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The Versatility of Perforator-Based Propeller Flap for Reconstruction of Distal Leg and Ankle Defects
Durga Karki,R. P. Narayan
Plastic Surgery International , 2012, DOI: 10.1155/2012/303247
Abstract: Introduction. Soft tissue coverage of distal leg and ankle region represents a challenge and such defect usually requires a free flap. However, this may lead to considerable donor site morbidity, is time consuming, and needs facility of microsurgery. With the introduction of perforator flap, management of small- and medium-size defects of distal leg and ankle region is convenient, less time consuming, and with minimal donor site morbidity. When local perforator flap is designed as propeller and rotated to 180 degree, donor site is closed primarily and increases reach of flap, thus increasing versatility. Material and Methods. From June 2008 to May 2011, 20 patients were treated with perforator-based propeller flap for distal leg and ankle defects. Flap was based on single perforator of posterior tibial and peroneal artery rotated to 180 degrees. Defect size was from 4?cm × 3.5?cm to 7?cm × 5?cm. Results. One patient developed partial flap necrosis, which was managed with skin grafting. Two patients developed venous congestion, which subsided spontaneously without complications. Small wound dehiscence was present in one patient. Donor site was closed primarily in all patients. Rest of the flaps survived well with good aesthetic results. Conclusion. The perforator-based propeller flap for distal leg and ankle defects is a good option. This flap design is safe and reliable in achieving goals of reconstruction. The technique is convenient, less time consuming, and with minimal donor site morbidity. It provides aesthetically good result. 1. Introduction Soft tissue reconstruction of ankle region is difficult and challenging. Due to limited mobility and availability of overlying skin, even a small defect in the distal leg and ankle region may require a microsurgical reconstruction. Random pattern flap are limited in size and mobility [1]. Local fasciocutaneous flaps with limited availability in distal leg resulted in donor site that always require skin grafting. Free microvascular transfer leads to considerable donor site morbidity, is time consuming, and requires expensive microsurgical facility. The field of reconstructive surgery has taken a significant leap forward with the introduction of perforator flaps. This has been made possible with the development of knowledge in vascular anatomy and cutaneous circulation [2, 3]. According to the Gent consensus, perforator flaps are composed of skin and subcutaneous fat nourished by perforators rising from deep vascular systems, which reach the surface by passing mostly through muscle and intramuscular septa [4].
Prevalence of Aflatoxin B1 and B2 in Poultary Feed
Sita R. Aryal,Durga Karki
Nepal Agriculture Research Journal , 2009, DOI: 10.3126/narj.v9i0.11648
Abstract: A total of 65 poultry feed samples were examined for the detection of aflatoxin (aflatoxin B 1 and aflatoxin B 2 ) using thin layer chromatography (TLC). Samples were collected from Chitwan and Kavrepalanchock districts. Out of those samples examined a total of 49 (75.38%) samples were found positive. Out of 49 (75.38%) samples positive, 42 (85.71%) samples were found positive both with aflatoxin B 1 and B 2 where as five (10.20%) samples were positive only with aflatoxin B1 and two (4.08%) samples were positive only with aflatoxin B2. Among them 13 (20%) samples were found positive having aflatoxin above permissible level. The concentration of aflatoxin in positive samples ranged from trace to 366 ppb (366 μg/kg). Likewise, out of 52 samples examined in rainy season, 40 samples (76.92%) were found positive where as out of 13 samples examined in winter season 9 (69.23%) were found positive. Nepal Agric. Res. J. Vol. 9, 2009, pp. 109-112 DOI: http://dx.doi.org/10.3126/narj.v9i0.11648
Near miss maternal morbidity and maternal mortality at Kathmandu Medical College Teaching Hospital
NS Shrestha,R Saha,C Karki
Kathmandu University Medical Journal , 2010, DOI: 10.3126/kumj.v8i2.3563
Abstract: Background: Maternal mortality traditionally has been the indicator of maternal health all over the world. More recently review of the cases with near miss obstetric events has been found to be useful to investigate maternal mortality. Cases of near- miss are those in which women present with potentially fatal complication during pregnancy, delivery or the puerperium, and survives merely by chance or by good hospital care.
Magnetic Properties of Fe/Cu Multilayers Prepared Using Pulsed-Current Electrodeposition
C.?Rizal,Y.?Ueda,B.R.?Karki
Journal of Nano- and Electronic Physics , 2012,
Abstract: [Fe (tFe) nm/Cu (tCu) nm]N multilayer films were prepared using pulsed-current electrodeposition method. The role of the pulsed-current deposition and Fe and Cu layer thicknesses on the magnetic properties was investigated. The microstructure of the multilayer films is dependent on the thicknesses of both the Fe and Cu layers. The saturation magnetization of the multilayers strongly correlated with the crystalline structure of Fe at the interface of Fe and Cu layers. [Fe (tFe) nm/Cu (tCu) nm]N multilayer films were prepared using pulsed-current electrodeposition method. The role of the pulsed-current deposition and Fe and Cu layer thicknesses on the magnetic properties was investigated. The microstructure of the multilayer films is dependent on the thicknesses of both the Fe and Cu layers. The saturation magnetization of the multilayers strongly correlated with the crystalline structure of Fe at the interface of Fe and Cu layers. [Fe (tFe) nm/Cu (tCu) nm]N multilayer films were prepared using pulsed-current electrodeposition method. The role of the pulsed-current deposition and Fe and Cu layer thicknesses on the magnetic properties was investigated. The microstructure of the multilayer films is dependent on the thicknesses of both the Fe and Cu layers. The saturation magnetization of the multilayers strongly correlated with the crystalline structure of Fe at the interface of Fe and Cu layers.
Role of FNAC in the Diagnosis of Thyroid Mailgnancy and its Comparison with Histopathology
S KC,R Karki,P Rayamajhi,K Rai,E Piya
Nepalese Journal of ENT Head and Neck Surgery , 2012, DOI: 10.3126/njenthns.v3i1.8180
Abstract: Nepalese Journal of ENT Head and Neck Surgery, Vol. 3 Issue 1 (Jan-June 2012) Page 9-10 DOI: http://dx.doi.org/10.3126/njenthns.v3i1.8180
Experience of Managing Urogenital Fistula
HK Pradhan,G Dhangal,A Karki,R Shrestha,K Bhattachan
Nepal Journal of Obstetrics and Gynaecology , 2014, DOI: 10.3126/njog.v9i1.11181
Abstract: ?Aim: The study was done to review the demography of urogenital fistulae including obstetric fistula (OF) and its surgical outcome in the early phase of fistula surgery and to create awareness about OF.
A young female case of acromegaly presenting with diabetic ketoacidosis
R Maskey,DR Shakya,D Peeyush,P Lavaju,P Karki
Sunsari Technical College Journal , 2012, DOI: 10.3126/stcj.v1i1.8662
Abstract: Diabetes mellitus is reported to be common in cases with acromegaly. However, diabetic ketoacidosis (DKA) is rarely reported in this disease. Here is a 17 year old female case with acromegaly who presented to our hospital with the first presentation was DKA. DOI: http://dx.doi.org/10.3126/stcj.v1i1.8662 Sunsari Technical College Journal Vol.1(1) 2012 57-60
Risk of neonatal hyperbilirubinemia in babies born to ‘O’ positive mothers: A prospective cohort study
BK Kalakheti,R Singh,NK Bhatta,A Karki,N Baral
Kathmandu University Medical Journal , 2009, DOI: 10.3126/kumj.v7i1.1758
Abstract: Introduction: Hyperbilirubinemia in a neonate is one of the most common problems that may occur in 60-70 % of term and 80% of preterm babies. It is known to be associated with significant morbidity like neonatal bilirubin encephalopathy and even death. Clinically, and almost exclusively ABO incompatibility occur in ‘A' and ‘B' blood group babies of O ‘+ve' mothers. These babies are reported to be at high risk of severe hyperbilirubinemia (serum bilirubin level more than 16 mg/dl). Objectives: To find out the incidence of hyperbilirubinemia in babies born to ‘O' positive mothers. To estimate the risk of ABO incompatibility in babies born to ‘O' positive mothers. Materials and methods: A prospective cohort study conducted in B. P. Koirala institute of Health Science (Department of Pediatrics and Dept. of Gynae and Obstetric) from July 2002 to June 2003. A total of 199 women having ‘O' positive blood group admitted to the Department of Gynae and Obstetric were included in the study. A piloted proforma was used to collect information. The blood group of neonates was tested by tile and slide method and serum bilirubin was estimated by diazo method in the Central Laboratory Services and Emergency laboratory of BPKIHS. The data was observed and analysis was carried out using statistical software SPSS-10. Results: Total 37 (18.5%) babies had developed hyperbilirubinemia and among them 14 (38%) were from group of babies having ‘O' Positive blood group and 23 (62%) were from group of babies having other than ‘O' Positive blood group. There was 2.6 times higher chance of having hyperbilirubinemia in the babies with ABO incompatibility than ‘O' Positive babies after adjusting other significant variables. Conclusion: Among different significantly associated variables, ABO incompatibility was found to be a major risk factor for neonatal hyperbilirubinemia.It was seen that neonate with ABO incompatibility had two times higher chances of having hyperbilirubinemia than those babies with O ‘+ve' blood group. This finding in BPKIHS suggests that there is a need of screening cord blood bilirubin and continuous monitoring of bilirubin level in the hospital especially among ABO incompatible neonates. Key words: Hyperbilirubinemia, Neonatal Jaundice, ABO-incompatibility doi: 10.3126/kumj.v7i1.1758 ? ? ? Kathmandu University Medical Journal (2009), Vol. 7, No. 1, Issue 25, 11-15 ?
Abundance and distribution of tiger prey base at Bardia- Katarniyaghat corridor forest, Nepal
A. Karki,S. R. Jnawali,S. Adhikari,S. K. Sharma
Banko Janakari , 2012, DOI: 10.3126/banko.v22i2.9199
Abstract: Not available. DOI: http://dx.doi.org/10.3126/banko.v22i2.9199 Banko Janakari : A Journal of Forestry Information for Nepal Vol. 22, No. 2, 2012 November Page:53-56 Uploaded date: 12/1/2013 ?
Study on quality and milling recovery of different varieties of rice at varying degree of polishing under Khumaltar condition
MJ Thapa, MB Shrestha, R Karki, CM Bhattarai
Agronomy Journal of Nepal , 2011, DOI: 10.3126/ajn.v2i0.7523
Abstract: In Khumaltar, under NARC, rice varieties; Khumal-4, Khumal-8 and Radha-32 as slender varieties and Khumal-11, Taichung, Chainung-242 as bold varieties were studied for assessing their qualitative traits during 2006-08. These were milled in Satake Sheller and polished in Yamamoto polisher at different degree of polishing (0, 4, 8 and 12%). The mean milling recovery (73.4%), head rice (84.8%), broken rice (15.1%), protein (7.71%), ash (0.84%) and fat (1.34%) were recorded from the experiments. Among them, milling recovery, head rice, protein, fat, and ash were found significant (P < 0.05) with increasing degree of polishing. These attributes (head rice, protein, ash, and fat) were recorded increased at 8 and 4% degree of polishing compared to that of 12%. However, for 12% degree of polishing the milling recovery, head rice, protein, fat and, ash content were low as against 4 and 8% degree of polishing. The study showed that nutritional value of protein, fat and, ash contents were found high at 4 and 8% degree of polishing compared to that of 12%. Similarly, the percentage of head rice also increased at 4 and 8% than at 12% degree of polishing. The percentage of broken rice was also increasing with the increasing degree of polishing. Therefore, the result could be concluded that lowering the degree of polishing from 12% to 8% to 4% for both slender and bold rice could be increased rice stock by 4% in country’s total rice production. Hence, the result of this study would help strengthen the food and nutritional security and improve quality of rice in the country as well. DOI: http://dx.doi.org/10.3126/ajn.v2i0.7523 Agronomy Journal of Nepal (Agron JN) Vol. 2: 2011 pp.88-92
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