Frequency and Risk Factors of Diabetic Retinopathy among Patients with Type 2 Diabetes Mellitus: A Single-Center Study from Bangladesh.

Diabetic retinopathy (DR) is the most frequent microvascular complication of diabetes mellitus (DM). DR remains a leading cause of blindness, currently accounting for 4.8% of the world's 37 million blindness cases. DR is one of the critical preventable causes of blindness. In Bangladesh, the number of studies reporting the prevalence and risk factors of DR in type 2 DM (T2DM) is limited. We conducted this cross-sectional study in a tertiary hospital in Bangladesh from March 2017 to August 2019 among 200 patients with T2DM for the presence and severity of DR by using color fundus photography in a dilated pupil. The diagnosis and grading of DR were made using the Early Treatment of Diabetic Retinopathy Study (ETDRS) Chart. Out of 200 subjects with T2DM, 35.5% had DR; the frequencies of NPDR and PDR were 19.0% and 16.5%, respectively. The mean age, diabetes duration, FPG, HbA1c, TG, TC, LDL-C, and serum creatinine were statistically higher, and eGFR was lower in the study subjects with DR than those without DR; BMI and HDL-C were indifferent in the two groups. The frequencies of males, subjects having monthly income of 10,000 Bangladeshi Taka (BDT) or more, smokers, hypertensives, and subjects having uncontrolled diabetes (HbA1c ≥7%), were higher in the DR group than the no DR group. Higher age (≥50 years), higher monthly income (≥10,000 BDT), urban residence, smoking, uncontrolled diabetes, and high LDL-C (≥100mg/dL) were found to be independent risk factors of DR in the study subjects. A large-scale nationwide study is needed to find out the actual prevalence of DR in Bangladesh.

Outcome of Transcanalicular Endolaser and External Dacryocystorhinostomy in Chronic Dacryocystitis.

Nasolacrimal duct obstruction due to chronic dacryocystitis is the most common cause of epiphora. Dacryocystorhinostomy (DCR) is the treatment of choice for chronic dacryocystitis. This can be carried out by external, endoscopic and endolaser surgical approach. Though external DCR is still a gold standard and most popular method, the latest procedure of less traumatic DCR is transcanalicular approach. The study was done to evaluate the outcome of Transcanalicular Endolaser DCR regarding epiphora and surgery related complications by measuring anatomical success rate (patency assessed by irrigation), functional success rate (symptom free) and complication rate and to compare with External DCR (Ext-DCR). This prospective interventional study was conducted from October 2011 to September 2012 in Ophthalmology department of Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh. Total 62 patients included in the study as per inclusion and exclusion criteria of them 31 for TCEL-DCR and 31 for Ext-DCR. But during follow-up one patient was dropped from each group and finally outcome of 30 patients analyzed in each group. Mean age of the patients TCEL-DCR was 38.3±11.54 and of Ext-DCR was 38.4±14.01. In both groups females were the most sufferer (female: male = 1.5: 1). Functional and anatomical success rate of TCEL-DCR showed 93.3% and 83.3% after 3 months; 83.3% and 76.7% after 6 months respectively. Statistically non-significant difference was observed about success rate in comparison between groups. Per-operative complications were pain excessive bleeding. In TCEL-DCR pain complained 13.3% and excessive bleeding occurred in 3.3%. Where as in Ext-DCR pain complained 16.7% and excessive bleeding occurred in 20%; difference was statistically significant (p=0.001). Post-operative complications were bleeding and scar formation. Bleeding occurred in TCEL-DCR 6.67% and in Ext-DCR 10%. So, TCEL-DCR could be an alternative option for the treatment of chronic dacryocystitis especially for those patients who are conscious about scar formation and afraid about Ext-DCR technique.

Evaluation of ophthalmic manifestations in patients with intracranial tumours.

The present study was done to observe the ophthalmic manifestations in patients with intracranial tumor. This was a prospective, purposive, consecutive, observational study conducted in patients with radiologically proven intracranial tumors in the department of Ophthalmology with collaboration of Department of Neuro-surgery of Bangabandhu Sheikh Mujib Medical University from January 2006 to December 2010. All cases had tissue histopathology confirmation post-operatively. The most common type of intracranial tumor was pituitary adenoma (58.04%), followed by craniopharyngioma (20.53%), posterior fossa tumour (12.50%) [medulloblestoma, ependymoma], meningioma (8.04%) [sphenoidalwing meningioma, petroclavel meningioma, oligodendroglioma] and others (0.89%) [nasopharyngial carcinoma, esthesio - astrocytoma]. Common neuro-ophthalmological findings were visual blur (91.07%), visual field defect (71.42%), optic disc changes (50%), pupillary light reaction defect (48.21%) and colour vision defect (46.42%). The study shows, pituitary adenoma is the most common tumor that impairs the visual pathway structures followed by craniopharyngioma, posterior fossa tumour & meningioma. Furthermore, decreased visual acuity, visual field defect, abnormal optic discs, relative afferent pupillary defect and ophthalmoplegia etc. are the common neuro-ophthalmic features that should be carefully examined for early detection of intracranial tumors.

In vitro antioxidant potential study of some synthetic quinoxalines.

In continuation of our study the in vitro antioxidant activity of some novel quinoxaline derivatives was investigated by 1,1-diphenyl-2-picrylhydrazyl (DPPH) method with respect to ascorbic acid. To determine the antioxidant activity, a number of substituted indoxyls (3A-G), cyclic ketones (2A-G), and quinoxalines (1A-G) were synthesized by both microwave and conventional heating methods. The present findings revealed that some quinoxalines and their precursors (1D, 1F, 1G and 2E) exhibited a marked scavenging effect on DPPH radical.

Bacterial and fungal community composition over time in chicken litter with high or low moisture content.

1. Changes in bacterial and fungal communities in chicken litter with high and low moisture content over a five week period during a single chicken grow out cycle in a poultry shed in subtropical Australia were investigated to study the association between specific microbes and odour production. 2. Microbial biomass, as indicated by DNA yields, was higher and community composition was more dynamic over time in moist compared with dry chicken litter. 3. Bacillus, Atopostipes and Aspergillus species increased in relative abundance in moist chicken litter samples over time reflecting the relatively high fitness and hence activity of these specific bacteria and this specific fungus in this environment.

Treatment of myasthenia gravis: a surgical profile.

Twenty three cases of thymectomy were performed in Bangabandhu Sheikh Mujib Medical University (BSMMU) from 2004-2006 for myasthenia gravis, age ranging from 18 to 65 years, male were 16 and female 07. Out of these cases 09 had thymoma of which 03 have shown features of malignancy. There was no pre-operative or post operative mortality. Thymectomy in myasthenia gravis was considered when there was clinical feature of drooping eye lids, difficulty in deglutition, nasal voice, generalized weakness etc. All patients received medical treatment before and after surgery. Medical treatment usually given at BSMMU anticholinesterase such as mastinon, if the patient is improved and well tolerated, this regime is continued. Although, role of steroid and immunosuppressive agents for the treatment of myasthenia gravis is controversial, steroid used in few cases of type II & type III. No steroid used in ocular variety. Patients were followed for one year and showed significant improvement after surgery.

Studies on the utilization of methionine sulfoxide and methionine sulfone by rumen microorganisms in vitro.

An in vitro experiment was conducted to test the ability of mixed rumen bacteria (B), protozoa (P), and their mixture (BP) to utilize the oxidized forms of methionine (Met) e.g., methionine sulfoxide (MSO), methionine sulfone (MSO(2)). Rumen contents were collected from fistulated goats to prepare the microbial suspensions and were anaerobically incubated at 39 degrees C for 12 h with or without MSO (1 mM) or MSO(2) (1 mM) as a substrate. Met and other related compounds produced in both the supernatants and hydrolyzates of the incubation were analyzed by HPLC. During 6- and 12-h incubation periods, MSO disappeared by 28.3 and 42.0%, 0.0 and 0.0%, and 40.6 and 62.4% in B, P, and BP suspensions, respectively. Rumen bacteria and the mixture of rumen bacteria and protozoa were capable to reduce MSO to Met, and the production of Met from MSO in BP (156.6 and 196.1 micromol/g MN) was about 17.3 and 14.1% higher than that in B alone (133.5 and 171.9 micromol/g MN) during 6- and 12-h incubations, respectively. On the other hand, mixed rumen protozoa were unable to utilize MSO. Other metabolites produced from MSO were found to be MSO(2) and 2-aminobutyric acid (2AB) in B and BP. MSO(2) as a substrate remained without diminution in all-microbial suspensions. It was concluded that B, P, and BP cannot utilize MSO(2); but MSO can be utilized by B and BP for producing Met.

Biosynthesis of methionine from homocysteine, cystathionine and homoserine plus cysteine by mixed rumen microorganisms in vitro.

This study quantitatively investigated the biosynthesis of methionine (Met) and the production of related compounds from homocysteine (Hcys), cystathionine (Cysta), and homoserine (Hser) plus cysteine (Cys) by rumen bacteria (B) or protozoa (P) alone and by a mixture of these bacteria and protozoa (BP). Rumen contents were collected from fistulated goats to prepare the microbial suspensions and were anaerobically incubated at 39 degrees C for 12 h. Hcys, Cysta, and Hser plus Cys were catabolized by all rumen microbial fractions to different extents. B, P, and BP converted Hcys to Met with 2-aminobutyric acid (2AB) and methionine sulfoxide. The Met-producing ability of B (83.2 micromol g(-1) microbial nitrogen; MN) from Hcys was about 3.6 times higher than that of P in a 6-h incubation period. The ability of BP, during the same incubation period, was about 30.0% higher than that of B. Hcys, Met, and 2AB were formed when Cysta was incubated with B, P, or BP. Rumen microbial fermentation of Hser plus Cys led to the formation of Cysta, Met (through Hcys), and 2AB. Thus the results indicated that a trans-sulfurylation pathway for Met synthesis was operating in the rumen bacteria and protozoa. The results mentioned above have been demonstrated for the first time in B, P, and BP in the present study.

Convenient method for the determination of arginine and its related compounds in rumen fluid by reversed-phase high-performance liquid chromatography.

In order to clarify arginine (Arg) metabolism by rumen microorganisms and by the tissues of ruminant animals, a convenient method for the simultaneous determination of Arg, citrulline (Cit), ornithine (Orn), proline (Pro) and 5-aminovaleric acid (5AV), and 4-aminobutyric acid (4AB) and lysine (Lys), incidentally, in goat rumen fluid was established by reversed-phase high-performance liquid chromatography (RP-HPLC). The separation was carried out by stepwise isocratic elution with two mobile phases (solvent A and solvent B) on a LiChrospher 100 RP-18 column (150x4.6 mm I.D., 5 microm particle size) equipped with a guard column (4.0x4 mm, 5 microm particle size). Solvent A is composed of acetonitrile-sodium citrate buffer (pH 7.2) (15:85, v/v) containing tetrahydrofuran (5 ml/100 ml), with solvent B comprising acetonitrile-sodium citrate buffer (pH 5.4) (40:60, v/v). Five compounds (Cit, Arg, Pro, 4AB and 5AV) were separated within 33 min in solvent A and the other two (Orn and Lys) in solvent B. Solvent A was automatically switched to solvent B with the help of a valve controller. Complete separation needs 62 min after sample injection in a single chromatogram. Samples were derivatized with 9-fluorenylmethyloxycarbonyl chloride (FMOC-Cl) and detected on a fluorescence detector at excitation and emission wavelengths of 263 and 611 nm, respectively. The minimum detectable concentrations (microM) (signal-to-noise ratio, S/N 3:1) of these compounds were: 0.65 for Cit, 0.65 for Arg, 1.9 for Pro, 1.3 for 4AB, 1.9 for 5AV, 0.12 for Orn and 0.48 for Lys. When applied to rumen fluid from goats, recoveries of all compounds added to the rumen fluid were 96.6-100.6% for an intra-day study and 93.9-99.4% for inter-day (5 days) studies. The average contents of Orn, 5AV and Lys in the rumen fluid of three goats before morning feeding were 7.3, 13.5 and 3.6 microM, but Cit, Arg, Pro, and 4AB were not found, although all these four compounds were detected 1 h after feeding. Pro (390 microM) and 5AV (497.6 microM) were highest 1 h after feeding and then decreased. Orn levels before morning feeding were most similar to those after feeding.

Studies on the possibility of histidine biosynthesis from histodinol, imidazolepyruvic acid, imidazoleacetica acid, and imidazolelactic acid by mixed ruminal bacteria, protozoa, and their mixture in vitro.

The possibility of histidine (His) synthesis using a main biosynthetic pathway involving histidinol (HDL) and also the recycling capability of imidazolic compounds such as imidazolepyruvic acid (ImPA), imidazoleacetic acid (ImAA), and imidazolelactic acid (ImLA) to produce His were investigated using mixed ruminal bacteria (B), protozoa (P), and a mixture of both (BP) in an in vitro system. Rumen microorganisms were anaerobically incubated at 39 degrees C for 18 h with or without each substrate (2 mM) mentioned. His and other related compounds produced in both the supernatants and hydrolyzates of the incubation were analyzed by high-performance liquid chromatography. B, P, and BP suspensions failed to show His synthesizing ability when incubated with HDL. His was synthesized from ImPA by B, P, and BP. Expressed in units "per gram of microbial nitrogen (MN)", ImPA disappearance was greatest in B (72.7 micromol/g MN per hour), followed by BP (33.13 micromol/g MN per hour) and then P (18.6 micromol/g MN per hour) for the 18-h incubation period. The production of His from ImPA in B (240.0, 275.9, and 261.2 micromol/g MN in 6, 12, and 18 h incubation, respectively) was about 3.5 times higher than that in P (67.3, 83.8, and 72.7 micromol/g MN in 6, 12, and 18 h incubation, respectively). Other metabolites produced from ImPA were ImLA, ImAA, histamine (HTM), and urocanic acid (URA), found in all microbial suspensions. ImLA as a substrate remained without diminution in all microbial suspensions. Although ImAA was found to be degraded to a small extent (3.4-6.3%) only after 18 h incubation, neither His nor other metabolites were detected on the chromatograms. These results have been demonstrated for the first time in rumen microorganisms and suggest that His may be an essential amino acid for rumen microorganisms.

Biosynthesis of threonine from homoserine by mixed rumen microorganisms: an in vitro study.

The biosynthesis of threonine (Thr) by using the main biosynthetic pathway involving homoserine (Hser) was quantitatively investigated by mixed rumen bacteria (B), protozoa (P), and their mixture (BP) in an in vitro system. Rumen contents were collected from fistulated goats to prepare the microbial suspensions and were incubated anaerobically at 39 degrees C for 12 h with or without Hser (2 mm) as a substrate. Thr and other related compounds produced in both the supernatants and hydrolysates of the incubation were analyzed by HPLC. During a 12-h incubation period, 84.2%, 58.1%, and 92.0% of Hser disappeared in B, P, and BP suspensions, respectively. Rumen bacteria and the mixture of rumen bacteria and protozoa were demonstrated for the first time to produce Thr from Hser, and the production of Thr from Hser in BP (371.9 and 297.2 micromol/g MN) (MN, microbial nitrogen) was about 13.0% and 9.1% higher than that in B alone (329.2 and 272.5 micromol/g MN) during 6- and 12-h incubations, respectively. On the other hand, mixed rumen protozoa were unable to synthesize Thr from Hser. Other metabolites produced from Hser were found to be glycine (Gly) and 2-aminobutyric acid (2AB) in B and BP. In P, Gly and 2AB were not found. The results mentioned above indicated the abilities of rumen bacteria and the mixture of rumen bacteria and protozoa to synthesize Thr de novo from Hser and appeared as first-time report.

Catabolism of methionine and threonine in vitro by mixed ruminal bacteria and protozoa.

In vitro studies were conducted to examine the metabolism of methionine (Met) and threonine (Thr) using mixed ruminal bacteria (B), mixed ruminal protozoa (P), and a combination of these two (BP). Rumen microorganisms were collected from fistulated goats fed with lucerne cubes (Medicago sativa) and a concentrate mixture twice a day. Microbial suspensions were anaerobically incubated with or without 1 mM each of the substrates at 39 degrees C for 12h. Met, Thr and their related amino compounds in both the supernatants and microbial hydrolyzates of the incubation were analyzed by HPLC. Met was degraded by 58.7, 22.1, and 67.3% as a whole in B, P, and BP suspensions, respectively, during 12h incubation. In the case of Thr, these values were 67.3, 33.4, and 76.2% in B, P, and BP, respectively. Met was catabolized by all of the three microbial suspensions to methionine sulfoxide and 2-aminobutyric acid. Catabolism of Thr by B and BP resulted in the production of glycine and 2-aminobutyric acid, while P produced only 2-aminobutyric acid. From these results, the existence of diverse catabolic routes of Met and Thr in rumen microorganisms was indicated.

In vitro catabolism of histidine by mixed rumen bacteria and protozoa.

An in vitro study was conducted to examine the metabolism of histidine (His) by mixed rumen bacteria (B), mixed rumen protozoa (P), and a combination of the two (BP). Rumen microorganisms were collected from fistulated goats fed with lucerne cubes (Medicago sativa) and a concentrate mixture twice a day. Microbial suspensions were anaerobically incubated with or without 2 mm each of His, or histamine (HTM), or 1 mm urocanic acid (URA) at 39 degrees C for 12 h. His and other related compounds in both supernatant and microbial hydrolysates were analyzed by HPLC. After 6- and 12-h incubations, the net degradation of His was 26.1% and 51.7% in B, 13.5% and 20.9% in P, and 21.7% and 46.0% in BP, respectively. The rate of the net degradation of His in B (98.0 micromol/g microbial nitrogen/h) was about 2.6 times higher than that of P during a 12-h incubation period. His was found to be degraded into urocanic acid (URA), imidazolelactic acid (ImLA), imidazoleacetic acid (ImAA), and histamine (HTM). Of these degraded His was mainly converted into URA in all microbial suspensions. The production of ImLA and ImAA was higher in B than in P suspensions, whereas the production of HTM was higher in P than in B suspensions. From these results, the existence of diverse catabolic routes of His in rumen microorganisms was indicated.

Convenient method of threonine, methionine and their related amino compounds by high-performance liquid chromatography and its application to rumen fluid.

A high-performance liquid chromatographic procedure for the quantitative determination of cysteine (Cys), homocysteine (Hcys), methionine sulfoxide (MSO), methionine sulfone (MSO2), homoserine (Hser), glycine (Gly), threonine (Thr), 2-aminobutyric acid (2AB), methionine (Met), cystathionine (Cysta) and its application to rumen fluid are described. The samples containing Thr, Met and other related amino compounds were derivatized with 9-fluorenylmethyl chloroformate. The separation of compounds was accomplished with a methanol gradient in 25 mM sodium citrate buffer (obtaining pH 6.40 and 3.80 by addition of 25 mM citric acid). All derivatized compounds were separated on a Mightysil RP-18 GP (150x4.6 mm I.D., 5 microm particle size) column. All analytes were detected at 265 nm with UV detection. The limits of detection (microM) (S/N ratio, 3:1) and quantification (microM) (S/N ratio, 10:1) of Cys, Hcys, MSO, MSO2, Hser, Gly, Thr, 2AB, Met and Cysta were 0.50 and 1.68; 1.76 and 5.85; 0.85 and 2.88; 0.92 and 3.09; 1.04 and 3.52; 0.76 and 2.52; 0.65 and 2.18; 0.39 and 1.36; 0.31 and 1.03; 0.17 and 0.58, respectively. The recoveries of all compounds in rumen fluid were 97.93-102.3% in the within-day study and 94.52-98.69% on different day (6 days) studies. The average contents (microM) of Cys, Gly, Thr, 2AB, Met and Cysta were 1.72, 45.6, 20.0, 4.3, 2.11 and 3.42 before morning feeding. The concentration of Thr, 2AB and Cysta in rumen fluid tended to increase with time after feeding whereas Met showed the opposite tendency.

Determination of histidine and related compounds in rumen fluid by liquid chromatography.

A liquid chromatographic procedure was developed for quantitative determination of histidine (His), histidinol (HDL), histamine (HTM), urocanic acid (URA), imidazolepyruvic acid (ImPA), imidazoleacetic acid (ImAA), and imidazolelactic acid (ImLA) in rumen fluid. The method is based on direct injection analysis by UV absorbance detection at 220 nm. The separation was performed under 2 different chromatographic conditions on a LiChrospher 100 NH2 column. In the first chromatographic system, the mobile phase used for isocratic elution was 67 mM potassium phosphate buffer (monobasic and dibasic) pH 6.45-90% acetonitrile in water (21 + 79); in the second system, an acetonitrile gradient in 63 mM potassium phosphate buffer (monobasic) pH 3.0, obtained by addition of 60 mM phosphoric acid, was used. Analyses of both systems were completed within 32 and 25 min, respectively. The limits of detection of these compounds were (microM): His, 2.8; HDL, 3.7; HTM, 4.0; URA, 0.75; ImPA, 4.7; ImAA, 1.2; and ImLA, 1.3. Recovery of these compounds added to rumen fluid was 97.4-103.0% within a 1-day study and 95.4-99.0% on different day studies. Detectable levels of His were found in the deproteinized rumen fluid of goats, with average concentrations of 16.10, 10.43, 11.14, and 13.62 microM in the rumen fluid collected before the morning feeding and 2, 4, and 6 h after feeding, respectively. HDL, HTM, URA, ImPA, ImAA, and ImLA were not detected in the rumen fluid before and after feeding. Trp, Phe, and Tyr were also identified in the rumen fluid, with average concentrations of 8.25, 29.04, and 12.6 microM, respectively, before the morning feeding.

Rapid determination of lysine in biological samples by isocratic liquid chromatography.

A simple, rapid, and sensitive method was developed for detection and quantitation of lysine (Lys) in various biological samples by isocratic liquid chromatography (LC). Samples containing Lys and other amino acids were derivatized with 9-fluorenylmethyl chloroformate (FMOC-CI). The mobile phase used for isocratic elution was 50 mmol/L sodium acetate buffer (pH 4.20)-acetonitrile (43 + 57, v/v). Lys was detected with a UV detector at 265 nm. The derivatized Lys eluted from a LiChrospher 100 RP-18 (150 x 4.0 mm id) column at a retention time of 5.6 min. The limit of detection was 0.73 mumol/L (signal-to-noise [S/N] ratio, 3:1), and the limit of quantitation was 2.37 mumol/L (S/N ratio, 10:1). Lys recoveries from fortified biological samples were > 97.5%. Average Lys contents found in rumen fluid samples collected before the morning feeding and at 2.0, 4.0, and 6.0 h after feeding were 4.26, 3.34, 3.58, and 3.82 mumol/L, respectively. The hydrolysate of a sample of mixed rumen microorganisms collected before the morning feeding was determined to contain 1.372 mumol/mg microbial nitrogen in the form of Lys. The Lys concentrations of human plasma, goat plasma, human urine, and goat urine were 140.0, 102.0, 58.0, and 32.0 mumol/L, respectively.

Corneal ulcer disease in Bangladesh.

The problem of acute infectious corneal disease in Bangladesh is discussed. Environmental situations combined with socioeconomic conditions create significant blindness due to this disease in this country. Clinical differentiation into bacterial and fungal ulcers was usually impossible in the advanced stages of ulceration with which the patients presented. Serious logistical problems hinder therapy. Fungal ulcers fared worse than bacterial ulcers. Conjunctival flaps were unsuccessful in alleviating the former. Critical shortage of medication as well as corneal tissue for therapeutic transplantation added to the difficulties. Large-scale public health and educational measures are indicated for effective, long-term solution.