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Background: Thyroid dysfunctions have been recognized to cause significant manifestations in physical health as well as mental health. A descriptive cross-sectional research design was used to assess anxiety, depression and self-care management among hypothyroidism attending Chitwan Medical College Teaching Hospital (CMC-TH). Methods: A total of 258 patients diagnosed with hypothyroidism were selected by convenience sampling. Data was collected from the date June 6, 2021 to November 17, 2021 using face to face interview schedule. The data was analyzed in SPSS version 20 using descriptive and inferential statistics was used to analyze the data. Result: Out of 258 respondents females constituted 64% of the sample. A total of 72.1% of the respondents had different level of anxiety based on GAD-7 among them 43.8% of the respondents had mild anxiety and 9.3% severe level of anxiety. Regarding depression 60.1 % of the respondents had different level of depression based on PHQ-9. Among them 27.1% had mild level of depression whereas 4.7% severe level of anxiety. More than fifty percentages of the respondents (54.3%) had inadequate level of self-care management. Anxiety was significantly associated with sex (0.044), marital status (0.000) and family history of mental illness (0.009) whereas depression was significantly associated with educational status (0.009) and duration of illness (0.002). Conclusion: It is concluded that anxiety and depression was more prevalent among hypothyroidism patients so, routine screening of hypothyroidism patients for psychiatric disorder and treating by both an endocrinologist and a psychiatrist in liaison with each other is very important to optimize their management and improve quality of life.

The reliable monitoring of the progression or extent of pitting-type corrosion in reinforced concrete members requires great effort due to non-uniformity. This paper presents a new approach for measuring the progression and extent of pitting-type (non-uniform) corrosion in reinforced concrete members by combining both non-destructive testing with optical fibre sensing results. Accelerated corrosion on the reinforcement (rebar) of the specimen was produced artificially using an alternate wetting and drying process in sodium chloride solution with 7.5% and 10% concentrations. The multimode optical fibre patch cords were attached to the reinforcement in three different arrangements in a single specimen (normal optical patch cord and loose and firm microbend patch cords). Intensity loss in a propagating light travelling inside an optical fibre takes place due to the development of pressure from surrounding concrete on the fibre from rust formation (corrosion). The study also describes the effect of corrosion in half-cell potentiometer, chloride ion resistivity and indirect pulse velocity readings obtained from the specimen. A later study found that the use of an optical microbend sensor is an effective alternate method for determining the starting time of initial depassivation in the reinforcement and validates it using half-cell potentiometer values. The study also developed models to predict overall mass loss in the rebar due to corrosion using combined non-destructive testing methods.

Background The meniscus plays an important role in maintaining healthy articular cartilage. Meniscus tear, one of the common intra-articular knee lesions, is treated by either debridement or repair. Objective This study aims at identifying the early outcome of meniscus tears treated by debridement or repair. This study also elaborates on the spectrum of meniscal injuries presented in a tertiary care hospital in Nepal. Method A retrospective descriptive cross-sectional study was conducted at Orthopedic Department of Dhulikhel Hospital from February 2018 until January 2020 among patients who underwent knee arthroscopies for meniscal tears treated either by debridement or repair. Patients having intra articular fractures, osteochondral injuries and multi-ligament injuries were excluded. The meniscal tears were classified according to location and type of tear. Those patients who had at least one-year of follow up were evaluated with Lysholm score for functional outcome. Data were compiled and analyzed with Microsoft Excel 2011. Result One hundred and ten cases of meniscal tears were managed over the study period. Ninety-three cases could be traced for outcome evaluation, which included 50 cases of meniscal debridement and 43 cases of meniscal repair. The mean Lysholm score of the patients who received debridement was 81.5 (SD 10.4) and those who received meniscal repair was 84.9 (SD 9.1) (p=0.105). The population distribution was found to be similar in both the groups according to age and sex distribution and associated ligamentous injuries. Conclusion Good functional outcome was seen for meniscal tears managed with debridement or repair in at least one year follow up and could not establish one modality of management better than the other.

Background: This study aimed to assess the prevalence, associated factors and awareness of hypertensive retinopathy among an elderly population with hypertension in Nepal Methods: A population-based, cross-sectional study was conducted from 2013 to 2015 in Bhaktapur district, Nepal. The sample size was 2100 subjects age 60 years and above. From this sample, all diagnosed patients with hypertension were analyzed. A detailed history was obtained, and an ocular examination was performed. Blood sugar and blood pressure were measured. Result: Information was complete for 1860 (88.57%) subjects. The age ranged from 60 to 95 years with the mean ± SD age of 69.64±7.31 years. Hypertension was found in 643 subjects (34.61%), of which 224 (12.04%) were newly diagnosed cases. Hypertensive retinopathy was found in 81 cases (12.6%). Grade 1, grade 2, and grade 3 hypertensive retinopathy comprised 53 (65.43%), 19 (23.46%), and 9 (11.11%) cases, respectively. Hypertensive retinopathy was more frequent in the age group 70-79 years (15.23%) compared to other age groups, among males (13.25%), illiterates (13.56%), diabetics (16.49%), and those with body mass index (BMI) ≥25 kg/m2 (14%). However, none of the factors was found to be statistically significant. Among the subjects with hypertension, awareness of hypertension’s effects on the eyes, retina and vision was found in 13.84%, 8.4%, and 11.98% respectively. Conclusion: Prevalence of hypertension, hypertensive retinopathy and associated factors among an elderly population were similar to other countries. Awareness of hypertensive retinopathy was found in only 8.4%. Increased emphasis should be directed toward improving awareness campaigns. Key words: Hypertension, hypertensive retinopathy, elderly, awareness, Nepal

A case of 28 years primigravida with refractory tachycardia at term is reported. She was refractory to medical cardioversion. Electrical cardioversion was applied before and after the delivery of baby. With several cycles of variable joules of electrical cardioversion, the normal rhythm was not obtained. However, patient’s rhythm reverted to sinus with anti-arrhythmic medication after third week of cesearean delivery.

Background Patients with diabetes mellitus have a higher prevalence of atherosclerotic heart disease and a higher incidence of myocardial infarction than the general population. Definitive diagnosis and precise assessment of anatomic severity of Coronary Artery Disease requires invasive diagnostic modality like coronary angiography. Objective To study angiographic characteristics and severity involving coronary arteries in patients with acute ST segment elevation Myocardial infarction and to compare the same in diabetics and non-diabetics. Method Among 150 patients with acute coronary syndrome, 75 diabetics and 75 nondiabetics admitted in Manmohan Cardiothoracic vascular and transplant Centre were selected randomly during a period of one year formed the study group. Random Blood Sugar, Fasting Blood Sugar was done in all 150 patients, HbA1c in all diabetics. All subjects with acute ST Elevation Myocardial Infarction were taken up for coronary angiography intended for primary PCI. Result In our study, 35 (46.7%) out of 75 diabetic patients had triple or multi-vessel disease compared to 10 (13.4%) out of 75 non diabetics. Non-diabetic patients had significantly higher single vessel disease (65.3%). There was a statistically significant association of duration of DM with vessels involved. The occurrence of Triple Vessel Disease/Multivessel Disease was significantly higher in the patients with DM duration > 10 years compared to patients with DM duration < 10 years (64.7% vs. 35.3%, P < 0.001), however there was no significant difference in type of vessel involved. Similarly, a significantly higher proportion of Triple vessel disease was observed in patients with poor glycemic control (HbA1c > 8.5%). 72.2% of the patients with HbA1c > 8.5% had Triple vessel disease/Multi vessel disease, whereas patients with good glycemic control (HbA1c < 7.0%) had predominantly Single vessel disease (90.0%), with no occurrence of Triple vessel disease/Multi vessel disease Conclusion Diabetic patients presenting with ST Elevation Myocardial Infarction are likely to have triple/multiple vessel disease compared to non-diabetic patients. The occurrence of Triple Vessel Disease/Multivessel Disease was significantly higher in the patients with DM duration > 10 years compared to patients with DM duration

Background: Floods and storms are the most common natural hazards. Communities in remote, riparian areas are the most vulnerable in such disasters, particularly when local populations lack reliable energy and early warning systems for hazard response. Our study will investigate energy and flood resilience issues in such communities and use remote methods to enable research continuity in intra and post-pandemic contexts. Methods/Design: A two-round Delphi process will be used to interview 16 participants from Nepal and Greece to understand their priorities and preferred solutions for energy and flood resilience issues. In Round One we aim to understand the current capabilities and vulnerabilities of our focus communities in these areas. In Round Two, we seek feedback on potential options that are either market-available/evidence-informed solutions or co-developed conceptual systems. Remotely deployed semi-structured interviews are the principal method for both rounds. The Round Two structured comparative review also employs choice-based conjoint analysis and SCORE analysis. Discussion: By collecting information from both professionals and non-experts, we aim to understand what options are perceived as reliable, realistic and appropriate for flood-prone communities. The remote research design enables continuity and community access to development-focused research and its outputs, and a flexible, cost-effective approach for researchers and partner organizations.

Optimum water and nutrient coupling are the primary requirements for sustainable plant production. A field experiment designed with three tiers of irrigation i.e., I0: rainfed, I1: 1.0 crop evapotranspiration (1.0 ) and I2: 0.75 and four tiers of nutrition i.e., N0: control (no manure and fertilizer), N1: 100% recommended dose of fertilizer (RDF) as FYM, N2: 50% RDF as FYM + 50% RDF as chemical fertilizers and N3: 100% RDF as chemical fertilizers was conducted for four consecutive years (2015-2018) on large cardamom in a hilly terrain of sub-Himalayan region in India. The results showed that microsprinkler irrigation at 1.0 along with full dose of chemical fertilizers (20:40:40::N:P2O5:K2O kg ha-1) recorded the highest growth, yield attributes, fresh (665.22 kg ha-1) and dry (282.03 kg ha-1) capsule yields, the greatest water use efficiency (0.18 kg ha-1 mm-1) and the largest soil availability and plant leaf accumulation of N, P and K. The soil water contents increased with incremental soil depth and irrigation regime, and continued to rise up to flowering stage, sharply dropped at capsule development stage and further increased at maturity stage. The predictive regressive models showed the linear relationships between the dry capsule yield and irrigation water and total water use.

Background In 2021, the Nepal national emergency care system’s assessment (ECSA) identified 39 activities and 11 facility-specific goals to improve care. To support implementation of the ECSA facility-based goals, this pilot study used the World Health Organization’s (WHO) Hospital Emergency Unit Assessment Tool (HEAT) to evaluate key functions of emergency care at tertiary hospitals in Kathmandu, Nepal. Methods This cross-sectional study used the standardized HEAT assessment tool. Data on facility characteristics, human resources, clinical services, and signal functions were gathered via key informant interviews conducted by trained study personnel. Seven tertiary referral centers in the Kathmandu valley were selected for pilot evaluation including governmental, academic, and private hospitals. Descriptive statistics were generated, and comparative analyses were conducted. Results All facilities had continuous emergency care services but differed in the extent of availability of each item surveyed. Academic institutions had the highest rating with greater availability of consulting services and capacity to perform specific signal functions including breathing interventions and sepsis care. Private institutions had the highest infrastructure availability and diagnostic testing capacity. Across all facilities, common barriers included lack of training of key emergency procedures, written protocols, point-of-care testing, and ancillary patient services. Conclusion This pilot assessment demonstrates that the current emergency care capacity at representative tertiary referral hospitals in Kathmandu, Nepal is variable with some consistent barriers which preclude meeting the ECSA goals. The results can be used to inform emergency care development within Nepal and demonstrate that the WHO HEAT assessment is feasible and may be instructive in systematically advancing emergency care delivery at the national level if implemented more broadly.

The constant threat of methane emissions from pipelines must be addressed as part of any serious future decarbonization strategy. Undetected leaks and deliberate venting of methane during maintenance activities represent over 10% of the carbon emitted by the oil and gas industry. One potential approach is to utilize hydrogen blended into traditional natural gas; hydrogen combustion results in zero carbon, and leaks become significantly less damaging to the environment. This work describes a novel omniphobic surface treatment technology that demonstrates significant resistance against cracking and embrittlement that may be caused by hydrogen-rich natural gas blends. The treatment is designed for broad applicability regardless of pipeline condition, preparation, or material of construction, reflecting the wide variance in existing pipelines today. Validation of the treatment in hydrogen-rich environments were conducted on the coupon scale, with SEM and XRD characterization of the protected substrate. Fracture testing, weathering and exposure were conducted as per ASTM F1624. The overall field application method was tested on a large scale, 20″ diameter pilot test and qualified by a third-party operator. API 5L equivalent steel substrates treated with the omniphobic surface treatment demonstrated superior protection when exposed to hydrogen blends up to 15%: fracture strength changed negligibly, whereas the unprotected steel suffered from severe embrittlement and cracking. Additionally, a chemical analog of the omniphobic material on a full-scale pipeline showed compatibility with typical in-situ pigging and magnetic flux leakage (MFL) inspection tools when applied by industry-accepted cleaning and coating techniques. The United States maintains almost 300,000 miles of interstate pipeline, and yet less than 1600 miles of it are currently being utilized for hydrogen transport. One significant challenge is the varying structural health and alloys currently being employed in transport pipelines, as well as the substantial cost to install new pipelines that are fully compatible with hydrogen fuels and blends. The use of this novel in-place treatment presents an economically advantageous way to support energy transition without the need for substantial upfront costs.

Burkholderia thailandensis is a member of the Burkholderia pseudomallei complex. It encodes the transcription factor MftR, which is conserved among the more pathogeniciBurkholderia/ispp. and previously shown to be a global regulator of gene expression. We report here that a B. thailandensis strain in which theimftR/igene is disrupted is more virulent in both Caenorhabditis elegans and onion. The ΔimftR/istrain exhibits a number of phenotypes associated with virulence. It is more proficient at forming biofilm, and theiarcDABC/igene cluster, which has been linked to anaerobic survival and fitness within a biofilm, is upregulated. Swimming and swarming motility are also elevated in ΔimftR/icells. We further show that MftR is one of several transcription factors which control production of the siderophore malleobactin. MftR binds directly to the promoter driving expression ofimbaS/i, which encodes the extracytoplasmic function sigma factor MbaS that is required for malleobactin production. Malleobactin is a primary siderophore in B. thailandensis as evidenced by reduced siderophore production inimbaS/i::Tc cells, in whichimbaS/iis disrupted. Expression ofimbaS/iis increased ~5-fold in ΔimftR/icells, and siderophore production is elevated. Under iron-limiting conditions,imbaS/iexpression is increased ~150-fold in both wild-type and ΔimftR/icells, respectively, reflecting regulation by the ferric uptake regulator (Fur). TheimbaS/iexpression profiles also point to repression by a separate, ligand-responsive transcription factor, possibly ScmR. Taken together, these data indicate that MftR controls a number of phenotypes, all of which promote bacterial survival in a host environment.bIMPORTANCE/bBacterial pathogens face iron limitation in a host environment. To overcome this challenge, they produce siderophores, small iron-chelating molecules. Uptake of iron-siderophore complexes averts bacterial iron limitation. IniBurkholderia/ispp., malleobactin or related compounds are the primary siderophores. We show here that genes encoding proteins required for malleobactin production in B. thailandensis are under the direct control of the global transcription factor MftR. Repression of gene expression by MftR is relieved when MftR binds xanthine, a purine metabolite present in host cells. Our work therefore identifies a mechanism by which siderophore production may be optimized in a host environment, thus contributing to bacterial fitness.

Background Patients with diabetes mellitus have a higher prevalence of atherosclerotic heart disease and a higher incidence of myocardial infarction than the general population. Definitive diagnosis and precise assessment of anatomic severity of Coronary Artery Disease requires invasive diagnostic modality like coronary angiography. Objective To study angiographic characteristics and severity involving coronary arteries in patients with acute ST segment elevation Myocardial infarction and to compare the same in diabetics and non-diabetics. Method Among 150 patients with acute coronary syndrome, 75 diabetics and 75 nondiabetics admitted in Manmohan Cardiothoracic vascular and transplant Centre were selected randomly during a period of one year formed the study group. Random Blood Sugar, Fasting Blood Sugar was done in all 150 patients, HbA1c in all diabetics. All subjects with acute ST Elevation Myocardial Infarction were taken up for coronary angiography intended for primary PCI. Result In our study, 35 (46.7%) out of 75 diabetic patients had triple or multi-vessel disease compared to 10 (13.4%) out of 75 non diabetics. Non-diabetic patients had significantly higher single vessel disease (65.3%). There was a statistically significant association of duration of DM with vessels involved. The occurrence of Triple Vessel Disease/Multivessel Disease was significantly higher in the patients with DM duration10 years compared to patients with DM duration10 years (64.7% vs. 35.3%, P0.001), however there was no significant difference in type of vessel involved. Similarly, a significantly higher proportion of Triple vessel disease was observed in patients with poor glycemic control (HbA1c8.5%). 72.2% of the patients with HbA1c8.5% had Triple vessel disease/Multi vessel disease, whereas patients with good glycemic control (HbA1c7.0%) had predominantly Single vessel disease (90.0%), with no occurrence of Triple vessel disease/Multi vessel disease Conclusion Diabetic patients presenting with ST Elevation Myocardial Infarction are likely to have triple/multiple vessel disease compared to non-diabetic patients. The occurrence of Triple Vessel Disease/Multivessel Disease was significantly higher in the patients with DM duration10 years compared to patients with DM duration10 years.

Background Accessing HIV testing services is a challenge for transgender women and men who have sex with men (MSM) in sub-Saharan Africa. Only a little about this issue has been understood and discussed. No systematic review exists that discusses barriers to HIV testing among transgender women and MSM on the regional level. Methods We systematically searched databases namely MEDLINE, CINAHL, and Google Scholar to identify qualitative studies that reported decision-making and/or experiences with HIV testing uptake among transgender women or MSM and that were conducted in sub-Saharan Africa between January 2005 and March 2020. Two independent authors performed the selection, extraction, and thematic analysis of data. Results Twelve out of 794 studies were found eligible and included for synthesis. The synthesis led to the development of a framework illustrating multi-level, inter-related barriers to HIV testing. Couple-based HIV testing policies, criminalizing same-sex behaviors, and (health) governance being influenced by traditional religious (Islamic or Christianity) belief systems were the barriers at the regional level. Discriminatory practices in the communities and health institutions were the community-specific barriers. Interpersonal barriers included interactions with healthcare providers leading to forced disclosure and/or discrimination, and individual level barriers included fears and depressive thoughts, and poor healthcare access. Conclusions We identified policies and practices at the regional and country levels that hindered HIV testing practices among transgender women and MSM, which should be reconsidered while providing HIV prevention services to people of gender-minority backgrounds. We also think that countries from the global west do have a responsibility to question the sovereignty of some African countries for their inability to provide optimal health care to gender minority populations. Key messages

Background Polycystic Ovarian Syndrome (PCOS) is the most frequent hormonal/endocrine disorder in women of reproductive age and is one of the most common causes of infertility. Approximately 20% of Danish women of reproductive age are diagnosed with PCOS, and yet only a little attention has been paid to the psychological symptoms appearing in women with PCOS. The present study investigated anxiety, depression, and lower quality of life among Danish women of reproductive age who are diagnosed with PCOS. Methods This was a cross-sectional survey study among 326 Danish women who self-reported as being diagnosed with PCOS. The Hospital Anxiety and Depression Scale (HADS) was used to measure anxiety and depression, and the PCOS-QOL scale was used to measure the quality of life. Chi-square tests and logistic regression analyses were used for analyzing data. Results Sixty-six percent of women were found to have anxiety (n = 216), 41% of women had depression and 70% of women had low quality of life The most frequently reported symptoms were irregular menstrual cycle (86%), overweight (73%), and mood swings (65%), and irregular menstrual cycle, overweight and infertility were the were perceived of having higher severity. After adjusting for age, ethnicity, education, and income, the severity of symptoms, namely irregular menstrual cycle, infertility, overweight, and hirsutism, were independently and positively associated with depression, and severity of symptoms, namely irregular menstrual cycle, mood swings, and hirsutism, was independently and positively associated with anxiety. Lower quality of life was independently associated with both anxiety and depression. Conclusions Women with PCOS are at higher risk of anxiety, depression, and consequently, lower quality of life. Clinicians and other healthcare professionals should pay attention to the importance of mental health support in women with PCOS and work towards promoting it. Key messages • Women with PCOS are at higher risk of anxiety and depression, and lower quality of life. • Health care professionals working with women with PCOS should be aware of this and be prepared to offer necessary support.

Background Visual impairment is an important cause of disability in children. There is a lack of information on rehabilitation needs and low vision support services for children with visual impairment in Nepal. This is a pilot study designed to translate, culturally adapt and pre-test the Dutch version of the Participation and Activity Inventory for Children and Youth (PAI-CY) with visual impairment aged 7–17 years to develop a Nepali version. Questionnaires (PAI-CY versions for 7–12 and 13–17 years) were translated using standardized methods and were culturally adapted by a panel of experts. They were pretested to evaluate comprehensibility and relevance among six children with visual impairment and blindness. Finally, participants completed a questionnaire evaluation form. Results The translation and cultural adaptation process resulted in the adaptation of nine items to make them suitable for Nepali culture. Most children had comprehensibility problems with some specific items because of vocabulary, sentence structure and the composition of items. Most of the children were satisfied with the questionnaires. Conclusion The study resulted in the development of a Nepali version of the PAI-CY. We worked with a small group of content experts and a small but representative sample of children which allowed us to use rigorous translation procedures to address language and cultural differences. A population based study has been planned to investigate the psychometric properties of these questionnaires.

Background: The aim of study is to evaluate the shoulder by sonography in patients presenting with shoulder pain and correlate the findings observed with the diabetic patient. Methods: Study was done in 60 patients who presented in the Department of Orthopedics with a history of the shoulder pain. Shoulder ultrasound was performed according to standard protocol, thickness of the supraspinatus tendon, presence of the tear, biceps tendon subacromial subdeltoid effusion and subacromial impingement were assessed. Results: Of the 60 patients, 46 were male and 14 were female. Among them 15 patients were diabetics, 12 patient were male and 3 patient were female. Supraspinatus(SST) tendon thickness was greater in diabetics than in non-diabetics. Similarly, Subacromial bursal effusion, Biceps tendon effusion and Subacromial impingement were also seen in greater frequency in diabetic patients. However, no significant correlation was found between tear and the diabetes.Conclusions: There was increased supraspinatus tendon thickness, subacromial impingement, subacromial bursal effusion and biceps tendon effusion in diabetic patient compared to non-diabetic patient.Keywords: Diabetes; rotator cuff; supraspinatus tendon; ultrasound

Background Supracondylar fractures are subclassified as high and low type depending on whether they are above or below the isthmus of the distal humerus and it play an important role in determining outcome. Objective To compare the clinical and radiological outcomes of patients with fractures above and below the distal humeral isthmus treated with closed reduction and percutaneous pinning. Method This is a prospective non-randomized analytical study of 40 patients with displaced extension type supracondylar fracture of distal humerus treated by closed reduction and percutaneous pinning. Radiological and functional outcomes was followed up to 6 months postoperatively. The significance of differences between means (baumann angle, carrying angle and time to recovery) were calculated using the independent t-test. Result Twenty-four (60%) patients were high type and 16 (40%) patients were low type. According to Flynn grading, there was no statistical significance between the high type and low type (p = 0.601). The time to recovery for the high type was 15.58 ± 2.95 weeks and for low type was 18.75 ± 2.18 weeks. Hence, the time to recovery for the low type was longer than high type and it was statistically significant (p = 0.001). Conclusion Low type supracondylar fractures require a longer period for the gain of elbow range of motion. However, in long term the prognosis of low type is comparable with that of high type fracture. Hence, the prognostic value of fracture level in the treatment of displaced supracondylar fractures is not statistically significant.

In spite of policy programs in place, good forest governance does not still persist in community forestry sector of Nepal. This study aims to understand how genderbased leadership affects good forest governance in the two community forest user groups, viz. the Bandeshwori CFUG and the Suryamod Perunge CFUG of Bhaktapur district, Nepal from gender perspective. Both the primary and secondary methods were employed for data collection. The collected data were screened, and analyzed qualitatively and quantitatively. The study compares the individual elements (transparency, accountability and participation) of the governance with the overall governance scenarios between the two community forests. As per the findings of this study, the female leadership was found to be better in forest management by maintaining all aspects of governance as compared to the male. This was because of the higher participation of all the users, regular audit of income and expenditure, accountability of executive committee towards user group, high-level of transparency and predictability. The study concludes that decentralization of power to female, and their active participation in leadership position are needed for maintaining good governance and proper management of community forest.

Background Ductus arteriosus is a vascular structure which connects the roof of main pulmonary artery near the origin of the left branch pulmonary artery to the proximal descending aorta. Patent ductus arteriosus (PDA) closure is indicated for any patient who is symptomatic from left to right shunting. Objective To investigate the hospital outcomes of surgical closure of patent ductus arteriosus over last 19 years starting from the very first case of our center. Method This is a retrospective analysis of all patent ductus arteriosus treated surgically from August 2001 to July 2019. Patients who underwent isolated surgical closure of patent ductus arteriosus were included. Data have been presented in three different eras (Era 1: 2001-2007, Era 2: 2008-2013, and Era 3: 2014-2019) to see the trend of evolution of this surgery. Result A total of 901 patients aged 8.67±8.76 years under went patent ductus arteriosus surgical closure over last 19 years. Patients in the initial era 2001-2007 were significantly older compared with other 2 eras (p=0.000). Males accounted for 35.5% of all cases. Twenty percent had severe pulmonary artery hypertension. Duration of mechanical ventilation was 3.57±9.64 hours with ICU stay of 1.55±1.53 days, and hospital stay of 3.9±2.3 days. Overall in hospital mortality was 0.8%; for isolated patent ductus arteriosus diagnosis, mortality was 0.2%. Chylothorax was noted in 0.4%. Conclusion This is the first report to analyze surgical outcomes of patent ductus arteriosus ligation in our center. We have discussed the evolution of patent ductus arteriosus surgery in our center, and have shown favorable outcomes in terms of morbidity and mortality.

BACKGROUND Genome-wide association studies (GWAS) of alcohol dependence (AD) and related phenotypes have identified multiple loci, but the functional variants underlying the loci have in most cases not been identified. Noncoding variants can influence phenotype by affecting gene expression; for example, variants in the 3' untranslated regions (3'UTR) can affect gene expression posttranscriptionally. METHODS We adapted a high-throughput assay known as PASSPORT-seq (parallel assessment of polymorphisms in miRNA target sites by sequencing) to identify among variants associated with AD and related phenotypes those that cause differential expression in neuronal cell lines. Based upon meta-analyses of alcohol-related traits in African American and European Americans in the Collaborative Study on the Genetics of Alcoholism, we tested 296 single nucleotide polymorphisms (SNPs with meta-analysis p values ≤ 0.001) that were located in 3'UTRs. RESULTS We identified 60 SNPs that affected gene expression (false discovery rate [FDR]

In recent years, metal–metal oxide catalysts have proven to be robust catalysts for hydrodeoxygenation (HDO) of oxygenated compounds derived from biorenewable feedstocks to value-added products. He...

Twelve common buckwheat (Fagopyrum esculentum Moench) genotypes received from Hill Crops Research Program, Kabre, Dolakha were evaluated for resistance against major foliar fungal diseases and high yielding traits at the research field of National Maize Research Program, Rampur, Chitwan during winter seasons of two consecutive years 2017 and 2018. The design of the experiment was Randomized Complete Block having three replications. The unit plot size was 3m x 2m with 25cm row to row spacing and continues plant to plant spacing was maintained and net harvested plot was 6 sq meters. The experiment was planted at last week of October in both years. The recommended dose of fertilizer was 30:30:0 for N:P:K kg ha-1 respectively and seed rate 50 kg ha-1. Disease data were recorded for downy mildew (Perenospora fagopyri), powdery mildew (Erysiphepolygoni) and botrytis leaf blight (Botrytis cinerea) severity on 20 randomly tagged plants/plot. The yield and yield attributing traits were recorded. Buckwheat genotypes differed significantly (p

Background: Thyroid dysfunction and hyperglycemia are common metabolic problem. Unrecognized thyroid dysfunction may amplify existing cardiovascular disease risk in hyperglycemic subjects. Early recognition and management of thyroid dysfunction helps to control blood glucose and prevent associated morbidity. The aim of this study was to assess thyroid function among prediabetics and compare it with healthy controls. Methods: This study conducted in Kathmandu University hospital was reviewed and approved by Institutional review committee. The total of 200 participants were recruited for the study among which 106 were prediabetics (HbA1c 5.7–6.4%) and 94 apparently healthy controls (HbA1c

Cycles of heavy drinking and abstinence can lead to alcohol use disorder. We studied the effects of chronic intermittent ethanol exposure (CIE) over 3 weeks on neuroblastoma cells, using an ethanol concentration frequently attained in binge drinking (40 mM, 184 mg/dL). There were many changes in gene expression but most were small. CIE affected pathways instrumental in the development or plasticity of neurons, including axonal guidance, reelin signaling, and synaptogenesis. Genes involved in dopamine and serotonin signaling were also affected. Changes in transporters and receptors could dampen both NMDA and norepinephrine transmissions. Decreased expression of the GABA transporter SLC6A11 could increase GABA transmission and has been associated with a switch from sweet drinking to ethanol consumption in rats. Ethanol increased stress responses such as the unfolded protein response. TGF-β and NFκB signaling were increased. Most of the genes involved in cholesterol biosynthesis were decreased in expression. Withdrawal for 24 h after CIE caused most of the CIE-induced expression changes to move back toward unexposed levels.