Geotechnical Effects of the 2015 Magnitude 7.8 Gorkha, Nepal, Earthquake and Aftershocks

This article summarizes the geotechnical effects of the 25 April 2015 M 7.8 Gorkha, Nepal, earthquake and aftershocks, as documented by a reconnaissance team that undertook a broad engineering and scientific assessment of the damage and collected perishable data for future analysis. Brief descriptions are provided of ground shaking, surface fault rupture, landsliding, soil failure, and infrastructure performance. The goal of this reconnaissance effort, led by Geotechnical Extreme Events Reconnaissance, is to learn from earthquakes and mitigate hazards in future earthquakes.This is the publisher’s final pdf. The published article is copyrighted by Seismological Society of America and can be found at: http://www.seismosoc.org/publications/srl

Hepatic segmental arterial mediolysis: A case report and brief literature review

Key Clinical message When evaluating patients with abdominal pain, it is important to consider SAM in the differential diagnosis, along with vasculitis, fibromuscular dysplasia (FMD), atherosclerosis, mycotic aneurysms, and cystic medial degeneration. Abstract Segmental arterial mediolysis (SAM) is a rare arteriopathy which is an under‐recognized and commonly missed diagnosis of abdominal pain. We report a case of a 58‐year‐old female who presented with abdominal pain and was misdiagnosed with a urinary tract infection. The diagnosis was made with CTA and managed with embolization. Despite appropriate intervention and close hospital monitoring, further complications were inevitable. We conclude that though literature has shown better prognosis and even complete resolution after medical and/or surgical intervention, close follow up and monitoring is needed to avoid unexpected complications

In Vitro Scanning Electron Microscopic Study on the Effect of Doxycycline and Vancomycin on Enterococcal Induced Biofilm

INTRODUCTION: Enterococcus (E) faecalis bacteria adhere to dentine of teeth root canals to form the biofilm. E. faecalis has been shown to be resistant to antibiotics. This in vitro study aimed to investigate the efficacy of vancomycin and doxycycline in inhibiting E. faecalis biofilm formation. MATERIALS AND METHODS: A total of 60 extracted human teeth were incubated with E. faecalis (ATCC 35550 strain) for 45 days to allow biofilm formation. The teeth were equally divided into six groups (n=10): 1) positive control, 2) negative control, 3) doxycycline alone 4) doxycycline with filing, 5) vancomycin alone, 6) vancomycin with filing. The relevant canals were irrigated with 4µg/mL of either vancomycin or doxycycline antibiotic. Teeth were processed for scanning electron microscopy (SEM). Areas of biofilm remaining in the canals after antibiotic treatment were measured with Scion image analysis software using the SEM images. RESULTS: Vancomycin is more effective in reducing the overall biofilm area compared with doxycycline; moreover filing after antibiotic administration increased this effect. CONCLUSION: We can conclude that vancomycin had greater efficacy than doxycycline for inhibiting and reducing E. faecalis biofilms growth in root canals.  However, it failed to completely eliminate biofilm formation

Effects of abortion legalization in Nepal, 2001-2010.

Abortion was legalized in Nepal in 2002, following advocacy efforts highlighting high maternal mortality from unsafe abortion. We sought to assess whether legalization led to reductions in the most serious maternal health consequences of unsafe abortion.We conducted retrospective medical chart review of all gynecological cases presenting at four large public referral hospitals in Nepal. For the years 2001-2010, all cases of spontaneous and induced abortion complications were identified, abstracted, and coded to classify cases of serious infection, injury, and systemic complications. We used segmented Poisson and ordinary logistic regression to test for trend and risks of serious complications for three time periods: before implementation (2001-2003), early implementation (2004-2006), and later implementation (2007-2010).23,493 cases of abortion complications were identified. A significant downward trend in the proportion of serious infection, injury, and systemic complications was observed for the later implementation period, along with a decline in the risk of serious complications (OR 0.7, 95% CI 0.64, 0.85). Reductions in sepsis occurred sooner, during early implementation (OR 0.6, 95% CI 0.47, 0.75).Over the study period, health care use and the population of reproductive aged women increased. Total fertility also declined by nearly half, despite relatively low contraceptive prevalence. Greater numbers of women likely obtained abortions and sought hospital care for complications following legalization, yet we observed a significant decline in the rate of serious abortion morbidity. The liberalization of abortion policy in Nepal has benefited women's health, and likely contributes to falling maternal mortality in the country. The steepest decline was observed after expansion of the safe abortion program to include midlevel providers, second trimester training, and medication abortion, highlighting the importance of concerted efforts to improve access. Other countries contemplating changes to abortion policy can draw on the evidence and implementation strategies observed in Nepal