A preliminary report on the genetic variation in pointed gourd (Trichosanthes dioica Roxb.) as assessed by random amplified polymorphic DNA

Pointed gourd (Trichosanthes dioica Roxb.) is an economically important cucurbit and is extensively propagated through vegetative means, viz vine and root cuttings. As the accessions are poorly characterized it is important at the beginning of a breeding programme to discriminate among available genotypes to establish the level of genetic diversity. The genetic diversity of 10 pointed gourd races, referred to as accessions was evaluated. DNA profiling was generated using 10 sequence independent RAPD markers. A total of 58 scorable loci were observed out of which 18 (31.03%) loci were considered polymorphic. Genetic diversity parameters [average and effective number of alleles, Shannon's index, percent polymorphism, Nei's gene diversity, polymorphic information content (PIC)] for RAPD along with UPGMA clustering based on Jaccard's coefficient were estimated. The UPGMA dendogram constructed based on RAPD analysis in 10 pointed gourd accessions were found to be grouped in a single cluster and may represent members of one heterotic group. RAPD analysis showed promise as an effective tool in estimating genetic polymorphism in different accessions of pointed gourd.

Recurrent pneumonia-H type Tracheoesophageal fistula, diagnostic dilemma

Tracheoesophageal fistula (TEF) without associated esophageal atresia (EA) is a rare congenital anomaly.  Most of the children are treated for episodes of pneumonia prior to definitive diagnosis.  A 5 months infant presented with recurrent pneumonia and diagnosis of H type TEF was made with contrast esophagram.DOI: http://dx.doi.org/10.3126/jnps.v34i1.8517   J Nepal Paediatr Soc 2014;34(1):71-73

ZnO nanowire arrays on 3D hierachical graphene foam: biomarker detection of Parkinson's disease

We report that vertically aligned ZnO nanowire arrays (ZnO NWAs) were fabricated on 3D graphene foam (GF) and used to selectively detect uric acid (UA), dopamine (DA), and ascorbic acid (AA) by a differential pulse voltammetry method. The optimized ZnO NWA/GF electrode provided a high surface area and high selectivity with a detection limit of 1 nM for UA and DA. The high selectivity in the oxidation potential was explained by the gap difference between the lowest unoccupied and highest occupied molecular orbitals of a biomolecule for a set of given electrodes. This method was further used to detect UA levels in the serum of patients with Parkinson's disease (PD). The UA level was 25% lower in PD patients than in healthy individuals. This finding strongly implies that UA can be used as a biomarker for PD.

Effect of Antibiotic Pretreatment on Cerebrospinal Fluid Profiles of Children with Acute Bacterial Meningitis

Background: Analysis of cerebrospinal fluid is gold standard for diagnosis of meningitis. There is considerable difficulty in interpreting laboratory finding after prior antibiotic therapy. This study was conducted to evaluate the effect of intravenous antibiotic administration before lumbar puncture on cerebrospinal fluid profiles in children with bacterial meningitis. Methods: A hospital based retrospective study carried out using the data retrieved from the medical record department of Manipal Teaching Hospital Pokhara, Nepal; from 1st July 2006 to 31st July 2011. Clinical findings and relevant investigations were entered in a predesigned proforma. Patients were divided in two different groups as bacterial meningitis with and without prior intravenous antibiotic therapy. Various laboratory parameters including CSF were compared between these two groups using the statistical software, SPSS version 18.0. Results: A total of 114 children were included in this study among which 49(43%) children had received intravenous antibiotics before lumbar puncture. Mean CSF WBC count was(267.6± 211 vs. 208.1±125.3.3) and protein level (114.1±65.9 vs. 98.3±37.7mg/dl) in untreated vs. pretreated groups respectively. Neutrophil percentage was decreased (57.1±28.1vs.72.9±18.9) with higher CSF sugar level (43.3±11.8 vs. 51.2±13.2) after prior antibiotics therapy (p<0.001). Conclusion: Antibiotic pretreatment was associated with higher cerebrospinal fluid glucose levels with decreased neutrophils and increased lymphocytes. Pretreatment did not modify total cerebrospinal fluid white blood cell count and cerebrospinal fluid protein levels. Nepal Journal of Medical Sciences | Volume 02 | Number 02 | July-December 2013 | Page 135-139 DOI: http://dx.doi.org/10.3126/njms.v2i2.8963

Sea urchin like shaped cdse nanoparticles grown in aqueous solutions via electron beam irradiation

Cadmium selenide (CdSe) nanoparticles have been grown from an aqueous solutions containing equimolar ammoniated cadmium sulphate and sodium selenosulphate as precursors in presence of citric acid as a capping agent, via electron beam irradiation. The radiolytic processes occurring in the medium result in the formation of CdSe nanoparticles through the reactions mediated by hydrated electrons (e(aq)-). The dynamics of the formation of these nanoparticles was investigated by pulse radiolysis studies. The size of the primary nanoparticles as estimated from the absorption spectra recorded immediately was less than 3 nm. These nanoparticles exhibited strong excitonic absorption pattern and broad photoluminescence at room temperature, which has been attributed to the presence of surface states/defects. This has been confirmed by Raman spectral studies, where CdSe nanoparticles exhibited characteristic surface phonon modes at around 250 cm(-1). The photoluminescence lifetime decay measurements further supported the existence of surface defects on the as-grown CdSe nanoparticles. These nanoparticles were found to exist in the agglomerated form of sea urchin like shapes of uniform size of about 500 nm as revealed from TEM and SEM images. These sea urchin like shaped CdSe nanoparticles grown in this route were found to be very stable under the ambient conditions. We infer that citric acid influences the growth as well as stability of these nanoparticles. It is expected that these nanomaterials could find potential applications in the field of sensors, catalysis and photovoltaics.

Validation of performance of certified medical assistants in preschool vision screening examination

INTRODUCTION

Preschool vision screening examination is still a new concept in Nepal. There is a need for developing cost-effective tools for detecting amblyogenic factors in Nepalese children. Certified medical assistants (CMA) are health personnel who work in village health posts.

OBJECTIVE

To find out the effectiveness of vision screening by certified medical assistants using simple tools like an HOTV chart and the Red Reflex test.

MATERIALS AND METHODS

A cross sectional and validation study was carried out in two phases. In the first phase, 20 CMAs from each Village Development Centre (VDC) of the Bhaktapur District were given training on visual acuity test by using an HOTV chart, Bruckner test by using a retinoscope and the test for ocular alignment by a torch light. In the second phase, children aged 3 - 7 years were examined by trained certified medical assistants in five remote VDCs of Bhaktapur District. These children underwent the gold standard examination by two pediatric ophthalmologists blind to the CMAs± findings.

RESULTS

The mean age of children was 5.26 ± 376 years. The overall sensitivity of certified medical assistants examination was 58 % and the specificity was 98 %. While comparing the test characteristics of different examination tools, the HOTV test was found to be the most effective one with the sensitivity of 80 % and the specificity of 98 %.

CONCLUSION

Vision screening by certified medical assistants can help in detection and early referral of children having amblyogenic risk factors with high sensitivity. The HOTV test is the most effective one with high sensitivity and specificity. In developing countries like Nepal,where access to regular eye examination is a rare possibility, preschool vision screening using the HOTV test can be effective.

Fulminant hepatic failure due to dengue

Dengue Fever (DF) is only rarely considered as a cause of acute liver failure even globally and only a few case reports of acute hepatic failure and encephalopathy occurring in DF in adults are available. We report a case of Acute Liver Failure due to Dengue during a major outbreak in 2010 in Chitwan. A 20 year old previously healthy female presented to the emergency department of Chitwan Medical College with fever, jaundice and altered sensorium. She was tested positive for Dengue IgM. Her biochemical and clinical parameters were suggestive of acute liver failure with total billirubin of 10.1 mg/dL, direct billirubin of 5.2 mg/dL, ALT 5760 IU, AST 14100 IU, alkaline phosphatase of 1250 IU, PT INR of 1.76 and platelet count of 30,000/mm3. Other causes for acute hepatic failure like acute viral hepatitis, leptospirosis, malaria, Reyes syndrome were ruled out. The patient was admitted and managed in the ICU with supportive care and platelet transfusion. With treatment she made a significant clinical and biochemical improvement with AST of 105 IU, ALT of 120 IU and platelet count of 150,000/mm3. She was discharged after 11 days of hospital stay.

Anterior tibial artery perforator plus flaps for reconstruction of post-burn flexion contractures of the knee joint

Background. Post-burn flexion contractures of the knee may arise even with adequate treatment of the burn injury. After release of the contracture, most of these defects require flap coverage. Here we describe the application of the perforator plus flap concept in the management of these contractures. Method. Between December 2010 and December 2011 five female and two male patients with knee contractures were operated on using a perforator plus flap from the anterior tibia artery perforator. In one patient both sides were operated on and the rest had unilateral surgeries. All patients had mature scars and the aetiology was thermal burn injury. All these contractures were categorized as Category 4 and Level 3 by the ICIDH guidelines with an average contracture angle of 87.5 degrees. The flap was raised after release of the defect and a Doppler study located the perforator below the fibular head. The base of the flap was kept intact at all times. The flap was then transposed towards the defect and inset in a tensionless manner. Results. All flaps survived well with marginal necrosis in only one flap, providing stable coverage to the knee joint. The average residual contracture was around 10 degrees and the average range of flexion was 10-120 degrees. Conclusion. The perforator plus flap can be an excellent choice in defects over the posterior aspect of the knee where important neurovascular structures and tendons are exposed.

LEVEL OF EVIDENCE

Level IV.

Strengthening national health systems for improving efficiency of health service delivery in Nepal

The success of Nepal's community-based health programmes in promoting maternal and child health has been achieved due to an overall improvement in service delivery facilities and health support systems. This article assesses the progress made by the Government of Nepal in improving health service delivery by introducing three key components: an improved health logistics management, facility-based maternal and neonatal health services, and decentralized health facility management.

Goldenhar Syndrome in Association with Duane Syndrome

Goldenhar syndrome (GHS) is also known as Oculo-Auriculo-Vertebral (OAV) syndrome or Branchial arch syndrome. Duane retraction syndrome (DRS) is a congenital disorder of ocular motility characterized by limited abduction, adduction or both. It is unilateral in 80% of cases. The important and interesting part of this eight months old child is presence of GHS with DRS. She has bilateral invol-vement, which is seen in only 5-8% of GHS, as compared to high incidence of unilateral involve-ment. This child also had refractive error of + 6.00/ - 1.5 * 180. At four year of age her vision with glass was 6/9. Children with GHS and DRS should have early eye examination done to treat the problem of refractive error. Keywords: Duane retraction syndrome; goldenhar syndrome, refractive error.

Bilateral Congenital Cataract Associated with Multiple Epiphyseal Dysplasia: A case Report

Cataract in children has varied etiology. It may be associated with systemic diseases including skeletal dysplasias. However cataract in Multiple Epiphyseal Dysplasia is a rare association. A child presented with bilateral dense posterior sub capsular cataract and multiple bony abnormalities. Clinical and radiographic findings suggested the disease to be Multiple Epiphyseal Dysplasia. The aim of presenting this case is to report a case of congenital cataract having a rare association with the Multipe Epiphyseal Dyspalsia. Key words: Congenital cataract; Multiple Epiphyseal Dysplasia; Skeletal dysplasia DOI: http://dx.doi.org/10.3126/jnps.v32i1.5434   J. Nepal Paediatr. Soc. Vol.32(1) 2012 71-72

Aberrant regeneration of the third cranial nerve

BACKGROUND

Aberrant regeneration of the third cranial nerve is most commonly due to its damage by trauma.

CASE

A ten-month old child presented with the history of a fall from a four-storey building. She developed traumatic third nerve palsy and eventually the clinical features of aberrant regeneration of the third cranial nerve. The adduction of the eye improved over time. She was advised for patching for the strabismic amblyopia as well.

CONCLUSION

Traumatic third nerve palsy may result in aberrant regeneration of the third cranial nerve. In younger patients, motility of the eye in different gazes may improve over time.

Goldenhar syndrome in association with Duane syndrome

Goldenhar syndrome (GHS) is also known as Oculo-Auriculo-Vertebral (OAV) syndrome or Branchial arch syndrome. Duane retraction syndrome (DRS) is a congenital disorder of ocular motility characterized by limited abduction, adduction or both. It is unilateral in 80% of cases. The important and interesting part of this eight months old child is presence of GHS with DRS. She has bilateral invol-vement, which is seen in only 5-8% of GHS, as compared to high incidence of unilateral involve-ment. This child also had refractive error of + 6.00/ - 1.5 * 180. At four year of age her vision with glass was 6/9. Children with GHS and DRS should have early eye examination done to treat the problem of refractive error.

Effective mechanical properties of hexagonal boron nitride nanosheets

We propose an analytical formulation to extract from energy equivalence principles the equivalent thickness and in-plane mechanical properties (tensile and shear rigidity, and Poisson's ratio) of hexagonal boron nitride (h-BN) nanosheets. The model developed provides not only very good agreement with existing data available in the open literature from experimental, density functional theory (DFT) and molecular dynamics (MD) simulations, but also highlights the specific deformation mechanisms existing in boron nitride sheets, and their difference with carbon-based graphitic systems.