Chest Radiography in the Evaluation of Mitral Valvular Disease and it's Correlation with Echocardiography

This study is aimed to find out various clinical, radio-graphical and echocardiographic variables to predict mitral valvular disease and their correlation with Echocardiography. This cross-sectional observational study was conducted in the Department of Radiology and Imaging, in collaboration with Department of Cardiology, Mymensingh Medical College Hospital (MMCH), Mymensingh, Bangladesh from January 2017 to December 2018. Total 50 consecutive cases enrolled in this study who was the patients of mitral valvular disease. Both chest radiograph and echocardiograph were done for each patient. There were 76% female and 26% male with a female-male ratio 3.16:1 with mean±SD (41.54±12.44). About 42% patients had previous history of rheumatic fever. The most common x-ray findings of heart were increased central density (90%) followed by enlargement in transverse diameter (88%), straightening of the left border (88%), widening of the carina (86%), full pulmonary conus (84%) and double contour of right border (76%). About 47(94%) patients confirmed mitral valvular heart disease on echocardiography. The prominent findings included left atrium was predominantly severely dilated (50%), severely reduced mitral valve orifice area (68%), mild mitral regurgitation (46%) and mild pulmonary hypertension (38%). And overall sensitivity, specificity, PPV, NPV and accuracy of chest radiograph in the detection of mitral valvular heart disease were 85.11%, 66.67%, 97.56%, 14.89% and 84%, respectively. These findings suggest that chest radiograph could be used as an adjunct tool with echocardiography.

Formulation and quality evaluation of instant mango drink powder

The study was conducted to develop a healthy instant mango drink powder and to compare its nutritional facts with commercially available mango drink powder. For this purpose, ripe Amropali mangoes were collected from a local source. After drying the mango pulp in a cabinet dryer, three formulations were prepared to compare with a locally available commercial brand mango drink powder. In this study, moisture, ash, protein, fat, carbohydrate, and energy contents were ranged from 0.2 to 4.6%, 0.4 to 2.6%, 0.7 to 2.2%, 0.6 to 0.9%, 89.5 to 97.8% and 375.4 to 400.5 kcal/100 g, respectively. The crude fiber was not found in any of the instant mango drink powder. Among the bioactive compounds, the flavonoid content in the commercial brand was higher than other formulated mango drink powder. In contrast, total anthocyanin content and total phenolic content values of all formulated instant mango drinks were higher than the commercial brand. Potassium, Magnesium, Chloride, Phosphorus, and Vitamin C were higher in formulated powder than the commercial preparation, but sodium, calcium, and iron contents were higher in the commercial mango drink powder. Antioxidant capacity was also found to be significantly higher in our formulated powder than that of commercial preparation. From the sensory and microbiological point of view, our formulated instant mango drink powder exhibited significant acceptability and stability. So, the formulated instant mango drink powder appears to be nutritionally and tastefully as acceptable as commercially available instant mango drink powders and able to meet day-to-day nutritional requirements as a supplement.

Magnetic Resonance Imaging of Cerebral Palsy in the Assessment of Time of Brain Insult

The aim of this cross-sectional study was to find out the role of Magnetic resonance imaging (MRI) in the assessment of time of brain insult in cerebral palsy (CP). The study was conducted in the Department of Radiology & Imaging, Mymensingh Medical College Hospital, Mymensingh and a total number of 35 patients with were enrolled from January 2015 to December 2016. Maximum patients (57.2%) were under five years followed by 34.3% were of 5 to <8 years and 8.7% were of 8 to <12 years of age and mean age was 4.7 years. Majority of the patients were male 28(80%) and female were 7(20%). Among the patients 23(65.7%) came from poor, whereas 11(31.4%) came from middle class and only one (2.9%) from rich socioeconomic group. According to gestational age of the patients, 26(74.3%) were term (≥37weeks) at delivery and rest (25.7%) were preterm (<37 weeks). Delayed cry after birth were present in 32 (80%) patients. Regarding types of cerebral palsy spastic diplegia, spastic quadriplegia, hemiplegia and extrapyramidal were found 3(8.6%), 25(71.4%), 4(11.4%) and 3(8.6%) respectively. Abnormal MRI was reported in 94.2% patients and gave clues to time of insult in 79.9% (excluding the 14.3% miscellaneous findings). The findings were mal-developments (5.7%), periventricular white matter lesions (25.7%), cortical or deep grey matter lesions (48.6%), miscellaneous (14.3%) and normal (5.7%). Brain mal-developments were more seen in term than in preterm born children (5% vs. 0%). Periventricular white matter lesions were seen significantly more in preterm than in term born children (77.8% vs. 3.9%). Cortical or deep grey matter lesions occurred significantly more in term than in preterm born children (60% vs. 20%). Based on the study it can be concluded that Magnetic Resonance Imaging (MRI) can help in the assessment of time of insult to the developing brain in cerebral palsy (CP).

Comparison of PCR, isoenzyme analysis, and antigen detection for diagnosis of Entamoeba histolytica infection

The diagnosis of amebiasis by microscopic identification of the parasite in stool is insensitive and unable to distinguish the invasive parasite Entamoeba histolytica from the commensal parasite E. dispar. In this study, we have tested a PCR technique for the detection of E. histolytica and compared it with isoenzyme analysis and the TechLab E. histolytica-specific antigen detection test. The nested-PCR test we used is based on amplification of the small subunit rRNA gene of E. histolytica and E. dispar followed by restriction digest analysis of the PCR product. Single stool samples were obtained from 98 patients from Dhaka, Bangladesh, with diarrhea: 88 patients diagnosed by microscopy and/or culture with E. histolytica and/or E. dispar infection and 10 patients without infection. Isoenzyme analysis identified 53 of the infections as E. histolytica and 28 as E. dispar. PCR and isoenzyme identification of E. histolytica agreed in 96% (51 of 53) of amebic cultures. PCR for E. histolytica was negative in all 10 samples that were negative for E. histolytica by isoenzyme and antigen detection. PCR and antigen detection had comparable sensitivities when performed directly on fresh stool specimens, identifying 87% (46 of 53) and 85% (45 of 53), respectively, of E. histolytica infections identified by isoenzyme analysis. The correlation of results by antigen detection and PCR for identification of E. histolytica in stool was 93% (45 of 48 cases). Mixed infections with E. histolytica and E. dispar were detected by PCR in 14% (12 of 88) of cases. In conclusion, all three techniques for specific identification of E. histolytica in fresh stool showed excellent correlation. Only the TechLab E. histolytica antigen detection test was both rapid and technically simple.