Clinical presentation of post-COVID pain and its impact on quality of life in long COVID patients: a cross-sectional household survey of SARS-CoV-2 cases in Bangladesh

BACKGROUND

Pain is one of the prevalent Long COVID Symptoms (LCS). Pain interferes with the quality of life (QoL) and induces disease burden.

PURPOSE

The study aimed to elicit the clinical presentation of pain and determine the relationships between QoL and pain in LCS.

METHODS

This household cross-sectional study of 12,925 SARS-CoV-2 cases between July and December 2021 was carried out in eight administrative divisions of Bangladesh. Stratified random sampling from the cases retrieved from the Ministry of Health was employed. Symptom screening was performed through COVID-19 Yorkshire Rehabilitation Scale, and long COVID was diagnosed according to World Health Organization (WHO) criteria. The analyses were conducted using IBM SPSS (Version 20.00).

RESULTS

The prevalence of pain in long COVID was between 01 and 3.1% in the studied population. The study also found five categories of pain symptoms as LCS in Bangladesh: muscle pain 3.1% (95% CI; 2.4-3.8), chest pain 2.4% (95% CI; 1.8-3.1), joint pain 2.8% (95% CI; 2.2-2.3), headache 3.1% (95% CI; 2.4-3.8), and abdominal pain 0.3% (95% CI; 0.01-0.5). People with LCS as pain, multiple LCS, and longer duration of LCS had significantly lower quality of life across all domains of the WHOQOL-BREF (P < 0.001) compared to asymptomatic cases.

CONCLUSION

Three out of ten people with long COVID experience painful symptoms, which can significantly reduce their quality of life. Comprehensive rehabilitation can improve the symptoms and reduce the burden of the disease.

Breast Cancer in Younger and Older Women: A Comparison of Clinicopathological Traits

Breast cancer stands as the prevailing invasive cancer globally, bearing high mortality rates among women. Existing evidence indicates diminished survival rates in younger patients. Consequently, this study endeavors to assess and contrast the pathological features of breast cancer in women under 40 years of age with their older counterparts. Conducted as a cross-sectional analysis, this study encompasses 560 patients diagnosed with breast cancer, seeking treatment at Mymensingh Medical College Hospital (MMCH), Community Based Medical College Bangladesh (CBMCB) and several private hospitals in Mymensingh. The gathered data incorporates information such as age, residential area, occupation, tumor histopathology, TNM classification, staging and status of hormone receptor. The patients' mean age (standard deviation) was 49.7±11.9 years, with 20.5% below 40, most were from rural areas and were housewives. Ductal carcinoma prevailed as the most common histopathologic type (87.67%). However, younger patients exhibited a higher prevalence of lobular and other rare carcinomas compared to their older counterparts (p=0.04). Additionally, the younger group demonstrated larger tumor sizes (p=0.01), lymphatic node involvement (p=0.04) and advanced staging (p=0.004). Notably, younger age showed more negativity for estrogen and/or progesterone receptors. The results suggested that women under 40 years old exhibit more aggressive tumor characteristics and a more severe form of breast cancer compared to their older counterparts.

Evaluation of Antimicrobial Efficacy and Clinical Outcomes of Triphala and 2.5% Sodium Hypochlorite as Intraradicular Irrigants in Pulpectomy of Primary Teeth

A natural irrigation solution with a broad spectrum of antimicrobial coverage, triphala was selected for the pulpectomy procedure. Because of its natural ingredients, it is well-known for promoting tissue healing. It also supposedly has certain additional qualities as compared to usual irrigation solutions that are made chemically. Although 2.5% NaOCl is thought to be perfect since it meets most of the requirements for an irrigation solution but it cannot be optimized for pulpectomy procedure. Primary teeth that were recommended for pulpectomy underwent this randomized controlled experiment. Two groups of eighty-four primary teeth were randomly assigned to receive irrigations: triphala in Group A; 2.5% Sodium hypochlorite in Group B. Sample were taken from infected primary root canals. A sterile test tube with bhi broth as the transport media was used to collect pre- and post-irrigation samples using sterile absorbent paper tips. On agar media, microorganisms were cultivated and their mean colony count was assessed. Following the procedure, the patient's follow-up visits at one, two and three months were used to evaluate the clinical result. The post-microbial colony count was dramatically reduced (p<0.001) by both irrigation treatments. Triphala in Group A is demonstrating desirable efficacy. Clinical success was found satisfactory in both the groups studied (p<0.001). But statistically significant difference was not found (p=0.175). Considering undesirable properties of sodium hypochlorite triphala can be a better alternative as a root canal irrigants in pulpectomy of primary teeth.

Comparative Efficacy and Safety of Amlodipine and Losartan Potassium in Essential Hypertension in a Tertiary Hospital of Bangladesh

Hypertension is a common disorder of major clinical, public health and economic importance. It affects men and women of all ages, and the prevalence is increasing in most countries. Maintenance of blood pressure below 140/90 mm of Hg is recommended by most of the guideline available around the world. Various classes of drugs are being used in the treatment of hypertension. Losartan potassium and amlodipine are two different antihypertensive agents belonging to two different groups used commonly around the world in treating essential hypertension. Losartan potassium is non-peptide Angiotensin-II receptor antagonist. Amlodipine which is the third generation dihydropyridine group of calcium channel blocker. The aim of the study was to compare the efficacy and safety of amlodipine and losartan for the treatment of essential hypertensive patients (18-75 years). A non-randomized comparative observational study was conducted in the Department of Pharmacology and Therapeutics in collaboration with Department of Medicine, Sylhet, MAG Osmani Medical College, Sylhet, Bangladesh from July 2021 to June 2022. In this study non-randomization was in two groups. Group A received amlodipine 5mg daily at morning and Group B received losartan potassium 50mg daily at night. The study parameters were systolic blood pressure (SBP), diastolic blood pressure (DBP), ankle oedema, serum K+ level. The result of treatment outcome was compared between two groups. After treatment the reduction of SBP was 5.19±2.93mm of Hg versus 3.27±1.34mm of Hg (p<0.001); reduction of DBP was 1.7±0.70 mm of Hg versus 0.68 mm of Hg (p<0.001) and serum K+ level 4.22±0.27mmol/L versus 4.21±0.16mmol/L (p<0.719) in amlodipine and losartan group respectively. Amlodipine is more effective than losartan potassium in respect to treatment of essential hypertension. Regarding adverse events losartan potassium causes angioedema, hyperkalemia, headache, dizziness etc. The study concluded that amlodipine is superior to losartan potassium in treating essential hypertension.

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.

Efficacy of neck muscle activation versus strengthening for adults with chronic cervical radiculopathy: a study protocol for a randomised clinical trial

Introduction

Chronic cervical radiculopathy is a common condition characterised by neck and arm pain, numbness and weakness. Both neck muscle activation and strengthening exercises are widely recognised treatments for cervical radiculopathy, but there is a research gap on the efficacy of neck muscle activation versus strengthening. This protocol will determine the efficacy of neck muscle activation alongside conventional care versus strengthening exercise and conventional care for cervical radiculopathy.

Methods and analysis

We planned a 5-week parallel, two-arm randomised clinical trial on 80 participants with chronic cervical radiculopathy (lasting over 3 months) between July and December 2023. Participants will be recruited from Dhaka's Agrani Specialised Physiotherapy Centre in Bangladesh and randomly assigned to two groups in a 1:1 ratio. Both groups will receive 14 sessions, each lasting 30-45 min. Post-treatment evaluations will be employed on Brief Pain Inventory (BPI), range of motion, craniovertebral angle (CVA), strength, endurance and Neck Disability Index (NDI) after 5 weeks and follow-up after 12 weeks of post-test analysis. Primary outcomes (strength, endurance and CVA) will be measured using a handheld dynamometer, digital inclinometer and goniometer. Secondary outcomes (pain, range of motion and disability) will be assessed through the BPI scale, digital inclinometer and NDI.

Ethics and dissemination

The Institute of Physiotherapy Rehabilitation and Research of Bangladesh Physiotherapy Association has approved the study. All participants will provide informed consent, and data will be anonymised and accessible only to authorised personnel. The study's findings will be disseminated in peer-reviewed journals and conferences.

Clinical trial registry India

CTRI/2023/09/057587 (13/09/2023).

Primary Tuberculosis of Cervix Which Simulated Endocervical Polyp: A Case Study

Tuberculosis has been described as the second great "Imitator" as it can imitate various other disease processes. The manifestations of genitourinary tuberculosis are protean in nature; still tuberculosis is a health concern in South-East Asia region. Tuberculosis of the cervix is rarely found and accounts for 5-10% among all types of genital tuberculosis. Despite meticulous history and clinical examination does not always lead to suspect this disease, the definitive diagnosis is based on the demonstration of the characteristic lesion on histopathology or on bacterial isolation. We are reporting a case of a 26-years-old woman who presented with secondary amenorrhea and a benign looking endocervical polyp. Diagnosis of cervical tuberculosis could be clinched after tissue biopsy which revealed caseous granuloma on histopathological examination along with other supportive laboratory investigation reports. Patient was subsequently started on antitubercular therapy (ATT) according to directly observed treatment schedule- category I, resulting in resumption of her menses after four months of starting of ATT. An awareness of the atypical clinical manifestations of tuberculosis is important, especially in regions where tuberculosis continues to be a major public health problem, such as Bangladesh. One should have high index of suspicion in order to diagnose tuberculosis of cervix in such cases, especially in high prevalence areas, so that patients can be managed appropriately with antitubercular therapy and complications can be prevented.

Anatomical Study of Number, Location and Position of Nutrient Foramina of Fully Ossified Dry Human Humerus

The nutrient foramen is the natural opening present in the shaft of the humerus. It passes the nutrient artery to the medullary cavity. The nutrient artery is the chief artery that enters the bone through a nutrient foramen to provide nutrition for its growth. It plays an important role in healing during fracture and trauma and is also important for bone grafting. This study aimed to determine the common location, position and number of nutrient foramina of fully ossified dry human humerus. One hundred samples (right- 43 and left- 57) were selected through the purposive sampling technique for this cross-sectional descriptive study carried out in the Department of Anatomy, Mymensingh Medical College, Bangladesh from July 2021 to June 2022. Any damaged, unossified bones or fractured bones were excluded. Data were tabulated and statistically analyzed using Microsoft Excel and SPSS software. Among 43 right humeri, 37(75.51%) have single-nutrient foramen and 06(24.49%) have double-nutrient foramina. Among 57 left humeri, 53(92.98%) have single nutrient foramen, 03(5.27%) have double nutrient foramina and 01(1.75%) has triple nutrient foramina. In case of location of nutrient foramina, among 49 right nutrient foramina, 45(91.84%) were found on the anteromedial surface, 02(4.08%) were found on the anterolateral surface and 02(4.08%) were on the posterior surface of the shaft of the humerus. In case of 62 left nutrient foramina, 57(91.94%) were found on the anteromedial surface and 05(8.06%) were found on the posterior surface of the shaft of the humerus. Among 49 right nutrient foramina, 01(2.04%) was found on the upper third, 46(93.88%) on the middle third and 02(4.08%) on the lower third of the shaft of the humerus. In case of 62 left nutrient foramina, 01(1.60%) was on the upper third, 57(91.95%) were on the middle third and 04(6.45%) were on the lower third of the shaft of the humerus.

The assessment of musculoskeletal disorders, quality of life, and comorbidities in older people in Bangladesh

Musculoskeletal disorders are debilitating conditions that significantly impact the state of health, especially in older people. The study, which employed a cross-sectional design and practical sampling, included 206 participants among them 124 (62.2%) were men and 82 (39.8%) were women, from all over Bangladesh with musculoskeletal issues of varying severity and impact. The mean age of the participants was 64.9 (SD 4.3). The study was carried out between January and June of 2022. The majority of participants experienced musculoskeletal pain. Back pain was the most commonly complained of symptom among the participants (74.9%). It was also common to have limited mobility as a result of arthritic change, which eventually affected daily activities like taking care of oneself. To improve the health of the older adult population, more studies must be conducted to identify the many factors that contribute to musculoskeletal issues. The development of effective prevention and rehabilitation programs must then be based on this knowledge.

Profile of long COVID symptoms needing rehabilitation: a cross-sectional household survey of 12,925 SARS-CoV-2 cases between July and December 2021 in Bangladesh

BACKGROUND AND AIMS

It is important to determine the profile of long COVID (LC) symptoms within the scope of rehabilitation in Bangladesh. This study's objective was to estimate the newly experienced long COVID symptoms needing rehabilitation by determining the prevalence and spectrum of impairments due to LC in Bangladesh.

METHODS

A Cross-sectional household survey of 12,925 COVID-19 patients confirmed by RT-PCR from 24 testing facilities in Bangladesh. LC was diagnosed according to WHO working group definition. COVID-19 Yorkshire Rehabilitation Scale (C19-YRS) was used to determine the symptom responses, symptom severity, new long COVID symptoms, and scope of rehabilitation.

RESULTS

The population proportion of LC symptoms requiring rehabilitation interventions are 0.22 [95% CI, 0.20-0.24] in Bangladeshi people diagnosed with SARS-CoV-2. Among them, 0.08 [95% CI, 0.07-0.09] had mild, 0.07 [95% CI, 0.06-0.09] had moderate, and 0.05 [95% CI, 0.04-0.06] had severe long COVID symptoms (LCS). There was a significant positive correlation between LCS and functional disabilities (r = 0.889, p < 0.001), while a negative correlation was observed between the severity of symptoms and overall health (r=-0.658, p < 0.001). In comparison to the pre-COVID status, 17 new LCS were observed and the increase in the scope of rehabilitation intervention among LCS ranged between 0.01 [95% CI, 0.001-0.01] and 0.21 [95% CI, 0.19-0.22]. In Bangladesh, 59% (n = 334) of the LC cases are out of reach for any rehabilitation interventions.

CONCLUSION

Nearly one-fourth of Bangladeshi Post-COVID-19 have long COVID (LC). Seventeen symptoms (LCS) were observed and more than half of the populations having long COVID are out of reach of any rehabilitation facilities.

Antibacterial Activities of Mint (Mentha piperita) Leaf Extracts (Aqueous) Against Two Food Borne infection causing pathogens: Staphylococcus aureus and Escherichia coli

Evaluation of the in vitro antibacterial activity of Aqueous extracts isolated from Mint (Mentha piperita) leaf against two food born infection causing pathogens, gram-positive Staphylococcus aureus and gram-negative Escherichia coli. This interventional study was carried out in the Department of Pharmacology and Therapeutics in collaboration with the Department of Microbiology, Mymensingh Medical College, Bangladesh from January 2021 to December 2021. The antibacterial activity was tested at different concentrations of Aqueous Mint leaf extracts by using disc diffusion & broth dilution method. The extract was prepared by using solvents Aqueous. The test microorganisms were also tested for their activity against a standard antibiotic Gentamicin by broth dilution method and the result was compared with that of Aqueous extracts. Aqueous extract of Mint leaves (AMLE) were used initially in eight different concentrations (25, 50, 100, 200, 400, 600, 800 and 1000μg/ml) and later in selected concentrations as needed to confirm the more precise margin of antimicrobial sensitivity of the extracts. Among different concentrations of the AMLE, 200μg/ml and above concentrations showed inhibitory effect against Staphylococcus aureus and 400μg/ml and above concentrations showed inhibitory effect against Escherichia coli. Minimum inhibitory concentration (MIC) for Staphylococcus aureus and Escherichia coli were 200 and 400μg/ml in AMLE respectively. The MIC of Gentamicin was 1μg/ml against Staphylococcus aureus and 1.5μg/ml against Escherichia coli. The MIC of Gentamicin was the lowest in comparison to MICs of AMLE for the test organisms. This study showed that Aqueous Mint extracts demonstrated antibacterial effects against food borne pathogens. It is clearly observed that there is definite antibacterial effect of the aqueous extract of Mint leaves against Staphylococcus aureus and Escherichia coli.

Physical, Psychological and Social Impact of COVID-19 Pandemic on Healthcare Workers at a COVID Designated Bangladeshi Public Hospital

The world has been devastated facing the outbreak of a novel infectious disease known as Corona virus disease (COVID-19). This has been declared as a pandemic by the World Health Organization. The frontline health care workers, who are directly involved in the diagnosis, treatment and care of patients with COVID-19, are taking significant personal risks on their own health and those of their family members. Objectives of the study include establishing the physical, psychological and social impact experience by the healthcare workers serving in public hospitals of Bangladesh. This prospective cross-sectional observational study was carried out at Kuwait Bangladesh Friendship Government Hospital, the first Covid-19 designated hospital of Bangladesh between the 1st June and the 31st August, 2020. A total of 294 doctors, nurses, ward boys and ailed healthcare workers were included in this study via purposive sampling. The study found statistically significant (p value 0.024) difference of medical co-morbidities between Covid-19 positive and Covid-19 negative groups of health care professionals. Significant association was found between duration of work and presence during aerosol generating procedure with COVID infectivity of the study subjects. 72.8% respondents experienced public fear of contracting the virus from them and 69.0% noticed negative attitude of the society towards them. Eighty five percent (85.0%) did not get any community support during this pandemic crisis. The health care professionals engaged in COVID-19 treatment have been taking significant personal risk on their life in terms of physical, psychological and social perspective. Providing safeguard to the health care workers are integral components of public health measures for addressing the COVID-19 pandemic. Special interventions to promote their physical wellbeing and arrangement of adequate psychological training need to be immediately implemented to cope up this critical situation.

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.

Heavy metals, trace elements, minerals and ascorbic acid content of occasionally consumed eight indigenous fruits in Bangladesh

Herein, a study was carried out to assess the nutritional potential of eight indigenous fruits namely sapodilla, stone apple, bilimbi, amla, litchi, strawberry, tamarind, elephant-apple particularly on the basis of heavy metal, mineral and ascorbic acid content along with the physicochemical properties. Inductively coupled plasma mass spectrometer (ICP-MS) and atomic absorption spectrophotometer (AAS) analysis were performed to determine the essential trace elements and heavy metals in the selected fruits, whereas sodium and potassium content was determined by flame-photometer. Even though the essential trace elements such as zinc, copper, manganese, selenium and cobalt were found in all the examined fruits, sapodilla, stone apple and tamarind were observed as a rich source of selenium and cobalt. The current research demonstrated the presence of toxic heavy metals like arsenic, cadmium, lead, and mercury in elephant-apple, sapodilla, stone apple and tamarind in trace levels which are below the Maximum Residue Limits (MRLs). All the selected eight fruits are found as rich sources of macro-minerals for instance sodium, potassium, calcium, magnesium and phosphorous. Ascorbic acid was estimated by HPLC which ranged from 4.10 to 475.0 mg/100 g of edible portion and the highest amount was found in amla. In summary, these fruits could be potential sources of macro and microminerals and safe from toxic heavy metal contamination. The nutritional data observed in the present study would be played a promising role in dietary recommendation, nutritional education, training, research, and food supplementation.

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.

Caring for carers: A virtual psychosocial supervision intervention to improve the quality and sustainability of mental health and psychosocial support in humanitarian contexts

Introduction

Mental health and psychosocial support (MHPSS) staff in humanitarian settings have limited access to clinical supervision and are at high risk of experiencing burnout. We previously piloted an online, peer-supervision program for MHPSS professionals working with displaced Rohingya (Bangladesh) and Syrian (Turkey and Northwest Syria) communities. Pilot evaluations demonstrated that online, peer-supervision is feasible, low-cost, and acceptable to MHPSS practitioners in humanitarian settings.

Objectives

This project will determine the impact of online supervision on i) the wellbeing and burnout levels of local MHPSS practitioners, and ii) practitioner technical skills to improve beneficiary perceived service satisfaction, acceptability, and appropriateness.

Methods

MHPSS practitioners in two contexts (Bangladesh and Turkey/Northwest Syria) will participate in 90-minute group-based online supervision, fortnightly for six months. Sessions will be run on zoom and will be co-facilitated by MHPSS practitioners and in-country research assistants. A quasi-experimental multiple-baseline design will enable a quantitative comparison of practitioner and beneficiary outcomes between control periods (12-months) and the intervention. Outcomes to be assessed include the Kessler-6, Harvard Trauma Questionnaire and Copenhagen Burnout Inventory and Client Satisfaction Questionnaire-8.

Results

A total of 80 MHPSS practitioners will complete 24 monthly online assessments from May 2022. Concurrently, 1920 people receiving MHPSS services will be randomly selected for post-session interviews (24 per practitioner).

Conclusions

This study will determine the impact of an online, peer-supervision program for MHPSS practitioners in humanitarian settings. Results from the baseline assessments, pilot evaluation, and theory of change model will be presented.

Disclosure

No significant relationships.

Effects of Amlaki (Emblica officinalis) on Serum Lipid Profile in Rats

The effect of Amlaki (Emblica officinalis) on lipid profile (Serum cholesterol, triglyceride, HDL-cholesterol & LDL-cholesterol) in normal and fat fed rats were studied. The experimental study was carried out in the department of Pharmacology, Sir Salimullah Medical College (SSMC), Mitford, Dhaka and in the animal house of Institute of Science & Technology (IFST) of Bangladesh Council of Scientific & Industrial Research (BCSIR) Laboratory, Dhaka, Bangladesh from January 2005 to December 2005. Twenty four adult rats of both sexes weighing between 200-300gms were used. The experiment was divided into two parts: Part-1 and Part-II. In Part-I: to demonstrate the effect of Amlaki on serum lipid profile in normal rats, a total number of twelve rats were taken and divided into two groups. Group A₁: Consisted of 6 rats, received normal laboratory diet and water to 1.5-2.0ml daily for 21 days and served as normolipidemic control group. Group A₂: Consisted of 6 rats which received normal laboratory diet and Amlaki in a dose of 1.5gm/kg body wt. daily orally for 21 days and served as normolipidemic experimental group. On 22nd day, rats of both groups were sacrificed and estimation of serum lipid profile was done. In the first part of this study, administration of Amlaki for 21 days to normal rats, significantly reduced the serum cholesterol level (p<0.01), triglycerides (p<0.01) and LDL-cholesterol level (p<0.01). But there was no significant change in serum HDL-cholesterol level (p>0.1). In Part-II: to demonstrate the effect of Amlaki on lipid profile in fat fed rats, a total number of twelve rats were taken and divided into two groups. Group B₁: Consisted of 6 rats, received normal lab. diet and fat (1% cholesterol plus 0.25% cholic acid dissolved in 100ml vegetable oil) in a dose of 1.5ml daily orally for 28 days serve as a hyper-lipidemic control group (fat fed). Group B₂: Consisted of 6 rats and received normal lab. diet and cholesterol rich diet and Amlaki in a dose of 1.5gm/kg body wt. daily orally for 28 days and served as a hyper-lipidemic experimental group. On 29th day, rats of both groups were sacrificed and estimation of serum lipid profile was done. In the second part of this study, fat feeding produced a significant increase in serum cholesterol (p<0.001), triglyceride (p<0.001) and LDL-cholesterol level (p<0.001) and a significant reduction of serum HDL-cholesterol level (p<0.001) i.e. a state of hyper-lipidemia was produced. In the 2nd part of this study, concomitant administration of Amlaki and fat rich diet daily orally in rats for 28 days, produced a significant reduction in serum total cholesterol (p<0.001), triglyceride (p<0.001) and LDL-cholesterol level (p<0.001). The serum HDL cholesterol level was increased but not significantly (p>0.1). In the light of these results, it may be concluded that Emblica officinalis (Amlaki) has significant hypo-lipidemic effect in both normal and fat fed rats.

Serum Leptin Correlates with Obesity But Does Not Differ Between Gestational Diabetes and Normal Glucose Tolerance during 24-28 Weeks of Gestation

Leptin is an adipocytokine secreted by adipocytes which positively correlates with obesity. It is considered as a potential mediator for precipitating Gestational diabetes mellitus (GDM) which is more evident during 24-28 weeks of gestation. This study was conducted to see serum leptin level during 24-28 weeks of gestation in GDM at the Department of Endocrinology, BSMMU, Bangladesh from March 2019 to August 2020. Pregnant women (N=108) were challenged with 75gm oral glucose (OGTT) at 24-28 weeks of gestation and divided into GDM [n=45, age: 27.80±3.98 years, mean±SD; BMI: 27.88 (24.46-30.43) kg/m², median Interquartile range (IQR)] and normal glucose tolerance [NGT; n=62, age: 26.19±5.30 years, mean±SD; BMI: 25.80 (23.65-28.42) kg/m², median (IQR)] on basis of WHO-2013 diagnostic criteria. Fasting serum leptin and glucose were measured by ELISA and glucose oxidase method respectively. No statistically significant difference was found between GDM and NGT for leptin [26.05(16.92-50.55) vs. 23.50(14.95-38.30) median (IQR), p=0.360]. It was also not different statistically between GDM and NGT either for age groups (p=NS for all) or for Asian categories of BMI subgroups (p=NS for all). However, it was higher in subjects with BMI ≥23kg/m² than that with BMI ≤23kg/m² for both GDM [16.65 (6.39, 35.75) vs. 28.35 (19.60, 51.10) median (IQR), p=0.114] and NGT [14.65(9.19, 19.60) vs. 26.00 (17.30, 43.40) median (IQR), p=0.002]. It was also statistically similar in the GDM subgroups divided by Asian BMI cut-off (p=NS). BMI correlated with leptin in NGT (r=0.495, p<0.001) but not in GDM (r=0.177, p=0.251) and regression analysis revealed BMI (kg/m²) as predictor for high leptin (p=0.008). ROC curve analysis for leptin showed AUC for GDM was 0.553 (p=0.360) suggesting it as a poor predictor. It is concluded that fasting leptin in 24-28 weeks of gestation better relates with BMI but does not differ between GDM and NGT anddoes not seem to be a good predictor for GDM. Further study is required to make a comment on its prediction over GDM.

The evaluation of rosemary (Rosmarinus officinalis) leaf extract inclusion in freezing medium on quality parameters of buffalo bull spermatozoa

BACKGROUND

The discrepancy between the endogenous antioxidants concentrations and free radicals results in oxidative stress and cellular injury.

OBJECTIVE

To appraise the usefulness of Rosemarinus officinalis (RO) aqueous extract in protecting buffalo spermatozoa during freezing / thawing process.

MATERIALS AND METHODS

Qualifying ejaculates from four well-restrained bulls were evaluated initially and then diluted in a freezing medium supplemented with RO-0.0, RO-0.5 %, RO-1.0%, RO-2.0 %, and RO-4.0 %, cooled to 4 degree C in 2 h, equilibrated for 4 h at 4 degree C, packed in straws, and cryopreserved, and thawed at 37 degree C for 30 s followed by evaluation.

RESULTS

We found that freezing medium supplemented with RO-2.0 % improves progressive motility (%) compared to the control. Similarly, a lower rate of apoptosis-like changes (%) was recorded with RO-4.0 % than the control, RO-0.5 % and RO-1.0 %. This response was accompanied by an increment in viable spermatozoa. Semen samples supplemented with RO-2.0 % and RO-4.0 % displayed higher TAC (total antioxidant capacity, uM per L) and ATP (nmol/million) content than the control. In addition, semen samples supplemented with RO-2.0 % displayed lower concentrations of ROS (reactive oxygen species, 10⁴ RLU/20 min/25 million) than the control and RO-0.05 %. Also LPO (lipid peroxidation, uM per L) with RO-2.0 % and RO-4.0 % was lower than the control.

CONCLUSION

The inclusion of rosemary aqueous extract ameliorates motility features, structural and functional parameters, viability, TAC and ATP content of bull sperm. Conversely, the inclusion of rosemary aqueous extract alleviates apoptosis-like changes, ROS and LPO in comparison to the control. Further studies are required to determine the mechanism of action of rosemary aqueous extract in ameliorating semen quality and fertility of buffalo spermatozoa. doi.org/10.54680/fr22210110712.

Demographic and Clinical Profile of COVID-19 ICU Patients of Bangabandhu Sheikh Mujib Medical University, Bangladesh

Corona viruses are a group of RNA viruses that cause infection in humans and animals. In human Corona viruses cause respiratory tract infections ranging from mild to critical illness. Corona virus disease 2019 (COVID-19) is caused by strain of severe acute respiratory syndrome corona virus 2 (SARS-CoV-2). The disease was first identified in Wuhan city, of China, in December 2019 and since spread all around the world. In Bangladesh first case has been declared by Institute of Epidemiology, Disease Control and Research (IEDCR) in 8th March, 2020 and first death on 18th march in an ICU and by 13th December total 489,178 cases and 7,020 deaths occurred in this country. The main objective of this study was to determine the Demographic and Clinical Profile of COVID-19 ICU patients in Bangladesh. This retrospective descriptive study on clinical profile along with short term treatment outcomes of COVID-19 patients conducted from COVID-19 dedicated Intensive care unit of Bangabandhu Sheikh Mujib Medical University (BSMMU), Bangladesh during July 2020 to November 2020. Total 300 ICU patients was included in this study. The age range of the patients was from 15 to 91 years. The highest percentage of patients about 49.00%, which was 147 patients were belonged to 61-75 years age group. The patients mean age was 62.80 years. Regarding gender distribution, among those 300 patients; 77.00% which is 231 were male and only 23.00% which is 69 were female. Patients admitted with symptoms like, respiratory distress/shortness of breath (100.00%), persistent worsening cough (60.00%), fatigue (55.00%) and fever (40.00%). Patients were also present with sore throat (35.00%), rhinorrhea (30.00%), altered mental status (20.00%), diarrhoea (10.00%) and chest pain (5.00%). Regarding co-morbidities, around half of the patients were suffering from Diabetes (60.22%) and Hypertension (53.44%). Significant amount of patients were also suffering from chronic obstructive pulmonary disease (27.00%) and bronchial asthma (16.78%). Ischemic heart disease was (10.33%), chronic kidney disease (10.89%), hypothyroidism (9.78%) and multiple co-morbidities (15.12%) at the time of admission. Mortality rate in this case were 71.00% and most of the death cases were in between 61 to 75 years of age group (40.00%). After improvement 27.00% patients were transferred to cabin for further management. We could discharge to home directly only 2.00% of patients.

Ameliorative effects of morel mushroom (Morchella esculenta) against Cadmium-induced reproductive toxicity in adult male rats

Cadmium (Cd) is one of the major toxicants, which affects human health through occupational and environmental exposure. In the current study, we evaluated the protective effects of morel mushrooms against Cd-induced reproductive damages in rats. For this purpose, 30 male rats were divided into 6 groups (n=5/group), the first group served as the control group, second group was treated with an intraperitoneal (i.p) injection of 1 mg/kg/day of Cd. Third and fourth groups were co-treated with 1 mg/kg/day of Cd (i.p) and 10 and 20 mg/kg/day of morel mushroom extract (orally) respectively. The final 2 groups received oral gavage of 10 and 20 mg/kg/day of morel mushroom extract alone. After treatment for 17 days, the animals were euthanized, and testes and epididymis were dissected out. One testis and epididymis of each animal were processed for histology, while the other testis and epididymis were used for daily sperm production (DSP) and comet assay. Our results showed that Cd and morel mushrooms have no effect on animal weight, but Cd significantly decreases the DSP count and damages the heritable DNA which is reversed in co-treatment groups. Similarly, the histopathological results of testes and epididymis show that morel mushrooms control the damage to these tissues. Whereas the morel mushroom extract alone could enhance the production of testosterone. These results conclude that morel mushrooms not only control the damage done by Cd, but it could also be used as a protection mechanism for heritable DNA damage.

Results of Laparoscopic Cholecystectomy in Acute Cholecystitis in Diabetic Patients: A Study with 50 Cases

Acute cholecystitis (AC) is a common surgical condition requiring emergency hospitalization. Diabetic patient with gall stones disease is more prone to develop acute cholecystitis and its complications e.g. mucocele, empyema, gangrene and perforation. Early laparoscopic cholecystectomy (ELC) has proved to be an effective and safe day case surgical procedure for AC and their complications. This cross sectional study of diabetic patients admitted with acute cholecystitis, at the Department of Surgery of Bangladesh Institute of Researcher of Rehabilitation in Diabetes, Endocrine and Metabolic Disorder (BIRDEM) General Hospital, Dhaka, Bangladesh from March 2016 to January 2017. A total number of 50 patients of known diabetes of acute cholecystitis were recruited irrespective of their age and sex and by excluding pregnant woman, obstructed jaundice and severe cardiopulmonary disease. More than half (52.0%) of the cholecystitis patients belonged to 31-40 years with mean age was 52.5±12.1 years. Females were predominant in this study (68.0%) with male: female ratio was 1:2.1. All (100%) patents had pain in right hypochondrium but relatively lower than non-diabetic patient due to diabetic neuropathy followed by majority 74.0% had nausea/vomiting, 70.0% had history of flatulence and dyspepsia, 62.0% had Murphy's sign positive. Thirty (60.0%) patients had glycaemic control and 20(40.0%) had uncontrolled DM. Insulin received patients were 35(70.0%) and 15 took oral hypoglycemic drug. Regarding postoperative complication, 8.0% had severe vomiting, right hypochondriac pain, 4.0% had wound sepsis and 2.0% had decreased pulmonary function and mild chest infection. In this study among laparoscopic finding during operation age and sex were not statistically significant. There was no mortality; laparoscopic cholecystectomy is the safe, accepted and preferred method of treatment for acute cholecystitis.

Correction to: Screening and computational analysis of colorectal associated non-synonymous polymorphism in CTNNB1 gene in Pakistani population

Following publication of the original article [1], the authors have flagged that the article has published with an error in the order of the affiliations.

Effects of endocrine disruptor furan on reproductive physiology of Sprague Dawley rats: An F1 Extended One-Generation Reproductive Toxicity Study (EOGRTS)

The present study investigated the reproductive toxicity of furan in an Extended One-Generation Reproductive Toxicity Study in rats. Sprague Dawley F0 weaning rats (30 per sex per group) were exposed to furan orally at 0, 1, 2.5, 5, and 10 mg kg^-1 for 10 weeks (males) and 2 weeks (females) and then mated. Results of F0 indicated that in the furan-treated groups (5 mg kg^-1 and 10 mg kg^-1), body weight (bw) gain decreased during prebreed and gestational period while increased during lactation periods. F0 animals prebreeding exposure resulted in head tilt and foot splay at 10 mg kg^-1. Number of live pups at birth were decreased (p < 0.001) at 10 mg kg^-1. At postnatal day (PND) 70, a significant (p = 0.03) decrease in testosterone levels of male rats and estrogen levels of female rats (p = 0.05) was observed in 10 mg kg^-1 furan-treated group in F1 generation. Luteinizing hormone, follicle-stimulating hormone, and progesterone levels were also reduced, but their reduction was not statistically significant in all groups. In higher dose furan group (10 mg kg^-1), testicular and ovarian weights were reduced in F1 generation at PND 70, with decreased daily sperm production (p = 0.01) and disturbed estrous cyclicity (p < 0.01). Some histopathological changes were also observed in testis and ovaries in groups whose parents were previously exposed to 10 mg kg^-1 bw of furan group. Based on the above results, it is suggested that exposure to food-based contaminant furan induced remarkable changes in the F0 (parental stage) and F1 (offspring, pubertal, and adult stage) generations of Sprague Dawley rats.

Effect of Different Concentrations of Fructose and Glycerol in Tris Citric Acid Extender on Postthaw Quality and Fertility of Buffalo Bull Spermatozoa

BACKGROUND

Fructose is considered a vital energy source for metabolic events occurring naturally in the seminal plasma of buffalo spermatozoa.

OBJECTIVE

To explore the effect of different concentrations of fructose and glycerol in tris citric acid extender on post thaw quality and in vivo fertility of buffalo spermatozoa.

MATERIALS AND METHODS

Semen was collected from three bulls through artificial vagina (42 °C). Two ejaculates were collected from each bull per collection day and were evaluated initially for consistency, volume, motility and concentration, followed by dilution in five extenders with supplements (Treatment 1: F0.1,G7 = fructose 0.1 % + glycerol 7 %; T2: F0.2,G7= fructose 0.2 % + glycerol 7 %; T3: F0.4,G6.5 = fructose 0.4 % + glycerol 6.5%; T4: F0.8,G6 = fructose 0.8 %, glycerol 6 %; T5: F1.0,G5 = fructose 1 % + glycerol 5 %). The experiment was replicated four times and the data were assessed with ANOVA.

RESULTS

The results showed that percent progressive motility, plasma membrane integrity and supra-vital plasma membrane integrity of spermatozoa was significantly higher (P < 0.05) in extender supplemented with T5 than T1 and T2. Spem hypo-resistivity, acrosome integrity and DNA integrity were significantly higher in extender supplemented with T5 than T1. Moreover, sperm in vitro quality was significantly higher in T5 than T1 during 30 and 60 min of incubation at 37 ºC. Sperm in vivo fertility was significantly higher in extenders supplemented with T5 (57.3%) as compared to T1 (41.3%).

CONCLUSION

It is concluded that extender supplemented with T5 improved post thaw semen quality and in vivo fertility of buffalo bull.

Prenatal BPA and its analogs BPB, BPF, and BPS exposure and reproductive axis function in the male offspring of Sprague Dawley rats

Research in the past has indicated associated long-term and low levels of exposure of bisphenol A (BPA) in early life and neuroendocrine disorders, such as obesity, precocious puberty, diabetes, and hypertension. BPA and its analogs bisphenol B (BPB), bisphenol F (BPF), and bisphenol S (BPS) have been reported to have similar or even more toxic effect as compared to BPA. Exposure of rats to BPA and its analogs BPB, BPF, and BPS resulted in decreased sperm production, testosterone secretion, and histological changes in the reproductive tissues of male rats. In the present study, BPA, BPB, BPF, and BPS were administered in drinking water at concentrations of (5, 25, and 50 μg/L) from pregnancy day (PD) 1 to PD 21. Body weight (BW), hormonal concentrations, antioxidant enzymes, and histological changes were determined in the reproductive tissues. BPA and its analogs prenatal exposure to female rats induced significant statistical difference in the antioxidant enzymes, plasma testosterone, and estrogen concentrations in the male offspring when compared with the control. Histological parameters of both testis and epididymis revealed prominent changes in the reproductive tissues. The present study suggests that BPA and its analogs BPB, BPF, and BPS different concentrations led to marked alterations in the development of the male reproductive system.

Detection of Retinopathy of Prematurity (ROP) in very Low Birth Weight Babies and Outcome of Management

The purpose of the present study was to early detection and management of retinopathy of prematurity (ROP). This observational descriptive/ interventional study was carried out to evaluate 96 babies brought by their parents to BIRDEM General Hospital during the period of January 2016 to June 2016 who fulfilled the inclusion and exclusion criteria. Screening of ROP was performed in all 96 babies after taking informed written consent. After screening of ROP, the babies who had ROP, staging was done and treatment was given as per requirement. Descriptive data in the study were shown by cross table and compared by student paired 't' test and Chi-square test. The study included total 96 babies of preterm low birth weight. Among them 64(66.66%) babies had no ROP, where 32(33.33%) babies had different stages of ROP. In these 32 babies, 18 babies didn't need any treatment, only 14 babies needed treatment according to their requirement (14 babies had 28 eyes, where 16 eyes needed Inj. Anti VEGF and laser and 11 eyes needed only laser and one eye had Stage V ROP, so observed that eye). Early detection of ROP and proper management not only restore the anatomical and functional outcome of the retina, but also restore the vision, prevent childhood blindness and decrease morbidity.

Effect of Cryopreservation on Casa Characteristics, Mitochondrial Transmembrane Potential, Plasma and Acrosome Integrities, Morphology and in vivo Fertility of Buffalo Bull Spermatozoa

BACKGROUND

Application of frozen-thawed semen is an important tool for improving the vivo fertility, but the process of freezing and thawing causes significant damage to spermatozoa.

OBJECTIVE

The aim of this study was to evaluate the effect of cryopreservation on CASA characteristics, mitochondrial transmembrane potential, plasma, and acrosome integrities, morphology and in vivo fertility of buffalo bull spermatozoa.

MATERIALS AND METHODS

Semen was collected from four mature buffalo bulls with artificial vagina at 42 °C. Ejaculates having > 1 mL volume, > 60 % sperm visual motility and > 0.5 x 10⁹ sperm/mL concentration from each bull were diluted in Tris-citric acid egg yolk glycerol extender (TCA) making two aliquots per bull for analysis at post dilution and cryopreserved respectively.

RESULTS

Analysis of variance (ANOVA) showed that the process of freezing and thawing significantly reduced (P < 0.05) CASA characteristics including total motility (TM, %), progressive motility (PM, %), rapid velocity (RV, %), average path velocity (VAP, µm/sec), straight line velocity (VSL, µm/sec), curvilinear velocity (VCL, µm/sec), beat cross frequency (BCF, Hz), straightness (STR, %) and linearity (LIN, %). Furthermore, the process of freezing and thawing significantly reduced (P < 0.05) subjective motility (SM, %), Supra-vital plasma membrane integrity (SVPMI, %), high mitochondrial membrane potential (HMMP, %), viable spermatozoa with intact acrosome (V/IACR, %). Moreover, it was observed that the freezing thawing process significantly decreased the in vivo fertility (%, 50.35 % vs. 61.39 %; P < 0.05) as compared to post diluted semen.

CONCLUSION

It is concluded that the process of freezing and thawing significantly reduced semen quality and in vivo fertility of buffalo bull in terms of various functional parameters.

Measurement of Ascaris lumbricoides IgG antibody, associated risk factors and identification of serum biochemical parameters as biomarkers of pathogenicity: among patients with gastrointestinal complains in Pakistan

Soil transmitted helminths are causing significant morbidity worldwide and the most common infection is Ascaris lumbricoides in developing countries. The present study aimed to determine the immuno-epidemiological status of ascariasis among patients with gastrointestinal complaints and to identify the associated risk factors and eventual changes in serum biochemical parameters to reflect its pathogenicity. This study was conducted on 700 respondents aged between 5-45 years. A total of 356 patients participated in an enzymelinked immunosorbent assay (ELISA) study to determine anti-Ascaris IgG levels and biochemical parameters. The overall seroprevalence was 58.4%, with 100% sensitivity and 84.4% specificity of the assay. The infection was highest among the 21-28 year age group (14.0%), and ascariasis was found to be not significantly (P>0.05) different between the age groups. The results showed that the risk of ascariasis was significantly (P<0.05) increased in individuals who had no contact with soil (OR=4.6, 95% CI: 1.9-10.8), eating unwashed vegetables one month prior to the study (OR=2.7, 95% CI: 1.4-5.2), eating mixed food (OR=2.4, 95% CI: 1.2-4.7), drinking pressure pump water (OR=3.4, 95% CI: 1.9-6.1), and those who had no complain of vomiting (OR=3.1, 95% CI: 1.6-5.8) and nausea (OR=1.9, 95% CI: 1.1-3.2). The results showed significantly (P<0.05) elevated level of serum alanine aminotransferase, alkaline phosphatase, serum cholesterol, total protein and globulin in anti-Ascaris IgG positive cases than the control group. The study concluded that patients who visited health care centres with gastrointestinal complain were at higher risk of ascariasis as compared to other diseases. In conclusion epidemiological studies are needed to establish baseline data for public health authorities in order to plan and implement health education programs to reduce the impact of the disease.

Prevalence and risk factors associated with intestinal parasitic infections among schoolchildren in Punjab, Pakistan

Intestinal parasitic infections (IPIs) are a major cause of morbidity worldwide and have been described as an important public health concern. The present study aimed to determine the prevalence and identification of risk factors associated with IPIs among 3-15 years old school age children residing in Mandi Bahauddin, Pakistan from 2011- 2013. A cross sectional school-based study was conducted using a structured pre-tested questionnaire. Anthropometric tools and stool tests were used to obtain epidemiological and disease data. The direct wet mount preperation in saline/iodine/haematoxylin stain and Kato-Katz methods were used for stool examination. Data were analysed using appropriate descriptive, univariate and multivariable logistic regression methods. Of the 1,434 children studied (mean age of 8.6±3.6 years) the overall prevalence rate for intestinal parasitic infections was found to be 33.3%. Children infected with single parasite accounted for 27.6% and 5.7% were detected with poly-parasitism. The study showed that helminths (21.4%) were more prevalent than protozoans (17.9%). Ascaris lumbricoides (17.5%), Giardia lamblia (9.8%), Entamoeba histolytica (8.2%), Hymenolepis nana (2.0%), Trichuris trichiura (1.3%) and Taenia saginata (0.7%) were identified in children living in irrigated areas. The multiple logistic regression model indicated that age of the child, gender, family size, source of drinking water, type of milk used, house condition, feeding habit, personal hygiene and socioeconomic status were significantly (p<0.05) associated with the IPIs. Intestinal parasites were prevalent in varying magnitude among the schoolchildren located in irrigated areas. We conclude that there is a need for mass scale campaigns to create awareness regarding health and hygiene in children, and the need for development of effective poverty control programmes because deworming alone is not adequate to control parasitic infections.

Role of Oral Clonidine Premedication on Intra-operative Haemodynamics and PONV in Laparoscopic Cholecystectomy

Laparoscopic cholecystectomy is a gold standard surgical procedure for gallbladder operation. It causes altered haemodynamic responses due to pneumoperitoneum and surgical procedure also causes high incidence of postoperative nausea &vomiting. Clonidine has been shown to reduce intraoperative haemodynamic instability. This randomized prospective single blind clinical study was designed to evaluate the efficacy of oral clonidine premedication for attenuation of haemodynamic responses associated with pneumoperitoneum & also reduce the incidence of postoperative nausea & vomiting and carried out in the department of Anaesthesia Analgesia and Intensive care Medicine, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh from January 2010 to June 2010. Sixty adult patients of ASA physical status I & II scheduled for elective laparoscopic cholecystecomy were recruited for a prospective randomized single blind study. They were selected randomized into two equal groups, thirty in each group. Group A received no premedication & Group B (Clonidine) received clonidine (100μgm) orally 60 minutes before induction of anaesthesia. Pulse rate, mean arterial pressure were recorded prior to induction, 2 minutes after endotracheal intubation, before pneumoperitoneum, 10 minutes & 20 minutes after pneumoperitoneum, 10 minutes after release of carbon dioxide & 10 minutes after extubation. Patients in Group B (Clonidine) maintained greater haemodynamic stability intraoperatively compare to Group A after intubation, during pneumoperitoneum and also extubation. Pulse rate & mean arterial pressure significantly varies in Group A compare with Group B (Clonidine) at different times of intraoperative period (p<0.05). Postoperative nausea & vomiting was significantly less in Group B (Clonidine). Premedication with oral clonidine attenuates the haemodynamic responses produced by pneumoperitoneum during laparoscopic cholecystectomy and also significantly nausea and vomiting, results better patient satisfaction and cost effective.

PKA-GSK3β and β-Catenin Signaling Play a Critical Role in Trans-Resveratrol Mediated Neuronal Differentiation in Human Cord Blood Stem Cells

The role of resveratrol (RV), a natural polyphenol, is well documented, although its role on neurogenesis is still controversial and poorly understood. Therefore, to decipher the cellular insights of RV on neurogenesis, we investigated the potential effects of the compound on the survival, proliferation, and neuronal differentiation of human cord blood-derived mesenchymal stem cells (hCBMSCs). For neuronal differentiation, purified and characterized hCBMSCs were exposed to biological safe doses of RV (10 μM) alone and in combination with nerve growth factor (NGF-50 ng). The cells exposed only to NGF (50 ng/mL) served as positive control for neuronal differentiation. The genes showing significant involvement in the process of neuronal differentiation were further funneled down at transcriptional and translational level. It was observed that RV promotes PKA-mediated neuronal differentiation in hCBMSCs by inducing canonical pathway. The studies with pharmacological inhibitors also confirmed that PKA significantly induces β-catenin expression via GSK3β induction and stimulates CREB phosphorylation and pERK1/2 induction. Besides that, the studies also revealed that RV additionally possesses the binding sites for molecules other than PKA and GSK3β, with which it interacts. The present study therefore highlights the positive impact of RV over the survival, proliferation, and neuronal differentiation in hCBMSCs via PKA-mediated induction of GSK3β, β catenin, CREB, and ERK1/2.

Obestatin modulates ghrelin's effects on the basal and stimulated testosterone secretion by the testis of rat: an in vitro study

The functional antagonism between obestatin and ghrelin in the testis is under investigation. We investigated the ability of obestatin to counteract the inhibitory effect of ghrelin on basal and stimulated testosterone (T) secretion in vitro. Testicular strips from adult rats were incubated with 10 ng/ml and 100 ng/ml of obestatin alone, ghrelin alone and obestatin + ghrelin. Obestatin modulation of stimulated T secretion was evaluated by incubation of testicular samples with 10 ng/ml and 100 ng/ml obestatin, ghrelin and obestatin + ghrelin in the absence and presence of 10 IU of human chorionic gonadotrophin (hCG). T concentrations in the hCG treated groups were significantly (P<0.0001) higher than those in the control groups. Obestatin caused a significant increase in basal T secretion in a dose-dependent manner; however, obestatin at the both 10 ng/ml and 100 ng/ml significantly (P<0.0001) increased hCG-stimulated T secretion. In contrast, ghrelin in a dose-dependent manner significantly (P<0.001) decreased both basal and hCG-induced T secretion by testicular slices. Obestatin opposed the inhibitory effect of ghrelin on T secretion under both basal and hCG-stimulated conditions at all doses tested. In conclusions, administration of obestatin was able to antagonize the inhibitory effect of ghrelin on testosterone secretion in vitro.

Adoptive Autophagy Activation: a Much-Needed Remedy Against Chemical Induced Neurotoxicity/Developmental Neurotoxicity

The profound significance of autophagy as a cell survival mechanism under conditions of metabolic stress is a well-proven fact. Nearly a decade-long research in this area has led scientists to unearth various roles played by autophagy other than just being an auto cell death mechanism. It is implicated as a vital cell survival pathway for clearance of all the aberrant cellular materials in case of cellular injury, metastasis, disease states, cellular stress, neurodegeneration and so on. In this review, we emphasise the critical role of autophagy in the environmental stressors-induced neurotoxicity and its therapeutic implications for the same. We also attempt to shed some light on the possible protective role of autophagy in developmental neurotoxicity (DNT) which is a rapidly growing health issue of the human population at large and hence a point of rising concern amongst researchers. The intimate association between DNT and neurodegenerative disorders strongly indicates towards adopting autophagy activation as a much-needed remedy for DNT.

Relationship between estimated foetal weight and renal volume in intra uterine growth retarded foetus in Bangladeshi women

Low birth weight (LBW) baby predisposes to long term renal disease, adult hypertension and related cardiovascular disease. This could be due to reduced nephron number in early life. From different studies, it is becoming increasingly clear that nephron number, indirectly reflected in renal volume may be related with normal or retarded foetal growth. This prospective study was undertaken in the department of Obstetric and Gynae in Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh. One hundred pregnant women were included in this study and divided into two groups (IUGR and normally growing foetuses). Forty one foetuses weighted less than 2.5kg and fifty nine foetuses weighed 2.5kg or more. Kidney dimensions and estimated feotal weight were measured by USG by the same ultrasonologist. There were no significant difference between two groups regarding age, height, weight, and parity. The subjects with intrauterine growth retardation had smaller head circumference, abdominal circumferences, biparietal diameters, femur length, estimated foetal weight and lower amniotic fluid indices than did the subjects with non-intrauterine growth retardation (IUGR). All biometric data shows significant deference except head circumference (HC). Intrauterine growth retardation (IUGR) foetus had significantly lower kidney volume than normally growing foetuses.

Vaginal rhinosporidiosis: a case report

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

Long versus standard initial prednisolone therapy in children with idiopathic nephrotic syndrome

The efficacy of longer initial course of prednisolone with standard regimen was compared in children with idiopathic nephrotic syndrome (INS). It was a randomized controlled trial in which patients with INS who responded to initial course of prednisolone, either long or standard regimen were included and followed for one year after completion of treatment of first attack. The long regimen consisted of prednisolone 60mg/m²/day for six weeks followed by 40mg/m² every alternate day single morning dose for further six weeks. The standard regimen consisted of prednisolone 60mg/m²/day for four weeks followed by 40mg/m² every alternate day single morning dose for further four weeks. There were 93 children who fulfilled the criteria of the study, 47 from long group and 46 from standard group though ultimately 72 completed the study (41 from long and 31 from standard group). The primary outcome measure was relapse within next one year. Relapse within one year was noted in 73.2% of long and 64.5% of standard group. The odds ratio for relapse within one year was 0.80 (95% confidence interval 0.22, 2.05). This did not reach statistical significance (p=0.696). Adverse effects of prednisolone between two groups were also not statistically significant (p>0.05). Prolongation of prednisolone therapy for initial episode of steroid-sensitive INS does not have a beneficial effect on the outcome in next one year.

Placental changes in pregnancy induced hypertension

A descriptive cross sectional study was carried out in Gynae and Obstetrics & Pathology department of Mymensingh Medical College Hospital (MMCH) to see the placental changes in normal pregnant & pregnancy induced hypertensive (PIH) mother. Total 80 placentas were collected, 40 from normal pregnant mothers having no hypertension and 40 from PIH group (one from gestational hypertension, 17 from pre-eclampsia and 22 from eclamptic mother). Macroscopic study of the placenta revealed placental weight, surface area and number of cotyledons were less in study group. Mean placental weight in study group was 419.50gm and in control group was 477.50gm (p<0.001). Mean surface area in study group & control group were 232.29cm² and 304.80cm² respectively (p<0.001). Mean number of cotyledons were 15.39 and 17.40 in study & control group respectively (p<0.001) and lower diameter of umbilical cord p<0.04667. But in the present study placental thickness was not significant p<0.539. In PIH group, macroscopic infractions were more marked. There was a single umbilical artery present in one patient in PIH group. In PIH group syncytial knots (95%), fibrinoid necrosis (80%), VSM formation, sclerosis, chorangiosis and calcification were more marked. Infarction was present in placenta of PIH 34(85%) and in control group 8(20%). Common placental changes were significant in this study. So, early intervention in PIH is rational to get the good perinatal morbidity and mortality.

Rotenone-induced oxidative stress and apoptosis in human liver HepG2 cells

Rotenone, a commonly used pesticide, is well documented to induce selective degeneration in dopaminergic neurons and motor dysfunction. Such rotenone-induced neurodegenration has been primarily suggested through mitochondria-mediated apoptosis and reactive oxygen species (ROS) generation. But the status of rotenone induced changes in liver, the major metabolic site is poorly investigated. Thus, the present investigation was aimed to study the oxidative stress-induced cytotoxicity and apoptotic cell death in human liver cells-HepG2 receiving experimental exposure of rotenone (12.5-250 μM) for 24 h. Rotenone depicted a dose-dependent cytotoxic response in HepG2 cells. These cytotoxic responses were in concurrence with the markers associated with oxidative stress such as an increase in ROS generation and lipid peroxidation as well as a decrease in the glutathione, catalase, and superoxide dismutase levels. The decrease in mitochondrial membrane potential also confirms the impaired mitochondrial activity. The events of cytotoxicity and oxidative stress were found to be associated with up-regulation in the expressions (mRNA and protein) of pro-apoptotic markers viz., p53, Bax, and caspase-3, and down-regulation of anti-apoptotic marker Bcl-2. The data obtain in this study indicate that rotenone-induced cytotoxicity in HepG2 cells via ROS-induced oxidative stress and mitochondria-mediated apoptosis involving p53, Bax/Bcl-2, and caspase-3.

Assessing glomerular filtration rate in healthy adult potential kidney donors in Bangladesh: a comparison of various prediction equations with measured glomerular filtration rate by diethylentriamine pentaacetic acid renogram

To ensure that potential kidney donors in Bangladesh have no renal impairment, it is extremely important to have accurate methods for evaluating the glomerular filtration rate (GFR). We evaluated the performance of serum creatinine based GFR in healthy adult potential kidney donors in Bangladesh to compare GFR determined by DTPA with that determined by various prediction equations. In this study GFR in 61 healthy adult potential kidney donors were measured with 99mTc-diethylenetriamine penta-acetic acid (DTPA) renogram. We also estimated GFR using a four variable equation modification of diet in renal disease (MDRD), Cockcroft-Gault creatinine clearance (CGCrCl), Cockcroft-Gault glomerular filtration rate (CG-GFR). The mean age of study population was 34.31 +/- 9.46 years and out of them 65.6% was male. In this study mean mGFR was 85.4 +/- 14.8. Correlation of estimated GFR calculated by CG-CrCl, CG-GFR and MDRD were done with measured GFR DTPA using quartile. Kappa values were also estimated which was found to be 0.104 for (p = 0.151), 0.336 for (p = 0.001) and 0.125 for (p = 0.091) respectively. This indicates there is no association between estimated GFR calculated by CG-CrCl, CG-GFR, MDRD with measured GFR DTPA. These results show poor performance of these equations in evaluation of renal function among healthy population and also raise question regarding validity of these equations for assessment of renal function in chronic kidney disease in our population.

The Incidence, Predisposing Factors, Complications and Outcome of Preeclampsia in Diabetic Pregnancy

Introduction: Preeclampsia is a serious complication of pregnancy and common cause of fetal and maternal morbidity as well as mortality worldwide. In diabetic women, the chance of preeclampsia is increased. The incidence of preeclampsia in diabetic pregnancy is approximately 10 to 15 percent, which is associated with poor glycaemic control. Aim: This study was carried out to find the predisposing factors related to preeclampsia and determine the complications of preeclampsia in diabetic pregnancy and also the impact of preeclampsia in infants born to diabetic mothers. Methods: This prospective study was carried out at the Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders (BIRDEM), Dhaka. The Patient population consisted of 80 diabetic pregnant women who attended or admitted to BIRDEM hospital during the study period. The women were divided into groups: 50 pregnant diabetic women with preeclampsia were taken as case. 30 pregnant diabetic women without preeclampsia were taken as control. Diagnosis of preeclampsia was made on the basis of the criteria of the Committee on Terminology of the American College of Obstetrician and Gynecologist. Results: Preterm delivery (<37 weeks gestation) was higher among study group (64%) compared to control (33.3%) women. Term delivery was 36.0 vs 66.7 percent among case and control women, respectively. The distribution is statistically significant (P<0.01). 35 percent of Caesarean section was done due to fetal distress in the study group and in control group it was 20 percent. In study group, 22.5 percent Caesarean sections were done due to impending eclampsia and eclampsia, 705 percent due to accidental haemorrhage and 5 percent due to IUGR. Maternal complication in study and control subjects. In the case group, maximum number of the women (16%) showed signs of impending eclampsia, while among control women, maximum number (10%) developed postpartum haemorrhage (PPH). 48 percent neonates were of low birth weight and in controls it was 13.3 percent. Both hyperbilirubinaemia (40%) and hypoglycaemia (30%) were more in study group than controls (16.66% and 20%, respectively). Perinatal outcome among study group and controls. Neonatal survival was 82.0 percent in study group and 86.7 percent in control group. Comparison of Perinatal outcome between the groups is not statistically significant. Most of the perinatal mortality was due to prematurity (8%) and intrauterine death (6%). In control group, most of the perinatal deaths were due to congenital anomalies (6.6%). Conclusion: The higher incidence among study group may be, in part, the result of more preterm birth or shortened gestational duration because early delivery is a consequence of preeclampsia. The higher rate in associated with preeclampsia was due to increased incidence of IUD and prematurity. DOI: http://dx.doi.org/10.3329/birdem.v1i1.12379 Birdem Med J 2011; 1(1): 10-14