Association of Aortic Valve Sclerosis with Angiographic Severity of Coronary Artery Disease in Patients with Acute Coronary Syndrome, Aged ≤65 Years

Aortic valve sclerosis (AVS) represents a degenerative process that progresses with advancing age. The study was intended to find out the association between aortic valve sclerosis and the severity of CAD in patient's age ≤65 years with acute coronary syndrome. This cross-sectional analytical study was carried out in the department of cardiology, National Institute of Cardiovascular Diseases (NICVD), Dhaka, Bangladesh during a period of October 2017 to September 2018. A total of 140 Acute coronary syndrome (ACS) patients undergoing coronary angiogram during index hospitalization were included in the study. Study patients were divided into two groups on the basis of echocardiographic presence or absence of Aortic valve sclerosis (AVS), with 70 patients in each group. Group I was patients with aortic valve sclerosis and Group II was patients without aortic valve sclerosis. All patients underwent transthoracic echocardiography before they underwent coronary angiography on different days. Severity of CAD was determined by Gensini score and Vessel score. Association of traditional risk factors (smoking habit, hypertension, diabetes mellitus, dyslipidaemia and family history of CAD) with severity of CAD was investigated. Coronary angiography showed that AVS group had a higher positive rate of CAD (82.9% vs. 54.3%, p<0.001) and incidence rate of triple vessel CAD (40% vs. 14.3%, p<0.001) than non-AVS group. Gensini score had higher in AVS group than non AVS group (37.9±27.8 vs. 12.5±14.2; p<0.001). Multivariate analysis showed that AVS (p=0.01) and age (p=0.04) were independent predictors of the presence of significant coronary artery disease. The study concluded that echocardiographically detected AVS is an independent predictor of coronary artery disease severity. There is positive correlation between severity of AVS and severity of CAD in patient's age ≤65 years with ACS.

Proportion and Pattern of Central Nervous System Involvement in Acute Leukemia on Diagnosis

The most common malignant neoplasm in Childhood is Leukemia which is about 41% of all malignancies. Incidence of CNS involvement is less than 5% in Acute Lymphoblastic Leukemia and 6-29% in Acute Myeloblastic Leukemia at Diagnosis. For Successful treatment of childhood leukemia it is mandatory, to give sufficient therapy directed to the CNS to treat sub clinical or overt CNS Leukemia. Without Central Nervous System- Directed therapy, relapses originating from the CNS in up to 75% cases. For this purpose it is crucial to find out the CNS involvement in acute leukemia at diagnosis. This study was conducted to find proportion and pattern of central nervous system involvement (central nervous system manifestation and/or cerebrospinal fluid findings) in acute leukemia at diagnosis in Bangladesh. A cross sectional study was conducted from May 2012 to November 2012 in the Department of Pediatric Hematology and Oncology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh. Total 50 samples were included those having age <15 years newly diagnosed with acute leukemia by purposive sampling. Common age group 1-5 years (48%), 32 patients (64%) were male and 18 patients (36%) were female. Out of 32 male patients 4 patients presented with CNS manifestation and among 18 female patients 2 patients presented with CNS manifestation. There is no association between sex and CNS presentation (P value 0.89). 25 (50%) patients had total leukocyte count >11,000-1,00,000. Twelve (24%) patients had total leukocyte count <4,000. Eight (16%) patients had total leukocyte count 4,000-11,000, and rest 05(10%) patients had leukocyte count >1,00,000. Proportion of CNS manifestation was found 6/50 patients. Eight (8) patients were suffering from AML and 42 patients were suffering form ALL. Among 8 AML patients 1 (11.1%) patient had CNS manifestation and Among 42 ALL patients 5(11.1%) patients had CNS manifestation. Out of 6 patients with CNS manifestation, 2 (04%) patients presented with clinical manifestation, and 5(10%) had positive CSF findings. Pattern of CSF finding of 50 leukemic children CNS-1 90%, CNS-2 02%, CNS-3 08%, and no patients had traumatic lumber puncture with concomitant presence of blasts cells. There is significant association was found between hyper leukocytosis and CNS manifestation (p=0.138) but there is no statistically significant association between positive CSF findings and neurological findings (p=0.082). At conclusion, CNS manifestation is not uncommon (6/50 patients) was found in acute leukemia at diagnosis. So, every patient of acute leukemia should be examined carefully for CNS involvement along with CSF cytospin.

Surgical Outcome of CSF Drainage in Paediatric Obstructive Hydrocephalus

Hydrocephalus (HCP) is occurred when there is inequality in the formation and absorption of CSF to such a level which causes accumulation of fluid and causing raised intracranial pressure. Hydrocephalus is the most frequent neurosurgical problem encountered in the paediatric age group. CSF diversion surgically is needed as treatment for certain condition. Endoscopic third ventriculostomy (ETV) and Ventriculo-peritoneal shunt (VPS) are most widely used CSF diversion procedure. Therefore, this study was conducted for comparing the surgical outcome of ETV and VP shunt in obstructive hydrocephalus. This is a prospective experimental study conducted in the Department of Neurosurgery, Dhaka Medical College and Hospital (DMCH) and Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from January 2017 to December 2019. Paediatric patients of both sex and 6 months to 18 years of age with obstructive hydrocephalus undergone endoscopic third ventriculostomy (ETV) or ventriculo-peritoneal shunt (VP shunt) were included after fulfilling inclusion and exclusion criteria. The patients divided into two groups (Group A and Group B). The Group A included 30 patients who treated by Endoscopic third ventriculostomy and the Group B include 30 patients, who was treated by Ventriculo-peritoneal shunt. Surgical outcome was analyzed in two procedures separately. In Group A (ETV group) symptomatic improvement, GCS score improves earlier and post-operative complications relatively less than Group B (VP shunt group). But in VP shunt group 3 months follow up reveals- improvement of papilledema, Occipital frontal circumference (OFC) regression and fontanelle size improvement was more than that of ETV group. This study concluded with suggesting that Endoscopic third ventriculostomy (ETV) is technologically superior surgical technique than VP shunt. Though ETV showed relatively more immediate procedural failure and intraventricular hemorrhage but long-term outcome is better and also associated with lower incidence of infection and re-operation in comparison to VP shunt.

Pancreatobiliary Diseases: Evaluation by Transabdominal and Endoscopic Ultrasound

Pancreaticobiliary diseases are the important causes of morbidity and mortality worldwide. Among the imaging modalities, Transabdominal ultrasound (TUS) is cheap, available, and noninvasive but it has some limitations. Endoscopic ultrasound (EUS) is invasive but it has some diagnostic and therapeutic advantages over TUS. This study was aimed to see the diagnostic yields of EUS and TUS in the pancreatobiliary diseases. This cross sectional study was conducted in Sir Salimullah Medical College Mitford Hospital (SSMC&MH), Dhaka, Bangladesh from March 2017 to February 2019. All (n=222) patients were evaluated clinically and with relevant investigations. TUS and EUS were done in all patients. Endoscopic retrograde cholangiopancreatography (ERCP) was done in 60 patients. Among 222 patients 56.8% were males; mean age was 46±16 years; the main presenting symptoms were abdominal pain and jaundice. In diseases of biliary tree, EUS showed dilated CBD alone or in combination with stone in 50 and 67 cases and TUS showed 37, 63 patients respectively. The difference between the findings of EUS and TUS was statistically significant (p=0.00). In gall bladder, EUS found microlithiasis in 6(2.6%) and sludges in 24(10.8%) cases whereas TUS found microlithiasis in 1(0.5%) and sludges in 17(7.7%) cases respectively (p=0.00). Both EUS and TUS detected cholelithiasis in equal number of patients 46(20.3%). On pancreatic evaluation, EUS and TUS detected pancreatic parenchymal abnormalities in 24(10.8%) and 12(5.5%) patients respectively with significant p value (0.00). In cases of pancreatic and cholangiocarcinoma the difference between the findings of EUS and TUS were statistically significant (p<0.05). EUS detected 7 cases of ampullary/peri-ampullary neoplasms whereas TUS detected only 2 cases. The sensitivity of EUS for detecting CBD dilatation, CBD stones, CBD SOL and pancreatic SOL was 85%, 91%, 93%, and 92% respectively. The sensitivity of TUS for detecting CBD dilatation, CBD stones, CBD SOL and pancreatic SOL was 42%, 52%, 40%, and 37% respectively. EUS is more sensitive than TUS in diagnosing pancreaticobiliary disorders. It is of paramount importance in patients in diagnosing CBD dilatation, choledocholithiasis, biliary microlithiasis and pancreaticobiliary neoplasm. EUS has important role before proceeding to further management by more invasive techniques like ERCP or surgery.

Effects of DBD air plasma treatment on the enhancement of black gram (Vigna mungo l.) seed germination and growth

Effects of black gram (vigna mungo L.cv. Barimash 3) seed treatments with 400 torr dielectric barrier discharge (DBD) air plasma on seed surface morphology, seed germination, seedling growth and antioxidant enzyme activities in the roots, shoots and leaves were investigated. The plasma discharge voltage, frequency, electrode spacing, gas temperature and power were 5kV, 4.5kHz, 60mm, 310K and 45W, respectively. The seeds were treated for the duration ranging from 20 to 180 s. Seed germination rate, seedling growth, total chlorophyll content, total soluble protein and sugar concentrations in the seedlings grown from the treated seeds were found to increase 13.67%, 37.13%, 37.26%,53.60% and 51.71%, respectively, with respect to control. This study reveals that the DBD air plasma was involved in the enhancement of nitrogen complex in the seed coat of black gram which upregulated the protein through nitrogen conversion that was ultimately responsible for the increased seed germination and seedling growth of black gram.

Miltefosine Induced Reduced Male Fertility Capacity after Treatment of Post Kala-azar Dermal Leishmaniasis, Bangladesh

Post Kala-azar Dermal Leishmaniasis (PKDL) is the sequel of visceral leishmaniasis in Indian subcontinent and may appear among patients with or without previous history of visceral leishmaniasis (VL). The aim of the study is to understand the male reproductive safety profile of miltefosine used for the treatment of Post Kala-azar Dermal Leishmaniasis (PKDL) in Bangladesh. From January 2017 to March 2017, an exploratory study was carried out on male fertility capacity in Bangladesh among male patients above 14 years old with PKDL treated with miltefosine. Twenty nine male patients were included to observe the effect of miltefosine on reproductive health. All PKDL patients had history of visceral leishmaniasis (VL) in different time periods. Among them three (10.3%) patients were unable to ejaculate semen. In semen analysis, 3 patients (10.3%) were found azoospermia (sperm count & motility- 0, viscosity- good, pH- 7 to 8), microscopically there was presence of RBC (5-15/HPF), WBC (8-15/HPF). Another 3 patients (10.3%) were found oligospermia (sperm count- 4.2 to 15.3 million/ml, motility- 20 to 50%, viscosity- good, pH- 6 to 9, RBC- 4 to 15/HPF, WBC- 4 to 15/HPF). The study documented some important findings in evaluating male infertility and selection of drug regimens in treating PKDL patients with miltefosine for 12 weeks.

Cold Injury and Flash Flood Damage in Boro Rice Cultivation in Bangladesh: A Review

Increasing population with decreasing resources and increasing climate vulnerability appeared as the great challenges to sustain food security of Bangladesh. Cold stress adversely affects growth and productivity of rice (Oryza sativa L.). Systematic studies have been carried out to improve understanding on rice cold tolerance. Two adverse conditions, such as low temperature stress at reproductive stages and flash flood at maturity affect the Boro rice in the haor areas of Bangladesh. Any deviation of these two phenomena is enough to cause disaster in haor areas. Here, we summarized different types of cold injury, rice cold injury scenario and cold tolerant rice varieties/genotypes available in different countries. Moreover, we discussed on rice cold tolerant barrier and flash flood risk in Boro rice cultivation at haor areas of Bangladesh. Based on the authors’ own research and available data, the concept of overcoming cold and flash flood damage was proposed. According to this concept there were distinguished possible ways how to improve cold tolerance and flash flood problem in Boro rice cultivation in BangladeshBangladesh Rice j. 2017, 21(1): 13-25

Higher Fertilizer Inputs Increase Fitness Traits of Brown Planthopper in Rice

Rice (Oryza sativa L.) is the primary staple food source for more than half of the world's population. In many developing countries, increased use of fertilizers is a response to increase demand for rice. In this study, we investigated the effects of three principal fertilizer components (nitrogen, phosphorus and potassium) on the development of potted rice plants and their effects on fitness traits of the brown planthopper (BPH) [Nilaparvata lugens (Stål) (Homoptera: Delphacidae)], which is a major pest of rice in Bangladesh and elsewhere. Compared to low fertilizer inputs, high fertilizer treatments induced plant growth but also favored BPH development. The BPH had higher survival, developed faster, and the intrinsic rate of natural increase (r _m ) was higher on well-fertilized than under-fertilized plants. Among the fertilizer inputs, nitrogen had the strongest effect on the fitness traits of BPH. Furthermore, both the "Plant vigor hypothesis" and the "Plant stress hypothesis" were supported by the results, the former hypothesis more so than the latter. These hypotheses suggest that the most suitable/attractive hosts for insect herbivores are the most vigorous plants. Our findings emphasized that an exclusive focus on yield increases through only enhanced crop fertilization may have unforeseen, indirect, effects on crop susceptibility to pests, such as BPH.

Response of Adult Brown Planthopper Nilaparvata lugens (Stål) to Rice Nutrient Management

Nitrogen (N) limitation is well documented for the brown planthopper (BPH) Nilaparvata lugens (Stål), but phosphorus (P) and potassium (K) limitation is poorly studied. We studied the effects of N, P, and K application on chemical composition of rice plants and its consequences on life parameters-adult longevity, fecundity, and egg hatchability of BPH. Life parameters of BPH were regressed as function of plant chemical composition. A completely randomized design with four replicates in a factorial scheme was used considering N, P, and K levels as factors. Nitrogen application increased N and soluble proteins (SP) and decreased silicon (Si) content in the plants resulting in increased adult longevity, fecundity, and egg hatchability of BPH. Phosphorus fertilization increased P content and showed markedly increased fecundity, but not egg hatchability or adult longevity. Significant interaction between N and P was observed for fecundity of BPH. Potassium supplementation increased K content but reduced N, Si, SP, and total free sugars (TFS) content in the plants, but it had no significant effect on life parameters of BPH. The association of BPH life parameters with N, SP, TFS, and P content was significant and positive, but it was negative with the content of Si. Thus, N and P fertilization on rice plants enhanced BPH fitness. In conclusion, judicious nutrient application can be helpful in avoiding generalized infestation of BPH to rice.

Response of Adult Brown Planthopper Nilaparvata lugens (Stål) to Rice Nutrient Management

Nitrogen (N) limitation is well documented for the brown planthopper (BPH) Nilaparvata lugens (Stål), but phosphorus (P) and potassium (K) limitation is poorly studied. We studied the effects of N, P, and K application on chemical composition of rice plants and its consequences on life parameters-adult longevity, fecundity, and egg hatchability of BPH. Life parameters of BPH were regressed as function of plant chemical composition. A completely randomized design with four replicates in a factorial scheme was used considering N, P, and K levels as factors. Nitrogen application increased N and soluble proteins (SP) and decreased silicon (Si) content in the plants resulting in increased adult longevity, fecundity, and egg hatchability of BPH. Phosphorus fertilization increased P content and showed markedly increased fecundity, but not egg hatchability or adult longevity. Significant interaction between N and P was observed for fecundity of BPH. Potassium supplementation increased K content but reduced N, Si, SP, and total free sugars (TFS) content in the plants, but it had no significant effect on life parameters of BPH. The association of BPH life parameters with N, SP, TFS, and P content was significant and positive, but it was negative with the content of Si. Thus, N and P fertilization on rice plants enhanced BPH fitness. In conclusion, judicious nutrient application can be helpful in avoiding generalized infestation of BPH to rice.

Muscle LIM protein/CSRP3: a mechanosensor with a role in autophagy

Muscle LIM protein (MLP) is a microtubule-associated protein expressed in cardiac and muscle tissues that belongs to the cysteine-rich protein (CSRP/CRP) family. MLP has a central role during muscle development and for architectural maintenance of muscle cells. However, muscle cells rely on autophagy during differentiation and for structural maintenance. To study the role of MLP in autophagy, we have used C2C12 mouse myoblasts silenced or overexpressing MLP. Our results show that MLP contributes to the correct autophagosome formation and flux by interacting with LC3 as demonstrated by co-immunoprecipitation and PLA assay. In fact, MLP silencing results in decreased LC3-II staining and absent degradation of long-lived proteins. Moreover, MLP silencing impaired myoblasts differentiation as measured by decreased expression of MyoD1, MyoG1 and myosin heavy chain. Ultrastructural analysis revealed the presence of large empty autophagosomes in myoblasts and multimembranous structures in myotubes from MLP-silenced clones. Impaired autophagy in MLP-silenced cells resulted in increased susceptibility to apoptotic cell death. In fact, treatment of MLP-silenced C2C12 myoblasts and myotubes with staurosporine resulted in increased caspase-3 and PARP cleavage as well as increased percentage of cell death. In conclusion, we propose that MLP regulates autophagy during muscle cell differentiation or maintenance through a mechanism involving MLP/LC3-II interaction and correct autophagosome formation.

Effect of different levels of Dhania seed (Coriandrum sativum) on the performance of broiler

A total of 72 as hatched Cobb 500 broilers were fed ad libitum on a diet with 0 %, 0.5 %, 1.0 % and 1.5 % of coriander seed meal (CSM) to assess its feeding value. Treatment group with 1.5 % of CSM significantly (p<0.05) affected live weight of broilers at the age of 28 and 35 days. Among the dietary groups there is no significant difference in feed intake and feed efficiency. Meat yield characteristics especially abdominal fat level decreased significantly (p<0.01) at 1.5 % level of CSM. Cost of production per kg live broiler decreased when dietary inclusion level was increased. Profit per kg of live broiler was significantly (p<0.05) increased with the increase levels of dietary CSM. These results suggest that the CSM could be considered as a potential natural growth promoter for poultry, and showed the best responses at a 1.5 % level of inclusion. It was concluded that the supplementation of the coriander seed meal to broiler diet had beneficial effects on body weight gain, feed conversion ratio and carcass yield.DOI: http://dx.doi.org/10.3329/bjas.v43i1.19383 Bang. J. Anim. Sci. 2014. 43 (1): 38-44

Long term cyclic heat stress influences physiological responses and blood characteristics in indigenous sheep

The present study was designed to elucidate changes in physiological and blood parameters of indigenous sheep during cyclic heat exposure. Twelve 2-4 year-old sheep with an average body weight of 10.5±0.5 kg were randomly allocated to one of three experimental heat treatments: control (21°C, stall feeding), short term (21°C to 32°C; 32°C for 4 h/d, grazing), and long term (21°C to 32°; 32°C for 8 h/d, grazing).The results have shown that sheep exposed to cyclic heat treatments exhibited higher (P=0.05) rectal temperature, body temperature, and respiratory rate compared to the control group. Cyclic heat treatments significantly decreased heart rate of sheep. There was a sharp reduction in rumination and an increase in time spent by sheep in eating during cyclic heat treatments. Long term heat treatment significantly increased RBC and WBC counts, PCV values, and hemoglobin level than that of the control and short term heat treatments. Similar responses were also observed in plasma glucose, uric acid, aspartate aminotransferase, and blood urea nitrogen levels. These results suggest that short term heat stress is tolerable but long term is physiologically detrimental to them to indigenous sheep.DOI: http://dx.doi.org/10.3329/bjas.v42i2.18486 Bang. J. Anim. Sci. 2013. 42 (2): 96-100

Histopathological Studies of Experimentally Infected Shing, Heteropneustes fossiliswith Aeromonas hydrophila Bacteria

Heteropneustes fossilis (shing) of 35g body weight were experimentally infected with Aeromonas hydrophila by two different methods: viz. intraperitonial and intramuscular injection. A standard dose of infection (6.4 × 107 CFU/ml) was selected based on predetermined LD50. Each method gave rise to the mortality of shing up to 85%. Clinical signs of fish included injury, hemorrhage and large ulcerative lesions on the body at the injected area. In kidney, liver and intestine pathologically, massive atrophy and focal necrosis were found. Hemorrhage, Vacuolation and atrophy of hepatic sinusoids represented by necrosis of the sinusoidal lining cells, degeneration of hepatic tissue and distribution of bacterial cell all over the tissue were found in liver. Atrophy, hemorrhage, villi missing and missing of epithelium were found in intestine of the experimentally infected shing. Bacterial cells were distributed in the whole hematopoietic tissue including the renal tubules. Tissue abscess characterized by focal necrosis, hemorrhage and Vacuolation were also found in the kidney of the infected shing. But the above symptoms were not found in the organs of the apparently healthy shing species.DOI: http://dx.doi.org/10.3329/pa.v19i1.17359 Progress. Agric. 19(1): 89 - 96, 2008 

Isolation of Aeromonas hydrophila from EUS Affected Shing Heteropneustes fossilis of a Fish Farm in Mymensingh

Aeromonas hydrophila bacteria was isolated from the suspected EUS-affected shing fish, Heteropneustes fossilis (Bloch). The disease investigations were primarily based on clinical signs and subsequently confirmed by the isolation of bacterial pathogen Aeromonas hydrophila from lesion of liver and kidney. The A. hydrophila isolates were identified by a series of morphological, physiological and biochemical tests. The total bacterial load in liver, intestine and kidney were 1.67 × 104 to 6.46 × 108 CFU/g, 1.71 × 103 to 1.18 × 109 CFU/g and 1.47 × 104 to 3.70 × 108 CFU/g respectively.DOI: http://dx.doi.org/10.3329/pa.v19i1.17362 Progress. Agric. 19(1): 117 - 124, 2008 

Hypersensitivity reaction to all drugs of category-1 anti-tuberculosis regime in an adult tuberculosis patient

Adverse drug reaction to tuberculous chemotherapy is not an uncommon problem. Usually it occurs to single drug and can be treated easily with minimal intervention. We follow WHO recommended guideline for National Tuberculosis Control Programs to treat these adverse reactions. Here we found an adult who has been suffering left sided pleural tuberculosis developed anaphylactic reaction to first dose of category-1 anti-TB regime. Later on it was found that he could not even tolerate smaller challenging doses of isoniazide, Ethambutol, Rifampicin and Pyrazinamide separately. It became very difficult to choose an alternate regime for this patient. Lastly a regime with levofloxacin, streptomycin and clarithromycin was give to treat him and patient was recovered with this regime successfully. This experience will help in management of unusual drug reactions to anti-tuberculosis drugs.

Efficacy of lower cut off value of serum prostate specific antigen in diagnosis of prostate cancer

Indications of prostate biopsy are high serum prostate specific antigen (PSA) value and or abnormal digital rectal examination (DRE) findings. Although serum PSA value of 4 ng/ml is the most commonly used threshold for recommending prostate biopsy, significant proportion of men harbor prostate cancer even when their serum PSA values are less than 4.0 ng/ml. Therefore present study was designed to determine the performance status of serum PSA in lower cut-off values. This hospital based prospective study was conducted in the Department of Urology of Bangabandhu Sheikh Mujib Medical University (BSMMU) and Comfort Nursing Home Pvt. Ltd, Dhaka from July 2009 to October 2010. Two hundred six male patients aged over 50 years having lower urinary tract symptoms (LUTS) and serum PSA more than 2.5 ng/ml were prepared for prostate biopsy. Trans rectal ultrasound (TRUS) guided biopsy was done. The test statistics used to analyze the data were descriptive statistics, sensitivity, specificity, positive and negative predictive value, ROC curve. For all analytical tests, the level of significance was set at 0.05 and p < 0.05 was considered significant. In 2.5-4 serum PSA range, 28.26% (13 out of 46) of all malignancy were found, which would be missed if we take cut off value 4. At 2.5 PSA cut-off, Sensitivity 91.3%, Specificity 14.37%, PPV 23.46%, NPV 85.18%, Efficacy 31.55%. At 4 PSA cut-off value, Sensitivity 71.73%, Specificity 46.25%, PPV 27.73%, NPV 85.05%, Efficacy 51.94%. So it can be concluded that, for early diagnosis of prostate cancer cut-off value of serum PSA of 2.5 ng/ml can be recommended as an indication for prostate biopsy.

Comparison between prostate volume and intravesical prostatic protrusion in detecting bladder outlet obstruction due to benign prostatic hyperplasia

The objectives of this study were to determine and compare the correlation of intravesical prostatic protrusion (IPP) and prostate volume (PV) with bladder outlet obstruction (BOO). This study was conducted in the department of urology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh, between July 2009 to September 2010. Fifty benign prostatic hyperplasia (BPH) patients were included in the study. Their evaluation consisted of history along with International Prostate Symptoms Score (IPSS), digital rectal examination (DRE), transabdominal ultrasonography to measure prostate volume, intravesical prostatic protrusion & post voidal residual (PVR) urine and pressure-flow studies to detect bladder outflow obstruction (BOO). Statistical analysis included Unpaired ‘t’ test, Chisquare test and Spearman’s Rank correlation test. Receiver Operator Characteristic (ROC) curves were used to compare the correlation of PV and IPP with BOO. Mean prostate volume was significantly larger in bladder outlet obstructed patients (P<0.05). Mean IPP was significantly greater in obstructed patients (P<0.001). Area under ROC curve was 0.700 for PV and 0.821 for IPP. Prostate volume & intravesical prostatic protrusion measured through transabdominal ultrasonography are noninvasive and accessible method that significantly correlates with bladder outlet obstruction in patients with benign prostatic hyperplasia and the correlation of IPP is much more stronger than that of prostate volume. Introduction Benign prostatic hyperplasia (BPH) is one of the most common diseases in elderly men. The prevalence of histological BPH increases with age and appears in approximately 40% of men aged 50- 60 years and in approximately 90% of men aged more than 80 years1. Benign prostatic hyperplasia may lead to prostatic enlargement, bladder outlet obstruction (BOO) and lower urinary tract symptoms (LUTS). But the symptoms and obstruction do not entirely depend on prostate’s size. In contrast, intravesical prostatic protrusion (IPP) has been found to correlate with BOO2. IPP is a morphological change due to overgrowth of prostatic median and lateral lobes into the bladder and may lead to diskinetic movement of bladder during voiding. This IPP would cause more obstruction than if there were no protrusion and just enlargement of lateral lobes, as the strong bladder contraction could force open a channel between the lobes3. Several studies have previously demonstrated that the ultrasonographic measurement of IPP is able to detect BOO in BPH patients quickly and non-invasively4. This study was designed to diagnose BOO through non-invasive methods and aimed to define the correlationDOI: http://dx.doi.org/10.3329/bmrcb.v38i1.10446  Bangladesh Med Res Counc Bull 2012; 38: 14-17

Pulmonary metastases of a papillary adeno-carcinoma of ovary in a pregnant lady

A 28 years young lady admitted to National Institute of Diseases of Chest and Hospital (NIDCH), Dhaka with the complaints of respiratory distress and cough for 2 months. She was in her last trimester of first pregnancy when she becomes dyspneic on exertion and at night. Gradually it increases in time and she become unable to walk when she consulted with specialists in Barisal. She was examined clinically and radiographically and found some opacity on both lung fields. She was on several antibiotics, but got no improvement. In the meantime, an emergency caesarean section was done to have a healthy baby and patient came to NIDCH for this unexplained breathlessness and cough. She was severely dyspneic, tachypnoic, cyanosed. There were bilateral coarse crepitations, bilateral opacities predominantly on both lower and middle zones of both lungs obscuring costo-phrenic angles on chest X-rays. CT scan of chest shows bilateral reticulo-nodular shadows with a homogenous opacity on right lower lung which enhances after contrast scanning. A CT guided FNAC was done from that opacity which revealed a papillary adeno-carcinoma with psammoma bodies on cytopathological study. Thereafter, to explore the primary site, thyroid gland, abdominal organs was assessed adequately and only positive finding was raised CA-125 (706 IU/ml) which was consistent with ovarian cancer. In this way, a primary ovarian carcinoma in a pregnant young lady with normal sized ovary that metastasizes to lung causing bilateral pleural effusion and lymphangitis carcinomatosa was explored. This was an unusual presentation of ovarian papillary adeno-carcinoma with cough and breathlessness at the last trimester of pregnancy in absence of any abdominal mass.

Primary disseminated MDR-TB in a Bangladeshi man: a silent and emerging clinical problem for clinicians

A 26 years old Bangladeshi man experienced sudden gross haematuria for 10 days when he was working in Italy in June'07 that was resolved spontaneously. Six months' later he again developed haematuria and was admitted into an Italian hospital for its evaluation and management. In the mean time, he developed low grade fever, cough, back pain, spinal angulations, walking difficulty. His X-ray chest postero-anterior view revealed cavitary lesions in upper zones of both lung fields. Intravenous Urography (IVU) was done which revealed hydronephrosis and hydroureter of left kidney. Magnetic Resonance Imaging (MRI) of dorso-lumber spine revealed collapse of D10-12 and L4-5 vertebral bodies with perivertebral and epidural abscess. Sputum and urine smear for Acid-Fast-Bacilli (AFB) demonstrated the organisms on Z-N stain and AFB culture and sensitivity demonstrated that it was resistant to isoniazide, Rifampicin and streptomycin and diagnosed as primary disseminated multi-drug Resistant tuberculosis (MDR-TB). Second-line drugs were started in Italy on 15th January'08 and were continued thereafter in National Institute of Diseases of the Chest and Hospital (NIDCH). A ureteric stent which was given in Italy to get relief of hydro-ureter was removed in Dhaka. A neurosurgery (costo-transversectomy with decompression of spine) was done in Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka and patient get relief of back pain paresthesia. Lastly, his sputum and urine AFB smear and AFB culture became negative. So, primary disseminated MDR-TB with renal, spinal and pulmonary involvement was diagnosed in this Bangladeshi man who had a sputum AFB culture and sensitivity during his initial diagnostic work-up in Italy. It's an alarming case that demonstrated necessity of sputum AFB culture and sensitivity during initial diagnostic work-up.

Clinical and laboratory parameters of pleural tuberculosis

This prospective observational clinical study was done to find out the clinical and laboratory parameters of pleural tuberculosis patients, to find out a sensitive and specific tool for diagnosis and to see the effectively of a standard anti-TB regime Isoniazide, Rifampicine, Pyrazinamide, Ethambutol, (2HRZE/4HR) for treatment of pleural tuberculosis in an adult medicine unit, department of Medicine, Chittagong Medical College Hospital, Chittagong, Bangladesh. A series of total thirty-three consecutive pleural tuberculosis patients admitted in that unit over a period of 6 months were enrolled. All thirty-three pleural tuberculosis patients were observed for their demographic and clinical parameters and undergone some relevant investigations like complete blood count, Mantoux test, pleural fluid study and pleural histopathological study. Later on, they were put on anti-tuberculosis therapy without steroid and followed their response after one month. All patients of pleural tuberculosis presented in this medicine unit had fever and cough associated with chest pain (87.9%), dysnoea (42.4%), haemoptysis (9.1%), weight loss (84.4%), anorexia (90.9%). Age of presentation was 34.1+/-16.2 years and of them, 60.7% patients were below 30. Mean Erythrocyte Sedimentation Rate (ESR) was 97.04 mm in 1st hour and 57.6% cases had ESR more than 100. 63.6% had Mantoux Test (MT) positive (>10 mm). Only 6.1% had hemorrhagic effusion and others had straw colored fluid. Mean pleural fluid protein is 5.9 gram/L and sugar 65.7 mg/dl. No Acid Fast Bacilli (AFB) was seen on microscopy in pleural fluid. Pleural biopsy revealed 54.5% granulomatous lesion with or without caseation and another 24.2% shows chronic inflammation. Seventy seven percentage (77%) patients were attended follow-up clinic after 1 month and all patients (100%) were improved with this anti-TB therapy. Of the total patient treated with anti TB drug, 53.5% had no pleural effusion, other had minimum effusion. Only 6.06% require subsequent steroid addition and other measures. Pleural biopsy is the investigations of choice for pleural tuberculosis especially in resource poor countries. Pleural tuberculosis can be treated with a standard anti-TB regime successfully without steroid.

Intralesional bleomycin in the treatment of cutaneous warts: a randomized clinical trial comparing it with cryotherapy

BACKGROUND

Though not in regular practice, intralesional (IL) bleomycin has been used for the treatment of warts since the 1970s and on the other hand, till now cryotherapy is quite regularly used to treat warts.

AIM

Our aim was to assess the evidence for the efficacy of IL bleomycin, in comparison with a control group of similar sample receiving cryotherapy, in the treatment of cutaneous warts.

METHODS

Patients were randomized using computer-generated codes to receive either cryotherapy (double freeze-thaw cycle) or IL bleomycin (0.1% solution with concurrent anesthesia) for a maximum of four treatments 3 weeks apart and a maximum of five warts treated in each visit for both groups. Patients had their warts measured at base-line and with each return visit including a post treatment follow-up that was 8 weeks apart from last treatment taken.

RESULTS

Of the 73 patients completing the study, 39 (53%) were treated with IL bleomycin and 34 (47%) were treated with cryotherapy. Out of 155 treated warts, 87 (56%) were treated with IL beomycin and 68 (44%) were treated with cryotherapy. The clearance rates in context of number of patients and number of warts were 94.9% and 97% for bleomycin and 76.5% and 82% for cryotherapy respectively (P < 0.05 by x(2) analysis and RR = 7.67).

CONCLUSION

IL bleomycin injection was significantly more effective than cryotherapy for treatment of cutaneous wart.

Upper abdominal mass with diagnostic dilemma

A 32 years old gentleman presented with a lump occupying the epigastric, left hypochondriac and umbilical region for the last 3 months which gradually increased in size & dull aching pain. He also complained of low grade fever and early satiety. On examination, he had a lump on upper abdomen which was irregular, firm, mildly tender, lobulated surface, restricted mobility, dull on percussion. USG examination of HBS revealed hepatomegaly and SOL in liver. CT abdomen revealed soft tissue mass in left upper abdomen. FNA revealed cells of mesenchymal origin. Per operatively a large lobulated, myxomatous highly vascular mass arising from the fundal part of the stomach was found and removed. Histopathology report comments about two differential diagnosis-leiomyosarcoma and gastrointestinal stromal tumour. CD117 immunostaining confirmed it was gastrointestinal stromal tumor (GIST). Post operatively patient was treated by Imatinib and is now under regular follow up.

Patient with bilateral breast enlargement and hypospadias

A 20 year old man was admitted in the surgical unit of Dhaka Medical College Hospital on August 2007 presented with Hypospadias & underdeveloped penis from childhood, gradual enlargement of both breasts for the last 10 years, absence of axillary and pubic hair from puberty & painful swelling of both testes for the last 3 years. The patient was regarded as a female upto the age of 10 years. He has got no voice change since puberty. On examination he had average body built, there was bilateral gynaecomastia, hypospadias, rudimentary penis & absence of pubic and axillary hair. His testosterone level, serum prolactin level, serum progesterone level, serum estradiol level was done. Cytology on buccal smear done and ultrasonography revealed no ovary and uterus. Ultimately patient was diagnosed as a case of androgen insensitivity syndrome (AIS). The case is reported for clinical awareness & to share our experience.

Histopathology based cancer pattern in Mymensingh region of Bangladesh

To our knowledge, population-based published data regarding the cancer profile in Mymensingh region of Bangladesh is not available. This study was designed to provide information regarding the frequencies of cancers through sample data retrieved from histopathology (surgical pathology) laboratory based cancer registry from two laboratories in Mymensingh. All malignant tumours recorded in 2006 in the register of pathology laboratory of Mymensingh Medical College and one private pathology laboratory in Mymensingh town were taken as sample data for analysis in terms of age groups, gender and types of cancer with relation to site. A total of 470 cases diagnosed as cancer were found in the register, of which males were 249(53%) and females were 221(47%) with male to female ratio 1.2: 1. Highest numbers of cases were found in the age group of 51-60 years. In male group frequency of malignant tumours was found in the age group of 51-60 years and the female group it is 41-50 years. Top five sites of cancer, irrespective of sex, were of stomach, uterine cervix, colo-rectum, lymph nodes and breast. According to decreasing order of frequency, in the males, the top five cancers were of stomach, lymph node, oesophagus, urinary bladder and colo-rectum. In the female groups these were of uterine cervix, breast, ovary, colo-rectum and stomach. Cancer cases in the age group of 51-60 years were significantly higher in males than in females (p<0.001). The commonest cancers in males and females were of stomach and cervix, respectively. As the analysis was based only on surgical specimens, the exact incidence of cancer of lung and liver could not be evaluated. Because, majorities of the malignancies in these organs are diagnosed mainly on cytological examination. Population-based cancer registry should be maintained to explore the exact patterns of cancer in the study region. Cervical cancer screening program and eradication of H. pylori infection program may be helpful for the reduction of incidence of cancer in this region.

External carotid ligation in extensive haemangioma of tongue & lip

Two patients were admitted in the surgical unit of Mymensingh Medical college Hospital on September 2005 & April 2006. The first case was a lady of 18 years presented with sudden huge enlargement of tongue & lower lip for 07 days resulting difficulty in deglutition & respiration. Since childhood she noticed multiple elevated bluish spots over the tongue, cheek & lips. The second case was a young man of 20 years presented with multiple diffuse swelling of lips, left side of face, cheek, lower eyelid since birth, which was gradually increasing in size. Colour Doppler evaluation of the lesions in both the cases revealed features suggestive of haemangioma. Bilateral external carotid artery ligation by skin crease incision at the level of upper border of thyroid cartilage was done in both the cases. In first case, tongue size reduced back to oral cavity in post operative period. After 04 weeks of operation tongue size became almost normal with only multiple bluish residual swelling. In second case, the swelling size gradually reduced in post operative period. Both the patients are under regular follow up.

Evaluation of 35 cases of abdominal lymphoma

Abdominal lymphoma is not a common clinical entity in Bangladesh. Still, in our Clinical practice we come across such problem occasionally. Because of their rarity and variable unusual behaviour, such case may present a major challenge even to experienced clinicians. Thirty five cases are reported in this series of which 29 were male and 6 were female (M:F = 4.8:1). Cases were collected from BSMMU, DMCH, MMCH, different clinics of Dhaka. Mean age was 36.7 years. Out of 35 cases 20(57.15%) had primary abdominal lymphoma, 08(22.85%) had secondary lymphomatous involvement, 07(20%) were cases of nodal lymphomas with or without superficial lymphnode involvement. All patients presented with gastrointestinal symptoms with or without an abdominal lump. Duration of symptoms of these patients ranged from 03 months to 02 years. In only 02 patients a clinical diagnosis of lymphoma was made pre-operatively. Various operative procedures were performed according to circumstances. Most common site of involvement was small intestine followed by large intestine, mesenteric lymphnodes, rectum and stomach. Among 35 cases, 28(80%) were Non-Hodgkin's, lymphoma 05(14.28%) were Hodgkin's and lymphoma 2(5.71%) were unclassified. All of the patients were referred to oncologist. Some of the patients received chemotherapy. The patients were followed up for a variable period. This study showed that abdominal lymphoma has a good prognosis provided diagnosed and treated early.

Childhood acute poisoning in a tertiary medical college hospital of Bangladesh

A total of 193(4.7%) cases of acute childhood poisoning admitted to paediatric Unit of Khulna Medical College Hospital, Bangladesh over a period of two years were studied to see the age and sex distribution, ingredients used, seasonal variation etc. Out of them 107(55.4%) cases were male and rest 86(44.6%) were female. 01-03 years was the most vulnerable age group to be affected. Kerosene was the commonest form of ingredient to be used. Overall mortality rate was 4.66%. Childhood poisoning was a common Medical emergency with considerable morbidity and mortality. Parents should be educated to keep the kerosene out of reach of the children. So, that mortality and morbidity can be reduced to a great extent.

Patch test for the detection of contact allergens

Patch Test was done in 340 suspected allergic contact dermatitis patients having different ages of both sexes during the period of January 2000 to December 2003 in the department of Dermatology and Venerology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka. Of these 340 cases 145 (42.65%) were male and 195 (57.35%) were female. Among these 340 cases, 250 (73.53%) cases were tested with international standard series allergen (ISS) and 90 (26.47%) cases with cosmetic series allergen (CSS), of which patch test was positive in 125 (50%) cases and 65 (72.22%) cases respectively. The 125 positive cases with ISS consisted of 56% male and 44% female. In 65 CSS positive cases 90.77% were female and 9.23% were male. Highest incidence of positive patch test was found in 61.54% cases in the age group of 30-39 years in ISS and 71.43% cases in the age group of 20-29 yrs in CSS. In ISS--Potassium Dichromate (19.2%), Fragrance mix (17.6%), Nickel Sulphate (15.2%) and PPD (11.2%) were found to be the common allergen and in CSS--Octyl Gallate (27.69%), Getrimide (18.92%), Balsum of Peru (15.38%), Thiomersal (12.31%) were found to be the common allergens.

Dynamic volume-averaged model of heat and mass transport within a compost biofilter: I. Model development

Successful, long-term operation of a biofilter system depends on maintaining a suitable biofilm environment within a porous medium reactor. In this article a mathematical study was conducted of the spatial and temporal changes of biofilter performance due to interphase heat and mass transport. The method of volume averaging was used to spatially smooth the three-phase (solid, liquid, and gas) conservation equations over the biofilter domain. The packing medium was assumed to be inert, removing the solid phase mass continuity equation from the system. The finite element method was used to integrate the resulting nonlinear-coupled partial differential equations, tracking eight state variables: temperature, water vapor, dry air, liquid water, biofilm, gas and liquid phase organic pollutant, and nutrient densities, through time and space. A multiphase, gas and liquid flow model was adapted to the biofilter model from previous studies of unsaturated groundwater flow. Newton's method accelerated by an LU direct solver was used to iterate the model for solutions. Effects of packing media on performance were investigated to illustrate the utility of the model. The moisture dynamics and nutrient cycling are presented in Part II of this article.

A mechanistic model for internal bone remodeling exhibits different dynamic responses in disuse and overload

Bone is a dynamic tissue which, through the process of bone remodeling in the mature skeleton, renews itself during normal function and adapts to mechanical loads. It is, therefore, important to understand the effect of remodeling on the mechanical function of bone, as well as the effect of the inherent time lag in the remodeling process. In this study, we develop a constitutive model for bone remodeling which includes a number of relevant mechanical and biological processes and use this model to address differences in the remodeling behavior as a volume element of bone is placed in disuse or overload. The remodeling parameters exhibited damped oscillatory behavior as the element was placed in disuse, with the amplitude of the oscillations increasing as the severity of disuse increased. In overload situations, the remodeling parameters exhibited critically sensitive behavior for loads beyond a threshold value. These results bear some correspondence to experimental findings, suggesting that the model may be useful when examining the importance of transient responses for bone in disuse, and for investigating the role fatigue damage removal plays in preventing or causing stress fractures. In addition, the constitutive algorithm is currently being employed in finite element simulations of bone adaptation to predict important features of the internal structure of the normal femur, as well as to study bone diseases and their treatment.

The role of osteopontin in the development of granulomatous lesions in lung

Osteopontin (OPN) has been shown to be expressed by cells in granulomas of various origins, but whether it plays a functional role in granuloma formation is not known. Here we used a cardiomyopathic hamster (TO2) model, to test the hypothesis that OPN contributes functionally to granuloma development. We immunized cardiomyopathic and normal hamsters by subcutaneous injection of bovine serum albumin in complete Freund's adjuvant, and assessed various tissues for both OPN RNA expression and granuloma formation. Cardiomyopathic hamsters expressed OPN, and formed granulomatous lesions, in heart tissue in both immunized and untreated animals. In addition, immunization induced expression of OPN in lung and lymph nodes of cardiomyopathic (but not normal) hamsters, and also induced granuloma formation in these organs. To test whether OPN expression could play a functional role in inducing granulomas, we produced an adenoviral vector containing the murine OPN gene, and introduced this vector intratracheally into the lungs of normal hamsters. The OPN-containing vector, but not the control vector, induced pulmonary granuloma formation. These studies provided direct in vivo evidence that OPN can contribute functionally to the formation of granulomatous lesions, and suggest that OPN expression may be a common factor involved in formation of granulomas of various origin.

Antibodies to different peptides in osteopontin reveal complexities in the various secreted forms

We have generated synthetic peptides corresponding to various portions of human osteopontin (OPN) and have immunized rabbits and mice with these peptides to generate polyclonal and monoclonal antibodies specific to human OPN. We then generated six distinct sandwich enzyme-linked immunoabsorbent assay (ELISA) systems by using different pairs of polyclonal and monoclonal antibodies against human OPN. These systems allowed us to detect not only various isoforms and truncated forms of recombinant OPN, but also the glycosylated form of native urinary OPN. Most importantly, tumor-derived OPN was differentially detected by the six ELISA systems. The ELISA systems that we have developed will be useful for clarifying the functional roles for OPN in vivo in various physiologic and pathologic conditions.

Involvement of CD28/CTLA4-B7 costimulatory pathway in the development of lymphadenopathy and splenomegaly in MRL/lpr mice

MRL/lpr mouse is an established animal model which develops autoimmune diseases including glomerulonephritis, sialoadenitis, hepatitis and inflammatory lung disease. Additionally, it has been reported that lpr strains uniquely accumulate CD3+ CD4- CD8- B220+ (double negative, DN) T cells in lymphoid organs leading to lymphadenopathy and splenomegaly. To investigate the role of CD28/CTLA4-B7 pathway in the development of lymphadenopathy and splenomegaly, MRL/lpr mice were treated with soluble form of CTLA4 molecules, CTLA4IgG, which efficiently blocks this pathway. It was demonstrated that (i) the development of DN T cells was independent of the CD28/CTLA4-B7 pathway, (ii) the CD28/CTLA4-B7 pathway was required for the development of lymphadenopathy and splenomegaly, (iii) the CD28/CTLA4-B7 pathway was important for the accumulation of various cell populations in the lymph node and spleen, (iv) composition of the accumulating cell populations was not altered by CTLA4IgG treatment, and (v) activation of conventional T cells and IL-4 production from conventional T cells were the CD28/CTLA4-B7 pathway dependent. Thus, we concluded that the CD28/CTLA4-B7 pathway was required for the development of full-blown lymphadenopathy and splenomegaly in MRL/lpr mice.

Hydrophobic property of handmade jute paper treated by sizing material 'rosin'

To produce hydrophobic handmade paper internal material rosin along with external additive (MCC suspension), internal additive (wax emulsion) and reinforcement were used. Optimum result was obtained when rosin along with alum was used as internal additive during pulp preparation and MCC in the form of suspension was applied as external additive. The hydrophobicity was increased by 92.46% due to rosin-alum treatment and application of MCC suspension as external additive. It was also observed that application of wax along with rosin hampered/hindered the hydrophobicity. Keyword: Handmade, Jute, Paper, Hydrophobic, Sizing material DOI: 10.3329/diujst.v5i1.4381 Daffodil International University Journal of Science and Technology Vol.5(1) 2010 pp.48-52

Determination of Inhibitory Action of Allamanda Leaf Extracts Against Some Important Plant Pathogens

Allamanda leaf extract and separated compounds were studied to determine their inhibitory efficiency against Phomopsis vexans, Fusarium sp, Rhizoctina solani, Sclerotiurn rolfsii and Phytophthora capsici. Four concentrations of the extract namely 1:1, 1:2, 1:3 and 1:4 were used. Extract at 1:3 concentration completely inhibited mycelial growth of P. vexans while other three concentrations were also near completely inhibitory. No concentration showed good performance to inhibit mycelial growth of Fusarium sp. But all concentrations completely inhibited the growth of mycelia of R. solani. Higher concentration (1:1, 1:2) completely inhibited S. rolfsii whereas lower concentration (1:3, 1:4) arrested its growth to some extent. In case of P. capsici, though 1:3 concentration completely inhibited mycelial growth but other three were also promising. For separated compounds, compound 1 and 3 completely inhibited the growth of P. vexans, the other one was not so much promising. In case of Fusarium sp and R. solani, compound 3 showed partial inhibition, but the same compound completely inhibited the growth of S. rolfsii and P. capsici. Water extract showed better performance compared to separated compounds which indicated that some of the essential compounds for the inhibitory action might have been removed during preparation of extracts in other solvents. Key words: Allamanda, leaf extracts, compounds, plant pathogens, efficiency. doi:10.3329/jard.v6i1.1664 J Agric Rural Dev 6(1&2), 107-112, June 2008