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It has long been recognized that there is a link between sustainable development, poverty and consistent access to useable water. Increased population is requiring more water and changing climate is altering the hydrological cycle making the water less accessible at the time when it is required. Combining the measurement of water availability and the socioeconomic capacity towards its access gives new insights in the fields of water resources management and poverty alleviation, which ultimately address the agenda of sustainable development. This paper customizes the water poverty index (WPI) indicators to encompass the climatic extremes and social settings to analyse the water stresses to the community people and their capacity to manage the water extremes focusing on the water availability in climatic variability condition in Karnali river basin in western Nepal. The indicators of the WPI were based on the multiple aspects of water focusing to water quantity and availability. The WPI is not only a useful tool to monitor progress; but it can even be used to identify areas of greatest need, thereby enabling prioritization of action in the water sector. [ABSTRACT FROM AUTHOR]

ABSTRACT Over the last few decades, weather and climate extremes have become a major focus of researchers, the media and general public due to their damaging effects on human society and infrastructure. Trends in indices of climate extremes are studied for the South Asian region using high-quality records of daily temperature and precipitation observations. Data records from 210 (265) temperature (precipitation) observation stations are analysed over the period 1971-2000 (1961-2000). Spatial maps of station trends, time series of regional averages and frequency distribution analysis form the basis of this study. Due to the highly diverse geography of the South Asian region, the results are also described for some specific regions, such as the island of Sri Lanka; the tropical region (excluding Sri Lanka); the Greater Himalayas above 35°N, the Eastern Himalayas (Nepal) and the Thar Desert. Generally, changes in the frequency of temperature extremes over South Asia are what one would expect in a warming world; warm extremes have become more common and cold extremes less common. The warming influence is greater in the Eastern Himalayas compared with that in the Greater Himalayas. The Thar Desert also shows enhanced warming, but increases are mostly less than in the Eastern Himalayas. Changes in the indices of extreme precipitation are more mixed than those of temperature, with spatially coherent changes evident only at relatively small scales. Nevertheless, most extreme precipitation indices show increases in the South Asia average, consistent with globally averaged results. The indices trends are further studied in the context of Atmospheric Brown Clouds (ABCs) over the region. Countries falling within the ABC hotspot namely Indo-Gangetic Plain (IGP) have shown a different behaviour on the trends of extreme indices compared with the parts outside this hotspot. IGP has increased temperature and decreased rainfall and tally closely with the actual trends. [ABSTRACT FROM AUTHOR]

Background: To avoid extended cardiopulmonary bypass (CPB), moderate temperatures are commonly accepted for hypothermic circulatory arrest (HCA), thereby jeopardizing organ protection. Distal aortic perfusion may be an option, but supportive experimental data is missing. Methods: Eight juvenile pigs (36 ± 2 kg) were cooled to 30°C followed by 60min of HCA with 50 min of lowflow(LF) lower bodyperfusion. Multimodal monitoring was used to measure overall metabolism, hemodynamics andmicrocirculation of the terminal ileum. The animals were observed for four hours following reperfusion. Organs were harvested for histopathological evaluation. Results: During LF perfusion, initially elevated llactate levels decreased subsequently (p < 0.05). Capillary blood flow decreased during cooling to 50% baseline levels (p = 0.03), but remained stable under LF conditions. Parameters indicative of reduced liver and kidney function were slightly elevated at the end of the experiment, but still within normal ranges. Conclusion: Under moderate hypothermia, low flow perfusion seems to provide adequate protection for the lower body organs. Microcirculatory parameters during perfusion as well as lactate levels within normal ranges throughout the experiments further confirm the concept. [ABSTRACT FROM AUTHOR]

Introduction: Lymphadenopathy is a common clinical finding at the outpatient setting that may be caused by a vast array of disease processes., Methods: A retrospective study to analyze the histopathological diagnosis of lymph node biopsies with respect to age, sex, and site was conducted. All the lymph nodes sent for histopathological examination from August 2003 to 2007 were included., Results: Of all patients with enlarged lymph nodes, 49% were males (mean age: 34.52 years) and 51% were females (mean age: 38.1 years). The most common diagnosis was tubercular lymphadenitis (42%), followed by non-specific (reactive) lymphadenitis (23%), metastatic deposits (10%), non-specific granuloma (3%), NHL (2%), and lymphadenitis due to various other causes (7%). Thirteen percent of the biopsied lymph nodes were normal in morphology. Most common site of lymph node enlargement was neck (44%) followed by mesentery (19%) and axilla (16%). Most of the patients were in the age group of 21-30 years (20%)., Conclusions: The neck lymph nodes were the most commonly sent nodes for histopathological examination and tuberculosis was the most common diagnosis.

Leiomyoma is a benign smooth muscle neoplasm. They can occur in any organ, but the most common forms occur in the uterus, small bowel and the esophagus. Leiomyoma of breast is a rare benign non epithelial tumor. Most leiomyomas in the breast are found in the subareolar region. There are few cases being reported in the literature. Here we report a case of 52 years old lady who presented to us with a painless right sided breast lump. There was no history of nipple discharge, trauma or use of oral contraceptive pills. Excisional biopsy revealed a growth pattern of interlacing fascicles of smooth-muscle cells consistent with leiomyoma of breast.

A 55 years old male presented with history of assault and insertion of a "glass object" through his anus. Examination and investigation of the patient revealed a bottle in the rectosigmoid colon. The bottle was manipulated and delivered out transanally under general anesthesia.

In this observational study (from August 2000 to January 2001) 102 patients of all age group with non-traumatic acute abdomen were studied to see the negative laparotomy rate and the diagnostic accuracy and predictive values of different investigations in acute abdomen. The disease was most common in the age group 20-29 years with male predominance. More than half of the acute abdomen was due to the acute appendicitis. Neutrophil leucocyte count had the highest sensitivity (91.5%) while Plain X-ray abdomen showed the highest specificity (88.8%) and positive predictive value (88.6%) in diagnosing acute abdomen. Urinalysis showed the highest negative predictive value (93.3%). Overall diagnostic accuracy was 78.4%, which was statistically significant (p<0.05). Diagnostic accuracy was highest in bowel obstruction (82.4%) and lowest in peritonitis due to viscus perforation (69.0%). Negative laparotomy rate was 17.6% in the study, which was statistically significant (p<0.05). It was highest with peritonitis due to viscus perforation (20.7%), and lowest in bowel obstruction (11.8%).

Ki-67 and p53 protein expression was evaluated immunohistochemically in 32 patients with intrahepatic, extrahepatic bile duct and gallbladder carcinomas, who underwent surgery at First Department of Surgery, The University of Tokushima School of Medicine. p53 expression was found more in the well differentiated group than poorly differentiated group (p = 0.007). MIB1 labelling index (MIB1 LI) was higher in EHC than in GBC (p = 0.0061). MIB1 LI (T), (MIB1 LI in tumor) was higher in cases with lymph node metastasis than in those without lymph node metastasis (p = 0.0189). Moreover, MIB1 LI (L) (MIB1 LI in metastasized lymph node) was higher in poorly differentiated than in well differentiated carcinoma (p = 0.0404). Prognostically, patients with high MIB1 LI (T) (> 56.93) had a worse prognosis after surgery than those with low MIB1 LI (T) (p < 0.05). There was no association between p53 positive tumors and MIB1 expression. These results suggest that cancer cell proliferative activity was markedly increased in cases with EHC compared to those with GBC and the poorly differentiated and lymph node metastasis group. MIB1 LI in tumor was found to be a good prognostic indicator whereas there was no association of p53 positive tumor with MIB1 expression and prognosis of the patients.