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Prakash Adhikari Final Year Resident (ENT- HNS) GMS Me mori al Acad emy of ENT and Head an d Neck Studies, TU Teaching Hospital, Kathmandu, Nepal

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Prakash Adhikari

Final Year Resident (ENT- HNS)

GMS Memorial Academy of ENT and Head and

Neck Studies,TU Teaching Hospital, Kathmandu, Nepal

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Intr ti n

Choosing topi

S pervisor

St rting thesis

hesis str t re

Further readings

ake home message

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"a proposition that is maintained by argument "

a lengthy, formal treatise, especially one written by a candidate

 for the doctoral degree at a university "

Thesis is a contention or principle of which you would like to

convince your reader

A dissertation is a written presentation of it.

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An argument

An exposition of an original piece of research

The product of an apprenticeship

Probably the largest piece of work you·llever do

Something that could be published:

No matter how good your research is, youMUST write a good thesis

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Part of a universit degree

Formal s ientifi  report whose purpose is to

show an original contribution to knowledge

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Cultivating an inquiring mind

Encouraging in depth study of common

problems afflicting our people

Generation of scientific data locally

Keeping abreast of new developments locally

and abroad

Understanding the fundamentals of research

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Contestable

Proposing an arguable point

 strong thesis is provocative

Takes a stand and justifies the discussion you

will present.

Specific and focused.

sserts your own conclusion based onevidence.

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Provides the reader with a map to guide

him/her through your work.

nticipates and refutes the counter-

argumentsAvoids vague language (like "it seems").

Specific topic + Attitude/Angle/Argument = Thesis

What you plan to argue + How you plan to argue it = Thesis

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Self interest

Identify problem and its relevance

Common problem

Applicable

What information is available

Ethical acceptance

Methods of data collectionAnalysis of data

Expected outcome

Usefulness of your thesis

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www.hinari.com

Login- nep002

Password:44374

www.pubmed.com

www.google.com

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you must present a thorough review of the

existing literature on the subject, and on

closely related subjects.

make direct reference to your literaturereview

you must d emonstrate that your question

has not been previously answered

is worth answering

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the examiners read your thesis to find the

answers to the following questions:

What is this student's research question?

Is it a good question? (has it been answeredbefore? is it a useful question to work on?)

Did the student convince me that the question

was adequately answered?

Has the student made an adequate contributionto knowledge?

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Maintain regular contact with your supervisor(s)

ou should show sections, or preferably complete chapters 

with a reference list, of your thesis to your supervisor(s) at 

regular intervals

At the end of each discussion with your supervisor, make

an appointment for your next meeting.

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Consult with supervisor

First- thesis protocol presentation in the

Department.

After approval- Presented to IRB of our hospital.

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Thesis to be done in following sub-speciality.

Name of Resident Unit

Arun KC I

Robin Acharya I

Shiva Kumar Shahi II

Lit Joy II

Saloni Sinha III

Ramesh Parajuli IV

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Thesis should be presented and started within first six months 

of residency

Completed in 2 ½ of residency

Submitted at that time

Total six presentation in the Department

One presentation in ethical approval committee

Presentation should be submitted to guides and co-guides:: 7-10 days before presentation

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Timetable and Milestones

Experience tells us (the supervisors) that 

thesis work always takes longer than

expected by the students 

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Problem / Interest

To set your research question, first you have toset the problem you want to deal with.

ou can start from checking those experiences that

you feel unsatisfactory about.

Or something you feel you are interested in. Or something unclear you want to clarify. Or something you want to make better.

Important: You are not to study the problem You are to address one or several of the questions

that explicate the problem.

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Problem Questions / Questions of Interest

You then develop problem questions/

statements around the problem.

Problem questions / statements of what youwant to know about the unsatisfactory

situation.

Choose from the problem questions to formyour research questions.

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Formulating Your Thesis Topic

Research Question / Thesis Topic 

Select a few of the problem questions yougenerated. Integrate them to form your

research question / thesis topic.

Refine your research question concisely to

form your thesis title.

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Comparison of once daily mometasonefuroate and fluticasone propionate aqueousnasal sprays for the treatment of allergic

rhinitis.

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Developing Your Thesis

P urpose / Rationale / Aim

You need to state the problem / interest thattriggers your research.

You also need to state, after addressing theresearch question, your rationale / purpose in

pursuing that research question.

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Developing Your ThesisHypotheses / Models / Relationships

 You have to break down your research question into anumber of hypotheses / relationships to examine.

Hypotheses are to state your expectations/affirmationsabout the nature of some situation regarding yourresearch question.

They are tentative propositions / models for investigation.

They are to be confirmed or denied by the evidencecollected from your research inquiry.

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DEVELOPING YOUR THESIS

Significance & Limitations of Study 

Significance of Study is to extend the utility and value of your

study beyond the context you are studying & applying.

Limitations of Study is to state the boundaries of your studyto stop readers from arguing with you on something out of your remits or difficult to carry out in the context of your

study.

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Capital letters

Short, understandable without abbreviations

Less than 10 words

Indicative and informative

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COMPARISON OF ONCE DAILY MOMETASONE FUROATE AND

FLUTICASONE PROPIONATE AQUEOUS NASAL SPRAYS FOR THETREATMENT OF ALLERGIC RHINITIS.

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This is to certify that Dr. Prakash Adhikari has workedunder our direct supervision and guidance on the thesis entitled ́ Efficacy of Fine Needle Aspiration Cytology inNonthyroidal Neck Swellingµ.

The work done in connection with this is original andgenuine.

Guide Prof. Bimal Kumar Sinha, M.S. Ganesh Man Singh Memorial Academy of ENT & Head and Neck

Studies, T. U., Institute of Medicine, Kathmandu Nepal. Co- Guide Prof. Dharma Kanta Baskota, D.L.O., F.C.P.S.

Ganesh Man Singh Memorial Academy of ENT & Head and NeckStudies, T. U., Institute of Medicine, Kathmandu Nepal.

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Dedicated to my patients

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I would like to express my sincere thanks an

gratitude to various people who have helped

and guided me on my thesis work.

I am indebted to my guide.....................

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Figure 1.

Figure 2.

Figure 3.

Figure 4.

Figure 5.

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Type one side of paper, double spacing, 12- pint 

font

Leave margin 1 ½ inch on each side

Write page numbers From declaration to abstract ² Roman no. (I,II)

From introduction onwards- Arabic (1,2,3,...)

Divide into sections

Begin each section in new page Write with a good English

Short and simple sentence

Around 20,000 words

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Keep the patient information- confidential

Take consent from patients/

caretakers/parents

Measurement ² SI unitTake ethical approval from IRB

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Verbosity

Tenses

singular and pleural forms

Technical jargon

Slang terms

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Typically 300 - 350 words

Concise, short, informative, explanatory, interesting

Summarizes thesis research and conclusions Structured abstract (IMRC)

First sentence should introduce the most important concept

Last sentence should be the ´take homeµmessage.

Past tense

Keywords: 3-7.

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IMRAD

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Start with a paragraph outlines the general 

theme of the subject and acts almost as a

¶thesis statement· Introduce your topic, in a way that indicates 

its importance

Indicate briefly the research that has been

done on the topic Identify a gap, problem, controversy, etc., in

the existing research

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Explain how the present research will fill 

that gap, solve that problem

² Usually done by an overview of the

relevant literature.² Be through, but not exhaustive

Enough information but not too much

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Current status of knowledge

Review relevant literature both positive and

negative

Go to the depth of your topicReview literature of last 5 years (Preferably)

If relevant and historical ² older references

If available - local literature

Reference the other·s literature

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Related to the statement of the problem

Starts with To.......

E.g.

Don·t use vague terms- to study, tounderstand etc.

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General objective

To compare efficacy of once daily mometasonefuroate nasal sprays with that of fluticasonefuroate for treatment of allergic rhinitis.

Specific objectives

To determine the efficacy of once dailymometasone furoate nasal sprays for the treatmentof allergic rhinitis.

To determine the efficacy of once daily fluticasone

propionate nasal sprays for the treatment of allergic rhinitis.

To compare efficacy of once daily mometasonefuroate nasal sprays with that of fluticasonefuroate for treatment of allergic rhinitis.

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Make your study powerful

Past tense

Follow a logical order

Correct measurement units

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Study design

Settings

Duration of the study

Inclusion criteria Exclusion criteria

Sampling method

Sample size calculation

Patient selection ( Study group/ control group)

Techniques used- explain it in details.

Instrument used--------details

Statistical analysis

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Present it in orderly manner- according to your objectives

Express in tables, text or figures

Number it

Analyze it with suitable statistical methods and their significance

Provide data whether it is significant e.g express p-value, CI etc.

Emphasize or summarize important observations but do not repeat all the data shown in tables or figures.

Do not give explanation of your result. Do not describe it

If patient lost for F/U: mention it

Legends: in table::above and in figures::below

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25

23

GENDER DISTRIBUTION OF LYMPH NODE IN NECK

FEMALE

MALE

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Revisit your hypotheses

Were they confirmed or not?

Interpret your findings in light of your objectives

Ask and answer the ´whyµ questions Discuss implications of your results

Comment on the limitations of study, if it 

warrants it.

Be very careful here. Discuss directions for future research or action.

Sometimes people end with an conclusion

paragraph.

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Relate your findings with other study

Weakness of your study

Future work

(do not write results again- you comparewith other study, present in a logical flow as 

per your aims and results)

State any new hypothesis, but make it clear 

that they are new.

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As per objectives

Based on your results

Recommendations for future studies

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Should be in consecutive order in which they

are first mentioned in the text.

Reference in text should be identified by

Arabic numerals as superscriptUse Vancouver system.

Controversial: abbreviation of journal as per 

index Medicus. ( But there should be

uniformity)

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1. Marrow SE, Bickler SW, Kennedy AP, Syndler 

CL. Baloon extraction of esophageal foreign

bodies in children. J Pediatr Surg

1998;33:266-70.2. Dunlap LB. Removal of an esophageal 

foreign body using a foley catheter. Am

Emerg Med 1981;10:101-3.

3. Calkins CM, Christians KK, Sell LL. Cost analysis in the management of esophageal 

coins: endoscopy versus bougienage. J

Pediatr Surg 1999;34:412-4.

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Be consistent in your references

Use relevant references that: Applies to your study site(s)

Supports your argument why your study is 

interesting Do not over-use or under-use references (e.g. 

more than 3 references in 1 sentence is toomany, but don·t

Make a lot of unsupported statements  Use the same citation method throughout the

thesis, even for manuscript style thesis.

All chapter references all go into the back in its own section. This saves a lot of pages!

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1. Adhikari P, Sinha BK, Bhattarai H, Shrivastav 

RP. Myiasis infestation in postoperative

mastoid cavity. Nepal Med Coll J 2007; 9(4):

284-5.2. Adhikari P, Guragain RPS. Lateral Sinus 

Thrombophlebitis: Review of Literature.Int 

Arch Otorhinolaryngol 2007; 11: 477-80

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Pramanik T, Adhikari P. Resistance Vs aerobic

exercise- is the later better choice? (Short communication) Nepal Med Coll J 2006; 

89(1): 59-60.

Sinha BK. Technology transfer for hearing

impaired (Editorial). J Inst Med 2006; 28:1.

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Healthy Human Society Research Team. 

Pattern of ear diseases in rural school 

children: Experiences of free health camps in

Nepal. Lancet 2008; 398: 11-20.

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Adhikari P. School health program: a new

perspective. In: Lennard V. Seebeki, editor. 

Leading Edge Health Education Issues (Ist 

ed.). Newyork: NovaP

ublishers 2006: 47-60.

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Adhikari P. Accuracy of references in indexed

journals of Nepal. Nepal Med Coll J (in

press).

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Ethics clearance or whatever key paperwork

that the committee feels should be included

with thesis

Supporting materials, such as unpublishedanalytical methods, long tables of CRM

results.

Raw data (very useful for future researchers 

looking to mine historical data 20 years downthe road!)

THESIS PERFROMA

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THESIS PERFROMA

Serial No. I.P./OPD No: Date of FNAC: Date of surgery:

Name: Age/Sex:

Address: Occupation:

Ethnic Group: DOA:

Clinical presentation

1. Swelling-a. Onset (Congenital/ acquired)

b. Site: c. Duration

d. Number e. progression

2. Associated symptoms

Pain/dysphagia/disfiguring /SOB/chronic cough/fever/weight loss/loss of appetite/hoarseness/hemoptysis

3. Other symptoms: if any

Past history: TB/DM/HTN

Family history:

Socioeconomic history:

Clinical Examination

Site

Shape

Size Number

Surface Consistency

Mobility Tenderness

Clinical Diagnosis:

FNAC Report: (No- )

HPE Report: (No- )

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Fig:1. Histopathology of LN showing Langhan·s giant cells (40HPF).

SN IP No Name Age/Sex Date of   FNAC No. FNAC Dx HPE No. HPE Dx Correlat on

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surgey

1. 6285 PMJ 51/F 064/5/19 189 RLN 2936 RLN Y

2. 720065 MM 41/F 064/6/2 708 TBL 294 TBL Y

3. 356911 MKT 18/F ³ 466 Schwannoma 732 Schwannoma Y

4. 763222 AS 29/F ³ 917 TBL 3119 TBL Y

5. 403315 ST 22/F ³ 967 GLN 594 TBL N

6. 698706 BS 20/F 064/6/9 581 TBL 2451 TBL Y

7. 355564 THB 42/M 064/6/23 489 Inconclusive 3411 AV malfn N

8. 743270 RB 24/M ³ 541 GLN 3123 GLN Y

9. 720121 N  A 19/M ³ 1121 RLN RLN Y

10. 404412 SM 28/F ³ 449 GLN 3732 GLN Y

11. 529234 SS 29/M 064/8/12 1178 Epider moid 3902 Epider moid Y

12. 811464 P  A 40/F ³ 1257 Epider moid Epider moid Y

13. 864136 NL 26/F ³ TB 4016 TB Y

14. 355563 PMM 40/F 064/6/23 Fibr osar coma 596 Fibr osar coma Y

14. 358096 GMR 70/F 064/6/23 470 War hin 547 War hin Y

15. 352232 KT 26/M ³ 936 Met Sq Cell Ca 547 Met Sq Cell Ca Y

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Look for mistakes

Start giving to your supervisors in sections

Mistakes are more found out by others.

Hard cover bindingMake ready of electronic version also

Colour illustrations if possible

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8 copies

3 copies- examination section

1 copy guide

1 /2 copy ² co- guide/s 1 copy - department

2 copies- authors

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1. Be constructive (diplomatic) in reviewingothers· work; don·t blast all previous work, don·t be dismissive and definitely don·t singleout anyone with scorn. Chances are they are

reviewing your proposal.

BAD:  All prev ious studies are w orthless because they f ailed  to recogniz e the e ff ect o f X on Y. Chen and  Smith (1998) tr ied  but their  a pproach w as sim ply w rong. Ours is the f irst stud y  to add ress this q uestion correctly .

BETTER: Previous studies have made important contributions to this challenging problem, however none of the published studies appear to have completely accounted for the effect of X on Y. A pioneering effort in this direction is described by Chen andSmith (1998), highlighting the need for additional 

investigation of the system properties when the full set ofinteractin factors are incor orated in the model. 

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 A Guide to Research Methodology, Biostatistics and Medical 

Writing ± CPSP 

 How to write thesis- by PR Sharma

Guidelines of University of Toronto

Guidelines of Fayetteville State UniversityGuidelines of Fayetteville State University

 ASEE SEMINAR, 2002. University of Texas ASEE SEMINAR, 2002. University of Texas

Writing a thesis. Linda Campbell. Queen¶s universityWriting a thesis. Linda Campbell. Queen¶s university

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Start finding your Guide and co- guides

Start searching a topic

Try to reach your targeted sample size soon

Start writing your thesis----never saytomorrow

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