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

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

Effect of photocatalysis (TiO2/UVA) on the inactivation and inhibition of Pseudomonas aeruginosa virulence factors expression

Water disinfection using visible light-active photocatalyst has recently attracted more attention due to its potential to inactivate microbes. In this study, we have investigated the efficiency of photocatalysis (TiO₂/UV_A) on the inactivation of Pseudomonas aeruginosa and the attenuation of its virulence factors. For this aim, the photocatalytic effects of TiO₂/UV_A on the cultivability and viability of P. aeruginosa were investigated. Furthermore, during the photocatalysis, the morphology of the bacterial cells was examined by atomic force microscopy (AFM) while the virulence factors were assessed by protease and lipase activities in addition to the mobility and communication of cells. The results revealed that during the photocatalysis the bacterial cells lost their cultivability and viability on agar under the action of the reactive oxygen species generated by the photocatalytic reaction. In addition, AFM observations have shown a damage of the bacterial membrane and a total disruption of the bacterial cells. Moreover, the major virulence factors such as biofilm, lipase and protease expression have been markedly inhibited by TiO₂/UV_A treatment. In addition, the bacteria lost their ability of communication 'quorum sensing' and mobility with twitching and swarming types after 60 min of photocatalytic treatment. Accordingly, TiO₂/UV_A is an effective method to reduce P. aeruginosa virulence and to prevent biofilm formation.

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

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

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

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

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

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

Effects of short- and long-term exposures of humic acid on the Anammox activity and microbial community

Humic acid has a controversial effect on the biological treatment processes. Here, we have investigated humic acid effects on the Anammox activity by studying the nitrogen removal efficiencies in batch and continuous conditions and analyzing the microbial community using Fluorescence in situ hybridization (FISH) technique. The results showed that the Anammox activity was affected by the presence of humic acid at a concentration higher than 70 mg/L. In fact, in the presence of humic acid concentration of 200 mg/L, the Anammox activity decreased to 57% in batch and under continuous condition, the ammonium removal efficiencies of the reactor decreased from 78 to 41%. This reduction of Anammox activity after humic acid addition was highlighted by FISH analysis which revealed a considerable reduction of the abundance of Anammox bacteria and the bacteria living in symbiosis with them. Furthermore, a total inhibition of Candidatus Brocadia fulgida was observed. However, humic acid has promoted heterotrophic denitrifying bacteria which became dominant in the reactor. In fact, the evolution of the organic matter in the reactor showed that the added humic acid was used as carbon source by heterotrophic bacteria which explained the shift of metabolism to the favor of heterotrophic denitrifying bacteria. Accordingly, humic acid should be controlled in the influent to avoid Anammox activity inhibition.

Comparative study on pilots between ANAMMOX favored conditions in a partially saturated vertical flow constructed wetland and a hybrid system for rural wastewater treatment

The objective of this research was to evaluate the nitrogen removal in a single stage rural wastewater treatment system. It was a modified subsurface vertical flow (SSVF) constructed wetland. The so-called Anaerobic Ammonium Oxidation(ANAMMOX) process is favored by imposing a saturated zone at the bottom of the basin. The nitrogen removal performances of this modified SSVF were compared to those of a conventional hybrid system where the well-known nitrification-denitrification process is performed. This study was carried out using three lab-scale pilots of constructed wetlands during four months: (1) a hybrid constructed wetlands with a reed-Phragmites australis SSVF bed in serial with a cattail-Typha angustofolia SSHF bed (SSVF_p + SSHF). (2) A reed-Phragmites australis SSVF bed partially saturated at 40% of its depth (SSVF_PS); (3) A cattail-Typha angustofolia SSVF bed partially saturated at 40% of its depth (SSVF_TS). The results showed that the three configurations used in this study were efficient for most of the pollutants reduction. In fact, single-stage reactors have achieved similar chemical oxygen demand (COD) removal in comparison to the two-stage reactor independently of the macrophytes species. However, for Total Kjeldahl Nitrogen (TKN), a slightly higher nitrogen removal efficiency was recorded for (SSVF _p + SSHF) with an average removal rate of 53% versus 48% and 51% for SSVF _PS and SSVF_TS respectively. These findings were highlighted with fluorescent in situ hybridization (FISH) analysis, which demonstrated the presence of major differences in the community composition and abundance of the bacteria involved with denitrification and nitrification in the three systems. In fact, SSVF_P of the hybrid system was characterized by highest relative abundance of nitrifying bacteria (13% Nitrosomonas, 11% Nitrosospira, 14% Nitrospira and 10% Nitrobacter). While, the SSHF of hybrid system had larger number of denitrifying species than SSVF, with relative abundances of pseudomonas (3%), Paracoccus (9%), Zoogloea (6%), Thauera (4%), Thiobacillus (2%) and Aeromonas (1%). Interestingly, in the SSVF_ST (planted with Thypha angustofolia) where the relative abundance of nitrifying bacteria was very low (4% Nitrosomonas, 4% Nitrosospira, 4% Nitrospira and 1% Nitrobacter), we have detected the presence of ANAMMOX bacteria (3%). Accordingly SSVF_ST in the presence of Thypha angustofolia have favored the development of ANAMMOX activity in comparison to the other configurations.

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

BACKGROUND

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

Evaluation of a hybrid anaerobic biofilm reactor treating winery effluents and using grape stalks as biofilm carrier

Wine production processes generate large amount of both winery wastewater and solid wastes. Furthermore, working periods, volumes and pollution loads greatly vary over the year. Therefore, it is recommended to develop a low-cost treatment technology for the treatment of winery effluents taking into account the variation of the organic loading rate (OLR). Accordingly, we have investigated the sequential operation of an anaerobic biofilm reactor treating winery effluents and using grape stalks (GSs) as biofilm carrier with an OLR ranging from 0.65 to 27 gCOD/L/d. The result showed that, during the start-up with wastewater influent, the chemical oxygen demand (COD) removal rate ranged from 83% to 93% and was about 91% at the end of the start-up period that lasted for 40 days. After 3 months of inactivity period of the reactor (no influent feeding), we have succeeded in restarting-up the reactor in only 15 days with a COD removal of 82% and a low concentration of volatile fatty acids (1 g/L), which confirms the robustness of the reactor. As a consequence, GSs can be used as an efficient carrier support, allowing a fast reactor start-up, while the biofilm conserves its activity during a non-feeding period. The proposed hybrid reactor thus permits to treat both winery effluents and GSs.

Sequential operation of a hybrid anaerobic reactor using a lignocellulosic biomass as biofilm support

Agro-industries are facing many economic and environmental problems associated with seasonal generation of liquid and solid waste. In order to reduce treatment costs and to cope with seasonal variation, we have developed a hybrid anaerobic reactor operated sequentially by using lignocellulosic biomass (LB) as biofilm carrier support. Six LBs were tested to evaluate the treatment performance during a succession of two start-up periods, separated by a non-feeding period. After a short acclimation phase of several days, all the reactors succeeded in starting-up in less than 1month to reach an organic loading rate of 25gCODL(-1)d(-1). In addition, they restarted-up successfully in only 15days after a 3month non-feeding period, indicating that biofilms conserved their biological activities during this last phase. As a consequence, the use of LB as a biofilm support gives the potential to sustain seasonal variations of wastewater loads for industrial application.

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

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

Methionine elicits H2O2 generation and defense gene expression in grapevine and reduces Plasmopara viticola infection

Methionine (Met) is a nutritionally essential sulfur-containing amino acid (SAA) known for its preponderant role as initiator in protein synthesis. However, other functions for Met in plants are not well described. The implication of this SAA in oxidative stress tolerance has been recently reported, however the mode of action of Met is still poorly understood. Here, we analyzed the elicitor activity of Met in grapevine as well as its effect on Plasmopara viticola resistance. The results show that Met induces hydrogen peroxide (H2O2) generation, a key element in plant defense signaling, and upregulates the expression of a battery of defense-related genes. Transcript levels of these genes were not further modulated by P. viticola inoculation of Met-pretreated plants, suggesting an elicitor role rather than a priming role for Met in grapevine. Met treatment also reduces P. viticola development in grapevine plants grown under glasshouse controlled-conditions. Fungitoxicity assays revealed that Met possesses a moderate antifungal activity compared with cysteine (Cys), another SAA known for its toxic effect to a large spectrum of fungi.

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

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

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

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

Thiamine modulates metabolism of the phenylpropanoid pathway leading to enhanced resistance to Plasmopara viticola in grapevine

BACKGROUND

Previously, we have reported the ability of thiamine (vitamin B1) to induce resistance against Plasmopara viticola in a susceptible grapevine cv. Chardonnay. However, mechanisms underlying vitamins, especially, thiamine-induced disease resistance in grapevine are still largely unknown. Here, we assessed whether thiamine could modulate phenylpropanoid pathway-derived phytoalexins in grapevine plants, as well as, the role of such secondary metabolites in thiamine-induced resistance process to P. viticola.

RESULTS

Our data show that thiamine treatment elicited the expression of phenylpropanoid pathway genes in grapevine plants. The expression of these genes correlated with an accumulation of stilbenes, phenolic compounds, flavonoids and lignin. Furthermore, the total anti-oxidant potential of thiamine-treaded plants was increased by 3.5-fold higher level as compared with untreated-control plants. Four phenolic compounds are responsible of 97% of the total anti-oxidant potential of thiamine-treated plants. Among these compounds, is the caftaric acid, belonging to the hydroxy-cinnamic acids family. This element contributed, by its own, by 20% of this total anti-oxidant potential. Epifluorescence microscopy analysis revealed a concomitant presence of unbranched-altered P. viticola mycelia and stilbenes production in the leaf mesophyll of thiamine-treated inoculated plants, suggesting that stilbenes are an important component of thiamine-induced resistance in grapevine.

CONCLUSION

This work is the first to show the role of thiamine, as a vitamin, in the modulation of grapevine plant secondary metabolism contributing to an enhanced resistance to P. viticola, the most destructive fungal disease in vineyards.

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

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

Characterization of ammonium retention processes onto cactus leaves fibers using FTIR, EDX and SEM analysis

In order to reduce the impact of nitrogen pollution and to increase the agronomic value of plant wastes to be reused as organic fertilizer, we have investigated the removal of ammonium from aqueous solutions onto cactus leave fibers (CLF), and the mechanisms involved in the retention of ammonium at CLF surface. The results showed that ammonium retention onto these fibers occurred for a wide pH (6-10) and temperature ranges (20-60°C) and the biosorption potential of CLF increased with temperature from 1.4 to 2.3 mg g(-1) for initial concentration of 50 mg L(-1). The modeling studies showed that the ammonium biosorption was well described by the pseudo-second-order model, predicting therefore, chemisorption interactions-type at earlier stages and by intraparticle diffusion at later stages. Biosorption is governed by film diffusion process at higher concentrations and by particle diffusion process at higher temperatures. The surface of CLF determined by SEM revealed the presence of cracks and cavities which may allow the intraparticle diffusion and the ion exchange processes. Moreover, FTIR and EDX analysis before and after ammonium retention showed that the main mechanisms involved in the removal of ammonium were the ionic exchange by calcium ions as well as H(+) and the complexation with carboxylic, alcoholic and phenolic groups.

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

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

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

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

Thiamine induced resistance to Plasmopara viticola in grapevine and elicited host-defense responses, including HR like-cell death

Recently, thiamine (VitaminB1) has been shown to induce resistance against Pseudomonas syringae in Arabidopsis plants through priming of defense responses. In this paper, we have demonstrated the efficiency of thiamine to induce resistance against downy mildew caused by the oomycete Plasmopara viticola in a susceptible Vitis vinifera cultivar "Chardonnay" under glasshouse controlled conditions by providing a dual mode of action involving direct antifungal activity and elicitation of host-defense responses. Thiamine-induced defense responses included the generation of hydrogen peroxide (H(2)O(2)) in both grapevine suspension cultured cells (SCC) and plant leaves, upregulation of an array of defense-related genes and the induction of other defense responses at subcellular level such as callose deposition in stomata cells, phenolic compounds accumulation and hypersensitive response (HR) like-cell death. Epifluorescence microscopy studies revealed dramatic changes in P. viticola individual developmental stages during its colonization of the intercellular space of the leaf mesophyll in thiamine-treated plants. Collectively, our report evidenced the efficiency of thiamine in the control of downy mildew in grapevine by direct and indirect effects, suggesting that thiamine could be an attractive alternative to chemical fungicides in disease management in vineyards.

Efficacy of Oral Itraconazole in the Treatment of Seborrheic Dermatitis

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

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

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

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

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

Nonspirometric aspects of pulmonary function in subjects with dust industries

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

Posidonia oceanica (L.) fibers as a potential low-cost adsorbent for the removal and recovery of orthophosphate

Adsorption efficiency of orthophosphate from aqueous solution onto Posidonia oceanica fibers (POF) as a raw, natural and abundant material was investigated and compared with other common natural materials. A series of batch tests were undertaken to assess the effect of the system variables, i.e. initial aqueous orthophosphate concentration, contact time, adsorbent dosage, pH and temperature. Results indicate that orthophosphate uptake increased with increasing initial orthophosphate concentration, temperature and adsorbent dosage and decreased with increasing pH values. The maximum adsorption capacity (Q(m)) determined from the Langmuir isotherm was calculated to be 7.45 mg g(-1) for the studied orthophosphates concentration range of 15-100 mg L(-1), pH 7; adsorbent dosage of 2 g L(-1) and temperature of 20±2°C. The adsorption data were very well described by the pseudo-second order model predicting a chemisorption process. The energy dispersive spectroscopy (EDS) and FTIR analysis before and after adsorption of orthophosphate onto POF showed that the main involved mechanisms are ligand exchange between orthophosphate and Cl(-), SO(4)(2-) and OH(-) and precipitation with calcium. In comparison with other natural adsorbents, raw POF could be considered as one of the most efficient natural materials for the removal of orthophosphate with the possibility of agronomic reuse.

Minor criteria for atopic dermatitis in children

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

Removal of phosphorus from aqueous solution by Posidonia oceanica fibers using continuous stirring tank reactor

The present study aims to develop a new potentially low-cost, sustainable treatment approach to soluble inorganic phosphorus removal from synthetic solutions and secondary wastewater effluents in which a plant waste (Posidonia oceanica fiber: POF) is used for further agronomic benefit. Dynamic flow tests using a continuous stirred tank reactor (CSTR) were carried out to study the effect of initial concentration of phosphorus, amount of adsorbent, feeding flow rate and anions competition. The experimental results showed that the removal efficiency of phosphorus from synthetic solutions is about 80% for 10 g L(-1) of POF. In addition, the variation of the initial concentration of phosphorus from 8 to 50 mg L(-1) increased the adsorption capacity from 0.99 to 3.03 mg g(-1). The use of secondary treated wastewater showed the presence of competition phenomenon between phosphorus and sulphate which could be overcoming with increasing the sorptive surface area and providing more adsorption sites when increasing the adsorbent dosage of POF. Compared with columns studies, this novel CSTR system showed more advantages for the removal of soluble phosphorus as a tertiary treatment of urban secondary effluents with more adsorption efficiency and capacity, in addition to the prospect use of saturated POF with nutriment as fertilizer and compost.

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

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

Phosphate mine wastes reuse for phosphorus removal from aqueous solutions under dynamic conditions

Phosphate mine slimes (PMS), an abundant waste generated from phosphate mines, was used in this study as a cost-effective adsorbent to investigate the phosphate anions removal from synthetic and urban secondary treated wastewater solutions. Dynamic experiments using laboratory reactors were carried out to study the effect of phosphate influent concentration, PMS dosage and feed flow rate on phosphate removal and a kinetic model was used to determine the phosphate mass transfer coefficients. The results show that the phosphate removal increases with influent phosphate concentration and PMS dosage. The feed flow rate has no significant effect. On the other hand, the phosphate removal from wastewater is less efficient than the synthetic solution due to anions competition process. The evaluation of phosphates mass transfer coefficients confirms the presence of anion competition phenomena and the necessity of increasing PMS dosage to provide more adsorption sites. The cost-effective and high adsorptive capability of PMS make them attractive materials for phosphate anions removal and recovery from secondary treated wastewaters with the possibility of agronomic reuse as fertilizer.

Effect of temperature and pH on the biosorption of ammonium onto Posidonia oceanica fibers: equilibrium, and kinetic modeling studies

In the present study, the effects of temperature and pH on ammonium biosorption onto Posidonia oceanica fibers were investigated. The results showed that the ammonium biosorption onto these fibers occurred for a wide pH range and the adsorption capacity of these fibers increased with increasing temperature. The modeling studies showed that the ammonium biosorption was well described by the pseudo-second-order model, predicting therefore chemisorption interactions-type at earlier stages and intraparticle diffusion at later stages. The ammonium biosorption was governed by film diffusion process at various temperatures. Besides, equilibrium data were very well represented by Langmuir isotherm, which confirmed the mono-layer coverage. The use of P. oceanica fibers presents an interesting option for both tertiary wastewater treatment (as a possible non-conventional biosorbent for the removal of ammonium), and waste recycling (as a fertilizer and compost).

Ammonium biosorption onto sawdust: FTIR analysis, kinetics and adsorption isotherms modeling

Sawdust, an available and renewable biomass, was investigated as a novel ammonium biosorbent. Biosorption occurred over a pH range of 6-10, reached an equilibrium state within only 20 min, and can be described by a pseudo-second-order model predicting a chemisorption process. Equilibrium data were very well represented by Langmuir isotherm and confirm monolayer coverage. FTIR analysis before and after biosorption of ammonium onto sawdust suggested that the main mechanisms involved in the removal of ammonium might be the ionic exchange and complexation. The use of sawdust presents an interesting option for both tertiary wastewater treatment (as a possible non-conventional biosorbent for the removal of ammonium), and waste recycling (as a fertilizer and compost).

Profile of lichen planus in Bangladesh

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

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

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

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

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

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

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

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

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

Efficacy of combination therapy for the management regime of Alopecia areata

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

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

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

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

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

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

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

Serum homocysteine concentration in patients with acute MI and chronic IHD

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

Necessity of antibiotics prophylaxis during extracorporeal shock wave lithotripsy

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

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

OBJECTIVE

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

DESIGN

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

SETTING

A maternity hospital in the United Kingdom.

MAIN OUTCOME MEASURES

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

RESULTS

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

CONCLUSION

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

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

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