Immunogenicity of pressure inactivated Edwardsiella tarda bacterin to Anguilla japonica (Japanese eel)

Japanese eel Anguilla japonica were immunized with inactivated Edwardsiella tarda bacterin preparations (formalin-killed cells, FKC (0.4%), formalin with heat-killed cells, FHKC (0.1% and 70 degreesC for 10 min), heat-killed cells, HKC (70 degrees C for 15 min), potassium chloride-killed cells, KKC (0.6%), tannic acid-killed cells, TKC (0.9%), citric acid-killed cells, CAKC (0.9%), pressure-killed cells, PKC (600 psi for 5 min) and electric current-killed cells, ECKC (100 mA at 12 v DC for 5 sec) via intraperitoneal injection in order to develop adequate inactivating method. Immune parameters in the immunized eel were measured to compare responses to different bacterins. Generally, eel rose agglutinating antibody titer in the serum within 2 week and the maximum titer occurred at 6 weeks post immunization. Elevated and significantly higher titer was produced with the PKC of E. tarda than other bacterin preparations. An Enzyme Linked Immunosorbent Assay (ELISA), to determine specific anti-E. tarda antibody in the serum, also showed significantly higher antibody titer with PKC than the other antigen preparations. Bacteriostatic assay with serum and live E. tarda indicated significantly higher activity in the PKC-immunized fish. Immunization with PKC also showed the increased level ofphagocytosis. PKC-inactivated vaccine at an immunization dose of 10(6) cells/fish induced high protection against experimental infection. Coincident with higher immune parameters and protection in the fish immunized with the PKC bacterin strongly suggested that pressure-killing is an effective inactivating method to develop an effective vaccine against edwardsiellosis.

Usher syndrome

A young girl of 10 years age came from Nalitabari, Sherpur was admitted in the department of Ophthalmology, Mymensingh Medical College Hospital, Mymensingh on the 5th January 2011 with the complaints of dimness of vision of both eyes, night blindness and profound deafness since birth. She had parental history of consanguineous marriage. Best corrected visual acuity of this patient was recorded 6/60 both the eyes with nystagmus. Fundus examination showed waxy pallor optic disc, arteriolar attenuation and bony spicule pigmentation both eyes. By history and clinical examination the patient was diagnosed as Usher syndrome.

Von Hippel-Lindau disease in a pregnant lady

Von Hippel-Lindau disease is a rare genetic disorder characterized by various tumours and cysts in the central nervous system and other viscera. Here a case was described in a young female who was pregnant at the time of initial presentation with the complaints of occasional headache, low back pain and pain in the upper abdomen. After the birth of a healthy baby she was admitted to the hospital and the CT scan of upper abdomen suggested a multiloculated pancreatic cyst. MRI of thoracolumbar spine revealed an intracanalicular extradural mass and CT scan of brain revealed a cerebellar cystic mass. The spinal and cerebellar masses both were diagnosed histologically as haemangioblastoma. After a month she underwent laparotomy with near total pancreatectomy. Microscopically it was a microcystic cystadenoma. Based on the clinical presentation, imaging and histopathology of spinal, cerebellar and pancreatic lesions as well as a family history of her father's death due to brain tumour the final diagnosis was Von Hippel-Lindau disease.

Physical training induced resting bradycardia and its association with cardiac autonomic nervous activities

Regular physical exercise causes resting bradycardia. This exercise-induced resting bradycardia may be associated with exercise-induced changes in Cardiac autonomic nervous activities (CANA). Power Spectral Analysis (PSA) of Heart rate variability (HRV) is one of the most promising new techniques to quantify CANA. Regular physical exercise induced bradycardia is associated with exercise-induced adaptation in CANA. To observe the HRV parameters by frequency domain method (PSA), in male adolescent athletes in order to find out the influence of regular physical exercise on resting heart rate (HR) and CANA. The cross sectional study was carried out on 62 adolescent male athletes aged 12-18 years (group B), in the Department of Physiology, Bangabandhu Sheikh Mujib Medical University from 1st July 2007 to 30th June 2008. For comparison 30 age, sex and socioeconomic condition matched apparently healthy sedentary subjects (group A) were also studied. The study group was selected from the BKSP (Bangladesh Krira Shikka Prothistan, Savar, Dhaka) and the control from a residential school of Dhaka city. HRV parameters were assessed by Polygraph (Polyrite D, version 2.2). For statistical analysis Independent-Samples t-test was done as applicable. Resting mean HR was significantly (p<0.001) lower in the athletes. The mean value of Total (variance), VLF, LF and HF power was significantly (p<0.001) higher in athletes than that of non-athetes. Regular physical exercise-induced resting bradycardia is associated with exercise-induced adaptation in cardiac autonomic nervous activities.

Pattern of ocular trauma

This prospective observational study was conducted in the department of Ophthalmology Mymensingh Medical College Hospital during the period of November, 2009 to October, 2010. Two hundred & fifty (250) patients of both sexes and all ages with ocular trauma were selected randomly for this study. A detailed history of patients, duration of trauma, relation of trauma with work, visual status prior to injury, any surgery prior to injury & patients were alcoholic or not were taken. Male patients were 190(76%) and female patients were 60(24%). Majority of patients were 11-20 years group (39.2%). Most of patients (40%) attended into hospital within 60 hours of ocular trauma. Accidental occupational trauma were more common (51.2%) and assault injury were less common (12.8%). Greater number of ocular trauma was caused by sharp objects (59.2%) and less number of ocular trauma was caused by chemical injuries (2.4%). Open globe injuries were more common (62%) than closed globe injury (38%). Visual acuity on admission between 6/60 to PL comprises highest number (64%) and also on discharge between 6/60 to PL comprises highest number of cases (50%). Most of the patients came from poor socioeconomic group (60%).

Hyperlipidemia in childhood idiopathic nephrotic syndrome during initial remission and relapse

The objective of this study was to correlate hyperlipidemia during initial remission of nephrotic child with relapse. This observational prospective study was carried out among 26 children, between 1 to 8 years age with first attack idiopathic nephrotic syndrome, who was seen at Paediatric Nephrology Department of BSMMU and Paediatric Nephrology Department, NIKDU, from December'2005 to August'2006 and were followed-up for at least 6 months after initial attack. Twenty two age and sex matched hospitalized children, suffering from non-renal diseases, were enrolled as controls. Fasting blood samples for lipid profile were taken at the time of diagnosis of both cases and controls and also during remission of cases only. These patients were divided into two groups based on serum lipid profile during remission. Group-I consisted 16 patients who had normal lipid profile during remission and Group-II consisted 10 patients who had abnormal lipid profile during remission. Both Groups I & II had higher mean levels of serum cholesterol, LDL, TG and Lp(a) than those of controls during initial diagnosis. Between two groups on remission, Group-II patients showed higher mean serum cholesterol (332.9±105.19 mg/dL vs. 183.13±16.89 mg/dL; p<0.001), serum LDL (252±101.67 mg/dL vs. 119.19±21.33mg/dL; p<0.001), and serum TG (182.8±73.83 mg/dL vs. 93.31±20.95 mg/dL; p<0.001). Five patients out of 10 patients of Group-II (19% of total case) developed subsequent relapse within 6 months follow-up. Among the relapsers, mean cholesterol (334±46 vs. 232±34 mg/dL; p<0.05) was significantly higher than that of non-relapsers of Group-II patients. On the other hand, no patient of Group-I developed relapse within 6 months follow-up. It may be concluded from this study that hyperlipidemia in general at remission, specifically serum total cholesterol, may be regarded as predictor of relapse in childhood idiopathic nephrotic syndrome.

Role of oral clonidine on intraopereative haemodynamic stability for craniotomies of intracranial space occupying lesion

This was an analytical comparative study. Aim of this study was to observe the effect of oral clonidine on intra operative haemodynamic stability in intracranial space occupying lesion (ICSOL) patients who underwent craniotomy. Total 60 patients were distributed into case and control group. Number of cases was 30 in each study group of this study. Mean age of experimental and control were significantly close to each other. Baseline weight, pulse, systolic blood pressure, diastolic blood pressure and mean pressure also showed a significant similarity between each group. Variable of each group was collected during different events of craniotomy. All variable of pulse, systolic blood pressure, diastolic blood pressure and mean pressure were tabulated by line chart and fluctuation of variable was measured by significance test. The fluctuation of mean pressure was respectively 11.6%, 11.2%, 12.4%, 11.4%, 14.2%, 15.6%, 10% and 9.4% in different events of craniotomy in hemodynamically unstable group and it was respectively 11.1%, 10.9%, 10.4%, 9.9%, 9.2%, 9.4%, 8.6% and 8.7% in hemodynamically stable group. 'P' value was less than 0.05. It was observed that fluctuation of haemodynamic parameters were significantly less in experimental group where oral clonidine was used as premedication.

Outcome of pregnancies after inadvertent exposure to GnRH agonist in early pregnancy

Four pregnancies were exposed to gonadotrophin-releasing hormone agonist (GnRHa) during early pregnancy and the patients were followed up to find out the outcome of their pregnancies. In three patients long-acting GnRHa (triptorelin acetate 3.75 mg) once monthly was used for severe pelvic endometriosis as part of preparation for undergoing assisted reproductive technology (ART) cycle, and in one patient daily injections of short-acting GnRHa (buserelin 0.05 mg) was given for down-regulation for ART cycle. The age of the patients ranged from 29 to 38 years and duration of infertility was 3 to 13 years. In patients prescribed long-acting GnRHa, diagnosis of pregnancy was done late at around 5-8 weeks by ultrasonography, whereas in patients using short-acting GnRHa diagnosis of pregnancy was made with blood beta human chorionic gonadotropin (HCG) level after the 26th day of injections. Three pregnancies were delivered around term and the babies had no apparent complication or any congenital anomaly. One of the pregnancies ended up into spontaneous abortion at 14 weeks of pregnancy. The children were regularly examined by pediatricians regarding physical and mental development and for any abnormal behavioral problems. All of them are normal till now.

Fibrolipomatous hamartoma of the digital branches of the median nerve

Fibrolipomatous Hamartoma is an idiopathic disorder which may be related to hypertrophy of mature fat cells and fibroblasts in the epineurium. It is a rare condition most commonly affects the median nerve. Presentation is usually before 30 years of age.Some of them are presented with signs and symptoms of nerve entrapment and some are associated with macrodactyly (macrodystrophia lipomatosa) with gross cosmetic abnormality. MRI can be an important preoperative diagnostic tool. Biopsy and histopathology report can confirm the pathology.This report describes a case of Fibrolipomatous Hamartoma of the digital branches of left index and middle fingers of median nerve associated with macrodactyly. A 25-year old male patient having this problem came to Apollo Hospitals Dhaka with abnormally large left index and middle finger. Debulking by excision of the lipomatous tissue along the digital branches of median nerve was performed. Three weeks postoperatively, the patient had no major complaints and the mass decreased in size without any motor or functional losses. Sensory function also found near normal with a small area of numbness at the tip of the left index finger.DOI: http://dx.doi.org/10.3329/pulse.v4i1.6967Pulse Vol.4 January 2010 p.40-42

Human thelaziasis in Bangladesh

Very few cases of Human Thelaziasis are reported worldwide. This is the first case of its kind from Bangladesh. A 58 years old man was admitted to Ophthalmology department of Mymensingh Medical College Hospital, Mymensingh, with itching, redness, foreign body sensation, lacrimation & filamentary discharge from right eye (R/E). He had visual acuity <6/60, conjunctival congestion & advanced bi-headed pterygium of R/E. After exposure of R/E ball with universal eye's speculum, a thin white nematode was found into the right lower conjunctival fornix. It was taken out by a plain forceps, placed into a bottle containing Hartman's solution & immediately sent to Microbiology department of Mymensingh Medical College for proper identification. Subsequently with the joint collaboration & detailed examination by the Parasitology department of Bangladesh Agricultural University (BAU), Mymensingh, the nematode was identified as an adult Thelazia callipaeda worm.

Postoperatve pain relief in children after subumbilical surgeries-a comparison between caudal bupivacaine and bupivacaine-clonidine

In a randomised case control study in children undergoing elective subumbilical surgery, we have assessed the clinical value of bupivacaine and bupivacaine-clonidine mixture for caudal analgesia. Sixty children aged 2-10 years, were allocated randomly to two equal groups (n=30) to receive 0.25% bupivacaine 1ml/kg (Group I) and 0.25% bupivacaine 1ml/kg with clonidine 2μg/kg (Group II). The baseline haemodynamic parameters, heart rate and blood pressure were recorded. Intraoperatively children in both groups maintained haemodynamic stability and required less amount of muscle relaxant. Duration of analgesia in minutes was assessed by the time interval between the caudal extradural injection and the first analgesic demand by the patient. It was significantly longer (p=0.000) in Group II (712 ± 15.30 minutes) as compared with Group I (246 ± 8.74 minutes). Group II required significantly less supplementary analgesia after operation. There was no significant difference in the incidence of side effects between the two groups. Group I received more doses of diclofenac suppository in first 24 postoperative hours. We conclude that, when added to bupivacaine, clonidine improves the duration of caudal analgesia in children undergoing subumbilical surgery.

Neck swelling with renal stone

Since the advent of screening of calcium and imaging techniques (CT and MRI), hyperparathyroidism has been detected with increasing frequency. Although in the past, most patients present with severe bone and renal diseases, a large number of patients are asymptomatic. Number of parathyroid glands and their ectopic locations in individuals are the problem of its management. Parathyroid adenoma or hyperplasia may be a part of Multiple Endocrine neoplasia type II. This is the story of a boy of 18 years who had got admitted in the department of Otolaryngology, Mymensingh Medical College Hospital with the complaints of a neck swelling, abdominal discomfort, inability to walk, frequency of micturation for almost same duration of 1 year. After search, hypercalcaemia, bilateral renal stone, raised parathormone level and enlarged one parathyroid gland in lower pole of left thyroid lobe was identified. Clinically it was diagnosed as parathyroid adenoma which was proved histologically after surgical excision. Many controversies still exist regarding the treatment policy of parathyroid adenoma.

Refractive status of medical students of mymensingh medical college

This study is done to find out the refractive status of medical students of Mymensingh Medical College (MMC), Mymensingh, Bangladesh. They are of the age of 17-19 years. This is a nonrandom purposive cross sectional study done at late part of the November 2008. Visual acuity estimation, automated refraction, streak retinoscopy, fundoscopy using +78D volk lens were done according to the need of the cases. Out of 175 students 53.14% are emmetropic and 46.86% are ametropic, ametropia is nearly equal in both sexes (male 51.22%, female 48.78%). About all students are of highest academic attainment (GPA 5). About one quarter of the ametropic students (21.61%) are not using spectacles. Simple myopia (81.70%) and myopic astigmatism (18.30%) are the types of ametropia. Out of 67 simple myopic students 56 are of bilateral involvement and 11 are of unilateral involvement. There is similarity in the distribution of sex & refractive status in between general population & medical students of Bangladesh. Myopia and myopic astigmatism are prevalent among medical students.

Diclofenac sodium and prednisolone acetate ophthalmic solution in controlling inflammation after cataract surgery

Cataract is the leading cause of blindness throughout the world. This prospective study was conducted in the department of ophthalmology, Mymensingh Medical college Hospital. Patients of both sexes of 45 to 70 years of age range admitted for cataract surgery were selected for this study. Patients were randomly selected during the period June 2007 to December 2008 with age related cataract. Total 80 patients were included in the study dividing into two groups. In Group-A, 40 patients were treated with diclofenac sodium 0.1% eye drop -1 drop 4 times daily for 30 days after cataract surgery. In Group-B 40 patients were treated with prednisolone acetate 1% eye drop-1 drop-2 hourly 1 week, 1 drop 4 hourly for 2 weeks than 1 drop 6 hourly for 30 days after cataract surgery. Male were 70% and female were 30% in both groups A & B. Post operative inflammation were evaluated by slit lamp examination of cells, flares & keratic precipitate (KP). Patients were evaluated on 1st, 7th and 30th postoperative day. Anterior chamber cells were found 10% in grade-I, 45% in grade-II, 45% in grade-III of group-A and 15% in grade-I, 40% in grade-II, 45% in grade-III patients of group-B in 1st visit. Anterior chamber cells reduce in 2nd visit & in final visit anterior chamber cells were absent in 90% patients in group-A & 92.5% patients in group-B. Anterior chamber flares were found in 32.5% in grade-I, 42.5% in grade-II, 25% patients in grade-III of group-A & 32.5% in grade-I, 47.5% in grade-II, 20% in grade-III of group-B in 1st visit. Anterior chamber flares reduce in both groups in 2nd visit. In final visit anterior chamber flares absent 90% patients in group-A & 90% patients in group-B. KP were found 17.5% patients in grade-I of group-A & 20% patients in grade-I of group-B. In 2nd visit KP reduced in both groups & in final visit KP were absent in 95% patients of group-A & 95% patients of group-B. Analysis shows no significant difference in cells, flares and KP in both groups. Visual acuity with pin hole at final visit- in group-A 5% had 6/18, 10% had 6/12, 50% had 6/9, 35% had 6/6 and in group-B 5% had 6/18, 5% had 6/12, 57.5% had 6/9 and 32.5% had 6/6. Visual outcome were good in both the groups. No statistical significant difference was found between two groups. At each visit there was no statistically significant difference of post operative inflammation between two groups of patients.

Two brothers with X linked adrenoleukodystrophy

In patients with Addison's disease, diagnosis of Adrenoleukodystrophy (ALD) is suggested by the abrupt development of neuropsychiatric symptoms, associated with Magnetic resonance imaging (MRI) confirmation of extensive, usually symmetric, white matter demyelinating lesion. In these two cases, diagnosis of ALD was strongly supported by symptoms, disease progression, MRI findings. The emergence of neuropsychiatric symptoms in a patient with a prior history of Addison's disease should prompt evaluation for this disorder. Early diagnosis of the disease is required for delaying the progression of the disease. Genetic counseling, carrier detection and antenatal diagnosis can reduce the incidence of this disease, which prognosis is grave in most of the cases.

Relationship of blood and semen lead level with semen parameter

Lead has for long been known to affect multiple organs and can affect reproduction in male and female as well as the offspring. The study was done to find out the level of lead in blood and semen of infertile men and to find its effect on the semen parameters, as well as the minimum level of lead in blood and semen that can have negative impacts on semen parameters. The study was cross sectional in design. Male partners of 57 infertile couples attending a tertiary infertility center in Dhaka, Bangladesh were recruited for the study. Blood lead was measured by the Graphite Furnance Atomic Absorption Spectrophotometer and semen analysis was done according to the WHO recommendation (1999). With increasing blood lead concentration there was corresponding increase in the mean semen lead concentration. Reduction of mean semen volume started at level of mean blood lead level of >40mugm/dl. Mean total count of sperm (x106/ml) started decreasing at blood lead level of >30mugm/dl with very significant reduction of the count at level >40mugm/dl. At mean blood lead level >35mugm/dl there was decrease in mean values for total motility and rapid linear motility of sperm. In 12.3 % of the patients mean blood lead level was above >35mugm/dl. Higher mean blood and semen lead level was associated with significant declining semen parameters.

The noncoding genome: implications for ruminant reproductive biology

Advances in the analyses of human and other higher eukaryotic genomes have disclosed a large fraction of the genetic material (ca 98%) which does not code for proteins. Major portion of this non-coding genome is in fact transcribed into an enormous repertoire of functional non coding RNA molecules (ncRNAs) rather than encoding any proteins. Recent fascinating and fast progress in bioinformatic, high-throughput sequencing and other biochemical approaches have fuelled rapid growth in our appreciation of the tremendous number, diversity and biological importance of these ncRNAs in the hidden layer of gene regulation both at transcriptional and post-transcriptional level. Broadly ncRNAs fall into three size classes namely, 20 nucleotides for the large family of microRNAs (miRNAs), to 25-200 nucleotides for other different families of small RNAs and finally to over thousands of nucleotides for macro ncRNAs involved in eukaryotic gene regulation. Among the ncRNAs that have revolutionized our understanding of eukaryotic gene expression, microRNAs (miRNAs) have recently been emphasized extensively with enormous potential for playing a pivotal role in disease, fertility and development. They are found to be potentially involved in various aspects of physiological regulation of reproductive tissues (testis, ovary, endometrium and oviduct), cells (sperm and oocytes) and embryonic development in addition to other body systems. Here, we review the recent work on miRNAs in details and some other small ncRNAs briefly in animal models focusing on their diverse roles in the physiology of reproductive cells and tissues together with their implications for ruminant reproductive biology.

Sedative and anxiolytic effects of different fractions of the Commelina benghalensis Linn

The present study was designed to investigate sedative and anxiolytic properties of the four different fractions (chloroform, pet ether, n-butanol and hydromethanol soluble fractions, coded as CFCB, PECB, NBCB and HMCB, respectively) of the aerial parts of Commelina benghalensis using rodent behavioral models, such as hole cross, open field and thiopental sodium induced sleeping time tests for sedative property and elevated plus-maze (EPM) test for anxiolytic potential, respectively. All fractions, at the doses of 200 mg/kg, p.o. and 400 mg/kg, p.o., displayed dose dependent suppression of motor activity, exploratory behavior (in hole cross and open field tests) and prolongation of thiopental induced sleeping time in mice; maximum effect was shown by chloroform (CFCB) and pet ether (PECB) fractions. In EPM test, chloroform (CFCB) and pet ether (PECB) fractions with similar doses significantly (p < 0.05) increased exploration to and time spent by the treated mice in EPM open arms in a way similar to that of diazepam while the effect of NBCB and HMCB fractions on entry to and time spent in open arms was not found to be statistically significant. These findings provide in vivo evidence that aerial parts of C. benghalensis in general, and chloroform (CFCB) and pet ether (PECB) soluble fraction has significant sedative and anxiolytic effects. Furthermore, these results may justify the scientific basis for the use of this plant in traditional medicine as a modality for anxiety and related disorders.

Hospital management of severely malnourished children: comparison of locally adapted protocol with WHO protocol

OBJECTIVES

To compare the effectiveness of locally adapted Institute of Child and Mother Health (ICMH) protocol with the WHO protocol for the management of severely malnourished children in Bangladesh.

DESIGN

Quasi-experimental non-randomized clinical trial.

SETTING

Hospital based.

PARTICIPANTS

Severely malnourished children (2-59 mo) with weight for height<70% (n=60).

INTERVENTION

Children treated with either WHO protocol (Group I, n=30) or ICMH protocol (Group II, n=30).

OUTCOME VARIABLES

Clinical improvement, weight gain, time taken to achieve target weight gain, and mortality among the study subjects.

RESULTS

Mean (SD) weight related to gain in Group I and Group II was 11.2 (4.1) and 11.1 (3.9) g/kg/day, respectively. The weight gain was not related to the age group or type of malnutrition. The time taken for edema to subside (7.3 d vs 8 d) and for improvement of appetite (6.5 d to 7.3 d vs 6.7 d to 8.4 d) was similar between the groups. The target weight gain was achieved in 28.3 (11.5) days in Group I against 27.9 (6.2) days in Group II (P=0.88). The mortality rate was 6.7% in each group.

CONCLUSION

Treatment of severe malnutrition with locally adapted ICMH protocol using locally available foods is as efficacious as the WHO protocol.

172 IDENTIFICATION OF MICRORNAS IN BOVINE OVARY

Tightly regulated expression and interaction of a multitude of genes for ovarian folliculogenesis leading to successful oocyte development could be regulated by recently identified new class of small RNAs of ~22 nt (i.e. microRNAs), which are already proved as one of the vital transcriptional regulators in different biological processes including development. But their presence and expression in bovine ovary has not yet been determined. Here, we have attempted to identify miRNAs in bovine ovary by small RNA-cDNA library construction through 5 ligation independent cloning. For this purpose, total RNA enriched with small RNA was isolated from ovary and size fractionated (18 to 24 nt) by denaturing PAGE. Extracted RNA was first 3′ linkered and after template switching by RT, the second 3′ linkering of the first strand cDNA was performed. These linkered small RNA-cDNAs were then amplified with linker-specific primers consisting of BAN I restriction sites, concatemerized by serial ligation, cloned into TOPO TA vector, and transformed into TOP 10 chemically competent cells. After screening, colonies were picked and sequenced. Bioinformatic analysis was done according to the published criteria for the small RNAs. From 233 clones a total of 479 reads were identified. Frequency of sequence length found in the library was 26.8% for ≤18 nt, 55.1% for 19 to 22 nt, and 18.1% for ≥23 nt. The total 479 sequences identified in the library represent 35% miRNAs, 12% mRNA, 12.1% rRNA, 5.6% tRNA, 4.2% repeat associated siRNA, 3.8% non-repeat-associated siRNA, 4% tiny noncoding RNA, 1% small nuclear RNA, and 16% sequences not matched to bovine genome. All 171 miR sequences comprised 79 distinct miRNAs, of which 45 miRNAs already annotated in miRBase for bovine and the other 34 miRNAs are new discoveries. Of the 34 newly identified miRNAs, 12 are described in other species but not yet in bovine. Most of the miRNAs cloned into multiple times, where let-7a cloned for 10, let-7b for 28, let-7c for 13, miR-21 for 4, miR-23b for 11, miR-24 for 7, miR-27a for 6, miR-126 for 4, and miR-143 for 11 times. Based on best hit score, P-value and free energy by online target prediction, some of the bta-miR identified in the library (let-7b, 15b, 18a, 23b, 101, 125b, 126, 140, 145, 199a) are found to target hundreds of genes related to follicular development, ovulation and hormonal regulation. Further functional characterization of some selected miRNAs including expression profiling and in situ localization in follicles of different size and cycles may supplement the results of this study and will enable us to gain insight into their relation to female fertility.

Histological variant of nephrotic syndrome with atypical presentation in children

Aims of the present study were to find out the histological pattern of atypically presenting nephrotic syndrome children and their response with oral corticosteroid therapy. This prospective study was carried out in the Paediatric Nephrology unit of Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, for a period of two years, from September 2001 to September 2003. Forty children with nephrotic syndrome with atypical presentations such as gross haematuria, renal impairment, hypertension and hypocomplementaemia were enrolled for the study. For each patient proper investigations were done to screen out infection and necessary treatment was given accordingly. Renal biopsy was done in all cases after treating infection and controlling hypertension and specimen were evaluated by light and immunofluorescence microscopy. All the patients were treated with oral prenisolone 60 mg/m2/day for 4 weeks and response were observed by heat coagulation test. In present study it was observed that mean age of presentation was 8.73+/-4.36 years. Hypertension, gross haematuria, impaired renal function and hypo-complementaemia were observed in 50%, 45%, 19% and 15% cases respectively. When histopathologies were considered, 90% cases had other than minimal change disease (MCD) and Mesangial proliferative glomerulonephritis (MesPGN) was the most common histopathology (47.5%). Regarding steroid therapy only 43.2% patients were responsive to oral prednisolone therapy within 28 days. Atypically presented nephrotic syndrome usually manifested with higher age of onset, gross haematuria, hypertension, renal insufficiency and hypocomplementaemia. Mesangial proliferative glomerulonephritis was the predominant histological type. The majority (56.8%) of these atypically presented nephrotic syndromes were resistant to steroid therapy.

A case of renal transplantation

A 12-year-old boy was admitted in paediatric nephrology unit of Bangabandhu Sheikh Mujib Medical University (BSMMU) with massive proteinuria, hypertension, respiratory distress and anaemia and diagnosed as nephrotic syndrome. Percutaneous needle biopsy was consistent with diffuse endocapillary proliferative glomerulonephritis and initially managed conservatively with injection methyl prednisolone, cyclophosphamide, lisinopril etc. without any improvement. Living-related renal transplantation was done successfully from paternal uncle. Two episodes of acute rejection occurred, one immediately after transplantation and another after one month. These were managed with IV methyl prednisolone for 3 days. At present, he is on oral prednisolone, cyclosporine, azathioprine and antihypertensives with normal haemoglobin and stable serum creatinine level (pre-transplant level 12.5mg/dl to post-transplant level 1.5mg/dl). He has been maintaining his normal life including schooling for last few months. It is concluded that a patient with uncommon presentation of nephrotic syndrome should be confirmed by renal biopsy and renal transplantation may be considered if conservative measures fail.

Urinary tract infection and vesicoureteric reflux in children

A retrospective study of 74 children with Urinary Tract Infection (UTI) were evaluated for the prevalence of vesicoureteric reflux (VUR) at a tertiary hospital in Dhaka, Bangladesh from 2003 to 2006. There were 45 (60%) girls and 29 (40%) boys; 58 (78%) were at an average age between 1-5 years, 11 (15%) were between 0-1 year and five (7%) were more than 5 years of age. All patients were documented to have UTI by history and laboratory investigations. There were 27 (36%) patients who had acute pyelonephritis at the initial clinical presentation and fourty seven (64%) patients had recurrent UTI. Thirty two (43%) patients had vesicoureteric reflux; fifteen (47%) had it bilaterally (VUR); and 13 (41%) had renal scarring. Five (7%) patients who had renal scarring were with- out reflux. Twenty three (72%) of the VUR patients had mild to moderate reflux (grade 1-3) and nine (28%) had severe reflux (grade 4-5). The age of the patients with VUR was below one year in 13 (40%), between 1 and 5 years in 17 (53%) and between 6 and 12 years 2 (7%) patients. There were 9 (33%) patients with acute pyelonephritis who had reflux. Follow-up of the VUR patients showed that reflux disappeared with out surgical intervention in 14 (44%), improved in three (9%) to lower grade and worsened in two (6%) to higher grade. Five (16%) patients underwent ureteral re-implantation; all the patient of VUR had recurrent UTI and were more than one year of age. While on chemoprophylaxis, two of the reimplanted patients developed break-through UTI. None of the study patients developed new scars, hypertension or renal failure during follow-up; the duration of follow-up was from 6 months to 3 years. Children with UTI below 6 years of age have high incidence of reflux and scarring with specially in patients with acute pyelonephritis.