Chronic Morbidities Overrule Acute Morbidities in Determining Self-Reported Health in Rural Bangladesh

Self- rated health (SRH) is a valuable screening-level measure of a community's health status. A better understanding of the factors that influence SRH is time-demanding and challenging. This study aims to examine the determinants of SRH by investigating health morbidities, demographic and socio-economic factors in Bangladesh perspective. This cross-sectional study was conducted among 908 adults (aged 18 years and above) in Manikganj district of central Bangladesh from 2nd January to 13th January 2017. Chi-square test was performed to test the association and binary logistic regression was performed to predict the relationship of SRH with all potential variables. The present study reveals the balance of bad health versus good health which was 27.2% and 72.8% respectively. Participants had at least one or more chronic diseases reported 3.40 times (p<0.001) bad health compared to those who did not have any chronic illness. In contrast, acute morbidity was not a significant determinant for SRH (OR=1.379, p=0.063). Older population aged 60 years and above had 3.96 times (p<0.001) higher chance of having self-reported bad health than the younger population. In addition, depression was also found a significant contributor (OR=2.05, p<0.001) to bad health. Chronic morbidity, older age and depression are the significant predictors of SRH. If SRH is used as a screening-level measure for the rural communities then the chronic disease status of rural Bangladesh will be identified quickly and easily.

Prevalence of Thyroid Dysfunction in Type 2 Diabetes Mellitus

The level of thyroid hormones is often changed in uncontrolled diabetic patients. Screening for Thyroid dysfunction (TD) among patients with Type 2 Diabetes mellitus (T2DM) should be performed considering the increased prevalence of thyroid disorders. This cross-sectional comparative study was conducted in outpatient department of Endocrinology and Medicine, Mymensingh Medical College Hospital, Mymensingh (MMCH) from 1st March 2020 to 30th August 2021. One hundred (100) patients with type 2 diabetes along with 100 (hundred) non-diabetic controls of same age group were enrolled in the study. After taking clinical data, patients were investigated to estimate Fasting plasma glucose (FPG), serum free tri-iodothyronine (FT3), free thyroxin (FT4) and thyroid stimulating hormone (TSH) level to see thyroid dysfunction. Patients were selected with purposive sampling. Thyroid dysfunction was found to be more in T2DM (15.0%) in comparison with non-diabetic controls (5.0%) and this difference was statistically significant (p=0.018). In both diabetic and non-diabetic groups, subclinical hypothyroidism and hypothyroidism were the most common thyroid dysfunction. Thyroid dysfunction was found more in 40-60 years that suggests the prevalence of thyroid dysfunction are increasing in diabetic patients with advancing age. Thyroid dysfunction was found more among overweight and obese patient in both groups. Mean BMI was found higher among diabetic patient with thyroid dysfunction. Logistic regression showed significant association of Thyroid dysfunction with age >50 years and high FPG level. We found thyroid dysfunction was more prevalent in patients with T2DM than non-diabetics. So, screening for thyroid dysfunction among type 2 diabetic patients by estimating Serum TSH, FT4 level should be performed.

The fabrication of the chitosan-based bioink for in vitro tissue repair and regeneration: A review

The repair and regeneration of the injured tissues or organs is a major challenge for biomedicine, and the emerging 3D bioprinting technology as a class of promising techniques in biomedical research for the development of tissue engineering and regenerative medicine. Chitosan-based bioinks, as the natural biomaterials, are considered as ideal materials for 3D bioprinting to design and fabricate the various scaffold due to their unique dynamic reversibility and fantastic biological properties. Our review aims to provide an overview of chitosan-based bioinks for in vitro tissue repair and regeneration, starting from modification of chitosan that affect these bioprinting processes. In addition, we summarize the advances in chitosan-based bioinks used in the various 3D printing strategies. Moreover, the biomedical applications of chitosan-based bioinks are discussed, primarily centered on regenerative medicine and tissue modeling engineering. Finally, current challenges and future opportunities in this field are discussed. The combination of chitosan-based bioinks and 3D bioprinting will hold promise for developing novel biomedical scaffolds for tissue or organ repair and regeneration.

Mental Health Assessment of Health Care Providers of Bangladesh during Covid-19 Pandemic: A Cross-Sectional Web-Based Study

SARS COV 2 raised immense agony to everyone. As health care workers remains direct contact with patients, they are vulnerable to mental health disorder. The study was done to identify mental health status of health care providers of Bangladesh. It was a cross sectional web based survey among health care providers of bangladesh. A structured web based questionnaire was prepared both in Bangla and English version for better understanding. Total 2594 health care workers responded to online survey. Male were 1303(50.2%) and female were 1291(49.8%). Occupational demography shows 98.5% were physicians. Mean value of patient health questionnaire 9 (PHQ9) and generalized anxiety disorder (GAD) were 8.43±6.082 and 8.27±5.234 respectively among healthcare providers. To overcome anxiety and depression, 93.4% of HCW didn't receive any psychological material and 85.6% HCW didn't find physiological resources even through media. Despite many lacking, healthcare workers were resilient in our study.

Synthesised and modified zeolite for effective management of beryllium contaminants in aqueous media under different conditions

The effective management of beryllium (Be) in solution is not well established. In this study, zeolite was synthesised from coal fly ash (CFA) and further modified to enhance Be sorption. Results indicated zeolite NaP1 was effectively synthesised, and cross-linked chitosan was grafted in/on the zeolite structure during modification. The Brunauer, Emmett, and Teller (BET) surface area substantially increased from 1.05 m2/g in CFA to 94.0 m2/g in the synthesised zeolite (SZ). Furthermore, the modified zeolite (MZ) showed improved functionality as a reactive site for Be sorption. A comparative sorption study revealed inferior sorption (11.3 %) and higher desorption (56.1 %) of Be using CFA than the sorption using SZ (93.0 % sorption, 2.9 % desorption) and MZ (93.0 % sorption, 1.5 % desorption). Consequently, SZ and MZ exhibited higher sorption efficacy than commercial zeolite (57.4 %) and other commercial sorbents. At an experimental pH of 5.5 [relevant to the pH of Little Forest Legacy Waste Site (LFLS) soil, a representative site for potential Be contamination], MZ showed higher sorption than SZ. The higher sorption in MZ resulted from its elevated ligand complexation [with nitrogen (N), phosphorous (P), and oxygen (O)] and some ion exchange (with Na+, -NH3+, and H+ ions) mechanisms. Moreover, increased sorption (up to 99 %) was observed using colloidal soil solution (CSS) collected from LFLS soil to simulate field conditions after extensive rainfall. Different environmental factors (e.g. pH, temperature, time, CSS, concentrations of sorbate, and sorbent) regulated Be sorption. The sorption mechanism was best described by the Langmuir model, and the pseudo-second-order kinetic model (R2 = 0.999). Moreover, the sorption reaction was spontaneous (ΔG = -Ve), enthalpically, and entropically influenced. Desorption hysteresis (ndesorption/nsorption < 1) suggested irreversible sorption, and the chemisorption mechanism of Be was confirmed by Fourier-transform infrared spectroscopy (FTIR) and X-ray photoelectron spectroscopy (XPS) analysis.

Investigation of herbicide sorption-desorption using pristine and organoclays to explore the potential carriers for controlled release formulation

Injudicious application of available commercial herbicide formulations leads to water, air and soil contamination, which adversely affect the environment, ecosystems and living organisms. Controlled release formulation (CRFs) could be an effective way to reduce the problems associated with commercially available herbicides. Organo-montmorillonites are prominent carrier materials for synthesising CRFs of commercial herbicides. Quaternary amine and organosilane functionalised organo-montmorillonite and pristine montmorillonite were used to investigate their potential as suitable carriers for CRFs in herbicide delivery systems. The experiment involved a batch adsorption process with successive dilution method. Results revealed that pristine montmorillonite is not a suitable carrier for CRFs of 2,4-D due to its low adsorption capacity and hydrophilic nature. Conversely, octadecylamine (ODA) and ODA-aminopropyltriethoxysilane (APTES) functionalised montmorillonite has better adsorption capacities. Adsorption of 2,4-D onto both organoclays is higher at pH.3 (232.58% for MMT1 and 161.29% for MMT2) compared to higher pH until pH.7 (49.75% for MMT1 and 68.49% for MMT2). Integrated structural characterisation studies confirmed the presence of 2,4-D on the layered organoclays. The Freundlich adsorption isotherm model fitted best to the experimental data, which revealed an energetically heterogeneous surface of the experimental organoclays, and adsorption which specifically involved chemisorption. The cumulative desorption percentages of adsorbed 2,4-D from MMT1_{(2,4-D loaded)} and MMT2_{(2,4-D loaded)} after seven desorption cycles were 65.53% and 51.45%, respectively. This outcome indicates: firstly, both organoclays are potential carrier materials for CRFs of 2,4-D; secondly, they have the ability to reduce the instantaneous release of 2,4-D immediately after application; and thirdly, eco-toxicity is greatly diminished.

First report of bacterial panicle blight (BPB) in Rice caused by Burkholderia gladioli in Bangladesh

Bacterial panicle blight (BPB) has become one of the most destructive diseases of rice worldwide and Burkholderia gladioli and B. glumae are two major pathogens causing BPB (1). This disease causes several types of damage, most importantly grain spotting, rot, and panicle blight, which can result in yield losses of 75% or more (1,3). In recent years, symptoms including sheath rot, grain spotting, grain rot, and panicle blight have been observed in both inbred and hybrid rice varieties. These symptoms resemble those of BPB and cause cultivar-dependent yield losses. (3) also reported the same symptoms for BPB. To confirm the cause of the disease, 21 rice panicles (Haridhan, a local variety) with typical BPB symptoms were collected from a farmer's field in the region of Mymensingh, Bangladesh during the rainy season in mid-October, 2021. Due to the severity of the outbreak, the panicles became dark brown and produced chaffy grains; nearly 100% of the rice panicles in that field were severely infected. To identify the causal pathogen(s), 1g of rice grains from 20 plants with typical BPB symptoms were surface-sterilized by immersing them in 70% ethanol for a few seconds followed by sodium hypochlorite solution (3%) for 1min. The grains were then rinsed with sterilized distilled water three times. Surface-sterilized grains were then ground with a mortar and pestle; 5mL of sterile distilled water was added during grinding. The extracted suspension (20µL) was then either streaked or spread onto the selective medium (S-PG) (2). Bacterial colonies showing purple color on the S-PG medium were selected and purified as candidate pathogens. For molecular characterization, species specific primers targeting gyrB gene were used to perform PCR and resulted in 479bp as reported by (4). To verify further, the PCR products of 16SF & 16SR were amplified and sequenced partially producing around 1400bp (1) and five 16SF partial sequences were deposited into NCBI GenBank (OP108276 to OP108280). 16S rDNA and gyrB revealed almost 99% homology with Burkholderia gladioli (KU851248.1, MZ425424.1) and B. gladioli (AB220893, CP033430) respectively using BLAST analysis. These purified bacterial isolates produced a diffusible light-yellow pigment on King's B medium indicating toxoflavin production (3). The candidate five bacterial isolates were then confirmed by inoculating 10ml suspension 10⁸CFU/mL into the panicles and sheaths of BRRIdhan28 in net house condition as described previously (1). All of the bacterial isolates obtained from the spotted rice grains produced light brown lesions on the inoculated leaf sheath as well as spotting on the grain. To fulfill Koch's postulates, the bacteria were re-isolated from the symptomatic panicles and were confirmed as B. gladioli by analyzing the sequences of gyrB and 16s rDNA genes. Taken together, these results confirmed that B. gladioli is responsible for causing BPB in the rice grain samples that we collected. To our knowledge, this is the first report of BPB caused by B. gladioli in Bangladesh and further research is necessary to develop an effective disease management technique, or else the production of rice will be severely hampered.

Native Trichoderma Induced the Defense-Related Enzymes and Genes in Rice against Xanthomonas oryzae pv. oryzae (Xoo)

The application of Trichoderma is a form of biological control that has been effective in combating Xanthomonas oryzae pv. oryzae, the causative agent of the devastating disease known as bacterial blight of rice. In this present study, four strains of Trichoderma, viz., T. paraviridescens (BDISOF67), T. erinaceum (BDISOF91), T. asperellum (BDISOF08), and T. asperellum (BDISOF09), were collected from the rice rhizosphere and used to test their potentiality in reducing bacterial blight. The expression patterns of several core defense-related enzymes and genes related to SA and JA pathways were studied to explore the mechanism of induced resistance by those Trichoderma strains. The results primarily indicated that all Trichoderma were significantly efficient in reducing the lesion length of the leaf over rice check variety (IR24) through enhancing the expression of core defense-related enzymes, such as PAL, PPO, CAT, and POD activities by 4.27, 1.77, 3.53, and 1.57-fold, respectively, over control. Moreover, the results of qRT-PCR exhibited an upregulation of genes OsPR1, OsPR10, OsWRKY45, OsWRKY62, OsWRKY71, OsHI-LOX, and OsACS2 after 24 h of inoculation with all tested Trichoderma strains. However, in the case of RT-PCR, no major changes in OsPR1 and OsPR10 expression were observed in plants treated with different Trichoderma strains during different courses of time. Collectively, Trichoderma induced resistance in rice against X. oryzae pv. oryzae by triggering these core defense-related enzymes and genes associated with SA and JA pathways.

Development of cell culture based peste des petits ruminants (PPR) virus vaccine candidate from Bangladeshi isolates

This study was conducted to develop a cell culture based PPR virus vaccine candidate using recent Bangladeshi strain of peste des petits ruminant's (PPR) virus. PPR virus was isolated from field outbreaks, confirmed by RT-PCR and used as viral inoculum for serial passaging in Vero cells for adaptation and attenuation. 60th serial passage had completed and RT-PCR and real time RT-PCR were done in every 5 passages for confirmation of PPR virus in tissue culture fluid (TCF). To assess the adaptation and attenuation cytopathology, virus titration, sequencing of both F and N genes and live animal experimentation were done. Different cellular alterations produced by PPR virus in infected Vero cells including syncytia formation, development of both intranuclear and intra cytoplasmic inclusion bodies and finally cell degradation are the indications of adaptation. The virus titre was found 2.5, 3.31, 3.55, 4.44, 4.71 and 6.5 Log₁₀ TCID₅₀/ml at 10th, 20th, 30th, 40th, 50th and 60th passages level respectively. In F gene sequence analysis it has been observed that few nucleotide (nt) and mino acid (aa) has been substituted as the effects of serial passaging of PPR virus in Vero cells. TCF at 60th passage level was found effective to produced protective antibody (Ab) titre in live animal experimentation. It is concluded that serially passaged and Vero cells adapted PPR virus TCF could be used as a vaccine candidate for further use to develop a potent & effective vaccine against PPR diseases.

Revealing the diversity of internal body temperature and panting response for feedlot cattle under environmental thermal stress

Core body temperature (CBT) regulation is crucial for mammalian wellbeing and survival. Cattle pant to dissipate excess heat to regulate CBT when ambient conditions exceed thermoneutral zones. However, to date, neither the variability in cattle heat response, the lagged response of CBT to thermal indices, nor the diurnal patterns of thermal indices, CBT and panting have been reported in the literature. We decomposed thermal indices, CBT and panting time-series data for 99 feedlot heifers across three discrete heat events into diurnal, trend and residual components. Both raw and decomposed data were analysed to explore the lagged CBT and panting responses and the association between series. We show ambient thermal conditions impact CBT with a 1-h lag despite a lag of between 1.5 to 3 h from raw data. Average individual panting scores were used to identify heat-susceptible and heat-tolerant cattle. Heat-susceptible cattle showed greater CBT (P < 0.01) between 8:00 and 23:00 and greater panting duration (P < 0.05) between 10:00 and 18:00 than heat-tolerant cattle under the same thermal conditions and these variations followed a similar pattern despite differences in cattle breed. This new information enables targeted amelioration and selection of individuals against heat susceptibility.

Socio-economic inequalities in undiagnosed, untreated, and uncontrolled diabetes mellitus in Bangladesh: is there a gender difference?

OBJECTIVES

We aimed to determine: (1) the prevalence and socio-economic distribution of undiagnosed, untreated, and uncontrolled diabetes mellitus (DM); (2) the relationship between socio-economic status (SES) and undiagnosed, untreated, and uncontrolled DM; and (3) if this relationship is mediated by gender.

STUDY DESIGN

Cross-sectional nationally representative household-based survey.

METHODS

We used data from the Bangladesh Demographic Health Survey from 2017 to 18. Our findings were based on the responses of 12,144 individuals aged 18 years and older. As a measure of SES, we focused on standard of living (hereinafter referred to as wealth). The study's outcome variables were prevalence of total (diagnosed + undiagnosed), undiagnosed, untreated, and uncontrolled DM. We used three regression-based approaches-adjusted odds ratio, relative inequality index, and slope inequality index-to assess different aspects of SES differences in the prevalence of total, undiagnosed, untreated, and uncontrolled DM. We used logistic regression analysis to look at the adjusted association between SES and the outcomes after gender stratification to see whether gender status moderates the association between SES and the targeted outcomes.

RESULTS

In our sample analysis, the age-adjusted prevalence of total, undiagnosed, untreated, and uncontrolled DM was 9.1%, 61.4%, 64.7%, and 72.1%, respectively. Females had a higher prevalence of DM and undiagnosed, untreated, and uncontrolled DM than males. When compared to people in the poor SES group, people in the rich and middle SES groups had 2.60 times (95% confidence interval [CI] 2.05-3.29) and 1.47 times (95% CI 1.18-1.83) higher chance of developing DM. When compared to individuals in the poor SES group, those in the rich SES groups were 0.50 (95% CI 0.33-0.77) and 0.55 times (95% CI 0.36-0.85) less likely to have undiagnosed and untreated DM.

CONCLUSIONS

In Bangladesh, rich SES groups were more likely than poor SES groups to have DM, whereas poor SES groups with DM were less likely than rich SES groups to be aware of their disease and obtain treatment. The government and other concerned parties are urged by this study to pay more attention to developing suitable policy measures to reduce the risk of DM, particularly among rich SES groups, as well as targeted efforts to screen for and diagnose DM in socio-economically disadvantaged groups.

Behavioural Phenomena of Family Firm Control Diversity and R&D Investment with Moderating Role CEO Compensation

Purpose

The novel study describes the behXavioural phenomena of family firm types and explores the relationship between the family firm types of control diversity and Research and Development (R&D) investments. Acquiring controlling rights is a psychological phenomenon for family firm owners. The moderating effect of CEO compensations on R&D investments is investigated.

Methodology

We collected data of listed A-share family firms in China from 2011 to 2020 in the China Stock Market and Accounting Research database. We used Tobit regression for data analysis.

Results/Finding

The study concludes that lone-controller family firms (LCFFs) are less willing to invest in R&D and multi-controller family firms (MCFFs) have positive behaviour towards R&D. The moderating role of CEO compensation deviates the willingness and behaviour to invest in R&D.

Conclusion/Originality

To the best of our knowledge, this study is the first to outline the paradoxical empirical evidence on family firms and R&D investments by analysing control diversity and how the moderating role of CEO compensation nexus can alter willingness towards R&D. The study is a novel attempt following De Massis et al's framework to test the willingness and ability of LCFFs and MCFFs. Previous studies based on agency theory have tacitly assumed that ability and willingness exist in family-controlled firms. However, this study challenges this implicit assumption.

Environmental chemistry response of beryllium to diverse soil-solution conditions at a waste disposal site

This study evaluated how the variation in different sorption conditions of beryllium (Be) in soil-water systems (electrolytes; ionic strengths; competing, counter, and co-existing ions; concentrations of Be and soil; and temperature) affected Be's environmental behaviour. For this reason, potentially contaminated soil was collected from a legacy waste site near Sydney, Australia. The sorption-desorption plateau for Be was found at >12.5 g L^-1 (soil/solution), considering higher sorption and limited desorption. Variable surface charges developed by different added ions (competing ions, counter ions, and co-existence of all ions) were not always correlated with Be sorption. However, effects of added ions in Be sorption (increased by counter ions and decreased by competing ions) primarily occurred at low pH, with no noticeable changes at pH > 6 due to the hydration and precipitation behaviour of Be at higher pH. Both laboratory data and modelling indicated the substantial effect of counter ions on increased sorption of Be. Relatively higher amounts of sorption under the co-existence of all added ions were suggested from synergistic actions. Sorption was favourable (K_L > 0, and 0 < R_L < 1) across all concentrations and temperatures at pH 5.5, and high retention (84-97%) occurred after four desorption cycles indicated specific sorption. The sorption process was exothermic (ΔH > -43 kJ mole^-1), while desorption was endothermic (ΔH > +78.4 kJ mole^-1). All sorption-desorption reactions were spontaneous (ΔG = -Ve), and executed without any structural deformation (ΔS = nearly zero) of soil particles. However, the effect of temperature on desorption was influenced by the concentrations of Be. Higher retention and different sorption-desorption parameters (K_d-desorption > K_d-sorption; K_f-desorption > K_f-sorption; n_desorption/n_sorption < 1) indicate limited mobility of Be and the presence of desorption hysteresis in the studied soil under the experimental conditions.

Serum Magnesium Level and It's Relation in Predicting Adverse In-Hospital Outcome in Patients with First Attack of Myocardial Infarction

Acute myocardial infarction (AMI) patients characterize a large proportion of admissions in coronary care unit and their management and risk stratification is of immense importance. Hypomagnesemia is a long-term risk factor for incident of both myocardial infarction and arrhythmia. We assessed whether serum magnesium levels at admission is associated with arrhythmias and in-hospital mortality in patients with acute myocardial infarction (AMI). The aim of the study was to evaluate the prognostic implications of serum magnesium level in patients with acute myocardial infarction. This cross-sectional observational study was conducted in the department of cardiology in Mymensingh Medical College Hospital from October 2017 to March 2019. Total 259 acute myocardial infarction patients were included considering inclusion and exclusion criteria. The sample population was divided into two groups: Group-I: Patients with acute myocardial infarction with serum magnesium ≥1.82mg/dl. Group-II: Patients with acute myocardial infarction with serum magnesium <1.82mg/dl. Serum magnesium level was measured on admission, and the incidence of in-hospital major cardiac events was assessed. In this study mean serum magnesium level of Group-I, Group-II were 2.21±0.14mg/dl, 1.60±0.15mg/dl respectively. It was statistically significant (p<0.05). In-hospital outcomes of the study group revealed that low risk group patients were uneventful outcome during hospitalization period, they had no any complication. In Group-I patient, 9(4.8%) were developed arrhythmias, 26(13.9%) were developed heart failure, 9(4.8%) were developed cardiogenic shock and 3(1.6%) were died and in Group-II patient, 44(61.10%) developed arrhythmias, 9(12.50%) were developed heart failure, 7(9.7%) were developed cardiogenic shock and 12(16.7%) were died out of them which was statistically significant (p<0.05). Mean duration of hospital stay of the study population according serum magnesium level was in Group-I, 4.27±0.68 days, in Group-II, 5.84±1.05 days which was statistically significant (p<0.05). In conclusion patient with serum magnesium level less than 1.82mg/dl increased the risk of in-hospital arrhythmia and death.

Platelet Count as a Prognostic Factor in Stage IV Non-Small Cell Lung Cancer

Increase platelet count can accompany various cancers including lung cancer. This finding has recently been suggested to indicate poor prognosis. In patients with malignancies, thrombocytosis has previously been related disease stage, histological type and survival. In this study, the prevalence of thrombocytosis and the prognostic information provided by platelet count were analyzed in patients with stage IV Non-Small Cell Lung Cancer (NSCLC) with an aim to assess elevated platelet count as a prognostic factor in patients with stage IV NSCLC and to investigate whether there is relationship between thrombocytosis, other clinico-pathologic factors and median survival. This prospective observational study was conducted in National Institute of Cancer Research and Hospital (NICRH), Dhaka, Bangladesh from September 2019 to August 2020. A total of 108 patients were enrolled purposively. Detail history taking, thorough physical examination was done along with relevant investigations. Data were collected by semi structured questionnaire and analysis was done with the help of Statistical Package for Social Science (SPSS), version 21.0. The mean age of the patients was found 56.4±12.2 years with range from 35 to 75 years. Majority (79.6%) patients were male, 52.8% patients came from low income and 36.1% were farmer. Majority (40.7%) were symptomatic; in bed >50.0% of day. Almost two third (59.3%) had <5.0% weight loss. Almost three fourth (69.4%) had squamous cell carcinoma. At the time of first assessment 75(69.4%) patients had normal and 33(30.6%) had elevated platelet count level. Age, sex and histological type were statistically not significant between normal and elevated platelet count level groups. But performance status, weight loss were statistically significant (p<0.05) between two groups. According to univariate analysis, age, performance status at presentation, weight loss more than 10.0% for 3 months and platelet count prior the start of treatment were all significant predictors for the overall survival. In multivariate analysis age, performance status at presentation and initial thrombocytosis were independent prognostic determinants for overall survival. Median survival time was significantly higher for the normal platelet count group and elevated platelet count group (7.5 months versus 5.5 months) respectively (95% CI, 5.5-7.5), p<0.001. The frequency of thrombocytosis in patients with stage-IV NSCLC at first presentation was 30.6% and median survival time in these patients was significantly shorter compared in patients without thrombocytosis. These results concluded that an elevated platelet count could be a useful prognostic factor for survival in patients with stage-IV NSCLC.

Role of beryllium in the environment: Insights from specific sorption and precipitation studies under different conditions

In this study, we examined factors influencing the environmental behaviour of Be, specifically considering soils collected from a legacy radioactive waste disposal site near Sydney (Australia). The precipitation study showed the formation of Be(OH)₂ (amorphous) from ICP standard solution, but a mixture of Be(OH)₂ (alpha), Be(OH)₂ (beta) and ternary Na/S-Be (ΙΙ)-OH(s) solid phase were formed from BeSO₄ solutions. The precipitation of Be started at relatively lower pH at higher concentrations than at the lower Be concentration as indicated by both laboratory data and simulation. Across the pH range, the Be sorption curve was divided into three phases, these being pH 3-6, pH 6-10, and pH > 10, within which sorption of Be with soil was 9-97%, 90-97%, and 66-90%, respectively. Beryllium solubility was limited at pH > 7, but a sorption study with soil showed chemisorption under both acidic and alkaline pH (pH 5.5 and 8) conditions, which was confirmed by FTIR and XPS analysis. At pH 5.5 (specifically relevant to the study site), sorption of Be was 72-95%, in which 77% and 46% Be was respectively sorbed by separated fulvic and humic acid fractions. The irreversible chemisorption mechanism was controlled by SOM at higher pH, and by metal oxyhydroxides at lower pH. Both organic and inorganic components synergistically influence the specific chemisorption of Be at the intermediate pH 5.5 of field soil.

Ocular Manifestation and Correlation with CD4+ T Cell Count among Adult HIV/AIDS Patients in Bangladesh

Patients with HIV or AIDS suffer from wide varieties of complications that are related to infection. The eye as an organ is not spared from HIV-related manifestations. The ocular manifestations can be the presenting sign of a systemic infection in an otherwise asymptomatic HIV-positive person. The disease can have adnexal, anterior segment, posterior segment, orbital and neuro-ophthalmic manifestations. The objective of the study was to evaluate the ophthalmological manifestations among adult HIV infected patients of Bangladesh and co-relate the findings with CD-4+ T cell count. This cross sectional study was conducted in the department of Community Ophthalmology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from January 2013 to September 2015. Purposive sampling technique was applied to enroll the patients. Total 110 patients were enrolled regardless of their immunological status by inclusion and exclusion criteria. Relevant clinical evaluation including history & physical examinations, laboratory investigations and some ocular examinations like- visual acuity, slit lamp biomicroscopy, IOP, indirect ophthalmoscopy with +90D (diopter) and +20D were done. The age of the study population ranged from 20-58 years with mean±SD 37.63±8.16 years. Among the study population 67(60.9%) were male and 43(39.1%) were female. According to ART status, 58(52.7%) were on ART and 52(47.3%) were ART naive. The mean CD4+ T- cells count was 410±281.65 with minimum to maximum was 6-1266 cells/μl. Among them 53(48.2%) had HIV related ocular findings and 57(51.8%) had no HIV related ocular manifestation. In relation with CD+ T- cells count, highly significant relation was found with lower CD4+ T- cells count and ocular manifestation (p=0.001).

Rep-PCR Analyses Reveal Genetic Variation of Ralstonia solanacearum Causing Wilt of Solanaceaous Vegetables in Bangladesh

Ralstonia solanacearum, a soil-borne and seed-borne plant pathogenic bacterium, causes bacterial wilt to several important crop plants causing substantial economic losses. To provide population information on this pathogen for developing effective control strategies, Rep-PCR was used to analyze the genetic variation of 18 representative isolates of R. solanacearum collected in Bangladesh. Phenotypic analyses revealed that all eighteen isolates belong to biotype 3 with wide diversity in aggressiveness on eggplant, tomato, and chili. Rep-PCR studies utilizing the REP, ERIC, and BOXIR primers showed a wide variation at the genetic level among the R. solanacearum isolates used in this study. Dendrogram constructed using REP, ERIC, and BOXIR primers based on banding patterns implied that R. solanacearum isolates were genetically diversified and distributed in four clusters at 83%, 80%, and 63% similarity index, respectively. The genetic relationship assayed by rep-PCR highlighted a wide range of genetic variation but no relation among geographical origin, aggressiveness, and phylogenetic groups of R. solanacearum isolates. These results conceded that other molecular markers related to virulence gene(s) might reveal the complex relationship among geographical origin, aggressiveness, and phylogenetic groups.

Predictors of Malignancy in Thyroid Nodules

Thyroid swellings are common clinical problem throughout the world and also in Bangladesh. Most of thyroid swellings are multinodular, but a good percentage is solitary thyroid nodule. There is no robust, feasible method for malignancy differentiation has not been well established. The study evaluated thyroid nodules for risk of malignancy and compared history, clinical, sonographic features and FNAC findings with histopathology. This was a cross sectional study on 160 consecutive subjects of thyroid nodules done in the department of ENT and Head Neck Surgery of Mymensingh Medical College Hospital (MMCH), Mymensingh, Bangladesh during from July 2018 to December 2019. All patients were admitted and diagnosed by detail history, clinical examination, investigations and underwent thyroidectomy. Detailed history, clinical examination, ultrasonographic finding and FNAC variables were documented retrospectively and a mathematical model was established for malignancy prediction. In this study mean age of the patients of thyroid nodules was 37.54±11.49 years and majority of the patients were within 21-40 years of age. Frequency of thyroid nodules is more in female with male female ratio 1:7. Most of the thyroid nodules appeared in this study within 0-2 years (61.9%). In this series of thyroid nodules constituted 88.1% firm, 8.8% hard, 3.1% cystic. Among the patients 89(55.6%) cases have solitary thyroid nodule and 71(44.4%) cases have multinodular goitre Majority of the nodules were warm 57.5% followed by cold 42.5%. FNAC showed nodular goitre 72.5%, Follicular neoplasm 1.3%, Papillary carcinoma of thyroid 7.5%, colloid goitre 9.4%, suspicious papillary carcinoma 3.8% and lymphocytic thyroiditis 1.3%. In this study out of 85 solid nodule, 69(81.18%) were benign and 16(18.82%) was malignant and out of 3 cystic nodule 3(100%) were benign. In this study most of the benign and malignant nodules were predominantly solid. Study showed the malignancy is significantly (p=0.001) more in solid than cystic nodules. Final diagnosis in this study was done on the basis of histopathological reports. Out of 160 patients, histopathologically benign lesion was 120(75%) and malignant was 40(25%). Among malignant cases 36(22.5%) cases were papillary carcinoma, 1 case was medullary carcinoma and 3 cases were follicular carcinoma.

Lead and other elements-based pollution in soil, crops and water near a lead-acid battery recycling factory in Bangladesh

Lead (Pb) pollution in the environment predominantly occurs through anthropogenic activities, which pose significant threats to human health and that of biota. In this study, Pb and other elements were investigated in different soils (n = 52), crops (n = 24) and water (n = 13) around a lead-acid battery (LAB) recycling workshop in southwestern Bangladesh. Most of the elements' concentrations (except Se and Ag) in soil were lower than the background concentrations. However, excessive concentrations of Pb were found in both surface (966 ± 2414 mg kg^-1 at 0-15 cm) and subsurface (230 ± 490 mg kg^-1 at 15-30 cm) soil. Although no definitive pattern or direction in elemental concentration in soil was observed, relatively higher concentrations of most elements were detected at the southeast part of the factory. The LAB factory, brick kiln, agricultural and geogenic activities might be the sources of these elements in soil. Extremely high amounts of Cr, As, Cd, and Pb were found in the food crops around the area. In particular, the Pb concentrations were 114 ± 155 and 665 ± 588 mg kg ^-1 dry weight in rice grain and straw, respectively, which reflected the emissions of Pb from the LAB recycling workshop. Moreover, 40% and 100% of the groundwater samples exceeded, respectively, the WHO provisional guideline values for As (0.01 mg L^-1) and Pb (0.05 mg L^-1). Consequently, a high level of Pb contamination in the soil was observed while assessing different soil pollution indices. Human health risk assessment indicated severe carcinogenic (from Pb, As, and Cr intake) and non-carcinogenic (from Pb, As, Co, Cr, Ni and Sb intake) health risks are associated with rice and groundwater consumption. It is concluded that all LAB recycling workshops should be better managed to prevent Pb pollution from seeping into the environment.

Beryllium in contaminated soils: Implication of beryllium bioaccessibility by different exposure pathways

Inhalation exposure and beryllium (Be) toxicity are well-known, but research on bioaccessibility from soils via different exposure pathways is limited. This study examined soils from a legacy radioactive waste disposal site using in vitro ingestion (Solubility Bioaccessibility Research Consortium [SBRC], physiologically based extraction test [PBET], in vitro gastrointestinal [IVG]), inhalation (simulated epithelial lung fluid [SELF]) and dynamic two-stage bioaccessibility (TBAc) methods, as well as 0.43 M HNO₃ extraction. The results showed, 70 ± 4.8%, 56 ± 16.8% and 58 ± 5.7% of total Be were extracted (gastric phase [GP] + intestinal phase [IP]) in the SBRC, PBET, and IVG methods, respectively. Similar bioaccessibility of Be (~18%) in PBET-IP and SELF was due to chelating agents in the extractant. Moreover, TBAc-IP showed higher extraction (20.8 ± 2.0%) in comparison with the single-phase (SBRC-IP) result (4.8 ± 0.23%), suggesting increased Be bioaccessibility and toxicity in the gastrointestinal tract when the contamination derives from the inhalation route. The results suggested Be bioaccessibility depends on solution pH; time of extraction; soil reactive fractions (organic-inorganic); particle size, and the presence of chelating agents in the fluid. This study has significance for understanding Be bioaccessibility via different exposure routes and the application of risk-based management of Be-contaminated sites.

Antimicrobial Resistance of E Coli Causing Urinary Tract Infection in Bangladesh

Rapid spread of multidrug resistant microorganisms is a matter of great concern throughout the glove including Bangladesh. The objective was to identify the causative organisms for urinary tract infection (UTI) and their sensitivity patterns to antibiotics. This descriptive cross-sectional study was conducted on patients admitted with UTI (n=60) at a tertiary level hospital in Dhaka, Bangladesh from March 2019 to September 2019. Data were collected through clinical record reviews. Data of all these 60 cases were analyzed for socio-demographic characteristics. Of the 60 patients, culture and sensitivity report was available for 42 patients. Therefore, data were further analyzed for these 42 cases. Median age of patients was 35 years and 80% were female. The main organisms isolated from urine culture of UTI patients were E. coli (64%), Klebsiella (12%) and Enterococci species (10%). Susceptibility to antibiotics was analyzed only for E. coli (n=27) since the number of isolates of other organisms were small. E. coli was found to be resistant to most of the first- and second-line antibiotics, such as Amoxicillin (100%), Amoxyclav (72%), Co-trimoxazole (89%), Nalidixic acid (78%), Ceftazidim (94%), Ceftriaxone (73%), Cefuroxime (100%), Ciprofloxacin (59%), Cephotaxime (80%), Cefixime (100%) and Moxifloxacin (100%). E. coli was the predominant organism responsible for UTI and was resistant to most of the first- and second-line antibiotics. Immediate action is needed to develop empirical guideline for empirical management of UTI and establish surveillance system for monitoring.

Recommendation and Roadmap of Mass Vaccination against Coronavirus Disease 2019 Pandemic in Bangladesh as a Lower-Middle-Income Country

Low-income countries (LICs) and lower-middle-income countries (LMICs) are still deprived of the optimum doses of coronavirus disease 2019 (COVID-19) vaccines for their population, equal access and distribution, as well as mass immunization roadmaps to be implemented for achieving herd immunity and protection from the ongoing pandemic. In this short report, we are interacting with the world public health experts, as well as national and global leaders for warranting the mass vaccination drive to be more progressive against COVID-19 with equitable access of vaccines to LICs or LMICs to save the lives of the poorest country people and refugees. From several scientific databases, such as Google Scholar, PubMed, as well as national and international news websites, the data were collected data by utilizing appropriate keywords regarding the topic. Bangladesh might be exemplified in this brief communication as the representative of LMIC. As of October 14, 2021, 48% of the world's people have received at least one dose of the COVID-19 vaccine. In contrast, only 2.5% of people from LICs have come in under COVID-19 vaccination for at least a single shot. Both LICs and LMICs need far more vision and ambition, including political, administrative, and diplomatic progress along with enhancing the vaccination drive for their population to be immunized through simultaneous mass vaccination progress of other countries with implementing public health safety measures against the COVID-19 pandemic.

Arsenic bioaccessibility and fractionation in abandoned mine soils from selected sites in New South Wales, Australia and human health risk assessment

Understanding the transport behaviour of arsenic (As) from soils to humans is critical when undertaking human health risk assessment and contamination control. This research examined As bioaccessibility in different As fractions and particle size fractions of As-enriched mine soils using different extractions. Bioaccessibility of As ranged from 0.24% to 32% for Solubility Bioaccessibility Research Consortium (SBRC) and Physiologically Based Extraction Test (PBET) methods, with extractable As (using 0.43 M HNO₃) being 1.3-24.9%. The highest As bioaccessibility (19-32%) was consistently observed in the fine particle size fraction (< 53 µm) of all three extractions. Sequential extractions revealed that As fractions were mostly associated with crystalline (30-73%) and amorphous (9-59%) Fe/Al oxyhydroxides. The bioaccessibility of As in the gastric phase of SBRC and PBET methods highlighted a positive correlation (R² = 0.83-0.88, p < 0.01) with exchangeable, surface and amorphous- bound As fractions, while the intestinal phase showed a strong positive correlation (R² = 0.85-0.89, p < 0.01) with exchangeable and surface bound fractions. The study revealed that As bioaccessibility in soils can potentially be determined using the 0.43 M HNO₃ extraction procedure. Health risk assessment confirmed that there was a strong increase in chronic daily intake, hazard quotient and cancer risk, with a reduction in particle size.

Manganese in potable water of nine districts, Bangladesh: human health risk

Safe drinking water is directly linked to good human health. An excessive amount of manganese (Mn) in drinking water supplies causes people show symptoms of neurotoxicity. In this study, the level of Mn in potable water sourced from tube wells located in 9 (nine) districts of Bangladesh was monitored. In total, 170 (one hundred and seventy) water samples were collected and Mn was quantified by atomic absorption spectroscopy (AAS). The levels of Mn found in the tube well water samples of Sirajganj, Meherpur, Chuadanga, Jhenaidah, Magura, Faridpur, Jashore, Satkhira, and Khulna were 0.37-1.86, 0.10-4.11, 0.30-0.76, 0.26-0.94, 0.01-0.18, 0.21-1.78, 0.08-1.23, 0.05-0.27, and 0.01-2.11 mg/L, respectively. Results revealed that Mn level was beyond the highest contaminated levels of 0.1 mg/L and 0.4 mg/L, which are recommended by Bangladesh Drinking Standard (BDS) and World Health Organization (WHO), respectively. The maximum Mn contaminated level reached up to 4.11 mg/L (mean, 0.53 mg/L). The Mn level in tube well water exceeded 51.1% and 75.9% set by the recommended value of WHO and BDS, respectively. Furthermore, the calculated hazard quotient (HQ) value for Mn was observed to be greater than unity, indicating both children and adults risked potential non-carcinogenic health issues. The water supply authorities should take steps to provide Mn-free drinking water for communities.

Efficacy of Clotrimazole 1% Solution Compared to Econazole Nitrate 1% + Triamcinolone Acetonide 0.1% Cream in Patient with Otomycosis

Fungal infection of the ear canal is called Otomycosis. It is more common in hot and humid condition. There are many modalities of treatment or therapeutic agent for treatment of otomycosis. Econazole Nitrate 1% + Triamcinolone Acetonide 0.1% cream is a topical antifungal agent described to be effective in the treatment of otomycosis. This study was performed to compare the efficacy of topical application clotrimazole 1% solution and Econazole Nitrate 1% + Triamcinolone Acetonide 0.1% cream in the treatment of otomycosis. A controlled, randomized and open clinical trial was carried out in ENT department of Mymensingh Medical College Hospital, Mymensingh, Bangladesh from January 2020 to July 2020. Patients diagnosed with fungal otitis externa who were treated with topical antifungals were included in this study. They were randomized into two treatment groups: i) Clotrimazole 1% solution, 2) Econazole Nitrate 1% + Triamcinolone Acetonide 0.1% cream. Patients were microscopically evaluated at two weeks of treatment to determine resolution of disease. Recurrence and complications were recorded. Demographic and clinical variables were collected and analyzed, follow up and final outcomes (absence of infection) were compared between two groups. One hundred & two (102) patients were included, 51 in the clotrimazole 1% solution group and 51 in the Econazole Nitrate 1% + Triamcinolone Acetonide 0.1% cream group. Predominant symptoms are pain, pruritus, aural fullness and hearing loss. Aspergillus organism was isolated most frequently (63.73%). Treatment with clotrimazole 1% solution groups resulted in 88.23% resolution vs. 80.39% resolution with Econazole Nitrate 1% + Triamcinolone Acetonide 0.1% cream at 2 weeks of treatment. Econazole Nitrate 1% + Triamcinolone Acetonide 0.1% cream group demonstrated higher treatment failure 11.76 and 19.60 respectively. Clotrimazole 1% solution is more effective than Econazole Nitrate 1% + Triamcinolone Acetonide 0.1% cream for uncomplicated otomycosis. More study is needed to corroborate our results.

Open Label Randomized Controlled Comparison of Three Alternative Regimes of Ciprofloxacin, Azithromycin and Cefixime for Treatment of Uncomplicated Typhoid Fever in Bangladesh

Multi-drug resistant Typhoid fever (resistant to previously used chloramphenicol, ampicillin, amoxicillin, and trimethoprim-sulfamethoxazole) has been commonly described in the South East Asia region and a recent report suggests that the salmonella typhi have reduced response to fluoroquinolones (nalidixic acid-resistant). The optimum treatment protocol for this type of serovar has not been established. This study compared different antimicrobial regimens for the treatment of uncomplicated typhoid fever which was conducted in the medicine ward of Dhaka Medical College Hospital (DMCH) and outdoor setting in private practice in Dhaka metropolitan city, Mymensingh and Sylhet town from January 2017 to December 2017. Bangladeshi adults with uncomplicated typhoid fever were included in this an open-label randomized controlled trial. Ciprofloxacin (20mg/kg of body weight/day for 14 days), azithromycin (20mg/kg/day for 14 days), and Cefixime (16mg/kg/day for 14 days) were compared. Of the 81 enrolled patients, 62 were eligible for analysis (61 S. enterica serovar Typhi, 1 Salmonella enterica serovar paratyphi A). Of the S enterica serovar Typhi isolates, 88.7% (55/62) were MDR and 93.5% (58/62) were nalidixic acid resistant (NAR). The clinical cure rate was 62% (13/21) with ciprofloxacin, 71% (15/21) with Cefixime, and 85% (17/20) with azithromycin (p=0.053). The mean (95% confidence interval [CI]) fever clearance time for patients treated with azithromycin (5.8 days [5.1 to 6.5 days]) was shorter than that for patients treated with cefixime (7.1 days [6.2 to 8.1 days]) and ciprofloxacin (8.2 days [7.2 to 9.2 days]) (p<0.001). All three antibiotics were well tolerated. A 7-day course of azithromycin can be successfully used in uncomplicated typhoid fever due to isolates of MDR S enterica serovar Typhi.

COVID 19 in Children: Gastrointestinal, Hepatobiliary and Pancreatic Manifestation

The most devastating pandemic of this era coronavirus disease-2019 (COVID-19) is caused by a novel virus named severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2). Although it is primarily a respiratory pathogen, it can also result in several extra-pulmonary manifestations includes gastrointestinal symptoms, hepatocellular injury. Angiotensin-converting enzyme-2 (ACE-2) receptor and transmembrane serine protease 2 (TMPRSS2), the entry receptor for the causative coronavirus SARS-CoV-2 is co-express in the gastrointestinal tract, hepatocyte, and cholangiocytes similar to the respiratory mucosa. The presence of these receptors facilitates the entry into the tissue and causes direct viral tissue damage, which is a proposed mechanism of injury. Diarrhoea, nausea, vomiting, abdominal discomfort are common gastrointestinal manifestations, whereas derangement of liver function tests is the most hepatic manifestation in COVID-19. In this article, we reviewed on SARS-CoV-2 disease COVID-19 regarding gastrointestinal, hepatic, and pancreatic manifestation, the mechanisms by which the virus may inflict damage, and their management perspective.

The influence of soil properties on sorption-desorption of beryllium at a low level radioactive legacy waste site

This study examined the influence of soil physicochemical properties on the sorption, desorption and kinetics of beryllium (Be) uptake and release on soils from a legacy waste site in Australia. This information is needed to help explain the current distribution of Be at the site and evaluate potential future environmental risks. Sorption was determined by a batch study and key soil properties were assessed to explain Be retention. The soil was favourable for sorption of Be (up to 99%) due to organic content, negative surface charge, soil oxyhydroxides (Fe/Al/Mn-O/OH) and the porosity of the soil structure. Lesser sorption was observed in the presence of a background electrolyte (NaNO₃). Sorption closely followed pseudo second order kinetics and was best described by the Langmuir model. FTIR analysis suggested that chemisorption was the predominant mechanism of Be sorption. Desorption was very low and best described by the Freundlich model. The low desorption reflected the high K_d (up to 6624 L/kg), and the presence of hysteresis suggested partially irreversible binding of Be with active surfaces of the soil matrix (minerals, SOM, oxyhydroxides of Fe/Al/Mn etc.). Intra-particle diffusion of Be and entrapment in the pores contribute to the irreversible binding. The sorption behaviour of Be helped to explain the relative immobility of Be at the site despite the significant quantities of Be disposed. Soil physicochemical properties were significant for Be sorption, through influencing both the uptake and desorption, and this demonstrates the implications of these measurements for evaluating potential future risks to the environment.

Bioaccessibility and speciation of arsenic in children's diets and health risk assessment of an endemic area in Bangladesh

This study determines the bioaccessibility of toxic and carcinogenic arsenic (As) in composite food samples and evaluates potential exposure from food intake in Bangladesh children. Total As (tAs), inorganic As (iAs) and bioaccessible As (BAs) in food composite samples consumed by children were compared between an exposed and a control group (based on As in drinking water). Total As concentrations in composite food samples of children exposed to mean As level of 331 µg/l in drinking and cooking water ranged from 586 to 1975 µg/kg, dry weight over 76-90 µg/kg in the unexposed group. Average iAs in food composites was 73.9% (range: 49.3-90.8%). The fraction of BAs using gastric and gastrointestinal phases was 91 ± 13% and 98 ± 11%, respectively. Daily intake of iAs in the exposed group ranged from 0.41 to 6.38 µg per kg body weight (BW), which was much higher than the unexposed group (0.08-0.15 µg per kg BW). High iAs content and BAs in composite food samples indicated the elevated risk to exposed children. Further research should include both adults and children using larger sample size to determine overall As exposure from food intake in Bangladesh, attention must be given to lowering of As in food.

Synthesis and characterization of nanozeolite based composite fertilizer for sustainable release and use efficiency of nutrients

In this research work, we propose macronutrients incorporated slow-release based nano-fertilizer using nanozeolite as a carrier. A simple chemical approach was used to synthesis the proposed nanozeolite composite fertilizer (NZCF). To gain an insight into the properties, morphology and structure of the synthesized NZCF, it was further characterized by different techniques such as powder XRD, FT-IR, SEM, and TG/DTA. A considerable enhancement of the quality and the water retention capacity of the soil was observed as a result of applying the proposed NZCF when compared with a commercial fertilizer. Furthermore, the swelling ratio and the equilibrium water content of NZCF were compared to the commercial fertilizer and their effect on plant growth was observed. Slow-release studies were carried out for both NZCF and the commercial fertilizer. The results of these studies reveled that NZCF possessed a long-term release pattern of the macronutrients and that showed a great potential for promoting plant growth. Hence, the prepared nanocomposite fertilizer can be safely used as an environment-friendly source of nutrients to enhance plant growth.

Comparison between Efficacy of Combined Use of Hyaluronidise and Triamcinolone versus Hyaluronidise, Triamcinolone Acetonide and Oral Colchicine in the Treatment of Oral Submucous Fibrosis

Oral submucous fibrosis (OSF) is a chronic complex potentially pre-malignant condition caused by chewing areca nut and other irritants. It is an insidious process characterized by Juxta-epithelial deposition of fibrous tissue in the oral cavity and pharynx. OSF is very common in Southeast Asia and also now a days increase in Europe and North America. The aim of this study to compare the effectiveness of intralesional injection of triamcinolone and hyalurunidase versus intralesional injection of triamcinolone plus injection hyalurunidase with oral colchicine. The study included 60 patients of clinically diagnosed case of oral submucous fibrosis. Patients were divided into two Groups A and B. Group A patients received combination intralesionsl injection of triamcinolone acetonide 10mg/ml in 1ml with injection hyalurunidase 1500IU in 2ml with injection 2% lidocaine 7ml. 15 days interval in 3 months and Group B received intralesional injection of triamcinolone acetonide 10mg/ml in 1ml with injection hyalurunidase 1500IU in 2ml with injection 2% lidocaine 7ml in each 15 days interval for 3 months with oral colchicine 0.5mg twice daily for 3 months. Diagnosis based on burning sensation of mouth, blanching of mucosa, ulceration in oral cavity and also reduced mouth opening. Follow up assessment was done at intervals 1st follow up on 21st days after starting of treatment then 2nd follow up after 3 months and last 3rd follow up after 6 months. Before starting of treatment all patients were properly explained about the study and took their written consent. Much more improvement occurred in Group B patients, reducing in burning sensation and also increases in opening of mouth. In both groups blanching mucosae were improved. Treatment regimen of Group B is more effective in increasing mouth opening and improves burning sensation of oral cavity. No side effects were seen in both groups' patients.

Timing of eating during transition impacts feedlot cattle diet and liveweight gain

The timing of eating, relative to when feed is offered, is affected by the social rank of feedlot cattle due to limited feed bunk space. As cattle can select feed based on dietary preference, the timing of eating for cattle in feedlot may be associated with the ingested diet composition. Our objectives were to determine the nutritive value and timing of feed ingested by 100 feedlot cattle during transition and the association of timing of eating with feeding behaviours and average daily gain (ADG). Cattle behaviour and timing of eating were determined on 100 feedlot cattle using accelerometer-based ear tag sensors from days 3 to 6 post feedlot induction (observation period), and the ongoing impact of this period on ADG was determined for the full feed period (75 days). To determine eating patterns at the time of feed offer, cattle were grouped according to the number of days they were recorded as eating within 1 h of feed being offered across 4 observation days, G⁰: not present across 4 days, G¹: present for 1 day, G²: 2 days, G³: 3 days and G⁴: present for each of the 4 days. Total mixed ration (TMR) samples were collected for nutritive value analysis from four locations along the feed bunk from the time feed was offered and at hourly intervals thereafter for 7 h each day during the observation period. The composition of feed in the bunk changed across the 7 h of measurement (P < 0.05). The DM and CP of feed increased from 65 to 70% and 15 to 16%, respectively, and the NDF decreased from 36 to 32%. Thus, the preferred TMR feed component was the fibrous dietary fraction. However, the overall composition of the ingested diet for 7 h post feeding was similar between groups. Cattle in G⁰ had reduced eating time (0.7 vs 4.8%; P < 0.001), rumination time (4.5 vs 19.5%; P < 0.001) and ADG (1.0 vs 1.3 kg/d; P < 0.05) across the study, as compared with cattle in G⁴. Offering a more fibrous ration during feedlot transition, and customised cattle segregation and/or customised feeding regimes based on sensor derived feeding behaviour profiles during acclimation to feedlot can optimise ADG, animal welfare and feedlot profit.

Frequency and Risk Factors of Diabetic Retinopathy among Patients with Type 2 Diabetes Mellitus: A Single-Center Study from Bangladesh

Diabetic retinopathy (DR) is the most frequent microvascular complication of diabetes mellitus (DM). DR remains a leading cause of blindness, currently accounting for 4.8% of the world's 37 million blindness cases. DR is one of the critical preventable causes of blindness. In Bangladesh, the number of studies reporting the prevalence and risk factors of DR in type 2 DM (T2DM) is limited. We conducted this cross-sectional study in a tertiary hospital in Bangladesh from March 2017 to August 2019 among 200 patients with T2DM for the presence and severity of DR by using color fundus photography in a dilated pupil. The diagnosis and grading of DR were made using the Early Treatment of Diabetic Retinopathy Study (ETDRS) Chart. Out of 200 subjects with T2DM, 35.5% had DR; the frequencies of NPDR and PDR were 19.0% and 16.5%, respectively. The mean age, diabetes duration, FPG, HbA1c, TG, TC, LDL-C, and serum creatinine were statistically higher, and eGFR was lower in the study subjects with DR than those without DR; BMI and HDL-C were indifferent in the two groups. The frequencies of males, subjects having monthly income of 10,000 Bangladeshi Taka (BDT) or more, smokers, hypertensives, and subjects having uncontrolled diabetes (HbA1c ≥7%), were higher in the DR group than the no DR group. Higher age (≥50 years), higher monthly income (≥10,000 BDT), urban residence, smoking, uncontrolled diabetes, and high LDL-C (≥100mg/dL) were found to be independent risk factors of DR in the study subjects. A large-scale nationwide study is needed to find out the actual prevalence of DR in Bangladesh.

Cartilage Ossiculoplasty from Stapes to Tympanic Membrane in One-Stage Intact Canal Wall Tympanoplasty for Cholesteatoma

This prospective study was conducted at Department of ENT, Mymensingh Medical College Hospital, a tertiary care center in Bangladesh January 2017 to December 2018 to report hearing results and post operative complications of cartilage interposition ossiculoplasty in one-stage intact canal wall (ICW) tympanoplasty for cholesteatoma where ossicular chain is eroded or has to be removed either partially or totally. Total 42 patients underwent Intact canal wall (ICW) tympanoplasty for cholesteatoma with at least intact stapes footplate and in conjunction, cartilage ossiculoplasty was done during the same procedure. Patients were followed up regularly at 1 week, 1 month, 3 month, 6 month and at 1 year as usual follow up protocol to note complications and hearing status in 1 year follow up. In intact stapes suprastructure group, in the preoperative period, the mean air conduction thresholds (AC), bone conduction threshold (BC) and air-bone gap (ABG) were 48.3db, 9.5db and 38.8db respectively. Postoperatively, with a mean follow-up of 12 months, AC, BC and ABG were 27.6db, 9.7db and 17.9db respectively. In missing stapes supra structuregroup, in the preoperative period, the mean air conduction thresholds (AC), Bone conduction threshold (BC) and air-bone gap (ABG) were 57.4db 13.5db and 43.9db respectively. Postoperatively, with a mean follow-up of 12 months, AC, BC and ABG, were 33.9db, 14.2db and 19.7db respectively. For management of cholesteatoma cases, cartilage ossiculoplasty can be done effectively in conjunction with of intact canal wall tympanoplasty in a single setting. Complications are a few and easily manageable. Hearing results are at least as good as with other prosthesis and helps in avoiding subsequent surgery, discomfort and cost to the patients.

Corporate social responsibility, innovation capability and firm performance: evidence from SME

Purpose

The purpose of this paper is to examine corporate social responsibility (CSR) and its effect on small and medium enterprises’ (SMEs) innovation capability and financial performance from the perspective of a developing country. It also aims to explore the role of innovation capability as a mediating factor in the linkage between CSR and SMEs’ financial performance.

Design/methodology/approach

A questionnaire was distributed among managers/owners of the sampled companies. Using a data set of 402 Eritrean firms and partial least squares structural equation modeling, direct and mediating effects were tested.

Findings

The result reveals that CSR has a positive and significant effect on the financial performance and innovation capability of SEMs. Besides, innovation capability has a positive and significant effect on the business performance of SMEs. The result also supports a partial mediation effect of innovation capability on the association between CSR and firm performance.

Practical implications

The findings from this research could enhance the awareness of the entrepreneurs, researchers and policymakers on CSR-SMEs’ relationship and help understand the importance of CSR as a crucial driver mechanism for companies to become more innovative and competitive.

Originality/value

By empirically examining the relationship between CSR, innovation capability and performance in SMEs, this study contributes to the ongoing scholarly discussion on the linkage between CSR and financial performance. Also, to the best of the authors’ knowledge, no other study investigated the mediating role of innovation capability on the link between CSR activities and firms’ financial performance in SMEs from a developing country perspective, making substantial contributions to research in terms of theory, practice and policy.

Doppler Evaluation of Carotid Vessels in Type 2 Diabetes

Type 2 diabetes considered as a compound of metabolic syndrome. It can cause both micro and macrovascular complications. Diabetes is a strong risk factor in the development of atherosclerosis and likewise carotid artery disease. Carotid artery stenosis may cause stroke. Doppler ultrasound is the most common imaging technique for the diagnosis of carotid disease. Objective of the study was to assess the percentage of atherosclerotic carotid disease in asymptomatic Type 2 diabetics (T2D) by Doppler sonography and to find out the association of different risk factors of diabetic patient with atherosclerosis. A cross sectional study was done. A total of 43 type 2 diabetic patients (27 male, 16 female) referred from the out patient department and admitted patients in Mymensingh Medical College Hospital (MMCH) during January 2017 to December 2017 for the purpose of evaluation of intima media thickness (IMT) and carotid artery stenosis by Duplex color Doppler ultrasonography examination were enrolled in this study. Patients with previous history of recent stroke or transient ischemic attack (<6 weeks), history of carotid surgery or cervical radiotherapy were excluded. Carotid artery disease was found 65.1% in asymptomatic type 2 diabetics. Among them increased IMT in 48.8% and carotid stenosis was present in 37.2% and >50% stenosis (Peak systolic velocity >125cm/sec) was present in 9.3%. Age >50% years, smoking, duration of DM >10 years, hypertension, history of ischaemic heart disease and history of diabetic retinopathy were found to be associated with carotid atherosclerosis as well as carotid stenosis. High percentage of carotid artery disease (65.1%) was found in asymptomatic type 2 diabetes mellitus. This result suggests the need for carotid Doppler evaluation of all Type 2 diabetics as a first measure of stroke prevention, with the hope that timely intervention might avert stroke and its accompanying disability.

Relation of Obesity with Breast Cancer among the Patients Attending at National Institute of Cancer Research & Hospital

Breast cancer among women is gradually increasing in Bangladesh day by day. A number of breast cancer related etiological factors identified as age, reproductive factors, menarche, menopausal status, life style, hormone replacement therapy, genetics and alcohol intake. Obesity is an important factor for developing breast cancer in different countries. Obesity is one of the modifiable factors. The aim of the study was to find out the factors which might be associated with obesity among female breast cancer patients in Bangladesh. It was a case-control study conducted at the Department of Medical Oncology, National Institute of Cancer Research & Hospital (NICRH), Dhaka, Bangladesh from August 2014 to July 2015. Ninety one case and equal numbers of age matched controls were included in the study. The mean age of the case was 42.99 (±9.24) years and that of the control was 44.11±8.97 years. Majority of patients i.e. 59.3% (n=54) in case group was in pre-menopausal state where as 52.7% (n=48) of respondents in control group were in menopausal state. Increased waist to hip ratio (>0.85) was associated with increased risk of breast cancer (OR: 8.1). This was also true for increased BMI of ≥25kg/m² (OR: 4.57), increased waist circumference (OR: 3.52) and ever OCP use (OR: 2.11). However, para >3, education and moderate to heavy work were found to be protective against breast cancer (OR: <1). In clinical setting waist-to-hip ratio, body mass index (BMI) and waist circumference (WC) can be used effectively to identify women with an increased risk of breast cancer.

Prevalence of Diabetic Nephropathy in Patients Attending the Endocrine Department of Mymensingh Medical College Hospital

Diabetic nephropathy (DN) is the leading cause of end-stage renal disease worldwide. Due to severe morbidity and mortality of DN and limited effective therapies, research has mainly focused on prevention of this debilitating illness by modification of risk factors. Aims of this study were to find out the prevalence of diabetic nephropathy, its factors and to correlate the functional status of the kidney. This cross-sectional study was conducted in the Department of Endocrinology, Mymensingh Medical College Hospital, Mymensingh, Bangladesh from 1st January 2013 to 30th June 2013. A total 105 patients having clinical diagnosis of Diabetes mellitus were enrolled in this study. Data were collected by interview of the patients, clinical examination and laboratory investigation. Data was analyzed using the Chi-square test for Categorical variables and unpaired Student's 't' test for differences in means for continuous variables. P value <0.05 was considered significant. With DN (30.5%) patients 21.1% had micro-albuminuria and 9.5% had macro-albuminuria. The mean age for the DN patient was 47.9±14.7 years and male female ratio was 1:1. BMI was found significantly low in patients with DN (p<0.05). Prolonged duration of diabetes (>5 years) and uncontrolled diabetes were found as significant risk factors associated with DN. Other risk factors were hypertension, family history of hypertension, family history of diabetes mellitus and irregular treatment of diabetes mellitus. Mean serum creatinine, mean estimated glomerular filtration rate (GFR) and mean blood sugar level was 1.3±0.6mg/dl, 69.4±26.7ml and 15.6±7.1mmol/L respectively in DN patients. Relation was significant for higher serum creatinine and lower eGFR values (p<0.05). Prevalence of diabetic nephropathy was 30.5%. Long standing diabetes (>5 years) and uncontrolled diabetes were the important risk factors for the development of diabetic nephropathy. Diabetic nephropathy is associated with higher serum creatinine and lower eGFR values.

Family firms propensity to lean innovation in the emerging economy: a moderating role of executive's compensation

Purpose

The purpose of this study is to investigate the empirical relationship between family firms and lean innovation (i.e. generating more output with less input) as well as the moderating role of the executive's compensation.

Design/methodology/approach

Panel data for ten years (2007–2016) have been collected from the CSMAR database. This study concludes the findings using descriptive statistics, correlation and panel data analysis techniques applying statistical software STATA.

Findings

Results show that family firms are not motivated to follow lean innovation strategies until unless the executives are compensated well. We further find that family firms are more likely to pursue a lean innovation strategy, and they demonstrate a superior record of converting R&D inputs as granted patents, and; both input and output innovation are significantly affected by executive compensations. However, this study shows an insignificant negative relationship of propensity to patents with the moderating effects of executive compensation.

Research limitations/implications

This research has been conducted on the emerging Chinese market. The study is useful for policymakers and managers to devise such strategies which can make the role of executive's more effective to reduce the agency cost and reap the benefits of innovation input more effectively (Petersen, 2009). Also, family firms are heterogeneous, and the research outcome may be applicable for both advanced and emerging economies.

Originality/value

The previous family firm's research paid less attention to the role of the executive's compensation on the relationship of family firms and lean innovation. Moreover, they prioritize insight into how executive's compensation affects different proxies of innovation. This study sheds new light on the paradoxical findings of family firms and lean innovation by analyzing the significant role of executive compensation.

Experience of Chikungunya in a Chikungunya Clinic at Tertiary Medical College Hospital in Bangladesh

A large outbreak of Chikungunya occurred in Bangladesh in 2017. It caused a serious impact on sufferers of the disease. Study aimed to assess the real scenario unfolding as case reporting to Directorate General of Health is less in Bangladesh by physicians. For this observational study a Chikungunya Clinic was set at Dhaka Medical College, Dhaka, Bangladesh and physicians were attached to the clinic who got training on Chikungunya by directorate General of Health from 9th July 2017 to 10th September 2017. A pre-tested questionnaire was supplied to all the physicians working at the clinic. Appropriate training was provided before data collection. Total 301 patients were enrolled. Most striking features were fever (99.3%), arthralgia (99.3%), rash 70.4%, Itching 64.8%, oral ulcer 23.9%, loose motion 18.6% and bleeding 8%.%. Most affected joints were MCP 76.9%, knee 74.9%, wrist 69.2%, Inter phalangeal joints of hand were 67.2%. Chikungunya was not very familiar with the physicians of Bangladesh. This was first time large scale experience by physicians of Bangladesh. Severity and chronicity of arthritis, rash, bleeding caused serious morbidity.

Comparison between Outcomes of Endoscopic Sinus Surgery and Surgical Excision in Case of Rhinosporiodiosis

Rhinosporiodiosis is a chronic granulomatous infection of the mucus membranes caused by Rhino sporidium seeberi that manifest as vascular friable polyps and arise in the nasal mucosa. The mode of infection is probably trans-epithelial penetration. Rhinosporiodiosis is endemic in India, Pakistan and Srilanka. It occurs sporadically in the United States of America. The aim of this study was to compare betweenthe outcomes of endoscopic sinus surgery andsurgical excision in rhinosporiodiosis. The cross sectional comparative study was conducted among 40 patients with rhinosporiodiosis from January 2018 to April 2019 in the department of Otolaryngology and Head-neck surgery of Mymensingh Medical College Hospital, Bangladesh. All the patients were following up to 6 month after surgery. Most of them are male 24(60.0%) and female are 16(40.0%). Age of the patients in this study was (Mean±SD) 34.8±13.5 years. More than half of the patients had rhinosporiodiosis in the inferior turbinate (25, 62.5%) followed by 8(20.0%) in nasal septum and 7(17.5%) in the nasal floor. Endoscopic Sinus Surgery was done purposively among 20 patients and surgical excision was done purposively among another 20 patients. At the time of operation no complication occurs in case of endoscopic sinus surgery but in case of surgical excision small of amount bleeding was present. All the patients were followed up to 6 month after surgery. No recurrence was found in patients with endoscopic sinus surgery but 7(35.0%) patients who underwent surgical excision had recurrence of rhinosporiodiosis at follow up after six months of surgery. Chi-square test showed that the incidence of recurrence after 6 months of surgery was significantly lower in endoscopic sinus surgery (p=0.004). The study results concluded that endoscopic sinus surgery is better option for rhinosporiodiosis.

A Modified Technique in Submandubular Salivary Gland Excision: Preservation of Facial Artery

Cutting and ligation of facial artery is the conventional practice for excision of submandibular gland. Facial artery is the main arterial supply to the lower face. Its preservation results in preservation of large proportion of vascularity to the lower face, preserves vascularity of platysma myocutaneous flap, allows repair of lower lip using Bernard's technique; facial artery is one of the most important recipient artery for microvascular free flap in modern reconstructive surgery in head and neck oncology. This prospective study was carried out in Department of Otolaryngology, Bangabandhu Sheikh Mujib Medical University Hospital (BSMMU), Dhaka, Bangladesh from October 2005 to October 2012 on 31 cases. Chronic submandibular sialoadenitis, benign submandibular gland tumours and cases of neck dissection where level I cervical lymph nodes were not involved by metastasis were included in this study. The facial artery was identified proximal to the gland and was dissected free from the gland by ligating or cauterizing its glandular branches to mobilize the gland. Appropriate anatomical aspects were noted and the time required for separation of the artery from the gland was recorded. Thirty-one consecutive cases were studied. The indications were chronic sialoadenitis (67.7%), pleomorphic adenoma (12.9%) and as a part of neck dissection for oncologic clearance of neck (19.4%). The mean duration of time for separation of the artery from the gland was 10.26 minutes. In two cases the facial artery could not be safely separated due to excessive adhesion from chronic inflammation. No significant complications were noted. Preservation of facial artery in submandibular gland excision is a simple procedure. So it should not be routinely sacrificed during this surgery.

Knowledge and Practice of Nurses on Pediatric Pain Management in Bangladesh

Among nurses due to inadequate pain management knowledge and practice skills, children's pain is often under treated. This study aimed to examine the level of knowledge and practice on pediatric pain management among nurses in Bangladesh. This was a descriptive survey study involving total 150 clinical pediatric nurses from two Medical College Hospital and a University hospital in Bangladesh. The data collection tool consisted of demographic data form, 32-items nurses' knowledge. There were 32 true and false questions related to nurses' knowledge on pediatric pain management in Bangladesh. The response formats to each item for correct answer was 1 and incorrect answer 0. The total scores were categorized into three levels including low (0-20), moderate (21-23) and high (24 and above). The data collection tool consisted of demographic data form, 19-item practice related questionnaire on pediatric pain management. Nurses' practice on pediatric pain management contained 19 items with 5-points Likert's scale ranging from 1=Never practice to 5=constantly practice. For each item, a score of 5 was accorded for constantly and 1 for never. The score ranged from 19-95. The total scores were categorized into three levels including low (19-38), moderate (39-76) and high (77-95). The results demonstrated that most of the nurses' knowledge score on pediatric pain management was at moderate level (mean=21.50, SD=2.35). Nurses' practice on pediatric pain management was also at moderate level (mean=75.45, SD=8.24). The relationship between nurses' knowledge and practice was not significant. In addition, nurses' knowledge and practice with demographic variables; there was significant relationship between nurse's knowledge and existence of pain management protocol, nurses' practice and their current position in unit and with reading nursing journal. This study showed moderate level of knowledge and practice indicating that they need to be enhanced the knowledge and practice skills in pediatric pain management.

Gastrointestinal stromal tumor of rectum

Although gastrointestinal stromal tumors (GISTs) frequently occur in the gastrointestinal tract, they are relatively rare in the rectum. Biopsy of the lesion and immunohistochemistry (IHC) confirm the diagnosis. Complete surgical resection is the principal curative procedure. In combination with surgery, immunotherapy with Imatinib shows cure in intermediate risk and improvement in high risk rectal GIST. We report a case of a 45-yearold female who  presented with constipation and generalized weakness, ultimately diagnosed to have rectal GIST. Journal of Surgical Sciences (2015) Vol. 19 (2) : 85-88

CRC Screening: Current Trend and Feasibility

Colorectal cancer, a rising health concern of both east and west , can be prevented and it’s mortality can be reduced by screening all men and women of average risk  at the age of 50 years or older and  at an earlier age for  high risk group of colorectal cancer. Several tests are available for colon cancer screening, including fecal occult blood test (FOBT), flexible sigmoidoscopy, double-contrast barium enema, and colonoscopy. Direct and indirect evidence indicates that all the tests are effective, but they differ in their sensitivity, specificity, cost, and safety. The available evidence does not currently support choosing one test over another. In addition, other new colorectal cancer tests, such as virtual colonoscopy or stool-based molecular testing, have the potential to become important screening tests in the future. Journal of Surgical Sciences (2015) Vol. 19 (2) : 61-66

The effect of temporal variation in feed quality and quantity on the diurnal feeding behaviour of dairy cows

The diurnal feeding patterns of dairy cows affects the 24 h robot utilisation of pasture-based automatic milking systems (AMS). A decline in robot utilisation between 2400 and 0600 h currently occurs in pasture-based AMS, as cow feeding activity is greatly reduced during this time. Here, we investigate the effect of a temporal variation in feed quality and quantity on cow feeding behaviour between 2400 and 0600 h as a potential tool to increase voluntary cow trafficking in an AMS at night. The day was allocated into four equal feeding periods (0600 to 1200, 1200 to 1800, 1800 to 2400 and 2400 to 0600 h). Lucerne hay cubes (CP = 19.1%, water soluble carbohydrate = 3.8%) and oat, ryegrass and clover hay cubes with 20% molasses (CP = 11.8%, water soluble carbohydrate = 10.7%) were offered as the 'standard' and 'preferred' (preference determined previously) feed types, respectively. The four treatments were (1) standard feed offered ad libitum (AL) throughout 24 h; (2) as per AL, with preferred feed replacing standard feed between 2400 and 0600 h (AL + P); (3) standard feed offered at a restricted rate, with quantity varying between each feeding period (20:10:30:60%, respectively) as a proportion of the (previously) measured daily ad libitum intake (VA); (4) as per VA, with preferred feed replacing standard feed between 2400 and 0600 h (VA + P). Eight non-lactating dairy cows were used in a 4 × 4 Latin square design. During each experimental period, treatment cows were fed for 7 days, including 3 days habituation and 4 days data collection. Total daily intake was approximately 8% greater (P < 0.001) for the AL and AL + P treatments (23.1 and 22.9 kg DM/cow) as compared with the VA and VA + P treatments (21.6 and 20.9 kg DM/cow). The AL + P and VA treatments had 21% and 90% greater (P < 0.001) dry matter intake (DMI) between 2400 and 0600 h, respectively, compared with the AL treatment. In contrast, the VA + P treatment had similar DMI to the VA treatment. Our experiment shows ability to increase cow feeding activity at night by varying feed type and quantity, though it is possible that a penalty to total DMI may occur using VA. Further research is required to determine if the implementation of variable feed allocation on pasture-based AMS farms is likely to improve milking robot utilisation by increasing cow feeding activity at night.