Quality of Life Among Post-Menopausal Women Residing in Selected Ward of Itahari Sub-Metropolitan City, Nepal

Background: Menopause is a critical period in a woman’s life that not only marks the end of reproductive ability but is also associated with multiple vasomotor, psychological, physical and sexual complaints. So, the study of Quality of Life in the post-menopause has become an essential component in clinical practices. The objective of this research was to assess the quality of life among post-menopausal women. Materials and Methods: A descriptive cross-sectional study was conducted among 102 women of Itahari Sub- Metropolitan city. Probability sampling technique was used to select the ward and non-probability purposive sampling technique was used for the selection of sample. Data was collected through face-to-face interview using a structured Menopause-Specific Quality of Life (MENQOL) questionnaire. Descriptive statistics (frequency, percentage, median and interquartile range) and (Man Whitney U test) for inferential statistics were applied using SPSS Version 25 for data analysis. Result: The study showed that the most common symptom reported by the respondents was feeling tired (98.04%) and the least frequent symptom was increase in facial hair (11.76%). The median scores and interquartile range of MENQOL for vasomotor, psychosocial, physical and sexual domains were 4(3,4), 12.50(10,15), 31(28,38) and 5(3,6) respectively. The significant difference was seen in vasomotor domain with marital status and occupation, psychosocial domain with age and marital status and sexual domain with occupation respectively. Conclusion: In this study, the most frequent reported symptom was feeling tired and the most affected domain was physical domain. The vasomotor domain has statistically significant difference with marital status and occupation, psychosocial domain has statistically significant difference with age and marital status and sexual domain has significant difference with occupation respectively. Hence, effective awareness and education programme regarding the symptoms and ways to minimize those symptoms should be planned and provided both at individual and community level

SubFoveal Choroidal Imaging in High Myopic Nepalese Cohort

Current image captioning models produce fluent captions, but they rely on a one-size-fits-all approach that does not take into account the preferences of individual end-users. We present a method to generate descriptions with an adjustable amount of content that can be set at inference-time, thus providing a step toward a more user centered approach to image captioning

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

The original version of this article unfortunately contained a mistake

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Smart Approach to Warehousing : Self-storage Industry

Self-storages are modified versions of industrial warehouses. Differing in functionality, except for the storage, industrial warehouses are more complex in design, operation, and technology. This research was conducted with an aim of unmasking the needs that lead to the emergence of such businesses. The relationship between features of a self-storage and its location are also listed under aim. In addition to these, the location selection methods are compared and checked for similarities or differences. Qualitative research method has been applied for collecting the necessary information with semi-structured interview questionnaires. The data is supported by a theoretical framework consisting of features and functions, structures and models for selection of location, of both industrial warehouses and self-storages, later, compared and analyzed with the empirical findings. Industrial warehouses’ functions are movement, storage, and information flow, whereas, self-storages are designed to offer storage units with proper maintenance and other features. The results show that moving and renovation dominates the list of needs for renting a storage unit whereas marriage and divorce, seasonal stocking and deaths are other contributors. Visibility, accessibility and drive-up units are the key factors for selecting a location. Aforementioned factors and the location are closely related. Factor Rating Method is the common one between industrial warehouses and self-storages as per the analytics. The self- storage industry holds great growth potential in the European markets with few numbers of such businesses compared to that of US. The demand for such services is increasing day by day as more people are being born, but the total area of the Earth never changes

Exploring power budget scheduling opportunities and tradeoffs for amr-based applications

Computational demand has brought major changes to Advanced Cyber-Infrastructure (ACI) architectures. It is now possible to run scientific simulations faster and obtain more accurate results. However, power and energy have become critical concerns. Also, the current roadmap toward the new generation of ACI includes power budget as one of the main constraints. Current research efforts have studied power and performance tradeoffs and how to balance these (e.g., using Dynamic Voltage and Frequency Scaling (DVFS) and power capping for meeting power constraints, which can impact performance). However, applications may not tolerate degradation in performance, and other tradeoffs need to be explored to meet power budgets (e.g., involving the application in making energy-performance-quality tradeoff decisions). This paper proposes using the properties of AMR-based algorithms (e.g., dynamically adjusting the resolution of a simulation in combination with power capping techniques) to schedule or re-distribute the power budget. It specifically explores the opportunities to realize such an approach using checkpointing as a proof-of-concept use case and provides a characterization of a representative set of applications that use Adaptive Mesh Refinement (AMR) methods, including a Low-Mach-Number Combustion (LMC) application. It also explores the potential of utilizing power capping to understand power-quality tradeoffs via simulation30th international symposium on computer architecture and high performance computing (SBAC-PAD)This work is supported in part by National Science Foundation via grants numbers ACI-1464317 and CNS-1305375, and was conducted as part of the Rutgers Discovery Informatics Institute (RDI2). Any opinions, findings, and conclusions or recommendations expressed in this material are those of the authors and do not necessarily reflect the views of the National Science Foundation. We acknowledge Weiqun Zhang and Marcus S. Day, from Lawrence Berkeley National Laboratory, for helping with LMC simulation applicatio

Application of PCR and Microscopy to Detect Helicobacter pylori in Gastric Biopsy Specimen among Acid Peptic Disorders at Tertiary Care Centre in Eastern Nepal

Background. Helicobacter pylori infection is most prevalent in developing countries. It is an etiological agent of peptic ulcer, gastric adenocarcinoma, and mucosal-associated lymphoid tissue (MALT) lymphoma. Despite the development of different assays to confirm H. pylori infection, the diagnosis of infection is challenged by precision of the applied assay. Hence, the aim of this study was to understand the diagnostic accuracy of PCR and microscopy to detect the H. pylori in the gastric antrum biopsy specimen from gastric disorder patients. Methods. A total of 52 patients with gastric disorders underwent upper gastrointestinal endoscopy with biopsy. The H. pylori infection in gastric biopsies was identified after examination by microscopy and 23S rRNA specific PCR. The agreement between two test results were analysed by McNemar’s test and Kappa coefficient. Result. H. pylori infection was confirmed in 9 (17.30%) patients by both assays, 6.25% in antral gastritis, 22.22% in gastric ulcer, 100% in gastric ulcer with duodenitis, 50% in gastric ulcer with duodenal ulcer, and 33.33% in severe erosive duodenitis with antral gastritis. Out of nine H. pylori infection confirmed patients, 3 patients were confirmed by microscopy and 8 patients by PCR. In case of two patients, both microscopy and PCR assay confirmed the H. pylori infection. The agreement between two test results was 86.54% and disagreed by 13.46% (p value > 0.05). Conclusion. We found that PCR assay to detect H. pylori is more sensitive than microscopy. However, we advocate for the combination of both assays to increase the strength of diagnostic accuracy due to the absence of the gold standard assay for H. pylori infection

Pattern of glomerular disease and clinicopathological correlation: A single-center study from Eastern Nepal

The pattern of glomerular disease varies worldwide. In the absence of kidney disease/kidney biopsy registry in Nepal, the exact etiology of different forms of glomerular disease is primarily unknown in our country. We analyzed 175 cases of renal biopsies performed from September 2014 to August 2016 in Internal Medicine Ward at B.P. Koirala Institute of Health Sciences. The most common indication for renal biopsy was nephrotic syndrome (34.9%), followed by systemic lupus erythematosus (SLE) with suspected renal involvement (22.3%). Majority of patients were in the 30–60 years’ bracket (57.2%), with the mean age of the patients being 35.37 years. The average number of glomeruli per core was 13, with inadequate sampling in 5.1%. Immunoglobulin A (IgA) nephropathy (17%) was found to be the most common primary glomerular disease, followed by membranous nephropathy (14.6%) and focal segmental glomerulosclerosis (14.6%). The most common secondary glomerular disease was lupus nephritis (LN). Complications associated with renal biopsy were pain at biopsy site in 18% of cases, hematuria in 6%, and perinephric hematoma in 4% cases. Although the most common primary glomerular disease was IgA nephropathy, significantly higher population of SLE with LN among Nepalese in comparison with other developing countries warrants further evaluation. As an initial attempt toward documentation of glomerular diseases in the national context, this study should serve as a stepping stone toward the eventual establishment of a full-fledged national registry of glomerular diseases in Nepal