Common Pitfall in Post Operative Fluid and Electrolyte Management: A Retrospective Study in Two Tertiary Centers in Bangladesh

Evaluation of our practice and recommend an appropriate fluid regime to maintain the fluid and electrolyte balance in the post operative period. The drug chart and clinical notes were retrospectively analysed manually of 758 patients who underwent surgery from January 2020 to January 2022 in Enam Medical College Hospital and Ibnsina Medical College Hospital, Dhaka, Bangladesh were reviewed by 3 individual clinicians and the obtained data were analysed. Total 407 patients met the inclusion criteria for the study. Fifty seven (57) patients underwent emergency operation and 350 patients had elective surgery. The average fluid replacement was 2.5 L/day, average Sodium- 154 mmol/day, average potassium 2.0 mmol/day and average glucose 125 mmol/day. Post operatively 97 patients developed hypokalemia. Among them 25 patients developed severe hypokalemia. A simple pathway for prescribing post operative fluid and electrolyte was proposed so that patients during 1st post operative day requiring maintenance fluid will have 25-30 ml/kg/day of water, approximately 1-2 mmol/kg/day Sodium and chloride, 1 mmol/kg/day of potassium and approximately 50-100 gm/day of glucose.

Characterization of Three Fusarium spp. Causing Wilt Disease of Cannabis sativa L. in Korea

In July 2021, wilting symptoms were observed in adult and seedling hemp (Cannabis sativa L. cv. Cherry Blossom) plants grown in a greenhouse. As the disease progressed, yellowing and wilting symptoms on the leaves developed, resulting in whole plant death. In seedling plants, typical damping-off symptoms were observed. To identify the pathogen, the roots of diseased plants were sampled, surface sterilized, and cultured on potato dextrose agar (PDA) media. From the culture, 4 different fungal isolates were recovered and purely cultured. Each fungal isolate showed distinct growth shapes and color development on malt extract agar, oatmeal agar, sabouraud dextrose agar, and PDA media. Microscopic observation and molecular identification using ribosomal DNA internal transcribed spacer sequencing identified them as 3 Fusarium spp. and 1 Thielaviopsis paradoxa. Additional sequencing of elongation factor 1-alpha and β-tubulin regions of 3 Fusarium spp. revealed that 2 of them are Fusarium solani, and the other one is Fusarium proliferatum. To examine which isolate can act as a causal agent of wilt disease of hemp, each isolate was tested for their pathogenicity. In the pathogenicity test, F. solani AMCF1 and AMCF2, and F. proliferatum AMCF3, but not T. paradoxa AMCF4, were able to cause wilting disease in hemp seedlings. Therefore, we report that F. solani AMCF1 and AMCF2, and F. proliferatum AMCF3 as causal agents of Fusarium wilt of hemp plants. To our knowledge, this is the first report of the wilt disease of C. sativa L. caused by Fusarium spp. in Korea.

Post-Operative Severe Hyperbilirubinemia: A Case Report

Hyperbilirubinemia is commonly seen in medical practice. But what could be the highest level of bilirubin in an individual that is still an unanswered question. We came across to a 37 years old lady in October 2018 with hepaticolithiasis who underwent extended choledocholithotomy. Her preoperative serum bilirubin was within normal range. Post-operatively she developed cholangitis and from 3rd post-operative day onwards she developed severe hyperbilirubinemia, which was high as 70.47 mg/dl on the 6th post-operative day. Other causes of post-operative hyperbilirubinemia were excluded. She was managed conservatively for this hyperbilirubinemia and bilirubin level gradually reduced.

Biocontrol Activity of Aspergillus terreus ANU-301 against Two Distinct Plant Diseases, Tomato Fusarium Wilt and Potato Soft Rot

To screen antagonistic fungi against plant pathogens, dual culture assay (DCA) and culture filtrate assay (CFA) were performed with unknown soil-born fungi. Among the different fungi isolated and screened from the soil, fungal isolate ANU-301 successfully inhibited growth of different plant pathogenic fungi, Colletotrichum acutatum, Alternaria alternata, and Fusarium oxysporum, in DCA and CFA. Morphological characteristics and rDNA internal transcribed spacer sequence analysis identified ANU-301 as Aspergillus terreus. Inoculation of tomato plants with Fusarium oxysporum f. sp. lycopersici (FOL) induced severe wilting symptom; however, co-inoculation with ANU-301 significantly enhanced resistance of tomato plants against FOL. In addition, culture filtrate (CF) of ANU-301 not only showed bacterial growth inhibition activity against Dickeya chrysanthemi (Dc), but also demonstrated protective effect in potato tuber against soft rot disease. Gas chromatography-tandem mass spectrometry analysis of CF of ANU-301 identified 2,4-bis(1-methyl-1-phenylethyl)-phenol (MPP) as the most abundant compound. MPP inhibited growth of Dc, but not of FOL, in a dose-dependent manner, and protected potato tuber from the soft rot disease induced by Dc. In conclusion, Aspergillus terreus ANU-301 could be used and further tested as a potential biological control agent.

A Rare Case of Insulinoma: A Case Report

Insulinoma is a rare variety of endocrine neoplasm and is usually benign, solitary, and small in size. The hallmark of this disorder is high endogenous insulin secretion resulting in development of symptoms of hypoglycemia. Insulinomas account for 60% of islet cell tumors (ICT) of the pancreas. Ninety percent (90%) of the insulinomas measure less than 2cm. Early localization of the disease is essential to prevent lethal hypoglycemia. Here we report a case of insulinoma in a 28 year old female who subsequently underwent distal pancreatectomy with splenectomy on February 2017 in Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh.

Acetic acid: a cost-effective agent for mitigation of seawater-induced salt toxicity in mung bean

The current study sought the effective mitigation measure of seawater-induced damage to mung bean plants by exploring the potential roles of acetic acid (AA). Principal component analysis (PCA) revealed that foliar application of AA under control conditions improved mung bean growth, which was interlinked to enhanced levels of photosynthetic rate and pigments, improved water status and increased uptake of K+, in comparison with water-sprayed control. Mung bean plants exposed to salinity exhibited reduced growth and biomass production, which was emphatically correlated with increased accumulations of Na+, reactive oxygen species and malondialdehyde, and impaired photosynthesis, as evidenced by PCA and heatmap clustering. AA supplementation ameliorated the toxic effects of seawater, and improved the growth performance of salinity-exposed mung bean. AA potentiated several physio-biochemical mechanisms that were connected to increased uptake of Ca2+ and Mg2+, reduced accumulation of toxic Na+, improved water use efficiency, enhanced accumulations of proline, total free amino acids and soluble sugars, increased catalase activity, and heightened levels of phenolics and flavonoids. Collectively, our results provided new insights into AA-mediated protective mechanisms against salinity in mung bean, thereby proposing AA as a potential and cost-effective chemical for the management of salt-induced toxicity in mung bean, and perhaps in other cash crops.