bluuebunny/crossref_metadata_2025_split huggingface dataset:
Efficacy of Short Course Antibiotic Prophylaxis in Surgical Treatment of Closed Fracture
Authors: Jha Subash Chandra , Baral Pramod , Shakya Prakash 
Published: May 2019

Introduction: Unnecessary and rampant use of antibiotic for perioperative prophylaxis are not only increasing cost of treatment but also are hazardous in terms of increasing antibiotic resistance, super infection with resistant pathogens and antibiotic toxicity.
Objective: Our primary objective is to assess the efficacy of short course antibiotic prophylaxis in preventing surgical site infection (SSI) in surgery of closed orthopedic fracture.
Methodology: Patients fulfilling all the inclusion criteria and willing and able to give informed consent were included in the study. All participants were treated by standard surgical technique following standard surgical protocol. Short course antibiotic prophylaxis was administered in peri-operative period to all patients in given format: Three divided dose of intravenous 1.5 gram cefuroxime during peri-operative period followed by no intravenous or oral antibiotics; 1st dose half an hour before incision; 2nd and 3rd dose repeated at 12 hours interval.
Results: Of total 100 patient included, three developed surgical site infection till one year follow-up. All three patients with surgical site infection were treated successfully with intravenous antibiotic based on the culture sensitivity report. The average cost of antibiotic for short course antibiotic prophylaxis was 1500 NPR for each patient.
Conclusions: There was no significant increase in rate of surgical site infection with short course antibiotic prophylaxis, rather it was less expensive and may have less adverse effect, in terms of antibiotic resistance and antibiotic side effects on long run.
Efficacy of 10% Ichthammol Glycerine Pack and Steroid-antibiotic Pack for Relieving Pain in Acute Otitis Externa. A Comparative Study.
Authors: Shrestha Karuna , Shah Rajeev , Sapkota Srijana 
Published: May 2019

Introduction: Otitis externa is a common painful condition presents with generalized infection of external auditory canal, typically reveals erythema and edema of the skin. Aural packing plays an important role in relieving the pain and edema. For packing, either we impregnated with 10% Ichthammol glycerine or steroid-antibiotic ointment.
Objective: To compare the efficacy of 10% Ichthammol Glycerine pack with steroid-antibiotic ointment pack for relieving the pain in acute otitis externa.
Methodology: A prospective, non-randomized clinical trial was carried out in 94 patients at Birat Medical College and Teaching Hospital, Biratnagar, Nepal from February 2018 to July 2018. Patients diagnosed with acute otitis externa were included in this study, where 47 patients were treated with 10% IG pack and remaining 47 patients treated with a combination steroid antibiotic ointment pack. Before aural packing was carried out, pain was assessed using visual analogue scale (VAS). Both groups of patients were evaluated after 48 hours for assessment of pain.
Results: The total number of patients included in this study was 94. Among them 41 (43.6%) were male and 53(56.4%) were female where male and female ratio was 1:1.29. Majority of the patients were below 40 years (83%). Treatment with steroid-antibiotic ointment pack had significant reduction in pain after 48 hours post treatment, none of them had severe pain, 4(8.5%) had moderate pain remaining and 43(91.4%) had only mild pain. Whereas in patients treated with 10% IG pack 1(2.1%) had severe pain, 14(29.7%) had moderate pain and 32(68%) had mild pain. There was statistically significant decrease in pain with steroid-antibiotic pack.
Conclusions: Both treatment modalities are effective but this study showed steroid-antibiotic ointment pack, the combined therapy is more effective than 10% IG pack for relieving the pain in acute otitis externa.
Correlative Analysis Between Serum Anti-mullerian Hormone Concentration and LH:FSH Ratio as Women's Age Advances: A Hospital-based Study
Authors: Mallick Ram Lala , Kafle Santosh Upadhyay , Dahal Prerana , Karna Tapeshwar Lal , Thakur Asmitanand 
Published: May 2019

Introduction: A term 'ovarian reserve' is described as quantity of ovarian follicular cohort and quality of oocytes. The assessment of an individual's ovarian reserve comprises evaluation of certain variables like age, follicle stimulating hormone, leutinizing hormone, LH:FSH ratio and prolactin as main task. Recently, scientists have reported anti-mullerian hormone as potential test for ovarian reserve. Recently, it is observed that higher levels of AMH correlate positively with greater number of oocytes with then the improved embryo morphology in in vitro fertilization (IVF) cycles. However, controversy still exists between correlation of AMH and other hormonal tests.
Objectives: To investigate correlation of AMH, FSH, LH, LH:FSH ratio and PRL in women who attended the local hospital.
Methodology: Venipuncture was performed to collect venous blood samples (n=110) under informed written consents. Following separation of sera, circulating levels of AMH was carried out by ELISA and assessment of FSH, LH and PRL were done using Dry chemistry immunoassay analyzer. Data were analyzed using SPSS software version 16.
Results: Our data demonstrated for existence of significant negative correlation between serum LH:FSH ratio and age. Here, the pattern of changes was in accordance to that of serum AMH concentration. So when we compared serum AMH concentrations with values of LH:FSH ratio in relation to age, the existence of a significant correlation was observed. Further, our findings demonstrate a degree of variations among other variables (such as LH, FSH and Prolactin) and are imperative in analytical point of view.
Conclusion: Our findings behind significant correlation between serum LH:FSH ratio and AMH level suggest that LH:FSH ratio can be a marker for ovarian reserve and applied to clinical evaluation with AMH for diagnostic purpose.
Knowledge and Awareness of Basic Life Support among Medical Staffs of Birat Medical College and Teaching Hospital
Authors: Arjyal Batsalya , Rajbanshi Lalit Kumar , Khanal Kanak , Bajracharya Akriti 
Published: May 2019

Introduction: It is essential that all the medical professionals should have adequate skill for basic life support (BLS) for better outcome of cardiac arrest patients. The objective of the study is to assess the knowledge and awareness of BLS among the medical doctors, nursing staffs and health care paramedics working in Birat Medical College and Teaching Hospital, Biratnagar.
Methodology: A three-month duration observational questionnaire-based survey was conducted at Birat Medical College and Teaching Hospital, Biratnagar to assess the knowledge, awareness of basic life support among the medical doctors, nursing staffs and health care paramedics. A total of ten questions were designed to assess the knowledge and awareness regarding BLS skill. Three questions were designed to assess the previous experiences on cardiac arrest situation and BLS training. Similarly, two additional questions were added to assess the self-grading of BLS knowledge which included poor, below average, good and excellent.
Result: It was observed that only 14% participants had previous BLS training. Surprisingly, 76% of the participants had encountered cardiac arrest situation in their clinical practice but they were managing those cases with limited knowledge on BLS. The correct answer to the self-structured questionnaire were ticked by less than 50% of participants and majority of the participants came below average on self-grading of the knowledge and awareness suggesting the need of easy accessibility of BLS training centers in the eastern part of Nepal.
Conclusion: This study revealed that the knowledge and awareness of basic life support skills among the various staffs was mostly below average to poor. Significant amount of cost effective BLS trainings must be conducted so as to develop competent staffs by various training centers
Prevalence and associated risk factor of hypertension among individuals of age 18-59 years in South-eastern Nepal: A cross-sectional study
Authors: Pyakurel Prajjwal , Yadav Deepak Kumar , Thapa Jeevan , Thakur Nishant , Sharma Pramita , Koirala Niraj , Yadav Suraj Kumar , Chaurasia Akanksha , Sharma Sumit , Thapa June , Thapa Santosh , Shah Amit , Panta Pratigya , Shrestha Rajina , Dangi Arpana , Acharya Bijay , Pyakurel Ujjwal , Jha Nilambar 
Published: May 2019

Background: Hypertension is one of the major risk factors for the rising burden of cardiovascular diseases (CVDs) in developing region. It has also been recognized as one of the major public health problems in the developing countries since the early seventies and the rate is increasing not only in urban areas but in rural areas with low socio-economic condition.
Methods: A cross sectional study was conducted in Jogidaha Village Development Comittee(VDC) and Triyuga Municipality of Udaypur district of South-Eastern Nepal. A total of 430 participants of age 18-59 years were selected. Semi-structured questionnaire (WHO NCD STEPS instrument) was used to collect information on demographic variables and associated risk factors with use of show cards. Clinical and anthropometric measurement were done. Primary outcome was prevalence of hypertension. Bivariate and multivariate analysis were performed to show strength of association among various risk factors with hypertension.
Results: The prevalence of hypertension was found to be 25.1%. Prevalence of overweight and obesity was found to be 49.8%. Hypertension was significantly associated with age (AOR=1.09, CI=1.05-1.10) and gender (male >female; AOR= 2.12,CI =1.22-3.68). Similarly, increased waist-hip ratio(7.12; CI 2.87-17.67),alcohol consumption(OR=2.82,CI=1.77-4.52), and use of tobacco products (OR =1.8,CI=1.02-3.20) showed significant association with hypertension.
Conclusion: There is high prevalence of hypertension in rural districts of South-Eastern Nepal. A community-based preventive approach with early detection and treatment and life-style modification is needed to reduce the burden of disease and make sustainable changes.
Non alcoholic fatty liver disease is a predictor of subclinical Carotid Atherosclerosis in the presence of Metabolic Syndrome
Authors: Kemaloglu Cemal , Kemaloglu Melek Didem 
Published: May 2019

Objective: The aim of this study is to identify the relationship between carotid intima-media thickness (c-imt) and non-alcoholic fatty liver disease (NAFLD), and to determine whether NAFLD is an independent predictor for the progression of atherosclerosis.
Method: This is a prospective randomized controlled study. 103 NAFLD patients who have hepatosteatosis with grade II and above were enrolled in this study. Patients were divided into NAFLD with metabolic syndrome (MS) and NAFLD without MS groups and compared with 50 healthy people. Basal demographic characteristics and C-imt of all patients and control group were measured.
Results: C-imt and carotid cross sectional area rates in the NAFLD groups were significantly higher than those in the control group. The mean and max. c-imt levels were significantly higher in the NAFLD group with metabolic syndrome (p<0,001). Homeostatic Model of Assessment-Insulin Resistance (HOMA-IR) levels were increased in the group with metabolic syndrome than those in the group without metabolic syndrome, with statistical significance (p<0.001). There was no difference in c-imt levels between HOMA-IR positive and negative groups (p=0.254) in patients with NAFLD and without metabolic syndrome. There was only a mild positive corelation between c-imt levels and high sensitive C-Reactive protein (hs-CRP) levels in metabolic syndrome positive group (p=0.026 r=0.30).
Conclusion: NAFLD was a significant predictor to determine the increased risk of carotid atherosclerosis.
Awareness regarding cardiac rehabilitation among patients with coronary heart disease attending a cardiac care centre, Kathmandu valley
Authors: Shrestha Rosy , Shrestha Sajeeb 
Published: May 2019

Introduction: Coronary heart disease (CHD) is gradually emerging as a leading cause of morbidity and mortality of many low middle income countries like Nepal. Cardiac rehabilitation awareness program has been proved to be effective for reducing the mortality as well as improving the quality of life among CHD patients. The aim of this study was to explore the awareness on cardiac rehabilitation (CR) in patients with CHD attending a cardiac care centre, Nepal.
Method: A descriptive cross sectional study design was used to examine 100 CHD patients attending out-patient departments of Shahid Gangalal National Heart Centre (SGNHC), Kathmandu, Nepal. Purposive sampling technique was used for data collection by face to face interview technique with self developed tool. Data was analyzed with descriptive and inferential statistics.
Results: Of all 100 respondents, 55.0% were male and the mean age was 53.23±14.22 years. The median score of awareness was 17 with interquartile range (IQR) 14.0-19.75 and majority (57.0%) of respondents were unaware about CR. The awareness regarding CR was found highest in awareness regarding CHD (75.0%) whereas lowest score was found in time and duration needed for exercise per week (14.0%). The significant influencing variables were age, education status, duration of treatment and participation in CR program for CHD patients.
Conclusion: The awareness on CR program in CHD patients in Nepal is not optimal, especially among 54 and above age group, illiterate people, those receiving treatment equal & more than 1 year duration and the CHD patients who didn’t get chance to participate on awareness programs. Hence, it is strongly recommended that health professionals including nurses should organize and promote CR programs including counseling session to improve the awareness level and ultimately enhance quality of life of CHD patients.
String percolation in AA and p+p collisions
Authors: Bautista I. , Pajares C. , Ramírez And J.E. 
Published: May 2019

A brief review of the string percolation model and its results are presented together with the comparison to experimental data. First, it is done an introduction to the quark-gluon phase diagram and the lattice results concerning the connement and the percolation of center domains. It is studied the interaction of the strings produced in nucleus-nucleus and proton-proton collisions showing how the string percolation arises. The main consequences of the string percolation, concerning the dependence on the energy and centrality, on the multiplicities and the mean transverse momentum are obtained comparing with experimental data. It is emphasized the non-abelian character of the color eld of the strings forming the cluster to reproduce the rise of the transverse momentum with multiplicity and the relative suppression of multiplicities. It is also studied dierent observables like multiplicity and transverse momentum distributions, dependence with multiplicity and transverse momentum correlations, forward-backward correlations, the strength of the Bose-Einstein correlations, dependence on the multiplicity of J/ψ production and its possible suppression in pp collisions at high multiplicity, strangeness enhancement, elliptic ow, and ridge structure. The comparison with the data shows an overall agreement. The thermodynamical properties of the extended cluster formed in the collision are discussed computingits energy and entropy density, shear viscosity over entropy density ratio, bulk viscosity, sound speed and trace anomaly as a function of temperature, showing a remarkable agreement with lattice QCD evaluations. The string percolation can be regarded as the initial frame able to describe the collective behavior produced in AA and pp collisions.
Dehydroabietyl Glycidyl Ether Grafted Hydroxyethyl Chitosan: Synthesis, Characterization and Physicochemical Properties
Authors: Wang Ting , Cai Zhao-sheng , Zhang Ting-ting , Li Man , Fang Gui-gan , Zhu Xue-mei 
Published: May 2019

Abstract
A series of novel polymeric nonionic surfactants based on water-soluble N,O-hydroxyethyl chitosan (N,O-HECTS) and dehydroabietyl glycidyl ether (DAGE), DAGE-g-N,O-HECTSs, were synthesized by an additive reaction between N,O-HECTS and DAGE. The structures of DAGE-g-N,O-HECTSs were characterized by FT-IR and 1H NMR. The substitution degree of hydroxyethylation (DSHE) of N,O-HECTS and the grafting degree (DG) of DAGE onto N,O-HECTS for DAGE-g-N,O-HECTSs were determined by elemental analysis. The surface activities of DAGE-g-N,O-HECTSs in aqueous solution were investigated by measuring the surface tension. The experimental results showed that the degree of grafting (DG) of DAGE-gN,O-HECTSs could have a significant impact on their critical micelle concentrations (CMCs) and surface tensions at the CMC (γCMC), but the DG of DAGE-g-N,O-HECTSs had almost no effect on the minimum of surface tensions (γmin). When using the DAGE-g-N,O-HECTSs as emulsifier, the increase in DG had a favorable influence on the stability of an emulsion of water and benzene. At a DG greater than 40.45%, the emulsifying power of DAGE-g-N,O-HECTS exceeded that of Tween-60.
Aircraft Landing Gear Fracture
Authors: Witherell Charles E. 
Published: May 2019

Abstract
The right landing gear on a twin-turboprop transport aircraft collapsed during landing. Preliminary examination indicated that the failure occurred at a steel-to-aluminum (7014) pinned drag-strut connection due to fracture of the lower set of drag-strut attachment lugs at the lower end of the oleo cylinder housing. Two lug fractures that were determined to be the primary fractures were analyzed. Results of various examinations indicated that stress-corrosion cracking associated with the origins of the principal fractures in the connection was the cause of failure. It was recommended that the design be modified to avoid dissimilar metal combinations of high corrosion potential.
Analysis of Wing Main Spar Cracking
Authors: Goldsmith N.T. , Clark G. 
Published: May 2019

Abstract
Following the crash of a Mirage III-0 aircraft (apparently caused by engine failure), a small crack was detected in a bolt hole in the wing main spar (AU4SG aluminum alloy). Because this area was considered to be critical to aircraft safety and similar cracking was found in other spars in service, the Royal Australian Air Force requested that the crack growth rate during service be determined. The loading history of the aircraft was made available in the form of flight by-flight records of the counts from the vertical accelerometer sensors fitted to the airframe and a series of “overstress” events recorded during the life of the aircraft. The bolt hole was examined by eddy current testing, visual examination, high-powered light microscope, and scanning electron microscope. Simulation tests were also conducted. The use of simulation specimens permitted actual crack growth rate data to be determined for the configuration of interest.
Failure of a Helicopter Main Rotor Blade
Authors: Kashar Lawrence 
Published: May 2019

Abstract
A Marine Corps helicopter crash was investigated. Efforts were directed to the failure of one of the main rotor blades that had apparently separated in the air. The apparent failure of a blade integrity monitor (BIM) system was also considered. The rotor blade comprised a long, hollow 6061-T651 aluminum alloy extrusion and 26 fiberglass “pockets” that provided the trailing-edge airfoil shape. Visual examination of the fracture surface of the aluminum extrusion indicated fatigue crack growth followed by ductile overload separation. Examination of the fatigue fracture region revealed several pits that appeared to have acted as fracture origin sites. Time to failure was determined using fracture mechanics. It was concluded that failure was caused by a fatigue crack that grew to critical length without detection. The crack originated at pits that resulted from the use of an improperly designed heating element used to cure fiberglass repairs.
Fatigue Failure of Regenerator Screens in a High-Frequency Stirling Engine
Authors: Moore Thomas J. , Hull David R. , Alger Donald L. 
Published: May 2019

Abstract
An investigation of a Stirling engine after an aborted test run revealed that the regenerator screens had suffered substantial damage. During the run, the individual screens oscillated as the helium working fluid was shuttled through the regenerator. In localized areas, the 41 mu m (1600 mu in.) diam type 304 stainless steel wire screening had been torn and pieces were missing. Scanning electron microscope revealed that the fracture had occurred at wire crossover locations by a fatigue mechanism. The problem was solved by sintering the individual screens into a single unit.
Effect of Strain Rate on the Failure Mode of a Rear Axle
Authors: Kashar Lawrence 
Published: May 2019

Abstract
Following an accident in which a light pickup truck left the road and overturned, one of the rear axles, made of approximately 0.30C steel, was found to be fractured adjacent to the bearing lock nut. A keyway was present in the failed area, as were threads for the lock nut. Fracture surfaces of the failed axle and exemplar fractures obtained from simulation tests were studied using scanning electron microscope. The examination showed that the outer perimeter fracture in the axle was very flat and composed of cleavage and that the interior portion was composed of both cleavage and dimples. No evidence of prior cracking was found. The exemplar specimens from the simulation impact testing failed in a manner consistent with that observed in the axle. The examination confirmed that the failure was a one-time impact overload fracture and not the result of any prior crack in the material, indicating that the axle failure did not initiate the accident.
Fatigue Failure of Welded Truck Cross Members
Authors: Proft Thomas L. 
Published: May 2019

Abstract
Four truck cross members intended for use in heavy-duty transport trucks were investigated. Two of the members had cracked on a prototype vehicle and two had been fatigue tested in the laboratory. The cross members were fabricated from SAE 950X plate and consisted of a formed channel section and an internal fillet-welded diaphragm. Sections from each of the cross members were subjected to a complete analysis, including chemical analysis, magnetic particle testing, mechanical testing, scanning electron microscope/fractography, and metallography. The primary mode of failure was found to be fatigue cracking that initiated at the toes of the fillet welds. Secondary fatigue cracking occurred at the torque rod mounting holes. Failure was attributed to cyclic stresses at the weld toes that exceeded the lowered fatigue strength at this location. A design change that eliminated the fillet welds alleviated the problem.
Failure Analysis of Admiralty Brass Condenser Tubes
Authors: Marden Keneth M. , Lewis Keith R. 
Published: May 2019

Abstract
Inhibited admiralty brass (UNS C44300) condenser tubes used in a natural-gas-fired cogeneration plant failed during testing. Two samples, one from a leaking tube and the other from an on leaking tube, were examined. Chemical analyses were conducted on the tubes and corrosion deposits. Stress-corrosion cracking was shown to have caused the failure. The most probable corrosive was ammonia or an ammonium compound in the presence of oxygen and water. All of the tubes were replaced.
Stress-Corrosion Cracking of Stainless Steel Heat Exchanger Tubes in a Fertilizer Plant
Authors: Perumal K.E. 
Published: May 2019

Abstract
Several type 304L (UNS S30400) stainless steel seamless tubes in a high-pressure synthesis gas cooler condensing ammonia in a fertilizer plant leaked in an unexpectedly short time. Representative samples of the tubes were subjected to chemical analysis, hardness tests, and optical microscopy examination. The tests revealed that the tubes conformed to specification. Crack morphology indicated stress-corrosion cracking by chlorides present in the cooling water. Use of a duplex stainless steel (for example, UNS S32304 S31803) as a tube material was recommended.