Role of pre-operative serum IL-6 and CA-125 in the prediction of malignant ovarian tumor

Background: Ovarian cancer is the most lethal gynecological malignancy. The present study was therefore designed to determine the accuracy of IL-6 and CA-125 in the early diagnosis of malignant ovarian tumors. The aim of the study was to evaluate the predictive value of pre-operative serum IL-6 and CA-125 levels in identifying malignant ovarian tumors.Methods: This cross-sectional study took place at BSMMU and NICRH in Dhaka, Bangladesh, from February 2022 to January 2023. It involved 94 women undergoing surgery for suspected ovarian tumors. The Mann-Whitney test was used to compare IL-6 and CA-125 levels between groups. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy were calculated to correlate serum markers with histopathological diagnoses. Statistical analysis used SPSS version 23.0 with significance set at p<0.05.Results: The study involved 94 patients with ovarian tumors, where the mean age was higher in those with malignant tumors. The most common malignant histopathological finding was serous carcinoma (34%), while benign tumors often included endometriotic cysts (12.8%) and mucinous cystadenomas (10.6%). Elevated levels of IL-6 and CA-125 were significantly associated with malignant tumors (p<0.05). Both IL-6 and CA-125 showed high diagnostic accuracy in identifying malignant ovarian tumors when used alone or in combination, as indicated by receiver-operator characteristic curves.Conclusions: Serum IL-6 shows higher sensitivity and specificity for detecting malignant ovarian tumors, both epithelial and non-epithelial, making it a valuable diagnostic tool alongside CA-125 in assessing suspicious ovarian masses.

Chronotherapy in dipper and nondipper hypertension patients, researching sodium in 24 hours urine and serum urotensin II levels

Background: The aim of this research was to study the chronotherapy in patients with differentiated dipper and nondipper hypertension, researching the differences between sodium in 24 hours urine and serum urotensin II. Methods: About 32 nondipper and 29 dipper hypertension patients who have study admission criteria, sodium levels in 24 hours urine, serum urotensin II levels and routine biochemical laboratory tests of were studied. The statistical relationship between the results was analyzed. Results: In the patient group we examined, nondipper patients were found older and predominantly seen in the female patient population. We determined that the dipper patients differed significantly in family history from nondipper patients. Although it is not statistical significance, we observed accordance of treatment who nondipper patients was worse, we have found that serum urotensin II levels can be used at this distinction. Conclusions: It is important to distinguish nondipper and dipper hypertension in terms of the prognosis of hypertension and the efficacy of the treatment. For this reason, we want to underline that nondipper patients are older and predominantly seen in the female patient population. Although left ventricular mass index is important in the course and outcome of hypertension, we determined that is was not useful in distinguishing dipper-nondipper hypertension. We think that serum urotensin II levels will be useful in determining the efficacy of the treatment used, the prognosis of hypertension and the differentiation of nondipper-dipper hypertension.

Assessment of serum IgE level in patients with transfusion related allergic reaction receiving fresh frozen plasma

Background: Blood transfusion is a routine lifesaving medical intervention which is generally regarded as safe when done properly. However, at the same time it also bears considerable risk. The aim of the study was to assess the serum IgE levels in patients experiencing transfusion-related allergic reactions after receiving fresh frozen plasma. Methods: This cross-sectional observational study was conducted at the Department of Transfusion Medicine, BSMMU, from March 2019 to August 2021, focusing on patients aged 5 to 60 years receiving fresh frozen plasma. Patients were included after obtaining informed consent from themselves or their legal guardians in the case of minors, according to the eligibility criteria. Data were analyzed using SPSS version 26, with statistical significance set at p<0.05, employing Chi-square tests and Pearson抯 correlation coefficient for variable comparisons. Results: Raised IgE level was significantly related with transfusion related allergic reaction after receiving fresh frozen plasma (p<0.05). The mean IgE was 521.4�4.6 in patients with reaction and 67.8�.2 in patients without reaction. Significant positive correlation was observed in serum IgE level with age in years. Conclusions: Patients with transfusion related allergic reaction receiving fresh frozen plasma had higher mean IgE levels as compared to those without reaction.

Study of serum ferritin as diagnostic and prognostic biomarker for severity of sepsis: a hospital-based study

Background: The objective of the study was to evaluate serum ferritin levels to define it as a diagnostic and prognostic biomarker for severity of sepsis.Methods: In this hospital-based descriptive type of observational study, conducted at the Department of Pediatrics, NIMS Medical College; 80 children of age group 6 months to 18 years with diagnosis of pediatric sepsis were included. Children were divided into grades of sepsis (sepsis, severe sepsis, septic shock, MODS). Progress of sepsis, severe sepsis, septic shock, and sepsis with MODS was followed with serum ferritin levels on day 1, day 3, day 7, or more than 7 days and one week post recovery.Results: Pneumonia was identified as the most common source of infection. The blood culture positivity rate was 32.5%. E. coli was the most common organism grown on blood culture. Median serum ferritin levels increased as sepsis severity worsened. A significant association was discovered between sepsis severity and CRP levels at the time of admission.Conclusions: There is a consistent pattern of Serum ferritin levels with increasing severity of pediatric sepsis. Routine use of serum ferritin levels in diagnosis and prognostication is both feasible and simple. CRP level correlate well with serum ferritin level for diagnosis of sepsis.

Effect of the mindfulness-based program on stress, anxiety and physiological changes among nurse aid students attending the 9 months course of nurse aid training in Myanmar

Background: Suffering under stress and anxiety was a big challenge for the majority of nurse aid students and it was requisite to pass the 9 months training without attrition to become a qualified nurse aid. Methods: From 1st week of February to 4th week of May, 2023, 104 nurse aid training students (51 participants in intervention group and 53 participants in control group) from 7 tertiary hospitals in the Yangon Region were conducted by a quasi-experimental study. Data collection was done by asking questionnaire for stress and anxiety, and by collecting blood samples to test serum cortisol level. Data was analysed by using SPSS 23 and independent t-test, one-way repeated measures ANOVA and multiple linear regression with propensity score adjustment were applied. Results: The mean changes (before- after- followed up) in the Perceived Stress Scale (PSS) and in the Generalized Disorder Scale (GAD) were significantly different between the intervention and control groups displaying a difference in difference mean change of 4.13 (2.41, 5.86) at p<0.001, 3.02 (95%CI: 1.05, 4.99) at p=0.003 and that of 2.45 (95% CI: 1.24, 3.66), p<0.001, 1.49 (95%CI: 0.16, 2.83) at p=029 respectively. Moreover, there was a significant decrease (before-after 8 week intervention) in the serum cortisol level between two groups showing a difference in difference mean change of 39.66 (95% CI: 4.97, 74.34), p=0.026. Conclusions: This study might observe as supportive evidence of the mindfulness-based program to manage stress and anxiety among nurse aid students.

Níveis séricos de magnésio, sua associação com diabetes mellitus tipo 2 e suas complicações/comorbidades com enfâse na doença cardiovascular / Serum magnesium levels and their association with type 2 diabetes mellitus and its complications/comorbidites, especially cardiovascular disease / Niveles séricos de magnesio y su asociación con diabetes mellitus tipo 2, sus complicaciones/comorbilidades con énfasis en la enfermedad cardiovascular

O diabetes mellitus tipo 2 (DM2) é uma doença que apresenta mecanismos fisiopatológicos multifatoriais e complexos, tendo como base a resistência insulínica (RI) e como consequências as doenças cardiovasculares (DCV). A hipomagnesemia tem sido implicada tanto na RI como em complicações micro e macrovasculares, incluindo-se as DCV que são consideradas a causa mais importante de morbimortalidade no DM2. Neste contexto, o presente estudo visa avaliar níveis séricos de magnésio (Mg) em pacientes diabéticos e sua possível associação com complicações crônicas e comorbidades, tendo como ênfase as doenças cardiovasculares; e identificar possível valor do nível sérico a ser considerado em nossa população a fim de rever sua verdadeira aplicabilidade clínica. Trata-se de estudo transversal, descritivo e analítico, envolvendo 99 pacientes com DM2 de ambos os sexos, atendidos em ambulatório público na cidade de Salvador (BA). Utilizou-se como instrumentos de pesquisa questionário de dados sociodemográficos e antropométricos; recordatório alimentar de 24 horas e análise bioquímica do magnésio sérico. Também foram registradas comorbidades e complicações crônicas dos pacientes, tais como hipertensão arterial, doença arterial coronariana, doença arterial obstrutiva periférica, arritmia cardíaca, acidente vascular cerebral, dislipidemia, neuropatia sensitiva periférica, retinopatia e nefropatia diabéticas. Os dados foram expressos por tabelas de forma descritiva e analítica. Os indivíduos foram divididos em dois grupos, magnésio baixo e normal/alto, e suas variáveis foram comparadas por meio de testes de hipóteses. Nossos achados evidenciaram nível sérico médio de magnésio de 1,97 mg% (IC 1,69 a 2,25 mg%) no total da amostra. Entre aqueles com magnésio baixo, níveis subclínicos estavam presentes em 29 sujeitos (29,3%), e níveis de hipomagnesemia em 34 indivíduos (34,3%). O nível médio do Mg no total da amostra diferiu significativamente (p<0,001) do valor normal ideal, mas não diferiu do considerado subclínico (p 0,311). No grupo com hipomagnesemia houve predomínio do sexo feminino e de pacientes com maior escolaridade. Glicemia de jejum foi mais elevada no grupo Mg baixo, e hemoglobina glicada no grupo Mg normal/alto, mas ambos sem diferença estatística. Níveis baixos de vitamina B12 foram encontrados em 12 pacientes (12,1%) e os níveis mais baixos de magnésio estavam presentes nos pacientes com deficiência de vitamina B12 (1,81±0,24 versus 2,01±0,29) com p=0,027. Antidiabéticos orais foram mais utilizados no grupo com Mg baixo. Não houve diferença entre magnésio sérico, ingestão calórica e magnésio e cálcio alimentares. Pacientes com DCV tiveram média de 2,01 mg% (IC 1,69-2,33 mg%) para o Mg. A doença cardiovascular esteve presente em 47,5% da amostra e pacientes com esta morbidade apresentaram 29,8% de prevalência de hipomagnesemia; infarto agudo do miocárdio (IAM) foi mais frequente no grupo com Mg normal/alto. Nossos dados apontam que hipomagnesemia em pacientes diabéticos deve ser considerada em níveis clínicos e subclínicos. Níveis baixos de Mg também estiveram associados à vitamina B12 baixa. Pacientes que apresentaram doenças cardiovasculares associadas também tiveram importante prevalência de hipomagnesemia incluindo níveis subclínicos, com exceção nos casos de IAM, em que níveis do magnésio sérico mantiveram-se no intervalo considerado normal ideal evidenciado por significativa diferença estatística (p<0,005).

Diabetes mellitus type 2 (DM2) is a multifactorial disease with complex physiopathological mechanisms, in which insulin resistance (IR) and its consequences, such as cardiovascular diseases (CVD), form its basis. Hypomagnesemia has been implicated in IR and micro and macrovascular complications, including CVD, which is considered the most important cause of morbidity and mortality in DM2. This study aims to evaluate serum magnesium (Mg) levels in diabetic patients and its possible association with chronic complications and comorbidities (especially cardiovascular diseases) and to find a possible serum level value to be considered in its population to review its true clinical applicability. This cross-sectional, descriptive, and analytical study involved 99 DM2 patients of all sexes who were served in a public outpatient clinic in Salvador-Ba. A sociodemographic and anthropometric data questionnaire, a 24-hour food recall, and serum magnesium analysis were used as research instruments. The comorbidities and chronic complications of patients, such as hypertension, coronary artery disease, peripheral arterial obstructive disease, cardiac arrhythmia, cerebrovascular accident, dyslipidemia, peripheral sensory neuropathy, diabetic retinopathy, and nephropathy, were also recorded. The data were expressed in descriptive and analytical tables. The individuals were divided into two groups, low and normal/high magnesium, and their variables were compared using hypothesis tests. Our findings showed an average serum magnesium level of 1.97 mg% (IC 1.69 to 2.25 mg%) in the whole sample. In those with low magnesium, subclinical levels occurred in 29 subjects (29.3%)and hypomagnesemia, in 34 individuals (34.3%). The median Mg level in the total sample significantly differed (p<0.001) from the ideal normal value, but failed to do in relation to the subclinical value (p=0.311). The hypomagnesemia group showed a predominance of women and patients with higher education. Fasting glucose was higher in the low Mg group and glycated hemoglobin in the normal/high Mg group, both without statistical differences. Low levels of vitamin B12 occurred in 12 patients (12.1%) and the lowest magnesium levels, in patients with vitamin B12 deficiency (1.81±0.24 versus 2.01±0.29) (p=0.027). Oral antidiabetics were more used in the group with low Mg. Serum magnesium, caloric intake, and dietetic magnesium and calcium showed no differences. Patients with CVD had an Mg average of 2.01 mg% (IC 1.69-2.33 mg%). Cardiovascular disease occurred in 47.5% of the sample. Patients with this morbidity had a 29.8% prevalence of hypomagnesemia. Moreover, myocardial infarction occurred more often in the normal/high Mg group. Data suggest that hypomagnesemia in diabetic patients should be considered at clinical and subclinical levels. Low Mg levels were also associated with low vitamin B12. Patients who showed cardiovascular diseases also had a high prevalence of hypomagnesemia, including subclinical levels, except in cases of myocardial infarction, in which serum magnesium levels remained within the normal ideal range, as evinced by its significant statistical difference (p<0.005).

La diabetes mellitus tipo 2 (DM2) es una enfermedad con mecanismos fisiopatológicos multifactoriales y complejos caracterizada por la resistencia a la insulina (RI) y sus consecuencias, como las enfermedades cardiovasculares (ECV). La hipomagnesemia está asociada con la RI y las complicaciones micro y macrovasculares, incluyendo las ECV, que se consideran la principal causa de morbimortalidad por la DM2. En este contexto, este estudio tiene como objetivo evaluar los niveles séricos de magnesio (Mg) en pacientes diabéticos y la posible asociación con complicaciones crónicas y comorbilidades, con énfasis en las enfermedades cardiovasculares; e identificar un posible valor de nivel sérico para considerar en esta población con el fin de revisar su verdadera aplicabilidad clínica. Se trata de un estudio transversal, descriptivo y analítico, en el cual participaron 99 pacientes con DM2 de ambos sexos, atendidos en un centro ambulatorio público en la ciudad de Salvador (Bahía, Brasil). Se utilizaron un cuestionario de datos sociodemográficos y antropométricos, un recordatorio alimentario de 24 horas y un análisis bioquímico del magnesio sérico. También se registraron las comorbilidades y complicaciones crónicas de los pacientes, como hipertensión arterial, enfermedad arterial coronaria, enfermedad arterial obstructiva periférica, arritmia cardíaca, accidente cerebrovascular, dislipidemia, neuropatía sensorial periférica, retinopatía y nefropatía diabética. Los datos se dispusieron en tablas para su análisis y descripción. Los individuos se separaron en dos grupos: bajo magnesio y normal/alto magnesio, y se compararon sus variables mediante pruebas de hipótesis. Los hallazgos evidenciaron un nivel sérico medio de magnesio de 1,97 mg% (IC 1,69 a 2,25 mg%) en el total de la muestra. Los bajos niveles subclínicos de magnesio estaban presentes en 29 sujetos (29,3%), y la hipomagnesemia en 34 individuos (34,3%). El nivel medio de Mg en el total de la muestra tuvo una diferencia significativa (p<0,001) del valor normal ideal, pero no difirió del valor subclínico (p=0,311). En el grupo con hipomagnesemia hubo predominio del sexo femenino y de pacientes con mayor nivel de estudios. La glucemia en ayunas fue más alta en el grupo de bajo Mg, y la hemoglobina glucosilada en el grupo de normal/alto Mg, pero en ninguno de los dos se encontró diferencia estadística. Los bajos niveles de vitamina B12 se encontraron en 12 pacientes (12,1%), y los niveles más bajos de magnesio estaban presentes en los pacientes con deficiencia de vitamina B12 (1,81±0,24 versus 2,01±0,29) con p=0,027. Los antidiabéticos orales se utilizaron más en el grupo con bajo Mg. No hubo diferencia entre el magnesio sérico, la ingesta calórica, el magnesio y el calcio en la dieta. Los pacientes con ECV tuvieron una media de 2,01 mg% (IC 1,69-2,33 mg%) para Mg. La enfermedad cardiovascular estuvo presente en el 47,5% de la muestra, y los pacientes con esta morbilidad tuvieron una prevalencia del 29,8% de hipomagnesemia; el infarto agudo de miocardio (IAM) fue más frecuente en el grupo con normal/alto Mg. Los resultados demuestran que la hipomagnesemia en los pacientes diabéticos debe considerarse en los niveles clínicos y subclínicos. Los bajos niveles de Mg también estuvieron asociados a bajos niveles de vitamina B12. Los pacientes que presentaron enfermedades cardiovasculares asociadas también tuvieron una alta prevalencia de hipomagnesemia, incluidos los niveles subclínicos, con excepción de los casos de IAM en los que los niveles séricos de magnesio se mantuvieron dentro del intervalo considerado normal ideal, evidenciado por una diferencia estadísticamente significativa (p<0,005).

Quantifying the influence of varying centrifugation spin paces and timespans on serum electrolyte dynamics in an Indian clinical laboratory

Background: A reduction in turnaround time at any laboratory is critical for early assessment. Our aim of the study was to evaluate the effects of various spin paces and timespans on certain serum electrolyte concentrations, such as sodium (Na+), potassium (K+), and chloride (Cl-). Methods: A cross-sectional, observational study was carried out on 66 apparently healthy volunteers. 10 ml of blood was drawn from each and divided into 4 labelled clot vials (2.5 ml in each vial). Concentrations of serum Na+, K+, and Cl- were assessed in 2 groups (1, 2), each with 33 individuals. Group 1 had varying spin pace parameters (1500 rpm, 2500 rpm, 3500 rpm, and 4500 rpm), and group 2 included various timespans (2 min, 5 min, 10 min, and 15 min). The observations were analyzed using statistical package for the social sciences (SPSS). Analysis of variance (ANOVA) was implied along with a post-hoc Tukey test. A p value of <0.05 was considered statistically significant. Results: Mean concentrations of Na+, K+, and Cl- at different spin paces for a fixed runtime of 2mins had statistically no differences between each other: Na+ (p=0.978), K+ (p 0.999), and Cl- (p=0.997). However, there were statistically significant mean differences at various timespans for Na+ (p<0.001), K+ (p<0.001), and Cl- (p<0.001). Conclusions: Our study concludes that Na+, K+, and Cl- concentrations were not altered at various spin paces. A timespan of 2 mins at 4500 rpm outperformed the benchmarks without affecting the results, signifying that it can be routinely chosen for estimating serum electrolytes such as Na+, K+, and Cl-, effectively lowering turnaround time.

Association of serum alpha-1 antitrypsin level with the severity of COPD

Background: Alpha-1 antitrypsin deficiency (AATD) is a hereditary disorder linked to early onset COPD, notably the emphysema variety, but often goes undetected. Low serum AAT levels may impact lung function and correlate with COPD severity. The aim of the study was to detect possible associations of serum AAT level with the severity of COPD patients on the basis of post bronchodilator FEV1 in Bangabandhu Sheikh Mujib Medical University (BSMMU). Methods: A cross-sectional study was conducted at the Department of Respiratory Medicine, BSMMU, Dhaka, from October 2022 to September 2023. Adult patients (?18 years) of both genders diagnosed with COPD based on spirometry were included. COPD was defined per GOLD guidelines, with a post-bronchodilator FEV1/FVC ratio <70%. Severity was categorized based on post-bronchodilator FEV1% predicted. Association between serum AAT level and COPD severity was analyzed using SPSS version 26, with significance set at p <0.05. Results: The study involved 80 COPD patients, with 1.25% showing low serum AAT levels and 98.75% normal. No significant differences in age, sex, or smoking status were observed among severity groups. Mean serum AAT levels varied across severity groups but were not statistically significant (p=0.377). Smoking was prevalent (66.3%), with common comorbidities like hypertension (26.3%), IHD (16.3%), and diabetes mellitus (15.0%). Shortness of breath (95.0%) and cough (92.5%) were common symptoms, with most patients having moderate disease severity (42.5%). Conclusions: The study indicates a weak association between serum AAT levels and COPD severity, with only 1.25% of 80 patients exhibiting low AAT levels.

Serum ferritin levels in children of simple febrile seizures in tertiary institute

Background: Seizure onset is impacted by a number of variables, including genetics, diet, geography, concurrent illnesses, metabolic state, history of head trauma, and blood levels of particular minerals. Due to the fact that iron is required for the proper functioning of a number of enzymes and neurotransmitters in the central nervous system, low blood ferritin levels may lower the seizure threshold. The aim of the study was to determine the association between serum ferritin levels and simple febrile seizures.Methods: The present observational study was conducted in department of pediatrics of a tertiary institute and included a total of 200 study subjects who visited to pediatric OPD/emergency room with febrile illness. The data was collected with the help of a structured clinical proforma. The collected data was recorded in Microsoft Excel sheet and statistical analysis was done with the help of SPSS version 21.0.Results: In our study, the maximum number of the study subjects were between 13 and 24 months (35%) with male to female ratio 1.2:1. In patients with simple febrile seizure the mean Hb level was 9.1�4 gm/dl, the mean MCV was 72.6�4 f1, mean MCH was 23.73�2 pg and mean serum ferritin was 13.4�5 ng/ml as compared to those patients with febrile illness without seizure the mean Hb level was 11.5�2 gm/dl, mean MCV was 82.1�5 f1, mean MCH was 29.6�9 pg and mean serum ferritin was 33.6�.2 ng/ml.Conclusions: It is concluded that the low serum ferritin level is a risk factor of simple febrile seizure.

Efficacy of Dr. SKS hair booster serum for the treatment of hair loss in COVID-19 induced persistent telogen effluvium

Background: Excessive hair shedding occurs in patients with coronavirus disease 2019 induced telogen effluvium. Dr. SKS hair booster serum has demonstrated encouraging benefits in different types of alopecia in previous studies. We sought to evaluate the efficacy of Dr. SKS hair booster serum for the treatment of COVID-19 induced persistent TE. Methods: A total of 500 patients aged 18 to 60 years who had recovered from reverse transcription-polymerase chain reaction proven COVID-19 infection but experienced sustained hair fall even after 6 months were included in the study. One millilitre of Dr. SKS hair booster serum injection was administered intradermally in scalp per session. Efficacy and safety outcomes were evaluated at baseline, 3 and 6 months after the treatment. Results: Approximately half of the patients demonstrated excellent improvement in expert panel global photographic assessment at 3 months (vertex area; 43.6% and frontal area; 46%) that was increased at 6 months (vertex area; 48% and frontal area; 50%). Each patient's clinical condition improved. All patients were satisfied with the results in terms of mean total hair growth satisfaction scale score of five aspects at 3 and 6 months treatment. Conclusions: Intradermal injection of Dr. SKS hair booster serum proves to be effective treatment for hair loss in COVID-19-induced persistent TE.

The association of serum ferritin with preeclampsia and its severity

Background: Preeclampsia, a pregnancy-related condition with heightened blood pressure and organ damage after 20 weeks, prompts concern. Serum ferritin, an iron-storing protein, gauged by blood tests, mirrors iron levels. Investigating link before conception between serum ferritin and preeclampsia could impact how we identify, manage, and treat this condition during pregnancy. Study aimed to assess the association of serum ferritin with preeclampsia and its severity.Methods: This case-control study was conducted in Bangabandhu Sheikh Mujib medical university hospital and Dhaka medical college hospital, Dhaka, Bangladesh from July 2011 to June 2012. A total of 100 pregnant women, comprising 50 cases (Preeclamptic) and 50 controls (Normal pregnant women), were purposively included as study subjects. Data analysis was performed using SPSS version 23.0.Results: In the case group, 64% were with mild and 36% with severe preeclampsia. Mean serum ferritin was significantly higher in cases than in controls (p<0.001); 76% of cases had elevated serum ferritin, compared to 44% in controls (p=0.001). Severe preeclampsia group had a mean serum ferritin of 192.8, mild preeclampsia group had 86.1, and normal pregnant women had 21.7 ng/ml, indicating higher serum ferritin with preeclampsia severity (p<0.001).Conclusions: Preeclamptic cases exhibit significantly elevated serum ferritin levels, with a fourfold increased likelihood compared to normal pregnancies. Furthermore, the severity of preeclampsia is associated with higher serum ferritin concentrations in comparison to uncomplicated pregnancies.

Effect of Murdannia edulis Faden roots on serum prolactin level and mammary glands of lactating female albino rats

Background: Murdannia edulis (Stokes) Faden (Myit-Cho in Myanmar) is a herb which has widely been used to induce or increase lactation by ethnic groups living in Tamu township of Sagaing division in Myanmar. This study aimed to explore the effect of Murdannia edulis on serum prolactin level and mammary glands of the lactating female rats. Methods: The type of the study was laboratory based experimental study. Thirty-six lactating dams were divided into six groups of 6 lactating rats in each group (n=6), namely group I (normal saline) as control, group II (5 mg/kg metoclopramide) as standard, groups III and IV (1 gm/kg and 2 gm/kg watery extract of Murdannia edulis), groups V and VI (1 gm/kg and 2 gm/kg ethanolic extract of Murdannia edulis), respectively. The extract and the drugs were orally administered from day 4 to 15 of lactation. At 16 days of lactation, the heart blood of lactating dams was collected under chloroform anaesthesia and serum prolactin level of dams was measured by using ELISA kit. The histological changes of mammary glands of the rats were also assessed. Results: The significant higher serum prolactin level were seen in ethanolic extract 2 gm/kg body weight treated group when compared to control. Histology of mammary glands in ethanolic extract treated rats showed stimulation of lobuloalveolar cell development. Conclusions: The lactogenic activity of the roots of Murdannia edulis may be due to promoting prolactin secretion and lobuloalveolar cell development of mammary glands.

Association of maternal serum zinc and cordblood zinc with neonatal birth weight

Background: Zinc is essential for optimal fetal growth because of the role of zinc in cellular division, growth and differentiation. Low maternal serum zinc and cord blood zinc has been reported to be associated with low birth weight and, a risk factor for neonatal morbidity and mortality. The aim of this study was to evaluate the association of maternal serum zinc, cord blood zinc with neonatal birth weight.Methods: This case-control study was conducted in department of obstetrics and gynecology of Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from November 2020 to October 2022. A total of 60 women in their postnatal period were included in this study.Results: In the present study, none of the socio-demographic characteristics in both case and control groups were statistically significant (p>0.05). Mean BMI was 23.88±1.36 kg/m2 in cases and 24.39±1.39 kg/m2 in controls, with 16.7% of cases overweight (p>0.05). Cases had lower maternal serum zinc (58.33±27.63 µg/dl) than controls (82.96±16.94 µg/dl), significantly affecting neonatal birth weight (p=0.001, r=+0.406). Low zinc levels (<68 µg/dl) increased the risk of birth weight <2.500 kg by nearly six times (OR 5.67, 95% CI 1.84-17.49; p=0.002).Conclusions: Low birth weight neonates and their mothers have significant zinc deficiency as compared to term neonates and their mothers and this deficiency is correlated with zinc deficiency in mothers of these low-birth-weight neonates.

Acute pancreatitis in pregnancy: a rare case report

Acute pancreatitis (AP) during pregnancy is a rare condition characterized by acute inflammation of pancreas due to premature activation of enzymes resulting in local pancreatic destruction and activation of an inflammatory cascade. This condition is most commonly caused by gall stones, hypertriglyceridemia, idiopathic factors. It’s very rare, incidence being 1 in 1000 to 1 in 12,000 pregnancies. Its more common in multigravida (75%) and relatively uncommon in first trimester. Patient usually present with acute severe pain abdomen radiating to back, nausea, vomiting, fever and anorexia. On examination there can be tachycardia, jaundice, epigastric tenderness, abdominal guarding and rigidity in severe cases. Serum amylase and lipase levels three times upper limit of normal value is diagnostic. Ultrasound remains imaging modality of choice. Vigorous fluid replacement is recommended. Prompt diagnosis and early treatment can prevent maternal and fetal morbidity and mortality. 23 years primigravida with 14 weeks of pregnancy came to outpatient with nausea and vomiting (10-15 episodes per day) and pain abdomen for 3 days. On abdomen examination epigastric tenderness was present. Serum amylase was 1246 Units/litre and serum lipase was 507.3 units/litre. She was given supportive care with IV fluids. Analgesics, antiemetics and antihistaminics were given. Gradually liquids were started and she recovered in 5 days.

Association of maternal serum zinc status with neonatal birth weight

Background: Zinc, a vital micronutrient, plays a significant role in cellular growth and immune function. Insufficient maternal zinc levels can impact fetal growth, leading to low birth weight, a risk factor for neonatal morbidity and mortality. The aim of this study was to evaluate the association of maternal serum zinc status with neonatal birth weight.Methods: This case-control study was conducted in Department of Obstetrics and Gynaecology of Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladeshfrom November 2019 to October 2021. A total of 60 women in their postnatal period were included in this study among which 30 women having a baby weighing < 2.5 kg were considered as the cases and 30 women having babies weighing ? 2.5 kg were enrolled as the controls.Results: In the present study, none of the socio-demographic characteristics in both case and control groups were statistically significant (p > 0.05). Mean BMI was 23.88±1.36 kg/m2 in cases and 24.39±1.39 kg/m2 in controls, with 16.7% of cases overweight (p>0.05). Cases had lower maternal serum zinc (58.33±27.63 mcg/dL) than controls (82.96±16.94 mcg/dL), significantly affecting neonatal birth weight (p=0.001, r=+0.406). Low zinc levels (<68 mcg/dL) increased the risk of birth weight <2.500 Kg by nearly six times (OR 5.67, 95% CI 1.84-17.49; p=0.002).Conclusions: From the findings, it can be concluded that serum zinc status is associated with the birth weight of the neonates. Low serum level of zinc is related to neonatal LBW.

Role of Bougainvillea glabra Stem Extract on Paracetamol and Alcohol-Induced Hepatotoxicity in Rats

The current study investigates the in-vivo hepatoprotective effectiveness of Bougainvillea glabra stem extract against alcohol and paracetamol-induced hepatotoxicity in animal models. The alterations in liver enzymes including serum glutamic oxaloacetic transaminase (SGOT), serum glutamic pyruvic transaminase (SGPT), alkaline phosphatase (ALP), and total bilirubin are studied in rats given B. glabra extract with paracetamol or alcohol to produce hepatotoxicity. The levels of glutathione and lipid peroxidation were also examined, and the outcomes were contrasted with silymarin as the reference. The acute toxicity studies presented the plant extract under category 5 of GHS system, which further motivated the studies for hepatoprotective activity. The induction of hepatotoxicity was confirmed with the elevated levels of serum and tissue biochemical by the administration of paracetamol and alcohol. Under paracetamol as a hepatotoxin, the animals with 200 and 400 mg/kg p.o demonstrated near figures for SGPT and SGOT of the group treated with silymarin with significance. The results were still more appreciative under alcohol as a hepatotoxin. In both cases, the group with 400 mg/kg p.o gave a promising result with the reduced inflammatory cells under histopathological studies.

Clinical profile and outcome of acute kidney injury in preterm neonates in a level three neonatal intensive care unit

Background: Acute kidney injury is an important cause of neonatal mortality and morbidity. Preterm neonates, in particular are a vulnerable population as they are associated with various risk factors, predisposing them to multi-organ injury. Data on AKI in preterm neonates in India are limited. There are several gaps including the risk factors, demographic profile and associations with other comorbidities which remain unanswered. The objectives of this study were to study the clinical profile, outcomes and various associated risk factors of AKI in preterm neonates.Methods: It is a prospective observational study conducted in neonatal intensive care unit of a government medical college hospital in Rajkot, Gujarat, India. 300 preterm neonates with AKI were selected and demographic details, risk factors associated with AKI and outcomes were studied.Results: It was found that among 300 newborns under study, 82% were males, 92% had sepsis, 65% had respiratory distress syndrome, 32% had birth asphyxia, 29% had shock, 30% had exposure to nephrotoxic drugs, 54% had requirement for mechanical ventilation, 94% patients were discharged and 6% patients expired.Conclusions: The most common risk factor associated with AKI was sepsis. The other important risk factors are birth asphyxia, respiratory distress syndrome, and shock. Monitoring of serum creatinine can help in early detection of acute kidney injury.

Comparison of etomidate and propofol as an induction agent to study hemodynamic effects and serum cortisol level following endotracheal intubation in hypertensive patients

Background: The present study aimed to compare hemodynamic parameters (heart rate, blood pressure) and adverse effects (injection pain, myoclonus, postoperative nausea/vomiting) between Etomidate and propofol groups. Methods: Patients were divided into two groups: Etomidate Group E and a Propofol Group P. All hemodynamic data were measured during induction, intubation, and post-intubation up to 15 min. Intravenous cortisol levels were measured at baseline, just after induction and at 24 hours after induction. Results: At 3 min and 5 min SBP was decreased by 22.04% and 18.39% in Group P. At 3 min there was fall in DBP by 20.13% in group P whereas there was an increase in group E by 0.13% which is statistically significant (p<0.001). At 1 min, 3 min and 5 min after intubation, fall in the MAP by 26.07%, 21.08% and 18.60% in group P and 0.77%, 0.42% and 1.30% in group E (p value <0.001). Serum cortisol level immediate after surgery was decrease (54%) in Group E (p value <0.001). In Group P, 40% of the patients and in group E 16.66 % of the patients complained of pain on injection (p value 0.046). Conclusions: The cortisol suppression by Etomidate may be beneficial for intubation stress response. Etomidate is better for its hemodynamic stability over propofol.

Assessment of electrolyte imbalance among benign prostate hyperplasia patients in Western Kenya

Background: Benign prostate hyperplasia (BPH) results in the enlargement of the gland and ultimately obstructs the bladder and the kidney. The effect on the kidney results in the dysregulation of the electrolyte causing electrolyte imbalance. Methods: An analytical cross-sectional study conducted at a tertiary teaching hospital aimed at assessing the levels and severity of electrolyte imbalance among BPH patients. The blood samples were analyzed for electrolytes and PSA levels for both patients and control group. An Independent t-test was used to compare the means of the BPH patients and healthy control subjects. Chi-square was used to determine the association between the electrolyte imbalance and the PSA levels of the BPH patients. Results: The mean age of the BPH patients and the healthy individuals was 65.47�.55 and 64.52�.19 years respectively. Hyponatremia, and hypernatremia were observed in 26.08% (n=104) and 4.22% (n=8) of the BPH patients respectively. There was a statistical significance positive correlation between potassium (K) and sodium (Na) concentrations (r=0.350, p<0.01), as well as a notable positive association between chloride (Cl) and magnesium (Mg) levels (r=0.288, p<0.01). PSA biomarker levels varied among the patients. There was a statistical significance (<0.0001*) difference in PSA levels between the BPH patients and the control group. Conclusions: With high prevalence of electrolyte imbalance among BPH patients there is a need to monitor the electrolytes and PSA levels in the management of BPH aiming at restoration of kidney function.

A comparative analysis of serum phosphorus levels and mineral metabolic markers in non-dialysis and dialysis chronic kidney disease patient: a cross-sectional study

Background: Chronic kidney disease is a major public health problem worldwide. As kidney function declines, it leads to several metabolic abnormalities including dysregulation of mineral metabolism. It is also reported that hyperphosphatemia in patients with advanced kidney disease is associated with an increased risk of mortality and cardiovascular events, and is higher in dialysis-dependent chronic kidney disease (CKD) patients compared to non-dialysis CKD. However, data in the Indian context is limited. Objectives were to evaluate and compare serum phosphorus levels and associated factors in non-dialysis and dialysis CKD patients. Also, the impact of dietary phosphate restriction and the use of phosphate binders on serum phosphorus is analysed. Methods: A cross-sectional study was conducted at a tertiary care hospital in Kolkata, India, with 100 CKD patients: 50 non-dialysis CKD patients and 50 dialysis-dependent CKD patients. Relevant demographic, clinical and laboratory parameters including serum phosphorus, calcium, parathyroid hormone (PTH), alkaline phosphatase, albumin and estimated glomerular filtration rate (eGFR) were collected. Data was analyzed using appropriate statistical tests. Results: Mean serum phosphorus was significantly higher in the dialysis CKD group (6.12±0.34 mg/dl) compared to the non-dialysis CKD group (4.56±0.80 mg/dl). Serum calcium and PTH were also higher while eGFR and albumin were lower in the dialysis CKD group. Serum phosphorus levels increased with advancing CKD stages in the non-dialysis group. Phosphate binder helped phosphorus control in dialysis CKD patients. Conclusions: Our study is in confluence with other reports and dietary phosphate restriction and the use of phosphate binders help optimize phosphorus levels in CKD patients.