bluuebunny/crossref_metadata_2025_split huggingface dataset:
Curved knife "Khukuri" injury in the back and anaesthesia induction in lateral position for thoracotomy
Authors: Subedi A , Tripathi M , Pathak L , Bhattarai B , Koirala R 
Published: September 2018

Penetrating injury in the back with knife (Khukri) demands induction of anaesthesia and intubation in lateral position. In thoracic injury a double lumen tube placement is required to facilitate one lung ventilation during thoracotomy. In emerging situation, we could successfully execute induction of patient in right lateral position using right sided DLT for left thoracotomy. Its correct placement was confirmed by fiberoptic bronchoscopy. In conclusion right-DLT intubation can be performed without difficulty by conventional direct laryngoscopy using Macintosh blade in lateral position.
Keywords: khukuri knife, lateral position, one lung ventilation, thoracic injury.
SURGICAL TREATMENT OF CARCINOMA OESOPHAGUS AT B P KOIRALA MEMORIAL CANCER HOSPITAL, BHARATPUR
Authors: Lamichhane Nirmal , Tan Z B , Neupane P R , Thakur B K , Shrestha B M , Dhakal H P 
Published: September 2018

To review resectability, lymph node status and post-operative complications in cases of carcinoma ofoesophagus treated surgically at B P Koirala memorial cancer hospital (BPKMCH), we reviewed the medicalrecords of 16 surgically treated cases of carcinoma oesophagus from January 2001 to March 2002. Therewere 5 patients in stage IIa and 9 patients in stage III. Tumor was resectable in 14 out of 16 patients (87.5%).There was no perioperative mortality. Anastomotic leak was seen in one case. Out of 14 resected specimens,7 (50%) of them had lymph node metastasis. Oesophagectomy is a safe procedure if done in a well-selected group of patients. Resectability is considerably high with minimal perioperative complications.Key Words: Carcinoma oesophagus, surgical therapy, lymphnode metastasis.
Retroperitoneal Hamartoma: A Rare Entity
Authors: Sigdel G , Karki K , Koirala U , Joshi BD , Dhital SP 
Published: September 2018

Retroperitoneal hamartoma in adult is an extremely rare entity. Here we report a case of 23-years-old lady who presented with alarge retroperitoneal mass and abdominal pain. The mass was surgically removed and the diagnosis of hamartoma was made on histological findings.
Keywords: hamartoma malformative tumor, retroperitoneal.
Plasma Cell Gingivitis: A Case Report
Authors: Lamdari N , Pradhan S 
Published: September 2018

Plasma cell gingivitis is a rare benign condition of the gingiva of unknown etiology characterized by sharply demarcated erythematous and edematous gingiva often extending to the mucogingival junction. This is sometimes considered as a hypersensitive reaction. It presents clinically as a diffuse, erythematous and papillary lesion of the gingiva, which frequently bleeds with minimal trauma. The histological appearance consists of a dense infiltration of normal plasma cells separated by collagenous stroma, usually confined to free and attached gingiva. The lesion can be eliminated by identifying and avoiding the source of the allergen along with nonsurgical periodontal therapy. We report a 29-years-old female patient diagnosed clinically as plasma cell gingivitis and confirmed histologically. The patient gave history of herbal dentifrice for a period of one year. Nonsurgical periodontal therapies along with discontinuation of herbal dentifrice lead to remission of the condition within a month.
Keywords: Herbal dentifrices, non-surgical periodontal therapy, plasma cell gingivitis
Perinatal Mortality At Kathmandu Model Hospital
Authors: Shrestha Sita Ram , Rajbhandari S 
Published: September 2018

Total number of 410 deliveries were performed at Kathmandu Model Hospital (KMH)during 33 months (April 96 -Dec 98 ). Among 410 deliveries 107 (26.09%) cases weredone by Lower Segment Caesarean Section (LSCS), 54 cases (13.37%) by forcepsdelivery, 188 (45.85%) cases normal vaginal delivery with epigiotomy and 61 (14.87%)normal vaginal delivery with or without tear.During this period, 6 twin delivery cases were observed. There were 14 cases of perinataldeaths (still birth -10 and neonatal-death - 4). Hence, perinatal mortality rateduring this peroid in this hospital was 34.15.Perinatal mortality was mostly due to severe prematurity, birth asphyxia, ante-partumhaemorrhage (APH), intrauterine growth retardation (IUGR), congenital abnormalitiesand sepsis.KEY WORDS: Neonatal death, Still birth, Perinatal mortality, Antepartum haemorrhage (APH), Sepsis.
CORONARY ARTERY DISEASE : AN EMERGING EPIDEMIC IN NEPAL
Authors: Maskey Arun , Sayami A , Pandey M R 
Published: September 2018

ABSTRACTCardiovascular disease is the commonest cause of death globally and is the major contributor to the burdenof premature mortality and morbidity. Coronary artery disease ( CAD) is greatest killer of mankind. Coronaryartery disease in western industrialized countries show a declining trend. However developing countrieshave shown an alarming increase. The identification of major risk factors and effective control of themthrough population based strategies of prevention were mainly responsible for this decline.A few cases ofacute myocardial infarction were seen in Kathmandu ,Nepal in 1950 and in the sixties the incidence startedrising rapidly. In a study between 1960-1968 a total of 150 cases were reported with myocardial infarctionin Kathmandu , Nepal. Although national datas for incidence and prevalence on CAD in Nepal is notavailable, hospital based datas on admission pattern in different hospitals of Kathmandu, capital city ofNepal show 40 fold increase in incidence of acute myocardial infarction (AMI) in last 30 years. Prevalenceof coronary artery disease (CAD) estimated from these figures of AMI cases indicate that 5 % of adultpopulation in Kathmandu suffer from CAD. Hence, Coronary artery disease is emerging as epidemic in Kathmandu, Nepal.Key Words: Coronary artery disease (CAD), acute myocardial infarction (AMI), Epidemic.
Time for an Undergraduate Curriculum in General Practice for Nepal
Authors: Butterworth K , Pradhan R 
Published: September 2018

Introduction: This is a qualitative study, to generate a framework for a core curriculum in General Practice in the undergraduate setting, designed specifically for Nepal.
Methods:
A Delphi process was used to involve representatives from the GP faculty in Institute of Medicine, BP Koirala institute BPKIHS, Patan Hospital/National Academy Medical Sciences and Tansen mission hospital. The Delphi involves getting input from an identified group of experts and progressively feeding back the results from each round of enquiry so that subsequent views are influenced until a point of convergence is reached. In effect the Delphi not only analyses problems and identifies solutions, but can begin the process of commitment to change.
Results:
A prioritized list of the key outcomes for an undergraduate GP curriculum was developed and a broad list of knowledge, skills and attitudes were defined. A balance was observed between the need to train doctors who are skilled in communication, who have compassion for their patients, who are also required to be excellent rational clinicians able to respond to emergency situations. There was also the need for doctors to be competent not just in individual clinical care, but in the care of communities.
Conclusions:
General Practice, as a core component of primary care, should be an obligatory part of every undergraduate medical curriculum. This Delphi process has produced an important framework for a national undergraduate curriculum in General Practice, designed specifically for Nepal.
Keywords: curriculum; delphi technique; education medical undergraduate; family practice; needs assessment
T-tube vs Primary Common Bile Duct Closure
Authors: Joshi M R , Singh DR 
Published: September 2018

INTRODUCTION:

Closure of the common bile duct over T-tube after exploration is a widely practiced traditional method. However, its use may give rise to many complications. We do primary closure of common bile duct after exploration. Aim of the study is to see the efficacy and safety of the primary closure.
METHODS:
Study was carried out to compare the results of both the techniques from 2006 to 2009 in the cases proven to have common bile duct stone with or without the features of obstructive jaundice. Post operative hospital stay and morbidities related to both the groups were recorded and analyzed.
RESULTS:
There were total 71 cases included in the study. Thirty one in T-tube group and 40 in primary closure group. T-tube was removed in most of the cases after three weeks where as average time of drain removal in primary closure group is 5.79 +/-1.79 days. Incidence of retained stone was equal in each group. Major complication in T-tube group is biliary peritonitis in four patients at the time of T-tube removal whereas none of the patient from primary closure group suffered from such major complication.
CONCLUSIONS:
Primary closure after the common bile duct exploration is safe and it helps to avoid the morbidities related to T-tube.
Keywords: Choledocholithiasis, Primary closure, retained stone, T-tube, Ureterorenoscope.
Need of Improvement in Timing of Prophylactic Antibiotic in Elective Surgery
Authors: Shah Jay N , Maharjan SB , Piya R , Shrestha A , Shrestha K , Bashnet NB , Gurung HM 
Published: September 2018

INTRODUCTION:

Infections in surgery are major concern of morbidity, mortality, and costs. Timely antibiotic prophylaxis before incision ensures optimum concentration of AP in blood and tissues to prevent surgical site infections . However, proper timing of AP remains problematic as reported by various studies, though none so far from Nepal. Aim of this prospective observational study was to assess and address the issues for improvements in timing of AP.
METHODS:
The pattern of antibiotic prophylaxis were prospectively collected in respect to time of induction, and incision time were recorded on predesigned 'AP form'. The study included all the elective major cases who received AP of intravenous Cefazoline 1 g as per our existing protocol. The emergency surgeries and obstetric cases were excluded from the study.
RESULTS:
There were 125 cases of which 89% received AP before incision (63% within 5 minutes before incision), while 11% had AP after the incision and 1% within the recommended time period of 2 hour to 30 minutes before incision.
CONCLUSIONS:
Current practice of antibiotic prophylaxis (AP) needs improvement as per standard guidelines of AP within 2 hour to 30 before incision.
Keywords: antibiotic, infection, prophylaxis, surgery.
In-vitro Activity of Three Brands of Ceftriaxone against different Clinical Isolates
Authors: Thapa B , Mahat K 
Published: September 2018

INTRODUCTION:

Ceftriaxone is an extended spectrum cephalosporin that has been used for decades for combating infections caused by wide array of pathogens and prescription of antibiotic is in favor of specific brands without realizing the potency of the brand. The in-vitro activity of three brands of ceftriaxone and various antibiotics against clinical isolates is studied.
METHODS:
This comparative study was carried in Kathmandu Medical College Teaching Hospital (KMCTH), Basic Science Complex, Duwakot, Bhaktapur in 2009. Thirteen clinical isolates isolated from the specimens processed in the Microbiology Laboratory at KMCTH were used. Minimum inhibitory concentration (MIC) of three brands of ceftriaxone (A, B, and C) was determined by agar dilution and antibiotic resistance patterns were deduced by disc diffusion test.
RESULTS:
MIC for three brands of ceftriaxone ranged from < 0.25 to > 256 mg/L. The MIC for brands A and C of ceftriaxone were consistent for all isolates while for brand B, MIC was higher by at least two fold suggesting this brand had less in-vitro activity against isolates tested. All isolates were multi-drug resistant. Ceftriaxone resistant isolates (n = 6) were simultaneously resistant to various antibiotics tested. Imipenem and amino glycosides were sensitive to the isolates studied.
CONCLUSIONS:
Different brands of ceftriaxone are available in Nepal and imprudent use of less potent antibiotics should be controlled to stop the emergence and spread of multi-drug resistant pathogens and to prevent undue economic burden to the patient and the country.
Keywords: agar dilution, ceftriaxone brands, multi-drug resistant.
Fracture Union in Closed Interlocking Nail in Femoral Fracture
Authors: Sahu R L , Sikdar J 
Published: September 2018

INTRODUCTION:

Fractures shaft femur is a major cause of morbidity and mortality in patients with lower extremity injuries. The objective of this study was to find out the outcome of Interlocking nail in fracture femur.
METHODS:
This study was conducted in the Department of Orthopaedic surgery in M. M. Medical College from July 2006 to November 2008. Seventy eight patients were recruited from Emergency and out patient department having closed fracture of femoral shaft. All patients were operated under general or spinal anesthesia. All patients were followed for nine months.
RESULTS:
Out of seventy eight patients, sixty nine patients underwent union in 90 to 150 days with a mean of 110.68 days. Touch down weight bearing was started on 2nd post-operative day. Complications found in four patients who had non-union, and five patients had delayed union which was treated with dynamization and bone graft. The results were excellent in 88.46% and good in 6.41% patients.
CONCLUSIONS:
We concluded that this technique is advantageous because of early mobilization (early weight bearing), less complication with good results and is economical.
Keywords: close reamed interlocking nail, dynamization, femoral shaft fractures, union
Antibiotic Susceptibility Patterns of Vibrio cholerae isolates
Authors: Shrestha S D , Malla S , Adhikari BR , Shakya G , Basnyat SR , Sharma S 
Published: September 2018

INTRODUCTION:

Cholera is one of the most common diarrhoeal diseases in Nepal. Etiological agent of cholera is Vibrio cholerae which removes essential body fluids, salts and vital nutrients, which are necessary for life causing dehydration and malnutrition. Emerging antimicrobial resistant is common. The aim of the present study was to determine the antibiotic susceptibility pattern of cholera patients in Nepal.
METHODS:
All the laboratory works were conducted in the bacteriology section of National Public Health Laboratory, Teku from March to September 2005. During this period a total of 340 stool samples from diarrhoeal patients were collected and processed according to the standard laboratory methods. Each patient suffering from diarrhoea was directly interviewed for his or her clinical history during sample collection.
RESULTS:
A total of 340 stool samples were processed and studied from both sex including all ages of patients. Among the processed sample 53 Vibrio cholerae cases were found. All isolated Vibrio cholerae O1 were El Tor, Inaba. All isolated (100%) Vibrio cholerae O1 were sensitive to Ampicillin, Ciprofloxacin, Erythromycin and Tetracycline whereas all were resistant to Nalidixic acid and Cotrimoxazole. Only 15.1% cases were sensitive to Furazolidone whereas 84.9% were resistant.
CONCLUSION:
All V. cholerae strains isolated in this study were found resistant to Multi Drug Resistant (resistant to at least two antibiotics of different group). Ampicillin, Ciprofloxacin, Erythromycin and Tetracycline were found still more potent antibiotics against Vibrio cholerae isolated during the study.
Keywords: antibiotics, susceptibility, Vibrio cholera.
Eating Disorder Recovery: Fostering an Inclusive Culture
Authors: Henley Emmy L , Monsour Diana L 
Published: September 2018

Eating disorder (ED) recovery is often difficult to define, which may leave those offering recovery support feeling lost and discouraged when determining ED services in their Collegiate Recovery Program (CRP). Although CRPs primarily support substance use disorders (SUD), research demonstrates 35% with a SUD recovery report also having an ED, thus making it imperative that CRPs understand and consider means for an ED supportive culture. Providing information to staff of CRPs on the state of ED recovery research and how to incorporate strategies for support, despite the size, tenure, or financial status of a CRP, is important for inclusion. Texas Tech offered their experience in their CRP and the evolution of ED support and culture within.
Social Justice, Diversity & Inclusion Keynote: Are We There Yet? Gender Equity in Recovery Settings
Authors: Austin Amy B , Flood Becky , Castedo Sierra , Hufnagel Mariel , Eisenhart Emily , Avila Mercedes 
Published: September 2018

Gender equity in recovery settings is the first topic we will tackle. Women represent just over 57% of the undergraduate college population in 2015 and are projected to climb to 58.8% of the total college population by 2024. While not as underrepresented as people of color in collegiate recovery programs (CRPs), women do make up a smaller share of CRP participants at 42.8%. While women are just as likely as men to become develop SUDs, they have lower rates of substance use and SUDs overall, and experience unique obstacles to treatment. Women of color may face additional obstacles and are at greater risk of being subjected to violence. We invite men, women, and transfolk alike to join our feminist recovery panel as we delve into issues of equity and inclusion. While some have deemed feminism, "the other "F" word, we will talk about how feminism benefits everyone. We bring an intersectional lens - realizing that no one shows up or experiences life through one aspect of identity. Our panelists will share from research, personal experience, and program data in order to describe how current societal structures inhibit the opportunities for women to get sober and work a program of recovery and the negative impact on men, collegiate recovery programs, higher education, and society as a whole. Considering an individual, group, and institutional framework for feminism, we hope to inspire attendees to challenge themselves to bring a feminist lens to their work to better create equity and access within collegiate recovery.
Sanility intrustion in Sai Gon-Dong Nai river system under the effects of the tides and sea level rising in Vung Tau estuary – East Sea, South of Vietnam
Authors: Ho Thong Chi , Dau Ngo Van , Tran Oanh Thi Phi 
Published: September 2018

A mathematical model was used by the authors (software developed by Dr. F28 Le Song Giang) to study the change of the salt boundary river systems Saigon - Dong Nai under the effect of sea level rise in the different cases for Ho Chi Minh City, taking into account the change of amplitude and phase shift of the South China Sea tide.
Results of the study indicated that:
1. There is a pretty good resemblance between model running results and results of water levels measurement. Salinity, calculated results have a larger amplitude slightly from measured data but this difference and oscillation phase can be acceptable.
2. Salinity 1 g / l - 3 g / l is increasingly encroaching into the infield under the sea level rise scenarios. Salt accounts is greater than 5 g / l and the margin of 10-15 g / l is also approaching deeply, so the future of Ho Chi Minh City will face to some water supply problems.
3. Saline in basin downstream Saigon - Dong Nai river is quite sensitive to the hydrological regime of the river, therefore, domestic regulation of irrigation reservoirs upstream can be used to push salt and improve salinity regime in the downstream part of the river
The tectonic evolution and new exploration results onhydrocarbon potential, cased study in the NE-Eastern part, Cuu Long basin,Vietnam continental shelf
Authors: Tran Huy Nhu , Tran Xuan Van , Ngo San Thuong , Tran Huong Thi Mai 
Published: September 2018

New exploration results proved the presence of Tertiary sedimentary basins with hydrocarbon potential in the boundaries of Vietnam continental shelf. These basins were perhaps formed in the Early Oligocene on the Mesozoic basement of continental crust and were filled with mainly deltaic clastic sediments. Since very early Miocene these basins have linked together and extended wider. Sediments of marine and prograding delta facies accumulated and widespreaded on the whole continental shelf. At the Middle Miocene to present-day the opening of the Bien Dong Sea (Vietnam East Sea), the regional tectonic subsidence and the eustatic fluctuation had created sedimentary formations of open and deep marine facies with turbidite shale, platform carbonate including reef build-up. Andesite and basalt extrusion occurred in form of dykes resulting from tectonic inversions in Late Oligocene, in the beginning of Middle Miocene, particularly in Late Miocene-Pliocene.
These Tertiary sedimentary basins are expected to have hydrocarbon potential and need to be investigated and explored adequately. The main risk is the drilling technology, the exploitation in the deep sea and high investment cost.
The recently exploration results in illustrated a better potential in Lower Oligocene reservoir in South East margin of Cuu Long basin and many new signs. These signs need to be highlight researched for predicting accumulation distribution in study area, in purpose of oil and gas exploration for next stages.
Hypercalcemia and cancer: Differential diagnosis and treatment
Authors: Zagzag Jonathan , Hu Mimi I. , Fisher Sarah B. , Perrier Nancy D. 
Published: September 2018

AbstractIncidentally detected hypercalcemia usually presents in an indolent manner and is most likely caused by primary hyperparathyroidism. In contrast, hypercalcemia in the patient with a history of cancer presents in a wide range of clinical settings and may be severe enough to warrant hospitalization. This form of hypercalcemia is usually secondary to hypercalcemia of malignancy and can be fatal. Hypercalcemia of malignancy is most commonly mediated by tumoral production of parathyroid hormone–related protein or by cytokines activating osteoclast degradation of bone. The initial workup, differential diagnoses, confirmatory laboratory testing, imaging, and medical and surgical management of hypercalcemia are described in the patient with cancer.
Les enfants et leurs monstres : traumatisme infantile et analyse transactionnelle
Authors: Morena Stefano , Blondel Agnès 
Published: September 2018

Cet article propose des réflexions sur la manière de travailler avec des enfants qui apportent leurs monstres en thérapie grâce au jeu, au dessin et au récit (D.M Poda, 2011). L’auteur s’appuie sur les théories d’analyse transactionnelle du traumatisme (P. Clarkson, 1990 ; J. Stuthridge, 2006) et du scénario pour conceptualiser ce qu’il pourrait se passer pour ces enfants au niveau de l’état du moi structural. En insistant sur l’importance de la relation thérapeutique, il décrit une approche visant à restructurer les états du moi en utilisant le transfert, les contrats, les opérations thérapeutiques d’É. Berne et l’autoparentage. Des exemples de cas montrent comment conceptualiser la relation qu’entretient l’enfant avec son ou ses monstres, comment le thérapeute peut les rencontrer et comment les apprivoiser.
La construction d’un outil de contrôle de gestion innovant dans l’économie sociale et solidaire : le cas de la fondation Apprentis d’Auteuil
Authors: Bollinger Raedersdorf Sophie 
Published: September 2018

Dans le secteur de l’économie sociale et solidaire, les structures se professionnalisent et la concurrence s’intensifie. Une nécessité de pilotage apparaît. Toutefois, les outils des organisations capitalistiques ne sont pas adaptés à ces structures lorsqu’ils sont directement répliqués dans ce secteur. Des tensions existent entre pilotage et objectifs sociaux et solidaires. Cet article propose de solliciter la théorie de l’attention pour réconcilier deux logiques qui semblent différentes et construire un outil innovant qui soit pertinent à ce secteur, accepté et utilisé par les acteurs au sein des organisations. CODES JEL : M40