Biological parameters of a silurid catfish Ompok bimaculatus (Bloch, 1794) from River Ghaghara, India

The present study examined a total of 446 samples of Ompok bimaculatus and describes the condition factor, gonadosomatic index, length-length relationships, sex ratio, size at first maturity. The regression parameter 'b' ranged from 3.06 to 3.76 (r2 > 0.90). During the pre-monsoon, the allometric coefficient 'b' of the LWR was close to isometric value (b = 3.06) while that of overall was positive allometric (b = 3.31) although it suggested positive allometric growth in monsoon (b = 3.21), and post-monsoon (b = 3.76), periods. The values of condition factor ranged from 0.524 to 0.573. In the study, sex ratio ranged from 1:1.03 to 1:1.3. Males ranged from 14.0-26.6 cm while females varied from 11.2-29.0 cm in length. A significant difference in length at 50% maturity (p < 0.05) was found between both the sexes. First maturity stages in males and females were 22.3 cm and 23.2 cm, respectively. The smallest mature female was 22.0 cm L; the largest immature female was 26.8 cm L. The smallest mature male was 20.0 cm L; the largest immature male was 24.5 cm L. The results of the study could be useful to help in sustainable fisheries management in the Ghaghara River.

Radiation mapping inside the bunkers of medium energy accelerators using a robotic carrier

The knowledge of ambient and peak radiation levels prevailing inside the bunkers of the accelerator facilities is essential in assessing the accidental human exposure inside the bunkers and in protecting sensitive electronic equipments by minimizing the exposure to high intensity mixed radiation fields. Radiation field mapping dynamically, inside bunkers are rare, though generally dose-rate data are available in every particle accelerator facilities at specific locations. Taking into account of the fact that the existing neutron fields with a spread of energy from thermal up to the energy of the accelerated charged projectiles, prompt photons and other particles prevailing during cyclotron operation inside the bunkers, neutron and gamma survey meters with extended energy ranges attached to a robotic carrier have been used. The robotic carrier movement was controlled remotely from the control room with the help of multiple visible range optical cameras provided inside the bunkers and the wireless and wired protocols of communication helped its movement and data acquisition from the survey meters. Variable Energy Cyclotron Centre, Kolkata has positive ion accelerating facilities such as K-130 room Temperature Cyclotron, K-500 Super Conducting Cyclotron and a forthcoming 30 MeV Proton Medical Cyclotron with high beam current. The dose rates data for K-130 Room Temperature Cyclotron, VECC were collected for various energies of alpha and proton beams losing their total energy at different stages on different materials at various strategic locations of radiological importance inside the bunkers. The measurements established that radiation levels inside the machine bunker dynamically change depending upon the beam type, beam energy, machine operation parameters, deflector condition, slit placement and central region beam tuning. The obtained inference from the association of dose rates with the parameters like beam intensity, type and energy of projectiles, helped in improving the primary beam transmission and minimizing the ambient radiation fields inside the bunkers.

Influence of renal impairment on plasma concentrations of conjugated bilirubin in cases ofPlasmodium falciparummalaria

In a study of the influence of malaria-associated renal impairment on plasma concentrations of bilirubin, 111 Indian cases of Plasmodium falciparum malaria who had >34.2 microM total bilirubin/litre plasma were investigated. As the aim was to exclude those cases who had concomitant hepatic or (non-malarial) renal dysfunction, 19 cases who had serum concentrations of alanine aminotransferase (ALT) or alkaline phosphatase (AP) that were at least double the normal mean values were withdrawn. Of the remaining 92 patients, 47 showed evidence of renal impairment, the other 45 having plasma concentrations of creatinine that were <177 microM/litre. Plasma concentrations of the liver enzymes ALT and AP were similar for those with and without renal impairment. The plasma concentration of conjugated bilirubin (P<0.02), that of total bilirubin (P<0.05) and the ratio between the two (P<0.01) were, however, all significantly higher in the 47 patients with renal impairment than in the 45 with apparently normal renal function. The plasma concentration of creatinine was found to be not only positively correlated with the plasma concentrations of total (r=0.34; P<0.01) and conjugated (r=0.41; P<0.001) bilirubin but also negatively correlated with the urinary excretion rate for conjugated bilirubin (r=-0.34; P<0.001). The malaria-associated mortality was significantly higher among the patients with renal impairment than among those with apparently normal renal function, with 12 and three deaths, respectively (P<0.001). With increasing renal impairment there therefore appears to be a fall in the renal excretion of conjugated bilirubin. This leads to a disproportionate rise in the plasma concentration of conjugated bilirubin and this, since bilirubin can be toxic to renal tissue, may further worsen the renal impairment.

Dynamics of dark hollow Gaussian laser pulses in relativistic plasma

Optical beams with null central intensity have potential applications in the field of atom optics. The spatial and temporal evolution of a central shadow dark hollow Gaussian (DHG) relativistic laser pulse propagating in a plasma is studied in this article for first principles. A nonlinear Schrodinger-type equation is obtained for the beam spot profile and then solved numerically to investigate the pulse propagation characteristics. As series of numerical simulations are employed to trace the profile of the focused and compressed DHG laser pulse as it propagates through the plasma. The theoretical and simulation results predict that higher-order DHG pulses show smaller divergence as they propagate and, thus, lead to enhanced energy transport.

Auto-immune hepatitis following delivery

Auto-immune hepatitis first presenting in the early postpartum period is rare. Immunosuppressive effects of pregnancy result in delayed manifestation of auto-immune hepatitis, and in established cases, the spontaneous improvements are there. Auto-immune hepatitis should be considered in the differential diagnosis of liver dysfunction first presenting in the early postpartum period. A case of postpartum hepatitis of auto-immune aetiology is being presented here. It is disease of unknown aetiology, characterised by inflammation of liver (as evidenced by raised serum transaminases, presence of interface hepatitis on histological examination), hypergammaglobulinaemia (> 1.5 times normal), presence of auto-antibodies [(antinuclear antibodies (ANA)], smooth muscle antibody (SMA) and antibody to liver-kidney microsome type 1 (LKM1) in the absence of viral markers ie, hepatitis B (HBsAg) and C (AntiHCV) and excellent response to corticosteroid therapy.

Nanostructures of Sr2+ doped BiFeO3 multifunctional ceramics with tunable photoluminescence and magnetic properties

Careful tuning of formation (calcination) temperature of Sr(2+) doped BiFeO(3) multiferroic ceramics results in tailorable particle morphologies ranging from spherical to pillar-like. Based on the minimization of Gibb's free energy approach, the dominant homogeneous mechanism for particle growth is suggested. The chemical substitution of a trivalent ion (Bi(3+)) by a divalent ion (Sr(2+)) causes the transformation of certain fraction of Fe(3+) to Fe(4+) and/or the appearance of oxygen vacancies. This has been respectively proved by the analysis of XPS and refinement of neutron diffraction data. Although significant modification in the particle morphology is observed, the crystal unit cell remains rhombohedral with a R3c space group but interesting variations in physical properties are achieved. O-vacancies induced strong and sharp photoluminescence activity in the IR region, similar to ZnO, is reported for the first time. This observation opens up a new application for multiferroic ceramics. SQUID M-H data confirms the straightening of the canted spin structure of BiFeO(3), which in turn results in magnetism similar to ferromagnetic materials. Findings of the magneto-dielectric effect are also discussed to claim the multiferroic nature of the sample.

The therapeutic value of yoga in neurological disorders

Background:

The ancient mind and body healing methods of yoga recently sparked fervor in the scientific community as an alternative and complementary means of therapy. Since the World Health Organization officially began promoting yoga in developing countries in 1978, yoga has been cited for its therapeutic potential and has been widely recognized in Western culture. However, as an increasing number of people practice yoga for remedial purposes, researchers raise two important questions: 1) Is yoga a valid complementary management and rehabilitation treatment modality? 2) What conditions show promise of treatment with this intervention?.

Objective:

This review article uses comprehensive scientific, evidence-based studies to analyze the efficacy of various basic and applied aspects of yoga in disease prevention and health promotion. It specifically intends to expose the effects of yoga in neurological disorders, particularly epilepsy, stroke, multiple sclerosis, Alzheimer's disease, peripheral nervous system disease, and fibromyalgia.

Materials and Methods:

Information was gathered from various resources including PubMed, Ovid, MD-Consult, USC, and U.C.L.A. libraries. Studies were selected and reviewed on the basis of sample size, control, randomization, double-blinding, and statistical analysis of results.

Results:

The pratice of yoga and meditation demonstrates statistically encouraging physiological and psychological improvements in the aforementioned neurological disorders. However, there were certain flaws and inadequacies in the study designs employed to evaluate the same. A critical analysis of these studies is presented.

Conclusions:

With the aim to focus attention on this widespread yet largely unexamined treatment modality, this paper seeks to provide direction and support for further research necessary to validate yoga as an integrative, alternative, and complementary therapy.

Dental implants in growing children

The replacement of teeth by implants is usually restricted to patients with completed craniofacial growth. The aim of this literature review is to discuss the use of dental implants in normal growing patients and in patients with ectodermal dysplasia and the influence of maxillary and mandibular skeletal and dental growth on the stability of those implants. It is recommended that while deciding the optimal individual time point of implant insertion, the status of skeletal growth, the degree of hypodontia, and extension of related psychological stress should be taken into account, in addition to the status of existing dentition and dental compliance of a pediatric patient.

Factors predicting surgical outcome of thymectomy in myasthenia gravis: A 16-year experience

Aim:

To assess the surgical outcome of myasthenia gravis (MG) following thymectomy and to determine the outcome predictors to such therapeutic approach.

Materials and Methods:

This study is a retrospective review of 80 consecutive thymectomies performed for MG over a 16-year period.

Results:

There were 41 females and 39 males (mean age, 34.32 years) with mean disease duration of 17.45 months prior to surgery. Stagewise distribution of the patients revealed 2.5% in stage I, 48.7% in stage IIA, 33.8% in stage IIB, 8.7% in stage III, and 6.3% in stage IV. The surgical approach was either trans-sternal (n=67) or video-assisted thoracoscopic route (n=13). Follow-up was obtained in 91.2% (n=73) of patients with mean duration of 67.7 months. At their last follow-up, 26.0% were in complete remission, 35.6% were asymptomatic on decreased medications, and 17.8% had clinical improvement on decreased medications. Overall, 79.4% of patients benefited from surgery, 8.2% had unchanged disease status, and 12.3% worsened clinically. Factors influencing favorable outcome include sex, disease stage, gland weight, and preoperative medication with anti-cholinesterase (P<0.05). There was one death in the perioperative period due to septicemia. Two patients died at fourth and seventh month following thymectomy.

Conclusion:

Thymectomy for MG is safe and effective. Certain influencing factors may shape treatment decisions and target higher risk patients.

Bacterial etiology of acute diarrhea in children under five years of age

BACKGROUND

Diarrheal diseases are major problem of developing countries. Though precise data on childhood mortality associated with diarrheal diseases in Nepal is not available, it has been estimated that approximately 25% of child death are associated with diarrheal disease, particularly acute diarrhea. The purpose of this study was to assess the incidence of bacterial pathogens causing acute diarrhea in children under 5 years of age.

METHODS

A total of 525 children with acute diarrhea in a children's hospital of Kathmandu, Nepal were enrolled between April 2011 to September 2011. Feacal specimens for culture were inoculated to the several media. The organisms were identified by different biochemical tests and serotyping. Their antibiotic sensitivity tests were performed by Kirby-Bauer's disc diffusion method as recommended by CLSI.

RESULTS

Out of total 525 enrolled cases bacterial infection was found to be 46 (8.8%). Bacterial infection was found to be of highest, 36 (78.3%) in the age group between 6-24 months. Among the total enrolled cases the prevalence of Shigella species was 24 (4.6%) followed by Escherichia coli 12 (2.3%) and Salmonella species 10 (1.9%). Chloramphenicol and Tetracycline showed efficacy in 9 (90.0%) isolates of Salmonella species, Gentamycin showed efficacy in 22 (91.7%) isolates of Shigella species and Chloramphenicol showed 100% efficacy against Escherichia coli whereas 7 (70.0%) isolates of Salmonella species were resistant to ampicillin in vitro. MDR was highest 7 (70.0%) in Salmonella species.

CONCLUSIONS

The bacterial pathogens were found to be a significant cause of acute diarrhea. The most common causative organism for acute diarrhea were Shigella spp. Awareness of improving hygiene and infectious diseases may reduce the burden of infection.

Metallo-beta-lactamase producing gram-negative bacterial isolates

BACKGROUND

The global emergence of metallo-β-lactamase (MBL) producing bacterial isolates causing lower respiratory tract infection (LRTI) has resulted in fewer therapeutic options in treatment modalities. However, to our knowledge no studies regarding MBLs had been done so far in Nepal. Therefore, this study was carried out to assess the current level of MBL producing bacterial isolates in our setup.

METHODS

This was a cross-sectional study conducted over a period of six months (June to November 2008) at Bacteriology laboratory of a teaching hospital. A total of 1120 specimens representing lower respiratory tract (sputum, endotracheal secretion and bronchial washing) were processed from outpatients and inpatients, with suspected LRTI, at TUTH. The specimens were collected and processed according to the standard methodology. Combination disk method and Double disk synergy test methods were used for the detection of MBL producing isolates.

RESULTS

Respiratory pathogens were recovered from 497 (44.4%) of suspected cases. Among these, gram-negative bacteria were observed in 448 (84.0%). Multidrug resistance (MDR) was found in 286 (53.7%) of the total bacterial isolates. MBL was present in 6 (1.3%) of the total 448 gram-negative isolates. MBL was detected by both DDST and CD methods in 3 isolates each of Pseudomonas aeruginosa and Acinetobacter spp. from inpatients. All MBL producers were MDR.

CONCLUSIONS

MBL-producing gram negative bacteria were detected from LRTI isolates in this study and this data can be used as base-line information of this novel type of β-lactamase in our setup.

Clinicopathological profile, airway management, and outcome in huge multinodular goiters: an institutional experience from an endemic goiter region

BACKGROUND

Huge goiters are common in iodine-deficient endemic regions. They are of concern to the surgeons because of the anticipated risk of difficult dissection and increased chances of surgical complications. Similarly, they are of concern to the anesthesiologists because of anticipated intubation-related difficulties and post-thyroidectomy tracheomalacia. In the present study we aimed to present our experience of managing goiters based on their gross weight, highlighting their clinicopathological profile, perioperative airway-related difficulties, and management of surgical morbidity.

METHODS

Retrospective analysis of patients who underwent total thyroidectomy in the primary setting at our institute from 1995 to 2009 was carried out based on the gross gland weight. The patients were thus grouped into group A: ≤200 g; group B: 201 to ≤400 g; group C: 401 to ≤600 g; group D: >600 g.

RESULTS

Group A (660 cases); group B (108 cases); group C (36 cases); and group D (9 cases) were included. As the goiter size increased, the mean duration of goiter, compressive symptoms, retrosternal extension (RSE), airway deformity, intubation difficulty, and tracheomalacia increased. The rate of tracheostomy, sternotomy, hemorrhage, visceral injury, and hospital stay was high with huge goiters. These features were more marked in malignant goiters compared to benign goiters. However, the postoperative complications were comparable in both of those groups.

CONCLUSIONS

Long-standing huge goiters are common in iodine-deficient endemic areas. The majority of patients have symptomatic or clinicoradiological evidence of airway involvement. The incidence of RSE, airway deformity, intubation difficulty, and tracheomalacia is high with huge goiters. The surgery is technically demanding with greater associated chances of injury to native structures. Malignancy influences the presentation and outcome in smaller goiters. In centers with experienced endocrine surgeons and dedicated anesthetists, huge goiters can be successfully managed with minimal short-term and long-term morbidity.

Comparison of experimental and modeled absorption enhancement by black carbon (BC) cored polydisperse aerosols under hygroscopic conditions

The quantification of the radiative impacts of light absorbing ambient black carbon (BC) particles strongly depends on accurate measurements of BC mass concentration and absorption coefficient (β(abs)). In this study, an experiment has been conducted to quantify the influence of hygroscopic growth of ambient particles on light absorption. Using the hygroscopic growth factor (i.e., Zdanovskii-Stokes-Robinson (ZSR) approach), a model has been developed to predict the chemical composition of particles based on measurements, and the absorption and scattering coefficients are derived using a core-shell assumption with light extinction estimates based on Mie theory. The estimated optical properties agree within 7% for absorption coefficient and 30% for scattering coefficient with that of measured values. The enhancement of absorption is found to vary according to the thickness of the shell and BC mass, with a maximum of 2.3 for a shell thickness of 18 nm for the particles. The findings of this study underline the importance of considering aerosol-mixing states while calculating their radiative forcing.

Inheritance of plumage colour variations in a large flock of Japanese quail

1. The inheritance of various plumage colour variants and their underlying interactions were investigated in a large flock of Japanese quail maintained at CARI (India) by conducting reciprocal crosses between four breeding stocks inheriting Pharaoh, White Breasted, White and Brown plumages, followed by test crosses. 2. Based on the proportion of plumage-colour types in the progeny, putative genotypes were determined for parents and offspring for each of the crosses. 3. The White and Brown phenotypes were attributed to the Panda (S) and Roux (Br) loci respectively in agreement with contemporary quail stocks. 4. The White Breasted plumage type present in our stock was caused by a novel mutation with dominant gene action at an autosomal locus that was not allelic to either Panda or the White feather locus. 5. A recessive epistatic action of the Panda locus (S) on White Breasted (Wb) resulted in a White colour phenotype. 6. A novel phenotype, White Breasted-Brown was co-expressed with the Br and Wb loci. 7. It was concluded that breeding for customized feather colour phenotypes in Japanese quail using colour mutations was feasible and would be advantageous in order to overcome the limitations of legislation to protect wildlife in India.

Genetics of hyperpigmentation associated with the Fibromelanosis gene (Fm) and analysis of growth and meat quality traits in crosses of native Indian Kadaknath chickens and non-indigenous breeds

1. The study investigated the extent of hyperpigmentation (a trait fixed in native Indian Kadaknath chickens), bodyweight, carcase quality and leanness at 12 weeks of age in F(1) and back-crosses of Kadaknath with White Leghorn, White Plymouth Rock and Aseel Peela chickens. 2. The objective of the study was to determine if hyperpigmentation was affected by the major gene Fibromelanosis (Fm) and to evaluate the effects of different proportions of Kadaknath genes on growth and carcase quality. 3. The pigmentation pattern of skin indicated that Fm behaved as the primary locus affecting dermal-hyperpigmentation and that the sex-linked Id locus produced an epistatic effect. 4. The results suggested that variable allelic forms of Id were acting in different crosses, which resulted in variation in melanosis of the host. However, no conclusive pattern for shank pigmentation could be explained through genotyping of the Id and Fm loci. 5. Analysis of quantitative traits indicated the positive impact of a Kadaknath genomic proportion of 50% or more on meat texture and carcase leanness. Improvement in leanness occurred in White Rock crosses but not in White Leghorn and Aseel Peela crosses. 6. Thigh-meat texture was influenced more by enhanced Kadaknath genomic proportions than the breast-meat. It was concluded that introgression of Kadaknath genomic proportion beyond 50% in a cross with meat-type chickens, irrespective of the impact Fm, brought improvement in meat quality whereas no such advantage was obtained for growth traits. 7. The beneficial impact of the Kadaknath genome on meat quality calls for further studies to identify causative genes for their selective use to improve meat quality in Kadaknath crossbred chickens.

Status of pathology professionals

BACKGROUND

The status of basic, general and specialist workforces in pathology services in Nepal needs to be defined and explored for better pathology services. The objective of the study was to find out the status of laboratory medicine professionals (pathology workforces) and the regulation of ethics and limitations of the different level of workforces.

METHODS

A cross-sectional descriptive study was conducted by observing and taking interview with the head of the clinical private institutions from August 2008 to January 2009. A total of 373 private pathology laboratories and the workforces working over there were included in the study.

RESULTS

The workforces heading private pathology services showed that 153 (41%) of laboratories were headed by laboratory assistant, 79 (21%) by laboratory technician, 90 (24%) by (medical technologist) pathology officer, 30 (8%) by histocytopathologist and 21 (6%) by non pathology professionals. Officer level Pathology workforce (eligible to work independently) was 113 (30%) whereas 260 (70%) of laboratories had no such workforces. Intermediate level Pathology workforce (eligible to work dependently and for some investigation independently) was 34% (127/373) where as 66% (246/373) of laboratories were lacking such workforces. Specialist level (MD/M. Sc) workforces in histocytopathology, clinical microbiology and cytopatholgy & hematology were 43 (11%), 10 (3%) and 3 (1%) respectively.

CONCLUSIONS

The workforces heading the private laboratories were not according to the norms of good laboratory practices. The workforces had crossed their limitations and ethical barrier in performing pathological investigations which did not abide by the rules and regulations made by respective councils of Nepal by pathology workforces. There was intervention of non medical/clinical workforce in laboratory services especially in microbiology and biochemistry.

Single Step Endodontic Management of Immature Apices using MTA

AIM

To examine the clinical and radiographic appearance of teeth with immature apices that were treated by single step procedure using mineral trioxide aggregate (MTA).

SUMMARY

Creation of a physiological hard tissue barrier with calcium hydroxide in a nonvital tooth although quite predictable has certain limitations, such as the very long duration of the treatment spread over multiple visits and increased risk of root fracture. Plugging the root canal end with MTA has been advocated as an alternative treatment modality for open apices. The technique has been proven to be successful in many recently reported cases. The cases reported here present the successful treatment of two traumatized maxillary central incisors with open apices and periapical lesions using MTA. In this case report, MTA has been used to create a hard tissue barrier after disinfection of the root canal.

Evaluation of effects of eicosapentaenoic acid on Na⁺-K⁺-ATPase in sheep pulmonary artery

In the present study, we have evaluated the effects of eicosapentaenoic acid (EPA) on Na(+)-K(+)-ATPase in sheep pulmonary artery. Acute (30 min) and prolonged (24 h) exposure of arterial rings to EPA (30 μM) significantly decreased potassium chloride (KCl)-induced relaxation, an index of functional Na(+)-K(+)-ATPase activity. In acute exposure, the pD(2) and E (max) (the maximal response) values for KCl-induced relaxation were 3.21 ± 0.33 and 61.58 ± 11.30% (n = 5) versus control 3.58 ± 0.07 and 82.44 ± 2.36% (n = 24), respectively. The pD(2) and E (max) values for KCl-induced relaxation in arterial rings exposed to EPA for 24 h in organ culture were 2.52 ± 0.11 and 55.00 ± 5.72% versus control 3.04 ± 0.19 and 80.74 ± 11.96%, respectively; n = 4. Exposure of the arterial rings to EPA (30 μM) for 24 h in organ culture, significantly decreased (17.58 ± 2.15%) the protein expression of α(1) isoform of Na(+)-K(+)-ATPase. Acute exposure to EPA for 30 min significantly decreased (21.06 ± 5.89%) the Na(+)-K(+)-ATPase activity as measured by inorganic phosphate (Pi) release. EPA, up to 100 μM concentration, marginally (<10% of 80 mM KCl contraction) increased the basal tone of the pulmonary artery. Additionally, EPA (10-30 μM) had no effect on Mg(2+)-ATPase activity as well as on cyclic guanosine monophosphate (cGMP) production. All these results show that EPA has inhibitory effect on Na(+)-K(+)-ATPase in sheep pulmonary artery but prolonged exposure had no additional effect on sodium pump, and EPA-induced inhibition of Na(+)-K(+)-ATPase may be due to attenuation in protein expression of α(1) isoform of Na(+)-K(+)-ATPase independent of cGMP production.

Immobilization of uricase enzyme on self-assembled gold nanoparticles for application in uric acid biosensor

An enzyme immobilization matrix is described by preparing a self-assembly of gold nanoparticles (GNPs) over a self-assembled monolayer (SAM) of 3-aminopropyltriethoxysilane (APTES) on an indium-tin-oxide (ITO) coated glass plate. The surface of the GNPs was modified with a mixed (1:9) SAM of 11-mercaptoundecanoic acid (MUA) and 3-mercapto-propionic acid (MPA). The enzyme, uricase was covalently immobilized to the carboxyl groups of the mixed SAM of MUA/MPA through carbodiimide coupling reaction. The whole assembly was constructed on 1 cm2 area of ITO-glass plate and was tested as an amperometric biosensor for the detection of uric acid in aqueous solution. The biosensor assembly was characterized by atomic force microscopy (AFM) and electrochemical techniques. The AFM of the enzyme biosensor assembly reveals an asymmetrical sharp regular island-like structure with an average roughness parameter value of 2.81 nm. Chronoamperometric response was measured as a function of uric acid concentration in aqueous solution (pH 7.4), which exhibits a linear response over a concentration range of 0.07 to 0.63 mM with a sensitivity of 19.27 microAmM(-1) and a response of 25 s with excellent reproducibility. These results are not influenced by the presence of interfering reagents such as ascorbic acid, urea and glucose. GNPs-biomolecule assemblies constructed using this method may facilitate development of new hybrid biosensing materials.

Primary hypothyroidism, precocious puberty and hypothalamic obesity in Langerhans cell histiocytosis

A 5 year old girl presented with central diabetes insipidus and primary hypothyroidism. No clinical or radiological evidence of Langerhans cell histiocytosis (LCH) was present. Absent posterior pituitary bright spot was seen in magnetic resonance imaging of the brain. She subsequently developed severe headache, massive obesity, accelerated growth and thelarche. A repeat MRI of the brain revealed hypothalamic tumor. Hormonal investigations revealed, paradoxically, undetectable growth hormone on a clonidine stimulation test. Langerhans cell histiocytosis was proved on electron microscopy of the thyroid tissue. There needs to be a high degree of suspicion for LCH as an etiology of primary hypothyroidism, especially in the presence of diabetes insipidus. Precocious puberty, accelerated growth despite growth hormone deficiency, hypothalamic obesity may occur in pediatric LCH. CNS lesions may have an evolving course, thus repeat neuroimaging is important.

Multiple drug resistance in bacterial isolates from liquid wastes generated in central hospitals of Nepal

BACKGROUND

Healthcare liquid wastes are the reservoirs of harmful infectious agents such as the pathogens and multiple drug resistant microorganisms. Potential infectious risks include the spread of infectious diseases and microbial resistance from health-care establishments into the environment and thereby posing risks of getting infections and antibiotic resistance in the communities.

OBJECTIVES

The objectives of this study were to assess the bacterial load of healthcare liquid waste generated in central hospitals and to explore the antimicrobial resistance pattern of these bacterial isolates.

MATERIALS AND METHODS

A descriptive study was carried out in 10 conveniently selected central hospitals of Nepal during the period of May to December 2008. Effluent specimens from each hospital were subjected to total viable count studies by spread plate method in nutrient agar plate and incubated for 24 hours at 37 °C using standard laboratory protocol. Similarly, all the specimens were cultured in Mac Conkey Agar media supplemented with 30 μg/ml of Chloramphenicol and 20 μg/ml of Gentamycin for the enumeration of multiple drug resistant (MDR) bacteria, which were further subjected to in-vitro antibiotic susceptibility test by modified Kirby Bauer disc diffusion technique for resistance patterns.

RESULTS

Total viable counts of hospital effluents significantly exceeded the standard heterotrophic plate count (p=0.000). Similarly, the numbers of multiple drug resistant bacteria were alarmingly high in three (more than 30% in 2 and 50% in 1) hospitals of this study. Drug resistant hospital effluent isolates showed simultaneous resistance for most of the antibiotics including Penicillin, Cephalosporin, Cotrimoxazole, Gentamycin and Quinolones.

CONCLUSION

Healthcare liquid wastes were laden with MDR bacteria and seemed to pose a huge public health threat in the transfer of such resistance to the bacterial pathogens causing community acquired infections, thereby limiting our antibiotic pool.