The Socio-Demographic Factors and Causes of Substance Abuse Relapse: 36 Cases

Background: Relapse is frequent among substance abusers all across the world, and Bangladesh is no exception. Drug-related issues are gradually becoming a hot topic in Bangladesh, from a social, economic, and medical standpoint. The present study aimed to find out sociodemographic factors associated with relapse amongst substance abuser. Material & Methods: This descriptive type of observational study conducted in the Combined Military Hospital and other Government/Private Hospital/Institute especially Central Drug Addict Treatment Center, Dhaka with a total sample size of 36 participants. Detailed information was obtained in each case according to protocol through complete history from patients or their accompanying attendants using a data collection sheet which was read out to them in Bangla. All the information was recorded in the pre fixed protocol. Collected data was classified, edited, coded and entered into the computer for statistical analysis by using SPSS-23. Results: The study found that yaba was the most commonly abused drug among 36 participants, with 27.78% reporting abuse. 27.78% of participants had a psychiatric illness, with the majority being male (97.22%) and Muslim (88.89%). The largest group of participants were aged 31-40 (47.22%) and most were unemployed (83.33%) and married (94.44%). Peer pressure and family problems were the most commonly reported causes of relapse (91.67% and 83.33%, respectively). Other factors such as unemployment, depression, and failure in life also contributed to relapse. Conclusion: Yaba was the most prevalent substance of abuse and the majority of participants were male, had a psychiatric illness, and were unemployed. Peer pressure and family problems were the main causes of relapse.

Comparison of Outcomes Between High and Standard Dose of N-acetylcysteine in Prevention of AKI in Patients with CKD

Background: Patients with chronic kidney disease (CKD) are at a common risk for contrast-induced acute kidney damage (CI-AKI) because of various complications. Intravenous N-acetylcysteine (NAC) in high doses (1200mg) is considered more effective than its conventional dose (600mg) to prevent CIN and related complications. Objective: The study aimed to compare the effectiveness of high dose versus standard dose of intravenous N-acetylcysteine (NAC) in the prevention of Acute Kidney Injury in patients with chronic kidney disease.Material & Methods:A total of 60 (sixty) patients diagnosed with CKD went to coronary angiography and/or percutaneous coronary intervention (PCI) were selected by simple random technique and categorized into two groups – Group A (30 patients) received high dose NAC (1200mg) and Group B (30 patients) – received standard dose NAC (600mg). For evaluation of renal damage serum creatinine level for at least >3 months, renal imaging revealed bilateral small echogenic kidneys, eGFR (<60 to 15ml/min/1.73m², measured by MDRD formula) and also by ACR >30 mg/gm, associated with IHD, admitted for percutaneous intervention (PCI) were taken in account. Statistical analysis was done by SPSS version 20 with taking 95% confidence interval. The quantitative data were expressed as mean and standard deviation and qualitative data were expressed as frequency distribution and unpaired t-test, Chi-square test, and Fisher exact analytic test were done.Results:The observed mean age group of the patients was 65 ± 8 years and 62 ± 7 years in group A and group B respectively with male predominance in both groups. Primary renal disease diabetic nephropathy (DN) more (36.66%) in group A than in group B (30.00%) but patients with Hypertensive nephropathy were the same (33.33%) in both groups. After interventions, S. Creatinine (mg/dl) level, e, GFR (ml/min/1.73m²), were statistically significant in cases of group A patients (P-value 0.001& 0.003 correspondingly) compared to group B Patients (P-value 0.075 & 0.001 respectively). Again, the mean of pre-intervention S. Creatinine was 1.7 ±0.5 in group A whereas this was 1.9 ± 0.8 (p-value, 0.599) in group B and after 48 hours of intervention this was 1.6 ± 0.5 and 2.0 ± 0.5 (p-value, 0.697) In group A and group B respectively. Overall, no patients were detected with nephropathy for high dose NAC whereas 27 (90%) out of 30 had developed CIN in standered dose.Conclusion:High-dose N-acetylcysteine (1200mg) is more potent and effective than the standard dose (600mg) in reducing contrast-induced acute kidney injury (CI-AKI) in patients with CKD.

Prophylactic Oral Iron Therapy During Pregnancy

Background: Anemia is one of the most common medical disorder during pregnancy and one of the important cause of maternal death in the third world countries. A sufficient supply of iron is also required for the proper development of the fetus and newborn baby. During pregnancy, iron deficiency and iron deficiency anemia (IDA) increase the risk of preterm birth and low birth weight. Iron is essential for the development of the fetal brain and the newborn’s cognitive abilities. Pregnant women receive oral iron prophylaxis have better iron status and are less likely to develop IDA. The aim of the study was to evaluate the effects of prophylactic oral iron therapy in pregnant women in terms of rise of haemoglobin level.Material & Methods:The present study was conducted at the department of obstetrics and gynecology, US-Bangla Medical College & Hospital, Dhaka, Bangladesh, from January 2020 to June 2021 with a sample size of 100 pregnant women. All the participants were non-anemic at the time of inclusion, and a proper follow-up was done. All the women were supplied with 60 mg dose of elemental iron prophylactic. During follow up haemoglobin level was measured and serum ferritin levelwas measured when anemia was found. The collected data were analyzed by using the Statistical Package for Social Science (SPSS-24) for windows version 10.0.Results:During the first follow-up, 89% were found non-anemic, 9% were mildly anemic and 2% were moderately anemic. S ferritin levels of the 11 anemic participants showed that 36.30% had <15 ng/mL ferritin levels, and 63.64% had 15-150 ng/mL ferritin levels. During the second follow-up, 86% were non-anemic, 1% was severely anemic, 4% were moderately anemic and 9% were mildly anemic. S. ferritin level test showed that among the 14 anemic women, 35.72% had <15 ng/mL, 57.14% had 15-150 ng/mL, and 7.14% had >150 ng/mL serum ferritin levels. During third follow up at 34-36 weeks, 81% were non-anemic, 1% were moderately anemic, 8% had mild anemia. S. ferritin levels of 9anamic women showed that 3 women (33.33%)had <15 ng/mL and 6 women (66.67 %) had between 15-150 ng/mL.Conclusions:Pregnancy produces relatively high iron demand. Iron requirements cannot be met merely through dietary iron intake. Even prophylacyic 60 mg elemental iron giving may not be sufficient to prevent maternal anemia. Regular follow up and monitoring is essential during whole pregnancy for better management of the patients.

Ecofriendly Management of Seedling Diseases of Chickpea (Cicer arietinum)

The experiment was carried out in the field of Plant Pathology Department, Bangladesh Agricultural University, Mymensingh, Bangladesh to determine the effect of BARI-biofertilizerand Integrated Pest Management (IPM) biopesticide for controlling foot and root rot diseases of chickpea. It was observed that both BARI-Biofertilizer and IPM biopesticide resulted significantly lower disease incidence of seedlings of the test pulse over the control. Soil treatment with BARI-Biofertilizer resulted the lowest disease incidence of chickpea var. Hyprosola, Binasola-2, Binasola-3 and Binasola-4 at 20 DAS (Days after sowing) that displayed reduction of disease incidence up to 83.77%, 54.48%, 70.76% and 71.45% respectively over control. While at 28 DAS, showedup to 82.82%, 71.92%, 84.72% and 68.39%, respectively, reduction of disease incidence over control. At 35 DAS, exhibited up to 79.91%, 73.18%, 81.32% and 73.44%, respectively, reduction of disease incidence over control. BARI-biofertilizer and IPM biopesticide increased fresh weight of plant, number of nodules per plant and fresh weight of nodules per plant.

Clinical Study of Serum Uric Acid Level on Outcome of Pregnancy in Cases of Pregnancy Induced Hypertension (PIH)

Background: Hypertensive disorder is one of the commonestmedical complications of pregnancy. It is assumed that serumuric acid elevation is a specific laboratory finding for thedisease.Objectives: To assess the effect of raised Serum uric acidlevel on outcome of pregnancy in cases of PIH (PregnancyInduced Hypertension).Methods: A Prospective study was conducted to pregnantpatients (between 28-40 weeks of pregnancy with PIH). Total100 patients were selected, who were separated into twogroups. Those who had Serum uric acid level more than6mg/dl (67 participants) are classified as Group A and thosewho had Serum uric acid level less than 6mg/dl (33participants) are classified as Group B.Results: Age of PIH patients were within 16-40 years. Theserum uric acid was significantly elevated in all the patients.Concentration of Serum uric acid is much higher in Eclampsiagroups, which is 4.5-12.0 mg/100ml (7.36 ± 2.17), incomparison to Preeclampsia patients, which is 2.6-9.6mg/100ml (6.28 ± 1.64). Comparing maternal outcome withSerum uric acid level between group A and group B patients,percentage of PPH and Abruptio placenta was higher in groupA than group B. In addition, Postpartum eclampsia, HELLPsyndrome and Pulmonary oedema were present in group A(each 2 in number); but these complications are not found ingroup B. In perinatal outcome, the better consequence wasobserved in group B in case of birth weight, intrauterine growthretardation, still birth and neonatal death rate. There wasstatistical significant association between Serum uric acid andbirth weight of group A & B (p= 032).Conclusion: The degree of hyperuricemia increases with theseverity of preeclampsia. Perinatal mortality was markedlyincreased when maternal serum uric acid concentration wereraised. Serum uric acid was an important indicator for maternalcomplications and prognosis of fetus.

Novel PCR primers to diagnose visceral leishmaniasis using peripheral blood, spleen or bone marrow aspirates

OBJECTIVE@#To establish a suitable method of diagnosis of visceral leishmaniasis (VL) using peripheral blood, spleen or bone marrow aspirates.@*METHODS@#Peripheral blood, bone marrow and spleen aspirate samples were collected from clinically suspected VL patients (n = 26). A new PCR primer pair (MK1F/R) was designed targeting kinetoplast mini circle DNA sequences of Leishmania donovani, and Leishmania infantum, and was used to diagnose VL along with some other established primers for VL in polymerase chain reactions. Test was validated by comparing with several other diagnostic methods.@*RESULTS@#The designed primer set showed 100% specificity and 98% sensitivity in detecting VL using blood samples, when compared with more invasive samples: bone marrow or spleen aspirates.@*CONCLUSIONS@#The newly designed primer MK1F/R could be a better alternative for PCR based diagnosis of VL using less invasive sample, peripheral blood instead of bone marrow or spleen aspirates.

Novel PCR primers to diagnose visceral leishmaniasis using peripheral blood, spleen or bone marrow aspirates

Objective To establish a suitable method of diagnosis of visceral leishmaniasis (VL) using peripheral blood, spleen or bone marrow aspirates. Methods Peripheral blood, bone marrow and spleen aspirate samples were collected from clinically suspected VL patients (n = 26). A new PCR primer pair (MK1F/R) was designed targeting kinetoplast mini circle DNA sequences of Leishmania donovani, and Leishmania infantum, and was used to diagnose VL along with some other established primers for VL in polymerase chain reactions. Test was validated by comparing with several other diagnostic methods. Results The designed primer set showed 100% specificity and 98% sensitivity in detecting VL using blood samples, when compared with more invasive samples: bone marrow or spleen aspirates. Conclusions The newly designed primer MK1F/R could be a better alternative for PCR based diagnosis of VL using less invasive sample, peripheral blood instead of bone marrow or spleen aspirates.

Apoptotic and antioxidant activities of methanol extract of Mussaenda roxburghii leaves

Present research work was designed to study the anticancer and antioxidant activities of methanol extract of Mussaenda roxburghii. Anticancer activity of MMR has been carried out on Ehrlich ascites carcinoma [EAC] cells with three different doses [20, 40 and 60 mg/kg/day] by observing different parameters such as tumor weight, survival time of EAC-bearing mice, growth inhibition of EAC cells, morphological changes and nuclear damage of EAC cells etc. whereas antioxidant activity was determined by measuring total antioxidant, DPPH free radical scavenging, ferrous reducing capacity assay. The extract showed highest anticancer activity at 60 mg/kg day[-1][i.p.]. It caused 81.4% [P<0.01] cells growth inhibition and reduced tumor burden significantly [78.5%; P<0.001] in comparison to control. It also increased life span of EAC-bearing mice significantly [73.5%; P<0.01]. MMR treated EAC cells showed membrane blebbing, chromatin condensation, nuclear fragmentation [apoptotic feature] in Hoechst 33342 staining under fluorescence microscope. DNA fragmentation assay in agarose gel [1.5%] electrophoresis also rectified that it causes EAC cells death by apoptosis. MMR also exhibited moderate antioxidant properties in dose dependent manner. Thus, this plant can therefore be considering a resource for natural chemo-preventive drugs as well as a possible pharmaceutical supplement

Advanced Abdominal Pregnancy with a Full-Term Live Fetus: Case Report.

Advanced abdominal pregnancy (AAP) with a viable full-term fetus is a rarity that a few obstetricians encounter during their professional carrier. Usually it has a dramatic and catastrophic consequence both for the fetus & the mother; rather subsequent delivery of a viable full term fetus is exceptional. It is difficult to diagnose preoperatively. Though relatively rare, we received an AAP at term with live fetus in Faridpur Medical College & hospital. Illiteracy, poverty and lack of antenatal care had resulted in her late presentation. After laparotomy the diagnosis was confirmed, a healthy male baby was delivered.

Uterine Rupture -- Experience of 30 Cases at Faridpur Medical College Hospital.

Rupture uterus is a rare and often catastrophic condition. It is associated with a high incidence of fetal and maternal mortality and morbidity. Our objective in this study is to determine incidence, etiology, trend, management, maternal and fetal outcome of uterine rupture in Faridpur Medical College Hospital. This is a prospective cross-sectional study of patients with ruptured uterus from the period of January 2011 to December 2011 admitted at Faridpur Medical College Hospital. All the cases of ruptured uterus who were either admitted with uterine rupture or who developed it in hospital were included in the study. Patients having ruptured uterus due to congenital anomaly were excluded from the study. Patients were initially assessed in labour ward, relevant sociodemographic data, previous antenatal and surgical history recorded. Ways of management, maternal and fetal outcome were taken for analysis. There were 30 cases of ruptured uterus out of total 3606 deliveries (including 1809 caesarian sections) over a one year time period, with a prevalence of 0.83%. The most common age group was 21-30 years. A majority of patients 16(53.3%) were cases of unscarred uterus presenting with rupture; the common cause of rupture in scarred uterus was injudicious use of oxytocin (13,43.33%). Proper antenatal care, appropriate counseling of patients with history of previous caesarian section for hospital delivery, training of skilled birth attendant can reduce mortality and morbidity due to rupture uterus.

Renal impairment after valvular heart surgery in adult

Cardiac surgery can either induce acute renal failure or improve GFR by improving the cardiac performance. Acute renal shutdown [urine output <0.5ml/kg/hr.] is an uncommon but fatal complication which occurs in cases of insufficient cardiac function and may be accompanied with multi-organ failure. Acute renal failure [ARF] after open heart valve surgery occurs in about 8% of adult cardiac surgical patients with some preoperative renal impairment and in about 3-4% of patients with normal preoperative renal function test. This study was done to determine the frequency of acute renal shutdown after valvular open heart surgery and to detect any suggestive risk factors. 90 patients undergoing valve replacement [mitral and/ or aortic] were prospectively evaluated in three time periods: before, 24 hours after surgery and 48 hours after surgery. The association between preoperative, intra-operative and postoperative variables and the development of ARF was assessed thoroughly. Of the 90 consecutive patients 3 [3.49%] patients developed acute renal failure [serum creatinine>2.5 mg/dl] and 16 [18.6%] patients developed acute renal dysfunction [serum creatinine 1.6-2.4 mg/dl]. The risk factors that were noted in the development of ARF were age, raised preoperative blood urea and creatinine, low cardiac output state, diabetes mellitus, oligurea, total cross clamp time total CPB time, and significant hypotension during the procedure or during intensive care unit [ICU] stay. Mortality rate for established ARF was extremely poor [50%]. Avoidance of this dangerous outcome looks better than trying to treat once it is fully established

Adult ebstein anomaly with right atrial myxoma

Ebstein Anomaly is rare in adults; a combination of this disease with cardiac myxoma has not been reported previously. Surgery was performed by removal of the myxoma and replacement of the tricuspid valve and correction of the abnormal atrialization of the right ventricle. The patient had a smooth postoperative recovery and improved dramatically after wards. We have dealt with this rare condition successfully and the patient had good outcome