Molecular Functionalization of 2H-Phase MoS2 Nanosheets via an Electrolytic Route for Enhanced Catalytic Performance.

The molecular functionalization of two-dimensional MoS2 is of practical relevance with a view to, for example, facilitating its liquid-phase processing or enhancing its performance in target applications. While derivatization of metallic 1T-phase MoS2 nanosheets has been relatively well studied, progress involving their thermodynamically stable, 2H-phase counterpart has been more limited due to the lower chemical reactivity of the latter. Here, we report a simple electrolytic strategy to functionalize 2H-phase MoS2 nanosheets with molecular groups derived from organoiodides. Upon cathodic treatment of a pre-expanded MoS2 crystal in an electrolyte containing the organoiodide, water-dispersible nanosheets derivatized with acetic acid or aniline moieties (∼0.10 molecular groups inserted per surface sulfur atom) were obtained. Analysis of the functionalization process indicated it to be enabled by the external supply of electrons from the cathodic potential, although they could also be sourced from a proper reducing agent, as well as by the presence of intrinsic defects in the 2H-phase MoS2 lattice (e.g., sulfur vacancies), where the molecular groups can bind. The acetic acid-functionalized nanosheets were tested as a non-noble metal-based catalyst for nitroarene and organic dye reduction, which is of practical utility in environmental remediation and chemical synthesis, and exhibited a markedly enhanced activity, surpassing that of other (1T- or 2H-phase) MoS2 materials and most non-noble metal catalysts previously reported for this application. The reduction kinetics (reaction order) was seen to correlate with the net electric charge of the nitroarene/dye molecules, which was ascribed to the distinct abilities of the latter to diffuse to the catalyst surface. The functionalized MoS2 catalyst also worked efficiently at realistic (i.e., high) reactant concentrations, as well as with binary and ternary mixtures of the reactants, and could be immobilized on a polymeric scaffold to expedite its manipulation and reuse.

[Radioiodine therapy outcome in toxic multinodular goiter patient with concomitant hereditary Hasharon hemoglobinopathy].

This research describes a clinical case of treatment of a patient with thyrotoxicosis with concomitant hematological pathology – carriage of unstable hemoglobin Hasharon. A patient diagnosed with «Diffuse toxic nodular goiter. Thyrotoxicosis of medium severity. Drug-induced hypothyroidism» was admitted to the Department of radionuclide therapy for the purpose of treatment with radioactive iodine. Onset of disease - summer 2018 (thyroid-stimulating hormone (TSH) – 0 mIU/ml). The instrumental studies (ultrasound, scintillation scanning of the thyroid gland) were performed at the pre-radioiodine therapy (RIT) diagnostic stage. The history of the disease indicates, that in 2000 the patient was suspected of having abnormal hemoglobin, since then no examinations have been conducted and anemia has never been detected. The diagnosis of ancestral hemoglobinopathy with the presence (17%) of unstable Hasharon-Sinai-Sealy hemoglobin in a heterozygous form was verified during the preparation to RIT. The radionuclide therapy I131 with activity of 400 MBq was performed on 02.07.2019. The monthly monitoring of laboratory and instrumental indicants was carried out during the post-therapeutic period: the state of hypothyroidism was reached by the end of 2 months after RT, no episodes of significant increase in bilirubin levels were observed during the observation period; no side effects from RT were stated. It becomes possible based on the example of the above observation, to judge the safety of conducting RT for treatment of thyrotoxicosis in patients with similar hemoglobinopathy, without excluding, however, the need for an individual approach in each case.

[Predictors of the efficacy of radioiodine therapy of Graves' disease in children and adolescents].

RATIONALE: Insufficient world-wide clinical experience in radioiodine therapy (RIT) for Graves' disease (GD) in children and adolescents, and limited knowledge of the predictors of RIT efficacy. AIMS: Analysis and identification of the most significant predictors of the efficacy of RIT in children and adolescents with Graves' disease. MATERIALS AND METHODS: A total of 55 patients (48 females and 7 males) aged from 8 to 18 years receiving primary RIT for GD were enrolled. RIT planning was based on the dosimetric method. Analyzed parameters included gender, age, ultrasound thyroid volume before and 6 months after treatment, the presence of endocrine ophthalmopathy, duration of antithyroid drug (ATD) therapy, relapse of thyrotoxicosis after ATD dose reduction, blood fT3, fT4 and TSH levels initially and at 1, 3, 6 months after treatment, TSH receptor Ab initially and at 3 and 6 months after treatment, thyroid 99mTc-pertechnetate uptake at 10-20 minutes (%), maximum thyroid 131I uptake (%), specific 131I uptake (MBq/g) and therapeutic 131I activity (MBq). Fisher exact test, non-parametric Mann-Whitney test, Wilcoxon signed-rank test, logistic regression modelling, ROC-analysis, proportional hazard model (the Cox regression), the Kaplan-Meier method and log-rank test were used for statistical analysis as appropriate. RESULTS: Six months after RIT, hypothyroidism was achieved in 45 (81.8%), euthyroid state - in 2 (3.6%), and in 8 (14.6%) patients thyrotoxicosis persisted. On univariate statistical analysis, the smaller thyroid volume, higher fT4 and lower TSH receptor Ab levels, lower 99mTc-pertechnetate uptake and higher specific 131I uptake were associated with hypothyroidism. On multivariate logistic regression analysis, the older patient's age (p=0.011), smaller thyroid volume (p=0.003) and higher fT4 (p=0.024) were independent predictors of RIT efficacy. Thyroid volume was also the only variable associated with achievement of hypothyroidism in time after RIT (p=0.011). CONCLUSION: The efficacy of dosimetry-based RIT in children and adolescents with GD 6 months after treatment was 81.2%. Older patients' age, smaller thyroid volume and higher fT4 level were independent predictors of therapy success. Smaller thyroid volume was also a predictor of the favorable time-related outcome. Statistical models obtained in this work may be used to prospectively estimate the chance of efficient RIT for GD in pediatric patients.

A direct route to activated two-dimensional cobalt oxide nanosheets for electrochemical energy storage, catalytic and environmental applications.

Two-dimensional Co3O4 nanosheets have emerged as attractive materials for use in a number of relevant technological applications. To exhibit a competitive performance in such uses, however, their structure needs to be activated, which is frequently accomplished via post-synthesis reduction strategies that introduce oxygen vacancies and increase the number of active Co(II) sites. Here, we investigate a direct route for the synthesis of activated Co3O4 nanosheets that avoids reduction post-treatments, yielding materials with a high potential towards energy- and environment-related applications. The synthesis relied on an interim amorphous cobalt oxide material with nanosheet morphology, which upon calcination afforded Co3O4 nanosheets having Co(II) sites in quantities similar to those usually found for Co3O4 nanostructures activated by reduction post-treatments. When tested as electrodes for charge storage, the nanosheets demonstrated a competitive behavior in terms of both capacity and rate capability, e.g., a gravimetric capacity of ∼293 mAh g-1 at 1 A g-1 with 57% retention at 60 A g-1 was measured for nanosheets calcined at 350 °C. The materials were shown to be efficient catalysts for the reduction of nitroarenes (4-nitrophenol and 4-nitroaniline), outperforming other Co3O4 nanostructures, as well as effective adsorbents for the removal of organic dyes (methyl orange, methylene blue) from water.

Epilepsy seizure types, classification and treatment

Epilepsy is a chronic condition whose building blocks are recurrent seizures. It is this varied presentation that at times poses a challenge to making a diagnosis. The response to treatment is also not uniform, making it necessary to individualise. This article discusses the various seizure types, the latest classification by the International League against Epilepsy (ILAE), treatment and prognosis of the condition

Cytology of body fluids from different sites: an approach for early diagnosis of malignancy.

Malignant effusions are a common presenting sign of malignancy and reflect dissemination. A retrospective study of all fluid samples accessioned at the Department of Pathology, TUTH from April 2000 to October 2002 were done. Over the study period, a total of 584 specimens were examined- 324 peritoneal fluid, 224 pleural fluid, 19 pericardial fluid, 9 knee joint effusion and 8 Cerebro-Spinal Fluid (CSF). One hundred and nine (18.66%) out of 584 cases were found to have malignancy, 57 were male and 52 were female. The age group of the adult male ranged from 42-78 years and female ranged from 43-62 years. Three patients were children with age ranging from 8-11 years. Adenocarcinoma was the commonest that comprised 89%, followed by Non Hodgkin's lymphoma 6.5% squamous cell carcinoma 2.7% and small cell carcinoma comprised 1.8 %. Exfoliative cytology is cheap, rapid and highly effective tool for the evaluation of body fluid and should be advised in all effusion cases.

Complications of home delivery: a retrospective analysis.

This study was conducted to analyze the cases who had attended Nepal Medical College Teaching Hospital (NMCTH) after home delivery in order to broadly review the complications. This is a retrospective descriptive study. The number of total deliveries during the study period of two years (April, 2002- April, 2004) was 1619, among which 88 (5.4%) were cases who attended after home delivery. Majority of women (35.2%) were primi, 57.9% belonged to 20-25 year age group, 17% were young primi, and 85.2% were full term deliveries whereas 9.1% were preterm. More than half of them (57.9%) had regular antenatal check up. Most of them came from within 1-2 km distance of NMCTH. 51.1% were brought only after 2 hrs of delivery. The most common reason for attending hospital was retained placenta (84.1%-74 cases) among whom 51 (68.9%) needed controlled cord traction, 8 cases (10.8%) needed manual removal, rest of the cases had placenta lying in the vagina. Fifteen (17%) cases had post partum hemorrhage, 9 cases (10.2%) were brought in a state of shock. 71.6% were anemic, 11 (12.5%) had Hb <7 gm%. Other complications included cervical, third degree perineal tear. Blood transfusion was needed in 19 (21.6%) cases. All cases improved with proper resuscitation, use of antibiotics and definitive management of complications. Most of them were discharged within 4 days of admission. Perinatal mortality rate was 65.9/1000 births. This study showed that home deliveries were associated with increased maternal morbidity especially the third stage complications. Studies done in developed countries have shown that home birth is safe for normal, low risk women, with adequate infrastructure and support i.e. given a well trained midwife and facilities to transfer to hospital if necessary. In our context, a community based obstetric service must be developed with emphasis on regular and quality antenatal care, health education to women and proper training of birth attendants.

Relation between gallbladder neoplasm and Helicobacter hepaticus infection.

OBJECTIVE: The main objective of this study was to see the various histopathological changes in the gallbladder with cholelithiasis and to correlate them with Helicobacter hepaticus infection. METHODS: A total of 380 cholecystectomy specimens were received during a study period from 2058/11/29 to 2059/11/4 at Department of Pathology, TU Teaching Hospital, Institute of Medicine. RESULTS: Among 380 cases, 249 (65.53%) were found to have chronic cholecystitis, 52 (13.68%) cholesterolosis, 29 (7.63%) adenomyosis, 20 (5.26%) metaplasia, 15 (3.95%) low grade dysplasia, 10(2.63%) malignancy, 4(1.05%) xanthogranulomatous change and 1(0.26%) carcinoma in situ. Out of these, 100 cases that were willing to provide gallbladder for study were taken as a study group. Sections were stained with Haematoxylin & Eosin for microscopic features and with Warthin Starry Silver stain for Helicobacter hepaticus. Among the study group, 43% cases were found to have chronic cholecystitis, 17% adenomyosis, 13% cholesterolosis, 9% low grade dysplasia, 9% metaplasia, 7% malignancy, 1% carcinoma in situ and 1% xanthogranulomatous change. All the malignant cases were found to be Adenocarcinoma. Out of total 100 cases, 82% cases were found to have Helicobacter hepaticus infection. Only one out of 7 malignant cases (14.29%) was found to be negative for Helicobacter Hepaticus infection. Gallbladder neoplasm was found to be common in Nepal comprising 2.63%. Helicobacter hepaticus infection was found in 82% of gallbladders and it was found in 87.5% of malignant cases. Whether Helicobacter hepaticus that might be the number one cause for the gallstone formation that ultimately leads to malignancy or itself acts as a risk factor for the pathogenesis of carcinoma gallbladder is yet to be determined.

Malignant teratoid medulloepithelioma in eye.

Malignant teratoid medulloepithelioma is an extremely rare tumor occurring in children younger than 5 years of age, arising from ciliary body epithelium or iris but few arise from optic nerve and retina. This report concerns a 5 years old boy who presented with pain, redness and protrusion of right eye. Histopathologically, the tumor was composed of epithelial and sarcomatoid component. The pseudostratified primitive appearing epithelial cells were arranged mainly in diffuse pattern, nests cords and tubules. At places, pseudo rosette and true rosette were seen. Mitoses were frequent consisting of 7-10/ HPF. The sarcomatoid component consisting of spindle shaped cells arranged in interlacing bundle were also seen. Mitoses counted 5-7/HPF. Massive areas of necrosis and hemorrhage along with calcification, focal area of mature cartilage were present. Vascular and optic nerve invasions were seen. This case of malignant teratoid medulloepithelioma is the second case diagnosed in TU Teaching Hospital within the period of 10 years and reported because of its rarity. The differentiations from other tumors of the orbit such as small cell tumor were discussed.

Combination of intraoperative embolisation with surgical resection for treatment of giant cerebral arteriovenous malformations.

OBJECTIVE: To reduce the risk of surgical resection of giant arteriovenous malformation (AVM) and prevent normal perfusion pressure breakthrough (NPPB) and thus to lower postoperative mortality. METHODS: During the operation, which was carried out under general anaesthesia, the proximal ends of the feeding arteries were first ligated and 0.5 ml IBCA mixed with 0.5 ml of 5% glucose was injected into the vessels towards the AVM, then the malformed vessels were totally resected. Postoperative digital subtraction angiography (DSA) of the four vessels was performed in all patients. RESULTS: Fifty patients with giant AVMs survived after operation, only 6 (12.0%) had transient neurological dysfunction and 44 (88.0%) recovered after a follow-up of 6-36 months. No patient suffered from NPPB. CONCLUSIONS: The embolisation could block the arteriovenous shunts sufficiently to decrease the blood flow away from the normal areas of the brain so as to prevent the incidence of intra- and post-operative rebleeding, especially in NPPB. Therefore, the combination of intraoperative embolisation with surgical resection is an effective strategy in the treatment of giant cerebral AVMs, which makes it possible to operate on patients who used to be regarded as inoperable cases.

Vitamin A or beta-carotene supplementation reduces symptoms of illness in pregnant and lactating Nepali women.

The contribution of nutritional interventions to the reduction in maternal morbidity rates in developing countries is not well known. We assessed the impact of weekly vitamin A and beta-carotene supplementation on the prevalence of pregnancy and postpartum illness symptoms among 15,832 Nepali women in a placebo-controlled, double-masked, cluster-randomized trial. There was no impact of either supplement on morbidity rates reported up to 28 wk of gestation, inclusive. However, in late pregnancy (>28 wk), symptoms of nausea, faintness and night blindness were reduced with vitamin A, but not beta-carotene, supplementation. Vitamin A supplementation shortened the length of labor by 1.5 h 50 min among nulliparous and multiparous women, respectively. Both interventions reduced the postpartum prevalence of at least four loose stools and night blindness. beta-Carotene supplementation also reduced symptoms of high fever postpartum. The mean number of days of any reported illness symptoms was 3-4 per wk throughout pregnancy. Among women receiving vitamin A, the total number of days of illness symptoms accrued over the last 12 wk of pregnancy was lower by 5 d compared with the placebo recipients. We found the burden of pregnancy-related illness symptoms to be high in this rural area of Nepal where antenatal care is poor and most deliveries occur at home. Maternal vitamin A or beta-carotene supplementation resulted in a reduction in the prevalence of selected illness symptoms during late pregnancy, at the time of birth and during 6 mo postpartum, suggesting that a diet adequate in vitamin A may be important for improving women's reproductive health.

Night blindness during pregnancy and subsequent mortality among women in Nepal: effects of vitamin A and beta-carotene supplementation.

Night blindness due to vitamin A deficiency is common during pregnancy among women in Nepal. The authors assessed the risk of maternal death during and after a pregnancy with night blindness among women participating in a cluster-randomized, placebo-controlled vitamin A and beta-carotene supplementation trial in Nepal from July 1994 to September 1997. Subjects were 877 women with night blindness and 9,545 women without night blindness during pregnancy. Women were followed from the time they declared that they were pregnant through the end of the study, representing a median follow-up of 90 weeks (interquartile range: 64-121 weeks). Mortality of night-blind women in the placebo group was 3,601 per 100,000 pregnancies. In comparison, the relative risk of dying among nonnight-blind women in the placebo group was 0.26 (95% confidence interval (CI): 0.13, 0.55), and the relative risk among women with or without night blindness in the vitamin A/beta-carotene group was 0.32 (95% CI: 0.10, 0.91) and 0.18 (95% CI: 0.09, 0.36), respectively. Night-blind women were five times (95% CI: 2.20, 10.58) more likely to die from infections than were women who were not night blind. These findings show that night blindness during pregnancy is a risk factor of both short- and long-term mortality among women. Vitamin A/beta-carotene supplementation ameliorates this risk to a large extent.

Double blind, cluster randomised trial of low dose supplementation with vitamin A or beta carotene on mortality related to pregnancy in Nepal. The NNIPS-2 Study Group.

OBJECTIVE: To assess the impact on mortality related to pregnancy of supplementing women of reproductive age each week with a recommended dietary allowance of vitamin A, either preformed or as beta carotene. DESIGN: Double blind, cluster randomised, placebo controlled field trial. SETTING: Rural southeast central plains of Nepal (Sarlahi district). SUBJECTS: 44 646 married women, of whom 20 119 became pregnant 22 189 times. INTERVENTION: 270 wards randomised to 3 groups of 90 each for women to receive weekly a single oral supplement of placebo, vitamin A (7000 micrograms retinol equivalents) or beta carotene (42 mg, or 7000 micrograms retinol equivalents) for over 31/2 years. MAIN OUTCOME MEASURES: All cause mortality in women during pregnancy up to 12 weeks post partum (pregnancy related mortality) and mortality during pregnancy to 6 weeks postpartum, excluding deaths apparently related to injury (maternal mortality). RESULTS: Mortality related to pregnancy in the placebo, vitamin A, and beta carotene groups was 704, 426, and 361 deaths per 100 000 pregnancies, yielding relative risks (95% confidence intervals) of 0. 60 (0.37 to 0.97) and 0.51 (0.30 to 0.86). This represented reductions of 40% (P<0.04) and 49% (P<0.01) among those who received vitamin A and beta carotene. Combined, vitamin A or beta carotene lowered mortality by 44% (0.56 (0.37 to 0.84), P<0.005) and reduced the maternal mortality ratio from 645 to 385 deaths per 100 000 live births, or by 40% (P<0.02). Differences in cause of death could not be reliably distinguished between supplemented and placebo groups. CONCLUSION: Supplementation of women with either vitamin A or beta carotene at recommended dietary amounts during childbearing years can lower mortality related to pregnancy in rural, undernourished populations of south Asia.

Puerperal inversion of the uterus in Nepal: case reports and review of literature.

Retrospective study of 6 cases of puerperal inversion of the uterus is being presented from 1975 to 1995 and a review of literature for 20 years of the period 1975-1995 has been summarised. In the present series, one case with acute puerperal inversion of uterus were treated by manual reposition, 2 cases of chronic puerperal inversion of uterus was treated surgically by Kustner's vaginal approach. Two cases with subacute puerperal inversion of uterus, 1 case of chronic puerperal inversion were treated by Haultain and Huntington method. Out of 241 cases of uterine inversion obtained from review of literature for last 20 years, 229 (95%) constituted puerperal and 12 (5%) were non puerperal inversions. Among puerperal inversions, 191 (83.4%) cases were of acute type and only 6 (2.62%) cases were of subacute variety. The chronic puerperal inversion constituted 32 (13.9%). Out of 63 cases of uterine inversions in India, maternal deaths were reported as 6 (9.5%) but there was no maternal death in the present series.

Chlamydial genital infection in Algiers: a sero-epidemiological survey.

Using a microimmunofluorescence test, the prevalence of antichlamydial immunoglobulin (Ig) G in 720 people in Algiers was studied. 34 (36%) of women with low genital infection, 28 (30%) of 91 patients attending a cancer screening clinic, and 44 (100%) of prostitutes had antichlamydial IgG at a titre greater than or equal to 1:16. Among 180 women seeking a rubeola test, 48 (26.6%) had IgG titres greater than or equal to 1:16. 144 infants less than 3 months old were also tested and 16.6% of them had IgG titres greater than or equal to 1:160; 20 (20.7%) of 97 men with chronic urethritis had IgG titres greater than or equal to 1:16. Antibody titres suggesting active disease in prostitutes, patients attending the cancer screening clinic and women with low genital infection were found in 95%, 11% and 17% respectively.

Biparietal diameter of nepalese foetus in different periods of gestation by ultrasonography.

This study presents an analysis of 316 primigravidas with their known date of last menstruation. These cases have been attending antenatal clinic from 14 to 40 weeks of gestation. The mean BPD (Biparietal Diameter) values and percentile values were calculated. It was observed that there is a steep rise of growth up to 31 weeks and thereafter a gradual rise up to 40 weeks. The maximum BPD from 31 to 40 weeks was 90.9 mm whereas western workers like Hansmann and Campbell reported 99 mm and 98.1 mm, respectively. Several factors like nutrition and hereditary may have influenced the foetus after 30 weeks leading to low birth weight in our newborns.

Clinical experience with trophoblastic diseases in Nepal.

The epidemiology of trophoblastic disease in Nepal remains unknown. In this study, the first data regarding patients with trophoblastic disease were collected from two hospitals in Kathmandu, Nepal. We found 68 molar pregnancies during 1986 to 1987 at the Maternity Hospital, there. The incidence of molar pregnancies during two years ranged 2.84 per 1000 pregnancies and 3.24 per 1000 deliveries, while the total number of trophoblastic diseases from 1985 to 1988 at Teaching Hospital, Tribhuvan University, Kathmandu, numbered 26. The incidence of trophoblastic disease ranged from 7.07 per 1000 pregnancies to 8.04 per 1000 deliveries. As a result, the rate of trophoblastic disease in Nepal seems to be higher than expected, and it indicates a incidence similar to that other Asian countries at sea level.

Rapid diagnosis of respiratory syncytial virus infection by antigen immunofluorescence detection with monoclonal antibodies and immunoglobulin M immunofluorescence test.

During a respiratory syncytial virus (RSV) infection outbreak in a pediatric hospital, diagnosis was made by immunofluorescence on smears by using an anti-RSV monoclonal antibody (IFm). Immunoglobulins M and G were titrated by indirect immunofluorescence on HEp-2 cells infected with an RSV strain. The IFm was sensitive (89%) and specific (75%) when compared with the cell culture method. We showed that the specimens which were found positive by IFm and negative by cell culture were truly positive. Under these conditions, the IFm test appears more sensitive and more specific than cell culture, particularly when no care is taken to maintain the specimens in the cold during transport. In this study the immunoglobulin M immunofluorescence test had a low sensitivity (34%), especially on serum samples taken on days 0 to 4 after the onset of illness.