Comparison of Risk Factors and Angiographic Profile between Younger and Older Patients with Acute Myocardial Infarction

Acute myocardial infarction (AMI) in younger adults (≤40 years) is being increasingly encountered in recent years among the South Asian population. Data regarding the presentation, risk factors and angiographic findings on this important subset of patients is lacking in our country. The aim of this study was to compare the risk factors and pattern of Coronary artery involvement in younger patients presenting with AMI with that of the older age group. This was a cross-sectional observational study conducted during the period from October 2018 to June 2019. Seventy consecutive AMI patients age ≤40 years and another 70 consecutive AMI patients age >40 years undergoing Coronary Angiogram (CAG) were included in the study. After taking informed written consent; demographic, anthropometric, risk factors, CAG findings were recorded in a pre-designed case record form. The severity of Coronary Artery Disease (CAD) was calculated by using Gensini score. The mean age of the younger and older patient groups was 36.89±4.4 years and 57.00±8.4 years respectively. Among the risk factors, smoking (67.1% versus 45.7%, p=0.017), positive family history CAD (38.6% versus 22.9%, p=0.040) and obesity (34.3% versus 20.0%, p= 0.05) were more common in younger group. Whereas, Hypertension (41.4% versus 72.9%, p=0.010) and DM (28.6% versus 50.0%, p=0.024) were more common in older patients. Younger patients mainly presented with STEMI (60.0% versus 48.6%) and predominantly had single vessel disease (42.9%), whereas older patients readily presented with NSTEMI (51.4%) and had a higher incidence of double vessel disease (32.9%) and triple vessel disease (30.0%). The Median Gensini score was significantly higher among the older patients than in the younger age group. Patients in younger age group showed a different pattern of risk factors and coronary artery involvement in comparison to the older age group. Thus, offering younger individuals to make them aware of these risk factors and their early detection, as well as an effective intervention may help to prevent AMI in younger people.

Evaluation of a probiotics, Bifidobacterium breve BBG-01, for enhancement of immunogenicity of an oral inactivated cholera vaccine and safety: a randomized, double-blind, placebo-controlled trial in Bangladeshi children under 5 years of age

To evaluate the probiotic, Bifidobacterium breve strain Yakult (BBG-01), for safety and enhancement of immunogenicity in an oral inactivated cholera vaccine, a randomized double-blind placebo-controlled study was performed. Bangladeshi children under 5-year-old received BBG-01 or placebo for 4 weeks with two doses of oral cholera vaccine. Serum/fecal antibodies and fecal bacterial flora in the study participants were monitored. All adverse events were mild and transient and had no significant difference between the two groups. Immunological responses were similar comparing the two groups. A negative correlation between Bifidobacterium and Enterobacteriaceae in the probiotic group suggests a possible involvement of BBG-01 in alteration of the enteric bacterial flora. In conclusion, BBG-01 is well tolerated by Bangladeshi children although the post vaccinal immunostimulatory effect of BBG-01 was not evident.

Distribution of naturally occurring radionuclides in soils of the southern districts of Bangladesh

The activity concentrations of naturally occurring radioactive materials in soil samples of an elevated radiation background area of nine southern districts of Bangladesh were determined using gamma-ray spectrometry with an aim of evaluating the environmental radioactivity. The outdoor and indoor external effective dose rates and the radiation hazard indices from the soil activity were evaluated with an aim of minimising the harmful effects of ionising radiation to the population of the area concerned. The activity of (137)Cs was measured and observed in some of the locations.

Cavitary Rhodococcus equi pneumonia with endobronchial granulomas: report of an unusual case

An unusual case of cavitary Rhodococcus equi pneumonia with endobronchial granulomas in congenital HIV infection is presented. The clinical features and radiological manifestations of pulmonary R. equi infection are discussed.

Study of natural radionuclide concentrations in an area of elevated radiation background in the northern districts of Bangladesh

The activity concentrations of naturally occurring radioactive materials in soil samples from an elevated radiation background area of three northern districts of Bangladesh were determined using gamma ray spectrometry. The outdoor and indoor external effective dose rates and the radiation hazard indices from these soil activities were evaluated. The dose rates were found to be about four times higher than the reported world average value. The concentration of natural radionuclides, derived radium equivalent activities and the representative level indices were also found to be higher. Recommendations on radiological and dosimetric measures have been suggested with an aim of minimising the harmful effects of ionising radiation to the population of the area concerned.

Attenuation coefficients of soils and some building materials of Bangladesh in the energy range 276-1332 keV

The linear and mass attenuation coefficients of different types of soil, sand, building materials and heavy beach mineral samples from the Chittagong and Cox's Bazar area of Bangladesh were measured using a high-resolution HPGe detector and the gamma-ray energies 276.1, 302.8, 356.0, 383.8, 661.6 and 1173.2 and 1332.5 keV emitted from point sources of 133Ba, 137Cs and 60Co, respectively. The linear attenuation coefficients show a linear relationship with the corresponding densities of the samples studied. The variations of the mass attenuation coefficient with gamma-ray energy were exponential in nature. The measured mass attenuation coefficient values were compared with measurements made in other countries for similar kinds of materials. The values are in good agreement with each other in most cases.

Assessment of occupational and patient dose from diagnostic and therapeutic radiation exposure using thermoluminescent dosimetry

Radiation doses of occupational personnel exposed from diagnostic x rays, therapeutic installations, and patients were measured using thermoluminescent dosimeters. The monthly occupational doses from diagnostic x ray ranged from 0.1076 mSv to 0.5774 mSv, and those from therapeutic treatment ranged from 0.365 mSv to 0.657 mSv, which is within the dose limit recommended by ICRP 60. The patient organ doses were evaluated and found to range from 0.0615 mSv s(-1) to 2.8823 mSv s(-1) for gonad, 0.3676 mSv s(-1) to 2.1088 mSv s(-1) for thyroid, and 0.00972 mSv s(-1) to 4.01 mSv s(-1) for eyes.

Radioactivity in sediments of the Karnaphuli river estuary and the Bay of Bengal

Sediment samples from the Karnaphuli river estuary, nearshore, and off-shore regions off the coast of Chittagong in the Bay of Bengal were analyzed for the natural radioactivity contents of 232Th, 238U and 40K and anthropogenic radioactivity contents of 137Cs and 134Cs using HPGe gamma spectrometry, together with the measurement of sediment pH and grain size analyses of the collected samples. The activity of 232Th found in sediment ranged from 10.44 +/- 2.31 to 64.02 +/- 8.13 Bq kg(-1), 238U activity ranged from 5.87 +/- 1.21 to 27.85 +/- 1.71 Bq kg(-1), 40K activity from 118.28 +/- 19.70 to 608.21 +/- 75.70 Bq kg(-1), and the activity 137Cs ranged from 0.09 +/- 0.06 to 4.64 +/- 0.19 Bq kg(-1), no 134Cs radioactivity was detected at any of the sampling stations.

Radioactivity in marine fish of the Bay of Bengal

The concentrations of natural radionuclides of 40K, 232Th and 238U and artificial radionuclides of 137Cs and 134Cs in different marine fish samples from the Bay of Bengal were determined. In some of the fish samples contamination of the 137Cs radionuclide was observed, but 134Cs was below detection level.

Mycoplasma stimulates HIV-1 expression from acutely- and dormantly-infected promonocyte/monoblastoid cell lines

Treatment of a myelo-monocyte cell line, J22HL-60, dormantly infected with human immunodeficiency virus type 1 (HIV-1) with heat-inactivated extracts of Acholeplasma (A) laidlawii (250 micrograms/ml) enhanced virus production more than 45-fold as assessed by p24 viral core antigen assay. When treated with a suboptimal dose of TPA or TNF-alpha, Acholeplasma extracts further augmented virus production in J22HL-60 cells. H7, an inhibitor of protein kinase C(PKC), almost completely abrogated HIV-1-inducing ability of Acholeplasma extracts in the cells. A. laidlawii and several other mycoplasmas also enhanced acute infection of U937 cells as shown by increased virus-positive cells and augmentation of HIV-1 production in the culture supernatant independent of their pathogenicity to humans.

cAMP stimulates human immunodeficiency virus (HIV-1) from latently infected cells of monocyte-macrophage lineage: synergism with TNF-alpha

The present experiments were designed to study whether GTP binding protein activation and the resulting cAMP plays any role in HIV replication. The results showed that cholera toxin (CT) enhanced HIV replication dose dependently in myelo-monocytic cell lines latently infected with HIV-1, U1 and J22HL-60. Three- to 4-fold enhancement of virus production was observed in U1 cells and 4- to 11-fold enhancement in J22HL-60 cells 4 days after treatment with 100 ng/ml of CT. The increment of intracellular cAMP accumulation was parallel with HIV augmentation by CT in both cells. Even at the low concentration 0.1 ng/ml, TNF enhanced virus production to about an 80-fold higher level than the untreated U1 control cells as described previously (11). However, a synergistic effect (80- to 238-fold enhancement) was observed, when TNF-alpha and CT were added together to U1 cells. Similar synergism was seen in J22HL-60 cells. HIV antigen positive cells and gp120 expression were also increased to a similar degree. Phosphodiesterase inhibitor IBMX had no effect on HIV production alone, but potentiated HIV induction by CT and TNF. Adenylate cyclase activator, forskolin (FK), at 100 microM also significantly augmented HIV production (> 4-fold) and potentiated TNF induction in J22HL-60 and U1 cells. On the other hand, CT did not show any effect on HIV replication as well as TNF induction in HIV-1-infected T cell line. Northern blot experiment confirmed that this enhancement was mediated through the activation of HIV transcription. These data suggest that cAMP augments HIV replication and potentiates TNF induction in a particular monocyte-macrophage system.

Increased production of human immunodeficiency virus (HIV) in HIV-induced syncytia formation: An efficient infection process

Syncytia or multinucleated giant-cell formation is one of the major cytopathic effects induced by human immunodeficiency virus (HIV) infection. Cell fusion results from the strong interaction of CD4 molecules on the surface of the uninfected T cells and gp120, an external envelope glycoprotein of HIV on the infected T cells. We studied the production of HIV in fusion cells between MOLT-4 and virus-infected MOLT-4/HIV cells and found that HIV production was enhanced up to three- to fivefold, which showed a good correlation with the appearance and extent of syncytia formation. Blocking the fusion by monoclonal antibody against a binding epitope of CD4 molecule to gp120 decreased the HIV production significantly. Enhancement of HIV production was observed by more than five-fold in comparison with chronically infected cells, which were fusion free 20 hr postcocultivation. Electron microscopic observation also showed the presence of abundant HIV particles inside the fused cells and on the outer surface. AZT blocked the HIV augmentation of fused cells in coculture completely. Southern blot analysis revealed that both integrated and unintegrated HIV DNA were highly accumulated in fusion cells, as compared with fusion-free MOLT-4/HIV cells. Among unintegrated DNA, circular and linear DNA were accumulated to a similar degree. Northern blot hybridization showed that rapid enhancement of all three species of HIV-specific RNA containing genomic (9.2 kb) and subgenomic (4.3 and 1.9 kb) RNAs were found 20 hr postinfection in fusion cells. These data suggest that syncytia formation is an extremely active infection process of HIV, by which multiple rounds of reinfection might take place.

Infection of human CD4+ rabbit cells with HIV-1: the possibility of the rabbit as a model for HIV-1 infection

Although human T cell surface glycoprotein CD4 is the cellular receptor for human immunodeficiency virus 1 (HIV-1), the introduction of the human CD4 gene into murine cells does not render them susceptible to HIV-1 infection. Here we have established rabbit transfectant cell lines expressing human CD4 on the cell surface and demonstrated that the CD4+ rabbit transfectants could be readily infected by HIV-1 by co-cultivating with a HIV-1-infected human MOLT-4 T cell line (MOLT-4/HIV). Avid syncytia formation was observed upon co-cultivation and the syncytia abundantly produced HIV-1 mature particles, as revealed by electron microscopy. A significant increase of HIV-1 p24 antigen was also detected in the culture supernatant. The syncytia formation was blocked by pretreating the transfectant with anti-human CD4 or by pretreating the MOLT-4/HIV with anti-HIV-1 serum obtained from an infected individual, indicating that the syncytia formed as a result of the interaction of human CD4 on the rabbit transfectant with the HIV-1 envelope protein expressed on MOLT-4/HIV. In contrast, only a very small proportion of the rabbit transfectants expressed HIV-1-specific antigens upon infection with an HIV-1 stock. This may indicate that, although rabbit cells have partially acquired susceptibility to HIV-1 by transfection of human CD4 gene, rabbit cells may further require such a molecule as might be provided by MOLT-4 to become fully susceptible to HIV-1 infection. The possibility of the rabbit as a model for HIV-1 infection is also discussed.