Recent Progress, Challenges, and Opportunities of Membrane Distillation for Heavy Metals Removal

Water is essential for the presence of life on this earth. However, water contamination due to the presence of heavy/toxic metals is one of the serious environmental issues for living beings. Several methods have been devoted to separating or removing those heavy metals from wastewater. Among them, membrane distillation (MD) has become one of the most attractive approaches due to its higher rejection rate than processes driven by pressure, lower energy consumption than traditional distillation processes. MD has gained significant attention for removing heavy metals than other techniques like ion exchange and adsorption in the last two decades. This review provides insight knowledge to the reader and focuses on how heavy metals impact humans and the environment, sources of heavy metals, current and especially removal methods using the MD method. Moreover, recent studies, challenges, and opportunities on MD membrane modules and heavy metal removal systems are discussed. More importantly, in this review, we have identified the gaps and opportunities that are required for enhancing the MD approach and its practical suitability for heavy metal removals. MD module and system showed high performance, proving their possible applications to remove heavy metal ions in water/wastewater treatment.

Prevalence and Pattern of Dyslipidemia in Diabetes Mellitus Patients Admitted in the Department of Cardiology, Mymensingh Medical College Hospital, Mymensingh, Bangladesh

Patients with Diabetes Mellitus are at high risk of cardiovascular events because of abnormal lipid metabolism. Dyslipidemia is common in patients with Diabetes Mellitus (DM). However; in Bangladesh this issue is not yet properly addressed. The aim of this study is to determine the prevalence and patterns of dyslipidaemia in patients with DM in a divisional city Mymensingh. This cross-sectional study was conducted in randomly selected eligible patients from the indoor registry of the Department of Cardiology, Mymensingh Medical College Hospital (MMCH), Bangladesh from April 2012 to March 2013. A well structured questionnaire and blood investigation for lipid profile and blood sugar were the tools of data collection from 120 randomly selected DM patients registered in the department of cardiology, MMCH. Out of 120 enrolled participants the prevalence of dyslipidemia in DM patients was 86.0%, prevalence of dyslipidemia in males was 88.0% while in females was 85.0% but the difference was not significant (p=0.42). Regarding age group, BMI and duration of DM, there is no significant association exists with dyslipidemia. About half of the studied DM patients have high serum total cholesterol level (50.83%), while 22.5% had low serum HDL-C levels and 35.0% had high serum LDC-C level, most of patients had serum triglyceride levels above normal range (67.5%) and so the common patterns of dyslipidemia in this study were serum triglyceride level followed by total cholesterol. High prevalence of dyslipidemia among diabetes mellitus in Mymensingh city were observed and so the common patterns of dyslipidemia is triglyceride followed by total cholesterol. This study emphasizes the importance of screening of lipid profile as these abnormalities may lead to development of cardiovascular diseases.

Efficacy of Itraconazole in the Prevention of Recurrence of Tinea Versicolor: A Three Year Follow Up

Pityriasis versicolor (PV) also known as tinea versicolor, which is chronic and superficial fungal skin disease caused by Malassezia yeasts. A permanent cure may difficult to achieve and this may explain the long-term nature of the disease. Consequently, a preventive treatment regimen may help to prevent the recurrence of pityriasis versicolor. Whether, the recurrence of tinea versicolor could be prevented by monthly itraconazole treatment regimen after a short course of itraconazole therapy. Open treatment followed by a randomized, single blind placebo control trial. Multi-center trial was characterized by an open, active treatment phase with itraconazole followed by a randomized placebo controlled treatment for prevention of recurrence. A total 200 patients (150 male and 50 female) were included in this study and was given 200mg itraconazole daily for 7 days (treatment phase). Patients in whom tinea versicolor was mycologically cured divided into Group A and Group B. Active open treatment was followed by preventive itraconazole treatment 200mg twice daily in Group A and placebo in Group B monthly for 6 consecutive months. The patients were diagnosed clinically and confirmed by Wood's lamp examination and KOH microscopy. Clinical improvement in 90%, negative Wood's lamp examination in 86.5% and Mycological cure in 85.5% were found at the end of open treatment. The mycological cure, 171 subjects were taken into this study for preventive treatment phase and divided into two groups- Group A & Group B. Preventive treatment was given in Group A and placebo in Group B. After the preventive treatment, the end point (After 6 months), clinical improvement, negative Wood's lamp examination and mycological cure were found in 81(90%), 76(84.4%) and 75(83.3%) in Group A and 44(55%), 41(51.3%) and 42(52.5%) in Group B respectively. In preventive treatment phase, 1 patient in Group A did not complete the study. No patient experienced any serious adverse effects. Prevention of recurrence of Pityriasis versicolor with itraconazole is as effective as treatment.

Serum Albumin Level and In-Hospital Outcome of Patients with First Attack Acute Myocardial Infarction

Acute myocardial infarction (AMI) patients constitute a large proportion of admissions in coronary care unit and their management and risk stratification is of immense importance. A decrease in serum albumin concentration might be associated with an increased risk in the incident of both cardiovascular diseases and worse hospital outcome. We assessed whether serum albumin levels at admission was associated with in-hospital adverse outcome in patients with first attack of acute myocardial infarction (AMI). The aim of the study was to evaluate association of serum albumin level with in-hospital outcome in patients with first attack of acute myocardial infarction. This cross-sectional analytical study was conducted in the department of cardiology in Mymensingh Medical College Hospital, Mymensingh, Bangladesh from March 2017 to February 2018. Total 374 patients of first attack of acute myocardial infarction included considering inclusion and exclusion criteria. The sample population was divided into two groups: Group I (Patients with acute myocardial infarction with serum albumin <3.5gm/dl) and. Group II (Patients with acute myocardial infarction with serum albumin ≥3.5gm/dl). Serum albumin level was measured within 24 hours of admission and the incidence of in-hospital major cardiac outcomes was observed. In this study mean±SD serum albumin level of Group I, Group II were 3.02±0.12gm/dl, 4.48±0.50gm/dl respectively. In Group I patient, 52(59.80%), 7(8.00%), 10(11.50%), developed heart failure, cardiogenic shock, arrhythmias respectively and 8(9.20%) died and in Group II patient 20(7.90%), 7(2.80%), 8(3.20%) developed heart failure, cardiogenic shock, arrhythmias respectively and 4(1.60%) died out of them and all of these outcome were statistically significant. Mean±SD duration of hospital stay of the study population according serum albumin level, in Group I, 5.76±1.83 days, in Group II, 4.40±1.22 days which was statistically significant (p<0.05). In conclusion, patient with first attack of acute myocardial infarction serum albumin level below 3.50gm/dl increased the risk of worse in-hospital outcome.

Living-Donor Liver Transplantation in Hepatitis C Virus Era: A Report of 500 Consecutive Cases in a Single Center

BACKGROUND

Living donor liver transplantation (LDLT) is considered a safe alternative to deceased donor liver transplantation (DDLT). In Egypt, DDLT program is still awaited, making LDLT the only hope for patients with end-stage liver disease, mainly due to chronic hepatitis C virus (HCV) infection. The current study is conducted to evaluate our experience of LDLT and discuss the lessons learned from 500 consecutive cases in HCV area.

METHODS

We reviewed the data of patients who underwent LDLT at Gastrointestinal Surgery Center, Mansoura University during the period between May 2004 and March 2017.

RESULTS

During the study period, 500 cases underwent LDLT at our unit. The median age was 51 years, and most of our cases were males (446, 89.2%) and had HCV infection (453, 90.6%). The median MELD score was 15. Median ICU stay was 5 days, and hospital stay was 22 days. Postoperative morbidities occurred in 220 cases (44%). Early mortality occurred in 69 patients (13.8%), and late mortality occurred in 45 patients (9%). The 1-, 3-, 5-, and 7-year overall survival rates of all cases were 80.9%, 78.2%, 75.7%, and 75%, respectively. Preoperative creatinine, worm ischemia, blood transfusion, ICU stay, postoperative morbidities, and small for size syndrome were independent predictors for overall survival.

CONCLUSIONS

In countries lacking DDLT, LDLT is the only effective alternative. LDLT requires a teamwork to achieve successful outcomes. LDLT should only be performed in centers with the adequate experience to avoid and decrease the hazards related to this procedure.

Structural, spectroscopic, optical, dielectric and mechanical study of pure and l-Proline doped ammonium dihydrogen phosphate single crystals

Single crystals of pure and l-Proline (LP) C5H9NO2 doped ammonium dihydrogen phosphate (ADP) (NH4) H2PO4 were grown by slow evaporation solution technique (SEST) at ambient conditions. Powder X-ray diffraction (PXRD) analysis was carried out to confirm the crystal structure and no additional phase was observed due to doping except a systematic variation in peak intensities. FT-Raman analysis also confirms that there is no additional phase formation due to doping. Fourier transform infrared spectral analysis was done to examine the presence of various functional groups in the grown crystals. UV-VIS-NIR spectroscopic analysis was carried out to see the change in optical transparency of pure ADP and crystals due to LP with different doping concentrations. The high-resolution X-ray diffraction (HRXRD) analysis was carried out to examine the crystalline perfection and observed reasonable changes with LP doping. Second harmonic generation (SHG) efficiency measurement was done to examine the enhancement in the nonlinear optical characteristics of the grown crystals. The dielectric behavior of the samples shows that the dielectric constant decreased with increase the value of frequency. The effect of LP dopant on crystal morphology, mechanical properties of ADP has also been presented in this paper. The above studies reveal the effect of incorporation of LP into the lattice of ADP crystals.

Effect of Mg doping on the growth aspects, crystalline perfection, and optical and thermal properties of congruent LiNbO3single crystals

Mg-doped congruent lithium niobate single crystals were grown by the Czochralski technique. High-quality single crystals were grown using a novel seeding technique in a resistive heating furnace. Analysis of crystalline perfection carried out by a multi-crystal X-ray diffractometer revealed that the grown crystals do not contain any structural grain boundaries but do contain point defects. The transmission characteristics showed an enhancement of band gap with an increase in Mg concentration. Conoscopy patterns revealed that the grown crystals are homogeneous and the incorporation of Mg into the lattice does not affect the optical sign (negative uniaxial) of the crystal. The refractive index measurements carried out using a prism coupler showed an increase in the optical birefringence (Δn), while the refractive index was found to decrease with the increase in doping concentration. Further, thermal conductivity was found to decrease with Mg incorporation in the lattice owing to phonon scattering from the Mg ions and, as a consequence, at high concentrations (>4 mol%) crack formation occurred. However, optimization of growth conditions reveals that a slower pulling rate leads to crack-free lithium niobate crystals even at 6 mol% Mg doping.

Effect of Preoperative Bolus Supplemental Fluid on Postoperative Nausea and Vomiting - A Prospective Study

DOI: http://dx.doi.org/10.3329/jafmc.v8i2.16342 JAFMC Vol.8(2) 2012 pp.16-21

Structural, optical and thermal properties of Zr–Fe co-doped congruent LiNbO3single crystals

Zr–Fe-doped congruent lithium niobate single crystals were grown by the Czochralski technique. The crystal structure and lattice parameter of the grown crystals were assessed by powder X-ray diffraction and the strain developed as a result of doping has been calculated (−1.19 × 10−3) by using the Williamson–Hall relation. The incorporated dopant concentration along with the dopant distribution in the specimen crystal was estimated by X-ray florescence spectrometry. A multi-crystal X-ray diffraction analysis was carried out to identify the crystalline perfection of the sample and revealed that the investigated crystal does not contain any structural grain boundaries but does contain point defects and micrometre size mosaic blocks. Birefringence measurements were carried out using a prism coupler spectrometer and found that the optical birefringence is 0.0822 for 532 nm and 0.705 for 1064 nm. A thermal conductivity (κ) study reveals that the doped sample has a lower κ value than the undoped equivalent.

Crystalline perfection, optical and third harmonic generation analyses of non-linear optical single crystal of L-lysine acetate

The potential organic non-linear optical single crystal of L-lysine acetate has been grown by slow evaporation solution growth technique (SEST) at room temperature. It crystallizes in the monoclinic system with space group of P2(1). The crystalline perfection of the grown single crystal has been examined by high resolution X-ray diffraction analysis (HRXRD). The functional groups of the synthesized compound have been identified by (13)C NMR, (1)H NMR and FTIR analyses. The optical absorption studies show that the crystal is transparent in the entire visible region with a cut-off wavelength of 236 nm. The optical band gap is found to be 5.29 eV. The steady-state PL spectra was recorded for pure L-lysine acetate crystal at room temperature. The third harmonic generation efficiency of the crystal has been evaluated by Z-scan technique and its non-linear optical coefficient has been calculated. Birefringence measurement has been carried out in order to see the optical homogeneity of the grown specimen. Its electrical properties has been assessed by dielectric measurement at different temperatures. The calculated optical band gap is 5.29 eV. Its thermal parameters like thermal diffusivity (α), thermal effusivity (e), thermal conductivity (k) and heat capacity (C(p)) have been determined by photopyroelectric technique. Vickers micro hardness studies were carried out using a Vickers hardness tester equipped with a diamond square indenter. The piezoelectric measurement for L-lysine acetate has been also been carried at ambient condition.

Analysis on structural, SHG efficiency, optical and mechanical properties of KDP single crystals influenced by Glycine doping

Good quality single crystals of potassium dihydrogen orthophosphate (KDP) were grown with different doping concentration of Glycine by conventional solution technique in aqueous solution. X-ray diffraction study has been carried out in order to see the effect of dopant on the structural parameters of KDP. There is no additional phase was observed which was further confirmed by Raman spectroscopic analysis. The second harmonic generation efficiency was measured by using Kurtz powder technique. The relative second harmonic generation (SHG) efficiency of the grown crystals was found to be increased with doping concentration up to 2.5 mol%. Optical transmission study also revealed the same behaviour with enhancement up to 2.5 mol% concentration and later decreased but still higher than pure KDP. The mechanical strength was found to increase with increasing the doping concentration.

Effect of crucible design on crystalline perfection and the enhanced optical properties of benzimidazole single crystals grown by the vertical Bridgman technique

Good quality benzimidazole (BMZ) single crystals were successfully grown by the vertical Bridgman technique (VBT). The unavoidable thermal-induced structural grain boundaries formed in the normal VBT growth of these crystals with low melting point were controlled by using a double-wall ampoule. The grown single crystals were subjected to high-resolution X-ray diffraction to assess their crystallinity. The enhancement of optical properties due to the improvement in crystalline perfection is also reported.

Studies on the effect of polymer coating on solution grown hygroscopic non-linear optical single crystal of L-lysine monohydrochloride

Nonlinear optical single crystals are getting attention because of its enormous applications in the area of fiber optic communication and optical signal processing. In this article, we are reporting the single crystal growth of l-lysine monohydrochloride by slow evaporation solution growth technique, by using double distilled water as the solvent. We found that the grown single crystal is bulk in size and fairly transparent. But after a period of time, due to its hygroscopic nature, the transparency is completely vanished and became opaque. Then we have attempted to coat the poly methyl methacrylate (PMMA) polymer on the surface of l-lysine monohydrochloride (l-LMHCL) single crystal by dip coating method. This polymer coating is giving resistance to hygroscopic nature and also acting as thin protective covering layer without affecting the other properties. Then we have systematically studied the different properties of bare, polymer coated and hygroscopic l-LMCHL single crystals. Its crystalline perfection was examined by high resolution X-ray diffractometer and found major differences in crystalline quality. Its structural and optical behavior was assessed by powder X-ray diffraction, UV-vis and luminescence analyses.

Efficacy and Safety of Hydroquinone, Kojic Acid and Glycolic Acid Combination in the Treatment of Melasma

Background & Methodology: It was an opened clinical trial. The study was carried out from March 2009 to February 2011, in the outpatient department of Dermatology and Venereology, Bangabandhu Sheikh      Mujib Medical University (BSMMU) Dhaka, Bangladesh to evaluate the efficacy and side effects of the combination therapy of hydroquinone(HQ), kojic acid(KA) and glycolic acid(GA) for the treatment of melasma. Patients suffering from melasma were selected as study population. Within the period of data collection, thirty patients of melasma were assigned purposively. The efficacy was evaluated using Melasma Area and Severity Index (MASI) Score. The severity of melasma of each of the four regions (forehead, right malar region, left malar region and chin) are assessed based on three variables, percentage of the total area involved (A), darkness (D) and homogenicity (H).Results:The study showed that majority (30%) of the cases were between 20 to 25 years, majority (77%) of patients were female, (50%) patients were housewives, (50%) were in graduation level of education, (50%) of patients was found as upper class and negative family history was present in majority (80%) of cases. It was seen that highest (93%) number of patients were malar type and 7% were centro-facial type. The study showed the change in MASI Score after treatment with combination therapy (GA 2%, HQ 2% and KA 1%). After 12 weeks of treatment, the average MASI score was decreased by 24.20% indicating mild reduction of the severity of melasma and 18%, 18%, 9% and 55% patients developed side -effects like itching, burning sensation, scaling, and erythema respectively. Conclusion: Combination therapy (GA 2%, HQ 2% and KA 1%) has a few lightening effect on melasma, with no remarkable side effects. Further study should be conducted with large number of sample and longer follow up. DOI: http://dx.doi.org/10.3329/bjms.v11i3.11720 Bangladesh Journal of Medical Science Vol. 11 No. 03 July’12  

Efficacy of Oral Itraconazole in the Treatment of Seborrheic Dermatitis

Background: Seborrheic dermatitis is a common papulosquamous  dermatosis and occurring in 2% to 5% of the  population. The prevalence of seborrheic dermatitis among  HIV-positive and AIDS patients between 34% and 83%. The  anti-inflammatory activity of oral itraconazole and efficacy  on Malessezia suggests that itraconazole capsule will be the  first oral treatment option in future in seborrheic dermatitis.  Unfortunately there is no data base study with the efficacy  of oral itraconazole for the treatment of seborrheic  dermatitis over Bangladeshi people.Objectives: To evaluate the efficacy of itraconazole in the  treatment of Seborrheic dermatitis.Methods: This was an interventional type of study and total  thirty seven patients of seborrheic dermatitis from department  of Dermatology and Venereology, Bangabandhu Sheikh  Mujib Medical University (BSMMU) was enrolled. The study  was carried out for a period of two years from January 2008  to December 2009 and purposive type non-probability  sampling technique was followed in this study.Results: The scoring of seborrhea was 6.33±1.15 before  treatment and 4.33 ±3.21 after treatment, scoring of itching  was 6.66 ±1.49 before treatment and 3.61 ±2.70 after  treatment and scoring of greasy crust was 7.12 ±2.70 before  treatment and 4.00 ±3.16 after treatment. It was observed  that before treatment, erythema was severe in 43.2% cases,  moderate in 51.4% cases and mild type erythema was present  in 5.4% cases. And after treatment, 29.7% had severe type  erythema, no patient had moderate type erythema, only  43.2% had mild type and 27% cases had no erythema at all.  Before treatment, papular eruption was severe in 27% cases,  moderate in 54.1% cases and only 18.9% had mild type  papular eruption. But after treatment, 10.8% had severe  type, 18.9% had moderate, 51.4% had mild and 18.9% had  no papular eruption at all. It was observed that before  treatment, squamation was severe in 37.8% cases and  moderate in 62.2% cases. But after treatment, 18.9% had severe type squamation, 10.8% had moderate, 45.9% had  mild and 24.3% had no squamation. Improvement was  shown in 26(70.27%) cases and 11(29.73%) cases shown  no improvement at all.Conclusion: The study suggests that oral itraconazole has significant efficacy profile for treatment option of seborrheic dermatitis. DOI: http://dx.doi.org/10.3329/jbcps.v29i4.11326 J Bangladesh Coll Phys Surg 2011; 29: 201-206

Optical, elemental and structural analyses of acetoacetanilide single crystals for nonlinear optical applications

Single crystals of acetoacetanilide have been successfully grown by slow evaporation solution growth method at room temperature. The grown crystal belongs to orthorhombic crystal system having the lattice dimensions of a=8.686Å, b=11.104Å, c=19.232Å. Its crystalline perfection was examined by home-made high resolution X-ray diffractometer (HRXRD), and found that that the quality of the specimen is reasonable. The presence of carbon, hydrogen and nitrogen were experimentally determined by elemental analysis and that are in good agreement with the theoretically calculated values. Its laser damage threshold, phase matching and second harmonic generation efficiency were determined by using Nd:YAG laser as a source. Optical behavior of acetoacetanilide was examined by using photoluminescence studies. Its hyerpolarizability and HOMO-LUMO energies were calculated by using density functional theory (DFT).

Unidirectional crystal growth and crystalline perfection ofL-arginine phosphate monohydrate

A large (∼20 mm diameter and 80 mm length) single crystal of L-arginine phosphate monohydrate (LAP) has been grown for the first time by the unidirectional Sankaranarayanan–Ramasamy method in an aqueous medium in a specially designed constant-temperature bath. The crystal structure has been confirmed by powder X-ray diffraction. The crystalline perfection was assessed by high-resolution X-ray diffractometry (HRXRD) which found that the quality of the grown single crystal is quite good. HRXRD studies along different directions show that the crystal contains a low density of edge-type dislocations formed along the growth direction. The thermal stability was assessed using thermogravimetric/differential thermal analysis. The mechanical behaviour was studied using an Omnitech micro-hardness tester. The dielectric studies were carried out over a wide frequency range of 10 Hz to 5 MHz at room temperature. The characterization studies reveal that the grown bulk single crystal of LAP is suitable for device applications.

Efficacy of topical application of Pimecrolimus cream in the treatment of discoid lupus erythematosus

The interventional type of study to assess the efficacy of Pimecrolimus cream in the treatment of patient of localized discoid lupus erythematosus (DLE) was carried out for a period of July 2008 to June 2009. It was observed that before treatment, erythema was severe in 43.2% cases, moderate in 51.4% cases and mild type erythema was present in 5.4% cases. The post- treatment revealed, 29.7% severe type erythema, none evidenced moderate type erythema, only 43.2% had mild type and 27% cases no erythema at all. Before treatment, infiltration was severe in 27% cases, moderate in 54.1% cases and only 18.9% had mild type infiltration. But after treatment, 10.8% had severe type infiltration, 18.9% had moderate, 51.4% had mild and 18.9% had no infiltration at all. Similar response to treatment was noticed with squamation which exhibited a drop from 37.8% to 18.9% in severe cases and from 62.2% to 10.8% in moderate cases. There was a 45.9% mild case and 24.3% had no squamation. The scoring result of photosensitivity, itching, disfigurement evidenced analogously score reduction of 2.0, 3.05 and 3.12 respectively. In conclusion, it was interpreted that score of patients of DLE, before treatment was 6.83 ± 1.30 and after treatment was 3.83 ± 1.18. Unpaired 't' test was found statistically significant (p<0.05) between before and after treatment by drug. Improvement was shown in 26(70.27%) cases and 11(29.73%) cases shown no improvement at all. Marked improvement observed on the 2nd follow up visit at the end of 12 weeks. Response was good in 23(88.46%) cases, fair 2(7.69%) and poor 1(3.85%) cases. The study suggests that pimecrolimus 1% cream has significant efficacy profile for treatment option of cutaneous lupus erythematosus.

Nonspirometric aspects of pulmonary function in subjects with dust industries

Bangladesh is a developing country. Many workers are involved in different industries which are polluted with dust e.g. saw mill, rice mill, jarda factory etc. The present study may give a preliminary idea about the lung function status of those workers. The study has been designed to analyze the lung function status of those workers by measuring TCO2 aiming to recommend necessary steps to improved the quality of life of workers of dust industry in our socioeconomic context. This study was to evaluate pulmonary functional status of those workers who are exposed to dust in industries like saw mill 26.00 mmol/l, rice mill 31.10 mmol/l and jarda factory 22.11 mmol/l. In all groups p values were >0.1 which was not significant except jarda factory worker in which p value was <0.001 and it was highly significant. This study was carried out to increase the awareness of the workers and to reduce the cost of employment.

Minor criteria for atopic dermatitis in children

Atopic dermatitis (AD) is a common pruritic, eczematous skin disorder that runs a chronic and relapsing course. Major and minor criteria exist as guideline for arriving at a diagnosis of AD. Minor features vary with ethnicity and genetic background and can be used to aid diagnosis. A descriptive study was conducted including 210 patients of 1-12 years age who had concurrent or past history of AD according to criteria of Hanifin and Rajka. This study was conducted in the department of Dermatology of three different Hospitals of Bangladesh. Out of 33 sub-criteria of Hanifin and Rajka, 20 of which were examined encompassed tendency towards cutaneous infection, environmental factor, high IgE level, intolerance of wool, xerosis, infra-orbital fold, ichthyosis, early age of onset, itch on sweating, palmer hyperlinearity, food hypersensitivity, keratosis pilaris, pityriasis alba, facial erythema, cheilitis, hand eczema, foot eczema, intolerance of lipid solvent, scalp scaling and infra-auricular fissure. Out of 20 examined minor criteria, most common was cutaneous infection in 168(80.0%) patients followed by coursed influenced by environmental factor in 140(66.7%), high IgE level in 126(60.0%), intolerance of wool in 105(50.0%), xerosis in 92(43.8%), infra-orbital fold in 83(39.5%), ichthyosis in 72(34.3%), early age of onset in 65(31.0%), itch on sweating in 56(26.7%), palmary hyperlinearity in 52(24.8%), food hypersensitivity in 40(19.0%), keratosis pilaris in 31(14.8%), pityriasis alba in 30(14.3%), facial erythema in 25(1.9%), cheilitis in 22(10.5%), hand eczema in 19(9.0%), foot eczema in 16(7.6%), intolerance of lipid solvent in 14(6.7% ), scalp scaling in 11(5.2%) and infra-auricular fissure in 10(4.8%). These features were present singly or in combination. The result evidenced that minor criteria are many a times important for the diagnosis where major criteria are uncertain.

Synthesis, growth, crystal structure and characterization of a new organic material: glycine glutaric acid

Glycine glutaric acid, a new organic compound has been synthesized and good quality single crystals were grown by slow evaporation technique. The structure of the grown crystal was elucidated by using single crystal XRD. The presence of the functional groups was confirmed by using FT-IR spectroscopy. The optical transparency was studied by using UV-vis spectrophotometer and it was found that the crystal is having high optical transparency. The thermal stability of the crystal was studied by using thermo-gravimetric and differential thermal analyses and found that it is stable up to 150°C. The room temperature dielectric studies were also carried out over the wide frequency range: 10 mHz to 10 MHz.

Enhancement of second harmonic generation, optical and dielectric properties inL-asparagine monohydrate single crystals due to an improvement in crystalline perfection by annealing

Single crystals of the relatively new nonlinear optical material L-asparagine monohydrate have been successfully grown by the slow evaporation solution growth technique at room temperature in aqueous solution. The crystal system of the title material has been confirmed by powder X-ray diffraction. The crystalline perfection of the as-grown and annealed crystals has been evaluated by high-resolution X-ray diffraction. The as-grown single crystals (particularly when their size is large) were found to contain internal structural grain boundaries, and the crystalline perfection of these crystals was found to be improved substantially by annealing at low temperatures. The crystalline perfection and the measured physical properties were found to be correlated such that the second harmonic generation efficiency, optical transparency, fluorescence and dielectric properties are enhanced as the crystal quality improves.

Profile of lichen planus in Bangladesh

Lichen planus is one of the common inflammatory disorders of skin, mucous membrane, nail and hair characterized by violaceous, polish, pruritic, polygonal, flat-topped papules usually distributed bilaterally symmetrically over the extremities. Our objectives in this study were to explore the prevalence of lichen planus in large area of Dhaka in Bangladesh and to establish the clinical characteristics of lichen planus. This descriptive type of cross sectional study was carried out from September 2006 to August 2008 in the Department of Dermatology and Venereology of Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka Medical College Hospital (DMCH) and Combined Military Hospital (CMH) in Dhaka. Patients suffering from lichen planus were selected as study population. By face to face interview and clinical observations, data were collected from sample. A total 120 patients of lichen planus were selected, on the basis of age, 30(25%) were 10-30 years of age, 75(62.56%) were 30-50 years and 16(13.33%) were over 50 years of age. The mean age of the patient was 40+/-4 years. Out of 120 patients, 80(66.66%) were male and 60(33.33%) were female and eight patients (6.67%) had positive family history among highest age group (30 to 50 years). In case of duration of disease, highest percentage (68%) of cases was 15 days to 6 months and considering clinical sign, koebnerization was present 45(37.5%) cases and Wickhams striae 22(18.33%) cases. Regarding site of onset of lesion, lesions were highest 100(83.33%) in upper limbs, next lower limbs, trunk, oral mucosa etc. The distribution of clinical pattern of lichen planus showing classic pattern (68.33%) was the most common type, followed by hypertrophic, actinic, ashy dermatoses, lichen plano-pilaris, erosive or ulcerative etc. This clinico-epidemiological study of lichen planus attending in the different hospital in Dhaka, Bangladesh has shown that lichen planus is usually associated with 30 to 50 years of age group, with higher male prevalence than female, 15 days to 6 months are mainly duration of disease, koebnerization and Wickhams striae are common clinical signs, upper limbs is mainly the site of onset of lesion, and classic pattern is the most common clinical type in lichen planus.

Various factors of attempted suicide in a selected area of Naogaon district

This descriptive type of study was carried out to determine the various factors of attempted suicide in a selected area at Patnitala and Dhamuirhat upazilla health complex of Naogaon district. All reported alive cases of attempted suicide (self poisoning, hanging, self burning or immolation, drowning etc) during the period from March to June 2003 were interviewed purposely. Data were collected by face to face interview and also from hospital records. Of the interviewed cases, the mean age was 21.4 years. Household workers, day labours, students and agricultural workers (42.6%, 23.9%, 15.5% and 11.3% respectively) were the major victims and nearly 60% had nuclear family. The highest number (77.5%) used organophosphorus compound. Highest number (25.4%) mentioned that husband mainly provoked for suicidal attempt, followed by mother and father. It was evident that 71.8% of suicidal attempt was due to their emotional stress, followed by family violence, disturbed family, social deprivation, stressful events and health problems (50.7%, 49.3%, 36.6%, 25.4%, and 8.5% respectively). It was evident that attempted suicide is proportionately higher among adolescents of unmarried, with early age at marriage, with higher income and with nuclear family compared with adult. Emotional stress, disturbed family, social deprivation, health related problems are appeared to be important reasons for attempted suicide among adolescents whereas family violence in adults.

Single dose (400 mg) versus 7 day (200 mg) daily dose itraconazole in the treatment of tinea versicolor: a randomized clinical trial

Tinea (pityriasis) versicolor is a superficial fungal infection and one of the most commonly found pigmentary disorders of skin caused by the yeast Malassezia. Multiple topical as well as systemic therapies are available for treatment. Systemic therapies are used for extensive disease, frequent relapse or where topical agents have failed. The aim that translates the rationale of the study was to compare the efficacy, safety, tolerability and cost effectiveness of single dose 400mg versus 7 day 200 mg daily dose of itraconazole in the treatment of tinea versicolor. A clinical study was done to compare the efficacy of single dose (400 mg) of itraconazole and 7 day 200 mg daily dose of itraconazole in the treatment of extensive tinea versicolor. Total 60 patients (aged 18-50 years) were selected for the study during the period of June 2007 to May 2008 in the department of Dermatology of three different hospitals in Bangladesh. Cases having with extensive involvement, diagnosed clinically and confirmed by wood's lamp and KOH microscopy were taken. Patients were randomly allocated into equal groups. Group A was given single dose 400 mg itraconazole and Group B was given 7 day 200 mg daily itraconazole. Fifty three (88%) male and 7(12%) female were included in the study. The mean age of group A was 32.37+/-9 years and in group B 33.23+/-8 years. The mean duration of the disease in group A was 2.63+/-2 months and 2.76+/-2 months in group B. In group A clinical responders was found cure 22(73.33%) and improvement 5(16.33%) and in group B it was found cure 24(79.99%) and improvement 4(13.33%). The measure at the End point (EP1) equals to 90% response and in-group B it was found cure 24 (79.99%) and improvement 4(13.33%). (Here the End point EP2) equals to 93.33%. The EP clinical analysis however shows 91.66% response. Both single dose and 7 day daily dose of itraconazole can be effective in the treatment of tinea versicolor with extensive involvement but single dose appears to be better for improving compliance and decreasing the cost of treatment.

Reversal of sterilisation vs. IVF: a cost-benefit analysis

A consecutive series of 132 cases of reversal of sterilisation carried out in a teaching hospital in England between 1982 and 1995 was analysed. Follow-up data was obtained on 112 patients. The overall cumulative conception rate was 47% at 12 months and 55% at 24 months. Among the 71 pregnancies there were seven miscarriages (9%) and 11 ectopic pregnancies (15%). Factors affecting the outcome of surgery were examined. The pregnancy rate achieved with microsurgical techniques was significantly higher than the conventional (macrosurgical) techniques (61% v. 40%, P = 0.05). The method of sterilisation also has a significant impact on the outcome; Filshie clips 69%; Fallope ring 46%; Pomeroy technique 31% (P < 0.05). Age, associated infertility factors and the interval between sterilisation and reversal operation did not appear to have a significant impact on the outcome. When compared with IVF, reversal of sterilisation is associated with a higher ectopic rate, lower multiple pregnancy rate and a lower miscarriage rate. We conclude that reversal of sterilisation carries a higher overall success rate than IVF and is more cost effective when the method of sterilisation is by the clip or ring and when the reversal operation is carried out with microsurgical techniques.

Genetic variation in strains of zebrafish (Danio rerio) and the implications for ecotoxicology studies

There is substantial evidence that genetic variation, at both the level of the individual and population, has a significant effect on behaviour, fitness and response to toxicants. Using DNA microsatellites, we examined the genetic variation in samples of several commonly used laboratory strains of zebrafish, Danio rerio, a model species in toxicological studies. We compared the genetic variation to that found in a sample of wild fish from Bangladesh. Our findings show that the wild fish were significantly more variable than the laboratory strains for several measures of genetic variability, including allelic richness and expected heterozygosity. This lack of variation should be given due consideration for any study which attempts to extrapolate the results of ecotoxicological laboratory tests to wild populations.

Efficacy of combination therapy for the management regime of Alopecia areata

Alopecia areata is a world wide cosmetic problem. Cases are seen in Bangladesh. Due to financial constraint and lack of modern facilities the patients of this country needs cheap, easily available and conveniently usable treatment modality. The present study revealed that the oral administration of prednisolone for 06 weeks followed by topical application of 02% minoxidil for another period of 14 weeks is noninvasive and could act as better remedy for alopecia areata. It is claimed that steroid could induce hair growth through immunosuppression rather than a direct effect on hair growth promotion. When applied together steroid it induced regrowing hair gave more encouraging result. The combination therapy indicated that the gradual loss of hair could be minimized and regrowth of hair could be made possible. To fulfill the demand for the best compliance of treatment modality further study should be directed and dictated amongst a large group of population.

Elevated sister chromatid exchange frequencies in dividing human peripheral blood lymphocytes exposed to 50 Hz magnetic fields

The in vitro cytomolecular technique, sister chromatid exchange (SCE), was applied to test the clastogenic potentiality of extremely low frequency (ELF) electromagnetic fields (EMFs) on human peripheral blood lymphocytes (HPBLs). SCE frequencies were scored in dividing peripheral blood lymphocytes (PBLs) from six healthy male blood donors in two rounds of experiments, R1 and R2, to determine reproducibility. Lymphocyte cultures in the eight experiments conducted in each round were exposed to 50 Hz sinusoidal (continuous or pulsed) or square (continuous or pulsed) MFs at field strengths of 1 microT or 1 mT for 72 h. A significant increase in the number of SCEs/cell in the grouped experimental conditions compared to the controls was observed in both rounds. The highest SCE frequency in R1 was 10.03 for a square continuous field, and 10.39 for a square continuous field was the second highest frequency in R2. DNA crosslinking at the replication fork is proposed as a model which could explain the mechanistic link between ELF EMF exposure and increased SCE frequency.

Role of cardiac troponin I in staging and prognosis of congestive heart failure subjects

Congestive heart failure is the one of the major cardiovascular disorder that is increasing in incidence and cause of death globally. Mortality rate has increased 40%-50% in advanced cardiac failure and 15%-25% in mild to moderate cardiac failure within one year of diagnosis. There is no established biochemical marker for the diagnosis, prognosis and staging of heart failure. Cardiac Troponin I may be a novel useful tool in identifying patients with Heart failure who are at increased risk for progressive ventricular dysfunction and death. Thirty six congestive heart failure cases and thirty six healthy controls were included in this study and serum cardiac troponin I and Ejection fraction were measured. All the study subjects were grouped according to the NYHA class they belong. Cardiac troponin I was significantly higher in CHF cases than the controls. Troponin I also significantly differed among groups. EF of cases was significantly lower than the controls and also differed among groups. A significant negative correlation between cardiac troponin I and progressive decline of ejection fraction was evident in this study. Cardiac troponin I increased progressively with progression of heart failure. Thus, Cardiac troponin I could be used to stratify patients undergoing heart failure in to high and low risk groups for future cardiac events. Cardiac troponin I could also be used as a very important marker for the prognosis of the patients with congestive heart failure.

Spot morning urine protein creatinine ratio and 24 hour urinary total protein excretion rate

Proteinuria helps to establish the diagnosis of most renal diseases and also to predict the outcome of such diseases. Proteinuria is biochemically represented by measuring the protein concentration in timed collection of 24 hour urine. But, 24-hour timed urine collection is time consuming, cumbersome and often unreliable due to collection errors and also results in undue delay on diagnostic process. An alternate approach avoiding arduous and inaccurate timed urine collection can be the measurement of protein creatinine ratio in spot morning urine. This study was aimed to evaluate whether the spot morning urine protein creatinine ratio can be a reliable alternative to 24-hour urinary total protein (UTP) estimation. The study was carried out in the department of Biochemistry, Bangabandhu Sheikh Mujib Medical University, Dhaka on 50 (fifty) non-diabetic Chronic Renal Disease (CRD) patients with an age ranging from 18 -70 years. The study subjects were grouped into mild, moderate and severe CRD on the basis of GFR. Urinary protein and creatinine concentrations were measured in spot morning urine samples and their ratios were calculated. Urinary protein measured in 24-hour timed collected urine samples gave the 24-hour UTP excretion rate. In our study, spot morning urine protein creatinine ratio significantly correlated with 24-hour UTP excretion rate in all CRD patients. Severe CRD patients gave significant positive correlation (p<0.05), whereas mild and moderate CRD patients gave very highly significant positive correlation (p<0.001). Therefore, it may be suggested that protein creatinine ratio in spot morning urine can be accepted as a reliable and alternative to 24-hour UTP excretion rate in non-diabetic chronic renal disease patients. This simple and inexpensive procedure will thus simplify the way of establishing the severity of renal disease along with its prognosis.

Serum homocysteine concentration in patients with acute MI and chronic IHD

This was an observational study carried out in the Department of Biochemistry, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka; with the active co-operation of Coronary Care Unit (CCU) of BSMMU & National Institute of Cardiovascular Disease (NICVD), Dhaka. This study was carried out from March 2002 to January 2003. Total seventy (70) subjects were studied. Out of them 20 were of Acute MI, 20 were Chronic ischemic heart disease (CHD) and 30 were age and sex matched healthy controls. Hospitalized diagnosed patients were selected by taking history, clinical examination and several investigations like ECG. Echocardiogram, Angiogram and several enzymes assay. Several studies in many countries showed that serum homocysteine (Hcy) was elevated in IHD Patient. Cardiovascular disease is alarmingly increasing in Bangladesh. So our aim and objective of the study was to find out the association of serum Hcy with Acute MI and chronic ischemic heart disease (CHD) patients in our population. Mean Hcy level of Acute MI were 21.16 +/- 4.56 (micromol/l), 27.55 +/- 10.40 (micromol/l) and that of control was 13.03 +/- 10.51(micromol/l). Serum Hcy was significantly higher in both cases than control. But insignificant difference was found between AMI vs CHD (P> 0.05). Quantitative measurement of serum Hcy was measured by fluorescence polarization Immunoassay (FPIA) in IMX analyzer (Abbott-USA).

Necessity of antibiotics prophylaxis during extracorporeal shock wave lithotripsy

A total of 360 patients with renal and ureteral calculi who had sterile urine before extracorporeal shock wave lithotripsy (ESWL) and did not have any increased risk of infection received Tab. Ciprfloxacin (500 mg) 12 hourly for the next 5 days or no prophylaxis were included in this prospective study. Patients were followed by urinalysis and culture together with clinical evaluations. In antibiotic prophylactic group 10 (6.4%) had post ESWL urine culture positive while in without prophylaxis 13 (8.8%) had positive urine culture. The incidence of urinary tract infection after ESWL is extremely low, provided that patients have sterile urine before the procedure.

A randomised, controlled study of uterine exteriorisation and repair at caesarean section

OBJECTIVE

To determine the surgical and anaesthetic benefits and problems associated with the practice of routine exteriorisation of the uterus to facilitate repair at caesarean section.

DESIGN

A randomised controlled study of women undergoing caesarean section. After establishment of anaesthesia, women were randomised to either exteriorisation and uterine repair or suture of the uterus in the abdomen.

SETTING

A maternity hospital in the United Kingdom.

MAIN OUTCOME MEASURES

Peri-operative haemoglobin change, duration of operation, maternal morbidity and length of hospital stay. Intra-operative pain, nausea, vomiting, pulling or tugging sensations were secondary outcome measures.

RESULTS

Three hundred and sixteen women were randomised, of whom 288 were subsequently analysed (139 women in whom the uterus was exteriorised and 149 where the uterus was not exteriorised). Exteriorisation of the uterus, an elective caesarean section and a spinal or general anaesthesia each had a statistically significant association with reduced blood loss (P < 0.05). There were no statistically significant differences between the two groups with regard to intra-operative complications or pain, nor were there any statistically significant difference in post-operative wound sepsis, pyrexia, deep vein thrombosis, blood transfusion or length of hospital stay.

CONCLUSION

With effective anaesthesia, exteriorisation of the uterus for repair following caesarean delivery is not associated with significant problems and is associated with less blood loss.

The effect of different types of intragastric balloons with and without a behavior modification program in morbid obesity

Two consecutive and matched groups of morbidly obese patients, i.e. group (1) and (2) were selected to be treated with Garren-Edward Bubble (18 patients) and the Danish-Ballobe (10 patients), respectively, and according to the American FDA criteria. All patients were put on 1000-1200 K. cal diet and given the choice to enroll in the behavior modification program (BMP) or not; (15) patients enrolled in it (group A) and (13) patients refused (group B). At the end of the treatment period (i.e. 3 months group 1; 4 months group 2) the mean loss in the body mass index (BMI) for group (1) and (2) were 5.46 +/- 4.6 kg/m(2), and 3.98 +/- 5.5 kg/m(2) respectively. With insignificant statistical difference (P>1.0). While the mean loss in the BMI was 7.17 +/- 4.54 kg/m(2) and 1.85 +/- 0.92 kg/m(2) for group A & B respectively. With a very significant statistical difference (P< 0.01). No major complication was noticed except that in two patients (group 1) and four patients (group 2), the ballon had to be removed within the first week of insertion due to intolerance. In conclusion, although both balloons are safe, they are weakly effective and the main effect could be attributed to the BMP.