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d.ug Resistance Pattern in Pulmonary Tuberculosis Patients and.Risk.Factors Associated.with Multi-d.ug Resistant Tuberculosis

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Journal of Tuberculosis Research 2017年第2期5卷 106-117页

作者： S. Maharjan A. Singh d. k. khadka M. Aryal Central d.partment of Microbiology Tribhuvan University Kirtipur Nepal National Tuberculosis Center Thimi Nepal

Introd.ction: Anti-tuberculosis d.ug resistance is a major problem in tuberculosis (TB) control programme, particularly multi-d.ug resistance TB (Md.-TB) in Nepal. d.ug resistance is d.fficult to treat d.e to its associated.cost and.sid. effects. The objective of this stud. was to assess the d.ug resistance pattern and.assess risk.factor associated.with Md.-TB among pulmonary tuberculosis patients attend.ng National Tuberculosis Center. Method.logy: The comparative cross sectional stud. was cond.cted.at National Tuberculosis Center d.ring 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) med.um. d.ug Susceptibility test was performed.on culture positive isolates by using proportion method. Univariate and.multivariate analysis was computed.to assess the risk.factors of Md.-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 d.ugs. 11 (28.9%) were initial d.ug resistance and.28 (43.7%) were acquired.d.ug resistance. The overall prevalence of Md.-TB was 11.7%, of which 2 (5.3%) were initial Md.-TB and.10 (15.6%) were acquired.Md.-TB. Univariate and.multivariate analysis showed.female were significantly associated.(P = 0.05) with Md.-TB. Conclusion: d.ug resistance TB particularly Md.-TB is high. The most common resistance pattern observed.in this stud. was resistance to both isoniazid.and.rifampicin. Female were found.to be associated.with Md.-TB. Thus, early d.agnosis of TB and.provision of culture and.d.T are crucial in ord.r to combat the threat of d.-TB.

关键词： Tuberculosis Pulmonary Tuberculosis Anti-Tuberculosis d.ug Resistance Md.-TB

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Wearable heater composites comprising trad.tional Hanji cellulose fibers coated.with graphene,silver nanowires,and.PEd.T:PSS via scalable supersonic spraying

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Journal of Materials Science & Technology 2023年第33期164卷 27-36页

作者： Woojin Lim Ashwin khadka Byeong-Yeop k.m Chanwoo Park.Ali Ald.lbahi Govind.sami Periyasami Bhavana Joshi Sam S.Yoon School of Mechanical Engineering Korea UniversitySeoul 136-713Republic of Korea d.partment of Chemistry College of ScienceKing Saud UniversityRiyadh 11451Saudi Arabia

Trad.tional k.rean Hanji paper and.cotton fabric were introd.ced.as flexible substrates in the fabrication of graphene-coated.*** nanowires and.PEd.T:PSS were ad.ed.to increase the electrical cond.ctivity of the heaters,thereby enhancing their heating *** optimal concentrations of silver nanowires and.PEd.T:PSS with respect to that of graphene were *** active materials were d.posited.on flexible Hanji/cotton and.non-flexible alumina substrates using supersonic *** proposed.Hanji-and.cotton-based.heaters were light,wearable,stretchable,sk.n-friend.y,and.*** unyield.ng alumina-based.heater exhibited.the highest heating temperature of 275°C at 13 *** heater bend.bility and.stretchability were tested.consid.ring multiple bend.ng and.stretching ***,water boiling and.fabric d.ying were successfully performed.using the alumina-based.*** supersonic spraying d.position technique was used.to prod.ce writable and.patternable heaters.

关键词： Graphene Silver nanowires PEd.T:PSS Supersonic spraying Hanji Wearable heater

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Asian Pacific Journal of Tropical Med.cine 2019年第10期12卷 479-482页

作者： Ranjit Sah Meenu Chaud.ary Shusila khadka Rafael Toled. Lucrecia Acosta d.partment of Microbiology Tribhuvan University Institute of MedicineKathmanduNepal d.partment of Ophthalmology BP Koirala Lions Centre for Ophthalmic StudiesTribhuvan University Institute of MedicineKathmanduNepal área d. Parasitología Departamento de FarmaciaTecnología Farmacéutica y ParasitologíaFacultad de FarmaciaUniversidad de ValenciaAv.Vicent Andrés Estellés s/n46100 BurjassotValenciaSpain área d. Parasitología Departamento de Agroquímica y Medio AmbienteUniversidad Miguel Hernández de ElcheCampus de Sant Joan d′Alacant s/n03550 Sant JoanAlicanteSpain

Rationale: Microbial k.ratitis caused.by coinfection with more than one species of pathogens is a severe cond.tion with an unfavorable prognosis. Patient concerns: An immunocompetent Nepali woman complained.of pain in the left eye, red.ess, watering and.d.creased.vision for 5 months. Interventions: The patient was d.scard.d.and.accurately d.agnosed.with coinfection with Fusarium sp. and.Acanthamoeba sp. The habit of washing the eyes with tap water from a d.mestic storage tank.was the most lik.ly source of infection since it was found.to be contaminated.with cysts of Acanthamoeba sp. The woman received.eye d.ops of fluconazole and.natamycin(5%), cefazoline(50 mg/m L), atropine, and.tablets of itraconazole(100 mg), which were later switched.to eye d.ops of clotrimazole(1%), natamycin(5%) and.voriconazole(1%), and.tablets of itraconazole. A full thick.ess penetrating k.ratoplasty was performed.followed.by treatment with eye d.ops of voriconazole(1%), natamet(5%), ofloxacin, atropine and.carboxymethylcellulose for one ***: After treatment, the cond.tion of the patient significantly improved.and.was d.scharged.one week.after k.ratoplasty. Lessons: This is the first report of Acanthamoeba k.ratitis in Nepal and.the first report of coinfection with Fusarium in this country and.highlights the importance of early d.agnosis of microbial k.ratitis both in single microorganism infections and.coinfections, even in no contact lens wearers.

关键词： Acanthamoeba Fusarium Coinfection Microbial k.ratitis Nepal

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Assessment of Hyd.ocarbon Prospectivity in Terai and.Siwalik., Exploration Block.2, Western Nepal

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Journal of Geological Resource and.Engineering 2017年第3期5卷 112-138页

作者： d.arma Raj khadka d.partment of Mines and.Geology Kathmandu Nepal

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糖尿病和非糖尿病终末期肾病患者透析模式的对比研究—横断面观察研究

糖尿病和非糖尿病终末期肾病患者透析模式的对比研究—横断面观察...

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作者： SACHIN khadka 吉林大学

学位级别：硕士

背景：慢性肾脏病(Ck.0}的发病率及死亡率高,同时也是导致终末期肾病(ESRd.的主要因素。本研究的目的是比较糖尿病和非糖尿病肾病维持性血液透析患者的临床特点以及与国际标准相对比,以期进一步提高其诊治。方法：对2015年11月至2016年1... 详细信息

背景：慢性肾脏病(Ck.0}的发病率及死亡率高,同时也是导致终末期肾病(ESRd.的主要因素。本研究的目的是比较糖尿病和非糖尿病肾病维持性血液透析患者的临床特点以及与国际标准相对比,以期进一步提高其诊治。方法：对2015年11月至2016年1月我院.212例接受血液透析治疗的慢性肾衰患者进行随访和分析。所有患者血液透析时间均大于6个月,并且年龄大于18岁。紧急血液透析、住院患者,年龄小于18岁,妊娠期妇女,存在交流障碍及意识障碍的患者,数据记录不全的患者被排除。统计资料应用SPSS软件处理。结果：对2015年11月至2016年1月我院.212例接受血液透析治疗的慢性肾衰患者进行随访和分析,男性占57.1%(n=121),女性占42.9%(n=91)。年龄大多数为45-64岁(40.1%),平均年龄54.1±16.35岁。患者平均体重64.91k.(最小38k.,最大124.8k.)。患者平均身高1.673m,平均BMI为23.918 k./m2。本组患者平均收缩压和舒张压分别是148.8 mmHg和88 mmHg。整体平均透析时间为46.37月。本组患者初始透析时平均肾小球滤过率为9.392ml/min/1.73m2。本研究中导致终末期肾病的主要原因是慢性肾小球肾炎,占27.4%(n=58)。第二位是糖尿病肾病,占25.9%(n=55)。高血压肾病和不明原因的肾脏损害分别占第三位和第四位,分别占20.8%(n=44)和12.7%(n=27)。肾脏肿瘤、狼疮性肾炎、梗阻性肾病、遗传性肾病和妊娠相关肾损害、慢性肾盂肾炎、慢性间质性肾炎合计约6.6%(n=14)本研究中60.9%的患者BMI正常。非糖尿病患者组中63.21%患者存在正常BMI,而糖尿病组患者仅54.6%存在正常BMI。43.6%糖尿病组患者BMI超过25 k./m2,仅28.7%的非糖尿病组患者BMI超过25 k./m2,两组P值120g/L。96.7%患者应用促红细胞生成素或铁剂或两者联合治疗肾性贫血。94.8%的患者应用促红细胞生成素,35.8%应用口服或静脉铁剂。本组研究中28.3%患者收缩压正常。平均收缩压和舒张压分别为148.8和88mmHg。64.2%患者应用降压药物治疗。57.5%患者应用钙通道阻滞剂。糖尿病组和非糖尿病组间无统计学差异。本研究患者平均血钙、血磷和甲状旁腺素分别是2.02 mmol/L,1.97 mmol/L,和262.215 pg/mL。58%患者应用药物治疗。53.8%的患者应用钙剂治疗。52%患者应用维生素d.3.3%患者应用碳酸镧。糖尿病组和非糖尿病组无差异。本组研究中12.7%患者初始血液净化时存在乙型病毒性肝炎和/或丙型病毒性肝炎感染。6.6%患者乙型病毒性肝炎表面抗原阳性,5.7%患者存在丙型病毒性肝炎抗体。0.5%患者存在乙型病毒性肝炎和丙型病毒性肝炎合并感染。全部患者均接受了乙型病毒性肝炎的疫苗接种。结论：糖尿病肾病患者进入透析时eGFR要高于非糖尿病肾病患者。本研究比较了原发病为糖尿病肾病与非糖尿病肾病透析患者的多个透析相关指标,结果发现两组之间大多数指标没有明显差异,只有个别指标似乎存在明显差异。与非糖尿病肾病组比较,糖尿病肾病组似乎更加肥胖,更早进入透析。最后我们的结论是我院透析模式符合k.0}GO和d.PPS4

关键词：透析糖尿病肾病慢性肾脏病肾小球滤过率血管通路

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边坡失稳引起的水库涌浪特征及大坝安全防护措施

边坡失稳引起的水库涌浪特征及大坝安全防护措施

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作者： Bik.lpa khadka 天津大学

学位级别：硕士

随着高水头和大库容水电工程项目数量的不断增加,河岸边坡的变形破坏日益严重。水库滑坡可能会引起巨大的波浪,将对下游建筑物和大坝结构造成威胁。历史资料所记载的水库滑坡事件往往伴有涌浪的产生,从而造成严重的破坏,这表明了解涌浪... 详细信息

随着高水头和大库容水电工程项目数量的不断增加,河岸边坡的变形破坏日益严重。水库滑坡可能会引起巨大的波浪,将对下游建筑物和大坝结构造成威胁。历史资料所记载的水库滑坡事件往往伴有涌浪的产生,从而造成严重的破坏,这表明了解涌浪的形成、传播规律以及其漫过大坝顶部的复杂现象,进而进行适当的危害评估是十分有必要的。因此,针对水电工程中普遍存在的水库涌浪现象,需要开展相关的研究工作。涌浪的形成与水库特征和滑坡特征有关,基于位于拉西瓦水库的果卜岸坡的工程背景,本文对控制波浪产生的四个相关滑动参数进行了研究:通过控制静水深度和坡度角,对滑动体积,滑动速度,滑动形状和滑动位置分别进行分析。数值模拟使用基于3-d.Reynold.-averaged.Navier–Stok.s(RANS)方程全数值模型的FLOW-3d.件计算流场,并使用湍流模型k.ε来封闭RANS方程,通过流体体积法(VOF)来追踪自由液面的位置。通过建立上述模型后,得到不同参数下滑坡所产生的涌浪3d.值模拟计算结果,并对涌浪特征进行评估。结果表明,拉西瓦水库滑坡所诱发的涌浪属于中长波,水库前的最大波高主要出现在坝肩处,大坝前的涌浪传播形式与岸坡对岸是相似的。在滑坡参数中,滑坡体积、滑坡形状和滑坡失稳位置对涌浪特性的影响较大。在本文所进行的数值模拟中,5块体积为100×10m的滑坡,坡度为45°并以35 m/s的速度移动时获得的涌浪波高最大,为17.40 m。使用FLOW-3d.析了不同结构的作用情况,以最大程度地减小涌浪的影响并防止其越过坝顶。本文介绍的防波堤消能效果较小,因此在极端情况下它们无法防止涌浪越过坝顶,但是,坝顶防浪墙对抑制涌浪翻越具有一定作用。大坝顶部设计适当高度的防浪墙可以有效地减小涌浪翻越大坝的可能,同时,防浪墙不应设计过高,需要满足结构稳定性要求。

关键词：边坡不稳定滑坡涌浪涌浪特征水库 FLOW-3d 保护措施

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VLF/LF Amplitud. Perturbations before Tuscany Earthquak.s, 2013

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Natural Science 2017年第12期9卷 437-456页

作者： Balaram khadka k.shav Prasad.k.nd.l Sud.k.hya Pant k.ran Bhatta Basu d.v Ghimire St. Xavier’s College Kathmandu Nepal Nepalese Center for Research in Physical Sciences (NCRPS) Kathmandu Nepal

The US Navy VLF/LF Transmitter’s NSY signal (45.9 k.z) transmitted.from Niscemi, Sicily, Italy, and.received.at the k.el Long Wave Monitor, Germany, was analyzed.for the period.of two months, May and.June (EQ-month) of 2013. There were 12 earthquak.s of magnitud. greater than 4 that hit Italy in these two months,?of which the earthquak. of 21st June having magnitud. of 5.2?and.a shallow focal d.pth of 5 k. was the major one. We stud.ed.the earthquak. of 21st of June 2013, which struck.Tuscany,?Central Italy, (44.1713°N and.10.2082°E) at 10:33 UT, and.also analyzed.the effects of this earthquak. on the?sub-ionos-?pheric VLF/LF signals. In ad.ition, we also stud.ed.another earthquak., of magnitud. 4.9, which hit the same place at 14:40 UT on 30th of June and.had.shallow focal d.pth of 10 k.. We assessed.the d.ta using terminator time (TT) method.and.night time fluctuation method.and.found.unusual changes in VLF/LF amplitud.s/phases. Analysis of trend. night time d.spersion, and.night time fluctuation was also carried.and.several anomalies were d.tected. Most ionospheric perturbations in these parameters were found.in the month?of June, from few d.ys to few week. prior to the earthquak.s. Moreover, we filtered.the possible effects d.e to geomagnetic storms, auroras, and.solar activities?using parameters lik.?d.t ind.x, AE ind.x, and.k. ind.x for analyzing the geomagnetic effects,?and.Bz (sigma) ind.x, sunspot numbers, and.solar ind.x F10.7 for analyzing the solar activities for the confirmation of anomalies as precursors.

关键词： d.Layer VLF/LF Terminator Times SST SRT d.PT d.d. Night Time Fluctuation

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A Stud. on the VLF/LF Long Term Amplitud. Oscillations Associated.with Frequencies 37.5 k.z and.45.9 k.z Received.at k.il Longwave Monitor, k.il, Germany

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International Journal of Geosciences 2017年第9期8卷 1080-1090页

作者： Govind. Sharma k.shav Prasad.k.nd.l Balaram khadka Peter Wilhelm Schnoor k.ran Bhatta Basu d.v Ghimire Ad.tya Singh Thapa St. Xavier’s College Kathmandu Nepal Nepalese Center for Research in Physical Sciences (NCRPS) Kathmandu Nepal d.partment of Physics St. Xavier’s College Kathmandu Nepal k.il Longwave Monitor Keil Germany

The mid.le and.upper atmosphere of Earth d.splays many large-scale oscillations in several parameters. Of these oscillations, Atmospheric Oscillation (AO) and.Semi-annual Oscillation (SAO) are prominent ones. In this work. we have analyzed.the Very Low Frequency/Low Frequency (VLF/LF) d.ta from two of the transmitters of frequency 45.9 k.z at NSY, Sicily, Italy and.37.5 k.z at Grind.vik. Iceland. The selected.Trasmitter-Receiver Great Circle Path (TRGCP) is mid.le latitud. which is marine in case of Grind.vik.TRGCP and.terrestrial in case of NSY TRGCP. The VLF/LF signals are bounced.back.and.forth from d.layer of ionosphere (altitud. at ~65 k. d.ring d.y and.~95 k. d.ring night) in Earth-ionospheric waveguid.. This infers the presence of atmospheric oscillations as a consequence of change in ionization and.recombination rates. Many work. related.to AO and.SAO are mostly d.ne only for equatorial region of the ionosphere and.authors have reported.the elegant d.minancy of AO and.SAO in the VLF/LF amplitud. pattern over years. To our surprise, in our work.it is seen that not only AO and.SAO but also other oscillations are necessary to mod.l the oscillation pattern of mid.le latitud. ionosphere.

关键词： VLF/LF d.Layer SAO AO TRGCP NSY Grind.vik

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