Pembrolizumab monotherapy versus chemotherapy in platinum-pretreated, recurrent or metastatic nasopharyngeal cancer (KEYNOTE-122): an open-label, randomized, phase III trial.

BACKGROUND: Pembrolizumab previously demonstrated robust antitumor activity and manageable safety in a phase Ib study of patients with heavily pretreated, programmed death ligand 1 (PD-L1)-positive, recurrent or metastatic nasopharyngeal carcinoma (NPC). The phase III KEYNOTE-122 study was conducted to further evaluate pembrolizumab versus chemotherapy in patients with platinum-pretreated, recurrent and/or metastatic NPC. Final analysis results are presented. PATIENTS AND METHODS: KEYNOTE-122 was an open-label, randomized study conducted at 29 sites, globally. Participants with platinum-pretreated recurrent and/or metastatic NPC were randomly assigned (1 : 1) to pembrolizumab or chemotherapy with capecitabine, gemcitabine, or docetaxel. Randomization was stratified by liver metastasis (present versus absent). The primary endpoint was overall survival (OS), analyzed in the intention-to-treat population using the stratified log-rank test (superiority threshold, one-sided P = 0.0187). Safety was assessed in the as-treated population. RESULTS: Between 5 May 2016 and 28 May 2018, 233 participants were randomly assigned to treatment (pembrolizumab, n = 117; chemotherapy, n = 116); Most participants (86.7%) received study treatment in the second-line or later setting. Median time from randomization to data cut-off (30 November 2020) was 45.1 months (interquartile range, 39.0-48.8 months). Median OS was 17.2 months [95% confidence interval (CI) 11.7-22.9 months] with pembrolizumab and 15.3 months (95% CI 10.9-18.1 months) with chemotherapy [hazard ratio, 0.90 (95% CI 0.67-1.19; P = 0.2262)]. Grade 3-5 treatment-related adverse events occurred in 12 of 116 participants (10.3%) with pembrolizumab and 49 of 112 participants (43.8%) with chemotherapy. Three treatment-related deaths occurred: 1 participant (0.9%) with pembrolizumab (pneumonitis) and 2 (1.8%) with chemotherapy (pneumonia, intracranial hemorrhage). CONCLUSION: Pembrolizumab did not significantly improve OS compared with chemotherapy in participants with platinum-pretreated recurrent and/or metastatic NPC but did have manageable safety and a lower incidence of treatment-related adverse events.

Short communication - Comparative study on peste des petits ruminants seroconversion level in sheep in Sudan.

Peste des petits ruminants (PPR) is endemic to Sudan. It is considered as a priority disease in the list of transboundary animal diseases (TADs). The aim of this study was to assess the reliability of the detection of PPR antibodies by a competitive enzyme-linked immunosorbent assay (cELISA) in naturally infected or vaccinated sheep. Sera were collected from 3,186 sheep from flocks located in six states of Sudan and additionally 100 sheep were vaccinated with a PPR homologous vaccine (produced locally) in a quarantine station. The percentages of PPR antibody-positive sera from the field varied between 72% and 100%, according to state. All sheep vaccinated in the quarantine station were PPR-seropositive. This study shows, first, that the percentages of PPR-seropositive animals were all very high, whether naturally infected or vaccinated. It also shows the reliability of the cELISA test used in this study.

La peste des petits ruminants (PPR) est présente au Soudan à l'état endémique. Elle est considérée comme une maladie prioritaire parmi celles de la liste des maladies animales transfrontalières (TAD). Les auteurs présentent une étude visant à évaluer la fiabilité d'une épreuve immuno-enzymatique de compétition (cELISA) pour la détection d'anticorps dirigés contre le virus de la PPR chez des ovins infectés naturellement ou vaccinés. Des échantillons sériques ont été prélevés sur 3 186 ovins provenant de troupeaux de six provinces du Soudan ; en outre, 100 ovins ont été vaccinés contre le virus de la PPR dans une station de quarantaine en utilisant un vaccin homologue (produit localement). Le pourcentage de sérums de terrain dans lesquels des anticorps dirigés contre le virus de la PPR ont été détectés variait de 72 % à 100 % suivant les provinces. Tous les ovins vaccinés dans la station de quarantaine ont donné un résultat positif au test sérologique. Cette étude a révélé un pourcentage très élevé d'animaux possédant des anticorps contre la PPR, tant chez les animaux infectés naturellement que chez les animaux vaccinés. Elle a également démontré la fiabilité de l'épreuve cELISA utilisée dans l'étude.

La peste de los pequeños rumiantes (PPR), endémica en el Sudán, tiene consideración de enfermedad prioritaria en la lista de enfermedades animales transfronterizas. Los autores describen un estudio encaminado a evaluar la fiabilidad del ensayo enzimoinmunoanálisis de competición (ELISAc) como método de detección de anticuerpos contra el virus de la PPR en ovejas vacunadas o infectadas por vía natural. En primer lugar, se obtuvieron muestras de suero de 3.186 ejemplares de rebaños ovinos situados en seis estados sudaneses y se administró a otras 100 ovejas una vacuna anti-PPR homóloga (de producción local) en un centro de cuarentena. Después se determinó el porcentaje de sueros positivos (con anticuerpos) de entre las muestras obtenidas sobre el terreno, que oscilaba entre un 72% y un 100%, según el estado. Todas las ovejas vacunadas en el centro de cuarentena fueron seropositivas. El estudio mostró, en primer lugar, que los porcentajes de animales seropositivos eran siempre muy altos, ya se tratara de ovejas vacunadas o de animales infectados por vía natural. Asimismo, puso de manifiesto la fiabilidad de la técnica de ELISAc empleada en el estudio.

Synthesis of recyclable carbon/lignin biocomposite sorbent for in-situ uptake of BTX contaminants from wastewater.

In this work, both palm-date pits and pulping black liquor industrial wastes were recycled as low-cost starting materials for the production of three series of granule activated carbon (gAC)/Kraft lignin (KL) (gAC/KLx, x = 33, 50 and 67%) biocomposites using a one-pot solid-state method. The gAC/KLx biocomposites with defined characteristics were examined towards batch adsorption of BTX (Benzene, Toluene, and Xylene) in multi-solute salty wastewaters. Optimization of adsorption performances under different experimental conditions were carried out using high performance liquid chromatography (HPLC). Adsorption modeling versus contact time (0-12 h) and BTX concentrations (150-2250 mg/L) were examined using non-linear forms of nine kinetic and five isotherm equations to best understand gAC/KL0.5 suitability for BTX sorption/recovery processing. Accordingly, the gAC/KLx at KL blended ratio of 50% was found to be the topmost to achieve the highest BTX capacity even at broad ranges of water salinity (0-100 g/L) and pH (3-9) values. The adsorption mechanism found to best described by physico-sorption (E ≈ 0.12-1.38 kJ/mol) via the hydrophobic interaction and diffusion mechanisms. In respect to gAC/KL0.5 affinities, the sorption capacity followed the descending sequence of X ≥ T > B. Particularly, the maximum theoretical BTX capacity using the best fitted Langmuir-Freundlich model (L-FM) for gAC/KL0.5 was found to be slightly higher than obtained by gAC (363.9 and 360.1 mg/g, respectively), along with higher initial sorption (h) rate (≈742.47 mg/g.h) than of gAC (≈559.85 mg/g.h) and KL (≈22.22 mg/g.h). Batch BTX sorption/recovery processes and estimated cost suggested the effective utilization of gAC/KL0.5 as a promising in-expensive sorbent (0.31 ±â€¯0.05 US$/kg) for commercial decontamination of petroleum hazardous (BTX) pollutants from wastewaters up to five reuse cycles.

Monocyte/granulocyte to lymphocyte ratio and the MELD score as predictors for early recurrence of hepatocellular carcinoma after trans-arterial chemoembolization.

BACKGROUND: The first-line treatment option for intermediate-stage hepatocellular carcinoma is trans-arterial chemoembolization (TACE). Blood indices, such as lymphocyte/monocyte ratio (LMR), lymphocyte count, neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), monocyte-granulocyte/lymphocyte ratio (MGLR) and red blood cell distribution width (RDW), are prognostic biomarkers in certain diseases. The model for end-stage liver disease (MELD) and Child-Turcotte-Pugh (CTP) scores have been designed for patients with cirrhosis waiting for liver transplantation and in patients with hepatocellular carcinoma. We hypothesized possible roles for these blood indices, and the MELD and CTP scores as predictors for early recurrence of hepatocellular carcinoma after TACE. METHODS: Routine laboratory indices determined the NLR, LMR, MGLR, RDW, PLR, as well as MELD and CTP scores in 147 patients. Sensitivity and specificity of the indices for hepatocellular carcinoma recurrence 36 months after TACE were estimated by receiver operator characteristic curve. RESULTS: In multivariate regression analysis, only male sex, the lymphocyte count, CTP, the MGLR and the MELD score significantly (P < 0.01) predicted recurrence. The area under curve (AUC) for detection of recurrence for MGLR at a cut-off value 2.75 was 0.63 (95% CI 0.54-0.72) with sensitivity 70.7%, specificity 59.2% and accuracy 63%. The MELD score at cut-off value 9.5 had diagnostic performance with AUC 0.71 (0.63-0.79), sensitivity 80% and specificity 55.8% and accuracy 71.3%. CONCLUSIONS: High MGLR and MELD scores are linked to increasing frequency of hepatocellular carcinoma recurrence after TACE and could be used as novel, simple, non-invasive prognostic tests.

A Young Boy with L-asparaginase-Induced Seizure.

L-Asparaginase is a critical component in the treatment of acute lymphoblastic leukemia in children. It is known to cause coagulation abnormalities, thrombosis and hemorrhage in the central nervous system in addition to vasculitis and hypersensitivity reactions. This syndrome generally occurs after a few weeks of therapy and may occur after L-asparaginase therapy is completed. Seizures are uncommon symptoms. We report a case of seizure associated with L-asparaginase therapy but no evidence of hemorrhagic or thrombotic cerebrovascular events, completed in the department of Hematology of Bangabandhu Sheikh Mujib Medical University during March & April 2016.

Secondary polycythaemia in a Malay girl with homozygous Hb Tak.

Hb Tak is one of more than 200 high affinity haemoglobin variants reported worldwide. It results from the insertion of two nucleotides (AC) at the termination codon, between codon 146 and codon 147 of the beta-globin gene [Beta 147 (+AC)]. Polycythaemia is the main clinical feature although affected carriers are usually asymptomatic and do not require intervention. Several case studies in this region have reported the co-inheritance of Hb Tak with Hb E, delta beta and beta thalassaemia with one case of homozygous Hb Tak in a Thai boy. In this case report, a cluster of haemoglobin Tak was found in a family of Malay ethnic origin. Cascade family screening was conducted while investigating a 4-year old girl who presented with symptomatic polycythaemia. She had 2 previous Hb analysis done, at 7-month and 2-year-old with the diagnosis of possible Hb Q Thailand and Homozygous Hb D, respectively. Both diagnosis did not fit her clinical presentations. She was plethoric, had reduced exercise tolerance as well as cardiomyopathy. Her parents were consanguineously married and later diagnosed as asymptomatic carriers of Hb Tak. Consequently, re-analysis of the girl's blood sample revealed a homozygous state of Hb Tak. In conclusion, high oxygen affinity haemoglobin like Hb Tak should be considered in the investigation of polycythaemic patients with abnormal Hb analyses. In this case, DNA analysis was crucial in determining the correct diagnosis.

Genetic relationship among Labisia pumila (Myrsinaceae) species based on ISSR-PCR.

The genus Labisia (Myrsinaceae) is a popular medicinal plant in Malaysia. We examined the genetic relationship among three varieties of L. pumila var. pumila, L. pumila var. alata, L. pumila var. lanceolata and Labisia paucifolia using an ISSR assay. Fifty-eight primers were tested, among which 18 gave reliable polymorphic banding patterns; these yielded 264 polymorphic markers. A similarity matrix was used to construct a dendrogram, and a principal component plot was developed to examine genetic relationships among varieties. Jaccard's similarity coefficient among species ranged from 0.09 to 0.14. At a similarity of 0.117%, species were divided into two main clusters. The mean value of the observed number of alleles, the effective number of alleles, mean Nei's gene diversity, and Shannon's information index were 1.98, 1.64, 0.38, and 0.57, respectively.

Optimise inlet condition and design parameters of a new sewer overflow screening device using numerical model.

After heavy rainfall, sewer overflow spills to receiving water bodies cause serious concern for the environment, aesthetics and public health. To overcome these problems this study investigated a new self-cleansing sewer overflow screening device. The device has a sewer overflow chamber, a rectangular tank and a slotted ogee weir to capture the gross pollutants. To design an efficient screening device a numerical computational fluid dynamic (CFD) model was used. A plausibility check of the CFD model was done using a one-dimensional analytical model. Results showed that an inlet parallel to the weir ensured better self-cleansing than an inlet perpendicular to the weir. Perforations should be at the bottom of the weir to get increased velocity and shear stress to create a favourable self-cleaning effect of the screening device. Increasing inlet length from 0.3 to 1.5 m reduced wave reflection up to 10%, which increased flow uniformity downstream and improved self-cleansing effect. The orientation of the ogee weir with the rectangular tank was found most uniform with a 1:3 (horizontal:vertical) slope. These results will help to maximise functional efficiency of the new sewer overflow screening device. Otherwise it would be too expensive to alter after installation and at times difficult to customise accordingly to existing urban drainage systems.

Clinical and haemato-pathological characteristics of adult acute lymphoblastic leukaemia.

Acute lymphoblastic leukaemia (ALL) is a heterogeneous group of disorders. It varies with respect to the morphologic, cytogenetic, molecular and immunologic features of the neoplastic cells reflecting the variable clinical-pathologic presentations and outcome of the patients. The aim of the study was to observe the clinical and haemato-pathological characteristics in newly diagnosed adult ALL patients. A total number of 61 patients morphologically diagnosed as acute lymphoblastic leukaemia aged 15 and above assigned for this observational study. The study was carried out in the Department of Haematology, BSMMU from January 2007 to December 2008. Among 61 patients, aged 15 to 80 years with median age 25 years, 79% were male and 21% were female. Most of the patients presented with anaemia (67%), fever (66%), lymphadenopathy (64%) and splenomegaly (57%). Other common clinical findings were hepatomegaly (39%), bone tenderness (44%) and bleeding manifestations (34%). Among haemato-pathological findings 67% patients had Hb level ≤10gm/dl, 46% patients had WBC count ≥30×109/L, 67% patients had platelet count ≤100×109/L, 93% patients had blast in peripheral blood and 61% patients had ≥90 % blasts in the bone marrow at the time of diagnosis. In this study adult ALL patients were analyzed only for their clinical and haemato-pathological characteristics. But their biologic characteristics were not analyzed due to lack of availability of facility. A progressive understanding of the biologic and genetic characteristics of ALL will allow us to identify different prognostic subgroups with specific molecular and cellular features. All the necessary measures have to be developed in our country in order to identify prognostically distinct subgroups of patients.

Adiponectin and leptin profiles among obese pregnant women with preeclampsia vs. non-preeclampsia: a systematic review and meta-analysis.

OBJECTIVE: Preeclampsia (PE) affects only about 10% of women who meet the criteria for obesity based on their body mass index (BMI). Obesity is suggested to play a role in preeclampsia pathophysiology, and in addition to BMI, associated biomarkers with higher sensitivity and specificity, such as with adipokines from adipose tissue, are needed to enable clinical risk assessment. This study aimed to investigate obese pregnant women with and without PE by comparing clinical profiles and adipokine profiles specific to general adipose tissue (adiponectin and leptin). MATERIALS AND METHODS: This meta-analysis was conducted following the PRISMA and was registered in PROSPERO (CRD42023478706). We utilized Cochrane, Scopus, and PubMed/Medline databases. The Cochrane ROBINS-I instrument was employed to assess the quality of studies. Pooled standard mean difference (SMD) and p-value were analyzed using a random-effects model with the DerSimonian-Laird method, while subgroup analysis with the Chi-square test and the inconsistency index (I2) were used to assess potential sources of heterogeneity. RESULTS: Three observational studies included a total of 2,646 obese pregnant women and found that adiponectin was more likely to have a lower level in pregnant women with obesity [SMD=-0.32; 95% CI: -0.34-0.17, p=0.003] and leptin was more likely to be higher in obese pregnant women with PE rather than non-PE [SMD=0.53; 95% CI: -0.19-1.08, p<0.00001]. CONCLUSIONS: Adiponectin levels were more likely to be lower in pregnant women with obesity in the PE group than in the non-PE group, and leptin levels were more likely to be higher.

Outdoor activities foster local plant knowledge in Karelia, NE Europe.

Wild edible plants, particularly berries, are relevant nutritional elements in the Nordic countries. In contrast to decreasing global trends, approximately 60% of the Finnish population is actively involved in (berry) foraging. We conducted 67 interviews with Finns and Karelians living in Finnish Karelia to: (a) detect the use of wild edible plants, (b) compare those results with the published data about neighbouring Russian Karelians, and (c) document the sources of local plant knowledge. The results revealed three main findings. First, we observed a similarity in wild food plant knowledge among Karelians and Finns from Karelia. Second, we detected divergences in wild food plant knowledge among Karelians living on both sides of the Finnish-Russian border. Third, the sources of local plant knowledge include vertical transmission, acquisition through literary sources, acquisition from "green" nature shops promoting healthy lifestyles, childhood foraging activities performed during the famine period following WWII, and outdoor recreational activities. We argue that the last two types of activities in particular may have influenced knowledge and connectedness with the surrounding environment and its resources at a stage of life that is crucial for shaping adult environmental behaviours. Future research should address the role of outdoor activities in maintaining (and possibly enhancing) local ecological knowledge in the Nordic countries.

Pleural fluid residue as a diagnostic tool for cytology-negative malignant pleural effusion: A proof-of-concept study.

Background: Pleural fluid residue, or macroscopic tissue, circulating freely in the pleural fluid obtained through direct filtration, may carry diagnostic histopathological information. We aimed to determine the histopathological concordance of pleural fluid residue in diagnosing TPE and MPE, compared with conventional pleural biopsy. This was a prospective cohort study of consecutive inpatients with cytology-negative exudative effusion who underwent pleuroscopy and had their initial suctioned pleural fluid filtered for residue samples. Pleural fluid residue demonstrated malignant cells in four out of seven cases of pleural biopsy-confirmed malignancy. Pleural fluid residue has comparable cytomorphology but reduced cellularity compared with pleural biopsy. No tuberculous histological features were present in the pleural fluid residue samples. In this preliminary study pleural fluid residue provided histopathological information for malignant pleural effusion, but no incremental diagnostic information for tuberculous effusion. However larger and more definitive studies are required to clarify these findings, and to explore the utility and suitability of pleural fluid residue for mutational analysis. What the study adds: This study demonstrates the potential of pleural fluid residue as a non-invasive diagnostic method for confirming malignancy in cytology-negative exudative effusion. What are the implications of the findings: In resource-limited settings or patients contraindicated for pleural biopsy, pleural fluid residue may provide a viable diagnostic alternative; however, this observation needs further validation.

Laparoscopic versus open pyloromyotomy for infantile hypertropic pyloric stenosis: an early experience.

This prospective comparative study was conducted with an initial experience in the Department of Pediatric Surgery, Dhaka Shishu (Children) Hospital during the period of December 2007 to January 2009, with the infants of 2-12 weeks age, diagnosed as Hypertrophic pyloric stenosis. Patients selection was done by simple random technique by means of lottery. For open pyloromyotomy conventional method & for laparoscopic pyloromyotomy three trocher techniques was applied. In this study, among 60 cases with infantile hypertrophic pyloric stenosis, 30 cases were finally selected for analysis irrespectively both in laparoscopic (Group A) & in open pyloromyotomy (Group B) group. Patients were studied under variables of operative time, required time of full feeds after operation, post operative hospital stay & both per and post operative complications. Regarding operative time, in Group A, mean±SD operating time (in minutes) was 61.59±51.73 whereas in Group B it was 28.33±8.40 & P value was 0.001. The result was statistically significant. The mean±SD time (in hours) of full feeds (ad libitum) was 35.00±31.70 hours in Group A compared to 28.95±10.99 hours in Group B and P value was found 0.342ns which was not statistically significant. On study of total length (in days) of post operative hospital stay, mean±SD was 3.09±2.25 & 2.58±1.15days in laparoscopic group & open pyloromyotomy group respectively. The p value was 0.355ns, which was statistically insignificant. Again, on study of complications, per operatively 6(19.5%) patients had developed haemorrage, 1(3.33%) had mucosal perforation & 4(13.36%) had developed duodenal serosal injury in laparoscopic group whereas only 1(3.33%) patient in open pyloromyotomy group had nothing else except simple hemorrhage. The p value (0.051ns) was also statistically insignificant. In regard to post operative complications, 2(6.6%) patients had developed wound hematoma, 2(6.6%) had wound infection, 1(3.33 %) had developed wound dehiscence and incisional hernia respectively in Group A. But in group B there was no subject with any complication. This result was also statistically insignificant. So, the overall study results denote that, laparoscopic pyloromyotomy would not be considered as a superior procedure or as safe as that of traditional open pyloromyotomy for the beginners.

Maternal serum zinc level and its relation with neonatal birth weight.

The present study was conducted in the Department of Obstetrics & Gynaecology, Mymensingh Medical College Hospital, Mymensingh and Molecular Microbiology & Central Laboratory of Bangladesh Institute of Nuclear Agriculture (BINA) from 15th November 2007 to 31st May 2009 to find out the relation between maternal serum zinc level with neonatal birth weight. Hundred pregnant women who were advised to take 61.8 mg zinc daily throughout pregnancy were assigned to study group while the pregnant woman did not take zinc orally were allocated into control group. Serum zinc levels were measured between 37-42 weeks gestation and birth weight were measured just after delivery. Data were processed and analyzed using SPSS version 11.5. The test used to analyze the data was descriptive statistics, Chi-square probability test, Pearson correlation, unpaired t-test and odds ratio. A probability value of <0.05 was considered significant. Majority (97%) of the cases who received zinc during their antenatal period had normal serum zinc (≥ 700µg/L) level compared to only 22% of the control group woman who did not receive zinc. Normal birth weight of babies in pregnant woman who received zinc is 5.7 times higher than the pregnant woman who did not receive zinc. As the present study was a cross-sectional one, further study with large sample size and prospective design is recommended.

Comparative study between Pap smear and visual inspection using acetic acid as a method of cervical cancer screening.

This prospective study was done for the comparison of visual inspection using acetic acid (VIA) and Pap smear as a method of cervical cancer screening. This study was also done to determine the proportion of women screened positive with VIA and proportion of women screened positive with Pap smear. Another aim was to compare the sensitivity and specificity of VIA and Pap smear. A total of 300 women attended to the outpatient gynecologic clinic and cervical cancer screening programme at Bangabandhu Sheikh Mujib Medical University (BSMMU) were included. On VIA, 23 out of 300 women screened had aceto-white lesions. On Pap smear, 14 out of the 300 women had ASCUS or worse lesions. Of the 300 enrolled women, 11 were positive on both VIA and cytology; 12 were positive on VIA only; and 3 were positive on cytology only. Those women (n=26) who showed positive test result with either VIA or Pap smear or both tests were further subjected to colposcopy directed biopsy. Histology was taken as gold standard to compare the performance of VIA and cytology (Pap's smear). Histological diagnosis of CIN/cancer was made in 18 Positive cases out of the total 26 patients who underwent biopsy. Pap smear picked up 10 out of the 18 biopsy-proven cases whereas VIA could identify 17 out of the 18 CIN/carcinoma cervices. VIA was more sensitive (94.44%) than pap smear (55.55%), which was statistically significant. However, the specificity of VIA was slightly lower (97.87%) than that of cytology (98.58%). The PPV of VIA was 73.91% versus 71.42 % for Pap smear.

Outcome of adult acute lymphoblastic leukaemia following induction chemotherapy with modified MRC UKALL XII/ECOG E2993 protocol.

Cure rates for adult acute lymphoblastic leukaemia (ALL) in developing countries are significantly lower because of problems unique to these countries. Recent studies have reported complete response rates for any induction regimen of more than 90% in adult ALL patients. This study was conducted to evaluate the response rate of induction chemotherapy in adult ALL patients in the Department of Haematology, Bangabandhu Sheikh Mujib Medical University, from January 2007 to December 2008. In this observational study, 35 newly diagnosed ALL patients classified either as L1/L2 according to French-American-British (FAB) classification, aged between 15 to 60 years were assigned for induction therapy with modified MRC UKALL XII/ECOG E2993 protocol. But ultimately 30 patients completed therapy and available for statistical analysis. Among the studied 30 cases 12(40%) patients after phase 1 and overall 24 (80%) patients after phase 2 induction therapy, achieved morphologic complete remission (CR). After phase 2 therapy 6 (20%) patients fell in the group of non responders (NR) as the blast percentage was > or = 5% at the time of bone marrow evaluation. This study shows the response rates in adult ALL with induction therapy slightly below the anticipated response rates of developed countries which may be due to little modification of the original protocol.

Measurement of Bone Mineral Density in the Transfusion Dependent Thalassemic Patients.

Low bone mineral density represents as a major cause of morbidity in thalassemic patient. The mechanism depends upon several factors. Transfusion dependent iron over load cause decrease secretion of growth hormone, insulin, thyroid hormone, parathyroid hormone, sex hormone and vitamin D from different endocrine organs which ultimately causes impairment of adequate bone mass achievement. Other causes of low bone mass are iron chelating agent and bony expansion due to increase erythropoiesis. To find out the frequency of low bone mineral density in thalassemia patients who are transfusion dependent. This study was designed as a cross sectional observational study, which was analyzed in the Department of Haematology, Bangabandhu Sheikh Mujib Medical University, Dhaka and National Institution of Nuclear Medicine and Allied Sciences (NINMAS), Bangladesh Atomic Energy Commission (BAEC) from September 2017 to August 2018. It had been performed over total 72 (Age ≥06 years to ≤40 years) thalassaemic patients who are transfusion dependent. Presence of bone diseases was detected by Bone mineral density (BMD). Seventy-two (72) patients with transfusion dependent thalassaemia, aged 6 to 39 years were enrolled. Mean age of patients was 20.9±7.2 years. Among them, 57(79.2%) patients were detected as a normal bone mineral density and fifteen (20.8%) patients were detected as a low bone mineral density in the left femoral neck. In transfusion dependent thalassaemic patient, Low bone mass was significantly associated with low BMI, total number of blood transfusion and serum ferritin level remarkably. This survey has established a new path for early detection of low bone mass and helped in prevention of bone loss and its sequel by starting early treatment in these groups of patients.

The larvicidal effect of neemazal T/S, clove oil and ginger oil on tomato leafminer, Tuta absoluta compared to coragen.

The present study aimed to evaluate the toxicity and biochemical changes of Tuta absoluta 3rd instar larvae affected by neemazal T/S, clove oil and ginger oil. These compounds were evaluated compared to the recommended pesticide, Coragen 20% SC. by means of sublethal concentrations, LC25 and LC50 under constant laboratory conditions. Results showed that neemazal T/S is more toxic than detected oils compared with higher toxicity of coragen with LC50 values of 57.52, 159.94, 633.38 and 930.71 µg mL-1 for coragen, neemazal, ginger oil and clove oil, respectively. There were highly significant differences between all treatments and untreated larvae. Neemazal possessed the greatest effect on activity level of most physiological parameters than selected oils. Larval content of digestive enzymes was decreased significantly 48 h after all treatments except for lipase, α-esterase and ß-esterase (in case of coragen and clove oil). Also, total proteins, total carbohydrates, total lipids and total free amino acids take the same trend. Based on this study, these sublethal doses caused a significantly dose-dependent perturbation in determined components.

Homozygous Hemoglobin Lepore: A Rare Condition Seen in a Bangladeshi Family.

Hb Lepore is one type of hemoglobin disorder in which there is structurally abnormal hemoglobin (Hb) that results from in-frame fusion between the 5 end of the δ-globin gene and the 3 end of the ß-globin gene, due to misalignment of homologous chromosomes during meiosis..Hb Lepore homozygous patients have clinical features indistinguishable from thalassemia major or intermedia. On 22 March 2018 a severely anaemic 2 year old child was referred to Dhaka Shishu Hospital Thalassaemia Center in Dhaka Shishu Hospital, Dhaka Bangladesh for thalassemia screening. HPLC report showed a very high level of Hb F 80.7% and Hb A2 level 16.16%. HPLC of both mother and father revealed a high A2 level and a hump in the download slope of Hb A2 peak and diagnosed as Hb Lepore. This was confirmed by GAP PCR and DNA analysis of the child and the parents and the child was diagnosed as suffering from homozygous Hb Lepore. Here we discuss Hb Lepore a rare homozygosity in a child seen in a Bangladeshi family.