Changes of antioxidant enzymes in the kidney after cardiac arrest in the rat model

Globally, cardiac arrest (CA) is a leading cause of death and disability. Asphyxial CA (ACA)-induced kidney damage is a crucial factor in reducing the survival rate. The purpose of this study was to investigate the role of antioxidant enzymes in histopathological renal damage in an ACA rat model at different time points. A total of 88 rats were divided into five groups and exposed to ACA except for the sham group. To evaluate glomerular function and oxidative stress, serum levels of blood urea nitrogen (BUN) and creatinine (Crtn) and malondialdehyde (MDA) levels in renal tissues were measured. To determine histopathological damage, hematoxylin and eosin staining, periodic acid-Schiff staining, and Masson's trichrome staining were performed. Expression levels of antioxidant enzymes including superoxide dismutase-1 (SOD-1), superoxide dismutase-2 (SOD-2), catalase (CAT), and glutathione peroxidase (GPx) were measured by immunohistochemistry (IHC). Survival rate of the experimental rats was reduced to 80% at 6 h, 55% at 12 h, 42.9% at 1 day, and 33% at 2 days after return of spontaneous circulation. Levels of BUN, Crtn, and MDA started to increase significantly in the early period of CA induction. Renal histopathological damage increased markedly from 6 h until two days post-CA. Additionally, expression levels of antioxidant enzymes were significantly decreased at 6 h, 12 h, 1 day, and 2 days after CA. CA-induced oxidative stress and decreased levels of antioxidant enzymes (SOD-1, SOD-2, CAT, GPx) from 6 h to two days could be possible mediators of severe renal tissue damage and increased mortality rate.

Effect of Sowing Dates and Varieties on Growth and Yield of Broccoli under Acidic Soil Condition of Sylhet

This experiment was conducted during October, 2013 to March, 2014 in the experimental field of Department of Horticulture, Sylhet Agricultural University (SAU), Bangladesh. The objective was to evaluate the effect of three planting dates (30 October, 15 November and 1 December) on growth, yield and yield attributes of three broccoli varieties (Premium, BR001 and BR002) under acidic soil condition of Sylhet. The two factors field experiment was laid out in Randomized Complete Block Design (RCBD) with three replications. Broccoli planted on 30 October recorded the minimum number of days to first curd harvest (64.77), the tallest plants at harvest (62.76 cm) with denser leaves (17.90), the highest primary curd weight (142.75 g) with increased curd length (11.93 cm), the maximum curd yield of both primary (5.29 t/ha) and secondary (5.24 t/ha). Variety Premium was the earliest in curd initiation (50.33 days) and curd harvest (64.44 days). Premium had the highest number of leaves at harvest (16.07), the maximum primary curd weight (207.59 g) with increased curd length (12.18 cm) and curd diameter (14.28 cm). The highest primary curd yield (7.70 t/ha) and secondary curd yield (4.02 t/ha) of Premium variety out yielded the other two varieties in this experiment. Interaction effect showed that the variety Premium planted on 30 October showed the best performance in primary curd weight (274.13 g), primary curd yield (10.17 t/ha) and secondary curd yield (8.43 t/ha). Therefore, the variety Premium can be recommended to cultivate at 30 October planting date under acidic soil condition of Sylhet.

Effects of Mulching on Soil Water Content, Maize Performance and Weed Growth in Dry Land Area of Bangladesh

Aims: The objectives of the research work were to evaluate the effects of mulching on soil water content, maize performance and weed growth in dry land area of Bangladesh Study Design: The experiment was laid out in a randomized complete block design (RCBD) with three replications Place and Duration of Study: Central research field of Sher-e-Bangla Agricultural University, Dhaka-1207 during November 2019 to April 2020. Methodology: The experimental field is divided into 3 blocks to represent 3 replications. There are 6 unit plots (each unit plot consists of 3m � 2m area) in the experimental farm. Distances of 1 m and 0.5 m are maintained between replication to replication and plots to plots, respectively. Plant to plant and row to row distances are considered to be 0.25 m and 0.75 m, respectively. The treatments are assigned in random plots. The land is ploughed four times followed by laddering to have fine tilth of the soil. The maize cultivars Shuvra and KS-510 are used as plant materials. Fig. 1 represents the six mulch treatments are imposed on the plants: Control (without mulch, CK), water hyacinth dry (10 t/ha, WH), rice straw dry (10 t/ha, RS), black polythene (4m � 3m, BP), white polythene (4m � 3m, WP), and transparent polythene (4m � 3m, TP) (S2). The mulches are applied as per treatment in each plot just after sowing to maintaining an equal thickness throughout the plot. Dried and cleaned mulches are used before applying to the experiment. The significance of the difference among the treatment means were estimated by the MSTAT-C package programme at 5% level of probability. Results: It is found in the experimental results that the soil water content of the no-mulching treatment is lower as compared to that of the other treatments from 0-10 cm, 10-20 cm and 20-30 cm soil depths. It is also observed that the RS mulching provides the highest soil water content, leaf area index (LAI), chlorophyll contents, and total biomass. Significant enhancement of maize yield (20.55 ton/ha) is recorded for the rice straw mulching. In contrast, the weed dry weight of 7.45g/m2 is observed in the RS mulching, which is lower than the other treatments. Conclusions: Therefore, it can be concluded that the RS mulching, compared to other mulching, would be more efficient for maximum utilization of limited water resources, weed suppression as well as to increase the maize yield. The present research approach would be applicable to manage the soil water for enhancing the maize production in dry land area.

Determination of alpha-amylase activity of Streptomyces spp isolated from Bangladeshi soils.

Streptomyces, the largest genus of actinobacteria, is a group of bacteria which is most commonly isolated from soil. In this study, total 24 indigenous Streptomyces spp. were isolated from soil samples collected from different parts of Bangladesh Of them, two species designated as S-31 and S-109 were studied to determine their alpha-amylase activity. The α-amylase activity of S-31 and S-109 was 2.26 unit/ml and 2.67 unit/ml .Based on this study, it can be concluded that both species of Streptomyces were good candidate for amylase production.

Designing of Culture Media for Increased Recovery of Total Heterotrophs From Water Samples.

Bacteriological examination of water is one of the most important areas of investigation because upto 80% of all sickness and diseases in the world are water related. Heterotrophic bacteria are the least studied indicator for water quality determination. The present investigation encompasses two different approaches to estimate water quality.e.g a) to modify the conventional culture media for maximal recovery of heterotrophs and b) to assess the load of the total aerobic heterotrophs as an indicator from drinking and surface water. Six samples from different sources were examined with nine different media such as NA, MNA, PCA, PCA-6, SDA-8, R2A, SE, SOE, and SSE for comparative evaluation. Among them,SE,SOE and SSE are newly formulated media using soil extract, soybean extract and the combination of both of them respectively.SDA-8 was found to be superior in most cases in relation to its comparative efficiency.SSE medium was also found to be superior in case of two samples. The range of heterotrophic bacterial count on different media varied from 3.0 x104 cfu/100ml to 8.6x 105 cfu/100ml and 9.5x106 cfu/100ml to 7.5x107 cfu/100ml in case of drinking water and surface water respectively.

A Rare Case Report on Benign Recurrent Intrahepatic Cholestasis.

Benign recurrent intrahepatic cholestasis is an inherited and occasionally sporadic disease presents as recurrent episodes of obstructive jaundice without any obstruction in billiary channel with intervening symptom free periods. Here we are presenting a case of 20-year-old male with a recurrent jaundice and pruritus who later diagnose as BRIC.

Articulation of speech of patients treated with radicular attachment assisted obturator following maxillectomy.

Background: Obturators are used to separate the oro-nasal opening. These improve speech and other oral functions as well as provide psychological support to the patients. Adding radicular attachments in an obturator makes more effective. Objective: To evaluate and compare the effectiveness of obturator with radicular attachment and conventional obturator in articulation of speech. Materials and Methods: Fifty patients, age ranged from 18 to 72 years, with maxillectomy defect were selected as the sample of the study. Among them 25 patients were treated with obturator with radicular attachment and another 25 patients were treated with conventional obturator. After insertion of obturator, data were collected on the basis of articulation of speech. Results: Patients treated with obturator with radicular attachment showed significantly better (P value <0.001) articulation of speech. Conclusion: Obturator with radicular attachment is more effective than conventional obturator.

Primary Tuberculosis of Tonsils: a Case Report.

The occurrence of tuberculosis of the upper respiratory tract including oral cavity has become uncommon. Isolated tuberculosis in the absence of active pulmonary tuberculosis is very rare clinical entity. Here is a report of primary tuberculosis of tonsil, presented with complaints of sore throat.

Association of Left Atrial Spontaneous Echocardiographic Contrast with Inflammatory Markers in Mitral Stenosis Patients.

Background: Spontaneous echocardiographic contrast (SEC) is a risk factor for left atrial thrombus formation and an important indicator of potential systemic embolism originated from heart. An established relation exists between the inflammatory status and the prothrombotic state. The present study was conducted to evaluate the association between left atrial spontaneous echocardiographic contrast with inflammatory markers in mitral stenosis patients. Methods: This observational analytical study was undertaken in the department of Cardiology, National Institute of Cardiovascular diseases (NICVD), Dhaka. A total of 70 patients with mitral stenosis were categorized into two groups: group I with left atrial SEC and group II without left atrial SEC. All patients underwent transthoracic as well as transoesophageal echocardiography. Complete blood count with ESR was done and neutrophil lymphocyte ratio was calculated. The high sensitive C-reactive protein (hs-CRP) was assayed. Results: The hs-CRP levels were significantly greater in the SEC-positive group (5.6±2.1vs 1.5±0.7, p=0.001). The mean ESR level was significantly greater in the SEC-positive group (32.6±15.5 mmvs15.8±4.7 mm).The neutrophil levels ((76.1±1.9 vs 63.7±3.3) were significantly greater in the SEC-positive group, and the lymphocyte levels (33.3±3.0 vs 21.5±1.3) were significantly greater in the SEC-negative group (p=0.001 for each). The neutrophil/lymphocyte (N/L) ratio was also significantly greater in the SEC-positive group (3.4±0.4 vs2.1±0.6, p=0.001).On multivariate analysis hs-CRP, neutrophil/lymphocyte ratio, raised ESR, mitral valve area and left atrial diameter were independent risk factors for SEC in patients with mitral stenosis. Conclusion: From this study it may be concluded that left atrial SEC is associated with raised inflammatory markers in majority of patients with mitral stenosis. So, SEC may be considered as a reflection of ongoing inflammatory process in patients with mitral stenosis.

Impaired Renal Function is Associated with Severe Coronary Artery Disease in Chronic Stable Angina Patients.

Background: Cardiovascular disease is the leading cause of morbidity and mortality in renal impaired patients. Many of the patients of chronic kidney disease die of cardiovascular disease before requiring dialysis. Cardiovascular disease in renal impaired patient is potentially preventable and treatable. The aim of this study was to evaluate the association between renal impairment and coronary artery disease severity in chronic stable angina patients. Methods: 110 patients with chronic stable angina who got admitted for coronary angiography were included in the study. They were divided into impaired renal function group (with estimated glomerular filtration rate [eGFR] <90 ml/min/1.73m2) and normal renal function group (eGFR e” 90 ml/min/1.73m2) on the basis of eGFR. The severity of the CAD was assessed by angiographic Vessel score and Gensini score. Results: Mean Gensini score was significantly high in impaired renal function group (42.30±24.9 vs 25.65±17.9, p <0.05). There was significant negative correlation between eGFR and vessel score (r=-0.30, p <0.05) and between eGFR and Gensini score (r =-0.65, P <0.05). In multivariate logistic regression analysis, after adjustment of factors eGFR remain independent predictors of severe CAD (P=0.002, OR -5.73). Conclusion: Impaired renal function, assessed by eGFR is associated with angiographic severe coronary artery disease in chronic stable angina patients and this association is independent of conventional cardiovascular risk factors.

Donor Site Evaluation After Lingual Mucosal Graft Harvest for Urethroplasty.

This study was carried out in the Department of Urology, National Institute of Kidney Diseases and Urology, (NIKDU), during the period from Jan' 09 to Dec' 10 to assess the complications at donor site after lingual mucosal graft harvesting for urethroplasty. A total of 30 patients with mean age of 36.6 years (rang 21 to 56 years) and mean urethal stricture length of 36 mm (range 22 to 59 mm) who underwent urethroplasty for anterior urethral strictures using dorsal onlay of a lingual mucosal graft (LMG) were selected for the study. The site of the harvest graft was ventrolateral mucosal lining of the tongue. Donor site complications like pain, numbness, tightness, slurring of speech, salivatory changes and difficulty in protrusion of tongue were noted. The mean period of follow-up was 14 months (range 6-18 months). At the first postoperative day, 96% of the patients experienced pain at donor site and 26% had slurring of speech. Pain was mild to discomforting in 60% and distressing to excruciating in 37% of the patients. By third postoperative day, 22 (73%) patients were pain free, 06 (20%) suffered from mild pain and 02 (6%) suffered from discomforting pain only and none had slurring of speech. On the fifth postoperative day, only 02 (6%) patient suffered pain. By day 6 of surgery, all patients were pain free. Only 01 (3.3%) patients reported numbness which persisted during the whole period of follow up. The study showed that LMG is easy to harvest and associated with less postoperative pain, minor risk of donor site complications and without any functional or esthetic deficiency. So tongue may be the best alternative donor site for anterior urothroplasty.

Study on Time-related Changes in Aerobic Bacterial Pattern of Burn Wound Infection.

A prospective study was carried out in 50 burn patients admitted in Burn unit of Dhaka Medical College Hospital over a period of one year from January 2005 to December 2005 to evaluate time-related changes in aerobic bacterial colonization and their sensitivity pattern. Periodic swabs were taken from the burn wound on Day 0, Day 7, Day 14 and Day 21 to see the changing pattern of organisms during hospital stay of patients. In the present study burn injury was highest in the age group 11-20 yrs (34%). Male to female ratio was 1.38:1. The mean percentage of burn was 35.79% of total body surface area (TBSA). Fire was the major cause of burn (38%) followed by electric burn (20%). Among the 200 samples, single organism was isolated in 71% samples and mixed organism in 13.5% and no growth in 14.5%. Among single isolates Pseudomonas aeruginosa was leading (28%) followed by Escherichia coli (17.5%), Staphylococcus aureus (16%), coagulse negative Staphylococcus (4.5%) and Klebsiella (2%). Among mixed growth Pseudomonas aeruginosa was still leading (11%) follow by E. coli (9.5%) Staphylococcus (5.5%), Proteus (1%) and Klebsiella (0.5%).There were time -related changes in bacterial isolation from burn wound during hospital stay of patients. On admission 42% of the isolated organisms were Staphylococcus aureus and only 6% each Pseudomonas aerunginosa and E. coli were isolated. No growth was found in 28%. samples. These findings were gradually changing with time and on day 21 Staphylococcus aureus were only 4% whereas Pseudomonas aeruginosa were 40% and E. coli 28%. Antimicrobial sensitivity test showed that pseudomonas aeruginosa was highly resistant to antimicrobial agents. It was most sensitive to Imipenem (98.72%) followed by Aztreonam (33.44%), Ceftazidime (38.32%) and Gentamicin (19.23%). E. coli was also found most sensitive to Imipenem (98.15%) followed by Gentamicin (38.95%), Chloramphenicol (37.1%), Ciprofloxacin (35.25%) and ceftraixone (29.70%). Staphylococcus aureus was 100% sensitive to Vancomycin followed by Amoxiclav and Oxacillin (53.43% each), Gentamicin (44.70%) and Cloxacillin (39.52%). It is crucial for every burn institution to determine the specific pattern of burn wound microbial colonization, the time-related changes in dominant flora, and the antimicrobial sensitivity profiles. This would enable early treatment of septic episodes with proper empirical systemic antibiotics without waiting for culture results, thus improving overall infection related morbidity and mortality.

Evaluation of Serum Calcium Level Measurement in Total Thyroidectomy Patients - A Prospective Study in Tertiary Hospitals.

Postoperative hypocalcemia is the most frequent and common complication after total thyroidectomy. It is necessary to diagnose hypocalcemia immediately after total thyroidectomy for minimizing complications. The objective of this study was to measure and to evaluate the serum calcium level in total thyroidectomy patients. This prospective observational study was carried out in the Department of Clinical Pathology in collaboration with Department of Surgery & Department of Otolaryngology of BSMMU and Department of Otolaryngology of DMCH, Dhaka, during the period of September 2010 to August 2011. Total 65 patients were enrolled those came for total thyroidectomy irrespective of age and sex. Hypocalcemia was found in 25 cases and normocalcemia was found in 40 cases. Male were 16.0% and female were 84.0%. Females were predominant. The incidence of hypocalcemia was 38.5%. Asymptomatic hypocalcemia was found in 22 and symptomatic hypocalcemia was found in 3 cases. Hypocalcemia was developed mostly in malignant thyroid diseases. The mean difference of intraoperative (20 minutes after total thyroidectomy), after 24 hours and after 48 hours calcium levels were statistically significant (p<0.05) between patient with hypocalcemia and patient with normocalcemia in unpaired t-test. Serum calcium level significantly decreased after total thyroidectomy and most critical time is first 24 hours of post-thyroidectomy period. If clinical sign symptoms of hypocalcemia are not developed in this period, patient is safe and can be discharged from hospital.

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.

Relationship of uterine artery with ureter.

The study was done to see the relationship of right and left uterine artery with corresponding ureter. Their distance from lateral border of uterus and site of crossing in relation to internal os in Bangladeshi female were observed. Sixty post mortem specimens containing uterus, uterine tube, ureter and surrounding structures were collected from cadavers of different age groups and fixed in 10% formol saline solution. Gross and fine dissections were carried out to study the relationship and distance of uterine artery where it crosses the corresponding ureter and the site of crossing in relation to internal os. In the present study our findings were compared with those of the standard text books. In this study, there were no variations regarding relations of right and left uterine artery with corresponding ureter. In all cases of all age groups, ureters were found to cross the uterine artery anteriorly on both sides. Site of crossing of uterine artery of both sides with ureter at the level of internal os was 50% in 2-12 years (Group A) 20.45% in 13-45 years (Group B) and 12.50% in 46-80 years (Group C) age group. Below the level of the os was found in remaining cases except one which crosses above the level of the os in group B. In this study mean distance of uterine artery where it crosses the ureter from lateral border of uterus was more on right side in all age groups, which was 1.67 cm, 2.30 cm and 2.11 cm in age Group A, B & C respectively.

Wilson's disease with hepatic presentation in childhood.

Diagnosis of Wilson's disease with hepatic presentation in childhood using clinical and common laboratory parameters is still challenging and is often missed or delayed. The aim of the study was to document the clinical and laboratory parameters of hepatic presentation of Wilson's disease in children. The study was conducted at a tertiary-care hospital in a developing country. Clinical and common laboratory parameters were recorded in 32 Wilson's disease children with hepatic presentation. The diagnosis was based on positive family history, Kayser-Fleischer ring, low serum ceruloplasmin level, elevated basal urinary copper excretion and favorable response to therapy with D-penicillamine. Mean age+/-SD at presentation was 9+/-2.97 years and 21 (65.6%) were boys. Chronic liver disease (21; 65.6%) followed by fulminant hepatic failure 1(6; 18.8%) were the commonest presentation. In the whole group, Kayser-Fleischer ring was found in 21 (65.6%), low serum ceruloplasmin in 16 (50%) and elevated basal urinary copper excretion in all 32 (100%) children. Diagnosis of Wilson's disease was made at presentation on the basis of i) Kayser-Fleischer ring, low serum ceruloplasmin, elevated basal urinary copper excretion and favorable response to D-penicillamine therapy in 11 (34.4%), ii) Kayser-Fleischer ring, elevated basal urinary copper excretion and favorable response to D-penicillamine therapy in 10 (31.2%), iii) elevated basal urinary copper excretion and favorable response to D-penicillamine therapy in 6 (18.8%) and iv) low ceruloplasmin, elevated basal urinary copper excretion and favorable response to D-penicillamine therapy in 5 (15.6%) children. Wilson's disease can not be excluded in children presenting with hepatic involvement using the commonly practiced clinical and laboratory parameters. A combination of various clinical and laboratory parameters were used for the diagnosis of Wilson's disease in the studied children with hepatic presentation.

Treatment of lower ureteric stones by ESWL and ICPL: a comparative study.

This study was carried-out to find-out better and effective treatment option for Lower Ureteric Stones (LUS) by comparing Extracorporeal Shock Wave Lithotripsy (ESWL) with ureterorenoscopic (URS) Intracorporeal Pneumatic Lithotripsy (ICPL). A total of 60 patients attending the outpatient department of Bangabandhu Sheikh Mujib Medical University (BSMMU) with lower ureteric stones were divided into two groups, 30 in group-I (URS + ICPL) and the remaining 30 in group-II (ESWL). In group-I, 60% were male with mean age of 32.76 years and in group-II, 40% were male with mean age of 36.23 years. The ratio of involvement of right to left ureter was 1.7:1. The mean stone size was 10.7 + 2.69 mm (SD) in group-I and 9.9 + 1.97 mm (SD) in group-II. The differences in age, sex and side of involvement of ureter were not significant (p > 0.05) between the two groups. Among the groups 24 (80%) in group-I and 26 (86.61%) of patients in group-II were found stone free. The post procedure loin pain, fever and haematuria were more common in group-I than in group-II. The LUTS and loin pain were significantly more in group-I than in group-II (p < 0.05). The post procedure fever was significantly more in group-I than in group-II (p < 0.001). The mean post procedure hospital stay was 5.7 + 2.54 days for group-I and 1.57 + 0.531 days for group-II. Post procedure hospital stay was significantly less in group-II than in group-I (p < 0.05). The post procedure follow up attendance in this study was significantly low in group-I than in group-II (p < 0.05). ESWL was found effective method than URS + ICPL for the treatment of lower ureteric stones.

Vaccination coverage survey in Dhaka District.

A survey was conducted in Dhaka District to measure the level of routine immunization coverage of children (12-23 months), to assess the tetanus toxoid (TT) immunization coverage among mothers of children (12-23 month), to evaluate EPI program continuity (dropout rates) and quality (percent of Invalid doses, vaccination card availability etc.) For this purpose, a thirty cluster cross-sectional survey was conducted in October 2002 to assess the immunization coverage in Dhaka. In this survey 30 clusters were randomly selected from a list of villages in 63 Unions of Dhaka following probability proportion to size (PPS) sampling procedure. A total of 210 children was studied using pre-tested structured questionnaire. Descriptive statistics was employed using software SPSS package for data analysis. The study showed that the routine immunization coverage in Dhaka among children by 12 months of age by card + history was 97% for BCG, 97% for Diphtheria, Pertussis Tetanus (DPT 1) and Oral Polio Vaccine (OPV 1), 75% for DPT3 and OPV3 and 67% for measles. Sixty six percent of all children surveyed had received valid doses of all vaccines by 12 months (fully immunized child). Programme access as measured by crude DPT1 coverage was better in Keranigonj (97%). Vaccination cards retention rate for children was 84%. Invalid DPT (1,2 or 3) doses were given to 25% of vaccinated children; 18% of measles doses were invalid. Surprisingly, major cause for invalid doses were not due to early immunizations or due to card lost but for giving tick in the card, instead of writing a valid date. DPT1 and DPT3 and DPT1- Measles drop out rates were 5% and 13% respectively. Major reason parents gave for never vaccinating their children (zero dose children) was (43%), major reasons for incomplete vaccination was lack of knowledge regarding subsequent doses (46%). TT surveys were also conducted for mothers of the children surveyed for vaccination coverage (mothers between 15-49 year old). Valid TT 1-5 coverage by card+ history was 97%, 55%, 44%, 24% and 11%, respectively. Card retention rate for TT was 67%. The findings of this study revealed that access to child and TT immunizations were good. But high dropouts and invalid doses reduced these percentages of fully immunized child to 66%. Programmatic strategy must be undertaken to reduce the existing high dropout rate in both child and TT immunizations.

Bilateral giant angiomyolipoma of kidneys: a case report and review of literature.

Angiomyolipoma is uncommon benign tumor of the kidney. Bilateral and multiple lesions are associated with tuberous sclerosis. We report a case with bilateral giant angiomyolipomas in a patient who had no other features of tuberous sclerosis. In this case, the involvement of the kidneys was diffuse rather than usual well-circumscribed lesions.