Scar among Bacillus Calmette-Guérin Vaccinated Children Presenting to an Immunisation Clinic at a Tertiary Hospital in Nepal: An Observational Study

Introduction: Bacillus Calmette-Guérin vaccination is associated with the development of scarring at the vaccination site in most children within 12 weeks of vaccination. However, due to various factors, some children do not develop scars. The aim of the study was to determine the prevalence of scar failure and the differences in clinical characteristics between scar-positive and scar-negative children. Methods: This observational cross-section study was conducted between 12 September 2022 and 15 April 2024 on children attending a vaccination clinic at a tertiary care hospital for 12 or 15-month vaccination. A purposive sampling method was used, and 386 children were enrolled in the study. During medical history, information was collected on Bacillus Clamettte-Guérin vaccination, child and maternal clinical profiles, and hospitalisations for respiratory tract infections in children. Results: Among 386 infants, prevalence of BCG scar was 341 (88.34%; 95% CI: 91.81%-91.37%). Vaccination was confirmed in 94.82% by history and card. The median scar size was 4mm (IQR: 2,5 mm) transversely and 3 mm (IQR: 2,5) vertically. Thirty-two (8.30%) infants required hospital admission for respiratory infections; none received anti-tubercular treatment. Conclusions: The BCG scar formation was higher compare to the scar failure. The scar failure was comparable to other studies

Growth and Yield of Summer Squash (Cucurbita pepo var. sunny house) in Response to Organic and Inorganic Mulching Materials at Rampur, Chitwan

Mulching, a widely employed agricultural practice, has been recognized for its influence on soil moisture retention, temperature regulation, and weed suppression, thereby improving growth and yield of crops. An experiment was conducted to study the effect of mulching materials on growth and yield attributes of summer squash under water constraint condition during March to May 2023 in Chitwan, Nepal. The experiment was laid in single factor Randomized Complete Block Design (RCBD) with four different mulches (rice straw, wheat straw, rice husk and silver on black plastic mulch 30 microns) and control replicated 4 times. All the Plant growth parameters, including plant height, number of leaves per plant and plant spread, were highest in silver plastic mulch and the poorest in the un-mulched plots. Mulching also significantly influenced floral characters, with plastic mulch demonstrating superiority in traits such as days to flowering, number of flowers per plant, and sex ratio compared to organic mulches and the control. Fruit length, diameter, and weight exhibited the highest values under plastic mulch and the lowest values under the control, while all organic mulches showed similar results. The highest yield of 41.44 Mt ha-1 was achieved with silver plastic mulch, highlighting its effectiveness in enhancing crop productivity, while the lowest yield of 11.77 Mt ha-1 was recorded in the control plots. Despite its higher cost, silver pastic mulch exhibited highest net return and benefit-cost ratio. Rice husk mulch, with the second highest benefit-cost ratio and relatively low cost of production, emerged as promising alternative. Although mulching did not notably affect the soil pH, the varying soil organic matter percentages were observed, with the highest on rice straw mulch and the lowest on silver plastic mulch. The study suggests that while plastic mulch can significantly boost productivity during water scarcity, rice husk mulch offers a cost-effective alternative with substantial economic benefit

Topography Of Short Hepatic Veins And Interface Veins For Safe Tunneling During Hanging Maneuver Of Liver

Introduction: During hanging maneuver liver resection, a tunnel is created at the interface of the liver and Inferior venacava (IVC). Gap between the middle and right hepatic vein is known as Fossa venacava. A gap between the Inferior right hepatic vein and the Caudate vein is known as a Vein gap. The Fossa venacava and Vein gap provide a safe plane for the insertion of forceps during tunneling. The aim of this study is to determine the topography of this safe plane. Methods: A cross-sectional study was done. Twenty livers were used in our study. Major hepatic veins, distance of Vein gap, Fossa venacava, and each vessel present at the interface between liver and IVC was measured by a Vernier caliper. All the collected data was entered and analyzed by using Statistical Package for Social Sciences version 20 (SPSS-20).  Results: The average length of retro hepatic IVC was 49.5±10.5 mm and the diameter of 25.6±4.4 mm. The inferior right hepatic vein was present in 60% of cases while the Caudate vein was present in 85% of cases. Fossa venacava had an average distance of 12.3±3.46 mm and the Vein gap was 18.9±7.1 mm. Conclusion: While tunneling between IVC and the liver, Fossa venacava could be as small as 4.6 mm. The shortest distance of the Vein gap could be as small as 5.8 mm. The intermediate course of forceps insertion is safer than the right or left course

Hepatic Encephalopathy among Patients with Chronic Liver Disease Admitted to the Department of Internal Medicine in a Tertiary Care Centre: A Descriptive Cross-sectional Study

Introduction: Hepatic encephalopathy is a condition that impairs the neurological and psychiatric function of a patient as a result of advanced liver disease or portosystemic shunt. Early detection and treatment of hepatic encephalopathy can lessen its severity, length of stay in the hospital and potential fatality. The aim of this study was to find out the prevalence of hepatic encephalopathy among patients with chronic liver disease admitted to the Department of Internal Medicine in a tertiary care centre. Methods: A descriptive cross-sectional study was done among patients with chronic liver disease admitted to the Department of Internal Medicine in a tertiary care centre. Data from 1 October 2021 to 15 May 2023 were collected between 20 May 2023 and 30 May 2023 from the hospital records. Ethical approval was obtained from the Institutional Review Committee (Reference number: 808/2023). The diagnosis was made based on the history, clinical examinations, and gradings were done as per West Haven criteria. Convenience sampling was done. Point estimate and 95% Confidence Interval were calculated. Results: Among 389 patients with chronic liver disease, hepatic encephalopathy was seen in 40 (10.28%) (7.26-13.30, 95% Confidence Interval). The mean age of patients was 55.27±13.52 years. Conclusions: The prevalence of hepatic encephalopathy among patients with chronic liver disease was lower than the studies conducted in similar settings

A Baby Born with Ectopia Cordis, Omphalocele, Cleft Lips and Palate: A Case Report

Ectopia cordis is a rare congenital defect with the prevalence of 5 to 8 per million live births. Here we report a rare case of preterm female live birth with ectopia cordis associated with omphalocele, cleft lip, and palate. In this case, 14+ weeks ultrasound did not show any fetal abnormalities and parents were unaware of the condition until 35+ weeks when ultrasound detected the anomaly a few days before delivery. After delivery, they didn’t give consent for further intervention which led to neonatal mortality 3 hours after birth. If the condition was diagnosed in time, an earlier intervention could have been done.</jats:p

Pericapsular nerve group block followed by regional anesthesia for pathological fracture fixation in a multiple myeloma patient

Key Clinical Message Appropriate anesthetic technique for fracture fixation in multiple myeloma is crucial in minimizing perioperative complications. The use of pericapsular nerve group block followed by spinal anesthesia for the operative management of pathological fracture in multiple myeloma patient along with proper pre‐ and postanesthetic care ensures better outcome for the patient. Abstract Multiple myeloma is a malignant plasma cell disease that often presents with anemia, renal failure, hyperkalemia and osteolytic bone lesions. The advancements in drug therapy of multiple myeloma have prolonged the lifespan of the affected people, resulting in a rise in cases of surgical management of fractures in such patients. Anesthetic management, despite being of utmost importance in minimizing perioperative complications in such patients, has not been widely studied, especially in this part of the world. Hence, we report a case of 64 years diabetic, HbSAg positive male with hypothyroidism and a known case of multiple myeloma since the last 6 years, under medication for his comorbidities who suffered acetabular fracture. In this case report, the use of pericapsular nerve group block followed by spinal anesthesia for the operative management of the fracture has been discussed along with several pre‐ and postanesthetic considerations. With appropriate anesthetic techniques and proper pre‐ and postanesthetic care, better outcomes can be guaranteed

Risk factors associated with obesity among middle aged adults residing in Bhaktapur, Nepal

Introduction: Obesity is a major public health problem worldwide and also in Nepal in which excess body fat has accumulated to the extent that it may have an adverse effect on health, leading to reduced life expectancy and/or increased health problems. Hence, this study was conducted to identify the factor associated with obe­sity among middle aged adults in Duwakot, Changunarayan. &#x0D; Methods: A descriptive, cross-sectional research design was used among 109 middle aged adults residing in Duwakot, Changunarayan, Bhaktapur. Probability, systematic random sampling technique was used. Semi structured questionnaire was used to collect data by conducting semi-structured interview schedule as well as anthropometric measurement was also taken to cal­culate the body mass index. Data was analyzed in descriptive and inferential statistics (chi-square test with odd ratio). &#x0D; Results: The prevalence of obesity among middle aged adults was 12.8%. On the basis of statistical analysis, age (p=0.035), ethnicity (p=0.050), alcoholic consumption (p=0.003), sleeping hours at night (p=0.006), physical activity (p-0.014), presence of chronic diseases (p=0.001), used medicine (p=0.001) and family his­tory of obesity (p=0.005) were significant associated factors for obesity among middle aged adult. &#x0D; Conclusion: Prevalence of obesity among middle aged adult was 12.8%. Significant associated factors of obesity were age, ethnicity, alcoholic consumption, sleeping hours at night, physical activity, presence of chronic diseases, used medicine and family history of obesity. So the concerned municipality, health care personnel and related health organization should conduct awareness raising program regarding importance of maintaining normal weight and consequences of obesity in their health.</jats:p

The Digitalization of Education in Nepal: a critical discussion of the affordances of digital commons

Digitalization has brought significant changes to education, particularly in the context of learning through various digital platforms and access to technology. This study entitled "The Digitalization of Education in Nepal: A Critical Discussion of the Affordances of Digital Commons" has aimed to find and explore more in the context of digitalization and the affordance of digital commons in Nepal. The research has applied a systematic literature review as methodology and has inquired more into the field of digitalization and education in Nepal. There are several requirements while using and applying digital resources which must be thought of by various levels and stakeholders. Collaboration, capacity building, and awareness raising initiatives are necessary to promote the use of digital commons in Nepal and the use of Open sources in teaching learning practices. The innovative use of open source software in computer science education has the potential to enhance course resources, but the decision to use them should be considered for desired outcomes in learning