Frequency of Post Endoscopic Retrograde Cholangiopancreatography Acute Pancreatitis in an Academic Hospital of Bangladesh

Post-ERCP acute pancreatitis (PEP) is a common and serious complication with high morbidity and mortality rates. There is a paucity of data on the frequency of PEP in a resource constraint setting like Bangladesh. Hence we have conducted a prospective study to determine the frequency of PEP and the factors associated with its occurrence. This prospective, observational study was carried out in Gastroenterology Department of Dhaka Medical College & Hospital, Dhaka, Bangladesh from April 2018 to December 2018 on the consecutive patients who underwent ERCP. PEP and its severity were diagnosed according to consensus definition. Serum lipase was done in all patients before procedure and 24 hours after procedure or if patient develops abdominal pain after the procedure which became earlier. Total 168 patients were included (mean age 46.97±14.35 years; male 72(43.0%). The most common indication of ERCP was choledocholithiasis 97(58.0%) followed by malignant biliary obstruction 45(27.0%), recurrent pyogenic cholangitis 8(5.0%), chronic pancreatitis 4(2.3%), biliary ascariasis 4(2.3%) and others 10(6.0%). Overall post ERCP complication rate was 46(27.3%) including cholangitis 29(17.3%), pancreatitis 16(9.5%), bleeding 12(7.1%), aspiration pneumonia 4(2.4%) and death 3(1.8%). Regarding the severity of PEP, 50.0%, 43.7% and 6.3% patients developed mild, moderate and severe pancreatitis respectively. Number of cannulation attempts >5 times [22(48%) vs. 17(14%); p=0.001], cannulation attempts duration more than 10 minutes [25(55%) vs. 27(22%); p=0.001], unintentional passage of guide wire into the pancreatic duct [8(17%) vs. 18(15%); p=0.001], pancreatic duct contrast injection [12(26%) vs. 2(1.6%); p=0.001] and pre-cut sphincterotomy [16(35%) vs. 6(4.9%); p=0.001] were significantly different between the patients who developed PEP compared to those who did not. In multiple logistic regressions analysis, pancreatic duct contrast injection was significantly associated with PEP [OR 25.523 with 95% CI (4.049- 100.0%)]. Around ten percent patients had developed PEP. Regarding the severity half of them were mild, 44.0% patients had moderate and 6.0% patient had severe type of pancreatitis. Difficult cannulation, unintentional passage of guide wire into the pancreas, pancreatic duct contrast injection and pre-cut sphincterotomy were associated with PEP. Among them pancreatic duct contrast injection had independent significance in the causation of PEP.

Bioactive silver phosphate/polyindole nanocomposites

Materials capable of releasing reactive oxygen species (ROS) can display antibacterial and anticancer activity, and may also have anti-oxidant capacity if they suppress intracellular ROS (e.g. nitric oxide, NO) resulting in anti-inflammatory activity. Herein we report silver phosphate (Ag₃PO₄)/polyindole (Pln) nanocomposites which display antibacterial, anticancer and anti-inflammatory activity, and have therefore potential for a variety of biomedical applications.

Materials capable of releasing reactive oxygen species (ROS) can display antibacterial and anticancer activity, and may also have antioxidant capacity if they suppress intracellular ROS (e.g. nitric oxide, NO) resulting in anti-inflammatory activity.

Au nanoparticle-decorated aragonite microdumbbells for enhanced antibacterial and anticancer activities

The present work reports the very first hydrothermal synthesis of 100% triclinic phase pure aragonite (A1) with microdumbbell microstructural architecture and Au Nanoparticle-decorated (AuNP-decorated) aragonites (A2, A3 and A4) with spherical, pentagonal/hexagonal and agglomerated AuNP-decorated microdumbbells having triclinic aragonite phase as the major and cubic AuNPs as the minor phase. Even in dark the AuNP-decorated aragonites (especially A2) show efficacies as high 90% against gram-negative e.g., Pseudomonas putida (P. putida) bacteria. Further the AuNP-decorated aragonites (A3) show anti-biofilm capability of as high as about 20% against P. putida. Most importantly the AuNP-decorated aragonites (A3) offer anti-cancer efficacy of as high as 53% while those of A1, A2, and A4 are e.g., 26%, 46% and 37%, respectively. For the very first time, based on detailed investigations, the mechanisms behind such advance antibiofilm and anticancer activities are linked to the generation of excess labile toxic reactive oxygen species (ROS). Thus, these materials show enormous potential as futuristic, multi-functional biomaterials for anti-bacterial, anti-biofilm and anti-cancer applications.

Effect of Morphology and Concentration on Crossover between Antioxidant and Pro-oxidant Activity of MgO Nanostructures

The toxicity of nanomaterials can sometimes be attributed to photogenerated reactive oxygen species (ROS), but these ROS can also be scavenged by nanomaterials, yielding opportunities for crossover between the properties. The morphology of nanomaterials also influences such features due to defect-induced properties. Here we report morphology-induced crossover between pro-oxidant activity (ROS generation) and antioxidant activity (ROS scavenging) of MgO. To study this process in detail, we prepared three different nanostructures of MgO (nanoparticles, nanoplates, and nanorods) and characterized them by HRTEM. These three nanostructures effectively generate superoxide anions (O₂^•-) and hydroxyl radicals (^•OH) at higher concentrations (>500 μg/mL) but scavenge O₂^•- at lower concentrations (40 μg/mL) with successful crossover at 200 μg/mL. Nanorods of MgO generate the highest levels of O₂^•-, whereas nanoparticles scavenge O₂^•- to the highest extent (60%). Photoluminescence studies reveal that such crossover is based on the suppression of F²⁺ and the evolution of F⁺, F₂⁺, and F₂³⁺ defect centers. The evolution of these defect centers reflects the antibacterial activity of MgO nanostructures which is initiated at 200 μg/mL against Gram-positive S. aureus ATCC 29737 and among different bacterial strains including Gram-positive B. subtilis ATCC 6633 and M. luteus ATCC 10240 and Gram-negative E. coli ATCC K88 and K. pneumoniae ATCC 10031. Nanoparticles exhibited the highest antibacterial (92%) and antibiofilm activity (17%) against B. subtilis ATCC 6633 in the dark. Interestingly, the nitrogen-centered free radical DPPH is scavenged (100%) by nanoplates due to its large surface area (342.2 m²/g) and the presence of the F₂⁺ defect state. The concentration-dependent interaction with an antioxidant defense system (ascorbic acid (AA)) highlights nanoparticles as potent scavengers of O₂^•- in the dark. Thus, our findings establish guidelines for the selection of MgO nanostructures for diverse therapeutic applications.

Phase pure, high hardness, biocompatible calcium silicates with excellent anti-bacterial and biofilm inhibition efficacies for endodontic and orthopaedic applications

Here we report for the very first time the synthesis of 100% phase pure calcium silicate nanoparticles (CSNPs) of the α-wollastonite phase without using any surfactant or peptizer at the lowest ever reported calcination temperature of 850 °C. Further, the phase purity is confirmed by quantitative phase analysis. The nano-network like microstructure of the CSNPs is characterized by FTIR, Raman, XRD, FESEM, TEM, TGA, DSC etc. techniques to derive the structure property correlations. The performance efficacies of the CSNPs against gram-positive e.g., S. pyogenes and S. aureus (NCIM2127) and gram-negative e.g., E. coli (NCIM2065) bacterial strains are studied. The biocompatibility of the CSNPs is established by using the conventional mouse embryonic osteoblast cell line (MC3T3). In addition, the biofilm inhibition efficacies of two varieties of CSNPs e.g., CSNPs(W) and CSNPs(WC) are investigated. Further, the interconnection between ROS e.g., superoxide (O₂^.-) and hydroxyl radical (^.OH) generation capabilities of CSNPs and their biofilm inhibition efficacies is clearly established for the very first time. Finally, the mechanical responses of the CSNPs at the microstructural length scale are investigated by nanoindentation. The results confirm that the α-wollastonite phases present in CSNPs(W) and CSNPs(WC) possess extraordinarily high nanohardness and Young's moduli values. Therefore, these materials are well suited for orthopaedic and endodontic applications.

Facile synthesis of hierarchical nickel (III) oxide nanostructure: A synergistic remediating action towards water contaminants

Heavy metal ion removal from consumable water is an indispensable need to maintain healthy life. Therefore cost effective and highly efficient sorbents are strongly needed to pose threat to real water pollution. Nanomaterials are widely used to maintain clean aqueous system in a very cost effective way with high removal efficiency. In this present work, pure coral like Ni₂O₃ nanostructures were prescribed for Cr(VI) remediation which were prepared by two step synthesis procedure at room temperature. The single hierarchical morphology as confirmed from HRTEM (size∼200 nm) were subjected to toxic Cr(VI) ion removal experiments. They were found to remove ∼65% Cr(VI) ions that was higher than that of pure Ni₂O₃ nanoparticles of comparable size. The enhanced properties were explained on the basis of the defect states present within the nanostructure, investigated by positron annihilation lifetime spectroscopy (PALS). It was found that the hierarchical nanostructure had more number of di-vacancies and vacancy-clusters as compared to the particles. On performing isotherm fitting, it was found that the coral like morphology had a high heterogeneity factor that aided to a high adsorption rate when compared to the pure Ni₂O₃ nanoparticles (which had a homogenous surface). The synthesized nanostructure was severely toxic to bacterial community having minimum inhibitory concentration (MIC) of ∼300 μg/L. Also the nanostructure exhibited dual functionality towards Cr(VI) and bacteria contaminated water at 200 μg/ml. The maximum Cr(VI) removal efficiency for this dual system is found to be 39% whereas antibacterial activity was turned out to be 30% which was extensively higher than that of toxic Cr(VI) ions. A plausible mechanism for the dual functionality was also predicted.

Life cycle of Oligonychus coffeae (Acari: Tetranychidae) on tea leaves in Darjeeling, West Bengal, India

The tea plant, Camellia sinensis (L.), has been cultivated since ancient time and is host to several pest species that can significant reduce productivity. One such pest species is the tea red spider mite. The life cycle of this species, Oligonychus coffeae, Nienter was studied on tea leaves in Darjeeling under laboratory conditions at 20°C and 65% relative humidity. Observations were recorded on freshly laid eggs on tea leaves and continued until individuals reached adulthood. The eggs required an average of 16.17 days to develop into adults. The average longevity of adult was 28.67 days. Our findings contribute to the understanding of mite abundance and population fluctuations in different seasons and climates, and will hopefully help to devise a management strategy for this pest species.

Effect of pre-emptive analgesia on self-reported and biological measures of pain after tonsillectomy

This prospective, double-blind, randomized study assessed effect of pre-emptive peritonsillar block in 30 ASA-I children, aged 6-12 years, of both sexes, scheduled for tonsillectomy. Patients were divided into three groups: those in group I received a sham block, whereas peritonsillar blocks with bupivacaine 0.25% were given to the children before tonsillectomy (group II) or immediately after surgery had been completed (group III). Constant pain, pain on swallowing, blood glucose, serum epinephrine and norepinephrine concentrations were measured immediately after surgery and 4h after operation. Patients in group I experienced more pain (P< 0.05) than those in groups II and III, both in the immediate postoperative period and over the next 4 h. Patients in groups II and III experienced similar pain (P> 0.05). The pain experienced when water was swallowed was similar to that of the constant pain. The rise of serum norepinephrine concentration in group II was significantly less (P< 0.05) compared to groups I and III. We found both pre-emptive and postoperative block to be equally effective in treating postoperative pain, with pre-emptive block being more effective in preventing the rise in norepinephrine concentration.

Experiences with fine needle aspiration cytology as a diagnostic procedure for breast lesions in a Calcutta Hospital

Nine hundred and forty cases of breast lesions were subjected to fine needle aspiration. Nine hundred twenty-four of them were females and sixteen were males. Smears from the 60 female cases were rejected as unsatisfactory. Of the remaining 864 female cases (aged 15 to 72 years) 704 (81.4%) were benign. Histopathological correlations were done in 448 cases with diagnostic accuracy of 97.3%. One hundred and sixty (18.5%) out of 864 females were malignant and cytohistological correlation was done in 142 cases with 98.6% corroboration. Ten of the 16 male cases were histologically examined with full corroboration. Overall accuracy considering both males and females was 98.6%. Though there was underdiagnosis involving 12 cases of infiltrating ductal carcinoma when the lesions were small and deeply situated there was no overdiagnosis in this study.

Cogan's syndrome: a rare systemic vasculitis

A 4 year old girl presented with keratitis and ataxia. Over the next two months she developed profound hearing loss, arthritis, and polychondritis. A diagnosis of Cogan's syndrome was made. The literature on the condition is reviewed and the importance of early diagnosis to prevent hearing loss is highlighted.

Oxidative side-chain and ring fission of pregnanes by Arthrobacter simplex

Metabolic processes involving side-chain and ring cleavage of progesterone, 17-hydroxyprogesterone, 11-deoxycortisol and 16-dehydropregnenolone by Arthrobacter simplex were studied. The formation of the metabolites from progesterone indicates a pathway somewhat different from normal in the enzymic reaction sequence, and the 17-hydroxyprogesterone metabolites reveal a non-enzymic rearrangement step. The presence of a hydroxy group at C-21, as in 11-deoxycortisol, induces reduction of the C-20 carbonyl group. The microbial preparation of a novel androstane analogue, 17 beta-hydroxy-16 alpha-methoxyandrosta-1,4-dien-3-one, by incubation of 16-dehydropregnenolone with the bacterial strain was achieved. The formation of this metabolite is a multistep process involving a novel microbial generation of a methoxy group from a double-bond transformation in a steroid skeleton.