Associated Risk Factors and Clinical Outcomes of Acute Coronary Syndrome Patients in A Tertiary Care Hospital

Background: Acute coronary syndrome (ACS) is a significant cause of morbidity and mortality worldwide. Identifying the risk factors, clinical outcomes, and complications of ACS patients is crucial for optimal patient management and resource allocation. This study aimed to investigate these factors in a tertiary care hospital in Bangladesh. Material & Methods: This cross-sectional observational study was conducted with a sample of 100 ACS patients at the Department of Cardiology, Cumilla Medical College Hospital, Cumilla, Bangladesh. The study duration was 6 months, from March 2013 to August 2013. Data were collected on socio-demographic characteristics, physical measurements, risk factors, presenting symptoms, ACS types, and outcome complications. Descriptive statistics were used to analyze the data. Results: The study population comprised 76% males and 24% females, with a mean age of 55.4 years. The most prevalent risk factors were smoking (59%), hypertension (41%), and diabetes mellitus (10%). Chest pain was the most common presenting symptom (86%). STEMI (48%), unstable angina (44%), and NSTEMI (8%) were the identified ACS types. Complications observed included heart failure (9%), cardiogenic shock (8%), conduction defects (10%), and arrhythmias (13%), with no reported deaths. Conclusion: Our findings emphasize the importance of addressing modifiable risk factors such as smoking, hypertension, and diabetes mellitus through targeted interventions and public health initiatives. Additionally, the study highlights the need for healthcare providers to be aware of both typical and atypical presentations of ACS to facilitate prompt diagnosis and treatment. Further research with larger, multicenter studies is needed to better understand the complexities of ACS risk factors and outcomes in Bangladesh and other low- and middle-income countries

Control of human filarial vector, Culex quinquefasciatus Say 1823 (Diptera:Culicidae) through bioactive fraction of Cayratia trifolia leaf

Objective:To investigate the mosquito larvicidal activity of Cayratia trifolia (L.) Domin (Vitaceae:Vitales) (C. trifolia) which is distributed in many parts of India with medicinal properties as vector control is facing threat due to the emergence of resistance to synthetic insecticides. Methods:Young and mature leaves of C. trifolia were investigated for larvicidal activity against 3rd instars larvae of Culex quinquefasciatus in different seasons throughout the year. The active fractions were extracted using six different solvents in a non-polar to polar fashion viz petroleum-ether, benzene, chloroform:methanol (1:1 v/v), acetone, absolute alcohol and distilled water. Dose dependent mortality was recorded against each solvent extract. Determination of LD50 and LD90 were executed through log-probit analysis using the most bioactive fraction. The fluctuations in mortality were statistically co-related through ANOVA analyses concerning different seasons and types of leaves as random variables. Justification of larvicidal activity was established through student’s t-test. Costing effects were evaluated on the non-target water fauna under laboratory conditions. Thin layer chromatographic techniques were performed for phytochemical analysis and categorization of chemical personality of the active fractions using the most effective solvent extract following standard methods. Results:Significant variations in mortality rate were noted with respect to the type of leaves (mature and senescence), concentration of leaf extract and between seasons. The water extract among all the solvent extracts was found to induce cent percent mortality at 50 mg/L in test mosquito species within 24 h with a LD50 and LD90 value of 10.70 mg/L and 27.64 mg/L respectively. No significant mortality was recorded in non-target water population. Chromatographic analyses of the water extract revealed the presence of steroids, triterpene glycosides, essential oil, phenolics and diterpenes as secondary phytochemicals. Conclusions:Water extract of C. trifolia leaf promised as a cost effective and potent larvicidal agent against Culex quinquefasciatus.

Mosquito larvicidal activity of Rauvolfia serpentina L. seeds against Culex quinquefasciatus Say

OBJECTIVE@#To establish the larvicidal activities, if any of solvent extracts of Rauvolfia serpentina (R. serpentina) L. seeds against Culex quinquefasciatus (Cx. quinquefasciatus) Say, 1823 as target species.@*METHODS@#Seeds of R. serpentina were extracted with five solvents graded according to the polarity [viz. petroleum ether, benzene, ethyl acetate, acetone and absolute alcohol] continuing one after another with the same seeds.@*RESULTS@#Mortality rate with petroleum ether extract was significantly higher than other extracts. The mortality rates of late 3rd instar larvae were 50.33±5.51, 10.00±1.00, 0.00±0.00, 21.33±1.53 and 0.00±0.00 in 100 ppm concentration of petroleum ether, benzene, ethyl acetate, acetone and absolute alcohol respectively, after 24 h of exposure period.@*CONCLUSIONS@#Results of this study show that petroleum ether extract of R. serpentina seed may be considered as a potent source of mosquito larvicidal agent.

Concurrent dengue and malaria in an area in Kolkata

OBJECTIVE@#To establish the nature and extent of dual dengue and malaria infections in an endemic area through a longitudinal study.@*METHODS@#A prospective study was conducted from August 2005 to December 2010 to document the nature and extent of concurrent dengue and malaria infections in an area in central Kolkata, endemic both for dengue and malaria.@*RESULTS@#Of 2 971 suspected cases of dengue fever, in 605 (20.36%) persons dengue infection was detected, of whom 46 (7.60%, 46/605) patients (40 and 6 suffered from secondary and primary dengue fever respectively) were simultaneously suffering from malaria (28 and 18 were infected with Plasmodium vivax (P.vivax) and Plasmodium falciparum (P. falciparum) respectively, such dual infections of dengue and malaria were detected in all the years of the study period, except 2007, indicating intense transmission of both dengue and malaria in the study area, and the phenomenon was not an isolated one, the rate of concomitant infections ranged from 25% in 2009 to 4.9% in 2005. Out of total population surveyed, 1.54% (46/2 971) had concurrent dengue and malaria infection.@*CONCLUSIONS@#These findings added a new dimension in diagnosis, treatment, epidemiology and control of dengue and malaria. The possible risk of concurrent dengue and malaria infections should always be kept in mind in endemic areas for early diagnosis employing modern technology and prompt and effective treatment to avoid serious complications.

Studies on breeding habitats and density of postembryonic immature filarial vector in a filarial endemic area

Objective: To obtain a complete and systematic data about the breeding habitats and density of vector immatures (larvae & pupae) in a filarial endemic area. Methods: All the possible permanent and temporary water bodies were surveyed systematically. Four hundred samples were taken in each season from each type of habitats. Sampling was done with a 250 mL dipper and immature mosquitoes were identified following standard keys. Results: In summer, rainy and winter seasons, overall 49.64%, 44.64%, and 28.57% of the habitats were positive for immature filarial vector (Culex quinquefasciatus) respectively; 36.93%, 35.11%, and 21.18%of the samples were positive for immatures respectively and overall per dip densities (PDD) of them were 10.29, 10.18, and 4.40 respectively. In the study year overall PDD were much higher in open cesspits (19.53) and drains (17.24) than in other habitats. Peak PDD of vector immatures in Dobas (ditches), open cesspits and drains were in March whereas in paddy fields and temporary water bodies peak PPD were in September. Conclusion: Dobas, paddy fields, open cesspits, drains, and temporary water bodies were found to be the main breeding sites of filarial vector, Cx. quinquefasciatus in different months. Open cesspits and drains were suitable almost throughout the year with peak in summer. Dobas also act as a steady breeding site throughout the year, whereas temporary water bodies immerge as strong breeding site during pre-monsoon and monsoon seasons. Information about the breeding habitats will be helpful to formulate a filarial vector control strategy and in turn to control the filarial diseases in the study area.

Isolation and identification of bioactive antibacterial components in leaf extracts of Vangueria spinosa (Rubiaceae)

OBJECTIVE@#The column chromatographic fraction of ethyl acetate (EA1, EA2, EA3, EA4 and EA5) leaf extracts of Vangueria spinosa (V. spinosa) were screened for antibacterial activity and phytochemical analysis.@*METHODS@#EA3 fraction was isolated and identified by column chromatography, thin layer chromatography, spectral data analysis and phytochemical screening were used for analysis.@*RESULTS@#EA3 fraction was significantly active at 4 to 64 mg/L against Staphylococcus aureus, Escherichia coli, Klebsiella pneumoniae and Pseudomonas aeruginosa with minimum inhibitory concentration of 1.5625 to 3.1250 mg/mL. The active fraction (EA3) revealed the presence of flavonoid with retention factor value (R(f)) of 0.39. The active antibacterial agent in the most potent fraction (EA3) was isolated and identified as flavonoid (-)-epicatechin-3-O-β-glucopyranoside by thin layer chromatography (TLC) and phytochemical screening. EA1 and EA2 show inhibitory activity at 4 to 64 mg/L against Staphylococcus aureus only where as fraction EA4 and EA5 do not shows any inhibitory activity within that range of concentration against any bacteria.@*CONCLUSIONS@#The results support the ethnomedicinal use of leaf of V. spinosa for the treatment of bacterial diseases.

Mosquito larvicidal activity of some common spices and vegetable waste on Culex quinquefasciatus and Anopheles stephensi

OBJECTIVE@#To investigate the larvicidal activities of crude and chloroform: methanol (1:1 v/v) extracts of some common spices (Cuminum cyminum, Allium sativum, Zingiber offinale, Curcuma longa) and vegetable waste (Solanum tuberosum germinated tuber) against Anopheles stephensi and Culex quinquefasciatus mosquito larvae.@*METHODS@#Larval mortality of above mosquito species were observed after 24, 48 and 72 h of exposure to five concentrations of aqueous extract (0.1%, 0.2%, 0.3%, 0.4% and 0.5%) and four concentrations (25, 50, 75 ppm) of chloroform: methanol (1:1 v/v) extract. The lethal concentration of individual spices or vegetable waste was determined by log-probit analysis (at 95% confidence level) and effect of crude and chloroform: methanol (1:1 v/v) extracts were recorded on non target organisms.@*RESULTS@#Relative mortality rate of both larval mosquito species were recorded in the following sequences: Cuminum cyminum >Allium sativum >Zingiber offinale, Curcuma longa >Solanum tuberosum germinated tuber for crude extract, and efficacy of chloroform: methanol (1:1 v/v) extract were as follows: Curcuma longa >Zingiber offinale >Solanum tuberosum germinated tuber >Cuminum cyminum >Allium sativum.@*CONCLUSIONS@#Crude and chloroform: methanol (1:1 v/v) extract of Cuminum cyminum, Allium sativum, Zingiber offinale, Curcuma longa and Solanum tuberosum germinated tuber can be recommended effectively in mosquito control programmes at very low concentrations. No mortality and other abnormalities were noticed on non target organisms and further studies are needed to investigate the chemical structure of active principal which are responsible for larvicidal activity.

Larvicidal activity of Dregea volubilis and Bombax malabaricum leaf extracts against the filarial vector Culex quinquefasciatus

OBJECTIVE@#To analyze the larvicidal activity of two plant leaf powder and leaf-extracts, Dregea volubilis and Bombax malabaricum against Culex quinquefasciatus.@*METHODS@#The larvicidal bioassay was done for powdered leaves of Dregea volubilis and Bombax malabaricum individually and their methanol extracts against first-, second-, third- and fourth-instar larval forms of Culex quinquefasciatus. Mortality rate was recorded after 24, 48 and 72 h of post-exposure. LC(50) and LC(90) values were calculated at different time intervals for third instar larvae.@*RESULTS@#All the graded concentration (0.1%, 0.2%, 0.3%, 0.4%, 0.5%) of powdered leaves showed significant (P <0.05) larval mortality. The mortality rate was higher in 50 ppm doses of methanolic extracts of both the plants against Culex quinquefaciatus. The corresponding LC(50) values were 56.97 ppm and 48.85 ppm, respectively after 24 h of exposure. There is no mortality of non-target organism such as Chironomous circumdatus, Oreochromis niloticus niloticus and Diplonichus annulatum within 72 h of post exposure to 0.1%, 0.2%, 0.3% crude powdered leaves and methanolic extracts of both the two individual plants under the laboratory condition. The results of preliminary qualitative phytochemical analysis of both the plants revealed the presence of many bioactive principles such as steroids, tannins, flavonoids, triterpenoids, saponins, etc. that may be responsible for their bio-control potentiality.@*CONCLUSIONS@#The results have shown potential and eco-friendly use of both plant extracts against larva of Culex quinquefasciatus for the first time.

Efficacy of Limonia acidissima L. (Rutaceae) leaf extract on larval immatures of Culex quinquefasciatus Say 1823

OBJECTIVE@#To investigate the role of leaf extract of Limonia acidissima L. (Rutaceae) as a biocontrol agent against the larval form of Culex quinquefasciatus, and characterization of bioactive component responsible for larvicidal activity.@*METHODS@#Larval mortality of mosquito species was observed after 24, 48 and 72 hours of exposure to different concentrations of aqueous extract, solvent extract and subsequently bioactive compound. The bioactive compound was subjected to IR and GC-MS analysis.@*RESULTS@#Mortality rate at 3% concentration of crude extract were highest (90%) amongst all concentrations tested and subsequently highest (95%) mortality was achieved in chloroform: methanol extract at 100 ppm concentrations. IR and GC-MS analysis of bioactive compound revealed the presence of steroid compound which may act as larvicide.@*CONCLUSIONS@#The chloroform: methanol extract of mature leaves of Limonia acidissima was found to exhibit considerable mosquito larvicidal activity against Culex quinquefasciatus.

Smoke repellency and mosquito larvicidal potentiality of Mesua ferra L. leaf extract against filarial vector Culex quinquefasciatus Say

Objective: Present study was made to evaluate the smoke repellent potentiality and mosquito larvicidal activity of Mesua ferra (M. ferra) leaves against filarial vector Culex quinquefasciatus (Cx.quinquefasciatus ). Methods: Crude, petroleum-ether, chloroform: methanol (1:1 v/v) and ethyl acetate extracts of mature plant leaves were investigated to establish its biocontrol potentiality under laboratory condition against larvae of Cx. quinquefasciatus at different concentrations i.e. 25 ppm, 50 ppm and 75 ppm. Mosquito coil prepared from M. ferra leaves powder were tested for smoke toxicity effect against Cx. quinquefasciatus adult mosquitoes. Results: The mortality rates of crude extract at 0.5% concentration were higher than all other concentrations tested against the first, second, third and fourth instars larvae at 24 h, 48 h and 72 h of exposure. Larval mortality rate in chloroform: methanol (1:1 v/v) extract was significantly higher (P<0.05) than other extracts. LC50 value of petroleum ether, chloroform: methanol (1:1 v/v) and ethyl acetate extracts were 195.33 ppm, 27.28 ppm and 74.19 ppm respectively, after 48 h of exposure. Smoke exposed gravid females oviposited fewer eggs when compared to non exposed female mosquitoes. Conclusions:In conclusion M. ferra crude and chloroform: methanol (1:1) extract can be used effectively against mosquito control programmes. Smoke from M. ferra can play an important role in the interruption of transmission of those diseases where mosquitoes act as vector at the individual level.

Synergistic effect of Croton caudatus (fruits) and Tiliacora acuminata (flowers) extracts against filarial vector Culex quinquefasciatus

Objective:To investigate the synergistic effect of crude and solvent extract of Croton caudatus (C. caudatus ) (fruits) and Tiliacora acuminata (T. acuminata) (flowers) against the larval form of Culex quinquefasciatus (Cx. quinquefasciatus). Methods: Crude and solvent [chloroform:methanol (1:1 v/v), benzene and ethyl acetate] extracts of two plants, C. caudatus (fruits) and T. acuminata (flowers) were examined separately against filarial vector Cx. quinquefasciatus larvae with gradually increasing concentration i.e. from 0.1%to 0.5%of crude extract and 25 ppm to 75 ppm of solvent extracts. To observe the synergistic effect, if any, extracts of these two plant parts were mixed at different concentrations and treated against mosquito larvae. Phytochemical analyses of extracts of both the plant parts were carried out. Results: In a 72-h bioassay experiment with plant extracts, highest mortalities were recorded at 0.5% (crude) and 75 ppm (solvent) concentration for fruits of C. caudatus and flowers of T. acuminata individually. For synergistic effect, only 0.2%of the mixture of these two crude extracts and 75 ppm concentration of chloroform:methanol (1:1 v/v) and ethyl acetate extracts showed 100%mortality after 24 h and 48 h of exposure respectively. Conclusions:In the field of mosquito control, insecticides of plant origin may serve as suitable alternative to the toxic chemicals. Some secondary metabolites in combination may be responsible for better larvicidal activity.