Results of Subtrochanteric Femoral Fractures Fixation by Proximal Femoral Locking Compression Plate.

The treatments of subtrochanteric femoral fractures are a challenge. It accounts about 10.0% to 34.0% of all hip fractures with a high complication rate. This area consists of mostly cortical bone with high stress generation thus heal slowly. The fracture is too proximal to adequately control with implants for femoral shaft and too distal to control with implants for intertrochanteric fractures. The intrinsic insecurity of this fracture and forces of the muscles with comminuted medial calcar is giving the fracture a tendency to varus crumple. Extramedullary implants are associated with higher rate of implant failure while intramedullary nails are not suitable for short proximal segment and wide medullary canal. Recently proximal femoral locking compression plate (PF-LCP) has been applied in treatment of proximal femur including subtrochanteric fractures. It has an excellent result in respect of union, fewer complications and early rehabilitation. The aim of this study was to assess the rate and time taken for union of fractures by PF-LCP and determine perioperative parameters. This prospective study was conducted from March 2019 to September 2020 at Mymensingh Medical College Hospital through non randomized purposive sampling. Total 25 patients aged above 18 years irrespective of sex with closed subtrochanteric fracture were included but pathological fractures, multiple injuries were excluded from the study. Union status evaluated by Radiographic Union Score for Tibial (RUST) fracture of Whelan; where antero-posterior and lateral radiographs (X-ray) based assessment of healing of the four cortices done. The entity cortical scores were added to give an entire score; 4 being the least amount demonstrating fracture are positively not healed and 12 being the highest score representing that the fracture is positively healed. The mean age of the patients was 42.04±14.97 years with range 22-70 years. Majority of patients were male (60.0%) and most of injury (64.0%) due to road traffic accident with most fractures was Seinsheimer type III (48.0%). Average operative time was 121.92 minutes, follow up period was 41.12 weeks (24-48 weeks) and time taken for union was 14.16 weeks (11-28 weeks). According to RUST scores; fracture union rate 88.0% with delayed union 12.0% and no nonunion. There were two patients with superficial wound infection and no implant failure. This study concludes that PF-LCP is a safe and reliable implant for the treatment of subtrochanteric femoral fractures.

Evaluation of Results of Primary Repair of Open Tendo-Achilles Injury in the Department of Casualty, MMCH, Bangladesh.

Achilles tendon injury has been increasing over recent years due to a variety of causes. The injury of the Achilles tendon is a disabling condition, which is difficult to treat if there is a gap or defect between the two ends of the disrupted tendon. Patients with a rupture of the Achilles tendon should be operated without delay. Most of the people in our country use flat pan in the latrine, which are at a same level of the toilet floor. Surface of the toilet pan breaks down and cause sharp cut. Some of the cases of open tendon injuries occur due to road traffic accident, cut by broken glass and also assault. It is generally accepted that surgical repair of fresh ruptures of the Achilles tendon gives excellent results. Objective of the study was to find out the evaluation of the results of primary repair of Open tendo-achilles injury (OTAI). This prospective study was done in the department of Casualty of Mymensingh Medical College Hospital, Bangladesh in the period of Octy 2021 to June 2022. Patients who came with OTAI in casualty department were selected randomly. All cases were selected as OTAI, without associated injury of other leg muscles, posterior tibial artery and nerve within 12 hours. All patients underwent primary end to end repair by Modified Kessler's method. Evaluation of the results of primary repair of OTAI were carried out and were find out the common causes of injury, age and sex incidence, level of injury and to proposed a protocol for treating such cases in comfortable, cheap and convenient way for the patients. Operations were done at Casualty operation theatre (COT). Then 48 patients were followed up at the Department of Casualty. Among them 43(89.58%) of patients were able to stand on tip toes, 4(08.33%) of patients were not stand on tip toes of affected foot unsupported but able to stand on tip toes supported, 1(02.08%) of patients failed to stand on affected foot unsupported due to severe infection and wound gap. Final result were Excellent - 29(60.0%), Good - 14(30.0%), Fair - 4(8.0%), Poor - 1(2.0%). Repair of OTAI is not difficult but early diagnosis, proper surgical toileting, meticulous repair; adequate post-operative management is the key of success. So, the result of this study, treatment protocol can be followed, which is easy for surgeon and convenient and cheap for the patients.

Association Between Median Household Income and Perioperative Outcomes of Lumbar Spinal Fusion: An Analysis of the National Inpatient Sample (2009-2020).

BACKGROUND: Relationships between low socioeconomic status (SES) and surgical outcomes are well established for certain procedures. However, scant literature has focused on relationships between median household income and lumbar fusion outcomes. METHODS: Patients who underwent fusion procedures between January 1, 2009 and December 31, 2020 were identified from the National Inpatient Sample (NIS) database. They were categorized into 4 quartiles, from lowest to highest, based on median household incomes in respective zip codes. We applied univariable and multivariable linear and logistic regression models to analyze perioperative data according to income quartiles. RESULTS: We included 2,826,396 patients. In multivariable regression, patients in the 3 lowest income quartiles exhibited higher rates of in-hospital cardiac events perioperatively, with odds ratios (OR) of 1.19 (95% confidence interval[CI]1.13-1.26, p<0.001), 1.10 (95%CI 1.05-1.16, p<0.001), and 1.06 (95%CI 1.01-1.12, p=0.011) for the first, second, and third quartiles, respectively. Patients in the lowest income (first) quartile had a higher occurrence of perioperative urinary complications (OR=1.07, 95%CI 1.03-1.12, p=0.001), systemic infectious complications (OR=1.17, 95% CI 1.04-1.32, p=0.006), neurological deficit (OR=1.17, 95%CI 1.06-1.30, p=0.002), and wound infections (OR=1.22, 95%CI 1.12-1.34, p<0.001). Those in the 3 lowest income quartiles were less likely to experience respiratory, gastrointestinal, and venous thrombotic complications (p<0.05). The lowest income quartile had protective associations for dural tears (OR 0.93, 95%CI 0.89-0.99, p=0.038) and postprocedure anemia across all 3 lower quartiles, with OR<1 and p<0.001. CONCLUSION: Reduced household income significantly affected perioperative outcomes after lumbar fusion and should be taken into consideration during the perioperative period.

Synergistic effects of rare-earth ions (Ho, Yb) doping on the photo-catalytic efficacy of V2O5 for removal of pollutants from industrial waste water.

The co-doping of vanadium pentoxide (V2O5) with rare-earth (RE) elements, namely 1.5 % holmium (Ho) and 1.5 % ytterbium (Yb) has been conducted using an eco-friendly, straightforward hydrothermal approach to assess the combined effects on structural, optical, and photocatalytic properties. The application of the density functional theory (DFT) approach effectively examined the impact of RE ions on the photocatalytic efficiency of co-doped V2O5. The stable orthorhombic crystal structure of co-doped V2O5 has been confirmed using DFT and X-ray diffraction without a secondary phase. It appears that homogeneous nucleation occurs while heterogeneous nucleation slows down in co-doped samples, as evidenced by the larger crystallite sizes in co-doped samples compared to doped ones. It means a result, the co-doped samples exhibit photodegrades more quickly and have a higher rate constant than the doped samples. This is because they have less dislocation density (4.26 × 10-3 nm-2) and internal micro-strain (4.93 × 10-3). The bandgap and degradation efficiency are determined by the UV-vis spectroscopy and found to be 2.33 eV and 95 %, respectively, at the optimal pH of 7 in the visible range. The co-doped sample has a rate constant of 24 × 10-3 min-1, which is the highest in the RE-doped V2O5 system. This is a good reason to think of co-doped V2O5 as a possible catalyst.

Hypothalamus-pituitary-adrenal axis in patients with post-traumatic stress disorders and related to oxidative stress.

OBJECTIVES: The study involves the effect of hypothalamus-pituitary-adrenal hormones disorders, and related to oxidative stress in individuals with PTSD to those in the healthy group after they experience a specific event that results in a congenital illness or limb loss. METHODS: Obtaining serum samples from males exclusively in cases where psychiatrists have determined that the men have experienced psychological damage brought on by a particular tragedy, and testing the men for hypothalamus-pituitary-adrenal axis and oxidative stress parameters in comparison to healthy participants. RESULTS: It was observed that there was a notable rise in cortisol levels (5.60 ± 0.93) at 4 pm compared with healthy control (3.43 ± 0.64) resulting from the stimulating effect of the pituitary gland, and this increase has a role in raising levels of oxidative stress in patients total oxidant status (1.08 ± 0.13) compared with control (0.70 ± 0.10). High oxidative stress may lead to increased prolactin levels and decreased testosterone levels. CONCLUSIONS: Transmission of incorrect chemical signals from the central nervous system has a role in causing disturbances in hormonal levels of the hypothalamus and its associated glands, and thus an imbalance in the metabolic rate due to high cortisol. Also, high levels of prolactin hormones play a role in a significant decrease in testosterone levels.

Novel crossover and recombination hotspots massively spread across primate genomes.

BACKGROUND: The recombination landscape and subsequent natural selection have vast consequences forevolution and speciation. However, most of the crossover and recombination hotspots are yet to be discovered. We previously reported the relevance of C and G trinucleotide two-repeat units (CG-TTUs) in crossovers and recombination. METHODS: On a genome-wide scale, here we mapped all combinations of A and T trinucleotide two-repeat units (AT-TTUs) in human, consisting of AATAAT, ATAATA, ATTATT, TTATTA, TATTAT, and TAATAA. We also compared a number of the colonies formed by the AT-TTUs (distance between consecutive AT-TTUs < 500 bp) in several other primates and mouse. RESULTS: We found that the majority of the AT-TTUs (> 96%) resided in approximately 1.4 million colonies, spread throughout the human genome. In comparison to the CG-TTU colonies, the AT-TTU colonies were significantly more abundant and larger in size. Pure units and overlapping units of the pure units were readily detectable in the same colonies, signifying that the units were the sites of unequal crossover. We discovered dynamic sharedness of several of the colonies across the primate species studied, which mainly reached maximum complexity and size in human. CONCLUSIONS: We report novel crossover and recombination hotspots of the finest molecular resolution, massively spread and shared across the genomes of human and several other primates. With respect to crossovers and recombination, these genomes are far more dynamic than previously envisioned.

Green radiography: Exploring perceptions, practices, and barriers to sustainability.

INTRODUCTION: Previous research has delved into the attitudes and behaviors of diverse professions regarding environmental sustainability. However, there needs to be more research specifically targeting radiographers. This study aims to survey radiographers' perceptions, practices, and barriers to change concerning environmental sustainability in radiology. METHODS: Institutional ethical approval was obtained (IRB-COHS-FAC-110-2024) and data collection was conducted using Google Forms (Google Inc., Mountain View, CA). The survey targeted 104 practicing radiographers across several countries. Questions were structured around five domains to gather insights into demographics, training in global warming and climate change, perceptions of sustainability and climate change, sustainability barriers, and current radiology practices on sustainability. Data analysis utilized descriptive and d inferential statistics. RESULTS: One hundred and four radiographers completed the study. Females had a significantly higher attendance rate in environmental protection campaigns (P = 0.01). The majority of respondents (68%) believe in climate change's knowledge and impact on the natural world. Our survey findings demonstrate that 74% of respondents believe there's a need to improve sustainability practices. The most commonly used strategies to decrease energy consumption and emissions were low-energy lighting (60%), real-time power monitoring tools (41%), and energy-efficient heating systems (32%). A significant concern regarding sustainability emerges among respondents: time (50%) and lack of leadership (48%) are prevalent concerns among the identified barriers. CONCLUSION: Participants are recognising the importance of environmental sustainability in radiology, but lack of leadership, support, authority, and facility limitations hinder their adoption. IMPACT ON PRACTICE: Radiology must prioritize environmental sustainability by providing resources and training for radiographers and collaborating with healthcare professionals, policymakers, and environmental experts to develop comprehensive strategies for a sustainable healthcare system.

Paraumbilical Perforator Flap: A Reliable Option for Coverage of Soft Tissue Defects of Forearm and Hand.

Soft tissue injuries of the hand or forearm often results in exposure of tendon or bone which needs coverage with a suitable flap. This prospective observational study was carried out in National Institute of Traumatology and Orthopaedic Rehabilitation (NITOR), Dhaka, Bangladesh from February 2019 to January 2020, to evaluate the use of the pedicled paraumbilical perforator flaps as a reliable flap to cover such defects. Total 34 patients having soft tissue defects in the hand and forearm with exposed tendons, bones or implant were included in this study. All the defects were covered by paraumbilical perforator flap. The defects were caused by road traffic accident (n=22), machinery injury (n=10) and burn injury (n=2). Sixteen patients had defects involving the forearm, six over dorsum of hand, another two over first web space and the rest had defects over two or more areas of forearm, hand and wrist. Lateral extent of flaps was upto anterior axillary line in 41.18% cases and upto mid-axillary line in 55.88% cases. Flap division and final inset was done in second stage after 3 weeks. Donor site closed primarily in all cases, except in two cases where it was covered by skin graft. All the flaps survived with no incidence of flap necrosis, dehiscence or infection after first stage. However, after the division of the flap, two patients developed marginal necrosis of the proximal margin which healed spontaneously by conservative treatment. The mean flap surface area utilized was 108 cm2. Donor area healed well without any major complications. Three patients developing scar hypertrophy were treated with intra-lesional triamcinolone injections. The paraumbilical perforator flap is a reliable option to cover soft tissue defects of hand and forearm due to easier planning and harvesting of the flap, adequate skin paddle and minimum donor site morbidity.

American College of Surgeons National Surgical Quality Improvement Program Surgical Risk Calculator as a Predictor of Postoperative Outcomes After Adult Spinal Deformity Surgery: A Retrospective Cohort Analysis.

BACKGROUND AND OBJECTIVES: In recent years, there has been an outpouring of scoring systems that were built to predict outcomes after various surgical procedures; however, research validating these studies in spinal surgery is quite limited. In this study, we evaluated the predictability of the American College of Surgeons National Surgical Quality Improvement Program Surgical Risk Calculator (ACS NSQIP SRC) for various postoperative outcomes after spinal deformity surgery. METHODS: A retrospective chart review was conducted to identify patients who underwent spinal deformity surgery at our hospital between January 1, 2014, and December 31, 2022. Demographic and clinical data necessary to use the ACS NSQIP SRC and postoperative outcomes were collected for these patients. Predictability was analyzed using the area under the curve (AUC) of receiver operating characteristic curves and Brier scores. RESULTS: Among the 159 study patients, the mean age was 64.5 ± 9.5 years, mean body mass index was 31.9 ± 6.6, and 95 (59.7%) patients were women. The outcome most accurately predicted by the ACS NSQIP SRC was postoperative pneumonia (observed = 5.0% vs predicted = 3.2%, AUC = 0.75, Brier score = 0.05), but its predictability still fell below the acceptable threshold. Other outcomes that were underpredicted by the ACS NSQIP SRC were readmission within 30 days (observed = 13.8% vs predicted = 9.0%, AUC = 0.63, Brier score = 0.12), rate of discharge to nursing home or rehabilitation facilities (observed = 56.0% vs predicted = 46.6%, AUC = 0.59, Brier = 0.26), reoperation (observed 11.9% vs predicted 5.4%, AUC = 0.60, Brier = 0.11), surgical site infection (observed 9.4% vs predicted 3.5%, AUC = 0.61, Brier = 0.05), and any complication (observed 33.3% vs 19%, AUC = 0.65, Brier = 0.23). Predicted and observed length of stay were not significantly associated (ß = 0.132, P = .47). CONCLUSION: The ACS NSQIP SRC is a poor predictor of outcomes after spinal deformity surgery.

Melt-extruded biocompatible surgical sutures loaded with microspheres designed for wound healing.

Sutures are commonly used in surgical procedures and have immense potential for direct drug delivery into the wound site. However, incorporating active pharmaceutical ingredients into the sutures has always been challenging as their mechanical strength deteriorates. This study proposes a new method to produce microspheres-embedded surgical sutures that offer adequate mechanical properties for effective wound healing applications. The study used curcumin, a bioactive compound found in turmeric, as a model drug due to its anti-inflammatory, antioxidant, and anti-bacterial properties, which make it an ideal candidate for a surgical suture drug delivery system. Curcumin-loaded microspheres were produced using the emulsion solvent evaporation method with polyvinyl alcohol (PVA) as the aqueous phase. The microspheres' particle sizes, drug loading (DL) capacity, and encapsulation efficiency (EE) were investigated. Microspheres were melt-extruded with polycaprolactone and polyethylene glycol via a 3D bioplotter, followed by a drawing process to optimise the mechanical strength. The sutures' thermal, physiochemical, and mechanical properties were investigated, and the drug delivery and biocompatibility were evaluated. The results showed that increasing the aqueous phase concentration resulted in smaller particle sizes and improved DL capacity and EE. However, if PVA was used at 3% w/v or below, it prevented aggregate formation after lyophilisation, and the average particle size was found to be 34.32 ± 12.82 µm. The sutures produced with the addition of microspheres had a diameter of 0.38 ± 0.02 mm, a smooth surface, minimal tissue drag, and proper tensile strength. Furthermore, due to the encapsulated drug-polymer structure, the sutures exhibited a prolonged and sustained drug release of up to 14 d. Microsphere-loaded sutures demonstrated non-toxicity and accelerated wound healing in thein vitrostudies. We anticipate that the microsphere-loaded sutures will serve as an excellent biomedical device for facilitating wound healing.

Geochemistry of Liquid Hydrocarbons and Natural Gases Combined with 1D Basin Modeling of the Oligocene Shale Source Rock System in the Offshore Nile Delta, Egypt.

The current study aims to integrate the geochemical characteristics of the Oligocene shale source rock system, oil, condensate, and natural gas samples in the Oligocene sandstone reservoirs from three exploration wells located in the offshore Nile Delta, East Mediterranean Sea, using organic geochemistry and a 1D basin modeling scheme. The Tineh shales exhibit total organic carbon values ranging between 0.90 and 1.89 wt %, along with hydrogen index values in the range of 54-240 mg hydrocarbon/g rock. The geochemical characterization suggests that the shale intervals of the Oligocene Tineh Formation contain type II-III and type III kerogens and, thereby, could be regarded as promising oil- and gas-prone source rocks with high contributions of gas generation potential. The study also reconstructs the 1D thermal and burial history models, showing that the Oligocene Tineh source rock system is in the main oil and wet gas generation phases from the late Miocene to the present time. The simulated basin models reveal the transformation (TR) of 10-50% kerogen to oil during the late Miocene-early Pliocene period and that the Oligocene Tineh source rock system has larger oil generation and expulsion competency, with a TR value of up to 65% during the early Pliocene-Pleistocene time period. The thermogenic gas was also formed during this time and continued to the present day. This study also investigated the presence of oil and condensate in the Oligocene sandstone reservoir samples and revealed that they were generated from mature source rock, ranging from moderately to highly mature stages. This source rock unit was deposited in fluvial to fluvial-deltaic environments under oxic mixed organic conditions and accumulated during the Tertiary time, as evidenced by the presence of the oleanane biomarker dating indicator. The molecular and isotope compositions of natural gases revealed that most of the natural gases in the Oligocene sandstone reservoir are mainly thermogenic methane gases that were generated from mainly mixed organic matter. The thermogenic methane gases were formed mainly from secondary cracking of oil and gas, with small contributions of primary kerogen cracking. The properties of natural gases together with oil and condensate in the Oligocene reservoir rocks suggest that most of the thermogenic methane gases and associated liquid hydrocarbons are derived primarily from the Oligocene shale source rock system and formed by primary kerogen cracking and secondary oil and oil/gas cracking in different thermal maturity stages. Therefore, the Oligocene Tineh Formation can be regarded as self-source generation and self-reservoir rock; hence, an intensive oil exploration and production program can be recommended whenever the Tineh source rock system is is well developed and deeply buried.

Initial Six Month's Study of Neonatal Covid-19 in a Tertiary Care Hospital of Bangladesh.

The pandemic Covid-19 affects mainly adult causing fatal illness specially who have co-morbidities. But as days pass by with increasing surveillances it's gradually obvious that this devastating disease also affects the children as well as neonates with greater number. The aim of study was to determine the Covid-19 in neonates. So, we can give proper emphasis on neonatal Covid-19. This cross-sectional study was conducted from April 2020 to September 2020 at Dhaka Shishu (Children) Hospital in Bangladesh. Neonates with suspected Covid-19 were tested for SARS-CoV-2 by RT- PCR. Newborn who had suspected or confirmed COVID-19 mother, exposed to relatives infected with Covid-19, related with cluster outbreak or with abnormal clinical courses such as respiratory distress, not responded to conventional treatment and also abnormal chest x-ray was selected for Covid-19 test. Data regarding gestational age, birth weight, gender, positive cases and other findings were collected and analyzed. Statistics analysis was done by SPSS version 26.0. Forty three cases were Covid-19 positive. Among them 28(65.1%) cases were male and 15(34.9%) female. Term was 39(90.6%) cases and preterm 4(9.4%). Twenty nine (67.5%) cases were belonged to medicine and 14(32.6%) surgical cases. Fourteen (32.5%) cases with Covid-19 lived in Dhaka and 29(67.5%) cases in outside of Dhaka. Eleven (25.5%) cases were positive for SARS -CoV-2 by RT- PCR within 3 days, among them 5 (11.6%) cases were within 24 hours of age. Nine (20.9%) and 23(53.5%) cases were test positive at day 4-7 and 8-28 days respectively. The main symptoms at admission were respiratory difficulty (12/43, 27.9%), fever (8/43, 18.6%), convulsion (8/43, 18.6%) and reluctance to feed (7/43, 16.6%). In neonate two or more diseases coexist in same cases. Sepsis was present in 20 (46.5%) cases with COVID-19. Perinatal asphyxia was present in 10(23.3%) and pneumonia in 8 (18.6%) cases. In laboratory findings low Hb% was present in 2/43(4.7%) cases, leukopenia in 4/43(9.3%), leukocytosis in 2/43(4.7%) and thrombocytopenia in 5/43(11.6%). Elevated CRP was present in 14/29 (32.6%) cases, hypernatremia in 10/33 (30.3%), hyponatremia in 1/33(3%), increased serum creatinine in 10/18(55.6%), and prolonged PT, aPTT in 2/2(100%). Hyperglycaemia was found in 1/15(6.7%) cases and hypoglycaemia in 2/15(13.3%). No organism was found in blood C/S. In chest X-ray, one showed patchy opacities in right lower lobe, another showed bilateral ground-glass opacity and third one revealed few patchy opacities in the right perihilar region. Among 43 cases 21(48.9%) were discharged with advice, 12(27.9%) cases referred to Covid-19 designated hospital, 2(4.7%) cases LAMA (Leave against medical advice) and 8(18.6%) cases died including one surgical case. A good number (43) of Covid-19 cases were found in this study. In neonates the clinical features could not be differentiated properly between Covid-19 or associated diseases unlike children and adult. The neonate may be a source of transmission of this disease. So, we should give proper emphasis on test, tracing and management of neonatal Covid-19.

Efficiency of natural oils as alternative adjuvants to mineral oils in inactivated avian influenza vaccine formulation.

1. The effectiveness of inactivated vaccines depends on selecting the suitable adjuvant for vaccine formulation. The potency of vaccines with low antigen content can be improved with the appropriate adjuvant. This could allow production of more doses and lower the production cost.2. This study evaluated the efficiency of vaccines prepared using oil extracted from natural sources including argan oil, almond oil, sesame seed oil, pumpkin oil, cactus oil and black seed oil as alternative adjuvants for improving the protection capacity of inactivated influenza virus vaccine as compared to commonly used mineral oils.3. Each vaccine formulation was evaluated for stability, safety and immunogenicity in chickens, as well as for reducing the viral shedding after challenge infection.4. The cactus, sesame and pumpkin seed oil-based vaccines were found to be potent and successfully induced the production of humoral immunity in vaccinated chickens.

Cervical Vertebral Bone Quality Score Independently Predicts Distal Junctional Kyphosis After Posterior Cervical Fusion.

BACKGROUND AND OBJECTIVE: Posterior cervical fusion is the surgery of choice when fusing long segments of the cervical spine. However, because of the limited presence of this pathology, there is a paucity of data in the literature about the postoperative complications of distal junctional kyphosis (DJK). We aimed to identify and report potential associations between the preoperative cervical vertebral bone quality (C-VBQ) score and the occurrence of DJK after posterior cervical fusion. METHODS: The authors retrospectively reviewed records of patients who underwent posterior cervical fusion at a single hospital between June 1, 2010, and May 31, 2020. Patient data were screened to include patients who were >18 years old, had baseline MRI, had baseline standing cervical X-ray, had immediate postoperative standing cervical X-ray, and had clinical and radiographic follow-ups of >1 year, including a standing cervical X-ray at least 1 year postoperatively. Univariate analysis was completed between DJK and non-DJK groups, with multivariate regression completed for relevant clinical variables. Simple linear regression was completed to analyze correlation between the C-VBQ score and total degrees of kyphosis angle change. RESULTS: Ninety-three patients were identified, of whom 19 (20.4%) had DJK and 74 (79.6%) did not. The DJK group had a significantly higher C-VBQ score than the non-DJK group (2.97 ± 0.40 vs 2.26 ± 0.46; P < .001). A significant, positive correlation was found between the C-VBQ score and the total degrees of kyphosis angle change (r 2 = 0.26; P < .001). On multivariate analysis, the C-VBQ score independently predicted DJK (odds ratio, 1.46; 95% CI, 1.27-1.67; P < .001). CONCLUSION: We found that the C-VBQ score was an independent predictive factor of DJK after posterior cervical fusion.

Thyroid Hormone Level in Children with Nephrotic Syndrome.

Nephrotic syndrome is the most common glomerular disease affecting children. Hypothyroidism is one of the most important complications which occur due to urinary loss of protein bound thyroid hormones, such as thyroxin binding globulin, transthyretin and albumin. This cross sectional study was conducted in the Department of Pediatric, Mymensingh Medical College Hospital (MMCH), Bangladesh from February 2018 to October 2019. This study was carried out to find out the thyroid profile in children with nephrotic syndrome and compared with thyroid profile of other acute illness in children. Total 122 children aged 2-12 years, further subdivided into Group A (n=61) suffering from nephrotic syndrome (1st attack, infrequent relapse) and Group B (n=61) other disease like viral fever, pneumonia, bronchiolitis, diarrhoea, UTI. Demographic details of patients and their relevant clinical details were obtained by an interviewer administered questionnaire. Blood for free T4, TSH were taken and compared between both groups. The mean FT4 values in Group A and Group B were 16.09±22.32fmol/ml and 68.22±11.65fmol/ml respectively, whereas the TSH level was significantly higher in Group A than controls (5.42±1.04 vs. 3.53±1.44). The T4 levels in nephrotic syndrome (Group A) patients were low. Analysis was done by using SPSS 22.0 version for windows software. Continuous and catagorical parameters were compared by unpaired 't' test and Chi-Square test. A p-value of 0.05 was considered significant. Hypothyroidism was found more in younger children i.e. age less than 6 years. This study concluded that children with nephrotic syndrome have a state of hypothyroidism.

Antimicrobial activity of essential oils of Curcuma longa and Syzygium aromaticum against multiple drug-resistant pathogenic bacteria.

The present study was conducted to investigate the antimicrobial potential of essential oils of Curcuma longa and Syzygium aromaticum against multidrug-resistant pathogenic bacteria. Four identified bacterial isolates including Methicillin-resistant Staphylococcus aureus (MRSA), Escherichia coli, Klebsiella pneumoniae, and Acinetobacter baumannii were selected and their antibiotic sensitivity was checked by disc diffusion assay. C. longa and S. aromaticum were subjected to steam distillation to obtain their essential oils. The crude essential oils were fractioned by employing column chromatography. Crude essential oils and their fractions were evaluated for their antibacterial activity by agar well diffusion assay and minimum inhibitory concentrations were calculated. All the selected bacterial isolates showed resistance to three or more than three antibiotic groups and were declared as multidrugresistant (MDRs). Crude essential oils of C. longa and S. aromaticum exhibited antimicrobial activity against all selected isolates but S. aromaticum activity was better than the C. longa with a maximum 19.3±1.50 mm zone of inhibition against A. baumannii at 1.04 µL/mL MIC. GC/MS analysis revealed the abundance of components including eugenol, eugenyl acetate, b- caryophyllene, and a- Humulene in both crude oil and fractions of S. aromaticum. While the main components of C. longa essential oil were Ar-tumerone, a-tumerone, b- Tumerone, I-Phellandrene, a-zingibirene, b- sesquiphellandrene, and p- Cymene. This study highlights that plant-based essential oils could be a promising alternative to antibiotics for which pathogens have developed resistance. C. longa and S. aromaticum carry compounds that have antimicrobial potential against multiple drug-resistant bacteria including MRSA. E. coli, K. pneumoniae and A. baumannii.

HOMA estimated insulin resistance as a marker for angiographic severity of coronary artery disease in non-diabetic and non-obese patients.

Background: Insulin resistance (IR) examined by homeostasis model assessment of insulin resistance (HOMA-IR) measures increased carotid atherosclerosis risks in non-diabetic and non-obese persons. The information about the relationship between IR and coronary atherosclerosis severity among non-diabetic and non- obese population showed conflicting results. The goal of the current study was to assess the relationship that links IR and coronary artery disease (CAD) among non-diabetic and non-obese Egyptian populations. Methods: 112 non-diabetic and non-obese patients were included in this study. These patients underwent coronary angiogram (CA) either due to acute coronary syndrome (ACS) or chronic stable angina with positive exercise tests. Results: Our study found a strong association between HOMA-IR and Gensini score (r = 0.831, with p<0.001) in general population. The HOMA-IR was the most influential independent predictor for the presence of extensive coronary atherosclerosis. Non-diabetic and non-obese people carrying the risk of developing the three-vessel disease (3VD) may be identified with a HOMA-IR score of over 5.9 according to the ROC curve analysis with a sensitivity of 67.7%. Conclusion: IR that developes in non-diabetic non-obese individuals coincides with more severe and more outspread CAD. In non-diabetic non-obese populations who need a CA, a single HOMA-IR value is higher than 5.9 may imply an elevated risk for clinically significant CAD. As insulin resistance is a reversible process, risk stratifications of CAD in non-diabetic non-obese populations could include HOMA-IR as one of its parameters.

Relationship between Clinical Profile, Severity and Outcome of Community Acquired Pneumonia with Hyponatremia in Children Aged 2-60 Months.

Hyponatremia is the most common electrolyte imbalance seen in clinical practice and a common laboratory findings in children with community acquired pneumonia. This study aimed to find out relationship between clinical profile, severity and outcome of community acquired pneumonia with hyponatremia in children aged 2-60 months. This descriptive cross-sectional study was done in pediatrics department of Mymensingh Medical College Hospital, Bangladesh. Study period was 6 month from November 2016 to April 2017. Data were collected from 2 months to 60 months old children who fulfill the selection criteria. In this study sampling technique was purposive. Detailed history was taken, and meticulous examinations and relevant investigations were performed. 100 patients with community acquired pneumonia were enrolled, 34.0% patient had hyponatremia and 66.0% patients had no hyponatremia. Hyponatremia is more marked (45.5%) in severe pneumonia followed by moderate pneumonia (33.3%) and no hyponatremia found in mild pneumonia. Mean temperature, respiratory rate, heart rate, head nodding, nasal flaring, grunting, stridor, cyanosis, convulsion, feeding problem, Poor air entry were significantly higher in patient of pneumonia with hyponatremia when compared to patient of pneumonia without hyponatremia. Mean duration of symptoms and mean duration of hospital stay were also significantly higher in patient of pneumonia with hyponatremia. The mean serum sodium concentration was 132.18±1.51mmol/L in hyponatremic patients and 137.91±1.94mmol/L in normonatremic patients. Mean values of total leucocyte count, ESR, and C-reactive protein were significantly higher in patient of pneumonia with hyponatremia. Serum hemoglobin was significantly lower in hyponatremic patients than normonatremic patients. Maximum (55.9%) patients of community acquired pneumonia (CAP) with hyponatremia had patchy opacity, 26.5% had consolidation, 11.8% had interstitial opacity and 5.9% had pneumatocele. All the patients were treated with appropriate antibiotics and fluid and discharged after complete recovery without any complication. There was no death in the study population. From this study we can conclude that, hyponatremia is directly related with the severity of community acquired pneumonia (CAP). The intensity of clinical profile and investigation findings are also directly related with the severity of pneumonia.

China's belt and road initiative (BRI) under the vision of 'maritime community with a shared future' and its impacts on global fisheries governance.

'Maritime Community with a Shared Future' is the broad vision through which China aims to lead the global fisheries governance. This research has been motivated by China's ambition of equating its maritime development goals with sustainable development goal - 14 (Life Below Water). Through this research, the influential role of China in 'global fisheries governance' has been put through an 'ocean governance mechanism at various levels (national, regional, and international). Therefore, China's role in 'global ocean and fisheries' are discussed side-by-side, focusing on and supporting a better understanding of China's potential challenges and opportunities in world fisheries. The role of China in global and regional fisheries governance has been critically analysed throughout the discussion. It is also discussed how China plays its part in Regional Fisheries Management Organisations (RFMOs) and how this role-playing can be utilised through the Belt and Road initiative (BRI) for effective governance, conservation and preservation of marine fisheries. The scope of China's national ocean and fisheries legislation is framed to support China's stance in leading global fisheries governance. The conclusion followed the discussion in descending order suggesting ocean and fisheries governance improvement and appropriate advocacy options available to China.