Role of Aluminium in Alzheimer’s disease: Ultrastructural Study in Rat Hippocampus

Background: Exposure to high levels of aluminium (Al) leads to neurotoxicity. Hippocampus is one of the preferred sites of aluminium accumulation. Nevertheless, the role of Al in Alzheimer’s disease (AD) remains controversial and there is little proof directly interlinking Al to AD. Aims: The present study was undertaken to find out the occurrence of AD pathogenesis in Hippocampus under moderate aluminium exposure in rats. Materials and Methods: Adult rats were divided into control (C) and aluminium treated (E) groups having eight animal each. The rats in group E were exposed to aluminium 4.2 mg/kg body weight for three months with due approval from Institute Animal Ethics Committee. The hippocampus was processed for histopathological and electron microscopy observation. Results: Moderate Al intake produces significant reduction in the count of Pyramidal cells in hippocampus identified by shrunken cells as well as pyknosis in cell bodies. The differences between the cell numbers in all groups were found to be statistically significant (P < 0.05). Cornu Ammonis (CA) exhibited significantly reduced nissl bodies with a marked reduction in neuronal cell loss. Neurofibrillary tangle and plaques were not seen in the given dose of Al exposure. Electron microscopy from experimental group showed that the majority of neurons were disintegrating, the nuclear membrane has ruptured, and nucleoli appeared significantly distorted. The chromatin condensed and the mitochondria had disintegrated. Many vacuoles and lipofuscin sediment in cytoplasm, as compared to the control group noted. Conclusion: Present data demonstrated that moderate chronic aluminium exposure 4.2mg/kg body weight induced neurodegeneration in hippocampus but not significant for Alzheimer’s disease pathogenesis.

Diabetes and Obesity are the Two Strong Risk Factors for Knee OA Progression

Background: Osteoarthritis (OA) are common diseases that frequently co-exist, along with overweight/obesity and diabetes. It affects mostly the hips, knees, hands and feet that causes severe disability and loss of quality of life, particularly in the elderly population. Objective: The present study was conducted to access the Prevalence of knee osteoarthritis in diabetes and obese patients.Material & Methods:This case study was conducted among 110 diabetic and 70 obese patients who attended Bangladesh Korea Friendship Hospital and Dhaka Pain Management center, Dhaka, Bangladesh. The data were analyzed using the SPSS version 25.0.Results:Out of 110 diabetic patients 55% were female and out of 70 obese patients 57% were female. Prevalence of knee osteoarthritis among diabetic patients was 50% and 65% for obese patients.Conclusions:Our findings bolster current public health strategies targeted at lowering the burden of knee OA by addressing obesity and diabetes. Obesity and diabetes are linked to knee osteoarthritis, and the risk is especially high among obese adults.

Arcuate Foramen: An Anatomical Variation in the Atlas Vertebrae

Background: Arcuate foramen is a variation in the posterior arch of atlas vertebrae. It is commonly called as Kimmerle’s anomaly, also known as Ponticulus Posticus. It is the product of the complete or incomplete ossification of the posterior atlantooccipital membrane over the vertebral artery groove resulting in the formation of arcuate foramen containing the vertebral artery and the posterior branch of the first cervical spinal nerve. Aims: The aim of the present study was to identify the percentage of incidence of arcuate foramen in the atlas and its clinical important. Materials and Methods: The study was conducted in the Department of Anatomy, Katihar Medical College, Katihar, India with 32 adult dried atlas vertebrae. Results: We found four (12.5%) atlas with arcuate foramen. One atlas having complete arcuate foramen and three having partial complete arcuate foramen. Conclusion: Awareness of this type of variation is very important for neurosurgeons and radiologist during their clinical practice. The presence of the arcuate foramen would also complicate screw placement during surgery. Clinical prescreening for signs of vertebrobasilar insufficiency is important for chiropractic and manual therapies.

Study to Determine the Definite Percentage of the Different Analgesic Drugs and Analgesic Techniques Used At the Postoperative Ward for Pain Management in Sir Salimullah Medical College Hospital, Mitford, Dhaka

Background: The rationale of determining the percentage ofanalgesics used in postoperative period is to determine the realutilization of opioid sparing effect of nonsteroidal antiinflammatory drugs and the concept of multimodal analgesia.Objectives: To determine the cost of opioids consumptionbecause the opioids are expensive.Methods: Total 541 patients were selected to find out thetypes of analgesics are being used in the postoperative eperiod irrespective of the types of operation and anaesthesia,premedication by analgesics and intraoperative analgesicsused or not. Patients were divided into several age groups.Results: In the existing prospective cross sectional study it isviewed that combination of intramuscular injection of pethidineand nonsteroidal anti-inflammatory drugs (either in suppositoryform or intravenous or intramuscular route) have the highestpercentage in postoperative pain relief.

Association of Atherosclerotic Renal Artery Stenosis with Coronary Artery Disease.

Background: The association between extent and severity of coronary artery disease (CAD) and renal artery stenosis (RAS) has been well established in many studies. The aim of this study was to assess the incidence and severity of RAS in patients with CAD. Methods: Coronary angiogram (CAG) and renal angiogram was done in standard protocol. A total of 95 patients was included in the study and divided into two groups according to the presence of significant renal artery stenosis. In Group I 45 patients were having normal or insignificant renal artery stenosis. In Group II 50 patients were having significant renal artery stenosis. All data were recorded systematically in preformed data collection form. Results: In Group I, most common CAG findings were single vessel disease (SVD) (91.1%), triple vessel disease (TVD) (2.2%) and double vessel disease (DVD) (6.7%). No patients in Group I had Left Main (LM) disease. In Group II, most common CAG findings were DVD (42.0%) followed by SVD 32.0%, TVD 26.0% and LM 8.0%. There is statistically significant difference in Vessels Score, Friesinger Score and Leaman Score between the groups (p<0.05). Conclusion: The study revealed significant association between atherosclerotic renal artery stenosis (RAS) and severity of coronary artery disease (CAD). This indicates significant atherosclerotic renal artery stenosis (RAS) predict the severity of coronary artery disease.

Effect of Vitamin D, Calcium and Multiple Micronutrients Supplementation on Lipid Profile in Pre-menopausal Bangladeshi Garment Factory Workers with Hypovitaminosis D.

Elevated total cholesterol and low-density lipoprotein cholesterol in sera are both well-known risk factors of coronary heart disease. Adequate vitamin D status is important for optimal function of many organs and tissues of our body. There is continuing controversy about the effect of adequate vitamin D consumption on serum lipids and lipoproteins. The present study assessed the effect of vitamin D, calcium and multiple micronutrients supplementation on the lipid profile in Bangladeshi young female garment factory workers who have hypovitaminosis D. This placebo-controlled intervention trial conducted over a period of one year randomly assigned a total of 200 apparently healthy subjects aged 16-36 years to 4 groups. The subjects received daily supplements of 400 IU of vitamin D (VD group) or 400 IU of vitamin D+600 mg of calcium lactate (VD-Ca group), or multiple micronutrients with 400 IU of vitamin-D+600 mg of calcium lactate (MMN-VD-Ca group), or the group consuming placebo (PL group). Serum concentrations of lipid and lipoprotein, 25-hydroxyvitamin D (25OHD) and intact parathyroid hormone (iPTH) were measured at baseline and after one year of follow-up. No significant changes in the serum levels of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), LDL-C/HDL-C ratio were observed in the supplemented groups compared to the placebo group. Supplementation had a positive effect (p<0.05) on very low-density lipoprotein cholesterol (VLDL-C) and triacylglycerol (TAG). A negative correlation between changes in serum iPTH and HDL-C was observed, which indicated that subjects with the greatest decline in S-iPTH had the greatest increase in HDL-C. The results suggest that consumption of adequate vitamin D with calcium or MMN for one-year may have no impact on serum lipid profile in the subjects studied. Longer-term clinical trials with different doses of supplemental vitamin D are warranted in evaluating the effect of intervention.

In vitro evaluation of antimicrobial, cytotoxic and antioxidant activities of Crude methanolic extract and other fractions of Sterculia villosa barks.

Crude methanolic extract and other fractions of Sterculia villosa barks were investigated for their antimicrobial, cytotoxic and antioxidant activity in this study. Antimicrobial activity of different extract was evaluated by measuring the diameter of the zone of inhibition against gram-positive & gram-negative bacteria and fungi using Ciprofloxacin as a standard antimicrobial agent. Free radical scavenging activity for the same extracts was determined by DPPH assay where BHT was used as positive control and Cytotoxicity was determined by Brine Shrimp nauplii where the minimum inhibitory concentration was assessed by serial dilution technique. Mild antimicrobial activity was found; crude methanolic extract showed effect against all the organisms, while other extracts showed effect for some of the organisms. The LC50 value for cytotoxicity assay was found 0.3, 2.95, 3.76, 35.33 & 55.98 μg/ml for CSV, PESV, CTSV, DCMSV & EASV extracts respectively where LC50 value of Vincristine Sulfate was 0.544 μg/ml. Ethyl acetate fraction showed good antioxidant properties and except Pet Ether fraction all other extracts showed considerable antioxidant activity. The bark of Sterculia villosa can be considered for further research for finding potent compounds of antioxidant, antimicrobial and cytotoxic activity.

Isolated Protein S Deficiency –Cause of Recurrent Stent Thrombosis-A Case Report.

Stent thrombosis (ST) is one of the major complications that occur in percutaneous coronary interventions (PCIs) with stents. Various factors have been attributed to the development of ST, and several strategies have been recommended for its management. Protein C or protein S deficiencies may uncommonly be responsible for coronary arterial thrombosis. We report a young woman with recurrent stent thrombosis due to the deficiency of protein S. After coronary stenting, stent thrombosis occurred two times despite aggressive medical therapy. This report suggests that the deficiency of protein C or S should be born in mind in a young patient with recurrent thrombotic events, and that anticoagulants in addition to antiplatelet agents considered in the presence of their deficiency.

Effect of Ramadan Fasting on Serum Lipid Profile of Bangladeshi Female Volunteers.

The study was conducted to evaluate the effects of fasting for a period of one month during Ramadan on the lipid profile of Bangladeshi female volunteers who fasted during the Arabic month of Ramadan, when there occurs a change, both in the pattern and timing of dietary intake. Findings of the study showed that Ramadan fast significantly reduced serum Total cholesterol (TC) (p=0.030) and Low density lipoprotein (LDL-C) (p=0.011). A statistically nonsignificant elevation of triglyceride (TG)) was observed (p=0.598). High density lipoprotein cholesterol (HDL-C) also found to be raised significantly at the end of fasting (p = 0.037). Findings of the study revealed that fasting during the month of Ramadan changes lipid profile pattern in an aniatherogenic direction and may be beneficial to health.

Foot drop after subarachnoid block for removal of McDonald cervical suture and cesarean section

Peripheral nerve lesions are a complication of operative procedures under both general and regional anesthesia. The study incorporates a case of twenty eight year old woman who developed left foot drop after removal of a McDonald cervical suture followed by Caesarean section under subarachnoid block [SAB]. Intra-operatively, she was put in lithotomy position for removal of the McDonald cervical suture. Her neurological deficit gradually recovered over the next ten months. We suggest that intra-operative positioning for cervical suture removal may have caused this injury

Drug-Eluting Stent (DES) Induced Coronary Artery Aneurysm - A Case Report.

Drug-eluting stents (DES), which locally elute antiproliferative drugs, can dramatically inhibit neointimal growth. However, several pathological studies have indicated that DES may delay healing after vascular injury, and DES implantation may be theoretically associated with a risk of coronary artery aneurysm formation. Coronary aneurysms have been reported from 3 days to up to 4 years after DES implantation procedures, with varying clinical presentations. Mr. X, 60 years old diabetic, hypertensive got admitted in NICVD and was diagnosed as a case of Chronic Stable Angina. His ETT was strongly positive, CAG showed significant long lesion in LAD. Direct stenting with DES to LAD done and whole procedure was uneventful. After 10 days of PCI patient got readmitted in hospital with complaints of chest discomfort with high grade fever for 2 days. ECG showed AMI (Extensive Anterior) indicating involvement of LAD territory with strong suspicion of Sub Acute Stent Thrombosis (SAST). Streptokinase could not be given due to delayed arrival. Patient was treated conservatively with Low Molecular Weight Heparin. Check CAG was done 7 days after readmission showing Patent stent in LAD with aneurysmal dilatation at the distal end of stent in LAD. The objective of this case report is to focus on the rare but not uncommon incidence of stent implantation.

Impact of Blood Glucose Levels on Contrast Induced Nephropathy after Percutaneous Coronary Intervention in Patients not known to be Diabetic with Acute Coronary Syndrome.

Background: Contrast-Induced Nephropathy (CIN) is an iatrogenic disorder, resulting from exposure to contrast media. The association between pre-procedural blood glucose levels and CI-AKI risk (regardless of pre-existing diabetes) is unknown. The present study was conducted to evaluate the incidence of CI-AKI in patients with admission hyperglycemia in non-diabetic ACS patients. Methods: This is Prospective, observational study done in the department of Cardiology, National Institute of Cardiovascular Diseases (NICVD), Dhaka. Considering inclusion and exclusion criteria, 50 patients were non diabetic with ACS with normal blood glucose (d”7.8 mmol/l or d”140 mg/dl) in (Group I) and 50 patients were non diabetic with ACS with high blood glucose (>7.8 mmol/l or >140 mg/dl) undergoing percutaneous coronary intervention in (Group II). On admission random blood glucose was measured. Non- ionic low osmolar contrast agents (lopamidol) was used in all patients. Serum creatinine, serum electrolytes was measured and creatinine clearance rate was determined within 24 hours before PCI and day 1 and 2 after PCI. Results: The incidence of CIN was 24% in high blood glucose group and 4% in normal blood glucose group (p=0.004). It was also observed that gradual incremental increase in risk of CIN associated with higher admission blood glucose level. There was positive correlation between s. creatinine and admission blood glucose but it showed negative correlation between CCr and admission blood glucose after PCI in ACS patients not known to be diabetic. Conclusion: The present study reveals that index admission high blood glucose in acute coronary syndrome patients not known to be diabetic is associated with increased incidence of contrast induced nephropathy after percutaneous coronary intervention.

Prolonged QTc Dispersion Correlates with Coronary Artery Disease in Acute ST Elevated Myocardial Infarction (STEMI).

Background: It has been found that there is strong association of QT dispersion and QT dispersion ratio with extent and severity of coronary artery disease. Qualitative importance of QTc dispersion on the base line ECG in patients with MI is recognized clinically but quantification of this phenomenon is less commonly used in clinical practice, which might be a better independent risk predictor of this group of patients. Methods: A total of 100 patients were selected, Study populations sub-divided into two groups on the basis of QTc dispersion. In group I (comparison group): QTc dispersion is <60 milliseconds (msec) in group II (study group) : QTc dispersion e”60milliseconds(msec). 50 patients in each group. QT dispersion was calculated on standard resting 12 lead ECGs. QT interval was measured from the beginning of the inscription of the QRS complex to the point at which the T wave returned to the isoelectric line. Angiographic severity of coronary artery disease was assessed by- Vessel score, Friesinger score and Leaman score. Interpretation of coronary angiogram was reviewed by at least two cardiologists. . Results: The mean vessel score for group I patients was 1.16±0.68 and that of group II patients was 2.30±0.64 and the mean difference was statistically significant (p<0.05). Patients those had single vessel involvement had mean QTc dispersion 57.05, patients those had double vessel disease mean QTc dispersion was 102.00 and patients those had triple vessel involvement had mean QTc dispersion 177.60. There was a strong positive correlation with the QTc dispersion and increasing number of vessel involvement (Pearson’s correlation coefficient). The mean Friesinger score for group I patients was 4.84±2.56 and that of group II patients was 9.80±2.60. The mean difference was significantly (p<0.05) higher in group II patients. There was a strong positive correlation between the QTc dispersion and Leaman score (Pearson’s correlation coefficient). In group I patients 56% had insignificant coronary artery disease and 44% had significant coronary artery disease defined by Friesinger index (n=100). In group II patients 6% had Insignificant coronary artery disease & had 94% significant coronary artery disease. Conclusion: QTc dispersion>60 ms had independent predictive value for the severity of coronary artery disease. The greater the QTc dispersion the higher the number of coronary artery involvement. We observed that there is a positive correlation between prolonged QT dispersion and coronary artery disease severity in terms of Vessel score, Friesinger score, Leaman score.

Effects of Pleurotus ostreatus on Blood Pressure and Glycemic Status of Hypertensive Diabetic Male VolunteersS.

Different species of mushrooms are being used increasingly for their nutritional and medicinal values. They are used in traditional medical practice in the treatment and prevention of diabetes, obesity, heart diesaes, hyperacidity, cancer and hypertension. This study was designed to see the effects of Pleurotus ostreatus on blood pressure and glycemic status of hypertensive diabetic male volunteers. The study was carried out in the National Mushroom development and Extension Center (NAMDEC) laboratory, Savar, Dhaka in collaboration with the Department of Pharmacy along with the Department of Biochemistry and Molecular Biology, Jahangirnagar University. A total of 27 hypertensive male volunteers suffering from type 2 diabetes mellitus with age range of 32 to 68 years, who were free from renal impairment and other known acute or chronic diseases were included in the study. Blood pressure, fasting plasma glucose, HbA1c and serum creatinine were measured before and after 3 months of regular intake of 3 grams mushroom powder capsule daily in in 3 divided doses. However they were allowed to continue the drugs they were taking already. The study showed that after 3 months of regular intake of Pleurotus ostreatus mushroom, both systolic and diastolic blood pressure decreased significantly (p<0.001). It was also observed that, Pleurotus ostreatus decreased fasting plasma glucose level significantly (p<0.001). Reduction of HbA1c % observed after 3 months of mushroom intake was found to be significant (p<0.001). But there was no significant change of plasma creatinine level (p>0.05) indicating Pleurotus ostreatus has no detrimental effect on renal system. From the study, it can be said that, Pleurotus ostreatus mushroom intake improves glycemic status and blood pressure control in diabetic hypertensive subjects.

Anti-inflammatory and antidiabetic activity of ethanolic extracts of Sterculia villosa barks on Albino Wistar rats.

Ethanolic extract of Sterculia villosa barks were studied for anti-inflammatory and antidiabetic activity. The acute oral toxicity showed that the ethanolic extract of S. villosa barks was safe until 4000mg/kg body weight and no macroscopical organ abnormalities were observed in acute oral models. The investigations on Albino (Wistar) rats at dosage of 100, 200 and 400 mg/kg of ethanolic extract of Sterculia villosa barks were made for aniti-inflammatory action by using carrageenan induced paw edema and cotton pellete granuloma technique. The results of the study suggested significant dose dependent activity of extracts as compared to control group for both acute and chronic inflammation. Ethanolic extract also showed significant antidiabetic activity at dose dependent manner compared to diabetic untreated group.

Disposal Practice for Unused Medications among the Students of the International Islamic University Malaysia.

This survey has lead to an enhanced international awareness of the potential detrimental effects on the environment. The main objective of this survey is to develop of public awareness about harmful effect of medications waste.This was a descriptive crosssectional survey involving with patients based on a structured questionnaire format with answer sets and asked why people do not use all of their medications; why they are keep unused medications, storage and how to dispose their medications. This study carried out at International Islamic University Malaysia (Health center Gombak campus, Selangor) and the medical college of the International Islamic University Malaysia (kuantan campus, Pahang). Although,87% of the respondents; they known about medications waste but only near about 2% of the respondents who are follow drug-take-back system because of above 93% of the respondents, they did not know about drug-take-back system. Most of the participants reported disposing of these in a manner that leads to their ending up in a landfill more than 65%. Finally, 83% of the respondents added to a disposal system ultimately ending up in a landfill. In this survey suggests that there is an urgent need to develop of public awareness and there is also need to develop dispensing policies & delivered to collection bag which deduction the volume of medication waste.

Impact of Low Hemoglobin on Contrast-Induced Nephropathy After Percutaneous Coronary Intervention.

Background: Contrast-Induced Nephropathy (CIN) is an iatrogenic disorder, resulting from exposure to contrast media. The aim of this study was to assess whether anaemia is a predictor of contrast induced nephropathy after Percutaneous Coronary Intervention (PCI). Methods: This was a prospective observational study. A total of one hundred patients fulfilling the inclusion and exclusion criteria who underwent (PCI) Percutaneous Transluminal Coronary Angioplasty with stenting, were studied during the study period of two years from January 2008 to December 2009. Patients were divided into two groups : Group-I (n=50), patients with low hemoglobin (male <13-10gm/dl, female < 12-10 gm/dl) and Group-II (n=50), patients with normal hemoglobin (male >13gm/dl, female >12gm/dl). Non-ionic low-osmolar contrast agents was used in all patients.Volume of contrast medium (ml) was recorded. Adequate hydration given intravenously (ml). Prior to procedure serum creatinine, serum electrolytes and Creatinine clearance rate were measured within 24 hrs before PCI and on days 1,2,3 after PCI. If there is renal impairment (CIN) serum creatinine, serum electrolytes and Creatinine clearance rate were measured daily from the 4th day onward after PCI until recovery. Results: The mean serum creatinine level of low hemoglobin group and normal hemoglobin group were 0.9mg/dl and 1mg/dl respectively at base line. The low hemoglobin group experienced a considerable increase in serum creatinine up to 1.5mg/dl at day 3 compared to 1.3 mg/dl in normal hemoglobin group. When the most common definition of contrast induced nephropathy (as an increase in the serum creatinine concentration >0.5 mg/dl from baseline) was used the incidence of CIN was 26% in low hemoglobin group and 8% in the normal hemoglobin group. Conclusion: preprocedural low hemoglobin is an independent determinant of increased incidence of contrast induced nephropathy after percutaneous coronary intervention.

Correlations of Serum Magnesium and Potassium in Acute Myocardial Infarction, Chronic Ischemic Heart Disease and Normal Healthy Volunteers of Bangladesh.

Magnesium (Mg) and potassium (K) are the major intracellular cations whose presence in the serum are low, but minor changes of those may show a remarkable change in the various body functions specially in the heart. The study was designed to find out the correlation between serum Mg and K in acute myocardial infarction (AMI), chronic ischemic heart disease (CIHD) and normal healthy volunteers. It was carried out over a period of 18 months in the Department of Biochemistry, Bangabandhu Sheikh Mujib Medical University (BSMMU) in collaboration with Department of Cardiology, Sir Salimullah Medical College & Mitford Hospital (SSMC & MH) and Atomic Energy Center, Dhaka. A total of 101 subjects were included in which 32 subjects were AMI, 34 CIHD and 35 normal healthy volunteers. Serum glucose and serum creatinine were estimated to exclude diabetes and renal dystrophies. Estimation of serum CK-MB and ECG tracing were done as diagnostic tools of AMI and to categories the subjects into various groups. Serum Mg was estimated by Atomic absorption spectrophotometer and serum K by Ion sensitive electrode. The present study shows that there is a strong positive correlation of serum Mg and K in AMI, CIHD and healthy control subjects (r = 0.566, p<0.01 level). So it is suggested to estimate and supplement both Mg and K in IHD patients for their better management.