RESUMEN
Low back pain (LBP) is a frequent complaint in the working milieu of pain physicians. Common LBP generators are the lumbar spine, soft tissues around the spine, and intra-abdominal viscera; however, in recent times, lumbar spine ligament (LL) degeneration is increasingly getting more coverage as an important LBP source. Among various LLs, interspinous and supraspinatus ligaments' sprain-degeneration can perpetuate localized central LBP as described in the present case study. Localized LL sprain-degeneration in association with radiating LBP from prolapsed lumbar intervertebral disc (PLID) compressing adjacent nerve roots might further impair a patient's quality of life. In the present report, we describe both LL sprain-degeneration and PLID (a dual source of LBP) in a 26-year-old Bangladeshi woman; physicians often fail to notice this combination in their regular clinical practice.
RESUMEN
Hepatitis B virus (HBV) infection is endemic in Bangladesh. Studies have indicated that HBV is the major cause of chronic hepatitis B (CHB), liver cirrhosis (LC), and hepatocellular carcinoma (HCC) in this country. Recently, HBV-related acute on chronic liver failure (HBV-ACLF) has emerged as a serious and emergent medical problem in Bangladesh. To develop a strategy to address HBV-related problems and their influence on health care delivery system, proper understandings about extent of problems and nature of economic burden should be explored. Conservative estimates indicate that about 50 million or more of Bangladeshi have been infected by HBV at some point of their life. Out of the total Bangladeshi population, about 2 to 5% is chronically infected with HBV (about 3-8 million) (1-6%) and considerable number of these patients will eventually develop LC, HCC, or ACLF (about 1 million). Although proper statistics is lacking, it is estimated that HBV-related liver diseases account for a majority of hospital admissions and around 20,000 deaths every year in Bangladesh. In addition, complex clinical features of HBV-related liver diseases have been documented in Bangladesh that show similarity and differences from HBV infection in other Asian countries. Although vaccination against HBV and containment of horizontal transmission are in progress in Bangladesh for reduction of new HBV infection, there is a lack of national strategy for treatment of millions of chronic HBV-infected subjects. This paper will provide an insight regarding the economic impact of HBV in Bangladesh that may act as a primary impetus for developing national HBV eradication program, a goal set by World Health Organization (WHO). HOW TO CITE THIS ARTICLE: Al Mahtab M, Chaudhury M, Uddin MH, Noor-E-Alam SM, Rahim MA, Alam MA, Moben AL, Khondaker FA, Choudhury MFI, Sarkar MJA, Poddar PK, Foez SA, Akbar SMF. Cost Assessment of Hepatitis B Virus-related Hepatitis in Bangladesh. Euroasian J Hepato-Gastroenterol 2016;6(2):163-166.
RESUMEN
The reaction mechanism of the Kolbe-Schmitt reaction of phenol and 2-naphthol has been investigated. An alkali metal phenoxide-CO2 complex is not an intermediate that can be easily transformed into a carboxylic acid, such as salicylic acid (SA) and p-hydroxybenzoic acid (pHBA). A direct carboxylation of phenoxide with CO2 takes place even at room temperature, and is competitive with the formation of the CO2 complex. The resulting complex decomposes thermally (above ca. 100 degrees C) to phenoxide, which then undergoes further competitive reactions. Experiments using a carbon-13 labeled complex support a mechanism of direct carboxylation, and not the mechanism via a CO2 complex. The reactivity, C-13 NMR and MOPAC/PM3 calculations suggest a new carbonate-like structure for the CO2 complex.
