Study of Body Mass Index, Blood Pressure, Serum Sodium in Newly Diagnosed Hypertensive Patients.

Hypertension 'The sustained elevation of systemic arterial pressure' is a significant risk factor for heart disease, stroke and other cardiovascular diseases and an estimated 970 million people worldwide suffer from the disease resulting in significant morbidity, mortality and financial burden globally. It is the leading modifiable risk factor for morbidity and mortality worldwide. Worldwide an estimated 1.28 billion adults aged 30-79 years have hypertension, the majority (two-thirds) living with low and middle income countries. One of the global targets for non-communicable diseases is to reduce the prevalence of hypertension by 33% between 2010 and 2030.Sodium plays an important role in blood pressure regulation with a reduced sodium intake being associated with a reduction in systolic and diastolic blood pressure. This study was done to evaluate the differences in body mass index (BMI) and serum sodium in hypertensive and normotensive subjects. This analytical type of cross sectional study was carried out in the Department of Physiology, Mymensingh Medical College, Mymensingh between the periods from January 2022 to December 2022. A total number of 140 male subjects, age ranged from (30-59) years were included in this study. Among them, seventy (70) hypertensive subjects were taken as study group (Group II) and seventy (70) age matched normotensive subjects were taken as control group (Group I). The results were calculated and analyzed by using Statistical Package for Social Science (SPSS) version 26.0. Anthropometric measurements like height and weight taken in meter and kilogram respectively. Systolic and diastolic blood pressure was performed by aneroid sphygmomanometer (ALPK2, Japan), laboratory analysis of serum sodium by colorimetric method. In this study we found that body mass index in control group 23.59±1.29 kg/m² and study group 26.81±2.31kg/m²; blood pressure (systolic pressure in control group 113.21±6.76 mm Hg and in study group 149.14±5.03 mm Hg, diastolic pressure in control group 75.57±4.55 mm Hg and in study group 100.21±5.28 mm Hg) and serum sodium in control group 138.84±2.12 & in study group was 147.94±1.41 which were significant in study group in comparison with control group. In study group parameters were significantly increased in comparison to control male group. Therefore, by this study we recommended that routine estimation of these parameters is important for prevention of complication related to hypertension for leading a healthy life.

Study on Body Mass Index, Serum Total Cholesterol and Serum Triglycerides in Adult Male Hypertensive Patients.

Hypertension or elevated blood pressure is a serious medical condition that significantly increases the risks of heart, brain, kidney and other diseases. An estimated 1.28 billion adults aged 30-79 years worldwide have hypertension, most (two-thirds) living in low- and middle-income countries. An estimated 46.0% of adults with hypertension are unaware that they have the condition. In Bangladesh, 21.3 million of the adult population has hypertension and that is 21.0% of total population. About half of them (48.7%) with hypertension are diagnosed and 34.9% are under treatment. One of the global targets for non communicable diseases is to reduce the prevalence of hypertension by 33.0% between 2010 and 2030. This study was done to evaluate the effects of hypertension and to find out the major complications occurring due to hypertension. This analytical type of cross sectional study was carried out in the Department of Physiology, Mymensingh Medical College, Mymensingh, Bangladesh from January 2021 to December 2021. A total number of 120 male subjects, age ranged from 20-59 years was included in this study. Among them, sixty (60) hypertensive subjects were taken as study group (Group II) and sixty (60) ages matched normotensive adult male subjects were taken as control group (Group I). The results were calculated and analyzed by using Statistical package for social science (SPSS). Anthropometric measurements such as height and weight were taken in meter and kilogram respectively. Systolic and diastolic blood pressure were measured by Aneroid Sphygmomanometer (ALPK2, Japan), laboratory analysis of fasting serum total cholesterol by CHOD-POD method, fasting serum triglycerides by GPO-POD method. In this study we found that in study group Mean±SD of body mass index (29.36±2.60, p<0.001), fasting serum total cholesterol (232.05±11.18, p<0.001) and fasting serum triglycerides (180.67±19.44, p<0.001) which were significantly increased with comparison to control group. It's concluded from this study we recommended that routine estimation of these parameters is important for prevention of complication related to hypertension for leading a healthy life.

Platelet Count as a Prognostic Factor in Stage IV Non-Small Cell Lung Cancer.

Increase platelet count can accompany various cancers including lung cancer. This finding has recently been suggested to indicate poor prognosis. In patients with malignancies, thrombocytosis has previously been related disease stage, histological type and survival. In this study, the prevalence of thrombocytosis and the prognostic information provided by platelet count were analyzed in patients with stage IV Non-Small Cell Lung Cancer (NSCLC) with an aim to assess elevated platelet count as a prognostic factor in patients with stage IV NSCLC and to investigate whether there is relationship between thrombocytosis, other clinico-pathologic factors and median survival. This prospective observational study was conducted in National Institute of Cancer Research and Hospital (NICRH), Dhaka, Bangladesh from September 2019 to August 2020. A total of 108 patients were enrolled purposively. Detail history taking, thorough physical examination was done along with relevant investigations. Data were collected by semi structured questionnaire and analysis was done with the help of Statistical Package for Social Science (SPSS), version 21.0. The mean age of the patients was found 56.4±12.2 years with range from 35 to 75 years. Majority (79.6%) patients were male, 52.8% patients came from low income and 36.1% were farmer. Majority (40.7%) were symptomatic; in bed >50.0% of day. Almost two third (59.3%) had <5.0% weight loss. Almost three fourth (69.4%) had squamous cell carcinoma. At the time of first assessment 75(69.4%) patients had normal and 33(30.6%) had elevated platelet count level. Age, sex and histological type were statistically not significant between normal and elevated platelet count level groups. But performance status, weight loss were statistically significant (p<0.05) between two groups. According to univariate analysis, age, performance status at presentation, weight loss more than 10.0% for 3 months and platelet count prior the start of treatment were all significant predictors for the overall survival. In multivariate analysis age, performance status at presentation and initial thrombocytosis were independent prognostic determinants for overall survival. Median survival time was significantly higher for the normal platelet count group and elevated platelet count group (7.5 months versus 5.5 months) respectively (95% CI, 5.5-7.5), p<0.001. The frequency of thrombocytosis in patients with stage-IV NSCLC at first presentation was 30.6% and median survival time in these patients was significantly shorter compared in patients without thrombocytosis. These results concluded that an elevated platelet count could be a useful prognostic factor for survival in patients with stage-IV NSCLC.

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.

Prevalence of Microalbuminuria and Overt Proteinuria in Diabetes Mellitus and their Association with Renal Function.

This cross sectional observational study was conducted in the Department of Nephrology, Mymensingh Medical College Hospital, Mymensingh, Bangladesh from April 2009 to March 2010. Samples were collectedfrom rural area of Khalishaur union of Purbadhala upazilla in Netrakona District, 30km away from Mymensingh Town. The main objective of the study was to find out the prevalence of microalbuminuria as well as overt proteinuria in diabetes mellitus in a rural population and to observe their association with renal function. In this study 1048 adult participants of 18 to 65 years in a rural area of Netrakona were included purposively as study subjects. Among them 54% were male and 46% were female. Mean age of study subjects was 42.4±13.4 years. Prevalence of microalbuminuria among diabetic participants was 29.72% where as in non diabetic non hypertensive participants it was 6.62%. Diabetic persons 9.45% and 3.9% of non diabetic participants showed overt proteinuria by dipstick test. Prevalence of hypertension in diabetic and non diabetic participants was 45.94% and 16.52% respectively. The mean eCCr of the diabetic patients and non-microalbuminuric healthy persons was 78.4±25.4 ml/min/1.73m² and 94.67±24.8 ml/min/l.73m² respectively according to Cock Croft-Gault equation. The mean eCCr of diabetic participants with overt proteinuria was 57.44±28.33 ml/min/l.73m² but diabetic patients with microalbuminuria had better mean eCCr 80.62±21.17 ml/min/1.73m² which justifies the importance of detection of microalbuminuria for early intervention. By regression analysis it was found that degree of microalbuminuria had linear relation with renal function and random blood sugar level. Neither BMI nor duration of diabetes showed any correlation with urine microalbumin. There was no effect of sex on the prevalence of microalbuminuria in diabetes mellitus. Microalbuminuria is the first sign of renal involvement in diabetic patients which is a risk factor for overt nephropathy. Monitoring of this condition is important because early treatment of microalbuminuria can prevent or postpone overt nephropathy.

Effect of Obesity on Fasting Blood Sugar.

Obesity is a disorder of body weight regulatory systems characterized by an accumulation of excess body fat. World Heath Organization recommended that 66% of deaths now occur in developing countries and recognizes obesity as a leading risk factor. Obesity is associated with chronic, low grade, systemic inflammation. The inflammatory state plays a causal role in the development of insulin resistance, type 2 diabetes and the metabolic syndrome. This study will design to evaluate the relation between obesity with fasting blood sugar (FBS). This descriptive type of cross sectional study had been performed to investigate the relationship between obesity with serum fasting glucose, of 100 obese and 100 normal weight persons from both sexes, aged between 25 to 60 years will be selected from Mymensingh Medical College, Mymensingh, Bangladesh and locality from July 2014 to January 2016. Data are collected through a simple questionnaire after informed consent taken. The result was calculated and analyzed by using SPSS (statistical package for social science, version 11.5). Statistical significance of difference between two groups was evaluated by unpaired Student's 't' test. Data were expressed as Mean±SE. P value less than 0.05 was taken as the level of significance. Anthropometric measurements such as height and weight were taken in meter and kilogram respectively. Pulse, systolic and diastolic blood pressure was measured by aneroid sphygmomanometer (ALPK2, Japan), laboratory analysis of serum fasting glucose will be estimated by GOD-PAP Method. In this study we found that fasting serum glucose is significantly increased in both male and female obese persons 4.07±0.79mmol/l & 5.58±0.64mmol/l respectively. In obese the values of FBS indicate the subjects are prone to develop cardiovascular & metabolic diseases. That has high morbidity and mortality. Therefore, by this study we recommended that routine estimation of fasting blood sugar is important for prevention of complication related to obesity for leading a healthy life.

Relationship of Hemoglobin Concentration in Adult Asthmatic Patients.

Asthma is a chronic inflammatory disorder of the airways, in which many cells and cellular elements play a role. Asthma is one of the most common diseases globally and currently affects 300 million people. The epidemic rise in anemia, asthma, and related allergic disease is a common major public health problem worldwide. Asthma and anemia associated with acute infections occur both in children and adults. This descriptive type of cross sectional study was done to find out the levels of hemoglobin concentration in adult asthmatic patients and carried out in the Department of Physiology, Mymensingh Medical College, Mymensingh, Bangladesh from July 2014 to January 2016. Fifty (50) male and 50 (fifty) female adult asthmatic patients aged 18-60 years were included in the study group. They are enrolled from the Department of Medicine, Mymensingh Medical College, Mymensingh, Bangladesh and also from locality. For comparison age matched 50 male and 50 female apparently healthy persons were also studied as control. Hemoglobin concentration was estimated by Cyanmethemoglobin method. For statistical analysis unpaired student's 't' test was used. Mean hemoglobin concentration was significantly decreased in study group in comparison to control group and the result was statistically significant (p<0.001). The study findings showed a high prevalence of anemia among asthmatic patients than non asthmatic healthy persons.

Blood Pressure in Third Trimester of Pregnancy.

Pregnancy is a great stressful physiological condition in women during their reproductive period. During pregnancy several hemodynamic, biochemical and hematological modifications occur as a part of the physiological adaptation of the body. Changes in blood pressure occur in third trimester of pregnancy, which may be associated with increased maternal and infant mortality and morbidity. This cross-sectional study was carried out in the Department of Physiology, Mymensingh Medical College, Mymensingh, from July 2013 to June 2014. Study subjects were selected by following purposive sampling procedure and the protocol of this study was approved by Institutional Ethics Committee (IEC) of Mymensingh. This study enrolled 100 pregnant women of third trimester of pregnancy and 100 aged matched non-pregnant women from Mymensingh district. Mean systolic blood pressure in study group were 124.8±14.51 mm of Hg and in control group were 106.50±10.67 mm of Hg, which was statistically increased. Diastolic blood pressure in study group was 83.00±13.37 mm of Hg and in control group 71.05±7.12 mm of Hg, which was also statistically significant. The changes in blood pressure in third trimester of pregnancy is the major concern of developing the risk of pre-eclampsia & eclampsia, and increased prevalence of IUGR, pre-maturity and perinatal mortality. This study reveals significant changes of blood pressure during third trimester of pregnancy.

Carpenter syndrome: a case report.

Carpenter syndrome is a rare hereditary disorder known as Acrocephalopolysyndyctyly (ACPS) type II characterized by acrocephaly, facial dysmorphism, brachedyctyly, syndyctyly, preaxial polydyctyly, obesity, congenital heart disease, cryptorchidism, hypogenitalism, bony abnormalities and umbilical hernia. Carpenter syndrome is autosomal recessive disorder and prenatal diagnosis of this syndrome is possible by ultrasonogram during pregnancy. We reported a case of carpenter syndrome of 2.5 months old female infant of consanguineous parents who was admitted in the paediatric ward of Bangabandhu Sheikh Mujib Medical University (BSMMU) on 30th March 2010. She was diagnosed as a case of Carpenter syndrome having acrocephaly prominent ridge of sagital suture, polydactyly, syndyctyly on history, clinical examination findings and investigation reports.

Pregnancy associated complications of mothers with gestational diabetes mellitus.

This study was conducted in Mymensingh Medical College and Hospital, Mymensingh. It lasted for one year commencing in July 2003, and was designed to find out and compare the outcomes of gestational diabetes mellitus (GDM) with a view to reducing the complications. Forty cases of GDM with single pregnancy were selected as experimental group, while forty other cases of pregnant women without GDM constituted the control group. Questionnaire and observation chart were the research instrument in this study. Statistical analyses were done manually. It was found that the GDM mothers had a higher risk of complications like pre-eclampsia, hypertension, urinary tract infection and cesarean delivery. On the basis of these findings, however, appropriate measures for prevention, treatment and management of GDM may be adopted for better pregnancy outcomes.

Infant outcomes of gestational diabetes mellitus.

This study was carried out in Mymensingh Medical College and Hospital, Mymensingh. The work, which lasted for one year commencing in July 2003, was designed to find out and compare the infant outcomes of gestational diabetes mellitus (GDM) with a view to reducing the complications. Forty cases of GDM with single pregnancy were selected as experimental group, while forty other cases of pregnant women without GDM constituted the control group. Questionnaire and observation charts were the research instruments. Statistical analyses were done manually. It was retrieved that the offspring of GDM mothers had a higher risk of macrosomia, neonatal jaundice and respiratory complications. The perinatal mortality rate was also more in GDM cases. However, befitting measures for prevention, treatment and management of GDM may be taken up to ameliorate the situation.

A role of VLA-6 laminin receptor in invasion of breast carcinoma.

The integrin VLA-6 as a laminin receptor and laminin as a ligand for laminin receptor were detected immunohistochemically in normal, benign tumor and carcinoma tissues of the breast. Epithelial cells of both normal breast and benign tumor were in almost all cases strongly immunoreactive for VLA-6 in the plasma membrane. Carcinoma cells in 34 of 70 cases (49%) with an invasive component were not immunoreactive for VLA-6, and no carcinoma cells showed strong positivity. Although carcinoma cells in only four of 51 cases (8%) with intraductal components were negative for VLA-6, 37 cases (72%) showed weak expression of VLA-6 and 10 cases (20%) showed strong expression of VLA-6. A concordant expression of VLA-6 on carcinoma cells and laminin around carcinoma cell nests with an invasive component was observed, and VLA-6 expression in carcinoma cells was correlated to tubular formation in carcinoma cell nests as an indicator of differentiation. These findings suggest that loss of VLA-6 plays a role in the invasion of breast carcinoma, and that VLA-6 laminin receptor and laminin may contribute to tubular differentiation of breast carcinoma cells.

Myxoma of the breast: report of a case with unique histological and immunohistochemical appearances.

A case of myxoma of the breast is reported. The patient, a 19 year old Japanese woman, showed a lump in the left breast which had enlarged gradually over 3 years. A tumor measuring 5 x 5 x 4.5 cm was located mainly in the mammary parenchyma, but partially involved the overlying subcutaneous tissue. Histologically the tumor was multinodular and each nodule consisted of an abundant myxoid substance with a few spindle or stellate mesenchymal cells. The presence of hyaluronic acid was observed in the myxoid area, and a few constituent cells showed immunoreactivities for S-100 protein and alpha 1-antichymotrypsin. Electron microscopic studies revealed that some constituent cells looked like undifferentiated mesenchymal cells, while others showed a differentiation similar to fibroblast or histiocyte. These findings suggest that the constituent cells might derive from totipotential primitive mesenchymal cells.

Elastosis in breast--correlation with epithelial proliferation in benign disease and carcinomatous growth.

Elastosis in the breast is an unusual phenomenon and its morphogenesis has not yet been fully ascertained. The degree of elastosis in the breast associated with benign diseases, including fibroadenoma and fibrocystic disease as well as with breast carcinoma, was examined with special reference to the correlation between the degree of epithelial proliferation and elastosis. Using the immunohistochemical method, the presence of elastase (EL) and alpha 1-antichymotrypsin (ACT), one of the protease inhibitors, in these epithelial cells was also investigated to elucidate the role of an imbalance in these enzymes in the morphogenesis of the elastosis. Consequently, it was shown that there is a tendency in fibroadenoma and fibrocystic disease, for epithelial proliferation to be related to the degree of elastosis, and that the lack of EL in proliferated epithelial cells might play a role in the occurrence of elastosis, although ACT has no significant correlation. On the contrary, in our study noninvasive carcinoma showed marked periductal elastosis but no stromal elastosis, while invasive carcinoma showed various degrees of periductal and stromal elastosis. In invasive carcinoma, especially scirrhous carcinoma, the degree of ACT in cancer cells correlated well with stromal elastosis, although there was no correlation with EL. These findings suggest that an imbalance of the protease-antiprotease system, produced by epithelial cells of the breast, contribute to the morphogenesis of elastosis, although the physiological event, aging, is only marginally related to elastosis. Further investigation of the cells producing elastin and regulatory factors may be necessary.

Epithelial hyperplasia of the breast. Comparison of incidence between cases of breast carcinoma and control autopsy specimens with immunohistochemical observation of blood group antigens.

Epithelial hyperplasia in the duct, ductule or lobule of the breast is a very common lesion and has been considered to carry a risk of subsequent invasive carcinoma. However, it is not known whether epithelial hyperplasia can transform into carcinoma or whether malignant change occurs de novo. We analyzed the incidence of epithelial hyperplasia of the breast by making a comparison between cases of breast carcinoma and control autopsy specimens, and studied differences in the membrane antigens of the constituent cells using immunohistochemical staining of blood group antigens. It was found that the frequency of epithelial hyperplasia was higher in the cases of breast carcinoma. The lesions showed loss of A, B and H antigens at high frequency, and the proportion of lesions showing loss of these antigens became higher as the atypia of the lesion increased. On the other hand, expression of Lea antigen was observed more frequently in atypical epithelial hyperplasia or in situ carcinoma than in ordinary epithelial hyperplasia. These findings suggest possible transformation from epithelial hyperplasia to carcinoma, and indicate that atypical epithelial hyperplasia may be precancerous in nature.

Quantitative risk assessment of carcinogenicity of urethane (ethyl carbamate) on the basis of long-term oral administration to B6C3F1 mice.

A carcinogenicity study of urethane was performed for quantitative assessment of its risk in humans. Three hundred 6-week-old male B6C3F1 mice were divided into 6 groups, each consisting of 50 mice, and urethane was given ad libitum in drinking water at levels of 0 (control), 0.6, 3, 6, 60 and 600 ppm for 70 weeks. The tumors with a clear dose-response relationship were lung tumor (alveolar/bronchiolar adenoma or carcinoma) and liver tumor (hemangioma or angiosarcoma). The incidences of these two types of tumor were applied to estimation of the virtually safe dose (VSD) at the level of 10(-6) by using four mathematical models (Logit, Probit, Weibull and Multistage models). The VSD based on the incidences of lung tumor by using the Logit model was estimated to be 1.8 x 10(-4) mg/kg body weight/day. On the other hand the VSD based on those of liver tumor by using the Weibull model was 7.2 x 10(-5) mg/kg body weight/day. Thus, the VSDs based on the incidences of the two different types of tumor using the most compatible mathematical model in each case, as judged from the P-values, were similar.