Multi-omics data integration and drug screening of AML cancer using Generative Adversarial Network

In the era of precision medicine, accurate disease phenotype prediction for heterogeneous diseases, such as cancer, is emerging due to advanced technologies that link genotypes and phenotypes. However, it is difficult to integrate different types of biological data because they are so varied. In this study, we focused on predicting the traits of a blood cancer called Acute Myeloid Leukemia (AML) by combining different kinds of biological data. We used a recently developed method called Omics Generative Adversarial Network (GAN) to better classify cancer outcomes. The primary advantages of a GAN include its ability to create synthetic data that is nearly indistinguishable from real data, its high flexibility, and its wide range of applications, including multi-omics data analysis. In addition, the GAN was effective at combining two types of biological data. We created synthetic datasets for gene activity and DNA methylation. Our method was more accurate in predicting disease traits than using the original data alone. The experimental results provided evidence that the creation of synthetic data through interacting multi-omics data analysis using GANs improves the overall prediction quality. Furthermore, we identified the top-ranked significant genes through statistical methods and pinpointed potential candidate drug agents through in-silico studies. The proposed drugs, also supported by other independent studies, might play a crucial role in the treatment of AML cancer. The code is available on GitHub; https://github.com/SabrinAfroz/omicsGAN_codes?fbclid=IwAR1-/stuffmlE0hyWgSu2wlXo6dYlKUei3faLdlvpxTOOUPVlmYCloXf4Uk9ejK4I.

Evaluating arsenic contamination in northwestern Bangladesh: A GIS-Based assessment of groundwater vulnerability and human health impacts

One of the biggest environmental worries in the world today is the risk of arsenic (As) contamination in groundwater. The Atomic Absorption Spectrometer (AAS) was used in this work to assess the As content in groundwater samples from 38 shallow (27 m) tubewells in northwest Bangladesh to determine the existing situation, potential source(s), and likely health risk of As and other important water quality parameters. The range of arsenic concentrations (μgL-1) was troublesome and greater than the WHO recommended level for drinking water, ranging from 0.50 to 164 (mean ± SD: 20.22 ± 36.46). In groundwater, the concentrations of Fe, and Mn vary from 0.04 to 52.75 mgL-1 (mean ± SD: 4.23 ± 9.68), and 0.23 to 3.27 mgL-1 (mean ± SD: 1.10 ± 0.67). The obtained groundwater samples have pH values ranging from 5.9 to 7.1, which indicates a somewhat acidic to neutral character. Major cations have an average abundance that is as follows: Ca2+ > Mg2+ > Na+ > K+, while major anions have an average abundance that is as follows: HCO3- > Cl- > SO42- > NO3-; Ca2+ and HCO3- are the main cation and anion, respectively. The groundwater in the Rajarampur village was deemed unfit for drinking or irrigation based on analyses of water quality performed using the entropy water quality index. The Ca-HCO3 type of water, in which Ca2+ and HCO3- are the main positive ions and negative ions, is suggested by the Piper tri-linear diagram. It was discovered that silicate weathering regulates the hydro-geochemical activities in groundwater using a bi-variate examination of several hydro-chemical variables. Four major clusters were observed for the water sample. According to reductive dissolution processes and principal component analysis, the arsenic in groundwater is geogenic in origin. Arsenic is discharged from sediment to groundwater by reductive dissolution of FeOOH and MnOOH, as shown by the modest connection between As, Fe, and Mn. The United Nations Environmental Protection Agency's (USEPA) suggested value for probable cancer risk assessment was 10-6, however the probable cancer risk assessment found a higher value, indicating that the population in the study region was at high risk for cancer. Remedial measures for arsenic mitigation include removing arsenic from groundwater after it is extracted, searching for alternative aquifers, and implementing various water-supply technologies such as dugwells, deep tubewells, pond-sand filters, and rainwater harvesting systems.

Assessing the Influence of Banana Leaf Ash as Pozzolanic Material for the Production of Green Concrete: A Mechanical and Microstructural Evaluation

This paper reports an investigation of the mechanical and microscopic properties of partially replaced banana leaf ash (BLA) concrete. In this research, the cement was partially replaced by BLA in two phases: Phase A (0%, 5%, 10%, 15%, 20%, 25% and 30%) and Phase B (0%, 10%, 20% and 30%). The consequence of partially replacing cement with BLA in concrete was investigated by the application of a range of tests, namely X-ray fluorescence (XRF), compressive strength, splitting tensile strength, flexure strength, ultrasonic pulse velocity and scanning electron microscopy (SEM) analysis. The properties were then correlated with the properties of a standard 100% Portland cement concrete of similar strength. The XRF result of the BLA identified a composition with 48.93% SiO2 and 3.48% Al2O3, which indicates that the material potentially possesses pozzolanic properties. The mechanical properties of the partially replaced BLA concrete noted minor strength loss, approximately 5% with 20% partial replacement. The nondestructive testing data showed enhanced performance up to 20% partial replacement, with ultrasonic pulse values above 3500 m/s. The scanning electron microscopy analysis illustrated that the morphology of BLA specimens contained increased microcracks compared with the control. The decrease in strength observed is attributed to the fibrous composition of the BLA. The mechanical, nondestructive testing and microscopic results highlight the potential to utilize BLA as a partial replacement for cement as a pozzolanic material in concrete at up to 20% by weight of cement.

Unconventionally fast transport through sliding dynamics of rodlike particles in macromolecular networks

Transport of rodlike particles in confinement environments of macromolecular networks plays crucial roles in many important biological processes and technological applications. The relevant understanding has been limited to thin rods with diameter much smaller than network mesh size, although the opposite case, of which the dynamical behaviors and underlying physical mechanisms remain unclear, is ubiquitous. Here, we solve this issue by combining experiments, simulations and theory. We find a nonmonotonic dependence of translational diffusion on rod length, characterized by length commensuration-governed unconventionally fast dynamics which is in striking contrast to the monotonic dependence for thin rods. Our results clarify that such a fast diffusion of thick rods with length of integral multiple of mesh size follows sliding dynamics and demonstrate it to be anomalous yet Brownian. Moreover, good agreement between theoretical analysis and simulations corroborates that the sliding dynamics is an intermediate regime between hopping and Brownian dynamics, and provides a mechanistic interpretation based on the rod-length dependent entropic free energy barrier. The findings yield a principle, that is, length commensuration, for optimal design of rodlike particles with highly efficient transport in confined environments of macromolecular networks, and might enrich the physics of the diffusion dynamics in heterogeneous media.

Green Coffee Bean Extract Assisted Facile Synthesis of Reduced Graphene Oxide and Its Dye Removal Activity

To discharge the colored effluents from industries there needs to be effective and affordable treatment options. Adsorption using reduced graphene oxide (rGO) as an adsorbent is a prominent one. In this study, green coffee bean extract (GCBE) is utilized as a safe reducing agent for the reduction of graphene oxide (GO) to synthesize rGO. The formation of rGO is confirmed by a new peak in the UV-vis spectra at 275 nm and a diffraction peak in the XRD patterns at 22°. The effective formation of rGO is further substantiated by a change in the GO peak's properties in the FTIR, EDX, and Raman spectra and a weight loss change in TGA. The SEM and TEM analyses demonstrate the effective production of the nano-sheets of rGO having exfoliated and segregated in a few layers. Furthermore, the obtained rGO exhibited outstanding efficacy in wastewater cleanup, effectively adsorbing MB as a prototype organic dye. The kinetics and isotherm study suggested that the adsorption leads by the chemisorption and monolayer formation on the homogeneous surface of rGO. The maximum adsorption capacity is found to be 89.3 mg g-1. This process offers a fresh opportunity for the economical and safe production of rGO for wastewater treatment.

Clinical trials show similar safety outcomes including febrile convulsion rates for GSK's and Merck's measles-mumps-rubella (MMR) vaccines

Combined measles-mumps-rubella (MMR) vaccines produced by GSK (GSK-MMR) and Merck (Merck-MMR) have demonstrated effectiveness and an acceptable safety profile, as documented over decades of post-licensure use in various regions worldwide. In the United States, 2 doses of the MMR vaccine are recommended at the ages of 12-15 months and 4-6 years. All-cause febrile convulsions have the highest incidence at 12-18 months of age, when the first MMR vaccine dose is administered. Because febrile convulsions can also occur rarely after MMR vaccine administration, we reviewed safety data of the GSK-MMR compared to the Merck-MMR vaccine from 4 clinical trials that evaluated a first dose in 12-15-month-olds and 2 clinical trials that evaluated a second dose in ≥4-year-olds. Overall frequencies of febrile convulsions were ≤0.4% across studies and vaccine groups. The frequency of febrile convulsions occurring 7-10 days post-vaccination with the GSK-MMR vaccine (5.7/10,000) was generally consistent with previously published data. The other safety outcomes were similar between the GSK-MMR and Merck-MMR vaccines in both age groups. Hence, as recommended by the Advisory Committee on Immunization Practices, the GSK-MMR vaccine can also be used for routine immunization of children according to the current immunization schedule in the United States to prevent MMR.

Short Term Outcome of Laparoscopic Anterior Resection for Rectal Carcinoma

Colorectal cancer is the second most common malignancy in the western countries and the rectum is the most frequent site involved. Carcinoma in the rectosigmoid junction, upper and middle 3rd of the rectum is now successfully managed by laparoscopic AR and postoperative morbidities are less and recovery is uneventful. The advantages of laparoscopic surgery are smaller incisions, shorter recovery time and less wound related complications. However the narrow confines and angulations of the bony pelvis and the standard practice of autonomic nerve sparing total mesorectum excision has made laparoscopic surgery in the setting of rectal cancer more challenging. This study was carried out in the Colorectal surgery Department, Bangabandhu Sheikh Mujib Medical University, Dhaka from April 2018 to March 2019. Forty (40) cases were selected according to inclusion criteria. Twenty (20) patients treated by conventional open AR were known as control group and rest 20 patients treated by laparoscopic AR were known as Experimental group. Patient's particulars, pre operative diagnosis, operative findings were recorded in a pre designed data sheet and postoperative follow up and early outcomes of the patients of both groups were recorded by the same manner to find out general and local complications till discharge. Postoperatively all the patients were referred to oncology department and advised to come for follow up after 2 weeks (1st follow up). Mean age of experimental group was 43.40 and standard deviation was 13.59. In both age groups, age was not a contraindication. In the both groups number of male is slightly higher than female. Laparoscopic anterior resection can be performed safely and effectively. During post-operative follow up no significant morbidities and complications were observed in post-operative period in both groups of population. Degree of pain along with use of analgesia is also less after laparoscopic AR. Ambulation, stoma function, feeding liquid and feeding solid all occurred earlier for experimental group. Mean length of hospital stay for experimental group was found to be shorter than that of control group. Early hospital discharge was possible after laparoscopic AR. Oncological parameters were equivalent to those of open procedures. Laparoscopic AR is acceptable for rectal carcinoma.

Postoperative Outcome of Fistulotomy with Marsupialization in the Surgical Management of Simple Anal Fistula Comparison between Fistulotomy-layopen Procedures

Assess the wound healing time and early post-operative outcome of fistulotomy with marsupialization, as a surgical treatment of simple fistula-in-ano. This interventional study was performed at the Department of Colorectal Surgery, Bangabandhu Sheikh Mujib Medical University, Bangladesh from July 2017 to June 2018. Total 30 cases of simple anal fistula were selected according to inclusion criteria. Patients were non-randomly divided in two groups. Fifteen (15) cases were undergone a fistulotomy-lay open (control group) and another 15 cases undergone a fistulotomy with marsupialization (experimental group). The result was tested by t-test, chi-square test. Statistical significance was set at p<0.05. The mean age of the study population was 42.07±13.69 years in fistulotomy-lay open group and 46.00±12.99 years in fistulotomy with marsupialization group. In both group, number of male was higher. Perianal discharge and induration or swelling at perianal skin was most common findings. Mean healing time was earlier in fistulotomy with marsupialization group (16.60±11.15 days) than lay open group (27.07±14.28 days) due to marsupialization technique, the matter of fact that the deep, unepithelized wound has become smaller. No significant difference of postoperative pain, bleeding, wound infection and fecal incontinence in both group. The study shows marsupialization of the wound after fistulotomy for simple fistula in ano results in significantly faster healing in comparison with lay open-fistulotomy, less bleeding without increasing postoperative pain and the infections.

Green Synthesized Silver Nanoparticles: A Potential Antibacterial Agent, Antioxidant, and Colorimetric Nanoprobe for the Detection of Hg2+ Ions

Silver nanoparticles (AgNPs) prepared by green synthesis have a lot of potentials in various fields. Among them, as an antioxidant, antibacterial agent, and nanoprobe for the colorimetric detection of mercury (Hg2+) ions is thought to be the most important. The antibacterial, antioxidant, and colorimetric sensing potential of the greenly produced AgNPs utilizing Piper chaba stem extract are all predicted in this investigation. By using the disc diffusion method, the antibacterial activity of greenly produced AgNPs are assessed, and the findings are measured from the zone of inhibition (ZOI). It is revealed that the Staphylococcus aureus, Micrococcus spp., Escherichia coli, and Pseudomonas aeruginosa bacterial strains are significantly resisted by the greenly produced AgNPs. The antioxidant activity test of AgNPs reveals a considerable impact on free radical scavenging having the inhibitory concentration (IC 50) is 1.13 mL (equivalent to 0.45 mg mL-1). Also, with a low limit of detection of 28 ppm, the resulting AgNPs are used as highly selective and economical colorimetric sensors for Hg2+ detection. The study's findings support the hypothesis that Piper chaba stems can serve as a source for the production of AgNPs with high antibacterial and antioxidant activity and usefulness for simple colorimetric readings of Hg2+.

Study on Myocardial Infarction in Young Adults: Risk Factor Analysis

Coronary heart disease (CHD) imposes a significant burden on health care systems because of high morbidity and mortality. There is documented evidence that South Asian people develop CHD at a higher rate and at an early age. If the affected individual is 40 years old or below, the tragic consequences are catastrophic. Identifying risk factors could be important for health promotion. The objectives of this study were to determine the frequency of risk factors in young patients with acute myocardial infarction and thus with ischemic heart disease (IHD) aged 40 years and below in our population. It was a descriptive observational study which was carried out at Coronary Care Unit of Rajshahi Medical college Hospital, Rajshahi, Bangladesh in 61 patients from January 2011 to June 2011. All patients who fulfilled the inclusion criteria admitted to coronary care unit (CCU) with a diagnosis of Acute MI were included. Their detailed history was then taken including symptoms at presentation and their risk factors were assessed according to the Framingham Risk Scoring System with the help of history and laboratory investigations. Mean age ±SD of the patients was 36±3.7 year. Most of the patients were male. Smoking was the major risk factor (73.8%) followed by family history of IHD (44.3%). Other risk factors were dyslipidaemia (39.35%), hypertension (37.7%), obesity (11.5%) and diabetes mellitus (8.2%). Majority of the patients were adopted in sedentary lifestyle. 91.8% patient presented with chest pain. Other symptoms were dyspnoea (37.7%), palpitation (59.0%), sweating (77.0%), nausea, vomiting (50.8%) and impaired consciousness (19.7%) etc. Most frequent risk factor for acute myocardial infarction (MI) at young age is smoking followed by family history of MI and dyslipidaemia. Majority of the patients had two or more than two identifiable antecedent risk factors.

Current Status and De Novo Synthesis of Anti-Tumor Alkaloids in Nicotiana

Alkaloids are the most diversified nitrogen-containing secondary metabolites, having antioxidant and antimicrobial properties, and are extensively used in pharmaceuticals to treat different types of cancer. Nicotiana serves as a reservoir of anti-cancer alkaloids and is also used as a model plant for the de novo synthesis of various anti-cancer molecules through genetic engineering. Up to 4% of the total dry weight of Nicotiana was found to be composed of alkaloids, where nicotine, nornicotine, anatabine, and anabasine are reported as the dominant alkaloids. Additionally, among the alkaloids present in Nicotiana, β-carboline (Harmane and Norharmane) and Kynurenines are found to show anti-tumor effects, especially in the cases of colon and breast cancers. Creating new or shunting of existing biosynthesis pathways in different species of Nicotiana resulted in de novo or increased synthesis of different anti-tumor molecules or their derivatives or precursors including Taxadiane (~22.5 µg/g), Artemisinin (~120 μg/g), Parthenolide (~2.05 ng/g), Costunolide (~60 ng/g), Etoposide (~1 mg/g), Crocin (~400 µg/g), Catharanthine (~60 ng/g), Tabersonine (~10 ng/g), Strictosidine (~0.23 mg/g), etc. Enriching the precursor pool, especially Dimethylallyl Diphosphate (DMAPP), down-regulating other bi-product pathways, compartmentalization or metabolic shunting, or organelle-specific reconstitution of the precursor pool, might trigger the enhanced accumulation of the targeted anti-cancer alkaloid in Nicotiana.

Clinical Profile of Parkinson's Disease Patients in a Tertiary Hospital

Parkinson's disease (PD) is the second most common neurodegenerative disorder after Alzheimer disease. The pathogenesis of PD is yet unknown. Aim of this study was to analyze the clinical profile of patient with early Parkinson disease. A total of seventy-six early Parkinson's disease patients were enrolled in this cross-sectional observational study which was carried out in the Department of Neurology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from September 2014 to March 2016. Analysis of the history and clinical findings were done among these patients. This study was performed with 76 early Parkinson disease patients. Among them, male and female were 69.7% and 30.3% respectively. The mean±SD age of patients was 53.25±11.53 years with an age range of 24 to 77 years. The patients were found in primary level accounted for 42.1% which was followed by secondary 19.7% and illiterate or non-formal education 17.1%. Only 5.3% study population was found in post-graduate. Occupant as 28.9% were service holder, 26.3% as a housewife, 1.3% as business and 43.5% other occupations. Regarding smoking, 28.9% was a current smoker, 59.2% non-smoker and 11.8% ex-smoker. Of them, 11.8% had a family history of Parkinson's disease. Of the total population, 30.3% had dyslipidemia, 21.1% had hypertension, and 7.9% had diabetes mellitus. Males are predominant in affecting this disease. Middle aged people are vulnerable to it. Parkinson's disease is common in nonsmoker and dyslipidaemia. Few patient had family history of Parkinson's disease.

Non-motor symptoms of Parkinson`s Disease patients attending at a tertiary care hospital of Bangladesh

Non-motor symptoms (NMS) are common in Parkinson’s disease (PD), affecting almost all patients during their illness. They may appear in early pre-symptomatic stage as well as throughout the disease course. This observational cross sectional study was carried out in the Movement Disorder Clinic, Department of Neurology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka to see the presence of non-motor symptoms in Parkinson’s disease. Seventy-six Parkinson’s Disease patients were recruited during October 2019 to September 2020. Presence of non–motor symptoms (NMSs) was sought by the 30-item Parkinson’s Disease Questionnaire (PDQ-30). All patients (100%) of this study were suffering from one or more non-motor symptoms. Most common non-motor symptoms of Parkinson’s disease were anxiety (78%), fatigue (78%), difficulty in falling or staying sleep (75%), depression (72%), forgetfulness 72%, dizziness (68%), loss of interest in doing activities (66%), flat mood (62%), lack of pleasure (60%), restless leg (59%) & problem in sustaining concentration (50%). Other non-motor symptoms were present in less than 50% patients. Non-motor symptoms are common and often unrecognized in Parkinson`s Disease. Address- ing this issue will help to manage these symptoms and thereby improve quality of life of patients with Parkinson`s Disease. BSMMU J 2021; 14(4): 121-124

Outcome of middle cerebral artery territory stroke without recanalization therapy in a tertiary care hospital of Bangladesh

Among all the large vessel territory stroke, middle cerebral artery (MCA) territory stroke is the most common . Outcome depends on awareness and availability of specific treatment and proper conservative management after stroke. This prospective cohort study enrolled 49 clinically and radiologically diagnosed MCA territory stroke patients admitted in Neurology Department of Bangabandhu Sheikh Mujib Medical University (BSMMU) from January 2018 to December 2020. The aim was to see the prognosis of the middle cerebral artery territory (MCA) stroke patient who were treated conservatively. The Modified Rankin Scale (mRS) was used to measure the prognosis just after admission, after three months, six months, one year and two years; and the mean scores were 3.88 ± 0.88, 3.33 ± 1.24, 2.98 ± 1.42, 2.67 ± 1.60 & 2.23 ± 1.56 respectively. Among 49 patients, 9 patients died over the study period; one patient within one month after stroke, 3 patients within 3 months and 5 patients within six months. Though death rate was high in first three months, the survived patients improved significantly with conservative management in next two years of follow-up period. BSMMU J 2021; 14(3): 74-78

Randomised controlled trial showed long-term efficacy, immunogenicity and safety of varicella vaccines in Norwegian and Swedish children

AIM

Several countries, such as Norway and Sweden, have not implemented universal varicella vaccination. We present data for Norway and Sweden that were generated by a paediatric multi-country Phase III study over a 10-year period. This assessed the efficacy, antibody persistence and safety of two varicella vaccines containing the same Oka strain.

METHODS

This was an observer-blind, controlled trial conducted in 10 European countries. Children aged 12-22 months (n = 5803) were randomised 3:3:1 and vaccinated between 1 September 2005 and 10 May 2006. The two-dose group received two tetravalent measles-mumps-rubella-varicella vaccine doses. The one-dose group received one monovalent varicella vaccine dose after a measles-mumps-rubella vaccine dose. Control group participants received two measles-mumps-rubella vaccine doses. Main study outcomes were vaccine efficacy against confirmed varicella cases and incidence of adverse events.

RESULTS

Vaccine efficacy in the two-dose group was ≥92.1% in both Norwegian and Swedish children compared to 72.3% in Norway and 58.0% in Sweden in the one-dose group. Incidences of adverse events and serious adverse events were similar in the Norwegian and Swedish study populations.

CONCLUSION

Consistent with overall study results, high efficacy against varicella and acceptable safety profiles of the two varicella vaccines were observed in Norwegian and Swedish populations. These findings highlight the benefits of varicella vaccines, particularly when administered as a two-dose schedule.

TB prevalence among patients with diabetes in Bangladesh

OBJECTIVE: 1) To assess the prevalence of TB among patients with diabetes mellitus (DM) attending diabetic care centres in Bangladesh, and 2) to compare TB- and DM-related sociodemographic and other factors in diabetic patients who had TB and those who did not.METHODS: This cross-sectional study was conducted from 1 June 2019 to 31 March 2020 in 108 centres of the Diabetic Association of Bangladesh (BADAS), with a sample size of 3,649 patients with DM. Data were collected by face-to-face interview using semi-structured questionnaire from each patient/guardian. Other ethical issues were also maintained.RESULTS: Out of 3,649 patients with DM, 676 presumptive TB cases were identified and tested; from them, 85 patients were detected as TB cases. Another 39 patients were already diagnosed and on anti-TB medication. Prevalence of TB among patients with DM attending diabetic care centres was 3.4%. Prevalence was higher in female than male (4.0% vs 2.6%). Underweight (9.0%) patients and patients having diabetes for more than 10 years (7.1%) had a higher prevalence of TB.CONCLUSION: TB prevalence was over 3% among study population with DM. Periodic screening and active case finding among DM patients should be strengthened to reduce the risk of TB infection among DM patients.

Bioinspired in situ repeatable self-recovery of superhydrophobicity by self-reconstructing the hierarchical surface structure

Inspired by the biological self-recovery mechanism of superhydrophobicity, a new class of waxgel material with sustainable hierarchical surface micro-structures has been reported. After being damaged or removed, the waxgel material can self-reconstruct its surface layer both chemically and structurally, as well as successfully recovers its superhydrophobicity. In addition, it shows non-fluorinated composition, durability to severe mechanical challenges, and self-recoverable surface structures without external input of any kind such as; heat, UV, plasma etc., which distinguishes waxgel from any previous self-healing superhydrophobic systems. This strategy will open a new path for improving the long-term functionality of different interfacial materials.

A randomized trial assessing the efficacy, immunogenicity, and safety of vaccination with live attenuated varicella zoster virus-containing vaccines: ten-year follow-up in Russian children

In Russia, a universal varicella vaccination (UVV) program has not been implemented, and varicella vaccination coverage is low. We assessed the efficacy, antibody persistence, and safety of one- and two-dose varicella vaccination schedules in Russian children with a ten-year follow-up period, as part of an international phase IIIB, observer-blind, randomized, controlled trial (NCT00226499). Children aged 12-22 months were randomized (3:3:1) to receive two doses of tetravalent measles-mumps-rubella-varicella vaccine (V2 group), one dose trivalent measles-mumps-rubella (MMR) vaccine and one dose of varicella vaccine (V1 group), or two doses of MMR vaccine (V0 [control] group), 42 days apart. Main study outcomes were: vaccine efficacy (VE) against confirmed varicella cases, anti-varicella zoster virus (VZV) seropositivity rates and geometric mean concentrations, and reporting of (serious) adverse events ([S]AEs). The total vaccinated cohort in Russia comprised 1000 children; 900 were followed up until study end (year [Y] 10). VE estimates against confirmed varicella (Y10) were 92.4% in the V2 group and 74.7% in the V1 group. Anti-VZV seropositivity rates remained ≥99.4% in the V2 group and ≥89.7% in the V1 group from day 42 post-vaccination 2 until Y10. Occurrence of (un)solicited AEs and SAEs was similar across groups and confirmed the safety profile of the vaccines. No vaccination-related SAEs or deaths were reported. These results are consistent with the global trial results, i.e., the highest VE estimates observed following the two-dose schedule compared to the one-dose schedule. These data may inform decision-making related to potential implementation of a UVV program.

Ten-year follow-up on efficacy, immunogenicity and safety of two doses of a combined measles-mumps-rubella-varicella vaccine or one dose of monovalent varicella vaccine: Results from five East European countries

BACKGROUND

We assessed the 10-year efficacy, immunogenicity and safety of two doses of a combined measles-mumps-rubella-varicella vaccine (MMRV) or one dose of a monovalent varicella vaccine (V) in children from Czech Republic, Lithuania, Poland, Romania and Slovakia.

METHODS

This was a phase IIIB follow-up of an observer-blind, randomized, controlled trial (NCT00226499). In phase A, healthy children aged 12-22 months from 10 European countries were randomized in a 3:3:1 ratio to receive two doses of MMRV (MMRV group), one dose of MMR followed by one dose of V (MMR + V group), or two doses of MMR (MMR; control group), 42 days apart. Vaccine efficacy (VE) against varicella (confirmed by viral DNA detection or epidemiological link and clinical assessment) was calculated with 95% confidence intervals using Cox proportional hazards regression model. Immunogenicity was assessed as seropositivity rates and geometric mean concentrations (GMCs). Solicited and unsolicited adverse events (AEs) and serious AEs (SAEs) were recorded.

RESULTS

A total of 3705 children were vaccinated (1590, MMRV group; 1586, MMR + V group; 529, MMR group). There were 663 confirmed varicella cases (47, MMRV group; 349, MMR + V group; 267, MMR group). VE ranged between 95.4% (Lithuania) and 97.4% (Slovakia) in the MMRV group and between 59.3% (Lithuania) and 74% (Slovakia) in the MMR + V group. At year 10, seropositivity rates were 99.5%-100% in the MMRV group, 98%-100% in the MMR + V group and 50%-100% in the MMR control group, and the anti-VZV antibody GMCs were comparable between MMRV and MMR + V groups. The occurrence of solicited and unsolicited AEs was similar across groups and no SAE was considered as vaccination-related. No new safety concerns were identified.

CONCLUSIONS

Our results indicated that two doses of varicella zoster virus-containing vaccine provided better protection than one dose against varicella and induced antibody responses that persisted 10 years post-vaccination.

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.

Correlation of protection against varicella in a randomized Phase III varicella-containing vaccine efficacy trial in healthy infants

BACKGROUND

Varicella vaccination confers high and long-lasting protection against chickenpox and induces robust immune responses, but an absolute correlate of protection (CoP) against varicella has not been established. This study models the relationship between varicella humoral response and protection against varicella.

METHODS

This was a post-hoc analysis of data from a Phase IIIb, multicenter, randomized trial (NCT00226499) conducted in ten varicella-endemic European countries. Healthy children aged 12-22 months were randomized 3:3:1 to receive one dose of measles-mumps-rubella and one dose of varicella vaccine (one-dose group) or two doses of measles-mumps-rubella-varicella vaccine (two-dose group) or two doses of measles-mumps-rubella vaccine (control group) six weeks apart. The study remained observer-blind until completion, except in countries with obligatory additional immunizations. The objective was to correlate varicella-specific antibody concentrations with protection against varicella and probability of varicella breakthrough, using Cox proportional hazards and Dunning and accelerated failure time statistical models. The analysis was guided by the Prentice framework to explore a CoP against varicella.

RESULTS

The trial included 5803 participants, 5289 in the efficacy (2266: one-dose group, 2279: two-dose group and 744: control group) and 5235 (2248, 2245 and 742 in the same groups) in the immunogenicity cohort. The trial ended in 2016 with a median follow-up time of 9.8 years. Six weeks after vaccination with one- or two-dose varicella-containing vaccine, more than 93.0% of vaccinees were seropositive for varicella-specific antibodies. Estimated vaccine efficacy correlated positively with antibody concentrations. The fourth Prentice CoP criterion was not met, due to predicted positive vaccine efficacy in seronegative participants. Further modelling showed decreased probability of moderate to severe varicella breakthrough with increasing varicella-specific antibody concentrations (ten-year probability <0.1 for antibody concentrations ≥2-fold above the seropositivity cut-off).

CONCLUSIONS

Varicella-specific antibody concentrations are a good predictor of protection, given their inverse correlation with varicella occurrence.

CLINICAL TRIAL

NCT00226499.

Solitary wave solutions to some nonlinear fractional evolution equations in mathematical physics

The objective of this article is to construct new and further general analytical wave solutions to some nonlinear evolution equations of fractional order in the sense of the modified Riemann-Liouville derivative relating to mathematical physics, namely, the space-time fractional Fokas equation, the time fractional nonlinear model equation and the space-time fractional (2 + 1)-dimensional breaking soliton equation by exerting a rather new mechanism (G'/G,1/G) -expansion method. We use the fractional complex transformation and associate the fractional differential equations to the solvable integer order differential equations. A comprehensive class of new and broad-ranging exact traveling and solitary wave solutions are revealed in terms of trigonometric, rational and hyperbolic functions. The attained wave solutions are sketched graphically by using Mathematica and make a comparison to the results attained by the presented technique with other techniques in a comprehensive manner. It is notable that the method can be considered as a reduction of the reputed (G'/G) -expansion method commenced by Wang et al. It is noticeable that, the two variable (G'/G,1/G) -expansion method appears to be more reliable, straightforward, computerized and user-friendly.

Comparison of pre and post-operative ODS (Obstructed Defecation Syndrome) score in patient with ODS undergoing Stapled Transanal Rectal Resection (STARR)

Background: There are a variety of surgical approaches for correction of ODS, most of these have high recurrence and complication rates. Stapled transanal rectal resection (STARR) was introduced in 2003 by Antonio Longo as a minimally invasive transanal operation for ODS associated with rectocele and or rectal intussusception. Objective: This study was designed to assess the efficacy of Stapled Transanal Rectal Resection (STARR) as a surgical treatment of Obstructed Defecation Syndrome(ODS). Methodology: This is a quasi experimental study that was carried out at Colorectal surgery unit of surgery department in Bangabandhu Sheikh Mujib Medical University. The sample size was 17. The admitted patient of Obstructed Defecation Syndrome with Rectocele and or Rectal intussusception was selected according to inclusion and exclusion criteria. The patient was evaluated by history, clinical examination, proctoscopy, colonoscopy and defecography. Preoperative Longo’s ODS score was determined for each patient and it was compared with postoperative ODS score. Regular follow up was done for each patient at one, three and six months after each operation. Results: Significant improvement of ODS score was observed in 82.35% patients. Only 02 (11.8%) patients didn’t respond to STARR procedure and their postoperative score was 13-15 may be due to coexistence of pelvic floor dysynergy. Postoperative defecatory urgency developed only in 02(11.76%) patients. No patient developed significant postoperative complication like hemorrhage or rectovaginal fistula. Conclusion: STARR is a simple, less invasive and effective procedure for the treatment of ODS due to rectocele and/or rectal intussusception without major morbidity but pelvic floor dyssynergy should be excluded preoperatively because it’s presence makes the surgical intervention fruitless. Journal of Surgical Sciences (2019) Vol. 23(2): 67-70

CRC Screening: Current Trend and Feasibility

Colorectal cancer, a rising health concern of both east and west , can be prevented and it’s mortality can be reduced by screening all men and women of average risk  at the age of 50 years or older and  at an earlier age for  high risk group of colorectal cancer. Several tests are available for colon cancer screening, including fecal occult blood test (FOBT), flexible sigmoidoscopy, double-contrast barium enema, and colonoscopy. Direct and indirect evidence indicates that all the tests are effective, but they differ in their sensitivity, specificity, cost, and safety. The available evidence does not currently support choosing one test over another. In addition, other new colorectal cancer tests, such as virtual colonoscopy or stool-based molecular testing, have the potential to become important screening tests in the future. Journal of Surgical Sciences (2015) Vol. 19 (2) : 61-66

Cavernous Hemangioma of Sigmoid Colon and Ano-Rectum: A Rare Cause of Haematochezia

Cavernous hemangioma of colon and rectum is a rare disease, with no more than 200 cases reported in the literature so far. The rectosigmoid is the most common site of this disease in the gastrointestinal tract. We report a case of a 32-year-old male with recurrent episodes of per-rectal bleeding, who was finally diagnosed of cavernous hemangioma of sigmoid colon and ano-rectum. The lesion, 23 cm in length, occupied the whole circumference of the sigmoid colon and rectum extending up to the margin of the anal sphincter. Ultra-low anterior resection with hand-sewn colo-anal anastomosis and temporary loop ileostomy was carried out. The patient is in regular follow up. He is now symptom free. Journal of Surgical Sciences (2014) Vol. 18 (2) : 83-86

Outcome of Laparoscopic Versus Open Abdominal Rectopexy for the Treatment of Complete Rectal Prolapse-Our experience in Bangabandhu Sheikh Mujib Medical University

Background: Complete rectal prolapse is a very distressing condition. In adults, the only potentially curative treatment for complete rectal prolapse is surgery either by transabdominal or perinea! approaches. Till date abdominal rectopexy is considered as the standard surgical treatment for complete rectal prolapse, which can be done laparoscopically or by open procedure. Objective: The purpose of the study was to observe the outcome of Laparoscopic rectopexy in the treatment of complete rectal prolapse by subjective assessment and to compare the result with that of conventional open abdominal rectopexy. Methodology: This randomized clinical trial was carried out in the Department of Surgery at Bangabandhu Sheikh Mujib Medical University, Dhaka, from July 2012 to June 2014 for a period of twenty four (24) months. Patients who presented with complete rectal prolapse with age ranging from 25 to 70 years irrespective of gender were selected as study population. Patients were randomized by lottery method into two groups as group I who underwent laparoscopic rectopexy (LR) and group II who underwent open rectopexy (OR). Result: A total number of 50 patients were recruited in this study of which 25 patients were. in group I and 25 patients were in group II. The mean (s.d.) age was 49.40 (13.22) years and 46.48(13.27) years in group I and group II respectively (p>0.05). The mean (s.d.) operative time was 115(19) minutes in group I and 75(12) minutes in group II (p<0.05). In this study 1(4.0%) patient and 6 (24.0%) patients had abdominal wound infection in group I and in group II respectively (p>0.05). Mean (s.d.) ambulation time was 1.96 (0.67) days in group I and 3.92(1.15) days in groups II (p<0.05). Postoperative hospital stay mean (s.d.) was 3.08(1.18) days in group I and 8.16(3.57) days in group II (p<0.05). Overall patients satisfaction were 92% and 76% in group I and group II respectively (p>0.05). Conclusion: Laparoscopic rectopexy is a better option than conventional open abdominal rectopexy for the treatment of complete rectal prolapse. Journal of Surgical Sciences (2015) Vol. 19 (1) : 3-7

Delorme's Procedure for Full-Thickness Rectal Prolapse - Our experience in Bangabandhu Sheikh Mujib Medical University

Background: The study was undertaken to validate the efficacy of Delorme's procedure as the treatment modality of choice for full-thickness rectal prolapse. Materials and Methods: In this study, results of Delorme's procedure for full-thickness rectal prolapse were assessed retrospectively. 14 patients with full-thickness rectal prolapse who were operated on with Delorme's procedure between January 2010 and October 2013 in the department of Colorectal surgery, Bangabandhu Sheikh Mujib Medical University were included in the study. Results: There were 8 males with mean age of 32.62 years (range 15-70) and 6 females with mean age of 26 years (range 12-70 ).The mean operative time was 65±4.5 minutes (range 60-90); there was no mortality and blood loss was minimal. Mean hospital stay was 3.5 days (2-6 days). Outcomes of the procedure were satisfactory and no patient reported recurrence of the disease in the follow up period.Delorme's procedure, especially in younger patients, is a relatively safe and effective treatment and should not be restricted to older frail patients. This procedure may not be suitable for recurrent cases Delorme's procedure, especially in younger patients, is a relatively safe and effective treatment and should not be restricted to older frail patients. This procedure may not be suitable for recurrent cases. Conclusion: Delorme's operation is a safe and effective treatment for complete rectal prolapse in patients of all age groups. Journal of Surgical Sciences (2015) Vol. 19 (1) : 21-24

Immunogenicity of the pneumococcal non-typeable Haemophilus influenzae protein D conjugate vaccine (PHiD-CV) administered concomitantly with the meningococcal serogroup B (4CMenB) vaccine in infants: A post-hoc analysis in a phase 3b, randomised, controlled trial

BACKGROUND

No data are currently available on immunogenicity of higher-valent pneumococcal conjugate vaccines when co-administered with a 4-component meningococcal serogroup B vaccine (4CMenB).

METHODS

Post-hoc analysis of pneumococcal non-typeable Haemophilus influenzae protein D conjugate vaccine (PHiD-CV) immunogenicity when co-administered with 4CMenB (2 + 1 schedule) and/or a CRM-conjugated meningococcal serogroup C vaccine (MenC-CRM) in a trial assessing 4CMenB reduced schedules and co-administration with MenC-CRM (NCT01339923). Infants were randomized to receive 4CMenB and MenC-CRM (Group 1) or MenC-CRM (Group 2) at 3, 5, and 12 months (M) of age. Both groups received PHiD-CV (3 + 1 schedule) as part of the Brazilian national immunisation programme at 3 M, 5 M, 7 M, and 12 M of age. Antibody responses were assessed pre-vaccination, 1 M post-dose 2, pre-booster, and 1 M post-booster.

RESULTS

Anti-pneumococcal antibody responses were in similar ranges in the two study groups.

CONCLUSIONS

4CMenB co-administration did not seem to impact antibody responses to PHiD-CV in infants.

Stressors perceived by the clinical undergraduate medical students towards the end of course

Response or reaction of the mind to the pressure of life is stress. Medical students of Bangladesh are in stress to meet the demands of the curriculum. This study was conducted on the regularly passed final year students of a medical college to find out the nature of stresses perceived by them. The response was collected on a validated structured set of questionnaire, 3 weeks prior to the University level summative examination and 63 students (33 male and 30 female) participated in the study. Stress was expressed in five levels and scored as 0 to 4. Academic related factors were identified as maximum stress provoking (2.5 ± 1.3) than group activity (1.6 ± 1.4), drive (1.4 ± 1.5), teaching-learning (2.3 ± 1.3), personnel (1.8 ± 1.6) or social (1.9 ± 1.5) related factors. Of that group of stress, ‘falling behind reading schedule’ and ‘large amount of content to be learned’ were revealed as heavy stressors. Examination was identified as a severe stressor in 42.4% male, but was marked less (16.7%) in the female. ‘Too much restriction in the campus’ was observed as heavy stressors among the factors other than the academic related stressors. Students may be motivated to develop a coping strategy for academic and teaching-learning related stress.

Extra Skeletal Ewing's Sarcoma Involving Perineum of a Young Male Patient

Ewing's Sarcoma is the second most common primary malignant bone tumor in children and young adults after osteosarcoma but exceptionally it can arise from extra skeletal sites also. Extra skeletal Ewing's sarcoma is of neuroectodermal origin and usually involves extremities, retroperitoneum and paravertebral regions. No case of extra skeletal Ewing's sarcoma involving perineum is yet reported. A 16 years old male patient admitted to colorectal surgery department of Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh in July 2015 having swellings in perineum as well as both inguinal regions. The swelling was near to anal verge. FNAC from perineal swelling and inguinal lymph node demonstrate small blue round cell tumor. After operation the tumor size was 5cm×4cm, cell type was malignant round cell arranged in sheet and perivascular forming rosette. Extra skeletal Ewing's sarcoma can be a differential diagnosis of soft tissue tumor arising in perineum.

Immune response to the hepatitis B antigen in the RTS,S/AS01 malaria vaccine, and co-administration with pneumococcal conjugate and rotavirus vaccines in African children: A randomized controlled trial

The RTS,S/AS01 malaria vaccine (Mosquirix) reduces the incidence of Plasmodium falciparum malaria and is intended for routine administration to infants in Sub-Saharan Africa. We evaluated the immunogenicity and safety of 10-valent pneumococcal non-typeable Haemophilus influenzae protein D conjugate vaccine (PHiD-CV; Synflorix) and human rotavirus vaccine (HRV; Rotarix) when co-administered with RTS,S/AS01 (www.clinicaltrials.gov NCT01345240) in African infants. 705 healthy infants aged 8–12 weeks were randomized to receive three doses of either RTS,S/AS01 or licensed hepatitis B (HBV; Engerix B) vaccine (control) co-administered with diphtheria-tetanus-acellular pertussis-Haemophilus influenzae type-b-conjugate vaccine (DTaP/Hib) and trivalent oral poliovirus vaccine at 8–12-16 weeks of age, because DTaP/Hib was not indicated before 8 weeks of age. The vaccination schedule can still be considered broadly applicable because it was within the age range recommended for EPI vaccination. PHiD-CV or HRV were either administered together with the study vaccines, or after a 2-week interval. Booster doses of PHiD-CV and DTaP/Hib were administered at age 18 months.

Non-inferiority of anti-HBV surface antigen antibody seroprotection rates following co-administration with RTS,S/AS01 was demonstrated compared to the control group (primary objective). Pre-specified non-inferiority criteria were reached for PHiD-CV (for 9/10 vaccine serotypes), HRV, and aP antigens co-administered with RTS,S/AS01 as compared to HBV co-administration (secondary objectives). RTS,S/AS01 induced a response to circumsporozoite protein in all groups. Pain and low grade fever were reported more frequently in the PHiD-CV group co-administered with RTS,S/AS01 than PHiD-CV co-administered with HBV. No serious adverse events were considered to be vaccine-related. RTS,S/AS01 co-administered with pediatric vaccines had an acceptable safety profile. Immune responses to RTS,S/AS01 and to co-administered PHiD-CV, pertussis antigens and HRV were satisfactory.

Immunologic non-inferiority and safety of the investigational pneumococcal non-typeable Haemophilus influenzae protein D-conjugate vaccine (PHiD-CV) 4-dose vial presentation compared to the licensed PHiD-CV 1-dose vial presentation in infants: A phase III randomized study

BACKGROUND

To support vaccination programs in developing countries, a 4-dose vial presentation of pneumococcal non-typeable Haemophilus influenzae protein D-conjugate vaccine (PHiD-CV) was developed. This study assessed immunologic non-inferiority and safety of the investigational PHiD-CV 4-dose versus licensed 1-dose vial presentation in infants.

METHODS

In this phase III, mono-center, observer-blind study in Bangladesh, 6-10-week-old infants were randomized 1:1 to receive PHiD-CV primary vaccination (at ages 6, 10, 18 weeks) and a booster dose (at age 9 months) with a 4-dose vial (with preservative, 4DV group) or 1-dose vial (preservative-free, 1DV group). DTPw-HBV/Hib was (co)-administered per study protocol and polio, measles and rubella vaccines as part of the national immunization program. Non-inferiority of PHiD-CV 4-dose versus 1-dose vial for each vaccine pneumococcal serotype (VT) and vaccine-related serotype 19A in terms of antibody geometric mean concentration (GMC) was assessed (criterion: upper limit of 2-sided 95% confidence interval of antibody GMC ratios [1DV/4DV] <2-fold). Immune responses were measured. Solicited, unsolicited and serious adverse events (AEs) were evaluated.

RESULTS

Of 320 infants (160 per group) vaccinated during the primary vaccination phase, 297 received a booster. Non-inferiority was demonstrated for each VT and 19A. One month post-primary vaccination, for most VT, ≥97.9% of infants in each group had antibody concentrations ≥0.2 μg/mL; for 19A ≥ 80.1% reached this threshold. Pneumococcal antibody responses and opsonophagocytic activity for each VT and 19A were within similar ranges between groups after primary and booster vaccination, as were anti-protein D responses. Booster immune responses were observed in both groups. Reported AEs were within similar ranges for both presentations.

CONCLUSION

Immunologic non-inferiority of PHiD-CV 4-dose vial (with preservative) versus PHiD-CV 1-dose vial (preservative-free) was demonstrated. Immune responses and reactogenicity following primary/booster vaccination were within similar ranges for both presentations. PHiD-CV 4-dose vial would help improve access and coverage in resource-limited countries. Clinical Trial Registry: NCT02447432.

Immunogenicity, safety and reactogenicity of the pneumococcal non-typeable Haemophilus influenzae protein D conjugate vaccine (PHiD-CV) in 2-17-year-old children with asplenia or splenic dysfunction: A phase 3 study

BACKGROUND

Immunization with pneumococcal vaccines is an important prophylactic strategy for children with asplenia or splenic dysfunction, who are at high risk of bacterial infections (including S. pneumoniae). This study aimed to assess immunogenicity and safety of pneumococcal non-typeable Haemophilus influenzae protein D conjugate vaccine (PHiD-CV, GSK) in this at-risk population.

METHODS

This phase III, multi-centre, open-label, controlled study, in which at-risk children with asplenia or splenic dysfunction were enrolled (age strata: 2-4, 5-10 and 11-17years), was conducted in Poland and the Russian Federation. For the 2-4years at-risk group, healthy age-matched children were enrolled as control. Unprimed children (not previously vaccinated with any pneumococcal vaccine) received 2 PHiD-CV doses (≥2months apart) and pneumococcal vaccine-primed children received 1 dose. Immune responses were assessed pre-vaccination and one month post-each dose. Solicited and unsolicited adverse events (AEs) were recorded for 4 and 31days post-vaccination, respectively, and serious AEs (SAEs) throughout the study.

RESULTS

Of 52 vaccinated children (18 at-risk primed, 28 at-risk unprimed and 6 control unprimed), 45 (18, 23 and 4, respectively) were included in the according-to-protocol cohort for immunogenicity. Post-vaccination (post-dose 1 in primed and post-dose 2 in unprimed children), for each vaccine pneumococcal serotype and vaccine-related serotype 6A all at-risk children had antibody concentrations ≥0.2µg/mL, and for vaccine-related serotype 19A at least 94.4%. Increases in antibody geometric mean concentrations were observed. For most serotypes, all at-risk children had post-vaccination opsonophagocytic activity (OPA) titers ≥8 and increases in OPA geometric mean titers were observed. No safety concerns were raised. One non-fatal SAE (respiratory tract infection, considered not vaccine-related) was reported by one at-risk unprimed child.

CONCLUSION

PHiD-CV was immunogenic and well tolerated in 2-17-year-old children with asplenia or splenic dysfunction. Clinical Trial Registry: www.clinicaltrials.gov, NCT01746108.

Effectiveness of Preoperative Lymphoscintigraphy for the Detection of Cervical Lymph Node Metastasis in Patients with Oral Squamous Cell Carcinoma

Background:

Oral squamous cell carcinoma (OSCC) is one of the most common malignant tumor. OSCC is the malignancy of squamous epithelium of oral cavity, which is the sixth most common malignancy reported worldwide and one with highest mortality rate among all malignancies.

Aims:

The aims of this study is to assess the diagnostic performance of lymphoscintigraphy (LSG) for the detection of cervical lymph node metastasis in patients with OSCC.

Materials and Methods:

This was a prospective study done in Oral and Maxillofacial Surgery Department and National Institute of Nuclear Medicine and Allied Science, Bangabandhu Sheikh Mujib Medical University during July 2015–June 2016. Thirty-six patients with OSCC were included in this study. Radioisotope technique was used in the detection of cervical metastases in patients with histologically proven OSCC. Patients were assessed by LSG after diagnosis of OSCC, and then, it was compared with postoperative histopathology report.

Results:

Lymphoscintigraphically out of 36 patients, 23 had lymphatic channel obstruction where histologically 20 patients had lymph node metastasis. There were 20 true positive cases, 13 true negative cases, and 3 false positive cases but no false negative case was found. The test of validity result reveals that sensitivity 100.0%, specificity 81.25%, accuracy 96.66%, positive predictive value 86.96%, and negative predictive value 100.0%.

Conclusion:

LSG for the detection of cervical lymph node metastasis has an important role for the management of OSCC. It is also cost-effective and decreases the morbidity.

Exploring new pharmacology and toxicological screening and safety evaluation of one widely used formulation of Nidrakar Bati from South Asia region

BACKGROUND

Nidrakar Bati (NKB) is an herbal remedy consisted with seven medicinal herbs widely used to cure Somnifacient (sleeping aid) in South Asia as Ayurvedic medicinal system. In the present study, pharmacological and toxicological effects of this medicine was investigated in mice to validate the safety and efficacy of the herb.

METHODS

Organic solvent extracts NKB were prepared using maceration method. Effect of extracts on the central nervous system was evaluated using hypnotic activity assay. Effect of the extracts on metabolic activity, assessing involvement of thyroid was conducted using hypoxia test. analgesic and anti-inflammatory activities were assessed in mice using acetic acid induced writhing, formalin induced paw edema, xylene induced ear edema assays. Anxiolytic activity was performed using plus maze, climbing out and forced swimming tests. Effect of the extracts on psychopharmacological effect was carried out using locomotor activity tests (open field, Hole-board and Hole-cross tests). Neuropharmacological effect of the extracts was performed using motor coordination (rotarod test). Toxicological potential of the extract was evaluated using gastro-intestinal activity (gastric emptying and gastrointestinal motility tests).

RESULTS

The studied formulation reduced the CNS stimulant effects dose independently. In the hypoxia test, only a dose of 100 mg/kg of NKB decreased the survival time. Orally administration of the NKB (200 and 400 mg/kg) produced significant inhibition (P < 0.01) of the acetic acid-induced writhing in mice and suppressed xylene induced ear edema and formalin-induced licking response of animals in both phases of the test. NKB showed locomotor activity (p < 0.05) both in higher and lower doses (100 and 400 mg/kg). NKB increased the total ambulation dose dependently (p < 0.05). NKB, at all tested doses (100, 200 and 400 mg/kg) increased some locomotion activity parameters (ambulation, head dipping and emotional defecation) in hole board test. At higher doses (200 and 400 mg/kg), NKB showed a significant increase in hole cross test. NKB showed an increase in the time on the open arms of the maze at low to medium doses (100 and 200 mg/kg). When using the Rotarod method, NKB showed a considerable increase on motor coordination of the mice. NKB produced marked gastric emptying effect and decreased gastrointestinal motility in mice at low dose.

CONCLUSIONS

NKB demonstrated various pharmacological effects and toxicological effects due to presence of several herbs in the formulation those are not closely fit for the effect of CNS depressants.

Otitis media with effusion in children admitted for adenoidectomy

This cross-sectional prospective study was done in the Department of Otolaryngology Head & Neck Surgery, Bangabandhu Sheikh Mujib Medical University, Dhaka during the period of January 2008 to December 2009 with the aim to find out the frequency of otitis media with effusion in patients with enlarged adenoid admitted for Adenoidectomy, To see the frequency of otitis media with effusion in different age group, To find out the degree of hearing loss in enlarged Adenoid patients. A total number of 60 patients who were admitted for adenoidectomy with or without tonsillectomy were purposively collected. Male female ratio was 1.6:1. Majority of patients (61.67%) came from lower socioeconomic group. Amongst the patients with enlarged adenoids, OME was found in 32(53.33%) cases. Out of 25 grossly enlarged adenoid cases, OME was found in 19(76%) cases. In 35 cases of moderately enlarge adenoid, OME was found in 13(37.14%) cases. Out of 28 enlarged adenoid cases in age group 0-5 years, OME was present in 19(67.86%) cases and out of 32 enlarge adenoid cases in age group 6-15 years; OME was present in 13(40.62%) cases. Most of the patients presented with multiple clinical features, the commonest was mouth breathing (80%), other features were snoring (58.33%), nasal discharge (56.67%) and hearing impairment (53.33%). In tympanometry, flat curve without peak was found in 25 cases and negative middle ear pressure was seen in 7 cases. Regarding hearing status of patients, 25 cases had a mild to moderate degree of hearing loss and PTA was not done in 7 cases due to lower age group (below 4 years).

Is malnutrition a risk factor of stroke?

Obesity is an established risk factor of stroke. Malnutrition in post-stroke period is common and can influence outcome. But malnutrition, though predicted, has not yet been established as a risk factor of stroke. This descriptive study was carried out in the Department of Neurology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka and Department of Neurology, Dhaka Medical College (DMC), from January 2009 to December 2010 to explore whether malnutrition is an independent risk factor of stroke. Nutritional status of 100 stroke patients and 100 healthy controls were assessed in this study. Anthropometric measurements including Body Mass Index (BMI), Triceps skin fold (TSF), Mid-arm circumference (MAC) and Arm-muscle circumference (AMC) were measured within 7 days of stroke. Haemoglobin and haematocrit percentage, serum iron and serum albumin were measured at the same time. No significant difference was observed regarding TSF thickness, MAC, AMC, mean Hb and mean albumin level between the stroke patients and the control group, although iron level was significantly lower in stroke group. Multiple logistic regressions analysis showed that increase in age, smoking and decreased serum iron level has a positive association with stroke. Malnutrition is, according to this study, not a significant risk factor of stroke and triceps skin fold (TSF) thickness, mid-arm circumference (MAC), arm-muscle circumference (AMC), hemoglobin and serum albumin are not appropriate predictor of stroke.

Zinc supplementation fails to increase the immunogenicity of oral poliovirus vaccine: a randomized controlled trial

BACKGROUND

Polio eradication remains a challenge in Pakistan and the causes for the failure to eradicate poliomyelitis are complex. Undernutrition and micronutrient deficiencies, especially zinc deficiency, are major public health problems in Pakistan and could potentially affect the response to enteric vaccines, including oral poliovirus vaccine (OPV).

OBJECTIVE

To assess the impact of zinc supplementation among infants on immune response to oral poliovirus vaccine (OPV).

METHODS

A double-blind, randomized placebo-controlled trial was conducted in newborns (aged 0-14 days). Subjects were assigned to either receive 10mg of zinc or placebo supplementation daily for 18 weeks. Both groups received OPV doses at birth, at 6 weeks, 10 weeks and 14 weeks. Data was collected on prior immunization status, diarrheal episodes, breastfeeding practices and anthropometric measurements at recruitment and at 6 and 18 weeks. Blood samples were similarly collected to determine the antibody response to OPV and for micronutrient analysis. Logistic regression was used to determine the relationship between seroconversion and zinc status.

RESULTS

Overall, 404 subjects were recruited. At recruitment, seropositivity was already high for poliovirus (PV) serotype 1 (zinc: 91.1%; control: 90.5%) and PV2 (90.0%; 92.7%), with lower estimates for PV3 (70.0%; 64.8%). By week 18, the proportion of subjects with measured zinc levels in the normal range (i.e. ≥60 μg/dL) was significantly greater in the intervention group compared to the control group (71.9%; 27.4%; p<0.001). No significant difference in seroconversion was demonstrated between the groups for PV1, PV2, or PV3.

CONCLUSIONS

There was no effect of zinc supplementation on OPV immunogenicity. These conclusions were confirmed when restricting the analysis to those with measured higher zinc levels.

A comparative study between fine needle aspiration cytology findings and histopathological report of major salivary gland neoplasm in a tertiary hospital of Bangladesh

Salivary gland tumours are relatively uncommon and most of the tumours arise from parotid gland. Fine needle aspiration cytology (FNAC) is advised preoperatively as diagnostic tool but sometimes found to shown both false positive and false negative results. This study was aimed to find out distribution of neoplasm of major salivary glands and also to explore the sensitivity and specificity of FNAC. The present cross sectional study was done in the Dept. of Otolaryngology Head and Neck Surgery, BSMMU from January 2007 to December 2008. A total number of 60 gender-matched patients with major salivary neoplasm, confirmed by FNAC, were recruited in the study. Operated salivary gland specimens were sent for histopathological examination, histopathological findings were compared. Overall male to female ratio was 1:1. Out of 60 cases, 47 (78.3%) patients had parotid and 13 (21.7%) patients submandibular gland neoplasm. Male to female ratio for parotid tumour was 1:1.1 and for submandibular 1.6:1. Mean age of the patients was 44.5 with range of 14-85 years. Of the total 60 cases 47 (78.3%) were benign and 13 (21.7%) malignant. Out of 47 parotid tumour 85.1% were benign and 14.9% malignant. Among the parotid tumour 97% were superficial lobe and 3.0% deep lobe. In case of submandibular gland 53.84% were benign and 46.15% tumour malignant. According to the sides of involvement, 25 (53.2%) cases of parotid neoplasm tumour were in the left and 22 (46.8%) the right. In submandibular gland the distribution was 7 (53.8%) and 6 (46.16%) respectively. Statistically incidence of parotid tumour was significantly higher than submandibular tumour (p < 0.05). Out of 60 cases in 56 (93.3%) preoperative FNAC and postoperative histopathological findings were same. There was 1.7% false positive and 5% were false negative results. Sensitivity, specificity of FNAC were 80% and 97.8% respectively. Positive predictive value was 92.3% and negative predictive 93.6% for FNAC.FNAC though cheap and safe but its diagnostic accuracy was 93.3%.Histopathologial examination remained to be of value for diagnostic confirmation of major salivary gland neoplasm.

Mortality rate and clinical features of highly pathogenic avian influenza in naturally infected chickens in Bangladesh

A retrospective study was performed to assess the mortality rates and clinical signs in commercial and backyard chickens naturally infected with the highly pathogenic avian influenza (HPAI) H5N1 virus in Bangladesh. All of the 33 commercial and 25 backyard farms, recorded during the first wave of HPAI outbreaks (January to November 2007) in Bangladesh, were enrolled in this study. The farm profile data, stock information and major clinical signs recognised by the farmers and/or farm attendants, were collected through a prototype questionnaire. The investigating veterinarians' retrospective appraisals of the clinical signs were recorded by interview. After the clinical onset, the incidence rates of mortality in breeder, commercial broiler, commercial layer and backyard chickens were, respectively: 0.0215, 0.0341, 0.0179 and 0.0703 per chicken-day at risk. The four major clinical signs observed were cyanotic combs and wattles, oedema of the head and face, drowsiness and huddling and ecchymotic discoloration of the leg shanks. The first sign (cyanotic combs and wattles) was equally observed in chickens from commercial and backyard farms (p = 0.44) but the second (oedema of the head and face) was more common in backyard farms (p = 0.03).

Anterior cervical discectomy, fusion and stabilization by plate and screw--early experience

Anterior cervical plating is commonly performed to stabilize anterior cervical fusion. The aim of the study was to evaluate the clinical and functional outcome, radiological fusion and operative complications in cases of cervical spondylotic myelopathy and radiculopathy who underwent Anterior Cervical Discectomy and Fusion (ACDF) by autograft and stabilized with plate and screw. We evaluated 16 consecutive patients (M: F = 10:6) from January 2008 to December 2010 in Bangabandhu Sheikh Mujib Medical University (BSMMU) and different private hospitals in Dhaka, in cases where adequate conservative treatment failed. Single level ACDF by autograft and stabilization by plate and screw was done in 10 patients and 06 patients had two levels fusion. The mean follow up period was 18 months. The patients improved significantly (p < 0.05) and the recovery rate was 87.50%. All patients showed radiological fusion (p < 0.001). There was no hardware failure, graft extrusion or plate breakage. ACDF with plate and screw is fairly safe and effective therapy for cervical disc degeneration leading to myelo-radiculopathy where major post operative complications are uncommon.

Zinc oxide-mediated photocatalytic decolorization of Ponceau S in aqueous suspension by visible light

ZnO, comprising nanosize particles (approximately 40 nm) has been prepared by heating (300°C) ZnCO3, which was obtained as precipitate by mixing ZnSO4 and (NH4)2CO3 solutions. The prepared ZnO was characterized by X-ray diffraction, scanning electron microscopy (SEM), laser-induced breakdown spectroscopy, and adsorption studies. It has been used to catalyze the decolorization of Ponceau S (PS), a model diazo dye, in an aqueous suspension under visible light (I ≈ 1.8 × 10−4 W cm−2). This ZnO was found to be more efficient as a photocatalyst compared to pristine ZnO. ZnO samples with higher temperatures (500°C and 700°C) show less catalytic activity. SEM images show that the particle size of ZnO increases with the increase in calcined temperature of ZnO through agglomeration, resulting in a decrease in surface area. Photodecolorization of PS is affected by its and ZnO concentrations, but unaffected by the initial pH of the solutions in the range of 4 to 7. Illumination for a sufficiently long time completely mineralizes the dye, but no Zn2+ can be detected in the clear solution.

Photodegradation kinetics in the ZnO suspension obeys the Langmuir-Hinshelwood equation, and some activation of the ZnO surface by light is indicated.