bluuebunny/crossref_metadata_2025_split huggingface dataset:
Conservative treatment in acute appendicitis
Authors: Paudel G R , Agrawal CS , Regmi R , Agrawal S 
Published: September 2018

INTRODUCTION:
Acute appendicitis is one of the commonest surgical problems and appendectomy is one of the most commonly done operations in the emergency world wide. Though there have been occasional reports with conservative treatment in acute appendicitis, it is not being practiced as a routine.
METHODS:
All patients between ten to sixty years of age admitted at BPKIHS with the diagnosis of acute appendicitis over a period of one year were enrolled in the study. After taking informed consent the patients were managed conservatively. Those who did not respond to antibiotics within 24 hours were operated. Total hospital stay and complications were recorded and they were followed up at first week, sixth week and sixth month. The success rate, conversion rate, recurrence rate and morbidity and mortality pattern were assessed as the final outcome of conservative treatment of acute appendicitis.
RESULTS:
A total of 96 patients (48 males and 48 females) underwent conservative treatment. The conservative treatment was successful in 79 (82.3%) cases and failed in 11 (11.4%) cases, which included: conversion to appendectomy during conservative treatment period 4 (4.2%) cases, recurrence 7 (7.3%) cases. There was no mortality in this study.
CONCLUSION:
Acute appendicitis can be treated successfully with conservative (antibiotics) treatment with a short hospital stay. Though there is a risk of recurrence in some cases, all the complications after appendectomy can be eliminated with the conservative treatment.Keywords: acute appendicitis, appendicular lump, conservative management
Contrast-enhanced Ultrasound for Non-tumor Liver Diseases
Authors: Maruyama H , Yokosuka O 
Published: September 2018

Contrast-enhanced ultrasound (CEUS) is a simple, safe and reliable technique for the clinical management of patients with various liver diseases. Although the major target of the technique may be focal hepatic lesions, it is also effective for the diagnosis of non-tumor liver diseases, such as grading hepatic fibrosis, characterization of chronic liver diseases and diagnosis of portal vein thrombosis. This review article aimed to overview the recent application of CEUS in the assessment of non-tumor liver diseases.
Keywords: Cirrhosis, contrast agent, fibrosis, idiopathic portal hypertension, microbubble, portal vein thrombosis, ultrasound.
Local resection of gastrointestinal stromal tumor of the second part of duodenum
Authors: Kansakar R , Adhikari S 
Published: September 2018

Gastrointestinal stromal tumors are relatively rare in the duodenum, representing 2-4% of Gastrointestinal stromal tumors of the gastrointestinal tract. We describe a huge Gastrointestinal stromal tumor arising from the second part of the duodenum invading the transverse colon which was removed successfully by local resection of the second part of the duodenum along with a segment of transverse colon.
Keywords: duodenum, gastrointestinal stromal tumor, segmental resection
Bilateral eventration of sciatic nerve
Authors: Sharma T , Singla RK , Lalit M 
Published: September 2018

During routine dissection of a 60 years male cadaver, it was observed that the two divisions of sciatic nerve were separate in the gluteal region on both the sides with the tibial nerve passing below the piriformis and the common peroneal nerve piercing the piriformis muscle. The abnormal passage of the sciatic nerve (SN), the common peroneal nerve (CPN), and the tibial nerve (TN), either through the piriformis or below the superior gemellus may facilitate compression of these nerves. Knowledge of such patterns is also important for surgeons dealing with piriformis syndrome which affects 5-6% of patients referred for the treatment of back and leg pain. A high division may also account for frequent failures reported with the popliteal block.
Keywords: eventration, piriformis muscle, piriformis syndrome, sciatic nerve
Ambiguous Phorate Granules for Sesame Seeds Linked to Accidental Organophosphate Fatal Poisoning
Authors: Khatiwada S , Tripathi M , Pokharel K , Acharya R , Subedi A 
Published: September 2018

Ingestion of organophosphate compound for suicidal attempt is a major health problem in developing countries. However, unintentional ingestion by an adult is rare. An 80-year-old lady and her 30-year-old granddaughter consumed phorate (organophosphate) granules thinking it to be the seeds of sesame. After grinding the granules and mixing with pickle, they consumed the preparation with rice. The granddaughter was brought dead at emergency department and the older lady after resuscitation shifted to intensive care unit. She was extubated on 17th day and discharged on 23rd day. Pesticide formulation resembling any edible items must be withdrawn from the market at the earliest. Stringent regulation on vendors, apparent formulation or packaging and education about the hazards of these compounds can prevent this type of unintentional poisoning.
Keywords: Ambiguous, organophosphate, phorate, sesame seeds, unintentional poisoning.
Abstruse diagnosis of obturator hernia--a case series
Authors: Basnet R B , Rijal B , Sharma VK 
Published: September 2018

The diagnosis of obturator hernia is one of suspicion as it is almost never seen and rarely palpated. The incidence is less than 1% of all hernias worldwide. Five cases of obturator hernias are reported where the diagnosis of obturator hernia were overlooked.
Keywords: obstruction, obturator hernia, small intestine
Attitude towards Mental illness and Psychiatry among the Medical students and Interns in a University Medical College
Authors: Risal Ajay , Sharma Pushpa Prasad , Sanjel Seshananda 
Published: September 2018

Introduction: Medical students tend to have a neutral or negative attitude to Psychiatry as a discipline. This study was initiated to explore the attitude towards Mental illness and Psychiatry among the Medical students and Interns in Kathmandu University School of Medical Sciences (KUSMS).Method: A cross-sectional Questionnaire based study was conducted among the Medical students and Interns at Dhulikhel Hospital (Kathmandu University Hospital). Two self-rating scales; Attitudes towards psychiatry (ATP-30) and Attitudes to mental illness (AMI) were used to assess attitudes towards mental illness and Psychiatry among the total 159 subjects. Descriptive statistics and independent sample t-test applied using SPSS-16 for analysis.Results: Among the total 159 subjects, 56.6% were males and 27.7% were Interns. Comparison of means of each item in ATP-30 and AMI was done between Males and Females, Medical students and Interns, First semester and Ninth semester students. Most of the subjects showed neutral attitude towards all the scoring items; though there were a few significant differences in mean scores of some items in group wise comparison. Conclusions: Overall attitudes towards Mental illness and Psychiatry among the Medical students and Interns in our Medical School were positive or neutral. A further study with medical students from different institutions is needed to get a detail nationwide picture. Key words: Attitude, Interns, Medical Students, Mental illness, Psychiatry.
Swyer Syndrome : A Case Report with Literature Review
Authors: Patnayak R , Suresh V , Jena A , Vijayalakshmi B , Reddy AP , Rukumangadha M , Sachan A 
Published: September 2018

Gonadoblastomas are known to develop in dysgenetic gonads, especially so, if Y chromosome material is present. A 20-years- old girl who noticed breast development since the age of 12 years presented with primary amenorhoea, distension of lower abdomen and intermittent pain for two months. She had breakthrough bleeding with six months of estrogen replacement. Tanner breast stage was fi ve and pubic hair stage was also fi ve. Examination revealed a mass in the lower abdomen extending into hypogastrium, umbilical and lumbar regions. Her gonadotropin levels were grossly elevated. Karyotyping showed 46XY. CT scan of abdomen showed a 17X11 cm mass in the pelvis without visible gonads. Surgical excision of the mass along with bilateral salpingophorectomy was performed. Histopathology revealed the mass to be a dysgerminoma, while the right gonad lodged gonadoblastoma. She was diagnosed as a rare case of Swyer syndrome.
Keywords: Dysgerminoma, gonadoblastoma, Swyer syndrome, XY gonadal dysgenesis.
Pure red cell aplasia caused by Parvo B19 virus in a kidney transplant recipient
Authors: Baral A , Poudel B , Agrawal R K , Hada R , Gurung S 
Published: September 2018

Parvo B19 is a single stranded DNA virus, which typically has affi nity for erythroid progenitor cells in the bone marrow and produces a severe form of anemia known as pure red cell aplasia. This condition is particularly worse in immunocompromised individuals. We herein report a young Nepali male who developed severe and persistent anaemia after kidney transplantation while being on immunosuppressive therapy. His bone marrow examination revealed morphological changes of pure red cell aplasia, caused by parvovirus B19. The IgM antibody against the virus was positive and the virus was detected by polymerase chain reaction in the blood. He was managed with intravenous immunoglobulin. He responded well to the treatment and has normal hemoglobin levels three months post treatment. To the best of our knowledge, this is the fi rst such case report from Nepal.
Keywords: Intravenous immunoglobulin, kidney transplant recipient, Parvovirus B19, pure red cell aplasia.
How did Nepal Reduce the Maternal Mortality? A Result from Analysing the Determinants of Maternal Mortality
Authors: Karkee R 
Published: September 2018

Nepal reportedly reduced the maternal mortality ratio by 48% within one decade between 1996-2005 and received the Millennium development goal award for this. However, there is debate regarding the accuracy of this figure. On the basis of framework of determinants of maternal mortality proposed by McCarthy and Maine in 1992 and successive data from Nepal demographic health survey of 1996, 2001 and 2006, a literature analysis was done to identify the important factors behind this decline. Although facility delivery and skilled birth attendants are acclaimed as best strategy of reducing maternal mortality, a proportionate increase in these factors was not found to account the maternal mortality rate reduction in Nepal. Alternatively, intermediate factors particularly women awareness, family planning and safe abortion might have played a significant role. Hence, Nepal as well as similar other developing countries should pay equal attention to such intermediate factors while concentrating on biomedical care strategy.
Keywords: Determinants, maternal mortality, Nepal, reduction.
HOW COST EFFECTIVE IS THE TREATMENT? ARE PRESCRIBERS CONCERNED ?
Authors: Das B P , Naga Rani M A , Rauniar G P , Sangraula H 
Published: September 2018

ABSTRACTCost-effective treatment should be of primary concern to prescribers in poor countries like Nepal. Thepresent study was carried out at a tertiary care hospital in Nepal to find out the perception of prices ofcommonly prescribed drugs among prescribers. The participants selected randomly were directed to writein 10 minutes on a proforma, the generic name(s) and price of the brand preparation of 18 most commonlyused drugs listed under their brand name.The price of the drug was considered correct if the price mentioned was within a range of 20% above orbelow the brand price. Results indicated that the participants were aware of the composition of majority(80%) of the drugs, but were not aware of the prices of 81.80% of the drugs. No single participant mentionedthe correct prices of all the drugs. Among the drug groups studied, the most accurate data was providedabout composition (90.43%) and price (24.47%) of non steroidal anti-inflammatory drugs (NSAIDs). Onlyin 9.22% of brand preparations of antimicrobial agents (AMA), the prices were mentioned correctly. Hence,sensitisation of physicians about cost-effective treatment is of immense importance and to facilitate this,hospital authorities could provide prescribers with regularly updated price lists of commonly prescribeddrugs and competitive prices of various brand preparations. Pharmacoeconomics may be introduced in the undergraduate curriculum which can be reinforced by continuing medical education.Key Words: Cost-effective, Pharmacoeconomics.
FUNCTIONAL RESULTS AFTER VOCAL CORD MEDIALIZATION PROCEDURE WITH SCULPTURED SILICON BLOCK
Authors: KC Toran , Shrestha S 
Published: September 2018

ABSTRACTMedialization technique has remained as a mainstay for the treatment of glottal insufficiency. This form oflaryngeal framework surgery not only improves the quality of voice but also protects the lungs from aspiration.We present six patients who underwent vocal cord medialization surgery. Of the six patients only onepatient had required revision surgery. Since these form of surgeries are performed under local anesthesiathe quality of the voice can be assessed per-operatively. This kind of surgery appears to be still new in the Nepalese context.Key Words: Isshiki Thyroplasty, Laryngoplasty, Laryngeal framework surgery,vocal cord paralysis, Voice disorders, glottal insufficiency.
Nurses’ Views on Need for Professional Development in Nepal
Authors: Shrestha Geeta Kamal , Bhandari N , Singh B 
Published: September 2018

INTRODUCTION:

This study explores the nurses' views on need for professional development and barriers in Nepal.
METHODS:
This is a qualitative content analysis study conducted among nurses from different health institutes. In-depth interviews and focus group discussions were used to obtain their views on need of professional development and major barriers against professional development in Nepal. Eleven nurses for in-depth interviews and three groups of six nurses each for focus group discussions were selected purposefully from Kathmandu University Hospital, Dhulikhel and Tribhuban University Teachng Hospital, Kathmnadu.
RESULTS:
Five themes emerged from qualitative data. "Continuing professional development", "supportive management", "nursing leadership", "recognition and respect" and "professional networking" were considered as essential factors for professional development. Lack of "commitment by the nurses", "female gender professional" and "lack of autonomy" were felt as barriers for the nursing professioanl development.
CONCLUSIONS:
Continuing professional development and supportive working environment are crucial to make nursing profession more dynamic and appealing in Nepal.
Keywords: continuing professional development, professional development, supportive managment
Single Incision Laparoscopic Cholecystectomy vs Conventional Cholecystectomy in Developing Country
Authors: Thapa P B , Maharjan DK , Singh DR 
Published: September 2018

INTRODUCTION:

Use of laparoscopic surgery has demanded principles of less trauma of access hence less scar and so probably less complications. Hence conventional laparoscopic surgeries were tried with natural orifice transluminal surgery (NOTES) and then single incision laparoscopic surgery (SILS). With refinement in instruments and surgeons skills SILS have bridged up between conventional and NOTES in order to quench the desire of less or no scar at all.
METHODS:
Comparative case control study between conventional laparoscopic cholecystectomy and SILS in public teaching hospital.
RESULTS:
Total 20 patients underwent SILS cholecystectomy and 20 underwent conventional cholecystectomy and found that no difference between both in terms of post operative pain score, hospital stay and post operative wound infection except significant difference in mean operative time and patient's level of satisfaction was less in patient with SILC if were subjected to pay for instruments in order to maintain cosmesis.
CONCLUSIONS:
Though SILS have gained rapid acceptance in surgical fraternity, large number of randomized controlled trials are necessary to show its benefit over conventional laparoscopic cholecystectomy.
Keywords: cholecystectomy, conventional, laparoscopy, single incision, surgery
Antimicrobial Resistant Streptococcus pneumoniae
Authors: Khanal B , Acharya A , Amatya R , Gurung R , Paudyal N , Shrestha S , Bhattacharya SK 
Published: September 2018

Introduction: Pneumococcal infections are important cause of morbidity and mortality. Knowledge of antimicrobial susceptibility patterns plays important role in the selection of appropriate therapy. Present study was undertaken to analyze the susceptibility patterns of pneumococcal isolates against commonly used antimicrobials with special reference to determination of minimum inhibitory concentration (MIC) of penicillin in a tertiary care hospital in eastern Nepal.
Methods: Twenty-six strains of S. pneumoniae isolated from various clinical specimens submitted to microbiology laboratory were evaluated. All isolates were tested for antimicrobial susceptibility by disk diffusion method. MIC of penicillin was tested by broth dilution method.
Results: Of the total isolates 19 (73%) were from invasive infections. Seven isolates were resistant to cotrimoxazole. No resistance to penicillin was seen in disk diffusion testing. Less susceptibility to penicillin (MIC 0.1-1.0 mg/L) was observed in five (17%) isolates. High level resistance to penicillin was not detected. One isolate was multidrug resistant.
Conclusions: S. pneumoniaeisolates with intermediate resistance to penicillin prevail in Tertiary Care Hospital in eastern Nepal, causing invasive and noninvasive infections. As intermediate resistance is not detected in routine susceptibility testing, determination of MIC is important. It helps not only in the effective management of life threatening infections but is also essential in continuous monitoring and early detection of resistance. In addition, further study on pneumococcal infections, its antimicrobial resistance profile and correlation with clinical and epidemiological features including serotypes and group prevalence is recommended in future.
Keywords: antimicrobial susceptibility pattern, penicillin, Streptococcus pneumoniae.
March Of Medicine
Authors: Author No 
Published: September 2018

Distribution Of First Lesions In Leprosy. Horton,R.J. & Povey, SChronic Ill Health From Unrecognised Malaria. Wills, N.E., Turner,P.P. , Somers, K. & Markandya, O.P.Infant Mortality Due To Congenital Malformations. Landtman, B. and Wallgren, E.I
Self Injurious Behavior in Temporal Lobe Epilepsy
Authors: Shakya D R , Shyangwa PM , Pandey AK , Subedi S , Yadav S 
Published: September 2018

Self-injurious behavior (SIB) or self-mutilating behavior (SMB) is rare but can occur in temporal lobe epilepsy. Such a behavior during seizures is not usually recalled by patient. Here is a case with self mutilating behavior in left temporal lobe epilepsy, presented because of its rare manifestation and diagnostic dilemma. A 19 year old unmarried Muslim student presented to emergency with SMB, guilty rumination and a persecutory delusion. The patient was intermittently confused about place and time. In subsequent assessments, he was found harboring death wishes and suicidal ideation. He transiently had auditory hallucination and thought broadcasting. He episodically tried to harm himself by severely biting only his left ring finger. It was difficult to influence him during such episodes. EEG revealed left temporal lobe seizure. Diagnosis of 'Epilepsy and Organic Psychosis' was made. The patient responded well to Antiepileptic and Antipsychotic medications.
Keywords: seizure, self injurious behavior, suicide, temporal epilepsy.
Complete Bicornuate Uterus with Complete Longitudinal Vaginal Septum
Authors: Suwal A , Kumar A 
Published: September 2018

Bicornuate Uterus is a type of lateral fusion disorder of the mullerian ducts. According to the American Fertility Society Classification of Mullerian Anomalies, bicornuate uterus is a class IV anomaly. Incidence of this anomaly varies. This may affect a woman's obstetric, as well as her gynecologic outcome. Here we present a 23 year primigravida at 38 weeks and 5 days gestation with footling breech presentation. She was identified, during cesarean section, of having complete bicornuate uterus with complete longitudinal vaginal septum.
Keywords: bicornuate, pregnancy, uterus, vaginal septum
Current status and risks of underground water for house holds in Cu Chi District - Ho Chi Minh City
Authors: Tran Oanh Thi Phi , Tran Dung Quoc , Do Cuong Quoc , Ho Thong Chi 
Published: September 2018

This study was conducted to survey the current status, the risks of groundwater resources for house holds in Pleistocene aquifers to serve the households in the Cu Chi district - Ho Chi Minh City during the period from March 1st– 30th 2015. The sample were divided into two main groups: from individual well for households which are used directly and from industrial pumping well by SAWACO.
Survey results showed that:
- Quality of water: There are popularly low iron content and pH in the survey area; however, Binh My Commune has very high iron content, above 10 mg / l. Other indicators are in accordance with standards except Pham Van Coi and Thái Mỹ Commune with very high NO3+ NH4+, beyond permitted standards.
- The treated water quality: 100% samples meet the QCVN02 standards: 2009 / BYT about water quality. Regarding risk assessment, this research is used to evaluate the water resource risks by DRASTIC and the health risks by substances, capable of causing cancer (As), incapable of causing cancer (Mn , Hg, Cr6 +, CN-).
These results showed that although the risks are considered very low, the measures still need taking to manage, control and to achieve a safe, sustainable water supply.
Vietnam’s economy 2015 - 2016 Stable and growing in economic integration
Authors: Nguyen Luan Van 
Published: September 2018

In 2015, Vietnam obtained stimulating achievements. The macroeconomy was stable and steady with economic and CPI growth of 6.58% and 0.63% respectively; financial markets had encouraging changes; difficulties in manufacturing and trading showed sign of abating; import – export reached double-digit growth rate. Results from the restructuring process of state-owned enterprises gave positive signal of a success outcome. These are impetus for the 2016 economic growth.
Targets of 2016 are to keep the macro economy stabilized, reach the GDP growth rate of 6.7%, improve growth quality and towards a sustainable development. It is also necessary to create favorable conditions for enterprises, uniformly and effectively implement administration reforms, actively integrate into international trade under trade agreements such as FTA, AEC, TPP.
To achieve 2016 economic targets, it is of importance to rigorously implement policies, system innovations and creativity, nation-wide and industry-wide scientific and technology development so as to create breakthrough results in the transition of structure and economic growth.
Une nouvelle base de données de stocks de capital physique pour la Chine (1952-2016)
Authors: Long Zhiming , Herrera Rémy 
Published: September 2018

Il n’existe pas, à ce jour, de données statistiques officielles de la Chine relatives aux stocks de capital physique. Ce manque handicape les études portant sur la croissance économique de ce pays. Des séries de stocks de capital sont certes proposées dans la littérature, mais la plupart des travaux empiriques disponibles sur ce sujet présentent des insuffisances. L’objet de cet article est de construire des séries statistiques de stocks de capital physique pour la Chine, les plus fiables et longues possibles. Nos séries originales sont ainsi mises à la disposition de la communauté des économètres pour réaliser de nouvelles études empiriques sur la Chine en longue période (1952-2016). CODES JEL : C13, C22, C52, C82, E22, E31, O53