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Oilseed crops play a vital role in the economy of Pakistan, yet the production of oilseeds is far less than the demand for them. White mustard (Sinapis alba L.) is an emerging crop, that belongs to the Brassicaceae family. It is considered to be an alternative to all other oilseed crops for dry temperate climates. White mustard develops rapidly, and has a large canopy and deep rooting system; hence, it can draw up nutrients from deeper layers. This study aimed to evaluate the influence of nitrogen on S. alba agro-morphological attributes and enhance nutrient use efficiencies. During the Rabi seasons of 2019-20 and 2020-21, an experiment was conducted at the University Research Farm, Chakwal Road, Rawalpindi. The study included seven treatments, i.e., T1-Control, T2-20, T3-40, T4-60, T5-80, T6-100, and T7-120 kg·ha−1. Each treatment was replicated three times, and the study utilized a randomized complete block design (RCBD). The results revealed that nitrogen at 100 kg·ha−1 was the optimal concentration and significantly increased the agro-morphological parameters, i.e., plant height (47.01%), primary branches (41.36%), secondary branches (45.33%), 1000 seed weight (54.35%), siliques/plant (41.57%), seeds/silique (52.30%) biological yield (68.38%), seed yield (54.90%), harvest index (11%), and oil yield (38.84%), as compared to the control. Moreover, protein contents and oil contents were significantly increased (5.15% and 6%, respectively), as compared to the control, while glucosinolate content was decreased (4.36%). Similarly, maximum agronomic efficiency (AE), apparent recovery efficiency (ARE) (53%), physiological efficiency (PE), and nutrient use efficiency (NUE) were also improved, as compared to the control. Hence, N application at a concentration of 100 kg·ha−1 can be recommended for S. alba under the present cropping system of Pothwar.

Biochar (BC) applications have multiple impacts on crops’ nutrient availability, growth and yield depending on the feedstock type and pyrolysis conditions. Pot and field experiments were conducted to examine the effects of biochars (BCs) prepared from three different feedstocks, Acacia modesta wood biochar (AWB), Dalbergia sissoo wood biochar (DWB) and poultry litter biochar (PLB), on soil’s nutrient availability, uptake by wheat (Triticum aestivum) and sunflower (Helianthus annuus) crops and their yield attributes. All BCs were applied at the rate of 10t ha−1 in each treatment in both experiments, and pot and field trials were designed according to a two-factor factorial completely randomized design (CRD) and two-factor factorial randomized complete block design (RCBD), respectively. The concentration of soil NO3-N, NH4-N, Olsen P and extractable K increased by 98.5, 296, 228 and 47%, respectively, in the pot experiment with the application of PLB+polyhalite (PH) treatments. Similarly, in field experiments, NO3-N, NH4-N and Olsen P contents increased by 91, 268 and 156% under the PLB+PH treatment, respectively. However, in both experiments, soil’s microbial biomass phosphorus (MBP) was significantly higher after AWB+PH treatment, and the increments were 127 and 109% while microbial biomass nitrogen (MBN) contents were 16 and 14% higher than the control under DWB+PH and AWB+PH treatments, respectively, in the field experiment. Similarly, combined PLB+PH increased the total organic carbon (TOC) of soil by 193%. Moreover, PLB+PH co-applications with PH significantly increased sunflower grain yields by up to 58% and the harvest index by 45%. Overall, no negative impact with respect to BCs was observed on the soil’s nutrient content and plant growth. Hence, for immediate crop benefits and soil health, using nutrient biochar (PLB) alone or in combination with chemical fertilizers is recommended.

Acute-on-chronic liver failure (ACLF) is a rapidly progressive illness with high short-term mortality. Timely liver transplant (LT) may improve survival. We evaluated various indices for assessment of the severity of liver failure and their application for eligibility and timing of living donor LT (LDLT). Altogether 1021 patients were analyzed for the severity and organ failure at admission to determine transplant eligibility and 28 day survival with or without transplant. The ACLF cohort [mean age 44 ± 12.2 years, males 81%) was of sick patients; 55% willing for LT at admission, though 63% of them were ineligible due to sepsis or organ failure. On day 4, recovery in sepsis and/or organ failure led to an improvement in transplant eligibility from 37% at baseline to 63.7%. Delay in LT up to 7 days led to a higher incidence of multiorgan failure (p

Multiple predictive models of mortality exist for acute-on-chronic liver failure (ACLF) patients that often create confusion during decision-making. We studied the natural history and evaluated the performance of prognostic models in ACLF patients.Prospectively collected data of ACLF patients from APASL-ACLF Research Consortium (AARC) was analyzed for 30-day outcomes. The models evaluated at days 0, 4, and 7 of presentation for 30-day mortality were: AARC (model and score), CLIF-C (ACLF score, and OF score), NACSELD-ACLF (model and binary), SOFA, APACHE-II, MELD, MELD-Lactate, and CTP. Evaluation parameters were discrimination (c-indices), calibration [accuracy, sensitivity, specificity, and positive/negative predictive values (PPV/NPV)], Akaike/Bayesian Information Criteria (AIC/BIC), Nagelkerke-RThirty-day survival of the cohort (n = 2864) was 64.9% and was lowest for final-AARC-grade-III (32.8%) ACLF. Performance parameters of all models were best at day 7 than at day 4 or day 0 (p 0.05 for C-indices of all models except NACSELD-ACLF). On comparison, day-7 AARC model had the numerically highest c-index 0.872, best accuracy 84.0%, PPV 87.8%, RAPASL-ACLF is often a progressive disease, and models assessed up to day 7 of presentation reliably predict 30-day mortality. Day-7 AARC model is a statistically robust tool for classifying risk of death and accurately predicting 30-day outcomes with relatively lower prediction errors. Day-7 AARC score 12 may be used as a futility criterion in APASL-ACLF patients.

Background Globally, congenital toxoplasmosis remains a significant cause of morbidity and mortality, and outbreaks of T. gondii infection represent a major public health threat, especially in developing countries. Evidence in the literature indicates that only a few studies have been conducted on the incidence of maternal and congenital toxoplasmosis in Saudi Arabia. This prospective study aims to measure the overall incidence of congenital toxoplasmosis, both patent and ‘silent’ infection, among pregnant women in the Eastern Province of Saudi Arabia. The study would attempt to relate the cord blood results with the time of seroconversion in the mother, underlining the importance of early intervention in such cases. Methods Five hundred paired maternal/cord blood samples were tested for anti-Toxoplasma IgG or IgM antibodies. Samples were collected during delivery from mother and newborn (cord blood) from November 2011 to May 2012. Only positive for anti-Toxoplasma IgG or/and IgM cord blood was processed for real-time PCR for confirmation. The age of mothers ranged from 16 to 45 years. Results The sample subjects were tested during child delivery for specific IgG and IgM antibodies against Toxoplasmosis, of which 21.0% (n = 105) mother/baby pairs were found serologically positive for anti-Toxoplasma IgG antibodies. The rate of maternal seropositivity for anti-Toxoplasma IgM antibodies was found among 4 participants (0.8%), who were also seropositive for anti-Toxoplasma IgG antibodies. None of the children tested positive for anti-Toxoplasma IgM antibodies, even those born to mothers with IgM positive. All 105 cord blood tests in the study sample were confirmed negative by real-time PCR. The seroprevalence of Toxoplasma IgG antibodies increased with maternal age, parity, and was significantly higher in women who gave birth to children with congenital anomalies (p = 0.008). Conclusion The findings of the current study indicate a dire need to develop and implement preventive programs against Toxoplasma gondii infection, as well as a health education program on how to avoid toxoplasmosis for all seronegative women during pregnancy.

Diet and feeding behavior data are crucial to a deep understanding of the behavioral response and adaptation of primates to a high-altitude environment. From August 2019 to June 2021, we collected data on the feeding behavior of a high-altitude rhesus macaque Macaca mulatta group from Yajiang County, Western Sichuan Plateau, which has an altitude of over 3,500 m. The results showed that feeding (33.0 ± 1.8%) and moving (28.3 ± 2.6%) were the dominant behavior of rhesus macaques. Macaques ate 193 food items, comprising 11 food categories from 90 species. Our study found that plant roots (30.9 ± 30.1%) and young leaves (28.0 ± 33.1%) were the main foods eaten by macaques. The preferred foods of rhesus macaques were young leaves, fruits, and seeds, and the consumption of these items was positively correlated with its food availability. When the availability of preferred foods was low, macaques took plant roots, barks, and fallen leaves as fallback foods. In particular, roots were a dominant food item in winter, and this way of feeding became a key survival strategy. Our results suggest that, facing the relative scarcity and strong seasonal fluctuations of food resources in high-altitude habitat, macaques adopt active foraging strategies, relying on a variety of food species and adjusting flexibly their food choices based on food availability, which may help to maximize the energy efficiency of high-altitude macaques.

Carbon dioxide (CO2) concentration in greenhouses is sub-optimal for vegetable production. Many techniques have been used to increase CO2 concentration in greenhouses but most of them are expensive with certain limitations and drawbacks. We adopted a new strategy to elevate CO2 concentration in the greenhouse throughout the day via crop residues and animal manure composting (CRAM). During the whole cultivation period, CRAM-treated greenhouse had doubled CO2 concentration which significantly increased the yield of cherry tomatoes (Lycopersiconesculentum L.) i.e. up to 38%. The influence of CRAM procedure on cherry tomato quality was also investigated and the concentrations of total soluble solids (TSS) and soluble sugar were found to be significantly higher in cherry tomatoes grown under composting greenhouse than that of non-composting greenhouse. Additionally, CRAM-CO2 enrichment also resulted in increased concentrations of ascorbic acid (Vitamin C) and titrate acid as compared with the control. In contrast, the concentration of nitrate was considerably decreased in cherry tomato grown under CO2 enriched condition than that of control. The increase in active oxygen metabolisms such as POD, CAT and SOD while a decrease in MDA, as well as APX was observed for cherry tomatoes grown under CO2 enriched condition. Hence, CO2 fertilization by using CRAM in greenhouse significantly improved quality and increased the yield of cherry tomatoes. Keywords: Cherry tomato, Crop residues, Animal manure, CO2 enrichment, Quality, Yield

Carbon dioxide (CO2) concentration in greenhouses is sub-optimal for vegetable production. Many techniques have been used to increase CO2 concentration in greenhouses but most of them are expensive with certain limitations and drawbacks. We adopted a new strategy to elevate CO2 concentration in the greenhouse throughout the day via crop residues and animal manure composting (CRAM). During the whole cultivation period, CRAM-treated greenhouse had doubled CO2 concentration which significantly increased the yield of cherry tomatoes (Lycopersiconesculentum L.) i.e. up to 38%. The influence of CRAM procedure on cherry tomato quality was also investigated and the concentrations of total soluble solids (TSS) and soluble sugar were found to be significantly higher in cherry tomatoes grown under composting greenhouse than that of non-composting greenhouse. Additionally, CRAM-CO2 enrichment also resulted in increased concentrations of ascorbic acid (Vitamin C) and titrate acid as compared with the control. In contrast, the concentration of nitrate was considerably decreased in cherry tomato grown under CO2 enriched condition than that of control. The increase in active oxygen metabolisms such as POD, CAT and SOD while a decrease in MDA, as well as APX was observed for cherry tomatoes grown under CO2 enriched condition. Hence, CO2 fertilization by using CRAM in greenhouse significantly improved quality and increased the yield of cherry tomatoes.

Limited data exist regarding outcomes of acute variceal bleeding (AVB) in patients with acute-on-chronic liver failure (ACLF), especially in those with hepatic failure. We evaluated the outcomes of AVB in patients with ACLF in a multinational cohort of APASL ACLF Research Consortium (AARC).Prospectively maintained data from AARC database on patients with ACLF who developed AVB (ACLF-AVB) was analysed. This data included demographic profile, severity of liver disease, and rebleeding and mortality in 6 weeks. These outcomes were compared with a propensity score matched (PSM) cohort of ACLF matched for severity of liver disease (MELD, AARC score) without AVB (ACLF without AVB).Of the 4434 ACLF patients, the outcomes in ACLF-AVB (n = 72) [mean age-46 ± 10.4 years, 93% males, 66% with alcoholic liver disease, 65% with alcoholic hepatitis, AARC score: 10.1 ± 2.2, MELD score: 34 (IQR: 27-40)] were compared with a PSM cohort selected in a ratio of 1:2 (n = 143) [mean age-44.9 ± 12.5 years, 82.5% males, 48% alcoholic liver disease, 55.7% alcoholic hepatitis, AARC score: 9.4 ± 1.5, MELD score: 32 (IQR: 24-40)] of ACLF-without AVB. Despite PSM, ACLF patients with AVB had a higher baseline HVPG than without AVB (25.00 [IQR: 23.00-28.00] vs. 17.00 [15.00-21.75] mmHg; p = 0.045). The 6-week mortality in ACLF patients with or without AVB was 70.8% and 53.8%, respectively (p = 0.025). The 6-week rebleeding rate was 23% in ACLF-AVB. Presence of ascites [hazard ratio (HR) 2.2 (95% CI 1.03-9.8), p = 0.026], AVB [HR 1.9 (95% CI 1.2-2.5, p = 0.03)], and MELD score [HR 1.7 (95% CI 1.1-2.1), p = 0.001] independently predicted mortality in the overall ACLF cohort.Development of AVB confers poor outcomes in patients with ACLF with a high 6-week mortality. Elevated HVPG at baseline represents a potential risk factor for future AVB in ACLF.

Background: Enterocytozoon bieneusi is a zoonotic pathogen with a wide range of animal host. In China, there are only a few reports of E. bieneusi infection in wild populations of Rhesus macaque. Here, we determined the prevalence of E. bieneusi in 9 populations of Rhesus macaque and assessed their zoonotic potential.Methods: A total of 324 fecal samples of Rhesus macaque were collected from 9 populations in 5 provinces (Sichuan, Chongqing, Qinghai, Tibet and Hainan) in China, and performed genotype of ITS gene to analyze the zoonotic potential.Results: 38 of the 324 (11.72%) specimens from wild Rhesus macaques were infected with E. bieneusi. 11 genotypes were identified including 3 known genotypes: D (n= 24), EbpC (n= 4) and SCC-2 (n= 1); 8 novel genotypes named Mul6 (n= 1), Mul7 (n= 1), Mul8 (n= 1), Mul9 (n= 1), Mul10 (n= 2), Mul11 (n= 1), Mul12 (n= 1) and Mul13 (n= 1). According to the phylogenetic analysis, Mul6, Mul7, Mul8, Mul9, Mul11 Mul12 and Mul13 were clustered into Group 1, while Mul10 were clustered into Group 5.Conclusions: To the best of our knowledge, this is the first study reporting the prevalence and genotypes of E. bieneusi in several wild populations of Rhesus macaque in China. It is concluded that, population of Rhesus Macaques is likely to prone of E. bieneusi transmission in many regions of China, which found the zoonotic genotypes D and EbpC and the novel genotypes with zoonotic potential, it should be paid more attention to prevent.

Health and climatic changes have been linked for centuries. Viruses, bacteria, fungi and parasites are sensitive to environmental conditions including ambient temperature, humidity, smog, and other climatic factors like exposure to sunlight. Viral respiratory tract infections such as seasonal influenza are known to become epidemic primarily during cold weather conditions influenced also by population density and travel patterns. The winter months in China are from November to March. The SARS-CoV-1 outbreak commenced in Guangdong Province, in November 2002 and the SARS-CoV-2 outbreak in Wuhan in early December 2019. Understanding how the emergence and spread of COVID-19 could be affected by climatic conditions may be an important aspect for disease control. As of August 4th 2020, 18 142 718 confirmed cases and 691 013 deaths have been reported to the WHO from all continents [...].

The first consensus report of the working party of the Asian Pacific Association for the Study of the Liver (APASL) set up in 2004 on acute-on-chronic liver failure (ACLF) was published in 2009. With international groups volunteering to join, the “APASL ACLF Research Consortium (AARC)” was formed in 2012, which continued to collect prospective ACLF patient data. Based on the prospective data analysis of nearly 1400 patients, the AARC consensus was published in 2014. In the past nearly four-and-a-half years, the AARC database has been enriched to about 5200 cases by major hepatology centers across Asia. The data published during the interim period were carefully analyzed and areas of contention and new developments in the field of ACLF were prioritized in a systematic manner. The AARC database was also approached for answering some of the issues where published data were limited, such as liver failure grading, its impact on the ‘Golden Therapeutic Window’, extrahepatic organ dysfunction and failure, development of sepsis, distinctive features of acute decompensation from ACLF and pediatric ACLF and the issues were analyzed. These initiatives concluded in a two-day meeting in October 2018 at New Delhi with finalization of the new AARC consensus. Only those statements, which were based on evidence using the Grade System and were unanimously recommended, were accepted. Finalized statements were again circulated to all the experts and subsequently presented at the AARC investigators meeting at the AASLD in November 2018. The suggestions from the experts were used to revise and finalize the consensus. After detailed deliberations and data analysis, the original definition of ACLF was found to withstand the test of time and be able to identify a homogenous group of patients presenting with liver failure. New management options including the algorithms for the management of coagulation disorders, renal replacement therapy, sepsis, variceal bleed, antivirals and criteria for liver transplantation for ACLF patients were proposed. The final consensus statements along with the relevant background information and areas requiring future studies are presented here., Article Highlights Updated on the basis of AARC data of >3300 cases enrolled into AARC registry prospectivelyACLF is distinct form Acute Decompensation of cirrhosisNewer sections on DILI-ACLF, AIH-ACLF, PVT/HVOTO–ACLFReversibility of Chronic Liver Disease in ACLFPortal and systemic hemodynamics and their relevance in ACLFAcute Portal Hypertension and Variceal progression in ACLFAARC score as a guide for treatment strategies in ACLFACLF in Children-first consensus on pediatric ACLF

The consolidation of numerous novel findings that produce a clear understanding of zinc (Zn) relevance to plant status is significant. The present review elaborates the roles of Zn in plant development and management with an aim to provide an updated picture to the current context of the topic for future studies. The fate of Zn utilization in plants starts with understanding the uptake and movement dynamics of the ion. Its uptake and translocation utilizes the symplastic or apoplastic route which could be influenced by water flow path and advection depending on transpiration rate. Cell membrane transporters can channel Zn ions to epidermal cells. Zinc has ameliorating effects in several plant stresses such as heavy metal toxicity, salinity and drought. Moreover, the transcriptional factors including zinc finger proteins (ZFPs) are involved in plant growth regulation and responses to biotic and abiotic stresses. Finally, the pivotal strategies aimed at optimizing plant Zn nutritional contents mainly target the improvement of plant Zn efficiency, genetic and agronomic biofortification to combat Zn malnutrition in the world.

Acute-on-chronic liver failure (ACLF) is a progressive disease associated with rapid clinical worsening and high mortality. Early prediction of mortality and intervention can improve patient outcomes. We aimed to develop a dynamic prognostic model and compare it with the existing models. A total of 1402 ACLF patients, enrolled in the APASL-ACLF Research Consortium (AARC) with 90-day follow-up, were analyzed. An ACLF score was developed in a derivation cohort (n = 480) and was validated (n = 922). The overall survival of ACLF patients at 28 days was 51.7%, with a median of 26.3 days. Five baseline variables, total bilirubin, creatinine, serum lactate, INR and hepatic encephalopathy, were found to be independent predictors of mortality, with AUROC in derivation and validation cohorts being 0.80 and 0.78, respectively. AARC-ACLF score (range 5–15) was found to be superior to MELD and CLIF SOFA scores in predicting mortality with an AUROC of 0.80. The point scores were categorized into grades of liver failure (Gr I: 5–7; II: 8–10; and III: 11–15 points) with 28-day cumulative mortalities of 12.7, 44.5 and 85.9%, respectively. The mortality risk could be dynamically calculated as, with each unit increase in AARC-ACLF score above 10, the risk increased by 20%. A score of ≥11 at baseline or persisting in the first week was often seen among nonsurvivors (p = 0.001). The AARC-ACLF score is easy to use, dynamic and reliable, and superior to the existing prediction models. It can reliably predict the need for interventions, such as liver transplant, within the first week.

Background: Urinary Tract Infection (UTI) is a common infection in nephrotic syndrome and have a propensity for long term renal damage. It may be an important cause of poor steroid response. The objective is to study the frequency and etiological organisms of urinary tract infection in idiopathic nephrotic syndrome children.Methods: This Comparative cross-sectional study was conducted in the Pediatric ward of Chittagong Medical College Hospital, Chittagong from 01.01.2009 to 31.12.2009. 52 nephrotic syndrome children diagnosed by serum albumin, serum cholesterol and 24 hours total urinary protein or protein creatinin index were included. After elaborate clinical evaluation, urine for R/M/E and C/S was done in all patients. Data regarding pyuria, hematuria, etiological organisms were analyzed by statistical method.Results: UTI was found in 30.8% nephrotic children and in majority cases (68.8%) they were asymptomatic. Male female ratio among UTI patients was 1:1. Mean serum cholesterol in nephrotic syndrome with UTI was higher than that of children without UTI (418.94 mg/dl vs 352.03 mg/dl, p value < 0.05).Pyuria had poor association with definite UTI (p value > 0.05). E-coli was the commonest organism isolated in urine culture followed by klebsiella.Conclusion: UTI is one of the most common infections in nephrotic syndrome and may be asymptomatic. It should be screened in every nephrotic child routinely.Chatt Maa Shi Hosp Med Coll J; Vol.15 (2); Jul 2016; Page 41-44

Carbon dioxide (CO2) concentration in greenhouses is sub-optimal for vegetable production. Many techniques have been used to increase CO2 concentration in greenhouses but most of them are expensive with certain limitations and drawbacks. We adopted a new strategy to elevate CO2 concentration in the greenhouse throughout the day via crop residues and animal manure composting (CRAM). During the whole cultivation period, CRAM-treated greenhouse had doubled CO2 concentration which significantly increased the yield of cherry tomatoes (Lycopersiconesculentum L.) i.e. up to 38%. The influence of CRAM procedure on cherry tomato quality was also investigated and the concentrations of total soluble solids (TSS) and soluble sugar were found to be significantly higher in cherry tomatoes grown under composting greenhouse than that of non-composting greenhouse. Additionally, CRAM-CO2 enrichment also resulted in increased concentrations of ascorbic acid (Vitamin C) and titrate acid as compared with the control. In contrast, the concentration of nitrate was considerably decreased in cherry tomato grown under CO2 enriched condition than that of control. The increase in active oxygen metabolisms such as POD, CAT and SOD while a decrease in MDA, as well as APX was observed for cherry tomatoes grown under CO2 enriched condition. Hence, CO2 fertilization by using CRAM in greenhouse significantly improved quality and increased the yield of cherry tomatoes.

Background: Hydatid disease is a zoonotic disease caused by Echinococcus granulosus. In humans, lungs are the second common organ involved after liver. Surgical treatment is considered gold standard. Different surgical techniques has developed. However, head to head comparison of these has not yet been done in our country. Methods: A prospective randomized study was done in the Department of Thoracic Surgery, National Institute of Diseases of the Chest and Hospital between July 2004 and June 2006. Patients with pulmonary hydatid disease were offered two surgical techniques, enucleation with or without capitonnage. Group I was offered enucleation of cyst with closure of bronchial opening. Group II was offered enucleation of cyst with capitonnage. Results: 43 patients (age range 7 – 45 years, mean 25 years) having hydatid disease of the lung were enrolled in the study. Group I involved 23 patients, Group II involved 20 patients. There were 15 males and 28 females. Presenting complaints were chest pain [76.7%], cough without sputum [46.5%], haemoptysis [30.2%], respiratory distress [27.9%], cough with sputum [11.6%] while 23.2% were asymptomatic. The right lung was affected more [65.11%] than left lung [23.3%] and bilateral disease was found in 11%. Postoperatively, in group I, 12.9% developed air-leakage, 4.3% wound infection. In group II, 20% developed air-leakage, 5% haemorrhage and 5% empyema. None of the patient in the former group had to stay in the hospital for >15 days, where as 10% of the latter group had to stay in hospital for >15 days. The hospital stay was found to be significantly higher in the latter group compared to the former group (p < 0.05). There was no significant difference between groups in the development of haemorrhage, empyema, wound infection and broncho-pleural fistula. There was also no significant difference in the rate of recurrence. No anaphylaxis or death occurred in either group. Conclusion: Capitonnage offered no added benefit rather increasing complications. So enucleation followed by closure of bronchial opening may be a reasonable approach. DOI: http://dx.doi.org/10.3329/jdmc.v23i1.22702 J Dhaka Medical College, Vol. 23, No.1, April, 2014, Page 94-101

The dog tapeworms Echinococcus granulosus develop hydatid cysts in various organs in human and domestic animals worldwide including Bangladesh. The aim of this study was to identify and characterize the genotype of E. granulosus isolated from cattle using 12S rRNA and Cytochrome oxidase 1 (COX 1) genes. A total of 43 hydatid cyst samples were collected from 390 examined cattle samples derived from slaughterhouses. Among them, three cysts were fertile. Genomic DNA was extracted from germinal membrane and/or protoscoleces followed by PCR amplification of mitochondrial 12S rRNA and Cytochrome oxidase 1 gene fragments. The sequence data revealed existence of G1 (64.28%) and possible G3 (21.43%) genotypes for the first time in Bangladesh. The study indicates that common sheep strain G1 is the dominant subtype of E. granulosus in Chittagong region of Bangladesh. 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Objective To detect the presence of specific CTX-M class of extended spectyum β-lactamases (ESBLs) in a collection of cephalosporin-resistant Enterobacteriaceae isolates from Bahrain. Methods A subset of 80 cephalosporin-resistant Enterobacteriaceae collected from Salmaniya Medical Complex, Bahrain, were characterized further for the presence of specific genogroups of CTX-M β-lactamases by multiplex- and monoplex- PCRs. The primers used for the multiplex and monoplex PCRs were of genogroups- 1, 2, 8, 9 and 25. Sequencing of the representative isolates was performed to find the circulating CTX-M-types. Results A total of 93.8% (75/80) isolates showed the amplicons corresponding to any of the genogroups (1, 2, 8, 9, 25) and the remaining 6.2% isolates turned out negative in multiplex PCR. Some of the isolates demonstrated multiple bands corresponding to the sizes of different genogroups. Further confirmation with respective monoplex PCR on these 75 isolates demonstrated that 93.3% (70/75) harbored CTX-M genogroup-1 and 6.7% (5/75) harbored genogroup-9. We did not find the presence of genogroups 2, 8, and 25 in these isolates by monoplex PCR. Sequencing results of genogroup-1 isolates demonstrated the presence of CTX-M-15-like ESBL, however, discrepant results were noticed in genogroup-9 isolates, sequencing showed them as CTX-M-55-like ESBL. Conclusions This is the first report from Bahrain characterizing the CTX-M genogroups of ESBLs and reporting the emergence of bla CTX-M-55 -like gene in this region.

Background: Non-alcoholic fatty liver disease (NAFLD) is becoming a public health problem with increasing incidence and it has been shown to be associated with diabetes, dyslipidemia, obesity and metabolic syndrome and ultimately puts more than half the world’s population at risk of developing NAFLD/NASH/cirrhosis in the coming decades. The importance of detection of patients with NAFLD is to intervene the associated factors and avoid transformation to more severe forms of the disease.Methods: An observational case control study was carried out at Medicine Department, Dhaka Medical College Hospital (DMCH), Dhaka, during the period of August, 2011 to June, 2012. A total number of 100 consecutive patients and 100 healthy controls was approaches DMCH were enrolled in this study. Out of 100 NAFLD patients only 20 patients gave consent for liver biopsy to see the extent of liver damage.Result: Less physical activity, Obesity, mean blood pressure, Diabetes, TG, TC were significantly (P5) was found in 9(45%) of the NAFLD group.Conclusion: Significant proportion of NAFLD patient suffers from NASH which is alarming and they have potential for the development of advanced liver disease. So recognition of these risk factors in patients of NAFLD can help in early implementation of strategies that halt the progression of this disease. DOI: http://dx.doi.org/10.3329/jom.v14i2.19665 J Medicine 2013, 14(2): 143-148

Aims: Asian Pacific Association for the Study of Liver (APASL) acute-on-chronic liver failure (ACLF) Research Consortium (AARC) proposed new prognostic scoring system of ACLF in cluding lactate. However, lactate is not routinely checked in clinical practice of patient with ACLF in Korea. Therefore, we aimed to investigate the predictive accuracy of lactate-free AARC-ACLF score for predicting short-term mortality in patients with alcoholic liver disease. Methods: A total of 749 ALD patients who had liver failure (bilirubin≥5mg/dL and INR≥1.5) in AARC database were in vestigated. Diagnostic performances for short-term mortality were compared according to the area under receiver operating characteristic (AUROC) curve. Predictive accuracy of lactate-free AARC-ACLF score were compared with other prognostic scores in 143 ALD patients with liver failure and 60 ALD patients with ACLF according to AARC definition in Korean ACLF cohort. Results: Among 749 patients, 30-day and 90-day mortality were 40.3% and 51.5%. There were no significant differences in AUROC for predicting 30-day and 90-day mortality between AARC-ACLF score and lactate-free AARC-ACLF score (30-day mortality: 0.752 vs. 0.751, P=0.918, 90-day mortality: 0.728 vs. 0.736, P=0.346). In Korean ACLF cohort, the AUROCs of lactate-free AARC-ACLF score for predicting 28-day and 90- day mortality were 0.861 and 0.846 in ALD with liver failure, and 0.884 and 0.874 in ALD patients with ACLF according to AARC definition, respectively. In Korean ALD patients with liver failure and ACLF according to AARC definition, diagnostic per formance of lactate-free AARC-ACLF score for predicting 28- day and 90-day mortality was comparable to those of Model for End-stage Liver Disease (MELD), MELD-Na, Chronic Liver Failure-Sequential Organ Failure Assessment score. Conclusions: Lactate-free AARC-ACLF score is as excellent as AARC-ACLF score in predicting short-term mortality in ALD patients with liver failure of AARC database and Korean ACLF cohort.

Hepatitis B viral infection is a worldwide problem. About 95% adult recovers from acute infection naturally. Anti HBs is a marker of recovery from acute hepatitis B. Anti HBs is a usually consistent with decline of cccDNA in hepatocytes. However there may be situations where viral rebound occurs due to persistence of cccDNA. This case report depicts such a picture. Measurement of cccDNA is perhaps essential before cure from hepatitis B infection can be declared.

There are paucity of information about prevalence and risk factor of hepatitis C virus (HCV) in Bangladesh.Blood was collected from 1018 randomly selected subjects from a semi-urban area of Bangladesh. Anti-HCVs were checked in the blood twice using a third-generation commercial kit. The data of the questionnaires were analyzed to find possible risk factors.Nine of the 1018 subjects (88%) were tested positive for anti-HCV. The HCV-positive subjects were28 years old. Major risk factors for HCV infection were treatment by unqualified and traditional practitioners, history of mass-vaccination against smallpox, hair cutting and shaving by barbers, and body piercing. However, known risk factors such as blood transfusion, surgery, invasive therapy, and intravenous drug use were not detected in any HCV-infected subjects.Control of HCV infection in Bangladesh may be difficult because the risk factors are related to normal tradition and culture of Bangladeshi people.

Introduction: Hepatitis C virus (HCV) is a leading cause of chronic liver disease worldwide including Bangladesh. Approximately 0.84% of our population is infected with HCV. Genotypes of HCV are important in the determination of treatment duration and in predicting the response to treatment in HCV infection. Methodology: 61 consecutive patients who presented to us with chronic hepatitis C (CHC) and who could afford treatment and having no features of decompensation were included in the study. Results: Of the 61 study subjects, 46 were males and 15 females. They were between 12 and 70 years of age. Of them 41% had genotype 3, 31% had mixed genotypes 3 + 4 and 21% had genotype 1. Patients also had genotypes 2, 4, 5 and mixed genotypes 5 + 6, the figure being 1.6% in each case. Conclusion: Genotype 3 is the commonest HCV genotype in Bangladesh, while we also have a high prevalence of mixed HCV genotypes.

Autoimmune hepatitis is defined as chronic liver disease of unknown aetiology with aberrant autoreactivity and genetic predisposition. It is characterized by female predominance, circulating auto-antibodies, hypergammaglobulinaemia and association with HLA DR3 and HLA DR4 [1]. Differential diagnosis includes chronic viral hepatitis, drug induced hepatitis and alcohol. We present two patients with autoimmune hepatitis representing the two extremes of hepatic involvement in this condition. The first patient is a young lady who was diagnosed with autoimmune chronic hepatitis. The second patient, on the other hand, is an elderly gentleman who presented to us with autoimmune hepatitis-related decompensated cirrhosis of liver.

The effectiveness of existing policies to control antimicrobial resistance is not yet fully understood. A strengthened evidence base is needed to inform effective policy interventions across countries with different income levels and the human health and animal sectors. We examine three policy domains-responsible use, surveillance, and infection prevention and control-and consider which will be the most effective at national and regional levels. Many complexities exist in the implementation of such policies across sectors and in varying political and regulatory environments. Therefore, we make recommendations for policy action, calling for comprehensive policy assessments, using standardised frameworks, of cost-effectiveness and generalisability. Such assessments are especially important in low-income and middle-income countries, and in the animal and environmental sectors. We also advocate a One Health approach that will enable the development of sensitive policies, accommodating the needs of each sector involved, and addressing concerns of specific countries and regions.