Protection Effect of Vaxxitek HVT + IBD Vaccine Against Infectious Bursal Disease in Broiler Chickens

The very virulent infectious bursal disease virus (vvIBDV) infection cause constant and frequent outbreaks of IBD. In order to prevent the disease caused by vvIBDV, moderate-virulent live vaccines are usually used in broilers, but these vaccine influence the immune system of chickens and cause the immunosuppression. VAXXITEK® HVT+IBD bivalent vaccine, a novel vaccine produced by Merial Company, is the recombinant vaccine generated by inserting IBDV VP2 gene into the HVT genome. The recombinant vaccine could prevent Marek’s disease and IBD of chickens at the same time after vaccinated by the subcutaneous route at 1-day-old. The objective of this study was to evaluate protection effect of this new vaccine against IBD in broilers. The results of the lab and field immunization trial showed that the vaccination of VAXXITEK® HVT+IBD vaccine did not damage the bursa of broilers; the level of IBD antibody of the VAXXITEK® HVT+IBD vaccination groups was higher than IBD-BLEN® vaccination groups at 21-day-old; the protection effect of the VAXXITEK® HVT + IBD vaccination groups was better than IBD-BLEN® vaccination groups, especially at 21-28 day. The results indicated that VAXXITEK® HVT + IBD vaccine could provide better protection to broiler chickens against IBD.DOI: http://dx.doi.org/10.3329/pa.v24i1-2.19102 Progress. Agric. 24(1&2): 69 - 78, 2013

Clinical and haemato-pathological characteristics of adult acute lymphoblastic leukaemia

Acute lymphoblastic leukaemia (ALL) is a heterogeneous group of disorders. It varies with respect to the morphologic, cytogenetic, molecular and immunologic features of the neoplastic cells reflecting the variable clinical-pathologic presentations and outcome of the patients. The aim of the study was to observe the clinical and haemato-pathological characteristics in newly diagnosed adult ALL patients. A total number of 61 patients morphologically diagnosed as acute lymphoblastic leukaemia aged 15 and above assigned for this observational study. The study was carried out in the Department of Haematology, BSMMU from January 2007 to December 2008. Among 61 patients, aged 15 to 80 years with median age 25 years, 79% were male and 21% were female. Most of the patients presented with anaemia (67%), fever (66%), lymphadenopathy (64%) and splenomegaly (57%). Other common clinical findings were hepatomegaly (39%), bone tenderness (44%) and bleeding manifestations (34%). Among haemato-pathological findings 67% patients had Hb level ≤10gm/dl, 46% patients had WBC count ≥30×10⁹/L, 67% patients had platelet count ≤100×10⁹/L, 93% patients had blast in peripheral blood and 61% patients had ≥90 % blasts in the bone marrow at the time of diagnosis. In this study adult ALL patients were analyzed only for their clinical and haemato-pathological characteristics. But their biologic characteristics were not analyzed due to lack of availability of facility. A progressive understanding of the biologic and genetic characteristics of ALL will allow us to identify different prognostic subgroups with specific molecular and cellular features. All the necessary measures have to be developed in our country in order to identify prognostically distinct subgroups of patients.

Malignant paraganglioma: a case report

A paraganglioma is a rare tumour composed of chromaffin cells. The malignant paraganglioma is a very rare presentation, diagnosed by local recurrence after total resection of primary mass or findings of distant metastasis. Recurrent paraganglioma developed in a 60 years old lady 10 years after first surgical resection. This time the patient presented with neck swelling as well as with vertebral metastases. The patient underwent radiotherapy and symptomatic improvement was there. We present the case to emphasize the role of imaging in early diagnosis, avoidance of complications of advanced disease and to make awareness among the physicians.

Influenza and Respiratory Syncytial viral infections in Malaysia: Demographic and Clinical perspective

Objective: Respiratory infections represent a major public health problem worldwide. The study aimed to determine the prevalence of respiratory syncytial and influenza virus infections and analyzed in respect to demography and clinical perspective.

Methods: The specimens were processed by cell culture and immunofluorescent assay (IFA) and real-time reverse transcriptase-PCR (rRT-PCR) for detection of respiratory viruses.

Results: Out of 505 specimens 189 (37.8%) were positive, in which RSV was positive in 124(24.8%) cases and influenza A was positive in 65(13%) cases. Positive cases for influenza virus A and RSV were analyzed based on demography: age, gender, ethnicity and clinical symptoms. There were no significant differences among gender, ethnicity and clinical symptoms in both RSV and influenza A virus infections. It was observed that children below 3 years of ages were more prone to RSV infections. On the contrary, influenza virus A infected all age groups of humans.

Conclusion: RSV infects mostly child below 3 years of age and influenza virus infects all age group. No specificity of RSV and influenza infection in relation to demography.

Aspirin resistance in patients with acute coronary events: risk factors and prevalence as determined by whole blood multiple electrode aggregometry

Objectives: To determine the prevalence of aspirin resistance and associated risk factors based on biochemical parameters using whole blood multiple electrode aggregometry.

Methods:The study was conducted at the outpatients cardiology clinic of the Universiti Kebangsaan Malaysia Medical Centre (UKMMC) from August 2011 to February 2012.

Subjects on aspirin therapy were divided into two groups; first-ever coronary event and recurrent coronary event. Aspirin resistance was measured by a Multiplate^® platelet analyser.

Results: A total of 74 patients (63 male, 11 female), with a mean age of 57.93 ± 74.1years were enrolled in the study. The patients were divided into two groups –first-ever coronary event group (n=52) and recurrent coronary event group (n=22). Aspirin resistance was observed in 12 out of 74 (16%) of the study patients, which consisted of 11 patients from the first-ever coronary event group and one patient from the recurrent coronary event group. There were significant correlations between aspirin resistance and age (r = -0.627; p = 0.029), total cholesterol (r = 0.608; p = 0.036) and LDL (r = 0.694; p = 0.012). LDL was the main predictor for area under the curve (AUC) for aspirin resistance. However, there was no association between aspirin resistance and cardiovascular events in both groups in this study.

Conclusions: Aspirin resistance was observed in 16% of the study population. LDL was the major predictor of aspirin resistance. No association was found in the study between aspirin resistance with recurrent coronary events.

Current Status of Service Centers Serving Autism Spectrum Disorder in Dhaka City

DOI: http://dx.doi.org/10.3329/bjdre.v4i1.18011 Bangladesh Journal of Dental Research & Education Vol.4(1) 2014: 16-20

Surgical management of rectourethral fistula in different situations

This study was done to see the outcome of repair of rectourethral fistula (RUF) in different situations between 2002 and 2009 in Chittagong and Dhaka Medical College Hospitals. We prospectively reviewed the records of all the patients who developed rectourethral fistula. Total 18 patients were included and in all cases faecal and urinary diversion was done preoperatively. In 4 patients fistulas size was <1cm where spontaneous closure of RUF occured after 6 months of diversion. In 8 patients repair of fistula was done through the perineal approach where excision of fistulas tract with anastomotic urethroplasty and repair of rectal wound was done. Out of these 8 patients tunica vaginalis flap was applied in 3 and dartos pedicle flap in 5 cases, in the remaining 6 patients transrectal York-Mason repair was done. Out of 6 patients of York-Mason repair, one developed recurrent fistula - which underwent repair with a graft through the perineal approach later on with good result. No patient developed urinary or faecal incontinence. In 2 patients leakage of urine was noted in post operative days in the perineal wound and catheter was kept for 3 weeks more. No one had erectile dysfunction. Both faecal & urinary diversion adds benefit to the outcome of the rectourethral fistula. Transrectal York-Mason repair is easier to do with less morbidity and complication while perineal approach with graft interposition may be done in cases where anastomotic urethroplasty is needed along with fistula repair.

Effect of levodopa and carbidopa on non-motor symptoms and signs of Parkinson's disease

Parkinson's disease (PD) patient presents with both motor and non-motor symptoms. This was descriptive type of interventional study carried out in the department of Neurology, Mymensingh Medical College Hospital, Mymensingh, Bangladesh from January 2009 to December 2010. Among the total 59 cases, 51 completed the proposed five months follow up. The rest eight cases attended Neurology department irregularly and were ultimately dropout from follow up. The case selection technique was purposive type of non probability sampling. Each patient was treated with levodopa+carbidopa. Then the effect of levodopa+carbidopa on non-motor symptoms and signs were evaluated in subsequent five visits at four week interval. All relevant information and follow-up were recorded in a pre-designed individual case record form. Chi square test was done and probability value <0.05 were considered as level of significance with 95% confidence limit. Among the non-motor symptoms (NMS), the most frequent symptoms at base line visit were fatigue 56.8%, excessive sweating 54.9%, insomnia 54.9%, akathisia 47.1%, anxiety 45.1%, constipation 17.6%. After five months of levodopa+carbidopa therapy, frequencies of most of the NMS decreased slightly in comparison to base line symptoms but there were no significant effect of levodopa+carbidopa on NMS of study subjects.

A giant hepatic cyst

Liver cysts occur in approximately 5% of the population. However, only about 5% of these patients ever develop symptoms. In general, cysts are thin-walled structures that contain fluid. Most cysts are single, although some patients may have several. Here we report a case of a giant hepatic cyst in a 50 year old female who was admitted in our Hospital for right upper quadrant pain and abdominal lump. She was thoroughly investigated with ultrasonography, and computerized tomography scan of the abdomen along with other supportive investigations, and was diagnosed as having a 30×25cm cyst in the right lobe of the liver. Exploratory laparotomy and partial cystectomy with drainage & marsupialization were performed in the patient.

Neurologic manifestations, diagnosis and management of Wilson's disease in children - an update

Wilson's disease (WD) is a genetic disorder of copper (Cu) metabolism. It is a progressive hepatolenticular degenerative disease due to toxic accumulation of copper in the various tissues particularly in the liver, brain and eyes. The neurologic manifestations of Wilson's disease are extremely varied like simple behavioral change such as irritability, depression, deterioration of school performance to severe form of neurologic presentations like dystonia, dysarthria, tremor and gait disturbance. Early diagnosis is possible by history of progressive neurologic dysfunction, clinical examination of Kayser Flescher rings (K-F rings) in eyes, along with some important investigations like low serum ceruloplasmin, high 24 hours urinary excretion of copper, presence of basal ganglia lesion in neuro imaging of the brain. Though hepatic copper estimation done by liver biopsy is the gold standard, is not available in Bangladesh. Most of the neurodegenerative diseases have no specific treatment and worse outcome. But it has a specific treatment with life long medication that reduces copper absorption or removes the excess copper from the body. Children on therapy must be monitored regularly for response, side effects and compliance. The aim of this article is to gather update information of neurologic manifestations of Wilson's disease and proper management as well to prevent the major neurological complications and better out come.

Changing trends in incidence and indications of caesarean section

Caesarean section is most frequently performed major operation in obstetrics. The rate of caesarean section has been increasing both in developed and developing countries in the past decade. This study was done to find out the change of sociodemographic condition of respondents, identify the different types & rate of caesarean section indications, the outcome of different indications, estimate the rate of caesarean section proportion of the elective & emergency indications and evaluate the complications of caesarean sections. This is a cross-sectional study of randomly selected 130 cases of lower caesarean section done at Sir Salimullah Medical College & Mitford Hospital, Dhaka from March 2006 to August 2006. In this study 80(61.5%) cases underwent emergency caesarean section and in 50(38.5%) cases elective caesarean section had done. Among indications of caesarean section repeat section scores the top of the list. No maternal mortality case recorded in this study. This study shows high incidence of caesarean section which does not reflect the picture of total population of Bangladesh.

Campylobacteriosis - an overview

Campylobacteriosis is a collective term, used for infectious, emerging foodborne disease caused by Campylobacter species comprising Gram negative, curved, and microaerophilic pathogens. The true incidence of human campylobacteriosis is unknown for most countries of the world including Bangladesh. But campylobacteriosis is not uncommon in our country. Due to its increasing incidence in many countries of the world, it is an important issue now a day. Animals such as birds are the main sources of infection. Farm animals such as cattle, poultry are commonly infected from such sources and raw milk, undercooked or poorly handled meat becomes contaminated. Transmission of campylobacteriosis to human occurs through consumption of infected, unpasteurized animal milk and milk products, undercooked poultry and through contaminated drinking water. Contact with contaminated poultry, livestock or household pets, especially puppies, can also cause disease. Due to variability of clinical features and limited availability of laboratory facilities, the disease remains largely under-reported. Early and specific diagnosis is important to ensure a favourable outcome regarding this food borne disease. Antibiotic treatment is controversial, and has only a benefit on the duration of symptoms. Campylobacter infections can be prevented by some simple hygienic food handling practices.

Role of adenosine deaminase in diagnosis of tubercular pleural effusion

The diagnosis of pleural tuberculosis (TB) continues to be a challenge in clinical practice. Traditional diagnostic methods are very useful for the diagnosis of pulmonary TB but have a low yield when applied to pleural fluid. It is produced during the inflammatory process triggered by the M. tuberculosis. Usefulness of adenosine deaminase (ADA) estimation in pleural fluid has been shown as a reliable chemical bio-marker specially when there is suspicion of tuberculosis in endemic areas. ADA level was determined in the pleural fluid of 100 patients present with pleural effusion admitted at Mymensingh Medical College Hospital during the period of March 2012 to September 2012. ADA level was >40IU/L among the 52 tubercular pleural effusion patients with sensitivity & specificity is 100% and 66% respectively. Thus is evident that ADA level can be used along with conventional methods for diagnosis of pleural TB.

A case of mycotic aneurysm due to Burkholderia pseudomallei

Burkholderia pseudomallei is an free-living gram-negative bacterium causing melioidosis and is endemic in Southeast Asia. A 56-year-old diabetic construction worker with a 1-month history of abdominal pain and 1-day history of high-grade fever was found to have a left non-dissecting infrarenal mycotic aortic aneurysm by abdominal computerized tomography scan. Bacteriological examination of his blood yielded Burkholderia pseudomallei. The patient was treated with right axillo-bifemoral bypass with excision of aneurysm and high-dose intravenous ceftazidime for two weeks, followed by oral trimethoprim/sulfamethoxazole and oral doxycycline for a minimum of five months.

Anti-cyclic citrullinated peptide antibody is a good indicator for the diagnosis of rheumatoid arthritis

Objectives: Anti-cyclic citrullinated peptide (CCP) antibody has recently been used in the classification of rheumatoid arthritis (RA). This antibody is more specific than rheumatoid factor (RF) for the diagnosis of RA. The study objectives were to determine the sensitivity, specificity, positive and negative predictive values of anti-CCP in RA diagnosis.

Methodology: Eighty RA patients and 80 non-RA individuals were included in the study. Blood was collected from both arms of study subjects and tested for anti-CCP and RF antibodies. Relevant clinical information and laboratory profiles of the RA patients were evaluated using patients’ medical records and Integrated Laboratory Management System (ILMS), respectively.

Results: The sensitivity and specificity of anti-CCP were 35% and 100% respectively. The positive and negative predictive values were 100% and 61%, respectively. Positive anti-CCP was found significantly associated with multiple joint pain (p< 0.001) and hand’s joints pain (p=0.01), symmetrical joints involvement (p=0.015) and high CRP value (p<0.001). Anti-CCP was also found to have positive association with RF (p<0.001).

Conclusion: Anti-CCP is highly specific for the diagnosis of RA. High positive predictive value should be taken into consideration for effective treatment.

Hepatitis C genotype and associated risks factors of patients at University Kebangsaan Malaysia Medical Centre

Objectives: Hepatitis C virus (HCV) genotyping is important for treatment and epidemiological purposes. The objective was to determine HCV genotype and their associations with certain risk factors at University Kebangsaan Malaysia Medical Centre (UKMMC).

Methods: A total of 89 samples were collected from December 2009 to January 2011. Demographic data of patients were collected from medical record. Reverse Transcriptase Polymerase chain reaction (RT PCR) was performed and sixty-four samples yielded positive for HCV. Sequencing was performed and analyzed based on sequence information in GenBank. Statistical analysis were done using SPSS version 15.

Results: HCV genotype 3 (73%) was the most frequent genotype, followed by genotype 1(27%). The distribution of HCV genotype/ subtype was as follows: 3a (64.8%), 1a (13.5%), 1 (10.8%), 3 (8.1%) and 1b (2.7%).

Conclusions: HCV subtypes 3a, 1a, and 1b were identified in patients at UKMMC, Malaysia with subtype 3a being the most prevalent. No significant association was found between HCV genotypes and patients’ demographic data.

Clinical experience with BIAsp 30: Results from the Bangladesh cohort of the global A1chieve study

The aim of A1chieve was to remedy the deficit of data on the efficacy and safety of insulin analogues in routine clinical care in less well-resourced developed countries. To present results from the Bangladesh cohort of the A1chieve study receiving BIAsp 30 ± oral anti diabetic drugs. A1chieve was a 6-month, observational study of 66,726 people with type 2 diabetes, started on insulin detemir, insulin aspart or biphasic insulin aspart (BIAsp 30) in 28 countries across four continents. A total of 1,093 subjects were recruited from 49 sites in Bangladesh and 580 subjects initiated on BIAsp 30 were studied. In the entire cohort, treatment with BIAsp 30 for 24 weeks significantly reduced mean HbA(1c) (2.8%, p < 0.001), fasting plasma glucose (4.0 mmol/L, p < 0.001) and post prandial plasma glucose (6.6 mmol/L, p < 0.001) levels from baseline. The rate of overall hypoglycaemic events in the entire cohort also reduced significantly at 24 weeks (1.86 to 0.02 events/person year, p < 0.0001). BIAsp 30 can be considered as a safe and effective option for initiating as well as intensifying insulin therapy for type 2 diabetes.

Calcium score of coronary artery stratifies the risk of obstructive coronary artery diseases

BACKGROUND AND AIMS

Coronary heart disease is a major health problem in Malaysia with high morbidity and mortality. Common primary screening tool of cardiovascular risk stratification is exercise treadmill test (ETT). This communication is to determine the performance of coronary artery calcium score a new method to stratify the presence of obstructive coronary artery disease (CAD) in comparison to traditional ETT in patients having coronary artery diseases.

MATERIALS AND METHODS

Patients between 30 to 60 years old attended the ETT to screen for ischemic heart disease were recruited for Agatston coronary artery calcium score (CACS) of multi-sliced computed tomography (MSCT). Subsequently all patients underwent a full MSCT coronary angiography. The major determinant was the state of CAD whether obstructive (50% stenosis or more) or non-obstructive (less than 50% stenosis). All patients diagnosed with obstructive CAD on MSCT coronary angiogram were subjected to invasive coronary angiogram (ICA) to confirm the findings and planned the need for revascularization.

RESULTS

The CACS was 100% sensitivity and 97.5% specificity in detecting obstructive CAD at the optimal cut-off value of 106.5 and above. The positive predictive value (PPV) at CACS ≥ 106 was 71.4% and the negative predictive value (NPV) was consistent at 100%. Compare to ETT, the CACS discriminative value and diagnostic performance was much better (PPV 71.4% vs. 45.5%), respectively.

CONCLUSION

CACS can be a good diagnostic screening tool in patients suspected of CAD, and particularly within the non-diagnostic ETT subgroup with low to moderate cardiovascular risks.

Production and Export of Shrimp of Bangladesh : Problems and Prospects

A study on problems and prospects of shrimp production and marketing from Bangladesh on the basis of secondary information was carried out from July to October 08. Shrimp farming has emerged one of the important economic activities in Bangladesh and become the second largest export industry after garments. Shrimp aquaculture in coastal areas plays a major role providing employment, income and food security to remote coastal people where alternative livelihood options are limited. Shrimp culture system is extensive to improved extensive type with total production of 55000 mt of brackish water shrimp and 12000 mt of freshwater shrimp. In coastal Bangladesh, shrimp culture has led to many social and environmental problems. In export markets, shrimps are great but many challenges remain ahead because of increasing requirements of quality, food hygiene and development of technological and trade barriers in large shrimp markets in USA and EU countries. However, challenges lies with good aquaculture practice and competitive export, which are the effective tools for poverty alleviation and national development program for Bangladesh.DOI: http://dx.doi.org/10.3329/pa.v20i1-2.16868 Progress. Agric. 20(1 & 2): 163 – 171, 2009

Antibiotic and Herbal Sensitivity of Some Aeromonas sp. Isolates Collected from Diseased Carp Fishes

Studies were conducted to identify Aeromonas sp. isolates collected from disease affected carp fishes (Cyprinus carpio and Labeo rohita), their antibiotic sensitivity pattern and sensitivity to 121 herb extracts. A total of 19 Aeromonas sp. isolates were identified from a total of 84 different isolates through a series of physiological, morphological and biochemical tests. Seven antibiotics viz., streptomycin, chloramphenicol, erythromycin, sulphamethoxazole, cephradine, oxytetracycline and gentamycin were tested by disc diffusion method where all of the Aeromonas sp. isolates were found sensitive to streptomycin, erythromycin and gentamycin. But, 78.95% of the isolates were found resistant to oxytetracycline. In addition, 5%, 11%, and 16% isolates exhibited resistance to chloramphenicol, cephradine and sulphamethoxazole, respectively. Twenty one percent of the isolates showed multiple resistance to the antibiotics. A total of 121 herb extracts were evaluated for their sensitivity to the fish pathogenic Aeromonas sp. isolates. Among these, 23 herbs were found to possess antimicrobial activity. Leaf extracts of Eugenia caryophyllus, Spondias pinnata and Terminalia chebula were found to inhibit the growth of all the Aeromonas sp. isolates. In this study, multiple antibiotic resistant isolates were also found to be sensitive to several herb extracts. Thus, herbal treatment would promise a greater viable solution for effective treatment of fish disease.DOI:http://dx.doi.org/10.3329/pa.v21i1-2.16758 Progress. Agric. 21(1 & 2): 117 - 129, 2010

Cutaneous metastatic adenocarcinoma - a case report

Cutaneous metastases from carcinoma are relatively uncommon in clinical practice but they are very important to recognize. Cutaneous metastases may herald the diagnoses, can lead to accurate diagnoses and timely treatment. A high index of suspicion is required because the clinical finding may be subtle. The patient of cutaneous metastases may present with rapidly developing nodules or tumors. Although asymptomatic in most instances, Pain and tenderness may be noted. Here we described a 38 year old male who presented with fever, anorexia, weight loss and multiple painful nodules, plaques and tumors on his scalp, face, upper trunk and proximal portion of the upper limbs. This case present with cutaneous metastatic adenocarcinoma with atypical presentation and detection of cutaneous metastasis before primary tumor detection.

Live worm in gallbladder: a case report

Ascariasis, the most common helminthic infection is caused by ascaris lumbricoides. Usually the adult worm lives in the small intestine. Rarely it migrates through the papilla of vater and may enter the common bile duct. We are reporting a case of live worm in gall bladder. Presence of Ascaris lumbricoides in gallbladder is rare entity as it is difficult to reach there due to narrow and tortuous cystic duct.

Changes in lipid profile of postmenopausal women

The study reveals that menopause leads to changes in hormonal status, metabolism and lipid profile. Since there is an increased risk of cardiovascular diseases for women after menopause, the present study is aimed at comparing the changes of serum lipid profile in premenopausal women with that of their postmenopausal counterparts. This is to enable us ascertain the relative risk of developing cardiovascular disease in postmenopausal women in Bangladesh. One hundred and eighteen (118) apparently healthy females (59 premenopausal = control and 59 postmenopausal = case) were selected for the study. The case-control cross-sectional study was carried out in the Department of Biochemistry, Mymensingh Medical College in cooperation with the Department of Gynaecology, Mymensingh Medical College Hospital and Community Based Medical College, Bangladesh during the period from January 2009 to December 2009. Data were collected through clinical evaluation from pre selected questionnaires and fasting blood samples were taken for laboratory investigations. Serum total cholesterol and their sub fractions- high-density lipoproteins (HDL), low-density lipoproteins (LDL) and triglycerides (TG) were measured by autoanalyzer using enzymatic and established mathematical methods. Statistical significance of difference between two groups were evaluated by using unpaired 't' test with the help of SPSS software package. The results showed statistically significant increase in total cholesterol and LDL cholesterol (p<0.001) of menopausal women compared to reproductive age group. The postmenopausal women had higher but non-significant (p=0.675) concentrations of triglycerides than the premenopausal women with regular menstruation. However, a significant reduction of HDL was present in the postmenopausal group (p<0.001) than the premenopausal group. Therefore, it can be concluded that menopause leads to changes in lipid profile by increasing total and LDL cholesterol and by reducing HDL cholesterol. The elevated LDL and the reduction of cardio protective HDL is an indication that menopause is an independent risk factor for developing cardiovascular disease in Bangladesh.

Placental changes in pregnancy induced hypertension

A descriptive cross sectional study was carried out in Gynae and Obstetrics & Pathology department of Mymensingh Medical College Hospital (MMCH) to see the placental changes in normal pregnant & pregnancy induced hypertensive (PIH) mother. Total 80 placentas were collected, 40 from normal pregnant mothers having no hypertension and 40 from PIH group (one from gestational hypertension, 17 from pre-eclampsia and 22 from eclamptic mother). Macroscopic study of the placenta revealed placental weight, surface area and number of cotyledons were less in study group. Mean placental weight in study group was 419.50gm and in control group was 477.50gm (p<0.001). Mean surface area in study group & control group were 232.29cm² and 304.80cm² respectively (p<0.001). Mean number of cotyledons were 15.39 and 17.40 in study & control group respectively (p<0.001) and lower diameter of umbilical cord p<0.04667. But in the present study placental thickness was not significant p<0.539. In PIH group, macroscopic infractions were more marked. There was a single umbilical artery present in one patient in PIH group. In PIH group syncytial knots (95%), fibrinoid necrosis (80%), VSM formation, sclerosis, chorangiosis and calcification were more marked. Infarction was present in placenta of PIH 34(85%) and in control group 8(20%). Common placental changes were significant in this study. So, early intervention in PIH is rational to get the good perinatal morbidity and mortality.

Effect of Heat Stress on Behavior, Physiological and Blood Parameters of Goat

The research was conducted to study the effect of heat stress on behavior, some physiological and blood parameters with nine goats of almost similar in age, sex and weight into three groups. Three groups were divided as zero hour (T0), four hours (T4) and eight hours (T8) heat exposure. Temperature–humidity index (THI) value was calculated as 28.17 which indicate the experimental animals were in extreme severe heat stress. Skin and rectal temperature had no significant differences among the treatment groups but respiration/panting and pulse rate were increased with the increased of heat stress from T0 to T8 group (P<0.01).  Significant difference was found in standing time and lying time (P<0.01) in experimental groups. There were significant changes (P<0.01) in number of urination and defecation per hour but no significant changes was found in duration per urination in heat treated groups. The amount of RBC, PCV%, Hb%, WBC were increased with the increased of heat stress (P<0.01). Neutrophil, eosinophil, lymphocyte and monocyte numbers increased significantly (P<0.01) in heat treated groups.  It can be concluded that heat stress had significant changes on some behavioral, physiological and blood parameters of goat.DOI: http://dx.doi.org/10.3329/pa.v22i1-2.16465 Progress. Agric. 22(1 & 2): 37 - 45, 2011  

Helicobacter pylori: molecular detection of vacA gene and vacuolating activity in human gastric adenocarcinoma cells

BACKGROUND AND AIMS

Helicobacter pylori strains secrete a vacuolating cytotoxin (VacA), plays an important role for the development of peptic ulcer disease and gastro-duodenal diseases. vacA gene is responsible to regulate the activity of the vacuolating cytotoxin. The objective of this study was molecular detection of vacA gene and observes the vacuolating activity on human gastric adenocarcinoma (AGS) cells.

MATERIALS AND METHODS

H. pylori vacA gene was determined by polymerase chain reaction. Vacuolation activity of VacA toxin in broth culture filtrates was assessed in AGS cells and quantified by neutral uptake assay. Different concentration dosages of VacA and incubation time were used in the measurement of the vacuolating activity on AGS cells.

RESULTS

The results showed that VacA toxin could stimulate vacuolating activity on AGS cells with minimum concentration 1.0 μg/ml from both of s1m1 and s1m2 alleles (vacA gene). The toxin produced optimal reaction at 5.0 μg/ml with significant differences observed between the alleles. The results also showed that both alleles commenced the vacuolating activity at the minimum of 3 hr incubation time, and the activity showed in time-dependent manner.

CONCLUSION

Optimal concentration of VacA toxin (s1m1 allele) causes more interaction with AGS cell producing more vacuolating activities. Time-dependent vaculation of both alleles might allow H. pylori for persistent infection without rapid destruction of gastric cells might promote gastro-duodenal diseases. The study provided us better understanding of the pathogenesis of the diseases associated with H. pylori infection which is an emerging problem in developing countries.

Clinical Profile of Acute Respiratory Infection (ARI) in Children

Bangladesh Journal of Medical Science Vol.1(4) 1994 pp.6-14

Etiological pattern of demented patients attending in a tertiary hospital

This is a cross sectional study where 125 demented patients were enrolled who attended in neurology department of Bangabandhu Sheikh Mujib Medical University (BSMMU) Hospital. The purpose of the study was to find out the etiology of dementia. Dementia was diagnosed by the criteria indicated by Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV and confirmed by Mini Mental State Examination (MMSE) score. Diagnosis of specific type of dementia was made on the basis of established criteria. The most common etiological factor was post stroke dementia (PSDE) (36%) followed by Alzheimer's disease (AD) (14.4%), multi infarct dementia (MID) (8%), Mixed AD and PSDE (6.4%), vitamin B₁₂ deficiency (4.8%) etc. Vascular dementia is the most common etiological factor. Next to this is the Alzheimer disease. This study will provide baseline information regarding the types of dementia occurring in Bangladeshi population and will be the basis of planning health program and data for future research.

Detection of TEM, SHV and CTX-M in Mymensingh region in Bangladesh

The development of antibiotic resistance in bacteria following introduction of antimicrobial agents has emerged as an important medical problem everywhere in the world including Bangladesh. Extended spectrum β-lactamases (ESBLs) are rapidly evolving group of β-lactamase enzymes produced by the Gram negative bacteria. This study was undertaken to characterize ESBL producing gram negative bacilli from urine, skin wound (pus and wound infection). A total of 300 gram negative bacilli were screened for resistance to third generation Cephalosporins (3GCs) by disc diffusion test. The ESBL status was confirmed by double disc diffusion test (DDDT), minimum inhibitory concentration (MIC) by agar dilution method as recommended by Clinical Laboratory Standard Institute 2010 (CLSI) and multiplex PCR for TEM, SHV and CTX-M, CTX-M-3, CTX-M-14 genes. The present study revealed a higher occurrence of multi drugs resistant ESBLs production among gram negative isolates where Klebsiella spp. were the leading bacteria 36/45 (80%), followed by Proteus spp. 40/55 (72.7%), Esch. coli 105/156 (67.3%) and others 25/35 (71.4 %). Rate of TEM, SHV and CTX-M genes present in study population were 50.46%, 18.69% and 46.72% respectively. Among the CTX-M positive genes CTX-M-3 and CTX-M-14 were 78.0% (39/50) and 80.0% (40/50) respectively. Results indicate that routine ESBL detection should be made mandatory and irrational use of third generation cephalosporins must be discouraged to reduce multi drugs resistance bacteria, to increase patients' compliance and to make an antibiotic policy.

Comparative efficacy of subcutaneous versus oral methotrexate in active rheumatoid arthritis

This prospective study was conducted in rheumatology clinic under the department of medicine of Bangabandhu Sheikh Mujib Medical University from December 2004 to December 2005 to asses the efficacy, safety and compliance of subcutaneous methotrexate (MTX) in active rheumatoid arthritis (RA) patients. A total of 92 active rheumatoid arthritis patients according to American College of Rheumatology (ACR) criteria were recruited for the trial for six months. Among them 46 cases belonged to injectable MTX group and 46 cases belonged to oral MTX group. Mean±SD age of patients was 45.54±12.42 vs. 44.63±13.99 years in subcutaneous group and oral group respectively. In the subcutaneous group 41 were female and 5 male; in the oral group 34 were female and 12 male. Mean duration of the disease was 49.74 months in subcutaneous group and 49 months in oral group. RA test was positive in 35 cases in both groups whereas Rose Waaler test was positive in 19 patients in subcutaneous group and 14 patients in oral group. At 24 week, response rate of ACR 20 was significantly higher in subcutaneous MTX than oral MTX group (93% vs. 80%, p=0.02). Similarly ACR 50 response was significantly higher in subcutaneous MTX than in oral group (89% vs. 72%, p=0.03). ACR 70 response was not significantly higher in SCMTX group then oral group (11% vs. 9 %, p=0.72). Adverse effects were relatively less in subcutaneous MTX and most common side effects were nausea (37% vs. 63%), vomiting (11% vs. 30%), dyspepsia (29% vs. 48%), dizziness (4l% vs. 52%) and alopecia (72% vs. 85%). The results of the study demonstrated that subcutaneous MTX was significantly more effective than oral MTX at the same dosage in active Rheumatoid arthritis patients with no increase in side effects.

Sexual and urinary outcome after surgical treatment for low rectal cancer

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

An unusual foreign body in the urinary bladder

In the urinary tract, foreign body is most commonly found in the urinary bladder. Most foreign bodies in the lower urinary tract are self-inserted via urethra as a result of exotic impulses, psychiatric illness, sexual curiosity, or sexual practice while intoxicated. Various types of foreign bodies have been reported such as wire, screw, fish, thermometer, or animal such as snake. Here we report a case of 22 years men who gave the history of self insertion of a large saline set both ends are cut. Diagnosis can be made by proper history taking, clinical examination, and relevant investigation. The treatment of foreign bodies is determined by their size, location, shape, and mobility. In most cases endoscopic management is appropriate but sometimes open procedure is required. Our case with an unusual foreign body admitted in general hospital Jamalpur for better management and subsequently foreign body was removed by suprapubic cystostomy.

Morphometric study of thyroid angle in different age and sex in Bangladeshi cadaver

This cross sectional descriptive study was to measure the thyroid angle and to establish the difference between sexes of different age groups in Bangladeshi cadaver. A total 60 human larynges were collected by purposive sampling from October 2008 to March 2009. Among them 45(male 23 and female 22) were collected from Bangladeshi cadavers (9 to 60 years) at the autopsy laboratory of Department of Forensic Medicine and 15 (male 6 and female 9) from stillborn infants of viable age (28 to 40 weeks of gestation) from Gynaecology and Obstetrics Department of Mymensingh Medical College, Mymensingh. The thyroid angle was measured and significant differences of the dimensions between different age and sex groups were observed. In the present study observed findings was compared with those of other researchers. The mean±SD thyroid angle was found as 65.00±11.65 degree in age Group A (28 to 40 weeks of gestation), 73.69±6.56 degree in age Group B (9 to 16 years) and 77.76±7.76 degree in age Group C (17 to 60 years). The mean thyroid angle was higher in female (83.1667±5.78220 degree) than that in male (73.9412±7.09460 degree) and statistically moderately significant in Group C, where t = 3.853 and p = 0.001. In statistical analysis, differences between age and sex groups were calculated by using Students (unpaired) 't' test. The present study revealed that the value was significantly greater in adult female than male and the value increased with age.

Effect of CeO₂ addition to Al₂O₃ supports for Pt catalysts on the aqueous-phase reforming of glycerol

A series of Pt catalysts supported on Al₂O₃ that was doped with different amounts of CeO₂ was developed, characterized, and tested in the aqueous-phase reforming (APR) of glycerol to H₂. Catalyst 3Pt/3CeAl, which bore 3 wt% Pt on a support that contained 3 wt % CeO₂, showed the highest carbon conversion to gas (85%) and the highest H₂ yield (80%) for a feedstock of 1 wt% glycerol in water at 240 °C and 40 bar. A CeO₂/Al₂O₃ support with only 1 wt% Pt also showed high H₂ selectivity and carbon conversion to gas, as well as a much lower CH₄ yield than the benchmark 3Pt/Al catalyst, clearly demonstrating that doping the support with 3 wt% CeO2 improved the APR of glycerol. H₂ chemisorption results showed that the highest metal dispersion (58%) and active surface area (4.3 m(2)g(-1)) were achieved for the support that contained 3 wt% CeO₂, and this effect appeared to be primarily responsible for the high H₂ yield and carbon conversion to gas. No CO was observed in the product gas; therefore, this gas could potentially be used directly in proton exchange membrane fuel cells. Thus, including CeO₂ in the Al₂O₃ catalyst support enhanced both the activity and selectivity towards H₂ of a Pt catalyst for the APR of glycerol.

Solvatochromic And Fluorescence Spectroscopic Studies On Polarity Of Ionic Liquid And Ionic Liquid-Based Binary Systems

Polarity behavior of a hydrophobic ionic liquid (IL) 1-ethyl-3-methylimidazolium bis(trifluoromethyl)sulphonylimide [EMI][TFSI] and binary mixtures of [EMI][TFSI] with ethanol, acetone and dichloromethane was investigated by solvatochromic method using Reichardt’s betaine dye. Fluorescence spectroscopic method using pyrene as a probe was also used for estimation of polarity of [EMI][TFSI] and [EMI][TFSI]-based binary systems. The binary mixtures of [EMI][TFSI] with the molecular solvents interestingly showed increase in polarity with increasing [EMI][TFSI] for all compositions. The comparative and contrastive features of the results of two methods have been discussed to judge relative merit of one method over the other. Both of the methods collectively provided information to correlate specific interaction of the IL with molecular solvents and define polarity behavior. Journal of Bangladesh Chemical Society, Vol. 25(2), 146-158, 2012 DOI: http://dx.doi.org/10.3329/jbcs.v25i2.15067

Nutritional Indicators for Postoperative Morbidity in Elective Oncological Surgery

Objective: This study was to establish the nutritional risk factors for morbidity following cancer surgery to reduce the incidence of related postoperative complications. Therefore this study was undertaken to assess the morbidity and to identify nutritional risk factors following cancer surgery in Bangladeshi population. Method: This cross-sectional observational study included 312 patients with malignancy who were waiting for surgery or within 60 days of postoperative period were enrolled for the study from indoor of surgical oncology department, NICR&H. Then the patients were submitted for further study to evaluate the preoperative fitness in terms of nutrition assessment – both clinical and biological. All the clinical (pre & post-operative including complication, if any), investigation findings were recorded accordingly. Results: Statistical correlation was discovered between BMI and morbidity but no statistical correlation was found between WL >10% and major surgical complications of either infectious or noninfectious origin (p = NS). No statistically significant correlation was found between nutritional condition or oedema and surgical morbidity. Conversely, a substantial statistical correlation was found between skin thickness or Hb% or albumin <30 g/l and major surgical complications (either infectious or noninfectious) (p= S). Conclusion: The best nutritional factor for detecting the risk of MC is albumin levels below 30 g/l. DOI: http://dx.doi.org/10.3329/jss.v16i1.14441 Journal of Surgical Sciences (2012) Vol. 16 (1) : 3-10

Primary closure of the Urinary Bladder, Urethra and Anterior Abdomen of Classical and Cloacal 39 Exstrophy - A Preliminary Experience of Three Consecutive Cases

A 4 years old female and 1.5 months old male with classical exstrophy and a 2 days old male child with cloacal exstrophy were admitted in Paediatric Surgery Department of Sher-e-Bangla Medical College Hospital (SBMCH), Barisal. The mothers of all children had complaints of protrusion of fleshy mass in lower abdomen from birth. They always remain wet producing smell of urine. The cloacal exstrophy case had a prolapsed ileum that was discharging stool. He had no anus too. All of the cases underwent one stage closure of urinary bladder and urethra and lower abdomen without osteotomy and patient was discharged. After 8 months of first operation the female patient underwent repair of the wound dehiscence. At the time of discharge her urinary bladder capacity was 10 ml and remained dry for 5 minute after manual evacuation. The male patient with classical exstrophy developed urethrocutaneous fistula on 15th post-operative day. The cloacal exstrophy case was discharged with end ileostomy on 10th post-operative day. DOI: http://dx.doi.org/10.3329/jss.v16i1.14447 Journal of Surgical Sciences (2012) Vol. 16 (1) : 39-43

Effects of nitrogen and potassium on growth and yield of gladiolus corms

A study was conducted at the Floriculture Research Field of Horticulture Research Centre of Bangladesh Agricultural Research Institute (BARI) during the period from November 2006 to May 2008 to determine the optimum rate of N and K for better growth and yield of corm and cormel of gladiolus. The treatment combination N150 K200 kg/ha produced the longest plant (42.1 cm), the broadest leaf (1.93 cm), the maximum percentage of spikes (88.1%), and corm (97.6%), the heaviest and the largest corm (19.5 g and 4.11 cm, respectively), cent percent flowering sized corm, and the highest corm number and cormel yield (1,20,000 and 1.66 t/ha, respectively). The corm produced from this treatment combination also showed better performances in the next year in respect of plant emergence (100%), florets/spike (13.1), spike and rachis length (82.2 cm and 45.4 cm, respectively), flower stick weight (57.1 g) and percentage of flower sticks (113%). DOI: http://dx.doi.org/10.3329/bjar.v37i4.14385 Bangladesh J. Agril. Res. 37(4): 607-616, December 2012

Effect of seasonal variations on jackfruit trunk borer (Batocera rufomaculata De Geer) infestation

The study of seasonal influence on incidence of trunk borer infestation was undertaken during 2010 at Kapasia upazila under district of Gazipur, Bangladesh. The borer was found in orchard from June to September with a peak emergence in mid July. The larval population of Jackfruit trunk borer is the destructive pest stage, which evokes concern in jackfruit growing areas of Bangladesh. The highest percentage of infestation was in July (7.33%) followed by June and August (6.00%). The cumulative infestation over the year in the study area was 35.33% in October. The lowest infestation was observed in February (0.67%) whereas no activity was found during November to January. The incidence of infestation of trunk borer was influenced by temperature, rainfall and relative humidity due to seasonal variations and their contribution of the regression (R2) were 63, 65 and 31%, respectively. Five independent weather factors in stepwise regression equation pooled responsible for 67.4% of the total variance. Stepwise regression showed that maximum temperature was the most important to influence 35.3% and the influence was lowest (2.1%) in case of average rainfall.

Pattern of cutaneous tuberculosis among children and adolescent

Cutaneous tuberculosis is one of the most subtle and difficult diagnoses for dermatologists practicing in developing countries. It has widely varied manifestations and it is important to know the spectrum of manifestations in children and adolescent. Sixty cases (age<19 years) of cutaneous tuberculosis were included in this one period study. The diagnosis was based on clinical examination, tuberculin reaction, histopathology, and response to antitubercular therapy. Histopahology revealed 38.3% had skin tuberculosis and 61.7% had diseases other than tuberculosis. Among 23 histopathologically proved cutaneous tuberculosis, 47.8% had scrofuloderma, 34.8% had lupus vulgaris and 17.4% had tuberculosis verrucosa cutis (TVC). Most common site for scrofuloderma lesions was neck and that for lupus vulgaris and TVC was lower limb. Cutaneous tuberculosis in children continues to be an important cause of morbidity, there is a high likelihood of internal involvement, especially in patients with scrofuloderma. A search is required for more sensitive, economic diagnostic tools. DOI: http://dx.doi.org/10.3329/bmrcb.v38i3.14335 Bangladesh Med Res Counc Bull 2012; 38(3): 94-97 (December)

Comparison of genes as target for molecular diagnosis of peste des petits ruminants in goats

Peste des petits ruminants (PPR) are an acute viral disease of sheep and goats. Rapid and accurate diagnosis is essential for successful control. Reverse transcriptase polymerase chain reaction (RT-PCR), a molecular diagnostic test based on amplification of the gene target is more sensitive than other tests. The study was to find an efficient primer set and structural gene, which would be more specific and sensitive for detecting PPR virus (PPRV) in field samples. Six primer sets for six structural genes of PPR were used. Primer against NP gene (np3/np4) was specific and sensitive. To ensure efficient amplification and detection of viruses in field samples, more than one set of primers should be used and F and N gene specific primers were the most suitable. DOI: http://dx.doi.org/10.3329/bvet.v29i2.14343 Bangl. vet. 2012. Vol. 29, No. 2, 56-62

Effects of Nishyinda, black pepper and cinnamon extract as growth promoter in broilers

An extract of nishyinda (Vitex negundo) leaves, black pepper (Piper nigrum) and cinnamon (Cinnamomum verum) (polyherbal extract) were used as growth promoter in broilers. A total of 20 day-old broiler chicks were purchased and after seven days of acclimatization randomly divided into two equal groups. No vaccination schedule was practised and no antibiotics were added in rations. Group A served as control while group B was supplemented with polyherbal extract 1 mL/litre in drinking water. Weekly body weight gain up to six weeks was measured and blood tests were performed at 21 and 42 days. Polyherbal extract significantly (P<0.05) improved weight gain. There was no change in haematological parameters. It can be concluded that the polyherbal extract was safe as a growth promoter in broiler production without adverse effects on chicken health. DOI: http://dx.doi.org/10.3329/bvet.v29i2.14345 Bangl. vet. 2012. Vol. 29, No. 2, 69-77

Evaluation of adenosine deaminase activity for diagnosis of tuberculous pleural effusion

Background: Tuberculosis is a leading cause of worldwide preventable morbidity and mortality from an infectious agent. A defi nite diagnosis of tubercular pleural effusion can be diffi cult to make because of low sensitivity and/or specifi city of noninvasive traditional diagnostic tools. This study is done to fi nd out a sensitive and specifi c marker for early diagnosis of tuberculous pleural effusion. Materials and Methods: One hundred and three pleural effusion cases were enrolled in the study, out of which 62 were tuberculous pleural effusion cases and 49 were non-tuberculous cases. Results: Considering 40 U/L as a cut off value for Adenosine deaminase assay level, the test result was positive in 58 out of 62 patients of tuberculosis indicating sensitivity of the test as 94%; however, among 41 non-tuberculous patients, 5 presented ADA activity level more than 40U/L, which lowers the specifi city of the test to 88%. ADA levels were signifi cantly higher in tuberculous than in non tuberculous cases (P value <0.001). Conclusion: It may be concluded that ADA levels are signifi cantly high in patients with tuberculous pleural effusion compared to that in non tuberculous group. Sensitivity (94%) and specifi city (88%) of the test in tuberculous pleural effusions are very high, when cut off value set at 40U/L. The result indicated that the analysis of ADA levels in pleural effusion constitute a very useful marker for the diagnosis of TPE which, in addition, can be made quickly in a non- invasive way. Journal of Pathology of Nepal (2013) Vol. 3, No.1, Issue 5, 367-373 DOI: http://dx.doi.org/10.3126/jpn.v3i5.7860

Histomorphological study of germinal centre of vermiform appendix in Bangladeshi cadaver

The study was done to find out the number of germinal centre in human vermiform appendix of Bangladeshi people to magnify the knowledge regarding the diverse number of germinal centre of human vermiform appendix in our population in the department of Anatomy, Mymensingh Medical College, Bangladesh from July 2006 to June 2007. Total 40 appendices were collected for histological study of different age and sex during postmortem examination in the autopsy laboratory of department of Forensic Medicine, Mymensingh Medical College. This cross sectional study was done by convenient sampling technique. For convenience of differentiating the changes in number of germinal centre of vermiform appendix in relation to age and sex, findings were classified in four groups, Group A up to 20 years, Group B 21-35 years, Group C 36-55 years and Group D 56-70 years. In the present study the number of germinal centre was highest in Group B (52.38%) but in Group D it was nil. Here mean number of germinal centre in male (1.05) were more than in female (0.8).

Wilson's disease in children with blindness: an atypical presentation

Wilson's disease (WD) is an autosomal recessive disease affecting copper metabolism causing copper induced organ damage. Common organs involved are liver and central nervous system. But RBC, eye, kidneys and bone may also be affected. In WD main defect remains in copper transporter protein p type ATPase resulting from gene mutation in chromosome 13. Neurological manifestations in WD develop due to deposition of copper in different brain areas like basal ganglia, cerebral cortex, corticospinal and corticobulbar pathway. Different types of neurological manifestations develop in WD but visual impairment is very rare. A 14 years old boy of WD presented to us with blindness, tremor and slurred speech along with end stage liver disease. Blindness was thought to be due to optic neuropathy which reversed after drug treatment.

Outcome of adult acute lymphoblastic leukaemia following induction chemotherapy with modified MRC UKALL XII/ECOG E2993 protocol

Cure rates for adult acute lymphoblastic leukaemia (ALL) in developing countries are significantly lower because of problems unique to these countries. Recent studies have reported complete response rates for any induction regimen of more than 90% in adult ALL patients. This study was conducted to evaluate the response rate of induction chemotherapy in adult ALL patients in the Department of Haematology, Bangabandhu Sheikh Mujib Medical University, from January 2007 to December 2008. In this observational study, 35 newly diagnosed ALL patients classified either as L1/L2 according to French-American-British (FAB) classification, aged between 15 to 60 years were assigned for induction therapy with modified MRC UKALL XII/ECOG E2993 protocol. But ultimately 30 patients completed therapy and available for statistical analysis. Among the studied 30 cases 12(40%) patients after phase 1 and overall 24 (80%) patients after phase 2 induction therapy, achieved morphologic complete remission (CR). After phase 2 therapy 6 (20%) patients fell in the group of non responders (NR) as the blast percentage was > or = 5% at the time of bone marrow evaluation. This study shows the response rates in adult ALL with induction therapy slightly below the anticipated response rates of developed countries which may be due to little modification of the original protocol.

Plasma total homocysteine is not associated with peripheral neuropathy in a groups Bangladeshi type 2 diabetic subjects

Aims: The present study was undertaken to explore the relationship of plasma homocysteine in the pathogenesis of neuropathy in diabetic patients.Subjects and Methods: Forty two type 2 diabetic patients [22 with neuropathy (DN group) and 20 without neuropathy (DNN group)], age range between 35-70 years had relatively controlled glycemia and duration of diabetes 7-15 years, were studied. Motor and sensory nerve conduction velocities and action potential amplitudes of peripheral nerves were determined by following standard protocol. HbA1c was estimated by modified HPLC (BIO-RAD Variant, USA). Serum C-peptide was measured by enzyme linked immunosorbentassay (ELISA), plasma total homocysteine by Fluorescent Polarization Immunoassay (FPIA). Results: Age, BMI and blood pressure of the study subjects were. Duration of diabetes between DN and DNN groups was comparable. DN group had significantly higher fasting glucose levels (9.8±3.8, mmol/l) compared to the DNN group (6.9±1.8, p=0.004). This trend was also reflected in the HbA1c level: 8.7± 2.1 vs 7.2±1.6 in DN group and DNN group respectively (p=0.009). The two diabetic groups had relatively higher absolute C-peptide level compared to the controls (p=ns). DN and DNN groups had significantly higher plasma homocysteine level compared to the Controls. But between the two diabetic groups no significant difference was observed. Ulnar and peroneal motor nerve conduction velocities and compound muscle action potentials in the diabetic neuropathy group significantly lower compared to diabetic counterpart and the controls. Ulnar and sural sensory nerve conduction velocities and action potentials were significantly lower in the diabetic neuropathy group compared to the diabetic counterpart and the controls. Plasma homocysteine did not show any correlation with nerve conduction velocities  and action potential amplitudes.Conclusions: The data concluded that (i) Diabetic neuropathy may not  be related to hyperhomocysteinemia in type 2 diabetic patients of Bangladeshi origin; (ii) Hyperglycemia, even at milder level, is related to neuronal dysfunction in these subjects; and (ii) Hyperinsulinemia don't seem to be prerequisite for neuropathy in these subjects. DOI: http://dx.doi.org/10.3329/bjms.v11i4.12607 Bangladesh Journal of Medical Science Vol. 11 No. 04 Oct’12  

Factors affecting the first service conception rate of cows in smallholder dairy farms in Bangladesh

The successful outcome of an insemination is a combination of both male and female fertility-linked factors. We investigated the first service conception rate of cows at artificial insemination (AI) in the smallholder dairy farms in Bangladesh. Frozen straws were prepared from ejaculates of Bos indicus (n = 7) and Bos indicus × Bos taurus (n = 7) AI bulls. Fertility was determined from 6101 first services in cows that were performed by 18 technicians in four regions between April 2004 and March 2005. Pregnancy was diagnosed by rectal palpation between 60 and 90 days post-insemination. The Asian version of Artificial Insemination Database Application (AIDA ASIA) was used for bulls-, cows- and AI-related data recording, and later retrieved for analysis. The mean ± SD number of inseminations performed from individual bulls and their conception rates were 436.0 ± 21.6 and 50.7 ± 1.9%, respectively. Logistic regression demonstrated body condition scores (BCS), heat detection signs, months of AI and their interactions had greatest effects (odds ratios: 1.24-16.65, p < 0.04-0.001) on first service conception rate in cows. Fertility differed (p < 0.02-0.001) between the regions, previous calving months, months of AI, BCS, parity and heat detection signs of cows. Inseminations based on mounting activity (n = 2352), genital discharge (n = 3263) and restlessness and/or other signs (n = 486) yielded a conception rate of 53.6%, 48.8% and 50.1%, respectively (p < 0.05). Conception rate between technicians ranged between 43.4% and 58.6% (p < 0.05). The days interval from calving to first service (overall mean ± SD = 153.4 ± 80.6) had relationship (p < 0.001) with BCS, months of previous calving and parity of the cows. Fertility at AI in smallholder farms can be improved by training farmers on nutrition and reproductive management of the cows.