Prevalence of Gall Bladder Carcinoma in Patients with Cholelithiasis

The objective of the study was to find out the prevalence of gallbladder carcinoma in patients having cholelithiasis. For this purpose a prospective study was carried out on 15 patients of both sexes in Shaheed Ziaur Rahman Medical College Hospital, Bogura. Their mean age was 56 ±8 years (range 30 to 70 years) having gall bladder mass. Gall bladder mass and stone were detected by history, Physical examination, ultrasonography and computed tomography of the abdomen. Carcinoma was confirmed by histopathological examination of specimens removed by operation. All gallbladder masses removed by operation showed malignat tumor on histopathological examination. Among them adenocarcinoma and squamous cell carcinoma were present in 94 and 6 percent respectively. Stones were present within gallbladder mass in 94 percent of cases. In 80 percent of cases the disease was in advanced stage. The results of the present study suggested that the patient having cholelithiasis are prone to develop malignancy in the gallbladder. However as the sample size is small further studies are needed by taking large number of sample to validate this statement Journal of Surgical Sciences (2012) Vol. 16 (2) : 68-70

Genetic diversity of Bangladeshi native chickens based on complete sequence of mitochondrial DNA D-loop region

1. The aim of this study was to explore genetic diversity and possible origin of Bangladeshi (BD) native chickens. The complete mtDNA D-loop region was sequenced in 60 chickens representing five populations; naked neck, full feathered, Aseel, Hilly and autosomal dwarf. The 61 reference sequences representing different domestic chicken clades in China, India, Laos, Indonesia, Myanmar, and other Eurasian regions were included. The mtDNA D-loop sequence polymorphism and maternal origin of five BD populations were analysed.2. A total of 35 polymorphic sites, and 21 haplotypes were detected in 60 mtDNA D-loop sequences. The haplotype and nucleotide diversity of the five populations were 0.921 ± 0.018 and 0.0061 ± 0.0019, respectively. Both mtDNA network and phylogenetic analysis indicated four clades (four haplogroups) in BD populations (21 haplotypes) along with 61 reference haplotypes. Clade E contained the most individuals (20) and haplotypes (11) of BD chickens, followed by clade D (17, 6), clade C (12, 2) and clade F (11, 2), respectively.3. The higher number of unique haplotypes found in Yunnan, China, suggested that the origin of BD chickens was in this region. The haplotypes from different haplogroups were introduced in Bangladeshi chickens from India, China and Myanmar. The phylogenetic tree showed a close relationship of BD chickens with the clusters from India, China, Myanmar and Laos, and indicated the dispersion of BD chickens from these sources. The phylogenetic information revealed high genetic diversity of BD chickens because of their origin from different lineages with high genetic variation and distance, which was determined from four cluster and neighbour-joining trees.4. In conclusion, BD populations had high genetic diversity. The mtDNA network profiles and phylogenetic trees showed multiple maternal origins of BD chickens from India, China, Myanmar and Laos.

Concentrations and Health Risk Assessment of Trace Elements in Cereals, Fruits, and Vegetables of Bangladesh

This study was conducted to determine concentrations of five toxic trace elements (Cr, Ni, As, Cd, and Pb) in cereals, fruits, and vegetables of Bangladesh. The range of mass fractions (mg/kg) of Cr, Ni, As, Cd, and Pb in the foodstuffs was 0.090-2.5, 0.03-2.6, 0.13-1.7, 0.010-0.74, and 0.37-2.2, respectively. This study indicates that concentration of Cr, and Pb in fruits; As, Cd, and Pb in vegetables were higher than WHO/FAO maximum allowable concentration levels. The hazard index (HI) values for adults and children of the toxic elements in studied cereals, fruits and vegetables were higher than 1.0, suggesting non-carcinogenic adverse health hazard to the consumers. The estimated target carcinogenic risk (TCR) values were greater than the threshold level of 1.0 × 10^-4 for Cr and Cd in cereals and vegetables indicate potential cancer risk to both adults and children for consumption of the foodstuffs. The present study reveals that trace elements contamination in foodstuffs is a serious issue of concern in Bangladesh.

Laparoscopic Adrenalectomy: Two Years Experience at Bangabandhu Sheikh Mujib Medical University

Laparoscopic surgery has become an efficient tool for many complex surgical procedures. In last decades, laparoscopic adrenalectomy has become a more viable option for removal of adrenal pathology, with many surgeons preferring it to the conventional open technique. This study was done to evaluate the outcomes of lateral transperitoneal adrenalectomy (LTA) in our department and evaluate the feasibility of lateral transperitoneal adrenalectomy (LTA) in our perspective. This study is case series observational study carried out at Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh from March 2015 to May 2017. Suspected primary adrenal malignancies were excluded. Seventeen (17) patients (10 male and 7 females with mean age of 35.29 years) underwent 18 adrenalectomy (one bilateral). Seventeen (17) adrenal tumours were resected through laparoscopy and one adrenal tumour is resected through open approach due to conversion. All the patients underwent hormonal evaluation, ultrasonogram and computed tomography of whole abdomen. Ten (10) patients (58.82%) had hormonal active adrenal mass. Seven (7) patients (41.18%) were asymptomatic of which 2 had associated cholelithiasis, 7 patients had generalized weakness, 3 had weight gain with Cushing syndrome (one drug induced) and one had Hirsutism with musculanizing effect. Nine (9) patients had hypertension and 6 patients had diabetes mellitus. Eight (8) right, 8 left and 1 bilateral LTA were performed. The mean age of the patients were 35.29 years, adrenal tumour size ranges from 15-65mm and operation time ranges from 75-120 minutes for unilateral adrenalectomies and 220 minutes for bilateral adrenalectomy. Estimated blood loss ranges from 30 to 130 ml in 16 cases and in one case it was 220 ml in which conversion was done. Mean post operative stay in hospital was 3.94 days. In 16 cases no major or minor complications were observed but in one case due to haemorrhage and infiltration of the tumour to kidney conversion are done in the form of right adrenalectomy with upper partial nephrectomy (Histopathology revealed angiomyolipoma). In pathological examination 9 patients (52.94%) had adrenocortical adenoma, 2 patients (11.76%) had phaeochromocytoma including bilateral one, 2 patients (11.76%) had myolipoma of which one converted to open, 2 patients (11.76%) had adrenocortical hyperplasia, one patient (5.88%) had adrenal cyst and one patient (5.88%) had haemorrhagic cyst. LTA is a safe and efficient minimally invasive treatment options for both secreting and non secreting adrenal masses. The procedure has a learning curve and should be performed by a surgeon experienced in both open and laparoscopic adrenal surgery.

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.

Hepatitis B Antibody Level Falls after Initial Phage of Chemotherapy in Childhood Haematological Malignancy

Hepatitis B virus (HBV) infection is a worldwide one of the major public health problem. Vaccination against HBV is highly effective at a very low cost. During treatment and for a variable period after completion of chemotherapy and radiotherapy children became immunosuppress. The main laboratory marker used to assess hepatitis B immunity is IgG antibody to the surface antigen (HBsAg). Surgical procedures and multiple blood transfusions increase the risk of hepatitis B virus infection in these immune suppressed patients. In Bangladesh, data are unavailable regarding prevalence of HBsAg in children with cancer and their protective immune status against hepatitis B virus while on treatment or after completion of chemotherapy. The results of this study may aid physicians in the development of evidence-based guidelines for revaccination of children with cancer during and after treatment with chemotherapy. This observational study was conducted from November 2013 to February 2015 in the department of Paediatric Haematology and Oncology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh. Children were recruited from both the inpatient and outpatient units of the department of Paediatric Hematology and Oncology at BSMMU. Blood specimens were collected from the children who were receiving inpatient and outpatient care from the department of Pediatric Hematology and Oncology, 2.0ml of venous blood was drawn and serum was separated and stored at -20°C until testing then HBV antibody titer was assayed at the department of Virology laboratory of BSMMU. A structured questionnaire was used for data collection. Among 28 children, 19(67.9%) were male and 9(32.1%) female, male female ratio 2.1:1. Among the 28 children, ALL was in 24(85.7%), NHL 3(10.7%), and APML 1(3.7%). Among 28 children, anti-HBs titer was more than 10mIU/ml in all patients. But six month after initiation of chemotherapy, 8(28.57%) patients had anti-HBs titer less than 10mIU/ml. Hepatitis B antibody titre level significantly reduced after 6 months chemotherapy in children with hematological malignancies.

Analysis of grain growth, structural and magnetic properties of Li-Ni-Zn ferrite under the influence of sintering temperature

The effect of sintering temperature (T_S) on the structural and magnetic properties of Li_0.15Ni_0.3Zn_0.4Fe_2.15O₄ is investigated and discussed. The sample is synthesized by the sol-gel auto combustion method and sintered at 1373–1573 K for 5 h. Phase identification of the powder sample was performed by using the X-ray diffraction (XRD). The XRD patterns confirmed the formation of single phase cubic spinel structure. The bulk density is correlated with T_S. From the energy-dispersive X-ray spectroscopy study, it is observed that the percentage of the elements in the component phases is well consistent with the nominal composition of the composites. Field Emission Scanning Electron Microscopy showed that the average grain size (D) is increased with increasing T_S. The frequency (100 Hz–120 MHz) dependent complex initial permeability spectra and relative quality factor increased with sintering temperature up to 1523 K then decreased for further increase in temperature. The complex initial permeability has been explained with the help of microstructure, and the redistribution of cations in their sites.

Management of Post Traumatic Kyphotic Deformity in Thoracolumbar Spine: Conservative versus Operative Treatment

Local post traumatic kyphosis may impair spinal sagittal balance and result in seven disability and programmed neurological deficit. In operative group the mean±SD fracture kyphosis was 34.21±3.7 at the time of admission and mean±SD kyphosis was 17.64±3.20 at the time of final follow up. In conservative group the mean±SD kyphosis was 32.96±4.06 at the time of admission and mean±SD kyphosis was 40.28±4.72 at the time of final follow up. It is interesting to note that in conservative group kyphosis increased (7.3) during final follow up but decreased (16.57) in operative group during final follow up due to spinal instrumentation and post-lateral fusion. Local post traumatic kyphosis may impair spinal sagittal balance and result in severe disability and progressive neurological deficit. Objective of the study is to find out the better option in the management of post traumatic kyphotic deformity in thoracolumbar Spain injury. The quasi-experimental study was carried out at the National Institute of Traumatology & Orthopedic Rehabilitation (NITOR), Dhaka, Bangladesh from January 2006 to December 2008. A total number of 40 patients with post traumatic thoracolumbar spine injuries with kyphotic deformity selected purposively. Out of 40 cases 1 patient missed from final follow up. Rest of 39 patients was included in this study. All patients were admitted within 3 weeks of injury. Most were referred from peripheral hospital & some were admitted in emergency and outpatient department of NITOR. Among those 25 patients were conservatively treated and 14 were operatively treated. In operative group the mean±SD fracture kyphosis was 34.21±3.7 at the time of admission and mean±SD kyphosis was 17.64±3.20 at the time of final follow up. In conservative group the mean±SD kyphosis was 32.96±4.06 at the time of admission and mean±SD kyphosis was 40.28±4.72 at the time of final follow up. It is to note that in conservative group kyphosis increased (7.3) during final follow up but decreased (16.57) in operative group during final follow up due to spinal instrumentation and post-lateral fusion.

Frequency of Fungal Species of Onychomycosis between Diabetic and Non-Diabetic Patients

Onychomycosis is a common nail problem in our country. Diabetic patients are more prone to develop onychomycosis. Various types of fungi are the causative agents of nail infections. This cross sectional explorative study was designed to find out the pattern of onychomycosis among diabetic and non-diabetic patients attending the out patient Department of Dermatology and Venereology and Endocrinology of Bangabandhu Sheikh Mujib Medical University Hospital, Dhaka, Bangladesh from July 2012 to June 2013. Clinically diagnosed patients of onychomycosis with diabetic or non-diabetic were included purposively in this study. Scraping or clipping from infected nail materials were processed for microscopy and culture in Sabouraud's dextrose agar media and Dermatophyte test media. Clinical features, microscopic examination results and culture interpretations were recorded and compared in two groups. A total of 87 clinically diagnosed patients of onychomycosis were included in this study. Out of 87 patients of onychomycosis, 54 patients were diabetic and 33 patients were non-diabetic. Trichophyton rubrum and Trichophyton mentagrophytes were found in 24(44.44%) and 19(35.18%) diabetic patients. Candida albicans and non-albicanscandida species were found in 1(1.85%) and 2(3.70%) diabetic patients. On the other hand, Trichophyton rubrum and Trichophyton mentagrophytes were found in 1(3.03%) and 2(6.06%) non-diabetic patients. Candida albicans and non-albicanscandida species were found in 8(24.24%) and 8(24.24%) non-diabetic patients. Growth of fungus was found in 46(85.19%) diabetic patients which was significant (p=0.004) compared to that found in 19(57.58%) non-diabetic patients. No growth was found in 8(14.81%) diabetic and in 14(42.42%) non-diabetic patients. Dermatophytes were more found in diabetic patients and Candida albicans and non-albican Candida spp. were more found in non-diabetic patients. So, the pattern of onychomycosis was different in diabetics compared to non-diabetics. Further study may be done with large number of sample to determine more accurate pattern of onychomycosis among diabetics.

Exploring the status of disaster risk reduction focusing coping strategies in Rangpur division of Bangladesh

Bangladesh is a low laying country where disaster events are common phenomena almost every year. Same as coastal areas of Bangladesh, the northern areas are now suffering huge events of floods, droughts and riverbank erosion. The main purpose of this study is to determine the practice of disaster coping strategies by the people in the study areas. The study was carried out at Rajibpur sub-district under Kurigram district, Saghatta sub-district under Gaibandha district, Gangachara sub-district under Rangpur district, Aditmari sub-district under Lalmonirhat district and Dimla sub-district under Nilphamari district. Data were collected from a sample of 300 respondents from 5 subdistricts by using interview schedules 12 January 2017 to 19 March 2018. About 80% respondents are dependent on the TV or Radio news for pre-disaster warning and forecasting as well as more than this population loses their property above BDT 50000 in every year due to disaster damage. During flood, the respondents maintain some scoping materials like raising plinth, making scaffold, using moveable cooking materials, taking loan from the Mahajan and sold their non-productive assets. Most of the respondents from various study area follow these kinds of measures and about 63.33% respondents use bamboo or wood for their cooking purpose during flood. About 40% respondents from these study areas are suffered of shelter due to riverbank erosion and they migrate here and there for better life. More than two third of the respondents have no opportunity to get any kind of help or relief from the GOs and NGOs. They are now depending on their own coping strategies. They badly need a new coping strategy for reducing the damage of flood or riverbank erosion. Disaster forecasting, early warning system and community-based flood management can save many lives and properties. For effective disaster management strategies, it could be applied early warning systems and adequate training as pre-disaster strategy and availability of relief and other inputs at acceptable price and loan with flexible conditions as post-disaster strategy. Progressive Agriculture 29 (3): 195-204, 2018

Evaluation of Knowledge Regarding Oral Anti-diabetic Agents among Hospitalized Diabetic Patients

Knowledge regarding oral anti-diabetic agents help to enhance compliance among diabetic patients. Though it is an important aspect of management, data evaluating it is scarce in our country. This cross sectional observational study carried out in the Department of Medicine, Mymensingh Medical College Hospital, Mymensingh, Bangladesh from September 2013 to February 2014 and was undertaken to determine basic knowledge about oral anti-diabetic agents among hospitalized diabetic patients taking or took oral anti-diabetic agents. In this study main outcome measures were socio-demographic characteristics, knowledge regarding oral anti-diabetic agents, frequency of previous hospital admission, regularity in taking oral anti-diabetic agents, causes of irregularity in taking medicine and knowledge related to hypoglycemia. Mean±SD age was 55±7.14 years, of the patients who were included in this study. Only 33% of patients knew side effects of oral anti-diabetic agents, 34% didn't know that drug should not be stopped before giving blood for glucose estimation, in answering to 9 basic question related to oral anti-diabetic agents 56% obtained score within 0-5, overall mean 5.2±1.47. Among them 38% used to take drug irregularly. Correlation with knowledge score and regularity in taking drug showed significant relation (p<0.01). This study has demonstrated unsatisfactory knowledge on oral anti-diabetic agents among type 2 diabetic patients and significant relation with knowledge on oral anti-diabetic agents and patients compliance. An improvement with this respect may be achieved through continuing patients education about diabetes and its treatment.

Outcome of Surgery in Chronic Inactive Mucosal Otitis Media

Chronic otitis media is a common condition seen in patients attending the otorhinolaryngology Department. The discharging ear presents the otologists with the dilemma of operating on it or not. The aim of the this cross-sectional observational study was to find out the outcome of surgery in chronic inactive mucosal otitis media and was conducted on 62 patients of either sex in the age group of 15-60 years in the Department of ENT and Head Neck surgery, Shaheed Suhrawardy Medical College Hospital (ShSMCH), Dhaka, Bangladesh From July 2015 to January 2016. Pre and post operative hearing assessment was done with pure tone audiometry (PTA). Post operative graft status also noted. All the information's were recorded in the fixed protocol. Collected data were classified, edited, coded and entered into the computer for statistical analysis by using updated computerized program SPSS-19. Among 62 cases the mean age were 36.79±10.33 in chronic inactive mucosal otitis media. Majority of the study population were in age group of between 15-25 in this group of which was 16(51.6%). Male were 36(58.06) and 26(41.94) were female. All patients presented with history of otorrhoea in this group, 52(83.87%) had hearing impairment in chronic inactive mucosal otitis media, 30(48.39%) involved in right ear and 26(41.94%) involved in left ear and 06(9.68%) in both ear in chronic inactive mucosal otitis media. Majority of perforation were medium in size in this group of which was 30(48.39%). anterior perforation was 24(38.71%), posterior perforation 28(45.16%) and subtotal 10(16.13%) in chronic inactive mucosal otitis media. Sixty two (100%) cases underwent myringoplasty. Post-auricular approach used in most of operation in this group of which was 60(96.77%). Preoperative air conduction threshold 32(51.61%) were in between 31-45 dB in myringoplasty group (p<0.05) that was statistically significant. Postoperative air conduction threshold 30(48.39%) were between 16-30 dB in myringoplasty group (p<0.05) that was statistically significant. Difference between preoperative and postoperative air conduction threshold mean difference was 11.38 dB and 36.75±5.84 and 25.37±7.46 respectively (p<0.001) in myringoplasty group. Hearing gain was 42(67.74%) in myringoplasty (p>0.05) that was not statistically significant. Graft uptake in myringoplasty was 52(83.9%). Graft failure in myringoplasty was 10(16.1%). post operative complication was tinnitus in 12(19.35%) cases in myringoplasty. Success rate was more in case of posterior perforation than anterior and subtotal perforation in both chronic inactive mucosal otitis media which was 92.86%. Success rate was more in case of medium size perforation than subtotal perforation in chronic inactive mucosal otitis media which was 86.67%. Success rate was (100%) in small perforation in this group. From this study it can be concluded that myringoplasty is a valid treatment modality for chronic inactive mucosal otitis media to achieve an intact tympanic membrane and to gain hearing.

Magnetic Resonance Imaging of Cerebral Palsy in the Assessment of Time of Brain Insult

The aim of this cross-sectional study was to find out the role of Magnetic resonance imaging (MRI) in the assessment of time of brain insult in cerebral palsy (CP). The study was conducted in the Department of Radiology & Imaging, Mymensingh Medical College Hospital, Mymensingh and a total number of 35 patients with were enrolled from January 2015 to December 2016. Maximum patients (57.2%) were under five years followed by 34.3% were of 5 to <8 years and 8.7% were of 8 to <12 years of age and mean age was 4.7 years. Majority of the patients were male 28(80%) and female were 7(20%). Among the patients 23(65.7%) came from poor, whereas 11(31.4%) came from middle class and only one (2.9%) from rich socioeconomic group. According to gestational age of the patients, 26(74.3%) were term (≥37weeks) at delivery and rest (25.7%) were preterm (<37 weeks). Delayed cry after birth were present in 32 (80%) patients. Regarding types of cerebral palsy spastic diplegia, spastic quadriplegia, hemiplegia and extrapyramidal were found 3(8.6%), 25(71.4%), 4(11.4%) and 3(8.6%) respectively. Abnormal MRI was reported in 94.2% patients and gave clues to time of insult in 79.9% (excluding the 14.3% miscellaneous findings). The findings were mal-developments (5.7%), periventricular white matter lesions (25.7%), cortical or deep grey matter lesions (48.6%), miscellaneous (14.3%) and normal (5.7%). Brain mal-developments were more seen in term than in preterm born children (5% vs. 0%). Periventricular white matter lesions were seen significantly more in preterm than in term born children (77.8% vs. 3.9%). Cortical or deep grey matter lesions occurred significantly more in term than in preterm born children (60% vs. 20%). Based on the study it can be concluded that Magnetic Resonance Imaging (MRI) can help in the assessment of time of insult to the developing brain in cerebral palsy (CP).

Molecular characterization of Staphylococcus aureus strains in bovine mastitis milk in Bangladesh

Staphylococcus aureus is a common causative agent of bovine mastitis in dairy herds worldwide. This study was designed to assess the prevalence of mastitis in cows through screening tests and molecular characterization of Staphylococcus aureus strains. Out of 175 randomly screened cows, mastitis was detected in 50 cows by California Mastitis Test (CMT), and from those mastitic cows, 200 quarter milk samples were collected for subsequent culture and PCR based identification. The herd, cow and quarter level prevalence of mastitis was 73.3, 28.6 and 29.5% respectively, and subclinical mastitis (SCM) was the predominant type in all cases. According to bacteriology the overall prevalence of herd, cow and quarter level Staphylococcus aureus mastitis was 72.7, 74.0 and 62.0%, respectively, and the pathogen was mostly associated with clinical mastitis (CM). Cows breed, parity, daily milk yield, regular teat dipping, and dry cow therapy were significantly associated (P < 0.05) risk factors for mastitis onset. This study identifies 145 Staphylococcus aureus isolates which varied greatly with the categories of mastitis (higher in CM), udder quarter location (highest in right rear quarters), and to a lesser extent in the study areas (P < 0.05). Antimicrobial susceptibility testing revealed that 79.3% Staphylococcus aureus strains were resistant to at least one antimicrobial, 49.0% to two or more antimicrobials, and clinical isolates showed more resistance to all tested antibiotics. The highest resistance rate was found to oxytetracyclin, and no resistance to ceftriaxone and azithromycin. Seven enterotoxin gene profile were detected in the tested isolates, and mecA was found in 20.0% isolates indicating the emergence and spread of methicillin-resistant Staphylococcus aureus (MRSA). The isolates were carrying genes in combination, and were found higher in SCM cases. In this study, plasmids (>23 kb to 2.9 kb) were detected in 70.3% strains, and 54.9% plasmid bearing strains were multiple drug resistant (MDR). Thus, the high prevalence of Staphylococcus aureus mastitis is an important concern for diary industry of Bangladesh since the strains of this pathogen is becoming more resistant to commercially available antimicrobials, and this is an alarming concern for both animal and public health.

Prevalence of Non-Alcoholic Fatty Liver Disease and Its Biochemical Predictors in Patients with Type-2 Diabetes Mellitus

Non-alcoholic fatty liver disease (NAFLD) is emerging as the most common chronic liver condition in the Western world and it is commonly associated with type 2 diabetes mellitus (DM). The aim of this study to determine the prevalence of NAFLD and identify the predisposing factors in type 2 DM patients with NAFLD. Total of 258 patients of type 2 DM were included in this observational study in the Department of Medicine, Mymensingh Medical College Hospital, Mymensingh, Bangladesh from 11th May 2013 to 11th November 2013. Patients with characteristic findings on ultrasonography were considered as having fatty liver. They were divided into fatty liver (Group I) and non-fatty liver group (Group II) and were further evaluated by measurement of body mass index, liver function tests and lipid profile. Out of 258 type 2 diabetic patients, 167 (64.7%) patients had fatty liver on ultrasonography. BMI, waist-hip ratio and triglyceride levels in the Group I was significantly higher than Group II. An increase in the levels of ALT, AST, total cholesterol, LDL and a decrease in HDL was observed in Group I as compared to Group II. The prevalence of NAFLD is common among in type 2 diabetic patients and it increases with the rising incidence of obesity. Obesity as well as elevated liver enzymes, triglyceride and cholesterol are significantly raised in NAFLD patients with type 2 DM. It highlights the importance of routine liver function test and lipid profile in subjects with type 2 DM and should be more closely observed for NAFLD and liver complications.

Influence of green grass-based diets on growth and reproductive performance in dairy heifers

The objective of this study was to monitor the changes in growth, dry matter intake, and blood profiles (nutrition and reproductive hormones) of dairy heifers in response to green grass-based diets. Twelve crossbred heifers were equally divided into group 1: rice straw and concentrate; group 2: rice straw, green grass, and concentrate; group 3: green grass and concentrate; group 4: green grass, soybean hay, and concentrate. Dry matter intake in group 4 was found 6% higher (P < 0.05) than group 1. Negative body weight gain was found in group 1 and group 2 showed 14% higher body weight gain per 30 days compared to groups 3 and 4 (P < 0.05). Heifers in group 4 had significantly (P < 0.05) higher heart girth gain, serum albumin, urea, and blood urea nitrogen than the heifers in other groups. Endocrine parameters were found similar among groups. Overall, supply of green grass especially a mix of leguminous and non-leguminous was found advantageous in heifer feeding.

Management of Traumatic Unstable Thoracolumbar Spine: Conservative versus Operative Treatment

Traumatic thoracolumbar spine injury result in significant instability of the spine and leads to an acute on delayed neurological deficit. Objective of the study is to find a better option in the management of unstable traumatic thoracolumbar spine with incomplete neurological lesion. This was quasi-experimental study. The study was carried out at National Institute of Traumatology & Orthopedic Rehabilitation (NITOR), Dhaka, Bangladesh from January 2006 to December 2008. A total number of 40 patients with traumatic thoracolumbar spine injuries with incomplete neurological lesion were selected purposively. Out of 40 cases 1 patient missed from final follow up. Rest of 39 patients was included in this study. All patients were admitted within 3 weeks of injury. Most were referred from peripheral hospital & some were admitted in emergency and outpatient department of NITOR. Among those 25 patients were conservatively treated and 14 were operatively treated. Neurological status improvement was assessed by Frankel grading; it was remarkable in operative group. In 56% of the conservative group improved by one grade but 21.42% of operative group had of similar improvement. This one-grade improvement has been classified as fair. Whereas two grade improvement was termed as good. So, good result was obtained in 40% of conservatively treated patients and 57.16% in operatively treated patients. In this study, an overall result was classified as excellent, good, fair andll poor. Three grade upper shifts were categorized as excellent. In excellent result was obtained by operative procedures and it was 21.42%. On the other ward, no patient showed excellent result in conservatively treated group. In Celbeti et al. reported that 16(33.3%) patients had excellent results, 23(57.9%) had good, 70(4.58%) had fair and 20(4.36%) Patients had poor results.

Magnetic Resonance Imaging in Evaluation of Sinonasal Masses with Histopathological Correlation

Sinonasal mass is the abnormal growth of tissue from nasal cavity and mucosa of the paranasal sinuses. The growth may be benign or malignant. The benign lesion grows slowly and does not metastasize. The malignant lesion grows rapidly and metastasizes early. The aim of this study is to evaluate and diagnose the various types of sinonasal masses with MRI and its correlation with histopathological findings. This cross sectional descriptive study was carried out for a period of 02 years, from July 2015 to June 2017. The patients were selected from the ENT outpatient department and from the department Radiology & Imaging of Mymensingh Medical College Hospital, Mymensingh, Bangladesh who were reported as case of sinonasal masses. Thirty three (33) patients (17 males and 16 females) with sinonasal masses were included after fulfilling exclusion & inclusion criteria which was confirmed by proper clinical examination & were subjected to MRI and histopathological examination. The age range was 11 to 85 years. The nasal cavity was the most commonly involved site with sinonasal malignancies (were 4 cases, 12.12%) followed by the maxillary sinuses (were 2 cases, 6.06%). The least commonly affected site was the frontal sinuses (was 1 case, 3.03%). Histopathological findings shows benign sinonasal tumors were present in 25 cases. The most common benign lesion was sinonasal polyposis 10 cases (30.30%), followed by inverted papilloma 6 cases (18.18%) & juvenile nasopharyngeal angiofibroma 6 cases (18.18%), adenoma 02 cases (6.06%), and one case was rhinosporidiosis (3.03%). Malignant sinonasal tumors were present in 8 cases. Most common malignant tumors were nasopharyngeal carcinoma in 4 cases (12.12%), adenoid cystic carcinoma in 3 cases (9.09%) and non-Hodgkin lymphoma was present in 01 case (3.03%). MRI report shows benign masses in 23 cases of which nasopharyngeal polyposis was 10(30.30%), inverted papilloma 6(18.18%), juvenile angiofibroma 4(12.12%), adenoma 02(6.06%) & rhinosporidiosis 1(3.03%). Among 10 malignant tumors nasopharyngeal carcinoma were 6(18.18%), adenoid cystic carcinoma 3(9.09%) & non-Hodgkin lymphoma 1(3.03%). MRI findings of malignant sinonasal masses revealed that sensitivity 87.5%, specificity 40.0%, positive predictive value (PPV) 70% & negative predictive value 66%. Statistically significant association was observed between histopathology & MRI findings, p value was 0.305. Statistically significant association was found between histopathology & MRI findings.

Comparative Study of Patellar Tendon Graft versus Hamstrings Graft for Anterior Cruciate Ligament Reconstruction

Graft selection for primary anterior cruciate ligament reconstruction is very important part of knee stability. The purpose of this Qasi experimental study was to compare the clinical outcomes after ACL reconstruction using either a BPTB graft or a four-strand hamstrings graft and conducted from January 2012 to December 2013. Patients presented with a symptomatic unilateral ACL rupture who were underwent ACL reconstruction by using either BPTB or Hamstrings graft, IPD of Department of Orthopedics at Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka as well as in a private hospital in Dhaka, Bangladesh were selected as study population. Patients were divided into Group A who were treated with the patellar tendon bone graft and Group B patients who were received hamstrings tendon graft. All surgery was performed by the same surgeon and the both procedures were arthroscopically assisted. Operation was performed at least three (03) weeks after initial trauma. All patients were assessed by independent examiner before surgery, at 6 months, 12 months and then annually by clinically. A total number of 70 patients were recruited for this study. The mean age with SD of Group A and Group B were 27.31±10.91 and 26.97±10.10 years respectively (p=0.892). Tegner scores were measured preoperatively and post-operatively. The score were 2.2±1.1 and 2.1±1.0 in preoperatively (p=0.817). In post-operatively the mean score were 6.0±1.7 and 5.8±1.5 in Group A and Group B respectively (p=0.508). Regarding outcome of the operation excellent was 18(51%) cases in both Group A and Group B, good was 15 (43%) and 16(46%) cases in Group A and Group B respectively (p=0.793). In conclusion there was no significant difference between the two groups of the ACL reconstructions cases.

Contamination and ecological risk assessment of trace elements in sediments of the rivers of Sundarban mangrove forest, Bangladesh

In this study, total concentrations of 16 trace elements (Al, V, Cr, Mn, Fe, Co, Ni, Cu, Zn, As, Cd, Sb, Hg, Pb, Th and U) in sediments of the rivers of the Sundarban mangrove forest, after the catastrophic oil spill accident in the Sela river of Sundarban, were determined. The overall mean concentrations of V, Cr, Fe and Cd in surface sediments of the Sundarban are remarkably higher than available literature data of those elements. Trace element contamination assessment, using different environmental contamination indices, reveals that As, Sb, Th and U are low to moderately contaminated while Cd is moderately to severely contaminated in the sediments of this area. The multivariate statistical analyses were applied to reveal the origin and behavior of the elements during their transport in the mangrove ecosystem. High Cr, Ni, Cu and As concentrations suggest the risk of potentially adverse biological effects in the ecosystem.

An Evaluation of the Result of Fenestration and Discectomy for the Treatment of Prolapsed Lumber Intervertrebal Disc (PLID)

The aim of this study is to asses the result of fenestration and discectomy for the treatment of PLID. This Prospective quasi experimental study was conducted on 29 Patient of PLID with different ages at Dhaka Medical College Hospital (DMCH), Dhaka, Bangladesh from July 2014 to June 2016. Post Operative outcome was assessed through Modified Macnab Criteria & Visual Analogue Score (VAS). The mean age of patient were 38.14±9.20 years and ranging from 24 to 55 years. The mean age of male was 37.21±9.72 years and female patient was 39.90±8.32 years. Overall subjective assessment of this study revealed that 79.2% patients had excellent functional outcome, 13.8% good and 6.9% fair and there was no poor functional outcome a according to modified Macnab criteria.

Acute Kidney Injury in Patients with Acute Viral Hepatitis: A Study in a Tertiary Care Hospital

This cross sectional observational study was done in the Department of Medicine, Mymensingh Medical College Hospital (MMCH), Mymensingh, Bangladesh from May 2013 to April 2014 to find out the proportion of acute kidney injury among patients with acute viral hepatitis and to identify risk factors associated with development of acute kidney injury (AKI). A total of 100 patients with acute viral hepatitis were included purposively as study subjects. Among them 61 were male and 39 were female. They were divided into AKI group (n=6) and non-AKI group (n=94) on the basis of development of AKI. There was no significant difference in mean age (39.0±13.1 years vs. 32.2±10.8 years, p=0.335) and sex (67% vs. 61% & 33.0% vs. 39.0%) p=0.769) between AKI group and non-AKI group. There were 27% acute viral hepatitis A, 21% acute viral hepatitis B and 52% acute viral hepatitis E but no case of acute viral hepatitis C was found in this study. Acute kidney injury (AKI) developed in 6 of 27 patients with acute viral hepatitis A. This study showed that 22.2% patients with acute viral hepatitis A developed acute kidney injury but patients with acute viral hepatitis B (HBV) and hepatitis E (HEV) did not develop acute kidney injury. Majority of the patients with acute kidney injury were smokers and hypertensive with elevated mean arterial pressure (p=0.0001) at presentation and had higher total bilirubin (p=0.0001), alanine aminotranseferase values (p=0.040), prolonged prothrombin time (INR) {p=0.0001}, lower albumin (p=0.0001), lower haematocrit level (p=0.0001), high CRP concentration (p=0.0001), leucocytosis (p=0.0001) and thrombocytopenia (p=0.0001) at presentation than patients without acute kidney injury. It is evident from the study that acute kidney injury is not a rare complication in patients with acute viral hepatitis.

A 15-year single centre retrospective study of antiphospholipid syndrome patients from Northern Malaysia

BACKGROUND

Antiphospholipid syndrome (APS) is an autoimmune disorder characterised by thrombosis and/or pregnancy morbidity in the presence of antiphospholipid antibodies (aPLs) based on the Sydney criteria. We aimed to explore the clinico-laboratory features and treatment strategies of APS patients retrospectively.

METHODOLOGY

The medical records of APS patients registered under Hospital Universiti Sains Malaysia (Kelantan state) between 2000 and 2015 were reviewed.

RESULTS

A total of 17 APS subjects (age 40.7 ± 12.8 years) including 11 primary (64.7%) and six secondary APS (35.3%) patients were identified. The follow-up period was 9.5 ± 6.7 years with male:female ratio of 1.0:4.7. Pregnancy morbidity was the most common clinical manifestation (11/14; 78.6%) followed by recurrent venous thrombosis (10/17; 58.8%). For other clinical features, menorrhagia was the most frequently observed manifestation (4/14; 28.6%) followed by aPLs-associated thrombocytopenia (4/17; 23.5%) and ovarian cyst (3/14; 21.4%). LA and aCL were positive in 94.1% (16/17) and 81.8% (9/11) of the patients, respectively. APTT value (76.7 ± 17.0 sec) was significantly high (p < 0.05). Low intensity warfarin alone was successful to maintain target INR (2.0 - 3.0) and prevent recurrence of thrombosis.

CONCLUSION

The tendency of pregnancy morbidity in this cohort of Malaysian Kelantanese APS patients was high compared to other previously reported APS cohorts. Low intensity warfarin was successful in preventing recurrence of thrombosis, however, APS women receiving long-term anticoagulants should be monitored for possible occurrence of menorrhagia and ovarian cysts.

3,4-Diaminotoluene sensor development based on hydrothermally prepared MnCoxOy nanoparticles

A facile hydrothermal process was used to prepare MnCo_xO_y nanoparticles (NPs) in alkaline medium (pH~10.5) at room temperature. The NPs were characterized by Fourier-transform infrared spectroscopy (FTIR), ultraviolet visible spectroscopy (UV/vis), field emission scanning electron microscopy (FESEM), X-ray photoelectron spectroscopy (XPS), energy-dispersive X-ray spectroscopy (EDS), and powder X-ray diffraction (XRD). A thin layer of NPs film as a chemical sensor was fabricated on a glassy carbon electrode (GCE) with the help of a conducting binder. The sensor was implemented successfully for the detection 3,4-DAT with reliable I-V approach at low potential. The sensor-features include good sensitivity (0.37 mAµmolL^-1cm^-2), low detection limit (LOD=0.26±0.01 pmolL^-1 at a signal to noise ratio of 3), low limit of quantification (LOQ=7.80±0.01 pmolL^-1), good reliability, good reproducibility, ease of integration, and long-term stability were investigated. The sensor response towards 3,4-DAT is linear in logarithmic scale over a large concentration range (1.0 pmolL^-1 to 1.0 µmolL^-1). This work is introduced a route for future sensitive sensor development based on MnCo_xO_y NPs by reliable I-V method for the detection of hazardous and carcinogenic toxins in environmental and health care fields.

Impact of teachers training on HIV/AIDS education program among secondary school students in Bangladesh: A cross-sectional survey

BACKGROUND

In 2007, the Government of Bangladesh incorporated a chapter on HIV/AIDS into the national curriculum for an HIV-prevention program for school students. For the efficient dissemination of knowledge, an intervention was designed to train the teachers and equip them to educate on the topic of HIV/AIDS. The present study intended to understand the impact of this intervention by assessing the knowledge, attitudes and behaviours related to HIV/AIDS, among the targeted students.

METHODS

A cross-sectional survey was conducted with the students at randomly selected schools from two adjacent districts. Considering exposure to intervention, one district was assigned for intervention and the other as a control. In total, 1,381 students, aged 13-18 years (or above) were interviewed, 675 from the control areas and 706 from the intervention areas. Univariate and bivariate analyses were performed on the collected data.

RESULTS

A significantly higher proportion (p<0.001) of students in the intervention areas attended HIV/AIDS classes, demonstrated better knowledge and fewer misconceptions regarding the transmission and prevention of HIV. The same was derived regarding their attitude towards people living with HIV, as a higher proportion (p<0.001) responded positively, compared to the control groups of the study. Additionally, multinomial logistic regression analysis showed that students in intervention area were more likely to have good knowledge on HIV transmission (OR 2.71, 95% CI 1.74-4.22) and prevention (OR 2.15, 95% CI 1.41-3.26) compared to the students in the control areas.

CONCLUSIONS

The training programme needs to be scaled up, since it is likely to have an impact among students; we have witnessed that the interventions particularly helped increase HIV/AIDS knowledge among students and positively change the students' attitudes towards HIV/AIDS.