Measurements of All-Particle Energy Spectrum and Mean Logarithmic Mass of Cosmic Rays from 0.3 to 30 PeV with LHAASO-KM2A

We present the measurements of all-particle energy spectrum and mean logarithmic mass of cosmic rays in the energy range of 0.3-30 PeV using data collected from LHAASO-KM2A between September 2021 and December 2022, which is based on a nearly composition-independent energy reconstruction method, achieving unprecedented accuracy. Our analysis reveals the position of the knee at 3.67±0.05±0.15  PeV. Below the knee, the spectral index is found to be -2.7413±0.0004±0.0050, while above the knee, it is -3.128±0.005±0.027, with the sharpness of the transition measured with a statistical error of 2%. The mean logarithmic mass of cosmic rays is almost heavier than helium in the whole measured energy range. It decreases from 1.7 at 0.3 PeV to 1.3 at 3 PeV, representing a 24% decline following a power law with an index of -0.1200±0.0003±0.0341. This is equivalent to an increase in abundance of light components. Above the knee, the mean logarithmic mass exhibits a power law trend towards heavier components, which is reversal to the behavior observed in the all-particle energy spectrum. Additionally, the knee position and the change in power-law index are approximately the same. These findings suggest that the knee observed in the all-particle spectrum corresponds to the knee of the light component, rather than the medium-heavy components.

Standardization of urinary tract infection diagnosis in the neonatal ICU: Experience at a tertiary care center

BACKGROUND

Urinary tract infections (UTIs) and antibiotic overexposure are common neonatal problems. Recently, evidence has emerged that a standardized approach to neonatal UTI can reduce unnecessary diagnosis without complications. This quality improvement project aimed to achieve those goals in our neonatal intensive care unit (NICU).

METHODS

A UTI diagnosis guideline was adapted from the literature with the goal of maximizing the proportion of diagnosed UTIs that conform to accepted diagnostic criteria: >10,000 CFU/mL of one organism with pyuria, or >50,000 CFU/mL of one organism regardless of pyuria. The guideline was implemented in a level III NICU. Adherence, results, and complications were monitored for 12 months.

RESULTS

Guideline adherence after implementation was favorable, as evidenced by increased adoption of urinalysis with microscopy. There was a non-significant increase in diagnostic adherence to criteria, 87% to 93%, and non-significant decrease in the rate of UTI diagnosis, 39% to 36%. Complications were not significantly changed. Most UTIs were due to gram-negative rods, especially E. coli; Enterococcus was a common contaminant.

CONCLUSIONS

A guideline for diagnosing UTIs can safely increase uniformity. In contrast to previously published results, no significant changes were seen in the rate of UTI or the proportion of diagnoses conforming to the criteria for UTI. It is likely that guideline effects depend on the established practices of NICU providers. Additionally, a consistent pattern was seen in which organisms were more likely to be judged the source of true UTIs or contaminated cultures, meriting further study.

Tea (Camellia sinensis (L.) Kuntze) as an emerging source of protein and bioactive peptides: A narrative review

Tea residues represent one of the major agricultural wastes that are generated after the processing of tea. They account for 21-28% of crude protein and are often discarded without the extraction of valuable proteins. Due to various bioactivity and functional properties, tea proteins are an excellent alternative to other plant-based proteins for usage as food supplements at a higher dosage. Moreover, their good gelation capacity is ideal for the manufacturing of dairy products, jellies, condensation protein, gelatin gel, bread, etc. The current study is the first to comprehend various tea protein extraction methods and their amino acid profile. The preparation of tea protein bioactive peptides and hydrolysates are summarized. Several functional properties (solubility, foaming capacity, emulsification, water/oil absorption capacity) and bioactivities (antioxidant, antihypertensive, antidiabetic) of tea proteins are emphasized.

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.

A124 PERORAL ENDOSCOPIC MYOTOMY IS THE PREFERRED TREATMENT FOR PATIENTS WITH SYMPTOMATIC ZENKER’S DIVERTICULUM

Background

Zenker’s diverticulum (ZD) is a mucosal herniation at the pharyngoesophageal junction presenting with dysphagia, regurgitation and aspiration. While open surgical myotomy (OSM) is the conventional treatment option, select patients can undergo myotomy using endoscopic techniques.

Purpose

Evidence on third-space flexible endoscopy with myotomy is lacking, especially in North America. We aimed to assess the safety and efficacy of peroral endoscopic myotomy (POEM) for symptomatic ZD.

Method

Retrospective cohort study was performed of consecutive patients undergoing OSM and POEM completed in a tertiary hospital from 2010-2020. Only patients with accessible electronic medical records and at least 3 months of follow-up were included in this study. Data collected included: demographics, comorbidities, ZD characteristics, clinical and patient-reported outcomes.

Result(s)

14 patients underwent OSM and 18 patients underwent POEM. 10 of the patients undergoing POEM were considered for but were not able to get stapled endoscopic myotomy, the most common reasons were related to the technical limitations (ZD size too small, unable to hyper-extend neck, unable to position suspension laryngoscope). There were no significant differences between groups in age (p=0.35), BMI (p=0.38), Charlson comorbidity index (p=0.26) and size of ZD (p=0.92). Length of stay was significantly lower for POEM (0.4 vs. 3.1, p<0.01). Complications were more common and severe with OSM (36%, n=5) versus POEM (11%, n=2). The only complications post-POEM were contained esophageal perforations. Complications post-OSM included esophageal perforations requiring open cervical drainage, surgical site infections, recurrent laryngeal nerve injury/paresis, esophageal strictures requiring multiple dilatations. All patients undergoing POEM had 100% technical success with post-treatment barium esophagogram showing 100% resolution of obstruction/hang-up. The median follow-up time post-POEM was 11 months. Over the follow-up period there was a significant improvement of patient-reported outcomes, with a mean decrease of Eckardt score (4.7 to 1.1, p<0.001) and mean increase of Dakkak-Watson score (20.7 to 41, p<0.001). Only one patient had persistent ongoing symptoms of dysphagia post-POEM and was subsequently diagnosed with ineffective esophageal motility on high resolution manometry.

Conclusion(s)

POEM is a minimally invasive treatment option for ZD with high treatment success as well as reduced length of stay and complications. It is less invasive than OSM, more versatile than stapled endoscopic myotomy and is less prone to technical limitations.

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Disclosure of Interest

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Molecular prevalence of Anaplasma marginale in ruminants and Rhipicephalus ticks in northern Pakistan

Anaplasma marginale is the most prevalent tick-borne haemoparasite of cattle and causes huge economic losses to the dairy industry worldwide. This study aimed to determine the occurrence of A. marginale infection in blood and tick samples collected from livestock animals in the districts located in Khyber Pakhtunkhwa (KPK), Pakistan. A total of 184 blood and 370 tick samples were included in this study. It has never been reported that sheep, goats, and cattle in Tank, Ghulam Khan, Birmil and Miran Shah areas were infected with A. marginale. All samples of blood and ticks were collected through random sampling from March 2021 to January 2022 from cattle, sheep and goats and screened through PCR for anaplasmosis by using primer pairs of Anaplasma spp. Three hundred and seventy ticks were collected from infested hosts (120/184, 64.21%). Among the four morphologically identified tick species, the highest occurrence was recorded for Rhipicephalus sanguineus (n=138, 37.29%), followed by Rhipicephalus microplus (n=131, 35.4%), Rhipicephalus annulatus (n=40, 10.81%), Hyalomma anatolicum (n=31, 8.37%), and Hyalomma marginatum (n=30, 8.1%). The occurrence of female tick was highest (n=160, 43.24%), followed by nymphs (n=140, 37.38%) and males ticks (n=70, 18.9%). Among these ticks, A. marginale was detected in female ticks of R. microplus, and R. sanguineus. Molecular identification of A. marginale was confirmed in 120 out of 184 blood samples and 6 out of 74 tick samples. Overall, occurrence of A. marginale in blood and tick samples was found to be 65.21% and 8.1% respectively. Species-wise occurrence in blood samples of goats were 71.11% followed by sheep 68.31% and cattle 50%. Specie-wise occurrence of A. marginale in tick samples of cattle were 12.5% followed by goats 6.89%. The obtained sequence showed similarity with A. marginale reported from Kenya and USA. We report the first PCR based detection of A. marginale infection in blood samples and in R. sanguineus ticks of goats simultaneously.

Tinospora cordifolia (Willd.) Hook.f. & Thomson polysaccharides: A review on extraction, characterization, and bioactivities

Human awareness of the need for health and wellness practices that enhance disease resilience has increased as a result of recent health risks. Plant-derived polysaccharides with biological activity are good candidates to fight diseases because of their low toxicity. Tinospora cordifolia (Willd.) Hook.f. & Thomson polysaccharides extract from different plant parts have been reported to possess significant biological activity such as anti-oxidant, anti-cancer, immunomodulatory, anti-diabetic, radioprotective and hepatoprotective. Several extraction and purification techniques have been used to isolate and characterize T. cordifolia polysaccharides. Along with hot-water extraction (HWE), other novel techniques like microwave-assisted extraction (MAE), ultrasound-assisted extraction (UAE), pulsed electric field (PEF), supercritical-fluid extraction (SFE), and enzyme-assisted extraction (EAE) are used to extract T cordifolia polysaccharides. SFE is a revolutionary technology that gives the best yield and purity of low-molecular-weight polysaccharides. According to the findings, polysaccharides extracted and purified from T. cordifolia have a significant impact on their structure and biological activity. As a result, the methods of extraction, structural characterization, and biological activity of T. cordifolia polysaccharides are covered in this review. Research on T. cordifolia polysaccharides and their potential applications will benefit greatly from the findings presented in this review.

H9N2 avian influenza virus dispersal along Bangladeshi poultry trading networks

Avian influenza virus subtype H9N2 is endemic in Bangladesh's poultry population. The subtype affects poultry production and poses a potential zoonotic risk. Insufficient understanding of how the poultry trading network shapes the dissemination of avian influenza viruses has hindered the design of targeted interventions to reduce their spread. Here, we use phylodynamic analyses of haemagglutinin sequences to investigate the spatial spread and dispersal patterns of H9N2 viruses in Bangladesh's poultry population, focusing on its two largest cities (Dhaka and Chattogram) and their poultry production and distribution networks. Our analyses suggest that H9N2 subtype avian influenza virus lineage movement occurs relatively less frequently between Bangladesh's two largest cities than within each city. H9N2 viruses detected in single markets are often more closely related to viruses from other markets in the same city than to each other, consistent with close epidemiological connectivity between markets. Our analyses also suggest that H9N2 viruses may spread more frequently between chickens of the three most commonly sold types (sunali-a cross-bred of Fayoumi hen and Rhode Island Red cock, deshi-local indigenous, and exotic broiler) in Dhaka than in Chattogram. Overall, this study improves our understanding of how Bangladesh's poultry trading system impacts avian influenza virus spread and should contribute to the design of tailored surveillance that accommodates local heterogeneity in virus dispersal patterns.

Study of Changes in Serum Copper Level in Patients with Acute Myocardial Infarction

Acute myocardial infarction (AMI) commonly known as heart attack is defined pathologically as the irreversible death of myocardial cells caused by ischemia. Risk factors include high blood pressure, smoking, diabetes, lack of exercise, obesity, high blood cholesterol and excessive alcohol intake. The major cause of acute MI is coronary atherosclerosis with superimposed luminal thrombus, which accounts for more than 80% of all infarcts. Micronutrients and trace elements are very essential for normal functioning of the body. Even though they are required in very small amount, an alteration in the level of this element may lead to serious diseases like CAD and its consequences. The injury induced by reperfusion of the ischemic myocardium could result partially from the cytotoxic effects of oxygen free radicals. Copper is involved in several of the reactions in the protection from free radical damage. So, this study was designed to evaluate serum cupper level in AMI patients. This case-control study was conducted in the Department of Biochemistry, Mymensingh Medical College, Mymensingh, Bangladesh from July 2016 to June 2017. Total number of subjects was 120 in number. Among them 60 were diagnosed case of acute myocardial infarction and 60 were apparently healthy volunteers. Data were collected using pre-designed data collection sheets. After proper counseling informed written consent was taken from the study population. The study revealed that mean serum copper level was higher in case group as compared to control group. The mean±SD values of copper were 105.44±24.15μg/dl and 146.49±23.52μg/dl in control and case group respectively. The level of significance was 0.001 (p<0.05). After analyzing the results of the study it is concluded that serum copper level was significantly higher in Acute Myocardial Infarction patients than normal individuals. Therefore, estimation of serum copper level in AMI patients might be useful to take appropriate measure to prevent free radical induced reperfusion injury.

Occurrence of ticks and tick-borne mixed parasitic microbiota in cross-bred cattle in District Lahore, Pakistan

The present study was focused on the incidence of ticks and tick-borne diseases (TTBD) in cross-bred cattle (Friesian x Sahiwal) of two farms (n = 2548) in district Lahore, Pakistan. We collected total of 572 ticks (adults and nymphs) and blood samples (10 ml) for microscopic i.e., blood smear test - Giemsa Stain (BST) and molecular analysis; Reverse Line Blot-General Primer-PCR (RLB-PCR) and Specie Specific Primer PCR (SP-PCR) from infested cattle (n = 100) from months of April to September. Results: The tick specie identified was Rhipicephalus microplus at both farms, with significant difference in infestations rate amongst both farms (p< 0.0001). The cross-bred cattle having higher ratio of Friesian blood and lower ratio of Sahiwal blood were mostly infested by ticks (p < 0.0458) and haemoparasites (p <0.474) and vice versa. The SP-PCR showed higher number of haemoparasites infection than BST, which revealed 16% T. annulata (p < 0.0001 and k value 0.485, 0.0001), 51% B. bigemina (p < 0.0001 and k value 0.485, 0.0001) and 15% A. marginale (p < 0.001 and k value 0.207, 0.001), respectively. The single infection with B. bigemina was 34% (n = 34/100) and A. marginale 6% (n = 6/100). The double infection with T. annulata/B. bigemina was 8% (n = 8/100) and B. bigemina/A. marginale 1% (n = 1/100). Whereas the triple infection with T. annulata/B. bigemina/A .marginale was 8% (n = 8/100). The phylogenetic study of isolated sequence of T. annulata revealed close homology to isolates from Iran (87%), B. bigemina to isolates from Cuba (94 to 100%) and A. marginale with isolates from Pakistan (99 to 98%).

Insight of PBZ mediated drought amelioration in crop plants

Water scarcity is a significant environmental limitation to plant productivity as drought-induced crop output losses are likely to outnumber losses from all other factors. In this context, triazole compounds have recently been discovered to act as plant growth regulators and multi-stress protectants such as heat, chilling, drought, waterlogging, heavy metals, etc. Paclobutrazol (PBZ) [(2RS, 3RS)-1-(4-chlorophenyl)- 4, 4-dimethyl-2-(1H-1, 2, 4-trizol-1-yl)-pentan-3-ol)] disrupts the isoprenoid pathway by blocking ent-kaurene synthesis, affecting gibberellic acid (GA) and abscisic acid (ABA) hormone levels. PBZ affects the level of ethylene and cytokinin by interfering with their biosynthesis pathways. Through a variety of physiological responses, PBZ improves plant survival under drought. Some of the documented responses include a decrease in transpiration rate (due to reduced leaf area), higher diffusive resistance, relieving reduction in water potential, greater relative water content, less water use, and increased antioxidant activity. We examined and discussed current findings as well as the prospective application of PBZ in regulating crop growth and ameliorating abiotic stresses in this review. Furthermore, the influence of PBZ on numerous biochemical, physiological, and molecular processes is thoroughly investigated, resulting in increased crop yield.

Distribution and Pattern of Anti-Tubercular Drug Resistance in Patients with Pulmonary Tuberculosis in Mymensingh Region of Bangladesh

Globally, the emergence of multidrug-resistant strains of Mycobacterium tuberculosis is an increasing problem that adversely affects patient care and public health. This cross sectional descriptive study was carried out in the Department of Microbiology, Mymensingh Medical College from January 2010 to December 2010 to isolate M. tuberculosis from smear-positive sputum samples by Lowenstein-Jensen (L-J) media and investigate the drug resistance pattern. Among 101 smear-positive cases 80(79.20%) yielded growth of Mycobacteria, 5(4.95%) were contaminated and 16(15.84%) showed no growth. Among 80 isolates 76(95.0%) were M. tuberculosis and the remaining 4(5.0%) were Non-tuberculous Mycobacteria (NTM). Out of 76 M. tuberculosis 27(35.52%) were resistant to at least one drug, 4(5.26%) to Isoniazid (INH), 1(1.32%) to Rifampicin (RMP), 8(10.53%) to Streptomycin (SM) and 0(0.0%) to Ethambutol (EMB) and multi-drug resistant tuberculosis (MDR-TB) was 9(11.84%). The present study creates the impression that fairly high rate of anti-tuberculosis drug resistance among the tuberculosis cases and also high MDR-TB (Resistant to both Rifampicin and Isoniazide). The emergence of MDR-TB poses significant trouble to TB control activities throughout the world. The complexity of MDR-TB operation makes it essential to produce new skills to design, plan, application and monitor interventions for the management of MDR-TB. More surveillance and immediate remedial interventions should be performed to combat the trouble of MDR-TB to the general population.

Development of soy-based nanocomposite film: Modeling for barrier and mechanical properties and its application as cheese slice separator

In the current study, soybean aqueous extract (SAE)-based nanocomposite film was developed by incorporating cellulose nanofiber (CNF) at various concentrations (0-10%). Effect of nanoreinforcement on essential properties of the nanocomposite film such as barrier, mechanical, water affinity, and optical properties were evaluated. Homogeneous films with improved barrier and mechanical properties were observed until 6% CNF, beyond which considerable reduction in desirable properties was noticed due to nanoparticle's agglomeration effect. Furthermore, the prediction of the mechanical and barrier properties of nanocomposite film was performed with mathematical models such as modified Halpin-Tsai and modified Nielsen equations, respectively. The model-fitting results reveal that the theoretically predicted values were in close agreement with the experimental values. Hence, these models were well suited for predicting respective properties. Model prediction also implies that the increase in the aspect ratio of fillers can considerably cause a reduction in water vapor permeability and improvement in mechanical properties. Suitability of developed film as cheese slice separator was evaluated: they had equivalent outcomes in terms of easiness in slice separation and wholeness of slices after separation compared to the commercial material.

Eryngium caeruleum: an update on ethnobotany, phytochemistry and biomedical applications

Background

A biennial or perennial plant of the Apiaceae family, Eryngium caeruleum M. Bieb. is traditionally used in medicine as an antitoxic, diuretic, digestive, anti-inflammatory and analgesic drug. This plant is widely distributed in temperate regions around the world. Young leaves of the plant are used in cooking as aromatic cooked vegetables in various local products in Iran.

Purpose

The current review aimed to highlight complete and updated information about the Eryngium caeruleum species, regarding botanical, ethnopharmacological, phytochemical data, pharmacological mechanisms as well as some nutritional properties. All this scientific evidence supports the use of this species in complementary medicine, thus opening new therapeutic perspectives for the treatment of some diseases.

Methods

The information provided in this updated review is collected from several scientific databases such as PubMed/Medline, ScienceDirect, Mendeley, Scopus, Web of Science and Google Scholar. Ethnopharmacology books and various professional websites were also researched.

Results

The phytochemical composition of the aerial parts and roots of E. caeruleum is represented by the components of essential oil (EO), phenolic compounds, saponins, protein, amino acids, fiber, carbohydrates, and mineral elements. The antioxidant, antimicrobial, antidiabetic, antihypoxic, and anti-inflammatory properties of E. caeruleum have been confirmed by pharmacological experiments with extracts using in vitro and in vivo methods. The syrup E. caeruleum relieved dysmenorrhea as effectively as Ibuprofen in the blinded, randomized, placebo-controlled clinical study.

Conclusion

Current evidence from experimental pharmacological studies has shown that the different bioactive compounds present in the species E. caeruleum have multiple beneficial effects on human health, being potentially active in the treatment of many diseases. Thus, the traditional uses of this species are supported based on evidence. In future, translational and human clinical studies are necessary to establish effective therapeutic doses in humans.

Sustainable Utilization of Textile Dyeing Sludge and Coal Fly Ash by Brick Production Through Traditional Kilns

The fundamental purpose of this study was to evaluate the technical feasibility of incorporating fly ash (FA) and dyeing sludge (DS) in the production of brick. An attempt was taken to replace 10% to 100% clay by DS and FA in brick-making by volume. A brick firing kiln was used to burn the uniform-shaped bricks after replacing clay with DS and FA. Size and shape, hardness, soundness, water absorption, efflorescence, dry density, loss of ignition, firing shrinkage, specific gravity, compressive strength, and leaching tests were carried out to study the properties of these bricks. The compressive strength of the brink ranged from 6.25 MPa to 0.33 MPa and indicates a decreasing pattern in strength with the increase in the volume of DS and FA. Only 18.8% water absorption capacity was found in control bricks without DS and FA, while a maximum absorption of 40.19% was found for a particular combination of DS and FA. Similarly, dry density decreased with the increase in the volume of DS and FA. Besides, efflorescence in bricks was found within the allowable limits for certain combinations of DS and FA, which exceeded the allowable limits for other combinations. The presence of heavy metals (Ni, Zn, Cr, Cu, and Pb) in the extraction solution was insignificant. Based on the results of this study, we recommend that up to 10% clay can be substituted with DS and FA without substantially affecting the quality of bricks.

Potential mechanisms of quercetin in cancer prevention: focus on cellular and molecular targets

Over the past few years, the cancer-related disease has had a high mortality rate and incidence worldwide, despite clinical advances in cancer treatment. The drugs used for cancer therapy, have high side effects in addition to the high cost. Subsequently, to reduce these side effects, many studies have suggested the use of natural bioactive compounds. Among these, which have recently attracted the attention of many researchers, quercetin has such properties. Quercetin, a plant flavonoid found in fresh fruits, vegetables and citrus fruits, has anti-cancer properties by inhibiting tumor proliferation, invasion, and tumor metastasis. Several studies have demonstrated the anti-cancer mechanism of quercetin, and these mechanisms are controlled through several signalling pathways within the cancer cell. Pathways involved in this process include apoptotic, p53, NF-κB, MAPK, JAK/STAT, PI3K/AKT, and Wnt/β-catenin pathways. In addition to regulating these pathways, quercetin controls the activity of oncogenic and tumor suppressor ncRNAs. Therefore, in this comprehensive review, we summarized the regulation of these signalling pathways by quercetin. The modulatory role of quercetin in the expression of various miRNAs has also been discussed. Understanding the basic anti-cancer mechanisms of these herbal compounds can help prevent and manage many types of cancer.

Drying kinetics and quality aspects of bitter gourd (Momordica charantia) dried in a novel cabinet dryer

An attempt was taken to investigate the effect of drying air temperature and slice thickness on the drying kinetics and quality of bitter gourd (Momordica charantia) dried in a novel cabinet dryer (HSTU Fruit and Vegetable Dryer). Fresh bitter gourd was sorted, cleaned, and sliced at 4 mm, 6 mm, and 8 mm thickness. All the samples were blanched in boiling water at 100°C for 3 mins. Then the slices with an initial moisture content of 96.47±0.6% were dried, spreading as a thin layer in the trays of the cabinet dryer using three drying air temperatures of 60, 70, and 80°C until the desired final moisture content (MC) of 4.66±0.4% was obtained. The results indicated that the shortest drying time (2.08 hrs) was required by the sample of 4 mm thickness, which was dried at 80°C to reduce moisture from 96.47±0.6% initial (wet basis, wb) to 4.66±0.4% final moisture (wb). The sample of 8 mm thickness dried at 60°C took the longest drying time (6.67 hrs). The higher drying rate (34.32 gm H2O/min.cm2 ) was noticed at a constant drying rate period in the case of a 6 mm thick slice at 70°C. Whereas a lower drying rate (9.29 gm H2O/min.cm2 ) was observed for drying 8 mm slices using 60°C air temperature. Even though, the effect of blanching on drying characteristics of bitter gourd was not noticed so much, the drying rate was found to be increased slightly of pretreated bitter gourd thus drying time was shorter. A comparison on colour analysis of both fresh and blanched bitter gourd showed that a 6 mm slice dried at 70°C was found better in retaining green colour than other samples. The rehydration ratio (6.63±0.62) and the percentage of water uptake (86.75±0.58) of rehydrated pretreated bitter gourd were also higher in a dried sample of 6 mm. Therefore, pretreated bitter gourd is suggested to dry quickly using 70oC in a cabinet dryer slicing at 6 mm thickness to obtain a better quality dried product.

Current trends in the development of soy-based foods containing probiotics and paving the path for soy-synbiotics

In the world of highly processed foods, special attention is drawn to the nutrient composition and safety of consumed food products. Foods fortified with probiotic bacteria confer beneficial effects on human health and are categorized as functional foods. The salubrious activities of probiotics include the synthesis of vital bioactives, prevention of inflammatory diseases, anticancerous, hypocholesterolemic, and antidiarrheal effects. Soy foods are exemplary delivery vehicles for probiotics and prebiotics and there are diverse strategies to enhance their functionality like employing mixed culture fermentation, engineering probiotics, and incorporating prebiotics in fermented soy foods. High potential is ascribed to the concurrent use of probiotics and prebiotics in one product, termed as "synbiotics," which implicates synergy, in which a prebiotic ingredient particularly favors the growth and activity of a probiotic micro-organism. The insights on emended bioactive profile, metabolic role, and potential health benefits of advanced soy-based probiotic and synbiotic hold a promise which can be profitably implemented to meet consumer needs. This article reviews the available knowledge about strategies to enhance the nutraceutical potential, mechanisms, and health-promoting effects of advanced soy-based probiotics. Traditional fermentation merged with diverse strategies to improve the efficiency and health benefits of probiotics considered vital, are also discussed.

Impacts, Tolerance, Adaptation, and Mitigation of Heat Stress on Wheat under Changing Climates

Heat stress (HS) is one of the major abiotic stresses affecting the production and quality of wheat. Rising temperatures are particularly threatening to wheat production. A detailed overview of morpho-physio-biochemical responses of wheat to HS is critical to identify various tolerance mechanisms and their use in identifying strategies to safeguard wheat production under changing climates. The development of thermotolerant wheat cultivars using conventional or molecular breeding and transgenic approaches is promising. Over the last decade, different omics approaches have revolutionized the way plant breeders and biotechnologists investigate underlying stress tolerance mechanisms and cellular homeostasis. Therefore, developing genomics, transcriptomics, proteomics, and metabolomics data sets and a deeper understanding of HS tolerance mechanisms of different wheat cultivars are needed. The most reliable method to improve plant resilience to HS must include agronomic management strategies, such as the adoption of climate-smart cultivation practices and use of osmoprotectants and cultured soil microbes. However, looking at the complex nature of HS, the adoption of a holistic approach integrating outcomes of breeding, physiological, agronomical, and biotechnological options is required. Our review aims to provide insights concerning morpho-physiological and molecular impacts, tolerance mechanisms, and adaptation strategies of HS in wheat. This review will help scientific communities in the identification, development, and promotion of thermotolerant wheat cultivars and management strategies to minimize negative impacts of HS.

Black soybean (Glycine max (L.) Merr.): paving the way toward new nutraceutical

Black soybean (BS) is a nutritious legume that is high in proteins, essential amino acids, dietary fiber, vitamins, minerals, anthocyanins, phenolic acids, isoflavones, and flavones. Traditional approaches for extracting BS bioactive compounds are commonly employed because they are simple and inexpensive, but they use toxic solvents and have lower yields. As a result, new extraction techniques have been developed, such as microwave, ultrasound, and enzyme-assisted extraction. Modern approaches are less harmful to the environment, are faster, and produce higher yields. The major anthocyanin in the BS seed coat was discovered as cyanidin-3-O-glucoside, accounting for nearly 75% of the total anthocyanins. BS and its seed coat also contains phenolic acids (p-hydroxybenzoic, gallic, vanillin, syringic acid), isoflavones (daidzein, glycitein and genistein), flavones, flavonols, flavanones, and flavanols. Bioactive compounds present in BS exhibit antioxidant, anti-cancerous, anti-diabetic, anti-obesity, anti-inflammatory, cardio and neuroprotective activities. The characterization and biological activity investigation of these bioactive compounds has provided researchers and food manufacturers with valuable information for developing functional food products and nutraceutical ingredients. In this review, the nutritional makeup of BS is reviewed, and the paper seeks to provide an insight of bioactive compound extraction methods as well as bioactive compounds identified by various researchers. The biological activities of BS extracts and their potential applications in food products (noodles), biodegradable films (pH sensitive film), and therapeutic applications (wound healing and anti-inflammation) are also discussed in the study. Therefore, BS have enormous potential for use in developing functional foods and nutraceutical components. This is the first review of its sort to describe and explain various extraction methodologies and characterization of bioactives, as well as their biological activity recorded in diverse works of literature, making it possible for food manufacturers and scientists to get a quick overview.

Malignant Infantile Osteopetrosis with Bone Marrow Involvement

Osteopetrosis (Marble bone disease) is a very rare congenital genetic disease of skeleton, resulting from defective bone resorption, due to functionally defective osteoclast, leading to accumulation of excessive bone mass. Malignant infantile osteopetrosis (MIO) is one of the varieties of osteopetrosis, which is fatal and is diagnosed in early infancy. Malignant infantile osteopetrosis is present with abnormal bone remodeling, hematological abnormities, features of extramedullary hematopoiesis. Radiology is the key of diagnosis. In this case, we present a 5-monthold male infant diagnosed as malignant infantile osteopetrosis, who presented with bronchopneumonia, anemia, thrombocytopenia, hepatosplenomegaly, failure to thrive (FTT).

Onion (Allium cepa L.) peels: A review on bioactive compounds and biomedical activities

Huge quantities of byproducts/wastes generated in onion processing are usually discarded, but they are excellent sources of bioactive compounds and phytochemicals. However, with growing interest in the sustainable use of resources and the circular economy to reduce adverse impacts on the environment, food processing wastes such as onion peel/skin can be extracted and employed as inputs in developing or reformulating nutrient supplements, and pharmacological drugs. This review highlights major bioactive components, especially total phenolics, total flavonoid, quercetin and its derivatives present in onion peel/skin and their therapeutic applications as cardioprotective, neuroprotective, antiobesity, antidiabetic, anticancer and antimicrobial agents. The present review emphasized that onion peel is one of the important agricultural by-products which is rich in bioactive compounds and can be utilized as health promoting ingredient especially in pharmacological and biomedical fields. Thus, with increasing burden of life style disorders/non-communicable diseases, finding suitable natural alternative for their treatment is one major concern of the researchers and onion peel and its extract can be exploited as a prime ingredient.

The effect of extracorporeal shockwave myocardial revascularization therapy to myocardial perfusion and function in indicated CABG-stable angina pectoris patients: case series

OBJECTIVE

Many studies have found a beneficial effect of Extracorporeal Shockwave Myocardial Revascularization (ESMR) therapy for refractory angina patients. However, clinical studies ESMR therapy for indicated coronary artery bypass grafting (CABG)-stable angina pectoris (SAP) patients are limited.

PATIENTS AND METHODS

Four indicated CABG-SAP patients CCS class I-III reviewed in this study. All patients refuse to CABG procedure. Data of myocardial perfusion and function from medical records were collected.

RESULTS

After ESMR therapy, summed rest score was improved in patient 1 from 14 to 8, Patient 2 from 10 to 5, and Patient 3 from 6 to 4. Summed stress score was improved in patient 1 from 31 to 19. Left ventricular ejection fraction was improved in patient 1 at rest from 59 to 67% and stress from 39 to 57%. The global longitudinal strain was improved in patient 1 from -16 to -20.9 and Patient 3 from -14.8 to -18.2. Diastolic dysfunction severity was improved in patient 2 and patient 3 from grade 2 to grade 1.

CONCLUSIONS

In our case series, ESMR therapy for indicated CABG-SAP patients might improve myocardial perfusion and function, especially for patients with a high ischemic burden.

Prevalence and control status of T2DM in Bangladesh: finding from a nationally representative survey

Background

With around 10 million diagnosed patients, Bangladesh remains at the forefront of the global type 2 diabetes mellitus (T2DM) epidemic. A comprehensive understanding of the current T2DM scenario is required to curb the disease burden. In this study, we aimed to identify the prevalence, associated factors, and control status of T2DM in Bangladesh.

Methods

This cross-sectional survey was conducted in 15 randomly selected community-based clusters in Bangladesh. Around 1,000 adults aged ≥18 years from each cluster were selected. Face-to-face interviews, anthropometric measurement, biospecimen collection, and point of care blood test were performed. Individuals with Fasting Blood Sugar (FBS) ≥126 mg/dl or previously diagnosed with T2DM by a qualified health provider were considered T2DM cases. Multivariate logistic regression analysis was performed to identify factors associated with T2DM.

Results

Data of 13,674 individuals were analysed for this study. The overall prevalence of T2DM was 10.0%, among whom 29.2% were undiagnosed. Among previously diagnosed patients, 64.9% had uncontrolled diabetes (FBS≥126 mg/dl). The prevalence of uncontrolled diabetes was higher among elderly, female, and urban participants. Patients with hypertension, high waist-hip ratio and high serum cholesterol had 2.20 times (95% CI: 2.17-2.23, p &lt; 0.001), 3.53 times (95% CI: 3.47-3.59, p &lt; 0.001) and 2.53 times (95% CI: 2.48-2.59, p &lt; 0.001) higher odds of having T2DM, respectively.

Conclusions

One out of every ten adults in Bangladesh had T2DM, and a substantial proportion of them had undiagnosed and uncontrolled diabetes. This finding indicates the lack of preparedness of the country's health system to address the problem. Pertinent stakeholders should adopt a multi-sectoral approach to develop comprehensive policies and implement target-specific interventions, e.g., population-based screening program, primary care based T2DM service, and community mobilisation to combat the T2DM epidemic.

Key messages

As the T2DM burden is high in Bangladesh, policy makers should adopt a collaborative approach to develop and implement effective public health programs for prevention and control of T2DM. As the burden of uncontrolled T2DM is high in Bangladesh, the country’s health system should ensure early diagnosis and provision of quality care at affordable cost for T2DM patients.

Demographic and Clinical Profile of COVID-19 ICU Patients of Bangabandhu Sheikh Mujib Medical University, Bangladesh

Corona viruses are a group of RNA viruses that cause infection in humans and animals. In human Corona viruses cause respiratory tract infections ranging from mild to critical illness. Corona virus disease 2019 (COVID-19) is caused by strain of severe acute respiratory syndrome corona virus 2 (SARS-CoV-2). The disease was first identified in Wuhan city, of China, in December 2019 and since spread all around the world. In Bangladesh first case has been declared by Institute of Epidemiology, Disease Control and Research (IEDCR) in 8th March, 2020 and first death on 18th march in an ICU and by 13th December total 489,178 cases and 7,020 deaths occurred in this country. The main objective of this study was to determine the Demographic and Clinical Profile of COVID-19 ICU patients in Bangladesh. This retrospective descriptive study on clinical profile along with short term treatment outcomes of COVID-19 patients conducted from COVID-19 dedicated Intensive care unit of Bangabandhu Sheikh Mujib Medical University (BSMMU), Bangladesh during July 2020 to November 2020. Total 300 ICU patients was included in this study. The age range of the patients was from 15 to 91 years. The highest percentage of patients about 49.00%, which was 147 patients were belonged to 61-75 years age group. The patients mean age was 62.80 years. Regarding gender distribution, among those 300 patients; 77.00% which is 231 were male and only 23.00% which is 69 were female. Patients admitted with symptoms like, respiratory distress/shortness of breath (100.00%), persistent worsening cough (60.00%), fatigue (55.00%) and fever (40.00%). Patients were also present with sore throat (35.00%), rhinorrhea (30.00%), altered mental status (20.00%), diarrhoea (10.00%) and chest pain (5.00%). Regarding co-morbidities, around half of the patients were suffering from Diabetes (60.22%) and Hypertension (53.44%). Significant amount of patients were also suffering from chronic obstructive pulmonary disease (27.00%) and bronchial asthma (16.78%). Ischemic heart disease was (10.33%), chronic kidney disease (10.89%), hypothyroidism (9.78%) and multiple co-morbidities (15.12%) at the time of admission. Mortality rate in this case were 71.00% and most of the death cases were in between 61 to 75 years of age group (40.00%). After improvement 27.00% patients were transferred to cabin for further management. We could discharge to home directly only 2.00% of patients.

Human Machine Interaction (HMI) in Offshore Drilling - oil rig workers’ opinion about their interaction with machines

Introduction: There are huge numbers of drilling platforms in the world and once the worker on those platforms meet with an accident, the situation could be very serious. The consequence of this could be environmental, economic and in some cases fatal. Middle East, being one of the oil rich regions hence some of the largest operator works here. Companies here own various types of jack up rigs ranging from old generation rigs to the latest cyber-rig. This paper addresses what oil rig workers have to say about their interaction with machines, and how Human Machine Interaction (HMI) in Offshore Drilling can be improved with design. Method: A case study approach was undertaken The analysis in this paper draws on the interviews conducted with two different employees involved in operating the drilling operations conducted in the driller’s cabin of newly designed offshore rigs. A semi-structured approach was adopted, using themes identified through analysis of the preceding. The interviews were transcribed by the research team. Each interview was analyzed thematically with existing system and reported discrepancy Results: The study on Human Machine Interaction (HMI) and Human Factor regarding this has been conducted in the latest generation cyber rigs. There are many aspects of HMI and ergonomics but in this study a special concentration has been given to deal with the ergonomic standpoint and evaluates the drillers console controls.  Conclusions: When comparison is done with the existing machinery, few modifications can be thought of for better human machine interaction. A better human machine interaction system will ensure a more productive environment for the oil-rig workers.

Efficacy and safety of the EMS Swiss LithoClast® Trilogy for PCNL: results of the European multicentre prospective study on behalf of European Section of UroTechnology

Purpose

PCNL requires a lithotrite to efficiently break stones, and some devices include active suction to remove the fragments. We set out to determine the efficacy and safety of the Swiss LithoClast® Trilogy, in a prospective European multicentre evaluation and compared it to published stone clearance rates for Trilogy based on surface area (68.9 mm²/min) and using the 3D calculated stone volume (526.7 mm³/min).

Methods

Ten European centres participated in this prospective non-randomized study of Trilogy for PCNL. Objective measures of stone clearance rate, device malfunction, complications and stone-free rates were assessed. Each surgeon subjectively evaluated ergonomic and device effectiveness, on a 1–10 scale (10 = extremely ergonomic/effective) and compared to their usual lithotrite on a 1–10 scale (10 = extremely effective).

Results

One hundred and fifty seven PCNLs using Trilogy were included (53% male, 47% female; mean age 55 years, range 13–84 years). Mean stone clearance rate was 65.55 mm²/min or 945 mm³/min based on calculated 3D volume. Stone-free rate on fluoroscopy screening at the end of the procedure was 83%. Feedback for suction effectiveness was 9.0 with 9.1 for combination and 9.0 for overall effectiveness compared to lithotrite used previously. Ergonomic score was 8.1, the least satisfactory element. Complications included 13 (8.2%) Clavien–Dindo Grade II and 2 (1.3%) Grade III. Probe breakage was seen in 9 (5.7%), none required using a different lithotrite.

Conclusions

We have demonstrated that Trilogy is highly effective at stone removal. From a user perspective, the device was perceived by surgeons to be highly effective overall and compared to the most commonly used previous lithotrite, with an excellent safety profile.

Guava (Psidium guajava L.) Leaves: Nutritional Composition, Phytochemical Profile, and Health-Promoting Bioactivities

Psidium guajava (L.) belongs to the Myrtaceae family and it is an important fruit in tropical areas like India, Indonesia, Pakistan, Bangladesh, and South America. The leaves of the guava plant have been studied for their health benefits which are attributed to their plethora of phytochemicals, such as quercetin, avicularin, apigenin, guaijaverin, kaempferol, hyperin, myricetin, gallic acid, catechin, epicatechin, chlorogenic acid, epigallocatechin gallate, and caffeic acid. Extracts from guava leaves (GLs) have been studied for their biological activities, including anticancer, antidiabetic, antioxidant, antidiarrheal, antimicrobial, lipid-lowering, and hepatoprotection activities. In the present review, we comprehensively present the nutritional profile and phytochemical profile of GLs. Further, various bioactivities of the GL extracts are also discussed critically. Considering the phytochemical profile and beneficial effects of GLs, they can potentially be used as an ingredient in the development of functional foods and pharmaceuticals. More detailed clinical trials need to be conducted to establish the efficacy of the GL extracts.

Pandemic Now and Then: A Historical Perspective of Non-Pharmaceutical Interventions Adopted In Covid-19

The coronavirus disease 2019 (COVID-19), first reported in Wuhan, China is now a major global health threat - a pandemic. Public health control measures are the cornerstones in the fight against COVID-19 in the absence of an effective vaccine or proven treatment. The aim of this review was to explore the historical use case of various public health measures adopted today to tackle COVID-19 spread. Although our knowledge about this novel coronavirus transmission is evolving over time, the fundamental non-pharmaceutical interventions e.g., handwashing, wearing a mask, physical distancing, isolation, quarantine and border control which are adopted globally at present are not new. This review highlighted that historically and religiously similar approaches were practised in the medieval past for controlling disease outbreaks. The successful implementation of the public health control measures largely depends on health systems resilience, community engagement and changes in population behaviour. Combined global efforts are essential to strengthen health systems, improve the capability of research and transparent information sharing with both public and international bodies to combat the pandemic.

Clinical evaluation of chemo-sterilization through histomorphology and hormonal changes in bucks

The study was aimed to evaluate methods for nonsurgical castration of Black Bengal bucks by intra-testicular injection of calcium chloride, sodium chloride, citric acid solutions or sterile deionized water. Twelve healthy bucks were randomly allotted to groups A, B, C, and D, consisting of three bucks each. The local anesthetic, 2% lidocaine hydrochloride, was infused into the spermatic cord of each buck, followed by bilateral intra-testicular injections of 30% calcium chloride (CaCl2), 25% sodium chloride (NaCl), 50% citric acid (C6H8O7) solutions, and sterile deionized water dosed at 2 ml per testis in groups A, B, C and D respectively. To evaluate the efficacy of chemical agents on the inactivation of testes, clinical parameters, changes in scrotal circumference, testicular fine needle aspiration (TFNA), histopathology and serum concentration of testosterone and LH were monitored. A significant decrease in the scrotal circumference was observed between the intra-testicular injection and day 14 in all the bucks. Absence of spermatogenic cells and spermatozoa in the testicular biopsy was observed on day 14 post injection in the bucks, except for one in group C. Histopathology revealed massive destruction of seminiferous tubules and disorganization of the testicular parenchyma. Serum testosterone concentration declined significantly on day 14 compared with day 0. Consequently, the gradual elevation in serum LH concentration was significant. Thus, intra-testicular injections of CaCl2 and NaCl were more effective than C6H8O7 in inducing chemical-based nonsurgical castration.

Mango (Mangifera indica L.) Leaves: Nutritional Composition, Phytochemical Profile, and Health-Promoting Bioactivities

Mangifera indica L. belongs to the family of Anacardiaceae and is an important fruit from South and Southeast Asia. India, China, Thailand, Indonesia, Pakistan, Mexico, Brazil, Bangladesh, Nigeria, and the Philippines are among the top mango producer countries. Leaves of the mango plant have been studied for their health benefits, which are attributed to a plethora of phytochemicals such as mangiferin, followed by phenolic acids, benzophenones, and other antioxidants such as flavonoids, ascorbic acid, carotenoids, and tocopherols. The extracts from mango leaves (MLs) have been studied for their biological activities, including anti-cancer, anti-diabetic, anti-oxidant, anti-microbial, anti-obesity, lipid-lowering, hepato-protection, and anti-diarrheal. In the present review, we have elaborated on the nutritional and phytochemical profile of the MLs. Further, various bioactivities of the ML extracts are also critically discussed. Considering the phytochemical profile and beneficial effects of the MLs, they can be used as a potential ingredient for the development of functional foods and pharmaceutical drugs. However, more detailed clinical trials still needed to be conducted for establishing the actual efficacy of the ML extracts.

Isolation and molecular identification of Lumpy Skin Disease (LSD) virus from infected cattle in Bangladesh

Lumpy Skin Disease (LSD) is a new disease of cattle in Bangladesh. It is endemic in Africa but through the last few years disease beings to spread to other countries of the world. The disease was widely spreaded in the many other countries in Asia and some parts of Europe. In Bangladesh, the disease was first time detected in April 2019, in southern part and then continued to spread all over the country.The disease caused enormous economic losses causing cutaneous and internal lesions, affecting milk production, hide quality and in some cases death of infected animal. LSD suspected samples were collected from different areas of the country during the period from July 2019 to January 2020. In this study, a total of 36 clinically suspected LSD samples of skin crustnodules, pus and ocular discharge were collected. Samples were examined by the published PCR protocol for LSD virus, GPV and SPV. Around 78% samples were found positive for LSD virus in PCR test. LSD virus was also identified from pus and ocular discharge of infected cattle. The virus can grow in the lamb testicular cell and clinically the disease is characterized by distinctive nodular lesions mostly on the skin of the affected animals.The results indicated that the LSD virus is circulating in the outbreak are as and is an emerging transboundary cattle disease in Bangladesh. Bang. J. Livs. Res. Vol. 26 (1&2), 2019: P. 15-20

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

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

A257 NEW ONSET ULCERATIVE COLITIS IN A PATIENT WITH KNOWN AUTOIMMUNE HEPATITIS TYPE 1

Background

Elevated transaminases can occur in up to 17 per cent of cases of Inflammatory Bowel Disease (IBD)1, with many cases related to concurrent autoimmune conditions of the liver. Primary Sclerosing Cholangitis (PSC) is the most common autoimmune disease of the liver that is associated with IBD. Other causes of liver inflammation in patients with IBD can include Autoimmune Hepatitis (AIH).

Aims

We aim to report a case of new onset ulcerative colitis in a patient with autoimmune hepatitis type 1 in the absence of concomitant PSC.

Methods

Case report and review of literature.

Results

A 25-year-old male with painless jaundice and was found to have Autoimmune hepatitis type 1 with typical morphological changes, positive Antinuclear antibodies and elevated IgG levels. Histopathological exam of the liver did not show any direct changes to the bile ducts to suggest PSC. The patient was started on steroids and Mycophenolate Mofetil (MMF) and developed new onset diarrhea. Colonoscopy was performed and both endoscopic and pathological findings were suggestive of likely inflammatory bowel disease, although drug induced colitis (MMF) could not be excluded.

Conclusions

We conclude that there is a link between autoimmune hepatitis with IBD, in absence of concomitant PSC.

Funding Agencies

None