Micropropagation of Stevia Plant from Nodal Segments

The experiment was conducted to develop and establish a reproducible protocol for plantlet regeneration in Stevia. Nodal cutting explants were cultured in Murashige and Skoog (MS) medium supplemented with different concentrations and combinations of ?-Napthaleneacetic acid (NAA) and 6-Benzylamino purine (BAP). The combination of NAA at 1.0 mgl-1 and BAP at 1.0 mgl-1 resulted in the highest percentage (100%) of callus initiation. The maximum shoot regeneration and development of shoot was observed at the same combination. The developed shoots from nodal cuttings, upon transfer to the MS medium containing indole butyric acid (IBA) at 0.1mgl-1 resulted in best rooting within 8 days.DOI: http://dx.doi.org/10.3329/pa.v19i2.16914 Progress. Agric. 19(2): 21 - 26, 2008

Traumatic gut injury: a study of 100 cases in Mymensingh Medical College Hospital

This study was done to find out the mode of presentations, management options and the factors which dictate the out-come of the patients with traumatic gut injury. It has been carried out in the department of Surgery, Mymensingh Medical College Hospital in 100 patients with traumatic gut injury from January 2009 to December 2010. Most of the patients were within 21-30 years (47%) and male patients were the predominant group (90%). In this study penetrating injury was more common (57%) than non-penetrating (43%) injury as a cause of gut injury. Stab (64.91%) was the main mechanism of penetrating abdominal trauma; while road traffic (58.14%) was the main mechanism of non-penetrating abdominal trauma. Diagnosis was made on clinical presentation, physical examination and some investigations. Abdominal pain (98%) was the chief complain and chief sign was abdominal tenderness (98%) and absent bowel sound (91%). Small gut injury was present in 71% patients, 20% patients had large gut injury and 9% had both gut injury. In small gut, jejunum (49.29%) was the most vulnerable portion and right sided colon (55%) was the most affected portion in large gut trauma. Spectrum of injury in small gut included single perforation (63%), multiple perforations (23%), laceration (11%) and devascularization (3%) injury. Primary repair in 60.87%, resection & anastomosis in 27.54% and resection anastomosis with proximal diversion in 11.59% patients were done in small gut injury. Injuries in the large gut were classified into three categories according to Flint Colon Injury Severity Scoring. Highest incidence was in Grade I (60%) category, second in Grade II (35%) and Grade III (5%) was the third one. Simple primary repair in 40%, primary repair or resection anastomosis with proximal diversion in 30%, loop ileostomy in 20% and Hartman's procedure in 10% were done in patients of large gut injury. Resection anastomosis with proximal diversion was performed in patients of both small and large gut injury. Outcome of management was quiet acceptable with 47% of patients having uneventful recovery. Delayed presentation, delayed definitive management, haemodynamically unstable patient, site and number of injuries in the gut were the crucial factor for the overall 44% morbidities of this series. Morbidity rate was 9%. More than half of the patients (56.04%) discharged from the hospital within 10 days. Only a few patients could be followed up for a few months after surgery, who reported to have a satisfactory outcome with no morbidity.

Sexual and urinary outcome after surgical treatment for low rectal cancer

Carcinoma involving the lower part of the rectum is now successfully managed by sphincter saving surgery with less morbidity and uneventful recovery. This study was designed to observe the sexual and urinary dysfunction in both sexes of the patients suffering from cancer of the lower third of the rectum managed by surgical intervention with preservation of sphincter. A comparative study was carried out on 54 patients with low rectal cancer who underwent ultra-low anterior resection in the department of surgery, Bangabandhu Sheikh Mujib Medical University, Dhaka from January, 2009 to December, 2010. Patients were divided into two groups depending on the tumor distance from anal verge. Thirty one (57%) patients were in Group A (Experimental) where tumor distance was 5cm from anal verge and upper 1cm of anal sphincter was sacrificed during surgical intervention. Twenty three (43%) patients were in Group B (Control) where tumor distance was 6cm from anal verge and whole length (4cm) of anal sphincter was preserved during surgical intervention. The mean±SD age of the patients was 45.96±14.41 years. During surgery, ultra low anterior resection was performed to remove the tumor in all patients and for anastomosis double stapling technique was performed in 52(96%) patients and hand sewn technique was performed in 2(4%) patients irrespective of tumor distance from anal verge. Covering ileostomy was fashioned in all but one patient. During post-operative follow up Sexual activity in both groups of male patients (Potency, P=0.17; ejaculation; satisfaction and loss of libido, P=0.15) and in female patients (Satisfaction and loss of libido, P=0.15) was not significantly hampered following surgery. Urinary function was assessed by incontinence, increased frequency (P=0.54) and retention (n=0) which were not impaired significantly following surgery. Sexual and urinary function was not significantly impaired in both sexes after low rectal cancer surgery. Sphincter saving surgery can be performed in a very low rectal cancer with preservation of anal sphincter.

Sphincter saving surgery is the standard procedure for treatment of low rectal cancer

Carcinoma rectum is a challenging problem both for the developed and underdeveloped countries. Colorectal cancer accounts for 9% of all cancer deaths (49,920) in 2009 in USA. Carcinoma involving the lower part of the rectum is now successfully managed by sphincter saving surgery with less morbidity and uneventful recovery. To observe the objective, subjective and functional outcome of the patients suffering from cancer of the lower third of the rectum managed by surgical intervention with preservation of sphincter. A comparative study was carried out on 54 patients with low rectal cancer who underwent ultra-low anterior resection in the department of surgery, Bangabandhu Sheikh Mujib Medical University, Dhaka from January 2009 to December 2010. Patients were divided into two groups depending on the tumor distance from anal verge. Thirty one (57%) patients were in Group A (Experimental) where tumor distance was 5cm from anal verge and upper 1cm of anal sphincter was sacrificed during surgical intervention. Twenty three (43%) patients were in Group B (Control) where tumor distance was 6cm from anal verge and whole length (4cm) of anal sphincter was preserved during surgical intervention. Functional integrity of anal sphincter was assessed between these two groups of patients following surgery. The mean age of the patients was 45.96±14.41 years. During surgery, ultra low anterior resection was performed to remove the tumor in all patients and for anastomosis double stapling technique was performed in 52(96%) patients and hand sewn technique was performed in 2(4%) patients irrespective of tumor distance from anal verge. Covering ileostomy was fashioned in all but one patient. During post-operative follow up anal sphincter muscle tone, anal sphincter function (Anal continence, p = 0.54), Quality of life (Social life, p = 0.54; Professional life, p = 0.23; House work and Need a diaper, p = 0.54) were not significantly impaired in both groups. Functional outcome of anal sphincter muscle and quality of life was not impaired in comparison to general population after low rectal cancer surgery.

Psychiatric in-patient care and suicide in England, 1997 to 2008: a longitudinal study

BACKGROUND

Psychiatric in-patients are at high risk of suicide. Recent reductions in bed numbers in many countries may have affected this risk but few studies have specifically investigated temporal trends. We aimed to explore trends in psychiatric in-patient suicide over time.

METHOD

A prospective study of all patients admitted to National Health Service (NHS) in-patient psychiatric care in England (1997-2008). Suicide rates were determined using National Confidential Inquiry and Hospital Episode Statistics (HES) data.

RESULTS

Over the study period there were 1942 psychiatric in-patient suicides. Between the first 2 years of the study (1997, 1998) and the last 2 years (2007, 2008) the rate of in-patient suicide fell by nearly one-third from 2.45 to 1.68 per 100,000 bed days. This fall in rate was observed for males and females, across ethnicities and diagnoses. It was most marked for patients aged 15-44 years. Rates also fell for the most common suicide methods, particularly suicide by hanging on the ward (a 59% reduction). Although the number of post-discharge suicides fell, the rate of post-discharge suicide may have increased by 19%. The number of suicide deaths in those under the care of crisis resolution/home treatment teams has increased in recent years to approximately 160 annually.

CONCLUSIONS

The rate of suicide among psychiatric in-patients in England has fallen considerably. Possible explanations include falling general population rates, changes in the at-risk population or improved in-patient safety. However, a transfer of risk to the period after discharge or other clinical settings such as crisis resolution teams cannot be ruled out.

PREVALENCE OF SUBCLINICAL MASTITIS IN DAIRY COWS IN SELECTED AREAS OF BANGLADESH

This research was carried out to determine the prevalence of subclinical mastitis in lactating Dairy Cow of Bangladesh Agricultural University dairy farm (BAUDF) and rural areas of Tangail sadar upazila of Bangladesh during the period of July 2009 to April 2010. A total of 200 milk samples (40 from BAUDF and 160 from Tangail sadar upazila) were collected for this study which were subjected to physical examination and subsequently screened for subclinical mastitis using three indirect tests viz. White Side Test (WST), California Mastitis Test (CMT), and Surf Field Mastitis Test (SFMT). Overall prevalence of subclinical mastitis (SCM) in lactating dairy cows found in this study was 29%. Cows were infected with SCM 29.5%, 27.5% and 25.5% detection by CMT, WST and SFMT respectively. Higher prevalence of SCM was detected in milch crossbred cows (36.36%) in comparison to local bred cows (24.61%) maintained under extensive management system in Rural area of Tangail sadar upazila. The prevalence of SCM was recorded in 31.58%, 30.76% and 68.75% in cows of local area of Tangail sadar upazila, and 25.0%, 40.0% and 71.42% in cows of BAU,DF during the early, mid and late stages of lactation respectively. The highest prevalence of SCM was recorded during the early lactation stage in both the local breed cows (30.0%) and cows of BAUDF (45.83%) in comparison to their respective mid and late stages of lactation. The prevalence of SCM was highest in lactating cows having third lactation and high yielding (cows produced >10 liter milk per day) both in local breed and crossbred cows.DOI = http://dx.doi.org/10.3329/bjvm.v9i1.11216 Bangl. J. Vet. Med. (2011). 9(1): 73-78 

Vecuronium and fentanyl requirement in abdominal surgery under combined epidural-general anaesthesia and general anaesthesia alone

Individual effect of epidural block and general anaesthesia is well established in the field of anaesthesiology. But adequate literature is yet not available to give decisive answer regarding the requirement of muscle relaxants and opioid analgesic when the two methods are combined together. In the present study, sixty patients, aged 18-50 years of both sexes with ASA (American Society of Anesthesiologists) grading I and II scheduled to undergo for major abdominal surgery were assigned randomly into two groups (30 in each group), where Group A received general anesthesia and Group B received combined epidural-general anesthesia. The patients with combined technique, epidural catheter tip were placed between T9-10. Ten ml of 0.125% bupivacaine was administered through the epidural catheter. Peripheral nerve stimulator was used to monitor neuromuscular transmission and subsequently to administer incremental dose of neuromuscular blocking drugs. All the patients were pre-medicated with fentanyl (2μg/kg) to reduce intubation reflex. Then the patients of both groups were pre-oxygenated for 3 minute and anaesthesia was induced with thiopental sodium 3-5 mg/kg body weight. Endotrachial intubation was facilitated by vecuronium 0.1mg/kg body weight. Anaesthesia was maintained with 60% N2O in O2 and halothane (0.4 to 0.8%). Fentanyl was given in incremental dose of 0.5 μg/kg to maintain an adequate analgesia. The vecuronium was given at the dose of 0.02 mg/kg, when TOF return to 25% of the base line. The mean±SD requirement of vecuronium in general anaesthesia group was 0.0016±0.00013 mg/kg/min and whereas in combined epidural-general anaesthesia, it was 0.0011±0.00014 mg/kg/min. The requirement of fentanyl was 0.71μg/kg/hr in general anaesthetic group whereas in combined group it was 0.31μg/kg/hr. These findings prompt us to place optimal dosing guidelines so as to avoid overdosing and thus delay recovery and help to get the excellent outcome of the surgery.

Correlation between clinical presentation, peroperative finding and histopathological report in acute appendicitis

Acute appendicitis is usually encountered clinically as acute abdomen. Typical cases are easy to diagnose, but sometimes it is very difficult to make a diagnosis in atypical cases. The objective of the study was to determine the diagnostic accuracy in patient of clinically diagnosed acute appendicitis. This prospective study conducted in Mymensingh medical college hospital on 1136 patients presented with acute abdomen and clinically diagnosed as acute appendicitis from July 2004 to June 2010. Emergency appendicectomy was done in all consecutive patients after relevant investigation. Intraoperative findings along with histopathological reports were compared with clinical diagnosis. On the basis of histopathological report, 85.65% were found to have acute appendicitis with misdiagnosis in rest of the subjects requiring unnecessary explorations. Negative exploration was more in emergency than office hour. This may be due to diagnostic inaccuracy and decision-making in the management of the acute appendicitis. Management errors can be significantly reduced by accurate preoperative diagnosis of acute appendicitis by improving clinical skill and appropriate investigations.

Blood conservation strategies for reducing peri-operative blood loss in open heart surgery

Defects in hemostasis are frequently seen in open heart surgery. Strategies should be reviewed about the peri-operative blood loss and conservation of blood here. In this study, comparison among three agents (Aprotinin, Tranaexaemic Acid & Epsilon Amino Caproic Acid) is done to reduce the peri-operative blood loss in open-heart surgery. Ninety male and female patients within 20-60 years of age were selected who underwent conventional cardiac surgery and anesthesia with Cardio-pulmonary-bypass for common open heart surgeries (ASD, VSD, AVR, etc) and randomly divided into three groups 30 patients in each. Group A, B, C was administered Inj. Aprotinin, Tranaexaemic acid & EACA respectively. Perioperative hemodynamic parameters and blood loss in suction bottle & drainage tube were noted until the 3rd POD. Requirement of blood transfusion, heparin, protamine and blood derived products were also noted. Activated clotting time was documented in the perioperative period. Clinically relevant outcome like re-exploration, mechanical ventilation, morbidities, mortality etc were also verified. Data were analyzed and results were calculated with student's T test & ANOVA. The groups were matched regarding recorded peri-operative variables. Peri-operative blood loss is significantly reduced (p<0.05) both in the Aprotinin and Tranexamic acid groups. Renal dysfunction was reported in 20% of aprotinin patients, 14.29% of tranexaemic acid patients and 18.51% of EACA patients. A conclusion was drawn from the study that Tranexamic acid can significantly reduce the peri-operative blood loss in open heart surgery cases and that it can be preferred as an agent of choice in blood conservation strategy in these cases.

Genetic Testing for Huntington's Disease in Parkinsonism

The study was conducted to find out Huntington's disease (HD) by genetic analysis from those presenting with parkinsonism in the Neurology department of Mymensingh Medical College & Hospital. A sample of about 5ml blood was collected by veni puncture in EDTA tube with informed consent from 9 patients & 7 healthy individuals after approval of the institutional ethics committee for genetic study. The neurological disorder along with a complete history and physical findings were recorded in a prescribed questionnaire by the neurologists of Mymensingh Medical College & Hospital. Extraction of genomic DNA from the venous blood using FlexiGene DNA kit (Qiagen, Japan) was performed in Faculty of Veterinary Science, Bangladesh Agricultural University, Mymensingh, Bangladesh. The extracted DNA was stored and accumulated and then these DNA were sent to Division of Clinical Genetics, Department of Medical Genetics, Osaka University Medical School, Suita, Osaka 565 0871, Japan for PCR and further analysis. PCR amplification of the CAG repeat in the 1T15 gene was performed with primers HD1 and HD3. HD PCR products revealed the DNA product of about 110bp (no. of CAG repeats=21) to 150bp (no. of CAG repeats=34) in both healthy individual and suspected PD patient DNA.

Sexual risk behaviour of rural-to-urban migrant taxi drivers in Dhaka, Bangladesh: a cross-sectional behavioural survey

OBJECTIVES

Human immunodeficiency virus (HIV) research in Bangladesh has mainly focused on key vulnerable groups (e.g. sex workers, drug users). In order to develop appropriate HIV prevention strategies in an evolving epidemic, there is a need for evidence on sexual practices in other population groups. This research aims to describe the prevalence of risky behaviours and factors affecting sexual behaviour/practices among rural-to-urban migrant taxi drivers in Dhaka.

STUDY DESIGN

Cross-sectional study.

METHODS

This paper reports on the cross-sectional survey component of a mixed methods research study amongst migrant workers in Bangladesh. The sample (n = 437) comprised rural-to-urban migrant taxi drivers in Dhaka (aged 18-35 years). The survey data were analysed statistically using Statistical Package for the Social Sciences.

RESULTS

Very high levels of pre- and extramarital sexual behaviour were found (84% and 51%, respectively) amongst the sample (n = 437). The reported sexual activity included high levels of risky/unsafe sex in the past year: 64% of the sample reported sex with multiple commercial sex partners (mean = 13.21), and 21.7% reported sex with other males/transgenders (mean = 2.53). Protection against risk was low: 78.2% reported that their last commercial sexual encounter was unprotected, and only 5.6% used condoms consistently. Multivariate analysis revealed that the odds of risky sexual behaviour were higher in migrant men who were not married (odds ratio 35.3, P < 0.001) and married men who were living apart from their spouses (odds ratio 41.7, P < 0.001). Additionally, reported risk behaviours were significantly associated with frequency of home visits, duration of separation from spouse and alcohol consumption. Thus, male migration without family or spouse appears to be a key driver of risky sexual practices.

CONCLUSIONS

This study provides important new information for understanding the dynamics of sexual behaviour in Bangladesh, and suggests that migrant men should be a key population for HIV prevention efforts. Nonetheless, the fact that most men were having unprotected sex with sex workers reinforces the importance of continuing to target interventions towards commercial sex contexts.

Percuteneous mitral balloon valvuloplasty in patients with post surgical mitral restenosis: result of 70 cases

OBJECTIVE

To evaluate the immediate results of balloon mitral valvulplasty in mitral restenosis patients with previous surgical mitral commissurotomy.

METHODS

Percuteneous balloon mitral valvuloplasty (BMV) was done in 145 cases of which 70patients had the history of previous surgical commissurotomy (Group I) and 75 patients were the new cases for the BMV (Group II).

RESULTS

In group I the age range was 35-65 years. In group I the duration of surgical commissurotomy (SC) was of 2-18 years past. In this group the result of balloon mitral valvuloplasty (BMV) was successful in 69 cases. Mitral valve area (MVA) before the procedure was 0.5-0.9 sq cm with mean 0.7 +/- 0.2 sq cm. Following procedure the MVA was 1.2-2.0 cm2 with a mean of 1.6 +/- 0.4 cm2. Mean gradient across mitral valve (MV) before the procedure was 15-25 mm of Hg with a mean 20 +/- 5 mm of Hg and after the procedure was 3-5 mm Hg with a mean of 4 +/- 1 mm Hg. In Group I, MVA > 1.8 cm2 was achieved in 25 cases & > 1.2-1.8 cm2 in 44 cases. Mitral regurgitation > or = grade 1 occurred in 8 cases (compared to previous echocardiography). In group II the age range was between 35-60 years. The result of BMV was successful in 74 cases. MVA before the procedure was 0.4-1.2 cm2 with a mean of 0.8 +/- 0.4 cm2. Following the procedure MVA was 1.3-2.1 cm2 with a mean of 1.7 +/- 0.4 cm2. Mean gradient across the mitral valve before the procedure was 15-29 mm of Hg with a mean of 22 +/- 7 mm of Hg. Mean gradient across the mitral valve after the procedure was 2-4 mm of Hg with a mean of 3 +/- 1 mm of Hg. MVA more than 1.8 cm2 was achieved in 29 cases and between 1.3-1.8 in 45 cases.

CONCLUSION

BMVin patients with mitral restenosis following Surgical mitral commissurtomy can be performed with almost similar success rate like that of BMV for the first time with low risk of major cardiac complication.

External and internal controls of lunar-related reproductive rhythms in fishes

Reproductive activities of many fish species are, to some extent, entrained to cues from the moon. During the spawning season, synchronous spawning is repeated at intervals of c. 1 month (lunar spawning cycle) and 2 weeks (semi-lunar spawning cycle) or daily according to tidal changes (tidal spawning cycle). In species showing lunar-related spawning cycles, oocytes in the ovary develop towards and mature around a specific moon phase for lunar spawners, around spring tides for semi-lunar spawners and at daytime high tides for tidal spawners. The production of sex steroid hormones also changes in accordance with synchronous oocyte development. Since the production of the steroid hormones with lunar-related reproductive periodicity is regulated by gonadotropins, it is considered that the higher parts of the hypothalamus-pituitary-gonad axis play important roles in the perception and regulation of lunar-related periodicity. It is likely that fishes perceive cues from the moon by sensory organs; however, it is still unknown how lunar cues are transduced as an endogenous rhythm exerting lunar-related spawning rhythmicity. Recent research has revealed that melatonin fluctuated according to the brightness at night, magnetic fields and the tidal cycle. In addition, cyclic changes in hydrostatic pressure had an effect on monoamine contents in the brain. These factors may be indirectly related to the exertion of lunar-related periodicity. Molecular approaches have revealed that mRNA expressions of light-sensitive clock genes change with moonlight, suggesting that brightness at night plays a role in phase-shifting or resetting of biological clocks. Some species may have evolved biological clocks in relation to lunar cycles, although it is still not known how lunar periodicities are endogenously regulated in fishes. This review demonstrates that lunar-related periodicity is utilized and incorporated by ecological and physiological mechanisms governing the reproductive success of fishes.

Maternal mortality: a twenty-year survey at the King Faisal University Hospital, Al-Khobar, Eastern Saudi Arabia

This was an institutional study of all maternal deaths that occurred among 56422 total births at the King Faisal University Hospital, Al-Khobar, Saudi Arabia, between 1983 and 2002. The underlying cause of each maternal death and potentially avoidable factors were analysed. There were 16 maternal deaths in the hospital during the study period, giving a maternal mortality rate of 28.4/100,000 births. The leading cause of death was haemorrhage in seven (43.75%) patients, followed by pulmonary embolism in four (25%) and general anaesthesia in two (12.5%) mothers. The risk factors noted were maternal age 35 years and parity 5 coupled with iron deficiency anaemia. The main avoidable factors were failure of the patients to seek timely medical care and to follow medical advice. More than half the number of direct obstetrical causes of death was thought to be preventable. A rapidly changing attitude of women towards childbirth is occurring through progressively increasing female education and community health programmes in the region. Further reduction of maternal mortality rates in the community is envisaged through greater patient acceptance of medical advice, family spacing and proficient obstetric services.

Surgical treatment of rectovaginal fistula of obstetric origin: a review of 15 years' experience in a teaching hospital

Fifty-two women with a rectovaginal fistula were managed over a period of 15 years. All the fistulae were caused by obstetric injury commonly resulting from breakdown of the repair of complete perineal tears or from unrecognised injury during forceps or precipitate delivery. In five patients the fistula healed spontaneously within 12 weeks of the injury. Thirty-nine patients underwent transvaginal purse-string repair by standard technique and eight patients had perineoproctotomy and sphincteroplasty for large fistulae associated with anal incontinence. Surgical repair was successful in all the 47 patients including two patients who had previous failed repair elsewhere. The routine postoperative follow-up period of the patients ranged between 6 months and 8 years. There were no residual symptoms of anal sphincter weakness in the patients treated with transvaginal purse-string repair. Two of the patients who underwent perineoproctotomy and sphincteroplasty complained of varying degrees of postoperative incontinence of flatus that resolved by 8 weeks postoperation. In our experience the transvaginal purse-string method of repair for small, low rectovaginal fistulae proved highly satisfactory with 100% cure rate. Perineoproctotomy and sphincteroplasty for larger fistulae associated with anal incompetence was equally successful with minimal postoperative morbidity.

Pregnancy complicated by maternal cardiac disease: a review of 274 patients

The outcome of 274 viable pregnancies in 229 patients with cardiac disease that delivered at the King Fahad Hospital, Al-Khobar, Saudi Arabia, between 1982 and 1998 was reviewed. The incidence was 0.6% of deliveries. Rheumatic heart disease complicated 208 (75.9%) pregnancies, congenital heart lesion in 49 (17.9%) and the remaining 17 (6.2%) pregnancies were a miscellaneous group that included supraventricular tachycardia, ectopic beats, ischaemic heart disease and cardiomyopathies. The NYHA grading was between 1-2 in 243 (88.7%) pregnancies antenatally. Thirty-one patients developed heart failure, most commonly in the antenatal period, 29 of whom were of Grade 1-2. One mother in the series died from heart failure following a cesarean section. She had had a mitral valvotomy before pregnancy and was categorised as Grade 2, antenatally. The perinatal mortality rate was 14.6/1000 deliveries in the study group. Prophylactic antibiotics were given to all the patients an hour before delivery. There were two instances of bacterial endocarditis in the series.

Obstetric complications and perinatal outcome in triplet pregnancies

The incidence of multiple pregnancies with more than two fetuses has significantly increased since the introduction of ovulation agents and assisted reproductive technologies. Over a 15-year period there were 35 triplet pregnancies beyond 24 weeks that delivered at the King Fahad Hospital, an incidence of 1 in 1,099 deliveries. Early diagnosis is important for improving the rate of fetal salvage in triplet pregnancy. These pregnancies were managed on an outpatient basis. Prophylactic interventions were not utilised. A total of 91% of the pregnancies had at least one antenatal complication, pre-term labour being the most common (80%) followed by anaemia (43%). The average gestational age at delivery was 31.7 weeks (SD 4.2 weeks). A total of 94.3% of the patients were delivered by lower segment caesarean section. The mean birth weight of the neonates was 1,552 g (SD 510 g) and mean 5-min Apgar score was 7.6 (SD 0.8). The corrected perinatal mortality rate in the study was 152/1,000. Pregnancy outcome did not vary with birth order or mode of conception. Higher rate of pre-term births among triplet pregnancies make considerable demands on the neonatal intensive care unit. All methods of assisted reproduction should aim at prevention of multifetal pregnancies.

In vitro culture of human chondrocytes (1): A novel enhancement action of ferrous sulfate on the differentiation of human chondrocytes

Chondrogenic differentiation of mesenchymal cells is generally thought to be initiated by the inductive action of specific growth factors and depends on intimate cell-cell interactions. The aim of our investigation was to characterize the influences of basic fibroblast growth factor (bFGF) and ferroussulfate (FeSO(4)) on proliferation and differentiation of human articular chondrocytes (HAC). This is the first report of the effects of FeSO(4) on chondrogenesis of HAC. Multiplied chondrocytes of hip and shoulder joints were cultured in chondrocyte growth medium supplemented with bFGF, FeSO(4), or both bFGF + FeSO(4) for4weeks. A 20 mul aliquot of a cell suspension containing2 x 10(7) cells ml(-1) was delivered onto each well of 24-well tissue culture plates. Cells cultured with the growth medium only was used as a control. Alamar blue and alcian blue staining were done to determine the chondrocyte proliferation and differentiation, respectively, after 4 weeks. The samples exposed to bFGF, FeSO(4), and combination of both indicated sufficient cell proliferation similar to the control level. Differentiations of the HAC exposed to bFGF, FeSO(4),and bFGF + FeSO(4) were 1.2-, 2.0-, and 2.2-fold of the control, respectively. Therefore, chondrocyte differentiation was significantly enhanced by the addition of FeSO(4) andbFGF + FeSO(4). The combined effects of bFGF and FeSO(4) were additive, rather than synergistic. These results suggest that treatment with ferrous sulfate alone or in combination with basic fibroblast growth factor etc, is a powerful tool to promote the differentiation of HAC for the clinical application.

Effects of deep heat therapy on the patients with chronic low back pain

A randomized clinical trial was conducted in the Department of Physical Medicine & Rehabilitation, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh, from 1st April 2006 to 31st March 2007. A total of 102 patients of Chronic LBP were included in the study. Out of them, 42 (41.2%) were male and 60 (58.8%) were female and male: female ratio was 1:1.43. The mean age of the patients was 42.22+/-8.07 years. They were divided randomly into two groups by the way of lottery for the clinical trial. Group A was treated with short wave diathermy (SWD) and non steroidal anti inflammatory drugs (NSAID) and Group B was treated with placebo SWD and NSAID. After treatment the result was compared and student's 't' test was done to see the level of significance. There was significant improvement after treatment in both the group (P=0). In comparison between two groups, it was found that there was no significant improvement in pre-treatment, after 1st week and after 2nd week. Improvement was found in Group A than Group B after 3rd week (P=0.05). And the improvement was gradually increased in Group A in comparison to Group B. Finally, it was found that there was significant improvement in Group A than Group B after 6th week (P=0). From the present study, it may be concluded that both the treatment (NSAID and SWD) is effective for the treatment of Chronic LBP. But the patient may be more benefited if SWD is used as an adjunct to NSAID.

The technique of detecting systolic and diastolic pressure from the transducer output of a PC-based blood pressure monitoring system

A pressure to voltage transducer is used along with a cuff, in a PC-based blood pressure and pulse rate monitoring system for human body. During the blood pressure measurement cycle, the output voltage of the pressure to voltage transducer is recorded digitally using a data acquisition system. The recorded data are then analyzed using software routines to determine the blood pressure and pulse rate of the person under test. However, it is difficult to identify the points of systole and diastole correctly from the recorded data. This paper presents the technique that may be used to determine the systolic and diastolic pressure from the collected data.

Socio-demographic characteristics of children infested with scabies in densely populated communities of residential madrashas (Islamic education institutes) in Dhaka, Bangladesh

BACKGROUND

Outbreaks of scabies in institutions and the socio-economic consequences have not been reported from overpopulated countries such as Bangladesh.

STUDY DESIGN

A community-based study among children from six residential Islamic education institutes (madrashas) in Dhaka. Multistage random sampling was used.

OBJECTIVES

To study the socio-economic profile, water-sanitation facilities, personal hygiene and living conditions of these children.

METHODOLOGY

Direct interviews were used to collect the data and clinical check up was performed in all children.

RESULTS

In total, 492 children received clinical check-ups; 92.5% were boys (mean age: 11.2+/-2.4 years). 63.4% of fathers and 98.5% of mothers were either illiterate or had only received primary education, 55.1% of fathers were in low-paid labouring jobs, and 99% of mothers were housewives. Of the 98% of children who had scabies, 71% had been re-infected (96% during the winter). Randomly assigned anti-scabies drugs revealed an average cure rate of 85.5%. Seventy-four percent of children were living in poorly ventilated buildings with overcrowded sleeping arrangements. They had poor personal hygiene: 21% shared towels; 8% shared undergarments; 30% shared bed linen; and 81% kept their used clothes on a communal line or shelf. Sanitation was also poor: 39% bathed infrequently, although 97% carried out mandatory ablution. Most children (61%) washed their clothes (including undergarments) two or three times a fortnight, 35% did so every 2-3 days, and 3.7% washed their clothes on alternative days. Disease severity and re-infection were associated with infrequent washing of clothes (P<0.001) and bed linen (P<0.001), overcrowded sleeping arrangements (P<0.001) and infrequent bathing (P<0.001) with soap (P<0.001). This was further related to household income (P<0.001 for both).

CONCLUSION

The study findings have potentially dangerous implications for public health. Immediate attention should be given to developing a sustainable long-term intervention programme to combat scabies hyperendemicity, and to save thousands of children from impending complications.

Preliminary antinociceptive, antioxidant and cytotoxic activities of Leucas aspera root

The ethanolic extract of Leucas aspera root was subjected to acetic acid induced writhing inhibition, 1,1-diphenyl-2-picryl hydrazyl (DPPH) free radical scavenging assay and brine shrimp lethality bioassay for screening of antinociceptive, antioxidant and cytotoxic activity, respectively. The extract produced significant writhing inhibition in acetic acid induced writhing in mice at the doses of 250 and 500 mg/kg. The extract showed a significant free radical scavenging activity with an IC(50) of 8 microg/ml. The extract showed significant lethality to brine shrimp with an LC(50) value.

Development of LiF:Mg,Cu,Si TL material (new KLT-300) with a low-residual signal and high-thermal stability

LiF-based thermoluminescence (TL) materials have been widely used for radiation dosimetry due to their attractive features. LiF:Mg,Cu,P is one of the most sensitive tissue-equivalent TL materials, approximately 40 times more sensitive than LiF:Mg,Ti (TLD-100), but it has two main drawbacks: a thermal loss of the TL sensitivity when annealed at temperatures>240 degrees C, and a relatively high-residual signal. Recently, LiF:Mg,Cu,Na,Si TL material was developed to overcome these drawbacks at the Korea Atomic Energy Research Institute, but it provided only marginal improvements in reducing the residual signal. The newly developed LiF:Mg,Cu,Si TL material has a significantly lower residual signal and a better stability to thermal treatments. In this article, the preparation method and some dosimetric properties (sensitivity and residual signal) of the new LiF:Mg,Cu,Si TL material are presented. At the end of the preparation procedures, a dual-step annealing method is introduced and this has proved as a very efficient method to reduce the high-temperature peak and is the cause of residual signal. Therefore, the high-temperature peak in the glow curve was significantly reduced. The sensitivity is approximately 20 times higher than that of TLD-100 and the residual signal was estimated to be approximately 0.04%.

Novel applications of Dermabond (2-octyl -cyanoacrylate) in cardiothoracic surgery

Dermabond (Ethicon Inc., Somerville, NJ, USA) is a cyanoacrylate adhesive normally indicated for skin wound closure. This study describes the emergency use of this adhesive to control bleeding close to coronary anastomoses in exceptional cases. Dermabond was used in 17 patients who underwent cardiac surgery during an eight-month period, where other haemostatic interventions were unsuitable. It was applied for haemorrhage in 15 patients and control air leaks in two of the patients. Haemostasis was successful with Dermabond alone in 11 patients; the remaining four required additional interventions. It effectively controlled haemorrhage from ventricular pacing wires, vascular sling holes, peri-anastomotic bleeding, and epicardial tears. The adhesive was not placed directly on any graft because of embolic risk. In the two patients with visible air leaks, it was successfully used. No patient events were recorded as a result of haemorrhage and no reported toxicity. Dermabond may be indicated in circumstances in which haemostasis with traditional methods has failed or is inappropriate. A need for further high-quality objective research exists on the effectiveness and long-term safety of 2-octyl cyanoacrylate in cardiac surgery.