Developments in Hand Surgery: Experience from a Tertiary Hospital of Northern Bangladesh.

Hand Surgery is a specialized branch of Plastic and Reconstructive surgery. There are many conditions that require hand surgery, for example, congenital deformity, electric or flame burn, mechanical or road traffic injury, and post burn or post traumatic deformity. A retrospective observational study was conducted in the department of Burn and Plastic surgery, Mymensingh Medical College Hospital, Bangladesh during a 2 years period extending from 9th September 2021 to 8th September 2023. The objective of this study was to see the hand surgery status in a tertiary hospital of Bangladesh during the post Covid pandemic period. During this period 236 hand surgery procedures were performed in 176 patients. The age of the patients ranged from 02 to 78 years (Mean 31.14±1.52). One hundred and four (59.0%) were male and 72(41.0%) were female. Thirty-four (19.32%) patients had co-morbidities e.g., Epilepsy, Diabetes Mellitus, Chronic Kidney Diseases and HBsAg +ve. Causes of surgery included, wound due to electric burn 49(27.84%), flame burn 36(20.45%), post traumatic 24(13.64%), post infective 11(06.25%), tumor excision 02(2.24%), Dupuytren's contracture 03(1.70%), congenital anomalies 06(3.41%), post burn scar contractures 41(23.29%), nerve injury 01(00.57%) and carpal tunnel syndrome 01 (00.57%). Procedures were performed: post burn scar contracture release 41(17.37%), syndactly release 06(2.54%), release of post traumatic contracture 06(2.54%), carpal tunnel release 01(00.42%), release of Dupuytren's contracture 03(01.27%), nerve repair 01(00.42%), debridement, amputation and Fillet flap 29(12.29%), split thickness skin graft 46 (19.49%), V-Y advancement flap 06(2.54%), transposition flap 18(07.63%), cross finger flap 16 (06.78%), reverse cross finger flap 02 (00.85%), first dorsal metacarpal artery (FDMA) flap 05 (02.12%), reverse FDMA flap 01 (00.42%), metacarpal artery perforator flap 08(3.39%), radial artery perforator flap 04(01.69%), posterior interosseous artery flap 05(2.12%), abdominal flap 11(04.46%) and flap division and insetting 27(11.44%). Outcome of surgery was satisfactory in 225(95.34%) and 11(04.46%) cases had complications (p value 0.453), which was not significant. So, it can be concluded that the outcome of various types of hand surgery procedures in tertiary hospital of northern Bangladesh during the post Covid period was satisfactory overall.

Coverage of defects over Posterior aspect of Ankle Joint and Heel with Lateral Calcaneal Artery Flap- Experience in Mymensingh Medical College Hospital.

Lateral calcaneal artery flap is randomly used by many Plastic Surgeons for covering any defect on the posterior aspect of heel. A prospective observational study was conducted in the Department of Burn and Plastic Surgery, Mymensingh Medical College Hospital, Mymensingh, Bangladesh from January 2020 to June 2022, to see the outcome of the flap for coverage of defects over the posterior aspect of ankle joint and heel. A total number of 09 patients, selected by purposive sampling, were included in the study. The age of the patients ranged from 06 years to 70 years. The cause of the defects were post traumatic in 07 cases, electric burn in 01 case and pressure sore in 01 case. The defect sizes varied from 3×2 to 6×3cm. and flap size ranged from 4×2.5 to 7×4.5cm. The follow-up period ranged from 3 to 6 months. All the flaps survived completely without any complications; except in two cases. In one case, there was marginal epidermal necrolysis that healed secondarily without the need of any further surgical intervention. In the other case, there was gangrene of about 0.5 cm area at the flap tip, which was debrided and the resulting wound healed secondarily. The average operating time was 63 minutes. The results were satisfactory on the context of adequate coverage, and flap and donor site morbidity. So, the lateral calcaneal artery flap can be a good and safe option for the coverage of posterior ankle and heel defects.

Dose- and time-dependent effects of interferon tau on bovine endometrial gene expression.

Failure by the developing conceptus to secrete sufficient interferon tau (IFNT), required for maternal recognition of pregnancy (MRP), at the appropriate time is related to early pregnancy loss in cattle. We aimed to test the hypothesis that there is a dose- and time-dependent relationship between IFNT and the endometrial expression of key interferon-stimulated genes (ISGs) involved in the signalling cascade leading to MRP in cattle. Candidate genes were identified first through a bioinformatic approach, where integrated transcriptomic data from two previous studies were analyzed to identify endometrial genes induced by IFNT. Next, expression of selected candidate genes was investigated in vitro in endometrial explants. Endometrial explants collected from cows (n = 8) in the late luteal phase of the estrous cycle were cultured in medium without (control) or with recombinant ovine IFNT (1, 10, 100 ng/mL) for 6 h. Simultaneously, endometrial explants were cultured in medium containing 100 ng/mL IFNT for different time periods (15 min, 30 min, 1 h, 3 h, 6 h). Gene expression was analyzed by RT-qPCR. We identified 54 endometrial genes responding to IFNT and to some degree to the conceptus, from which five ISGs (CMPK2, BPNT1, IFI35, TNFSF10 and TRIM38) were further selected for the dose- and time-dependent experiments. Classical ISGs (ISG15, OAS1, MX1 and MX2) were up-regulated (P < 0.05) in endometrium by 1 ng/mL IFNT. However, other selected ISGs (CMPK2, BPNT1, IFI35, TNFSF10 and TRIM38) were induced only by higher concentrations (10 and 100 ng/mL) of IFNT (P < 0.05). In terms of duration of exposure, IFNT at 100 ng/mL induced a significant (P < 0.05) increase in ISG15 and CMPK2 expression after 1 h incubation, while all other studied ISGs in the endometrium were upregulated when cultured for 3 or 6 h, but did not affect expression when the duration of culture was for 1 h or less. These results suggest that IFNT acts on the uterus in both a dose- and time-dependent manner in cattle and that timely exposure of the endometrium to sufficient IFNT is essential for appropriate signalling to ensure successful pregnancy establishment.

A Comparative Study of Collagen Sheet versus 1% Silver Sulfadiazine Dressing in Superficial Partial Thickness Burns.

Burn injury causes a lot of suffering. The goal of burn management is to achieve rapid wound healing, pain relief, rehabilitation with minimum scars and optimal functional ability. Objective of this study was to compare the efficacy of collagen sheets and 1% silver sulfadiazine dressing (SSD) for superficial partial thickness burns. This prospective observational study was conducted among the patients of Department of Plastic surgery, Dhaka Medical College Hospital, and Sheikh Hasina National Institute of Burn and Plastic Surgery, Dhaka, from 1st April 2020 to 31st March 2021. Total 60 patients with superficial partial thickness burns by purposive sampling 30 patients of them were treated with collagen sheet dressing (Group A) and 30 patients with 1.0% silver sulfadiazine dressing (Group B). First case was selected by tossing a coin. Then every alternate patient was provided the same kind of dressing material (either collagen sheet or 1.0% silver sulfadiazine). Data were collected by semi structured data collection sheets. Pearson's chi-square test and student's 't' test were used for data analysis (p value was significant at <0.05). It was observed that a total of 18(60.0%) patients belonged to age <10 years in Group A and 17(56.7%) patients in Group B. The mean age was 14.9±14.2 years in Group A and 11.6±10.2 years in Group B. Good quality of healing was significantly higher in the collagen group compared to the SSD group (<0.05). The mean complete healing time in the collagen group was 10.47±2.21 days and in the 1.0% SSD group were 13.07±2.33 days. The mean healing time was significantly lower in the collagen group compared to the 1.0% SSD group (p<0.001). There was no significant difference in infection rate between the two groups (p>0.05). Considering the overall outcome, Collagen sheet dressing decreases pain, reduces the need for analgesics, aids in early healing as compared to the patients treated with 1% silver sulfadiazine.

Crane Principle in Plastic Surgery- Experience in Mymensingh Medical College Hospital.

The crane principle is a Plastic surgical technique whereby, a pedicled flap can be used as an engineering crane to lift and transport subcutaneous tissue from one area and deposit it in another. The flap can be returned later to its original bed. It takes only one week for the conveyance. Here we present a case of 25 year old female patient with degloving injury of scalp with exposed skull bone was initially managed with transposition flap for coverage of the scalp defect in Mymensingh Medical College Hospital (MMCH), Mymensingh, Bangladesh on 07 December 2017. After 8 months the scalp flap was returned to its original site following the crane principle and the new wound was covered by split-thickness skin graft. The flap survived completely and patient was satisfied.

Successful Multi-vessel Percutaneous Coronary Intervention for Recent Myocardial Infarction in a Patient with Dextrocardia and Situs Inversus.

Dextrocardia with situs inversus is a state which is characterized by abnormal positioning of the heart and other internal organs. It is a rare congenital anomaly and the exact cause is not known. More than 60 recognized genes are significant for the proper positioning and patterning of the organs in the body. However, a specific genetic cause of dextrocardia with situs inversus has not been identified and inheritance prototypes have not been established in the majority cases. There are partial available case reports of successful percutaneous coronary intervention (PCI) in these patients who have atherosclerotic coronary artery disease, especially when presenting with myocardial infarction. PCI is technically difficult because of dextrocardia. We hereby describe a 51-year-old male, who had a recent inferior wall myocardial infarction and underwent successful coronary angiography and PCI at a tertiary level hospital in Dhaka, Bangladesh.

Influence of the Interval between Antenatal Corticosteroid Therapy and Delivery on the Incidence of Respiratory Distress Syndrome in Neonate.

In spite of the recommendation for rescue antenatal corticosteroids (ACS), the optimal time interval between primary and rescue courses has not been clearly demonstrated. The aim of this retrospective study was to determine the effects of the interval between a single ACS (Dexamethasone) course and delivery on the incidence of respiratory distress syndrome (RDS) in neonates at Mymensingh Medical College Hospital Center from 1st January 2017 to 30th June 2017. Injection Dexamethasone 2 doses (12.5mg IM 12 hourly for 2 doses) or 4 doses (6mg IM every 12 hours for 4 doses) use to arrest preterm labor as well as to prevent RDS delivered beyond 48 hours after ACS administration between 24 and 34 weeks gestation. The risk of RDS was compared between patients who delivered within seven days (Group I) and 7-14 days (Group II) after ACS administration. We included 140 and 60 patients in Group I and Group II respectively. After adjusting for confounders, the ACS delivery interval was significantly associated with RDS in Group II (adjusted odds ratio 12.8, 95% confidence interval 1.31-164.7). A longer ACS delivery interval is associated with a higher risk of RDS. Thus, the use of a rescue course could be expected to reduce the incidence of RDS in patients beyond seven days after ACS administration who remain at risk for preterm delivery within seven days, especially in cases of placenta previa and/or women bearing a male fetus.

Binocular Visual Discomfort after First Eye Cataract Surgery: An Inattentive Burning Issue.

Cataract surgery is the most frequent surgical procedure performed among the elderly. Aniseikonia and anisometropia increased after the first eye cataract surgery. The study was performed to evaluate unwanted visual status after first eye cataract surgery. It was an observational and cross-sectional study performed among the cataract surgery patients attending in out patient department (OPD) of Dr K Zaman BNSB Eye Hospital, Mymensingh from July 2018 to September 2018 for post-operative follow up. Five hundred patients were selected randomly. Patients with gross corneal diseases were excluded from the study. Three hundred forty one patients (68.2%) were with first eye cataract surgery, among them 319 patients (63.8%) had different degree of cataract in other eye. One hundred forty three patients (44.7%) had good presenting vision (≥6/18) in operated eye and much reduced vision in other eye due to cataract, experienced binocular visual discomfort when opened two eyes, which was not experienced by the patients who had reduced vision in both eyes or good vision in both eyes. Cataractous eye interfered with visual function of the pseudophakic eye. So, cataract Surgery for both eyes in separate events is the appropriate treatment for the patients with bilateral cataract to eliminate visual disability and to achieve comfortable visual outcome.

Posterior Tibial Artery Perforator Based Propeller Flap for Lower Leg and Ankle Defect Coverage: A Prospective Observational Study.

Reconstruction of lower leg and ankle defect with exposed bone or tendon is a challenging task for a Plastic Surgeon. There are various options, among them perforator based propeller flap is a very good option though this is a microsurgical procedure but no need of microvascular anastomosis. This study was designed to see the clinical results of Posterior tibial artery perforator based propeller flap for lower leg and ankle defect coverage. The study was a prospective observational study. It was conducted in the Department of Burn and Plastic Surgery, Mymensingh Medical College Hospital, Mymensingh, Bangladesh from July 2017 to June 2018. Sample size was 9. Sampling was carried out purposively. Postoperative follow up period was up to 6 weeks. Among the 9 cases, 8 flaps completely survived, 1 case developed marginal necrosis which was secondarily healed. There were total 2 complications among 9 cases i.e. transient venous congestion and superficial epidermonecrolysis which were resolved spontaneously. Regarding the cause of the defect, maximum cases were post traumatic wound (66.7%), others were post infective, post malignancy excision and post electric burn wound. Defect size was 2cm×2cm to 7cm×5cm. Maximum dimension of the flap was 19cm×6cm and minimum size was 7cm×3cm. Posterior tibial artery perforator location was 4cm to 9cm from lowest level of medial malleolous (mean 6.2±1.6cm). Rotation of the flap was 145°-180° (mean 163°±1.39°). In all cases donor site was covered with split thickness skin graft. Operation time was 120 minutes to 180 minutes; mean operative time was 143.3±2.38 minutes. After operation hospital stay was 10 days to 21 days, mean 11.44±3.64 days. So, posterior tibial artery perforator based propeller flap for lower leg and ankle defect coverage is a very good option.

Fetomaternal Outcome in Eclampsia in Relationship with Gravidity.

Eclampsia is a well-recognized major cause of maternal and perinatal morbidity and mortality. Patient's age, occupational status, socioeconomic status, educational status, regular ANC (antenatal care) and gravidity may affect the outcome of mother and foetus. The purpose of this study is to see the fetomaternal outcome in eclampsia in relationship with gravidity. This prospective observational cross-sectional study carried out among the alternate cases of primigravid and multigravid eclamptic patients. Total number of patients was 100 eclamptic patients among them, 50 patients were primigravida and 50 patients were multigravida. The study was conducted in Eclampsia unit of Department of Gynaecology and Obstetrics, Dhaka Medical College Hospital, Dhaka, Bangladesh from 21 November 2011 to 20 May 2012. In this study, it was observed that ARF (acute renal failure) occurred in 6%, of these 4 cases of multigravida and 2 cases of primigravida. Cerebro vascular accident (CVA) was reported in 16 patients and 26% in multigravida and 6% in primigravid patients. HELLP (Haemolysis, Elevated liver enzymes and low platelets) syndrome developed in 25 cases of multigravida and 6 cases of primigravida. Heart failure occurred in 7% cases, out of these 6 cases were multigravida and 1 case was primigravida. Pulmonary edema was observed in 41%, among were 21 cases of multigravida and 20 cases of primigravida. Incidence of DIC (disseminated intravascular coagulation) was noted in 2 cases of multigravida and 1 case of primigravida. PPH (postpartum haemorrhage) occurred in 10 cases of multigravida and 3 cases of primigravid patients. Puerperal psychosis was reported in 8% of multigravida and 4% of primigravida. Total 4% of patients expired, among them 3 cases were multigravida and 1 case was primigravida. Perinatal mortality was 21 cases in multigravida and 8 cases in primigravida. The incidence of live birth, in case of multigravida was 39 cases and primigravida 45 cases. Data were analyzed by paired student's 't' test. There was no statistically significant difference between primi and multigravida in feto-maternal outcome. This study reveals that gravidity does not alter the feto-maternal outcome in eclampsia.

Antibiotic Resistance: New Challenge in the Management of Bacterial Eye Infections.

Ophthalmologists are still facing difficulties in managing bacterial eye infections. The study was designed for the isolation and identification of bacteria from infected eyes and observation of the sensitivity and resistant pattern. This cross sectional study was performed among 160 patients of suspected bacterial eye infection at Dr. K. Zaman BNSB Eye Hospital, Mymensingh and Department of Microbiology and Hygiene, Bangladesh Agricultural University, Mymensingh from March, 2010 to June, 2014. After collection of the samples from suspected infected eyes, it was nourished into nutrient broth in shaking incubator for three hours and then cultured into nutrient agar media followed by Mannitol salt agar, MacConkey's agar and blood agar. Bacteria were categorized by colony characteristics and Gram staining. Antibiogram was performed by disc diffusion method on Mueller Hinton agar media. McFarland Equivalence Turbidity Standard was maintained. The efficacy of the drug was evaluated by measuring the diameter of the zone of inhibition surrounding the disc. Ten percent Staphylococcus species isolates was resistant to Gatifloxacin, Gentamicin, Tobramycin and Cloxacillin, 26.0% to Ciprofloxacin, 40.0% to Azythromycin and Moxifloxacin, 58.0% to Cefixime and 64.0% to Cephalexin. Methicillin resistant Staphylococcus aureus was 62.8%. About 24.0% Streptococcus species isolates was resistant to Gatifloxacin, 33.3% to Azythromycin, Ciprofloxacin, Gentamycin, Moxifloxacin and Tobramycin, 52.4% to Cefixime and 71.4% to Cephalexin. About 9.0% of Pseudomonas species was resistant to Gatifloxacin and Tobramycin, 14.7% to Ciprofloxacin, 26.5% to Cefixime, 29.4% to Gentamicin and Moxifloxacin, 44.1% to Azythromycin and 82.3% to Cephalexin and Cloxacillin. Rational use of antibiotics and proper attentions of concerned authorities are necessary to overcome the emergent ocular situation leaded by antibiotic resistant.

Management of Infective Corneal Ulcer: Epidemiology Needs To Be Evaluated As Priority Basis.

Because of known and unknown etiology, management of ocular devastating situation like corneal ulcer is still a challenge for the Ophthalmologists. The cross sectional study was designed for detection of predisposing factor and identification of causal agent. To serve the above purpose, a cross sectional study was performed among 140 patients of the corneal ulcer at Dr K Zaman BNSB Eye Hospital, Mymensingh and Department of Microbiology and Hygiene, Bangladesh Agricultural University, Mymensingh, Bangladesh. Detail history of patient was taken and recorded in a pretest questionnaire sheet. Two pieces of sample were collected from each corneal ulcer patient. One sample was examined in KOH wet mount for fungus. Other sample was nourished into nutrient broth and for further culture and identification. Bacterial corneal ulcer was higher among the patient of age group ≥46 years (61.9%) followed by 31-45 years (21.5%). P value is 0.261. Males were found predominant (58.5%). P value is 0.13. Agricultural related work was identified as most risky occupation in 83.1% of the total bacteria positive samples. P value is 0.01. Trauma was noted as most predominant influencing factor (56.9%). P value is <0.05. Bacteria were identified in 65(46.4%) and fungus in 40(28.6%) samples. Pseudomonas species were predominant (52.3%) followed by Staphylococcus species (26, 2%) and Streptococcus species (21.5%). No mixed infection was identified. For easier and earlier diagnosis of corneal ulcer, information about epidemiology is very essential. History should be taken meticulously followed by the laboratory procedures.

Retrobulbar abscess in a child.

A 14 months old male child was admitted into Mymensingh Medical College Hospital (MMCH), Bangladesh, with fever, watering, swelling, redness of right eye and running nose. On initial examination, patient was febrile, toxic, right-sided severe proptosis, restricted ocular movement, conjunctival chemosis and exposure keratitis of right eye. A sluggish pupillary light reaction was present in the right eye. Visual acuity was not recordable. CT scan of Brain and Orbit revealed, retrobulbar abscess of right orbit. The left eye was normal. The abscess was drained through a wide bore needle. The extraocular motility improved and pupil became brisk with a reduction in the temperature and toxic signs within 48 hours following surgery. Proptosis at the time of discharge from the hospital was absent in the right eye with no other complication. Post operative 8 months follow up period was excellent.

Household food insecurity and dietary diversity as correlates of maternal and child undernutrition in rural Cambodia.

OBJECTIVES: To assess household food insecurity and dietary diversity as correlates of maternal and child anthropometric status and anemia in rural Cambodia. METHODS: Trained interviewers administered a survey to 900 households in four rural districts of Prey Veng, Cambodia. The Household Food Insecurity Access Scale (HFIAS) and Household Dietary Diversity Score (HDDS) were used to assess household food insecurity and dietary diversity. The height, weight and hemoglobin concentration of the mother and youngest child under 5 years in each household were measured. Multivariate logistic regression models were constructed to assess the association between household food insecurity and dietary diversity, and child stunting and wasting, maternal thinness, maternal and child anemia. RESULTS: The mean (s.d.) HFIAS and HDDS scores were 5.3 (3.9) and 4.7 (1.6), respectively. The respective prevalences of mild, moderate and severe food insecurity were 33, 37 and 12%. Maternal thinness, child stunting and child wasting were present in 14.6, 25.4 and 8.1% of respondents, respectively. The risk of maternal thinness, but not child stunting or wasting, increased as the severity of household food insecurity increased. Household food insecurity was also positively associated with maternal, but not child, anemia. Household dietary diversity status was not significantly associated with any of the outcomes we assessed. CONCLUSIONS: Efforts to improve household food security are important as a means of promoting maternal nutritional status; however, additional research is needed to better understand the role of other factors that are driving the burden of child undernutrition in Cambodia.

Molecular epidemiology of tuberculosis in rural Matlab, Bangladesh.

OBJECTIVE: To characterise and classify clinical isolates collected from tuberculosis (TB) patients in rural Bangladesh and to investigate the mode of transmission. DESIGN: An epidemiological study using a combination of conventional and molecular methods was performed in a rural population of Bangladesh. A total of 168 clinical isolates were collected from TB patients. Deletion analysis, used for rapid differentiation of members of the Mycobacterium tuberculosis complex, spoligotyping and variable number tandem repeats of mycobacterial interspersed repetitive units (VNTR-MIRU) typing were used. RESULTS: Deletion analysis identified all isolates as M. tuberculosis and further divided them into 109 strains (65%) carrying the M. tuberculosis deletion region 1 (TbD1-intact or 'ancestral' strains) and 59 strains (35%) lacking this region (TbD1 or 'modern' strains). MIRU analyses showed that 149 strains (89%) had unique patterns, whereas 19 strains (11%) clustered into eight groups. The largest cluster comprised five TbD1 strains of the Beijing type. The rate of recent transmission was estimated to be 6.5%. CONCLUSIONS: Our results suggest that TB in rural Bangladesh is caused primarily by reactivation of latent infections involving TbD1 intact strains, overlaid with the recent emergence of Beijing strain clusters that include multidrug-resistant isolates.

Effect of water management, arsenic and phosphorus levels on rice in a high-arsenic soil-water system: II. Arsenic uptake.

Rice consumption is one of the major pathways for As intake in populations that depend on a rice diet in several countries of South and South-east Asia. Pot experiments were undertaken to investigate the effects of water management (WM), arsenic (As) contaminated soil-water and Phosphorus (P) rates on As uptake in rice plants. There were 18 treatments comprising of three each of As rates (0, 20 and 40 mg kg(-1) soil) and P rates (0, 12.5 and 25 mg kg(-1) soil) and two WM (aerobic and anaerobic) strategies on winter (boro var. BRRI dhan 29) and monsoon (aman var. BRRI dhan 32) rice at the Wheat Research Center (WRC), Nashipur, Dinajpur, Bangladesh. Arsenic concentrations in rice grain and straw increased significantly (P ≤ 0.01) with the increasing As rates in the soil. Arsenic availability in soil pore-water solution was less (58%) under aerobic WM (redox potential-Eh=+135 to +138 mV; pH-6.50 at 24.3 °C) as compared to anaerobic WM (flooded: Eh=-41 to -76 mV; pH-6.43 at 23 °C). The highest total grain As content 2.23 ± 0.12 mg kg(-1) and 0.623 ± 0.006 mg kg(-1) was found in T(6) (P(12.5)As(40)-anaerobic) and T(9) (P(25)As(40)-anaerobic) in BRRI dhan 29 and BRRI dhan 32, respectively, which was significantly higher (41-45%) than in the same As and P treatments for pots under aerobic WM. The As content in rice straw (up to 24.7 ± 0.49 ppm in BRRI dhan 29, 17.3 ± 0.49 mg kg(-1) in BRRI dhan 32 with the highest As level) suggested that As can more easily be translocated to the shoots under anaerobic conditions than aerobic condition. BRRI dhan 29 was more sensitive to As than BRRI dhan 32. Under aerobic WM, P soil amendments reduced As uptake by rice plants. The study demonstrated that aerobic water management along with optimum P amendment and selection of arsenic inefficient rice varieties are appropriate options that can be applied to minimize As accumulation in rice which can reduce effects on human and cattle health risk as well as soil contamination.

Epidemiology and outcome of non viral keratitis.

This cross sectional study was done to evaluate the epidemiological pattern of fungal keratitis. It was done among 120 patients, selected randomly, at the cornea clinic, BNSB Eye Hospital, Mymensingh during the period of April 2008 to July 2008. In this study Chi-square test was done and males were predominant. Rural patients were mostly affected (93%). Study showed bacterial infection (41.66%) and fungal infection (39.16%). Among the fungus infected patient, 49% had history of trauma and 51% had no history of trauma (p>0.05), about 30% had vegetative injury and 19% had injury other than vegetative. Fungus was identified under microscope, 95% of which was confirmed by culture. Fifty five percent (55%) patients of bacterial infection and 31% patients of fungal infection attended with hypopyon (p<0.05). For fungal keratitis, trauma considered as the important predisposing factor. Immuno-compromised condition, ocular surface disease and climatic effects should also be kept in consideration. Microscopic investigation at the beginning of the treatment might help to achieve better outcome.

Effect of water management, tillage options and phosphorus status on arsenic uptake in rice.

High arsenic (As) concentrations in soil may lead to elevated concentrations of arsenic in agricultural products. Field experiments were conducted to examine the effects of water management (WM) and Phosphorus (P) rates on As uptake, rice growth, yield and yield attributes of winter (boro) and monsoon (aman) rice in an As contaminated soil-water at Gobindagonj, Gaibandha, Bangladesh in 2004 and 2005. Significantly, the highest average grain yields (6.88±0.07 t ha(-1) in boro 6.38±0.06 t ha(-1) in aman) were recorded in permanent raised bed (PRB; aerobic WM: Eh=+360 mV) plus 100% P amendment. There was a 12% yield increase over conventional till on flat (CTF; anaerobic WM: Eh=-56 mV) at the same P level. In boro, the As content in grain and As content in straw were about 3 and 6 times higher in CTF compared to PRB, respectively. The highest total As content (0.646±0.01 ppm in grain and 10.93±0.19 ppm in straw) was recorded under CTF, and the lowest total As content (0.247±0.01 and 1.554±0.09 ppm in grain and straw, respectively) was recorded under PRB (aerobic WM). The results suggest that grain and straw As are closely associated in boro rice. The furrow irrigation approach of the PRB treatments consistently reduced irrigation input by 29-31% for boro and 27-30% for aman rice relative to CTF treatments in 2004 and 2005, respectively, thus reducing the amount of As added to the soil from the As-contaminated irrigation water. Yearly, 30% less As was deposited to the soil compared to CTF system through irrigation water during boro season. High As concentrations in grain and straw in rice grown using CTF in the farmers' field, and the fact that using PRB reduced grain As concentrations to value less than half of the proposed food hygiene standard.

Serine 28 phosphorylation of NRIF3 confers its co-activator function for estrogen receptor-alpha transactivation.

NRIF3 is an estrogen-inducible nuclear receptor coregulator that stimulates estrogen receptor-alpha (ERalpha) transactivation functions and associates with the endogenous ER and its target gene promoter. p21-activated protein kinase 1 (Pak1) phosphorylates ERalpha at Ser305 and this modification is important in ERalpha transactivation function. Although ERalpha transactivation functions are regulated by co-activator activity of NRIF3, it remains unclear whether Pak1 could impact ER functions via a posttranslational modification of NRIF3. Here, we report that Pak1 phosphorylates NRIF3 at Serine28 and that NRIF3 binds to Pak1 in vitro and in vivo. We found that NRIF3 phosphorylation, co-activator activity and association with ERalpha increased following Pak1 phosphorylation of NRIF3's Ser28 and that activated ERalpha-Ser305 and NRIF3-Ser28 cooperatively support transactivation of ERalpha. NRIF3 expression increased significantly in cells with inducible Pak1 expression. We found that NRIF3 and ERalpha interaction, subcellular localization and ERalpha transactivation activity all increased in cells expressing the Pak1 phosphorylation-mimicking mutant NRIF3-Ser28Glu. Consistently, the NRIF3-Ser28Glu mutant exhibited an enhanced recruitment to the endogenous ER target genes and increased expression following estrogen stimulation. Finally, breast cancer cells with stable overexpression of NRIF3 showed increased proliferation and enhanced anchorage-independent growth. These findings suggest that NRIF3-Ser28 is a physiologic target of Pak1 signaling and contributes to the enhanced NRIF3 co-activator activity, leading to coordinated potentiation of ERalpha transactivation, its target gene expression and estrogen responsiveness of breast cancer cells.

Phosphorylation of the ErbB3 binding protein Ebp1 by p21-activated kinase 1 in breast cancer cells.

The ErbB3 binding protein (Ebp1) is a transcriptional corepressor that inhibits the activity of proliferation-associated genes and the growth of human breast cancer cell lines. Treatment of breast cancer cells with the ErbB3 ligand heregulin (HRG) results in increased phosphorylation of Ebp1 and transcriptional repression. The p21-activated serine/threonine kinase 1 (PAK1), which plays an important role in breast cancer progression and resistance to the anti-oestrogen tamoxifen, is also activated by HRG. We therefore examined the ability of PAK1 to phosphorylate and regulate the function of Ebp1. We found that PAK1 phosphorylated Ebp1 in vitro and mapped the phosphorylation site to threonine 261. Both HRG treatment and expression of a constitutively activated PAK1 in MCF-7 breast cancer cells enhanced threonine phosphorylation of Ebp1. In MCF-7 cells, ectopically expressed Ebp1 bound endogenous PAK1 and this association was enhanced by treatment with HRG. Mutation of the PAK1 phosphorylation site to glutamic acid, mimicking a phosphorylated state, completely abrogated the ability of Ebp1 to repress transcription, inhibit growth of breast cancer cell lines and contribute to tamoxifen sensitivity. These studies demonstrate for the first time that Ebp1 is a substrate of PAK1 and the importance of the PAK1 phosphorylation site for the functional activity of Ebp1 in breast cancer cells.