Glycaemic Status of Asthma Patients Using Inhaled Fluticasone

Inhaled fluticasone is used in asthma for long duration. However, it's adverse effect on glycaemia is debatable. This study observed the outcome of inhaled fluticasone in asthma patients. A cross sectional comparative study was conducted among the normoglycaemic asthma patients aged 18 years and above attending outpatient department of Internal Medicine and Respiratory Medicine department of Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh from June 2017 to May 2018. Study group were getting inhaled fluticasone for minimum three months whereas comparative group were not on any steroids. Each group had 35 eligible participants (n=70). Spirometry and plasma glucose at fasting and 2-hour after 75gm oral glucose intake were measured along with HbA1c%. Statistical analysis was done using SPSS 21.0. In study group mean plasma glucose at fasting was 5.27±0.48mmol/L, 2-hour after 75gm oral glucose was 6.04±1.21mmol/L and mean of HbA1c was 5.57±0.41% whereas in comparative group these were5.17±0.59mmol/L, 5.69±1.09mmol/L, 5.47±0.40% respectively (p=0.25, 0.20, 0.75 respectively). There was no specific co-relation between duration of use of fluticasone inhaler and glycaemic parameters like plasma glucose at fasting, 2-hour after 75gm oral glucose and HbA1c% (r=0.016, p=0.46; r=0.015, p=0.47; r=0.019, p=0.42 respectively). Use of inhaled fluticasone for 3months or more has insignificant effect on plasma glucose levels of asthma patients. Duration of use of inhaled fluticasone has no specific correlation with plasma glucose and HbA1c values.

Detection of Antimicrobial Resistance Pattern and ESBL Production among Clinical Isolates of Salmonella Species in Mymensingh, Bangladesh

The occurrence of antimicrobial resistance in Salmonella enterica serovars (both typhoidal and non-typhoidal Salmonellae) is a major public health problem especially in developing countries, which have been associated with treatment failures. Therefore, the study was undertaken to determine the current antimicrobial resistance pattern and extended spectrum β-lactamase (ESBL) production among clinical isolates of Salmonella spp. during 2019-2020 in Mymensingh, Bangladesh. In this cross sectional study, 36 Salmonella enterica isolates were obtained from blood and stool culture of suspected 200 enteric fever and 100 gastroenteritis patients attending at Mymensingh Medical College Hospital, Mymensingh, Bangladesh. Isolated Salmonella species were identified by biochemical tests and Polymerase Chain Reaction (PCR). Disk diffusion test was performed by modified Kirby Bauer method. Minimum Inhibitory Concentration (MIC) of ceftriaxone was detected by agar dilution method. Double disk synergy test was used as a screening test for ESBL production. PCR was done for detection of blaTEM, blaSHV and blaCTX-MU genes. The isolates showed 25% resistance to Ceftriaxone and 58.3% to Azithromycin. The highest sensitivity rates were 88.9% to Meropenem and 83.3% to Amikacin. Whereas 6(16.7%) isolates were Multi Drug Resistant (MDR). Eight (8) isolates were confirmed as ESBL producer by DDST. The marked increase in MIC was observed between 8->512μg/ml to ceftriaxone. blaTEM, blaSHV and blaCTX-MU genes were detected in 3, 5 and 8 isolates respectively. In conclusion, the current study observed, higher level of resistance to ceftriaxone and azithromycin. At the same times 22.2% isolates showed ESBL production, which is a cause for concern as it may lead to treatment failure. On the other hand the study also showed the re-emergence of chloramphenicol and Sulfamethoxazole-Trimethoprim sensitivity.

Observation of a Near-Threshold Structure in the K^{+} Recoil-Mass Spectra in e^{+}e^{-}→K^{+}(D_{s}^{-}D^{*0}+D_{s}^{*-}D^{0})

We report a study of the processes of e^{+}e^{-}→K^{+}D_{s}^{-}D^{*0} and K^{+}D_{s}^{*-}D^{0} based on e^{+}e^{-} annihilation samples collected with the BESIII detector operating at BEPCII at five center-of-mass energies ranging from 4.628 to 4.698 GeV with a total integrated luminosity of 3.7  fb^{-1}. An excess of events over the known contributions of the conventional charmed mesons is observed near the D_{s}^{-}D^{*0} and D_{s}^{*-}D^{0} mass thresholds in the K^{+} recoil-mass spectrum for events collected at sqrt[s]=4.681  GeV. The structure matches a mass-dependent-width Breit-Wigner line shape, whose pole mass and width are determined as (3982.5_{-2.6}^{+1.8}±2.1)  MeV/c^{2} and (12.8_{-4.4}^{+5.3}±3.0)  MeV, respectively. The first uncertainties are statistical and the second are systematic. The significance of the resonance hypothesis is estimated to be 5.3  σ over the contributions only from the conventional charmed mesons. This is the first candidate for a charged hidden-charm tetraquark with strangeness, decaying into D_{s}^{-}D^{*0} and D_{s}^{*-}D^{0}. However, the properties of the excess need further exploration with more statistics.

Model-Independent Determination of the Spin of the Ω^{-} and Its Polarization Alignment in ψ(3686)→Ω^{-}Ω[over ¯]^{+}

We present an analysis of the process ψ(3686)→Ω^{-}Ω[over ¯]^{+} (Ω^{-}→K^{-}Λ, Ω[over ¯]^{+}→K^{+}Λ[over ¯], Λ→pπ^{-}, Λ[over ¯]→p[over ¯]π^{+}) based on a dataset of 448×10^{6}  ψ(3686) decays collected with the BESIII detector at the BEPCII electron-positron collider. The helicity amplitudes for the process ψ(3686)→Ω^{-}Ω[over ¯]^{+} and the decay parameters of the subsequent decay Ω^{-}→K^{-}Λ (Ω[over ¯]^{+}→K^{+}Λ[over ¯]) are measured for the first time by a fit to the angular distribution of the complete decay chain, and the spin of the Ω^{-} is determined to be 3/2 for the first time since its discovery more than 50 years ago.

The transCampus Metabolic Training Programme Explores the Link of SARS-CoV-2 Virus to Metabolic Disease

Currently, we are experiencing a true pandemic of a communicable disease by the virus SARS-CoV-2 holding the whole world firmly in its grasp. Amazingly and unfortunately, this virus uses a metabolic and endocrine pathway via ACE2 to enter our cells causing damage and disease. Our international research training programme funded by the German Research Foundation has a clear mission to train the best students wherever they may come from to learn to tackle the enormous challenges of diabetes and its complications for our society. A modern training programme in diabetes and metabolism does not only involve a thorough understanding of classical physiology, biology and clinical diabetology but has to bring together an interdisciplinary team. With the arrival of the coronavirus pandemic, this prestigious and unique metabolic training programme is facing new challenges but also new opportunities. The consortium of the training programme has recognized early on the need for a guidance and for practical recommendations to cope with the COVID-19 pandemic for the community of patients with metabolic disease, obesity and diabetes. This involves the optimal management from surgical obesity programmes to medications and insulin replacement. We also established a global registry analyzing the dimension and role of metabolic disease including new onset diabetes potentially triggered by the virus. We have involved experts of infectious disease and virology to our faculty with this metabolic training programme to offer the full breadth and scope of expertise needed to meet these scientific challenges. We have all learned that this pandemic does not respect or heed any national borders and that we have to work together as a global community. We believe that this transCampus metabolic training programme provides a prime example how an international team of established experts in the field of metabolism can work together with students from all over the world to address a new pandemic.

Roosting ecology and morphometric analysis of Pteropus medius (Indian flying fox) in Lower Dir, district, Pakistan

The present study was conducted to explore morphometric variations of Pteropus medius (the Indian flying fox) and the roosting trees in Lower Dir, Pakistan. The bats were captured from Morus alba, Morus nigra, Brousonetia papyrifera, Pinus raxburghii, Hevea brasiliensis, Platanus orientalis, Populous nigra, Melia azedarach, Eucalyptus camaldulensis and Grevillea robusta through sling shot and mess net methods. A total of 12 bats were studied for the differential morphological features based on age and sex. Male bats were recorded higher in weight than females. The variations were found in body mass (821.1±34.65gm), circumference of body with wings (25.43±0.39cm), wingspan (112.58±1.90cm), Body length (20.73±0.68cm), Snout length (3.42±0.04cm), Eye length (1.45±0.033cm), Length of ear (3.56±0.05cm), Width of ear (2.46±0.04cm), Length b/w ear (5.51±0.11cm), Circumference of neck (12.23±0.24cm), Circumference of body without wings (18.68±0.31cm), Arm wing length (23.2±1.03cm), Length of thumb (5.43±0.1cm), Length of nail (1.89±0.05cm), Hand wing length (29.1±0.51cm), Maximum width of wing (21.03±0.68cm), Length b/w tip of wing to 5th digit (29.39±0.30cm), Length b/w 5th digit to foot (22.97±1.09cm), Length b/w feet (18.31±0.74cm) and Length of foot claw (4.23±0.05cm). This study was designed for analysis of external morphological variations for P. medius (the Indian flying fox) that may help in identification of these bats and their roosting sites.

Preparation, characterization and stability studies of cross-linked α-amylase aggregates (CLAAs) for continuous liquefaction of starch

In current study, α-amylase of fungal origin was immobilized using cross-linking strategy. The influence of precipitant (ammonium sulphate) and cross-linker (glutaraldehyde) concentration revealed that 60% (w/v) precipitant and 1.5% (v/v) cross-linker saturation was required to attain optimum activity. Cross-linked amylase aggregates (CLAAs) were characterized and 10-degree shift in optimum temperature (soluble enzyme: 50 °C; cross-linked: 60 °C) and 1-unit shift in pH (soluble enzyme: pH -6; cross-linked: pH -7) was observed after immobilization. The V_max for soluble α-amylase and its cross-linked form was 1225 U ml^-1 and 3629 U ml^-1, respectively. The CLAAs was more thermostable than its soluble form and retained its 30% activity even after 60 min of incubation at 70 °C. Moreover, cross-linked amylase retained its activity after two months while its soluble counterpart lost its complete activity after 10 and 20 days at 30 °C and 4 °C storage, respectively. Reusability test showed that cross-linked amylase could retain 13% of its residual activity after 10 repeated cycles. Therefore, 10 times more glucose was produced after cross-linking than soluble amylase when it was utilized multiple times. This study indicates that amylase aggregates are highly effective for continuous liquefaction of starch, hence have strong potential to be used for different industrial processes.

Suture rectopexy versus ventral mesh rectopexy for complete full-thickness rectal prolapse and intussusception: systematic review and meta-analysis

Background

This systematic review and meta-analysis aimed to compare recurrence rates of rectal prolapse following ventral mesh rectopexy (VMR) and suture rectopexy (SR).

Methods

MEDLINE, Embase, and the Cochrane Library were searched for studies reporting on the recurrence rates of complete rectal prolapse (CRP) or intussusception (IS) after SR and VMR. Results were pooled and procedures compared; a subgroup analysis was performed comparing patients with CRP and IS who underwent VMR using biological versus synthetic meshes. A meta-analysis of studies comparing SR and VMR was undertaken. The Methodological Items for Non-Randomized Studies score, the Newcastle–Ottawa Scale, and the Cochrane Collaboration tool were used to assess the quality of studies.

Results

Twenty-two studies with 976 patients were included in the SR group and 31 studies with 1605 patients in the VMR group; among these studies, five were eligible for meta-analysis. Overall, in patients with CRP, the recurrence rate was 8.6 per cent after SR and 3.7 per cent after VMR (P < 0.001). However, in patients with IS treated using VMR, the recurrence rate was 9.7 per cent. Recurrence rates after VMR did not differ with use of biological or synthetic mesh in patients treated for CRP (4.1 versus 3.6 per cent; P = 0.789) and or IS (11.4 versus 11.0 per cent; P = 0.902). Results from the meta-analysis showed high heterogeneity, and the difference in recurrence rates between SR and VMR groups was not statistically significant (P = 0.76).

Conclusion

Although the systematic review showed a higher recurrence rate after SR than VMR for treatment of CRP, this result was not confirmed by meta-analysis. Therefore, robust RCTs comparing SR and biological VMR are required.

Prediction of Esophageal Varices in Chronic Liver Disease by Liver Stiffness-Spleen Size-to-Plalelet Ratio Risk Score

Non-invasive tools are needed to rule out the presence of esophageal varices (EV) in patients with chronic liver disease. The aim of this study was to evaluate diagnostic accuracy of Liver stiffness-spleen size-to-platelet ratio (LSPS) for EV detection and identification of high risk EV in patients with CLD. A total of 70 patients with CLD irrespective of the etiology attending at OPD and admitted in Department of Gastrointestinal, Hepatobiliary and Pancreatic Disorders (GHPD) of BIRDEM General Hospital, Dhaka, Bangladesh from January 2016 to October 2017 were enrolled in this observational cross-sectional study. All patients underwent routine laboratory tests, liver function tests, ultrasonography, liver stiffness (LS) measurement and esophagogastroduodenoscopy. Clinical value of LSPS was compared with platelet count, spleen size and LS for detection of esophageal varices. Diagnostic accuracy was assessed by the Area under the receiver operating characteristic (AUROC) curve. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated using ROC curve. LSPS has better diagnostic accuracy for detection of EV in terms of AUROC, showing superiority over each factor alone. LSPS also detect high risk EV but accuracy was lower than detection of EV. The optimal cutoff values of LSPS for EV and high risk EV were 0.879 and 4.132 respectively, at which AUROC, negative predictive value, and accuracy were 0.910 [95% confidence interval (CI) 0.832-0.988], 90.9% and 90.0% and 0.695 (95% CI 0.520-0.870), 62.5% and 69.4% respectively. LSPS represents a useful, noninvasive method to detect EV and a high risk EV in patients with CLD. Clinicians should recommend those patients with CLD who show higher values of LSPS to undergo further endoscopic examination.

Comparison between Efficacy of Combined Use of Hyaluronidise and Triamcinolone versus Hyaluronidise, Triamcinolone Acetonide and Oral Colchicine in the Treatment of Oral Submucous Fibrosis

Oral submucous fibrosis (OSF) is a chronic complex potentially pre-malignant condition caused by chewing areca nut and other irritants. It is an insidious process characterized by Juxta-epithelial deposition of fibrous tissue in the oral cavity and pharynx. OSF is very common in Southeast Asia and also now a days increase in Europe and North America. The aim of this study to compare the effectiveness of intralesional injection of triamcinolone and hyalurunidase versus intralesional injection of triamcinolone plus injection hyalurunidase with oral colchicine. The study included 60 patients of clinically diagnosed case of oral submucous fibrosis. Patients were divided into two Groups A and B. Group A patients received combination intralesionsl injection of triamcinolone acetonide 10mg/ml in 1ml with injection hyalurunidase 1500IU in 2ml with injection 2% lidocaine 7ml. 15 days interval in 3 months and Group B received intralesional injection of triamcinolone acetonide 10mg/ml in 1ml with injection hyalurunidase 1500IU in 2ml with injection 2% lidocaine 7ml in each 15 days interval for 3 months with oral colchicine 0.5mg twice daily for 3 months. Diagnosis based on burning sensation of mouth, blanching of mucosa, ulceration in oral cavity and also reduced mouth opening. Follow up assessment was done at intervals 1st follow up on 21st days after starting of treatment then 2nd follow up after 3 months and last 3rd follow up after 6 months. Before starting of treatment all patients were properly explained about the study and took their written consent. Much more improvement occurred in Group B patients, reducing in burning sensation and also increases in opening of mouth. In both groups blanching mucosae were improved. Treatment regimen of Group B is more effective in increasing mouth opening and improves burning sensation of oral cavity. No side effects were seen in both groups' patients.

Measurement of Placental Index in Different Gestational Age Groups in Bangladeshi Women

Placenta is the mirror of maternal and fetal status; it reflects the changes due to complications in pregnancy of mother. The growth and survival of the fetus in utero is directly related to formation, development and maturation of the placenta. Placental index was correlated to poor pregnancy outcomes. Placental index can help to identify fetal growth restriction which is result of placental insufficiency and is characterized by insufficient trasnsplacental transport of nutrients and oxygen. This cross sectional descriptive study would provide information about the ratio of placental index in different gestational age group in Bangladeshi women. To achieve this aim the study was performed on 60 human placenta and corresponding fetuses and gestational age (in weeks) categorized as Group A (28-32), Group B (33-37), Group C (38-40). These sample and information were collected from normal pregnancy in Gynecology and Obstetrics Department of Mymensingh Medical College Hospital from July 2009 to June 2010. After preservation in 10% formal saline, study was done in Department of Anatomy in Mymensingh Medical College. In this study, the mean±SD placental index was in Group A (0.187±0.113), Group B (0.153±0.025) and Group C (0.166±0.025) and also observed that mean placental index decreased with age up to certain level then increase in Group C. The mean placental index was maximum in Group A (0.187±0.113) and was minimum in Group B (0.153±0.025). The mean difference of placental index between Groups A&B, A&C and B&C was statistically not significant. Observed findings of this study were compared with those of Western and Bangladeshi researches.

Investigation of the efficacy of the short regimen for rifampicin-resistant TB from the STREAM trial

BACKGROUND

The STREAM trial demonstrated that a 9-11-month "short" regimen had non-inferior efficacy and comparable safety to a 20+ month "long" regimen for the treatment of rifampicin-resistant tuberculosis. Imbalance in the components of the composite primary outcome merited further investigation.

METHODS

Firstly, the STREAM primary outcomes were mapped to alternatives in current use, including WHO programmatic outcome definitions and other recently proposed modifications for programmatic or research purposes. Secondly, the outcomes were re-classified according to the likelihood that it was a Failure or Relapse (FoR) event on a 5-point Likert scale: Definite, Probable, Possible, Unlikely, and Highly Unlikely. Sensitivity analyses were employed to explore the impact of informative censoring. The protocol-defined modified intention-to-treat (MITT) analysis population was used for all analyses.

RESULTS

Cure on the short regimen ranged from 75.1 to 84.2% across five alternative outcomes. However, between-regimens results did not exceed 1.3% in favor of the long regimen (95% CI upper bound 10.1%), similar to the primary efficacy results from the trial. Considering only Definite or Probable FoR events, there was weak evidence of a higher risk of FoR in the short regimen, HR 2.19 (95%CI 0.90, 5.35), p = 0.076; considering only Definite FoR events, the evidence was stronger, HR 3.53 (95%CI 1.05, 11.87), p = 0.030. Cumulative number of grade 3-4 AEs was the strongest predictor of censoring. Considering a larger effect of informative censoring attenuated treatment differences, although 95% CI were very wide.

CONCLUSION

Five alternative outcome definitions gave similar overall results. The risk of failure or relapse (FoR) may be higher in the short regimen than in the long regimen, highlighting the importance of how loss to follow-up and other censoring is accounted for in analyses. The outcome of time to FoR should be considered as a primary outcome for future drug-sensitive and drug-resistant TB treatment trials, provided sensitivity analyses exploring the impact of departures from independent censoring are also included.

Stress in Parents of Children With Genetically Determined Leukoencephalopathies: A Pilot Study

Genetically determined leukoencephalopathies comprise a group of rare inherited white matter disorders. The majority are progressive diseases resulting in early death. We performed a cross-sectional pilot study including 55 parents from 36 families to assess the level of stress experienced by parents of patients with genetically determined leukoencephalopathies, aged 1 month to 12 years. Thirty-four mothers and 21 fathers completed the Parenting Stress Index-4th Edition. One demographic questionnaire was completed per family. Detailed clinical data was gathered on all patients. Statistical analysis was performed with total stress percentile score as the primary outcome. Mothers and fathers had significantly higher stress levels compared with the normative sample; 20% of parents had high levels of stress whereas 11% had clinically significant levels of stress. Mothers and fathers had comparable total stress percentile scores. We identified pediatric behavioral difficulties and gross motor function to be factors influencing stress in mothers. Our study is the first to examine parental stress in this population and highlights the need for parental support early in the disease course. In this pilot study, we demonstrated that using the Parenting Stress Index-4th Edition to assess stress levels in parents of patients with genetically determined leukoencephalopathies is feasible, leads to valuable and actionable results, and should be used in larger, prospective studies.

Predominance of Leptospira wolffii in north-central Bangladesh, 2019

Leptospira was detected in 48.9% of blood samples from 182 febrile patients in north-central Bangladesh in 2019. Most Leptospira were classified as L. wolffii (93%) on the basis of phylogenetic analysis of 16S ribosomal RNA genes, while others were assigned to L. borgpetersenii and L. meyeri.

Observation of the Doubly Cabibbo-Suppressed Decay D^{+}→K^{+}π^{+}π^{-}π^{0} and Evidence for D^{+}→K^{+}ω

Using 2.93  fb^{-1} of e^{+}e^{-} collision data collected at a center-of-mass energy of 3.773 GeV with the BESIII detector, the first observation of the doubly Cabibbo-suppressed decay D^{+}→K^{+}π^{+}π^{-}π^{0} is reported. After removing decays that contain narrow intermediate resonances, including D^{+}→K^{+}η, D^{+}→K^{+}ω, and D^{+}→K^{+}ϕ, the branching fraction of the decay D^{+}→K^{+}π^{+}π^{-}π^{0} is measured to be (1.13±0.08_{stat}±0.03_{syst})×10^{-3}. The ratio of branching fractions of D^{+}→K^{+}π^{+}π^{-}π^{0} over D^{+}→K^{-}π^{+}π^{+}π^{0} is found to be (1.81±0.15)%, which corresponds to (6.28±0.52)tan^{4}θ_{C}, where θ_{C} is the Cabibbo mixing angle. This ratio is significantly larger than the corresponding ratios for other doubly Cabibbo-suppressed decays. The asymmetry of the branching fractions of charge-conjugated decays D^{±}→K^{±}π^{±}π^{∓}π^{0} is also determined, and no evidence for CP violation is found. In addition, the first evidence for the D^{+}→K^{+}ω decay, with a statistical significance of 3.3σ, is presented and the branching fraction is measured to be B(D^{+}→K^{+}ω)=(5.7_{-2.1}^{+2.5}_{stat}±0.2_{syst})×10^{-5}.

Molecular Detection of Human Coronavirus from North Central Part of Bangladesh Depending on ORF1ab and N Gene

The Coronavirus disease 2019 (COVID-19) resulted severe respiratory illness such as pneumonia and lung dysfunctions that was first identified at Wuhan, the capital of Hubeiin China during the end of December 2019. The etiological cause of COVID-19 has been confirmed as a novel coronavirus known as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) which was similar with the zoonotic virus SARS-CoV (2002). Now a days for early diagnosis of COVID-19 the nucleic acid based test like RT PCR (real time reverse transcription polymerase chain reaction) is most consistent and used all over the world. In this study among 11,280 cases 825(7.31%) were positive by molecular RT PCR method on June 2020 at Microbiology department of Mymensingh Medical College and the samples are collected from different areas of Northern part of Bangladesh. Among this positive cases 588(71%) N gene, 10 ORF1ab (2%) and 227(27%) both N and ORF gene showed significant curve which is specific for COVID-19 positive patients. Because N and ORF gene of this virus inhibit immune system of human body especially interferon. Out of SARS-CoV-2 positive cases maximum number of N gene were found in male patients and above 40 years old aged group. So, Molecular diagnosis of this pandemic virus especially by N and ORF gene might be helpful to reduce the spread of SARS-CoV-2 as well as early treatment for saving many lives.

Assembling Si2BN nanoribbons into a 3D porous structure as a universal anode material for both Li- and Na-ion batteries with high performance

The development of anode materials is critical to the success of sodium ion batteries (SIBs). Because of the size difference between Li and Na, the commercial anode material graphite in Li-ion batteries does not work for Na-ion batteries. Thus, it will be ideal if some universal anode materials could work for both Li- and Na-ion batteries with high performance. Inspired by a recent study on the high performance of a 2D-Si2BN sheet as an anode material for Li-ion batteries, we design a three dimensional (3D) porous structure by using the nanoribbons of a Si2BN sheet as building blocks. Based on the state-of-the-art ab initio calculations, we find that the resulting 3D porous Si2BN structure is stable chemically, dynamically and thermally, exhibiting a high specific capacity of 512.42 (341.61 mA h g-1), a low voltage of 0.27 V (0.15 V), a small volume expansion of 2.5% (2.7%), and a low migration energy barrier of 0.44 eV (0.19 eV) for Li- (Na-) ion batteries. These intriguing features, together with the light mass and rich abundance of Si, B and N, suggest that the 3D porous Si2BN structure is a promising candidate for the anode material of both Li- and Na-ion batteries.

Molecular Detection of Human Brucellosis among Patients with Pyrexia of Unknown Origin

This study describes the molecular detection of human brucellosis among patients with pyrexia of unknown origin. It was a cross-sectional descriptive study and was carried out in the Department of Microbiology, Mymensingh Medical College, Mymensingh, Bangladesh. Non-probability purposive type of sampling technique was used. Blood samples were collected from 400 pyretic patients from September 2018 to August 2019. BCSP31 Brucella genus-specific TaqMan real-time PCR and SYBR Green real-time PCR were undertaken for molecular detection. Out of 400 samples, 22 (5.5%) samples found BCSP31 Brucella genus-specific real-time PCR positive. The study revealed that a considerable number of brucellosis is present in rural areas among risk as well as non-risk group study population having definite male predominancy, most prone to develop among >40-80 years age group. Brucella genus and species-specific real-time PCR might be performed for confirmation and also to avoid unjustified costs, drug toxicity, and un-masking of other potentially dangerous diseases.

Setting up pharmacovigilance based on available endTB Project data for bedaquiline

SETTING: Active pharmacovigilance (PV) is recommended for TB programmes, notably for multidrug-resistant TB (MDR-TB) patients treated with new drugs. Launched with the support of UNITAID in April 2015, endTB (Expand New Drug markets for TB) facilitated treatment with bedaquiline (BDQ) and/or delamanid of >2600 patients in 17 countries, and contributed to the creation of a central PV unit (PVU).OBJECTIVE: To explain the endTB PVU process by describing the serious adverse events (SAEs) experienced by patients who received BDQ-containing regimens.DESIGN: The overall PV strategy was in line with the ‘advanced´ WHO active TB drug safety monitoring and management (aDSM) system. All adverse events (AEs) of clinical significance were followed up; the PVU focused on signal detection from SAEs.RESULTS and CONCLUSION: Between 1 April 2015 and 31 March 2019, the PVU received and assessed 626 SAEs experienced by 417 BDQ patients. A board of MDR-TB/PV experts reviewed unexpected and possibly drug-related SAEs to detect safety signals. The experts communicated on clusters of risks factors, notably polypharmacy and off-label drug use, encouraging a patient-centred approach of care. Organising advanced PV in routine care is possible but demanding. It is reasonable to expect local/national programmes to focus on clinical management, and to limit reporting to aDSM systems to key data, such as the SAEs.

Introducing new and repurposed TB drugs: the endTB experience

In 2015, the initiative Expand New Drug Markets for TB (endTB) began, with the objective of reducing barriers to access to the new and repurposed TB drugs. Here we describe the major implementation challenges encountered in 17 endTB countries. We provide insights on how national TB programmes and other stakeholders can scale-up the programmatic use of new and repurposed TB drugs, while building scientific evidence about their safety and efficacy. For any new drug or diagnostic, multiple market barriers can slow the pace of scale-up. During 2015-2019, endTB was successful in increasing the number of patients receiving new and repurposed TB drugs in 17 countries. The endTB experience has many lessons, which are relevant to country level introduction of new TB drugs, as well as non-TB drugs and diagnostics. For example: the importation of TB drugs is possible even in the absence of registration; emphasis on good clinical monitoring is more important than pharmacovigilance reporting; national guidelines and expert committees can both facilitate and hinder innovative practice; clinicians use new and repurposed TB drugs when they are available; data collection to generate scientific evidence requires financial and human resources; pilot projects can drive national scale-up.

Seasonal abundance and distribution of dragonflies in upper Siran valley of District Mansehra Pakistan

Present study was conducted to study seasonal abundance and distribution of dragonflies in upper Siran valley district Mansehra Pakistan. To collect data, eleven localities were visited for three consecutive years (2016-2018). Results come up with a sum of 300 specimens identified under three families, eight genera and twenty species. Highest seasonal abundance recorded during summer and spring were 80.67% and 13.33% respectively while minimum 6.00% was recorded during early autumn. Dominant species observed were, Orthetrum chrysis (14.00%), followed by O. gluacum (12.00%), Palpoleura sexmaculata sexmaculata (11.33%) and O. cancellatum cancellatum (8.00%). However the highest population of dragonflies was found in Munda Gucha with a percentage of 11.33 followed by Jabbar (11.00%) and Sachan (9.67%). The lowest populations were recorded in Suham (6.00%), Dadar (7.67%) and Jabori (7.67%). The surveyed valley showed diverse Anisopterous fauna and thus further extensive surveys are recommended that can come up with more important species from the area.

Susceptibility to prosocial and antisocial influence in adolescence

Introduction

Adolescents are particularly susceptible to social influence and previous studies have shown that this susceptibility decreases with age. The current study used a cross-sectional experimental paradigm to investigate the effect of age and puberty on susceptibility to both prosocial and antisocial influence.

Methods

Participants (N = 520) aged 11–18 from London and Cambridge (United Kingdom) rated how likely they would be to engage in a prosocial (e.g. “help a classmate with their work”) or antisocial (e.g. “make fun of a classmate”) act. They were then shown the average rating (in fact fictitious) that other adolescents had given to the same question, and were then asked to rate the same behaviour again.

Results

Both prosocial and antisocial influence decreased linearly with age, with younger adolescents being more socially influenced when other adolescents’ ratings were more prosocial and less antisocial than their own initial rating. Both antisocial and prosocial influence significantly decreased across puberty for boys but not girls (independent of age).

Conclusions

These findings suggest that social influence declines with increasing maturity across adolescence. However, the exact relationship between social influence and maturity is dependent on the nature of the social influence and gender. Understanding when adolescents are most susceptible to different types of social influence, and how this might influence their social behaviour, has important implications for understanding adolescent social development.

Frequency and comparison among antibiotic resistant Staphylococcus aureus strains in selected hospitals of Peshawar, Pakistan

Objective

To assess and compare the frequency of antibiotic-resistant staphylococcus aureus strains.

METHODS

A retrospective study was conducted at the privately-owned Welfare Medical Laboratory, Peshawar, Pakistan, and comprised record related to the period between 07th February 2017 and 23rd March 2018 of patients referred for pus-testing from Khyber Teaching Hospital, Lady Reading Hospital and the Hayatabad Medical Complex. Pus samples were obtained from various parts of body with cotton swabs. The samples were cultured and the isolated staphylococcus aureus strains were analysed against selected antibiotics. The frequency of the isolated strains was tested and compared using Prism 7 software.

RESULTS

Of the 6780 samples, staphylococcus aureus was found in 4315(63.64%). Wild-type staphylococcus aureus strains were 2133(31.46%), followed by 825(12.16%) methicillin resistant, 792(11.68%) vancomycin intermediate, and 565(8.33%) vancomycin-resistant staphylococcus aureus strains. The isolated strains were significant (p<0.0001) for operated wounds, and non-significant (p=0.8915) for diabetic foot cases.

CONCLUSIONS

The frequency of antibiotic-resistant staphylococcu saureus strains was high.