Attributable risk of Capillaria species in domestic pigeons (Columba livia domestica) / Risco atribuível de espécies Capillaria em pombos domésticos (Columba livia domestica)

Fecal samples were collected from 120 domestic pigeons to determine the Attributable risk of Capillaria spp. The Capillaria spp. was observed in 64 out of 120 (51%) pigeons (70 males and 50 females) under this study. A total of 64 (39 males and 25 females) were found naturally infected with Capillaria spp. with infection percentage of 51% and 50% in males and females respectively. Qualitative examinations include the direct microscopy and faecal floatation while quantitative examination includes McMaster technique (worms load was calculated per gram of the faeces). Month wise Attributable risk showed that eggs of the worms were found to be abundant in the month of July during the present study (60% to 73%) because of high humidity. Very high and very low temperature is not suitable for the proper development of the eggs. Qualitative and quantitative examination revealed that Capillaria spp. was more prevalent in males (51%) than females (50%) but overall there was no significant difference (P>0.05) in the male and female because both individuals invest equal amount of energy in search of food and incubating the eggs. Different breeds of pigeons gave different Attributable risk in different months during the study. Groups of pigeons from different locations showed different variable Attributable risk. Areas with high humidity were more suitable for the development of eggs, which is the reason why higher Attributable risk was observed in Shahdara (75%) area of Lahore, Pakistan.(AU)

Amostras de fezes foram coletadas de 120 pombos domésticos para determinar os fatores de risco de Capillaria spp. Capillaria spp. foi observado em 64 de 120 (51%) pombos (70 machos e 50 fêmeas) neste estudo. Um total de 64 (39 machos e 25 fêmeas) foram naturalmente infectados com Capillaria spp. sendo 51% em machos e 50% em fêmeas. Exames qualitativos incluem microscopia direta e suspensão de fezes, e exames quantitativos incluem a técnica McMaster (vermes são calculados por grama de fezes). O risco por mês demonstrou que ovos dos vermes foram encontrados em abundância no mês de Julho durante o presente estudo (60% a 73%) por causa da alta umidade. Temperaturas muito altas e muito baixas não são adequadas para o desenvolvimento adequado de ovos. O exame qualitativo e quantitativo revelou que Capillaria spp. era mais prevalente em machos (51%) que em fêmeas (50%), mas no geral não houve diferença significativa (P>0.05) entre machos e fêmeas porque ambos investem a mesma energia na busca por alimento e incubação de ovos. Diferentes raças de pombos tem diferentes riscos em diferentes meses durante o estudo. Grupos de pombos de diferentes locais demonstraram risco diferenciado. Áreas com alta umidade eram mais propensas para o desenvolvimento de ovos, o motivo pelo qual maior risco foi observado em shahdara (75%).(AU)

Histopathological Alterations Induced by Naja naja Crude Venom on Renal, Pulmonary and Intestinal Tissues of Mice Model.

Aim: Snake bite causes a significant number of mortality and morbidity throughout the world. So, the current study was carried out to estimate the extinct of damage caused by intraperitoneal introduction of cobra venom on kidney, lung and intestinal tissues of mice model using histological technique. Place and Duration of Study: The entire study including the treatment along with preparing histological slide was conducted in protein science laboratory, Department of Genetic Engineering and Biotechnology, University of Rajshahi, Bangladesh between December 2013 to July 2014. Methods: Twenty five mature female albino mice were divided mainly into two groups as control and envenomated group. Lyophilized Naja naja venom was dissolved in 0.9% NaCl solution and injected intraperitoneally into the mice of the envenomated group at dosages equivalent to LD50 (0.25 mg/kg). Whereas the animals from control group were not received any venomous component. Both groups of animal were sacrificed for histological study and visualized under light microscope. Results: Injection of cobra venom induced a range of histological changes in all envenomated mice comparing with their control. Results from the histopathological examination showed mainly inflammatory cellular infiltration, vacuolation in renal tubules, shrinking of glomeruli, raising space between the walls of Bowman’s capsule in renal tissue and alveolar haemorrhage, inflammatory cellular infiltration and edema in pulmonary tissue. No significant histopathological alterations in intestinal tissue were observed without infiltration and mild hemorrhage. Conclusion: The findings from the current study revealed that, cobra venom at lethal dose causes multiple organ failure in experimental animal which could be considered among the factors that lead to death. By observing the site and the mode of action on tissue level, these findings may help to allay the severity of damage by discovering novel anti venom drug.

Dual use of tobacco among Bangladeshi men.

INTRODUCTION: Dual use of tobacco (using smoking and smokeless forms) in Bangladesh is uncommon in women but common in men. Dual users are at additional risk of cancers and heart diseases compared with a single form of tobacco use. Knowledge about their socioeconomic background is necessary for planning appropriate interventions. We report here socioeconomic background of the dual users of tobacco from a nationally representative survey. METHODS: The study adopted a probability proportionate to size sampling technic of divisional population stratified into urban and rural areas to recruit men aged 25 years or older from their households. A total of 4312 men were recruited. Variables included questions on 20 household assets, tobacco use and other behavioral risk factors, and measurement of body weight and height. RESULTS: The average age of dual users was 46.7 years old compared to 43.4 and 52.3 years for smokers and smokeless tobacco users. Prevalence of “smoking only,” “smokeless only” and “dual use” of tobacco was 40.6%, 15.2%, and 14.2%, respectively. Among all tobacco users, dual users constituted 20%. These dual users had lower educational achievement, rural residence, lower intake of fruit, and higher intake of alcohol. They were more undernourished as indicated by a thin body mass index compared to nonusers and smokers. Dual users were of socioeconomically deprived as measured by wealth quartiles constructed out of household assets. CONCLUSION: Dual use of tobacco is common in Bangladesh, and it is intimately linked with socioeconomic deprivation. Poverty reduction strategy and campaigns should address tobacco control not only tobacco in general, but its dual use in particular.

Fabrication and Optimization of Novel Lornoxicam Matrix Tablets Using 3-Factor 3-Level Box-Behnken Statistical Design: Invitro and Invivo Evaluation.

In the present study efforts have been made to prepare sustained release matrix tablets of Lornoxicam. Matrix tablets were prepared by direct compression method by using Hydroxypropyl methyl cellulose K15 (HPMC- K15), Ethyl cellulose (EC) and Sodium carboxy methyl cellulose (Na-CMC) as polymers in different concentrations. A 3-factor 3- level Box-Behnken statistical design was used as an optimization tool having total of 17 experimental runs with 5 central points. All three polymers were selected as independent variables while %age drug release at various time intervals and hardness were used as dependant variables. In vivo studies were conducted on human plasma using Tenoxicam as internal standered. All the detections were made on SYKNM HPLC. Foriour Transform Infrared Spectroscopy (FTIR) and Differential Scanning Calorimetery (DSC) studies were conducted and no chemical interaction was found between drug and polymers. The drug release mechanism was mainly governed by non-fickian (anomalous) diffusion and zero-order (case II) transport diffusion. Regression analysis was performed on dissolution data obtained with the selected response variables and polynomial models were constructed. Polynomial models were further validated using one way ANOVA and results indicated that all the polymers used have significant effect on selected response (p>0.05). Contour plots and three dimensional response surface curves were drawn. In- vivo studies were conducted on two tablet formulation indicating slow and sustained release of the drug from matrix. From Behnken design it is possible to successfully formulate and optimize Lornoxicam sustained release matrix tablets with three polymers (HPMC- K15, EC and Na-CMC) in combination.

Outcome and prognostic factors of acute meningoencephalitis in children of Southern Bangladesh.

Objective: To estimate the outcome of acute meningoencephalitis (AME) in children and evaluate the impact of prognostic factors. Design and setting: A prospective cross sectional study was conducted in the paediatric ward of Khulna Medical College Hospital from 2007- 2009. Method: All admitted children, aged 1 month to 12 years, satisfying the case definition were enrolled into the study. Cerebrospinal fluid (CSF) was collected for cytology and biochemistry to categorize AME into pyogenic, viral or normal varieties. CSF was tested for common bacterial antigen and, along with serum was also tested for Japanese encephalitis virus antibodies. Patients were monitored twice daily until the final outcome. Results: One hundred and forty children were inducted constituting 2.5% of admissions. Infants (30%) were the worst sufferers. Twenty one (15%) children with AME died which is 4 times higher than the overall mortality (3.8%) in paediatric ward (p<0.001). Among the 11 bacteria positive cases one died from S Pneumoniae. Low GCS score was associated with higher mortality (p<0.05). Eighteen (13%) cases developed neurological sequelae. Paralysis (27%) was the most frequent followed by hydrocephalus (23%) and involuntary movements (14%). Number of sequelae was significantly higher in pyogenic (44%) meningoencephalitis in comparison to non-pyogenic (14%) variants (OR=3.30, 95% CI: 1.08-10.01, p<0.05). Conclusions: Mortality from AME was 15%. Low GCS score was associated with higher fatality.

Predictors of tobacco smoking and smokeless tobacco use among adults in Bangladesh.

Introduction: To examine predictors of current tobacco smoking and smokeless tobacco use among the adult population in Bangladesh. Materials and Methods: We used data from the 2009 Global Adult Tobacco Survey (GATS) in Bangladesh consisting of 9,629 adults aged ΃15 years. Differences in and predictors of prevalence for both smoking and smokeless tobacco use were analyzed using selected socioeconomic and demographic characteristics that included gender, age, place of residence, education, occupation, and an index of wealth. Results: The prevalence of smoking is high among males (44.7%, 95% confidence interval [CI]: 42.5-47.0) as compared to females (1.5%, 95% CI: 1.1-2.1), whereas the prevalence of smokeless tobacco is almost similar among both males (26.4%, 95% CI: 24.2-28.6) and females (27.9%, 95% CI: 25.9-30.0). Correlates of current smoking are male gender (odds ratio [OR] = 41.46, CI = 23.8-73.4), and adults in older age (ORs range from 1.99 in 24-35 years age to 5.49 in 55-64 years age), less education (ORs range from 1.47 in less than secondary to 3.25 in no formal education), and lower socioeconomic status (ORs range from 1.56 in high wealth index to 2.48 in lowest wealth index. Predictors of smokeless tobacco use are older age (ORs range from 2.54in 24-35 years age to 12.31 in 55-64 years age), less education (ORs range from 1.44 in less than secondary to 2.70 in no formal education), and the low (OR = 1.34, CI = 1.0-1.7) or lowest (OR = 1.43, CI = 1.1-1.9) socioeconomic status. Conclusion: Implementation of tobacco control strategies needs to bring special attention on disadvantaged group and cover all types of tobacco product as outlined in the WHO Framework Convention on Tobacco Control (FCTC) and WHO MPOWER to protect people's health and prevent premature death.

Mycotic Aneurysm of Aorta Following Mitral Valve Replacement – A Case Report.

The term mycotic aneurysm refers to aneurysm associated with infection by microorganism. Sir William Osler first coined the term mycotic aneurysm in 1885 by disclosing the relation between abnormal cardiac valves and infection with micrococci not with fungi. An 11 years old female from Feni presented with asymptomatic vascular swelling in abdomen referred by a cardiologist. CT angiogram revealed fusiform aneurysm in distal part of abdominal aorta involving ostioproximal part of both common iliac arteries and saccular aneurysm of distal part of superior mesenteric arteries suggestive of mycotic aneurysm. Patient underwent vascular operation aorto biilliac bypass by PTFE graft with excision and ligation of aneurysm of superior mesenteric arteries .Mycotic aneurysm in bacterial endocarditis is rare. It is a challenging job for the cardiologists, infectious disease specialists and vascular surgeon. Time appropriate skilled prompt surgical management can bring smile for both patients and physicians.

Exporting "failure": why research from rich countries may not benefit the developing world / Exportando "fracasso": porquê a pesquisa de países desenvolvidos pode não beneficiar os países em desenvolvimento

The '10/90 gap' was first highlighted by the Global Forum for Health Research. It refers to the finding that 90 percent of worldwide medical research expenditure is targeted at problems affecting only 10 percent of the world's population. Applying research results from the rich world to the problems of the poor may be a tempting, potentially easy and convenient solution for this gap. This paper had the objective of presenting arguments that such an approach runs the risk of exporting failure. Health interventions that are shown to be effective in the specific context of a Western industrialized setting will not necessarily work in the developing world.

O "gap 10/90" foi inicialmente apontada pelo Global Forum for Health Research. Refere-se ao achado de que 90 por cento dos gastos mundiais em pesquisa médica é voltada a problemas que afetam apenas 10 por cento da população mundial. Resultados de pesquisa aplicáveis provenientes dos países ricos aos problemas dos pobres poderiam ser uma solução tentadora, conveniente e potencialmente fácil para solução desse gap. O artigo teve por objetivo apresentar argumentos de que tal abordagem acarretaria o risco de exportar fracassos. Intervenções em saúde que se mostram efetivas no contexto específico de um país ocidental industrializado necessariamente não funcionará em um país em desenvolvimento.

Evaluation of Serum Levels of Hepatic Enzymes and Plasma Proteins between Different Types of Acute Viral Hepatitis.

This cross-sectional study was carried out in 80 serologically diagnosed cases of acute viral hepatitis to assess and compare the serum hepatic enzymes & plasma proteins between four different types (A,B,C,E), 20 in each group. Hepatitis E, hepatitis B and hepatitis C were more prevalent in males than that in females. The study showed that geometric mean of S.AST of all the four types differed significantly (F= 274.94, p<0.001). Geometric mean of S.ALT, S.AST and S.ALP in cases of HCV were significantly lower than others (p<0.001). Geometric mean of S.ALT & S.AST in cases of HEV were significantly increased than others (p<0.001). But the geometric mean of S.ALP of HBV was significantly higher than others (p<0.001). On the other hand though S.ALP of HAV and HEV was lower than HBV but significantly higher than HCV (p<0.001). The mean±SD of serum albumin of HCV was decreased significantly in contrast to those of HAV and HBV (p<0.001). A:G ratio of HCV was also significantly lower than other three (p<0.001). It was revealed through the study that hepatic enzymes were most affected in cases of HEV but least affected in cases of HCV.

Ebstein’s Anomaly Corrected by Tissue Valve: Case Report.

Ebstein’s anomaly is a rare form of congenital heart disease with incidence of 1% of all congenital heart diseases. There are two modes of surgical correction of Ebstein’s anomaly: either biventricular repair with or without tricuspid valve replacement, or palliative univentricular repair consisting of bidirectional Glenn shunt or Fontan procedure. We treated a case of severe form of Ebstein’s anomaly with ASD secundum with WPW syndrome. Radiofrequency ablation was done to treat WPW syndrome preoperatively. Celermajer’s index is a prognostic indicator for tricuspid valve repair or replacement. On 04.03.08 tricuspid valve was replaced with 31 mm Carpentier-Edwards bovine pericardial valve under cardiopulmonary bypass. Postoperative period was uneventful. Follow up echo done on 01.06.08 which revealed normally functioning tissue valve found in tricuspid position TR Grade I. So, in conclusion, preoperative evaluation and workout of Celermajer’s index is essential before surgical intervention for decision of tricuspid valve repair or replacement. Last but not the least, any event of arrhythmia should be properly evaluated.

Prevalence of ischemic heart disease in a rural population of Bangladesh.

Bangladeshi people, as other South Asians, have high susceptibility to ischemic heart disease (IHD) but population-based data are lacking in Bangladesh. We investigated for IHD burden in a rural population of Bangladesh in 2001. Information was sought on use of medications for IHD and electrocardiogram was done in 447 adults (157 men and 290 women) aged 20 years or older (mean 40 years). Prevalence of IHD defined by presence of pathological Q wave on electrocardiogram or current medication for IHD is 3.4% (95% confidence interval, 1.7% to 5.1%). Prevalence in men (4.6%, 1.3% to 7.9%) was almost twice than in women (2.7%, 0.8% to 4.6%). However, this sex-difference should be cautiously interpreted because of small sample size for men. It appears that IHD is an important problem even in this traditional rural population of Bangladesh.

Identification of serogroups of beta hemolytic streptococci in children with tonsillo-pharyngitis.

Rheumatic fever and post streptococcal glomerulonephritis are common sequelae of beta hemolytic streptococci among Bangladeshi children. The occurrence of these serious complications of beta hemolytic streptococcal throat infections are related to the epidemiology of group A beta hemolytic streptococci. Little is known about the epidemiology of beta hemolytic streptococci in Bangladesh. We have studied 6890 school boys and girls of Narayangonj to find out the prevalence of beta hemolytic streptococcal infections of throat. From them we selected 2175 children, who were suffering from tonsillo-pharyngitis. This cross sectional study was conducted during March-December 1999. All statistical analysis was done by using statistical package SPSS windows version 8. The mean (SD) age of the children was 11.1 (3.3) years. Four hundred and twenty eight isolates of beta hemolytic streptococci were recovered from tonsillo-pharyngeal swab cultures obtained from 428 children. Among the isolated beta hemolytic streptococci, 92 (21.5%) belonged to group A, 5 (1.2%) to group B, 14 (3.3%) to group C and 317 (74.0%) to group G. These findings demonstrated the predominance of group G followed by A infection among school children. Therefore special attention should be paid not only to group A but also to group G. Further studies to determine prevalence of M serotypes are necessary.

Antioxidant vitamins improves hemoglobin level in children with group a beta hemolytic streptococcal infection.

A study was done on school children infected with group A beta hemolytic streptococci to examine whether antioxidant vitamins play a role in improving the hemoglobin level. A total of 606 primary school children aged 5 to 15 years were randomly divided into two intervention groups. Group 1 (n=299) was treated with pehnoxymethyl penicillin V and group 2 (n=307) was treated with phenoxymethyl penicillin V plus antioxidant vitamins for eight weeks. From each group two blood samples were drawn in acute and convalescent (after eight weeks) states. Before treatment, mean hemoglobin values were 11.0 and 10.8 mg/dL in groups 1 and 2 respectively. After treatment hemoglobin values were 10.5 and 11.6 mg/dL respectively. Values were significantly decreased in group 1 (P=0.0001), whereas increased in group 2 (P=0.001). Adjustment for age and sex by ANCOVA confirmed the difference in hemoglobin levels between group (LS means-0.5 vs 0.8 in groups 1 and 2 respectively (P=0.0001). Hemoglobin level increases after antioxidant vitamin supplementation in children suffering from group A beta hemolytic streptococcal infection.

Streptococcal antibodies among rural school children in Bangladesh.

The upper limit of normal values of group A streptococcal antibodies should be known for a population concerned because it is influenced by many local conditions. As yet the reference value of the these antibodies has not been determined by using a quantitative method among Bangladeshi children. We determined the reference value of anti-streptolysin O and anti-deoxyribonuclease B among 361 apparently healthy rural Bangladeshi primary school children (aged 5 to 14 years, mean 9.2 years). Anti-streptolysin O was measured by an auto-analyzer and antideoxyribonuclease B was measured by microtitre method. The geometric mean titres for the entire group was 241 IU/ml and 222 IU/ml for anti-streptolysin O and anti-deoxyribonuclease B respectively. The upper limit of normal values (80th percentile) was 390 and 340 for anti-streptolysin O and anti-deoxyribonuclease B, respectively. These limits should be of value to physicians, epidemiologists and clinical laboratory personnel as well.

Dissecting the contradictory findings of angiotensin converting enzyme genetic polymorphism with blood pressure and hypertension.

The studies on the association of deletion/insertion (D/I) polymorphism of angiotensin converting enzyme (ACE) gene with blood pressure and hypertension reported contradictory results. We review the articles that considered blood pressure or hypertension as the main outcome measure to have an overview of the situation. There is heterogeneity of allele frequencies of ACE locus among ethnic groups. In descending order of D allele frequencies, ethnic groups are: Gulf Bedouin (0.657), Black (0.597), White (0.577), Chinese (0.400), Japanese (0.377), Bangladeshi (0.374) and Indian Sikh (0.373). Multiple studies were available for the Caucasians and Japanese with relatively large sample sizes. Three out of five studies in the Caucasians found association either in males or in females with blood pressure or hypertension. None of the three Japanese studies observed an association. So, ACE locus may be considered a marker for blood pressure or hypertension in the Caucasians but not in the Japanese. This racial difference is not surprising, because heterogenecity of ACE activity according to ACE genotypes has been reported among ethnic groups, and important differences in environmental factors persist. Studies in other populations were either small or sampling procedures were not adequately described. Given that the studies varied in designs, settings, sample size, and adjustment for confounding variables, adequately powered large-scale multicentre, multi-ethnic population-based studies using same method are required to resolve this contradiction.

Incidence of spontaneous echocontrast in left atrium in mitral stenosis detected by transoesophageal echo cardiography and related factors.

The incidence of left atrial (LA) spontaneous echo contrast (SEC) and the clinical and echocardiographic variables related to it were prospectively evaluated in a series of 60 patients with mitral stenosis (MS) undergoing transoesophageal echocardiography (TEE) with a 5 MHz multiplane transducer. LA-SEC was found in 39 patients (65%) employing TEE. Statistical analysis showed a significant relationship between the presence of SEC and MS without mitral regurgitation (MR) (P < 0.05), MS with < or = MR grade II (P < 0.05), atrial fibrillation (P < 0.001) and increased left atrial dimension (P < 0.05). Age, sex, mitral valve area and ejection fraction did not show any positive association (P > 0.05). Thus, it is concluded that LA-SEC is a common finding observed in approximately 65% of MS patients undergoing TEE and associated with conditions favouring stasis of left atrial blood.

Humoral immune response in a sample of Bangladeshi children with rheumatic fever.

Several researchers have investigated cellular response, and antibody response to different antigens of group A beta-haemolytic streptococci, cardiac tissues and B cell alloantigen in rheumatic fever (RF). However, immunoglobulins (Ig) which may indicate general immune status did not receive attention. This study was done in the outpatient clinic of the National Center for Control of Rheumatic Fever and Heart Diseases, Dhaka, to compare Ig levels in subjects with and without RF who have had recent group A beta-haemolytic streptococcal infections. We have recruited 44 RF cases aged 5 to 20 years, and 44 subjects without RF were randomly matched for age and sex as controls. Convalescent blood samples were used to measure antistreptolysin O and IgG, IgM, and IgA levels. The cases, as compared with the controls, had significantly higher levels of antistreptolysin O (mean 399 versus 321 IU/ml), IgG (mean 2386 versus 1885 mg/dl), IgM (mean 286 versus 222 mg/dl) and IgA (mean 258 versus 184 mg/dl). It is not clearly known why the immune response is higher in the RF cases. We have to elucidate factors responsible for higher immune response in children with RF.

Association of angiotensin converting enzyme (ACE) gene polymorphism with hypertension in a Bangladeshi population.

The association of angiotensin converting enzyme (ACE) gene insertion/deletion (I/D) polymorphism with hypertension has not been confirmed. Inconsistencies may be due to the differences of background population characteristics. Till date, there has been no report in Bangladeshi population. This study was to examine the association of ACE (I/D) polymorphism with hypertension. Fifty-one primary hypertensives and fifty-two normotensives were recruited from a hospital in Dhaka city. Height, weight and blood pressure were measured. ACE (I/D) genotypes was established using polymerase chain reaction protocol. The genotype and allele frequencies did not differ significantly (P > 0.05) between the groups. In logistic regression analysis, adjusted for age, sex and body mass index, the genotypes were not associated with hypertension (DD vs II: Adds ratio = 2.6, P = 0.34; ID vs II: 0.4, 0.23; ID + DD vs II: 0.8, 0.69). In this hospital-based sample of Bangladeshi people, significant association of ACE I/D genotype with hypertension was not observed.