Biogenic iron oxide nanoparticles enhance callogenesis and regeneration pattern of recalcitrant Cicer arietinum L

This study is the first report on the biosynthesized iron oxide nanoparticles (IONPs) which mediate in-vitro callus induction and shoot regeneration in economically important recalcitrant chickpea crop (Cicer arietinum L.). Here, we used leaf extract of Cymbopogon jwarancusa for the synthesis of IONPs in order to achieve a better biocompatibility. The bioactive compounds in C. jwarancusa leaf extract served as both reducing and capping agents in the fabrication process of IONPs. Field emission scanning electron microscopy (FE-SEM) revealed rods like surface morphology of IONPs with an average diameter of 50±0.2 nm. Energy-dispersive X-ray spectroscopy (EDS) depicted formation of pure IONPs with 69.84% Fe and 30.16% O2. X-ray diffractometry (XRD) and attenuated total reflectance-fourier transform infrared (ATR-FTIR) validate the crystalline structure, chemical analysis detect the presence of various biomolecular fingerprints in the as synthesized IONPs. UV-visible absorption spectroscopy depicts activity of IONPs under visible light. Thermo-gravimetric analysis (TGA) displayed thermal loss of organic capping around 500°C and confirmed their stabilization. The biosynthesized IONPs revealed promising results in callus induction, shoot regeneration and root induction of chickpea plants. Both chickpea varieties Punjab-Noor 09 and Bittle-98 explants, Embryo axes (EA) and Embryo axes plus adjacent part of cotyledon (EXC) demonstrated dose-dependent response. Among all explants, EXC of Punjab-Noor variety showed the highest callogenesis (96%) and shoot regeneration frequency (88%), while root induction frequency was also increased to 83%. Iron content was quantified in regenerated chickpea varieties through inductively coupled plasma-optical emission spectrometry. The quantity of iron is significantly increased in Punjab-Noor regenerated plants (4.88 mg/g) as compare to control treated plants (2.42 mg/g). We found that IONPs enhance chickpea growth pattern and keep regenerated plantlets infection free by providing an optimum environment for rapid growth and development. Thus, IONPs synthesized through green process can be utilized in tissue culture studies in other important recalcitrant legumes crops.

Green fabricated zinc oxide nanoformulated media enhanced callus induction and regeneration dynamics of Panicum virgatum L

The current study focuses on the usage of bio synthesized zinc oxide nanoparticles to increase the tissue culture efficiency of important forage grass Panicum virgatum. Zinc being a micronutrient enhanced the callogenesis and regeneration efficiency of Panicum virgatum at different concentrations. Here, we synthesized zinc oxide nanoparticles through Cymbopogon citratus leaves extract to evaluate the effect of zinc oxide nanoparticles on plant regeneration ability in switchgrass. X-ray diffraction (XRD) and attenuated total reflectance-Fourier transform infrared (ATR-FTIR) validate phase purity of green synthesize Zinc oxide nanoparticles whereas, electron microscopy (SEM) has illustrated the average size of particle 50±4 nm with hexagonal rod like shape. Energy dispersive spectroscopy X-ray (EDS) depicted major peaks of Zn (92.68%) while minor peaks refer to Oxygen (7.32%). ZnO-NPs demonstrated the incredibly promising results against callogenesis. Biosynthesized ZnO-NPs at optimum concentration showed very promising effect on plant regeneration ability. Both the explants, seeds and nodes showed dose dependent response and upon high doses exceeding 40 mg/L the results were recorded negative, whereas at 30 mg/L both explants demonstrated 70% and 76% regeneration frequency. The results conclude that ZnO-NPs enhance the plant growth and development and tailored the nutritive properties at nano-scale. Furthermore, eco-friendly approach of ZnO-NPs synthesis is strongly believed to improve in vitro regeneration frequencies in several other monocot plants.

Outcome of Operative Management of Lumbar Spinal Canal Stenosis at Mymensingh Medical College & Hospital

Variety of conditions may be responsible for low back pain but lumber spinal canal stenosis is an important cause of low back pain. Lumber spinal canal stenosis usually presents with low backache with neurogenic claudication and shortness of walking distance in adult patient. Surgical management of lumbar spinal canal stenosis by decompression surgery is effective method. This prospective interventional study was performed in patient with clinical features like low back pain with radicular pain, neurogenic claudication, signs of root compression, positive MRI findings attending in department of Orthopaedic Surgery Mymensingh Medical College Hospital and Private Hospital from July 2016 to June 2019. Thirty patients were evaluated among those 20(66.6%) were 50 years and above. The mean age was 47.5±1.6 years. Male to female ratio was roughly 8:1. Almost all of the patients had low backache with radiation to the back of the thigh and leg with motor weakness (60%). About 66.6% of the patients had sensory deficit and 83.3% had neurogenic claudication. Majority (80.0%) of the patients at presentation had a suffering of 12 or >12 months. The mean duration of suffering was 14.7±5.1 months. About 55% of the patients were able to perform heel-walking and 36.0% tip-toe walking. Nearly 57% of the patients had sensory deficit along the distribution of 1st sacral nerve and 53.3% along the distribution of lumber 5 nerves. Diagnosis shows that 16.6% of patients had L4 lesion, 50% L5, 10.0% patients had L4 & L5 and 46.6% S1. Laminectomy was done in 26.6% of patients, laminectomy and disectomy in 33.3% and laminectomy, discectomy & foraminal decompression in 40.0% of patients. Twenty five (83.5%) of patients was free from symptoms. Eighty percent (80.0%) of patients shows minimal disability and 20.0% moderate disability on the basis of Oswestry Disability Index, while by MacNab criteria, most (80%) of patients was excellent, 10% good and another 10% fair. Repeated measure ANOVA statistics showed that mean Oswestry score decreased significantly from 54.5% at baseline to 22% at the end of 1 year (p<0.001).

Effectiveness of Pressurized Normal Saline Irrigation of Subcutaneous Tissue Following Appendicectomy in Decreasing Wound Infection: A Quasi Experimental Study

Acute appendicitis is the commonest cause of acute abdomen necessitating surgical intervention and wound infection is the most frequently encountered complication following appendicectomy. To assess the effectiveness of pressurized normal saline irrigation of subcutaneous tissue following appendicectomy in decreasing wound infection this quasi experimental study was done in Surgery Unit III, Mymensingh Medical College Hospital from January 2018 to December 2018. In this study total 200 patients of acute appendicitis were enrolled according to inclusion and exclusion criteria and assigned equally into two groups by non-equivalent control group design. In control group all the standard protocol of wound closure following appendicectomy was followed and in experimental group along with the standard protocol the subcutaneous tissue was irrigated by pressure with normal saline and all the data were recorded in individual case record form. Among the sample most of the patients were between 10-19 years of ages and the male female ratio was 1.38:1. In control group 30% patients developed wound infection while 12% patients developed wound infection in experimental group with a P value of 0.027. Mean hospital stay of experimental group was less than the control group (P value less than 0.05). Overall postoperative outcome in context of wound infection and hospital stay is better following pressurized normal saline irrigation of subcutaneous tissue during closure.

Epidemiology of electrical injury: findings from a community based national survey in Bangladesh

OBJECTIVES

The objective of this study is to explore the magnitude and pattern of electrical injury in Bangladesh.

METHOD

A national survey was conducted between January and December 2003 in Bangladesh. Nationally representative data were collected from 171,366 rural and urban households comprising a 819,429 population. The survey was conducted at a household level with a structured questionnaire.

RESULTS

The incidence of fatal and non-fatal injury was found to be 1.6 and 73.7 per 100,000 population year respectively. Compared to females, males were found at a higher risk (RR 1.62; 95% CI 1.37-1.91) and rural people found more vulnerable compared to urban people (RR 5.97; 95% CI 4.71-7.57). The home was found as the most common place for electrical injury, with more than 50% of injury taking place at home. The household source of electricity was found as the most common source of electrical injury. Lightning was also found as major source for electrical injury which constituted more than 25% of the injuries cause by electrical current. More than 80% of electrical injuries occurred between 6a.m. and 6p.m.

CONCLUSION

Electrical injury is an emerging cause of mortality and morbidity in both urban and rural areas of Bangladesh. Males and rural people were the more vulnerable group for electrical injury compared to women and the urban population. The home is the most common place for injury occurrence.

Consequences of non-fatal electrical injury: findings of community-based national survey in Bangladesh

This study was designed to document the consequences of electrical injury in Bangladesh. A community-based cross-sectional survey was conducted from January to December 2003. Nationally representative data were collected from 171,366 rural and urban households, comprising a total of 819,429 population. Face-to-face interview was chosen as a data collection method. The overall rate of electrical injury was 73.7 per 100,000 population-year. The rate of permanent disability due to electrical injury in Bangladesh was 0.366 per 100,000 population-year. Among the total 604 non-fatal electrical injuries in the survey, 282 (46.7%) had suffered from temporary disabilities for different durations. A total of 172 students were injured from electrical injury and among them 139 (80.8%) missed school for different durations due to their illness. Mean duration of absence from school was 9.72 days (SD±10.98), ranging from 1 to 45 days. Among the working people average duration of work loss was 10.56 days (SD±14.98), ranging from 1 to 90 days. About 39% of the total patients with electrical injury were contributors to their family income. For each family the expenditure for each seriously injured patient due to electrical injury was USD 271. Electrical Injury is a major cause of morbidity in Bangladesh. It is responsible for significant loss of school days and work days and creating serious health and economic hardship for the inflicted families. A nationwide prevention program needs to be developed to address this problem.

Managing burn patients in a fire disaster: Experience from a burn unit in Bangladesh

Although burn disaster is not a frequent event, with urbanisation and industrialisation, burn disaster is becoming an emerging problem in Bangladesh. On 3 June 2010, a fire disaster killed 124 people in Neemtali, Dhaka, Bangladesh. This paper narrates the management of burn patients of this disaster in the burn unit of Dhaka Medical College Hospital. The burn unit managed 192 burn victims of the disaster. Forty-two victims were admitted and 150 of them received primary care at the emergency room and were sent back home. Ten patients among 42 in-patients died. The in-patient mortality was 23.8%. Burn unit in Dhaka Medical College Hospital is the only burn management centre in Bangladesh. Proper planning and coordinated effort by all sectors and persons concerned were the key elements in this successful management.

Burn mortality in Bangladesh: findings of national health and injury survey

OBJECTIVE

The study was designed to explore the epidemiology of burn mortality in Bangladesh.

METHODS

A population-based cross-sectional survey was conducted between January and December 2003. Nationally representative data was collected from 171,366 rural and urban households, comprising of a total population of 819,429.

RESULTS

Overall mortality burn rate was 2.2 per 100,000 populations per year. The rate was higher amongst females. Most of the deaths were accidental in nature, only 5% of deaths were from self-inflected burn. The rate was higher amongst the rural population compared to the urban population. About 90% of the burn incidences were at home with the kitchen the most frequent place at home for burn incidence to occur. A majority, 89%, of the deaths were caused by flame burn. Cooking fire, heating fire and fire from kerosene lamps were the major sources of flames. The majority of burn deaths occurred during winter season.

CONCLUSION

Burn is a considerable cause of death in Bangladesh. Females, rural dwellers and populations of low socioeconomic condition are more vulnerable to burn injury. With simple intervention many of the deaths due to burn can be prevented. Considering the magnitude of the problem it is very important to address it as a public health problem and develop a national burn prevention program.

Non-fatal burn is a major cause of illness: findings from the largest community-based national survey in Bangladesh

OBJECTIVE

To examine the incidence and characteristics of non-fatal burn injury in Bangladesh.

METHODS

A population-based cross-sectional survey was conducted between January and December 2003 in Bangladesh. Nationally representative data were collected from 171 366 rural and urban households, with a total sample size of 819,429.

RESULTS

The incidence of non-fatal burns was 166.3 per 100,000 per year. The rate was higher in females than in males (RR 1.15; 95% CI 1.03 to 1.27). Children less than 5 years of age were at much higher risk of burn injury than those older than 5 years (RR 7.05; 95% CI 6.35 to 7.8). Rural people were at more than three times higher risk of burn. The average number of days absent from school due to burn injury was 21.64 (SD 19.64); the average number of workdays lost was 22.96 (SD 35.94). The average duration of assistance required in daily living activities was 17.26 (SD 20.34) days. The hospitalisation rate was 12.6 per 100,000 population per year. The mean duration of hospital stay was 15.88 (SD 20.47) days. The rate of permanent disability was 2.6 per 100,000 population-years.

CONCLUSION

Burn is a major cause of morbidity, disability, school absence, and workday loss. Young children, females, and rural dwellers are at highest risk. Home is the most risky place for children and females in terms of burn injury risk. To halt this devastating health issue, a national strategy and programme for burn prevention must be developed.

Health seeking behaviour of parents of burned children in Bangladesh is related to family socioeconomics

OBJECTIVE

The study was design to explore the health seeking behaviour of Bangladeshi parents for their children during burn injuries.

METHODS

A population-based cross-sectional survey was conducted between January and December 2003 in Bangladesh. Nationally representative data were collected from 171,366 rural and urban households comprising of a total population of 819,429, including 351,651 children of 0-18 years. Mothers or heads of households were interviewed with a structured questionnaire in obtaining the information.

RESULTS

About sixty percent parents seek health care from unqualified service providers for their children during a childhood burn injury. Educated and the higher income groups parents choose qualified service provider at significantly higher rate compared to illiterate and poor. Higher proportion of parents of urban residence chooses qualified service provider compared to rural. No significant difference of health seeking behaviour of parent in choosing care provider was found in relation to sex of the children.

CONCLUSION

Education, economic condition and place of residence were found as the contributory factors in choosing service provider. Education to the parents can contribute in changes in health seeking behaviour which ultimately contribute in reducing morbidity and mortality from childhood burn injuries. Including parent's education a national burn prevention program needs to be developed to combat the devastating child injury, burn.

Heterotopic sternum transplant in rats: A new model of a vascularized bone marrow transplantation

We introduced the heterotopic vascularized sternum transplant as a more simple and pure alternative to allogeneic hind limb transplantation for the study of bone marrow transplantation. We report the clinical and histopathological manifestations after transplantation of syngeneic and allogeneic sternal grafts with and without immunosuppression with FK-506. Syngeneic grafts maintained normal histology, whereas allografts showed rejection, which was prevented by FK-506. FK-506-treated allografts developed chimerism that was present throughout the observation period. Transplantation of the sternum may be a valuable model to study vascularized bone marrow transplantation and its effects on repopulation of bone marrow of the host, chimerism, and tolerance.

Pseudoaneurysm of the superior mesenteric artery with an arteriovenous fistula after simultaneous kidney-pancreas transplantation

Vascular complications remain a significant source of morbidity after pancreatic transplantation. We describe a pseudoaneurysm of the superior mesenteric artery (SMA) with an arteriovenous fistula (AVF) involving the SMA and the superior mesenteric vein (SMV) discovered and treated surgically in the second week after kidney pancreas transplantation. The patient experienced pain over the graft, and subsequent radionuclide and Doppler ultrasound scan were suggestive of a pseudoaneurysm in the head of the pancreas. Awaiting confirmatory angiography, the patient became hypotensive and after resuscitation, underwent emergency surgery when a pseudoaneurysm was found in the head of the pancreas. After looping the proximal and distal recipient iliac artery and base of the donor Y vascular graft, the AVF was separated and ligated. The SMV was dissected off the pancreatic head and repaired over a tamponading intraluminal Foley catheter. Graft function was preserved. Based on this experience, an AVF with or without a pseudoaneurysm in the pancreas allograft should be corrected as soon it is suspected.

Mirizzi syndrome--a report of 3 cases with a review of the present classifications

We report three cases of Mirizzi syndrome, two with external compression of the common hepatic duct and another with cystobiliary fistula. All patients presented with jaundice. The diagnosis was suggested by ultrasonography and confirmed by endoscopic retrograde cholangiography (ERC). All three had the stones removed surgically, one through a choledochotomy, another through an opening in the gall bladder and the third at the time of subtotal cholecystectomy. We would like to propose a simple classification of Mirizzi syndrome, based on surgical procedures necessary for the correction of the pathological anatomy. If it involves the removal of calculi with some form of cholecystectomy, we consider it as Type I, whereas Type II involves the construction of a hepaticojejunostomy apart from the removal of calculi.

Recurrent pyogenic cholangitis: 'sump syndrome' following choledochoduodenostomy

An uncommon and late complication of side-to-side choledochoduodenostomy (CDD), the 'sump syndrome', developed in a patient 4 years after surgery. Recurrent right upper abdominal pain, fever with chills and rigors and latterly, mild jaundice made her seek repeated hospital admissions which were treated successfully with antibiotics. During the last admission, ultrasonography, endoscopic retrograde cholangiography (ERC), computerized scanning (CT) and hepatic iminodiacetic acid (HIDA) scan using Tc99m confirmed multiple intrahepatic calculi with proximal dilatation, debris in the distal blind segment and delayed excretion through the CDD. At surgery, the choledochoduodenostomy was taken down and a Rouxen-Y hepaticojejunostomy (RHJ) was fashioned after ductal clearance. The closed end of the Roux loop was placed subcutaneously for subsequent percutaneous access for cholangiography and removal of calculi. She is asymptomatic and well 28 months after surgery.

Incidence, timing, and management of biliary tract complications after orthotopic liver transplantation

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Ascarid worms causing recurrent cholangitis in a patient with an obstructing ampullary tumour

This is a report of a 57-year-old Malay lady who presented with recurrent episodes of cholangitis and septicaemia. A dilated biliary tree caused by a stenosing periampullary tumour was found to contain adult round worms. A pancreatico-duodenectomy was performed following biliary decompression. Ascarid worms are a rare cause of cholangitis in malignant biliary obstruction.

Diagnosis and management of blunt pancreatic trauma: a case report with review of the literature

Details of a young logger who sustained a clean prevertebral transection of the pancreas to the left of the superior mesenteric vessels and a crush injury in segments 2 and 3 of the liver are presented. CT scan was not done but ultrasound scan revealed free intraperitoneal fluid and no comment was made about the pancreas. The pancreatic injury was discovered at laparotomy carried out 24 hours after admission and treated by resection.

Multifocal mucus secreting papillary adenocarcinoma of the bile duct causing obstructive jaundice

We present a 64-year-old Malay lady who had undergone a choledochoduodenostomy (CDD) two years ago for obstructive jaundice. She was admitted with jaundice and underwent ultrasonography, percutaneous transhepatic cholangiography (PTC), endoscopic retrograde cholangio pancreatography (ERCP) and computed tomographic (CT) scanning of the liver and biliary tree. All the investigations confirmed a type IVa choledochal cyst. At operation, the grossly dilated biliary system was packed with a thick mucoid material and the mucosa of the bile ducts was visibly abnormal with scattered nodules. This mucoid material had caused occlusion of the entire biliary tree resulting in obstructive jaundice. To the best of our knowledge, this is probably the first report of obstructive jaundice caused by thick mucus. The peculiar management problems of this case and the risk of malignant change in choledochal cysts are discussed.

Modified subtotal cholecystectomy: a procedure for the difficult gall bladder

Modified subtotal cholecystectomy involves removal of the gall bladder after circumferential division of the neck. Either the impacted stone or the surgeons finger was used as a guide to identify the neck. The stump cavity in the neck is obliterated with interrupted sutures to prevent recurrent stone formation. Indications for this procedure are obscure anatomy, due either to the severe inflammation in acute cholecystitis or dense adhesions in the small fibrosed gall bladder. The decision to perform modified subtotal cholecystectomy is taken during the operation. Forty three patients (14%) underwent this procedure during the period between August 85 and April 90. Out of 289 cholecystectomies performed seven were emergency and thirty-six were early cholecystectomies. With the increasing trend towards urgent and early cholecystectomy in acute cholecystitis the author has found this to be a safe and definitive procedure.