Association of Triglyceride and C-reactive Protein Level with Severity of Angiographically Defined Coronary Artery Disease

Coronary artery disease (CAD) is considered as a major cause of morbidity and mortality worldwide. Inflammatory cytokines play an important role in the pathogenesis and progression of atherosclerosis. The aim of the study was to find out the association of C-reactive protein (CRP) and triglyceride (TG) level on the severity of CAD in patients with ischemic heart disease (IHD). This cross-sectional study was performed in the Department of Cardiology, National Institute of Cardiovascular Diseases, Dhaka, Bangladesh during the period of March 2018 to February 2021. Total 431 patients with ischemic heart disease were enrolled after taking informed written consent. CRP values were categorized into normal (<6 mg/L), borderline (6-10 mg/L) and high (>10mg/L) and TG level were categorized into normal (<150 mg/dl), borderline (150-199mg/dl) and high (≥200 mg/dl). Patients with ischemic heart disease (IHD) were stratified according to CRP value and TG level. Severity of CAD was assessed by the Gensini score. Most of the patients (33.4%) belonged to age 51-60 years. The mean age was 51.31±10.30 years. The majority (74.5%) of patients were male. Among risk factors, the highest 205(47.6%) patients were smokers followed by hypertension 190(44.1%) and diabetes mellitus 175(40.5%). The association of TG and CRP with the whole spectrum of IHD was found statistically significant (p<0.05). Severe CAD was found higher in high TG and high CRP level group compared with the other groups and was statistically significant. Inflammation assessed by high CRP and hypertriglyceridemia associated with the risk and severity of CAD.

Internet of medical things and blockchain-enabled patient-centric agent through SDN for remote patient monitoring in 5G network

During the COVID-19 pandemic, there has been a significant increase in the use of internet resources for accessing medical care, resulting in the development and advancement of the Internet of Medical Things (IoMT). This technology utilizes a range of medical equipment and testing software to broadcast patient results over the internet, hence enabling the provision of remote healthcare services. Nevertheless, the preservation of privacy and security in the realm of online communication continues to provide a significant and pressing obstacle. Blockchain technology has shown the potential to mitigate security apprehensions across several sectors, such as the healthcare industry. Recent advancements in research have included intelligent agents in patient monitoring systems by integrating blockchain technology. However, the conventional network configuration of the agent and blockchain introduces a level of complexity. In order to address this disparity, we present a proposed architectural framework that combines software defined networking (SDN) with Blockchain technology. This framework is specially tailored for the purpose of facilitating remote patient monitoring systems within the context of a 5G environment. The architectural design contains a patient-centric agent (PCA) inside the SDN control plane for the purpose of managing user data on behalf of the patients. The appropriate handling of patient data is ensured by the PCA via the provision of essential instructions to the forwarding devices. The suggested model is assessed using hyperledger fabric on docker-engine, and its performance is compared to that of current models in fifth generation (5G) networks. The performance of our suggested model surpasses current methodologies, as shown by our extensive study including factors such as throughput, dependability, communication overhead, and packet error rate.

In silico exploration of Serratia sp. BRL41 genome for detecting prodigiosin Biosynthetic Gene Cluster (BGC) and in vitro antimicrobial activity assessment of secreted prodigiosin

The raising concern of drug resistance, having substantial impacts on public health, has instigated the search of new natural compounds with substantial medicinal activity. In order to find out a natural solution, the current study has utilized prodigiosin, a linear tripyrrole red pigment, as an active ingredient to control bacterial proliferation and prevent cellular oxidation caused by ROS (Reactive Oxygen Species). A prodigiosin-producing bacterium BRL41 was isolated from the ancient Barhind soil of BCSIR Rajshahi Laboratories, Bangladesh, and its morphological and biochemical characteristics were investigated. Whole genome sequencing data of the isolate revealed its identity as Serratia sp. and conferred the presence of prodigiosin gene cluster in the bacterial genome. "Prodigiosin NRPS", among the 10 analyzed gene clusters, showed 100% similarity with query sequences where pigC, pigH, pigI, and pigJ were identified as fundamental genes for prodigiosin biosynthesis. Some other prominent clusters for synthesis of ririwpeptides, yersinopine, trichrysobactin were also found in the chromosome of BRL41, whilst the rest displayed less similarity with query sequences. Except some first-generation beta-lactam resistance genes, no virulence and resistance genes were found in the genome of BRL41. Structural illumination of the extracted red pigment by spectrophotometric scanning, Thin-Layer Chromatography (TLC), Fourier Transform Infrared Spectroscopy (FTIR), and change of color at different pH solutions verified the identity of the isolated compound as prodigiosin. Serratia sp. BRL41 attained its maximum productivity 564.74 units/cell at temperature 30˚C and pH 7.5 in two-fold diluted nutrient broth medium. The compound exhibited promising antibacterial activity against Gram-positive and Gram-negative bacteria with MIC (Minimum Inhibitory Concentration) and MBC (Minimum Bactericidal Concentration) values ranged from 3.9 to15.62 μg/mL and 7.81 to 31.25 μg/mL respectively. At concentration 500 μg/mL, except in Salmonella enterica ATCC-10708, prodigiosin significantly diminished biofilm formed by Listeria monocytogens ATCC-3193, Pseudomonas aeruginosa ATCC-9027, Escherichia coli (environmental isolate), Staphylococcus aureus (environmental isolate). Cellular glutathione level (GSH) was elevated upon application of 250 and 500 μg/mL pigment where 125 μg/mL failed to show any free radical scavenging activity. Additionally, release of cellular components in growth media of both Gram-positive and Gram-negative bacteria were facilitated by the extract that might be associated with cell membrane destabilization. Therefore, the overall findings of antimicrobial, antibiofilm and antioxidant activities suggest that in time to come prodigiosin might be a potential natural source to treat various diseases and infections.

Nutritional characteristics and antiradical activity of turmeric (Curcuma longa L.), beetroot (Beta vulgaris L.), and carrot (Daucus carota L.) grown in Bangladesh

Curcuma longa L. (turmeric), Beta vulgaris L. (beetroot), and Daucus carota L. (carrot) grown in Bangladesh were analyzed for nutritional and phytochemical contents to reveal their comparative nutritional compositions and antiradical properties. Ash, protein, and carbohydrate content were significantly preeminent in beetroot as compared to others. Whereas fat content was found to be high in turmeric, carrots contained a great percentage of crude fiber. Beetroot was shown to have much greater potassium, calcium, and iron levels than others. Regarding amino acids, glutamic acid was found to be greater in beetroot and carrot whereas turmeric had significantly high aspartic acid content. Leucine had the highest concentration among essential amino acids in these three samples. Total antioxidant activity, total flavonoids, and phenolic contents in the methanolic extract of turmeric were found to be substantially higher than in beetroot and carrot. Furthermore, the extract of turmeric (IC50 value: 13.46 μg/mL) scavenged 1,1-diphenyl-2-picrylhydrazyl radical (DPPH) free radicals considerably to a greater extent than beetroot (IC50 value: 380.61 μg/mL) and carrot (IC50 value: 1252.85 μg/mL). A positive correlation was found between the phytochemical contents and antiradical activity. The information from this study will help to find the potential ingredients from these plants for functional food.

4SQR-Code: A 4-state QR code generation model for increasing data storing capacity in the Digital Twin framework

INTRODUCTION

The usage of Quick Response (QR) Codes has become widely popular in recent years, primarily for immense electronic transactions and industry uses. The structural flexibility of QR Code architecture opens many more possibilities for researchers in the domain of the Industrial Internet of Things (IIoT). However, the limited storage capacity of the traditional QR Codes still fails to stretch the data capacity limits. The researchers of this domain have already introduced different kinds of techniques, including data hiding, multiplexing, data compression, color QR Codes, and so on. However, the research on increasing the data storage capacity of the QR Codes is very limited and still operational.

OBJECTIVES

The main objective of this work is to increase the data storage capacity of QR Codes in the IIoT domain.

METHODS

In the first part, we have introduced a 4-State-Pattern-based encoding technique to generate the proposed 4-State QR (4SQR) Code where actual data are encoded into a 4SQR Code image which increases the data storage capacity more than the traditional 2-State QR Code. The proposed 4SQR Code consists of four types of patterns, including Black Square Box (BSB), White Square Box (WSB), Triangle, and Circle, whereas the traditional 2-State QR Codes consist of BSB and WSB. In the second part, the 4SQR Code decoding module has been introduced using the adaptive YOLO V5 algorithm where the proposed 4SQR Code image is decoded into the actual data.

RESULTS

The proposed model is tested in a Digital Twin (DT) framework using randomly generated 3000 testing samples for the encoding module that converts into 4SQR Code images successfully and similarly for the decoding module that decodes the 4SQR Code images into the actual data.

CONCLUSION

Experimental results show that this proposed technique offers increased data storage capacity two times than traditional 2-State QR Codes.

2D-2D Nanoheterostructure of an Exposed {001}-Facet CuO and MoS2 Based Bifunctional Catalyst Showing Excellent Surface Chemistry and Conductivity for Cathodic CO2 Reduction

A novel CuO-MoS2 based heterostructure catalyst model system is proposed where a CuO nanosheet with exposed {001} facet with proper termination is the active surface for the catalysis and a MoS2 nanosheet is the supporting layer. Density functional theory (DFT) calculations were performed to validate the model. The MoS2 bilayer forms a stable heterostructure with {001} faceted CuO with different terminations exposing oxygen and copper atoms (active sites) on the surface. The heterostructure active sites with a low oxidation state of the copper atoms and subsurface oxygen atoms provide a suitable chemical environment for the selective production of multicarbon products from CO2 electrocatalytic reduction. Furthermore, our heterostructure model exhibits good electrical conductivity, efficient electron transport to active surface sites, and less interfacial resistance compared to similar heterostructure systems. Additionally, we propose a photoenhanced electrocatalysis mechanism due to the photoactive nature of MoS2. We suggest that the photogenerated carrier separation occurs because of the interface-induced dipole. Moreover, we utilized a machine learning model trained on a 2D DFT materials database to predict selected properties and compared them with the DFT results. Overall, our study provides insights into the structure-property relationship of a MoS2 supported 2D CuO nanosheet based bifunctional catalyst and highlights the advantages of heterostructure formation with selective morphology and properly terminated surface in tuning the catalytic performance of nanocomposite materials.

Actual rating calculation of the zoom cloud meetings app using user reviews on google play store with sentiment annotation of BERT and hybridization of RNN and LSTM

The recent outbreaks of the COVID-19 forced people to work from home. All the educational institutes run their academic activities online. The online meeting app the "Zoom Cloud Meeting" provides the most entire supports for this purpose. For providing proper functionalities require in this situation of online supports the developers need the frequent release of new versions of the application. Which makes the chances to have lots of bugs during the release of new versions. To fix those bugs introduce developer needs users' feedback based on the new release of the application. But most of the time the ratings and reviews are created contraposition between them because of the users' inadvertent in giving ratings and reviews. And it has been the main problem to fix those bugs using user ratings for software developers. For this reason, we conduct this average rating calculation process based on the sentiment of user reviews to help software developers. We use BERT-based sentiment annotation to create unbiased datasets and hybridize RNN with LSTM to find calculated ratings based on the unbiased reviews dataset. Out of four models trained on four different datasets, we found promising performance in two datasets containing a necessarily large amount of unbiased reviews. The results show that the reviews have more positive sentiments than the actual ratings. Our results found an average of 3.60 stars rating, where the actual average rating found in dataset is 3.08 stars. We use reviews of more than 250 apps from the Google Play app store. The results of our can provide more promising if we can use a large dataset only containing the reviews of the Zoom Cloud Meeting app.

Socio-economic inequalities in undiagnosed, untreated, and uncontrolled diabetes mellitus in Bangladesh: is there a gender difference?

OBJECTIVES

We aimed to determine: (1) the prevalence and socio-economic distribution of undiagnosed, untreated, and uncontrolled diabetes mellitus (DM); (2) the relationship between socio-economic status (SES) and undiagnosed, untreated, and uncontrolled DM; and (3) if this relationship is mediated by gender.

STUDY DESIGN

Cross-sectional nationally representative household-based survey.

METHODS

We used data from the Bangladesh Demographic Health Survey from 2017 to 18. Our findings were based on the responses of 12,144 individuals aged 18 years and older. As a measure of SES, we focused on standard of living (hereinafter referred to as wealth). The study's outcome variables were prevalence of total (diagnosed + undiagnosed), undiagnosed, untreated, and uncontrolled DM. We used three regression-based approaches-adjusted odds ratio, relative inequality index, and slope inequality index-to assess different aspects of SES differences in the prevalence of total, undiagnosed, untreated, and uncontrolled DM. We used logistic regression analysis to look at the adjusted association between SES and the outcomes after gender stratification to see whether gender status moderates the association between SES and the targeted outcomes.

RESULTS

In our sample analysis, the age-adjusted prevalence of total, undiagnosed, untreated, and uncontrolled DM was 9.1%, 61.4%, 64.7%, and 72.1%, respectively. Females had a higher prevalence of DM and undiagnosed, untreated, and uncontrolled DM than males. When compared to people in the poor SES group, people in the rich and middle SES groups had 2.60 times (95% confidence interval [CI] 2.05-3.29) and 1.47 times (95% CI 1.18-1.83) higher chance of developing DM. When compared to individuals in the poor SES group, those in the rich SES groups were 0.50 (95% CI 0.33-0.77) and 0.55 times (95% CI 0.36-0.85) less likely to have undiagnosed and untreated DM.

CONCLUSIONS

In Bangladesh, rich SES groups were more likely than poor SES groups to have DM, whereas poor SES groups with DM were less likely than rich SES groups to be aware of their disease and obtain treatment. The government and other concerned parties are urged by this study to pay more attention to developing suitable policy measures to reduce the risk of DM, particularly among rich SES groups, as well as targeted efforts to screen for and diagnose DM in socio-economically disadvantaged groups.

Vertical profile of dissolved oxygen and associated water variables in the Pasur-Rupsha estuary of Bangladesh

Vertical profile of dissolved oxygen (DO) and associated water variables were measured in the head of the Pasur-Rupsha estuary of Bangladesh. Water samples were collected from two stations at 0.60 m depth intervals during high and low tides from July, 2016 to January, 2017. DO concentration was ranged from 6.0 to 8.6 mg/l with maximum two units of variation in the profiles of the stations and demonstrated an inconsistent stratification pattern. The observed stratification pattern was remarkably triggered by a relatively high concentration of DO in the bottom layer than that of the surface layer during both the high and low tides in most of the study periods. High rate of freshwater flow at the surface; existence of estuarine gravitational circulation with 5-15 m depth profile; and lack of consumers in the bottom due to the high deposition of sediment particles were found responsible for the relatively high concentration of DO at bottom and low in surface layer of the estuary. Water temperature, salinity, pH, phytoplankton density and transparency were ranged from 22 to 32 °C, 0-6 ppt, 7.0 to 8.5, 1000-23000 ind/l and 13-17 cm respectively considering the depth profiles in the study periods. Temperature and plankton density were found significantly (P < 0.000) correlated with DO while the pH and salinity did not show any significant (P > 0.3) correlation. The ecosystem process associated with the vertical profile of DO explained in this study will provide considerable advances in understanding the ecosystem dynamics of the Pasur-Rupsha Estuary of Bangladesh.

SDN-IoT empowered intelligent framework for industry 4.0 applications during COVID-19 pandemic

The industrial ecosystem has been unprecedentedly affected by the COVID-19 pandemic because of its immense contact restrictions. Therefore, the manufacturing and socio-economic operations that require human involvement have significantly intervened since the beginning of the outbreak. As experienced, the social-distancing lesson in the potential new-normal world seems to force stakeholders to encourage the deployment of contactless Industry 4.0 architecture. Thus, human-less or less-human operations to keep these IoT-enabled ecosystems running without interruptions have motivated us to design and demonstrate an intelligent automated framework. In this research, we have proposed "EdgeSDN-I4COVID" architecture for intelligent and efficient management during COVID-19 of the smart industry considering the IoT networks. Moreover, the article presents the SDN-enabled layer, such as data, control, and application, to effectively and automatically monitor the IoT data from a remote location. In addition, the proposed convergence between SDN and NFV provides an efficient control mechanism for managing the IoT sensor data. Besides, it offers robust data integration on the surface and the devices required for Industry 4.0 during the COVID-19 pandemic. Finally, the article justified the above contributions through particular performance evaluations upon appropriate simulation setup and environment.

On the Integration of Blockchain and SDN: Overview, Applications, and Future Perspectives

Blockchain (BC) and software-defined networking (SDN) are leading technologies which have recently found applications in several network-related scenarios and have consequently experienced a growing interest in the research community. Indeed, current networks connect a massive number of objects over the Internet and in this complex scenario, to ensure security, privacy, confidentiality, and programmability, the utilization of BC and SDN have been successfully proposed. In this work, we provide a comprehensive survey regarding these two recent research trends and review the related state-of-the-art literature. We first describe the main features of each technology and discuss their most common and used variants. Furthermore, we envision the integration of such technologies to jointly take advantage of these latter efficiently. Indeed, we consider their group-wise utilization—named BC–SDN—based on the need for stronger security and privacy. Additionally, we cover the application fields of these technologies both individually and combined. Finally, we discuss the open issues of reviewed research and describe potential directions for future avenues regarding the integration of BC and SDN. To summarize, the contribution of the present survey spans from an overview of the literature background on BC and SDN to the discussion of the benefits and limitations of BC–SDN integration in different fields, which also raises open challenges and possible future avenues examined herein. To the best of our knowledge, compared to existing surveys, this is the first work that analyzes the aforementioned aspects in light of a broad BC–SDN integration, with a specific focus on security and privacy issues in actual utilization scenarios.

Hybrid EuIII Coordination Luminophore Standing on Two Legs on Silica Nanoparticles for Enhanced Luminescence

In this study, we have demonstrated a two-legged, upright molecular design method for monochromatic and bright red luminescent Ln^III -silica nanomaterials. A novel Eu^III -silica hybrid nanoparticle was developed by using a doubly binding TPPO-Si(OEt)₃ (TPPO: triphenyl phosphine oxide) linker. The TPPO-Si(OEt)₃ was confirmed by ¹ H, ³¹ P, ²⁹ Si NMR spectroscopy and single-crystal X-ray analysis. Luminescent Eu(hfa)₃ and Eu(tfc)₃ moieties (hfa: hexafluoroacetylacetonate, tfc: 3-(trifluoromethylhydroxymethylene)camphorate) were fixed onto TPPO-Si(OEt)₃ -modified silica nanoparticles, producing Eu(hfa)₃ (TPPO-Si)₂ -SiO₂ and Eu(tfc)₃ (TPPO-Si)₂ -SiO₂ , respectively. Eu(hfa)₃ (TPPO-Si)₂ -SiO₂ exhibited the higher intrinsic luminescence quantum yield (93 %) and longer emission lifetime (0.98 ms), which is much larger than those of previously reported Eu^III -based hybrid materials. Eu(tfc)₃ (TPPO-Si)₂ -SiO₂ showed an extra-large intrinsic emission quantum yield (54 %), although the emission quantum yield for the precursor Eu(tfc)₃ (TPPO-Si(OEt)₃ )₂ was found to be 39 %. These results confirmed that the TPPO-Si(OEt)₃ linker is a promising candidate for development of Eu^III -based luminescent materials.

Strong circularly polarized luminescence of mixed lanthanide coordination polymers with control of 4f electronic structures

This paper reports chiral mixed Eu(iii)-Ln(iii) coordination polymers (Ln = Gd and Sm) with a high dissymmetry factor of circularly polarized luminescence (gCPL = 0.15) for the enhancement of the emission quantum yield (Φtot ≥ 50%), achieved via control of 4f electronic structures.

Formulation of a Hybrid Nanofertilizer for Slow and Sustainable Release of Micronutrients

In this work, we have proposed a new formulation of a hybrid nanofertilizer (HNF) for slow and sustainable release of nutrients into soil and water. Urea-modified hydroxyapatite was synthesized, which is a rich source of nitrogen, calcium, and phosphate. Nanoparticles such as copper, iron, and zinc were incorporated into urea-modified hydroxyapatite to increase the efficiency of the proposed fertilizer. Different techniques including powder X-ray powder diffraction, Fourier-transform infrared spectroscopy, and scanning electron microscopy were used to get insight into the properties, morphology, and structure of the as-prepared fertilizer. The developed HNF was used in a field experiment on the ladies' finger (Abelmoschus esculentus) plant. The slow release of HNF was observed during leaching studies and confirmed the availability of Ca²⁺, PO₄ ^3-, NO^2-, NO^3-, Cu²⁺, Fe²⁺, and Zn²⁺. Furthermore, the presence of Cu²⁺, Fe²⁺, and Zn²⁺ nutrients in ladies' finger was confirmed by the inductively coupled plasma-optical emission spectrometry (ICP-OES) experiment. A considerable increase in the physicochemical properties such as swelling ratio and water absorption and retention capacities of the proposed fertilizer was observed, which makes the fertilizer more attractive and beneficial compared with the commercial fertilizer. The composition of the proposed HNF was functionally valuable for slow and sustainable release of plant nutrients. The dose of prepared HNF applied was 50 mg/week, whereas the commercial fertilizer was applied at a dose of 5 g/week to A. esculentus. The obtained results showed a significant increase of Cu²⁺, Fe²⁺, and Zn²⁺ nutrient uptake in A. esculentus as a result of slow release from HNF.

Person-following by autonomous robots: A categorical overview

A wide range of human–robot collaborative applications in diverse domains, such as manufacturing, health care, the entertainment industry, and social interactions, require an autonomous robot to follow its human companion. Different working environments and applications pose diverse challenges by adding constraints on the choice of sensors, degree of autonomy, and dynamics of a person-following robot. Researchers have addressed these challenges in many ways and contributed to the development of a large body of literature. This paper provides a comprehensive overview of the literature by categorizing different aspects of person-following by autonomous robots. Also, the corresponding operational challenges are identified based on various design choices for ground, underwater, and aerial scenarios. In addition, state-of-the-art methods for perception, planning, control, and interaction are elaborately discussed and their applicability in varied operational scenarios is presented. Then some of the prominent methods are qualitatively compared, corresponding practicalities are illustrated, and their feasibility is analyzed for various use cases. Furthermore, several prospective application areas are identified, and open problems are highlighted for future research.

The Association of HER-2 Over-expression in Relation to Hormonal Receptor Status and Common Clinico-pathological Parameters in Breast Carcinoma

Objective: To determine the association of Human Epidermal growth factor Receptor2 (HER-2) with hormonal receptor status and common clinico-pathological parameters of breast carcinoma. Study Design: Cross-sectional, observational study. Place and Duration of Study: Department of Surgery, Sir Salimullah Medical College Mitford Hospital, Dhaka, Bangladesh during the period from January 2009 to December 2009. Methodology: A total of 100 patients of female breast carcinoma with HER-2 status, hormonal receptor profile and clinico-pathological parameters were included in this study. Patient's age, menopausal status, tumour size, lymph node status, Estrogen Receptor (ER) and Progesterone Receptor (PR) status were evaluated and their association was determined with H.ER-2 over expression using the chi-square test for analysis. Results: Of these 100 cases, mean age of diagnosis was 48 years and mean tumour size 4.4 cm. Lymph node metastases were present in 50% cases. HER-2 over-expression was seen in 29% cases, while ER and PR expression was seen in 61 % and 43% respectively. ER and PR showed inverse association (p <0.05) with HER-2 while positive association was seen with tumour size and lymph node metastases (p <0.05). No association was seen with menopausal status. Further, among 61 ER positive cases, 4 cases also HER-2 over expressed. Conclusion: The study had indicated that Her-2 may be a powerful predictor of poor prognosis as its over-expression was strongly directly associated with tumor size and lymph node involvement and inversely associated with hormonal receptor status of breast carcinoma. ER positive cases can also be HER-2 over expressed (4%), so ER status cannot be used to select tumours for evaluation of HER-2 status. As treatment modalities of ER positive and HER-2 over expressed is different, so all the patients should be studied with both receptor and treat accordingly. Journal of Surgical Sciences (2012) Vol. 16 (2) : 59-67

A Case Study on Chronic Hepatitis-C Viral infection Associated with Hepatocellular Carcinoma in a Tertiary Hospital of Bangladesh

Hepatocellular carcinoma (HCC) is an important reason of liver-related death globally. HCC is the fifth most common cancer, the third most common cause for cancer related death in the world and responsible for approximately one million deaths each year. The incidence of HCC is expected to increase in the next two decades, largely due to hepatitis C infection and secondary cirrhosis. We have reported a case of hepatocellular carcinoma in a 56-year-old man with peritoneal metastasis. Diagnostic imaging (Ultra sonogram & CT-Scan) shown: a large hypo density, irregular outline lesion noted in right lower liver, post contrast image shown patchy enhancement of the lesion. His serum Alpha-Feto Protein (AFP) level was very high with elevated serum alanine amino transaminase (ALT) enzyme and prothrombin time. Histopathological (microscopic) features are compatible with Hepatocellular carcinoma. His Hepatitis C viral DNA load e.g., core protein variants and genotype 1, have been reported. The patient was treated by surgical resection followed by conservative treatment includes sorafenib & interferon alpha. This case report aims to outlines the epidemiology of HCC in chronic HCV, risk factors and pathophysiology that contribute to this disease process, related pathophysiology of patient's clinical features, screening recommendations, and the available statistics on the impact of new direct-acting antiviral treatment on the development on HCC.

A 35 Year Old Bangladeshi Lady with Hereditary Mucinous Ovarian Cancer, Complicated with Omental Metastasis

Approximately 80% ovarian tumors are benign, and these arise mostly in young adult females. Malignant tumors are more prevalent in ageing women, between the ages of 45-65 years. Mucinous ovarian cancer represents about 5% of epithelial ovarian cancers (EOC). We have reported a case of mucinous cystadenocarcinoma in 35-year-old lady with metastasis to momentum. Imaging (Radiograph & CT scan) studies showed a large right sided pelvic mass with probable origin in the right ovary. Cancer antigen-125 was elevated, while carcinoembrionic antigen and alpha-fetoprotein were normal. Mutational profiles shown distinct finding, as KRAS mutations positive nevertheless p53 and BRCA mutations are absent. She had undergone total abdominal hysterectomy with bilateral salphingo-oopherectomy along with pelvic dissection for removal of lymph nodes at the age of 35. She was given 3 cycles of chemotherapy with cisplatin and paclitaxel. To the best of our knowledge, this is the one of the little cases of ovarian mucinous cystadenocarcinoma being reported at a relatively young age and the first case being reported from Bangladesh.

Pattern and Extent of Tricuspid Valve Involvement in Chronic Rheumatic Heart Disease

Rheumatic heart disease causes a significant number of morbidity and mortality in Bangladesh. Although the mitral and the aortic valve are the two most involved valves in rheumatic heart disease, the tricuspid valve disease is not uncommon secondary to, or in association with, mitral or aortic valve disease, but receives less attention as compared to the primary left-sided valve disease. Appropriate treatment of the tricuspid valve disease may improve long-term functional outcome. But the pattern and extent of the tricuspid valve involvement was not studied recently. This study was carried out to observe the pattern and extent of tricuspid valve involvement in Rheumatic Heart Disease patients. This observational analytical study was undertaken in the department of Cardiology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh from December 2010 to September 2011. Considering all ethical issues, data were collected from 173 subjects who underwent Echocardiography for their Chronic Rheumatic heart disease. Pattern of tricuspid valve involvement was observed by using Transthoracic Echocardiography by 2D, M mode and Doppler assessment. One hundred seventy three (173) patients with Rheumatic Heart disease was studied, out of these, 36 patients had evidence of tricuspid valve involvement based on echocardiographic findings. Fifteen (15) patients had Tricuspid stenosis and 36 patients had Tricuspid Regurgitation in the patients with TV involvement. All the patients with TV involvement had thickened leaflets. Doming, restriction of motion and calcification were present in different proportions. From this study, it can be concluded that organic tricuspid valve involvement in RHD is not uncommon in our country.

Hydrogeochemical quality and suitability studies of groundwater in northern Bangladesh

Agriculture, rapid urbanization and geochemical processes have direct or indirect effects on the chemical composition of groundwater and aquifer geochemistry. Hydro-chemical investigations, which are significant for assessment of water quality, were carried out to study the sources of dissolved ions in groundwater of Dinajpur district, northern Bangladesh. The groundwater samplish were analyzed for physico-chemical properties like pH, electrical conductance, hardness, alkalinity, total dissolved solids and Ca2+, Mg2+, Na+, K+, CO3(2-), HCO3(-), SO4(2-) and Cl- ions, respectively. Based on the analyses, certain parameters like sodium adsorption ratio, soluble sodium percentage, potential salinity, residual sodium carbonate, Kelly's ratio, permeability index and Gibbs ratio were also calculated. The results showed that the groundwater of study area was fresh, slightly acidic (pH 5.3-6.4) and low in TDS (35-275 mg I(-1)). Ground water of the study area was found suitable for irrigation, drinking and domestic purposes, since most of the parameters analyzed were within the WHO recommended values for drinking water. High concentration of NO3- and Cl- was reported in areas with extensive agriculture and rapid urbanization. Ion-exchange, weathering, oxidation and dissolution of minerals were major geochemical processes governing the groundwater evolution in study area. Gibb's diagram showed that all the samples fell in the rock dominance field. Based on evaluation, it is clear that groundwater quality of the study area was suitable for both domestic and irrigation purposes.

Community acquired pneumonia in diabetic and non-diabetic hospitalized patients: presentation, causative pathogens and outcome

Both community acquired pneumonia (CAP) and diabetes mellitus are common in Bangladesh. Though hospitalization of diabetic patients with CAP is increasing, data regarding their clinical presentation, microbial characteristics, antimicrobial susceptibility and outcome are lacking. This study was aimed at finding any difference in clinical presentation, bacterial causes, antimicrobial susceptibility pattern of isolated bacteria and outcome in diabetic and non-diabetic hospitalized patients with CAP. In this study total 47 diabetic and 43 non-diabetic adult hospitalized patients with CAP were enrolled. Clinical presentation of CAP differed in diabetics and non-diabetics. Frequency of atypical presentation and CURB-65 score were significantly higher in diabetics. Pleural effusion with multilobar infiltration was also common feature for CAP in diabetic patients. Klebsiella pneumoniae was the most frequent causative pathogen for CAP in diabetic patients, whereas Streptococcus pneumoniae was the most frequent causative agent for non-diabetic patients. Bacteria isolated from sputum sample of diabetic patients with CAP were resistant to almost all recommended antibiotics used for CAP but 100% of isolates were sensitive to Carbapenems. Pulmonary complications were relatively more in diabetics than in non-diabetics. Hospitalized diabetics with CAP required referral to intensive care unit more than that of non-diabetics. So, diabetic patients with CAP need extra attention.

Association of serum uric acid with ischemic stroke

The present study has examined the association between ischemic stroke and hyperuricemia in Bangladeshi population. This age and sex matched case control study was carried out in the Department of Neurology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh during the period of January 2007 to December 2008. A total of 120 subjects were included in this study, among them 60 were cases and another 60 were controls. Data were collected purposively. Multiple logistic regressions were done to identify the risk factors for ischemic stroke. In this study 68.3% were male and 31.7% were female in both the groups. Male and female ratio of stroke patients was 2.16:1. Mean±SD of serum uric acid level of case and control group was 4.94±1.76 and 3.72±1.09 respectively. Among the case group 76.7% had normal and 23.3% had abnormal serum uric acid level. On the other hand, 93.3% respondents of control group had normal and 6.7% had abnormal serum uric acid (SUA) level. Significant differences was found between case and control group in term of SUA level (p<0.05). Since SUA level is a quantitative numerical variable, an increase in 1mg/dl has a 47.0% (95% CI 1.0% to 2.16%) increase in odds ratio (OR) of having ischemic stroke. This 47.0% is obtained by taking OR for uric acid-1. Elevated serum uric acid level is not significant for ischemic stroke among the Bangladeshi population.

Design of potential siRNA molecules for T antigen gene silencing of Merkel Cell Polyomavirus

Merkel cell carcinoma (MCC) is the most aggressive skin cancer. Recently, it was demonstrated that human Merkel cell polyomavirus (MCV) is clonally integrated in 80% of MCC tumors. Genetic studies of MCV have shown that T antigen protein is responsible for replication of genome and play a foremost role in viral infection. Therefore, T antigen protein may be used as suitable target for disease diagnosis. Viral activity can be restrained through RNA interference (RNAi) technology, an influential method for post transcriptional gene silencing in a sequence specific manner. In current study four effective siRNA molecules for silencing of MCV were rationally designed and validated using computational methods, which may lead to knockdown the activity of virus. Thus, this approach may provide an insight for the chemical synthesis of antiviral RNA molecule for the treatment of MCC at genome level.

Pattern of cancer in young adults at National Institute of Cancer Research and Hospital (NICRH), Bangladesh

This is an analysis of 1624 young adults (20-44 years) new cancer patients who attended Out Patient Department of NICRH in 2005 from 01 January to 31 December. This study was carried out to know the age and sex distribution and types of cancer they are suffering from. Histologiacally or cytologically confirmed patients or those patients having radiological or clinical evidence of malignancy were included in the study. There were 42.9% male and 57.1% female with male to female ratio of 0.75: 1.00. Female populations of this age group were the most cancer sufferers. Mean age of young adults was 34.47 (SD+/-6.33) years. Muslims (93.4%) were in majority and 36.5% were illiterate. This study revealed that the top five cancers found in both sexes were breast cancer (19.2%), female genital organ cancer (17.7%), GIT cancer (13.5%), head & neck cancer (12.2%) and respiratory tract cancer (7.9%). Breast cancer and GIT cancer ranked top among females and males respectively.

Factors influencing the outcome of patients with acute extradural haematomas undergoing surgery

Background: Acute extradural haematoma (EDH) remains most common cause of mortality and disability resulting from traumatic brain injury. In the last three decades, improvements in rescue, neuromonitoring, diagnostic procedure and intensive care have led to better outcomes. The purpose of this study was to evaluate the factors influencing the outcome in patients with EDH undergoing surgery treated in a tertiary hospital in Bangladesh. Methods: In this retrospective study, 102 consecutive patients with acute EDH who underwent craniotomy were included. The study was carried out from July 2003 to December 2005. The diagnosis was made clinically and radiologically by CT scan. Patients were grouped on the basis of Glasgow Coma Scale (GCS) and operative outcomes were evaluated by Glasgow Outcome Scale (GOS) Results: More than half sampled respondents’ (57%) age were more than 20 years while rests of the patients below 20 years with male predominance (Male: Female -12:1). About 7 in 10 respondents (70.6%) were working. Similarly, majority of the respondents (79.4%) had lost more than 30 ml blood. A notable proportion of the respondents (73.5%) had good GCS score (9-15 score) during admission. Similarly majority of the respondents (70.6%) had GCS score 9-15 and 29.4% had GCS score 3-8 before surgery. Road Traffic Accident (RTA) (65%) is the most common cause of EDH followed by assault (20%) and fall from height (12%). Temporal and temporo-parietal locations were the most common site of EDH (56%). Patients with good GCS before surgery had significantly better outcome (89%) compare to those who had bad GCS (10%). Conclusion: Level of consciousness before surgery is the most important factor affecting the outcome. Hence, early diagnosis and surgical intervention is very essential. Key words: Acute Extradural Haematoma (EDH); Glasgow Coma Scale (GCS); Glasgow Outcome Scale (GOS). DOI: http://dx.doi.org/10.3329/bjms.v10i2.7806 Bangladesh Journal of Medical Science Vol.10 No.2 Apr’11 pp.112-120

Surgical experience with a huge supratentorial primitive neuroectodermal tumour in a 3 years old boy

The concept of Primitive Neuroectodermal Tumor (PNET) has been evolving for many years, since its nomenclature has been done. A 3 years old boy presented with unable to stand and walk, vertigo, vomiting and visual disturbances. MRI of brain revealed suggestive of malignant tumour with intratumoral hemorrhage involving the frontotemporo- parietal region. A gross total removal of tumor was achieved through craniotomy. The pathological finding was consistent with PNET. This case is an exclusive one as it was huge size. Supratentorial PNETs are rare tumour and carry poor prognosis. Newer modalities of treatment should be tried to improve survival. Key words: Supratentorial Primitive Neuroectodermal Tumour; Radiotherapy; Chemotherapy. DOI: 10.3329/bjms.v9i3.6482Bangladesh Journal of Medical Science Vol.09 No.3 July 2010, pp.177-182