Supremum, infimum and hyperlimits in the non-Archimedean ring of Colombeau generalized numbers.

It is well-known that the notion of limit in the sharp topology of sequences of Colombeau generalized numbers R ~ does not generalize classical results. E.g. the sequence 1 n ↛ 0 and a sequence ( x n ) n ∈ N converges if and only if x n + 1 - x n → 0 . This has several deep consequences, e.g. in the study of series, analytic generalized functions, or sigma-additivity and classical limit theorems in integration of generalized functions. The lacking of these results is also connected to the fact that R ~ is necessarily not a complete ordered set, e.g. the set of all the infinitesimals has neither supremum nor infimum. We present a solution of these problems with the introduction of the notions of hypernatural number, hypersequence, close supremum and infimum. In this way, we can generalize all the classical theorems for the hyperlimit of a hypersequence. The paper explores ideas that can be applied to other non-Archimedean settings.

Perception Regarding Care of Attempted Suicide Patients among Nursing Students in Kathmandu University School of Medical Sciences.

Background Suicide is an act of deliberately killing oneself. It is a global health problem and is the second leading cause of death in 15 to 29 years. Thus, studying nursing students' perception towards suicide attempters has paramount importance in understanding and addressing the existing gaps in healthcare delivery system. Objective To assess the nursing students' perception towards attempted suicide and to find out the association between perception and selected variables. Method A descriptive, cross sectional design was carried out to assess the nursing students' perception towards suicide attempters in Kathmandu University School of Medical Sciences. The respondents were 193 nursing students. A structured questionnaire was used in order to collect data. Descriptive statistics including frequency, percentage, mean and standard deviation were calculated to summarize the data and inferential statistics, Mann Whitney-U test was used for the association between perception and selected variables. Result A total 193 nursing students participated in this study. The scores between 1 and 2.4 were considered 'positive', 'unsure' or 'uncertain', between 2.5 and 3.4 and negative for 3.5 and above' over all nurses showed relatively negative perception towards suicide attempters. According to results from eight domains of perception, those who did not attend the courses on psychiatry nursing presented higher score, which was found to have significant association with permissiveness, unpredictability and incomprehensibility. A younger nursing student shows significant association with incomprehensibility. Younger nursing student showed statistically significant association with duration of suicide process. Conclusion Nursing students are frequently encountered with attempted suicide patients. Therefore, they must be aware of their attitudes toward this group of patients as part of their professional and therapeutic role. Thus a nurse's positive perception towards attempted suicide can play a key role in communicating and preventing a future suicide attempt.

Prevalence and Predictors of Abuse in Elderly Patients with Depression at a Tertiary Care Centre in Saurashtra, India.

CONTEXT: Elder abuse has devastating consequences such as poor quality of life, psychological distress and loss of property and security. Abuse of elderly patients with depression has not been adequately researched in India. AIMS: To explore the prevalence and predictors of abuse and its relation to various sociodemographic variables in elderly patients with depression. SETTINGS AND DESIGN: A cross-sectional, observational study carried out at a tertiary care centre in Jamnagar. METHODS AND MATERIALS: In all, 100 elderly patients with depression, attending Out Patient Department of Psychiatry at Shree M. P. Shah Government Medical College and Guru Gobind Singh Hospital, Jamnagar, were selected using simple random sampling by lottery method. Actual Abuse Tool and Elder Abuse Suspicion Index were used to detect abuse. Geriatric Depression Scale was used to assess depression, and Mini Mental State Examination was used to rule out dementia. STATISTICAL ANALYSIS: Descriptive statistics, Chi-square test, and binary logistic regression were used. RESULTS: The prevalence of abuse was 24%. Among those who had experienced abuse, 50% had experienced psychological abuse, 17% had experienced neglect, 8% had experienced exploitation and 4% had experienced physical abuse. About 54% of patients with severe depression had experienced abuse. Daughters-in-law (54%) and sons (42%) were the most common perpetrators. Illiteracy and severe depression were found to be the predictors of abuse.

Biological effects of carbon nanotubes generated in forest wildfire ecosystems rich in resinous trees on native plants.

Carbon nanotubes (CNTs) have a broad range of applications and are generally considered human-engineered nanomaterials. However, carbon nanostructures have been found in ice cores and oil wells, suggesting that nature may provide appropriate conditions for CNT synthesis. During forest wildfires, materials such as turpentine and conifer tissues containing iron under high temperatures may create chemical conditions favorable for CNT generation, similar to those in synthetic methods. Here, we show evidence of naturally occurring multiwalled carbon nanotubes (MWCNTs) produced from Pinus oocarpa and Pinus pseudostrobus, following a forest wildfire. The MWCNTs showed an average of 10 walls, with internal diameters of ∼2.5 nm and outer diameters of ∼14.5 nm. To verify whether MWCNT generation during forest wildfires has a biological effect on some characteristic plant species of these ecosystems, germination and development of seedlings were conducted. Results show that the utilization of comparable synthetic MWCNTs increased seed germination rates and the development of Lupinus elegans and Eysenhardtia polystachya, two plants species found in the burned forest ecosystem. The finding provides evidence that supports the generation and possible ecological functions of MWCNTs in nature.

Amitraz Poisoning Treated Successfully with Atropine.

Very few cases have been reported with Amitraz as a suicidal agent from India. Here we present such a case treated successfully with atropine sulphate.

Comment on 'Carbon and fullerene nanomaterials in plant system'.

A recent review article entitled "Carbon and fullerene nanomaterials in plant system" published in this journal, misinterprets a component of our (published) work on the interactions of carbon nanotubes with plants. In this comment, we provide the rationale to counter this misconstruction.

Over 75% incident-photon-to-current efficiency without solid electrodes.

The efficiency of photoelectrochemical reactions is conventionally defined in terms of the ratio between the current responses arising from the collection of carriers at electrical contacts and the incident photon flux at a given wavelength, i.e. the incident-photon-to-current-efficiency (IPCE). IPCE values are determined by a variety of factors such as the absorption constant of the active layer, bulk and surface recombination of photogenerated carriers, as well as their characteristic diffusion length. These parameters are particularly crucial in nanostructured photoelectrodes, which commonly display low carrier mobility. In this article, we examine the photoelectrochemical responses of a mesoporous TiO2 film in which the IPCE is enhanced by fast extraction of carriers via chemical reactions. TiO2 films are spontaneously formed by destabilisation of colloidal particles at the polarisable interface between two immiscible electrolyte solutions. The photocurrent arises from hole-transfer to redox species confined to the organic electrolyte, which is coupled to the transfer of electrons to oxygen in the aqueous electrolyte. The dynamic photocurrent responses demonstrate that no coupled ion transfer is involved in the process. The interplay of different interfacial length scales, molecularly sharp liquid/liquid boundary and mesoporous TiO2 film, promotes efficiencies above 75% (without correction for reflection losses). This is a significant step change in values reported for these interfaces (below 1%), which are usually limited to sub-monolayer coverage of photoactive molecular or nanoscopic materials.

Pattern of Pediatric Admissions in a Tertiary Care Hospital of Central Nepal.

INTRODUCTION: An understanding of the epidemiological trend in hospital admissions, including morbidity and mortality patterns and the economic impact, is critical for healthcare planning and appropriate resource allocation. As we find very few literature on the pattern of paediatric admissions outside Kathmandu Valley, it is essential to conduct studies in the various parts of the country to determine the paediatric inpatient burden as well resource allocations. METHODS: A retrospective study was carried out at Department of Pediatrics, College of Medical Sciences-Teaching Hospital, Bharatpur, Chitwan, Nepal over a period of one year. All the admissions were analyzed for age, sex, address, seasonal variation, frequency of diseases according to the organ system involved, duration of hospital stay, and the outcome. RESULTS: Out of the total 814 cases admitted 68.8% of the patients were younger than five years. There was male preponderance with male to female ratio of 1.9:1. Majority (43.6%) admissions were from Chitwan itself. Respiratory, gastrointestinal and neurologic conditions were the main cause for admission. The mean duration of hospital stay was 5.28 days and the mortality was only 0.1%. CONCLUSIONS: In this study under five-year patients contributed to 2/3rd of the hospital admissions. Respiratory, gastrointestinal and neurologic conditions were the main cause for admission with pneumonia, URTI and acute gastroenteritis being the most common diseases.

CYP2C9*3 polymorphism presenting as lethal subdural hematoma with low-dose warfarin.

Warfarin is the most common and cheap oral anticoagulant currently used in clinical practice. A high inter-individual variation is seen in the response to warfarin. Recently, pharmacogenetics has gained importance in managing patients on warfarin, both in predicting the optimum required dose as well as in decreasing the risk of bleeding. This case report is a description of a 49-year-old patient who had a lethal subdural hematoma with low-dose warfarin. He was subsequently found to have CYP2C9 gene polymorphism (*1/*3). This case report stresses the importance of pre-prescription assessment of genetic analysis for those initiated on warfarin.

Efficient ELISA for diagnosis of active tuberculosis employing a cocktail of secretory proteins of Mycobacterium tuberculosis.

Rapid and accurate diagnosis is important for preventing transmission of Mycobacterium tuberculosis. Currently available tuberculosis (TB) diagnostic methods lack desired sensitivity and specificity, and require sophisticated equipment and skilled workforce including weeks' long duration to yield results. In this study, extracellular proteins or secretory protein antigens of M. tuberculosis H37Rv have been isolated using ion exchange chromatography, immunocharacterized and exploited for the development of efficient enzyme-linked immunosorbent assay (ELISA) for diagnosis of active TB with enhanced specificity and sensitivity. Apparent molecular masses for purified proteins were found to be 6, 27, 30, 38 and 64 kDa. Out of five purified proteins, one (64 kDa) was found to be novel. Of the five proteins, four (6, 27, 30 and 38 kDa) were found significant to be used in the development of ELISA for pulmonary and extra-pulmonary TB. The immune responses of serum samples of TB patients and other healthy subjects against the above-mentioned antigens' cocktail were evaluated. Critical parameters of newly developed ELISA were optimized and it was observed that the cocktail antigens have a greater specificity (98.06 %) and sensitivity (98.67 %) as compared to other commercially available diagnostic tests. The present findings suggest that the developed ELISA is an effective tool for routine screening and early-stage diagnosis of TB.

Association of panic disorder with quality of life among individuals with headache.

OBJECTIVE: To study the association of panic disorder with severity of anxiety symptoms and quality of life among individuals presenting with headache. METHODS: This was a single-centre, cross-sectional, observational, questionnaire-based study performed at the psychiatry outpatient department of a tertiary care hospital. Participants of both genders, aged between 18 and 60 years, and having headache as a presenting complaint for at least 3 months were evaluated for symptoms of panic disorder. The severity of headache was evaluated with the visual analogue scale and that of anxiety disorder with the Hamilton Anxiety Rating Scale (HAM-A). The quality of life was evaluated with the World Health Organization Quality of Life Scale brief version. Proportions of participants were compared using Chi-square test, and scores by Mann-Whitney test or Kruskal-Wallis test followed by Dunn's post-hoc multiple comparisons. RESULTS: The frequency of panic disorder among patients with headache was 67%. Those with daily headache and panic disorder (with or without agoraphobia) showed higher HAM-A score and poorer quality of life than those with intermittent headache and without panic disorder, respectively. CONCLUSIONS: Co-morbid panic disorder among patients with headache was associated with high anxiety score and poor quality of life.

Clinical Profile of Neonates with Perinatal Asphyxia in a Tertiary Care Hospital of Central Nepal.

INTRODUCTION: Birth asphyxia is a serious clinical problem worldwide. It claims approximately 9 million deaths each year. It can lead to serious neurological sequaele, such as cerebral palsy, mental retardation, and epilepsy. METHODS: All babies admitted in College of Medical Sciences Teaching Hospital, Chiwan, Nepal, NICU from January 2013 to December 2013 with a diagnosis of birth asphyxia (5 min Apgar<7 or those with no spontaneous respirations after birth) were included in the study (n=125). This was a descriptive observational study. Clinical information was collected (gravida, hour at presentation, mode of delivery, sex of baby, gestational age of the baby, requirement of resuscitation). Neonates were admitted to NICU, observed for complications and managed as per hospital protocol. RESULTS: Among the 722 neonates admitted to NICU, 125 had perinatal asphyxia (17.3%). Babies with Hypoxic ischemic encephalopathy(HIE) Grade I had a very good outcome but HIE III was associated with a poor outcome. Outborn neonates had higher grades of perinatal asphyxia as compared to inborns (p=0.018). Term gestation, Males and Multigravida were associated with a higher rate of birth asphyxia. 22.4% neonates were delivered via caesarean section and 74.4% required bag and mask ventilation at birth. CONCLUSIONS: Birth asphyxia was one of the commonest causes of admission NICU. Babies with HIE Grade III had a very poor prognosis. Outborn neonates with birth asphyxia had a higher mortality. Males were frequently affected than females.