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Drug Resistance Pattern in Pulmonary Tuberculosis Patients and Risk Factors Associated with Multi-Drug Resistant Tuberculosis  [PDF]
S. Maharjan, A. Singh, D. K. Khadka, M. Aryal
Journal of Tuberculosis Research (JTR) , 2017, DOI: 10.4236/jtr.2017.52012
Abstract: Introduction: Anti-tuberculosis drug resistance is a major problem in tuberculosis (TB) control programme, particularly multi-drug resistance TB (MDR-TB) in Nepal. Drug resistance is difficult to treat due to its associated cost and side effects. The objective of this study was to assess the drug resistance pattern and assess risk factor associated with MDR-TB among pulmonary tuberculosis patients attending National Tuberculosis Center. Methodology: The comparative cross sectional study was conducted at National Tuberculosis Center during August 2015 to February 2015. Early morning sputum samples were collected from pulmonary tuberculosis suspected patients and subjected to Ziehl-Neelsen staining and fluorochrome staining and culture on Lowenstein-Jensen (LJ) medium. Drug Susceptibility test was performed on culture positive isolates by using proportion method. Univariate and multivariate analysis was computed to assess the risk factors of MDR-TB. Results: Out of 223 sputum samples, 105 were fluorochrome staining positive, 85 were ZN staining positive and 102 were culture positive. Out of 102 culture positive isolates, 37.2% were resistance to any four anti-TB drugs. 11 (28.9%) were initial drug resistance and 28 (43.7%) were acquired drug resistance. The overall prevalence of MDR-TB was 11.7%, of which 2 (5.3%) were initial MDR-TB and 10 (15.6%) were acquired MDR-TB. Univariate and multivariate analysis showed female were significantly associated (P = 0.05) with MDR-TB. Conclusion: Drug resistance TB particularly MDR-TB is high. The most common resistance pattern observed in this study was resistance to both isoniazid and rifampicin. Female were found to be associated with MDR-TB. Thus, early diagnosis of TB and provision of culture and DST are crucial in order to combat the threat of DR-TB.
Understanding the Efficacy of Diclofenac Use-ban and its Aftermath Effect on Gyps Vulture in Koshi Tappu Wildlife Reserve, Nepal
Kapil K Khadka,Rabindra Kumar Mandal
Journal of Entomology and Zoology Studies , 2013,
Abstract: Study on efficacy of Diclofenac ban and its aftermath effect on Gyps vulture status was conducted in Koshi Tappu Wildlife Reserve in Nepal. Nest survey of the Gyps vulture and questionnaire survey was carried out. Gyps vulture nest were not found in the area. However, a flock of soaring vultures was observed one morning. Use of diclofenac was found to be stopped suggesting gyps vulture potential recovery in the area. Gyps vulture did not appear to be food limited given that the half of the people practice open disposal of carcass. Nonetheless, further study and monitoring of the Gyps vulture is warranted given the fact that there were not any nests of the vultures in the area.
Wheat Production under Long-term Application of Inorganic and Organic Fertilizers in Rice-Wheat System under Rainfed Conditions
Suresh K. Rai,Yajna G. Khadka
Nepal Agriculture Research Journal , 2009, DOI: 10.3126/narj.v9i0.11640
Abstract: Under rainfed rice-wheat cropping system, experiments were conducted on wheat variety Annapurna-2 from 1998 to 2002 to study the effect of continuous application of inorganic and organic fertilizers in longer run on wheat production and soil properties in alluvial soil of Khumaltar, Lalitpur at 1365 msal. Eleven different fertilizers combinations comprised of inorganic? and organic fertilizers were used. The results of the five-year experiment ?indicate that the applications of optimal level of inorganic fertilizers could? supply the plant nutrients to wheat crop to produce sustainable yield. On the other hand, organic fertilizers could help to increase the crop yield and maintain soil fertility at the same time. Residual effect of available? phosphorus applied in previous rice crop had significant response on wheat yield. For maintaining soil fertility, application of FYM and incorporation of? crop residue into soil are worth practicable. Nepal Agric. Res. J. Vol. 9, 2009 , pp. 40-48 DOI: http://dx.doi.org/10.3126/narj.v9i0.11640
Separating climate resilient crops through screening of drought tolerant rice land races in Nepal
RR Puri, K Khadka, A Paudyal
Agronomy Journal of Nepal , 2010, DOI: 10.3126/ajn.v1i0.7546
Abstract: Many studies have shown that local landraces are found to be better adapted to changing climatic conditions. The screening of local land races is one of important processes to detect drought tolerant behavior of crop species to further verify in similar field situation and genomic/molecular level studies. In 2009 for main season rice, a study was done to identify different land races of rice in Jhapa and Kailali districts to know their performance on drought stressed conditions by field techniques. Among the 22 rice land races studied, Kataush showed maximum drought tolerant efficiency (DTE) of 192.8% and minimum drought susceptibility index (DSI) of -0.88% followed by Guthanisaro (DTE=181% and DSI= -0.77%). Likewise, in the cluster analysis, these genotypes formed a cluster with two highest DTE and minimum DSI. Hence, these two land races could be used for drought stressed breeding program in the future to include drought resistant genes for variety impovement. Also, it was recorded that these land races could be used as the most drought tolerant variety in Terai region similar to Jhapa and Kailali, Nepal. These varieties could play important role in climate extreme situations, where farmers can adopt them as climatic resilient rice genotypes. DOI: http://dx.doi.org/10.3126/ajn.v1i0.7546 Agronomy Journal of Nepal (Agron JN) Vol. 1: 2010 pp.80-84
Performance Analysis of Hybrid Forecasting Model in Stock Market Forecasting
Mahesh S. Khadka,K. M. George,N. Park
International Journal of Managing Information Technology (IJMIT) , 2012,
Abstract: This paper presents performance analysis of hybrid model comprise of concordance and Genetic Programming (GP) to forecast financial market with some existing models. This scheme can be used for in depth analysis of stock market. Different measures of concordances such as Kendall’s Tau, Gini’s Mean Difference, Spearman’s Rho, and weak interpretation of concordance are used to search for the pattern in past that look similar to present. Genetic Programming is then used to match the past trend to presenttrend as close as possible. Then Genetic Program estimates what will happen next based on what had happened next. The concept is validated using financial time series data (S&P 500 and NASDAQ indices) as sample data sets. The forecasted result is then compared with standard ARIMA model and other model to analyse its performance.
Knowledge regarding preventive measures of heart disease among the adult population in Kathmandu  [PDF]
Radha Acharya Pandey, Ismita Khadka
Health (Health) , 2012, DOI: 10.4236/health.2012.49094
Abstract: Heart disease is the leading cause of death globally. Prevention is the most effective way of combating its epidemic in the resource poor nations. Knowledge on preventive measures of heart diseases has been identified as a prerequisite for change in behavior. This study was conducted with the purpose of identifying the knowledge on heart disease and its prevention among the adults population residing in Dadhikot VDC of Bhaktapur district by interviewing house to house survey. A total of 405 respondents who met the eligible criteria were systematically sampled and interviewed face to face for the study. A pretested Nepali version semi-structured interview schedule was used to collect data from adults. The duration of the study was one month i.e. June, 2011. Among total respondents, 57.8 percent had adequate knowledge on heart disease. Only less than half (46.9%) knew age as non-modifiable risk factor for heart disease followed by hereditary (39.8%) and sex (13.8%). Regarding modifiable risk factors, the most cited response was fatty food consumption (72.6%) followed by smoking (70.4%), stress (63.7%), physical inactivity (61.7%), hypertension (59%), obesity (58.8%), high cholesterol diet (36.5%) and diabetes (30.1%). Most of the respondents (57.8%) knew dyspnea during exertion as symptom of heart disease followed by chest pain (24%). Majority of respondents (80.7%) cited decreasing fatty diet as preventive measure of heart disease following daily exercise (75.6%), eating vegetables and fruits (71.6%), keeping blood pressure under control (59%) and keeping diabetes under control (33.8%) respectively. Knowledge was significantly associated with age, gender, education level and family history of heart disease. Conclusion: The findings concluded that significant percentage (42.2%) of respondents had inadequate knowledge on heart disease. The findings also highlighted the lack of knowledge on high cholesterol diet and diabetes as modifiable risk factors for heart disease i.e. 36.5% and 30.1% respectively. So it is recommended that awareness raising programs could be beneficial on prevention of heart disease is correcting in the deficient areas of knowledge regarding preventive measures of heart disease.
Knowledge Regarding Modifiable Risk Factors of Coronary Atherosclerosis Heart Diseases in Kathmandu Municipality
M Khadka
Nepalese Heart Journal , 2012, DOI: 10.3126/njh.v9i1.8347
Abstract: Background Progressive urbanization and adoption of the “western” lifestyle contributes to the rising burden of cardiovascular disease in the developing world Coronary Atherosclerotic Heart Disease is no longer confined by geographical area or socioeconomic boundary. The prevalence of Coronary Atherosclerotic Heart Disease is increasing in Nepal. Knowledge is an important pre-requisite for implementing both primary and secondary preventive strategies for cardiovascular diseases. This investigation attempts to quantify knowledge of modifiable risk factors of Coronary Atherosclerotic Heart Disease among sample population in Kathmandu metropolitan city. Methods Community based cross-sectional descriptive study design using quantitative method of study was conducted in ward no 5 of Kathmandu out of 35 wards. Selection was done by simple random technique (lottery method). Total house hold serial number of selected ward was identified from election commission record section and data was collected using systemic random sampling. The household head aged 18 years and above was taken as representative sample (n= 196). Standard questionnaire was used to interview participants. The risk factors specifically included smoking, hypertension, elevated cholesterol levels, diabetes mellitus and obesity. Results The mean age (SD) of the 196 participants was 51.26 (13.56) years. Of the participants only 22% had good level of knowledge regarding modifiable risk factors of Coronary Atherosclerotic Heart Disease. This study showed that majority of the respondent lack predefined good level of knowledge regarding modifiable risk factors of Coronary Atherosclerotic Heart Disease. 85.2%, 61.73%, 40.31%, 28.6%, 17.86% correctly identified hypertension, obesity, cholesterol, smoking and diabetes mellitus respectively as modifiable risk factor of Coronary Atherosclerotic Heart Disease. Stud y found association of good level of knowledge in male participants (p=0.006), Brahmin cast (p=0.001), living in nuclear family (p= 0.041), ex-smoker (p=0.06), doing regular exercise ( p= 0.006). Conclusion This study call for efforts such as targeted public health education to increase the level of knowledge about the modifiable risk factors of heart disease. DOI: http://dx.doi.org/10.3126/njh.v9i1.8347 Nepalese Heart Journal Vol.9(1) 2012 pp.37-42
Use of Qualitative Research Approach in Postmodern Studies: Sharing of Some Anthropological Experiences of the Study on the Pahari People of Central Nepal
Anju Khadka
Nepalese Journal of Qualitative Research Methods , 2007, DOI: 10.3126/njqrm.v1i0.1971
Abstract: doi: 10.3126/njqrm.v1i0.1971 Keywords: postmodern studies; Pahari People Nepalese Journal of Qualitative Research Methods Vol.1 2007 pp.37-50
Reformulating the Notion of Intercultural Communication Style within a Rhetorical Frame
Santosh Khadka
Bodhi: An Interdisciplinary Journal , 2013, DOI: 10.3126/bodhi.v6i0.9240
Abstract: DOI: http://dx.doi.org/10.3126/bodhi.v6i0.9240 Bodhi Vol.6 2013: 1-16
The importance of rating scales in measuring patient-reported outcomes
Jyoti Khadka, Vijaya K Gothwal, Colm McAlinden, Ecosse L Lamoureux, Konrad Pesudovs
Health and Quality of Life Outcomes , 2012, DOI: 10.1186/1477-7525-10-80
Abstract: Seventeen existing PROs designed to measure vision-related quality of life dimensions were mailed for self-administration, in sets of 10, to patients who were on a waiting list for cataract extraction. These PROs included questions with ratings of difficulty, frequency, severity, and global ratings. Using Rasch analysis, performance of rating scales were assessed by examining hierarchical ordering (indicating categories are distinct from each other and follow a logical transition from lower to higher value), evenness (indicating relative utilization of categories), and range (indicating coverage of the attribute by the rating scale).The rating scales with complicated question format, a large number of response categories, or unlabelled categories, tended to be dysfunctional. Rating scales with five or fewer response categories tended to be functional. Most of the rating scales measuring difficulty performed well. The rating scales measuring frequency and severity demonstrated hierarchical ordering but the categories lacked even utilization.Developers of PRO instruments should use a simple question format, fewer (four to five) and labelled response categories.
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