Hyperglycaemia is associated with impaired vasa vasorum neovascularization and accelerated atherosclerosis in apolipoprotein-E deficient mice

OBJECTIVE

A direct correlation between blood glucose levels and the microvascular complications of diabetes is well established. However, the effects of hyperglycaemia on the vasa vasorum, a microvascular network which surrounds and supplies the walls of large arteries, is not known. The objective of this study is to investigate the effects of hyperglycaemia on the vasa vasorum and to examine correlations between these effects and the development of atherosclerosis in a mouse model.

METHODS

The micro- and macrovascular effects of hyperglycaemia were examined in streptozotocin-injected apolipoprotein-E deficient (ApoE(-/-)) mice. Retina and aortic sinus were isolated from hyperglycaemic mice and normoglycaemic controls at 5-20 weeks of age. Retinal and vasa vasorum microvessel densities were quantified and correlated to atherosclerotic lesion development. The expression levels of pro-angiogenic factors including vascular endothelial growth factor (VEGF) and VEGF receptor 2 were examined.

RESULTS

In normoglycaemic ApoE(-/-) mice atherogenesis is associated with vasa vasorum expansion, which likely corresponds to the increasing blood supply demands of the thickening artery wall. In hyperglycaemic ApoE(-/-) mice there is no significant neovascularization of the vasa vasorum, despite the fact that lesions are significantly larger. This defect may result from a localized deficiency in VEGF.

CONCLUSIONS

These findings are the first evidence that hyperglycaemia alters the structure of the vasa vasorum. Such microvascular changes directly correlate, and may contribute to, the development and progression of atherosclerosis in hyperglycaemic ApoE-deficient mice.

Avian infectious bronchitis and deep pectoral myopathy - a case control study

Infectious bronchitis is caused by a coronavirus, infectious bronchitis virus (IBV). Infectious bronchitis is an acute and highly contagious disease of economic importance due to the reduction in weight gain observed with infected broilers and the drop in egg quality and production associated with infected laying hens. The presence of deep pectoral myopathy has been associated with IBV variants. This lesion is detected at slaughterhouses and is characterized by paleness and atrophy of the deep pectoral muscle, including necrosis of the region, leading to condemnations of the breast muscle, a valuable meat cut in the market. This work aimed to study the relationship between deep pectoral myopathy and IBV by describing tracheal and muscle lesions and comparing the frequency of IBV detection via reverse-transcription (RT) PCR in muscle, tracheal, and cecal tonsil samples from broilers with and without myopathy. A case-control study was conducted in 40 broiler flocks vaccinated with the Massachusetts strain. The case group consisted of 23 flocks that presented myopathic lesions under sanitary inspection and a control group of 17 flocks without myopathic lesions. The tracheal, cecal tonsil, and supracoracoid muscle (with and without lesions) samples from the 40 broiler flocks were screened by RT-PCR to detect IBV. Histopathology of muscle and tracheal tissue was carried out. Upon microscopic examination, the muscle samples from the case group presented extensive necrosis, intense mononuclear inflammatory infiltration, muscle fiber fragmentation, and fibrotic tissue, confirming myopathy, whereas muscles from the control group showed no alterations. The tracheal samples presented a large number of infiltrated mononuclear inflammatory cells that in some areas formed submucosal nodules. A total of 25 flocks tested IBV positive by RT-PCR: 14 from the case group and 11 from the control group. The IBV was detected by RT-PCR directly in muscle samples. Despite that, the relationship between deep pectoral myopathy and IBV was not established. The higher positive IBV RT-PCR percentage noted in the cecal tonsil samples demonstrates how important the choice of organs is for diagnostic purposes.

A cross sectional survey of newborn care practices in rural Sindh, Pakistan: implications for research and policy

INTRODUCTION

Of annual four million neonatal deaths, majority in the developing world, approximately three-quarters die within the first week of life. Pakistan has one of the highest newborn mortality rates.

STUDY DESIGN

We conducted a cross sectional study to assess knowledge, attitudes and practices of women of reproductive age in rural Pakistan.

RESULTS

Of 1490 mothers interviewed, prevalence of newborn care practices ranged between 32% (early bathing of newborn) and 69% (use of traditional cord applications). Uptake of antenatal care services was identified as a strong predictor of good newborn care after controlling for skilled birth attendance, socio-economic status, age of mother and sex of infant (OR = 1.26; 95% CI: 1.00-1.57).

CONCLUSIONS

The association of uptake of antenatal care services with good newborn care highlights the necessity to improve coverage of services with the integration of counseling about newborn care in order to reduce the burden of neonatal morbidity and mortality.

The Incidence, Predisposing Factors, Complications and Outcome of Preeclampsia in Diabetic Pregnancy

Introduction: Preeclampsia is a serious complication of pregnancy and common cause of fetal and maternal morbidity as well as mortality worldwide. In diabetic women, the chance of preeclampsia is increased. The incidence of preeclampsia in diabetic pregnancy is approximately 10 to 15 percent, which is associated with poor glycaemic control. Aim: This study was carried out to find the predisposing factors related to preeclampsia and determine the complications of preeclampsia in diabetic pregnancy and also the impact of preeclampsia in infants born to diabetic mothers. Methods: This prospective study was carried out at the Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders (BIRDEM), Dhaka. The Patient population consisted of 80 diabetic pregnant women who attended or admitted to BIRDEM hospital during the study period. The women were divided into groups: 50 pregnant diabetic women with preeclampsia were taken as case. 30 pregnant diabetic women without preeclampsia were taken as control. Diagnosis of preeclampsia was made on the basis of the criteria of the Committee on Terminology of the American College of Obstetrician and Gynecologist. Results: Preterm delivery (<37 weeks gestation) was higher among study group (64%) compared to control (33.3%) women. Term delivery was 36.0 vs 66.7 percent among case and control women, respectively. The distribution is statistically significant (P<0.01). 35 percent of Caesarean section was done due to fetal distress in the study group and in control group it was 20 percent. In study group, 22.5 percent Caesarean sections were done due to impending eclampsia and eclampsia, 705 percent due to accidental haemorrhage and 5 percent due to IUGR. Maternal complication in study and control subjects. In the case group, maximum number of the women (16%) showed signs of impending eclampsia, while among control women, maximum number (10%) developed postpartum haemorrhage (PPH). 48 percent neonates were of low birth weight and in controls it was 13.3 percent. Both hyperbilirubinaemia (40%) and hypoglycaemia (30%) were more in study group than controls (16.66% and 20%, respectively). Perinatal outcome among study group and controls. Neonatal survival was 82.0 percent in study group and 86.7 percent in control group. Comparison of Perinatal outcome between the groups is not statistically significant. Most of the perinatal mortality was due to prematurity (8%) and intrauterine death (6%). In control group, most of the perinatal deaths were due to congenital anomalies (6.6%). Conclusion: The higher incidence among study group may be, in part, the result of more preterm birth or shortened gestational duration because early delivery is a consequence of preeclampsia. The higher rate in associated with preeclampsia was due to increased incidence of IUD and prematurity. DOI: http://dx.doi.org/10.3329/birdem.v1i1.12379 Birdem Med J 2011; 1(1): 10-14

A subunit vaccine against hydropericardium syndrome using adenovirus penton capsid protein

Hydropericardium syndrome (HPS) is a disease of poultry that is caused by fowl adenovirus-4. Inactivated liver homogenate from diseased birds is still the choice of vaccine in some countries which disseminates numerous pathogens along with inactivated virus. Moreover incomplete attenuation or inactivation, reversion to virulence and the oncogenic potential/genetic instability of the adenoviruses have prevented their use in routine vaccines. To address this problem an effort is made to develop a subunit vaccine. For this purpose penton base protein of HPS virus was expressed in Escherichia coli and used as subunit vaccine in broilers. Immunogenicity of the recombinant penton base protein and challenge protection test against pathogenic virus demonstrated the ability of recombinant penton base protein to confer (90%) protection. Results suggest that the recombinant penton base protein is a candidate for subunit vaccine against HPS.

Changing pattern of Peripheral Vascular disease in Asian countries

Not available DOI: http://dx.doi.org/10.3329/bjms.v11i3.11713 Bangladesh Journal of Medical Science Vol. 11 No. 03 July’12

A comparison of the effect of glitazones on serum sialic acid in patients with type 2 diabetes

Although management of hyperglycaemia represents one of the principal treatment goals of diabetes therapy, the high incidence of cardiovascular (CV) complications in diabetes also needs effective management. Therefore, the present study was designed to determine and compare the effect of glitazones on serum sialic acid (SSA), a known risk marker for CV disease, along with fasting plasma glucose (FPG), glycohaemoglobin (HbA1-c) and blood lipids, in overweight, previously only diet-treated patients with type 2 diabetes (n=60). The study was conducted for a period of 12 months. Significant improvement in FPG and HbA1-c were shown by both rosiglitazone (p<0.003 and p<0.001, respectively) and pioglitazone (p<0.005 and p<0.001, respectively), compared with baseline, and pioglitazone showed greater beneficial effects on other parameters monitored, significantly reducing total cholesterol (TC) (p≤0.05). Both the drugs showed a decrease in SSA and no significant differences were observed between the groups. However, the decrease was significant only in the pioglitazone-treated group at month 12 (p≤0.05), compared with baseline. A significant decrease in SSA by pioglitazone indicates its greater cardioprotective effect compared with rosiglitazone.

Feeding practices and nutritional status of children under two years of age

A descriptive cross sectional study was done in the department of Pediatrics Mymensingh Medical College Hospital. The purpose of the study was to assess breast feeding pattern, complementary feeding pattern, types of complementary foods and also to assess the nutritional status and to detect any relationship with the nutritional status and the feeding practices. Mothers with their children aged less than 2 years were included and very sick children, mother less children, handicapped children were excluded. Four hundred (400) consecutive children were enrolled from eight upazillas of Mymensingh district who were selected randomly. Out of 400 children, 214 children (53.5%) were male and 186 children (47.5%) were female and M:F was 1.2:1. Exclusive breastfeeding rate was 41.5%. Pre-lacteal feeding rate were 30.7% and most common pre-lacteal foods were honey and sugar water. Colostrum was given in 69.3% children. Breast feeding continued at the time of interview was 58.1%. Complementary feeding started in time in 35.8%, early weaning in 44.5% children. Type of complementary food was mainly luta (rice powder mixed with boiled water and sugar only) in 38.8% and khichuri (rice, pulses, soybean oil) in 19.5%. Bottle feeding rate was 31.30%. Around 43% children were underweight and 10.25% children were severely underweight and common in between 12 to 23 months of age group. Around 29% children were stunted among 11.25% were severely stunted. About 13.5% children were wasted and among them 2.5% were severely wasted. Stunting prevalent over the age of 9 months and wasting started after 6 months of age. Malnutrition was common in partially breast fed and early weaning with carbohydrate rich food.

Metaplastic squamous cell carcinoma in association with invasive lobular breast carcinoma with metastasis to axillary lymph nodes

Squamous cell carcinoma (SCC) of the breast is very rare entity and when encountered it is found in association with invasive ductal carcinoma of the breast. We report a very unusual association of an invasive lobular carcinoma with metaplastic squamous cell carcinoma of the breast which was found not only in a mastectomy specimen but also in the axillary lymph nodes. The patient reported first with a lump breast which was diagnosed a case of invasive lobular carcinoma in a lumpectomy specimen, followed by adjunct radiation and chemotherapy. We encountered such association in only one case report in the literature.

Electrical characterization of composition modulated In(1-x)Sb(x) nanowire field effect transistors by scanning gate microscopy

In this work high quality crystalline In(1_x)Sb(x) nanowires (NWs) are synthesized via a template-based electrochemistry method. Energy dispersive spectroscopy studies show that composition modulated In(1-x)Sb(x) (x approximately 0.5 or 0.7) nanowires can be attained by selectively controlling the deposition potential during growth. Single In(1-x)Sb(x) nanowire field effect transistors (NW-FETs) are fabricated to study the electrical properties of as-grown NWs. Using scanning gate microscopy (SGM) as a local gate the I(ds)-V(ds) characteristics of the fabricated devices are modulated as a function of the applied gate voltage. Electrical transport measurements show n-type semiconducting behavior for the In0.5Sb0.5 NW-FET, while a p-type behavior is observed for the In0.3Sb0.7 NW-FET device. The ability to grow composition modulated In(1-x)Sb(x) NWs can provide new opportunities for utilizing InSb NWs as building blocks for low-power and high speed nanoscale electronics.

Heterofunctional nanomaterials: fabrication, properties and applications in nanobiotechnology

Nanotechnology and nanoengineering includes a novel class of materials that are gaining significant recognition to pursuit technological/biological advances in diverse fields including, biology, medicine, electronics, engineering etc. due to their unique size- and shape-dependent intrinsic physicochemical, optoelectronic and biological properties. Characteristics such as high surface to volume ratios and quantum confinement results in materials that are qualitatively different from their bulk counterparts. These properties not only make them suitable for numerous applications in existing and emerging technologies, but also have outstanding role in many fields that provide inspiration for their fabrication. In Today's trend nanotechnology is spreading vigorously where researchers all over the world are focusing towards their synthesis and applications. Therefore, this review is helpful for the researchers in the field of nanobiotechnology/nanomedicine, providing a brief overview of nanotechnology, covering nanomaterial synthesis methods (with emphasis on environmentally benign greener approaches), their properties, and applications; such as drug delivery, bio-labeling, nanotoxicity etc. The influence of synthesis methods and surface coatings/stabilizing agents and their subsequent applications is discussed, and a broad outline on the biomedical applications into which they have been implemented is also presented.

Sophistication of Medical writings

Bangladesh Journal of Medical Sciences Vol.8(3) 2009 p44-45

Exsanguinating upper GI bleeds due to Unusual Arteriovenous Malformation (AVM) of stomach and spleen: a case report

BACKGROUND

In this paper we are reporting one case of exsanguinating upper gastrointestinal tract (GIT) bleed requiring massive blood transfusion and immediate life saving surgery.

CASE PRESENTATION

A 30 years old female, 12 weeks pregnant was referred to our hospital from the earth-quake affected area of Kashmir with history of upper abdominal pain, haematemesis and melaena for one week. After stabilizing the patient, upper gastro-intestinal endoscopy was performed. It revealed gastric ulcer just distal to the gastro-esophageal junction on the lesser curvature. Biopsy from the ulcer edge led to profuse spurting of the blood and patient went into state of shock. Immediate resuscitation led to rebleeding and recurrence of post haemorrahagic shock.

CONCLUSION

The patient was immediately explored and total gastrectectomy with splenectomy concluded as life saving procedure. A review of literature was conducted to make this report possible.

The orthodontic management of a patient presenting with cemento-osseous dysplasia

Cemento-osseous dysplasias are sometimes seen on routine radiographic examination of the tooth-bearing areas of the jaws, most commonly amongst adult female patients. Lesions present as radiolucent to radio-opaque areas, depending on various levels of maturity. Extraction of teeth is strongly contraindicated because there is a high risk of infection with a possibility of bone sequestration, as antibiotics are unable to cross the thick cortical marginal bone that surrounds these lesions. No report has been found in the literature on the orthodontic management of patients with this condition. This paper reports on a 28-year-old black female patient with cemento-osseous dysplasia who received orthodontic treatment.

Spectral analysis andin vitrocytotoxicity profiles of novel organotin(IV) esters of 2-maleimidopropanoic acid

Six novel triorganotin(IV) 2-maleimidopropanoato complexes: R3SnOCOCH3(CH)(COCH)2, (R: Me(l), Et(2), n-Pr(3), n-Bu(4), Ph(5), Bz(6) have been synthesized. Their solid-state configuration has been determined by FT IR and lI9mSn Mössbauer spectroscopy. The tin(IV) atom is five-coordinated in all the complexes with 2-maleimidopropanoic acid behaving as a monoanionic bidentate ligand coordinating the tin(IV) atom through a chelating or bridging carboxylate group. The solution-state configuration has been elucidated by means of 1H-, 13C- and 119Sn-NMR spectroscopy which assigned a tetrahedron. Elemental analysis and FAB MS data also supported a 1:1 metal to ligand stoichiometry. The title complexes have been screened in vitro for anti-tumour, anti-fungal, anti-leishmanial and urease inhibition activities and displayed promising results.

Accuracy of Triple Test Score in The Diagnosis of Palpable Breast Lump

Breast lump is a very sensitive issue for the patient so a reliable, non invasive and prompt diagnosishelps to lessen the associated anxiety and leads to early definitive treatment. The aim of this studywas to evaluate the acuracy of Triple Test Score (TTS) as a clinical tool for the diagnosis of a palpablebreast lump. This diagnostic test study was carried out in the Department of Surgery of TribhuvanUniversity Teaching Hospital. Of the 117 patients admitted with breast diseases from the breastclinic over thirteen months, 87 had breast lump. Fifty patients underwent Triple Test Score ( physicalexamination, mammography and fine needle aspiration cytology) and were categorized into benign,suspicious and malignant. This was later correlated with the histopathological findings. Nineteenpatients with breast lumps interpreted by TTS as benign correlated with the histopathologicalfindings whereas of 31 malignant lumps, 30 turned out to be malignant and one benign. This givesTTS an over all accuracy of 98% with 100% sensitivity, 95.2% specificity and positive predictive valueof 96.7%. Carcinoma was seen in 29 (58%) cases in the age group of 35 to 70 years. The mean age atdiagnosis of benign and malignant disease was 41.8 and 45.1 years respectively. In conclusion, TTS isan accurate and least invasive diagnostic test based on which definitive treatment can be initiated.Key words : breast lump, carcinoma breast, triple test score

Accuracy of triple test score in the diagnosis of palpable breast lump

Breast lump is a very sensitive issue for the patient so a reliable, non invasive and prompt diagnosis helps to lessen the associated anxiety and leads to early definitive treatment. The aim of this study was to evaluate the accuracy of Triple Test Score (TTS) as a clinical tool for the diagnosis of a palpable breast lump. This diagnostic test study was carried out in the Department of Surgery of Tribhuvan University Teaching Hospital. Of the 117 patients admitted with breast diseases from the breast clinic over thirteen months, 87 had breast lump. Fifty patients underwent Triple Test Score ( physical examination, mammography and fine needle aspiration cytology) and were categorized into benign, suspicious and malignant. This was later correlated with the histopathological findings. Nineteen patients with breast lumps interpreted by TTS as benign correlated with the histopathological findings whereas of 31 malignant lumps, 30 turned out to be malignant and one benign. This gives TTS an over all accuracy of 98% with 100% sensitivity, 95.2% specificity and positive predictive value of 96.7%. Carcinoma was seen in 29 (58%) cases in the age group of 35 to 70 years. The mean age at diagnosis of benign and malignant disease was 41.8 and 45.1 years respectively. In conclusion, TTS is an accurate and least invasive diagnostic test based on which definitive treatment can be initiated.

Transient ischaemic attacks due to a pulsating mass in the neck produced after incision and drainage of parapharyngeal abscess

Carotid endarterectomy is the most commonly performed vascular surgical procedure. One of the complications of carotid endarterectomy is Pseudoaneurysm of the carotid artery frequently managed by endo-vascular technique. Pseudoaneurysm caused by other aetiological factors is rare entity. Penetrating trauma and neck surgery are known but very rare causes of pseudo aneurysm of the carotid artery. We have successfully managed a case of carotid artery pseudoaneurysm caused by incision and drainage of parapharyngeal abscess. This surgery also leads to the palsy of right vagus nerve causing complete hoarseness of voice. The patient presented with Transit Ischaemic Attacks (TIA) and amurosis fugos. Resection of aneurysm and reconstruction of right carotid artery lead to complete recovery. Vocal cord palsy was managed by Vox implant injection leading to full recovery.

Efficacy of cervicothoracic sympathectomy versus conservative management in patients suffering from incapacitating Raynaud's syndrome after frost bite

BACKGROUND

Raynaud's syndrome is a known complication of cold injuries. Stress, smoking and metabolic diseases may further aggravate the disease course. The purpose of this study was to determine the efficacy of Cervico-thoracic sympathectomy as compared to conservative management in severe Raynaud's syndrome after frostbite.

METHODS

This non-randomized controlled trial was conducted at Railway Hospital, Rawalpindi and Islamic International Medical Complex, Islamabad between January 1999 and June 2006. All patients sustained severe cold trauma in the mountain ridges of Himalayas in Kashmir. In all cases, an informed consent was obtained from patients and families. All operations performed were free of charges. Out of the total 48 patients who developed incapacitating Raynaud's syndrome of the upper limbs after frost bite, 17 patients underwent thoracic sympathectomy through anterior supraclavicular route. Remaining 31 patients were treated conservatively and were placed in the control group. Data was collected on pre-designed proforma and assessed using SPSS (version 11). Chi-square test was applied to assess the effectiveness of the two treatment modalities.

RESULTS

All operated cases initially showed improvement in symptoms and incapacitation. Among sympathectomised patients, 11 patients became symptom free and 3 patients showed mild but improved symptoms. Two patients after initial transient improvement developed incapacitating symptoms requiring further treatment, one patient developed gangrene ofdistal phalanx nine month after sympathectomy requiring amputation of the finger. Frequency of attacks and duration between the attacks reduced in all operated patients of cervical sympathectomy (p < 0.05) as compared to conservative management.

CONCLUSION

Cervical sympathectomy is a very effective modality of treatment in patients having severe Raynaud's disease of upper limbs secondary to frost bite.

Complex carbohydrate specificity of lectin from fruiting body of Ganoderma lucidum. A surface plasmon resonance study

The thermodynamics and kinetics of binding of glycans and glycoproteins to Ganoderma lucidum lectin was studied using surface plasmon resonance. The lectin showed highest affinity for asialo triantennary N glycan (Ka = 3.52 x 10(5)) among the glycans tested. There was a several fold increase in affinity for glycoproteins compared to their corresponding glycans and coincident increase in contribution from enthalpy (DeltaH), suggesting the involvement of hydrogen bonding in the interaction as well as involvement of protein-protein interactions. Increased affinity also showed increase in unfavorable negative binding entropy (DeltaS) which was compensated with higher enthalpy. The glycoproteins showed faster association rates (k(1)) and the activation energy (E(1)) in the association process was much lower for the glycoproteins than glycans, resulting in their faster associations. These observations elaborate the role of protein matrix in lectin-glycoconjugate interaction.