Search results for: Smriti Gurung

Authors: Kumar Khatri, Bibhuti Ranjan Jha, Smriti Gurung, Udhab Raj Khadka

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Freshwater fishes are crucial components of aquatic ecosystems but are being affected by a range of anthropogenic activities. A large number of freshwater bodies in Nepal are under different anthropogenic threats, thereby affecting freshwater biodiversity, including fish fauna. Inter-basin water transfer (IBWT) involving damming and diversion has been considered as one of the major threats to the rivers, yet many such projects are in the pipeline. Impact assessment of such projects include generation of baseline information on different biotic and abiotic variables. The aim of this study was to generate baseline information on fish diversity from the glacial-fed Bheri and the spring-fed Babai rivers and their selected tributaries from Western Nepal in the wake of the first inter-basin water transfer from the former to the latter. A total of 10 sites, 5 each from Bheri and Babai systems, were chosen strategically. Seasonal electrofishing was conducted in 2018 following the standard method. A total of 32 species with Catch per Unite Effort (CPUE) of 46.94±24.06 from Bheri and 42 species with CPUE of 63.02±51.80 from Babai were recorded. Cyprinidae, followed by Nemacheilidae, were the most dominant fish Family in both river systems. Barilius vagra and Schistura beavani were the most dominant species in the Bheri and the Babai systems, respectively. Species richness and abundance showed a significant difference between the rivers. The difference in fish assemblages reflects differences in the ecological regimes of these rivers. Of the total species, at least 8 are in the threatened categories of the IUCN Red List, which need active conservation measures. The findings provide a reference to assess the impacts of water transfers on fish in these river systems and could be helpful to other similar river systems in the future.

Keywords: babai river, bheri river, fish diversity, damming

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Authors: Rushiraj Heshi, Smriti Bhandari

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Master Data Management requires creation of Central repository, applying constraints on Repository and designing processes to manage data. Designing of Repository, constraints on repository and business processes is very tedious and time consuming task for large Enterprise. Hence Visual Repository, constraints and Process (Workflow) modeling is the most critical step in Master Data Management.In this paper, we realize a Visual Modeling tool for implementing Repositories, Constraints and Processes based on Eclipse Plugin using GMF/EMF which follows principles of Model Driven Engineering (MDE).

Keywords: EMF, GMF, GEF, repository, constraint, process

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Authors: Anjli Pathak, Harshit Sosan Lakra, Smriti Mishra

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The increasing urbanization affects the external environment in which people exist and imposes livelihood vulnerability to shocks and stresses. Although research on the linkages between urbanization and vulnerability has been increasing, only a few studies have examined the caste/ethnicity in livelihood vulnerability. In this study, we explore how physical capital influences vulnerability among indigenous people in the context of livelihood. The study identifies the dimensions and indicators of physical capital that influence the profile of household vulnerability in the livelihood-building process. The result identified five dimensions and 19 indicators of livelihood vulnerability. The study also visualizes the inter-relationship between physical capital and other livelihood capital in formulating the livelihood vulnerability framework.

Keywords: urbanization, livelihood vulnerability, indigenous people, physical capital

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Authors: Yozna Gurung

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This paper presents preliminary findings from an on-going study on the use of Internal State Terms (IST) in the production of narratives of Hindi-English bilinguals in an attempt to identify children at risk for Specific Language Impairment. Narratives were examined for macrostructure (story structure and story complexity) and internal state terms or mental state terms (IST/MST). 31 students generated stories based on six pictures that were matched for content and story structure in L1 (Hindi) and L2 (English) using a wordless picture narrative. From 30 sample population, 2 students are at risk of Specific Language Impairment, according to this study i.e 6.45%. They showed least development in story grammar as well as IST in both their languages.

Keywords: internal state terms, macrostructure, specific language impairment, wordless picture narrative

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Authors: Tara Gurung, Suprina Prajapati

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Health and well being of people is a crucial for accomplishing sustainable development goals of any country. The present study focuses on quality of life of patients undergoing hemodialysis. Hemodialysis is a life sustaining treatment for patients with end stage renal disease (ESRD). Hemodialysis can bring about significant impairment in health related quality of life (HRQOL). The purpose of this study was to assess the quality of life of hemodialysis patients undergoing hemodialysis. A descriptive cross-sectional research design was utilized in total 100 samples using random sampling technique. The findings revealed that the total quality of life of the patients was 30.41±3.99 out of 100. The total physical component score was statistically significant with education status of the patients where p value for t test was 0.03 (p=0.03) and occupation of the patients where p value for the ANOVA test was 0.007 (p=0.007). The study recommended that it would be better if awareness programs regarding chronic kidney disease and life style modification in hemodialysis patients is given to the patients so that it would help patients to maintain the HRQOL.

Keywords: health and well bing, hemodialysis, patients quality of life

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Authors: Smriti Mary Gupta

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This article intends to show strong facts of ‘Judeo-Christian myth’ and ‘Celtic myth’ in selected plays of William Shakespeare. Giving the vast proliferation of Shakespeare studies we examine the strong impact of Bible in his plays. Inevitably, for instance, the study of Shakespeare and the Bible overlaps the study of Shakespeare and religion, which justify the use of Judeo-Christian myth in his works. There is some evidence that Shakespeare had read and used the ‘Geneva Bible’ in his works. The glimpse of parables and references of Biblical myth can be seen very clearly in Macbeth, King Lear and Measure for Measure. Defining a religion based on myths is difficult because it is built upon a belief of large number of people in the society. The Judeo-Christian myth which is based on the Bible, Celtic religious myth will also be discussed in this paper which had a strong impact on the audience of sixteenth century and it is still continuing at the present time.

Keywords: Celtic myth, Geneva Bible, Judeo-Christian myth, Shakespearean plays

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Authors: Smriti Agarwal, Ashish Payal, B. V. R. Reddy

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IEEE 802.15.4 is a Low Rate Wireless Personal Area Networks (LR-WPAN) standard combined with ZigBee, which is going to enable new applications in Wireless Sensor Networks (WSNs) and Internet of Things (IoT) domain. In recent years, it has become a popular standard for WSNs. Wireless communication among sensor motes, enabled by IEEE 802.15.4 standard, is extensively replacing the existing wired technology in a wide range of monitoring and control applications. Researchers have proposed a routing framework and mechanism that interacts with the IEEE 802.15.4 standard using software platform. In this paper, we have designed and implemented MAC based routing (MBR) based on IEEE 802.15.4 standard using a hardware platform “SENSEnuts”. The experimental results include data through light and temperature sensors obtained from communication between PAN coordinator and source node through coordinator, MAC address of some modules used in the experimental setup, topology of the network created for simulation and the remaining battery power of the source node. Our experimental effort on a WSN Testbed has helped us in bridging the gap between theoretical and practical aspect of implementing IEEE 802.15.4 for WSNs applications.

Keywords: IEEE 802.15.4, routing, WSN, ZigBee

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Authors: Smriti Bhatnagar

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This study aims to find if the Transit-oriented planning and development approach benefit the quality of air in neighborhoods of New Delhi. Two methodologies, namely the land use regression analysis and the Transit-oriented development index analysis, are being used to explore this relationship. Land Use Regression Analysis makes use of urban form characteristics as obtained for 33 neighborhoods in Delhi. These comprise road lengths, land use areas, population and household densities, number of amenities and distance between amenities. Regressions are run to establish the relationship between urban form variables and air quality parameters (dependent variables). For the Transit-oriented development index analysis, the Transit-oriented Development index is developed as a composite index comprising 29 urban form indicators. This index is developed by assigning weights to each of the 29 urban form data points. Regressions are run to establish the relationship between the Transit-oriented development index and air quality parameters. The thesis finds that elements of Transit-oriented development if incorporated in planning approach, have a positive effect on air quality. Roads suited for non-motorized transport, well connected civic amenities in neighbourhoods, for instance, have a directly proportional relationship with air quality. Transit-oriented development index, however, is not found to have a consistent relationship with air quality parameters. The reason could this, however, be in the way that the index has been constructed.

Keywords: air quality, land use regression, mixed-use planning, transit-oriented development index, New Delhi

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Authors: Smriti Mary Gupta

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This article intends to show how literature may be used in language classes to develop student’s knowledge of English. First, we examine the evolution of literature in the language classroom, then we give account of some reasons that justify its use in language classes, of the role of reading in language development, and of the way poetry is treated in the ESL classroom. This paper aims to emphasize the use of literature as a popular tool to teach language skills (i.e. reading, writing, listening and speaking), language areas (i.e. vocabulary, grammar and pronunciation) as well as moral teachings, which is the necessity in present time. Reason for using religious literary texts in foreign language classroom and main criteria for selecting suitable religious literary texts in foreign language classes are stressed so as to make the reader familiar with the underlying reasons and criteria for language teachers, using and selecting religious literary texts. Moreover, religious literature and teaching of language skills, benefits the different genres of religious literature (i.e. poetry, fiction and drama), and also gaining knowledge of a particular religion through language teaching but some problems had been observed by language teachers within the area of English through religious literature (i.e. lack of preparation in the area of literature teaching in TESL/TEFL programs, absence of clarity in objectives defining the role of literature in ESL/EFL), language teachers not having the background, training and appropriate knowledge in religious literature, lack of pedagogically-designed teaching material that can be used by language teachers in a classroom.

Keywords: religious literature, teaching literature, teaching of language skills, foreign language teaching, literary competence

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Authors: Narayan Gurung, Fawu Wang, Ranjan Kumar Dahal

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Nepal is highly prone to earthquakes and has witnessed at least one major earthquake in 80 to 90 years interval. The Gorkha earthquake, that measured 7.8 RS in magnitude and struck Nepal on 25th April 2015, after 81 years since Mw 8.3 Nepal Bihar earthquake in 1934, was the largest earthquake after Mw 8.3 Nepal Bihar earthquake. In this paper, an attempt has been made to highlight the lessons learnt from the MwW 7.8 Gorkha (Nepal) earthquake. Several types of damage patterns in buildings were observed for reinforced concrete buildings, as well as for unreinforced masonry and adobe houses in the earthquake of 25 April 2015. Many field visits in the affected areas were conducted, and thus, associated failure and damage patterns were identified and analyzed. Damage patterns in non-engineered buildings, middle and high-rise buildings, commercial complexes, administrative buildings, schools and other critical facilities are also included from the affected districts. For most buildings, the construction and structural deficiencies have been identified as the major causes of failure; however, topography, local soil amplification, foundation settlement, liquefaction associated damages and buildings built in hazard-prone areas were also significantly observed for the failure or damages to buildings and hence are reported. Finally, the lessons learnt from Mw 7.8 Gorkha (Nepal) earthquake are presented in order to mitigate impacts of future earthquakes in Nepal.

Keywords: Gorkha earthquake, reinforced concrete structure, Nepal, lesson learnt

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Authors: J. B. Sharma, Vivek Kakkar, Sunesh Kumar, K. K. Roy, Rajesh Kumari, Kavita Pandey, Smriti Hari

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Background: Stress urinary incontinence (SUI) is a common problem affecting the quality of life of women. Methods: It is a prospective study conducted over 40 women of SUI by endovaginal ultrasound on rest and Valsalva preoperatively and six months postoperatively for levator hiatus, pubovisceral thickness, urethral length, and bladder neck position. A 24-hour pad test was also performed on all women at the same time for grading of SUI. Treatment given was medical in 4 (10%), Burch colposuspension in 18 (45%), and tension-free obturator tape in 18 (45%). Results: Mean age, parity, and body mass index in the study were 41.60 years, 2.73, and 24.2 kg/m², respectively. All 40 (100%) patients had SUI, with the mean duration of symptoms being 4.04 years. On the 24-hour pad test, mild SUI was in 4 (10%), moderate SUI in 33 (82.5%), and severe SUI in 3 (7.5%), with mean preoperative 24-hour pad test being 36.69 gm which significantly reduced to 9.79 gm postoperatively (p 0.001). There was a significant change in levator hiatus and pubovisceral thickness with the treatment of SUI. Overall urethral length increased, but there was a significant decrease in urethral length on Valsalva after the treatment (0.40 versus 0.28 cm, p 0.04) and a significant reduction in bladder neck descent after Valsalva after treatment (0.41 cm versus 0.27 cm, p 0.001). Conclusion: Endovaginal ultrasound and 24-hour pad test are useful diagnostic modalities for SUI diagnosis and to see the impact of treatment.

Keywords: stress urinary incontinence, endovaginal ultrasound, 24-hours pad test, pubovisceral muscle thickness

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Authors: Smriti Mishra, Jaydip Barman, Shashi Kant Pandey

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Many scholars suggest that waterfront development projects have an all round impact on cities. However, their research stops short of considering the perception of local residents, of what they think about the impact of such developments and the kind of waterfront development which they would prefer to support. Therefore, this paper attempts to address this imbalance in the literature by analysing a survey of residents' perceptions of such developments. The paper discusses the issue in the Indian context by considering Sabarmati Riverfront Development Project (SRFD) of Ahmadabad. It gives an overview of the project components of the SRFD; discusses its development issues and concerns associated with it. It further examines the structural relationship between socio-economic and demographic attributes of local residents and their attitudes and perception towards the economic impact of such developments. The study suggests that the economic component that riverfront development will attract more investment in their community and that riverfront development will increase real estate tax revenue emerged as strong components. While the economic component of substantial premiums to developers, land owners and local government and the other of cost of developing riverfront facilities are too much of a burden on government and public sector agencies appear to be weaker economic components of the perceived economic impacts of urban riverfront development. This paper also gives an overview of the urban waterfront development in the global scenario. It highlights the need to consider residents perception in the development of such projects.

Keywords: urban waterfront development, riverfront, economic impact, resident perception, SRFD

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Authors: Manita Pyakurel, Ram Chandra Silwal, Padam Simkhada, Edwin van Teijlingen, Bikesh Bajracharya, Sushila Sapkota, Tina Gorkhali, Salita Gurung

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Introduction: Gender-based violence (GBV) has been identified as a social and personal security concern for women with disabilities who are at increased risk for various types of abuse. This study aims to determine the prevalence rates of physical, psychological, and sexual violence among women and girls with disability in Nepal. Methods: This cross-sectional study was conducted in 28 municipalities, 14 districts, and 7 provinces representing all three ecological regions of Nepal from January to March 2021. Study respondents were girls and women with disabilities, aged between 15 and 59 years, at the study sites. Face-to-face semi-structured interviews were conducted among 1294 respondents using the KoBo toolbox application on a smartphone or tablet. Results: Among the total study population, 35.3% shared lifetime violence experience. Only 4.8% formally reported violence experienced. Among the violence experienced participants maximum (92.6%) of women and girls identified no change in violence before and after the COVID-19 pandemic. Women who were married had protective odds of 0.71 for violence experienced in their lifetime [aOR-0.71, CI (0.56-0.90)]. Conclusion: More than one-third experienced violence in their lifetime. Intimate partner violence was the most common violence experienced by women and girls with disability in Nepal. Sexual violence was the least type of violence experienced. The most common perpetrator of violence includes the mother or father-in-law. Most of the women and girls never reported violence.

Keywords: gender-based violence, prevalence, girls, women

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Authors: Ganga Sagar Bhattarai, Swastika Gurung

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Antibiotics were being misused in both humans and animals, which led to the development of multidrug-resistant microorganisms. Antibiotic abuse is likely rampant among goats, cows, and buffaloes in order to boost growth and reduce production losses. The aim of this study is to know the multidrug resistance (MDR) bacteria in goats, cows, and buffaloes. Out of 68 samples that were examined, S. aureus, Bacillus spp., E. coli, Shigella spp., Klebsiella spp., S. epidremidis, and Salmonella spp. were isolated. S. aureus was the highest isolated bacteria (91.17%), Bacillus spp. (61.76%), E. coli (48.52%), Shigella spp. (22.05%), Klebsiella spp. (17.64%), S. epidermidis (13.23%), and the Salmonella spp. (7.35%). Salmonella spp. and E. coli showed multidrug resistance to at least four antibiotics, including Amoxicillin, Tetracycline, Piperacillin, and Ciprofloxacin, in Salmonella and to at least three antibiotics, including Amoxicillin, Tetracycline, and Nalidic acid. The highest resistance bacteria Salmonella spp. showed (57.14%) E. coli and Bacillus spp. showed (42.85%) S. aureus, S. epidermidis, and Shigella spp. showed (28.57%), and Klebsiella spp. showed (14.28%). This study showed that antibiotic-resistant bacteria with high levels of Amoxicillin, Penicillin, and Tetracycline resistance are present in healthy farm animals such as goats, cows, and buffaloes. Options for antibiotic therapy in both humans and animals will likely be limited as a result. The use, distribution, storage, and sale of antibiotics in veterinary practices must consequently be under strict control.

Keywords: multidrug resistance, multidrug resistance bacteria, susceptibility testing, bacterial infections

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Authors: Dwarika P. Shrestha, Dipendra Gurung, Rushma Shrestha, Inger Rosdahl

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Introduction: Skin diseases are one of the most common health problems in Nepal. The objectives of this study are to determine the prevalence of skin diseases and impact on quality of life in rural areas in Nepal. Materials and methods: A house-to-house survey was conducted, to obtain socio-demographic data and identify individuals with skin diseases, followed by health camps, where the villagers were examined. A pilot study was conducted in one village, which was then extended to 10 villages in 4 districts. To assess the impact on quality of life, the villagers were interviewed with Skin Disease Disability Index. This is a questionnaire developed and validated by the authors for use in Nepal. Results: In the pilot study, the overall prevalence of skin diseases was 20.1% (645/3207). In the additional 10 villages with 7348 (3651/3787 m/f) inhabitants, 1862 (721/1141 m/f, mean age 31.4 years) had one or more skin diseases. The overall prevalence of skin diseases was 25%. The most common skin disease categories were eczemas (13.7%, percentage among all inhabitants) pigment disorders (6.8%), fungal infections (4.9%), nevi (3.7%) and urticaria (2.9%). These five most common skin disease categories comprise 71% of all skin diseases seen in the study. The mean skin disease disability index score was 13.7, indicating very large impact on the quality of life. Conclusions: This population-based study shows that skin diseases are very common in the rural areas of Nepal and have significant impact on quality of life. Targeted intervention at the primary health care level should help to reduce the health burden due to skin diseases.

Keywords: prevalence and pattern of skin diseases, impact on quality of life, rural Nepal, interventions

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Authors: Santosh Thapa, Sankar Gurung

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Chaupadi is a tradition widely practiced in the far and mid-western region of Nepal. It is a practice where girls and women are not allowed to inter the house and touch the food, water and milk during their menstruation period of 4-7 days. They have to spend all the nights during the period in a specific hut (Chhaupadi Goth) which is a bit far from their residence where they faces various kinds of risk and violence like bullying, snakes and insect bite, wild animal attack etc. Sometimes the girls even do not go to school during their menstruation periods. After childbirth, the woman must stay in a cow shed for 11 days in such Chhaupadi practiced areas. This study limits the Achham district of the far western region which is the most vulnerable Chhaupadi practicing district. Several governmental and non-governmental organizations have been involving and spending huge amount of money for capacity building and awareness raising campaign for last 2 decades but still 9 out of 75 Village Development Committees (VDCs) have been partially practicing Chaupadi in the district. This study shows that the school attendance rate of the girls during the period have visibly increased which helps to increase the number of the girl graduation as well. Similarly, the practice of Chhaupadi is one of the reasons for increasing the number of cases of uterus prolapsus and poor reproductive health of women and girls. Triggering tools are the one of the best ways to accelerate the awareness campaign in the VDCs. This study recommends that the local bodies should coordinate and lead the overall awareness campaign program to sustain the Chaupadi free VDCs.

Keywords: awareness campaign, chaupadi practice, gender discrimination, violence

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Authors: Smriti Gour, Neelam Pandey

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The objective of this study was to describe and analyse the mutual relationship between the coping mechanisms used by the families of a child with Autism Spectrum Disorder (ASD) and family dynamics and the effect sibling interactions have on the dynamics and coping mechanisms in an urban setup. In-depth interviews were conducted for 25 families, with 4 members each in the Delhi NCR area in India. The families who were interviewed had a younger child who had received a diagnosis of ASD between the ages of 5-12. The in-depth questionnaires contained open-ended questions and the interviews were conducted separately for the mother, father and the typically developing sibling. The key findings of the study suggested that lack of communication was a common factor in most families (n=19) leading to other difficulties like stress and relationship dysfunction. It also fostered a fallacious perception of the relationship dynamics in the family in most of the interviewed families and changed depending on the family member being interviewed. In families where the typically developing elder sibling had a good relationship with the autistic child, the family dynamics were found to be more stable, and the overall family well-being was better maintained. The coping mechanisms employed by the families were also more positive and tended to work better if the typically developing sibling maintained a positive and interactive relationship with the parents and the autistic child. The type of coping mechanisms had a major impact on the relationship between the parents and in dictating the dynamics of the family of the child with ASD. Spirituality, professional help, family support and household help emerged to be the most effective coping mechanisms for the families, with spirituality emerging to be the most positive and effective coping mechanism in the families interviewed.

Keywords: autism spectrum disorder, coping mechanism, family dynamics, parental relationships, siblings

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Authors: Smriti, Ajeet Kumar

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We present a variant of the Irving-Kirkwood procedure to obtain the microscopic expressions of the cross-section averaged continuum fields such as internal force and moment in one-dimensional nanostructures in the non-equilibrium setting. In one-dimensional continuum theories for slender bodies, we deal with quantities such as mass, linear momentum, angular momentum, and strain energy densities, all defined per unit length. These quantities are obtained by integrating the corresponding pointwise (per unit volume) quantities over the cross-section of the slender body. However, no well-defined cross-section exists for these nanostructures at finite temperature. We thus define the cross-section of a nanorod to be an infinite plane which is fixed in space even when time progresses and defines the above continuum quantities by integrating the pointwise microscopic quantities over this infinite plane. The method yields explicit expressions of both the potential and kinetic parts of the above quantities. We further specialize in these expressions for helically repeating one-dimensional nanostructures in order to use them in molecular dynamics study of extension, torsion, and bending of such nanostructures. As, the Irving-Kirkwood procedure does not yield expressions of stiffnesses, we resort to a thermodynamic equilibrium approach to obtain the expressions of axial force, twisting moment, bending moment, and the associated stiffnesses by taking the first and second derivatives of the Helmholtz free energy with respect to conjugate strain measures. The equilibrium approach yields expressions independent of kinetic terms. We then establish the equivalence of the expressions obtained using the two approaches. The derived expressions are used to understand the extension, torsion, and bending of single-walled carbon nanotubes at non-zero temperatures.

Keywords: thermoelasticity, molecular dynamics, one dimensional nanostructures, nanotube buckling

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Authors: Pankaj Kumar Jha, Saroj Sapkota, Dil Bahadur Gurung, Raju Kadel, Neena Amatya Gorkhali, Bhola Shankar Shrestha

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The study was conducted to evaluate the seminal attributes, effectiveness of cooling process and post-thawed semen quality of a Nepalese indigenous Khari buck. Thirty-two ejaculates, 16 from each buck were studied for seminal attributes of fresh semen: volume, color, mass activity, motility, viability, sperm concentration, and morphology. The pooled mean values for each seminal attributes were: volume 0.7±0.3 ml; colour 3.1±0.3 (milky white); mass activity 3.8±0.4 (rapid wave motion with formation of eddies at the end of waves to very rapid wave motion with distinct eddies formation); sperm motility 80.9±5.6%; sperm viability 94.6±2.0%; sperm concentration 2597.0±406.8x106/ml; abnormal acrosome, mid-piece and tail 10.7±1.8% and abnormal head 5±1.7%. For freezing semen, further 6 ejaculates from each buck were studied with Tris based egg yolk citrate extender. The pooled mean values of motility and viability of post diluted semen for 90 and 120 minutes each for cooling and glycerol equilibration were 73.8±4.8%, 88.1±2.6% and 69.2±6.0%, 85.0±1.7%, respectively. The pooled mean values of post thaw motility and viability with advancement of preservation time were: 0hour 49.0±4.6%, 81.2±1.9%; 2nd day 41±2.2%, 79±1%; 5th day 41±2.2%, 78.6±0.9% and 10th day 41±2.2%, 78.6±0.9%. We concluded from the above study that the seminal attributes and results of post-thaw semen quality were satisfactory and in accordance with other work in foreign countries, which indicated the feasibility of cryopreserving buck semen. For more validation, research with large number of bucks, different types of diluents and freezing trials by removing seminal plasma followed by pregnancy rate is recommended.

Keywords: cryopreservation, Nepalese indigenous Khari (Hill goat) buck, post-thaw semen quality, seminal attributes

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Authors: Ram Sharan Mehta, Gayanandra Malla, Anita Gurung, Anu Aryal, Divya Labh, Hricha Neupane

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Objectives: Lack of resuscitation skills of nurses and doctors in basic life support (BLS) and advanced life support (ALS) has been identified as a contributing factor to poor outcomes of cardiac arrest victims. The objective of this study was to examine retention of life support measures (BLS/ALS) knowledge and skills of nurses following education intervention programme. Materials and Methods: Pre-experimental research design was used to conduct the study among the nurses working in medical units of B.P Koirala Institute of Health Sciences, where CPR is very commonly performed. Using convenient sampling technique total of 20 nurses agreed to participate and give consent were included in the study. The theoretical, demonstration and re-demonstration were arranged involving the trained doctors and nurses during the three hours educational session. Post-test was carried out after two week of education intervention programme. The 2010 BLS & ALS guidelines were used as guide for the study contents. The collected data were analyzed using SPSS-15 software. Results: It was found that there is significant increase in knowledge after education intervention in the components of life support measures (BLS/ALS) i.e. ratio of chest compression to ventilation in BLS (P=0.001), correct sequence of CPR (p <0.001), rate of chest compression in ALS (P=0.001), the depth of chest compression in adult CPR (p<0.001), and position of chest compression in CPR (P=0.016). Nurses were well appreciated the programme and request to continue in future for all the nurses. Conclusions: At recent BLS/ALS courses (2010), a significant number of nurses remain without any such training. Action is needed to ensure all nurses receive BLS training and practice this skill regularly in order to retain their knowledge.

Keywords: pre-experimental, basic and advance life support, nurses, sampling technique

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Authors: Pranab Kumar Goswami, Elena Gurung

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Small and medium enterprises (SME) are considered as the driving force for the economic growth of a developing country like India. Most of the SMEs are located in residential/non-industrial areas to avoid legal obligations of occupational safety and health (OSH) provisions. This study was conducted in Delhiwith a view to analyze the accidents that occurredduringthe year 2019 & 2020. The objective of the study was to find out the accident prone SMEs in Delhi and major causes of such accidents. Methods: Survey and comprehensive data analysis methods, followed by applying simple statistical techniques, were used for this study. The accident reports for the study period collected from the labour department and police stations were analyzed for the study. The injured workers were interviewed to ascertain safety compliances, training and awareness programs, etc. The study was completed in March2021. Results: It was found that most of the accidents took place in SMEs located in residential/non- industrial areas in Delhi. The accident-prone machines were found to be power presses (42%) and injection moulding machines (37%). Predominantly unsafe machinery or unsafe working conditions and lack of training of worker were observed to be the major causes of accidents in such industries. Conclusions: It was concluded from the study that unsafe machinery/equipment and lack of proper training to the workers were two main reasons for increase in accidents.It was also concluded that the industries located in industrial areas were better placed in terms of workplace compliances. The managements who were running their operations from residential/non-industrial areaswere found to be less aware on health and safety issues. Lack of enforcement by government agencies in such areas has escalated this problem. Adequate training to workers, managing safe & healthy workplace, and sustained enforcement can reduce accidents in such industries.

Keywords: SME, accident prevention, cause of accident, unorganised

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Authors: Smriti Pahwa, Karishma Vats, Aditi Macwan, Jija Dutt, Sumukhi Vaid

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Age approporiate complementary feeding has been stressed upon for sound young child nutrition and appropriate growth. National Infant and Young Child Feeding guidelines, policies and programs indicate cognizance of the issue taken by the country’s government, policy makers and technical experts. However, it is important that ordinary people, the caregivers of young children too understand the importance of appropriate feeding. For this, an interface might be required where ordinary people could participate in assessing the gaps in IYCF as a first step to take subsequent action. In this context an attempt was made to extrapolate a citizen led learning level survey that has been involving around 25000 ordinary citizens to reach out to 600,000 children annually for over a decade in India. Based on this philosophy of involving ordinary people in simple assessments to produce understandable actionable evidence, a rapid diet assessment tool was developed and collected from caregivers of 90 < 3year children from two urban clusters in Ahmedabad and Baroda, Gujarat. Target sample for pilot was selected after cluster census. Around half the mothers reported that they had not yet introduced water or other fluids to their < 6 month babies. However, about a third were already feeding them food other than mother’s milk. Although complementary feeding was initiated in almost all (95%) children more than 6 months old, frequency was suboptimal in 60%; in 80% cases no measure was taken to either improve energy or nutrient density; only 33% were fed protective foods; Green Leafy Vegetables consumption was negligible (1.4%). Anganwadi food was not consumed. By engaging ordinary people to generate evidence and understand the gaps, such assessments have the potential to be used to generate useful evidence for action at scale as well as locally.

Keywords: citizen led, grass root engagement, IYCF (Infant and Young Child Feeding), rapid diet assessment, under nutrition

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Authors: Kumari Rekha, Mathur K Dhananjay, Maheshwari Deepanshu, Nautiyal Nidhi, Shubham Smriti, Laal Deepika, Sinha Swati, Kumar Anupam, Biswas Subhrajit, Shiv Kumar Sarin

Abstract:

Background: Mesenchymal stem cells are multipotent stem cells derived from mesoderm and are used for therapeutic purposes because of their self-renewal, homing capacity, Immunomodulatory capability, low immunogenicity and mitochondrial transfer signaling. MSCs have the ability to regulate the mechanism of both innate as well as adaptive immune responses through the modulation of cellular response and the secretion of inflammatory mediators. Different sources of MSC are UC MSC, BM MSC, Dental Pulp, and Adipose MSC. The most frequent source used is umbilical cord tissue due to its being easily available and free of limitations of collection procedures from respective hospitals. The immunosuppressive role of MSCs is particularly interesting for clinical use since it confers resistance to rejection by the host immune response. Methodology: In this study, T helper cells (TH4), Cytotoxic T cells (CD-8), immunoregulatory cells (CD25 +FOXP3+) are compared from isolated MSC from three different methods, UC Dissociation Kit (Miltenyi), Explant Culture and Collagenase Type-IV. To check the immunomodulatory property, these MSCs were seeded with PBMC(Coculture) in CD3 coated 24 well plates. Cd28 antibody was added in coculture for six days. The coculture was analyzed in FACS Verse flow cytometry. Results: From flow cytometry analysis of coculture, it found that All over T helper cells (CD4+) number p<0.0264 increases in (All Enzymes) MSC rather than explant MSC(p>0.0895) as compared to Collagenase(p>0.7889) in a coculture of Activated T cell and Mesenchymal Stem Cell. Similar T reg cells (CD25+, FOXP3+) expression p<0.0234increases in All Enzymes), decreases in Explant and Collagenase. Experiments have shown that MSCs can also directly prevent the cytotoxic activity of CD8 lymphocytes mainly by blocking their proliferation rather than by inhibiting the cytotoxic effect. And promoting the t-reg cells, which helps in the mediation of immune response in various diseases. Conclusion: MSC suppress Cytotoxic CD8 T cell and Enhance immunoregulatory T reg (CD4+, CD25+, FOXP3+) Cell expression. Thus, MSC maintains a proper balance(ratio) between CD4 T cells and Cytotoxic CD8 T cells.

Keywords: MSC, disease, T cell, T regulatory

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Authors: Claudia Carbajal, Jija Dutt, Smriti Pahwa, Sumukhi Vaid, Karishma Vats

Abstract:

ASER Centre, the research and assessment arm of Pratham Education Foundation sees measurement as the first stage of action. ASER uses primary research to push and give empirical foundations to policy discussions at a multitude of levels. At a household level, common citizens use a simple assessment (a floor-level test) to measure learning across rural India. This paper presents the evidence on the applicability of an ASER approach to the health sector. A citizen-led assessment was designed and executed that collected information from young mothers with children up to a year of age. The pilot assessments were rolled-out in two different models: Paid surveyors and student volunteers. The survey covered three geographic areas: 1,239 children in the Jaipur District of Rajasthan, 2,086 in the Rae Bareli District of Uttar Pradesh, and 593 children in the Bhuj Block in Gujarat. The survey tool was designed to study knowledge of health-related issues, daily practices followed by young mothers and access to relevant services and programs. It provides insights on behaviors related to infant and young child feeding practices, child and maternal nutrition and supplementation, water and sanitation, and health services. Moreover, the survey studies the reasons behind behaviors giving policy-makers actionable pathways to improve implementation of social sector programs. Although data on health outcomes are available, this approach could provide a rapid annual assessment of health issues with indicators that are easy to understand and act upon so that measurements do not become an exclusive domain of experts. The results give many insights into early childhood health behaviors and challenges. Around 98% of children are breastfed, and approximately half are not exclusively breastfed (for the first 6 months). Government established diet diversity guidelines are met for less than 1 out of 10 children. Although most households are satisfied with the quality of drinking water, most tested households had contaminated water.

Keywords: citizen-led assessment, rapid health assessment, Infant and Young Children Feeding, water and sanitation, maternal nutrition, supplementation

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Authors: Smriti Rastogi, Narsingh Verma

Abstract:

Background: A vast body of research exists on the use of oral hypoglycaemic drugs, insulin injections and the like in managing diabetes but no such research exists that has taken into consideration the parameter of time restricted meal intake and its positive effects in managing diabetes. The utility of this project is immense as it offers a solution to the woes of diabetics based on circadian rhythm and normal physiology of the human body. Method: 80 Diabetics, enrolled from the Out Patient Department of Endocrinology, KGMU (King George's Medical University) were randomly divided based on consent to early dinner TRM(time restricted meal) group or not (control group). Follow up was done at six months and 12 months for anthropometric measurement, height, weight, waist-hip ratio, neck size, fasting, postprandial blood sugar, HbA1c, serum urea, serum creatinine, and lipid profile. The patient was given a clear understanding of chronomedicine and how it affects their health. A single intervention was done - the timing of dinner was at or around 7 pm for TRM group. Result: 65% of TRM group and 40 %(non- TRM) had normal HbA1c after 12 months. HbA1c in TRM Group (first visit to second follow up) had a significant p value=0.017. A p value of <0.0001 was observed on comparing the values of blood sugar (fasting) in TRM Group from the first visit and second follow up. The values of blood sugar (postprandial) in TRM Group (first visit and second follow up) showed a p-value <0.0001 (highly significant). Values of the three parameters were non- significant in the control group. Hip size(First Visit to Second Follow Up) TRM Group showed a p-value = 0.0344 (Significant) (Difference between means=2.762 ± 1.261)Detailed results of the above parameters and a few newer ones will be presented at the conference. Conclusion: Time restricted meal intake in diabetics shows promise and is worth exploring further. Time Restricted Meal intake in Type 2 diabetics has a significant effect in controlling and maintaining HbA1c as the reduction in HbA1c value was very significant in the TRM group vs. the control group. Similar highly significant results were obtained in the case of fasting and postprandial values of blood sugar in the TRM group when compared to the control group. The effects of time restricted meal intake in diabetics show promise and are worth exploring further. It is one of the first studies which have been undertaken in Indian diabetics, although the initial data obtained is encouraging yet further research and study are required to corroborate results.

Keywords: chronomedicine, diabetes, endocrinology, time restricted meal intake

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Authors: Pascale Brasseur, Binu Gurung, Nicholas Halfpenny, James Eaton

Abstract:

Development of minimally invasive treatments in recent years provides a potential alternative to invasive surgical interventions which are of limited value to patients with spinal metastases due to short life expectancy. A systematic review was conducted to explore the efficacy and safety of radiofrequency ablation (RFA), a minimally invasive treatment in patients with spinal metastases. EMBASE, Medline and CENTRAL were searched from database inception to March 2017 for randomised controlled trials (RCTs) and non-randomised studies. Conference proceedings for ASCO and ESMO published in 2015 and 2016 were also searched. Fourteen studies were included: three prospective interventional studies, four prospective case series and seven retrospective case series. No RCTs or studies comparing RFA with another treatment were identified. RFA was followed by cement augmentation in all patients in seven studies and some patients (40-96%) in the remaining seven studies. Efficacy was assessed as pain relief in 13/14 studies with the use of a numerical rating scale (NRS) or a visual analogue scale (VAS) at various time points. Ten of the 13 studies reported a significant decrease in pain outcome, post-RFA compared to baseline. NRS scores improved significantly at 1 week (5.9 to 3.5, p < 0.0001; 8 to 4.3, p < 0.02 and 8 to 3.9, p < 0.0001) and this improvement was maintained at 1 month post-RFA compared to baseline (5.9 to 2.6, p < 0.0001; 8 to 2.9, p < 0.0003; 8 to 2.9, p < 0.0001). Similarly, VAS scores decreased significantly at 1 week (7.5 to 2.7, p=0.00005; 7.51 to 1.73, p < 0.0001; 7.82 to 2.82, p < 0.001) and this pattern was maintained at 1 month post-RFA compared to baseline (7.51 to 2.25, p < 0.0001; 7.82 to 3.3; p < 0.001). A significant pain relief was achieved regardless of whether patients had cement augmentation in two studies assessing the impact of RFA with or without cement augmentation on VAS pain scores. In these two studies, a significant decrease in pain scores was reported for patients receiving RFA alone and RFA+cement at 1 week (4.3 to 1.7. p=0.0004 and 6.6 to 1.7, p=0.003 respectively) and 15-36 months (7.9 to 4, p=0.008 and 7.6 to 3.5, p=0.005 respectively) after therapy. Few minor complications were reported and these included neural damage, radicular pain, vertebroplasty leakage and lower limb pain/numbness. In conclusion, the efficacy and safety of RFA were consistently positive between prospective and retrospective studies with reductions in pain and few procedural complications. However, the lack of control groups in the identified studies indicates the possibility of selection bias inherent in single arm studies. Controlled trials exploring efficacy and safety of RFA in patients with spinal metastases are warranted to provide robust evidence. The identified studies provide an initial foundation for such future trials.

Keywords: pain relief, radiofrequency ablation, spinal metastases, systematic review

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Authors: Bidisha Chatterjee, Sonal Grover, Rekha Gurung

Abstract:

Postpartum dissection of the internal carotid artery is a relatively rare condition and is considered as an underlying aetiology in 5% to 25% of strokes under the age of 30 to 45 years. However, 86% of these cases recover completely and 14% have mild focal neurological symptoms. Prognosis is generally good with early intervention. The risk quoted for a repeat carotid artery dissection in subsequent pregnancies is less than 2%. 36-year Caucasian primipara presented on postnatal day one of forceps delivery with tachycardia. In the intrapartum period she had a history of prolonged rupture of membranes and developed intrapartum sepsis and was treated with antibiotics. Postpartum ECG showed septal inferior T wave inversion and a troponin level of 19. Subsequently Echocardiogram ruled out post-partum cardiomyopathy. Repeat ECG showed improvement of the previous changes and in the absence of symptoms no intervention was warranted. On day 4 post-delivery, she had developed symptoms of droopy right eyelid, pain around the right eye and itching in the right ear. On examination, she had developed right sided ptosis, unequal pupils (Rt miotic pupil). Cranial nerve examination, reflexes, sensory examination and muscle power was normal. Apart from migraine, there was no medical or family history of note. In view of Horner’s on the right, she had a CT Angiogram and subsequently MR/MRA and was diagnosed with dissection of the cervical portion of the right internal carotid artery. She was discharged on a course of Aspirin 75mg. By 6 week post-natal follow up patient had recovered significantly with occasional episodes of unequal pupils and tingling of right toes which resolved spontaneously. Cervical artery dissection, including VAD and carotid artery dissection, are rare complications of pregnancy with an estimated annual incidence of 2.6–3 per 100,000 pregnancy hospitalizations. Aetiology remains unclear though trauma during straining at labour, underlying arterial disease and preeclampsia have been implicated. Hypercoagulable state during pregnancy and puerperium could also be an important factor. 60-90% cases present with severe headache and neck pain and generally precede neurological symptoms like ipsilateral Horner’s syndrome, retroorbital pain, tinnitus and cranial nerve palsy. Although rare, the consequences of delayed diagnosis and management can lead to severe and permanent neurological deficits. Patients with a strong index of suspicion should undergo an MRI or MRA of head and neck. Antithrombotic and antiplatelet therapy forms the mainstay of therapy with selected cases needing endovascular stenting. Long term prognosis is favourable with either complete resolution or minimal deficit if treatment is prompt. Patients should be counselled about the recurrence risk and possibility of stroke in future pregnancy. Coronary artery dissection is rare and treatable but needs early diagnosis and treatment. Post-partum headache and neck pain with neurological symptoms should prompt urgent imaging followed by antithrombotic and /or antiplatelet therapy. Most cases resolve completely or with minimal sequelae.

Keywords: postpartum, dissection of internal carotid artery, magnetic resonance angiogram, magnetic resonance imaging, antiplatelet, antithrombotic

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