The endogenous tonB gene of Escherichia coli was used as a target for 9-aminoacridine-induced mutations that were identified in recA(-) and uvrA(-) cells. The cytotoxicity of 9-aminoacridine was enhanced in the uvrA and recA strains compared to the wild-type strain, and the mutagenicity of 9-aminoacridine in the uvrA and recA strains was similar to that in the wild type. For all three strains, the most common mutations were minus frameshifts in repetitive G:C base-pairs followed by minus frameshifts in nonrepetitive G:C base-pairs. 9-aminoacridine-induced minus frameshifts in the wild-type strain were distributed with several hot and warm spots. These sites were also hot and warm spots for minus frameshifts in the recA and uvrA stains. Furthermore, they were hot and warm sites in a 9-aminoacridine-treated strain carrying the target tonB gene oriented in the opposite direction. 9-Aminoacridine is known to interact with DNA to form intercalations which are involved in minus frameshift mutagenesis. In this study, we therefore argue that 1) 9-aminoacridine can induce bulky DNA lesions which are excised by nucleotide excision repair and not involved in mutagenesis, 2) the presence or absence of a recA-dependent repair pathway does not influence the mutagenic effect of 9-aminoacridine, and 3) both leading strand and lagging strand replication equally produce minus frameshifts, therefore gene orientation is not an important determinant of the formation of hot and warm spots by 9-aminoacridine.

Background: Lung cancer is the most common cancer worldwide and in Nepal. Non small cell carcinoma is the commoner histological type. The incidence of adenocarcinoma subtype is increasing globally. This study aims to evaluate the clinical-radiological and histological profile and the diagnostic yield of various modalities in the diagnosis of lung cancer at a tertiary hospital in Nepal.Methods: This is a prospective cross-sectional study conducted at National Academy of Medical Sciences, Kathmandu. Patients presenting with clinical and radiological features consistent with lung cancer and undergoing tissue sampling were included. The clinical and radiological characteristics, distribution of various histological subtypes and the diagnostic yield of various modalities were evaluated.Results: Of the 253 patients screened, 77 meeting the inclusion criteria were enrolled into the study. Lung cancer was diagnosed in 53 patients. Forty (75.5%) patients had non small cell carcinoma and 13 (24.5%) had small cell carcinoma. Among the non small cell variants, 20 (37.7%) had adenocarcinoma and 19 (35.9%) had squamous cell carcinoma. Hitopathological diagnosis of lung cancer was established in 39 of the 42 (92.9%) patients by bronchoscopy. Image guided biopsy and/or aspiration yielded the diagnosis in 13 (24.5%) patients. The diagnostic yields of endobronchial biopsy, needle aspiration, bronchial brush and bronchial wash cytology were 86.5%, 70%, 63% and 34.3%respectively. Conclusions: The result of this study concurs with the global trend of rising incidence of adenocarcinoma subtype. Bronchoscopy remains the most commonly used tool for diagnosis of lung cancer and combination of procedures such as biopsy, bronchial brush, needle aspiration and bronchial wash provided the highest yield in our study.Keywords: Bronchoscopy, Histological subtypes, Lung cancer, Tertiary hospital, Nepal.

Background: Enteric fever is a significant cause of morbidity in Nepal. In the past, Salmonella entericaserovar Typhi (S. Typhi) was the major causative organism of enteric fever. However, more recently, Salmonella entericaserovar Paratyphi (S.Paratyphi) A has been isolated from most patients presenting with enteric fever in various regions of Nepal. This study aimed to evaluate age differences in patients presenting with typhoid and paratyphoid fever.Materials & Methods: Between December 2014 and October 2015, 186 patients presented with enteric fever to the Civil Service Hospital in Kathmandu. S. Typhi and S.Paratyphi A were isolated from blood cultures in 48.4% and 51.6% of the cases, respectively. Age groups of the patients infected with either serovar were compared.Results: The mean age of patients from whom S. Typhi was isolated was 19.3 years, while the mean age of patients from whom S. Paratyphi A was isolated was 25.2 years; p=0.025.Conclusion: Our study shows that age is an important factor in having either typhoid or paratyphoid fever. This will help in the prevention of typhoid and paratyphoid fever in various age groups.Journal of Nobel Medical CollegeVolume 6, Number 2, Issue 11 (July-December, 2017) Page:25-28

CLIPPERS is a rare, chronic inflammatory neurological syndrome affecting multiple regions of the brain including the brainstem, cerebellum, and spinal cord. More than 100 cases have been documented globally since its initial description in 2010. This article reports the first case of the CLIPPERS syndrome in Nepal. Clinical and radiological evidences of the patient lead to the diagnosis of this disease. Brain MRI reveals punctate and curvilinear gadolinium enhancement in the pons and cerebellum, which is diagnostic for the disease. Steroid therapy has been reported to be effective in treating CLIPPERS syndrome. Although its pathophysiology indicates an immune-mediated process, the etiology is yet unknown. The treatment and prognosis of this illness depend on an early and accurate diagnosis.

Background: Thyroid eye disease represents an organ-specific autoimmune process that is usually associated with thyroid disease. Graves' disease is the most common thyroid abnormality associated with thyroid eye disease. Aim: This study was conducted for the profile of ocular manifestation in Thyroid Eye Disease (TED). Methodology: A cross-sectional study of 117 cases of thyroid dysfunction was carried out at BP Koirala Institute of Health System, out of which 84 (71.79%) cases had ocular manifestation. They were evaluated and analyzed in detail and the characteristics documented included patient's demography, ocular and systemic history and as well as ocular examination and some of the systemic and laboratory findings. Results: In this study, mean age of presentation of TED was 39.7 years. 59 patients were female and 25 were male. The maximum patients of both sexes were in the fourth decade of their lives. The common lid signs were lid retraction and lid lag. Proptosis was seen in 33.3% of cases out of which 68% had bilateral proptosis. Corneal ulcer was seen in 7.1% and optic neuropathy in 1.2% of cases. In 27.3% of cases there was elevation of IOP. Dry eye was seen in 61.9% of cases and POAG seen in 8.3% of cases. In the study population 75% were hyperthyroiditic, 16.7% were hypothyroiditic and 8.3% were in euthyroid state. Conclusion: Female was more commonly affected. The maximum number of patients of both sexes was in the fourth decade of their lives. Hyperthyroidism patient had greater chance of ocular manifestation.

Introduction Diabetes mellitus (DM) and lipid disorders (LD) in hypertensive patients are associated with increased risk of cardiovascular complications requiring close follow-up and more aggressive treatment. Hence, the present study was done to study the prevalence of diabetes and dyslipidemia in young hypertensive patients i.e. <40 years in a tertiary care hospital, Nepal. MethodsThis is a hospital based cross-sectional study carried out in Civil Service Hospital, Kathmandu. Study included 165 patients of <40 years who had hypertension, either newly diagnosed or undergoing antihypertensive treatment from September 2018 to September 2019. Blood pressure was measured two times on right upper arm in sitting position at interval of 30 minutes and the aver­age was taken. Fasting Lipid Profile and Fasting Blood Glucose was measured after 12 hours of fasting and the prevalence of dyslipidemia and diabetes were analyzed from the data collected. All calculations and statistical analyses are processed by the SPSS 25.0. ResultsAmong 165 patients included, majority of patients, 107 (64.8%) were among 31-39 years, followed by 53 (32.1%) patients among 21-30 years. In total, 98 (59.4%) were male and 67 (40.6%) female. The prevalence of diabetes was 24 (14.5%) and pre-diabetes was 49 (29.7%). The prevalence of dyslipidemia was 125 (75.6%), high triglyceride being the most common disorder followed by low HDL in 87 (52.1%). Elevated total cholesterol was found in 53 (32.1%) patients and 48 (29%) had high LDL cholesterol level. ConclusionA high prevalence of diabetes, pre-diabetes and dyslipidemia was observed in the hypertensive patients <40 years of age.