Antibiotic Resistance in Plant Pathogenic Bacteria: Recent Data and Environmental Impact of Unchecked Use and the Potential of Biocontrol Agents as an Eco-Friendly Alternative

The economic impact of phytopathogenic bacteria on agriculture is staggering, costing billions of US dollars globally. Pseudomonas syringae is the top most phytopathogenic bacteria, having more than 60 pathovars, which cause bacteria speck in tomatoes, halo blight in beans, and so on. Although antibiotics or a combination of antibiotics are used to manage infectious diseases in plants, they are employed far less in agriculture compared to human and animal populations. Moreover, the majority of antibiotics used in plants are immediately washed away, leading to environmental damage to ecosystems and food chains. Due to the serious risk of antibiotic resistance (AR) and the potential for environmental contamination with antibiotic residues and resistance genes, the use of unchecked antibiotics against phytopathogenic bacteria is not advisable. Despite the significant concern regarding AR in the world today, there are inadequate and outdated data on the AR of phytopathogenic bacteria. This review presents recent AR data on plant pathogenic bacteria (PPB), along with their environmental impact. In light of these findings, we suggest the use of biocontrol agents as a sustainable, eco-friendly, and effective alternative to controlling phytopathogenic bacteria.

Evaluation of accuracies of genomic predictions for body conformation traits in Korean Holstein

OBJECTIVE

This study aimed to assess the genetic parameters and accuracy of genomic predictions for twenty-four linear body conformation traits and overall conformation scores in Korean Holstein dairy cows.

METHODS

A dataset of 2,206 Korean Holsteins was collected, and genotyping was performed using the Illumina Bovine 50K single nucleotide polymorphism (SNP) chip. The traits investigated included body traits (stature, height at front end, chest width, body depth, angularity, body condition score, and locomotion), rump traits (rump angle, rump width, and loin strength), feet and leg traits (rear leg set, rear leg rear view, foot angle, heel depth, and bone quality), udder traits (udder depth, udder texture, udder support, fore udder attachment, front teat placement, front teat length, rear udder height, rear udder width, and rear teat placement), and overall conformation score. Accuracy of genomic predictions was assessed using the single-trait animal model genomic best linear unbiased prediction method implemented in the ASReml-SA v4.2 software.

RESULTS

Heritability estimates ranged from 0.10 to 0.50 for body traits, 0.21 to 0.35 for rump traits, 0.13 to 0.29 for feet and leg traits, and 0.05 to 0.46 for udder traits. Rump traits exhibited the highest average heritability (0.29), while feet and leg traits had the lowest estimates (0.21). Accuracy of genomic predictions varied among the twenty-four linear body conformation traits, ranging from 0.26 to 0.49. The heritability and prediction accuracy of genomic estimated breeding value (GEBV) for the overall conformation score were 0.45 and 0.46, respectively. The GEBVs for body conformation traits in Korean Holstein cows had low accuracy, falling below the 50% threshold.

CONCLUSION

The limited response to selection for body conformation traits in Korean Holsteins may be attributed to both the low heritability of these traits and the lower accuracy estimates for GEBVs. Further research is needed to enhance the accuracy of GEBVs and improve the selection response for these traits.

Exploring the Role of Extracellular Vesicles in the Pathogenesis of Tuberculosis

Tuberculosis (TB) remains a significant global health concern, necessitating accurate diagnosis and treatment monitoring. Extracellular vesicles (EVs), including exosomes, play crucial roles in disease progression, with their associated genes serving as potential biomarkers and therapeutic targets. Leveraging publicly available RNA-Seq datasets of TB patients and healthy controls (HCs), to identify differentially expressed genes (DEGs) and their associated protein-protein interaction networks and immune cell profiles, the common EV-related DEGs were identified and validated in the GSE42830 and GSE40553 datasets. We have identified nine common EV-related DEGs (SERPINA1, TNFAIP6, MAPK14, STAT1, ITGA2B, VAMP5, CTSL, CEACAM1, and PLAUR) upregulated in TB patients. Immune cell infiltration analysis revealed significant differences between TB patients and HCs, highlighting increased proportions of various immune cells in TB patients. These DEGs are involved in crucial cellular processes and pathways related to exocytosis and immune response regulation. Notably, VAMP5 exhibited excellent diagnostic performance (AUC-0.993, sensitivity-93.8%, specificity-100%), with potential as a novel biomarker for TB. The EV-related genes can serve as novel potential biomarkers that can distinguish between TB and HCs. VAMP5, which functions in exosome biogenesis and showed significant upregulation in TB, can be targeted for therapeutic interventions and treatment outcomes.

Acceptability, cost-effectiveness, and capacity of a facility-based seasonal influenza vaccination among high-risk groups: a study protocol in selected tertiary care hospitals of Bangladesh

BACKGROUND

In Bangladesh, seasonal influenza imposes considerable disease and economic burden, especially for those at high-risk of severe disease. The most successful approach for influenza prevention is the administration of a vaccine. Many poor and middle-income nations, including Bangladesh, do not have a national strategy or program in place for seasonal influenza vaccines, despite the World Health Organization's (WHO) advice to prioritize high-risk populations. Additionally, there is a scarcity of substantial data on the cost-effectiveness of seasonal influenza vaccination in these countries. The aim of our study is to determine acceptability, health beliefs, barriers, and intention of receiving influenza vaccine among high-risk populations, assess the cost-effectiveness of implementing a facility-based seasonal influenza vaccination programme, and investigate the required capacity for a potential seasonal influenza vaccination programme.

METHODS

We will undertake this study following STROBE guidelines. We will conduct the study in inpatient and outpatient departments of three selected tertiary-level hospitals leveraging the ongoing hospital-based influenza surveillance (HBIS) platform. The study population will include the WHO-defined four high-risk groups excluding healthcare workers: children six months to eight years, pregnant women, elderly ≥ 60 years, and adults with chronic diseases. We will collect quantitative data on participants' acceptability, health beliefs, barriers, and vaccination intentions using the health belief model (HBM) from patients meeting the criteria for high-risk populations attending two public tertiary-level hospitals. In one of the two public tertiary-level hospitals, we will arrange an influenza vaccination campaign before the influenza season, where the vaccine will be offered free of cost to high-risk patients, and in the second hospital, vaccination will not be offered. Both the vaccinated and unvaccinated participants will then be followed-up once a month for one year to record any influenza-like illness, hospitalization, and death. Additional data for objective two will be collected from patients with symptoms of influenza-like illness (ILI) and severe acute respiratory infection (SARI) at one public and one private hospital to determine both direct and indirect costs associated with influenza illness. We will estimate the required number of influenza vaccines, safe injections, and total storage volume utilizing secondary data. We will use a deterministic Markov decision-analytic model to estimate the cost-effectiveness of facility-based influenza vaccination in Bangladesh.

DISCUSSION

The results of this study will enable the National Immunization Technical Advisory Group and the Ministry of Health & Family Welfare of Bangladesh to decide what steps to take to develop and implement an influenza vaccination strategy targeting high-risk populations.

TRIAL REGISTRATION

The Clinicaltrials.gov registration number is NCT05996549. The registration for the protocol version 2.0 took place in August 2023, with the initial participant being enrolled in March 2022.

Genomic Predictions in Korean Hanwoo Cows: A Comparative Analysis of Genomic BLUP and Bayesian Methods for Reproductive Traits

This study aimed to predict the accuracy of genomic estimated breeding values (GEBVs) for reproductive traits in Hanwoo cows using the GBLUP, BayesB, BayesLASSO, and BayesR methods. Accuracy estimates of GEBVs for reproductive traits were derived through fivefold cross-validation, analyzing a dataset comprising 11,348 animals and employing an Illumina Bovine 50K SNP chip. GBLUP showed an accuracy of 0.26 for AFC, while BayesB, BayesLASSO, and BayesR demonstrated values of 0.28, 0.29, and 0.29, respectively. For CI, GBLUP attained an accuracy of 0.19, whereas BayesB, BayesLASSO, and BayesR scored 0.21, 0.24, and 0.25, respectively. The accuracy for GL was uniform across GBLUP, BayesB, and BayesR at 0.31, whereas BayesLASSO showed a slightly higher accuracy of 0.33. For NAIPC, GBLUP showed an accuracy of 0.24, while BayesB, BayesLASSO, and BayesR recorded 0.22, 0.27, and 0.30, respectively. The variation in genomic prediction accuracy among methods indicated Bayesian approaches slightly outperformed GBLUP. The findings suggest that Bayesian methods, notably BayesLASSO and BayesR, offer improved predictive capabilities for reproductive traits. Future research may explore more advanced genomic approaches to enhance predictive accuracy and genetic gains in Hanwoo cattle breeding programs.

Characterization of lignin and hemicellulose degrading bacteria isolated from cow rumen and forest soil: Unveiling a novel enzymatic model for rice straw deconstruction

Application of greener pretreatment technology using robust ligninolytic bacteria for short duration to deconstruct rice straw and enhance bioethanol production is currently lacking. The objective of this study is to characterize three bacterial strains isolated from the milieux of cow rumen and forest soil and explore their capabilities of breaking down lignocellulose - an essential process in bioethanol production. Using biochemical and genomic analyses these strains were identified as Bacillus sp. HSTU-bmb18, Bacillus sp. HSTU-bmb19, and Citrobacter sp. HSTU-bmb20. Genomic analysis of the strains unveiled validated model hemicellulases, multicopper oxidases, and pectate lyases. These enzymes exhibited interactions with distinct lignocellulose substrates, further affirmed by their stability in molecular dynamic simulations. A comprehensive expression of ligninolytic pathways, including β-ketoadipate, phenyl acetate, and benzoate, was observed within the HSTU-bmb20 genome. The strains secreted approximately 75-82 U/mL of cellulase, xylase, pectinase, and lignin peroxidase. FT-IR analysis of the bacterial treated rice straw fibers revealed that the intensity of lignin-related peaks decreased, while cellulose-related peaks sharpened. The values of crystallinity index for the untreated control and the treated rice straw with either HSTU-bmb18, or HSTU-bmb19, or HSTU-bmb20 were recorded to be 34.48, 28.49, 29.36, 31.75, respectively, which are much higher than that of 13.53 noted for those treated with the bacterial consortium. The ratio of fermentable cellulose in rice straw increased by 1.25-, 1.79-, 1.93- and 2.17-fold following treatments with HSTU-bmb18, HSTU-bmb20, HSTU-bmb19, and a mixed consortium of these three strains, respectively. These aggregative results suggested a novel model for rice straw deconstruction utilizing hydrolytic enzymes of the consortium, revealing superior efficacy compared to individual strains, and advancing cost-effective, affordable, and sustainable green technology.

Genome-Wide Association Studies for Body Conformation Traits in Korean Holstein Population

The objective of this study was to identify quantitative trait loci (QTL) and nearby candidate genes that influence body conformation traits. Phenotypic data for 24 body conformation traits were collected from a population of 2329 Korean Holstein cattle, and all animals were genotyped using the 50 K Illumina bovine SNP chip. A total of 24 genome-wide significant SNPs associated with 24 body conformation traits were identified by genome-wide association analysis. The selection of the most promising candidate genes was based on gene ontology (GO) terms and the previously identified functions that influence various body conformation traits as determined in our study. These genes include KCNA1, RYBP, PTH1R, TMIE, and GNAI3 for body traits; ANGPT1 for rump traits; MALRD1, INHBA, and HOXA13 for feet and leg traits; and CDK1, RHOBTB1, and SLC17A1 for udder traits, respectively. These findings contribute to our understanding of the genetic basis of body conformation traits in this population and pave the way for future breeding strategies aimed at enhancing desirable traits in dairy cattle.

Assessment of genomic breeding values and their accuracies for carcass traits in Jeju Black cattle using whole-genome SNP chip panels

The objective of the present study was to evaluate the breeding value and accuracy of genomic estimated breeding values (GEBVs) of carcass traits in Jeju Black cattle (JBC) using Hanwoo steers and JBC as a reference population using the single-trait animal model. Our research included genotype and phenotype information on 19,154 Hanwoo steers with 1097 JBC acting as the reference population. Likewise, the test population consisted of 418 genotyped JBC individuals with no phenotypic records for those carcass traits. For estimating the accuracy of GEBV, we divided the entire population into three groups. Hanwoo and JBC make up the first group; Hanwoo and JBC, who has both the genotype and phenotypic records, are referred to as the reference (training) population, and JBC, who lacks phenotypic information is referred to as the test (validation) population. The second group consists of the JBC (without phenotype) as the test population and Hanwoo as a reference population with phenotype and genotypic data. The only JBCs in the third group are those who have genotypic and phenotypic data on them as a reference population but no phenotypic data on them as a test population. The single-trait animal model was used in all three groups for statistical purposes. The reference populations estimated heritabilities for carcass weight (CWT), eye muscle area (EMA), backfat thickness (BF), and marbling score (MS) as 0.30, 0.26, 0.26, and 0.34 for the Hanwoo steer and 0.42, 0.27, 0.26, and 0.48 for JBC. The average accuracy for carcass traits in Group 1 was 0.80 for the Hanwoo and JBC reference population compared with 0.73 for the JBC test population. Although the average accuracy for carcass traits in Group 2 was 0.80, it was 0.80 for the Hanwoo reference population and only 0.56 for the JBC test population. The average accuracy for the JBC reference and test populations was 0.68 and 0.50, respectively, when they were included in the accuracy comparison without the Hanwoo reference population. Groups 1 and 2 used Hanwoo as reference population, which led to a better average accuracy; however, Group 3 only used the JBC reference and test population, which led to a lower average accuracy. This might be due to the fact that Group 3 used a smaller reference size than the group that came before it and that the genetic makeup of the Hanwoo and JBC breeds differed. The GEBV accuracy for MS was higher than that of other traits across all three analysis groups, followed by CWT, EMA, and BF, which may be partially explained by the MS traits' higher heritability. This study suggests that in order to achieve more accuracy, a large reference population particular to a breed should be established. Therefore, to increase the accuracy of GEBV prediction and the genetic benefit from genomic selection in JBC, individual reference breeds, and large populations are required.

Genome-Wide Association Study to Identify QTL for Carcass Traits in Korean Hanwoo Cattle

This study aimed to identify genetic associations with carcass traits in Hanwoo cattle using a genome-wide association study. A total of 9302 phenotypes were analyzed, and all animals were genotyped using the Illumina Bovine 50K v.3 SNP chip. Heritabilities for carcass weight (CWT), eye muscle area (EMA), backfat thickness (BF), and marbling score (MS) were estimated as 0.42, 0.36, 0.36, and 0.47, respectively, using the GBLUP model, and 0.47, 0.37, 0.36, and 0.42, respectively, using the Bayes B model. We identified 129 common SNPs using DGEBV and 118 common SNPs using GEBV on BTA6, BTA13, and BTA14, suggesting their potential association with the traits of interest. No common SNPs were found between the GBLUP and Bayes B methods when using residuals as a response variable in GWAS. The most promising candidate genes for CWT included SLIT2, PACRGL, KCNIP4, RP1, XKR4, LYN, RPS20, MOS, FAM110B, UBXN2B, CYP7A1, SDCBP, NSMAF, TOX, CA8, LAP3, FAM184B, and NCAPG. For EMA, the genes IBSP, LAP3, FAM184B, LCORL, NCAPG, SLC30A9, and BEND4 demonstrated significance. Similarly, CYP7B1, ARMC1, PDE7A, and CRH were associated with BF, while CTSZ, GNAS, VAPB, and RAB22A were associated with MS. This finding offers valuable insights into genomic regions and molecular mechanisms influencing Hanwoo carcass traits, aiding efficient breeding strategies.

Characterization of Growth-Promoting Activities of Consortia of Chlorpyrifos Mineralizing Endophytic Bacteria Naturally Harboring in Rice Plants-A Potential Bio-Stimulant to Develop a Safe and Sustainable Agriculture

Eighteen pesticide-degrading endophytic bacteria were isolated from the roots, stems, and leaves of healthy rice plants and identified through 16S rRNA gene sequencing. Furthermore, biochemical properties, including enzyme production, dye degradation, anti-bacterial activities, plant-growth-promoting traits, including N-fixation, P-solubilization, auxin production, and ACC-deaminase activities of these naturally occurring endophytic bacteria along with their four consortia, were characterized. Enterobacter cloacae HSTU-ABk39 and Enterobacter sp. HSTU-ABk36 displayed inhibition zones of 41.5 ± 1.5 mm, and 29 ± 09 mm against multidrug-resistant human pathogenic bacteria Staphylococcus aureus and Staphylococcus epidermidis, respectively. FT-IR analysis revealed that all eighteen isolates were able to degrade chlorpyrifos pesticide. Our study confirms that pesticide-degrading endophytic bacteria from rice plants play a key role in enhancing plant growth. Notably, rice plants grown in pots containing reduced urea (30%) mixed with either endophytic bacterial consortium-1, consortium-2, consortium-3, or consortia-4 demonstrated an increase of 17.3%, 38.6%, 18.2%, and 39.1% yields, respectively, compared to the control plants grown in pots containing 100% fertilizer. GC-MS/MS analysis confirmed that consortia treatment caused the degradation of chlorpyrifos into different non-toxic metabolites, including 2-Hydroxy-3,5,6 trichloropyridine, Diethyl methane phosphonate, Phorate sulfoxide, and Carbonochloridic. Thus, these isolates could be deployed as bio-stimulants to improve crop production by creating a sustainable biological system.

A short communication of 2022 dengue outbreak in Bangladesh: a continuous public health threat

Dengue virus infection, a highly prominent health concern, has caused many health complications, positive cases, and deaths in Bangladesh in previous years. However, the prevalence of this infection and fatality rates in 2022 has shattered all prior records. The dengue virus vector, mosquitoes, found a high prevalence of infection due to the weather's favorable conditions for breeding in the months of June and July. While there is presently no particular vaccination for dengue infection, awareness of its epidemiology, pathogenesis, signs, and symptoms may aid in the development of improved diagnostic and treatment strategies. The government should also improve the infrastructure of cities to make prevent mosquito breeding and the spread of dengue infection.

Enhanced rice plant (BRRI-28) growth at lower doses of urea caused by diazinon mineralizing endophytic bacterial consortia and explorations of relevant regulatory genes in a Klebsiella sp. strain HSTU-F2D4R

Endophytic biostimulant with pesticide bioremediation activities may reduce agrochemicals application in rice cultivation. The present study evaluates diazinon-degrading endophytic bacteria, isolated from rice plants grown in the fields with pesticide amalgamation, leading to increased productivity in high-yielding rice plants. These endophytes showed capabilities of decomposing diazinon, confirmed by FT-IR spectra analysis. Growth promoting activities of these endophytes can be attributed to their abilities to produce an increased level of IAA content and to demonstrate high level ACC-deaminase activities. Furthermore, these endophytes demonstrated enhanced level of extracellular cellulase, xylanase, amylase, protease and lignin degrading activities. Five genera including Enterobacter, Pantoea, Shigella, Acinetobacter, and Serratia, are represented only by the leaves, while four genera such as Enterobacter, Escherichia, Kosakonia, and Pseudomonas are represented only by the shoots. Five genera including, Klebsiella, Enterobacter, Pseudomonas, Burkholderia, and Bacillus are represented only by the roots of rice plants. All these strains demonstrated cell wall hydrolytic enzyme activities, except pectinase. All treatments, either individual strains or consortia of strains, enhanced rice plant growth at germination, seedling, vegetative and reproductive stages. Among four (I-IV) consortia, consortium-III generated the maximum rice yield under 70% lower doses of urea compared to that of control (treated with only fertilizer). The decoded genome of Klebsiella sp. HSTU-F2D4R revealed nif-cluster, chemotaxis, phosphates, biofilm formation, and organophosphorus insecticide-degrading genes. Sufficient insecticide-degrading proteins belonging to strain HSTU-F2D4R had interacted with diazinon, confirmed in molecular docking and formed potential catalytic triads, suggesting the strains have bioremediation potential with biofertilizer applications in rice cultivation.

Comparisons of Physicochemical Properties, Bacterial Diversities, Isoflavone Profiles and Antioxidant Activities on Household and Commercial doenjang

In this study, the physicochemical properties (pH, acidity, salinity, and soluble protein), bacterial diversities, isoflavone contents, and antioxidant activities of doenjang (fermented soy paste), household doenjang (HDJ), and commercial doenjang (CDJ), were assessed and compared. The values of pH 5.14-5.94 and acidity 1.36-3.03%, indicated a similar level in all doenjang. The salinity was high in CDJ at 12.8-14.6%, and the protein contents (25.69-37.54 mg/g) were generally high in HDJ. Forty-three species were identified from the HDJ and CDJ. The main species were verified to be Bacillus amyloliquefaciens (B. amyloliquefaciens), B. amyloliquefaciens subsp. plantarum, Bacillus licheniformis, Bacillus sp. and Bacillus subtilis. Comparing the ratios of isoflavone types, the HDJ has an aglycone ratio of >80%, and 3HDJ indicates a ratio of isoflavone to aglycone of 100%. In the CDJ, except 4CDJ, glycosides account for a high proportion of more than 50%. The results of antioxidant activities and DNA protection effects were variedly confirmed regardless of HDJs and CDJs. Through these results, it is judged that HDJs have a variety of bacterial species compared to CDJs, and these are biologically active and converted from glycoside to aglycone. Bacterial distribution and isoflavone contents could be used as basic data.

Correlation between Antero-posterior Diameter and Vertical Diameter of Both Ends of Fully Ossified Dry Human Clavicle

Clavicle is an upper limb locomotory bone which helps in formation of pectoral girdle and connected the upper limb with axial skeleton. There is no baseline data of clavicle in contrast to demographic variation in our country, so the study was designed to obtain baseline data on clavicle for anthropological, forensic and clinical use. This descriptive cross-sectional study was done among 150 (65 right and 85 left) fully ossified dry human clavicle in Mymensingh Medical College, Mymensingh, Bangladesh from January 2020 to December 2020. Sample was collected by the help of nonrandom purposive sampling technique from Department of Anatomy of Mymensingh Medical College and Community Based Medical College, Bangladesh, Mymensingh. The parameters were the antero-posterior diameter and vertical diameter of sternal and acromial ends of clavicle, measured with the help of digital vernier slide caliper and expressed in millimeter. In the current study the mean±SD antero-posterior diameter of sternal end of 65 clavicles of right side was 21.97±2.889mm and 85 clavicles of left side were 20.30±3.459mm. The mean±SD antero-posterior diameter of acromial end of 65 right sided clavicles was 21.96±5.161mm and 85 clavicles of left side were 21.00±4.002mm. Correlation was done in between antero-posterior diameter and vertical diameter of sternal end of clavicle and the differences were highly significant on both sides. Similarly, when correlation was done for the acromial end of clavicle the difference was found non-significant on right side and highly significant on left side.

Seasonal influenza vaccine uptake among healthcare workers in tertiary care hospitals, Bangladesh: Study protocol for influenza vaccine supply and awareness intervention

Background

Healthcare workers (HCWs), such as doctors, nurses, and support staffs involved in direct or indirect patient care, are at increased risk of influenza virus infections due to occupational exposures. Vaccination is the most effective way to prevent influenza. Despite the World Health Organization (WHO) recommendations, Bangladesh lacks a seasonal influenza vaccination policy for HCWs, and thus vaccination rates remain low. The current project aims to investigate the effect of interventions on influenza vaccine awareness and availability of vaccine supply, explore HCWs’ knowledge and perceptions about influenza vaccination, understand the barriers and motivators for influenza vaccine uptake, and understand policymakers' views on the practicality of influenza vaccination among HCWs.

Method

We will conduct the study at four tertiary care teaching hospitals in Bangladesh, using a cluster randomized controlled trial approach, with the hospital as the unit of randomization and intervention. The study population will include all types of HCWs.The four different types of intervention will be randomly allocated and implemented in four study hospitals separately. The four interventions will be: i) ensuring the availability of influenza vaccine supply; ii) developing influenza vaccine awareness; iii) both ensuring influenza vaccine supply and developing influenza vaccine awareness and iv) control arm with no intervention. Both quantitative and qualitative approaches will be applied to assess the intervention effect. We will estimate the Difference in Differences (DID) with 95% CI of the proportion of vaccine uptake between each intervention and control (non-intervention) arm, adjusting for the clustering effect. The qualitative data will be summarised using a framework matrix method.

Discussion

The results of this study will inform the development and implementation of a context-specific strategy to enhance influenza vaccination rates among Bangladeshi HCWs.

Trial registration

Clinicaltrials.gov NCT05521763. Version 2.0 was registered in September 2022, and the first participant enrolled in March 2022. Retrospectively registered.

Noonan Syndrome Presenting with Stunted Growth: A Case Report

Noonan syndrome is a genetic disorder of autosomal dominant inheritance that prevents normal development in various parts of the body. A spontaneous mutation without any family history may also result in the condition. Noonan syndrome can affect normal growth. Birth weight may be normal, but growth slows over time. The growth spurt usually seen during the teenage years may be delayed, and bone maturity also is delayed. In this case A 13 year's male admitted inpatient Department of Endocrinology, Mymensingh Medical College Hospital in April 2021 with not attaining appropriate height and delayed development of secondary sexual characteristics. His birth weight was normal; gestational and neonatal history was uneventful. He was diagnosed with severe pulmonary stenosis at four years and underwent cardiac surgery at his four and eleven years. He was noted to have growth failure from the age of 9 years onward. He had no family history of such type of disease. On examination, he was short statured, underweight, having an upper: lower segment ratio of 1.05 with an arm span of 126cm. He had craniosynostosis, high arched palate, the thick helix of ears (outer rim), small, upturned nose, depressed broad nose, deeply grooved philtrum, keratosis pilaris of the face and upper arm, slant eyes with proptosis, keloid scar over mid-chest, widely spaced nipple, shield chest, pectus excavatum and cubitus valgus. His sexual maturation score was A1, P1, B1. He had pulmonary stenosis with pulmonary hypertension. He had mild microcytic anemia with normal liver, renal, blood glucose, and calcium profile. His bone age was delayed (9 years), thyroid function was normal. The growth hormone dynamic test after clonidine stimulation was normal. His karyotype was 46XY. We have considered giving recombinant growth hormone therapy to accelerate his height.

Prevalence of Hepatitis B Virus Infection among Children with Liver Disease Admitted In Mymensingh Medical College Hospital

Hepatitis B virus infection is an important cause of liver disease. Hepatitis B Virus may present with varying degree of severity. In older children, 5-10% cases leading to chronic liver disease, cirrhosis and hepatocellular carcinoma. This descriptive cross sectional study was done to assess the prevalence of Hepatitis B Virus infection among hospitalized children with liver disease in pediatric department of Mymensingh Medical College Hospital, Bangladesh from December 2015 to October 2016. All the children of both sexes having age between six months to twelve years admitted in the pediatric ward with acute or chronic liver disease were included in this study by purposive sampling. A written consent was obtained from legal guardian of children before inclusion. Ethical clearance was obtained from competent authority. A detailed history was taken from parents in each case according to pre-designed questionnaire about demography of the patients and the risk factors of the liver disease. A thorough clinical examination and available relevant investigations like serological testing for HBV infection was done in all patients. We had figure out the seropositivity of HBV among patients having liver disease by doing HBsAg and Anti-HBc IgM. Progress of the patient was monitored by daily clinical examinations and by investigating HBsAg and Anti-HBc IgM. Finally data analysis was done by SPSS version 21.0. Among total 100 patients most (44%) patients were in 7-10 years old and most (62%) of the participants were male. Acute liver disease was 58% cases and chronic liver disease was 42% cases. HBsAg was positive in 1 case among acute liver disease and 5 cases among chronic cases. Total 6 (six) patients were found positive for HBsAg. Anti HBc IgM was positive in 4 patients among acute liver disease. Among these Anti HBc IgM positive (4) patients only one had both HBsAg and Anti HBc IgM positive. So, four patients were confirming suffered from acute viral hepatitis because they had anti HBc IgM positive. On the contrary 5 patients suffered from chronic hepatitis by hepatitis B because they were only HBsAg positive. So, in this study 9 patients (9%) were confirming suffered from HBV infection. Possible transmission factors of hepatitis B were history of (H/O) blood transfusion/trauma/parenteral injection, H/O umbilical sepsis, H/O maternal illness/infection during pregnancy. HBV still is a major cause of morbidity. All the children with liver disease should be routinely tested for HBV.

A Prospective Study of Deep Vein Thrombosis after Major Abdominal Surgery in a Tertiary Level Hospital

This prospective study was conducted to find the rate of deep and risk factors associated with vein thrombosis following major abdominal surgery in Sylhet MAG Osmani Medical College Hospital from 1st November 2017 to 30th April 2018. Total 103 patients aged above 20 years both male and female who got admitted in Department of Surgery, Sylhet MAG Osmani Medical College Hospital, Sylhet for their disease requiring routine and emergency major abdominal operation during the study period and fulfilling the inclusion and exclusion criteria were selected in this study. Informed written consent was obtained from the patients after full explanation of the purpose of the study. After full investigations and proper preparation of each patient for operative procedure major abdominal surgery were done. Peroperative findings were noted and post-operative period were followed up routinely. Duplex scanning was done on 3rd POD in all cases. The age of the patients ranged from 25 to 74 years with the mean age of 49.5±13.8 years. There were 60(58.3%) male and 43(41.7%) female. Deep vein thrombosis (DVT) developed in 5(4.9%) of cases and not developed in 98(95.1%) cases. All the five cases were confirmed by color duplex scan. DVT was detected in 2(3.3%) of the 60 males and 3(7.0%) of the 43 females undergoing major general surgical procedures. Among 63 patients in whom the duration of surgery was up to 2 hours, none developed DVT, while among the 40 patients in whom the duration of surgery lasted more than 2 hours, 5(12.5%) developed DVT. Among 23 patients in whom the surgery for malignancy was done, 4(17.4%) developed DVT, while among the 80 patients in whom surgery for non-malignancy, 1(1.2%) developed DVT. The Incidence of DVT in patients undergoing major abdominal surgery is 4.9%. Patients undergoing major abdominal surgery for malignancy and duration of operation greater than 2 hours have higher risk of developing DVT. But there is no significant increase in risk of development of DVT relation to age and sex; and also in patients on oral contraceptives, diabetes mellitus, obesity and smoking. Clinical findings alone cannot be relied upon for the diagnosis of DVT. The study has to be continued with larger sample size to get statistically significant results.

Salinity Influences Plant-Pest-Predator Tritrophic Interactions

Climate change-induced salinity intrusion into agricultural soils is known to negatively impact crop production and food security. However, the effects of salinity increase on plant-herbivore-natural enemy systems and repercussions for pest suppression services are largely unknown. Here, we examine the effects of increased salinity on communities of rice (Oryza sativa), brown planthopper (BPH), Nilaparvata lugens, and green mirid bug (GMB), Cyrtorhinus lividipennis, under greenhouse conditions. We found that elevated salinity significantly suppressed the growth of two rice cultivars. Meanwhile, BPH population size also generally decreased due to poor host plant quality induced by elevated salinity. The highest BPH density occurred at 2.0 dS/m salinity and declined thereafter with increasing salinity, irrespective of rice cultivar. The highest population density of GMB also occurred under control conditions and decreased significantly with increasing salinity. Higher salinity directly affected the rice crop by reducing plant quality measured with reference to biomass production and plant height, whereas inducing population developmental asynchrony between BPH and GMB observed at 2 dS/m salinity and potentially uncoupling prey-predator dynamics. Our results suggest that increased salinity has harmful effects on plants, herbivores, natural enemies, as well as plant-pest-predator interactions. The effects measured here suggest that the bottom-up effects of predatory insects on rice pests will likely decline in rice produced in coastal areas where salinity intrusion is common. Our findings indicate that elevated salinity influences tritrophic interactions in rice production landscapes, and further research should address resilient rice insect pest management combining multipests and predators in a changing environment.

Comparison of Nutritional Status of Children with Congenital Heart Diseases with Minor Illness of Other Children in a Tertiary Level Hospital

This cross sectional comparative analytical study was undertaken with the objectives to find out the nutritional status of children with congenital heart disease by anthropometric measurement and was compared it with those of children having minor illness and without any congenital heart disease in indoor and outdoor Department of Paediatrics of Mymensingh Medical College Hospital (MMCH), Mymensingh, Bangladesh from December 2015 to November 2016. Purposive sampling was done. One hundred children aged 6 to 60 months with congenital heart disease confirmed by echocardiogram were taken as Group A and one hundred children of same age and sex matched having minor illness and without any congenital heart disease were taken as Group B. Age of the patients ranged from 6 to 60 months. There was no obvious difference of socio-demographic status between two groups. Most of the patient (64.0%) had acyanotic congenital heart disease among them VSD was commonest (68.8%). Thirty-six percent (36.0%) patient had cyanotic congenital heart disease and among them Tetralogy of Fallots (83.3%) was commonest. There were significant differences regarding weight, height and MUAC values in between two Groups. Underweight (51%), Stunting (50%) and Wasting (29%) all were higher in congenital heart disease than that of Group B where they were 28%, 31% and 13% respectively and the differences were statistically significant (p<0.05). The findings of this study imply that malnutrition is very common among children with congenital heart disease. So, anthropometric measurement should be done in each and every child with congenital heart disease.

Seasonal analysis of food items and feeding habits of endangered riverine catfish Rita rita (Hamilton, 1822)

This investigation presents the food and feeding activity of and endangered riverine catfish Rita rita, during February 2017-January 2018. A total of 225 fish individuals was analyzed for stomach contents by characterizing the dominant food items and morphometric features. The results divulged ten major food items consumed, preferably fish scales and eggs, teleost fishes, copepods, cladocerans, rotifers, and mollusks. Total length and body weight of fish varied between 9-34 cm (20.53 ± 6.90 cm) and 10-400 g (9125.94 ± 102.07 g), respectively. The index of relative importance (IRI%) showed the importance of rotifers over the other food items. Morisita's index of diet overlap indicated seasonal variations in catfish diets with summer and monsoon displaying the least overlap, while maximum overlap during monsoon and winter seasons. The non-metric multidimensional scaling (nMDS) indicated the close association between the food items available during summer and winter seasons with a significant difference among the seasons (ANOSIM, R = 0.638, P = 0.013). Levin's niche breadth index arranged in the order of 0.88>0.81>0.78>0.63>0.43 for the size classes of V, IV, III, II and I, respectively. The PCA explained 95.39% of the total variance among the food items and fish size groups. Small-sized fish individuals displayed a greater correlation with food items suitable for their mouth size. In conclusion, the variety and frequency of food items recorded indicated considerable feeding plasticity and opportunistic feeding behavior with a shift from carnivorous to omnivorous feeding nature. This study could render useful information on the food and feeding habits of R. rita and provide background for preparing its diet for future aquaculture practices.

Effect of milk pH at heating on protein complex formation and ultimate gel properties of free-fat yoghurt

The effect of milk pH before heating on casein-whey protein interactions and ultimate gel properties of the free-fat yoghurt was investigated. Reconstituted skim milk at different pH values (6.4, 6.8 and 7.2) was heated at 80 °C for 30 min. The type of protein and size of casein micelle in milk were determined. The storage modulus (G'), loss tangent (tan δ), flow behaviour as well as microstructure, firmness and water holding capacity of the yoghurt samples were measured. Heating milk at pH 7.2 formed mostly soluble protein complexes whereas at pH 6.4 micelle bound complexes was dominant. However, heating milk at pH 6.8 resulted in a relatively compact protein network due to a balanced contribution from both soluble protein/κ-casein complexes and whey protein-casein micelle associated complexes. Yoghurt prepared with milk heated at pH 6.8 showed significantly higher G' values, shorter gelation times, higher water holding capacity, firmness and more compact protein network compared to those at pH 6.4, 7.2 and unheated milk. The obtained results demonstrated that milk pH adjustment before heating could be an important factor governing uniform quality yoghurt production.

Study on Alanine Aminotransferase in Patients of Type 2 Diabetes Mellitus

Type 2 Diabetes mellitus (DM) is associated with various types of liver disorders including elevated liver enzymes. This study was carried out to observe hepatocellular injury in type 2 Diabetes mellitus as evidenced by raised Alanine aminotransferase (ALT) among the type 2 Diabetes mellitus patients and to find out association between elevated ALT and glycaemic control. This was a descriptive cross-sectional comparative study carried out in Department of Medicine, Rajshahi Medical College Hospital and Rajshahi Diabetic Association Hospital, Rajshahi, Bangladesh from July 2009 to June 2010. One hundred (100) diagnosed type 2 diabetic patients according to WHO criteria and 30 apparently healthy people of both sexes were included. Age of the study people were >40 years. All of those study population were free from taking any hepatotoxic drugs, inj. Insulin, alcohol and preexisting liver disease. Detailed History, thorough clinical examination and relevant investigations were done for exclusion. The frequency of abnormal ALT, Serum bilirubin, Aspartate aminotransferase (AST), Alkaline phosphatase, Prothrombin time and Serum albumin were 30%, 6%, 7%, 6%, 54% and 12% respectively in type 2 diabetic patients and 3.3%, 00%, 00%, 6.7%, 10% and 3.3% respectively in normal people. Serum ALT (U/L) level (mean±SD) of the type 2 diabetic patients and normal people were (39.00±24.21) and (28.26±6.67) respectively. This difference is highly significant (p<0.001). Elevated serum ALT level of type 2 diabetic patients showed positive association with increased Body mass index (BMI) (p<0.05) and poor glycaemic control (p<0.05) and fatty liver (p=0.055). So, a high proportion of patients with type 2 diabetes mellitus have raised serum Alanine aminotransferase level. Elevated serum ALT level was also associated with high BMI, poor glycaemic control and fatty liver which may be a marker of NAFLD and insulin resistance.

High carbon-di-oxide modified atmospheric packaging on quality of ready-to-eat minimally processed fresh-cut iceberg lettuce

Fresh-cut lettuce is a very well-known salad for today's routines because it obliges minimal preparation to minimize the loss of health beneficial vitamins, minerals, antioxidants and other phytochemicals. It is a prodigious challenge to serve its consumers fresh. Quality of freshly processed lettuce under high CO₂ modified atmosphere packaging (MAP) has been investigated as a realistic alternative technique for its preservation. Storage under high CO₂ atmospheric treatments exhibited a significant impact in microbial development, electrolyte leakage, volatile metabolites and sensory quality of fresh-cut iceberg lettuce. This storage condition (MAP 1: 5 kPa O₂ and 20 kPa CO₂ balanced by N₂ at 7 °C for 6 days) inhibited the growth of mesophilic bacteria and yeasts; delayed the enzymatic browning (cut-edges and intact surface) of fresh-cut iceberg lettuce and overall visual quality was also in acceptance limit. The development of off-odors was perceived in high CO₂ MAP as a consequence of volatiles (ethanol and acetaldehyde) accumulation which was persisted at an inexcusable level during 6 days of storage periods.

A Case Report on Small Cell Carcinoma with Bilateral Vocal Cord Palsy and Superior Vena Cava Syndrome

Small cell lung cancer (SCLC), previously known as oat cell carcinoma, is considered distinct from other lung cancers, which are called non-small cell lung cancers (NSCLC) because of their clinical and biologic characteristics. Small cell lung cancer is a neuroendocrine carcinoma that exhibits aggressive behavior, rapid growth, early spread to distant sites, excuisite sensitivity to chemotherapy and frequent association with distinct paraneoplastic syndromes, including syndrome of inappropriate secretion of antidiuretic hormone (SIADH), ectopic adrenocorticotropic hormone (ACTH) production and many others. Approximately 98% of patients with small cell lung cancer have a smoking history. Here, we report a case of small cell lung cancer in a 70-year-old male presenting to us with bilateral vocal cord palsy and superior vena cava syndrome. Bangladesh Journal of Medical Science Vol.19(4) 2020 p.769-771

Molecular docking based virtual screening of the breast cancer target NUDT5

Breast cancer affects one in eight women in Bangladesh and is the most common cancer among women in South Asia next to skin cancer. NUDT5 are nucleotide-metabolizing enzymes (NUDIX hydrolases) linked with the ADP ribose and 8-oxo-guanine metabolism. It is known to be associated with the hormone dependent gene regulation and proliferation in breast cancer cells. It blocks progestin-dependent, PAR-derived nuclear ATP synthesis and subsequent chromatin remodeling, gene regulation and proliferation in this context. We describe the structure based binding features of a lead compound (7-[[5-(3, 4-dichlorophenyl)-1,3,4-oxadiazol-2-yl]methyl]-1,3-dimethyl-8piperazin-1yl-purine-2,6-dione-C₂₀H₂₀C_l2N₈O₃) with NUDT5 for further in vitro and in vivo validation. It is a promising inhibitor for blocking NUDT5 activity. Thus, structure based virtual screening is used to identify a potential therapeutic inhibitor for NUDT5.

Metal-Adapted Bacteria Isolated From Wastewaters Produce Biofilms by Expressing Proteinaceous Curli Fimbriae and Cellulose Nanofibers

Bacterial biofilm plays a pivotal role in bioremediation of heavy metals from wastewaters. In this study, we isolated and identified different biofilm producing bacteria from wastewaters. We also characterized the biofilm matrix [i.e., extracellular polymeric substances (EPS)] produced by different bacteria. Out of 40 isolates from different wastewaters, only 11 (27.5%) isolates (static condition at 28°C) and 9 (22.5%) isolates (agitate and static conditions at 28 and 37°C) produced air–liquid (AL) and solid–air–liquid (SAL) biofilms, respectively, only on salt-optimized broth plus 2% glycerol (SOBG) but not in other media tested. Biomass biofilms and bacteria coupled with AL biofilms were significantly (P ≤ 0.001) varied in these isolates. Escherichia coli (isolate ENSD101 and ENST501), Enterobacter asburiae (ENSD102), Enterobacter ludwigii (ENSH201), Pseudomonas fluorescens (ENSH202 and ENSG304), uncultured Vitreoscilla sp. (ENSG301 and ENSG305), Acinetobacter lwoffii (ENSG302), Klebsiella pneumoniae (ENSG303), and Bacillus thuringiensis (ENSW401) were identified based on 16S rRNA gene sequencing. Scanning electron microscope (SEM) images revealed that biofilm matrix produced by E. asburiae ENSD102, uncultured Vitreoscilla sp. ENSG301, A. lwoffii ENSG302, and K. pneumoniae ENSG303 are highly fibrous, compact, and nicely interlinked as compared to the biofilm developed by E. ludwigii ENSH201 and B. thuringiensis ENSW401. X-ray diffraction (XRD) results indicated that biofilm matrix produced by E. asburiae ENSD102, uncultured Vitreoscilla sp. ENSG301, and A. lwoffii ENSG302 are non-crystalline amorphous nature. Fourier transform infrared (FTIR) spectroscopy showed that proteins and polysaccharides are the main components of the biofilms. Congo red binding results suggested that all these bacteria produced proteinaceous curli fimbriae and cellulose-rich polysaccharide. Production of cellulose was also confirmed by Calcofluor binding- and spectrophotometric assays. E. asburiae ENSD102, Vitreoscilla sp. ENSG301, and A. lwoffii ENSG302 were tested for their abilities to form the biofilms exposure to 0 to 2000 mg/L of copper sulfate (for Cu), zinc sulfate (for Zn), lead nitrate (for Pb), nickel chloride (for Ni), and potassium dichromate (for Cr), several concentrations of these metals activated the biofilm formation. The polysaccharides is known to sequester the heavy metals thus, these bacteria might be applied to remove the heavy metals from wastewater.

Psychiatric Disorders in Drop out from Educational Attainment Attending Mental Health Facilities: A Descriptive Cross Sectional Study

Studies of the impact of mental disorders on educational attainment are rare. Mental disorders, those beginning in childhood or adolescence may increase the risk of early drop out from education. The latter has been shown to have adverse life-course consequences on individuals such as greater demand on social welfare entitlements. A descriptive cross sectional study was carried out at the department of Psychiatry, Comilla Medical College, Comilla, Bangladesh. All cases were selected from patients attending at Comilla Medical College Hospital and Private Mental Health Facilities in Comilla City from March 2015 to February 2016. We found out the psychiatric disorders and socio-demographic status of patients with educational drop out over the early life course. A total of 50 dropout patients aged 10 to 30 years who fullfiled the enrolment criteria included in the study. Sociodemographic questionnaires, diagnostic information (DSM-5 and ICD-10) as well as an account of a various level of education were used as research instruments. The Frequency tables, summary tables and appropriate graphs were prepared to describe the population characteristics and study finding. The most of the psychiatric morbidity presents in male (62%) and age group of 18-24 years (54%). In this study, anxiety disorders was 8%, behaviour/ impulse control disorders was 8%, mood disorders was 16%, substance use disorders was 24%, schizophrenia spectrum disorders was 12% and composite psychiatric disorders was 32%. Among drop out patient's non- completion of primary education was 14%, non-completion of secondary education was 20%, non- completion of higher secondary education was 24%, not entry to tertiary education was 12% and non-completion of tertiary education was 30%. Among behaviour/impulse control disorders non-completion of primary education was 6%, substance use disorders non-completion of higher secondary education was 10%, mood disorder both non-completion of higher secondary education and non-completion of tertiary education were 6%. Among composite psychiatric disorders non-completion of secondary education, non-completion of higher secondary education and non-completion of tertiary education were 8%, 6% and 12% respectively. Onset of mental disorders and subsequent drop out from education was found in this study. Further multi-centered prospective and population-based studies should be designed to find out the exact situation.

A Case of Wilson’s Disease Presenting as Chronic Liver Disease

Wilson’s disease is one of the most common inherited liver diseases with a worldwide incidence of 10-30 million cases. The increased frequency in certain countries is due to high rates of consanguinity and the fulminant presentation of the disease is more common in females than in males. It is an autosomal-recessive disorder caused by mutation in the ATP7B gene, with resultant impairment of biliary excretion of copper. Subsequent copper accumulation, first in the liver but later on in the brain and other tissues, produces clinical manifestations that may include hepatic, neurological, psychiatric, ophthalmological and other derangements. Genetic testing is impractical because of the multitude of mutations that have been identified, so accurate diagnosis relies on judicious use of laboratory and other diagnostic tests. Lifelong palliative treatment with a different combination of medications, or with liver transplantation if needed, can successfully ameliorate or prevent the progressive deterioration of the disease, otherwise death would inevitably ensue. Since effective treatment is available for this disease, early and correct diagnosis is very important. Here, we report a case of Wilson’s disease in a 15-year-old girl presenting to us as chronic liver disease.Bangladesh Journal of Medical Science Vol.15(3) 2016 p.495-498

Niemann-Pick Disease Type B in a 21 Year Old Male

Niemann-pick disease is a group of autosomal recessive disorder of lipid storage with progressive accumulation of sphingomyelin and other lipids in the lysosomes of various tissues. We are reporting a 21 year old male who had hepatosplenomegaly, cherry red macula and normal cognitive function. Bone marrow biopsy showed plenty of foam cells and sphingomyelinase level was low, thus conforming our diagnosis. Survival into adulthood and absence of gross neurological involvement suggests Niemann-Pick disease type B.

Cogon grass (Imperata cylindrica), a potential biomass candidate for bioethanol: cell wall structural changes enhancing hydrolysis in a mild alkali pretreatment regime

BACKGROUND

Imperata cylindrica is being considered as a biomass candidate for bioethanol. This work aimed to evaluate a mild alkali pretreatment effect on the Imperata recalcitrant structure. Therefore, varied concentrations of NaOH (0, 7.5, 15, 20, and 25 g L(-1) ) were applied as treatments to Imperata at 105 °C for 10 min.

RESULTS

Scanning electron microscopy, atomic force microscopy, and Fourier transform infrared spectroscopy studies revealed that 20 to 25 g L(-1) NaOH-treated Imperata exposed amorphous cellulose on surface granules composed of lignin, waxes, and partly hemicelluloses were abolished due to the comprehensive disruption of the linkages between lignin and carbohydrates. The cellulose crystalline index was increased with 7.5 to 20 g L(-1) NaOH treatments and reduced with a 25 g L(-1) NaOH treatment. In fact, the cellulose content in solids increased with the increasing NaOH concentration and was estimated to be 720 and 740 g kg(-1) for the 20 and 25 g L(-1) NaOH treatments, respectively. The yield of the reducing sugar was obtained 805 and 813 mg g(-1) from 20 and 25 g L(-1) NaOH-treated Imperata, respectively.

CONCLUSION

Considering the cost of pretreatment, the 20 g L(-1) NaOH treatment is judged to be effective for disrupting Imperata recalcitrance in this pretreatment regime.

Status of Serum Zinc in Multidrug Resistant Tuberculosis

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

Biomass Fuel Smoke and Tuberculosis: A Case-Control Study

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

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

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

In situ degradation studies of two-dimensional WSe₂-graphene heterostructures

Heterostructures of two-dimensional materials can be vulnerable to thermal degradation due to structural and interfacial defects as well as thermal expansion mismatch, yet a systematic study does not exist in the literature. In this study, we investigate the degradation of freestanding WSe2-graphene heterostructures due to heat and charge flow by performing in situ experiments inside a transmission electron microscope. Experimental results show that purely thermal loading requires higher temperatures (>850 °C), about 150 °C higher than that under combined electrical and thermal loading. In both cases, selenium is the first element to decompose and migration of silicon atoms from the test structure to the freestanding specimen initiates rapid degradation through the formation of tungsten disilicide and silicon carbide. The role of the current flow is to enhance the migration of silicon from the sample holder and to knock-out the selenium atoms. The findings of this study provide fundamental insights into the degradation of WSe2-graphene heterostructures and inspire their application in electronics for use in harsh environments.

Pylorus Preserving Pancreaticoduodenectomy vs. Standard Whipple's Procedure in Case of Carcinoma head of the Pancreas and Periampullary Carcinoma

Pancreatic carcinoma is a life threatening condition. Surgical resection is the only hope of cure. Advances in surgical technique have reduced the mortality rate. Nevertheless, operative complications related with morbidity still remains high. Two operation techniques in the treatment of periampullary and pancreatic head cancer: the Standard Whipple operation (SW) and Pylorus Preserving Pancreaticoduodenectomy (PPPD) are performed predominantly. This study was performed to compare the results of Pylorus Preserving Pancreaticoduodenectomy (PPPD) with that of the Standard Whipple's (SW) procedure. This prospective study was carried out in the Department of General Surgery, BSMMU in two years duration. All admitted patient's with periampullary carcinoma and carcinoma of the head of the pancreas were included and randomized for a SW or a PPPD resection. Data regarding patients demographics, preoperative assessment, intraoperative and postoperative findings were collected and analyzed. Less blood loss (2.67±0.65 units in Group I and 2.88±0.64 units in Group II), fewer need of blood transfusions and shorter hospital stay in the PPPD group were observed. Gastrointestinal leakage was similar in both groups of patients (1:1). One pancreatic fistula (8.3% in Group I) was observed in PPPD group and one intra-abdominal abscess developed in Standard Whipple's procedure (00.0% in Group I and 12.5% in Group II). Bile leakage was higher in standard Whipple procedure (8.3% in Group I and 37.5% in Group II). Morbidity was more or less similar in both groups (58.0% in Group I and 50.0% in Group II) but one patient (12.5% in Group II) died in standard Whipple's resection. PPPD procedure is more effective treatment for periampullary carcinoma and cancer of the pancreatic head region than the standard Whipple's operation.

Association of hypoglycemia, hypocalcemia and hypomagnesemia in neonates with perinatal asphyxia

The clinical evidence of neurological menifestations associated with asphyxia is described as hypoxic ischaemic encephalopathy (HIE). A variety of metabolic problems are present in asphyxiated newborns including hypoglycemia, hypocalcemia, hypomagnesemia and others metabolic abnormalities. Some of these biochemical disturbances may trigger seizure or potentiate further brain damage. This cross sectional case-control study was done in Mymensingh Medical College Hospital, to identify the association of hypoglycemia, hypocalcemia, hypomagnesemia in neonates with perinatal asphyxia. Study period was six months. Sample size was 60. Among total sample 30 term asphyxiated newborns of <24 hours age were case and equal number term healthy newborns <24 hours age were control. The main clinical presentations were delayed cry after birth along with respiratory distress, convulsion and absence of cry in asphyxiated newborns. Major physical findings were cyanosis, convulsion and tachypnoea in asphyxiated group. The mean value of serum calcium level was significantly lower in asphyxiated newborns (7.37 ± 0.10mg/dl) than control value (8.04±0.09mg/dl). Hypocalcemia was found among 23.33% babies in case group. On the contrary, hypocalcemia was found in single baby among control group. The mean value of serum magnesium was significantly lower in asphyxiated newborns (1.83 ± 0.04mg/dl) than control value (1.96 ± 0.05mg/dl). Hypomagnesemia was found among 3(10%) newborns but none was found among control group. Hypoglycemia was found in 7(23.33%) cases though the mean value of blood glucose was higher in case group (5.72 ± 0.62mmol/l) than control group (4.87 ± 0.15mmol/l) difference was not statistically significant. Combined hypoglycemia, hypocalcemia and hypomagnesemia were found in 1(3.33%) case; combined hypoglycemia and hypocalcemia were found in 2(6.67%) cases; and combined hypocalcemia and hypomagnesemia were found in 1(3.33%) case. During the study period, 3(10.0%) cases were expired but no death occurred among control group. This study shows isolated or combined hypoglycemia, hypocalcemia, hypomagnesemia are frequently found in newborns with perinatal asphyxia. So, it is necessary to monitor blood glucose, serum calcium and also serum magnesium among asphyxiated newborns for proper management.

Morphometric study of dentate nucleus of cerebellum in Bangladeshi cadaver

This cross sectional descriptive study was done by using nonprobability sampling technique and performed by examining 63 (sixty three) cerebellum. Out of them 40 postmortem human cerebellum collected from Bangladeshi cadavers of both sexes (male 25 and female 15) age ranging from 5 to 60 years and 23 cerebellums from caesarian section of intrauterine death cases of both sexes (male 14 and female 9) age ranging from 34 to 41 weeks of gestation. Specimens were collected from dead bodies autopsied on different dates from April' 2009 to September' 2009 at the autopsy laboratory of department of Forensic Medicine and prenatal cases from Gynaecology and Obstetrics Department of Mymensingh Medical College, Mymensingh. The collected specimens were grouped into three age groups like Group A (28 to 42 weeks of gestation), Group B (5 to 30 years) and Group C (31 to 60 years) and, two sex groups (male and female) and two sides (right and left). A transverse section was made at the level of horizontal fissure, and length and breadth of dentate nucleus were measured by divider and scale. The mean (±SD) length and breadth of dentate nucleus was 8.619±2.995mm and 14.770±3.604mm respectively and it was observed that length and breadth of dentate nucleus increased with age upto certain level then slightly decreased in the late age Group C. In this study, differences of the mean length of dentate nucleus on both right and left sides were statistically moderately significant between age Groups A&B. The differences of mean breadth of dentate nucleus on both right and left side were statistically highly significant between age Groups A&B and moderately significant between age Groups A&C on right side and only significant on left side. The differences between male & female were statistically insignificant in length and breadth of dentate nucleus.

Case report on carotid body tumor

A 40 years old lady presented to us with the complaints of repeated attack of syncope with left sided neck swelling. Ultrasonography, Color Doppler study and arteriography were done which revealed a solid vascular mass in the carotid bifurcation. Mass was resected and histopathology was done. Histopathologic findings were typical of a carotid body tumour. As carotid body tumour is a rare disease. So, we are going to present this in this article.

Pattern of dyslipidaemia among the Bangladeshi type 2 diabetic patients presented with acute coronary syndrome

Increasing prevalence of diabetes and its complications in the developing communities would pose a threat in respect to their existing health care service. An increased incidence of atherosclerosis in insulin-dependent diabetic patients has long been recognized. Hyperlipidaemia, a common finding in these patients, may be one of the contributing factors. The objective of our study is to find out the patterns of dyslipidaemia among the Bangladeshi patients with type-2 diabetes mellitus presented with acute coronary syndrome. This study was conducted in the department of cardiology of BIRDEM and Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh during the period of January 2009 to December 2009. A total of 100 patients were included in this study, according to the inclusion and exclusion criteria. Diabetes Mellitus and Acute Coronary Syndrome was diagnosed according to the guideline of American Diabetic Association and American College of Cardiology respectively. Among the respondents Mean±SD of fasting blood sugar and 2 hours ABF were 9.23±3.6mmol/L and 12.61±8.52mmol/L respectively. Mean±SD of HbA1C of the respondents was 7.23±2.12. Total cholesterol level <150mg/dl, 150-200mg/dl and >200mg/dl were 27.0%, 42.0% and 31.0% respectively. HDL cholesterol <40mg/dl and >40mg/dl were 76.0% and 24.0% respectively. LDL cholesterol <150mg/dl and >150mg/dl were 43.0% and 57.0% respectively. TG within 40 to 160mg/dl and >160mg/dl were 73.0% and 27.0% respectively, Mean±SD of Total Cholesterol, HDL Cholesterol, LDL Cholesterol and Triglyceride were 162.43±38.62, 37.41±8.59, 137.43±22.73 and 156.43±41.92mg/dl respectively.

The site of attachment of umbilical cord and branching pattern of umbilical arteries within the placenta

Placenta is the mirror of maternal and fetal status; it reflects the changes due to complication in pregnancy of mother. Numerous common and uncommon findings of the placenta, umbilical cord and membranes are associated with abnormal fetal development and perinatal morbidity. So, the examination of the placenta can yield information that may be important in the immediate and later management of mother and newborn. This information may also be essential for protecting the attending physician in the event of an adverse maternal or fetal outcome. This cross sectional descriptive study was carried out to determine the incidence of different types of placenta depending on attachment site and branching pattern of arteries of umbilical cord in Bangladeshi Women. To achieve this aim sixty placenta with umbilical cord were collected. Placenta was from 28 weeks to 42 weeks gestational age of normal pregnancy during normal labour at gynaecology and obstetric department of Mymensingh Medical College Hospital. After preservation in 10% formol saline, study was done in the Department of Anatomy of Mymensingh Medical College. In the present study, incidence of different types of placenta depending on attachment site of umbilical cord was 50% Central, 46% Paracentral and 18% Marginal in type. In this study it was also observed that 58% placenta were Disperse in type and 42% were Magistral in type depending on the distribution of umbilical arteries. Observed findings of this study were compared with those of Western and Bangladeshi researchers.

Cloning and expression of ophB gene encoding organophosphorus hydrolase from endophytic Pseudomonas sp. BF1-3 degrades organophosphorus pesticide chlorpyrifos

Chlorpyrifos is an organophosphate pesticide that has adverse effect on animals and plants. We isolated endophytic bacterial strain, Pseudomonas sp. BF1-3, from balloon flower root which can hydrolyze chlorpyrifos. A gene (ophB) encoding a protein involved in chlorpyrifos degradation from this strain was cloned into Escherichia coli DH5α for confirming enzyme activity. After sequencing, total 1024bp nucleotide sequences were found in the open reading frame of ophB. The chlorpyrifos degradation patterns by E. coli DH5α (ophB) were observed. During incubation in minimal salt (M9) medium supplemented with chlorpyrifos (100mgL(-1)), the E. coli DH5α harboring ophB degraded about 97% initial chlorpyrifos (100mgL(-1)) and accumulated 86mgL(-1) 3,5,6-trichloro-2-pyridinol (TCP) within 9 days. In addition, optical density (OD) of E. coli DH5α (ophB) culture at 600nm was increased from 0.172 to 1.118 within 2 days of inoculation in the chlorpyrifos supplemented M9 medium. The estimated molecular weight of purified OphB protein was determined to be 31.4kDa by SDS-PAGE. The OphB enzyme was most active at pH 8 and an optimal temperature around 35°C. These results indicate that endophytic bacteria are supposed to be useful for biological control of environments contaminated with pesticides.

Intermittent prophylaxis of recurrent febrile seizures with clobazam versus diazepam

Febrile seizures are the most common type of seizure among children that can be prevented by using prophylactic drugs like Clobazam and Diazepam. The present prospective study was conducted in the Department of Pediatrics, Mymensingh Medical College Hospital and Community Based Medical College Hospital, Bangladesh over a period of 1 year from July 2012 to June 2013 to compare the effectiveness of intermittent Clobazam versus Diazepam therapy in preventing the recurrence of febrile seizures and assessed adverse effects of each drug. A total of 65 patients (32 children administered Clobazam and rest 33 children received Diazepam) of simple and complex febrile seizures aged 6 months to 5 years of both sexes were the study population. Data were collected by interview of the patients, clinical examination and laboratory investigations using the research instrument. Data were analyzed by using Chi-square (χ2) Test, Student's 't' Test and Fisher's Exact Test. For all analytical tests, the level of significance was set at 0.05 and p<0.05 was considered significant. The proportion of patients was higher between age 12-36 months and male was predominant in the both Clobazam and Diazepam groups. Over 31% of patients in Clobazam group who experienced episode of fever within 3 months, 40.6% within 6 months and 9.4% within 9 months compared to 36.4% in Diazepam group within 3 months, 45.5% within 6 months & 12.1% within 9 months after discharge from the hospital. Three (9.4%) patients in Clobazam group and 7(21.3%) in Diazepam group who experienced febrile convulsion during the follow up period. From the data adverse effects within 3 and 6 months experienced by the patient's drowsiness, sedation and ataxia were higher in Diazepam group than those in Clobazam group. However, within 9 months lethargy and irritability were somewhat higher in Clobazam group than those in Diazepam group. The mean duration of hospitalization was significantly higher in Diazepam group compared to Clobazam group (6.0±1.0 vs. 4.6±0.08 days, P<0.001). Seven (21.2%) out of 33 children with febrile seizures in Diazepam group had a history of recurrent seizures, whereas 3(9.4%) of 32 children in the Clobazam group. The risks of recurrent febrile seizure in the Diazepam group was 2.6 times greater compared to those in the Clobazam group (P=0.186). The result indicates that Clobazam is safe, efficacious, requires less frequent dosing and has less adverse effects such as drowsiness, sedation, ataxia and irritability as compared to Diazepam. So, Clobazam may be an alternative to Diazepam given intermittently for prevention of recurrent febrile seizures.

Comparison between azithromycin and cefixime in the treatment of typhoid fever in children

An intervention study was carried out in the department of paediatrics of Mymensingh Medical College Hospital, Mymensingh to compare the clinical efficacy of Azithromycin in the treatment of childhood typhoid fever with that of cefixime for a period of one year from January 2011 to December 2011. A total of 60 cases of typhoid fever were enrolled in to a randomized clinical trial and was divided into two groups. The inclusion criteria of the cases were: Documented fever for more than 4 days plus two or more of the following clinical features: toxic physical appearance, intestinal complaints, coated tongue, ceacal gurgling, hepatomegaly and splenomegaly, diarrhoea and constipation plus positive Widal test and/or blood culture positivity. Patients who had complication like GIT heamorrhage; intestinal perforaion and/or shock were excluded from the study. Data were collected in a structured questionnaire. Azithromycin was given at a dose of 10mg/kg/day for a period of 07 days Cefixime was given at a dose of 20mg/kg/day in two divided dose for 14 days. The mean time of defervesence was 4.05+1.14 days with azithromycin and 3.41+0.95 with cefixime respectively. The minimum defervesence time was 02 days and maximum defervesence time was 07 days. Clinical cure rate was 87% in azithromycin group and 93% in cefixime group. No serious adverse effect was noted related to azithromycin and cefixime therapy except nausea, vomiting, diarrhoea and jaundice. It was found that azithromycin is almost as effective as cefixime in the treatment of typhoid fever.

Vaginal rhinosporidiosis: a case report

The female genital tract is an extremely rare site for Rhinosporidiosis. Here we described a 13 year old girl who presented with a slow growing polypoid fleshy mass in the posterior vaginal wall near the orifice for 6 months with scanty bleeding from the mass. The girl was admitted to hospital with profuse watery vaginal discharge. Excision of the mass was followed by histopathological examination which confirmed the diagnosis Rhinosporidiosis.