Comparative dataset on productivity, proximate, biochemical and pigment content of marine Gonyostomum sp. and freshwater Tetraedron sp. microalgae

The dataset includes a comparative analysis of Gonyostomum sp. and Tetraedron sp. to characterize their productivity, proximate composition, biochemical composition and pigments. Growth data were collected through cell density and optical density and subsequently mass-cultured to utilize biomass for other analyses. The onset of the stationary phase (12 to 18 days) varied between the species. Volumetric productivity, areal productivity, and SGR were also significantly higher (p ˂ 0.05) in Gonyostomum sp. whereas, Tetraedron sp. showed significantly higher (p ˂ 0.05) cell duplication time and cell doublings per day (K). Gonyostomum sp. showed significantly higher (p ˂ 0.05) protein (42.86±1.13%), carbohydrate (13.56±0.48%) and lipid (27.4 ± 0.69%) content than Tetraedron sp. Significantly higher (p ˂ 0.05) polyunsaturated fatty acids (PUFA) were obtained from both Gonyostomum sp. and Tetraedron sp. Non-essential amino acids were prevalent in both microalgae than essential amino acids. Significantly higher (p ˂ 0.05) chlorophyll-a (5.51±0.00), chlorophyll-b (2.27±0.04) and phycobiliprotein (2.32±0.05) were found in Tetraedron sp. Conversely, Gonyostomum sp. exhibited higher (p ˂ 0.05) carotenoid content (2.48±0.05). These findings may contribute to the screening and utilization of these microalgae in the aquaculture, pharmaceuticals, and nutraceuticals sectors.

Dataset representing growth performance, nutritional assay and biochemical profile of Oscillatoria spp

Cyanobacteria are regarded as vital constituents of aquatic ecosystems which recently become viable option for bioremediation since it can remove contaminants from polluted water. They possess intriguing metabolic properties and exhibit differential growth patterns. This study elucidates the isolation and identification of two marine and two freshwater indigenous Oscillatoria spp., their growth performance, nutritional composition along with intricate biochemical profiles. Agar streak plate method was used for the isolation, growth curve was determined through chlorophyll content and optical density. Freshwater and marine Oscillatoria spp. were mass cultured in commercial Bold Basal Media and Conway media respectively. Wet biomass was harvested through centrifugation at the early stationary phase of their respective growth curve and oven-dried at 40 °C to determine the nutritional and biochemical profiles. Oscillatoria sp. 2 displayed significantly higher (p ˂ 0.05) chlorophyll-a (22.72 ± 0.04 µg/mL) and OD value (1.87 ± 0.03) in the stationary phase (9th to 11th day) than the other species. Crude protein contents (%) varied from 21.56 ± 0.09 to 56.97 ± 0.03. Crude lipid (%) ranged from 9.07 ± 0.07 to 17.13 ± 0.13 and Crude fiber content (%) showed the range from 7.49 ± 0.15 to 17.04 ± 0.08. Fatty acid and amino acid were also found variable among the species. Present study will contribute to the meticulous selection and characterization of Oscillatoria sp. to utilize it in the rigorous scientific investigations and diverse commercial applications.

Association of Serum Magnesium Level with Severity of Neurological Disability in Patients with Acute Ischemic Stroke

Magnesium (Mg) has important effects on vascular system and deficiency of this cation is thought to be a risk factor for cerebrovascular atherosclerosis and complications. The study was planned to find out the association of serum magnesium level with severity of neurological disability in patient with acute ischemic stroke. This cross-sectional descriptive study was conducted in the department of Neurology and Medicine at Mymensingh Medical College & Hospital, Mymensingh from June, 2018 to October, 2019. Patients with acute ischemic stroke were evaluated following informed written consent. Diagnosis was confirmed by neuroimaging of brain. Moreover, serum magnesium assay was done for each patient. Data were collected by interview, clinical examination and laboratory investigations of patients using a case record form and analysis was carried out by using the SPSS 22.0 (IBM Inc., Armonk, NY, USA). Mean age of acute ischemic stroke patients was 63.94±13.93 years with male predominance (58.30%). Majority of the respondents (70.2%) had NIH Stroke Scale (NIHSS) score 5-15 (moderate stroke), 13.1% had score 1-5 (minor stroke), 13.1% had score15-20 (Moderate to severe stroke) and 3.6% had score 21-42 (severe stroke). Mean serum magnesium level was 1.83±0.283mg/dl. Hypomagnesaemia was present in 28(33.3%) patients and it was related with higher NIHSS scoring (p<0.05). Multiple regression showed that among the risk factors, serum magnesium level was independently associated with severity of neurological disability of the acute ischemic stroke (p<0.001). In this study, the correlation coefficient between serum magnesium level and NIHSS score was found as r= - 0.667 which showed negative relationship between serum magnesium and NIHSS score. Lower serum magnesium level is associated with the severity of neurological disability of acute ischemic stroke patient. Further case-control studies are required to validate this finding.

Genetic variations among the isolates of Bipolaris Maydis based on phenotypic and molecular markers

Abstract Maydis leaf blight, caused by Bipolaris maydis, is an important disease of maize crop in Khyber Pakhtunkhwa (KP) Pakistan. Fifteen isolates of the pathogen, collected across KP, were studied for variability based on phenotypic and molecular markers. Significant variability among the isolates was observed when assessed using phenotypic traits such as radial growth, spore concentration, fungicide sensitivity and virulence. The isolates were classified into six culture groups based on colour, texture and margins of the colony. Conidial morphology was also variable. These were either straight or slightly curved and light to dark brown in colour. Fungicide test showed significant variation in the degree of sensitivity against Carbendazim. Isolate Bm8 exhibited maximum radial growth on carbendazim spiked plates. Conversely, isolate Bm15 showed the lowest radial growth. Variations in virulence pattern of the isolates were evident when a susceptible maize variety Azam was inoculated with spores of B. maydis. Genetic variability amongst the isolates was also estimated by RAPD as well as sequencing of ITS region. The RAPD dendrogram grouped all the isolates into two major clusters. Average genetic distance ranged from 0.6% to 100%, indicating a diverse genetic gap among the isolates. Maximum genetic distance was found between isolates Bm9 and Bm10 as well as Bm2 and Bm8. Conversely, isolates Bm13 and Bm15 were at minimum genetic distance. Phylogenetic dendrogram based on sequencing of ITS region grouped all the isolates into a single major cluster. The clusters in both the dendrogram neither correlate to the geographical distribution nor to the morphological characteristics.

Does climate change affect the transmission of COVID-19? A Bayesian regression analysis

Aim

Coronavirus is an airborne and infectious disease and it is crucial to check the impact of climatic risk factors on the transmission of COVID-19. The main objective of this study is to determine the effect of climate risk factors using Bayesian regression analysis.

Methods

Coronavirus disease 2019, due to the effect of the SARS-CoV-2 virus, has become a serious global public health issue. This disease was identified in Bangladesh on March 8, 2020, though it was initially identified in Wuhan, China. This disease is rapidly transmitted in Bangladesh due to the high population density and complex health policy setting. To meet our goal, The MCMC with Gibbs sampling is used to draw Bayesian inference, which is implemented in WinBUGS software.

Results

The study revealed that high temperatures reduce confirmed cases and deaths from COVID-19, but low temperatures increase confirmed cases and deaths. High temperatures have decreased the proliferation of COVID-19, reducing the virus's survival and transmission.

Conclusions

Considering only the existing scientific evidence, warm and wet climates seem to reduce the spread of COVID-19. However, more climate variables could account for explaining most of the variability in infectious disease transmission.

Effects of shipwrecks on spatiotemporal dynamics of metal/loids in sediments and seafood safety in the Bay of Bengal

Metal/loid pollution from shipwrecking activities has drawn significant concern due to their persistent threat to the marine ecosystem and human health. We investigated the spatiotemporal distribution, pollution characteristics, risks, sources, and potential impact of metal/loids in the sediments and seafood in the Bay of Bengal at nearby open beaching shipwrecking yards in Bangladesh. We collected 78 sediments and 208 seafood samples from the exposed and control sites from 2018 to 2020 during the dry and wet seasons. The concentrations of 16 elements, including cadmium, arsenic, lead, chromium, manganese, copper, zinc, iron, tin, antimony, nickel, cobalt, molybdenum, vanadium, selenium, and thallium were measured using validated inductively coupled plasma-mass spectrometry (ICP-MS) methods. Based on the pollution indices (enrichment factor, geoaccumulation index, pollution index, and pollution load index), lead, arsenic, cadmium, selenium, copper, zinc, and tin from the dry season showed higher contaminations compared to the wet and their concentrations were increased from 2018 to 2020 with seasonal fluctuations. Sediment cadmium and arsenic posed relatively higher and moderate ecological risks. Health risk analysis indicated that lead, cadmium, and inorganic arsenic (estimated) in seafood species pose a possible health threat to the general population. Further, there were possible ecological and health risks for the metal/loids in combination based on the ecological risk index in sediment and the hazard index in seafood, respectively. Source apportionment suggested that anthropogenic activities through uncontrolled shipwrecking operations over the last four decades were the largest polluting dominator, contributing 55-77% of the metal/loid concentrations. Therefore, the data may inform mitigation strategies for emission control at the shipwrecking yards to protect marine ecosystems and their local population.

Alcohol-based Hand Sanitizers amid COVID-19: Chemical Formulation, Analysis, Safety

Alcohol-based hand sanitizers (ABHSs) containing ethanol (EtOH) or isopropyl alcohol (IPA) to inactivate microorganisms help prevent the spread of respiratory diseases. These products have become very popular during the COVID-19 pandemic. Apart from vaccines or other preventative antiseptic measures, the majority of consumers have relied on different types of ABHSs to disinfect their hands. As a result, there has been a global rush in the demand for these ABHSs and other antiseptic hygiene products. This has resulted in the formation of many new commercial sanitizer producers. There are around fifty companies of varying sizes that have been marketing their ABHSs in Bangladesh, most of which have only been manufacturing their products for the first time since the COVID-19 pandemic. To monitor the quality and components of these products, the Bangladesh Council of Scientific and Industrial Research (BCSIR) analyzed approximately 200 different hand sanitizer samples using GC-FID method. All samples were alcohol-based except for 3 which were alcohol-free aqueous hand sanitizers. Of the supplied formulated ABHSs, 80 samples were found to contain only IPA and 54 contained only EtOH. However, 28 samples were found to be contaminated with methanol (MeOH), 7 samples contained only MeOH and 18 samples contained both EtOH and IPA. This is the first study to explore the analysis of alcohol content in formulated ABHSs and their marketing status in Bangladesh, but the findings could be of use in other jurisdictions as similar issues have been raised in many parts of the world.

Effects of climate variables on the COVID-19 mortality in Bangladesh

Infectious diseases such as severe acute respiratory syndrome (SARS) and influenza are influenced by weather conditions. Climate variables, for example, temperature and humidity, are two important factors in the severity of COVID-19's impact on the human respiratory system. This study aims to examine the effects of these climate variables on COVID-19 mortality. The data are collected from March 08, 2020, to April 30, 2022. The parametric regression under GAM and semiparametric regression under GAMLSS frameworks are used to analyze the daily number of death due to COVID-19. Our findings revealed that temperature and relative humidity are commencing to daily deaths due to COVID-19. A positive association with COVID-19 daily death counts was observed for temperature range and a positive association for humidity. In addition, one-unit increase in daily temperature range was only associated with a 1.08% (95% CI: 1.06%, 1.10%), and humidity range was only associated with a 1.03% (95% CI: 1.02%, 1.03%) decrease in COVID-19 deaths. A flexible regression model within the framework of Generalized Additive Models for Location Scale and Shape is used to analyze the data by adjusting the time effect. We used two adaptable predictor models, such as (i) the Fractional polynomial model and (ii) the B-spline smoothing model, to estimate the systematic component of the GAMLSS model. According to both models, high humidity and temperature significantly (and drastically) lessened the severity of COVID-19 death. The findings on the epidemiological trends of the COVID-19 pandemic and weather changes may interest policymakers and health officials.

Malignant Neuroendocrine Tumor of Gall Bladder: An Incidental Finding

Neuroendocrine tumor of the gallbladder is a rare gallbladder tumor with aggressive behavior and poor prognosis. Cholelithiasis is the most important risk factor for it. The clinical presentations of most patients are non-specific and vague abdominal pain is the most common initial symptom followed by cholecystitis, with obstructive jaundice, weight loss, ascites, pruritus or palpable mass and occasional associated endocrine manifestations. Surgery remains the main cornerstone for it. In January 2019, in the department of Hepatobiliary, Pancreatic and Liver transplant surgery in Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh, a 30-year-old female presented with incidental finding of gallbladder mass. Extended cholecystectomy was performed. Histopathology examination revealed small cell neuroectodermal tumor of the gallbladder.

Hemosuccus Pancreaticus: A Rare Cause of Gastrointestinal Bleeding

Hemosuccus pancreaticus or bleeding from the pancreatic duct into the gastrointestinal tract via the ampulla of Vater is caused by rupture of the pseudoaneurysm of a peripancreatic vessel into pancreatic duct or pancreatic pseudocyst in the context of pancreatitis or pancreatic tumour or trauma. It produces diagnostic and therapeutic dilemma due to its anatomical location and that bleeding into the duodenum is intermittent and cannot be easily diagnosed by endoscopy, often needs CE-CT and angiography. In August 2019, a 60-year-old male presented with intermittent abdominal pain, gastrointestinal bleeding and high serum lipase. Upper GIT endoscopy showed blood mixed bile coming out through ampulla, suspecting Hemosuccus pancreaticus. Contrast-enhanced computed tomography (CT) scan demonstrated pancreatic pseudo cyst with partially thrombosed splenic artery pseudoaneurysm. At laparotomy, splenic artery pseudoaneurysm was ligated along with splenectomy. Later on, the patient had no further occurrence of gastrointestinal bleeding.

Risk factors of suicidality among married adults: A cross-sectional survey in Rajshahi City, Bangladesh

Background

Suicide is a serious public health concern all over the world including Bangladesh. About 9% of the patients admitted with suicidal ideation (SI) or suicide attempt (SA) later complete suicide. To understand and prevent suicide, the study of SI and SA is necessary but research in this area is scanty in Bangladesh. Therefore, we studied suicidality (SI and SA) among married adults in Rajshahi City, Bangladesh.

Methods

This was a household cross-sectional study. A total of 708 married adults were selected for this study using a multi-stage random sampling. Suicidality was measured based on two factors: (i) suicidal ideation, and (ii) suicide attempt. Frequency distribution, Chi-square test and multiple binary logistic regression model were used in this study according to our objectives.

Results

The prevalence of suicidal ideation, suicide attempt, and suicidality was 5.8%, 3.4%, and 8.3% respectively among married adults. A multiple binary logistic regression model provided the following risk factors of suicidality: (i) joint family (AOR = 0.310, p<0.01), (ii) ≥26 years of age at the first marriage (AOR = 0.379, p<0.05), (iii) twice or more marriage (AOR = 0.214, p<0.01), (iv) conjugal life of ≥16 years (AOR = 0.410, p<0.05), (v) having no child (AOR = 6.343, p<0.01) and (vi) having 1–2 children (AOR = 6.190, p<0.01), (vii) medical comorbidity (AOR = 0.421, p<0.01), (viii) mental comorbidity (AOR = 0.253, p<0.01), (ix) stress-anxiety (AOR = 0.311, p<0.01), (x) family history of mental disorders (AOR = 0.059, p<0.01), (xi) family history of suicide/suicide attempt (AOR = 0.009, p<0.01), (xii) substance abuse (AOR = 0.065, p<0.01), (xiii) poor relationship with spouse (AOR = 0.209, p<0.01), and (xiv) poor relationship with other family members (AOR = 0.347, p<0.05).

Conclusion

The prevalence of suicidality is remarkable in Rajshahi city, Bangladesh. The government and non-government agencies can use the findings of this study to identify the vulnerable groups and undertake measures for preventing and reducing suicidality.

Disparity in physician-patient communication by ethnicity: evidence from Bangladesh

Background

Physician-patient communication behavior (PPCB) is the primary process by which medical decision-making occurs and health outcome depends. Physician-patient communication differences may partly from the ethnic disparities. To examine this problem, this study aims to explore whether physician-patient communication differs by ethnicity during primary care medical consultations.

Methods

The study was conducted among the Bengali and ethnic minority patients (N = 850) who visited a physician for medical consultations. Data were collected using a structured post-consultation questionnaire. T-test was conducted to compare the communication between the Bengali and ethnic minority patients. Multiple linear regression analyses were performed to identify the factors associated with favorable communication behavior from the physicians.

Results

Bengali patients received more supportive communication behaviors from the Bengali doctors than that of ethnic minority patients including physicians’ cheerful greetings, encouraging patients to express health problems and asking questions, listening carefully, responding to questions and concerns, explaining to patients about medical examination procedures, medication, probable side effects, discussing treatment options, involved the patients in decisions, and spending adequate time. Results of linear regression showed that respondents’ level of education, internet use, knowledge about the health issue, having a pre-organized plan about the content of medical consultation, information seeking about the health problem, visiting female doctors, and a quiet ambience of the doctor’s room are significantly associated with a better PPCB score for the Bengali patients. In contrast, age, being the resident of an urban area, perception of affecting a minor health problem, having a pre-organized plan about the content of medical consultation, patients’ involvement in physicians’ decision-making about the treatment, and talking time resulted in better physician-patient communication for the ethnic minority patients.

Conclusion

This study suggests that reducing disparity in the socio-economic status of the ethnic minority groups through development programs and educating healthcare providers on how to use patient-centered communication skills to engage with their patients is one solution to improve equity in the delivery of healthcare and ensure than patients are receiving high-quality treatment, no matter their race or ethnicity.

Evaluation of Invertase Inhibition Activity and Cytotoxicity of Ethanol and Acetone Extracts of Swietenia macrophyllia Leaves, Syzygium cumini and Trigonella foenum-graecum Seeds

Invertase, the key enzyme responsible for sucrose hydrolysis. Inhibition of invertase can decrease the postprandial blood sugar level in diabetic patients and keep the blood glucose level normal where cytotoxicity to fast-growing cells like those of brine shrimp (Artemia salina) nauplii is a great measurement for further important drug development. This study was aimed to investigate potential anti-diabetic and cytotoxic activities of the ethanol and acetone extracts of Swietenia macrophylla leaves, Syzygium cumini and Trigonella foenum-graecum seeds. Invertase inhibition activities of S. macrophylla leaves, S. cumini, and T. foenum-graecum seeds were measured by spectrophotometrically using standard protocols and cytotoxicity were measured by brine shrimp lethality bioassay. Among the plant extracts, all ethanol extracts showed higher invertase inhibition activities than all acetone extracts. S. cumini seed ethanol extract showed the highest invertase inhibition activity whereas S. macrophylla leaves acetone extract showed the lowest invertase inhibition activity. The maximum toxicity was observed in ethanol extract of T. foenum-graecum seed whereas the lowest toxicity was observed in acetone extract of S. macrophylla leaves. Both ethanol and acetone extract of T. foenum-graecumseeds showed significant cytotoxic activities. This investigation suggested that S. cumini and T. foenum-graecum seeds possess potential antidiabetic activities and T. foenum-graecum seeds have potential cytotoxicity.

Single Sitting Surgery for Concomitant Hydatid Cyst of Lung and Liver: A Case Report

Hydatid disease is one of the diseases that have been discovered in the ancient times. Liver and lung are the most commonly affected organs, though it can involve any organs. Hydatid disease involving both the liver and the lung is reported about 10% of the cases. Here we report a case of 34 year old male presented with upper abdominal pain and intermittent fever for 3 months admitted in October 2016. His chest radiograph and computed tomography scan revealed large cystic lesion at right lung and another similar large lesion in the right lobe of liver. Echinococcus antibody was found positive. We treated him surgically. Histopathology reports confirmed concomitant hydatid cyst of both the lung and the liver.

Porcelain Gallbladder: A Case Report

"Porcelain gallbladder" term has been used to highlight the blue staining and fragile consistency of the gallbladder wall at surgery. Some authorities avoid these terms and alternately call all calcified gallbladders "porcelain gallbladders". It is a morphological deviation of chronic cholecystitis. Inflammatory scarring of the wall combined with dystrophic calcification inside the wall transforms the gallbladder into a porcelain-like container. In porcelain gallbladder patients are usually asymptomatic and the condition is usually noted incidentally on plain abdominal radiographs, sonograms, or computed tomography (CT) images. Porcelain gallbladder is a rare condition; recognizing the clinical and imaging characteristics of the disease is important because of the high frequency (22%) of adenocarcinoma in porcelain gallbladder. Operation should not be delayed even if the patient is asymptomatic, because the incidence of carcinoma in porcelain gallbladder is extremely high. Here we present a case of 45 years old lady with porcelain gallbladder who was initially diagnosed as a case of carcinoma gallbladder at Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh on 5th August 2017. But she was found to have a benign gallbladder after cholecystectomy.

Apelin inhibition prevents resistance and metastasis associated with anti-angiogenic therapy

Angiogenesis is a hallmark of cancer, promoting growth and metastasis. Anti-angiogenic treatment has limited efficacy due to therapy-induced blood vessel alterations, often followed by local hypoxia, tumor adaptation, progression, and metastasis. It is therefore paramount to overcome therapy-induced resistance. We show that Apelin inhibition potently remodels the tumor microenvironment, reducing angiogenesis, and effectively blunting tumor growth. Functionally, targeting Apelin improves vessel function and reduces polymorphonuclear myeloid-derived suppressor cell infiltration. Importantly, in mammary and lung cancer, Apelin prevents resistance to anti-angiogenic receptor tyrosine kinase (RTK) inhibitor therapy, reducing growth and angiogenesis in lung and breast cancer models without increased hypoxia in the tumor microenvironment. Apelin blockage also prevents RTK inhibitor-induced metastases, and high Apelin levels correlate with poor prognosis of anti-angiogenic therapy patients. These data identify a druggable anti-angiogenic drug target that reduces tumor blood vessel densities and normalizes the tumor vasculature to decrease metastases.

Solid Pseudopapillary Tumor of the Pancreas: A Case Report

Solid pseudopapillary tumors (SPT) of the pancreas are rare neoplasms of the pancreas accounting for only 1-2% of all pancreatic neoplasms, often detected initially on imaging. Its histogenesis is still uncertain and it has a low-grade malignant potential but excellent post-surgical curative rates and rare metastasis. Pathological and/or cytological evaluation still remains the gold standard in reaching a definitive diagnosis. It occurs most commonly in young females. We report a case of solid pseudopapillary tumor in the head of the pancreas in a 20 years old female admitted in Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh on 5th December 2015. Whipple's operation was done as a definitive treatment.

Overweight, hypertension and microalbuminuria in urban and rural Bangladeshi schoolchildren

Background The prevalence of childhood overweight and obesity has increased over the last two decades due to high caloric intake and decreased physical activity. The dramatic increase in the prevalence of overweight children occurred in conjunction with increasing prevalence of hypertension. Microalbuminuria is an early sign of damage to the kidney and cardiovascular system. Hypertensive, overweight children have an increased chance of microalbuminuria. Objectives To assess the prevalence of overweight, hypertension, and microalbuminuria in urban and rural school going children and contributing risk factors and associations. Methods This cross-sectional study was done in schoolchildren aged 6 to 16 years, from urban and rural areas, in Bangladesh, from September 2015 untill August 2016. Subjects’ weights, heights, and blood pressures (BP) were measured. Overweight and hypertension (HTN) statuses were determined with age-appropriate standardized charts. Subjects were divided into overweight and normoweight groups to evaluate risk factors for overweight such as family history (F/H) of obesity, F/H of HTN, daily physical outdoor activities, and monthly family income by comparative analysis. All overweight children were divided into hypertensive and normotensive groups in order to compare their fasting lipid profiles, urine microalbumin, serum creatinine, and random blood sugar. Results A total of 976 schoolchildren from urban (471, 48.3%) and rural (505, 51.7%) areas were included. Overweight was observed in 22.3% of the urban group and in 8.1% of the rural group (P<0.001). Hypertension was observed in 24.7% of overweight children and in 2.5% of normal weight children (P<0.001).  Contributing risk factors for overweight were less physical outdoor activities, F/H of obesity, F/H of HTN, and higher family income (P<0.001). Microalbuminuria and random blood sugar were significantly increased in the overweight with hypertension group compared to the normotensive group (P <0.005). Conclusion Overweight is a health problem, noted especially in urban areas. Hypertension is also significantly increased in overweight children. Factors like F/H of hypertension, obesity, sedentary lifestyle, and higher socioeconomic status are significantly associated with overweight. Microalbuminuria and increased random blood sugar are also significantly higher observed in hypertensive overweight children compared to normotensive overweight children.

Recent sediment flux to the Ganges-Brahmaputra-Meghna delta system

The physical sustainability of deltaic environments is very much dependent on the volume of water and sediment coming from upstream and the way these fluxes recirculate within the delta system. Based on several past studies, the combined mean annual sediment load of the Ganges-Brahmaputra-Meghna (GBM) systems has previously been estimated to vary from 1.0 to 2.4 BT/year which can be separated into components flowing from the Ganges (260 to 680 MT/year) and Brahmaputra (390 to 1160 MT/year). Due to very limited data and small contribution of the Meghna system (6-12 MT/year) to the total sediment flux of the GBM system, the data of the Meghna is not considered in the analysis assuming the sediment flux from GB system as the sediment flux of GBM. However, in this paper our analysis of sediment concentration data (1960-2008) collected by Bangladesh Water Development Board shows that the sediment flux is much lower: 150 to 590 MT/year for the Ganges versus 135 to 615 MT/year for the Brahmaputra, with an average total flux around 500 MT/year. Moreover, the new analysis provides a clear indication that the combined sediment flux delivered through these two major river systems is following a declining trend. In most of the planning documents in Bangladesh, the total sediment flux is assumed as a constant value of around 1 billion tons, while the present study indicates that the true value may be around 50% lower than this (with an average decreasing trend of around 10 MT/year).

Expression and DNA methylation of SERK, BBM, LEC2 and WUS genes in in vitro cultures of Boesenbergia rotunda (L.) Mansf

The process of somatic embryogenesis and plant regeneration involve changes in gene expression and have been associated with changes in DNA methylation. Here, we report the expression and DNA methylation patterns of SOMATIC EMBRYOGENESIS RECEPTOR-LIKE KINASE (SERK), BABY BOOM (BBM), LEAFY COTYLEDON 2 (LEC2) and WUSCHEL (WUS) in meristematic block of newly emerged shoots from rhizome, embryogenic and non-embryogenic calli, prolonged cell suspension culture, ex vitro leaf, and in vitro leaf of regenerated plants of Boesenbergia rotunda. Among all seven samples, based on qRT-PCR, the highest level of expression of SERK, BBM and LEC2 was in embryogenic callus, while WUS was most highly expressed in meristematic block tissue followed by embryogenic callus. Relatively lower expression was observed in cell suspension culture and watery callus for SERK, LEC2 and WUS and in in vitro leaf for BBM. For gene specific methylation determined by bisulfite sequencing data, embryogenic callus samples had the lowest levels of DNA methylation at CG, CHG and CHH contexts of SERK, LEC2 and WUS. We observed negative correlation between DNA methylation at the CG and CHG contexts and the expression levels of SERK, BBM, LEC2 and WUS. Based on our results, we suggest that relatively higher expression and lower level of DNA methylation of SERK, BBM, LEC2 and WUS are associated with somatic embryogenesis and plant regeneration in B. rotunda.

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

BACKGROUND

Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world.

METHODS

This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231.

FINDINGS

Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p<0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05-2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p<0·001).

INTERPRETATION

Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication.

FUNDING

DFID-MRC-Wellcome Trust Joint Global Health Trial Development Grant, National Institute of Health Research Global Health Research Unit Grant.

Immune Response against Hepatitis B virus after Pentavalent Vaccination in Children

This study was done to know the real status of immune response to Hepatitis B vaccine among the pentavalent vaccinated children as per EPI schedule of Bangladesh. It was prospective observational study done in the EPI corner of Paediatric OPD of Dhaka National Medical College & Hospital (DNMCH), Dhaka from July 2015 to July 2016. Sixty (60) children ranging from 9 months to 2 years of age, who received pentavalent vaccination (Hepatitis B + DPT + Hib) according to EPI schedule, were included. The testing for anti-HBs titres were conducted in the Department of Virology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh. Out of 60 children, 9(15%) had anti-HBs titres <10 IU/L (non-protected) while 51(85%) had anti-HBs titres >10 IU/L (protected). Twenty seven (27) were male and of them 21(77.8%) protective and 6(22.2%) non-protective. Thirty three (33) were female, out of them 30(90.9%) protective while 3(9.1%) non-protective. The difference was not significant between male and female (p=0.156). Fifty (50) children received vaccination by EPI (Government) (pentavalent) out of which 9(18%) non-protective and 41(82%) protective level. However, 10 children received privately Hepatitis B vaccination of which all developed protective level. The difference was not significant between Government (EPI) and privately vaccine (p=0.145). Most of the children showed positive immune response after pentavalent vaccination.

Introgression, Generational Expression and Salinity Tolerance Conferred by the Pea DNA Helicase 45 Transgene into Two Commercial Rice Genotypes, BR28 and BR47

DNA helicase (PDH45) from the pea plant (Pisum sativum) is a member of the DEAD box protein family and plays a vital regulatory role in saline stress tolerance in plants. We previously reported that over-expression of PDH45 gene confers both seedling and reproductive stage salinity tolerance to a Bangladeshi rice landrace, Binnatoa (BA). In this study, transgenic BA-containing PDH45 (♂) was crossed with two different farmer-popular BRRI rice varieties (♀), BR28 and BR47, in a contained net house. F1 plants positive for the transgene and having recipient phenotype were advanced from F1 to F5. Expression of the PDH45 gene was detected in all generations. The expression level of PDH45 was 200-fold higher in the donor compared to the two recipient genotypes but without any effect on their salt stress tolerance ability in various assays. Under 120 mM NaCl stress at seedling stage, all rice genotypes showed vigorous growth, higher chlorophyll content, lower electrolyte leakage and lower LDS (Leaf Damage Score) compared to their corresponding wild types. At the reproductive stage under continuous salinity stress at 80 mM NaCl, the cross-bred lines BR28 and BR47 showed significantly better spikelet fertility and yield per plant, which were two- and 2.5-folds, respectively, than their corresponding wild types. The PDH45 transgene was observed to increase the expression of 6 salt stress-related downstream genes at 150 mM NaCl stress to similar differential degrees in the donor and recipient genotypes. However, the expression of OsLEA was significantly higher in transgenic BR28 compared to transgenic BR47, where the latter shows comparatively higher salt tolerance. The study shows stability of transgene expression across generations. It also demonstrates that there may be an effect of background genotype on transgene expression. Moreover, some downstream effects of the transgene may also be genotype-specific.

Complete Annular Pancreas with Concurrent Entero-Pancreatico-Biliary Symptoms in Adult: A Case Report

Complete Annular pancreas (AP) is a rare congenital anomaly, often presented and operated at the early age of life. Adult presentation group usually presents with either biliary or duodenal or pancreatic symptoms. We report a case of 43 years old female presenting with concurrent enteric, biliary and pancreatic symptoms admitted on April 2016 in Hepatobiliary and Pancreatic Surgery Department of BSMMU, Dhaka, Bangladesh. A complete type of annular pancreas with partial duodenal stenosis and dilated common bile duct was observed during laparotomy. We performed gastrojejunostomy as well as hepaticojejunostomy (Roux-en-Y anastomosis). Patient was discharged in a good symptom free condition. Complete Annular Pancreas can present at any age, with any one or all of the biliary, pancreatic or duodenal symptoms. Surgery is the treatment of choice and has a good outcome.

A Rare Case of Polycystic Disease of the Pancreas

Polycystic disease of the pancreas is very rare and only few cases have been reported in the literature. We report a case of 27 year old female presented with recurrent upper abdominal pain associated with nausea and vomiting. Her ultrasonography of whole abdomen and computed tomography (CT) scan revealed polycystic pancreas associated with hepatic cysts. She underwent distal pancreatectomy with splenectomy. Histological examination revealed typical features of polycystic pancreatic disease in the resected specimen. Previously two of her sisters and her mother were also diagnosed as cases of polycystic pancreatic disease and they all underwent operative treatments. Among them one of those sisters and her mother received treatment under our department in 2009 and 2014 accordingly.

Surgery for spinal tuberculosis: a multi-center experience of 582 cases

BACKGROUND

Tuberculosis (TB) of the spine is a common site of osseous TB, accounting for 50%-60% of cases. Spinal TB still occurs in both developed and developing countries. The diagnosis of spinal TB is difficult and it commonly presents at an advanced stage. Delays in establishing diagnosis and management result in complications such as spinal cord compression and spinal deformity.

METHODS

A total of 582 patients with TB of the cervical, thoracic and lumbar spine with moderate to severe cord compression were studied. Variable degrees of neurological deficit with deformity were treated from January, 2003 to July, 2014. Thoracotomy along with anterolateral decompression and autogenous strut bone grafting with simultaneous fixation by screws and rods were performed in 113 cases. Posterior decompression, posterior interbody and posterolateral fusion by bone graft with stabilization by transpedicular screws and rods were done in the remaining 469 cases. Appropriate anti-TB drugs were given to all patients for 18-24 months. The follow-up period was 3 months to 10 years.

RESULTS

The average age was 32.5 years. All patients survived surgery. There were 7 cases of superficial infections (1.2%) whilst there were 4 cases (0.7%) of deep infections. Revision surgery was performed in 6 patients (1.0%). Implant failure occurred in 4 cases (0.7%) whilst malposition of screws occurred in 12 cases (2.1%). Perioperative bleeding complications were reported for 4 patients (0.7%). Neurological improvement occurred in all patients except for 2 cases (0.3%). Preoperatively, the majority of patients (n=221, 38%) were classified with Class A on the American Spinal Injury Association (ASIS) neurological impairment scale. This was significantly reduced postoperatively to 0.4%.

CONCLUSIONS

For patients with spinal TB anterior debridement, auto graft bone fusion, anterior or posterior fixation appears to be effective in arresting disease, correcting kyphotic deformity and maintaining correction until solid spinal fusion.

Role of Ultrasonography in Otolaryngology

Ultrasonography (US) is frequently requested by the otolaryngologists in their day to day practice. Though US assessment is sensitive and in many situations, specific investigation for prognosis and management of patients, FNAC and Ultrasonography carries more predictive value. Ultrasonography is very useful for assessment of neck nodes and in combination with CT scan is an excellent imaging tool for follow up of head and neck cancers. Inflammatory neck nodes vary in characteristics from neoplastic nodes and US can classify them with fair degree of predictability. Thyroid nodules should strictly follow standard protocol of management, as most of the masses are benign and unnecessary diagnostic or therapeutic interventions are not required. Kim’s criteria and American Association for Clinical Endocrinology recommendations are sensitive and specific for offering systematic guidance for management of thyroid nodules. US have limited roles in the assessments of sialadenitis, Sialolithiasis and salivary tumors. US is an effective tool in guiding biopsies and aspirations for diagnostic and therapeutic purposes.

Outcome after PORT in ypN2 or R1/R2 versus no PORT in ypN0 Stage III-N2 NSCLC after Induction Chemotherapy and Resection

INTRODUCTION

We investigated patients with contemporarily staged and treated stage III-N2 NSCLC treated with induction chemotherapy and surgery with or without postoperative radiotherapy (PORT). We focused on survival and toxicity and investigated what additional PORT may offer in patients with ypN2 status or incomplete resection.

METHODS

We identified 161 patients with pathologically proven, resectable stage III-N2 NSCLC from our prospective database who were treated between 1998 and 2012. Of these patients, 150 without progressive disease after chemotherapy underwent resection. Patients with ypN2 status or R1/2 resection received three-dimensional PORT (n = 70) to a dose of 50 to 66 Gy in 2-Gy fractions.

RESULTS

The mean follow-up time was 49 months. The 5-year overall survival (OS) rate was 35.1% in intention-to-treat analysis; relapse-free survival was 31.8%, the cumulative local recurrence (LR) rate was 50.9%, and the distant metastasis rate was 63.4%. The 5-year OS, relapse-free survival, and cumulative LR and distant metastasis rates were 32.0%, 32.9%, 47.0%, and 63.9% in the PORT group versus 38.1%, 30.7%, 54.1%, and 63.2% in the non-PORT group. These results were not significantly different, even though patients in the PORT group had worse prognostic features. Cardiac toxicity was higher in the non-PORT group (p = 0.02), but pulmonary toxicity was similar (p = 0.15). There was no difference between the two groups regarding dyspnea (p = 0.32), cough (p = 0.37), forced expiratory volume in 1 second (p = 0.30), and diffusing capacity of the lung for carbon monoxide (p = 0.61).

CONCLUSIONS

A similar outcome (OS, LR, and toxicity) was seen in both patient groups (PORT versus non-PORT group). Despite the limitations of this retrospective study, PORT can be both effective and safe for patients with stage III-N2 NSCLC with an R1/R2 resection or yN2 after induction chemotherapy and surgery.

Amino Acid and Secondary Metabolite Production in Embryogenic and Non-Embryogenic Callus of Fingerroot Ginger (Boesenbergia rotunda)

Interest in the medicinal properties of secondary metabolites of Boesenbergia rotunda (fingerroot ginger) has led to investigations into tissue culture of this plant. In this study, we profiled its primary and secondary metabolites, as well as hormones of embryogenic and non-embryogenic (dry and watery) callus and shoot base, Ultra Performance Liquid Chromatography-Mass Spectrometry together with histological characterization. Metabolite profiling showed relatively higher levels of glutamine, arginine and lysine in embryogenic callus than in dry and watery calli, while shoot base tissue showed an intermediate level of primary metabolites. For the five secondary metabolites analyzed (ie. panduratin, pinocembrin, pinostrobin, cardamonin and alpinetin), shoot base had the highest concentrations, followed by watery, dry and embryogenic calli. Furthermore, intracellular auxin levels were found to decrease from dry to watery calli, followed by shoot base and finally embryogenic calli. Our morphological observations showed the presence of fibrils on the cell surface of embryogenic callus while diphenylboric acid 2-aminoethylester staining indicated the presence of flavonoids in both dry and embryogenic calli. Periodic acid-Schiff staining showed that shoot base and dry and embryogenic calli contained starch reserves while none were found in watery callus. This study identified several primary metabolites that could be used as markers of embryogenic cells in B. rotunda, while secondary metabolite analysis indicated that biosynthesis pathways of these important metabolites may not be active in callus and embryogenic tissue.