Pattern of congenital anomalies in newborns in a tertiary level hospital in Bangladesh

To find out frequency of various congenital malformations in neonates in a tertiary care hospital. Descriptive study. Department of Neonatology, Mymensingh Medical College Hospital [MMCH], Mymensingh, Bangladesh from April 2011 to March 2012. A total 6040 babies were studied in the neonatal period immediately after admission and all cases with congenital anomalies were enrolled. A detailed history for any risk factor was taken. A thorough physical examination was performed. Confirmation of internal defect was done by various imaging modalities; i.e., radiography, ultrasound, echocardiography and CT scan. A detailed history was taken regarding maternal age, gestational age, and previous history of delivery of abnormal baby. A total of 106 neonates had one or more congenital anomalies accounting to a frequency of 1.75% malformation. The number of congenital anomalies were more in males [M:F=1.2:1] and in neonates of young and elderly mothers. The pattern of congenital anomalies related to head and neck, chest and gastrointestinal tract [20.75%], nervous system [19.81%], cardiovascular system [18.87%], musculoskeletal system [12.26%], genitourinary system [11.32%], chromosomal abnormalities [6.6%] and others [10.37%]. Overall frequency of congenital anomalies remained low. Most frequent anomalies were related to nervous system and cardiovascular system.

Immune functions of the garment workers

Occupational exposure to cotton dust, fibers, metal fumes and different chemicals used in the apparel manufacturing industries cause a wide range of physical and psychological health problems in the garment workers that may also affect their immune function. To assess the immune system function in garment workers. A total of 45 workers of a garment factory, and 41 control subjects, not exposed to the garment working environment were enrolled in this study. In the study subjects, the complement system function was assessed as bactericidal activity on Escherichia coli DH5alpha cells using the standard plate count method. Serum complement components C[3] and C[4] were measured by immunoprecipitation, and IgG was measured by immunonephelometry. The bactericidal activity of serum complement in the garment workers [range: 93.5%-99.9%] was significantly [p<0.01] lower than that in the controls [range: 98.6%-100%]. The heat-inactivated serum of the workers showed a significantly enhanced bactericidal activity. In the garment workers, the mean levels of complement C[3], and C[4] were 1.75 and 0.26 g/L, respectively that were close to those of the controls. The mean IgG level in the garment workers was 13.5 g/L that was significantly [p<0.001] higher than that in the controls. Working in a garment factory may affect the immune system

Complement mediated bactericidal activity and humoral immune response in type 2 diabetes mellitus

Since diabetic patients suffer from protracted infections, the aim of this study was to determine the functions of serum complement and its relationship with immunoglobulin profiles in patients with type 2 diabetes mellitus [DM]. A total of 55 DM patients and 54 healthy volunteers were included in this study. Serum IgG was measured by nephelometry, complement components C3 and C4, and IgA were measured by immunoturbidometric methods. The bactericidal activities of complement from fresh serum and complement-inactivated serum were assessed against Escherichia coli DH5alpha cells using the standard plate count method. In the DM patients, IgG [p<0.001], IgA [p<0.02] and complement component C4 [p<0.001] were found to be significantly elevated whereas the levels of C3 were slightly lowered [p<0.4]. The complement mediated bactericidal activity in diabetic patients was significantly lower than the controls [p<0.01]. In contrast, while the serum complements were inactivated by heat treatment, the DM patients had significantly higher [p<0.01] bactericidal activity associated with heat-stable immune effector molecules, possibly elevated levels of serum IgG and IgA. The results of this study indicate that serum complement mediated bactericidal activity was impaired in type 2 diabetic patients, which might be a cause for delayed wound healing and repeated infections

Evaluation of the role of laparoscopic guided liver biopsy during a therapeutic laparoscopic procedure in detecting early cirrhotic changes of the liver in patients at risk

We have included in this study 100 patients, who have undergone different therapeutic laparoscopic operations. All these patients proved not to have liver cirrhosis, preoperatively, according to the results of preoperative laboratory tests and imaging studies done for these patients but had a risk factor for development of liver cirrhosis. Laparoscopic appearance of the liver was evaluated and laparoscopic guided liver biopsies were taken from all patients and sent for histopathological examination. 46 patients of our studied patients have proved to have liver cirrhosis and/or fibrosis, and we did not have any intraoperative or postoperative complications from the sites of biopsy. This reflects the important role of laparoscopic guided liver biopsy as a very safe procedure to detect early pathological changes of the liver not detectable by routine preoperative investigations, and it is better to be done for all patients who are going to be operated by laparoscopy, and having a risk factor for developing liver cirrhosis

Prevalence and management of helicobacter pylori infection in patients with peptic ulcer disease statement of responsibility

This study included 70 patients with peptic ulcer disease. 58 patients of our studied patients have proved to have been infected with H. pylori in the biopsy specimens of the peptic ulcer site. The other 12 patients did not have H. pylori in their biopsies from ulcer sites. The infected patients with H. pylori has been divided into 2 equal groups: Group [I]: patients received triple therapy in the form of omeprazole, ampicillin and metronidazole. Group [2]: Patients received only omeprazole. The 12 non-infected patients constituted group [3], and received also omeprazole only. Follow up endoscopy for all patients has shown much better rate of healing for peptic ulcer patients in group 1 than in group 2. Healing rate in group [3] was also still better than healing in group [2]. We can conclude from our study that H. pylori plays a definite role in pathogenesis of peptic ulcer patients and the best healing of peptic ulcer patients infected with H. pylori can be achieved by the triple therapy used in our study

Impact of a new scoring system on selection of endoscopic retrograde cholangiopancreatography or magnetic resonance cholangio-pancreatography prior to cholecystectomy in patients with suspected common bile duct stones

Background: Endoscopic retrograde cholangiopancreatography [ERCP] with stone extraction is the gold standard for the management of common bile duct [CBD] stones. Many scoring systems had developed aiming at prediction of CBD stones prior to cholecystectomy to avoid unnecessary ERCP. On the other hand Magnetic Resonance Cholangiopancreatography [MRCP] had proved efficiency in diagnosis of CBD stones and was replacing ERCP in some centers but with additional cost for therapeutic ERCP in case of CBD stones

Aim of the work: the aim of this study was to evaluate the validity of the scoring system, predicting CBD stones, in selecting patients with suspected CBD stones for ERCP or MRCP prior to cholecystectomy

Patients and methods: One hundred twenty consecutive patients with cholelithiasis and suspected CBD stones were enrolled in this study between July 2001 and Dec. 2004. They were randomized into three groups, group 1 for ERCP, group 2 for MRCP followed by ERCP if there was stone and group 3, according to the scoring system, for either MRCP if the score is < 4 or ERCP if the score is >/= 4

Results: CBD stones were found in 67 out of 120 patients [56%]. The success rate for diagnostic ERCP was 100%, and successful therapeutic ERCP was 98.5%. The incidence of unnecessary ERCP was reduced significantly from 40% [Group 1] to 5.9% [Group 3A] [P< 0.001]. Also additional ERCP after +ve MRCP was reduced significantly from 55% [Group 2] to 21.7% [Group 3A] [P <0.05]

Conclusion: This study confirms the validity of this new scoring system, predicting CBD stones, in selecting patients for ERCP or MRCP prior to cholecystectomy to avoid unnecessary ERCP

Advancement flap [sphincter saving] versus lateral internal sphincterotomy in management of chronic anal fissure with low anal sphnicter pressure

In this study, we have included 80 patients who had symptomatic chronic anal fissure, proved to have low anal sphincter pressure. Half of these patients [group 1] have been treated by local advancement flap, the other half [group 2], has been treated by lateral internal sphincterotomy. In group 1 patients satisfactory healing of the fissure with continent anal sphincter has occurred, while in group 2 patients, significant complications in the form of anal incontinence and persistent fissure symptoms, have occurred. The results in this study have given rise to the recommendation for sphincter assessment before traditional surgery through measurement of anal sphincter pressured by manometry. The patients with sphincter pressure [hypotonic] is better to be treated by sphincter saving operation as the island advancement flap as the treatment of choice for patients suffering from chronic anal fissure with low anal sphincter pressure

Relatyive yields of crops and crop losses due to weed competition in bangladesh

An estimate of crop losses due to weed competition has been done on the basis of experimental data available in the country. The relative yields of 27 crop species are calculated and the ranking of competitive power of the crop species has been established. On average 37.33% of crop produce is damaged if weeds are not controlled in Bangladesh. Crops valued at approximately Taka 59665.70 million might be lost annually due to unrestricted growth of weeds in the country. The pest may cause a loss of 9.66 million tons of food valued at Taka 56711.12 million [$1383 million] every year if they are not controlled in the crop fields. Production losses may also occur due to weeds as 33.16% in food crops, 41.26% in cereals, 3 1.88% pulses, 40.82% in oilseeds, 34.23% in fibre crops and 40.28% in rice crops in the country. However, an average of 13.1% of crop produce is actually lost in the farmers field even after adopting traditional weed controls in Bangladesh. On this basis, crops valued at Taka 20,938.13 million is lost every year due to weeds. More than 2.5 million tons of food grain [cereals, pulses and oilseeds] valued at Taka 17232.80 million is lost per annum. Of the crop species investigated, tea and khesari are the most competitive crops followed by sugar-cane and lentil. Onion is the least competitive crop against weeds

Comparision of infiltration measurement techniques in border irrigation

Volume balance and cylinder infiltrometer method of infiltration measurements were carried out at Bangladesh Agricultural University farms to determine the infiltration characteristics in Border irrigation for better irrigation management. First, second and third irrigation trials were conducted in non-vegetative border and fourth trial was conducted in vegetative border [Maize crop]. The rate of application of water in first, second, third and fourth trial were 12.42, 2.21, 5.19 and 5.191 s-1, respectively. A general equation of infiltration rate was developed for the study area and comparison was made between Volume balance method and Cylinder infiltrometer method. It was observed that for all the trials cumulative infiltration and infiltration rate by Volume balance method was higher than that of cumulative infiltration and infiltration rate by Cylinder infiltrometer method. It was also observed that the values of infiltration characteristic constants a and b by Volume balance method were higher than those of the values of a and b by Cylinder infiltrometer method

Fructosamine: an alternative assessment of past glycaemic control in developing countries

Fructosamine assay determines glycaemic control in diabetic patients by measuring glycosylated plasma protein. This study was done to assess the value of fructosamine as an alternative test to HbA1c as a measure of glycaemia. Sixty patients [both insulin dependent diabetes mellitus and non insulin dependent diabetes mellitus] were selected from the diabetic clinic and fasting blood samples were collected for estimation of glucose, HbA1 c and fructosamine levels. The results were compared by correlation analysis and major discrepancies/discordance was detected by dividing the results into 3 clinical categories and detecting the cases in which the values fell in opposite clinical categories. Fructosamine correlated well with HbA1c [r= 0.41, p < 0.01] and with fasting blood glucose [r= 0.45 p < 0.01]. Major discordance was detected in the results of only 7 patients which can partly be attributed to different periods over which HbA1 c and fructosamine reflect average glycaemia. Fructosamine measures glycaemia over the past 2-3 weeks and HbA1c over 8 weeks. As fructosamine assay is relatively inexpensive, reliable and simple to perform; it can be used as an alternative to HbA1c and is particularly suited for developing countries

First quinolone resistant typhoid salmonella

The susceptibility of typhoid salmonellae to one of the quinolones [OFLOXACIIM] was first reported in 1986. Since then more than 1500 blood culture isolates have been tested in various Armed Forces Laboratories, for their susceptibility to different quinolones. As yet resistance to quinolones has not been reported from anywhere though we have reported that S.paratyphi A strains generally possessed higher MICs of the quinolones as compared to S.typhi. During May 1 992, a strain of S.paratyphi A was isolated from the blood of a clinically suspencpted typhoid case who had failed to respond to the empirical use of adequate dose of ofloxacin for eight days. This isolate of S.paratyphi A was subjected to extensive investigation as regards its susceptibility to the conventional antityphoids, as well as to all the available quinolones. The disk diffusion, broth dilution and agar dilution methods were used. The isolate was found to be fully sensitive to trimethoprim [TMP] and sulphamethoxazole [SMX]. Consequently the patient was successfully managed with cotrimoxazole [TMP + SMX]. Some of the recently isolated and lyophilized strains of S.paratyphi A were also re-evaluated. The susceptibility pattern of the isolate to various quinolones is discussed

Risk factors and outcome of ischemic heart disease in young Pakistani adults

Risk factors for ischemic heart disease [IHD] were compared between a group of 42 patients under forty years [mean 34 years] with IHD and an age an d sex matched control group of 45 patients. Six risk factors were analyzed; family history, hyperlipidemia, smoking, hypertension, obesity and diabetes mellitus. Patients with IHD had higher incidence of positive family history 57% vs 35.5% [p=0.02], a higher incidence of hyper-tension 47.6% vs 4.4% [p<0.001] as well as hyperlipidemia 63.2% vs 33.2% [p=0.01]. Also patients with IHD had higher smoking history 42.8% vs 24.4% [p=0.03] and diabetes mellitus 35.7% vs 0% [p<0.001]. The difference in incidence of obesity was not significant between both groups. One year follow up of patients under 40 years who sustained myocardial infarctions showed that only 39% remained asymptomatic. Mortality rate was 4.5% and the rest had complications during this period