Search

Background: Sodium and potassium intake is known to be a modifiable determinant of hypertension. Also, daily intake of these electrolytes is subject to much geographical and ethnic variation. The impact of sodium and potassium intake on blood pressure in Bangladeshi subjects in incompletely known. Our objective was to determine the relationship between urinary sodium and potassium excretion, and blood pressure in Bangladeshi subjects. Methods: Patients attending the Outpatient Department of the Department of Cardiology, SSMC & MH, who fulfilled the inclusion and exclusion criteria, were taken as study sample. Hypertensive individuals were considered as group 1 and apparently healthy individuals who did not have hypertension were considered as group 2 for the study. Estimates of 24-hour sodium and potassium excretion were made from a single spot urine specimen and were used as surrogates for intake. We assessed the relationship between sodium and potassium excretion and blood pressure. Results: The spot urinary sodium excretion was significantly higher in hypertensive group than in normotensive group (98.03 ± 71.13 mmol/L vs. 77.11 ± 41.71 mmol/L) (p=0.011). On the other hand, the spot urinary potassium excretion was lower in hypertensive group than normotensive group (33.95 ± 41.03 mmol/L vs. 39.43 ± 31.47 mmol/L), but the differences did not reach statistical significance (p=0.679). The estimated 24-hour urinary sodium excretion was higher in hypertensive group than in normotensive group (8.84 ± 3.57 gm vs. 7.67 ± 3.16 gm) and the difference was statistically significant (p = 0.015). Estimated 24-hour urinary potassium excretion was lower in hypertensive group (4.15 ± 1.37 gm) than in normotensive group (4.48 ± 1.56 gm), but the difference between 2 values did not reach statistical significance (p=0.114). Conclusion: Compared to the normotensive counterparts, sodium intake is significantly higher and potassium intake is lower in hypertensive Bangladeshi subjects. Cardiovasc j 2023; 15(2): 118-123

Decision science has a wide range of applications in daily life. Decision information is usually incomplete and partially reliable. In the fuzzy set theory, Z-numbers are introduced to handle this situation because they contain the restriction and reliability components, which complement the impaired information. The ranking of Z-numbers is a challenging task since they are composed of pairs of fuzzy numbers. In this research, the vectorial distance and spread of Z-numbers were proposed synergically, in which the vectorial distance measures how much the fuzzy numbers are apart from the origin, which was set as a relative point, and their spreads over a horizontal axis. Furthermore, a ranking method based on the convex compound was proposed to combine the restriction and reliability components of Z-numbers. The proposed ranking method was validated using several empirical examples and a comparative analysis was conducted. The application of the proposed ranking method in decision-making was illustrated via the development of the Analytic Hierarchy Process-Weighted Aggregated Sum Product Assessment (AHP-WASPAS) model to solve the prioritization of public services for the implementation of Industry 4.0 tools. Sensitivity analysis was also conducted to evaluate the performance of the proposed model and the results showed that the proposed model has improved its consistency from 66.67% of the existing model to 83.33%. This research leads to a future direction of the application of ranking based on the vectorial distance and spread in multi-criteria decision-making methods, which use Z-numbers as linguistic values.

Background: Different adaptation and changes have been practiced during COVID-19 pandemic. Objective: In this paper we investigated the impact of the COVID-19 pandemic on service delivery in the department of interventional neurology and adaptation of the department to the changed environment. Methodology: This was a retrospective analysis of diagnostic digital subtraction angiography (DSA) procedures done from January 2018 to December 2020 and were analyzed to detect significant breaks in time trend. Results: A total of 358, 426 and 251 patients got admitted for DSA in consecutive three years from 2018 to 2020 respectively. There was a sudden drop in the number of DSA procedures from 30 to 50 patients per month in the pre-COVID era before March 2020 to less than 10 patients per month during the COVID period of March to June 2020. However, the situation gradually improved following the introduction of RT-PCR test for SARS CoV-2 in June 2020. A poison regression showed a significant increase in monthly DSA procedures in the year 2019 compared to the year 2018, but a significant decrease in the pandemic year of 2020. Conclusion: By incorporating COVID-19 testing as a pre-requisite test before DSA procedures, the department of interventional neurology recovered from experiencing a significant drop in the number of performed DSA procedures in the initial periods of the pandemic to reaching a level observed in the pre-COVID era. Bangladesh Journal of Infectious Diseases, April 2022;9(Suppl_1): S3-S8

Freshwater prawn farming has become an important component in the livelihood of marginal farmers in the freshwater interface of Southwestern coastal Bangladesh. This prawn farming has been integrated with rice and/or vegetable either simultaneously or sequentially. In an attempt to assess the status of integrated prawn-agriculture gher farming in the area, 20 farms at Fakirhat Thana, Bagerhat were surveyed during August-October, 2005. Farmers were interviewed with questionnaire on the production and economics of such integrated farms. Stocking of prawn PL was done at the densities 0.5 to 2.0 PL m-2 during February-March in simultaneous culture and at the densities 3.0 to 7.0 PL m-2 during June-July in sequential system. This integrated prawn farming has beneficial impact on the income of the farmers. Net profit was calculated to be Tk 20,395 ha-1 from a cycle (5-6 months) of simultaneous culture and Tk 35,457 ha-1 from sequential system, and Tk 127,000 ha-1 from rice + prawn + vegetable farming.

Background: Thalassaemia is an emerging global public health concern. It is considering as a rapidly growing major health burden for low- and middle income countries. The prevalence of thalassaemia is increasing in Bangladesh, indicates that thalassemia will be an emerging health burden for our country. Objective: To assess the level of mental stress among parents with a thalassemic child. Materials and Methods: A cross-sectional study was conducted among the 141 parents with a thalassemic child in the purposively selected two hospitals’ Dhaka Shishu Hospital and Bangladesh Thalassemia Hospital in Dhaka. ‘Parental stress scale’ (PSS) was used to measure the level of stress. Results: The mean age of the parents was 36.2±8.8 years and nearly two-thirds (63.8%) of them were aged below 40 years. Almost half of the participants (49.6%) and their spouses (59.6%) completed their education upto the higher secondary level. The mean monthly family income was 27,113.5±46,696.9 taka. More than half of the parent’s (53.2%) had low level of mental stress. The education, occupation, monthly family income, presence of >1 thalassaemic child in family, received blood from a voluntary blood donor, normal growth of thalassaemic child and history of thalassaemic child death were significantly associated with the level of mental stress by PSS scores of the parents (p1 beta thalassaemia major child (47.6%), received blood from a voluntary blood donor (50.0%), had a history of normal growth of thalassaemic child (60.4%) and had no history of thalassaemic child death (50.0%). Conclusion: Existence of the children with thalassemia in a family cause massive stress and anxiety for parents. Psychological supports for them are essential as a part of comprehensive medical care along with clinical management of the thalassemic child. The burden of disease can be reduced through effective preventive approaches, such as carrier screening, prenatal counseling and diagnosis. KYAMC Journal Vol. 13, No. 02, July 2022: 102-107

INTRODUCTION This study determined the distribution of sasX, qacA/B and mupA genes from methicillin-resistant Staphylococcus aureus (MRSA) isolated from clinical samples and nasal swab samples of the same patients and analysed their genetic relatedness. METHODS Polymerase chain reaction was used to detect the presence of sasX, qacA/B and mupA genes from 47 paired MRSA isolates. A paired isolate was defined as one nasal swab (colonising) isolate and clinical isolate that caused infection in the same patient. 22 selected paired isolates were subjected to multilocus sequence typing (MLST). The genetic relatedness among the isolates and association between the putative genes with epidemic sequence types (STs) were investigated. RESULTS 7 (14.9%, n = 14) paired isolates were positive for the sasX gene. qacA/B genes were positive in 7.4% (n = 7) of the isolates, from three paired isolates and one clinical isolate whose paired colonising isolate was negative. The paired sample of three patients were positive for both genes. The mupA gene was not detected in all the isolates. MLST revealed two epidemic STs, ST22 and ST239, and a novel ST4649. sasX and qacA/B genes were found in ST239 in 29.5% (n = 13) and 13.6% (n = 6) of cases, respectively. Gene co-existence occurred in 13.6% (n = 6) of MRSA ST239 and 2.3% (n = 1) of MRSA ST4649. CONCLUSION sasX and qacA/B genes were present in the MRSA isolates, while the mupA gene was undetected. ST22 and ST239 were the major MRSA clones. The circulating MRSA genotypes conferred different virulence and resistance determinants in our healthcare settings.

Background Genome-Wide Association Studies have identified genetic polymorphisms located at the Adenylate Cyclase 5 (ADCY5) and Parathyroid Hormone 1 Receptor (PTH1R) genes on chromosome 3 as susceptibility loci for type 2 diabetes mellitus (T2DM) in different population. The present study investigates the association of these two susceptibility loci (rs11708067 at the ADCY5 and rs11926707 at the PTH1R gene) with T2DM in Bangladeshi population. Furthermore, the association of circulating levels of vitamin D, Calcium (Ca), phosphate, and parathyroid hormone (PTH) with T2DM and the different genotypes of these SNPs were also studied.Methods and Materials A total of 415 individuals (211 T2DM patients and 204 healthy controls) were enrolled in the current study. The rs11708067 and rs11926707 were genotyped using the Taqman SNP Genotyping Assays. Univariate logistic regression analyses were performed for parameter associations with T2DM.Results In a sex-stratified analysis, the variant allele of the ADCY5 SNP (rs11708067) was associated to T2DM in males (odds ratio = 2.5, p-value = 0.02) but PTH1R SNP (rs11926707) did not show any significant correlation with T2DM (odds ratio 1.0 in both sexes, p-value > 0.05). In the correlation study, phosphate was shown to be significantly linked with Ca (p-value Conclusion Although ADCY5 has been identified as a T2DM susceptible locus in the Bangladeshi male population, the same cannot be said for the PTH1R locus in either males or females.

The date palm (Phoenix dactylifera L.) is a popular edible fruit consumed all over the world and thought to cure several chronic diseases and afflictions. The profiling of the secondary metabolites of optimized ripe Ajwa date pulp (RADP) extracts is scarce. The aim of this study was to optimize the heat extraction (HE) of ripe Ajwa date pulp using response surface methodology (RSM) and artificial neural network (ANN) modeling to increase its polyphenolic content and antioxidant activity. A central composite design was used to optimize HE to achieve the maximum polyphenolic compounds and antioxidant activity of target responses as a function of ethanol concentration, extraction time, and extraction temperature. From RSM estimates, 75.00% ethanol and 3.7 h (extraction time), and 67 °C (extraction temperature) were the optimum conditions for generating total phenolic content (4.49 ± 1.02 mgGAE/g), total flavonoid content (3.31 ± 0.65 mgCAE/g), 2,2-diphenyl-1-picrylhydrazyl (11.10 ± 0.78 % of inhibition), and cupric-reducing antioxidant capacity (1.43 µM ascorbic acid equivalent). The good performance of the ANN was validated using statistical metrics. Seventy-one secondary metabolites, including thirteen new bioactive chemicals (hebitol II, 1,2-di-(syringoyl)-hexoside, naringin dihydrochalcone, erythron-guaiacylglycerol-β-syringaresinol ether hexoside, erythron-1-(4′-O-hexoside-3,5-dimethoxyphenyl)-2-syrngaresinoxyl-propane-1,3-diol, 2-deoxy-2,3-dehydro-N-acetyl-neuraminic acid, linustatin and 1-deoxynojirimycin galactoside), were detected using high-resolution mass spectroscopy. The results revealed a significant concentration of phytoconstituents, making it an excellent contender for the pharmaceutical and food industries.

The fuzzy time series forecasting model is a powerful tool in forecasting the time series data. The nature of the fuzzy set exhibits its role in handling the uncertainty of the data. The intuitionistic fuzzy set (IFS) is a generalization of a fuzzy set that makes the forecasting process more precise and accurate. This paper proposes a new fuzzy forecasting model based on IFS via the de-i-fuzzification approach, namely equal distribution of hesitancy. The proposed model consists of four main parts; the fuzzification of historical data; the establishment of the IFS; the de-i-fuzzification; and the defuzzification. For the fuzzification, the historical data is partitioned into 14 intervals using the frequency density-based method and trapezoidal fuzzy numbers are used to fuzzify the data. The data are then converted into IFS. The data in IFS form is reduced to fuzzy set using equally distributed with the degree of hesitancy approach. The arithmetic rules based on centroid defuzzification is used to calculate the forecasted output. The proposed model shows a better performance than the existing forecasting models based on IFS, indicating that the equal distribution of hesitancy de-i-fuzzification managed to handle the non-determinism in the forecasting with simplified procedure. In the future, an improved method will be proposed to defuzzify the IFS into crisp values without going through the de-i-fuzzification process, yet preserving the nature of IFS.

IntroductionRohu (Labeo rohita Hamilton) is a globally significant aquaculture species for which genetically improved strains are increasingly available. In 2020, a multiplier population, comprised of highly–ranked generation-three (G3) families from the WorldFish Rohu Genetic Improvement Program, was released to hatcheries in Bangladesh for development into broodstock.MethodsTo estimate realised genetic gain for harvest weight in the G3-multiplier population, one pond from each of 19 Bangladeshi semi-commercial farms (ten in Jashore and nine in Natore–Rajshahi districts) were stocked with equal numbers of tagged fish from each of three strains. Strains included in the study were the ‘G3-multiplier’ released to hatcheries, a ‘control’ (putatively genetically equivalent to the unimproved base population which was spawned from fish of river origin) and fish sourced from a ‘commercial’ hatchery. Once stocked, fish were managed according to each farmer’s normal practices.ResultsThe G3-multiplier was found to be the most rapidly growing strain. Back-transformed means for harvest weight across farms for the commercial, control and G3-multiplier strains were 594 g, 659 g and 914 g, respectively, in Jashore, and 545 g, 626 g and 845 g in Natore–Rajshahi.DiscussionThese results equate to realised genetic gains of 38.6% (Jashore) and 34.9% (Natore–Rajshahi) for the G3-multiplier over the control strain and provide evidence that a family-based (i.e. pedigree-based) approach to genetic improvement is able to generate substantial levels of genetic gain in rohu. Furthermore, the clear growth advantages exhibited by the G3-multiplier strain over the control and commercial strains in this study, should encourage more Bangladeshi hatcheries, nurseries and farmers to adopt genetically improved rohu.

Aging-induced alterations to the blood-brain barrier (BBB) are increasingly being seen as a primary event in chronic progressive neurological disorders that lead to cognitive decline. With the goal of increasing delivery into the brain in hopes of effectively treating these diseases, a large focus has been placed on developing BBB permeable materials. However, these strategies have suffered from lack of specificity towards regions of disease progression. Here we report on the development of a nanoparticle (C1C2-NP) that targets regions of increased claudin-1 expression that reduces BBB integrity. Using dynamic contrast enhanced magnetic resonance imaging (DCE-MRI) we find that C1C2-NP accumulation and retention is significantly increased in brains from 12-month-old mice as compared to non-targeted NPs and brains from 2-month-old mice. Furthermore, we find C1C2-NP accumulation in brain endothelial cells with high claudin-1 expression, suggesting target-specific binding of the NPs, which was validated through fluorescence imaging, in vitro testing, and biophysical analyses. Our results further suggest a role of claudin-1 in reducing BBB integrity during aging and show altered expression of claudin-1 can be actively targeted with NPs. These findings could help develop strategies for longitudinal monitoring of tight junction protein expression changes during aging as well as be used as a delivery strategy for site-specific delivery of therapeutics at these early stages of disease development.

Automated keyphrase extraction is crucial for extracting and summarizing relevant information from a variety of publications in multiple domains. However, the extraction of good-quality keyphrases and the summarising of information to a good standard have become extremely challenging in recent research because of the advancement of technology and the exponential development of digital sources and textual information. Because of this, the usage of keyphrase features for keyphrase extraction techniques has recently gained tremendous popularity. This paper proposed a new unsupervised region-based keyphrase centroid and frequency analysis technique, named the KCFA technique, for keyphrase extraction as a feature. Data/datasets collection, data pre-processing, statistical methodologies, curve plotting analysis, and curve fitting technique are the five main processes in the proposed technique. To begin, the technique collects multiple datasets from diverse sources, which are then input into the data pre-processing step by utilizing some text pre-processing processes. Afterward, the region-based statistical methodologies receive the pre-processed data, followed by the curve plotting examination and, lastly, the curve fitting technique. The proposed technique is then tested and evaluated using ten (10) best-accessible benchmark datasets from various disciplines. The proposed approach is then compared to our available methods to demonstrate its efficacy, advantages, and importance. Lastly, the results of the experiment show that the proposed method works well to analyze the centroid and frequency of keyphrases from academic articles. It provides a centroid of 706.66 and a frequency of 38.95% in the first region, 2454.21 and 7.98% in the second region, for a total frequency of 68.11%.

In this study, expanded polystyrene (EPS) was photodegraded in vitro, and its water-soluble degradation products were extracted using solid-phase extraction. An in vivo test using the MTT assay showed that EPS exhibited increased toxicity upon photodegradation. This clearly demonstrates the necessity of investigating the degradation products at a molecular level, and thus, we conducted analyses using high-resolution mass spectrometry coupled with liquid chromatography. Overall, 68 compounds were detected, of which 13 were identified after comparing the retention times and tandem mass spectra of the extracted compounds with those of standards. The toxicity of the degraded EPS was studied by examination of the detected compounds combined with published reports. In addition, the quantification of the most abundant compounds showed that discarded EPS can generate a significant amount of chemicals by UV degradation. The data in this study show that degraded EPS can pose a significant environmental threat as a source of potentially hazardous chemicals. This study provides a fundamental basis for the evaluation of the fate and toxicity of photodegraded EPS.

No biodegradation methods are absolute in the treatment of all textile dyes, which leads to structure-dependent degradation. In this study, biodegradation of three azo dyes, reactive black 5 (RB5), acid blue 113 (AB113), and acid orange 7 (AO7), was investigated using an immobilized fungus, Trametes hirsuta D7. The degraded metabolites were identified using UPLC-PDA-FTICR MS and the biodegradation pathway followed was proposed. RB5 (92%) and AB113 (97%) were effectively degraded, whereas only 30% of AO7 was degraded. Molecular docking simulations were performed to determine the reason behind the poor degradation of AO7. Weak binding affinity, deficiency in H-bonding interactions, and the absence of interactions between the azo (-NN-) group and active residues of the model laccase enzyme were responsible for the low degradation efficiency of AO7. Furthermore, cytotoxicity and genotoxicity assays confirmed that the fungus-treated dye produced non-toxic metabolites. The observations of this study will be useful for understanding and further improving enzymatic dye biodegradation.

Background: Vitamin D are needed for normal functioning of cardiovascular system, and its deficiency has been linked to different cardiovascular disorders, including hypertension. However, the relationship between vitamin D deficiency and ischaemic heart disease is not yet clear. The present study was intended to find out the association between serum vitamin D level and acute coronary syndrome (ACS). Methods: The cross-sectional analytical study was carried out in a tertiary care hospital of Dhaka, Bangladesh. Fifty-one consecutive ACS patients admitted into the Department of Cardiology of the hospital were considered as the cases and 51 apparently healthy subjects were considered as the controls. The exposure and outcome variables were serum vitamin D and ACS respectively. Vitamin D insufficiency and deficiency were defined as serum 25(OH) D

Background: Dental caries is a chronic dental disorder of children and it can result in substantial morbidity due to pain, dysfunction, poor appearance, and problems of speech development. The study was conducted to assess the association between passive smoking and pediatric dental caries. Methods: The cross-sectional study was conducted among 92 school children aged 5-10 years. Data on exposure to passive smoking at both indoor and outdoor were obtained through face to face interview of the parents with the help of semi-structured questionnaire and checklist. Dental caries was diagnosed by clinical examination and passive smoking exposure was assessed by estimated urinary cotinine level. Results: The study revealed that 58.70% children were male and 41% were female respectively. The mean age of the children was 7.20 years. It was found that 59.8% father of the studied children were smoker where 68.5% children reported that some of their family members were indoor smokers. Of all the children, 62% had dental caries and 85.5% of the children had dental caries who were exposed to passive smoking and had significant association between exposure to passive smoking and dental caries (p

Background: Nerve conduction studies (NCS) are the most objective measure of nerve function, and their use is recommended in the clinical and epidemiological evaluation of diabetic polyneuropathy. Objective: This study was conducted to describe the pattern of electrophysiological abnormality in long-standing type-2 Diabetes Mellitus patients. Methodology: This cross-sectional study was conducted in the Department of Neurophysiology at the National Institute of Neurosciences & Hospital, Dhaka, Bangladesh from July 2017 to June 2019. Among the one hundred and eight consecutive patients of type 2 diabetes with a duration of more than 10 years attending the Neurophysiology laboratory, patients were selected for the study based on the inclusion and exclusion criteria. NCS study of the right upper limb (median and ulnar nerves) and left lower limbs (tibial, peroneal, and sural nerves) were done. NCS of other nerves were also done when indicated. Result: A total number of 92 patients were recruited for this study. NCS was abnormal in 56 (60.9%) patients. 43.5% (n=40) patients were male and 56.5% (n=52) patient were female. Among the 56 (60.9%) patients with abnormal NCS, most [35 (38%)] had mixed types (both sensory and motor) of neuropathy. In 28 (30.4%) patients, both demyelination and axonal involvement were present. The median nerve (46.7%) was the commonest nerve to be involved followed by the Sural nerve. In patients with elevated HbA1C, the axonal loss was more pronounced in the lower limbs’ nerves. Polyneuropathy (28.26%) was more than mononeuropathy (21.74%). Conclusion: Most of the patients of type 2 long-standing DM developed a mixed type of polyneuropathy and elevated HbA1C was significantly associated with the axonal involvement predominantly in lower limbs’ nerves. Journal of National Institute of Neurosciences Bangladesh, January 2021, Vol. 7, No. 1, pp. 10-13

Fuzzy time series is a powerful tool to forecast the time series data under uncertainty. Fuzzy time series was first initiated with fuzzy sets and then generalized by intuitionistic fuzzy sets. The intuitionistic fuzzy sets consider the degree of hesitation in which the degree of non-membership is incorporated. In this paper, a fuzzy set time series forecasting model based on intuitionistic fuzzy sets via delegation of hesitancy degree to the major grade de-i-fuzzification approach was developed. The proposed model was implemented on the data of student enrollments at the University of Alabama. The forecasted output was obtained using the fuzzy logical relationships of the output, and the performance of the forecasted output was compared with the fuzzy time series forecasting model based on fuzzy sets using the mean square error, root mean square error, mean absolute error, and mean absolute percentage error. The results showed that the forecasting model based on induced fuzzy sets from intuitionistic fuzzy sets performs better compared to the fuzzy time series forecasting model based on fuzzy sets.

Background: Outcome of TBM can be modified by several predictors. Objective: This study was undertaken to evaluate the predictors of outcome of tuberculous meningitis (TBM) at 6 and 9 months. Methodology: This hospital based prospective cohort study was carried out from October, 2016 to September, 2017 (1 year) in the in-patient Department of Neurology at the National Institute of Neurosciences & Hospital (NINS & H), Dhaka, Bangladesh. All the patients with age 18 years or more of both sexes with features of TBM fulfilling the case definition criteria was included as the study population. The outcome was measured at 6 and 9 months by modified Rankin Scale (mRS) with no disability (score=0-1), mild disability (score = 2), moderate disability (score=3-4), severe disability (score=5) and dead (score=6). For statistical analysis outcome was classified as death and survival group. A number of clinical, laboratory and radiological parameters were evaluated initially by univariate and finally multiple regression analysis. Results: A total 54 TBM patients were included in this study. Over 70% of the patients were adolescent or young adult (< 30 years) with mean age of 28.2 ± 12.3 years and 63% were female. Staging of the TBM showed that nearly half (48.1%) were at stage II and 37% cases were in stage III disease. Baseline imaging (CT-scan and MRI) showed basal meningeal enhancement in 40.7% cases, hydrocephalus in 40.7%, infarction 46.3% and tuberculoma in 29.6% cases. Final diagnosis was established as definite TBM in 3(5.6%) cases, probable TBM 30(55.6%) and possible TBM in 21(38.9%) cases. In terms of 6-months outcome, 16(29.6%) cases died and 10(18.5%) had recovered without any neurological sequelae; however, mild, moderate and severe disability were in11.1%, 27.8% and 13% cases respectively. At the 9 months of evaluation 13 (24.0%) had complete recovery without any neurological sequelae, 22 (40.9%) patients survived with various degree of disabilities like visual impairment, hemi or paraplegia, cognitive impairment, rests died giving a total mortality of 19(35.1%). In univariate analysis, age >50 years (p=0.019), duration of illness before initiation of treatment (>45 d) (p = 0.041), convulsion (p = 0.010), altered sensorium (p1 month (p=0.041) and stage III TBM (p1 month (p=0.043) emerged as independent predictors of mortality. Conclusions: In conclusion stage III TBM, altered sensorium and delayed initiation of treatment more than 1 month are the independent predictors of mortality in TBM patients. Journal of National Institute of Neurosciences Bangladesh, January 2021, Vol. 7, No. 1, pp. 14-19

Background: COVID-19 was declared as a pandemic by WHO on March 11, 2020. Though the most common and important presentation is with respiratory disease, reports of neurological features are increasing. Objective: In this study it was described the pattern of stroke in COVID-19 patients admitted in a dedicated stroke unit and their short term outcome. Methodology: This single arm, single centreprospective cohortstudy was conducted in the Stroke Unit of National Institute of Neurosciences and Hospital, Dhaka, Bangladesh from April to August, 2020 and wasincluded acute stroke patients irrespective of age and sex who were found RT-PCR positive for SARS CoV-2. The patientswere evaluated clinically, biochemically and by imaging. After diagnosis patients were referred to a COVIDdedicated hospital and were followed up over phone for 4 weeks from the day of admission in stroke unit to assess short term outcome. Results: Among the 41 patients, 21 were male and 20 female with an age range of 26 to 90 years where 58.5% patients were aged 60 and above. Majority (58.5%) of them came from different urban areas. Common co-morbidities were Hypertension (68.3%) and Diabetes mellitus (39%). Most common presenting features were hemiplegia (48.8%) and altered level of consciousness (39%). More than seventy percent (70.7%) patients had GCS of 10 or less and 56.1% patients had oxygen saturation 90% or less in room air. CT brain imaging revealed infarct in 39% and hemorrhage in 51.2%. Chest radiography revealed abnormality in 14.6% cases. Regarding the short term outcome, total 20 (48.8%) patients died where 7 died before referral to COVID-19 dedicated hospital. Death was higher in hemorrhagic stroke but there was no significant association between outcome and the type of stroke (p value>0.05). Conclusions: Hemorrhagic stroke is the most commonly occurring stroke among the COVID-19 patients and associated with p oor outcome. Journal of National Institute of Neurosciences Bangladesh, January 2021, Vol. 7, No. 1, pp. 25-28

Dependency on forest resources poses a threat to the environment in Patharghata, Bangladesh. Therefore, this study explores the role of forest resource in the life and livelihood of coastal people as well as to understand the effectiveness of forest and status of forest dependency in and around south-central coast in Patharghata, Bangladesh. We collected data randomly from 105 household heads through both open and close-ended questionnaire. To investigate the forest dependency and people’s perception regarding alternative solutions, Microsoft excel software program has been applied. The findings reveal that usage of fuelwood in cooking, housing structure, fish catching, honey & fodder collection significantly contributes to household dependency on forest resources, while other variables seem to be insignificant. Our study amplifies that the share of forest income to the total household income was only 19% while other earning sources provided 81% income. The result shows that respondent people collect forest resources primarily for cooking purpose with a share of 71% where 9% forest resources are collected as fodder followed by 8% forest resource collection as food and sheltering purposes. Moreover, the study found that using alternative cooking system, artificial instruments, declaring the forest as tourist spot, changes in housing structure, occupation are some effective options to reduce forest dependency. The study concludes that these alternative options need more financial and other support from the government, non-government and other civil society organizations to cut down forest resource dependency.

Background: The visual evoked potentials (VEP) is a valuable tool to document occult lesions of the central visual channels especially within the optic nerve. Objectives: The purpose of the present study was to observe the findings of first few cases of VEP done in the neurophysiology department of the National Institute of Neurosciences (NINS), Dhaka, Bangladesh. Methodology: This cross-sectional study was conducted in the Department of Neurophysiology at the National Institute of Neurosciences and Hospital, Dhaka, Bangladesh from September 2017 to March 2020. All patients referred to the Neurophysiology Department of NINS for VEP were included. Pattern reversal VEPs were done using standard protocol set by International Federation of Clinical Neurophysiology (IFCN). Results: The mean age of the study population was 30.70 (±12.11) years (6-68 years) with 31 (46.3%) male and 36 (53.7%) female patients. The mean duration of illness was 8.71 (±1.78) months (3 days- 120 months). Most common presenting symptom was blurring of vision (37.3%) and dimness of vision (32.8%). Patterned VEP revealed mixed type (both demyelinating and axonal) of abnormality in most cases [29(43.35)]. The most common clinical diagnosis was multiple sclerosis (29.85%) and optic neuropathy (26.87%). In the clinically suspected cases of multiple sclerosis, optic neuropathy and optic neuritis most of the cases of VEP were abnormal and the p value is 0.04 in optic neuropathy and optic neuritis. Conclusion: The commonest presentation of the patients in this series were blurring of vision and dimness of vision. The most common clinical diagnosis for which VEP was asked for, was optic neuritis and multiple sclerosis. Most abnormalities were of mixed pattern (demyelinating and axonal). Journal of National Institute of Neurosciences Bangladesh, 2020;6(2): 74-77

Background: In evaluation of non-traumatic subarachnoid hemorrhage CT angiography (CTA) has 97-98% sensitivity and near 100% specificity. Objective: This study was conducted to evaluate the CTA findings of CT positive non traumatic subarachnoid hemorrhage. Methodology: This is an observational cross sectional study performed in Neurology department of National Institute of Neurosciences and Hospital, Dhaka over one year period (January 2019 to December 2019). Total 87 CT positive subarachnoid hemorrhage cases were purposively included in this study. All CT positive patients underwent CTA of Cerebral vessels for further evaluation. The angiography were evaluated by competent neuro-radiologists blinded about the study. Result: Among 87 patients, 40.2% were male and 59.8% were female. The average age was 53.33±11.1 years. Among the studied patient the source of bleeding was found 78.16% aneurysmal and 21.84% non-aneurysmal. 85.30% patients had single aneurysm and 14.70% had multiple aneurysm. The highest number of patient had Acom aneurysm (41.17%) followed by MCA (22.05%), ICA (13.23%), ACA (7.35%) and vertebral artery (1.14%) in order of frequency. Among the multiple aneurysm group most of the patients had combination of Acom, MCA and ICA aneurysm. Conclusion: From this study, we can conclude that CTA can be used as the primary diagnostic tool in evaluation of spontaneous SAH. Journal of National Institute of Neurosciences Bangladesh, 2020;6(2): 78-81