Prevalence of Cardiotoxicity Induced by Chemotherapy Measured by Dobutamine Stress Echocardiogram (DSE) in BSMMU

Background: Cardiotoxicity related to cancer treatment is an alarming source of significant morbidity and mortality, and may differ from subclinical myocardial dysfunction to irreversible heart failure or even death. DSE is a safe, feasible, and accurate modality for finding of myocardial ischemia and prognostication in patients with known or suspected coronary artery disease, particularly when they have limited exercise capacity.Materials& Methods:This study is a cross-sectional observational study which was conducted at the department of Cardiology, in BSMMU, Dhaka from June 2019- December 2019. The sample size for this study was 50.Results:The mean age was 56� where 17(34%) of the respondents were <65 years and 33(66%) were >65 years. The male respondent was 35(70%) where female was 15(30%). Diabetes was found in 3(6%) cases and followed by Acute ischemia, Hypertension 6(12%), Coronary Artery Disease (CAD) 4(8%), ACE-inhibitors 5(10%), Beta-blockers 3(6%), Nitrates 3(6%). Acute leukemia was found in 13(26%). in M12-18 was 45�and followed by mean of LVESD (mm) was 27� 29� 29� 30� 30� 31� Mean of IVSd (mm) was 9� 9� 9� 9� 8� 8� Mean of Peak E (cm/s) was 80�, 76�, 74�, 73�, 66� 63� and the p-value was seen <0.001 which denotes a significant improvement in treatment (p<0.005).Conclusions:The early discovery of cardiotoxicity may ensure the improved chemotherapeutic process and timely management of the treatment of cardiomyopathy, such as beta-blockers and ACE inhibitors.

Factors associated with length of stay in the Emergency Department: A narrative review

@#BACKGROUND: Increasing demand and complex procedures may associate with the length of stay (LOS) in the Emergency Department (ED). Prolonged LOS may decrease the quality of ED care and increase patient harm. Therefore, it is pivotal to analyze factors that may contribute to ED LOS. OBJECTIVE: This review aimed to identify and discuss factors that contribute to the Emergency Department length of stay (ED LOS) to improve the quality of care. METHODS: Relevant healthcare databases including PubMed and CINAHL were searched using the combinations of search terms: length of stay, length of visit, emergency department, emergency room, and patient flow. Inclusion criteria included publications between 2007-2017. RESULTS: A total of 24 relevant papers was selected. The literature indicates that three main factors are associated with ED LOS: input (older patients and acuity level), throughput (diagnostic tests and or radiology, specialist consultation), and output (need for admission and boarding time). CONCLUSION: Input, throughput, and output factors are contributed to ED LOS. Further review is necessary to determine organizational factors that may contribute ED LOS including the number of health staff, staff workload, flow studies, and health system.

Effect of senescence on some apoptosis and oxidative stress markers in infertile normozospermic and oligospermic men: a cross-sectional study

Background: male senescence may affect testicular function, sperm indices and generation of high levels of oxidants and apoptosis

Objective: this study evaluates the effect of male age on the expression of some apoptosis and oxidative stress markers in seminal fluid of males investigated for infertility in a tertiary health institution in Nigeria

Materials and Methods: in this cross-sectional study, 122 men aged 20-60 yr. who were investigated for infertility and were stratified according to age into four groups. Seminal plasma caspase 3, cytochrome C, and total antioxidant capacity [TAC] were assayed by ELISA technique, while manual semen analysis was performed according to WHO standard

Results: seminal caspase 3 and cytochrome C activity increased while TAC and sperm indices decreased with increasing age. Cytochrome C [r=0.288; p=0.002] and caspase 3 [r=0.250; p=0.05] correlated significantly with age in normospermia while cytochrome C [r=0.314; p=0.02], caspase 3 [r=0.268; p=0.05], TAC [r=-0.342; p=0.01] and morphology percentage [r=-0.414; p=0.002] correlated with age in oligospermic infertile males

Conclusion: the measured apoptotic markers increased with increasing age while TAC and sperm indices decreased with increasing age of subjects evaluated. Although the levels of measured apoptosis and oxidative stress markers correlated with age in normozospermia, the effect on sperm indices was severe among oligospermia compare to normozospermia. Therefore, these markers may be assayed in aged men attending fertility clinics

Hypoglycemic, Hypolipidemic and Antioxidant Potentials of Aqueous and Ethanolic Leaf Extracts of Anacardium occidentale in Alloxan Induced Type I Diabetic Rat Model.

Aim: The current study investigated the hypoglycemic, antioxidant and hypolipidemic effects of the aqueous and ethanolic leaf extracts of Anarcardium occidentale in alloxan-induced diabetic rats. Study Design: In vivo experiment. Place and Duration of Study: Department of Biochemistry, Adekunle Ajasin University, Akungba-Akoko, Ondo State, Nigeria, between Oct 2011 and Jan 2012. Methodology: Diabetes was induced in albino rats by the administration of alloxan (150 mg/kg b.w.) intraperitoneally. Aqueous and ethanolic extracts of A. occidentale (200 mg/kg b.w.) were administered by oral gavage once a day for a period of 21 days. The effect of the extracts on blood glucose, lipids, total protein, liver marker enzymes and also on enzymatic antioxidants of defence systems such as superoxide dismutase (SOD), catalase (CAT), enzyme activities, in liver and pancreas were studied. Results: Both aqeous and ethanolic extracts of A. occidentale reduced the blood glucose, total cholesterol (TC), triglycerides (TG) levels, total protein and activity of alanine aminotransferase (ALT), aspartate aminotransferase (AST) and alkaline phosphatase (ALP) in alloxan-diabetic rats. The extracts also significantly mitigated the increase in malonyldialdehyde (MDA) level, and increased SOD and CAT activities in both liver and pancreas. The levels of high-density lipoprotein (HDL) were significantly increased in A. occidentale treated diabetic rats in comparison with control group. Our findings suggest that both extracts of A. occidentale prevented the alloxan-induced hyperglycemia and increased MDA levels. These effects could be attributed to the presence of bioactive phytochemicals present in these extracts. Conclusion: These results suggest that A. occidentale extracts possess hypoglycemic, hypolipidemic and antioxidant properties.

The role of protein phosphatase 2A B56β holoenzyme in the regulation of heavy metal CdCl2 induced cytotoxicity / 中华预防医学杂志

<p><b>OBJECTIVE</b>To investigate the role of holoenzyme containing Protein Phosphatase 2A B56β in regulating CdCl2 induced cytotoxicity.</p><p><b>METHOD</b>CdCl2-induced cytotoxicity in normal human cell line L-02, AFB1-transformed hepatic cell line L-02 RT-AFB1 and tumor cell line Bel7402 was measured by modified MTT assay. Stable cell lines L-02 SHAKT, L-02 SHB56β, L-02 RT-AFB1-B56β and Bel7402-B56β were generated by infecting L-02 cells or Bel7402 cells with retroviral vectors encoding lentiviral AKT shRNA, lentiviral B56β shRNA and B56β. The relative cell viability was measured in normal human cell line AFB1-transformed hepatic cell line and tumor cell line when treated by CdCl2 (0, 20, 40, 80, 160 µmol/L). After treated by wortmannin (2.5, 5.0 µmol/L) combined with 40 µmol/L CdCl2, Western blot was applied to measure the expression of associated protein in L-02.Western blot was applied to measure the expression of B56β, MT (metallothionein), AKT, and p-AKT in these cell lines treated by CdCl2.</p><p><b>RESULTS</b>The levels of MT were 0.12 ± 0.02, 0.06 ± 0.06 in L-02 RT-AFB1 and Bel7402, which were lower than L02 (0.92 ± 0.14) (F = 1 148.16, P < 0.001) when treated by 40 µmol/L CdCl2. When treated by 40 µmol/L CdCl2, the expression of p-AKT in L-02 SHAKT-1 and L-02 SHAKT-2 were 0.08 ± 0.02, 0.08 ± 0.05, which levels were lower than L-02 SHGFP (0.18 ± 0.15) (F = 724.70, P < 0.001); and the expression of MT were both 0.62 ± 0.16 in L-02 SHAKT-1 and L-02 SHAKT-2, which levels were higher than L-02 SHGFP (0.22 ± 0.14) (F = 94.73, P < 0.001). After treated by wortmannin (2.5, 5.0 µmol/L) combined with 40 µmol/L CdCl2, the expression of p-AKT in L-02 were 0.28 ± 0.07, 0.15 ± 0.11, which levels were lower than wortmannin untreated cells (0.52 ± 0.11) (F = 578.57, P < 0.001); and the expreesion of MT were 1.62 ± 0.80, 1.08 ± 0.15, which levels were higher than wortmannin untreated cells (0.69 ± 0.18) (F = 12.34, P < 0.001). When treated by 40 µmol/L CdCl2, the levels of p-AKT in L-02 SHB56β-1 and L-02 SHB56β-2 were 0.57 ± 0.13, 0.59 ± 0.02, which were higher than L-02 SHGFP (0.32 ± 0.02) (F = 87.16, P < 0.001); and the levels of MT were 0.35 ± 0.07, 0.20 ± 0.03 in L-02 SHB56β-1 and L-02 SHB56β-2, which were lower than L-02 SHGFP (1.51 ± 0.13) (F = 2 457.10, P < 0.001). After treated by 40 µmol/L CdCl2, the expression of p-AKT in L-02 RT-AFB1-B56β and Bel7402-B56β were 0.10 ± 0.11, 0.09 ± 0.01, which were lower than L-02 RT-AFB1 (0.36 ± 0.01) and Bel7402 (0.43 ± 0.11) (F = 877.62, P < 0.001); and the levels of MT were 0.92 ± 0.13, 0.95 ± 0.08 in L-02 RT-AFB1-B56β and Bel7402-B56β,which were higher than L-02 RT-AFB1 (0.44 ± 0.12) and Bel7402 (0.77 ± 0.06) (F = 51.97, P < 0.001).</p><p><b>CONCLUSION</b>Protein phosphatase 2A complexes containing B56β participated in the regulation of MT expression through direct dephosphorylation of AKT, finally affected the cytotoxicity responding to CdCl2. Our study revealed a key signaling pathways of PP2A involved in heavy metals induced cytotoxicity.</p>

Non-doctor consultations and self-medication practices in patients seen at a tertiary dental center in Ibadan.

Aim: The aim of this study was to determine the prevalence of self-medication practices among dental out patients presenting at a tertiary health care center in Ibadan, and to determine factors that are associated with these practices. Materials and Methods: All patients presenting over a 4-month period, who consented to participate in the study, had a semi-structured questionnaire, highlighting age, sex, income and educational qualification, history of past practice of self-medication, substances used and reasons for resorting to self-medication administered to them. Data obtained were analyzed with the SPSS 12.0.1 software. Frequency tables were generated and statistical relationship between the variables was analyzed using the Chi-square test. Statistical significance was set at P>0.05. Results: There were 108 (38.03%) males and 176 (61.97%) females. A total of 139 (48.9%) of the respondents claimed that they have been involved in self-medication. 54.7% of the people involved in self-medication were female, while 41.7% were male. There was a statistically significant difference in self-medication between males and females (P=0.001). 71.2% of the respondents had post-secondary education and only 28.8% had secondary education or less. Conclusion: Self-medication practices were quite high in this study, and these practices were also prevalent among the educated people. Drug control enforcement needs to be intensified and dental public health education needs to be given greater priority in the overall public health campaigns.