Universal College

Snakebite envenomation is an endemic problem in tropical countries like Nepal. Deaths from envenomation are preventable through robust management systems and widespread public awareness. This case report describes a case of a 16-year-old boy from the Terai region of Nepal who presented with acute bilateral ptosis, head lag, and inability to elicit protrusion of his tongue after a krait bite. The patient was managed with antivenom, mechanical ventilation, and supportive care. Early neurological recovery after krait-bite envenomation is generally expected in victims who receive timely antivenom along with intensive supportive care. As usual, recovery of ptosis, tongue protrusion, and head lag occurred within a week; however, residual weakness in all limbs persisted for months. Gradual onset and offset of neurological symptoms are often characteristic of krait bites. Delayed neurological recovery after krait-bite envenomation is uncommon as illustrated in this case.

Artikel ini bertujuan untuk menganalisis pengaruh Work-Life Balance (WLB) terhadap Produktivitas Karyawan Generasi Z di Kota Bandung. Masalah difokuskan pada apakah keseimbangan antara kehidupan kerja dan personal dapat bertindak sebagai pendorong kinerja yang signifikan bagi angkatan kerja muda ini. Guna mendekati masalah ini dipergunakan acuan teori dari Social Exchange Theory yang mendukung adanya hubungan timbal balik antara dukungan organisasi dan output karyawan. Data-data dikumpulkan melalui kuesioner terstruktur yang disebarkan kepada 100 responden Gen Z di sektor industri kreatif Kota Bandung dan dianalisis secara kuantitatif dengan menggunakan Regresi Linier Sederhana. Hasil menunjukkan bahwa tingkat WLB karyawan Gen Z cenderung berada pada kategori sedang hingga tinggi, yang sejalan dengan tingkat produktivitas mereka yang juga tinggi. Kajian ini menyimpulkan bahwa Work-Life Balance berpengaruh positif dan signifikan terhadap Produktivitas Karyawan Gen Z. Koefisien Determinasi (R2) menunjukkan bahwa WLB mampu menjelaskan 62,3% variasi produktivitas. Temuan ini menegaskan WLB sebagai variabel krusial dan investasi langsung dalam peningkatan kinerja, bukan hanya sebagai faktor kesejahteraan semata.

Breast cancer remains a leading cause of cancer-related mortality among women worldwide, highlighting the need for safer multitarget therapies. Genistein (GNT) and Apigenin are plant-derived flavonoids with reported anticancer properties, but their dual mechanisms against key breast cancer targets have not been comprehensively explored. An integrative in silico approach was employed, including network pharmacology, onco-omics profiling, protein–protein interaction analysis, molecular docking, and 100 ns molecular dynamics (MD) simulations, to identify and validate key targets of GNT and Apigenin. Gene expression, immune infiltration, and survival analyses were performed using GEPIA2 and TIMER2.0. ADMET and toxicity predictions assessed drug-likeness and safety. Cytotoxic activity was evaluated in HCC1937 cells, a triple-negative breast cancer cell line selected to assess estrogen receptor–independent anticancer effects, using the MTT assay. Network analysis prioritized PARP1 and ESR1 as central targets. Docking showed strong affinities of Apigenin for PARP1 (–9.6 kcal/mol) and GNT for ESR1 (–8.3 kcal/mol). MD simulations and MM-GBSA confirmed stable binding with favorable free energy (ΔG_bind = − 74.9 kcal/mol). KEGG enrichment highlighted pathways including estrogen signaling, endocrine resistance, and PI3K–Akt signaling. Both compounds exhibited favorable ADMET profiles and low predicted toxicity. In vitro, GNT and Apigenin produced dose-dependent cytotoxicity against HCC1937 cells with IC50 values of 67.01 ± 1.67 µM and 70.24 ± 1.45 µM, respectively. These findings demonstrate that GNT and Apigenin modulate key oncogenic pathways through PARP1 and ESR1 interaction and exert cytotoxic effects in TNBC cells. This suggests their potential as low-toxicity adjuvant agents in breast cancer therapy, particularly where endocrine resistance or BRCA1-associated tumor progression is involved.

Background: Assessment of joint mobility is a fundamental component of the physical examination of the upper extremities. Accurate measurement of wrist movement helps clinicians evaluate joint laxity, functional capacity, and subtle variations in musculoskeletal structure. Radial and ulnar deviations, in particular, play an important role in activities requiring precision and dexterity, making their evaluation essential in clinical practice, rehabilitation, and research. Materials and Methods: This cross-sectional, descriptive study included 100 healthy female undergraduate Medical students of NMCTH, participants aged 18–24 years with normal wrist skeletal structure. Radial and ulnar deviations of both wrists were measured using a standard universal goniometer following established procedures. Results: The overall range of motion (ROM) across all four movements was comparable, averaging between 39° and 41°. Mean radial deviation was 38.76° ± 11.32° in the right hand and 41.18° ± 10.21° in the left hand. Mean ulnar deviation measured 39.84° ± 11.27° on the right and 40.46° ± 10.86° on the left. ROM values were consistently higher in the left wrist for both movements. Conclusion: This study demonstrates slightly greater wrist mobility on the left side compared to the right for both radial and ulnar deviations. No significant difference was observed between radial and ulnar deviation ranges themselves. Reduced mobility of the right wrist in predominantly right-handed individuals may reflect early functional strain or mild degenerative changes affecting the joint and surrounding ligaments.

Introduction: Diabetes mellitus is a chronic systemic disorder characterized by hyperglycemia, various systemic metabolic derangements and complications. Recent research has increasingly reported hearing impairment as one of the complications of diabetes mellitus. The relationship between diabetes and hearing loss has been a subject of investigation for many years. Objective: To evaluate the hearing status of diabetic patients compared with non-diabetic controls and to assess the association of hearing loss with age and duration of diabetes. Methods: A prospective comparative study was conducted in the Department of Ear Nose Throat, Head and Neck Surgery, Bir Hospital, NAMS, Kathmandu, from May 2021 to May 2022. Pure tone audiometry was performed on 89 type 2 diabetes mellitus patients and 89 age matched non-diabetic controls aged 35–60 years. Hearing thresholds were compared between groups, and associations with age and duration of diabetes were analyzed. Results: The mean age of diabetic patients was 48.8 years compared to 46.6 years in controls. Among diabetics, 35.95% demonstrated some degree of sensorineural hearing loss with a mean hearing threshold of 30.23 dB, whereas only 12.3% of healthy controls had hearing loss, with a mean threshold of 24.66 dB. The difference was statistically significant (p<0.05 95% CI). No significant correlation was found between duration of diabetes and hearing loss within the study population. Conclusion: Patients with diabetes mellitus have a significantly higher prevalence of sensorineural hearing loss compared to age-matched healthy individuals, highlighting the need for early audiological screening in diabetic patients

Neurofibroma is a benign tumor of nerve sheath of peripheral nervous system. It frequently involves the skin and rarely the oral mucosa. The pattern of the disease has been recognized as hereditary with an autosomal dominant trait with variable penetrance. The most common variant is neurofibromatosis type I (NF-I). The oral lesions occur as discrete, nonulcerated nodules, which tend to be of the same color as the surrounding mucosa. Usually occurs on the buccal mucosa, palate, alveolar mucosa, vestibule and the tongue. A case of asymptomatic swelling of the right side of the tongue near the tip since 02 years is presented. The swelling was gradual in onset and slowly increased in size. It was a solitary diffuse, smooth, firm and non-tender swelling of the right side of the tongue near the tip. Excision was done under lingual nerve block by local anesthetics (2% Lidocain with Adrenalin) and biopsy was performed and histological examination revealed spindle cells having serpentine nuclei, arranged in bundle and fascicles is a fibrillary background. Bangladesh J Otorhinolaryngology 2025; 31 (1) Page-42-46

Introduction: Respectful Maternity Care (RMC) involves upholding a woman’s dignity, privacy, informed decision-making, and emotional support throughout childbirth. However, many women worldwide, including in Nepal, continue to experience mistreatment such as neglect, verbal abuse, and inadequate privacy, which undermines their trust in healthcare. This study explores postnatal mothers’ experiences with RMC during labor and childbirth. Methods: The qualitative study was conducted in the postnatal ward among 13 mothers who had normal vaginal deliveries. Using a non-probability purposive sampling technique, researchers conducted in-depth interviews after obtaining ethical and administrative approvals. Participants gave written consent, and interviews were held privately to ensure confidentiality. Interviews were transcribed, translated, and thematically analyzed. Field notes were coded, and transcripts reviewed to identify key concerns. Results: The findings of the study are summarized in seven key themes: informed consent, right to information, privacy & confidentiality, freedom from abuse, freedom from discrimination, neglect & abandonment and dignity & respect. Interpretation of the data showed that women reported positive experiences when informed about procedures. However, issues regarding pain relief options and privacy were noted, where some women felt their privacy was not maintained during examinations, which is a crucial aspect of respectful maternity care. Conclusion: This study reveals strengths and gaps in RMC. While verbal consent and non-discriminatory care were noted, key aspects like informed decision-making, communication, privacy, and emotional support were often missing. Neglect and mistreatment highlight systemic issues, calling for better training, staffing, and a respectful, accountable care environment.

Abstract. Planktic foraminifera are a major contributor to global marine inorganic carbon production. They leave abundant calcium carbonate shells on the seafloor that serve as prime proxies for the physical and chemical attributes of past oceans. Despite their well-preserved fossil record and widespread use in palaeoceanography, our understanding of their ecology remains limited due to their low-standing stocks in the modern ocean and the challenges in culturing multiple generations under laboratory conditions, even after decades of data collection. This limitation affects our ability to interpret their fossil remains to describe past ecosystems and predict their responses to ongoing environmental changes. Trait-based ecology offers a powerful framework to characterise how and why foraminifera interact with their environment. Here, we review the current state of knowledge on key planktic foraminifera traits, including morphological, physiological, behavioural, and life history traits. Most spinose taxa are carnivorous, host to dinoflagellate photosymbionts, and are abundant and diverse in oligotrophic environments. In contrast, non-spinose taxa are typically herbivorous and most common in high-productivity regions. We highlight the potential of trait modelling to generate hypotheses testable in the field. Integration of trait-based modelling with metabarcoding, environmental DNA, and enhanced standardised data collection made openly available will help to fill critical gaps in our understanding of planktic foraminiferal ecology and allow us to use foraminifera as a key model organism for addressing fundamental ecological questions.

Background: Pseudoexfoliation (PXF) is a common age-related brillopathy characterized by the accumulation of extracellular material in ocular tissues. It is associated with small pupil size and zonular weakness, complicating cataract surgery. Objective: To assess pupil size and the effect of mydriatics in patients with pseudoexfoliation syndrome. Methods: A cross-sectional study conducted over 5 months at Santhiram Medical College, Nandyal. Adult patients with PXF underwent pupillary diameter measurement before and after administration of mydriatic drops. Results: 40% of patients had a small pupil pre-dilatation; post-dilatation, 84% still had pupils ≤6 mm. No signicant association between pupil size and age or sex was found. Conclusion: Small pupil in PXF patients poses challenges for cataract surgery. Early recognition and proper preoperative planning can reduce intraoperative complications and improve surgical outcomes.

Endotracheal intubation is a critical skill in veterinary anaesthesia, requiring knowledge of species-specific anatomy and techniques. This article explores intubation methods, endotracheal tube selection, securing techniques, placement confirmation, cuff inflation and extubation across various species, including canines, felines, rabbits, guinea pigs and avians. Key considerations include anatomical differences, risk factors such as laryngospasm in felines and rabbits, and alternative airway devices like supraglottic airway devices. Proper technique and monitoring, including end-tidal carbon dioxide assessment, enhance patient safety and successful intubation. Veterinary nurses and technicians must adapt their skills for optimal airway management across species.