The purpose of the present work is to introduce and study the concept of interval type-2 (IT2) fuzzy grammar which recognizes the given IT2 fuzzy languages. The relationship between IT2 fuzzy automata and IT2 fuzzy (weak) regular grammars is discussed. Specifically, the results we obtained here are ( i ) IT2 fuzzy weak regular grammar and IT2 fuzzy regular grammar generate the same classes of IT2 fuzzy languages ( ii ) for a given IT2 fuzzy regular grammars, there exists an IT2 fuzzy automata such that they accept the same IT2 fuzzy languages, and vice versa. In addition, we define some operations on IT2 fuzzy languages and it is shown that IT2 fuzzy languages recognized by IT2 fuzzy automata are closed under the operations of union, intersection, concatenation and Kleene closure, but are not closed under complement.

The industries and metropolitan wastes produced by anthropogenic activities are of great concern for nature as it causes soil contamination and deteriorate the environment. Plastic utilization is rapidly enhancing globally with passing days that last for a more extended period in the environment due to slow decomposition and natural degradation. Excessive use of polymer has risked the life of both marine, freshwater and terrestrial organisms. Lack of proper waste management and inappropriate disposal leads to environmental threats. Bioremediation processes involve microbes such as fungi, bacteria, etc. which contribute a crucial role in the breakdown of plastics. Extremophiles secrete extremozymes that are functionally active in extreme conditions and are highly crucial for polymer disaggregation in those conditions.

Introduction: Enhancing wellbeing and lessening emotional distress are especially important in developing nations like Nepal that have limited mental health resources or where there is resistance to formal treatment. This is even more so the case during times of crisis. The goal of this project was to create a cross-cultural adaptation of a psychoeducational instrument, Healthy Habits of Emotional Wellbeing. Material and Method: Using World Health Organization guidelines for translations, we created a cross cultural adaptation of Healthy Habits of Emotional Wellbeing into the Nepali language. The instrument was translated from English to Nepali, extensively reviewed and modified by a bilingual panel, back-translated, and field testing with 10 Nepali citizens. Results: The adaptation, as tested with individuals representing Nepal’s rural and urban settings, appears to be a culturally sensitive and linguistically appropriate psychoeducational tool that can be used in medical and social settings, widely disseminated, and posted online. Conclusion: Psychoeducational self-help tools such as Healthy Habits may be especially helpful during times of crisis, when mental health resources are limited, not accessible, or not accessed due to prevailing stigma. It may also be appropriate for disaster preparedness, management, and recovery use in an effective and cost efficient manner.

ISSN: 2319-7706 Volume 9 Number 1 (2020) Journal homepage: http://www.ijcmas.com This study was undertaken to determine the prevalence of Gram negative and Gram positive in various clinical samples collected during study and to analyze the antibiotic susceptibility patterns of various drugs against these isolates to find which drug offers the best solution against multidrug resistant Gram negative and Gram positive pathogens. In the current study, a total of 741 isolates were isolated from different clinical specimens between October 2018 to January 2019. Antibiotic susceptibility testing were carried out according to the recommendations of Clinical Laboratory Standards Institute (CLSI) guidelines. Out of 741 clinical isolates, 575 (77.59%) were of Gram negative and 166 (22.40%) were of Gram positive. Among Gram negative pathogens, (n=575), the highest occurrence of pathogens was found in urine samples (81.57%) followed by stool (17.04%), pus (0.35%) and others 1.04%, whereas Gram positive (n=166) isolates were more dominant in sputum (24.70%) followed by pus/swab (23.49%), throat (18.07%), vagina (9.04%), synovial fluid (1.2%), each of ear swab, aural fluid, conjuctival fluid contributed to 0.6% and others making 21.69%. Further analysis of pathogens (n=741), Escherichia coli (63.43%) was the most dominant pathogen followed by Streptococcus pyogenes (9.18%), Streptococcus species (8.77%), Enterobacter species (8.64%), Proteus species (3.78%), Streptococcus haemolyticus (3.10%), Klebsiella species (1.48%) Staphylococcus species (1.35%) and Pseudomonas species (0.27%). Our susceptibility data revealed that Potentox was the most active antibacterial agent with the majority of isolates displaying 88.66% susceptibility, which is 20.10-54.25% high compared to other tested drugs. Levofloxacin appeared to be second most active agent (68.56%) followed by cefepime plus tazobactam (58.30%), meropenem (45.75%) and amikacin (34.41%). From the above results, it is evident that Potentox has enhanced in-vitro antibacterial activity and exhibited 20 to 54 % superiority over other drugs. Therefore, it can be a better choice to treat the infections caused by drug-resistant Gram negative and Gram positive pathogens in the clinical settings, and can be an important empiric consideration as a drug of choice to carbapenem. K e y w o r d s Cefepime + amikacin, Cefepime, Clinical isolates, Potentox, Susceptibility Accepted: 20 December 2019

Background: The extensive use of mobile phones in the hospital among health care workers (HCWs) can lead to infectious agents being transferred from one patient to another and thus serve as a vehicle in the transmission of nosocomial pathogens. Objectives: This study aimed to investigate the prevalence of Methicillin Resistant Staphylococcus auerus (MRSA) contamination of mobile phones and hands of HCWs in Gandaki Medical College and Teaching Hospital. Methods: The present study was hospital and laboratory based cross-sectional study, carried out from April, 2017 to December, 2017. A total of 100 mobile phone swab and 100 hand swab samples of HCWs were collected and cultured directly on MacConkey agar, blood agar, and mannitol salt agar after 24 hrs of enrichment. All the isolated organisms including MRSA were identified using standard microbiological techniques and subjected to antibiotic susceptibility testing using disc diffusion technique. Results: Among the Gram positive isolates, frequency distribution from mobile phones showed the highest prevalence of coagulase negative Staphylococci (CONS) (34.69%), followed by Staphylococcus aureus (20.41%), Bacillus spp (15.31%), Micrococci spp (11.23%), however considerable number of Diptheroides (8.16%), Enterococci (6.12%) and Streptococcus pneumoniae (4.08%). Siimilarly from hand swabs CONS (39.62%), followed by S. aureus (26.42%), Bacillus spp (10.38%), Micrococci (11.32%), Enterococci (6.60%) and Diptheroids (5.66%) were isolated. The frequency of MRSA was 20%, 25% among mobile phones and hands of HCWs respectively. Drugs like Vancomycin, Amikacin, Clindamycin and Gentamycin were found quite effective against S. aureus in the present study and would be better options for the management of such infections. Conclusions: Mobile phones and hands of HCWs were the potential source of nosocomial infections including multidrug-resistant pathogens like methicillin-resistant S. aureus.

Fermented drinks are always found to be connected with the culture and existence of the ethnic tribes throughout the world. Traditional rice beer of North-east India is an indispensible part of tribal life style attached culturally and religiously with them. There are more than 150 major tribes in Northeast India and almost all are having a traditional way of preparing rice beer from time immemorial. The present paper is a comparative review on the methods of preparing rice beer by some popular tribes of Northeastern India. The methodology they use is found to be unique in many senses from rest of the world. The uniqueness not only lies in the starter culture preparation, which is the prime source of yeast but also in the other ingredients like indigenous plant species and rice varieties used as substrate resulting variation in taste and aroma. Almost all the traditional rice beer has unique soothing taste, aroma, colour and nutritional as well as therapeutic values having significant role in their socio cultural lives. In the present scenario the tradition is fading and facing lots of challenges. But, still the traditional rice beer has got lots of scope for its scientific up-gradation and commercialization.

Background: Pleural effusion is the pathologic accumulation of fluid in the pleural space. The fluid analysis yields important diagnostic information, and in certain cases, fluid analysis alone is enough for diagnosis. Analysis of pleural fluid by thoracentesis with imaging guidance helps to determine the cause of pleural effusion. The purpose of this study was to assess the accuracy of computed tomography (CT) in characterizing pleural fluid based on attenuation values and CT appearance. Materials and Methods: This prospective study included 100 patients admitted to Gandaki Medical College and Teaching Hospital, Pokhara, Nepal between January 1, 2017 and February 28, 2018. Patients who were diagnosed with pleural effusion and had a chest CT followed by diagnostic thoracentesis within 48 hours were included in the study. Effusions were classified as exudates or transudates using laboratory biochemistry markers on the basis of Light’s criteria. The mean attenuation values of the pleural effusions were measured in Hounsfield units in all patients using a region of interest with the greatest quantity of fluid. Each CT scan was also reviewed for the presence of additional pleural features. Results: According to Light’s criteria, 26 of 100 patients with pleural effusions had transudates, and the remaining patients had exudates. The mean attenuation of the exudates (16.5 ±1.7 HU; 95% CI, range, -33.4 – 44 HU) was significantly higher than the mean attenuation of the transudates (11.6 ±0.57 HU; 95% CI, range, 5 - 16 HU), (P = 0.0001). None of the additional CT features accurately differentiated exudates from transudates (P = 0.70). Fluid loculation was found in 35.13% of exudates and in 19.23% of transudates. Pleural thickening was found in 29.7% of exudates and in 15.3% of transudates. Pleural nodule was found in 10.8% of exudates which all were related to the malignancy. Conclusion: CT attenuation values may be useful in differentiating exudates from transudates. Exudates had significantly higher Hounsfield units in CT scan. Additional signs, such as fluid loculation, pleural thickness, and pleural nodules were more commonly found in patients with exudative effusions and could be considered and may provide further information for the differentiation.

Introduction: Tuberculosis (TB) remains a major global health problem. The most common method for diagnosing TB in developing countries is sputum smear microscopy; however, the sensitivity of this test is relatively lower. Detection of Mycobacterium tuberculosis using conventional culture and biochemical-based assays is time-consuming and laborious. Polymerase Chain Reaction (PCR) is also available for diagnosis of Mycobacterium tuberculosis. However, the PCR assay requires an expensive thermal cycler to amplify the DNA fragment in multiple temperature-dependent steps. Therefore, a simple and sensitive method for rapid detection has been anxiously awaited. The loop-mediated isothermal amplification (LAMP) assay is a diagnostic technique which can aid in the fight against TB in resource-poor countries. The LAMP assay can amplify a targeted sequence at a constant temperature. Therefore, a large and costly thermal cycler is not necessary for a LAMP assay. Objectives: The objective of this study was to identify Mycobacterium tuberculosis directly from sputum by LAMP and to compare its efficacy over routinely used methods. Methods: A total of 106 (53 fluorochrome staining positive and 53 fluorochrome staining negative) sputum samples were collected in this study. Mycobacterial DNA was extracted from concentrated sputum samples by freezing and boiling method. LAMP assay using a set of six specific primers targeting the M. tuberculosis 16S rRNA gene with high sensitivity was used to analyze sputum samples. The results were then compared with that of the culture method, which was considered as the gold standard method. Results: Among total of 106 samples studied by microscopy and culture, 53 were positive by both, whole four were positive by culture but negative by microscopy. With reference to culture, the microscopy had sensitivity 92.98%, specificity 100%, and predictive value of positive test 100%, predictive value of negative test 92.5%. Out of 106 samples subjected to culture and LAMP for the diagnosis of TB, 55 samples were positive by both tests and two were positive only in culture, while 48 were negative in both tests and one was negative only in culture. While comparing the LAMP with culture as a gold standard, the sensitivity of LAMP was 96.49%, specificity was 97.95%, predictive value of positive test was 98.21%, predictive value of negative test was 96%. Conclusions: Comparative experiments showed that the LAMP assay is a rapid, sensitive, and specific method to detect M. tuberculosis infection. Indeed, an inexpensive LAMP assay would be potential as a diagnostic test for tuberculosis, especially in resource-limited settings. J-GMC-N | Volume 11 | Issue 01 | January-June 2018, Page: 27-34

Some new derivatives of natural chrysin have been synthesized and evaluated for antibacterial, antibiofilm and antifungal activities.Three compounds, namely 2a, 2e, 2i showed excellent activities (MIC 14.0-18.3µg/mL) against six bacterial and two fungal type strains while most of the other compounds showed comparatively low to moderate values of such activities.Significant antibiofilm and bactericidal activities (MBC ranges from 17-20 µg/mL) were also observed for 2a, 2e, 2i against pneumonia causing two bacterial strains.This study further indicated that the chrysin compounds with 7-O-alkyl type substitution were much more effective than corresponding aryl substituted congeners which signifies that 7-O position of chrysin is crucial for antimicrobial activities.Thus, this article would contribute to further design and development of potential antimicrobial agents via structural modulation of natural chrysin, which is a potential molecular skeleton with diverse biological activities.

Introduction: Splenomegaly is an enlargement of the spleen which is a quite common problem in any part of the world. Spleen is enlarged in various clinical disorders e.g. infections, metabolism or storage disor­ders and hematological abnormalities. Splenomegaly is an indicator of pathologic process that may be of primary splenic origin but also may be a reflection of disease in virtually any other organ system. Thus, it is important to estimate the splenic size in vivo in the diagnosis, treat­ment and prognosis of a variety of disorders.Objective: The objective of this study was to determine the normal dimension of the spleen in the adult Nepalese people.Methods: This is a prospective study in which 320 adults subjects were scanned by using 3.5 MHz curvilinear probe. We used ultrasonography to examine 160 males and 160 females, not to have any condition likely to be associated with splenic enlargement. The measurement for the length and thickness of spleen were obtained in right lateral position.Results: This study revealed the splenic dimensions for males were greater than in females. The men spleen length were (10.07 ±0.7 cm, 10.1 ±0.54 cm, 9.5 ±0.7 cm and 9.0 ±0.43 cm for age group of 16 - 30, 31 - 45, 46 - 60 and 61 - 75 years respectively). The females spleen length were (9.83 ±0.53 cm, 9.58 ±0.58cm, 9.2 ±0.64 cm and 8.8 ±0.36 cm for age group of 16 - 30, 31 - 45, 46 - 60 and 61 - 75 years respec­tively). The men spleen thickness were more (4.1 ±0.5 cm, 4.05 ±0.58 cm, 3.43 ±0.38 cm and 3.0 ±0.36 cm for age group of 16 - 30, 31 - 45, 46 - 60 and 61 - 75 years respectively). The females splenic thickness were 4.06 ±0.47 cm, 3.78 ±0.48 cm, 3.38 ±0.35 cm and 2.29 ±0.23 cm for age group of 16 - 30, 31 - 45, 46 - 60 and 61 - 75 years respectively. Thus significant differences between male and female splenic dimen­sions were found for each age group chosen (P <0.05).Conclusions: The results show that the splenic length and thickness decreased with increase in age in both males and females and all the di­mensions were greater in males than in females. This study established normogram that can be more reliably used as both a complementary modality to clinical evaluation and as a more sensitive means of evalu­ating and screening patients for splenic disorders for any pathologi­cal enlargement or reduction of size in clinical practice in a Nepalese populations.Journal of Gandaki Medical College Vol. 10, No. 1, 2017, page: 11-16

The purpose of present work is to study some algebraic aspect of fuzzy multiset regular languages. In between, we show the equivalence of multiset regular language and fuzzy multiset regular language. Finally, we introduce the concept of pumping lemma for fuzzy multiset regular languages, which we use to establish a necessary and sufficient condition for a fuzzy multiset language to be non-constant.

Introduction: The accurate identification of Staphylococcus aureus clinical isolates requires a series of tests. Morphological features and slide coagulase test are two criteria on which S. aureus are identified. Resort to tube coagulase test is sought when results of slide coagulase test are equivocal or doubtful. Both coagulase tests detect the enzymes that convert fibrinogen into fibrin. Human, rabbit or sheep pooled plasma is used as substrate for both tests. Slide coagulase test is simpler and faster as compared to tube coagulase test. The plasma could be carrier of many human and animal pathogens like HIV, HBV, HCV etc. Storage of plasma for longer duration is fraught with chances of contamination. Improperly stored plasma can lead to false positive or negative results. Citrated plasma may be unsuitable for this test if contaminated with citrate utilizing bacteria. Considering the role of S. aureus as a common etiological agent in nosocomial and community infections, there is a need of implementing rapid, easy and cost-effective phenotypic test. Objectives: Considering the disadvantages and risks associated with fresh plasma, this study aims to launch for safer, more reliable substitute with longer shelf life that may provide reliable results for prompt identification of S. aureus by slide coagulase test. Methods: The present work evaluates slide coagulase test (SCT), and urea fibrinogen slide coagulase test (UF-SCT) for S. aureus detection considering Tube coagulase test (TCT) as the reference method. Sensitivity, specificity, positive predictive value and negative predictive values of SCT and UF-SCT were calculated using TCT as gold standard. Results: A total of 150 staphylococcal isolates from different clinical specimens ere selected for the evaluation of coagulase tests. All the specimens were subjected to SCT, UF-SCT and TCT. The UF-SCT showed better sensitivity (95.04%), specificity (100%), PPV (100%), and NPV (82.85%) with reference to TCT. UF-SCT showed similar sensitivity and specificity to SCT. None of the isolates were negative in UF-SCT and positive in SCT. Since UF-SCT does not incorporate plasma directly and at the same time has a very good sensitivity and specificity, it is recommended that UF-SCT could replace SCT for identification of S. aureus. Conclusion: The findings of present study shall encourage laboratories to use the urea-fibrinogen slide coagulase test routinely for the rapid identification of S aureus. Journal of Gandaki Medical College Vol. 10, No. 1, 2017, Page: 5-10

The purpose of the present work is to introduce and study the concept of minimal deterministic automaton with rough output which recognizes the given rough languages. Specifically, we use two concepts for such construction, one is based on Myhill-Nerode’s theory and the other is on the basis of derivatives of the given rough language. Lastly, we discuss monoid representations of the given rough languages.

'Huanglongbing' (HLB), previously known as 'citrus greening' is a severe and widespread disease of citrus caused by 'Candidatus Liberibacter spp.' Major citrus cultivation of Tripura produced in the north district were surveyed and detected with HLB symptoms. Characteristic symptoms of HLB viz. blotchy mottle leaves, yellow veins and severe chlorosis were observed. A preliminary survey of citrus orchards in the northern district of Tripura revealed that 16-20% of trees are symptomatically affected with HLB disease. Diagnosis of HLB in two citrus species, Citrus reticulata (mandarin) and Citrus macroptera (satkara) were substantiated by conventional polymerase chain reaction (PCR). OI1 and OI2c primers which are specific to 16S rDNA of the pathogen 'Candidatus Liberibacter asiaticus' amplified a DNA fragment of 1160 bp. This study validates the causal factor of the drastic decline of citrus cultivation in Tripura.

Seasonal diversity of rhizospheric microfungi associated with two different age group of tea plantation was examined by using serial dilution and soil plate methods on the Czapek’s Dox Agar medium supplemented with antibiotic Streptomycin. Identification and characterization of soil microfungi were done with the help of accessible manuals of fungi. Soil physico-chemical properties including soil pH, electrical conductivity, moisture content, water holding capacity, bulk density, soil texture, organic carbon, organic matter, nitrogen, potassium and phosphorus content were also analyzed. A total of 32 fungal species and white sterile hyphae were isolated and identified from both the selected plantation sites. Among the identified fungal species, 2 species are belonging to the genus Alternaria, Fusarium and Rhizophus, 6 species belong to Aspergillus, 4 species belong to the genus Penicillium while 3 species are belong to the genus Verticillium. Only one species from each of the genus Bispora, Botrytis, Candida, Cephalosporium, Cladosporium, Culvularia, Dendropsis, Giocladium, Giotrichum, Helminthosporium, Humicola, Nigrospora and Trichoderma were also isolated and identified during the course of the work. Sterile hyphae were highly isolated from both the plantation sites. Aspergillus niger, Humicola brevis and Verticillium effusum were isolated throughout the year. The dominant genera in both the selected plantation were Aspergillus and Penicillium.

The purpose of this paper is to introduce and study the concepts of homomorphism, fuzzy multiset transformation semigroup and coverings of fuzzy multiset finite automata. We establish their basic properties for the algebraic study of fuzzy multiset automata theory.

BACKGROUND:Smoking and health are intimately related and thus, smoking among future health care personnel is an important issue. As future physicians and dentists who will witness the continued burden of smoking-related diseases among their patients, represent a primary target for smoking prevention programs.OBJECTIVES:To explore the magnitude of smoking problem and assess the major causes aggravating the burden of smoking among medical and dental students. METHODS; A cross sectional study was conducted between June and July 2009 among 345 medical and dental students. Pre-tested self-administered questionnaire containing questions regarding smoking and its various correlates were used to collect the data. Chi square test was used for testing hypothesis.RESULTS:Prevalence of smoking was estimated as 38.4%, among whom majority started smoking during 15 to 19 years of life. Peer pressure was the major cause behind smoking (29.5%). Nearly one third of the participants used to consume alcohol along with smoking. Presence of parental smoking and use of other drugs were significantly associated with smoking among the students.CONCLUSION:Tobacco smoking is a significant health problem among the male medical and dental students. Medical and dental students were approached as they are the treatment providers for smoking and disease related to it in the future. The results in our study are discouraging and reveal that the medical knowledge regarding ill effects of smoking has not been able to check its use.

The need for an alternative drug for malaria initiated intensive efforts for developing new antimalarials from indigenous plants. The information from different tribal communities of northeast India along with research papers, including books, journals and documents of different universities and institutes of northeast India was collected for information on botanical therapies and plant species used for malaria. Sixty-eight plant species belonging to 33 families are used by the people of northeast India for the treatment of malaria. Six plant species, namely, Alstonia scholaris, Coptis teeta, Crotolaria occulta, Ocimum sanctum, Polygala persicariaefolia, Vitex peduncularis, have been reported by more than one worker from different parts of northeast India. The species reported to be used for the treatment of malaria were either found around the vicinity of their habitation or in the forest area of northeast India. The most frequently used plant parts were leaves (33%), roots (31%), and bark and whole plant (12%). The present study has compiled and enlisted the antimalarial plants of northeast India, which would help future workers to find out the suitable antimalarial plants by thorough study.

Assam and Arunachal Pradesh have very rich tradition of herbal medicines used in the treatment of various ailments. Tribal communities practice different types of traditional healing practices. Enough documentation is available on the healing practices in other tribal communities except Mishing community of Assam and foot hill of East Siang district of Arunachal Pradesh hence the attempt was made for the same. A survey on folk medicinal plants and folk healers of Mishing tribe was conducted in few places of Lakhimpur and Dhemaji district of Assam and East Siang district of Arunachal Pradesh, where this ethnic group is living since time immemorial. All information was collected based on interview and field studies with local healers within the community. The identification of medicinal plants collected with help of indigenous healers was done. Such medicines have been shown to have significant healing power, either in their natural state or as the source of new products processed by them. This study is mainly concentrated with plants used to cure diseases and to enquire about different healing systems. Detail note on the method of preparation of precise dose, the part/parts of plants used and method of application is given.