Risk Factors of Neonatal Sepsis in Neonatal Intensive Care Unit (NICU) of Mymensingh Medical College Hospital.

Neonatal sepsis is associated with increased mortality and morbidity including prolonged hospital stay. Management of such cases is difficult, costly and need expert centers in many cases. Therefore, continued surveillance is mandatory to identify risk factors of neonatal sepsis which help optimizing its management. With the above idea, this cross-sectional descriptive study was conducted at the neonatal intensive care unit (NICU) in the department of Neonatology, Mymensingh Medical College Hospital (MMCH), Mymensingh, Bangladesh from July 2017 to December 2017 to observe the effects of maternal and neonatal risk factors in the development of neonatal sepsis and to determine risk factors of neonatal sepsis. Ninety four neonates (0-28 days) who were admitted in NICU with suspected sepsis were included in this study by purposive sampling technique. After admission written informed consent from parents or guardians obtained and histories were obtained including perinatal history and full physical examination of the infants were done and septic screening were sent. All the relevant information was recorded in a pre-designed questionnaire and all data were compiled, tabulated and then analyzed by SPSS version 21.0. Among 94 cases, 72.3% were preterm and 27.6% were term. There was male predominance and male/ female ratio was 1.9:1. Most (76.6%) of the patient admitted within 72 hours of birth. Most (83%) had low birth weight (<2500gm). Most came from rural area 61(64.9%) and also from low income family 59(62.8%). Premature onset of labour 40(42.6%), PROM >18 hours 36(38.3%), vaginal route of delivery 52(55.3%), instrumental resuscitation 15(16%), prelacteal feeding 11(11.7%), bottle feeding 15(16%) were the antenatal, natal and postnatal risk factors in this study. Also the neonatal factors, like prematurity, resuscitation at birth and low APGAR score carried the significant risk of developing sepsis. Poor feeding, lethargy, respiratory distress, jaundice were more common presenting symptoms. Tachycardia, tachypnea, chest indrawing, cyanosis hypothermia, hyperthermia and apnoea were found as more common presenting sign of sepsis in this study. Based on result it is concluded that prolonged rupture of membrane>18 hours, vaginal route of delivery, preterm birth, instrumental resuscitation, prelacteal feeding, bottle feeding were the major perinatal risk factors in this study.

Ischemic stroke: prevalence of modifiable risk factors in male and female patients in Pakistan.

Stroke is the commonest neurological cause of morbidity and mortality all over the world being the third leading cause of death. Estimation of stroke risks in population is not only helpful for healthcare providers but also important to identify persons at elevated risk and to select proper treatments in clinical trials. The aim of the present study was to identify the prevalence of common modifiable risk factors for ischemic stroke in Pakistan. Patients of either sex above the age of 25 yrs who were admitted to Neurology Ward or came to OPD in Jinnah Post Graduate Medical Centre were included in the study. Type of stroke was identified by brain CT scans or MRI and risk factors for stroke and other details were noted on a proforma. Out of 55 patients studied for present study, 78% were males and 22% were females. Most of them belonged to low socioeconomic status and almost 50% were having family history of stroke. Most of the patients had multiple risk factors which included: hypertension (65%), smoking (32%), diabetes mellitus (36.3%), dyslipidemia (32.7%), coronary artery disease (9%), obesity (18%), epilepsy (16.3%) and left ventricular hypertrophy (3.6%). On the basis of these findings, it can be concluded that hypertension, smoking, dyslipidemia and diabetes mellitus are major risk factors for stroke and might be considered as main targets for primary and secondary prevention of stroke.

Role of WNT signaling in normal and malignant hematopoiesis.

The WNT pathway is a powerful signaling pathway that plays a crucial role in cell fate determination, survival, proliferation and movement in variety of tissues. Abnormalities in the WNT signaling pathway have been implicated in a number of diseases, most notably cancer. Recent exciting evidence suggests that WNT signaling also plays an important role in hematopoietic stem cell self-renewal and progenitor development. In this review we discuss current state of knowledge on WNT signaling in hematopoiesis and extend our focus on aberrant WNT signaling in hematological malignancies.

Greenhouse and Field Evaluation of Biological Control of Fusarium Head Blight on Durum Wheat.

Fusarium head blight (FHB) is a devastating disease that causes extensive yield and quality losses to wheat and barley. In durum wheat, the pathogen-produced toxin deoxynivalenol (DON) is retained in semolina at ˜50%, and the causal agent of FHB, Gibberella zeae, has a strong adverse effect on pasta color. Two bacteria and two yeast strains with known efficacy against G. zeae on hexaploid wheats were produced in liquid culture and assayed on two cultivars of durum wheat in greenhouse bioassays. All antagonists reduced FHB severity on cultivar Renville, and three of the four reduced severity on cultivar Ben, with Bacillus subtilis strain AS 43.3 decreasing FHB severity by as much as 90%. In separate greenhouse bioassays, the car-bon:nitrogen ratio of the medium used to produce antagonists did not consistently influence antagonist efficacy. All antagonist/production medium combinations but one were effective in reducing disease on both durum cultivars. Of six antagonists tested at field sites, Cryptococcus sp. OH 71.4 and C. nodaensis OH 182.9 reduced disease severity by as much as 57% in Peoria, IL, while Cryptococcus sp. OH 181.1 reduced disease severity by as much as 59% in a trial at Langdon, ND. Antagonists did not influence the DON content of grain in the Peoria trial. Relative performance indices for four antagonists calculated from greenhouse and field results on the two durum cultivars demonstrated that the bioassay location, but not the cultivar of durum, influenced the relative performance of antagonists. Yeast antagonists OH 71.4, OH 181.1, and OH 182.9 appear to have the highest potential for contributing to the reduction of FHB on du-rum wheat in the field.

Cripto-1 enhances migration and branching morphogenesis of mouse mammary epithelial cells.

Cripto-1 is an EGF-CFC protein that performs an important role during early vertebrate development and is overexpressed in several types of human cancer. In the present study mouse EpH4, NMuMG, and TAC-2 mammary epithelial cells that are negative for endogenous cripto-1 expression were transfected with the murine cripto-1 cDNA. Cripto-1-transfected cell lines exhibited functional and physiological differences from the original cell lines including enhanced anchorage-independent growth in soft agar (EpH4 cells), growth in serum-free medium, increased proliferation, and formation of branching, duct-like structures when grown in a three-dimensional collagen type I matrix. Furthermore, cripto-1-expressing cell lines showed elevated migration in vitro in Boyden chamber and wound-healing assays. These results indicate that cripto-1 can function through an autocrine pathway that enables mammary epithelial cells to undergo an epithelial to mesenchymal transition.

Identification of Cripto-1 in human milk.

Cripto-1 (CR-1) is an epidermal growth factor (EGF)-related peptide that plays an important role in normal mammary gland development. CR-1 is expressed in the growing terminal end buds in the virgin mouse mammary gland and its expression increases during pregnancy and lactation. Furthermore, CR-I is involved in the early stages of mouse mammary tumorigenesis and in the pathogenesis of human breast cancer. Since CR-1 is expressed in the mouse mammary gland at high levels during pregnancy and lactation, we have evaluated whether this protein is present in human milk. In the present study we demonstrate that a 28 kDa immunoreactive CR-1 protein is present in 24 human milk samples as assessed by western blot analysis and that by enzyme-linked immunosorbent assay the concentration of CR-1 ranges between 62 and 118 ng/ml. In addition, CR-1 that had been purified from human milk is able to stimulate the phosphorylation of mitogen activated protein kinase in nontransformed NMuMG mouse mammary epithelial cells. These results suggest that CR-1 in human milk may be important in regulating mammary gland development during pregnancy and lactation.

Selection and Evaluation of Microorganisms for Biocontrol of Fusarium Head Blight of Wheat Incited by Gibberella zeae.

Gibberella zeae incites Fusarium head blight (FHB), a devastating disease that causes extensive yield and quality losses to wheat and barley. Of over 700 microbial strains obtained from wheat anthers, 54 were able to utilize tartaric acid as a carbon source when the compound was supplied as choline bitartrate in liquid culture. Four tartaric acid-utilizing and three nonutilizing strains reduced FHB in initial tests and were selected for further assays. Antagonists were effective against three different isolates of G. zeae when single wheat florets were inoculated with pathogen and antagonist inoculum. All seven antagonists increased 100-kernel weight when applied simultaneously with G. zeae isolate Z3639 (P ≤ 0.05). Bacillus strains AS 43.3 and AS 43.4 and Cryptococcus strain OH 182.9 reduced disease severity by >77, 93, and 56%, respectively. Five antagonists increased 100-kernel weight of plants inoculated with G. zeae isolate DAOM 180378. All antagonists except one increased 100-kernel weight, and four of seven antagonists reduced disease severity (P ≤ 0.05) when tested against G. zeae isolate Fg-9-96. In spray-inoculation experiments, Bacillus strains AS 43.3 and AS 43.4 and Cryptococcus strains OH 71.4 and OH 182.9 reduced disease severity, regardless of the sequence, timing, and concentration of inoculum application (P ≤ 0.05), though 100-kernel weight did not always increase when antagonists were applied 4 h after inoculum of G. zeae. Overall, 4 of 54 isolates that utilized tartaric acid in vitro were effective against G. zeae versus only 3 of 170 isolates tested that did not utilize tartaric acid (P ≤ 0.05, χ-square test of goodness of fit), demonstrating the potential benefit of prescreening candidate antagonists of FHB for their ability to utilize tartaric acid. Biological control shows promise as part of an integrated pest management program for managing FHB.

The EGF-CFC family: novel epidermal growth factor-related proteins in development and cancer.

The EGF-CFC gene family encodes a group of structurally related proteins that serve as important competence factors during early embryogenesis in Xenopus, zebrafish, mice and humans. This multigene family consists of Xenopus FRL-1, zebrafish one-eyed-pinhead (oep), mouse cripto (Cr-1) and cryptic, and human cripto (CR-1) and criptin. FRL-1, oep and mouse cripto are essential for the formation of mesoderm and endoderm and for correct establishment of the anterior/posterior axis. In addition, oep and cryptic are important for the establishment of left-right (L/R) asymmetry. In zebrafish, there is strong genetic evidence that oep functions as an obligatory co-factor for the correct signaling of a transforming growth factor-beta (TGFbeta)-related gene, nodal, during gastrulation and during L/R asymmetry development. Expression of Cr-1 and cryptic is extinguished in the embryo after day 8 of gestation except for the developing heart where Cr-1 expression is necessary for myocardial development. In the mouse, cryptic is not expressed in adult tissues whereas Cr-1 is expressed at a low level in several different tissues including the mammary gland. In the mammary gland, expression of Cr-1 in the ductal epithelial cells increases during pregnancy and lactation and immunoreactive and biologically active Cr-1 protein can be detected in human milk. Overexpression of Cr-1 in mouse mammary epithelial cells can facilitate their in vitro transformation and in vivo these Cr-1-transduced cells produce ductal hyperplasias in the mammary gland. Recombinant mouse or human cripto can enhance cell motility and branching morphogenesis in mammary epithelial cells and in some human tumor cells. These effects are accompanied by an epithelial-mesenchymal transition which is associated with a decrease in beta-catenin function and an increase in vimentin expression. Expression of cripto is increased several-fold in human colon, gastric, pancreatic and lung carcinomas and in a variety of different types of mouse and human breast carcinomas. More importantly, this increase can first be detected in premalignant lesions in some of these tissues. Although a specific receptor for the EGF-CFC proteins has not yet been identified, oep depends upon an activin-type RIIB and RIB receptor system that functions through Smad-2. Mouse and human cripto have been shown to activate a ras/raf/MAP kinase signaling pathway in mammary epithelial cells. Activation of phosphatidylinositol 3-kinase and Akt are also important for the ability of CR-1 to stimulate cell migration and to block lactogenic hormone-induced expression of beta-casein and whey acidic protein. In mammary epithelial cells, part of these responses may depend on the ability of CR-1 to transactivate erb B-4 and/or fibroblast growth factor receptor 1 through an src-like tyrosine kinase.

[Reoperations in bradyarrhythmic forms of disorders of heart conductivity]. / Povtornye operatsii pri bradiaritmicheskikh formakh narushenii provodimosti serdtsa.

Under analysis were causes of reoperations in bradyarrhythmic forms of disturbances of conductivity of the heart. 565 operations connected with electrocardiostimulation were performed on 276 patients. Reoperations in patients with the myocardial stimulation were made on 63 patients, with the endocardial stimulation--in 226 patients. Causes of reoperations were as follows: depletion of the source of ECS--31.5%; dislocation of the electrode--8.2%; damage of the electrode--15%, suppuration of the bed, decubitus of the stimulator--28.8%; competing rate--7.4%; break of the contact in the connecting system of the electrode and cardiostimulator--9.4%.

Visceral leishmaniasis and its control in Bangladesh.

Visceral leishmaniasis, which is also known as kala-azar, reappeared in Bangladesh during the 1980s, approximately 7-8 years after large-scale use of DDT had been abandoned by the malaria eradication programme in the country. Pabna, Mymensingh and Rajshahi were the regions most affected with kala-azar. The article presents a historical review and information about the present status of leishmaniasis in Bangladesh together with control strategies and a proposed plan of operation.

A comparison of counterimmunoelectrophoresis and indirect haemagglutination tests for the immunoepidemiological investigation of kala-azar.

Counterimmunoelectrophoresis (CIE) using cell-free extracts of Leishmania donovani promastigotes and Trypanosoma brucei as antigens and indirect haemagglutination (IHA) using commercially prepared reagents were compared for their diagnostic efficacy and applicability to immunoepidemiological studies in an area of Bangladesh where kala-azar is present. The CIE was positive for all parasitologically confirmed cases whereas the IHA positivity was only 60%. The T. brucei antigen was equally as good, if not better, than the L. donovani antigen for CIE. The CIE test was negative for all of 34 apparently healthy villagers. For this same group of individuals, 10 (29%) were low titre-IHA positive. The findings suggest that CIE is the more reliable diagnostic test but both methods should be employed for immunoepidemiological investigations.

[Regional pulmonary ventilation and blood flow in patients with mitral valve stenosis according to radionuclide study]. / Regionarnaia legochnaia ventiliatsiia i krovotok u bol'nykh mitral'nym stenozom po dannym radionuklidnogo issledovaniia.

It is shown, on the basis of ventilation and perfusion scintigraphy, that marked pulmonary flow redistribution from basal to apical departments, combined with relatively normal distribution of ventilation volumes, is a regular feature of mitral stenosis combined with pulmonary hypertension. The quantitative assessment of the intensity of pulmonary perfusion redistribution can be used as a measure of pulmonary hypertension. Also, a right-to-left unbalance was established in the pulmonary flow distribution, manifested as hyperperfusion of the left lung.

[Effect of balanced anesthesia on lung histamine release in patients operated on for mitral heart defects with varying degrees of pulmonary hypertension]. / Vliianie sbalansirovannoi anestezii na vydelenie legkimi gistamina u bol'nykh, operirovannykh po povodu mitral'nykh porokov serdtsa s razlichnoi stepen'iu legochnoi gipetenzii.

The histamine concentration was estimated in the mixed venous and arterial blood in 28 patients with mitral defects subjected to closed mitral commissurotomy under balanced anesthesia. The oxygen content was determined simultaneously and the amount of blood shunting in the lungs was calculated by the oxygen method. It was established that the amount of histamine in the mixed venous blood coming to lungs was increased in patients with high degree lung hypertension. The balanced anesthesia itself did not influence the histamine concentration in the blood. The cessation of anesthesia, however, is followed by increased histamine concentration in the blood of patients with high lung hypertension. The process of blood shunting in the lungs is not controlled by histamine.

[Radiocardiographic evaluation of the hemodynamic effect of mitral commissurotomy at different stages of the postoperative period]. / Radiokardiograficheskaia otsenka gemodinamicheskogo éffekta mitral'noi komissurotomii na étapakh posleoperatsionnogo perioda.

The analysis of hemodynamic effect of closed mitral commissurotomy in 73 patients it different postoperative terms is presented. Within the first day after operation a dramatic hyperfunction of the myocardium was observed in patients with the 3d stage of blood circulation disorders. In patients with the 4th stage of the disease mitral commissurotomy failed to give a positive hemodynamic effect both within the first day and at later terms. In the late postoperative period there were no substantial differences between the data of central hemodynamics and postoperative data independent of the stage of the blood circulation disturbance.