Citizen Charter in Nepali Public Sector Organizations: Does it Really Work?

Citizen Charter is an instrument of citizen-centric governance that confirms quality in public service delivery by holding public sector organizations directly accountable, responsive, and transparent. In this regard, this study aimed to disclose the current picture of Citizen Charter in Nepali public sector organizations from service users’ perspectives. For this, the survey was conducted in key six public sector organizations of Lalitpur Metropolitan City by using the client exit interview method, with the help of a semi-structured interview schedule. The study result indicates that the use of the Citizen Charter is extensively low. Service users are not fully aware and well informed about it, and its values. Service users prefer to receive services by asking from duty holders, intermediates (agents), and previous service users than the Citizen Charter. Service users believe that the promises of the Citizen Charter and the behavior of duty holders are inconsistent. However, some service users are demanding services as per the Citizen Charter

Seawater pre-treatment for reverse osmosis system

University of Technology Sydney. Faculty of Engineering and Information Technology.Membrane based desalination technology such as reverse osmosis (RO) has rapidly become a viable alternative to conventional treatment for drinking water production from seawater. However, membrane fouling is a major concern in reverse osmosis (RO) based seawater desalination. The fouling on RO membrane deteriorates the performance of RO membranes and increases the energy consumption and even requires more frequent replacement of the membranes. The objective of the study was to assess the different pre-treatment systems to reduce membrane fouling reduction, and remove organic matter in terms of dissolved organic carbon in RO desalination projects. Silt density index (SDI), modified fouling index (MF/UF-MFI) and cross-flow sampler modified fouling index (CFMF-MFI) were used to study the pre-treatment efficiency of different process such as flocculation, deep bed filtration, microfiltration, ultrafiltration and biofiltration. A long term on site biofilter experiment was investigated in terms of removal of particulate matter, different fouling indices and dissolved organic carbon (DOC) from sea water by the use of biofiltration. In this study, three biofilter columns were operated packed with granular activated carbon (GAC), anthracite and sand as a filter media. The experimental results indicated that biofiltration pre-treatment systems reduced organic matter and particulate matter. It was expected that biofilter can lower fouling to a subsequent RO process in desalination plant. In terms of DOC removal efficiency, GAC biofilter showed higher and stable removal efficiency (41-88%), than sand biofilter (7-76%) and anthracite biofilter (3-71%). All biofilters used in this study removed most of hydrophobic organic compounds (around 94%). On the other hand, hydrophilic organic removal varied depending on the media filter. GAC biofilter removed more organic bio-polymers (51%), humic substances (75%) and building blocks (50%) compared with sand and anthracite biofilters. Thus GAC filter was the best medium to provide the lowest fouling potential as it showed the highest removal efficiency of DOC, including hydrophilic, humic, building blocks and biopolymer. The fouling potential of treated seawater (filtrate) was evaluated using three different fouling MF-MFI, UF-MFI, and CFMF-MFI. GAC biofilter had lower fouling potential compared to sand and anthracite biofilters. The in-line flocculation and spiral-flocculation followed by media filtration (sand or anthracite) have been investigated as a pre-treatment of seawater to reverse osmosis (SWRO). In the case of in-line flocculation filtration system, the seawater was passed through the media filter just after rapid mixing of raw seawater with flocculants for 10 seconds. In the case of spiral-flocculation filtration, after the rapid mixing of seawater with flocculants, it was then passed through the spiral-flocculation. Both filtrations showed good turbidity removal efficiency (up to 71%). In-line flocculation filtration showed 2-3 times higher headloss than the spiral-flocculation filtration. The UF-MFI reduction was 63-70% for sand as medium in the presence of the flocculant whereas it was 65-76% for anthracite. Both filtration systems in the presence of flocculant (3 mg/L Fe³⁺) led to 50-65% removal of hydrophobic organics. The hydrophilic organic removal was around 30-38%. The predominant portion of hydrophilic was humic substances which had a poor removal. In general sand filter gave a higher removal than anthracite filter. The performance of TiCl₄ and Ti(SO₄)₂ was compared to FeCl₃ at different coagulant concentrations (1-30 mg/l) of Ti salts and FeCl₃ and at different pH of 5 to 9. Coagulation was conducted using conventional jar test. For each jar test, six 1 litre beakers were filled with raw seawater. The pH was adjusted with 0.1 N solution of hydrochloride acid and sodium hydroxide prior to coagulant addition. The solution was subjected to rapid mixing (100 rpm) for 2 min followed by slow mixing (20 rpm) for 30 min. It was then stopped to allow the aggregated flocs to settle down for 30 min. The supernatant samples were drawn for the measurements of turbidity, UV-254 absorbance and DOC, zeta potential and particle size distribution. The results showed that at pH of 8.0 (similar to seawater pH), TiCl₄ had advantages over FeCl₃ and Ti(SO₄)₂ at the same coagulant dose of 20 mg/L. Under this condition, TiCl₄ achieved ~70% DOC and UV-254 removal. This was approximately two times higher than FeCl₃ and Ti(SO₄)₂. Nevertheless, FeCl₃ and Ti(SO₄)₂ showed better turbidity removal. At higher coagulant dose (30 mg/L), the turbidity removal of TiCl₄, was especially compromised. The differences in the performance of the coagulants were associated with the coagulant mechanisms based on the floc zeta potential evaluation. The coagulant mechanisms of Ti-salts could be associated to charge neutralization while FeCl₃was inclined towards adsorption mechanism. The study found that biofiltration, in-line flocculation and spiral-flocculation followed by media filtration, coagulation and flocculation are appropriate pre-treatment before RO. In particular, Biofilter showed to a consistent removal of organic matter over a long period of time

Infective complications after percutaneous nephrolithotomy in relation to preoperative urine culture status

Introductions: Fever and sepsis after percutaneous nephrolithotomy (PCNL) secondary to urinary tract infection is a major determinant of overall post PCNL complications. This study aims to analyse infective complications after PCNL in relation to pre-operative urine culture status. Methods: A comparative analysis of post PCNL infective complications in pre-operative urine culture positive (Group A) and negative (Group B) was done for one year during June 2017 to May 2018 in department of urology, Bir Hospital, National Academy of Medical Sciences, Kathmandu, Nepal. Demographics, stone characteristics, mean operative time, post-operative hospital stay and post-operative complications as per Modified Clavien classification were compared between the two groups. Results: Out of total 136 PCNL patients, 51 were in Group A and 85 in Group B. Infective complications were significantly high, 28 (54.90%) in group A compared to 20 (23.53%) in group B, p=0.004. The most common isolate was Escherichia coli 19 (37.25%), sensitive to amikacin 37 (72.55%). The mean operation time, transfusion and hospital stay was not statically different in two groups. Morality occurred in 1 (1.96%) in group A. Conclusions: Infective complications were significantly high after PCNL in patients with preoperative positive urine culture, even when it was treated to sterile with sensitive antibiotics, compared to patients with preoperative negative urine culture. Keywords: modified Clavien classification, percutaneous nephrolithotomy PCNL, sepsis, urine cultur

Assesment of electricity excess in an isolated hybrid energy system: A case study of a Dangiwada village in rural Nepal

The increasing demand of power can be fulfilled through different architectures and electricity supply models by utilizing the available local resources. But most of the isolated energy system suffers from high energy cost and unreliable energy supply. This study identifies different electricity supply models to fulfill the dynamic demand of power in a remote area, which is analyzed in terms of cost of energy and causes for the high cost of energy. Among different factors, the presence of unusable energy (Electricity Excess) produced by the energy system during fulfillment of the demand is found to be major one cause for the high cost of energy. Further, the importance of energy storage system in isolated energy system is discussed. In this case, up to 83.4 % of electricity excess is observed, which can be utilized in different manners to reduce the total energy cost. Electricity excess profile for different energy model, their impacts and possible techniques of the solution with open views are discussed

A Novel Universal Primer-Multiplex-PCR Method with Sequencing Gel Electrophoresis Analysis

In this study, a novel universal primer-multiplex-PCR (UP-M-PCR) method adding a universal primer (UP) in the multiplex PCR reaction system was described. A universal adapter was designed in the 5′-end of each specific primer pairs which matched with the specific DNA sequences for each template and also used as the universal primer (UP). PCR products were analyzed on sequencing gel electrophoresis (SGE) which had the advantage of exhibiting extraordinary resolution. This method overcame the disadvantages rooted deeply in conventional multiplex PCR such as complex manipulation, lower sensitivity, self-inhibition and amplification disparity resulting from different primers, and it got a high specificity and had a low detection limit of 0.1 ng for single kind of crops when screening the presence of genetically modified (GM) crops in mixture samples. The novel developed multiplex PCR assay with sequencing gel electrophoresis analysis will be useful in many fields, such as verifying the GM status of a sample irrespective of the crop and GM trait and so on

The global, regional, and national burden of adult lip, oral, and pharyngeal cancer in 204 countries and territories:A systematic analysis for the Global Burden of Disease Study 2019

Importance Lip, oral, and pharyngeal cancers are important contributors to cancer burden worldwide, and a comprehensive evaluation of their burden globally, regionally, and nationally is crucial for effective policy planning.Objective To analyze the total and risk-attributable burden of lip and oral cavity cancer (LOC) and other pharyngeal cancer (OPC) for 204 countries and territories and by Socio-demographic Index (SDI) using 2019 Global Burden of Diseases, Injuries, and Risk Factors (GBD) Study estimates.Evidence Review The incidence, mortality, and disability-adjusted life years (DALYs) due to LOC and OPC from 1990 to 2019 were estimated using GBD 2019 methods. The GBD 2019 comparative risk assessment framework was used to estimate the proportion of deaths and DALYs for LOC and OPC attributable to smoking, tobacco, and alcohol consumption in 2019.Findings In 2019, 370 000 (95% uncertainty interval [UI], 338 000-401 000) cases and 199 000 (95% UI, 181 000-217 000) deaths for LOC and 167 000 (95% UI, 153 000-180 000) cases and 114 000 (95% UI, 103 000-126 000) deaths for OPC were estimated to occur globally, contributing 5.5 million (95% UI, 5.0-6.0 million) and 3.2 million (95% UI, 2.9-3.6 million) DALYs, respectively. From 1990 to 2019, low-middle and low SDI regions consistently showed the highest age-standardized mortality rates due to LOC and OPC, while the high SDI strata exhibited age-standardized incidence rates decreasing for LOC and increasing for OPC. Globally in 2019, smoking had the greatest contribution to risk-attributable OPC deaths for both sexes (55.8% [95% UI, 49.2%-62.0%] of all OPC deaths in male individuals and 17.4% [95% UI, 13.8%-21.2%] of all OPC deaths in female individuals). Smoking and alcohol both contributed to substantial LOC deaths globally among male individuals (42.3% [95% UI, 35.2%-48.6%] and 40.2% [95% UI, 33.3%-46.8%] of all risk-attributable cancer deaths, respectively), while chewing tobacco contributed to the greatest attributable LOC deaths among female individuals (27.6% [95% UI, 21.5%-33.8%]), driven by high risk-attributable burden in South and Southeast Asia.Conclusions and Relevance In this systematic analysis, disparities in LOC and OPC burden existed across the SDI spectrum, and a considerable percentage of burden was attributable to tobacco and alcohol use. These estimates can contribute to an understanding of the distribution and disparities in LOC and OPC burden globally and support cancer control planning efforts

Spatial, temporal, and demographic patterns in prevalence of chewing tobacco use in 204 countries and territories, 1990-2019 : a systematic analysis from the Global Burden of Disease Study 2019

Interpretation Chewing tobacco remains a substantial public health problem in several regions of the world, and predominantly in south Asia. We found little change in the prevalence of chewing tobacco use between 1990 and 2019, and that control efforts have had much larger effects on the prevalence of smoking tobacco use than on chewing tobacco use in some countries. Mitigating the health effects of chewing tobacco requires stronger regulations and policies that specifically target use of chewing tobacco, especially in countries with high prevalence. Findings In 2019, 273 center dot 9 million (95% uncertainty interval 258 center dot 5 to 290 center dot 9) people aged 15 years and older used chewing tobacco, and the global age-standardised prevalence of chewing tobacco use was 4 center dot 72% (4 center dot 46 to 5 center dot 01). 228 center dot 2 million (213 center dot 6 to 244 center dot 7; 83 center dot 29% [82 center dot 15 to 84 center dot 42]) chewing tobacco users lived in the south Asia region. Prevalence among young people aged 15-19 years was over 10% in seven locations in 2019. Although global agestandardised prevalence of smoking tobacco use decreased significantly between 1990 and 2019 (annualised rate of change: -1 center dot 21% [-1 center dot 26 to -1 center dot 16]), similar progress was not observed for chewing tobacco (0 center dot 46% [0 center dot 13 to 0 center dot 79]). Among the 12 highest prevalence countries (Bangladesh, Bhutan, Cambodia, India, Madagascar, Marshall Islands, Myanmar, Nepal, Pakistan, Palau, Sri Lanka, and Yemen), only Yemen had a significant decrease in the prevalence of chewing tobacco use, which was among males between 1990 and 2019 (-0 center dot 94% [-1 center dot 72 to -0 center dot 14]), compared with nine of 12 countries that had significant decreases in the prevalence of smoking tobacco. Among females, none of these 12 countries had significant decreases in prevalence of chewing tobacco use, whereas seven of 12 countries had a significant decrease in the prevalence of tobacco smoking use for the period. Summary Background Chewing tobacco and other types of smokeless tobacco use have had less attention from the global health community than smoked tobacco use. However, the practice is popular in many parts of the world and has been linked to several adverse health outcomes. Understanding trends in prevalence with age, over time, and by location and sex is important for policy setting and in relation to monitoring and assessing commitment to the WHO Framework Convention on Tobacco Control. Methods We estimated prevalence of chewing tobacco use as part of the Global Burden of Diseases, Injuries, and Risk Factors Study 2019 using a modelling strategy that used information on multiple types of smokeless tobacco products. We generated a time series of prevalence of chewing tobacco use among individuals aged 15 years and older from 1990 to 2019 in 204 countries and territories, including age-sex specific estimates. We also compared these trends to those of smoked tobacco over the same time period. Findings In 2019, 273 & middot;9 million (95% uncertainty interval 258 & middot;5 to 290 & middot;9) people aged 15 years and older used chewing tobacco, and the global age-standardised prevalence of chewing tobacco use was 4 & middot;72% (4 & middot;46 to 5 & middot;01). 228 & middot;2 million (213 & middot;6 to 244 & middot;7; 83 & middot;29% [82 & middot;15 to 84 & middot;42]) chewing tobacco users lived in the south Asia region. Prevalence among young people aged 15-19 years was over 10% in seven locations in 2019. Although global age standardised prevalence of smoking tobacco use decreased significantly between 1990 and 2019 (annualised rate of change: -1 & middot;21% [-1 & middot;26 to -1 & middot;16]), similar progress was not observed for chewing tobacco (0 & middot;46% [0 & middot;13 to 0 & middot;79]). Among the 12 highest prevalence countries (Bangladesh, Bhutan, Cambodia, India, Madagascar, Marshall Islands, Myanmar, Nepal, Pakistan, Palau, Sri Lanka, and Yemen), only Yemen had a significant decrease in the prevalence of chewing tobacco use, which was among males between 1990 and 2019 (-0 & middot;94% [-1 & middot;72 to -0 & middot;14]), compared with nine of 12 countries that had significant decreases in the prevalence of smoking tobacco. Among females, none of these 12 countries had significant decreases in prevalence of chewing tobacco use, whereas seven of 12 countries had a significant decrease in the prevalence of tobacco smoking use for the period. Interpretation Chewing tobacco remains a substantial public health problem in several regions of the world, and predominantly in south Asia. We found little change in the prevalence of chewing tobacco use between 1990 and 2019, and that control efforts have had much larger effects on the prevalence of smoking tobacco use than on chewing tobacco use in some countries. Mitigating the health effects of chewing tobacco requires stronger regulations and policies that specifically target use of chewing tobacco, especially in countries with high prevalence. Copyright (c) 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.Peer reviewe

Spatial, temporal, and demographic patterns in prevalence of smoking tobacco use and attributable disease burden in 204 countries and territories, 1990-2019 : a systematic analysis from the Global Burden of Disease Study 2019

Background Ending the global tobacco epidemic is a defining challenge in global health. Timely and comprehensive estimates of the prevalence of smoking tobacco use and attributable disease burden are needed to guide tobacco control efforts nationally and globally. Methods We estimated the prevalence of smoking tobacco use and attributable disease burden for 204 countries and territories, by age and sex, from 1990 to 2019 as part of the Global Burden of Diseases, Injuries, and Risk Factors Study. We modelled multiple smoking-related indicators from 3625 nationally representative surveys. We completed systematic reviews and did Bayesian meta-regressions for 36 causally linked health outcomes to estimate non-linear dose-response risk curves for current and former smokers. We used a direct estimation approach to estimate attributable burden, providing more comprehensive estimates of the health effects of smoking than previously available. Findings Globally in 2019, 1.14 billion (95% uncertainty interval 1.13-1.16) individuals were current smokers, who consumed 7.41 trillion (7.11-7.74) cigarette-equivalents of tobacco in 2019. Although prevalence of smoking had decreased significantly since 1990 among both males (27.5% [26. 5-28.5] reduction) and females (37.7% [35.4-39.9] reduction) aged 15 years and older, population growth has led to a significant increase in the total number of smokers from 0.99 billion (0.98-1.00) in 1990. Globally in 2019, smoking tobacco use accounted for 7.69 million (7.16-8.20) deaths and 200 million (185-214) disability-adjusted life-years, and was the leading risk factor for death among males (20.2% [19.3-21.1] of male deaths). 6.68 million [86.9%] of 7.69 million deaths attributable to smoking tobacco use were among current smokers. Interpretation In the absence of intervention, the annual toll of 7.69 million deaths and 200 million disability-adjusted life-years attributable to smoking will increase over the coming decades. Substantial progress in reducing the prevalence of smoking tobacco use has been observed in countries from all regions and at all stages of development, but a large implementation gap remains for tobacco control. Countries have a dear and urgent opportunity to pass strong, evidence-based policies to accelerate reductions in the prevalence of smoking and reap massive health benefits for their citizens. Copyright (C) 2021 The Author(s). Published by Elsevier Ltd.Peer reviewe

The global burden of cancer attributable to risk factors, 2010-19 : a systematic analysis for the Global Burden of Disease Study 2019

Background Understanding the magnitude of cancer burden attributable to potentially modifiable risk factors is crucial for development of effective prevention and mitigation strategies. We analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 to inform cancer control planning efforts globally. Methods The GBD 2019 comparative risk assessment framework was used to estimate cancer burden attributable to behavioural, environmental and occupational, and metabolic risk factors. A total of 82 risk-outcome pairs were included on the basis of the World Cancer Research Fund criteria. Estimated cancer deaths and disability-adjusted life-years (DALYs) in 2019 and change in these measures between 2010 and 2019 are presented. Findings Globally, in 2019, the risk factors included in this analysis accounted for 4.45 million (95% uncertainty interval 4.01-4.94) deaths and 105 million (95.0-116) DALYs for both sexes combined, representing 44.4% (41.3-48.4) of all cancer deaths and 42.0% (39.1-45.6) of all DALYs. There were 2.88 million (2.60-3.18) risk-attributable cancer deaths in males (50.6% [47.8-54.1] of all male cancer deaths) and 1.58 million (1.36-1.84) risk-attributable cancer deaths in females (36.3% [32.5-41.3] of all female cancer deaths). The leading risk factors at the most detailed level globally for risk-attributable cancer deaths and DALYs in 2019 for both sexes combined were smoking, followed by alcohol use and high BMI. Risk-attributable cancer burden varied by world region and Socio-demographic Index (SDI), with smoking, unsafe sex, and alcohol use being the three leading risk factors for risk-attributable cancer DALYs in low SDI locations in 2019, whereas DALYs in high SDI locations mirrored the top three global risk factor rankings. From 2010 to 2019, global risk-attributable cancer deaths increased by 20.4% (12.6-28.4) and DALYs by 16.8% (8.8-25.0), with the greatest percentage increase in metabolic risks (34.7% [27.9-42.8] and 33.3% [25.8-42.0]). Interpretation The leading risk factors contributing to global cancer burden in 2019 were behavioural, whereas metabolic risk factors saw the largest increases between 2010 and 2019. Reducing exposure to these modifiable risk factors would decrease cancer mortality and DALY rates worldwide, and policies should be tailored appropriately to local cancer risk factor burden. Copyright (C) 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.Peer reviewe

Penilaian Kinerja Keuangan Koperasi di Kabupaten Pelalawan

This paper describe development and financial performance of cooperative in District Pelalawan among 2007 - 2008. Studies on primary and secondary cooperative in 12 sub-districts. Method in this stady use performance measuring of productivity, efficiency, growth, liquidity, and solvability of cooperative. Productivity of cooperative in Pelalawan was highly but efficiency still low. Profit and income were highly, even liquidity of cooperative very high, and solvability was good