Structural and functional assessment of macula to diagnose glaucoma.

PurposeTo compare the diagnostic abilities of structural (ganglion cell-inner plexiform layer (GCIPL) thickness measured using spectral domain optical coherence tomography (SDOCT)) and functional (visual sensitivities measured using standard automated perimetry (SAP) and microperimetry (MP)) assessments of macula in glaucoma.MethodsIn a prospective study, 46 control eyes (28 subjects) and 61 glaucoma eyes (46 patients) underwent visual sensitivity estimation at macula (central 10°) by SAP and MP, and GCIPL thickness measurement at macula by SDOCT. Glaucoma was diagnosed by experts based on the optic disc and retinal nerve fiber layer changes. Area under the receiver-operating characteristic (AUC) curves and sensitivities at 95% specificity were used to assess the diagnostic ability of visual sensitivity and GCIPL measurements at various macular sectors.ResultsAUCs of GCIPL parameters ranged between 0.58 and 0.79. AUCs of SAP and MP sensitivities ranged between 0.59 and 0.71, and 0.59 and 0.72, respectively. There were no statistically significant differences between the AUCs of corresponding sector measurements (P>0.10 for all comparisons). Sensitivities at 95% specificities ranged from 31-59% for GCIPL parameters, 16-34% for SAP, and 8-38% for MP parameters. Sensitivities were significantly better with GCIPL compared with SAP and MP parameters in diagnosing glaucoma. Inferotemporal, inferior, and superotemporal sector measurements of GCIPL and visual sensitivity showed the best abilities to diagnose glaucoma.ConclusionsComparing the diagnostic abilities of structural and functional tests at macula in glaucoma, GCIPL thickness measurements with SDOCT performed better than the visual sensitivity measurements by SAP and MP.

Anti-tuberculosis drug resistance in Bangladesh: reflections from the first nationwide survey.

OBJECTIVE: To determine the prevalence of tuberculosis (TB) drug resistance in Bangladesh. DESIGN: Weighted cluster sampling among smear-positive cases, and standard culture and drug susceptibility testing on solid medium were used. RESULTS: Of 1480 patients enrolled during 2011, 12 falsified multidrug-resistant TB (MDR-TB) patients were excluded. Analysis included 1340 cases (90.5% of those enrolled) with valid results and known treatment antecedents. Of 1049 new cases, 12.3% (95%CI 9.3-16.1) had strains resistant to any of the first-line drugs tested, and 1.4% (95%CI 0.7-2.5) were MDR-TB. Among the 291 previously treated cases, this was respectively 43.2% (95%CI 37.1-49.5) and 28.5% (95%CI 23.5-34.1). History of previous anti-tuberculosis treatment was the only predictive factor for first-line drug resistance (OR 34.9). Among the MDR-TB patients, 19.2% (95%CI 11.3-30.5; exclusively previously treated) also showed resistance to ofloxacin. Resistance to kanamycin was not detected. CONCLUSION: Although MDR-TB prevalence was relatively low, transmission of MDR-TB may be increasing in Bangladesh. MDR-TB with fluoroquinolone resistance is rapidly rising. Integrating the private sector should be made high priority given the excessive proportion of MDR-TB retreatment cases in large cities. TB control programmes and donors should avoid applying undue pressure towards meeting global targets, which can lead to corruption of data even in national surveys.

Prevalence of smear-positive tuberculosis in persons aged ≥ 15 years in Bangladesh: results from a national survey, 2007-2009.

The aim of this study was to determine the nationwide prevalence of smear-positive tuberculosis (TB) in Bangladesh. A multi-stage cluster survey of a random sample of persons aged ≥ 15 years was included in 40 clusters (20 urban, 20 rural). Two sputum samples were collected from study participants and tested initially by fluorescence microscopy and confirmed by the Ziehl-Neelsen method. The crude and adjusted prevalence rates and 95% confidence intervals (CIs) were calculated using standard methods. A total of 33 new smear-positive TB cases were detected among 52 098 individuals who participated in the study. The average participation rate was over 80%. The overall crude prevalence of new smear-positive TB in persons aged ≥ 15 years was estimated as 63.3/100 000 (95% CI 43.6-88.9) and the adjusted prevalence was 79.4/100 000 (95% CI 47.1-133.8). TB prevalence was higher in males (n = 24) and in rural areas (n = 20). The prevalence was highest in the 55-64 years age group (201/100 000) and lowest in 15-24 years age group (43.0/100 000). The prevalence was higher in persons with no education (138.6/100 000, 95% CI 78.4-245.0). The overall prevalence of smear-positive TB was significantly lower than the prevalence estimate of the previous nationwide survey in Bangladesh in 1987-1988 (870/100 000).

Adults with chronic cough in urban Bangladesh: healthcare utilization and management of cases by private practitioners.

Tuberculosis (TB) case detection under the Directly Observed Treatment - Short-course (DOTS) strategy largely relies upon care seeking of chronic coughers and the actions taken by their healthcare providers. This study aimed to describe the healthcare utilization of people 15 years of age with a chronic cough in urban areas of Bangladesh and to understand their management by private practitioners. A community-based, household survey included 60,382 persons ≥ 15 years of age from two administrative areas of Dhaka City. A total of 1138 (2%) were identified to have had a cough for 3 weeks or more. This survey was linked to interviews of licensed and unlicensed practitioners in Dhaka and the Chittagong City Corporation of Bangladesh. Among identified coughers, 1046 (92%) were interviewed, of whom 648 (62%) reported having sought care from any provider. Among care seekers, 16% directly attended a DOTS facility. The remaining 84% sought care from the private sector, where less than 1% reported referral to a DOTS facility. Bivariate and multivariate assessments showed that care seeking from a licensed private practitioner or a DOTS centre was significantly associated with severity of the disease and previous diagnosis of TB.

Sesbania grandiflora diminishes oxidative stress and ameliorates antioxidant capacity in liver and kidney of rats exposed to cigarette smoke.

Cigarette smoke is a major risk factor for many chronic diseases. However, it may be possible to relieve the smoke-induced damage by increasing the defensive system. In this study, we planned to evaluate the protective mechanism of Sesbania grandiflora (S. grandiflora) leaves against cigarette smoke-induced oxidative damage in liver and kidney of rats. Adult male Wistar-Kyoto rats were exposed to cigarette smoke for a period of 90 days and consecutively treated with S. grandiflora aqueous suspension (SGAS, 1000 mg/kg body weight per day by oral gavage) for a period of 3 weeks. Hepatic marker enzymes like aspartate aminotransferase (AST), alanine aminotransferase (ALT) and alkaline phosphatase (ALP), as well as renal markers such as urea and creatinine were analysed in serum. Lipid peroxidation marker mainly thiobarbituric acid reactive substances (TBARS) and antioxidant enzymes namely superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx), glutathione reductase (GR), glutathione-S-transferase (GST) and glucose-6-phosphate dehydrogenase (G6PDH) activities and non-enzymatic antioxidants such as reduced glutathione, ascorbic acid and alpha-tocopherol levels were studied. In addition, micronutrients mainly copper (Cu), zinc (Zn), manganese (Mn) and selenium (Se) levels were analyzed in liver and kidney of rats exposed to cigarette smoke. The results indicated that SGAS significantly decreased the elevated hepatic, renal and lipid peroxidation markers and ameliorated the diminished antioxidant levels while restored the hepatic and renal architecture in cigarette smoke-exposed rats. This study concludes that S. grandiflora leaves restrain cigarette smoke-induced oxidative damage in liver and kidney of rats.

Protective effect of Sesbania grandiflora against cigarette smoke-induced oxidative damage in rats.

Sesbania grandiflora, commonly known as "sesbania" and "agathi," is widely used in Indian traditional medicine for the treatment of a broad spectrum of diseases. In the present study, we evaluated the possible protective effect of an aqueous suspension of S. grandiflora (ASSG) leaves against cigarette smoke-induced oxidative damage in rats. Adult Wistar-Kyoto rats were exposed to cigarette smoke for a period of 90 days and treated with ASSG (1,000 mg/kg of body weight/day, p.o) for a period of 3 weeks. The levels of protein carbonyl and activities of cytochrome P450, NADPH oxidase, and xanthine oxidase were significantly increased, whereas the levels of total thiol, protein thiol, non-protein thiol, nucleic acids, and tissue protein were significantly reduced in lung, liver, kidney, and heart of cigarette smoke-exposed rats as compared with control rats. Plasma nitric oxide levels, measured as nitrite plus nitrate, were significantly increased in cigarette smoke-exposed rats when compared to the control rats. The above changes were ameliorated to near control in the treatment group. These results suggest that supplementation with ASSG reversed the cigarette smoke-induced oxidative damage in rats through its antioxidant potential. These results provide further support for the traditional use of S. grandiflora in the treatment of smoke-related diseases.

A survey of TB services in hospitals in seven large cities in Asia and North Africa.

SETTING: Hospitals in Bangkok, Cairo, Dhaka, Jakarta, Karachi, Kathmandu and Manila. OBJECTIVES: To evaluate tuberculosis (TB) services provided in public and private hospitals in big cities. DESIGN: A survey on TB services in hospitals was carried out in 2005 by visiting hospitals and face-to-face interviews. Selection criteria were determined for each city. All hospitals were included if feasible. RESULTS: The number of hospitals included in the survey ranged from 52 in Bangkok to 106 in Jakarta. The proportion of private hospitals with access to a National Tuberculosis Programme (NTP) manual ranged from 8% in Jakarta to 89% in Bangkok. Private hospitals rarely functioned as a basic management unit (BMU) of the NTP, except in Bangkok. TB treatment was not always free of charge in BMU hospitals. The proportion of non-BMU hospitals that never referred/reported TB patients to the NTP was substantial in Bangkok, Dhaka, Jakarta, Karachi and Manila. Non-BMU hospitals did not routinely use standard NTP regimens, especially in Jakarta, Karachi and Manila. In non-BMU hospitals, patient tracing mechanisms were generally lacking and treatment outcome was not known. CONCLUSION: TB services provided in non-BMU hospitals were not satisfactory. NTPs need to involve non-BMU hospitals in TB control.

Preventive role of Gynandropsis gynandra L., against aflatoxin B1 induced lipid peroxidation and antioxidant defense mechanism in rat.

G. gynandra extract was found to potentially diminish the rate of lipid peroxidation, with a significant increase in the levels of enzymatic (superoxide dismutase, catalase and glutathione peroxidase) and non-enzymatic (reduced glutathione vitamins E and C, and uric acid) antioxidants, which were found, altered during aflatoxin B1 (AFB1) injection. The result confirmed that G. gynandra extract exerts its chemopreventive efficacy by preventing the rate of lipid peroxidation and influenced the enzymatic and non-enzymatic antioxidants in AFB1 induced male albino rats.

Modulatory effect of Gynandropsis gynandra L. on glucose metabolizing enzymes in aflatoxin B1-induced hepatocellular carcinoma in rats.

The modulation of glucose-metabolizing enzymes activities play a vital role in the depletion of energy metabolism and leads to inhibition of cancer growth. In the present study, the effect of Gynandropsis gynandra L. extract on aflatoxin B1 (AFB1)-induced hepatocellular carcinoma (HCC) was studied on glucose-metabolizing enzymes in rats. A significant increase (p < 0.001) in the activities of the key glycolytic enzymes viz., hexokinase and phosphoglucoisomerase, with a significant decrease (p < 0.001) in the gluconeogenic enzymes glucose-6-phosphatase and fructose-1,6-bisphosphatase were observed in HCC-bearing rats, when compared with the control. Administration of G. gynandra extract caused a significant decrease in the activities of glycolytic enzymes and an increase in the gluconeogenic enzymes activities to near normal values. Thus, findings suggest the G. gynandra extract has a definite modulating role on the key enzymes of glucose metabolism in HCC. The modulatory effect may be due to the phytoactive constituents present in the extract of G. gynandra.

Effect of Aerva lanata on calcium oxalate urolithiasis in rats.

Calcium oxalate (CaOx) stone was induced in rats using 0.75% of ethylene glycol in drinking water for 28 days. Ethylene glycol treated rats showed significant increase in the activities of oxalate synthesizing enzymes such as glycolic acid oxidase (GAO) in liver and lactate dehydrogenase (LDH) in liver and kidney. CaOx crystal deposition, as indicated by increased excretion of stone-forming constituents in urine, such as calcium, oxalate, uric acid, phosphorus and protein and decreased concentration of inhibitors, such as citrate and magnesium was observed in ethylene glycol induced urolithic rats. Histopathological studies also confirmed the deposition of CaOx crystals. Administration of Aerva lanata aqueous suspension (2g/kg body wt/dose/day for 28 days) to CaOx urolithic rats had reduced the oxalate synthesizing enzymes, diminished the markers of crystal deposition in the kidney. The results of the present study confirmed that A. lanata can be used as an curative agent for urolithiasis.

Prevalence of sputum smear-positive tuberculosis in a rural area in Bangladesh.

The objective of the study was to determine the prevalence of smear-positive tuberculosis (TB) in a rural area in Bangladesh at Matlab. A TB surveillance system was established among 106,000 people in rural Bangladesh at Matlab. Trained field workers interviewed all persons aged > or = 15 years to detect suspected cases of TB (cough > 21 days) and sputum specimens of suspected cases were examined for acid-fast bacilli (AFB). Of 59,395 persons interviewed, 4235 (7.1%) had a cough for > 21 days. Sputum specimens were examined for AFB from 3834 persons, 52 (1.4%) of them were positive for AFB. The prevalence of chronic cough and sputum positivity were significantly higher among males compared to females (P < 0.001). The population-based prevalence rate of smear-positive TB cases was 95/100,000 among persons aged > or = 15 years. Cases of TB clustered geographically (relative risk 5.53, 95% CI 3.19-9.59). The high burden of TB among rural population warrants appropriate measures to control TB in Bangladesh. The higher prevalence of persistent cough and AFB-positive sputum among males need further exploration. Factors responsible for higher prevalence of TB in clusters should be investigated.

Antimicrobial studies of some selected medicinal plants.

Antimicrobial activities were detected in the 80% ethanolic extract of Achyranthes aspera, Ficus glomerata, Leucas aspera, Thespesia populnea and Zizyphus jujube against Escherichia coli, Klebsiella pneumoniae and salmonella typhi. The treatments resulted in the formation of various inhibitory zones, in contrast to the control where no inhibitory zone was observed.

Tuberculosis and patient gender in Bangladesh: sex differences in diagnosis and treatment outcome.

SETTING: The public health sector of Bangladesh. OBJECTIVE: To assess gender differences in access to tuberculosis diagnosis and in tuberculosis treatment outcome in Bangladesh. METHODS: Information on the age and sex of a sample of patients in 1997 was collected from out-patient registers and tuberculosis laboratory and treatment registers in 59 thanas in three divisions in Bangladesh. RESULTS: The female/male ratio was 0.79 among 42,877 out-patients with respiratory complaints, 0.51 among 5,665 tuberculosis suspects undergoing sputum smear microscopy, 0.36 among 869 tuberculosis suspects with positive sputum smears, and 0.35 among 5,632 patients registered for tuberculosis treatment. Treatment was successful (cured or treatment completed) in 86% of female and 84% of male patients. CONCLUSION: Women in Bangladesh appear to have less access to public out-patient clinics than men, and if they present with respiratory symptoms they are less likely to undergo sputum smear examination. If examined, women are less likely than men to be smear-positive. No gender bias was observed in tuberculosis treatment outcome. It is recommended to focus further research on exploration of sex differences in the incidence of respiratory conditions, identification of constraints among women in accessing out-patient clinics and verification of the quality of sputum submitted by women for examination.

Anti histaminic activity of cissus quadragularis.

Anti histaminic activity of cissus quadrangularis stem powder was carried out determining the histamine activity and histamine content in carrageenin induced rat paw swelling model and formalin induced peritonitis respectively. The crude powder at the dose of 100mg/1QQ00 gm exerted reduction to the maximum of 44% in the early hisamine phase swelling. Further it significantly reduced the histamine content in the peritoneal fluid. For comparison standard steroidal drug hydrocortisone and avil were used.

Anti-inflammatory activity of Salacia oblonga Wall. and Azima tetracantha Lam.

The anti-inflammatory activity of Salacia oblonga rootbark powder and Azima tetracantha leaf powder was assayed in male albino rats using carrageenan-induced rat paw oedema (acute inflammation) and cotton pellet granuloma (chronic inflammation) methods. Both the crude drugs were maximally active at a dose of 1000 mg/kg. In the cotton pellet granuloma assay, these drugs were able to suppress the transudative, exudative and proliferative components of chronic inflammation. Furthermore, these drugs were able to lower the lipid peroxide content of exudate and liver, gamma-glutamyl transpeptidase activity in the exudate of cotton pellet granuloma. The increased acid and alkaline phosphatase activity and decreased serum albumin in cotton pellet granulomatous rats were normalised after treatment with these drugs. It is likely that these drugs may exert their activity by antiproliferative, antioxidative and lysosomal membrane stabilization.

Trace element analysis of some copper containing herbs.

Siddha system specifies medicinal plants containing various metal constituents for curing ailments. The plants reported as copper containing were subjected to atomic absorption spectrophotometic analysis. Among these mangifera indica and coccinia indica were found to contain comparatively higher content of copper while manganese was move in coccinia indica aloe perfoliata, cassia auriculata and Nelumbium nicifera.

Effect of Withania somnifera on glycosaminoglycan synthesis in carrageenin-induced air pouch granuloma.

The effect of W. somnifera on glycosaminoglycan synthesis in the granulation tissue of carrageenin-induced air pouch granuloma was studied. W. somnifera was shown to exert significant inhibitory effect on incorporation of 35S into the granulation tissue. The uncoupling effect on oxidative phosphorylation (ADP/O ratio reduction) was also observed in the mitochondria of granulation tissue. Further, Mg2+ dependent ATPase activity was found to be influenced by W. somnifera. W. somnifera also reduced the succinate dehydrogenase enzyme activity in the mitochondria of granulation tissue.

Hypoglycemic effect of cotton seed aqueous extract in alloxan-induced diabetes mellitus in rats.

The aqueous extract of cotton seed is able to reduce blood sugar in alloxan-induced diabetes mellitus in rats. A dose of 1000 mg/kg was found to be an effective dose. Cotton seed extract was able to enhance the liver glycogen, like glibenclamid, and was also able to reduce blood cholesterol which was found raised in the diabetic state. Further it was able to normalize the altered level in the liver lipid peroxide content. The role of cotton seed aqueous extract is suggested in the lipid metabolism which is altered during diabetes mellitus.