Hearing Evaluation after Myringoplasty in Underlay Technique

Objective: to determine the success rate of underlay technique of myringoplasty regarding rate of graft take, complications and hearing improvement. Methods: This Cross sectional study was done in the department of ENT & Head-Neck Surgery, Dhaka Medical College Hospital & Shaheed Suhrawardy Medical college Hospital, Dhaka from July 2012 to December 2012. Sixty(60) patients who underwent myringoplasties were included in the study. All myringoplasty were performed by a postaural approach using autologous temporalis fascia and underlay technique. Results: The total success rate (graft uptake) was 88.3% and of the successful cases an overall hearing improvement was achieved in 73.58% of cases. The mean audiological improvement in air conduction threshold was 13.24 dB & mean closure of the air bone gap was 11.64 dB. The mean values of hearing gain of small perforations and subtotal perforations have shown significant difference.The mean values of hearing gain between posterior perforation and subtotal perforation have shown significant difference. Conclusion: Underlay myringoplasty is an effective technique of repairing the tympanic membrane perforation due to high rate of graft take and marked hearing improvement. Bangladesh J Otorhinolaryngol; October 2016; 22(2): 84-89

Selection of reference genes for quantitative studies in acute myeloid leukaemia

INTRODUCTION

Quantitative polymerase chain reaction (qPCR) is commonly used in the investigation of acute myeloid leukaemias (AML). Stable reference genes (RG) are essential for accurate and reliable reporting but no standard method for selection has been endorsed.

MATERIALS AND METHODS

We evaluated simple statistics and published model-based approaches. Multiplex-qPCR was conducted to determine the expression of 24 candidate RG in AMLs (N=9). Singleplex-qPCR was carried out on selected RG (SRP14, B2M and ATP5B) and genes of interest in AML (N=15) and healthy controls, HC (N=12).

RESULTS

RG expression levels in AML samples were highly variable and coefficient of variance (CV) ranged from 0.37% to 10.17%. Analysis using GeNorm and Normfinder listed different orders of most stable genes but the top seven (ACTB, UBE2D2, B2M, NF45, RPL37A, GK, QARS) were the same. In singleplex-qPCR, SRP14 maintained the lowest CV in AML samples. B2M, one of most stable reference genes in AML, was expressed near significantly different in AML and HC. GeNorm selected ATP5B+SRP14 while Normfinder chose SRP14+B2M as the best two RG in combination. The median expressions of combined RG genes in AML compared to HC were less significantly different than individually implying smaller expression variation after combination. Genes of interest normalised with RG in combination or individually, displayed significantly different expression patterns.

CONCLUSIONS

The selection of best reference gene in qPCR must consider all sample sets. Model-based approaches are important in large candidate gene analysis. This study showed combination of RG SRP14+B2M was the most suitable normalisation factor for qPCR analysis of AML and healthy individuals.

Susac Syndrome: A Rare Case Report

Susac syndrome is a rare autoimmune disease, which is characterized by microangiopathic changes that affects the brain, retina and cochlea. A 60-years-old female Muslim housewife, hypertensive, non-diabetic patient was admitted into Ophthalmology department of Mymensingh Medical College Hospital, Mymensingh, Bangladesh on 18 December 2017 presented with the complains of gross dimness of vision of left eye for 10 years, vitiligo over the whole body for 5years,hearing loss with tinnitus in both ear for one year. Fluoresce in fundus angiography of Left eye shows Central retinal artery occlusion & was treated by Pan retinal photocoagulation in left eye, Magnetic resonance image of brain shows hyper intense lesions in periventricular white matter & corpus callosum, pure tone audiometry shows bilateral sensorineural type of hearing loss. Early diagnosis and early initiation of treatment is important in reducing the permanent disability.

Human leukocyte antigen (HLA) class II association in chronic hepatitis B patients with hepatocellular carcinoma in a Malay population: A pilot study

Asian countries account for almost three quarter of hepatocellular carcinoma (HCC) reported globally and chronic hepatitis B infection is one of the main contributors. Clinical observations show that Malay patients with chronic hepatitis B and HCC tend to have a worse outcome, when compared to other two major races in Malaysia. The objectives of this study was to determine the frequency of human leukocyte antigen (HLA) class II alleles in chronic hepatitis B patients with HCC among Malays compared to the general population to identify potential associations of HLA alleles with this disease. HLA class II typing was performed in chronic hepatitis B patients with hepatocellular carcinoma (n=12) by -polymerase chain reaction, sequence specific primer (PCR-SSP) method. There were higher allelic frequencies of certain HLA-DQB1 and HLA-DRB1 alleles; HLA-DQB1*03 (07) (41.7%), and HLA-DRB1*12 (41.7% vs 28.6%) and compared to controls (41.7% vs 29.7%). However, there was no significant statistical correlation found when compared with the normal healthy general population. This study provides an insight into the HLA Class II association with chronic hepatitis B and hepatocellular carcinoma in Malays. However, findings from this study should be validated with a larger number of samples using a high resolution HLA typing.

Sympathetic Ophthalmitis: A Rare Case Report

Sympathetic ophthalmitis (SO) is defined as bilateral granulomatous panuveitis occurring after penetrating ocular trauma or intraocular surgery. It is now rare due to micro-surgical repair of ocular injury and use of steroid. An 18 years old boy admitted into Ophthalmology department of Mymensingh Medical College Hospital, Mymensingh, Bangladesh on 2nd March 2018. He got penetrating corneal injury in R/E with sharp pointed object 01 month back. It was conservatively managed but his right eye became phthisical. After 04 weeks his left eye was affected in which VA became 3/60, features of panuveitis developed. It was managed with high dose steroid and immunomodulatory drug (Azathioprine). Ultimately his vision of left eye is fully preserved (6/6). So, after a trauma or surgery to one eye, another eye should be meticulously examined and followed up. Early diagnosis and prompt treatment of Sympathetic Ophthalmitis may prevent from blindness.

Comparison of oil and fat supplementation on lactation performance of Nili Ravi buffaloes

The effects of feeding rumen-inert fat sources on production responses of lactating dairy cows have been well reported but less thoroughly described in lactating dairy buffalo. The objective of this study was to investigate the effect of oil and 2 different rumen-inert fat sources on dry matter intake, milk yield, milk composition, and milk fatty acid (FA) profile in Nili Ravi buffalo. Twelve multiparous mid-lactating Nili Ravi buffaloes received 4 treatments in a 4 × 4 Latin square design with a period length of 21 d. The treatments were (1) the basal diet without supplementation of oil or fats (CTRL), (2) the basal diet supplemented with canola oil (CO), (3) the basal diet supplemented with calcium salts of palm FA (Ca-FA), and (4) the basal diet supplemented with high palmitic acid (PA). Dry matter intake was decreased by 4.4% in the CO compared with Ca-FA and PA. Milk yield and milk fat yield were increased by 7.8 and 14.3%, respectively, in CO, Ca-FA, and PA compared with the CTRL. Milk fat content increased by 7.5%, whereas milk fat yield tended to increase with the supplementation of Ca-FA and PA compared with CO. No effect on milk yield and milk composition was observed in Ca-FA versus PA treatments. The yield of medium-chain FA was increased by Ca-FA and PA versus CO. The CO treatment increased the yield of long-chain FA compared with Ca-FA and PA treatments. Plasma glucose level was higher in CO, Ca-FA, and PA compared with the CTRL. In conclusion, feeding rumen-inert fats in the lactating buffalo diet proved to be a useful strategy to increase the 3.5% fat-corrected milk yield due to the higher milk fat content in this study.

Entanglement in ladder-plus-Y double quantum dot structure via entropy

Quantum entropy in a ladder-plus-Y double quantum dot system was calculated. The controlling parameters that are examined are four coherent optical fields, three tunneling components, and incoherent optical pumping. This work differs from others by the inclusion of a wetting layer (WL) and the calculation of momenta for each transition. The results showed that the entropy depends on the difference between the carrier occupations in the states of these two quantum dots (QDs). It is also shown that the probe optical field reduces the entropy, while the pumping field increases it. Turning off the main tunneling component removes the entropy, while high WL-QD momentum increases the entropy. Taking the same value of momentum for all transitions (the case of other works) underestimates the entropy.

In the World of Politics and Stigma Around Cancer, Can Cancer Survivors With Political Career Become Cancer Advocates?

Background and context: According to WHO estimates in 2012, around 20,000 Afghans suffered from various types of cancers while around 15,000 die of this disease. Until late 2015, there was not a single dedicated bed for cancer patients nor there was a doctor, nurse or other cancer care professionals within the structure of Afghan government, especially within the Ministry of Public Health. In November 2014 when Dr. Shinkai Karokhail, member of parliament, returned Afghanistan after spending almost a year overseas for breast cancer treatment misdiagnosed in Afghanistan, she and H.E. the First Lady, Rolla Ghani, began advocating for cancer prevention and control in Afghanistan. They managed to bring the few cancer care professionals and advocates under one umbrella called Afghanistan Cancer Foundation (ACF). Aim: To provide cancer care services to cancer patients. Strategy/Tactics: The main strategy was the involvement of known social and political figures in cancer advocacy. Considering the disparity in cancer incidence among men and women and breast cancer being the leading cancer, one of the most influential people was H.E. the First Lady who is a strong advocate of women rights. The other tactic was the involvement of members of parliament who were cancer survivors. Program/Policy process: Once the political commitment regarding cancer prevention and control was gained, H.E. the First Lady and members of parliament asked the Ministry of Finance to allocate fund for cancer prevention and control. Thus, first fund of only $50,000 was provided by the Ministry of Finance provided to Ministry of Health in the fiscal year 2015. Outcomes: As a result of the advocacy efforts by cancer control advocates, especially by Ms. Shinkai Karokhail, the breast cancer survivor, and H.E. the First Lady of Afghanistan, the first 10-bed day-care and 29-bed IPD cancer center was established in Afghanistan in March 2016. Subsequently, the National Cancer Control Program (NCCP) was created in January 2017 within the Ministry of Public Health. In addition, the first hospital-based cancer registry was formed which will be followed by establishment of Kabul Cancer Registry. The only cancer center provided health care services to around 12,000 patients in 2017 who were either not receiving cancer care services or were traveling to neighboring countries for diagnosis and treatment. What was learned: Cancer patients/survivors who have political career can be the best cancer prevention and control advocates.

S1PR1 drives a feedforward signalling loop to regulate BATF3 and the transcriptional programme of Hodgkin lymphoma cells

The Hodgkin/Reed-Sternberg cells of classical Hodgkin lymphoma (HL) are characterised by the aberrant activation of multiple signalling pathways. Here we show that a subset of HL displays altered expression of sphingosine-1-phosphate (S1P) receptors (S1PR)s. S1P activates phosphatidylinositide 3-kinase (PI3-K) in these cells that is mediated by the increased expression of S1PR1 and the decreased expression of S1PR2. We also showed that genes regulated by the PI3-K signalling pathway in HL cell lines significantly overlap with the transcriptional programme of primary HRS cells. Genes upregulated by the PI3-K pathway included the basic leucine zipper transcription factor, ATF-like 3 (BATF3), which is normally associated with the development of dendritic cells. Immunohistochemistry confirmed that BATF3 was expressed in HRS cells of most HL cases. In contrast, in normal lymphoid tissues, BATF3 expression was confined to a small fraction of CD30-positive immunoblasts. Knockdown of BATF3 in HL cell lines revealed that BATF3 contributed to the transcriptional programme of primary HRS cells, including the upregulation of S1PR1. Our data suggest that disruption of this potentially oncogenic feedforward S1P signalling loop could provide novel therapeutic opportunities for patients with HL.

Pole-placement Predictive Functional Control for under-damped systems with real numbers algebra

This paper presents the new algorithm of PP-PFC (Pole-placement Predictive Functional Control) for stable, linear under-damped higher-order processes. It is shown that while conventional PFC aims to get first-order exponential behavior, this is not always straightforward with significant under-damped modes and hence a pole-placement PFC algorithm is proposed which can be tuned more precisely to achieve the desired dynamics, but exploits complex number algebra and linear combinations in order to deliver guarantees of stability and performance. Nevertheless, practical implementation is easier by avoiding complex number algebra and hence a modified formulation of the PP-PFC algorithm is also presented which utilises just real numbers while retaining the key attributes of simple algebra, coding and tuning. The potential advantages are demonstrated with numerical examples and real-time control of a laboratory plant.

TiO2 Nanotube-Carbon (TNT-C) as Support for Pt-based Catalyst for High Methanol Oxidation Reaction in Direct Methanol Fuel Cell

In this study, TiO₂ nanotubes (TNTs) were synthesized via a hydrothermal method using highly concentrated NaOH solutions varying from 6 to 12 M at 180 °C for 48 h. The effects of the NaOH concentration and the TNT crystal structure on the performance for methanol oxidation were investigated to determine the best catalyst support for Pt-based catalysts. The results showed that TNTs produced with 10 M NaOH exhibited a length and a diameter of 550 and 70 nm, respectively; these TNTs showed the best nanotube structure and were further used as catalyst supports for a Pt-based catalyst in a direct methanol fuel cell. The synthesized TNT and Pt-based catalysts were analysed by FESEM, TEM, BET, EDX, XRD and FTIR. The electrochemical performance of the catalysts was investigated using cyclic voltammetry (CV) and chronoamperometric (CA) analysis to further understand the methanol oxidation in the direct methanol fuel cell (DMFC). Finally, the result proves that Pt-Ru/TNT-C catalyst shows high performance in methanol oxidation as the highest current density achieved at 3.3 mA/cm² (normalised by electrochemically active surface area) and high catalyst tolerance towards poisoning species was established.

Insulin storage in hot climates without refrigeration: temperature reduction efficacy of clay pots and other techniques

AIM

Insulin loses potency when stored at high temperatures. Various clay pots part-filled with water, and other evaporative cooling devices, are used in less-resourced countries when home refrigeration is unavailable. This study examined the cooling efficacy of such devices.

METHODS

Thirteen devices used in Sudan, Ethiopia, Tanzania, Mali, India, Pakistan and Haiti (10 clay pots, a goat skin, a vegetable gourd and a bucket filled with wet sand), and two identical commercially manufactured cooling wallets were compared. Devices were maintained according to local instructions. Internal and ambient temperature and ambient humidity were measured by electronic loggers every 5 min in Khartoum (88 h), and, for the two Malian pots, in Bamako (84 h). Cooling efficacy was assessed by average absolute temperature difference (internal vs. ambient), and % maximal possible evaporative cooling (allowing for humidity).

RESULTS

During the study period, mean ambient temperature and humidity were 31.0°C and 32.0% in Khartoum and 32.9°C and 39.8% in Bamako. All devices reduced the temperature (P < 0.001) with a mean (sd) reduction from 2.7 ± 0.5°C to 8.3 ± 1.0°C, depending on the device. When expressed as % maximal cooling, device efficacy ranged from 20.5% to 71.3%. On cluster analysis, the most efficacious devices were the goat skin, two clay pots (from Ethiopia and Sudan) and the suspended cooling wallet.

CONCLUSIONS

Low-cost devices used in less-resourced countries reduce storage temperatures. With more efficacious devices, average temperatures at or close to standard room temperature (20-25°C) can be achieved, even in hot climates. All devices are more efficacious at lower humidity. Further studies are needed on insulin stability to determine when these devices are necessary.

Effects of Varying Levels of Fungal (Arachniotus sp.) Treated Wheat Straw as an Ingredient of Total Mixed Ration on Growth Performance and Nutrient Digestibility in Nili Ravi Buffalo Calves

The study was carried out to explore the effects of replacing wheat straw with fungal treated wheat straw as an ingredient of total mixed ration (TMR) on the growth performance and nutrient digestibility in Nili Ravi buffalo male calves. Fungal treated wheat straw was prepared using Arachniotus sp. Four TMRs were formulated where wheat straw was replaced with 0 (TMR1), 33 (TMR2), 67 (TMR3), and 100% (TMR4) fungal treated wheat straw in TMR. All TMRs were iso-caloric and iso-nitrogenous. The experimental TMRs were randomly assigned to four groups of male calves (n = 6) according to completely randomized design and the experiment continued for four months. The calves fed TMR2 exhibited a significant improve in dry matter intake, average daily weight gain, feed conversion ratio and feed economics compared to other groups. The same group also showed higher digestibility of dry matter, crude protein, neutral-, and acid detergent fibers than those fed on other TMRs. It is concluded that TMR with 33% fungal-treated wheat straw replacement has a potential to give an enhanced growth performance and nutrient digestibility in male Nili Ravi buffalo calves.

Effect of preputial washing on bacterial load and preservability of semen in Murrah buffalo bulls

Aim:

To study the effect of preputial washing on bacterial load, preservability and semen quality in Murrah buffalo bulls

Materials and Methods:

A total of 36 collections of three Murrah buffalo bulls maintained at Artificial Breeding Research Centre, ICAR-National Dairy Research Institute, Karnal, were collected at weekly intervals from each bull without preputial washing and latter ejaculates from same bull with preputial washing by infusing normal saline (0.85%), KMnO₄ (0.02%) and savlon (2.0%) to first, second and third bull, respectively. The microbial load and semen quality were evaluated during different hours of storage at refrigerated temperature (0, 24 and 48 h) and after thrawing of cryopreserved (at −196°C) semen.

Results:

The results of preservation of semen at refrigerated temperature showed that bacterial load was markedly lower in ejaculates of bulls subjected to preputial washing. Semen preserved at refrigerator temperature and cryopreserved, the effect of washing solution was significant for individual motility (IM), non-eosiniphilic count, hypo-osmotic swelling reactivity (HOST), total plate count (TPC) and acrosome integrity. KMnO₄ was found to be the best in lowering bacterial load, sperm abnormalities and in improving semen quality such as motility, non-eosinophilic count, HOST and acrosome integrity even up to 48 h of preservation and cryopreserved semen. Effect of duration of preservation and stage of cryopreservation was also significant for IM, non-eosiniphilic count, HOST, sperm abnormalities and acrosome integrity.

Conclusion:

Overall the results suggested that preputial washing with KMnO₄ solution improved the semen quality and reduced microbial load of Murrah buffalo bull’s semen preserved at refrigerated temperature and cryopreservation.