Socio-Demographic, Clinical and Diabetes Status of Foot Ulcer Patients

Background: Foot ulcers are considered as a serious complication, especially for patients with diabetes. People with diabetes and people with peripheral vascular disease are more likely to develop foot ulcers. If an infection occurs in an ulcer and is not treated in the proper way, it can develop into cellulitis, osteomyelitis, or gangrene that may require some part of the toe, foot, or lower leg to be amputated. The aim of this study was to find the socio-demographic, clinical, and diabetes status of foot ulcer patients. Material & Methods: This prospective observational study was conducted in the Department of Surgery, Rajshahi Medical College Hospital, Rajshahi, Bangladesh, during the period from March 2012 to August 2012. In total 100 patients with foot ulcers in the different surgical units of the mentioned hospital were enrolled in this study as study subjects. Data from the study regarding age, sex, occupation, smoking habit, and socio-demographic condition were recorded in the prescribed questionnaire. The purposive sampling technique was used for this study. All data were processed, analyzed, and disseminated using MS Excel and SPSS version 23 programs as necessary. Results: In this study, the male-female ratio of the participants was 2:1. The maximum number of patients (42%) were from the age of 51-60 years and the highest number of patients were housewives (28%), followed by farmers (22%). Among the total male patients, 87.88% were smokers. Low HDL was found in 51% of patients and 68% of patients had been suffering from diabetes mellitus,18% from Buerger’s disease and 6% from atherosclerosis, and 8% from malignant foot ulcer. Most of the diabetic patients (95.59%) were hyperglycemic on admission and 55.88% had diabetes for 6-10 years. On admission, 3 patients (4.41%) had controlled blood sugar and 65 patients (95.59%) had uncontrolled blood sugar. Conclusion: The frequency of foot ulcers among the male population was higher than that in females. Concerning occupation of the patients, housewives and farmers were the most prevalent. Smokers were most affected groups among the study population. Pre-diagnosed diabetes mellitus for a long period was one of the major clinical issues in most of the patients. Uncontrolled blood sugar was also seen in majority of the patients regarding clinical background.

Evaluation of Clinical & Functional Outcomes Bristow Latarjet Procedure in the Management of Recurrent Anterior Shoulder Dislocation

Background: Glenohumeral joint is highly susceptible to dislocation due to its wide range of movements. Recurrent anterior shoulder dislocations are common in young adults. The Bristow Latarjet procedure is one of the effective techniques for the treatment of recurrent anterior shoulder dislocation. This study aimed to assess the clinical and functional outcome of the Bristow Latarjet procedure in the management of recurrent anterior shoulder dislocation. Material & Methods: This prospective interventional study was conducted in the Department of Orthopaedic Surgery, BSMMU, from October 2017 to September 2019. Within this period, a total of 40 cases of recurrent anterior shoulder dislocation that meet inclusion criteria were taken as a sample. Patients were evaluated both pre and postoperatively for functional outcomes according to Rowe’s score for instability. A purposive non-randomized sampling technique was used in this study. All the data were compiled and sorted properly and the quantitative data were analyzed statistically by using Statistical Package for Social Science (SPSS-25). The results were expressed as frequency, percentage and mean ± SD. Paired Student’s‘t’ test was performed to compare pre and final postoperative follow-up. The level of significance was calculated at a confidence interval of 95% and p-value <0.05. Results: : In this study age of the patient ranged from 18-40 years and the mean age was 28.2±6.3. 29(72.5). Surgery was done within 4-6 months of the first dislocation in 5 patients, within 6-12 months in 21 patients and after 12 months in 14 patients. The mean (±SD) Rowe score for instability was significantly (p<0.001) higher 6 months after the Bristow Latarjet procedure at 91.87(±9.00) in comparison to preoperative periods 52.62(±18.40). Results were excellent in 32(80%), good in 4(10%), fair in 3(7.5%) and poor in 1(2.5%) patients. 36(90%) patients were in the satisfactory group and only 4(10%) in the unsatisfactory group. Only 1(2.5%) patient developed screw migration, 2(5%) patients developed subluxation, and 1(2.5%) patient developed postoperative arthritis. Conclusion: It can be concluded that the Bristow-Latarjet procedure is a very effective and safe procedure with reduced complications, presenting very satisfactory functional results in the treatment of recurrent anterior shoulder dislocation.

Polysomnographic Outcomes of 62 Patients in Dhaka City a Single-Center Study

Background: Obstructive sleep apnea (OSA) is a very common form of sleep disorder with associated health risks. OSA has been accompanied by more insidious conditions, like hypertension, heart disease, diabetes, stroke, and even daytime somnolence. For the diagnosis of sleep disorders, polysomnography is a comprehensive test. It records the patient`s brain waves, the oxygen level in the blood, ‘breathing and heart rate’, and ‘eye and leg movements during the study. Aim of the study: The aim of this study was to assess the effectiveness of polysomnography in the diagnosis of sleep apnea.Material & Methods:This comparative observational study was conducted in the Department of Otolaryngology &, Head Neck Surgery, Bashundara Ad-Din Medical College and Hospital, Bangladesh during the period from July 2020 to June 2021. In total 62 participants were included in the study population for this study. All the participants were divided into two groups. In group A, there were 5 healthy people without obstructive sleep apnea (No OSA group). On the other hand, in group B, there were 57 obstructive sleep apnea patients (OSA group). Ethical approval had been taken from the ethical committee of the mentioned hospital. Data were analyzed by using MS Office and SPSS version 23 programs as per need.Results:In analyzing the sleep scoring between both the groups, in both TRT minutes and total sleep time minutes we did not find any significant correlation (Table: 2). In analyzing the apnea, in comparing mean (±SD) obstructive, total, and AI calculations, we found significant correlations between the groups (Table: 3, Apnea; P values: 0.036, 0.035, and 0.024 respectively. In comparing different parameters of hypopneas (rule 1A), in most of the events, we found significant correlations except mean (±SD) central (Table 3 hypopneas: rule 1A) even, in comparing total mean (±SD) apneas and hypopneas combinedly we found the P-value as 0.002 (Table:3). In the OSA severity comparison between both the groups, in calculating AHI 1 to<15 events/hour, AHI 15 to<30 events/hour, and AHI ?30 events/hour we found significant correlations (P=.001, Table 3: OSA severity). In assessing the Mean (SD) AHI, OAI, RDI (AI+HI+RI), O2 Desats?3% and O2 Desats?3% Index (ODI) we found significant correlations (P values were 0.001, 0.041, 0.001, 0.003, 0.005 respectively). Besides these, in analyzing both the low SpO2 n (%) and snoring: n (%) there was a significant correlation between the group’s patients (P values were .007 and .001 respectively).Conclusion:Polysomnography may be considered an effective method for detecting measuring and treating obstructive sleep apnea (OSA). Sleep scoring and respiratory events analysis plays an important role in assessing the presence and severity of obstructive sleep apnea.

A Comparative Study on Wound Management by Vacuum Assisted Closure With Low Cost Negative Pressure Wound Therapy and Conventional Moist Wound Dressing

Objective: Moist wound dressing (MWD) therapy,conventionally used for surgical closure after debridement,takes long time to heal and thus it creates considerable logisticand financial burden. In the present study locally developedrelatively low cost negative pressure wound healing therapy(NPWT) equipment based on the Vaccum-assisted closure(VAC) with the MWD for clinical outcome.Materials and Methods: Sixty patients with full thicknesswounds were randomly divided into two groups to be treatedwith VAC and MWD therapies. Treatment efficacy was theprimary outcome variable and it was assessed a semiquantitative scoring of wound conditions and wound surfacemeasurement. The secondary outcomes were complicationsduring therapy and postoperative duration of hospital stay.Results: Initially the proportion of the patients with differentoutcome variables (pain, pus, oedema, wound size, color,bleeding and slough) did not differ significantly between thetwo groups. At the first follow up visit after 3 days all the signsymptom, except oedema and color, started to improve atproportions which were not significantly different between thegroups. In contrast to the presence of oedema among 70%subjects in the MWD group, the sign was present only among40% case in the VAC group (p= 0.02). Similarly, dark red colorwas present in 60% case of the MWD group in contrast to only10% case of the VAC group. At the 2nd follow up visit after 6days, except oedema and color again, all the parameterimproved in the two groups in similar proportions oedema anddark red color were present among 50% and 53% subjects inthe MWD group in contrast to 10% and <10% subjects in theVAC group (p<0.05). In parallel to the earlier improvement inoedema and color (along with other features) the patients inthe VAC group could be released from the hospital earlier ascompared to the MWD group (duration of hospital stay, M±SD,6.86±1.63 in VAC vs 9.44±1.89 in MWD groups, p<0.05).Conclusions: For the treatment of wounds by NPWT, thelocally developed low cost VAC equipment is an acceptabletool with clinical effectiveness comparable to the conventionalMWD therapy and it has an added advantage for quickerclosure of the wounds.

Characterization, prevalence and antibiogram study of Staphylococcus aureus in poultry

Objective To reveal the presence of methicillin resistant Staphylococcus aureus (S. aureus) (MRSA) in poultry samples and to determine the antibiogram pattern against five antibiotics. Methods Samples from different poultry farm of Chittagong city, Bangladesh were examined for S. aureus by different biochemical tests and confirmed as MRSA by identifying the presence of mecA gene using PCR. Antibiotic resistance pattern in S. aureus was determined by antibiotic disk diffusion method. Results In this study, a total of 60 samples (30 from nasal swabs and 30 from cloacal swabs) were used, of which 54 were confirmed as S. aureus by different biochemical tests. Among these, 12 were confirmed as MRSA by detecting mecA gene using PCR. During antibiogram study, both nasal and cloacal samples showed the highest resistance against penicillin-G and the lowest resistance was observed against neomycin. Conclusions Based on the present study, it can be said that different antibiotics are used extensively in poultry that leads to MRSA and is alarming for human health.

Leonurus sibiricus L. (honeyweed): A review of its phytochemistry and pharmacology

Leonurus sibiricus is a herbaceous plant found in many countries in Asia and America. This plant is widely practiced as a remedy for the treatment of diabetes, menstrual irregularities, and bronchitis. The approval of therapeutic implications of any drugs depends on the well characterized mode of actions of the compounds. The bioactive compounds like diterpenes, triterpenes, flavonoids and phenolic acids in Leonurus sibiricus show analgesic, anti-inflammatory, anti-oxidant, anti-atherogenic and anti-hemorrhagic, anti-diabetic, anti-bacterial and allelopathic potency. Interestingly, the expression level of some genes is altered by the crude extract treatments, which are effective against cancers, diabetes and cardiovascular diseases where the molecular mechanisms are yet to be explored. Intriguingly, the extracts significantly induce nitric oxide production by endothelial nitric oxide synthase, a signaling molecule of vasodilation in combination with interferon-γ indicating positive effect on atherosclerosis. Further investigations are required to unlock the effects of bioactive compounds found in extracts at clinical settings.

N-acetyl-L-cysteine and cysteine increase intracellular calcium concentration in human neutrophils

N-acetyl-L-cysteine (NAC) and cysteine have been implicated in a number of human neutrophils' functional responses. However, though Ca²⁺ signaling is one of the key signalings contributing to the functional responses of human neutrophils, effects of NAC and cysteine on intracellular calcium concentration ([Ca²⁺]ᵢ) in human neutrophils have not been investigated yet. Thus, this study was carried out with an objective to investigate the effects of NAC and cysteine on [Ca²⁺]ᵢ in human neutrophils. We observed that NAC (1 µM ~ 1 mM) and cysteine (10 µM ~ 1 mM) increased [Ca²⁺]ᵢ in human neutrophils in a concentration-dependent manner. In NAC pre-supplmented buffer, an additive effect on N-formyl-methionine-leucine-phenylalanine (fMLP)-induced increase in [Ca²⁺]ᵢ in human neutrophils was observed. In Ca²⁺-free buffer, NAC- and cysteine-induced [Ca²⁺]ᵢ increase in human neutrophils completely disappeared, suggesting that NAC- and cysteine-mediated increase in [Ca²⁺]ᵢ in human neutrophils occur through Ca²⁺ influx. NAC- and cysteine-induced [Ca²⁺]ᵢ increase was effectively inhibited by calcium channel inhibitors SKF96365 (10 µM) and ruthenium red (20 µM). In Na⁺-free HEPES, both NAC and cysteine induced a marked increase in [Ca²⁺]ᵢ in human neutrophils, arguing against the possibility that Na⁺-dependent intracellular uptake of NAC and cysteine is necessary for their [Ca²⁺]ᵢ increasing activity. Our results show that NAC and cysteine induce [Ca²⁺]ᵢ increase through Ca²⁺ influx in human neutrophils via SKF96365- and ruthenium red-dependent way.

In vitro Plantlet Regeneration of Four Local Garlic (Allium sativum) Accessions of Bangladesh.

Aims: The genetic improvement of garlic can be achieved by biotechnological manipulations as breeding in this vegetatively propagated crop is limited. The current research was conducted with a view to develop an efficient in vitro regeneration protocol for four local garlic accessions namely, G121, G122, G123 and G124. Place, Duration and Design of Study: The experiment was conducted in the Tissue Culture Laboratory of the Department of Genetics and Plant Breeding, Bangladesh Agricultural University during the period from June 2013 to June 2014 using three-factorial experimental design. Methodology: The root tips, basal disc and leaf base were cultured in MS medium supplemented with 2, 4-Dichlorophenoxyacetic acid (2, 4-D) alone, and with both 2, 4-D and 6-Benzylaminopurine (BAP) together for callus induction and the later for subsequent sub-culturing and proliferation of callus. MS medium supplemented with 1-Naphthaleneacetic acid (NAA) and BAP was used for plantlet regeneration. Results: The percentage of callus induction increased with the increase in the concentration of 2,4- D, starting from 0.5 mg L-1 till 2.0 mg L-1 and declined with further increase in the concentration of 2,4-D. The MS medium supplemented with 2,4-D and BAP showed higher percentage of callus induction and callus proliferation compared to that of with 2,4-D alone. The highest percentage of callus induction was observed in the genotype G124 from the explant basal disc (85%) and in the genotype G121 from the explant leaf base (80%) with 2.0 mg L-1 2,4-D and 2.0 mg L-1 BAP. MS medium supplemented with 2 mg L-1 2,4-D + 0.5 mg L-1 BAP showed highest percentage of callus proliferation (90%) in almost all the genotypes. The highest percentage of plantlet regeneration were observed in the genotype G124 for the explants basal disc (63.33%) in MS medium supplemented with 2 mg L-1 NAA + 1 mg L-1 BAP. The survival rate of the plantlets after acclimatization varied from 40% (in G123) to 70% (in G121). Conclusion: The optimized protocol of plant regeneration from local garlic accessions will be useful for any future garlic improvement programs using biotechnological means.

Protective effects of Acanthopanax divaricatus extract in mouse models of Alzheimer's disease

BACKGROUND: Acanthopanax divaricatus var. albeofructus (ADA) extract has been reported to have anti-oxidant, immunomodulatory, and anti-mutagenic activity. MATERIALS/METHODS: We investigated the effects of ADA extract on two mouse models of Alzheimer's disease (AD); intracerebroventricular injection of beta-amyloid peptide (Abeta) and amyloid precursor protein/presenilin 1 (APP/PS1)-transgenic mice. RESULTS: Intra-gastric administration of ADA stem extract (0.25 g/kg, every 12 hrs started from one day prior to injection of Abeta1-42 until evaluation) effectively blocked Abeta1-42-induced impairment in passive avoidance performance, and Abeta1-42-induced increase in immunoreactivities of glial fibrillary acidic protein and interleukin (IL)-1alpha in the hippocampus. In addition, it alleviated the Abeta1-42-induced decrease in acetylcholine and increase in malondialdehyde levels in the cortex. In APP/PS1-transgenic mice, chronic oral administration of ADA stem extract (0.1 or 0.5 g/kg/day for six months from the age of six to 12 months) resulted in significantly enhanced performance of the novel-object recognition task, and reduced amyloid deposition and IL-1beta in the brain. CONCLUSIONS: The results of this study suggest that ADA stem extract may be useful for prevention and treatment of AD.

Protective effects of Acanthopanax divaricatus extract in mouse models of Alzheimer's disease

BACKGROUND: Acanthopanax divaricatus var. albeofructus (ADA) extract has been reported to have anti-oxidant, immunomodulatory, and anti-mutagenic activity. MATERIALS/METHODS: We investigated the effects of ADA extract on two mouse models of Alzheimer's disease (AD); intracerebroventricular injection of beta-amyloid peptide (Abeta) and amyloid precursor protein/presenilin 1 (APP/PS1)-transgenic mice. RESULTS: Intra-gastric administration of ADA stem extract (0.25 g/kg, every 12 hrs started from one day prior to injection of Abeta1-42 until evaluation) effectively blocked Abeta1-42-induced impairment in passive avoidance performance, and Abeta1-42-induced increase in immunoreactivities of glial fibrillary acidic protein and interleukin (IL)-1alpha in the hippocampus. In addition, it alleviated the Abeta1-42-induced decrease in acetylcholine and increase in malondialdehyde levels in the cortex. In APP/PS1-transgenic mice, chronic oral administration of ADA stem extract (0.1 or 0.5 g/kg/day for six months from the age of six to 12 months) resulted in significantly enhanced performance of the novel-object recognition task, and reduced amyloid deposition and IL-1beta in the brain. CONCLUSIONS: The results of this study suggest that ADA stem extract may be useful for prevention and treatment of AD.

Prevalence of Underweight and Effect of Nutritional Status on Academic Performance of Primary School Children in Chapainawabganj District, Bangladesh

The high prevalence of underweight among children is a serious health concern in Bangladesh. Nutritional status influences students' academic performance directly or indirectly. This study aimed to determine factors that affect the academic performance of students in primary schools. Methods: Data were collected from several schools and madrasahs in Chapainawabganj district, Bangladesh using multistage stratified sampling with proportional allocation technique. Results: The prevalence of underweight children was 32.3%, with 43.0% of them being girls and 21.4% boys. Multiple logistic regression analysis demonstrated that normal weight children were more likely (p3.50) than underweight children. Children with gestational age of 39 to 41 weeks were more likely to obtain good results than those whose gestational age was 37 and 38 weeks. Children who were breastfed for 3.50) compared to their counterparts. Children whose parents had a higher income or higher education had a significantly better chance of obtaining good results compared to their counterparts. Conclusion: These results suggest that childhood nutritional status, parents' education and economic level are significant common factors which affect children's academic performance. Consequently, under-nutrition and poverty can be considered as the major problems for good academic performance of Bangladeshi children and requires attention

Scant Extracellular NAD Cleaving Activity of Human Neutrophils is Down-Regulated by fMLP via FPRL1

Extracellular nicotinamide adenine dinucleotide (NAD) cleaving activity of a particular cell type determines the rate of the degradation of extracellular NAD with formation of metabolites in the vicinity of the plasma membrane, which has important physiological consequences. It is yet to be elucidated whether intact human neutrophils have any extracellular NAD cleaving activity. In this study, with a simple fluorometric assay utilizing 1,N6-ethenoadenine dinucleotide (etheno-NAD) as the substrate, we have shown that intact peripheral human neutrophils have scant extracellular etheno-NAD cleaving activity, which is much less than that of mouse bone marrow neutrophils, mouse peripheral neutrophils, human monocytes and lymphocytes. With high performance liquid chromatography (HPLC), we have identified that ADP-ribose (ADPR) is the major extracellular metabolite of NAD degradation by intact human neutrophils. The scant extracellular etheno-NAD cleaving activity is decreased further by N-formyl-methionine-leucine-phenylalanine (fMLP), a chemoattractant for neutrophils. The fMLP-mediated decrease in the extracellular etheno-NAD cleaving activity is reversed by WRW4, a potent FPRL1 antagonist. These findings show that a much less extracellular etheno-NAD cleaving activity of intact human neutrophils compared to other immune cell types is down-regulated by fMLP via a low affinity fMLP receptor FPRL1.

Effect of arsenic on paracetamol binding to bovine serum albumin using site specific probes.

Arsenic contamination in groundwater is a global health challenge. A large number of people worldwide are affected by arsenic poisoning. Paracetamol is a widely used analgesic-antipyretic drug. Effect of arsenic on paracetamol binding to protein has been investigated using two site specific probes and equilibrium dialysis method was used for the experiment. In absence of any site specific probes free concentration of paracetamol bound to bovine serum albumin increased from 3.95 ± 1.164% to 25.36 ± 1.164%. In presence of site-I specific probe warfarin sodium the % release of drug was steady at around 14%. But in presence of site-II specific probe an increment of free drug concen-tration was observed from 14.38 ± 1.164% to 54.72 ± 1.552%. Thus it can be assumed that the free concentration of paracetamol was increased to a greater extent in presence of arsenic and probably arsenic bound to site-II of BSA. Thus arsenic may displace paracetamol by binding with high affinity binding site, site-II in the BSA and probably arsenic has little effect to site-I.

Effect of arsenic on paracetamol binding to bovine serum albumin using site specific probes.

Arsenic contamination in groundwater is a global health challenge. A large number of people worldwide are affected by arsenic poisoning. Paracetamol is a widely used analgesic-antipyretic drug. Effect of arsenic on paracetamol binding to protein has been investigated using two site specific probes and equilibrium dialysis method was used for the experiment. In absence of any site specific probes free concentration of paracetamol bound to bovine serum albumin increased from 3.95 ± 1.164% to 25.36 ± 1.164%. In presence of site-I specific probe warfarin sodium the % release of drug was steady at around 14%. But in presence of site-II specific probe an increment of free drug concen-tration was observed from 14.38 ± 1.164% to 54.72 ± 1.552%. Thus it can be assumed that the free concentration of paracetamol was increased to a greater extent in presence of arsenic and probably arsenic bound to site-II of BSA. Thus arsenic may displace paracetamol by binding with high affinity binding site, site-II in the BSA and probably arsenic has little effect to site-I.