Three-Dimensional Extrusion Printed Urinary Specific Grafts: Mechanistic Insights into Buildability and Biophysical Properties

The compositional formulations and the optimization of process parameters to fabricate hydrogel scaffolds with urological tissue-mimicking biophysical properties are not yet extensively explored, including a comprehensive assessment of a spectrum of properties, such as mechanical strength, viscoelasticity, antimicrobial property, and cytocompatibility. While addressing this aspect, the present work provides mechanistic insights into process science, to produce shape-fidelity compliant alginate-based biomaterial ink blended with gelatin and synthetic nanocellulose. The composition-dependent pseudoplasticity, viscoelasticity, thixotropy, and gel stability over a longer duration in physiological context have been rationalized in terms of intermolecular hydrogen bonding interactions among the biomaterial ink constituents. By varying the hybrid hydrogel ink composition within a narrow compositional window, the resulting hydrogel closely mimics the natural urological tissue-like properties, including tensile stretchability, compressive strength, and biophysical properties. Based on the printability assessment using a critical analysis of gel strength, we have established the buildability of the acellular hydrogel ink and have been successful in fabricating shape-fidelity compliant urological patches or hollow cylindrical grafts using 3D extrusion printing. Importantly, the new hydrogel formulations with good hydrophilicity, support fibroblast cell proliferation and inhibit the growth of Gram-negative E. coli bacteria. These attributes were rationalized in terms of nanocellulose-induced physicochemical changes on the scaffold surface. Taken together, the present study uncovers the process-science-based understanding of the 3D extrudability of the newly formulated alginate-gelatin-nanocellulose-based hydrogels with urological tissue-specific biophysical, cytocompatibility, and antibacterial properties.

Assessment of the Relationship between Non-motor features and Severity of Parkinson's Disease Patients in Bangladesh

Parkinson's disease (PD) is second most common neurodegenerative disorder after Alzheimer's disease that may present with both motor and non-motor symptoms (NMSs). Many of the ignored NMSs may potentiate further deterioration of the patient's quality of life (QoL). But there is scarcity of data regarding NMSs of PD patients and their relationship with the disease severity in Bangladesh. This study was aimed to investigate the frequency of NMSs and assess their debatable impact on the severity of PD patients in Bangladesh. This cross-sectional type of observational study was conducted in neurology department of Dhaka Medical College Hospital, Bangladesh from January 2012 to June 2013 which recruited 60 eligible PD patients. The PD patients and disease severity was demonstrated by UK Parkinson's Disease Society Brain Bank criteria for idiopathic PD and the Hoehn and Yahr scale respectively. Whereas, NMSs were demonstrated by the self-structured questionnaire which had encountered 30 common symptoms of PD. The mean age of our study cohort was found 57.88±10.56 years with male female ration 2:1. According to the Hoehn and Yahr (H & Y) severity scale 38.3%, 38.3%, 20.1% and 3.3% patients had been suffering from stage ?, stage II, stage III and stage ?V Parkinson's disease respectively. Irrespective of the severity of the PD the frequency of NMSs was nocturia (66.7%), sadness or blues (65.0%), memory disturbance (61.7%), anxiety (58.3%), insomnia (56.7%), orthostatic hypotension (55.0%), erectile dysfunction (50.0%), urinary urgency (46.7%), anhedonia (45.0%), olfactory disturbance (38.3%), constipation (38.3%), hyper or hypo sexuality (31.7%) and restless leg syndrome (31.7%). However, after head-to-head NMSs analysis, daytime dribbling of saliva (p=0.024), urinary urgency (p=0.036), nocturia (p=0.001), weight loss (p=0.001), anhedonia (p=0.027), excessive daytime sleepiness (p=0.024), insomnia (p=0.007), vivid dream (p=0.024), REM behavior disorder (p=0.010), restless leg syndrome/ periodic leg movements (p=0.043) had significantly been reported higher among the stage II PD patients than that of stage I patients. Whereas fall (p=0.001), dysphagia or choking (p=0.002), constipation (p=0.003), fecal incontinence (p=0.033), excessive daytime sleepiness (p=0.033), anxiety (p=0.036) and anhedonia (p=0.044) were significantly more prevalent among the advanced stage (III) than stage (II) PD patients. Mean total NMS increased significantly with PD severity based on H and Y staging with a mean NMSQ-T (Non-Motor Symptoms Questionnaire Test) of 5.43 in stage 1, 9.22 in stage 2, 13.75 in stage 3 and 17.0 in stage 4 (p=0.0001). This study revealed that there was high frequency of NMSs among the PD patients and most common symptoms were nocturia, sadness, memory impairment, anxiety, insomnia, orthostatic hypotension, erectile dysfunction, anhedonia, urinary urgency and constipation. Finally, the more advanced disease as indicated by a higher H&Y stage was associated with significantly higher number of reported NMSs.

Pattern of Infections and Antibiotic Sensitivity in Diabetic Patients Admitted in A Tertiary Care Hospital in Dhaka

Infections are well recognized cause of morbidity and mortality in people with diabetes. This study was done to observe the pattern of infections and microorganism with sensitivity pattern in patients with diabetes admitted at a specialized referral hospital in Dhaka. This cross-sectional study was carried out in Bangladesh Institute of Research and Rehabilitation for Diabetes, Endocrine and Metabolic Disorders (BIRDEM) General Hospital, Dhaka from March 2014 to April 2015. It included 309 patients of diabetes (male-169, female-140; age mean±SD- 49.3±14.7 years) admitted in medicine or endocrinology department, who were screened for clinical evidence of infections according to revised McGeer criteria. Culture and sensitivity pattern of responsible microorganisms were sought from clinically appropriate specimen. Among the participants 25.9% (80 out of 309) had evidence of infection. The most common of them were urinary tract infection (53.8%) and respiratory tract infection (30.0%). E. coli and Klebsiella were the most common organisms that were isolated by urine (55.3% and 13.2%) and blood culture (57.1% and 42.9%). Acinetobacter was the most common pathogen in tracheal aspirate (80%) and Klebsiella in sputum (100%). Culture of wound swab exclusively revealed growth of Staphylococcus. E. coli was fairly sensitive to meropenem (100%), amikacin (93.5%) and nitrofurantoin (93.1%), while sensitivity of Klebsiella was almost similar to that of E. coli. Acinetobacter was fully resistant to ceftazidime, nitrofurantoin and meropenem while only modestly sensitive to ciprofloxacin and amikacin (25% and 20% respectively). Pseudomonas was 100% sensitive to ceftazidime, amikacin and meropenem, but 100% resistant to ciprofloxacin and nitrofurantoin. One in four admitted diabetes patient had evidence of infection, most commonly involving urinary and respiratory tracts. E. coli and Klebsiella both fairly sensitive to common antibiotics, were common isolates from urine and blood culture; whereas Acinetobacter isolated from tracheal aspirates and urine, was only modestly sensitive.

Kearns-Sayre Syndrome: A Rare Mitochondrial Deletion Disorder

A 9 yr girl presented with bilateral ptosis and deafness of gradual onset for the last four years. Associated ophthalmoplegia and pigmentary retinopathy, heart block, raised CSF protein and serum lactate was suggestive of the diagnosis of Kearns-Sayre syndrome (KSS), a rare entity in the spectrum of the mitochondrial deletion syndrome. Search for endocrinopathy revealed no abnormality. DOI: http://dx.doi.org/10.3126/jnps.v33i1.6696 J Nepal Paediatr Soc. 2013;33(1):61-62

Efficacy of amitriptyline, pizotifen and propranolol in the prevention of migraine

This intervention study conducted in the Neurology outpatient Department of Mymensingh Medical College Hospital (MMCH) from January 2006 to December 2007 to compare efficacy of amitriptyline, pizotifen and propranolol in the prophylaxis of migraine. Ninety cases were selected following certain inclusion and exclusion criteria. Result showed that the differences in duration, frequency and severity of attack were reduced in all groups but the differences among the groups were not significant (p>0.05). However, compared with amitriptyline and pizotifen, the propranolol group needed tablet paracetamol as abortive therapy less frequently which was statistically significant (p<0.05). All the drugs were well tolerated with minimum adverse effects.

Sex differentiation and risk factor evaluation in stroke patients

This study was conducted to find out the possible influencing factors on stroke in two sexes. It was a descriptive type of cross sectional study, conducted on 177 stroke patients admitted in Mymensingh medical college hospital from February 2009 to March 2010. Patients were selected according to WHO stroke definition and confirmed by CT or MRI. The results of the study showed that Stroke was more common (58.19%) in male than female (41.8%), mean age of male stroke patients was 60.58±12.36 years and that of female was 63.58±13.62 years with no significant statistical sex difference. But after 70 years, females are more sufferer than male. Hypertension, Diabetes mellitus, ischemic heart disease, atrial fibrillation and dyslipidemia in male and female were equally present without significant difference, although male had a higher rate of smoking and previous stroke (p<0.05). Motor weakness was more in male than female and unconsciousness was more in female (p<0.05). Type and sub types of stroke showed no significant difference. Females had more severe stroke in terms of severity score (Scandinavian Stroke Scale) on admission. Duration of hospital stay were similar among male and female but on discharge functional scale (Modified Rankin Scale) score was higher in male (p<0.05) and in hospital mortality was higher in female (p<0.05) which was statistically significant.

Lipid profile among ischemic and haemorrhagic stroke patients

This study is a prospective cross- sectional study conducted in the Neurology and Medicine department of Mymensingh Medical college Hospital (MMCH) to see the association of different components of serum lipids among ischemic and hemorrhagic stroke patients. Cases were selected following certain inclusion and exclusion criteria. Result showed that both types of stroke were more common after the age of 50 years. Male suffered more than female. M:F in ischemic stroke group was 1.73:1, and in hemorrhagic group was 1.42:1. Both types of stroke belong to middle class people. Smoking, hypertension and diabetes mellitus were equally common in both types of stroke. Low density lipoprotein (LDL) level were more than desired level in both types of stroke and there was no significant difference between two groups (p>0.05). Other components of lipid profile (total cholesterol, HDL, Triglyceride) were within normal range and there was no significant difference between two groups (p>0.05).

Changes in the Allergenicity during Different Preparations of Pomfret, Hilsa, Bhetki and Mackerel Fish as Illustrated by Enzyme-Linked Immunosorbent Assay and Immunoblotting

BACKGROUND

Although the identification and characterization of several fish allergens have already been reported, there is almost no data on Indian fish allergens and the effect of thermal processing on their allergenicity. This study aimed at the evaluation of the changes in the level of allergenicity of 4 highly consumed Indian fishes, i.e. pomfret, hilsa, bhetki and mackerel, that occurred after boiling and frying.

METHODS

In this study 110 patients with fish hypersensitivity as evidenced by clinical history and symptoms were recruited based on their positive skin prick test results. The raw, boiled and fried muscle extracts of the 4 fishes were prepared, and each extract was tested by ELISA and immunoblotting with patients' sera.

RESULTS

ELISA and immunoblotting studies demonstrated that the raw muscle extracts of pomfret, hilsa, bhetki and mackerel were allergenic. While the allergenicity of boiled and fried extracts of pomfret and hilsa was considerably reduced, maximum allergenicity of bhetki was demonstrated in the fried extract. The degree of allergenicity of bhetki was demonstrated in the order fried>boiled>raw while that of mackerel followed the order raw>boiled approximately fried.

CONCLUSION

The specific IgE-binding activity and immunoblot profile clearly showed that pomfret and hilsa fish allergens are heat-labile, while allergens of bhetki and mackerel maintained strong reactivity even after thermal treatment.

Allelic imbalance at chromosome 11 in head and neck squamous cell carcinoma in an Indian patient population

BACKGROUND

Genetic instability of chromosome 11 is a frequent event in many solid tumours, including head and neck squamous cell carcinoma (HNSCC).

AIMS

To perform allelic imbalance analysis of cytogenetically mapped altered regions of human chromosome 11 in patients with HNSCC from eastern India.

METHODS

Genomic alterations were investigated using highly polymorphic microsatellite markers in both HNSCC and leukoplakia tissues.

RESULTS

Microsatellite markers D11S1758 from 11p13-15 and D11S925 from 11q23.3-24 had the highest frequency (38% and 32%, respectively) of loss of heterozygosity among all the markers analysed. Allelic loss at the marker D11S925 was seen in both leukoplakia and in all stages of HNSCC tumour tissues suggesting that it is an early event in HNSCC tumorigenesis. Microsatellite size alteration was also found to be high (> 20%) in several markers. In leukoplakia samples microsatellite instability was seen at a higher frequency than loss of the allele, indicating such alterations might initiate the process of tumorigenesis in HNSCC.

CONCLUSIONS

The high rate of chromosomal alterations at 11q21-24 in HNSCC suggests the presence of a putative tumour suppressor gene in this region.

Development of Fasciolopsis buski (Trematoda : Fasciolidae) in Hippeutis umbilicalis and Segmentina trochoideus (Gastropoda : Pulmonata)

Sequential development and histopathologic effects of Fasciolopsis buski larvae were examined in two species of pulmonate snail, Hippeutis umbilicalis and Segmentina trochoideus. Miracidial attachment and penetration began 5 min post-exposure (PE). On day 2 PE, the sporocysts rapidly increased in size and over days 3-7 PE, they transformed into mother rediae which migrated to the ovotestis on day 10 PE. In both species of snail, daughter rediae were initially observed on day 17 PE, the first cercariae emerged on day 21 PE, and from that day onward daughter rediae were the dominant larval form occupying the ovotestis. Histopathologic changes were confined exclusively to the ovotestis and included lytic lesions due to mechanical damage, and disappearance of all cellular elements. No inflammatory responses were observed in the ovotestis, and no degenerated larvae of any kind were observed in the snails. Infected snails did not produce egg masses and lived no longer than 35 days. The lack of differences in miracidial recognition and penetration, and in the temporal, sequential, and spatial development of F. buski larvae in H. umbilicalis and S. trochoideus indicate that both these snail species are equally susceptible to F. buski.

Fungal metabolites from Aspergillus niger AN27 related to plant growth promotion

Two metabolites have been isolated from Aspergillus niger AN27, a biocontrol agent, and identified as 2-carboxymethyl 3-n-hexyl maleic acid (compound 1) and 2-methylene-3-hexylbutanedioic acid (compound 2). Their biological activities related to crop growth promotion have been assayed. Both the compounds increased germination and improved crop vigour. Compound 1 was more effective for increase in germination and shoot length, whereas compound 2 had relatively greater role in increasing the root length and biomass of cauliflower seedlings.

Bacteremia during diarrhea: incidence, etiology, risk factors, and outcome

To determine the importance of bacteremia in hospitalized patients with diarrhea in Bangladesh, from September 1982 through August 1983 the authors obtained blood for culture from 1,824 patients who were suspected of having sepsis (44% of all admissions). Nontyphoid bacteremia occurred in 243 patients. The most common pathogens were the Enterobacteriaceae (n = 66 episodes), Staphylococcus aureus (n = 65), Pseudomonas aeruginosa and other non-glucose-fermenting bacilli (n = 50), Streptococcus pneumoniae (n = 40), and Haemophilus influenzae (n = 16). When compared with an equal number of control patients without bacteremia, bacteremic patients were significantly (p less than 0.05) more likely to be under 1 year of age (46.5% of bacteremic patients vs. 30.0% of control patients) and more often had abdominal tenderness (20.1% vs. 11.5%), hypoproteinemia (a serum protein level less than 60 g/liter) (58.9% vs. 42.9%), and a prior intravenous infusion (49.0% vs. 30.9%). The case-fatality rate was 29.7% in bacteremic patients versus 7.8% in controls (relative risk (RR) = 3.8, p less than 0.001). Factors that were associated with an increased risk of death in bacteremic patients were infection with a Gram-negative pathogen (RR = 2.48), decreased peristalsis (RR = 2.66), hypoproteinemia (RR = 3.36), hypothermia (RR = 2.54), and hypotension (RR = 2.19). Bacteremia appears to be an important link between diarrheal illness and death in Bangladesh. In children with diarrhea who are suspected of being septic, early implementation of antimicrobial therapy that is effective against the broad range of pathogens identified appears to be indicated.

Role of bacterial and host factors in the pathogenesis of Shigella septicemia

To determine the role of bacterial and host factors in the pathogenesis of shigellemia, blood and fecal Shigella isolates were compared for serum resistance and siderophore production, and shigellemic patients were examined for decreased serum bactericidal activity or increased serum transferrin saturation compared to control patients with non-bacteremic shigellosis. The majority of both blood (36/38) and fecal (36/48) Shigella isolates were sensitive to normal serum (greater than 2 log kill/60 min). Shigella dysenteriae type 1 strains were the most sensitive, and Shigella sonnei strains were the most resistant. Siderophore production was species- and serotype-dependent. Shigella dysenteriae type 1 produced only enterochelin; most Shigella flexneri expressed only aerobactin, and Shigella sonnei secreted both types of siderophores. No difference in siderophores was noted between blood and fecal strains within a given serotype. In contrast, shigellemic patients exhibited a 43-fold decrease in serum bactericidal activity and a two-fold increase in transferrin saturation compared to well-nourished control patients. These results indicate that the pathogenesis of Shigella septicemia is not related to serum resistance or siderophore production but may involve serum abnormalities associated with malnutrition.

Effect of ouabain on the rabbit ear artery contraction to serotonin: enhanced response mediated by serotonergic rather than alpha adrenergic receptors

The effect of ouabain on the rabbit ear artery response to serotonin was assessed in isolated vascular rings mounted in tissue baths for the measurement of isometric contractions and denervated with 6-hydroxydopamine in vitro. Ouabain, 1 and 10 microM, caused 5- and 6-fold shifts to the left of the serotonin concentration-response curve (CRC). However, 10 microM ouabain caused only a 1.6-fold shift to the left of the norepinephrine CRC. In the absence of ouabain, 0.01 microM ketanserin had little effect, whereas 0.1 microM prazosin caused a marked shift to the right of the serotonin CRC. In the presence of ouabain, prazosin exhibited little or no antagonism below 3 microM serotonin. Antagonism by ketanserin was increased by 1 and 10 microM ouabain, yielding 6.5- and 10.5-fold shifts to the right of the serotonin CRC, respectively. Benextramine pretreatment to inactivate alpha adrenoceptors nearly abolished the rabbit ear artery response to serotonin. However, in the presence of 10 microM ouabain, there was a substantial recovery of the response to serotonin, and this response was antagonized by ketanserin. These results are consistent with our hypothesis that serotonergic receptors are present in the smooth muscle cell membranes of the rabbit ear artery but are either uncoupled to the contractile mechanism or in a low efficacy state. In the presence of ouabain, these receptors either become coupled or convert to a high efficacy state and thereby contribute to the serotonin-induced contraction. Because the serotonin CRC was shifted to the left in the presence of ouabain, it is likely that most of the CRC was below the threshold concentration at which serotonin activates alpha adrenoceptors. Thus antagonism by prazosin was lost.

Epidemiology and serology of Giardia lamblia in a developing country: Bangladesh

The age-specific prevalence of Giardia lamblia was determined in two Bangladeshi villages and malnourished children in hospital in Dhaka City. Age-specific acquisition rates, the duration of infection and age-specific sero-positivity to (immunofluorescent assay) G. lamblia trophozoites were determined. Infection was acquired early (less than one year) and in 16% of infected children persisted for longer than three months. Prevalence was higher in 5 to 10-year-old village children (21%) and one to five-year-old malnourished children (51%). Over 40% of the children much less than 7 years acquired G. lamblia within 18 months; acquisition rates did not change with age. Positive antibody titres were acquired between six months and one year and the prevalence of sero-positivity remained high in all age groups No association was found between positive antibody titres and positive stool examinations. In developing countries serum antibodies are useful epidemiologically, but are not diagnostic in the individual patient.

Endemic focus of Fasciolopsis buski infection in Bangladesh

Stool surveys were conducted on children 2--10 years of age in 27 villages within Dacca District and around this index area (1,668 children were sampled), revealing an endemic focus of Fasciolopsis buski infection to the south and the east of Dacca District. In order to determine the seasonal variation in the total snail populations and the natural rate of F. buski infection in the snails, two species of planorbid snails, Segmentina (Trochorbis) trochoideus and Hippeutis (Helicorbis) umbilicalis, were periodically sampled for 12 months from a village endemic for F. buski infection. Gymnocephalous cercariae were found in S. (T.) trochoideus snails during August, September and October. The size of the snail population (n = 1,275) was significantly correlated with inches of rainfall (r = +0.62; P less than 0.05) and water temperature (r = +0.59; P less than 0.05). The natural infection rate of F. buski in the snails ranged from 0.5--2%. Snails from non-endemic areas were exposed to 3--10 miracidia. A total of 13 of 49 (27%) of H. (H.) umbilicalis and 6 of 14 (43%) of S. (T.) trochoideus had gymnocephalous cercariae present 4 to 6 weeks after exposure to miracidia. Thus, snail strain variation is unlikely to be a barrier to F. buski transmission.

Single dose piperazine therapy for Ascaris lumbricoides: an unsuccessful method of promoting growth

One-hundred eighty-five Bangladeshi children age 1 1/2 to 8 yr with no Ascaris lumbricoides infection or with light, moderate, or heavy infection were randomly assigned to treatment of placebo groups, with treatment given in a double-blind fashion. The groups were comparable for nutritional and socioeconomic parameters. Treatment consisted of a single dose of piperazine citrate administered twice within a 2-wk period. The cure rates for the low, moderate, and heavy A. lumbricoides infected subgroups were 53, 31, and 36%, respectively. With more severe infections, worm eradication was more difficult and the rate of reinfection after treatment was more rapid. The rate of reinfection was significantly different for the low A. lumbricoides infected treatment and placebo subgroups for 5 months after treatment, for the moderate treatment and placebo subgroups for 3 months after treatment, and for the heavy A. lumbricoides infected treatment and placebo subgroups there was a difference, although not significant, for 1 month after treatment. Anthropometric measurements were obtained for a period of 11 months. Analysis of covariance revealed no significant difference for change of weight, change of height, weight-for age, weight-for-height, height-for-age, triceps skinfold, midarm circumference, and the abdominal girth to chest circumference ratio between the treatment and placebo groups after drug administration. The results of this study do not support single dose worm therapy as a means to enhance growth.