Trans-radial Angioplasty of Anomalous Origin of Right Coronary Artery: A Single-Centre Experience.

Successful percutaneous coronary intervention (PCI) to anomalous coronary arteries is technically challenging, particularly through transradial route. The application of appropriate techniques and devices may help overcome these challenges. The objective of this study is to explore the technical and procedural challenges in percutaneous coronary intervention (PCI) of anomalous origin of right coronary artery (AORCA) through the trans-radial route. This prospective study consisted of 25 consecutive patients who underwent PCI for an angiographically significant stenosis in AORCA from November 2017 to May 2019 at Ibrahim Cardiac Hospital & Research Institute (ICHRI). Demographic details and procedural data including numbers of catheters used, access, hardware, techniques, duration of procedure, volume of contrast and complications were recorded and statistically analyzed. The origin of AORCA was 48.0% each from the right and left coronary sinus, with 4.0% arising from the ascending aorta. Among those of right coronary sinus origin, superior take off was 83.3% and inferior take-off was 8.3%, with a further 8.3% originating from the left main, with a common origin with the left anterior descending (LAD) artery, from right coronary sinus. The mean age was 55.8±7.5 years. Diabetics were 84.0%, hypertensive 88.0%, dyslipidemic 68.0% and 20.0% had a history of smoking. Percutaneous coronary intervention (PCI) was performed successfully in 100.0% cases. Transradial access was the default route for coronary angiography in all cases. Angioplasty was performed trans-radially in 92.0% and trans-femoral in 8.0%, for two cases requiring switch over from radial to femoral route. The average number of guide catheters used was (2.0±1.0), (range: 1-4). The guide catheter hooked the coronary ostium selectively in 32.0%, off ostium in 56.0% and deep intubation was done in 12.0% cases. Anchoring wire to enhance guide support was used in 12.0%. 6 Fr guide extension catheter Guidezilla was used in 8.0% cases. The average duration of the procedure was 39.4 (range; 15-90) minutes, the average volume of contrast used was 67.0 (range: 30-150) ml. Average stent length was 28.6 (range; 12-43) mm. For PCI, Judkin's left (JL) and Judkin's Right (JR) were most commonly used guides (36.0% and 28.0% respectively), followed by multipurpose angled (MPA) guide (12.0%). The majority of the lesions stented were of ACC/AHA classification of type B (48.0%) followed by type A (36.0%) and type C (16.0%). Thrombus extraction was performed in a single case. One case was complicated by coronary artery dissection. PCI of AORCA through transradial route is technically challenging but feasible with a reasonable amount of contrast and radiation, and appropriate use of guides and techniques. Proper localization of ostium and selection of suitable guide is the key to success, aided by additional devices in the armamentarium of interventional cardiology such as guide extension catheter and anchoring wires.

Experimental and computational study on the influence of cobalt substitution on the structural, impedance, electronic, magnetic, and optical properties of pseudobrookite-structured Fe2TiO5.

We report on how Co substitution of the Fe sites of pseudobrookite (Fe2TiO5) influences the crystal structure, high-temperature electric permittivity, impedance, electronic structure, magnetic, and optical properties via experimental and theoretical investigations. The pseudobrookite phase contains two types of octahedral sites, Fe atoms reside on type of the sites while Ti on the others and replacing Fe with Co can have a huge influence on one or more physical properties that can render the material more useful for solar energy applications. X-ray diffraction and high-temperature electric permittivity/impedance were the experimental tools used. A temperature range of 20-300 °C and a frequency range of 100 Hz to 1 MHz were used for studying various types of relaxation mechanism via impedance analysis, including grains, grain boundaries, and interfacial effects. To explore the electronic structure, magnetic, and optical properties from first principles, dispersion-corrected density functional theory (PBE-D2/U) was employed. The structure as well as the electric impedance properties are impacted slightly by the Co substitution of Fe in Fe2TiO5 whereas the electronic structure and magnetic properties are influenced significantly. The bandgap is reduced slightly and the average magnetic moment per Fe ion is reduced upon Co substitution of Fe in Fe2TiO5.

Spectroscopic and crystallographic analysis of nephrite jade gemstone using laser induced breakdown spectroscopy, Raman spectroscopy, and X-ray diffraction.

The elemental composition, mineral phases, and crystalline structure of nephrite jade were investigated using calibration-free laser-induced breakdown spectroscopy (CF-LIBS), Raman spectroscopy, and X-ray diffraction (XRD). For compositional analysis, the laser-induced plasma was generated on the surface of nephrite jade. The plasma emissions were then acquired and analyzed, which revealed several elements in the sample, including Si, Mg, Ca, Li, Fe, Al, Na, K, and Ni. The plasma temperature was extracted from the Boltzmann plot before and after two-step self-absorption correction, and used in CF-LIBS calculations to get the elemental concentration. After self-absorption correction, the quantitative results obtained using CF-LIBS were found to be in close agreement with ICP-OES. The Raman spectrum of nephrite jade exhibits Si-O and M-OH stretching vibrations in the regions of 100 cm-1 to 1200 cm-1 and 3600 cm-1 to 3700 cm-1, respectively, whereas the XRD spectrum revealed the monoclinic crystalline phase of tremolite.

Structural Evaluation and Conformational Dynamics of ZNF141T474I Mutation Provoking Postaxial Polydactyly Type A.

Postaxial Polydactyly (PAP) is a congenital disorder of limb abnormalities characterized by posterior extra digits. Mutations in the N-terminal region of the Zinc finger protein 141 (ZNF141) gene were recently linked with PAP type A. Zinc finger proteins exhibit similarity at their N-terminal regions due to C2-H2 type Zinc finger domains, but their functional preferences vary significantly by the binding patterns of DNA. Methods: This study delineates the pathogenic association, miss-fold aggregation, and conformational paradigm of a missense variant (c.1420C > T; p.T474I) in ZNF141 gene segregating PAP through a molecular dynamics simulations approach. Results: In ZNF141 protein, helices play a crucial role by attaching three specific target DNA base pairs. In ZNF141T474I protein, H1, H3, and H6 helices attain more flexibility by acquiring loop conformation. The outward disposition of the proximal portion of H9-helix in mutant protein occurs due to the loss of prior beta-hairpins at the C terminal region of the C2-H2 domain. The loss of hydrogen bonds and exposure of hydrophobic residues to solvent and helices turning to loops cause dysfunction of ZNF141 protein. These significant changes in the stability and conformation of the mutant protein were validated using essential dynamics and cross-correlation maps, which revealed that upon point mutation, the overall motion of the proteins and the correlation between them were completely different, resulting in Postaxial polydactyly type A. Conclusions: This study provides molecular insights into the structural association of ZNF141 protein with PAP type A. Identification of active site residues and legends offers new therapeutic targets for ZNF141 protein. Further, it reiterates the functional importance of the last residue of a protein.

Predictors of In-hospital Mortality in Patients Presenting with Acute Coronary Syndromes in a Tertiary Cardiac Center in Dhaka, Bangladesh.

The outcomes of acute coronary syndromes (ACS) vary internationally, given regional differences in patient co-morbidities, access to health care, interventional procedures and adherence to guideline-based management practices. This study aimed to identify the predictors of mortality from a large ACS registry of patients admitted to a tertiary care cardiac centre in Dhaka, Bangladesh. This was a hospital record based retrospective cross sectional observational study that included all patients presenting with ACS to Ibrahim Cardiac Hospital and Research Institute, Dhaka, Bangladesh from January 2013 to December 2013. Data were collected from cardiac catheterization laboratory database and hospital discharge records. Statistical analysis was done using Statistical Package for Social Sciences (SPSS) version 16.0. A p value <0.05 was considered statistically significant. Ethical approval was obtained by Institutional Review Board of the hospital. A total of 1914 ACS patients were studied: 39.8% presented with ST-elevation myocardial infarction (STEMI), 39.7% with non-ST-elevation myocardial infarction (NSTEMI) and 20.5% with unstable angina (UA). There were 146 in-hospital deaths (7.6%). Mortality was highest among STEMI patients (10.5%), followed by NSTEMI (8.1%) and UA (1.03%). The mean age of expired patients was significantly higher than that of those who survived (64.82±12.14 years vs. 57.32±11.99 years; p<0.001). Male patients were 71.4%, with no significant gender differences observed between expired and surviving groups. Age >50 years {odds ratio (OR) 2.56, p=0.005}, chronic kidney disease (CKD) (OR 2.1, p<0.001), shock (OR 16.82, p<0.001), left ventricular failure (LVF) (OR 2.43, p<0.001) and STEMI (OR 1.92, p=0.002) were independent predictors of mortality among ACS patients. Although diabetes per se was not associated with mortality (OR 1.3; 95% CI=0.89-1.91; p=0.169), uncontrolled diabetes defined as HbA1c levels ≥7.5% had significant risk of mortality (OR 51.4, p<0.001). ACS patients who did not undergo angiography (OR 16.4; p<0.001) or PCI (OR 18.9; p<0.001) had greater risk of mortality. ACS patients complicated with shock, LVF, uncontrolled diabetes and CKD had increased risk of in-hospital mortality. Improved outcomes may be likely with prompt angiography and PCI during index admission. This study is a preliminary initiative, and prospective multi-centre registries with nation-wide involvement are warranted.

Community- vs. hospital-based management of multidrug-resistant TB in Pakistan.

BACKGROUND Multidrug-resistant TB (MDR-TB) treatment takes 18-24 months and is complex, costly and isolating. We provide trial evidence on the WHO Pakistan recommendation for community-based care rather than hospital-based care.METHODS Two-arm, parallel-group, superiority trial was conducted in three programmatic management of drug-resistant TB hospitals in Punjab and Sindh Provinces, Pakistan. We enrolled 425 patients with MDR-TB aged >15 years through block randomisation in community-based care (1-week hospitalisation) or hospital-based care (2 months hospitalisation). Primary outcome was treatment success.RESULTS Among 425 patients with MDR-TB, 217 were allocated to community-based care and 208 to hospital-based care. Baseline characteristics were similar between the community and hospitalised arms, as well as in selected sites. Treatment success was 74.2% (161/217) under community-based care and 67.8% (141/208) under hospital-based care, giving a covariate-adjusted risk difference (community vs. hospital model) of 0.06 (95% CI -0.02 to 0.15; P = 0.144).CONCLUSIONS We found no clear evidence that community-based care was more or less effective than hospital-based care model. Given the other substantial advantages of community-based care over hospital based (e.g., more patient-friendly and accessible, with lower treatment costs), this supports the adoption of the community-based care model, as recommended by the WHO.

Temporal and Spatial Differences between Symptomatic and Asymptomatic Malaria Infections in the Chittagong Hill Districts, Bangladesh.

Mapping asymptomatic malaria infections, which contribute to the transmission reservoir, is important for elimination programs. This analysis compared the spatiotemporal patterns of symptomatic and asymptomatic Plasmodium falciparum malaria infections in a cohort study of ∼25,000 people living in a rural hypoendemic area of about 179 km2 in a small area of the Chittagong Hill Districts of Bangladesh. Asymptomatic infections were identified by active surveillance; symptomatic clinical cases presented for care. Infections were identified by a positive rapid diagnostic test and/or microscopy. Fifty-three subjects with asymptomatic P. falciparum infection were compared with 572 subjects with symptomatic P. falciparum between mid-October 2009 and mid-October 2012 with regard to seasonality, household location, and extent of spatial clustering. We found increased spatial clustering of symptomatic compared with asymptomatic infections, and the areas of high intensity were only sometimes overlapping. Symptomatic cases had a distinct seasonality, unlike asymptomatic infections, which were detected year-round. In a comparison of 42 symptomatic Plasmodium vivax and 777 symptomatic P. falciparum cases from mid-October 2009 through mid-March 2015, we found substantial spatial overlap in areas with high infection rates, but the areas with the greatest concentration of infection differed. Detection of both symptomatic P. falciparum and symptomatic P. vivax infections was greater during the May-to-October high season, although a greater proportion of P. falciparum cases occurred during the high season compared with P. vivax. These findings reinforce that passive malaria surveillance and treatment of symptomatic cases will not eliminate the asymptomatic reservoirs that occur distinctly in time and space.

Frequency, distribution and determinants of Helicobacter pylori infection in adults and adolescents with gastric symptoms: cross-sectional epidemiological inquiry in district Haripur, Pakistan.

Helicobacter pylori (HP) is a vital element in the etiology of peptic ulcers and gastric cancer. This research aimed to determine the frequency, distribution, and determinants of HP infection in adults and adolescents with gastric symptoms in district Haripur, Khyber Pakhtunkhwa, Pakistan. This cross-sectional study was performed from June 2018 to June 2020 at the Medical Laboratory Technology Department, The University of Haripur, Pakistan. Presence of HP was a research variable, while sex, age groups, education status, overcrowding, dining habits, milk intake, drinking water source and animal contact were grouping variables. Immuno-chromatographic technique (ICT) was used to for serological detection of HP antibodies. All variables were represented by frequency and percentage with 95%CI. Prevalence of HP and its distribution by eight socio-demographic variables was testified by the chi-square goodness-of-fit test while association was testified by chi-square test of association. Out of total 1160 cases, 557 (48%) were positive for HP. Population prevalence was higher in men, in the age group 20-40 years, illiterate, family size ≤ 10 persons, taking restaurant food, using tetra pack, using municipal water, and having animal contact. The observed prevalence of HP was similar to its expected prevalence in the population. The observed distribution of HP in the sample was different from its expected distribution in population by eight socio-demographic variables. Presence of HP was associated with all eight socio-demographic variables besides age groups.

Inferior ST-elevation myocardial infarction secondary to coronary artery spasm in a patient on maintenance sirolimus postrenal transplantation.

Renal transplantation is the treatment of choice for patients with end-stage renal disease. While transplantation improves the quality of life and reduces the mortality risk for most patients when compared with maintenance dialysis, it introduces significant morbidity associated with induction and maintenance immune suppression. Sirolimus, a mammalian target of rapamycin (mTOR) inhibitor, is frequently used as a second-line maintenance immunosuppressive agent in solid organ transplant recipients. Sirolimus may, however, have adverse vascular effects and has previously been shown to induce endothelial cell dysfunction and impaired nitric oxide production in vitro. Sirolimus-eluting coronary artery stents have been associated with rare reports of severe coronary artery vasospasm; however, systemic sirolimus therapy has not previously been associated with vasospastic complications.

On the structure-property relationships of (Al, Ga, In)-doped spinel cobalt ferrite compounds: a combined experimental and DFT study.

We report a combined experimental and theoretical study of pure and doped cobalt ferrite where 25% of Fe3+ ions were replaced by Al3+, Ga3+, and In3+ ions, respectively, i.e., CoFe1.5X0.5O4 (X = Al, Ga, and In). The ferrite compositions were successfully synthesized using the solid-state reaction method. The X-ray powder diffraction method established that all ferrite samples had a spinel unit cell structure with the Fd3[combining macron]m (No. 227) space group. The lattice constants of ferrites increased from 8.382 Å (for undoped CoFe2O4) to 8.520 Å (for In-doped cobalt ferrite) in direct relation to the dopant ion size. The magnetic properties were obtained at 4.3 K and 300 K. At 4.3 K, the In-doped CoFe2O4 showed the highest saturation magnetic moment of 4.68 µB f.u.-1, while Al-doped CoFe2O4 showed the smallest value of 2.72 µB f.u.-1. The Fe3+ distribution among the spinel tetrahedral and octahedral sites was determined from the Mössbauer spectra. From ultraviolet-visible diffuse reflectance spectroscopy the direct optical bandgaps were determined, which have values between 1.20 eV and 1.28 eV for these ferrites. The ferrite compositions were also studied theoretically using plane-wave density functional theory using the CASTEP code where it was revealed that arrangements of the non-magnetic cations at the tetrahedral and octahedral sites strongly influence the electronic structure, the bandgap value, and the net magnetic moment per formula unit. Light Al3+ ions at the octahedral site give a low value of the net magnetic moment while the heavier Ga3+ and In3+ ions at the tetrahedral sites of the spinel give an enhanced magnetic moment. The magnetic moment values obtained from theoretical calculations match very well with the experimental values. Moreover, the theoretical calculations reveal that there exists a strong p-d hybridization among the oxygen and magnetic ions, which is affected by the non-magnetic dopant ions. The change in hybridization with the non-magnetic ion doping is responsible for the altered magnetic moments of the doped ferrites. Thus, our study provides a comprehensive investigation covering the synthesis and characterization of ferrites along with a good understanding of the phenomenon of how non-magnetic ion doping into spinel ferrites provides a method to tune the electronic and magnetic properties of the spinel ferrite.

An innovative route for valorising iron and aluminium oxide rich industrial wastes: Recovery of multiple metals.

Several industrial wastes including biomass, fly ashes, red mud, mill scales, water treatment residues, have significant concentrations of metal oxides: Fe2O3, Al2O3, TiO2, SiO2 etc. Several efforts have been made towards recovering metals within these wastes. Rather than recovering one metal at a time, we report a novel approach for simultaneously extracting multiple metals from mixed oxides in a single process step. Using three distinct furnaces/heating regimes, the carbothermic reduction of Fe2O3/Al2O3/SiO2 system was investigated at 1450-1700 °C for up to 2 h over a wide composition range. Complete reduction was achieved for both Fe2O3 and SiO2 in all cases leading to the formation of Fe and Fe-Si alloys. The reduction of alumina at moderate temperatures was the key challenge. No alumina reduction was observed during reductions at 1450 °C. A partial reduction of alumina and the formation of Fe-Al alloys was detected in the Al2O3/Fe2O3/C system at 1550 °C. The formation of Fe-Si-Al alloys was also observed in the Fe2O3/SiO2/Al2O3/C system at 1550 °C. Complete reduction of alumina was observed at 1600-1700 °C, even for up to 50 wt% alumina in the system. Optimal operating conditions and reference standards were established for the simultaneous recovery of multiple metals from waste oxides. While conserving natural resources, this novel route will lower the burden on waste storage facilities with significant contributions to the economic and environmental sustainability of industrial waste management.

Healing of a large avulsed mandibular bony segment: report of a unique case.

This case report puts an emphasis on retaining and re-fixing any avulsed bony segments in the maxillofacial region and maintaining the periosteal layer whenever possible, especially in young patients. Adequate bony fixation and watertight soft tissue closure are vital components for bone healing. The healing potential of facial bones is much higher as compared to the long bones, due to the superior blood supply.

Coding-Complete Genome Sequences and Mutation Profiles of Nine SARS-CoV-2 Strains Detected from COVID-19 Patients in Bangladesh.

Here, we report the coding-complete genome sequences of nine clinical severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants and their mutations. The samples were collected from nine Bangladeshi coronavirus disease 2019 (COVID-19) patients. We have identified the E484K escape mutation and the S359T mutation within the spike protein coding region of the sequenced genomes.

T-cell pseudolymphoma secondary to ixazomib for multiple myeloma.

We present a case of a 54-year-old male with multiple myeloma (MM) who presented with widespread pruritic erythematous lesions following ixazomib treatment. This occurred after his third cycle of treatment with ixazomib, thalidomide and dexamethasone and was controlled by potent steroids and temporary cessation of ixazomib. The strong correlation between the timeline of the rash, ixazomib treatment and subsequent cessation led to a diagnosis of a drug-induced rash. Skin biopsy histology, immunochemistry and the absence of monoclonal T-cell receptor gene rearrangement further confirmed the diagnosis of a T-cell pseudolymphoma secondary to ixazomib. Ixazomib is an oral proteasome inhibitor used in the treatment of MM. Other proteasome inhibitors have been reported to trigger cutaneous adverse effects. However, to our knowledge, this is the first report of pseudolymphoma following proteasome inhibitor use. Dermatologists should be aware of this potential effect and the possible management pathways such as cessation and dose reduction.

Devoid Knowledge and Low Adherence Precipitate Uncontrolled Blood Pressure: A Depiction From Cross-Sectional Study.

OBJECTIVE: The present study was aimed to assess knowledge regarding disease, adherence to medication and blood pressure control among hypertensive patients. METHODS: A cross-sectional study involving 384 hypertensive patients attending a tertiary care, public sector hospital in Islamabad, Pakistan, was conducted. Data was collected by using Urdu versions of pre-validated hypertension knowledge questionnaire and Medication Adherence Scale by Morisky. Each patient's blood pressure was measured through a calibrated mercury sphygmomanometer. Data was analyzed statistically by using SPSS software version 21.0. Chi-square test was performed to determine association level among study variables. Mann-Whitney and Kruskal-Wallis tests were performed to assess for statistically significant differences of demographic variables with systolic BP and diastolic BP. Multiple regression was used to predict the impact of two or more independent variables on dependent variable. P value of <.05 was considered to be significant. RESULTS: Mean (SD) systolic and diastolic blood pressures of 384 patients were 140.39 ± 15.485 and 88.74 ± 10.683 in mmHg respectively. The mean knowledge score was (13.26 ± 5.16 out of 22) and median score was 13. 103 (26.8%) of the patients had poor knowledge, whereas, 191 (49.7%) had moderate knowledge regarding hypertension with most of them at bottom line in the scale of moderate knowledge. The mean medication adherence score was (4.66 ± 2.743 out of 8), while 204 (53.1%) were categorized as poor adherent. CONCLUSION: The current study concluded that knowledge regarding hypertension, adherence to treatment and blood pressure control among hypertensive patients was found poor.

Investigation of Streptomyces scabies Causing Potato Scab by Various Detection Techniques, Its Pathogenicity and Determination of Host-Disease Resistance in Potato Germplasm.

Streptomyces scabies is a Gram-positive bacterial pathogen that causes common scab disease to several crops, particularly in the potato. It is a soil borne pathogen, a very devastating scab pathogen and difficult to manage in the field. Streptomyces has several species that cause common scab such as S. scabiei, S. acidiscabies, S. europaeiscabiei, S. luridiscabiei, S. niveiscabiei, S. puniciscabiei, S. reticuliscabiei, S. stelliscabiei, S. turgidiscabies, S. ipomoeae. Common scab disease harmfully affects potato economic and market value due to the presence of black spots on the tuber. Owing to its genetic diversity and pathogenicity, the determination of pathogen presence in potato fields is still challenging. In this study, S. scabies genetic diversity was measured by surveying five potato-growing areas of Pakistan during the growing season 2019. A total of 50 Streptomyces isolates, including S. scabies, S. acidiscabies, S. griseoflavus were isolated and identified based on morphologic, biochemical and molecular analysis. Virulent confirmation assays confirmed ten virulent strains of Streptomyces spp. On the potato cultivars Cardinal and Santee. Among the Streptomyces species, S. scabies showed the highest scab index, followed by S. acidiscabies and S. griseoflavus by exhibiting the scab-like lesions on potato tubers. Ten potato cultivars were screened against these virulent isolates of Streptomyces. The Faisalabad white variety showed the highest scab index followed By Cardinal, Tourag, Kuroda, Santee, Lady Rosetta, Asterix, Diamant, Faisalabad red and Sadaf. Moreover, genetic diversity and pathogenicity of Streptomyces spp. on potato tubers were also likely diverse in different geographical regions and also potato cultivars. This study represents a contribution to understanding the local interaction between potatoes and Streptomyces spp. in Pakistan. It will aid in supporting a solution for the management of this pathogen around the world.

Characterization of native plant growth promoting rhizobacteria and their anti-oomycete potential against Phytophthora capsici affecting chilli pepper (Capsicum annum L.).

Phytophthora capsici is a notorious fungus which infects many crop plants at their early and late growth stages. In the present study, twelve P. capsici isolates were morphologically characterized, and based on pathogenicity assays; two highly virulent isolates causing post-emergence damping-off on locally cultivated chilli pepper were screened. Two P. capsici isolates, HydPak1 (MF322868) and HydPk2 (MF322869) were identified based on internal transcribed spacer (ITS) sequence homology. Plant growth promoting rhizobacteria (PGPR) play a significant role in disease suppression and plant growth promotion in various crops. Out of fifteen bacterial strains recovered from chilli rhizosphere, eight were found potential antagonists to P. capsici in vitro. Bacterial strains with strong antifungal potential were subjected to biochemical and molecular analysis. All tested bacterial strains, were positive for hydrogen cyanide (HCN), catalase production and indole-3-acetic acid (IAA) production (ranging from 6.10 to 56.23 µg ml-1), while siderophore production varied between 12.5 and 33.5%. The 16S rRNA sequence analysis of tested bacterial strains showed 98-100% identity with Pseudomonas putida, P. libanensis, P. aeruginosa, Bacillus subtilis, B. megaterium, and B. cereus sequences available in the National Center for Biotechnology Information (NCBI) GenBank nucleotide database. All sequences of identified bacteria were submitted to GenBank for accessions numbers (MH796347-50, MH796355-56, MH801129 and MH801071). Greenhouse studies concluded that all tested bacterial strains significantly suppressed the P. capsici infections (52.3-63%) and enhanced the plant growth characters in chilli pepper. Efficacy of many of these tested rhizobacteria is being first time reported against P. capsici from Pakistan. Plant growth promoting rhizobacteria (PGPR) exhibiting multiple traits may be used in the development of new, eco-friendly, and effective bioformulations as an alternative to synthetic fungicides.

National Clinical Guidance for the Management of Cardiovascular Intervention in the COVID-19 Pandemic: From Bangladesh Society of Cardiovascular Interventions (BSCI).

Since the first recorded case of SARS-CoV-2 in Bangladesh on 8th March 2020, COVID-19 has spread widely through different regions of the country, resulting in a necessity to re-evaluate the delivery of cardiovascular services, particularly procedures pertaining to interventional cardiology in resource-limited settings. Given its robust capacity for human-to-human transmission and potential of being a nosocomial source of infection, the disease has specific implications on healthcare systems and health care professionals faced with performing essential cardiac procedures in patients with a suspected or confirmed diagnosis of COVID-19. The limited resources in terms of cardiac catheterization laboratories that can be designated to treat only COVID positive patients are further compounded by the additional challenges of unavailability of widespread rapid testing on-site at tertiary cardiac hospitals in Bangladesh. This document prepared for our nation by the Bangladesh Society of Cardiovascular Interventions (BSCI) is intended to serve as a clinical practice guideline for cardiovascular health care professionals, with a focus on modifying standard practice of care during the COVID-19 pandemic, in order to ensure continuation of adequate and timely treatment of cardiovascular emergencies avoiding hospital-based transmission of SARS-COV-2 among healthcare professionals and the patients. This is an evolving document based on currently available global data and is tailored to healthcare systems in Bangladesh with particular focus on, but not limited to, invasive cardiology facilities (cardiac catheterization, electrophysiology & pacing labs). This guideline is limited to the provision of cardiovascular care, and it is expected that specific targeted pharmaco-therapeutics against SARS-CoV-2 be prescribed as stipulated by the National Guidelines on Clinical Management of Corona virus Disease 2019 (COVID-19) published by the Director General of Health Services, Ministry of Health and Family Welfare of Bangladesh.

The effect of gestational age on women's preference for quality goods.

BACKGROUND: It is a well-established fact that hormonal changes significantly influence the consumer behaviors and their purchase intentions. However, attention to the conspicuous buying due to the mood swings, as a result of hormonal changes, during the pregnancy have been largely ignored in the literature. AIMS: The current research aims to examine the prospective association of conspicuous purchase intentions with hormonal changes and mood swings during the pregnancy. METHODS: An experimental procedure was used to assess the data collected from pregnant women (n = 116) and the hypotheses were analyzed using recall probability and recall position measures. RESULTS: The hormonal changes during the pregnancy were analyzed in three stages known as pregnancy trimesters suggested by the relevant literature (Trimester-1 = 39, Trimister-2 = 36 and Trimester-3 = 41). The respondents were exposed to visual attention of specifically designed images with a unique combination of the status and functional products. The ROC values for Trimester 2 is higher in all 4 graphs (0.923, 0.960, 0.892, and 0.923) respectively than Trimester 1 and 3. CONCLUSION: Findings revealed that the women purchase preferences shift as pregnancy move from one trimester to another. Women pay more attention to status products during the 2nd trimester as compared to 1st and 3rd trimesters of pregnancy.

Etiological Evaluation of Patients with Lymphadenopathy by Clinical, Histopathological and Microbiological Assessment.

Lymph node enlargement is a common presenting complaint in outpatient and inpatient department. The present observational cross sectional study was conducted in department of Internal Medicine, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh during the period from December 2014 to May 2016 to evaluate etiologies of significant lymphadenopathy by clinical, histopathological and microbiological assessment. Biopsy/FNA materials of 177 patients of 18-75 years age range with significant lymphadenopathy were sent for histopathology/cytology, Gram stain & culture, AFB stain & culture and Gene Xpert. Among them, 102(57.62%) were granulomatous lymphadenitis, 52(29.38%) were lymphoma, 12(6.78%) reactive lymphadenitis, 7(3.95%) metastatic malignancy, 2(1.13%) atypical lymphoid hyperplasia, 1(0.57%) myeloid sarcoma and 1(0.57%) chronic sialadenitis. Growth of MTB was on 23(22.55%) cases; among 102 granulomatous lymphadenitis and Gene Xpert was positive in 73(71.56%) cases with 100% Rif. sensitive. Gene Xpert is an important tool for diagnosis of tuberculous lymphadenitis. Time of symptoms to diagnosis of most of the TBL patients was within 2-8 months.