Efficacy of F-75 & F-100 Recipes in theTreatment of Severe Acute Malnutrition: A Randomized Controlled Trial

Severe malnutrition is an important cause of death in children. According to new WHO-growth chart 2006, the proportion of children with severe wasting is 3.1% thus the total number being 4, 65000 (BDHS 2014). Overall risk of death among children with severe acute malnutrition (SAM) is 9 times more than well nourished children. The death rate among hospitalized children of SAM was as high as 15%. Once properly treated, severely malnourished children would grow up leading a normal life. Severe malnutrition in children can be successfully treated by using WHO guidelines that have been shown to be feasible and sustainable even in small district hospital with limited resources. A randomized controlled trial was conducted at department of Pediatrics, Dhaka Medical College Hospital, Dhaka, Bangladesh from July 2014 to September 2015. The trial enrolled 92 SAM patients (46 cases + 46 controls) aged 06 months to 59 months of either sex who meet the inclusion criteria consecutively. Enrolled children were randomized by lottery method into two groups, Group I and Group II. Patients in Group I was treated with F-75 and F-100 recipes and managed in two phases, initial stabilization phase with F-75 recipes then subsequently rehabilitation phase by F-100 recipes. Patients in Group II was treated with prepackaged F-75 & F-100 formulae and feeding was given in two phases i.e. initial stabilization phase and subsequently rehabilitation phase according to national guidelines for the management of severe malnourished children. Then play therapy was given for half an hour daily with red colored toy in Ashic play centre Dhaka Medical College Hospital for patients of both groups. The time (days) taken to return of appetite (mean±SD) was 5.1±1.16 and 4.8±1.34 in Group I and Group II respectively, disappearance of edema (mean±SD) 4.8±1.53 in and 4.9±1.05 for Group I Group II respectively, to gain target weight (mean±SD) 13.8±2.20 days and 13.5±1.74 days in Group I and Group II respectively, rate of weight gain (mean±SD) 17.70±7.07gm/kg/day for Group I and 16.20±4.63gm/kg/day for Group II. The side effects, diarrhea was equal in both group, vomiting was more in Group II, combined diarrhea and vomiting was more in Group I but the differences were not statistically significant. The treatment cost (mean±SD) was higher in Group II (97.2±78.24 BDT/child/day) than in Group I (58.5±54.36 BDT/child/day). Return of appetite and disappearance of oedema and target weight gain were similar in both groups but treatment cost was higher in Group II than Group I, which was statistically significant.

Comparison of Ultrasonogram of Brain Findings of Asphyxiated and Non-Asphyxiated Baby Admitted in Neonatal Ward in a Tertiary Level Hospital

Perinatal asphyxia is a major cause of neonatal mortality and morbidity in developing countries. A significant portion of patient with perinatal asphyxia is admitted with complications. Cerebral complications are the most devastating and the child may be left with lifelong neurological impairment. Therefore, the high index of suspicion, prompt recognition and thorough understanding of common sonographic abnormalities are necessary to ensure timely intervention, management and counseling. A hospital based case control study was conducted in the neonatal unit of Mymensingh Medical College Hospital, Mymensingh, Bangladesh. Study period was six months (June 2012 to December 2012). This study was done to compare the ultra sonogram of brain findings of admitted asphyxiated babies with admitted non-asphyxiated babies. A total of 30 asphyxiated (case) and another 30 non-asphyxiated (control) neonate of this department were enrolled in the study. Necessary information was collected by taking detailed history, clinical examination and also close follow up of the neonates according to pre-designed questionnaire. The main outcome variable was abnormality in cranial ultrasound. Among case group (30 neonates), ultrasonogram of brain findings were abnormal in 9(30.0%) cases. Among them most common was ventricular dilatation 5(16.6%), followed by Intraventricular hemorrhage (IVH) 1(3.0%), intracranial hemorrhage 1(3.0%), HIE 1(3.0%) and cerebral edema in 1(3.0%) cases. On the contrarary, among asphyxiated control group all 30 cases had normal ultra sonogram of brain. In case group 22 babies had normal birth weight and 08 had low birth weight. Among the 22 normal birth weight neonates in case group total 6(27.2%) cases had abnormal ultra sonogram findings. Among normal birth weight cases 3(13.6%) had ventricular dilatation, 1(4.5%) Intracranial hemorrhage (ICH), 1(4.5%) HIE, 1(4.5%) cerebral edema. Among 08 low birth weight neonates in case group total 3(37.5%) cases had abnormal ultrasonogram of brain finding. Among low birth weight cases 2(25%) had ventricular dilatation, 1(12.5%) IVH. Ultrasonogram brain findings difference between two groups was statistically significant. Abnormal findings were also common in low birth weight babies than normal birth weight babies. So, early detection of abnormal brain changes can help us for proper management and counseling.

Diagnostic Performance of RBC Indices in Beta Thalassaemia Trait

Beta thalassaemia trait is one of the most common forms of thalassaemia in Bangladesh. This clinical entity usually remains undiagnosed because they present with mild anaemia or sometimes no anaemia. Determination of trait is the mainstay of prevention of thalassaemia. RBC indices can provide valuable diagnostic tool for beta thalassaemia trait. This was a hospital based cross-sectional, analytical study, done at Department of Paediatrics, Rangpur Medical College Hospital, Rangpur, Bangladesh from July 2014 to June 2016. A total of 150 anaemic children, aged 1-15 years from inpatient and outpatient department were included by purposive sampling. Blood samples were collected and sent to the Department of Biochemistry, Rangpur Medical College to determine the value of RBC indices. Out of 150 anaemic children 37(24.66%) children were diagnosed as E-trait, 9(9%) E-disease 6(4%) as E-Beta thalassaemia, 1(0.66%) had error in the report, a total of 53 children were excluded from the study. Finally, 32(21.3%) children, diagnosed as beta thalassaemia trait and 65(43.33%) children, diagnosed as normal Hb variant, so a total of 97 children were enrolled in this study. Age of the children was 1-15 years. Their mean age was 6.4 years. Male female ratio was 1.15:1. There was significant difference of HbA₂ between BTT and non BTT group of participants (p value <0.001). Value of MCV and MCH were significantly greater in BTT than non BTT group (p value <0.05). Sensitivity, Specificity, Positive predictive value, Negative predictive value and Youden index of MCV were 81.25%, 90.76%, 81%, 90% and 71 respectively. Sensitivity, Specificity, Positive predictive value, Negative predictive value and Youden index of MCH were 84.37%, 92.30%, 84%, 92% and 76 respectively.

Growth performance of local and genetically improved chicken of Bangladesh

The experiment was conducted to compare the growth performance among four genotypes of indigenous chicken namely Non-descriptive Native (ND), genetically Improved Native (IN), Hilly (HC) and Naked Neck (NN) of Bangladesh under free-range rearing system.  A total of 288 day old chicks (DOC) from four genotypes were divided into four treatments having eight replications of each for a period of 12 weeks under free-range system with supplementation of commercial broiler diet. During first 4 weeks, all chicks were kept together, whereas chicks of ND was brooded in the same room but separated by a partition. At 5 weeks of age chicks were randomly distributed to the selected farmers. Growth parameters were recorded to determine the comparative growth performance among four genotypes of chicken. The highest body weight (1110.76 g/bird) was achieved by HC, followed by IN (900.63 g/bird) and NN (831.13 g/bird) at 12 weeks of age. The lowest body weight (734.13 g/bird) however was found in ND chicken. During the growing period under free range rearing (5-12 weeks), HC group consumed the highest amount of feed (2697.02 g/bird) with an average FCR of 3.06 while the lowest feed consumption (2666.13 g/bird) with the highest FCR of 4.90 was observed in ND. IN consumed (2674.63 g/bird) feed with an average FCR of 3.92 and BLRI improved NN consumed (2668.13 g/bird) feed with an average FCR of 4.19. Live weight gains in all the four genotypes of indigenous chicken were changed almost in a similar pattern. Significant differences were observed in live weight, dressing percentage, breast meat, drumstick, thigh meat among the four genotypes of chicken. The HC was superior to other genotypes of indigenous chicken including ND in terms of growth performance, meat yield characteristics and net returns. Bang. J. Anim. Sci. 2018. 47 (2):76-84

Bt Eggplant Project in Bangladesh: History, Present Status, and Future Direction

The purpose of this article is to provide information on the history, accomplishments, and future direction of the Bt brinjal (eggplant) program in Bangladesh, formerly under the Agricultural Biotechnology Support Project II, now the South Asia Eggplant Improvement Partnership (SAEIP). The India-based Maharashtra Hybrid Seed Company (Mahyco) developed an eggplant expressing Cry1Ac (EE-1) for control of the eggplant fruit and shoot borer (EFSB). In a partnership among Mahyco, USAID, Sathguru Management Consultants and Cornell University EE-1 was provided to the Bangladesh Agricultural Research Institute (BARI) who bred it into local varieties. After regulatory approval, four varieties were distributed to 20 farmers who harvested Bt brinjal in 2014. Adoption in subsequent years has increased rapidly so that, in 2018, 27,012 farmers used this technology. This article provides background information on the process leading up to current adoption levels, the level of control of EFSB achieved and the economic benefits of Bt brinjal. Efforts on stewardship, farmer training and communication are discussed. In order to ensure the long-term future of the partnership, we discuss the need to enhance involvement of the private sector in the production and stewardship of Bt eggplant. Bt brinjal is the first genetically engineered crop to be commercially released in Bangladesh, and other GE crops are in the pipeline. Hence, success of the Bt brinjal partnership is likely to affect the future of other GE crops in Bangladesh, as well as other parts of the world where biotechnology is needed for food security and environmental safety.

Socio-economic performance of Bt eggplant cultivation in Bangladesh

A study was conducted in 35 districts of Bangladesh during 2016-17 winter season for assessing the farm level performance of Bt eggplant in reducing pesticide use, cultivation cost and increase farm income. Five hundred five Bt eggplant farmers were selected purposively and 350 non-Bt eggplant farmers were selected randomly for the study. Net returns per hectare were Tk. 179,602/ha for Bt eggplant as compared to Tk. 29,841/ha for non-Bt eggplant. Pesticides were applied 11 times to Bt eggplant where as it was 41 times to non-Bt eggplant for controlling sucking pests. The Bt eggplant farmers saved 61 percent of the pesticide cost compared to non-Bt eggplant farmers, experienced no losses due to fruit and shoot borer, and received higher net returns. The experience with Bt eggplant technology was good for most of the locations and up to the mark and off course this technology will be significantly improved to their socio-economic conditions in future as reported by the Bt respondents. All Bt and 86% non-Bt farmers wanted to cultivate Bt eggplant in the next year if they can obtain the seeds/seedlings from the research station. For getting higher yield and economic benefits, in the course of technology dissemination, the importance of good production practices must be emphasized.Bangladesh J. Agril. Res. 43(2): 187-203, June 2018

Moebius Syndrome with Hypoglossal Palsy, Syndactyly, Brachydactyly, and Anisometropic Amblyopia

Moebius syndrome is a rare cause of congenital facial and abducens palsy. It is sometimes associated with musculoskeletal abnormalities and other cranial nerve palsies. Genetics and ischemic insults to the fetus are considered to be the cause of this syndrome. We report here a 12-year-old female patient who was presented to us with poor cosmesis of her face, with associated decreased vision and lagophthalmos in her left eye. She didn't have any signs of exposure keratopathy in the affected eye. Her best-corrected vision was 20/20 and 20/60 in right and left eyes respectively. The cause of decreased vision in her left eye was found to be anisometropic amblyopia, due to asymmetric hyperopic astigmatism in her eyes. She did not report diplopia in any gaze position. Examination of her cranial nerve revealed left facial, abducens, and hypoglossal nerve palsy, leading us to the diagnosis of Moebius syndrome. Apart from that, she had syndactyly in one of her hands, and brachydactyly in both. Since the eyes were straight in their primary position, no surgical intervention was carried out for her lagophthalmos, which was measured to be only 2 mm. This was to prevent any post-operative iatrogenic ptosis. The condition requires a multidisciplinary approach involving the opinions of a neuro-ophthalmologist, strabismologist, and oculoplastics for the management of the complications associated with the disease.

Differential effects of experimental hyperthyroidism on declined immunity of broiler chicken

Thyroid hormones (THs) are involved in the development of lymphoid organs and regulation of immune function in birds. However, their role as an immune-modulator in the hyperthyroid state is still debatable. To explore the interrelationship of thyroxine (T₄ ) and the immune system, chicks were divided into three groups. Group I was comprised of control birds, who received the basal diet while group II and III were given diets supplemented with 5 μg and 10 μg thyroxine/kg feed, respectively, from 15 to 28 days of age. Cell-mediated immune response was evaluated through in vitro abdominal macrophage phagocytosis assay, macrophage nitric oxide (NO) production, heterophil-to-lymphocyte (H:L) ratio and delayed-type hypersensitivity response against phytohemagglutinin (PHA). Humoural immune response was assessed through serum IgG and IgM antibody production against sheep red blood cells (SRBCs) and antibody production against infectious bronchitis virus (IBV). Sampling was carried out at 7, 14 and 21 days of treatment. Results have shown higher levels (p < .001) of circulating T₄ in both treatment groups compared to the control group. There was a lower (p < .05) macrophage engulfment percentage, an increase in H:L ratio (p < .001) in treated birds, while their NO production remained higher (p < .05) in thyroxine supplemented groups after bacterial lipopolysaccharide stimulation. The humoural immune response revealed a significant decline (p < .001) in IgG, IgM antibody production against SRBCs but IBV circulating antibodies increased with age. In conclusion, hyperthyroidism has a strong co-relation with decreased immune performance of birds.

Response of antioxidant enzymes in Mythimna separata (Lepidoptera: Noctuidae) exposed to thermal stress

The oriental army worm Mythimna separata (Lepidoptera: Noctuidae) is a migratory pest in Eastern Asia and China. Seasonal high temperatures in Southern China and low temperatures in Northern China are pressures favouring the annual migration of this species, while cold tolerance determines the northern limit of its overwintering range. A number of physiological stress responses occur in insects as a result of variations in temperature. One reaction to thermal stress is the generation of reactive oxygen species (ROS), which can be harmful by causing oxidative damage. The time-related effects (durations of 1, 4 and 7 h) of thermal stress treatments of M. separata at comparatively low (5, 10, 15 and 20°C) and high (30, 35, 40 and 45°C) temperatures on the activities of antioxidant enzymes, including superoxide dismutase (SOD), catalase (CAT), peroxidase (POX) and glutathione S-transferases (GSTs), and total antioxidant capacity (T-AOC) were determined. Thermal stress resulted in significant elevation of the activities of SOD, CAT and GSTs, indicating that these enzymes contribute to defence mechanisms counteracting oxidative damage caused by an increase in ROS. However, at high-temperatures, POX and T-AOC were also found to contribute to scavenging ROS. Our results also indicate that extreme temperatures lead to elevated ROS production in M. separata. The present study confirms that thermal stress can be responsible for oxidative damage. To overcome such stress, antioxidant enzymes play key roles in diminishing oxidative damage in M. separata.

Primary Angioplasty for the Treatment of Acute ST Elevated Myocardial Infarction: Single Centre Experience

Worldwide primary angioplasty is a recommended strategy of reperfusion in patient with acute myocardial infarction as because it ensures reperfusion of the infarct-related vessels more than 90% whereas, with thrombolytics it is only 60-70%. This retrospective observational study includes all patients treated with primary angioplasty at United Hospital from Between March 2007 to January 2011. Total 114 consecutive patients with acute myocardial infarction were treated with primary angioplasty included. Those presented beyond 12 hours of onset of chest pain, in cardiogenic shock, resuscitate and intubated before the procedure were excluded from the study. Majority (89%) of the patient were male, age was minimum 30 years and maximum 90 years, 41.5% were diabetics, 58.4% were hypertensive, 43.5% were dyslipidaemic, 17% were smoker, 29.3% with positive family history. Fifty seven percent patients presented with anterior MI , 42 % with inferior MI and 1% with lateral MI. Left anterior descending (LAD) is the most common vessel involved (57%), followed by Right coronary artery (RCA) 31%, Left circumflex artery (LCX) 8 %, Ramus 1.3% and Graft vessel 2.7%. Our door to balloon time was minimum 23 min, maximum 184 min. We used drug eluting stents for most of the patients, GP IIb- IIIa receptor blockers used in 50% cases and thrombus suction device were used when indicated. We faced complications like arrhythmias in 24%, hypotension in18%, no flow or slow flow in 45%, cardiac arrest in 3% and coronary perforation in 1%. Our overall survival was 97.9%. Primary angioplasty is an emerging area in context of our country. Many of the new centers start this novel strategy which helps to save many lives Primary angioplasty is feasible and safe method of reperfusion in patient with acute myocardial infarction in our center. With the help of our initial experience we can perform PAMI with confidence to those who can afford and who need most.

Voiceless Bangla vowel recognition using sEMG signal

Some people cannot produce sound although their facial muscles work properly due to having problem in their vocal cords. Therefore, recognition of alphabets as well as sentences uttered by these voiceless people is a complex task. This paper proposes a novel method to solve this problem using non-invasive surface Electromyogram (sEMG). Firstly, eleven Bangla vowels are pronounced and sEMG signals are recorded at the same time. Different features are extracted and mRMR feature selection algorithm is then applied to select prominent feature subset from the large feature vector. After that, these prominent features subset is applied in the Artificial Neural Network for vowel classification. This novel Bangla vowel classification method can offer a significant contribution in voice synthesis as well as in speech communication. The result of this experiment shows an overall accuracy of 82.3 % with fewer features compared to other studies in different languages.

Analgesic and antidepressant activities of Brassica rapa subspecies chinensis (L.) Hanelt on Swiss-albino mice model

Bangladesh being a subtropical country provides varieties of herbs and vegetables. Brassica is a broad genus available in Bangladesh and it encompasses a lot of nutritive herbs. Among these, Brassica rapa subspecies chinensis (L.) Hanelt (Family-Brassicaceae) is popular in many parts of the world. In the quest of medicinal property, this plant was investigated here for observing analgesic and antidepressant activities in Swiss-albino mice model. The herb was extracted well with methanol and then assayed by acetic acid-induced writhing and tail immersion methods for analgesic action. Besides, thiopental sodium induced sleeping time test, tail suspension test and forced swim test were conducted for the evaluation of its antidepressant activity. The plant extract was orally administered to the mice at 200 and 400 mg/kg body weight and it exhibited significant analgesic and antidepressant activities in compare to the controlled groups. This is the first time comprehensive report for analgesic and antidepressant activities of this plant.

First Metatarsalphalangeal Joint Arthrodesis: A Retrospective Comparison of Two Methods of Fixation

First metatarsalphalangeal joint arthrodesis is a well established and successful treatment; however there still remains controversy over the best choice of construct. We performed a retrospective study of patients undergoing first metatarsalphalangeal fusion over eighteen months (n=52) using either dorsal non-locking plate with additional compression lag screw fixation or dorsal non-locking plate alone. We found when assessing clinical criteria, patients with dorsal non-locking plates and additional compression lag screw fixation had a significantly higher rate of fusion (100% vs 77.8%), significantly higher rate of fusion within the first two months (55.6% vs 83.3%), significantly earlier time to fusion (52.2 days vs 75.6 days), and significantly lower rate of non-union (0% vs 22.2%). When blindly assessing radiographic criteria, the patients treated with the plate and compression screw had a significantly higher rate of fusion and lower rate of non-union (0% vs 33%). There was no statistically significant difference between the frequencies of complications in the groups. We believe that the interfragmentary compression is a crucial factor in achieving good union rates and recommend the use of non-locking pre-contoured plating with additional interfragmentary compression screw as the fixation method of choice for these procedures.

Factors affecting the adoption of improved varieties of mustard cultivation in some selected sites of Bangladesh

Mustard is a leading oil crop in Bangladesh. Relevant data and information on the adoption of improved mustard varieties is very scanty and sporadic in Bangladesh. Therefore, an attempt was made to assess the extent of adoption of improved mustard varieties and their management practices at farm level. The study used data from 540 mustard growing farmers under Manikgonj, Rajshahi and Dinajpur districts. Probit regression model along with other descriptive statistics were used to analyze the collected data. Analysis revealed that the farm level adoption of different production practices were not encouraging as most farmers did not follow the recommendations made by Bangladesh Agricultural Research Institute (BARI) for mustard cultivation. The variety adoption scenario was also discouraging since only 40% of the farmers cultivated improved mustard varieties. However, farmers showed positive attitude towards adoption of improved mustard varieties since about 53% of the adopters wanted to increase area under improve mustard cultivation in next growing season considering the high yielding ability, low cultivation cost, high profit, and less labour requirements. Although mustard is considered to be a profitable crop, many farmers showed negative attitude towards its production due to some drawbacks. Non-availability of improved mustard seed was also found to be a barrier to its adoption at farm level.Bangladesh J. Agril. Res. 40(3): 363-379, September 2015

Re-DCR with Silicone Tube Intubation: An Effective Method of Management of Failed DCR

This prospective observational study was performed with twenty nine eyes of Twenty eight patients who were operated upon for chronic dacryocystitis eight months to two years six months before, presented with history of persistent watering and discharge. Number of male was 6(21%) and female was 22(79%). Re-DCR with silicone tube intubation was performed in all the patients. Post operative follow up for a period of 12-24 months revealed absence of symptoms in 28 eyes (97%) while 1(3%) eye persisted with watering and discharge despite uncomplicated surgical procedure. There are so many options for management of Failed DCR, among them Re-DCR with Silicone Tube Intubation is the most safe and less cost effective method.

Comparison of P2Y12 receptor inhibition by clopidogrel and prasugrel in patients undergoing percutaneous coronary intervention

Dual antiplatelet treatment (DAPT) with aspirin and clopidogrel is vital after percutaneous coronary intervention (PCI). Clopidogrel and prasugrel act on P2Y12 platelet surface receptors. Both these P2Y12 inhibitors are pro-drugs and depend on cytochrome system of the liver for their conversion to active metabolite. There is growing concern regarding suboptimal response in platelet inhibition by clopidogrel. Verify Now system got approval by Federal Drug Administration, USA, for assessing platelet function as its result is almost comparable to gold standard Light Transmission Aggregometry (LTA). There are no data on the prevalence of clopidogrel resistance in Bangladeshi population. Prasugrel, as an antiplatelet drug, is a newer introduction in this country. This study will show light on the efficacy of these drugs on our population especially in patients who undergo PCI where DAPT is mandatory. A total 120 (60 diabetics) patients with Acute Coronary Syndrome (ACS), were alternatively given 600 mg clopidogrel loading dose (LD) followed by 75 mg maintenance dose (MD) daily or 60 mg LD of prasugrel followed by 10 mg MD daily. Five samples of blood were taken at different time intervals over a period of 2 weeks. Measurement of percent inhibition of P2Y12 was done by VerifyNow. Patients who showed less than 20% inhibition (clopidogrel resistant) at any stage were switched to prasugrel. The outcomes of clopidogrel, prasugrel and clopidogrel switched to prasugrel groups were then compared. Nearly half (46.7%) of the patients in the clopidogrel group was found resistant to the drug as opposed to none in the prasugrel group. No difference was found between diabetic and non-diabetic subjects with respect to drug resistance. Intracoronary blood samples showed high degree of platelet inhibition with prasugrel. There was a gradual decline of platelet inhibition over two weeks with prasugrel. Almost fifty percent of the population is clopidogrel resistant in our study. Prasugrel is a much more potent antiplatelet drug and should be preferred in patients undergoing PCI. Prasugrel may also show resistance over time.

Fertility and Hatchability of Pekin and Muscovy Duck Eggs and Performance of Their Ducklings

Five hundred ten duck eggs of Pekin and each of Muscovy duck eggs were incubated to determine fertility and hatchability. The eggs were cleaned and stored at 18-21oC for 6 days prior to setting in the incubator. The eggs were incubated in a forced-draft electric incubator and the hatching performances were recorded. Ninety Pekin and ninety Muscovy day-old ducklings were randomly selected from the hatched ducklings for a growth trial. Each breed was divided into three replications and each replication had 30 ducklings. They were reared up to 10 weeks of age. Fertility of Muscovy duck eggs tended to be higher (P>0.05) than that of Pekin duck eggs. Hatchability of Pekin egg on fertile egg was higher (P<0.05) than that of Muscovy eggs. But, dead in shell of Muscovy duckling was higher (P<0.05) than that of Pekin duckling. Feed consumption was higher (P<0.01) in Muscovy ducklings than that of Pekin ducklings. Feed conversion was slightly higher (P>0.05) in Muscovy ducklings than that of Pekin. At 10 weeks of age, Muscovy ducklings were slightly heavier (P>0.05) than that of Pekin. It was concluded that the fertility of Pekin and Muscovy ducks are more or less similar while hatchability is higher in Pekin ducks. Muscovy ducks are superior in respect of feed conversion and growth rate.DOI: http://dx.doi.org/10.3329/pa.v20i1-2.16859 Progress. Agric. 20(1 & 2): 93 – 98, 2009

Neurofibroma of paranasal sinuses - a case report

Primary neurogenic tumors in nose and paranasal sinuses are unusual entities. The majority of the reported cases have dealt with neurilemmomas and isolated neurofibromas are extremely rare. Here a case of neurofibroma of the paranasal sinuses is described.

Fasting glycaemic and lipidaemic status in acute coronary syndrome patients within 24 hours of onset of chest pain

This is a descriptive type of cross sectional study done in Mymensingh Medical College Hospital during the period of June 2008 to November 2009 to estimate and analyze the fasting blood glucose (FBG) and fasting lipid profile of acute coronary syndrome (ACS) patients within 24 hours of onset of chest pain. Total 50 patients of either sex diagnosed as acute coronary syndrome whose fasting blood sample would have been collected within 24 hours of chest pain were included. Among 50 patients 42(84%) were male and 8(16%) were female. Age range was 30-80 years with a mean ± SD of 50.74 ± 12.05 years. Among 50 ACS patients, 9 patients (18%) suffered from unstable angina (US), 2(4%) from non-ST segment elevation myocardial infarction (NSTEMI) and 39(78%) suffered from ST segment elevation myocardial infarction (STEMI). Study results revealed 41(82%) patients had euglycemia (70-110 mg/dl), 2(4%) patients had impaired fasting glucose (IFG) (110-125 mg/dl), and 7(14%) patients had hyperglycemia (>126 mg/dl). Dyslipidemia found in 38(76%) patients. Among them total cholesterol (TC) >200mg/dl in 14(28%), decreased level of HDL-C (< 40 mg/dl in male and <50mg/dl in female) in 22(44%), increased level LDL-C ≥ 130 mg/dl in 13(26%), and TG >150 mg/dl was found in 16(32%) patients.

Pattern of congenital heart diseases

This prospective observational study was done to find out the frequency of various forms of congenital heart disease (CHD) diagnosed by echocardiography. During the study period (January 2002 to December 2005) 2050 patients were screened by echocardiography. All patients were evaluated by cardiologists and had chest radiograph, electrocardiogram and echocardiography. Total 2050 patients were studied and among them 1071 had congenital heart disease. Male was 561(52.38%) and female was 510(47.62%). Atrial septal defect (ASD) was 374(34.92%), ventricular septal defect (VSD) was 318(29.69%), patent ductus arteriosus (PDA) 83(7.75%), pulmonary stenosis (PS) 58(5.42%), tetralogy of Fallot 162(15.13%), transposition of great vessels (TGA) 16(1.49%), Ebstein anomaly 5(0.4%), coarctation of aorta 1(0.09%) and single ventricle 2(0.19%). This distribution is more or less similar to that reported in studies at home and abroad. In this study atrial septal defect (ASD) was the commonest in acyanotic CHD and tetralogy of Fallot was the commonest cyanotic CHD.

Anhidrotic ectodermal dysplasia presenting as atrophic rhinitis

Ectodermal dysplasia is a complex group of familial disorders with numerous clinical characteristics, with an incidence of 7 in 10000 born alive children. Ectodermal dysplasia affects structures of ectodermal origin like the skin and its appendages as well as other non-ectodermal structures. The most common sites of involvement are the defects in the skin, hair, teeth, nails and sweat glands,which are of ectodermal origin. Though the dermatologists and paediatricians often manage such cases, we report one case of ectodermal dysplasia presenting with atrophic rhinitis.

Outcome of pregnancy in patients with congenital heart diseases

This prospective study was conducted to evaluate the outcome of pregnancies in women with congenital heart diseases. In this study 50 pregnant women age between 20-45 years with congenital heart diseases were included. Twenty two (44%) were presented with atrial septal defect, 12(24%) with ventricular septal defect, 5(10%) were with patent ductus arteriosus, 6(12%) with Fallot's tetralogy, 2(4%) with pulmonary stenosis, 2(4%) with Eisenmenger syndrome, 1(2%) with dextrocardia. Shortness of breath (60%) was the main presenting complaint. Normal vaginal delivery (52%) was done in majority of cases. Spontaneous abortion occurred in 16% of pregnancies. Major complications were heart failure 16%, arrhythmias 21%, cardiovascular mortality 4%, preeclampsia 4%, and eclampsia 2%. Premature birth 16%, fetal demise 4%, neonatal death 2% and cardiac anomaly at birth 2% were also observed. The outcome of pregnancy in women with congenital heart diseases is favourable with considerable maternal and neonatal complications.

Valvular heart disease in pregnancy: maternal and fetal outcome

The aim of this study was to evaluate the maternal and fetal outcome of pregnancy in Valvular Heart Disease (VHD). A better understanding of the effects of valvular abnormalities on pregnancy outcome is of value for risk assessment and the design of a therapeutic plan from the available information of a series of patient. A multicenter prospective study was carried out over a period of 5 years (2005-2009) involving 60 pregnant patients with valvular heart disease. Thirty eight patients (64%) had single valve involvement and mitral stenosis was the most predominant lesion (50%). Ten patients (16.7%) had undergone interventional and surgical correction prior to the pregnancy. Fourteen (24%) patients were identified as a NYHA class III-IV. Women with VHD had 8.35% pulmonary edema, 15.03% developed different types arrhythmia. The incidence of preterm birth and small for gestational age newborn was 11.69% and 13.36% respectively. There was one (1.67%) maternal death. Pregnancy in women with valvular heart disease is associated with remarkable unfavourable effect on maternal and fetal outcome which are related to severity of disease.

Carbonyl reductase 1 protects pancreatic β-cells against oxidative stress-induced apoptosis in glucotoxicity and glucolipotoxicity

Carbonyl reductase 1 (CBR1) plays an important role in the detoxification of reactive lipid aldehydes. Oxidative stress has been implicated in the pathogenesis of pancreatic β-cell failure. However, the functional role of CBR1 in pancreatic β-cell failure has not been studied yet. Therefore, we investigated the role of CBR1 in pancreatic β-cell failure under glucotoxic and glucolipotoxic conditions. Under both conditions, knockdown of CBR1 by specific siRNA increased β-cell apoptosis, expression of lipogenic enzymes (such as ACC, FAS, and ABCA1), intracellular lipid accumulation, oxidative stress, ER stress, and nuclear SREBP1c, but decreased glucose-stimulated insulin secretion. In contrast, overexpression of CBR1 showed the opposite effects. The antioxidants N-acetyl-l-cysteine and Tiron, as well as the FAS inhibitor cerulenin, reversed the effects of CBR1 knockdown. Interestingly, the expression level and enzyme activity of CBR1 were significantly decreased in pancreatic islets of db/db mice, compared with those of wild-type mice. In conclusion, CBR1 protects pancreatic β-cells against oxidative stress and promotes their survival in glucotoxicity and glucolipotoxicity.

Balloon mitral valvuloplasty: immediate and short term haemodynamic and clinical outcome

This prospective study was carried out in the Department of Cardiology, University Cardiac Center, Banghabandhu Sheikh Mujib Medical University, Dhaka, to evaluate the short term clinical and haemodynamic outcome of Balloon mitral valvuloplasty in mitral stenosis. Total 100 patients underwent percutaneous mitral commissurotomy out of which 60 cases had pure mitral stenosis and 40 patients had concomitant other nonsignificant valvular disease. Mitral valve dilatation increases in mitral valve area from 0.5+/-0.22 to 1.80+/-0.41 cm2. Mitral valve mean pressure gradient decline from 24.0+/-6.48 mm of Hg to 6.1+/-3.0 mm of Hg: mean left arterial pressure decline from 21.40+/-4.80 mm of Hg to 6.50+/-2.82 mm of Hg (p<0.001). The pulmonary artery systolic pressure decreased from 78.7+/-20.34 mm of Hg to 30.18+/-10.8 mm of Hg (p<0.001). Procedural success, as defined final mitral valve area>1.5 cm2 or>50% increase in area, was achieved in 95% patients. Serious complications occurred in 2(2%) patients and no death occurred in the study. Minor complications such as vasovagal reaction (03%), balloon rupture without sequelae (1%), hypotension, Seizure etc. during the procedure were also noted. Although percutaneous transvenous mistral commissurotomy appears to be effective at relieving the hemodynamic effects of rheumatic mitral stenosis, it is not without risk. In properly selected patients, however, it appears to have low morbidity and mortality. The overall results of this study demonstrate that the short term clinical and haemodynamic outcome of the procedure were excellent and the incidence of related complications were reasonable.

The effect of composite pig islet-human endothelial cell grafts on the instant blood-mediated inflammatory reaction

Instant blood-mediated inflammatory reaction (IBMIR) causes rapid islet loss in portal vein islet transplantation. Endothelial cells are known to protect against complement-mediated lysis and activation of coagulation. We tested composite pig islet-human endothelial cell grafts as a strategy to overcome IBMIR. Porcine islets were cocultured with human endothelial cells in specially modified culture medium composed of M199 and M200 for 1-9 days. A positive control group, negative control group, and the endothelial cell-coated group were examined with an in vitro tubing loop assay using human blood. The endothelial cell-coated group was subdivided and analyzed by degree of surface coverage by endothelial cells (< or = 50% vs. > 50%) or coculture time (< 5 days vs. > or = 5 days). Platelet consumption and complement and coagulation activation were assessed by platelet count, C3a, and thrombin-antithrombin complex (TAT), respectively. After 60-min incubation in human blood, the endothelial cell-coated group showed platelet consumption inhibition and low C3a and TAT assay results compared to uncoated controls. When the endothelial cell-coated group was subdivided by degree of surface coverage, the < or = 50% coated group showed less platelet consumption and less activation of complement and coagulation compared with the positive control (uncoated) group. On analysis by coculture time, only the subgroup cocultured for < 5 days showed the same protective effect. Human endothelial cell-coated pig islets, especially the partially coated and short-term cocultured pig islet-human endothelial cell composites, reduced all components of IBMIR. If the optimal endothelial cell-islet coculture method could be identified, human endothelial cell coating of pig islets would offer new strategies to improve xenogenic islet transplantation outcomes.

New salirepin derivatives from Symplocos racemosa

The phytochemical investigation of the n-butanol soluble fraction of the bark of stem of Symplocos racemosa Roxb. yielded two new phenolic glycosides of salirepin series, symplocuronic acid (1) and sympocemoside (2), while salirepin (3) was isolated for the first time from this plant. The structures of the new compounds were identified by 1D and 2D NMR techniques along with other spectral evidences and by comparison with the published data of closely related compounds.

[Calcified aortal stenosis and osteoporosis: bone metabolism of systemic calcium metabolism in the elderly]

AIM

To examine bone tissue, systemic calcium metabolism and bone remodeling in patients with calcified aortal stenosis of degenerative origin (DAS).

MATERIAL AND METHODS

The examination of 310 patients (mean age 73.2 years) was made with application of questioning, echocardiography, double energetic x-ray absorptionmetry, measurements of C-telopeptides, osteocalcin, vitamin D, parathyroid hormone with solid phase enzyme immunoassay.

RESULTS

Bone tissue mineral density (BTMD) was abnormal in 71% of examinees (osteopenia--40%, osteoporosis--31%). Vitamin D concentration under 50 nmol/l was in 76.3%, parathyroid hormone elevated above 100 pg/ml in 15.8% patients.

CONCLUSION

The severity of lumbar spine affection depended on severity of calcinosis of aortic valve, was associated with lowering of osteosynthetic activity and was not associated with the presence of osteoporosis risk factors, constitutional parameters, calcium metabolism changes. This suggests the existance of a special form of BTMD disorder in elderly patients with aortal stenosis.

Evaluation of results of radiotherapy alone vs combined surgery and postoperative radiotherapy in carcinoma external auditory canal-10 years review

Forty-one patients of external auditory canal (EAC) cancer attended the Department of Radiotherapy (RT), Medical College Hospital, Kolkata during the period from 1987 to 1996. Majority were above 50 years of age with slight female preponderance. Out of 41 patients 36 patients completed the full course of treatment of which 12 patients underwent combined modality treatment (RT 50-55 Gy plus surgery) and 24 patients received primary RT alone (55-60 Gy). Radiation therapy was given in standard fractionation schedule. Retrospective analysis revealed complete response in 8/12 (66.7%) in combined modality treatment group and in 3/24 (12.5%) in RT alone group. The actuarial 2 year survival was 19%. following RT alone, 85% following combined modality, 70% in early lesions and 18% in advanced lesions. The study suggests, surgical resection followed by postoperative irradiation is an effective method and better treatment option than RT alone as primary treatment modality for carcinoma of EAC.

A new structural alternative in benzo[b]furans for antimicrobial activity

Two series of 2-substituted and three new diacetyl benzofurans were synthesized through palladium-catalyzed reactions and their in vitro antimicrobial spectra were assessed. The compounds demonstrated mild to significant growth inhibition against antibiotic-susceptible standard and clinically isolated strains of Gram-positive and Gram-negative bacteria as well as human fungal pathogens. Ampicillin and kanamycin were used as references for antibacterial screening; nystatin and amphotericin B were used for antifungal screening. Varying substitution at the benzofuran moiety and subsequent antimicrobial screening identified the C-3-acetyl functionality as a new structural alternative for optimal antimicrobial property in the benzofuran class of compounds.

Neolignan and megastigmane glycosides from the leaves of Pterospermum semisagittatum

Three compounds namely, (7S,8R)-dihydrodehydrodiconiferyl alcohol-9'-O-beta-D-glucopyranoside (1), 10-hydroxy-4,7-megastigmadien-3-one-9-O-beta-D-glucopyranoside (2) and 9-hydroxy-4,7-megastigmadien-3-one-10-O-beta-D-glucopyranoside (3) were isolated from the methanol extract of Pterospermum semisagittatum. The structures of these compounds were elucidated by spectroscopic methods. While glycosides 2 and 3 appear to be new, this is the third report of isolation of compound 1 from any natural source.

Antibacterial activity and cytotoxicity of extractives from Ravenia spectabilis

A methanolic extract of Ravenia spectabilis, an isolated alkaloid, arborinine plus a fraction comprising arborinine and gamma-fagarine (VLC), showed mild to significant in vitro antibacterial activity. In a brine shrimp lethality bioassay, the extract and the fraction were found to exhibit moderate cytotoxicity having LC50 of 76.26 microg/ml and 14.98 microg/ml, respectively.

Cytotoxicity and antibacterial activity of extractives from Wedelia calendulacea

The cytotoxicity and antibacterial activity of petroleum ether, chloroform and methanol extracts of Wedelia calendulacea were assayed by brine shrimp lethality bioassay and standardized disk diffusion method against 19 bacterial strains. Three diterpenes isolated from the plant were also evaluated for in vitro antibacterial activities. The LC50 for the crude extracts against the brine shrimp nauplii were found to be 4.59 microg/ml, 7.99 microg/ml and 14.88 microg/ml, respectively, whereas the positive control, vincristine sulfate showed an LC50 of 0.58 microg/ml. Among the crude extracts and pure compounds tested, (-)-kaur-16-en-19-oic acid isolated from the chloroform extract showed the highest inhibitory activity against most of the bacterial strains with mean zone of inhibition of 10-21 mm at 200 microg/disc.

Analgesic, antiinflammatory and CNS depressant activities of sesquiterpenes and a flavonoid glycoside from Polygonum viscosum

Analgesic, antiinflammatory and CNS depressant activities of four sesquiterpenes, viscosumic acid, viscozulenic acid, viscoazucine and viscoazulone, and a flavonoid glycoside, quercetin-3-O-(6''-feruloyl)-beta-D-galactopyranoside isolated form the aerial parts of Polygonum viscosum (Polygonaceae) have been assessed. All test compounds exhibited CNS depressant activity in open field test, all but viscoazulone showed analgesic activity in Eddy's hot plate test, all sesquiterpenes inhibited acetic acid induced abdominal writhing in mice, and all but viscoazucine and the flavonoid glycoside exhibited mild to moderate antiinflammatory effect on carrageenan induced rat paw edema.

Triterpene constituents from the leaves of Melicope indica

Phytochemical investigation of a petroleum ether extract of Melicope indica afforded two unusual pentacyclic triterpenes viz. neohop-13(18)-en-3alpha-ol (1) and fern-8(9)-en-3beta-ol (2) and the ubiquitous steroids, stigmasterol and sitosterol. The structures of 1 and 2 were independently elucidated on the basis of 2D NMR data and confirmed by comparison with those of related compounds. While compound 1 is a new natural product, this is the first report of occurrence of fern-8(9)-en-3beta-ol (2) from the genus Melicope.

Antimicrobial and cytotoxic constituents of Loranthus globosus

(+)-Catechin, 3,4-dimethoxycinnamyl alcohol and 3,4,5-trimethoxycinnamyl alcohol were isolated from the barks of Loranthus globosus. All compounds showed significant antimicrobial and cytotoxic activities.

Antibacterial activity and cytotoxicity of extractives from Uvaria hamiltonii stem bark

The extracts as well as piperolactum C, goniopedaline, 6beta-hydroxystigmasta-4,22-dien-3-one and a mixture of cis- and trans-4-hydroxymelleins obtained from Uvaria hamiltonii stem bark exhibited mild to moderate in vitro antibacterial activity. The results obtained were compared with a standard antibiotic, kanamycin. In a brine shrimp lethality bioassay the pet-ether, dichloromethane, methanol extracts and a major alkaloid, piperolactum C were found to exhibit mild to moderate cytotoxicity.

Lunamarin C, a new terpenoid coumarin from Clausena heptaphylla

The petroleum ether extract of the leaves of Clausena heptaphylla afforded a new coumarin, lunamarin C (1). Its structure was determined by extensive analysis of spectral data, including 2D NMR and by comparison with structurally related compounds, lunamarins A (2) and B (3).

Absolute stereochemistry and anti-HIV activity of minquartynoic acid, a polyacetylene from Ochanostachys amentacea

Anti-HIV bioassay-guided fractionation of an organic extract of Ochanostachys amentacea provided an HIV-inhibitory polyacetylenic acid. The identity of this compound was established as (-)-17-hydroxy-9,11,13,15-octadecatetraynoic acid (1), also known as minquartynoic acid, by comparison of its physical and spectral data with previously reported values. Analysis of Mosher's ester derivatives of the methyl ester of 1 allowed assignment of S absolute stereochemistry to the lone chiral center. In an in vitro XTT-based anti-HIV assay, 2-5 micrograms/mL of minquartynoic acid (1) effectively inhibited human lymphoblastoid cell killing by HIV-1.

New cytotoxic N-methylated beta-carboline alkaloids from the marine ascidian Eudistoma gilboverde

Bioassay-guided fractionation of an extract of the marine ascidian Eudistoma gilboverde provided three new beta-carboline alkaloids identified as 2-methyleudistomin D (1), 2-methyleudistomin J (2), and 14-methyleudistomidin C (3). Six known metabolites, eudistomins C, D (4), E, J (5), K, and L, were also isolated and characterized. The structures of the new metabolites were elucidated by spectroscopic analyses and by comparison of their spectral data with related literature values. Of the three new compounds, 14-methyleudistomidin C (3) exhibited the most potent cytotoxic activity with IC(50)'s of < 1.0 microg/mL against four different human tumor cell lines.

Chondropsin D, a new 37-membered-ring macrolide lactam from the marine sponge Chondropsis species

Chondropsin D (2), a new 37-membered-ring macrolide lactam, was isolated as a minor constituent of an aqueous extract of the marine sponge Chondropsis sp. This sponge sample had previously been the source of chondropsins A (1) and B, two novel polyketide-derived macrolides with potent cytotoxic activity. The structure of 2 was initially deduced from analysis of spectral data. This assignment was supported by the observation that chondropsin A (1), which contains a 35-membered macrocyclic ring, could be converted to chondropsin D (2) by a base-catalyzed intramolecular transesterification reaction. Rearrangement of the methylated derivative of chondropsin A (3) to the corresponding methylated analogue of chondropsin D (4) confirmed the structure of 2.

A new isoquinoline alkaloid from the marine sponge Haliclona species

Two isoquinoline alkaloids, including the new compound 1, were isolated from the cytotoxic fractions of an aqueous extract of the marine sponge Haliclona sp. The structures of these compounds were established as 1-hydroxymethyl-7-methoxyisoquinolin-6-ol (1) and mimosamycin (2) by conventional spectroscopic methods and by comparison with related compounds. Mimosamycin (2) was the principal cytotoxin with an IC(50) of approximately 10 microg/mL against melanoma and ovarian human tumor cell lines.

Thoracic vascular injuries: a major problem in trauma

OBJECTIVE

We present a review of our experience in the management of thoracic vascular injuries during the past 10 years in one of Sweden's busiest emergency departments, with morbidity and mortality as the main outcome measures.

DESIGN

Of eight patients who sustained chest trauma with thoracic vascular injuries, six presented with shock. Angiography was the gold standard in diagnosing aortic and subclavian injuries.

RESULTS

Lesions of the inferior vena cava, left internal mammary artery, and intercostal vessels were detected only at surgery. Two patients died of exsanguination. Managing thoracic vascular injuries is still difficult and challenging for thoracic and trauma surgeons.

CONCLUSION

Early thoracotomy is important for salvage of patients with chest-wall vascular injury. Despite our limited experience, which is characteristic for Scandinavian and European countries, our results were satisfactory.

Antibacterial activity of Vitex trifolia

The petroleum ether and ethanol extracts of Vitex trifolia leaves exhibited moderate inhibiting activity against both gram-positive and gram-negative bacteria.

Isolation and structure elucidation of viscoazucine, a novel sesquiterpene from Polygonum viscosum

A new sesquiterpene, 1,4-dimethoxycarbonyl-7-(1-methylethyl)- 3,3a,6,7,8,8a-hexahydroazulene (viscoazucine) (1), and a known flavone, 3',5,7-trihydoxy-3,4',5'-trimethoxyflavone (4), have been isolated from Polygonum viscosum. The structures of these compounds were elucidated by spectroscopic analyses, notably UV, MS and NMR.