Catheter-related blood stream infections: prevalence, risk factors and antimicrobial resistance pattern.

BACKGROUND: Intravascular devices have significant potential for producing iatrogenic diseases resulting in catheter-related blood stream infections (CRBSIs). A study was undertaken to find the prevalence of CRBSI among patients in acute wards and to analyze the associated risk factors, causative pathogens with their antibiotic susceptibility (ABST) patterns. METHODS: Randomly ten days per month were chosen, for a period of two years. All the acute wards patients who were on indwelling blood catheters were identified. Those fulfilling the CRBSI criteria were further worked up for confirmation of diagnosis by differential time to positivity. The catheter tip was cultured by Maki's semiquantitative method. ABST of the isolates obtained was performed by Kirby-Bauer disk diffusion method. RESULTS: The prevalence of CRBSI was found to be 39.25% with the most common organism isolate being Serratia marcescens (23.81%). The immunocompromised status of the patients and catheterisation time were significant risk factors. Methicillin resistance was found to be 33.33% in coagulase-negative staphylococci. The resistance to vancomycin among the Entercoccus faecium isolates was found to be 33.33%. Among the gram negatives, resistance to aminoglycosides, fluoroquinolones and third-generation cephalosporins was high. CONCLUSION: The study highlights the importance of regular surveillance programs, an efficient infection control program, strict adherence to antiseptic measures and use of a rational antibiotic policy for the early diagnosis and better management of CRBSI.

Impact of feeding chromium supplemented flaxseed based diet on fatty acid profile, oxidative stability and other functional properties of broiler chicken meat.

A total of 240 broiler chicken of same hatch with uniform weight were used in a biological experiment with completely randomized design to investigate the effects of incorporating organic chromium (Cr) in flaxseed meal based diet on the fatty acid profile, oxidative stability and functional properties of broiler chicken meat. Five diets were formulated as per the recommendations of BIS (Nutrient requirements for poultry 13: 9863, Bureau of Indian Standards, New Delhi, 1992) in which flaxseed meal was used to replace 10% of soyabean in basal diet and four levels of Cr (0.0, 0.5, 1.0 and 1.5 mg/kg diet) as Cr-picolinate were used. The results revealed that flaxseed feeding significantly increased the percentage of unsaturated fatty acids, including MUFA, PUFA, ω-3, ω-6 fatty acids and ω-3:ω-6 and PUFA:SFA ratios, whereas, significant decline was seen in saturated fatty acids and no effect of Cr was observed on the fatty acid profile of broiler chicken. Flaxseed feeding significantly reduced the cholesterol and fat percentage of meat, whereas, significant progressive reduction was observed with increasing Cr levels. The combination of 10% flaxseed with 1.0 mg Cr/kg diet increased the final pH of broiler meat. The addition of flaxseed significantly reduced water holding capacity, extract release volume and antioxidant potential of broiler meat, whereas, increasing Cr supplementation progressively increased them. Flaxseed feeding significantly increased the drip loss and lipid peroxidation of broiler meat, whereas, Cr supplementation decreased them. It was concluded that inclusion of 10% flaxseed and 1.5 mg Cr/kg diet results in desirable fatty acid profile, oxidative stability and functional properties of broiler chicken meat.

To study the effects of gamma irradiation on single donor apheresis platelet units by measurement of cellular counts, functional indicators and a panel of biochemical parameters, in order to assess pre-transfusion platelet quantity and quality during the shelf life of the product.

BACKGROUND: The occurrence of transfusion associated graft versus host disease can be prevented by gamma irradiation of blood components. This study was undertaken to assess the effects of gamma irradiation on single donor platelet (SDP) concentrate units. METHOD: SDPs were collected by a continuous flow apheresis technique (n = 400). The SDPs from each donor were divided into two parts, one gamma-irradiated with 25 Gy and the other used as a non-irradiated control. Swirling and morphological features, cellular counts, biochemical parameters including blood gas analysis, and platelet activation levels (CD62P: p-selectin) by flow cytometry were analyzed on Day 1 and on Day 5. RESULTS: Swirling and morphology were maintained in all products, in both the groups throughout the shelf life. No significant change was seen in both groups, on the first and fifth day, as far as pO2, pCO2, Na(+), K(+), HCO3 (-) & Ca(2+) were concerned. However, lactate increased and glucose decreased significantly in irradiated products over 5-day storage period. A small but significant decrease in pH and platelet count was found in the irradiated PCs after 5-day storage. The mean proportion of platelets expressing CD62P over 5-day storage increased significantly. CONCLUSION: After an overall assessment of all our in vitro parameter results and observations, a few of which were significant, while most were not significant, we concluded that a well-preserved quality of gamma irradiated apheresis platelets is maintained throughout the entire 5-day shelf life of the platelet product, with minimal difference compared to non-irradiated platelets.

Plankton as an indicator of heavy metal pollution in a freshwater reservoir of Madhya Pradesh, India.

Halali Reservoir is an important freshwater body of Madhya Pradesh. The water of the reservoir is used for drinking, irrigation and aquaculture practices. It receives untreated sewage, wastes from small scale industries and agricultural runoff from the catchment area. Various heavy metal (Cd, Cr, Cu, Ni, Pb and Zn) levels were measured in plankton of Halali Reservoir during 2006-2007 by inductively coupled plasma-optical emission spectrometry. Mean concentration ranges for Cd, Cr, Cu, Ni, Pb and Zn were 0.0018-0.0037, 0.0038-0.2257, 0.0013-0.0228, 0.0011-0.0086, 0.0133-0.0494 and 0.0130-0.1168 µg g⁻¹, respectively. Overall, mean Cr concentrations in the plankton were generally the highest of the six metals at four of the five study sites. Metal concentrations at these four sites generally followed the order: Cr > Zn > Pb > Cu > Ni > Cd. Mean concentrations of all metals at a fifth site were consistently lower than at the other sites. The high levels of Cr in the plankton are in agreement with high Cr levels that have been reported in fish from this reservoir, indicating that plankton may serve as a useful indicator of metal pollution in fish.

Comparative study of outcome of the endoscopic sinus surgery and conventional surgery for nasal polyposis.

This is a cross-sectional study done in Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka Medical College & Hospital (DMCH) & Bangladesh Institute of Research and Rehabilitation of Diabetic Endocrine and Metabolic Disorder (BIRDEM), Dhaka during the period of January 2009 to August 2010. This study included 60 cases of nasal polyposis, among them in 30 cases Functional Endoscopic Sinus Surgery (FESS) was done and in 30 cases conventional surgical procedure was done as treatment procedure. Here mean age of patient in FESS was 45.43 years and in conventional surgery was 45.13 years and male female ratio was 3.3:1. In this study postoperative complication of FESS were found in 07(23.33%) cases whereas in conventional surgery it were in 16 (53.33%) cases (p = <0.01, df = 1, Chi-squire = 7.65). In case of outcome, complete relief of symptoms occur in 22(73.33%) cases by FESS and 14(46.66%) cases by conventional procedure (p = <0.05 df = 2, Chi-squire = 9.29). In FESS 22(73.33%) cases and in conventional technique 14(46.67%) cases discharged within 24-48 hours (p = <0.05, df = 1, Chi-squire = 4.44). Recurrence after FESS was 6.67% cases and conventional surgery was 30% cases. The results of this series reveled that FESS had the combined advantages of precise removal of the disease with minimal complication.

Parathyroid failure following thyroid surgery.

This cross-sectional study was done to see the association of post thyroidectomy parathyroid failure with thyroid disease and type of surgery. It was carried out in the Department of Otolaryngology-Head and Neck Surgery, Bangabandhu Sheikh Mujib Medical University, Dhaka during the period of July 2008 to June 2010. Total 50 cases of thyroid malignancy and multinodular goiter who had undergone total or near total thyroidectomy with or without neck dissection were studied. In this study highest number of cases were found in 3rd decade of age (28%) and there was female predominance (M:F=1:3.54). Overall frequency of post operative hypocalcaemia was 30% (26% was temporary hypocalcaemia and 4% was permanent). Hypocalcaemia revealed clinically in 20% cases and remained subclinical in 10% cases. Hypocalcaemia developed in 42.30% cases of malignant thyroid disease and 16.66% cases of benign thyroid disease (p<0.05). It was found in 54.54% cases with neck dissection and 23.07% cases without neck dissection (p<0.05). Hypocalcaemia developed in 62.5% cases where parathyroid gland were not identified and 23.8% cases where parathyroid gland was identified. Hypocalcaemia developed most commonly on the 2nd post operative day (73.33%). There is a significance difference with development of parathyroid failure after thyroid surgery between benign and malignant thyroid disease and also between thyroid surgery with or without neck dissection.

Presentation of primary hyperparathyroidism due to adenoma.

This descriptive study was done to evaluate the clinical, biochemical and radiological findings of primary hyperthyroidism (pHPT) patients with parathyroid adenoma. This study was done in the department of Otolaryngology and Head-Neck surgery, BIRDEM, Dhaka from July 2000 to June 2007. We retrospectively reviewed the clinical presentation, biochemical and radiological features from the case records from the last 7 years of 32 patients at a tertiary care centre in Dhaka who had documented pHPT due to adenoma. Of them 18 were male and 14 were female. Mean age±SD of the patients was 42.16±11.64 years. Median preoperative serum calcium, serum phosphate and serum parathyroid hormone (PTH) levels were 11.42 mg/dL (range 8.4-14.0mg/dL), 3.11 mg/dL (range 2.5-4.5) and 293.22 pg/mL (range 65-700 pg/mL), respectively. Of all patients 75% had raised serum calcium level and 100.0% had raised serum PTH levels but all had normal serum phosphate level. Common radiological features were nephrocalcinosis, renal calculi, osteopenic changes in finger and toe, Brown tumour in forearm, 'Salt and pepper' appearance in skull, fracture of femur, fracture radius. pHPT due to adenoma in Bangladesh continues to be a symptomatic disorder with skeletal and renal manifestations.

The food-energy-water-carbon nexus of the rice-wheat production system in the western Indo-Gangetic Plain of India: An impact of irrigation system, conservational tillage and residue management.

The conventional rice-wheat system in the western Indo-Gangetic plain of India is energy and water intensive with high carbon footprint. The transition towards resource-efficient eco-friendly production technologies with lower footprint is required for inclusive ecological sustenance. A five-year (2016-17 to 2020-21) field experiment was conducted in RWS with hypothesis that pressurized irrigation systems [drip (DRIP) and mini-sprinkler (MSIS)] in conservation tillage [reduced (RT)/zero (ZT)] and crop residue management [incorporation (RI)/mulch (RM)] might result in higher resource use efficiency with lesser carbon footprint compared to conventional system. Experiment consisted five treatments namely (1) puddled transplanted rice followed by conventionally tilled wheat (PTR/CTW), (2) DRIP irrigated reduced till direct seeded rice (RTDSR) followed by zero-till wheat with 100 % rice residue mulching (ZTW + RM) (DRIP-RTDSR/ZTW + RM), (3) surface irrigated RTDSR followed by ZTW + RM (SIS-RTDSR/ZTW + RM), (4) MSIS irrigated RTDSR followed by ZTW + RM (MSIS-RTDSR/ZTW + RM), and (5) MSIS irrigated RTDSR with 1/3rd wheat residue incorporation followed by ZTW + RM (MSIS-RTDSR + RI/ZTW + RM). The pressurized irrigation system in RWS established under conservational tillage and residue management (DRIP-RTDSR/ZTW + RM and MSIS-DSR + RI/ZTW + RM) produced at par system productivity compared to PTR/CTW. Substantial nitrogen (79-114 ka ha-1) and irrigation water (536-680 mm) savings under pressurized irrigation systems resulted in 41-64 % higher partial factor productivity of nitrogen with 48-61 % lower water footprint. These systems had lower energy consumption attaining 15-21 % higher net energy, 44-61 % higher energy use efficiency, and 31-38 % lower specific energy. Efficient utilization of farm inputs caused lower greenhouse gas emission (39-44 %) and enhanced carbon sequestration (35-62 %) resulting 63-76 % lower carbon footprint over PTR/CTW. The information generated here might useful in developing policies for resource and climate-smart food production system aiming livelihood security and ecological sustainability in the region. Further, trials are needed for wider adaptability under different climate, soil and agronomic practices to develop site-specific climate smart practices.

Impact of sequential herbicides application on crop productivity, weed and nutrient dynamics in soybean under conservation agriculture in Vertisols of Central India.

Adoption of conservation agriculture (CA) is very slow due to weed infestations. The application of herbicides is the only viable option to deal with problem of weed management to adhere with basic principles of CA. A field experiment was carried out for three years to evaluate the expediency of different herbicides and their sequential applications under CA. In this study, seven treatments comprised of either alone or sequential application of pre-emergence (PE) and post-emergence (PoE) herbicides, hand weeding and weedy check were tested in soybean. Result indicated that sequential application of glyphosate at 1 kg ai ha-1 + pendimethalin at 1 kg ai ha-1as PE followed by PoE application of imazethapyr at 100 g ai ha-1 at 30 days after sowing (DAS) proved to be the best economical option in terms of plant growth parameters, crop biomass, seed yield, weed index and carbon and nutrient recycling. Pearson's correlation coefficients matrix revealed that grain yield was significantly (P<0.0001) related to weed density at harvest (r = -0.84), (WDH) (r = -0.63), weed dry biomass (WDB) (r = -0.52), weed nitrogen (N), phosphorus (P) and potassium (K) uptake (r = -0.56, r = -0.59 and r = -0.66), respectively and weed index (WI) (r = -0.96). The bivariate linear regression study of grain yield on weed control efficiency (WCI) biomass, N, P and K uptake by grain showed a clear significant (P<0.0001) dependence with R2 value of 0.53, 0.99, 0.95 and 0.98, respectively. The fitted stepwise multiple regression model also revealed that N and P uptake in grain, weed density at 20 DAS and K uptake in weed were actual predictor for grain yield. We concluded that, effective and economical weed control under CA in soybean can be achieved through sequential application of glyphosate along with pendimethalin at 1 kg ai ha-1 each PE followed by PoE use of imazethapyr at 100 g ai ha-1 at 30 DAS.

Potassium fractions in black soil mediated by integrated nutrient management modules under maize-chickpea cropping sequence.

A field experiment was conducted at the Research Farm of the ICAR-Indian Institute of Soil Science, Bhopal (India) to study influence of different integrated nutrient management (INM) modules on soil potassium (K) fractions. The experiment comprised with twelve treatments laid out in randomized block design (RBD) with three replications under maize-chickpea cropping sequence. The treatments included general recommended dose (GRD), soil test crop response (STCR) dose; combinations of inorganic and organic inputs and only organic modules. The soil samples were collected at crop harvest and analyzed for various K fractions viz., water soluble-K, available-K, exchangeable-K, HNO3-K, lattice-K and total-K. The results indicated that potassium fractions were significantly (p = 0.05) affected by different treatments. Different INM modules significantly enhanced significantly K availability in soil. Among various INM modules studied, treatment 11 (application of 20 t ha-1 FYM in maize with 5 t ha-1 FYM every year in chickpea) proved most beneficial for improving the soil K fractions. Findings of this type are important for K fertilizer management during crop production in areas with low soil fertility.

Soil bacterial community structure and functioning in a long-term conservation agriculture experiment under semi-arid rainfed production system.

Soil microbial communities are important drivers of biogeochemical cycling of nutrients, organic matter decomposition, soil organic carbon, and Greenhouse gas emissions (GHGs: CO2, N2O, and CH4) and are influenced by crop and soil management practices. The knowledge on the impact of conservation agriculture (CA) on soil bacterial diversity, nutrient availability, and GHG emissions in semi-arid regions under rainfed conditions is vital to develop sustainable agricultural practices, but such information has not been systemically documented. Hence, studies were conducted for 10 years in rainfed pigeonpea (Cajanus cajan L.)-castor bean (Ricinus communis L.) cropping system under semi-arid conditions to assess the effects of tillage and crop residue levels on the soil bacterial diversity, enzyme activity (Dehydrogenase, urease, acid phosphatase, and alkaline phosphatase), GHG emissions, and soil available nutrients (Nitrogen, phosphorus, and potassium). Sequencing of soil DNA through Illumina HiSeq-based 16S rRNA amplicon sequencing technology has revealed that bacterial community responded to both tillage and residue levels. The relative abundance of Actinobacteria in terms of Operational Taxonomic Unit (OTUs) at phyla, class as well as genera level was higher in CA (NTR1: No Tillage + 10 cm anchored residue and NTR2 NT + 30 cm anchored residue) over CT (conventional tillage without crop residues). CA resulted in higher enzyme activities (dehydrogenase, urease, acid phosphatase, and alkaline phosphatase) and reduction in GHG emissions over CT. CA recorded 34% higher and 3% lower OC, as compared to CT, and CTR1, respectively. CA recorded 10, 34, and 26% higher available nitrogen, phosphorus, and potassium over CT and CTR1, respectively. NTR1 recorded 25 and 38% lower N2O emissions as compared to CTR1 and CTR2, respectively. Whereas only NT recorded 12% higher N2O emissions as compared to CT. Overall, the results of the study indicate that CA improves the relative abundance of soil bacterial communities, nutrient availability, and enzyme activities, and may help to contribute to the mitigation of climate change, and sustainability in rainfed areas.

Quality evaluation of functional chicken nuggets incorporated with ground carrot and mashed sweet potato.

This study was envisaged to evaluate the effect of ground raw carrot (0%, 5%, 10% and 15%) and mashed sweet potato (0%, 5%, 10% and 15%) as functional ingredients on the quality of chicken meat nuggets. The products were evaluated for physicochemical quality, proximate composition, nutritive value, sensory quality as well as color and texture profile analyses. Additions of either raw carrot or mashed sweet potato represent an improvement in the nutritional value and have some beneficial effects due to the presence of dietary fibers and ß-carotene. They were also found to be effective in sustaining the desired cooking yield and emulsion stability. Treated samples showed lower (p > 0.05) protein, fat and ash contents but higher (p < 0.05) moisture content than control. There were differences among the nugget samples with respect to sensory qualities, and control samples as well as samples with 10% added carrot/sweet potato had higher overall acceptability scores. Hunter color values (L*, a* and b* values) were higher (p < 0.05) for both the formulated products, while their textural parameters were nearly unchanged. In conclusion, carrot and sweet potato at 10% added level have greater potential as good source of dietary fibers and ß-carotene and may find their way in meat industry.

Seasonal variation in physicochemical parameters and heavy metals in water of Upper Lake of Bhopal.

Heavy metal pollution of fresh water is the single most important environmental threat to the future. Upper Lake is a freshwater lake, which is the major source of drinking water in the city of Bhopal, the capital city of M.P., the central province of India, but due to anthropogenic activities this lake is being polluted. During the investigation heavy metals and physicochemical parameters were analyzed to determine the water quality seasonally in the year of 2006 and 2007. All the physicochemical parameters except DO (6.50-6.97 mg l⁻¹), Free CO2 (0.8-1.6 mg l⁻¹) and BOD (5.47-6.85 mg l⁻¹) were below the prescribed limit as recommended by Bureau of Indian Standards (BIS) for drinking water standards. In case of heavy metals, Ni (0.173-0.253 mg l⁻¹) and Cr (0.047-0.087 mg l⁻¹) were found beyond the prescribed limits (0.02 and 0.05 mg l⁻¹, respectively), whereas Pb (0.057-0.087 mg l⁻¹), Cu (0.016-0.020 mg l⁻¹) and Hg (0.0006-0.0011 mg l⁻¹) were within the safe limit. This study reveals that water of upper lake is partially polluted with heavy metals. It is recommended that strict vigilance and constant monitoring are needed to maintain water quality of the lake, which is a major source of potable water for the Bhopal city.

Tubercular lymphadenitis - diagnostic evaluation.

Tuberculosis is one the commonest disease affecting peripheral lymph node and cervical tubercular lymphadenitis are frequently encountered in Otolaryngological practice. Three hundred fifty six (356) cases of Fine Needle Aspiration for Cytology (FNAC) positive tubercular lymphadenitis were studied from January 2006 to December 2008. FNAC positive but histopathologically negative cases were excluded from the study. Among 356 cases of FNAC positive cervical lymphadenopathy 300 cases (84.27%) were confirmed tuberculosis on histopathological examination. Remaining 50 cases (15.73%) were diagnosed as nontubercular lymphadenitis where nonspecific lymphadenitis was the commonest finding 34(9.55%) followed by metastatic carcinoma 7(1.97%), lymphoma 6(1.08%), Kikuchiz's disease 6(1.08%), Kala-Azar 2(0.56%) & Leukemia 1(0.28%). Most of the patients presented with only multiple lymph node swelling with other symptoms, such as fever 18(5.06%), pain (15.7%), tenderness 53(14.88%), weight loss 29(8.14%), anorexia 33(9.26%). Following observations are evident from this study: i) Disease is comparatively common between 12-35 years ii) Multiple matted/discrete lymph nodes are the earliest presentation iii) Multiple lymph node is the most consistent finding for clinical diagnosis. iv) Very few patients have constitutional symptoms v) Suppuration with or without abscess formation although confirms the diagnosis even then certainty is very essential. Though the evidence of cervical tuberculosis was thought to be decreasing in developing countries the real picture seems to be different. Random survey among the whole population was not done in any country rather hospital based laboratory research was made.

Efficacy of soy protein isolate as a fat replacer on physico-chemical and sensory characteristics of low-fat paneer.

The nutritional and textural properties of low fat paneer using soy protein isolate (SPI) as fat replacer was investigated. The physico-chemical and sensory characteristics of 4 types of paneer made of low-fat milk (3% milk fat (MF) and 10% solids-not-fat (SNF)) and SPI of 0 (T1), 0.1 (T2), 0.2 (T3) and 0.3% SPI (T4) were compared with high fat paneer (TC) made of high fat milk (6% MF and 9% SNF). CaCl2 (0.2%, w/v) was used as coagulant at 75 ± 1°C. Increased level of SPI in paneer increased yield, protein, ash, moisture content and decreased fat, moisture protein ratio, lactose and calorie contents. Titratable acidity and pH varied in narrow range. Instrumental firmness was higher (p ≤ 0.05) in T1-T4 than in TC. The gumminess, chewiness and firmness showed the same trend. Resilience and cohesiveness values showed no significant difference among the samples. Hunter colour L values showed a decreasing, and a and b values increasing trend with increasing levels of SPI. Sensory appearance and colour scores were lower (p ≤ 0.05) for T1-T4 than TC. More than 0.2% SPI imparted beany flavour to paneer.

Comparison between 2D and 3D Echocardiography in Efficient Detection of Commissural Calcification in Rheumatic Mitral Stenosis.

Rheumatic heart disease causes a substantial number of morbidity and mortality in Southeast Asia. In Bangladesh prevalence of Rheumatic Fever and Rheumatic heart disease is still high, 0.6 and 0.3 per thousand populations, respectively. Mitral valve mostly involved in the form of mitral stenosis in the rheumatic process. Treatment selections and its success largely depend upon the severity of disease especially the extent and distribution of calcification. Echocardiography has got the key role in determining the pattern, extent and severity of mitral stenosis. Two dimensional and Doppler echocardiography are conventionally used. With the increasing availability of 3D echocardiography, better cardiac imaging is possible now. The heart being a complex three-dimensional structure, the 3D evaluation would definitely offer better imaging for accurate assessment of the severity of mitral stenosis, especially details of commissural involvements. Many scoring systems are available for the assessment of the severity of rheumatic Mintral Stenosis (MS), mostly 2DE based; among them, Wilkins is mostly practiced. This cross-sectional observational study was conducted in University Cardiac Centre, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from May 2012 to October 2012. Data were collected from 50 subjects who underwent transthoracic 2D and 3D Echocardiography for the assessment of rheumatic mitral stenosis especially detection of calcification also it's severity, extent, and distribution, furthermore the presence of commissural calcification. Precise measurement of Mitral valvular area is essential in the assessment of severity, which is found similar by both 2DE (0.98±0.24cm²) and 3DE (0.92±0.23cm²). But in identifying calcification and its extent especially commissural involvement is better detected by 3DE (p=0.002). This has paramount importance in therapeutic decision making of chronic rheumatic MS. To make a well-organized management plan and also for the confident prediction of complications, three-dimensional echocardiography has promising prospects in detecting commissural calcification and should be considered as an essential adjuvant to the conventional two-dimensional echocardiography.

Comparison between 2D and 3D Echocardiographic Parameters used for Diagnostic and Therapeutic Purpose in Patients with Rheumatic Mitral Stenosis.

Rheumatic heart disease causes a substantial number of morbidity and mortality in South Asia. With the increasing urbanization & antibiotic availability, it is now in declining trends. The prevalence of Rheumatic Fever and Chronic Rheumatic Heart Disease in Bangladesh is 0.6 and 0.3 per thousand populations, respectively. Mitral valve is mostly involved in the rheumatic process, particularly in the form of mitral stenosis. Treatment options of mitral stenosis depend upon the severity of the disease. Echocardiography has a key role in determining the pattern, extent and severity of the involvement of the mitral valve apparatus. 2D and Doppler echocardiography are conventionally used. 3D echocardiography is more available nowadays. The heart being a complex three-dimensional structure, a 3D evaluation would definitely offer better visualization for accurate assessment of the severity of rheumatic mitral stenosis. There are many echocardiography based scoring systems are available for the assessment of the severity of rheumatic MS. Those are mostly 2DE based; among them, Wilkins is widely practiced. Real-time 3DE based score for mitral stenosis is developed recently. This cross-sectional observational study was done in the University Cardiac Centre, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from May 2012 to October 2012. Considering all ethical issues, data were collected from 50 subjects who underwent transthoracic 2D and 3D Echocardiography for the assessment of the extent and severity of mitral stenosis. Precise measurement of the mitral valvular area is of a pivotal role in the assessment of severity, which is found almost similar by both 2DE (0.98±0.24cm²) and 3DE (0.92±0.23cm²). But in identifying calcification and its extent specifically commissural involvement is better detected by 3DE (p=0.002). Detail assessment of subvalvular involvement particularly chordal adhesion can better be done by 3DE (p<0.001). All of these have important contributions in formulating the most favorable therapeutic roadmap in chronic rheumatic MS. To make an efficient management plan and also for the confident prediction of complications, three-dimensional echocardiography has promising prospects and should be considered as an important adjuvant to the conventional two-dimensional echocardiography.

A Prospective Study of Deep Vein Thrombosis after Major Abdominal Surgery in a Tertiary Level Hospital.

This prospective study was conducted to find the rate of deep and risk factors associated with vein thrombosis following major abdominal surgery in Sylhet MAG Osmani Medical College Hospital from 1st November 2017 to 30th April 2018. Total 103 patients aged above 20 years both male and female who got admitted in Department of Surgery, Sylhet MAG Osmani Medical College Hospital, Sylhet for their disease requiring routine and emergency major abdominal operation during the study period and fulfilling the inclusion and exclusion criteria were selected in this study. Informed written consent was obtained from the patients after full explanation of the purpose of the study. After full investigations and proper preparation of each patient for operative procedure major abdominal surgery were done. Peroperative findings were noted and post-operative period were followed up routinely. Duplex scanning was done on 3rd POD in all cases. The age of the patients ranged from 25 to 74 years with the mean age of 49.5±13.8 years. There were 60(58.3%) male and 43(41.7%) female. Deep vein thrombosis (DVT) developed in 5(4.9%) of cases and not developed in 98(95.1%) cases. All the five cases were confirmed by color duplex scan. DVT was detected in 2(3.3%) of the 60 males and 3(7.0%) of the 43 females undergoing major general surgical procedures. Among 63 patients in whom the duration of surgery was up to 2 hours, none developed DVT, while among the 40 patients in whom the duration of surgery lasted more than 2 hours, 5(12.5%) developed DVT. Among 23 patients in whom the surgery for malignancy was done, 4(17.4%) developed DVT, while among the 80 patients in whom surgery for non-malignancy, 1(1.2%) developed DVT. The Incidence of DVT in patients undergoing major abdominal surgery is 4.9%. Patients undergoing major abdominal surgery for malignancy and duration of operation greater than 2 hours have higher risk of developing DVT. But there is no significant increase in risk of development of DVT relation to age and sex; and also in patients on oral contraceptives, diabetes mellitus, obesity and smoking. Clinical findings alone cannot be relied upon for the diagnosis of DVT. The study has to be continued with larger sample size to get statistically significant results.

Bioaccumulation of heavy metals in fish tissues of a freshwater lake of Bhopal.

Contamination of heavy metals, namely, lead, cadmium, zinc, nickel, copper, chromium and mercury was evaluated in the samples of water and tissues of Labeo rohita and Ctenopharyngodon idella of Upper Lake of Bhopal collected during summer, rainy and winter seasons of 2005-2006. Different organs of the fishes accumulated varying quantities of different heavy metals. In L. rohita, accumulation of heavy metals was in the sequence liver>kidney>gills>muscles, and in C. idella, it was gills>liver>kidney>muscles. Zn was the highest accumulating metal in fish, whilst Hg was the lowest and was well corroborated with those of water. The values of heavy metals were so far well within the maximum permissible standard value of heavy metals for drinking water and for fish culture as prescribed by various national and international agencies.

Chemical, biochemical, and biological impact of untreated domestic sewage water use on Vertisol and its consequences on wheat (Triticum aestivum) productivity.

In the peri-urban areas of central India, sewage water is a valuable resource for agricultural production. In this study, impact of domestic sewage water irrigation for 5 years on Vertisol with no previous history of sewage irrigation was investigated in an ongoing field experiment at Bhopal (India) under subtropical monsoon type climate. The wheat (Triticum aestivum) crop was grown during post-rainy winter season with 30 cm of irrigation (groundwater or sewage water) and four nutrient treatments (T(1), 0; T(2), 100%; T(3), 50%; and T(4), 50% of general recommended doses of NPK + FYM at 10 Mg/ha). Results showed that sewage irrigation of about 150 cm over a period of 5 years resulted significant increases in salinity as well as available fractions of N, P, K, and micronutrients, viz., Zn, Fe, and Mn in soils. Carbon and phosphorus applied through sewage water were accumulated more in subsoil layer compared to topmost plough layer. Soil microbiological activity, as indicated by soil respiration, microbial biomass C, as well as dehydrogenase enzyme activity was higher in sewage water-irrigated soils. There was also significant increase in fungal and actinomycetes as well as total coliform population in such soils. Nutrients supplied through sewage water were not able to raise the productivity of wheat to the level that obtained through fertilizers at the recommended level which indicated that additional nutrients through fertilizers are required to obtain higher productivity of wheat under sewage farming. Protein and Zn content in wheat grains were more when the crop was grown with sewage irrigation. Overall results show that except for increase in coliform population, short duration (5 years) of municipal sewage water irrigation did not have any appreciable harmful effect on soil quality as well as crop productivity; rather, it proved beneficial in improving soil fertility, wheat productivity, and produce quality.