Enhancing Healthcare with EOG: A Novel Approach to Sleep Stage Classification

We introduce an innovative approach to automated sleep stage classification using EOG signals, addressing the discomfort and impracticality associated with EEG data acquisition. In addition, it is important to note that this approach is untapped in the field, highlighting its potential for novel insights and contributions. Our proposed SE-Resnet-Transformer model provides an accurate classification of five distinct sleep stages from raw EOG signal. Extensive validation on publically available databases (SleepEDF-20, SleepEDF-78, and SHHS) reveals noteworthy performance, with macro-F1 scores of 74.72, 70.63, and 69.26, respectively. Our model excels in identifying REM sleep, a crucial aspect of sleep disorder investigations. We also provide insight into the internal mechanisms of our model using techniques such as 1D-GradCAM and t-SNE plots. Our method improves the accessibility of sleep stage classification while decreasing the need for EEG modalities. This development will have promising implications for healthcare and the incorporation of wearable technology into sleep studies, thereby advancing the field's potential for enhanced diagnostics and patient comfort

Randomized controlled trial comparing outcome of hybrid Ilizarov versus distal tibial metaphyseal locking plate (P) for treatment of distal tibial fractures in adults

Background: Distal tibia fractures include extra-articular fractures of the metaphysis and the more severe intra-articular tibial plafond or pilon fractures.Several treatment methods have been recommended for the treatment of these injuries, with a recent emphasis on minimally invasive techniques and Ilizarov technique also. Several studies regarding distal tibial fracture treatment are available. Few of them are only randomized controlled trial. So, we conducted this research comparing distal tibial plating (P) versus hybrid Ilizarov (HI) for treatment of distal tibial fractures.Methods: The randomized controlled trial was conducted in B.P. Koirala Institute of Health Sciences, a tertiary care hospital in Eastern Nepal, over a period of fifteen months from June 2015 to August 2016. Patient in group A underwent HI fixation, and group B underwent P.Results: Gender ratio for male: female was 2.63 in HI, 1.35 in P group. Mean age was 47.03±15.93 and 42.1±12.788 for HI and P respectively. Most fractures in both group belonged to AO A3 type. Most surgeries were done at interval of 1 day to 1 week. Mean hospital stay was 6.43±4.545 and 4.93±4.676 for HI and P respectively. Mean Lower extremity functional score (LEFS) was 66.55 in HI and 67.15 in P group. Mean Percentage of maximal function (LEFS/80 *100) was 83.56. Three cases among 40 cases in P had infection but no infection in HI group was seen at the end of 12th week follow up.Conclusions: Our study showed that there is no significant difference in terms of LEFS criteria, union, fracture alignment, ROM (knee, ankle), infection and other outcome measures between HI fixation and P in the treatment of distal tibia fracture in adults

Sexual Dimorphism of Maxillary Sinus: A Morphometric Analysis using Computed Tomography

 Introduction: Gender determination is the important aspect of forensic science. Most of the bones used for sex determination are badly disfigured and found in incomplete state, thus bones recovered intact are used. Maxillary sinus being recovered intact can be used for gender determination by measuring maxillary sinus dimension through computed tomography (CT). The aim of this study was to assess sexual dimorphism using morphometric maxillary sinus measurements through CT scan. Methods: This analytical cross-sectional study included CT scan images of 80 patients (40 males and 40 females). Maxillary sinus mediolateral (ML), superoinferior (SI), anteroposterior (AP) linear dimensions and volume were measured. All the measured parameters were then subjected to Student’s t-test to determine mean difference between males and females and discriminative statistical analysis to determine gender. Results: The mean value of maxillary sinus length, width, height and volume in males on both right and left sides were (3.80±0.175, 3.74±0.209) cm, (2.57±0.317, 2.51±0.295) cm, (3.55±0.338, 3.5±0.286) cm and (17.49±3.909, 16.54±3.274) cm3 respectively and in females (3.67±0.250, 3.64±0.256) cm, (2.37±0.297, 2.34±0.3222) cm, (3.29±0.280, 3.23±0.254) cm and (14.42±2.935, 13.81±2.779) cm3 respectively. The discriminative analysis showed that the accuracy of maxillary sinus measurements was 72.5% in females and 75% ofmales (overall accuracy = 73.8%). Conclusion: The maxillary sinus measurements are valuable guide for sex determination with relatively good accuracy rate

Association of dry eye syndrome with oral Isotretinoin therapy for severe nodulocystic acne and recalcitrant acne vulgaris

Introductions: Oral Isotretinoin was registered in Nepal almost three decades later its first introduction in the USA. It remains the most clinically effective medication for acne. Dry eye syndrome is a ‘certain’ adverse effect of oral Isotretinoin therapy which can be validated by tear film break up time and Schirmer I tests. Methods: Fifty patients aged above 12 years presenting to Dermatology outpatient department of Dhulikhel Hospital with severe nodulocystic acne or recalcitrant acne vulgaris not responding to three months of systemic antibiotics along with topical agents were included. Tear film break up time and Schirmer I tests before, at 45 and 90 days, and one month after taking oral Isotretinoin were performed to study association of dry eye syndrome due to oral Isotretinoin. Results: Both eyes of fifty selected patients were sampled. Baseline mean tear film break up time of 12.37±4.17sec decreased to 9.69±3.70sec, 9.09±3.77sec and 10.67±3.50sec at 45 and 90 days and on follow up, respectively. Likewise, baseline mean Schirmer I value of 16.68 ± 8.73mm decreased to 12.26 ±7.64mm, 11.49 ± 8.07mm and 11.76 ± 8.11mm respectively at 45 and 90 days and on fo

Appointment Scheduling System

According to the existing system, students schedule appointments either through email or going in person to the advisor\u27s assistant and request for an appointment. This process is very tedious and time taking. In our project we will build an online appointment scheduling web application for every student to schedule an appointment by them self whenever and wherever they are. This system helps to lessen the burden of waiting at the advisor\u27s assistant\u27s desk or to conserve time and use it in an efficient manner we will bring this appointment scheduling process online. All this process is available online through our web application APPOINTMENT SCHEDULING SYSTEM . Any changes in the scheduled appointments such as cancellation of visiting hours will be notified through email

Demand and Supply of Forest Products in Bandevi Buffer Zone Community Forest, Chitwan National Park, Nepal

Buffer Zone Community Forestry (BZCF) in the Chitwan National Park (CNP) started with an objective to engage locals and fulfill their resource needs without jeopardizing conservation. This study estimates the forest product demand and supply of fuelwood, fodder, and timber in Bandevi BZCF user group. Data was collected using stratified random sampling and forest inventory using the quadrate method. Results indicated Bandevi BZCF conditions improved since its handover to the community. However, the study estimated a deficit of 26173 cubic meters per year of timber, 3.21 million tonnes per year (Mt/yr) of fodder, and 0.12 Mt/yr of fuelwood. Deficits were fulfilled from agricultural lands outside BZCF and illegal collection from the Bharandavar corridor forest and CNP. BZCF program is a success in improving forest conditions and needs continuation. Policy and programs must focus primarily on livelihood improvement and income generations to reduce the dependency of local people on the forest

A Facile Catalyst-free Pudovik Reaction for the Synthesis of α-Amino Phosphonates

Some imines were synthesized by the reaction of 5-amino 1-naphthol with substituted aromatic aldehydes in ethanol under reflux conditions. Dialkyl phosphites underwent addition with aromatic imines to give novel α-amino phosphonates. All the title compounds were characterized by elemental analysis, IR, 1H, 13C, 31P NMR and mass spectral data. All the newly-synthesized compounds (4a–j) exhibited moderate antibacterial and antifungal activity.Keywords: 5-Amino-1-naphthol, imines, dialkyl phosphite, α-amino phosphonates, antimicrobial activit

Effect of gender preference on fertility: cross-sectional study among women of Tharu community from rural area of eastern region of Nepal

BACKGROUND: Son preference is predominant in developing countries especially South Asian countries and its effect is most visible when the fertility is on transition. Nepal is a country in South Asia where the fertility has declined and son is valued highly. This study examines the parent’s gender preference for children and its effect on fertility and reproductive behaviors. METHODS: Study was conducted in Sonapur village development committee of Sunsari district among women of Tharu community of reproductive age (15–49) currently in union and having at least one child. Data was collected by house to house survey. Data was analyzed with IBM SPSS 20 version. Multinomial and binary logistic regression were used to analyze the relationship among variables. RESULTS: Three hundred women of reproductive age were included in the study. Current average age of the respondents was 31.97 years and mean age at marriage was 18.87 (SD +/-2.615). Child Sex ratio (male: female) of the respondents who didn’t want any more children was 1.41. The birth spacing following male baby was 3.09 years whereas the average birth spacing following female baby was 2.71 years. Age of the respondents and education status of the respondents were also significantly associated with contraceptive practice. Presence of only female children in family significantly increased the desire of other children (AOR = 10.153, 95% CI = 2.357-43.732). CONCLUSION: This study finds that the gender preference affects the fertility and reproductive behavior of the respondents and it is necessary to reduce son preference for the health and well being of children and women

Unidentified bright objects of spleen on arterial phase CT: mimicker of splenic vascular injury in blunt abdominal trauma

PURPOSEWe have described unidentified bright objects of spleen (UBOS), a hitherto undescribed entity, as hyperdense areas on arterial phase (AP) computed tomography (CT) seen in relation to splenic lacerations and are isodense to the normal parenchyma on portal venous phase with no correlate on digital subtraction angiography (DSA). UBOS mimic splenic vascular injuries like active contrast extravasation and pseudoaneurysm and need to be differentiated from them as it would have implications on patient management. We undertook this study to identify CT features of UBOS that can differentiate them from splenic vascular injuries and to calculate their diagnostic accuracy.METHODSThis retrospective study was approved by the institutional ethical committee and the need for informed consent was waived. Patients with splenic injury who had undergone dual-phase CT and DSA were included. All the lesions that were hyperdense on AP were evaluated for their outline, their relation to the adjacent/parallel margins of a laceration (margin sign), string of beads appearance, and the presence of adjacent normal parenchyma (adjacent parenchyma sign). The Hounsfield unit (HU) of the lesion and the aorta on the AP were also noted. The diagnostic accuracy of various signs for distinguishing UBOS from splenic vascular injuries was calculated using DSA as the reference standard.RESULTSOf 48 patients, 5 were excluded due to suboptimal quality of the examination or a time difference of more than 6 hours between the CT and DSA. A total of 54 hyperdense lesions were detected on AP in 43 patients. These were classified as vascular injuries (pseudoaneurysm, n=11; active contrast extravasation, n=11) and UBOS (n=32) based on DSA. The margin sign, string of beads appearance, and ill-defined outline had high specificity (95%, 86%, and 82%, respectively) but low sensitivity (50%, 65%, and 63%, respectively). The adjacent parenchyma sign had a moderate sensitivity and specificity of 84% and 77%, respectively. ROC analysis showed that a difference of 50 HU between the aorta and the lesion had a high sensitivity and specificity of 88.9% and 90.6%, respectively, with an area under the curve of 0.90.CONCLUSIONAn attenuation difference of over 50 HU between the aorta and the lesion and the presence of normal adjacent parenchyma had the highest diagnostic accuracy, while an ill-defined outline, string of beads appearance, and margin sign had high specificity but low sensitivity for differentiating UBOS from splenic vascular injuries