Seasonal variation of Mastophorus muris (Nematoda: Spirurida) in the water vole Arvicola amphibius from southern Sweden.

This study focused on the spirurid nematode Mastophorus muris in water voles (Arvicola amphibius) trapped in three regions in southern Sweden during spring and fall 2013. The collection of water voles formed part of a larger project (EMIRO) on the cestode Echinococcus multilocularis in rodents. The voles' stomach contents were examined for the presence of M. muris. Prevalence, mean abundance and mean intensity of infection were calculated. A generalized linear model model was used to examine the effects of sex, functional group, season and region on the number of M. muris individuals in each vole. Forty-seven of 181 (26%) voles were infected with M. muris, with up to 74 worms each. The overall mean intensity (worms per infected vole) was 15 (95% CI 10-21), and abundance (mean number of worms in all voles) was 4 (95% CI 2-6). Model output indicated a significant effect of season and region with respect to abundance of nematode infection, which was independent of sex and functional group of the investigated host.

A randomized trial comparing skin closure in cesarean section: interrupted suture with nylon vs subcuticular suture with No '1' polyfilament.

BACKGROUND: Cesarean section is one of the most commonly performed operations in most countries of the world including Nepal. Hence there is a load on the financial resources of healthcare system. The rational of this study was to utilize the remaining No '1' polyfilament after closing rectus sheath to stitch skin. So, the primary objective was to determine the wound complication rates for subcuticular suture with No'1' petcryl (polyfilamentpolyglycolic acid) Vs intermittent suture with nylon 2-0 for skin closure at cesarean delivery and secondary objective was to compare postoperative pain and patient satisfaction about the scar. METHODS: One hundred and thirty eight women undergoing cesarean section at Chitwan Medical College was randomized to either intermittent skin suture with nylon 2-0 or subcuticular with polyfilament No '1' (remaining suture after closing rectus sheath). Evidence of wound infection, pain and overall satisfaction were assessed postoperatively. RESULTS: The overall wound complications rate in subcuticular stitch with No'1' polyfilament suture were similar as in intermittent mattress stitch with nylon 2-0 (15.9% vs. 14.49%). Pain on postoperative third day and six weeks and overall satisfaction about wound were similar in both groups. Only prolong rupture of membrane >18 hours was found to be a significant risk factor of wound infection (OR: 3.4; p=0.04). CONCLUSIONS: The remaining no '1' polyfilament suture (petcryl) after suturing rectus sheath can be safely used to close skin suture in cesarean section.

Site energies of active and inactive pheophytins in the reaction center of Photosystem II from Chlamydomonas reinhardtii.

It is widely accepted that the primary electron acceptor in various Photosystem II (PSII) reaction center (RC) preparations is pheophytin a (Pheo a) within the D1 protein (Pheo(D1)), while Pheo(D2) (within the D2 protein) is photochemically inactive. The Pheo site energies, however, have remained elusive, due to inherent spectral congestion. While most researchers over the past two decades placed the Q(y)-states of Pheo(D1) and Pheo(D2) bands near 678-684 and 668-672 nm, respectively, recent modeling [Raszewski et al. Biophys. J. 2005, 88, 986 - 998; Cox et al. J. Phys. Chem. B 2009, 113, 12364 - 12374] of the electronic structure of the PSII RC reversed the assignment of the active and inactive Pheos, suggesting that the mean site energy of Pheo(D1) is near 672 nm, whereas Pheo(D2) (~677.5 nm) and Chl(D1) (~680 nm) have the lowest energies (i.e., the Pheo(D2)-dominated exciton is the lowest excited state). In contrast, chemical pigment exchange experiments on isolated RCs suggested that both pheophytins have their Q(y) absorption maxima at 676-680 nm [Germano et al. Biochemistry 2001, 40, 11472 - 11482; Germano et al. Biophys. J. 2004, 86, 1664 - 1672]. To provide more insight into the site energies of both Pheo(D1) and Pheo(D2) (including the corresponding Q(x) transitions, which are often claimed to be degenerate at 543 nm) and to attest that the above two assignments are most likely incorrect, we studied a large number of isolated RC preparations from spinach and wild-type Chlamydomonas reinhardtii (at different levels of intactness) as well as the Chlamydomonas reinhardtii mutant (D2-L209H), in which the active branch Pheo(D1) is genetically replaced with chlorophyll a (Chl a). We show that the Q(x)-/Q(y)-region site energies of Pheo(D1) and Pheo(D2) are ~545/680 nm and ~541.5/670 nm, respectively, in good agreement with our previous assignment [Jankowiak et al. J. Phys. Chem. B 2002, 106, 8803 - 8814]. The latter values should be used to model excitonic structure and excitation energy transfer dynamics of the PSII RCs.

Orthotopic neobladder urinary diversion for carcinoma of urinary bladder.

BACKGROUND: Invasive cancers of urinary bladder need radical cystectomy as an optimal treatment. Urinary diversions of different types are available after the procedure. Orthotopic neo-bladder reconstruction is an emerging technique of diversion in suitable patients. The aim of this study was to see the outcome of this procedure in our set up. METHODS: The patient with carcinoma of urinary bladder who underwent radical cystectomy and orthotopic neo- bladder reconstruction during five year period were included in the study from department of surgical oncology in a hospital. Studer type ileal pouches were made in all the patients and their outcomes were studied. RESULTS: There were 30 patients among which 28 were male and 2 female. Age ranged from 38-60 years with mean age of 49.6 years. Average operative time was 330 minutes. Average hospital stay was 16 days (range 14-30 days). Majority of patients were transitional cell carcinoma 26 (86.7%) in histology. Majority of cases presented in stage II (53.3%). Post-operative complications were ileus in 30%, urinary leak in 26.6% and pneumonia in 13.3% of patients. Mortality was 1 (3.3%) on 29th postoperative day. Patients were able to micturate with satisfactory stream postoperatively. CONCLUSIONS: Orthotopic neobladder has similar complication rates compared with other forms of continent diversions. This method gives less psychological trauma to the patients with higher acceptance. So we recommend transforming the technique from ileal conduits to neobladder in well-established pelvic reconstruction set ups.

The impact of Nepal's national incentive programme to promote safe delivery in the district of Makwanpur.

OBJECTIVE: Nepal's Safe Delivery Incentive Programme (SDIP) was introduced nationwide in 2005 with the aim of encouraging greater use of professional care at childbirth. It provided cash to women giving birth in a public health facility and an incentive to the health provider for each delivery attended, either at home or in the facility. We aimed to assess the impact of the programme on neonatal mortality and health care seeking behaviour at childbirth in one district of Nepal. METHODS: Impacts were identified using an interrupted time series approach, applied to houSehold data. We estimated a model linking the level of each outcome at a point in time to the start of the programme, demographic controls, a vector of time variables and community-level fixed effects. FINDINGS: The recipients of the cash transfer in the programme's first two years were disproportionately wealthier households, reflecting existing inequality in the use of government maternity services. In places with women's groups--where information about the policy was widely disseminated--the SDIP substantially increased skilled birth attendance, but failed to impact on either neonatal mortality or the caesarean section rate. In places with no women's groups, the SDIP had no impact on utilisation outcomes or neonatal mortality. IMPLICATIONS FOR POLICY: The lack of any impact on neonatal mortality suggests that greater increases in utilisation or better quality of care are needed to improve health outcomes. The SDIP changed health care seeking behaviour only in those areas with women's groups highlighting the importance of effective communication of the policy to the wider public.

Failure of subarachnoid block in caesarean section.

Subarachnoid block is the most convenient and safe anaesthesia during caesarean section. But there are incidences where subarachnoid block does not work and other methods of anaesthesia have to be employed. This study was done in 2039 female patients who underwent caesarean Section at Paropakar Maternity and Women's Hospital, Thapathali, Kathmandu Nepal from 1st October 2005 to end of September 2006 to find the rate of failure of subarachnoid block in Caesarean Section and look for the causes of failure. Patients of age 17 years to 43 years (mean age 25.40 years) and ASA I and II were included in the study. Spinal needle (Sprotte) of 26 Gauze with Quincke's bevel was used. Solution injected was 2.20 ml of 0.5% hyperbaric Bupivacaine. Of the total 2039 patients who received subarachnoid block with the above mentioned methods, 6.0% (n=123) needed further anesthetic agents. Conversion to general anesthesia was needed in 87 (4.3%) patients. Rest 1.8% (n=36) could be operated with further administration of intravenous agents (Ketamine, Diazepam and/or Pentazocine) only.