Tuning friction and slip at solid-nanoparticle suspension interfaces by electric fields

We report an experimental Quartz Crystal Microbalance (QCM) study of tuning interfacial friction and slip lengths for aqueous suspensions of TiO₂ and Al₂O₃ nanoparticles on planar platinum surfaces by external electric fields. Data were analyzed within theoretical frameworks that incorporate slippage at the QCM surface electrode or alternatively at the surface of adsorbed particles, yielding values for the slip lengths between 0 and 30 nm. Measurements were performed for negatively charged TiO₂ and positively charged Al₂O₃ nanoparticles in both the absence and presence of external electric fields. Without the field the slip lengths inferred for the TiO₂ suspensions were higher than those for the Al₂O₃ suspensions, a result that was consistent with contact angle measurements also performed on the samples. Attraction and retraction of particles perpendicular to the surface by means of an externally applied field resulted in increased and decreased interfacial friction levels and slip lengths. The variation was observed to be non-monotonic, with a profile attributed to the physical properties of interstitial water layers present between the nanoparticles and the platinum substrate.

Magnetic Monopole Search with the Full MoEDAL Trapping Detector in 13 TeV pp Collisions Interpreted in Photon-Fusion and Drell-Yan Production

MoEDAL is designed to identify new physics in the form of stable or pseudostable highly ionizing particles produced in high-energy Large Hadron Collider (LHC) collisions. Here we update our previous search for magnetic monopoles in Run 2 using the full trapping detector with almost four times more material and almost twice more integrated luminosity. For the first time at the LHC, the data were interpreted in terms of photon-fusion monopole direct production in addition to the Drell-Yan-like mechanism. The MoEDAL trapping detector, consisting of 794 kg of aluminum samples installed in the forward and lateral regions, was exposed to 4.0  fb^{-1} of 13 TeV proton-proton collisions at the LHCb interaction point and analyzed by searching for induced persistent currents after passage through a superconducting magnetometer. Magnetic charges equal to or above the Dirac charge are excluded in all samples. Monopole spins 0, ½, and 1 are considered and both velocity-independent and-dependent couplings are assumed. This search provides the best current laboratory constraints for monopoles with magnetic charges ranging from two to five times the Dirac charge.

Survey of current materials and impression techniques for Complete Dentures among Nepalese Prosthodontists

ABSTRACTBackground: Impression making is one of the critical factors in determining success or failure of complete denture therapy. The precise reproduction of edentulous foundation is essential for retention, stability, and support of the removable prosthesis. Evidence suggests that there is variability in materials and techniques regarding impressions making for complete dentures. There is little published information on studies conducted among Nepalese Prosthodontists. The purpose of this study was to evaluate current materials andmethods for impressions for complete denture prosthodontics in Nepal. Materials & Methods: A questionnaire based survey was conducted among Nepalese Prosthodontists. Ethical approval for the beginning of the study was obtained via Institutional Review Committee, Nepal Medical College. A self-administered anonymous questionnaire was distributed to the participants. Data were analyzed by using frequency distribution.Results: Majority of responses indicated use of irreversible hydrocolloid in stock metal tray for making the preliminary impression. The selective pressure was the predominantly used impression philosophy (78.3%). The most common material for the fabrication of custom trays was autopolymerizing acrylic resin (96.7%). All respondents border molded the custom tray prior to making the final impression. The final impression materials used were zinc oxide eugenol impression paste (73.3%), polyvinylsiloxane (11.7%), polyether (11.7%) and polysulphide (3.3%). Conclusion: Although there is variability in impression materials andtechniques used by Prosthodontists in Nepal for the fabrication of complete dentures, the results showed interesting trends. Most practitioners followed the traditional techniques of complete denture impression procedures.Keywords: complete denture; custom tray; edentulism; impression.

Alternative Technique of Iris Orientation in a Custom-Made Ocular Prosthesis

Accurate positioning of the iris is critical for the success of an ocular prosthesis. Precise duplication of size and location of the iris is essential for the establishment of realism, symmetry, and a natural-appearing gaze. This article explores an alternative procedure for positioning the iris in a custom-made ocular prosthesis using a pupillary distance ruler (PD ruler). The orientation and mediolateral dimension of the iris of the natural eye was measured from the graduated scale on a PD ruler and transferred on to the sculpted scleral wax pattern. The iris button was positioned in the marked area, and the established orientation was evaluated for symmetry and a natural-appearing gaze. Accurate, predictable, and easy positioning of the iris with the transfer of these dimensions to the definitive prosthesis provided a good result in terms of patient esthetics and satisfaction.

The Etiology of Upper Gastrointestinal Bleeding in Patients with Liver Cirrhosis in Dhulikhel Hospital

Background Acute upper gastrointestinal bleeding is a serious medical problem in cirrhotic patients. Patients with cirrhosis may develop upper gastrointestinal bleeding from a variety of lesions, including those due to portal hypertension, namely gastroesophageal varices and portal hypertensive gastropathy and other lesions as seen in the general population. Objective To investigate the etiology of upper gastrointestinal bleeding in liver cirrhotic patients. Method A retrospective review of 72 patients with liver cirrhosis and upper gastrointestinal bleeding from January 2013 to March 2016 was carried out at Dhulikhel Hospital. Child Pugh score was used to assess severity. Endoscopic diagnosis was documented. Result Out of 72 patients, 56 (77.8 %) were male and 16 (22.2%) were female. The most common age group was 30-42 years age. Fifty four cases of cirrhosis were associated with alcohol consumption. The Child-Pugh score was A in 20 patients (27.8%), B in 15 patients (20.8%) and C in 37 patients (51.4%). A combination of alcohol consumption and HCV infection was significantly associated with a higher Child-Pugh score (p=0.031). Twenty six (36.11%) patients had esophageal varices as cause of bleeding on endoscopic examination while 29(40.28%) had varices and other lesions identified at endoscopy. Of these 29 patients, 18 were found to have bled from esophageal varices, and 11 were found to have bled from coexisting lesion. Conclusion We found that variceal bleeding was the commonest cause of bleeding in cirrhotic patients, with 55 (78.5%) having varices and 44 (61%) actually bleeding from varices.

A Simplified Approach for Fabrication of a Lightweight Individualized Impression Tray with the Aid of Existing Obturator Prosthesis Using Lost Salt Technique

Maxillary defects resulting from ablative oncologic surgery can be extensive and usually have complex contours. Impression procedures for such defects can be time consuming and cumbersome, challenging the skills of even the most-experienced clinician. A well-oriented impression tray with proper extension and adequate contour is essential for successfully capturing the relevant details in impression. This article describes a method using the patient's existing obturator prosthesis to simplify and expedite the fabrication of a lightweight individualized impression tray directly on an irreversible hydrocolloid impression, thus avoiding the preliminary impression procedure for the patient.

Outcome of minimally invasive plate osteosynthesis in distal tibial fractures

Introduction: Distal tibial fractures present as a major challenge for the orthopedic trauma surgeons. Most non-operative treatments result in non-union or malunion and needs prolonged immobilization of the knee and ankle joints, with resulting stiffness. Open reduction and internal fixation as well as external fixation has high rate of infection and non-union. Minimally Invasive Plate Osteosynthesis has been shown to have a better outcome and has been the procedure of choice in most distal tibial fractures since the introduction of the locking compression plate. The objective of the study is to review the outcome of Minimally Invasive Percutaneous Osteosynthesis (MIPO) in unstable distal tibial fractures.Methods: Charts of patients who underwent MIPO from the year 2008 to 2013 for unstable distal tibial fractures over five years at Patan Hospital and Om Hospital were reviewed. All displaced closed fractures and Gustillo Anderson Type I and II fractures were included in the study. Plates consisted of the anatomically contoured 4.5 mm LCP and 3.5 mm LCP-Pilon form plate. A simple uniplanar external fixator was used to retain the reduction till the plate was inserted and secured with locking screws. The outcome of MIPO in distal tibial fractures were followed up and evaluated.  Clinical and radiological assessments were performed at 6 weeks, and at 3, 6, 9, 12 and 24 months.Results: Of the 75 patients (45 male, 30 female) age ranging from 19 to 70 years (mean 47 years), 5 patients were lost to follow-up. 28 patients at 3 months, 32 at 6 months, and 8 at 9 months met the criteria for a healed fracture. Two patients required autologous bone grafting at 9 months for non-union ultimately resulting in the fracture union at 16 months. There was one malunion attributable to the loss of reduction during plate fixation. There were no deep infections, no soft tissue complications and no failures of fixation. The cause of fracture were RTA (n=35), fall from height (n=9), twisting of ankle as a result of fall from standing height (n=22), and others (n=11). The mean time for surgery from the time of injury was 5 (range, 2 to 14) days; the mean hospital stay was 10 (range, 7 to 21) days.Conclusion: MIPO is an effective treatment for closed, unstable fractures of the distal tibia, avoiding the complications associated with more traditional methods of internal fixation and/or external fixation.Journal of Society of Surgeons of NepalVol. 17, No. 2, 2014, Page: 7-11

Plasmablastic Lymphoma

Plasmablastic lymphoma is a rare and aggressive lymphoma reported to be commonly associated with immunodeficiency state. It possesses a challenge to the clinician owing it aggressiveness and poor prognosis. No standard of care treatment is available for the disease. Here we report a case of an immunocompetant 67 years female who is unique in her presentation as she did not have any of the conventional clinical features and had a history of urothelial carcinoma three months back.

Thermal conductivity, thermal diffusivity, and volumetric heat capacity of silicone elastomer nanocomposites

Silicone elastomer (SiR) nanocomposites were prepared using multiwalled carbon nanotubes (MWCNT) and nano-graphite (NG). The morphology of the SiR nanocomposites has been studied using scanning electron microscopy and high-resolution transmission electron microscopy techniques. Detailed analysis of the morphology reveals a uniform distribution of the MWCNT and NG filler particles in the silicone matrix. On increasing the filler loading, a continuous network structure is formed and aggregation takes place. The effect of the MWCNT and NG loadings on the thermal properties of the silicone elastomer has been investigated. The thermal properties of the SiR nanocomposites were measured by a thermal properties analyzer based on the transient hot-wire method. Studies also suggest that incorporation of nanoparticles improves the thermal conductivity of SiR nanocomposites. The thermal conductivity of SiR nanocomposites increased from 0.200 W/(m K) to 0.440 W/(m K) and to 0.310 W/(m K) for 6 wt% MWCNT and NG loadings, respectively. Because of the positive temperature coefficient and the conductive nature of the nanoparticles, the thermal conductivity of the material increased on increasing the temperature. The thermal diffusivity and the volumetric heat capacity of the SiR nanocomposites were measured. The thermal diffusivity of the SiR nanocomposites increased from 0.1194 mm2/s to 0.3209 mm2/s and to 0.2050 mm2/s for 6 wt% MWCNT and NG loadings, respectively. This indicates that the temperature response becomes faster with MWCNT and NG loadings. The volumetric heat capacity of the silicone elastomer nanocomposites decreased from 1.80 MJ/(m3K) to 1.34 MJ/(m3K) and to 1.40 MJ/(m3K) for 6 wt% MWCNT and NG loadings, respectively. Thus, MWCNT particles are more effective in increasing the thermal conductivity and diffusivity of the SiR nanocomposites, when compared to NG fillers at any loading.

Search for Magnetic Monopoles with the MoEDAL Forward Trapping Detector in 13 TeV Proton-Proton Collisions at the LHC

MoEDAL is designed to identify new physics in the form of long-lived highly ionizing particles produced in high-energy LHC collisions. Its arrays of plastic nuclear-track detectors and aluminium trapping volumes provide two independent passive detection techniques. We present here the results of a first search for magnetic monopole production in 13 TeV proton-proton collisions using the trapping technique, extending a previous publication with 8 TeV data during LHC Run 1. A total of 222 kg of MoEDAL trapping detector samples was exposed in the forward region and analyzed by searching for induced persistent currents after passage through a superconducting magnetometer. Magnetic charges exceeding half the Dirac charge are excluded in all samples and limits are placed for the first time on the production of magnetic monopoles in 13 TeV pp collisions. The search probes mass ranges previously inaccessible to collider experiments for up to five times the Dirac charge.

Indoor Staying During Winter Season Makes People More Susceptible to Flu

An infectious diseases caused by RNA virus, the influenza is also commonly known as Flu. It mainly transmitted through air by coughs or sneezes of infected. The symptoms of flu like fever and headache are the result of the huge amounts of proinflammatory cytokines and chemokines (such as interferon or tumor necrosis factor) produced from influenza-infected cells. The activated vitamin has extreme effects on human immunity. Vitamin D prevents too much release of cytokines and chemokines. Staying much time indoor, away from contact of sunlight during winter season lowers the vitamin D level in human body. Thus, the chance of getting flu increases in winter season. Formulation of policy regarding vitamin D supplementation in diet for people such as elderly and with low sunlight exposure is hereby recommended. It will be beneficial to reduce influenza related morbidity and mortality during winter season.

Chlamydia trachomatis among HIV infected patients using PCR technique

Background and Objectives: Chlamydia trachomatis is a sexually transmitted organism and an important public health problem in the sexually active age group. Limited studies are found regarding the prevalence of Chlamydia trachomatis in Nepal. Moreover, no study in Nepal reports the association of Chlamydia and HIV infection. The current study attempts to determine the burden of Chlamydia on HIV positive patients. Material and Methods: A total of 117 HIV positive patients visiting a HIV clinic in Kathmandu, were screened for Chlamydia infection. For this, Urine samples were collected and analyzed using the Multiplex polymerase chain reaction technique (MPCR) and Agarose gel electrophoresis. DNA isolation was performed using QIAamp DNA and Blood mini kit handbook protocol. Results: C. trachomatis was detected in 4.27% of the total 117 HIV patients. Out of positive cases 60% were males and 40% were females. However, Chlamydia is found more prevalent among females (6.89%) than in males (3.4%). Eighty percent of positive cases were asymptomatic. Conclusion: Chlamydia infection was found less commonly among studied patients and most of those cases were asymptomatic. So there is difficulty in timely detection of C. trachomatis and track the clinical sequel, which might be devastating. Hence, routine checkup is recommended for all suspected cases for timely management of the disease Janaki Medical College Journal of Medical Sciences (2013) Vol. 1 (2): 3-10 DOI: http://dx.doi.org/10.3126/jmcjms.v1i2.9261

Chlamydia trachomatis detection in HIV infected patients using polymerase chain reaction

Introduction: Chlamydia trachomatis is a sexually transmitted organism and causes important public health problem in the sexually active age group. Limited studies are found regarding the prevalence of C. trachomatis in Nepal. Moreover, currently there are no any study in Nepal reporting the association of chlamydia and HIV infection. This study attempts to determine the burden of chlamydia on HIV positive patients. Materials and Methods: A total of 117 HIV positive patients visiting a HIV clinic in Kathmandu, were screened for chlamydia infection. For this, urine samples were collected and analyzed using the Polymerase Chain Reaction Technique (PCR). Results: C. trachomatis was detected in 4.2% of the total 117 HIV patients. Out of positive cases 60% were males and 40% were females. However, chlamydia was found more prevalent among females (6.8%) than males (3.4%). Eighty percent of positive cases were asymptomatic. Conclusions: Although, the prevalence of chlamydia infection was found less HIV patients, most of those cases were asymptomatic. Therefore, routine checkup is recommended for all suspected cases for timely management of the disease. DOI: http://doi.dx.org/10.3126/ijim.v2i1.8003 Int J Infect Microbiol 2013;2(1):12-16

Early initiation of community-based programmes in Nepal: a historic reflection

Community-based programmes have long been an integral part of Nepal's health sector strategy and has contributed to the progress seen in maternal and child health. This paper reviews three early community-based programmes - the acute respiratory infection programme and its evolution to the fully scaled-up community-based integrated management of childhood illness programme, the national vitamin A programme and the female community health volunteer programme - and how the Government of Nepal rapidly accepted them to address pressing maternal and child health issues in an evidence-informed manner, moving rapidly from research to feasibility studies, to implementation and scale-up.

Developing, piloting and scaling-up of Nepal's neonatal care program

The Community-based Newborn Care Package is a set of neonatal care interventions to be delivered through the existing government system of facility-based health workers and community based volunteers in Nepal. The package was developed by the government of Nepal in 2007 based on the evidence from Nepal and neighboring countries and designed to be implemented as a comprehensive package to improve newborn survival. This paper reviews the process, progress, and lessons learned from the program design, early-implementation and monitoring and provides future directives to improve upon this integrated package that uses a continuum of care approach from the pre-pregnancy to neonatal periods by involving the communities, health workers and the private sector.

Comparison of Maxillary Occlusal Plane with Various Craniofacial Reference Lines in Nepalese and Indian Young Adults

Orientation of occlusal plane for complete dentures play a vital role as it affects all the basic requirements of complete dentures. Depending on soft tissue landmarks for orienting occlusal plane seems to be unreliable. Cephalometrics were introduced in Prosthodontics to orient the occlusal plane in the same position as it was with the lost natural teeth. In the present study, 60 lateral cephalometric radiographs of a group of male and female dentulous subjects of Indian and Nepali origin (30 subjects in each group) were obtained and tracings were made. All the subjects selected were in the age group of 20-30 years in whom the facial growth was completed. Angular measurements were made between FH (Frankfort Horizontal plane)- CP (Camper's Plane), FH-OP (Occlusal Plane) and CP-OP and subjected to statistical analysis to determine the degree of separation between these planes in Indian and Nepalese ethnic groups. The absolute parallelism between the natural occlusal plane and Camper's plane were not proven in both Indian and Nepalese subjects involved in this study. This significantly reduces the reference values of these planes in Prosthodontics.

Developing community-based intervention strategies and package to save newborns in Nepal

In Nepal, the proportion of under 5 deaths that are neonatal (0-28 days) has been increasing in the last decade, due to faster declines in infant and child mortality than in neonatal mortality. This trend is likely due to a focus on maternal and child survival programs that did not adequately address newborn health needs. Policy and actions to save newborn lives resulted from increased attention to newborn deaths in 2001, culminating in the endorsement of the National Neonatal Health Strategy in 2004, a milestone that established newborn health and survival as a national priority. Operationalization of the National Neonatal Health Strategy took place in 2007 with the development of the Community-Based Newborn Care Package (CB-NCP). This paper describes how national stakeholders used global, regional and in-country research and policies to develop the CB-NCP, thus outlining key ingredients to make newborn health programming a reality in Nepal. A technical working group was constituted to review existing evidence on interventions to improve newborn survival, develop a tool to prioritize neonatal interventions, and conduct program learning visits to identify key components appropriate to the Nepal context that should be included in the Community Based Integrated Newborn Care Package. The group identified interventions based on the evidence of impact on newborn survival, potential mechanisms within the existing health system to deliver the interventions, and linkages with existing programs and different tiers of the health system. Not only was Nepal one of the first countries in south-east Asia where government adopted a national strategy to reduce neonatal deaths, but it was also one of the first to endorse a package of neonatal interventions for pilot testing and scaling up through existing community-based health systems that provide basic health services throughout the country. CB-NCP was designed to be gradually scaled up throughout the country by integration with Safe Motherhood and Child survival programs that are currently operating at scale. Under Ministry of health and Population leadership, a network of academia, professional bodies and partners developed a common vision for improving newborn health and survival, and launched district-level pilot programs to demonstrate and learn how newborn health interventions could be effectively and efficiently delivered and scaled up in Nepal.

Tamoxifen for Breast Cancer

Breast cancer is one of the common cancers. Hormonal therapy along with surgery, chemotherapy, radiotherapy and targeted therapy are vital modalities for the management of breast cancer. Tamoxifen has been the most widely used hormonal therapy for more than two decades. In this article we review the benefits, dose, duration and timing of Tamoxifen therapy in patients with breast cancer. Keywords: breast cancer, hormonal therapy, tamoxifen.