Urinary tuberculosis presented as isolated bladder lesion - a case report

Extra-pulmonary Tuberculosis (EPTB) may affect all organs of the body with varied presentations. Genitourinary tuberculosis (GUTB) carries importance for its morbidity, though it is an uncommon form of TB. A widow of 45 years was admitted with several episodes of painless haematuria and recently developed urinary incontinence. Diagnosis of urinary bladder tuberculosis was made only by histopathology from bladder lesion with supportive evidence of few nonspecific constitutional symptoms and positive family history of pulmonary tuberculosis (PTB) and persistent sterile pyuria. Upper urinary tract involvement was not found. Category 1 anti-TB treatment was started. With this treatment recovery of the patient is satisfactory and symptoms are disappearing except for the incontinence. Urinary tuberculosis should be ruled out in a case of painless haematuria, repeated sterile pyuria.

Outcome of single-stage transanal endorectal pull through for short segment Hirschsprung's disease in neonates and infants

Hirschsprung's disease (HD) is developmental disorder of the enteric nervous system. Diagnosis can be confirmed by rectal biopsy. The surgical management of HD includes so many procedures. The purpose of this study was to evaluate the out come of single-stage transanal endorectal pull-through operation for short segment HD in neonates and infants. This prospective study was carried out in the Department of Pediatric Surgery, Dhaka Shishu (Children) Hospital, Dhaka, Bangladesh during the period from January 2004 to December 2009. The study included neonates & infants (age 1 day to 1 year) of both sex, who were clinically suspected and biopsy proven HD with barium enema suggesting rectosigmoid HD. We excluded patients with short segment HD who had associated anomalies, and with hugely dilated proximal colon, operated cases with less than 6 months' follow up. During study period, single-stage transanal endorectal pull through (TEP) operation done in 68 neonates and infants patients (8 excluded) of short segment HD. The mean operative time, postoperative hospital stay, followed up time were 120 minutes, 7.94 days and 12 months respectively. Transeverse colostomy was needed in 4 patients because of anastomotic leakage and they were complicated with anastomotic stenosis, however managed by progressive dilatation. Overall parents' satisfaction was achieved. Single-stage primary transnanl endorectal pull-through for short segment HD is feasible in neonates and infants. It preserves all the advantages of minimally invasive surgery. TEP is a better option in terms of comfort, operative success, postoperative morbidity, cosmetic appearance and parents' satisfaction.

Sustained virological response after treatment in patients with chronic hepatitis C infection--a five year follow up

Peginterferon alpha-2a and ribavirin combination therapy achieves a sustained virological response (SVR) in patients with chronic hepatitis C. Little is know about long-term durability of hepatitis C virus--Ribonucleic acid (HCV-RNA) negativity in patient treated with pegylated interferon and ribavirin therapy. Aim of this study was to evaluate the durability of virologic response in patients with SVR to anti-viral therapy treated at our centre. A total of 52 patients with chronic hepatitis C virus infection who had obtained SVR after Peginterferon alpha-2a and ribavirin combination therapy were followed up to 5 years with annual HCV-RNA testing. During this follow up period, 4 of 52 patients with initial SVR developed late relapse of hepatitis C virus infection. Relapse was more common in patients who has cirrhosis (3/6 [50%]) vs (1/46 [2.17%]) without cirrhosis. In conclusion, SVR is durable in most patients, but some patients do have late relapse; long-term follow up may be particularly important in a subset of patients with hepatitis C virus infection who have liver cirrhosis.

Pesticide Residues In Some Selected Pond Water Samples Of Meherpur Region Of Bangladesh

Water samples collected from some selected ponds of Meherpur region were studied for the presence of organophosphorus and carbamate pesticide residues. High performance liquid chromatography (HPLC) technique was used to determine the concentration levels of those residues. The results obtained indicate slight contamination of some of the water samples with residues of diazinon, chlorpyriphos (organophosphorus insecticide) and carbofuran (carbamate insecticide). The residues level of diazinon and chlorpyriphos ranged from 0.033 to 0.079 ppm and 0.010 to 0.471 ppm respectively. Among carbamate pesticides, carbofuran identified in two samples ranged from 0.0143 to 0.0387 ppm, and carbaryl was not detected in any of the samples. Limit of detection (LOD) was 0.01 ppm. However, the residue level was also within the acceptable ranges according to the WHO guideline value of water quality. But, the presence of such residues is indicative of weak regulatory control which is required to be in place for safety of the environment and to stop further aggravation of the situation. J. Asiat. Soc. Bangladesh, Sci. 39(1): 77-82, June 2013 DOI: http://dx.doi.org/10.3329/jasbs.v39i1.16036

Protective ileostomy in low anterior resection for rectal cancer -- can it be avoided?

The necessity of a protective ileostomy in patients subjected to low anterior resection for rectal cancer has been discussed controversially. This prospective observational study was carried out to see the outcome of low anterior resection without a covering ileostomy. Forty patients underwent low anterior resection for primary rectal carcinoma in mid and distal rectum without any covering ileostomy from January 2007 and June 2010 in the department of Surgery of Bangabandhu Sheikh Mujib Medical University and two other private hospitals in Dhaka city. The primary objective of the study was to demonstrate clinical anastomotic leak rate, reoperation rate and morbidity and mortality related to leak. Thirty two male and eight female patients underwent low anterior resection for primary rectal carcinoma. Median age was 53 years (range 23-67). Majority of the tumors were located within 10cm from anal verge and most of the cases were in Duke's stage B and C. One male patient (overall 2.5%) developed clinical anastomotic leakage, but responded well to conservative treatment. There was no 30 days mortality. Covering ileostomy can be avoided in selected patients with low anterior resection for primary carcinoma in mid and distal rectum.

Thelazia callipaeda infestation in Bangladesh: a case report

A 5 years old girl was admitted to Ophthalmology department of Mymensingh Medical College Hospital, Mymensingh with excessive watering, redness and movement of something in her right eye for last 2 months. She had unaided visual acuity- 6/6, matted eye lashes and mucoid discharge in right eye. Follicles were present on the fornices and lower palpebral conjunctiva of the same eye. On eversion of the right upper lid there were silicon tube like coiled moving structures seen at the lateral part of the upper fornics. Six nematodes were seen in the upper fornics around the duct of lacrimal glands. After removing the nematodes, one specimen was sent to parasitology department of Bangladesh Agriculture University for species identification. They reported that sending specimen is an adult "Thelazia Callipaeda". By the present study, the presence of human ocular T. callipaeda infestation is second reported case in Bangladesh. Ophthalmologists should be aware about parasitic infestation of conjunctiva.

Portopulmonary hypertension

Pulmonary involvement is common in patients with portal hypertension and can manifest in diverse manners. Changes in pulmonary arterial resistance, manifesting either as the hepatopulmonary syndrome or portopulmonary hypertension (POPH), have been increasingly recognized in these patients in recent years. The prognosis in patients with liver disease who also suffer from significant POPH is considered to be poor. Higher degree of pulmonary artery pressure (PAP) may preclude a patient from liver transplant as mortality in these patients is high. This review summarizes the clinicopathologic features, diagnostic criteria, as well as the latest concepts in the pathogenesis and management of POPH, which is defined as is a form of pulmonary arterial hypertension (PAH) associated with portal hypertension with or without underlying chronic liver disease.

Serum calcium level among smear positive pulmonary tuberculosis patients in Bangladesh

This case control study was carried out in the Department of Biochemistry, Mymensingh Medical College, Bangladesh in cooperation with the Outpatient Department and Medicine Units of Mymensingh Medical College Hospital, Fulbaria Upazilla Health Complex, Mymensingh and some DOTS centers of BRAC, a non-government organization during the period of July 2006 to June 2007. The aim of the study was to explore the status of serum calcium level in smear positive Bangladeshi pulmonary tuberculosis patients. A total of 120 people of different age groups were included in this study. Subjects were divided into two groups - Group I (Control; n=60) apparently healthy people selected matching by age, sex and socioeconomic status with the cases and Group II (Case; n=60) people with smear positive pulmonary tuberculosis. Serum calcium was estimated by colorimetric principle. Serum calcium was adjusted by serum albumin concentration. Statistical analysis was done by using SPSS windows package. Among the groups, mean±SD of adjusted serum calcium in Group II (2.41±0.15mmol/L) was significantly higher (p<0.001) than that in Group I (1.85±0.11mmol/L). It is evident from the study that serum calcium level significantly increases in smear positive Bangladeshi pulmonary tuberculosis patients.

Peak expiratory flow rate of normal school going children in Mymensingh municipality

This cross sectional study was conducted to measure the PEFR values of normal school going children of Mymensingh, Bangladesh. Peak expiatory flow rate (PEFR) is a lung function test which is easily measurable and reproducible but the base line values of PEFR have not been studied in large scale among Bangladeshi children. In Mymensingh municipality out of 79 schools 4 schools were selected purposively. A total of 984 (499 boys and 485 girls, nearly equal in ratio) normal children (6-15 years), were selected randomly by using lottery technic in classroom. To obtain peak expiratory flow rate (PEFR) mini Wright peak flow meter was used. The highest of three readings was taken as the correct value. Anthropometric parameters including body weight and height were recorded by bathroom scale and stadiometer respectively and body surface area was calculated. According to age interval (10 months) in boys and girls the mean difference of PEFR values showed that among age categories of 6, 7 & 8 years had no significant (p were <0.18, <0.73 and <0.70 accordingly) and all other age categories the mean difference of PEFR between boys and girls had significant (p<0.01). The correlation coefficient (r values) and the level of significance between different anthropometric parameters and PEFR in case of boys and girls were significant (p<0.001). Correlation of height (boys r=0.961 & girls r=0.954) with PEFR was the highest in comparison to other anthropometric parameters (age, sex and body weight). Boys had significantly higher values of PEFR than the girls at any height.

Nanosized metal oxide and nanobelts prepared by selective dealloying of Ti-based amorphous powders

Two typical nanomaterials, nanosized metal oxides and nanobelts, are obtained in one-pot selective dealloying process by using multiple-component Ti-based amorphous powders as dealloying precursors. The microstructure and photoelectric conversion property of the as-synthesized Zr-doped nanobelts are comprehensively investigated. Particularly, a core-shell structure, for example, residual amorphous alloy as the microsized core and nanosized metal oxide composites (mainly TiO2 and CuO) as the shell, forms as a byproduct of the selective dealloying. These resultant metal oxide composites show large specific surface area, and superior adsorption efficiency and capacity for removing toxic Cr(6+) in aqueous solution. The differences in the standard electrode potentials between the multiple-component elements in amorphous powders trigger their selective dealloying in alkaline solutions.

Open Tension Free Mesh Repair of Inguinal Hernias: The Lichtenstein Technique- 26 Our Experience for Last Ten Years

Objective : Recurrences following hernia repair is one of the significant problem for both patient & surgeon. Open tension free mesh techniques of inguinal hernia repair offers good results. Prosthetic materials have been increasingly used in hernia repair to prevent recurrences. Their use has been associated with several advantages, such as less postoperative pain, rapid recovery and low recurrence rates. Materials and method : In this retrospective study, 1050 tension-free inguinal hernia repairs were performed between January 2001 and December 2010 in various medical institutes including BSMMU, DMCH & some private clinics in Dhaka city, using a polypropylene mesh (Lichtenstein technique). The main outcome measure was early and late morbidity and especially recurrence. Results : Inguinal hernia was indirect in 76 % of cases (798 patients), direct in 22% (231 patients) and of the pantaloon (mixed) type in 2 % (21 patients). Mean patient age was 44.5 years (range, 18 – 85). Follow-up was completed in 630 patients (60 %) by clinical examination or phone call. The median follow-up period was 2.5 years (range 1 – 5 years). Seroma and hematoma formation requiring drainage was observed in 25 and 8 patients respectively, while transient testicular swelling occurred in15 patients. Infection was found in 9 patients. Rejection of mesh occurred in 4 patients. There was 6 recurrence of the hernia (in one of these patients with late mesh rejection) (recurrence rate = 0.57 %). Postoperative neuralgia was observed in 25 patients (2.38 %). Conclusion : Lichtenstein tension-free mesh repair of inguinal hernia is a simple, safe, comfortable, effective method. Tension free repair using synthetic meshes have been reported to result in better patient comfort and lower recurrence rates compared with the conventional procedures like Shouldice’s or Bassini’s operation2-4. Therefore it is the preferred method for hernia repair since 1994. DOI: http://dx.doi.org/10.3329/jss.v16i1.14444 Journal of Surgical Sciences (2012) Vol. 16 (1) : 26-29

Surgical outcome of laparoscopic and open surgery of pediatric inguinal hernia

Inguinal hernia repair is one of the most frequently performed surgical procedures in infants and young children. This prospective comparative study was conducted with initial experience in the department of pediatric surgery, Dhaka Shishu (children) hospital during the period of July 2007 to August 2008. We enrolled 62 children undergoing surgery for inguinal hernia, of which 30 underwent laparoscopic procedure (bilateral in 21, unilateral 9) and 32 open procedures (bilateral in 5, unilateral in 27). Mean±SD patient age was 5.92±2.11 months in laparoscopic group and 6.63±2.64 months in open group (p=0.264), 3 months to 5 years in both groups. Patients were studied under variables of operative time, duration of postoperative hospital stay & post operative complications. During laparoscopy a contralateral patent processus vaginalis of ≥2cm was noted and repaired peroperatively in 18 out of 27 children (66%), who were initially diagnosed as unilateral hernia. For unilateral repair mean±SD operative time was significantly longer in Group A (62.63±52.75) minutes compares to the Group B (29.37±9.40), p<0.001. On the contrary, for bilateral repair Mean±SD operative time was comparable between the two groups (64.65±49.70) minutes for laparoscopy & (35.65±11.53 minutes) for open herniotomy & P=0.01, that was not remarkably significant. The mean±SD post operative length of hospital stay (in hours) 36.00±32.7 hours in Group A compared to 29.97±11.82 hours in Group B which was not statically significant (p=0.342). The mean±SD follow up was 24.5±10.5 months in laparoscopic group (Group A) & 22.5±10.5 months in open group (Group B), p=0.251. Regarding post operative complication, in this study, contra lateral metachronous inguinal hernia (CMIH) manifested in none of the patient out of 27 (total unilateral repaired number) patients in laparoscopic group but contrary to this in open group 2 patients out of 27 had developed CMIH & p value was <0.05, which is statistically significant. There were 2 cases of scrotal hydrocele out of 30, observed in Group A whereas 1 case out of 32 in Group B, p=0.49, which was statistically insignificant. The scrotal hydrocele was lasted only for 2 days & resolved spontaneously. About recurrence after operation, our study noted that, 1 case (3.3%) out of 30 in laparoscopic group and 2 cases (6%) out of 32 in open surgery group had developed recurrent inguinal hernia in about one year follow up where p value was 0.459, & it was statistically insignificant. In this study, none of the patient had developed post operative testicular atrophy (due to any vas or vascular injury) or testicular ascend. So, overall this study result implies that, Laparoscopic herniotomy might be a safe and effective option as open herniotomy for the treatment of inguinal hernia in children but which one would be superior or best option it requires a large series of randomized trial.

Demographic and clinical evaluation of secondaries to liver

Liver is one of the common sites of metastasis from primary malignancies from different sources. The study was undertaken to know the demographic profile, clinical presentation, investigation findings and primary sources of metastatic lesions in liver among Bangladeshi patients. The study was done on patients with secondary lesion in liver who were admitted into the department of Gastroenterology and department of Hepatology in Bangabandhu Sheikh Mujib Medical University over the period of one year from July 2009 to June 2010. Total 75 patients were included. Mean age of 49.6±6.92 years and the peak incidence was between 41 to 50 years. Seventy six percent (76%) were male and 24% were female and male to female ratio was 3.17:1. Only 5.3% had family history of cancer. More than half of patients had Hb level ≤11gm/dl and two third had raised ESR. All patients showed raised alkaline phosphatase and prolonged prothrombin time found in one forth of patients. Carcinoma stomach was the most common primary source of liver metastasis followed by carcinoma gallbladder, carcinoma pancreas, carcinoma of unknown primary and carcinoma colon.

Controlling scabies in madrasahs (Islamic religious schools) in Bangladesh

OBJECTIVES

To assess the effectiveness of a scabies control programme in reducing the prevalence of scabies in urban Bangladesh madrasahs, where the condition is extremely common.

STUDY DESIGN

A controlled trial involving four intervention madrasahs (total students 2359) and four control madrasahs (total students 2465) in Dhaka Metropolitan Area.

METHODS

A baseline scabies sample survey was carried out on 40 and 44 students of four intervention and four control madrasahs, respectively. Another 40 students of the intervention madrasahs were administered a pre-intervention test on scabies knowledge. This was followed by mass treatment of all students, teachers and staff of the eight madrasahs with topical 5% permethrin cream. The subsequent intervention involved daily monitoring of students for five key personal hygiene practices, weekly 10-min scabies health education classes, supply of simple and inexpensive products to students to prevent cross-infestation to/from peers (e.g. plastic bags, clothes hangers), and chemotherapy of new students detected with scabies. After 4 months of the intervention, the prevalence of scabies, personal hygiene practices and scabies knowledge were assessed in students of the intervention madrasahs.

RESULTS

Before the intervention, the prevalence of scabies was 61% and 62% in intervention and control madrasahs, respectively (P = 1.00). After mass scabies treatment in all eight madrasahs and 4 months of intervention, the prevalence of scabies was reduced to 5% and 50% in intervention and control madrasahs, respectively (P < 0.001). There were significant improvements in all five personal hygiene practices at the intervention madrasahs. Mean test scores for scabies knowledge were 40% before the intervention and 99% after the intervention in the four intervention madrasahs. The cost of this programme was US$1.60 per student, and primarily included products such as plastic bags and clothes hangers, and health education material.

CONCLUSIONS

This programme demonstrates a pragmatic and cost-effective way to control scabies in a residential institutional setting. It is recommended that this programme should be scaled up to all residential madrasahs in Bangladesh.

Enteropathogens associated with acute diarrhea in a tertiary hospital of Bangladesh

Acute diarrheal diseases are great concern throughout the world, as they are responsible for considerable morbidity and mortality, especially in developing countries. The present study was carried out during the period from January' 2011 to December' 2011 in the Department of Microbiology, Mymensingh Medical College. A total of 300 stool specimens were examined by standard laboratory methods for identification of enteropathogens. Rotavirus was detected by Polyacrylamide Gel electrophoresis (PAGE). Different diarrheagenic E. coli (DEC) were detected by Multiplex PCR following standard methods. Of the 300 stool specimens examined, Enteropathpgens were detected in 160(53.5%) cases. Rota virus was detected in 82(27.5%) cases, followed by DEC in 54(18%), Shigella spp. in 8(2.4%), Salmonella spp. in 5(1.6%), Entameoba histolytica in 4(1.5%) and Giardia lamblia in 3(1.0%) cases. Among the DEC, the Enterotoxigenic E. coli (ETEC) was most prevalent (72%, 39/54). The present study revealed a high prevalence of rotavirus and DEC as the predominant causes of diarrhea in this region.

Ventral free oral mucous membrane graft for bulbar urethral stricture

The use of oral mucous membrane graft onlay urethroplasty represents the most widespread method of bulbar urethral stricture repair. We investigated the short term result of oral mucous membrane graft placed on the ventral surface for management of bulbar urethral stricture. Patients with Bulbar urethral stricture of any length, infection free urinary tract and informed consent for oral mucosa harvesting and urethroplasty were selected for study. We enrolled 108 cases of bulbar urethral stricture patients from January 2004 to July 2009. The mean ± SD preoperative maximum flow rate of 5.2 ± 2.6 ml/sec and mean ± SD PVR 87 ± 58.3 ml were treated by substitution urethroplasty with oral mucous membrane by a single surgical team in a private hospital. Causes of stricture were trauma 26(24.1%), infection 58(53.7%), catheter induced 8(7.4%), post TURP 11(10.2%) and unknown 5(4.6%). Oral mucous membrane was harvested from the cheek or from the inner side of lower lip. Defect of the urethra displayed by longitudinal ventral urethrotomy and the graft was sutured over the edges of the incised urethral mucosa over a 14 Fr latex Foley's catheter. Spongiosum tissue was closed over the graft. Pericatheter urethrogram was performed in all cases to check for the anastomotic leakage and the Catheter was removed after 2 weeks of the procedure. After removal of catheter uroflowmetry & ultrasound scan of bladder were performed to estimate the maximum flow rate and post voidal residue. The patient was followed-up every 3 months with uroflowmetry & ultrasonography. The median (range) age of the patients was 32(21-72) years. Mean follow up period was 36 months (range 12-54). Mean ± SD stricture length was 3.7 ± 2.6 cm. The overall success rate was 91.7%. Mean ± SD flow rate was 23 ± 4.2 ml/sec, mean ± SD post void residue was 25 ± 15.5 ml and patient quality of life (QOL) was excellent in almost all patients. Overall complications were seen in 9(8.3%) cases. Of which, restricture occurred in 6 patients; periurethral fistulae seen in 2 cases and per urethral bleeding in 1 patient. No significant complications were observed at the donor site. Oral numbness and mild discomfort complained by 67.6% patients which were managed by reassurance only. In our experience ventral placement of oral mucous membrane graft along with spongioplasty is a very easy procedure with very encouraging short term result.

Responses of monosex nile tilapia (Oreochromis niloticus) to intraperitoneal challenge by Streptococcus iniae after vaccination with ghosts of the bacterium

The vaccine potential of Streptococcus iniae ghosts produced by gene E mediated lysis was investigated using tilapia (Oreochromis niloticus). Tilapia immunized with S. iniae ghosts (SIG) and formalin killed S. iniae (FKC) vaccines showed significantly higher serum agglutination titres than control fish. Fish immunized with SIG showed no significant differences with fish immunized with FKC in serum agglutination titres, but showed significantly higher bactericidal activity than fish immunized with FKC. Furthermore, fish immunized with SIG showed higher protection than fish immunized with FKC. As this promising type of a non-living whole cell envelope preparation seems to be favorable over conventional vaccines, we suggest S. iniae ghosts as a new vaccine candidate DOI: http://dx.doi.org/10.3329/bvet.v29i1.11889 Bangl. vet. 2012. Vol. 29, No. 1, 31-37     

The Stability Constants and Thermodynamic Parameters of Borate - Carbohydrate Complexes by pH Measurements

The complexation of borate with carbohydrates was studied potentiometrically at  temperatures 298.15-328.15K in aqueous medium at constant ionic strength, I = 0.1M  KCl. The stability constants (?) and thermodynamic parameters of borate-carbohydrate  complexes were determined using the technique proposed by Verchere and Hlaibi.  Carbohydrates such as D-fructose, D-Sorbitol, D-Mannitol, D-Galactose, D-Glucose and  D-Raffinose were used as ligands in this study. The ?1 values for the complexes at  different temperatures were found to follow the order: D-fructose > D-Sorbitol > DMannitol > D-Galactose > D-Glucose > D-Raffinose. The ?G0 values were found to be  negative and the negative values increased according to the above order. The values of  ?H0 and ?S0 were both negative which indicated that the complex formation was an  exothermic process and the spontaneity of its formation is driven by enthalpic  contribution overcoming the negative contribution of ?S0. DOI: http://dx.doi.org/10.3329/jbcs.v25i1.11766 Journal of Bangladesh Chemical Society, Vol. 25(1), 15-20, 2012

Monitoring of selected pesticides residue levels in water samples of paddy fields and removal of cypermethrin and chlorpyrifos residues from water using rice bran

Consumption of pesticides associated foods increased in recent decades in Bangladesh. Most of the pesticides come from paddy, as rice is the main food items here and about 70 % pesticides are used only on paddy fields. Water samples of paddy fields and Kaliganga River of Manikganj district were analyzed to provide base line data on cypermethrin, chlorpyrifos and diazinon residue by using high performance liquid chromatography. Levels of Cypermethrin, chlorpyrifos and diazinon detected in the paddy field water samples were (0.605 ± 0.011 μg/L), (0.06 ± 0.001 μg/L) and (0.039 ± 0.002 μg/L), respectively. 0.11 ± 0.003 μg/L of cypermethrin and 0.012 ± 0.0006 μg/L of chlorpyrifos were also identified in the water samples of Kaligonga River. Diazinon residue was not detected in the river water samples. The detected concentrations of pesticide residues in the river water were below the accepted maximum residue limit (MRL) value of drinking water (0.1 μg/l) adopted by the FAO/WHO Codex Alimentarius Commission. Cypermethrin and chlorpyrifos were chosen for decontamination through rice bran, as it was found in river water. Two gm rice bran could easily decontaminated 95.6 % and 96.4 % of cypermethrin and chlorpyrifos. The result of this study showed that pesticide residue was detected in water samples were below the MRLs value, which can easily be decontaminated through absorption of rice bran.

IMPORTANT VIRAL DISEASES ASSOCIATED WITH MORTALITY OF LAYER CHICKENS IN COMMERCIAL POULTRY FARMS IN BANGLADESH

Disease profile investigation on 1751 dead chickens supplied from about 100 commercial large or small scale poultry farms of Gazipur district and surrounding area in Bangladesh during one year period from January to December 2002 at the BRAC Poultry Disease Diagnostic Centre, Nagapara, Gazipur showed that 22.73% (n = 398) cases with five different viral diseases, of which infectious bursal disease (IBD) (n = 196) and Newcastle disease (ND) (n = 181) showed significantly (p < 0.01) higher rate of occurrence than infectious bronchitis (IB) (n = 6), avian leukosis (AL) (n = 6) and fowl pox (FP) (n = 4). Age-wise occurrence of IBD showed highest infection rate in growing stage (82.65%) in comparison to brooding (3.06%), pullet (6.12%) and adult layer (8.16%) chickens. Although more or less all age groups of chickens were affected by ND (1.66% to 50.83%) but it was found significantly (p < 0.01) highest in adult (50.83%) chickens. Infectious bronchitis was recorded only in adult chickens. Avian leukosis was found higher in pullet (66.67%) than the adult (33.33%) layer birds. Fowl pox also recorded only in pullet stage of chickens. Seasonal influence showed significantly (p < 0.01) highest occurrence of IBD during summer (44.39%) in comparison to rainy (30.61%) and winter (25.00%) seasons. Similarly ND was recorded more or less uniformly in all the three seasons of the year with significantly (p < 0.01) higher rate during summer (41.99%) season. Infectious bronchitis was recorded significantly (p < 0.01) higher in summer (63.66%) season while avian leukosis was recorded in winter (66.67%). Fowl pox was found equally in winter and summer seasons (50%). Although IBD was found with other concurrent infection e.g., dual (23.98%) and triple (2.55%) types of infection but highest occurrence was recorded as a single type (73.47%) of infection. ND was found with dual (44.75%), triple (7.18%) and fourth (1.10%) types of infection but specially single infection (46.96%) were associated with high mortality. IB was recorded highest in single infection (54.55%) in comparison to dual (9.09%), triple (18.18%) and fourth types (18.18%) of infection. Avian leukosis was recorded higher as a single infection (83.33%) than dual (16.67%) type of infection. Fowl pox was recorded equally (50%) as single and triple types of infection. It may be concluded that both the single and concurrent infection of viral diseases, greatly influenced by season and age associated with high mortality, should be considered during vaccination programme, diagnosis, prevention and control.

Nutritional parameters in children with cancer

The study was conducted in the Departments of Pediatric Haemato-Oncology, Bangabandhu Sheikh Mujib Medical University, Shahbagh, Dhaka, Bangladesh from January 2007 to May 2009. Total 44 children (34 males and 10 females) aged between 10 months and 12 years with newly diagnosed malignancy. Nutritional status of 44 children with newly diagnosed malignancy was evaluated by anthropometric, hematological results and biochemical parameters before initiating therapy and response to therapy was assessed during follow up. Malnutrition was seen in 56.8% children by weight for age criteria (WFA <-2z). Low hemoglobin was found in 82% children, 25% had low total proteins (<5.7g/dL), 20.5% low serum albumin (<3.2g/dL), 27.3% low serum transferrin (<210mg/dL) and 16.3% low serum iron (<60μg/dL). Mean anthropometric and biochemical parameters were higher among the survivors compared to non-survivors. Significant difference between the well nourished and the malnourished group was detected in the achievement of remission/response (69.5% vs. 38.1%), delays in therapy (8.7% vs. 38.1%) and mortality (30.5% vs. 61.9%). Complications like febrile neutropenia and bleeding were more in the malnourished group. A statistically significant higher incidence of infection was seen in children with serum iron <60μg/dL than those with higher values of serum iron (42.8% vs. 8%).

Laparoscopic versus open pyloromyotomy for infantile hypertropic pyloric stenosis: an early experience

This prospective comparative study was conducted with an initial experience in the Department of Pediatric Surgery, Dhaka Shishu (Children) Hospital during the period of December 2007 to January 2009, with the infants of 2-12 weeks age, diagnosed as Hypertrophic pyloric stenosis. Patients selection was done by simple random technique by means of lottery. For open pyloromyotomy conventional method & for laparoscopic pyloromyotomy three trocher techniques was applied. In this study, among 60 cases with infantile hypertrophic pyloric stenosis, 30 cases were finally selected for analysis irrespectively both in laparoscopic (Group A) & in open pyloromyotomy (Group B) group. Patients were studied under variables of operative time, required time of full feeds after operation, post operative hospital stay & both per and post operative complications. Regarding operative time, in Group A, mean±SD operating time (in minutes) was 61.59±51.73 whereas in Group B it was 28.33±8.40 & P value was 0.001. The result was statistically significant. The mean±SD time (in hours) of full feeds (ad libitum) was 35.00±31.70 hours in Group A compared to 28.95±10.99 hours in Group B and P value was found 0.342ns which was not statistically significant. On study of total length (in days) of post operative hospital stay, mean±SD was 3.09±2.25 & 2.58±1.15days in laparoscopic group & open pyloromyotomy group respectively. The p value was 0.355ns, which was statistically insignificant. Again, on study of complications, per operatively 6(19.5%) patients had developed haemorrage, 1(3.33%) had mucosal perforation & 4(13.36%) had developed duodenal serosal injury in laparoscopic group whereas only 1(3.33%) patient in open pyloromyotomy group had nothing else except simple hemorrhage. The p value (0.051ns) was also statistically insignificant. In regard to post operative complications, 2(6.6%) patients had developed wound hematoma, 2(6.6%) had wound infection, 1(3.33 %) had developed wound dehiscence and incisional hernia respectively in Group A. But in group B there was no subject with any complication. This result was also statistically insignificant. So, the overall study results denote that, laparoscopic pyloromyotomy would not be considered as a superior procedure or as safe as that of traditional open pyloromyotomy for the beginners.

Depression and its association with socio-demographic characteristics among type 2 diabetes mellitus patients of Bangladesh

Diabetes mellitus is being increasingly recognized as a serious global health problem and is frequently associated with co-morbid depression. A cross sectional study was conducted among 178 adult type 2 diabetes mellitus patients attending Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders (BIRDEM), Dhaka, Bangladesh to find out influence of socio-demographic characteristics for occurrence of depression among them. Data were collected through face-to-face interview. Depressive symptoms were measured using Centre for Epidemiological Studies Depression Scale. Proportion of depression was found 34.8% which included 20.2% with severe depression and 14.6% with mild to moderate depression. Both mild to moderate and severe depression were significantly more common in female, odds ratios were 2.72 (95% CI=1.13-6.53) and 5.94 (95% CI=2.49-14.20), respectively. Currently not married respondents were also suffered from higher depressive symptoms. For mild to moderate depression odds ratio was 4.38 (95% CI=1.46-13.18) and for severe depression odds ratio was 9.51 (95% CI=3.69-24.50). Among socio-demographic characteristics marital status was identified as the best predictor of depression, which was followed by education upto secondary level, female sex and primary education. Depression was identified as a significant health problem among adult type 2 diabetes mellitus patients. Its association with socio-demographic characteristics should be considered while planning therapeutic approaches for diabetic patients.