Antimicrobial Susceptibility Pattern of Methicillin-Resistance Staphylococcus aureus from Different Tertiary Care Hospitals Including Mymensingh Medical College Hospital

The aim of this study was to detect antimicrobial susceptibilities and the presence of drug resistance genes of MRSA from tertiary care hospitals. This study was carried out in the Department of Microbiology, Mymensingh Medical College during the period from Jan, 2015 to Dec, 2015. Clinical samples, including wound swab, pus, exudates from diabetic ulcer and burn ulcer, aural swab, blood and urine were collected. Standard microbiological procedure & biochemical tests were carried out to detect S. aureus. Oxacillin disk diffusion test was done by Kirby-Bauer disk diffusion method. Total 69 isolates of S. aureus were selected for the study. The isolates were collected from three different tertiary care hospitals, of which 33, 27 and 9 were from Mymensingh Medical College Hospital (MMCH), BIRDEM hospital and Sir Salimullah Medical College Hospital (SSMCH) respectively. Among the 69 isolates, 17(24.6%) and 52(75.3%) were distinguished as MRSA and MSSA respectively by ODDM (Oxacillin disk diffusion method). In contrast, detection of presence and absence of mecA gene by PCR identified 20 (28.9%) and 49 (71.01%) isolates as MRSA and MSSA respectively. All of the S. aureus (MRSA and MSSA) isolates were sensitive to vancomycin and gentamicin. All MRSA isolates (100%) showed resistance to Penicillin and Oxacillin. Among the MRSA isolates about 88.2% were resistance to Ceftazidime, 64.7% were resistance to Erythromycin and Ciprofloxacin, 11.7% were resistance to Tetracycline. Among the MSSA isolates about 94.2% were resistance to Penicillin and 9.6% resistance to Ciprofloxacin. The MSSA were less resistance for non-beta lactam drugs than MRSA. Regarding drug resistance genes, the blaZ genes were present in 47 out of 49(95.8%) MSSA and in 18 out of 18 (100%) MRSA. The erythromycin resistance gene ermB was found in 8.69% isolates, of which highest 20% in MRSA and 4.08% in MSSA. The ermA was not found in any isolates. Among tetracycline resistance genes, tetK were detected in 10.1% and tetL were found in 2.8% of MRSA. The highest tetK genes were found in 20% of MRSA and in 6.1% of MSSA. Regarding, the gentamicin drug resistance, the aac(6')-Iaph(2'')-Ia gene was not found in any isolates. The relatively high proportion of MRSA and the associated antibiotic resistance seen in this study emphasizes the need for country based surveillance to characterize and monitor MRSA and to develop strategies that will improve MRSA treatment and control.

Should diuretics be prescribed for idiopathic carpal tunnel syndrome? Results of a controlled trial

Diuretics are often prescribed to treat carpal tunnel syndrome (CTS) but their beneficial effect is unproven. In this double-blind controlled trial of bendrofluazide given for one month in 48 patients with the idiopathic CTS, treated and control patients showed similar clinical improvement, but the treated group showed more improvement than controls on electrophysiological tests. We conclude that bendrofluazide 5mgm daily for one month does not confer additional clinical benefit in the idiopathic CTS, but further trials with stronger diuretics and/or longer periods of treatment are warranted.

Study on Neurological Consequence of Eclampsia

The present study was carried out in the Department of Obstetrics and Gynecology at Mymensingh Medical College Hospital, Mymensingh, Bangladesh for a period of one year from 1st June 2009 to 30th June 2010 to see the Neurological Consequence of Eclampsia. A total number of 37 patients were enrolled in this study. Among 37 patients majority are in the age group of 21-30 years which is 19(51.4%) cases followed by less than or equal to 20 years and more than 30 years which are 13(35.1%) cases and 5(13.5%) cases respectively. Knee jerk is present in 28(75.7%) cases and absent in 8(21.6%) cases. The exaggerated knee jerk is present in only in 1(2.7%) case. The rate of Glasgow coma scale is less than 5 in 21(56.8%) cases, 14(37.8%) cases in 5-10 and 2(5.4%) cases is in more than 10. Focal sign is absent in 22(59.5%) cases and present in 15(40.5%) cases. Majority of the patients is presented with absence of neck stiffness which is 35(94.6%) cases and the rest 2(5.4%) cases are presented with neck stiffness. Flexor planter response is found in 20(54.1%) cases which is the highest in number followed by extensor which is 15(40.5%) cases. In only 2(5.4%) cases the planter reflex is not elicitable. Presence of infarct is found in 15(40.5%) cases which is the highest number. Cerebral edema and Presence of haemorrhage is found in 3(8.1%) cases in each. Leuko-encephalopathy is found in 2(5.4%) cases. Encephalopathy and Both infarct & haemorrhage is found in 1(2.7%) case of each. Normal CT scan findings of brain are found in 12(32.4%) cases.

Clinical Profile and Biochemical Abnormalities of Neonatal Seizure at NICU of a Tertiary Care Hospital

Seizures are most common neurological emergency in the neonatal period and present as a diagnostic and therapeutic challenge to clinicians worldwide. This prospective observational study was conducted in the Neonatal Intensive Care Unit of Mymensingh Medical College Hospital from January 2015 to March 2015. Total 318 patients were enrolled in the study who presented with convulsion. Most of the patients were term (72.95%) and birth weight was normal (77.3%). Around 75% patients were delivered at home. Most common causes of convulsion were Perinatal Asphyxia (78%) followed by Septicemia, Hypoglycemia and Meningitis in order of frequency. Commonest type of seizure was subtle seizure (45.5%). Most of the patients recovered completely (73%) and 8.4% patients died due to complications.

Correlation between Troponin-I and B-Type Natriuretic Peptide Level in Acute Myocardial Infarction Patients with Heart Failure

Troponins are regarded as markers of choice for the diagnosis of acute myocardial infarction (AMI). But B-type natriuretic peptide (BNP) level is also elevated in AMI and is a quantitative biochemical marker related to the extent of infarction and the left ventricle systolic dysfunction. Thus, BNP has prognostic value. In this study, we investigate the correlation of Troponin-I with BNP levels in patients presenting with AMI with or without Acute Heart Failure. Rationale of this study is to see, whether quantitative Troponin alone can serve for both diagnosis and prognosis of AMI Patients with heart failure or not. This cross-sectional analytical study was conducted in the Department of Cardiology in Mymensingh Medical College Hospital from January 2014 to December 2014. Total 100 patients were studied and divided into two groups - 50 patients in each group. Group I: Patients with first attack of acute myocardial infarction (without heart failure) & Group II: Patients with first attack of acute myocardial infarction with acute heart failure. Mean Troponin-I of Group I and Group II were 3.10±2.68 and 62.93±32.75ng/ml respectively & mean BNP value of Group I and Group II were 20.96±14.18 and 615.65±249.27pg/ml respectively. In this study, it was shown that the levels of BNP had positive correlation with Troponin-I levels, with medium strength of association (r=0.734, p<0.05). Echocardiography shows that patients with high BNP level has low ejection fraction (LVEF) and patients with low BNP level has preserved ejection fraction (LVEF). Thus, the present study shows that the higher the Troponin-I levels, the higher the BNP levels in first attack of AMI patients and the more severe the heart failure (more severe left ventricle dysfunction). There is positive correlation between Troponin-I and BNP levels in first attack of AMI patients with acute heart failure.

A 47 Years Lady with Intrathoracic Lipoma

A case of a 47 years old female who presented to Mymensingh Medical College Hospital, Medicine Unit-5, complaining of severe dyspnea and occasional leg swelling. Chest X-ray, USG of chest and chest CT scan revealed a right sided giant intrathoracic mass extending across the posterior mediastinum into the left chest cavity. CT guided FNAC of right lung revealed lipoma.

Estimation of Thyroid Hormone in Early Pregnancy and it's Clinical Correlation

This descriptive cross sectional study was done for the estimation of thyroid hormone in early pregnancy and it's clinical correlation. It was conducted at the Antenatal Clinic of Mymensingh Medical College Hospital, Mymensingh from December 2010 to November 2011. Total 185 cases in early pregnancy were taken purposively and randomly. Among the pregnant women, age ranged from 18-42 years with the Mean±SD age 25.77±4.96 years, the gestational weeks ranged 6±1 to 13±1weeks having Mean±SD 9.06± 2.49 weeks. The gravida ranged from primi to 8th gravida Mean±SD 1.89±1.10. Haemoglobin level ranged from 9.0 to 13.2gm/dl; Mean±SD 10.90±0.99gm/dl. Mean±SD of serum FT4 was 17.77±7.25 and Mean±SD of TSH was 3.95±2.94mIU/L. In present study, 5.40% (n=10) of the respondents had hypothyroidism and 0.54% (n=1) showed hyperthyroidism. The present study showed that, the incidence of hypothyroidism had relatively increased then the reference ranges but not statistically significant. But hyperthyroidism was within the reference range. This study showed slightly higher percentage of hypothyroidism in both ≤30 (4.52%) and ≥30 (10%) years of age groups especially a bit higher percentage in the elderly group. In present study, hypothyroidism was common among women of lower income group. Present study showed a higher percentage of stillbirth &miscarriage among study population. This study showed a relatively higher prevalence of abnormal thyroid function (especially hypothyroidism) in the study population and suggests the routine screening of thyroid hormone in early pregnancy in addition to routine antenatal care.

Optimization of sterile male ratio of oriental fruit fly, Bactrocera dorsalis (HENDEL)

The study was conducted to establish the Sterile Insect Technique (SIT) method of controlling oriental fruit fly, Bactrocera dorsalis (Hendel). The sterile male ratio of oriental fruit fly was optimized for possible field application of Sterile Insect Technique. Several batches of 5 and 6-dayold pupae were irradiated at 30, 40, 50 and 60 Gray (Gy) to optimize the radiation dose of sterilization. Highest pupal duration and abnormal adults were found after imposing gamma radiation in 5-day-old pupae treated with 60 Gy dose. Radiation significantly increased the nonemergence percentage and decreased the normal emergence of oriental fruit fly. The sterilizing doses were recorded as 60 Gy for 5-dayold pupae. Fixed number of virgin females of oriental fruit flies were allowed to mate with unirradiated and irradiated males at 1:1, 1:2, 1:5 and 1:9 ratios in different cages to find out the rate of suppression against wild population. Minimum pupal recovery and percent normal emergence observed at 1:9 ratio. Deformed and undeveloped (not emerged) population increased with the ratio of irradiated males. The 1:9 ratio was found as the best for suppression of wild population of B. dorsalis.SAARC J. Agri., 13(2): 50-60 (2015)

Status of Serum Zinc in Multidrug Resistant Tuberculosis

Zinc plays a vital role in the immune status. Its deficiency affects host defense by reducing the number of circulating T cells and phagocytosis activity of other cells which ultimately impair cell mediated immunity. The cell-mediated immunity plays a major role in the causation of pulmonary tuberculosis. The present study was carried out to estimate serum zinc level in newly detected multidrug resistant tuberculosis (MDR-TB) in adult population. In this study total fifty (50) MDR-TB patients were enrolled conveniently from the in-patients departments of National Institute of Diseases of the Chest Hospital (NIDCH), Bangladesh. Serum zinc was estimated by atomic absorption spectrophotometry method from early morning fasting blood sample. Serum zinc level was assessed according to normal cut-off value 70-120 μgm/dl and 76% studied population were found lower than this value. The mean±SD serum zinc level was observed 60.40±8.91 μgm/dl. No associations were found between serum zinc level with age (p=0.11) and with sex (p=0.085) of the study population respectively. The low level of serum zinc in MDR-TB patients suggested impaired immune status of our study population.

Incomplete Pentalogy of Cantrell--A Case Report

Cantrell's Pentalogy is a rare congenital malformation consists of supraumbilical abdominal wall defect, defect in the lower part of sternum, agenesis of anterior portion of diaphragm, an absence of the diaphragmatic part of the pericardium and intracardiac malformation. This case report presents a female neonate, who was born at 40 weeks of gestation weighing 2400 gm and was admitted 4 hours after delivery with the complaints of something coming out from chest. On physical examination her vital signs were within normal limit, she had a systolic murmur on heart at lower left sternal area and there was a vascular structure present on the upper part of abdomen which was pulsatile and pulsation was synchronized with cardiac pulsation. On investigation chest X-ray lateral view showed absence of lower part of sternum, echocardiography findings were different in different institutes. Echocardiography findings at Mymensingh medical college hospital (MMCH) were large VSD (Ventriculo septal defect), ASD (Atrial septal defect) and rotated heart. On colour Doppler ultrasonogram at MMCH showed there were VSD, ASD, and a small epigastric swelling which was vascular and appears to be attached to the apex of the heart. On the other hand echocardiography findings of LAB AID hospital in Dhaka were Dextrocardia, complete AV (atrio ventricular) canal defect, almost common atrium, almost single ventricle, common AV valve, double outlet right ventricle (DORV), Cortriatriatum, mild A-V valve regurgitation and severe pulmonary hypertension (PAH). Echocardiography was also done at national heart foundation hospital in Dhaka. Findings were situs solitus, mesocardia to dextrocardia, DORV, large VSD, mild mitral inflow, mild TR (triuspid regurgitation), good LV (left ventricle) and RV (right ventricle) systolic function. Cardiologists at Dhaka in Bangladesh were suggested for surgery. Then the patient was consulted at Naryan Institute of Cardiac Science, Chennai in India. Here echocardiography findings were dextroversion/dextrocardia, DILV (Double inlet left ventricle), large inlet VSD with bidirectional shunt, mild TR, severe PAH with good ventricular function. Cardiologists in India were given comment about this patient. This patient was highly risky for surgery. They advised medical treatment and requested to review after one year. By taking medical treatment patient condition is well except failure to thrive and cyanosis develops during feeding and crying according to the statement of guardian of the patient. This case has 3 criterias among the five criteria of Cantrell's Pentalogy. So, it is incomplete Pentalogy of Cantrell.

Methylglyoxal: An Emerging Signaling Molecule in Plant Abiotic Stress Responses and Tolerance

The oxygenated short aldehyde methylglyoxal (MG) is produced in plants as a by-product of a number of metabolic reactions, including elimination of phosphate groups from glycolysis intermediates dihydroxyacetone phosphate and glyceraldehyde 3-phosphate. MG is mostly detoxified by the combined actions of the enzymes glyoxalase I and glyoxalase II that together with glutathione make up the glyoxalase system. Under normal growth conditions, basal levels of MG remain low in plants; however, when plants are exposed to abiotic stress, MG can accumulate to much higher levels. Stress-induced MG functions as a toxic molecule, inhibiting different developmental processes, including seed germination, photosynthesis and root growth, whereas MG, at low levels, acts as an important signaling molecule, involved in regulating diverse events, such as cell proliferation and survival, control of the redox status of cells, and many other aspects of general metabolism and cellular homeostases. MG can modulate plant stress responses by regulating stomatal opening and closure, the production of reactive oxygen species, cytosolic calcium ion concentrations, the activation of inward rectifying potassium channels and the expression of many stress-responsive genes. MG appears to play important roles in signal transduction by transmitting and amplifying cellular signals and functions that promote adaptation of plants growing under adverse environmental conditions. Thus, MG is now considered as a potential biochemical marker for plant abiotic stress tolerance, and is receiving considerable attention by the scientific community. In this review, we will summarize recent findings regarding MG metabolism in plants under abiotic stress, and evaluate the concept of MG signaling. In addition, we will demonstrate the importance of giving consideration to MG metabolism and the glyoxalase system, when investigating plant adaptation and responses to various environmental stresses.

Awareness among Parents of β-Thalassemia Major Patients Regarding Prenatal Diagnosis and Premarital Screening in Day Care Centre of Transfusion Medicine Department

Thalassemia is one of the most common genetic diseases in the world. It is a major health problem, brings much morbidity, early mortality and a great deal of misery for a family both financially and emotionally. The patients suffering from beta thalassemia major do not survive for more than 5 years without blood transfusion. Blood transfusion is usually administered every two to five weeks to maintain the pre-transfusion hemoglobin level of 9-10 gm/dL. This study carried out in the department of Transfusion Medicine of Mymensingh Medical College Hospital from January 2014 to June 2014. A total of 200 parents were interviewed. There was a slight preponderance of females which accounted for 57.5% of the parents. Ninety seven (45.5%) had an income less than Rs. 5000 per month. Nearly 50% were illiterate with only 24.5% with a higher education. Consanguinity was positive in 72.5% of the parents with extended family history of thalassemia positive in 40.8%. Only 29.5% were immunized against Hepatitis B. Around 27.5% did not know whether they should be immunized. Fifty five percent of parents knew children should receive Dysferol. Twelve percent were aware of consanguinity to be a risk factor for thalassaemia with only 5% having undergone antenatal diagnosis. Parental knowledge about thalassemia and its preventive measures is inadequate; this requires intervention in the form of public health education programs concentrating on high risk/targeted population.

Anti-Bacterial effect of Aqueous Garlic Extract (AGE) determined by Disc Diffusion Method against Escherichia coli

The study was performed to determine the antibacterial effect of aqueous extract of garlic (Allium sativum) against standard strain of Escherichia coli ATCC 25922. An interventional study was conducted in Department of Pharmacology and Therapeutics in collaboration with Department of Microbiology, Mymensingh Medical College, Mymensingh. Antibacterial effect of AGE was determined by disc diffusion method. Sensitivity of AGE determined in disc diffusion and the zone of inhibition (ZOI) was 4 mm, 10 mm and 20 mm at 25 μg/10 μl, 50 μg/10 μl and 100 μg/10 μl concentrations respectively. From the findings it is clearly determined the extract has definite antibacterial effect upon Escherichia coli. Further studies are required to detect and isolate the active ingredients present in the Garlic extract as well as detail steps of mechanism responsible for antibacterial effect. Then their effects against the studied organism should be studied in vivo separately and its toxicity profile should also be taken into account.

Biomass Fuel Smoke and Tuberculosis: A Case-Control Study

This case control study was done to ascertain the association between exposures to biomass cooking fuel smoke and pulmonary tuberculosis. Cases were all newly diagnosed pulmonary tuberculosis patients, randomly collected from the Hospital (DOTS centers) Registry from January 2012 to June 2012 from two Upazillas of Sirajganj district, Bangladesh. A home visitation program was done subsequently. Healthy controls were recruited from the neighbourhood of each case through a predefined procedure. Total 276 new pulmonary tuberculosis cases and 276 neighbourhood controls were enrolled. A semi-structured questionnaire containing demographic information, smoking habits, cooking place, kitchen condition, use of biomass fuel for cooking was used for interview. Crude (unadjusted) odd ratios and their corresponding 95% confidence limits for independent variables were determined by binary logistic regression. All significant variables were entered into a multivariate conditional logistic regression model and a final fitted model was determined by backward elimination methods. In univariate analysis, member of a nuclear family {Unadjusted odd ratio (Unadj. OR) 1.570, 95% CI 1.008-2.44)}, having non-formal education (Unadj. OR 2.739, 95% CI 1.219, 6.153) or primary (Unadj. OR 3.407, 95% CI 1.492, 7.782) to secondary level (Unadj. OR 2.392, 95% CI 1.032, 5.544) education, using cow dung (Unadj. OR 3.961, 95% CI 1.267, 12.376) and biomass fuel i.e. plant origin (Unadj. OR 3.382, 95% CI 1.087, 10.518) for cooking, past smoker (Unadj. OR 2.504, 95% CI 1.061, 5.910), using open oven (Unadj. OR 3.109, 95% CI 0.995, 9.716), having small kitchen area (Unadj. OR 0.99, 95% CI 0.989, 0.999) all were significantly associated with tuberculosis. When all significant variables were entered into a multivariate conditional logistic regression model nuclear family {Adjusted odd ratio (Adj OR) 1.808, 95% CI 1.127, 2.9)}, primary level education (Adj OR 2.86, 95% CI 1.23, 6.647) and non formal education (Adj OR 2.312, 95% CI 1.013, 5.276), biomass fuel (plant origin, Adj OR 3.497, 95% CI 1.059, 11.55), and cow dung (Adj OR 4.368, 95% CI 1.319, 14.464)) used in cooking and irregular smoker (who stop smoking at least 6 month back) (Adj OR 2.806, 95% CI 1.141, 6.901) were significantly associated with tuberculosis cases. From this study significant association have been found between exposure to combustion of biomass cooking fuel and tuberculosis.

Specific gyrA gene mutations predict poor treatment outcome in MDR-TB

OBJECTIVES

Mutations in the gyrase genes cause fluoroquinolone resistance in Mycobacterium tuberculosis. However, the predictive value of these markers for clinical outcomes in patients with MDR-TB is unknown to date. The objective of this study was to determine molecular markers and breakpoints predicting second-line treatment outcomes in M. tuberculosis patients treated with fourth-generation fluoroquinolones.

METHODS

We analysed treatment outcome data in relation to the gyrA and gyrB sequences and MICs of ofloxacin, gatifloxacin and moxifloxacin for pretreatment M. tuberculosis isolates from 181 MDR-TB patients in Bangladesh whose isolates were susceptible to injectable drugs.

RESULTS

The gyrA 90Val, 94Gly and 94Ala mutations were most frequent, with the highest resistance levels for 94Gly mutants. Increased pretreatment resistance levels (>2 mg/L), related to specific mutations, were associated with lower cure percentages, with no cure in patients whose isolates were resistant to gatifloxacin at 4 mg/L. Any gyrA 94 mutation, except 94Ala, predicted a significantly lower proportion of cure compared with all other gyrA mutations taken together (all non-94 mutants + 94Ala) [OR = 4.3 (95% CI 1.4-13.0)]. The difference in treatment outcome was not explained by resistance to the other drugs.

CONCLUSIONS

Our study suggests that gyrA mutations at position 94, other than Ala, predict high-level resistance to gatifloxacin and moxifloxacin, as well as poor treatment outcome, in MDR-TB patients in whom an injectable agent is still effective.

Association of bacteria in diabetic and non-diabetic foot infection - An investigation in patients from Bangladesh

The microbial community on a host relies on its immune status and pathophysiological condition. Diabetes mellitus is a metabolic disorder associated with a 25% increased risk of developing foot infection. The pathophysiological differences between diabetic foot infection (DFI) and non-DFI patients may alter the microbial composition in infections. The present study aims to comparatively analyze the microbes colonized in DFI and non-DFI patients in Bangladesh. Pus specimens were collected from 67 DFI and 12 non-DFI patients to investigate the bacteria associated with foot infection. For this investigation, an array of microbiological, molecular biological and immunological approaches were performed. Common bacteria detected in both DFI/non-DFI samples were Pseudomonas spp. (22/29%), Bacillus spp. (12/3%), Enterobacter spp. (22/7%), Staphylococcus spp. (13/13%) and Acinetobacter spp. (10/10%). Enterococcus spp. (9%) and Klebsiella spp. (8%) occurred only in DFI patients, whereas Citrobacter spp. (29%) was only detected in non-DFI samples. The rate of occurrence of three organisms, namely, Enterococcus spp. |Z|=2.2125, Klebsiella spp. |Z|=1.732, Bacillus spp. |Z|=1.9034, were also statistically significant. Most of the isolates from DFI patients were commonly resistant to the cephalosporin (Ceftazidime, Ceftriazone, Cefurozime) and monobactam (Aztreonam) groups of antibiotics. DFI patients had comparatively higher C-reactive protein (CRP) levels than non-DFI patients, and a positive correlation was observed between multi-antibiotic resistance and CRP levels (one of the markers of chronic subclinical inflammation). The present investigation implicated a complex association of the bacterial population in DFI compared with non-DFI with different antimicrobial resistance properties, which was linked with CRP levels.

An in silico model to demonstrate the effects of Maspin on cancer cell dynamics

Most cancer treatments efficacy depends on tumor metastasis suppression, where tumor suppressor genes play an important role. Maspin (Mammary Serine Protease Inhibitor), an non-inhibitory serpin has been reported as a potential tumor suppressor to influence cell migration, adhesion, proliferation and apoptosis in in vitro and in vivo experiments in last two decades. Lack of computational investigations hinders its ability to go through clinical trials. Previously, we reported first computational model for maspin effects on tumor growth using artificial neural network and cellular automata paradigm with in vitro data support. This paper extends the previous in silico model by encompassing how maspin influences cell migration and the cell-extracellular matrix interaction in subcellular level. A feedforward neural network was used to define each cell behavior (proliferation, quiescence, apoptosis) which followed a cell-cycle algorithm to show the microenvironment impacts over tumor growth. Furthermore, the model concentrates how the in silico experiments results can further confirm the fact that maspin reduces cell migration using specific in vitro data verification method. The data collected from in vitro and in silico experiments formulates an unsupervised learning problem which can be solved by using different clustering algorithms. A density based clustering technique was developed to measure the similarity between two datasets based on the number of links between instances. Our proposed clustering algorithm first finds the nearest neighbors of each instance, and then redefines the similarity between pairs of instances in terms of how many nearest neighbors share the two instances. The number of links between two instances is defined as the number of common neighbors they have. The results showed significant resemblances with in vitro experimental data. The results also offer a new insight into the dynamics of maspin and establish as a metastasis suppressor gene for further molecular research.

Gender Variation in the Risk Factors with Ischemic Stroke: Bangladesh Perspective

It is suggested in different studies that gender has a great impact on the distribution of risk factors of stroke. This study aims at determining the gender differences in risk factors of acute ischemic stroke among male and female patients. Data extracted for this study were taken from a case control study which was carried out in the departments of Neurology and Medicine of Dhaka Medical College Hospital (DMCH) and Shaheed Suhrawardy Medical College Hospital (ShSMCH) Dhaka from July 2009 to June 2011. We collected data of 125 patients with ischemic stroke and 129 healthy controls from the primary source. All secondary data were divided on the basis of gender. Among all male respondents 70 stroke patients were considered as case and 72 healthy respondents were considered as control and in female group 55 were stroke patients (case) and 57 were healthy control. Risk factors of stroke for male and female were evaluated separately. After multivariate analysis ever smoking (both present and ex smoker) (adj. OR 3.799, 95% CI 1.416, 10.19), diabetes mellitus (adj. OR 5.687, 95% CI 1.99, 16.26), hypertension (adj. OR 18.53, 95% CI 6.43, 53.4) and total cholesterol (adj. OR 1.017, 95% CI 1.01, 1.03) were found significant predictors for stroke in male whereas diabetes mellitus (adj. OR 6.989, 95% CI 1.54, 31.64), hypertension (adj. OR 17.85, 95% CI 5.1, 62.38), serum low density lipoprotein (LDL) (adj. OR 1.04, 95% CI 1.013, 1.07) and serum triglyceride (TG) (adj. OR 1.012, 95% CI 1.004, 1.02) were found significant in female. Besides taking the controlling measure for hypertension and diabetes mellitus, life style modification is an important factor to prevent stroke in both sexes.

Pattern of Dermatophytes in Patients Attend in Mymensingh Medical College Hospital

Dermatophytosis is a common fungal disease which involves the keratinized tissue. This is an attempt to observe the spectrum of dermatophytes among the clinically suspected cases of dermatophytosis attending the outpatient department of Dermatology and Venereology, Mymensingh Medical College Hospital, Mymensingh during the period of July 2013 to December 2014. Two hundred thirty (230) clinically suspected cases of dermatophytosis were subjected in this study. Sixty three cases (27.39%) were positive for fungus in direct microscopy while 53(23.04%) were culture positive. Among the clinical types tinea unguium was the most common followed by tinea corporis. Dermatophytosis was more common in the age group of 21-30 years. The male to female ratio was 1.53:1. Trichophyton rubrum 44(83.04%) was found common etiological dermatophyte species followed by Trichophyton mentagrophytes 5(9.43%) and Epidermophyton floccosum 4(7.55%).

Rotavirus is Predominent Enteropathogen in Acute Childhood Diarrhea in Mymensingh

The study was carried out from July 2011 to June 2012 in the Department of Microbiology, Mymensingh Medical College. A total of 200 clinically diagnosed diarrheal paediatrics patients were included in this study. Stool specimens were examined by standard laboratory methods for identification of enteropathogens. Diarrheagenic Escherichia coli strains were detected by Multiplex PCR following standard methods and Rotavirus genome was detected by Polyacrylamide Gel Electrophoresis (PAGE). Rotavirus was the most common enteropathogen detected in 69(34.5%) cases, followed by Diarrheagenic Escherichia coli (DEC) and Campylobacter species in 34(17.0%) and 23(11.5%) cases respectively. Rotavirus detection rate was high in upto 1 year age group which was 51(25.5%).

Hyperhomocysteinemia Association With Transient Global Amnesia: A Rare Case Report

Context:

Transient global amnesia (TGA) is an intriguing condition that classically presents with an abrupt onset of temporary complete anterograde amnesia and partial retrograde amnesia. Most individuals who experience such a form of amnesia usually have only one attack but recurrent attacks are possible. Most attacks last for a few minutes or few hours and the ability to lay down new memories may also be affected but gradually improves, leaving only a dense amnestic gap for the duration of the episode. There has been some discussion about the etiology behind TGA; however, there has yet to be a consensus with regard to any significant association.

Case Report:

We report the case of a 65-year-old male presenting with a sudden onset of memory loss that is typical of TGA and who was found to have elevated homocysteine levels. There has only been one other case previously reported that discussed a possible correlation between hyperhomocysteinemia and TGA. It is yet to be determined if increased homocysteine level is a significant risk factor for attacks of TGA.

Conclusion:

Although it was first described more than half a century ago, it can still be misdiagnosed frequently as many physicians are not familiar with this condition. Furthermore, there are quite a few medical conditions that may cause sudden memory impairment, such as epilepsy and stroke, which make it difficult to distinguish them from this form of amnesia. The knowledge of these clinical identities is necessary for a high index of suspicion, which may lead to a meticulous medical evaluation as required for proper diagnosis.

Two guard cell mitogen-activated protein kinases, MPK9 and MPK12, function in methyl jasmonate-induced stomatal closure in Arabidopsis thaliana

Methyl jasmonate (MeJA) and abscisic acid (ABA) signalling cascades share several signalling components in guard cells. We previously showed that two guard cell-preferential mitogen-activated protein kinases (MAPKs), MPK9 and MPK12, positively regulate ABA signalling in Arabidopsis thaliana. In this study, we examined whether these two MAP kinases function in MeJA signalling using genetic mutants for MPK9 and MPK12 combined with a pharmacological approach. MeJA induced stomatal closure in mpk9-1 and mpk12-1 single mutants as well as wild-type plants, but not in mpk9-1 mpk12-1 double mutants. Consistently, the MAPKK inhibitor PD98059 inhibited the MeJA-induced stomatal closure in wild-type plants. MeJA elicited reactive oxygen species (ROS) production and cytosolic alkalisation in guard cells of the mpk9-1, mpk12-1 and mpk9-1 mpk12-1 mutants, as well in wild-type plants. Furthermore, MeJA triggered elevation of cytosolic Ca(2+) concentration ([Ca(2+)]cyt ) in the mpk9-1 mpk12-1 double mutant as well as wild-type plants. Activation of S-type anion channels by MeJA was impaired in mpk9-1 mpk12-1. Together, these results indicate that MPK9 and MPK12 function upstream of S-type anion channel activation and downstream of ROS production, cytosolic alkalisation and [Ca(2+)]cyt elevation in guard cell MeJA signalling, suggesting that MPK9 and MPK12 are key regulators mediating both ABA and MeJA signalling in guard cells.