Search

Since large percentage (24.9%) of GDP (2077-78) of Nepal is covered by agricultural Sector [1]. Food is the most necessary supply of human beings as well as animals. Food is survival. Earlier must of the farming is done by traditional method. Now in few places it is replaced by modern farming comprised of IC engine tractors. Fossil fuel is degrading the environment and is expensive in Nepal as it is importing oriented [2]. By 2081 B.S. (2025 A.D.) green electricity production in Nepal will be surplus as per data from Nepal Electricity Authority (Nepal Electricity Authority) [3]. That's why electric tractor is both vision and future in case of Nepal. In this paper we are going to discuss about Vehicle dynamics and components and SWOT analysis of e-tractor., {"references":["www.moald.gov.np. Yearly Inspection Report. Ministry of Agriculture & Livestock Development, 2079 B.S.(2021).","Department of Transport Management,Nepal. Vehicle Details. Department of Transport Management,Nepal, 2078 B.S.","Nepal Electricity Authority. \"A Year in Review- Fiscal Year 2021/2022.\" A Year in Review- Fiscal Year 2021/2022 (2022). .","Coppenolle, Hermine Van, et al. \"The War in Ukraine.\" The War in Ukraine (April 2022).","Dias, Rui, et al. \"(The 2020 Oil price war has increased Integration Between G7 Stock markets and Crude oil.),2022\".","Minisstry Of Finnce, Nepal. (n.d.). .","","Aumer, Wolfgang, et al. \"Electric Tractor: Vision or Future?\" Electric Tractor: Vision or Future? (2008).","Dar, Abdul Lateef. \"Electric Tractor.\" Electric Tractor (n.d.).","Karki, Abhisek; Shrestha, Bim Prasad; Tuladhar, Daniel; Basnet, Subarna; Phuyal, Sudip; Baral, Bivek;. \"Parameters Matching for Electric Vehicle Conversion.\" Parameters Matching for Electric Vehicle Conversion (2019)."]}

Background and purpose: Chronic subdural hematoma (cSDH) poses a significant morbidity and mortality risk particularly in elderly population. It can be treated with simple surgical techniques like burr hole drainage under local anesthesia, however it often recurs after surgical evacuation in significant number of patients. Material and methods: A randomized controlled trial was designed at Mayo Hospital/KEMU in 2013 to 2016. Total number of 98 patients who met the inclusion and exclusion criteria were randomized into ‘with drain’ and ‘without drain’ arm. All of them were treated with burr hole drainage under local anesthesia. Half of them had subdural drain while the remaining half did not. Recurrence of hematoma and surgical outcome was compared. Result: Among 98 patients included in the study(54 males and 44 females) met the inclusion criteria. Mean age of presentation was 63 years ± 12.4 (range 40-100). There was left sided preponderance in hematoma location (53.1%). Mean midline shift was 2.7 mm ± 1.5. Owing to drainage of cSDH, post-operative MRC score of patients along with midline shift in the CT brain showed statistically significant improvement. However, irrespective of insertion of drainage system, there was no significant difference noted in recurrence of cSDH, midline shift and improvement in presenting symptoms (hemiparesis or monoparesis) considering all post-operative days. Conclusion: There is no significant difference in recurrence rate depending on weather a postoperative external drainage is placed or not.

Background and purpose: Obstructive hydrocephalus can be treated with External ventricular Drainage (ETV), Ventriculo peritoneal shunt insertion, upfront tumor removal without cerebrospinal fluid diversion procedures or more recently ETV. Aim of our study was to study the outcome of ETV in treating such patients. Material and method: Descriptive observational study conducted at Upendra Devkota Memorial Institute Of Neurological and Allied Sciences from Sep 2015 to may 2017. Result: Twenty-three patients met the inclusion criteria. Among which, 14 (39%) patients were male with male to female ratio of 1.55. We included wide age range from 3 years to 68 years. Seven patients (30.4%) were less than 10 years while 6 patients (23%) were above 60 years old. Patients with Posterior fossa presented with varied symptoms. Ten patients (43.4%) presented with decreased level of consciousness, 14 (60.8%) presented with visual symptoms, 17 (73.9%) presented with vomiting and 23 (100%) presented with headache (Figure. 3). Visual acuity was normal among 3 (13%), decreased among 11 (48%) and with no perception of light among 3 (13%). However, acuity was not assessed among 6 (26%) patients (Figure 4).Funduscopic evaluation revealed papilledema among 20 (87%) patients while secondary optic atrophy among 3 (13%) patients. Patients were evaluated in follow up for symptomatic improvement. Consciousness were improved among 8 (80%) patients, visual symptoms improved among 10 (71.4%) patients, vomiting subsided among 15 (88.2%) patients while headache improved among 100%. Following ETV, 5 (21.7%) patients developed complications, 3 (13%) patients had intraventricular bleeding while 2 (8.6%) patients had CSF leakage from the wound. Conclusion: Endoscopic third ventriculostomy is a relatively safe and valid option for treatment obstructive hydrocephalus due to posterior fossa lesions.

Aneurysmal subarachnoid hemorrhage (aSAH) is a devastating disease with a high rate of mortality and permanent morbidity. An important neurologic complication is hydrocephalus reported to range from 6 to 67% while only 10-20% of them will require permanent CSF diversion. The purpose of this study was to identify predictive factors for the development of shunt dependant hydrocephalus among patients with aSAH. This is a retrospective study conducted in among 72 patients who underwent clipping of aneurysm for subarachnoid hemorrhage in our institute during 2 years. EVD placement done for acute hydrocephalus while VP shunt was done for chronic hydrocephalus or requiring prolonged EVD placement. Various clinical and radiological factors were registered on admission and during the intensive care stay. Multivariate logistic regression analysis was done to predict risk of shunt dependant hydrocephalus. P value less than 0.05 was considered significant. Among 72 patients with aSAH. Intraventricular extension of blood was seen in 24 (33.3%) patients while hydrocephalus was seen among 19 (26.4%) patients. Eight patients (11.1%) required EVD placement for acute hydrocephalus while 10 (13.9%) patients required permanent shunt placement for chronic hydrocephalus. In univariate analysis, SAH with fisher grade >2, presence of hydrocephalus, intraventricular extension of hemorrhage and need of EVD placement were found to have significant association in shunt dependency. However multivariate logistic regression model showed EVD requirement for acute hydrocephalus as an independent predictor of shunt dependent hydrocephalus at p value 0.006 (OR=21.3; 95% CI=2.38 to 191.51). Hydrocephalus is a common complication following aneurysmal subarachnoid hemorrhage. SAH with fisher grade >2, presence of hydrocephalus, intraventricular extension of hemorrhage and need of EVD placement were found to have significant association in shunt dependency however only EVD requirement is an independent predictor of SDH