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Various coverages of perylene thin films on Au(111) were investigated using scanning tunneling microscopy (STM) and ultraviolet photoelectron spectroscopy and x-ray photoelectron spectroscopy. A Schottky junction formed between Au(111) and perylene consisted of a large 0.65 eV interface dipole and a hole barrier height of 0.85 eV. A wetting layer of approximately 4 Å thickness was initially formed followed by island formation, consistent with Stranski–Krastanov growth. Room temperature STM investigations of nominal one monolayer perylene films revealed symmetry equivalent domains and two different stable commensurate lattice structures. Perylene film growth mode, film structure and the energy level diagram are discussed. [ABSTRACT FROM AUTHOR]

Introduction: Reverse sural artery flap has been used effectively to cover defects of distal leg, ankle and foot. This flap is easier and quick to harvest and is a versatile flap in terms of extensive mobility and reliable vascularity and, in many instances it has obviated the need for free tissue transfer. Methods: This is a retrospective study of sural flaps done at the Department of Plastic Surgery' and Burns in Tribhuvan University Teaching Hospital over a period of 4 years from April 2011 to March 2015. It included 21 flaps carried out in 21 patients with soft tissue defects at distal lower leg, ankle and foot. Results: Among 21 patients, 10 were men and 11 were women with an average age of 41 years (17 - 81). Successful flap coverage was obtained in 16 cases out of 21 (76%) which included 10 cases of complete survival (48%) and 6 cases (28%) of marginal flap necrosis. Four cases (19%) had partial flap loss and one case (5%) lost flap completely. Conclusion: we found that reverse sural artery' flap has good reliability with low incidence of complications and is a versatile flap for the reconstruction of defects in distal leg, ankle and foot. [ABSTRACT FROM AUTHOR]

Background and purpose A 1988 pilot study in Peru suggested an association between migraine and chronic exposure to high altitude. This study provides epidemiological evidence corroborating this. Methods In a cross-sectional nationwide population-based study, a representative sample of Nepali-speaking adults were recruited through stratified multistage cluster sampling. They were visited at home by trained interviewers using a culturally adapted questionnaire. The altitude of dwelling of each participant was recorded. Results Of 2100 participants, over half [1100 (52.4%)] were resident above 1000 m and almost one quarter [470 (22.4%)] at ≥2000 m. Age- and gender-standardized migraine prevalence increased from 27.9% to 45.5% with altitude between 0 and 2499 m and thereafter decreased to 37.9% at ≥2500 m. The likelihood of having migraine was greater (odds ratio, 1.5-2.2; P ≤ 0.007) at all higher altitudes compared with <500 m. In addition, all symptom indices increased with altitude across the range <500 m to 2000-2499 m, i.e. median attack frequency from 1.3 to 3.0 days/month ( P < 0.001), median duration from 9 to 24 h ( P < 0.001) and pain intensity [the proportion reporting 'bad pain' (highest intensity)] from 35.5% to 56.9% ( P = 0.011). Each of these showed a downward trend above 2500 m. Conclusions Dwelling at high altitudes increases not only migraine prevalence but also the severity of its symptoms. [ABSTRACT FROM AUTHOR]

Aims: Timely administration of antibiotic before incision ensures effective concentration in blood and tissues. Compliance with established guidelines is problematic due to logistics. Aim of this study was to improve timing of antibiotic prophylaxis (AP) with appropriate intervention in existing practices. Methods: Cross sectional study was conducted from May-June 2011 with target of enrolling at least 100 elective major cases (excluding obstetrics) who received AP before surgery. Anesthetists took responsibility of AP administration (Cefazoline 1 g as per our protocol unless indicated otherwise) instead of floor nurse as our earlier practice. Institutional ethical committee approved the study. Data collected in a pre-designed proforma was analyzed using Microsoft Excel. Results: Out of 120 patients, 64% were female. Average age was 43 years (4 to 87). General surgery cases were 51%, urosurgery 20%, gynecology and orthopaedic each 13% and others 6%. One hundred nineteen (99%) received AP before incision, 58(48%) within 60 to 30 minutes before incision and 1 (1%) after the incision. Conclusions: Anesthetist taking charge of the team for AP administration is a feasible option to improve compliance. [ABSTRACT FROM AUTHOR]

Newborn infants require special care when they homesick. Majority of the newborn require only feeding, warmth and loving care by the mothers. Nearly 15-20% of newborns homesick requiring care in hospital. Most of these babies can be managed using low cost locally made equipment which makes newborn care affordable. This is a prospective study of 201 sick newborns looked after in the Special Care Baby Unit (SCBU) of Kathmandu Medical College Teaching Hospital (KMCTH) using locally made low cost equipment. In the period of 28 months from 2nd July, 2001 to 17th Oct. 2003, 882 babies were delivered at Kathmandu Medical College Teaching Hospital (KMCTH). 859 were live births. Out of 859 live births, 173 (20.1%) were admitted in the special care baby unit (SCBU). SCBU of this hospital also admitted 28 babies born outside the hospital. The main causes of admission in SCBU were low birth weight (37.3%), neonatal jaundice (18.9%), birth asphyxia (6.9%), septicaemia (2.4%) and out of 201 babies admitted in SCBU, 89% were discharged in good condition, 3.9% of the babies left against medical advice, 2 babies (one with congenital hydronephrosis and another with congenital hypertrophic pyloric stenosis) were transferred to Kanti Children Hospital for surgery and 11 babies (5.4%) expired. The main causes of neonatal deaths were extreme prematurity (70%), septicaemia (23%), birth asphyxia (15.3%) and congenital anomalies (7.6%). The perinatal mortality rate (PMR) and neonatal mortality rate (NMR) during this period were 26.4/1000 births and 15.1/1000 live births respectively. In SCBU, locally made low cost equipment (Resuscitaire, Warm cot, Phototherapy and Oxygen hood designed by Prof U.S. Manandhar) are being used in the manangement of sick babies, since the unit was started on 2nd July, 2001. Babies with birth weight as low as 1020 gms and gestation as low as 28 weeks have survived in this unit. This unit has shown that Level II care could be provided with... [ABSTRACT FROM AUTHOR]