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Pediatric acute promyelocytic leukemia (APL) is one of the most curable subtypes of acute myeloid leukemia of childhood. But it may have many early complications, especially in developing countries. This study aims to describe the outcome and complications of pediatric APL patients in Bangladesh. This prospective observational study was conducted in the pediatric hematology and oncology department of Bangabandhu Sheikh Mujib Medical University, Dhaka from September 2017 to March 2019. In this study, PML:RAR-α (Promyelocytic leukemia-retinoic acid receptor-α) positive APL cases were included and observed while being treated with risk-directed ATRA (All-trans-retinoic acid) based chemotherapy. Among twenty PML:RAR-α positive APL cases, 13 children were in the high risk group and hemorrhagic manifestations were present in 95% of patients. Post-induction remission was achieved in 85% of the patients. 3-year overall survival was 70% (45-85% with 95% confidence interval). There was no refractory disease or relapses. Neutropenic sepsis was the most common complication and also the most common cause of mortality. In Bangladesh, the 3-year overall survival of pediatric APL is 70% (45-85% with 95% CI). Post-chemotherapy neutropenic sepsis is the most common complication and also the most common cause of mortality in this potentially curable malignancy in Bangladesh.

Background: Acute lymphoblastic leukemia (ALL) is presented with different immunophenotypic pattern. Objective: The purpose of the study was to evaluate the immunophenotypic pattern of ALL and also, to recognize the frequency of different ALL subtypes and treatment outcome after induction remission therapy. Methodology: This prospective study was conducted in the Department of Paediatric Hematology and Oncology at Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh from June 2017 to July 2018 for a period of one year. Newly diagnosed admitted cases of ALL aged 1 to 17.9 years were included. Immunophenotyping from aspirate marrow samples were done in a special hematology laboratory. Patients were monitored during induction remission period with physical examination and required investigations. Result: Among 87 analyzed patients, 81 patients (93.1%) were B-cell ALL and 6 patients (6.9%) were T-cell ALL. After completion of induction remission therapy 61 patients had undergone complete remission and among them B cell ALL were 56(69.1%) and T cell were 5(83.3%) (P=0.464). None of the patient had partial response or induction failure. Complication were developed in 53(60.91%) patients during induction therapy. Most common cause of death was septicemia (22/26). Death was more in patients who had total WBC count >50X109/L (p=0.017) and received regimen B (p=0.031). Conclusion: B cell ALL was more common and most of the patients had undergone complete remission after induction remission therapy. Journal of Current and Advance Medical Research, January 2021;8(1):59-64

Background: Hepatoblastoma is a rare malignant liver tumour that occurs almost exclusively in childhood. Although surgical resection is the foundation of curative therapy, with the use of effective neoadjuvant and adjuvant chemotherapy the 5 years overall survival of patient with hepatoblastoma had recently reached up to 80% to 90 %. But the frequency and severity of haematological toxicity is one of the major concerns of intensive chemotherapy. Objective: To evaluate the frequency and severity of haematological toxicities following treatment of childhood hepatoblastoma with two different regimens of multi-agent chemotherapy. Methodology: This was a comparative observational study conducted at Bangabandhu Sheikh Mujib Medical university in 24 childhood hepatoblastoma patients who received either cisplatin/carboplatin /doxorubicin (Group A; n=14) or cisplatin/ vincristine/5- fluorouracil (Group B; n= 10) to between March 2010 and July 2014. Results: Grade 3 or 4 anaemia and thrombocytopenia, and Grade 4 neutropenia were observed in 64.3% vs 60%, 35.7% vs 20% and 57.1% vs 20% respectively in group A and Group B. Febrile neutropenia occurred in 100% vs 70% and septicaemia developed in 92.9% vs 70%. Red cell concentrates and Platelet transfusions were required in 35.7% vs 50% and 14.3% vs 10% respectively in two groups. Deaths due to haematological toxicities occurred in 21.4% in Group A and 21% in Group B. Conclusion: We found similar toxicity profiles for two chemotherapy regimens except for higher rates of febrile neutropenia and septicaemia in patients treated with cisplatin/carboplatin /doxorubicin compared to cisplatin/ vincristine/5- fluorouracil.

Easy refill and recharge battery cells is direct methanol fuel cells (DMFCs). To overcome the commercialization issues of DMFCs, we prepared four types of Polyvinyl Alcohol (PVA) based membranes using the solution casting method for DMFCs application. The composition of the membranes was 1) Pure Polyvinyl Alcohol (PVA), 2) PVA/Polyethylene Glycol (PEG), 3) PVA/PEG/SiO2 nanoparticles, and 4) PVA/PEG/Clay. We characterized the membranes by FTIR, water uptake, scanning electron microscopy (SEM) for surface morphology, ionic conductivity and fuel permeability. Among the four types of composition of the membranes which was investigated, the PVA/PEG/SiO2 membrane shown good balance in water uptake, conductivity and fuel permeability.

Ziziphus mauritiana Lam. was assessed for phytochemical constituent, antioxidant and cytotoxic activities. Powder prepared from the air-dried leaf was extracted with methanol. The concentrated extract was partitioned with petroleum ether, carbon-tetrachloride, and chloroform. A triterpenoid acid was isolated from the petroleum ether soluble fraction of the plant extract by gel permeation chromatography using Sephadex LH-20 followed by preparative thin layer chromatography over silica gel. The structure of the isolated compound was elucidated as zizyberenalic acid (1) by extensive analysis of its NMR spectral data and confirmed by comparison with published value. The methanol extract (IC50 = 7.37 ± 0.38 μg/ml) and its chloroform soluble materials (IC50 = 24.14 ± 0.53 μg/ml) produced strong antioxidant effect where it was comparable to standard agent tert-butyl-1-hydroxy toluene (IC50 = 32.47 ± 0.72 μg/ml) in DPPH free radical assay. The petroleum ether soluble fraction also showed strong cytotoxicity (LC50 = 1.31 ± 0.01 μg/ml) in brine shrimp lethality assay which was comparable to the standard drug, vincristine sulfate (LC50 = 0.31 ± 0.01 μg/ml). The results of the present study suggest that the plant leaf could be considered as a significant natural source for the development of antioxidant as well as cytotoxic compounds.

Comparison of cost of surgery among different centres

Epistaxis in children is one of the important presenting symptoms for attending emergency department in paediatric patients. Recurrent epistaxis is common in children. Although epistaxis in children usually occurred due to different benign conditions, it may be one of the important presenting symptoms of some inherited bleeding disorder. Whereas most bleeding disorders can be diagnosed through different standard hematologic assessments, diagnosing rare platelet function disorders may be challenging. In this article we describe one case report of platelet function disorders on Glanzmann’s thrombasthenia (GT). Our patient was a 10-year old girl who presented to us with history of recurrent severe epistaxis. She had a bruise on her abdomen and many scattered petechiae in different parts of the body. Her previous investigations revealed no demonstrable haemostatic anomalies. After performing platelet aggregation test, she was diagnosed as GT.

Introduction: Nausea and vomiting are the most important side effects of cytotoxic chemotherapy and it is reported by the patients who receive chemotherapy for malignancies. Ondansetron and granisetron (5 HT3 receptor antagonists) are effective compounds with relatively less toxicity to prevent nausea and vomiting induced by high and moderate emitogenic chemotherapy. Objective: This study was carried out to evaluate the efficacy of granisetron and ondansetron preventing chemotherapy induced nausea and vomiting (CINV). Methods: In this randomized double blind trial 60 children (4-11 years) with acute lymphoblastic leukemia (ALL) who received high dose methotrexate (HDMTX-2.5gm/ m2). Each patients received either ondansetron 4 mg or granisetron 1mg (n=30) orally half an hour before HDMTX. Nausea and vomiting were assessed based on ‘’modified Morrow Assessment of Nausea and Emesis’’ (MANE) scale for application to the children. Results: Complete response of granisetron significantly differed from ondansetron from day 2-4 (delayed emesis) (p=0.028).Complete response to acute CINV were 90% in granisetron and 70% in ondansetron treated children (p=0.053), which was not statistically significant. No Child of granisetron group required additional dose but 16.7% children of ondanseton group required additional dose on the first day (p=0.05). Episodes of nausea found in ondansetron treated children 36.7% and in granisetron group 3.3% on day four (p=0.001). Maximum episodes of vomiting found in ondansetron treated children 33.3% and minimum episodes in granisetron group 3.3% on day 2 (p=0.003). In few cases adverse effects (headache, constipation, abdominal pain, loose motion and decreased appetite) were observed in both group of patients (p=0.999). Only in 3.3% cases anticipatory nausea and vomiting had observed. Conclusion: In conclusion, single dose oral granisetron (1mg) is superior to oral ondansetron (4mg) preventing chemotherapy induced emesis in children with ALL receiving HDMTX therapy. DOI: http://dx.doi.org/10.3329/bjch.v36i3.14272 BANGLADESH J CHILD HEALTH 2012; VOL 36 (3) : 115-121

A new series of phenothiazine-based polymeric electrolytes were developed to obtain a high power conversion efficiency (PCE) of dye-sensitized solar cells (DSSCs). Phenothiazine-based click polymers were synthesized using Cu(I)-catalyzed click reaction methods. The resulting polymers were soluble in common organic solvents and had a reasonable molecular weight. The thermal properties, emission spectra, and energy band gap of synthesized click polymers were also investigated. The polymer electrolytes were composed of iodide and triiodide redox species embedded in phenothiazine-based click polymers or polyacrylonitrile (PAN) as a polymer matrix. DSSCs were fabricated with a configuration of SnO2:F/TiO2/N719 dye/polymer electrolyte/Pt devices using these click polymers or PAN as an electrolyte components and compared photovoltaic performance. The maximum PCE of the phenothiazine-based click polymers as polymer electrolytes for DSSCs was obtained 5.30% (at 1 sun). These enhanced click polymers are expected to find applications as an electrolyte component in DSSCs in the future. Open image in new window

Two different methods were used to synthesize fluorene-based click polymers, and their effects on their photovoltaic performance in dye-sensitized solar cells were compared. The dye-sensitized solar cells with a configuration of SnO 2 :F/TiO 2 /N719 dye/polymer electrolyte/Pt devices were fabricated using these click polymers as the electrolyte components. We also compared the photovoltaic performance of these liquid crystal embedded in click polymers to that of poly(acrylonitrile). Among the devices, the device composed of the Cu I -catalyzed click polymer exhibited high power conversion efficiency of 4.70% at 1 sun, which was as high as that of the poly(acrylonitrile)-composed polymer electrolyte.

The three different methods of click reaction has been used to synthesize fluorene-based click polymers and compared its effect on polymer electro-optical properties as well as photovoltaic performances in DSSCs. The DSSCs devices with configuration of SnO 2 :F/TiO 2 /N719 dye/quasi-solid-state electrolyte/Pt devices were fabricated using these click polymers as a quasi-solid-state electrolyte components. Among the devices, the catalyzed click polymer composed DSSCs device exhibited high power conversion efficiency (PCE) of 4.62% under AM 1.5G illumination. These click polymers are promising materials for device application and the CU I -catalyst 1,3-dipolar cycloaddition click reaction is an efficient synthetic methodology.

The following series of blue EL polymers was synthesized using the Suzuki polymerization method: poly(3′,6′-bis(3,7-dimethyloctyloxy)-9,9′-spirobifluorene-2,7-diyl) poly[(OC10)2-spirobifluorene], poly(3′,6′-bis(3,7-dimethyloctyloxy)-9,9′-2,7-diyl-co-4-(3,7-dimethyloctyloxy) phenyl-diphenylamine-4′,4′-diyl} poly[(OC10)2-spirobifluorene-TPA] (5∶1, 9∶1) and poly(3′,6′-bis(3,7-dimethyloctyloxy)-9′,9′-spirobifluorene-2,7-diyl-co-4-(6-((3-methyloxetan-3-yl)methoxy) hexyloxyphenyl-bisphenylamine-4′,4′-diyl) poly[(OC10)2-spirobifluorene-TPA-oxetane]. The weight average molecular weight (Mw) and polydispersity of the resulting polymers ranged from 1.6×104–1.5×105 and 1.77–2.31, respectively. The resulting polymers were completely soluble in common organic solvents and were easily spin-coated onto an indium tin oxide (ITO) substrate. The polymers exhibited strong blue emission peaking at 450 nm. The maximum brightness and luminance efficiency were 9,960 cd/m2 and 1.2 cd/A, respectively.

The mechanism of failure of patterned ITO electrodes on PET was investigated under static and cyclic bending in the mechanical stress mode. When mechanical stresses are increased, two types of micro-cracks are observed depending on the stress modes. The direction of the micro-crack in ITO electrodes is perpendicular to the load for the static mode. The electrical resistance of an ITO electrode is related to the density of the micro-cracks and failure mechanism of ITO electrode.

Quasi-solid-state DSSCs in SnO(2):F/quasi-solid-state electrolyte/Pt devices have been fabricated with click polymers for the first time; they show a maximum power conversion efficiency (PCE) of 2.80%.