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Surface water quality is among the significant challenges in the Sutlej River basin, passing through Pakistan's most densely populated province. Currently, the overall surface water quality is grossly polluted, mainly due to the direct discharge of wastewater from the urban areas to the Sutlej River directly or through stream networks. Escherichia coli concentrations vary under extreme weather events like floods and droughts and socioeconomic circumstances like urbanization, population growth, and treatment options. This paper assesses the future E. coli load and concentrations using the Soil and Water Assessment Tool (SWAT) along with scenarios based on Shared Socioeconomic Pathways (SSPs) and Representative Concentration Pathways (RCPs) developed by the Intergovernmental Panel on Climate Change (IPCC). E. coli concentrations according to a more polluted scenario disclose a near and mid future increase by 108% and 173%, and far future increases up to 251% compared to the reference period (baseline) concentrations. The E. coli concentration is reduced by - 54%, - 68%, and - 81% for all the projected time steps compared to the baseline concentrations. While highly improved sewerage and manure management options are adapted, the concentration is further reduced by - 96%, - 101%, and - 105%, respectively, compared to the baseline. Our modeling and scenario matrix study shows that reducing microbiological concentrations in the surface water is possible. Still, it requires rigorous sanitation and treatment options, and socioeconomic variables play an essential role besides climate change to determine the microbiological concentration of water resources and be included in future studies whenever water quality and health risks are considered.

Aim: Tuberculosis (TB) and diabetes mellitus continue to be significant public health problems. Diabetes screening of tuberculosis patients will provide early case diagnosis, improved diabetes control, and improved tuberculosis treatment result. The purpose of this study was to ascertain the prevalence and risk factors for diabetes in tuberculosis patients, as well as their influence on the treatment result of tuberculosis. Methods: This cross-sectional study was conducted at Bangladesh's randomly chosen peripheral health institutions. All TB patients above the age of 18 years were checked for diabetes. Age, gender, family history, smoking, and BMI were all considered as risk factors. Results: Out of 165 participants, diabetes was shown to be prevalent in 35% of TB patients. Diabetes was related to advanced age and type of tuberculosis; its origin (pulmonary or extra pulmonary) and socioeconomic level were found to be significant. Conclusion: Diabetes is a common comorbidity among tuberculosis patients. Over the age of 50 years, the risk of this twin morbidity increases significantly. Screening tuberculosis patients for fasting blood sugar values will aid in the early diagnosis of diabetes and will lead to a better prognosis.

The microtubule-associated protein tau is involved in more than 20 different neurological disorders characterized by aberrant intracellular aggregation of tau in the brain. Here, we investigated the aggregation of a novel 20-residue model peptide, tau

Background: Breast cancer is the most frequently diagnosed cancer and the leading cause of cancer death in females, accounting for 23 percent of total cancer cases and 14 percent of cancer deaths.1 The lifetime probability of developing breast cancer is one in six overall (one in eight for invasive disease).2 In Bangladesh breast cancer is the 2nd most common cancer and also 2nd most leading cause of cancer death among the female population after cervical cancer.3 Despite the decreases in incidence rates in North America, breast cancer incidence has been increasing in other parts of the world, such as Asia and Africa. These international differences are thought to be related to societal changes occurring during industrialization.4,5 Methods: This was a Prospective Observational cross-sectional studyconducted among the 150 adult patients of breast carcinoma admitted in Department of surgery of Dhaka Medical College & Hospital, Bangabandhu Sheikh Mujib Medical University and Ahsania Mission Cancer & General Hospital during July 2012 to June 2013. After admission in surgery department, diagnosed patients (by ultrasonography and FNAC) with breast cancer were evaluated by history and physical examination, ultrasonography or mammography in a data collection sheet by the study physician.Tumor size was measured by physical examination, ultrasonography or mammography and during histopathological slide preparation. Histopathology of the dissected axillary lymph nodes determined the axillary lymph node status.Case record forms with appropriate questionnaire were filled for all patients. Results: This prospective documented study enrolled 150 cases of diagnosed breast cancer patient. The mean (+SD) age of the patients was 42.16 + 11.18 years with the range from 18 – 65 years. In this study, commonest presentation was painless breast lump in case of 84% patients. Next to it was nipple retraction (40%). Clinically, 52% of study populations were at stage II. Histologically, most of the tumor was at T2 stage (2.1 to 5 cm). Duct cell carcinoma was the predominant histological type (99.33%) and 58% patient had grade II tumors. 66% population showed metastasis of tumor cells in the axillary lymph node(s). Frequency of axillary lymph node metastasis increased as the tumor size increased. We found 33.33% T1 tumors had axillary lymph node metastasis, where as 58.97% T2 tumors and 93.75% T3 tumors showed axillary lymph node metastasis respectively. AKMMC J 2020; 11(2) : 107-112

Aims Sepsis is a cluster of heterogeneous syndromes associated with progressive endotoxemic developments, ultimately leading to damage of multiple organs, including the heart. However, the pathogenesis of sepsis-induced myocardial dysfunction is still not fully understood. The present study is the first to examine alterations in expression of key angiogenic signaling system mediated by vascular endothelial growth factor (VEGF) in septic heart and the effects of endothelin dual blocker (ETDB) on it. Main methods Normal Wistar rats were either administered with: a) vehicle only (control group), b) lipopolysaccharide only (LPS: 15 mg/kg) and then sacrificed at different time points (1 h, 3 h, 6 h and 10 h), and c) the last group was co-administered with LPS and ETDB (SB-209670, 1 mg/kg body weight) for 6 h and then sacrificed. Key findings Administration of LPS resulted in increases in levels of: a) serum tumor necrosis factor (TNF)-α, b) serum VEGF and c) serum endothelin (ET)-1 levels accompanied by up-regulation of cardiac VEGF and its downstream angiogenic signaling molecules. While cardiac TNF-α level was unchanged among experimental groups, cardiac ET-1 level was significantly higher in LPS-administered group. Significance We conclude that elevation in VEGF angiogenic signaling may be triggered by diminished oxygenation in the myocardium following LPS administration as a consequence of sepsis-induced microvascular dysfunction. Because of this cardiac dysfunction, oxygen supply may be inadequate at microregional level to support the normal heart metabolism and function. ETDB at 6 h further increased the elevated levels of VEGF angiogenic signaling in endotoxemic heart.

Aims: Endothelin-1 (ET-1) is a mediator of various physiological and pathological processes, including vascular inflammation, cell proliferation and vasoconstriction. Attenuation of ET action using ET-1 antagonists reduces pulmonary vascular leakage and inflammation in several models of lung injuries and experimental acute respiratory distress syndrome (ARDS). Based on these earlier reports, the current study investigates the patterns of ET-1 levels in circulation and pulmonary tissues in an experimental model of lavage-induced surfactant-depleted lung injury. Additionally, we also test the effects of open endotracheal suctioning (OES) and hyperinflation (HI) as recruitment maneuver following OES on ET-1 levels. Main methods: Briefly, 24 Japanese white rabbits were anesthetized and intubated. Normal saline was instilled into the lung and washed mildly. After instillation, rabbits were ventilated at definite settings at a total duration of 3 hours. OES and HI were performed every 15 minutes from the beginning of the protocol. Key findings: Here, we show that both circulatory and pulmonary ET-1 levels increased in models with lung injury induced by saline lavage compared to healthy control group. No further aggravation in expression of pulmonary ET-1 was seen after OES and HI, although OES and HI worsened arterial hypoxygenation and severity of lung injury. In contrast, circulatory ET-1 levels significantly decreased after OES and HI but were not associated with blood pressure changes. Significance: We conclude that in a saline lavage-induced lung injury model, both circulatory and pulmonary ET-1 levels increased. Further, OES and HI exerted differential effects on ET-1 expression at both circulatory and pulmonary levels.

Aims: Prevalence of non-communicable diseases is a challenging problem among menopausal women especially in a least developing country like Bangladesh. Recently, plasma levels of endothelin-1 or related molecules are reported to be associated with metabolic syndrome and its components. So we determined the circulatory level of endothelin-1 in Bangladeshi rural pre- and post-menopausal women and its association with various cardiometabolic risk factors. Main methods: This study is based on a community based cross-sectional survey among 1678 rural women over the age of 15. We measured plasma level of endothelin-1 by ELISAand used multipleregressions to estimate the association between circulatory endothelin-1 level and cardio-metabolic risk factors. Key findings: Endothelin-1 levels were significantly higher in post-menopausal subjects than in pre-menopausal (post-menopausal vs. pre-menopausal: 3.13 ± 0.09 vs. 2.29 ± 0.05pg/ml, p=0.001). Mean values of age, systolic blood pressure, diastolic blood pressure, plasma triglyceride level, fasting plasma glucose level, and HDL cholesterol were significantly higher in post-menopause compared to pre-menopausal group (P

Aims: Septic shock, the severe form of sepsis, is associated with development of progressive damage in multiple organs. Kidney can be injured and its functions altered by activation of coagulation, vasoactive-peptide and inflammatory processes in sepsis. Endothelin (ET)-1, a potent vasoconstrictor, is implicated in the pathogenesis of sepsis and its complications. Protease-activated receptors (PARs) are shown to play an important role in the interplay between inflammation and coagulation. We examined the time-dependent alterations of ET-1 and inflammatory cytokine, such as tumor necrosis factor (TNF)-a in kidney tissue in lipopolysaccharide (LPS)-induced septic rat model and the effects of PAR2 blocking peptide on the LPS-induced elevations of renal ET-1 and TNF-a levels.Main methods: Male Wistar rats at 8 weeks of age were administered with either saline solution or LPS at different time points (1, 3, 6 and 10 h). Additionally, we treated LPS-administered rats with PAR2 blocking peptide for 3 h to assess whether blockade of PAR2 has a regulatory role on the ET-1 level in septic kidney. Key fndings: An increase in ET-1 peptide level was observed in kidney tissue after LPS administration time-dependently. Levels of renal TNF-a peaked (around 12-fold) at 1 h of sepsis. Interestingly, PAR2 blocking peptide normalized the LPS-induced elevations of renal ET-1 and TNF-a levels.Significance: The present study reveals a distinct chronological expression of ET-1 and TNF-a in LPS-administered renal tissues and that blockade of PAR2 may play a crucial role in treating renal injury, via normalization of inflammation, coagulation and vaso-active peptide.

Aims Endothelin (ET)-1 is the best known potent vasoconstrictor and has been implicated in pathogenesis of sepsis-associated acute kidney injury (AKI) in human or lipopolysaccharide (LPS)-induced AKI in animal models. We have previously shown that ET-1 is highly up-regulated in renal tissues and in plasma after LPS administration. Here, we investigated whether landiolol hydrochloride, an ultra-short-acting beta-blocker, can play an important role in ameliorating levels of LPS-induced up-regulation of renal HIF-1α–ET-1 system and inflammatory cytokines in a rat model of endotoxemia. Main methods Male Wistar rats at 8 weeks of age were either administered with: a) lipopolysaccharide (LPS) only for three hours (3 h) or b) LPS, followed by continuous administration of landiolol for 3 h; c) third group was only treated with vehicle. Key findings At 3 h after LPS administration there was: a) minimal injury in kidney tissues; b) circulatory levels of creatinine, blood urea nitrogen and NGAL increased and c) expression of inflammatory cytokines, such as TNF-α, IL-6 and iNOS increased at the level of both circulatory and renal tissues. In addition, LPS significantly induced renal expression of ET-1 and HIF-1α compared to control. Finally, treatment of LPS-administered rats with landiolol for 3 h normalized elevated serum markers of renal injury and up-regulated levels of renal HIF-1α–ET-1 system with normalization of TNF-α. Significance Taken together, these data led us to conclude that landiolol ameliorates the up-regulation of HIF-1α–ET-1 system in minimally morphologically-injured kidney and normalizes biomarkers of renal injury in early hours of endotoxemia of a rat model.

Aims Landiolol hydrochloride, an ultra-short-acting highly cardio-selective β-1 blocker, has become useful for various medical problems. Recent studies have demonstrated that co-treatment with landiolol protects against acute lung injury and cardiac dysfunction in rats of lipopolysaccharide (LPS)-induced systemic inflammation, and was also associated with a significant reduction in serum levels of the inflammation mediator HMGB-1 and histological lung damage. Endothelin (ET)-1, a potent vasoconstrictor, has been implicated in pathogenesis of sepsis and sepsis-induced multiple organ dysfunction syndrome. Here, we investigated whether landiolol hydrochloride can play important roles in ameliorating LPS-induced alterations in cardiac ET system of septic rats. Main methods Eight-week-old male Wistar rats were administered LPS only for 3 h and the rest were treated with LPS as well as with landiolol non-stop for 3 h. Key findings At 3 h after LPS (only) administration, circulatory tumor necrosis factor (TNF)-α level, blood lactate concentration and percentage of fractional shortening of heart were significantly increased. In addition, LPS induced a significant expression of various components of cardiac ET-1 system compared to control. Finally, treatment of LPS-administered rats with landiolol for 3 h normalized LPS-induced blood lactate levels and cardiac functional compensatory events, without altering levels of plasma TNF-α and ET-1. Most strikingly, landiolol treatment significantly normalized various components of cardiac ET-1 signaling system in septic rat. Significance Taken together, these data led us to conclude that landiolol may be cardio-protective in septic rats by normalizing the expression of cardiac vasoactive peptide such as ET, without altering the circulatory levels of inflammatory cytokines.

Background: Prevalence of non-communicable diseases are a challenging problems among menopausal women specially in a least developed country like Bangladesh, where majority of women suffering from at least one chronic diseases after menopausal age. So, the main objective of this study was to determine the prevalence of metabolic syndrome and related risk factors in Bangladeshi pre- and post-menopausal women living in the rural setting. Methods: This study is based on a community based cross-sectional survey among 1802 rural women aged ≥15 years. Metabolic syndrome was defined according to the criteria of NCEP-ATP III. Logistic regression was used to estimate the association between menopausal status and metabolic syndrome and its components. Results: Metabolic syndrome was presented in 25.6% respondents and it was more prevalent among post-menopausal (39.3%) as compared to pre-menopausal (16.8%) women. Logistic regression analysis reveals that prevalence of metabolic syndrome was 1.78 times higher in post-menopausal women than pre-menopausal women (P = 0.001). Prevalence of high blood pressure, elevated fasting blood glucose, and high triglyceride were significantly higher in post-menopausal women than pre-menopausal women (P < 0.05). However, prevalence of low high-density lipoprotein cholesterol was significantly lower in post-menopausal women than pre-menopausal women (P < 0.001). Conclusions: Metabolic syndrome seems to be a major health problem among post-menopausal women in many developing countries like Bangladesh and proper policy emphasis should be given on its prevention and control.