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Search Results: 1 - 10 of 849 matches for " Prami Shrestha "
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Tourism in Nepal: A Historical Perspective and Present Trend of Development
Hari Prasad Shrestha,Prami Shrestha
Himalayan Journal of Sociology and Anthropology , 2012, DOI: 10.3126/hjsa.v5i0.7039
Abstract: Tourism is the movement or travel of people from one place to another; whether it is within their own country or to other countries, for pleasure, business, pilgrimage and other purpose. The evolution of tourism dates back to ancient times. In Nepal, tourism, despite having a long history was, developed since 1950s only. The recent trend of tourists' arrival in Nepal seems satisfactory. However, from the perspective of tourism based resources and its availability in the country seems rather pessimistic. To promote tourism sector and its contribution to socio-economic sector of the country, we need to utilize available resources properly and beneficially. For this, there is need of dynamic and tourism friendly policy and joint effort of the government and the private sector as well. DOI: http://dx.doi.org/10.3126/hjsa.v5i0.7039 Himalayan Journal of Sociology & Anthropology-Vol. V (2012) 54-75
Comparative prevalence of MRSA in two Nepalese tertiary care hospitals  [PDF]
Bidya Shrestha
Open Journal of Clinical Diagnostics (OJCD) , 2013, DOI: 10.4236/ojcd.2013.32013
Abstract: This comparative study has been focused on the prevalence of MRSA types and their antibiotic resistance in two tertiary care hospitals of Nepal. During November 2007 to June 2009, clinical samples from patients with nosocomial infection from two Nepali hospitals, Kathmandu Based Hospital (KBH) and Lalitpur Based Hospital (LBH) were cultured and antibiotic susceptibility tests done following standard methodology in Microbiology laboratory, Tribhuvan University Teaching Hospital, Kathmandu, Nepal. Occurrence of MRSA (52.9% of 304 Staphylococcus aureus isolates) in KBH and that of MSSA (62% of 100 S. aureus isolates) in LBH were significant. No association of age was observed with MRSA or MSSA. Among MSSA from both hospitals, the highest resistance was found against penicillin. KBH urinary isolates were resistant to norfloxacin (51.4%), while isolates from other sites were resistant to ciprofloxacin (30.6%), erythromycin (12%), gentamicin (10.3%). LBH isolates were resistant to co-trimoxazole (22.6%), erythromycin (17.2%), ciprofloxacin (13.8%), gentamicin (12.9%). Among MRSA, most of the isolates from both hospitals were resistant to a wide array of antibiotics. A majority of the MSSA and MRSA isolates were susceptible to rifampicin and chloramphenicol. Most of KBH MRSA were homogeneous MRSA, 80.5% (significant), of which, 99.2% were multiresistant oxacillin resistant S. aureus (MORSA). And among the heterogeneous MRSA isolates from KBH, 71% were MORSA. On the other hand, among LBH MRSA isolates, 52.6% were homogeneous MRSA, cent percent of which were MORSA while 47.4% were heterogeneous MRSA of which 44.5% were MORSA. Since almost all of the homogeneous MRSA and most of the heterogeneous MRSA from both hospitals were MORSA, there is a possibility that a hospital acquired S. aureus could be MORSA. Hence, every infected patient should be considered as a potential source of MORSA.
Long Lead-Time Streamflow Forecasting Using Oceanic-Atmospheric Oscillation Indices  [PDF]
Niroj Kumar Shrestha
Journal of Water Resource and Protection (JWARP) , 2014, DOI: 10.4236/jwarp.2014.66062

Climatic variability influences the hydrological cycle that subsequently affects the discharge in the stream. The variability in the climate can be represented by the ocean-atmospheric oscillations which provide the forecast opportunity for the streamflow. Prediction of future water availability accurately and reliably is a key step for successful water resource management in the arid regions. Four popular ocean-atmospheric indices were used in this study for annual streamflow volume prediction. They were Pacific Decadal Oscillation (PDO), El-Nino Southern Oscillation (ENSO), Atlantic Multidecadal Oscillation (AMO), and North Atlantic Oscillation (NAO). Multivariate Relevance Vector Machine (MVRVM), a data driven model based on Bayesian learning approach was used as a prediction model. The model was applied to four unimpaired stream gages in Utah that spatially covers the state from north to south. Different models were developed based on the combinations of oscillation indices in the input. A total of 60 years (1950-2009) of data were used for the analysis. The model was trained on 50 years of data (1950-1999) and tested on 10 years of data (2000-2009). The best combination of oscillation indices and the lead-time were identified for each gage which was used to develop the prediction model. The predicted flow had reasonable agreement with the actual annual flow volume. The sensitivity analysis shows that the PDO and ENSO have relatively stronger effect compared to other oscillation indices in Utah. The prediction results from the MVRVM were compared with the Support Vector Machine (SVM) and the Artificial Neural Network (ANN) where MVRVM performed relatively better.

Mortality and Morbidity Pattern of Preterm Babies at a Tertiary Level Hospital in Nepal
Laxman Shrestha,Prabina Shrestha
Journal of Nepal Paediatric Society , 2013, DOI: 10.3126/jnps.v33i3.9200
Abstract: Introduction: Preterm birth is a major determinant of neonatal mortality and morbidity and has long-term adverse consequences for health. The objectives of this study were to find the demographic characteristics and clinical course of preterm babies admitted at Neonatal Unit of TU Teaching Hospital. Materials and Methods: A retrospective study was done by collecting data from labour room, NICU and by reviewing medical records of all preterm babies admitted to NICU in 2011. Results: There were total of 266 preterm deliveries in TUTH in the year 2011. About 45% of them required NICU admission. Ninety five babies were included in the study. Most common cause of premature delivery was maternal pregnancy induced hypertension (26%). Other causes were preterm premature rupture of membrane (24%) and in 25% of cases the cause was unknown. There were 10 (10.5%) severe preterm babies with mean weight 1.4 ± 0.3 kg, 27 (28.5 %) moderate preterm babies with mean weight 1.8 ± 0.4 kg and 58 (61%) late preterm babies with mean weight 2.2 ± 0.5 kg. Respiratory distress syndrome (RDS) was seen in 32% babies, hyperbilirubinemia in 40% babies, sepsis occurred in 37% and NEC in 4%. Hypothermia was seen in 10.5% and hypoglycemia in 5% babies. Apnea of prematurity was seen in 7% babies. Mechanical ventilation was required in 7% babies. The overall mortality was 12%. The main causes of death were respiratory distress syndrome and sepsis. The mean duration of stay was 10.2±8.8days. The survival rate of severe preterm babies was 80%, moderate preterm babies was 78% while that of late preterm was 95%. Conclusion: The main causes of morbidities in preterm babies were respiratory distress, hyperbilirubinemia and sepsis. Respiratory distress syndrome and sepsis were the predominant causes of mortality in these babies. DOI: http://dx.doi.org/10.3126/jnps.v33i3.9200 J. Nepal Paediatr. Soc. 2013;33(3):201-205
Clinical Profile of Paediatric Cataract and Surgery in a Tertiary Eye Care Centre, Nepal
UD Shrestha,MK Shrestha
Journal of Nepal Paediatric Society , 2012, DOI: 10.3126/jnps.v32i1.5378
Abstract: Introduction: Paediatric cataract is the opacification of lens and its capsule in children below 14 years of age. The management of paediatric cataract is lens aspiration with or without anterior vitrectomy, with or without intra-ocular lens implantation. The objective was to present the profile of pediatric cataract of operated eyes in children ≤14 years.
Ultrasonographically detected renal fusion anomalies in Western Region of Nepal
OK Shrestha,GL Shrestha
Journal of Chitwan Medical College , 2014, DOI: 10.3126/jcmc.v4i2.10857
Abstract: To establish the incidence and patterns of renal fusion anomalies based on Ultrasonography (USG) in Western region of Nepal. In 2 years period, patients undergoing abdominal USG at Gandaki Medical College between 2010 and 2012 were screened for renal fusion anomalies. After identification, incidence and male:female ratio were stratified for total renal fu-sion anomalies, horseshoe kidney, crossed fused ectopia and fused pelvic kidney. Out of 31498 patients who underwent abdominal USG, there were 71(1:444) cases of renal fusion anomalies, 61 (1:516) of horseshoe kidneys, 9 (1:3500) of crossed-fused ectopia and 1 (1:31498) of fused pelvic kidney. Male:Female ratio was 1:2 for horseshoe kidney and 1.25:1 for crossed fused ectopia. Renal fusion anomalies are rare congenital malformation. USG is a sensitive and reliable modality for its detection. Horseshoe kidney is the most common renal fusion anomaly followed by crossed fused ectopia. Our ultrasonograhic evaluation for incidence of renal fusion anomalies closely matches past autopsy and radiographic data. DOI: http://dx.doi.org/10.3126/jcmc.v4i2.10857 Journal of Chitwan Medical College 2014; 4(2): 25-28
Visceral fat versus subcutaneous fat: comparison of their association with type 2 diabetes mellitus
OK Shrestha,GL Shrestha
Journal of Chitwan Medical College , 2014, DOI: 10.3126/jcmc.v4i2.10853
Abstract: To compare abdominal visceral fat with subcutaneous fat in relation to their association with type 2 diabetes. Abdominal fat distribution was measured using Computed Tomography in 60 subjects (30 diabetics and 30 non-diabetics). Computed tomography images obtained at two intervertebral locations L2-L3 and L4-L5 were used to measure areas of total fat, visceral fat and subcutaneous fat using slice thickness of 5mm and attenuation range of -190 to -30 Hounsfield units. Data were analyzed using logistic regression. At L2-L3 level, taking visceral fat and subcutaneous fat as predictor variables, diabetes was correctly classified at 78.0% and 66.10% respectively. At L4-L5 level, taking visceral fat and subcutaneous fat as predictor variables, diabetes was correctly classified at 72.88% and 67.80% respectively. Regardless of the measurement site, visceral fat has significantly stronger association with diabetes, compared to subcutaneous fat. Visceral fat at L2-L3 level alone may be a better predictor of diabetes. Abdominal fat distribution, visceral fat, subcutaneous fat, type 2 diabetes. DOI: http://dx.doi.org/10.3126/jcmc.v4i2.10853 Journal of Chitwan Medical College 2014; 4(2): 9-12
Comparative Study of Three β Lactamase Test Methods in Staphylococcus aureus Isolated from Two Nepalese Hospitals  [PDF]
Shrestha Bidya, Rana Shamser Suman
Open Journal of Clinical Diagnostics (OJCD) , 2014, DOI: 10.4236/ojcd.2014.41009
Abstract: Background: β lactamase is a plasmid-encoded enzyme that hydrolyzes β lactam ring of β lactam antibiotics rendering them ineffective. These enzymes, produced by Staphylococcus aureus along with many other organisms, have hindered the use of many useful and once life-saving β lactam antibiotics from clinical practice. Methods: This study was aimed to compare three test methods-chromogenic, acidimetric and iodometric-for the detection of β lactamase enzyme produced by 404 nosocomial induced S. aureus isolated from two Nepali hospitals, Kathmandu based hospital (KBH) and Lalitpur based Hospital (LBH). The study was carried out following standard methodology during November 2007 to June 2009 in the Department of Microbiology, Institute of Medicine, Kathmandu, Nepal. Sensitivity, specificity, efficiency, positive predictive value, and negative predictive values of the tests were calculated taking penicillin resistance and sensitivity as the standard. Results: Chromogenic method was found to be the most sensitive (98.93%) and efficient (98.51%) test and had a high positive predictive value (99.46%). Sensitivity (98.4%) and efficiency (98.27%) of iodometric method was found to be comparable to chromogenic test; its specificity (96.55 %) and positive predictive value (99.73%) were the highest among the 3 tests. Acidimetric test was the least sensitive (97.33%) and efficient (96.78%). Of note, the sensitivity and specificity of these test methods have been compromised due to the negativity of few penicillin resistant isolates and positivity of some penicillin sensitive isolates, respectively. Conclusion: Chromogenic method was found comparatively to be the best test method for the detection of β lactamase production. However, in contrast to the other two test methods whose reagents can be locally and economically prepared, chromogenic test’s use has been impeded by its cost and unavailability in the local Nepali market.
Identification of Influential Sea Surface Temperature Locations and Predicting Streamflow for Six Months Using Bayesian Machine Learning Regression  [PDF]
N. K. Shrestha, G. Urroz
Journal of Water Resource and Protection (JWARP) , 2015, DOI: 10.4236/jwarp.2015.73016
Abstract: Sea surface temperature (SST) has significant influence in the hydrological cycle and affects the discharge in the stream. SST is an atmospheric circulation indicator which provides the predictive information about the hydrologic variability in the region around the world. Use of right location of SST for a given location of stream gage can capture the effect of oceanic-atmospheric interaction, improving the predictive ability of the model. This study aims on identifying the best locations of SST at the selected stream gage in the state of Utah that spatially covers the state from south to north, and use them for next six-month streamflow volume predictions. The data-driven model derived from the statistical learning theory was used in this study. Using an appropriate location of SST together with local climatic conditions and state of basin, an accurate and reliable streamflow was predicted for next six months. Influence of Pacific Ocean SST was observed to be stronger than that of Atlantic Ocean SST in the state of Utah. The SST of North Pacific developed the best model in most of the selected stream gages. Each model was ensured to be robust by the bootstrap analysis. The long-term streamflow prediction is important for water resource planning and management in the river basin scale and is a key step for successful water resource management in arid regions.
Brick Kilns of Nepal: A Non-Governmental Organization Perspective  [PDF]
Shilpa Shrestha, Steven M. Thygerson
Open Journal of Safety Science and Technology (OJSST) , 2019, DOI: 10.4236/ojsst.2019.91001
Abstract: Better Brick Nepal (BBN) works under the larger NGO, Global Fairness Initiatives, to promote the reliably sourced brick manufacturing by eliminating forced, bonded labor, and child labor, promoting workplace safety and health, providing fair wages, and preventing workplace harassment. The brick industry is regarded as the second largest source for air pollution after vehicle emissions in Kathmandu Valley. The brick kiln workers who live on the kiln premises in huts are highly exposed to both indoor and outdoor air pollution. This study reviewed the practices of BBN kilns that adhere to recommended standards for worker rights, health and safety. An NGO such as BBN is proving successful at eliminating inhumane work practices and in improving brick kiln worker health and safety.
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