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Background Traumatic brain injury (TBI) is one of the leading causes of mortality and morbidity. Economic impact is much worse in developing countries like Bangladesh, as victims are frequently male, productive, and breadwinners of the families. Objectives The objective of our study was to highlight the etiological pattern and distribution of varieties of head injuries in Bangladesh and give recommendations regarding how this problem can be solved or reduce to some extent at least. Methods From January 2017 to December 2019, a total of 14,552 patients presenting with head injury at emergency got admitted in Neurosurgery department of Dhaka Medical College and Hospital and were included in this study. Results The most common age group was 21 to 30 years (36%: 5,239) with a male-to-female ratio of 2.6:1. Injury was mostly caused by road traffic accident (RTA [58.3%: 8,484]), followed by fall (25%: 3,638) and history of assault (15.3%: 2,226). The common varieties of head injury were: acute extradural hematoma (AEDH [42.30%: 1,987]), skull fracture either linear or depressed (28.86%: 1,347), acute subdural hematoma (ASDH [12.30%: 574]), brain contusion (10.2%: 476), and others (6.04%: 282). Conclusion RTA is the commonest cause of TBI, and among them motor bike accident is the severe most form of TBI. AEDH is the commonest variety of head injuries. Proper steps taken by the Government, vehicle owners, and drivers, and proper referral system and prompt management in the hospital can reduce the mortality and morbidity from TBI in Bangladesh.

Background: Stereotactic neurosurgery involves mapping the brain in a three-dimensional coordinate system. With the help of MRI and CT scans and 3D computer workstations, neurosurgeons are able to accurately target any area of the brain especially deep seated and brain stem. Objectives: Stereotactic brain biopsy is a minimally invasive procedure that uses this technology to obtain samples of brain tissue for diagnostic purpose of multiple brain disorder where start to any medication was impossible or no response to any medical management for long term. Materials and Methods: Twenty-five patients underwent stereotactic biopsy of brain lesions using“KOMAI” Stereotactic frame system and were enrolled. Results: Of the 25 cases, positive tissue biopsy was found in 20 cases. In 5 patients, biopsy showed gliotic brain tissue or normal brain tissue. There was no post-operative new deficits or mortality seen. Conclusion: Stereotaxy is minimally invasive procedure having no complication. So, before starting any medication blindly stereotactic tissue diagnosis can help a lot in many medical and surgical diseases. J Bangladesh Coll Phys Surg 2021; 39(1): 24-35

Background: Surgical management of extradural hematoma is evacuation of extradural hematoma until otherwise. But, a number of authors have suggested that small epidural hematoma may be managed conservatively with normal outcome in selected cases. The goal of this study was to define the clinical and radiological parameters that may help in the management of the patient with small epidural hematoma where the hematoma was asymptomatic. Objective: This study was conducted to find out the factors influencing the decision making in the management of asymptomatic extradural hematoma though they have no evidence of raised intracranial pressure or any focal neurological deficit. Methods: Three hundred patients were evaluated clinically and by CT scan of head to see of hematoma, location of hematoma, midline shifting and overlying skull fractures etc. Results: All 300 patients were diagnosed within 72 hours of trauma and were tired to be managed expectantly but was not possible sometimes. All these patients were analyzed on the basis of tome since trauma, GCS score, overlying skull fracture traversing any artery, vein or any venous sinuses. Among 300 patients 225 (75%) patients underwent CT scan of head within 24 hours of trauma and 185 (61.67 %) patients had overlying skull fracture. 51 (17%) deteriorated later on and 31 (10.33%) patients among them required surgical evacuation of hematoma. Conclusion: It can be concluded that patients with small epidural hematoma with a fracture overlying major vessels or major sinuses, diagnosed within 24 hours of trauma are at risk of subsequent deterioration and may require surgical evacuation. Bang. J Neurosurgery 2020; 10(1): 20-26

The structural modification of existing supramolecular architecture is an efficient strategy to design and synthesize supramolecular gels with tunable and predictable properties. In this work, we have modified bis(pyridyl urea) compounds with different linkers, namely hexylene and butylene, to their corresponding bis(pyridyl-N-oxide urea). The gelation properties of both the parent and the modified compounds were studied, and the results indicated that modification of the 3-pyridyl moieties to the corresponding 3-pyridyl-N-oxides induced hydrogelation. The stability of the parent and modified compounds were evaluated by sol-gel transition temperature (Tgel) and rheological measurements, and single-crystal X-ray diffraction was used to analyze the solid-state interactions of the gelators. The morphologies of the dried gels were analyzed by scanning electron microscopy (SEM), which revealed that the structural modification did not induce any prominent effect on the gel morphology. The stimuli-responsive behavior of these gels in the presence of salts in DMSO/water was evaluated by rheological experiments, which indicated that the modified compounds displayed enhanced gel strength in most cases. However, the gel network collapsed in the presence of the chloride salts of aluminum(III), zinc(II), copper(II), and cadmium(II). The mechanical strength of the parent gels decreased in the presence of salts, indicating that the structural modification resulted in robust gels in most cases. The modified compounds formed gels below minimum gel concentration in the presence of various salts, indicating salt-induced gelation. These results show the making and breaking ability of the gel network in the presence of external stimuli (salts), which explains the potential of using LMWGs based on N-oxide moieties as stimuli-responsive materials.

Meningiomas were named by Harvey Cushing in 1922 and described as common tumors that arise from arachnoid cap cells...

This paper attempts to describe the outbreak of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) or named as novel coronavirus (COVID-19) via an epidemic model. This dangerous virus has dissimilar effects in different countries in the world. It is observable that the number of new active coronavirus cases is increasing day by day across the globe. India is now in the second stage of COVID-19 spreading, and as a densely populated country, it will be an epidemic very quickly if proper protection / strategies are not under-taken based on the database of the transmission of the disease. This paper is using the current data of COVID-19 for the mathematical modeling and its dynamical analysis. As an alternative of the standard SEIR model, we bring in a new representation to appraise and manage the outbreak of infectious disease COVID-19 through SEQIR pandemic model, which is based on the supposition that the infected but undetected by testing individuals are send to quarantine during the incubation period. During the incubation period if any individual be infected by COVID-19, then that confirmed infected individuals are isolated and the necessary treatments are arranged in proper way so that they cannot taint the other residents in the community. Dynamics of the SEQIR model is presented by basic reproduction number R₀ and the comprehensive stability analysis. Numerical results are depicted through apt graphical appearances using the data of five states and India.

Diabetes Mellitus is caused due to disorders of metabolism and its one of the most common diseases in the world today, and growing. Threshold Based Clustering Algorithm (TBCA) is applied to medical data received from practitioners and presented in this paper. Medical data consist of various attributes. TBCA is formulated to effectually compute impactful attributes related to Mellitus, for further decisions. TBCAs primary focus is on computation of Threshold values, to enhance accuracy of clustering results.

Outer membrane vesicles (OMVs) are secreted by all Gram-ve pathogens. These nano-scale delivery vehicles contain discrete arrays of prokaryotic pathogenic determinants, including a family of low molecular weight (MW) lipidic quorum signaling alkyl-quinolones (AQs). These are synthesized from β-keto-fatty acids and function like primordial lipidic hormones, which regulate numerous pathogenic factors both inter-species and intra-species. Significantly, AQs can also directly exacerbate pathogenesis by cross-kingdom signaling with the host immune, metabolic, and other systems. In Pseudomonas aeruginosa more than 50 AQs are reported; many with pathogenic mechanisms that are largely unknown. Some of these AQs are exclusively associated with OMVs. Accurate characterization of these OMV-AQs may reveal novel mechanism of diseases and Pseudomonas aeruginosa presents an ideal model. Matrix-free laser desorption/ionization mass spectrometry (LDI-MS) technologies enjoy unique advantages in mass spectrometry (MS)-based imaging and low MW analysis. We report single-step isolation of Pseudomonas aeruginosa OMV on inert ceramic filters and high-resolution mass spectrometry (HRMS) analysis of AQs vesicle in situ.

The present study was carried out to understand the adaptive strategies developed by S. maltophilia for chronic colonization of the cystic fibrosis (CF) lung. For this purpose, 12 temporally isolated strains from a single CF patient chronically infected over a 10-year period were systematically characterized for growth rate, biofilm formation, motility, mutation frequencies, antibiotic resistance, and pathogenicity. Pulsed-field gel electrophoresis showed over time the presence of 2 distinct groups, each consisting of 2 different pulsotypes. The pattern of evolution followed by S. maltophilia was dependent on pulsotype considered, with strains belonging to pulsotype 1.1 resulting to be the most adapted, being significantly changed in all traits considered. Generally, S. maltophilia adaptation to CF lung leads to increased growth rate and antibiotic resistance, whereas both in vivo and in vitro pathogenicity as well as biofilm formation were decreased. Our results show for the first time that S. maltophilia can successfully adapt to a highly stressful environment such as CF lung by paying a “biological cost”, as suggested by the presence of relevant genotypic and phenotypic heterogeneity within bacterial population. This indicates that S. maltophilia populations are significantly more complex and dynamic than can be described by the analysis of any single isolate and can fluctuate rapidly to changing selective pressures.

Alpha-melanocyte stimulating hormone (alpha-MSH) is an endogenous anti-inflammatory peptide reported to possess antimicrobial properties, however their role as antibacterial peptides is yet to be established. In the present study, we examined in vitro antibacterial activity of alpha-MSH against S. aureus strain ISP479C and several methicillin-sensitive (MSSA) and methicillin-resistant (MRSA) S. aureus strains. Antibacterial activity was examined by varying several parameters, viz., bacterial cell densities, growth phase, pH, salt concentration, and temperature. Antibacterial activity was also examined in complex biomatrices of rat whole blood, plasma and serum as well as in biofilm form of bacteria. Our results showed that alpha-MSH possessed significant and rapid antibacterial activity against all the studied strains including MRSA (84% strains were killed on exposure to 12 microM of alpha-MSH for 2h). pH change from 7.4 to 4 increased alpha-MSH staphylocidal activity against ISP479C by 21%. Antibacterial activity of alpha-MSH was dependent on bacterial cell density and independent of growth phase. Moreover, antimicrobial activity was retained when alpha-MSH was placed into whole blood, plasma, and serum. Most importantly, alpha-MSH exhibited antibacterial activity against staphylococcal biofilms. Multiple membrane permeabilization assays suggested that membrane damage was, at least in part, a major mechanism of staphylocidal activity of alpha-MSH. Collectively the above findings suggest that alpha-MSH could be a promising candidate of a novel class of antimicrobial agents.

A computational method for arbitrary crack motion through a finite element mesh, termed as the generalized cohesive element technique, is presented. In this method, an element with an internal discontinuity is replaced by two superimposed elements with a combination of original and imaginary nodes. Conventional cohesive zone modeling, limited to crack propagation along the edges of the elements, is extended to incorporate the intra-element mixed-mode crack propagation. Proposed numerical technique has been shown to be quite accurate, robust and mesh insensitive provided the cohesive zone ahead of the crack tip is resolved adequately. A series of numerical examples is presented to demonstrate the validity and applicability of the proposed method.

Prostate specific antigen (PSA) is a prominent marker for the prostate carcinoma. It is found in human blood in free (f-PSA) and complex forms. These two forms together are called total PSA (t-PSA). Estimation of both forms is essential to predict malignancy. In this study we report a unique and effective technique of electrochemical detection of f-PSA using magnetic beads on a three-electrode screen-printed sensor. A magnetic bead enzyme linked immunosorbent assay (ELISA) was performed in a cuvette. Following the immunoassay, magnetic beads were recovered by a magnetic concentrator and transferred on the working electrode of the 3-electrode assembly. The amperometric response, a measure of the amount of residual enzyme activity on the beads and hence the concentration of analyte in solution, was determined by addition of enzyme substrate. The device has a detection limit of less than0.1 ng mL(-1) f-PSA and a linear range of 0 to 1 ng mL(-1) f-PSA.

The size of the phytoecdysteroids family is rapidly growing. Recent data shows over 250 ecdysteroid analogs have been identified so far in plants. It is theorized that there are over 1000 possible structures, which might occur in nature, but it is a fact that ecdysteroids usually occur in plants as a complex cocktail of structurally different compounds. Among these compounds, the major component is usually the common ecdysteroid-like 20-hydroxyecdysone. Ecdysteroids are polar steroids, almost sugar-like in their solubility properties. Extraction and purification of ecdysteroids (polyhydroxy steroids) is complicated by their polar nature and poor crystallizing properties. These properties make them difficult to separate from other polar plant constituents. Besides, this plant extract is very often processed by multistep procedures to isolate the major and minor ecdysteroids from the new or existing sources. A simplified scheme consisting of a few extraction steps for the purification of ecdysteroid from plants is in great demand. A quantitative approach through high-performance liquid chromatography has been initiated for developing an easy method for the extraction of ecdysteroids from Ipomoea hederacea (kaladana) seeds.

Allergen levels in indoor environments, leading to many diseases, eg asthma, rhinitis and conjunctivitis, affect a large and increasing fraction of the population. A quite effective and inexpensive method of a rough but very rapid overall assessment of total allergen level in the environment has been developed. The method involved estimation of protein in allergen extracts by screen-printed electrodes using two different techniques. The biosensor comprised a rhodinised carbon working electrode, a silver/silver chloride reference electrode and a carbon counter electrode. In the first method the enzyme protease reacted with allergen protein to release amino acid, which produced hydrogen peroxide in the presence of amino acid oxidase. This was detected amperometrically. The second method used potassium bromide as electrolyte and the electrode was subjected to dual potential. Bromine, released due to electrolysis at higher potential, was consumed by the allergen protein at lower potential. In the first method, a unique technique was used to microencapsulate the enzyme protease and immobilise it on the surface of the electrode by in-situ polymerisation to avoid contact with the amino acid oxidase. A total of seven allergens were tested and the results gave a good correlation with the standard protein measurement method. Environmental specimens from indoors, schools and workplaces can be evaluated for the aeroallergens produced by dust mites, animal hairs, cockroach debris, pollens, etc as a means of determining the exposure risk. (c) 2005 Society of Chemical Industry.

Genetically encoded antibiotic peptides are evolutionarily ancient and widespread effector molecules of immune defence. Mammalian defensins, one subset of such peptides, have been implicated in the antimicrobial defence capacity of phagocytic leukocytes and various epithelial cells, but direct evidence of the magnitude of their in vivo effects have not been clearly demonstrated. Paneth cells, specialized epithelia of the small intestinal crypt, secrete abundant alpha-defensins and other antimicrobial polypeptides including human defensin 5 (HD-5; also known as DEFA5). Although antibiotic activity of HD-5 has been demonstrated in vitro, functional studies of HD-5 biology have been limited by the lack of in vivo models. To study the in vivo role of HD-5, we developed a transgenic mouse model using a 2.9-kilobase HD-5 minigene containing two HD-5 exons and 1.4 kilobases of 5'-flanking sequence. Here we show that HD-5 expression in these mice is specific to Paneth cells and reflects endogenous enteric defensin gene expression. The storage and processing of transgenic HD-5 also matches that observed in humans. HD-5 transgenic mice were markedly resistant to oral challenge with virulent Salmonella typhimurium. These findings provide support for a critical in vivo role of epithelial-derived defensins in mammalian host defence.

Paneth cells (PCs) were described over a century ago as granulated cells located at the base of small intestinal crypts, the 'crypts of Lieberkühn.' Various histochemical staining procedures were developed that identified PCs based on their distinctive granule-staining pattern. Early on, PCs were proposed to perform a specialized function other than absorption of digested nutrients, the predominant task of the small intestinal epithelium. Since then, many constituents of the PC granules have been biochemically characterized. The presence of various granule-associated antimicrobial substances and their release upon microbial challenge suggest that PCs function as specialized defense cells in the small intestine. Altered resistance to microbial infection in animal models with disrupted or augmented PC function provides further support for the host defense role of PCs. Other PC components suggest that PCs may also participate in the regulation of lumenal ionic composition, crypt development, digestion, and intestinal inflammation.

Background Fermentative hydrogen production is an attractive means for the sustainable production of this future energy carrier but is hampered by low yields. One possible solution is to create, using metabolic engineering, strains which can bypass the normal metabolic limits to substrate conversion to hydrogen. Escherichia coli can degrade a variety of sugars to hydrogen but can only convert electrons available at the pyruvate node to hydrogen, and is unable to use the electrons available in NADH generated during glycolysis. Results Here, the heterologous expression of the soluble [NiFe] hydrogenase from Ralstonia eutropha H16 (the SH hydrogenase) was used to demonstrate the introduction of a pathway capable of deriving substantial hydrogen from the NADH generated by fermentation. Successful expression was demonstrated by in vitro assay of enzyme activity. Moreover, expression of SH restored anaerobic growth on glucose to adhE strains, normally blocked for growth due to the inability to re-oxidize NADH. Measurement of in vivo hydrogen production showed that several metabolically engineered strains were capable of using the SH hydrogenase to derive 2 mol H2 per mol of glucose consumed, close to the theoretical maximum. Conclusion Previous introduction of heterologous [NiFe] hydrogenase in E. coli led to NAD(P)H dependent activity, but hydrogen production levels were very low. Here we have shown for the first time substantial in vivo hydrogen production by a heterologously expressed [NiFe] hydrogenase, the soluble NAD-dependent H2ase of R. eutropha (SH hydrogenase). This hydrogenase was able to couple metabolically generated NADH to hydrogen production, thus rescuing an alcohol dehydrogenase (adhE) mutant. This enlarges the range of metabolism available for hydrogen production, thus potentially opening the door to the creation of greatly improved hydrogen production. Strategies for further increasing yields should revolve around making additional NADH available.

The major bifunctional transpeptidases/transglycosylases of Escherichia coli, penicillin-binding proteins (PBPs) 1a and 1b, were evaluated for their influence on biofilm formation. While the PBP1a mutant was unaffected, the PBP1b mutant exhibited significantly decreased biofilm formation and motility. Interestingly, the extracellular indole concentration was higher in the PBP1b mutant, and similar phenotypic defects were replicated in the wild-type upon addition of exogenous indole. Expression of PBP1b in trans substantially decreased indole production and restored normal phenotypes. Results further suggest that rpoS deletion has a counteracting effect on the mrcB mutant. These findings indicate that PBP1b deletion influences biofilm formation and motility, possibly through indole.

EPITHELIAL LOSS CORRELATED WITH DECREASED BETA DEFENSINS AND INCREASED RISK OF CANDIDA INFECTIONS IN ORAL LICHEN PLANUS Jeyaseelan Augustine, Chiranjit Maity, Priya Kumar, Shalini Gupta, Dipankar Ghosh, Mahesh Verma, Maulana Azad Institute of Dental Sciences, New Delhi, India; Special Centre for Molecular Medicine, Jawaharlal Nehru University, New Delhi, India Objective: To correlate epithelial erosion with beta defensin expression in OLP and risk for Candida infections. Study Design: Sample biopsy tissues from 35 cases of clinical OLP vs. appropriate controls were statistically analyzed for beta-defensin expression using quantitative PCR (Q-PCR) and immunohistochemistry. Results: Beta defensins expression was correlated with epithelial integrity in OLP. Loss of epithelial cells due to erosion resulted in concomitant decrease in beta defensins and increased Candida biofilms in vitro. Conclusions: Despite transcriptional upregulation of defensin expression in OLP; the loss of epithelial cells in erosive OLP cohorts results in concomitant decrease in defensin and higher risk of Candida infections. Pre-emptive anti-Candida therapy is advised in erosive OLP.

Background: Upper gastrointestinal tract intestinal metaplasia (IM) is termed Barrett’s oesophagus (BO) or gastric intestinal metaplasia (GIM), depending on its location. BO and GIM are associated with chemical exposure resulting from gastro–oesophageal reflux and chronic Helicobacter pylori infection, respectively. Paneth cells (PCs), characterised by cytoplasmic eosinophilic granules, are found in a subset of IM at these sites, but histology may not accurately detect them. Aim: To determine human defensin 5 (HD5; an antimicrobial peptide produced by PCs) expression in BO and GIM, and to investigate its association with H pylori infection. Methods: Endoscopic biopsies from 33 patients with BO and 51 with GIM, and control tissues, were examined by routine histology and for H pylori infection and HD5 mRNA and protein expression. Results: In normal tissues, HD5 expression was specific for PCs in the small intestine. Five patients with BE and 42 with GIM expressed HD5, but few HD5 expressing cells in IM had the characteristic histological features of PCs. Most HD5 positive specimens were H pylori infected and most HD5 negative specimens were not infected. Conclusions: HD5 immunohistochemistry was often positive in IM when PCs were absent by conventional histology. Thus, HD5 immunohistochemistry may be superior to histology for identifying metaplastic PCs and distinguishing GIM from BO. The higher frequency of HD5 expression in GIM than in BO is associated with a higher frequency of H pylori infection, suggesting that in IM PCs may form part of the mucosal antibacterial response.

The antimicrobial peptide human alpha-defensin 5 (HD5) is expressed in Paneth cells, secretory epithelial cells in the small intestine. Unlike other characterized defensins, HD5 is stored in secretory vesicles as a propeptide. The storage quantities of HD5 are approximately 90 450 microg per cm2 of mucosal surface area, which is sufficient to generate microbicidal concentrations in the intestinal lumen. HD5 peptides isolated from the intestinal lumen are proteolytically processed forms--HD5(56-94) and HD5(63-94)--that are cleaved at the Arg55-Ala56 and Arg62-Thr63 sites, respectively. We show here that a specific pattern of trypsin isozymes is expressed in Paneth cells, that trypsin colocalizes with HD5 and that this protease can efficiently cleave HD5 propeptide to forms identical to those isolated in vivo. By acting as a prodefensin convertase in human Paneth cells, trypsin is involved in the regulation of innate immunity in the small intestine.

Prostate specific antigen (PSA) has been identified as the most reliable clinical tool for diagnosing and monitoring prostate cancer (CAP). Since, there is no curative therapy available for prostate cancer, detecting the disease at the early stage is the best hope of increasing mortality rate. There are some procedures available for the detection of prostate cancer e.g. Tandem-R PSA, Hybritech Inc. (USA), IMx-PSA Abbott Laboratories (USA). However, these are time consuming and costly. We have developed a very simple and cost effective technique for identification and monitoring of prostate cancer using amperometric immunosensor. PSA is a glycoprotein with 93% peptide and 7% sugar content and isoelectric pH of 6.9. It may exist in the human serum as free (f-PSA) and complex (PSA-ACT) forms. Normally if the total PSA (t-PSA) level is more than 10 ng/ml, CAP is suspected. This paper presents an amperometric detection procedure for t-PSA using three electrode system in which working electrode (WE) is made of hydroxyethyl cellulose (HEC) and rhodinised carbon. The method used is rapid, very easy to use and involves low cost compared with other procedures. The electrochemical response was directly observed due to enzymatic reaction via a sandwich immunoassay on the WE. Monoclonal capture antibody (Mab) to PSA was immobilised on the WE and the other Mab labelled by the enzyme marker, horseradish peroxidase (HRP), was used as a tracer antibody.

Background: Distinguishing Crohn' s disease (CD) from mucosal ulcerative colitis (UC) to identify candidates for ileal pouch after proctocolectomy is important, but sometimes difficult. Approximately 15% of cases defy clear categorization even after colectomy and are commonly referred to as indeterminate colitis. Current biologic markers lack adequate specificity. Human defensin 5 (HD5) is an antimicrobial peptide normally expressed in Paneth cells of the terminal ileum. However the expression of this peptide in inflammatory bowel disease is not known. Aim: To assess whether HD5 immunoreactivity and routine Paneth cell histochemistry of the terminal ileum may be useful in the differentiation of CD from UC. Methods: From our pathology records, surgically-resected or endoscopically-biopsied specimens of terminal ileum from patients with CD (n=6) with or without colitis and UC (n= 12) were studied by routine histochemistry (phloxinetartrazine stain to enhance visualization of the intracytoplasmic eosinophilic granules normally present in Paneth cells) and by HD5 immunohistochemistry (avidin-biotin-peroxidase technique). The intensity of the immunohistochemical signal was recorded as ordered categorical data. The presence of characteristic granules in HD5-expressing cells was noted. Results: HD5 immunostaining was detected in crypt cells of the terminal ileum from all cases of UC and CD. Comparison of the constituent ratio of the intensity of HD5 immunostaining showed no significant difference between the UC and CD groups (p>0.05). The HD5-expressing cells from all CD cases (100%) contained intracytoplasmic "salmon egg-colored" secretory granules characteristic of normal Paneth cell morphology, while only 1 of 12 cases of UC (8.3%) showed evidence of secretory granules (p