Abstract-Recent innovations in Network Virtualization and Elastic Optical Networks (EONs) enable flexible deployment of optical networks as a service. However, one open challenge is how to embed Virtual Optical Network (VON) requests onto the physical substrate network to maximize the sharing of physical resources, which is the so called Virtual Network Embedding (VNE) problem. EONs are prone to the fragmentation of spectral resources during the process of routing and spectrum allocation. The fragmentation of spectral resources in the substrate fiber links may lead to the blocking of incoming virtual network requests. This degrades the utilization of the physical resources of the Infrastructure Providers and also, decreases the revenue of the Service Providers. In this paper, we propose a novel virtual network embedding algorithm called Alignment and Consecutiveness-aware Virtual Network Embedding (ACT-VNE), which takes into account the spectrum alignment and relative loss in spectrum consecutiveness when mapping virtual nodes/links onto the physical substrate nodes/links. We also propose a minmax reconfiguration scheme called Relative Consecutiveness Lossaware and Misalignment-aware Virtual Network Reconfiguration (RCLM-VNR) that minimizes relative consecutiveness loss and maximizes alignment with adjacent links when reconfiguring the virtual network. Simulation results show that ACT-VNE and RCLM-VNR yield a lower blocking probability and a higher link utilization ratio, which leads to better utilization of the physical resources and increased revenue.

Background Family caregivers of psychiatric disorders likely to face burden. There is a paucity of data regarding the caregiver burden in psychiatric disorders in context of Nepal. Objective To study the caregiver burden in families with psychiatric illness and to find association between socio-demographic variables and caregiver burden in families with psychiatric illness. Method This is an analytical cross-sectional study. The participants (n=96) were caregiver of patients visiting outpatient department of two government of Nepal primary health care centers namely, Panchkhal Primary Health Care Center (PHC) Kavre District and Barhabise Health Care Center Sindhupalchowk district. The sample size has been determined by using statistical formula. Family burden assessment schedule (FBIS) was used for the study. Result The majority of the caregivers were females 56.3%. Most of the caregivers were aged below 45 years 54.2%. The large number of participants were single or separated 74%. The mean score of family burden assessment schedule was 27 ± 9.8 (range 0 to 48) with positive rate of 59.4%.Among the objective burden domains disruption of family leisure 61.5% was the most frequently reported burden. The subjective burden was reported in 95%. There were significant differential demographic associations with different domains of caregivers’ burden. Conclusion Caregivers of Psychiatric patients experience different kind of burden of care. Our findings highlight the support to the family members to reduce their burden.

Generation adequacy assessment of electrical power systems is vital in ensuring proper decision making in generation expansion planning and system operations in the face of stochastic system performance such as equipment failures and variations of generation and load. This paper presents the results of generation adequacy assessment of the Zesco generation system using the probabilistic approach. The system is analyzed under several scenarios in order to investigate the effect of each of these scenarios on the reliability of the system. The analytical method is applied to evaluate the stochastic system performance and reliability indices. In this study, the generation adequacy of the Zesco generation system was assessed considering the existing and the future generation capacity. Therefore, the purpose of the study was to assess the adequacy of Zesco generation system to meet the load requirements taking into consideration the existing and forecasted electricity demand. The results show that Zesco system was not very adequate in 2009 to meet the load requirements. On the other hand, the system is will be adequate in 2020 after addition of new generation capacity of 1280MW.

Background Lower segment caesarean section (LSCS) is a common surgical mode of delivery and surgical site infection is the most common infectious complication in these patients. The main objective of the study was to analyse the risk factors and microbial etiology of surgical site infection (SSI) following LSCS. Methods 300 consecutive patients undergoing LSCS, irrespective of indication, were studied. A questionnaire was developed to assess the risk factors associated with development of SSI. All patients were followed up from day one of surgery till discharge and then up till 45 days following LSCS.

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Aims: The aim of this study is to assess learning curves for laparoscopic hysterectomies, compare the performance of surgeons and review demographic parameters of the patients, varieties of complications experienced and indications of the procedures. Methods: A retrospective study was conducted in Kathmandu University Hospital, Kavre of January 1, 2011 to June 30, 2018. Results: A total of 1849 cases were already performed by mid 2018. Of them, 261 (14.12%) cases were LAVH and TLH cases. Mean duration for laparoscopic hysterectomies (for both LAVH and TLH) was 142.21±43.46 minutes (range 55 to 310 minutes) and one third of the cases performed in a range of 121 to 150 minutes. There is difference in mean duration of operation between surgeons which is statistically significant (p <0.001). Beside one of four surgeons (surgeon B) had significant reduction in mean duration for LAVH surgery (p=0.004). Same surgeon has significant reduction in mean duration for performing TLH (p=0.0047). Of the 261 laparoscopic hysterectomies, 8 cases (3.07%) turned into laparotomy. Conclusions: Laparoscopic hysterectomies are feasible with reducing mean operating time across the period. These minimal invasive surgeries are safe with low rate of complications and less conversion to open even in our set up.

Background: Intrauterine growth restricted (IUGR) fetuses are at higher risk of developing neonatal complications and also known to develop metabolic syndrome in adult life. So, an early antenatal detection, choosing the optimal time and method of delivery and intervention when required could minimize the risk significantly.Objective: To find out the perinatal outcome and the maternal and placental risk factors. , at a Teaching Hospital. A singleton pregnancy, above 28 weeks of gestation with clinical diagnosis of IUGR and confirmed by ultrasonography were included in the study. The statistical analysis was performed by Statistical Package of Social Sciences (SPSS) 23.0 software. Results:Maternal risk factors like low pregnancy body mass index, preeclampsia, anaemia, hypothyroidism and placental factors like retroplacental hemorrhage were mainly responsible for intrauterine growth restriction. Conclusions:The early identification of risk factors and management of the same antenatally is an important issue to prevent adverse perinatal outcomes associated with IUGR.