Review Committee Research Articles

Synonymous variant of TLR7 at restriction site rs864058 identified in Covid 19 Pakistani patients.

TLR7, the receptor accountable for immune response to RNA viruses, has been studied extensively to identify its variants related to the severity of Covid-19 in different populations worldwide. However, the genotype of Pakistani population is still unknown. This study aimed to determine the TLR7 genotypes and their relation with severity in our population. This cross sectional study collected data on 151 Covid-19 positive patients (aged 18-80 years), from June 2022 to May 2023, after an informed consent, from Ziauddin University and Hospital. Prior to that approval from ethics review committee was taken. The demographic variables and comorbidities were recorded along with health status till LAMA (Leave Against Medical Advise), recovery or death. The DNA was extracted from collected blood samples, PCR and Sanger sequencing was done for identification of TLR7 variants. SPSS was used for data analyses and Chi-Square for categorical variables. P-values of <0.05 was considered significant. Out of 151 patients' sequencing was done for 59 samples. The restriction site, rs864058 of TLR7 gene, identified G/A and G/G variants. This missense variant of TLR7 identified at rs864058 of TLR7 gene, has not been previously reported in population control databases. The genotype G/G was main variant of 49 (83%) patients, whereas, G/A was found in 10 (17%). Majority, 25 (51%) of patients with mild covid-19 had GG genotype but results were not significant (P=0.684). Among female patients the main genotype was GA 8 (80%) while male had G/G 29 (59.2%) with significant results (P=0.024). Since G/G genotype was the major genotype, high percentage was found in hypertensives [20 (40.8%)], Diabetics [13 (26.5%)], depression [24 (49%)] and pneumonia patients [20 (40.8%)]. However, significant association (P=0.023) was only found with pneumonia. Males, in majority had severe [17 (68%)] infection and death [40 (26.4%)], whereas, females had mild [14 (25%)] with [12 (7.9%)] deaths. A variant rs864058 "G/A" of TLR7, in relation to covid-19 were found in our population. Males were found more at risk of morbidity and mortality due to covid-19. Larger studies are required to further confirm these results.

Impact of tobacco smoking and alcohol consumption on the treatment efficacy among psoriasis patients: A study protocol.

Psoriasis is a common skin disease. With an in-depth understanding of psoriasis, small-molecule drugs and biologics are developed and used in clinical practice, but some patients still cannot achieve a satisfactory therapeutic effect. Tobacco smoking and alcohol drinking are proven to be factors affecting psoriasis. Still, evidence of the impact of tobacco smoking and alcohol consumption on the efficacy of psoriasis treatment is limited. This study aims to understand the prevalence of tobacco smoking and alcohol drinking among patients with psoriasis in Shanghai and to examine the association between tobacco smoking as well as alcohol drinking and the therapeutic effect in patients with psoriasis. We conducted a longitudinal observational study and recruited at least 500 psoriasis patients at Shanghai Skin Disease Hospital. In this study, patients with clinically diagnosed psoriasis vulgaris, aged ≥18 years, both males and females, with informed consent were recruited. However, patients with pregnancy, serious underlying disease conditions, communication barriers, and violation of medication regulations were excluded. Patients with psoriasis in this study receive a physical examination and case record form interview. The primary outcome indicator is the proportion of patients with PASI75 achievement at Week 8. In this study, we use SAS 9.2 software to analyze the data. This study has been reviewed and approved by the Institutional Ethics Review Committee of Shanghai Skin Disease Hospital in 2021 (NO. 2021-44). It has been registered in the Chinese Clinical Trial Registry (ChiCTR2200066403). Patient recruitment began in January 2021 and is proposed to be finished in December 2024. The findings in this study will provide evidence of how tobacco smoking and alcohol drinking impact the treatment efficacy among patients with psoriasis. Therefore, the implementation of tobacco control and alcohol abstinence benefit the improvement of treatment responses.

Clinical and Epidemiological Profile of Intracranial and Extracranial Arterial Stenosis of Stroke Patients in the Southwestern Region of Saudi Arabia

Abstract Background: Stroke is a significant contributor to global morbidity and mortality, affecting populations worldwide, including the southwestern region of Saudi Arabia. Intracranial arterial stenosis and extracranial arterial stenosis are recognized as common risk factors for stroke. The main aim of this study was to investigate the prevalence of intracranial and extracranial arterial stenosis among stroke patients residing in the southwestern region of Saudi Arabia. Materials and Methods: This descriptive cross-sectional study was conducted in the southwestern region of Saudi Arabia from January 2022 to December 2022. Ethical approval was obtained from the Institutional Review Committee. Data were collected through a comprehensive review of medical records, capturing demographic information, risk factors, stroke subtype, severity, comorbidities, and results of magnetic resonance imaging, magnetic resonance angiography, and transcranial Doppler examinations. Data were analyzed using SPSS. Results: In this study, 201 stroke patients were analyzed, with 113 (56.2%) males and 88 (43.8%) females. The prevalence of stenosis in stroke patients was 57.21%, with 63 patients having intracranial stenosis, 30 patients having extracranial stenosis, and 22 patients having both types of stenosis. Most intracranial stenosis cases exhibited 50%–69% stenosis, while extracranial stenosis cases were evenly distributed between 50%–69% and 100% stenosis. The presence of diabetes, dyslipidemia, metabolic syndrome, and cardiovascular disease was significantly associated with stenosis (P values of 0.029, 0.005, 0.043, and 0.012, respectively). High glycated hemoglobin (HbA1c) levels and elevated triglyceride levels were also strongly correlated with stenosis (P values of 0.003 and 0.021, respectively). Conclusion: This study reveals a high prevalence (57.21%) of arterial stenosis in stroke patients in the southwestern region of Saudi Arabia, with diabetes, dyslipidemia, metabolic syndrome, and cardiovascular disease significantly associated with stenosis. Elevated HbA1c and triglyceride levels were strongly correlated with stenosis, emphasizing the importance of comprehensive risk factor management and targeted interventions to reduce stroke burden.

Government Initiatives for Research Ethics During COVID-19 Pandemic in Korea.

Despite the growing necessity for government-led policy changes on clinical research ethics during pandemic, the scope of previous literature is limited to Korean government's pandemic response strategies or reflections of research ethics at the level of institutions and academic societies. This paper examines the proactive policy changes and responses by the South Korean government in addressing the challenges and issues of research ethics against the backdrop of the urgency of rapid development and emergency supply of medical products during the coronavirus disease 2019 (COVID-19) pandemic. We conducted searches of various government documents, using predetermined keywords related to research ethics and integrity during the COVID-19 pandemic. Only documents issued by governments or public institutions were included. A total of 24 documents were selected for analysis. They were divided into two phases: the first phase for urgent response (January 2020-February 2021) and the second phase (March 2021-February 2023) for long-term preparedness. The Korean government recommended several measures of research governance to accelerate the ethical review of COVID-related research to be shortened less than one week: the joint operation of Institutional Review Boards (IRBs), exempted or expedited review by a special review committee, guidelines for urgent reviews, and designation of the Korean Academy of Medical Sciences as the supervising agency for the Clinical Trial Safety Support Institution as well as the Central IRB. It allowed temporary non-face-to-face methods for informed consent process (telephone explanations and a photo of the original signed consent) and clinical trials (telephone counselling and prescription, proxy prescription, and drug delivery and supply to clinical trial participants, and online ethics training). As a result of South Korea's commitment to ethical principles in their pandemic response, the medical system did not experience collapses due to the pandemic, and pandemic research was conducted with careful ethical considerations. The pandemic ethics immunization during the Middle East respiratory syndrome epidemic in 2015 laid the foundation for prompt government initiatives that ensured both pandemic research ethics and pandemic response ethics.

The Ethics of Using News Stories concerning Minors as Empirical Material in Health Research: Reflections on a Swedish Case.

In 2021, we were designing a research study in Sweden in which we planned to use newspaper articles focusing on children and adolescents under the age of eighteen during the Covid-19 pandemic as empirical material. As we developed this study, an ethical question arose: do studies using journalistic articles that may contain health information about individuals as empirical material have to be approved by an ethics review committee? Sweden, in contrast to other countries, requires the approval of an ethics review committee for the use of publicly available material in research when such material might include sensitive personal data such as health-related information. This case study calls for harmonized laws and policies that support global research by clarifying what kinds of empirical material and what types of research must be assessed by national ethics review committees, including with consideration for children's safety and rights.

Transcultural adaptation of Odia version of health-related kidney disease and quality of life-36 instrument

Objective: The study objective was to translate, validate, and test the reliability of the original kidney disease and quality of life-36 (KDQOL-36™) instruments in Odia. Materials and Methods: A cross-sectional design with a purposive sampling technique was used. According to RAND Corporation guidelines, initially, the items of the KDQOL-36™ questionnaires were translated into Odia by two independent, bilingual, professional translators, and then back-translated to English, followed by tryout and field testing. The experts validated the KDQOL-36™ instrument review committee for review related to kidney health conditions. The tool was implemented among 180 patients undergoing “maintenance” hemodialysis. The following tests evaluated reliability and validity: test–retest reliability with Cronbach’s alpha correlation (stability), (reliability) internal consistency, and contents validity index. Results: The Cronbach’s alpha value and intraclass correlation coefficient (ICC) score of all five domains, namely “physical component summary, mental component summary (MCS), the burden of kidney disease, symptoms and problems of kidney disease, and effects of kidney disease” of both KDQOL-36™ English and Odia (KDQOL-36-E™ and KDQOL-36-O™) version, recommended excellent homogeneity. A high positive correlation (r = 0.998) was found between the Odia version of KDQOL-36™ and the English version KDQOL-36™ questionnaire. The ICC score ranges from 0.889 to 0.997 at a 95% confidence interval for test–retest reliability, and Cronbach’s alpha was 0.832. Conclusion: This study explores the Odia version of KDQOL-36™ psychometric properties, depicted at an acceptable level of internal consistency. The KDQOL-36-O™ instrument is a valid and reliable tool for assessing the kidney disease-related quality of life in Odia-speaking hemodialysis patients.

PRE-TRIAL ADMINISTRATIVE DISPUTES RESOLUTION IN GERMANY, FRANCE, ITALY AND UKRAINE: COMPARATIVE ASPECT

Background. This article highlights the main issues of the introduction and legislative approach to regulation of pre-trial administrative disputes resolution in Ukraine together with some examples from such European countries as Germany, France and Italy. Relevance of the contemplated study is that there is no exact definition of the concept "pre-trial administrative disputes resolution" in Ukrainian legislation, and there is also a lack of a clear understanding of the essence of pre-trial procedures in Ukraine. The purpose of the research is to analyze the existing practice of legal regulation regarding similar procedures in European countries of Romano-Germanic legal group as Germany, France and Italy and to define their effectiveness as well as to discuss the necessity of their being borrowed by Ukraine. Methods. The methodological bases for the article are general and special methods of legal science, namely: the method of analysis, the method of synthesis, formal and logical, normative and dogmatic, comparative methods. Results. It has been concluded that mediation and pre-trial administrative disputes resolution are different legal procedures both in Ukraine and in the legal practice of above-mentioned states. A brief description of the new institution for pre-trial dispute resolution in Ukraine – the complaint review commission – is offered. An illustrative comparative study of pre-trial dispute resolution procedures in Germany, France and Italy including an administrative complaint, objection to administrative act, remonstration, conciliation, extraordinary appeal, arbitration and examples of its application regarding administrative cases is observed. A brief description of the legal rules of Germany, France and Italy establishing mandatory pre-trial tax disputes resolution, disputes in the field of public service and disputes in the field of social guarantees is also provided. Conclusions. The unequivocal need for the national legislature to apply the experience of legislative regulation and practice of mentioned countries regarding establishment of mandatory procedures for pre-trial administrative disputes resolution, in particular, tax disputes, is justified; the need for qualitative improvement and broader legal regulation of administrative appeal in Ukraine is confirmed; impracticality of establishing mandatory mediation in certain categories of administrative disputes before bringing an action to the administrative court is explained.

Evaluation of a new patient safety educational programme to reduce adverse events by encouraging staff to speak up: application of the trigger tool methodology

BackgroundPoor communication contributes to adverse events (AEs). In our hospital, following an experience of a fatal incident in 2014, we developed an educational programme aimed at improving communication for better...

Adaptação transcultural do Instrumento de Rastreio para a Disfonia (IRD-Br) para o Português Europeu (PE)

ABSTRACT Purpose To perform a cross-cultural adaptation of the Brazilian Dysphonia Screening Tool (DST-Br) for European Portuguese (EP). Methods The cross-cultural adaptation of the DST-Br for EP was carried out in four stages: translation, back-translation, expert committee review, and pre-testing. The pre-testing involved 30 dysphonic individuals (24 women and 6 men) aged between 18 and 87 years old. Results An additional statement was required in the EP version of the instrument. Disagreement in the back-translation of the title was resolved through an expert committee review. One item presented discrepancies in the translation and back-translation, with the final version determined through an expert committee review. One item and the answer key reached a consensus in all stages. During pre-testing, all items received 100% "yes" or "no" responses, and none were marked as "not applicable". Conclusion The cross-cultural adaptation of DST-Br for use in EP was successfully carried out. The European Portuguese version of the instrument was named the Instrumento de Rastreio para a Disfonia em português europeu (IRD-PT) / Dysphonia Screening Tool in European Portuguese.

Translation and Cross-Cultural Adaptation of the Toronto Extremity Salvage Score (TESS) for Latin American Spanish-Speaking Patients With Limb Sarcoma: Latin American Spanish TESS Adaptation.

Background and Objectives: This study aims to translate and culturally adapt the Toronto Extremity Salvage Score (TESS) for Latin American Spanish-speaking patients, enhancing the tool's accessibility for evaluating postsurgical functional outcomes in sarcoma patients across Latin America. Methods: The TESS questionnaires for lower extremity (LE) and upper extremity (UE) were translated and adapted following international guidelines. The process included forward and backward translation, expert committee review, and pretesting with cognitive interviewing. Patients treated for bone or soft tissue tumors in LE or UE were recruited to complete the adapted questionnaires. Test-retest reliability was evaluated by having participants complete the questionnaire again 2 weeks after the initial assessment. Results: A total of 89 participants completed the questionnaires. The study found high internal consistency, with Cronbach's alpha values reaching 0.9437 for LE and 0.9402 for UE. An agreement rate of 98.4% for the global score of TESS-LE (95% confidence interval [CI]: 0.909-1.059) and 93.9% for TESS-UE (95% CI: 0.882-0.995) was observed, demonstrating strong test-retest reliability. Conclusions: The Latin American Spanish version of TESS for both lower and upper extremities is a reliable and culturally appropriate tool for assessing physical function in limb sarcoma patients. Further validation across diverse Latin American populations is encouraged to strengthen its broad applicability.

Intercalibration: A Cornerstone of the Success of the GEOTRACES Program

The international GEOTRACES program was developed to enhance knowledge about the distribution of trace elements and their isotopes (TEIs) in the ocean and to reduce the uncertainty about their sources, sinks, and internal cycling. Recognizing the importance of intercalibration from the outset, GEOTRACES implemented intercalibration efforts early in the program, and consensus materials were generated that included the full range of TEIs dissolved in seawater, in suspended particles, and from aerosols. The GEOTRACES section cruises include “crossover station(s)” that are occupied by two or more sections and whereby all aspects of sample collection, preservation, and processing can be compared and intercalibrated. Once datasets are generated, an international intercalibration committee reviews intercalibration reports and works with the community to address issues and provide intercalibrated data for intermediate data products. This process has resulted in a highly cooperative community that shares advances in protocols to strengthen capacity building and GEOTRACES outcomes, including an unprecedented oceanic atlas of TEIs, with data quality that is state-of-the-art. This article outlines the development and implementation of the successful GEOTRACES intercalibration process.

Cross-cultural adaptation of the Dysphonia Screening Tool (DST-Br) for European Portuguese (EP).

To perform a cross-cultural adaptation of the Brazilian Dysphonia Screening Tool (DST-Br) for European Portuguese (EP). The cross-cultural adaptation of the DST-Br for EP was carried out in four stages: translation, back-translation, expert committee review, and pre-testing. The pre-testing involved 30 dysphonic individuals (24 women and 6 men) aged between 18 and 87 years old. An additional statement was required in the EP version of the instrument. Disagreement in the back-translation of the title was resolved through an expert committee review. One item presented discrepancies in the translation and back-translation, with the final version determined through an expert committee review. One item and the answer key reached a consensus in all stages. During pre-testing, all items received 100% "yes" or "no" responses, and none were marked as "not applicable". The cross-cultural adaptation of DST-Br for use in EP was successfully carried out. The European Portuguese version of the instrument was named the Instrumento de Rastreio para a Disfonia em português europeu (IRD-PT) / Dysphonia Screening Tool in European Portuguese.

Adaptação transcultural para o português brasileiro e validação exploratória de duas medidas de alimentação emocional

ABSTRACT Objective This study aimed to cross-culturally adapt the Positive-Negative Emotional Eating Scale and the Florence Emotional Eating Drive into the Portuguese language and investigate their dimensionality (i.e., validity) for a sample of Brazilian individuals. Methods The cross-cultural adaptation process entailed translation, synthesis, expert committee review, pretesting, back-translation, and submission to the original authors. From the translations, synthesized versions of the measures emerged, which were evaluated by a committee of experts. Subsequently, the preliminary version was pre-tested with the target audience. A larger group of individuals completed the final Portuguese version of the instruments online, and the data were subjected to exploratory factor analysis to ascertain their dimensionality. Results Thirty-six individuals (female: 76.5%, mean age: 26.3±9.6 years) participated in the pretest, reporting ease in comprehending the content of both Positive-Negative Emotional Eating Scale and Florence Emotional Eating Drive. The back-translations closely resembled the originals, as confirmed by the authors of the instruments. Data from 721 individuals (female: 61.2%, mean age: 32.2±10.6 years) who completed the measures were analyzed. A two-factor model for Positive-Negative Emotional Eating Scale demonstrated a good fit, consistent with the original proposal. For Florence Emotional Eating Drive, a three-factor model akin to the original proposal emerged, with six items loading on different factors. Conclusion The Positive-Negative Emotional Eating Scale and Florence Emotional Eating Drive were successfully adapted to Portuguese, with Brazilian participants indicating good understanding. The dimensionality of the measures remained consistent with the original proposals. These findings offer valuable insights for future screening protocols to foster appropriate eating behaviors.

Validation of the Bengali version of the Caregiver Collusion Questionnaire: A tool for measuring collusion among caregivers of terminally ill patients.

In palliative care settings, collusion or "conspiracy of silence" frequently interferes with communication and interpersonal relationships among patients, caregivers, and healthcare professionals. The "Caregiver Collusion Questionnaire" is the only tool available for assessing caregiver collusion. The purpose of the study is to translate and adapt the English version of this instrument into Bengali, followed by standard validation. The study was carried out in two stages. Four independent translators conducted forward and backward translations of the English version of the "Caregiver Collusion Questionnaire" into Bengali. The Bengali version of the instrument was finalized following expert committee reviews, pre-testing, and cognitive debriefing. The final validation was carried out among 71 caregivers of patients with advanced incurable illnesses admitted to the palliative medicine and internal medicine departments of two Bangladeshi hospitals. In the final phase, the validity (content, face, and construct validity) and reliability (interclass item-wise correlation coefficient) of the translated tool were assessed. 60% of the participants fully understood 19 items, whereas 40% struggled with one or more items. The expert committee expressed their satisfaction with the face and content validity of the translated version. The Bengali version also had quite good reliability (α = 0.62). Seven components were identified using principal component analysis with the distribution of Varimax Rotation distribution. Items under each factor had adequate factor loading, ranging from 0.4 to 0.8. The Bengali version of the "Caregiver Collusion Questionnaire" was found valid reliable and culturally acceptable for measuring caregiver collusion among the Bengali-speaking people. Based on the scale, the reasons for collusion can be identified and measures can be taken for breaking the collusion.

The Role of NHRC in Regulating Health Research Ethics in Nepal: A Narrative Review

This study aims to chart Nepal's evolution of health research ethics over time and the role of the Nepal Health Research Council (NHRC) in its regulation. This narrative review article mentions the pervasiveness of contract research and the contribution of universities and international organizations in producing data and supporting pilot projects. It further highlights the structural inequalities and limitations of health research in Nepal, including lack of technology, infrastructure, funding, limited access to resources and global scientific networks. It discusses Nepal's emerging regulatory and ethical field, establishing the NHRC and developing ethical guidelines and review committees. The challenges faced by NHRC in terms of capacity and resources and the need to strengthen research ethics monitoring and compliance are also marked. This article also discusses several key challenges and areas of concern regarding research ethics and capacity building in Nepal's health research context. The conflicts arising from defining health research and determining which activities require ethical review are highlighted, especially about programmatic interventions and monitoring and evaluation exercises. The need for comprehensive mapping of health research activities is emphasized as an initial step toward understanding the research landscape. Additionally, issues related to timely ethical reviews, the co-investigator’s role, institutional research capacity, data ownership, publication practices, and the ethical considerations of health and development interventions are discussed. It emphasizes redressing these challenges and promoting responsible research practices in Nepal.

TYPES OF ITEM WRITING FLAWS IN MULTIPLE CHOICE QUESTIONS IN MEDICAL EDUCATION AND THEIR EFFECT ON PASSING RATE OF STUDENTS

Background: The most popular written exam in health professions education is the multiple-choice style question (MCQ). This study sought to understand the effects of multiple-choice writing errors on students' academic performance in medical education. Methods: This descriptive study was done from December 2017 to June 2019 in Azad Jammu Kashmir (AJK) Medical College, Muzaffarabad. Ten block examinations were included. The item review committee reviewed all MCQs for flaws. Two tests from each class of MBBS were taken. The original tests containing all items were labeled as flawed tests and the result of each flawed test was evaluated. The students were graded into high, moderate and low achievement groups with scores of more than 79.9, between 50–79.9 and less than 50 percent respectively. Flawed items were then removed from the tests by the review committee and the scores of each test (standard test) were determined and compared with flawed tests and its effects were assessed in three achieving groups of students. Optical mark reading (OMR) classic-4 software was used for post-exam analysis and data were analyzed by using SPSS-25. Results: The passing rate ranged from 68.18% to 90.82% in flawed and 75.54% to 93.69% in standard tests. Most standard tests (7) had higher passing rates than flawed tests. Conclusion: Tests containing in-house developed MCQs have frequent item writing flaws and their inclusion in assessment did affect the passing rates of students but were not statistically significant. Pak J Physiol 2023;19(4):49–52

Exploring Factors Influencing the Transition from Laparoscopic to Open Cholecystectomy

Background: Gallstones represent a prevalent gastrointestinal ailment often necessitating hospitalization. The preferred surgical approach for most patients is laparoscopic cholecystectomy. Instances where the procedure is converted to an open cholecystectomy typically result from factors such as adhesions, complex anatomy at Calot's triangle, or injury to the common bile duct [1]. This study focused on patients admitted to the surgery department to identify the factors leading to the shift from laparoscopic to open cholecystectomy within a tertiary care center. Secondary objectives encompassed assessing age, gender, and etiological factors associated with cholelithiasis. Methods: This prospective observational study involved 200 admitted patients after obtaining informed consent and ethical clearance from the Institutional Review and Research Committee (IRRC). Those diagnosed with cholelithiasis through imaging techniques like ultrasonography (USG), magnetic resonance cholangiopancreatography (MRCP), and/or endoscopic retrograde cholangiopancreatography (ERCP) were planned for laparoscopic cholecystectomy [2]. The study investigated the factors linked to the conversion of laparoscopic cholecystectomy to an open procedure. Results: Among the 200 patients included in the study, 18 required conversion to an open cholecystectomy. The primary reason for conversion was adhesions, accounting for the highest proportion at 8%. Other reasons included CBD injury (2%), bleeding of the cystic artery (2%), bowel injury (1%), and unclear anatomy (3%). Conclusion: Laparoscopic cholecystectomy is a secure and minimally invasive procedure characterized by a low conversion rate. In this study, the primary reason for conversion was the significant presence of dense adhesions in Calot's triangle, underlining its importance as a common factor leading to a shift from laparoscopic to open cholecystectomy.

Prevalence and Variations of Sesamoid Bones in the Hands of Patients Visiting Teaching Hospital of Kaski District: A Retrospective Study

Introduction: Sesamoids are small, well-corticated, ovoid or nodular, may be bipartite ormultipartite bones/ossifications found close to a bone or a joint that are subject to significant morphological variations. Although it is difficult to determine the symptomatic nature of these bones, imaging provides important diagnostic information. The objective of this study is to assess the prevalence and variations of sesamoid bone in hands of patients visiting a teaching hospital of Kaski district.&#x0D; Methods: A hospital based retrospective cross-sectional study was conducted by analyzing X-rays of hand with Anteroposterior (AP) view, a total of 150 both male and female patients between the age group of 18 to 85 wereimaged between August 1, 2022 to December 30, 2022 at Department of Radiology &amp; Imaging(X-Ray Unit). Presence of sesamoid bone of hand was noted on 1st, 2nd, 3rd, 4th and 5th metacarpophalangeal joints (MCPj), and the 1st interphalangeal joint (IPj), separately. The data were analyzed for correlation using Pearson’s correlation test. Ethical approval was taken from the Institutional Review Committee of Gandaki Medical College (Reference No.159/079/080).&#x0D; Results: The prevalence of sesamoid bone at 1st, 2nd, 3rd, 4th and 5th MCPj, and 1st IPj were 100 (100%), 60 (46%), 24(16%), 20(13.3%), 100(66.7%), and 114(76%) respectively. Variation was more prominent among females at 2nd, 3rdand 5th MCPj and 1st IPj, Also, SB variation was more prominent on left hand compared to right hand in 2nd, 4thand 5th MCPj and 1st IPj.&#x0D; Conclusions:No significant correlation between the gender and laterality with presence or absence of SB in the hands were noted.

Morbidity Pattern in Psychiatry Ward in a Tertiary Care Hospital

Background: Worldwide mental health conditions are in increasing trend. South Asian countries report the highest prevalence of common mental disorders globally, which accounts for 8.8% to 16.6% of the total burden of disease. In Nepal, the prevalence of mental disorders among adults and children is 13.2% and 11.2%, respectively. In Nepal, there is limited data on the pattern of morbidity in inpatient psychiatric wards. Hence, the need is felt to carry out this study to monitor the psychiatric morbidity patterns of patients admitted to the psychiatric ward. Methods: This is a retrospective, cross- sectional study conducted in Kist Medical College. After ethical approval from Institutional Review committee, the data of all patients admitted to Psychiatry Ward of Kist Medical College Teaching Hospital from 14 th April, 2022 to 13 th April, 2023 were collected from Record section. We used ICD-10 and CDDG criteria for the diagnosis of mental and behavioral disorders. Data was analyzed using SPSS version 16. Results: Out of 285 patients 70.40% patients belonged to age group 25-54 years .The mean age with standard deviation was 55.4±72.3 years. Most of the patients were Male (72.60%) and Janajati (44.80%). The most common diagnosis was Alcohol Dependence Syndrome. The duration of hospital stay of most (46.90%) of the patient was 1-2 weeks. Conclusion: The most common diagnosis for which admission was made in Kist Medical College was Alcohol Dependence Syndrome. This indicate that the alcohol related disorder may have important implications for care and planning in the community. The overall outcome was satisfactory.

시·도교육청 통합재정안정화기금의 현황과 과제

With the revision of the 「Local Finance Act」 in 2017, the Local Office of Education can establish and operate a stabilization fund to adjust the fiscal income imbalance. Currently, all Offices of Education operate stabilization funds. As the Office of Education's funds increase rapidly in 2022, the Office of Education is operating carelessly due to excessive financial resources, and despite the decrease in the number of students, education finances are increasing, so it is widely argued that the local education finance structure should be reorganized. In this situation, the Office of Education, which does not have much experience in fund management, is experiencing confusion and difficulty in operating stabilization funds. In this study, the concept and characteristics of the fund were examined, the stabilization fund management status of the Local Offices of Education was analyzed, and the problems and tasks of fund management were presented.&#x0D; The characteristics of general and special accounts and funds were examined, and the current status was presented focusing on the size and use requirements of the stabilization fund. The stabilization fund's tasks include setting standards for the appropriate accumulation size, clarifying requirements for using the fund, establishing a comprehensive management system for the fund through the fund's General Manager, efforts to increase profits through fund management, and enhancing the expertise of the Fund Management Review Committee. For efficient fund management, first, it is necessary to establish a comprehensive management system for the fund, second, to establish a systematic analysis and evaluation system for fund management, and third, to strengthen the capabilities of fund manager and actively utilize external experts.