Notes

End-user engagement within a systematic report on quantitative and also qualitative study involving non-pharmacological surgery with regard to attention deficit hyperactivity disorder delivered at school settings: insights about the influences and also challenges.
Early and late introduction of complementary feeding is associated with increased morbidity and nutritional deficiencies in children. In 2016, the under 5 mortality rate of Nepal was 39 deaths per 1000 live births and around 1 million under 5 children had suffered from chronic malnutrition. The main aim of this study was to identify the level of knowledge and practice regarding complementary feeding among the mothers of children aged group 6 to 24 months in Bhanu Municipality, Tanahu District, Nepal.

A descriptive cross-sectional study was conducted with 158 mothers of children age group 6 to 24 months from ward number 1 and 2 in Bhanu Municipality, Tanahu District, Nepal. Data collection was done after taking ethical approvalby using a semi-structured questionnaire via face-to-face interviews. Collected data were entered and descriptive analysis was carriedout in Statistical Package for the Social Services version 20. Categorical variables were presented using frequency and percentage. Clopper-pearson meothers. As a result, enhancing existing strategies and developing new intervention measures including capacity building of healthworkers to improve child feeding practices must be mandatory actions for the government and policymakers.
Patellofemoral pain is the leading cause of knee pain in young adults. Magnetic resonance imaging plays an important role in early diagnosis of patellofemoral joint pathology. This study was carried out to evaluate the patellofemoral joint using magnetic imaging resonance and describe various predisposing factors for patellofemoral instability.

The study was carried in Department of Radiology, BPKIHS over a period of six months from February 2020 to August 2020. All patients with clinical diagnosis of patellar instability were included and Magnetic resonance imaging was done using standard knee protocol and findings were noted on structured proforma. Analysis was done using statistical package for the social sciences version 20 applying simple descriptive statistical methods.

A total of 60 patients who underwent MRI knee were analyzed, out of which 28(46.7%) patients were male while 32(53.3%) patients were female. 44 patients (58.3%) had various predisposing factors for patellar instability. The commonest predisposing factor was patellar subluxation (73.3%) followed by abnormal trochlear groove angle (58.3%) and patellar translation (increased tibia tubercle trochlear groove distance) (53.3%). Histone Methyltransferase inhibitor Various MRI findings in our study were bone contusion (28 cases,46.7%), joint effusion (36 cases,60%), medial patellofemoral ligament injury (11cases ,18.3%), erosion of patellar cartilage (5 cases,8.3%), femoral cartilage erosion (3 cases,5%),loose bodies (2 cases,3.3%), subchondral edema (3 cases,5%) and meniscus injury (18 cases,30%).

Magnetic resonance imaging is not only useful in assessing lesions of the bone, cartilage and ligaments of patellofemoral joint but also enables detection of various predisposing factors for patellofemoral instability.
Magnetic resonance imaging is not only useful in assessing lesions of the bone, cartilage and ligaments of patellofemoral joint but also enables detection of various predisposing factors for patellofemoral instability.
Pregnancy has been identified as a vulnerable period for both the initiation and escalation in severity of domestic and family violence. There is a significant dearth of scholarly literature documenting the relationship of domestic and family violence with the mental health and quality of life among pregnant women of Nepal.

Baseline data of 140 women enrolled in a trial of a psychosocial intervention for abused pregnant women were analysed. Face-to-face interviews were conducted using standardised scales. Prevalence of domestic and family violence and mental health conditions were estimated and inferential statistics were used to assess the association of domestic and family violence with mental health, quality of life, social support, and use of safety behaviours.

The lifetime prevalence of domestic and family violence was found to be 27.7% (n = 173), followed by 17.1% of women (n = 107) fearing someone in their family. Domestic and family violence in the last 12 months was significantly associated with anxiety (p = 0.001), depression (p = 0.005), quality of life (p < 0.05), and perceived social support (p = 0.001). Use of safety behaviours (p = 0.037) was significantly low among women reporting domestic and family violence in the past year as well as during the current pregnancy (p = 0.017).

There exists a high psychological morbidity among pregnant women exposed to domestic and family violence. The findings support the need of implementing a screening and support intervention for abused women seeking antenatal services.
There exists a high psychological morbidity among pregnant women exposed to domestic and family violence. The findings support the need of implementing a screening and support intervention for abused women seeking antenatal services.
Acute Appendicitis is a clinical diagnosis with atypical presentation in young, elderly, females, genitourinary and gynecological conditions. Delayed appendectomy increases the risk of appendicular perforation, sepsis morbidity and mortality. Literature reports as high as 20-40% negative appendectomy. Raja Isteri Pengiran Anak Saleha score has come with higher sensitivity and diagnostic accuracy than Alvarado score in Asian population. This study aims to compare RIPASA and Alvarado score for diagnostic accuracy.

Appendectomy patients at Patan Hospital from April to September 2014 were compared on raja isteri pengiran anak saleha (cut-off value 7.5 out of 15) and Alvarado score (cut-off value 7 out of 10). Final diagnosis was histopathology based. Microsoft Excel and SPSS 17 were used for analysing sensitivity, specificity and diagnostic accuracy of both scores. The study included patients who underwent appendectomy with histopathology report and excluded those with conservative management, generalized peritonitis, appendicular lump and abscess.

There were 88 appendectomy patients with median age 26 (18.25, 35) years, and male 52 (59.1%). Negative appendectomy was 10 (11.36%). Sensitivity and specificity of Raja Isteri Pengiran Anak Saleha 98.71% and 80.00% respectively, and for Alvarado 52.56% and 70%.The Raja Isteri Pengiran Anak Saleha score had statistically significant sensitivity (p=0.000). Positive Predictive value, Negative Predictive Value and diagnostic accuracy were 97.46%, 88.89% and 96.6% for RIPASA and 93.18%, 15.19% and 54.4% for Alvarado respectively.

The Raja Isteri Pengiran Anak Saleha score had better diagnostic accuracy compared to Alvarado score for diagnosis of Acute Appendicitis.
The Raja Isteri Pengiran Anak Saleha score had better diagnostic accuracy compared to Alvarado score for diagnosis of Acute Appendicitis.
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