Development of PR & Restenosis after Percutaneous Balloon Pulmonary Valvuloplasty

Background: Pulmonary stenosis is not an uncommon congenital heart disease in our population. Various age groups present with severe pulmonary stenosis require intervention either surgical or percutaneous catheter-based. Often lifesaving surgical intervention is not feasible considering procedural risk, the patient’s physical condition, and young age. Percutaneous balloon pulmonary valvuloplasty is safe, effective, almost painless, economical, and less hospital stay in any age group with immediate and long-term success. This study aimed to analyze the rate of development of (Pulmonary Regurgitation) PR & restenosis after Percutaneous Balloon Pulmonary Valvuloplasty (PBPV). Material & Methods: This hospital-based prospective observational study was conducted in the Department of Paediatric Cardiology Combined Military Hospital (CMH), Dhaka from January to December 2021. 0-18 years aged 50 population with PS who were referred to the Paediatric Cardiology Department of CMH Dhaka during the study period were selected as study subjects as per inclusion criteria. The purposive Sampling technique was used in this study. Data were collected with a predesigned standard data collection sheet. Statistical significance was set as a 95% confidence level at a 5% acceptable error level. Categorical variables were expressed as frequency and percentages. Mean, standard deviation, and/or medians with interquartile ranges were used to express the continuous variables. Paired t-test was performed in categorical comparison. A p-value of <0.05 was considered statistically significant. Collected data were analyzed using SPSS Version 24. Written informed consent was taken from every parent. Ethical clearance was taken from the Ethics Review Committee of CMH Dhaka for conducting the study. Results: 50(6.39%) had isolated valvular PS. The international standard for the prevalence of isolated PS is 8-10% which is very close to this study’s result. In this study, male predominance was found with the male-female ratio of 3:2 though there was no gender dominance found in other studies. Out of 50 cases, 3(6%) are neonates,7(14%) are infants, 27 (54%) are 1-5 years aged, and 13(26%) are more than 5 years aged. A total of 13(26%) cases developed PR, and all 13 patients developed trivial PR on D1 echo, out of them 1 patient developed mild PR on D30 Echo but in D90 and D180 Echo patients persisted the same mild PR. Out of 50 cases, 46(92%) were successful and 4 cases were procedure failed. None of the successful cases developed restenosis. Out of 4 procedure failed cases 1 patient developed restenosis on D30 follow up and 2 patients develop restenosis on the D90 follow-up. At D180 follow up none of the patients developed restenosis. All the restenosis cases had dysplastic pulmonary valves. One patient’s PS gradient persisted at 30-50 mm of Hg throughout the follow-up period. Overall restenosis in 180-day follow-up is 3(6%) and the remaining 47(94%) cases lead a healthy life in 6 months follow-up. Reballooning was done immediately after diagnosis of restenosis in stenosed cases. Conclusion: Immediate and intermediate-term (6 months) follow-up with Doppler echocardiography showed excellent outcomes in all cases except 3 (6.0%) restenosis cases and 13 (26.0%) insignificant PR cases. The baby who all had restenosis, had the risk factor, like- dysplastic PV. It may be concluded that balloon valvuloplasty is the procedure of choice for moderate, severe, and critical pulmonary valve stenosis.

Thyroid Dysfunction in Adults with Newly Detected Type 2 Diabetes Mellitus: A Study in a Tertiary Care Hospital, Dhaka, Bangladesh

Background: Thyroid disorders and diabetes mellitus are common endocrine disorders that often coexist and can significantly impact each other’s management. The American Diabetes Association recommends that people with diabetes be periodically screened for thyroid dysfunction due to the strong link between the two conditions. It is important for individuals to be aware of the risk factors for both conditions and to seek appropriate medical care if necessary, and for healthcare providers to consider testing for thyroid dysfunction in adults with newly detected type 2 diabetes mellitus. The aim of the study was to find out thyroid dysfunction in adults with newly detected type 2 diabetes mellitus. Material & Methods: This cross-sectional, descriptive study was conducted at the Departments of Medicine and Endocrinology at Sir Salimullah Medical College and Mitford Hospital in Dhaka. The study period lasted six months, from May to October 2019. A total of 102 adult patients (above 20 years old) with newly diagnosed type 2 diabetes mellitus who were attending the Endocrinology and Medicine Outpatient Department participated in the study. Results: Out of 102 adults with newly detected type 2 diabetes mellitus, the majority (86.3%) had normal thyroid function (euthyroid), while a smaller number (13.7%) had thyroid dysfunction. The most common subgroup of thyroid dysfunction was subclinical hypothyroidism (7.8%), followed by hypothyroidism (3.9%), subclinical thyrotoxicosis (1.0%), and hyperthyroidism (1.0%). The majority of the study population was male (66%) and from urban areas (88%), with a mean age of 45.1 years, a mean BMI of 25.0 kg/m2, and a mean waist circumference of 98.4 cm. About 45% had a family history of diabetes mellitus and 37% were smokers. The blood pressure of the study population was within normal limits. A minority (30%) had co-morbidities such as hypertension, dyslipidemia, and ischemic heart disease. The predictors of thyroid dysfunction were observed Age (OR=0.785), F/H of thyroid disorder (OR=0.495) BMI (OR=1.059), Anti-TPO Ab(OR= 0.021). Conclusion: Thyroid dysfunction and diabetes are commonly associated with each other and can impact clinical presentation and laboratory results. It is important to routinely screen for thyroid function in all patients with type 2 diabetes mellitus to detect, treat, and prevent complications of both these conditions.

Rice bran oil reduces organ-specific fat deposition, attenuates hyperlipidaemia and abnormal liver function in Long Evans rats with high fat intake

@#Introduction: High-calorie diets, particularly the quality of dietary fats, are regarded as an independent risk factor for developing obesity, hyperlipidaemia, and liver diseases. The present study examined the impact of rice bran oil (RBO) on organ-specific fat deposition, lipid profile, and liver function enzymes in Long Evans rats. Methods: Long Evans rats (n=24) were fed for six weeks with a controlled high-fat diet (HFD) to induce hyperlipidaemia and abnormal liver function. Rats were then divided into two groups: one group continued feeding on HFD, and the other group was fed with a RBO diet, replacing the fat source. After six weeks of feeding, six rats from each group were sacrificed and required analytical tests were performed. The remaining obese rats (n=12) were divided into continued HFD and RBO diet, and after sacrificing, essential analytical tests were done. Results: RBO feeding to hyperlipidaemic rats for six weeks significantly reduced brown adipose tissue, abdominal adipose tissue, epididymal adipose tissue, and liver fat compared to continuing HFD group (p<0.05). Similarly, serum levels of total cholesterol, triacylglycerides, and low-density lipoprotein cholesterol were all decreased, whereas high-density lipoprotein cholesterol increased in response to RBO compared to HFD (p<0.05). Additionally, rats fed with RBO showed reduced alanine aminotransferase, aspartate aminotransferase, and gamma-glutamyl transferase levels when compared with continuing HFD-fed rats (p<0.05). Conclusion: These findings suggest that RBO supports the reduction of fat storage from major fat depots, controls lipid profile, and restores healthy liver functions in rats.

Association of dietary pattern and childhood obesity with cardiovascular disease in patients from Tangail city, Bangladesh

@#Introduction: Obesity in childhood is a major cause for developing cardiovascular diseases (CVD) at adulthood. The present study was a cross-sectional research aimed to examine the relationship between childhood obesity and dietary pattern with CVD in patients (n=100) from Tangail City, Bangladesh. Methods: Dietary patterns, laboratory tests, demographic, and anthropometric interrelated data were measured in patients with stroke and heart attack from five hospitals. The research also used 24-hour recall method and a food frequency questionnaire for assessing daily energy and macronutrient intakes. Results: Weight (p=0.004), body mass index (BMI) (p=0.001), mid-upper arm circumference (MUAC) (p=0.009), and waist circumference (WC) (p=0.030) was significantly different between males and females whereas lipid profile was not significantly different between genders. There were no significant associations between intakes of red meat, salt, fast food, fish, egg, nuts and seeds with heart attack and stroke. On the contrary, there were significant associations between fried food intake with heart attack and stroke (p=0.080 and p=0.020). The results indicated that there was a significant relationship between carbohydrate (p=0.001), protein (p=0.001), and fat (p=0.001) intakes with the total energy intake of respondents. The findings also showed that there was a significant relationship between carbohydrate (p=0.003), protein (p=0.001), and fat (p=0.001) intakes with body mass index of the respondents. Conclusion: CVD diagnosis in adult patients was found to be associated with fried food intake but not with childhood obesity.

A study of the different learning styles of the present first professional MBBS students at United Institute of Medical Sciences, United Medicity, Prayagraj, India

Background: The study is designed to evaluate the different learning styles of the present first professional MBBS students. Students were requested to complete the visual-aural-read/write-kinesthetic (VARK) questionnaire at VARK-LEARN.COM. Results of the questionnaire were collected by email and analyzed using Microsoft Excel. We found that 68.2% had multimodal learning preferences and 31.7% had single learning preference. Aims and Objectives: The objective of this study is to analyze the different learning styles of MBBS 1st year students of United Institute of Medical Sciences, Prayagraj, using the VARK questionnaire. Materials and Methods: This study includes the informed consent taken from each student before participating. The Institutional Ethics Committee approved the study. Copyright permission was taken from the website vark-learn.com, from VARK Learn Limited, New Zealand. One hundred and two students had consented, and out of them, 85 students participated in the study. The students were asked to complete the questionnaire on the website. The data on their learning styles were collected and analyzed using Microsoft Excel. Results: Out of 85 Students, 58 (68.2%) had multimodal learning preferences. Of these, 28.2% of students had four-part VARK or quadrimodal preferences, 28.2% of students had bimodal, and 11.7% had trimodal learning preferences. Twenty-seven (31.7%) had single learning preferences, and, out of these 27 students, 17 (20%) had kinesthetic, 6 (7.05%) had visual learning preferences, and 4 (4.7%) students had aural learning preferences. Conclusion: With the help of this study, we concluded that most of the students who participated in our study are multimodal learners, and out of the students who had a single learning preference, most had kinesthetic learning preferences.

Polysomnographic Outcomes of 62 Patients in Dhaka City a Single-Center Study

Background: Obstructive sleep apnea (OSA) is a very common form of sleep disorder with associated health risks. OSA has been accompanied by more insidious conditions, like hypertension, heart disease, diabetes, stroke, and even daytime somnolence. For the diagnosis of sleep disorders, polysomnography is a comprehensive test. It records the patient`s brain waves, the oxygen level in the blood, ‘breathing and heart rate’, and ‘eye and leg movements during the study. Aim of the study: The aim of this study was to assess the effectiveness of polysomnography in the diagnosis of sleep apnea.Material & Methods:This comparative observational study was conducted in the Department of Otolaryngology &, Head Neck Surgery, Bashundara Ad-Din Medical College and Hospital, Bangladesh during the period from July 2020 to June 2021. In total 62 participants were included in the study population for this study. All the participants were divided into two groups. In group A, there were 5 healthy people without obstructive sleep apnea (No OSA group). On the other hand, in group B, there were 57 obstructive sleep apnea patients (OSA group). Ethical approval had been taken from the ethical committee of the mentioned hospital. Data were analyzed by using MS Office and SPSS version 23 programs as per need.Results:In analyzing the sleep scoring between both the groups, in both TRT minutes and total sleep time minutes we did not find any significant correlation (Table: 2). In analyzing the apnea, in comparing mean (±SD) obstructive, total, and AI calculations, we found significant correlations between the groups (Table: 3, Apnea; P values: 0.036, 0.035, and 0.024 respectively. In comparing different parameters of hypopneas (rule 1A), in most of the events, we found significant correlations except mean (±SD) central (Table 3 hypopneas: rule 1A) even, in comparing total mean (±SD) apneas and hypopneas combinedly we found the P-value as 0.002 (Table:3). In the OSA severity comparison between both the groups, in calculating AHI 1 to<15 events/hour, AHI 15 to<30 events/hour, and AHI ?30 events/hour we found significant correlations (P=.001, Table 3: OSA severity). In assessing the Mean (SD) AHI, OAI, RDI (AI+HI+RI), O2 Desats?3% and O2 Desats?3% Index (ODI) we found significant correlations (P values were 0.001, 0.041, 0.001, 0.003, 0.005 respectively). Besides these, in analyzing both the low SpO2 n (%) and snoring: n (%) there was a significant correlation between the group’s patients (P values were .007 and .001 respectively).Conclusion:Polysomnography may be considered an effective method for detecting measuring and treating obstructive sleep apnea (OSA). Sleep scoring and respiratory events analysis plays an important role in assessing the presence and severity of obstructive sleep apnea.

Determinants of Observance to Osteoporosis Treatment in Clinical Practice in a Single Center Study

Background: Improve compliance to prescribed medications is common in clinical practice, and it can lead to potentially fatal outcomes. This continues to be a common issue in the treatment of osteoporosis, although the causes of discontinuation and low compliance are complicated and understudied.Material & Methods:A survey was conducted in 101 patients at Narsingdi Sadar Hospital, Narsingdi, Dhaka, Bangladesh for osteoporosis management for a follow-up assessment, one year (July 2020 to June 2021) after having been prescribed a treatment with one of the following drugs: Calcium+vitamin D supplements alone (CaVitD), hormone replacement therapy (HRT), risedronate 5 mg/day (RIS), alendronate (ALN OW), Ibandronic acid monthly and Zolindronic acid I/V inj yearly.Results:Overall, 19.1 % stopped taking their prescribed medication before their bone mass reevaluations, with more than half of them doing so within the first 6 months. The dropout rate differed dramatically between regimens. ALN-OW was by far the least interrupted (6.9 %; p0.001 versus any other treatment). The most common causes for cessation were drug-related side effects, a lack of willingness to continue therapy, and a fear of negative effects. The reasons for discontinuation differed by treatment: safety concerns were very common for HRT, lack of motivation was the most common cause for CaVitD and drug-related side effects were the most common cause for RIS, ALN, Ibandronic acid and Zolindronic acid . Patients having a history of vertebral fractures, densito-metric osteoporosis, or who were using corticosteroid or anti-inflammatory medications had a considerably greater rate of treatment adherence. Patients on benzodiazepine or gastroprotective drugs, as well as those for whom a bone measurement was not easily accessible, had a considerably greater probability of treatment interruption. ALN OW and HRT had the highest compliance to recommended dosing (p0.001 versus any other) and CaVitD had the lowest (p0.01 versus any other). Poor treatment compliance (50 percent medicine taken) was strongly associated with benzodiazepine and gastroprotective usage, whereas significantly higher compliance was associated with established osteoporosis risk factors: early menopause, low bone mass values, and past vertebral fractures. Adherence was lowest when treatments were prescribed by general practitioners (GPs) and orthopaedic surgeons (p0.01 compared to the global mean).Conclusions:According to the conclusions of this large survey of Bangladeshi osteoporotic women, the kind of medicine provided is the most important factor of both persistence

An Observational Study on Idiopathic Intracranial Hypertension (IIH) in a Tertiary Care Hospital in Bangladesh

Background: Among the risk factors of cardiovascular diseases, hypertension is one of the major reason. Intracranial hypertension (IIH) is a pressure buildup around the brain. It can happen unexpectedly, as a result of a severe head injury, stroke, or brain abscess could be occurred. It could also be a chronic, long-term condition, known as IIH. It results in the signs and symptoms of a brain tumor. Which is also known as benign intracranial hypertension. Cerebrospinal fluid, or CSF, is the fluid that surrounds the spinal cord and brain. CSF can accumulate if too much fluid is produced or not enough is reabsorbed. This can induce symptoms similar to a brain tumor. Intracranial Hypertension can be classified into three categories, they are Acute, Chronic and Idiopathic. IIH is recognized when the increased intracranial pressure cannot be explained by any other underlying cause.Aim: The aim of the study was to observe idiopathic intracranial hypertension patients in a select tertiary care hospital of Bangladesh.Methods:This cross-sectional observational study was conducted at the Department of Neurosurgery, Sylhet M. A. G. Osmani Medical College Hospital, Sylhet, Bangladesh. The study duration was from January 2012 to December 2020. A total number of 47 participants had been recruited as study population. Results:Male: female ratio was 1:10.75, and 91% of the total participants were female. 40.43% of the participants were aged between 21-30 years. 46.81% were overweight and 34.04% were obese. Most common symptom was nausea, followed by visual impairment and double vision.Conclusion:The prevalence of Idiopathic Intracranial Hypertension is much higher among the female. Female and high BMI are significant risk factors of IIH. It is more prevalent among young adults, and results on various vision related symptoms.

Comparative molecular studies of halophilic bacteria from saline water and soil in the Saudi environment / Estudos moleculares comparativos de bactérias halofílicas de água salina e solo no meio ambiente saudita

Halophilic bacteria are microorganisms that grow optimally in the presence of the very high concentration of sodium chloride. Halophiles are vital sources of various enzymes including hydrolases, which are very stable and catalytically highly efficient at high salt concentration and other extreme conditions such as high temperature, pH and presence of organic solvents. Several hydrolases such as amylases, proteases, and lipases have been obtained from halophilic bacteria and are commonly used for various industrial applications. We initiated a screening to isolate and characterize the halophilic bacteria from the Red Sea, which is one of the saltiest bodies of water in the world. Water and soil samples, collected from the Red Sea coast, Jeddah, Saudi Arabia, were screened for isolation of halophilic bacteria. Ten bacterial isolates were obtained, which were characterized by biochemical tests and 16S rRNA gene sequencing. Hydrolase producing bacteria among the isolates were screened by plate assay on starch and gelatin agar plates for amylase and protease, respectively. Two bacterial isolates i.e. Bacillus glycinifermentans S3 and Enterobacter cloacae W1were found to possess significant amylase and protease activity.

Bactérias halofílicas são microrganismos que crescem de maneira ideal na presença de uma concentração muito alta de cloreto de sódio. Halófilos são fontes vitais de várias enzimas, incluindo hidrolases, que são muito estáveis e cataliticamente altamente eficientes em alta concentração de sal e outras condições extremas, como alta temperatura, pH e presença de solventes orgânicos. Várias hidrolases como amilases, proteases e lipases foram obtidas a partir de bactérias halofílicas e são comumente usadas para várias aplicações industriais. Iniciamos uma triagem para isolar e caracterizar as bactérias halofílicas do Mar Vermelho, que é um dos corpos de água mais salgados do mundo. Amostras de água e solo, coletadas na costa do Mar Vermelho, Jeddah, na Arábia Saudita, foram examinadas quanto ao isolamento de bactérias halofílicas. Foram obtidos dez isolados bacterianos, caracterizados por testes bioquímicos e seqüenciamento do gene 16S rRNA. As bactérias produtoras de hidrolase entre os isolados foram triadas por ensaio em placa em placas de amido e ágar de gelatina para amilase e protease, respectivamente. Verificou-se que dois isolados bacterianos, isto é, Bacillus glycinifermentans S3 e Enterobacter cloacae W1, possuíam significativa atividade de amilase e protease.

Genetic authentication of Eclipta prostrate (Asteraceae) from Penthorum chinense (Penthoraceae) by Sequence Characterized Amplified Region (SCAR) markers

Introduction: For the rapid and accurate genetic identification and authentication of living organisms, improved random amplified polymorphic DNA (RAPD) fragment based development of sequence-characterized amplified region (SCAR) markers is an important genetic technique. Objective: This study aimed to develop SCAR markers for perennial herb Eclipta prostrate (E. prostrate). Methods: Here the RAPD fragments by improved RAPD amplification with primers A11 and N-7 for E. prostrate were cloned into pGEX-T vector, and PCR amplification identified the positive clones. After the enzymatic digestion, they were sequenced with Sanger sequencing. Results: Two SCAR markers were developed, which were very specific to E. prostrate, not found in Penthorum chinense Pursh(P. chinense). The nucleotide sequence search by BLAST GenBank database showed that they are novel in E. prostrate, therefore they were deposited in Genbank with accession number KX671034, KX671035. The markers did not show any identity to other species. Conclusions: Thus, in this study two specific SCAR markers were developed for genetically distinguishing and identifying the plant species E. prostrate from herb P. chinense and others.

Introducción: Verificación genética del arbusto Eclipta prostrate (Asteraceae) (Para la identificación y verificación genética rápida y precisa de organismos vivos, el uso de fragmentos de ADN polimórfico amplificado aleatoriamente (RAPD) mejorado de marcadores de región amplificada caracterizada por secuencia (SCAR) es una técnica genética importante. Objetivo: Este estudio tuvo como objetivo desarrollar marcadores SCAR para la hierba perenne Eclipta postrate (E. postrate). Métodos: En este estudio os fragmentos RAPD mediante amplificación RAPD mejorada con los cebadores A11 y N-7 para E. postrate se clonaron en el vector pGEX-T, y la amplificación por PCR identificó los clones positivos. Después de la digestión enzimática, se realizó una secuenciación Sanger. Resultados: Se desarrollaron dos marcadores SCAR, muy específicos para E. postrate, que no se encuentran en Penthorum chinense Pursh (P. chinense). La búsqueda de las secuencias de nucleótidos con BLAST en GenBank mostró que son nuevos en E. postrate, por lo que fueron depositados en Genbank con los números de acceso: KX671034 y KX671035. Los marcadores no mostraron ninguna identidad a otras especies. Conclusiones: En este estudio se desarrollaron dos marcadores SCAR específicos para distinguir e identificar genéticamente la especie de planta E. postrate de la hierba P. chinense y otras.

KAP Study of Tobacco Users among the Garment Workers at Dhaka City in Bangladesh

The readymade garment (RMG) industry is a key sector of Bangladesh economy. This sector brings in about 78% of the country’s total merchandize export earnings. More than 3.2 million people are working in this sector and mostly females from underprivileged social classes.Employment in this Ready-made garment sector in Bangladesh provides workers with economic benefits and some empowerment. A descriptive cross-sectional study followed by a qualitative approach was utilized. Through proportionate quota sampling, 560 garments workers were recruited from 6(one large, two medium, and three small) garment factories in Mirpur area of Dhaka city.Almost all of the garments workers knew that both smoking and smokeless tobacco (98.4%) is harmful for health. Knowledge on specific health hazards of smoking (96.96%) tobacco was relatively higher than those of smokeless (90%) tobacco. Electronic media (Radio/TV/Cinema) was themost common source of their knowledge (92.9%). In case of smoking tobacco, cancer (63.6%) was the mostly reported disease caused by smoking tobacco, followed by lung cancer (15.7%) and heart attack (11.3%). On the other hand, for smokeless tobacco, cancer (29.8%), followed by oral cancer (26.6%) and lung cancer (15.0%) was mostly reported diseases by the garments workers. Garment workers’ knowledge on tobacco control policy was found to be very low. Only 35.0% knew about the policy. Although few garments workers know about the rules for prohibition of tobacco product in public place (25.7%) and public transport (11.3%), other specific rules under tobacco control policy were not known to majority of them. The present study provides a scientific base regarding current tobacco using practice among garments workers in Dhaka city and their knowledge and attitude towards tobacco. Finding revealed from qualitative analysis of data suggested that now-a-days smoking is considered as a trend; people have to smoke for showing smartness or to maintain social status. Peer influence also plays an important role for initiating and maintaining smoking status. Socio-cultural influence for smokeless tobacco consumption was not well documented by this study which indicated a need for more focused qualitative study.

Mistakes of Surgeons: “Gossypiboma” Sometimes Brings Grave Consequence to the Patient

Retained surgical mop in the abdominal cavity is a serious butavoidable complication which may manifest either as aninflammatory reaction with formation of abscess and fistula orwith a fibrotic reaction developing into a mass. We report thecase of a 25 years old women who presented four monthsafter a Caesarean section with features of intestinalobstruction. Plain abdominal radiograph and ultrasound scanraised high index of suspicion of the presence of gossypibomaand the diagnosis was confirmed at laparotomy. Even after 2ndand 3rd look surgery, the patient faced a sad demise.Gossypiboma, term derived from the latin ‘gossypium’ (cotton)and the swahilli ‘boma’ (place of concealment) is the term formretained surgical sponge. Two usual responses to retainedmops are exudative inflammatory reaction to develop a mass.Intraluminal migration is rare, leading to obstruction. Patientmay develop symptoms of abdominal pain, nausea, vomitingand weight loss resulting from obstruction or a malabsorptionsyndrome caused by multiple intestinal fistulas or intraluminalbacterial overgrowth. Early recognition of this entity will ensureprompt diagnosis and appropriate treatment, reducingmorbidity and mortality in such patients.

Effectiveness of Standard Treatment Outcome for Different Stages of Chronic Obstructive Pulmonary Disease Patients: Role of 6 Minute Walk Test

ABSTRACTBackground: Chronic Obstructive Pulmonary Disease (COPD)is defined as a avertible and curable disease characterized by“persistent airflow limitation” that is usually advanced andassociated with an heightened chronic inflammatory responsein the airways, and the lung tonoxious particles or gases.Habitual smoking of cigarette represents the most significantrisk for impeding COPD, as well as low birth weight, recurrentinfections, indoor air pollution with biomass fuel, low socioeconomic status, occupational exposure such as xoal dust,silica, cadmium etc, Different stages of COPD based on postbronchodilator FEV1, in patients with FEV1/FVC <0.70.Aim: To find out the effectiveness of the combined treatmentoutcomes by studying the patients with different stages ofseverity of Chronic Obstructive Pulmonary Disease.Methods: A Prospective study was carried out during theperiod from 1stJune 2018 to 31st December 2018 in theoutpatients department (OPD) of Patuakhali 250 Bed SadarHospital, Patuakhali. One Hundred and Fifty COPD patientswere included in this study. The study was conducted bymeasuring the response of patients with by following the “6Minute Walk Test” or

Blind Transthoracic Fine Needle Aspiration Cytology as a Diagnostic Tool in Suspected Lung Cancer in Resource Poor North-Eastern Part of India

Unguided FNAC may be the only option left for accurate diagnosis of malignant lesions in the lung in resource poor settings. The present study was done with the aim of assessing the accuracy and utility of unguided transthoracic fine needle aspiration cytology in the diagnosis of lung cancer. Methods: An interventional study was taken up in the Department of Respiratory Medicine, JN Institute of Medical Sciences, Imphal. All patients admitted in the IPD with suspected malignant lung lesions during the period July 2017-Dec 2018 was included. After obtaining prior informed written consent fine needle aspiration was done from the dullest area on chest wall by using a lumbar puncture needle under local anaesthesia. The slides prepared thereafter were alcohol-fixed and sent to the Department of Pathology, JNIMS for cytological examination. The patients were observed closely after the intervention to detect any complications. Results: Completed data sets could be obtained from 20 study subjects. Unguided fine needle aspiration cytology had a diagnostic yield of 75% for detecting malignant lesions in the lung. Only minor post-procedure complications were encountered in 10% of the patients. Conclusion: The unguided trans-thoracic fine needle aspiration cytology has many merits. It is rapid, safe, accurate and cost-effective for the diagnosis of intra-thoracic peripheral lesions. It can also be used as an outdoor procedure even in peripheral health centres in properly selected cases.

Prevalence of Hepatitis B Infection Among Kidney Patient Attending for Haemodialysis in Gazi Medical College Centre, Khulna, Bangladesh

Kidney disease is increasing day by day in the form of AKD orCKD. CKD patients who have developing end stage renaldisease (ESRD) required haemodialysis for survival. There is apotential risk of increasing blood borne viral infectionparticularly Hepatitis B infection. The proportion of hepatitis Binfection increasing with increased frequency of dialysis. Therisk is 1.47 times more in the patients receiving haemodialysis.We have a retrospective study. The study times was January2017 to December 2017 all the patients attendinghaemodialysis unit at Gazi Medical College. A total 236patients were selected. Among them 151 patients werevaccinated and 67 patients vaccinated during dialysis and 18patients were not vaccinated. There was a history of bloodtransfusion of 145 patients and 91 patients have no history ofblood transfusion. There were 30 patients were HbsAg positiveout of 236 patients. 12 patients were vaccinated before thediagnosis of CKD and 18 were not vaccinated. The finding ofthe study will help the doctor and policy maker totake appropriate measurement to decrease the morbidity andmortality from Hep B infection who are receivinghaemodialysis.

The Effect of Aqueous Extract of MomordicaCharantia on Blood Glucose Level in Alloxan Induced Diabetic Rats

Introduction: Diabetes mellitus is one of the five leadingcauses of death in the world.Objective: Our main goal is to estimate the effect of aqueousextract of Momordica charantia on blood glucose level inalloxan induced diabetic rats.Methodology: This experimental study was carried out atDepartment of pharmacology, Dhaka medical college, Dhakafrom July 2014 to June 2015 where the study was divided intotwo parts, Experiment-1 and Experiment-2. In Experiment-1include group A and group B. Experiment-2 include group C,group D and group E. Blood was collected from group A andgroup B on day 1 and day 15 and from group C,D and E onday 1,4 and 15 of experiment.Results: During the result in group-A (served as control andreceived normal rat diet for 14 days) the blood glucose levels(mean ± SD) were 4.90±0.50 mmol/L and 5.3±0.38mmol/L onday 1 and day 15 respectively. Percent inhibition was 4.8 andin group-B the blood glucose levels (mean ± SD) were5.00±0.36mmol/L and 5.05±0.32 mmol/L on day 1 and 15respectively. Also for in group C, the blood glucose levels(mean ± SD) were 5.31± 0.45 and 14.24±.51 on day 1 andday 15 respectively.Conclusion: From the analysis we can conclude that thataqueous extract of Momordica charantia has hypoglycaemiceffect, thus provide a rational for its use in development of newdrug require for treatment and prevention of complications ofdiabetes mellitus.

Awareness Regarding Neonatal Jaundice Treatment Among Mothers: A Descriptive Study in Tertiary Level Hospital

Background: Neonatal Jaundice (NNJ) is a major publichealth problem worldwide and is present among 50 – 60 % offull term and 80% of preterm newborns. This study wascarried out in order to assess the knowledge on neonataljaundice treatment among the mothers in a selected tertiarylevel hospital of Jessore district town.Methodology: It was a descriptive type of cross – sectionalstudy. 110 samples were selected by non – randomizedpurposive sampling technique with the administration of apretested modified and semi – structured questionnaire by faceto face interview.Results: Study found that majority of the respondents(54.55%) was in the age group 20 – 25 years. Regardingknowledge on preventive measures of NNJ 95.45%respondents had knowledge on ‘‘putting jaundiced baby underdirect sun light’’, 41.82% had knowledge on ‘phototherapy’.97.27% indicated’’ consult with doctor` A significant associationwas also found between age and `consultation with doctor`(p=0.025).Conclusion: Awareness should be created among theexpecting mothers about neonatal jaundice and encouragethem to take preventive measures to reduced neonatalmortality and morbidity.

Genetic analysis of Penthorum chinense Pursh by improved RAPD and ISSR in China

Background: Penthorum chinense Pursh (P. chinense) is a well-known traditional Chinese medicine (TCM) plant, which has long been used for the prevention and treatment of hepatic diseases. This study aimed to genetically characterize the varieties of P. chinense from different geographic localities of China by random amplification of polymorphic DNA (RAPD)-PCR technique and verified with inter-simple sequence repeat (ISSR) markers. Results: The P. chinense samples were collected from nine different geographic localities. Previously improved RAPD and ISSR markers were utilized for genetic analysis using DNA amplification. The genetic relationship dendrogram was obtained by conducting cluster analysis to the similarity coefficient of improved RAPD and ISSR markers. Improved RAPD yielded 185 scorable amplified products, of which 68.6% of the bands were polymorphic, with an average amplification of 9.25 bands per primer. The ISSR markers revealed 156 alleles with 7.8 bands per primers, where 59.7% bands were polymorphic. Furthermore, the similarity coefficient ranges of RAPD and ISSR markers were 0.71­0.91 and 0.66­0.89, respectively. Conclusions: This study indicated that improved RAPD and ISSR methods are useful tools for evaluating the genetic diversity and characterizing P. chinense. Our findings can provide the theoretical basis for cultivar identification, standardization, and molecular-assisted breeding of P. chinense for medicinal use.

Evaluation of Recently Developed Regression Equation with Direct Measurement of Low-density Lipoprotein Cholesterol in a Bangladeshi Population.

Background: Meaningful underestimation of low-density lipoprotein (LDL) cholesterol is an important shortcoming of Friedewald’s formula (FF) at higher triglyceride (TG) levels. Recently a regression equation (RE) has been developed using lipid profiles in one setting and validated externally for the calculation of LDL cholesterol. This newly developed RE requires more studies in different settings. Objective: The aim of this study was to evaluate the performance of the regression equation against direct measurement. Materials and Methods: Lipid profiles of 600 subjects attending a tertiary healthcare center were included in this study. Specimens were collected and lipid profiles were measured by standard methods. Sixty two lipid profiles with TG above 400 mg/dL were excluded. Calculated LDL cholesterol values using FF and RE were compared with measured LDL cholesterol by Pearson’s correlation test, Passing & Bablok regression, accuracy within ±5% and ±12% of measured LDL cholesterol and two-tailed paired t test at various TG ranges. Results: The mean value of LDL cholesterol was 148.6 ± 37.2 mg/dL for direct measurement, 146.9 ± 42.4 mg/dL for FF and 148.6 ± 34.7 mg/dL for RE. The correlation coefficients of calculated LDL cholesterol values with measured LDL cholesterol were 0.949 (p<0.001) for FF and 0.959 (p<0.001) for RE. Passing & Bablok regression equation against measured LDL cholesterol was y = 0.897x + 16.2 for FF and y = 1.0842x – 13.1 for RE. Accuracy within ±5% of measured LDL cholesterol was 45% for FF, 57% for RE and within ±12% of measured LDL cholesterol was 84% for FF, 93% for RE. When calculated LDL cholesterol was compared with measured LDL cholesterol at different TG ranges, FF significantly underestimated LDL cholesterol at TG concentrations above 200 mg/dL whereas no significant difference was observed for RE. Conclusion: This study reveals that RE equation has similar performance to direct measurement for calculation of LDL cholesterol.