Association of Triglyceride and C-reactive Protein Level with Severity of Angiographically Defined Coronary Artery Disease

Coronary artery disease (CAD) is considered as a major cause of morbidity and mortality worldwide. Inflammatory cytokines play an important role in the pathogenesis and progression of atherosclerosis. The aim of the study was to find out the association of C-reactive protein (CRP) and triglyceride (TG) level on the severity of CAD in patients with ischemic heart disease (IHD). This cross-sectional study was performed in the Department of Cardiology, National Institute of Cardiovascular Diseases, Dhaka, Bangladesh during the period of March 2018 to February 2021. Total 431 patients with ischemic heart disease were enrolled after taking informed written consent. CRP values were categorized into normal (<6 mg/L), borderline (6-10 mg/L) and high (>10mg/L) and TG level were categorized into normal (<150 mg/dl), borderline (150-199mg/dl) and high (≥200 mg/dl). Patients with ischemic heart disease (IHD) were stratified according to CRP value and TG level. Severity of CAD was assessed by the Gensini score. Most of the patients (33.4%) belonged to age 51-60 years. The mean age was 51.31±10.30 years. The majority (74.5%) of patients were male. Among risk factors, the highest 205(47.6%) patients were smokers followed by hypertension 190(44.1%) and diabetes mellitus 175(40.5%). The association of TG and CRP with the whole spectrum of IHD was found statistically significant (p<0.05). Severe CAD was found higher in high TG and high CRP level group compared with the other groups and was statistically significant. Inflammation assessed by high CRP and hypertriglyceridemia associated with the risk and severity of CAD.

Study of Serum Electrolytes (Sodium and Potassium) Abnormalities in Acute Stroke

Stroke is the common cause of death and disability worldwide, as well as in Bangladesh. Serum electrolytes abnormalities or dyselectrolytaemia is one of the major acute complications of stroke. Dyselectrolytaemia or serum electrolytes (sodium and potassium) abnormalities are more common in patients with acute stroke that can be easily measured. The study was planned to find out the serum electrolytes (sodium and potassium) abnormalities in acute stroke patients. This cross-sectional study was conducted in the Department of Neurology and Medicine, Mymensingh Medical College and Hospital from January 2019 to June 2020. Total 84 purposively selected patients with acute strokes were evaluated following informed written consent. Diagnosis was confirmed by neuroimaging of brain. Moreover, serum electrolytes level was measured for each patient. Data were collected by interviews, clinical examinations & laboratory investigations of the patients using a case record form and analysis was carried out by the help of SPSS 25.0. Mean age of the patients with acute strokes were 57.65±15.79 years. About two thirds (60.7%) of the patients were male and the remaining (39.3%) were female. Sodium imbalances were observed in 32.2% and potassium imbalances in 25.0% cases. About 66.7% haemorrhagic strokes patients and 42.2% ischaemic strokes patients had dyselectrolytaemia (p<0.05). More than twenty eight percent (28.6%) of all stroke patients had hyponatraemia, which was more common (35.9%) among haemorrhagic strokes patients (p<0.05). Of all stroke patients 21.4% had hypokalaemia, which was more common (28.2%) in haemorrhagic strokes patients (p<0.05). This study reveals that, serum electrolytes (sodium and potassium) abnormalities are more common in haemorrhagic than ischaemic strokes, which is mainly hyponatraemia and hypokalaemia.

Neuropharmacological assessment and identification of possible lead compound (apomorphine) from Hygrophila spinosa through in-vivo and in-silico approaches

The aim of this research is to examine possible neurological activity of methanol, ethyl acetate, and aqueous extracts of Hygrophila spinosa and identify possible lead compounds through in silico analysis. In vivo, neuropharmacological activity was evaluated by using four distinct neuropharmacological assessment assays. Previously reported GC-MS data and earlier literature were utilized to identify the phytochemicals present in Hygrophila spinosa. Computational studies notably molecular docking and molecular dynamic simulations were conducted with responsible receptors to assess the stability of the best interacting compound. Pharmacokinetics properties like absorption, distribution, metabolism, excretion, and toxicity were considered to evaluate the drug likeliness properties of the identified compounds. All the in vivo results support the notion that different extracts (methanol, ethyl acetate, and aqueous) of Hygrophila spinosa have significant (*p = 0.05) sedative-hypnotic, anxiolytic, and anti-depressant activity. Among all the extracts, specifically methanol extracts of Hygrophila spinosa (MHS 400 mg/kg.b.w.) showed better sedative, anxiolytic and antidepressant activity than aqueous and ethyl acetate extracts. In silico molecular docking analysis revealed that among 53 compounds 7 compounds showed good binding affinities and one compound, namely apomorphine (CID: 6005), surprisingly showed promising binding affinity to all the receptors . An analysis of molecular dynamics simulations confirmed that apomorphine (CID: 6005) had a high level of stability at the protein binding site. Evidence suggests that Hygrophila spinosa has significant sedative, anxiolytic, and antidepressant activity. In silico analysis revealed that a particular compound (apomorphine) is responsible for this action. Further research is required in order to establish apomorphine as a drug for anxiety, depression, and sleep disorders.Communicated by Ramaswamy H. Sarma.

Association and expression study of SEPW1 and JAML as preliminary candidate genes related to lamb odor and flavor

The current study aimed to identify the SEPW1 and JAML genes in lamb as candidate genes related to lamb odor and flavor. The polymorphism study showed that the SEPW1 gene was polymorphic at the BanI restriction site with three genotypes (AA, AG, and GG), whereas the JAML gene was monomorphic at HhaI with genotype (GG). The association of SEPW1 between genotype and lamb odor and flavor (BCFAs and skatole) was analyzed using GLM (General Linear Model). MNA (4-methylnonanoic) was significantly associated (p < 0.05) with lamb odor and flavor. AA genotype has a lower level of MNA than AG and GG, while MOA (4-methyloctanoic), EOA(4-ethyloctanoic), MI (3-methylindole) and MP (3-methylphenol) was not significantly associated with lamb odor and flavor (p > 0.05). Furthermore, to analyze the mRNA expression of SEPW1 in liver tissues, the lambs were divided into three groups based on the genotypes AA, AG, and GG, however, mRNA expression was not differentially expressed between AA, AG, and GG (p > 0.05). These results will enhance the understanding of the functions of SEPW1 gene relation to odor and flavor traits and will shed light on the polymorphism of SEPW1 gene in lamb as a candidate gene for reducing MNA in lamb.

Natural defense against multi-drug resistant Pseudomonas aeruginosa: Cassia occidentalis L. in vitro and in silico antibacterial activity

Cassia occidentalis L. is widely used in indigenous and traditional medicine, but its impact on multi-drug resistant (MDR) bacterial infections mostly remains unknown. Therefore, this study aimed to evaluate the in vitro antibacterial efficiency of methanol and ethyl acetate extracts of C. occidentalis L. leaves (MECOL and EAECOL) against multi-drug resistant Pseudomonas aeruginosa and to identify potential antibacterial agents through computational studies targeting the LasR protein. Initially, 82 compounds were identified using GC-MS analysis, and the functional groups were determined through FT-IR analysis. Both extracts of the plant exhibited dose-dependent antibacterial activity, with MICs of 104.16 ± 36.08 μg mL-1 for MECOL and 83.33 ± 36.08 μg mL-1 for EAECOL, and an MBC of 125 μg mL-1. Among the 82 compounds, 12 potential compounds were identified based on binding scores using molecular docking with the LasR protein and MM-GBSA analysis. Furthermore, screening for ADME properties, including physicochemical features, water solubility, lipophilicity, RO5 compliance, and toxicity, identified the top three compounds: methyl dihydrojasmonate, methyl benzoate, and 4a-methyl-4,4a,5,6,7,8-hexahydro-2(3H)-naphthalenone, which also demonstrated binding affinity with the active site residues of the LpxC protein of the bacteria. Additionally, molecular dynamics (MD) simulations confirmed the binding reliability of these three phytochemicals to LasR's active pocket, comparable to the protein native inhibitory ligands (C12-HSL). The study offers scientific support for the traditional use of C. occidentalis in treating bacterial infections, highlighting the potential of the three compounds as leads for developing LasR inhibitors to combat multi-drug resistant P. aeruginosa.

Transcatheter Aortic Valve Replacement in Bicuspid Aortic Valve: A Case Report

Among other valvular heart disease Aortic stenosis (AS) is the most common in the developed world. Transcatheter Aortic Valve Replacement (TAVR) is most acceptable treatment option for patient with severely calcified aortic stenosis with high and intermediate risk group. Among several challenges, one of the main challenges is to deal with bicuspid aortic valve (BAV). Non-circular annulus, bulky leaflets leading to perivalvular leaks and risk for rupture and often very severe calcification may contribute to periprocedural strokes leading to poor clinical outcome. This case, a 68-year-old woman with a history of type 2 diabetes mellitus (DM), hypothyroidism, bicuspid aortic valve and severe aortic stenosis, bronchial asthma, who had repeatedly refused any suggestion for open heart surgery, was our volunteer candidate for TAVR. After successful TAVR the peak pressure gradient decreased from 100mmHg to 17mmHg. So, TAVR could be a viable option for highly selected patients with severe aortic stenosis and bicuspid aortic valve who have favourable anatomy.

Ocular Involvement in Transfusion Dependent Thalassemia Children

Thalassemia is one of the most common haemoglobinopathies in the world. Transfusion dependent thalassemia patients need regular blood transfusion. Repeated blood transfusions lead to iron overloads which can affect various organs in the body including eyes. The present study aims to evaluate the ocular involvements in transfusion dependent thalassemia children and their relationship with duration of the disease and serum ferritin level. This cross-sectional observational study included 46 multi-transfused thalassemia children aged 3-18 years. Detailed ophthalmological examination including visual acuity, slit lamp bio microscopy, direct and indirect ophthalmoscopy was done. Statistical analysis was done using SPSS version (IBM) 23.0. Student's t-test and chi-square (χ²) test was done and p value of <0.05 was considered significant. Out of 46 thalassemia children male were 25(54.3%) and female were 21(45.7%). Mean age of the children was 8.94±5.04 years, mean duration of disease was 7.02±3.5 years and mean serum ferritin level 1543.68±914.43ng/dl. Ocular involvements were detected in 19(41.3%) children. Among them 8(17.39%) children had more than one ocular involvements. The ocular manifestations were decreased visual acuity in 17(36.95%), corneal dryness in 7(15.21%), lens opacity in 6(13.04%), optic disc atrophy in 7(15.21%), peripheral retinal pigmentation in 5(10.86%) and retinal vessels tortuosity in 3(6.52%) children. Higher serum ferritin level and increased duration of the disease were significantly (p<0.001) related with ocular involvement. Various ocular involvements were found in transfusion dependent thalassemia children. Therefore, transfusion dependent thalassemia children should be screened periodically for early detection and proper management of ocular changes.

Prediction of Coronary Artery Disease Severity by Using CHA2DS2-VASC-HSF Score in Patients with ST-Elevation Myocardial Infarction

CHADS₂ and CHA₂DS₂-VASc scores are widely used in clinical practice and include similar risk factors for the development of coronary artery disease (CAD). It is known that the factors comprising the newly defined CHA₂DS₂-VASC-HSF score promote atherosclerosis and associated with severity of CAD. Objective of the study was to find out the association of the CHA₂DS₂-VASC-HSF score with the severity of CAD in patients with ST elevation myocardial infarction (STEMI). One hundred (100) patients with STEMI were enrolled in this study after considering inclusion and exclusion criteria over a one year period from October, 2017 to September, 2018 in the Department of Cardiology, National Institute of Cardiovascular Diseases, Dhaka, Bangladesh. Coronary angiogram was done within index hospitalization and coronary artery disease severity was assessed by SYNTAX score system. Patients were divided into two groups on the basis of SYNTAX score. Patients with SYNTAX score ≥23 assigned as Group I and SYNTAX score <23 assigned as Group II. The CHA₂DS₂-VASC-HSF score was calculated. Cut-off value of high CHA₂DS₂-VASC-HSF score was ≥4.0. In this study mean age of study population was 51.8±9.8, male patients were predominant (79.0%). Among the studied patients, highest percentage had history of smoking followed by hypertension, diabetes mellitus and family history of CAD in Group I patients. It was found that DM and family history of CAD and history of stroke/TIA were significantly higher in Group I than Group II. An increasing trend of SYNTAX score was observed according to the CHA₂DS₂-VASc-HSF score. SYNTAX score was significantly higher in CHA2DS2-VASc-HSF score ≥4 than CHA₂DS₂-VASc-HSF score <4 (26.3±6.3 vs. 12.1±7.7, p<0.001). Patients with CHA₂DS₂-VASC-HSF score ≥4 had severe coronary artery disease than CHA₂DS₂-VASC-HSF score <4 assessed by SYNTAX score with 84.4% sensitivity and 81.9% specificity (AUC:0.83, 95% CI: 0.746-0.915, p<0.001). CHA₂DS₂-VASc-HSF score was positively correlated with the severity of CAD. This score could be considered as a predictor of coronary artery disease severity.

Effect of Duration of Hemostatic Compression on Radial Artery Occlusion after Transradial Percutaneous Coronary Intervention

Radial artery occlusion (RAO) is now a major concern in transradial approach (TRA). RAO limits future radial artery use for further TRA, for as a conduit during CABG, for invasive hemodynamic monitoring and for creation of arteriovenous fistula for hemodialysis in Chronic Kidney Disease (CKD) patients through same vascular approach. The effect of duration of hemostatic compression of RAO is unknown in Bangladesh. This prospective observational study was conducted in the department of Cardiology, National Institute of Cardiovascular Diseases, Dhaka, Bangladesh (NICVD) from September 2018 to August 2019, to evaluate the effect of duration of hemostatic compression on the incidence of radial artery occlusion (RAO) after transradial percutaneous coronary intervention. A total of 140 patients underwent percutaneous coronary intervention (PCI) through TRA. RAO was defined as an absence of antegrade flow or monophasic flow or invert flow on Duplex study. In this study 70 patients (Group I) received 2 hours hemostatic compression after transradial PCI. Another 70 patients (Group II) received 6 hours hemostatic compression after transradial PCI. Radial arterial blood flow assessed at early (24 hours) and late (30 days) by color duplex study after the procedure in both groups. Early radial artery occlusion occurred in 4.3% of patients in Group I and 12.8% of patients in Group II, (p=0.04). Late radial artery occlusion occurred in 2.8% of patients in Group I and 11.4% of patients in Group II, the difference was statistically significant (p=0.04). From multivariate logistic regression analysis duration of hemostatic compression time 6 hours (p=0.01), post-procedural nitroglycerine use (p=0.03) and procedure time (p=0.03) were predictors of RAO. Shorter duration of hemostatic compression is associated with a lower incidence of early and late radial artery occlusion after transradial intervention.

Role of Intra-arterial Nitroglycerin (Post Procedural, Prehemostasis) to Reduce Radial Artery Occlusion after Transradial Catheterisation: A Doppler-guided Study

The study was intended to evaluate efficacy of Intra-arterial nitroglycerin through the sheath at the end of a transradial procedure to preserve the patency of the radial artery. This prospective observational study was done in the Department of Cardiology, National Institute of Cardiovascular Diseases (NICVD), Dhaka, Bangladesh from May 2017 to April 2018, by including a total 200 patients undergoing coronary procedures (CAG and / or PCI) through TRA. RAO was defined as an absence of antegrade flow or monophasic flow or invert flow on Doppler study. In this study 102 patients (Group I) received 200 mcg intra-arterial nitroglycerine, prior to trans-radial sheath removal. Another 98 patients (Group II) did not receive intra-arterial nitroglycerine prior to trans-radial sheath removal. Conventional haemostatic compression methods were applied (average 2 hours) in both groups of patients. Evaluation of radial arterial arterial blood flow by colour Doppler study was done on next day after the procedure in both groups. Results of this study in which RAO was determined by vascular doppler study showed that frequency of radial artery occlusion were 13.5% one day after transradial coronary procedures. We found the incidence was 8.8% vs. 18.4%, (p=0.04) in Group I and Group II respectively. The incidence of RAO was significantly lower in post procedural nitroglycerine group. From multivariate logistic regression analysis diabetes mellitus (p = 0.02), hemostatic compression time for more than 02 hours after sheath removal (p = <0.001) and procedure time (p = 0.02) was predictors of RAO. So, the administration of nitroglycerin at the end of a transradial catheterization reduced the incidence of RAO, as shown by 1 day after the radial procedure by doppler ultrasound.

Evaluation of Senna tora (L.) Roxb. leaves as source of bioactive molecules with antioxidant, anti-inflammatory and antibacterial potential

Senna tora (L.) Roxb. is an ethno-medicinal herb used by rural and tribal people of the Satpura region of Madhya Pradesh in India and the Phatthalung Province of Thailand for treating rheumatism, bronchitis, ringworm, itches, leprosy, dyspepsia, liver disorders and heart disorders. It is also used in Chinese and Ayurvedic medicine. This study was conducted to investigate the potential of Senna tora (L.) Roxb. as a source of drug candidates against oxidants, inflammation, and bacterial infection. Preliminary phytochemical screening (PPS) and GC-MS were performed to identify the phytochemicals in the ethyl acetate extract of Senna tora (L.) Roxb. leaves (EAESTL). The in vitro antioxidant activity was assessed by 2,2-diphenyl-1-picrylhydrazyl (DPPH)- and H₂O₂-scavenging tests; the in vitro anti-inflammatory activity was determined by bovine serum albumin (BSA) denaturation and red blood cell (RBC) hemolysis inhibition; and the antibacterial activity was evaluated by agar-well diffusion methods. Cytotoxicity was estimated by Artemia salina larvae lethality, while acute toxicity was evaluated by oral delivery of the extract to mice. In silico antioxidant, anti-inflammatory, and antibacterial activities were predicted by the Prediction of Activity Spectra for Substances (PASS) program. The pharmacokinetics related to ADME and toxicity tests were determined by the admetSAR2 and ADMETlab2 web servers, and drug-able properties were assessed by the SwissADME server. GC-MS detected fifty-nine phytochemicals that support the types of compounds (phenols, flavonoids, tannins, terpenoids, saponins, steroids, alkaloids, glycosides and reducing sugar) identified by phytochemical screening. EAESTL exhibited dose-dependent antioxidant, anti-inflammatory, and antibacterial activities without any adverse effects or fluctuations in body weight. The PASS program predicted that the identified phytochemicals have antioxidant, anti-inflammatory and antibacterial activities. Among 51 phytochemicals, 16 showed good ADME, and 8 fulfilled drug-able properties without toxicity. Altogether, four phytochemicals, viz., benzyl alcohol, 3-(hydroxy-phenyl-methyl)-2,3-dimethyl-octan-4-one, phenylethyl alcohol and 2,6,6-trimethylbicyclo [3.1.1] heptane-3-ol, showed good pharmacokinetics and drug-able properties without toxicity, along with antioxidant, anti-inflammatory, and antibacterial activities. The obtained results suggest that Senna tora (L.) Roxb. leaves contain bioactive phytochemicals that have the potential to fight against oxidants, inflammation, and bacterial infection as potential drug candidates.

Health Related Quality of Life in Patients with Pulmonary Tuberculosis

Tuberculosis (TB) is one of the major public health issues in many developing nations especially in Bangladesh. Though most focus is being directed towards mortality and incidence rate, the changes in morbidity and other health status parameters are not been well considered. The aim of the study was a comprehensive assessment of patients with pulmonary tuberculosis by measuring patient's quality of life which may lead to better outcome in patients' health, infection surveillance and prevention programs. This prospective study was conducted in the department of Respiratory and Internal Medicine, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from September 2015 to March 2017. The quality of life scores of 61 smear positive pulmonary tuberculosis cases were measured by validated Bangla version of SF-36 questionnaire before or at the starting of treatment, after the initial phase and at the end of treatment. Then the score was compared with those of 75 healthy matched controls. The changes of the quality of life with the stage of treatment and with socio-demographic variables were assessed. Before treatment, all domains of HRQoL of the pulmonary TB patients were significantly lower than those of the control group (p<0.001). At the end of six-month treatment period, HRQoL of the pulmonary TB patient had significantly increased compared to before treatment (p<0.001). There was no significant difference of scores after six months of treatment with that of control (p>0.05). The lowest score in tuberculosis patients was related to general health perception and vitality. Patients with low socio economic status, low educational level, prolonged disease duration and increased number of symptoms had lower HRQoL scores.

Safety and Feasibility of Trans Radial Percutaneous Coronary Intervention Approach in Elderly Patients with Acute Coronary Syndrome

Coronary catheterization is usually performed using the transfemoral approach but trans-radial has been increasingly used as an alternative to transfemoral approach due to less vascular complications, earlier ambulation time and improved patient comfort. The aim of the study was to compare the safety and feasibility of trans-radial and transfemoral PCI in the elderly ACS patients. This prospective observational study was conducted in the NICVD, Dhaka from October 2017 to September 2018. Total 80 patients were categorized into two groups according to the approach of PCI. Group I consists 40 patients who underwent trans-radial PCI and Group II consists 40 patients who underwent transfemoral PCI. Patients with abnormal Allen's test, history of CABG, CKD were excluded. Patient's demographics were same in both groups. The mean procedural time in min (37.44±5.13 vs. 34.42±4.42, p=0.004) and fluoroscopy time in min (21.6±4.11 vs. 17.55±2.78, p=0.02) were more in Group I but the mean hemostasis time in min (7.58±1.11 vs. 15.59±3.33, p=0.005) and the ambulation time in hour (0.00±0.00 vs. 15.59±3.33, p=0.001) were more in Group II. Significant arterial spasm following puncture (10.0% vs. 0.0%, p=0.01) were more in Group I. Post procedural major bleeding (0.0% vs. 10.0%, p=0.004), minor bleeding (10.0% vs. 20.0%, p=0.004) were significant in Group II but vessel occlusion (5.0% vs. 0.0%, p=0.02) were significant in Group I. Transradial PCI is safe in respect of procedural and post procedural vascular complications. Transradial procedure leads to improved quality of life after the procedure and thus gives much comfort to the patient. It also shortened mean duration of hospital stay. So transradial approach is an attractive alternative to conventional transfemoral approach in the elderly.

Adverse In-Hospital Outcome of Transradial PCI in Comparison to Transfemoral PCI in NSTEMI Patients during Index Hospitalization: A Single Center Study in Bangladesh

NSTEMI patients, in comparison to STEMI patients, are more at risk of bleeding, access site complication and MACE after PCI during index hospitalization. Because they get, multiple adjuvant anti-thrombotic agents before PCI than do the STEMI patients undergoing primary PCI. Transradial access (TRA) is proven to decrease those adverse in-hospital outcomes compared to transfemoral access (TFA) in STEMI patients. But very few studies were conducted in this regard considering NSTEMI patients. We observed prospectively the adverse in-hospital outcomes of total 180 NSTEMI patients who had undergone PCI through TRA (Group I = 80) and TFA (Group II = 100) during index hospitalization between October 2017 to September 2018 in National Institute of Cardiovascular Disease (NICVD), Dhaka, Bangladesh. Samples were selected purposively. Patients were followed up 2 hours after PCI and thereafter every day until discharge. Demographic and risk factor variables were almost same in both groups. TRA, compared with TFA, yielded less major bleeding (0% versus 3%, p=0.12) which was statistically non-significant. Minor bleeding was significantly less in Group I (2.5% versus 13.0%, p=0.04). Overall bleeding was also significantly less in Group I (2.5% and 10.0%; p=0.002). Access site complication was non-significantly less in Group I (0% versus 1%, p=0.91). TRA caused non-significant reduction in MACE (2.5% versus 5%; p=0.38) but significant reduction of total adverse in-hospital outcome (5% versus 20%, p=0.006%). In this study TRA seems to have less adverse in-hospital outcome than TFA in NSTEMI patients undergoing PCI during index hospitalization.

Soil organic carbon dynamics in the agricultural soils of Bangladesh following more than 20 years of land use intensification

Soil organic carbon (SOC) is a key soil quality indicator, as it is a source and storage of plant nutrients and plays a vital role in soil fertility and productivity maintenance. Intensification of agriculture is known to cause SOC decline; however, much of the evidence stems from field-scale experimental trials. The primary aim of this study is to investigate how more than 20 years of agricultural land use intensification in Bangladesh has influenced SOC levels at landscape levels. This was achieved by revisiting in 2012 four sub-sites from the Brahmaputra and Ganges alluviums which were previously sampled (1989-92) by the Soil Resource Development Institute and collecting 190 new samples. These were located at different elevations and subjected to differing amounts of inundation. The SOC was determined using the same method, potassium dichromate wet oxidation, used in the 1989-92 campaign. A comparison of the SOC in the 2012 samples with their historic levels (1989-92) revealed that overall SOC declined significantly across both alluviums as well at their four sub-sites. Further analysis, however, showed that SOC has declined more at higher sites. The higher sites are inundated to a limited level, which makes them suitable for growing multiple crops. Among the land types considered here, the low land sites (because of their topographical position) remain inundated for a greater part of the year, allowing a maximum of only one crop of submerged rice. As a result of reduced biomass decomposition due to anaerobic conditions when inundated, and lower land use/cropping intensity, SOC accretion has occurred in the lower land sites. The SOC levels in South Asian countries are inherently low and agricultural land use intensification fuelled by growing food production demand is causing further SOC loss, which has the potential to jeopardise food security and increase the environmental impact of agriculture.

Curcuma longa L. Prevents the Loss of β-Tubulin in the Brain and Maintains Healthy Aging in Drosophila melanogaster

Loss of tubulin is associated with neurodegeneration and brain aging. Turmeric (Curcuma longa L.) has frequently been employed as a spice in curry and traditional medications in the Indian subcontinent to attain longevity and better cognitive performance. We aimed to evaluate the unelucidated mechanism of how turmeric protects the brain to be an anti-aging agent. D. melanogaster was cultured on a regular diet and turmeric-supplemented diet. β-tubulin level and physiological traits including survivability, locomotor activity, fertility, tolerance to oxidative stress, and eye health were analyzed. Turmeric showed a hormetic effect, and 0.5% turmeric was the optimal dose in preventing aging. β-tubulin protein level was decreased in the brain of D. melanogaster upon aging, while a 0.5% turmeric-supplemented diet predominantly prevented this aging-induced loss of β-tubulin and degeneration of physiological traits as well as improved β-tubulin synthesis in the brain of D. melanogaster early to mid-age. The higher concentration (≥ 1%) of turmeric-supplemented diet decreased the β-tubulin level and degenerated many of the physiological traits of D. melanogaster. The turmeric concentration-dependent increase and decrease of β-tubulin level were consistent with the increment and decrement data obtained from the evaluated physiological traits. This correlation demonstrated that turmeric targets β-tubulin and has both beneficial and detrimental effects that depend on the concentration of turmeric. The findings of this study concluded that an optimal dosage of turmeric could maintain a healthy neuron and thus healthy aging, by preventing the loss and increasing the level of β-tubulin in the brain.

Glycaemic Status of Asthma Patients Using Inhaled Fluticasone

Inhaled fluticasone is used in asthma for long duration. However, it's adverse effect on glycaemia is debatable. This study observed the outcome of inhaled fluticasone in asthma patients. A cross sectional comparative study was conducted among the normoglycaemic asthma patients aged 18 years and above attending outpatient department of Internal Medicine and Respiratory Medicine department of Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh from June 2017 to May 2018. Study group were getting inhaled fluticasone for minimum three months whereas comparative group were not on any steroids. Each group had 35 eligible participants (n=70). Spirometry and plasma glucose at fasting and 2-hour after 75gm oral glucose intake were measured along with HbA1c%. Statistical analysis was done using SPSS 21.0. In study group mean plasma glucose at fasting was 5.27±0.48mmol/L, 2-hour after 75gm oral glucose was 6.04±1.21mmol/L and mean of HbA1c was 5.57±0.41% whereas in comparative group these were5.17±0.59mmol/L, 5.69±1.09mmol/L, 5.47±0.40% respectively (p=0.25, 0.20, 0.75 respectively). There was no specific co-relation between duration of use of fluticasone inhaler and glycaemic parameters like plasma glucose at fasting, 2-hour after 75gm oral glucose and HbA1c% (r=0.016, p=0.46; r=0.015, p=0.47; r=0.019, p=0.42 respectively). Use of inhaled fluticasone for 3months or more has insignificant effect on plasma glucose levels of asthma patients. Duration of use of inhaled fluticasone has no specific correlation with plasma glucose and HbA1c values.

Risk factors associated with morbidity and mortality outcomes of COVID-19 patients on the 28th day of the disease course: a retrospective cohort study in Bangladesh

Diverse risk factors intercede the outcomes of coronavirus disease 2019 (COVID-19). We conducted this retrospective cohort study with a cohort of 1016 COVID-19 patients diagnosed in May 2020 to identify the risk factors associated with morbidity and mortality outcomes. Data were collected by telephone-interview and reviewing records using a questionnaire and checklist. The study identified morbidity and mortality risk factors on the 28th day of the disease course. The majority of the patients were male (64.1%) and belonged to the age group 25-39 years (39.4%). Urban patients were higher in proportion than rural (69.3% vs. 30.7%). Major comorbidities included 35.0% diabetes mellitus (DM), 28.4% hypertension (HTN), 16.6% chronic obstructive pulmonary disease (COPD), and 7.8% coronary heart disease (CHD). The morbidity rate (not-cured) was 6.0%, and the mortality rate (non-survivor) was 2.5%. Morbidity risk factors included elderly (AOR = 2.56, 95% CI = 1.31-4.99), having comorbidity (AOR = 1.43, 95% CI = 0.83-2.47), and smokeless tobacco use (AOR = 2.17, 95% CI = 0.84-5.61). The morbidity risk was higher with COPD (RR = 2.68), chronic kidney disease (CKD) (RR = 3.33) and chronic liver disease (CLD) (RR = 3.99). Mortality risk factors included elderly (AOR = 7.56, 95% CI = 3.19-17.92), having comorbidity (AOR = 5.27, 95% CI = 1.88-14.79) and SLT use (AOR = 1.93, 95% CI = 0.50-7.46). The mortality risk was higher with COPD (RR = 7.30), DM (RR = 2.63), CHD (RR = 4.65), HTN (RR = 3.38), CKD (RR = 9.03), CLD (RR = 10.52) and malignant diseases (RR = 9.73). We must espouse programme interventions considering the morbidity and mortality risk factors to condense the aggressive outcomes of COVID-19.

Outcome of Open Reduction and Internal Fixation of Posterior Wall Fracture of Acetabulum

Acetabular fracture usually occurs as a result of high velocity injury and often affects the young and economically productive population. Previously, treatment of acetabular fracture was grossly inadequate and many patients were left with incapacitating pain, limitation of movement. Proper management should be given in our set-up to save lives and to minimize long term complications and related disabilities. This study was done to evaluate the outcome of open reduction and internal fixation of posterior wall fracture of acetabulum. This prospective observational study was carried out in Dhaka Medical College Hospital, Dhaka, Bangladesh from July 2016 to June 2018. Total twenty five cases were selected. Radiological and functional outcome were evaluated six months after surgery according to Matta radiographic criteria and Merle d Aubigne and Postel criteria respectively. Effect of age, gender, hip dislocation, displacement of fracture fragment, associated injury, reduction quality, trauma to surgery time, complication of operation on the functional outcome was evaluated. Age range was 18-60 years. The mean age was 38±11 years. Male 23 and female 2, male and female ratio was 11.5:1. Mean follow up 8.5±1.7 months, range 6-12 months. According to Matta radiographic criteria, 6 months after surgery, 10 patients had excellent, 10 patients had good, 3 patients had fair and 2 patients had poor radiological outcome. According to Merle d Aubigne and Postel criteria, 6 months after surgery, 11 patients had excellent, 10 patients had good, 3 patients had fair and 1 patient had poor functional outcome. Overall functional outcome of the study population revealed that 21 patients (84%) belonged to satisfactory (Excellent + Good) and 4 patients (16%) belonged to unsatisfactory (Fair + Poor) outcome. AVN (avascular necrosis) of femoral head had been occurred in two patients, post-operative wound infection had been occurred in two patients and myositis ossificans around hip joint had been occurred in two patients. Twenty (20) patients were achieved anatomic (0, 1mm) reduction, 3 patients were achieved imperfect (2, 3mm) reduction and 2 patients were achieved poor (>3mm) reduction. This study concludes that open reduction and internal fixation of posterior wall fracture of acetabulum is a satisfactory method of treatment.

National Clinical Guidance for the Management of Cardiovascular Intervention in the COVID-19 Pandemic: From Bangladesh Society of Cardiovascular Interventions (BSCI)

Since the first recorded case of SARS-CoV-2 in Bangladesh on 8th March 2020, COVID-19 has spread widely through different regions of the country, resulting in a necessity to re-evaluate the delivery of cardiovascular services, particularly procedures pertaining to interventional cardiology in resource-limited settings. Given its robust capacity for human-to-human transmission and potential of being a nosocomial source of infection, the disease has specific implications on healthcare systems and health care professionals faced with performing essential cardiac procedures in patients with a suspected or confirmed diagnosis of COVID-19. The limited resources in terms of cardiac catheterization laboratories that can be designated to treat only COVID positive patients are further compounded by the additional challenges of unavailability of widespread rapid testing on-site at tertiary cardiac hospitals in Bangladesh. This document prepared for our nation by the Bangladesh Society of Cardiovascular Interventions (BSCI) is intended to serve as a clinical practice guideline for cardiovascular health care professionals, with a focus on modifying standard practice of care during the COVID-19 pandemic, in order to ensure continuation of adequate and timely treatment of cardiovascular emergencies avoiding hospital-based transmission of SARS-COV-2 among healthcare professionals and the patients. This is an evolving document based on currently available global data and is tailored to healthcare systems in Bangladesh with particular focus on, but not limited to, invasive cardiology facilities (cardiac catheterization, electrophysiology & pacing labs). This guideline is limited to the provision of cardiovascular care, and it is expected that specific targeted pharmaco-therapeutics against SARS-CoV-2 be prescribed as stipulated by the National Guidelines on Clinical Management of Corona virus Disease 2019 (COVID-19) published by the Director General of Health Services, Ministry of Health and Family Welfare of Bangladesh.

Etiological Evaluation of Patients with Lymphadenopathy by Clinical, Histopathological and Microbiological Assessment

Lymph node enlargement is a common presenting complaint in outpatient and inpatient department. The present observational cross sectional study was conducted in department of Internal Medicine, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh during the period from December 2014 to May 2016 to evaluate etiologies of significant lymphadenopathy by clinical, histopathological and microbiological assessment. Biopsy/FNA materials of 177 patients of 18-75 years age range with significant lymphadenopathy were sent for histopathology/cytology, Gram stain & culture, AFB stain & culture and Gene Xpert. Among them, 102(57.62%) were granulomatous lymphadenitis, 52(29.38%) were lymphoma, 12(6.78%) reactive lymphadenitis, 7(3.95%) metastatic malignancy, 2(1.13%) atypical lymphoid hyperplasia, 1(0.57%) myeloid sarcoma and 1(0.57%) chronic sialadenitis. Growth of MTB was on 23(22.55%) cases; among 102 granulomatous lymphadenitis and Gene Xpert was positive in 73(71.56%) cases with 100% Rif. sensitive. Gene Xpert is an important tool for diagnosis of tuberculous lymphadenitis. Time of symptoms to diagnosis of most of the TBL patients was within 2-8 months.

Motor Outcome of Stroke Patients with Low Dose Levodopa Therapy

Stroke is one of the leading cause of disability worldwide. Motor function deficits due to stroke contribute to overall low quality of life. The objective was of this study is to observe functional motor outcome after stroke with low dose Levodopa therapy. This prospective follow up study was carried out in the Department of Neurology, Mymensingh Medical College Hospital, Mymensingh, Bangladesh from July 2014 to June 2016 to see the effect of low dose of Levodopa (110mg) on motor outcome after stoke disability. Motor deficit was measured by Medical Research Council (MRC) grading and Rivermead Mobility Index (RMI) score. Two groups were selected by simple random method, consisted of both ischemic and hemorrhagic stroke. All the patients of both the groups were suffering from at least some post stroke motor disability and attended full course of physiotherapy. The group (L) received 110mg Levodopa with physiotherapy. On the other hand (NL) group received only physiotherapy. They were all followed up for four times within two months of time and were assessed for recovery of motor function. Mean age was 59.03±11.56 years in Levodopa (L) group and 57.10±12.41 years in the Non Levodopa (NL) group; Males were predominant in both groups. Ninety three (77.50%) cases had ischemic stroke and 27(22.50%) cases had hemorrhagic stroke. Most common risk factors were hypertension and smoking. No known risk factor was detected in 8 (6.67%) patients. Single or multiple risk factors were confirmed in 112 patients (93.33%). MRC score was significantly higher both in affected upper and lower limb in Levodopa group comparing non Levodopa group at 4th visit. RMI score was also significantly higher in Levodopa group comparing non Levodopa group at 4th visit. The Levodopa (L) group showed better recovery pattern than Non Levodopa (NL) group. It can be concluded that motor recovery was better with administration of a single low dose of Levodopa in combination with physiotherapy. Motor outcome was significantly higher in levodopa group than non-levodopa group.

Effects of arsenic and phosphorus on the growth and nutrient concentration in rice plant

A pot experiment was carried out with arsenic (As) viz. 0, 0.1, 1 and 2 mgL-1 as sodium arsenite and phosphorus viz, 0, 15 and 30 μgmL-1 as ammonium dihydrogen phosphate to evaluate their effects on dry matter yield and nutrients concentration in rice plants (Oryza sativa L.) in the net house. Arsenic toxicity caused more damage to root than to shoot. As reduced plant height and dry matter yields but lower level increased the same significantly. A maximum diminution of 26.70% shoot weight and 32.30% root weights were observed where 2 mgL-1As and 0 μgmL-1 P were applied. Micronutrients were found to be more strongly antagonized by arsenic than the macronutrients. Maximum and minimum accumulation of different nutrients was found at 30 μgmL-1 and 0 μgmL-1 P applications, respectively. The lowest concentration of most of the nutrients were found at 2 mgL-1As and 0 μgmL-1 P. Experiment revealed that the concentrations of nitrogen, potassium, sulphur, iron, copper, zinc and manganese in the root and shoot of rice plants showed an antagonistic effect with As and synergistic effect with P. J. Biodivers. Conserv. Bioresour. Manag. 2019, 5(1): 31-38

Chebyshev collocation computation of magneto-bioconvection nanofluid flow over a wedge with multiple slips and magnetic induction

In this article, the steady two-dimensional stagnation point flow of a viscous incompressible electrically conducting bio-nanofluid over a stretching/shrinking wedge in the presence of passively control boundary condition, Stefan blowing and multiple slips is numerically investigated. Magnetic induction is also taken into account. The governing conservation equations are rendered into a system of ordinary differential equations via appropriate similarity transformations. The reduced system is solved using a fast, convergent Chebyshev collocation method. The influence of selected parameters on the dimensionless velocity, induced magnetic field, temperature, nanoparticle volume fraction and density of motile microorganisms as well as on the local skin friction, local Nusselt number, local Sherwood number and density of motile microorganism numbers is discussed and presented graphically. Validation with previously published results is performed and an excellent agreement is found. The study is relevant to electromagnetic manufacturing processes involving bio-nanofluids.

Stress Hyperglycemia and Stroke Outcome in Patients with Acute Stroke

Stroke is leading cause of death world wide, after coronary artery disease and cancer. A high proportion of patients suffering from an acute stress such as stroke or myocardial infarction may develop hyperglycemia, even in the absence of a preexisting diagnosis of diabetes. An observational comparative study was carried out at the Department of Neurology and Medicine, Mymensingh Medical College, Mymensingh, Bangladesh from July 2011 to June 2013 among purposively selected ninety-three patients with a view to assess the outcome of stress hyperglycemia on acute stroke. Data were collected through interview, physical examinations & laboratory investigations by using case record form. Statistical analysis was performed using SPSS (Statistical package for social science) version 17. The mean age of this study was 59.04±15.01 years in the hyperglycemic group and 62.06±13.81 years in the normoglycemic group. The male female ratio in the Hyperglycemic and normoglycemic group was 2.12:1 and 2.44:1 respectively. Smoker was 48.8% in the hyperglycemic group and 52% in the normoglycemic group. 70% of the Hyperglycemic group and 66% of the normoglycemic were found hypertensive. Mean±SD blood glucose level was found 11.86±0.58mmol/L in the Hyperglycemic group and 6.50±1.55mmol/L in the normoglycemic group. Mean HbAlc were 6.14±0.56 in hyperglycemic group and 5.29±0.54 in normoglycemic group. Stroke severity score were 21.79±11.85 in Hyperglycemic and 28.64±9.53 in normoglycemic group on admission. Functional outcome was measured on discharge & at the end of 4th weeks of every patient by Glasgo Outcome Scale (GOS). The study also suggests that stress hyperglycemia is an important risk factor of poor stroke outcome.

Serum Zinc Concentrations in Patients with Pulmonary Tuberculosis

Bangladesh is a tuberculosis (TB) burden country. It is one of the most important causes of mortality and morbidity and a major barrier of social and economic development. Zinc is a major trace element and an essential component of the body immune system. It's an important determinant of resistance to infection by maintaining cell mediated immunity. This analytical case control study was conducted in the Department of Internal Medicine, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh to see the association of serum zinc concentrations with pulmonary tuberculosis (PTB) in adult population (18-60 years) from January 2015 to January 2016. Freshly diagnosed PTB patients before initiating anti-TB chemotherapy as cases (N=43) and TB negative subjects as controls (N=48) were included conveniently in this study with a rigid selection criteria. Serum zinc concentrations were estimated by using atomic absorption spectrophotometer. The mean±SD age and BMI of the case group and control group were 33.30±14.71 and 32.69±11.60 years, 19.88±2.31 and 22.08±2.80 kg/m2 respectively. The concentrations of serum zinc were significantly lower (P=0.01) in PTB group (840.9±230.0 μgm/l) compared with the control group (965.6±219.9 μgm/l). There was marked variation of mean±SD serum zinc concentrations between male (1008.95±246.16 μgm/l) and female (937.24±200.35 μgm/l) in control group (P=0.182) though the variation is minimal in PTB group (P=0.724). The serum zinc concentrations showed positive correlation with BMI (P=0.642) but negative correlation with age (P=0.023) in both case and control. The lower serum zinc concentrations (12.06%) in PTB patients indicate relative immune deficiency. Routine assessment of serum zinc concentration of PTB patients should be considered and further outcome should be assessed with zinc supplementation.

Association between Serum Apolipoprotein-B and Acute Ischaemic Stroke

Stroke is one of the leading causes of death and disability in developed as well as developing countries like Bangladesh. There is a crucial need to identify additional risk factors that are easily measurable and treatable in general population. Role of serum lipids, lipoproteins and lipoprotein related variables in the prediction of stroke is less clear. Abnormalities in plasma lipoproteins are the most firmly established and best understood risk factors for atherosclerosis and they are probable risk factors for ischaemic stroke, largely by their link to atherosclerosis. High serum apolipoprotein-B (Apo-B) levels may predict an increased risk for ischaemic stroke. Aim of the study was to evaluate the association between serum Apo-B level and acute ischaemic stroke and to measure and compare serum Apo-B level in ischaemic stroke and normal subjects. A cross-sectional comparative study was carried out in the department of Neurology, Mymensingh Medical College Hospital, Mymensingh, Bangladesh from July 2013 to June 2015. A total number of 100 subjects within 18-70 years were considered for the study. Fifty (50) subjects with stroke (both clinically as well as CT scan of head or MRI of brain proven) were taken as the cases and 50 age and sex matched nearly healthy individuals without stroke were taken as the controls by using non-probability sampling procedure. Total cholesterol, HDL cholesterol and triglycerides were estimated by enzymatic method using Semiautoanalyser. LDL cholesterol was estimated by Friedewald formula. Apo-B was estimated by immunoturbidimetric method using Semiautoanalyser. Finally collected data were analyzed by using SPSS software Version 20. Student 't' test was used to compare the data between cases and controls. P value was set <0.05. Diagnostic validity tests were conducted to assess the diagnostic efficiency of Apo-B. Total cholesterol, LDL cholesterol and triglycerides are significantly increased in cases compared to controls. HDL-cholesterol was significantly decreased in cases compared to controls. Apo-B was significantly increased in cases compared to controls. The result was statistically significant. Apo-B may be used as predictors of ischaemic stroke components.

Associations between resistance phenotype and gene expression in response to serial exposure to oxacillin and ciprofloxacin in Staphylococcus aureus

This study was designed to delineate the relationship between resistance phenotypes and gene expression in wild-type (SA^WT ), oxacillin-induced (SA^OXA ), ciprofloxacin-induced (SA^CIP ) and clinically acquired antibiotic-resistant Staphylococcus aureus (SA^CA ) exposed to oxacillin (β-lactam) and ciprofloxacin (fluoroquinolone). The phenotypic response and gene expression were varied with the antibiotic exposure. SA^WT was highly resistant to oxacillin (MIC = 8 μg ml^-1 ) after serial exposure to oxacillin, while the oxacillin susceptibility was not changed in SA^WT when exposed to ciprofloxacin (MIC = 0·25 μg ml^-1 ). The clinical isolate, SA^CA , was highly resistant to all classes of antibiotics used in this study. The increased resistance of SA^OXA and SA^CIP to penicillinase-labile penicillins was attributed to the production of β-lactamase, which is in good agreement with the overexpression of blaZ (>2-fold). The overexpression of efflux pump-related genes (norA, norB, norC, mdeA, mepR, mgrA and lmrS) was associated with the increased resistance of SA^CIP and SA^CA to aminoglycosides and quinolones. This study confirmed that the linkage between resistance phenotypes and molecular genotypes highly varied depending on intrinsic resistance profile, response to antibiotic exposure and genes conferring resistance. This study provides useful information for understanding the mechanisms of methicillin resistance in S. aureus in association with phenotypic and genotypic resistance determinants.

SIGNIFICANCE AND IMPACT OF THE STUDY

The improvement in current standards is essential to accurately detect methicillin-resistant Staphylococcus aureus in consideration of various resistance phenotypes and genotypes. The varied and distinctive expression patterns of antibiotic resistance-related genes were observed in S. aureus exposed to oxacillin and ciprofloxacin. It is worth noting the relationship between resistance phenotype and resistance genotype in terms of MIC values and expression of antibiotic resistance determinants. This study provides useful information for understanding the mechanisms of methicillin resistance in S. aureus in association with phenotypic and genotypic resistance determinants.

Mucinous Adenocarcinoma of the Appendix: A Case Report

Primary tumors of the appendix are unusual and most of them are carcinoids. Their main presentation is that of an acute appendicitis or as a palpable mass, mainly in the right lower quadrant. A 40 years old male patient presented in Dhaka Community Medical College Hospital, Dhaka, Bangladesh on 31st October 2013 with mucous adenocarcinoma of the appendix, which primarily presented as heaviness in right lower abdomen and atypical abdominal pain. Diagnosis of the disease was made after right hemicolectomy and histopathological analysis of the specimen. Mucin producing adenocarcinomas of the appendix are a category of rare cancers of the gastrointestinal tract. Although at present they are a well studied pathological entity, the crucial issue of their preoperative diagnosis remains unsolved.

Detection of Cervical Cancer through Visual Inspection of Cervix with Acetic Acid (VIA) and Colposcopy at Mymensingh Medical College Hospital

Cervical cancer is the second most common cause of cancer related morbidity and mortality in women with 50% mortality rate. It is preventable if cervical cellular changes are detected and managed at early stage. This was a retrospective study conducted at VIA center of outpatient department and Colposcopy clinic at in-patient department of Mymensingh Medical College Hospital, Bangladesh covering a period from September 2013 to November 2014. Objective of this study was detection of cervical cancer and precancerous condition amongst patients reported to VIA center and Colposcopy clinic. In primary screening at VIA Center, total respondents were 3604, their mean age was 35.9 and highest were in the age group 31 to 40 years. At VIA center, 110(3.05%) were found positive and highest were between 31 to 40 years. In Colposcopy Clinic, out of 700 patients, 51.7% were CIN 1, 4.9% CIN 2, 1.4% CIN 3, invasive carcinoma was 0.3% and unsatisfactory or inconclusive were 34.3%. Most of the respondents were housewives and majority had poor monthly income. Amongst respondents, 72.1% were from rural area and Colposcopic findings revealed in 62.5% abnormal cervical changes, 46.5% were from rural area. Mean age at marriage or age at first coitus was found 16.25 years and 92.7% were in 11 to 20 years. Maximum abnormal cervical findings including CIN were between the ages ranged from 11 to 20 years of marriage age. In patients having 1 - 5 number of child having abnormal (58%) cervical changes, 48% were CIN 1. Histopathology reports found 19.6% CIN 1 (Total CIN 20.7%), cervical carcinoma 1.3%, inflammatory 7.0% and 0.42% cases were reported normal. Amongst 438 histopathology advised cases, 230 respondent's reports with patients were not available. VIA followed by Colposcopy has been a feasible, easy and reliable tools for screening cervical cancer in Bangladesh.

Study on Neurological Consequence of Eclampsia

The present study was carried out in the Department of Obstetrics and Gynecology at Mymensingh Medical College Hospital, Mymensingh, Bangladesh for a period of one year from 1st June 2009 to 30th June 2010 to see the Neurological Consequence of Eclampsia. A total number of 37 patients were enrolled in this study. Among 37 patients majority are in the age group of 21-30 years which is 19(51.4%) cases followed by less than or equal to 20 years and more than 30 years which are 13(35.1%) cases and 5(13.5%) cases respectively. Knee jerk is present in 28(75.7%) cases and absent in 8(21.6%) cases. The exaggerated knee jerk is present in only in 1(2.7%) case. The rate of Glasgow coma scale is less than 5 in 21(56.8%) cases, 14(37.8%) cases in 5-10 and 2(5.4%) cases is in more than 10. Focal sign is absent in 22(59.5%) cases and present in 15(40.5%) cases. Majority of the patients is presented with absence of neck stiffness which is 35(94.6%) cases and the rest 2(5.4%) cases are presented with neck stiffness. Flexor planter response is found in 20(54.1%) cases which is the highest in number followed by extensor which is 15(40.5%) cases. In only 2(5.4%) cases the planter reflex is not elicitable. Presence of infarct is found in 15(40.5%) cases which is the highest number. Cerebral edema and Presence of haemorrhage is found in 3(8.1%) cases in each. Leuko-encephalopathy is found in 2(5.4%) cases. Encephalopathy and Both infarct & haemorrhage is found in 1(2.7%) case of each. Normal CT scan findings of brain are found in 12(32.4%) cases.

Clinical Profile of Peripheral Neuropathy in Leprosy

The objectives of the study were to see the association of peripheral neuropathy in leprosy and to find out the clinical profile of peripheral neuropathy and disability status in leprosy. It was descriptive type of cross sectional study was conducted among the cases of leprosy attended in the out-patient departments of neurology, Mymensingh Medical College Hospital (MMCH) and Mymensingh tuberculosis and leprosy hospital that fulfilled the inclusion criteria were included in this study, during the study period of January 2010 to December 2011.In this study of 62 cases revealed that leprosy is more common in male (71%) people and 21% leprosy patient had contact with known case of leprosy. Leprosy causes peripheral neuropathy (61.3%). Duration of occurrence of peripheral neuropathy was prolonged (>6 month) in most of the patients (47.4%) and the disease progression was also slow (63.2%). Numbness was complained by 89.4% patients and 65.8% subjects complained of weakness of limbs. Deformities and ulcers were present in 26.3% and 50% of patients respectively. Ulnar nerve (43.6%), Lateral popliteal nerve (41.9%), Posterior tibial nerve (41.9%) and Great auricular nerve (17.7%) were the most commonly involved thickened peripheral nerves. The rate of visible physical impairment (WHO Grade 2 disability) among people affected by leprosy in feet was 27.4% and in hands was 16.1%. The position and vibration sense was found to normal all patients of peripheral neuropathy.

Chronic Gastritis and its Association with H. Pylori Infection

This cross sectional study was designed to see association of chronic gastritis including its type with H. pylori infection. Consecutive patients undergoing endoscopic examination having histopathological evidence of chronic gastritis were enrolled in the study and was done in Sylhet MAG Osmani Medical College from July 2011 to June 2012. Biopsies were taken from antrum, body and fundus in all patients. Histopathological examinations were done using H-E stain and for detection of H. pylori, rapid urease test, anti-H.pylori antibody test and histopathological test with modified Giemsa stain were done. Patients having results positive in at least two methods were considered infected by H. pylori. Total 80 dyspeptic patients having chronic gastritis were evaluated. Out of them 67(83.8%) had H. pylori infection and 13(16.2%) were H. pylori negative. Among all patients 57(71.2%) had pangastritis and 23(28.8%) had antral gastritis with female and male predominance respectively. H. pylori infection was present in 49(86.0%) cases of pangastritis and 18(78.3%) cases of antral gastritis. H. pylori infection was a little higher among males (34, 50.7%) females (33, 49.3%). H. pylori infection is the predominant cause of chronic gastritis and pangastritis is the major type.

Smear Positive Tuberculosis amongst Suspects Reported to DOTS Corner of Mymensingh Medical College Hospital, Bangladesh

Sputum microscopy still remains the primary tool for the laboratory diagnosis of tuberculosis. A retrospective study was conducted in the directly observed treatment, short-course (DOTS) corner of Mymensingh Medical College Hospital (MMCH), in Bangladesh from May 2013 to May 2014. The study was designed to evaluate the extent of smear positive microscopy including multi-drug resistance (MDR) amongst tuberculosis suspected cases. A total of 2,361 Pulmonary Tuberculosis (PTB) suspects were noticed to DOTS corner during this period, with the mean age of 43 years. The male female ratio was 2.02:1 and the smear positivity rate was about 10%. Study found majority of the suspects were in the economically productive year of life 20-70 years. Smear negative suspects were not re-evaluated further, though smear negativity does not rule out absence of tuberculosis. Extra pulmonary or non tuberculous mycobacteria were not evaluated in this study. Twenty two patients 0.9% of total 2361 were identified as MDR during the study period where 61 clinically highly suspected cases were sent for GeneXpert that seems to be much lesser than the national rate (3.6% in new cases and 19% in retreated cases). The smear positivity rate of all three (1st, 2nd and 3rd) smear was 94.5%, all the second smear was 100% positive and the third were 95.47% positive. It is evident from this study that two smear microscopy was found sufficiently reliable to diagnose TB. However, further in depth prospective study might be undertaken to ascertain the scenario of this chronic diseases.

Surgical Decompression of Resistant Cases of DeQuervain's Disease

DeQuervain's disease of the first dorsal compartment of the wrist, is a common wrist pathology, pain results from resisted gliding of the abductor pollicis longus and the extensor pollicis brevis tendon in the fibroosseous canal. Management of resistant cases of DeQuervain's disease with failed conservative treatment treated by surgical decompression yield satisfactory outcomes. A large number of patients being dissatisfied with the medical treatment, still present with persistent pain and positive clinical finding. Surgical decompression is an effective method for the treatment of resistant cases of DeQuervain's disease. Outcome variables were measured by Scheller, Forget and Macey evaluation criteria. Most of our patients were female 28(93.3%), housewife 17(56.7%) with mean age of 41.57 years, ranging from 25-60 years. Right sided involvement was 20(66.7%) and Left sided involvement was 10(33.3%). Restricted movement of thumb in 30(100%) were the predominant symptoms. One (3.3%) patient develop chronic tenosynovitis, 1(3.3%) patient develop hypertrophic scar. There was no wound infection in the follow-up period of 3-18 months. Satisfactory results were found in 29(96.7%).

Genetic testing for spinocerebellar ataxias in patients diagnosed as Parkinson's disease in Bangladesh

This study was conducted to find out Spinocerebellar Ataxias (SCA) by genetic analysis from those patients presenting with Parkinsonism in the Neurology department of Mymensingh Medical College Hospital, Bangladesh. A sample of about 5ml blood was collected by venipuncture in EDTA tube after having informed consent from each patients and healthy individual, with due Institutional Ethical committee approval for genetic study of 7 healthy people and 9 patients. The neurological disorder along with a complete physical and/or psychological, as well as family history and demographic data was recorded with a prescribed questionnaire by the neurologists of Mymensingh Medical College Hospital. Extraction of genomic DNA from the venous blood using Flexi Gene DNA kit (Qiagen, Japan) was performed in Faculty of Veterinary Science, Bangladesh Agricultural University, Mymensingh, Bangladesh. The extracted DNA was stored, accumulated and then were sent to Division of Clinical Genetics, Department of Medical Genetics, Osaka University Medical School, Suita, Osaka 565 0871, Japan for PCR and further analysis. PCR amplification of the CAG repeat was performed for the SCA1, SCA2, SCA3, SCA6 loci using primers SCA1N-F1 and SCA1N-R1, SCA2-F1 and SCA2-R1, MJDF1 and MJDR1, SCA6-F1 and SCA6-R1, respectively. SCA1 PCR of both healthy individual and suspected Parkinsons Disease (PD) patients DNA was found 250 bp (no. of CAG repeats=36). SCA2 PCR products reveal the DNA products of about 150 bp (no. of CAG repeats=23) except one patient that was suspected and it was sequenced and revealed 175bp (no. of CAG repeats=30). SCA3 PCR product size of both healthy individual and patient DNA was within 250 (no. of CAG repeats=11) to 300 bp (no. of CAG repeats=28) except one patient which was about 320 bp and its CAG repeats was about 34. SCA6 PCR product size of both healthy individual and patient DNA was about 150 bp (no. of CAG repeats=16).

Evaluation of extra pulmonary tuberculosis in Bangladeshi patients

This is a retrospective study of 200 cases of Extra Pulmonary Tuberculosis (EPTB) and this study was conducted from January 2010 to July 2011 at Sheheed Ziaur Rahman Medical College Hospital and TB clinic, Bogra, Bangladesh. Data were collected from the Hospital records on demographics, clinical, laboratory and treatment out come status. The incidence of EPTB was high in 16-45 years age group (55%), mean age was 35.67±14.6 years and predominated in Female patients (60%). Extra pulmonary Tuberculosis (EPTB) still constitutes an important clinical problem in Bangladesh. The objective of this study was to evaluate the demography and features of patients with EPTB in our high burden tuberculosis country. Lymph nodes are the most common site of involvement (50%) followed by tubercular pleural effusion (15%) and virtually every site of the body can be affected by tuberculosis. Since the clinical presentation of EPTB is atypical, tissue samples for the confirmation of diagnosis can sometimes be difficult procedure and conventional diagnostic method have a poor yield, so the diagnosis is often delayed. EPTB constitutes about 15-20% of all cases of TB patients and it is more common in low socio-economic group (60%) Biopsy and/ or surgery, FNAC is required to procure tissue samples and pus and/or aspirated fluids are required for diagnosis and for managing complications. The EPTB usually responds to standard anti tubercular drug regimen.

Roles of superthermal electrons and positrons on positron-acoustic solitary waves and double layers in electron-positron-ion plasmas

Positron-acoustic (PA) solitary waves (SWs) and double layers (DLs) in four-component plasmas consisting of immobile positive ions, mobile cold positrons, and superthermal (kappa distributed) hot positrons and electrons are investigated both numerically and analytically by deriving Korteweg-de Vries (K-dV), modified K-dV (mK-dV), and Gardner equations along with their DLs solutions using the reductive perturbation method. It is examined that depending on the plasma parameters, the K-dV SWs, Gardner SWs, and DLs support either compressive or rarefactive structures, whereas mK-dV SWs support only compressive structure. It is also found that the presence of superthermal (kappa distributed) hot positrons and hot electrons significantly modify the basic features of PA SWs as well as PA DLs. Besides, the critical number density ratio of hot positrons and cold positrons play an important role in the polarity of PA SWs and DLs. The implications of our results in different space as well as laboratory plasma environments are briefly discussed.

Socio-demographic characteristics, types and Slit Skin Smear (SSS) of the leprosy patients: a hospital based study

This study was aimed to identify the socio-demographic profile, to know the types and to find out the Slit Skin Smear (SSS) result associated with leprosy. It was a descriptive type of cross sectional study. Total 62 patients having clinical features of leprosy, attending in Department of Neurology of Mymensingh Medical College Hospital (MMCH) and Mymensingh Tuberculosis and Leprosy Hospital, Mymensingh from January 2010 to December 2011 were included. Patients underwent a detailed clinical evaluation followed by laboratory investigations. Out of 62 cases, the results showed that the mean age of leprosy patients were 37.8±14.6 years with the age range 12-80 years and the peak incidence was between 20-40 years. The frequency of male and female was 70.9% and 29.1% respectively with M: F of 2.4:1. From rural area 74.2% leprosy patients and 25.8% patients were from urban area and mainly day-labours (25.8%) and housewife (24.2%) by occupation. Married was 87.1% of patients and 12.9% were unmarried. Twenty one percent (21%) leprosy patients were found contact with leprosy. It was observed in this study that, 35.5% patients were PB (Pauci Bacillary) group and 64.5% of the patients were in MB (Multi Bacillary) group. Lepromatous Leprosy (LL) patients were (17.7%) and Borderline Lepromatous (BL) patients were (11.3%). Patients with Tuberculoid Type (TT) were (3.2%) and patients with Borderline Tuberculoid (BT) were (61.3%). The result of Slit skin smear (SSS) examination was negative in 59.7% patients and positive in 40.3%.

Cutaneous anthrax in a school teacher

Cutaneous anthrax is an infection of the skin caused by Bacillus anthracis. This is a report of a case of cutaneous anthrax attending outpatients of Mymensingh Medical College Hospital in October, 2010. The infected person was a retired school teacher with a very good body build. He reported to handle cow flesh about 4-5 days ago, developed few painless papules over shin of right leg, which gradually became large bullae and blackish eschar developed over the lesion. Smears from the lesions were investigated which confirmed the causative agent B. anthracis. The patient was treated with oral Ciprofloxacin (500mg) twice daily for seven days which cured the infection as observed on his subsequent follow up visits on 7 and 14 days later. Oral Ciprofloxacin is found effective as recommended by the World Health Organization.

Effect of levodopa and carbidopa on non-motor symptoms and signs of Parkinson's disease

Parkinson's disease (PD) patient presents with both motor and non-motor symptoms. This was descriptive type of interventional study carried out in the department of Neurology, Mymensingh Medical College Hospital, Mymensingh, Bangladesh from January 2009 to December 2010. Among the total 59 cases, 51 completed the proposed five months follow up. The rest eight cases attended Neurology department irregularly and were ultimately dropout from follow up. The case selection technique was purposive type of non probability sampling. Each patient was treated with levodopa+carbidopa. Then the effect of levodopa+carbidopa on non-motor symptoms and signs were evaluated in subsequent five visits at four week interval. All relevant information and follow-up were recorded in a pre-designed individual case record form. Chi square test was done and probability value <0.05 were considered as level of significance with 95% confidence limit. Among the non-motor symptoms (NMS), the most frequent symptoms at base line visit were fatigue 56.8%, excessive sweating 54.9%, insomnia 54.9%, akathisia 47.1%, anxiety 45.1%, constipation 17.6%. After five months of levodopa+carbidopa therapy, frequencies of most of the NMS decreased slightly in comparison to base line symptoms but there were no significant effect of levodopa+carbidopa on NMS of study subjects.

Evaluation of foot ulcers in diabetic patients

This is a prospective observational study of 50 cases of diabetic foot ulcer conducted from June 2010 to May 2011 in the Department of Surgery of Shaheed Ziaur Rahman Medical College Hospital and the Diabetic Hospital, Bogra. This study revealed that diabetic foot ulcers are not uncommon complication in our country. The purpose of the study was to undergo a thorough evaluation of diabetic foot ulcers for better management as well as better outcome of patients. The maximum age group of this study was 41-50 years; mean±SD age was 55±15 years and male to female ratio was 1.4:1. This study showed that diabetic foot ulcers were more common in low-socio-economic group, among smokers, among poor glycemic controlled group and long duration of diabetics. In this series, 92% patients had peripheral neuropathy, 22% had foot deformity and 70% patients had vascular insufficiency in the foot and legs. In this series, 68% patients presented early diabetic complication i.e. 44% patients belonged to grade '0' and 24% patients belonged to Grade 1, which were suitable for safety of the limb or reducing major amputation if treated properly.

Effect of Different Substrate on Growth and Yield of Button Mushroom

An experiment was conducted at the Mushroom growth house and Tissue Culture Laboratory, Horticulture Demonstration and Training Centre (HDTC), Kewatkhali, Mymensingh during February to May, 2006 to investigate the effect of different substrate on growth and yield of Button mushroom (Agaricus biporus). The substrates which were used in the experiment were wheat: paddy (1:1) straw compost, paddy straw compost and decomposed cowdung. The parameters observed in first and second flush were number of primordia, number of fruiting bodies and fresh weight of mushroom. Data were statistically analyzed following Completely Randomized Design (CRD). Data revealed that different substrate significantly affected the production of number of primordia, number of fruiting bodies and fresh weight. In both the first and second flush, all the three observed parameters were obtained highest in wheat: paddy straw compost and the lowest were in decomposed cowdung.DOI: http://dx.doi.org/10.3329/jesnr.v5i2.14810 J. Environ. Sci. & Natural Resources, 5(2): 177-180 2012

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

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

Electrolyte changes in stroke

The present study was carried out in the department of Neurology and Medicine, Mymensingh Medical College Hospital, Bangladesh during the period of January 2009 to December 2010 to see the electrolyte changes in stroke. The serum concentration of Na⁺, K⁺, and Cl⁻ were measured in 110 cases during acute period of stroke (55 ischemic and 55 haemorrhagic strokes). Data were analyzed by computer with SPSS programme using 't' test and chi square test. In haemorrhagic stroke, out of 55 patients 29(52.72%) had abnormal sodium level, of them 23(41.8%) had hyponatremia, 6(10.9%) had hypernatremia. In contrast in ischemic stroke 23(41.80%) out of 55 had abnormal sodium level, of them 21(38%) had hyponatremia. The result showed that hyponatremia is almost equally common in both haemorrhagic and ischaemic group without significant difference (p>0.05). The study also revealed that hyponatremia is more common than hypernatremia in both groups. Mean ± SD of age of the haemorrhagic group was 60.80 ± 15.97 while the age of ischaemic group was 59.89 ± 15.84 years. Male, female ratio in haemorrhagic and ischaemic group 1:0.62 and 1:0.89 respectively. Mean ± SD of serum Na⁺, K⁺, Cl⁻ in haemorrhagic group were 136.18 ± 10.5, 3.83 ± 0.65, 97.96 ± 16.74 mmol/L, in ischaemic group 135.08 ± 9.08, 4.00 ± 0.75, 100.27 ± 8.39 mmol/L. The result showed no significant difference in haemorrhagic and ischemic stroke. Hyponatremia, hypokalamia and hyperchloredemia were more common than hypernatremia, hyperkalamia and hyperchloredemia. In haemorrhagic stroke, out of 55 patients, 21(38.18%) had abnormal potassium level, of them 19(34.55%) had hypokalemia, 2(3.63%) had hyperkalemia. In contrasts, in ischemic stroke, 15 out of 55(27.22%) had abnormal potassium level. Of them 12(21.81%) had hypokalemia and 3(5.45%) had hyperkalemia. The finding showed that hypokalemia is almost equally common in both haemorrhagic and ischaemic group without significant difference. The study also revealed that hypokalemia is more common than hyperkalemia in both groups. In haemorrhagic stroke, out of 55 patients 33(60%) had abnormal chloride level. Of them 20(36.4%) had hypochrloridemia, 13(23%) had hyperchrloridemia, in contrast, in ischemic stroke, 40 out of 55(60%) had abnormal chloride level, of them 22(40%) had hypochrloridemia and 18(32.7%) had hyperchrloridemia. The result showed that changes in chloride level after haemorrhagic and ischemic stroke are similar. The result showed hypochrloridemia is more common than hyperchrloridemia in both groups.

Characterization of some representative soils from the Ganges floodplain of Bangladesh

DOI: http://dx.doi.org/10.3329/dujbs.v21i2.11519Dhaka Univ. J. Biol. Sci. 21(2): 201-205, 2012 (July)

Proteinuria is an independent risk factor for ischemic stroke among diabetic patients

This study was done to assess the relationship between proteinuria and ischemic stroke in subjects with diabetes mellitus, and to determine whether proteinuria is an independent risk factor for stroke. This comparative study was conducted in Mymensingh Medical College Hospital from January 2009 to June 2010. It was done to establish the relationship between proteinuria (Microalbuminuria) and ischemic stroke among diabetic patients. Other risk factors were also assessed. Patients were divided in Group A - diabetic patients with ischemic stroke (n=50) and Group B diabetic patients without stroke (n=50). Mean age of the Group A & B were 60.16±8.33 and 57.19±7.73 years (p=0.068). Mean Blood sugar (2 hours after Break Fast) was 14.68±4.32mmol/L in Group A and 14.75±4.02mmol/L in Group B (p>0.05). Albumin Creatinine ratio was abnormal in 84.0% in Group A and 22.0% in Group A (p=0.001) [Odds ratio (95%CI) = 18.61 (6.78-51.09)]. Logistic regression analysis has also shown that microalbuminuria (ACR) is an independent risk factor for ischemic stroke (p=0.001), [Odds ratio (95%CI) = 19.811(5.915-66.348)]. In diabetic patients increased urinary protein is a risk factor for stroke. Estimation of urinary protein (Microalbuminuria) may be used as a predictor for ischemic stroke in patients with diabetes.

Pattern of congenital heart diseases

This prospective observational study was done to find out the frequency of various forms of congenital heart disease (CHD) diagnosed by echocardiography. During the study period (January 2002 to December 2005) 2050 patients were screened by echocardiography. All patients were evaluated by cardiologists and had chest radiograph, electrocardiogram and echocardiography. Total 2050 patients were studied and among them 1071 had congenital heart disease. Male was 561(52.38%) and female was 510(47.62%). Atrial septal defect (ASD) was 374(34.92%), ventricular septal defect (VSD) was 318(29.69%), patent ductus arteriosus (PDA) 83(7.75%), pulmonary stenosis (PS) 58(5.42%), tetralogy of Fallot 162(15.13%), transposition of great vessels (TGA) 16(1.49%), Ebstein anomaly 5(0.4%), coarctation of aorta 1(0.09%) and single ventricle 2(0.19%). This distribution is more or less similar to that reported in studies at home and abroad. In this study atrial septal defect (ASD) was the commonest in acyanotic CHD and tetralogy of Fallot was the commonest cyanotic CHD.

Demographic and clinical profile of myelopathy patients

This descriptive type of cross sectional study was aimed to identify the demographic profile, clinical presentations of myelopathy and to find out the etiological factors associated with myelopathy. Total 65 patients having clinical features of myelopathy, admitted in Neurology and Medicine ward of Mymensingh Medical College Hospital from February 2009 to December 2010 were purposively studied. Patients underwent a detailed clinical evaluation followed by laboratory investigations and neuro-imaging studies. Out of 65 cases, 80.0% were male and 20.0% were female with mean age 39.15 ± 16.8 years. Highest number of cases (41.6%) was farmers. Most of the cases (72.3%) hailed from rural area. Mean duration of illness was 7.74 ± 15.8 months. 41.54% patients presented with paraplegia/paraparesis and 58.46% with quadriparesis/quadriplegia. 63.1% patients had sensory disturbance. It is observed that 58.5% had urinary sphincter disturbance and 21.5% had bowel sphincter disturbance. Among the causes of myelopathy found in this study, 29.23% patients had spondylotic myelopathy and 24.62% had transverse myelitis (ATM). In 12.31% patients the cause of myelopathy could not be identified. Myelopathy is more common in males and most of the patients are farmers. Spondylotic and Transverse myelopathy is the main etiology of compressive and non-compressive myelopathy respectively.