Atypical Clinical Features in Paediatric Dengue Patients: Is There a Changing Trend?

Background: Dengue fever is the most rapidly spreading mosquito borne viral disease worldwide. It is estimated that the incidence has increased 30-fold over the last five decades. Recently, the reappearance of dengue in the pediatric population is a matter of concern among pediatricians, especially due to the presence of atypical features, leading to delayed diagnosis. There are few studies regarding the changing trendof paediatric dengue patients due to under reporting of the cases.Material & Methods:This prospective study was conducted among forty-five paediatric dengue patients below 15 years of age(n=45)at MH Samorita Hospital & Medical College, Dhaka over a period of 6 months from July 2021 to December 2021. Neonates and patients with co-infection were not included in the study. All clinical and laboratory details were collected during their hospital stay in a structured questionare form.Results:Forty-five paediatric dengue patients below 15 years of age were enrolled in the study (n=45). Out of the 45 cases 35 patients were non-severe dengue (undifferentiated fever, dengue fever with warning signs, and dengue fever without warning signs) and 10 patients were of severe dengue (DHF and DSS) according to WHO guidelines. The male to female ratio was 1.6: 1 in our study group. The majority of the cases 25 (55.5%) were within 6 to 10 years of age. Patients having features of severe dengue were also seen mostly (17.7%) in this age group. The mean age of hospitalized patients was 8.9 years. In our study there were 16 patients (35.6%) with classical dengue fever, 23 (51.1%) patients with dengue hemorrhagic fever without shock and 6 patients (13.3%) with features of dengue shock syndrome. Atypical clinical features were seen in 17 cases (37.8%). The most common atypical features found in twelve children were acalculous cholecystitis (26.7%). Renal impairment and hepatitis were present in 17.8% and 13.3% of patients. Among neurological manifestations two patients (4.4%) developed impaired consciousness and one patient (2.2%) had seizure. Conclusion:Atypical manifestations of DF can be fatal in many paediatric patients. There should be a high index ofsuspicion among clinicians for timely detection and management of atypicalmanifestation of severe dengue infection to prevent mortality.

Impact of supplemental vitamins and natural honey for treatment of COVID-19: A review

Abstract The main aim of the paper is to assess whether vitamin C, vitamin D, and natural honey can be administered in the course of the COVID-19 pandemic for promising in line methods with recent evidence. Both systematic literature and clinical trial identification were conducted by searching various databases. A total 58 articles and 29 clinical trials were selected wherein 11 for vitamin C, 16 for vitamin D, and 2 for natural honey were identified for analysis. The high doses of vitamin C (i.e. '200 mg/kg body weight/day, divided into 4 doses') has been found to reduce COVID-19 lung damage, various flu infections. Additionally, the high doses of vitamin C can shorten around 7.8% stay in the intensive care unit. At the same time, vitamin D can effectively protect from lung injury and acute respiratory infections whereas vitamin D deficiency severely affects 75% of the institutionalized people (serum 25(OH) D < 25 nmol/L). Meanwhile, natural honey which contains proteins (0.1-0.4%); ash (0.2%); water (15-17%) has potential antiviral effects and the ability to improve immunity. Therefore, the administration of vitamins and honey is the promising evidence-based approach for reducing fatalities, saving lives, and bringing the COVID-19 pandemic to a rapid end. It is believed that the utilization of vitamin C, vitamin D, and natural honey with the current treatment may be effective in treating COVID-19-caused fatal complications such as pneumonia. Therefore, high-level clinical studies are required on COVID-19 to administrate the effects of vitamins and natural honey

KAP Study of Tobacco Users among the Garment Workers at Dhaka City in Bangladesh

The readymade garment (RMG) industry is a key sector of Bangladesh economy. This sector brings in about 78% of the country’s total merchandize export earnings. More than 3.2 million people are working in this sector and mostly females from underprivileged social classes.Employment in this Ready-made garment sector in Bangladesh provides workers with economic benefits and some empowerment. A descriptive cross-sectional study followed by a qualitative approach was utilized. Through proportionate quota sampling, 560 garments workers were recruited from 6(one large, two medium, and three small) garment factories in Mirpur area of Dhaka city.Almost all of the garments workers knew that both smoking and smokeless tobacco (98.4%) is harmful for health. Knowledge on specific health hazards of smoking (96.96%) tobacco was relatively higher than those of smokeless (90%) tobacco. Electronic media (Radio/TV/Cinema) was themost common source of their knowledge (92.9%). In case of smoking tobacco, cancer (63.6%) was the mostly reported disease caused by smoking tobacco, followed by lung cancer (15.7%) and heart attack (11.3%). On the other hand, for smokeless tobacco, cancer (29.8%), followed by oral cancer (26.6%) and lung cancer (15.0%) was mostly reported diseases by the garments workers. Garment workers’ knowledge on tobacco control policy was found to be very low. Only 35.0% knew about the policy. Although few garments workers know about the rules for prohibition of tobacco product in public place (25.7%) and public transport (11.3%), other specific rules under tobacco control policy were not known to majority of them. The present study provides a scientific base regarding current tobacco using practice among garments workers in Dhaka city and their knowledge and attitude towards tobacco. Finding revealed from qualitative analysis of data suggested that now-a-days smoking is considered as a trend; people have to smoke for showing smartness or to maintain social status. Peer influence also plays an important role for initiating and maintaining smoking status. Socio-cultural influence for smokeless tobacco consumption was not well documented by this study which indicated a need for more focused qualitative study.

Evaluation of Antioxidant and Cholinesterase Inhibitory Activities of Hoya parasitica Variegata - An In-vitro Study

Aim: Oxidative stress is responsible for the development of different neurological disorders such as Alzheimer’s disease (AD). In the present study, Hoya parasitica variegata belonging to the family Apocynaceae was evaluated for its cholinesterase inhibitory and antioxidant activities with an objective of searching a new natural source to treat different neurological disorders. Study Design: The methanolic extract of H. parasitica was subjected for in-vitro evaluation which included antioxidant and cholinesterase inhibitory activities. Place and Duration of Study: Department of Pharmacy, Southeast University, Banani, Dhaka-1213, Bangladesh, from July to December 2016. Methodology: The cholinesterase inhibitory and antioxidant activities were assessed by total phenol content, flavonoid content, total antioxidant, iron reducing power capacity, DPPH and hydroxyl radical scavenging capacity, lipid peroxidation inhibition, metal chelating activity as well as acetylcholinestrase (AChE) and butyrylcholinestrase (BChE) inhibitory activities. Results: Total phenolic and flavonoid content of the extract were 53.31 mg of gallic acid and 129.88 mg of quercetin equivalent respectively. The methanolic extract of H. parasitica (MEHP) showed considerable total antioxidant activity and reducing capacity. In DPPH and hydroxyl radical scavenging assay, the MEHP showed IC50 of 485 μg/mL and 39.65 μg/mL respectively. In lipid peroxidation inhibition activity MEHP showed IC50 value of 857.63 μg/mL and exhibited metal chelating activity with IC50 value 961.21 μg/mL. The MEHP represented inhibition of bovine brain acetylcholinesterase and human blood butyrylcholinesterase and the IC50 value was 269.5 μg/mL and 343.14 μg/mL respectively. Conclusion: The results obtained from present study revealed that MEHP has considerable amount of antioxidant activity as well as anti-acetylcholinesterase and anti-butyrylcholinesterase activity suggesting its potential use in different neurological disorders such as AD.

Pharmacological Activities of Youngia japonica Extracts

Objectives: Youngia japonica (YJA), belonging to the family asteraceae, exhibits strong antiallergic, antioxidant and antitumor activities. The present study was carried out to assess the antioxidant potentials, analgesic, anti-inflammatory and CNS depressant activities of different fractions of YJA plant extracts. Study Design: For the purpose of this experiment the different plant extracts were subjected for an in-vitro and in-vivo study. Place and Duration of Study: The study was carried out on March 2015 in the Department of Pharmacy, Southeast University, Dhaka, Bangladesh. Methods: The antioxidant capacity of ethyl acetate (EA), pet ether (PET) and chloroform(CLF) extracts of YJA were investigated for free radical scavenging activity using DPPH and hydroxyl radical scavenging assay. Total antioxidant activity and total phenolic content of different extracts were determined spectroscopically. Analgesic activity was evaluated by using acetic acid induced writhing, formalin test and eddy’s hot plate method. Extracts of YJA were also investigated for anti-inflammatory activity using carrageenan induced hind paw edema model. The CNS depressant activity was evaluated by hole cross test. Results: In DPPH scavenging assay, CLF exhibited the highest DPPH scavenging activity (IC50 9.70 μg/ml). In case of hydroxyl radical scavenging assay, EA extracts showed the most significant activity (IC50 15.09 µg/ml). This result was in line up with the total phenolic content where EA extracts possessed the highest amount of it (43.92 mg of GAE / gm. of dried extract). Moreover, the highest total antioxidant activity was also found in EA fraction (109.30 GAE/gm of dried sample) that rationalizes the previous outcome. All fractions significantly (p<0.01) reduced the writhing and the number of licking in a dose dependent manner (100 and 200 mg/kg). The Extracts also showed significant (p<0.001) inhibition of carrageenan induced paw edema. A statistically significant (p<0.001) decrease in locomotor activity was also observed. Conclusion: The result demonstrates that the YJA has appreciable antioxidant, analgesic, anti-inflammatory and CNS depressant activities.

Antinociceptive and bioactivity of leaves of Murraya paniculata (L. ) Jack, Rutaceae / Antinociceptiva e bioatividade das folhas de Murraya paniculata (L. ) Jack, Rutaceae

The results of antinociceptive and toxicological studies on the ethanol extract of the leaves of Murraya paniculata (L.) Jack, Rutaceae, are reported. The extract (250 and 500 mg/kg dosages) was found to produce a profound antinociceptive activity in a dose dependent manner. The extract showed considerable brine shrimp toxicity (LD50 = 32 μg/mL).

Os resultados dos estudos de atividade antinociceptiva e toxicológicos do extrato etanólico de Murraya paniculata (L.) Jack, Rutaceae são relatados. O extrato (nas doses de 250 e 500 mg/kg) produziu um alta atividade antinociceptiva na forma dose-dependente. O extrato também mostrou considerável toxicidade no teste de Artemia salina (DL50 = 32 μg/mL).

Bioactivity of Excoecaria agallocha / Bioatividade de Excoecaria agallocha

The results of neuropharmacological, microbiological and toxicological studies on the ethanol extract of the bark of Excoecaria agallocha are reported. The extract (100 and 200 mg/kg dosages) was found to produce a profound decrease in exploratory activity in a dose-dependent manner. It also showed a marked sedative effect as evidenced by a significant reduction in gross behaviour and potentiation of sodium thiopental-induced sleeping time. The totality of these effects showed that the extract possesses depressant action on the central nervous system (CNS). The extract of E. agallocha exhibited significant in vitro antibacterial activity against Staphylococcus aureus, Shigella dysenteriae, Shigella sonnei and Enterococci with the zones of inhibition ranging from 11 to 15 mm. While the extract showed considerable brine shrimp toxicity (LD50 = 20 mg/mL), it displayed only low level of toxicity in mice.

Os resultados dos estudos neurofarmacológicos, microbiológicos e toxicológicos do extrato etanólico da casca de Excoecaria agallocha são reportados. O extrato (dosagens de 100 e 200 mg/kg) produziu uma diminuição profunda na atividade exploratória de maneira dose-dependente. Ele também mostrou um efeito sedativo marcante conforme evidenciado por uma redução significativa no comportamento total e potencialização do tempo de sono induzido por tiopental sódico. A totalidade destes efeitos mostrou que o extrato possui ação depressora sobre o sistema nervoso central (SNC). O extrato de E. agallocha exibiu significante atividade antibacteriana in vitro contra Staphylococcus aureus, Shigella dysenteriae, Shigella sonnei e Enterococci com as zonas de inibição medindo entre 11 a 15 mm. Enquanto o extrato mostrou considerável toxicidade em Artemia salina (DL50 = 20 mg/mL), ele exibiu apenas baixo nível de toxicidade em camundongos.