Diagnostic Value of Ultrasonography in Determination of Knee Joint Pathologies with Comparison to MRI.

Knee pain is a common musculoskeletal symptom in the general population and results in significant disability, reducing the quality of life and inducing financial burden to the health care system. This cross-sectional, descriptive type of observational study was conducted with a total 52 patients having symptomatic knee joint disease in the Department of Radiology and Imaging, Mymensingh Medical College Hospital, Bangladesh from April 2019 to September 2020. This study was performed to find out the effectiveness of ultrasonography as a modality of investigation in the determination of knee joint pathologies with comparison to MRI, considering MRI as the gold standard. The majority of the patients 13(25.0%) were in the age group of 15-25 years with mean age was 39.88±15.308 years. In detecting synovial effusion, bursal collection, baker's cyst, tendinopathy and tumor pathologies ultrasound had 100.0% sensitivity, specificity and accuracy for each whether bursitis has 100.0%, 96.4% and 98.07% respectively. MCL tear had 100.0%, 97.8%, 98.07%. LCL tear detection showed 100.0%, 97.8%, 98.07%. PCL tear had 66.7%, 95.9%, 94.2%. ACL tear had 50.0%, 97.6%, 88.4% sensitivity, specificity and accuracy. Meniscal tear showed 66.7%, 97.8%, 88.4% sensitivity and accuracy. In all cases difference was statistically significant with a p value <0.0001 which strongly supported against null hypothesis. From this study, it is concluded that high-resolution USG showed high sensitivity, specificity and accuracy compared to MRI in detecting common knee abnormalities, and could be considered as the first-line imaging modality in the evaluation of knee pain.

A new genus of caryophyllidean tapeworms (Cestoda) from Mystus catfishes (Bagridae) in India: cleaning up taxonomic chaos.

A new genus, Mystocestus, is proposed to accommodate a new species, Mystocestus anindoi n. g., n. sp. from Mystus vittatus (Bloch) (type host) in West Bengal and Mystus cavasius (Hamilton) (Siluriformes: Bagridae) in Maharashtra, India. The new genus is most similar to Lucknowia Gupta, 1961 in the shape of the body, which is elongate, slightly tapering towards the anterior end, and scolex, which is digitiform, but differs in the shape of the ovary, which is H-shaped (vs. inverted A-shaped in Lucknowia), the absence of a seminal receptacle (present in Lucknowia) and exclusively cortical vitelline follicles (vs. some follicles in the medulla in the latter genus). Molecular data support the erection of the new genus and place it close to Bovienia Fuhrmann, 1931, species of which can be easily distinguished by exclusively lateral vitelline follicles (lateral and median in the new genus), the presence of a seminal receptacle (absent in Mystocestus) and scolex shape (digitiform, with blunt or slightly concave anterior edge in the new genus vs. small, unspecialized or spatulate in Bovienia). The convoluted taxonomy of tapeworms placed in Mystoides Mathur, 1992 is critically reviewed to clean up taxonomic chaos in Indo-Malayan caryophyllideans. Mystoides was erected in an unpublished PhD thesis and thus its generic name becomes unavailable and also, its type species is conspecific with Lucknowia fossilisi Gupta, 1961 from the stinging catfish, Heteropneustes fossilis (Bloch). Other species of this genus are also conspecific with L. fossilisi. In addition, specific names of most of these taxa are unavailable because they were described in unpublished theses or conference abstracts. Based on recent revisions of Indo-Malayan caryophyllideans, the following nine genera with 15 species are considered valid (numbers of species of individual genera are provided in parentheses): Bovienia (3), Djombangia (1), Lucknowia (2), Lytocestus (2), Mystocestus (1), Pseudocaryophyllaeus (2) (all family Lytocestidae); Adenoscolex (1), Lobulovarium (2), Paracaryophyllaeus (1) (all family Caryophyllaeidae).

Antenatal care and skilled birth attendance in Bangladesh are influenced by female education and family affordability: BDHS 2014.

OBJECTIVES: Antenatal care (ANC) during pregnancy and skilled birth attendance (SBA) during delivery are important policy concerns to reduce maternal deaths. Bangladesh is one of the developing countries which has made remarkable progress in both services during the last couple of decades by improving the SBA service rate from 16% in 2004 to 42.1% in 2014. However, this rate remains below the targeted level (50%) of the Health Population and Nutrition Sector Development Program set by the Ministry of the Health and Family Welfare of Bangladesh. This article explored the sociodemographic factors associated with the ANC and SBA service attainment. Furthermore, the possible implication of using ANC on SBA was also investigated. STUDY DESIGN: The study followed a cross-sectional design using the Bangladesh demographic and health survey 2014, with a sample of size 4603 women with at least one live birth 3 years preceding the survey. METHODS: Following a bivariate analysis, linear mixed-effect models were used to assess the relationship between sociodemographic factors and the outcome indicators (ANC and SBA). Finally, the association between SBA and ANC was evaluated through another mixed-effect model. RESULTS: Wealth index, participation in household decisions, and partner's and respondent's education were significant predictors of ANC; whereas, residence, age at first birth, wealth index, working status, participation in household decisions, and partner and respondent's education were significant for SBA. Female education and household affordability were the strongest predictors for both ANC and SBA. ANC showed significant association with SBA as women accessing essential ANC during delivery seemed to be 4 times more likely (95% confidence interval: 3.05-5.93) to avail SBA services. CONCLUSIONS: Overall, four factors were significant: residence, wealth index, education, and ANC access. Women residing in urban areas, having higher financial solvency, completing higher education, and accessing ANC by skilled personnel were more likely to receive SBA at delivery than their counterparts. Accessibility to skilled care during pregnancy leads to increased professional care during delivery. Thus, policies to encourage women and heads of families to seek skilled care during pregnancy would be beneficial to reach the maternal healthcare targets of Bangladesh.

Effect of Reduced Glutathione, Water Soluble Vitamin E Analogue and Butylated Hydroxytoluene on the Post Thaw Characteristics of Boar Spermatozoa.

BACKGROUND: Antioxidant in freezing extender of boar semen improved post thaw sperm function. OBJECTIVE: The study compared the effects of reduced glutathione (GSH), water soluble vitamin E analogue Trolox and butylated hydroxytoluene (BHT) on quality of cryopreserved boar spermatozoa. MATERIALS AND METHODS: Using split sample technique three different antioxidants namely, GSH (1 mM), vitamin E (0.2 mM) and BHT (0.2 mM) were added to the freezing medium of lactose-egg yolk-glycerol extender, and samples were frozen using controlled freezing rate of 40°C/min from -6 to -140°C. Samples were evaluated for sperm motility, acrosomal status, plasma membrane integrity, mitochondrial membrane potential, lipid peroxidation and sperm DNA integrity after equilibration and after freezing. RESULTS: The supplementation of GSH, vitamin E and BHT resulted in significantly higher post thaw motility, live intact acrosome and plasma membrane intact sperm. The incidence of post thaw sperm lipid peroxidation was significantly reduced after addition of antioxidants. However, antioxidants treatment neither significantly improved mitochondrial membrane potential of live sperm sub-population nor sperm DNA integrity after freezing. There was no significant difference of the post thaw sperm characteristics among three antioxidants. Protective effect of GSH, vitamin E and BHT are comparable on cryopreserved boar spermatozoa.

Carotid artery screening at the time of coronary artery bypass - Does it influence neurological outcomes?

OBJECTIVE: Patients undergoing coronary artery bypass graft (CABG) are recommended to undergo carotid duplex study in presence of risk factors. Aim of the study was to quantify the relationship between risk factors and presence of carotid disease and examine if screening influenced outcomes. METHODS: Over a four year period in a single institution, 4364 consecutive patients presenting for primary isolated CABG were enrolled to undergo carotid duplex scanning. Patients were grouped as no significant carotid artery stenosis (<50%), moderate stenosis (50%-70%) and severe stenosis (>70%). Sub group analysis of patients with severe carotid stenosis was performed. Sensitivity of risk factors thought to be associated with carotid disease was also assessed. RESULTS: Of the 4364 patients, 406 patients (9.3%) had moderate or severe carotid artery stenosis. 32 (7.88%) had bilateral disease. Age>65, hypertension, left main stem stenosis, peripheral vascular disease, and previous neurological injury were all associated with carotid artery disease (p<0. 01). Diabetes (p=0.06) and smoking (p=0.79) were not significant risk factors. In patients with moderate carotid artery stenosis there was no difference in the incidence of major 4 (0.98%) vs.18 (0.45%) p=0.14 or minor 8 (1.9%) vs. 56 (1.41%); p=0.38 neurological outcomes. However, severe carotid stenosis was associated with an increase in all-cause mortality but no increase in neurological events. CONCLUSIONS: In the presence of risk factors carotid screening identifies at risk population. Severe carotid stenosis was associated with increased all-cause mortality. However, moderate stenosis did not influence neurological outcomes or mortality in patients undergoing coronary artery bypass grafting.

Evaluation of synergistic effects of sulforaphene with photodynamic therapy in human cervical cancer cell line.

Sulforaphene from cruciferous vegetable has shown to modulate various signaling pathways of apoptosis. But it has not yet been studied extensively for the cervical cancer treatment. Previous studies show the promising role of photodynamic therapy for cervical cancer. Here, we confirm that sulforaphene can synergistically enhance the efficacy of photodynamic therapy. Human cervical cancer cells HeLa were treated with a very low dose of sulforaphene (2.0 µg/ml) and photodynamic therapy with radachlorin (0.5 µg/ml) at a fluence of 27 J/cm2 (30 milliwatts/cm2, λmax ∼ 670 ± 3 nm). The combination treatment showed a synergistic effect to induce apoptosis. The mitochondrial apoptotic pathway was activated via caspase 3 and caspase 9. On the other hand, caspase 12 and C/EBP homologous protein (CHOP) were expressed that indicated endoplasmic reticulum stress. This combination treatment also activated death receptor pathway via activation of caspase 8 and inhibited cell proliferation via down-regulation of EGFR. Thus, several apoptotic pathways were simultaneously activated in this combination treatment which results in a synergistic efficacy of sulforaphene with photodynamic therapy. Therefore, this study could be useful in the improvement of therapies for human cervical and other types of cancers.

Persistent Trophoblastic Disease at Cesarean Scar.

Pregnancy over the cesarean scar is the rarest cause of ectopic pregnancy and development of persistent trophoblastic disease at the scar site is extremely rare. A high index of suspicion is needed for early diagnosis and management of cesarean scar molar pregnancy. This condition is difficult to diagnose and must be considered in the patient with a history of cesarean section who has persistent vaginal bleeding or symptoms of pregnancy after suction evacuation. Diagnosis can be confirmedby measuring ß Human Chorionic Gonadotropin levels, transvaginal ultrasound with doppler flow evaluation. As this is an uncommon condition, this case report with conservative non surgical approach will add up to its clinical spectrum.

miR-16 rescues F508del-CFTR function in native cystic fibrosis epithelial cells.

Cystic fibrosis (CF) is due to mutations in the CFTR gene, which prevents correct folding, trafficking and function of the mutant cystic fibrosis transmembrane conductance regulator (CFTR) protein. The dysfunctional effect of CFTR mutations, principally the F508del-CFTR mutant, is further manifested by hypersecretion of the pro-inflammatory chemokine interleukin-8 into the airway lumen, which further contributes to morbidity and mortality. We have hypothesized that microRNA (miR)-based therapeutics could rescue the dysfunctional consequences of mutant CFTR. Here we report that a miR-16 mimic can effectively rescue F508del-CFTR protein function in airway cell lines and primary cultures, of differentiated human bronchial epithelia from F508del homozygotes, which express mutant CFTR endogenously. We also identify two other miRs, miR-1 and miR-302a, which are also active. Although miR-16 is expressed at basal comparable levels in CF and control cells, miR-1 and miR-302a are undetectable. When miR mimics are expressed in CF lung or pancreatic cells, the expression of the F508del-CFTR protein is significantly increased. Importantly, miR-16 promotes functional rescue of the cyclic AMP-activated apical F508del-CFTR chloride channel in primary lung epithelial cells from CF patients. We interpret these findings to suggest that these miRs may constitute novel targets for CF therapy.

Tuberculous dacryoadenitis in a child.

BACKGROUND: Orbital tuberculosis is rare even in endemic areas. The disease may involve soft tissue, lacrimal gland, or the periosteum or bones of the orbital wall. CASE: We present an Indian girl, who presented with a slowly growing left-sided superotemporal orbital mass, with no significant previous medical history. The swelling turned to an abscess and burst spontaneously giving rise to a discharging sinus. The discharge was negative for any organism on Gram and Giemsa staining. A tuberculin skin test was strongly positive. Incisional biopsy showed caseating granuloma and Langhan 's giant cells suggestive of tubercular aetiology. The patient responded well to tuberculous chemotherapy. CONCLUSION: Although tuberculous dacryoadenitis is a very rare manifestation of tuberculosis,still the possibility should be entertained in a slowly growing mass of the lacrimal gland, especially in developing countries where the prevalence of tuberculosis is high.

Tissue polypeptide specific antigen as a marker used to determine the liver diseases.

BACKGROUND: Tissue polypeptide specific antigen and its specific M3 epitope are increased in malignant as well as in some benign diseases. The level of tissue polypeptide specific antigen in serum is related mostly to proliferation capacity rather than tumor mass and cell necrosis. OBJECTIVE: The aim of this study was to evaluate the levels of tissue polypeptide specific antigen and other tumor markers in patients with liver cirrhosis, chronic active hepatitis and hepatoma to determine if tissue polypeptide specific antigen is important to other tumor markers in hepatoma patients. METHODS: Ninety-seven patients and 30 controls were included in the study. The patients were divided into three subgroups as cirrhosis, hepatoma and chronic active hepatitis. The levels of tissue polypeptide specific antigen, carcinoembryonic antigen, CA19.9, alpha-fetoprotein and transaminases were determined in all patients. RESULTS: Tissue polypeptide specific antigen levels were significantly higher in all patients than in the control group (p less than 0.005) According to Kruskal-Wallis test with regard to subgroups, the differences in mean values of tissue polypeptide specific antigen and alpha-fetoprotein were significant (p less than 0.0001 for both). There was a low correlation between tissue polypeptide specific antigen and alpha-fetoprotein in the cirrhotic and hepatoma groups, but these were significantly correlated in the chronic active hepatitis group. The correlation coefficient between tissue polypeptide specific antigen and transaminases in all patients was low. CONCLUSIONS: Tissue polypeptide specific antigen is efficient for determining primary hepatoma patients and also that this marker is specific for proliferation of cells.

Analysis of T-cell proliferation and cytokine secretion in the individuals exposed to arsenic.

Over six million people in nine districts of West Bengal, India are exposed to very high levels of arsenic primarily through their drinking water. More than 300,000 people showed arsenic-induced skin lesions in these districts. This is regarded as the greatest arsenic calamity in the world. Chronic arsenicosis causes varied dermatological signs ranging from pigmentation changes, hyperkeratosis to non-melanocytic cancer of skin, and also malignancies in different internal organs. Higher incidences of opportunistic infections are found in the arsenic-exposed individuals, indicating that their immune systems may be impaired somehow. We have thus investigated the effect of arsenic on T-cell proliferation and cytokine secretion in 20 individuals with arsenic-induced skin lesions and compared the results with 18 arsenic-unexposed individuals. A marked dose-dependent suppression of Concanavalin A (Con A) induced T-cell proliferation was observed in the arsenic-exposed individuals compared with the unexposed (P < 0.001) individuals. This correlated with a significant decrease in the levels of secreted cytokines by the T cells (TNF-alpha, IFN-gamma, IL2, IL10, IL5, and IL4) in the exposed individuals (P < 0.001). Thus it can be inferred that arsenic exposure can cause immunosuppression in humans.

Reproductive tract infection: an experience in rural West Bengal.

A community based cross-sectional study was conducted in the villages of Singur block, Hooghly district, West Bengal during September 2000 to February 2001. The objectives of the study were to find out the magnitude of Reproductive Tract Infections (RTI) among reproductive age group women, their knowledge about RTI and utilization of service available locally. Out of an estimated 896 women of reproductive age group in the study area, 186 women were selected by multistage random sampling technique. The study revealed that 66.1% respondents experienced one or more symptoms of RTI in four weeks recall period of this study. There was significant association (p < 0.01) between literacy status and their experiences of reproductive illness. 57% had knowledge about RTI. This increased gradually with increase of their ages (p < 0.01); literacy status (p < 0.01) and their socio-economic condition (p < 0.05). 27.6% of RTI patient did not receive any treatment, and majority of those received treatment (41.5%) sought advice from private practitioners.

Utilisation pattern of blood in a teaching hospital of Kolkata.

An annual utilisation of blood transfusion services at several depts. of R.G. Kar Medical College and Hospital, Kolkata were assessed among a sample of 3122 patients selected by Systematic Random Sampling Technique from the register made available in the blood bank there. Record analysis revealed that overall 79.4% of supplied blood units were actually transfused, wastage of 21.6%. Wastage was maximum in the Department of Gynae & Obstetrics (33.11%) and Surgery (32.87%). Only single unit of blood was requisitioned and transfused for 5.44% & 30.90% of the patients respectively. Most common indications of blood transfusion were for surgical cases (37.92%), followed by anaemia (34.80%) and haemorrhage (26.92%). The use of blood and blood products merit attention, appraisal and instructional guiding accordingly.

A study on arsenical dermatosis in rural community of West Bengal.

The spatial distribution of chronic arsenicosis due to consumption of arsenic contaminated tube well water in different districts of West Bengal was gradually unfolding since 1983. Arsenical dermatosis was found to be the commonest and earliest manifestation of chronic arsenic toxicity. This study was conduct in Baruipur block of South 24 Parganas district of West Bengal. Total 313 people selected from three randomly selected villages with reported arsenic contamination in tube well water and 342 people living three randomly selected villages without such evidence of contamination were examined as control population. 5.97% of exposed population and 2.05% of unexposed population showed melanosis (p < 0.01). Moreover, 5.11% of exposed population and 0.88% of unexposed population showed keratosis (p < 0.01). The prevalence of dermatosis among exposed population was also seen to have increased with increasing age, from 7.19% in 0-19 year age group to 37.50% in above 40 year group (p < 0.001). Prevalence was also found to be more with increase in level of contamination. The prevalence rate of dermatosis among unexposedgroup was 2.92%. But age adjusted prevalence rate among exposed group was 19.08% at arsenic contamination level of 0.487 ppm. Mean arsenic concentration in nail and hair samples of exposed group was also found higher than the prescribed limit.

Inhibition of drug-induced Fas ligand transcription and apoptosis by Bcl-XL.

Fas/Fas ligand system triggers apoptosis in many cell types. Bcl-XL overexpresion antagonizes Fas/Fas ligand-mediated cell death. The mechanism by which Bcl-XL influences Fas-mediated cell death is unclear. We have found that microtubule-damaging drugs (e.g. Paclitaxel) induce apoptosis in a Fas/FasL-dependent manner. Inhibition of Fas/FasL pathway by anti-FasL antibody, mutant Fas or a dominant negative FADD blocks paclitaxel-induced apoptosis. Paclitaxel induced apoptosis through activation of both caspase-8 and caspase-3. Overexpression of Bcl-XL leads to inhibition of paclitaxel-induced FasL expression and apoptosis. Bcl-XL prevents the nuclear translocation of NFAT (nuclear factor of activated T lymphocytes) by inhibiting the activation of calcineurin, a calcium-dependent phosphatase that must dephosphorylate NFAT for it to move to the nucleus. The loop domain in Bcl-XL can suppress the anti-apoptotic function of Bcl-XL and may be a target for regulatory post-translational modifications. Upon phosphorylation, Bcl-XL loses its ability to bind with calcineurin. Without NFAT nuclear translocation, the FasL gene is not transcribed. Thus, paclitaxel and other drugs that disturb microtubule function kill cells, at least in part, through the induction of FasL, and Bcl-XL-mediated resistance to these agents is related to failure to induce FasL expression.

Phosphatidylinositol 3,4,5-trisphosphate directs association of Src homology 2-containing signaling proteins with gelsolin.

Podosomes are adhesion structures in osteoclasts and are structurally related to focal adhesions mediating cell motility during bone resorption. Here we show that gelsolin coprecipitates some of the focal adhesion-associated proteins such as c-Src, phosphoinositide 3-kinase (PI3K), p130(Cas), focal adhesion kinase, integrin alpha(v)beta(3), vinculin, talin, and paxillin. These proteins were inducibly tyrosine-phosphorylated in response to integrin activation by osteopontin. Previous studies have defined unique biochemical properties of gelsolin related to phosphatidylinositol 3,4,5-trisphosphate in osteoclast podosomes, and here we demonstrate phosphatidylinositol 3,4,5-trisphosphate/gelsolin function in mediating organization of the podosome signaling complex. Overlay and GST pull-down assays demonstrated strong phosphatidylinositol 3,4,5-trisphosphate-PI3K interactions based on the Src homology 2 domains of PI3K. Furthermore, lipid extraction of lysates from activated osteoclasts eliminated interaction between gelsolin, c-Src, PI3K, and focal adhesion kinase despite equal amounts of gelsolin in both the lipid-extracted and unextracted experiment. The cytoplasmic protein tyrosine phosphatase (PTP)-proline-glutamic acid-serine-threonine amino acid sequences (PEST) was also found to be associated with gelsolin in osteoclast podosomes and with stimulation of alpha(v)beta(3)-regulated phosphorylation of PTP-PEST. We conclude that gelsolin plays a key role in recruitment of signaling proteins to the plasma membrane through phospholipid-protein interactions and by regulation of their phosphorylation status through its association with PTP-PEST. Because both gelsolin deficiency and PI3K inhibition impair bone resorption, we conclude that phosphatidylinositol 3,4,5-trisphosphate-based protein interactions are critical for osteoclast function.

Use of EPR spectroscopy to study macromolecular structure and function.

Electron paramagnetic resonance (EPR) spectroscopy is now part of the armory available to probe the structural aspects of proteins, nucleic acids and protein-nucleic acid complexes. Since the mobility of a spin label covalently attached to a macromolecule is influenced by its microenvironment, analysis of the EPR spectra of site-specifically incorporated spin labels (probes) provides a powerful tool for investigating structure-function correlates in biological macromolecules. This technique has become readily amenable to address various problems in biology in large measure due to the advent of techniques like site-directed mutagenesis, which enables site-specific substitution of cysteine residues in proteins, and the commercial availability of thiol-specific spin-labeling reagents (Figure 1). In addition to the underlying principle and the experimental strategy, several recent applications are discussed in this review.

An unusual paratyphoid fever.

Salmonella typhi is known to produce acalculous cholecystitis and related gall bladder perforation. Following is a documentation of a patient of sub-phrenic abscess and gall bladder perforation which was possibly a result of Salmonella paratyphi A.