Calculated Fracture Risk among Hypertensive and Non-hypertensive Osteoporotic Women.

Vertebral and Hip fractures are the commonly encountered in low bone mass condition termed as osteoporosis. Bone mass and structure also affected by hypertension leading to increased susceptibility to fractures. This comparative cross-sectional study was conducted at two tertiary care centers in Dhaka metropolis from 1st January 2017 to 31st December 2017 under the department of Community Medicine, National Institute of Preventive and Social Medicine (NIPSOM) to assess whether HTN is linked with higher OP fracture risk. In this study 54 hypertensive and 34 non-hypertensive osteoporotic female patients were involved. After face to face interview data were collected by using semi-structured questionnaire and checklist. Online assessment of fracture risk probability was done among the two groups by Fracture Risk Assessment Tool (FRAX) and statistical analysis was performed by Statistical Packages for Social Sciences (SPSS-23.0). In this study it is found that the mean ages were 61.94±9.362 years and 59.18±11.269 years for hypertensive and non-hypertensive patients respectively. Most of the patients with hypertensive (96.3%) and non-hypertensive (82.4%) were housewives. Mean duration of hypertension in osteoporotic women was 6.41±4.049 years while mean duration of osteoporosis was 8.80±5.022 years and 7.53±5.920 years in hypertensive and non-hypertensive patients respectively. The difference in risk of major osteoporotic fractures (MOF) by age was significantly (Χ², p<0.05) higher among patients aged 60-79 years and remarkably higher in hypertensive patients. In hypertensive patients though the risk of MOF by hypertension was relatively higher but it was not significant statistically (Χ², p>0.05). However the risk of hip fracture (HF) by hypertension was relatively higher among hypertensive patients and it was significant statistically (Χ², p<0.05). This reflects that the risk of hip fracture is higher significantly in hypertensive patients.

Role of SSW on thermal-gradient induced domain-wall dynamics.

We study the thermal gradient (TG) induced domain wall (DW) dynamics in a uniaxial nanowire in the framework of the Stochastic-Landau-Lifshitz-Gilbert equation. TG drives the DW in a certain direction, and DW (linear and rotational) velocities increase with TG linearly, which can be explained by the magnonic angular momentum transfer to the DW. Interestingly, from Gilbert damping dependence of DW dynamics for fixed TG, we find that the DW velocity is significantly smaller even for lower damping, and DW velocity increases with damping (for a certain range of damping) and reaches a maximal value for critical damping which is contrary to our usual desire. This can be attributed to the formation of standing spin wave (SSW) modes (from the superposition of the spin waves and their reflection) together with travelling spin wave (TSW) modes. SSW does not carry any net energy/momentum to the DW, while TSW does. Dampingαcompels the spin current polarization to align with the local spin, which reduces the magnon propagation length and thusαhinders to generate SSWs, and contrarily the number of TSWs increases, which leads to the increment of DW speed with damping. For a similar reason, we observe that DW velocity increases with nanowire length and becomes saturated to maximal value for a certain length. Therefore, these findings may enhance the fundamental understanding as well as provide a way of utilizing the Joule heat in the spintronics (e.g. racetrack memory) devices.

Nosocomial Infection Among Burn Patients Admitted to a Tertiary Care Hospital of Bangladesh: A Cross-Sectional Study.

Nosocomial infection is a major challenge for the appropriate management of burns. The present study aimed to investigate incidence, risk factors, and causative organisms of nosocomial infection in burn patients of Khulna, Bangladesh. This cross-sectional study was conducted among patients admitted to the Burn and Plastic Surgery Department of Khulna Medical College Hospital (KMCH) from January to December 2020. Relevant data were collected from the patients' hospital records. Samples of wound swabs and blood were collected and cultured in the microbiology laboratory of KMCH. Logistic regression models were used to determine risk factors for infective complications in burn patients. All statistical analyses were carried out using SPSS version 26.0. A total of 100 burn patients were included. Mean age was 29.2 years with a male-female ratio of 1.3:1. Flame burns were most prevalent among the patients (41%), followed by scald (23%) and electric burns (15%). Almost 40% patients had full thickness burn. The incidence of nosocomial infection was 42% (wound infection 33% and septicemia 9%). Total body surface area of burn >40% (OR 7.56, 95% CI 2.89-19.81), full thickness burn (OR 34.40, 95% CI 3.25-97.14) and prolonged hospital stay (aOR 1.31, 95% CI 1.15-1.51) were significant risk factors for nosocomial infection. Staphylococcus aureus was the most commonly isolated organism (45%), followed by Streptococcus (24%), Pseudomonas aeruginosa (19%) and Escherichia coli (12%). As the epidemiology of nosocomial infection is not the same in different health facilities, a facility-based comprehensive burn management protocol considering the local epidemiology and causative organisms of burn wound infection is crucial for the prevention and management of nosocomial infections in burn patients.

Les infections nosocomiales sont une préoccupation majeure du traitement bien conduit des brûlés. Cette étude a eu pour but d'évaluer l'incidence, les facteurs de risque de survenue et les bactéries isolées d'infections nosocomiales survenues dans le CTB de Kulna (Bangladesh). Elle a étudié les dossiers l'ensemble des 100 patients admis dans le CTB du CHU de Kulna en 2020. Les analyses bactériologiques ont été réalisées dans le laboratoire du CHU. Une régression logistique a été utilisée pour déterminer les facteurs de risque d'infection. Toutes les analyses statistiques ont été réalisées avec SSPS 26.0. L'âge moyen était de 29,2 ans, le sex-ratio de 1,3H/1F. Les flammes représentaient 41% des causes, les liquides 23% et l'électricité 15%. Quasiment 40% des patients avaient des brûlures profondes. L'incidence des accidents infectieux était de 42% (cutanée 33%, bactériémies 9%). Les facteurs de risque indépendants de survenue d'une infection étaient une atteinte sur >40 % SCT (OR 7,56; IC95 2,89-19,81), une brûlure profonde (OR 34,40 ; IC95 3,25-97,14) et un séjour prolongé (OR 1,31; IC95 1,15-1,51). Les quatre bactéries les plus fréquentes étaient S. aureus (45%), Streptococcus spp (24%), P. æruginosa (19%), et E. coli (12%). Les épidémiologies bactériennes variant selon les services d'où elles sont issues, c'est sur l'épidémiologie locale que doivent se centre les mesures de contrôle des infections nosocomiales.

Magnesium for Implants: A Review on the Effect of Alloying Elements on Biocompatibility and Properties.

An attempt is made to cover the whole of the topic of biodegradable magnesium (Mg) alloys with a focus on the biocompatibility of the individual alloying elements, as well as shed light on the degradation characteristics, microstructure, and mechanical properties of most binary alloys. Some of the various work processes carried out by researchers to achieve the alloys and their surface modifications have been highlighted. Additionally, a brief look into the literature on magnesium composites as also been included towards the end, to provide a more complete picture of the topic. In most cases, the chronological order of events has not been particularly followed, and instead, this work is concentrated on compiling and presenting an update of the work carried out on the topic of biodegradable magnesium alloys from the recent literature available to us.

Evaluation of Short Term Outcome of Stapled Transanal Rectal Resection (STARR) for ODS (Obstructed Defecation Syndrome) by Comparing Pre and Post-operative ODS Score.

Obstructed defecation syndrome (ODS) is a common anorectal problem and it can be corrected by various surgical approaches but most of these have high recurrence and complication rates. Antonio Longo introduced Stapled transanal rectal resection (STARR) in 2003 as a minimally invasive transanal operation for correction ODS associated with rectocele and or rectal intussusception. This study was designed to assess the short term outcome of Stapled Transanal Rectal Resection (STARR) as a surgical treatment of Obstructed Defecation Syndrome (ODS). This is a quasi experimental study which was carried out in the department of Colorectal Surgery, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh from May 2016 to June 2017. Seventeen (17) patients were included in the study. Patients with obstructed defecation syndrome and rectocele and or rectal intussusception admitted in the department of Colorectal Surgery were enrolled in the study as per inclusion and exclusion criteria. History, clinical examination, Proctoscopy, Colonoscopy and MR Defecography was done for evaluation of the patients. During evaluation preoperative Longo's ODS score of every patient also determined and compared with postoperative ODS score. The patient was followed up regularly at one, three and six months after each operation. The ODS score in 82.35% patients improved significantly. The postoperative score was high (13-15) only in 02(11.8%) patients probably due to presence of physiological factors. Post-operative defecatory urgency was developed in only 02(11.76%) patients. Major postoperative complication like hemorrhage or rectovaginal fistula did not develop in any patient. STARR is an effective, less invasive and simple procedure for the treatment of ODS with rectocele and/or rectal intussusception without major morbidity but other physiological causes of ODS should exclude preoperatively because its presence makes the surgical intervention fruitless.

Antimicrobial Resistance of E Coli Causing Urinary Tract Infection in Bangladesh.

Rapid spread of multidrug resistant microorganisms is a matter of great concern throughout the glove including Bangladesh. The objective was to identify the causative organisms for urinary tract infection (UTI) and their sensitivity patterns to antibiotics. This descriptive cross-sectional study was conducted on patients admitted with UTI (n=60) at a tertiary level hospital in Dhaka, Bangladesh from March 2019 to September 2019. Data were collected through clinical record reviews. Data of all these 60 cases were analyzed for socio-demographic characteristics. Of the 60 patients, culture and sensitivity report was available for 42 patients. Therefore, data were further analyzed for these 42 cases. Median age of patients was 35 years and 80% were female. The main organisms isolated from urine culture of UTI patients were E. coli (64%), Klebsiella (12%) and Enterococci species (10%). Susceptibility to antibiotics was analyzed only for E. coli (n=27) since the number of isolates of other organisms were small. E. coli was found to be resistant to most of the first- and second-line antibiotics, such as Amoxicillin (100%), Amoxyclav (72%), Co-trimoxazole (89%), Nalidixic acid (78%), Ceftazidim (94%), Ceftriaxone (73%), Cefuroxime (100%), Ciprofloxacin (59%), Cephotaxime (80%), Cefixime (100%) and Moxifloxacin (100%). E. coli was the predominant organism responsible for UTI and was resistant to most of the first- and second-line antibiotics. Immediate action is needed to develop empirical guideline for empirical management of UTI and establish surveillance system for monitoring.

Deep Learning for Reliable Classification of COVID-19, MERS, and SARS from Chest X-ray Images.

Novel coronavirus disease (COVID-19) is an extremely contagious and quickly spreading coronavirus infestation. Severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS), which outbreak in 2002 and 2011, and the current COVID-19 pandemic are all from the same family of coronavirus. This work aims to classify COVID-19, SARS, and MERS chest X-ray (CXR) images using deep convolutional neural networks (CNNs). To the best of our knowledge, this classification scheme has never been investigated in the literature. A unique database was created, so-called QU-COVID-family, consisting of 423 COVID-19, 144 MERS, and 134 SARS CXR images. Besides, a robust COVID-19 recognition system was proposed to identify lung regions using a CNN segmentation model (U-Net), and then classify the segmented lung images as COVID-19, MERS, or SARS using a pre-trained CNN classifier. Furthermore, the Score-CAM visualization method was utilized to visualize classification output and understand the reasoning behind the decision of deep CNNs. Several deep learning classifiers were trained and tested; four outperforming algorithms were reported: SqueezeNet, ResNet18, InceptionV3, and DenseNet201. Original and preprocessed images were used individually and all together as the input(s) to the networks. Two recognition schemes were considered: plain CXR classification and segmented CXR classification. For plain CXRs, it was observed that InceptionV3 outperforms other networks with a 3-channel scheme and achieves sensitivities of 99.5%, 93.1%, and 97% for classifying COVID-19, MERS, and SARS images, respectively. In contrast, for segmented CXRs, InceptionV3 outperformed using the original CXR dataset and achieved sensitivities of 96.94%, 79.68%, and 90.26% for classifying COVID-19, MERS, and SARS images, respectively. The classification performance degrades with segmented CXRs compared to plain CXRs. However, the results are more reliable as the network learns from the main region of interest, avoiding irrelevant non-lung areas (heart, bones, or text), which was confirmed by the Score-CAM visualization. All networks showed high COVID-19 detection sensitivity (> 96%) with the segmented lung images. This indicates the unique radiographic signature of COVID-19 cases in the eyes of AI, which is often a challenging task for medical doctors.

Milestones of Development in Infancy: A Prospective Study in a Tertiary Level Hospital of Bangladesh.

The timing of milestone is influenced by many factors. Sex and socioeconomic status has significant effect to some psycomotor milestones. The study was conducted to determine the pattern of milestones of development of infants in our country and to compare it in different sex and socioeconomic condition. It was a hospital based prospective study done in Sir Sallimullah Medical College and Mitford Hospital, Dhaka, Bangladesh from October 2014 to November 2015. Healthy term newborn infants with average birth weight were included in this study and milestones of this birth cohort were assessed monthly from birth to 12 months of age by using a set of 60 milestones. Total number of 217 babies was enrolled but during follow up 0.9% developed meningitis, 43.7% was lost to follow up and 55.2% of the cohort was followed up to 12 months of age. Among 120 babies 51.7% were male, 48.3% were female babies and 51.7% belong to lower, 32.5% middle and 15.8% upper socioeconomic group. There was no significant difference between male and female infants achieving most of the milestones of development except in language development in which female infants were little bit higher than male infants.

Diagnostic Value of Clinical Profile and Proposed a Clinical Diagnostic Criterion of Enteric Fever.

Enteric fever is a common bacterial infection in the tropics and endemic to Bangladesh. The volatile manifestations of enteric fever construct this disease a true diagnostic confrontation. There are limited current objective data on the value of individual clinical features of enteric fever in the diagnosis of enteric fever. The aim of the study was analysis of clinical features and also proposed a clinical diagnostic criterion of enteric fever among adult in Bangladesh. This cross-sectional comparative study was performed among which of fifty confirmed enteric fever and hundred non enteric febrile adult patients in Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh from January 2015 to December 2015. Purposive sampling technique was implied for convenience of the study. In this study, history of step ladder fever, diarrhoea and relative bradycardia, ceacal gurgle, abdominal distension were proved to be powerful markers of enteric fever with high specificity (100.0%, 90.0%, 95.0%, 92.0% and 95.0% respectively). Tender right iliac fossa (RIF) and coated tongue, hepatomegaly were moderately powerful with 86.0%, 88.0%, 89.0% specificity respectively. Positive predictive value (PPV) was highest for step ladder fever (100%) and negative predictive value (NPV) was highest for headache (92.5%). Highest sensitivity, PPV and NPV were found for relative bradycardia and tender RIF but most of the signs had good specificity. Regarding accuracy it was highest for step ladder fever (91.3%), relative bradycardia (94%), tender RIF (87%), coated tongue (82%) and splenomegaly (84%). Therefore, a clinical diagnostic criterion was submitted with diagnostic accuracy more than 70% were taken into deliberation. The Major criteria were considered step ladder fever, relative bradycardia, tender RIF with diagnostic accuracy 91.0%, 94.0% and 87.0% respectively. Minor criteria included splenomegaly, diarrhoea, coated tongue, ceacal gurgle, chills with diagnostic accuracy 85.0%, 85.0%, 82.0%, 76.0%, 72.0% respectively and after amalgamation of various major and minor criteria a final diagnostic criterion was submitted having accuracy more than 60.0%. In conclusion the clinical profile of enteric fever in culture proven patients with a view to highlight the predictive value of those features which would help general practitioners in the diagnosis and empiric treatment.

COVID-19 Rehabilitation Response in Bangladesh: Ongoing Efforts and Future Directives.

COVID-19 pandemic brings significant number of post-acute and chronic disabilities requiring attention to Physical Medicine and Rehabilitation (PMR) services. Total Health and Rehabilitation sector in Bangladesh is overwhelmed; patient care and academic activities are seriously impacted by this pandemic. Rehabilitation team works and academic calendar is disrupted. Bangladesh PMR working to manage COVID-19 imposed rehabilitation challenges with adjustment and adaptations of the existing facilities. There is an urgent need to undertake additional measures promptly, including rehabilitation capacity building anticipating the potential challenge that would be faced by the hospitals in the estimated upsurge of COVID-19 cases and its complications thereafter. This topic highlights the activity log for COVID-19 preparedness and mitigation for rehabilitation services in Bangladesh with a message for other rehabilitation settings in the world.

In-Vivo and Ex-Vivo Measurements of Blood Glucose Using Whispering Gallery Modes.

The permittivity of blood glucose is not a strong function of its concentration in microwave or millimeter-wave frequencies. Measuring glucose concentrations remains a challenge, particularly in the presence of interference caused by the ambient leaky waves. In this paper, however, we demonstrate that a near-linear correlation between the glucose concentration and the blood permittivity was noticeably observed at a whispering gallery mode resonance. METHOD: the proposed sensor was a vacuum suction aspirator partially wounded with a turn of the Goubau line. This arrangement enabled a fixed cylindrical volume of a skin tissue bump or glucose/water solution to be formed and used as a whispering gallery resonator for in-vivo and ex-vivo measurements. RESULTS: in the in-vivo study, a near-linear correlation between the glucose levels and the S21 parameters was noticeably observed at the fundamental whispering gallery resonance (i.e., at 2.18 GHz). In the ex-vivo study, a similar correlation was observed between the concentration of a glucose/water solution and the S21 parameters 56.6 GHz. CONCLUSION: the results of both investigations were consistent not only with the invasive measurements using the Accu-checkTM, but also with the conclusion drawn by some other research groups who have successfully measured blood glucose concentrations at millimeter-wave frequencies.

Legg-Calve-Perthes Disease: Correlation between Computed Radiography and Magnetic Resonance Imaging.

The purpose of this study is to diagnose Legg-Calve-Perthes disease by computed radiography and Magnetic resonance imaging and accurate staging and correlating the findings of these two modalities. Thirty five (35) patients complaining pain in groins and painful walking, after thorough physical examinations were sent to Department of Radiology & Imaging, Mymensingh Medical College Hospital, Mymensingh, Bangladesh for computed radiography and Magnetic Resonance Imaging examination. This cross sectional study was conducted in the Department of Radiology, Mymensingh Medical College Hospital, Mymensingh, Bangladesh from July 2016 to June 2018. Legg-Calve-Perthes disease among the selected 35 cases were started at the age of 5(2.9%) and age range of the patients were 5-13 years; mean age was (9.63±1.82) years and most of them belonged to 8-10 years of age (51.4%). Patients with Legg-Calve-Perthes disease had been suffering from pain in right and left groins forvarious durations. Maximum duration was 1-2 years (~88.57%). Maximum proportion of diagnosed patients was delivered by normal delivery (60%) and maximum proportion of patients was premature (65.7%). Most of the patients were low birth weight baby (65.7%). Here chi-square test was done and found no significant relationship between delivery mode and birth weight in case of Legg-Calve-Perthesdisease (x²=1.712) (P=0.191). The result of the X-ray and MRI findings by cross table of chi square test found fair inter relationship between two diagnostic instruments. Result found fine difference in staging of the disease between X-ray and MRI findings. It can be said that MRI definitely a better tool for early diagnosis of Legg-Calve-Perthes disease and its staging but X-ray modality can be used. A primary tool for diagnosis and staging of the disease can be done where the MRI facility is not available or cost expensive for patient.

A Low Cost and Portable Microwave Imaging System for Breast Tumor Detection Using UWB Directional Antenna array.

Globally, breast cancer is a major reason for female mortality. Due to the limitations of current clinical imaging, the researchers are encouraged to explore alternative and complementary tools to available techniques to detect the breast tumor in an earlier stage. This article outlines a new, portable, and low-cost microwave imaging (MWI) system using an iterative enhancing technique for breast imaging. A compact side slotted tapered slot antenna is designed for microwave imaging. The radiating fins of tapered slot antenna are modified by etching nine rectangular side slots. The irregular slots on the radiating fins enhance the electrical length as well as produce strong directive radiation due to the suppression of induced surface currents that radiate vertically at the outer edges of the radiating arms with end-fire direction. It has remarkable effects on efficiency and gain. With the addition of slots, the side-lobe levels are reduced, the gain of the main-lobe is increased and corrects the squint effects simultaneously, thus improving the characteristics of the radiation. For experimental validation, a heterogeneous breast phantom was developed that contains dielectric properties identical to real breast tissues with the inclusion of tumors. An alternative PC controlled and microcontroller-based mechanical MWI system is designed and developed to collect the antenna scattering signal. The radiated backscattered signals from the targeted area of the human body are analyzed to reveal the changes in dielectric properties in tissues. The dielectric constants of tumorous cells are higher than that of normal tissues due to their higher water content. The remarkable deviation of the scattered field is processed by using newly proposed Iteratively Corrected Delay and Sum (IC-DAS) algorithm and the reconstruction of the image of the phantom interior is done. The developed UWB (Ultra-Wideband) antenna based MWI has been able to perform the detection of tumorous cells in breast phantom that can pave the way to saving lives.

Thermal gradient driven domain wall dynamics.

The issue of whether a thermal gradient acts like a magnetic field or an electric current in the domain wall (DW) dynamics is investigated. Broadly speaking, magnetization control knobs can be classified as energy-driving or angular-momentum driving forces. DW propagation driven by a static magnetic field is the best known example of the former in which the DW speed is proportional to the energy dissipation rate, and the current-driven DW motion is an example of the latter. Here we show that DW propagation speed driven by a thermal gradient can be fully explained as the angular momentum transfer between thermally generated spin current and DW. We found DW-plane rotation speed increases as DW width decreases. Both DW propagation speed along the wire and DW-plane rotation speed around the wire decrease with the Gilbert damping. These facts are consistent with the angular momentum transfer mechanism, but are distinct from the energy dissipation mechanism. We further show that magnonic spin-transfer torque (STT) generated by a thermal gradient has both damping-like and field-like components. By analyzing DW propagation speed and DW-plane rotational speed, the coefficient ([Formula: see text]) of the field-like STT arising from the non-adiabatic process, is obtained. It is found that [Formula: see text] does not depend on the thermal gradient; increases with uniaxial anisotropy [Formula: see text] (thinner DW); and decreases with the damping, in agreement with the physical picture that a larger damping or a thicker DW leads to a better alignment between the spin-current polarization and the local magnetization, or a better adiabaticity.

Clinical and Neuro-radiological Presentation of Tuberous Sclerosis Complex in Tertiary Care Centre.

Tuberous sclerosis complex (TSC) is a common neurocutaneous disorder characterized by hamartomatous changes in the lungs, brain, kidneys, skin, heart, and other organs. This retrospective study was done to see the clinical presentation and neuro imaging pattern of TSC in a tertiary care centre of Bangladesh and was conducted at Pediatric Neurology Unit of Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from January 2013 to December 2013. Among total 10 patients male-female ratio was 3:2. Commonest age group was 1-5 year in 50%. Common cutaneous abnormality was facial angiofibroma in 100%. Commonest neurological presentation was epilepsy in100%, ASD in 20% patient. Common renal manifestation was multicystic kidney disease (20%). CT/MRI findings were periventricular calcifications in 70% patients. In this study facial angiofibroma is the most common skin manifestation and epilepsy is the common neurological presentationandperiventricular calcification is the most common neuro-radiological findings in tuberous sclerosis complex.

Transcriptome analysis, using RNA-Seq of Lomandra longifolia roots infected with Phytophthora cinnamomi reveals the complexity of the resistance response.

The plant pathogen Phytophthora cinnamon the causal agent of disease in numerous species, is a major threat to natural vegetation and has economic impacts in agriculture. The pathogen principally invades the root system, which, in susceptible species, is rapidly colonised and functionally destroyed. Few species are resistant, however, where resistance is expressed the pathogen is restricted to small, localised lesions. The molecular mechanisms that underpin this response in resistant species are not well understood. Lomandra longifolia, an Australian native species, is highly resistant to P. cinnamomi. In an earlier study, we showed induction of resistance-related components such as callose, lignin and hydrogen peroxide (H2 O2 ) in L. longifolia roots that had been inoculated with P. cinnamomi. Here, in order to further identify, during the very early stages of infection, the molecular components and regulatory networks that may trigger resistance, a comprehensive root transcriptome analysis was performed using next generation sequencing. Overall, 18 cDNA libraries were produced generating 52.8 GB 126 base pair reads, which were de novo assembled into contigs. Differentially expressed genes (DEGs) were identified allowing the identification of infection-responsive candidate genes that were putatively related to resistance, and from this set ten were selected for qRT-PCR to validate the RNA-Seq expression value. Further analysis of individual candidates revealed that many were involved in PAMP-triggered immunity (PTI; pattern recognition receptors, glutathione S-transferase, callose synthases, pathogenesis-related protein-1, mitogen activated protein kinases) and effector-triggered immunity (ETI) (NBS-LRR, signalling genes, transcription factors and anti-pathogenic compound synthase genes). As these candidate genes or mediated components activate different defence signalling systems, they may have potential for investigation of novel approaches to disease control and in transgenic approaches for improvement, in susceptible species, of resistance to P. cinnamomi.

Incidence of Diabetes Insipidus in Postoperative Period among the Patients Undergoing Pituitary Tumour Surgery.

Post operative complications after pituitary tumour surgery vary according to procedure. There are several surgical procedures being done such as transcranial, transsphenoidal microsurgical and transsphenoidal endoscopic approaches. One of the commonest complications is diabetes insipidus (DI). Our main objective was to find out the incidence of diabetes insipidus in post operative period among patients undergoing surgical intervention for pituitary tumour in our institute. The presence of diabetes insipidus in the postoperative period was established by measuring serum Na+ concentration, hourly urine output and urinary specific gravity to find out the incidence of diabetes insipidus in postoperative period in relation to age, gender, tumour diameter, function of tumour (i.e., either hormone secreting or not) and operative procedure used for surgical resection of pituitary tumor. As it is the most common postoperative complication so, in this study we tried to find out how many of the patients develop diabetes insipidus in postoperative period following surgical resection of pituitary tumour. This cross sectional type of observational study was carried out in the department of Neurosurgery, BSMMU from May 2014 to October 2015 on 33 consecutive patients who underwent surgical intervention for pituitary tumour for the first time. Data was collected by using a data collection sheet. The incidence of diabetes insipidus was found 23.1% of patients in <30 year age group, 38.5% of patients in 31-40 year age group and 38.5% of patients in ≥40 year age group (p=0.764). In case of distribution of patients according to gender 38.5% of male and 61.5% of female developed diabetes insipidus (p=0.073). Regarding tumour size 30.8% and 69.2% of patients developed diabetes insipidus having tumour diameter <30mm and ≥30mm respectively (p=0.590). In case of operative procedure 69.2% of patients developed diabetes insipidus who was operated by transsphenoidal endoscopic approach, 23.1% and 7.7% of patients developed diabetes insipidus who underwent pituitary tumour resection through transsphenoidal microscopic approach and transcranial microscopic approach respectively (p=0.432). 17.6% of patients develop DI having functioning pituitary macroadenoma and 62.5% of patients develop DI having nonfunctioning pituitary macroadenoma. This observational study has been performed to find out the incidence of diabetes insipidus. Incidence of postoperative DI is more at or around the age of 40 years. It is slightly predominant in female. Most of the patients manifest DI in the first 24 hours of surgical intervention. Incidence of DI is low among patients having functioning pituitary macroadenoma.

Acinar Cell Carcinoma of the Pancreas: A Case Report.

Acinar cell carcinoma (ACC) of the pancreas is a very rare neoplasm. We report a case of pancreatic acinar cell carcinoma involving the uncinate process of the pancreas. A 45 year old man presented with a painful upper abdominal mass without any jaundice or weight loss. Computed Tomography (CT) and Magnetic Resonance Cholangio-Pancreatography (MRCP) indicated a mass lesion in the uncinate process of the pancreas. He underwent Whipple's procedure (Pancreaticoduodenectomy). Histological slides revealed features of Acinar cell carcinoma (ACC) in the uncinate process of the pancreas and a lymph node.