Search

The risk of disseminated Histoplasmosis increases among immunocompromised HIV infected patients. It can clinically present with skin manifestation. We report a forty years HIV infected male with severe immunodeficiency clinically presenting as a disseminated Histoplasmosis with dermatological manifestation and diagnosis.

This paper portrays my personal experience articulating narrative inquiry as a viable research approach to language pedagogy. It brings a personal nostalgia to the epistemic understanding of narrative inquiry. For this, I employed a qualitative research approach in my paper. For the successful accomplishment of the paper, I employed secondary sources; particularly data collected from research articles, books, dissertations, different websites and reports related to narrative research, etc. Within the qualitative continuum, I used the document analysis method and connected it with my own research experiences of using secondary sources of data in narrative research. More specifically, it explored how the research's paradigm was undergoing to bring the narratives as information to systematize the random experiences in research. In particular, this paper offers a metaphorical three-dimensional narrative inquiry space as a way to explore the aesthetic and artistic dimensions of narrative inquiry. Furthermore, narrative inquiry research paves the way to understanding what researchers know and what they believed about their research practices. The core process of narrative research is to systematize its design and set its conceptual framework. The principal attraction of narrative as a method is its capacity to render life experiences, both personal and social, in relevant and meaningful ways. It shows that researchers must learn to assume possible research procedures linearly to address their actions and performance. Moreover, narrative inquiry as a method serves as a pioneering foundation to replicate human experiences and establish itself as a prior research method in educational research.

Introduction: Tuberculosis (TB) has been the most common acute opportunistic infection in HIV positive patients and accounts for more than half of all AIDS cases in underdeveloped nations. Hence, rapid laboratory diagnosis of M. tuberculosis is needed for vulnerable patients. Methodology: In this study, 72 sputum samples were collected from ART-naive and patients using ART for 6 months. The samples were tested with the GeneXpert MTB / RIF assay to diagnose TB and drug resistance and AFB smear microscopy as per NTP guidelines. Results: Among 72 sputum samples studied, males were more diagnosed with TB than females. People aged 25-56 years were more infected with HIV-TB co-infection. Four patients (5.56%) were found to be TB positive with both techniques, 7 (9.72%) were GeneXpert MTB/RIF positive but smear-negative and 61 patients (84.72%) were negative with both methods. The positivity for MTB detected for GeneXpert MTB/RIF method in females was 3 (15%) and the males were 8 (15.38%), while for the ZN staining method the positivity in females was 2 (10%) and the males were 2 (3.85%). The GeneXpert MTB/RIF assay was also capable of detecting TB in smear-negative cases. Conclusion: This study showed that the GeneXpert MTB/RIF assay is an effective tool for the early diagnosis of TB among HIV patients as compared to AFB smear staining method.

During the time of COVID-19 outbreak there is dilemma in diagnosis of acute lung infections. This is further hindered among immunocompromised patients due to bizarre clinical and radiological findings. We report young male severely immunocompromised HIV infected ART naïve patient presenting with acute onset of pneumonia and hypoxemia with SARS CoV-2 PCR positive.

Birds are the indicators of ecosystem health. Several environment variables affect the diversity, distribution and migration of birds. Kahundanda of Pokhara Valley is one of the important hillscapes having different habitat types such as human settlements, forest, farmland, wetland and open areas. This study revealed the factors affecting the diversity and distribution of birds of Kahundanda. The direct observation by “point count” method was applied for the bird survey. A total of 49 points were fixed along the nine transects in every 200–250m distance of the Kahundanda (elevation ranges from 700m to 1424m). In each point, we also recorded habitat types and disturbance factors. A total of 101 species of birds belonging to 18 orders and 41 families were reported from the study area. The species diversity was the highest in forest habitat (H' = 3.558) and least in open area (H' = 2.365). Among them, 58.42% of birds were resident and 41.58% were migratory including four globally threatened (one critically endangered, two endangered and one near threatened) species. Other factors such as the number of livestock present, distance from roads and settlement, environmental factors such as distance from the water resources, elevation and number of fruiting trees present significantly affected the distribution of the birds at Kahundanda. Thus, environmental factors such as habitat types, human disturbance and proximity to water resources are important for bird species conservation in the human-dominated landscape.

There are an increasing number of studies on the cosmeceutical properties of medicinal plants growing in various climatic zones. The formulation of phenolic rich plant extracts into cosmetic cream products can maximize the commercial value of such products. Most of the herbs used in Nepal for cosmetic purposes are locally available Ayurvedic herbs. The antioxidant property of the ethanolic extracts of Moringa oleifera L. leaves collected from Rupandehi and Makawanpur districts respectively were determined by 2, 2-diphenyl-1-picrylhydrazyl (DPPH) scavenging activity. Total phenolic and total tannin content was determined by Foline Ciocalteu reagent. Total phenolic content was found from 35.51 and 42.89 mg/100 g gallic acid in the Makawanpur and Rupandehi districts. Overall, findings revealed that there were slight differences in antioxidant properties between the two samples. The cream formulated from the Makawanpur plant sample had considerable physiochemical parameters within the range of acceptance. These findings provide strong evidence for further development of commercial creams with antioxidant properties

This study aims at analyzing Govinda Raj Bhattaria’s novel Sukaratka Paila within the theoretical framework of structuralism. More specifically, this study uses the procedures of analysis called seek-find-lose and seek-but-don’t find grammar structure of narratives in which the major characters are studied. The idea is how one character seeks the other, finds him or her and again loses him or her. Bhattaria’s novel Sukaratka Paila embeds the structure of romance within the structure of full of irony and the second structure offers realities of the contemporary time when narrator professor Socrates realizes at the end when he sees Ananta's alike body hanging on the ceiling fan of his own room. The promises of living together being the life partners goes in vain for both Ananta and Purnima. Moreover, this study examines the structure of the novel in which structure plays an essential part in a literary work which juxtaposes the plot and other elements of the story to make the narration comprehensible for the readers and also to clutch the meaning which the novelist wants to convey. The prime purpose of the paper is to unfold the underlying assumptions and unconscious regularities of human characters and their experiences based on their behaviors, society and culture. This analysis captures the writer’s intention of fabricating the story through its characters, theme and setting. The study reveals that structural reading of a fiction paves the ways for exploring another vantage of point in literary works.

स्नातक तहका लागि हाल पठनपाठनमा ल्याइएको अनिवार्य नेपाली विषयको पाठ्यांशका सवल रसुधारयोग्य पक्ष बाहिर ल्याई सरोकारवाला वर्गलाई आवश्यक सुझाव दिने हेतु तयार पारिएको यस अध्ययनले पाठ्यांश विश्लेषण गर्ने प्रमुख आधार वा विधिका रूपमा पाठ्यक्रम अध्ययन तथा विश्लेषणलाई लिइएको छ । जसमा पाठ्यांशको शीर्षक सार्थक र सान्दर्भिक देखिनु, पाठ्यांश परिचय सरल भाषामा सटिक, सुस्पष्ट र परिचयात्मक रहनु, भाषाका चार ओटै सिपलाई सन्तुलित ढङ्गबाट लैजानु पर्नेमा सुनाइ सिपको विकासमा पाठ्यक्रमका विशिष्ट उद्देश्य प्रायः मौन देखिनु, कक्षा ११ र १२ मा राखिएको नयाँ साहित्यिक विधा रिपोर्ताजमूलक रचनालाई यस पाठ्यांशमा स्तरण नगरिनु, पाठ्यवस्तुको समग्र वितरण सार्थक नै पाइनु, शिक्षकको निर्देशनमा ३० पूर्णाङ्कको स्वअध्ययन कार्यमार्फत शिक्षण गराइने भनिए तापनि स्वअध्ययनको स्पष्ट किटान नहुनु, पाठ्यांशमा ३० पूर्णाङ्कको प्रयोगात्मक र ७० पूर्णाङ्कको वाह्यपरीक्षाको सुरुवात गरेर मूल्याङ्कन प्रणालीलाई थप समयसापेक्ष बनाइनु तथा पाठ्यक्रमले प्रस्ताव गरेका पाठ्यसामग्री अपुग देखिनु र केही कमीकमजोरीलाई सुधार गर्दै प्रविधिमैत्री भर्चुअल लर्निङ्सँग जोडिई इन्टरनेट सञ्जालमा उपलब्ध गुणस्तरीय सामग्री छनोट गरी पाठ्यक्रमका उद्देश्य, मूलभूत आवश्यकता, समसामयिक मागका आधारमा पाठ्यांशलाई अझ बढी रुचिपूर्ण, प्रभावकारी, सान्दर्भिक एवम् व्यावहारिक बनाउन सकिने निष्कर्ष निकालिएको छ । {This study has been prepared to bring out the correctable aspects of the compulsory Nepali subjects currently introduced in teaching for the undergraduate level and to give necessary suggestions to the stakeholders. In which the title of the lesson should be meaningful and relevant, the introduction of the lesson should be accurate, clear and introductory in simple language, the specific objectives of the curriculum in the development of listening skills should be taken in a balanced manner, the new literary genre of reportorial composition placed in class 11 and 12 in this lesson Not being graded, the overall distribution of the curriculum is found to be meaningful, although it is said that teaching will be done through self-study work of 30 full marks under the guidance of the teacher, there is no clear evidence of self-study Making the evaluation system more timely by starting the practical exam of 30 full marks and the external exam of 70 full marks in the course and making the course material offered by the course seem insufficient and correcting some shortcomings by combining it with technology-friendly virtual learning available on the Internet It has been concluded that the lesson can be made more interesting, effective, relevant and practical based on the objectives of the course, basic needs and current demands by selecting quality materials.}

In this paper, I examine how the interpretative prototype is undertaking its supremacy in the educational research model and how a narrative inquiry paradigm supported and helped me to explore different realities of teachers' pedagogical capital in the context of Nepal. It aims to relate how the perceptions of pedagogical capital affect teachers’ performance in the language classroom. Data for this study were collected from three participants purposively. The data, in this research, have been analyzed based on the framework of Stake (1995). The study uses Bourdieu's (1977) notion of cultural capital for theoretical substantiation and the findings indicate that teachers' pedagogic capital is an ability that can be employed for an effective teaching-learning process. More specifically, this paper pinpoints how narrative inquiry could be considered as an alternative tool to recapitulate teachers' pedagogical capital in educational research.

In today’s context the demand for healthcare service has increased due to people’s awareness on the importance of health and quality of life. Though there is a lot of advancement in medical technology employees are considered an important asset of an organization. Employees' commitment is important matter to consider because the presence of committed employees helps in reducing absenteeism, delays and turnover in the organization. So, the aim of the study is to investigate the factors affecting organizational commitment of employees in healthcare sector of Kathmandu Valley. In order to fulfill the objectives of the study, the survey was conducted using a well-structured and self-administered questionnaire. The sample of 185 was randomly selected from sampling frame of 4683 employees of 11 private hospitals of Kathmandu Valley. Data were analyzed using descriptive statistics, correlation and regression analysis. The study revealed that the level of employee commitment is moderate in hospitals of Kathmandu Valley. The findings derived from multiple regression analysis confirmed that organizational reward and work-life balance are important factors that positive and significantly affect organizational commitment. It indicates that higher the organizational reward and work-life balance, higher would be the organizational commitment. However, supervisory support, training and development and organizational culture do have insignificant influence on organizational commitment of employees in health care sector of Kathmandu Valley. Thus, it is assured that the results from the study are more valid and they could have a significant policy implication for concerning health sector authorities of Nepal.

Migration has been a main pillar of the nation as well as the household economy of Nepal. However, COVID-19 has caused stigma and discrimination and increased risks of violence, disrupting GBV prevention and response mechanisms. The objectives of the study are to examine the prevalence and determinants of experience of violence due to COVID-19 among returnee migrants of the Far-western province of Nepal. Data for this survey were collected through a cross-sectional research design using quantitative methods in the Far-western province of Nepal. A total of 1182 respondents were surveyed to gather quantitative information. Univariate, Bivariate and multivariate analyses were applied to data. In addition, multivariable analysis was used to identify whether independent variables affected the risk of Gender-Based Violence. An overwhelming majority of returnee migrants were male (94.2%), while about 6 percent were female. One-third of respondents were youth aged below 25 years. Thirty-two percent of them had primary or below education. Eighteen percent of returnee migrants do not have food sufficient for a month in their household. Three in five returnee migrants (60%) reported that they had experienced violence. Multivariate analysis shows that female migrants were more likely to experience violence (aOR=2.1, 95% CI=1.02-4.3) than male migrants. Older age migrants were more likely to experience violence than younger migrants aged below 20. Migrants from poor households were more likely to experience violence (aOR=4.5, 95% CI= 3.1-6.7) than rich households. Physically disabled migrants were 4 times more likely (aOR=4.5, 95% CI= 2.6-7.5) than those who are not disabled. Experience of violence is very high among returnee migrants of Sudurpashchim province of Nepal. Our study found that female migrants, physically disabled migrants, who had elderly in their houses, and migrants from poor households were more likely to experience violence. Therefore, there is a need for a comprehensive awareness program and services that can help to prevent violence among returnee migrants.

Introduction: Dental caries though preventable oral health problem is affecting school children worldwide and around 50% of Nepalese children are suffering from it. Baseline data with good understanding of dental caries and associated risk factors are necessary to form preventive strategies for setting and achieving oral health goals. Objective: This study was conducted to determine dental caries experience and associated risk factors among school-going children of 6-13 years old in Dharan sub-metropolitan city, Nepal. Methods: A cross-sectional study was conducted from 5th Jan 2018 to 4th Jan 2019 among 680 school children selected by multistage cluster sampling method. Pretested, standardized, closed-ended questionnaire answered by the parents was used to gather information regarding the associated risk factors. Dental caries experience was obtained from deft/DMFT (WHO modification 1997). Comparison of categorical data was done using Chi-square test. Multivariable binary logistic regressions were used for the statistical analysis. Results: The overall caries prevalence was 61.6%, in primary dentition it was 48.25% and in permanent dentition it was 34.4%. Dental caries experience was with mean deft 4.67 (±2.7) in primary dentition and mean DMFT 1.72 (±1.05).in permanent dentition. Multivariate analysis showed significant association between dental caries experience and grade three and grade four school children had experienced greater caries (p

INTRODUCTION: The most common disorders presenting with microcytic hypochromic anaemia are iron deficiency anaemia (IDA) and β-Thalassemia trait (β-TT), and each of them has different pathogenesis and treatment modality. Here we intend to see the haematological profile in microcytic hypochromic anaemia in children apart from IDA and Thalassemia with respect to age and gender. MATERIAL AND METHODS: A total of 95 pediatric patients between the ages of 2 to 12 years with microcytic hypochromic anaemia were included in the study. Blood samples obtained from each patient were evaluated for various haematological and biochemical profiles along with haemoglobin electrophoresis. It was a hospital based observational cross-sectional study done for a period of 18 months from January 2019 to July 2020. RESULTS: Severe anaemia was seen in 55 (57.89%) cases, followed by 38 (40.00%) cases with moderate anaemia and 2 (2.11%) cases with mild anaemia. Majority of the cases showed IDA, which were 85 (89.5%) cases, followed by 6 (6.3%) cases with β-TT and 4 (4.2%) cases with β-TM. RBC count, hematocrit and RDW showed significant variation between IDA, β-TM and β-TT. Most number of correctly diagnosed cases were shown by Ricerca Index with 90 (94.74 %). CONCLUSION: Our study concludes RBC count and RDW, along with Srivasthava Index, Ricerca Index and RDW Index could be used as reliable indices to differentiate between iron deficiency anaemia and β-Thalassemia. Red cell indices, serum iron profile and haemoglobin electrophoresis complement each other for the precise diagnosis of underlying cause of microcytic hypochromic anaemia.

The purpose of this study is to quantify species diversity of birds in the study area and to explore the biotic and abiotic factors affecting the bird population. This study was carried out by using the fixed point counting method. The study area was situated in Annapurna Rural Municipality of Kaski district. A total of 147 bird species belonging to 46 families and 14 orders were identified in the study area. It was found that Muscicapidae was the largest family and Passeriformes the largest order. Among the reported species, 50% were residents, 31% were full-migrants, 18% were altitudinal migrants and the remaining were 1% nomadic. Habitats of birds included the forest 68%, the scrubland 17 %, the grassland 7% and the wetland 6 % of the study area. Similarly, the rocky area and artificial area covered 1% of the total species. The results showed that most of the bird species i.e. 136 were least concerned, 4 of them were nearly threatened, 3 of them were endangered, 3 were critically endangered and only one species was vulnerable. The most important threats included hunting and trapping, killing for fun, shift in crop production, use of insecticides and pesticides, improved storage devices, habitat destruction, developmental activities, tourism, buried carcasses and predatory.

Since the 1980s, due to the failure of previous development strategies, nongovernmental organizations have emerged as major actors in development, particularly in developing countries like Nepal. However, in recent years, most countries have perceived that NGOs are not operating genuinely to fulfill their expected goals. In this context, this paper set out to answer two questions: why NGOs tend to represent donors' preferences and why developing countries like Nepal become unable to adopt strict NGO regulations. It is based on the analysis of archival documents and review of previous study findings and draws insights from resource dependence theory. It concludes that when NGOs depend on external donors for financial resources, they are compelled to represent donor's interests. Similarly, aid-dependent developing countries like Nepal often hesitate to adopt strict NGO regulations because of the fear of external pressure from their donor agencies. Thus, resource dependency makes both NGOs and the governments unable to resist the pressure of donor agencies. Its conclusions can be useful to adopt an appropriate framework to regulate NGOs in Nepal.

Not available.

Correction: The first author's name was mis-spelt on the webpage. On 18th November 2021, 'Bastika' was changed to 'Bastola'. The PDF remains correct. Thesis writing requires a wide range of reading, the skill of critiquing, a good skill of academic writing, and a proper collaboration of student and supervisor; however, it is poorly understood, less explored, and replete with problems. In this paper, we present the merits of thesis writing, supervisors' and students' commonly held perceptions, the effectiveness of supervisory feedback, and the value of student engagement. Then we present two components of thesis writing (i.e., introduction and literature review, including theoretical framework). Considering the need of the novice researchers (i.e., master's students) who are writing their thesis for the first time, we present these two components' introduction and provide suggestions for supervisors. We also present commonly used language features and examples. This paper is expected to be beneficial to students and supervisors alike.

Project-based learning is an innovative method to improve language skills. This study explores the five assets of project-based learning in the Nepalese context. It aims to examine how different dynamics of projects help students overcome their language learning difficulties and to show the relevancy of Project-Based Learning despite having many approaches and techniques in the anti-method era. Data for this study were collected both from primary and secondary sources. For eliciting primary information, I interviewed two of the EFL teachers and for the secondary data, I consulted research articles, books, dissertations, and reports related to project-based learning. I also employed the document analysis method in the paper since it is a theoretical review-based article where the researcher coded, thematized, and analyzed very sequentially to elicit meaning, gain understanding, and develop empirical knowledge about project-based learning. Innovative and learner-friendly curriculum demands for practical, pedagogical and project-based engagement in the 21st-century classroom which has seriously been ignored in the Nepalese EFL classroom. Noticing the unexplored status of the project-based learning approach, I stressed exploring the relevancy of PBL in the EFL classroom. More specifically, the prior methods used for achieving the expected outcomes of the paper are synthesis, deduction, analysis, interpretation and generalization. Findings indicate that project-based learning is an alternative tool and the best option for students to enhance their pedagogical content knowledge, creativity, and critical thinking.

Toxoplasmosis is a zoonotic disease caused by Toxoplasma gondii affecting about one third of the world’s population. It can be asymptomatic to fatal toxoplasmic encephalitis depending on the immune status of infected individuals. Among HIV/AIDS patients, it usually manifest as life-threatening condition. We, therefore, studied the seroprevalence of T. gondii infection among HIV/AIDS patients in Nepal and this report constitutes the first report from Nepal. A total of 45 HIV/AIDS patients were included in this study. The serum samples collected and stored at -20°C were tested for Toxoplasma IgG and IgM antibodies at National Public Health Laboratory, Teku, Kathmandu using Snibe Maglumi 1000 Fully Automated Immunoassay Analyzer and the results were expressed in AU/ml. The blood put into the EDTA tube was used for CD4 count using BD FACS Calibur Flow Cytometer. In this study, 33.3% (15/45) HIV infected patients were seropositive for anti-T. gondii IgG. However, none of them were positive to anti- T. gondii IgM. Most of the patients (36 out of 45 patients) had 0.05).

Maize (Zea mays L.) is one of the most commonly cultivated crop after rice in Nepal. The present study was done to evaluate and recommend the best performing white maize genotypes in mid hill region of Nepal. This study was conducted at research field of Kavre, Nepal during the rainy season of 2019. Five white maize genotypes were evaluated in randomized complete block design with four replications where Deuti used as standard check. Ear and plant height of plant, days to 50% silking and tasseling, count of leaf above and below main cob, total number of leaf, cob length, cob diameter, kernel rows per cob, kernels count per row, thousand kernels weight, shelling and sterility percentage, stay green and grain yield parameters were observed. Deuti and DMH-7314 had good stay green and husk cover rating. Plant height (282.6 cm) and ear height (162.4 cm) was more in HB-008. Number of kernels per row was more in HB-008 (36.5) and HB-007 (36.5) and thousand kernel weights was more in DMH-7314 (386.3 g) followed by Deuti (353.9 g). DMH-7314 was late in tasseling (86 days) and silking (89 days) but shelling percentage was lowest in DMH-7314 (70.8) than other varieties. Analysis of variance reveled that genotype HB-008 (9.70 t/ha) as compared to standard check Deuti (7.80 t/ha). Thus genotype HB-008 perform better in mid hill region of Kavre, Nepal.

This paper titled, The Trait Theory of Leadership and The Eight-Fold Noble Path as Buddhist Leadership Paradigm: A Stark Scrutiny, strives to explore an affinity between the trait theory and the eight-fold noble path, to scrutinize the theoretical and practical implication of the integrated approach of both from the Nepalese perspective, and to expedite potential paradigm shift to enhance the leadership competencies of the 21st century. It is a conceptual paper. The secondary data has been profoundly analyzed to accumulate required facts, details, and information through comprehensive literature reviews. In conclusion, there is an obvious and precise affinity between both conceptions to propose an integrated paradigm transmutation for the enhancement of leadership competencies of the 21st century. From the Nepalese perspective, the empirical implication and application of the integrated leadership approach with the amalgamation of both i.e. the trait theory and the eight-fold noble path are seen inevitable as well as undeniable.

An experiment was conducted in Chitwan, Central Tarai, Nepal in three factorial strip-split plot design to simulate the effect of agronomic management and climate change parameters on growth and yield of rice under two crop establishment methods (transplanted in puddling and direct seeded in zero tillage); two residue retention levels (residue kept at 3 t/ha and no residue); and two nitrogen (N) levels (recommended dose: 100 kg N/ha and farmers dose: 50 kg N/ha) using the variety ‘Ramdhan’ during the rainy season of 2016. Soil of the experiment site was sandy loam and moderately acidic. Decision Support System for Agrotechnology Transfer (DSSAT) ver. 4.6 was used to validate the datasets of field experiment. File-A, File-T, File-W, File-X and Soil file were prepared and genetic coefficient of the variety was determined as P1 (900.00), P2O (70.00), P2R (800.00), P5 (12.60), G1 (99.00), G2 (0.035), G3 (0.02), G4 (0.85) and PHINT (83.0). Crop geometry (row spacing from 20 cm × 20 cm to 15 cm × 15 cm) increased the simulated grain yield from 5406 kg/ha to 5539 kg/ha, and simulated straw yield from 5410 kg/ha to 5797 kg/ha. Either early or late planting from 22 June decreased the simulated grain yield of rice. The increase in temperature by the years 2020, 2050 and 2080 A.D. decreased the simulated grain yield to 4518, 4098 and 2543 kg/ha, respectively, and increase in the level of CO2 concentration and solar radiation can increase the yield slightly with increase in the minimum and maximum temperature’s.

नेपालको वर्तमान भाषा नीति र योजना कस्तो छ र यसको कार्यान्वयनका लागि केकस्ता चुनौतिहरू छन् ? यी दुई समस्यामा आधारित उद्देश्य तय गरी प्रस्तुत लेख तयार पारिएको छ । भाषामा भौगोलिक सामाजिक, लैङ्गिक आर्थिक उमेरगत परिवेशगत तथा प्रयोगगत रूपमा विविधता सिर्जना हुन्छ । जाति तथा भाषाका आधारमा प्रत्येक समूहका आफ्ना सामाजिक सांस्कृतिक भाषिक र अन्य प्रचलित विशेषताहरू रहेका हुन्छन् । यस्ता विशेषता सुरक्षित राख्न सर्वप्रथम भाषाकै सुरक्षा अपरिहार्य हुन्छ । राज्यको भाषिक अवस्थिति अनुरूप भाषा सम्बन्धी राज्यले लिने भाषा नीति तथा योजनाले भाषिक विविधता संरक्षणमा प्रमुख भूमिका खेल्दछ । भाषाका धेरै भेदहरूमध्ये सम्पर्क भाषाका रूपमा एउटा भेद कसरी छनोट गर्ने, भाषाको स्तरीय रूप विकास गर्न भाषाको मानकीकरण प्रक्रिया कसरी अघि बढाउने, भाषा नीति तथा योजना निर्माणका क्रममा विभिन्न भाषाभाषीका बीच आपसी समझदारी बनाउदै राष्ट्रिय एकता अभिवृद्धि गराउने गरी साझा माध्यम भाषा कसरी विकसित गर्ने, भाषा देशको सामाजिक र सांस्कृतिक पक्षको सम्वद्र्धनको अपरिहार्यता राज्य पक्षलाई कसरी बुझाउने आदि चुनौति खडा हुन पुग्दछन् । यी सबै चुनौतिको कुशलतापूर्वक सामना गर्न सके मात्र नेपालको बहुभाषिकतालाई महत्त्वपूर्ण राष्ट्रिय सम्पदाका रूपमा संरक्षण र संवद्र्धन गर्न सकिन्छ भन्ने निष्कर्षमा पुगिएको छ । यस निष्कर्षका लागि प्रस्तुत अध्ययनमा पुस्तकीय अध्ययन कार्य गरी विश्लेषणात्मक विधि अपनाइएको छ ।

Introduction: Acute appendicitis is the common surgical disease however, accurate diagnosis and exclusion of acute appendicitis always remains challenge to the surgeons. Although diagnoses rely mostly on clinical examination but C- reactive protein (CRP) can be of valuable armamentarium. Hence, this study was conducted to find the diagnostic role of C-reactive protein in Acute Appendicitis Methods: A retrospective cross sectional study was conducted among 100 respondents in the Department of Surgery, Bharatpur Hospital from September 2019 to August 2020. Ethical approval was taken from the Institutional Review Committee (IRC) Bharatpur Hospital. Statistical analysis was done by using SPSS version 16 using descriptive statistics. Results: Total of 100 patients was included in study with mean age 31 years old.Out of which 60% were male and 40% were female. CRP value was raised (>6) in 87 (87%) cases and normal in 13(13%) cases. Among those with raised CRP, three patients had normal appendix histopathologically and 57 had uncomplicated appendicitis and 27 had complicated appendicitis histopathologically with sensitivity, specificity, positive predictive value and diagnostic accuracy rate of 95.45 %, 75 %, 96.55 % and 93% respectively. When white blood count (WBC) and CRP level were combined with HPE findings, its sensitivity, specificity and diagnostic accuracy rate were 100%, 80% and 93.83 % respectively. Conclusions: CRP improves the diagnostic accuracy of Acute appendicitis. The adjunct use of CRP and leucocyte count can effectively reduce the negative appendectomy rate.

Introduction: The burden of malnutrition is of significant concern in Nepal. The objectives of this study are to classify the nutritional status in children admitted in nutritional rehabilitation home of Pokhara Academy of Health Sciences and to relate the demographic characteristics and the effectiveness of the nutritional intervention measures on status of malnutrition which can help in the policy formulation to tackle the burden of malnutrition. Materials and Methods: This is a hospital based retrospective study in which total of 238 children with malnutrition admitted in nutritional rehabilitation home of Pokhara Academy of Health Sciences during July 2014 to July 2018 were followed. The socio-demographic factors and nutritional status were analyzed at admission and at discharge using the available record. Data was analyzed using SPSS 16. Results: Out of 238 malnourished children, 167(70.2%) were cases of moderate acute malnutrition and 76(29.8%) were cases of severe acute malnutrition. The mean weight at admission was 7.18±1.73 kg, mean weight at discharge was 7.82±1.82 kg and mean weight increased after nutritional intervention was 0.62 kg±0.40. The average weight gain in severe acute malnutrition was 4.7gm/kg/day. A statistically significant difference was obtained between mean weight (p=0.00, t= - 24.62) of children at admission and discharge. There was significant statistical difference between mean weight gain (p

Objectives: To determine prevalence of Methicillin Resistant Staphylococcus aureus in different clinical specimens and biofilm production along with antimicrobial susceptibility pattern of isolates. Methods: Cross-sectional study was conducted from September 2019 to February 2020at Sukraraj Tropical and Infectious Disease Hospital. Total 3091 clinical specimens like blood, urine, sputum, pus, swab, body fluid were processed. Identification was done on the basis of colony characteristics, gram staining, culture in Mannitol Salt Agar, coagulase and oxidation fermentation test. Antibiotic susceptibility test and biofilm detection were performed by Kirby Bauer’s disc diffusion methods and Tissue Culture Plate technique (TCP) respectively. Methicillin resistant Staphylococcus species were detected by using Cefoxitin disc. Results: Out of 52 Staphylococcus species, 39 were Staphylococcus aureus and 13 were Coagulase negative Staphylococcus species. Highest numbers of Staphylococcus species were isolated from blood Sixteen (30.8%) were Methicillin resistant Staphylococcus aureus (MRSA) and 5(9.6%) were Methicillin resistant Coagulase negative Staphylococcus species. There was no significant association (p=0.25) between age group and prevalence of MRSA, MSSA, MRCoNS and MSCoNS. Methicillin resistant Staphylococcus species were resistant to antibiotics like amoxicillin, cloxacillin, erythromycin and higher sensitivity was found in gentamycin. Among 52 Staphylococcal isolates, 11(21.1%) were biofilm producers and 41(78.9%) were non biofilm producers. 90.9%of 90.9% of Biofilm producing Staphylococcus species were resistant towards penicillin and erythromycin Conclusion: The study shows Methicillin resistant Staphylococcus species were resistant to most antibiotics and rate of resistance was slightly higher in biofilm producing isolates comparing to other isolates. resistance. Regular surveillance of methicillin resistance Staphylococcus species and routine screening of biofilm production is important.

Objectives: Acquisition of mecA gene in infectious strains of Methicillin resistant Staphylococcus aureus (MRSA) are considered as one of the potential virulence factors that enables the host bacteria to carry out several nosocomial and community-acquired infections. The main aim of this study was to determine the prevalence of MRSA, their antibiogram and mecA gene in the bacterial isolates obtained from the asymptomatic healthcare workers (HCWs) working in Sukraraj Tropical and Infectious Disease Hospital (STIDH), Kathmandu Nepal. Methods: This prospective cross-sectional study involved the collection of nasal and hands swab of 125 randomly selected HCWs from December 2019 to February 2020. Conventional microbiological methods were used to isolate and identify S. aureus. Antimicrobial susceptibility testing was done by modified Kirby Bauer disc diffusion method. MRSA was confirmed by using cefoxitin disc. Detection of mecA gene in the chromosome which was extracted by Phenol: Chloroform: isoamyl alcohol DNA extraction method, amplified by using PCR and visualized by running agarose gel electrophoresis. Results: The overall and MRSA carriage rate among the HCWs was found to be 28% (35/125) and 10.4% (13/125) respectively. S. aureus carriage rate was highest among sanitation staffs (34.2%) followed by pharmacy staffs (33.3%), laboratory personnel (18.8%), doctors (9.1%) and nurses (7.5%). Similarly, 34.2% (13/38) of the S. aureus isolates were resistant to methicillin, 31.6% (12/38) were inducible-clindamycin resistant and 63.2% (24/38) of them were multi-drug resistant (MDR). All the 13 MRSA isolates harbored the mecA gene. Conclusions: Carriage rate of MRSA among HCWs was high and alarming, indicating the prompt need of intervention measures to curb the growth and spread of resistant isolates in the hospital settings. Effective surveillance (of infectious diseases) and establishment of advanced diagnostic facilities can assist in estimating the actual burden of the MRSA which in turn helps to formulate and implement the appropriate policies and infection-control programs to address the increasing antimicrobial resistance in the country.

Posterior reversible encephalopathy syndrome is a condition occurring in majority of case of hypertensive encephalopathy mainly affecting white matter of parietooccipital region in neuroimaging. It is reversible if timely treatment of hypertensive emergency is done. Here, we are reporting a 11-year-old female child with acute post streptococcal glomerulonephritis leading to typical clinical and radiological features of posterior reversible encephalopathy syndrome.