bluuebunny/crossref_metadata_2025_split huggingface dataset:
Trend of utilization of Safe Motherhood Services in rural Nepal
Authors: Dangal Binod , Kalaunee Shankar Prasad , Upreti Arun , Khadka Shyam , Khati Karuna , Lamichhane Reena , Khadka Himshail , Thapa Roshan Kumar 
Published: March 2023

Introduction: The government of Nepal has implemented Safe Motherhood programs throughout the country to decrease the perinatal morbidity and mortality. Safe motherhood service includes normal vaginal delivery, Caesarian Section (CS) and perinatal management. CS rates are a major public concern. Currently 18.6% of all births occur by CS, ranging from 6 to 27.2% in different parts of the world.
Methods: Retrospectively collected data from Electronic Health Record (EHR) of deliveries from May 1,2016 to October 31,2020 were used. We have analyzed demographic profiles like age, geographical location. Similarly, gestational age, caste, gravida, parity, various indications of CS, maternal, fetal and neonatal outcomes were also recorded.
Results: A total of 4168 deliveries were conducted over four and half years with 3694 (88.6%) vaginal deliveries and 474 (11.4%) CS. There was constant maintenance of CS rate from 5-15% over four and half years, 11% in 2016 to 12% in 2019. Fetal distress was the commonest indication of overall CS followed by Non-progress of labor. The women from Bhimeshwor municipality were 156 (32.9%). The most CS was done in the age group of 20-24 years, which was 192 (40.5%). Neonatal Death was 3/1000 births. There was one maternal mortality due to PPH and late presenation.
Conclusion: Different from the other evidences, we found that our CS rate was within the limit of WHOâ€™s recommendation for lower resource setting. Following strict guidelines and with dedicated care, itâ€™s possible to maintain recommended CS rate with less neonatal and maternal morbidities even in lower resource setting where there are no NICU, ICU facilities and Electronic Fetal Monitoring (EFM).
Study of endometrium in abnormal uterine bleeding at Patan Academy of Health Sciences, Patan Hospital Nepal
Authors: R.C. Laxmi 
Published: March 2023

Introduction:Abnormal uterine bleeding (AUB) is considered as one of the most common and challenging problem presenting to the gynecologist. Establishing a cause of AUB is important, as medical therapy is effective in managing abnormal bleeding in most cases and should be attempted prior to surgical management. Endometrial biopsy is a safe and effective diagnostic step in evaluation of endometrium after ruling out any medical causes. The objective of this study is to evaluate the different histopathological patterns of the endometrial biopsy specimens in women presenting with AUBat Patan Hospital.
Method: A two year retrospective study of AUB covering the year 2068 to 2069 . Patients charts were retrieved from the medical record section and reviewed.
Result: The most common age group presenting with AUB was 41â€“50 years 58(49.1%).Among these patients,normal physiological patterns 62 (52.5%) with secretory endometrium(24.6%), proliferative endometrium 29 (22.9%) and menstrual phase 6 (5.1%) were observed. The commonest pathology irrespective of the age group was disordered proliferative pattern 23 (19.5%). Othercauses identified were endocervical polyp 8 (6.8%), hormonal effect 5 (4.2%), atrophic endometrium 5 (4.2%),endometrial carcinomas 5 (4.2%), complications of pregnancy 3 (2.5%), endometrial hyperplasias 3 (2.5%), endometritis 3 (2.5%) and endometrial polyp 1 (0.8%).
Conclusion:Histopathological variations of the endometrium can detect the cause of the disorders taking into account the age and phase of a menstrual cycle. Timely evaluation of AUB by histopathology can be life saving diagnostic tool for early management.
Improving access block in emergency department: An audit cycle
Authors: Rijal Suraj , Adhikari Sunil 
Published: March 2023

Introduction: Emergency department crowding is a major problem worldwide and has been associated with a variety of deleterious patient care and outcomes. 1Crowding has also been implicated in increased work load, burnout and staff turnover. ED is the common entry point to hospitals for nearly all patients with acute problems. Prolonged length of ED stay is the most common cause of patient dissatisfaction.
Method: Plan-Do-Study-Act (PDSA) cycle will be used. The barrier identified for first cycle was delay in access is due to delay in consultation, evaluation by admission team, and delay in transfer of patient to ward. There are two cycles of data collections. In first cycle. we identified a barrier and set an indicator to measure it. We did a first cycle, analysed and evaluated the data and did necessary interventions. Then did second cycle to see the improvement and consistency for various departments.
Result: In first cycle, average of length of overall ED stay of all admitted patients is 401.95mins (Median time-368.5min). Total numbers of patients analyzed were 165. 63.63% of patients were transferred to respected admitting departments within 8 hours of ED stay. In second cycle, average of length of overall ED stay of all admitted patients is 375. 01mins (median time-341.5min). Total patient analyzed were 161. 67.5% of patients were transferred to respected admitting departments within 8 hours of ED stay.
Conclusion: Delay in access is due to delay in consultation, evaluation by admission team, and delay in transfer of patient to ward.
COVID-19 Preparation at a Rural District Hospital in Nepal: The days following the lockdown
Authors: Aryal Prayush 
Published: March 2023

Since the beginning of 2020 AD, the world is grappling with the COVID-19 pandemic and in Nepal, the first case was seen in the month of January itself. The second case, however, was detected only after 2 months and this gave the country an opportunity to upgrade the health system, especially for the pandemic. It also imposed a nationwide lockdown to contain the spread of the disease.
Myagdi, a rural district of Nepal and its district hospital in Beni also prepared for the disease with the resources it had. The incoming route to the district was sealed off and people were asked to stay indoors unless there was an emergency. The regular OPD services of the hospital was also closed and a fever clinic was established where all the fever and suspected COVID-19 cases were seen.
An isolation building was set up where the strong suspected cases were admitted and kept there until their PCR reports came out. Similarly, quarantine facilities were also made outside the hospital premises for those who had returned to the district from abroad. The hospital staffs were given Personal Protective Equipment, but they were scarce and had to be re-used. The whole scenario had appeared to put a mental toll on the hospital staffs as many of them were anxious and scared.
At the same time, Dengue and Scrub Typhus cases also emerged in the district, adding to the health woes. However, the hospital staffs and the local bodies are stepping up to the challenge and are toiling hard to plan and execute for the containment of the disease in the district.
QUALITY OF LIFE OF PATIENTS WITH POSTOPERATIVE HYPOTHYROID AND HASHIMOTO THYROIDITIS
Authors: FELEK Duygu , DUMAN Gülhan 
Published: March 2023

Purpose: The symptoms and findings resulting from thyroid dysfunctions display a picture similar to mood disorders such as depression and anxiety, which are the most common psychiatric disorders in the community. Therefore, this study aims to examine patients with Hashimoto thyroiditis receiving L-thyroxine therapy and euthyroid patients with postoperative hypothyroidism receiving L-thyroxine therapy in terms of their susceptibility to anxiety and depression and the change in their quality of life, as well as determine the role of the thyroid gland in psychosocial life.
Material and method: For evaluating anxiety, depression, and quality of life, Beck depression and Beck anxiety inventories and SF-36 were administered to 120 people (20-80 years old) who were applied to the Department of Endocrinology of XXXX University. 40 of them had developed hypothyroidism after thyroid surgery, 40 were diagnosed with Hashimoto thyroiditis at some point in their life and are now in a euthyroid state after L-thyroxine treatment, and 40 were healthy people in the control group. Data were analyzed on SSPS.
Results: The reasons for these psychosocial effects on individuals were evaluated in multiple ways, such as thyroid dysfunction, having a chronic disease, the idea of constant drug use, the effect of autoimmunity, and endogenous hormone secretion. Thyroidectomy patients' anxiety and depression were higher, and their quality of life was poorer than both Hashimoto thyroiditis patients and the control group (p
multimodal analysis of humour as an engagement strategy in YouTube research dissemination videos
Authors: Bernad-Mechó Edgar , Girón-García Carolina 
Published: March 2023

Science popularisation has received widespread interest in the last decade. With the rapid evolution from print to digital modes of information, science outreach has been seen to cross educational boundaries and become integrated into wider contexts such as YouTube. One of the main features of the success of research dissemination videos on YouTube is the ability to establish a meaningful connection with the audience. In this regard, humour may be used as a strategy for engagement. Most studies on humour, however, are conducted solely from a purely linguistic perspective, obviating the complex multimodal reality of communication in the digital era. Considering this background, we set out to explore how humour is used from a multimodal point of view as an engagement strategy in YouTube research dissemination. We selected three research dissemination videos from three distinct YouTube channels to fulfil this aim. After an initial viewing, 22 short humoristic fragments that were particularly engaging were selected. These fragments were further explored using Multimodal Analysis - Video (MAV)[1], a multi-layered annotation tool that allows for fine-grained multimodal analysis. Humoristic strategies and contextual features were explored, as well as two main types of modes: embodied and filmic. Results show the presence of 9 linguistic strategies to introduce humour in YouTube science dissemination videos which are always accompanied by heterogeneous combinations of embodied and filmic modes that contribute to fully achieving humoristic purposes.
[1] Multi-layer annotation software used to describe the use of semiotic modes in video files. By using this software, researchers may analyse, for instance, how gestures, gaze, proxemics, head movements, facial expression, etc. are employed in a given file.
Micro-shear bond strength of different calcium silicate materials to bulk-fill composite
Authors: Falakaloğlu Seda , Yeniçeri Özata Merve , Plotino Gianluca 
Published: March 2023

Introduction
This study aimed to compare the micro-shear bond strength (µSBS) performances of two resin-based calcium silicate-based cement (CSC) (TheraCal PT and TheraCal LC), Biodentine, and two modified-MTA CSC materials (NeoMTA 2 and BioMTA+) to bulk-fill restorative material.

Materials and Methods
Fifty 3D printed cylindrical resin blocks with a central hole were used (2 mm in depth and 4 mm in diameter). CSCs were placed in the holes (per each group n = 10) and incubated for 24 h. Cylindrical polyethylene molds (2 mm in height and diameter) were used to place the bulk-fill restorative materials on the CSCs and polymerize for 20 s. Then, all specimens were incubated for 24 h at 37 °C at a humidity of 100%. Specimen’s µSBSs were determined with a universal testing machine. Data were analyzed with one-way ANOVA (Welch) and Tamhane test.

Results
Statistically higher µSBS was found for TheraCal PT (29.91 ± 6.13 MPa) (p < 0.05) respect to all the other materials tested. TheraCal LC (20.23 ± 6.32 MPa) (p > 0.05) reported higher µSBS than NeoMTA 2 (11.49 ± 5.78 MPa) and BioMTA+ (6.45 ± 1.89 MPa) (p < 0.05). There was no statistical difference among TheraCal LC, NeoMTA 2 and Biodentine (15.23 ± 7.37 MPa) and between NeoMTA 2 and BioMTA+ (p > 0.05).

Conclusion
Choosing TheraCal PT as the pulp capping material may increase the adhesion and µSBS to the bulk-fill composite superstructure and sealing ability.
Major Symptoms and Outcome of Covid-19 Positive Patients: A Study in a Tertiary Care Hospital in Bangladesh
Authors: Rahman Md. Zillur , Nahar Nazmun , Akhtar Rawshan , Alam Md. Mahbubul , Swapon Shamsul Alom , Rashid Rubaiyat , Mollah Abdul Hamid 
Published: March 2023

Background: An outbreak of Covid-19 caused by the SARS-Cov-2 initially emerged in China in December 2019 and the first Covid-19 patient was detected on 8 March 2020 in Bangladesh. The preconception about the major symptoms and outcomes of Covid-19-positive patients may be helpful for healthcare professionals in the management of Covid-19 patients. This study aimed to evaluate the major symptoms and outcomes of covid-19 positive patients.
Methods: This prospective observational study was conducted in the Department of Medicine, Rajshahi Medical College Hospital, Rajshahi, Bangladesh from January 2021 to December 2021. In total 67 confirmed Covid-19 cases by RT-PCR tests who attended the mentioned hospital were enrolled in this study as the study population. For data collection, a pre-designed questionnaire was used. Along with demographic and clinical features data regarding in-hospital mortality, intensive care unit (ICU) admission, use of invasive mechanical ventilation, total hospital length of stay, complications, and treatment patterns were recorded. Collected data were processed, analyzed and disseminated by using the MS Excel program.
Results: The highest number of patients were with a cough which was found among 49% of cases. Besides this, shortness of breath, hypoxemia/oxygen use, lower limb swelling and bleeding were found among 39%, 27%, 12% and the rest 7% of patients respectively. The highest number of patients were with hypertension (HTN) as comorbidity which was found in 15% of cases. Besides this, diabetes mellitus (DM), chronic kidney diseases (CKD), chronic respiratory diseases (CRD), cancer/immunodeficiency and cardiac diseases were found among 12, 10%, 7%, 4% and the rest 1% of patients, respectively. As the outcomes, the cure rate was found up to 97% and death occurred in only 3% (n=2) cases. We observed that 10% of patients did not stay at the hospital even for a single day. For only 7% of patients, ventilation facilities were in needed and the average ventilation time was 13.5 days.
Conclusion: Cough and shortness of breath are two major symptoms for Covid-19 patients. Proper ventilation and ICU facilities can decrease the suffering, mortality as well as morbidity of Covid-19 patients.
Evaluation of Selected Vitamins and Antioxidant Potential of Methanol Seed Extract of Persea americana
Authors: Omorovbiye Omorevbarhia, , Chidozie Umerie, Sunday , Louis Aniefuna, Ejike , Enoch Oguazu Chinenye 
Published: March 2023

Introduction: Persea americana seeds have been used in ethnomedicine as a potent remedy for putative health conditions such as muscular and menstrual pains, hypertension, diabetes mellitus, anaemia, insomnia, hyperlipidaemia, diarrhoea, dysentery, gastric and peptic ulcers.
Aim: This study investigated the antioxidant scavenging activities of the methanol extract of Persea americana seed.
Methods: The seed samples were collected, dried, ground into powder and extracted in methanol by cold maceration. The antioxidant activity was determined using 2,2-diphenyl-1-picryhydrazyl, lipid peroxidation and reducing power assays. Antioxidant vitamins (A, E and C) and enzymes (superoxide dismutase, peroxidase and catalase) were assayed using absorption spectroscopic methods.
Results: There was a significant increase (p≤0.05) in the DPPH scavenging effect and inhibition of lipid peroxidation activity with increasing extract concentration. There is an increase in spectroscopic absorbance value as the concentration of the sample extract, in the reaction mixture, increases indicating its reducing power ability. The EC50 values for DPPH, lipid peroxidation and reducing power assays were 610 µg/ml, 640.51 µg/ml and 580 µg/ml respectively. Vitamin E (267.73 ± 0.07 mg/ 100 g) content was the highest among the antioxidant vitamins investigated (Vitamin A (7.60 ± 0.01 mg/100 g) and C (3.88 ± 0.03 mg/100 g).
Conclusion: The chemical compositions of the investigated samples might be responsible for their medicinal values in phytomedicine. This study shows that Persea americana seeds are adequate in maintaining healthy nutrition for preventing the accumulation of destructive free radicals. The radical scavenging abilities exhibited by the seed extract may be attributed to the high polyphenolic content and antioxidant enzymes present.
Potential of Pterocarpus erinaceus Aqueous Stem Bark Extract to Prevent Oxidative Kidney Damage in Diabetic Rats
Authors: Nzute O. P. , Ijeomah A. U. , Ajiboso S. O. , Muhammad B. Y. , Haruna I. Y. 
Published: March 2023

Diabetes is a chronic, metabolic disease characterized by elevated levels of blood glucose, which over time leads to serious damage to the heart, blood vessels, eyes, kidneys and nerves. This present study investigated the potential of Pterocarpus erinaceus aqueous stem bark extract to prevent oxidative kidney damage in diabetic rats. Thirty six (36) male wistar rats of 100 to 200g were used. The rats were divided into six groups (A-F). Diabetes mellitus was induced in groups B-F by injecting alloxan at the dose of 150 mg/kg body weight. After 72hours, diabetes was confirmed. Vitamin C 25 mg/kg b.wt was used as standard treatment for group C and aqueous extract of Pterocarpus erinaceus stem bark at doses of 100, 200 and 400 mg/kg b.wt were administered to groups D, E and F respectively. All treatments were given orally, daily for 14 days. Phytochemical screening of the extract, Blood glucose level and oral glucose tolerance test were determined. At the end of the experiment, the serum, kidney tissue and kidney homogenate were obtained for the determination of kidney function parameters, histology, lipid peroxidation, antioxidant and inflammation markers. Phytochemical results shows the presence of phenols, tannins, saponins, alkaloids, glycosides, cardiac glycosides and flavonoides. Diabetic rats administered with Pterocarpus erinaceus aqueous stem bark extract showed significant (P<0.05) decrease in, blood glucose, creatinine, blood urea nitrogen (BUN), potassium, MDA, TNF-alpha, IL-6 and TGF-β when compared with diabetic control rats. Also a non significant (P>0.05) decrease in uric acid, albumin, and an increase in sodium, GSH when compared with the diabetic control group. A significant (P<0.05) increase was observed in SOD, CAT, GPx, and GST when compared with diabetic control rats. The kidney histology shows well protected kidney. These results obtained shows that aqueous extract of Pterocarpus erinaceus stem bark exhibited significant antihyperglycemic, improvement in kidney function, antioxidant and anti inflammatory markers and prevented kidney tissue damage in alloxan-induced diabetic rats. This might be useful in the management diabetes mellitus patients.
Credit Management Practices and Loan Default in Deposit Money Banks (DMBs) in Osun State, Nigeria
Authors: Adegbola A. S. , Ajayi-Owoeye A. O. , Alalade Yimka S. A. 
Published: March 2023

Background: Loan default has been shown in existing literature to have a negative impact on banks as it reduces the performance of banks and may lead to total collapse of these institutions. The high rate of default associated with loans in Nigerian banks is indicative of existing poor credit management practices by the banks.
Aim: As such, this study examined the effect of credit management practices on loan default in deposit money banks in Osun State.
Methods: The study employed the survey research design, using a well-structured questionnaire to collect responses of one hundred and twenty (120) officers and managers from two hundred and fifty two (252) officers and managers of sixty (60) bank branches in Osun State. Using descriptive and multiple linear regressions, the collated data was presented using tables, while the research hypothesis was tested at the 5% level of significance.
Findings: The study found that credit management has no significant effect on loan default, with both credit appraisal and credit monitoring exhibiting negative but non-significant effects on loan default, and credit collection policy exhibiting positive and significant effect on loan.
Conclusion: The study concluded that credit management practices have no significant effect on loan default. In other words, loan default experienced in the banks were not influenced by the loan management practices put in place. While the processes were in existence in the banks under investigation, they have not been able to affect the incidences of loan default.
Association Between Acute Alcohol Use and Firearm-Involved Suicide in the United States
Authors: Lange Shannon , Jiang Huan , Kaplan Mark S. , Kim Kawon Victoria , Rehm Jürgen 
Published: March 2023

ImportanceFirearms are the method of suicide used most often in the US. Acute alcohol use is associated with an increased risk of suicide by firearm. However, the dose-response association between acute alcohol use and the probability of using a firearm as the method of suicide is unknown.ObjectiveTo evaluate the association between the amount of alcohol consumed and the probability of using a firearm as the method of suicide.Design, Setting, and ParticipantsThis cross-sectional study used mortality data from the US National Violent Death Reporting System on suicide decedents aged 18 years or older with a positive blood alcohol concentration (BAC; ie, ≥0.01 g/dL). Statistical analysis was performed from January 2003 to December 2020.ExposureAcute alcohol use, ascertained via postmortem toxicologic examination.Main Outcomes and MeasuresProbability of using a firearm as the method of suicide compared with all other methods of suicide.ResultsThe study included 45 959 male suicide decedents (mean [SD] age, 42.6 [14.8] years) and 12 136 female suicide decedents (mean [SD] age, 44.2 [13.8] years) with a positive BAC; of those, 24 720 male decedents (53.8%) and 3599 female decedents (29.7%) used a firearm as the method of suicide. The probability of using a firearm as the method of suicide when alcohol is consumed was higher for male decedents, with the probability starting at just below 0.50 and increasing to approximately 0.75. In contrast, for female decedents, the probability began at just above 0.30 and increased to approximately 0.55. For both male and female decedents, the dose-response curves were an inverted U shape; as BAC increased, the probability of firearm-involved suicide initially increased and then decreased at very high BACs (approximately 0.40 g/dL for male decedents and approximately 0.30 g/dL for female decedents; these BACs were present among only a small percentage of alcohol-involved suicides: male decedents, 589 [1.3%]; female decedents, 754 [6.2%]).Conclusions and RelevanceThis cross-sectional study of suicide decedents who had consumed alcohol prior to their death suggests that, as alcohol consumption increased, the probability of a firearm-involved suicide increased until a certain BAC, at which point the probability started to decrease.