Serum Uric Acid and Serum Lipid Levels in Patients with Acute Ischemic Stroke Admitted in Mymensingh Medical College Hospital.

Stroke is the second-leading cause of death and also a leading cause of combined death and disability. In Bangladesh, stroke prevalence is 11.39 per 1000 population, but highest prevalence of stroke is 14.71 per 1000 population in the Mymensingh division. Hyperuricemia has been reported as an independent risk factor for stroke in different studies and a significant association between serum uric acid and dyslipidemia has also been stated. On the contrary, some studies suggest that uric acid has a neuroprotective role. This cross-sectional study was completed in the Medicine Department of Mymensingh Medical College Hospital, Mymensingh, Bangladesh from March 2021 to January 2023. In this cross-sectional study, 352 adult acute ischemic stroke patients were included from the Medicine Department of Mymensingh Medical College Hospital. Serum uric acid and fasting serum lipid levels were measured within 48 hours of admission. The mean age ±SD of the respondents was 61.9±12.8 years. Hyperuricemia was found among 18.2% of respondents, whose mean ±SD serum uric acid was 5.7±1.9 mg/dl. Dyslipidemia was present in 88.4% of patients. The mean ±SD of the National Institutes of Health Stroke Scale (NIHSS) score was 12.0±5.9. Most of the patients (65.6%) were suffering from moderate stroke, followed by moderate to severe stroke (15.1%), severe stroke (10.8%) and minor stroke (8.5%). After multiple linear regressions, the independent variables age, gender, serum uric acid and total cholesterol were found to be significant predictors of the NIHSS score of the respondents. In conclusion, the majority of acute ischemic stroke patients have an association with dyslipidemia, but only around one-fifth of patients have hyperuricemia. There is a significant association of high serum uric acid and high serum total cholesterol with stroke severity (NIHSS score). But low-density lipoprotein cholesterol, high-density lipoprotein cholesterol and, triglycerides have no association with stroke severity.

Universal Measure for the Impact of Adiabaticity on Quantum Transitions.

Adiabaticity is crucial for our understanding of complex quantum dynamics and thus for advancing fundamental physics and technology, but its impact cannot yet be quantified in complex but common cases where dynamics is only partially adiabatic, several eigenstates are simultaneously populated and transitions between noneigenstates are of key interest. We construct a universally applicable measure that can quantify the adiabaticity of quantum transitions in an arbitrary basis. Our measure distinguishes transitions that occur due to the adiabatic change of populated system eigenstates from transitions that occur due to beating between several eigenstates and can handle nonadiabatic events. While all quantum dynamics fall within the scope of the measure, we demonstrate its usage and utility through two important material science problems-energy and charge transfer-where adiabaticity could be effected by nuclear motion and its quantification will aid not only in unraveling mechanisms but also in system design, for example, of light harvesting systems.

Clinical and Liver Enzymes among the Patients with Metabolic Syndrome with or without Non Alcoholic Fatty Liver Disease attending a Tertiary Care Hospital.

Metabolic syndrome is characterized by central obesity, dyslipidemia, raised blood pressure and impaired blood sugar levels. Patients with metabolic syndrome are at increased risk of type 2 diabetes and atherosclerotic cardiovascular disease. This cross-sectional observational study was carried out from January 2019 to December 2019 at the inpatient and outpatient department of BIRDEM General Hospital, Dhaka, Bangladesh. Adult subjects aged ≥18 years with metabolic syndrome (IDF criteria, 2006) were included and purposive sampling was done. A total of 242 participants were included and the mean age was 40.2±14.1 years ranging from 18-70 years. Among them, 140(57.85%) were female and 102(42.15%) were male. Out of 242 participants, 170(70.25%) subjects had Metabolic Syndrome (MetS) with Non-Alcoholic Fatty Liver (NAFLD) and 72(29.75%) subjects had metabolic syndrome without NAFLD. In the male participants, the mean waist-hip ratio (WHR) of MetS with NAFLD and MetS without NAFLD was 1.01±0.07 vs. 0.96±0.08 respectively (p-value 0.003). In female subjects, the mean waist-hip ratio (WHR) of MetS with NAFLD and MetS without NAFLD group was 0.90±0.10 vs. 0.86±0.08 respectively (p-value 0.026). MetS with NAFLD subjects were more hypertensive than MetS without NAFLD subjects (61.2% vs. 42.7%). In the MetS with NAFLD group (n=170), 11.8% was normoglycemic, 43.5% was prediabetic and 44.7% was diabetic. In the MetS without NAFLD group (n=72), 19.5% was normoglycemic, 50% was prediabetic and 30.5% was diabetic. SGPT value was significantly raised in MetS with NAFLD subjects (56.4%) than MetS without NAFLD (38.9%) subjects (p-value 0.038). SGOT value was significantly raised in MetS with NAFLD subjects (58.8%) than MetS without NAFLD subjects (41.7%); (p-value 0.005). Mean Total Cholesterol and Triglyceride were significantly raised in MetS with NAFLD subjects than MetS without NAFLD subjects (p-value 0.01). In Subjects with grade I fatty liver, mean SGPT and SGOT were 42.27±22.31 vs. 39.59±16.93 respectively. In Subjects with grade II fatty liver, mean SGPT and SGOT were 62.13±32.42 vs. 52.45±28.56 respectively. In grade III fatty liver, mean SGPT and SGOT were 51.50±32.19 vs. 41.00±17.52 respectively (p value <0.001). More than two-third of participants with metabolic syndrome had non-alcoholic fatty liver disease (NAFLD) and a significant elevation of liver enzymes than metabolic syndrome without NAFLD participants. About 85.0% of metabolic syndrome participants had glucose intolerance in the form of prediabetes and diabetes.

Carbimazole-Resistant Graves' Disease Responding to Oral Prednisolone: A Case Report.

Conventional management of Graves' disease includes antithyroid drugs, radioactive iodine and thyroidectomy. Patients rarely may be resistant to antithyroid drugs and may require additional management, including corticosteroids. We treated an 18-year-old girl with Graves' thyrotoxicosis and resistance to Carbimazole. She was clinically and biochemically hyperthyroid despite getting 75mg Carbimazole and 120mg Propranolol daily. We added tablet Prednisolone (20mg for 15 days, then 10mg for the next 15 days) to Carbimazole (75mg/day). Four weeks later, she was free from thyrotoxic symptoms and her free T4 and total T3 levels normalized. The dose of tablet Prednisolone was lowered to 5mg/day for the next 15 days and Carbimazole was continued at 45mg/day. She received 10mCi Iodine-131 (131¹) at this stage and Carbimazole was discontinued. She remained clinically and biochemically euthyroid when she was followed up at 7th and 24th weeks after radioiodine ablation.

Noonan Syndrome Presenting with Stunted Growth: A Case Report.

Noonan syndrome is a genetic disorder of autosomal dominant inheritance that prevents normal development in various parts of the body. A spontaneous mutation without any family history may also result in the condition. Noonan syndrome can affect normal growth. Birth weight may be normal, but growth slows over time. The growth spurt usually seen during the teenage years may be delayed, and bone maturity also is delayed. In this case A 13 year's male admitted inpatient Department of Endocrinology, Mymensingh Medical College Hospital in April 2021 with not attaining appropriate height and delayed development of secondary sexual characteristics. His birth weight was normal; gestational and neonatal history was uneventful. He was diagnosed with severe pulmonary stenosis at four years and underwent cardiac surgery at his four and eleven years. He was noted to have growth failure from the age of 9 years onward. He had no family history of such type of disease. On examination, he was short statured, underweight, having an upper: lower segment ratio of 1.05 with an arm span of 126cm. He had craniosynostosis, high arched palate, the thick helix of ears (outer rim), small, upturned nose, depressed broad nose, deeply grooved philtrum, keratosis pilaris of the face and upper arm, slant eyes with proptosis, keloid scar over mid-chest, widely spaced nipple, shield chest, pectus excavatum and cubitus valgus. His sexual maturation score was A1, P1, B1. He had pulmonary stenosis with pulmonary hypertension. He had mild microcytic anemia with normal liver, renal, blood glucose, and calcium profile. His bone age was delayed (9 years), thyroid function was normal. The growth hormone dynamic test after clonidine stimulation was normal. His karyotype was 46XY. We have considered giving recombinant growth hormone therapy to accelerate his height.

The Pattern of Lipid Profile in Patients with Chronic Kidney Disease.

Dyslipidemia is a common problem in chronic kidney disease patients. Dyslipidemia in chronic kidney disease patients has been known to be a major risk factor of their cardiovascular disease and may contribute to progressive renal dysfunction. The result of the study might be of interest in improving preventive strategies and in management of dyslipidemia in chronic kidney disease patients. This cross sectional study was conducted to evaluate changes in lipid profile in patients with chronic kidney disease stage-3 to stage-5 patients and to correlate the biochemical abnormalities with progression of the disease in Mymensingh Medical College Hospital, Bangladesh from October, 2016 to April, 2017. In this study 200 patients were including and subjected to do complete blood count, erythrocyte sedimentation rate, random blood sugar, routine examination of urine, serum creatinine and fasting lipid profile. Two hundred (200) patients (134 males, 66 females) with the mean age were 50.5±12.43 years. 44.5% patients were in CKD stage-5, 37.5% patients were in CKD stage-4, 18% patients were in CKD stage-3. Mean value of Triglyceride (TG) was 194±47.20. Eighty nine percent (89%) patient had hyper-triglyceridemia and 11% had normal triglyceride level. It was statistically significant increased in triglyceride level (p<0.05). Mean value of High density lipoprotein cholesterol (HDL-C) was 34±6.10. Low HDL-C had in 87.5% patients, normal in 12.5% patients and was statistically significant reduction in HDL-C level (p<0.05). Low Density Lipoprotein cholesterol (LDL-C) mean was 113±35.6. High level of LDL-C had optimal/or near optimal in 47% patients, 39% patients had borderline high and 14% patients had that was not statistically significant (p>0.10). Total cholesterol (TC) mean was 212±45.3. In 38% patients had within desirable level, 62% patients had high level of Total cholesterol (TC). It was not statistically significant change (p>0.01).

Comparative evaluation of antiproliferative activity and induction of apoptosis by some fluoroquinolones with a human non-small cell lung cancer cell line in culture.

Lung cancer is the leading cause of cancer- related death in the world today. Since the effective management of drug resistant lung cancer, and particularly non-small cell lung carcinomas is a major problem, attempts need to be made to identify new potential anticancer drugs that can kill non-small cell lung cancer cells efficiently. In the present study, a human non-small cell lung carcinoma NCI-H460 cell line was used to evaluate the antiproliferative activity of Fluoroquinolones like Enoxacin, Norfloxacin, Ciprofloxacin and Levofloxacin. As determined by Sulphorodhamine B assay (SRB assay), all Fluoroquinolones caused cellular growth inhibition in a concentration and time-dependent manner. Enoxacin was found to be the most effective Fluoroquinolone followed by Norfloxacin, Ciprofloxacin and Levofloxacin. Growth inhibitory effects were also found to be independent of the concentrations of serum growth factors in culture medium or variation of initial cell seeding density and proved to be irreversible in nature. Appearance of rounded cells with altered morphology and cell surface blebbing indicated cell killing by apoptosis. Cell shrinkage, nuclear condensation & fragmentation, and cytoplasmic blebbing as indicated by MGG staining confirmed this to be the case. Thus, this investigation clearly demonstrated that the NCI-H460 human non-small cell lung carcinoma cell line is highly sensitive to Fluoroquinolone treatment. The Fluoroquinolones used in this study which are clinically used as antibacterial agents, can also inhibit tumor cell growth suggesting their potential use in a strategy for cancer treatment which might help in controlling cancer.