Traumatic Diaphragmatic Hernia: An Uncommon Entity

Traumatic Diaphragmatic hernia is secondary to penetrating injuries and blunt abdominal and thoracic trauma. It is an uncommon entity. Early diagnosis is necessary to decrease morbidity and mortality. Here we report a case of 22-year-old male with diagnosis of traumatic diaphragmatic hernia. On examination abdomen was distended, guarding present, tender present and bowel sound not appreciated with decreased air entry over left side. CT Scan showed left sided diaphragmatic defect with intrathoracic herniation of abdominal viscera. Laparotomy and exploration revealed a diaphragmatic tear of size 7.5cm X 5cm, with herniation of stomach, spleen, splenic flexure of colon, distal pancreas through diaphragmatic tear

A CRITICAL REVIEW ON MANAGEMENT OF ARSHA (HEMORRHOIDS) IN AYURVEDA

The Shalya tantra, a prime branch of Astanga Ayurveda is rich in much aspect of modern surgical concepts. Sushruta elaborately described the advances of the Tantra in various Ano-rectal diseases, as Arsha is one among them. The term ‘Arsha’ is derived from “Ru Gatau” Dhatu with the suffix “Asun”, gives the meaning of as violent as enemy. It is the commonest ano rectal disease and affects anyone at any time. In Ayurveda, the sufficient descriptions are described regarding etiology, pathology, symptomatology, types and management or treatment measures of Arsha. All the classics of Ayurveda enumerate that the present sedentary life style, irregularities in food intake, taking junk, spicy, non-fibrous foods, inactive occupation and mental stress etc., are causative factors for ‘Arsha' (Hemorrhoid) and that leads to hypo function of digestive enzymes, which in turn leads to constipation, itching, burning sensation and pain in the region of Guda and finally bleeds and thus Arsharoga originates. Acharyas described various Chikitsa modalities of Arsha critically for prevention and cure of Arsha along with avoiding causative factors (Nidanaparivarjana). Acharya Sushruta has described four dimensions of the treatment for Arsha, all these are applied on the basis of Dosha involvement and stages of Arsha like Bheshaja Karma, Shastra Karma, Kshara Karma, Agni Karma, similarly Snehana, Swedana, Vamana, Virechana, Asthapana and Anuvasana Basti for Vataja Arsha, Virechana for Pittaj Arsha, Aharadravya mixed with Sunthi and kulatha for Kaphaj Arsha and Shamana Chikitsa for Raktaj Arsha etc

Application of Multi Criteria Decision Making tools in Selection of Concrete Mix

304-309Now a day decision making plays a major role in deciding the execution of any task. Two key tools are available to serve the purpose of decision-making. These include AHP as well as TOPSIS, both falls under Multi Criteria Decision Making (MCDM) tools. These techniques are now also brought in the field of civil engineering. MCDM techniques are used in various applications of civil engineering. This paper presents comparison of AHP and TOPSIS for making final decisions for the best concrete mix with fibres of steel and basalt available with different proportions. The comparison is made on the tests of split tensile strength, compressive strength and flexure results. Results of the experiment are used to validate results of AHP and TOPSIS. Optimum hybrid mixes for mechanical properties is M-S0.5-B0 at 28 days

Traumatic Diaphragmatic Hernia: An Uncommon Entity

Traumatic Diaphragmatic hernia is secondary to penetrating injuries and blunt abdominal and thoracic trauma. It is an uncommon entity. Early diagnosis is necessary to decrease morbidity and mortality. Here we report a case of 22-year-old male with diagnosis of traumatic diaphragmatic hernia. On examination abdomen was distended, guarding present, tender present and bowel sound not appreciated with decreased air entry over left side. CT Scan showed left sided diaphragmatic defect with intrathoracic herniation of abdominal viscera. Laparotomy and exploration revealed a diaphragmatic tear of size 7.5cm X 5cm, with herniation of stomach, spleen, splenic flexure of colon, distal pancreas through diaphragmatic tear

Application of Multi Criteria Decision Making tools in Selection of Concrete Mix

Nowadays decision making plays a major role in deciding the execution of any task. For this purpose, two widely known key tools are available to us. These include AHP as well as TOPSIS, both falls under MCDM tools. These techniques are now also brought in the field of civil engineering. Both techniques are used to analyze the results with the help of comparative data studies related to different concrete mixes. The study includes the analysis of results of compressive strength, split tensile strength and flexure strength and then validate the results obtained with AHP and TOPSIS techniques. These techniques will help in identification of best to worst concrete mix

Perceived fear of COVID-19 and its associated factors among Nepalese older adults in eastern Nepal : a cross-sectional study

Coronavirus disease 2019 (COVID-19) has affected all age groups worldwide, but older adults have been affected greatly with an increased risk of severe illness and mortality. Nepal is struggling with the COVID-19 pandemic. The normal life of older adults, one of the vulnerable populations to COVID-19 infection, has been primarily impacted. The current evidence shows that the COVID-19 virus strains are deadly, and non-compliance to standard protocols can have serious consequences, increasing fear among older adults. This study assessed the perceived fear of COVID-19 and associated factors among older adults in eastern Nepal. Methods A cross-sectional study was conducted between July and September 2020 among 847 older adults (?60 years) residing in three districts of eastern Nepal. Perceived fear of COVID-19 was measured using the seven-item Fear of COVID-19 Scale (FCV-19S). Multivariate logistic regression identified the factors associated with COVID-19 fear. Results The mean score of the FCV-19S was 18.1 (SD = 5.2), and a sizeable proportion of older adults, ranging between 12%-34%, agreed with the seven items of the fear scale. Increasing age, Dalit ethnicity, remoteness to the health facility, and being concerned or overwhelmed with the COVID-19 were associated with greater fear of COVID-19. In contrast, preexisting health conditions were inversely associated with fear. Conclusion Greater fear of the COVID-19 among the older adults in eastern Nepal suggests that during unprecedented times such as the current pandemic, the psychological needs of older adults should be prioritized. Establishing and integrating community-level mental health support as a part of the COVID-19 preparedness and response plan might help to combat COVID-19 fear among them

A qualitative study to understand drivers of psychoactive substance use among Nepalese youth

Background Psychoactive substance use among youth is an emerging public health issue in Nepal. This exploratory study aimed to better understand the drivers of psychoactive substance use among Nepalese youth in Rupandehi district of Nepal. Materials and methods This study used a qualitative approach for data collection. Both in-depth interviews (IDI, seven participants) and focus group discussions (FGD, 13 participants) were conducted among study participants who self-reported as psychoactive substance users or had history of psychoactive substance use. Participants for IDI were aged between 11 and 24 years and between 18 and 35 years old for FGDs. Semi-structured interview guides were prepared separately for IDIs and FDGs. Interviews were conducted in Nepali language and were audio recorded, which were there transcribed and translated into English for coding and analyses. In addition, interviews notes were taken by two research assistants. An inductive thematic analysis was used to analyze the data. Results This study identified a range of drivers of psychoactive substances use among Nepalese youths. Themes included (i) socio-cultural factors, (ii) individual factors, (iii) academic environment, (iv) physical environment and the (v) influence of media. The socio-cultural factors were categorized into sub-themes of family relationships, ethnic identity and psychoactive substance use and lack of social acceptance. Individual factors included peer pressure, stress relief and coping with financial challenges. Accessibility and availability of psychoactive substances in the surrounding environment and lack of monitoring and reinforcement of rules/ law and regulations were other drivers to psychoactive substance use among this Nepalese youth cohort. Conclusion Our study identified several important drivers of psychoactive substance use among youth in the Rupandehi district of Nepal. Future works are anticipated to further explore youth initiation and use of psychoactive substances and support the design of interventions that address these risk factors to reduce and prevent subsequent harms

Analysis of Yield Attributing Characters of Different Genotypes of Wheat in Rupandehi, Nepal

Field experiment was conducted at National Wheat Research Program, Bhairahawa, Rupandehi with the objective to identify high yielding superior wheat genotypes for Rupandehi district of Nepalduring 2014. Experiment was laid out in one factorial Randomized completely block design with ten wheat genotypes including both released and promising; Annapurna 1, Annapurna 3, Pasang Lahmu, Bijaya, BL 3623, Bhirkuti, NL 297, BL 4316, BL 3978 and BL 4347with three replications. The results showed that the grain yield of BL 3978 was found higher (4.03 t ha-1) than other genotypes followed by BL 4347 (3.93t ha-1). BL 3978 have also higher number of effective tillers m-2 and test weight. Among release varieties, NL 297 show higher yield (4 t ha-1) followed by Bhirkuti (3.43 t ha-1)and Bijaya (3.37 t ha-1). From this experiment it can be concluded that BL 3978 was found promising among all genotypes however should be tested at on-farms before promoted for general cultivation in Rupandehi district of Nepal