Cholelithiasis in a goat associated with chronic fascioliosis in Bangladesh: A case report and review of literatures

The objective of the present study was to describe a very rare case of gallstone (cholelithiasis) in a goat associated with chronic fasciolosis. During a routine slaughterhouse-based survey, a two-and-half-year-old female Black Bengal Goat was found to be affected with severe chronic fascioliosis characterized by the massive damage in the liver. Through systemic dissection of liver, we isolated 94 adult Fasciola spp., and by PCR, we confirmed the fluke as Fasciola gigantica. The gallbladder of the goat was oedematous. On opening the gallbladder, we recovered 255 stones of variable sizes. Stones were whitish in colour and friable, and some of the fragile stones were attached to the wall of the gallbladder. To the authors' knowledge, this is the first report of the cholelithiasis in a goat associated with F. gigantica.

Lipidation alters the phase-separation of resilin-like polypeptides

Biology exploits biomacromolecular phase separation to form condensates, known as membraneless organelles. Despite significant advancements in deciphering sequence determinants for phase separation, modulating these features in vivo remains challenging. A promising approach inspired by biology is to use post-translational modifications (PTMs)-to modulate the amino acid physicochemistry instead of altering protein sequences-to control the formation and characteristics of condensates. However, despite the identification of more than 300 types of PTMs, the detailed understanding of how they influence the formation and material properties of protein condensates remains incomplete. In this study, we investigated how modification with myristoyl lipid alters the formation and characteristics of the resilin-like polypeptide (RLP) condensates, a prototypical disordered protein with upper critical solution temperature (UCST) phase behaviour. Using turbidimetry, dynamic light scattering, confocal and electron microscopy, we demonstrated that lipidation-in synergy with the sequence of the lipidation site-significantly influences RLPs' thermodynamic propensity for phase separation and their condensate properties. Molecular simulations suggested these effects result from an expanded hydrophobic region created by the interaction between the lipid and lipidation site rather than changes in peptide rigidity. These findings emphasize the role of "sequence context" in modifying the properties of PTMs, suggesting that variations in lipidation sequences could be strategically used to fine-tune the effect of these motifs. Our study advances understanding of lipidation's impact on UCST phase behaviour, relevant to proteins critical in biological processes and diseases, and opens avenues for designing lipidated resilins for biomedical applications like heat-mediated drug elution.

Design and construction of heterostructured Zn2V2O7 cubes and hexagons as an electrode material for high-performance asymmetric supercapacitor applications

Hierarchical nanostructures have harvested noteworthy attention lately owing to their remarkable capabilities in the fields of energy storing and transformation, catalysis, and electrical devices. We established an effort less and template-free synthetic method to create hierarchical hetero nanostructures of Zn2V2O7, taking into account the benefits of hierarchical nanostructures, we investigated the performance of HNs (Hierarchical Nanostructures) as electrochemical supercapacitors. Electrochemical tests were tested in a 6 M KOH solution to assess their capabilities. The Zn2V2O7 electrode's measured specific capacitance was 750F/g at 1 A/g, with outstanding stability and an excellent retention capacity of 85 % later 5000 cycles in three- electrode electrochemical cells. Asymmetric device such as Zn2V2O7//AC provides a specific capacitance of 76.8F/g at 1 A/g with energy and power densities of 27.3 Wh kg-1 and 800 W kg-1 respectively. The device withstands 85 % of its initial capacity after 5000 continuous GCD cycles at 10 A/g. The outstanding performance observed clearly demonstrates the significant potential and practical utility of Zn2V2O7 in the realm of more efficient energy storage applications.

Correction: Development of electrochemical sensors for quick detection of environmental (soil and water) NPK ions

[This corrects the article DOI: 10.1039/D4RA00034J.].

Risk Factors of Patients with Postpartum Acute Kidney Injury: An Observational Study

Postpartum acute kidney injury (AKI) is a condition characterized by a sudden and rapid decline in kidney function that occurs shortly after childbirth. Several risk factors may be associated with postpartum acute kidney injury (AKI). Understanding the possible risk factors is essential for timely intervention and improved maternal healthcare. The aim of the study was to assess the risk factors of postpartum acute kidney injury patients. This prospective observational study took place at Mymensingh Medical College Hospital, from March 2020 to April 2021. It was carried out in the Departments of Nephrology and Departments of Obstetrics & Gynecology, where 153 postpartum acute kidney injury (AKI) patients were enrolled through purposive sampling. The study collected data on patient demographics, etiology and presentation. Statistical analysis was conducted using SPSS (Statistical Package for the Social Sciences) version 26.0, with a significance threshold set at p<0.05 for all tests. Among participants, puerperal sepsis (77.8%) and toxemia of pregnancy (58.8%) were prevalent risk factors. Intrauterine death was rare (1.3%). Other risk factors such as postpartum hemorrhage 22.2%, HELLP syndrome 11.1%, and antepartum hemorrhage 15.0% were found. A statistically significant difference in postpartum hemorrhage prevalence (p=0.038) was noted between hemodialysis and non-hemodialysis patients. Puerperal sepsis is the most common risk factor for postpartum acute kidney injury, closely followed by toxemia of pregnancy. Intrauterine death is rare, while postpartum hemorrhage significantly affects subjects, with variations noted between hemodialysis and non-hemodialysis patients.

Meta-analysis investigating the impact of the LEPR rs1137101 (A>G) polymorphism on obesity risk in Asian and Caucasian ethnicities

Obesity is a chronic condition which is identified by the buildup of excess body fat caused by a combination of various factors, including genetic predisposition and lifestyle choices. rs1137101 (A > G) polymorphism in the CHR1 domain of LEPR protein linked to different diseases including obesity. Nevertheless, the connection between this polymorphism and the likelihood of developing obesity has not been determined definitively. Therefore, a meta-analysis was conducted to assess the relationship between rs1137101 and the risk of obesity. The meta-analysis included all studies meeting pre-defined criteria, found through searching databases up until February 2023. A combined odds ratio with a 95% confidence interval was estimated as overall and in continent subgroups for homozygous, heterozygous, recessive, dominant and allelic models using the fixed or the random-effects model. The meta-analysis identified 39 eligible studies with cases and controls (6099 cases/6711 controls) in 38 articles under different ethnic backgrounds. The results indicated a significant relationship between rs1137101 and the likelihood of developing obesity in each of the genetic models [the homozygous model (GG vs. AA: 95% Confidence Interval = 1.12-1.73, Odds Ratio = 1.39, P value = 0.003); the heterozygous model (AG vs. AA: 95% Confidence Interval = 1.07-1.42, Odds Ratio = 1.23, P value = 0.005); the dominant model (AG/GG vs AA: 95% Confidence Interval = 1.10-1.49, Odds Ratio = 1.28, P value = 0.001); the recessive model (GG vs AA/AG: 95% Confidence Interval = 1.02-1.45, Odds Ratio = 1.21, P value = 0.03); and the allelic model (G vs A; 95% Confidence Interval = 1.07-1.33, Odds Ratio = 1.19, P value = 0.002)] tested. Additionally, with an FDR <0.05, all genotypic models demonstrated statistical significance. The association remained significant among subgroups of Asian and Caucasian populations, although analysis in some genetic models did not show a significant association. Begg's and Egger's tests did not show publication biases. In sensitivity analysis, one particular study was found to have an impact on the Recessive model's significance, but other models remained unaffected. The current meta-analysis found significant indications supporting the association between rs1137101 and obesity. To avail a deeper understanding of this association, future research should include large-scale studies conducted in diverse ethnic populations.

Development of electrochemical sensors for quick detection of environmental (soil and water) NPK ions

All over the world, technology is becoming more and more prevalent in agriculture. Different types of instruments are already being used in this sector. For the time being, every farmer is trying to produce more crops on a piece of land. Eventually, soil loses its nutrients; however, to grow more crops, farmers use more fertilizers without knowing the proper conditions of the soil in real time. To overcome this issue, many scientists have recently focused on developing electrochemical sensors to detect macronutrients, i.e., nitrogen (N), phosphorus (P), and potassium (K), in soil or water rapidly. In this review, we focus mainly on the recent developments in electrochemical sensors used for the detection of nutrients (NPK) in different types of samples. As it is outlined, the use of smart and portable electrochemical sensors can be helpful for the reduction of excess fertilizer and can play a vital role in maintaining suitable conditions in soils and water. We are optimistic that this review can guide researchers in the development of a portable and suitable NPK detection system for soil nutrients.

Ascaridia galli, a common nematode in semiscavenging indigenous chickens in Bangladesh: epidemiology, genetic diversity, pathobiology, ex vivo culture, and anthelmintic efficacy

Ascaridia galli is the most common nematode in chickens. Ascaridia galli is highly prevalent in chickens reared in scavenging or semiscavenging systems. Here, we studied the epidemiology, pathology, genetic diversity, ex vivo culture protocol and anthelmintic sensitivity of A. galli prevalent in indigenous chickens in Bangladesh. Through morphological study and molecular analyses, the isolated worms were confirmed as A. galli. Of the chickens examined, 45.6% (178 out of 390) were found infected. The male and young chickens were significantly (P < 0.05) more prone to A. galli infection. Prevalence of the infection was significantly (P < 0.05) lower in the summer season. In heavy infections, A. galli blocked the small intestine. Marked inflammation, increased mucus production and petechial hemorrhages were evident in the small intestine, particularly in the duodenum. Also, there were desquamation and adhesion of the mucosal villi; degeneration, necrosis of the epithelial cells and goblet cell hyperplasia. The mucosal layer was infiltrated mainly with eosinophils and heterophils. We developed a hen egg white-based long-term ex vivo culture protocol which supported the survival and reproduction of A. galli for more than a week. Levamisole (LEV) and ivermectin (IVM) efficiently killed A. galli. However, albendazole (ABZ), mebendazole (MBZ), and piperazine (PPZ) did not kill the worms even at 120 μg/mL and 1mg/mL concentrations, respectively. Taken together, our results suggest that A. galli is highly prevalent in semiscavenging chickens in Bangladesh. Ascaridia galli can be easily maintained ex vivo in egg white supplemented M199 medium. LEV and IVM, but not ABZ, MBZ and PPZ, can be used for treating and controlling A. galli infections in chickens.

An integrated coastal ecosystem monitoring strategy: Pilot case in Naf-Saint Martin Peninsula, Bangladesh

Rapid population growth creating an excessive pressure on the marine environment and thus monitoring of marine ecosystem is essential. However, due to high technical and financial involvement, monitoring of coastal ecosystem is always challenging in developing countries. This study aims to develop an integrated coastal ecosystem monitoring system that combines scientific sampling, numerical model simulation and citizen science observations to monitor the coastal ecosystem of Bangladesh. This concept of integrated monitoring approach was piloted from January 2022 to April 2023 at the South East coastal zone of Bangladesh. Scientific sampling and numerical model simulations were performed for temperature and salinity data collection. Citizen science approach was employed to collect data on environmental conditions, fisheries, plankton, other marine resources, and plastic pollution. Numerical model simulations and citizen scientists observations of temperature and salinity showed good agreement with the scientifically collected data. In addition, citizen scientists observations on fisheries, plankton, other marine resources and plastic pollution were also in line with the existing database and previous studies. The proposed integrated monitoring approach presents a viable technique, creating a new avenue for coastal and marine ecosystem monitoring where infrastructural facilities are limited.

Electronic aggregated data collection on cervical cancer screening in Bangladesh since 2014: what the data tells us?

INTRODUCTION

To reduce the high prevalence of cervical cancers among the Bangladeshi women, the Government of Bangladesh established a national cervical cancer screening programme in 2005 for women aged 30 to 60 years. The District Health Information System Version 2 (DHIS2) based electronic aggregated data collection system is used since the year 2013. This study summarises data from the year 2014 to 2022 to assess the effectiveness of the electronic data collection system in understanding the outcome of the screening programme.

METHODS

This is a descriptive study based on secondary data extracted in MS Excel from the DHIS2-based electronic repository of the national cervical cancer screening programme of Bangladesh. The respondents were women aged 30-60 years, screened for cervical cancer using VIA (Visual Inspection of cervix with Acetic acid) method in 465 government health facilities. The data were collected on the participants' residential location, month and year of screening, name and type of health facilities performing VIA, and VIA screening results.

RESULTS

The national screening programme reported a total 3.36 million VIA tests from 465 government hospitals in 8 years (2014 to 2022). The national average VIA-positivity rate was 3.6%, which varied from 1.4 to 9.5% among the districts. This national screening programme witnessed an exponential growth, year after year, with 83.3% increase in VIA test from 2014 to 2022. The primary and the secondary care hospitals were the highest collective contributors of VIA tests (86.2%) and positive cases (77.8%). The VIA-positivity rates in different hospital types varied widely, 7.0% in the medical university hospital, 5.7% in the medical college hospitals, 3.9% in the district/general hospitals, and 3.0% in the upazila health complexes.

CONCLUSIONS

A national cervical cancer screening programme using VIA method and a DHIS2-based electronic data collection backbone, is effective, sustainable, and useful to understand the screening coverage, VIA positivity rate and geographic distribution of the participants and case load to initiate policy recommendations and actions. Decentralization of the screening programme and more efforts at the primary and secondary care level is required to increase screening performances.

Association of Serum Magnesium Level with Severity of Neurological Disability in Patients with Acute Ischemic Stroke

Magnesium (Mg) has important effects on vascular system and deficiency of this cation is thought to be a risk factor for cerebrovascular atherosclerosis and complications. The study was planned to find out the association of serum magnesium level with severity of neurological disability in patient with acute ischemic stroke. This cross-sectional descriptive study was conducted in the department of Neurology and Medicine at Mymensingh Medical College & Hospital, Mymensingh from June, 2018 to October, 2019. Patients with acute ischemic stroke were evaluated following informed written consent. Diagnosis was confirmed by neuroimaging of brain. Moreover, serum magnesium assay was done for each patient. Data were collected by interview, clinical examination and laboratory investigations of patients using a case record form and analysis was carried out by using the SPSS 22.0 (IBM Inc., Armonk, NY, USA). Mean age of acute ischemic stroke patients was 63.94±13.93 years with male predominance (58.30%). Majority of the respondents (70.2%) had NIH Stroke Scale (NIHSS) score 5-15 (moderate stroke), 13.1% had score 1-5 (minor stroke), 13.1% had score15-20 (Moderate to severe stroke) and 3.6% had score 21-42 (severe stroke). Mean serum magnesium level was 1.83±0.283mg/dl. Hypomagnesaemia was present in 28(33.3%) patients and it was related with higher NIHSS scoring (p<0.05). Multiple regression showed that among the risk factors, serum magnesium level was independently associated with severity of neurological disability of the acute ischemic stroke (p<0.001). In this study, the correlation coefficient between serum magnesium level and NIHSS score was found as r= - 0.667 which showed negative relationship between serum magnesium and NIHSS score. Lower serum magnesium level is associated with the severity of neurological disability of acute ischemic stroke patient. Further case-control studies are required to validate this finding.

Microplastic contamination in commercial fish feeds: A major concern for sustainable aquaculture from a developing country

Plastic pollution has become a global issue nowadays. Due to the increased population in developing countries, we largely depend on fish from our aquaculture industry to meet the required protein demand. Though several studies documented plastic ingestion in freshwater and marine organisms, very limited studies have been conducted to elucidate microplastic (MP) contamination in commercial fish feed. Therefore, this study was designed to identify, quantify, and characterize microplastics (MPs) in commercial fish feeds in Bangladesh and assess possible health risks in fish consuming different commercial fish feeds. All fish feed samples were 100 % contaminated with MPs, where the mean abundance of MPs ranged between 500 and 2200 MPs/kg. No significant differences among different types of feeds (e.g., starter, grower, and finisher) were observed in terms of MPs abundance (F = 0.999, p = 0.385). This study revealed that fiber was the most dominant shape of MPs (90 %), while the most dominant color of MPs was red (34 %), followed by black (31 %) and blue (19 %). The 100-1500 µm size class covers 88 % of the total MPs in the collected fish feed samples. Identified polymers in the samples were polyethylene (PE, 37.71 %), polyvinyl chloride (PVC, 27.14 %), polypropylene (PP, 22.08 %), and polyethylene terephthalate (PET, 13.07 %), respectively, where PE and PVC fall under the risk category IV to V. The Pollution load index (PLI) values of all fish feed samples were <10, indicating the risk category of I (low risk). Therefore, this study highly recommended avoiding plastic materials in the packaging and storing purposes of feed ingredients in the feed mills to ensure contamination-free fish feed for sustainable aquaculture.

'Synthesis, antiviral activity, molecular docking, and molecular dynamics studies of ethoxy phthalimide pyrazole derivatives against Cytomegalovirus and Varicella-Zoster virus: potential consequences and strategies for developing new antiviral treatments'

Substituted ethoxy phthalimide pyrazole derivatives (6a-e) have been produced using a one-pot synthesis technique. Spectral analysis was used to establish the molecular structure of the synthesized compounds, and they were examined in silico and in vitro for their ability to bind to and inhibit replication of the AD-169 strain, the Davis strain of CMV, the OKA strain and the 07/1 strain of Varicella-Zoster virus (VZV). Molecular Docking was used to estimate the binding mechanism and energy of compounds 4, 6a-e to their respective target proteins, thymidine kinase (TK), Varicella-Zoster protease (VZP) of VZV and tegument protein pp71 (TPpp71) of Cytomegalovirus (CMV). The MIC50 and EC50 were utilized to evaluate the antiviral and cytotoxic activities of test compounds in human embryonic lung (HEL) cells against the two reference medicines, Ganciclovir and Acyclovir. The chemicals studied showed a high affinity for binding sites and near binding sites of target proteins by generating H-bonds, carbon-hydrogen bonds, π-anion, π-sulfur, π-sigma, alkyl and π-alkyl interactions. All of the test compounds (6a-e) had higher binding energy than the standard medications. The ADME/T data suggests that these potential inhibitors are less toxic. Drug-protein complexes are structurally compact and demonstrate minimal conformational change in molecular dynamics (MDs) simulations, indicating stability and stiffness. MM-PBSA and post-simulation analysis can predict lead compound active cavity binding stability. By inhibiting multitargeted proteins, these synthetic compounds may improve antiviral therapy. Our research suggests that these unique synthesized chemicals may be useful and accessible adjuvant antiviral therapy for Varicella Zoster and CMV. HighlightsTwo components synthesis of substituted ethoxy phthalimide pyrazole derivatives (6a-e).Tested compounds (6a-e) have antiviral and cytotoxicity activity against CMV and Varicella-Zoster virus (VZV) in HEL cells.Compounds bind to TK, Varicella-Zoster protease (VZP) of VZV, and modeled TPpp71 of Cytomegalovirus (CMV).In comparison to reference drugs, compounds have strong binding free energy and interactions with VZV and CMV protein complexes.The RMSD, RMSF, Rg, residual correlative motion (RCM), No. of hydrogen bonds, protein secondary structure content, per-residue protein secondary structure and MM/PBSA energy calculated for the selected compound with thymidine kinase (TK), VZP of VZV, and modeled tegument protein pp71 (TPpp71) of CMV through MD simulation studies for 50 ns.In comparison to the two reference drugs, ligands/compounds were found to meet the Lipinski rule of five and to have strong biological activity.Communicated by Ramaswamy H. Sarma.

Dynamics of chemically reactive Carreau nanomaterial flow along a stretching Riga plate with active bio-mixers and Arrhenius catalysts

Nanomaterial flow has fascinated the concern of scientists across the globe due to its innovative applications in various manufacturing, industrial, and engineering domains. Bearing aforementioned uses in mind, the focal point of this study is to examine the Carreau nanofluid flow configured by the Riga surface with Arrhenius catalysts. Microorganisms are also suspended in nanofluid to strengthen the density of the regular fluid. Time-dependent coupled partial differential equations that represent the flow dynamics are modified into dimensionless patterns via appropriate non-dimensional variables, and handled through an explicit finite difference approach with stability appraisal. The performances of multiple flow variables are examined graphically and numerically. Representation of 3D surface and contour plots for heat transportation and entropy generation are also epitomized. The findings express that the modified Hartmann number strengthens the motion of nanomaterial. Reverse outcomes for heat transport rate and entropy are seen for the radiation variable. Concentration diminishes for chemical reaction variable. Activation energy enhances the concentration of nanomaterial, whereas reduction happens in the movement of microbes for bio-Lewis number. Greater Brinkman variable heightens the entropy.

Insights into the diagnosis, vaccines, and control of Taenia solium, a zoonotic, neglected parasite

Taenia solium taeniasis/cysticercosis (TSTC) is a foodborne, zoonotic neglected tropical disease affecting predominately low- and middle-income countries. Humans are definitive hosts for T. solium, whereas pigs act as intermediate hosts. Taeniasis, i.e. intestinal infection with adult T. solium in the human host, occurs through ingestion of undercooked pork infected with the larval stage (porcine cysticercosis, PCC). Human cysticercosis occurs after humans ingest T. solium eggs, acting as accidental intermediate hosts. Migration of cysticerci to the human brain results in neurocysticercosis (NCC), manifesting in a variety of clinical symptoms, most notably epilepsy. NCC is the leading cause of acquired epilepsy cases in endemic areas. PCC results in reduced pork value because of condemnation or the risk of condemnation of the meat. Available serological diagnostic tests for porcine and human cysticercosis are characterized by low sensitivity and are not cost-effective. An effective vaccine for T. solium cysticercosis in pigs has been developed, although it is not yet commercially available in all endemic countries, and still no vaccine is available for use in humans. This primer highlights the recent development in the field of diagnostic tests and vaccine production and explores possible strategies for future control and eradication of T. solium. In the absence of highly specific diagnostic tests and human vaccines, treatment of infected pigs and tapeworm carriers and prevention of disease transmission remain the principal means to interrupt the zoonotic cycle of T. solium in endemic countries.

Association of Chest Pain with Rate Pressure Product and ST-segment Changes after Sub Arachnoid Block in Caesarean Section

When healthy women undergo caesarean section (CS) under sub arachnoid anaesthesia, transient electrocardiographic changes, such as ST-segment depression and T-wave abnormalities, are observed. During an elective caesarean section under sub arachnoid anaesthesia, about one-third of healthy parturient experience chest pain and ECG changes suggestive of myocardial ischemia. To assess the ST-segment and Rate Pressure Product changes with chest pain in patients with elective caesarean section under subarachnoid block. The Department of Anesthesia, Analgesia and Intensive Care Medicine at Bangabandhu Sheikh Mujib Medical University (BSMMU), Bangladesh was the site of this prospective observational study. The study included 86 healthy women between the ages of 20 and 35 who needed an elective caesarean section under a single shot sub arachnoid block and who visited the Department of Anesthesia, Analgesia, and Intensive Care Medicine at BSMMU in Shahbagh, Dhaka from January 2019 to June 2019. In comparison to the no chest pain group, ST-segment changes among the chest pain group at delivery, 5 minute, 10 minute after delivery and at the end of the surgery were highly significant (p=0.001). Comparatively, Rate Pressure Product changes were found to be significantly higher in the group with chest pain than in the group without chest pain (p=0.001). It is concluded that there is a substantial association of chest pain with rate pressure product and ST-segment changes after subarachroid block in caesarean section.

Relation between Acute Ischemic Stroke and Left Ventricular Systolic Dysfunction

Stroke is one of the leading causes of mortality and morbidity all over the world. The economic cost for stroke disability and post stroke rehabilitation is a growing concern. Ischemic stroke comprises 80.0 - 85.0% of total stroke cases caused by thrombotic or embolic occlusion of cerebral arteries. The source of embolism may be a larger artery or cardiac. Overt heart failure is an independent predictor of long term unfavorable functional outcome in stroke patients. However, there is little research whether the acute ischemic stroke risk is associated with mild to moderate degree of Left Ventricular Systolic Dysfunction (LVSD). This study was aimed to investigate the relation between LVSD and acute ischemic stroke (AIS) and to evaluate the relation between left ventricular systolic dysfunction and severity of neurological deficits after acute ischemic stroke. This case-control study was carried out in the Department of Neurology and Department of Medicine, Mymensingh Medical College and Hospital, Bangladesh from January 2019 to December 2020. One hundred twenty (120) patients of first ever AIS and 120 age and sex matched apparently healthy controls were enrolled in the study. Severity of stroke was measured by National Institute of Health Stroke Scale (NIHSS). Left ventricular (LV) systolic function was assessed by transthoracic 2-dimensional echocardiography. Mean±SD age was 58.23±9.34 years and 55.92±9.72 years respectively in cases and controls. Male to female ratio was 1.86:1. Left ventricular systolic dysfunction of any degree was more frequent in stroke patients (23.3%) than in controls (5.8%; p<0.001). The mean±SD of LVEF were 59.21±9.68 and 63.54±6.84 among case and control groups respectively. Mild LV dysfunction was observed 16.7% in AIS patients and 5.8% in control group. Moderate LV dysfunction was found in 6.7% in AIS patients. Participants with mild LVSD had significantly higher odds of being in the cases compared to participants with no LVSD (OR: 3.48; 95% CI: 1.41-8.59). Similarly, participants with moderate LVSD were 9.74 times more likely to be in ischemic stroke group compared to participants with no LVSD (OR: 9.74; 95% CI:1.19-19.29). LVSD was associated with AIS even after adjusting for other stroke risk factors (OR: 2.7462; 95CI for OR: 1.0204, 7.3906; p=0.0435). The NIHSS was significantly negatively correlated with LVEF (r=-0.443; p<0.001). The study may conclude that Left ventricular systolic dysfunction of mild to moderate degree, is associated with acute ischemic stroke. AIS patients with higher neurological deficit also had lower LVEF.

Study of Serum Zinc Level in Patients with Type 2 Diabetes Mellitus

A major global public health concern is the prevalence of diabetes mellitus, especially in developing countries like Bangladesh. While still battling communicable diseases, Bangladesh is already inundated with non-communicable diseases. Type 2 diabetes has been found in almost 90.0% of all instances of diabetes. The main risk factors for type 2 diabetes are an excessively caloric diet, advanced age, sedentary behavior and obesity. Along with preexisting risk factors, many micro-nutrients have been related to a rise in the incidence of diabetes. The study's objective was to measure and contrast the zinc levels in serum between individuals with type 2 diabetes mellitus and healthy controls. This cross-sectional study was conducted from July 2018 to June 2019 at the Mymensingh Medical College, Mymensingh, Bangladesh. Based on inclusion and exclusion criteria, the subjects were chosen using a purposeful (non-random) sample method. In total, 100 people participated in this study. They were divided into two groups: 50 individuals who had been diagnosed with type 2 diabetes mellitus were chosen as cases and 50 individuals who appeared to be in generally excellent health were chosen as controls. For the analytical aims of this investigation, serum zinc levels were examined. All values were expressed as the mean SD. The statistical analyses were carried out using the Windows program statistics package for social science (SPSS). The statistical significance of the difference between the case and control groups was evaluated using the Student's unpaired 't' test. A thorough research revealed that type 2 diabetes mellitus patients had significantly lower mean serum zinc levels than healthy controls (case group was 110.96±13.60 and control group 130.18±9.95μg/dl). Cross-sectional research was used in this study. The current study's findings showed that type 2 diabetes mellitus patients had dramatically changed serum zinc levels. The study's hypothesis was verified as a result.

Status of Serum Pro-inflammatory Cytokines (IL-1, IL-6, TNF-α) and Anti-inflammatory Cytokines (IL-4, IL-10, IL-13) in Newly Diagnosed Bangladeshi Patients with Type 2 Diabetes Mellitus

As limited or no studies on pro-inflammatory cytokines (IL-1, IL-6, TNF-α)) and anti-inflammatory cytokines (IL-4, IL-10, IL-13) were reported in type 2 diabetes mellitus (T2DM) from Bangladesh. This case-control prospective interventional study was therefore undertaken to ascertain the status of them newly diagnosed Bangladeshi patients with T2DM at Medical Research Unit (MRU), MCW&H Building, MHWT, Uttara, Dhaka, Bangladesh from July 2018 to June 2021. Suspected patients with T2DM had undergone oral glucose tolerance test (OGTT) after overnight fasting. Blood samples were collected from patients at 'O' minute (Fasting) and at 2Hr (120 min) of OGTT. Newly OGTT positive 36 adult Bangladeshi patients (Male: 15, Female: 21, Age range: 35-65 years; mean±SD: 47±18 years) and 30 normal healthy subjects (Male: 12, Female: 18; Age range: 32-67 years; mean ±SD: 45±16 years) were included in the study. Serum levels of pro-inflammatory and anti-inflammatory cytokines were determined by enzyme immunoassay methods using research kits obtained from reputed companies at Medical Research Unit laboratory, Uttara, Dhaka, Bangladesh; Fasting serum levels of pro-inflammatory cytokines (IL-1, IL-6, TNF-α) were much elevated in patients compared to controls by Students t-test (p<0.001); At 2Hr of OGTT, the serum levels of these cytokines in patients remained elevated even at 2Hr of OGTT compared to their fasting levels (p<0.001). Among the anti-inflammatory cytokines, serum IL-4 level was found to be higher in patients compared to controls (p<0.05). Interestingly, F-IL-10 and F-IL-13 levels were significantly lower in patients compared to controls (p<0.001). These anti-inflammatory cytokines (IL-10 and IL-13) at 2Hr of OGTT also remained low among patients as revealed by Paired t-test (p?0.05); These results reported for the first time in Bangladeshi patients supported the concept that T2DM possibly develops due to imbalance among pro-inflammatory and anti-inflammatory cytokines. Further studies are warranted along this line involving more respondents.

Unraveling the impact of ORF3a Q57H mutation on SARS-CoV-2: insights from molecular dynamics

ORF3a is a conserved accessory protein of SARS-CoV-2, linked to viral infection and pathogenesis, with acquired mutations at various locations. Previous studies have shown that the occurrence of the Q57H mutation is higher in comparison to other positions in ORF3a. This mutation is known to induce conformational changes, yet the extent of structural alteration and its role in the viral adaptation process remain unknown. Here we performed molecular dynamics (MD) simulations of wt-ORF3a, Q57H, and Q57A mutants to analyze structural changes caused by mutations compared to the native protein. The MD analysis revealed that Q57H and Q57A mutants show significant structural changes in the dimer conformation than the wt-ORF3a. This dimer conformer narrows down the ion channel cavity, which reduces Na + or K + permeability leading to decrease the antigenic response that can help the virus to escape the host immune system. Non-bonding interaction analysis shows the Q57H mutant has more interacting residues, resulting in more stability within dimer conformation than the wt-ORF3a and Q57A. Moreover, both mutant dimers (Q57H and Q57A) form a novel salt-bridge interaction at the same position between A:Asp142 and B:Lys61, whereas such an interaction is absent in the wt-ORF3a dimer. We have also noticed that the TM3 domain's flexibility in Q57H is increased because of strong inter-domain interactions of TM1 and TM2 within the dimer conformation. These unusual interactions and flexibility of Q57H mutant can have significant impacts on the SARS-CoV-2 adaptations, virulence, transmission, and immune system evasion. Our findings are consistent with the previous experimental data and provided details information on the structural perturbation in ORF3a caused by mutations, which can help better understand the structural change at the molecular level as well as the reason for the high virulence properties of this variant.Communicated by Ramaswamy H. Sarma.

Understanding residents' behaviour intention of recycling plastic waste in a densely populated megacity of emerging economy

Plastic waste is choking our planet, but the recycling rate is still universally low. Understanding factors affecting recycling behaviours can help address this pressing issue. Taking Dhaka as an example, this study explores the determinants of the intentions to recycle plastic waste. We employed the Theory of Planned Behaviour (TPB) and extended it with two additional variables: Moral Norms, and Perceived sufficiency of knowledge and policy support. Survey data of 577 were collected and analysed using PLS-SEM. The findings suggest attitude, perceived behavioural control, moral norms and subjective norms significantly impact recycling intention, among which moral norms (β = 0.148, p < 0.05) acts even more strongly than subjective norms (β = 0.12, p < 0.05). Moreover, low level perception of knowledge and policy support makes people perceive less control over recycling behaviour (β = 0.188, p < 0.05), but actually reinforce their recycling intention (β = -0.091, p < 0.1). This study enriches the theoretical discussion of TPB, and contributes to the efforts of encouraging plastic recycling in populated megacity of emerging economy.

Structural and functional effects of the L84S mutant in the SARS-COV-2 ORF8 dimer based on microsecond molecular dynamics study

The L84S mutation has been observed frequently in the ORF8 protein of SARS-CoV-2, which is an accessory protein involved in various important functions such as virus propagation, pathogenesis, and evading the immune response. However, the specific effects of this mutation on the dimeric structure of ORF8 and its impacts on interactions with host components and immune responses are not well understood. In this study, we performed one microsecond molecular dynamics (MD) simulation and analyzed the dimeric behavior of the L84S and L84A mutants in comparison to the native protein. The MD simulations revealed that both mutations caused changes in the conformation of the ORF8 dimer, influenced protein folding mechanisms, and affected the overall structural stability. In particular, the ⁷³YIDI⁷⁶ motif has found to be significantly affected by the L84S mutation, leading to structural flexibility in the region connecting the C-terminal β4 and β5 strands. This flexibility might be responsible for virus immune modulation.  The free energy landscape (FEL) and principle component analysis (PCA) have also supported our investigation. Overall, the L84S and L84A mutations affect the ORF8 dimeric interfaces by reducing the frequency of protein-protein interacting residues (Arg52, Lys53, Arg98, Ile104, Arg115, Val117, Asp119, Phe120, and Ile121) in the ORF8 dimer.  Our findings provide detail insights for further research in designing structure-based therapeutics against the SARS-CoV-2.Communicated by Ramaswamy H. Sarma.

Relation of Neutrophil-Lymphocyte Ratio with Clinical Severity in Patients with Guillain-Barre Syndrome

Guillain-Barre syndrome (GBS) is an acute autoimmune polyradiculoneuropathy. Neutrophil-lymphocyte ratio (NLR) is a novel prognostic and inflammatory marker in patients with neurological diseases. The study was designed to observe the relation between neutrophil lymphocyte ratio and the clinical severity in patients with Guillain-Barre Syndrome (GBS). This cross-sectional descriptive study was conducted at the department of Neurology and Medicine, Mymensingh Medical College and Hospital from April 2019 to September 2020. Total 58 patients with GBS were enrolled according to the inclusion and exclusion criteria within 7 days of development of symptoms. The clinical diagnosis of GBS was done according to Ausbury and Cornblath's diagnostic criteria; moreover clinical severity was done according to Hughes and Rees scale, Medical Research Council (MRC) grade, cranial nerve involvement and autonomic involvement. After measuring complete blood count, NLR was calculated by dividing neutrophil count to lymphocyte count. Data analysis was done on SPSS 23.0. Mean age of the GBS patients was 36.21±11.55 years. Among 58 respondents 70.69% (41) were male and 29.31% (17) were female. Most of the patients had a GBS severity score of 4(62.07%) followed by 3(27.59%) and 5(10.34%). The mean NLR of the respondents was 3.22±2.25. Acute motor axonal neuropathy (AMAN) was in 48.28% respondents and their mean NLR was 3.89±0.31, 31.03% had AIDP and mean NLR was 3.28±0.46 and 20.69% had Acute motor sensory axonal neuropathy (AMSAN) and mean NLR was 4.5±0.52. The mean NLR of the MRC grade 0, 1, 2, 3 patients was 6.61±1.78, 3.39±0.92, 2.71±1.39 and 1.45±0.40 respectively. Hughes score had a positive correlation (r=0.5333 and p<0.01) and MRC grade had a negative correlation (r= - 0.76805 and p<0.01) with NLR. Severity of GBS was significantly associated with raised NLR. Increase Hughes and Rees scale and decrease MRC grade also related to increased NLR.

Dexmedetomidine as an Adjuvant to Bupivacaine in Caudal Analgesia in Children Undergoing Infra-Umbilical Surgery

When performing infra-umbilical procedures, caudal epidural analgesia with bupivacaine is frequently used to provide both intra- and post-operative analgesia. Dexmedetomidine, an alpha 2 agonistsare extensively used in neuraxial blocks and peripheral nerve blocks to prolong the action of bupivacaine. To find out the effects of dexmedetomidine as an adjuvant to bupivacaine for caudal analgesia in children undergoing infra-umbilical surgery. This was a randomized, controlled double-blinded prospective observational study and was performed from July 2019 to December 2019. A total of 60 (Sixty) patients with different infra-umbilical surgical problems underwent different procedure under caudal anaesthesia in different operation theatre in Bangabandhu Sheikh Mujib Medical University, Dhaka were enrolled in this study. Elaborate personal history, meticulous clinical examinations and relevant laboratory investigations was done. Post-operative adverse effects also were monitored. All information from history of illness, clinical, laboratory findings, duration of analgesia and post-operative adverse effects were recorded in a preformed data sheet (Appendix-I) and statistical analysis was done by SPSS 22.0. Mean age of the children in Group A (dexmedetomidine + bupivacaine) was 5.50±2.61 years and in Group B (bupivacaine) was 5.66±2.75. Mean weight of the children in Group A was 19.22±8.58 kg and in Group B was 19.70±8.94 kg in this study. Mean duration of anaesthesia was 27.5±6.5 minute in Group A and 28.5±5.5 minute in Group B. The mean duration of analgesia was 4.32±0.54 hours for Group A and 2.12±0.32 hours in Group B. In Group A, 46.7% patients required 1 and 3.3% required 2 rescue analgesic but in Group B, 43.3% patients required single rescue analgesic and 33.3% required two rescue analgesics (p<0.05). In Group A, 6.7% patients had nausea/ vomiting and in Group B, 16.7% patients had nausea/ vomiting (p>0.05). It can be concluded that dexmedetomidine with bupivacaine for caudal analgesia in infra-umbilical surgery significantly prolongs the duration of postoperative analgesia when compared to bupivacaine alone without any side-effects.

Endosulfan affects embryonic development synergistically under elevated ambient temperature

In the present study, we determined the developmental toxicity of endosulfan at an elevated ambient temperature using the zebrafish animal model. Zebrafish embryos of various developmental stages were exposed to endosulfan through E3 medium, raised under two selected temperature conditions (28.5 °C and an elevated temperature of 35 °C), and monitored under the microscope. Zebrafish embryos of very early developmental stages (cellular cleavage stages, such as the 64-cell stage) were highly sensitive to the elevated temperature as 37.5% died and 47.5% developed into amorphous type, while only 15.0% of embryos developed as normal embryos without malformation. Zebrafish embryos that were exposed concurrently to endosulfan and an elevated temperature showed stronger developmental defects (arrested epiboly progress, shortened body length, curved trunk) compared to the embryos exposed to either endosulfan or an elevated temperature. The brain structure of the embryos that concurrently were exposed to the elevated temperature and endosulfan was either incompletely developed or malformed. Furthermore, the stress-implicated genes hsp70, p16, and smp30 regulations were synergistically affected by endosulfan treatment under the elevated thermal condition. Overall, the elevated ambient temperature synergistically enhanced the developmental toxicity of endosulfan in zebrafish embryos.

A comprehensive review on clinically proven natural products in the management of nerve pain, with mechanistic insights

Introduction

People are treating their neuropathic pain with several approved and licensed pharmacological drugs. But due to having existing limitations like low efficacy with some side effects, there needs to be a more effective alternative and complementary therapeutic options.

Purpose

s: The study was designed to discuss the mechanistic role of several clinically proven natural products that have been shown to play a significant role against different nerve pain or neuropathic pain.

Method

ology: Information for this review article was salvaged using several accessible searching databases like SciVerse Scopus ® (Elsevier Properties S. A, USA), Web of Science® (Thomson Reuters, USA), and PubMed® (U.S. National Library of Medicine, USA) considering some search items like - nerve pain, natural products in pain/nerve pain management, clinically proven natural products in pain management, pain-reducing agents and so on.

Result

Our study reported the therapeutic efficacy of natural products and their possible mechanism against neuropathic pain in the human body. Natural products widely used to treat neuropathic pain include comfrey root extract ointment, lavender oil, Rose Oil, aromatic essential oil, ginger oil, vitex agnus-castus, peganum oil, and ajwain 10%. Some common pathways are involved in pain relief through sensory stimulation, enzymatic, anti-inflammatory, and pain-related receptor regulation.

Conclusion

The present study suggests that the mentioned natural products can be an appropriate choice for the treatment and management of neuropathic pain.

Economic perspectives and policy insights on carbon capture, storage, and utilization for sustainable development

Carbon capture storage and utilization (CCSU) has the potential to become a key tool to help mitigate climate change, thus, aiding in achieving the objectives of the 2015 Paris Agreement. Even though the relevant remediation technology has achieved technical maturity to a certain extent, implementation of CCSU on a larger scale is currently limited because of non-technical parameters that include cost, legalization, lack of storage reservoir, and market mechanism to penalize CO₂ emitter. Among these, cost emerges as the primary barrier to the dissemination of CCSU. Hence, necessary policy frameworks and incentives must be provided by governing agencies to enable faster dissemination of carbon capture and utilization (CCU) and capture and storage (CCS) globally. Meanwhile, strict implementation of a carbon tax across nations and market demand for products generated using captured CO₂ can aid in the fast adoption of CCU and CCS. This review assessed the economic feasibility and sustainability of CCS and CCU technologies to identify the barriers to commercializing these technologies.

Predicting Difficult Intubation by using Modified Mallampati (MMT) with or without Thyromental Height Test (TMHT)

Failed Tracheal Intubation with Subsequent inability to maintain an open airway and adequate oxygenation is the most frequent cause of brain damage or death during anesthesia. Recognizing before anesthesia the potential for difficult intubation allows time for optimal preparation. Proper Selection of equipment and techniques is needed to avoid unwanted situation. To find out difficulties associated with endotracheal intubation using Modified Mallampati Test (MMT) combined with Thyromental Height Test (TMHT) and MMT without TMHT. This prospective observational study was conducted at the Department of Anesthesia in Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from April 2018 to September 2018. Two hundred two patients with different surgical procedures under general anaesthesia in different operation theaters of BSMMU, Dhaka were selected as study population. After taking written consents from each patient or his/her attendant elaborate history of illness, meticulous clinical examinations were performed and relevant laboratory investigations were done. All information was recorded in a preformed data sheet and statistical analysis was done by SPSS-22.0. Mean age ±SD of the study subjects was 42.49±14.29 years in MMT with TMHT group and 43.40±15.39 years in MMT without TMHT group. Females were enrolled more than males in both the groups. BMI was 28.75±3.59kg/m² in MMT with TMHT group and 29.44±8.64kg/m² in MMT without TMHT group. There were no significant differences in age, gender and BMI between the groups. Sensitivity, specificity, PPV, NPV and accuracy were 100.0%, 96.0%, 96.2%, 100.0% and 98.0% respectively of MMT with TMHT in predicting intubation difficulty. Sensitivity, specificity, PPV, NPV and accuracy were 100.0%, 96.0%, 96.2%, 100.0% and 98.0% respectively of MMT only in predicting intubation difficulty. MMT combined with TMHT is a better predictor of intubation difficulty than MMT alone.

Relationship of Serum Creatinine Level in Heart Failure Patients in Bangladesh

Heart failure means that the heart is unable to pump blood around the body properly. It usually happens because the heart has become too weak or stuff. In collaboration with department of Cardiology, Mymensingh Medical College Hospital, Mymensingh, Bangladesh this cross-sectional study from January to December 2018 was performed in the department of Biochemistry in Mymensingh Medical College, Mymensingh, Bangladesh. The aim of this study was to explore the relationship of serum creatinine in patients with heart failure (HF) for management purpose. In this study 120 subjects were included, where 60 patients of diagnosed HF acts as case group and 60 individuals were normal healthy acts as control group. Serum creatinine was determined by colorimetric method from each sample. Statistical analysis was performed by SPSS windows package, version 21. Among the study groups the mean serum creatinine levels were 2.20±0.87mg/dl and 0.92±0.26mg/dl in case and control group respectively. Analysis showed that the mean serum creatinine level was highly significantly (p<0.001) increased in HF patients in comparison to that of control group.

Food- and vector-borne parasitic zoonoses: Global burden and impacts

Around 25% of the global population suffer from one or more parasitic infections, of which food- and vector-borne parasitic zoonotic diseases are a major concern. Additionally, zoonoses and communicable diseases, common to man and animals, are drawing increased attention worldwide. Significant changes in climatic conditions, cropping pattern, demography, food habits, increasing international travel, marketing and trade, deforestation, and urbanization play vital roles in the emergence and re-emergence of parasitic zoonoses. Although it is likely to be underestimated, the collective burden of food- and vector-borne parasitic diseases accounts for ∼60 million disability-adjusted life years (DALYs). Out of 20 neglected tropical diseases (NTDs) listed by the World Health Organization (WHO) and the Centres for Disease Control and Prevention (CDC), 13 diseases are of parasitic origin. There are about 200 zoonotic diseases of which the WHO listed eight as neglected zoonotic diseases (NZDs) in the year 2013. Out of these eight NZDs, four diseases, namely cysticercosis, hydatidosis, leishmaniasis, and trypanosomiasis, are caused by parasites. In this review, we discuss the global burden and impacts of food- and vector-borne zoonotic parasitic diseases.

Lipidation Alters the Structure and Hydration of Myristoylated Intrinsically Disordered Proteins

Lipidated proteins are an emerging class of hybrid biomaterials that can integrate the functional capabilities of proteins into precisely engineered nano-biomaterials with potential applications in biotechnology, nanoscience, and biomedical engineering. For instance, fatty-acid-modified elastin-like polypeptides (FAMEs) combine the hierarchical assembly of lipids with the thermoresponsive character of elastin-like polypeptides (ELPs) to form nanocarriers with emergent temperature-dependent structural (shape or size) characteristics. Here, we report the biophysical underpinnings of thermoresponsive behavior of FAMEs using computational nanoscopy, spectroscopy, scattering, and microscopy. This integrated approach revealed that temperature and molecular syntax alter the structure, contact, and hydration of lipid, lipidation site, and protein, aligning with the changes in the nanomorphology of FAMEs. These findings enable a better understanding of the biophysical consequence of lipidation in biology and the rational design of the biomaterials and therapeutics that rival the exquisite hierarchy and capabilities of biological systems.

Molecular detection of Babesia and Theileria from crossbred cattle in Sirajganj and Rangpur districts of Bangladesh

BACKGROUND

Babesia and Theileria are potential threats to the livestock industry, causing considerable economic losses. These tick-borne blood parasites are more prevalent in crossbred cattle than local cattle in Bangladesh.

OBJECTIVES

To confirm the species of Babesia and Theileria in crossbred cattle from the northern part of Bangladesh using conventional and molecular tools.

METHODS

A total of 385 crossbred cattle blood samples were subjected to DNA extraction and PCR. For molecular detection, B. bigemina rhoptry-associated protein 1a, B. bovis spherical body protein-4, and Theileria spp. 18S rRNA were used as the marker genes.

RESULTS

Using PCR, only 72 (18.7%) samples were found piroplasm positive, of which 12.2% Theileria, 4.7% Babesia, and 1.8% mixed infections. Both Babesia (7.3%), Theileria (7.7%) and mixed (2.8%) infections were detected in Sirajganj, and only Theileria (20.4%) was detected in Rangpur district. By PCR and nPCR we detected B. bigemina and T. annulata in Sirajganj district, and Theileria sp. in Rangpur district. The target gene sequences of isolated pathogens confirmed B. bigemina and T. annulata, and Theileria sp from these samples. Blood smears of all samples were also examined microscopically for Babesia and/or Theileria spp. and 14.3% of samples were found positive, of which 5.9% Babesia and 8.3% Theileria. Generally, the pathogens detected in Sirajgang and Rangpur were genetically related to South Asia, particularly South East Asian isolates.

CONCLUSIONS

These findings provide information for a better understanding of the epidemiology of Babesia and Theileria as well as to improve the approaches for diagnosis and control of tick-borne diseases in Bangladesh.

A comprehensive review on clinically proven medicinal plants in the treatment of overweight and obesity, with mechanistic insights

Background and objectives

Obesity has become a global health issue, more precisely, a pandemic throughout the present world due to its high prevalence in the recent era. Increased risk of morbidity and mortality in obese patients can be attributed to its association with the development of different life-threatening conditions. Plants are considered one of the most important sources of bioactive molecules which are used against a wide range of health disorders. This systematic review explores the efficacy as well as the safety profile of commonly used medicinal plants in the management of obesity that may help people to maintain a healthy weight.

Methods

This review is based on comprehensive literature searches from PubMed, Science Direct, Scopus, and Google Scholar databases using the keywords- "plants in obesity", "plants used in weight reduction" or keywords that are similar to those. Medicinal plants which have been clinically proven for their anti-obesity effect have only been selected for this study and attempts to investigate beneficial effects and adverse effects along with their mechanism of action have also been taken in this review.

Results

A significant reduction of weight in both human and other animals are exhibited by the extracts of Phaseolus vulgaris, green coffee, Yerba Mate, green tea, Gynostemma pentaphyllum, and the combination of Cissus quadrangularis/Irvingia gabonensis. All of those plant extracts seemed to work on different physiological pathways and none of those extracts showed any notable adverse effects in human or animal models.

Conclusion

Our review suggests that the discussed medicinal plants are effective in reducing the weight of obese patients without causing notable adverse reactions. Although further study is necessary to confirm their exact molecular mechanism and safety in human use.

Multidisciplinary Conservative Treatment Outcomes of in-Patient Physiotherapy Set-Up Among Patients with Lumbar Disc Herniation in Dhaka City, Bangladesh: A Retrospective, Cross-Sectional Study

Background

The study aimed to determine the outcome of Multidisciplinary physiotherapist-led conservative treatment of lumbar disc herniation at an in-patient set-up of a specialized spine center in Dhaka, Bangladesh.

Methods

This was a retrospective cross-sectional study of 228 cases completing treatment and follow-up sessions. The outcome was evaluated as pain at rest and five different functional positions, neurological recovery, and Magnetic resonance imaging (MRI) changes during discharge and follow-up.

Results

80.3% had a complete recovery with a typical motor and sensory status, no limitations in straight leg raise (SLR), no cauda equina symptom (CES), and no or <3 pain during more than 30 minutes of daily living activities. Statistically significant changes were noted at all outcome measures at the follow-up (day 90), compared to baseline (day 1) P<0.01. In the posthoc tests, pain, SLR, and CES had the most significant improvement at discharge (day 12) compared to the baseline (P < 0.01) and at follow-up compared to discharge (P < 0.01). No major adverse events noted.

Conclusion

Physiotherapist-led in-patient treatment results in significant resting and functional pain outcomes in 12 days. Also, the improvements in neurological recovery and normalizing disc position are statistically significant in 90 days.

Study of Serum Calcium and Magnesium Levels in Type 2 Diabetes Mellitus Patients

The prevalence of diabetes mellitus is a significant global public health concern, particularly in emerging nations like Bangladesh. Bangladesh is already overrun with non-communicable diseases while still battling communicable diseases. About 90.0% of all cases of diabetes that have been diagnosed are type 2 diabetes. High calorie diet, age, sedentary lifestyle and obesity are the main risk factors for type 2 diabetes. Different micronutrients have been linked to an increased incidence of diabetes in addition to existing risk factors. The goal of the study was to assess the serum levels of calcium and magnesium in people with type 2 diabetes mellitus and compare them to those in healthy controls. This cross-sectional study was conducted from July 2018 to June 2019 at the Mymensingh Medical College, Mymensingh, Department of Biochemistry in cooperation with the Department of Endocrinology, Mymensingh Medical College Hospital, Mymensingh, Bangladesh. Purposive (non-random) sampling was used to pick the subjects based on inclusion and exclusion criteria. This study had 100 individuals in total. Out of them, 50 people with type 2 diabetes mellitus who had been diagnosed were chosen as cases, and another 50 people who appeared to be in generally good health were chosen as controls. Serum calcium and magnesium levels were measured for this study's analytical purposes. The mean±SD was used to express all values. The statistical package for social science (SPSS), a Windows application, was used to conduct the statistical analyses. Using the Student's unpaired 't' test, the statistical significance of the difference between the case and control groups was assessed. Following comprehensive analysis, it was discovered that type 2 diabetes mellitus patients had considerably lower mean serum calcium (in case group was 8.46±0.63 and control group 8.86±0.64mg/dl) and magnesium levels (in case group was 2.09±0.42 and control group 2.24±0.16mg/dl) than healthy controls. According to the results of the current investigation, patients with type 2 diabetes mellitus had significantly altered serum calcium and magnesium levels. As a result, the study's hypothesis was accepted.

HbA1c and Troponin-I Levels and Their Relationship in Patients with Acute Coronary Syndrome

Acute coronary syndrome is a growing public health concern. Diabetic patients are more vulnerable to develop acute coronary syndrome due to accelerated atherosclerosis. Acute coronary syndrome is common in diabetes mellitus and is a major cause of mortality and morbidity in these patients. Troponin-I is a biochemical marker for cardiac muscle injury. Elevated glycated hemoglobin (HbA1c) is also regarded as an independent risk factor for acute coronary syndrome in patients with diabetes mellitus.The aim of this study was to assess the relationship of HbA1c and Troponin-I level in patients with acute coronary syndrome. This cross-sectional study was conducted in the Department of Biochemistry, Dhaka Medical College, Dhaka, Bangladesh from July 2018 to June 2019. Total study subjects were ninety five of both gender selected from the admitted patients of the cardiology department of the National Institute of Cardiovascular Diseases (NICVD), Dhaka. Diagnosis of acute coronary syndrome was confirmed by cardiologist. Diagnosis of diabetes mellitus was confirmed by Random Blood Glucose (RBG) level. Study subjects were grouped, acute coronary syndrome with diabetes mellitus as Group A and acute coronary syndrome without diabetes mellitus as Group B. Baseline parameters was recorded in data collection sheet. HbA1c, Troponin-I level of all study subjects were analyzed and recorded. Mean age of the study subjects in Group A and Group B were 51.06 years and 51.66 years respectively. Male gender was predominant in both groups. Mean SBP and DBP were significantly higher in Group A than Group B. Mean HbA1c level of the study subjects in Group A was significantly higher than Group B (p=0.001). Mean Troponin-I level in Group A was also significantly higher than Group B (p=0.023). HbA1c and Troponin-I levels were positively correlated in Group A (r=0.471, p=0.001). The present study demonstrated significant positive correlation of HbA1c and Troponin-I level in diabetic patients with acute coronary syndrome.

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.

Recent advances in lignocellulosic and algal biomass pretreatment and its biorefinery approaches for biochemicals and bioenergy conversion

As the global demand for sustainable energy increases, lignocellulosic (such as agricultural residues, forest biomass, municipal waste, and dedicated energy crops) and algal (including macroalgae and microalgae) biomass have attracted considerable attention, because of their high availability of carbohydrates. This is a potential feedstock to produce biochemical and bioenergy. Pretreatment of biomass can disrupt their complex structure, increasing conversion efficiency and product yield. Therefore, this review comprehensively discusses recent advances in different pretreatments (physical, chemical, physicochemical, and biological pretreatments) for lignocellulosic and algal biomass and their biorefining methods. Life cycle assessment (LCA) which enables the quantification of the environmental impact assessment of a biorefinery also be introduced. Biorefinery processes such as raw material acquisition, extraction, production, waste accumulation, and waste conversion are all monitored under this concept. Nevertheless, there still exist some techno-economic barriers during biorefinery and extensive research is still needed to develop cost-effective processes.

Study of Changes in Serum Copper Level in Patients with Acute Myocardial Infarction

Acute myocardial infarction (AMI) commonly known as heart attack is defined pathologically as the irreversible death of myocardial cells caused by ischemia. Risk factors include high blood pressure, smoking, diabetes, lack of exercise, obesity, high blood cholesterol and excessive alcohol intake. The major cause of acute MI is coronary atherosclerosis with superimposed luminal thrombus, which accounts for more than 80% of all infarcts. Micronutrients and trace elements are very essential for normal functioning of the body. Even though they are required in very small amount, an alteration in the level of this element may lead to serious diseases like CAD and its consequences. The injury induced by reperfusion of the ischemic myocardium could result partially from the cytotoxic effects of oxygen free radicals. Copper is involved in several of the reactions in the protection from free radical damage. So, this study was designed to evaluate serum cupper level in AMI patients. This case-control study was conducted in the Department of Biochemistry, Mymensingh Medical College, Mymensingh, Bangladesh from July 2016 to June 2017. Total number of subjects was 120 in number. Among them 60 were diagnosed case of acute myocardial infarction and 60 were apparently healthy volunteers. Data were collected using pre-designed data collection sheets. After proper counseling informed written consent was taken from the study population. The study revealed that mean serum copper level was higher in case group as compared to control group. The mean±SD values of copper were 105.44±24.15μg/dl and 146.49±23.52μg/dl in control and case group respectively. The level of significance was 0.001 (p<0.05). After analyzing the results of the study it is concluded that serum copper level was significantly higher in Acute Myocardial Infarction patients than normal individuals. Therefore, estimation of serum copper level in AMI patients might be useful to take appropriate measure to prevent free radical induced reperfusion injury.

Unlocking SGK1 inhibitor potential of bis-[1-N,7-N, pyrazolo tetraethoxyphthalimido{-4-(3,5-Dimethyl-4-(spiro-3-methylpyazolo)-1,7-dihydro-1H-dipyrazolo[3,4-b;4',3'-e]pyridin-8-yl)}]p-disubstituted phenyl compounds: a computational study

SGK1 (Serum and Glucocorticoid Regulated Kinase 1), a serine/threonine kinase that is activated by various stimuli, including serum and glucocorticoids. It controls inflammation, apoptosis, hormone release, neuro-excitability and cell proliferation, all of which play an important role in cancer progression and metastasis. SGK1 was recently proposed as a potential drug target for cancer, diabetes, and neurodegenerative diseases. In this study, molecular docking, physiochemical, toxicological properties and molecular dynamic simulation of the Bis-[1-N,7-N, Pyrazolo tetraethoxyphthalimido{-4-(3,5-Dimethyl-4-(spiro-3-methylpyazolo)-1,7-dihydro-1H-dipyrazolo[3,4-b;4',3'-e]pyridin-8-yl)}]p-disubstituted phenyl compoundsand reference EMD638683 against new SGK1 target protein. Compared to the reference inhibitor EMD638683, we choose the best compounds (series 2-6) based on the binding energy (in the range from -11.0 to -10.6 kcal/mol). With the exception of compounds 2 and 6, none of the compounds posed a risk for AMES toxicity or carcinogenicity due to their toxicological properties. 100 ns MD simulation accompanied by MM/PBSA energy calculations and PCA. According to MD simulation results, the binding of compounds 3, 4 and 5 stabilizes the SGK1 structure and causes febrile conformational changes compared to EMD638683. As a result of this research, the final selected compounds 3, 4 and 5 can be used as scaffolds to develop promising SGK1 inhibitors for the treatment of related diseases such as cancer.Communicated by Ramaswamy H. Sarma.

Molecular docking and simulation studies of flavonoid compounds against PBP-2a of methicillin-resistant Staphylococcus aureus

Methicillin-Resistant Staphylococcus aureus (MRSA), a pathogenic bacterium that causes life-threatening outbreaks such as community-onset and nosocomial infections as emerging 'superbug'. Time and motion study of its virulent property developed resistance against most of the antibiotics such as Vancomycin. Thereby, to curb this problem entails the development of new therapeutic agents. Plant-derived antimicrobial agents have recently piqued people's interest, so in this research, 186 flavonoids compound selected to unmask the best candidates that can act as potent inhibitors against the Penicillin Binding Protein-2a (PBP-2a) of MRSA. Molecular docking performed using PyRx and GOLD suite to determine the binding affinities and interactions between the phytochemicals and the PBP-2a. The selected candidates strongly interact with the different amino acid residues. The 30 ns molecular dynamics (MD) simulations with five top-ranked compounds such as Naringin, Hesperidin, Neohesperidin, Didymin and Icariin validated the docking interactions. These findings are also strongly supported by root-mean-square deviation, root-mean-square fluctuation and the radius of gyration. ADME/T analysis demonstrates that these candidates appear to be safer inhibitors. Our findings point to natural flavonoids as a promising and readily available source of adjuvant antimicrobial therapy against resistant strains in the future.Communicated by Ramaswamy H. Sarma.

Identification of novel inhibitors of high affinity iron permease (FTR1) through implementing pharmacokinetics index to fight against black fungus: An in silico approach

Mucormycosis is a life-threatening fungal infection, particularly in immunocompromised patients. Mucormycosis has been reported to show resistance to available antifungal drugs and was recently found in COVID-19 as a co-morbidity that demands new classes of drugs. In an attempt to find novel inhibitors against the high-affinity iron permease (FTR1), a novel target having fundamental importance on the pathogenesis of mucormycosis, 11,000 natural compounds were investigated in this study. Virtual screening and molecular docking identified two potent natural compounds [6',7,7,10',10',13'-hexamethylspiro[1,8-dihydropyrano[2,3-g]indole-3,11'-3,13-diazatetracyclo[5.5.2.01,9.03,7]tetradecane]-2,9,14'-trione and 5,7-dihydroxy-3-(2,2,8,8-tetramethylpyrano[2,3-f]chromen-6-yl)chromen-4-one] that effectively bind to the active cavity of FTR1 with a binding affinity of -9.9 kcal/mol. Multiple non-covalent interactions between the compounds and the active residues of this cavity were noticed, which is required for FTR1 inhibition. These compounds were found to have inhibitory nature and meet essential requirements to be drug-like compounds with a considerable absorption, distribution, metabolism, and excretion (ADME) profile with no toxicity probabilities. Molecular dynamics simulation confirms the structural compactness and less conformational variation of the drug-protein complexes maintaining structural stability and rigidity. MM-PBSA and post-simulation analysis predict binding stability of these compounds in the active cavity. This study hypothesizing that these compounds could be a potential inhibitor of FTR1 and will broaden the clinical prospects of mucormycosis.

Cell cycle associated miRNAs as target and therapeutics in lung cancer treatment

Lung cancer is the primary cause of cancer related deaths worldwide. Limited therapeutic options and resistance to existing drugs are the major hindrances to the clinical success of this cancer. In the past decade, several studies showed the role of microRNA (miRNA) driven cell cycle regulation in lung cancer progression. Therefore, these small nucleotide molecules could be utilized as promising tools in lung cancer therapy. In this review, we highlighted the recent advancements in lung cancer therapy using cell cycle linked miRNAs. By highlighting the roles of the specific cell cycle core regulators affiliated miRNAs in lung cancer, we further outlined how these miRNAs can be explored in early diagnosis and treatment strategies to prevent lung cancer. With the provided information from our review, more medical efforts can ensure a potential breakthrough in miRNA-based lung cancer therapy.

Clinical Outcome of 0.2% Glyceryl Trinitrate Topical Ointment Compared to Lateral Internal Sphincterotomy in the Treatment of Patient with Chronic Anal Fissure: A Randomized Control Trial

The objective of study was to evaluate the clinical outcome of topical 0.2% Glyceryl trinitrate topical (GTN) ointment in the treatment of chronic anal fissure. This randomized control trial was carried out in the Colorectal Surgery Unit, Department of Surgery, Bangabandhu Sheikh Mujib Medical University (BSMMU), Bangladesh from May 2015 to April 2016. Total 94 patients were included in this trial, where 47(50.0%) patients were treated by 0.2% GTN ointment as Trial group 12 hourly for 8 weeks and 47(50.0%) patients by lateral internal sphincterotomy (LIS) as Control group in this study. Patients were randomized in two groups by lottery following purposive sampling. Post-procedural outcome variables with 6 months follow up were evaluated. Majority of the patients were found in between 20 to 40 years of age in both groups. The mean age was 34.6±10.4 years and 33.2±8.6 years in GTN and LIS respectively. Overall male female ratio was 0.88:1. All (100.0%) patients presented with pain in anus and 86.15% patients presented with per rectal bleeding. Pain relief in GTN arm versus LIS arm in 2nd and 6th week was 55.31% vs. 76.6%, 74.5% vs. 87.23% with no significant difference between two groups. But at 6 month it was 57.44% vs. 93.6% respectively. The fall in pain relief at 6th month in GTN arm was due to recurrence of fissure. At the end of 2nd, 6th week and 6month, cessation of bleeding improved gradually in both groups after treatment but the improvement was significantly better in LIS group than in GTN group indicating sphincterotomy stops bleeding better. Healing after 2nd week in both groups was minimum but equal 2(4.26%) patients. After 6 weeks LIS group had significant better healing than GTN 40(85.1%) versus 26(55.3%) with p value <0.001. In 6 month time GTN group had increased healing but LIS group had significant better healing than GTN group 42(89.36) vs. 32(68.08) with p value 0.004. Transient flatus and liquid incontinence were 8.51% and 6.4% respectively in LIS group with 0.0% in GTN group. Headache and recurrence were significantly higher in GTN group 61.7% and 34.04% with p<0.001. Lateral internal anal sphincterotomy is superior to the topical application of 0.2% nitroglycerin ointment in the treatment of chronic anal fissure with the advantages of good symptomatic relief, high rate of healing and a very low rate of transient continence disturbances.

Evaluation of Liver Function Tests in β-Thalassemia Major Children

Thalassemia is the most prevalent single gene defect in human beings worldwide. Repeated blood transfusions along with chelation therapy are mainstay of treatment in thalassemia patients. However these recurrent blood transfusions result in iron overload which along with chelation therapy causes deterioration of liver function. Aim of the study was to evaluate the liver function tests in β-thalassemia major patients. This cross sectional study was conducted in the Department of Biochemistry, Dhaka Medical College, Dhaka, Bangladesh from January 2017 to December 2017. In this study, 50 diagnosed patients of β Thalassemia major (Group A) and 50 apparently healthy children (Group B) of both sexes were selected from the department of Paediatrics, Dhaka medical college. The study parameters were serum ferritin, bilirubin, AST, ALT, ALP. The results were compared statistically between groups. Serum ferritin level (mean±SD) in thalassemic major patients in Group A (890±446.38 microgram/L) which is significantly higher above normal level. Serum bilirubin in Group A (3.27±2.62 mg/dl) and in Group B (0.48±0.24 mg/dl), Serum ALT in Group A (53.06±34.0 U/L) and in Group B (16.70±4.81 U/L), AST in Group A (84.56±33.54 U/L) and in Group B (11.60±2.72 U/L) and ALP levels in Group A (422.42±226.99 IU/L) and in Group B (221.86±80.54 IU/L). All the values were significantly higher (p<0.001) in β-thalassemia patient than that of normal children. This study concludes that liver function parameters are significantly higher in β thalassemia major patients. So routine evaluation of liver function tests may be advocated for thalassemic patients to predict early onset of hepatic dysfunction.

Comparison between Lichtenstein And Laparoscopic Totally Extraperitonial (TEP) Tension Free Mesh Repair of Inguinal Hernia

To compare the outcome of the laparoscopic totally extra peritoneal (Lap TEP) and open Lichtenstein tension free mesh repair (OLMR) of inguinal hernia. This study was conducted as a prospective comparative (Quasi experimental) study from January 2010 to December 2010 at Combined Military Hospital (CMH), Dhaka, Bangladesh. A total of 100 male patients aged 24 to 70 years who underwent laparoscopic totally extra-peritoneal (Lap TEP) and open Lichtenstein tension free mesh repair (OLMR) of inguinal hernia were included in this study. Data of operating time, intraoperative and short-term postoperative complications, postoperative pain, postoperative hospital stay and return to normal activity were recorded and analyzed with SPSS program. Mean age of the patients was 51.39±15.099 years in OLMR group (Group A) and 47.10±9.338 years in Lap TEP group (Group B). Mean operating time was longer in Laparoscopic TEP group (Group B, 57.67±6.915 minutes) then open Lichtenstein mesh repair group (Group A, 50.56±6.292 minutes). Patient in the Lap TEP group (Group B) experienced less post operative pain, less post operative complications, shorter hospital stay and early return to normal activity then OLMR group (Group A). One patient (3.33%) in group B needed conversion to open Lichtenstein method. Two (6.66%) patients developed pneumoperitoneum in Group B (Lap TEP repair). Superficial wound infection developed in five (7.14%) patients in OLMR group (Group A) and two (6.66%) patients in Lap TEP group (Group B). In Laparoscopic TEP group (Group B) and Lichtenstein group (Group A), patients return to normal activity within on an average 07 and 11 days respectively. Laparoscopic totally extra peritoneal (TEP) mesh repair technique was associated with less post operative pain, less post operative complications, shorter hospital stay, faster recovery with early return to normal activity compared with Lichtenstein tension free mesh repair of inguinal hernia.

Modulation of osmoprotection and antioxidant defense by exogenously applied acetate enhances cadmium stress tolerance in lentil seedlings

To examine the potential role of acetate in conferring cadmium (Cd) stress tolerance in lentil (Lens culinaris), several phenotypical and physio-biochemical properties have been examined in Cd-stressed lentil seedlings following acetate applications. Acetate treatment inhibited the translocation of Cd from roots to shoots, which resulted in a minimal reduction in photosynthetic pigment contents. Additionally, acetate-treated lentil showed higher shoot (1.1 and 11.72%) and root (4.98 and 30.64%) dry weights compared with acetate-non-treated plants under low-Cd and high-Cd concentrations, respectively. Concurrently, acetate treatments increase osmoprotection under low-Cd stress through proline accumulation (24.69%), as well as enhancement of antioxidant defense by increasing ascorbic acid content (239.13%) and catalase activity (148.51%) under high-Cd stress. Acetate-induced antioxidant defense resulted in a significant diminution in hydrogen peroxide, malondialdehyde and electrolyte leakage in Cd-stressed lentil seedlings. Our results indicated that acetate application mitigated oxidative stress-induced damage by modulating antioxidant defense and osmoprotection, and reducing root-to-shoot Cd transport. These findings indicate an important contribution of acetate in mitigating the Cd toxicity during growth and development of lentil seedlings, and suggest that the exogenous applications of acetate could be an economical and new avenue for controlling heavy metal-caused damage in lentil, and potentially in many other crops.

Comparison of clinical characteristics of COVID-19 between children and adult

The aim of the study was to evaluate and compare the clinical characteristics of COVID-19 infection in children and adult. This observational cross-sectional study was conducted in multiple corona dedicated hospitals, situated in Dhaka, Bangladesh from April 2020 to January 2021. Data of COVID -19 positive hospitalized patients were collected in a pre-tested question- naire during hospital stay with proper protective measures. Clinical characteristics of the COVID-19 positive hospitalized children and adult patients were evaluated. Approval was taken from institutional review board of respective institutes. Statistical analyses of the results were obtained by using SPSS-25. In this study the male-to-female ratio was 1:1.6 and 2.8:1 in child and adult patients respectively. More than three quarter (75.4%) of subjects had family members affected before the illness in the child group and more than half (50.9%) cases in the adult group. History of contact or exposure with any symptomatic case was present in 61.4% cases in the adult group but only 14% in the child group. The mean duration of illness was less (9.1}8.6 days) in the child group than in the adult group (14.8}9.5 days). The difference was statistically significant (p<0.05) between the two groups. The most common symptoms in the child group were fever (71.9%), cough (77.2%) and runny nose (52.6%) whereas in the adult group most common symptoms were fatigue, excessive tiredness, or lethargy (80.7%), cough (77.2%) and anosmia (70.3%). There were statistically significant (p<0.05) differences in symp- toms between the two groups. Raised body temperature was (>1010 F) was found in the majori- ty (86.0%) subjects' in the child group than in the adult group where it was 50.9%. The mean SPo2 without oxygen was 96.8}1.2% in the child group and 92.8}5.7% in the adult group. Ten (17.5%) subjects had a symptom-free total illness in the child group and 3(5.3%) in the adult group. The difference in temperature, SPo2 without oxygen, consciousness, and symptom-free total illness were statistically significant (p<0.05) between the two groups. In adult group 94.7% patient required hospital admission according to guideline, but in child group only 40.3% actually needed hospitalization, rest of the children got admitted along with family member or due to other diseases. Fever, cough and runny nose were more frequent symptoms in children however, fever, fatigue, excessive tiredness, anorexia, nausea, vomiting, anosmia, diarrhoea and body ache were more common in adult patients. These differences were statistically signifi- cant. In comparison to COVID-19 infected adult cases, infected children had higher oxygen saturation (without additional oxygen) by pulse oximeter. BSMMU J 2022; 15(1): 35-42