Intraocular and neuro-cysticercosis with diffuse stromal choroiditis

Intraocular cysticercosis with central nervous system involvement is not that rare. We report a male child with a right-sided painful blind eye who had intraocular cysticercosis and granuloma in the left frontal lobe of the brain. There was an incidental finding of chronic inflammation in the choroid of that eye supported by histopathology. Immunohistochemistry for T-cells marker and B-cells marker was variable. The patient was treated with antiparasitic, anti-epileptic medications, and oral steroids subsequently.

Acupuncture Treatment in Rheumatoid Arthritis Patients in a Specialized Acupuncture Center in Dhaka Bangladesh: A Case Report

Background: Two recognized antibodies, Rheumatoid Factor (RF) and Anti-Citrullinated Peptide Antibody (ACPA), are produced in rheumatoid arthritis to target common autoantigens that are expressed in and around the joints. Tobacco and microorganisms, as well as the relationship between genetics and environment, play a critical role in the progression of the illness (e.g. Porphyromonas gingivalis). Rheumatoid arthritis is visualized as a Th1 and Th17 illness in the first stages of the disease. There is a significant role for inflammatory cytokines in the hierarchy of RA processes. Additionally, RA-related joint degradation is mediated by the Wnt system and osteoprotegerin抯 impact on osteoclasts, as well as the matrix synthesis dysregulation that causes cartilage degeneration. Rheumatoid arthritis is a disease in which both innate and adaptive immunity have been shown to play a key role, thanks to the development of effective therapies for TNF-, IL-6 receptor, IL-1, CD20 B cells, and T-cell/Dendritic cell interactions.

Hemoprotozoa and Anaplasma spp. in rodents and shrews of Bangladesh

@#Hemoprotozoans are important pathogens of animals and humans, among which some species have zoonotic significance. The prevalence of different hemoprotozoa and Anaplasma spp. in larger mammals have been reported from different regions of the world. But, very few studies have been conducted to estimate the prevalence of hemoprotozoa in rodents and shrews of South-East Asia. The study assessed the prevalence of hemoprotozoa and Anaplasma spp. in rodents and shrews of Bangladesh. Blood samples (n=451) were collected from rodents and shrews between June 2011 and June 2013 and July-December 2015 from 4 land gradients of Bangladesh. Giemsa-stained blood smears revealed that 13% of animals were harboring hemoprotozoa (4.7% Babesia spp., 0.67% Plasmodium spp.), and Anaplasma spp. (7.5%). The study may serve as a guide for future hemoparasitic research of rodents and shrews.

Human ocular thelaziasis caused by gravid Thelazia callipaeda � A unique and rare case report

An 80-year-old male reported to the clinic with complaints of diminished vision, foreign body sensation, and occasionally some black object moving in front of the right eye. Detailed ocular examination revealed three slender creamy white live worms in the conjunctival sac of the right eye. Total three worms were retrieved and sent to the pathology department for detailed examination. The worm was identified as gravid Thelazia callipaeda. As per the search results in PubMed and Cochrane search engine, this is the first report of human case of gravid Thelazia infestation with simultaneous existence of embryonated or ensheathed eggs and primary-stage larvae in the same worm.

Trans-catheter Treatment of Lutembacher Syndrome -A Case Report.

Lutembacher syndrome is a rare combination of congenital Atrial Septal Defect (ASD) and acquired Rheumatic Mitral Stenosis (MS).It is usually treated by surgical repair with potential risk of cardiopulmonary bypass. With the advancement of interventional methods of treatment it is amenable to nonsurgical transcatheter management. We are reporting a case of Lutembacher syndrome that was successfully treated with percutaneouos Inoue balloon mitral valvuloplasty and device closure of atrial septal defect.

Effect of Formulation Variables on the Release of Letrozole from Natural Biodegradable Polymeric Implants.

Aim: Letrozole, a non-steroidal aromatase inhibitor, prevents the body from producing its own estrogen. The objective of the present study was to explore the fabrication and evaluation of natural biodegradable polymeric Letrozole implant for long term drug release targeting postmenopausal women with metastatic breast cancer. Methodology: The effect of different formulation variables i.e. different types of excipients and different hardening times (6 hrs, 12 hrs and 24 hrs) with exposure to formaldehyde vapour was investigated on drug loading efficiency and drug release profile. The result of in-vitro dissolution study was fitted to different kinetic models to evaluate the kinetic data. Results: Letrozole release was studied for 10 to 19 days with some excipients. The in vitro Letrozole release from Gelatin-Sodium Alginate biodegradable polymeric implant was maximum, about 19 days, where Cetyl alcohol was incorporated as excipient. The release kinetics was explored and explained using Higuchi, zero and first order while the mechanism of release was confirmed with Korsmeyer-peppas model. Implants were found to follow Higuchi model the best in most cases. Good correlations were also obtained with Korsmeyere-Peppas model. According to these models, the drug released from implants were of diffusion controlled, where the drug was found to leave the matrix through pores and channels formed by entry of dissolution medium. Conclusion: The addition of different excipients and variation in hardening times were found to influence the drug loading efficiency and drug release significantly. Further investigation would confirm its potential in breast cancer therapy.

Antioxidant Vitamin (E&C) Contents in Colostrum of Bangladeshi Women.

Background: Colostrum is the first product of lactation and can be considered as first vaccine for newborns. It contains numerous nutrients as well as antioxidant vitamins necessary for newborns. Objective: The aim of the study was to measure the antioxidant vitamin (vitamins E and C) contents in colostrum and to compare them with the nutritional status, age and parity of the lactating mothers and birth weight of the babies. Materials and method: In this cross sectional study antioxidant vitamins E and C of colostrum of seventy six post-partum mothers were estimated irrespective of their age, parity, socioeconomic and nutritional status. High Performance Liquid Chromatography (HPLC) was employed to analyze the colostral content of vitamin E and spectrophotometric method was used for estimation of vitamin C (ascorbic acid) level. These levels were then compared against maternal and fetal characteristics. Results: The mean concentration (±SD) of vitamin E and C were 519.809(±1.16) μgm/dl and 1.33(±0.076) mg/dl respectively. No significant relationship was found between maternal age, parity, BMI or birth weight of the baby and the colostral content of vitamin E and C. Conclusion: Colostrum of Bangladeshi women are rich in antioxidant vitamins and not dependent on sociodemographic variables of mothers and / or birth weight of baby.

Pattern of hypothyroid cases in Bangladeshi People: A pilot study.

Aims: The present study was undertaken to explore the pathological basis of hypothyroidism and it relationship to clino-biochemical features of Bangladeshi patients. Material and Methods: A total number of 47 hypothyroid patients with duration less than two years and had no other comorbid disease were consecutively recruited from BIRDEM Out-patient department. Patients having serum FT4 level <9.14 pmol/L and serum TSH >5.01 IU/ml were identified as hypothyroidism. Presence of either anti TG antibody >40 IU/ml or anti TPO antibody > 35 IU/ml or both were defined as autoimmune hypothyroidism. Thyroid gland was examined and classified according to joint criteria of WHO, UNICEF and ICCIDD criteria. Results: Female preponderance was observed in this series though small total number of samples. Familial hypothyroidism was reported in 19% of cases and 8% of patients came from iodine deficient area. Out of 47 cases autoimmune markers were done in 40 and of them 32 (68%) were positive for autoantibodies. Of the positive case 22% were positive for anti TPO antibody and 6% for anti TG antibody; 72% cases both. Drug and radiation were excluded as the cause of hypothyroidism in this series. Family history of hypothyroidism was positive in 22% and 25% autoimmune and non-autoimmune study cases. Of the autoimmune case 44% had age between 30-44 years and among non-autoimmune case 37% were 15-30 years. Eleven of 32 (34%) autoimmune hypothyroid cases presented with irregular menstrual cycle. Out of 47 hypothyroid patients in this study, 36 (77%) had palpable or enlarged thyroid gland. Of the 40 cases autoimmune status evaluated palpable among 25 (78%) autoimmune and 6 (75%) non-autoimmune hypothyroid patients. Conclusions: It is concluded that higher proportion of hypothyroid cases are of antoantibody positive. These subjects have heterogeneous phenotypic presentation. This necessitates that all newly detected hypothyroidism should be screened for autoimmune status with the same importance as given for thyroid hormone level and managed accordingly.

Effect of superdisintegrants and their mode of incorporation on disintegration time and release profile of carbamazepine from immediate release tablet.

In this experiment the effect of mode of incorporation of some superdisintegrants such as sodium starch glycolate, croscarmellose sodium, crospovidone (kollidon CL), ludiflash and Xanthan gum (XG) on dissolution profile and disintegration time of carbamazepine (CBZ), apoorly water soluble drug was studied. The superdisintegrants were incorporated by extragranularly, intragranularly and in direct compression method. Different amount of superdisintegrants (1%, 3% and 6%) was incorporated in different formulations whereas all the other excipients as well as the active drug remained same. The results indicated that sodium starch glycolate, when incorporated extragranularly in wet granulation method significantly enhanced the release profile of CBZ. Kollidon CL was the most effective superdisintegrant in decreasing disintegration time of different tablet formulations (1.95 minutes when extragranularly incorporated). On the other hand, tablets prepared with SSG were found most effective in % drug release irrespective of its mode of incorporation (99.99% when extragranularly incorporated and 99.75 when intragranularly incorporated within one hour). Tablets prepared by direct compression method also showed similar drug release with other methods but tablet hardness was found lower. So addition of superdisintegrants in tablet formulation may be an effective technique to comply compendial drug release.

Ethical considerations on in vitro fertilization technologies in Bangladesh.

This paper aims to address ethical issues related to the assisted reproductive technology method ‘in vitro fertilization (IVF)’ from the Islamic Shar?‘ah. This review reflects that the Islamic ethical viewpoint IVF is rational, comprehensive, and aims at the greatest good of mankind.

Use of fluorescein diacetate (FDA) staining to detect viable Mycobacterium tuberculosis.

Objective: Drug resistant tuberculosis has long been a common problem prevailing in developing countries including Bangladesh. Present study focused on the rapid identification of live Mycobacterium tuberculosis among treatment failure cases. Materials and Methods: Sputum samples from a total of 100 category-I and category-II treatment failure cases, assumed as multidrug resistant tuberculosis, were studied through fluorescein diacetate (FDA) staining under light emitting diode (LED) fluorescence microscope. Considering culture method as gold standard, we also compared the results of FDA staining with that of auramine O staining. Results: A total of 85% acid-fast bacilli were detected by FDA staining, 82% by auramine O staining and a total of 85% isolates were detected in Lowenstein-Jensen (LJ) culture. The sensitivity of FDA staining (96.47%) was estimated to be slightly higher than that of auramine O staining (91.76%). Moreover, 76.47% cases were detected as multidrug resistant tuberculosis (MDR-TB). Conclusion: Taken together, FDA staining method has been proposed to be appropriate for the rapid diagnosis of drug resistant tuberculosis.

Anthelmintic and diuretic activity of bark extracts of Sterculia villosa.

The study was evaluated for diuretic and anthelmintic activity of the ethanolic extract of the barks of Sterculia villosa Roxb, (Sterculiaceae). The diuretic assay was done on both healthy wistar rats and rabbits. The dose used for the diuretic assay was 100, 200 & 400mg/kg of the extract. Compared to the control and standard drug furosemide (20mg/kg), the result of diuretic study showed dose dependent activity of the extracts. The result also indicated higher excretion of Na+, K+ & Cl- in urine. Pheretima posthuma, adult earthworms were used for anthelmintic activity and the results of anthelmintic assessment at the dose of 50, 100 & 200mg/ml showed significant activity compared with control and standard drug albendazole (10mg/ml).

Antidiuretic and antidiarrhoeal activities of polar and non-polar extract of Brassica oleracea.

Diuretic activities of both polar and non-polar extract of leaves of Brassica oleracea were investigated on male white rabbits and male Sprague-Dawley rats. Anti diarrheal activity of the same extract was investigated on male and female swiss albino mice. Both polar and non-polar extract exhibited anti diuretic activities on both rats and rabbits. Polar and Non-polar extract also showed anti diarrheal activity on male and female mice. Anti diarrheal activity affects both latent period and number of stools.

Formulation and Evaluation of Bi-layered Sustained Release Matrix Tablets of Tramadol Hydrochloride.

Bi-layer tablets of tramadol hydrochloride were prepared by direct compression technique incorporating an immediate release layer and a sustained release layer. An immediate release layer was successfully designed to release the bolus dose instantaneously. Water soluble Xanthan gum, water insoluble Kollidon SR and Eudragit L 100 were used as carriers in the sustained release layer of the matrix tablet. All the tablets were evaluated for thickness, diameter, weight variation, hardness and friability. The in vitro drug release was studied for eight hour, first two hours dissolution in acidic medium followed by six hour dissolution in buffer medium. Matrix tablet showed a sustained release rate with a controlled fashion as a function of the quantity of polymer used. The in vitro drug release data were fitted with several mathematical models and mean dissolution time along with fractional dissolution time values (T25%, T50% and T80%) were calculated. Xanthan gum was found to be the most effective rate retarding agent compared to Kollidon SR and Eudragit L 100, when used at same ratio in the formulations.

Pattern and treatment of Gout in Bangladesh: a hospital based survey at Dhaka city, Bangladesh.

Gout is a common metabolic disorder which occurs due to excessive deposition of uric acid in different bone joints. Increasing life expectancy, life style change, changes in diet are causing an increased incidence of the disease nowadays. The present study was aimed to understand the pattern and treatment of gout in Bangladesh. 150 patients at four tertiary care hospitals in Dhaka city were surveyed. The findings of the present study suggests that both male and female are suffering from the disease and age seems to be related to the disease as 62% of gout patients were found over 50 years of age. Body weight may be a contributing factor of the disease. Most of the gout patients under the survey were suffering from high blood pressure (65.33%). Primary gout was found more prevalent in this investigation (70.66%) and viral hepatitis was found to be the most common cause of the disease (50%). The patients presented common sign and symptoms of gout.

Small dense LDL and its Association with Hypertension: a Case-Control Study.

Hypertension is one of the most common diseases affecting humans throughout the world. The commonest variety of hypertension is benign essential hypertension. Cardiovascular risk is more in hypertensive patients as their lipid profile is more atherogenic than normotensive subjects. Traditionally, estimation of total serum cholesterol and LDL-C are used as an indicator of atherogenicity. But subjects may develop hypertension and CHD with normal levels of LDL cholesterol. So assessment of LDL cholesterol concentration may not entirely reflect its atherogenic potential. Because LDL-C is not a single entity rather it consists of seven distinct subclasses of different particle size. The size of the LDL particle is inversely correlated to their atherogenicity. Smaller LDL particles are more atherogenic despite their less cholesterol content than the larger more buoyant LDL particles containing more cholesterol. Therefore individuals having smaller LDL particles are more atherogenic and more at risk to develop hypertension inspite of even normal LDL cholesterol concentration. So measurement of small dense LDL particle is more important than any other lipid measure. With this aim 122 subjects were included in this study, among them 82 were diagnosed cases of essential hypertension with the mean age of 42.56±9.98 years and 40 were healthy controls. Serum apo-B was measured in all study subjects. The amount of apoB is almost similar in every LDL subtypes but the amount of cholesterol increases with the increasing particle size. So the ratio of cholesterol to apo-B decreases as the particle size decreases, thus LDL cholesterol / apo-B £ 1 indicates the presence of atherogenic small dense LDL. So the prevalence of small dense LDL was evaluated by calculating the ratio of LDL-C/apo B. The ratio was significantly lower in hypertensive cases (0.093±0.18) compared to controls, indicating presence of sd LDL in hypertensive patients. When the risk ratio was calculated, the patients having small dense LDL in their plasma were found to have 2.87 times more risk for developing CVD then the persons who doesn't have small dense LDL in their plasma.

Comparative in vitro dissolution study of Aceclofenac Marketed Tablets in Two Different Dissolution Media by Validated Analytical Method.

In this study five marketed brands of aceclofenac 100 mg tablets have been evaluated using dissolution test in two different media with the aim to assess bioequivalence and to select a proper dissolution medium. Other general quality parameters of these tablets like weight variation, hardness, friability, disintegration time were also determined according to established protocols. All the brands complied with the official specification for friability, uniformity of weight, disintegration time and drug content. UV spectroscopic and RP-HPLC methods were validated for the parameters like linearity, accuracy, precision and robustness. Potency was determined by using these two methods. Potency obtained from UV method and HPLC methods were found similar with paired t test. Dissolution test results were subjected to further analysis by difference factor (f1), similarity factor (f2) and dissolution efficiency (% DE). Higher drug release was found in phosphate buffer pH 6.8 than in 0.05% sodium lauryl sulphate solution. All brands were found similar in respect of drug release in phosphate buffer pH 6.8 but they differ in respect of drug release in 0.5% sodium lauryl sulphate. So phosphate buffer pH 6.8 may be a suitable media for dissolution study of aceclofenac tablets.

Development of Sustain Release Matrix Tablet of Ranolazine Based on Methocel K4M CR: In Vitro Drug Release and Kinetic Approach.

In this study an attempt was made to design and evaluate oral sustained release matrix tablets of ranolazine using Methocel K4M CR as the retardant polymer. Tablets were prepared by conventional wet granulation technique. Tablets were evaluated for parameters such as weight variation, hardness, friability and drug content. All the formulations showed compliance with pharmacopieal standards. In vitro release studies were performed using USP type II apparatus (paddle method) in 900 mL of 0.1N HCl at 50 rpm for 8 hours. The release kinetics was analyzed using the zero-order, first order, Higuchi, Hixson-Crowell and Korsmeyer-Peppas equations to explore and explain the mechanism of drug release from the matrix tablets. In vitro release studies revealed that percent drug release decreased with increase of polymer loading. Based on the dissolution data comparison with innovator brand F-5 formulation (16% Methocel K4M CR w/w of drug) was elected as the best formulation. The drug release profile of the best formulation was well controlled and uniform throughout the dissolution studies. The drug release of optimized formulation follows the Higuchi kinetic model (R2 = 0.99) and the mechanism is found to be non-Fickian/anomalous according to Korsmeyer–Peppas equation. All the formulations were checked for stability as per ICH guidelines and formulations were found stable during the study.

Development and Validation of RP-HPLC Method for the Simultaneous Estimation of Domperidone and Naproxen in Tablet Dosage Form.

A simple, selective and rapid reversed phase High Performance Liquid Chromatographic (RP-HPLC) method has been developed and validated for the simultaneous analysis of domperidone and naproxen in tablet dosage form. The chromatographic system consisted of two LC-20 AT pump, SPD-20A UV detector, SIL-20A auto-sampler and CTO- 10ASVP column oven. Chromatographic separation of drugs was achieved on an Shim-Pack C18 column (250 mm x 4.6 mm, 5 μm) as stationary phase with a mobile phase comprising of phosphate buffer (pH adjusted to 3.00 with sodium hydroxide): methanol in the ratio 30:70 (v/v) at a flow rate of 1.0 ml/min with UV detection at 280 nm. Retention time was 3.17 minutes for domperidone and 5.42 minutes for naproxen. The method was found selective and peaks of domperidone and naproxen were well separated (resolution 10.72). The proposed method is linear (r2 = 0.999 for domperidone and naproxen), accurate with 99.5% recovery for domperidone and 99.39% recovery for naproxen and precise (%RSD < 1%). The method has been used to determine potency of commercial product and potency was found within limit. The method can be used for the analysis of domperidone and naproxen in tablet dosage form.

ABO and Lewis Blood Grouping with ABH Secretor and Non-secretor Status: A Cross Sectional Study in Dhaka.

A cross sectional study was done with 42 apparently healthy persons aged 6 years and above from both sexes. Most of them are blood donors in the department of Transfusion Medicine, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh. Few, other than blood donor, were selected from the same locality. Five ml venous blood was collected with all aseptic precautions. ABO blood grouping and Lewis phenotyping were done by tube method. ABO reverse grouping was also done from serum. With all precautions 2 ml of saliva was collected from all subjects. Secretor status was detected from the saliva by haemagglutination inhibition method. ABO blood grouping shows 36% 'O' group, 24% 'A' group, 33% 'B' group and 7% 'AB' group. Distribution of Lewis phenotype are Le(a+b-) 19%, Le(a-b+) 53%, Le(a-b-) 26% and Le(a+b+) 2% only. 60% of study population was ABH secretor and 40% non-secretor.