bluuebunny/crossref_metadata_2025_split huggingface dataset:
Predictors of Multiple Micronutrient Powder Intake Adherence among Children Aged 6-23 Months in Rasuwa District, Nepal: A Cross-sectional Study
Authors: Timalsina Ashish , Paudel Rajan , Upadhyaya Dipak P , Bhattacharya Sujay , Kuikel Bihari S , Joshi Naresh P , Adhikari Sunil , Aung Aye A 
Published: June 2021

Introduction Breastfeeding would not be sufficient to meet the micronutrient requirement of children after six months and more prone to iron deficiency anemia. Micronutrient powder (MNP) can be mixed with semi-solid food to feed the children aged 6-23 months, contains 12 different micronutrients, one of the appropriate strategies. The study’s objective was to assess adherence to MNP and its predictors among children aged 6-23 months in Rasuwa district of Nepal.
MethodsA cross-sectional study was conducted in the Uttargaya rural and the Kalika rural municipality of Rasuwa district among 200 mothers of children aged 6-23 months who were fed MNP. Proportionate random sampling was used to select eligible mothers for interviews, and a semi-structured questionnaire was employed for data collection. Multivariate logistic regression was used to obtain adjusted odds ratio with 95% C.I.
ResultsSample mean was calculated among 155 mothers who received 60 sachets of MNPs;41.3% had adhered to 60 sachets intake of MNP. The mean age of the mother was 25. 29±5.3 years and the mean age of children was 14. 66±5.2 months. In bivariate analysis, the mother having one child less than five years (COR=0.5, 95% CI: 0.24-1.0) and MNP received from the health facility (COR=1.96, 95% CI: 1.02-3.76) were statically significant. Further, multivariate analysis, a mother who accepted the properties of MNP (AOR=2.52, 95% CI: 1.27-5.00), was associated with high adherence.
ConclusionAcceptability of MNP by the mother is the key to increase adherence to MNP. The distribution of MNP from a health facility, tailored with nutrition education is essential to improve adherence to MNP.
Correlation of Hypoechoic Lesions in Trans-rectal Ultrasound of Prostate with Histopathology in Prostate Cancer
Authors: Chataut Dinesh , Basnet Babin , Lohani Benu , Suwal Sundar , Paudel Sharma , Kayastha Prakash 
Published: June 2021

Introduction Prostate cancer is one of the most common cancer in elderly male. Suspicion of prostate cancer is based on increased Prostate Specific Antigen (PSA) level and abnormal digital rectal examination (DRE) findings. Transrectal ultrasonography (TRUS) can detect and localize hypoechoic lesions in prostate which are considered as suspicious for malignancy. TRUS can also guide for prostate biopsy, which is the gold standard for diagnosis of prostate cancer. The study was aimed to find out TRUS findings in suspected prostate cancer patients and correlate these findings with histopathological findings.
MethodsProspective study was done in 66 males of age >40 years, sent for prostate biopsy in suspicion for prostate cancer (PSA >4 ng/ml, and/or abnormal DRE findings). Prostate was evaluated with TRUS and subsequently underwent TRUS guided six core biopsy of prostate. Total 396 cores of biopsy were taken. Histopathology reports were collected and correlated with the TRUS findings.
ResultsTwenty three patients were positive for prostate cancer and 14 of them showed hypoechoic lesions in TRUS. Total 81 suspicious hypoechoic lesions were seen in prostate of all the patients and among them 42 lesions matched with histopathology report for cancer. Cancerous focus detection rate of TRUS was 51.85%.
ConclusionTRUS is a supplementary tool in diagnosis of prostate cancer, however when used alone it has less sensitivity for detection of prostate cancer.
Comparison of Round Window Anatomy between Pediatric and Adult Population: A Perspective from Cochlear Implantation Surgery
Authors: Pradhananga Rabindra B , Gyawali Bigyan R , Rayamajhi Pabina 
Published: June 2021

Introduction The round window is thought to be an ideal port for inserting electrodes during cochlear implantation. Considering its complex anatomy with an individual variation, this study aims to review the anatomy of round window based on the visibility of round window niche and round window membrane via posterior tympanotomy in pediatric and adult population who underwent cochlear implantation.
MethodsThis was a retrospective observational study conducted at the Department of ENT-HNS, Institute of Medicine, Kathmandu, Nepal. Surgical notes of adult (>15 years) and pediatric cases (<15years) who underwent primary cochlear implantation from January 2015 to January 2018 were assessed for different grading of round window niche and round window membrane visibility via posterior tympanotomy. Cases with revision surgery and with incomplete documentation of intra-operative findings were excluded from the study. Statistical analysis was done using SPSS software version 25. We used Chi-square and Fisher’s exact tests to analyze the statistical association.
ResultsType B round window niche (partially visible) was the most common variant seen in the pediatric group while in adults, both Type B (partially visible) and Type C (fully visible) round window niche were common. Compared to the adults, the pediatric group had good visibility of RWM. However, there was no statistical association between these observations.
ConclusionThe round window has a wide range of anatomical variations with different levels of visibility of RWN and RWM in the different age groups. Although statistically insignificant, RWM visibility seemed to be better in pediatric cases compared to adults.
Comparative Study on Effectiveness and Safety of Atorvastatin with Rosuvastatin in Hyperlipidemic Patients at a Tertiary Care Hospital in Nepal
Authors: Raut Binod , Paudel Nimesh , Shrestha Deepti , Bhosekar Anant 
Published: June 2021

Introduction Hyperlipidemia is one of the most contributing factors to coronary heart diseases. Statins have become standard medicine in clinical practice to reduce total cholesterol, low density lipoprotein and to increase high density lipoprotein cholesterol. This study is conducted to compare the effectiveness and safety of atorvastatin with rosuvastatin in hyperlipidemic patients.
MethodsThis is a prospective observational study involving 150 patients conducted in the Department of Internal Medicine of Kathmandu Medical College and Teaching Hospital from July 2019 to March 2020. Patients newly diagnosed with hyperlipidemia were enrolled. Patients that were prescribed with 10 mg of atorvastatin and 5 mg of rosuvastatin by the treating physician once daily for 6 weeks were divided into two groups. Data was recorded in the customized proforma and the SPSS package version 20 was used for analysis.
ResultsPatients that were prescribed with atorvastatin were put in group I and those prescribed with rosuvastatin were included in group II with 75 participants in each group. The mean age of the patients were 50.56± 10.08 years in group I and 52.45±10.20 years in group II with male to female ratio of 3:1. The mean BMI of group I was 25.36±1.74 and that of group II was 26.48±2.21 before therapy. There was a significant main effect of duration (F1,74=401.02, p<0.001) on the TG and TC levels (F1,74=1134.23, p<0.001) as well as (F1,74=614.99, p<0.001) on the LDL and HDL levels (F1,74=146.38, p<0.001).
ConclusionRosuvastatin was significantly more effective than atorvastatin in reducing levels of TG, TC and LDL-C. Rosuvastatin also significantly increased the level of HDL.
Prevalence of Stunting among 6-59 Months Children and its Association with Water, Sanitation and Hygiene Practice in Urban Slums of Kathmandu, Nepal
Authors: Singh Sarswoti , Dhital Nil P , Paudel Rajan , Sah Dipak K , Hamal Arjun , Shrestha Junu 
Published: June 2021

Introduction Childhood malnutrition is a critical public health concern in Nepal. Slums are supposed to have poor water, sanitation and hygiene practices. This study has aimed to examine association between water, sanitation and hygiene (WASH) variables and stunting among 6 to 59 months children of slums of Kathmandu metropolitan city.
MethodsDescriptive cross-sectional study design was employed where 335 households were included in the study. Data were collected using standard questionnaire and observation checklist. Weight and height of children were taken using seca digital weighing scale and wooden height board of UNICEF respectively. Anthropometric analysis was done using WHO Anthro version 3.2.2 software and other statistical analysis was conducted using SPSSversion 22 software.
ResultsThe prevalence of stunting was 23%. Four out of five household (80%) in slum used to drink water from unimproved source. Absence of handwashing station (AOR=2.109, 95% CI:1.05-3.27) and absence of water storage covering (AOR=2.46, 95% CI: 1.16–5.23) were found to be significantly contributing to stunting status.
ConclusionThis study highlights the importance of good WASH practices, and the potential of WASH interventions, to contribute for the improved childhood stunting living in urban slums in Nepal. Also, the findings recommend the need of strategies on purification of water, improvement of toilets, behaviour change and awareness related activities to improve the stunting among children.
Patterns and Causality Assessment of Adverse Drug Reactions in Inpatients of a Tertiary Care Hospital, Nepal
Authors: Mudvari Anish , Yadav Dipendra , Ghimire Rakesh , Prasad Pravin 
Published: June 2021

Introduction Adverse drug reaction (ADR) is a leading cause of morbidity and mortality around the world. Causality assessment is done to establish relation of drug exposure with undesired clinical events. This study conducted in tertiary care hospital was undertaken to evaluate the patterns of ADR and causality assessment using Naranjo causality algorithm.
MethodsData on suspected ADR cases were collected retrospectively from Medicine and Dermatology wards of Tribhuvan University Teaching Hospital, Kathmandu from April 2018 to April 2019. Naranjo causality assessment was performed. Statistical analysis was done using SPSS version 18.
ResultsOf 34 suspected ADR, occurrence of ADR was more in females (18) as compared to males (16). Skin and integumentary system was the most common organ affected (35.29%). Pyrazinamide induced hepatitis was found to be the most common suspected ADR. Causality assessment was performed and ADRs were categorized as possible 17 (50%), probable 16 (47.06%) and definite 1 (2.94%).
ConclusionThe patients are commonly admitted at the hospital due to suspected ADRs. Pyrazinamide induced hepatitis was the most common suspected ADR.
Risk Score for Prediction of Severe Postoperative Complications After Pancreaticoduodenectomy
Authors: Shah Surendra , Bhandari Ramesh S , Vaidya Pradeep , Singh Yogendra P , Joshi Lakhey Paleswan 
Published: June 2021

Introduction Morbidity after pancreaticoduodenectomy (PD) still remains high. Postoperative pancreatic fistula (POPF) is the most common cause of increased morbidity after PD. Assessment of predictability of risk score for severe postoperative complications was the objective of this study.
MethodsThis was a retrospective observational study. Patients undergoing pancreaticoduodenectomy at Tribhuvan University Teaching Hospital (TUTH) between January 2017 to December 2017 were included in the study. Variables were recorded from case sheets of the patients. The “Risk Score” was calculated using the pancreatic duct diameter and body mass index (BMI). Association of risk score and severe postoperative complications were analyzed.
ResultsA total number of patients were 43, including 23 (53.5%) males and 20 (46.5%) females. The mean age was 57.09 ± 11.85 years ranges from 29 years to 76 years. The POPF and delayed gastric emptying (DGE) was 23.3% (10/43); and post-pancreaticoduodenectomy hemorrhage (PPH) was 11.6% (5/43). Severe postoperative complications were present in 13.9% (6/43) patients. In univariate analysis, pancreatic duct diameter (p=0.045) and Risk Score (p=0.02) were significantly associated with severe postoperative complications after PD. However none of them were significant in multivariate analysis.
ConclusionRisk score failed to predict severe postoperative complication after pancreaticoduodenectomy.
A Tale of β-Lactamases and Multidrug Resistance in Pseudomonas aeruginosa Isolated from Inpatients in a University Hospital
Authors: Yadav Santosh K , Sharma Sangita , Mishra Shyam K , Sherchand Jeevan B 
Published: June 2021

Introduction In this era of modern medicine, antimicrobial resistance can be regarded as a major health calamity. The emergence of multidrug-resistant (MDR) Pseudomonas aeruginosa strains poses therapeutic challenges and lead to treatment failure in hospitalized patients. This study was conducted to determine various types of β-lactamases among MDR P. aeruginosa isolates recovered from hospitalized patients.
MethodsThis study was conducted at Tribhuvan University Teaching Hospital, Maharajgunj, Nepal. The clinical samples collected from inpatients were processed for detection of P. aeruginosa isolates and antibiotic susceptibility profile was determined. The MDR strains were identified and ceftazidime-resistant isolates were subjected for detection of extended-spectrum-β-lactamase (ESBL), metallo-β-lactamase (MBL), and Klebsiella pneumoniae carbapenemase (KPC).
ResultsA total of 161 P. aeruginosa isolates were recovered during the study period encompassing 73.3% (n=118) MDR isolates. The MDR isolates included 50.0% (n=59) from lower respiratory tract infections; and 39.8% (n=47) were from the intensive care unit patients. The MDR isolates showed a high resistance profile towards piperacillin, cephalosporins, and fluoroquinolones (>85%). Resistance to carbapenems and aminoglycosides were up to 80% and 60% respectively. Extended spectrum-β-lactamase, MBL, and KPC mediated resistance were seen in 34.7%, 43.6%, and 14.4% MDR isolates, respectively.
ConclusionMultidrug resistance as well as resistance mediated by β-lactamases production were high among P. aeruginosa isolates. Therefore, early detection of antimicrobial resistance and rational use of antibiotics play a critical role to fight against this MDR pathogen.
Correlation of Status of Mastoid with Outcomes of Myringoplasty with Cortical Mastoidectomy in Mucosal Otitis Media with High Risk Perforation
Authors: Shrestha Asmita , Bhattarai Hari , Rayamajhi Pabina , Pradhananga Rabindra B 
Published: June 2021

Introduction Chronic mucosal otitis media is one of the common disease prevalent in our society. This study was done to correlate the status of mastoid with outcomes of myringoplasty with cortical mastoidectomy in mucosal otitis media with high risk perforation.
MethodsThis prospective, observational study was done at Department of Otorhinolaryngology and Head and Neck Surgery, Tribhuvan University Teaching Hospital. Thirty-four patients of ag|e 15 and above with chronic mucosal otitis media having high-risk perforation undergoing cortical mastoidectomy with myringoplasty were included. The status of middle ear, aditus, and mastoid air cells were assessed. Post-operatively, patients were assessed for graft uptake and hearing after three months. The post-operative graft uptake and hearing results were correlated with the peroperative status. Four patients who had preoperative sensorineural hearing loss were studied in terms of graft uptake only.
ResultsThe graft success rate in patients with normal mastoid air cells was 90% whereas in diseased cases was 71.4% which was statistically not significant with p value 0.20. The success rate in terms of hearing was 68.8% in normal mastoid whereas it was 64.3% in diseased mastoid which was statistically not significant with p-value of 1.
ConclusionIn correlation with the status of mastoid air cells with graft uptake and hearing result, the observed differences were not statistically significant. However, averages of post-operative air conduction threshold and air-bone gap of all cases were better as compared to preoperative levels.
पाठकको दृष्टिकोणमा पगेनीको प्रणयवेदका ऋचाहरूः पाठकीय प्रवृत्तिको अध्ययन [Pageni’s Hymns of Pranaya Veda from the Reader’s Perspective: A Study of Affective Stylistics]
Authors: [Bodha Raj Dhakal] बोधराज ढकाल 
Published: June 2021

प्रस्तुत अनुसन्धानात्मक लेखमा प्रकट पगेनी ‘शिव’ को प्रणयवेदका ऋचाहरू गजलसङ्ग्रहमा प्रस्तुत पाठकीय प्रवृत्तिको विश्लेषण गरिएको छ । गजलका प्रवृत्तिहरूलाई पाठकीय सिद्धान्तमा ढालेर गरिने विश्लेषणलाई पाठकीय प्रवृत्ति भनिन्छ । यहाँ लेखकीय अभिमत वा लेखकसँग कुनै सरोकार नराखी निर्वैयक्तिक रूपमा पाठकीय प्रवृत्तिका आधारमा कृतिको विश्लेषण गरिएको छ । प्रणयवेदका ऋचाहरू गजलसङ्ग्रहलाई प्राथमिक स्रोत सामग्री र गजल सिद्धान्तसँग सम्बन्धित ग्रन्थहरू, समालोचनात्मक कृतिहरू, समीक्षात्मक लेखहरू तथा शोध सामग्रीहरूलाई द्वितीय स्रोतका सामग्रीको रूपमा लिइएको छ । यस लेखमा गजलीय सिद्धान्तका मान्यताहरूलाई आधार मान्दै पाठपरक विधिमार्फत विश्लेषण गरिएको छ । पाठकीय परिवृत्तका आधारमा विश्लेषण गर्दा प्रतिनिधिमूलक रूपमा गजलहरूका उदाहणहरू प्रस्तुत गरिएको छ । पाठकीय प्रवृत्तिका संरचनागत, विषयगत, अर्थगत र शैलीगत आधारहरूमध्ये संरचनागत र विषयवस्तुगतका आधारमा विश्लेषण गरिएको छ । संरचनागत प्रवृत्तिका आक्षरिक, शेर, काफिया, रदिफ र तखल्लुसहरूको प्रयोग गजलहरूमा भए पनि अक्षरगत र शेरगत प्रयोगमा एकरूपता भएको देखिँदैन । तखल्लुसको प्रयोग पनि गजलीय सिद्धान्तको मूल मर्मअनुरूप नगरी केवल प्रयोगका लागि मात्र प्रयोग गरेको देखिन्छ । गजलहरूको विषयवस्तुगत पक्षलाई नियाल्दा प्रायः सबै गजलहरूको विषय प्रणयपरक वा श्रृङ्गारिक (संयोग) रहे पनि एउटा गजलको विषय श्रृङ्गारिक कम तर नेपाली संस्कृति पक्ष सबल रहेको देखिन्छ । यसै गरी केही गजलहरू शब्दगत र भावगत रूपमा अति अश्लील रहेका छन् तापनि विषयवस्तुको कोणबाट यिनका गजलहरू मुसलसल शैलीमा प्रस्तुत भएका छन् । [This article analyzes the reading tendency presented in Hymns of Pranaya Veda, a collection of ghazals, authored by Prakat Pageni 'Shiva'. An analysis of the trends in ghazal based on the reader response theory is called reading tendency. Here, the work is analyzed based on the impersonal reading without any relation to the author's opinion. Examples of ghazals are presented representatively when analyzing the work. The ghazal collection itself is considered as the primary source material and the secondary sources include the texts related to ghazal theory, critical works, critical articles and research materials. In this article, the analysis is based on the basic tenets of ghazal and reader response theory. The analysis is based on the structural and thematic angles out of the structural, thematic, semantic and stylistic bases of the reader’s responses. Although there is abundant use of the components of ghazals like structured uses of the alphabets, sher, kafia, radif and takhallus, there does not seem uniformity in the use of sher and the alphabets. The use of takhallus also seems to have been used without following the basic tenets of the ghazal theory. Looking at the thematic aspect of ghazals, the subject matter of almost all ghazals is romantic or erotic (coincidentally) but the content of one ghazal seems to be less erotic but more Nepali cultural. Similarly, some ghazals in the collection are very vulgar both verbally and emotionally. However, from the point of view of subject matter, the ghazals have been presented in Musalsal.]
Investigation of the Substituting Effect of Se on the Physical Properties and Performances of Cd〖Se〗_x 〖Te〗_(1-x)and Zn〖Se〗_x 〖Te〗_(1-x) Materials for Semiconductor Radiation Detectors
Authors: Radia Malki , Abdelghani Tebboune , ElHouari Galouci , Asmaa Saim , Ahmed Hafid Belbachir 
Published: June 2021

The structural and electronic properties of and semiconductor detectors at various concentrations x = 0, 0.25, 0.5, 0.75 and 1 of Selenium (Se) were determined by using the full potential-linearized augmented plane wave (FP-LAPW) based on the density functional theory (DFT). The compositional dependence of such properties was analysed and discussed. The concentration dependence of lattice parameter and bulk modulus show nonlinearity. All the investigated alloys have a direct bandgap (Γ-Γ) which decreasesnonlinearly with increase in Se concentration. On the other hand, Geant4 simulations have been performed for studying the absolute and full-energy peak detection efﬁciencies and energy resolution at 1.5”×1.5” of these alloys as semiconductor detectors in the 511-1332 keV gamma-ray energy range. Ours findings are in a good agreement with the available theoretical and experimental data. We hope that our results serve as are reference for future theoretical and experimental researches.
STOCHASTIC MODEL OF EVOLUTION OF HOMOTOPY TYPE OF PHASE
Authors: Malkhaz M. 
Published: June 2021

In this paper, we introduced the concepts of full number invariant for homotopy type and entropy of homotopy type of some topological spaces.
Based on this concept discrete random process describing evolution of the homotopy type of phase space of c closed dynamical system there is built.
In this paper we introduced also the entropy of trajectory of evolution of homotopy type of phase space of closed dynamical system, constructed random value on set this trajectories, proved that the mathematical expectation of this random value coincide to sequence of mathematical expectations in the phase spaces of the constructed random process with respect to the corresponding random values.
Concomitant central venous sinus thrombosis and subdural hematoma in acute promyelocytic leukemia: middle meningeal artery embolization enables safe anticoagulation. Illustrative case
Authors: Maini Kushagra , Afzal Feroze , Giurgiutiu Dan-Victor , Rahimi Scott Y. , Shah Manan , Switzer Jeffrey A. , Vale Fernando L. , Garcia Klepper Alfredo 
Published: June 2021

BACKGROUND
Acute promyelocytic leukemia (APL) has long been associated with coagulation disorders. The proposed mechanism is a combination of fibrinolysis, proteolysis, platelet dysfunction, thrombocytopenia, and possibly disseminated intravascular coagulation. Hemorrhagic complications are prominent.

OBSERVATIONS
In this case, a 25-year-old female with newly diagnosed APL developed extensive cerebral venous thrombosis (CVT) and was initiated on a protocol with idarubicin and all-trans retinoic acid. The general recommendation for treating CVT is anticoagulation to stabilize the existing thrombus and prevent propagation. The patient was initiated on a heparin drip, but her clinical course was complicated by subdural hemorrhage (SDH) and epidural hemorrhage in the setting of thrombocytopenia. Anticoagulation was held, and her CVT propagated on follow-up imaging. To restart anticoagulation for CVT with a limited risk of SDH, the authors pursued middle meningeal artery (MMA) embolization. The patient was transitioned to apixaban and discharged to home.

LESSONS
MMA embolization enables safe anticoagulation in patients with concomitant CVT and SDH. The authors report the complex clinical course and effective management of this rare clinical scenario.
Nanotechnology to deliver cannabinoids in dermatology
Authors: Adusumilli Nagasai C. , Hazuka Elizabeth L. , Friedman Adam J. 
Published: June 2021

<img src=” https://s3.amazonaws.com/production.scholastica/article/24597/large/prnano_662021g_fig_1_060721.jpg?1623108176”> Cannabis-derived compounds and therapies targeting the endocannabinoid system (ECS) are demonstrating benefit for clinical conditions beyond current indications. As our understanding of the ECS in the skin continues to develop, cannabinoids are rapidly showing promise for treating cutaneous pathology. However, unstable pharmacokinetics, bioavailability and skin permeability have been significant constraints on their utility in dermatology. As cannabinoids shift from commercial herbal preparations to prescription drugs, nanosized drug delivery strategies can tackle these physiochemical limitations and allow well-designed clinical trials to establish safety and efficacy. This review summarizes the latest evidence for cannabinoids for skin disease, details the challenges of formulating cannabinoids, and highlights how the success of nanomedicine across therapeutic fields can translate to novel nanocannabinoid therapeutics in dermatology.