Symposium review: Uncertainties in enteric methane inventories, measurement techniques, and prediction models.

Ruminant production systems are important contributors to anthropogenic methane (CH4) emissions, but there are large uncertainties in national and global livestock CH4 inventories. Sources of uncertainty in enteric CH4 emissions include animal inventories, feed dry matter intake (DMI), ingredient and chemical composition of the diets, and CH4 emission factors. There is also significant uncertainty associated with enteric CH4 measurements. The most widely used techniques are respiration chambers, the sulfur hexafluoride (SF6) tracer technique, and the automated head-chamber system (GreenFeed; C-Lock Inc., Rapid City, SD). All 3 methods have been successfully used in a large number of experiments with dairy or beef cattle in various environmental conditions, although studies that compare techniques have reported inconsistent results. Although different types of models have been developed to predict enteric CH4 emissions, relatively simple empirical (statistical) models have been commonly used for inventory purposes because of their broad applicability and ease of use compared with more detailed empirical and process-based mechanistic models. However, extant empirical models used to predict enteric CH4 emissions suffer from narrow spatial focus, limited observations, and limitations of the statistical technique used. Therefore, prediction models must be developed from robust data sets that can only be generated through collaboration of scientists across the world. To achieve high prediction accuracy, these data sets should encompass a wide range of diets and production systems within regions and globally. Overall, enteric CH4 prediction models are based on various animal or feed characteristic inputs but are dominated by DMI in one form or another. As a result, accurate prediction of DMI is essential for accurate prediction of livestock CH4 emissions. Analysis of a large data set of individual dairy cattle data showed that simplified enteric CH4 prediction models based on DMI alone or DMI and limited feed- or animal-related inputs can predict average CH4 emission with a similar accuracy to more complex empirical models. These simplified models can be reliably used for emission inventory purposes.

Improved milk production through PG-PL system by provision of in-house shelter management in lactating Murrah buffaloes during winter season.

Comprehensive information on the role of ß-casein and plasminogen-plasmin (PG-PL) system in milk secretion of Murrah buffaloes during winter season is lacking, although effects of cold stress can be ameliorated to an extent by altering microclimate at farm level. Hence, this study was aimed to determine the changes in productivity along with PG-PL system of milk, plasma hormones and metabolites of buffaloes during winter (December-January) season under two different management systems. Average minimum temperature and wind chill index during this season were 7.02 and 12.74 °C respectively. Buffaloes were divided in two groups of six animals each: control and treatment, where treatment group animals were placed in-house with floor bedding of paddy straw and the control group animals in loose housing system without straw bedding. Physiological responses were recorded, and milk and blood samples were collected at weekly intervals for six-week experimental period. Under in-house management system, buffaloes experienced better comfort by alleviating environmental stress as their physiological responses such as respiration rate and pulse rate were significantly reduced (p < 0.01) as compared to the control, which subsequently resulted higher milk yield by 9.92% (p < 0.05). Analysis of milk samples revealed higher concentration of plasminogen (10.6 vs. 8.05 µg/ml; p < 0.01) and ß-casein (p < 0.05), and lower plasmin level (0.299 vs. 0.321 µg/ml; p < 0.05) in buffaloes under treatment group. It was also found that plasma cortisol, glucose and non-esterified fatty acids levels were higher (p < 0.01) in control group as compared to the treatment animals by 13.6%, 8.14% and 12.6% respectively. However, milk composition, growth hormone, epinephrine and norepinephrine level in plasma were similar in both the groups. Hence, it may be concluded that provision of in-house shelter management with floor bedding of paddy straw during winter was effective to minimize environmental stress and improved milk production through manipulation of PG-PL system in buffaloes.

HER2 status in Gastric and Gastroesophageal Junction Adenocarcinoma.

Gastric carcinoma is a biologically heterogenous disease and survival varies among the patients with same stage. Recent studies have shown that a subset of gastric and gastroesophageal junction adenocarcinoma over express the HER2/neu protein and these patients can be treated by monoclonal antibody against HER2/neu protein. The purpose of this study was to detect the frequency of HER2 expression in gastric and gastroesophageal junction adenocarcinoma and to evaluate the relationship between HER2 expression and clinicopathological features in these patients. This descriptive cross sectional study was carried out at the Department of Pathology, Dhaka Medical College, from January 2013 to December 2014. A total of 130 patients with primary gastric and gastroesophageal junction adenocarcinomas were included in this study. All the cases were evaluated for routine histological examination and immunohistochemical examination was done for HER2/neu protein. Among the 130 cases, HER2 over expression was found in 12.3% cases and was more frequent in gastroesophageal junction (28%) than in gastric carcinoma (8.6%) (P=0.026). HER2 positivity was found significantly more in intestinal type carcinoma (19%), papillary carcinoma (63%) and in fungating growth pattern (P=0.003, 0.001 and 0.001 respectively). HER2 expression was also positive in grade-I or grade-II tumor but negative in grade-III tumor (P=0.001). No significant association of HER2 expression was found with age, sex, lymph node metastasis and extent of tumor. In conclusion it can be stated that gastric and gastroesophageal junction adenocarcinoma of intestinal type or papillary and tubular type with well to moderate differentiation can be targeted for therapy using Herceptin.

Molecular-Characterization of Methicillin-Resistance Staphylococcus aureus (MRSA) from Different Tertiary Care Hospitals in Bangladesh.

Infections caused by Staphylococcus aureus were treated by methicillin, but about 95% of S. aureus has been resistance to methicillin, both in the community and hospitals and are increasing day by day. MRSA produces altered penicillin binding protein, PBP2a, due to the expression of mecA gene. Some strains of both the MRSA and MSSA carry PVL gene. This cross sectional observational study was conducted to detect the molecular-characterization of methicillin resistant Staphylococcus aureus (MRSA) and carried out in the Department of Microbiology, Mymensingh Medical College from July 2014 to December 2015. Clinical samples for this study were wound swab, pus, exudates from diabetic ulcer and burn ulcer, aural swab, blood and urine which were collected from three tertiary care hospitals such as from MMCH, BIRDEM hospital and SSMCH. Standard microbiological procedure & biochemical tests were carried out to detect S. aureus. Oxacillin disk diffusion method (ODDM) was done by Kirby-Bauer disk diffusion method. Out of a total 109 culture positive samples 69 isolates of S. aureus were selected for the study. Among the 69 isolates 33, 27 and 09 were from MMCH, BIRDEM hospital and SSMCH respectively. Among the 69 isolates, 17(24.6%) and 52(75.3%) were distinguished as MRSA and MSSA respectively by ODDM. In contrast, detection of presence and absence of mecA gene by PCR identified 20(28.9%) and 49(71.01%) isolates as MRSA and MSSA respectively. Multiplex PCR was performed by standard protocol with specific primers for detection of 16S rRNA gene for Staphylococcus, nuc gene for Staphylococcus aureus, mecA gene for MRSA, PVL gene as a virulence factor and ACME-arc gene for worldwide spreading USA 300 MRSA clone. The PVL gene were detected in 3 out of 20 MRSA (15%) and 19 out of 49 MSSA (38.7%) and the ACME- arc gene was not found in any isolates. All of the S. aureus (MRSA and MSSA) isolates were sensitive to Vancomycin and Gentamicin. All MRSA isolates (100%) showed resistance to Penicillin and Oxacillin. Of the MRSA isolates about 88.2% were resistance to Ceftazidime, 64.7% were resistance to Erythromycin and Ciprofloxacin, 11.7% were resistance to Tetracycline. Among the MSSA isolates 94.2% were resistance to Penicillin and 9.6% resistance to Ciprofloxacin. The MSSA were less resistance for non-beta lactam drugs than MRSA.

Open-label randomized non-inferiority trial of a fixed-dose combination of glimepiride and atorvastatin for the treatment of people whose Type 2 diabetes is uncontrolled on metformin.

AIMS: To evaluate, in a randomized, open-label study, the non-inferiority of a bioequivalent fixed-dose combination of glimepiride and atorvastatin vs. separately co-administered tablets in people with Type 2 diabetes mellitus. METHODS: Participants with HbA1c ≥ 53 to < 80 mmol/mol (≥ 7.0 to < 9.5%), average fasting blood glucose > 7.0 mmol/l, who were on metformin for ≥ 3 months, were randomized to combination (n = 215) or co-administered glimepiride and atorvastatin (n = 212) once daily for 20 weeks. Up-titration of glimepiride (1-4 mg) and atorvastatin (10-20 mg) were based on average fasting blood glucose and LDL cholesterol, respectively. Co-primary endpoints were change from baseline to week 20 in HbA1c and LDL cholesterol. RESULTS: Non-inferiority was demonstrated for both co-primary endpoints: the upper limits of 95% CIs for differences (combination-reference) were less than the prespecified margins of 3.3 mmol/mol (0.3%) for change from baseline in HbA1c [difference 0.1 mmol/mol (95% CI -1.6, 1.9); 0.01% (95% CI -0.15, 0.17)] and 6% for percentage change from baseline in LDL cholesterol [difference 0.87% (95% CI -2.47, 4.21)]. Similar proportions of participants on combination and reference had treatment-emergent adverse events (64 vs. 61%). More participants on combination had hypoglycaemia (21 vs. 13%); most events were considered by the treating physician to be unrelated to study drug. CONCLUSIONS: The combination was non-inferior to separately co-administered tablets and the safety profile was consistent with the known profiles of glimepiride and atorvastatin. The observed increase in hypoglycaemia on the combination cannot be explained, but may be attributable to non-systematic collectiof glucose readings and may have been influenced by reporting bias in this open-label trial.

Up-regulation of milk secretion with modified microclimate through manipulating plasminogen-plasmin system in Murrah buffaloes during hot dry season.

The present study was aimed at determining changes in milk yield and composition along with the plasminogen-plasmin system of milk, plasma hormones, and metabolites of buffaloes during hot dry season (air temperature range 39.7 to 44.8 °C) under two different management systems. Buffaloes were divided in two groups of six animals each: control and treatment, where treatment group animals accessed benefit of mist and fan cooling from 9:30 a.m. to 5:00 p.m., while control group animals were devoid of it. Duration of experiment was 6 weeks. Under mist and fan cooling system, buffaloes experienced better comfort by alleviating environmental stress as their physiological responses such as rectal temperature, respiration rate, pulse rate, and forehead and middorsal temperatures were significantly (P < 0.05) reduced compared to control, which subsequently resulted higher milk yield by 4.44 % (P < 0.001). Analysis of milk samples revealed higher concentration of plasminogen (7.99 vs 6.27 µg/ml; P < 0.01) and ß-casein (1.09 vs 0.92 g/dl; P < 0.001) and lower plasmin level (0.178 vs 0.194 µg/ml; P < 0.05) in buffaloes under the treatment group compared to that under the control. Plasma glucose level was higher (P < 0.001) by 21.08 %, whereas cortisol, norepinephrine, and NEFA levels were lower (P < 0.001) by 19.19, 15.38, and 11.41 %, respectively, in treatment animals. However, exposure of buffaloes to cooling system did not alter composition and calcium content of milk, GH, and epinephrine level in plasma. Hence, it may be concluded that provision of cooling system during summer was effective to minimize environmental stress and improve milk production by manipulation of the PG-PL system in buffaloes.

Comparison of Low Density Lipoprotein Cholesterol Level in Second and Third Trimester of Pregnancy in Mymensingh Region of Bangladesh.

Altered metabolic and hormonal status of the body in pregnancy leads to changes in lipid profile. High Lipid profile, a major factor behind atherosclerosis may leads to unconsciousness. To avoid such problems during pregnancy this longitudinal study was carried out in the Department of Biochemistry, Mymensingh Medical College in co-operation with the Department of Obstetrics and Gynaecology, Mymensingh Medical College Hospital and Community Based Medical College Hospital, Bangladesh during the period from July 2011 to December 2012 to compare the changes in low density lipoprotein cholesterol level during 2nd and 3rd trimester of pregnancy. A total of one hundred subjects were participated in this study comprising of second and third trimester of pregnancy. All subjects were made to fast overnight at least for a minimum of 8 hrs. Blood samples were taken and analyzed by enzymatic colorimetric kit method. Pregnancy has being found to be associated with changes in lipid profile and this differs with each trimester. The average results were analyzed with respect to each pregnancy for the whole group. The study proves that serum Low Density Lipoprotein (LDL) cholesterol increases in third trimester (174.83±13.78 mg/dl) than second trimester (156.77±7.96 mg/dl) of pregnancy. Therefore, lipid profile estimation and monitoring should be made as a part of routine investigation during antenatal period.

Antimicrobial Susceptibility Pattern of Methicillin-Resistance Staphylococcus aureus from Different Tertiary Care Hospitals Including Mymensingh Medical College Hospital.

The aim of this study was to detect antimicrobial susceptibilities and the presence of drug resistance genes of MRSA from tertiary care hospitals. This study was carried out in the Department of Microbiology, Mymensingh Medical College during the period from Jan, 2015 to Dec, 2015. Clinical samples, including wound swab, pus, exudates from diabetic ulcer and burn ulcer, aural swab, blood and urine were collected. Standard microbiological procedure & biochemical tests were carried out to detect S. aureus. Oxacillin disk diffusion test was done by Kirby-Bauer disk diffusion method. Total 69 isolates of S. aureus were selected for the study. The isolates were collected from three different tertiary care hospitals, of which 33, 27 and 9 were from Mymensingh Medical College Hospital (MMCH), BIRDEM hospital and Sir Salimullah Medical College Hospital (SSMCH) respectively. Among the 69 isolates, 17(24.6%) and 52(75.3%) were distinguished as MRSA and MSSA respectively by ODDM (Oxacillin disk diffusion method). In contrast, detection of presence and absence of mecA gene by PCR identified 20 (28.9%) and 49 (71.01%) isolates as MRSA and MSSA respectively. All of the S. aureus (MRSA and MSSA) isolates were sensitive to vancomycin and gentamicin. All MRSA isolates (100%) showed resistance to Penicillin and Oxacillin. Among the MRSA isolates about 88.2% were resistance to Ceftazidime, 64.7% were resistance to Erythromycin and Ciprofloxacin, 11.7% were resistance to Tetracycline. Among the MSSA isolates about 94.2% were resistance to Penicillin and 9.6% resistance to Ciprofloxacin. The MSSA were less resistance for non-beta lactam drugs than MRSA. Regarding drug resistance genes, the blaZ genes were present in 47 out of 49(95.8%) MSSA and in 18 out of 18 (100%) MRSA. The erythromycin resistance gene ermB was found in 8.69% isolates, of which highest 20% in MRSA and 4.08% in MSSA. The ermA was not found in any isolates. Among tetracycline resistance genes, tetK were detected in 10.1% and tetL were found in 2.8% of MRSA. The highest tetK genes were found in 20% of MRSA and in 6.1% of MSSA. Regarding, the gentamicin drug resistance, the aac(6')-Iaph(2'')-Ia gene was not found in any isolates. The relatively high proportion of MRSA and the associated antibiotic resistance seen in this study emphasizes the need for country based surveillance to characterize and monitor MRSA and to develop strategies that will improve MRSA treatment and control.

Outcome of Induction of Labour in Prolonged Pregnancy.

This was a hospital based prospective clinical study conducted among women having prolonged pregnancy to assess the outcome of induction of labour in prolonged pregnancy cases. One hundred and thirty nine women having uncomplicated prolonged pregnancy were studied. The study was carried out in Sir Salimullah Medical College & Mitford Hospital, Dhaka from 01 July 2010 to 30 March 2011. In this study 66% of the respondents had vaginal delivery on routine induction of labour and in 34% cases induction failed. Ninety three percent (93%) of the multigravida had vaginal delivery and in primigravida their vaginal delivery rate was 47.5%. Regarding cervical condition for delivery, 75% of the respondents having favourable cervix had vaginal delivery and in case of unfavourable cervix respondents, they had 55% cases of vaginal delivery. About the foetal outcome it was evidenced from this study that the perinatal adverse outcome increases with the increasing age of gestation beyond 40 completed weeks of gestation. This study showed that the use of prostaglandins for cervical ripening and by confirming the diagnosis of prolonged pregnancy, the delivery outcome in prolonged pregnancy can be improved. The study also showed that induction of labour is not associated with any major complications and the routine induction of labour in prolonged pregnancy is beneficial for both mother and the baby.

Non-Hodgkin's lymphoma by immunohistochemistry.

Non Hodgkin's lymphomas (NHL) constitute a heterogeneous group of neoplasm of the lymphoid system. There are many histological subtype of NHL based on WHO classification of hematopoietic and lymphoid neoplasm. This cross-sectional study was carried out in the department of Pathology, Dhaka Medical College, Dhaka from January 2009 to December 2010 to observe the different subtypes of NHL using immunohistochemistry (IHC) with CD3. A total of 50 microscopically diagnosed case of NHL irrespective of age and sex were included in the study. The diagnostic morphologic criteria of each lymphoma subcategory were compiled and diagnosis was made. Mean age of the study subjects were 42.0±19.7 years with range 3-75 years and male female ratio was 1.8:1. Nodal NHL was 66% and extranodal cases were 34%. Maximum number of histolgic subtypes belonged to diffuse large B-cell lymphoma (DLBCL) and male was predominant in all histological subtypes, except peripheral T-cell lymphoma (PTCL). DLBCL was predominant in all B-cell NHL whereas PTCL was predominant in all T-cell NHL. The most childhood patients belonged to lymphoblastic lymphoma. Regarding cell lineage B-cell NHL was more common than T-cell NHL (88% vs. 12%), but high grade pattern was more predominant in T-cell type (83.3% vs. 65.9%). Among 50 study subjects histological (H & E) diagnosis reveals 46 cases as B-cell NHL and 4 as T-cell NHL but IHC confirms 6 cases as T-cell NHL.

Pattern of Dermatophytes in Patients Attend in Mymensingh Medical College Hospital.

Dermatophytosis is a common fungal disease which involves the keratinized tissue. This is an attempt to observe the spectrum of dermatophytes among the clinically suspected cases of dermatophytosis attending the outpatient department of Dermatology and Venereology, Mymensingh Medical College Hospital, Mymensingh during the period of July 2013 to December 2014. Two hundred thirty (230) clinically suspected cases of dermatophytosis were subjected in this study. Sixty three cases (27.39%) were positive for fungus in direct microscopy while 53(23.04%) were culture positive. Among the clinical types tinea unguium was the most common followed by tinea corporis. Dermatophytosis was more common in the age group of 21-30 years. The male to female ratio was 1.53:1. Trichophyton rubrum 44(83.04%) was found common etiological dermatophyte species followed by Trichophyton mentagrophytes 5(9.43%) and Epidermophyton floccosum 4(7.55%).

Use of modified blood agar plate for identification of pathogenic campylobacter species at Mymensingh Medical College .

This cross sectional study was carried out from July 2011 to June 2012 in the Department of Microbiology, Mymensingh Medical College to diagnose etiology of diarrhea caused by Campylobacter species. A total of 200 clinically diagnosed diarrheal pediatric patients were included in this study. Among the 200 stool specimens evaluated, 23(11.5%) samples were positive for Campylobacter species, isolation rate was 15(65.2%) in upto 1 year age group and 08(34.7%) in more than 1 year age group. Among 23 positive cases, 20(86.95%) were C. jejuni and 03(13.05%) were C. coli. The prevalence of Campylobacter infection found in the present study was higher below 1 year age group and was very much close to other countries of this Sub continent.

Clinico-Pathological Profile and Outcome of Multiple Ultrasonogram Guided Aspiration of Breast Abscess in Outpatient Department Setup: A Prospective Study.

Treating breast abscess by conventional incision and drainage, followed by regular dressing with prolonged hospital stay, anesthesia, unsatisfactory scar and chances of developing milk fistula in lactating mother is unsatisfactory. Here we study the outcome of ultrasonogram guided multiple aspirations in non-admitted outpatient setup, for its effectiveness as a replacement of conventional surgery. This descriptive, prospective and observational study was carried out from July 2018 to December 2020 with purposive sampling of all cases of breast abscess in a secondary care hospital who underwent ultrasonogram guided aspiration and oral antibiotics, on multiple visits in outpatient department and followed up for three months to study outcome. Mean age of patient was 28.19 years. Fifteen (46.9%) were non-lactating women. The right breast 18(56.3%) and upper outer quadrant 8(25.0%) was affected slightly more. All cases had tender lump except one (3.1%) who had a non-tender lump, but 20(62.5%) had no maximum fluctuating point, usually found in abscesses of other parts of the body. Fever was not a common feature in 8(25.0%) patients and axillary lymph node was not palpable in 26(81.3%) patient. Eighteen (56.3%) patients had healthy nipple, 8(25%) patients had cracked and 5(15.6%) had retracted nipple 11(34.4%) with pus discharge from nipple. Mean duration of symptom was 7 days. Mean sonographic diameter was 5.53cm and volume was 21.09ml. Mean aspirated total volume was 28±10.5 ml. Fifteen (46.9%) patients required 3 aspirations, 10(31.3%) needed 4 aspirations. Success rate was 84.4%, while 25(78.1%) had no complications. Mean healing time in this study was 14 days. We conclude that multiple aspirations under ultrasonogram guidance in outpatient setup day care procedure, is equally effective as conventional surgery and also devoid of many avoidable complications, but meticulous evaluation and high suspicion of background pathology for non-responding case is crucial.

Influence of Black pepper (Piper nigrum L) Seed Extract in Methanol against Gram Positive Staphylococcus aureus and Gram-Negative Pseudomonas aeruginosa.

Antibiotics' usefulness is threatened by multi-drugs resistance in harmful microorganisms because of abuse and regulatory problems. Emerging microbes, resistance mechanisms and antimicrobial drugs all require extensive investigation. Evaluation of the in vitro antibacterial activity of Methanolic extracts isolated from Black pepper seeds (Piper nigrum L.) against two infection causing pathogens, Gram-positive Staphylococcus aureus and Gram-negative Pseudomonas aeruginosa. From July 2022 and June 2023, this experimental study was conducted at the Mymensingh Medical College's Department of Pharmacology and Therapeutics in conjunction with the Department of Microbiology. The solvents Methanol and 10.0% Di-Methyl Sulfoxide (DMSO) were used to make the extract. Using the disc diffusion and broth dilution methods, the antibacterial activity of methanolic extract of black pepper seeds (MBPE) was evaluated at various doses. Using the broth dilution procedure, the conventional antibiotic Ciprofloxacin was utilized, and the outcome was contrasted with that of Methanol extracts. Methanolic extract of black pepper seeds (MBPE) at seven distinct concentrations (100, 80, 60, 40, 20, 10 and 5mg/ml) were utilized, then later in chosen concentrations as needed to confirm the extracts' more precise margin of antimicrobial sensitivity. At 80mg/ml and above doses of the MBPE, it had an inhibitory impact against the aforementioned microorganisms. For Staphylococcus aureus and Pseudomonas aeruginosa the MIC were 60 and 70mg/ml in MBPE respectively. As of the MIC of Ciprofloxacin was 1µg/ml against Staphylococcus aureus and 1.5µg/ml for Pseudomonas aeruginosa. In comparison to MICs of MBPE for the test organisms, the MIC of Ciprofloxacin was the lowest. This study clearly shows that Staphylococcus aureus and Pseudomonas aeruginosa are sensitive to the methanolic extract of black pepper seeds' antibacterial properties.

Association of Maternal Serum Homocysteine level with Maternal Birth Weight.

A baby's weight at birth is an important predictor of infant growth and survival. Low birth weight leads to an impaired growth of the infant and its attendant risks of a higher mortality and morbidity. Various studies found higher maternal plasma homocysteine level was associated with lower offspring birth weight. Therefore, this study was carried out to find out association between maternal serum homocysteine and birth weight. A cross sectional study was conducted in the Department of Obstetrics and Gynaecology, BSMMU from September 2018 to August 2019. Pregnant women at their third trimester between 37-40 weeks admitted to in patient Department of Obstetrics and Gynaecology, BSMMU were included in this study. Ethical committee clearance was obtained from the institution. After matching eligibility criteria informed written consent were taken from the patients. Data was collected from the patients using the structured design by interview, observation, clinical examination and haematological investigations. The serum homocysteine level of these patients and birth weight of their babies was measured immediately after delivery. Negative correlation was found between maternal serum homocysteine level and neonatal birth weight, (r = -0.419, p<0.05). During regression analysis maternal homocysteine and gestational age was found significant when adjusted with maternal age, parity, maternal BMI and sex of the baby. So, increased maternal serum homocysteine is negatively associated with low birth weight babies.

An Alarming Rise of Candidemia Caused by Non-Albicans Candida Species in Intensive Care Unit in Mymensingh, Bangladesh.

In Intensive Care Units (ICUs) infection represents the most frequent complication leading to high mortality. Particularly the incidence of fungal infections, especially due to Candida spp., has been increasing during the last years. Over last two decades there is predominance of Non albicans Candida (NAC) infection with increased isolation of novel species and decreased susceptibility. Early identification of Candida species and determination of antifungal susceptibility pattern is essential for effective management. Therefore, the study was conducted to isolate and identify Candida species from the blood samples of the patients suspected of candidemia and assess their antifungal susceptibility pattern. This cross-sectional, descriptive type of observational study was conducted in the Department of Microbiology, Mymensingh Medical College, Bangladesh from March 2021 to February 2022. Venous blood was collected from clinically suspected patients admitted at ICU, Neonatal Intensive Care Unit (NICU), Mymensingh Medical College Hospital, Bangladesh. Primary blood culture was performed by automated method followed by sub-culture in Saboraud's Dextrose Agar (SDA) and blood agar media. Candida species were recognized by phenotypic and genotypic methods. Antifungal susceptibility testing was done by disk diffusion and broth microdilution method (BMD). Out of 125 blood specimens collected, Candida species were isolated from 39(31.0%) blood samples of which NAC species were 35(89.0%) whereas C. albicans was only 4(10.2%). Eight (8) different Candida species were identified of which C. parapsilosis was predominant 16(41.0%). Rare and emerging drug resistant species of C. ciferrii 23.0%, C. auris 7.7%, C. rugosa 10.3%, C. lusitaniae 2.6% were also isolated. Candidemia was highest in neonate 33(84.61%) with male predominance 24(61.54%). Use of broad-spectrum antibiotics, prolonged hospital stay, pre-maturity and low birth weight (LBW) were found to be important risk factors. In candidemia the highest resistance was to Fluconazole-33% and lowest to Voriconazole-5%. The study showed that NAC species were more common with emergence of rare and multidrug resistant species.

Antimicrobial Susceptibility Patterns of Bacterial Isolates from Blood Culture of Pediatric Patients with Suspected Sepsis at a Tertiary Care Hospital in Mymensingh, Bangladesh.

Sepsis is a serious, life-threatening condition, occurring when an infectious agent invades the body, resulting in systemic inflammatory response syndrome (SIRS). Neonates and children are among the most vulnerable population groups of developing sepsis because of their weak immune barrier. Despite major advances in prevention, diagnosis and treatment of bacterial infections, invasive infections followed by sepsis remain one of the leading causes of childhood mortality. The aim of this study was to identify bacterial agents and antimicrobial resistance patterns of aerobic bacteria among children suspected of having sepsis. This cross-sectional descriptive type of observational study was conducted in the Department of Microbiology, Mymensingh Medical College, Bangladesh from March 2021 to February 2022. Blood samples were collected from pediatric patients, suspected of having sepsis referred from inpatient facility of department of Neonatology and Pediatrics, Mymensingh Medical College Hospital (MMCH). Blood samples were inoculated into BacT/ALERT PF Plus bottles followed by sub-culture of positive samples in blood agar, MacConkey agar and chocolate agar plates. Isolated bacteria were identified by routine biochemical tests. Antimicrobial resistance pattern of all isolated bacteria was seen by disk diffusion method. MIC of vancomycin by agar dilution method was determined for isolated S. aureus and Coagulase negative Staphylococci (CoNS). The prevalence of pediatric sepsis was 31.82% with highest isolation rate 35.55% among neonates. The isolation rate of gram-positive bacteria was 62.50% where S. aureus was the most common isolate 32.15% followed by CoNS 30.36%. Out of 21 gram-negative bacteria, Pseudomonas spp. was the most frequent isolate 7(33.33%), all of which were resistant to cefuroxime, ceftriaxone and ceftazidime along with all klebsiella and Acinetobacter isolates. Out of 18 S. aureus isolates, 94.44%, 88.89% and 66.67% were resistant to Azithromycin, Penicillin-G and Ciprofloxacin respectively. The MIC of Vancomycin by agar dilution method was observed <2µg/ml against all isolated S. aureus and CoNS. All the Gram-positive isolates were sensitive to Linezolid and Vancomycin. Early detection of bacteria followed by antimicrobial susceptibility test can help by selection of appropriate antibiotic and prevent spread of infection.

Rumen microbial variation and nutrient utilisation in mithun (Bos frontalis) under different feeding regimes.

The aim of the study was to investigate the effect of feeding different diets on fermentation, enzyme activities and microbial population in the rumen fluid of mithun (Bos frontalis). In a randomized block design, 20 male mithun (6-8 months of age, 152 ± 12.6 kg body weight) were randomly divided into four experimental groups (n = 5/group) and fed experimental diets ad libitum for 180 days. The diet R1 contained tree foliages (TF), R2 comprised of 50% concentrate mixture (CM) and 50% TF, R3 contained 50% CM and 50% rice straw, and R4 contained 50% CM, 25% TF and 25% rice straw. Rumen liquor was collected at 0 and 180 days of the experiment for estimation of different ruminal parameters and a digestion trial was conducted at the end of the experiment. Rumen fluid was analysed for pH, ammonia nitrogen (NH3 -N), total-N, ruminal enzymes, short chain fatty acid (SCFA) and microbial profile. The relative quantification of ruminal microbes was carried out with real-time PCR using bacteria as the house keeping gene. The dry matter intake, nutrients digestibility, body weight gain, NH3 -N, total-N, carboxymethyl cellulase, avicelase, xylanase, amylase, protease and molar proportion of butyrate were (p < 0.05) higher in mithun fed R2 , R3 and R4 compared to those fed R1 diet. In contrast, increased (p < 0.05) ruminal pH, molar proportion of acetate and, acetate to propionate ratio was recorded in mithun fed only TF than those fed concentrate supplemented diets. Similarly, an increase (p < 0.05) in the population of Fibrobacter succinogenes, Ruminococcus flavefaciens and total bacteria were evident in mithun fed R2 , R3 and R4 compared to those fed R1 . Therefore, it is concluded that TF 25% and/or rice straw 25% along with CM 50% may be fed to the growing mithun for improved rumen ecology, nutrient utilization and thus better performance under stall fed system.

Prevalence and antimicrobial susceptibility pattern of ESBL producing isolates.

Extended spectrum ß-lactamases (ESBLs) are produced by Gram negative bacteria showing resistance to new generations of antimicrobial agents. This study was undertaken to characterize ESBL producing bacteria from 222 urinary isolates. Antimicrobial resistance was screened by disc diffusion test. The ESBL status was confirmed by double disc diffusion test (DDDT) and minimum inhibitory concentration (MIC) by agar dilution method by standard procedure. The study revealed the following distribution of ESBL producing isolates: Klebsiella spp (81.6%), Proteus spp (78.1%) E. coli (72.3%) and Pseudomonas spp (66.7%). All the isolates were sensitive to imipenem and nitrofurantoin followed by amikacin 92.9%. A relatively higher rate of resistance to gentamicin, co-trimoxazole, azithromycin and quinolones were also observed for ESBL producers. The study suggested routine detection of ESBL and avoidance of irrational use of third generation cephalosporins to reduce the emergence of multidrug resistance bacteria following an antibiotic policy.

Methicillin-resistant coagulase-negative staphylococci (MRCoNS) by disk diffusion method.

The antimicrobial susceptibility of 80 coagulase-negative staphylococci (CoNS) isolates from surgical wound, pus from infected skin lesions, burn exudates and diabetic ulcer exudates of patients in Mymensingh Medical College Hospital, Bangladesh, was evaluated in order to see their pattern of antimicrobial resistance. The study was carried out in the department of Microbiology, Mymensingh Medical College during the period from July 2009 to May 2011. The 80 CoNS isolates were subjected to antimicrobial susceptibility to relevant antibiotics including oxacillin by disk diffusion method. Out of 80 CoNS isolates, the highest number were resistant to oxacillin 36(45%), followed by gentamicin 32(40%), cefuroxime 25(31%), ceftriaxone 24(30%) and ciprofloxacin 18(22%). All isolates of CoNS were sensitive to imipenem and vancomycin. As MRCoNS were found multidrug resistant, therefore, antibiotic sensitivity must be done prior to treatment in infections caused by these species.