Crop Co-efficient Values of Sunflower for Different Growth Stages by Lysimeter Study.

The experiment was conducted on sunflower (variety BARI Surjomukhi-2) crop during the month of mid-November, 2014 to mid-March, 2015, in a lysimeter (dimension:1 m X 1 m X 1 m size) to measure crop evapotranspiration (ETc) and determine crop coefficient (kc) values at Irrigation and Water Management Division, Bangladesh Agricultural Research Institute, Gazipur. The study was examined by applying four irrigation at an interval of 10, 15, 20, and 25 days allowing drainage within and adjacent the tank. Results reveals that irrigation at 15 days interval produced the highest yield and was considered suitable for estimating ETc and kc. Seasonal total ETc was found as 270.89 mm. The kc values of sunflower under different ET0 methods for initial, development, mid-season and late season ranged from 0.34 to 0.48, 0.80 to 1.10, 1.06 to 1.55, and 0.27 to 0.36, respectively. Among different methods, P-M method gave relatively higher value than those of other methods and also FAO recommended value. Therefore, this information would be a helpful tool for crop water requirement and irrigation scheduling for similar semi-arid climates.

Association between anthropometry, cardiometabolic risk factors, & early life factors & adult measures of endothelial function: Results from the New Delhi Birth Cohort.

Background & objectives: Abnormal endothelial function represents a preclinical marker of atherosclerosis. This study was conducted to evaluate associations between anthropometry, cardiometabolic risk factors, and early life factors and adult measures of endothelial function in a young urban Indian cohort free of clinical cardiovascular disease. Methods: Absolute changes in brachial artery diameter following cuff inflation and sublingual nitroglycerin (400 μg) were recorded to evaluate endothelium-dependent and -independent measures of endothelial function in 600 participants (362 men; 238 women) from the New Delhi Birth Cohort (2006-2009). Data on anthropometry, cardiometabolic risk factors, medical history, socio-economic position, and lifestyle habits were collected. Height and weight were recorded at birth, two and 11 yr of age. Age- and sex-adjusted linear regression models were developed to evaluate these associations. Results: The mean age of participants was 36±1 yr. Twenty two per cent men and 29 per cent women were obese (BMI > 30 kg/m2). Mean systolic blood pressure (SBP) was 131±14 and 119±13 mmHg, and diabetes prevalence was 12 and 8 per cent for men and women, respectively. Brachial artery diameter was higher for men compared with women both before (3.48±0.37 and 2.95±0.35 cm) and after hyperaemia (3.87±0.37 vs. 3.37±0.35 cm). A similar difference was seen before and after nitroglycerin. Markers of increased adiposity, smoking, SBP, and metabolic syndrome, but not early life anthropometry, were inversely associated with endothelial function after adjustment for age and sex. Interpretation & conclusions: The analysis of the current prospective data from a young urban Indian cohort showed that cardiometabolic risk factors, but not early life anthropometry, were associated with worse endothelial function.

Osteosarcoma: an immunophenotypic study for characterization and behavior.

Background: Osteosarcoma is the most common primary bone tumor occurring in second and third decades of life with a second peak later. Biopsy (needle or incision) is necessary for diagnosis along with imaging modalities (X-ray, CT scan etc) and serology. Due to diagnostic dilemma in certain cases and for prognosis of patients, immunohistochemistry is increasingly used. Aims: To assess the pathologic features and determinants of osteosarcoma in patients of the Indian subcontinent that would put an insight into its appearance and behavior. Methods and Material: Forty cases of biopsy proven osteosarcoma were selected over a period of three years. Histopathology was done for tumor typing, along with serology (pre and post-operative serum alkaline phosphatase). In all cases TNM staging and immunohistochemistry for antibodies to Osteonectin (ON) (diagnosis), S100 (differentiation), Ki 67 and Her2 (prognosis) was done. Results: Serum alkaline phosphatase was high in 37 (92%) cases initially and remained high in metastatic and recurrent lesions. Osteonectin was positive in 38 (95%) cases, S100 in 31 (77%), Ki 67 showed overlapping labeling indices between 4.8-18.8% and Her2 showed more positivity in higher stage tumors. Conclusions: Biopsy (along with imaging) is mandatory to diagnose osteosarcoma. Osteonectin is a good immunohistochemical marker to differentiate osteosarcoma from its mimics. For prognostication, serum alkaline phosphatase, post chemotherapy tumor necrosis (more than 90%), lack of Her2 expression are good parameters. S100 and Ki67 were found to have limited role in diagnosis and prognosis of osteosarcoma.

Management of Inferior Vena Cava Injury in a Non Specialized Tertiary Hospital-a Case Report.

Abdominal vascular injury are among the most challenging and lethal injuries in the traumatized patients. Inferior vena cava (IVC) is the most frequently injured vein during the blunt or penetrating trauma. Ligation of IVC, venorrhaphy, venoplasty, end to end anastomosis, endovascular stenting or graft interposition should be considered in selected cases. However most of the procedures require special setting and surgical team. Relatively simple procedure e.g. venorrhaphy produces narrowing of lumen in many cases. Ligation of IVC may result in thrombosis and embolism thus increases morbidity of patients. Here, in the present case the authors report a patient with IVC injury repaired by venoplasty (cavaplasty) with great saphenous vein patch in a non specialized tertiary hospital and it can be performed by a team led by general surgeon.

Comparison of Ondansetron Used Alone and in Combination with Dexamethasone as a Prophylaxis for Postoperative Nausea and Vomiting Following Laparoscopic Cholecystectomy.

Postoperative nausea and vomiting (PONV) is common after anaesthesia and surgery. In patients undergoing laparoscopic cholecystectomy (LC) without antiemetic prophylaxis, the incidence can be as high as 76% which would cause unexpected delay in hospital discharge. This study was designed to compare the efficacy of the ondansetron alone with combination of ondansetron and dexamethasone the given as prophylaxis for PONV in patients undergoing laparoscopic cholecystectomy. One hundred patients undergoing elective laparoscopic cholecystectomy were selected and randomly divided into 2 groups of 50 each. Group I received 4mg of ondansetron intravenously (iv), whereas Group II received ondansetron 4mg and dexamethasone 4mg just before induction of anaesthesia. Postoperatively, the patients were assessed for episodes of nausea, vomiting and need for rescue antiemetic. Complete response defined as no nausea and vomiting during first 24 hours, was noted in 76% of patients in Group I and in 92% of patients in Group II. Rescue anti emetic requirement was less in Group II (4%) than Group I (20%). So it can be concluded that the combination of ondansetron and dexamethasone is more effective in preventing PONV in patients undergoing laparoscopic cholecystectomy than ondansetron alone.

Giant Juvenile Fibroadenoma of the Breast: Report of 2 Cases.

Giant fibroadenomas are benign tumors, but their rapid growth and large size together with their rarity may determine difficulties in the clinical approach. The authors present 2 cases of giant juvenile fibroadenoma of the breast in girls aged 14 and 16 years, and the respective diagnostic workup and conservative surgical treatment. The diagnosis was made on fine needle aspiration cytology which was confirmed on histopathology. These tumours are almost always benign and should be treated with breast conserving surgery.

Stapled Haemorrhoidopexy Compared with Conventional Haemorrhoidectomy--A Systematic Review.

Haemorrhoids are one of the most common anorectal disorders. Conventional haemorrhoidectomy (CH) is the most commonly practiced surgical technique. Stapled haemorrhoidopexy (SH) [procedure for prolapsed haemorrhoids (PPH)] is newly developed method for the surgical management of Haemorrhoids. This review looks at the surgical management of prolapsed haemorrhoids in light of this recent development and suggests a treatment approach based on this current evidence. A Medline, Pubmed and Cochrane data base search was performed using key words "haemorrhoid" or 'hemorrhoid' and staple. Relevant papers e.g. randomized controlled trials, review and metaanalyses from different parts of the world were collected. Data were analyzed and compiled. Though early small RCTs (stapled haemorrhoidopexy comparing with traditional excisional surgery) have shown stapled haemorrhoidopexy is less painful and it is associated with quicker recovery but recent large meta-analyses and long term follow up have shown SH is associated with a higher long term risk of haemorrhoid recurrence and symptoms of prolapse.

Result of Simultaneous Correction of Alar Deformity with Primary Repair of Unilateral Cleft Lip.

Cleft lip and cleft palate has been a recognized congenital malformation from a very early stage in recorded history. The infant born with an orofacial deformity, which leads to develop an unwilling psychosocial problem among the parents and also among the relatives. Successful treatment of cleft is based on overcoming in tissue shortage and repositioning of the tissues in normal anatomical pattern so that it restores both appearance and function. Various modalities of theme, works, observations and involvement of multidisciplinary approaches were tried to achieve better cosmetic, aesthetic and functional aspect in management of cleft face. Poorly performed primary surgery carries a high risk of iatrogenic disturbances of subsequent orofacial growth. Delayed nasal repair in patient with cleft lip did not produce satisfactory aesthetic and functioning result. Aim & objective of the study is to achieve a cosmetically well-accepted face in respect to lip, philtrum and nose of both sides after cleft lip surgery and to reduce the incidence of secondary correction of deformed nose in a patient with cleft lip. In our study total 86 cases are studied according to preformed inclusion and exclusion criteria. Simultaneous correction of alar cartilage deformity at the time of primary repair of cleft lip may lessen the staged operative procedure and markedly reduce the economic burden to the family.

Road Traffic Accidents by 'Nasimon' and 'Karimon'-A Study in Faridpur Medical College Hospital.

Road traffic accidents in Bangladesh have been rapidly increasing with huge mortality through road accidents each year. There are many causes of road accidents in recent years; one important cause is running of locally made improvised three wheelers (flat bed tricycle) in the urban areas and also on the highways, popularly known as 'Nasimon' and 'Karimon'. This prospective study was carried out in Faridpur Medical College Hospital from January through June 2011, to study the accident patients caused by 'Nasimon' and 'Karimon'. Fifty six (12%) patients were of RTA by 'Nasimon' and 'Karimon' out of a total of 468 patients admitted into our hospital during this period. Most patients (41, 73.21%) were male, highest accidents (24, 42.86%) were observed among 21-30 years age group and most victims (33, 58.93%) were belonged to low socioeconomic status. Commonest (31, 55.36%) victims were passengers of 'Nasimon' and 'Karimon' while maximum number of accidents (46, 82.14%) took place in the urban areas and on the highways. Injury pattern of victims were similar to that found in any other road accident patients. These three wheelers 'Nasimon' and 'Karimon' are run in violating of Bangladesh Motor Vehicles Act (1983) as they are totally unfit for plying on the highways. Strict surveillance against these illegal and risky vehicles on the highways and in the urban areas by law enforcing agencies is required as a measure to reduce the burden of road accidents in our country.

A Case Report on Unilateral Double Testicles.

A unilateral double testicle is a rare anomaly characterized by migration of one testicle towards the opposite inguinal canal. The commonest erratic development is the more or less incomplete descent of the testicle along the normal route of descent, which is known as cryptorchidism. In ectopia of the testicles, as opposed to cryptorchidism, the displaced testicle does not descend along the usual route but as it migrates downwards it moves into an entirely abnormal position. Usually the migrating testicle remains on its own side of the body but may end up in an unusual position e.g. in the superficial tissue of the inguinal region above the external ring, in the area of the base of the penis, in the upper part of the thigh, in the region of perineum or in the pelvic cavity. In this case, the right and left testicles were found to descend together on the right side, whereas the left side of the scrotum was entirely empty. The case was treated with 'Bilateral Transeptal Subdartos Orchidopexy'. The case reported here is evidently one of extreme rarity as there are about 148 reported cases since the first described by Von Lenhossek in1886.

Rate of Conversion and Postoperative Complications of Laparoscopic Cholecystectomy in District Level Hospital of Bangladesh..

Laparoscopic cholecystectomy (LC) has become the gold standard for the surgical treatment of gallbladder disease, but conversion to open cholecystectomy and postoperative complications are still inevitable in certain cases. Knowledge of the rate and underlying reasons for conversion and postoperative complications could help surgeons during preoperative assessment and improve the informed consent of patients. We decide to review the rate and causes of conversion and postoperative complications of our LC series. This study included 760 consecutive laparoscopic cholecystectomies from July 2006 to June 2011 at Faridpur Central Hospital and Faridpur Medical College Hospital. All patients had surgery performed by same surgeon. Conversion to open cholecystectomy required in 19 (2.5%) patients. The most common reasons for conversion were severe adhesions at calot's triangle (6, 0.83%) and acutely inflamed gallbladder (5, 0.66%). The incidence of postoperative complications was 1.58%. The most common complication was wound infection, which was seen in 5 (0.66%) patients followed by biliary leakage in 3 (0.40%) patients. Delayed complications seen in our series is port site incisional hernia (2, 0.26%). LC is the preferred method even in difficult cases. Our study emphasizes that although the rate of conversion to open surgery and complication rate are low in experienced hands, the surgeons should keep a low threshold for conversion to open surgery and it should not be taken as a step in the interest of the patient rather than be looked upon as an insult to the surgeon.

A Case Report of Adrenal Pheochromocytoma.

Pheochromocytoma is a rare catecholamine secreting tumour originating usually from adrenal medulla and produces signs and symptoms due excessive catecholamine secretion from tumour. A young female patient of 21 year age presented with paroxysmal attacks of hypertension causing palpitation, dizziness, blurring of vision and headache for last 06 months. Clinical suspicion of pheochromocytoma was confirmed by 24 hour urinary catecholamine level, transabdominal USG and CT scan of abdomen. After having two weeks of preoperative preparation with phenoxybenzamine and propanolol, open surgical removal of pheochromocytoma was done. Peroperative fluctuation of BP was well managed by IV fluid overload, intravenous phentolamine, intravenous esmolol and intravenous ephedrine. Postoperative recovery was uneventful and BP regains to normal range from 1st postoperative day. Pheochromocytoma is a rare cause of hypertension. If the diagnosis of pheochromocytoma is overlooked, the consequences could be disastrous, even fatal; however, if a pheochromocytoma is identified, it is potentially curable, as being one of the cause of surgically correctable hypertension.

Role of Glutathione in Male Infertility.

Infertility is a worldwide problem and in almost 50% of cases infertility results from abnormality of the male partners. Apart from endocrine disorders, definitive cause and mechanism of male infertility is not clear in many cases. Recent evidence indicates that imbalance between pro-oxidant stress and antioxidant defense plays an important role in the pathogenesis of male infertility. Among the endogenous antioxidant systems, reduced glutathione (GSH) plays a significant role in the antioxidant defense of the spermatogenic epithelium, the epididymis and perhaps in the ejaculated spermatozoa. The current study was therefore designed to evaluate any association that may exist between GSH levels and male infertility. Infertile male patients (having female partners with normal fertility parameters; n=31) and age- matched healthy male fertile control subjects (n=30) were included in this study. In addition to medical history, semen analyses including semen volume, sperm count, motility and morphology were done for each subject. As a measure of antioxidant capacity erythrocyte and seminal plasma GSH concentrations were measured by Ellman's method in fertile and infertile male subjects. The infertile subjects were similar to fertile subjects in terms of age. However, semen volume and sperm count was found significantly lower (p<0.001) in infertile males compared with healthy fertile male subjects. Percentage of subjects with abnormal sperm morphology and motility were found higher in infertile group compared with fertile group. The median (range) erythrocyte GSH level did not differ between the two groups (12.62 (0.67-29.82) versus 13.93 (2.10-21.08) mg/gm Hb). However, the seminal plasma GSH level was found markedly suppressed in infertile group (1.64 (0.23-7.50)) compared with fertile group (4.26 (2.32-7.50)) mg/dl (p<0.001). In the present study seminal plasma GSH level was found markedly suppressed along with abnormal values for semen volume, sperm concentration and sperm morphology and motility in infertile subjects compared with fertile subjects. This finding indicates that low level of seminal plasma GSH level may be associated with male infertility.

Initial Experience Of Laparoscopic Incisional Hernia Repair.

The laparoscopic incisional hernia repair is a safe alternative to open mesh repair. The procedure has the advantages of minimal access surgery and lower recurrence rate. A prospective study of laparoscopic incisional hernia repair of our first 11 patients was performed from July 2008 to December 2009. No serious intraoperative or postoperative morbidity was encountered, only two patients developed seroma. The mean operating time was 90 minutes (60 to 180 minutes). The mean day of discharge after surgery was 3 days (2-7 days). No patient developed a recurrence during mean follow up period of 10 months. Laparoscopic repair of incisional hernia has been shown to be feasible, safe and effective. However, careful patient selection and acquiring the necessary advanced laparoscopic surgical skills coupled with the proper use of equipment are mandatory before embarking on this procedure.

Retrograde Jejunogastric Intussusception: A Case Report.

Jejunogastric Intussusceptions is a rare but potentially life threatening complication of a previous gastrectomy or gastrojejunostomy. A 70 years old man presented with severe epigastric pain followed by haematemesis, 8 years after truncal vagotomy and gastrojejunostomy for pyloric stenosis. Ultrasonography revealed dilated stomach with a large intragastric mass which has minimal peristaltic movement. Endoscopy of upper GIT revealed prolapsed segment of jejunal loops through the gastrojejunostomy stoma. Laparotomy disclosed a retrograde type II jejunogastric intussusception and was managed by reduction of jejunogastric intussusception, resection of gangrenous segment and end to end anastomosis. Post operative recovery was uneventful. Retrograde jejunogastric intussusceptions is a rare condition and around 200 cases has been reported since its first description in 1914. Urgent recognition and surgical treatment is mandatory to reduce the mortality rate from this complication.