Clinico-epidemiological profile of molar pregnancies in a tertiary care centre of Eastern Nepal: a retrospective review of medical records

BACKGROUND: The incidence of molar pregnancy has demonstrated marked geographic and ethnic differences. The reported data in Nepal is inconsistent with minimal published literature. Thus, we designed a study to determine prevalence of molar pregnancies and demonstrate clinical and epidemiological characteristics of the patients attending a tertiary care center in eastern Nepal. METHODS: A retrospective review of medical records was conducted to determine the prevalence of molar pregnancies at the B.P. Koirala Institute of Health Sciences (BPKIHS) from the year 2008 to 2012. Secondary data from the medical records were analyzed. Annual and 5-year prevalence of molar pregnancy per 1000 live births was calculated. Demographic characteristics, clinical presentation, management methods and complications of molar pregnancy were studied. RESULTS: The 5- year prevalence of molar pregnancy at BPKIHS is 4.17 per 1000 live births with annual prevalence ranging 3.8-4.5 per 1000 live births. More than one third of the patients were in the age group of 20-35 years and majority of them were of Hindu religion. For more than one third (41.7 %) of the patients, it was their first pregnancy while about 10 % gave a positive past history of molar pregnancy. Abnormal uterine bleeding (86.3 %) was the most frequent complaint, suction evacuation was the most common method of treatment and more than half of the patients required prolonged care after initial management. CONCLUSION: There is a need for studies at country level which will give us a national figure on molar pregnancies. Thus, a standardized clinic-epidemiological profile of molar pregnancy in Nepal can be created

PCR Based Genotyping of Lulu Cattle of Nepal for A1, A2 Type Beta-caseins

Lulu is an indigenous breed of cattle (Bos taurus) found in high altitude regions of western Nepal. Population of Lulu cattle has been declining due to introgression with other exotic breeds to increase milk productivity. Here we aimed at finding potential approach for conserving Lulu cattle and its assets by studying the milk contents and investigating which variant of beta-casein protein is present in this breed. Beta caseins are an abundant protein in cow milk with A1 and A2 being the most common genetic variants of this protein. Consumption of A1 type of milk has numerous health-related complications whereas A2 type of milk has numerous human health promoting factors. We used restriction fragment length polymorphism (RFLP) for determining the A1 and A2 variant of beta casein in Lulu cattle. For performing DNA extraction, we collected (n = 18) blood samples of Lulu from Mustang and (n=17) Nepal Agriculture research council farm. The amplified fragments in 3% agarose at 251bp and 213bp respectively confirmed the presence of both A1 and A2 gene in Lulu; however, A2 was of greater abundance. Our study indicated that Lulu has A2 variant of beta-casein predominantly. The gene frequency of A1A1 is 0, A1A2 is 0.06 and A2A2 is 0.94. We further found that the allele frequency of A1 and A2 is 0.03 and 0.97 respectively. We designed special primer for sequencing CSN2 genes since A2 type beta casein gene was predominantly seen on Lulu. The sequencing result further supports our RFLP result as most of our samples have “C” nucleotide SNP in amplified CSN2 gene sequence. The Chi-square value of the current study is 0.04 which supports Hardy-Weinberg equilibrium inferring that Lulu cattle are still in the pure state, where there is no genetic introgression with the exotic breed for the sake of improvement of productivity

Prevalence of Multidrug-Resistant Foodborne Pathogens and Indicator Bacteria from Edible Offal and Muscle Meats in Nashville, Tennessee

This study investigated the prevalence of antimicrobial-resistant bacteria in retail edible offal and muscle meats in Nashville, Tennessee. A total of 348 retail meats (160 edible offal and 188 muscle) were analyzed for Salmonella enterica serovar, Campylobacter, Escherichia coli, E. coli O157:H7, and enterococci. Bacteria was identified using biochemical and PCR methods. Salmonella enterica serovar (4.4% and 4.3%), Campylobacter (1.9% and 1.1%), E. coli (79.4% and 89.4%), and enterococci (88.1% and 95.7%) was detected in offal and muscle meats, respectively. Chicken liver (9.7%) was most frequently contaminated with Salmonella enterica serovar, followed by ground chicken (6.9%) and chicken wings (4.2%). No Salmonella enterica serovar was detected in beef liver, beef tripe, and ground beef. The prevalence of Campylobacter was 6.9%, 2.3%, and 1.4% in beef liver, ground beef, and ground chicken, respectively. None of the meats were positive for E. coli O157:H7. Resistance of isolates was significantly (p \u3c 0.05) highest in erythromycin (98.3%; 99.1%), followed by tetracycline (94%; 98.3%), vancomycin (88.8%; 92.2%) as compared to chloramphenicol (43.1%; 53.9%), amoxicillin/clavulanic (43.5%; 45.7%), and ciprofloxacin (45.7%; 55.7%) in offal and muscle meats, respectively. Imipenem showed the lowest resistance (0%; 0.9%). A total of 41 multidrug-resistant patterns were displayed. Edible offal could be a source of antibiotic-resistant bacteria

Maternal, Fetal and Newborn Outcome with Respect to Anemic Status of Women Admitted in Maternity Ward of BPKIHS

Background: Anemia is a common problem in pregnancy particularly in developing countries. In Nepal, the prevalence of anemia in pregnancy is 48%. It is defined by WHO as hemoglobin level less than 11gm/dL in pregnancy. It leads to a number of threats to mother, fetus and newborn. Objectives: The objective of the study was to assess the maternal, fetal and newborn outcome with respect to anemic status of women admitted in maternity ward of BPKIHS, Dharan, Nepal. Methods: A descriptive cross-sectional study was conducted among the 20 to 35 years women admitted in maternity ward of BPKIHS. Total 193 respondents were included in the study by purposive sampling technique. Out of 193 respondents, 78 were anemic and 115 were non-anemic. Maternal, fetal and newborn outcome among all the respondents were assessed by interview and review of records. Pearson Chi-square test was used to find the association between two categorical variables. Results: Maternal outcomes such as preterm delivery, mode of delivery and fetal and newborn outcomes such as abnormal fetal heart rate, IUGR, LBW, low APGAR scores at 1 minute and at 5 minutes, need for resuscitation and need for admission in ward/nursery/NICU were significantly associated with anemic status of women at p value <0.05. The prevalence of anemia among the pregnant women was 40.5%. Conclusion: Maternal outcome such as preterm delivery, cesarean section were associated with anemia. Regarding the fetal and newborn outcome; abnormal fetal heart rate, IUGR, low birth weight, APGAR scores below 7, need for resuscitation, need for admission in ward/ nursery/NICU were associated with anemia

Tumors with Pilosebaceous Differentiation: A Five Year Retrospective Study at BPKIHS

Background: Skin appendageal tumors (SAT) are a large and diverse group of tumors that are commonly classified according to their state of appendageal differentiation: Follicular, sebaceous, eccrine and apocrine. Most adnexal neoplasms are uncommonly encountered in routine practice, and pathologists can easily recognise frequently encountered tumours. In this study, the histological features of important benign and malignant tumors of pilosebaceous origin were reviewed considering its morphologic types, subtypes, age, sex and anatomic site. Methods: This is a hospital based retrospective study which includes all cases of tumors with pilosebaceous differentiation diagnosed histologically during the period of five years (1st January, 2008 to 31st December, 2012). Tumors were analyzed considering the anatomic location and type of the tumor, along with age and sex of the patient. The Histological characterization was done according to the WHO classification system for SAT. Collected data were entered in Microsoft Excel 2000 and converted it into SPSS PC+ 11.5 Version for statistical analysis. Results: A total of 53 neoplasms of pilosebaceous differentiation included, 52 (98.1%) were benign and one (1.8%) was malignant. The mean age was 39.23 years. Females comprised of 35 (66%) and 18 (34%) were males. Most common location was in head and neck area. Of all, 51 (96.2%) tumors were follicular, and two (3.7%) were with sebaceous differentiation. Among all follicular tumors, Pilomatricoma (33.9%), Keratoacanthoma (26.4%) and Trichoepithelioma (22.6%) were the commonest tumors observed. Conclusion: The study findings reveal majority of the tumors origin were of follicular differentiation and all were benign.  J-GMC-N | Volume 11 | Issue 01 | January-June 2018, Page: 33-3

DNA end resection by Dna2–Sgs1–RPA and its stimulation by Top3–Rmi1 and Mre11–Rad50–Xrs2

The repair of DNA double-strand breaks (DSBs) by homologous recombination requires processing of broken ends. For repair to start, the DSB must first be resected to generate a 3′-single-stranded DNA (ssDNA) overhang, which becomes a substrate for the DNA strand exchange protein, Rad51 (ref. 1). Genetic studies have implicated a multitude of proteins in the process, including helicases, nucleases and topoisomerases. Here we biochemically reconstitute elements of the resection process and reveal that it requires the nuclease Dna2, the RecQ-family helicase Sgs1 and the ssDNA-binding protein replication protein-A (RPA). We establish that Dna2, Sgs1 and RPA constitute a minimal protein complex capable of DNA resection in vitro. Sgs1 helicase unwinds the DNA to produce an intermediate that is digested by Dna2, and RPA stimulates DNA unwinding by Sgs1 in a species-specific manner. Interestingly, RPA is also required both to direct Dna2 nucleolytic activity to the 5′-terminated strand of the DNA break and to inhibit 3′ to 5′ degradation by Dna2, actions that generate and protect the 3′-ssDNA overhang, respectively. In addition to this core machinery, we establish that both the topoisomerase 3 (Top3) and Rmi1 complex and the Mre11–Rad50–Xrs2 complex (MRX) have important roles as stimulatory components. Stimulation of end resection by the Top3–Rmi1 heterodimer and the MRX proteins is by complex formation with Sgs1 (refs 5, 6), which unexpectedly stimulates DNA unwinding. We suggest that Top3–Rmi1 and MRX are important for recruitment of the Sgs1–Dna2 complex to DSBs. Our experiments provide a mechanistic framework for understanding the initial steps of recombinational DNA repair in eukaryotes

Resource Planning for Neglected Tropical Disease (NTD) Control Programs: Feasibility Study of the Tool for Integrated Planning and Costing (TIPAC).

<p>Resource Planning for Neglected Tropical Disease (NTD) Control Programs: Feasibility Study of the Tool for Integrated Planning and Costing (TIPAC)</p

SOCIO-PSYCHOLOGICAL STUDY AMONG INJECTABLE DRUG USERS IN KATHMANDU VALLEY

On the background of ever increasing HIV transmission in our community through various routes, the psychosocial factors related with intravenous drug abuse has become necessary to be studied. Aim of the study was to assess the Socio-psychological factors that influence people to use drugs, especially to use Injectable drugs. We enrolled a sample of 393 Intravenous drug users, all male, in the Kathmandu Valley. Participants were administered a semi structured proforma to assess the psychosocial issues related with the drug intravenous drug abuse. Mean age of the sample was 27.76+ 4.86 years. Majority were single, unemployed, Hindu and by caste Newars, with education more than high school (SLC or more). The first psychoactive substance use by most of them was cannabis. The most frequently used psychoactive substance was injection Buprenorphine (Tidigesic), which was followed by mixture of various substances (opiates, benzodiazepines, antihistamines) and Diacetyl morphine (Brown sugar). Factors associated with the start of the drugs were for enjoyment, friend’s pressure and to alleviate mental tension. Many accepted Injectable drug use contributing to problems in mental, marital, social, economic and legal aspects of their life. Despite knowing the harms caused by the drugs majority persist on its use. A needle exchange programme has been viewed positively by many. Key words: buprenorphin, needle sharing, needle replacement, HIV transmission

Physiological strength electric fields modulate human T cell activation and polarisation

Acknowledgements: This work was supported by grants from an NHS Grampian Endowment Fund (Grant number 10/19). C.E.A was supported by an Institution of Medical Science University studentship. The authors acknowledge and are grateful to all volunteers for donating blood for T cell isolation. The authors also thank the University of Aberdeen Iain Fraser Cytometry Centre for their assistance.Peer reviewedPublisher PD

What motivates open defecation? A qualitative study from a rural setting in Nepal

Introduction Open defecation is ongoing in Nepal despite the rise in efforts for increasing latrine coverage and its use. Understanding the reasons for open defecation would complement the ongoing efforts to achieve the ‘open defecation free’ status in Nepal. This study aimed at exploring different motivations of people who practice open defecation in a village in Nepal. Methods This study was conducted among the people from the Hattimudha village in Morang district of eastern Nepal, who practiced open defecation. Maximum variation sampling method was used to recruit participants for 20 in-depth interviews and 2 focus group discussions. We adopted a content analysis approach to analyze the data. Results We categorized different reasons for open defecation as motivation by choice and motivation by compulsion. Open defecation by choice as is expressed as a medium for socializing, a habit and an enjoyable outdoor activity that complies with spiritual and religious norms. Open defecation by compulsion include reasons such as not having a latrine at home or having an alternative use for the latrine structures. Despite having a private latrine at home or access to a public latrine, people were compelled to practice open defecation due to constraints of norms restricting latrine use and hygiene issues in general. For women the issues with privacy and issues refraining women to use the same latrine as men compelled women to look for open defecation places. Conclusion Open defecation is either a voluntary choice or a compulsion. This choice is closely linked with personal preferences, cultural and traditional norms with special concerns for privacy for women and girls in different communities. The ongoing campaigns to promote latrine construction and its use needs to carefully consider these factors in order to reduce the open defecation practices and increase the use of sanitary latrines