI in Shahid Gangalal National Heart Centre (SGNHC), Nepal.
Methods: Shahid Gangalal National Heart Centre-ST-elevation registry (SGNHC-STEMI) registry was a cross sectional, observational, registry. All the patients who were admitted with the diagnosis of STEMI from January 2018 to December 2018 were included.
Results: In this registry, 1460 patients out of 1486 patients who attended emergency were included. The mean age of patients was 60.8±13.4 years (range: 20 years to 98 years) with 70.3% male patients. Most of the patients (83.2%) were referred from other hospitals and 16.8% of patients directly attended the SGNHC emergency. During the presentation, smoking (54%) was the most common risk factor, followed by hypertension (36.6%), diabetes mellitus (25.3%), and dyslipidemia (7.8%). After admission, new cases of dyslipidemia, HTN, Impaired Fasting Glucose (IFG), and Type 2 DM were diagnosed in 682 (51.3%), 182 (20.1%), 148 (10.3%) and 95 (8.9%) respectively. At the time of presentation, 73.3% were in Killip class I and 26.3% were above Killip class II with 5.1% in cardiogenic shock. Thirty-one percent of the cases received reperfusion therapy (Primary percutaneous intervention in 25.2% and fibrinolysis in 5.8%). Inferior wall MI was the most common type of STEMI. Among the patients who underwent invasive therapy, the multi-vessel disease was noted in 46.2% cases and left main coronary artery involvement in 0.7% cases. In-hospital mortality was 6.2% with cardiogenic shock being the most common cause. Aspirin (97.8%), clopidogrel (96.2%), statin (96.4%), ACEI/ARB (76.8%) and beta-blocker (76.8%) were prescribed during discharge.
Conclusion: The SGNHC-STEMI registry provides valuable information on the overall aspect of STEMI in Nepal. In general, the SGNHC-STEMI registry findings are consistent with other international data.
Precipitating factors leading to decompensation of heart failure in patients attending a tertiary care centre of Nepal
Authors: Adhikari Suman , Gajurel Ratna Mani , Poudel Chandra Mani , Shrestha Hemanta , Thapa Sanjeev , Devkota Surya , Yadav Vijay , Sharma Manju 
Published: May 2020

Background and Aims: Heart failure is one of the debilitating conditions in patients with various forms of heart disease. It can have impacts on various aspects of the life of a patient. There have been few studies on the etiological aspects and precipitants of heart failure in the Nepalese population. The aim of our study is to find out the major factors that lead to decompensation of heart failure in patients who already have established heart failure.
Methods: This study was a single-centre, prospective, observational study conducted in the emergency department of Manmohan Cardiothoracic Vascular and Transplant Centre (MCVTC) from 1st June 2019 to 30th November 2019. Hundred and one patients with established heart failure in the past, who presented again with decompensated heart failure were enrolled.
Results: The mean age of the patients was 62.81 years (SD=15.92). Factors responsible for acute decompensation of heart failure were identified in 95.0 % of patients included in the study. The most common factor identified was poor compliance with medications and diet and fluid intake (38.6%). Next to it was arrhythmia identified in about 35.6% of cases.Other important factors responsible for decompensation in our study were infection (12.8%), anemia (4.9%) and ischemia (2.9%).
Conclusion: Preventable and identifiable factors are responsible for the decompensation of heart failure. Most of these factors can be modified with the use of proper patient counseling/patient education, thereby reducing recurrent hospital admissions and economic burden to the patient and the government as well.
Adherence to guideline-directed medical therapy among left ventricular systolic dysfunction patients in Shahid Gangalal National Heart Centre, Kathmandu, Nepal
Authors: Manandhar Reeju , Bogati Amrit , Prajapati Dipanker , Aslam Sheikh , Choudhary Taanya , Mahat Sanjeev , Tamrakar Binita , Neupane Pushpa , Adhikari Chandra Mani 
Published: May 2020

Background and Aims: Heart Failure (HF) with reduced Ejection Fraction (HFrEF) is defined as the clinical diagnosis of HF and left ventricular ejection fraction (LVEF) ≤ 40%, also referred to as systolic HF. Guideline-directed medical therapy (GDMT) has shown to reduce mortality for HFrEF. We aim to evaluate adherence to GDMT treatment in our outpatients.
Methods: It was a cross-sectional observational study. All patients who attended the Department of preventive medicine and cardiac rehabilitation for medical counseling from October 2016 to May 2018 and have already completed 3 months of follow up for HF were included in this study. Performa was designed to collect patient information which included; age, gender, NYHA functional class, LVEF, systolic and diastolic blood pressure, pulse rate, creatinine, potassium and drugs with doses were recorded.
Results: Among the 451 patients, ninety-nine (65.6%) were male and 52 (34.4%) were female. The mean age was 56.2±4.2 years. Most of the patients were in NYHA class II 114 (75.5%) and in Sinus rhythm 119 (79.4%). Mean LVEF was 26.6±6.1%. Dilated Cardiomyopathy was the most common clinical diagnosis in 76 (50.3%). Diuretic, Angiotensin-converting enzyme inhibitor (ACEI)/Angitensin receptor blocker (AB), Aldosterone Antagonist, β-blocker and digoxin were prescribed in 151 (100%), 140 (93.3%), 127 (84.1%), 114 (75.4%) and 46 (30.4%) patients respectively. The mean dose of furosemide, Enalapril, Losartan, carvedilol, bisoprolol and metoprolol succinate was 45.3mg, 4.0mg, 33.2mg, 33.6mg, 18.8mg, 3.0mg, and 27.5mg was respectively.
Conclusion: Our center's adherence to GDMT in HFrEF patients is comparable to international studies. We still need more effort to re-emphasize the importance of GDMT by focusing on the optimization of drug doses during out-patient visits.