Copper and Zinc Status in Patients with Preeclampsia in Bangladesh

This study assessed maternal serum copper and zinc levels in preeclampsia to find out the role of trace element disorder in the aetiology of preeclampsia. This cross sectional study was conducted in the dept of Physiology of BSMMU during 2009. Sixty patients of Preeclampsia (BP--140/90 aged 18-39 years, with >20th weeks of pregnancy with proteinuria and edema) participated. Thirty normotensive gravida was control. All subjects were collected from in and out patient department of Obstetric and Gynecology of BSMMU and Dhaka medical college hospital. Serum copper and zinc levels were measured by auto analyzer and atomic absorption sprectrophotometric method respectively. Data were compared between preeclampsia and normotensive pregnant women. Data were expressed as mean and SD and independent sample 't' test and two proportion 'z' test was used for statistical analysis. Mean value of maternal serum zinc (p<0.001) and copper (<0.01) levels were significantly decreased in preeclampsia. In addition Cu/Zn ratio was significantly higher (<0.01) in preeclampsia. Hypozincemia was found in 13% and hypocupremia was found in 38% of preeclampsia. The result of this study concludes that trace element disorders may be involved in the etiology of preeclampsia.

Characteristics and Management of Children with Continuous Spikes and Waves during Slow Sleep

This study was done to describe the clinical spectrum, EEG characteristics and treatment modalities in children with continuous spike and slow wave in sleep (CSWS). Ten patients with CSWS had been treated between 2012 and 2013. Mean age of the patients was 6.9 years; male female ratio was 3:2. The main etiologic group in this study was epilepsy (10), cerebral palsy (3) and brain lesion (arachnoid cyst). All the patients had prior seizure. Presenting features were abnormal behavior (4), agitation (4), aggression (4), eye blinking (2) and involuntary movement (2). Three patients had speech regression and 1 had motor regression. Regarding EEG finding, 7 out 10 cases had SWI>85% whereas, rest of them had SWI 50 to 80%. Most of the patients were resistant to two or more oral AED. The AED found to be efficacious were Midazolam drip, pulse methyl prednisolone and valproate. Eighty percent (80%) patient responded to midazolam drip. Methyl prednisolone caused 50% improvement in one patient but failed in 2 cases. In contrast to the previous studies where high dose valproic acid, levetiracetam, Injection ACTH was more efficacious, this study demonstrates significant positive result with midazolam drip.

Postnatal Support Strategies for Improving Rates of Exclusive Breastfeeding in Case of Caesarean Baby

Despite awarness of the many advantages of breast feeding exclusive breastfeeding (EBF) rate is still lower than recommended practice and the rate is less in case of caesarean baby. In an effort towards achieving better breast feeding practices, UNICEF and WHO launched the baby friendly hospital initiative in 1991 to ensure that all maternity facilities support mothers in making the best choice about feeding. The implementation of effective programs improves rates of short and long term exclusive breast feeding even in case of caesarean baby. The objective of present study was to investigate whether postnatal support improves the rate of exclusive breast feeding in case of caesarean baby compared with usual hospital care. This was a longitudinal study over one and half year period, from April 2009 to October 2011 done in Combined Military Hospital in Mymensingh. A total of 565 pregnant women were included this study. Primary outcome was early establishment of breast feeding after caesarean section. Secondary outcome was exclusive breast feeding at discharge from hospital, two weeks and six weeks after caesarean section delivery. Early establishment of breast feeding within one hour after caesarean section was higher in postnatal support group than usual care group (70.29% vs. 57.14%). Rates of exclusive breastfeeding in the postnatal support strategies group were significantly higher when compared with those who received usual hospital care at discharge (89.13% vs. 75.94%, p=0.004), at 2 weeks (85.51% vs. 53.38%, p<0.001) and at 6 weeks (74.64% vs. 38.35%, p<0.001). Postnatal lactation support, as single intervention based in hospital significantly improves rates of exclusive breast feeding.

Simplified molecular input line entry system-based: QSAR modelling for MAP kinase-interacting protein kinase (MNK1)

Quantitative structure-activity relationship (QSAR) models were built for the prediction of inhibition (pIC50, i.e. negative logarithm of the 50% effective concentration) of MAP kinase-interacting protein kinase (MNK1) by 43 potent inhibitors. The pIC50 values were modelled with five random splits, with the representations of the molecular structures by simplified molecular input line entry system (SMILES). QSAR model building was performed by the Monte Carlo optimisation using three methods: classic scheme; balance of correlations; and balance correlation with ideal slopes. The robustness of these models were checked by parameters as rm(2), r(*)m(2), [Formula: see text] and randomisation technique. The best QSAR model based on single optimal descriptors was applied to study in vitro structure-activity relationships of 6-(4-(2-(piperidin-1-yl) ethoxy) phenyl)-3-(pyridin-4-yl) pyrazolo [1,5-a] pyrimidine derivatives as a screening tool for the development of novel potent MNK1 inhibitors. The effects of alkyl group, -OH, -NO2, F, Cl, Br, I, etc. on the IC50 values towards the inhibition of MNK1 were also reported.

Soft tissue tumours and tumour like lesions - a demographic and clinicopathologic study of 461 cases from different regions of Bangladesh

Soft tissue tumours and tumour like lesions are relatively rare. They pose diagnostic difficulty due to wide morphological variation as well as overlapping clinical and pathological features. The relative frequency of soft tissue tumours varies throughout world. This study was undertaken to find out the distribution of soft tissue tumours and tumour like lesions in Babgladesh. Four hundred and sixty one cases of soft tissue tumour and tumour like lesions were studied to see the demographic and clinicopathologic pattern. Benign 320(69.4%) and malignant 141(30.6%) cases were recorded. Of all cases mean age was 31.07±16.87 years with M:F ratio of 1:0.71 (p=0.001). Upper extremity was the most common site. Majority of the benign cases (84.1%) were superficially located whereas majority of malignant cases (89.2%) were deep seated (p=0.001). Lipoma and fibrosarcoma was the most common benign and malignant tumour respectively observed in this study. In childhood group, rhabdomyosarcona was the commonest one. The distribution pattern of soft tissue tumours in Bangladeshi population is roughly similar to that described in other countries with few exceptions.

Water stable triazolyl phosphonate MOFs: steep water uptake and facile regeneration

Triazole and phosphonate donors connect Co²⁺ ions to a water stable 3D framework with hydrophilic nanopores featuring water uptake at low relative pressure.

Hypoxia modulates the activity of a series of clinically approved tyrosine kinase inhibitors

BACKGROUND AND PURPOSE

Hypoxia in tumours is known to cause resistance to conventional chemotherapeutic drugs. In contrast, little is known about the effects of hypoxia on targeted anti-cancer drugs. This study evaluated the effect of hypoxia on a series of clinically approved tyrosine kinase inhibitors (TKIs).

EXPERIMENTAL APPROACH

The effect of hypoxia (0.1% oxygen) on the activity of conventional cytotoxic drugs (5-fluorouracil, doxorubicin and vinblastine), the hypoxia-activated prodrug tirapazamine and 9 TKIs was determined in a panel of cell lines. Where hypoxia had a marked effect on chemosensitivity, Western blot analysis was conducted to determine the effect of hypoxia on target expression and the effect of TKIs on cell signalling response under aerobic and hypoxic conditions.

KEY RESULTS

Three patterns of chemosensitivity were observed: resistance under hypoxia, equitoxic activity against hypoxic and aerobic cells, and preferential cytotoxicity to hypoxic cells. Significant hypoxia selectivity (independent of HIF1) was observed in the case of dasatinib and this correlated with the ability of dasatinib to inhibit phosphorylation of Src at tyrosine 530. Sorafenib was significantly less effective under hypoxic conditions but resistance did not correlate with hypoxia-induced changes in Raf/MEK/ERK signalling.

CONCLUSIONS AND IMPLICATIONS

Hypoxia influences the activity of TKIs but in contrast to conventional cytotoxic drugs, preferential activity against hypoxic cells can occur. The search for hypoxia-targeted therapies has been long and fruitless and this study suggests that some clinically approved TKIs could preferentially target the hypoxic fraction of some tumour types.

A rare case of primary adenoid cystic carcinoma of lung

A 33-year-old male presented with repeated episodes of blood-streaked sputum for last one-and half-year. Chest radiograph showed consolidation in the right lower zone. Fibreoptic bronchoscopy revealed an endoluminal growth in the right lower lobe bronchus. Histopathological examination of bronchoscopic biopsy specimen confirmed adenoid cystic carcinoma.

A critical re-evaluation of the prediction of alkalinity and base cation chemistry from BGS sediment composition data

The model of Begum et al. (2010) that predicts alkalinity and Ca and Mg concentrations in river water from available sediment composition data has been critically re-evaluated using an independent validation data set. The results support the hypothesis that readily available stream water sediment elemental composition data are useful for prediction of mean and minimum concentrations of alkalinity and Ca and Mg in river water throughout the River Derwent catchment in North Yorkshire without requiring land-use data inputs as stream water sediment composition reflects all aspects of the riparian zone soil system, including land-use. However, it was shown for alkalinity prediction that rainfall exerts a significant dilution effect and should be incorporated into the model in addition to flow path-weighted sediments Ca% and Mg%. The results also strongly suggest that in catchments with substantial rough moorland land-use neutralization of organic acids consumes alkalinity and this fact should be considered in any future development of the model.

Diagnostic Efficacy of HbA1c in Diagnosis of Diabetes Mellitus in a Bangladesh Population

American Diabetic Association (ADA) affirms HbA1c with cut off value of 6.5% as a diagnostic criteria of diabetes mellitus. World Health Organization (WHO) also supports but recommended that a value <6.5% does not exclude diabetes which is diagnosed by glucose test. The aim of this study was to evaluate the diagnostic efficacy of HbA1c in terms of sensitivity, specificity, positive and negative predictive value and accuracy in a selected group of Bangladeshi subjects. This cross-sectional study included 761 adult Bangladeshi subjects of both sex attending the outdoor in a tertiary healthcare center during the period of September 2009 to September 2010. Fasting, postprandial (2 hours after glucose load) plasma glucose and HbA1c were measured. Diabetes is defined according to HbA1c and plasma glucose. Sensitivity, specificity, positive and negative predictive value of HbA1c were 90.00% (CI 86.48-92.86%), 76.21% (CI 71.68-80.35%), 78.17% (CI 73.94-82.00%) and 88.96% (CI 85.10-92.10%) respectively. Accuracy was 82.92% with odds ratio (OR) 28.84 (CI 19.10-43.54%); p < 0.001. Though HbA1c revealed remarkable diagnostic efficacy and ease of performance, still it can not over rule the role of plasma glucose in diagnosis of diabetes mellitus. DOI: http://dx.doi.org/10.3329/bmj.v41i1.18785 Bangladesh Medical Journal 2012 Vol. 41 No. 1; 53-54

Land Cover Change Analysis Around the Sundarbans Mangrove Forest of Bangladesh using Remote Sensing and GIS Application

Land cover change is a widespread and prominent feature in Bangladesh. It is more energetic in the South-west coastal region such as Khulna and Satkhira region. The research was completed by 30 years (1980 to 2009) by using four Landsat satellite images (1980, 1989, 2002 and 2009). During research it was originated that the main classes of changes were homestead, fallow land, water bodies and mangrove vegetation in the study area. The most imperative change was observed in fallow lands (the types of cultivable lands with or without any standing crops and also uncultivable lands). Fallow land was decreased, concerning 2,259 sq km in 2009 which land was 3,867 sq km during in 1980. It was dropped 49% to 29% of total study area between the years of 1980 to 2009. The water bodies were increased about 10% in those 30 years, regarding 14% to 24%. The total water bodies covered 1140 sq km at 1980 which was increased 1851 sq km during 2009 in the study area. The sea-level rise, increasing salinity and availability of less fresh water are responsible for inland intrusion of saline water and creating favorable environment for shrimp farming in the region. As a result farmers are converting fallow lands to shrimp farming which is economically very beneficial. Important agricultural and non-agricultural lands also converted by homestead intended for increasing population of Bangladesh. There was only 398 sq km (only 5%) area covered by homestead during 1980. But the homestead covered area was increased about 1490 sq km (19%) at 2009. So, compared to the last 30 years 14% homesteads land cover areas are increased. There was not any astonishing changed in mangrove vegetation. Some mangroves areas were shattered and some other mangroves were full-fledged again in delta areas. The harmful land cover changes are not expectable for the natural environment. But it transpires by many natural and anthropogenic tricks now a day. So, the authority should seize initiatives to protect this category of catastrophe. DOI: http://dx.doi.org/10.3329/jsf.v9i1-2.14652 J. Sci. Foundation, 9(1&2): 95-107, June-December 2011

Fetal Outcome of Pre-eclamptic Mothers with Hyperuricemia

Pre-eclampsia (PE) is considered as a major cause of maternal and fetal morbidity and mortality. When a pre-eclamptic woman develops associated hyperuricemia then fetal outcome may become worse. To observe the fetal outcome of hyperuricemic pre-eclamptic pregnancy in relation to normo-uricemic pre-eclamptic pregnancy in a hospital based comparative and cross-sectional study 62 pre-eclamptic patients were selected purposively. PE was diagnosed by hypertension and proteinuria. PE patients were divided into two groups by there serum uric acid level - Hyperuricemic & Normo-uricemic. Then fetal outcome markers (Stillbirth and low birth weight fetus) of the study groups were observed. In this study significant increased number of low birth weight fetuses was observed in babies born to hyperuricemic pre-eclamptic mothers in comparison with babies born to normo-uricemic pre-eclamptic mothers. According to the observation the estimation of serum uric acid may be considered in management of pre-eclamptic mothers, especially in lowering the rate of poor fetal outcome. DOI: http://dx.doi.org/10.3329/jdnmch.v17i1.12192 J. Dhaka National Med. Coll. Hos. 2011; 17 (01): 41-43

Beta thalassemia in a tertiary care hospital with their chelation habit

Beta-thalassemia which is one of the most common genetic disorders in Bangladesh encompasses a group of monogemic diseases that have reduced synthesis or no synthesis of one or more globin chain of haemoglobin. The defects involved are extremely heterogenous and give rise to a large phenotypic spectrum with patients that are almost asymptomatic to cases in which regular blood transfusions are required to sustain life. The aim of the study is to estimate the frequency of beta thalassemia among the blood recipients in the Day Care Centre of Transfusion Medicine Department of Mymensingh Medical College Hospital from July, 2009 to June, 2010 along with their chelation habit. Retrospective cross-sectional study with the sample size of 784, clinical and family data was collected and descriptive statistics were done in the Laboratory of Transfusion Medicine Department. Among the 784 subjects, the beta thalassemia was 521 (66.46%), among the thalassemic patients only 59(11.32%) take injection Dysferrioxamine (Dysferol), the iron chelating agent. Male are predominant than female (63.53%). Those of the affected patients 67.18% were in age group 6 to 20 years. Although beta thalassemia is one of the first monogemic diseases and represents a global health problem, only recently has the scientific community started to focus on the real molecular mechanisms that underline this disease, opening new & exciting therapeutic perspectives for thalassemic patients worldwide. It is concluded from our study that availability of blood transfusion facilities along with an orally and cheaper iron chelator is an urgent need to ensure the management of needy thalassemic patients in Bangladesh.

Carpenter syndrome: a case report

Carpenter syndrome is a rare hereditary disorder known as Acrocephalopolysyndyctyly (ACPS) type II characterized by acrocephaly, facial dysmorphism, brachedyctyly, syndyctyly, preaxial polydyctyly, obesity, congenital heart disease, cryptorchidism, hypogenitalism, bony abnormalities and umbilical hernia. Carpenter syndrome is autosomal recessive disorder and prenatal diagnosis of this syndrome is possible by ultrasonogram during pregnancy. We reported a case of carpenter syndrome of 2.5 months old female infant of consanguineous parents who was admitted in the paediatric ward of Bangabandhu Sheikh Mujib Medical University (BSMMU) on 30th March 2010. She was diagnosed as a case of Carpenter syndrome having acrocephaly prominent ridge of sagital suture, polydactyly, syndyctyly on history, clinical examination findings and investigation reports.