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Introduction: Dengue is a major public health concern in our country. The alarming thing is that the seasonal trend of dengue infection is changing with time in Bangladesh due to climate change and unplanned urbanization. Our study was conducted to determine the frequency of dengue virus infection among the febrile patients in 2018 at Dhaka Medical College Hospital (DMCH) and to observe the seasonal trend. Materials and Methods: The study was carried out on 899 febrile patients attended in DMCH from January to December, 2018. Whole blood samples were collected and sera were tested for dengue NS1 antigen and anti-dengue IgM antibodies using commercial test kits (NS1 by OMC Healthcare (Pvt.) Ltd & IgM antibody by Omega Diagnostics Ltd.), respectively. All negative dengue cases were tested for anti Chikungunya antibody to exclude chikungunya. Results: Of the total 899 febrile patients, 350(38.93%) were positive for Dengue infection. Out of them 264(75.43%) were positive for NS1, 82 (23.43%) were positive for IgM and 4 (1.14%) were positive for dengue NS1antigen + anti dengue IgM antibody. More than 50% patients belonged to age group 15-29 years. Males were predominant. More than 60% cases were detected in the post monsoon season. Conclusion: Highest dengue cases were detected in this year in comparison to the previous year’s probably due to re-emergence of DEN-3 serotype. Due to pattern of climate change, seasonal trend of dengue infection was not maintained. Moreover, unplanned urbanization and poor solid waste management have worsened the situation more. J Dhaka Medical College, Vol. 28, No.1, April, 2019, Page 105-111

Summary 10.6% patients were CRE positive. Only 27% patients were prescribed at least 1 antibiotic to which infecting pathogen was susceptible. Burn and ICU admission and antibiotics exposures facilitate CRE acquisition. Escherichia coli ST167 was the dominant CRE clone. Background Given the high prevalence of multidrug resistance (MDR) across South Asian (SA) hospitals, we documented the epidemiology of carbapenem-resistant Enterobacterales (CRE) infections at Dhaka Medical College Hospital between October 2016 and September 2017. Methods We enrolled patients and collected epidemiology and outcome data. All Enterobacterales were characterized phenotypically and by whole-genome sequencing. Risk assessment for the patients with CRE was performed compared with patients with carbapenem-susceptible Enterobacterales (CSE). Results 10.6% of all 1831 patients with a clinical specimen collected had CRE. In-hospital 30-day mortality was significantly higher with CRE [50/180 (27.8%)] than CSE [42/312 (13.5%)] (P = .001); however, for bloodstream infections, this was nonsignificant. Of 643 Enterobacterales isolated, 210 were CRE; blaNDM was present in 180 isolates, blaOXA-232 in 26, blaOXA-181 in 24, and blaKPC-2 in 5. Despite this, ceftriaxone was the most commonly prescribed empirical antibiotic and only 27% of patients were prescribed at least 1 antibiotic to which their infecting pathogen was susceptible. Significant risk factors for CRE isolation included burns unit and intensive care unit admission, and prior exposure to levofloxacin, amikacin, clindamycin, and meropenem. Escherichia coli ST167 was the dominant CRE clone. Clustering suggested clonal transmission of Klebsiella pneumoniae ST15 and the MDR hypervirulent clone, ST23. The major trajectories involved in horizontal gene transfer were IncFII and IncX3, IS26, and Tn3. Conclusions This is the largest study from an SA public hospital combining outcome, microbiology, and genomics. The findings indicate the urgent implementation of targeted diagnostics, appropriate antibiotic use, and infection-control interventions in SA public institutions.

Background: Cervical cancer is one of the most common types of cancer affecting women worldwide. Persistent HPV infection plays a major role in cervical cancer. The risk of cervical cancer has increased in parallel with the incidence of certain genotypes of human papilloma virus (HPV). Methods: The study was aimed to detect the distribution of HPV genotypes among cervical cancer patients from a specialized hospital in Dhaka, Bangladesh. HPV DNA testing was done by polymerase chain reaction (PCR) using SPF-10 broad-spectrum primers followed by genotyping by reverse hybridization using the INNO-LIPA genotyping system at the Department of Virology, Bangabandhu Sheikh Mujib Medical University, Dhaka. Results: HPV 16 was more prevalent (72.0%) in cervical cancer patients from Bangladesh followed by type 18 (6.0%) and 45 (2.0%). Genotype 16 and 18 alone and as co-infection were detected in 88.0% cases. Multiple HPV infection was found in 20% patients. Along with high risk (HR) HPV 16, 18 and 45 HR HPV 56, 39, 31 and 58 were also prevalent in multiple infections. Conclusion: Thus the study concluded that HR HPV 16 and HPV 18 were more prevalent genotypes among cervical cancer patients in a specialised hospital in Bangladesh. Along with HR HPV 16 and HPV 18, HR HPV 45, 56, 39, 31 and 58 were also prevalent Bangladesh Med Res Counc Bull 2019; 45: 86-92

The anti-stress potential of dietary L-arginine (Arg) was assessed in psychosocially stress-loaded senescence-accelerated (SAMP10) mice. Although this strain of mouse is sensitive to stress, daily administration of Arg at 3 mg/kg significantly suppressed aging-related cognitive decline and behavioral depression at nine months of age and counteracted stress-induced shortened lifespan. To investigate the mechanism of the anti-stress effect of Arg in the brain, early changes in oxidative damage and gene expression levels were measured using SAMP10 mice that were stress-loaded for three days. Increased lipid peroxidation in the brains of stressed mice was significantly lowered by Arg intake. Several genes associated with oxidative stress response and neuronal excitotoxic cell death, including Nr4a1, Arc, and Cyr61, remarkably increased in response to psychosocial stress, however, their expression was significantly suppressed in mice that ingested Arg even under stress conditions. In contrast, the genes that maintain mitochondrial functions and neuronal survival, including Hba-a2 and Hbb-b2, were significantly increased in mice that ingested Arg. These results indicate that Arg reduces oxidative damage and enhances mitochondrial functions in the brain. We suggest that the daily intake of Arg plays important roles in reducing stress-induced brain damage and slowing aging.

Senescence-accelerated mouse prone 10 (SAMP10) exhibits cerebral atrophy and depression-like behavior. A line of SAMP10 with spontaneous mutation in the Slc5a2 gene encoding the sodium-glucose cotransporter (SGLT) 2 was named SAMP10/TaSlc-Slc5a2slc (SAMP10-&Delta, Sglt2) and was identified as a renal diabetes model. In contrast, a line of SAMP10 with no mutation in SGLT2 (SAMP10/TaIdrSlc, SAMP10(+)) was recently established under a specific pathogen-free condition. Here, we examined the mutation effect in SGLT2 on brain function and longevity. No differences were found in the survival curve, depression-like behavior, and age-related brain atrophy between SAMP10-&Delta, Sglt2 and SAMP10(+). However, memory retention was lower in SAMP10-&Delta, Sglt2 mice than SAMP10(+). Amyloid beta (A4) precursor-like protein 1 (Aplp1) expression was significantly lower in the hippocampus of SAMP10-&Delta, SGLT2 than in SAMP10(+) at 2 months of age, but was similar at 12 months of age. CaM kinase-like vesicle association (Camkv) expression was remarkably lower in SAMP10(+). These genes have been reported to be involved in dendrite function. Amyloid precursor proteins have been reported to involve in maintaining homeostasis of glucose and insulin. These results suggest that mutation in SGLT2 results in down-regulation of Aplp1 in young age, which can lead to poor memory retention in old age.

Senescence-accelerated mouse prone 10 (SAMP10) mice, after ingesting green tea catechins (GT-catechin, 60 mg/kg), were found to have suppressed aging-related decline in brain function. The dose dependence of brain function on GT-catechin indicated that intake of 1 mg/kg or more suppressed cognitive decline and a shortened lifespan. Mice that ingested 1 mg/kg GT-catechin had the longest median survival, but the dose was less effective at suppressing cognitive decline. The optimal dose for improving memory acquisition was 60 mg/kg, and memory retention was higher in mice that ingested 30 mg/kg or more. To elucidate the mechanism by which cognitive decline is suppressed by GT-catechin, changes in gene expression in the hippocampus of SAMP10 mice one month after ingesting GT-catechin were analyzed. The results show that the expression of immediate-early genes such as nuclear receptor subfamily 4 (Nr4a), FBJ osteosarcoma oncogene (Fos), early growth response 1 (Egr1), neuronal PAS domain protein 4 (Npas4), and cysteine-rich protein 61 (Cyr61) was significantly increased. These results suggest that GT-catechin suppresses age-related cognitive decline via increased expression of immediate-early genes that are involved in long-term changes in plasticity of synapses and neuronal circuits.

Introduction: Dengue is now established as one of the most important Arboviral infection in tropical countries. As the epidemic continues worldwide, this Aedes mosquito-transmitted pathogen is considered a major re-emerging tropical disease and significant public health concern. The study was conducted to determine the sero-epidemiology and clinical picture of dengue virus infection among the clinically suspected patients attended in Dhaka Medical College Hospital during January to December 2016.Materials and Methods: The study was carried out on 145 clinically suspected Dengue patients attended in Dhaka Medical College Hospital from January to December 2016 who had fever with temperature >39°C. Blood sample was collected during acute febrile phase of patients and separated sera were tested for NS1 dengue antigen and IgM antibodies using commercial test kits (NS1 by OMC Healthcare (Pvt.) Ltd & IgM antibody by Omega Diagnostics Ltd.).Results: Of the total 145 patients 40 (27.6%) were positive for Dengue NS1 antigen and or IgM antibody test. Of the positive 40 patients, 18 (45%) were positive for NS1, 19 (47.5%) were positive for IgM and 3 (7.5%) were positive for both NS1 and IgM antibody. Major clinical manifestations were fever with arthralgia (79.5%) and retro-orbital pain (50%).Conclusion: Outbreak of Dengue fever is continuing every year and typical presentation of Dengue fever has changed. Arthralgia and retro orbital pain was the most common clinical feature in the present study instead of headache and rash with fever. A large number of suspected dengue cases were negative by Dengue tests for antigen NS1 and IgM antibody which suggests other organisms of similar clinical manifestations are becoming prevalent in Dhaka city.J Dhaka Medical College, Vol. 26, No.2, October, 2017, Page 111-116

not availableJ Dhaka Medical College, Vol. 26, No.2, October, 2017, Page 86-88

The stress-reducing effect of matcha, a high-quality fine-powdered green tea, has recently been clarified by animal experiments and clinical trials. However, the effect of matcha added to confectioneries is not clear. One aim of this study was to evaluate the relationship between matcha components and their stress-reducing effect in mice that were loaded with territorially-based stress. Adrenal hypertrophy, a marker of stress, was significantly suppressed in stress-loaded mice that had ingested matcha components, displaying a caffeine and epigallocatechin gallate to theanine and arginine (CE/TA) ratio of 2 or less. Another aim was to evaluate, in humans, the stress-reducing effect of matcha in cookies using test-matcha (CE/TA = 1.79) or placebo-matcha (CE/TA = 10.64). Participants, who were fifth year pharmacy college students, consumed 4.5 g of matcha in three pieces of cookie daily for 15 days. Salivary α-amylase activity, a stress marker, was significantly lower in the test-matcha group than in the placebo group. These results indicate that the CE/TA ratio of tea components is a key indicator for the suppression of stress. Moreover, matcha with a CE/TA ratio of 2 or less displays a stress-reducing effect, even if it is included in confectionery products. Such products may also benefit individuals who have no habit of drinking matcha as a beverage.

We report a clonal outbreak of multidrug-resistant (MDR) Klebsiella variicola (sequence type [ST] 771) in a Bangladeshi neonatal unit from October 2016 to January 2017, associated with high mortality (54.5%). During the outbreak, K. variicola ST771 acquired an MDR plasmid harboring blaNDM-1, linked to high exposure to ceftriaxone and amikacin.

Unhealthy diet promotes progression of metabolic disorders and brain dysfunction with aging. Green tea extracts (GTEs) have various beneficial effects and alleviate metabolic disorders. GTEs have neuroprotective effects in rodent models, but their effects against brain dysfunction in models of aging fed unhealthy diets are still unclear. Here, we showed that GTEs attenuate high-fat (HF) diet-induced brain dysfunction in senescence-accelerated mouse prone-8 (SAMP8), a murine model of senescence. SAMP8 mice were fed a control diet, HF diet, or HF diet with 0.5% GTEs (HFGT) for four months. The HF diet reduced memory retention and induced amyloid &beta, 1&ndash, 42 accumulation, whereas GTEs attenuated these changes. In HF diet-fed mice, lipid oxidative stress, assessed by malondialdehyde levels, was increased. The levels of proteins that promote synaptic plasticity, such as brain-derived neurotrophic factor (BDNF) and postsynaptic density protein 95 (PSD95), were reduced. These alterations related to brain dysfunction were not observed in HFGT diet-fed mice. Overall, our data suggest that GTEs intake might attenuate brain dysfunction in HF diet-fed SAMP8 mice by protecting synaptic plasticity as well as via anti-oxidative effects. In conclusion, GTEs might ameliorate unhealthy diet-induced brain dysfunction that develops with aging.

Tea is one of the most consumed beverages in the world. Green tea, black tea, and oolong tea are made from the same plant Camellia sinensis (L.) O. Kuntze. Among them, green tea has been the most extensively studied for beneficial effects on diseases including cancer, obesity, diabetes, and inflammatory and neurodegenerative diseases. Several human observational and intervention studies have found beneficial effects of tea consumption on neurodegenerative impairment, such as cognitive dysfunction and memory loss. These studies supported the basis of tea&rsquo, s preventive effects of Parkinson&rsquo, s disease, but few studies have revealed such effects on Alzheimer&rsquo, s disease. In contrast, several human studies have not reported these favorable effects with regard to tea. This discrepancy may be due to incomplete adjustment of confounding factors, including the method of quantifying consumption, beverage temperature, cigarette smoking, alcohol consumption, and differences in genetic and environmental factors, such as race, sex, age, and lifestyle. Thus, more rigorous human studies are required to understand the neuroprotective effect of tea. A number of laboratory experiments demonstrated the benefits of green tea and green tea catechins (GTCs), such as epigallocatechin gallate (EGCG), and proposed action mechanisms. The targets of GTCs include the abnormal accumulation of fibrous proteins, such as A&beta, and &alpha, synuclein, inflammation, elevated expression of pro-apoptotic proteins, and oxidative stress, which are associated with neuronal cell dysfunction and death in the cerebral cortex. Computational molecular docking analysis revealed how EGCG can prevent the accumulation of fibrous proteins. These findings suggest that GTCs have the potential to be used in the prevention and treatment of neurodegenerative diseases and could be useful for the development of new drugs.

Over the last three decades, green tea has been studied for its beneficial effects, including anti-cancer, anti-obesity, anti-diabetes, anti-inflammatory, and neuroprotective effects. At present, a number of studies that have employed animal, human and cell cultures support the potential neuroprotective effects of green tea catechins against neurological disorders. However, the concentration of (−)-epigallocatechin gallate (EGCG) in systemic circulation is very low and EGCG disappears within several hours. EGCG undergoes microbial degradation in the small intestine and later in the large intestine, resulting in the formation of various microbial ring-fission metabolites which are detectable in the plasma and urine as free and conjugated forms. Recently, in vitro experiments suggested that EGCG and its metabolites could reach the brain parenchyma through the blood–brain barrier and induce neuritogenesis. These results suggest that metabolites of EGCG may play an important role, alongside the beneficial activities of EGCG, in reducing neurodegenerative diseases. In this review, we discuss the function of EGCG and its microbial ring-fission metabolites in the brain in suppressing brain dysfunction. Other possible actions of EGCG metabolites will also be discussed.

Green soybean (Glycine max L.), which was used in this study, retains the green color of the seed coat cotyledon even after ripening, even though many soybean cultivars become yellow during maturation. We have reported that ingestion of green soybean extract (GSE) suppressed cognitive dysfunction and reduced amyloid β accumulation more than yellow soybean extract (YSE) in aged senescence-accelerated (SAMP10) mice, a mouse model of brain senescence. To clarify the mechanism by which GSE suppresses cognitive dysfunction, we examined the effect of GSE and YSE on neurite outgrowth in human neuroblastoma SHSY-5Y cells. GSE significantly increased cell number and neurite outgrowth at 5 ng/ml (as isoflavones, 30 pg/ml), but the effect of YSE was lower than that of GSE. Although isoflavone aglycones, genistein and daidzein increased the number of SH-SY5Y cells, the effect was only observed at a high concentration [0.05 μM (13 ng/ml)]. ICR mice were fed a diet containing 3% soybean extract for 3 weeks (3-4 g/kg; as isoflavones, ca. 20 mg/kg) to examine cognitive function. Learning and memory abilities, as evaluated by a step-through passive avoidance task, a Y-maze and a novel object recognition test, were significantly higher in mice that ingested GSE than control mice that were fed a normal diet. The expression of brain-derived neurotrophic factor (BDNF) in the hippocampus, as detected by western blot analysis, was higher in mice that ingested GSE than in control mice. This study suggests that the ingestion of GSE enhances learning and memory abilities in mice. The effect by which GSE improved cognitive function appears to be caused, in part, by increased neuritogenesis and BDNF expression.

not availableJ Dhaka Medical College, Vol. 26, No.1, April, 2017, Page 1-2

Tea is derived from the leaves and buds of Camellia sinensis (Theaceae) plant, and is consumed worldwide. Green tea was discovered in the People's Republic of China approxi- mately 3,000 BC. Lu Yu (733-803) published a book that describes the history of tea, the techniques, and utensils used for manufacturing, the method of preparation, and drinking of tea in the People's Republic of China. Green tea contains various components with specific health- promoting effects and is believed to exert protective effects against diseases such as cancer, obesity, diabetes, hepatitis, and neurodegenerative diseases. Of the various tea components, the polyphenol catechins have been the subject of extensive investigation. Among the catechins, (−)-epigallocatechin gallate has the strongest bioactivity in most cases. Caffeine induces alert- ness, decreases the sensation of fatigue, and has a diuretic effect. Theanine and γ-aminobutyric acid can lower the blood pressure and regulate brain function. Vitamin C exhibits antiscorbutic activity, prevents cataracts, and may boost the immune system. Majority of the scientific evi - dence based on cellular and animal experiments as well as a number of human epidemiological and intervention studies indicate that green tea and (−)-epigallocatechin gallate have beneficial health effects against various diseases. However, conflicting results have also been reported. Since confounding factors could affect the results, future studies should be designed to elimi- nate such factors for better understanding of the benefits of green tea on human health. Genetic and environmental factors such as race, sex, age, and lifestyle may also influence the results of human studies. Although care should be taken to avoid the consumption of green tea and supplements with very high catechin content, recent findings suggest that habitual drinking of green tea promotes longevity.

Current investigation attempted to uncover common risk factors associated with HBsAg positivity among the suspected patients of Hepatitis B viral infection. Blood specimens were collected from patients prescribed to undergo HBsAg positivity test and tested for the detection of HBsAg through enzyme-linked immunosorbent assay (ELISA). HBsAg positivity was analyzed in relation to age, family history of HBV infection, unprotected sex, multiple sexual partners, blood transfusions, frequency of needle pricks, intravenous drug addiction, dental surgery and other surgical operations of the patients. Out of 50 patients, 23 were found to be HBsAg positive. After statistical analysis of all the factors it was deduced that patients who had unprotected sex and whose families (especially the mother of the patient) had a history of HBV infection were mostly found to be HBsAg positive. Detection of HBsAg positive cases with multiple associated risk factors revealed that the general people in Bangladesh need to be more conscious on the possible infection aware of getting infected with HBV as they are being frequently exposed subjected to the risk factors.