Tracing geochemical sources and health risk assessment of uranium in groundwater of arid zone of India.

Water quality degradation and metal contamination in groundwater are serious concerns in an arid region with scanty water resources. This study aimed at evaluating the source of uranium (U) and potential health risk assessment in groundwater of the arid region of western Rajasthan and northern Gujarat. The probable source of vanadium (V) and fluorine (F) was also identified. U and trace metal concentration, along with physicochemical characteristics were determined for 265 groundwater samples collected from groundwater of duricrusts and palaeochannels of western Rajasthan and northern Gujarat. The U concentration ranged between 0.6 and 260 µg L-1 with a mean value of 24 µg L-1, and 30% of samples surpassed the World Health Organization's limit for U (30 µg L-1). Speciation results suggested that dissolution of primary U mineral, carnotite [K2(UO2)2(VO4)2·3H2O] governs the enrichment. Water-rock interaction and evaporation are found the major hydrogeochemical processes controlling U mineralization. Groundwater zones having high U concentrations are characterized by Na-Cl hydrogeochemical facies and high total dissolved solids. It is inferred from geochemical modelling and principal component analysis that silicate weathering, bicarbonate complexation, carnotite dissolution, and ion exchange are principal factors controlling major solute ion chemistry. The annual ingestion doses of U for all the age groups are found to be safe and below the permissible limit in all samples. The health risk assessment with trace elements manifested high carcinogenic risks for children.

Prevalence of Hepatitis B Virus Infection among Children with Liver Disease Admitted In Mymensingh Medical College Hospital.

Hepatitis B virus infection is an important cause of liver disease. Hepatitis B Virus may present with varying degree of severity. In older children, 5-10% cases leading to chronic liver disease, cirrhosis and hepatocellular carcinoma. This descriptive cross sectional study was done to assess the prevalence of Hepatitis B Virus infection among hospitalized children with liver disease in pediatric department of Mymensingh Medical College Hospital, Bangladesh from December 2015 to October 2016. All the children of both sexes having age between six months to twelve years admitted in the pediatric ward with acute or chronic liver disease were included in this study by purposive sampling. A written consent was obtained from legal guardian of children before inclusion. Ethical clearance was obtained from competent authority. A detailed history was taken from parents in each case according to pre-designed questionnaire about demography of the patients and the risk factors of the liver disease. A thorough clinical examination and available relevant investigations like serological testing for HBV infection was done in all patients. We had figure out the seropositivity of HBV among patients having liver disease by doing HBsAg and Anti-HBc IgM. Progress of the patient was monitored by daily clinical examinations and by investigating HBsAg and Anti-HBc IgM. Finally data analysis was done by SPSS version 21.0. Among total 100 patients most (44%) patients were in 7-10 years old and most (62%) of the participants were male. Acute liver disease was 58% cases and chronic liver disease was 42% cases. HBsAg was positive in 1 case among acute liver disease and 5 cases among chronic cases. Total 6 (six) patients were found positive for HBsAg. Anti HBc IgM was positive in 4 patients among acute liver disease. Among these Anti HBc IgM positive (4) patients only one had both HBsAg and Anti HBc IgM positive. So, four patients were confirming suffered from acute viral hepatitis because they had anti HBc IgM positive. On the contrary 5 patients suffered from chronic hepatitis by hepatitis B because they were only HBsAg positive. So, in this study 9 patients (9%) were confirming suffered from HBV infection. Possible transmission factors of hepatitis B were history of (H/O) blood transfusion/trauma/parenteral injection, H/O umbilical sepsis, H/O maternal illness/infection during pregnancy. HBV still is a major cause of morbidity. All the children with liver disease should be routinely tested for HBV.

Stress Hyperglycemia and Stroke Outcome in Patients with Acute Stroke.

Stroke is leading cause of death world wide, after coronary artery disease and cancer. A high proportion of patients suffering from an acute stress such as stroke or myocardial infarction may develop hyperglycemia, even in the absence of a preexisting diagnosis of diabetes. An observational comparative study was carried out at the Department of Neurology and Medicine, Mymensingh Medical College, Mymensingh, Bangladesh from July 2011 to June 2013 among purposively selected ninety-three patients with a view to assess the outcome of stress hyperglycemia on acute stroke. Data were collected through interview, physical examinations & laboratory investigations by using case record form. Statistical analysis was performed using SPSS (Statistical package for social science) version 17. The mean age of this study was 59.04±15.01 years in the hyperglycemic group and 62.06±13.81 years in the normoglycemic group. The male female ratio in the Hyperglycemic and normoglycemic group was 2.12:1 and 2.44:1 respectively. Smoker was 48.8% in the hyperglycemic group and 52% in the normoglycemic group. 70% of the Hyperglycemic group and 66% of the normoglycemic were found hypertensive. Mean±SD blood glucose level was found 11.86±0.58mmol/L in the Hyperglycemic group and 6.50±1.55mmol/L in the normoglycemic group. Mean HbAlc were 6.14±0.56 in hyperglycemic group and 5.29±0.54 in normoglycemic group. Stroke severity score were 21.79±11.85 in Hyperglycemic and 28.64±9.53 in normoglycemic group on admission. Functional outcome was measured on discharge & at the end of 4th weeks of every patient by Glasgo Outcome Scale (GOS). The study also suggests that stress hyperglycemia is an important risk factor of poor stroke outcome.

High Wall Motion Score Index after Acute Myocardial Infarction is Associated with Worse In-Hospital Outcome.

Myocardial Infarction is a major cause of death and disability worldwide. The incidence of coronary heart disease is high and second most cause of death after cancer. This prospective study conducted on 100 patients admitted with first attack of acute myocardial infarction in the department of Cardiology in Mymensingh Medical College Hospital, Mymensingh, Bangladesh from July 2012 to June 2013 who were observed 3 to 8 days of hospital stay without doing further echocardiography and evaluated the relationship between echocardiographic wall motion score index (WMSI) assessed within 24 hours of admission and in-hospital outcomes. Mean age was 53.24±10.17 years in WMSI <2 and 55.58±12.68 years in WMSI ≥2 groups; difference was statistically non-significant (p>0.05). In both groups, males were predominant sufferer. Male-female ratio was 3.55:1 and the difference was statistically non-significant (p>0.05). As a risk factor, smoking was significantly higher in both groups but the difference was not statistically significant (p>0.05) between groups. Hypertension was 34(49.28%) cases in WMSI <2 and 13(41.93%) cases in WMSI ≥2 group; difference was not statistically significant (p>0.05). Diabetes mellitus was 13(18.84%) cases in WMSI <2 and 16(51.61%) cases in WMSI ≥2 group that was statistically significant (p<0.05). Dyslipidemia was 28(40.58%) cases in WMSI <2 group and 23(74.19%) cases in WMSI ≥2 group that was statistically significant (p<0.05). Site of involvement of MI in WMSI <2 group were 39(56.52%) cases AMI (Anterior) and 30(43.48%) cases AMI (Inferior). In WMSI ≥2 group, AMI (Anterior) were 29(93.55%) and AMI (Inferior) were 02(6.45%). It revealed that AMI (anterior) was significantly higher in WMSI ≥2 group and AMI (Inferior) was significantly higher in WMSI <2 group. Heart failure class (Killip class) increases with the increasing of WMSI. In Killip class-I, 4(5.80%) were WMSI <2 and 01(3.23%) was WMSI ≥2 (p>0.05). In Killip class-II, 8(11.59%) were WMSI <2 and 02(6.45%) were WMSI ≥2 (p>0.05). In Killip class-III, 4(5.80%) were WMSI <2 and 13(41.94%) were WMSI ≥2 (p<0.05). In Killip class-IV, 2(2.89%) were WMSI <2 and 05(16.13%) were WMSI ≥2 (p<0.05) that was statistically significant. Arrhythmia was 14(20.29%) cases in WMSI <2 group and 13(41.94%) cases in WMSI ≥2 group that was statistically significant (p<0.05). Death was 2(2.90%) cases in WMSI <2 and 07(22.58%) cases in WMSI ≥2 group that was statistically significant (p<0.05). Early mortality rate was greater in patients with both WMSI ≥2 and a higher Killip's class. The higher the WMSI determined within 24 hours of admission, the worse the in-hospital outcome. Echocardiography is an affordable and readily available technique, which may be used to identify and stratify the risk following acute MI.

A Retrospective Comparative Study of Concomitant Chemoradiotherapy followed by Adjuvant Temozolomide Versus Radiotherapy Alone In Newly Diagnosed Glioblastoma Multiforme - An Experience at Radium Institute, Patna Medical College and Hospital, India.

INTRODUCTION: Glioblastoma Multiforme (WHO grade IV glioma) still remains a dreadful diagnosis in oncology with the median survival ranging between 12 to 17 months, despite the recent advances in its management. It is the most common malignant primary tumour in adults(13). The standard of care is Maximal Safe Resection followed by Concomitant ChemoRadiotherapy. METHODS: During the period 2006 to 2010 at Radium Institute, Patna Medical College and Hospital (PMCH) in India, a study was conducted on 37 newly diagnosed GBM cases in which the control-arm (c-arm) received Conventional Radiotherapy (60Gy/30#) only whereas the study arm (s-arm) received Concomitant Chemoradiotherapy followed by Adjuvant Temozolomide. RESULTS: The median survival was 15.4 months in the s-arm as compared to 12.4 months in the c-arm. The OS showed a significant improvement with p-value of 0.05 and PFS also showed a benefit with a p-value of 0.005. CONCLUSION: The results were encouraging with improvement in OS as well as PFS in the s-arm and were at par with the other similar studies conducted in different parts of the world.

Role of taxanes in the treatment of advanced NHL patients: A randomized study of 87 cases.

UNLABELLED: NHL is a highly chemo-sensitive as well as radiosensitive disease. From May 2005 to June 2010, 87 patients were randomised into 2 arms. The control arm received the standard CHOP regimen + IFRT, whereas the study arm received Paclitaxel, 135/m2 additionally. The results showed a better Overall Response (87% vs 78%) in the study arm. The 3yr and 5yr overall survival were significantly better in the study arm (89% vs 77%, p- value <0.05; 83% vs 67%, p-value <0.05). However, the incidence and severity of the side effects, haematological and non- haematological were enhanced but manageable in the study arm. KEYWORDS: Taxanes, Paclitaxel, Non Hodgkin's Lymphoma.

Identification of candidate sialome components expressed in ixodid tick salivary glands using secretion signal complementation in mammalian cells.

Ixodid ticks manipulate mammalian host pathways by secreting molecules from salivary glands. Novel cDNAs containing functional secretion signals were isolated from ixodid tick salivary glands using a signal sequence trap. Only 15/61 Rhipicephalus appendiculatus and 1/7 Amblyomma variegatum cDNAs had significant identity (< 1e-15) to previously identified sequences. Polypeptides that may interact with host pathways included a kinase inhibitor. Two proteins encoded homologues of the yolk protein vitellogenin and seventeen contained glycine-rich motifs. Four proteins without sequence matches had conserved structural folds, identified using a Threading algorithm. Predicted secretion signals were between fifteen and fifty-seven amino acids long. Four homologous polymorphic proteins contained conserved (26/27 residues) signal peptides. Ten functional tick secretion signals could not be unambiguously identified using predictive algorithms.

Penoscrotal transposition: a case report and review.

We report on a boy born with complete penoscrotal transposition, normal scrotum, twisted penile shaft with hypoplastic penile urethra, meatal stenosis, normal bladder, and bilateral cystic dysplastic kidneys. The patient died of renal failure at 2.5 months. This is the 13th reported case of complete penoscrotal transposition with normal scrotum. The possible pathogenesis is discussed and the literature is reviewed.

Evaluation of an enzyme-linked immunoassay and confirmatory test for the detection of Chlamydia trachomatis in male urine samples.

First pass urine (FPU) samples were compared with urethral swab culture from 304 males attending a genitourinary medicine clinic using an enzyme immuno assay (EIA). All of the EIA positive samples were retested by incorporating a novel blocking reagent into the EIA protocol; 101 were positive by culture of which 83 were also positive by FPU EIA, an additional four were detected in FPU only and not by culture; 86 of these 87 were also confirmed positive by the blocking reagent. Discrepant results were evaluated by Syva MicroTrak. The sensitivity and specificity of FPU EIA as compared with urethral swab culture was 82.2% (83/101) and 98% (199/203) respectively with positive and negative predictive values of 95.4% (83/87) and 91.7% (199/217). Male urethral swab culture is more sensitive than FPU EIA; however, when culture is not available then FPU offers a reliable non-invasive alternative to swab EIA which may be of enormous benefit in community screening of asymptomatic as well as symptomatic patients.

Carcinoma of the stomach.

Seventy-five cases of stomach carcinoma were analyzed. The incidence was highest between 41 and 50 years of age. Male to female ratio was 4:1. The average duration of symptoms was one year. There was no correlation between incidence and the dietary and smoking habits of the patients. Epigastric pain was the commonest complaint followed byanorexis, vomiting and loss of weight. Anemia was the commonest finding. Epigastric mass was present in nearly 50% of cases. Pyloric obstruction was common. Upper gastrointestinal x-ray studies were rewarding. Occult blood was often found in the stools. The majority of patients were about equally distributed between blood groups A and O. Many patients had no or low acid levels but 7.5% had normal or high acid levels. At operation, the growth was commonly found near the pylorus. Diffuse involvement was infrequent. Curative surgery could be done in only 20% of cases. One-third of the patients had palliative gastrojejunostomy. The operative mortality and morbidity were high. The overall five-year survival was only 5%.

Primary carcinoma of the gallbladder.

The clinical and pathological features of 100 consecutive cases of primary carcinoma of the gallbladder, treated by a single surgical unit, are described. Females out numbered males by 2 to 1. The maximum incidence was seen in the fifth decade. Pain and the presence of a mass were the two most common clinical features. Gallstones coexisted in 45 per cent of cases. Ancillary investigations were of little value in preoperative diagnosis. At laparotomy biopsy alone was possible in a large number of cases owing to the advanced disease process. Two patients were alive 5 years after surgery. Prophylactic cholecystectomy for all diseased gallbladders, whether symptomatic or not, is advocated.