The effects of trans fat diet intake on metabolic parameters and pancreatic tissue in offspring of prenatal bisphenol A exposed rats

Bisphenol A (BPA) is a plasticiser used in the manufacturing of many products and its effects on human health remain controversial. Up till now, BPA involvement in metabolic syndrome risk and development is still not fully understood. In this study, we aimed to investigate the effect of prenatal BPA exposure with postnatal trans-fat diet intake on metabolic parameters and pancreatic tissue histology. Eighteen pregnant rats were divided into control (CTL), vehicle tween 80 (VHC), and BPA (5 mg/kg/day) from gestational day (GD) 2 until GD 21, then their weaning rat's offspring were fed with normal diet (ND) or trans-fat diet (TFD) from postnatal week (PNW) 3 until PNW 14. The rats were then sacrificed and the blood (biochemical analysis) and pancreatic tissues (histological analysis) were collected. Glucose, insulin, and lipid profile were measured. The study has shown that there was no significant difference between groups with regard to glucose, insulin, and lipid profiles (p > 0.05). All pancreatic tissues showed normal architecture with irregular islets of Langerhans in TFD intake groups compared to offspring that consumed ND. Furthermore, the pancreatic histomorphometry was also affected whereby the study findings revealed that there was a significant increase in the mean number of pancreatic islets in rats from BPA-TFD group (5.987 ± 0.3159 islets/field, p = 0.0022) compared to those fed with ND and BPA non-exposed. In addition, the results have found that prenatal BPA exposure resulted in a significant decrease in the pancreatic islets diameter of the BPA-ND group (183.3 ± 23.28 µm, p = 0.0022) compared to all other groups. In conclusion, prenatal BPA exposure with postnatal TFD in the offspring may affect glucose homeostasis and pancreatic islets in adulthood, and the effect may be more aggravated in late adulthood.

Outdoor activities foster local plant knowledge in Karelia, NE Europe

Wild edible plants, particularly berries, are relevant nutritional elements in the Nordic countries. In contrast to decreasing global trends, approximately 60% of the Finnish population is actively involved in (berry) foraging. We conducted 67 interviews with Finns and Karelians living in Finnish Karelia to: (a) detect the use of wild edible plants, (b) compare those results with the published data about neighbouring Russian Karelians, and (c) document the sources of local plant knowledge. The results revealed three main findings. First, we observed a similarity in wild food plant knowledge among Karelians and Finns from Karelia. Second, we detected divergences in wild food plant knowledge among Karelians living on both sides of the Finnish-Russian border. Third, the sources of local plant knowledge include vertical transmission, acquisition through literary sources, acquisition from "green" nature shops promoting healthy lifestyles, childhood foraging activities performed during the famine period following WWII, and outdoor recreational activities. We argue that the last two types of activities in particular may have influenced knowledge and connectedness with the surrounding environment and its resources at a stage of life that is crucial for shaping adult environmental behaviours. Future research should address the role of outdoor activities in maintaining (and possibly enhancing) local ecological knowledge in the Nordic countries.

Comparison of Non-Alcoholic Fatty Liver Disease (NAFLD) Model using Diet-Induced Nafld Mice with Genetically Modified Mice

Prevalence of non-alcoholic fatty liver disease (NAFLD) is increasing steadily every year affecting all population both Western and Asian countries. The current treatments available for NAFLD are non-conclusive warranting newer effective pharmacological agents. Newly formulated agents require prior testing using animal models. However, in developing countries, these models are often costly. The possibility of using more affordable animal model in local settings should be investigated. In this study, ten Institute of Cancer Research (ICR) and seven B6.Cg-LepOb/J leptin-knockout (JAX) male mice were recruited. Five ICR and all JAX mice were subjected to high-fat diet (60% kcal fat) and remaining ICR mice were given standard diet (SD) for six weeks. Body weight and food intake were measured weekly while abdominal circumference, random blood glucose and liver span were measured at the end of the HFD study. Livers collected were subjected to histology assessment. Compared to ICR group, JAX group presented with significantly higher body weight (58 ± 0.72, p<0.05), larger body weight changes (16.57 ± 0.81, p<0.05), more HFD intake (197.14 ± 0.812, p<0.05) and larger abdominal circumference (11.79 ± 0.34: p<0.05). Liver from JAX group appeared with general steatosis and presentation of high-grade panacinar steatosis, low number of lobular inflammations and minimal fibrosis. Liver of ICR mice showed Zone 3 steatosis with high number of lobular inflammations without fibrosis. The NAFLD characteristics presented in JAX group suggested that B6.Cg-LepOb/J mice developed characteristics of NAFLD resembling human while ICR is suitable NAFLD model resembling human population resilient towards NAFLD.

Measurement of Bone Mineral Density in the Transfusion Dependent Thalassemic Patients

Low bone mineral density represents as a major cause of morbidity in thalassemic patient. The mechanism depends upon several factors. Transfusion dependent iron over load cause decrease secretion of growth hormone, insulin, thyroid hormone, parathyroid hormone, sex hormone and vitamin D from different endocrine organs which ultimately causes impairment of adequate bone mass achievement. Other causes of low bone mass are iron chelating agent and bony expansion due to increase erythropoiesis. To find out the frequency of low bone mineral density in thalassemia patients who are transfusion dependent. This study was designed as a cross sectional observational study, which was analyzed in the Department of Haematology, Bangabandhu Sheikh Mujib Medical University, Dhaka and National Institution of Nuclear Medicine and Allied Sciences (NINMAS), Bangladesh Atomic Energy Commission (BAEC) from September 2017 to August 2018. It had been performed over total 72 (Age ≥06 years to ≤40 years) thalassaemic patients who are transfusion dependent. Presence of bone diseases was detected by Bone mineral density (BMD). Seventy-two (72) patients with transfusion dependent thalassaemia, aged 6 to 39 years were enrolled. Mean age of patients was 20.9±7.2 years. Among them, 57(79.2%) patients were detected as a normal bone mineral density and fifteen (20.8%) patients were detected as a low bone mineral density in the left femoral neck. In transfusion dependent thalassaemic patient, Low bone mass was significantly associated with low BMI, total number of blood transfusion and serum ferritin level remarkably. This survey has established a new path for early detection of low bone mass and helped in prevention of bone loss and its sequel by starting early treatment in these groups of patients.

Untargeted serum metabolites profiling in high-fat diet mice supplemented with enhanced palm tocotrienol-rich fraction using UHPLC-MS

Excessive high fat dietary intake promotes risk of developing non-alcoholic fatty liver disease (NAFLD) and predisposed with oxidative stress. Palm based tocotrienol-rich fraction (TRF) has been reported able to ameliorate oxidative stress but exhibited poor bioavailability. Thus, we investigated whether an enhanced formulation of TRF in combination with palm kernel oil (medium-chain triglycerides) (ETRF) could ameliorate the effect of high-fat diet (HFD) on leptin-deficient male mice. All the animals were divided into HFD only (HFD group), HFD supplemented with ETRF (ETRF group) and HFD supplemented with TRF (TRF group) and HFD supplemented with PKO (PKO group). After 6 weeks, sera were collected for untargeted metabolite profiling using UHPLC-Orbitrap MS. Univariate analysis unveiled alternation in metabolites for bile acids, amino acids, fatty acids, sphingolipids, and alkaloids. Bile acids, lysine, arachidonic acid, and sphingolipids were downregulated while xanthine and hypoxanthine were upregulated in TRF and ETRF group. The regulation of these metabolites suggests that ETRF may promote better fatty acid oxidation, reduce oxidative stress and pro-inflammatory metabolites and acts as anti-inflammatory in fatty liver compared to TRF. Metabolites regulated by ETRF also provide insight of its role in fatty liver. However, further investigation is warranted to identify the mechanisms involved.

Seropositivity of Human Brucellosis among Patients with Pyrexia of Unknown Origin on Both Risk and Non-Risk Group of Individuals and Molecular Detection by Real-time PCR

Brucellosis is a zoonotic disease that is one of the important infectious causes of Pyrexia of Unknown Origin (PUO). The objective of the present study was to determine the seropositivity and molecular detection of human brucellosis among the patients with pyrexia of unknown origin on both risk and non-risk group of individuals in greater Mymensingh. A total of 400 blood samples were randomly collected from pyretic patients started from September 2018 to August 2019. Questionnaires were used to collect data on both risk and non-risk group of individuals. All samples were initially screened for anti-Brucella antibodies using the Brucella-specific latex agglutination test. For accurate investigation, seropositive as well as seronegative serum samples were tested by BCSP31 Brucella genus-specific TaqMan real-time PCR. Overall 32(8%) cases were positive out of 400 samples by Brucella-specific latex agglutination test and/or BCSP31 Brucella genus-specific real-time PCR. Brucella-specific latex agglutination test documented 7% (28/400) positivity for brucellosis. 22(5.5%) samples found Brucella genus-specific real-time PCR positive out of 400 samples. Most real-time PCR positive cases were found from sero-positive samples of risk group population (15/32). Sero-negative but real-time PCR positive cases also found only from risk group population (4/32). There were 10 seropositive cases where real-time PCR was negative. In addition to Brucella-specific latex agglutination test as a screening test, Brucella genus-specific real-time PCR was performed for confirmation and also to avoid unjustified costs, drug toxicity, and masking of other potentially dangerous diseases.

Homozygous Hemoglobin Lepore: A Rare Condition Seen in a Bangladeshi Family

Hb Lepore is one type of hemoglobin disorder in which there is structurally abnormal hemoglobin (Hb) that results from in-frame fusion between the 5 end of the δ-globin gene and the 3 end of the β-globin gene, due to misalignment of homologous chromosomes during meiosis..Hb Lepore homozygous patients have clinical features indistinguishable from thalassemia major or intermedia. On 22 March 2018 a severely anaemic 2 year old child was referred to Dhaka Shishu Hospital Thalassaemia Center in Dhaka Shishu Hospital, Dhaka Bangladesh for thalassemia screening. HPLC report showed a very high level of Hb F 80.7% and Hb A₂ level 16.16%. HPLC of both mother and father revealed a high A₂ level and a hump in the download slope of Hb A₂ peak and diagnosed as Hb Lepore. This was confirmed by GAP PCR and DNA analysis of the child and the parents and the child was diagnosed as suffering from homozygous Hb Lepore. Here we discuss Hb Lepore a rare homozygosity in a child seen in a Bangladeshi family.

Extensive genetic diversity with novel mutations in spike glycoprotein of severe acute respiratory syndrome coronavirus 2, Bangladesh in late 2020

In Bangladesh, coronavirus disease 2019 (COVID-19) has been highly prevalent during late 2020, with nearly 500 000 confirmed cases. In the present study, the spike (S) protein of severe acute respiratory coronavirus 2 (SARS-CoV-2) circulating in Bangladesh was genetically investigated to elucidate the diversity of mutations and their prevalence. The nucleotide sequence of the S protein gene was determined for 15 SARS-CoV-2 samples collected from eight divisions in Bangladesh, and analysed for mutations compared with the reference strain (hCoV-19/Wuhan/WIV04/2019). All the SARS-CoV-2 S genes were assigned to B.1 lineage in G clade, and individual S proteins had 1-25 mutations causing amino acid substitution/deletion. A total of 133 mutations were detected in 15 samples, with D614G being present in all the samples; 53 were novel mutations as of January 2021. On the receptor-binding domain, 21 substitutions including ten novel mutations were identified. Other novel mutations were located on the N-terminal domain (S1 subunit) and dispersed sites in the S2 subunit, including two substitutions that remove potential N-glycosylation sites. A P681R substitution adjacent to the furin cleavage site was detected in one sample. All the mutations detected were located on positions that are functionally linked to host transition, antigenic drift, host surface receptor binding or antibody recognition sites, and viral oligomerization interfaces, which presumably related to viral transmission and pathogenic capacity.

Spatial differences in prey preference by tigers across the Bangladesh Sundarbans reveal a need for customised strategies to protect prey populations

The Sundarbans is the only mangrove habitat in the world to support tigers Panthera tigris, whose persistence there is believed to be dependent on a very limited number of prey species. Conservation managers therefore need to understand how tigers utilise available prey species on a spatial scale in order to formulate a prey-based protection strategy for this global-priority tiger landscape. A total of 512 scat samples were collected during a survey of 1984 km2 of forest across 4 sample blocks in the 6017 km2 of the Bangladesh Sundarbans. Analysis of scat composition and prey remains reliably identified 5 major prey species, of which spotted deer Axis axis and wild pig Sus scrofa contributed a cumulative biomass of 89% to tiger diet. Tiger preference for prey species was highly skewed towards spotted deer and wild pig, but the relative contribution of these 2 species differed significantly across the 4 study areas, which spanned the Sundarbans, demonstrating important spatial patterns of tiger prey preference across the Sundarbans landscape. Given the comparatively limited number of prey species available to support the dwindling tiger population, different strategies are needed in different parts of the Sundarbans to support tiger populations and to protect spotted deer and wild pig populations from unabated poaching.

Leptin-induced increase in blood pressure and markers of endothelial activation during pregnancy in Sprague Dawley rats is prevented by resibufogenin, a marinobufagenin antagonist

Levels of leptin and marinobufagenin (MBG), a cardiotonic steroid, are elevated in the serum of women with pre-eclampsia. Besides this, leptin administration to pregnant rats increases systolic blood pressure (SBP), urinary protein excretion and serum markers of endothelial activation. The link between leptin and MBG is unknown and it is also unclear if leptin-induced increases in blood pressure and proteinuria in the pregnant rat could be prevented by an MBG antagonist. To ascertain this link, this study investigated the effect of resibufogenin (RBG), a marinobufagenin antagonist, on leptin-induced increases in blood pressure and proteinuria during pregnancy in rats. Four groups of Sprague-Dawley rats, aged 12 weeks, were given either normal saline (CONTROL) or 120 μg/kg/day of leptin (LEP), or 120 μg/kg/day of leptin+30 μg/kg/day of resibufogenin (L + RBG) or 30 μg/kg/day of resibufogenin (RBG) from Day 1-20 of pregnancy. Systolic blood pressure and urinary protein excretion (UPE) were measured during the study period. Animals were euthanized on day 21 of pregnancy and vascular cell adhesion molecule 1, (VCAM-1), soluble intracellular cell adhesion molecule 1 (sICAM-1), E-selectin and endothelin-1 (ET-1) were estimated in the serum. SBP, UPE, VCAM-1, sICAM-1 and ET-1 were significantly higher only in the LEP group when compared with those in CONT and in L + RBG and RBG groups. The prevention by RBG of leptin-induced increases in SBP, proteinuria, and endothelial activation during pregnancy seem to suggest a potential role for MBG in leptin-induced adverse effects on blood pressure, urinary protein excretion and endothelial activity during pregnancy in the rat.

Pulmonary Langerhans cell histiocytosis with inguinal abscess: Unusual presentation

We report a case of a 30-year-old man who was treated as recurrent right inguinal abscess following a 2-month history of right inguinal swelling and intermittent fever with no respiratory symptoms. Resection of his right inguinal lymph node and the histopathological analysis revealed the diagnosis of Langerhans cell histiocytosis. In addition, the CT of the thorax showed presence of bilateral cystic lung changes consistent with pulmonary Langerhans cell histiocytosis.

Adult entero-enteric intussusception secondary to lipoma

Diagnostic imaging methods are normally required to make the preoperative diagnosis of adult intussusception. Furthermore, it helps to define the location and nature of the associated mass as lead point if present. Lipoma may appear as lesion of fat attenuation expressed in Hounsfield unit on CT scan.

Molecular characterization of Orientia tsutsugamushi causing scrub typhus among febrile patients in north-central Bangladesh

Scrub typhus is a mite-borne rickettsial disease caused by Orientia tsutsugamushi, which is endemic in Asia Pacific region. In this study, infection rate and molecular epidemiologic traits of O. tsutsugamushi was investigated in Mymensingh, located in north-central Bangladesh. Among the blood samples from 453 febrile patients who visited Mymensingh medical college hospital in 2018, the 47 kDa protein gene of O. tsutsugamushi was detected in 78 samples (17.2%) by nested PCR. Phylogenetic analysis of the O. tsutsugamushi 56 kDa protein gene (18 samples) revealed a predominance of Karp-related genotype (89%), while the remaining belonged to Gilliam genotype. Samples of the Karp-related genotype mostly clustered with those of China, Taiwan, Thailand and India, etc., in emergent subgroups clades 2 and 4, which were distinct from clade 1, including prototype Karp strains. Among the 18 samples, three variable domains (VD) of 56 kDa type-specific antigen had different types of sequence diversity; VDI contained two or three repeats of eight amino acid units, while VDII and VDIII had amino acid substitution, deletion or insertion. The present study documented a potentially high prevalence of genetically diverse O. tsutsugamushi in north-central Bangladesh.

First molecular identification of two Leptospira species (Leptospira interrogans and Leptospira wolffii) in Bangladesh

Leptospiral 16S rRNA genes were detected in 13 blood samples from 74 febrile patients in north-central Bangladesh, and their sequences phylogenetically clustered with those of Leptospira interrogans or Leptospira wolffii. Genetic diversity in O-antigen polymerase (wzy) was found in an L. interrogans sample.

Red Cell Alloantibodies in Thalassaemia Patients Who Received Ten or More Units of Transfusion

Thalassaemia patients are the highest consumers of blood. Recurrent exposure to allogenic red cell antigen puts this population at increased risk of alloimmunization. This causes delayed hemolytic transfusion reactions. So transfusion requirement increases. But no data regarding alloimmunization was available in Bangladesh. Aim of this study was to estimate the prevalence of alloimmunization and to find out the potential factors associated with its development. This analytical cross sectional study was done by enrolling 97 patients, received at least 10 units transfusions, through convenient sampling. Indirect and direct antiglobulin tests were done to detect immunization by spin tube technique keeping an autocontrol and carried out in the Department of Haematology & Department of Transfusion Medicine, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from March 2016 to March 2017. Polyclonal anti-AHG reagent was used. A total 21 patients developed alloimmunization (21.6%) and 4 patients (4.1%) developed autoimmunization. Age, gender, splenectomy and number of transfusion are shown significant risk factors for alloimmunization. Data from this study demonstrate that the RBC alloimmunization is significantly high in our country. So, pretransfusion antibody screening needs to be initiated in order to ensure safe transfusion and RBC phenotyping should be started before starting first transfusion to prevent alloimmunization.

Periadrenal inflammatory myofibroblastic tumour: half a decade before cure

A 30-year-old ex-smoker with a background history of childhood asthma presented with worsening shortness of breath despite receiving high doses of oral corticosteroid for pemphigus vulgaris which was diagnosed 5 years earlier. A high-resolution CT examination of the thorax reported non-specific bronchiectatic changes and revealed an incidental suprarenal mass. A subsequent CT scan confirmed a large adrenal mass with areas of necrosis and calcification. Serum renin and aldosterone, urinary catecholamine and 5-hydroxyindoleacetic acid were within normal limits. Surgical intervention was delayed due to difficulty in optimising preoperative respiratory functions. He finally underwent a midline laparotomy for removal of the tumour. Histopathological examinations revealed extrapulmonary inflammatory myofibroblastic tumour arising from the periadrenal soft-tissue, with presence of normal adrenal gland. He showed immediate improvements of his asthmatic symptoms and pemphigus vulgaris following the surgery. His oral steroid was rapidly reduced and he achieved complete remission 2 months later.

Role of Immune Cells and Cytokines for Immune Response in Kala-Azar

Resolution of leishmanial infection is dependent on the coordinated interactions between components of cell mediated immune response, central to which is the activation of targeted T-cell populations for appropriate cytokine production and activation of infected cells. There is a correlation between the clinical outcome of Leishmania infection and the cytokine response profile. While a protective immune response against Leishmania has been clearly identified to be related to the influence of a type-l response and IFN-γ production, the precise role of T helper (TH) 2 cytokines in non-healing infections requires further exploration. Experimental evidence and clinical studies indicate multifaceted role of various factors leading to parasite survival and multiplication. In early stage of infection, generation of reactive oxygen and nitrogen intermediates play significant role in curtailing the parasite multiplication. In later phase, hepatic resistance is expressed by the dominant role played by nitric oxide synthase (NOS)-2 gene regulation and on the other hand, production of inhibitors of NOS-2 gene expression, interleukin 10 (IL-10) and transforming growth factor-β (TGF-β) correlate well with reduced parasite killing. The hepatic infection is usually self-limiting due to production of multiple cytokine responses including moderate level of tumour necrosis factor (TNF) but in spleen excess TNF mediates destructive pathology. CD8+ T cells appear to play multiple roles comprising both cytotoxic activity and secretion of cytokines and chemokines. A better understanding of the innate and acquired immune functioning of the host could aid in rational control and better therapeutic intervention of the disease.

Ovarian Endometrioid Adenocarcinoma Arising in Endometriosis: A Case Report

Malignant transformation of ovarian endometriosis was first described in 1925 by Sampson; later on it has been described in extragonadal regions by few authors also. Ovarian endometrioid and clear cell carcinoma are highly associated with endometriosis. Here we present a case of malignant transformation of ovarian endometrioma into endometrioid adenocarcinoma and review the clinical and pathological features of these tumors. A 45-years old infertile woman diagnosed as a case of bilateral chocolate cyst with pelvic endometriosis underwent total hysterectomy with bilateral salpingo-oophorectomy. A solid portion was also identified in the right sided cyst, histology of which revealed a well-differentiated endometrioid adenocarcinoma grade-II with foci of squamous morules and keratin pearls. Her pre-operative CA-125 level was within normal range. Women with endometriosis should be considered at an increased risk for the development of ovarian cancer even with normal CA-125 level.

Policies and practices on the programmatic management of latent tuberculous infection: global survey

SETTING

Global survey among low tuberculosis (TB) burden countries, which are primary target countries for the World Health Organization (WHO) guidelines on the programmatic management of latent tuberculous infection (LTBI).

OBJECTIVE

To perform a baseline assessment of policies and practices for the programmatic management of LTBI.

DESIGN

Online and paper-based pre-tested questionnaire filled out by national TB programme managers or their equivalents from 108 countries.

RESULTS

Of 74 respondent countries, 75.7% (56/74) had a national policy on LTBI. The majority of the countries (67/74, 90.5%) provided LTBI testing and treatment for child contacts of TB cases, while almost two thirds (49/74, 66%) reported provision of LTBI testing and treatment to people living with the human immunodeficiency virus (PLHIV). Six countries (8.1%) did not report providing LTBI management to child contacts and PLHIV. Among countries that reported both the availability of policy and practice of testing and treatment of LTBI for at-risk populations, a system for recording and reporting data was available in 62% (33/53) for child contacts and in 53% (21/40) for PLHIV.

CONCLUSION

Countries need to ensure that national LTBI policies and a standardised monitoring and evaluation system are in place to promote the programmatic management of LTBI.

Secondary polycythaemia in a Malay girl with homozygous Hb Tak

Hb Tak is one of more than 200 high affinity haemoglobin variants reported worldwide. It results from the insertion of two nucleotides (AC) at the termination codon, between codon 146 and codon 147 of the beta-globin gene [Beta 147 (+AC)]. Polycythaemia is the main clinical feature although affected carriers are usually asymptomatic and do not require intervention. Several case studies in this region have reported the co-inheritance of Hb Tak with Hb E, delta beta and beta thalassaemia with one case of homozygous Hb Tak in a Thai boy. In this case report, a cluster of haemoglobin Tak was found in a family of Malay ethnic origin. Cascade family screening was conducted while investigating a 4-year old girl who presented with symptomatic polycythaemia. She had 2 previous Hb analysis done, at 7-month and 2-year-old with the diagnosis of possible Hb Q Thailand and Homozygous Hb D, respectively. Both diagnosis did not fit her clinical presentations. She was plethoric, had reduced exercise tolerance as well as cardiomyopathy. Her parents were consanguineously married and later diagnosed as asymptomatic carriers of Hb Tak. Consequently, re-analysis of the girl's blood sample revealed a homozygous state of Hb Tak. In conclusion, high oxygen affinity haemoglobin like Hb Tak should be considered in the investigation of polycythaemic patients with abnormal Hb analyses. In this case, DNA analysis was crucial in determining the correct diagnosis.

Investigating the role of the IGF axis as a predictor of biochemical recurrence in prostate cancer patients post-surgery

BACKGROUND

Between 20% and 35% of prostate cancer (PCa) patients who undergo treatment with curative intent (ie, surgery or radiation therapy) for localized disease will experience biochemical recurrence (BCR). Alterations in the insulin-like growth factor (IGF) axis and PTEN expression have been implicated in the development and progression of several human tumors including PCa. We examined the expression of the insulin receptor (INSR), IGF-1 receptor (IGF-1R), PTEN, and AKT in radical prostatectomy tissue of patients who developed BCR post-surgery.

METHODS

Tissue microarrays (TMA) of 130 patients post-radical prostatectomy (65 = BCR, 65 = non-BCR) were stained by immunohistochemistry for INSR, IGF-1R, PTEN, and AKT using optimized antibody protocols. INSR, IGF1-R, PTEN, and AKT expression between benign and cancerous tissue, and different Gleason grades was assessed. Kaplan-Meier survival curves were used to examine the relationship between proteins expression and BCR.

RESULTS

INSR (P < 0.001), IGF-1R (P < 0.001), and AKT (P < 0.05) expression was significantly increased and PTEN (P < 0.001) was significantly decreased in cancerous versus benign tissue. There was no significant difference in INSR, IGF-1R, or AKT expression in the cancerous tissue of non-BCR versus BCR patients (P = 0.149, P = 0.990, P = 0.399, respectively). There was a significant decrease in PTEN expression in the malignant tissue of BCR versus non-BCR patients (P = 0.011). Combinational analysis of the tissue proteins identified a combination of decreased PTEN and increased AKT or increased INSR was associated with worst outcome. We found that in each case, our hypothesized worst group was most likely to experience BCR and this was significant for combinations of PTEN+INSR and PTEN+AKT but not PTEN+IGF-1R (P = 0.023, P = 0.028, P = 0.078, respectively).

CONCLUSIONS

Low PTEN is associated with BCR and this association is strongly modified by high INSR and high AKT expression. Measurement of these proteins could help inform appropriate patient selection for postoperative adjuvant therapy and prevent BCR.

A Young Boy with L-asparaginase-Induced Seizure

L-Asparaginase is a critical component in the treatment of acute lymphoblastic leukemia in children. It is known to cause coagulation abnormalities, thrombosis and hemorrhage in the central nervous system in addition to vasculitis and hypersensitivity reactions. This syndrome generally occurs after a few weeks of therapy and may occur after L-asparaginase therapy is completed. Seizures are uncommon symptoms. We report a case of seizure associated with L-asparaginase therapy but no evidence of hemorrhagic or thrombotic cerebrovascular events, completed in the department of Hematology of Bangabandhu Sheikh Mujib Medical University during March & April 2016.

Clinical and haemato-pathological characteristics of adult acute lymphoblastic leukaemia

Acute lymphoblastic leukaemia (ALL) is a heterogeneous group of disorders. It varies with respect to the morphologic, cytogenetic, molecular and immunologic features of the neoplastic cells reflecting the variable clinical-pathologic presentations and outcome of the patients. The aim of the study was to observe the clinical and haemato-pathological characteristics in newly diagnosed adult ALL patients. A total number of 61 patients morphologically diagnosed as acute lymphoblastic leukaemia aged 15 and above assigned for this observational study. The study was carried out in the Department of Haematology, BSMMU from January 2007 to December 2008. Among 61 patients, aged 15 to 80 years with median age 25 years, 79% were male and 21% were female. Most of the patients presented with anaemia (67%), fever (66%), lymphadenopathy (64%) and splenomegaly (57%). Other common clinical findings were hepatomegaly (39%), bone tenderness (44%) and bleeding manifestations (34%). Among haemato-pathological findings 67% patients had Hb level ≤10gm/dl, 46% patients had WBC count ≥30×10⁹/L, 67% patients had platelet count ≤100×10⁹/L, 93% patients had blast in peripheral blood and 61% patients had ≥90 % blasts in the bone marrow at the time of diagnosis. In this study adult ALL patients were analyzed only for their clinical and haemato-pathological characteristics. But their biologic characteristics were not analyzed due to lack of availability of facility. A progressive understanding of the biologic and genetic characteristics of ALL will allow us to identify different prognostic subgroups with specific molecular and cellular features. All the necessary measures have to be developed in our country in order to identify prognostically distinct subgroups of patients.

Optimise inlet condition and design parameters of a new sewer overflow screening device using numerical model

After heavy rainfall, sewer overflow spills to receiving water bodies cause serious concern for the environment, aesthetics and public health. To overcome these problems this study investigated a new self-cleansing sewer overflow screening device. The device has a sewer overflow chamber, a rectangular tank and a slotted ogee weir to capture the gross pollutants. To design an efficient screening device a numerical computational fluid dynamic (CFD) model was used. A plausibility check of the CFD model was done using a one-dimensional analytical model. Results showed that an inlet parallel to the weir ensured better self-cleansing than an inlet perpendicular to the weir. Perforations should be at the bottom of the weir to get increased velocity and shear stress to create a favourable self-cleaning effect of the screening device. Increasing inlet length from 0.3 to 1.5 m reduced wave reflection up to 10%, which increased flow uniformity downstream and improved self-cleansing effect. The orientation of the ogee weir with the rectangular tank was found most uniform with a 1:3 (horizontal:vertical) slope. These results will help to maximise functional efficiency of the new sewer overflow screening device. Otherwise it would be too expensive to alter after installation and at times difficult to customise accordingly to existing urban drainage systems.

Outcome of adult acute lymphoblastic leukaemia following induction chemotherapy with modified MRC UKALL XII/ECOG E2993 protocol

Cure rates for adult acute lymphoblastic leukaemia (ALL) in developing countries are significantly lower because of problems unique to these countries. Recent studies have reported complete response rates for any induction regimen of more than 90% in adult ALL patients. This study was conducted to evaluate the response rate of induction chemotherapy in adult ALL patients in the Department of Haematology, Bangabandhu Sheikh Mujib Medical University, from January 2007 to December 2008. In this observational study, 35 newly diagnosed ALL patients classified either as L1/L2 according to French-American-British (FAB) classification, aged between 15 to 60 years were assigned for induction therapy with modified MRC UKALL XII/ECOG E2993 protocol. But ultimately 30 patients completed therapy and available for statistical analysis. Among the studied 30 cases 12(40%) patients after phase 1 and overall 24 (80%) patients after phase 2 induction therapy, achieved morphologic complete remission (CR). After phase 2 therapy 6 (20%) patients fell in the group of non responders (NR) as the blast percentage was > or = 5% at the time of bone marrow evaluation. This study shows the response rates in adult ALL with induction therapy slightly below the anticipated response rates of developed countries which may be due to little modification of the original protocol.

Maternal serum zinc level and its relation with neonatal birth weight

The present study was conducted in the Department of Obstetrics & Gynaecology, Mymensingh Medical College Hospital, Mymensingh and Molecular Microbiology & Central Laboratory of Bangladesh Institute of Nuclear Agriculture (BINA) from 15th November 2007 to 31st May 2009 to find out the relation between maternal serum zinc level with neonatal birth weight. Hundred pregnant women who were advised to take 61.8 mg zinc daily throughout pregnancy were assigned to study group while the pregnant woman did not take zinc orally were allocated into control group. Serum zinc levels were measured between 37-42 weeks gestation and birth weight were measured just after delivery. Data were processed and analyzed using SPSS version 11.5. The test used to analyze the data was descriptive statistics, Chi-square probability test, Pearson correlation, unpaired t-test and odds ratio. A probability value of <0.05 was considered significant. Majority (97%) of the cases who received zinc during their antenatal period had normal serum zinc (≥ 700μg/L) level compared to only 22% of the control group woman who did not receive zinc. Normal birth weight of babies in pregnant woman who received zinc is 5.7 times higher than the pregnant woman who did not receive zinc. As the present study was a cross-sectional one, further study with large sample size and prospective design is recommended.

Laparoscopic versus open pyloromyotomy for infantile hypertropic pyloric stenosis: an early experience

This prospective comparative study was conducted with an initial experience in the Department of Pediatric Surgery, Dhaka Shishu (Children) Hospital during the period of December 2007 to January 2009, with the infants of 2-12 weeks age, diagnosed as Hypertrophic pyloric stenosis. Patients selection was done by simple random technique by means of lottery. For open pyloromyotomy conventional method & for laparoscopic pyloromyotomy three trocher techniques was applied. In this study, among 60 cases with infantile hypertrophic pyloric stenosis, 30 cases were finally selected for analysis irrespectively both in laparoscopic (Group A) & in open pyloromyotomy (Group B) group. Patients were studied under variables of operative time, required time of full feeds after operation, post operative hospital stay & both per and post operative complications. Regarding operative time, in Group A, mean±SD operating time (in minutes) was 61.59±51.73 whereas in Group B it was 28.33±8.40 & P value was 0.001. The result was statistically significant. The mean±SD time (in hours) of full feeds (ad libitum) was 35.00±31.70 hours in Group A compared to 28.95±10.99 hours in Group B and P value was found 0.342ns which was not statistically significant. On study of total length (in days) of post operative hospital stay, mean±SD was 3.09±2.25 & 2.58±1.15days in laparoscopic group & open pyloromyotomy group respectively. The p value was 0.355ns, which was statistically insignificant. Again, on study of complications, per operatively 6(19.5%) patients had developed haemorrage, 1(3.33%) had mucosal perforation & 4(13.36%) had developed duodenal serosal injury in laparoscopic group whereas only 1(3.33%) patient in open pyloromyotomy group had nothing else except simple hemorrhage. The p value (0.051ns) was also statistically insignificant. In regard to post operative complications, 2(6.6%) patients had developed wound hematoma, 2(6.6%) had wound infection, 1(3.33 %) had developed wound dehiscence and incisional hernia respectively in Group A. But in group B there was no subject with any complication. This result was also statistically insignificant. So, the overall study results denote that, laparoscopic pyloromyotomy would not be considered as a superior procedure or as safe as that of traditional open pyloromyotomy for the beginners.

Comparative study between Pap smear and visual inspection using acetic acid as a method of cervical cancer screening

This prospective study was done for the comparison of visual inspection using acetic acid (VIA) and Pap smear as a method of cervical cancer screening. This study was also done to determine the proportion of women screened positive with VIA and proportion of women screened positive with Pap smear. Another aim was to compare the sensitivity and specificity of VIA and Pap smear. A total of 300 women attended to the outpatient gynecologic clinic and cervical cancer screening programme at Bangabandhu Sheikh Mujib Medical University (BSMMU) were included. On VIA, 23 out of 300 women screened had aceto-white lesions. On Pap smear, 14 out of the 300 women had ASCUS or worse lesions. Of the 300 enrolled women, 11 were positive on both VIA and cytology; 12 were positive on VIA only; and 3 were positive on cytology only. Those women (n=26) who showed positive test result with either VIA or Pap smear or both tests were further subjected to colposcopy directed biopsy. Histology was taken as gold standard to compare the performance of VIA and cytology (Pap's smear). Histological diagnosis of CIN/cancer was made in 18 Positive cases out of the total 26 patients who underwent biopsy. Pap smear picked up 10 out of the 18 biopsy-proven cases whereas VIA could identify 17 out of the 18 CIN/carcinoma cervices. VIA was more sensitive (94.44%) than pap smear (55.55%), which was statistically significant. However, the specificity of VIA was slightly lower (97.87%) than that of cytology (98.58%). The PPV of VIA was 73.91% versus 71.42 % for Pap smear.

Factors influencing performance of Global Fund-supported tuberculosis grants

OBJECTIVE

To explore grant and country characteristics associated with the performance of tuberculosis (TB) grants supported by the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund), which uses performance-based funding of grants.

METHODS

We used Global Fund grant data to compute the average programmatic performance of 108 TB grants in 88 countries. Using stepwise regression models, we examined the correlation of grant performance with a range of grant and country characteristics.

RESULTS

Funding duration and funding per estimated smear-positive TB case were positively correlated with grant performance (partial correlations of 0.386-0.416 for the former, 0.200 for the latter). Successful completion of an evaluation of a grant during the second year of funding was linked to higher performance (0.357). Performance was further influenced by the independent organisation hired by the Global Fund to provide ongoing monitoring of the grants (0.197-0.243). Two country-specific factors were significantly correlated with performance: political stability (0.197-0.234) and disease burden (-0.211).

DISCUSSION

Successful evaluation that leads to continued funding predicts higher performance of TB grants, even in challenging settings such as weak health services. However, other contextual factors affect grant performance and should be considered when assessing grants to ensure that countries that have a high disease burden and are politically unstable are not penalized.

Malignant phyllodes tumour with liposarcomatous differentiation, invasive tubular carcinoma, and ductal and lobular carcinoma in situ: case report and review of the literature

A 43-year-old woman presented with a right breast lump that had enlarged over 5 months. She had chemoradiotherapy for non-Hodgkin's lymphoma in 1989. Histology revealed a malignant phyllodes tumour (PT) with liposarcomatous differentiation and ductal carcinoma in situ (DCIS) within the tumour with invasive tubular carcinoma, DCIS, and lobular carcinoma in situ in the surrounding breast. She had surgery and adjuvant radiotherapy. One year follow-up showed no recurrence or metastatic disease. Liposarcomatous differentiation is uncommon in PTs, and coexisting carcinoma is rare with 38 cases in 31 reports in the literature. Carcinoma is reported in malignant (n = 19), benign (n = 16) and in borderline PTs (n = 3) with invasive carcinoma (n = 18) and pure in situ carcinoma (n = 19) recorded in equal frequency. Carcinoma is more commonly found within the confines of benign PTs; whereas it is more often found surrounding the PT or in the contralateral breast in malignant PTs. Previous radiotherapy treatment is reported in only two cases. The aetiology of co-existing carcinoma is unclear but the rarity of previous radiotherapy treatment suggests that it is incidental. This case highlights the diverse pathology that can occur with PTs, which should be considered when evaluating pathology specimens as they may impact on patient management.

Diclofenac sodium and prednisolone acetate ophthalmic solution in controlling inflammation after cataract surgery

Cataract is the leading cause of blindness throughout the world. This prospective study was conducted in the department of ophthalmology, Mymensingh Medical college Hospital. Patients of both sexes of 45 to 70 years of age range admitted for cataract surgery were selected for this study. Patients were randomly selected during the period June 2007 to December 2008 with age related cataract. Total 80 patients were included in the study dividing into two groups. In Group-A, 40 patients were treated with diclofenac sodium 0.1% eye drop -1 drop 4 times daily for 30 days after cataract surgery. In Group-B 40 patients were treated with prednisolone acetate 1% eye drop-1 drop-2 hourly 1 week, 1 drop 4 hourly for 2 weeks than 1 drop 6 hourly for 30 days after cataract surgery. Male were 70% and female were 30% in both groups A & B. Post operative inflammation were evaluated by slit lamp examination of cells, flares & keratic precipitate (KP). Patients were evaluated on 1st, 7th and 30th postoperative day. Anterior chamber cells were found 10% in grade-I, 45% in grade-II, 45% in grade-III of group-A and 15% in grade-I, 40% in grade-II, 45% in grade-III patients of group-B in 1st visit. Anterior chamber cells reduce in 2nd visit & in final visit anterior chamber cells were absent in 90% patients in group-A & 92.5% patients in group-B. Anterior chamber flares were found in 32.5% in grade-I, 42.5% in grade-II, 25% patients in grade-III of group-A & 32.5% in grade-I, 47.5% in grade-II, 20% in grade-III of group-B in 1st visit. Anterior chamber flares reduce in both groups in 2nd visit. In final visit anterior chamber flares absent 90% patients in group-A & 90% patients in group-B. KP were found 17.5% patients in grade-I of group-A & 20% patients in grade-I of group-B. In 2nd visit KP reduced in both groups & in final visit KP were absent in 95% patients of group-A & 95% patients of group-B. Analysis shows no significant difference in cells, flares and KP in both groups. Visual acuity with pin hole at final visit- in group-A 5% had 6/18, 10% had 6/12, 50% had 6/9, 35% had 6/6 and in group-B 5% had 6/18, 5% had 6/12, 57.5% had 6/9 and 32.5% had 6/6. Visual outcome were good in both the groups. No statistical significant difference was found between two groups. At each visit there was no statistically significant difference of post operative inflammation between two groups of patients.

Comparison of post operative morbidity between laparoscopic and open appendectomy in children

This prospective comparative study was conducted in the department of Pediatric Surgery, Dhaka Shishu (children) Hospital during the period of June 2007 to September 2008 with the children of <12 years, diagnosed as acute Appendicitis. Patient selection was done by simple random technique by means of lottery. For open Appendectomy (OA) conventional method & for Laparoscopic Appendectomy (LA) 3 trocher technique was applied. Data was analyzed with the help of SPSS version 10. In this study 60 cases with acute Appendicitis including both gender were studied by two groups, group-A include 30 cases for laparoscopic and group-B include 30 cases for open appendectomy. Postoperative pain was assessed in both groups by using FLACC scale and compared at 1st 6-hours, 24 hours, 72 hours, 96 hours & at day 7. At 1st 6-hours, most of the children 24(80%) of group A had moderate pain whereas 17(56.7%) children of group B had severe pain (p<0.001). At 24 hours most of the patient 17(56.7%) of group A had mild pain compared to 27 (90%) patients of group B had moderate pain (p<0.0001). At 48 hours in group A most of the children 23(76.7%) had mild pain compared to moderate pain in 18(60%) children of group B (p<0.0001). Subsequently at 72 hours and at 96 hours most of the patients of LA group were free of pain compared to OA group. At final follow-up on day 7, 29(96.7%) children of group A had no pain compared to 26(86.7%) of group B. Regarding analgesics requirement both qualitative & quantitative requirements of analgesics were less in LA group than OA group. About post operative wound infection in group A only 1(3.3%) case had developed post operative wound infection whereas in group B 7(23.3 %) cases had. The mean (+/-SD) of post operative length of hospital stay was 52.00+/-11.62 (range 48-96) hours for group A and 76.00+/-12.74 (range 48-96) hours for group B children (p<0.001). Laparoscopic Appendectomy is more effective, preferable & superior procedure than that of open Appendectomy to reduce the post operative morbidity in children undergone appendectomy for acute appendicitis.

Use of povidone-iodine drop instead of sub-conjunctival injection of dexamethasone and gentamicin combination at the end of phacoemulsification cataract surgery

To evaluate the use of 5% povidone-iodine drop with subconjunctival injection of dexamethasone and gentamicin combination at the completion of phacoemulsification cataract surgery. This prospective randomized study was conducted at the department of Ophthalmology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh during the period of July, 2005 to June 2006. Senile & pre-senile cataract patients undergoing phacoemulsification cataract surgery were included in the study. Thirty patients were randomly included in Group A, receiving sub-conjunctival injection of dexamethasone and gentamicin combination and 30 patients in Group- B, receiving 5% povidone-iodine drop at the end of phacoemulsification surgery. Protocol for pre-operative medications, phacoemulsification technique and post-operative medications were similar in both groups. All patients were followed for 6 months post-operatively. Outcome measures were i) patients experience of pain and discomfort post-operatively ii) grade of inflammation post-operatively and iii) visual outcome. Difference of data between two groups was analyzed by unpaired 't' test and chi-square test. In Group A, mean age were 56.86+/-10.25 (SD) years and in Group B, mean age was 57.70+/-10.25 (SD) years. In Group A, 18(60%) patients were male and 12(40%) were female. In Group B, 16(53.33%) were male and 14(46.67%) were female. Pain and discomfort perceived by patients were measured by VAS at the end of operation, on 1st POD and after 7 days post-operatively. Mean VAS score was 5.7 in Group A and 2.7 in Group B at the end of surgery, 2.5 in Group A and 2.2 in Group B on 1st POD and 0.7 in Group A and 0.6 in Group B on 7th POD. Post-operative inflammation was assessed by slit lamp considering conjunctival congestion, chemosis, corneal striation, corneal oedema, cells and flare in anterior chamber. No significant difference was observed between two groups. Mean visual acuity was 0.16+/-0.12 in Group A and 0.15+/-0.13 in Group B. Anti-inflammatory, anti-infective effects and visual outcome are similar in both groups. But sub-conjunctival injection resulted more pain and hence less acceptable to patients.

On the origin, homologies and evolution of primate facial muscles, with a particular focus on hominoids and a suggested unifying nomenclature for the facial muscles of the Mammalia

The mammalian facial muscles are a subgroup of hyoid muscles (i.e. muscles innervated by cranial nerve VII). They are usually attached to freely movable skin and are responsible for facial expressions. In this study we provide an account of the origin, homologies and evolution of the primate facial muscles, based on dissections of various primate and non-primate taxa and a review of the literature. We provide data not previously reported, including photographs showing in detail the facial muscles of primates such as gibbons and orangutans. We show that the facial muscles usually present in strepsirhines are basically the same muscles that are present in non-primate mammals such as tree-shrews. The exceptions are that strepsirhines often have a muscle that is usually not differentiated in tree-shrews, the depressor supercilii, and lack two muscles that are usually differentiated in these mammals, the zygomatico-orbicularis and sphincter colli superficialis. Monkeys such as macaques usually lack two muscles that are often present in strepsirhines, the sphincter colli profundus and mandibulo-auricularis, but have some muscles that are usually absent as distinct structures in non-anthropoid primates, e.g. the levator labii superioris alaeque nasi, levator labii superioris, nasalis, depressor septi nasi, depressor anguli oris and depressor labii inferioris. In turn, macaques typically lack a risorius, auricularis anterior and temporoparietalis, which are found in hominoids such as humans, but have muscles that are usually not differentiated in members of some hominoid taxa, e.g. the platysma cervicale (usually not differentiated in orangutans, panins and humans) and auricularis posterior (usually not differentiated in orangutans). Based on our observations, comparisons and review of the literature, we propose a unifying, coherent nomenclature for the facial muscles of the Mammalia as a whole and provide a list of more than 300 synonyms that have been used in the literature to designate the facial muscles of primates and other mammals. A main advantage of this nomenclature is that it combines, and thus creates a bridge between, those names used by human anatomists and the names often employed in the literature dealing with non-human primates and non-primate mammals.

From fish to modern humans--comparative anatomy, homologies and evolution of the pectoral and forelimb musculature

In a recent study Diogo & Abdala [(2007) J Morphol 268, 504-517] reported the results of the first part of a research project on the comparative anatomy, homologies and evolution of the pectoral muscles of osteichthyans (bony fish and tetrapods). That report mainly focused on actinopterygian fish but also compared these fish with certain non-mammalian sarcopterygians. This study, which reports the second part of the research project, focuses mainly on sarcopterygians and particularly on how the pectoral and forelimb muscles have evolved during the transitions from sarcopterygian fish and non-mammalian tetrapods to monotreme and therian mammals and humans. The data obtained by our own dissections of all the pectoral and forelimb muscles of representative members of groups as diverse as sarcopterygian fish, amphibians, reptiles, monotremes and therian mammals such as rodents, tree-shrews, colugos and primates, including humans, are compared with the information available in the literature. Our observations and comparisons clearly stress that, with regard to the number of pectoral and forelimb muscles, the most striking transition within sarcopterygian evolutionary history was that leading to the origin of tetrapods. Whereas extant sarcopterygian fish have an abductor and adductor of the fin and a largely undifferentiated hypaxial and epaxial musculature, extant salamanders such as Ambystoma have more than 40 pectoral and forelimb muscles. There is no clear increase in the number of pectoral and forelimb muscles within the evolutionary transition that led to the origin of mammals and surely not to that leading to the origin of primates and humans.

Yield of serial sputum specimen examinations in the diagnosis of pulmonary tuberculosis: a systematic review

Current international tuberculosis (TB) guidelines recommend the microscopic examination of three sputum specimens for acid-fast bacilli in the evaluation of persons suspected of having pulmonary TB. We conducted a systematic review of studies that quantified the diagnostic yield of each of three sputum specimens. By searching multiple databases and sources, we identified a total of 37 eligible studies. The incremental yield in smear-positive results (in studies using all smear-positive cases as the denominator) and the increase in sensitivity (in studies that used all culture-positive cases as the denominator) of the third specimen were the main outcomes of interest. Although heterogeneity in study methods and results presented challenges for data synthesis, subgroup analyses suggest that the average incremental yield and/or the increase in sensitivity of examining a third specimen ranged between 2% and 5%. Reducing the recommended number of specimens examined from three to two (particularly to two specimens collected on the same day) could benefit TB control programs, and potentially increase case detection for several reasons. A number of operational research issues need to be addressed. Studies examining the most effective and efficient means to utilize current technologies for microscopic examination of sputum would be most useful if they followed an internationally coordinated and standardized approach, both to strengthen the country-specific evidence base and to permit comparison among studies.

National anti-tuberculosis drug resistance survey, 2002, in Myanmar

SETTING

Thirty townships of Myanmar.

OBJECTIVES

To determine the proportions of drug-resistant tuberculosis (TB) in new and previously treated pulmonary tuberculosis (PTB) cases in Myanmar.

DESIGN

A cross-sectional study. Drug susceptibility was tested by the proportion method at the National Tuberculosis Reference Laboratory, Yangon.

RESULTS

Of 874 TB patients included from 30 sites, 849 isolates obtained from individual patients (733 from new cases and 116 from previously treated cases) were tested for susceptibility to four primary anti-tuberculosis drugs. Of 733 isolates tested from new TB patients, 10% were resistant to any one of the anti-tuberculosis drugs, 6.5% to isoniazid (INH), 4.6% to rifampicin (RMP) and 4.0% were multidrug-resistant (MDR). Of the 116 previously treated patients, 30.2% were resistant to any one of the drugs, 26.7% to INH, 15.5% to RMP and 15.5% were MDR. Previous anti-tuberculosis treatment of more than 1 month was strongly associated with the development of MDR-TB (adjusted OR 4.8, 95% CI 2.5-9.1).

CONCLUSION

The first national drug resistance survey in Myanmar revealed 4% and 15.5% MDR-TB among new and retreatment cases, respectively. Previous antituberculosis treatment was an important risk factor for MDR-TB. Continuous monitoring of drug resistance trends is needed

Rectovestibular fistula with vaginal malformations

Anorectal malformations are associated with other anomalies among which vaginal malformations are occasionally encountered and may go unnoticed by the primary physician. Between January 1998 and December 2003, 563 cases of anorectal malformations were managed in Pediatric Surgery Department, Chittagong Medical College & Hospital, Chittagong, Bangladesh. Among these, five cases of rectovestibular fistula were associated with vaginal malformations. In this retrospective study age, physical findings, operative findings and procedures, outcome of operation and postoperative follow-up were evaluated. Mean age at presentation was 8.67 years (range 2 months to 17 years). All cases referred as rectovaginal fistula and vaginal anomalies (atresia to agenesis) were detected after thorough examination. Initial pelvic colostomy was done in all patients. Cases 1, 3 and 4 had distal vaginal agenesis and underwent posterior sagittal anorectovaginoplasty. In case 5, atretic vaginal duplication was found with didelphic hypoplastic uterus and absent left kidney. Case 2 (vaginal atresia) operated elsewhere is waiting for definitive surgery. Colostomy closure was done in four cases. The third patient had already married and conceived. Bowel habits are regular in all except the second patient. In females, a thorough understanding of anorectal malformations is necessary to identify the association with vaginal anomalies and awareness of this association will lead to earlier diagnosis and appropriate operative measures.

Modelling number of services per conception of Japanese Black cattle by random regression

Repeated records of number of services per conception (NSC) were collected on 607 Japanese Black cows. Data were analysed by random regression (RRM) and multiple trait (MTM) models, considering NSC in each parity as a separate trait. The chosen RRM included additive genetic and permanent environmental effects fitted with a third-order Legendre polynomials of parity. Heritabilities (h2) estimated by RRM decreased along the NSC trajectory from 0.15 in the first parity to 0.04 in the sixth parity and then increased up to 0.22 in the 10th parity. The corresponding estimates obtained by MTM ranged between 0.04 in parity 9 and 0.13 in parity 1. Permanent environmental proportions (p2) of the total phenotypic variance estimated by RRM showed similar pattern and magnitude to those of h2 estimated by the same method. On the contrary, the p2 estimated by MTM ranged between 0.04 in the first parity and 0.11 in the 10th parity. Additive genetic (r(G)), permanent environmental (r(P)) and phenotypic (r(PH)) correlations were also estimated. The values estimated by RRM between adjacent parities were higher than those of parities far apart. The corresponding values estimated by MTM were lower than those estimated by RRM with no certain trend. The results indicated that NSC in heifers is more heritable than NSC in cows with different parities. Reproductive traits are economically important traits and hence, they should be considered in breeding goals.

Proliferation Potential of 18-Month-Old Callus ofAnanas comosusL. cv. Moris

Differential effect of plant growth regulators and additives in proliferation of 18-month-old calli of Ananas comosus L. cv. Moris were assessed in vitro. The proliferation of callus relied on the growth regulators and additives. Of the different auxins supplemented in the Murashige and Skoog (MS) media, 32.22 μM α-naphthaleneacetic acid (NAA) gave the highest mean fresh weight of callus (46.817 g). Medium supplemented with 2,4-dichlorophenoxyacetic acid (2,4-D) was inferior to NAA, while b-naphthoxy acetic acid (BNOA) and p-chlorophenoxy acetic acid (4-CPA) were not effective in proliferating 18-months old callus. Addition of casein hydrolysate and coconut water to NAA supplemented medium showed better proliferation and production of callus. However, in terms of callus production, NAA at 32.22 μM was economically better.

The Beijing genotype is a major cause of drug-resistant tuberculosis in Kazakhstan

SETTING

Nine Kazakhstan oblasts, 2001.

OBJECTIVE

To analyse the genetic relationship of drug-resistant Mycobacterium tuberculosis strains from Kazakhstan and to determine the frequency of the Beijing genotype.

DESIGN

All drug-resistant smear-positive cases identified in nine oblasts during the 2001 nationwide drug resistance survey were analysed by IS6110 fingerprinting and spoligotyping. Isolates were obtained from 150 patients (64 new and 86 retreated cases).

RESULTS

Eight cases (5.3%) of dual infection were identified. Of the remaining 142 strains, 91 (64.1%) were grouped in 18 clusters, indicating a high rate of recent transmission of resistant tuberculosis (TB). This was further confirmed by the origin of the patients as well as by the similar drug resistance patterns of the clustered strains. Accordingly, more than one third of all clustered strains were new cases. About 70% of the resistant strains belonged to the Beijing genotype, compared to only 37.5% in a control group of 40 susceptible isolates.

CONCLUSIONS

Transmission of drug-resistant strains seems to contribute to the spread of resistant TB in this high incidence region. The Beijing genotype should be seen as a major cause of drug-resistant TB in Kazakhstan and was found to be associated with drug resistance.

Estimation of direct and maternal genetic and permanent environmental effects for weights from birth to 356 days of age in a herd of Japanese Black cattle using random regression

A total of 11,815 weight records from 23,94 Japanese Black calves was used to estimate direct, maternal, direct permanent environmental, and maternal permanent environmental effects on growth from birth to 356 d of age. The data were collected from a herd of Japanese Black cattle in Shiroshi city, Miyagi prefecture, Japan. A random regression model, including parity of dam and year-season of calving-sex of calf as fixed effects and animal, dam, animal permanent environmental, and maternal permanent environmental as random effects, was fitted to the data using Legendre polynomials for age of calf. Direct heritability estimates increased from 0.38 at birth to 0.65 at 120 d of age, decreased to 0.38 at 300 d, and then increased again up to 0.47 at 356 d. The ratio of animal permanent environmental variance to phenotypic variance decreased from 0.41 at birth to 0.12 at 90 d, and then increased gradually up to 0.40 at 270 d and oscillated around this value up to the end of the test period. Maternal genetic heritabilities increased from 0.04 at birth to 0.09 at 120 d and then decreased to 0.06 thereafter, whereas the variance ratios due to maternal permanent environment were fairly constant across the age trajectory, fluctuating around the value of 0.03. Direct genetic, phenotypic, maternal genetic, animal permanent environmental, and maternal permanent environmental correlations between different ages were all positive, and they generally decreased as the interval between ages increased. These correlations were lower between weights from nonadjacent ages than those between weights from adjacent ages. Results suggest that selection on preweaning weights would have a positive effect on weights at later ages.

Corneal foreign body--an occupational hazard

An attempt is made to describe the ocular surface injury by foreign body among the people those who are working in welding, grinding, hammering factory. Corneal foreign body which is usually iron in nature is the most common problem among the people those who are working in these factories. Clinical presentation, clinical pictures, and management are discussed. Corneal foreign body is a common cause of ocular morbidity and loss of working hour in the work place. Most of the victims do not use protective glass during work. We conclude that protective glass will useful in reduction of these accidents and alertness of both ophthalmologists and their patients are necessary.