Severity of COVID-19 manifestations in HIV patients: a systematic review and meta-analysis.

OBJECTIVE: The incidence of coronavirus disease 2019 (COVID-19) pandemic among people living with HIV (PLWH) is experiencing major increases. This demographic is vulnerable due to compromised immune function, but the individuals are subjected to antiretroviral therapy (ART), which shows potential as a treatment for the pandemic. Therefore, this study aimed to investigate the severity of various forms of COVID-19 in PLWH as opposed to the general population. MATERIALS AND METHODS: The study followed PRISMA guidelines and included a systematic review of literature from Pubmed, Science Direct, and Cochrane Library, comprising English-language articles from 2019 to 2022. This study included articles discussing HIV and COVID-19 case prevalence data by severity. A random effect model was used to demonstrate the pooled prevalence of COVID-19 among PLWH, as well as the prevalence of moderate and critical severity of COVID-19 among PLWH. The Joanna Briggs Institute checklist was used to assess the quality of studies. This study is registered in INPLASY No. INPLASY2023100063. RESULTS: Out of a total of 1,965 articles relevant to the specified keyword combination, 13 articles conformed with inclusion and exclusion criteria. For HIV and non-HIV COVID-19 patients, the mean age was 52.98 ± 6.45 years and 55.84 ± 9.73 years, respectively. Approximately 73% of HIV COVID-19 patients were male. Symptoms among PLWH included fever (57%), cough (48.9%), and shortness of breath (37%). The pooled prevalence of COVID-19 among PLWH was 3.0% (95% CI, 1.0 - 8.5%), with critical, moderate, and mild severity in 4.8% (95% CI, 1.6 - 13.3%), 24.4% (95% CI, 1.9 - 29.8%), and 9.9% (95% CI, 1.9 - 38%), respectively. CONCLUSIONS: PLWHs and HIV-negative individuals showed comparable rates and intensity of COVID-19. ART users exhibited immunological health comparable to immunocompetent people, demonstrating the essential role of ART in reducing the severity and mortality of PLWH with COVID-19.

Early Outcome of On-pump Versus Off-pump Elective Surgical Revascularization in Patients with Prior ST-Segment Elevation Myocardial Infarction.

Coronary artery bypass graft surgery (CABG) is a proven treatment for coronary artery disease. History of a ST-elevation myocardial infarction (STEMI) is considered an independent risk factor for CABG irrespective of timing for an emergency or elective surgery. Patients with STEMI are candidates for both On-pump and Off-pump CABG procedures. This paper discusses the possible best option for elective surgical revascularization in patients with prior STEMI. This prospective clinical trial of 60 eligible patients with prior STEMI was conducted in a Tertiary Care Hospital from April 2018 to March 2019. Among them, 30 patients underwent off-pump (Group A) and 30 patients underwent on-pump (Group B) CABG procedures. Outcomes between both groups were observed from surgery to 1 month postoperatively. Data was analysed by the software statistical program for social science (SPSS 25.0 Inc). The surgery was successful in both groups of patients. Differences were observed by mean number of grafts per patient (2.77±0.43 vs. 3.10±0.71) and duration of operation (4.41±0.35 hours vs. 5.71±0.48 hours). An improvement in Left Ventricular Ejection Fraction (LVEF %) was observed in both groups postoperatively (17.98% vs. 10.98%) and the postoperative LVEF% at different time points were found statistically significant (p<0.05) over preoperative LVEF%. Multivariable stepwise logistic regression analysis correlated on-pump CABG with prolonged need for ionotropic support, need for blood transfusion, longer hospital stay and less improvement in LVEF%. The study supports the Off-pump CABG as a better surgical option over on-pump CABG in patients with prior STEMI.

Alternative genome sequencing approaches of SARS-CoV-2 using Ion AmpliSeq Technology.

A thorough understanding of SARS-CoV-2 genetic features is compulsory to track the ongoing pandemic across multiple geographical locations of the world. Thermo Fisher Scientific USA has developed the Ion AmpliSeq SARS-CoV-2 Research Panel for the targeted sequencing of SARS-CoV-2 complete genome with high coverage and lower error rate. In this study an alternative approach of complete genome sequencing has been validated using different commercial sequencing kits to sequence the SARS-CoV-2. Amplification of cDNA with the SARS-CoV-2 primer pool was performed separately using two different master mixes: 2X environmental master mix (EM) and Platinum™ PCR SuperMix High Fidelity master mix (PM) instead of 5X Ion AmpliSeq™ HiFi Mix whereas NEBNext® Fast DNA Library Prep Set for Ion Torrent™ kit was used as an alternative to Ion AmpliSeq Library Kit Plus for other reagents. This study demonstrated a successful procedure to sequence the SARS-CoV-2 whole genome with average ∼2351 depth and 98.1% of total the reads aligned against the reference sequence (SARS-CoV-2, isolate Wuhan-Hu-1, complete genome). Although genome coverage varied, complete genomes were retrieved for both reagent sets with a reduced cost. This study proposed an alternative approach of high throughput sequencing using Ion torrent technology for the sequencing of SARS-CoV-2 in developing countries where sequencing facilities are low. This blended sequencing technique also offers a low cost protocol in developing countries like Bangladesh.

Assessment of microplastic contamination in shrimps from the Bay of Bengal and associated human health risk.

Microplastics (MPs) were analyzed in seven shrimp species Tiger shrimp (Penaeus monodon), Red tiger shrimp (Caridina cantonensis), Indian shrimp (Penaeus indicus), Red shrimp (Metapenaeus dobsoni), White shrimp (Penaeus merguiensis), Brown shrimp (Metapenaeus monoceros), and Roshna shrimp (Palaemon styliferus) collected from the Bay of Bengal. The abundance and characteristics of MPs were assessed in the gastrointestinal tract (GIT), which certainly translocated to the muscle of shrimp species. The highest MP abundance was found in C. cantonensis with 7.2 items/individual (25.3 items/g in the GIT and 6.3 items/g in muscle). The prominent types of MPs in shrimp samples were fibers (30 %) and fragments (29 %). The ingestion rate of MPs of black and transparent color was comparatively higher, with 64 % of the ingested MPs were < 100 µm. The primary polymer types detected based on Fourier Transform Infrared (FTIR) analysis were Low-Density Polyethylene (LDPE), High-Density Polyethylene (HDPE), Polymethyl Methacrylate (PMMA), Polyvinyl Chloride (PVC), Polypropylene (PP), and Ethylene Vinyl Acetate (EVA). Results from Scanning Electron Microscopy (SEM) showed rough surface textures and adhered particles on the MPs isolated from shrimps. The margin of exposure for females was 71.42, and for males, it was 80.64, indicating that women in Bangladesh are more likely to be exposed to MPs and face a higher risk than men. Sensitivity analysis revealed that MPs particle size was the most sensitive parameter. These findings provide a comprehensive understanding of MP ingestion, human exposure, and contamination in shrimps of Bangladesh, which can help future monitoring efforts.

A Rare Case of Primary Sjogren's Syndrome with Idiopathic Pulmonary Fibrosis with Variable Presentations: A case report.

We diagnosed and treated a case of Primary SjoGren's Syndrome with Idiopathic Pulmonary Fibrosis (IPF) in a 65 years old woman who presented with dyspnoea and multiple joint pains for 5 years and remained undiagnosed. She had variable presentation and was initially established as a case of mixed connective tissue disease which consists of Systemic Lupus Erythematosus (SLE), Systemic Sclerosis and Dermatomyositis. She complained of xerostomia, xerophthalmia, difficulty in opening mouth, progressive dysphagia with solid foods and raynaud's phenomenon. In addition to this she noticed photosensitive rash, oral ulcers and difficulty in raising arms above head especially while combing hair. Examination revealed bi basal fine end inspiratory crepitations unaltered while coughing, bed side 6 minutes walking test showed exertional desaturation of SpO2 from 92.0% to 84.0%. Grade 2 tenderness was noted in wrists, knees, elbows and small joints of hands and feet except DIP. However, no oral lesions or dental carries were found. Unstimulated salivary flow rate was 1.0 ml in 15 minutes and sublingual salivary pool was significantly reduced. Schirmer's test was positive. HRCT lung revealed reticulonodular shadowing, honey combing and traction bronchiectasis in basal segments of both lobes, suggestive of usual interstitial pneumonia in both lungs. Auto antibody tests revealed ANA, RA, anti CCP and anti ds DNA negative, CPK was 63U/L. ENA (Extractable Nuclear Antigen) profile demonstrated positive Anti SS- A antibody while it remained insignificant for anti SS-B, anti RNP, anti Sm antibody, anti Scl-7o, anti Jo-1. According to the American-European Consensus Criteria for SjoGren's Syndrome, it meets all the criteria to be diagnosed as Primary Sjogren's Syndrome. We finally diagnosed a case of Primary SjoGren's syndrome with IPF and the patient was treated with pirfenidone, prednisolone, artificial tears and vaccination against Haemophilus influenzae and Streptococcal pneumoniae. The 10 year survival rate for such patients is nearly 80.0%.

TEE-Graph: efficient privacy and ownership protection for cloud-based graph spectral analysis.

Introduction: Big graphs like social network user interactions and customer rating matrices require significant computing resources to maintain. Data owners are now using public cloud resources for storage and computing elasticity. However, existing solutions do not fully address the privacy and ownership protection needs of the key involved parties: data contributors and the data owner who collects data from contributors. Methods: We propose a Trusted Execution Environment (TEE) based solution: TEE-Graph for graph spectral analysis of outsourced graphs in the cloud. TEEs are new CPU features that can enable much more efficient confidential computing solutions than traditional software-based cryptographic ones. Our approach has several unique contributions compared to existing confidential graph analysis approaches. (1) It utilizes the unique TEE properties to ensure contributors' new privacy needs, e.g., the right of revocation for shared data. (2) It implements efficient access-pattern protection with a differentially private data encoding method. And (3) it implements TEE-based special analysis algorithms: the Lanczos method and the Nystrom method for efficiently handling big graphs and protecting confidentiality from compromised cloud providers. Results: The TEE-Graph approach is much more efficient than software crypto approaches and also immune to access-pattern-based attacks. Compared with the best-known software crypto approach for graph spectral analysis, PrivateGraph, we have seen that TEE-Graph has 103-105 times lower computation, storage, and communication costs. Furthermore, the proposed access-pattern protection method incurs only about 10%-25% of the overall computation cost. Discussion: Our experimentation showed that TEE-Graph performs significantly better and has lower costs than typical software approaches. It also addresses the unique ownership and access-pattern issues that other TEE-related graph analytics approaches have not sufficiently studied. The proposed approach can be extended to other graph analytics problems with strong ownership and access-pattern protection.

Genetic Analyses of Mungbean [Vigna radiata (L.) Wilczek] Breeding Traits for Selecting Superior Genotype(s) Using Multivariate and Multi-Traits Indexing Approaches.

Mungbean [Vigna radiata (L.) Wilczek] is an important food, feed, and cash crop in rice-based agricultural ecosystems in Southeast Asia and other continents. It has the potential to enhance livelihoods due to its palatability, nutritional content, and digestibility. We evaluated 166 diverse mungbean genotypes in two seasons using multivariate and multi-traits index approaches to identify superior genotypes. The total Shannon diversity index (SDI) for qualitative traits ranged from moderate for terminal leaflet shape (0.592) to high for seed colour (1.279). The analysis of variances (ANOVA) indicated a highly significant difference across the genotypes for most of the studied traits. Descriptive analyses showed high diversity among genotypes for all morphological traits. Six components with eigen values larger than one contributed 76.50% of the variability in the principal component analysis (PCA). The first three PCs accounted for the maximum 29.90%, 15.70%, and 11.20% of the total variances, respectively. Yield per plant, pod weight, hundred seed weight, pod length, days to maturity, pods per plant, harvest index, biological yield per plant, and pod per cluster contributed more to PC1 and PC2 and showed a positive association and positive direct effect on seed yield. The genotypes were grouped into seven clusters with the maximum in cluster II (34) and the minimum in cluster VII (10) along with a range of intra-cluster and inter-cluster distances of 5.15 (cluster II) to 3.60 (cluster VII) and 9.53 (between clusters II and VI) to 4.88 (clusters I and VII), suggesting extreme divergence and the possibility for use in hybridization and selection. Cluster III showed the highest yield and yield-related traits. Yield per plant positively and significantly correlated with pod traits and hundred seed weight. Depending on the multi-trait stability index (MTSI), clusters I, III, and VII might be utilized as parents in the hybridization program to generate high-yielding, disease-resistant, and small-seeded mungbean. Based on all multivariate-approaches, G45, G5, G22, G55, G143, G144, G87, G138, G110, G133, and G120 may be considered as the best parents for further breeding programs.

Nutritional status and dietary diversity of pregnant and nonpregnant reproductive-age Rohingya women.

There are no data on the nutritional status and dietary diversity of the pregnant and nonpregnant reproductive-age Rohingya women who have recently shifted to the Bhasan Char Relocation Camp located on an island in the Bay of Bengal. A cross-sectional survey was conducted in November-December, 2021 to assess the nutritional status and evaluate the dietary diversity of two vulnerable groups of the forcibly displaced Rohingya population: nonpregnant reproductive-age women and pregnant mothers. Multivariable logistic regression was applied to identify the factors associated with nutritional impairments. Overall, 7.6% of the nonpregnant reproductive-age women were underweight (Body Mass Index [BMI] < 18.5 kg/m2), and nearly one-third of them had a BMI ≥ 25 kg/m2. However, 26.7% of the pregnant mothers were undernourished (BMI < 20.0 kg/m2) and almost one-fourth of them were either overweight or obese (BMI ≥ 25.0 kg/m2). The prevalence of thinness (Mid Upper Arm Circumference [MUAC] < 23 cm) was 34.5% among pregnant mothers, and 10.1% of them were severely thin (MUAC < 21 cm). The mean (±SD) of the Women's Dietary Diversity Score (WDDS) was 3.3 (±1.1) for nonpregnant reproductive-age women and 3.7 (±1.3) for pregnant mothers enrolled in this study. Overall, 63.8% of the nonpregnant women of childbearing age and 46% of the pregnant mothers had a low WDDS (WDDS < 4). The WDDS was found to be protective against thinness among nonpregnant reproductive-age women (AOR = 0.61; 95% CI = 0.37, 0.93; p-value = .03) and low BMI in pregnant mothers (AOR = 0.71; 95% CI = 0.55, 0.91; p-value = .01). The results of this survey will assist in early recognition of the nutritional demands, and act as a guide to planning nutrition-based programs among Rohingya reproductive-age women relocated to the Bhasan Char Island.

Insights into Omicron's Low Fusogenicity through In Silico Molecular Studies on Spike-Furin Interactions.

The Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron variant and its subvariants have a unique set of mutations. Two of those mutations (N679 K and P681 H) reside close to the S1 /S2 furin cleavage site (FCS; 685-686). When these mutations reside together, they exert less-efficient membrane fusion than wild type and most other variants of concern such as the Delta variant. Here, we in silico targeted these mutations to find out which of the amino acids and interactions change plays the key role in fusion. To comprehend the epistatic effect of N679 K and P681 H mutations on the spike protein, we in silico constructed three types of spike protein sequences by changing the respective amino acids on 679 and 681 positions (P681 H, N679 K, K679 N-H681 P variants). We then analyzed the binding affinity of furin and spike (Furin-Wild, Furin-Omicron, Furin-P681 H, Furin-N679 K, and Furin-K679 N/H681 P) complexes. Omicron and P681 H variants showed a similar higher binding energy trend compared to the wild type and N679 K. The variation in hydrogen, hydrophobic, and salt bridge bonds between spike protein and furin provided an explanation for the observed low fusogenicity of Omicron. The fate of the epistasis in furin binding and possible cleavage depends on the efficient interaction between FCS in spike and furin catalytic triad, and in addition, the loss of the hydrogen bond between Arg 681 (spike) and Asn 295 (furin) along with inhibitor-like ineffective higher affinity plays an important role in the enzymatic activity.

Patient safety in radiology: Our experience.

Background: Present-day radiology departments have very high footfall of patients and are prone to patient safety errors. This study analyses such errors in our hospital. Methods: Observational cross-sectional analysis of errors over the last 30 months was performed. These were classified using the Eindhoven classification model into technical, organizational, and human errors. Technical errors focused on equipment safety. Organizational errors related to policies. Human errors were subclassified as per the skill rule knowledge model. Root cause analysis was performed wherever necessary, and possible mitigation strategies for ensuring safety were suggested. Errors peculiar to the Armed Forces environment were specifically addressed. Results: Seventy-seven errors were analyzed. Two were equipment based including faulty pressure injector syringes and radiation leakage from the computed tomography gantry. Of 44 skill-based errors, 09 involved dispatch of wrong reports to dependents owing to identifying patients with serving personnel's name. Four were due to scanning wrong sites. Eleven involved reporting abnormality on the wrong side. Six involved underreporting due to not viewing specific images. The rest were due to failure to omit conflicting elements in the report. Rule-based errors included wrong protocol selection (9 errors), omitting a particular sequence due to individual preference (6 errors), and so on. Knowledge-based errors were due to misinterpretation of findings (4 errors), reporting an abnormality as normal (3 errors), and selection of wrong modality (3 errors). Conclusion: The findings of this study highlights the importance of voluntary reporting, diligent recording, and in-depth analysis of errors for understanding the causes and formulating possible mitigation strategies.

Abundance and characteristics of microplastics in major urban lakes of Dhaka, Bangladesh.

Microplastics (MPs) are prevalent in nature due to the proliferation of plastic in the environment. However, the presence of microplastics in lakes is largely unknown in comparison to other aquatic bodies. This study was performed to evaluate the abundance and characteristics of MPs in water, sediment, and fish from three major urban lakes in Dhaka, Bangladesh, namely Dhanmondi, Gulshan, and Hatir Jheel lake. The highest concentrations of microplastics in surface water (36 items/L), sediment (67 items/kg), fish (17 items/individual), and the gastrointestinal tract (4.88 items/gm) were observed. Highest abundance of microplastic in an individual fish was observed in Oreochromis mossambicus from Dhanmondi Lake. The samples were visually examined using stereomicroscope and SEM, which revealed that films were the most prevalent kind of microplastics in both the water and the sediment samples, whereas pellets and foams predominated in the fish samples. Visual observation also revealed MPs dominated by <100 µm in size and transparent in color. According to the Fourier Transform Infrared (FTIR) analysis, the dominant polymers in the analyzed samples were high-density polyethylene, low-density polyethylene, ethylene vinyl acetate, polyvinyl chloride, polycarbonate, cellulose acetate, and polypropylene. MPs were relatively higher in the water and sediment samples of Gulshan Lake, and fish samples of Dhanmondi Lake. The results of this study indicate that microplastic contamination has occurred not only in the water and sediment but also in the inhabitant fishes of the lakes. However, it is discovered that the microplastic intake of fish was significantly related to body weight and length. The implication of the finding suggests that the presence of MPs in urban lakes has raised concerns about the potential human health impact.

Streamflow characteristics of Sangu-Matamuhuri watershed in the southeastern part of Bangladesh.

Quantification of streamflow chatacteristics is considered crucial for designing effective management practices in a watershed. Sangu and Matamuhuri are two major rivers of Chittagong Hill Tracts (CHT's) and main sources of upland freshwater inflows to the south-eastern part of Bangladesh. This study was performed to evaluate the streamflow characteristics of Sangu-Matamuhuri watershed based on 25 years historical observed streamflow and rainfall records. Mean daily discharge data recorded by Bangladesh Water Development Board were collected and analyzed for the period of 1995-2019. Stream flow characteristics were determined in terms of different parameters including mean annual runoff discharge, specific water yield, run-off ratio, peak flow, seasonal flow and flow duration. Various statistical measures including mean, standard deviation, co-efficient of variation, lag-1 serial correlation, Mann Kendall test and Sen's slope estimator were applied to justify these parameters. The mean annual runoff discharges of 2167.77 and 1490.61 million cubic meters (mcm) were measured at the gaging stations at Sangu and Matamuhuri watershed, respectively. Matamuhuri basin showed higher value of specific water yield (1.52 mcm/sq. km) compared to the Sangu basin (1.02 mcm/sq. km). The average annual runoff coefficient value of Sangu watershed was found 0.36 while in case of Matamuhuri watershed it was about 0.49. The mean annual peak discharges of 25 years were found 607.63 m3s-1 and 628.42 m3 s-1 at Sangu and Matamuhuri watershed, respectively. Mann-Kendall Test (MK) and Sen's Slope Estimator method were applied for temporal trend analysis. An increasing trend in runoff observed during wet season which may cause flash floods and a decreasing trend observed during dry season that may cause water scarcity in Sangu-Matamuhuri watershed area. Flow duration curves based on 25 years' hydrological data were developed which showed progressive reduction in flows over time in both the watersheds for three periods 1995-2002, 2003-2010 and 2011-2019 with major changes occurred in Matamuhuri watershed during 2011-2020 which might be due to the impact of land use and land cover changes as well as changes in precipitation pattern. Implications of these findings indicate baseline information that can be used to evaluate the impacts of land use changes and climate change, and thereby may facilitate the planning and local management of water resources in the long term.

Evaluation of RT-PCR assays for detection of SARS-CoV-2 variants of concern.

Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) pandemic has been considered with great importance on correct screening procedure. The detection efficiency of recent variants of concern were observed by comparing 5 commercial RT-PCR kits and a SYBR-green method developed and validated in our laboratory. The RNA was extracted from nasopharyngeal samples from suspected COVID-19 patients and RT-PCR assay was performed according to the instruction of the respective manufacturers. The specificity and sensitivity of Maccura kit was 81.8% and 82.5%, A*Star kit was 100% and 75.4%, Da An Gene kit was 100% and 68.4%, Sansure kit was 54.5% and 91.2% and TaqPath kit was 100% and 70.2% respectively. Our in house SYBR-Green method showed a consistent detection result with 90.9% specificity and 91.2% sensitivity. We also found that detection kits targeting more genes showed better accuracy which facilitates less false positive results (< 20%). Our study found a significant difference (p < 0.005) in Ct value reported for common target genes shared by the RT-PCR kits in relation with different variants of COVID-19 infection. Recent variants of concerns contain more than 30 mutations in the spike proteins including 2 deletion and a unique insertion mutation by which makes detection of these variants difficult and these facilitates the variants to escape from being detected.

Deep remission improves the quality of life of patients with Crohn's disease and anoperineal fistula treated with darvadstrocel: results of a French pilot study.

BACKGROUND: The injection of allogeneic adipose tissue-derived mesenchymal stem cells (MSC) into anal fistulas in patients with Crohn's disease has never been evaluated in "real-life" conditions in France. METHODS: We prospectively studied the first patients receiving MSC injections at our center and undergoing 12 months of follow-up. The primary endpoint was the clinical and radiological response rate. The secondary endpoints were symptomatic efficacy, safety, anal continence, quality of life (Crohn's anal fistula-quality of life scale, CAF-QoL), and predictive factors of success. RESULTS: We included 27 consecutive patients. The complete clinical and radiological response rates at M12 were 51.9% and 50%, respectively. The combined complete clinical-radiological response (deep remission) rate was 34.6%. No major adverse effects or changes in anal continence were reported. The perianal disease activity index decreased from 6.4 to 1.6 (p < 0.001) for all patients. The CAF-QoL score also decreased from 54.0 to 25.5 (p < 0.001). At the end of the study, M12, the CAF-QoL score was significantly lower only in patients with a complete combined clinical-radiological response relative to those without a complete clinical-radiological response (15.0 versus 32.8, p = 0.01). Having a multibranching fistula and infliximab treatment were associated with a combined complete clinical-radiological response. CONCLUSIONS: This study confirms reported efficacy data for the injection of MSC for complex anal fistulas in Crohn's disease. It also shows a positive impact on the quality of life of patients, particularly those for whom a combined clinical-radiological response was achieved.

Prediction of Hazardous Effect of Heavy Metals of Point-Source Wastewater on Fish (Anabas cobojius) and Human Health.

Aquatic ecosystems are exceedingly contrived due to industrial dispenses, as a huge amount of toxicants especially heavy metals are released, causing drastic effects on aquatic lives and the human body. This study was performed to assess the quality of point-source industrial wastewater at varying percentage levels and their subsequent hazardous effect on fish (Anabas cobojius) and human health. The perceived value revealed that water quality parameters declined with the increase of wastewater concentration and trace metal evaluation index (TEI) ascertained a high level of water pollution due to Cr, Mn, Fe, Co, Ni, Cu, Zn, and As content for all percentages of wastewater. Concentration of wastewater and culture treatment duration largely impacted on fish mortality rate, body dis-pigmentation, mucus secretion rate, coagulation of mucus all over the body, and accumulation of heavy metals by fish samples. Metal pollution index (MPI) indicated low contamination of fish by the measured elements. Zn and Hg exceeded the threshold limit of target hazard quotient (THQ > 1) and contributed significantly to non-carcinogenic health implications for both the population group. Maximum hazard index in adults and children was observed to be 10.638 and 16.548 for 100% effluent at 96-h exposure period and the overall HI value manifested a very high to medium significant health effects regardless of age. Carcinogen Pb showed insignificant risk but Cr and Ni showed extremely high to medium-high risk for both the population group, and children were found more vulnerable receptors than adults. However, source of heavy metals in wastewater and fish samples stipulated anthropogenic sources.

Genomic analysis and in vivo efficacy of Pediococcus acidilactici as a potential probiotic to prevent hyperglycemia, hypercholesterolemia and gastrointestinal infections.

Lactic acid bacteria are the well acknowledged probiotics that can cure a variety of diseases. In this study, we observed the in vivo potentials of Pediococcus to treat hyperglycemia, hypercholesterolemia and gastrointestinal infections. A total of 77 Lactobacillus were isolated from the milk of 10 cows and 10 goats, four of those strains inhibited both carbohydrates-hydrolyzing enzymes, α-glucosidase, and α-amylase. They all showed antagonistic effects on pathogenic E. coli and S. Typhimurium which were confirmed by performing pathogen challenge test and visualizing on Electron microscopy. 16S rRNA gene sequence identified that all four strains belong to Pediococcus genus which were further distinguished as Pediococcus acidilactici by pheS gene sequence. Whole genome sequence analysis revealed their non-pathogenic properties for human and the presence of probiotic genes responsible for stress resistance, immunomodulation, adhesion, metal and drug resistance. In vivo trial with diabetes-induced mice ascertained that all Pediococcus acidilactici had significant potentials to reduce elevated glucose and low-density lipoprotein level in blood. Interestingly, two out of four strains were significantly more effective (p < 0.0001 each) than metformin in reducing the blood glucose level. This in vivo study demonstrated that Pediococcus acidilactici might be a promising probiotic to prevent hyperglycemia, hypercholesterolemia and gastrointestinal infections.

Clinical Outcome of 0.2% Glyceryl Trinitrate Topical Ointment Compared to Lateral Internal Sphincterotomy in the Treatment of Patient with Chronic Anal Fissure: A Randomized Control Trial.

The objective of study was to evaluate the clinical outcome of topical 0.2% Glyceryl trinitrate topical (GTN) ointment in the treatment of chronic anal fissure. This randomized control trial was carried out in the Colorectal Surgery Unit, Department of Surgery, Bangabandhu Sheikh Mujib Medical University (BSMMU), Bangladesh from May 2015 to April 2016. Total 94 patients were included in this trial, where 47(50.0%) patients were treated by 0.2% GTN ointment as Trial group 12 hourly for 8 weeks and 47(50.0%) patients by lateral internal sphincterotomy (LIS) as Control group in this study. Patients were randomized in two groups by lottery following purposive sampling. Post-procedural outcome variables with 6 months follow up were evaluated. Majority of the patients were found in between 20 to 40 years of age in both groups. The mean age was 34.6±10.4 years and 33.2±8.6 years in GTN and LIS respectively. Overall male female ratio was 0.88:1. All (100.0%) patients presented with pain in anus and 86.15% patients presented with per rectal bleeding. Pain relief in GTN arm versus LIS arm in 2nd and 6th week was 55.31% vs. 76.6%, 74.5% vs. 87.23% with no significant difference between two groups. But at 6 month it was 57.44% vs. 93.6% respectively. The fall in pain relief at 6th month in GTN arm was due to recurrence of fissure. At the end of 2nd, 6th week and 6month, cessation of bleeding improved gradually in both groups after treatment but the improvement was significantly better in LIS group than in GTN group indicating sphincterotomy stops bleeding better. Healing after 2nd week in both groups was minimum but equal 2(4.26%) patients. After 6 weeks LIS group had significant better healing than GTN 40(85.1%) versus 26(55.3%) with p value <0.001. In 6 month time GTN group had increased healing but LIS group had significant better healing than GTN group 42(89.36) vs. 32(68.08) with p value 0.004. Transient flatus and liquid incontinence were 8.51% and 6.4% respectively in LIS group with 0.0% in GTN group. Headache and recurrence were significantly higher in GTN group 61.7% and 34.04% with p<0.001. Lateral internal anal sphincterotomy is superior to the topical application of 0.2% nitroglycerin ointment in the treatment of chronic anal fissure with the advantages of good symptomatic relief, high rate of healing and a very low rate of transient continence disturbances.