Complete endoscopic management of a retained bullet in the bladder.

A 25-year-old male gunshot victim presented at our institution with gross hematuria following Foley catheter insertion. Computed tomography and cystogram did not show a bladder perforation, but were notable for a left ischial fracture and the presence of a bullet within the bladder. After failed attempts at retrieving the bullet with a resectoscope and loop, as well as a cystoscope and stone crusher, a 26 French nephroscope was inserted transurethrally, and the bullet was successfully engaged and removed using a Perc NCircle (Cook Medical, Bloomington, IN) grasper.

Recurrent neurofibroma of the orbit.

A 55-year-old male patient presented with gradual progressive outward and downward deviation of right eye since last two years, with history of a similar complaint 10 years ago when he was diagnosed as having neurofibroma of the orbit. Computed Tomography imaging revealed a large, multilobulated, heterogeneous, soft tissue density mass lesion in the retro bulbar region on the medial side of right orbit suggestive of a neurofibroma. Excision and histopathology confirmed it to be a recurrence of neurofibroma of the orbit.

Disseminated cerebral and spinal tuberculomas: rare cause of triparesis.

Tuberculosis continues to remain a significant public health problem in developing nations, causing substantial morbidity and mortality. Central nervous system (CNS) tuberculosis is frequently observed in endemic zones of tuberculosis including India. The emergence of infections like HIV and malnutrition ruined the public health measures to restrain tuberculosis in developing countries.

Management of symphysis fracture in a 3-year-old child with prefabricated acrylic splint and circum-mandibular wiring.

Pediatric mandibular fractures are often the sequelae of facial skeletal injuries in patients with trauma and frequently require hospitalization. Due to the retrusive mid-face position relative to the calvarial prominence, facial fractures are rare in children younger than 5 years of age. Although rare, they most often occur as a result of motor vehicle accidents.

Long-term pulmonary outcomes of patients with bronchopulmonary dysplasia.

Bronchopulmonary dysplasia (BPD) is the commonest cause of chronic lung disease in infancy. The incidence of BPD has remained unchanged despite many advances in neonatal care. BPD starts in the neonatal period but its effects can persist long term.

Neutrophils release extracellular DNA traps during storage of red blood cell units.

Background: Blood transfusion is associated with an increased risk of organ damage, infection, and alloimmunity. Neutrophil extracellular traps (NETs) are extracellular chromatin fibers decorated with neutrophil granular proteins that have been linked to cytotoxicity, thrombosis, and autoimmunity. We questioned whether neutrophils in blood products release NETs during storage and thus could contribute to adverse reactions from blood transfusions.

Ceramide-2 nanovesicles for effective transdermal delivery: development, characterization and pharmacokinetic evaluation.

Unlabelled: Abstract Context: The vesicles based on skin lipid have a drug localization effect and its main lipid, ceramide provides protective and regenerative effects while oleic acid (OA) is a penetration enhancer, however, it causes slight irritation, so we have formulated formulation incorporating both of these to develop a transdermal formulation for better permeation.

Objective: Present study investigated the preparation and characterization of physicochemical properties and permeation of nanovesicles of ceramide-2 containing OA and palmitic acid (PA) respectively and a commercial gel.

Materials And Methods: The vesicles were made using ceramide 2, cholesterol (Chol), cholesteryl sulfate (CS) and OA or PA, respectively, using film hydration method.

Biomarkers in bronchopulmonary dysplasia.

Bronchopulmonary dysplasia (BPD) is a complex disorder secondary to gene-environment interactions, and is the commonest chronic lung disease in infancy. There is no specific or effective treatment available to date for BPD. Since the aetiopathogenesis of BPD is multifactorial, involving diverse molecular signaling pathways, a variety of biomarkers detected in biological fluids have been proposed for early identification of infants predisposed to BPD.

Road traffic accidents in Kathmandu--an hour of education yields a glimmer of hope.

After the Metropolitan Traffic Police, Kathmandu initiated a "No Drinking and Driving" policy in 2011 in which a major intervention for intoxicated drivers was mandatory 1-hour class to modify drunk driving behaviors, reports show that the number of road traffic accidents in the year 2012 decreased by 23 percent from the year 2011. The injury to fatality ratio decreased by 21 percent in this period. We remain encouraged by these statistics which confirm that increased enforcement of road traffic rules, combined with behavioral change programs, can have positive changes in LMICs which suffer considerably from the global burden of trauma.

Gyrate atrophy of choroid and retina with myopia, cataract and systemic proximal myopathy: A rare case report from rural India.

Gyrate atrophy is a rare metabolic disease with autosomal recessive inheritance pattern characterised by hyperornithinemia and typical ocular findings. This report presents a 17-year-old intellectually challenged girl consulting for a progressive fall of visual acuity with night blindness. Fundus examination showed patches of chorioretinal atrophy with typical scalloped borders and peri vascular pigmentation in the equatorial region.

Wdr68 requires nuclear access for craniofacial development.

Wdr68 is a highly conserved scaffolding protein required for craniofacial development and left-right asymmetry. A Ras-Map3k-Wdr68-Dyrk1 signaling relay may mediate these and other diverse signaling events important in development and disease. While the sub-cellular localization of Wdr68 has been shown to be dependent on that of its interaction partners, it is not clear where Wdr68 activity is required during development.

Antioxidant potential and total phenolic content of methanolic bark extract of Madhuca indica (koenig) Gmelin.

This study was carried out to investigate the antioxidant and free radical scavenging activity of methanolic extract of Madhuca indica bark in varios systems. DPPH radical, superoxide anion radical, nitric oxide radical, hydroxyl radical, lipid peroxidation, and total phenolic content assays were carried out to evaluate the antioxidant potential of the extract. The percentage inhibition of 40 μg/ml concentration of MMI in DPPH radical scavenging model was found as 74.

Preparation, characterization and permeation studies of a nanovesicular system containing diclofenac for transdermal delivery.

Context: Transdermal formulations contain permeation enhancer which causes skin damage. Ceramide 2 is natural lipid found in stratum corneum (SC).

Objective: Drug-loaded nanovesicles of ceramide-2, cholesterol, palmitic acid, cholesteryl sulfate were formulated and analyzed for physical and biological properties.

Behavior of an MBT waste in monotonic triaxial shear tests.

Legislation in some parts of the world now requires municipal solid waste (MSW) to be processed prior to landfilling to reduce its biodegradability and hence its polluting potential through leachate and fugitive emission of greenhouse gases. This pre-processing may be achieved through what is generically termed mechanical-biological-treatment (MBT). One of the major concerns relating to MBT wastes is that the strength of the material may be less than for raw MSW, owing to the removal of sheet, stick and string-like reinforcing elements during processing.

Whole-genome sequencing in autism identifies hot spots for de novo germline mutation.

De novo mutation plays an important role in autism spectrum disorders (ASDs). Notably, pathogenic copy number variants (CNVs) are characterized by high mutation rates. We hypothesize that hypermutability is a property of ASD genes and may also include nucleotide-substitution hot spots.

The effect of acute versus delayed remote ischemic preconditioning on reperfusion induced ventricular arrhythmias.

Introduction: The effect of remote ischemic preconditioning (RIPC) on arrhythmias in in vivo models is unknown. Our purpose was to determine effects of both acute and delayed RIPC on arrhythmias.

Methods And Results: In the acute protocol anesthetized open chest rats were exposed to 5 minutes of proximal left coronary artery occlusion (CAO) and 10 minutes of reperfusion.

Stabilization of enzymatically polymerized phenolic chemicals in a model soil organic matter-free geomaterial.

A variety of remediation methods, including contaminant transformation by peroxidase-mediated oxidative polymerization, have been proposed to manage soils and groundwater contaminated with chlorinated phenols. Phenol stabilization has been successfully observed during cross polymerization between phenolic polymers and soil organic matter (SOM) for soils with SOM >3%. This study evaluates peroxidase-mediated transformation and removal of 2,4-dichlorophenol (DCP) from an aqueous phase in contact with a natural geomaterial modified to contain negligible (<0.

Stokes scattering matrix for human skin.

We use a layered model of normal human skin based on size distributions of polydisperse spherical particles and their complex refractive indices to compute the Stokes scattering matrix at wavelengths in the visible spectral band. The elements of the Stokes scattering matrix are required in a polarized radiative transfer code for a coupled air-tissue system to compute the polarized reflectance and examine how it is dependent on the vertical structure of the inherent optical properties of skin, including the phase matrix. Thus, the elements of the Stokes scattering matrix can be useful for investigating polarization-dependent light propagation in turbid optical media, such as human skin tissue.

Helicobacter pylori in gastric malignancies.

Helicobacter pylori infection remains common worldwide and is significantly associated with gastric adenocarcinoma and gastric mucosa-associated lymphoid tissue (MALT)lymphoma. This article reviews recent developments in the field of H. pylori with an emphasis on mechanisms of carcinogenesis, and the bacterial, environmental and host factors that may alter risk of developing gastric cancer or gastric MALT lymphoma.

Effect of metabolic syndrome on pathologic features of prostate cancer.

Objective: The prevalence of metabolic syndrome has been increasing worldwide, however its association with prostate cancer (CaP) is unclear. We reviewed patients undergoing robot assisted radical prostatectomy (RARP) to evaluate if those with metabolic syndrome had more aggressive disease.

Materials And Methods: A prospective database of patients undergoing RARP between January 2005 and December 2008 (n = 2756) was queried for components of metabolic syndrome (BMI ≥ 30 and ≥ 2 of the following: hypertension, diabetes or elevated blood glucose, and dyslipidemia; n = 357).

Stigma related to tuberculosis among patients attending DOTS clinics of Dharan municipality.

Background: The patients suffering from tuberculosis are receiving shame and unfair treatment from the people living around them within their own society attending DOTS clinic of Dharan municipality.

Objective: To assess the stigma experienced by tuberculosis patients and to find out the association between stigma experienced by Tuberculosis patient and the selected variables (socio-demographic characteristics, clinical profile and illness experience).

Methods: Descriptive Cross Sectional study was done among sixty tuberculosis patients.

Fitting Community Based Newborn Care Package into the health systems of Nepal.

Community-based strategies for delivering effective newborn interventions are an essential step to avert newborn death, in settings where the health facilities are unable to effectively deliver the interventions and reach their population. Effective implementation of community-based interventions as a large scale program and within the existing health system depends on the appropriate design and planning, monitoring and support systems. This article provides an overview of implementation design of Community-Based Newborn Care Package (CB-NCP) program, its setup within the health system, and early results of the implementation from one of the pilot districts.

State of maternal, newborn and child health programmes in Nepal: what may a continuum of care model mean for more effective and efficient service delivery?

The cost-effective interventions exist across the continuum of maternal to child survival at each level of the health system that can contribute to achieve the Millennium Development Goals 4 and 5. However, implementation inefficiency, low coverage and equity gaps along this continuum remain a serious challenge to Nepal's efforts to achieve these goals. This paper proposes a continuum of care model; discusses the readiness of policy and programs to provide high impact interventions across the continuum; identifies existing gaps in MNCHN programs; and recommends policy and program actions to improve coverage, equity, effectiveness and efficiency along the continuum of MNCHN service delivery in Nepal.

Newborn survival in Nepal: a decade of change and future implications.

Nepal is on target to meet the Millennium Development Goals for maternal and child health despite high levels of poverty, poor infrastructure, difficult terrain and recent conflict. Each year, nearly 35,000 Nepali children die before their fifth birthday, with almost two-thirds of these deaths occurring in the first month of life, the neonatal period. As part of a multi-country analysis, we examined changes for newborn survival between 2000 and 2010 in terms of mortality, coverage and health system indicators as well as national and donor funding.

Anvaya: a workflows environment for automated genome analysis.

Anvaya is a workflow environment for automated genome analysis that provides an interface for several bioinformatics tools and databases, loosely coupled together in a coordinated system, enabling the execution of a set of analyses tools in series or in parallel. It is a client-server workflow environment that has an advantage over existing software as it enables extensive pre & post processing of biological data in an efficient manner. "Anvaya" offers the user, novel functionalities to carry out exhaustive comparative analysis via "custom tools," which are tools with new functionality not available in standard tools, and "built-in PERL parsers," which automate data-flow between tools that hitherto, required manual intervention.