Artificial neural network (ANN) analysis on thermophysical properties of magnetohydrodynamics flow with radiation in an arc-shaped enclosure with a rotating cylinder.

The objective of this research is to examine the thermophysical features of magnetic parameter (Ha) and time step (τ) in a lid-driven cavity using a water-based Al2O3 nanofluid and the efficacy of ANN models in accurately predicting the average heat transfer rate. The Galerkin weighted residual approach is used to solve a set of dimensionless nonlinear governing equations. The Levenberg-Marquardt back propagation technique is used for training ANN using sparse simulated data. The findings of the investigation about the flow and thermal fields are shown. Furthermore, a comparative study and prediction have been conducted on the impact of manipulating factors on the average Nusselt number derived from the numerical heat transfer analysis. The findings of the research indicate that, in the absence of magnetohydrodynamics, a rise in the Hartmann number resulted in a drop in both the fluid velocity profile and magnitude. Conversely, it was observed that the temperature and Nusselt number exhibited an increase under these conditions. The mean temperature of the fluid rises as the Hartmann number drops, reaching a peak value of 0.114 when Ha = 0. The scenario where Ha = 0, representing the lack of magnetohydrodynamics, shows the highest average Nusselt number, whereas the instance with Ha = 45 presents the lowest Nusselt number. The ANN model has a high level of accuracy, as seen by an MSE value of 0.00069 and a MAE value of 0.0175, resulting in a 99% accuracy rate.

Identification of genetic biomarkers, drug targets and agents for respiratory diseases utilising integrated bioinformatics approaches.

Respiratory diseases (RD) are significant public health burdens and malignant diseases worldwide. However, the RD-related biological information and interconnection still need to be better understood. Thus, this study aims to detect common differential genes and potential hub genes (HubGs), emphasizing their actions, signaling pathways, regulatory biomarkers for diagnosing RD and candidate drugs for treating RD. In this paper we used integrated bioinformatics approaches (such as, gene ontology (GO) and KEGG pathway enrichment analysis, molecular docking, molecular dynamic simulation and network-based molecular interaction analysis). We discovered 73 common DEGs (CDEGs) and ten HubGs (ATAD2B, PPP1CB, FOXO1, AKT3, BCR, PDE4D, ITGB1, PCBP2, CD44 and SMARCA2). Several significant functions and signaling pathways were strongly related to RD. We recognized six transcription factor (TF) proteins (FOXC1, GATA2, FOXL1, YY1, POU2F2 and HINFP) and five microRNAs (hsa-mir-218-5p, hsa-mir-335-5p, hsa-mir-16-5p, hsa-mir-106b-5p and hsa-mir-15b-5p) as the important transcription and post-transcription regulators of RD. Ten HubGs and six major TF proteins were considered drug-specific receptors. Their binding energy analysis study was carried out with the 63 drug agents detected from network analysis. Finally, the five complexes (the PDE4D-benzo[a]pyrene, SMARCA2-benzo[a]pyrene, HINFP-benzo[a]pyrene, CD44-ketotifen and ATAD2B-ponatinib) were selected for RD based on their strong binding affinity scores and stable performance as the most probable repurposable protein-drug complexes. We believe our findings will give readers, wet-lab scientists, and pharmaceuticals a thorough grasp of the biology behind RD.

Association of Chest Pain with Rate Pressure Product and ST-segment Changes after Sub Arachnoid Block in Caesarean Section.

When healthy women undergo caesarean section (CS) under sub arachnoid anaesthesia, transient electrocardiographic changes, such as ST-segment depression and T-wave abnormalities, are observed. During an elective caesarean section under sub arachnoid anaesthesia, about one-third of healthy parturient experience chest pain and ECG changes suggestive of myocardial ischemia. To assess the ST-segment and Rate Pressure Product changes with chest pain in patients with elective caesarean section under subarachnoid block. The Department of Anesthesia, Analgesia and Intensive Care Medicine at Bangabandhu Sheikh Mujib Medical University (BSMMU), Bangladesh was the site of this prospective observational study. The study included 86 healthy women between the ages of 20 and 35 who needed an elective caesarean section under a single shot sub arachnoid block and who visited the Department of Anesthesia, Analgesia, and Intensive Care Medicine at BSMMU in Shahbagh, Dhaka from January 2019 to June 2019. In comparison to the no chest pain group, ST-segment changes among the chest pain group at delivery, 5 minute, 10 minute after delivery and at the end of the surgery were highly significant (p=0.001). Comparatively, Rate Pressure Product changes were found to be significantly higher in the group with chest pain than in the group without chest pain (p=0.001). It is concluded that there is a substantial association of chest pain with rate pressure product and ST-segment changes after subarachroid block in caesarean section.

Enhancing radiative efficiency in MHD micropumps using plasma-infused hybrid bioconvective nanofluids for advanced radiative oncology at tertiary level.

This research paper investigates the optimization of radiation performance of a plasma-based bioconvective nanofluid integrated Magneto-hydrodynamic (MHD) micropump for radiative oncology. It addresses a literature gap by analysing the radiative impact of blood-based hybrid nanofluids in MHD micropumps. Three blood-based bio-convective radiating hybrid nanofluids-blood-Pt, blood-Au and blood-MWCNT are studied to understand their radiation behaviour in MHD pump while being employed as transportation medium. The investigation employs two non-dimensional parameters, namely Rd (Radiation number) and Ha (Hartmann number), to examine the fluid dynamics, magnetic characteristics, and electrical properties of the MHD micropump. The temperature gradient, velocity distribution, and pressure drop along the flow channel are examined within the specified range of Rd and Ha. Magnetic flux density (MFD) and electric flux intensity (EFI) are evaluated to understand nanoparticle behaviour during drug delivery and blood transportation. Findings highlight that MWCNT and Pt are the most efficient bioconvective nanoparticles for plasma transportation under high radiative conditions. MWCNT-based blood flow exhibits desirable characteristics, including sufficient intake pressure of 4.5 kPa and minimal relative pressure drop of 34%. Coherence between radiation flux and electromagnetic flux reduces pumping power and ensures uniform heat dissipation for improved drug delivery. Au nanoparticles provide moderate magnetic flux density with least fluctuation within the range of Ha and Rd number (2.57 T to 4.39 T), even in highly radiative environments (such as-Rd = 4, Rd = 5), making them suitable for applications like embedded chemotherapy or cell treatment. Au nanoparticles maintain moderate electrical flux intensity with a minimal drop of 16nA, particularly at higher radiative environments influenced by the Radiation number (Rd = 4 to Rd = 5) while Ha values from Ha = 2 to Ha = 4. Conclusively, it has been identified that MWCNT and Au are superior nanofluids for advanced radiative oncological treatments. These nanofluids have the potential to enhance plasma transportation, thermal regulation, and aetilogical disease management. The present study provides significant findings on enhancing the radiation performance in MHD micropumps through utilization of blood-based hybrid nanofluids, thereby offering potential advantages to the domain of biomedical engineering.

Dexmedetomidine as an Adjuvant to Bupivacaine in Caudal Analgesia in Children Undergoing Infra-Umbilical Surgery.

When performing infra-umbilical procedures, caudal epidural analgesia with bupivacaine is frequently used to provide both intra- and post-operative analgesia. Dexmedetomidine, an alpha 2 agonistsare extensively used in neuraxial blocks and peripheral nerve blocks to prolong the action of bupivacaine. To find out the effects of dexmedetomidine as an adjuvant to bupivacaine for caudal analgesia in children undergoing infra-umbilical surgery. This was a randomized, controlled double-blinded prospective observational study and was performed from July 2019 to December 2019. A total of 60 (Sixty) patients with different infra-umbilical surgical problems underwent different procedure under caudal anaesthesia in different operation theatre in Bangabandhu Sheikh Mujib Medical University, Dhaka were enrolled in this study. Elaborate personal history, meticulous clinical examinations and relevant laboratory investigations was done. Post-operative adverse effects also were monitored. All information from history of illness, clinical, laboratory findings, duration of analgesia and post-operative adverse effects were recorded in a preformed data sheet (Appendix-I) and statistical analysis was done by SPSS 22.0. Mean age of the children in Group A (dexmedetomidine + bupivacaine) was 5.50±2.61 years and in Group B (bupivacaine) was 5.66±2.75. Mean weight of the children in Group A was 19.22±8.58 kg and in Group B was 19.70±8.94 kg in this study. Mean duration of anaesthesia was 27.5±6.5 minute in Group A and 28.5±5.5 minute in Group B. The mean duration of analgesia was 4.32±0.54 hours for Group A and 2.12±0.32 hours in Group B. In Group A, 46.7% patients required 1 and 3.3% required 2 rescue analgesic but in Group B, 43.3% patients required single rescue analgesic and 33.3% required two rescue analgesics (p<0.05). In Group A, 6.7% patients had nausea/ vomiting and in Group B, 16.7% patients had nausea/ vomiting (p>0.05). It can be concluded that dexmedetomidine with bupivacaine for caudal analgesia in infra-umbilical surgery significantly prolongs the duration of postoperative analgesia when compared to bupivacaine alone without any side-effects.

Predicting Difficult Intubation by using Modified Mallampati (MMT) with or without Thyromental Height Test (TMHT).

Failed Tracheal Intubation with Subsequent inability to maintain an open airway and adequate oxygenation is the most frequent cause of brain damage or death during anesthesia. Recognizing before anesthesia the potential for difficult intubation allows time for optimal preparation. Proper Selection of equipment and techniques is needed to avoid unwanted situation. To find out difficulties associated with endotracheal intubation using Modified Mallampati Test (MMT) combined with Thyromental Height Test (TMHT) and MMT without TMHT. This prospective observational study was conducted at the Department of Anesthesia in Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from April 2018 to September 2018. Two hundred two patients with different surgical procedures under general anaesthesia in different operation theaters of BSMMU, Dhaka were selected as study population. After taking written consents from each patient or his/her attendant elaborate history of illness, meticulous clinical examinations were performed and relevant laboratory investigations were done. All information was recorded in a preformed data sheet and statistical analysis was done by SPSS-22.0. Mean age ±SD of the study subjects was 42.49±14.29 years in MMT with TMHT group and 43.40±15.39 years in MMT without TMHT group. Females were enrolled more than males in both the groups. BMI was 28.75±3.59kg/m² in MMT with TMHT group and 29.44±8.64kg/m² in MMT without TMHT group. There were no significant differences in age, gender and BMI between the groups. Sensitivity, specificity, PPV, NPV and accuracy were 100.0%, 96.0%, 96.2%, 100.0% and 98.0% respectively of MMT with TMHT in predicting intubation difficulty. Sensitivity, specificity, PPV, NPV and accuracy were 100.0%, 96.0%, 96.2%, 100.0% and 98.0% respectively of MMT only in predicting intubation difficulty. MMT combined with TMHT is a better predictor of intubation difficulty than MMT alone.

A classification of MRI brain tumor based on two stage feature level ensemble of deep CNN models.

The brain tumor is one of the deadliest cancerous diseases and its severity has turned it to the leading cause of cancer related mortality. The treatment procedure of the brain tumor depends on the type, location and size of the tumor. Relying solely on human inspection for precise categorization can lead to inevitably dangerous situation. This manual diagnosis process can be improved and accelerated through an automated Computer Aided Diagnosis (CADx) system. In this article, a novel approach using two-stage feature ensemble of deep Convolutional Neural Networks (CNN) is proposed for precise and automatic classification of brain tumors. Three unique Magnetic Resonance Imaging (MRI) datasets and a dataset merging all the unique datasets are considered. The datasets contain three types of brain tumor (meningioma, glioma, pituitary) and normal brain images. From five pre-trained models and a proposed CNN model, the best models are chosen and concatenated in two stages for feature extraction. The best classifier is also chosen among five different classifiers based on accuracy. From the extracted features, most substantial features are selected using Principal Component Analysis (PCA) and fed into the classifier. The robustness of the proposed two stage ensemble model is analyzed using several performance metrics and three different experiments. Through the prominent performance, the proposed model is able to outperform other existing models attaining an average accuracy of 99.13% by optimization of the developed algorithms. Here, the individual accuracy for Dataset 1, Dataset 2, Dataset 3, and Merged Dataset is 99.67%, 98.16%, 99.76%, and 98.96% respectively. Finally a User Interface (UI) is created using the proposed model for real time validation.

Network based systems biology approach to identify diseasome and comorbidity associations of Systemic Sclerosis with cancers.

Systemic Sclerosis (SSc) is an autoimmune disease associated with changes in the skin's structure in which the immune system attacks the body. A recent meta-analysis has reported a high incidence of cancer prognosis including lung cancer (LC), leukemia (LK), and lymphoma (LP) in patients with SSc as comorbidity but its underlying mechanistic details are yet to be revealed. To address this research gap, bioinformatics methodologies were developed to explore the comorbidity interactions between a pair of diseases. Firstly, appropriate gene expression datasets from different repositories on SSc and its comorbidities were collected. Then the interconnection between SSc and its cancer comorbidities was identified by applying the developed pipelines. The pipeline was designed as a generic workflow to demonstrate a premise comorbid condition that integrate regarding gene expression data, tissue/organ meta-data, Gene Ontology (GO), Molecular pathways, and other online resources, and analyze them with Gene Set Enrichment Analysis (GSEA), Pathway enrichment and Semantic Similarity (SS). The pipeline was implemented in R and can be accessed through our Github repository: https://github.com/hiddenntreasure/comorbidity. Our result suggests that SSc and its cancer comorbidities share differentially expressed genes, functional terms (gene ontology), and pathways. The findings have led to a better understanding of disease pathways and our developed methodologies may be applied to any set of diseases for finding any association between them. This research may be used by physicians, researchers, biologists, and others.

LungNet: A hybrid deep-CNN model for lung cancer diagnosis using CT and wearable sensor-based medical IoT data.

Lung cancer, also known as pulmonary cancer, is one of the deadliest cancers, but yet curable if detected at the early stage. At present, the ambiguous features of the lung cancer nodule make the computer-aided automatic diagnosis a challenging task. To alleviate this, we present LungNet, a novel hybrid deep-convolutional neural network-based model, trained with CT scan and wearable sensor-based medical IoT (MIoT) data. LungNet consists of a unique 22-layers Convolutional Neural Network (CNN), which combines latent features that are learned from CT scan images and MIoT data to enhance the diagnostic accuracy of the system. Operated from a centralized server, the network has been trained with a balanced dataset having 525,000 images that can classify lung cancer into five classes with high accuracy (96.81%) and low false positive rate (3.35%), outperforming similar CNN-based classifiers. Moreover, it classifies the stage-1 and stage-2 lung cancers into 1A, 1B, 2A and 2B sub-classes with 91.6% accuracy and false positive rate of 7.25%. High predictive capability accompanied with sub-stage classification renders LungNet as a promising prospect in developing CNN-based automatic lung cancer diagnosis systems.

Machine Learning Approaches to Identify Patient Comorbidities and Symptoms That Increased Risk of Mortality in COVID-19.

Providing appropriate care for people suffering from COVID-19, the disease caused by the pandemic SARS-CoV-2 virus, is a significant global challenge. Many individuals who become infected may have pre-existing conditions that may interact with COVID-19 to increase symptom severity and mortality risk. COVID-19 patient comorbidities are likely to be informative regarding the individual risk of severe illness and mortality. Determining the degree to which comorbidities are associated with severe symptoms and mortality would thus greatly assist in COVID-19 care planning and provision. To assess this we performed a meta-analysis of published global literature, and machine learning predictive analysis using an aggregated COVID-19 global dataset. Our meta-analysis suggested that chronic obstructive pulmonary disease (COPD), cerebrovascular disease (CEVD), cardiovascular disease (CVD), type 2 diabetes, malignancy, and hypertension as most significantly associated with COVID-19 severity in the current published literature. Machine learning classification using novel aggregated cohort data similarly found COPD, CVD, CKD, type 2 diabetes, malignancy, and hypertension, as well as asthma, as the most significant features for classifying those deceased versus those who survived COVID-19. While age and gender were the most significant predictors of mortality, in terms of symptom-comorbidity combinations, it was observed that Pneumonia-Hypertension, Pneumonia-Diabetes, and Acute Respiratory Distress Syndrome (ARDS)-Hypertension showed the most significant associations with COVID-19 mortality. These results highlight the patient cohorts most likely to be at risk of COVID-19-related severe morbidity and mortality, which have implications for prioritization of hospital resources.

Value of Serum Adenosine Deaminase (ADA) in Distinguishing between Tuberculous and Non-tuberculous Lymphadenopathies.

Persistent lymphadenopathy with or without fever is often a diagnostic challenge to the physician which are usually caused by infection like tuberculosis, hematological malignancy (lymphoma, leukemia), connective tissue diseases (SLE, RA, Sjogren's syndrome etc.), sarcoidosis, storage diseases, drugs (like phenytoin) in Bangladesh. To establish the cause of lymphadenopathy, we need to do a good number of investigations including invasive tests like FNAC or histopathology of the involved lymph node. In many instances these are not possible due to unavailability or cost. But for last few years the adenosine deaminase is an enzyme involved in purine catabolism and its significance in the diagnosis of tuberculosis has been demonstrated by many studies. In addition to tuberculosis, elevated serum adenosine deaminase has also been found in lymphoma, sarcoidosis and some connective tissue diseases. The study was intended to assess if there are any significant diagnostic difference in the level of elevated adenosine deaminase between tubercular and different types of non tubercular lymphadenopathy. It included 68 patients, equally divided into two groups, tuberculous lymphadenitis and non-tuberculous lymphadenopathy. Epitheloid granuloma with caseation necrosis in biopsy or FNAC was taken as case definition of tuberculous lymphadenitis. Causes of non-tuberculous lymphadenopathy were established on the basis of clinical findings, laboratory investigations and histopathological diagnosis of biopsy or FNAc materials. This cross-sectional observational study was done in Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh over a period of one year and participants of 18 years and above of both genders were included as per consecutive sampling technique. Serum ADA concentrations were estimated by enzymatic method. Mean serum ADA concentration was 25.52±7.11 in tuberculous lymphadenitis and in non-tuberculous lymphadenopathy patients it was 27.29±15.91U/L with no significant difference (p=0.480). The non-tuberculous lymphadenopathy group consisted of Hodgkin disease (n=9), non-Hodgkin lymphoma (n=10), sarcoidosis (n=2), reactive lymphadenitis (n=9) and other lymphadenopathy group (n=4) (that consisted one case of each of follicular hyperplasia, adult Still disease, sinus histiocytosis and Castleman's disease). The mean ADA of these groups was 32.77±13.14U/L, 46.40±46.10U/L, 13.94±2.81U/L and 21.75±3.17U/L respectively. Tuberculous lymphadenitis patients had significantly higher serum ADA than persistent reactive lymphadenitis. On the other hand, there were statistically significant elevation of serum ADA in non-Hodgkin lymphoma and sarcoidosis than in tuberculous lymphadenitis.

Evaluation of Surgical Correction of Adolescent Idiopathic Scoliosis by Transpedicular Screws and Rods.

Transpedicular screw fixation is a challenging procedure for the correction of deformity of Adolescent Idiopathic Scoliosis (AIS) in the dorso-lumbar spine. The inadvertently misplaced screws have a high risk of complications. The exactness of the pedicle screws is normally distinct as the screws axis being fully enclosed within the cortices of the pedicle. Evaluation of the surgical correction of adolescent idiopathic scoliosis by transpedicular screws and rods was done in single posterior dynamic approach. This prospective observational study was conducted in the National Institute of Traumatology and Orthopedic Rehabilitation, Dhaka and different Hospitals in Dhaka, Bangladesh from July 2015 to March 2017. Ten patients at the age >9 years and <19 years who were admitted with a diagnosis of AIS during the period of study. The pedicle is a power nucleus of the vertebra and offers a secure grip of all 3 columns. Pedicle screw instrumentation has advantages of rigid fixation with improved 3D correction and it has been accepted as a reliable method with a high margin of safety. Accurate placement of the pedicle screws is important to reduce possible irreversible complication. So, all cases were corrected by transpedicular screws and rods in single posterior approach. In every case fusion was done in selected segments. In this study out of 10 patients 7(70.0%) were 10 to 14 years of age and 3(30.0%) were 15 to 18 years. Mean age 9.51±2.13 years. Minimum 10 years and maximum 18 years. Majority 7(70.0%) of the patients were female and the rest 3(30.0%) male. Five (50.0%) presented with level of involvement, 3(30.0%) patients thoracic and 2(20.0%) patients had lumbar. Maximum 7(70.0%) presented right sided involvement and rest 3(30.0%) left sided involvement. Before surgical intervention 100% patients had rib hump and positive Adams forward bending test, 70.0% patients had asymmetry of shoulder and uneven hip and also 50% patients had pain. After surgical treatment with transpedicular screws and rods through posterior approach, 70% of patients improved in terms of deformity. The average major curve deformity as defined by Cobb angle measurements was measured to be 54.9°±9.9° (40°-68°) in pre-surgery. After surgery this deformity corrected to 16.0°±4.9° (10°-24°) on average as measured in erect posture posterior anterior and lateral view. This represents significant improvement average of 71.4±4.3% (64.6-75.09) (p<0.001). This correction was maintained at 24 months after surgery. Functional results assessed by Modified Macnab criteria, significant number of 7(70.0%) patients had excellent outcome, 2(20.0%) patients had good outcome, 1(10.0%) patients had fair outcome and no poor outcome. Ninety percent (90%) patients had satisfactory results. No patient deteriorates neurologically after surgery. It is concluded that satisfactory curve correction and maintenance thereof is possible in adolescent idiopathic scoliosis, with posterior instrumentation by transpedicular screw and rods with effective reduction of cost and associated risks.

Discovering novel cancer bio-markers in acquired lapatinib resistance using Bayesian methods.

Signalling transduction pathways (STPs) are commonly hijacked by many cancers for their growth and malignancy, but demystifying their underlying mechanisms is difficult. Here, we developed methodologies with a fully Bayesian approach in discovering novel driver bio-markers in aberrant STPs given high-throughput gene expression (GE) data. This project, namely 'PathTurbEr' (Pathway Perturbation Driver) uses the GE dataset derived from the lapatinib (an EGFR/HER dual inhibitor) sensitive and resistant samples from breast cancer cell lines (SKBR3). Differential expression analysis revealed 512 differentially expressed genes (DEGs) and their pathway enrichment revealed 13 highly perturbed singalling pathways in lapatinib resistance, including PI3K-AKT, Chemokine, Hippo and TGF-$\beta $ singalling pathways. Next, the aberration in TGF-$\beta $ STP was modelled as a causal Bayesian network (BN) using three MCMC sampling methods, i.e. Neighbourhood sampler (NS) and Hit-and-Run (HAR) sampler that potentially yield robust inference with lower chances of getting stuck at local optima and faster convergence compared to other state-of-art methods. Next, we examined the structural features of the optimal BN as a statistical process that generates the global structure using $p_1$-model, a special class of Exponential Random Graph Models (ERGMs), and MCMC methods for their hyper-parameter sampling. This step enabled key drivers identification that drive the aberration within the perturbed BN structure of STP, and yielded 34, 34 and 23 perturbation driver genes out of 80 constituent genes of three perturbed STP models of TGF-$\beta $ signalling inferred by NS, HAR and MH sampling methods, respectively. Functional-relevance and disease-relevance analyses suggested their significant associations with breast cancer progression/resistance.

Giant Villous Adenoma: A Rare Case of Colorectal Adenoma that Mimic Colorectal Cancer.

Colorectal cancer being the 4th most common cause of cancer death in which most arise from a preexisting adenomatous polyp. Among the various adenomas Giant villous adenoma (GVA) is less common. We came across a 65 years female with intermittent per rectal mucus discharge for last 10 years and intermittent fresh, painless, scanty per rectal bleeding along with weakness and fatigue for last 5 years. No members of her family had been suffering from colorectal malignancy. DRE revealed irregular gritty feelings of rectal mucosa starting 2cm from anal verge and the examining fingertip was blood tinged mixed with mucus. On proctoscopic examination the accessible rectum was studded with thousands of polyps with granular appearance, with variable sizes and there was mucus mixed blood within the rectum. Colonoscopy reveals- polypoid lesion starting 2cm from anal verge and extends up to 2cm with granular and velvety appearance. Biopsy was done 2 times for suspicious lesion and histopathology reveals tubulovillous adenoma with dysplasia. However as clinical suspicion of an adenocarcinoma was strong but histopathological report of colonoscopic biopsy was contradictory, intersphincteric ultra-low anterior resection with coloanal anastomosis with covering ileostomy was done. Resected specimen was sent for histopathological study and it reveals- villous adenoma with low grade dysplasia. Two months later reversal of ileostomy was done and now the patient is under regular follow up and now she is asymptomatic.

Dataset on applying HPMC polymer to improve encapsulation efficiency and stability of the fish oil: In vitro evaluation.

Data examines the effect of hydroxypropyl methylcellulose (HPMC) HPMC15 cP, and HPMC 5 cP polymer composition on the physicochemical traits of encapsulated oil made using lab scale spray drying (180 °C). The data found showed that the properties of the reconstituted fish oil powder are significantly affected by the polymer's composition and ratio (p < 0.05). In this experiment, powder with the particle sizes below 60 µm was produced and it was observed that HPMC is a good emulsifier for all formulations and the encapsulation efficiency is high with 75.21% for AF1 formulation. It was also observed that the process of fish oil encapsulation employed by HPMC 5 cP produce a more volatile oil powder, while encapsulation with HPMC 15 cP produced a more stable fish oil powder. These finding shows that the utilisation of HPMC as a polymer to encapsulate fish oil can produce a more efficient and stable compound.

Progressive Pseudo-rheumatoid Dysplasia: Two Cases in One Family.

Progressive pseudo-rheumatoid dysplasia is an autosomal recessive skeletal dysplasia. Spine radiographs show platyspondyly. The clinical presentations are similar to juvenile idiopathic arthritis, but not the laboratory findings. We report 2 cases of progressive pseudo-rheumatoid dysplasia in the same family. A 26 years old male was admitted in the department of Rheumatology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh with the complain of inflammatory joint pain, joint swelling, range-of-motion limitation, and joint deformities in the hands, wrists, ankles, knees and hips for 20 years. He was treated as juvenile idiopathic arthritis with different anti-inflammatory medications having progressing by flares and remissions. Erythrocyte sedimentation rate, C-reactive protein, rheumatoid factor, anti ccp antibody and HLAB27 levels were normal. Synovial fluid of the knees showed mechanical properties. Plain radiographs of the hands and knees showed evidence of joint destruction. Radiograph of the pelvis notes bilateral hip dysplasia. Platyspondyly was found in spinal radiograph. The diagnosis of juvenile idiopathic arthritis was reconsidered. His 22 years old younger brother had similar manifestations without laboratory evidence of inflammation; radiographs disclosed dysplasia of the hips and metacarpophalangeal epiphyses. Manifestation of spinal stiffness, thoracic kyphosis, and motion-range limitation at the hips; radiographs showed normal sacroiliac joints and bilateral hip dysplasia. So, a diagnosis of progressive pseudo-rheumatoid dysplasia with polyarticular involvement was done.

Carboxymethyl fenugreek galactomannan-g-poly(N-isopropylacrylamide-co-N,N'-methylene-bis-acrylamide)-clay based pH/temperature-responsive nanocomposites as drug-carriers.

The current study dealt with the synthesis and characterization of carboxymethyl fenugreek galactomannang-g-poly(N-isopropylacrylamide-co-N,N'-methylene-bis-acrylamide)-bentonite [CFG-g-P(NIPA-co-MBA)-BEN] based nanocomposites (NCs) as erlotinib (ERL)-delivery devices for lung cancer cells to suppress excessive cell proliferation. The blank NCs exhibited outstanding biodegradability and pH/temperature-dependent swelling profiles, which were significantly influenced by their BEN contents (0-20%). The molar mass (M¯c) between the crosslinks of these NCs was declined with temperature. The composite architecture of these scaffolds was confirmed by XRD, FTIR, TGA, DSC and SEM analyses. The corresponding ERL-loaded matrices (F-1-F-3) portrayed outstanding drug encapsulation efficiency (DEE, 93-100%) with zeta potential between -8 and -16 mV and diameter between 615 and 1258 nm. These formulations demonstrated sustained ERL elution profiles (Q8h, 62-98%) with an initial burst release of drug. The drug dissolution pattern of the optimized matrices (F-3) obeyed first-order kinetic model and was driven by Fickian diffusion. The mucin adsorption behavior of F-3 was best fitted to Freudlich isotherms. The ERL-loaded formulation suppressed A549 cell proliferation and promoted apoptosis to a greater extent than the pristine drug, as detected by cellular uptake analysis, MTT cytotoxicity test and AO/EB staining assay.

Total Lip Reconstruction after Excision of Cancer with Composite Radial Forearm Palmaris Longus Tendon Free Flap.

Reconstruction of total lip is a challenging task for a plastic surgeon. It becomes more complicated when there is loss of additional tissues like angle of mouth, buccal mucosa or floor of the mouth. Radial forearm flap with palmaris longus tendon provides an easier but reliable technique for three dimensional lip reconstructions with good functional and aesthetic outcome. In this short observational series we included 5 patients of total lip reconstruction and conducted at Sylhet MAG Osmani Medical College Hospital and Private Clinic of Sylhet, Bangladesh from January 2014 to December 2017. Among these one was a case of basal cell carcinoma of upper lip and rest was squamous cell carcinoma of lower lip. The mean age was 71 years. All the flaps survived and patients had normal speech and oral continence. Composite radial forearm flap with palmaris longus tendon is a good, reliable option for total lip reconstruction.

Tuberculosis in Systemic Lupus Erythematosus Patients.

The tubercular infections (TB) are most important cause of morbidity and mortality in SLE patients worldwide and an ongoing alarming issue in developing countries. This observational study was carried out in SLE clinic of BSMMU, Bangladesh from April 2015 to March 2016 after taking ethical clearance from IRB to observe frequency and risk factors of tuberculosis in SLE patients. A total 230 consecutive SLE patients were enrolled. Patient's clinical characteristics, history of TB, SLEDAI score, cumulative doses of immunosuppressants were recorded. In clinically suspected cases tuberculin test, chest X-ray, spot and first morning sputum for AFB, Gene Xpert MTB/RIF, ADA, FNAC and tissue biopsy were requested along with routine tests. The multivariate logistic regressions were done for risk factors. Out of 230 patients TB was documented in 23 (10%) subjects. Among TB cases 16 women and 7 men. Mean age of patients was 27.56±9.3 years and mean duration of occurrence of tuberculosis after SLE diagnosis was 4.26±5.38 years. Present and past TB was observed in 10 and 13 cases respectively. Cough, night sweat, fever, anorexia were significant presenting features. Fifteen and 8 patients had pulmonary and extra pulmonary TB respectively. Organ involvement pattern was multi-lobed lungs, joint, meninges, lymph nodes, peritoneum and pleura. High disease activity disease (SLEDAI score >12), total intake of prednisolone >1000mg were risk factors of TB. Frequency of tuberculosis was high (10%) in SLE patients. Awareness including prevention of flares and judicious use of steroids might reduce the rate of TB.

Polyarthritis is a Rare Manifestation of Pachydermoperiostosis: A Case Report.

Pachydermoperiostosis or primary hypertrophic osteoarthropathy, also known as Touraine-Solente-Gole syndrome, is a rare process, frequently inherited. In its complete form it is characterized by pachydermia (thickening of the skin), skeletal changes (periostosis) and acropachia (digital clubbing). Diagnosis can be made considering the typical clinical features and the histological feature. We report a patient of 25-year old man presented with joint pain involving in multiple joints for last 7 years and progressive enlargement of his hands and feet with profuse sweating of palms and soles for last 4 years. Physical examination revealed thickened skin with excessive furrowing of his forehead, dropping of both eyelids, clubbing of all fingers, toes and enlargement of his hands and feet with pamoplantar hyperhidrosis. Laboratory investigation shows raised CRP, X-ray feet lateral view showed normal heel pad thickness, new bone formation and periosteal elevation in lower end of tibia and fibula and skin biopsy showed dense fibrocollagenous tissue in dermis and subcutis and mild acanthosis. With this scenario he was diagnosed as primary hypertrophic osteoarthropathy (Pachydermoperiostosis). After diagnosis he was treated with cholchicine (0.6mg) twice daily, naproxen (500mg) twice daily, and risedronate (150mg) monthly. After one year his skin texture became less thickened, joint pain improved, there was no further enlargement of acral part of fore arm. In this report we review the characteristic features of this syndrome. We highlight the importance of ruling out secondary forms of hypertrophic osteoarthropathy and of a close follow-up of these patients because of complications that might develop on long-term. Although no treatment was satisfactory, we wanted to emphasize that NSAIDs, Cholchicine and risedronate could be an effective treatment option.