Is smokeless tobacco use associated with lower health-related quality of life? A cross-sectional survey among women in Bangladesh

INTRODUCTION

Bangladesh has 22 million adult users of smokeless tobacco (ST). The prevalence among women is higher (24.8%). Health-related quality of life outcome (HRQoL) for ST use is little known. We investigated the association between HRQoL and daily ST use among adult women in Bangladesh.

METHODS

Using multi-stage design, a cross-sectional survey was conducted. Adult women (randomly selected) were surveyed from 4 purposively selected divisions (Dhaka, Chittagong, Khulna and Rangpur). Female ST users and non-users were compared using HRQoL scores. Self-perceived Visual Analogue Scale (EQ-VAS) values and HRQoL scores were modelled to examine their association with ST use.

RESULTS

A total of 2610 women (1149 users and 1461 non-users) were surveyed. The proportion reported any type of problem in all health dimensions was significantly higher among female ST users than non-users (mobility: 43.3% vs 19.5%, self-care: 29.6% vs 11.9%, usual activities: 48.7% vs 21.8%, pain or discomfort: 69.8% vs 40.6%, and anxiety or depression: 61.3% vs 37.5%). The average HRQoL scores were 0.79 (95% CI: 0.78-0.81) and 0.90 (95% CI: 0.89-0.90) for users and non-users, respectively. Moreover, EQ-VAS average values were significantly higher for non-users [80.7 (95% CI: 79.9-81.6) vs 70.27 (95% CI: 69.2-71.2)]. Controlling the sociodemographics, ST use significantly reduced the HRQoL score by an average of 0.15 points. The EQ-VAS values on average decreased by 0.04 points for ST use.

CONCLUSIONS

ST use is significantly associated with the HRQoL of females in Bangladesh. Considering the higher prevalence of ST, especially among women, HRQoL hazards need to be communicated for awareness building.

Association of Serum Vitamin D level with Asthenozoospermic Male

Although vitamin D deficiency is one of the most common health problems throughout the world, conflicting information exists on the potential association between serum vitamin D levels and semen quality. Currently available data identifies that vitamin D has a vital role in reproductive process as it affects sperm motility. This study was done with the rationality to evaluate the association between serum vitamin D levels with asthenozoospermic males. This cross-sectional analytic study was conducted on 314 men who attended the Department of Reproductive Endocrinology and Infertility, Bangabandhu Sheikh Mujib Medical University (BSMMU), Bangladesh July 2018 to June 2019. Considering the inclusion and exclusion criteria all participants were categorized into two groups; Group I included 157 asthenozoospermic male and Group II included 157 normozoospermic male according to World Health Organization 'strict' criteria 2010. Participants completed the questionnaires after they had agreed on a informed consent. Blood and semen samples were obtained for assessment and all data were adjusted for age, body mass index (BMI), total motility and progressive motility. Vitamin D levels were classified according to the Endocrine Society guideline. Statistical analyses were carried out by using the Statistical Package for Social Sciences version 22.0 for Windows (SPSS Inc., Chicago, Illinois, USA). The results showed that the mean vitamin D level was 16.63±5.54ng/ml in asthenozoospermic group and 19.83±5.33ng/ml in normozoospermic group. The mean vitamin D level was significantly (p<0.05) lower in asthenozoospermic group. It was noticed that 86.6% patients had vitamin D deficiency (≤20ng/ml) in asthenozoospermic group compared to 56.7% in the normozoospermic group. The study found that low vitamin D was associated with a fivefold increased risk of developing asthenozoospermia at 95% CI (2.74-8.99). Moreover, there was a positive significant correlation (r=0.285; p<0.001) between serum vitamin D level with total motility and progressive motility (r=0.232; p<0.001). Hence, the study suggests a significant association between asthenozoospermia and low vitamin D levels. However, clinical trials are warranted to further reinforce the findings.

Bark extract of Chaetocarpus castanocarpus (Roxb.) exhibits potent sedative, anxiolytic, and antidepressant effects through an in vivo approach in Swiss albino mice

OBJECTIVE

Standard phytochemical investigations were performed to identify the secondary metabolites in the methanol extract of Chaetocarpus castanocarpus bark (MECC) and investigate the neuropharmacological potential of MECC in Swiss albino mice.

MATERIALS AND METHODS

Swiss albino mice were used in the forced swimming test (FST) and tail suspension test (TST) to evaluate the antidepressant effect of MECC. Also, the hole board test (HBT) and elevated plus maze (EPM) were conducted to examine anxiolytic activities. In contrast, the open field test (OFT) and hole cross test (HCT) were employed to evaluate sleeping disorders.

RESULTS

Alkaloids, glycosides, flavonoids, terpenoids, coumarins, and tannins are only a few secondary metabolites identified in MECC by qualitative and quantitative phytochemical investigations. The oral administration of MECC considerably shortened the immobility duration during FST and TST. Encouraging dose-dependent anxiolytic effects were also observed in all relevant experiments compared to the control. Additionally, during the OFT and HCT assessment, a noteworthy decline in the locomotor activities of the experimental animals was observed.

CONCLUSIONS

The results of this investigation suggest that the Chaetocarpus castanocarpus bark is a possible source of therapeutic candidates for treating neurological disorders.

Evaluation of Fecal Pancreatic Elastase-1 as a Measure of Pancreatic Exocrine Function in Children with Pancreatitis

Pancreatic exocrine insufficiency occurs as a clinical consequence of chronic pancreatitis leading to fat maldigestion, malabsorption and malnutrition. Fecal elastase-1 is a laboratory-based test used for the diagnosis or exclusion of pancreatic exocrine insufficiency. The aim of the study was to observe the value of fecal elastase-1 in children with pancreatitis as an indicator of pancreatic exocrine insufficiency. This was a cross-sectional descriptive study conducted from January 2017 through June 2018. Thirty children with pain abdomen as control and 36 patients with pancreatitis as cases were included. An ELISA technique which recognizes human pancreatic elastase-1 from spot stool sample was employed for the test. Fecal elastase-1 activity in spot stool samples in acute pancreatitis (AP) ranged from 198.2-500μg/g with a mean of 342.1±136.4μg/g, acute recurrent pancreatitis (ARP) ranged from 15-500μg/g with a mean of 332.8±194.5μg/g and chronic pancreatitis (CP) ranged from 15-492.8μg/g with a mean of 222.2±197.1μg/g was obtained. In controls, fecal elastase-1 ranged from 28.4-500μg/g with a mean of 398.8±114.9μg/g. Disease severity was classified as mild to moderate pancreatic insufficiency (fecal elastase-1 100 to 200μg/g stool) was found in AP (14.3%) and CP (6.7%) cases. The severe pancreatic insufficiency (fecal elastase-1<100μg/g stool) was observed in ARP (28.6%) and CP (46.7%) cases. Malnutrition was observed in severe pancreatic insufficiency cases. This study result showed that fecal elastase-1 can be used as a measure of pancreatic exocrine function in children with pancreatitis.

Association between Serum Vitamin D and Metabolic Syndrome in Women with Polycystic Ovary Syndrome

Vitamin D deficiency (VDD) is common in women with and without polycystic ovary syndrome (PCOS) and may be associated with metabolic and endocrine disorders in PCOS. Aim of the study was to evaluate the association between serum vitamin D level and metabolic syndrome (MS) in PCOS. This cross-sectional study was conducted in PCOS clinic of infertility outpatient department of the department of Reproductive Endocrinology and Infertility at Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from July 2018 to June 2019. A total of 170 diagnosed patients with PCOS of aging 20 to 40 years were included in this study. Out of which 85 patients with PCOS MS and rest 85 patients without PCOS MS were considered as Group I and Group II respectively. Serum vitamin D was measured using a chemiluminescent microparticle immunoassay (CMIA). Almost two third (72.9%) populations had vitamin D moderate deficiency (10-20ng/ml) in Group I and 46(54.1%) in Group II. The mean vitamin D was 13.97±4.53ng/ml in Group I 16.02±6.62ng/ml in Group II. There were significant negative correlation found between vitamin D level with weight (r = -0.169; p=0.028), waist circumference (r = -0.208; p=0.007), Waist/Hip ratio (r = -0.205; p=0.007) and diastolic blood pressure (r = -0.187; p=0.014). In binary logistic regression analysis diastolic blood pressure (OR=1.04, 95% CI 0.89-1.29), fasting Glucose (OR=1.09, 95% CI 0.89 - 1.42), HDL (OR=1.11, 95% CI 1.05 - 1.17) and Vitamin D (OR=1.37, 95% CI 1.01 - 1.82) were significant risk factors of metabolic syndrome of the study patients. Vitamin D level was lower in PCOS subjects having MS and higher frequency of body weight, vitamin D deficiency was observed in them compared to the non-MS group. Waist: hip ratio, waist circumference and diastolic blood pressure were the negatively correlated with of vitamin D in the study subjects.

Cinematic reflectometry using QIKR, the quite intense kinetics reflectometer

The Quite Intense Kinetics Reflectometer (QIKR) will be a general-purpose, horizontal-sample-surface neutron reflectometer. Reflectometers measure the proportion of an incident probe beam reflected from a surface as a function of wavevector (momentum) transfer to infer the distribution and composition of matter near an interface. The unique scattering properties of neutrons make this technique especially useful in the study of soft matter, biomaterials, and materials used in energy storage. Exploiting the increased brilliance of the Spallation Neutron Source Second Target Station, QIKR will collect specular and off-specular reflectivity data faster than the best existing such machines. It will often be possible to collect complete specular reflectivity curves using a single instrument setting, enabling "cinematic" operation, wherein the user turns on the instrument and "films" the sample. Samples in time-dependent environments (e.g., temperature, electrochemical, or undergoing chemical alteration) will be observed in real time, in favorable cases with frame rates as fast as 1 Hz. Cinematic data acquisition promises to make time-dependent measurements routine, with time resolution specified during post-experiment data analysis. This capability will be deployed to observe such processes as in situ polymer diffusion, battery electrode charge-discharge cycles, hysteresis loops, and membrane protein insertion into lipid layers.

Occupational safety practice among metal workers in Bangladesh: a community-level study

BACKGROUND

The overall information on occupational health and safety (OHS)-related knowledge and workplace practices are scarce in Bangladesh. This study aimed to (i) examine the prevalence of occupational injuries, (ii) explore the level of OHS-related knowledge and practice among workers and associated factors, and (iii) investigate the socioeconomic factors and OHS-related knowledge and practice scores as determinants of injury among metal workers at a community setting in Bangladesh.

METHODS

This was a cross-sectional study conducted on all the functional metal workshops in a community of a town. The sociodemographic characteristics, history of injury and its consequences, and the state of knowledge and practice were measured using descriptive statistics. Univariate and multivariate analyses were used to measure the association between practice scores and sociodemographic factors and knowledge. Logistic regression was conducted to get the odds ratio of getting injured.

RESULTS

A high annual rate (82.9%) of occupational injuries was documented in a one-year timeframe and the majority (81.1%) of injured workers lost more than three working days (median 20 days). Workers working in workshops with more than three workers were 3.3 times more likely to be injured [AOR = 3.33, 95% CI = 1.16, 9.58] compared to the workers in factories with one to three workers. Most of the workers had the basic knowledge related to OHS but the mean practice score was very low, 1.86 (SD 1.17). Higher education, lower monthly family income, and being an owner significantly led to higher practice scores.

CONCLUSIONS

The OHS-related knowledge was not properly translated into good workplace practices in small informal metal workshops because of the absence of implementation of OHS policies and monitoring by the relevant authority. Government should support the informal metal working sector to increase awareness and skills for the prevention and proper management of injuries and risks, and to ensure access to safety equipment and a safe environment.

Determinants of anxiety and depression among Bangladeshi adults during COVID-19 lockdown: An online survey

Background

Human health and well-being are adversely affected by the effects of COVID-19. This study examined the prevalence of anxiety and depression during COVID-19 lockdown in Bangladesh, and their association with some less explored factors like perceived and relative health status, having elderly members in the family, fear for own and family future, and others from the Asian context.

Methods

Using an online survey, data were collected from the population aged 18 years and above, on socio-demographic and economic attributes, and two separate standardized twelve-item scales were used to assess the level of anxiety and depression. Both descriptive and multivariate linear regression were used to analyze the factors associated with anxiety and depression scores.

Results

The respondents had an average anxiety score of 21.74 (SD = 8.20) on a scale ranging from 12 to 60 and an average depression score of 24.39 (SD = 10.30) on the same scale. The study findings revealed that respondents' concern for future well-being, perceived physical health status compared to others in the same cohort, and perceived physical health status during the survey compared to prior COVID-19 were significantly associated with anxiety and depression scores during COVID-19 lockdown. In addition, the anxiety score was significantly higher (p = 0.046) for women respondents than men. Moreover, respondents aged 18-24 years had significantly higher (p < 0.001) depression than others.

Conclusions

The increased level of anxiety and depression during COVID-19 of adult people in Bangladesh are associated with several factors of which their greater concern about the future of their own and family members and health-related attributes are important. These findings may lead to developing interventions to reduce the psychological crisis during the pandemic in Bangladesh.

Neuropharmacological Effects of Chassalia curviflora (Rubiaceae) Leaves in Swiss Albino Mice Model

The current study aimed to investigate the neuropharmacological properties of ethanol, acetone, and ethyl acetate leaf extracts of Chassalia curviflora (C. curviflora) in mouse models. The neuropharmacological properties of this plant were studied on Swiss albino mice at dosages of 50, 100, and 200 mg/kg body weight in thiopental sodium-induced sleeping time test, and at dosages of 100 and 200 mg/kg body weight in other tests. The extracts caused a marked reduction in the initiation and sleep length (P<0.05) in studies on thiopental sodium-induced sleeping time at dosages of 100 and 200 mg/kg and a significant decrease (P<0.05) was found in terms of unconstrained locomotor and explorative activities in both hole crossing and open field tests at dosages of 100 and 200 mg/kg. Furthermore, the extracts increased sleeping time with a dosage-dependent onset of action. The hole-board test extracts also reduced the number of head dips at dosages of 100 and 200 mg/kg (P<0.05). It was found in this study that C. curviflora had the best neuropharmacological properties at a dosage of 200 ml/kg. Our findings also showed that all of the extracts from C. curviflora were experimentally active in an in vivo model. The study results suggested that the leaves had strong anti-depressant and hypnotic CNS properties that might be exploited for neuropharmacological adjuvant therapy in conventional medicine. However, pharmacological studies are warranted to explore the active substances and the mode of action.

Evaluation of Short Term Outcome of Stapled Transanal Rectal Resection (STARR) for ODS (Obstructed Defecation Syndrome) by Comparing Pre and Post-operative ODS Score

Obstructed defecation syndrome (ODS) is a common anorectal problem and it can be corrected by various surgical approaches but most of these have high recurrence and complication rates. Antonio Longo introduced Stapled transanal rectal resection (STARR) in 2003 as a minimally invasive transanal operation for correction ODS associated with rectocele and or rectal intussusception. This study was designed to assess the short term outcome of Stapled Transanal Rectal Resection (STARR) as a surgical treatment of Obstructed Defecation Syndrome (ODS). This is a quasi experimental study which was carried out in the department of Colorectal Surgery, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh from May 2016 to June 2017. Seventeen (17) patients were included in the study. Patients with obstructed defecation syndrome and rectocele and or rectal intussusception admitted in the department of Colorectal Surgery were enrolled in the study as per inclusion and exclusion criteria. History, clinical examination, Proctoscopy, Colonoscopy and MR Defecography was done for evaluation of the patients. During evaluation preoperative Longo's ODS score of every patient also determined and compared with postoperative ODS score. The patient was followed up regularly at one, three and six months after each operation. The ODS score in 82.35% patients improved significantly. The postoperative score was high (13-15) only in 02(11.8%) patients probably due to presence of physiological factors. Post-operative defecatory urgency was developed in only 02(11.76%) patients. Major postoperative complication like hemorrhage or rectovaginal fistula did not develop in any patient. STARR is an effective, less invasive and simple procedure for the treatment of ODS with rectocele and/or rectal intussusception without major morbidity but other physiological causes of ODS should exclude preoperatively because its presence makes the surgical intervention fruitless.

Pattern of Tubercular Uveitis in Active Pulmonary Tuberculosis

Ocular tuberculosis is an extra-pulmonary form of systemic Tuberculosis (TB). It is rarely found concomitant with active pulmonary tuberculosis (PTB). The aim of this prospective observational study was to evaluate the pattern of tubercular uveitis (TBU) in the patients with active PTB who attended in our Uvea clinic at NIO&H from July 2018 to December 2020. Active PTB patients who had uveitis consistent with TBU and TBU patients who were confirmed as active lung lesion were included in the study. Chest X-ray, TST, IGRA (QuantiFERON-TB Gold Test), RT PCR of aqueous fluid for tubercular bacillus, Gene Xpert TB test of sputum were done to confirm the diagnosis of ocular and primary TB. If the induration is 15 mm of TST was considered patient in this study. Among 33 patients of active PTB, 4 had TBU (12.12%). Among 48 patients of TBU, 5 had active PTB (10.41%). 13 eyes of 9 patients were affected. Mean age at presentation was 41.8 years. There were anterior uveitis in 23.00% eyes, posterior uveitis in 69% eyes and panuveitis in 7.00% eyes. Choroidal granuloma was the most common presentation of posterior uveitis (46.00%). There were more than 4 times chance to develop choroidal granuloma in patients with active PTB than extrapulmonary TB (Χ²=4.53, <0.05), TBU patients with choroidal granuloma should be evaluated meticulously for active PTB and active PTB patients should be evaluated routinely by ophthalmologist for the search of TBU.

237 Antibiotic Prophylaxis of Precision Point Prostate Biopsy Under LA: Changed Practice in a District General Hospital

Aim

More than 4 million prostate biopsies are performed worldwide each year (1). Out of three different techniques (Template, transperineal, TRUS), Transperineal precision point biopsy under local anaesthesia is the latest and reported to have fewer infectious complications (2). UTI, Urosepsis, septicaemia are some well-known infectious complications following prostate biopsies. Therefore, the Canadian Urological Association recommended the use of broad-based Gram-negative antibiotic prophylaxis 30 to 60 minutes before the procedure and continued for 2 to 3 days in their guideline (3). Our aim was to compare the outcome of two different antibiotic prophylaxis regimens.

Method

In our study to assess the outcome of single-dose prophylaxis compared to regular dose, we collected retrospective data of 119 patients who had undergone precision point biopsy in our hospital.

Results

Among 119 patients, 52 (43.69%) were given 3 days of oral antibiotic followed by preprocedural dose and 67 (56.31%) were given just a single dose before the procedure. None of these patients from both groups were readmitted with any infectious complication post-procedure. 1 patient from the second group (single dose) was admitted with urinary retention but no increased inflammatory markers were found.

Conclusions

TRUS biopsy breeches the rectal mucosa and carries higher chances of post-biopsy infection so requires antibiotic prophylaxis. Single-dose antibiotic prophylaxis is recommended option for transperineal biopsies as the infection rate is lower. Our study shows the same outcome for single-dose and 3-day regimens for transperineal precision point prostate biopsy. Moreover, the use of single dose will significantly reduce medicine costs and antibiotic resistance to improve patient compliance.

Menstrual Hygiene Practice among Rural Adolescent School Girls: An Intervention Study

Menstruation, an essential part of the reproductive cycle, is experienced by all adolescent girls. Poor menstrual hygiene is associated with serious ill-health and drop-out from school. An intervention study was carried out to evaluate the outcome of health education on menstrual hygiene practice among randomly selected 45 adolescent girls attending in a purposively selected Shomospur Girls' High School, Khoksha at Kushtia district in 2018. Data were collected before and after intervention by pre-tested, semi-structured interview schedule with a view to explore the practice during menstruation. Majority 23(51.11%) subjects were between 10 to 14 years of age with a mean of 14.42±1.03 years. Mean age at menarche was 12.38±1.15 years. During menstrual period, adolescent girls used to refrain from performing daily household chores (34), skip from attending school (26), stay alone (26) and avoid to mix with others (25). Over two-thirds 31(68.89%) girls forbade nutritious foods like fish, meat, egg and tamarinds. As many as 39(86.67%) girls used to clean their genitalia, and everybody used to have regular bath and washing hands after changing menstrual absorbent. Generally, most of the girls (39, 86.67%) accustomed to use the reusable absorbent. Nearly one third 15(33.33%) girls used to dry the reusable absorbent in room corner, while 5(11.11) in shaded area and 3(6.67%) in the toilet. A considerable number of girls (12) stored the reusable materials in room corner and under the bed. At least 27(60.00%) girls did not use to change menstrual absorbent at school. While after intervention, none of the girls hesitated to attend others and felt safe to perform daily household chores. Moreover, they were confident to attend school and need not to stay alone during menstruation. Cent percent girls practiced to have food containing iron, vitamin C, and drank plenty of water. Warm water with soap and/or detergent was used for cleaning sanitary cloths. An overwhelming number 42(93.33%) of girls used to dry reusable materials in sunlight with a statistically significant difference (p<0.05). Change of behaviour as to frequency of changing sanitary pad (p<0.05) and methods of disposal of sanitary materials was revealed. It can be concluded that imparting knowledge to adolescent girls is effective to keep away from harmful social behaviours, food intake practice and use of sanitary napkin, replace of menstrual absorbent at regular interval and cleaning and storage of reusable sanitary materials with their hygienic disposal.

Providing care for older adults in the Emergency Department: expert clinical recommendations from the European Task Force on Geriatric Emergency Medicine

Aim

The aim was to develop expert clinical recommendations on Geriatric Emergency Medicine to be disseminated across Europe.

Findings

Eight posters with expert clinical guidelines on the most important topics in Geriatric Emergency Medicine are now available through https://posters.geriemeurope.eu/.

Message

Expert clinical recommendations for Geriatric Emergency Medicine in Europe were created and are ready for dissemination across Europe.

Supplementary Information

The online version contains supplementary material available at 10.1007/s41999-021-00578-1.

Purpose

Despite the rapidly expanding knowledge in the field of Geriatric Emergency Medicine in Europe, widespread implementation of change is still lacking. Many opportunities in everyday clinical care are missed to improve care for this susceptible and growing patient group. The aim was to develop expert clinical recommendations on Geriatric Emergency Medicine to be disseminated across Europe.

Methods

A group of multi-disciplinary experts in the field of Geriatric Emergency Medicine in Europe was assembled. Using a modified Delphi procedure, a prioritized list of topics related to Geriatric Emergency Medicine was created. Next, a multi-disciplinary group of nurses, geriatricians and emergency physicians performed a review of recent guidelines and literature to create recommendations. These recommendations were voted upon by a group of experts and placed on visually attractive posters. The expert group identified the following eight subject areas to develop expert recommendations on: Comprehensive Geriatric Assessment in the Emergency Department (ED), age/frailty adjusted risk stratification, delirium and cognitive impairment, medication reviews in the ED for older adults, family involvement, ED environment, silver trauma, end of life care in the acute setting.

Results

Eight posters with expert clinical recommendations on the most important topics in Geriatric Emergency Medicine are now available through https://posters.geriemeurope.eu/.

Conclusion

Expert clinical recommendations for Geriatric Emergency Medicine may help to improve care for older patients in the Emergency Department and are ready for dissemination across Europe.

Supplementary Information

The online version contains supplementary material available at 10.1007/s41999-021-00578-1.

1214 A Combined Approach to Prioritise Patients for Colonoscopy

Aim

Correlating colonoscopy finding with presenting features to assess the diagnostic yield of different symptoms.

Method

We looked at findings of 100 patients retrospectively who had colonoscopy in Dhaka Medical College Hospital, Bangladesh during first peak of COVID (August 2020 to December 2020). We reviewed NICE guideline for high-risk symptoms and NHS guideline for prioritisation of colonoscopy patients.

Results

100 cases were reviewed, 67% were male among the patients, average age was 42.11 (4 – 75 years). 47 were found to have significant pathology. Findings included colorectal malignancy (28%), Polyp (9%), IBD (6%), tuberculosis (2%) etc. PR bleed had highest diagnostic yield (21.27%), followed by abdominal lump (17.02%) and lower abdominal pain (14.89%). Weight loss showed lowest diagnostic yield (4.25%). 28% colonoscopy findings were normal. Patients were chosen based on clinical assessments and imaging results, as stool biochemical marker tests (FIT test, faecal calprotectin) are not available in DMCH.

Conclusions

Being an aerosol generating procedure which has a considerable amount of risk of transmitting COVID infection from patient to clinician or vice versa, it is important to triage patients with lower GI symptoms for colonoscopy. In a developing country like Bangladesh, it is essential to make the most reasonable use of limited resources. Symptoms-based triaging systems are poor predictors of clinically significant disease on colonoscopy. Therefore, a more holistic and novel approach needs to be studied and formulated using a combination of symptoms, blood, and stool biomarkers in order to reduce the need for a ‘negative’ colonoscopy and avoid unnecessary risks.

Preoperative Analysis of CA-I25 and its Relation with Histopathological Study in Ovarian Tumours

Ovarian cancer (OC) is the seventh most common cancer among women in the world. Epithelial OC is the most predominant pathological subtype, with five major histotype. All five subtypes that differ in origination, pathogenesis, molecular alterations, risk factors and prognosis. The clinical presentations of ovarian tumors are variable and not specific. Most of the malignant ovarian tumor seeks medical advice at advanced stage of the disease. At that stage no effective treatment could be possible. There are several researches are going on developing a screening test for ovarian cancer. But there hasn't been much success yet. Clinical examination such as complete pelvic examination together with two investigations is used most often to screen the ovarian cancer. These investigations are transvaginal ultrasound (TVUS) and the blood test CA-125. The measurement of CA-125 level usually in combination with other modalities like bimanual pelvic examination, transvaginal ultrasonography is the proposed modality of early detection of ovarian cancer. The most promising application of this tumor marker is the screening. Therefore this cross sectional and observational study was conducted to observe the relationship of histopathological diagnosis and clinical features with serum CA-125 levels. Study conducted from January 2017 to December 2017 at Sir Salimullah Medical College& Mitford Hospital, Dhaka, Bangladesh. All admitted Gynecological patients having ovarian tumors during study period were included purposively for this study. Sample size was 50. Clinical features and preoperative findings of CA-125 level of these 50 patients were collected. Finally histopathological reports were accumulated after operative treatment. Gastrointestinal & constitutional complain, gynecologic mass and pain in abdomen were the selected symptoms. CA-125 levels were evaluated in relation with histopathological findings. The different findings were correlated with those of studies done at home and abroad. Mean age of the study population was (Mean±SD) 34.25±14.65. Histological findings among the study population showed that benign tumors were 72% (n=36) and malignant tumors were 28% (n=14). In case of benign ovarian tumors among 36 women, 94.4% (n=34) of them showed CA 125 level <35U/ml, other 5.6% (n=2) showed more than normal (>35U/ml) but range was 35-65U/ml. While 14 of the study population having histopathologically proven malignant ovarian tumor, showed the tumor marker level >35U/ml among 71.4% (n=10) and 28.6% (n=4) showed tumor marker <35U/ml. This finding was statistically significant (p=0.001). Histopathological findings revealed that there were significant increases in CA-125 levels in women with malignant serous histotype of serous cyst adenocarcinoma where range of CA-125 level were 2018.88 to 4249.63U/ml. Constitutional symptoms such as weight loss, loss of appetite, symptoms of mass effect such as urinary retention and rapidly progressing tumor were the symptoms of malignant ovarian tumors. Preoperative elevated level of CA-125 is the differentiating points of malignant serous histotype from benign ovarian tumors. This study will put forward some clues about the clinical diagnosis of ovarian tumor which may be utilized for making investigation and management plan. Also it will help for making prompt decision during pre-operative and per-operative procedures.

Comparative metabolomic responses of low- and high-cadmium accumulating genotypes reveal the cadmium adaptive mechanism in Brassica napus

Recently, oilseed rape has gathered interest for its ability to withstand elevated metal contents in plant, a key feature for remediation of contaminated soils. In this study, comparative and functional metabolomic analyses using liquid chromatography/mass spectrometry were undertaken to explore the metabolic basis of this attribute under cadmium (Cd) stress. Results revealed both conserved and differential metabolomic responses between genotype CB671 (tolerant Cd-accumulating) and its sensitive counterpart ZD622. CB671 responded to Cd stress by rearranging carbon flux towards production of compatible solutes, sugar storage forms and ascorbate, as well as jasmonates, ethylene and vitamin B6. Intriguingly, IAA abundance was reduced by 1.91-fold, which was in connection with tryptophan funnelling into serotonin (3.48-fold rise). In ZD622 by contrast, Cd provoked drastic depletion of carbohydrates and vitamins, but subtle hormones alteration. A striking accumulation of unsaturated fatty acids and oxylipins in CB671, paralleled by glycerophospholipids build-up and induction of inositol-derived signalling metabolites (up to 5.41-fold) suggested ability for prompt triggering of detoxifying mechanisms. Concomitantly, phytosteroids, monoterpenes and carotenoids were induced, denoting fine-tuned mechanisms for membrane maintenance, which was not evident in ZD622. Further, ZD622 markedly accumulated phenolics from upstream sub-classes of flavonoids; in CB671 however, a distinct phenolic wiring was activated, prioritizing anthocyanins and lignans instead. Along with cell wall (CW) saccharides, the activation of lignans evoked CW priming in CB671. Current results have demonstrated existence of notable metabolomic-based strategies for Cd tolerance in metal-accumulating oilseed rapes, and provided a holistic view of metabolites potentially contributing to Cd tolerance in this species.

Effect of dairy milk, eggs, meat, fish and fruits intake on academic performances of secondary school students in Bangladesh

Background: Contribution of dairy milk and other food items and schools to academic performances of students are the important factors to build a peaceful meritorious nation with sound mental and physical health.Objective: This experiment was designed to study the contribution of dairy milk and other food item intake pattern and schools to academic performances.Method: Students of class nine in Bangladesh were enumerated using a preprescribed questionnaire during March 2016 to June 2016 by direct interview method. Collected primary data were analyzed using the Statistical Package for the Social Sciences version 14.015.Results: Male (69.63%) students and students of schools in the town (84.97%) performed better. Majority of the students in towns (46.85%; 49.65%) and villages (45.51%; 50.90%) drank dairy milk and ate meat respectively, once or twice in a week. Many students in towns (30.77%) and villages (38.92%) ate eggs for 3 to 4 days in a week. Maximum students in town (53.50%) and in village (46.71%) took fish for 5 to 7 days and 3 to 4 days in a week, respectively. Many students in town (39.86%) and in village (59.88%) took fruits 1 to 2 days and 5 to 7 days in a week, respectively. Most (74.31%) of the students who took dairy milk, meat (73.68%), fruits (66.67%), fish (65.81%) and eggs (64.71%) everyday in a week obtained A grade.Conclusions: Schools, availability of dairy milk, meat, fruits, fish and eggs, Tiffin intake status and gender affected the academic performances but educational institutions had no effect on weekly dairy milk, eggs and meat intake of the students but weekly fish and fruits intake status were affected.Bangladesh Journal of Medical Science Vol.17(3) 2018 p.355-359

Changes of Peak Expiratory Flow Rate in Adult Asthmatic Patient

Asthma is a common pulmonary disorder characterizerized by airway inflammation, airway- hyper reactivity, and reversible airflow obstruction. The classic triad of symptoms is wheezing, chronic episodic dyspnea and chronic cough. The prevalence of asthma increased steadily over the latter part of the last century, first in the developed and then in the developing world. The number of people with asthma in the world may be as high as 334 million. Asthma in Bangladesh appears to be a substantial public health problem: an estimated 11.6 million people including 4.1 million children suffer from asthma-related symptoms. A cross sectional study was conducted from January 1999 to August 1999 on 5642 Bangladeshi people and another same study carried out from November 2009 to April 2010 on 8088 subjects. In 1999 the prevalence of asthma was 6.9% whereas in 2010 it is 6.96%. Airway resistance is always increased during the asthmatic attack. Airways obstruction, such as that caused by asthma, results in a reduced and variable Peak Expiratory Flow Rate (PEFR). PEFR is classically reduced in asthma. Recent asthma guidelines recommended the assessment of severity levels based on the most severe symptoms and peak expiratory flow rate. This descriptive type of cross-sectional study was done to find the changes of Peak expiratory flow rate in adult asthmatic patients and carried out in the Department of Physiology, Mymensingh Medical College, Mymensingh, Bangladesh from July 2014 to January 2016. Fifty (50) male and 50 (fifty) female adult asthmatic patients aged 18-60 years were included in the study group. They are enrolled from the Department of Medicine, Mymensingh Medical College, Mymensingh, Bangladesh and also from locality. For comparison age matched 50 male and 50 female apparently healthy persons were also studied as control. PEFR was estimated by Wright's Peak flow meter. For statistical analysis unpaired student's 't' test was used. Mean PEFR were significantly decreased in study group in comparison to control group and the result was statistically significant (p<0.001). From this study, it may be concluded that peak expiratory flow rate was decreased in asthmatic patient and there was a significant relation of decline lung function.

Study on Hemoglobin Concentration in Patient with Chronic Kidney Disease

In the present study hemoglobin concentration were estimated in chronic kidney diseased patient to observe the frequency of low hemoglobin level in chronic kidney diseased (CKD) patient and to assess the incidence of anaemia. This cross sectional study was carried out in the department of Physiology of Mymensingh Medical College, Mymensingh, Bangladesh from July 2014 to June 2015. For this purpose, total 200 subjects with age ranged from 25 to 60 years were selected and divided into100 healthy persons as control group and 100 CKD patients as study group. Both control and study group were further divided into 50 male and 50 female. Hemoglobin concentration was evaluated by the Cyanmethemoglobin (CMG) method. Statistical analysis of data was done by unpaired student's 't' test. The results showed that hemoglobin levels decreased significantly in chronic kidney diseased patients than the normal healthy persons. The decreasing frequency of hemoglobin level in CKD may predispose the patients to anemia and increasing the other complications.

Interaction between Hypertension and Asthma in Adult

Asthma has been defined as a chronic inflammatory disorder of the airways that is associated with recruitment of inflammatory cells and the clinical development of wheezing, shortness of breath, chest tightness, and cough. The prevalence of asthma increased steadily over the latter part of the last century, first in the developed and then in the developing world. Current estimates suggest that asthma affects 300 million people worldwide, with a predicted additional 100 million people affected by 2025. This cross sectional study was conducted from January 1999 to August 1999 on 5642 Bangladeshi people and another same study carried out from November 2009 to April 2010 on 8088 subjects. In 1999 the prevalence of asthma was 6.9% whereas in 2010 it is 6.96%. Both asthma and hypertension are spastic disorders of smooth muscle, there is the similarities between these two diseases may predispose the individuals with one disease to the other. This descriptive type of cross-sectional study was done to find the Interaction between hypertension and asthma in adult and carried out in the Department of Physiology, Mymensingh Medical College, Mymensingh, Bangladesh from July 2014 to January 2016. Fifty (50) male and fifty (50) female adult asthmatic patients aged 18-60 years were included in the study group. They are enrolled from the Department of Medicine, Mymensingh Medical College, Mymensingh and also from locality. For comparison age matched 50 male and 50 female apparently healthy persons were also studied as control. Blood pressure was estimated by auscultatory method by sphygmomanometer. For statistical analysis unpaired student's 't' test was used. Mean blood pressure were significantly increased in study group in comparison to control group and the result was statistically significant (p<0.001). The study findings showed a high prevalence of hypertension among asthmatic patients than non asthmatic healthy persons. From this study, it may be concluded that hypertension and asthma are closely connected.

Challenges to cervical cancer treatment in Bangladesh: The development of a women's cancer ward at Dhaka Medical College Hospital

Cervical cancer is the second most common cause of female cancer mortality worldwide. Concurrent chemoradiotherapy represents the standard of care for patients with stages IB2 to IVa cervical cancer. Unfortunately radiation therapy capacity is severely limited to non-existent in many Low and Middle-Income Countries. One solution has been to use chemotherapy to reduce tumor size to allow for radical surgery or in the case of inoperable cancers, as a placeholder until radiation is available. In Bangladesh, there has been the progressive development of resources for the treatment of women with gynecologic cancers. However, radiation therapy resources are limited with a six-month waiting period to receive radiation. Neoadjuvant chemotherapy (NACT) remains the main primary treatment intervention for women with advanced cervical cancer in Bangladesh. This implementation study summarizes of the experience and challenges to caring for women in a new gynae-oncology ward at Dhaka Medical College Hospital, a 2600 bed government hospital in Dhaka, Bangladesh.

•

The literature on cervical cancer treatment in Bangladesh is nonexistent.

•

The majority of women are diagnosed with stages III and IV cervical cancers.

•

Radiation therapy is an extremely limited resource in Bangladesh with only one machine per over 10 million people.

•

The strategy has been to treat woman with chemotherapy in the hopes of making their cancers surgically resectable.

•

Systematic reviews of neoadjuvant chemotherapy show pathologic responses but no improvement in long term survival.

School Refusal: How to Address When He is an Adolescent with Asperger’s Syndrome - A Case Report

A fifteen and a half years old adolescent boy was referred by the psychiatrist to the Child Development Centre (CDC) for an evaluation of his mental status as he was stubbornly resisting to take medication in spite of regular counselling efforts. This boy presented with school refusal with manifestations of Obsessive Compulsive Disorder (OCD) with a complicated family dynamic to the psychiatrist. His interesting atypical development in early childhood led to clinician’s concern of excluding Autism Spectrum Disorder (ASD). He was finally diagnosed and jointly managed as a case of High Functioning Autism (HFA) with co-morbid conditions by a joint multidisciplinary team approach of CDC and Psychiatry Department of AHD.Pulse Vol.9 January-December 2016 p.64-68

Substance Abuse amongst the Street-children in Guwahati City, Assam

BACKGROUND

The nature of continuous exposure to the street and its associated life-styles make street children vulnerable to the use of psychoactive substances.

AIMS

The aim of the present study is to study some social factors of street children in Guwahati city and to ascertain the substance use behavior of the street children.

SUBJECTS AND METHODS

A population based cross-sectional study conducted during September 2008 to August 2009 among 215 street children between the ages of 5 and 18 years of Guwahati City Assam. The main outcome measures were substance use and its related risk factors prevalent among street children. The data collected were analyzed in Microsoft Office and percentages and Chi-square tests were used to analyze the variables.

RESULTS

Around 174/215 (80.9%) of study participants were substance abusers. It is noteworthy that as the age increases substance use was more common when compared to younger age group. The risk of substance abuse was 1.26 times relatively higher among those who had never been to school and 1.12 times more common in those from a joint family when compared to others. However the correlations were not found to be statistically significant. Substance abuse was 1.19 times more common in case of deaths of both parents and the association was found to be statistically significant (P = 0.02). Presence of step parents and substance use in the family was seen to be a risk factor for substance abuse and the association was highly significant (P < 0.001). The association of substance abuse with duration of street life was found to be highly significant. Majority of the substance users 152/174 (87.4%) were in the habit of sniffing glue and this was followed by smoking 147/174 (84.5%).

CONCLUSION

Substance abuse is an important concern affecting street children. Street and its associated life-styles make street children vulnerable to the use of psychoactive substances. Non- government organizations and Government should come forward to curb this problem and save millions of vulnerable lives.

"Satan has afflicted me!" Jinn-possession and mental illness in the Qur'an

Mental health stigma in Muslim communities may be partly due to a commonly held belief among some Muslims about the supernatural causes of mental illness (i.e. jinn-possession brought on by one's sinful life). A thematic analysis was carried out on four English translations and the Arabic text of the Qur'an to explore whether the connection between jinn-possession and insanity exists within the Muslim holy book. No connection between spirit-possession and madness or mental illness was found. Pagans taunted and labelled people as jinn-possessed only to ostracize and scapegoat. Linking the labelling of people as jinn-possession to a pagan practice may be used to educate Muslims, so they can reassess their community's stigma towards the mentally ill.

Laboratory studies of electron and ion irradiation of solid acetonitrile (CH₃CN)

The structure and bonding of solid acetonitrile (CH₃CN) films on amorphous silica are studied, and chemical and physical processes under irradiation with 200 keV protons and 250-400 eV electrons are quantified using transmission infrared spectroscopy, reflection-absorption infrared spectroscopy and temperature-programmed desorption, with the assistance of basic computational chemistry and nuclear materials calculations. The thermal desorption profiles are found to depend strongly on the balance between CH₃CN-surface and CH₃CN-CH₃CN interactions, passing from a sub-monolayer regime (binding energy: 35-50 kJ mol⁻¹) to a multilayer regime (binding energy: 38.2±1.0 kJ mol⁻¹) via a fractional order desorption regime characteristic of islanding as the coverage increases. Calculations using the SRIM code reveal that the effects of the ion irradiation are dominated by electronic stopping of incident protons, and the subsequent generation of secondary electrons. Therefore, ion irradiation and electron irradiation experiments can be quantitatively compared. During ion irradiation of thicker CH₃CN films, a cross section for secondary electron-promoted chemical destruction of CH3CN of 4 (±1) × 10⁻¹⁸ cm² was measured, while electron-promoted desorption was not detected. A significantly higher cross section for electron-promoted desorption of 0.82-3.2 × 10⁻¹⁵ cm² was measured during electron irradiation of thinner CH₃CN films, while no chemical products were detected. The differences between the experimental results can be rationalized by recognizing that chemical reaction is a bulk effect in the CH₃CN film, whereas desorption is a surface sensitive process. In thicker films, electron-promoted desorption is expected to occur a rate that is independent of the film thickness; i.e. show zeroth-order kinetics with respect to the surface concentration.

Effect of maternal oral hydration therapy in oligohydramnios

This was a randomized controlled trial on 64 pregnant women from 32 to 35 weeks gestation, in one year period to determine the effect of maternal hydration by oral water in oligohydramnios amniotic fluid index (AFI) ≤ 5. Studied women were randomly divided into two groups. Group A (intervention group) women were instructed to drink 2 liters of water within 2 hours and from the next day extra 2 liters of water daily for 7 days. Group B (control group) women were allowed for routine water intake. AFI was done after 2 hours, 24 hours and 7 days of oral hydration therapy in both the groups. P values less than 0.05 was considered statistically significant. Pre-treatment mean AFI was 4.77 ± 0.42 (mean ± SD) vs. 4.80 ± 0.43 (mean ± SD) and post treatment AFI after 2 hours was 6.35 ± 0.65 vs. 4.81 ± 0.42; after 7 days was 7.08 ± 0.21 vs. 5.0 ± 0.20 in oral hydration group and control group respectively. Delivery at 37-40 weeks was 53.1% vs. 12.4%, normal vaginal delivery in 71% vs. 21.8%, caesarean section in 29% vs. 78.2% and low birth weight babies were 12.5% vs. 81.25% in intervention and control group respectively. Foetal outcome was healthy in 87.1% vs. 59.4%, asphyxiated in 12.9% vs. 50% and perinatal death was 3.22% vs. 21.8% between intervention and control group. Still born were 6.3% cases in control group. Maternal oral hydration therapy significantly increases the AFI, reduces the caesarean section rate and improves the foetal outcome.

Rutin prevents cognitive impairments by ameliorating oxidative stress and neuroinflammation in rat model of sporadic dementia of Alzheimer type

The objective of the present study was to assess the neuroprotective role of rutin (vitamin P) and delineate the mechanism of action. Recent evidence indicates that rutin exhibits antioxidant potential and protects the brain against various oxidative stressors. More precisely, the aim of the present study was to examine the modulating impacts of rutin against cognitive deficits and oxidative damage in intracerebroventricular-streptozotocin (ICV-STZ)-infused rats. Rats were injected bilaterally with ICV-STZ (3 mg/kg), whereas sham rats received the same volume of vehicle. After 2 weeks of streptozotocin (STZ) infusion, rats were tested for cognitive performance using Morris water maze tasks and thereafter euthanized for further biochemical, histopathological, and immunohistochemical studies. Rutin pretreatment (25 mg/kg, orally, once daily for 3 weeks) significantly attenuated thiobarbituric acid reactive substances (TBARS), activity of poly ADP-ribosyl polymerase, and nitrite level and decreased level of reduced glutathione (GSH) and activities of its dependent enzymes (glutathione peroxidase [GPx] and glutathione reductase [GR]) and catalase in the hippocampus of ICV-STZ rats. ICV-STZ rats showed significant cognitive deficits, which was improved significantly by rutin supplementation. The results indicate that rutin attenuates STZ-induced inflammation by reducing the expression of cyclooxygenase-2 (COX-2), glial fibrillary acidic protein (GFAP), interleukin-8 (IL-8), inducible nitric oxide synthase (iNOS), nuclear factor-kB, and preventing the morphological changes in hippocampus. The study thereby suggests the effectiveness of rutin in preventing cognitive deficits and might be beneficial for the treatment of sporadic dementia of Alzheimer type (SDAT).

The effect of aqueous extract of Embelia ribes Burm on serum homocysteine, lipids and oxidative enzymes in methionine induced hyperhomocysteinemia

Objective:

The present study was designed to evaluate the effect of the aqueous extract of Embelia ribes Burm fruits on methionine-induced hyperhomocysteinemia, hyperlipidemia and oxidative stress in albino rats.

Materials and Methods:

Adult male Wistar albino rats were fed with the aqueous extract of Embelia ribes (100 and 200 mg/kg, p.o.) for 30 days. Hyperhomocysteinemia was induced by methionine treatment (1 g/kg, p.o.) for 30 days and folic acid (100 mg/kg, p.o.) was used as a standard drug. The animals were evaluated for various biochemical parameters in serum and brain homogenates, followed by histopathological studies at the end of the study.

Results:

Administration of methionine (1 g/kg, p.o.) for 30 days to vehicle control rats produced significant increase (P < 0.01) in homocysteine, lactate dehydrogenase (LDH), total cholesterol, triglycerides, low density lipoprotein (LDL-C), very low density lipoprotein (VLDL-C) levels in serum and lipid peroxides (LPO) levels in brain homogenates, with reduction in high density lipoprotein (HDL-C) levels in serum, and glutathione (GSH) content in brain homogenates, as compared to vehicle control rats. Administration of the aqueous extract of Embelia ribes (100 and 200 mg/kg, p.o.) for 30 days, to hyperhomocysteinemic rats, significantly (P < 0.01) decreased the levels of homocysteine, LDH, total cholesterol, triglycerides, LDL-C and VLDL-C and increased the HDL-C levels in serum. In addition, a significant (P < 0.01) decrease in LPO levels with increase in GSH content was observed in hyperhomocysteinemic rats treated with the aqueous extract of Embelia ribes. The results were comparable to those obtained with folic acid, a standard antihyperhomocysteinemic drug.

Conclusion:

The present results provide clear evidence that the aqueous extract of Embelia ribes treatment enhances the antioxidant defense against methionine-induced hyperhomocysteinemia, hyperlipidemia and oxidative stress in brain.

Utility of C-reactive protein and hematological parameters in the detection of neonatal sepsis

The present study was undertaken to find out and compare the usefulness of C-reactive protein (CRP) and hematological value with the blood culture in the diagnosis of neonatal sepsis. This prospective and cross sectional study was carried out in the Department of Neonatology, Bangabandhu Sheikh Mujib Medical University (BSMMU) during the period of July 2003 to January 2005. One hundred cases of suspected septicemia and fifty of controls were enrolled in this study. Blood was collected for the estimation of CRP, hematological parameters (total leukocyte count, differential count, platelet count) and blood culture from the newborns having suspected sepsis and CRP and hematological parameters from the control. CRP was raised in 72% of cases and 4% of control. Total leukocyte count (TLC) was elevated in a total of 10% cases and only in 4% controls. Leucopenia occurred in 6% cases. In 50% cases of culture proven sepsis there was thrombocytopenia. Sensitivity and specificity of CRP were 78.6%and 62.5% respectively in suspected neonatal sepsis & 92.86% and 36.11% respectively in culture proven sepsis. This study concluded that CRP is most sensitive method (93%) in culture proven sepsis and (79%) in suspected sepsis and its positive predictive value in suspected sepsis amounts to 88%. In this study among the suspected sepsis TLC and its differential count didn't show any positive results significantly but thrombocytopenia was present in 50% cases of culture positive sepsis. Therefore, CRP can be taken as alternate method for the diagnosis of neonatal sepsis specially in developing countries like Bangladesh.

Evaluation of antioxidant and neuroprotective effect of ethanolic extract of Embelia ribes Burm in focal cerebral ischemia/reperfusion-induced oxidative stress in rats

Antioxidants have been the focus of studies for developing neuroprotective agents to be used in the therapy for stroke, which is an acute and progressive neurodegenerative disorder and is the second leading cause of death throughout the world. In fact, many herbal antioxidants have been developed in in vitro and in vivo experiments and some of these have been tested in clinical studies of stroke. Embelia ribes have been reported to have antioxidant and antidiabetic effects. In addition to these effects, this study was designed to investigate the neuroprotective effect of ethanolic extract of E. ribes Burm fruits on middle cerebral artery occlusion (MCAO)-induced focal cerebral ischemia in rats. Male Wistar albino rats were fed ethanolic E. ribes extract (100 and 200 mg/kg body weight; p.o.) for 30 days. After 30 days of feeding, all animals were anaesthetized with chloral hydrate (400 mg/kg, i.p.). The right middle cerebral artery was occluded with a 4-0 suture for 2 h. The suture was removed after 2 h to allow reperfusion injury. Ischemia followed by reperfusion in ischemic group rats significantly (P < 0.001) reduced the grip strength activity and non-enzymatic (reduced glutathione, GSH) and enzymatic [glutathione peroxidase (GPx), glutathione reductase (GR) and glutathione-S-transferase (GST)] antioxidant levels in hippocampus and frontal cortex compared to sham-operated rats. Further, serum lactate dehydrogenase (LDH) and thiobarbituric acid reactive substance (TBARS) levels in hippocampus and frontal cortex were significantly increased in ischemic group compared to sham-operated rats. Furthermore, ethanolic E. ribes extracts pretreatment significantly (P < 0.001) increased the grip strength activity, and GSH, GPx, GR and GST levels in hippocampus and frontal cortex with significant decrease in LDH levels in serum and TBARS levels in hippocampus and frontal cortex compared to MCAO + vehicle group rats. The data from this study suggest that chronic treatment with ethanolic E. ribes extract enhances the antioxidant defense against MCAO- induced focal cerebral ischemia in rats and exhibits neuroprotective activity.

Cardioprotective effect of aqueous extract of Embelia ribes Burm fruits against isoproterenol-induced myocardial infarction in albino rats

In the present study, cardioprotective effect of aqueous extract of fruits of Embelia ribes Burm (ER) was evaluated in a rat model having acute myocardial infarction, induced by isoproterenol (5.25 and 8.5 mg/kg, sc, for two consecutive days). Aqueous ER extract (100 mg/kg) pretreatment orally for 40 days in isoproterenol (ISO)-treated rats significantly decreased the heart rate, systolic blood pressure, increased levels of serum lactate dehydrogenase, serum creatine kinase and myocardial lipid peroxides and significantly increased the myocardial endogenous antioxidants (glutathione, superoxide dismutase and catalase) levels. The results of biochemical observations in serum and heart tissues were supplemented by histopathological examination of rat's heart sections to confirm the myocardial injury. The results were comparable to that of gliclazide treated group. The present results provide evidence for the first time, that aqueous ER extract pretreatment ameliorated myocardial injury and enhanced the antioxidant defense against ISO-induced myocardial infarction in rats and exhibited cardioprotective property.

Zingiber officinale exhibits behavioral radioprotection against radiation-induced CTA in a gender-specific manner

At the organismic level, exposure to radiation can produce taste aversion (CTA) learning and emesis, which have been proposed as behavioral endpoints that are mediated by harmful effects of radiations on peripheral systems, primarily the gastrointestinal system. Thus, the aim of the present investigation was to study the gastroprotective action of hydroalcoholic extract of zingiber rhizome (Zingiber officinale Rosc.) against radiation-induced conditioned taste aversion (CTA) in both male and female species of animals, for testing its potential as a behavioral radioprotector. Administration of zingiber extract 1 h before 2-Gy gamma-radiation was significantly effective in blocking the saccharin avoidance response, with 200 and 250 mg/kg b.wt. i.p., being the most effective doses for male and female rats, respectively. A comparison of the efficacy of zingiber extract with two antiemetic drugs, ondansteron and dexamethasone, revealed that the extract rendered comparable protection against radiation-induced CTA. Our experiments also confirmed the existence of sex dichotomy (i.e., the sex of animal greatly influenced response towards radiation exposure) in relation to behavioral responses (CTA) or differential metabolism. The observed gender variations were hypothesized to be a result of hormonal fluctuations and differences in pharmacological parameters in male and female rats. To correlate the mechanism of action, the free-radical-scavenging potential of zingiber extract to scavenge hydroxyl ion and nitric oxide was also tested, in cell-free system and a concentration of 1000 microg/ml, was found to be the most potent, which has been proposed as one the many activities assisting in its overall ability to modulate radiation-induced taste aversion. The results demonstrate that Z. officinale possesses antioxidant, radioprotective and neuromodulatory properties that can be effectively utilized for behavioral radioprotection and for efficiently mitigating radiation-induced CTA in both males and females species.

Role of fine needle aspiration cytology (FNAC) in the diagnosis of prostatic lesions with histologic correlation

This study was carried-out to evaluate the diagnostic accuracy of fine needle aspiration cytology (FNAC) and the role of FNAC in the diagnosis of prostatic lesions. FNAC was performed on 64 patients presented with enlarged prostate. Cytological diagnosis by fine needle aspiration (FNA) of the prostate was compared with histological diagnosis in 60 patients. Of these, 42 cases were cytologically diagnosed as benign lesions, 18 cases as malignant. In remaining 4 cases, materials were inadequate for diagnosis in one case and biopsy materials were not available in 3 cases. On histological examination, 42 cases which were cytologically diagnosed as benign, 40 cases were found to be benign and 2 cases were malignant histologically leading to 2 false negative diagnoses. Of the 18 cases diagnosed cytologically as malignant (considering atypical hyperplasia and carcinoma as malignant), 15 cases were proved to be so by histological examination. So there were false positive diagnoses in 3 cases. No patient suffered from any complication following the aspiration biopsy. The sensitivity of this study for detection of prostatic carcinoma was 88 percent; specificity was 93 percent and diagnostic accuracy 91.7 percent. In this prospective study, FNAC of prostate was found to be associated with high diagnostic yields. These data support the value of transrectal FNAC as sensitive, easy to perform method for sampling of an enlarged prostate. The procedure may be used as an efficient primary screening tool in the diagnosis of prostatic lesions. Frequent use of this technique in our country should be encouraged.

Zingiber officinale Rosc. modulates gamma radiation-induced conditioned taste aversion

The aim of the present study was to investigate the neurobehavioral protective efficacy of a hydroalcoholic extract of ginger (Zingiber officinale Rosc.) in mitigating gamma radiation-induced conditioned taste aversion in Sprague-Dawley rats. Administration of Zingiber extract 1 h before 2-Gy gamma irradiation was effective in blocking the saccharin avoidance response for 5 post-treatment observational days, both in a dose- and time-dependent manner, with 200 mg/kg b.w. i.p. being the most effective dose. Highest saccharin intake in all the groups was observed on the fifth post-treatment day. The potential of ginger extract to inhibit lipid peroxidation induced by radiation (2 Gy) and ascorbate-ion stress in brain homogenate and its ability to scavenge highly reactive superoxide anions were evaluated. The 1000-microg/ml and 2000-microg/ml concentration of ginger extract showed the highest efficiency in scavenging free radicals and in inhibiting lipid peroxidation. The lipid peroxidation and superoxide-anion scavenging ability of the extract further supports its radioprotective properties. The results clearly establish the neurobehavioral efficacy of ginger extract and the antioxidant properties appear to be a contributing factor in its overall ability to modulate radiation-induced conditioned taste aversion. Ginger extract has tremendous potential for clinical applications in mitigation of radiation-induced emesis in humans.

Arsenic concentrations in rice, vegetables, and fish in Bangladesh: a preliminary study

Arsenic contaminating groundwater in Bangladesh is one of the largest environmental health hazards in the world. Because of the potential risk to human health through consumption of agricultural produce grown in fields irrigated with arsenic contaminated water, we have determined the level of contamination in 100 samples of crop, vegetables and fresh water fish collected from three different regions in Bangladesh. Arsenic concentrations were determined by hydride generation atomic absorption spectrophotometry. All 11 samples of water and 18 samples of soil exceeded the expected limits of arsenic. No samples of rice grain (Oryza sativa L.) had arsenic concentrations more than the recommended limit of 1.0 mg/kg. However, rice plants, especially the roots had a significantly higher concentration of arsenic (2.4 mg/kg) compared to stem (0.73 mg/kg) and rice grains (0.14 mg/kg). Arsenic contents of vegetables varied; those exceeding the food safety limits included Kachu sak (Colocasia antiquorum) (0.09-3.99 mg/kg, n=9), potatoes (Solanum tuberisum) (0.07-1.36 mg/kg, n=5), and Kalmi sak (Ipomoea reptoms) (0.1-1.53 mg/kg, n=6). Lata fish (Ophicephalus punctatus) did not contain unacceptable levels of arsenic. These results indicate that arsenic contaminates some food items in Bangladesh. Further studies with larger samples are needed to demonstrate the extent of arsenic contamination of food in Bangladesh.