Rice Vision for Bangladesh: 2050 and Beyond

CORRECTION: Due to a number of formatting and layout issues, the PDF of this paper was replaced on 10th October 2016.Combined efforts of farmers, rice scientists, extension personnel and Government of Bangladesh have yielded clean rice growth rate of 0.34 million ton (MT) year-1 during 2009-10 to 2013-14 in the country. In 2014-15, the country acquired a rice surplus of about 2 MT. However, maintaining the current surplus of rice in the coming decades is a great challenge. Authentic estimation of future rice requirement and future resource availability would guide to way forward. This paper presents rice vision for Bangladesh leading to 2050 and beyond. In this study, secondary data from different government-owned statistics and research institutes were collected, analyzed and synthesized to develop models and/or model parameters to generate outputs such as future population, rice production and rice requirement. Population of Bangladesh will reach 215.4 million in 2050, when 44.6 MT of clean rice will be required. With the pace of rice-production-increase in the last five years, production can reach 47.2 MT, having a surplus of 2.6 MT in 2050. The study sets 2.6 MT as the target for clean rice surplus every year leading to 2050 and beyond. Several hurdles, such as increasing population, decreasing resources and increasing climate vulnerability, can hinder achieving the target. Three major interventions?accelerating genetic gain, minimizing yield gap and curtailing adoption lag?are proposed to break the barriers to achieve the target. Major challenges to implement the interventions include shrinking net cropped area, decreasing availability of irrigation water and increasing pressure on soil fertility. Smart technology such as, location specific variety, profitable cropping sequences, innovative cultural management, and mechanization coupled with smart dissemination using multiple means would ease production barriers. We recommend a number of measures, such as, guaranteeing a minimum cropped area, accelerating the rate of genetic gain in varietal development and intensifying collaboration among the stakeholders to reduce adoption lag of newly released promising rice varieties, to achieve the rice vision of Bangladesh leading to 2050 and beyond.Bangladesh Rice j. 2015, 19(2): 1-18

Analgesic and antidepressant activities of Brassica rapa subspecies chinensis (L.) Hanelt on Swiss-albino mice model

Bangladesh being a subtropical country provides varieties of herbs and vegetables. Brassica is a broad genus available in Bangladesh and it encompasses a lot of nutritive herbs. Among these, Brassica rapa subspecies chinensis (L.) Hanelt (Family-Brassicaceae) is popular in many parts of the world. In the quest of medicinal property, this plant was investigated here for observing analgesic and antidepressant activities in Swiss-albino mice model. The herb was extracted well with methanol and then assayed by acetic acid-induced writhing and tail immersion methods for analgesic action. Besides, thiopental sodium induced sleeping time test, tail suspension test and forced swim test were conducted for the evaluation of its antidepressant activity. The plant extract was orally administered to the mice at 200 and 400 mg/kg body weight and it exhibited significant analgesic and antidepressant activities in compare to the controlled groups. This is the first time comprehensive report for analgesic and antidepressant activities of this plant.

Mesoblastic Nephroma in a 22 Years Old Woman

Mesoblastic nephroma is an uncommon renal tumor of infancy and rarely occurs in adults. We report a case of mesoblastic nephroma in adult. A 22-year-old woman, who presented with left flank pain, was found to have a left renal mass by abdominal ultrasonography. Computed tomography revealed a heterogeneous tumor. Left radical nephrectomy was performed. The tumor was a creamy white solid mass. Microscopically, the tumor was composed of spindle cell proliferation. Atypia and mitoses were not identified. Among the tumor cells, there were tubular arranged epithelial elements. The patient was free of recurrence 18 months postoperatively. Mesoblastic nephroma is classified as a benign tumor but recurrence and malignant transformation of this tumor have been reported, so regular postoperative follow up is required.

Maternal body mass index and risk of birth and maternal health outcomes in low- and middle-income countries: a systematic review and meta-analysis

We conducted a systematic review and meta-analysis of population-based cohort studies of maternal body mass index (BMI) and risk of adverse birth and health outcomes in low- and middle-income countries. PubMed, Embase, CINAHL and the British Nursing Index were searched from inception to February 2014. Forty-two studies were included. Our study found that maternal underweight was significantly associated with higher risk of preterm birth (odds ratio [OR], 1.13; 95% confidence interval [CI], 1.01-1.27), low birthweight (OR, 1.66; 95% CI, 1.50-1.84) and small for gestational age (OR, 1.85; 95% CI, 1.69-2.02). Compared with mothers with normal BMI, overweight or obese mothers were at increased odds of gestational diabetes, pregnancy-induced hypertension, pre-eclampsia, caesarean delivery and post-partum haemorrhage. The population-attributable risk (PAR) indicated that if women were entirely unexposed to overweight or obesity during the pre-pregnancy or early pregnancy period, 14% to 35% fewer women would develop gestational diabetes, pre-eclampsia or pregnancy-induced hypertension in Brazil, China, India, Iran or Thailand. The highest PAR of low birthweight attributable to maternal underweight was found in Iran (20%), followed by India (18%), Thailand (10%) and China (8%). Treatment and prevention of maternal underweight, overweight or obesity may help reduce the burden on maternal and child health in developing countries.

Improving litter size by boar spermatozoa: application of combined H33258/CTC staining in field trial with artificial insemination

Conventional semen analysis offers basic information on infertility; however, its clinical value in predicting fertility status is unclear. To establish an accurate diagnosis of male fertility, semen analysis under capacitation condition is necessary because only capacitated spermatozoa are capable of fertilizing oocytes. The objective of this study was to verify male fertility based on conventional semen analysis before and after capacitation, including the assessment of motility (%), motion kinematics, and capacitation status of spermatozoa. A computer-assisted sperm analysis system and chlortetracycline staining were applied to evaluate the motility parameters and capacitation status, respectively. To enable efficacy of the two methods for predicting fertility, correlation analysis was performed with the historic litter size. Our results showed that sperm motility (%), motion kinematics, and their variations before and after capacitation represented a statistical non-significant correlation with litter size. Litter size showed significant correlation with acrosome reaction (AR) after capacitation (r = 0.375), as well as differences (Δ) in AR (r = 0.333) and capacitated (B) pattern (r = -0.447) before and after capacitation. The overall accuracy of the assay for predicting litter sizes using the AR and differences (Δ) in the AR and B pattern was 70%. On the basis of these results, we propose that capacitation status of spermatozoa is a more reliable indicator for evaluating male fertility status compared to motility parameters. Therefore, we suggest that analysis of capacitation status in company with conventional semen analysis may accept to evaluate more accurate diagnosis or prognosis of male fertility.

Genetic testing for spinocerebellar ataxias in patients diagnosed as Parkinson's disease in Bangladesh

This study was conducted to find out Spinocerebellar Ataxias (SCA) by genetic analysis from those patients presenting with Parkinsonism in the Neurology department of Mymensingh Medical College Hospital, Bangladesh. A sample of about 5ml blood was collected by venipuncture in EDTA tube after having informed consent from each patients and healthy individual, with due Institutional Ethical committee approval for genetic study of 7 healthy people and 9 patients. The neurological disorder along with a complete physical and/or psychological, as well as family history and demographic data was recorded with a prescribed questionnaire by the neurologists of Mymensingh Medical College Hospital. Extraction of genomic DNA from the venous blood using Flexi Gene DNA kit (Qiagen, Japan) was performed in Faculty of Veterinary Science, Bangladesh Agricultural University, Mymensingh, Bangladesh. The extracted DNA was stored, accumulated and then were sent to Division of Clinical Genetics, Department of Medical Genetics, Osaka University Medical School, Suita, Osaka 565 0871, Japan for PCR and further analysis. PCR amplification of the CAG repeat was performed for the SCA1, SCA2, SCA3, SCA6 loci using primers SCA1N-F1 and SCA1N-R1, SCA2-F1 and SCA2-R1, MJDF1 and MJDR1, SCA6-F1 and SCA6-R1, respectively. SCA1 PCR of both healthy individual and suspected Parkinsons Disease (PD) patients DNA was found 250 bp (no. of CAG repeats=36). SCA2 PCR products reveal the DNA products of about 150 bp (no. of CAG repeats=23) except one patient that was suspected and it was sequenced and revealed 175bp (no. of CAG repeats=30). SCA3 PCR product size of both healthy individual and patient DNA was within 250 (no. of CAG repeats=11) to 300 bp (no. of CAG repeats=28) except one patient which was about 320 bp and its CAG repeats was about 34. SCA6 PCR product size of both healthy individual and patient DNA was about 150 bp (no. of CAG repeats=16).

Sodium nitroprusside suppresses male fertility in vitro

Sodium nitroprusside is a nitric oxide donor involved in the regulation of the motility, hyperactivation, capacitation, and acrosome reaction (AR) of spermatozoa. However, the molecular mechanism underlying this regulation has not yet been elucidated. Therefore, this study was designed to evaluate the molecular basis for the effects of sodium nitroprusside on different processes in spermatozoa and its consequences on subsequent oocyte fertilization and embryo development. In this in vitro study, mouse spermatozoa were incubated with various concentrations of sodium nitroprusside (1, 10, and 100 μM) for 90 min. Our results showed that sodium nitroprusside inhibited sperm motility and motion kinematics in a dose-dependent manner by significantly enhancing intracellular iron and reactive oxygen species (ROS), and decreasing Ca(2+), and adenosine triphosphate levels in spermatozoa. Moreover, short-term exposure of spermatozoa to sodium nitroprusside increased the tyrosine phosphorylation of sperm proteins involved in PKA-dependent regulation of intracellular calcium levels, which induced a robust AR. Finally, sodium nitroprusside significantly decreased the rates of fertilization and blastocyst formation during embryo development. Based on these results, we propose that sodium nitroprusside increases ROS production and precocious AR may alter overall sperm physiology, leading to poor fertilization and compromised embryonic development.

Cor-triatriatum –A Rare Congenital Heart Disease Presented in Adulthoodsurgical treatment in Apollo Hospitals Dhaka

Abstract not available DOI: http://dx.doi.org/10.3329/pulse.v5i2.20268 Pulse Vol.5 July 2011 p.58-60

Defending the fort: a role for defensin-2 in limiting Rickettsia montanensis infection of Dermacentor variabilis

The importance of tick defensins is evidenced by their expression in a wide variety of tick tissues and prevalence across many tick genera. To date, the functional and biological significance of defensin-2 as a rickettsiastatic or rickettsiacidal antimicrobial peptide has not been addressed. In a previous study, defensin-2 transcription was shown to increase in Dermacentor variabilis ticks challenged with Rickettsia montanensis. In the present study, the hypothesis that defensin-2 is functional as a rickettsiastatic and/or rickettsiacidal antimicrobial peptide is tested. We show that defensin-2 plays a role in reducing burden after acquisition of Rickettsia montanensis through capillary feeding. Moreover, defensin-2 is shown to associate with R. montanensis in vitro and in vivo, causing cytoplasmic leakiness.

Comparative efficacy of pregabalin and therapeutic ultrasound versus therapeutic ultrasound alone on patients with post stroke shoulder pain

The study was designed to compare the efficacy of pregabalin, an anticonvulsant on pain behavior of stroke patients with shoulder pain in a comparative study with ultrasound therapy and ultimately to recommend a better treatment option to improve pain and function in post stroke shoulder pain. This study was carried out in a private neurology Hospital in Dhaka during January to December 2010. Data were collected from 70 post stroke patients with shoulder pain and were divided into two groups. The patients in Group A were treated with pregabalin 100mg twice daily along with therapeutic ultrasound 10 minutes daily and group B were treated with therapeutic ultrasound alone for the same dose and duration. Pain free range of motion exercise was given to both groups as the therapeutic exercise. Pain parameters in the form of VAS were measured at one and two weeks and were compared. Seventy one percent of the patients were male with 80% were above 60 years old. Pain scoring in VAS of 100 was 21.32±6.01 in group A and 41±4.58 in groups B at the end of two weeks assuming the pretreatment VAS of all patients as 100. Marked improvement in shoulder pain were observed in both groups and Group A had better improvement in pain than group B. Therapeutic ultrasound when given with pregabalin found to have added benefit over therapeutic ultrasound alone in post stroke shoulder pain. Differences were statistically significant.

A Cyclic Voltammetric Study of the Redox Reaction of Cu(II) in Presence of Ascorbic Acid in Different pH Media

The electrochemical redox behavior of Cu(II), and Cu(II) in presence of ascorbic acid has been investigated at glassy carbon electrode (GCE) in aqueous phosphate buffer solution (PBS) at various pH. In the studied pH range the voltammogram consists of a cathodic and an anodic peak. Cu(II) follows one step two-electron transfer electrochemical redox reaction. The intensities of both cathodic and anodic peak current increase with increasing scan rate that are consistent with Randles-Sevcik equation. The linear behavior of peak current with the square root of scan rate indicates that the electrochemical processes are diffusion controlled. In presence of ascorbic acid both of the cathodic and anodic peak current of Cu(II) is reduced and peak positions are shifted compared to those of Cu(II) alone. These observation suggest that Cu(II) undergoes a strong interaction with ascorbic acid in the studied medium. DOI: http://dx.doi.org/10.3329/dujs.v61i2.17064 Dhaka Univ. J. Sci. 61(2): 161-166, 2013 (July)

Micropropagation of Stevia Plant from Nodal Segments

The experiment was conducted to develop and establish a reproducible protocol for plantlet regeneration in Stevia. Nodal cutting explants were cultured in Murashige and Skoog (MS) medium supplemented with different concentrations and combinations of ?-Napthaleneacetic acid (NAA) and 6-Benzylamino purine (BAP). The combination of NAA at 1.0 mgl-1 and BAP at 1.0 mgl-1 resulted in the highest percentage (100%) of callus initiation. The maximum shoot regeneration and development of shoot was observed at the same combination. The developed shoots from nodal cuttings, upon transfer to the MS medium containing indole butyric acid (IBA) at 0.1mgl-1 resulted in best rooting within 8 days.DOI: http://dx.doi.org/10.3329/pa.v19i2.16914 Progress. Agric. 19(2): 21 - 26, 2008

Traumatic gut injury: a study of 100 cases in Mymensingh Medical College Hospital

This study was done to find out the mode of presentations, management options and the factors which dictate the out-come of the patients with traumatic gut injury. It has been carried out in the department of Surgery, Mymensingh Medical College Hospital in 100 patients with traumatic gut injury from January 2009 to December 2010. Most of the patients were within 21-30 years (47%) and male patients were the predominant group (90%). In this study penetrating injury was more common (57%) than non-penetrating (43%) injury as a cause of gut injury. Stab (64.91%) was the main mechanism of penetrating abdominal trauma; while road traffic (58.14%) was the main mechanism of non-penetrating abdominal trauma. Diagnosis was made on clinical presentation, physical examination and some investigations. Abdominal pain (98%) was the chief complain and chief sign was abdominal tenderness (98%) and absent bowel sound (91%). Small gut injury was present in 71% patients, 20% patients had large gut injury and 9% had both gut injury. In small gut, jejunum (49.29%) was the most vulnerable portion and right sided colon (55%) was the most affected portion in large gut trauma. Spectrum of injury in small gut included single perforation (63%), multiple perforations (23%), laceration (11%) and devascularization (3%) injury. Primary repair in 60.87%, resection & anastomosis in 27.54% and resection anastomosis with proximal diversion in 11.59% patients were done in small gut injury. Injuries in the large gut were classified into three categories according to Flint Colon Injury Severity Scoring. Highest incidence was in Grade I (60%) category, second in Grade II (35%) and Grade III (5%) was the third one. Simple primary repair in 40%, primary repair or resection anastomosis with proximal diversion in 30%, loop ileostomy in 20% and Hartman's procedure in 10% were done in patients of large gut injury. Resection anastomosis with proximal diversion was performed in patients of both small and large gut injury. Outcome of management was quiet acceptable with 47% of patients having uneventful recovery. Delayed presentation, delayed definitive management, haemodynamically unstable patient, site and number of injuries in the gut were the crucial factor for the overall 44% morbidities of this series. Morbidity rate was 9%. More than half of the patients (56.04%) discharged from the hospital within 10 days. Only a few patients could be followed up for a few months after surgery, who reported to have a satisfactory outcome with no morbidity.

Sexual and urinary outcome after surgical treatment for low rectal cancer

Carcinoma involving the lower part of the rectum is now successfully managed by sphincter saving surgery with less morbidity and uneventful recovery. This study was designed to observe the sexual and urinary dysfunction in both sexes of the patients suffering from cancer of the lower third of the rectum managed by surgical intervention with preservation of sphincter. A comparative study was carried out on 54 patients with low rectal cancer who underwent ultra-low anterior resection in the department of surgery, Bangabandhu Sheikh Mujib Medical University, Dhaka from January, 2009 to December, 2010. Patients were divided into two groups depending on the tumor distance from anal verge. Thirty one (57%) patients were in Group A (Experimental) where tumor distance was 5cm from anal verge and upper 1cm of anal sphincter was sacrificed during surgical intervention. Twenty three (43%) patients were in Group B (Control) where tumor distance was 6cm from anal verge and whole length (4cm) of anal sphincter was preserved during surgical intervention. The mean±SD age of the patients was 45.96±14.41 years. During surgery, ultra low anterior resection was performed to remove the tumor in all patients and for anastomosis double stapling technique was performed in 52(96%) patients and hand sewn technique was performed in 2(4%) patients irrespective of tumor distance from anal verge. Covering ileostomy was fashioned in all but one patient. During post-operative follow up Sexual activity in both groups of male patients (Potency, P=0.17; ejaculation; satisfaction and loss of libido, P=0.15) and in female patients (Satisfaction and loss of libido, P=0.15) was not significantly hampered following surgery. Urinary function was assessed by incontinence, increased frequency (P=0.54) and retention (n=0) which were not impaired significantly following surgery. Sexual and urinary function was not significantly impaired in both sexes after low rectal cancer surgery. Sphincter saving surgery can be performed in a very low rectal cancer with preservation of anal sphincter.

Sphincter saving surgery is the standard procedure for treatment of low rectal cancer

Carcinoma rectum is a challenging problem both for the developed and underdeveloped countries. Colorectal cancer accounts for 9% of all cancer deaths (49,920) in 2009 in USA. Carcinoma involving the lower part of the rectum is now successfully managed by sphincter saving surgery with less morbidity and uneventful recovery. To observe the objective, subjective and functional outcome of the patients suffering from cancer of the lower third of the rectum managed by surgical intervention with preservation of sphincter. A comparative study was carried out on 54 patients with low rectal cancer who underwent ultra-low anterior resection in the department of surgery, Bangabandhu Sheikh Mujib Medical University, Dhaka from January 2009 to December 2010. Patients were divided into two groups depending on the tumor distance from anal verge. Thirty one (57%) patients were in Group A (Experimental) where tumor distance was 5cm from anal verge and upper 1cm of anal sphincter was sacrificed during surgical intervention. Twenty three (43%) patients were in Group B (Control) where tumor distance was 6cm from anal verge and whole length (4cm) of anal sphincter was preserved during surgical intervention. Functional integrity of anal sphincter was assessed between these two groups of patients following surgery. The mean age of the patients was 45.96±14.41 years. During surgery, ultra low anterior resection was performed to remove the tumor in all patients and for anastomosis double stapling technique was performed in 52(96%) patients and hand sewn technique was performed in 2(4%) patients irrespective of tumor distance from anal verge. Covering ileostomy was fashioned in all but one patient. During post-operative follow up anal sphincter muscle tone, anal sphincter function (Anal continence, p = 0.54), Quality of life (Social life, p = 0.54; Professional life, p = 0.23; House work and Need a diaper, p = 0.54) were not significantly impaired in both groups. Functional outcome of anal sphincter muscle and quality of life was not impaired in comparison to general population after low rectal cancer surgery.

Psychiatric in-patient care and suicide in England, 1997 to 2008: a longitudinal study

BACKGROUND

Psychiatric in-patients are at high risk of suicide. Recent reductions in bed numbers in many countries may have affected this risk but few studies have specifically investigated temporal trends. We aimed to explore trends in psychiatric in-patient suicide over time.

METHOD

A prospective study of all patients admitted to National Health Service (NHS) in-patient psychiatric care in England (1997-2008). Suicide rates were determined using National Confidential Inquiry and Hospital Episode Statistics (HES) data.

RESULTS

Over the study period there were 1942 psychiatric in-patient suicides. Between the first 2 years of the study (1997, 1998) and the last 2 years (2007, 2008) the rate of in-patient suicide fell by nearly one-third from 2.45 to 1.68 per 100,000 bed days. This fall in rate was observed for males and females, across ethnicities and diagnoses. It was most marked for patients aged 15-44 years. Rates also fell for the most common suicide methods, particularly suicide by hanging on the ward (a 59% reduction). Although the number of post-discharge suicides fell, the rate of post-discharge suicide may have increased by 19%. The number of suicide deaths in those under the care of crisis resolution/home treatment teams has increased in recent years to approximately 160 annually.

CONCLUSIONS

The rate of suicide among psychiatric in-patients in England has fallen considerably. Possible explanations include falling general population rates, changes in the at-risk population or improved in-patient safety. However, a transfer of risk to the period after discharge or other clinical settings such as crisis resolution teams cannot be ruled out.

PREVALENCE OF SUBCLINICAL MASTITIS IN DAIRY COWS IN SELECTED AREAS OF BANGLADESH

This research was carried out to determine the prevalence of subclinical mastitis in lactating Dairy Cow of Bangladesh Agricultural University dairy farm (BAUDF) and rural areas of Tangail sadar upazila of Bangladesh during the period of July 2009 to April 2010. A total of 200 milk samples (40 from BAUDF and 160 from Tangail sadar upazila) were collected for this study which were subjected to physical examination and subsequently screened for subclinical mastitis using three indirect tests viz. White Side Test (WST), California Mastitis Test (CMT), and Surf Field Mastitis Test (SFMT). Overall prevalence of subclinical mastitis (SCM) in lactating dairy cows found in this study was 29%. Cows were infected with SCM 29.5%, 27.5% and 25.5% detection by CMT, WST and SFMT respectively. Higher prevalence of SCM was detected in milch crossbred cows (36.36%) in comparison to local bred cows (24.61%) maintained under extensive management system in Rural area of Tangail sadar upazila. The prevalence of SCM was recorded in 31.58%, 30.76% and 68.75% in cows of local area of Tangail sadar upazila, and 25.0%, 40.0% and 71.42% in cows of BAU,DF during the early, mid and late stages of lactation respectively. The highest prevalence of SCM was recorded during the early lactation stage in both the local breed cows (30.0%) and cows of BAUDF (45.83%) in comparison to their respective mid and late stages of lactation. The prevalence of SCM was highest in lactating cows having third lactation and high yielding (cows produced >10 liter milk per day) both in local breed and crossbred cows.DOI = http://dx.doi.org/10.3329/bjvm.v9i1.11216 Bangl. J. Vet. Med. (2011). 9(1): 73-78 

Vecuronium and fentanyl requirement in abdominal surgery under combined epidural-general anaesthesia and general anaesthesia alone

Individual effect of epidural block and general anaesthesia is well established in the field of anaesthesiology. But adequate literature is yet not available to give decisive answer regarding the requirement of muscle relaxants and opioid analgesic when the two methods are combined together. In the present study, sixty patients, aged 18-50 years of both sexes with ASA (American Society of Anesthesiologists) grading I and II scheduled to undergo for major abdominal surgery were assigned randomly into two groups (30 in each group), where Group A received general anesthesia and Group B received combined epidural-general anesthesia. The patients with combined technique, epidural catheter tip were placed between T9-10. Ten ml of 0.125% bupivacaine was administered through the epidural catheter. Peripheral nerve stimulator was used to monitor neuromuscular transmission and subsequently to administer incremental dose of neuromuscular blocking drugs. All the patients were pre-medicated with fentanyl (2μg/kg) to reduce intubation reflex. Then the patients of both groups were pre-oxygenated for 3 minute and anaesthesia was induced with thiopental sodium 3-5 mg/kg body weight. Endotrachial intubation was facilitated by vecuronium 0.1mg/kg body weight. Anaesthesia was maintained with 60% N2O in O2 and halothane (0.4 to 0.8%). Fentanyl was given in incremental dose of 0.5 μg/kg to maintain an adequate analgesia. The vecuronium was given at the dose of 0.02 mg/kg, when TOF return to 25% of the base line. The mean±SD requirement of vecuronium in general anaesthesia group was 0.0016±0.00013 mg/kg/min and whereas in combined epidural-general anaesthesia, it was 0.0011±0.00014 mg/kg/min. The requirement of fentanyl was 0.71μg/kg/hr in general anaesthetic group whereas in combined group it was 0.31μg/kg/hr. These findings prompt us to place optimal dosing guidelines so as to avoid overdosing and thus delay recovery and help to get the excellent outcome of the surgery.

Correlation between clinical presentation, peroperative finding and histopathological report in acute appendicitis

Acute appendicitis is usually encountered clinically as acute abdomen. Typical cases are easy to diagnose, but sometimes it is very difficult to make a diagnosis in atypical cases. The objective of the study was to determine the diagnostic accuracy in patient of clinically diagnosed acute appendicitis. This prospective study conducted in Mymensingh medical college hospital on 1136 patients presented with acute abdomen and clinically diagnosed as acute appendicitis from July 2004 to June 2010. Emergency appendicectomy was done in all consecutive patients after relevant investigation. Intraoperative findings along with histopathological reports were compared with clinical diagnosis. On the basis of histopathological report, 85.65% were found to have acute appendicitis with misdiagnosis in rest of the subjects requiring unnecessary explorations. Negative exploration was more in emergency than office hour. This may be due to diagnostic inaccuracy and decision-making in the management of the acute appendicitis. Management errors can be significantly reduced by accurate preoperative diagnosis of acute appendicitis by improving clinical skill and appropriate investigations.

Blood conservation strategies for reducing peri-operative blood loss in open heart surgery

Defects in hemostasis are frequently seen in open heart surgery. Strategies should be reviewed about the peri-operative blood loss and conservation of blood here. In this study, comparison among three agents (Aprotinin, Tranaexaemic Acid & Epsilon Amino Caproic Acid) is done to reduce the peri-operative blood loss in open-heart surgery. Ninety male and female patients within 20-60 years of age were selected who underwent conventional cardiac surgery and anesthesia with Cardio-pulmonary-bypass for common open heart surgeries (ASD, VSD, AVR, etc) and randomly divided into three groups 30 patients in each. Group A, B, C was administered Inj. Aprotinin, Tranaexaemic acid & EACA respectively. Perioperative hemodynamic parameters and blood loss in suction bottle & drainage tube were noted until the 3rd POD. Requirement of blood transfusion, heparin, protamine and blood derived products were also noted. Activated clotting time was documented in the perioperative period. Clinically relevant outcome like re-exploration, mechanical ventilation, morbidities, mortality etc were also verified. Data were analyzed and results were calculated with student's T test & ANOVA. The groups were matched regarding recorded peri-operative variables. Peri-operative blood loss is significantly reduced (p<0.05) both in the Aprotinin and Tranexamic acid groups. Renal dysfunction was reported in 20% of aprotinin patients, 14.29% of tranexaemic acid patients and 18.51% of EACA patients. A conclusion was drawn from the study that Tranexamic acid can significantly reduce the peri-operative blood loss in open heart surgery cases and that it can be preferred as an agent of choice in blood conservation strategy in these cases.

Genetic Testing for Huntington's Disease in Parkinsonism

The study was conducted to find out Huntington's disease (HD) by genetic analysis from those presenting with parkinsonism in the Neurology department of Mymensingh Medical College & Hospital. A sample of about 5ml blood was collected by veni puncture in EDTA tube with informed consent from 9 patients & 7 healthy individuals after approval of the institutional ethics committee for genetic study. The neurological disorder along with a complete history and physical findings were recorded in a prescribed questionnaire by the neurologists of Mymensingh Medical College & Hospital. Extraction of genomic DNA from the venous blood using FlexiGene DNA kit (Qiagen, Japan) was performed in Faculty of Veterinary Science, Bangladesh Agricultural University, Mymensingh, Bangladesh. The extracted DNA was stored and accumulated and then these DNA were sent to Division of Clinical Genetics, Department of Medical Genetics, Osaka University Medical School, Suita, Osaka 565 0871, Japan for PCR and further analysis. PCR amplification of the CAG repeat in the 1T15 gene was performed with primers HD1 and HD3. HD PCR products revealed the DNA product of about 110bp (no. of CAG repeats=21) to 150bp (no. of CAG repeats=34) in both healthy individual and suspected PD patient DNA.

Sexual risk behaviour of rural-to-urban migrant taxi drivers in Dhaka, Bangladesh: a cross-sectional behavioural survey

OBJECTIVES

Human immunodeficiency virus (HIV) research in Bangladesh has mainly focused on key vulnerable groups (e.g. sex workers, drug users). In order to develop appropriate HIV prevention strategies in an evolving epidemic, there is a need for evidence on sexual practices in other population groups. This research aims to describe the prevalence of risky behaviours and factors affecting sexual behaviour/practices among rural-to-urban migrant taxi drivers in Dhaka.

STUDY DESIGN

Cross-sectional study.

METHODS

This paper reports on the cross-sectional survey component of a mixed methods research study amongst migrant workers in Bangladesh. The sample (n = 437) comprised rural-to-urban migrant taxi drivers in Dhaka (aged 18-35 years). The survey data were analysed statistically using Statistical Package for the Social Sciences.

RESULTS

Very high levels of pre- and extramarital sexual behaviour were found (84% and 51%, respectively) amongst the sample (n = 437). The reported sexual activity included high levels of risky/unsafe sex in the past year: 64% of the sample reported sex with multiple commercial sex partners (mean = 13.21), and 21.7% reported sex with other males/transgenders (mean = 2.53). Protection against risk was low: 78.2% reported that their last commercial sexual encounter was unprotected, and only 5.6% used condoms consistently. Multivariate analysis revealed that the odds of risky sexual behaviour were higher in migrant men who were not married (odds ratio 35.3, P < 0.001) and married men who were living apart from their spouses (odds ratio 41.7, P < 0.001). Additionally, reported risk behaviours were significantly associated with frequency of home visits, duration of separation from spouse and alcohol consumption. Thus, male migration without family or spouse appears to be a key driver of risky sexual practices.

CONCLUSIONS

This study provides important new information for understanding the dynamics of sexual behaviour in Bangladesh, and suggests that migrant men should be a key population for HIV prevention efforts. Nonetheless, the fact that most men were having unprotected sex with sex workers reinforces the importance of continuing to target interventions towards commercial sex contexts.

Percuteneous mitral balloon valvuloplasty in patients with post surgical mitral restenosis: result of 70 cases

OBJECTIVE

To evaluate the immediate results of balloon mitral valvulplasty in mitral restenosis patients with previous surgical mitral commissurotomy.

METHODS

Percuteneous balloon mitral valvuloplasty (BMV) was done in 145 cases of which 70patients had the history of previous surgical commissurotomy (Group I) and 75 patients were the new cases for the BMV (Group II).

RESULTS

In group I the age range was 35-65 years. In group I the duration of surgical commissurotomy (SC) was of 2-18 years past. In this group the result of balloon mitral valvuloplasty (BMV) was successful in 69 cases. Mitral valve area (MVA) before the procedure was 0.5-0.9 sq cm with mean 0.7 +/- 0.2 sq cm. Following procedure the MVA was 1.2-2.0 cm2 with a mean of 1.6 +/- 0.4 cm2. Mean gradient across mitral valve (MV) before the procedure was 15-25 mm of Hg with a mean 20 +/- 5 mm of Hg and after the procedure was 3-5 mm Hg with a mean of 4 +/- 1 mm Hg. In Group I, MVA > 1.8 cm2 was achieved in 25 cases & > 1.2-1.8 cm2 in 44 cases. Mitral regurgitation > or = grade 1 occurred in 8 cases (compared to previous echocardiography). In group II the age range was between 35-60 years. The result of BMV was successful in 74 cases. MVA before the procedure was 0.4-1.2 cm2 with a mean of 0.8 +/- 0.4 cm2. Following the procedure MVA was 1.3-2.1 cm2 with a mean of 1.7 +/- 0.4 cm2. Mean gradient across the mitral valve before the procedure was 15-29 mm of Hg with a mean of 22 +/- 7 mm of Hg. Mean gradient across the mitral valve after the procedure was 2-4 mm of Hg with a mean of 3 +/- 1 mm of Hg. MVA more than 1.8 cm2 was achieved in 29 cases and between 1.3-1.8 in 45 cases.

CONCLUSION

BMVin patients with mitral restenosis following Surgical mitral commissurtomy can be performed with almost similar success rate like that of BMV for the first time with low risk of major cardiac complication.

External and internal controls of lunar-related reproductive rhythms in fishes

Reproductive activities of many fish species are, to some extent, entrained to cues from the moon. During the spawning season, synchronous spawning is repeated at intervals of c. 1 month (lunar spawning cycle) and 2 weeks (semi-lunar spawning cycle) or daily according to tidal changes (tidal spawning cycle). In species showing lunar-related spawning cycles, oocytes in the ovary develop towards and mature around a specific moon phase for lunar spawners, around spring tides for semi-lunar spawners and at daytime high tides for tidal spawners. The production of sex steroid hormones also changes in accordance with synchronous oocyte development. Since the production of the steroid hormones with lunar-related reproductive periodicity is regulated by gonadotropins, it is considered that the higher parts of the hypothalamus-pituitary-gonad axis play important roles in the perception and regulation of lunar-related periodicity. It is likely that fishes perceive cues from the moon by sensory organs; however, it is still unknown how lunar cues are transduced as an endogenous rhythm exerting lunar-related spawning rhythmicity. Recent research has revealed that melatonin fluctuated according to the brightness at night, magnetic fields and the tidal cycle. In addition, cyclic changes in hydrostatic pressure had an effect on monoamine contents in the brain. These factors may be indirectly related to the exertion of lunar-related periodicity. Molecular approaches have revealed that mRNA expressions of light-sensitive clock genes change with moonlight, suggesting that brightness at night plays a role in phase-shifting or resetting of biological clocks. Some species may have evolved biological clocks in relation to lunar cycles, although it is still not known how lunar periodicities are endogenously regulated in fishes. This review demonstrates that lunar-related periodicity is utilized and incorporated by ecological and physiological mechanisms governing the reproductive success of fishes.