Pyogenic Vertebral Column Osteomyelitis in Adults: Analysis of Risk Factors for 30-Day and 1-Year Mortality in a Single Center Cohort Study

Jeevan Vettivel,Cole Bortz,Peter Gust Passias,Joseph Frederick Baker 대한척추외과학회 2019 Asian Spine Journal Vol.13 No.4

Study Design: Retrospective cohort study. Purpose: To describe our experience in the management and outcomes of vertebral column osteomyelitis (VCO), particularly focusing on the risk factors of early and late mortality. Overview of Literature: Previous reports suggest a global increase in spinal column infections highlighting significant morbidity and mortality. To date, there have been no reports from our local population, and no previous report has assessed the potential relationship of frailty with mortality in a cohort of patients with VCO. Methods: We reviewed 76 consecutive patients with VCO between 2009 and 2016 in Waikato Hospital, New Zealand. Demographic, clinical, microbiological, and treatment data were collected. Comorbidities were noted to calculate the modified Frailty Index (mFI). Mortality at 30 days and 1 year was recorded. Univariate and multivariate analyses were used to identify the predictors of mortality. Results: The mean age of patients was 64.1 years, with 77.6% being male. Most patients presented with axial back pain (71.1%), with the lumbar spine most commonly affected (46%). A mean of 2.1 vertebral bodies was involved. Methicillin-sensitive Staphylococcus aureus was the most common organism of infection (35.5%), and 15.8% of patients exhibited polymicrobial infection. Twenty patients (26.3%) underwent surgical intervention, which was more likely in patients with concomitant spinal epidural abscess (odds ratio [OR], 4.88) or spondylodiscitis (OR, 3.81). Mortality rate was 5.2% at 30 days and 22.3% at 1 year. The presence of frailty (OR, 13.62) and chronic renal failure (OR, 13.40) elevated the 30-day mortality risk only in univariate analysis. An increase in age (OR, 1.07) and the number of vertebral levels (OR, 2.30) elevated the 1-year mortality risk in both univariate and multivariate analyses. Conclusions: Although the mFI correlated with 30-day mortality in univariate analysis, it was not a significant predictor in multivariate analysis. An increase in age and the number of levels involved elevated the 1-year mortality risk.

Estimation of Soil Erosion Using RUSLE Model and GIS Techniques for Conservation Planning from Kulekhani Reservoir Catchment, Nepal

jeevan kumar ban,유인상,정상만 한국방재학회 2016 한국방재학회논문집 Vol.16 No.3

This study intended to spatially estimate the soil erosion rate of Kulekhani reservoir catchment area, Nepal applying Revised Universal Soil Loss Equation (RUSLE), adopting remote sensing data and geographic information system (GIS) techniques. Average soil erosion rate of watershed was found to be 195.11Mg ha -1 year -1 which is quite high as compared to threshold rate of erosion 15Mg ha -1 year -1 applicable for Himalayan region. It is concluded that soil erosion rate of comparatively 41% area was tolerable but has no distinct zone and approximately 58% area of catchment was on the verge of high to very severe intensity classes. Higher severity of soil erosion was scattered all over the watershed hence conservation measures should be implemented over whole catchment area. The research demonstrates that the use of remote sensing data and GIS has an abundant advantage in predicting soil erosion rate for the sustainable land use and ecological management planning of Himalayan region of Nepal.

Are Free Maternity Services Completely Free of Costs?

Jeevan Acharya 질병관리본부 2016 Osong Public Health and Research Persptectives Vol.7 No.1

Objectives: The Government of Nepal revised free maternity health services, “Aama Surakshya Karyakram”, beginning at the start of Fiscal Year 2012/13, which specifies the services to be funded, the tariffs for reimbursement, and the system for claiming and reporting on free deliveries each month. This study was designed to investigate the amount of monetary expenditure incurred by families using apparently free maternity services. Methods: Between August 2014 and December 2014, a hospital-based crosssectional study was conducted at Manipal Teaching Hospital and Western Regional Hospital. Nepalese women were not involved with family finances and had very little knowledge of income or expenditures. Therefore, face-to-face interviews with 384 postpartum mothers with their husbands or the head of the family household were conducted at the time of discharge by using a pre-tested semi-structural questionnaire. Results: The average monthly family income was 19,272.4 NRs (189.01 US$), the median duration of hospital stay was 4 days (range, 2-19 days), and the median patient expenditure was equivalent to 13% of annual family income. The average total visible cost was 3,887.07 NRs (38.1 US$). When the average total hidden cost of 27,288.5 NRs (267.6 US$) was added, then the average total maternity care expenditure was 31,175.6 NRs (305.76 US$), with an average cost per day of 7,167.5 NRs (70.29 US$). The mean patient expenditure on food and drink, clothes, transport, and medicine was equivalent to 53.07%, 9.8%. 7.3%, and 5.6% of the mean total maternity care expenditure, respectively. The earnings lost by respondent women, husbands, and heads of household were 5,963.7 NRs (58.4 US$), 7,429.3 NRs (72.9 US$), and 6,175.9 NRs (60.6 US$), respectively. Conclusion: The free maternity service in Nepal has high out-of-pocket expenditures, and did not represent a system completely free of costs. Therefore, arrangements should be made by hospitals free of cost to provide medicine that is not included as essential during the hospital stay and at discharge time. Similarly, arrangements for liquid, food, and hot water, as well as clothes for mothers and newborns, should be made by the hospital in order to enhance hospital attendance.

Media sharing in Smart Vehicular Network

Jeevan Kharel(지번 커렐),Soo Young Shin(신수용) 한국통신학회 2016 한국통신학회 학술대회논문집 Vol.2016 No.6

Power Conversion System for Low Power High Altitude Wind Power Generating System

Jeevan Adhikari,Prasanna IV,Godwin Ponraj,S. K. Panda 전력전자학회 2015 ICPE(ISPE)논문집 Vol.2015 No.6

In high altitude wind power (HAWP) generating system, medium voltage AC (MV-AC) permanent magnet synchronous generator (PMSG) is used. The generated electrical power is transmitted to ground without any power conditioning in the air-borne unit. The ground based power conversion system (PCS) interfaces variable voltage and variable frequency medium voltage power into distribution level grid voltage. The proposed PCS consists of a three-level vienna rectifier for generation side control, a half bridge DC-DC converter for isolation and stepdown purpose and a grid/load connected inverter for load side active power control. Three-level operation in the generation side converter reduces the switch/diode voltage stress to half and therefore allows to use low voltage rating power semiconductor devices. The vienna rectifier is controlled for sensorless maximum power-point tracking (MPPT) of the air-borne wind turbine. The phase lock loop (PLL) is used for speed and rotor position detection of the PMSG for optimal torque control of the airborne wind turbine (AWT). Simulation studies have been carried out using computer programs like PSIM and MATLAB. For the validation of the proposed methodology, scaled down laboratory based prototype is built and tested. The obtained experimental results confirm the performance of the PCS for interfacing HAWP generation system to the grid.

Smart Health Monitoring System of Employee for Smart Factory

Jeevan Kharel(지번 커렐),Soo Young Shin(신수용) 한국통신학회 2017 한국통신학회 학술대회논문집 Vol.2017 No.1

2016 International Conference on Landslide and Debris Flow Disaster: At a Glance

Jeevan Kumar Ban 한국방재학회 2017 한국방재학회지 Vol.17 No.1

System Architecture for Early Sleep Detection and Warning System for Driver’s Safety

Jeevan Kharel(지번 커렐),Reda Haftu Tasew(레다 하프투 따서우),Soo Young Shin(신수용) 한국통신학회 2017 한국통신학회 학술대회논문집 Vol.2017 No.6

Two-Level Anterior Cervical Discectomy and Fusion versus Hybrid Total Disc Replacement for Bilevel Pathology with Cervical Radiculopathy/Myelopathy: A Comparative Study with a Minimum 2-Year Follow-up in an Indian Population

Sharma Jeevan Kumar,Varma Kalidindi Kalyan Kumar,Mallepally Abhinandan Reddy,Marathe Nandan,Rustagi Tarush,Mohapatra Bibhudendu,Yadav Padmini,Das Kalidutta 대한척추외과학회 2022 Asian Spine Journal Vol.16 No.4

Study Design: Retrospective study. Purpose: To study the outcomes of two-level anterior cervical discectomy and fusion (2L-ACDF) versus hybrid total disc replacement (H-TDR) for cervical myeloradiculopathy. Overview of Literature: For bilevel disc issues of the cervical spine, 2L-ACDF has been a historical tool with numerous implants used at different time frames. Recent developments in total disc replacement at mobile level with fusion at a spondylotic level known as hybrid fixation have added a new armamentarium for such disorders. Methods: An analysis of 49 consecutive patients who underwent 2L-ACDF (n=22) and H-TDR (n=27) from January 1, 2014 to December 31, 2017 was performed. Data were studied as retrieved from InstaPACS ver. 4.0 (Mediff Technologies Pvt. Ltd., Bengaluru, India) and medical records. Results: Twenty-two patients with 2L-ACDF and 27 patients with H-TDR were included. The mean±standard deviation (SD) follow-up duration was 4.0±1.5 years in H-TDR and 3.1±1.1 years in 2L-ACDF. The mean±SD Neck Disability Index (NDI) decreased from 26.1±7.6 to 6.5±3.9 in the H-TDR group and from 27.6±7.2 to 6.4±4.8 in the 2L-ACDF group at final follow-up. Disc height at suprajacent level in the 2L-ACDF group was 4.12±0.48 mm, 4.10±0.45 mm, and 4.05±0.48 mm preoperatively, at 1-year, and final follow-up, respectively. Disc height at supradjacent level in the H-TDR group was 4.28±0.36 mm, 4.20±0.32 mm, and 4.19±0.34 mm preoperatively, at 1-year, and final follow-up, respectively. Conclusions: There was significantly improved NDI in both groups. Adjacent segment disc height loss was greater in the 2L-ACDF group than in H-TDR but not statistically significant (p=0.304). Supradjacent segment range of motion was greater in the 2L-ACDF group than in the H-TDR group (p=0.003). Both findings supported radiographic adjacent segment degeneration (ASD), but symptomatic ASD was absent in both groups.

Conductivity of Polypyrrole Composite Films Containing Lignosulfonic Acid

M. Jeevan Kumar Reddy,Bo Kyoung Shin(신보경),Do Sung Huh(허도성) 한국고분자학회 2017 폴리머 Vol.41 No.4

리그노술폰산(LSA)을 함유한 폴리피롤 복합체를 암모늄퍼셜페이트 개시제를 사용하여 합성하였다. 이 때 포함시키는 리그노술폰산의 양은 달리 하였다. 합성된 폴리피롤 복합체에서 LSA가 폴리피롤 속에서 강한 화학 결합을 하고 있음을 UV와 IR 스펙트럼 방법과 표면성상 분석을 통해 확인하였다. 복합체의 온도 의존성 전도도 특성이 연구되었으며, 아울러 전도도 값을 통하여 전자 이동에 관한 활성화 에너지를 계산해보았다. 전기전도도는 LSA의 양이 증가할수록 증가하였는데, 이 결과는 LSA에 의한 전자 활성에 기인하는 것으로 여겨진다. Polypyrrole (PPy) composites containing lignosulfonic acid (LSA) were prepared via the polymerization of pyrrole monomer with different concentrations (wt%) of LSA sodium salt using ammonium persulfate as an oxidant. The strong interaction of LSA with PPy to form PPy-LSA composites was supported by spectral characterization and surface morphological studies. The electrical properties of the composite films were examined through temperature-dependent direct current conductivity measurements at 300-500 K to understand the conduction behavior of the composites. The activation energy for electron transport was also calculated based on the conductivity data. The conductivity of the films was increased by increasing LSA concentration (wt%) in the PPy- LSA composites. The result can be attributed to the increased mobility of the charge carriers by the increased concentration of LSA in the composites. The incorporation of LSA in PPy can cause the cost-effective transformation of the conductive polymer of PPy into a biodegradable polymer.