Pattern of Prescribing Analgesics and Their Response in Cancer Patients Attending Outpatient Department of Palliative Care Service in Two Teaching Hospitals of Bangladesh

Palliative care is a valued aspect of clinical care which is an urgent humanitarian need for people worldwide with cancer and other chronic fatal diseases. Patients experience many different symptoms including severe pain in advanced cancer. Palliative care focuses on relief from symptoms, pain and stress by using different analgesics and adjuvant. The goal of palliative care is to improve the quality of life. So, this prospective observational study was carried out to assess pattern of drugs used and their response to pain in cancer patients attending out-patient department of palliative care service in two teaching hospitals of Bangladesh. One hundred forty (140) cancer patients were purposively selected who attended in out-patient department of palliative care unit in Bangabandhu Sheikh Mujib Medical University (BSMMU) and Dhaka Medical College Hospital (DMCH) from July 2018 to June 2019. Outcome variables were commonly presenting complaints, pain intensity, commonly prescribed drugs and analgesic prescription according to WHO three-step analgesic ladder, etc. The mean age ±SD of the respondents was 51.30±15.38 years, male-female ratio 1:1. Common sites of cancer were alimentary origin (20.0%), genitourinary system (17.86%), hepatobiliary system (11.43%), respiratory system (10.71%). The prescribed drugs were analgesics (96.4%), PPIs (74.3%), laxatives (62.1%), anti-emetics (38.6%), multivitamins (32.9%), H2 antagonists (17.1%), sedatives (17.1%), and corticosteroids (8.6%). Level 1 analgesics (Paracetamol or other NSAIDs) were prescribed to 42.65%, level 2 analgesics (Tramadol) were prescribed to 50.00% patients and level 3 analgesics (Morphine) were prescribed to 51.42% patients. The relation between and receiving three levels of analgesic prescriptions was statistically significant. The association between level of analgesic prescription was significant with site of cancer (p<0.001) and intensity of pain (p<0.001). This study showed that morphine was prescribed to more than half of the patients. Other level of analgesics were also used either single or in combination. Younger and male patients were treated more with level III analgesics. Prescribing analgesics were dependent on sites of cancer and intensity of pain.

Antibacterial Activities of Methanolic Seeds Extract of Black pepper (Piper nigrum L.) against Gram Positive Staphylococcus aureus & Gram-Negative Escherichia coli

Evaluation of the in vitro antibacterial activity of Methanolic extracts isolated from Black pepper seeds (Piper nigrum L.) against two infection causing pathogens, Gram-positive Staphylococcus aureus and Gram-negative Escherichia coli. Between July 2022 and June 2023, this experimental study was conducted at the Mymensingh Medical College's Department of Pharmacology and Therapeutics in conjunction with the Department of Microbiology. Using the disc diffusion and broth dilution methods, the antibacterial activity of methanolic extract of black pepper seeds (MBPE) was evaluated at various doses. The solvents Methanol and 10.0% Di Methyl Sulfoxide (DMSO) were used to make the extract. Using the broth dilution procedure, the conventional antibiotic Ciprofloxacin was utilized and the outcome was contrasted with that of Methanol extracts. Methanolic extract of black pepper seeds (MBPE) at seven distinct concentrations (100, 80, 60, 40, 20, 10 and 5 mg/ml) were utilized, then later in chosen concentrations as needed to confirm the extracts' more precise margin of antimicrobial sensitivity. At 80 mg/ml and above doses of the MBPE, it had an inhibitory impact against the aforementioned microorganisms. For Staphylococcus aureus and Escherichia coli the MIC were 60 and 75 mg/ml in MBPE respectively. As of the MIC of Ciprofloxacin was 1μg/ml against Staphylococcus aureus and Escherichia coli. In comparison to MICs of MBPE for the test organisms, the MIC of Ciprofloxacin was the lowest. This study clearly shows that Staphylococcus aureus and Escherichia coli are sensitive to the methanolic extract of black pepper seeds' antibacterial properties.

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

OBJECTIVE

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

MATERIALS AND METHODS

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

RESULTS

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

CONCLUSIONS

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

Cardiovascular Risk Scoring of Hospitalized Chronic Kidney Disease Patients by Framingham Risk Score

Patients with chronic kidney disease (CKD) are more likely to have complications due to cardiovascular diseases (CVD). This cross sectional descriptive study was conducted in the Department of Medicine and Nephrology, Chittagong Medical College (CMC), Chittagong, Bangladesh from June to December, 2014 and was performed to estimate the risk of cardiovascular events according to Framingham's Risk Score of CKD patients. In this research, 100 patients who was diagnosed as CKD and admitted in the Chittagong Medical College Hospital were enrolled. Estimated glomerular filtration rate (eGFR) was calculated with the MDRD formula. Cardiovascular risk factors were analyzed by Framinghams criteria and after compilation data were analyzed by SPSS-18.0. Among 100 patients, most of patients were under 60 years of age where males (56.0%) were more than females (44.0%). Framingham Cardiovascular Risk Score revealed that most of the male were at high risk group compared to female. Regarding different components of lipid profile with Framingham risk score, higher risk group had high mean total cholesterol (212.17mg/dl) and also low mean HDL level (38.58mg/dl). Patient with different stages of CKD with cardiovascular risk showed stage 5 CKD was 80%, stage 4 was 15.0% and rest 5 was at stage 3 and most were in low risk group (56.0%). There were significant positive correlations found in between age and serum total cholesterol level with the cardiovascular risk scoring but not with HDL and eGFR. The predominant cardiovascular risk factors were age, male gender, smoking and high serum total cholesterol.

Spectrochemical Analysis of Nutritional and Toxic Metals in Different Brands of Candies Using Advanced Diagnostic Approaches

Candies are frequently consumed sweetened food products among children, and their consumption can expose them to potential toxins and contamination. The present study employed calibration-free-laser-induced breakdown spectroscopy (CF-LIBS) as a steadfast diagnostic technique to analyze the presence of nutritional and heavy metals in candies from various brands available in local markets in Haripur, Pakistan. A pulsed Nd-YAG laser was used to create a microplasma on the target surface. The emitted light was collected using a dedicated spectrometer to analyze and quantify the species present in the candies. The analysis revealed the presence of micronutrients, macronutrients, and trace toxic metals such as Ca, K, Mg, Fe, Na, Al, Pb, Cr, Mn, Zn, Cu, and Ni. The optimization of our LIBS system was achieved through a parametric dependence study. The confirmation of the assumption of local thermodynamic equilibrium was achieved by assessing McWhirter's criterion and considering the relaxation time and the diffusion length of atoms in plasma. The highest concentrations (measured in mg/kg) of Pb, Cr, and Mn were determined to be 15 mg/kg, 340 mg/kg, and 880 mg/kg, respectively. The levels of Pb and Cr were found to be well above the maximum accepted limit set by the WHO. Similarly, the concentration of Mn in S-4 and S-5 exceeded the permissible limits set by the WHO. However, Zn, Cu, and Ni were found within safe limits in all the collected samples. In addition, the abundance obtained through CF-LIBS was compared to the concentration of similar (duplicate) candies samples analyzed using a standard analytical technique like inductively coupled plasma-optical emission spectroscopy. Excellent harmony could be seen in both outcomes. Moreover, energy-dispersive X-ray spectroscopy (EDX) was also utilized to confirm the presence of detected toxins. The significance of our findings lies in creating awareness among the public about the health risks associated with consuming toxins through candies, thereby protecting numerous human lives.

Hanging: Commonly Encountered by Forensic Experts at Autopsy

Though human lives have become easier and faster due to rapid twist in urbanization, industrialization and digitalization suicidal tendency among common people are often seen. Hanging is the commonly chosen method to do so. The study was designed to find out the pattern of hanging cases and to discover the immensity of hanging as a method of committing suicide. This retrospective study was done for three years by retrospectively collected data at the department of Forensic Medicine and Toxicology of Chattogram Medical College. A total of 193 cases (6.73%) of hanging were observed among 2850 autopsies done from January 2015 to December 2017. The age group of 31-40 years was mostly affected i.e. in 54(27.97%) followed by 21-30 years 48(24.87%). Males 112(58.03%) out numbered the females 81(41.96%). Clothes 88(45.59%) were mostly used as ligature material followed by jute rope (33.67%) and nylon rope (20.72%). Maximum cases were atypical hanging 160(82.90%), while we observed 33 typical (17.09%) hangings. In 166 cases (86.01%) we observed no injuries to the neck while contusion of the neck in 27 cases (13.99%). This study revealed fracture of the thyroid cartilage in 5 cases (2.59%) and hyoid in 2 cases (1.03%). One hundred & eighty five (185) cases (95.85%) were of suicidal and only 8 cases (4.14%) were of accidental. As per observation of this study, hanging has been found to be a common means of committing suicide in Bangladesh.

Pattern of Prescribing Drugs in Chronic Obstructive Pulmonary Disease in a Tertiary Care Hospital of Bangladesh

Chronic obstructive pulmonary disease (COPD) is a chronic obstructive disease of the airways. It is one of the most common and important chronic respiratory conditions in terms of years lived with disability. Incidence is increasing in Bangladesh like other developing countries. To evaluate drug prescription pattern for COPD, this cross-sectional, observational study was conducted from January to December in 2020 at the Department of Pharmacology in collaboration with the Department of Medicine in Mymensingh Medical College, Bangladesh. A total of 168 patients were selected for the study by non-random purposive sampling technique. Age distribution indicates that 31.5% of patients were in the 50-59 years age group and males were 93.5%. The majority (82.1%) of the participants were smokers. In this study, majority (34.12%) of the drugs were used as oral form and second most common dosage form was nebulization (26.75%). Bronchodilators were mostly prescribed 652(57.19%), followed by corticosteroids 222(19.47%) and antibiotics 165(14.47%) among drugs used for COPD. Beta sympathomimetics 322(45.49%) were mostly prescribed, followed by anticholinergics 186(28.52%) and methylxanthines 144(22.08%) as bronchodilators. Out of 1140 drugs for COPD, 53.06% and 34.12% were delivered as inhalation and oral forms, respectively. Inhalation route was the most (60.37%) preferred one over oral route (37.63%) for steroid use. The most of the patients [152 (90.48%)] were treated with combination therapy. Mostly (39.6%) used Fixed Dose Combination (FDC) therapy was salbutamol and ipratropium bromide followed by salmeteroal and Fluticasone (30.83%). Both FDC were prescribed in 57.7% of study population. Considering nomenclature, trade name was used in 24.4% of prescription.

Health-related quality of life among thalassemia patients in Bangladesh using the SF-36 questionnaire

Thalassemia is one of the most common autosomal recessive hereditary blood disorders worldwide, especially in developing countries, including Bangladesh. Thus, this study aimed to determine HRQoL and its determinants of thalassemia patients (TP) in Bangladesh. A cross-sectional survey was performed on 356 randomly selected thalassemia patients. Participants were invited to face-to-face interviews. Descriptive statistics (frequencies and percentages), independent t-test, ANOVA, and multivariate (linear and logistic regression) analysis was performed to analyze the data. Our demographic data showed that among 356 patients, 54% and 46% were male and female, respectively, with an average age of 19.75 (SD = 8.02) years. Most were transfusion-dependent (91%), 26% had comorbidities, and 52% were from low-income families. In the case of HRQoL, male patients showed significantly higher scores of bodily pains and physical health summaries than female patients. Lower income, high blood transfusion status, disease severity, comorbidities, and medical expenses (p < 0.05; CI 95%) are significantly associated with lower SF-36 scores. This study found an association between lower income, blood transfusion, disease severity, comorbidities, as well as medical expenses, and the deterioration of HRQoL among TP. Male patients experienced poorer HRQoL than females. National action plans are required to guarantee the holistic welfare of thalassemia patients.

Occurrence of new Philometra sp. in mangrove red snapper Lutjanus argentimaculatus from the Karachi coast, Pakistan

A recent examination of Philometra nematodes from mangrove red snapper Lutjanus argentimaculatus (Forsskal, 1775) from the Karachi coast, Kemari was done in the years 2021-2022. The present study reported three new species of genus Philometra (Costa, 1845) (Nematoda: Philometridae) Philometra kolachii, Philometra lutjani and Philometra kemarii. A total of 140 fish samples were examined, and 76 were infected. The intensity of infected fish was 54.28%. In Pakistan, literature on Philometrid nematodes is limited, therefore, this research would be helpful for the documentation and enhancement of nematods in Pakistan.

Estimation and Quantification of Toxic Metals in Hugely Consumed Chicken Livers by Advanced Diagnostic Approaches

Contamination of toxins in chicken's liver is a serious concern for human health owing to related threats of cytotoxicity and general pathologies after their digestion. The quantitative investigations were accomplished by calibration curves plotted for all the detected toxins via typical samples arranged in the known concentrations in the chicken liver's matrix. The chicken liver samples were collected from the Khyber Pakhtunkhwa province of Pakistan and found to contain heavy metals like Cu, Mn, Ni, Pb, and Zn. The analytical estimations were performed under the suppositions of local thermodynamic equilibrium (LTE) in terms of optical thin plasma. The maximum concentrations (parts per million) of Cu, Mn, Ni, Pb, and Zn were as 2.87 ± 0.02 ppm, 7.80 ± 0.13 ppm, 2.84 ± 0.02 ppm, 4.00 ± 0.08, and 83.5 ± 2.10 ppm respectively. Abundance of Cu, and Pb was found considerably beyond the maximum accepted boundary of WHO. Likewise, the level of Ni exceeded the permitted bounds of WHO in samples 01 and 02. To validate our laser-induced breakdown spectroscopy investigation, we approximated the abundance of identical (duplicate) chicken livers through digesting the specimens in suitable solvents by a typical technique such as inductively coupled plasma/optical emission spectrometry (ICP/OES) and the results acquired were in outstanding harmony. Furthermore, the existence of detected toxins was also checked using energy dispersive X-ray spectroscopy (EDX). It is worth stating that larger amounts of Cu, Ni, and Pb in poultry may cause a severe hazard to customers which required security actions and precautions. Our findings are extremely important to make an awareness among the people due to associated health hazards after the digestion of toxins through chicken liver and to protect numerous human lives.

Ultra-sculpturing of seed morphotypes in selected species of genus Salvia L. and their taxonomic significance

The taxonomic importance of macromorphological and micromorphological seed characteristics was investigated using SEM of ten species of the Salvia genus from Pakistan. The aim was to identify diagnostic seed ultrastructural features that could aid in species delimitation, correct identification and phylogenetic position. The ultrastructure of Salvia varies greatly, and a wide range of unique micromorphological features have been observed. Seed micromorphological features were explored by SEM, including seed shape, colour, texture, cell outline, surface sculpturing, epidermal cell arrangement, anticlinal, and periclinal wall pattern. Seed shapes were categorized as obovate, spherical, spheroid, broadly elliptic, elliptic and oblong, mostly with a terminal hilum. Seed colours were black, light brown, dark brown, brown and yellow. Exo-morphological characters, i.e. epidermal cell arrangements, included irregular, wavy pentagonal-hexagonal, regular pentagonal-hexagonal. Cluster analysis was used to assess similar and distinct species within Salvia with a feasible explanation. Taxonomic keys were made based on micromorphological qualitative features that help to delimit species and identify them quickly within the Salvia genus. Seed morphology of ten Salvia species was described and investigated, and the diagnostic significance of features evaluated using SEM. This study analysed seed features, especially at the species level, which might provide much new taxonomic information. The results revealed that, in seed morphology, using SEM can help with taxon identification, especially at the genus and species levels.

Safety of maintaining elective and emergency surgery during the COVID-19 pandemic with the introduction of a Protected Elective Surgical Unit (PESU): A cross-specialty evaluation of 30-day outcomes in 9,925 patients undergoing surgery in a University Health Board

Background

The COVID-19 pandemic has caused unprecedented health care challenges mandating surgical service reconfiguration. Within our hospital, emergency and elective streams were separated and self-contained Protected Elective Surgical Units were developed to mitigate against infection-related morbidity. Aims of this study were to determine the risk of COVID-19 transmission and mortality and whether the development of Protected Elective Surgical Units can result in significant reduction in risk.

Methods

A retrospective observational study of consecutive patients from 18 specialties undergoing elective or emergency surgery under general, spinal, or epidural anaesthetic over a 12-month study period was undertaken. Primary outcome measures were 30-day postoperative COVID-19 transmission rate and mortality. Secondary adjusted analyses were performed to ascertain hospital and Protected Elective Surgical Unit transmission rates.

Results

Between 15 March 2020 and 14 March 2021, 9,925 patients underwent surgery: 6,464 (65.1%) elective, 5,116 (51.5%) female, and median age 57 (39–70). A total of 69.5% of all procedures were performed in Protected Elective Surgical Units. Overall, 30-day postoperative COVID-19 transmission was 2.8% (3.4% emergency vs 1.2% elective P < .001). Protected Elective Surgical Unit postoperative transmission was significantly lower than non–Protected Elective Surgical Unit (0.42% vs 3.2% P < .001), with an adjusted likely in-hospital Protected Elective Surgical Unit transmission of 0.04%. The 30-day all-cause mortality was 1.7% and was 14.6% in COVID-19–positive patients. COVID-19 infection, age > 70, male sex, American Society of Anesthesiologists grade > 2, and emergency surgery were all independently associated with mortality.

Conclusion

This study has demonstrated that Protected Elective Surgical Units can facilitate high-volume elective surgical services throughout peaks of the COVID-19 pandemic while minimising viral transmission and mortality. However, mortality risk associated with perioperative COVID-19 infection remains high.

Antibacterial Effect of Moringa (Moringa oleifera) Leaf Ethanolic Extract Against Staphylococcus aureus and Escherichia coli

Increasing resistance of pathogenic microorganisms to synthetic antibiotics has lead to the search for alternative drug sources. In this regard, one of the reputed Medicinal plant, Moringa (Moringa oleifera) was investigated for potential antimicrobial effect against some commonly encountered bacteria such as Staphylococcus aureus, Escherichia coli. This experimental study was conducted from July 2019 to June 2020 in the Department of Pharmacology and Therapeutics in collaboration with the Department of Microbiology, Mymensingh Medical College, Bangladesh to determine the antibacterial effect of Ethanolic extract of Moringa oleifera leaf (EMLE) against aforementioned bacteria. The antibacterial activity was tested at different concentrations (100, 200, 400, 600, 800 and 1000μg/ml) of Ethanolic extract by using disc diffusion and broth dilution method. Dose dependent inhibitory effect was seen against the test organisms using disc diffusion method. The maximum zone of inhibition was 19 mm against S. aureus and 20mm against E. coli at 100.0% (1000μg/ml) concentration. The minimum inhibitory concentrations (MICs) of EMLE were 400μg/ml and 500μg/ml against Staphylococcus aureus and Escherichia coli respectively. The present study showed that Ethanolic extract of Moringa leaf demonstrated antibacterial effects against food borne pathogens. Further studies are required to detect and isolate the active ingredients present in the Moringa leaves extract responsible for its antibacterial effect.

Clinical and Haematological Findings in Dengue Fever

From 2000 onwards dengue fever has been occurring at regular intervals in Bangladesh. Ultrasonography is a useful diagnostic procedure. This study was done, keeping this background in mind. Objective of this study was to identify the role of ultrasonography as a useful tool in early diagnosis of dengue haemorrhagic fever. This was a cross-sectional descriptive type of observational study. Results of ultrasonography, haematogy an immunology were observed in 2004 and 2019 in 32 patients on each occasion. In 2004 out of 32 patients 29 had positive ultrsonographic findings supported by corresponding haematological and immunological findings. In 2019 ultrsonography was done in three out of thirty two patients, all three had had positive ultra sonographic findings which were supported by haematological and immunological findings. Dengue fever has serious complications like plasma leakage which manifest in the form of ascites, pleural effusion, thick gallbladder wall etc. If such complications can be detected at an early stage many lives can be saved.

Comparative Effect of Losartan and Atenolol on Heart Rate Variability in Untreated Essential Hypertensive Patients by Power Spectral Analysis

Autonomic balance in untreated essential hypertension is altered and antihypertensive drugs may improve autonomic balance. Losartan and atenolol is drug of choice to treat essential hypertension. Power spectral analysis of Heart Rate Variability (HRV) is a tool for detecting autonomic balance. This study aimed to compare the effect of losartan and atenolol on autonomic balance in essential hypertensive patients. This longitudinal study was conducted in the Department of Physiology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from July 2012 to June 2013. For this study, 120 diagnosed male hypertensive patients without any treatment (age 30-55 years) were selected from the Out Patients Department of Cardiology, BSMMU, Dhaka on their first day of visit. Sixty apparently healthy normotensive male subjects with similar age were also studied as control. Patients were divided into two equal groups. Sixty (60) patients received 50 mg losartan (oral) and 60 patients received 50 mg atenolol (oral) daily. Autonomic balance was assessed by power spectral analysis of HRV and HRV data were recorded by a polyrite D. HRV data of the patients were measured at baseline, after 3 months and 6 months of medication and data of control were recorded at baseline. For statistical analysis ANOVA, independent sample 't' test and paired sample 't' were performed. High frequency normalized units (HF n.u), total power (TP) were significantly lower (p<0.001) and low frequency normalized unit (LF n.u), LF/HF ratio were significantly higher (p<0.001) in all patients before treatment compared to control. In both drug groups HF n.u and total power were found significantly higher (p<0.001) whereas LF n.u and LF/HF ratio were found significantly lower (p<0.001) after 3 months of treatment compared to their baseline values. After 6 months of treatment, data demonstrated significant further increase (p<0.001) in HF n.u and total power compared to their values after 3 months of treatment. Again these values were found significantly higher in atenolol treated patients compared to losartan group at the end of 6 months of treatment. These result concluded that cardiac autonomic nerve functions may be impaired in essential hypertensive patients before treatment which may improve by treatment with both drugs but the effect is more pronounced in atenolol treatment after longer duration.

Silent Sinus Syndrome: A Case Report

To describe a case of silent sinus syndrome in the perspective of imaging studies, on 2 January 2020 we present this case of a 26-year-old Bangladeshi man with unilateral right facial asymmetry and no sino-nasal symptoms. He was referred to the Ophthalmology Department with complain of right palpebral ptosis and facial asymmetry for 7 months. On physical examination, painless enophthalmos and hypo globus of the right eye was seen. The computed tomography scan of the paranasal air sinuses showed opacification of the right maxillary sinus along with retraction of the walls of the sinus. Regardless of the clinical doubt, the conclusion can only be given by imaging studies, radiologist play a key role here.

Students’ perception, knowledge, attitude and behaviour towards halal food products in Malaysia

The perception, knowledge, attitude, and behaviour of Muslims are important in determining their purchasing behaviour of halal food products. This study exclusively focused on the purchasing behaviour of young Muslim university students who live independently and hold their purchasing power. The main objective of this study is to investigate the perception, knowledge, attitude, and behaviour of university students towards halal food products in Malaysia. This study has adopted the framework based on Ajzen’s Theory of Planned Behaviour (TPB) that hypothesized three determinants of behavioural intention; attitude, subjective norms and perceived behavioural control with the addition of two other variables; religiosity and ambience. This study has found that all the TPB determinants attitude (r = 0.187, p<0.05), subjective norms (r = 0.266, p<0.01), perceived behavioural control (r = 0.336, p<0.01) including the other two additional; religiosity (r = 0.245, p<0.245) and ambience (r = 0.254, p<0.01) were positively and significantly associated with purchasing intention of halal food products among the students. This study also revealed that families and media play an important role in introducing halal food products to these young consumers. Therefore, it was suggested that the authorities create a positive social norm on halal products among society

276 Safety of Maintaining Elective and Emergency Surgery During the COVID-19 Pandemic with the Introduction of an Innovative Protected Elective Surgical Unit (PESU): A Cross-Specialty Evaluation of 30-Day Outcomes in 9925 Patients Undergoing Surgery in a University Health Board

Aim

High quality mobile health applications (mhealth apps) have the potential to enhance the prevention, diagnosis, and treatment of burns. The primary aim of this study was to evaluate whether the quality of mhealth apps for burns care is being adequately assessed. The secondary aim was to determine whether these apps meet UK regulatory standards.

Method

We searched AMED, BNI, CINAHL, Cochrane library, Embase, Emcare, Medline and PsychInfo to identify studies assessing mhealth app quality for burns. The PRISMA reporting guideline was adhered to. Two independent reviewers screened s to identify relevant studies. We analysed whether seven established domains of mhealth app quality were assessed: design, information/content, usability, functionality, ethical issues, security/privacy, and user-perceived value.

Results

Of the 28 included studies, none assessed all seven domains of quality. Design was assessed in 4/28 studies; information/content in 26/28 studies; usability in 12/28 studies; functionality in 10/28 studies; ethical issues were never assessed in any studies; security/privacy was not assessed; subjective assessment was made in 9/28 studies. 17/28 studies included apps that met the definition of ‘medical device’ according to MHRA guidance, yet only one app was appropriately certified with the UK Conformity Assessed (UKCA) mark.

Conclusions

The quality of mHealth apps for burns are not being adequately assessed. The majority of apps should be considered medical devices according to UK standards, but only one was appropriately certified. Regulatory bodies should support mhealth app developers, so as to improve quality control whilst simultaneously fostering innovation.

Fatty acid profile variations after exposure to textile industry effluents in Indian Major Carps

Indian major carps are the widely consumed fish species of Pakistan, being a cheap source of proteins and unsaturated fatty acids, they are good for cardiovascular health. Water pollution due to discharge of untreated industrial waste water into water bodies contaminates this precious source of nutrients. The present study therefore, was aimed to assess deterioration of fatty acid profile of three Indian major carp species due to different concentrations of industrial wastes. The water samples were collected from the river Chenab at the site where it receives industrial wastewater via Chakbandi drain. After exposure to 1.5%, 3.0%, and 4.5% dilutions of collected water in different aquaria it was observed that proportion of unsaturated fatty acids in selected fish species were decreased significantly as the intensity of the dose increased (P < 0.05). Conversely the level of saturated fatty acids increased with the increasing dose of treatment (P < 0.05). These findings suggest that untreated wastewater not only deteriorate the fatty acid profile of aquatic animals but also these toxic substances can reach human body through fish meat and pose further health hazards. Therefore, it is highly recommended that industrial effluents should be treated before they are dumped into water bodies.

Development of laser induced breakdown spectroscopy technique to study irrigation water quality impact on nutrients and toxic elements distribution in cultivated soil

This study is focused mainly on impact of irrigation water quality in cultivated soil on distribution of essentials nutrients (Al, Mg, Ca, Fe, S, Si, Na, P, and K) and relatively toxic metals (As, Ba, Cr, Cu, Ti, Sn, Mn, Ni, and Zn) using an elegant Laser induced breakdown spectroscopy (LIBS) technique. A pulsed Nd:YAG laser operating at 1064 nm in conjunction with suitable detector was applied to record soil emission spectra. The abundance of these elements were evaluated via standard calibration curve Laser Induced Breakdown Spectroscopy (CC-LIBS) and calibration free Laser Induced Breakdown Spectroscopy (CF-LIBS) approaches. Quantitative analyses were accomplished under conjecture of local thermodynamic equilibrium (L.T.E) and optically thin plasma. The average electron temperatures were estimated by Boltzmann plot method for cultivated soil samples in 7800 to 9300 K range. The electron number density was ~ 1.11 × 1017 cm − 3 to 1.60 × 1017 cm − 3. Prior to application on soil samples, the experimental setup was optimized at the following parameters: pulsed energy = 60 mJpulse-1, sample to lens distance of 9.0 cm, and the gate delay of 3.5 μs. It is noteworthy that nutritional elements content of cultivated soils were found strongly dependent upon the irrigation water quality. The cultivated soil from industrial area was found rich of toxins while the cultivated land using tube well water contains toxins in least amount. Our LIBS findings were also validated by comparing its results with contents measured using a standard inductively coupled plasma optical emission spectroscopy (ICP-OES) method and both were found in excellent agreement. The present study could be highly beneficial for agricultural applications and for farmers to produce safe food products and higher crops yield.

Comparison of Polybrene DAT and Conventional DAT in Cases of Suspected DAT Negative Autoimmune Hemolytic Anemia (AIHA)

Introduction/Objective

A negative Direct Antiglobulin Test (DAT) is seen in approximately 1-5% of patients presenting with signs and symptoms of immune hemolysis. A well-performed ‘standard’ DAT detects ~100-500 molecules of bound IgG per red cell. A more sensitive polybrene DAT may be helpful in order to confirm a diagnosis of AIHA in patients whose samples have tested negative via standard DAT. However, there has been little reported on utility of the polybrene DAT in evaluating such cases with modern DAT reagents. We hypothesized that the polybrene DAT would not contribute substantially to the analysis of Coombs-negative hemolytic anemia (C-NHA), based primarily on our anecdotal observation. As such, we undertook a study to assess results of polybrene DAT in cases evaluated for possible (C-NHA).

Methods/Case Report

Two study sites were used for data analysis (Yale-New Haven Hospital, Site A, and VA Connecticut, Site B) over a five year period (2016-2021). During this time, standard DATs were performed at both study sites by the tube method using polyspecific antiglobulin and, if positive, reflex to anti-IgG and -C3. For cases of suspected C-NHA (which are reported to Blood Bank via a consult mechanism), conventioned DAT- samples are referred to our regional immunohematology laboratory (American Red Cross, Farmington, CT) for manual hexadimethrine bromide (Polybrene) DAT. Polybrene DAT is reported as negative with two sources of polyspecific AHG. Subsets of patients also underwent acid elution studies (Gamma ELU-KITII) as part of a C-NHA algorithm developed during the study period. Results of standard DAT, acId elution, and polybrene DAT were extracted from Blood Bank electronic records at both study sites.

Results (if a Case Study enter NA)

Evaluation for C-NHA was performed in 32 patients/cases over the study period. Amongst these individuals, 96.8% (31/32) underwent polybrene DAT assessment and none (0%; 0/31) demonstrated a positive polybrene DAT result. Notably, acid elution studies were performed in 90.6% (29/32) of traditional DAT negative cases. Of these, 10.3% (3/29) had reactive eluates.

Conclusion

Performance of the polybrene DAT appeared to be of no value in the assessment of suspected C-NHA. Given that nearly 10% of individuals with a negative conventional DAT had a positive acid elution, this testing step appears to be of greater value in potentially identifying an autoantibody in suspected cases of C-NHA.

Histopathological alterations in gills, liver, kidney and muscles of Ictalurus punctatus collected from pollutes areas of River

Abstract Untreated sewage and industrial wastes from Faisalabad city are disposed to River Chenab through Chakbandi Main Drain (CMD). The present project is planned to investigate the effects of this freshwater pollution on the body of fish Ictalurus punctatus. The specimens of this fish species were collected upstream and downstream of the entrance of CMD into River Chenab. Fish gills, liver, kidney and muscles from dorsolateral regions of fish were subjected to histopathology. Farmed fish and fish from upstream areas were used as control. Fish collected from polluted experimental sites showed significant damage in selected organs. Gill tissues showed an abnormality in the form of an uplifting of the primary epithelium, fusion, vacuolation, hypertrophy, and necrosis. While liver tissues subjected to hepatocytes degeneration, necrosis, mitochondrial granular hepatocyte, and sinusoids dilation. Kidney tissues indicated increased bowmen space and constricted glomerulus and degenerated nephrons. Edema, necrosis, and atrophy were observed in muscle tissues of fish from polluted areas. Fish from the upstream area showed fused gill lamellae, inflammatory cell infiltration, hypertrophy and vacuolation in hepatocytes. Kidney tissues indicated the presence of nuclear tubular cells, destructive renal tubules, hemorrhage, and necrosis at tubular epithelium. Intra myofibril spaces were also observed in muscles. Specimens of control fish indicated no variation in gills, liver, kidney, and muscles. The present study revealed a strong correlation between the degree of tissue damage and environmental contamination. Present findings also compel global warnings to protect our water bodies and fish to rescue the human population.

Molecular Phylogenetics of Physa acuta (Pulmonata: Basommatophora): an Invasive species in Central Punjab Pakistan

Physids belong to Class Gastropoda; belong to Phylum Mollusca and being bioindicators, intermediate hosts of parasites and pests hold a key position in the ecosystem. There are three species of Genus Physa i.e. P. fontinalis, Physa acuta and P. gyrina water bodies of Central Punjab and were characterized on the basis of molecular markers High level of genetic diversity was revealed by polymorphic RAPD, however SSR markers were not amplified. The multivariate analysis revealed polymorphism ranging from 9.09 percent to 50 percent among the three Physid species. Total number of 79 loci were observed for the three species under study and 24 loci were observed to be polymorphic. These RAPD fragment(s) can be developed into co dominant markers (SCAR) by cloning and can be further sequenced for the development of the Physa species specific markers to identify the introduced and native species in Pakistan.

Characterization of the species of genus Physa on the basis of typological species concept from Central Punjab

Physids belong to Class Gastropoda; Phylum Mollusca have important position in food web and act as bio indicators, pests and intermediate host. Being resistant these are called cockroaches of malacology. Physid snails were collected from different water bodies of Faisalabad (Punjab) and were identified up to species using morphological markers. The morphometry of the specimens was carried out with the help of a digital Vernier caliper in millimeters (mm) using linear measurement of shell characters. Linear regression analysis of the AL/SW ratio vs AL and SL/SW ratio vs AL indicated that allometric growth exists only in Physa acuta when compared with P.gyrina and P. fontinalis. This study will lead to assess the status of the Physid species in Central Punjab. The Principal component analysis shows that the Component 1 (Shell Length) and component 2 (Shell Width) are the most prolific components and nearly 80 percent of the identification. The distance between P. acuta and P. fontinalis is 5.4699, P. acuta and P. gyrina is 7.6411, P. fontinalis and P. gyrina is 16.6080 showing that P. acuta resembles with P. fontinalis, and both these specimens donot resemble with P. gyrina. P.acuta is an invasive species and shows bioactivity making it a potent candidate for bioactive substances.

Amelioration of N,N'-dimethylhydrazine induced colon toxicity by epigallocatechin gallate in Wistar rats

Colon cancer is a life-threatening disease all over the world and is linked to constant oxidative stress and inflammation. Epigallocatechin gallate (EGCG), is a naturally occurring flavone possessing health benefiting pharmacological properties including antioxidant, anti-inflammatory and free radical scavenging properties. Our study investigates the role of EGCG on N,N'-dimethylhydrazine (DMH), a toxic environmental pollutant, induced colon toxicity. To investigate the effect of EGCG, Wistar rats were given EGCG for 7 days at the two doses of 10 and 20 mg/kg body weight and DMH was injected on the seventh day in all the group rats except the control. Our results indicate that DMH administration increased the oxidative stress (MDA) and depleted the glutathione and antioxidant enzyme activities (SOD, CAT, GR, GST and GPx) which was significantly ameliorated by EGCG treatment. Additionally DMH treatment upregulated inflammatory markers expression (NF-κB, COX-2 and IL-6) and enhanced mucosal damage in the colon. EGCG treatment significantly reduced inflammation and restored the normal histoarchitecture of the colon. We can conclude from the present study findings that EGCG protects the colon from DMH toxicity through its antioxidant and anti-inflammatory potential.

Proximate composition analysis of chicken burgers from night market stalls and selected fast-food restaurants

This study was aimed to determine and compare the proximate composition of chicken burgers from night market stalls and selected fast-food restaurants. The methods used for determination of proximate composition were AOAC Official Methods 973.48, 960.39, 991.43, 990.19 and 999.11 for protein, fat, fibre, moisture and ash, respectively except total available carbohydrate. The energy content of all samples was calculated based on 4, 4 and 9 kcal/100 g for carbohydrate, protein and fat, respectively. The protein content of burger samples from fast-food restaurant ranged 14.48-18.6%, whereas the samples from night market stalls had protein content ranged 13.26%-19%. Fat contents of burger samples from fast-food restaurant and night market stalls were 18.57-19.11% and 26.33- 28.0%, respectively. There were statistically significant differences (p<0.05) in the percentage of insoluble dietary fibre, but no significant differences were found for soluble and total dietary fibres in the burger samples between night market stalls and the restaurants. Night-stall burger samples had higher fibre content (0.14-0.20%) than the fastfood restaurant samples which ranged 0.11-0.16%. Burger samples from the fast-food restaurant had higher carbohydrate content ranged between 17.77% and 18.55% compared to night stall samples (7.70-8.94%). Also, the energy content of all burger samples ranged 296–360 kcal. There were significant differences for the protein, fat, carbohydrate, energy and ash content of the burger samples between night market stalls and fast-food restaurants but not for moisture and fibre content. The findings indicated that the nutritional composition of burger samples varied among different locations where a variation in preparation method was observed

Frequency of three mutations in the fumonisin biosynthetic gene cluster of Fusarium fujikuroi that are predicted to block fumonisin production

Fusarium fujikuroi is the most prominent pathogen found in rice. In addition to gibberellin, F. fujikuroi produces various secondary metabolites, including the polyketide mycotoxins, fumonisins. Fumonisin production is conferred by the fumonisin biosynthetic gene (FUM) cluster consisting of 15-17 genes. F. fujikuroi is phylogenetically subclassified into one group with fumonisin production (F-group) and another group in which fumonisin production is undetectable (G-group). In a previous study, a G-to-T substitution (FUM21_G2551T) in the FUM cluster transcription factor gene, FUM21, was identified as a cause of fumonisin-non-production in a G-group strain. In the current study, further analysis of G-group strains identified two additional mutations that involved FUM-cluster genes essential for fumonisin production: (1) a 22.4-kbp deletion in the FUM10-FUM19 region; and (2) a 1.4-kbp insertion in FUM6. PCR analysis of 44 G-group strains, indicated that 84% had the FUM21_G2551T mutation, 50% had the 22.4-kbp FUM10-FUM19 deletion, and 32% had the 1.4-kbp insertion in FUM6, and some strains had two or all the mutations. None of the mutations were detected in the 51 F-group strains examined. Each of the three mutations alone could account for the lack of fumonisin production in G-group strains. However, one G-group strain did not have any of the mutations. Therefore, another mutation(s) is likely responsible for the lack of fumonisin production in some G-group strains of F. fujikuroi.

Production of high quality biodiesel from novel non-edible Raphnus raphanistrum L. seed oil using copper modified montmorillonite clay catalyst

This study focused on producing high quality and yield of biodiesel from novel non-edible seed oil of abundantly available wild Raphnus raphanistrum L. using an efficient, recyclable and eco-friendly copper modified montmorillonite (MMT) clay catalyst. The maximum biodiesel yield of 83% was obtained by base catalyzed transesterification process under optimum operating conditions of methanol to oil ratio of 15:1, reaction temperature of 150 °C, reaction time of 5 h and catalyst loading of 3.5%. The synthesized catalyst and biodiesel were characterized for their structural features and chemical compositions using various state-of-the-art techniques, including x-ray diffraction, scanning electron microscopy, energy dispersive x-ray spectroscopy, Fourier transform infrared spectroscopy, nuclear magnetic resonance (¹H, ¹³C) and gas chromatography-mass spectroscopy. The fuel properties of the biodiesel were estimated including kinematic viscosity (4.36 cSt), density (0.8312 kg/L), flash point (72 °C), acid value (0.172 mgKOH/g) and sulphur content (0.0002 wt.%). These properties were compared and found in good agreement with the International Biodiesel Standards of American (ASTM-951, 6751), European Committee (EN-14214) and China GB/T 20828 (2007). The catalyst was re-used in five consecutive transesterification reactions without losing much catalytic efficiency. Overall, non-edible Raphnus raphanistrum L.. seed oil and Cu doped MMT clay catalyst appeared to be highly active, stable, and cheap contenders for future biofuel industry. However, detailed life cycle assessment (LCA) studies of Raphnus raphanistrum L. seed oil biodiesel are highly recommended to assess the technical, ecological, social and economic challenges.

Nutritional and toxic elemental analysis of dry fruits using laser induced breakdown spectroscopy (LIBS) and inductively coupled plasma atomic emission spectrometry (ICP-AES)

Quantitative investigation of essential and trace heavy elements present in health-beneficial dry fruits (Pistachio, Almonds, Black walnut, White walnut, and Cashew) was investigated using Laser Induced Breakdown Spectroscopy. For an accurate elemental exposure using LIBS technique, the local thermo-dynamical equilibrium of the laser induced plasma was established and verified using McWhirter criterion based on the electron number density in the plasma. Earlier to engage, our LIBS detector was optimized. For quantification of elements, standard calibration curves (CC)-LIBS method was applied. Using our LIBS system, the nutritional elements such as Al, Mg, Ca, Fe, K, Zn, and Na and toxins like Pb, Cr, and Cu were detected in dry fruits. The elemental quantification of dry fruit contents were validated using standard (ICP-AES) method and the relative accuracy of our experimental setup in comparison to ICP approach was in the ranging from 0.1 to 0.3 at 2.5-% error confidence.

Detection of nutritional and toxic elements in Pakistani pepper powders using laser induced breakdown spectroscopy

In the current study, we applied laser induced breakdown spectroscopy (LIBS) to determine the elemental distribution of nutritional and trace heavy metals in pepper powders available in Pakistan using the standard calibration curve of laser induced breakdown spectroscopic (CC-LIBS) technique. The samples were found to contain elements such as K, Ca, Mg, Na, Fe, Zn, Al, Pb, Cu, and Cr. In addition, we also identified the atmospheric H-alpha line of hydrogen in the spectra, which was used to estimate the electron number density. To achieve a highly sensitive LIBS system to determine the trace amounts of nutritional and toxic metals in the pepper powders and to achieve the best limit of detection, the LIBS system was optimized by studying the dependency of the LIBS signal intensity on laser irradiance, variation in spacing between the focusing lens and target, as well as on the gate width. To justify the results of the LIBS study, we also determined the concentration of similar (duplicate) peppers by digesting the samples in appropriate solvents using a standard method such as inductively coupled plasma-optical emission spectrometry (ICP-OES). The minimum detection limit was obtained for trace heavy metals from the calibration curves. The results of LIBS displayed noteworthy conformity with those acquired from the ICP-OES analysis. The results of both the techniques clearly revealed that K was the most abundant element in all the peppers, followed by Ca, Mg, Na, Fe, Al, Pb, Zn, Cu, and Cr. The relative accuracy of our LIBS system for different species as compared with the ICP technique was in the range of 0.08-0.3 at 2.5% error confidence. Conclusively, the present work demonstrated the suitability of the LIBS technique due to its rapid, non-destructive, and eco-friendly approach for food security.

In Vitro Antibacterial Activity of Ethanol Extracts of Cinnamomum zeylanicum against Pseudomonas aeruginosa

Cinnamomum zeylanicum as medicinal plants are measured as new resources for preparing elements in the treatment of antibiotic-resistant microbes as alternatives to antibiotics. This study was aimed to evaluate the antibacterial activity of ethanol extracts of Cinnamomum zeylanicum against a Gram-negative bacteria Pseudomonas aeruginosa. This experimental study was carried out in the department of Pharmacology & Therapeutics and department of Microbiology, Mymensingh Medical College, Mymensingh, Bangladesh from July 2017 to July 2018. Evaluation of the in vitro antibacterial activity of ethanol extracts of Cinnamomum zeylanicum against Pseudomonas aeruginosa was performed by disc diffusion method. And also in this study we used broth dilution method to determine the minimum inhibitory concentration (MIC). Ethanol cinnamon extract (ECE) was found active against P. aeruginosa. Zone of inhibition (ZOI) ranged between 6-25mm at different concentration of extracts. The MIC was 0.3g/ml. Cinnamomum zeylanicum showed strong antibacterial activity against a Gram-negative bacteria Pseudomonas aeruginosa. The results may contribute to the development of potential antimicrobial agents for inclusion in antipseudomonal regimens.

Salt Intake Behaviors among Type 2 Diabetic Patients of a Tertiary Level Hospital in Dhaka City

Hypertension and diabetes co-exist frequently. Therefore, salt intake behavior, a risk factor of hypertension, in diabetic patients plays an important role in determining their cardiovascular outcome. The purpose of this study was to assess the knowledge and behaviors of health risks associated with a salt intake in adults with type 2 diabetes. This cross-sectional study was conducted among the type 2 diabetic in-patients of Bangladesh Institute of Health Sciences General Hospital, Dhaka, Bangladesh from October to December 2016. Data were collected from 131 respondents through interview using WHO STEPS module of salt with adaptation to local context like on amount of added salt while taking meal. Information on blood pressure, body mass index and relevant co-morbidities were also collected. About half of the respondents were women (56.5%). Mean age of the respondents was 54.3±14.4 years. More than six in 10 of them (62.6%) took added salt while taking meal; and 40.5% took processed foods with high salt. The mean amount of added salt intake among the users was 4.4±1.6gm per day having no significant difference between men and women. Though 47.3% of the respondents believed that lowering salt in meal is very important and 77.9% of them believed that excess salt or salty sauce can cause health problems. Salt intake behavior is poor in patients with type 2 diabetes even having regular contacts with doctors and other health professionals. Appropriate measures can be taken to increase awareness, change their attitude and behavior regarding salt consumption.

Protective role of diosmin against testosterone propionate-induced prostatic hyperplasia in Wistar rats: Plausible role of oxidative stress and inflammation

Benign prostatic hyperplasia (BPH) is an important key health concern for aging men. Polyphenolic compounds have been found to possess important roles in the inhibition of numerous ailments that involve reactive oxygen species and inflammation. Diosmin is a citrus flavone that possesses antioxidant, anti-inflammatory, antiproliferative, and anticancer activities, so based on these properties of diosmin, we decided to evaluate its effect on testosterone propionate (TP)-induced BPH. A total of 30 Wistar rats were randomly assigned to five groups having six animals in each. This study was of 28 days in which TP (5 mg kg−1) was administered to induce BPH in the last 10 days of the study. It was found that diosmin at the doses of 20 and 40 mg kg−1significantly reduced malondialdehyde and xanthine oxidase formation in a dose-dependent manner; however, it replenished catalase, glutathione (GSH), and GSH-dependent enzymes, that is, glutathione peroxidase, glutathione reductase, and glutathione- S-transferase significantly against TP-induced BPH. Further, immunohistochemical study showed that diosmin alleviated inflammatory markers (nuclear factor kappa-light-chain-enhancer of activated B cells, cyclooxygenase-2, and interleukin-6). It was also found that diosmin downregulated the expression of androgen receptor and decreased the prostate-specific antigen concentration dose-dependently, significantly against TP-induced BPH. Diosmin also restored histoarchitecture of the prostate in a dose-dependent manner. Findings from the present study revealed the protective role of diosmin against TP-induced BPH in Wistar rats.

Assessment of heavy metals and its impact on DNA fragmentation in different fish species

This study was conducted to assess water pollution by examining DNA fragmentation in selected fish organs (kidney, liver, gills, and muscle tissue) from Wallago attu, Sperata sarwari, Vulgaris vulgaris, and Labeo rohita collected from a known polluted section of the Chenab River, Pakistan, and from a control site. The fish were caught using a gill net and were assigned to three different weight groups (W1, W2, and W3) to study the degree of variation in DNA fragmentation in relation to body weight. In fish from the polluted site, DNA fragmentation was higher in kidney, liver, gills, and muscles, compared to the control. No significant DNA fragmentation was observed in fish collected from the control site. Highly significant (P < 0.01) relationship between body weight and DNA fragmentation was found in the organs of fish procured at the contaminated site. DNA fragmentation in body organs was found to be affected by the concentrations of lead, copper, nickel, and cadmium in W. attu, S. sarwari, L. rohita, and V. vulgarus harvested from Chenab River. DNA fragmentation in different freshwater fish species is therefore a reliable biomarker of water pollution.

The Antibacterial Activity of Ethanolic Extract of Cinnamon (Cinnamomum zeylanicum) against two Food Borne Pathogens: Staphylococcus aureus And Escherichia coli

Evaluation of the in vitro antibacterial activity of the ethanolic extract isolated from Cinnamomum zeylanicum bark against two food borne pathogens, Gram-positive Staphylococcus aureus and Gram-negative Escherichia coli. This experimental study was carried out in the department of Pharmacology & Therapeutics in collaboration with the department of Microbiology, Mymensingh Medical College, Mymensingh, Bangladesh from July 2017 to July 2018. The antibacterial activity was tested at different concentrations of extracts of spice by using disc diffusion method. The extracts were prepared by using a solvent ethanol. The test microorganisms were also tested for their activity against a standard antibiotic Amikacin (500mg) by disc diffusion method and the result was compared with that of ethanolic extracts. Cinnamon had inhibitory activity against both Staphylococcus aureus and Escherichia coli. The ethanolic extracts were more effective against Staphylococcus aureus than E. coli. Staphylococcus aureus showed activity from 60% conc. (zone of inhibition 17mm) where E. coli from 80% conc. (ZOI 18mm). Maximum zone of inhibition was 26mm for both the test organisms. This result was also compared to those obtained against a standard antibiotic Amikacin where extract produced wider zone of inhibition of 26mm as compared to Amikacin for both test organisms. The present study showed that ethanolic extract of cinnamon demonstrated stronger antimicrobial effect against food borne pathogens.

Quantitative analysis of Fuller's earth using laser-induced breakdown spectroscopy and inductively coupled plasma/optical emission spectroscopy

Fuller's earth, most commonly known as Multani Matti (clay) in Urdu, among its various utilizations is traditionally used in skin care cosmetics, particularly for removing blackheads and to treat oily skin. It is also used for improving skin complexion. In this paper, laser-induced breakdown spectroscopy (LIBS) was effectively employed for the quantitative investigation of various clay samples for their special uses. To get the LIBS spectra with an optimal signal-to-noise as well as for a more robust and accurate analytical investigation, different experimental parameters (laser energy, gate delay time, and the distance between target and focusing lens) were optimized before the experiments on actual samples. The analysis of emission spectra revealed the presence of many different elements, including Al, Ca, Fe, Mg, Mn, Na, K, Li, S, Si, and Zn. The electron number density and plasma temperatures were determined using the Stark broadened line profile and Boltzmann plot method, respectively. To determine the relative concentration of observed elements, we used an integrated intensity ratio method, integrated intensity of every line from all elements, and calibration free (CF)-LIBS. The prevailing condition of local thermodynamic equilibrium during the experimental executions was verified with multiple criteria. The spectral lines used in CF-LIBS were characterized for the influence from the self-absorption phenomenon, but the same was found insignificant. The findings of our LIBS system were found to agree excellently with the outcomes of the inductively coupled plasma/optical emission spectroscopy, thereby yielding a high statistical correlation factor and hence enlighten the significance of LIBS as a safe and reliable tool for elemental analysis of clay samples.

Patient Characteristics Associated With Medication Adherence to Anti-Diabetic Drugs

The aim of the present study was to assess the patient characteristics associated with medication adherence to anti-diabetic drugs. This observational, cross sectional study was conducted from January 2016 to June 2016 among patients attending at endocrine outpatient department of the Mymensingh Medical College Hospital and Medicine outpatient department of the Community Based Medical College Hospital, after obtaining requisite consent from the patients. Once the consultation by the physician was over, the patients were interviewed. Medication adherence was assessed through the specific four questions patient questionnaire, the modified morisky medication adherence scale that has high reliability and validity and the patient was considered to be highly adherent if he or she answered in the negative to all four questions (score-0). All filled questionnaires on the pattern of medication adherence to anti-diabetic drugs were entered into the computer for subsequent analysis using SPSS method version 20.1. Male patients had shown high rate of adherence than female. Elderly patients were more adherent. Urban patients had shown higher rate of adherence compared to rural. Patients with higher secondary education and businessman had higher compliance. Improved medication adherence was seen in patients with diabetes mellitus for long duration (>10 years). Our results had shown that therapeutic adherence was significantly affected by different patient - centered factors like age, educational status, employment status, and place of residence.

Do It Better: Cross Mattress for Chest Drain Insertion Site Security Offers Quality Outcome in Chest Trauma Patients Required Tube Thoracostomy

We examined the hypothesis that the cross mattress for chest drain insertion site security is better than that of polypropylene horizontal mattress in chest trauma patient required tube thoracostomy at the Department of Casualty Surgery, Dhaka Medical College Hospital, Dhaka, Bangladesh from January 2016 to June 2016. Accordingly we prospectively studied 50 consecutive patients who needed chest tube insertion. In 25 consecutive cases chest drain insertion site was secured with polypropylene horizontal mattress technique (Control- Group A) and another 25 consecutive patients had a cross-mattress with non-absorbable suture materials (Experimental- Group B). All chest tubes were inserted into the triangle of safety to following the BTS guideline. A baseline x-ray chest was compared with post-procedure chest x-ray. Male preponderance and young adults were comprised in both the groups; mean age in Group A and Group B was 38.7±15.5 and 37.3±14.1 respectively. Haemo-pneumothorax was the most common cause of tube thoracostomy among the trauma victims. This study shows that, polypropylene horizontal mattress results in increased chest tube site infection 52% in Control Group vs. 12% in Experimental Group (p=0.002). Although there was similar incidence of blood loss between the groups, the length of Hospital stay was significantly higher in Control Group. We conclude that cross mattress for chest drain insertion site security showed a better clinical outcome, less wound complications and less hospitalization.

Frequency of Fungal Species of Onychomycosis between Diabetic and Non-Diabetic Patients

Onychomycosis is a common nail problem in our country. Diabetic patients are more prone to develop onychomycosis. Various types of fungi are the causative agents of nail infections. This cross sectional explorative study was designed to find out the pattern of onychomycosis among diabetic and non-diabetic patients attending the out patient Department of Dermatology and Venereology and Endocrinology of Bangabandhu Sheikh Mujib Medical University Hospital, Dhaka, Bangladesh from July 2012 to June 2013. Clinically diagnosed patients of onychomycosis with diabetic or non-diabetic were included purposively in this study. Scraping or clipping from infected nail materials were processed for microscopy and culture in Sabouraud's dextrose agar media and Dermatophyte test media. Clinical features, microscopic examination results and culture interpretations were recorded and compared in two groups. A total of 87 clinically diagnosed patients of onychomycosis were included in this study. Out of 87 patients of onychomycosis, 54 patients were diabetic and 33 patients were non-diabetic. Trichophyton rubrum and Trichophyton mentagrophytes were found in 24(44.44%) and 19(35.18%) diabetic patients. Candida albicans and non-albicanscandida species were found in 1(1.85%) and 2(3.70%) diabetic patients. On the other hand, Trichophyton rubrum and Trichophyton mentagrophytes were found in 1(3.03%) and 2(6.06%) non-diabetic patients. Candida albicans and non-albicanscandida species were found in 8(24.24%) and 8(24.24%) non-diabetic patients. Growth of fungus was found in 46(85.19%) diabetic patients which was significant (p=0.004) compared to that found in 19(57.58%) non-diabetic patients. No growth was found in 8(14.81%) diabetic and in 14(42.42%) non-diabetic patients. Dermatophytes were more found in diabetic patients and Candida albicans and non-albican Candida spp. were more found in non-diabetic patients. So, the pattern of onychomycosis was different in diabetics compared to non-diabetics. Further study may be done with large number of sample to determine more accurate pattern of onychomycosis among diabetics.

Effect of foliar application of iron and zinc on nutrient uptake and grain yield of wheat under different irrigation regimes

A field experiment was carried out to study the zinc-iron relationship in wheat (BARI Gom-26) plant grown under water stress condition in the field near net house of Soil Science Division, BARI, Joydebpur, Gazipur, during November 2015 to March 2016. The experiment was designed in a split plot on sixteen treatments comprising four irrigation treatments (regular irrigation, stopping irrigation at crown root initiation, stopping irrigation at booting stage and stopping irrigation at grain filling stage) and four foliar application of zinc and iron (control, 0.05% of zinc, 0.05% of iron and 0.05% of zinc +0.05% of iron). Zinc sulphate monohydrate (ZnSO4. H2O) and ferrous sulphate (FeSO4. H2O) were used as a source of Zn and Fe. The highest yield (4.01 t ha-1) was recorded in stopping irrigation at grain filling stage which was identical with regular irrigation. Water stress at crown root initiation stage had the most negative effect on growth and yield. Foliar application of zinc and iron played a major role on yield and yield components of wheat at later stages of growth. The results obtained from the present research showed that iron and zinc spray increased grain yield and quality of wheat and improved the effects caused by drought stress.Bangladesh J. Agril. Res. 43(3): 395-406, September 2018

Optimized laser-induced breakdown spectroscopy for the determination of high toxic lead in edible colors

An optimized laser-induced breakdown spectroscopy (LIBS) system was utilized as a robust tool for the detection of high toxic lead (Pb) in often used edible colors available in local markets. Edible colors are extensively used in different food stuffs and sweet dish items. To attain a highly sensitive LIBS system for the determination of trace amounts of toxic Pb in edible colors and to achieve the best detection limit, various parametric dependence studies were performed. The quantitative determinations were accomplished under the condition of local thermodynamic equilibrium in terms of optically thin plasma. Besides toxic Pb, other elements like Ca, Mg, Fe, and Na were also detected in edible colors. To estimate the concentration of toxic lead in edible colors, calibration curves were plotted by preparing standard samples of different lead concentrations in an edible colors matrix. Results of the LIBS technique were compared with the outcomes of the same samples studied using a standard analytical technique of inductively coupled plasma-optical emission spectroscopy to confirm the contemporary LIBS setup. The color samples were found above the safe permissible level due to the mass of toxic lead. Limit of detection of the LIBS setup was found at 0.86+/-0.03  ppm for toxic lead present in edible color samples.

Heavy metal accumulation in leafy vegetables grown in industrial areas under varying levels of pollution

The concentration of lead (Pb), cadmium (Cd), nickel (Ni), cobalt (Co) and chromium (Cr) in three popular leafy vegetables such as spinach (Spinacia oleracea), red amaranth (Amaranthus tricolor) and amaranth (Amaranthus oleraseus) and that in the respective soils were assessed. These crops and soils were collected from two industrial areas (Kalakoir and Zorun, Konabari, Gazipur), and one non-industrial area (Bangladesh Agricultural Research Institute-BARI) under Gazipur district. The concentration of heavy metal in different parts of plant followed the roots>leaves>stem and in soils the order was Kalakoir (pollution)> Zorun (medium pollution) > BARI (low/non-pollution). In all three leafy vegetables similar trend of metal contents was observed i.e. Ni>Cr>Pb>Co>Cd. In the highly pollution area (Kalakoir) the Pb and Ni concentration was found in the order of amaranth>spinach>red amaranth. The Cd concentration was in the order of spinach>amaranth>red amaranth whereas for Cd it was amaranth>red amaranth>spinach and for Cr it was red amaranth>amaranth>spinach. The Pb, Cd, Ni, Co and Cr concentrations in the studied vegetables grown in the low polluted area were below the maximum acceptable levels proposed by the Joint FAO/WHO Expert Committee on Food Additives, except, Cd in spinach and amaranth. However, the higher concentrations of Pb, Cd, Ni, Co and Cr in vegetables grown in the industrial areas indicates that industrial discharge causes heavy metals contamination of soil and eventually their accumulation in plants.Bangladesh J. Agril. Res. 43(1): 39-51, March 2018

Potential of natural repellents methylanthranilate and anthraquinone applied on maize seeds and seedlings against house sparrow (Passer domesticus) in captivity

Various bird pests caused severe economic losses to valuable crops and fruit orchards all over the world. Among the birds, house sparrow is also considered to cause heavy plunder, not only to seeds of crops but also seedlings especially in organic farming. In present study two bird repellents, methylanthranilate and anthraquinone tested against house sparrows on maize seeds and seedlings in aviary conditions. Trial group in aviary-I, the treated maize seeds and seedlings with different doses of both bird repellents, control group in aviary-II, untreated seeds and seedlings were provided for three hours in the early morning. In each aviary, two closed circuit cameras were also installed to monitor the behavioral responses against different concentrations of both chemical repellents. Statistical analysis showed that there existed highly significant (P<0.01) variations among the trial and control groups for seeds and seedlings. By comparing both repellents, significant (P<0.05) differences were detected and anthraquinone showed better efficacy when compared to methylanthranilate, but in maize seedlings both repellents equal repellent properties. Non-significant (P>0.05) differences were observed in different grading of both natural chemical repellents for maize seeds while significant (P<0.05) variations were noticed for maize seedlings when provided to sparrows. By videotaped behavior sparrows presented manifest head juddering and feather upsetting activities by consumption of treated seeds and seedlings with higher concentrations of both natural bird repellents.

Determination of toxic and essential metals in rock and sea salts using pulsed nanosecond laser-induced breakdown spectroscopy

A spectrometer based on pulsed nanosecond laser-induced breakdown spectroscopy (LIBS) was employed for the quantitative determination of heavy and essential metals in salts from various sources available in Pakistan. Six salt samples were collected from sea salt and rock salt. Toxic metals (Cu, Cd, and Ni) and other microessentials (Fe, Ca, Co, Mg, Mn, S, and Zn) were investigated from the recorded spectra. The detection system was calibrated using a parametric dependence study. The quantitative analyses were accomplished under the assumption of local thermodynamic equilibrium and optically thin plasma. The results by the LIBS technique were in agreement with the outcomes of the same samples studied using a more standard approach like inductively coupled plasma-atomic emission spectroscopy (ICP-AES). When the concentrations of heavy and essential metals were calculated using a calibration-free LIBS method that does not need a standard salt specimen and dilution, both LIBS and ICP-AES were also in good agreement. The limit of detection of the experimental set up was determined for the observed heavy metals in the studied samples.