Prevalence, Risk Factors and Clinical Features of Post Dural Puncture Headache (PDPH): A Prospective Study

Background: Post-dural puncture headache (PDPH), formerly known as post-lumbar puncture headache, is a well-known adverse event that follows diagnostic and/or therapeutic puncture of the dura, or accidentally, following spinal anesthesia. Material & Methods: This prospective study was carried out on 152 patients at Shaheed Ziaur Rahman Medical College Hospital in Bogura, from 2013 to 2015 and North Bengal Medical College from 2016 to 2022, Bangladesh. Results: A total of 152 patients were enrolled into the study where 122(80.3%) were aged between 18-28 years, 30(19.7%) were 29-39 years, 38(25%) were male and 114(75%) were female. 122(80.3%) patients were non obese (<25) and 30(19.7%) were obese (>25). 17(11.2%) patients had previous history of anaesthesia and 17(11.2%) had previous history of PDPH. On majority 100 patients were used big size needle (18-23 G) and rest of the patients were used small (23-25G). 146 (96.1%) patients position was lateral and 92(60.5%) were used less than two or equal three drops. 61(40.1%) patients were needed one attempt, 64(42.1%) were needed two and 27(27.8%) were needed greater than two. The prevalence of PDPH was found in 44(28.9%) cases out of 152 where severity of 29(65.9%) percent was mild, 20(45.5%) cases headache onset were at the first day and mean duration of headache was 2.6. There was a statistically significant association between development of PDPH and younger age (26.3±8.7 years vs 32.6±7.4, p< 0.001), female gender (p=00.009), previous history of PDPH (p<0.001), number of attempts (3.1±1.2 vs 1.2±0.8, p<0.001), small needles (p=0.04), pre LP headache (p<0.001) and CSF RBS (2.6±2.1 vs 13.8±1.3, p= 0.48). Conclusion: This study recommends that the neurologists should be treating this population in the manner so that it may help to prevent this painful adverse event, and identification of risk variables is vital in predicting PDPH.

Rice bran oil reduces organ-specific fat deposition, attenuates hyperlipidaemia and abnormal liver function in Long Evans rats with high fat intake

@#Introduction: High-calorie diets, particularly the quality of dietary fats, are regarded as an independent risk factor for developing obesity, hyperlipidaemia, and liver diseases. The present study examined the impact of rice bran oil (RBO) on organ-specific fat deposition, lipid profile, and liver function enzymes in Long Evans rats. Methods: Long Evans rats (n=24) were fed for six weeks with a controlled high-fat diet (HFD) to induce hyperlipidaemia and abnormal liver function. Rats were then divided into two groups: one group continued feeding on HFD, and the other group was fed with a RBO diet, replacing the fat source. After six weeks of feeding, six rats from each group were sacrificed and required analytical tests were performed. The remaining obese rats (n=12) were divided into continued HFD and RBO diet, and after sacrificing, essential analytical tests were done. Results: RBO feeding to hyperlipidaemic rats for six weeks significantly reduced brown adipose tissue, abdominal adipose tissue, epididymal adipose tissue, and liver fat compared to continuing HFD group (p<0.05). Similarly, serum levels of total cholesterol, triacylglycerides, and low-density lipoprotein cholesterol were all decreased, whereas high-density lipoprotein cholesterol increased in response to RBO compared to HFD (p<0.05). Additionally, rats fed with RBO showed reduced alanine aminotransferase, aspartate aminotransferase, and gamma-glutamyl transferase levels when compared with continuing HFD-fed rats (p<0.05). Conclusion: These findings suggest that RBO supports the reduction of fat storage from major fat depots, controls lipid profile, and restores healthy liver functions in rats.

Association of dietary pattern and childhood obesity with cardiovascular disease in patients from Tangail city, Bangladesh

@#Introduction: Obesity in childhood is a major cause for developing cardiovascular diseases (CVD) at adulthood. The present study was a cross-sectional research aimed to examine the relationship between childhood obesity and dietary pattern with CVD in patients (n=100) from Tangail City, Bangladesh. Methods: Dietary patterns, laboratory tests, demographic, and anthropometric interrelated data were measured in patients with stroke and heart attack from five hospitals. The research also used 24-hour recall method and a food frequency questionnaire for assessing daily energy and macronutrient intakes. Results: Weight (p=0.004), body mass index (BMI) (p=0.001), mid-upper arm circumference (MUAC) (p=0.009), and waist circumference (WC) (p=0.030) was significantly different between males and females whereas lipid profile was not significantly different between genders. There were no significant associations between intakes of red meat, salt, fast food, fish, egg, nuts and seeds with heart attack and stroke. On the contrary, there were significant associations between fried food intake with heart attack and stroke (p=0.080 and p=0.020). The results indicated that there was a significant relationship between carbohydrate (p=0.001), protein (p=0.001), and fat (p=0.001) intakes with the total energy intake of respondents. The findings also showed that there was a significant relationship between carbohydrate (p=0.003), protein (p=0.001), and fat (p=0.001) intakes with body mass index of the respondents. Conclusion: CVD diagnosis in adult patients was found to be associated with fried food intake but not with childhood obesity.

Tridax procumbens flavonoids: a prospective bioactive compound increased osteoblast differentiation and trabecular bone formation

BACKGROUND: The Tridax procumbens extracts (TPE) are known for their ethno-medicinal properties to increase osteogenic functioning in mesenchymal stem cells. Recently, we found that the T. procumbens flavonoids (TPF) significantly suppressed the RANKL-induced osteoclasts differentiation and bone resorption. The TPF also promoted osteoblasts differentiation and bone formation demonstrated by increasing bone formation markers in cultured mouse primary osteoblasts. However, the effects of the TPF on in vivo bone formation remain unclear. In this study, we investigated the effects of the TPF on in vivo bone formation, injected the TPF (20 mg/kg) twice a day in the low calcium diet mice and killed them after 21 day. Radiographic and histomorphometric analyses were performed on the dissected bones to determine the anabolic effects of the TPF. RESULTS: Bone mineral density and bone mineral content of the TPF-treated mice were significantly increased compared to the control mice. Bone formation-related indices like osteoblast number, osteoblast surface, bone volume, mineralizing surface, mineral apposition rate and bone formation rate were significantly increased in the TPF-treated mice compared to the control mice. CONCLUSION: Our findings point towards the stimulation of bone formation by TPF, suggested that the TPF could be a potential natural anabolic agent to treat patients with bone loss-associated diseases such as osteoporosis.

Flavonoids isolated from Tridax procumbens (TPF) inhibit osteoclasts differentiation and bone resorption

BACKGROUND: The Tridax procumbens flavonoids (TPF), are well known for their medicinal properties among local natives. The TPF are traditionally used for dropsy, anaemia, arthritis, gout, asthma, ulcer, piles, and urinary problems. It also used in treating gastric problems, body pain, and rheumatic pains of joints. The TPF have been reported to increase osteogenic functioning in mesenchymal stem cells. However, their effects on osteoclastogenesis remain unclear. The TPF isolated from T. procumbens and investigated the effects of the TPF inhibit on osteoclast differentiation and bone resorption activities using primary osteoclastic cells. Osteoclast formation was assessed by counting the number of tartrate resistant acid phosphatase (TRAP) positive multinucleated cells and by measuring both TRAP activities. RESULTS: The TPF significantly suppressed the RANKL-induced differentiation of osteoclasts and the formation of pits in primary osteoclastic cells. The TPF also decreased the expression of mRNAs related to osteoclast differentiation, including Trap, Cathepsin K, Mmp-9, and Mmp-13 in primary osteoclastic cells. The treatment of primary osteoclastic cells with the TPF decreased Cathepsin K, Mmp-9, and Mmp-13 proteins expression in primary osteoclastic cells. CONCLUSION: These results indicated that TPF inhibit osteoclastogenesis and pits formation activities. Our results suggest that the TPF could be a potential anti-bone resorptic agent to treat patients with bone loss-associated diseases such as osteoporosis.

Tridax procumbens flavonoids promote osteoblast differentiation and bone formation

BACKGROUND: Tridaxprocumbens flavonoids (TPFs) are well known for their medicinal properties among local natives. Besides traditionally used for dropsy, anemia, arthritis, gout, asthma, ulcer, piles, and urinary problems, it is also used in treating gastric problems, body pain, and rheumatic pains of joints. TPFs have been reported to increase osteogenic functioning in mesenchymal stem cells. Our previous study showed that TPFs were significantly suppressed the RANKL-induced differentiation of osteoclasts and bone resorption. However, the effects of TPFs to promote osteoblasts differentiation and bone formation remain unclear. TPFs were isolated from Tridax procumbens and investigated for their effects on osteoblasts differentiation and bone formation by using primary mouse calvarial osteoblasts. RESULTS: TPFs promoted osteoblast differentiation in a dose-dependent manner demonstrated by up-regulation of alkaline phosphatase and osteocalcin. TPFs also upregulated osteoblast differentiation related genes, including osteocalcin, osterix, and Runx2 in primary osteoblasts. TPFs treated primary osteoblast cells showed significant upregulation of bone morphogenetic proteins (BMPs) including Bmp-2, Bmp-4, and Bmp-7. Addition of noggin, a BMP specific-antagonist, inhibited TPFs induced upregulation of the osteocalcin, osterix, and Runx2. CONCLUSION: Our findings point towards the induction of osteoblast differentiation by TPFs and suggested that TPFs could be a potential anabolic agent to treat patients with bone loss-associated diseases such as osteoporosis.

Pesticidal and pest repellency activities of rhizomes of Drynaria quercifolia (J. Smith) against Tribolium castaneum (Herbst)

BACKGROUND: Tribolium castaneum (Herbst) is a harmful pest of stored grain and flour-based products in tropical and subtropical region. In the present study, rhizome of Drynaria quercifolia (J. Smith) was evaluated for pesticidal and pest repellency activities against T. castaneum, using surface film method and filter paper disc method, respectively. In addition, activity of the isolated compound 3,4-dihydroxybenzoic acid was evaluated against the pest. RESULTS: Chloroform soluble fraction of ethanol extract of rhizome of D. quercifolia showed significant pesticidal activity at doses 0.88 to 1.77 mg/cm² and significant pest repellency activity at doses 0.94 to 0.23 mg/cm². No pesticidal and pest repellency activity was found for petroleum ether, ethyl acetate and methanol soluble fractions of ethanol extract as well as for 3,4-dihydroxybenzoic acid. CONCLUSION: Considering our findings it can be concluded that chloroform soluble fraction of rhizome of D. quercifoliais useful in controlling T. castaneum of stored grain and flour-based products.