Conclusions about differences in linear growth between Bangladeshi boys and girls depend on the growth reference used

OBJECTIVE

To examine sex differences in height-for-age z-scores and the percentage stunting among Bangladeshi children estimated using three growth references.

DESIGN, SETTING AND SUBJECTS

Data collected between 1990 and 1999 by Helen Keller International's nutritional surveillance system in rural Bangladesh were analyzed for 504 358 children aged 6-59 months. Height-for-age z-scores were estimated using the 1977 NCHS, 2000 CDC and 1990 British growth references.

RESULTS

The shape of the growth curves for Bangladeshi boys and girls, and their positions relative to one another, depend on which of the three growth references is used. At 6 months of age the British reference showed no sex difference whereas the NCHS and CDC showed girls to have higher average z-scores than boys by 0.14 and 0.28 s.d., respectively. While all references showed a faster deterioration of girls' z-scores from 6 to 24 months, the magnitude and direction of the sex differences, and how they changed with age, were different. There was greater disagreement about girls' z-scores than boys. Discontinuities at 24 months in the NCHS and CDC produced jagged curves whereas the British curves were smooth.

CONCLUSIONS

The assessment of sex differences in linear growth depends on the growth reference used. Reasons for the different results need to be determined and may aid the final development of the new WHO international growth reference and the guidelines for its use. The findings suggest that anthropometry as a tool to explore the effects of societal gender inequality must be used with caution.

Triterpene and coumarins from Skimmia laureola

In the course of our studies on the chemical constituents of the leaves of Skimmia laureola, a new triterpene O-methyl cyclolaudenol (1) and a new coumarin, (+)-7-methoxy-6-(2'R-methoxy-3'-hydroxy-3'-methyl butyl) coumarin (2) were isolated. In addition five known coumarins, isogospherol (3), heraclenol (4), 5,8-dimethoxy coumarin-2H-1-benzopyran-2-one (5), 7-methoxy-6[2'-oxo-3'-methyl butyl] coumarin (6), and (+)-ulopterol (7) were also isolated for the first time from this plant. The structures were identified by spectroscopic studies and the stereochemistry at C-2' in compounds 3 and 4 were established by Horeau's procedure.

A comparative study of body iron status and lipid profile in acute myocardial infarction patients

This study was carried out to evaluate the relationship between body iron status and lipid profile in hospital admitted clinically diagnosed AMI patients considering the concept that there is a potential association between body iron status and coronary heart disease (CHD). Total 80 subjects were selected, of which 40 were healthy adults and 40 were AMI patients. Fasting blood samples were collected from healthy adults. Blood samples of AMI patients were collected within 24 hours of the attack of myocardial infarction. Body iron status was measured in term of 3 variables serum total iron concentration, TIBC and transferrin saturation. Lipid profile variables measure were total cholesterol, triglyceride, LDL-cholesterol and HDL-cholesterol. No correlation was found between serum iron and the variables of lipid profile. TIBC was found to maintain negative correlation with total cholesterol, triglyceride and LDL-cholesterol but positive correlation with HDL-cholesterol. Transferrin saturation was found to maintain strongly positive correlation with total cholesterol, triglyceride and LDL-cholesterol but strongly negative correlation with HDL-cholesterol. This correlation of TIBC and transferrin saturation with lipid profile supports the hypothesis that there is a potential association between body iron status and coronary heart disease.

3-Monoterpenyl-2,4-dioxygenated quinoline alkaloids from the aerial parts of Halfordia kendack

The aerial parts of Halfordia kendack (Rutaceae) have yielded the known alkaloid trans-erioaustralasine ([rel]-1-acetoxymethyl-4.8'-epoxy-3-(1'beta,2'beta-epoxy-3'beta,4'alpha-para-menthyl-3'-yl)quinolin-2-one) together with four new alkaloids. The latter were characterised by spectroscopic methods as trans-deacetoxyerioaustralasine ([rel]-1-methyl-4.8'-epoxy-3-(1'beta,2'beta-epoxy-3'beta,4'alpha-para-menthyl-3'-yl)quinolin-2-one), trans-deacetoxyerioaustralasine hydrate ([rel]-1-methyl-4.8'-epoxy-3-(1'alpha,2'alpha-dihydroxy-3'beta,4'alpha-para-;menthyl-3'-yl)quinolin-2-one), trans-erioaustralasine hydrate ([rel]-1-acetoxymethyl-4.8'-epoxy-3-(1'alpha,2'alpha-dihydroxy-3'beta,4'alpha-para-menthyl-3'-yl)quinolin-2-one) and trans-1-epi-deacetoxyerioaustralasine hydrate ([rel]-1-acetoxymethyl-4.8'-epoxy-3-(1'beta,2'alpha-dihydroxy-3'beta,4'alpha-para-menthyl-3'-yl)quinolin-2-one).

In vitro activity of ceftizoxime and ceftazidime in presence of essential and trace elements

The research work comprises of the study of the changes in antimicrobial activity of ceftizoxime and ceftazidime after interaction with essential and trace elements. The minimum inhibitory concentration (MIC) was observed and thereafter compared with the standard MIC's of the respective drug by agar dilution method against both Gram positive and Gram-negative organisms so as to evaluate changes in antimicrobiological activity of the standard cephalosporins after metal interactions. It was observed that these metal elements that are essential for our body, either present within the body or coadminstered with vitamins markedly influence the MIC's of antibiotics by producing synergism or antagonism.

Cefuroxime antacid interactions

Cefuroxime sodium a second generation semi-synthetic cephalosporin is effective for treating meningitis, lower respiratory tract infections, gonorrhea, bone and joint infections and is approved for surgical prophylaxis. There are number of synergistic and as well as antagonistic drug interactions reported for this antibiotic. Withstanding to gastric irritations caused by this antibiotic, antacids may possibly be co-administered with cefuroxime, which may result in severe adverse drug interaction. The present work describes the effect of magnesium carbonate, magnesium hydroxide, magnesium trisilicate, megaldrate powder, sodium bicarbonate, aluminum oxide and simethicone suspension on the in vitro availability of cefuroxime sodium. The mechanism of interaction between antibiotic and antacids was also studied.

3,5-Dimethoxy-3-(1,1-dimethylprop-2-enyl)-3,4-dihydropsoralen-4-one: an unusual furanocoumarin derivative from Halfordia kendack

The aerial parts of Halfordia kendack (Rutaceae) have yielded a new furanocoumarin derivative which has been identified as 3,5-dimethoxy-3-(1,1-dimethylprop-2-enyl)-3,4-dihydropsoralen-4-one on the basis of spectroscopic and X-ray examination. This new compound, present in high concentration, is probably formed from a 4-O-prenylated precursor furanocoumarin via a Claisen rearrangement. No trace of the putative precursor was found in this sample.

Prenatal diagnosis of beta-thalassaemia in Pakistan: experience in a Muslim country

A service for prenatal diagnosis of beta-thalassaemia was introduced in Pakistan in May 1994. Two renowned Islamic scholars, consulted before the service was introduced, ruled that a pregnancy can be terminated if the fetus is affected by a serious genetic disorder, and if termination is before 120 days (17 weeks) of gestation. During the first 3(1/2) years of the service 300 couples requested the test. Almost all the couples had been informed by their treating doctors. Most diagnoses were made between 10 and 16 weeks of gestation, and only 15 (5%) were reached after the 16th week. DNA analysis was by the amplification refractory mutation system (ARMS). A multiplex ARMS was developed in which three primer combinations identified the mutations in 91.5% of the couples. In 13 couples (4. 3%) linkage analysis was required for the fetal diagnosis. In 47/53 (88.7%) women carrying an affected fetus the pregnancy was terminated. In six cases it was declined principally on religious grounds. Postnatal confirmation of the prenatal diagnosis was possible in 117 unaffected children. One year after the start of the service, interviews with 141 couples with an affected child showed that 72% knew of the availability of prenatal diagnosis. Thirty-two of the informed couples had had a pregnancy, but only 18 (56%) used prenatal diagnosis. The main reasons for non-utilization of prenatal diagnosis were the cost of the test and fear of undergoing the test, though some gave no clear explanation. This study demonstrates that prenatal diagnosis is feasible and acceptable in a Muslim country such as Pakistan.

A role for nuclear PTEN in neuronal differentiation

Mutations of phosphatase and tensin homolog deleted on chromosome 10 (PTEN), a protein and lipid phosphatase, have been associated with gliomas, macrocephaly, and mental deficiencies. We have assessed PTEN's role in the nervous system and find that PTEN is expressed in mouse brain late in development, starting at approximately postnatal day 0. In adult brain, PTEN is preferentially expressed in neurons and is especially evident in Purkinje neurons, olfactory mitral neurons, and large pyramidal neurons. To analyze the function of PTEN in neuronal differentiation, we used two well established model systems-pheochromocytoma cells and cultured CNS stem cells. PTEN is expressed during neurotrophin-induced differentiation and is detected in both the nucleus and cytoplasm. Suppression of PTEN levels with antisense oligonucleotides does not block initiation of neuronal differentiation. Instead, PTEN antisense leads to death of the resulting, immature neurons, probably during neurite extension. In contrast, PTEN is not required for astrocytic differentiation. These observations indicate that PTEN acts at multiple sites in the cell, regulating the transition of differentiating neuroblasts to postmitotic neurons.

Down's syndrome: prospects for prevention by antenatal diagnosis

The results of a prospective study on cytogenetic analysis of Chorionic Villus Samples (CVS) taken in early pregnancy (after 10 weeks) from pregnant ladies aged between 22 and 50 years are being presented.

OBJECTIVE

To find out the prevalence of chromosomal defects with advancing age of the mother.

SETTING

Department of Medical Genetics, Armed Forces Institute of Pathology, Rawalpindi.

METHODS

A total of 48 samples have been studied. Ten patients were above the age of 35 years and 38 were below the age of 35 years. Chorionic villus samples were obtained after 10th week of pregnancy through transabdominal approach. Cytogenetic cultures were set up both by the direct and routine methods.

RESULTS

Three out of the seven samples taken from expecting mothers aged above 35 and one culture from a patient aged less than 35, showed trisomy 21.

CONCLUSION

This study highlights the fact that incidence of chromosomal aberrations and the Down's syndrome in particular, increases with the advancing maternal age. Prenatal studies can therefore be utilized to decrease the incidence of various chromosomal abnormalities.

Gliclazide

The crystal structure of gliclazide, N-[(perhydrocyclopenta [c]pyrrol-2-yl)aminocarbonyl]-p-toluenesulfonamide, C15H21B3O3S, a second-generation oral hypoglycemic agent, contains discrete molecules with normal molecular dimensions. Both of the five-membered fused rings adopt envelope conformations. The molecules are linked into chains by intermolecular hydrogen bonds involving amino-H atoms, with N...O separations of 2.967 (3) and 2.949 (3) A.

Isolation and structural studies on the chemical constituents of skimmialaureola

Studies on the chemical constituents of the aerial parts of Skimmia laureola have led to the isolation of four new alkaloids, ptelefoliarine (1), acetoxyptelefoliarine (2), acetoxyedulinine (3), and orixiarine (4). Their structures were established by spectroscopic studies.

The role of the anti-sperm autoantibodies in the management of patients with primary infertility

The role of antibody mediated infertility in patients with primary/secondary unexplained infertility is the subject of current interest worldwide. A prospective study was conducted to study the role of anti sperm antibodies in Pakistani patients with infertility. Patients reporting in the outpatient clinic of a local gynaecology department with problem of infertility were subjected to a detailed scrutiny by history and clinical examination including post-coital test and hysterosalpingography. Hormonal profile consisting of serum FSH, LH, Prolactin and Progesterone was assessed. Most of the ladies also underwent a pelviscopic examination. A total of 117 patients were selected where post-coital test was abnormal, semen analysis was not satisfactory or who had unexplained infertility. Tests were performed on the serum specimen from the husbands, wives and in some cases on the seminal plasma as well, for the measurement of the anti sperm agglutinating and anti-sperm immobilizing antibodies by the microagglutination technique. Fifteen of these patients were found positive for these antibodies, 7 were positive for the agglutinating antibody, 6 for the immobilizing antibody and two for both types. These results indicate that immunomodulation may be responsible for some cases of infertility in our population.

Erythromycin-antacid interaction

The in vitro release of erythromycin stearate in the presence of aluminium hydroxide, aluminium trisilicate, magnesium oxide, magnesium trisilicate, sodium hydrogen carbonate and a combination of aluminium hydroxide gel, magnesium hydroxide and dimethyl polysiloxane has been studied by the USP XX dissolution method. The dissolution of erythromycin was found to be markedly retarded in the presence of all the antacids studied except sodium hydrogen carbonate. An attempt was made to elucidate the mechanism of this effect.

Detection of early xerophthalmia by impression cytology and rose Bengal staining--a comparative study

Twenty two cases were studied for early detection of Xerophthalmia by impression cytology and Rose Bengal staining. Patients were below 6 years of age and admitted in the paediatric ward of Dhaka Medical College Hospital. Assessment were done by conjunctival impression cytology and staining with 1% Rose Bengal dye. Estimation of serum retinol level was done by HPLC to correlate conjunctival findings with biochemical status. The mean age of the subjects were 3.15 +/- 1.75. Rose Bengal staining was positive in 40% cases and impression cytology was in 60% cases. The mean serum retinol level of the diseased children were 10.5 +/- 3. ug/dl. The sensitivity of Rose Bengal staining was 53.3% and that of impression cytology was 80% in detecting vitamin A deficiency when compared with serum retinol level. The specificity of Rose Bengal staining was 40% and that of impression cytology was 100%. Sensitivity of impression cytology was 100% in patient with retinol level 10 ug/dl.

Nurses' attitudes towards computerization in clinical practice

This descriptive research project was designed to replicate the study of Brodt & Stronge (1986) and to extend and investigate the attitudes of nurses towards computers in clinical practice. Lack of an adequate study into nurses' attitudes to computers was the motive behind this study. The research project was carried out in a district general hospital in the United Kingdom. Data was collected by means of a Likert's type closed-structure attitude-scale questionnaire. The sample consisted of 58 nurses working in a clinical setting. The overall conclusion was that nurses' attitudes to computers were more unfavourable than favourable.

Patients with acute poisoning seen in the department of intensive care-Jinnah Postgraduate Medical Centre, Karachi

A review of 157 cases of acute poisoning admitted to the intensive care unit shows that poisoning was responsible for 40 15% of the cases treated at this unit between 15th January to 31st December, 1976. Inspite of limited facilities the over all mortality from acute poisoning was 9.5% while that due to organo-phosphorus insecticides alone was 7%. A considerable infrequency of organophosphorus insecticides poisoning was observed in developed countries when their data was compared with the present series.

Organo-phosphorus insecticide poisoning-review of 53 cases

A review of 53 cases of organo-phosphorus insecticide poisoning admitted to the department of intensive care at the Jinnah Postgraduate Medical Centre between 15th January to 31st December, 1976 has shown that these insecticides form a majority of the causes of acute poisoning and are associated with a comparatively high mortality rate. Out of a total of 157 cases of acute poisoning admitted to the department, 34% were cases of organo-phosphorus insecticide poisoning forming 13 5% of the total admissions. These insecticides being easily accessible, are frequently used as suicidal agents specially by uneducated housewives. They are highly toxic and their management is very complicated. Of a total of 15 deaths from poisoning, 11 (73%) were due to this cause. This being such a common mode of poisoning in our country, we have presented here our experience of the clinical features and management of these cases.

Prevalence of Metabolic Syndrome in Newly Diagnosed Type 2 Diabetes Mellitus

Background: People with metabolic syndrome are twice as likely to die from, and three times as likely to have a heart attack or stroke compared with people without the syndrome. People with metabolic syndrome have a five-fold greater risk of developing type 2 diabetes. We investigated the prevalence of metabolic syndrome in patients with newly diagnosed diabetes mellitus. Methods: It was a cross sectional study. The study was conducted in Department of Biochemistry, Sylhet MAG Osmani Medical College, Sylhet & Diabetic Hospital, Sylhet. The study was conducted From July 2008 to June 2009 among 200 patients with newly diagnosed type 2 diabetic patients with age >20 years. Along with blood glucose, different components of metabolic syndrome was assessed, i.e. serum triglyceride level, serum HDL level, blood pressure and waist circumference. Results- Prevalence of metabolic syndrome was 73.5% according to NCEP-ATP III criteria, 81.0% according to modified NCEP-ATP III criteria, 82.5% according to modified WHO criteria and 61.0% according to IDF criteria. All variables other than waist hip ratio and fasting blood sugar had statistically significant higher mean values among patients with metabolic syndrome than patients without metabolic syndrome. Conclusion: It may be concluded that prevalence of metabolic syndrome is considerable in newly diagnosed type 2 diabetic patients in our population. The considerable prevalence of metabolic syndrome in our population is implicative of an alarming risk of cardiovascular disease in future. Keywords: Metabolic syndrome; Type II diabetes mellitus. DOI: http://dx.doi.org/10.3329/cardio.v4i1.9385 Cardiovasc. J. 2011; 4(1): 17-25

Study of serum non-HDL cholesterol in cerebrovascular disease

Background: Non-HDL cholesterol is a potential newer risk factor for cerebrovascular diseases (CVD). Objective: To explore the association of non-HDL cholesterol with cerebrovascular disease. Methods: This case control study was carried out in the Department of Biochemistry, BSMMU, Dhaka during the period of January to December 2007 to evaluate the association of non-HDL cholesterol with CVD in Bangladeshi population. A total number of 135 subjects of both sexes were grouped as Group-I (CVD cases) and Group-II (Healthy controls). Group-I include 85 cases of which 59 were ischaemic cerebrovascular diseases (ICVD) and 26 were haemorrhagic cerebrovascular diseases (HCVD). By taking the history and doing clinical examination and laboratory investigations, diabetes mellitus, malignant disease, renal disease, liver disease and diuretic medication were excluded from study subjects. Serum non-HDL cholesterol was measured in all study subjects. Statistical analysis was performed by using SPSS for windows version 12.0. Mean values of the findings were compared between groups. One way ANOVA test and multiple comparison (Bonferroni‘t’) test were used to see the level of significance. Results: Serum non-HDL cholesterol found significantly increased in CVD, ICVD and HCVD cases in comparison to control subjects. But ICVD and HCVD cases did not differ with respect to serum non-HDLcholesterol. Conclusion: The result shows that elevated non-HDL cholesterol is associated with CVD. Prospective study with large sample size is required to evaluate the elevated Non-HDL cholesterol as a risk factor of CVD. Key words: Non-HDL cholesterol; Cerebrovascular disease; Ischaemic cerebrovascular disease; Haemorrhagic cerebrovascular disease. DOI: 10.3329/bjms.v9i3.6469Bangladesh Journal of Medical Science Vol.09 No.3 July 2010, pp.143-149

Oral Versus Vaginal Misoprostol for Induction of Labour

It is sometimes difficult to select the most effective, easy to use, safest, widely accepted and less expensive method for induction of labour and thereby spontaneous vaginal delivery. Prostaglandin E1 analogue ie misoprostol as a successful method both in oral and vaginal form has been used for induction of labour. The present study was conducted with an aim to compare the efficacy and safety of oral and vaginal administration of misoprostol tablets for cervical ripening and induction of labour in pregnant women using similar dosing regimen in two groups of pregnant women. A prospective randomized trial was done on one hundred pregnant women for the purpose. They were between 37 and 42 weeks of gestation with singleton pregnancy, cephalic presentation and unfavourable cervix (modified Bishops score of 4 or less) in the department of Obstetrics and Gynaecology of Dhaka Medical college Hospital during the period between February 2003 and March 2004. The mode of delivery did not vary significantly between the two groups. Mean induction delivery interval, mean doses of misoprostol, number of women delivered within 24 hours, oxytocin requirement and mean time to delivery were nearly similar in the two groups. Only nulliparous women in oral group took longer time to deliver than vaginal group though it was not statistically significant. The mode of delivery also did not differ significantly. The proportion of emergency caesarean section was high in vaginal group than oral group. Neonatal outcome was satisfactory and the results were comparable. (J Bangladesh Coll Phys Surg 2006; 24: 44-49)

Effects of oxalate intake on calcium and phosphorus balance in bulls fed Napier

An experiment was conducted to examine the effects of oxalate intake on calcium and phosphorus balance in bulls fed Napier silage. Eighteen growing bulls having average live weight of 249 ± 8.38 Kg and aged about 40 months were divided into three groups of six animals in each group. They were assigned to dietary treatments T0 (considered as control), T1 and T2 consisting of rice straw, rice straw and Napier silage (1:1, DM basis) and Napier silage ad libitum, respectively for a period of 21 days. A concentrate mixture composed of 940 g wheat bran, 60g dicalcium phosphate (DCP) and 50g common salt was fed to each bull at the rate of 1.05 Kg/d. With the increase of Napier silage intake there was a significant (P<0.01) increase of oxalate intake (17.91, 24.65 and 30.97 g/d, with T0, T1 and T2 diets, respectively) with the subsequent increase of (P<0.01) their excretion through feces (3.02, 8.66 and 11.02 g/d, respectively). The fecal and urinary excretion of calcium (11.41, 18.25 and 25.28 g/d, respectively) and phosphorus (13.37, 16.85 and 20.09 g/d, respectively) of the animals fed different diets were significantly (P<0.05) high when the straw diet was replaced with 50 and 100 % Napier silage, respectively and there were calcium and phosphorus deficiencies in bulls fed Napier silage. Thus, Napier silage diets brought about a significant (P<0.05) reduction in calcium (12.19, 6.87 and 1.36 g/d, respectively) and phosphorus (7.17, 6.40 and 5.39 g/d, respectively) balances though the intake of these two minerals were adequate showing linear reverse relationship with the increase of oxalate intake from Napier silage. Key words: Napier silage; Oxalate; Calcium; Phosphorus; Bull DOI: http://dx.doi.org/10.3329/bjas.v39i1-2.9677 Bang. J. Anim. Sci. 2010, 39(1&2): 58-66