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.

ANTIMICROBIAL RESISTANCE OF ESCHERICHIA COLI ISOLATED FROM MILK, BEEF AND CHICKEN MEAT IN BANGLADESH

Food-borne pathogens causing infections and intoxications can affect everyone. Escherichia (E) coli is one of the major food borne bacterial pathogens. This study was conducted to investigate the prevalence of E. coli in milk, chicken meat and beef and to determine the multi-drug resistance profile of E. coli in Mymensingh district, Bangladesh. A total of 169 samples including milk (n=108), chicken meat (n=51) and beef (n=10) were collected from Bangladesh Agricultural University (BAU) dairy farm, American dairy farm, Gazipur and retail markets of municipal area during July 2016 to June 2017. E. coli were isolated and identified by  colony characteristics on selective agar like Eosine-methylene blue (EMB) agar, Salmonella-Shigella (SS) agar, Gram staining, biochemical test and Polymerase Chain Reaction (PCR). The overall prevalence of E. coli in all food samples was 37.86%. A total of 32 (29.63%) milk, 25 (49.02%) chicken meat and 07 (70%) beef samples were E. coli positive through conventional method. Among 64 samples only 23 samples (35.94%) were confirmed by PCR. Multi-drug resistant E. coli were detected by disc diffusion test using 10 commonly used antibiotics. Antibiogram study showed that E. coli isolated from chicken meat were resistant to oxytetracycline (92%), sulphonamide-trimethoprim (84%), amoxycillin (76%) and erythromycin (60%). E. coli isolated from beef sample were resistant to erythromycin (85.71%) and oxytetracycline (71.43%) and sensitive to ciprofloxacin (100%), gentamicin (100%) and neomycin (100%). However, all isolates of E. coli were found sensitive to amikacin (100%). E. coli isolated from milk sample were 100% sensitive to gentamicin followed by neomycin, ciprofloxacin, azithromycin, oxytetracycline and erythromycin. Overall 50% of E. coli isolates of food were found multi-drug resistant. About 28.13%, 57.14% and 76% of the E. coli isolates originated from milk, beef and chicken meat respectively were multi-drug resistant. The higher prevalence of E. coli in chicken meat, beef and milk indicates unhygienic production and processing of these foods. Presence of multi-drug resistant E. coli in these foods might pose serious public health threats. The antibiogram profile of the isolates will help therapeutic decision making in the treatment of colibacillosis in cattle and poultry in Bangladesh.

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.

Wet-chemically prepared low-dimensional ZnO/Al2O3/Cr2O3 nanoparticles for xanthine sensor development using an electrochemical method

A reliable xanthine (XNT) chemical sensor was fabricated using a facile wet-chemical method (by co-precipitation) to prepare ZnO/Al₂O₃/Cr₂O₃ nanoparticles (NPs) in an alkaline medium at low temperature. Powder X-ray diffraction (XRD), X-ray photoelectron spectroscopy (XPS), field emission scanning electron microscopy (FESEM), energy-dispersive X-ray spectroscopy (EDS), Fourier transform infrared spectroscopy (FTIR) and ultraviolet-visible spectroscopy (UV-vis) were implemented for detailed characterization of the NPs. To fabricate the working electrode as a XNT chemical sensor probe, a glassy carbon electrode (GCE) with a 0.0316 cm² surface area was coated with an ethanolic slurry of the prepared ZnO/Al₂O₃/Cr₂O₃ NPs to make a thin layer and used to analyse XNT in a phosphate buffer system. To evaluate the analytical performances of the XNT chemical sensor, the calibration curve of XNT was plotted as the relationship of current versus the concentration of XNT. The plotted calibration curve was found to be linear over the LDR (linear dynamic range) of 0.05 nM to 5.0 μM. The assembled XNT electrochemical sensor exhibited the highest sensitivity (70.8861 μA μM⁻¹ cm⁻²), the lowest detection limit (1.34 ± 0.07 pM), good reproducibility performance with high accuracy and long-term stability with standard results under ambient conditions. This is a simple route to selectively detect XNT with wet-chemically prepared co-doped ZnO/Al₂O₃/Cr₂O₃ nanomaterials using a reliable electrochemical method at a large scale for safety within healthcare fields.

This is a simple route to detect the selective xanthine with wet-chemically prepared co-doped ZnO/Al₂O₃/Cr₂O₃ nanomaterials by reliable electrochemical method at large scales for the safety of healthcare fields.

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.

Outcome of Pregnancy Related Acute Kidney Injury Observed in a Tertiary Care Hospital

This prospective case control study was carried out in Mymensingh Medical College Hospital (MMCH) from April 2011 to March 2012. The main objective of the study was to determine the short term maternal outcome of pregnancy related Acute Kidney Injury and to identify aetiological factors and to observe clinical features of pregnancy related Acute Kidney Injury. Total 60 pregnant women with AKI were included in the study as sample and equal (60) number of pregnant women with normal renal function was taken as control. Mean ages (±SD) of study and control group were observed 31.6±6.9 years and 25.5±4.7 years respectively. It was observed that most patients were from rural area with low income group. Most women were multiparous and presented in third trimester and postpartum period. Majority of the study subjects did not receive antenatal care at any stage of pregnancy. Fifty (86.7%) of the study subjects were oligo-anuric, forty-nine (81.7%) were edematous and fifty one (85%) were anaemic. Twenty-five (41.7%) patients presented with abnormal vaginal bleeding. Sepsis (including septic abortion and puerperal sepsis) was responsible for of Pregnancy Related AKI (PR-AKI) in more than two fifths of cases. Haemorrhage (APH & PPH combined) was the next common cause of Pregnancy Related AKI (PR-AKI). Toxemia of Pregnancy was responsible in one fourth of cases. Dialysis (HD & IPD combined) was required for two fifths of the patients. Rest patients were treated conservatively with antibiotics, blood transfusion, maintenance of fluid and electrolytes balance etc. Maternal outcome of Pregnancy related acute kidney injury was considered for the period of patient's hospital staying. 56.6% patients recovered completely, 15.0% patients recovered partially, 6.7% did not recover at the time of hospital discharge; while 21.7% died. So it can be concluded that, pregnancy related acute kidney injury is a critical condition, associated with worse prognosis.

Risk Factors and Immediate Outcome of Very Low Birth Weight Babies (Appropriate For Gestational Age) In Newly Established SCANU, Mymensingh Medical College Hospital

Low birth weight (LBW) is the most important preventable cause in the neonatal period leading to very high neonatal mortality and morbidity in developing countries like Bangladesh. A cross sectional study was conducted in the neonatology ward, Mymensingh Medical College Hospital, Mymensingh from July 2014 to December 2014 to identify the risk factors and immediate hospital outcome of Very Low Birth Weight (VLBW) Appropriate for Gestational Age (AGA) babies in context of present neonatal hospital care standard. Total 100 preterm very low birth weight babies were enrolled and selected by weight, intra uterine growth chart and new ballad score. There is slight preponderance of male babies (64%) over female babies (36%). The overall survival and mortality rate was 50% and 50% respectively in the present study. Mortality is highest (76.47%) in babies whose gestational age 28 weeks and the mortality rate gradually decrease as gestational age increases. Correlation co-efficient (r) between gestational age and number of died is -0.85. It indicates highly opposite relation between the variables, p value (<0.069) which is strong opposite relation. Mortality is highest (66.66%) in babies whose birth weight below1100gm, in comparison to those whose birth weight above 1100gm and correlation co-efficient (CC) r = -0.433 (p<0.466) which is not significant. That means not only birth weight but also other factors are responsible for mortality of very low birth weight baby. Neonatal mortality bears inverse relationship with birth weight and gestational age. This emphasized the need for large scale study which will provide the guideline for appropriate measures to be taken to combat the situation.

Quality of Life in Children with Asthma in Bangladesh

Asthma is a public health problem that adversely affects different aspects of quality of life. Childhood asthma is common in Bangladesh affecting their lifestyle. The objective of the study was to assess health-related quality of life in children with bronchial asthma. A descriptive, cross-sectional study was carried out from January 2014 to December 2014 at the Outpatient Department of National Asthma Centre, Mohakhali, Dhaka among hundred sixty-two purposively selected children of both sexes with bronchial asthma aged from 7 to 17 years. Data were collected through interview with children or their parents using an interviewer-administered questionnaire based on Pediatric Asthma Quality of Life Questionnaire (PAQLQ). Data were analyzed by computer software SPSS version 16.0. The mean age was 12.5 years with a standard deviation (SD) of 2.9 years. Overwhelming majority 157(96.9%) of children were literate, while only 5(3.1%) children were illiterate. Eighty (49.4%) children were male, while 82(50.6%) female. As many as 148(91.4%) children were students, while 10(6.2%) children were engaged in some type of job and 4(2.5%) children had no occupation. Parents of 145(89.5%) children were currently married, while 10(6.2%) children had single parent and 7(4.3%) children's parents were divorced or separated. Quality of life in children with asthma decreases with age as the disease intensity increases with age. Female asthmatic children had lower overall score of Quality of life (p=0.017), as well as lower activity domain score (p<0.001). Emotional domain score was found lower in children with single parent (p=0.021) and low monthly family income (p<0.001). Furthermore, children with lower monthly family income and working children had lower Quality of life score in all domains.

Bone Age Determination by Radiology & Imaging in Bangladesh Perspective

Determination of age is one of the most important and vital demand in legal affairs, court and young sports, especially from 7-21 years. There is no established age determination table in our county. So we are dependent upon Galstaun, Bashu & Bashu and other European tables, which sometimes provide misinterpretation and variation of opinion. We should have our own table suitable for our nation. So, this prospective study was carried out in the Department of Radiology and Imaging of Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from July 2010 to June 2014 (five years) to assess the general skeletal maturity. Three hundred boys and girls of known date of birth were selected on random basis from Dhaka. Ages were limited within 7 to 21 year. Every 20 person for each age group, of them 10 were male and 10 were female. To observe the bony maturity, radiographs were taken at the end of their age belongs to. Thus a growth table is to be prepared for further evaluation.

Familial liability to psychosis is a risk factor for multimorbidity in people with psychotic disorders and their unaffected siblings

BACKGROUND

Multimorbidity may impose an overwhelming burden on patients with psychosis and is affected by gender and age. Our aim is to study the independent role of familial liability to psychosis as a risk factor for multimorbidity.

METHODS

We performed the study within the framework of the Genetic Risk and Outcome of Psychosis (GROUP) project. Overall, we compared 1024 psychotic patients, 994 unaffected siblings and 566 controls on the prevalence of 125 lifetime diseases, and 19 self-reported somatic complaints. Multimorbidity was defined as the presence of two or more complaints/diseases in the same individual. Generalized linear mixed model (GLMM) were used to investigate the effects of gender, age (adolescent, young, older) and familial liability (patients, siblings, controls) and their interactions on multimorbidity.

RESULTS

Familial liability had a significant effect on multimorbidity of either complaints or diseases. Patients had a higher prevalence of multimorbidity of complaints compared to siblings (OR 2.20, 95% CI 1.79-2.69, P<0.001) and to controls (3.05, 2.35-3.96, P<0.001). In physical health multimorbidity, patients (OR 1.36, 95% CI 1.05-1.75, P=0.018), but not siblings, had significantly higher prevalence than controls. Similar finding were observed for multimorbidity of lifetime diseases, including psychiatric diseases. Significant results were observed for complaints and disease multimorbidity across gender and age groups.

CONCLUSION

Multimorbidity is a common burden, significantly more prevalent in patients and their unaffected siblings. Familial liability to psychosis showed an independent effect on multimorbidity; gender and age are also important factors determining multimorbidity.

Use of multivitamin, acidifier and Azolla in the diet of broiler chickens

Objective

The experiments were carried out to measure the effect of multivitamin, acidifier and Azolla on growth performance, profitability and lipid profiles of blood of broiler chickens to produce safe and cost effective broilers.

Methods

In experiment 1, 240 day-old Cobb-500 broiler chicks were fed diets; D₁ (control), D₂ (D₁ with 1 mL multivitamin/liter water), D₃ (D₁ with 1 mL acidifier/liter water), D₄ (D₁ with 1 mL multivitamin and 2 mL acidifier/liter water) having 3 replications in each, and 20 chicks/replication. In experiment 2, 150 day-old Cobb-500 broiler chicks were fed diets; T₁ (control), T₂ (5% Azolla in the diet), T₃ (7% Azolla in the diet) and T₄ (T₁ with 1 mL multivitamin and 1 mL acidifier/liter water) having 3 replications in each, and 20 chicks/replication in control, and 10 chicks/replication in the remaining dietary treatment groups for 35 days.

Results

In experiment 1, the highest live weight was observed in D₄ (p<0.05), however, feed intake was statistically similar between diets (p>0.05). The lowest feed conversion ratio (FCR) (p<0.001) and mortality (p<0.05) were observed in D₂ followed by D₄, D₁, and D₃, respectively. There were no significant differences between diets for feed cost and net profit (p>0.05). However, evidently but not significantly, the highest net profit was obtained in D₂ followed by D₄, D₁, and D₃, respectively. In experiment 2, the highest live weight (p<0.05) and feed intake (p<0.001) were observed in T₄. Mortality (p<0.01), FCR (p<0.01), feed cost (p<0.05) and net profit (p<0.05) were significantly different among diets. Considering net profit, T₂ was the best performing dietary group followed by T₃, T₁, and T₄, respectively. The lowest lipid profiles were observed in D₃ followed by D₁, D₄, and D₂, respectively (p<0.05). In experiment 2, the lowest total cholesterol, TG, and the highest amount of high density lipoprotein were observed in T₂, followed by T₃, T₁, and T₄, respectively (p<0.05). Evidently but not significantly, low density lipoprotein was the highest in T₂ followed by T₃, T₄, and T₁, respectively (p>0.05).

Conclusion

In conclusion, Azolla and acidifier reduced lipid profiles of broiler chickens. Considering net profit and lipid profiles, 5% Azolla may be the suitable dietary group for producing safe and profitable broilers. However, more studies are needed to confirm this study prior to suggesting using Azolla in the poultry industry.

Evaluation of Bcr-Abl Gene Rearrangement among Bangladeshi Chronic Myeloid Leukaemia Patients

Chronic Myeloid Leukaemia (CML) is a clonal myeloproloferative disorder. Presence of molecular translocation t (9; 22) in CML patients can be confirmed by Reverse Transcriptase Polymerase Chain Reaction (RT-PCR). Among haematological malignancies CML is the commonest leukaemia of adults in Asia. Despite this, there are very few studies published from Bangladesh, documenting the frequency of bcr-abl fusion transcripts. So, we would like to perform this observational study to evaluate bcr-abl fusion transcripts and demographic status among RT-PCR positive chronic phase CML patients at BIRDEM & other two centers of Dhaka city, Bangladesh where patients admitted from different districts of Bangladesh in the period of January 2010 to June 2012. Twenty patients from three centers willing to perform RT-PCR test and showed positive PCR result, were enrolled under written consent before starting treatment with targeted molecular therapy. The age range of the sample was 18 to 52 years, with mean age of 34.80 and male - female ratio of 4:1. This study showed among chronic phase CML patients bcr-abl transcript rearrangement frequency was b3a2 (e14a 2) 45% while b2a2 (e13a2) was 55% by RT-PCR testing method. Cytogenetic and molecular analysis has become mandatory in order to make a correct diagnosis and monitoring response to newer molecular targeted treatment modalities. So our health sector should be enriched with laboratories with modern technology to diagnose haemato-oncological diseases as per WHO guideline.

MOLECULAR DETECTION AND CHARACTERIZATION OF SALMONELLA SPP. ISOLATED FROM FRESH FISHES SOLD IN SELECTED UPAZILA MARKETS OF BANGLADESH

Aquatic environments are the major reservoirs of Salmonella. Therefore, fishery products have been recognized as a major carrier of food-borne organism. Fish is known to harbor bacteria of public health significance. Aquatic environments are known to influence the bacterial loads in the harvested fish. The present work was undertaken for molecular detection and characterization of Salmonella species isolated from fresh fishes sold in different markets of Jamalpur,Tangail, Kishorganj and Netrokona districts of Bangladesh. The isolates were identified by their morphological, cultural and biochemical characteristics with standard reference organisms, and molecular methods. Out of 20 pangas fish (Pangasius spp.) samples the number of samples found to be positive for Salmonella spp was 14 (70%); of 20 koi fish (Anabas spp.) samples this number was 17 (85%); and of 20 tilapia fish (Oreochromis spp.) samples it was 15 (75%). All the isolates of Salmonella were confirmed by targeting genus specific histidine transport operon gene. Antimicrobial susceptibility test was performed to know the susceptibility and resistance patterns of the isolates to different antimicrobial agents. Results of antimicrobial susceptibility test shows that 40 (86.95%) isolates were found to be resistant to azithromycin, 42 (91.30%) were resistant to erythromycin. On the other hand all isolates were 100% susceptible to ciprofloxacin and gentamicin, 38 (82.62%) were susceptible to norfloxacin, 40 (86.95%) were susceptible to streptomycin.

Ethanol sensor development based on ternary-doped metal oxides (CdO/ZnO/Yb2O3) nanosheets for environmental safety

Herein, we report the construction of a dynamic, highly sensitive, stable, reliable, and reproducible selective ethanol sensor based on a ternary metal oxide system of CdO/ZnO/Yb₂O₃ nanosheets (NSs).

Diagnostic Importance of Platelet in Patients with Acute Coronary Syndrome Admitted in Mymensingh Medical College Hospital

This cross sectional descriptive study was carried out in the Department of Cardiology, Mymensingh Medical College Hospital from July 2015 to December 2015, included 50 patients admitted with acute coronary syndrome diagnosed on the basis of history, typical anginal type of chest pain, characteristic electrocardiographic changes and increased cardiac biomarkers. Platelet count (PC), Mean platelet volume (MPV) and platelet distribution width (PDW) were measured using automated hematological analyzer and compared them with 50 age and sex matched healthy controls. All platelet parameter indices - platelet count (PC), mean platelet volume (MPV) & platelet distribution width (PDW) - were significantly raised in patients with ACS. In patients with ACS the mean values of platelet count, MPV & PDW were 352.2×10⁹/L), 13.9fL & 15.6fL, respectively; while in normal healthy control the mean values of these indices were 256.2×10⁹/L), 8.1fL & 10.5fL, respectively. Statistically significant difference in mean values of these indices was found (p value <0.05). Larger platelets are haemostatically more active and are a risk factor for developing coronary thrombosis and subsequent acute coronary events (myocardial infarction and unstable angina). Patients with larger platelets can easily be identified during routine hematological analysis and could possibly benefit from preventive treatment.

Cost and cost-effectiveness of tuberculosis treatment shortening: a model-based analysis

Background

Despite improvements in treatment success rates for tuberculosis (TB), current six-month regimen duration remains a challenge for many National TB Programmes, health systems, and patients. There is increasing investment in the development of shortened regimens with a number of candidates in phase 3 trials.

Methods

We developed an individual-based decision analytic model to assess the cost-effectiveness of a hypothetical four-month regimen for first-line treatment of TB, assuming non-inferiority to current regimens of six-month duration. The model was populated using extensive, empirically-collected data to estimate the economic impact on both health systems and patients of regimen shortening for first-line TB treatment in South Africa, Brazil, Bangladesh, and Tanzania. We explicitly considered ‘real world’ constraints such as sub-optimal guideline adherence.

Results

From a societal perspective, a shortened regimen, priced at USD1 per day, could be a cost-saving option in South Africa, Brazil, and Tanzania, but would not be cost-effective in Bangladesh when compared to one gross domestic product (GDP) per capita. Incorporating ‘real world’ constraints reduces cost-effectiveness. Patient-incurred costs could be reduced in all settings. From a health service perspective, increased drug costs need to be balanced against decreased delivery costs. The new regimen would remain a cost-effective option, when compared to each countries’ GDP per capita, even if new drugs cost up to USD7.5 and USD53.8 per day in South Africa and Brazil; this threshold was above USD1 in Tanzania and under USD1 in Bangladesh.

Conclusion

Reducing the duration of first-line TB treatment has the potential for substantial economic gains from a patient perspective. The potential economic gains for health services may also be important, but will be context-specific and dependent on the appropriate pricing of any new regimen.

Electronic supplementary material

The online version of this article (doi:10.1186/s12879-016-2064-3) contains supplementary material, which is available to authorized users.