bluuebunny/crossref_metadata_2025_split huggingface dataset:
Awareness of Infection Control among Dental Students and Interns
Authors: Ghimire Barsha , Chandra Suresh 
Published: September 2018

Introduction: Disease transmission can occur through direct contact, blood, oral fluids, or other secretions and indirect contact with contaminated instruments, operatory equipment, or objects. Prevention of cross contamination helps in reducing the infection. The level of education of the students, and their knowledge about the infection control directly relates to the patient care. The current study aims to determine the level of knowledge and infection control procedures among dental students in a clihnical practice.
Methods: This was a cross-sectional study with a self-administered questionnaire comprised of 18 open and close-ended questions related to infection control and prevention. Answers of the questions were analysed by SPSS version 20.
Results: Among the students included, 53 (36.8%) participants were intern, 31 (21.5%) from fifth year, 31 (21.5) from fourth year and 29 (20.1) were third year. Performance satisfaction shows that the students were fairly satisfied with their performance. When students were asked to rate the implementation of infection control policy in their clinical practice 1 (0.7%) were very good, 74 (51.4%) were fair, 44 (30.6%) were good are while 25 (17.4%) were poor to implement infection control policy in their practice.
Conclusions: The level of knowledge and practice of infection control measures was poor among dental students. The attitude towards infections control measures was positive, but a greater compliance was needed. Formal class and examination may help improve knowledge and clinical practices.
Autonomic Influence on Heart Rate for Deep Breathing and Valsalva Maneuver in Healthy Subjects
Authors: Jha Reena Kumari , Acharya Amrita , Nepal Ojashwi 
Published: September 2018

Introduction: The Autonomic nervous system is responsible for regulation and integration of visceral functions. Disturbance of autonomic nervous system play crucial role in pathogenesis and clinical course of many diseases. In the present study deep breathing test and valsalva maneuver have been described to monitor parasympathetic function genderwise.
Methods: A cross-sectional study was conducted among 100 subjects, aged 18-25 years, from May to November 2017, in exercise physiology laboratory, Kathmandu University School of Medical Sciences, Chaukot, Kavre. Electrocardiograph recorded by AD instrument was used to calculate the resting heart rate and the heart rate response to deep breathing test and valsalva maneuver.
Results: Heart rate response to deep breathing test (31.69±14.79 Vs. 36.08±18.65, P=0.195) and valsalva ratio (1.59±0.39 Vs. 1.69±0.54, P=0.314) tend to be higher in female than male subjects but not significant. The resting heart rate of females was significantly higher than that of males (84.37 ± 11.08 Vs. 78.43 ± 12.06, P<0.05). Heart rate was significantly increased during and decreased after valsalva maneuver in both male and female subjects.
Conclusions: This study concludes that both deep breathing test and valsalva maneuver activates parasympathetic system inhealthy subjects. And also dominant parasympathetic activity was found in female comparison to male subjects.
Acoustic Analysis of Voice in School Teachers
Authors: Mahato Nain Bahadur , Bista Meera , Regmi Deepak , Sherpa Pema 
Published: September 2018

Introduction: The term ‘voice' is the acoustic energy generated from the vocal tract that are characterized by their dependence on vocal fold vibratory pattern. Teachers as professional voice users are afflicted with dysphonia and are discouraged with their jobs and seek alternative employment. Loud speaking and voice straining may lead to vocal fatigue and vocal fold tissue damage.
Methods: Sixty teachers from various schools, volunteered to participate in this study. Acoustic analysis Doctor Speech Tiger Electronics, USA was used to assess the voice quality of the school teachers before and after teaching practice. The data were collected and analyzed using Doctor Speech Tiger Electronics, USA. Analysis was performed in terms of perturbation (jitter and shimmer), fundamental frequency, harmonic to noise ratio and maximum phonation time.
Results: We found statistically significant difference in all the four parameters except the Jitter value. The fundamental frequency and shimmer value has significantly increased (P<0.001) and (P=0.002) respectively after teaching practice. Unlikely, there was significant decrease in harmonic to noise ratio value (P<0.001) and maximum phonation time value (P<0.01) after teaching practice.
Conclusions: Vocal abuse, overuse, or misuse in teaching practice over a long period of time can result in inadequate phonatory pattern due to vocal fold tissue damage, which ultimately results in vocal nodules or polyps. So voice evaluation is particularly important for professional voice users and for the people who are concerned about their quality of voice.
Health Problems while Working as a Volunteer or Humanitarian Aid Worker in Post-Earthquake Nepal
Authors: Bhandari Durga , Pandey Prativa 
Published: September 2018

Introduction: Volunteers and humanitarian aid workers working in disaster struck areas of the world are a vulnerable group of travelers. Nepal saw an influx of these humanitarian aid workers following earthquakes in April and May 2015.
Methods: This was a descriptive cross-sectional study conducted at CIWEC Hospital located in Kathmandu. A questionnaire was given to all volunteers and aid workers who arrived at the hospital for evaluation of health related problems and agreed to be part of the study.
Results: Ninety-five volunteers were enrolled in the study. Among these, 65 (68%) were female and 30 (32%) were male. The immunizations received before travel were Hepatitis A 82 (86%), Hepatitis B 82 (86%), Typhoid 70 (73%), Rabies 38 (40%), Japanese Encephalitis 34 (36%), Influenza within last one year 23 (24%), measles 48 (51%), Cholera 34 (36%),Tetanus within 10 years 71 (75%) and Varicella 38 (40%). Forty-four (45%) of travelers carried medication for treatment of Traveler’s Diarrhea (TD) which included Ciprofloxacin, Azithromycin, Loperamide and others like Metronidazole and Charcoal. The common illnesses encountered were gastrointestinal, skin problems , injury and musculoskeletal problems, respiratory problems, genitourinary problems, cardiovascular, psychological problems, syncope, and miscellaneous.
Conclusions: Traveler’s Diarrhea and dermatological problems were the most common health related problems. Volunteers were not properly prepared for self-treatment and pre-travel preparation was sub-optimal. Important pre travel health advice will decrease the incidence of health problems in this group.
Cervical Cancer Awareness and Practice of Pap Smear Test Among Women with Gynecological Problems
Authors: Thapa Meena 
Published: September 2018

Introduction: Cervical cancer is the most common cancer in women in Nepal. Pap smear test is the most important screening test for cervical cancer, which helps in reducing mortality from it. This study is to assess the knowledge of cancer cervix and practice of Pap smear test and to analyze the impact of educational status on them.
Methods: This was a descriptive cross-sectional study, carried out among the married women who attended the Out Patient Department for gynecological problems at Kathmandu Medical College. Structured questionnaires were used to collect the data. The questionnaire consisted of three sections which included the demographic profile in first part , second part included assessment of the knowledge of cancer cervix, and third part included evaluation of the utilization of Pap smear test.
Results: A total of 205 married women were included in the study. Out of them, 74% were aware of cancer cervix. Only 39% of women were aware of Pap smear test. Pap smear test coverage was 16.6% in studied population. Main reason of not doing Pap smear test was lack of knowledge of the test. High educational status of the women had significant positive impact on knowledge of cancer cervix and practice of Pap smear test.
Conclusions: The knowledge of cancer cervix was good in our women, but knowledge and the practice of Pap smear test was poor. Good educational status of the women was found to influence the on knowledge of cancer cervix and uptake of Pap smear test.
Need of the Regulation for Profit Percentage Investment by Pharmaceutical Companies in New Drug Discovery Research from the Various Local Traditional Medicinal and Plant Systems
Authors: Bhattarai M D 
Published: September 2018

In the modern medical systems the active pharmacological ingredients, effective against any disease is identified, purified and studied for its various effects and side-effects whereas it is not so in the traditional systems. Therefore, it is not surprising that safety concerns have often been raised about the traditional medical products. The major issue now, is to make appropriate situation with basic supports to bring all the available experts and resources together for the identification, purification, and study of efficacy and safety of the active molecules of the popular traditional medicines.
Government and public sectors in the countries with such rich traditional medicinal and plant systems have related experts, but they also have much hurdle regarding recruitment and retention of expert human resources, getting fund, purchase and maintenance of equipment, bureaucratic formalities and others. The pharmaceutical companies have basic laboratories with related infrastructure and human resources as well as interest about bringing the drug molecules. To bridge the gap, there is a need of the regulation which will make the pharmaceutical companies to invest certain percentage of their profit in the field of research to identify new drug molecules and to study their effects. It is just not an issue of discovering the active molecule but also of creating the concept and culture of research, purity and quality of drugs, safety of people, and future direction of the human society.
Keywords: drug development; investments; medicinal plants; pharmaceuticals; public-private participation;research; traditional medicine.
Lemierre's Syndrome in a Patient with Severe Lupus Nephritis
Authors: Paudyal B P 
Published: September 2018

Lemierre’s syndrome is a rare septic thrombophlebitis of the internal jugular vein with frequent metastatic complications following an acute oropharyngeal infection. Immunocompromised patients are at higher risk of developing this syndrome owing to the decreased host response and increased risk of oropharyngeal sepsis. We herein report a 24-year-old woman with severe lupus nephritis on immunosuppressive therapy, who developed Lemierre’s syndrome following a pharyngeal infection despite an adequate and timely antibiotic therapy. We hereby draw an attention to the importance of accurate and timely diagnosis and appropriate management of Lemierre’s syndrome in immunocompromised patients so as to achieve a successful prognosis for this deadly infection.
Keywords: Lemierre’s syndrome, lupus nephritis, immunocompromised state
Blood Pressure in Inhabitants of High Altitude of Western Nepal
Authors: Shrestha S , Shrestha A , Shrestha S , Bhattarai D 
Published: September 2018

Introduction: Studies conducted amongst the inhabitants of high altitude suggested that systolic and diastolic blood pressures are lower in the high than in low altitude population. So a study was designed to look at the blood pressure values among permanent residents of high altitudes of rural Western Nepal.
Methods: This is a descriptive cross sectional study conducted at two different altitudes (2670 and 2950 meters) of Humla District, Nepal, looking at the blood pressure values among the permanent inhabitants at these altitudes.
Results: Total number of 137 subjects with 73 (53.3%) from 2950 meters and 64 (46.7%) from 2670 meters altitude were enrolled. Mean age of the study population was 35.29 years. Male were 57 (41.6%) and female 80 (58.4%). The difference in systolic blood pressures (118.59 and 114.66 mmHg, P=0.01) and mean arterial pressures (92.0 and 89.5 mmHg, P=0.02) at the altitudes of 2670 and 2950 meters were statistically significant whereas the difference in diastolic BP at these altitudes were not statistically significant. There was no significant correlation of BMI with blood pressure values and no difference was noted in the blood pressure values among the two different ethnic groups at the given altitudes.
Conclusions: Lower rate of hypertension was observed among the inhabitants of high altitude of rural western Nepal. Blood pressure was found to decreases with increase in altitude among permanent inhabitants of high altitude.
Keywords: altitude; blood pressure; high altitude inhabitants; hypertension; physiological change.
Family Planning Knowledge and Practices among Women in a District Hospital of Nepal
Authors: Gupta S , Singh A , Gupta N , Shrestha V L 
Published: September 2018

Introduction: Family planning services have the potential to improve the quality of the lives of people. The study was done to assess the family planning practice and methods among the married women of reproductive age attending female clinic of district hospital of Nepal.
Methods: This is a cross sectional descriptive study carried out from October 2011 till December 2011 at Lamjung district hospital. One hundred randomly selected married women of 15-49 years, who had at least one child were the subjects of the study. A structured questionnaire on knowledge, practice and methods of use of contraception was composed and fi lled up.
Results: The results were encouraging with 94 (94%) of participants having knowledge about contraception. The study showed that 32 (32%) of the married women belonged to 20-24 years of age group. Among them 64 (68%) were using modern contraception methods. Injectables hormonal contraceptives were most commonly practiced by 34 (54%) women. Among not using any contraceptives, 18 (60%) of them said their husband being abroad.
Conclusions: Family planning knowledge and practice among the rural women utilizing the service was appreciable. Temporary method of contraception was most commonly practiced.
Keywords: district hospital; knowledge; practice, family planning.
Surgical Management of Cervical Spondylotic Myelopathy
Authors: Sah S , Wang L , Dahal M , Acharya P , Dwivedi R 
Published: September 2018

Introduction: The surgical procedure by the anterior, posterior and combined antero-posterior approaches had applied for the treatment of cervical spondylotic myelopathy.
Methods: During the treatment process, all patients were pre-operatively as well post-operatively graded according to Japanese Orthopaedics Association. Several surgical methods such as anterior approach, posterior approach, and combined antero-posterior approach have been addressed for CSM patients, with the choice based on the pathogenesis of the myelopathy. The main indications for surgery were evidence of myelopathy on physical examinations, a JOA score below 13 points help with spinal cord compression observed on plain X-ray, CT scan, MRI studies.
Results: The pre-operative JOA scores were 7.60±1.23 in laminoplasty, 8.30±1.03 in diskectomy and corpectomy and 7.10±1.20 in combined antero-posterior approach patients. At the follow-up after three months the JOA scores were laminoplasty 13.30±1.30, diskectomy and corpectomy 13.55±1.15 and combined antero-posterior 13.50±1.08. The JOA recovery rate averaged, 61.08±11.25% in laminoplasty, 60.67±10.60% in diskectomy and corpectomy and 64.67±10.72% in combined anteroposterior approach. The high- signal intensity changed to normal in 18 out of 28 and no any kyphotic change and instability were found in cervical spine at the follow up.
Conclusions: Patients with OPLL (continuous, segmental and mixed type), stenosis of cervical spinal canal, multilevel cervical spondylosis, large and high ossification of IVDP with stenosis were improved with laminoplasty. Patients with PIVD, CSM with kyphosis, post laminectomy , OPLL herniated type, unstable vertebral alignment, stenosis by osteophytes, were improved with anterior approach . Ossified or deformed OPLL, unstable vertebral with stenosis ,OPLL or OYL with cervical meandearing (swan-neck) were improved with Combined anterior and posterior approach.
Keywords: cervical spondylotic mylopathy, anterior cervical diskectomy and fusion, corpectomy.
Extraventricular Neurocytoma
Authors: Karki B , Tamrakar K , Kai Xu Yi , Kui Wu Yuan , Wei Zhang Wei 
Published: September 2018

Extraventricular neurocytoma (EVN) is a rare neuroepithelial tumor. Its propensity to occur in cerebral hemisphere is much higher. EVN has a histological resemblance to central neurocytoma but radiologically, it is more complex. Ganglionic differentiation is more common in EVN and tends to have more of a cystic component. Calcification is frequent but hemorrhage is only an occasional finding. Although it has been reported to occur in various regions, the propensity to occur in cerebral hemisphere is much higher. Herein, we report two cases which presented as a mass in the right frontal lobe and right parietal lobe. MRI showed hypointesity on T1, hyperintesity on T2-weighted images with moderate enhancement after contast injection. In short extraventricular neurocytoma should be considered indifferential diagnosis of complex intracranial masses.
Keywords: central neurocytoma; computed tomography; xtraventricular neurocytoma; MagneticResonance Imaging.
A Diagnostic Dilemma of Cryptogenic Organising Pneumonia
Authors: Gurung K 
Published: September 2018

Cryptogenic Organising Pneumonia is a rare lung condition, which has incidence of 6-9 cases per 1000,000 people with onset at age group between 50-60. The pathogenesis of this condition remains unknown. It mimics like pneumonia but has a good outcome with steroid treatment. Early recognition is very important and treatment with steroid therapy can save lives. This case highlights the unusual cause of shortness of breath due to COP and co existing incidental severe AS where we faced a diagnostic dilemma till lung biopsy was performed.
Keywords: Cryptogenic organising pneumonia; Pneumonia.
Lambda Light Chain Myeloma with Oliguric Cast Nephropathy and Remission with Bortezomib, Doxorubicin and Dexamethasone
Authors: Hada R , Poudyal B , Sharma A , Khatri R 
Published: September 2018

Cast nephropathy is one of the major causes of renal failure in patients with multiple myeloma resulting from precipitation of free light chains inside the tubules. Timely diagnosis and treatment confers a better prognosis though around 10% of patients with cast nephropathy remain dialysis dependent in spite of treatment.We report the clinical course and outcome of a patient presenting with acute kidney injury and oliguria, preceded by acute gastroenteritis and intake of Chinese medications and dialysis dependent state for eight weeks. Kidney biopsy revealed cast nephropathy with lambda light chain restriction and severe tubular injury. Serum protein electrophoresis was normal with no “M spike” but serum free light chain ratio was altered with very high lambda and normal kappa light chain levels. Bone marrow biopsy showed >85% atypical plasma cells. Haemodialysis was continued and chemotherapy with bortezomib, doxorubicin and dexamethasone was started. Kidney function gradually improved with discontinuation of dialysis after 1 month and complete remission of acute kidney injury and myeloma in 4 months of chemotherapy.
Keywords: acute kidney injury; bortezomib; cast nephropathy; multiple myeloma.
Subcutaneous Emphysema in Pregnancy
Authors: Shrestha A , Acharya S 
Published: September 2018

Spontaneous pneumomediastinum and subcutaneous emphysema are rare complications of labor, especially in the late pregnancy period, but they are usually self-limiting. Management includes avoidance of exacerbative factors and close observation with supportive treatment. A 19-year-old primi gravida at 36 weeks pregnancy presented with swelling over the right side of the face, neck and chest. Her general examination was normal. Systemic examination revealed swelling with palpatory crepitation over the right side of chest, neck and face, and other examination findings were normal. Chest X-ray revealed subcutaneous emphysema without pneumothorax. The patient left hospital against medical advice.
Keywords: Pregnancy; subcutaneous emphysema; pneumomediastinum.
Impact and Determinants of Gender Preference in Duhavi VDC of Eastern Nepal
Authors: Uprety S , Jha N , Poudel IS , Pokharel Pk , Poudel M , Niraula SR 
Published: September 2018

Introduction: Gender equality has been a priority area of demographic research. One of the major reasons for high fertility and low acceptance of family planning is the prevalence of gender preference among couples. The objectives of this study were to identify the determinants and examine the extent of gender preference on fertility.
Methods: This is a cross-sectional study carried from June 2008 to July 2009 in Duhavi VDC of Sunsari district of Nepal. Three hundred and fi ve randomly selected ever-married women of 15 - 49 years, who had at least one child were the subjects of the study. A questionnaire covering the areas on gender and fertility preference and methods and use of contraception was given and fi lled up.
Results: The study showed that 42.6 % of the ever-married women belonged to the 25 - 29 years age group. Around 92 % of women whose last child was a male were using family planning methods whereas only 40 % of women whose last child was a female were using family planning methods. This difference was statistically signifi cant (P < 0.0001).
Conclusions: The contraception use among the women having a female child was low, showing a desire for a male child which is one of the factors in the increase of family size in our society. Due to the patrilineal society, women are discouraged in the practice of contraception. Effective intervention programs need to be planned and conducted to rectify this situation.
Keywords: Determinants, Duhavi VDC, gender preference, impact, Nepal.
Medical negligence- Meaning and Scope in India
Authors: Kumar L , Bastia BK 
Published: September 2018

It is a principle recognized by our as well as by other legal systems that ignorance of the law is no excuse for violating it. The rule is also expressed in the form of a legal presumption that everyone knows the law. It is the duty of every man to know that part of it which concerns him. A doctor, in particular, is conclusively presumed to know the law, and is dealt with as if he did know it, because in general he can and ought to know it. In the matter of professional liability, the medical profession differs from other occupations for the reason that the former operates in spheres where success cannot be achieved in every case and very often success or failure depends upon factors beyond a medical man’s control. Due to the increasing awareness of the rights of a patient in present day society, a medical man has become more vulnerable to being sued by a litigation suit of any kind, civil or criminal. The basis of a medical negligence suit is still alien to the majority of the practicing doctors in our country. Hence, the present article aims at discussing the various aspects of negligence, like the meaning and types of negligence, and the concept of duty of care, degree of care, and standard.
Keywords: degree of care, duty of care, medical negligence, standard of care.