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ABSTRACT Introduction: Hypogonadism is one of the most frequent complications in transfusion-dependent thalassemia patients and early recognition and treatment is the core element in restoring impaired gonadal function. Despite the high burden of disease, relevant studies are scarcely addressing the gonadal function of such patients in Bangladesh. The pattern of gonadal function in transfusion-dependent thalassemia patients must be characterized before planning a generalized management plan. Moreover, since iron overload is a key reason behind hypogonadism in thalassemia patients, investigating the role of serum ferritin level as a diagnostic tool for hypongadism was also an aim of this study. Methods: This cross-sectional study was conducted at the Department of Transfusion Medicine of the Bangabandhu Sheikh Mujib Medical University. According to the inclusion and exclusion criteria, a total of 94 patients were enrolled in this study. A detailed history and thorough clinical examination were carried out in each patient and recorded using a pretested structured questionnaire. In addition, the laboratory assessment of serum ferritin, luteinizing hormone (LH), follicle stimulating hormone (FSH), testosterone and estradiol in serum were also performed. The data were analyzed using the STATA (v.16). Results: The mean age of the patients with transfusion-dependent thalassemia was 18.81 ± 4.65 (SD), with 53.3% of the patients being male. The overall prevalence of hypogonadism was 35.11%, 18.1% being normogonadotropic, 11.7% being hypogonadotropic and 5.3% being hypergonadotropic. The serum ferritin level was significantly higher (p < 0.001) in patients with hypogonadism (Eugonadal: 2,174.79 (± 749.12) ng/ml; Hypogonadal: 3,572.59 (± 1,199.49) ng/ml). The area under the receiver operating characteristic (ROC) curve of serum ferritin was high (0.83) and the p-value was highly significant (< 0.001). Conclusion: Therefore, the serum ferritin level and gonadal hormone analysis of transfusion-dependent thalassemia patients can be considered a screening tool for assessing gonadal function and early detection and prevention of hypogonadism.
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Background: Along with several significant factors in chemotherapy treatment management’s nurses plays the pivotal role. The objective of this study was to evaluate the knowledge of nurses in relation to handling chemotherapy and the current practice of cancer centers in different hospitals in Bangladesh.Methods: The cross-sectional study was designed based on anonymous self-administered questionnaire. The questionnaire was developed from literature and expert input and validated by subject experts.Results: A total of 96 nurses were the respondents in this study. Around half of them already exposed directly with chemotherapy agents. Some 72.9% of nurses had not any training and 58.3% of respondents were not aware about use of closed system transfer devise in chemotherapy. A greater proportion 58.3% of nurses did not know the same health hazard of both oral and parenteral drugs. One third (33.3%) respondents used biological safety cabinet for doing preparation. Nurses’ did not use especial personal protective equipment and the designed treatment room also was absent. None of nurses went through regular medical checkup.Conclusions: The evidence-based results suggested that nurses have average knowledge about chemotherapy handling, however, use of personal protective equipment and biological safety cabinet, follow guidelines, medical surveillance and training are appeared to be a hindrance. More fundamentally, nurses need more education and professional training about chemotherapy agents handling in nursing school and through in-service continuing education as well as adopt required facilities are necessary.
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Tick saliva is critically important for continuous attachment to the host, blood feeding for days, and transmission of tick-borne pathogens. To characterize the patterns of inflammatory cytokine gene expression during its attachment and blood sucking time, peripheral blood samples of rabbits infested with Haemaphysalis longicornis ticks were collected at different intervals. Blood histamine concentration was evaluated as well as gene encoding IFN-γ, TNF-α, IL-2, IL-6, IL-4, and IL-10 were compared with non-infested rabbits. Blood histamine concentration of tick-infested rabbits during fast feeding time was significantly higher than that of non-infested rabbits. In both nymph and adult tick infested rabbits, expression of TNF-α and IFN-γ genes were decreased significantly (P < 0.05), while expression of IL-4, IL-6, and IL-10 were increased 1.3 to 7 folds in adult infested rabbits with the exception of IL-6 that was significantly (P < 0.05) decreased in nymph infested rabbits. IL-2 was not expressed in either nymph or adult infestation. H. longicornis saliva is capable of modulate host responses through a complex correlation with histamine and Th1, Th2 mediated cytokines that suppress the inflammatory responses directed toward inflammatory mediators introduced into the host during tick feeding.
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Adult , Humans , Rabbits , Cytokines , Gene Expression , Histamine , Interleukin-10 , Interleukin-2 , Interleukin-4 , Interleukin-6 , Nymph , Saliva , TicksABSTRACT
@#Objectives: The objectives of our study were to determine the mean age of onset of thelarche and menarche, to determine the ages of each stage of puberty and to investigate if there are any ethnic differences in these ages amongst female adolescents in Kuala Lumpur, Malaysia. Methods: This was a cross-sectional study involving three secondary schools in Cheras, Kuala Lumpur. A total of 730 students were recruited via stratified random sampling. Self-administered survey forms on menstruation and puberty were used. Results: Out of 730 recruited respondents, 385 (52.74%) completed the survey and informed consents were obtained from their parents/legal guardians. Our respondents’ ages ranged between 13 to 17 years old with the median (IQR) age of 14.00(2.00) years. With regards to ethnicity, 329 (85.50%) were Malay, 46 (11.90%) were Chinese, 9 (2.30%) were Indian and 1(0.30%) was a Bajau. The mean age for breast development (thelarche) and menarche were 11.72 ±1.10 and 11.97±1.11 years respectively. The majority, 363 (94.30%), out of 385 respondents had attained menarche. There appeared to be a later onset of puberty amongst Malays comparatively. Conclusion: The mean ages of pubertal onset and menarche amongst female adolescents in the Cheras area are similar to those reported worldwide.
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Objective To evaluate the effect of methanolic extract of Syzygium cumini (L.) Skeels (S. cumini) seeds on the major organs in an animal model of diabetes through biochemical and histopathological studies. Methods The methanolic extracts of S. cumini seeds (100 and 200 mg/kg body weight) were administered to alloxan-induced diabetic rats daily, with fasting blood glucose levels being measured by glucometry at one-day interval for a duration of two weeks. Biochemical assays to evaluate changes in the functions of the heart, liver, pancreas and kidney were carried out. Histopathological changes in the diabetic rat organs (pancreas, liver, heart, kidney and spleen) were also observed after the 14 days of treatment with the extracts. Results Oral administration of methanolic extracts of S. cumini seeds (100 and 200 mg/kg body weight), with gliclazide as a positive control (25 mg/kg), showed beneficial effects including lowering blood glucose levels (P < 0.001), improved heart and liver functions, and hyperlipidemia due to diabetes. At 200 mg/kg, the extracts reversed cardiac and liver damage caused by alloxan. Conclusions In addition to the anti-hyperglycemic activity of methanolic extracts of S. cumini seeds, the extracts demonstrates potential to minimize cardiac and hepatic complications.
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The plethora of genome sequence information of bacteria in recent times has ushered in many novel strategies for antibacterial drug discovery and facilitated medical science to take up the challenge of the increasing resistance of pathogenic bacteria to current antibiotics. In this study, we adopted subtractive genomics approach to analyze the whole genome sequence of the Fusobacterium nucleatum, a human oral pathogen having association with colorectal cancer. Our study divulged 1,499 proteins of F. nucleatum, which have no homolog's in human genome. These proteins were subjected to screening further by using the Database of Essential Genes (DEG) that resulted in the identification of 32 vitally important proteins for the bacterium. Subsequent analysis of the identified pivotal proteins, using the Kyoto Encyclopedia of Genes and Genomes (KEGG) Automated Annotation Server (KAAS) resulted in sorting 3 key enzymes of F. nucleatum that may be good candidates as potential drug targets, since they are unique for the bacterium and absent in humans. In addition, we have demonstrated the three dimensional structure of these three proteins. Finally, determination of ligand binding sites of the 2 key proteins as well as screening for functional inhibitors that best fitted with the ligands sites were conducted to discover effective novel therapeutic compounds against F. nucleatum.
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Humans , Anti-Bacterial Agents , Bacteria , Binding Sites , Colonic Neoplasms , Colorectal Neoplasms , Computer Simulation , Drug Delivery Systems , Drug Discovery , Fusobacterium nucleatum , Fusobacterium , Genes, Essential , Genome , Genome, Human , Genomics , Ligands , Mass Screening , Mining , ProteomeABSTRACT
Objective: To investigate the comparative effects of Diospyros blancoi (Ebenaceae) leaves (DBL), root bark (DBRB) and stem bark (DBSB) on free radicals and cancer. Methods: The polyphenol contents, antioxidant and free radical scavenging properties were determined using standard spectrophotometric methods. Cytotoxicity and anticancer activities were performed on brine shrimp nauplii and Ehrlich ascite carcinoma cells, respectively. Results: Among the extracts, DBSB showed the highest total antioxidant capacity and reducing capacity on ferrous ion. Based on 1,1-diphenyl-2-picrylhydrazyl and hydroxyl radical scavenging activities, DBSB showed (95.760 ± 0.343)% and (67.460 ± 2.641)% scavenging with IC
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Objectives: to study and to establish the overall trends of computed tomography [CT] use and associated outcomes in the pediatric emergency department [PED] at Royal Hospital, Oman, from 2010 to 2014
Methods: the hospital electronic medical record was retrospectively searched to find children [from birth to 12 years old] who had visited the PED and the number of CT requests between 1 January 2010 and 31 December 2014. The types of CT examinations ordered were analyzed according to anatomical location and were as follows; head, abdomen/pelvis, chest, cervical spine/neck, and others
Results: there were a total of 67 244 PED visits during the study period, 569 of which received 642 CT scans. There was a remarkable rise in CT uses per 1000 visits from 7 in 2010 to 12 in 2014. There was a 56% hike in CT requests from 87 in 2010 to 175 in 2014 while the number of pediatric emergency visits rose by about 28% from 11 721 to 15 052. Although head CT scans were the most common, cervical spine CT scans had the highest rate of increase [600%] followed by the chest [112%], head [54%] and abdomen [13%]. There were no significant changes in other CT scan requests. The cost of CT scans increased from $18 096 to $36 400 during the study period, which increased the average PED cost by about $2 per visit. The average time between a CT being requested and then performed was 1.24 hours
Conclusions: CT use in the pediatric emergency department has risen significantly at a rate that markedly exceeds the growth of emergency visits. This is associated with an increase in PED costs and longer waiting times
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In developing countries threat of cholera is a significant health concern whenever water purification and sewage disposal systems are inadequate. Vibrio cholerae is one of the responsible bacteria involved in cholera disease. The complete genome sequence of V. cholerae deciphers the presence of various genes and hypothetical proteins whose function are not yet understood. Hence analyzing and annotating the structure and function of hypothetical proteins is important for understanding the V. cholerae. V. cholerae O139 is the most common and pathogenic bacterial strain among various V. cholerae strains. In this study sequence of six hypothetical proteins of V. cholerae O139 has been annotated from NCBI. Various computational tools and databases have been used to determine domain family, protein-protein interaction, solubility of protein, ligand binding sites etc. The three dimensional structure of two proteins were modeled and their ligand binding sites were identified. We have found domains and families of only one protein. The analysis revealed that these proteins might have antibiotic resistance activity, DNA breaking-rejoining activity, integrase enzyme activity, restriction endonuclease, etc. Structural prediction of these proteins and detection of binding sites from this study would indicate a potential target aiding docking studies for therapeutic designing against cholera.
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Humans , Bacteria , Binding Sites , Cholera , Computer Simulation , Developing Countries , DNA , DNA Restriction Enzymes , Drug Discovery , Drug Resistance, Microbial , Genome , Integrases , Sewage , Solubility , Vibrio cholerae , Vibrio cholerae O139 , Water PurificationABSTRACT
Lutembacher syndrome is a rare combination of congenital Atrial Septal Defect (ASD) and acquired Rheumatic Mitral Stenosis (MS).It is usually treated by surgical repair with potential risk of cardiopulmonary bypass. With the advancement of interventional methods of treatment it is amenable to nonsurgical transcatheter management. We are reporting a case of Lutembacher syndrome that was successfully treated with percutaneouos Inoue balloon mitral valvuloplasty and device closure of atrial septal defect.
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Aims: Metformin Hydrochloride, a biguanide, is an orally active antihyperglycemic agent, used in the treatment of non-insulin dependent diabetes mellitus (NIDDM). It has relatively short plasma half life, low absolute bioavailability. Extended release formulation of Metformin Hydrochloride by direct compression method has significant challenges due to its poor inherent compressibility and high dose. The aim of this study was to develop extended release tablets of Metformin Hydrochloride by direct compression method and In vitro evaluation. Study Design: Nine different formulations were made by varying drug-polymer ratio and were subjected to different physical property tests of the powder blend as well as prepared tablets, followed by dissolution test. Place and Duration of Study: Department of Pharmacy, State University of Bangladesh, Dhaka, Bangladesh, between January 2013 and July 2013. Methodology: Nine formulations of Metformin Hydrochloride matrix tablets - F-1, F-2, F- 3, F-4, F-5, F-6, F-7, F-8 and F-9 - were prepared by direct compression method using release retarding materials, Methocel K100 MCR Premium (derivative of hydroxypropyl methylcellulose - HPMC) and Xanthan gum. The drug and polymer ratio were 1:0.41, 1:0.45, 1:0.49, 1:0.59, 1:0.63, 1:0.67, 1:0.77, 1:0.81 & 1:0.85 respectively. The micromeritic behavior of the powder blends were evaluated for bulk density, angle of repose, compressibility index along with post compressional attributes of the tablets such as thickness, hardness, friability, weight variation and content of Metformin Hydrochloride in the tablets. The in-vitro drug release study was carried out in 1000 mL phosphate buffer medium (pH 6.8) at 37±0.5°C at 100 rpm for 10 hours using USP Apparatus Type-II (paddle) method. Results: FT-IR study showed drug-excipient compatibility and DSC analysis showed no solid state interaction between components. The physical properties of the powder blend and the tablets were within the acceptable limits. Maximum and minimum drug release were found in formulation F-1 and F-9 respectively which indicate that release rate is inversely proportional to the concentration of Methocel K100 MCR Premium and Xanthan gum in combination. Dissolution study also showed that, formulations F-7, F-8 & F-9 do not comply with drug release specification of USP and among the rest six formulations F- 3, F-4 & F-5 comply better with drug release specification of USP. After fitting the data to Korsmeyer-Peppas equation we found that diffusion along with erosion could be the mechanism of drug release.Considering the micromeritic behaviour of the powder blend, physical attributes of the compressed tablets, and dissolution, formulation F-4 seemed most suitable. Conclusion: Extended release Metformin Hydrochloride tablets can be produced to overcome frequent dosing related problems. However, Further study on formulation optimization and scale up, stability and bioequivalence is needed to confirm the appropriateness of these formulated extended release tablets.
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Objective: To evaluate hydrophilic extracts from edible portions of fifteen plants for total phenolic content (TPC) and anti-oxidant capacity (AC) as an effort to find possible sources for future novel antioxidants. Methods: Folin-Ciocalteau and DPPH radical scavenging assays were employed to determine TPC and AC, respectively. Results: Among the assayed plants, TPC (mean±SD), expressed as gallic acid equivalent, varied from 0.04±0.01 (Amaranthus spinosus) to 6.01±0.04 (Zanthoxylum rhetsa) mg gallic acid equivalent/g fresh weight. AC (mean±SD), expressed as trolox equivalent, ranged from 0.14±0.00 (Alternanthera philoxeroides) to 7.54±0.00 (Zanthoxylum rhetsa) μmol trolox equivalent/g fresh weight. A significant and positive linear relationship (R
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OBJECTIVE@#To evaluate hydrophilic extracts from edible portions of fifteen plants for total phenolic content (TPC) and anti-oxidant capacity (AC) as an effort to find possible sources for future novel antioxidants.@*METHODS@#Folin-Ciocalteau and DPPH radical scavenging assays were employed to determine TPC and AC, respectively.@*RESULTS@#Among the assayed plants, TPC (mean±SD), expressed as gallic acid equivalent, varied from 0.04±0.01 (Amaranthus spinosus) to 6.01±0.04 (Zanthoxylum rhetsa) mg gallic acid equivalent/g fresh weight. AC (mean±SD), expressed as trolox equivalent, ranged from 0.14±0.00 (Alternanthera philoxeroides) to 7.54±0.00 (Zanthoxylum rhetsa) μmol trolox equivalent/g fresh weight. A significant and positive linear relationship (R(2)=0.99) was observed between TPC and AC of Zanthoxylum rhetsa, Oxalis corymbosa, and Alternanthera sessilis.@*CONCLUSIONS@#The results of the present study implies that the analyzed plants possess varying degree of antioxidant capacity and, therefore, the antioxidant potency of these underused plants may be utilized to prevent oxidative damage and oxidative stress related disorders.
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<p><b>OBJECTIVE</b>To investigate the antioxidant, antibacterial and cytotoxic activity of whole Leucas aspera (Labiatae) (L. aspera) alcoholic extract.</p><p><b>METHODS</b>Whole L. aspera powder was extracted by absolute ethanol (99.50%). The ethanolic extract was subjected to antioxidant, antibacterial and brine shrimp lethality assay.</p><p><b>RESULTS</b>The extract showed potent radical scavenging effect (antioxidant) with IC50 value of (99.58±1.22) µg/mL which was significant (P<0.01) in comparison to ascorbic acid with IC50 value of (1.25±0.95) µg/mL. In case of antibacterial screening, the extract showed notable antibacterial effect against the tested microbial strains. Significant (P<0.05) zone of inhibitions against Gram positive Bacillus subtilis [(12.00±1.32) mm] and Bacillus megaterium [(13.00±1.50) mm], Staphylococcus aureus [(8.00±0.50) mm] and Gram negative Salmonella typhi [(6.00±0.50) mm], Salmonella paratyphi [(8.00±1.00) mm], Shigella dysenteriae [(9.00±1.32) mm] and Vibrio cholerae [(9.00±0.66) mm] was observed. In brine shrimp lethality bioassay, the extract showed the LC50 value as (181.68±2.15) µg/mL which was statistically significant (P<0.01) compared to positive control vincristine sulfate [LC50=(0.76±0.04) µg/mL].</p><p><b>CONCLUSIONS</b>The results demonstrate that the ethanolic extract of L. aspera could be used as antibacterial, pesticidal and various pharmacologic actives.</p>
Subject(s)
Animals , Anti-Bacterial Agents , Chemistry , Pharmacology , Antioxidants , Chemistry , Pharmacology , Artemia , Biphenyl Compounds , Dose-Response Relationship, Drug , Inhibitory Concentration 50 , Lamiaceae , Chemistry , Microbial Sensitivity Tests , Phytochemicals , Chemistry , Pharmacology , Picrates , Plant Extracts , Chemistry , Pharmacology , Toxicity TestsABSTRACT
The study was conducted to evaluate the serum immunoglobulin levels in patients suffering from panic disorder and to assess the relationship between the changes of immunoglobulin levels and the socioeconomic parameters, as well as nutritional status. 54 panic patients were randomly selected from the Department of Psychiatry, Bangabandhu Sheikh Mujib Medical University [BSMMU] and Dhaka Medical College Hospital, Bangladesh. Fifty two, age and gender matched healthy volunteers [42 males and 10 females, mean age of 30 +/- 6 yrs] were also enrolled in this study. Immunoglobulin levels were measured by turbidimetry method using immunoglobulin kits. It was found that the mean serum immunoglobulin concentrations of IgG, IgM and IgA of panic disorder patients were 0.999 +/- 0.26 [g/L], 0.1 +/- 0.028 [g/L] and 0.194 +/- 0.066 [g/L] respectively whereas the values were 1.24 +/- 0.39 [g/L], 0.096 +/- 0.022 [g/L], 0.194 +/- 0.053 [g/L] in healthy volunteers. IgG level in panic disorder patient was found significantly [p <0.05] lower than that of the controls but the change in concentration of IgM and IgA were not significant [p=0.497, p=0.962]. Socioeconomic data reveals that most of the patients were from lower income group and educated. BMI [Mean +/- SD] of the patients [22.62 +/- 3.74 kg/m[2]] and controls [23.74 +/- 2.71 kg/m[2]] were well within the normal range. From correlative analysis it has been found that income has significant effect [p=0.047] on the change of the serum IgG level in panic disorder patient and it was also been justified by the regression analysis [p=0.049]. This finding may play a key role in the diagnosis and treatment of the panic disorder patients. Further studies have been suggested with a large number of populations to confirm these findings
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Patients with moderate to severe psoriasis generally require phototherapy, photochemotherapy or systemic agents to control their disease adequately. The potential toxic effects of long term use of the classic antipsoriatics, prolonged continuous therapy, higher cost and low socio-economic conditions of patients obligate us to consider some cheaper older alternatives like colchicine. A prospective, randomized controlled clinical trial was carried out on two groups of patient of psoriasis, group A [Case, n=30] was treated with 2.1 mg per day oral colchicine, in two divided doses and group B [Control, n= 30] was treated with 7.5 mg of oral methotrexate once weekly for 8 weeks. No topical agent except bland emollients was applied during the trial period. Psoriasis area severity index [PASI] was calculated as main outcome measure at entry level and follow up after one month and two months. The mean percentage reduction of PASI was statistically significant [p=0.001] at both first and second follow up with oral colchicine. PASI-50 was achieved in 23.3% of respondent in colchicine group and 53.3% in methotrexate group [p<0.05]. Oral colchicine is an effective therapy for chronic plaque psoriasis but it is less effective than methotrexate, the gold standard antipsoriatic therapy [p<0.05]
Subject(s)
Humans , Adolescent , Adult , Colchicine , Methotrexate , Prospective Studies , Treatment Outcome , Colchicine/adverse effects , Methotrexate/adverse effectsABSTRACT
This short communication describes the various modes of presentation, complications and management of tiger bite. All patients presenting to the emergency department with a history of tiger bite were included in the study. A total of 6 patients were admitted at the Department of Surgery, Khulna Medical College Hospital, Bangladesh, from 2003 to 2006. Injury involved different parts of the body; predominantly, the upper part. All patients needed emergency surgery including wound toileting, debridement and even reconstructive surgery. One patient died due to infective complications. Tiger bite is a major public health problem in the greater Sundarban area of Bangladesh. Timely hospitalization and effective management can save valuable human lives
Subject(s)
Humans , Male , Bites and Stings , Wound Healing , Wounds and Injuries/surgery , Plastic Surgery ProceduresABSTRACT
Analysis of management in 22 ectopic pregnancies clinically presented as an atypical form. Twenty two patients with suspected ectopic pregnancy were successfully managed laparoscopically during three years period at Victory Nursing and infertility management centre, Khulna, Bangladesh. All patients had dull ache pain in lower abdomen or any one of the iliac fossa. All cases were hemodynamically stable and ambulatory. Ultrasonography findings were complex Heterogeneous mass without any free fluid in 8 cases, definitive gestational sac in 6, and sac like structure in 8 cases. Urinary beta"hCG was positive in 40.9% and negative in 59% cases. Pre-operative diagnoses were chronic ectopic pregnancy in 11, ruptured corpus luteum in six and chocolate cyst in five cases. Operating diagnosis were chronic ectopic pregnancy 14, unruptured tubal and cornual pregnancy 5, ovarian ectopic in three cases. Surgical procedures were salpingostomy, salpingectomy, salpingo-ophrectomy, partial ovarian resection and only sac removal with peritoneal toileting. Operating time was 30"120 minutes. The average post- operative stay was 24"48 hours without any complications. Unruptured early ectopic may present with minimal symptomotology. Hence in all women of child bearing age the provisional diagnosis of ectopic pregnancy may be kept in mind while examining and investigating a patient