Improving neonatal health in Nepal: Major challenges to achieving millennium development goal 4

Background: Globally, more than 40% of all under-five child deaths occur during the neonatal period. Neonatal mortality in Nepal is 33 per 1,000 live births, eight times that of developed regions. So there is an urgent need for neonatal care to prevent these deaths, in order to achieve the fourth Millennium Development Goal by 2015. Objective: The objective of this article was to review the major challenges in improving neonatal health in Nepal and to identify possible keys to achieving Millennium Development Goal 4. Methodology: Key literature searches were conducted of electronic databases and relevant web-sites. Furthermore, personal contact with the local population in Nepal and hand searching of key journals was performed. Results: In Nepal, there exist harmful cultural practices during pregnancy and after childbirth. Under utilization of basic maternal and neonatal healthcare, limited health infrastructure with a shortage of trained health care professionals, poverty, illiteracy, women's low status in the society and political instability are major challenges facing neonatal health in Nepal. Conclusions: In order to improve neonatal health in Nepal, it is imperative to focus on biomedical, nursing and social interventions, in addition to family centred care. Health promotion regarding the practices to be adopted during pregnancy and after childbirth, improving health infrastructure and integrating skilled delivery personnel into local health services are important measures. Longer-term solutions could include: improving mother's nutrition and women's position in society, increasing the proportions of girls attending school, as well as involving men in neonatal health matters

Impact of Expressive Writing about Workplace Events : Stress, Job Satisfaction and Well-Being

Expressive Writing interventions have been widely used in clinical and medical settings. It has been shown that by exploring thoughts and feelings associated with stressful events can help individuals benefit in terms of reducing stress and improving health and psychological well-being. The present study examines the effectiveness of an expressive writing intervention among expatriates from Asia working in Information Technology industry in United States. A pre-post test design was applied. The study was conducted over 12 weeks, in which participants (N=30) completed pre assessment, and then were randomly assigned to different writing conditions Thoughts and Emotions condition (focused on thinking processes and feeling aspects) and Thoughts, Emotions and Social Support condition (focused on thoughts and feeling along with emphasis on support systems during a stressful event) in which they wrote for 3 consecutive days and this was followed by a post assessment. Post intervention, participants reported significant benefits of expressive writing through self report measures of stress, higher levels of job satisfaction & improved health and well-being. Interestingly, the study did not report any significant improvement on the social support variable, but noted a significant improvement in the social support satisfaction levels. Finally, the study also did not report any significant difference between the two writing conditions. The findings from this study gives insight into the use and benefits of EW intervention in workplace setting and suggest that there is tremendous potential in exploring the benefits of expressive writing in other sphere of workplace

Maximize resource utilization based channel access model with presence of reactive jammer for underwater wireless sensor network

Underwater sensor networks (UWSNs) are vulnerable to jamming attacks. Especially, reactive jamming which emerged as a greatest security threat to UWSNs. Reactive jammer are difficult to be removed, defended and identified. Since reactive jammer can control and regulate (i.e., the duration of the jam signal) the probability of jamming for maintaining high vulnerability with low detection probability. The existing model are generally designed considering terrestrial wireless sensor networks (TWSNs). Further, these models are limited in their ability to detect jamming correctly, distinguish between the corrupted and uncorrupted parts of a packet, and be adaptive with the dynamic environment. Cooperative jamming model has presented in recent times to utilize resource efficiently. However, very limited work is carried out using cooperative jamming detection. For overcoming research challenges, this work present Maximize Resource Utilization based Channel Access (MRUCA). The MRUCA uses cross layer design for mitigating reactive jammer (i.e., MRUCA jointly optimizes the cooperative hopping probabilities and channel accessibility probabilities of authenticated sensor device). Along with channel, load capacity of authenticated sensor device is estimated to utilize (maximize) resource efficiently. Experiment outcome shows the proposed MRUCA model attain superior performance than state-of-art model in terms of packet transmission, BER and Detection rate

Design and Evaluation of High Gain Microstrip Patch Antenna Using Double Layer With Air Gap

Wireless technology is one of the main areas of research in the world of communication and a study of communication system is incomplete without understanding the operation of an antenna. Recent trends of wireless mobile communication technology are towards the miniaturization and demand for more robust and compact designs. This paper proposed a low cost, efficient, high gain and wideband Microstrip Antenna (MSA) using rectangular patch for wireless applications. In this paper an attempt is made to optimise and fabricate a double layer RMSA with air gap to obtain a high gain antenna operating over a 2.4-2.483 GHz ISM band. It consist of double sided copper ensure using one side as ground plane and other side as feed network. By inserting an air gap between radiating and ground planes. The air gap reduces both the electric field concentration on the lossy epoxy and the effective dielectric constant of the radiating plane. This structure is low cost, easy for fabrication and FR4 is used which is easily available substrate with permittivity 4.4, height 1.59 mm and loss tangent of 0.02. The structure is optimised using Zeland IE3D version 14.10. The optimised MSA provides a maximum gain of about 8.6 dBi with less than 1dBi gain variation over the operating frequency band, RL 18 dB and efficiency > 75% . The close similarity between simulation results and fabricated results has been observed. DOI: 10.17762/ijritcc2321-8169.150317

Pharmaco-prophylaxis of deep vein thrombosis for in-patients at risk, in a tertiary care hospital

Background: There is limited data from India on Deep Vein Thrombosis (DVT) Prophylaxis. This study was done in hospitalised patients at high risk for DVT, to determine the patterns and rates of pharmacoprophylaxis, drugs used and their clinical outcomes.Methods: This prospective study screened patients for risk of DVT using the Padua risk assessment model. Padua score ≥4 were included and data on disease demographics, prophylaxis and outcomes of DVT at 12 weeks were collected. Factors affecting prophylaxis were assessed using multivariate logistic regression.Results: Out of 453 screened, 200 eligible patients were recruited. 48.5% were females; mean age was 54.6±16.6; 50.5% received some thromboprophylaxis, of which 24%, 35.5% and 9% received pharmacoprophylaxis, mechanoprophylaxis and a combination of both respectively. Low Molecular Weight Heparin was the most commonly used drug (77.1%). Adverse drug reactions reported were 24, none related to anticoagulant use. At 12 weeks, 18 (9%) patients gave history suggestive of DVT. 5 deaths were reported, but the cause could not be ascertained. Patients who had cardiac/ respiratory failure [OR =5.2 (95%CI - 1.13, 24.6), p = 0.03], acute MI or stroke [OR = 9.0 (3.5, 23.09), p <0.001], those admitted to medical specialties [OR = 3.4 -1.4, 7.9), p = 0.004] and to private wards [OR = 7.4 (3.13, 17.5), p <0.001] had significantly higher chances of receiving prophylaxis.Conclusions: Underutilisation of effective prophylaxis, despite high prevalence of DVT risk. Emphasis on routine risk assessment of hospitalized patients and administration of appropriate prophylaxis to those at high risk is required

Field induced single molecule magnet behavior in Dy-based coordination polymer

A new mononuclear Dysprosium based Coordination Polymer {Dy-CP} was investigated magnetically using dc and ac magnetic susceptibility. The dc magnetic susceptibility does not exhibit any long-range ordering down to 1.8 K and the negative value of Curie Constant (~ - 4 K) indicate the dominance of antiferromagnetic interactions between the Dy (III) spins. Ac susceptibility exhibits absence of single molecular magnet behavior at zero dc magnetic field and shows signal of quantum tunneling magnetization (QTM) below 8 K. However, on the superimposition of dc magnetic field (3 kOe), frequency dependent relaxation peak emerged at T_f = 5 K and QTM signal suppress at higher fields. The intermediate value of Mydosh parameter calculated from the shift in peak position (T_f) in ac susceptibility reflects the formation of superparamagnetic state. Further, the temperature dependence of Tf is analyzed with Arrhenius and Cole-Cole plot. The magnetic susceptibility analysis yields characteristics pre-relaxation factor 1.40x10^(-12) sec and energy barrier {\Delta}E/k_B = 93.4 K, indicating the slow spin relaxation. The Cole-Cole fit to the ac susceptibility data shows further evidence for the single ion spin relaxation. Thus, the magnetic measurements support the single-molecule magnet behavior in Dy-CP under the application of dc magnetic field.Comment: 4 pages, 3 figure

Extraskeletal myxoid chondrosarcoma of thigh: a rare case report

Extraskeletal myxoid chondrosarcoma (EMC) are a rare entity of soft tissue tumors that occur predominantly in soft tissue of lower extremities. Here we present a case of 45-year-old female presented with left thigh swelling. MRI finding suggested primary neoplastic lesion. Fine needle aspiration cytology (FNAC) suggested myxoid soft tissue neoplasm/sarcoma. Morphological examination revealed typical extraskeletal myxoid chondrosarcoma with strong immunoreactivity for vimentin and focal immunoreactivity for epithelial membrane antigen (EMA)