CRC Screening: Current Trend and Feasibility

Colorectal cancer, a rising health concern of both east and west , can be prevented and it’s mortality can be reduced by screening all men and women of average risk  at the age of 50 years or older and  at an earlier age for  high risk group of colorectal cancer. Several tests are available for colon cancer screening, including fecal occult blood test (FOBT), flexible sigmoidoscopy, double-contrast barium enema, and colonoscopy. Direct and indirect evidence indicates that all the tests are effective, but they differ in their sensitivity, specificity, cost, and safety. The available evidence does not currently support choosing one test over another. In addition, other new colorectal cancer tests, such as virtual colonoscopy or stool-based molecular testing, have the potential to become important screening tests in the future. Journal of Surgical Sciences (2015) Vol. 19 (2) : 61-66

Cavernous Hemangioma of Sigmoid Colon and Ano-Rectum: A Rare Cause of Haematochezia

Cavernous hemangioma of colon and rectum is a rare disease, with no more than 200 cases reported in the literature so far. The rectosigmoid is the most common site of this disease in the gastrointestinal tract. We report a case of a 32-year-old male with recurrent episodes of per-rectal bleeding, who was finally diagnosed of cavernous hemangioma of sigmoid colon and ano-rectum. The lesion, 23 cm in length, occupied the whole circumference of the sigmoid colon and rectum extending up to the margin of the anal sphincter. Ultra-low anterior resection with hand-sewn colo-anal anastomosis and temporary loop ileostomy was carried out. The patient is in regular follow up. He is now symptom free. Journal of Surgical Sciences (2014) Vol. 18 (2) : 83-86

Outcome of Laparoscopic Versus Open Abdominal Rectopexy for the Treatment of Complete Rectal Prolapse-Our experience in Bangabandhu Sheikh Mujib Medical University

Background: Complete rectal prolapse is a very distressing condition. In adults, the only potentially curative treatment for complete rectal prolapse is surgery either by transabdominal or perinea! approaches. Till date abdominal rectopexy is considered as the standard surgical treatment for complete rectal prolapse, which can be done laparoscopically or by open procedure. Objective: The purpose of the study was to observe the outcome of Laparoscopic rectopexy in the treatment of complete rectal prolapse by subjective assessment and to compare the result with that of conventional open abdominal rectopexy. Methodology: This randomized clinical trial was carried out in the Department of Surgery at Bangabandhu Sheikh Mujib Medical University, Dhaka, from July 2012 to June 2014 for a period of twenty four (24) months. Patients who presented with complete rectal prolapse with age ranging from 25 to 70 years irrespective of gender were selected as study population. Patients were randomized by lottery method into two groups as group I who underwent laparoscopic rectopexy (LR) and group II who underwent open rectopexy (OR). Result: A total number of 50 patients were recruited in this study of which 25 patients were. in group I and 25 patients were in group II. The mean (s.d.) age was 49.40 (13.22) years and 46.48(13.27) years in group I and group II respectively (p>0.05). The mean (s.d.) operative time was 115(19) minutes in group I and 75(12) minutes in group II (p<0.05). In this study 1(4.0%) patient and 6 (24.0%) patients had abdominal wound infection in group I and in group II respectively (p>0.05). Mean (s.d.) ambulation time was 1.96 (0.67) days in group I and 3.92(1.15) days in groups II (p<0.05). Postoperative hospital stay mean (s.d.) was 3.08(1.18) days in group I and 8.16(3.57) days in group II (p<0.05). Overall patients satisfaction were 92% and 76% in group I and group II respectively (p>0.05). Conclusion: Laparoscopic rectopexy is a better option than conventional open abdominal rectopexy for the treatment of complete rectal prolapse. Journal of Surgical Sciences (2015) Vol. 19 (1) : 3-7

Delorme's Procedure for Full-Thickness Rectal Prolapse - Our experience in Bangabandhu Sheikh Mujib Medical University

Background: The study was undertaken to validate the efficacy of Delorme's procedure as the treatment modality of choice for full-thickness rectal prolapse. Materials and Methods: In this study, results of Delorme's procedure for full-thickness rectal prolapse were assessed retrospectively. 14 patients with full-thickness rectal prolapse who were operated on with Delorme's procedure between January 2010 and October 2013 in the department of Colorectal surgery, Bangabandhu Sheikh Mujib Medical University were included in the study. Results: There were 8 males with mean age of 32.62 years (range 15-70) and 6 females with mean age of 26 years (range 12-70 ).The mean operative time was 65±4.5 minutes (range 60-90); there was no mortality and blood loss was minimal. Mean hospital stay was 3.5 days (2-6 days). Outcomes of the procedure were satisfactory and no patient reported recurrence of the disease in the follow up period.Delorme's procedure, especially in younger patients, is a relatively safe and effective treatment and should not be restricted to older frail patients. This procedure may not be suitable for recurrent cases Delorme's procedure, especially in younger patients, is a relatively safe and effective treatment and should not be restricted to older frail patients. This procedure may not be suitable for recurrent cases. Conclusion: Delorme's operation is a safe and effective treatment for complete rectal prolapse in patients of all age groups. Journal of Surgical Sciences (2015) Vol. 19 (1) : 21-24

Immunogenicity of the pneumococcal non-typeable Haemophilus influenzae protein D conjugate vaccine (PHiD-CV) administered concomitantly with the meningococcal serogroup B (4CMenB) vaccine in infants: A post-hoc analysis in a phase 3b, randomised, controlled trial

BACKGROUND

No data are currently available on immunogenicity of higher-valent pneumococcal conjugate vaccines when co-administered with a 4-component meningococcal serogroup B vaccine (4CMenB).

METHODS

Post-hoc analysis of pneumococcal non-typeable Haemophilus influenzae protein D conjugate vaccine (PHiD-CV) immunogenicity when co-administered with 4CMenB (2 + 1 schedule) and/or a CRM-conjugated meningococcal serogroup C vaccine (MenC-CRM) in a trial assessing 4CMenB reduced schedules and co-administration with MenC-CRM (NCT01339923). Infants were randomized to receive 4CMenB and MenC-CRM (Group 1) or MenC-CRM (Group 2) at 3, 5, and 12 months (M) of age. Both groups received PHiD-CV (3 + 1 schedule) as part of the Brazilian national immunisation programme at 3 M, 5 M, 7 M, and 12 M of age. Antibody responses were assessed pre-vaccination, 1 M post-dose 2, pre-booster, and 1 M post-booster.

RESULTS

Anti-pneumococcal antibody responses were in similar ranges in the two study groups.

CONCLUSIONS

4CMenB co-administration did not seem to impact antibody responses to PHiD-CV in infants.

Stressors perceived by the clinical undergraduate medical students towards the end of course

Response or reaction of the mind to the pressure of life is stress. Medical students of Bangladesh are in stress to meet the demands of the curriculum. This study was conducted on the regularly passed final year students of a medical college to find out the nature of stresses perceived by them. The response was collected on a validated structured set of questionnaire, 3 weeks prior to the University level summative examination and 63 students (33 male and 30 female) participated in the study. Stress was expressed in five levels and scored as 0 to 4. Academic related factors were identified as maximum stress provoking (2.5 ± 1.3) than group activity (1.6 ± 1.4), drive (1.4 ± 1.5), teaching-learning (2.3 ± 1.3), personnel (1.8 ± 1.6) or social (1.9 ± 1.5) related factors. Of that group of stress, ‘falling behind reading schedule’ and ‘large amount of content to be learned’ were revealed as heavy stressors. Examination was identified as a severe stressor in 42.4% male, but was marked less (16.7%) in the female. ‘Too much restriction in the campus’ was observed as heavy stressors among the factors other than the academic related stressors. Students may be motivated to develop a coping strategy for academic and teaching-learning related stress.

Extra Skeletal Ewing's Sarcoma Involving Perineum of a Young Male Patient

Ewing's Sarcoma is the second most common primary malignant bone tumor in children and young adults after osteosarcoma but exceptionally it can arise from extra skeletal sites also. Extra skeletal Ewing's sarcoma is of neuroectodermal origin and usually involves extremities, retroperitoneum and paravertebral regions. No case of extra skeletal Ewing's sarcoma involving perineum is yet reported. A 16 years old male patient admitted to colorectal surgery department of Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh in July 2015 having swellings in perineum as well as both inguinal regions. The swelling was near to anal verge. FNAC from perineal swelling and inguinal lymph node demonstrate small blue round cell tumor. After operation the tumor size was 5cm×4cm, cell type was malignant round cell arranged in sheet and perivascular forming rosette. Extra skeletal Ewing's sarcoma can be a differential diagnosis of soft tissue tumor arising in perineum.

Immune response to the hepatitis B antigen in the RTS,S/AS01 malaria vaccine, and co-administration with pneumococcal conjugate and rotavirus vaccines in African children: A randomized controlled trial

The RTS,S/AS01 malaria vaccine (Mosquirix) reduces the incidence of Plasmodium falciparum malaria and is intended for routine administration to infants in Sub-Saharan Africa. We evaluated the immunogenicity and safety of 10-valent pneumococcal non-typeable Haemophilus influenzae protein D conjugate vaccine (PHiD-CV; Synflorix) and human rotavirus vaccine (HRV; Rotarix) when co-administered with RTS,S/AS01 (www.clinicaltrials.gov NCT01345240) in African infants. 705 healthy infants aged 8–12 weeks were randomized to receive three doses of either RTS,S/AS01 or licensed hepatitis B (HBV; Engerix B) vaccine (control) co-administered with diphtheria-tetanus-acellular pertussis-Haemophilus influenzae type-b-conjugate vaccine (DTaP/Hib) and trivalent oral poliovirus vaccine at 8–12-16 weeks of age, because DTaP/Hib was not indicated before 8 weeks of age. The vaccination schedule can still be considered broadly applicable because it was within the age range recommended for EPI vaccination. PHiD-CV or HRV were either administered together with the study vaccines, or after a 2-week interval. Booster doses of PHiD-CV and DTaP/Hib were administered at age 18 months.

Non-inferiority of anti-HBV surface antigen antibody seroprotection rates following co-administration with RTS,S/AS01 was demonstrated compared to the control group (primary objective). Pre-specified non-inferiority criteria were reached for PHiD-CV (for 9/10 vaccine serotypes), HRV, and aP antigens co-administered with RTS,S/AS01 as compared to HBV co-administration (secondary objectives). RTS,S/AS01 induced a response to circumsporozoite protein in all groups. Pain and low grade fever were reported more frequently in the PHiD-CV group co-administered with RTS,S/AS01 than PHiD-CV co-administered with HBV. No serious adverse events were considered to be vaccine-related. RTS,S/AS01 co-administered with pediatric vaccines had an acceptable safety profile. Immune responses to RTS,S/AS01 and to co-administered PHiD-CV, pertussis antigens and HRV were satisfactory.

Immunologic non-inferiority and safety of the investigational pneumococcal non-typeable Haemophilus influenzae protein D-conjugate vaccine (PHiD-CV) 4-dose vial presentation compared to the licensed PHiD-CV 1-dose vial presentation in infants: A phase III randomized study

BACKGROUND

To support vaccination programs in developing countries, a 4-dose vial presentation of pneumococcal non-typeable Haemophilus influenzae protein D-conjugate vaccine (PHiD-CV) was developed. This study assessed immunologic non-inferiority and safety of the investigational PHiD-CV 4-dose versus licensed 1-dose vial presentation in infants.

METHODS

In this phase III, mono-center, observer-blind study in Bangladesh, 6-10-week-old infants were randomized 1:1 to receive PHiD-CV primary vaccination (at ages 6, 10, 18 weeks) and a booster dose (at age 9 months) with a 4-dose vial (with preservative, 4DV group) or 1-dose vial (preservative-free, 1DV group). DTPw-HBV/Hib was (co)-administered per study protocol and polio, measles and rubella vaccines as part of the national immunization program. Non-inferiority of PHiD-CV 4-dose versus 1-dose vial for each vaccine pneumococcal serotype (VT) and vaccine-related serotype 19A in terms of antibody geometric mean concentration (GMC) was assessed (criterion: upper limit of 2-sided 95% confidence interval of antibody GMC ratios [1DV/4DV] <2-fold). Immune responses were measured. Solicited, unsolicited and serious adverse events (AEs) were evaluated.

RESULTS

Of 320 infants (160 per group) vaccinated during the primary vaccination phase, 297 received a booster. Non-inferiority was demonstrated for each VT and 19A. One month post-primary vaccination, for most VT, ≥97.9% of infants in each group had antibody concentrations ≥0.2 μg/mL; for 19A ≥ 80.1% reached this threshold. Pneumococcal antibody responses and opsonophagocytic activity for each VT and 19A were within similar ranges between groups after primary and booster vaccination, as were anti-protein D responses. Booster immune responses were observed in both groups. Reported AEs were within similar ranges for both presentations.

CONCLUSION

Immunologic non-inferiority of PHiD-CV 4-dose vial (with preservative) versus PHiD-CV 1-dose vial (preservative-free) was demonstrated. Immune responses and reactogenicity following primary/booster vaccination were within similar ranges for both presentations. PHiD-CV 4-dose vial would help improve access and coverage in resource-limited countries. Clinical Trial Registry: NCT02447432.

Immunogenicity, safety and reactogenicity of the pneumococcal non-typeable Haemophilus influenzae protein D conjugate vaccine (PHiD-CV) in 2-17-year-old children with asplenia or splenic dysfunction: A phase 3 study

BACKGROUND

Immunization with pneumococcal vaccines is an important prophylactic strategy for children with asplenia or splenic dysfunction, who are at high risk of bacterial infections (including S. pneumoniae). This study aimed to assess immunogenicity and safety of pneumococcal non-typeable Haemophilus influenzae protein D conjugate vaccine (PHiD-CV, GSK) in this at-risk population.

METHODS

This phase III, multi-centre, open-label, controlled study, in which at-risk children with asplenia or splenic dysfunction were enrolled (age strata: 2-4, 5-10 and 11-17years), was conducted in Poland and the Russian Federation. For the 2-4years at-risk group, healthy age-matched children were enrolled as control. Unprimed children (not previously vaccinated with any pneumococcal vaccine) received 2 PHiD-CV doses (≥2months apart) and pneumococcal vaccine-primed children received 1 dose. Immune responses were assessed pre-vaccination and one month post-each dose. Solicited and unsolicited adverse events (AEs) were recorded for 4 and 31days post-vaccination, respectively, and serious AEs (SAEs) throughout the study.

RESULTS

Of 52 vaccinated children (18 at-risk primed, 28 at-risk unprimed and 6 control unprimed), 45 (18, 23 and 4, respectively) were included in the according-to-protocol cohort for immunogenicity. Post-vaccination (post-dose 1 in primed and post-dose 2 in unprimed children), for each vaccine pneumococcal serotype and vaccine-related serotype 6A all at-risk children had antibody concentrations ≥0.2µg/mL, and for vaccine-related serotype 19A at least 94.4%. Increases in antibody geometric mean concentrations were observed. For most serotypes, all at-risk children had post-vaccination opsonophagocytic activity (OPA) titers ≥8 and increases in OPA geometric mean titers were observed. No safety concerns were raised. One non-fatal SAE (respiratory tract infection, considered not vaccine-related) was reported by one at-risk unprimed child.

CONCLUSION

PHiD-CV was immunogenic and well tolerated in 2-17-year-old children with asplenia or splenic dysfunction. Clinical Trial Registry: www.clinicaltrials.gov, NCT01746108.

Effectiveness of Preoperative Lymphoscintigraphy for the Detection of Cervical Lymph Node Metastasis in Patients with Oral Squamous Cell Carcinoma

Background:

Oral squamous cell carcinoma (OSCC) is one of the most common malignant tumor. OSCC is the malignancy of squamous epithelium of oral cavity, which is the sixth most common malignancy reported worldwide and one with highest mortality rate among all malignancies.

Aims:

The aims of this study is to assess the diagnostic performance of lymphoscintigraphy (LSG) for the detection of cervical lymph node metastasis in patients with OSCC.

Materials and Methods:

This was a prospective study done in Oral and Maxillofacial Surgery Department and National Institute of Nuclear Medicine and Allied Science, Bangabandhu Sheikh Mujib Medical University during July 2015–June 2016. Thirty-six patients with OSCC were included in this study. Radioisotope technique was used in the detection of cervical metastases in patients with histologically proven OSCC. Patients were assessed by LSG after diagnosis of OSCC, and then, it was compared with postoperative histopathology report.

Results:

Lymphoscintigraphically out of 36 patients, 23 had lymphatic channel obstruction where histologically 20 patients had lymph node metastasis. There were 20 true positive cases, 13 true negative cases, and 3 false positive cases but no false negative case was found. The test of validity result reveals that sensitivity 100.0%, specificity 81.25%, accuracy 96.66%, positive predictive value 86.96%, and negative predictive value 100.0%.

Conclusion:

LSG for the detection of cervical lymph node metastasis has an important role for the management of OSCC. It is also cost-effective and decreases the morbidity.

Exploring new pharmacology and toxicological screening and safety evaluation of one widely used formulation of Nidrakar Bati from South Asia region

BACKGROUND

Nidrakar Bati (NKB) is an herbal remedy consisted with seven medicinal herbs widely used to cure Somnifacient (sleeping aid) in South Asia as Ayurvedic medicinal system. In the present study, pharmacological and toxicological effects of this medicine was investigated in mice to validate the safety and efficacy of the herb.

METHODS

Organic solvent extracts NKB were prepared using maceration method. Effect of extracts on the central nervous system was evaluated using hypnotic activity assay. Effect of the extracts on metabolic activity, assessing involvement of thyroid was conducted using hypoxia test. analgesic and anti-inflammatory activities were assessed in mice using acetic acid induced writhing, formalin induced paw edema, xylene induced ear edema assays. Anxiolytic activity was performed using plus maze, climbing out and forced swimming tests. Effect of the extracts on psychopharmacological effect was carried out using locomotor activity tests (open field, Hole-board and Hole-cross tests). Neuropharmacological effect of the extracts was performed using motor coordination (rotarod test). Toxicological potential of the extract was evaluated using gastro-intestinal activity (gastric emptying and gastrointestinal motility tests).

RESULTS

The studied formulation reduced the CNS stimulant effects dose independently. In the hypoxia test, only a dose of 100 mg/kg of NKB decreased the survival time. Orally administration of the NKB (200 and 400 mg/kg) produced significant inhibition (P < 0.01) of the acetic acid-induced writhing in mice and suppressed xylene induced ear edema and formalin-induced licking response of animals in both phases of the test. NKB showed locomotor activity (p < 0.05) both in higher and lower doses (100 and 400 mg/kg). NKB increased the total ambulation dose dependently (p < 0.05). NKB, at all tested doses (100, 200 and 400 mg/kg) increased some locomotion activity parameters (ambulation, head dipping and emotional defecation) in hole board test. At higher doses (200 and 400 mg/kg), NKB showed a significant increase in hole cross test. NKB showed an increase in the time on the open arms of the maze at low to medium doses (100 and 200 mg/kg). When using the Rotarod method, NKB showed a considerable increase on motor coordination of the mice. NKB produced marked gastric emptying effect and decreased gastrointestinal motility in mice at low dose.

CONCLUSIONS

NKB demonstrated various pharmacological effects and toxicological effects due to presence of several herbs in the formulation those are not closely fit for the effect of CNS depressants.

Otitis media with effusion in children admitted for adenoidectomy

This cross-sectional prospective study was done in the Department of Otolaryngology Head & Neck Surgery, Bangabandhu Sheikh Mujib Medical University, Dhaka during the period of January 2008 to December 2009 with the aim to find out the frequency of otitis media with effusion in patients with enlarged adenoid admitted for Adenoidectomy, To see the frequency of otitis media with effusion in different age group, To find out the degree of hearing loss in enlarged Adenoid patients. A total number of 60 patients who were admitted for adenoidectomy with or without tonsillectomy were purposively collected. Male female ratio was 1.6:1. Majority of patients (61.67%) came from lower socioeconomic group. Amongst the patients with enlarged adenoids, OME was found in 32(53.33%) cases. Out of 25 grossly enlarged adenoid cases, OME was found in 19(76%) cases. In 35 cases of moderately enlarge adenoid, OME was found in 13(37.14%) cases. Out of 28 enlarged adenoid cases in age group 0-5 years, OME was present in 19(67.86%) cases and out of 32 enlarge adenoid cases in age group 6-15 years; OME was present in 13(40.62%) cases. Most of the patients presented with multiple clinical features, the commonest was mouth breathing (80%), other features were snoring (58.33%), nasal discharge (56.67%) and hearing impairment (53.33%). In tympanometry, flat curve without peak was found in 25 cases and negative middle ear pressure was seen in 7 cases. Regarding hearing status of patients, 25 cases had a mild to moderate degree of hearing loss and PTA was not done in 7 cases due to lower age group (below 4 years).

Is malnutrition a risk factor of stroke?

Obesity is an established risk factor of stroke. Malnutrition in post-stroke period is common and can influence outcome. But malnutrition, though predicted, has not yet been established as a risk factor of stroke. This descriptive study was carried out in the Department of Neurology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka and Department of Neurology, Dhaka Medical College (DMC), from January 2009 to December 2010 to explore whether malnutrition is an independent risk factor of stroke. Nutritional status of 100 stroke patients and 100 healthy controls were assessed in this study. Anthropometric measurements including Body Mass Index (BMI), Triceps skin fold (TSF), Mid-arm circumference (MAC) and Arm-muscle circumference (AMC) were measured within 7 days of stroke. Haemoglobin and haematocrit percentage, serum iron and serum albumin were measured at the same time. No significant difference was observed regarding TSF thickness, MAC, AMC, mean Hb and mean albumin level between the stroke patients and the control group, although iron level was significantly lower in stroke group. Multiple logistic regressions analysis showed that increase in age, smoking and decreased serum iron level has a positive association with stroke. Malnutrition is, according to this study, not a significant risk factor of stroke and triceps skin fold (TSF) thickness, mid-arm circumference (MAC), arm-muscle circumference (AMC), hemoglobin and serum albumin are not appropriate predictor of stroke.

Zinc supplementation fails to increase the immunogenicity of oral poliovirus vaccine: a randomized controlled trial

BACKGROUND

Polio eradication remains a challenge in Pakistan and the causes for the failure to eradicate poliomyelitis are complex. Undernutrition and micronutrient deficiencies, especially zinc deficiency, are major public health problems in Pakistan and could potentially affect the response to enteric vaccines, including oral poliovirus vaccine (OPV).

OBJECTIVE

To assess the impact of zinc supplementation among infants on immune response to oral poliovirus vaccine (OPV).

METHODS

A double-blind, randomized placebo-controlled trial was conducted in newborns (aged 0-14 days). Subjects were assigned to either receive 10mg of zinc or placebo supplementation daily for 18 weeks. Both groups received OPV doses at birth, at 6 weeks, 10 weeks and 14 weeks. Data was collected on prior immunization status, diarrheal episodes, breastfeeding practices and anthropometric measurements at recruitment and at 6 and 18 weeks. Blood samples were similarly collected to determine the antibody response to OPV and for micronutrient analysis. Logistic regression was used to determine the relationship between seroconversion and zinc status.

RESULTS

Overall, 404 subjects were recruited. At recruitment, seropositivity was already high for poliovirus (PV) serotype 1 (zinc: 91.1%; control: 90.5%) and PV2 (90.0%; 92.7%), with lower estimates for PV3 (70.0%; 64.8%). By week 18, the proportion of subjects with measured zinc levels in the normal range (i.e. ≥60 μg/dL) was significantly greater in the intervention group compared to the control group (71.9%; 27.4%; p<0.001). No significant difference in seroconversion was demonstrated between the groups for PV1, PV2, or PV3.

CONCLUSIONS

There was no effect of zinc supplementation on OPV immunogenicity. These conclusions were confirmed when restricting the analysis to those with measured higher zinc levels.

A comparative study between fine needle aspiration cytology findings and histopathological report of major salivary gland neoplasm in a tertiary hospital of Bangladesh

Salivary gland tumours are relatively uncommon and most of the tumours arise from parotid gland. Fine needle aspiration cytology (FNAC) is advised preoperatively as diagnostic tool but sometimes found to shown both false positive and false negative results. This study was aimed to find out distribution of neoplasm of major salivary glands and also to explore the sensitivity and specificity of FNAC. The present cross sectional study was done in the Dept. of Otolaryngology Head and Neck Surgery, BSMMU from January 2007 to December 2008. A total number of 60 gender-matched patients with major salivary neoplasm, confirmed by FNAC, were recruited in the study. Operated salivary gland specimens were sent for histopathological examination, histopathological findings were compared. Overall male to female ratio was 1:1. Out of 60 cases, 47 (78.3%) patients had parotid and 13 (21.7%) patients submandibular gland neoplasm. Male to female ratio for parotid tumour was 1:1.1 and for submandibular 1.6:1. Mean age of the patients was 44.5 with range of 14-85 years. Of the total 60 cases 47 (78.3%) were benign and 13 (21.7%) malignant. Out of 47 parotid tumour 85.1% were benign and 14.9% malignant. Among the parotid tumour 97% were superficial lobe and 3.0% deep lobe. In case of submandibular gland 53.84% were benign and 46.15% tumour malignant. According to the sides of involvement, 25 (53.2%) cases of parotid neoplasm tumour were in the left and 22 (46.8%) the right. In submandibular gland the distribution was 7 (53.8%) and 6 (46.16%) respectively. Statistically incidence of parotid tumour was significantly higher than submandibular tumour (p < 0.05). Out of 60 cases in 56 (93.3%) preoperative FNAC and postoperative histopathological findings were same. There was 1.7% false positive and 5% were false negative results. Sensitivity, specificity of FNAC were 80% and 97.8% respectively. Positive predictive value was 92.3% and negative predictive 93.6% for FNAC.FNAC though cheap and safe but its diagnostic accuracy was 93.3%.Histopathologial examination remained to be of value for diagnostic confirmation of major salivary gland neoplasm.

Mortality rate and clinical features of highly pathogenic avian influenza in naturally infected chickens in Bangladesh

A retrospective study was performed to assess the mortality rates and clinical signs in commercial and backyard chickens naturally infected with the highly pathogenic avian influenza (HPAI) H5N1 virus in Bangladesh. All of the 33 commercial and 25 backyard farms, recorded during the first wave of HPAI outbreaks (January to November 2007) in Bangladesh, were enrolled in this study. The farm profile data, stock information and major clinical signs recognised by the farmers and/or farm attendants, were collected through a prototype questionnaire. The investigating veterinarians' retrospective appraisals of the clinical signs were recorded by interview. After the clinical onset, the incidence rates of mortality in breeder, commercial broiler, commercial layer and backyard chickens were, respectively: 0.0215, 0.0341, 0.0179 and 0.0703 per chicken-day at risk. The four major clinical signs observed were cyanotic combs and wattles, oedema of the head and face, drowsiness and huddling and ecchymotic discoloration of the leg shanks. The first sign (cyanotic combs and wattles) was equally observed in chickens from commercial and backyard farms (p = 0.44) but the second (oedema of the head and face) was more common in backyard farms (p = 0.03).

Anterior cervical discectomy, fusion and stabilization by plate and screw--early experience

Anterior cervical plating is commonly performed to stabilize anterior cervical fusion. The aim of the study was to evaluate the clinical and functional outcome, radiological fusion and operative complications in cases of cervical spondylotic myelopathy and radiculopathy who underwent Anterior Cervical Discectomy and Fusion (ACDF) by autograft and stabilized with plate and screw. We evaluated 16 consecutive patients (M: F = 10:6) from January 2008 to December 2010 in Bangabandhu Sheikh Mujib Medical University (BSMMU) and different private hospitals in Dhaka, in cases where adequate conservative treatment failed. Single level ACDF by autograft and stabilization by plate and screw was done in 10 patients and 06 patients had two levels fusion. The mean follow up period was 18 months. The patients improved significantly (p < 0.05) and the recovery rate was 87.50%. All patients showed radiological fusion (p < 0.001). There was no hardware failure, graft extrusion or plate breakage. ACDF with plate and screw is fairly safe and effective therapy for cervical disc degeneration leading to myelo-radiculopathy where major post operative complications are uncommon.

Zinc oxide-mediated photocatalytic decolorization of Ponceau S in aqueous suspension by visible light

ZnO, comprising nanosize particles (approximately 40 nm) has been prepared by heating (300°C) ZnCO3, which was obtained as precipitate by mixing ZnSO4 and (NH4)2CO3 solutions. The prepared ZnO was characterized by X-ray diffraction, scanning electron microscopy (SEM), laser-induced breakdown spectroscopy, and adsorption studies. It has been used to catalyze the decolorization of Ponceau S (PS), a model diazo dye, in an aqueous suspension under visible light (I ≈ 1.8 × 10−4 W cm−2). This ZnO was found to be more efficient as a photocatalyst compared to pristine ZnO. ZnO samples with higher temperatures (500°C and 700°C) show less catalytic activity. SEM images show that the particle size of ZnO increases with the increase in calcined temperature of ZnO through agglomeration, resulting in a decrease in surface area. Photodecolorization of PS is affected by its and ZnO concentrations, but unaffected by the initial pH of the solutions in the range of 4 to 7. Illumination for a sufficiently long time completely mineralizes the dye, but no Zn2+ can be detected in the clear solution.

Photodegradation kinetics in the ZnO suspension obeys the Langmuir-Hinshelwood equation, and some activation of the ZnO surface by light is indicated.