Fatty acid profile variations after exposure to textile industry effluents in Indian Major Carps

Indian major carps are the widely consumed fish species of Pakistan, being a cheap source of proteins and unsaturated fatty acids, they are good for cardiovascular health. Water pollution due to discharge of untreated industrial waste water into water bodies contaminates this precious source of nutrients. The present study therefore, was aimed to assess deterioration of fatty acid profile of three Indian major carp species due to different concentrations of industrial wastes. The water samples were collected from the river Chenab at the site where it receives industrial wastewater via Chakbandi drain. After exposure to 1.5%, 3.0%, and 4.5% dilutions of collected water in different aquaria it was observed that proportion of unsaturated fatty acids in selected fish species were decreased significantly as the intensity of the dose increased (P < 0.05). Conversely the level of saturated fatty acids increased with the increasing dose of treatment (P < 0.05). These findings suggest that untreated wastewater not only deteriorate the fatty acid profile of aquatic animals but also these toxic substances can reach human body through fish meat and pose further health hazards. Therefore, it is highly recommended that industrial effluents should be treated before they are dumped into water bodies.

Histopathological alterations in gills, liver, kidney and muscles of Ictalurus punctatus collected from pollutes areas of River

Abstract Untreated sewage and industrial wastes from Faisalabad city are disposed to River Chenab through Chakbandi Main Drain (CMD). The present project is planned to investigate the effects of this freshwater pollution on the body of fish Ictalurus punctatus. The specimens of this fish species were collected upstream and downstream of the entrance of CMD into River Chenab. Fish gills, liver, kidney and muscles from dorsolateral regions of fish were subjected to histopathology. Farmed fish and fish from upstream areas were used as control. Fish collected from polluted experimental sites showed significant damage in selected organs. Gill tissues showed an abnormality in the form of an uplifting of the primary epithelium, fusion, vacuolation, hypertrophy, and necrosis. While liver tissues subjected to hepatocytes degeneration, necrosis, mitochondrial granular hepatocyte, and sinusoids dilation. Kidney tissues indicated increased bowmen space and constricted glomerulus and degenerated nephrons. Edema, necrosis, and atrophy were observed in muscle tissues of fish from polluted areas. Fish from the upstream area showed fused gill lamellae, inflammatory cell infiltration, hypertrophy and vacuolation in hepatocytes. Kidney tissues indicated the presence of nuclear tubular cells, destructive renal tubules, hemorrhage, and necrosis at tubular epithelium. Intra myofibril spaces were also observed in muscles. Specimens of control fish indicated no variation in gills, liver, kidney, and muscles. The present study revealed a strong correlation between the degree of tissue damage and environmental contamination. Present findings also compel global warnings to protect our water bodies and fish to rescue the human population.

Molecular Phylogenetics of Physa acuta (Pulmonata: Basommatophora): an Invasive species in Central Punjab Pakistan

Physids belong to Class Gastropoda; belong to Phylum Mollusca and being bioindicators, intermediate hosts of parasites and pests hold a key position in the ecosystem. There are three species of Genus Physa i.e. P. fontinalis, Physa acuta and P. gyrina water bodies of Central Punjab and were characterized on the basis of molecular markers High level of genetic diversity was revealed by polymorphic RAPD, however SSR markers were not amplified. The multivariate analysis revealed polymorphism ranging from 9.09 percent to 50 percent among the three Physid species. Total number of 79 loci were observed for the three species under study and 24 loci were observed to be polymorphic. These RAPD fragment(s) can be developed into co dominant markers (SCAR) by cloning and can be further sequenced for the development of the Physa species specific markers to identify the introduced and native species in Pakistan.

Characterization of the species of genus Physa on the basis of typological species concept from Central Punjab

Physids belong to Class Gastropoda; Phylum Mollusca have important position in food web and act as bio indicators, pests and intermediate host. Being resistant these are called cockroaches of malacology. Physid snails were collected from different water bodies of Faisalabad (Punjab) and were identified up to species using morphological markers. The morphometry of the specimens was carried out with the help of a digital Vernier caliper in millimeters (mm) using linear measurement of shell characters. Linear regression analysis of the AL/SW ratio vs AL and SL/SW ratio vs AL indicated that allometric growth exists only in Physa acuta when compared with P.gyrina and P. fontinalis. This study will lead to assess the status of the Physid species in Central Punjab. The Principal component analysis shows that the Component 1 (Shell Length) and component 2 (Shell Width) are the most prolific components and nearly 80 percent of the identification. The distance between P. acuta and P. fontinalis is 5.4699, P. acuta and P. gyrina is 7.6411, P. fontinalis and P. gyrina is 16.6080 showing that P. acuta resembles with P. fontinalis, and both these specimens donot resemble with P. gyrina. P.acuta is an invasive species and shows bioactivity making it a potent candidate for bioactive substances.

Clinicopathologic Features of Gastric and Gastrooesophageal Junction Adenocarcinoma

Gastric cancer (GC) is one of the most common tumors and remains the second leading cause of cancer mortality in the world. The incidence of gastric carcinoma is declining in the last few years in some areas like USA, UK, Canada etc, because of reduction in chronic H. pylori infection, smoking, decrease use of smoked and salted food. The gastric carcinoma still remains a burden for Bangladesh as the prevalence of H. Pylori has not substantially decreases. Among the gastric carcinomas, adenocarcinomas are the most common type. So the study was performed to observe the location and histomorphologic pattern of Gastric and gastrooesophageal junction (GEJ) adenocarcinoma. This descriptive cross sectional study was carried out at the Department of Pathology, Dhaka Medical College, Dhaka, Bangladesh from January 2013 to December 2014. A total of 130 patients with primary gastric and GEJ adenocarcinomas were included in this study. All the cases were evaluated for routine histological examination. The age range of the patients was 17 to 80 years and male to female ratio was 2.25:1. Antrum is the most common (66.9%) site being affected, followed by GEJ (19.2%), body (13%) and fundus (0.76%). Tumors of the antrum and GEJ were found mostly in the late age. On macroscopic examination, the ulcerated tumor mass (69.2%) was most frequent then the others. Regarding histological examination, 84(64.6%) cases were intestinal type, 32(24.6%) diffuse and 14(10.8%) mixed type by Laurens classification. According to WHO classification, about half of the cases (49.2%) were tubular carcinoma and rest were others. Most of the intestinal type carcinoma (71.4%) was presented with moderately differentiated and 25.0% with well differentiated. Where as the diffuse type presented with poorly differentiated in 96.9% cases.

Assessment of heavy metals and its impact on DNA fragmentation in different fish species

This study was conducted to assess water pollution by examining DNA fragmentation in selected fish organs (kidney, liver, gills, and muscle tissue) from Wallago attu, Sperata sarwari, Vulgaris vulgaris, and Labeo rohita collected from a known polluted section of the Chenab River, Pakistan, and from a control site. The fish were caught using a gill net and were assigned to three different weight groups (W1, W2, and W3) to study the degree of variation in DNA fragmentation in relation to body weight. In fish from the polluted site, DNA fragmentation was higher in kidney, liver, gills, and muscles, compared to the control. No significant DNA fragmentation was observed in fish collected from the control site. Highly significant (P < 0.01) relationship between body weight and DNA fragmentation was found in the organs of fish procured at the contaminated site. DNA fragmentation in body organs was found to be affected by the concentrations of lead, copper, nickel, and cadmium in W. attu, S. sarwari, L. rohita, and V. vulgarus harvested from Chenab River. DNA fragmentation in different freshwater fish species is therefore a reliable biomarker of water pollution.

Prevalence of Serological Markers of Viruses in Patients of Acute Hepatitis

Infections due to hepatitis A (HAV), hepatitis B (HBV), hepatitis C (HCV) and hepatitis E (HEV) viruses are the major causes of hepatitis and are associated with significant morbidity and mortality in developing countries like Bangladesh. The aim of this study was to assess the distribution pattern of serological markers in patients of acute viral hepatitis. This was a hospital based observational cross sectional study among purposively selected 107 patients admitted with acute viral hepatitis in the Department of Medicine, Mymensingh Medical College Hospital, Mymensingh, Bangladesh from April 2017 to September 2017. Data were collected by face-to-face interview of the patients, clinical assessment and investigations of biochemical and serological parameters using a structured questionnaire. Descriptive analysis was done using the analytic software SPSS version 21.0. The mean age of the patients was 33.35±12.97 years. Majority was male (68.2%), Muslim (87.9%), married (72.9%) and came from urban area (63.6%) with different level of educational qualifications. The prevalence of viral hepatitis is higher in male (68.22%) than female (31.78%). The common clinical presentations were dark coloured urine (100.0%), yellow colouration of the sclera (100.0%), anorexia (90.6%), nausea/vomiting (79.4%) and abdominal pain (68.2%). Of the 107 patients, 51.40% (n=55) had acute viral E hepatitis, 36.40% (n=39) had acute viral B hepatitis, 12.15% (n=13) had acute viral A hepatitis. Mixed infection with both hepatitis E and A viruses was 1.87% (n=2). HEV and HBV are common in relatively older age while HAV is common in relatively younger age to cause acute viral hepatitis. The study revealed a high prevalence of HEV followed by HBV and HAV in the Bangladeshi population suspected of having suffered from acute viral hepatitis.

Potential of natural repellents methylanthranilate and anthraquinone applied on maize seeds and seedlings against house sparrow (Passer domesticus) in captivity

Various bird pests caused severe economic losses to valuable crops and fruit orchards all over the world. Among the birds, house sparrow is also considered to cause heavy plunder, not only to seeds of crops but also seedlings especially in organic farming. In present study two bird repellents, methylanthranilate and anthraquinone tested against house sparrows on maize seeds and seedlings in aviary conditions. Trial group in aviary-I, the treated maize seeds and seedlings with different doses of both bird repellents, control group in aviary-II, untreated seeds and seedlings were provided for three hours in the early morning. In each aviary, two closed circuit cameras were also installed to monitor the behavioral responses against different concentrations of both chemical repellents. Statistical analysis showed that there existed highly significant (P<0.01) variations among the trial and control groups for seeds and seedlings. By comparing both repellents, significant (P<0.05) differences were detected and anthraquinone showed better efficacy when compared to methylanthranilate, but in maize seedlings both repellents equal repellent properties. Non-significant (P>0.05) differences were observed in different grading of both natural chemical repellents for maize seeds while significant (P<0.05) variations were noticed for maize seedlings when provided to sparrows. By videotaped behavior sparrows presented manifest head juddering and feather upsetting activities by consumption of treated seeds and seedlings with higher concentrations of both natural bird repellents.

Current Trends of Using Systemic Antifungal Drugs and their Comparative Efficacy in Tinea Corporis and Tinea Cruris in Outpatient Department of Dermatology in a Tertiary Level Hospital

Tinea corporis & cruris are one of the earliest known fungal infection and are very common throughout the world. Although tinea corporis and tinea cruris does not cause mortality but causes morbidity and poses a major health problem. This study was conducted to evaluate the Comparative Efficacy of Terbinafine and Fluconazole in the Treatment of Tinea corporis and Tinea cruris. This cross sectional comparative type of analytical study was carried out at the department of Pharmacology & Therapeutics with collaboration of Dermatology and Venereology in Mymensingh Medical College Hospital, Mymensingh, Bangladesh from January 2016 to December 2016. In this study 168 newly diagnosed Tinea corporis and Tinea cruris patient was purposively selected where pattern of comparative efficacy of terbinafine and fluconazole were analyzed. Among 168 patients most of the patients presented with tinea corporis (58.33%). Most patients belong to 21-30 years age group. Male female ratio in this study was 1.15:1. In this study 143 patients were treated by fluconazole 50mg once daily for 4 weeks and 25 patients were treated by terbinafine 250 mg once daily for 4 weeks. After 4 weeks, improvement rate by fluconazole was 86.02% and terbinafine 96.00%. The clinical score of both groups after 4th week of treatment, there was slight more reduction of clinical score in terbinafine using group than fluconazole using group. The difference between these two clinical score was not statistically significant (p>0.05). Although no significant difference was observed between these two groups of patient in clinical aspect, but due to its lower price and availability in the hospital, it is suggested that fluconazole is more suitable for the treatment of tinea corporis and tinea cruris.

Current Trend of Using Anti-Hypertensives in Pregnancy and Postpartum Period in a Tertiary Level Hospital

Hypertensive disorders are one of the most common disorders in pregnancy. They are amongst the major cause of maternal and perinatal morbidity and mortality. Incidence is increasing in developing countries like Bangladesh. This cross sectional descriptive study has done to observe the utilization of antihypertensive drugs in hypertensive disorders of pregnancy and conducted from January 2016 to December 2016 in the department of Pharmacology in collaboration with department of Gynecology and Obstetrics in Mymensingh Medical College Hospital, Mymensingh, Bangladesh. Non random purposive sampling technique was used. Total of 300 patients participated in the study, 281 anti partum and 19 postpartum. Age distribution showed 42% patients were in 21-25 years age group. Majority of the participants (91%) were housewife and majority (79%) came from poor socioeconomic status with below SSC education (68%). About 82% patients lived in rural area. Trimester and gravida wise distribution showed most of the participants were 3rd trimester (61%) and primigravida (57%) and only 6% patients belong to postpartum period. In this study preeclampsia was highest (63.8%) among all other types of hypertensive diseases in pregnancy. Majority of the patient were preferred for dual therapy (53%), mono therapy was used in 29% of cases. Most frequently given drug in pregnancy associated hypertension was methyldopa that is 88.33% (single 22.3%, combination 66%). Second most commonly used drug was nifidipine consisting of 47.6% but used in combination in all cases. Average number of anti hypertensive drugs prescribed per prescription was 1.87 and majorities (92%) were from essential drug list but used as trade name. Preeclampsia and eclampsia were more common among the hypertensive disorders in tertiary level hospital cases. Methyldopa was found to be the commonest prescribed antihypertensive in monotherapy and in combination.

Alanine Aminotransferase and Total Bilirubin Concentration in Preeclampsia and Eclampsia

Eclampsia is an important cause of maternal mortality in developing countries. This cross-sectional comparative study was conducted in the Departments of Clinical Pathology, Bangabandhu Sheikh Mujib Medical University (BSMMU), and Obstetrics and Gynecology, BSMMU, and Dhaka Medical College Hospital, Dhaka, Bangladesh, from March 2012 to February 2013 and was designed to evaluate liver markers to predict preeclampsia. One hundred fifty (150) women with pregnancy of ≥28 weeks, 50 for each normal, preeclampsia and eclampsia group, were enrolled purposively. The protocol was approved by IRB of BSMMU. Consent was taken from each patient. Serum total Bilirubin and ALT were assessed. Data was collected in a questionnaire and analyzed by SPSS-16. Quantitative data were compared by ANOVA or 't' test and qualitative data by chi-square test. P value <0.05 was considered significant. The patients of all groups were similar in age and gravida. The mean±SD serum total bilirubin and ALT were significantly higher in preeclampsia and eclampsia groups than normal pregnancy. However they were similar in preeclampsia and eclampsia group.

Waste corn-cob cellulose supported bio-heterogeneous copper nanoparticles for aza-Michael reactions

Waste corn-cob cellulose supported Cu-nanoparticles were found to be a highly effective catalyst for aza-Michael reactions at room temperature.

Comparison of Common Tonsillectomy Methods

This prospective randomized study was done to compare operative time, intra-operative blood loss, post operative pain, secondary haemorrhage in common tonsillectomy methods. Thirty two (32) paediatric population of age 7-12 years from each group randomly selected, operative techniques adopted consecutively and this study was conducted in Bangabandhu Sheikh Mujib Medical University, Dhaka, Islami Bank Hospital, Dhaka, and Desh Medical Services, Chittagong, from January 2011 to December 2013. Surgery was performed by single midlevel surgeon. Postoperatively one month was followed the entire patient. Total 96 pediatrics population (32 for each group) was studied. Mean operating time and mean intra-operative blood loss was in cold dissection method 22 min and 15 ml, in bipolar dissection tonsillectomy 18 min and 10 ml & in laser tonsillectomy 17 min and 9 ml. Differences of operating time and variation of blood loss in various methods are not statistically significant. Laser and bipolar electro dissection tonsillectomy are popularized due to its relative less bleeding and quicker methods than that of cold dissection tonsillectomy; there is no significant difference among them.

Comparison of Serum CA72-4 and CEA Levels in Patient with Endoscopically Suspected Gastric Carcinoma

Several serum tumour markers have been described for gastric cancer. Preoperative level of tumor marker helps to predict the diagnosis of gastric carcinoma. CA72-4 as a serum tumour marker for gastric cancer is evaluated, and compared its utility in this regard with that of carcinoembryonic antigen (CEA). Analysis of gastric carcinoma by serum levels of CEA and CA72-4 and their correlation with histopathology help the clinician to develop his management strategies for gastric carcinoma. A prospective observational study was carried out in the Department of Clinical Pathology, Bangabandhu Sheikh Mujib Medical University (BSMMU) in collaboration with Department of Surgery BSMMU, DMCH, Delta Hospital Limited, Dhaka, during the period of October 2010 to September 2011. Serum CA72-4 and CEA were analyzed in 71 endoscopically suspected patients for gastric carcinoma. Among them 58 cases were diagnosed as malignant gastric disease and 13 cases were nonmalignant gastric disease. Sensitivity of CA 72-4 and CEA were 48.3% and 31% respectively and specificity were 92.3% and 76.9% respectively. In poorly differentiated carcinoma, positivity for CA72-4 and CEA were 55.6% and 36.1% respectively. Because of the high positivity of CA72-4 in poorly differentiated carcinoma, CA72-4 is reliable tumour marker in advanced cases. As the sensitivity of CA72-4 was more than that of CEA in diagnosis of gastric cancer, CA72-4 can be used in conjunction with other diagnostic tests like endoscopy that would be more helpful for the patients.

Correlation of Connective Tissue Growth Factor (CTGF/CCN2) with Hepatic Fibrosis in Chronic Hepatitis B

CTGF/CCN2 plays an important role in the formation and development of hepatic fibrosis. This study determined the correlation between serum CTGF/CCN2 and stages of hepatic fibrosis and explored the clinical value of serum CTGF/CCN2 in the assessment of hepatic fibrosis in chronic hepatitis B. This cross sectional study was done in department of Clinical Pathology, Bangabandhu Sheikh Mujib Medical University, Dhaka from March 2012 to February 2013. Serum CTGF was measured by using of a sandwich immunoassay technique. Forty (40) chronic hepatitis B patients were included in this study. The sensitivity of CTGF/CCN2 was 71.6%, specificity 67.5%. Spearman's rank correlation coefficient was 0.652 between serum CTGF/CCN2 and stages of hepatic fibrosis (p<0.001). The area under receiver-operating curve (ROC) was 0.750 for identification of hepatic fibrosis. This present data revealed that serum CTGF/CCN2 in chronic hepatitis B were strongly associated with stages of hepatic fibrosis. CTGF/CCN2 may useful diagnostic tool for assessing the hepatic fibrosis in chronic hepatitis B.

Monitoring of trace metals in tissues of Wallago attu (lanchi) from the Indus River as an indicator of environmental pollution

We aimed to assess the bioaccumulation of selected four trace metals (Cd, Ni, Zn and Co) in four tissues (muscles, skin, gills and liver) of a freshwater fish Wallago attu (lanchi) from three different sites (upstream, middle stream and downstream) of the Indus River in Mianwali district of Pakistan. Heavy metal contents in water samples and from different selected tissues of fish were examined by using flame atomic absorption spectrometry. The data were statistically compared to study the effects of the site and fish organs and their interaction on the bioaccumulation pattern of these metals at P < 0.05. In W. attu the level of cadmium ranged from 0.004 to 0.24; nickel 0.003–0.708; cobalt 0.002–0.768 and zinc 47.4–1147.5 μg/g wet weight. The magnitude of metal bioaccumulation in different organs of fish species had the following order gills > liver > skin > muscle. The order of bioaccumulation of these metals was Ni < Zn < Co < Cd. Heavy metal concentrations were increased during the dry season as compared to the wet season. The results of this study indicate that freshwater fish produced and marketed in Mianwali have concentrations below the standards of FEPA/WHO for these toxic metals.

Methylome repatterning in a mouse model of Maternal PKU Syndrome

Maternal PKU Syndrome (MPKU) is an embryopathy resulting from in utero phenylalanine (PHE) toxicity secondary to maternal phenylalanine hydroxylase deficient phenylketonuria (PKU). Clinical phenotypes in MPKU include mental retardation, microcephaly, in utero growth restriction, and congenital heart defects. Numerous in utero toxic exposures alter DNA methylation in the fetus. The PAH(enu2) mouse is a model of classical PKU while offspring born of hyperphenylalaninemic dams model MPKU. We investigated offspring of PAH(enu2) dams to determine if altered patterns of DNA methylation occurred in response to in utero PHE exposure. As neurologic deficit is the most prominent MPKU phenotype, methylome patterns were assessed in brain tissue using methylated DNA immunoprecipitation and paired-end sequencing. Brain tissues were assessed in E18.5-19 fetuses of PHE unrestricted PAH(enu2) dams, PHE restricted PAH(enu2) dams, and heterozygous(wt/enu2) control dams. Extensive methylome repatterning was observed in offspring of hyperphenylalaninemic dams while the offspring of PHE restricted dams displayed attenuated methylome repatterning. Methylation within coding regions was dominated by noncoding RNA genes. Differential methylation of promoters targeted protein coding genes. To assess the impact of methylome repatterning on gene expression, brain tissue in experimental and control animals were queried with microarrays assessing expression of microRNAs and protein coding genes. Altered expression of methylome-modified microRNAs and protein coding genes was extensive in offspring of hyperphenylalaninemic dams while minimal changes were observed in offspring of PHE restricted dams. Several genes displaying significantly reduced expression have roles in neurological function or genetic disease with neurological phenotypes. These data indicate in utero PHE toxicity alters DNA methylation in the brain which has downstream impact upon gene expression. Altered gene expression may contribute to pathophysiology of neurologic presentation in MPKU.

A comparative study of chemical and immunological method of fecal occult blood test in the diagnosis of occult lower gastrointestinal bleeding

Fecal occult blood test is the most widely used screening test for diagnosis of gastrointestinal bleeding disorders specially colorectal carcinoma. Among the various methods of fecal occult blood tests, chemical method is being used commonly, but the method has some drawbacks like low participation rate, high false positive rate, low sensitivity etc. To overcome these short comings, newer immunological method was introduced. This study evaluated the role of immunological method of fecal blood test in the diagnosis of occult lower GIT bleeding. Stool samples from two hundred patients were examined by both chemical and immunological method. The patients who were positive by any or both methods of occult blood test, were advised for colonoscopy. During colonoscopy tissues were taken for histopathology which was the gold standard of this study. Among 110 OBT positive patients pathological lesions were detected in 65 patients by colonoscopy and histopathology. The diseases detected by colonoscopy and histopathology 18 colorectal polyp, 8 colorectal cancer, 24 ulcerative lesions and 5 inflammatory bowel disease etc. Regarding comparative analysis of chemical and immunological method, the higher sensitivity (95.4% vs. 49.2%), specificity (44.4% vs. 37.8%), accuracy (74.5% vs. 44.5%), PPV (71.3% vs. 53.3%) and NPV (87% vs. 34%) of immunological method than chemical method was observed. Thus immunological method of fecal occult blood test was appeared to be a better alternative to conventional chemical method of fecal occult blood test in the diagnosis of occult lower GIT bleeding. DOI: http://dx.doi.org/10.3329/bmrcb.v39i2.19641 Bangladesh Med Res Counc Bull 2013; 39: 52-56

Value of red cell distribution width (RDW) and RBC indices in the detection of iron deficiency anemia

Iron deficiency anemia is the common problem during pregnancy. Detection of iron deficiency early during pregnancy can reduce maternal and child mortality and morbidity. Red cell distribution width is a new routine parameter in fully automated hematology analyzer that can give the idea of early iron deficiency before other test. It gives the idea of red cell size variation which is the earliest morphologic changes in iron deficiency anemia. In prelatent and latent stage of iron deficiency MCV are normal. Whereas in latent stage Red Cell Distribution Width (RDW) would be expected to increase because of a microcytic population of cells appears in the blood. This study evaluates the role of red cell distribution width and RBC indices in determining iron deficiency early and provide reliable and useful technique. In this study 190 pregnant women were included. RDW, MCV, MCH, MCHC and iron profile were done. RDW compared with MCV, MCH and MCHC in various stages of iron deficiency. In latent stage of iron deficiency higher RDW was found significant than MCV, MCH, MCHC (p<0.05). In this study RDW had sensitivity 82.3% and specificity 97.4%. Whereas MCV, MCH and MCHC had 29.2%, 68.1% and 15% sensitivity but specificity was 98.7%, 83.1% and 96.1% in the detection of iron deficiency. Iron deficiency anaemia without other complicating disease could be screened out early by increased RDW when RBC indices were normal.

Intraoperative serum parathyroid hormone level is an indicator of hypocalcaemia in total thyroidectomy patients

Postoperative hypocalcaemia is the most frequent and common complication after total thyroidectomy. It is necessary to diagnose or to predict hypocalcaemia immediately after total thyroidectomy for minimizing complications. A prospective observational study was carried out in the Department of Clinical Pathology in collaboration with Department of Microbiology & Immunology, Department of Surgery, Department of Otolaryngology, Bangabandhu Sheikh Mujib Medical University (BSMMU) and Department of Otolaryngology, Dhaka Medical College & Hospital (DMC&H), Dhaka, during the period of September 2010 to August 2011 to evaluate intraoperative (20 minutes after total thyroidectomy) parathyroid hormone (PTH) measurement as a predictor of post thyroidectomy hypocalcaemia. Total 65 patients were enrolled in this study those came for total thyroidectomy. Postoperative hypocalcaemia developed in 25 cases. Intraoperative PTH was assessed and significant correlation was found between intraoperative PTH level and development of hypocalcaemia. The sensitivity, specificity, accuracy, positive predictive value, negative predictive value of intraoperative serum PTH for prediction of post total thyroidectomy hypocalcaemia were 84.0%, 85.0%, 84.6%, 77.8%, and 89.5% respectively. Because of the high sensitivity, specificity and accuracy of intraoperative serum PTH of this study, the early prediction of hypocalcaemia could be made by single assay of intraoperative serum PTH level at 20 minutes after total thyroidectomy. DOI: http://dx.doi.org/10.3329/bmrcb.v38i3.14331 Bangladesh Med Res Counc Bull 2012; 38(3): 84-89 (December)

Management of bilateral congenital choanal atresia

This study was conducted to adopt better management technique for better outcome of bilateral congenital choanal atresia. Six consecutive neonates with bilateral congenital choanal atresia were included in this study. Emergency and elective management was done in various ways. Postoperative outcome was assessed clinically and endoscopically. Surgical management was done in two approaches. Three done in endoscopic transnasal approach and another 3 in transpalatine approach. Patient with endoscopic approach recovered earlier with minimum morbidity. Application of mitomycin-c minimizes granulation tissue and adhesions. Management of bilateral congenital choanal atresia is better by endoscopic transnasal approach with application of mitomycin-c.