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Background and objectives: There are few details available regarding the prevalence of hepatitis B virus (HBV) infection in the general Bangladeshi population. There is a dearth of data on prevalence of HBV infection in children and adolescents who were born before the hepatitis B vaccine was introduced in the Expanded Program on Immunization (EPI). The objective of the current study was to use archived data to describe the seroepidemiology of HBV infection (HBsAg and anti-HBc Antibody) among school children in a particular rural area of Bangladesh. Also, the study correlated serum vitamin A level with the HBV infection status among a subset of children. Materials and method: The study analyzed the archived data of a study conducted in 2003 and 2004. The samples were collected from 1995 children, aged 5 to 15 years, from a purposively selected rural area located about 100 km north-east of capital Dhaka. HBsAg (HBV surface antigen) and anti-HBc antibody were determined by ELISA method. Vitamin A (retinol) in blood was assayed by HPLC technique. The prevalence rates of HBsAg and anti-HBc antibody was determined by simple percentages. All associations between different characteristics were tested by Chi square test. Results: Of the total 1995 children, 988 (49.5%) and 1007 (50.5%) were male and female respectively. Among them, 23 (1.2%) were HBsAg positive or HBV carriers and 79 (8.1%) were anti-HBc antibody positive. Neither HBsAg nor anti-HBc antibody positivity rate showed any difference in male and female children. There was also no significant difference of HBsAg positivity rate amongst children of different age groups; whereas, anti-HBc antibody positivity rate increased significantly (p

Background: Ectopic pregnancy is a life threatening complication of the first trimester of pregnancy that arises in 1.3 – 2.4% of all pregnancies. Objective: The aim of this study was to determine the frequency of ectopic pregnancy and to evaluate the clinical presentation, risk factors and management outcomes of ectopic pregnancies. Methods: This was a retrospective, descriptive study of ectopic pregnancies managed at Dhaka Community Medical College Hospital during the period of January 2013 to December 2017. Total 70 cases of ectopic pregnancies were included. The medical records of the patients managed for ectopic pregnancies were retrived and data were collected from registers. The relevant data were analyzed with simple descriptive statistics and presented in frequency chart and tables. Results: Total 70 cases of ectopic pregnancies were managed during the study periods which constituted 3.6% of all gynaecological admissions. Most of the patients (35.7%) were between 25 – 29 years age group. It was most common in multiparae with a percentage of 85.7% . The commonest (92.9% ) clinical presentation was abdominal pain. Almost 14.3% were in a state of shock at admission. Among the identified risk factors 28.6% had a previous history of induced abortion and 22.9% had pelvic inflammatory disease. Out of 70, 60 patients (85.7%) had ruptured ectopic pregnancies, 4 (5.7%) were unruptured and 5 (7.1%) produces a complex tubo-ovarian mass. Only 1(1.4%) case was presented early & treated with intramuscular methotrexate injection. Surgery by open method in the form of salpingectomy 64(91.4%) and salpingo-oophorectomy 5(7.1%) were the mainstay of management. No maternal mortality found in this series. Conclusions: Since ectopic pregnancy remains a gynaecological catastrophe in developing countries and a major challenge to the reproductive performance of women worldwide, it should be considered a relevant public health issue. Early diagnosis, identifying of underlying risk factors and timely intervention in the form of conservative or surgical treatment will help in reducing the morbidity and mortality associated with ectopic pregnancy. Bangladesh J Obstet Gynaecol, 2021; Vol. 36(1): 28-32

Background and objectives: Recent publications have reported alarming prevalence of hypovitaminosis D in South Asian countries including Bangladesh. But, data on vitamin D levels in different occupational groups are lacking. This study addressed the prevalence of hypovitaminosis D in different occupational groups of Bangladesh. Additionally, the study estimated parathyroid hormone, phosphate, calcium and metabolic syndrome in these groups to see the effect of hypovitaminosis D on these parameters. Materials and method: Seven diverse occupational groups (agrarian workers, rickshaw-pullers, young cricketers and footballers, fishermen, dry fish industry workers, garment-workers and medical students) of Bangladesh were selected based on grade of physical activity and level of sun exposure. Blood was collected for the estimation of 25(OH) vitamin D, fasting glucose,lipid profiles, calcium, phosphate, magnesium and intact parathyroid (iPTH) hormone. Multiple comparisons of these variables among the 7 groups were estimated by ANOVA. Results: A total of 785 (m / f = 359 / 426) participants volunteered. Of them, 54.2% had vitamin D deficiency. Metabolic syndrome was 5% and showed no significant association with hypovitaminosis D (x2 = 0.9, p=0.43). For biophysical characteristics, the mean (±SD) values of age, body mass index, waist to hip ratio and waist to height ratio were – 33.8±16.3y, 22.3±4.1 kg/m2, 0.87±0.06 and 0.39±0.16, respectively. The values for vitamin D (ng/ml), calcium (mg/dl), iPTH (pgm/ml) and phosphate (mg/dl) were 20.25±13.1, 9.57±1.85, 38.22±24.54 and 4.18±0.81, respectively. The comparisons of vitamin D and other related variables among the groups (ANOVA) showed vitamin D level in the garments worker was significantly (p

Background: Pneumonia is the leading cause of childhood death under five years old in developing countries. Anemia is the commonest ailment affecting health, socio-economic development and the overall betterment of mankind. This study was conducted to determine the association between iron deficiency anemia (IDA) and pneumonia in the age group 6 months to 5 years. Methods: A cross-sectional analytical study was conducted in the Department of Pediatrics, SSMC & Mitford Hospital. According to selection criteria, 64 patients with pneumonia were considered as cases and matched 64 patients with fever and cough and but having no pneumonia, participated as control. Chest X-ray and complete blood count with RBC indices, iron profile was done to see pneumonia and IDA. A comparison was done between two groups. p-value was significant when < 0.05. Results: The mean age was 18.65±16.43 months in the case group and 14.17±10.76 months in the control group. Male was found 65.6% in the case and 73.4% in the control group. Females were 34.4% in the case and 26.6% in the control group. No significant difference in age and sex between the two groups. Decreased level of Hb, RBC, MCV, MCHC & increase RDW and also decreased level of serum iron, ferritin, transferrin & increased TIBC in the case group; all of which were statistically significant when compares to the control group. IDA was 65.6% in the case group; 17.2% in the control group. IDA was significantly higher in the case group compared to the control group. Conclusion: Sixty-six percent of children of 6 months to 5 years of both sexes with pneumonia associated with IDA. So, Iron deficiency anemic child more risk of developing pneumonia. EMCJ. July 2022; 7(2): 10-15

Background: Patients with bacterial meningitis (BM) frequently present with febrile seizures (FS) without any signs or symptoms of BM. To perform a lumbar puncture on all FS patients to rule out meningitis is still debatable. The goal of this study was to estimate the frequency of meningitis among first-time febrile seizures (FTFS). Methods: From July 2013 to June 2014, a cross-sectional study was conducted at Sir Salimullah Medical College and Mitford Hospital, Dhaka. CSF and blood reports and detailed histories and examinations were examined in children aged 6 months to 36 months with FTFS (simple or complex). Results: The first complex febrile seizure (FCFS) and the first simple febrile seizure (FSFS) occurred in 58% and 42% of the 73 children included in this study. 11 (15%) cases had meningitis based on CSF and blood reports, where 2 (3%) had confirmed BM, 2 (3%) had probable BM, and 7 (10%) had viral meningitis (PVM). One of two children with confirmed BM had Klebsiella spp. in CSF culture and Streptococcus pneumoniae in CSF gram stain. Others with probable BM had CSF pleocytosis with low sugar and high protein levels. Leukocytosis was found in all four children with BM. Two of the seven children with PVM had isolated pleocytosis, one had low sugar, and four had high protein CSF. Blood cultures were negative in all 11 meningitis cases. Conclusion: Although meningitis is common in FCFS, this study found no cases of BM children with FSFS, though PVM was not uncommon. Sir Salimullah Med Coll J 2022; 30: 108-114

Background : Seizure is common neurological disorder in children. It is one of the common causes of referral of child to hospital and often requires emergency intervention. Rectal diazepam is the established first line drug for this purpose, but seizure recurrence and respiratory depression are the two major side effects. Midazolam is a water-soluble benzodiazepine with anticonvulsive activity at physiologic PH, which facilitates its effects on brain tissue. Midazolam is also easy to use, and no adverse events were reported in relation to the route of administration. Objectives : To compare the efficacy and safety of buccal midazolam with rectal diazepam in the treatment of prolonged seizures in children. Methodology : This prospective randomized study was conducted in the Department of pediatrics, Sir Salimullah Medical College (SSMC) and Mitford Hospital, from March 2018 to December 2018.Fifty (50) patients aged 3 months to12 months who were convulsing and experiencing prolonged seizure (lasted >5 minutes) were included. Patients was randomly assigned to one of the two treatment arms: rectal diazepam and buccal midazolam. Primary and secondary outcome was compared between 2 treatment arms. Primary outcome was: 1. cessation of visible seizure activity within 10 minutes. 2. without recurrence of seizure in the subsequent hour. Secondary outcome included: 1. proportion with cessation of convulsion and exact time needed for cessation of convulsion within 10 minutes2. proportion of seizure recurrence in the sub sequent hours and within 24 hours after initial control and exact time of recurrence within the respective period. Also the safety and adverse effects were also compared. Results : The two groups did not differ significantly in sex, age, type of seizures, temperature, and baseline RBS, respiratory rate and blood pressure. Comparing the 2-treatment group, 13 (52%) patient experienced treatment failure who received rectal diazepam compared with 7 (28%) who received buccal midazolam (P>0 .05). For initial cessation of seizures, 18 (72%) seizures terminated within 10 minutes in the diazepam group compared with 19 (76%) in the midazolam and mean time to cessation of the seizure was 4.02±1.03 minutes and 4.4 ± 1.09 minutes respectively (p>0.05). Among the 18 children in whom seizure was initially controlled within 10 minutes by rectal diazepam, 6 (33.33%) of them experienced a seizure recurrence in the subsequent hour compared with 1 (5.26%) of 19 children in the buccal midazolam group (P

Background and objectives: For decades the global population has been experiencing diabetic epidemic. The risks related to obesity, diabetes mellitus (DM) and coronary artery diseases (CAD) are well known. This study aimed to assess the prevalence of coronary artery disease (CAD) and its related risks in Bangladeshi diabetics. Materials and methods: The study was conducted at Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders (BIRDEM), a largest referral center for diabetes in Bangladesh. Socio-demographic and clinical history including biochemical investigation report were collected from the BIRDEM registry. The eligible criteria of study participants were: age 30 – 60 year, having DM, non-smoker, free from retinopathy, nephropathy and neuropathy. The prevalence of CAD, systolic hypertension (SHTN) and diastolic hypertension (DHTN) in the registered diabetic patients were estimated. Additionally, the study addressed the risk and predictors of CAD among those with DM. Investigations included – anthropometry, blood pressure, blood glucose, serum lipids and electrocardiogram (ECG). CAD was diagnosed on: (a) history of angina plus positive ECG - either on rest or on stress, post-myocardial infarction (MI) with Q-wave MI or non-Q-MI or echocardiographic evidences. Lipids namely triglycerides (TG), total cholesterol (T-Chol), high density lipoproteins (HDL) and low-density lipoproteins (LDL) were estimated by Hitachi-704 auto-analyzer using enzymatic method. Results: A total of 693 (M /W =295/398) participants volunteered. The prevalence of CAD, SHTN, DHTN and mean arterial hypertension (MAH) were 18.6%, 23.2%, 13.6% and 17.7%, respectively. Their mean (±SD) values of age, body mass index (BMI - kg/m2), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR) and mean arterial pressure (MAP) were 47 (8.6) years, 24.6 (3.5), 0.98(0.05), 0.56(0.06) and 101(11.3) mmHg, respectively. The mean (±SD) of FBG (mmol/L), T-Chol, TG and HDL (mg/dl) were 10.2 ± 4.0, 206 ± 44, 218 ± 86 and 47.5 ± 9.3 respectively. The women had significantly higher BMI (p55y: 95% CI: 1.09 - 43.7) and highest TG-quintile (281mg/dl: 95% CI: 1.45-59.7) were proved to be significant predictor of CAD and HDL highest quintile (>54mg/dl) was proved to be significant protecting factor for CAD (95% CI: 0.005-0.583). Conclusion: The study observed the importance of MAP, TG, HDL, T-Chol/HDLR (T-Chol -to HDL ratio) and TG/HDLR (triglycerides-to HDL ratio) as risks for CAD among diabetics. Further study with investigations of echocardiogram, ETT, coronary angiogram and coronary calcium scoring would be helpful in confirming these findings related to CAD risks. IMC J Med Sci. 2023; 17(1): 002. DOI: https://doi.org/10.55010/imcjms.17.002 *Correspondence: M Abu Sayeed, Department of Community Medicine, Ibrahim Medical College, 1/A, Ibrahim Sarani, Segunbagicha, Dhaka 1000, Bangladesh. Email: sayeed1950@gmail.com

Background: Patients with nephrotic syndrome are susceptible to numerous bacterial, viral, and fungal infections. To design preventive measures, it is vital to identify the various types of infections, their causative organisms, and sensitivity patterns in the local settings. Methods: From January 2012 to July 2014, this descriptive cross-sectional study was conducted in the Pediatric department of Sir Salimullah Medical College, Mitford Hospital, Dhaka. Children younger than 12 years admitted with nephrotic syndrome were screened for infection. Laboratory analysis with culture and sensitivity of urine, blood, CSF, and peritoneal fluids was performed to identify and analyze the causative organisms. Results: The most prevalent age range for the 90 admitted children with nephrotic syndrome was 2-5 years, and the male to female ratio was 0.95:1. 73% of the children had their initial attack of nephrotic syndrome, while 27% had recurrence. During admission, 38% of patients had various infections, and 57% of these infections occurred in children aged 2 to 5 years. Urinary tract infection (UTI), peritonitis, septicemia, and pneumonia were the most prevalent illnesses (incidence, 46%, 26%, 11%, and 9%, respectively). Escherichia coli, Proteus sp., and Streptococcus sp., commonly caused urinary tract infections, peritonitis, septicemia, and pneumonia. Organisms for UTI, peritonitis and pneumonia were sensitive to ciprofloxacin, azithromycin, and ceftriaxone, respectively. Conclusion: Infection should be ruled out carefully in every case of nephrotic syndrome during management in the hospital. Escherichia coli is the dominant causative agent for UTI. After sending relevant body fluids for culture sensitivity, ciprofloxacin for a suspected UTI, and azithromycin for peritonitis can be started immediately.

Background: Febrile seizures occur in 2 to 5% of all children with a recurrence rate of 30 to 40%. Calcium and magnesium is closely related to pathophysiology of seizures and aim of this study was to find out the association of serum calcium and magnesium level with febrile seizure. Methods: A cross sectional analytical study was conducted among One hundred (100) subjects of both sexes with age range 6 months to 60 months in department of pediatrics from June 2019 to May 2020. The subjects were grouped into case (group A) and control (group B) by purposive sampling who were seeking fever with convulsion (group A) and fever without convulsion (group B). Statistical analyses were performed by Chi-square test and/or Fisher’s exact test as applicable for comparing qualitative variables and for quantitative variables using unpaired t-test and/or Mann-Whitney U test for comparing between the groups. Pearson’s Correlation Coefficient test was done to observe the correlation between low calcium and Magnesium level in febrile seizure. A p-value of

Background: The amount of protein excretion is a reflection of disease activity in Nephrotic Syndrome. 24-hour urine collection has remained as the method of choice to quantify proteinuria. An alternative method for quantitative evaluation of proteinuria is measuring the ratio of protein or albumin to creatinine in an untimed ‘‘spot’’ urine specimen. Objective: To compare 12-hour versus 24-hour proteinuria in nephrotic syndrome and its correlation to spot urinary protein creatinine ratio. Materials & Methods: A comparative cross-sectional study was conducted in the Department of Pediatrics, Sir Salimullah Medical College Mitford Hospital (SSMC & MH), Dhaka over a period from September 2016 to June 2017. All the babies developing 1st attack of Nephrotic Syndrome and meeting the clinical criteria were included in the study. Complete history was taken from accompanying attendants. Thorough clinical examinations and relevant laboratory investigations (12- hour day urinary protein, 12-hour night urinary protein, 24-hour urinary total protein, S. Albumin, S. Cholesterol, Urinary spot Protein Creatinine ratio) were done. All the information was recorded in the fixed protocol. Collected data were classified, edited, coded and entered into computer for statistical analyses. Results: Out of 50 cases, the mean age was found 58.3±29.0 months. 12-hour day urinary protein was found 2.02±0.167 gm/m2/12 hours, mean; 12-hour night urinary protein was found 2.12±2.18 gm/m2/12 hours, mean; 24-hour urinary total protein was found 4.10±3.32 gm/m2/24 hours. The mean spot urinary protein creatinine ratio was found 12.58±7.21 with range from 2.02 to 29.85. There was no statistically significant difference between 12- hour day sample and 12-hour night sample. There was also no significant difference between 12-hour day & night sample with 24-hour sample. Results of all 03 samples were comparable to urinary protein creatinine ratio. Conclusion: This study reveals no statistically significant difference in quantitative estimation of 12-hour day and night protein with 24-hour urinary total protein. The 12- hour day and night protein and urinary total protein were comparable with each other and also with urinary spot protein creatinine ratio.So 12-hour day or night urinary total protein may be a diagnostic tool for nephrotic syndrome. Sir Salimullah Med Coll J 2021; 29(2): 105-111

Background and objectives: Diabetes mellitus (DM) is a major health problem in South Asian Region including Bangladesh. Increasing prevalence of DM is likely to cause higher morbidity and mortality. The objective of this study was to find out the prevalence and incidence of diabetic complications in a Bangladeshi diabetic cohort attending BIRDEM, a largest referral center in Bangladesh for endocrine and metabolic diseases. Methodology: The study was conducted in BIRDEM-OPD (outpatient department) from 1 January to 31 December of 1995 and analyzed the data of diabetic cases preserved in BIRDEM registry since 1956. Up to 31 December 1985, the REFERENCE NUMBER (Ref No) of last case was ‘49,510’. Therefore, this retrospective cohort comprised of all those patients having Ref No 49,510 or less and attending BIRDEM-OPD for follow-up. In the year 1995, the cohort had follow-up for at least ten years. The duration of follow-up was 39 years (1956 to 1995). The study also retrieved follow-up data from the guidebook of each registered diabetic patient. All data regarding clinical, anthropometric and biochemical investigations preserved in BIRDEM registry and in the patient's guidebook were retrieved and analyzed. The cohort was categorized into three groups (Gr1, 2 and 3) based on follow-up duration: >15, 10-15 and 15y and Gr2 with follow-up 10-15y. Compared with the Gr2, retinopathy (34.4 vs. 48.5 %: c2 =11.5, p

Agrobacterium mediated genetic transformation of BRRI Dhan 58 was conducted by using immature embryos following indirect regeneration. High percentage of callus induction at 96.5% was obtained when seeds of BRRI dhan 58 were cultured on modified MS medium supplemented with 2.5 mg/l 2, 4-D under dark condition. The maximum regeneration response was rerecorded when MS was supplemented with 3 mg/l BAP + 0.5 mg/l NAA and 1.0 mg/l Kn. Genetic transformation was performed using A. tumefaciens strain LBA4404 harboring pCAMBIA1301 plasmid carrying the marker genes for β-glucuronidase (GUS) and hygromycin resistance (hptII). Integration of the GUS gene into the genome of the rice plants was confirmed by PCR. The leaf segments of the PCR positive transformed plants showed the expression of GUS. The results of this study would be an effective tool for crop improvement and functional studies of gene on rice plant. Plant Tissue Cult. & Biotech. 31(1): 71-80, 2021 (June)

Background and objectives: The developing countries are facing the double burden of the communicable (CD) and non-communicable (NCD) diseases. The initiation of primary health care (PHC) adopted in the past century, which included sanitation and immunization, remarkably reduced the load of CDs in the least developing nations. The burden of NCDs remained the same or showed an increasing trend. Of the NCDs, diabetes has become a serious threat to human health and the related morbidity and mortalities are affecting the younger people. As a consequence, the disease complications render huge number of people to disabilities and unusual enormous health expenditures. Very few studies addressed the prevalence of complications among the diabetes patients in a rural community. This study aimed to determine the prevalence of sequels (morbidity and mortality) among the diabetic cases eight years after the initial diagnosis of diabetes in a rural community cohort Subjects and Methods: A rural community survey in 10 villages was conducted in 1993. The survey screened 1319 (797 men, 522 women) for diabetes mellitus (DM) and impaired glucose tolerance (IGT). Those who were diagnosed DM and IGT referred to a referral center (BIRDEM) for registration. A retrospective cohort was designed in 2001. The addresses of the patients were retrieved from the BIRDEM registry. These registered patients, both survivors and non-survivors, were traced in ten villages. The survivors were investigated (anthropometry, glycemia, fundoscopy, urine protein etc.). A verbal autopsy was performed to determine the cause(s) of death in the non-survivors. Results: Of the188 registered cases, 79 were found and located (survivors 43 (54.4%, non-survivors 36 (45.6%). Of the survivors, 44.2% developed complications. The observed complications were sensory neuropathy 16.3%, CAD 9.3%, retinopathy 7% and nephropathy 4.7%. Among the non-survivors, 19.4% were found to have nephropathy leading to end-stage renal disease. Conclusions: The study cohort revealed that more than one-third of the people with diabetes died in less than ten years after being diagnosed. The cohort also revealed that diabetic nephropathy (end-stage renal disease) and dearth of dialysis facilities contributed to early death in the rural community. Among the complications, most frequent incidence was neuropathy and neuro-psychiatric disorders. IMC J Med Sci 2021; 15(1): 005 *Correspondence: M. Abu Sayeed, Department of Community Medicine, Ibrahim Medical College, 1/A Ibrahim Sarani, Segunbagicha, Dhaka-1000. email: sayeed@imc.ac.bd

Background The World Health Organization recommends the Xpert MTB/RIF Ultra assay for diagnosing pulmonary tuberculosis (PTB) in children. Though stool is a potential alternative to respiratory specimens among children, the diagnostic performance of Xpert Ultra on stool is unknown. Thus, we assessed the diagnostic performance of Xpert Ultra on stool to diagnose PTB in children. Methods We conducted a cross-sectional study among consecutively recruited children (, Xpert Ultra may be used on stool, an easy-to-obtain specimen, for childhood pulmonary tuberculosis diagnosis. Future studies with follow-up and clinical evolution are needed to provide insight on management of children with trace call.

Introduction: Perineal tear (PT) is the most frequently occurring injury during vaginal birth. Striae gravidarum (SG) is a reflecting marker of connective tissue elasticity. This study aimed to assess SG score and to predict the likelihood of PT during childbirth. Materials & Methods: This was a cross-sectional study done at Sir Salimullah Medical College & Mitford Hospital. Initially, all pregnant women admitted for vaginal delivery were enrolled but who subsequently needed lower segment caesarean section were excluded. Finally, 189 patients who gave vaginal birth were included. SG score was assessed using the Atwal numerical scoring system. The association was examined between PT as the outcome measure, defined by tears or lacerations and the total striae score (TSS) obtained at abdomen, hips, buttocks and breasts. Results: More than half of study patients developed PT. Majority belonged to moderate striae group. Significant correlation was found between PT and TSS. Moderate and severe striae had significantly increased prevalence of PT as compared to mild striae (43.4% vs. 11.6%). Patients who were given episiotomy in moderate and severe striae group had less PT. Weight gain during pregnancy and TSS were significantly associated with a higher incidence of PT. Conclusion: A woman’s SG score in general is a useful clinical predictor of the risk for PT during childbirth. Selective episiotomy in patients with moderate and severe striae can reduce the incidence of PT. SG score can be used as a simple and noninvasive tool by all categories of health personnel to better define women at risk for PT. Medicine Today 2019 Vol.31(2): 64-67

Weight measurement is essential for the management of pediatric patients to calculate the dose of the drugs. But it is not possible to move the child to a weighing scale for determination of body weight when the child is in a critical condition. The purpose of this study was to check if foot length correlates with child’s body weight in our situation and to devise a formula for prediction of weight based on foot– length observed. This Cross-sectional study was carried out in the Department of Pediatrics, Sir Salimullah Medical College, Mitford hospital, Dhaka over a period of 12 months between January 2008 and December 2008. A total of 300 children, between 0 day to five years, meeting the predefined eligibility criteria were included in the study. Using the available data, simple linear regression analysis was performed between the dependent variable weight and independent variable foot length. The estimated linear regression line was: Predicted weight (kg) = a+ [b× foot length]. Data were analyzed using correlation coefficient (r) between foot length and children’s weight. In this study correlation between foot length and weight (r) was 0.92(P

This multi-institutional observational study conducted among 11 countries in East and Southeast Asia aimed to assess the clinical outcomes of prophylactic extended-field concurrent chemoradiation therapy using weekly cisplatin for patients with locally advanced cervical cancer.

Background: Acute Lower Respiratory Tract Infections (ALRI), particularly Pneumonia and Bronchiolitis, are important causes of death in childhood in Bangladesh. The cardiovascular and respiratory systems function as a single unit and alteration in cardiorespiratory interactions, can cause significant changes in cardiac function. The objective of this study was to find out any electrical and functional changes, myocardial injury, frequency of heart failure and the outcomes in these patients with ALRIs. Methodology: It was a prospective observational study carried out at DMCH from January to June 2012 on 35 consecutive children admitted with ALRI, which were further diagnosed as pneumonia or bronchiolitis using operational definitions. Heart failure cases were identified and all the cases were then evaluated for any cardiovascular changes. Results: Most of the patients were male. ECG changes occurred in the form of tachycardia. Abnormal echocardiographic findings were noted in the form of pulmonary hypertension, left ventricular systolic (LV) dysfunction and tricuspid regurgitation. 82.9% had raised CK-MB and was significantly higher in patients with tachycardia and having abnormal echocardiographic changes. Nine patients developed heart failure, 3 of them had pulmonary hypertension along with LV systolic dysfunction and one of pulmonary hypertension and LV systolic dysfunction each. CK-MB was raised significantly in all the patients with heart failure. Conclusion: Raised CK-MB, tachycardia out of proportion on ECG and pulmonary hypertension with left ventricular systolic dysfunction were common findings in patients with ALRI. Bangladesh J Child Health 2019; VOL 43 (1) :27-34

Background: Early stage breast cancer can often be cured with surgery alone though there are chances of recurrent disease and decrease in survival. Adjuvant poly-chemotherapy with docetaxel-based regimens can improve both disease-free and overall survival in patients with operable breast cancer. Objective: This study was designed to evaluate the patient profile and current pattern of care with docetaxel based adjuvant regimen in operable breast cancer patients including the treatment outcome from clinical practice. Materials and method: This prospective, observational, non-comparative study planned to enroll newly diagnosed operable breast cancer patients with high risk of recurrence after surgery. Selection of docetaxel-based treatment strategy and dosage of therapy was at the discretion of individual oncologists as per routine clinical practice. Patient data were recorded during inclusion, each cycle of therapy, and follow-up at 1 year (+/- 1 month) after inclusion. Results: Between August 2008 and July 2011 a total of 85 patients with median age of 53 years (23-73 years) were enrolled and 53 (62.4%) patients were postmenopausal. Ductal carcinoma, the most common cancer type,was found in 73 (85.9%) patients. Receptor status was positive for estrogen, progesterone or Her2/neu/erbB2 in 65.9%, 47.1% and 5.8% patients, respectively. Mastectomy either partial or total was performed in 76 (89.4%) patients for the current disease. An average of 8 (range: 2-15) lymph nodes (LN) mostly in axilla were excised in 56 patients and average of 4 (range: 1-11) LN nodes were positive. Sentinel LNs were negative, excised in 4 patients. The mean tumor size was 5.5 cm and most (82.4%) patients were diagnosed at Stage II disease including some at Stage I and III (7.1%, 10.6%). Docetaxel (Taxotere®) was combined with cyclophosphamide alone or in addition with doxorubicin, epirubicin, 5 FU and trastuzumab either in combination or sequential regimen. Taxotere in combination with adriamycin and cyclophosphamide was planned for 63.5% patients. Trastuzumab as sequential therapy could be afforded by 1 patient only. Data regarding radiotherapy or hormone therapy was not recorded. At the end of four cycles, 83.5% of patients were found disease free and 5.9% had loco regional relapse. At 1 year 71 (93.4%) patients were alive, 63 (88.7%) were relapse-free and 8 (11.2%) had loco regional relapse. Nausea, vomiting, diarrhea, alopecia, anemia and neutropenia were most commonly reported adverse events classified as Grade 1 or Grade 2. Grade 3 neutropenia was reported in 5 patients and 2 patients reported grade 4 neutropenia. Grade 3 diarrhea was reported in 1 patient. Conclusion: Docetaxel as adjuvant chemotherapy offered one year survival in 93.4% (71/76) of the patients and 88.7% (63/71 patients) were disease-free. The safety profile of docetaxel based regimens was expected and manageable. Delta Med Col J. Jan 2019 7(1): 4-10

Genomic mutation of the virus may impact the viral adaptation to the local environment, their transmission, disease manifestation, and the effectiveness of existing treatment and vaccination. The objectives of this study were to characterize genomic variations, non-synonymous amino acid substitutions, especially in target proteins, mutation events per samples, mutation rate, and overall scenario of coronaviruses across the country. To investigate the genetic diversity, a total of 184 genomes of virus strains sampled from different divisions of Bangladesh with sampling dates between the 10th of May 2020 and the 27th of June 2020 were analyzed. To date, a total of 634 mutations located along the entire genome resulting in non-synonymous 274 amino acid substitutions in 22 different proteins were detected with nucleotide mutation rate estimated to be 23.715 substitutions per year. The highest non-synonymous amino acid substitutions were observed at 48 different positions of the papain-like protease (nsp3). Although no mutations were found in nsp7, nsp9, nsp10, and nsp11, yet orf1ab accounts for 56% of total mutations. Among the structural proteins, the highest non-synonymous amino acid substitution (at 36 positions) observed in spike proteins, in which 9 unique locations were detected relative to the global strains, including 516E>Q in the boundary of the ACE2 binding region. The most dominated variant G614 (95%) based in spike protein is circulating across the country with co-evolving other variants including L323 (94%) in RNA dependent RNA polymerase (RdRp), K203 (82%) and R204 (82%) in nucleocapsid, and F120 (78%) in NSP2. These variants are mostly seen as linked mutations and are part of a haplotype observed in Europe. Data suggest effective containment of clade G strains (4.8%) with sub-clusters GR 82.4%, and GH clade 6.4%.HighlightsWe have sequenced 137 and analyzed 184 whole-genomes sequences of SARS-CoV-2 strains from different divisions of Bangladesh.A total of 634 mutation sites across the SARS-CoV-2 genome and 274 non-synonymous amino acid substitutions were detected.The mutation rate of SARS-CoV-2 estimated to be 23.715 nucleotide substitutions per year.Nine unique variants were detected based on non-anonymous amino acid substitutions in spike protein relative to the global SARS-CoV-2 strains.

Background: Cervical cancer is one of the leading causes of death among women in our country. .It is a preventable disease and early carcinoma cervix can be cured by proper treatment. Lack of countrywide well accepted screening program of cervical cancer may be a cause of this hidden advancement of disease.Objectives: To assess the clinical and pathological profile of patients with cervical cancer.Method: This cross sectional descriptive study was conducted in the Department of Gynaeoncology of National Institute of Cancer Research & Hospital (NICRH) from January, 2011 to December, 2011. Initially 76 patients were enrolled in the study by purposive sampling. Thereafter they were scrutinized by eligibility criteria and ultimately 67 patients were finalized. A case record form was prepared which was pre-structured, interview and observation based and peer reviewed. Data regarding socio-demographic, clinical and pathological profiles were collected in standard data sheet. Data were recorded, compiled, edited and analyzed. P-value was determined as significant at

Fusarium wilt is an economically important disease of cucumber caused by the fungus Fusarium oxysporum f. sp. cucumerinum (Foc). It causes severe losses in the yield and quality of cucumber and is extremely difficult to control conventionally using chemical fungicides. Biological control offers an eco-friendly alternative to chemical pesticide for sustainable plant disease management. In this context, biocontrol activity of rhizosphere soil bacteria was investigated against Foc in vitro. Thirty-five rhizobacterial isolates were screened for antagonistic activity in dual culture, and isolate BA5 showed the highest antagonistic activity (58.33% mycelial growth inhibition) against Foc. Maximum fungal biomass reduction (90.20%) was found in King’s B broth in shake flask culture. Cell-free culture filtrate and ethyl acetate crude extract inhibited mycelial growth of Foc by 56.66 and 25.0%, respectively. Further, the selected isolate produced siderophores, volatile compound(s), hydrocyanic acid, and protease. Siderophores and volatile compound(s) were involved in the isolate-induced antagonism. In addition, the isolate exhibited several plant growth-promoting traits, including phosphate and zinc solubilization, ammonia production, organic acid production, and in vitro biofilm formation. Based on the morphological, physiological, biochemical characteristics, and phylogeny analysis, the isolate BA5 was identified as Pseudomonas aeruginosa, and the 16S rDNA sequence was submitted in the NCBI GenBank under the strain name RKA5. Because of the novel antifungal and plant growth promotion potentials, the strain can be used as a promising biocontrol agent against the fungal pathogen Foc.

Background and objective – Disaster prone coastal population has least accessibility to health care and very little is known about the prevalence of diabetes, diabetic retinopathy (DR) and visual impairment. This study addressed the prevalence of visual impairment and DR and risk factors related to DR among population residing in disaster prone areas of Bangladesh. Methods : Thirty-two coastal communities in six coastal districts were purposively selected. All coastal people of age 18 years or more were considered eligible. Investigations included clinical history, anthropometry (height, weight, waist- and hip-girth), blood pressure and fasting blood glucose (FBG). The participants with hyperglycemia (FBG ≥5.6mmol/l) were undertaken for eye examination. Visual acuity was measured bilaterally using the Snellen chart. An Early treatment diabetic retinopathy study (ETDRS) cut out chart with E Optotypes was used. Results: A total of 7567 participants volunteered and 1540 had hyperglycemia (FBG ≥5.6mmol/l). Of the hyperglycemic participants, 1214 (91.7%) participated for complete eye examination. Visual impairment of any type was found in 14.1%, any type cataract in 27.8% and any type DR in 18%. The participants of advancing age of higher social class and higher central obesity had excess risk for developing DR. The participants with known family history of diabetes also had greater risk. Compared with the group having FBG 5.6 – 6.9mmol/l those having FBG >6.9mmol/l had significant risk for DR (OR 3.11, 95%CI 2.04 – 4.76). Conclusion : The study concludes that visual impairment and cataract of any type is almost comparable with other coastal populations. The coastal people had higher prevalence of DR compared to rural population from other areas of Bangladesh and it was also higher than global estimate. The persons with higher age from higher social class with higher central obesity had excess risk for DR. The risk of DR increased with increasing hyperglycemia. Further study may be undertaken to confirm these findings. IMC J Med Sci 2016; 10(1): 10-17

Background : Ischemic Heart Disease (IHD) requires long term treatment which poses huge financial burden.It is very difficult for the patients of developing countries to maintain the treatment costs of IHD.Objectives : To estimate the medical treatment cost and to find out the coping ways of that in Ischemic Heart Disease patients.Methods: A descriptive type of cross sectional study was done during January 2014 to December 2014 at medical out-patient department of National Institute of Cardiovascular Disease (NICVD), Dhaka. Data were collected by using a pre-tested, semi-structured Questionnaire. Medical cost was calculated by drug cost, consultation cost, laboratory investigation cost, surgical cost, hospital cost and food cost. Data analysis was performed by using SPSS software version 20.Results : Out of 201 patients, majority (64.7%) were in the age group of 40-59 years. Most (92.54%)of them were male. Majority (56.2%) of the respondents had monthly family income of Tk. 10001-20000. Among all patients 43.8%spent total medical cost was with a range from Tk.50001-180000. 85.71%, 81.8%, 69.9% and 66.71% had coped with families by life style change whose monthly Tk. 20001-50000,Tk. 50001-100000, Tk. 10001-20000, Tk. 5000-10000 respectively. Coping ways in family by compromising treatment cost of other family members was minimum 0.0% within the income group Tk.5000-10000, which was statistically significant (p

Purpose This multi-institutional observational study conducted among 11 countries in East and Southeast Asia aimed to assess the clinical outcomes of prophylactic extended-field concurrent chemoradiation therapy using weekly cisplatin for patients with locally advanced cervical cancer. Methods and Materials Between October 2007 and May 2016, 106 patients with untreated squamous cell carcinoma of the cervix were enrolled in the present study. Radiation therapy consisted of pelvic irradiation (total dose, 50 Gy in 25 fractions including central shielding), prophylactic paraortic regional irradiation (36-40 Gy in 20 fractions), and either high- or low-dose-rate intracavitary brachytherapy (ICBT) according to institutional practice. The planned point A dose was 21 to 28 Gy in 3 to 4 fractions for high-dose-rate ICBT and 40 to 41 Gy in 1 to 2 fractions for low-dose-rate ICBT. Five cycles of weekly cisplatin (40 mg/m2) were administered during the radiation therapy course. Results A total of 106 patients were enrolled. Of these, 9 had major protocol violations and 2 did not receive treatment because of worsened general condition. Thus, 95 patients were evaluable. The median follow-up was 56 months. Of the 95 patients, 76 (80%) received 4 or 5 cycles of chemotherapy. Acute grade 3 leukopenia was observed in 20 of the patients (21%), and late grade 3 gastrointestinal toxicity was observed in 3%. The 2-year local control, progression-free survival, and overall survival rate for all patients were 96%, 78%, and 90%, respectively. Conclusions The results indicated that prophylactic extended-field concurrent chemoradiation therapy using weekly cisplatin is feasible and effective for patients with locally advanced cervical cancer in East and Southeast Asia.

Colorectal cancer (CRC) is the second most common cause of cancer-related death in the world, but early diagnosis ameliorates the survival of CRC. This report aimed to identify molecular biomarker signatures in CRC. We analyzed two microarray datasets (GSE35279 and GSE21815) from the Gene Expression Omnibus (GEO) to identify mutual differentially expressed genes (DEGs). We integrated DEGs with protein–protein interaction and transcriptional/post-transcriptional regulatory networks to identify reporter signaling and regulatory molecules, utilized functional overrepresentation and pathway enrichment analyses to elucidate their roles in biological processes and molecular pathways, performed survival analyses to evaluate their prognostic performance, and applied drug repositioning analyses through Connectivity Map (CMap) and geneXpharma tools to hypothesize possible drug candidates targeting reporter molecules. A total of 727 upregulated and 99 downregulated DEGs were detected. The PI3K/Akt signaling, Wnt signaling, extracellular matrix (ECM) interaction, and cell cycle were identified as significantly enriched pathways. Ten hub proteins (ADNP, CCND1, CD44, CDK4, CEBPB, CENPA, CENPH, CENPN, MYC, and RFC2), 10 transcription factors (ETS1, ESR1, GATA1, GATA2, GATA3, AR, YBX1, FOXP3, E2F4, and PRDM14) and two microRNAs (miRNAs) (miR-193b-3p and miR-615-3p) were detected as reporter molecules. The survival analyses through Kaplan–Meier curves indicated remarkable performance of reporter molecules in the estimation of survival probability in CRC patients. In addition, several drug candidates including anti-neoplastic and immunomodulating agents were repositioned. This study presents biomarker signatures at protein and RNA levels with prognostic capability in CRC. We think that the molecular signatures and candidate drugs presented in this study might be useful in future studies indenting the development of accurate diagnostic and/or prognostic biomarker screens and efficient therapeutic strategies in CRC.

Purpose: Among the therapeutic modalities available for the treatment of cervical cancer, irradiation is regarded to be the standerd treatment for all tumor stages, which includes external beam radiation therapy and HDR brachytherapy or a combination of these two. This modality of cancer, needless to say, is prevalent in Bangladesh as the women are coming forward for its detection. Dramatic advances have been made in brachytherapy for cervical cancer. Radiation treatment planning has evolved from two-dimensional to three-dimensional, incorporating magnetic resonance imaging and/or computed tomography into the treatment paradigm. This allows for better delineation and coverage of the tumor, as well as improved avoidance of surrounding organs. Brachytherapy applications are not restricted to one method only; any method could be combined with another, as well as other radiotherapy techniques. In cervical cancer, intracavitary brachytherapy (ICBT) has been used for practical reasons. Lately though, combination of ICBT and interstitial brachytherapy (ISBT) techniques are being evaluated in deference to feasibility, practicality and reproducibility. Advanced brachytherapy can achieve very high rates of local control with a reduction in morbidity, compared with historic approaches. This study provides an overview of state-of-the-art gynecologic brachytherapy, with a focus on recent advances and their implications for women with cervical cancer. Materials and Methods: Three patients were selected on different staging. Three different types of applicator (Cylinder, Tandem and Ovoid and Interstitial Implant) were inserted according to the patient’s anatomy and staging. Prescribed dose were different for the implant technique. Result: Progress from 2D- to 3D-based imaging and treatment planning for cervical cancer brachytherapy has improved local control, reduced toxicity, and improved overall survival for women. Conclusion: The result of our study indicates that a precise delivery of treatment by applying a appropriate applicator and the choice of treatment planning technique is more important for a better outcome.

Introduction: Avian influenza is considered as serious global public health problem for poultry industry. Literature suggests that when HPAI/H5N1 Avian influenza (AI) outbreaks, humans are prone to increased risk of transmission. The recent pandemic caused by highly pathogenic AIA (H5N1) in domestic poultry is currently rated phase-3 by the World Health Organization on the pandemic alert scale. Every year 244 species of migratory birds visit Bangladesh in the winter season (October-March) of which approximately 21 species may carry the H5N1 or HPAI (Highly Pathogenic Avian influenza) virus. Objective: To assess socio demographic status and knowledge on mode of transmission of avian influenza among the poultry workers of selected poultry farms in Dhaka city. Materials and Methods: This was a cross-sectional study carried out among the poultry workers of selected poultry farms in Dhaka city. The study was conducted over a period of six months from January 2008 to June 2008. A total of 150 poultry workers aged 9 years and above irrespective of sexes were interviewed face to face by using semi-structured questionnaire. Results: Majority of the respondents were male (92%) and nearly 78% of the respondents had educational level from Class-V to SSC. About three fourth of the respondents (68%) mentioned that avian influenza was transmitted by direct contact. Eighty percent (80%) of the respondents had the knowledge on transmission from poultry to human whereas 63% had the knowledge on transmission from human to human. Good, fair and poor knowledge on mode of transmission of avian influenza was found in 21.33%, 42.67% and 36% of the subjects respectively. Among the respondents belonging to

A dose audit of 16 facilities in 11 countries has been performed within the framework of the Forum for Nuclear Cooperation in Asia (FNCA) quality assurance program. The quality of radiation dosimetry varies because of the large variation in radiation therapy among the participating countries. One of the most important aspects of international multicentre clinical trials is uniformity of absolute dose between centres. The National Institute of Radiological Sciences (NIRS) in Japan has conducted a dose audit of participating countries since 2006 by using radiophotoluminescent glass dosimeters (RGDs). RGDs have been successfully applied to a domestic postal dose audit in Japan. The authors used the same audit system to perform a dose audit of the FNCA countries. The average and standard deviation of the relative deviation between the measured and intended dose among 46 beams was 0.4% and 1.5% (k = 1), respectively. This is an excellent level of uniformity for the multicountry data. However, of the 46 beams measured, a single beam exceeded the permitted tolerance level of ±5%. We investigated the cause for this and solved the problem. This event highlights the importance of external audits in radiation therapy.

A dose audit of 16 facilities in 11 countries has been performed within the framework of the Forum for Nuclear Cooperation in Asia (FNCA) quality assurance program. The quality of radiation dosimetry varies because of the large variation in radiation therapy among the participating countries. One of the most important aspects of international multicentre clinical trials is uniformity of absolute dose between centres. The National Institute of Radiological Sciences (NIRS) in Japan has conducted a dose audit of participating countries since 2006 by using radiophotoluminescent glass dosimeters (RGDs). RGDs have been successfully applied to a domestic postal dose audit in Japan. The authors used the same audit system to perform a dose audit of the FNCA countries. The average and standard deviation of the relative deviation between the measured and intended dose among 46 beams was 0.4% and 1.5% (k = 1), respectively. This is an excellent level of uniformity for the multicountry data. However, of the 46 beams measured, a single beam exceeded the permitted tolerance level of ±5%. We investigated the cause for this and solved the problem. This event highlights the importance of external audits in radiation therapy.

Objective : There is growing concern that exposure to arsenic during pregnancy can have adverse effects on the developing fetus. To investigate the effect of arsenic exposure on reproductive health outcomes this study was carried out.Materials and methods : This prospective birth cohort study was carried out by Harvard School of Public Health and Dhaka Community Medical College & Hospital in 2004 through the Sirajdikhan and Birahimpur community clinics as a pilot project. The study included 421 pregnancies at the time of enrollment. Water samples were collected at the time of enrollment and within one month of delivery from the tubewell of each participant identified as their primary source of drinking water. These samples were analyzed by inductively coupled plasma mass spectrometry.Results: Of 421 pregnancies, 38 women withdrew from the study or were lost to follow up (9.0%), 30 resulted in spontaneous abortion or miscarriage (7.1%), 32 were stillbirths (7.6%) and 321 were live births (76.2%). At the time of enrollment, the average drinking water arsenic exposure level was 31.6 ?g/L (standard deviation, 83.7 ?g/L; range

Background: Metabolic syndrome is a risk factor for cardiovascular disease. Objectives: The purpose of the present study was to see the association of metabolic syndrome with essential hypertension. Methodology: This cross sectional study was carried out in the OPD of the Department of Cardiology at Shaheed Suhrawardy Medical college Hospital, Dhaka from January 2008 to December 2010. All the All the Metabolic syndrome was defined as abnormal fasting serum level of glucose (≥ 110 mg/dl or 6.1 mmol/L) with abdominal obesity (waist circumference > 102 cm in men and > 88cm in women), triglycerides (≥ 150mg/dl), High density lipoprotein cholesterol (< 40 mg/dl in men and < 50 mg/dl in women) and hypertension. Results: . A total of 322 patients were enrolled Among hypertensive patients 31.8% had hyperglycemia, 37.9% had high waist circumference, 69.8% had low HDL cholesterol and 54.3% high triglycerides. As per definition of NCEP-ATP-III, metabolic syndrome had been detected in 17% of male, 37% of female and 27% of total population. Conclusion: Metabolic factors are a common association in hypertensive cases. These patients are at increased risk of coronary and cerebro-vascular disease and require more vigorous prevention. Furthermore in all hypertensive patients metabolic screening is recommended. Journal of Science Foundation 2014;12(2): 34-38 DOI: http://dx.doi.org/10.3329/jsf.v12i2.27736

The prevalence of hypertension was reported higher in the coastal areas in different populations of the world. There was no study on the prevalence of hypertension among the coastal people in Bangladesh. This study addressed the prevalence and risk of hypertension among people living in the coastal areas of Bangladesh. Total 32 different coastal communities were selected purposively in the six coastal districts (Barisal, Borguna, Vola, Pirojpur, Potuakhali and Jhalukathi) of Bangladesh. All people over 18 years were considered eligible. Social, clinical and family histories were taken. Height, weight, waist- and hip-girths were measured including systolic and diastolic blood pressure (SBP and DBP). Fasting blood glucose and lipids were also estimated. The accepted cut offs for systolic hypertension (sHTN) was ?135mmHg and diastolic hypertension (dHTN) was ?85 mmHg. Overall, 7058 (m / f = 2631 / 4427) people volunteered to participate in the study. The crude prevalence of sHTN was 17.8% [95% CI, 17.39 – 18.21] and dHTN was 19.0% [95% CI 18.08 – 19.92]. Compared to female, the male participants had higher prevalence of both sHTN (16.4 v. 20.2 %, p

The aim of this study was to evaluate the toxicity and efficacy of radiotherapy concurrent with weekly cisplatin for T3-4 and N0-1 nasopharyngeal cancer. Between 2005 and 2010, 70 patients with nasopharyngeal cancer (T3-4 N0-1 M0, World Health Organization Type 2-3) from Vietnam, Indonesia, Malaysia and Thailand were registered. Patients were treated with 2D radiotherapy concurrent with weekly cisplatin (30 mg/m(2)). Neither adjuvant nor induction chemotherapy was given. Ninety-three percent of the patients completed at least four cycles of weekly cisplatin during radiotherapy. The median total doses for the primary tumor and positive lymph nodes were 70 and 66 Gy, respectively. The median overall treatment time of concurrent chemoradiotherapy was 52 days. No treatment-related deaths occurred. Grade 3-4 acute toxicities of mucositis, nausea/vomiting and leukopenia were observed in 34%, 4% and 4% of patients, respectively. With a median follow-up time of 52 months for the 40 surviving patients, the 3-year local control, locoregional tumor control, distant metastasis-free survival and overall survival rates were 80%, 75%, 74% and 80%, respectively. In conclusion, the current results illustrate that our concurrent chemoradiotherapy regimen was feasible, but disease control remained insufficient. Further research is encouraged in order to improve clinical outcomes.

Osteoporosis is a disease that causes bones to become weak and brittle. It affects 55 of Americans aged 50 or above of which about 80 are women. Millions of fractures occur annually. An effective way of preventing osteoporosis is to maximize the attainment of peak bone mineral density pBMD. Thus the knowledge of average pBMD that prevails in a nation is very important. Not much study appears to have been done on the subject in Bangladesh. 170 Bangladeshi patients and volunteers were studied at nuclear medicine centers of Comilla and Rajshahi. Bone mineral densities BMD at different sites of the skeleton were measured using Dual Energy X-ray Absorptiometer DXA. Graphs of Age versus BMD were plotted. Data was fitted with the help of polynomials. The best fit was obtained with polynomials of degree 4 in each case. By using bootstrapping method a large number of samples were generated and pBMD was obtained from each of the samples. Mean value of the pBMD was then calculated. pBMD values of the male patients were found to be slightly greater than those of the females. During puberty gender differences become more expressed. After the age of 50 females lose bones more rapidly and quantitatively than males. Bangladeshis seem to belong to the group of nations having low pBMDs.

The aim of this study was to evaluate the toxicity and efficacy of radiotherapy concurrent with weekly cisplatin for T3-4 and N0-1 nasopharyngeal cancer. Between 2005 and 2010, 70 patients with nasopharyngeal cancer (T3-4 N0-1 M0, World Health Organization Type 2-3) from Vietnam, Indonesia, Malaysia and Thailand were registered. Patients were treated with 2D radiotherapy concurrent with weekly cisplatin (30 mg/m(2)). Neither adjuvant nor induction chemotherapy was given. Ninety-three percent of the patients completed at least four cycles of weekly cisplatin during radiotherapy. The median total doses for the primary tumor and positive lymph nodes were 70 and 66 Gy, respectively. The median overall treatment time of concurrent chemoradiotherapy was 52 days. No treatment-related deaths occurred. Grade 3-4 acute toxicities of mucositis, nausea/vomiting and leukopenia were observed in 34%, 4% and 4% of patients, respectively. With a median follow-up time of 52 months for the 40 surviving patients, the 3-year local control, locoregional tumor control, distant metastasis-free survival and overall survival rates were 80%, 75%, 74% and 80%, respectively. In conclusion, the current results illustrate that our concurrent chemoradiotherapy regimen was feasible, but disease control remained insufficient. Further research is encouraged in order to improve clinical outcomes.

The prevalence of non-communicable diseases (NCD) like diabetes, hypertension, dyslipidemia and atherosclerotic cardiovascular diseases (CVD) are on the increase globally and predominantly in the South East Asian Region (SEAR). The increasing NCD and its complications burdened the health cost of Bangladesh. The available literatures suggest that edible mushrooms are effective in controlling metabolic risks like hyperglycemia and hypercholesterolemia.The study addressed the metabolic effects of edible oyster mushroom (Pleurotus ostreatus) in diabetic individuals and to assess the undesirable effects of mushroom.A total of 5000 newly registered diabetic women were screened for eligible participants (urban housewives, age 30 – 50y, BMI 22 – 27, FBG 8 – 12 mmol/l; free from complications or systemic illnesses and agreed to adhere to the study for 360 days). The investigations included weight and height for BMI, waist- and hip-girth for WHR, BP, FBG, 2ABF, T-chol, TG, HDL, LDL, ALT and Creatinine starting from the day 0 (baseline) and each subsequent follow-up days: 60, 120, 180, 240, 300 and 360 for comparison between placebo and mushroom groups and also within group (baseline vs. follow up days), individually for placebo and mushroom. The daily intake of mushroom was 200g for the mushroom group and an equivalent calorie of vegetables for the placebo group.Overall, 73 diabetic housewives (mushroom / placebo = 43 /30) volunteered. The mean (with SEM) values of BMI, WHR, BP, FBG, 2ABF, T-chol, TG, HDL, LDL, ALT and Creatinine of the placebo group were compared with the mushroom group. Compared with the placebo, the mushroom group showed significant reductions of FBG (p

Background: As hypofractionated radiotherapy for post-operative breast cancer patients safe, effective and more convenient, it might be beneficial for patients of developing countries like ours. Objective: This study was done to evaluate the safety and efficacy of hypofractionated whole breast radiation therapy in patients who underwent breast conserving surgery and hypofractionated radiation therapy in patients who underwent mastectomy and axillary clearance. Materials and method: This cross sectional study was conducted in Delta Hospital Ltd, Dhaka, Bangladesh, including 50 postoperative patients, (12 patients in Breast Conservation Therapy group and 38 in Post Mastectomy Radiation Therapy group), with invasive ductal carcinoma of breast treated with this hypofractionated radiotherapy protocol during the last 1.5 year. The patients were treated with 3DCRT, LINAC, 6 MV photon and appropriate electron energy. Results: Minimal post treatment acute morbidity was observed. Forty seven patients (94%) had grade-I acute skin toxicity and only 3 patients (6%) developed grade-II acute skin toxicity. Conclusion: Hypofractionated radiotherapy is as safe and effective as conventional fractionated radiotherapy and superior in terms of convenience. DOI: http://dx.doi.org/10.3329/dmcj.v3i1.22232 Delta Med Col J. Jan 2015; 3(1): 04-08

The prevalence of hypertension was reported higher in the coastal areas in different populations of the world. There was no study on the prevalence of hypertension among the coastal people in Bangladesh. This study addressed the prevalence and risk of hypertension among people living in the coastal areas of Bangladesh. Total 32 different coastal communities were selected purposively in the six coastal districts (Barisal, Borguna, Vola, Pirojpur, Potuakhali and Jhalukathi) of Bangladesh. All people over 18 years were considered eligible. Social, clinical and family histories were taken. Height, weight, waist- and hip-girths were measured including systolic and diastolic blood pressure (SBP and DBP). Fasting blood glucose and lipids were also estimated. The accepted cut offs for systolic hypertension (sHTN) was ³135mmHg and diastolic hypertension (dHTN) was ³85 mmHg. Overall, 7058 (m / f = 2631 / 4427) people volunteered to participate in the study. The crude prevalence of sHTN was 17.8% [95% CI, 17.39 – 18.21] and dHTN was 19.0% [95% CI 18.08 – 19.92]. Compared to female, the male participants had higher prevalence of both sHTN (16.4 v. 20.2 %, p

The study was conducted to select the best promising keratinolytic bacterial strain. A good keratinase positive bacterium isolated from the soil samples of Hazaribagh tannery industrial zone, Dhaka was identified as Arthrobacter genus depending on the conventional techniques and confirmed as Arthrobacter sp. by sequencing 16S rRNA gene. The medium components and culture conditions were optimized to enhance keratinase production through shake flask culture. Keratin and feather powder (10 g/l or 1%) were good substrates for the highest keratinase production along with yeast extract (0.2 g/l or 0.02%) as an organic nitrogen source and potassium nitrate (1 g or 0.1%) as an inorganic nitrogen source. Maximum yield of keratinase was found after 24 h of incubation at 37 °C with an initial pH of 7.0 and inoculums volume 5% under 150 rpm when keratin, yeast extract and potassium nitrate were used as nutrient sources. Keratinase production was more than 5.0-fold increased when all optimized parameters were applied simultaneously. The optimum reaction temperature and pH were determined to be 40 °C and 8.0 respectively for crude keratinase activity. Therefore, Arthrobacter sp. NFH5 might be used for large scale production of keratinase for industrial purposes in less time. Electronic supplementary material The online version of this article (doi:10.1186/s13568-017-0462-6) contains supplementary material, which is available to authorized users.

Gestational diabetes mellitus (GDM) or hyperglycemia in pregnancy is associated with adverse perinatal outcomes such as large for gestational age (LGA), excess fetal adiposity and cesarean delivery. This study addressed the prevalence of diabetes in pregnancy and to compare the perinatal outcomes between GDM and non-GDM in a rural pregnancy cohort of Bangladesh. Ten villages were purposively selected in a rural area about 100 km off Dhaka City. A population census was conducted. A randomized sample of married women of age 15-45y was drawn from the census data. These women having either regular menstruation (non-regnant) or cessation of menstruation for ?24weeks (pregnant) were considered eligible. Both the pregnant and non-pregnant women were invited to volunteer the study. Weight, height, waist- and hip-girth and blood pressure were taken. Fasting blood sample was collected for the estimation of plasma glucose (FPG), triglycerides (TG), cholesterol (chol), high-density lipoprotein (HDL). FPG >5.1 mmol/L was taken as cut-off for hyperglycemia in non-pregnant and gestational diabetes mellitus (GDM) for the pregnant women. The biophysical characteristics were compared between pregnant and non-pregnant; and then GDM and non-GDM. Only the pregnant women were taken as a pregnancy cohort. The cohort had followup from 24wks of pregnancy through 28 post-natal days. Results The census yielded 23545 (m / f=11896 / 11649) people of all ages. The married women of age 15-45y were 4526. Of them, 2100 were randomly selected for investigation and 1585 (75.5%) volunteered. The overall prevalence (95% CI) of hyperglycemia (FPG >5.1 mmol/L) was 18.5% (16.7 – 20.3). The prevalence of GDM was 8.9% (7.0 – 10.8) and non-GDM was 19.8% (18.8 – 20.8). The BMI and WHR were significantly higher in the pregnant than non-pregnant women; whereas, there was no significant difference between GDM and non-GDM group. The prevalence rates of abortions, stillbirths, hospital delivery, cesarean delivery, hospital stay ?7days, puerperal sepsis and neonatal death did not differ between GDM and non-GDM subjects significantly. The prevalence of GDM in rural Bangladesh is comparable with any other population with higher prevalence of GDM. The prevalence of hyperglycemia was found significantly higher in the non-pregnant than the pregnant women. The anthropometric measures did not differ significantly between GDM and non-GDM though FPG was found significantly higher in the former. Compared with the non-GDM the GDM subjects had no significantly higher fetomaternal morbidity and mortality possibly due to non-sedentary habit, non-obesity, non-dyslipidemia or may be due to inherent genetic makeup. A well designed study in a larger sample may explain our findings. DOI: http://dx.doi.org/10.3329/imcj.v7i2.20101 Ibrahim Med. Coll. J. 2013; 7(2): 21-27

The present study demonstrates the first direct evidence of the novel role of OsACA6 in providing Cd 2+ stress tolerance in transgenic tobacco by maintaining cellular ion homeostasis and modulating ROS-scavenging pathway. Cadmium, a non-essential toxic heavy metal, interferes with the plant growth and development. It reaches the leaves through xylem and may become part of the food chain, thus causing detrimental effects to human health. Therefore, there is an urgent need to develop strategies for engineering plants for Cd2+ tolerance and less accumulation. The members of P-type ATPases family transport metal ions including Cd2+, and thus play important role an ion homeostasis. The present study elucidates the role of P-type 2B Ca2+ ATPase (OsACA6) in Cd2+ stress tolerance. The transcript levels of OsACA6 were up-regulated upon Cd2+, Zn2+ and Mn2+ exposure. Transgenic tobacco expressing OsACA6 showed tolerance towards Cd2+ stress as demonstrated by several physiological indices including root length, biomass, chlorophyll, malondialdehyde and hydrogen peroxide content. The roots of the transgenic lines accumulated more Cd2+ as compared to shoot. Further, confocal laser scanning microscopy showed that Cd2+ exposure altered Ca2+ uptake in OsACA6 transgenic plants. OsACA6 expression in tobacco also protected the transgenic plants from oxidative stress by enhancing the activity of enzymatic (SOD, CAT, APX, GR) and non-enzymatic (GSH and AsA) antioxidant machinery. Transgenic lines also tolerated Zn2+ and Mn2+ stress; however, tolerance for these ions was not as significant as observed for Cd2+ exposure. Thus, overexpression of OsACA6 confers Cd2+ stress tolerance in transgenic lines by maintaining cellular ion homeostasis and modulating reactive oxygen species (ROS)-scavenging pathway. The results of the present study will help to develop strategies for engineering Cd2+ stress tolerance in economically important crop plants.

Chronic kidney disease (CKD) with diabetes mellitus is one of the most common and major public health problems globally. In Bangladesh, several studies indicate an increasing prevalence of diabetes though very few studies are available on CKD. For CKD, diagnostic method, criteria or cutoffs still remained undecided. This study aimed to determine the prevalence of CKD among the hospitalized patients and to compare the diagnostic approach practiced in the hospital. Methods: All patients admitted to the Department of Nephrology at BIRDEM from May 1 to July 31, 2012 were selected for investigation. An almost equal number of patients were also selected from other units of Medicine. The information included were age, sex, social class, blood pressure, height, weight, blood glucose, creatinine, triglycerides, total cholesterol, high-density lipoproteins and electrolytes. The CKDcreat was diagnosed based on creatinine (>1.2mg/dl) and the CKDgfr based on estimated GFR (1.2 mg/dl) groups. Similar comparisons were also made between CKDgfr and non-CKDgfr (>60 vs. ? 60 ml/min/1.732) groups. Results: A total of 4172 patients got admitted in the study period of 90 days; and 442 patients (m / f = 256 / 186) were investigated. Of the total (n=4172), 241 (5.8%) had CKDcreat and 272 (6.5%) had CKDgfr. Of the investigated 442 patients, 241 (54.5%) had CKDcreat and 272 (61.5%) had CKDgfr. The differences of characteristics between CKDcreat and non-CKDcreat groups were almost similar to the differences between CKDgfr and non-CKDgfr groups. Higher age, higher social class and higher blood pressure showed significant (p1.2 mg/dl and CKDgfr

The p68, a prototypic member of DEAD-box protein family, is involved in pre-mRNA splicing, RNA-induced silencing and transcription regulation. However, the role of plant p68 in stress tolerance and molecular targets responsible for this has not been reported. Here, we report the isolation and characterization of salinity-induced pea p68 (Psp68). The expression of Psp68 was more in aerial parts as compared to the roots in response to the abiotic stress. The transgenic-overexpressing Psp68 showed enhanced tolerance to salinity stress by efficiently attenuating ionic adjustment and scavenging reactive oxygen species (ROS). The enhanced tolerance was further confirmed by observing several physiological indices. Psp68-overexpressing rice accumulated higher K+ and Ca2+ and lower Na+ level as compared to the wild-type (WT) plants. Furthermore, Psp68 interacts with pea argonaute (AGO1), a catalytic component of the RNA-induced silencing complex (RISC) responsible for the gene silencing. The microarray analysis showed that Psp68 regulates many transcripts involved in the abiotic and oxidative stress responses as well as gene-silencing mechanisms in rice. Thus, the Psp68 functions as a molecular switch in different signaling pathways leading to stress tolerance. Overall, Psp68 may serve as a useful biotechnological tool for the improvement of stress tolerance crops.

DEAD-box helicases play essential role in DNA and RNA metabolism such as replication, repair, recombination, transcription, translation, ribosome biogenesis and splicing which regulate plant growth and development. The presence of helicases in the stress-induced ORFs identified by cDNA microarray indicates that helicases might be playing an important role in stabilizing growth in plants under stress. p68 DEAD-box helicase has been identified and characterized from animal systems but the properties and functions of plant p68 are poorly understood. In this study, the identification, purification and characterization of recombinant p68 from Pisum sativum (Psp68) is presented. Psp68 possesses all the characteristic motifs like DEAD-box ATP-binding and helicase C terminal motifs and is structurally similar to human p68 homologue. Psp68 exhibits ATPase activity in the presence of both DNA and RNA and it binds to DNA as well as RNA. It contains the characteristic RNA helicase activity. Interestingly Psp68 also shows the unique DNA helicase activity, which is bipolar in nature (unwinds DNA in both the 5'-3' and 3'-5' directions). The Km values of Psp68 for ATPase are 0.5126 and 0.9142 mM in the presence of DNA and RNA, respectively. The Km values of Psp68 are 1.6129 and 1.14 nM for DNA helicase and RNA helicase, respectively. The unique properties of Psp68 suggest that it could be a multifunctional protein involved in different aspect of DNA and RNA metabolism. This discovery should make an important contribution to better understanding of nucleic acids metabolism plants.

BACKGROUND: Santhal (Santals) tribe is one of the oldest and largest aboriginal pre Aryan populations in India and Bangladesh. There was no published report on the prevalence of diabetes and hypertension. OBJECTIVE: To determine the prevalence of type 2 diabetes mellitus (T2DM) and hypertension in a Santhal tribe of Bangladesh. RESEARCH DESIGN AND METHODS: Eight villages inhabited largely by Santhal tribe were purposively selected. All Santhals aged 20 years or more were considered eligible and enlisted for the study. Investigations included socio-demographic information (age, sex, education, income), clinical history (general illness), anthropometry (height, weight, waist-girth, hip-girth) and blood pressure. Body mass index (BMI) and waist-to-hip ration (WHR) were calculated. Blood samples were collected for fasting plasma glucose (FPG), total cholesterol (Chol), triglycerides (TG), urea and creatinine. RESULTS: Thirteen hundred eligible Santhals were enlisted. Of them, 1049 (80.7%) participated in the study. The male and female participants were 40% and 60%, respectively. The prevalence of T2DM was 0.6% and hyperglycemia (FPG > 5.5 mmol/l) was 10.0%. The prevalence of systolic hypertension (sHTN) was 24.4% and diastolic hypertension (dHTN) was 24.6%. Compared with the males the females had significantly higher prevalence of sHTN (OR, 2.20 with 95% CI, 1.62 - 3.02) and dHTN (OR, 1.81 with CI, 1.34 - 2.0); whereas, the prevalence of T2DM and IFG did not differ. Regarding obesity 45% of the participants had BMI 23.1. Logistic regression estimated that the increasing age, female sex, higher FPG (>5.5 mmol/l) and higher Chol (>160 mg/dl) had independent risk for sHTN and dHTN. CONCLUSIONS: The Santhals had less risk for diabetes but increased risk for hypertension. The Santhal females had excess risk of hypertension. Advancing age, female sex, hyperglycemia and hypercholesterolemia were found to have significant risk for hypertension. Obesity had no effect on diabetes or hypertension. High dietary salt intake among Santhals might have contributed to the development of hypertension. Further study may confirm the study findings and to understand why this tribe is less susceptible to diabetes and more to hypertension.

Importance of imaging in all clinical or medical research, and especially, of Computerized Axial Tomography (CAT scan), has demonstrated a unique place in diagnostic or radiation therapy. Two-dimensional images of internal structures of the body are examined and reported. This process of imaging, any anatomical location, viz. head and neck, thorax, pelvis, etc. takes about 30 seconds to perform with a minimal dose of less than 1.6- 2.0 mGy. The images are constructed by the hardware with software algorithm, using the attenuation and absorption of X rays of tissues, of varying electron densities of the anatomical structures. Sometimes a contrast dye is injected to a patient intravenously, rectally or orally, to make hollow or fluid-filled structures such as blood vessels more visible. Radiologists and radiation oncologists are confronted with a task to delineate the information of the CT images to a meaningful diagnosis. The images are, therefore, valuable for diagnostic reports, some of these may relate to cancerous tumors and tissues. Cancer treatment, radiation therapy or else, from such observations may start. But an artifact and distortion on such images will contribute to erroneous and/or unusable interpretations in offering a clinical report to provide wrong clinical decisions. The implications of the presence of distortion in CT images is, for a patient, described here so as to instruct the experts, in medical and clinical fields, to rectify the situation in acquiring a sharp and flawless image or in reaching the correct clinical goal. DOI: http://dx.doi.org/10.3329/dmcj.v2i1.17789 Delta Med Col J. Jan 2014; 2(1): 3-8