bluuebunny/crossref_metadata_2025_split huggingface dataset:
Adherence to Therapeutic Regimen in Diabetic Patients Attending a Tertiary Level Hospital
Authors: Shrestha Krishna D , KC Takma , Ghimire Rachana 
Published: June 2021

Introduction Adherence to treatment regimen among diabetes patients is very crucial for good glycemic control. Poor adherence is a widely recognized problem causing great impact on poor health outcomes and healthcare costs. Hence, this study was conducted to identify the adherence to prescribed therapeutic regimen among diabetic patients.
MethodsA descriptive cross sectional research design was adopted. Data was collected purposively among 422 respondents attending at medical OPD in Tribhuvan University Teaching Hospital through interview using structured questionnaire. Analysis was done by descriptive and inferential statistics.
ResultsThe study findings revealed good follow up adherence (57.8%). Adherence to medicine, diet and exercise were (28.5%), (16.1%) and (8.8%) respectively. Dietary adherence was associated with sex (p=0.03), educational level (p<0.001), occupation (p=0.04), attending diabetic counseling (p<0.001) and knowledge level (p<0.001). Exercise adherence was associated with sex, educational level, attending diabetic counseling, history of hospitalization and knowledge level (p<0.05). Medication adherence was associated with attending diabetic counseling (p=0.03). Follow up adherence was associated with education, occupation, attending diabetic counseling, duration of diabetes mellitus, frequency of follow up visit, and knowledge level (p<0.05). Moreover, respondents with good adherence to exercise (75.7%), medicine (63.3%) and follow up adherence (66%) had controlled fasting blood sugar level (p=0.01, p=0.03 and p=0.01 respectively).
ConclusionAdherence on diet and exercise was very low than other components among diabetes patients. So, it is recommended to focus on education especially on diet and exercise adherence which would be of great benefit in glycemic control.
Incidence of Contrast Induced Acute Kidney Injury, Its Risk Factors and In-Hospital Outcomes in Patients Undergoing Coronary Angiography and Angioplasty
Authors: Upadhaya Prashun , Thapa Pradeep , Gajurel Ratna M , Sigdel Mahesh R 
Published: June 2021

Introduction Contrast-induced acute kidney injury (CI-AKI) is a serious complication of angiographic procedures with significant morbidity and mortality. We aimed to find the incidence, risk factors and outcomes of CI-AKI in patients who have undergone coronary angiography/angioplasty in a referral hospital in Nepal.
MethodsIt was a descriptive observational study of consenting consecutive patients above 18 years undergoing coronary angiography/angioplasty at Manmohan Cardiothoracic Vascular and Transplant Centre, Nepal from July 2015 to September 2017. CI AKI was defined as an elevation of serum creatinine of >25% or ≥0.5 mg/dl (44 μmol/L) from baseline within 48 hour of exposure to contrast. Statistical analysis was performed using SPSS 18 software. Statistical analysis was completed using Student’s t-test, chi-square test and multivariable logistic regression analysis.
ResultsOut of 240 patients, 156 (65%) were male, mean age was 60.36±11.29 years. Eighteen patients (7.5%) developed CI-AKI. Incidence of CI-AKI was 20% in patients with chronic kidney disease (CKD), 5.4% in diabetics, 13.6% in patients >70 years, 12.79 % in patients with anaemia and 12.3% in patients with prior contrast exposure. Multivariate logistic regression analysis found smoking and history of prior contrast exposure to be independent predictors for development of CI-AKI. Among patients with CI-AKI, one (5.88%) required dialysis and one (5.88%) died.
ConclusionIncidence of CI-AKI after coronary angiography/angioplasty was 7.5%. Patients with prior contrast exposure and smoking were at significantly increased risk of CI-AKI; higher trend of CI-AKI was seen in patients with CKD, diabetes, elderly and anaemia.
Does Drilling Induce Hearing Loss after Modified Radical Mastoidectomy? A Retrospective Study
Authors: Neupane Yogesh , Kharel Bijaya , Dutta Heempali 
Published: June 2021

Introduction Incidence of sensory neural hearing loss following mastoid surgery varies from 1.2 – 4.5%.There are various causes for postoperative sensorineural hearing loss during mastoid surgery. This study aims to identify whether there is any correlation between drilling and postoperative sensory neural hearing loss.
MethodsA retrospective study was conducted in the Department of ENT from January 2018 to June 2019. A total number of 68 patients above five years of age who underwent modified radical mastoidectomy for chronic otitis media squamous were included. Revision surgery, preoperative sensorineural hearing loss, injury to the ossicular chain during surgery, patients with lack of follow up or doubtful reports in mentally challenged were excluded from the study. The average bone conduction threshold was calculated from 500, 1000, 2000, 4000 Hz and compared using the Wilcoxon signed-rank test.
ResultsThere were 43 males and 25 females in the study with a median age of 23.5 years (16-55). The mean preoperative bone conduction threshold in the four frequencies of 500 Hz, 1kHz, 2kHz, 4kHz were -2.06dB, -2.06dB, 3.31dB, 4.63 dB respectively and the mean postoperative bone conduction thresholds were 1.03, 1.32, 5.29, 4.04 respectively. There was a decline of mean of 3.09 dB and 3.38dB only at the low-frequencies (500Hz and 1kHz) BC threshold respectively which were statistically significant, whereas at higher frequency there was no decline in average postoperative BC threshold.
ConclusionThere is no definite role of drill in inducing hearing loss and if present other causes of hearing loss should be sought in postoperative sensorineural hearing loss.
Normative Measurement of Orbital Structures in Computed Tomography
Authors: Rokka Damodar , Poudel Sharma , Kayastha Prakash , Suwal Sundar , Poudyal Sudil , Chhetry Saroj , Shrestha Shantalall , Karn Rakesh 
Published: June 2021

Introduction Normal orbital dimensions are important for diagnosing orbital pathologies. Computed tomography (CT) of the orbit is an important modality offering high accuracy for precise measurements of orbit. The study was disbursed to ascertain criteria for the normative values of the various orbital dimensions using computed tomography in patients visiting Tribhuvan University Teaching Hospital, Kathmandu.
MethodsOrbital volume, ocular diameter, length of the interzygomatic line (IZL), the distance of the posterior extent of the globe from the interzygomatic line, globe position, diameters of extraocular muscles (medial, lateral, superior group, and inferior rectus) and lens density were measured in each eye of 172 patients undergoing CT examination of paranasal sinuses. The correlations with age and sex were also analyzed.
ResultsMean values (mean±SD) of orbital volume, ocular diameter, IZL, globe position and lens density were 24.54±2.57 cm3, 2.44±0.22 cm, 94.3±6.2 mm, 12.3±2.4 mm and 141.43±16.62 HU respectively. Mean diameters of extraocular muscles were 3.67± 0.52 mm, 3.36± 0.50 mm, 3.74±0.42 mm and 3.87±0.38 mm for medial rectus, lateral rectus, inferior rectus and the superior group respectively. There was no significant age and gender difference in most of the measurements. There was significant positive correlation of age with lens density, orbital volume and ocular diameter (p<0.05).
ConclusionNormative data of different orbital measurements were obtained. The present result may help radiologists and ophthalmologists to accurately assess various orbital parameters, particularly in Nepalese populations.
Post-Transplant Erythrocytosis in Live Donor Kidney Transplant Recipients: A Retrospective Single Center Study
Authors: Maharjan Suresh , Chhetri Santosh , Khatri Bikash , Sapkota Nisha , Sigdel Mahesh R 
Published: June 2021

Introduction Post-transplant erythrocytosis (PTE) is defined as persistently elevated hemoglobin>17 g/dl and/or PCV>51% in kidney transplant recipients. The incidence of PTE varies from 5% to 17%, with occasional life‑threatening thromboembolic complications. We aimed to study the prevalence, risk factors and complications of PTE.
MethodsWe conducted a retrospective single center study in 132 kidney transplant recipients who had undergone live donor kidney transplantation at Tribhuvan University Teaching Hospital, Nepal, between October 2017 and March 2019. Prior approval was obtained from Institutional Review Committee of Institute of Medicine. Patients with hemoglobin>17 g/dl were defined as PTE group, and others as non‑PTE group. The pattern of hemoglobin, serum creatinine, pre-transplant hemoglobin, native kidney disease, immunosuppression medications, rejection episodes, and new onset diabetes after transplantation were analyzed and compared between two groups.
ResultsOut of the 132 kidney transplant recipients, PTE was diagnosed in 28 (21.2%) patients, out of which 27 patients (96.4%) were male and 1 (3.6%) were female with the mean time of onset at 7 months after transplantation. Patients with erythrocytosis had a relatively shorter duration of pre transplant dialysis (p=0.001). The mean pre transplant Hb and Hct in PTE group was 9.72g/dl and 30.35% whereas in non PTE group 10.02 g/dl and 31.31%. Thromboembolic and any other PTE related complications were not observed. Seventeen patients of PTE (60.7%) were treated with ACE Inhibitors and 11 (39.9%) patients did not require any treatment.
ConclusionPost-transplant erythrocytosis was seen in nearly one fifth kidney transplant recipients at mean time of seven months post-transplantation; was more common in male with good graft function, and short duration of pre transplant dialysis. Response to ACE inhibitors was good.
Outcome of Extracranial Carotid Pseudoaneurysm Surgery: A Retrospective Study
Authors: Bhandari Nikesh , Shrestha Uttam K , Shrestha Kajan R , Gurung Dinesh 
Published: June 2021

Introduction Extracranial carotid pseudoaneurysm (ECPA) is commonly associated with blunt or penetrating trauma and can result in thromboembolic event, cranial nerves palsies, rupture and hemorrhage. Due to the limited number of large studies, safety and efficacy of surgical and interventional management of ECPA is not well characterized. Open surgery with resection of pseudoaneurysm with end-to-end anastomosis or interposition graft is currently the preferred method of management. The aim of this study is to study the demographics, etiopathogenesis, presentation and outcome after surgical intervention of ECPA at our center.
MethodsAll patients who underwent surgery for carotid pseudoaneurysm form June 2012 to December 2019, at Department of Cardiothoracic and Vascular Surgery were included in this retrospective chart review study after evaluation of the hospital record book and electronic medical record. Patients who had stroke or cranial nerve injury before surgery, were excluded from this study.
ResultsFifteen patients met the inclusion criteria. Male to female ratio was 11:4. Mean age of presentation was 38.17±18.98 years. All patients presented with tender and pulsatile neck swelling. Common carotid artery involvement was more common. Three patients suffered from stroke postoperatively, and all of these patients died, however, one patient with stroke died due to reasons not related to pseudoaneurysm. Two patients suffered cranial nerve injury and ten patients had no other disabling complications.
ConclusionECPA is an uncommon but a serious disease and ischemic stroke after surgery is associated with high mortality.
Assessment Of Third Ventricular Parameters in Computed Tomography of Head: A Pilot Study in Tertiary Level Hospital
Authors: Khanal Umesh P , Sah Keshav , Chand Ram B 
Published: June 2021

Introduction Measurement of ventricles of the brain is important for evaluating changes due to growth, ageing, intrinsic and extrinsic pathologies. The aim of this study was to determine the various parameters of the third ventricle and to assess their association with gender and age using computed tomography (CT) scans of head.
MethodsThis retrospective, quantitative, cross sectional study was performed in the Department of Radiology and Imaging, Tribhuvan University Teaching Hospital from July to October 2019 (4 months) on images of 100 patients (50 males and 50 females) whose age group were 18-87 years, who underwent non-contrast and contrast enhanced CT scan of head.
ResultsThe total mean of width of third ventricle was found to be 0.33±0.09 cm, 0.35±0.10 cm in male and 0.31±0.06 cm in female. Third ventricle width (TVW) showed statistically significant correlation with male and also with Age. Mean of third ventricle sylvian fissure distance index was 0.41±0.67 cm, 0.42±0.65 cm in male and 0.39±0.06 cm in female respectively. Mean of third ventricle ratio was 0.03±0.09 cm, 0.03±0.09 cm in male and 0.02±0.09 in female respectively. The value were slightly higher in male.
ConclusionThe third ventricle width in CT in this study was 0.33±0.09 cm. CT was very useful to determine the upper limits of normal value and its variation with age.
Diurnal Variability of Peak Expiratory Flow Rate in Healthy Adult Employees of a Medical College of Kathmandu
Authors: Khakurel Gita , Gautam Kalyan , Chalise Sanat 
Published: June 2021

Introduction Peak expiratory flow measurement is a simple measure of respiratory capacity to diagnose airflow obstruction and monitor treatment response in patients with pulmonary diseases. But there is wide diurnal variability in its values. The objectives of this study was to determine the diurnal variability of peak expiratory flow rate in healthy adults.
MethodsThis cross-sectional study was done in employees of Kathmandu Medical College, Duwakot between March to August 2020. A total of 74 subjects of 30-45 years were included in the study. After adequate training, subjects were asked to record their own peak expiratory flow five times a day by Mini-Wright peak flow meter. Diurnal variability was expressed as amplitude percent mean and standard deviation percent mean. Data analysis was done by student’s unpaired t-test and one-way ANOVA.
ResultsThe mean peak expiratory flow rate (in L/min) were lowest in morning (male: 478.75±45.91; female: 362.86±20.51) followed by progressive rise throughout the day and highest at evening (male: 531.88 ±43.95; female: 415.71±20.97) with slight fall at bedtime (male: 486.88±46.38; female: 362.86±20.51). The difference in peak expiratory flow rate at different time periods was statistically significant in both males and females (p<0.001). The diurnal variability as calculated by amplitude percent mean and standard deviation percent mean were found to be significantly higher in females (p=0.001 and 0.004 respectively).
ConclusionThere is a variation of peak expiratory flow rate recorded during different time points of the day in healthy adults.
Cloward’s approach for Pancoast neurogenic tumors: illustrative cases
Authors: Kuo Yi-Hsuan , Hsu Po-Kuei , Wu Jau-Ching , Huang Wen-Cheng , Tu Tsung-Hsi 
Published: June 2021

BACKGROUND
Pancoast tumors are a wide range of tumors located in the apex of the lung. Traditional surgery for Pancoast neurogenic tumors frequently involves extensive approaches, whether anterior or posterior or a combination, in which osteotomies are sometimes required. In this study, the authors proposed a less invasive surgical strategy using the standard Cloward’s approach for complete resection of a schwannoma arising from the T1 nerve root.

OBSERVATIONS
Two patients, each harboring a large T1 tumor, one on each side, underwent Cloward’s approach with and without thoracoscopic surgery. Both patients had complete resection of the tumor. Considering the benign and encapsulated nature of neurogenic tumors, Cloward’s approach under neuromonitoring, which is a common procedure for anterior cervical discectomy for most neurosurgeons, is a safe and less invasive alternative for Pancoast neurogenic tumors. For patients whose tumor cannot be removed completely via Cloward’s approach, video-assisted thoracoscopic surgery is a viable backup plan with minimal invasiveness.

LESSONS
Cloward’s approach is a viable option for Pancoast neurogenic tumors.
Posterior occipitocervical instrumented fusion for atlantoaxial instability in a 27-month-old child with Down syndrome: illustrative case
Authors: Ohba Tetsuro , Oda Kotaro , Tanaka Nobuki , Masanori Wako , Endo Tomoka , Haro Hirotaka 
Published: June 2021

BACKGROUND
Upper cervical spine instability is one of the most serious orthopedic problems in patients with Down syndrome. Despite the recent advancement of instrumentation techniques, occipitocervical fusion remains technically challenging in the very young pediatric population with small and fragile osseous elements.

OBSERVATIONS
A 27-month-old boy with Down syndrome was urgently transported to the authors’ hospital because of difficulty in standing and sitting, weakness in the upper limbs, and respiratory distress. Radiographs showed os odontoideum, irreducible atlantoaxial dislocation, and substantial spinal cord compression. Emergency posterior occipitoaxial fixation was performed using O-arm navigation. Improvement in the motor paralysis of the upper left limb was observed from the early postoperative period, but revision surgery was needed 14 days after surgery because of surgical site infection. The patient showed modest but substantial neurological improvement 1 year after the surgery.

LESSONS
There are several clinical implications of the present case. It warns that Down syndrome in the very young pediatric population may lead to rapid progression of spinal cord injury and life crisis. This 27-month-old patient represents the youngest case of atlantoaxial instability in a patient with Down syndrome. O-arm navigation is useful for inserting screws into very thin pedicles.
Z-axis limit switch 3D printer
Authors: Shalenko Vadym , Korniychuk Boris , Masluyk Andriі 
Published: June 2021

Not much time has passed since the appearance of the first 3D printer. Today there are many different printers. They differ in various 3D printing technologies, namely: Stereolithography – SL, Selective Laser Sintering, Fused Deposition Modeling – FDM, Laminated Object Manufacturing – LOM, Polyjet and Ployjet Matrix.
In recent years, the spread of 3D printing technology has become and continues to be used more and more today. Of course, in the future we will see a large-scale spread of additive methods, but the practical application of 3D printing today is available to everyone. Melting deposition modeling technologies have become widespread and available.
The authors in this article consider possible options for upgrading the mounting of the end sensor of the Z Axis and automating the process of calibration of the zero gap of the extruder nozzle relative to the working surface of the printer. This calibration is important. This affects the accuracy and printing process of the future plastic model.
During the operation of the 3D printer, it is often necessary to service the extruder, which forces the process of calibrating the zero gap of the printer nozzle. Optimally correct selected nozzle clearance affects the accuracy, geometry of the model and printing as a whole. It also allows you to get rid of peeling off the model from the desktop surface and the destruction of the model during printing.
Sistem Pendukung Keputusan Pengangkatan Jabatan Pimpinan Tinggi Pratama Dengan Metode Simple Additive Weighting
Authors: Bintang Nina Karina Lolo , Sinaga Bosker 
Published: June 2021

Abstrak— Proses rekrutmen masih memanfatakan prinsip konvensional dalam pengolahan data sehingga memungkinkan terjadinya perubahan angka-angka ataupun nilai masing-masing calon dan tentunya ada pihak yang dirugikan, dalam proses pengolahan data membutuhkan waktu yang lama. Temuan yang lainnya adalah terjadinya penumpukan berkas karena syarat adminsitrasi membutuhkan berkas-berkas dari para calon yang mendaftar. Data diperoleh dari BKD (Badan Kepegawaian Daerah) Kabupaten Karo. Kriteria Berdasarkan Peraturan Daerah Kabupaten Karo yaitu Tes Kompetensi, Uji Gagasan Tertulis, Uji Gagasan Lisan, Rekam Jejak. Dengan bantuan perangkat lunak brainware dapat membangun sistem melalui Bahasa pemrograman. Pada Aplikasi Sistem Pendukung Keputusan ini Perangkat lunak yang digunakan untuk membangun sistem Pendukung Keputusan dengan Menggunakan Metode SAW (Simple Addictive Weighting). Aplikasi yang dikembangkan berbasis web dengan menggunakan PHP dan Mysql. Nilai terbesar ada pada V1 dan V3 sehingga alternatif V1 dan V3 adalah alternatif yang direkomendasikan oleh Sistem dengan nilai yang sama yaitu 1.Kata kunci: rekrutmen, kriteria, perangkingan, SPK, SAW Abstract— The recruitment process still utilizes conventional principles in data processing so as to allow changes in the numbers or values of each candidate and of course there are parties who are disadvantaged, in the data processing process it takes a long time. Another finding is the accumulation of files because the administrative requirements require documents from the registering candidates. Data obtained from BKD (Regional Civil Service Agency) Karo Regency. The criteria based on the Karo Regency Regional Regulation are Competency Test, Written Idea Test, Oral Idea Test, Track Record. Decision Support Using the SAW (Simple Addictive Weighting) Method. The application is developed based on web using PHP and Mysql. The biggest values are in V1 and V3 so that the alternatives V1 and V3 are the alternatives recommended by the system with the same value, namely 1.Keywords:
IDENTIFIKASI FAKTOR-FAKTOR KEPEMIMPINAN TERHADAP KINERJA PEGAWAI di UMKM Jerukkasturifaakenque
Authors: Irawan Risca Yuniadewi , Kurniawan Tjahyono , Supiyati Melly , Fadhlansyah Muhammad , Riyanto Mardi 
Published: June 2021

<div><table cellspacing="0" cellpadding="0" align="left"><tbody><tr><td align="left" valign="top"><p><em>Kepemimpinan adalah Entitas yang mengarahkan kinerja para anggota untuk mencapai tujuan organisasi. Kepemimpinan yang baik diyakini mampu mengikat, mengharmonisasi, serta mendorong potensi sumber daya organisasi agar dapat bersaing secara profesional.</em><em> Untuk mencapai visi dan misi perusahaan maka perilaku pemimpin yang memiliki kinerja baik akan mendorong bawahannya untuk selalu dapat bersikap positif yang pada akhirnya akan memberikan dampak yang baik untuk kemajuan perusahaan terutama UMKM. </em><em>Penelitian ini bertujuan untuk </em><em>mengidentifikasi faktor-faktor kepemimpinan apa saja yang diterapkan di U</em><em>M</em><em>KM Jeruk</em><em> </em><em>kasturifaa</em><em>-</em><em>kenque sehingga bisa bertahan dan omzetnya selalu meningkat walau</em><em>pun</em><em> pada masa pandemi COVID19 seperti saat ini. </em><em>Hasil penelitian menunjukkan bahwa beberapa faktor antara lain prilaku pemimpin sebesar 80%, gaya kepemimpinan (situasional) </em><em>sebesar 75%</em><em>, motivasi</em><em> sebesar 80% berpengaruh positif</em><em> terhadap kinerja karyawan. Maka figur seorang pemimpin yang berkompeten akan menyebabkan kinerja pegawai menjadi baik</em><em></em></p></td></tr></tbody></table></div>