Applicability of near-miss tools to address maternal mortality

In India, there is a mandate to increase institutional delivery, which has led to an overwhelming response in health-care delivery. The maternal mortality rate has been an essential yardstick, used by health-care planners to assess the quality of obstetric services. As of late, there has been a shift in focus to maternal near-misses (MNMs) as a more valuable indicator of maternal health than the maternal mortality rate. The aim of this research article was to compare various standardized tools to address MNM, namely, the World Health Organization MNM tool, The Government of India's facility-based MNM review tool, etc.

Dyslipidemia Associated with Hypertension Increases the Risks of CHD among cardiac patients: A Case-Control Study

Background: Coronary Heart Disease (CHD) is one of the largest contributors to mortality and morbidity worldwide. Globally, CHD accounts for 17.5 million deaths in 2012, with over 75% of deaths occurring in developing countries. By 2015, 16% of all female and male deaths were caused by CHD. Dyslipidemia is the most common risk factor of CHD for the excessive level of lipids in blood. Most dyslipidemias are hyperlipidemias in developing countries; that is, an accumulation in blood lipids. CHD was 18 times more likely to grow according to hypertension with dyslipidemia category than with non-dyslipidemias. The aim of this study was to assess the effect of dyslipidemia associated with hypertension for coronary heart disease and identify risk factors for CHD among cardiac patients. Material & Methods: This was a case control study and was conducted in the Department of Medicine, LABAID Specialized Hospital, Dhaka, Bangladesh during the period from May,2022 to March,2023. We included 170 cardiac patients in our study. The patients were divided into two groups – Case group (Patients diagnosed with CHD) & Control group. Results: In total 170 patients from both the groups completed the study. In our study we found most of our patients were male (58%) compared to female (42%). We found the mean age was 46.1±11.3 & 47.1±9.3 years in case & control group respectively. Family history of hypertension was significantly higher in case group (52%). Among all patients, BMI was higher in case group. Cholesterol, systolic & diastolic bp was found significantly higher in case group than control group. HDL was found lower & LDL was found higher in case group. Among 85 cases, majority (68%) had dyslipidemia associated with hypertension. We found dyslipidemia was 55% & 36% in case & control group respectively. Hypertension was also found significantly higher in case group. Age ? 60 years, family history of CHD, smoking, diabetes & obesity were also individual risk factors of CHD among cardiac patients. In dyslipidemia with hypertension group 68 patients were diagnosed with CHD which is higher than non-hypertension group. Conclusion: In our study, we found that dyslipidemia, hypertension, age ? 60 years, family history of CHD, smoking, diabetes & obesity are individual risk factors of CHD development. Relationship of dyslipidemia with coronary heart disease in hypertension is significant. We also found dyslipidemia with hypertension is an established risk factor of prime importance that increased the risks of CHD among cardiac patients

Morphometry of the patellar tendon using a simple tracing method: a gold standard for anterior cruciate ligament reconstruction / 대한해부학회지

The anterior cruciate ligament (ACL) is mostly damaged in sporting activities. To reconstruct the damaged ACL, a patellar tendon (PT) is often the most preferred graft due to its fast healing and bone integration i.e. bone-patellar tendon-bone graft. Suitability of the PT often depends on the morphometric profile of the tendon. This study reported on the harvestable surface area (SA) of the tendon using a simple tracing method. The PT of 79 adult formalin–fixed cadavers of South Africans of European Ancestry were dissected, and the margins of the PT were traced on a wax paper before the tracings were scanned. The SA, straight proximal width (SPW), curved proximal width (CPW), straight distal width (SDW), curved distal width (CDW) and length of tendon (LOT) from the digitized image of the PT was measured. In addition, the length of the lower limbs was measured to normalize the measurements. The results showed no significant side differences, and the measurements were not sexually dimorphic. A strong correlation was reported for SA vs. LOT, SPW vs. CPW and SDW vs. CDW for both sexes and sides. The presented morphological profile provides additional information on the usability of the graft and with respect to healing and recovery.

Understanding Antimicrobial Resistance with perspective of One Health

The concept of "One Health" recognizes the intrinsic relationship among health of human, animal and environment as a whole. All facets of One Health are undermined by the irrational use of antimicrobials and AMR cannot be effectively contained without coordinated actions of all key stakeholders including community participation.

Prophylactic Oral Iron Therapy During Pregnancy

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

The ability of patients with Parkinson's disease to recognize masked faces during the COVID-19 pandemic / A capacidade dos pacientes com doença de parkinson de reconhecer rostos mascarados durante a pandemia de covid-19

ABSTRACT. Patients with Parkinson's disease (PwP) have face recognition difficulties. Objective: This study aimed to evaluate the difficulties of PwP in recognizing masked faces during the COVID-19 pandemic. Methods: A total of 64 PwP, 58 age-matched older healthy controls (OHCs), and 61 younger healthy controls (YHCs) were included in the study. The Benton Face Recognition Test - short form (BFRT-sf) and the 13-item questionnaire on face recognition difficulties due to masks during the pandemic developed by the authors were applied to all three study groups. Results: Both the PwP and OHC groups scored worse in BFRT-sf when compared with the YHC group (p<0.001 and p<0.001, respectively). The number of those who had difficulty in recognizing people seen every day and the number of those who asked people to remove their masks because they did not recognize them were higher in the PWP group (p=0.026 and p=0.002, respectively). The number of individuals who looked at the posture and gait of people when they did not recognize their masked faces and those who stated that this difficulty affected their daily lives were higher in the OHC group (p=0.002 and p=0.009, respectively). The number of participants whose difficulty in recognizing masked faces decreased over time was higher in the YHC group (p=0.003). Conclusions: The PwP group demonstrated similar performance to their peers but differed from the YHC group in recognizing masked faces. Knowing difficulties experienced by elderly people in recognizing people who are masked can increase awareness on this issue and enhance their social interaction in pandemic conditions through measures to be taken.

RESUMO. Pacientes com doença de Parkinson (PcP) têm dificuldades de reconhecimento facial. Objetivo: Avaliamos as dificuldades de PcP em reconhecer rostos mascarados durante a pandemia de COVID-19. Métodos: Incluímos 64 PcP, 58 controles saudáveis ​​mais velhos (CSVs) pareados por idade, 61 controles saudáveis mais jovens (CSJs) no estudo. O Benton Face Recognition Test-short form (BFRT-sf) e o questionário de 13 itens sobre dificuldades de reconhecimento facial devido a máscaras durante a pandemia desenvolvido pelos autores foram aplicados a todos os três grupos de estudo. Resultados: Ambos os grupos PcP e CSV tiveram pior pontuação no BFRT-sf quando comparados com o grupo CSJ (p<0,001 e p<0,001, respectivamente). O número daqueles que tiveram dificuldade em reconhecer as pessoas atendidas todos os dias e o número daqueles que pediram para as pessoas retirarem suas máscaras por não as reconhecer foram maiores no grupo PcP (p=0,026 e p=0,002, respectivamente). O número de indivíduos que olharam para a postura e marcha das pessoas quando não reconheceram seus rostos mascarados e aqueles que afirmaram que essa dificuldade afetou seu cotidiano foi maior no grupo CSV (p=0,002 e p=0,009, respectivamente). O número de participantes cuja dificuldade em reconhecer rostos mascarados diminuiu ao longo do tempo foi maior no grupo CSJ (p=0,003). Conclusões: O grupo PcP demonstrou desempenho semelhante aos seus pares, mas diferiu do grupo CSJ no reconhecimento de rostos mascarados. Conhecer as dificuldades vivenciadas pelos idosos em reconhecer as pessoas mascaradas pode aumentar a conscientização sobre essa questão e potencializar sua interação social em condições de pandemia por meio de medidas a serem tomadas.

Assessment of Pain Experience After Simple Tooth Extraction

Background: Removal of teeth causes pain, swelling, and difficulty in opening the mouth. The present study was conducted to assess pain experience after simple tooth extraction.Material & Methods:90 patients undergoing extraction of both genders were recorded. Pain assessment was recorded on the 10-mm NS (“No pain” to “Worst pain possible”). The character of pain was indicated (yes/no) using 4 descriptors according to the McGill Pain Questionnaire: constant pain, shooting pain, dull pain, and pain when chewing or biting.Results:Out of 90 patients, males were 40 and females were 50. Pain characters was constant in 30, shooting in 15, mild in 12, when chewing in 8 and none in 25 cases. The difference was significant (P< 0.05). Pain occurred in 52 chronically inflamed teeth and 38 grossly decayed teeth. The difference was significant (P< 0.05).Conclusions:Pain after tooth extraction is common and hence use of analgesics and anti- inflammatory is recommended.

Mental health of mothers after natural childbirth and cesarean section: a comparative study in kohat, khyber pakhtunkhwa, pakistan / Saúde mental de mães após parto normal e cesariana: um estudo comparativo em kohat, khyber pakhtunkhwa, paquistão / Salud mental de madres después del parto normal y cesárea: un estudio comparativo en kohat, khyber pakhtunkhwa, pakistán

ABSTRACT Objective: to compare the quality of life of women after natural childbirth and cesarean section from a mental health perspective. Method: this is a causal-comparative study that included 104 women, 52 of whom underwent natural childbirth: and 52 cesarean sections. It was conducted in the gynecology ward of Liaqat Memorial Hospital in Kohat Khyber Pakhtunkhwa, Pakistan using the Quality-of-Life Questionnaire. Pakistani Nurses made direct translation of it in to Urdu language, interview by interview (read in English and told in Urdu). The results related to Emotional Health Problems, Energy, Emotions and Social Activities were analyzed. Results: women after cesarean section reported more problems regarding emotional health variables than women after natural childbirth. The mean quality of life score among the natural childbirth group was 89.94 and 66.02 among the cesarean section group (p<0.001). Conclusion: women who undergo natural childbirth have better quality of life than women who undergo cesarean section (average versus poor quality of life). Mental health is also affected, especially for those who undergo cesarean section. Thus, natural childbirth demonstrates benefits in the puerperium in terms of emotional indicators.

RESUMO Objetivo: comparar a qualidade de vida de mulheres após parto normal e cesariana na perspectiva da saúde mental. Método: estudo causal-comparativo que incluiu 104 mulheres, das quais 52 tiveram parto normal e 52 cesarianas. O estudo foi realizado na enfermaria de ginecologia do Liaqat Memorial Hospital em Kohat Khyber Pakhtunkhwa, Paquistão, usando o Questionário de Qualidade de Vida. As enfermeiras paquistanesas fizeram a tradução direta para o idioma Urdu, entrevista por entrevista (lida em inglês e falada em urdu). Foram analisados os resultados relacionados aos Problemas de Saúde Emocional, Energia, Emoções e Atividades Sociais. Resultados: as mulheres após cesariana relataram mais problemas em relação às variáveis de saúde emocional do que as mulheres após o parto normal. O escore médio de qualidade de vida no grupo de mulheres após parto normal foi de 89,94 e 66,02 no grupo de mulheres após cesariana (p<0,001). Conclusão: as mulheres que realizaram parto normal apresentaram melhor qualidade de vida do que as mulheres após cesariana (média versus má qualidade de vida). A saúde mental também é afetada, principalmente para aquelas que são submetidas a cesariana. Assim, o parto normal demonstra benefícios no puerpério em termos de indicadores emocionais.

RESUMEN Objetivo: comparar la calidad de vida de las mujeres después del parto natural y cesárea desde la perspectiva de la salud mental. Método: estudio causal-comparativo que incluyó 104 mujeres, de las cuales 52 tuvieron parto natural y 52 cesáreas. El estudio se realizó en la enfermería de ginecología del Liaqat Memorial Hospital en Kohat Khyber Pakhtunkhwa, Pakistán, utilizando el Cuestionario de Calidad de Vida. Las enfermeras paquistaníes hicieron la traducción directa al idioma Urdu, entrevista por entrevista (leída en inglés y hablada en urdu). Los resultados relacionados con los Problemas de Salud Emocional, Energía, Emociones y Actividades Sociales fueron analizados. Resultados: Las mujeres después de la cesárea reportaron más problemas en relación a las variables de salud emocional que las mujeres después del parto natural. El puntaje medio de calidad de vida en el grupo de parto natural fue de 89,94 y 66,02 en el grupo de cesárea (p<0,001). Conclusión: las mujeres que tuvo parto natural tienen mejor calidad de vida que las mujeres después de la cesárea (media versus mala calidad de vida). La salud mental también se ve afectada, especialmente para aquellos que se someten a cesárea. Por lo tanto, el parto natural muestra beneficios en el período posparto en términos de indicadores emocionales.

A comparative profile of bactericidal action of a partially purified bacteriocin from lactic acid bacteria with antibiotics

Aims@#The menace of antibiotic resistance has led to the search for alternatives, which in turn has diverted the attention to bacteriocins, antimicrobial peptides (AMPs) produced by bacteria for their bactericidal properties. The aim of our study was to isolate and partially purify bacteriocin from lactic acid bacteria (LAB) and comparing its antimicrobial activity with antibiotics.@*Methodology and results@#Among 38 LAB screened using agar spot assay, LAB 28D1 showed the highest antimicrobial activity against the test bacterial strains. The proteinaceous nature of the antimicrobial compound extracted from LAB 28D1 was confirmed by its inactivation after treatment with proteolytic enzymes. The crude bacteriocin was found to be stable over a wide range of temperatures (60-100 °C) and pH (4-9). The bacteriocin was partially purified by ammonium sulfate precipitation (ASP) and the activity units were 204,800 AU/mL. The total protein and the specific activity of partially purified bacteriocin were found to be 24.585 mg and 124,954.24 AU/mg respectively. The molecular weight of partially purified bacteriocin was determined to be 8.5 kDa approximately. The efficacy of the partially purified bacteriocin against indicator bacterial strains was compared with antibiotics by the disc diffusion method and minimum inhibitory concentration (MIC). According to our study, the hospital waste isolate Enterococcus spp. was found to be multidrug-resistant (MDR) but sensitive to bacteriocin from LAB (MIC 0.06 ± 0 µg/mL).@*Conclusion, significance and impact of the study@#Bacteriocin from LAB has potential in combating MDR enterococcal infections.

Immunohistochemistry of Canine Hair Follicle Stem Cells (cHFSCs) by using CK15 and CK19

Adult body harbors powerful reservoir of stem cells that maintains homeostasis by tissue regeneration and in response to disease and injury. Hair follicle is a dynamic mini organ supporting important biological functions of the body in maintaining homeostasis and skin tissue self-renewal. This study was carried out with the objective of finding the adult stem cells in canine hair follicular tissue. To conduct this study, adult canine skin samples (n=12) irrespective of breed and sex were collected. To characterize the hair follicle stem cells, paraffin sections of canine hair follicles were immunostained with positive hair follicle stem cell markers like Anti- cytokeratin 15 (CK15) and Anti-cytokeratin 19 (CK19) and FITC conjugated and HRP conjugated secondary antibodies were used. Immunoreactivities for CK15 and CK19 were observed in the bulge/isthmus region of hair follicles in between the infundibulum and suprabulbar regions and occupied most part of the peripheral layer of outer root sheath cell. Immunophenotyping of canine Hair Follicle Stem Cells (cHFSCs) in the bulge region of hair follicle helps in confirmation of in vitro culture of cHFSCs from the bulge region which will be further used for translational research

La parathyroïdectomie dans le traitement de l'hyperparathyroïdie secondaire chez les dialysés chroniques

Introduction: L'hyperparathyroïdie secondaire est une complication grave de l'insuffisance rénale chronique, ayant un impact négatif sur la morbi-mortalité. La parathyroïdectomie trouve toute son indication en cas d'échec du traitement médical. Le but de cette étude était de partager notre expérience dans la prise en charge de l'hyperparathyroïdie secondaire et de présenter les caractéristiques démographiques, biochimiques, cliniques et thérapeutiques des patients opérés dans notre service. Matériels et Méthodes : Etude d'une série de cas consécutifs opérés entre janvier 2002 et décembre 2013. Etaient inclus tous les patients ayant présenté une hyperparathyroïdie secondaire prouvée biologiquement et remplissant les critères d'opérabilité. Résultats : La série était composée de 69 patients (35 femmes, 34 hommes). La moyenne d'âge était de 37,7 ±13 ans. Le tableau clinique était dominé par les signes osseux et cutanés. En préopératoire, la valeur moyenne de la PTH était de 1727 ± 1380,10 pg/mL et celle de la calcémie de 2,39 ± 0,28 mmol/L. Sur le plan chirurgical, la parathyroïdectomie était subtotale chez 60 patients (87%) et totale chez 9 patients (13%) dont 7 avec auto transplantation et 2 sans autotransplantation. En post opératoire, la valeur de la PTH avait baissé significativement par rapport à la valeur préopératoire (p<0,01). Conclusion : Les résultats de cette étude suggèrent que la parathyroïdectomie entre les mains d'experts est un moyen efficace pour réduire la sécrétion de PTH avec une faible morbi-mortalité dans le cadre de l'hyperparathyroïdie secondaire réfractaire au traitement médical

Serum Cystatin C Concentrations in Patients with Graves’ Ophthalmopathy

Purpose@#To evaluate the concentration of serum cystatin C (CysC) in patients with Graves’ ophthalmopathy (GO) and the us-ability of the serum CysC concentrations in the follow-up of the disease. @*Methods@#Thirty patients with GO and 30 healthy age-matched volunteers were included in this cross-sectional study. GO was diagnosed based on the European Group on Graves’ Orbitopathy consensus. Serum thyroid-stimulating hormone, free triiodothyronine, free thyroxine, and CysC concentrations were measured in the participants. The serum CysC concentrations were compared between patients with GO and controls. Patients with GO were subdivided into hyperthyroid and euthyroid patients, and their serum CysC concentrations were compared. In addition, the CysC concentrations in hyperthyroid and eu-thyroid patients with GO were compared separately with those of healthy subjects. Kruskal-Wallis test and Student’s t-test were used for statistical evaluation. @*Results@#The mean serum CysC concentrations in GO patients and controls were 1.04 ± 0.36 and 0.74 ± 0.09 mg/L, respectively.There was a statistically significant difference in the serum CysC concentrations between patients with GO and control subjects (p < 0.001). Fifteen patients had hyperthyroid status, and 15 patients had euthyroid status. The mean serum CysC concentrations in hyperthyroid and euthyroid patients with GO were 1.35 ± 0.22 and 0.72 ± 0.13 mg/L, respectively. Serum CysC concentrations were significantly higher in hyperthyroid patients than in euthyroid patients (p = 0.001). In addition, hyperthyroid patients had significantly higher serum CysC concentrations than healthy subjects. Among patients with GO, 21 and nine had mild and moder-ate-to-severe GO, respectively. Active and inactive GO were observed in eight and 22 patients, respectively. @*Conclusions@#The serum CysC concentrations in hyperthyroid patients were higher than those in healthy subjects. Moreover, hyperthyroid patients had higher serum CysC concentrations than euthyroid patients. Further studies with a larger sample size are needed to confirm these results.

Pattern of buccal and palatal bone density in the maxillary premolar region: an anatomical basis of anterior-middle superior alveolar (AMSA) anesthetic technique

Background@#The anterior-middle superior alveolar (AMSA) anesthetic technique has been reported to be a less traumatic alternative to several conventional nerve blocks and local infiltration for anesthesia of the maxillary teeth, their periodontium, and the palate. However, its anatomic basis remains controversial. The present study aimed to determine if the pattern of cortical and cancellous bone density in the maxillary premolar region can provide a rationale for the success of the AMSA anesthetic technique.Method: Cone-beam computed tomography scans of 66 maxillary quadrants from 34 patients (16 men and 18 women) were evaluated using a volumetric imaging software for cortical and cancellous bone densities in three interdental regions between the canine and first molar. Bone density was measured in Hounsfield units (HU) separately for the buccal cortical, palatal cortical, buccal cancellous, and palatal cancellous bones. Mean HU values were compared using the Mann-Whitney U test and one-way ANOVA with post-hoc analysis. @*Results@#Cancellous bone density was significantly lower (P ≤ 0.001) in the palatal half than in the buccal half across all three interdental regions. However, there was no significant difference (P = 0.106) between the buccal and palatal cortical bone densities at the site of AMSA injection. No significant difference was observed between the two genders for any of the evaluated parameters. @*Conclusions@#The palatal half of the cancellous bone had a significantly lower density than the buccal half, which could be a reason for the effective diffusion of the anesthetic solution following a palatal injection during the AMSA anesthetic technique.

Pattern of buccal and palatal bone density in the maxillary premolar region: an anatomical basis of anterior-middle superior alveolar (AMSA) anesthetic technique

Background@#The anterior-middle superior alveolar (AMSA) anesthetic technique has been reported to be a less traumatic alternative to several conventional nerve blocks and local infiltration for anesthesia of the maxillary teeth, their periodontium, and the palate. However, its anatomic basis remains controversial. The present study aimed to determine if the pattern of cortical and cancellous bone density in the maxillary premolar region can provide a rationale for the success of the AMSA anesthetic technique.Method: Cone-beam computed tomography scans of 66 maxillary quadrants from 34 patients (16 men and 18 women) were evaluated using a volumetric imaging software for cortical and cancellous bone densities in three interdental regions between the canine and first molar. Bone density was measured in Hounsfield units (HU) separately for the buccal cortical, palatal cortical, buccal cancellous, and palatal cancellous bones. Mean HU values were compared using the Mann-Whitney U test and one-way ANOVA with post-hoc analysis. @*Results@#Cancellous bone density was significantly lower (P ≤ 0.001) in the palatal half than in the buccal half across all three interdental regions. However, there was no significant difference (P = 0.106) between the buccal and palatal cortical bone densities at the site of AMSA injection. No significant difference was observed between the two genders for any of the evaluated parameters. @*Conclusions@#The palatal half of the cancellous bone had a significantly lower density than the buccal half, which could be a reason for the effective diffusion of the anesthetic solution following a palatal injection during the AMSA anesthetic technique.

Phytochemical Screening and Comparative Antioxidant Activities of Fractions Isolated from Sonneratia caseolaris (Linn.) Bark Extracts

Aims: Our study was carried out to appraise the phytochemical screening and antioxidant potentials of Sonneratia caseolaris (Linn.) bark extracts. Study Design: For the purpose of this experiment the extracts were subjected for an in-vitro study. Place and Duration of Study: The study was carried out in August 2014 in the Department of Pharmacy, Southeast University, Dhaka, Bangladesh. Methodology: The various fractions of Sonneratia caseolaris (Linn.) barks as Ethanolic (ETF), ethyl acetate (EAF), chloroform(CLF) and pet ether (PTF) fractions-were obtained after extraction were subjected to preliminary phytochemical screening. The antioxidant capacity of these fractions were evaluated using 1, 1-diphenyl-2-picryl-hydrazyl (DPPH) free radical scavenging assay .Total antioxidant activity and total phenolic content of ETF, EAF, CLF and PTF extracts of S. caseolaris were determined. Results: The phytochemical screening showed the presence of flavonoid, steroid, tannin compounds in large amounts. In DPPH scavenging assay among the extracts, ethanolic fractions exhibited the highest radical scavenging activity with IC50 of 4.57 μg /ml .The highest phenolic content was found in EAF extracts (63.00 mg of GAE / g. of dried extract) followed by CLF (36.25 mg of GAE / g. of dried extract) and PTF (26.28 mg of GAE /g. of dried extract). The highest total antioxidant activity was also found in ETF fraction (185 GAE/g of dried sample followed by EAF fraction (99.00GAE/g of dried sample), PTF (84.00 GAE/g of dried sample) and Chloroform (49.00 GAE/g of dried sample). Conclusion: Our result demonstrates that all the extractives of S. caseolaris have appreciable antioxidant activities. But, further study is necessary to isolate the active compounds.

Can Venous blood gas be a reliable substitute for Arterial blood gas in modern clinical practice?

Background: It is clearly mentioned in the medicine books that blood gas analysis from arterial puncture is the gold standard. But in the past few years it is commonly seen that clinicians have started trusting on venous blood gas analysis as well as started advising VBG (Venous blood gas) in the initial diagnosis of critical patients in emergency setting. Keeping this fact in mind, we designed a study to determine whether VBG could be a better replacement of ABG (Arterial blood gas) in the emergency where diverse pathological conditions are encountered.Methods: This prospective cross-sectional study comprised of 50 patients of 20-60 yrs age with a variety of diagnoses admitted in the emergency department. 50 paired samples (ABG+VBG) were obtained from them under strict aseptic precautions after obtaining their verbal consent. With a minimum delay of less than 2 min blood gas analysis was performed on blood gas analyzer. Parameters (pH, PCO2, PO2, HCO3, Base Excess and O2 saturation) from ABG and VBG were recorded and compared using Student’s Unpaired ‘t’ test.Results: pH and HCO3 showed statistical significant (p value <0.05) differences between ABG and VBG, while BE showed statistical non-significant (p value >0.05) difference between them. Contrary to this, PCO2, PO2 and O2 saturation from ABG and VBG showed statistical highly significant (p value <0.0001) differences.Conclusions: VBG should not be interchangeably considered in place of ABG with regard to pH, HCO3, PCO2, PO2 and O2 saturation in conditions where actual oxygenation status of patient is required (e.g.; hypovolemic shock, respiratory disorders, mechanically ventilated patients, etc.)

Novel deleterious mutation in MYO7A, TH and EVC2 in two Pakistani brothers with familial deafness

Objective: In Pakistan, 74% of consanguineous marriages are among the first cousins. Continuity of consanguineous marriages over generations increases the risk of recessive diseases such as deafness. The objective of this study was to investigate genetic origin of Pakistani deaf brothers with parents of consanguineous marriage

Methods: DNA was extracted from the blood through Qiagen kit. Paired-end sequencing library was prepared according to protocol of Illumina's TruSight Rapid Capture kit and TruSight Inherited Disease Panel. Library was normalized and used for Next Generation Sequencing through MiSeq. NGS data were analyzed using various bioinformatics tools

Results: Both brothers were found to have novel deleterious mutation in MYO7A [c.2476G>A] while the younger brother had additional novel deleterious mutation in TH [c.43C>T] and EVC2 [c.2614C>T] genes

Conclusion: It is concluded that in addition to novel mutations in MYO7A, TH and EVC2, the CDH23 and GJB2 can also be responsible for deafness in the family with consanguineous marriages.

Dengue in Fiji: epidemiology of the 2014 DENV-3 outbreak

Introduction@#Dengue virus serotype-3 caused a large community-level outbreak in Fiji in 2013 and 2014. We aimed to characterize the demographic features of affected individuals and to determine dengue mortality during the outbreak.@*Methods@#All laboratory-confirmed dengue cases and deaths were included in this study. Incidence and mortality were calculated according to demographic variables.@*Results@#A total of 5221 laboratory-confirmed cases of dengue were included in this analysis. The majority of patients were male (54.5%) and indigenous Fijians (iTaukei) (53.5%). The median age was 25 years old. The overall incidence was 603 per 100 000 population. The age-specific incidence was highest among people between 20 and 24 years of age (1057 per 100 000) for both sexes. The major urban and peri-urban areas of Suva and Rewa subdivisions reported the highest incidence of >1000 cases per 100 000 population. A total of 48 deaths were included in this analysis. The majority of dengue-related deaths occurred in males (62.5%) and in the iTaukei (60.4%) population. The median age at death was 35 years old. The overall dengue-related deaths was estimated to be 5.5 deaths per 100 000 population. Dengue mortality was higher for males (6.8 per 100 000) than females. The highest age- and sex-specific mortality of 18 per 100 000 population was among males aged 65 years and older.@*Discussion@#Dengue morbidity and mortality were highest among males, indigenous people and residents of urban and peri-urban locations. Effective and integrated public health strategies are needed to ensure early detection and appropriate outbreak control measures.

In vitro Antioxidant and Cholinesterase Inhibitory Activities of Methanolic Extract of Grewia nervosa L. (Family: Tiliaceae) Leaf

Aims: The methanolic extract of Grewia nervosa L. leaves belongs to the family of Tiliaceae. The purpose of this study was to evaluate total phenolics, total flavonoids, total proanthocyanidins, total antioxidant capacity, iron reducing power capacity, free radical scavenging activity, hydroxyl radical scavenging activity, Lipid peroxidation inhibition activity, anti-acetylcholinestrase activity, anti-butyrylcholinestrase activity, metal chelating activity, total flavonols, nitric oxide radical scavenging activity and phytochemical screening. Place and Duration of Study: The study was carried out between April 2015 to June 2015 in the Department of Pharmacy, Southeast University, Dhaka, Bangladesh. Methodology: Antioxidant activity and neuroprotective activities were determined by several standard methods. Phytochemical screening was done by characteristic colour changes or colour precipitate using standard phytochemical reaction methods. Results: The anti-acetylcholinesterase activity of different extracts of G. nervosa was assessed by a slightly modified Ellman coupled enzyme assay. IC50 of the crude extract and its fractions petroleum ether fraction (PEF), chloroform fraction (CLF), ethyl acetate fraction (EAF) and aqueous fraction (AQF) was found to be 17.07 µg/ml, 15.08 µg/ml, 135.57 µg/ml, 274.78 µg/ml respectively. In butyrylcholinesterase inhibitory assay, the lowest activity was found in PTEF with IC50 value 15.79 and the highest activity was found in CLF with IC50 value 7.55. The crude methanol extract and its different fractions showed considerable total antioxidant activity and reducing capacity. In DPPH scavenging assay and hydroxyl radical scavenging assay, the crude methanol extract showed 79.54% and 89.54% scavenging having IC50 of 11.36 and 15.06 μg/ml respectively. Among the fractions, ethyl acetate exhibited the highest DPPH scavenging activity with IC50 of 14.98 μg/ml, while the petroleum ether fraction exhibited the lowest activity with IC50 of 553.09 μg/ml. In hydroxyl radical scavenging activity aqueous fraction exhibited the highest scavenging activity with IC50 of 14.84 μg/ml, while petroleum ether fraction exhibited the lowest activity with IC50 of 33.39 μg/ml. In the lipid peroxidation assay, crude methanol extract showed significant inhibition of peroxidation at all concentrations, with IC50 of 54.41 μg/ml. Among the fractions, ethyl acetate fraction demonstrated the highest activity with IC50 of 33.46 μg/ml. Conclusion: Observing the in-vitro studies, it can be concluded that the methanolic extract of G. nervosa leaves could be used in different diseases because of its effective pharmacological properties. So, further studies are recommended to isolate the exact compounds responsible for this activity and their efficacy needs to be tested.

Acantholytic Squamous Cell Carcinoma Of Oral Cavity, Mimicker Of Angiosarcoma: A Rare Case Report

Acantholytic squamous cell carcinoma (ASCC) is an uncommon variant of SCC. It was first described by Lever in 1947. It usually develops on sun-exposed areas of older-aged individuals. Histologically, the tumor consists of a nodular, epidermal-derived proliferation that forms islands like structures. At least focally or sometimes extensively, the tumor cells show a loss of cell cohesion within the central gland-like or tubular spaces. The lesions present as slowly growing scaly and occasionally ulcerated papules or plaques. Areas of acantholysis may produce large intraepidermal cavities which may extend to the adjacent follicular structures. ASCC is rarely seen in the oral cavity. Here, we report an unusual case of ASCC of the oral cavity, which was initially misinterpreted as angiosarcoma on histopathology. Then, on immunohistochemistry, ASCC was confirmed.