In-Hospital Outcomes of Patients with Acute Kidney Injury Following Acute Coronary Syndrome in a Tertiary level Hospital

Background: Acute Kidney Injury (AKI) is a strong predictor of in-hospital adverse outcomes, which is a common complication of acute coronary syndromes (ACS). ACS patients with renal impairment during hospitalization are associated with adverse outcomes like heart failure, cardiogenic shock, arrhythmia, dialysis requirement and mortality. Objective: To compare ACS patients with or without AKI has significant risk of in-hospital adverse outcomes. Methods: This prospective comparative study was conducted in the Department of Cardiology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, during the period of July 2017 to June 2018. A total of 70 eligible patients were included in this study. Electrocardiography, blood test for serum creatinine (on admission, 12 hours, 48 hours and at the time of discharge), lipid profile, RBS, 2-D echocardiography along with serum troponin, CK MB and electrolytes were done for all patients. Results: It was observed that mean age was 58.0±8.5 years in group A (ACS with AKI) and 55.6±12.3 years in group B (ACS without AKI). Male population was predominant in both the groups (85.7% and 74.2%, respectively). Heart failure was more common in group A than in Group B (74.3% vs 34.2% p=0.001 respectively). Arrhythmia was more common in group A than in Group B (100% vs 74.2% respectively). The mean duration of hospital stay was significantly higher in Group A than in the Group B (9.4±2.3 vs 7.2±0.6; p=0.001) days. Conclusion: This study showed adverse outcomes including longer duration of hospital stays were more common in the patients with AKI (group A) than in the patients without AKI (group B).

Frequency & Pattern of Chronic Rheumatic Heart Disease in Patient Undergoing Echocardiography: Experience in a Tertiary Level Hospital of Bangladesh

Rheumatic heart disease & rheumatic fever is important public health issue. overall incidence and prevalence of acute rheumatic fever is in downtrend in Bangladesh. But exact incidence & prevalence of chronic rheumatic heart disease (CRHD) is unknown. Objective: We wanted to find out prevalence of CRHD among adult patients undergoing echocardiography in a tertiary level hospital of Bangladesh. Methods: The study was conducted in the department of cardiology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka between January 2018 to December 2018. Echocardiography was done with VividE9® machine. Patients who underwent echocardiography for various indication on indoor and outdoor basis were screened for this study. Among them 1000 male & female patients, age between 18-65 years who had their echo done by the investigators were enrolled for analysis. CRHD was defined as per latest echocardiography guideline. Frequency & pattern of CRHD were calculated. Results: Out of 1000 patients 74 cases were diagnosed as CRHD (7.4%), among them 52 patients were female. Mitral stenosis (MS) was found in 28.3% cases, Isolated mitral regurgitation (MR) in 5.4%, MS with MR in 18.9%, Aortic stenosis (AS) in 8.1%, Aortic regurgitation (AR) in 10.85%, AS with AR in 13.5%, involvement of both aortic & mitral valve in 27%, involvement of mitral, aortic & tricuspid valve in 1.3%. Conclusion: Findings of the study will help to set public health programs for primary & secondary prevention of CRHD. Further population-based study is required to know the exact prevalence of the disease.

Community-associated methicillin-resistant Staphylococcus aureus infections in Aboriginal children attending hospital emergency departments in a regional area of New South Wales, Australia: a seven-year descriptive study

Objective: Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) can cause bacterial skin infections that are common problems for Aboriginal children in New South Wales (NSW). MRSA is not notifiable in NSW and surveillance data describing incidence and prevalence are not routinely collected. The study aims to describe the epidemiology of CA-MRSA in Aboriginal children in the Hunter New England Local Health District (HNELHD). Methods: We linked data from Pathology North Laboratory Management System (AUSLAB) and the HNELHD patient administration system from 33 hospital emergency departments. Data from 2008–2014 for CA-MRSA isolates were extracted. Demographic characteristics included age, gender, Aboriginality, rurality and seasonality. Results: Of the 1222 individuals in this study, 408 (33.4%) were Aboriginal people. Aboriginal people were younger with 45.8% aged less than 10 years compared to 25.9% of non-Aboriginal people. Most isolates came from Aboriginal people who attended the regional Tamworth Hospital (193/511 isolates from 149 people). A larger proportion of Aboriginal people, compared to non-Aboriginal people, resided in outer regional (64.9% vs 37.2%) or remote/very remote areas (2.5% vs 0.5%). Most infections occurred in summer and early autumn. For Aboriginal patients, there was a downward trend through autumn, continuing through winter and spring. Discussion: Aboriginal people at HNELHD emergency departments appear to represent a greater proportion of people with skin infections with CA-MRSA than non-Aboriginal people. CA-MRSA is not notifiable in NSW; however, pathology and hospital data are available and can provide valuable indicative data to health districts for planning and policy development.

Development of an Efficient Plant Regeneration System of Field Mustard (Brassica campestris).

Aims: The present study was conducted with a view to develop an efficient protocol for high frequency plant regeneration of Brassica campestris for further crop improvement program by biotechnological manipulation and to optimize this system for regeneration of a number of B. campestris genotypes. Study Design: Completely Randomized Design. Place and Duration of Study: This experiment was carried out in the Genetic Engineering Laboratory of the Department of Genetics and Plant Breeding, Sylhet Agricultural University, Bangladesh during the period of July 2013 to June 2014. Methodology: Cotyledon and hypocotyl explants of B. campestris cv. BARI sarisha-12 were cultured on MS medium supplemented with different concentrations of 6-Benzylaminopurine (BAP) and α-Naphthaleneacetic acid (NAA) for callus initiation and shoot regeneration. Later on subsequent subculturing is done for shoot elongation and multiplication. MS medium supplemented with various concentrations of NAA were used for root formation. Results: From a total of 15 different combinations of BAP and NAA tested, the combination of 1.0 mg L-1 BAP and 0.5 mg L-1 NAA gave the highest frequency of callus initiation (94.44%) as well as shoot regeneration (63.89%) in case of cotyledon explants where as hypocotyl explants showed 47.62% callus initiation and 19.04% shoot regeneration frequency. Four days old cotyledon explants showed the highest shoot regeneration frequency (72.22%) and higher number of shoots per explant (3.94) than those from older seedling. The shoot regeneration frequency markedly enhanced to 83.33% by the addition of 2.0 mg L-1 AgNO3 to the MS medium supplemented with 1.0 mg L-1 BAP, 0.5 mg L-1 NAA and this combination also showed the maximum number of shoots per explant (6.86). Shoot regeneration potentiality of five B. campestris genotypes were investigated and indicated that this system would be widely applicable to all the genotypes. The regenerated shoots were easily rooted on MS medium supplemented with 0.2 mg L-1 NAA and the whole plants were transferred to pot soils and grown to maturity. Conclusion: MS medium supplemented with 1.0 mg L-1 BAP, 0.5 mg L-1 NAA and 2.0 mg L-1 AgNO3 is more efficient for multiple shoot regeneration by using cotyledon explants and it may be utilized for In vitro improvement program of B. campestris.

Knowledge attitudes and practice of parents regarding fever in children and its management at home

Fever may be a sign of both infectious and non-infectious disorders, occurs commonly in children and makes their parents unduly worried and panic as they perceived it a danger ailment. There are numerous myths and fallacy among parents related to fever management in children

Objectives Study aimed to identify the parent's knowledge regarding childhood fever and understanding of belief and attitude in the management of fever

Methods: A descriptive hospital based cross sectional study carried out among parents whose children under age 6 years were admitted to pediatric wards of a public sector teaching hospital in Peshawar with different medical conditions

Results: More than [93%] person were wrong about normal body temperature. About [37%] don't know about causes of fever where [90%] parents detect fever through tactile method, about [57%] parents don't know about appropriate body part for placing thermometer to record accurate temperature and large number of parents [40%] visit chemist for treatment after detecting fever in their kids, about [37%] brought their children to hospitals and only [13%] of total treat their children for fever at home

Conclusion: Parent's knowledge about fever and its home management was found poor in the study. Need is there to educate parents about proper assessment, detecting, recording of fever and safe practicing of fever management at home

Serum and urinary inorganic phosphate in stone formers and non stone formers at Peshawar

Geographical variation in the rates of kidney stones has been observed for many years. Pakistan is situated in stone belt. Calculus diseases is endemic in Pakistan, perhaps the incidence in Pakistan is highest in the world. To evaluate etiology and biochemical risk factors [inorganic Phosphate] in the Peshawar. The study was carried out at Leady Reading Hospital, Hayatabad Medical Complex, Peshawar for the period of nine months. Study was conducted at LRH and Hayatabad Hospitals of Peshawar for the period of nine months. Two hundred patients and same number of controls were selected. The mean value of mean inorganic phosphate in non stone formers were less than that of stone formers. The mean of urinary inorganic phosphate excretion in stone formers was greater than that of non-stone formers. We conclude that inorganic phosphate is an independent risk factor for renal stone formation

Serum magnesium and hypertension

Despite advances in the prevention and treatment of hypertension over the past decade, hypertension remains an important public health challenge. Recent efforts to reduce the prevalence of hypertension have been focused on non-pharmacologic means, specifically diet. An increased in take of magnesium has been shown in some but not all studies to reduce blood pressure in patients with hypertension. Decreased Serum magnesium levels are associated with development of hypertension. This study was planned to investigate relation of serum magnesium with blood pressure in patients with mild uncomplicated hypertension. Study was conducted at LUMHS hospital Jamshoro and DHQ hospital charssadda for the period of six months. Fifty known cases of uncomplicated mild hypertensive patients were selected, same number of healthy controls were also examined. When results were summed up and test parameters were compared, it was seen that no significant differences were found in serum magnesium levels among both groups, when compared statistically. Finally we conclude that no relation of magnesium with hypertension was observed. Much more work on wide scale population may be needed to clarify the idea

Serum sex steroids, gonadotrophins and sex hormone-binding globulin in prostatic hyperplasia

Benign prostatic hyperplasia [BPH] develops in elderly males when serum androgens are relatively lower than in healthy younger males, but it is not well understood whether and how sex steroids are altered in prostatic hyperplasia. It is also uncertain whether there is any change in sex steroid levels in males older than 40 years of age. The use of androgens in elderly males is often discouraged because of the probable worsening effect of androgens on prostatism. This study aimed to determine the relationship between prostatic hyperplasia and sex steroid levels and whether there is any significant change in these hormones after the age of 40 years. We studied healthy males of age 240 years with [n=92] or without [n=93] clinical prostatic hyperplasia. Serum testosterone, estradiol, gonadotrophins and sex hormone-binding globulin [SHBG] were compared. The hormones and SHBG were also correlated with age. No significant difference was found in any hormone in cases with prostatic hyperplasia as compared with the controls. There was no significant age-related change in any hormone except estradiol where as a negative correlation [P<.003] with age was found. Serum sex steroids and SHBG remained unchanged in symptomatic prostatic hyperplasia and except for estradiol there was no significant age-related change in serum testosterone, gonadotrophins and SHBG in healthy males after the fourth decade. More studies are needed to confirm the age-related decline of estrogens in males

Gonadal hormones and gonadotrophins in healthy males beyond forty years

To determine and compare the sex hormones, gonadotrophins and sex hormone binding globulin [SHBG] in healthy males of different age groups. One hundred eighty five consecutive healthy nonobese males of age 40-90 years were studied. Serum samples were assayed for total testosterone, estradiol, LH, FSH and SHBG estimation by radioimmunometric method. The subjects were divided into five age groups and the mean serum concentrations of each parameter were compared among the groups. No significant difference in the mean serum concentrations of total testosterone, SHBG, LH and FSH was found among the different age groups[p> 0.05 by Anova]. Significant age related decrease was found in the serum estradiol concentration [p< 0.05] by both Anova and Pearson's Correlation test. There is no significant age related change in serum total testosterone, gonadotrophin and SHBG concentrations in healthy males beyond forty years. Significant age related decrease in serum estradiol needs further studies