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.

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.

Comparison of Low Density Lipoprotein Cholesterol Level in Second and Third Trimester of Pregnancy in Mymensingh Region of Bangladesh

Altered metabolic and hormonal status of the body in pregnancy leads to changes in lipid profile. High Lipid profile, a major factor behind atherosclerosis may leads to unconsciousness. To avoid such problems during pregnancy this longitudinal study was carried out in the Department of Biochemistry, Mymensingh Medical College in co-operation with the Department of Obstetrics and Gynaecology, Mymensingh Medical College Hospital and Community Based Medical College Hospital, Bangladesh during the period from July 2011 to December 2012 to compare the changes in low density lipoprotein cholesterol level during 2nd and 3rd trimester of pregnancy. A total of one hundred subjects were participated in this study comprising of second and third trimester of pregnancy. All subjects were made to fast overnight at least for a minimum of 8 hrs. Blood samples were taken and analyzed by enzymatic colorimetric kit method. Pregnancy has being found to be associated with changes in lipid profile and this differs with each trimester. The average results were analyzed with respect to each pregnancy for the whole group. The study proves that serum Low Density Lipoprotein (LDL) cholesterol increases in third trimester (174.83±13.78 mg/dl) than second trimester (156.77±7.96 mg/dl) of pregnancy. Therefore, lipid profile estimation and monitoring should be made as a part of routine investigation during antenatal period.

Use of Anticoagulant Warfarin in Patients Presenting With Atrial Fibrillation in a Tertiary Level Hospital

Atrial fibrillation (AF) is the most common sustained arrhythmia in the World, occurring in approximately 0.4% of the general population. The purpose of the present study was to see the trend of use of warfarin in hospital admitted patients with atrial fibrillation. It was conducted in the department of cardiology, University Cardiac Centre, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh from January 2008 to January 2009. A total of 150 patients with atrial fibrillation were enrolled in this study. Out of them, male were 60(40%) and female 90(60%); age range 22-79 years. Most common presenting symptoms were palpitation (80%) & dyspnoea (70%). Chronic rheumatic heart disease (Mitral stenosis) (33%) was found in most cases followed by IHD (22%), hypertension (21%). According to CHADS₂ score, most of the patients belonged to moderate risk group (47%) and 32% in low risk group. Anticoagulation with warfarin was used in 40% cases of valvular AF & 25% patients with non valvular AF. Among non valvular AF, it was prescribed for 38% in high risk group, 34% in moderate risk & 3% in low risk group. The study states that warfarin is underused in both valvular & non valvular AF.

B-type Natriuretic Peptide Assay in Differentiating Congestive Heart Failure from Lung Disease in Patients Presenting with Dyspnea

This cross-sectional analytical study was conducted in Cardiology & Medicine Department of Mymensingh Medical College Hospital. After fulfilling the exclusion & inclusion criteria, B-type natriuretic peptide concentrations were measured in a convenience sample of 100 predominantly male (94%) dyspnic patients who got admitted in Cardiology & Medicine Department of Mymensingh Medical College & Hospital from November 2013 to October 2014. The diagnosis of Congestive Heart Failure (CHF) was based on generally accepted Framingham criteria with corroborative information including hospital course (response to diuretics, vasodilators, inotropes or hemodynamic monitoring) and results of further cardiac testing, including echocardiography. Patients with right heart failure from cor pulmonale were classified as having CHF. Pulmonary disease was confirmed by using the following diagnostic tools: i) A chest X-ray without signs of heart enlargement or pulmonary venous hypertension or a chest X-ray with signs of chronic obstructive lung disease, ii) Normal heart function as seen by echocardiography, iii) Abnormal pulmonary function tests or follow-up results and iv) A positive response to treatment with steroids, nebulizers or antibiotics in hospital. Patients with CHF (n=50) had mean BNP level 1146.72pg/ml (range 103 to 5000pg/ml), which is significantly higher than the group of patients with a final diagnosis of pulmonary disease (n=50) whose BNP was 34pg/ml (range 10 to 90pg/ml) (p<0.05). In conclusion, it was found that B-type natriuretic peptide is an important biomarker for differentiating congestive heart failure from lung disease in patients presenting with dyspnea.

Huge Perineal Tumour: A Rare Presentation of Gastrointestinal Stromal Tumour of Rectum

Gastrointestinal stromal tumour (GIST) is a relatively rare neoplasm of gastrointestinal tract of which Rectal GIST is uncommon. It produces symptoms of per rectal bleeding or change in bowel habit. Recurrences following curative resection are predominantly intraabdominal, hepatic metastasis occurring at a median 20-25 months following the primary surgery. A 42 years old male presented a huge mass in hypogastrium, the size of which was reduced ofter neoadjuvant therapy for period of 1.5 years. He underwent abdominoperineal resection. He developed recurrences in perineum three times and in thigh at short intervals after primary resection. He also developed liver metastasis. He died two and half years after primary diagnosis. Rectal GIST should be included in differential diagnosis of intraabdominal mass and preoperative diagnosis based on histopathological as well as the immunohistochemical feature of the CD(117) and CD(34). Although complete surgical resection with negative tumour margin is the principal curative procedure for primary and non metastatic tumours, further studies are still needed for the determination of the most effective treatment strategy for patients of rectal GIST.

Effect of Sn Doping on the Properties of Nano-Structured ZnO Thin Films Deposited by Co-Sputtering Technique

In this study, tin doped zinc oxide (ZnO:Sn) nano-structured thin films were successfully deposited by co-sputtering of ZnO and Sn on top of glass substrate. The effect of Sn doping on the microstructure, phase, morphology, optical and electrical properties of the films were extensively investigated by means of XRD, EDX, SEM, AFM, Hall Effect measurement, and UV-Vis spectrometry. The results showed that the undoped ZnO film exhibited preferred orientation along the c-axis of the hexagonal wurtzite structure. With increase of Sn doping, the peak position of the (002) plane was shifted to the higher 20 values, and ultimately changed to amorphous structure. The absorption edge was shifted to blue region which confirmed the excitonic quantum confinement effect in the films. Consequently, improved surface morphology with optical bandgap, reduced average particle size, reduced resistivity, enhanced Hall mobility and carrier concentration were observed in the doped films after vacuum annealing. Among all of the as-deposited and annealed ZnO:Sn films investigated in this study, annealed film doped with 8 at.% of Sn concentration exhibited the best properties with a bandgap of 3.84 eV, RMS roughness of 2.51 nm, resistivity of 2.36 ohm-cm, and Hall mobility of 83 cm2 V(-1) s(-1).

High quit rate among smokers with tuberculosis in a modified smoking cessation programme in Dhaka, Bangladesh

SETTING

BRAC, a non-governmental organisation, implemented a modified smoking cessation programme for tuberculosis (TB) patients based on International Union Against Tuberculosis and Lung Disease (The Union) guidelines in 17 peri-urban centres of Dhaka, Bangladesh.

OBJECTIVE

To determine whether a modified version of The Union's smoking cessation intervention was effective in promoting cessation among TB patients and determinants associated with quitting smoking.

DESIGN

Cohort study of routinely collected data.

RESULTS

A total of 3134 TB patients were registered from May 2011 to April 2012. Of these, 615 (20%) were current smokers, with a mean age of 38 years (±13.8). On treatment completion, 562 patients were analysed, with 53 (9%) lost to follow-up or dead, while 82% of smokers had quit. Patients with extra-pulmonary TB were less likely to quit than those with pulmonary TB. Patients with high-intensity dependence were less likely to quit than those with low-intensity dependence.

CONCLUSION

This study suggests that a simplified smoking cessation intervention can be effective in promoting smoking cessation among TB patients in Bangladesh. This is encouraging for other low-resource settings; the Bangladesh National Tuberculosis Control Programme should consider nationwide scaling up and integration of this smoking cessation plan.

Beyond drugs: tuberculosis patients in Bangladesh need nutritional support during convalescence

SETTINGS

All sputum microscopy laboratories under the BRAC Tuberculosis Programme in Dhaka City.

OBJECTIVES

To study the nutritional status of tuberculosis (TB) patients attending microscopy laboratories during convalescence following DOTS.

DESIGN

The study included 1068 TB patients registered for treatment at 10 laboratories from May 2010 to December 2011, and 910 healthy neighbourhood controls. Weight (in kg), height (in cm) and mid-upper arm circumference (MUAC; in cm) were measured before, at 2 months and immediately after completion of treatment. Body mass index (BMI) < 18.5 kg/m(2) and MUAC < 22.0 cm were taken as cut-offs for defining malnourishment.

RESULTS

Two thirds of the patients (67%) had a low BMI (<18.5 kg/m(2)) before treatment, compared to only 23% among the healthy controls. At the end of treatment, 50% of the patients still had a low BMI, including 12% who had severe malnourishment (BMI ≤ 16 kg/m(2)). MUAC < 22.0 cm was higher among patients before (42%), at 2 months (39%) and immediately after completion of treatment (34%) compared to the control group (9%).

CONCLUSIONS

Malnutrition is a serious problem among TB patients in peri-urban areas of Dhaka City. Under the circumstances, additional nutritional supplements, combined with education on nutrition, are expected to contribute to rapid and sustained recovery during DOTS-based treatment.

Particle emissions from microalgae biodiesel combustion and their relative oxidative potential

Microalgae are considered to be one of the most viable biodiesel feedstocks for the future due to their potential for providing economical, sustainable and cleaner alternatives to petroleum diesel. This study investigated the particle emissions from a commercially cultured microalgae and higher plant biodiesels at different blending ratios. With a high amount of long carbon chain lengths fatty acid methyl esters (C20 to C22), the microalgal biodiesel used had a vastly different average carbon chain length and level of unsaturation to conventional biodiesel, which significantly influenced particle emissions. Smaller blend percentages showed a larger reduction in particle emission than blend percentages of over 20%. This was due to the formation of a significant nucleation mode for the higher blends. In addition measurements of reactive oxygen species (ROS), showed that the oxidative potential of particles emitted from the microalgal biodiesel combustion were lower than that of regular diesel. Biodiesel oxygen content was less effective in suppressing particle emissions for biodiesels containing a high amount of polyunsaturated C20-C22 fatty acid methyl esters and generated significantly increased nucleation mode particle emissions. The observed increase in nucleation mode particle emission is postulated to be caused by very low volatility, high boiling point and high density, viscosity and surface tension of the microalgal biodiesel tested here. Therefore, in order to achieve similar PM (particulate matter) emission benefits for microalgal biodiesel likewise to conventional biodiesel, fatty acid methyl esters (FAMEs) with high amounts of polyunsaturated long-chain fatty acids (≥C20) may not be desirable in microalgal biodiesel composition.

Analysis of genetic variability, heritability and genetic advance for yield and yield associated traits in some promising advanced lines of rice

A field experiment was conducted using twenty three rice genotypes including three check varieties during the period from June to December, 2013, at the Agronomy Field Laboratory, Department of Agronomy, Bangladesh Agricultural University, Mymensingh to study genetic variability, heritability and genetic advance (GA) for yield and yield associated traits in rice. The experiment was laid down in a randomized complete block design with three replications. Plant height, number of filled grains per panicle, days to 50% flowering, thousand grain weight, grain width and grain yield showed relatively high genotypic co-efficient of variation (GCV) and phenotypic co-efficient of variation (PCV) estimates. The PCV were higher than GCV for all eight traits indicating that they all interacted with the environment to some extent. High heritability was obtained for grain width (88.54%), followed by days to 50% flowering (87.61%), thousand grain weight (81.96%), grain length (81.94%), days to maturity (81.81%) and number of filled grains per panicle (78.19%) which indicates high heritable portion of variation. High to medium estimates of heritability and genetic advance were obtained for number of filled grains per panicle (18.97), days to 50% flowering (11.89), days to maturity (12.16) indicating the roles of additive gene action and a good scope of selection using their phenotypic performance. Considering, all of these characters, filled gains per panicle and days to 50% flowering and maturity were important yield related traits and could be used for selection in rice breeding programs.Progressive Agriculture 26:26-31, 2015

Bilateral Tubercular Mastitis - Case Reports

Breast tuberculosis is a rare form of tuberculosis. Moreover the disease is often overlooked and misdiagnosed as carcinoma or pyogenic abscess. Reports on breast tuberculosis have been few; reported incidence of breast tuberculosis amongst the total number of mammary conditions varies between 0.1 and 4 percent. Bilateral involvement is still more uncommon (3%). Here we report 3 cases of adult female ranging from 27 to 35 years who presented with 1 to 4 months history of firm lumps in both breasts and no axillary lymphadenopathy. Fine needle aspiration cytology (FNAC) of breast lump in all 3 cases were done but in 1 case showed evidence of tubercular mastitis and other 2 cases findings were inconclusive. Subsequent Excisional Biopsy of those 2 cases showed features of tuberculosis. All 3 were prescribed with four drug anti-tubercular treatments continued for 12 months in 2 cases and 9 months in other case depending upon their response. The lumps disappeared and ulcer healed after anti-tubercular treatment.

Deconjugation of soy isoflavone glucuronides needed for estrogenic activity

Soy isoflavones (SIF) are present in the systemic circulation as conjugated forms of which the estrogenic potency is not yet clear. The present study provides evidence that the major SIF glucuronide metabolites in blood, genistein-7-O-glucuronide (GG) and daidzein-7-O-glucuronide (DG), only become estrogenic after deconjugation. The estrogenic potencies of genistein (Ge), daidzein (Da), GG and DG were determined using stably transfected U2OS-ERα, U2OS-ERβ reporter gene cells and proliferation was tested in T47D-ERβ cells mimicking the ERα/ERβ ratio of healthy breast cells and inT47D breast cancer cells. In all assays applied, the estrogenic potency of the aglycones was significantly higher than that of their corresponding glucuronides. UPLC analysis revealed that in U2OS and T47D cells, 0.2-1.6% of the glucuronides were deconjugated to their corresponding aglycones. The resulting aglycone concentrations can account for the estrogenicity observed upon glucuronide exposure. Interestingly, under similar experimental conditions, rat breast tissue S9 fraction was about 30 times more potent in deconjugating these glucuronides than human breast tissue S9 fraction. Our study confirms that SIF glucuronides are not estrogenic as such, and that the small % of deconjugation in the cell is enough to explain the slight bioactivity observed for the SIF-glucuronides. Species differences in deconjugation capacity should be taken into account when basing risk-benefit assessment of these SIF for the human population on animal data.

Maternal and foetal outcome of 206 high risk pregnancy cases in border guard hospital, dhaka

This observational study was carried out to identify the various types of high risk pregnancy and to determine the maternal and foetal outcome. The study was carried out on 206 pregnant high risk women in the Gynecology and Obstetrics department of Border Guard Hospital, Dhaka from January 2012 to December 2012. During mentioned period among 598 pregnant women 206 high risk pregnancy cases were randomly selected. Pregnant women (gestational age from 34 weeks upto 40 weeks) having medical condition and pregnancy related high risk factors were included and uncomplicated pregnancy, pregnancy before 37 weeks, post dated pregnancy were excluded from this study. Data was collected from semi structured history sheet and data analysis done by percentage. High risk pregnant women were grouped into three. Group A and Group B includes pregnant women having medical condition before and during pregnancy respectively. Group C consists of pregnant women had pregnancy related high risk issues. Among 206 high risk pregnancy cases majority 47.57% women had medical condition during pregnancy, 31.55% patient had medical condition before pregnancy. Among them majority 30.58% of the patient suffered from pregnancy induced hypertension, 15.04% patients suffered from gestational Diabetes Mellitus and premature rupture of membranes were 12.13%. In this study majority 43.68% of high risk pregnant patients were in age group of 30-35 years, 19.90% pregnant women were in age group of >35 years and 19.40% were in age group of upto 20 years. Among study groups maximum 65.04% of the patients were multiparous. Among 206 study population 60.19% high risk pregnant women were at term at the time of delivery and 39.8% women delivered their babies preterm. Caesarean section was done in 69.41% of high risk pregnant women. After delivery majority 77.66% women had no complication, only 10.19%, 8.25%, 2.91% and 0.97% high risk pregnant women suffered from fever, UTI, abdominal wound infection and post partum hemorrhage respectively. In this study, among 206 pregnancy cases 91.31% of the neonates had Apgar score >7 and 8.61% neonates had Apgar score <7%, 33.49% neonates had low birth weight and premature 39.80%. During the study period no maternal and neonatal death were observed.

Patient costs during tuberculosis treatment in Bangladesh and Tanzania: the potential of shorter regimens

OBJECTIVE

To estimate the costs incurred by patients during the intensive and continuation phases of the current 6-month tuberculosis (TB) regimen in Bangladesh and Tanzania, and thus identify potential benefits to patients of a shorter, 4-month treatment regimen.

DESIGN

The validated Stop TB patient cost questionnaire was adapted and used in interviews with 190 patients in the continuation phase of treatment with current regimens.

RESULTS

In both countries, overall patient costs were lower during 2 months of the continuation phase (US$74 in Tanzania and US$56 in Bangladesh) than during the 2 months of the intensive phase of treatment (US$150 and US$111, respectively). However, continuation phase patient costs still represented 89% and 77% of the 2-month average national income in the respective countries. Direct travel costs in some settings were kept low by local delivery system features such as community treatment observation. Lost productivity and costs for supplementary foods remained significant.

CONCLUSIONS

Although it is not a straightforward exercise to determine the exact magnitude of likely savings, a shorter regimen would reduce out-of-pocket expenses incurred by patients in the most recent 2 months of the continuation phase and allow an earlier return to productive activities.

Source apportionment and pollution evaluation of heavy metals in water and sediments of Buriganga River, Bangladesh, using multivariate analysis and pollution evaluation indices

Concentrations of heavy metals in water and sediment samples of Buriganga River in the capital city Dhaka, Bangladesh, were studied to understand the level of heavy metals and their source apportionment. The results showed that the mean concentrations of heavy metals both in water and sediment samples were very high and, in most cases, exceeded the permissible limits recommended by the Bangladesh government and other international organizations. Significantly higher concentrations of Pb, Cr, Mn, Co, Ni, Cu, Zn, As, and Cd were found in sediment samples. However, average concentrations of metals both in water and sediment samples were above the effect range median. The heavy metal pollution index (HPI) and degree of contamination (Cd) yielded different results in water samples despite significant correlations between them. The heavy metal evaluation index (HEI) showed strong correlations with HPI and Cd and provided better assessment of pollution levels. The enrichment factor (EF) and geoaccumulation index (Igeo) showed the elevated value of Cr, Pb, and Cd in access of background values. The measured elements were subjected to positive matrix factorization (PMF) and examining correlations in order to explain the content, behavior, and source apportionment of metals. PMF resulted in a successful partitioning of variances into sources related to background geochemistry and contaminant influences. However, the PMF approach successfully demarcated the major sources of metals from tannery, paint, municipal sewage, textiles, and agricultural activities.

Outcome of modified Bristow-Laterjet procedure in post-traumatic recurrent anterior shoulder dislocation in young population

Anterior shoulder dislocation (ASD) is a common injury of young population which may progress to recurrent episodes. The treatment is initially conservative but surgery is indicated when it fails. Out of more than 150 techniques, modified Bristow-Latarjet procedure has become most favorable even to arthroscopic techniques. We have intended to retrospectively assess the outcome of it in post-traumatic recurrent ASD of young non-athletes, performed at our different private settings between January 2007 and July 2012; which included 15 male patients of 20-39 years with minimum 2 years follow up. Clinical, functional, radiological and overall outcome status were evaluated. There was significant improvement of shoulder stability (p<0.05, chi-square test) despite significant deterioration (p<0.05, paired t-test) of external rotation (21.67°±00.61° loss). The patient self assessed pain and instability had highly significant (p<0.001, paired t-test) and all components of activities of daily living (except above shoulder weight carrying and overhead throwing) had significant improvement (p<0.05, paired t-test). Despite of intra-operative difficulties, radiological transplant errors (33.33%) and post-operative complications (06.67%), overall satisfactory outcome (86.67%) had been significant (p<0.05, chi-square test).

Forest biomass flow for fuel wood, fodder and timber security among tribal communities of Jharkhand

The study investigated extraction and consumption pattern of fuel wood, fodder and timber and forest biomass flow for fuel wood, fodder and timber security among tribal communities in Bundu block of Ranchi district in Jharkhand (India). The study is based on personal interviews of the selected respondents through structured interview schedule, personal observations and participatory rural appraisal tools i.e. key informant interviews and focus group discussions carried out in the sample villages, using multi-stage random sampling technique. The study revealed that the total extraction of fuel wood from different sources in villages was 2978.40 tons annum(-1), at the rate of 0.68 tons per capita annum(-1), which was mostly consumed in cooking followed by cottage industries, heating, community functions and others. The average fodder requirement per household was around 47.77 kg day(-1) with a total requirement of 14227.34 tons annum(-1). The average timber requirement per household was computed to be 0.346 m3 annum(-1) accounting for a total timber demand of 282.49 m3 annum(-1), which is mostly utilized in housing, followed by agricultural implements, rural furniture, carts and carriages, fencing, cattle shed/ store house and others. Forest biomass is the major source of fuel wood, fodder and timber for the primitive societies of the area contributing 1533.28 tons annum(-1) (51.48%) of the total fuel wood requirement, 6971.55 tons annum(-1) (49.00%) of the total fodder requirement and 136.36 m3 annum(-1) (48.27%) of the total timber requirement. The forest biomass is exposed to enormous pressure for securing the needs by the aboriginal people, posing great threat to biodiversity and environment of the region. Therefore, forest biomass conservation through intervention of alternative avenues is imperative to keep pace with the current development and future challenges in the area.

Factors contributing to the duration of untreated psychosis

BACKGROUND

Shortening the duration of untreated psychosis (DUP) - with the aim of improving the prognosis of psychotic disorders - requires an understanding of the causes of treatment delay. Current findings concerning several candidate risk factors of a longer DUP are inconsistent. Our aim was to identify factors contributing to DUP in a large sample that represents the treated prevalence of non-affective psychotic disorders.

METHOD

Patients with a non-affective psychotic disorder were recruited from mental health care institutes from 2004 to 2008. Of the 1120 patients enrolled, 852 could be included in the present analysis. Examined candidate factors were gender, educational level, migration status, premorbid adjustment and age at onset of the psychotic disorder. DUP was divided into five ordinal categories: less than one month, one month to three months, three months to six months, six months to twelve months and twelve months and over. An ordinal logistic regression analysis was used to identify the risk factors of a longer DUP.

RESULTS

Median DUP was less than one month (IQR 2). The factors migration status (p=0.028), age at onset of the psychotic disorder (p=0.003) and gender (p=0.034) were significantly associated with DUP in our analysis.

CONCLUSION

First generation immigrant patients, patients with an early onset of their psychotic disorder and male patients seem at risk of a longer DUP. These findings can assist in designing specific interventions to shorten treatment delay.