bluuebunny/crossref_metadata_2025_split huggingface dataset:
Modified Limberg Flap Cover for Recurrent Sacrococcygeal Pilonidal Sinus: Our Experience at a Medical College In Nepal
Authors: Adhikari Budhi Nath , Bhattarai Abhishek , Devkota Pragya , Khatiwada Sushma 
Published: June 2021

Introduction: Pilonidal sinus is an inflammatory disease seen mostly in the intergluteal region of young males. Although any treatment strategy of this condition is generally free of life-threatening complications due to its superficial nature, it is still a feared disease because of recurrence which greatly increases the morbidity.
Objective: To investigate the results of wide rhomboid excision and modified Limberg transposition flap reconstruction to treat recurrent pilonidal sinus.
Methodology: Well-documented records of all patients with recurrent sacrococcygeal pilonidal sinus who underwent wide excision and a modified Limberg transposition flap at our center during the past 3 years and followed up for longer than 12 months were analyzed. The modification primarily consisted of an asymmetrically rotated rhomboid excision and lateralization of the lower midline. Patient demographics, days of hospitalization, complications, patient satisfaction and recurrence rates were evaluated.
Result: Most patients in the study were overweight. No relationship was detected between BMI and number of sinus openings, hospital stay, drain placement or recurrences but an association with infection was noted. The number of pilonidal sinus orifices did not have a correlation with age, number of previous surgeries, duration of hospital stay or drains placement. The mean duration of hospitalization was 7.89 ± 3.41 days and the mean duration of suction drainage was 6.33±2.87 days. Half of our patients developed complications in the postoperative period. The only patient who developed superficial wound infection stayed the most in the hospital. All patients had some complaints regarding the operation site; however, they were satisfied with the result of the operation and had no recurrence at 12 months of follow-up.
Conclusion: Rhomboid excision of recurrent sacrococcygeal pilonidal sinus with modified Limberg flap closure is a promising surgical technique with advantages of a good patient satisfaction and no recurrence after a year of surgery.
Astigmatic Changes in Sutureless Small Incision Cataract Surgery
Authors: Yadav Roshan Dev , Bajracharya Kabindra , Shrestha Neelam , Joshi Kriti , Gupta Aman Kumar 
Published: June 2021

Introduction: Cataract is the main cause of bilateral blindness in Nepal. Surgery is the accepted treatment option for cataract with Small incision Cataract Surgery (SICS) and Phacoemusification being the common procedures being performed with comparable results. Corneal astigmatism has been a byproduct of cataract surgery since the first limbal incision was made with improved techniques. Self-sealing scleral pocket incisions are stable and provides early healing, faster visual restoration and more importantly superior astigmatism control. A variety of scleral incisions are being used in manual SICS, with the aim of keeping the post-operative astigmatism to a minimum. Despite having many techniques of scleral incision, there have been only few studies which compares surgical induced astigmatism (SIA) between them
Objective: To determine surgical induced astigmatism following frown, chevron and straight incision forms in suture-less small incision cataract surgery(SICS).
Methodology: A prospective study was done on a total of 120 patients aged 40years and above with senile cataract. The patients were randomly divided into three groups where each group received specific incision- Straight, Frown and Chevron. SICS with intraocular lens (IOL) implantation was performed. The patients were compared on 2 weeks and 6 weeks post operatively for uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA) and keratometric reading. Surgical induced astigmatism (SIA) was calculated using the SIA calculator version 2.0. The study was analysed using SPSS version 20.0.
Results: At 6 weeks UCVA of 6/18-6/6 was attained by 63.41%, 78.94% and 84.61% of patients in group straight, frown and chevron. However about 97% of patients attained BCVA of 6/18-6/6 in all three groups. Mean SIA was least in Chevron group (0.30 D ± 0.16) and was most in the straight group (1.22 D ±0.36) which was statistically significant.
Conclusion: Chevron incision induces the least astigmatism compared to frown and straight incision.
Histopathological Study of Cystoscopic Bladder Biopsies in a Tertiary Care Center
Authors: Dhakal Rachana , Joshi Hem Nath , Makaju Ramesh , Sigdel Shailendra 
Published: June 2021

Introduction: Non-neoplastic urinary bladder lesions are not life threatening, but are an important source to cause clinical symptoms and signs. However, neoplasms of the bladder are a source of morbidity, mortality, and exhibit more clinical challenges. Cystoscopy provides overall information about an anatomical/pathological condition of the urinary bladder which will be helpful for patients' management. A cystoscopic biopsy is a primary diagnostic tool for diagnosing urinary bladder cancer.
Objectives: The objective of the study was to find the frequency and histomorphological characteristics of urinary bladder lesions in Dhulikhel Hospital, to find the clinical presentation of urinary bladder lesions and to grade the urothelial tumors based on the World Health Organization (WHO)/ International Society of Urological Pathology (ISUP) classification 2004.
Methodology: This was a retrospective, cross-sectional, observational study carried out in the Department of Pathology, Dhulikhel Hospital-Kathmandu University Hospital. Convenient sampling was done. All cystoscopy biopsies received from January 2014 to December 2018 were studied. All tissue blocks were retrieved, cut, and stained with Hematoxylin and Eosin. The stained slides were examined under a light microscope by the primary investigator.
Result: A total of 70 cystoscopic biopsies were analyzed. The majority of patients 20 (28.6%) were in the age group between 60 and 69 years and males were predominant 43 (61.4%). The neoplastic lesions constituted 40 (57.1%) of all bladder lesions, among them urothelial carcinoma accounted for 38 (54.2%). Similarly, chronic cystitis 27(38.6%) was the most common non-neoplastic lesion.
Conclusion: The study found that the neoplastic lesions were commonly encountered in urinary bladder lesions. Among them, lowgrade urothelial carcinoma was the most common bladder tumor. However, most of the non-neoplastic lesions were inflammatory in origin. Cystoscopy combined with histomorphological examination helps in the early detection of bladder lesions.
Growth Parameters of Exclusively Breastfed versus Non-Exclusively Fed Infants in the First 5 Months of Life before Introduction of Semi-Solid Foods
Authors: Gauchan Eva 
Published: June 2021

Introduction: Exclusive breast-feeding has many advantages over nonexclusive feeding; better growth and lower risks of infections being most important. The aim of this study was to find the hospital prevalence of exclusive breast-feeding, find any differences in growth and morbidity patterns in babies who were exclusively breast-fed as compared to those who were not.
Methodology: This was a hospital-based cross-sectional study over a period of one year which enrolled infants 1.5 months, 2.5 months, 3.5 months and 5 months of age who were on exclusive breast-feeding or non-exclusive feeding and who had not been started on semi-solid foods. Growth and morbidity patterns were recorded. Statistical analysis was done by SPSS version 25. Continuous variables were reported as median [IQR] while categorical variables were reported as absolute number (%). Mann-Whitney U test and Chi-square test were used to find the level of significance respectively.
Results: The hospital prevalence of exclusive breast-feeding was found to be 62%. Weight for age was significantly higher in infants who were on exclusive breast-feeding (p=<.05) at 1.5, 2.5 and 3.5 months of age. Similarly length for age was higher in infants at 1.5 months (p=.034) of age but there after no difference was seen. Undernutrition was seen in 5.5% of non-exclusively fed infants as compared to 0.9% of exclusively breast-fed babies (p=<.001). Illnesses like pneumonia, diarrhea, ear infection and urinary tract infection were seen more in infants who were on nonexclusive feeding as opposed to infants who were exclusively breast-fed (p=<.05).
Conclusions: Exclusively breast-fed babies have betier growth in terms of weight and lesser morbidities as compared to those babies who are non-exclusively fed.
Lower Segment Cesarean Section for Guillain- Barre Syndrome - A Novel Anaesthetic Technique
Authors: Bhattarai Rupak , Lamichhane Sabina , Das Chitta Ranjan 
Published: June 2021

Introduction: Guillain Barre Syndrome in pregnant ladies, undergoing cesarean section, has not yet reported in Nepal. Anaesthetic management of 15 patients with Guillain Barre Syndrome who underwent lower segment cesarean section at Nobel Medical College Teaching Hospital is reported here.
Objective: The purpose of this study is to assess the benefits of Rectus sheath nerve block along with infiltration of retropubic space of Retzius in Guillain Barre syndrome patients planned for lower segment cesarean section (LSCS).
Methodology: During the period from 1st August 2015 to 31st April 2020 at NMCTH, a retrospective descriptive analysis of 15 pregnant ladies with Guillain Barre Syndrome who underwent lower segment cesarean section under Rectus sheath nerve block along with Retro pubic space of Retzius, infiltration and visceral peritoneum infiltration is discussed.
Result: Considering Surgeons opinion about the operating conditions like Relaxation, Straining, Coughing, Bucking, Satisfactory to good operative conditions were reported. Excellent to good satisfaction was expressed by 39.9% of patients, 60% patients reported satisfactory. Hypotension and Arrhythmias was seen in 2 patients. Diaphoresis was seen in 1 patient. Fetomaternal outcome was good. There was no mortality.
Conclusion: Rectus sheath block along with infiltration of retro pubic space of Retzius block can be considered as a good alternative to general anaesthesia or neuraxial block incase where general anesthesia & neuraxial block is risky or contraindicated for lower segment cesarean section in patients with Guillain Barre Syndrome.
Inflammatory Bowel Disease in Maldives; A Single Center Clinical Experience
Authors: Khadka Mohan 
Published: June 2021

Introduction: Inflammatory bowel disease (IBD), once considered disease of west is also increasingly diagnosed in Asia in recent years. As there are already studies about IBD in Southeast Asia like India, Srilanka, it would be more informative to study the disease in Maldives as being closer to India and Srilanka. This is probably the first study about the disease from Maldives conducted in a single tertiary hospital center. The objectives of the study were to determine the prevalence, clinical characteristics and treatment of IBD in Maldives.
Methodology: A preliminary hospital-based retrospective observational study was performed in ADK multispecialty hospital, a referral tertiary center located in the capital city of Maldives. Patients visiting gastroenterology OPD, who were diagnosed as IBD either Crohn's disease (CD) or Ulcerative colitis (UC) on basis of internationally established standard practice, were recruited in the study after informed oral consents for the duration of three years from January, 2017 to December, 2020. We collected clinical data including gender, age at diagnosis, symptomatology, severity, smoking habits, family history, disease phenotype, and behavior at diagnosis from each involved patients as per clinical proforma prepared for UC and Crohn's disease in separate forms.
Result: Total 41 patients of IBD with 15 CD and 26 UC were recruited during study period. The prevalence of IBD in the country was estimated to be at least 20 per 100000 persons. Ileocolonic phenotype in CD and Extended colitis in UC were more common. Clinically, majority IBD patients presented with moderate to severe form. Biologic agents were frequently used in IBD.
Conclusion: The prevalence of IBD in Maldives is also more or less similar to other Asian countries where as some aspects of clinical characteristics are similar to Western countries. There needs to be nationwide epidemiological study or multi center hospital based prospective or at least cross sectional study for detail and optimal information about various aspects of IBD.
Improvement of the system of social work through activation ombudsman
Authors: Surovtseva Iryna 
Published: June 2021

The article is devoted to the partnership of social workers and ombudsmen as an influential tool for the citizens' rights protection. The common aspects of professional activity of social workers and ombudsmen in the citizens' rights protection of Ukraine and European countries are analyzed. Analyzed the annual reports of the National Ombudsman, clarified the dynamics of the receipt of citizens' reports about violations of their rights. There is a growing number of human rights violations in the field of social protection. The ombudsman has the right to make recommendations to the central executive bodies, which are ripe after the monitoring visits. Through the activities of social workers and the ombudsman, the state assumes the main functions of ensuring human rights in the social sphere.
Foreign experience on the significant role of «natural allies» (social workers and ombudsmen) in drafting a formal protocol of strategic and tactical cooperation to optimize the residents' interests based on a friendly advisory approach have been highlighted.
Most often, social workers and ombudsmen are forced to act as intermediaries between people and the state or other bodies to uphold justice and provide protection in cases where measures taken by the state in the interests of society as a whole threaten the rights and freedoms of individuals or groups. There is a need to intensify cooperation between the ombudsman's offices, social protection departments and social service providers (for example, through the joint Commissions on the quality of social services establishment, joint investigations into unsatisfactory social or medical care complaints). It seems relevant to expand the positions of specialized ombudsmen (for social protection (security), military ombudsman) as independent officials in communities (municipalities) for Ukraine.
Readyness of future social workers to work in an inclusive youth environment
Authors: Ostryanko Tetiana 
Published: June 2021

The article analyzes the issue of future social workers' training to work in an inclusive youth environment. The gradual establishment of inclusive values in Ukrainian society requires changes in the behaviour and perception of people with special needs.
There is a need to train professionals who can translate change and develop an inclusive environment, including youth. The author identifies organizational and managerial components in the structure of training as one of the main in the work with youth in the conditions of inclusion. In the updated formulation of readiness criteria, some functions and roles perform a social worker in a youth inclusive environment. It is determined that the main content of the managerial criterion is that during the work the social worker could influence the change in the motivation of young people's behaviour, thinking, perception. The structural components of the organizational criterion are staging goals, planning, control, evaluation. Research levels of organizational and managerial readiness for future social workers used: Methodology of L.Umanskaya, O. Lutoshkin "Methodology for detecting the level of the organism. The study of the readiness level for activities in the inclusive youth environment showed that the level of development of communicative and organizational capabilities predominate the average levels determined. This is evidenced that an insufficient level of knowledge is in future social workers to establish contact interaction in the youth environment, also at the level between sectoral cooperation.
HUBUNGAN KINERJA KELOMPOK TANI DENGAN PENDAPATAN USAHATANI PADI SAWAH (Oryza sativa, L.) DI KECAMATAN TUKDANA, KABUPATEN INDRAMAYU
Authors: Fahmariza Mohammad , Hikmana Entus , Tohidin Tohidin 
Published: June 2021

Penelitian ini bertujuan untuk mengetahui kinerja kelembagaan kelompok tani di Kecamatan Tukdana Kabupaten Indramayu dan mengetahui tingkat hubungan kinerja kelembagaan kelompok tani terhadap pendapatan usahatani padi sawah (Oryza sativa, L.) di Kecamatan Tukdana Kabupaten Indramayu. Objek penelitian ini adalah kelompok tani di Kecamatan Tukdana Kabupaten Indramayu sebanyak 10 kelompok tani. Metode yang digunakan dalam penelitian ini adalah survei. Desain penelitian yang digunakan yaitu metode Survei Explanatori. Terdapat 50 populasi (kelompok tani) penentuan sampel dilakukan secara sengaja (Purposive) mengakibatkan penelitian ini memiliki 40 responden terdiri dari 10 kelompok tani masing-masing ketua, sekertaris, bendahara dan anggota kelompok tani tersebut untuk mengetahui kinerja dan pendapatannya. Teknik pengambilan data dilakukan observasi dan wawancara. Analisi yang digunakan dalam penelitian ini untuk menguji hubungan keeratan antara variabel kinerja kelompok tani dengan pendapatan usahatani, menggunakan analisis korelasi Product moment dengan menggunakan alat bantu aplikasi SPSS 20. Kinerja kelompok di Kecamatan Tukdana Kabupaten Indramayu sudah cukup baik, sebagian besar kinerja kelompok tani adalah tergolong klasifikasi cukup dengan skor 246 – 455, yaitu 8 kelompok tani sudah tergolong klasifikasi cukup dan 2 kelompok tani tergolong klasifikasi kurang ( 245). Hasil dari analisis diperoleh angka koefisien korelasi sebesar 0,678 artinya tingkat kekuatan hubungan (korelasi) antara variabel kinerja kelompok tani dengan pendapatan adalah kuat (0,600 – 0,799). Dengan nilai sebesar 0,678 dapat menggambarkan sejauhmana keeratan hubungan antara variabel kinerja kelompok tani dengan pendapatan usahatani padi sawah dengan nilai 67,8%. Jadi hubungan antara kinerja kelompok tani dengan pendapatan padi sawah di Kecamatan Tukdana Kabupaten Indramayu dapat dinyatakan positif maka hubunganya searah.
ECONOMIC AND ENVIRONMENTAL ASSESSMENT OF THE CHOICE OF PLANNING AND ENGINEERING PREPARATION OF TERRITORIES FOR CONSTRUCTION
Authors: Banakh Andrii , Banakh Viktor , Fostashchenko Olena , Fedchenok Oleksandr , Polikarpova Liliia 
Published: June 2021

Due to the fact that the process of urban engineering of territories includes procedures for socio-economic and engineering-economic assessment of the planning decision of the territory, there is a need to develop appropriate methods. Common for comparing different areas for construction and engineering preparation of the territory should be considered the amount of costs, consisting of the cost of different types of work to compensate for loss to the stability of the territory, as well as the cost of special studies to identify potential ways to reduce damage and engineering preparation and engineering protection of territory being developed or reconstructed. Damage assessment can be carried out based on the specific location of the territory (a certain part of the site) and landscaping of this area, with due regard for the types of buildings. The inclusion of procedures for the socio-economic and engineering-economic assessment of the planning decision of the territory in the process of urban engineering is justified. The dependences of the total values of losses in case of loss of stability of the territory depending on the type of object are established. Separately, the cost of measures for the engineering preparation of the territory depending on the angle of inclination of the relief was determined. An environmental assessment of the choice of planning option and engineering preparation of the building area is carried out. The largest share in the structure of economic losses from the possible activation of destructive processes in the soil brings housing – about 60% – so special attention in the analysis of anthropogenic impacts on the stability of territories should be paid to anthropogenic factors arising development of housing. The cost of engineering training measures is determined by the capacity of the soil layer, which loses stability, the capacity of the groundwater flow and the angle of inclination of the sliding surface of landslides in unstable areas of housing. To determine the degree of increase in the stability of the territory per unit of costs, it is necessary to take into account both simultaneous and current costs to be developed. Of all the possible options for stabilization measures, the best is the one that, under equal conditions, provides a minimum of reduced costs.
JURIDICAL ANALYSIS ON THE LEGAL POWER OF COLLATERAL SEIZURE ON MATRIMONIAL JOINT ASSETS IN THE DECISION OF MANNA RELIGIOUS COURT NO. 54/PDT.G/2019/PA.MNA BASED ON ISLAMIC LAW
Authors: Fauzi Fauzi , Subanrio Subanrio , Muslih Akhmad 
Published: June 2021

The objectives of the study were to find out and analyze: (1) the reasons of collateral seizure on matrimonial joint assets where it can guarantee the Plaintiff's rights and (2) The views of Islamic law on the collateral seizure of matrimonial joint assets in the decision of Manna Religious Court No.54/Pdt.g/2019/PA.Mna. This study was normative legal research. The reasons for the seizure of the collateral filed by the Plaintiff in the lawsuit case No.54/Pdt.G/2019/PA.Mna were: a) the reasons for collateral seizure on matrimonial joint assets were due to the Plaintiff’s claim in the lawsuit concerning the assets under the Defendant's authority; b). Judge panel considered the rules based on Al-Qur'an surah An-Nisa verse 32, regulation in Marriage Law, and Compilation of Islamic Law that state the right of Matrimony Joint Assets belongs to both parties, and since the assets were under the Defendant's authority, a collateral seizure is considered necessary; c) the reasons of collateral seizure on matrimonial joint assets were also to provide legal certainty and equal rights to each party; d) to ensure the integrity of the assets, to get them to remain maintained and present; and e) the seizure was to avoid the right transfer of the asset to other parties and to prevent the assets from being misused or damaged. The legal power of collateral seizure of matrimonial joint assets in the decision of Manna Religious Court No.54/Pdt.g/2019/PA.Mna could give the Plaintiff's legal rights in writing, but when viewed from Islamic law it could not be able to achieve the objectives of Islamic law itself, namely the benefit and usefulness principles. This was due to the absence of sanctions and strong foundations for those who did not carry out the decision. The court only granted the seizure stamp and joint assets seizure but did not decide the execution over the joint assets, so the Plaintiff's rights could not be fully protected. Islamic law considered the collateral seizure on matrimonial joint assets in the decision of the Manna Religious Court No.54/Pdt.g/2019/PA.Mna as something that is not prohibited and mentioned in surah Al-Baqarah verse 188.