Assessment of human health risk from potentially toxic elements and predicting groundwater contamination using machine learning approaches

The Rooppur Nuclear Power Plant (RNPP) at Ishwardi, Bangladesh is planning to go into operation within 2024 and therefore, adjacent areas of RNPP is gaining adequate attention from the scientific community for environmental monitoring purposes especially for water resources management. However, there is a substantial lack of literature as well as environmental datasets for earlier years since very little was done at the beginning of the RNPP's construction phase. Therefore, this study was conducted to assess the potential toxic elements (PTEs) contamination in the groundwater and its associated health risk for residents at the adjacent part of the RNPP during the year of 2014-2015. For the purposes of achieving the aim of the study, groundwater samples were collected seasonally (dry and wet season) from nine sampling sites and afterwards analyzed for water quality indicators such as temperature (Temp.), pH, electrical conductivity (EC), total dissolved solid (TDS), total hardness (TH) and for PTEs including Iron (Fe), Manganese (Mn), Copper (Cu), Lead (Pb), Chromium (Cr), Cadmium (Cd) and Arsenic (As). This study adopted the newly developed Root Mean Square water quality index (RMS-WQI) model to assess the scenario of contamination from PTEs in groundwater whereas the human health risk assessment model was utilized to quantify the risk of toxicity from PTEs. In most of the sampling sites, PTEs concentration was found higher during the wet season than the dry season and Fe, Mn, Cd and As exceeded the guideline limit for drinking water. The RMS score mostly classified the groundwater in terms of PTEs contamination into "Fair" condition. The non-carcinogenic risks (expressed as Hazard Index-HI) revealed that around 44% and 89% of samples for adults and 67% and 100% of samples for children exceeded the threshold limit set by USEPA (HI > 1) and possessed risks through the oral pathway during dry and wet season, respectively. Furthermore, the calculated cumulative HI score was found higher for children than the adults throughout the study period. In terms of carcinogenic risk (CR) from PTEs, the magnitude of risk decreased following the pattern of Cr > As > Cd. Although the current study is based on old dataset, the findings might serve as a baseline for monitoring purposes to reduce future hazardous impact from the power plant.

Assessment of hydrogeochemistry in groundwater using water quality index model and indices approaches

Groundwater resources around the world required periodic monitoring in order to ensure the safe and sustainable utilization for humans by keeping the good status of water quality. However, this could be a daunting task for developing countries due to the insufficient data in spatiotemporal resolution. Therefore, this research work aimed to assess groundwater quality in terms of drinking and irrigation purposes at the adjacent part of the Rooppur Nuclear Power Plant (RNPP) in Bangladesh. For the purposes of achieving the aim of this study, nine groundwater samples were collected seasonally (dry and wet season) and seventeen hydro-geochemical indicators were analyzed, including Temperature (Temp.), pH, electrical conductivity (EC), total dissolved solids (TDS), total alkalinity (TA), total hardness (TH), total organic carbon (TOC), bicarbonate (HCO3-), chloride (Cl-), phosphate (PO43-), sulfate (SO42-), nitrite (NO2-), nitrate (NO3-), sodium (Na+), potassium (K+), calcium (Ca2+) and magnesium (Mg2+). The present study utilized the Canadian Council of Ministers of the Environment water quality index (CCME-WQI) model to assess water quality for drinking purposes. In addition, nine indices including EC, TDS, TH, sodium adsorption ratio (SAR), percent sodium (Na%), permeability index (PI), Kelley's ratio (KR), magnesium hazard ratio (MHR), soluble sodium percentage (SSP), and Residual sodium carbonate (RSC) were used in this research for assessing the water quality for irrigation purposes. The computed mean CCME-WQI score found higher during the dry season (ranges 48 to 74) than the wet season (ranges 40 to 65). Moreover, CCME-WQI model ranked groundwater quality between the "poor" and "marginal" categories during the wet season implying unsuitable water for human consumption. Like CCME-WQI model, majority of the irrigation index also demonstrated suitable water for crop cultivation during dry season. The findings of this research indicate that it requires additional care to improve the monitoring programme for protecting groundwater quality in the RNPP area. Insightful information from this study might be useful as baseline for national strategic planners in order to protect groundwater resources during the any emergencies associated with RNPP.

Study on Myocardial Infarction in Young Adults: Risk Factor Analysis

Coronary heart disease (CHD) imposes a significant burden on health care systems because of high morbidity and mortality. There is documented evidence that South Asian people develop CHD at a higher rate and at an early age. If the affected individual is 40 years old or below, the tragic consequences are catastrophic. Identifying risk factors could be important for health promotion. The objectives of this study were to determine the frequency of risk factors in young patients with acute myocardial infarction and thus with ischemic heart disease (IHD) aged 40 years and below in our population. It was a descriptive observational study which was carried out at Coronary Care Unit of Rajshahi Medical college Hospital, Rajshahi, Bangladesh in 61 patients from January 2011 to June 2011. All patients who fulfilled the inclusion criteria admitted to coronary care unit (CCU) with a diagnosis of Acute MI were included. Their detailed history was then taken including symptoms at presentation and their risk factors were assessed according to the Framingham Risk Scoring System with the help of history and laboratory investigations. Mean age ±SD of the patients was 36±3.7 year. Most of the patients were male. Smoking was the major risk factor (73.8%) followed by family history of IHD (44.3%). Other risk factors were dyslipidaemia (39.35%), hypertension (37.7%), obesity (11.5%) and diabetes mellitus (8.2%). Majority of the patients were adopted in sedentary lifestyle. 91.8% patient presented with chest pain. Other symptoms were dyspnoea (37.7%), palpitation (59.0%), sweating (77.0%), nausea, vomiting (50.8%) and impaired consciousness (19.7%) etc. Most frequent risk factor for acute myocardial infarction (MI) at young age is smoking followed by family history of MI and dyslipidaemia. Majority of the patients had two or more than two identifiable antecedent risk factors.

Performance Evaluation of SARS-CoV-2 Viral Transport Medium Produced by Bangladesh Reference Institute for Chemical Measurements

A viral transport medium (VTM) was developed following the Centers for Disease Control and Prevention, USA (US-CDC) standard operating procedure (SOP) DSR-052-05 with necessary improvisation and was used for storing coronavirus disease 2019 (COVID-19) swab specimens. Considering Bangladesh's supply chain and storage conditions, improvisation was essential for extending sample storage time while retaining efficiency. In-house VTM was produced using Hank's balanced salt solution (HBSS) supplemented with 1% bovine serum albumin V (BSA), 0.5 µg /mL of gentamicin sulfate, and 100 µg/mL of fluconazole. The produced VTM composition, quality, sterility, specificity, and efficiency were verified in-house and through an independent contract research organization (CRO). An accelerated stability study projected that under the recommended temperature (4 °C), it would remain stable for four months and preserve samples for over a month. The real-time reverse transcriptase-polymerase chain reaction (rRT-PCR) test detected the targeted N gene and ORF1ab gene from the VTM stored samples. Our VTM is equally as effective as the Sansure Biotech VTM in keeping SARS-CoV-2 RNA specimens detectable in rRT-PCR (100% sensitivity and specificity in random and blinded samples). In conclusion, the BRiCM VTM will make the battle against pandemics easier by effectively collecting and storing nasopharyngeal and oropharyngeal swabs for COVID-19 detection.

Structural Determination of Lysine-Linked Cisplatin Complexes via IRMPD Action Spectroscopy: NNs and NO- Binding Modes of Lysine to Platinum Coexist

Despite its success as an anticancer drug, cisplatin suffers from resistance and produces side effects. To overcome these limitations, amino-acid-linked cisplatin analogues have been investigated. Lysine-linked cisplatin, Lysplatin, (Lys)PtCl₂, exhibited outstanding reactivity toward DNA and RNA that differs from that of cisplatin. To gain insight into its differing reactivity, the structure of Lysplatin is examined here using infrared multiple photon dissociation (IRMPD) action spectroscopy. To probe the influence of the local chemical environment on structure, the deprotonated and sodium-cationized Lysplatin complexes are examined. Electronic structure calculations are performed to explore possible modes of binding of Lys to Pt, their relative stabilities, and to predict their infrared spectra. Comparisons of the measured IRMPD and predicted IR spectra elucidate the structures contributing to the experimental spectra. Coexistence of two modes of binding of Lys to Pt is found where Lys binds via the backbone and side-chain amino nitrogen atoms, NN_s, or to the backbone amino and carboxylate oxygen atoms, NO^-. Glycine-linked cisplatin and arginine-linked cisplatin complexes have previously been found to bind only via the NO^- binding mode. Present results suggest that the NN_s binding conformers may be key to the outstanding reactivity of Lysplatin toward DNA and RNA.

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.

Prolonged Jaundice in a Patient with Coexisting Hepatitis A Virus Infection and Wilson's Disease

Hepatitis A virus (HAV) is the most common cause of acute viral hepatitis in the world. Infection with hepatitis A virus can cause severe or even fatal illness in patients with chronic liver disease. Here we present a case which seems to be an isolated acute viral hepatitis A infection at the beginning but later found to be coexisted with Wilson's disease. A 14-year-old girl presented in the Department of Gastroenterology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh on 11th April 2019 with progressive jaundice with prodrome, dark urine, itching, hepatomegaly and thyromegaly. She was found positive for serum IgM HAV antibody. Her jaundice was increasing along with prolonged prothrombin time and low albumin. She had coexisting Wilson's disease evidenced by increased 24 hours urinary copper (138μgm/day). She was treated with D-Penicillamine and Zinc acetate. Hepatitis A can be considered as a factor for acute decompensation in undiagnosed patients with Wilson's disease. So it is very crucial to investigate Wilson's disease in appropriate clinical setting of prolonged jaundice and liver dysfunction.

Exponentially Complex "Classically Entangled" States in Arrays of One-Dimensional Nonlinear Elastic Waveguides

We demonstrate theoretically, using multiple-time-scale perturbation theory, the existence of nonseparable superpositions of elastic waves in an externally driven elastic system composed of three one-dimensional elastic wave guides coupled via nonlinear forces. The nonseparable states span a Hilbert space with exponential complexity. The amplitudes appearing in the nonseparable superposition of elastic states are complex quantities dependent on the frequency of the external driver. By tuning these complex amplitudes, we can navigate the state's Hilbert space. This nonlinear elastic system is analogous to a two-partite two-level quantum system.

Molecular Detection and Differentiation of Mycobacterium Tuberculosis Complex and Non-tuberculous Mycobacterium in the Clinical Specimens by Real Time PCR

Mycobacteria are subdivided into three groups: the Mycobacterium tuberculosis complex, the non-tuberculous mycobacteria called NTM or MOTT (Mycobacteria Other Than Tuberculosis) and Mycobacterium leprae. Over the past few decades, the incidence of infections caused by NTM has increased world wide. The differentiation of Mycobacterium tuberculosis complex from NTM is of primary importance for infection control and choice of antimicrobial therapy. However, there is so far no report in Bangladesh about the detection of NTM and hence differentiation of MTB and NTM. Neither acid-fast bacilli (AFB) staining nor histopathology can discriminate MTB and NTM. In order to detect and differentiate Mycobacterium tuberculosis complex and NTM we used commercially available LyteStar TB/NTM Real Time PCR kit (Altona Diagnostics, Germany) and analyzed 782 clinical specimens from tuberculosis suspected patients. We have found 49 MTB and 74 NTM positive samples from variety of clinical specimens such as sputum, bronchial lavages, body fluids, tissues, needle aspirates and swabs. Many of the PCR positive specimens were AFB negative on direct microscopic examination thus, indicating strong sensitivity of PCR than AFB staining. This is the first report in the country about detection of NTM and it warrants further elaborate investigation. Moreover, our results showed that multiplex real-time PCR assay is an effective sensitive tool for the rapid identification and differentiation of MTB and NTM directly from clinical specimens.

The influence of central neuropathic pain in paraplegic patients on performance of a motor imagery based Brain Computer Interface

•

Motor imagery based BCI-classifier built on EEG data of paraplegic patients, gives higher classification accuracy in patients with central neuropathic pain compared to patients with no chronic pain.

•

Higher BCI classification accuracy in paraplegic patients with central neuropathic pain is accompanied with stronger event related desynchronisation during motor imagery.

•

BCI classification accuracy between feet and a hand was comparable with classification accuracy between hands, in all three groups of participants.

Objective

The aim of this study was to test how the presence of central neuropathic pain (CNP) influences the performance of a motor imagery based Brain Computer Interface (BCI).

Methods

In this electroencephalography (EEG) based study, we tested BCI classification accuracy and analysed event related desynchronisation (ERD) in 3 groups of volunteers during imagined movements of their arms and legs. The groups comprised of nine able-bodied people, ten paraplegic patients with CNP (lower abdomen and legs) and nine paraplegic patients without CNP. We tested two types of classifiers: a 3 channel bipolar montage and classifiers based on common spatial patterns (CSPs), with varying number of channels and CSPs.

Results

Paraplegic patients with CNP achieved higher classification accuracy and had stronger ERD than paraplegic patients with no pain for all classifier configurations. Highest 2-class classification accuracy was achieved for CSP classifier covering wider cortical area: 82 ± 7% for patients with CNP, 82 ± 4% for able-bodied and 78 ± 5% for patients with no pain.

Conclusion

Presence of CNP improves BCI classification accuracy due to stronger and more distinct ERD.

Significance

Results of the study show that CNP is an important confounding factor influencing the performance of motor imagery based BCI based on ERD.

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 

Beat-to-beat QT interval variability and T-wave amplitude in patients with myocardial infarction

The purpose of this study was to investigate the effects of T-wave amplitude and ECG lead on beat-to-beat QT interval variability (QTV) in patients with myocardial infarction (MI) compared to healthy subjects. Standard resting 12-lead ECGs of 79 MI patients and 69 healthy subjects were investigated. Beat-to-beat QT intervals were measured separately for each lead using a template matching algorithm. In addition, we extracted the beat-to-beat T-wave amplitude in each lead. We computed the standard deviation of beat-to-beat QT intervals as a marker of QTV for both healthy subjects and MI patients. Significant QTV differences were observed between the 12 ECG leads as well as between the groups of healthy subjects and MI patients. Beat-to-beat QTV was significantly higher in MI patients than in healthy subjects for half of the leads. Furthermore, significant T-wave amplitude differences across leads and between groups were observed. A significant inverse relation between beat-to-beat QTV and T-wave amplitude was demonstrated. The group differences in QTV remained significant after co-varying for the T-wave amplitude. In conclusion, the increase in beat-to-beat QTV that has been repeatedly reported in patients with MI is partly due to the lower T-wave amplitudes. However, QTV remains significantly increased in MI patients after covarying for this effect.

Prevalence and determination of occupational diseases of

DOI: http://dx.doi.org/10.3329/ujzru.v31i0.15437Univ. j. zool. Rajshahi Univ. Vol. 31, 2012 pp. 79-82

Investigation on the Nitrogen Fixing Cyanobacteria (BGA) in Rice Fields of North-West Region of Bangladesh. I: Nonfilamentous

The experiment was conducted to carry out the nitrogen fixing cyanobaterial (BGA) resources and their distribution pattern in rice fields of North-West region of Bangladesh during the period of 2011. Considering the vast importance of Blue-green algae (BGA) in agricultural land especially in rice fields, twelve months long systematic observation was undertaken. A total of 15 genera with 42 species of non-filamentous (unicellular and colonial) blue-green algal forms were identified and recorded from this region. Out of 42 species, 9 species belonging to the genus Aphanocapsa, 8 to Chroococcus, 5 to Gloeocapsa, 4 to Aphanothece, 3 to Gloeothece, 3 to Merismopedia and 2 to Coelosphaerium; while 1 species belonging to each genus of Chroococcidiopsis, Synechococcus, Synechocystis, Dactylococcopsis, Microcystis, Myxosarcina, Hydrococcus and Xenococcus. The distribution pattern of non-filamentous BGA in rice fields over the study area has also been observed in this study. With few exceptions, the non-filamentous BGA are more or less uniformly distributed all over the study areas. All of the BGA members have a tremendous ability to contribute on enhancing agricultural production by fixing atmospheric nitrogen and adding organic matter, vitamins, growth promoting substances etc to the soil and crops.DOI: http://dx.doi.org/10.3329/jesnr.v5i2.14812 J. Environ. Sci. & Natural Resources, 5(2): 185-192 2012

Removal of Remazol Red from Textile Waste Water Using Treated Sawdust - An Effective Way of Effluent Treatment

Activated carbon prepared from sawdust is endeavored as adsorbent for the removal of reactive dye, namely Remazol Red (RR) from aqueous media. The adsorption of RR has been studied onto activated sawdust at various particle size, adsorbent dose, temperature and pH values. The adsorptions of the above mentioned dye were designed for the Langmuir and Freundlich Isotherms. Pseudo first and second order kinetic models were used to calculate the amount adsorbed at equilibrium (q_e). The calculated values of qe for pseudo-second order equation were found to be in good agreement with those of experimental values. The monolayer capacity (qm) for treated sawdust (8.00 mg g–1) is greater than commercial charcoal (0.074 mg g–1). It is established that treated sawdust has been used as a better adsorbent for the removal of RR as compared to commercial charcoal. This process may eventually be used to get industrial waste free purified water. DOI: http://dx.doi.org/10.3329/bpj.v16i1.14501 Bangladesh Pharmaceutical Journal 16(1): 93-98, 2013

Removal of chromium from aqueous waste solution using liquid emulsion membrane

This paper presents a comprehensive study in recovery of Cr (VI) from dilute HCl solution using liquid emulsion membrane (LEM). The liquid membrane is made up of Tri-octylphosphine oxide (TOPO) as a carrier, cyclohexane as an organic diluent, sodium hydroxide as a stripping solution and Span-80 (sorbitain monooleate) as an emulsifying agent. The selection of the extractant (TOPO) and the stripper (NaOH) was chosen on the basis of conventional liquid-liquid extraction studies. The important parameters affecting the permeation of Cr (VI) through the prepared membrane are hydrogen ion concentration in the external aqueous phase, stirring speed of mixing the two phases, type of diluents, carrier concentration, stripper concentration, membrane to feed ratio and volume fraction were systematically investigated. The effect of surfactant types and concentration on the stability of LEM were studied because of its important role in the permeation process.

Modeling of gadolinium recovery from nitrate medium with 8-hydroxyquinoline by emulsion liquid membrane

The extraction equilibrium of Gd(III) from nitrate medium by 8-hydroxyquinoline (HOX) in toluene was studied. Liquid-liquid investigations were first carried out. Based on the equilibrium results, the extraction of Gd(III) from aqueous nitrate medium into an emulsion liquid membrane system (ELM) containing 8-hydroxyquinoline in toluene as extractant, HNO(3) as stripping solution, Span-80 as surfactant was studied. The stability of the prepared ELM was studied in terms of the degree of membrane breakage. The different parameters affecting the permeation of gadolinium (III) were also studied. A general permeation model for the recovery of Gd(III) by the selected membrane is presented. The internal mass transfer in the water in oil (W/O) emulsion drop, the external mass transfer around the drop, the rates of formation and decomposition of the complex at the external aqueous-organic interface were considered.

Detection and Processing Techniques of FECG Signal for Fetal Monitoring

Fetal electrocardiogram (FECG) signal contains potentially precise information that could assist clinicians in making more appropriate and timely decisions during labor. The ultimate reason for the interest in FECG signal analysis is in clinical diagnosis and biomedical applications. The extraction and detection of the FECG signal from composite abdominal signals with powerful and advance methodologies are becoming very important requirements in fetal monitoring. The purpose of this review paper is to illustrate the various methodologies and developed algorithms on FECG signal detection and analysis to provide efficient and effective ways of understanding the FECG signal and its nature for fetal monitoring. A comparative study has been carried out to show the performance and accuracy of various methods of FECG signal analysis for fetal monitoring. Finally, this paper further focused some of the hardware implementations using electrical signals for monitoring the fetal heart rate. This paper opens up a passage for researchers, physicians, and end users to advocate an excellent understanding of FECG signal and its analysis procedures for fetal heart rate monitoring system.

EstimatingIn VivoAirway Surface Liquid Concentration in Trials of Inhaled Antibiotics

Antibiotic drugs exhibit concentration dependence in their efficacy. Therefore, ensuring appropriate concentration of these drugs in the relevant body fluid is important for obtaining the desired therapeutic and physiological action. Until recently there had been no suitable method available to measure or estimate concentration of drugs in the human airways resulting from inhaled aerosols or to determine the amount of inhaled antibiotics required to ensure minimum inhibitory concentration of a drug in the airway surface liquid (ASL). In this paper a numerical method is used for estimating local concentration of inhaled pharmaceutical aerosols in different generations of the human tracheobronchial airways. The method utilizes a mathematical lung deposition model to estimate amounts of aerosols depositing in different lung generations, and a recent ASL model along with deposition results to assess the concentration of deposited drugs immediately following inhalation. Examples of concentration estimates for two case studies: one for the antibiotic tobramycin against Pseudomonas aeruginosa, and another for taurolidine against Burkholderia cepacia are presented. The aerosol characteristics, breathing pattern and properties of nebulized solutions were adopted from two recent clinical studies on efficacy of these drugs in cystic fibrosis (CF) patients and from other sources in the literature. While the clinically effective tobramycin showed a concentration higher than the required in vivo concentration, that for the ineffective taurolidine was found to be below the speculated required in vivo concentration. Results of this study thus show that the mathematical ASL model combined with the lung deposition model can be an effective tool for helping decide the optimum dosage of inhaled antibiotic drugs delivered during human clinical trials.

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.

Growth status of Jordanian schoolchildren in military-funded schools

OBJECTIVE

To study the growth status of Jordanian boys and girls in comparison with the Centers for Disease Control (CDC) growth charts.

DESIGN

Cross-sectional study. SUBJECTS AND DATA COLLECTION: A total of 5826 boys and 1414 girls, aged 6.5-17.5 y, were included in the study. Height and weight were measured. Body mass index (BMI) was calculated as weight (kg) divided by the square of the height (m). Socioeconomic data were collected using a structured questionnaire.

RESULTS

The height-for-age values fluctuated between the 5th and 10th percentiles of the CDC for both sexes, and then after the age of 8.5 and 14.5 y for boys and girls, respectively, values were just above the 10th percentile. The body weight-for-age values were just above the 25th percentile for boys and fluctuated between the 25th and 50th percentiles for girls; then after the age of 14.5 and 12.5 y for boy and girls, respectively, values fluctuated between the 25th and 50th percentiles for boys and just above the 50th percentile for girls of the CDC values. BMI values for boys were just above the 50th percentile of the CDC and for girls values fluctuated between the 50th and 75th percentiles until the age of 13.5, then values matched the 75th percentile of the CDC.

CONCLUSION

The height of Jordanian children ranges from the 5th to the 10th percentile of the CDC reference values during schools years. Girls have a tendency toward obesity after puberty.

Partial lipodystrophy and rapidly progressive nephritis

We report the association of partial lipodystrophy (PL) and nephritis in an 11-year-old boy. He had symmetric absence of facial fat with retention of adipose tissue in the arms, chest, abdomen and hips associated with macroscopic hematuria, proteinuria combined with depression of the complement C3 level. The patient had rapidly progressive glomerulonephritis (RPGN) and the histopathological study showed findings of mesangio-capillary glomerulonephritis (MCGN) and crescents. We managed and followed up this patient for three years. At the last follow-up visit, he still has mild proteinuria and microscopic hematuria and stable renal function.

Wolfram's (DIDMOAD) Syndrome and Chronic Renal Failure

Wolfram's syndrome is usually considered as an autosomal recessive condition, with wide phenotypic variation. The syndrome is commonly called DIDMOAD (diabetes insipidus, diabetes mellitus, optic atrophy and deafness), although some patients have additional clinical findings including ataxia, hypogonadism, hydronephrosis and psychiatric illnesses. We report a patient with DIDMOAD syndrome with emphasis on the urological tract and its progressive complications. Unfortunately, he developed end-stage renal failure and needed hemodialysis at the age of 14 years. The presentation, investigations and management are discussed.

Autoregressive moving average modeling for finger tapping with an external stimulus

We report the Autoregressive Moving Average (ARMA) structures of interresponse interval and interstimulus interval in rhythmic finger tapping and how tapping schemes arise from these structures. The interstimulus interval is chosen to be a metronome cue slightly perturbed from its periodic mode by a zero-mean sine-wave modulated sequence. These metronome sequences were chosen to follow an exact Autoregressive model of the third order and are generated using metronome interval durations of 400, 500, and 600 msec. At each frequency, four different perturbation rates were presented to seven subjects: 1, 3, 5, and 7% of the base interval. Synchronization error, i.e., tap-to-beat phase deviations, induced by these ARMA models are stable and thus were bounded. This framework is useful in characterizing the relationship between motor control variables, interresponse interval, synchronization error, and interstimulus interval. Also, several known models can be easily derived and analyzed in this setting.

Sertoli Cell Tumor of Testes in a Child with Peutz-Jeghers syndrome

The Peutz-Jeghers syndrome (PJS) is known to be commonly associated with ovarian tumors. However, its association with testicular tumors is uncommon. We report an eight-year old boy who presented with gynecomastia and had Sertoli cell tumor of both testes with high aromatase activity. To the best of our knowledge, this is the seventh such case being reported in the literature and the presenting manifestation in all seven was gynecomastia.

Depth of epidural space in children

We have studied the depth of epidural space in 586 children who had lumbar epidural block as part of their anaesthetic management. The mean depth of epidural space in neonates was 1 cm (SD 0.2, range 0.4-1.5 cm). The depth of epidural space in older infants and children correlated significantly with age and weight with regression equations of depth (cm) = 1 + 0.15 x age (years) and depth (cm) = 0.8 + 0.05 x weight (kg) respectively.

A new technique for fibreoptic intubation in children

We describe a technique involving the use of a laryngeal mask airway, fibreoptic bronchoscope and a guide wire to manage the intubation of a child who was known to be a difficult intubation. The technique is simple, atraumatic, permits the use of an adult bronchoscope for infants and children, and allows control of the airway and ventilation throughout the period of intubation.

Isoflurane in labour

A comparison of the analgesic efficacy of Entonox (50% nitrous oxide in oxygen) and Entonox with 0.2% isoflurane was made in 18 consenting mothers during the first stage of labour. The inhalational gases were self-administered during contractions over a 3 h study period using a standard Entonox demand valve and breathing system. Isoflurane 0.2% was added from an Ohmeda Isotec drawover vaporizer and the inspired concentration of isoflurane was analysed continuously using a Datex Ultima analyser. Linear analogue scores for pain were significantly lower (p < 0.001) during the Entonox-isoflurane administration compared with Entonox alone. Drowsiness was not a clinical problem and there was a high acceptance rate for Entonox-isoflurane inhalational analgesia during labour.

Comparison of automatic oscillometric arterial pressure measurement with conventional auscultatory measurement in the labour ward

We have compared two non-invasive methods of arterial pressure (AP) measurement used in labour wards: an automatic oscillometric measurement obtained by Dinamap 1846, and a conventional auscultatory measurement obtained by midwives. A total of 369 AP measurements were recorded, involving 28 normotensive and hypertensive pregnant women during labour, with or without extradural analgesia. Compared with the midwife group, the Dinamap group had a greater systolic AP, by 2.7 mm Hg (P < 0.01) and smaller diastolic AP, by 9.8 mm Hg (P < 0.01). The correlations between the two methods were highly significant, but the limits of agreement were relatively wide for both systolic and diastolic AP measurements. We conclude that a clinically important difference exists in diastolic AP measurements. Dinamap diastolic AP must be corrected using a regression equation, or simply by adding 10 mm Hg, before being compared with the available normal and hypertensive AP values.

Chronic diarrhoeal diseases in adults (a preliminary report)

The relationship of chronic diarrhoeal diseases in adults on socio-economic condition, parasitic infestation and degree of anaemia have been investigated. The disease was more prevalent in poor socio-economic group of people. Most of the patients had mixed parasitic infestations. Anaemia was present in all the cases. Difference in the degree of anaemia was not significant amongst the patients having either Ascaris or hookworm infestation.