Impact of postsurgical rehabilitation on outcomes for degenerative cervical myelopathy.

OBJECTIVE: Despite widespread use, there is limited evidence to support postsurgical rehabilitation to enhance neurological recovery after surgery for degenerative cervical myelopathy (DCM). Outcomes research for DCM seldom accounts for the effect of postsurgical rehabilitation. The aim of this study was to quantify the impact of postsurgical rehabilitation on outcomes after surgery for DCM. METHODS: This was a retrospective analysis of prospectively collected data from a single center. The study enrolled 66 patients who underwent spinal surgery for DCM. In addition to patient demographic, imaging, and surgical data, chart review was performed to document the timing, type, duration, and outcomes of postsurgical rehabilitation therapy. Outcomes were collected prospectively, including the modified Japanese Orthopaedic Association (mJOA) score, Neck Disability Index (NDI) score, and SF-36 physical component summary (PCS) score. Linear regression models were created to determine the independent effects of type and timing of postsurgical occupational therapy (OT) and physical therapy (PT) on outcomes. RESULTS: A total of 66 patients were included in the analysis. Multivariate regression analysis showed that postsurgical OT was associated with significantly greater improvement in 12-month SF-36 PCS scores (p = 0.009) and mJOA scores (p = 0.019). In the subset of patients who received therapy, delayed therapy (> 42 days after surgery) compared to early therapy (< 42 days after surgery) was associated with less improvement in SF-36 PCS scores (p = 0.03). CONCLUSIONS: Postsurgical outpatient rehabilitation was independently associated with improved postsurgical outcomes within the 1st year after surgery for DCM, and early therapy (< 42 days) was associated with superior outcomes compared to delayed therapy. This is one of the first studies to use a prospective database to demonstrate an independent effect for postsurgical rehabilitation on outcomes after surgery for DCM.

Tobacco smoking clusters in households affected by tuberculosis in an individual participant data meta-analysis of national tuberculosis prevalence surveys: Time for household-wide interventions?

Tuberculosis (TB) and non-communicable diseases (NCD) share predisposing risk factors. TB-associated NCD might cluster within households affected with TB requiring shared prevention and care strategies. We conducted an individual participant data meta-analysis of national TB prevalence surveys to determine whether NCD cluster in members of households with TB. We identified eligible surveys that reported at least one NCD or NCD risk factor through the archive maintained by the World Health Organization and searching in Medline and Embase from 1 January 2000 to 10 August 2021, which was updated on 23 March 2023. We compared the prevalence of NCD and their risk factors between people who do not have TB living in households with at least one person with TB (members of households with TB), and members of households without TB. We included 16 surveys (n = 740,815) from Asia and Africa. In a multivariable model adjusted for age and gender, the odds of smoking was higher among members of households with TB (adjusted odds ratio (aOR) 1.23; 95% CI: 1.11-1.38), compared with members of households without TB. The analysis did not find a significant difference in the prevalence of alcohol drinking, diabetes, hypertension, or BMI between members of households with and without TB. Studies evaluating household-wide interventions for smoking to reduce its dual impact on TB and NCD may be warranted. Systematically screening for NCD using objective diagnostic methods is needed to understand the actual burden of NCD and inform comprehensive interventions.

Subclinical respiratory dysfunction and impaired ventilatory adaptation in degenerative cervical myelopathy.

Degenerative cervical myelopathy (DCM) is a debilitating neurological condition characterized by chronic compression of the cervical spinal cord leading to impaired upper and lower limb function. Despite damage to areas of the cervical spinal cord that house the respiratory network, respiratory dysfunction is not a common symptom of DCM. However, DCM may be associated with respiratory dysfunction, and this can affect the ventilatory response to respiratory challenges during emergence from anesthesia, exercise, or pulmonary disease. Surgical spinal cord decompression, which is the primary treatment for DCM, leads to improved sensorimotor function in DCM; yet its impact on respiratory function is unknown. Here, using a clinically relevant model of DCM, we evaluate respiratory function during disease progression and assess adaptive ventilation to hypercapnic challenge before and after surgical intervention. We show that despite significant and progressive forelimb and locomotor deficits, there was no significant decline in eupneic ventilation from the early to late phases of spinal cord compression. Additionally, for the first time, we demonstrate that despite normal ventilation under resting conditions, DCM impairs acute adaptive ventilatory ability in response to hypercapnia. Remarkably, akin to DCM patients, surgical decompression treatment improved sensorimotor function in a subset of mice. In contrast, none of the mice that underwent surgical decompression recovered their ability to respond to hypercapnic ventilatory challenge. These findings underscore the impact of chronic spinal cord compression on respiratory function, highlighting the challenges associated with ventilatory response to respiratory challenges in individuals with DCM. This research highlights the impact of cervical spinal cord compression on respiratory dysfunction in DCM, as well as the persistence of adaptive ventilatory dysfunction after surgical spinal cord decompression. These results indicate the need for additional interventions to enhance recovery of respiratory function after surgery for DCM.

Robot-assisted T12 pediculectomy and resection of a ventral thoracic meningioma.

Spinal meningiomas represent 25%-45% of intradural spinal tumors and are commonly seen in the thoracic spine. Ventral midline spinal meningiomas in the thoracic spine are challenging lesions to resect given their location in relation to the spinal cord. Resection for symptomatic or growing lesions requires adequate bone removal to limit retraction of the spinal cord. Surgical adjuncts such as intraoperative navigation, robotics, and ultrasound can improve the efficiency of and safety for resection of these lesions. The authors present a case of a complete resection of a ventral thoracic meningioma using a T12 transpedicular approach with robot-assisted navigated pediculectomy and intraoperative ultrasonography.

Lessons learned from identifying clusters of severe acute respiratory infections with influenza sentinel surveillance, Bangladesh, 2009-2020.

Background: We explored whether hospital-based surveillance is useful in detecting severe acute respiratory infection (SARI) clusters and how often these events result in outbreak investigation and community mitigation. Methods: During May 2009-December 2020, physicians at 14 sentinel hospitals prospectively identified SARI clusters (i.e., ≥2 SARI cases who developed symptoms ≤10 days of each other and lived <30 min walk or <3 km from each other). Oropharyngeal and nasopharyngeal swabs were tested for influenza and other respiratory viruses by real-time reverse transcriptase-polymerase chain reaction (rRT-PCR). We describe the demographic of persons within clusters, laboratory results, and outbreak investigations. Results: Field staff identified 464 clusters comprising 1427 SARI cases (range 0-13 clusters per month). Sixty percent of clusters had three, 23% had two, and 17% had ≥4 cases. Their median age was 2 years (inter-quartile range [IQR] 0.4-25) and 63% were male. Laboratory results were available for the 464 clusters with a median of 9 days (IQR = 6-13 days) after cluster identification. Less than one in five clusters had cases that tested positive for the same virus: respiratory syncytial virus (RSV) in 58 (13%), influenza viruses in 24 (5%), human metapneumovirus (HMPV) in five (1%), human parainfluenza virus (HPIV) in three (0.6%), adenovirus in two (0.4%). While 102/464 (22%) had poultry exposure, none tested positive for influenza A (H5N1) or A (H7N9). None of the 464 clusters led to field deployments for outbreak response. Conclusions: For 11 years, none of the hundreds of identified clusters led to an emergency response. The value of this event-based surveillance might be improved by seeking larger clusters, with stronger epidemiologic ties or decedents.

Association of diabetes, smoking, and alcohol use with subclinical-to-symptomatic spectrum of tuberculosis in 16 countries: an individual participant data meta-analysis of national tuberculosis prevalence surveys.

Background: Non-communicable diseases (NCDs) and NCD risk factors, such as smoking, increase the risk for tuberculosis (TB). Data are scarce on the risk of prevalent TB associated with these factors in the context of population-wide systematic screening and on the association between NCDs and NCD risk factors with different manifestations of TB, where ∼50% being asymptomatic but bacteriologically positive (subclinical). We did an individual participant data (IPD) meta-analysis of national and sub-national TB prevalence surveys to synthesise the evidence on the risk of symptomatic and subclinical TB in people with NCDs or risk factors, which could help countries to plan screening activities. Methods: In this systematic review and IPD meta-analysis, we identified eligible prevalence surveys in low-income and middle-income countries that reported at least one NCD (e.g., diabetes) or NCD risk factor (e.g., smoking, alcohol use) through the archive maintained by the World Health Organization and by searching in Medline and Embase from January 1, 2000 to August 10, 2021. The search was updated on March 23, 2023. We performed a one-stage meta-analysis using multivariable multinomial models. We estimated the proportion of and the odds ratio for subclinical and symptomatic TB compared to people without TB for current smoking, alcohol use, and self-reported diabetes, adjusted for age and gender. Subclinical TB was defined as microbiologically confirmed TB without symptoms of current cough, fever, night sweats, or weight loss and symptomatic TB with at least one of these symptoms. We assessed heterogeneity using forest plots and I2 statistic. Missing variables were imputed through multi-level multiple imputation. This study is registered with PROSPERO (CRD42021272679). Findings: We obtained IPD from 16 national surveys out of 21 national and five sub-national surveys identified (five in Asia and 11 in Africa, N = 740,815). Across surveys, 15.1%-56.7% of TB were subclinical (median: 38.1%). In the multivariable model, current smoking was associated with both subclinical (OR 1.67, 95% CI 1.27-2.40) and symptomatic TB (OR 1.49, 95% CI 1.34-1.66). Self-reported diabetes was associated with symptomatic TB (OR 1.67, 95% CI 1.17-2.40) but not with subclinical TB (OR 0.92, 95% CI 0.55-1.55). For alcohol drinking ≥ twice per week vs no alcohol drinking, the estimates were imprecise (OR 1.59, 95% CI 0.70-3.62) for subclinical TB and OR 1.43, 95% CI 0.59-3.46 for symptomatic TB). For the association between current smoking and symptomatic TB, I2 was high (76.5% (95% CI 62.0-85.4), while the direction of the point estimates was consistent except for three surveys with wide CIs. Interpretation: Our findings suggest that current smokers are more likely to have both symptomatic and subclinical TB. These individuals can, therefore, be prioritised for intensified screening, such as the use of chest X-ray in the context of community-based screening. People with self-reported diabetes are also more likely to have symptomatic TB, but the association is unclear for subclinical TB. Funding: None.

Knowledge of breast cancer and breast self-examination practices and its barriers among university female students in Bangladesh: Findings from a cross-sectional study.

Early diagnosis of breast cancer is the best approach towards its control that may result in alleviating related mortality and morbidity. This study aimed to evaluate knowledge about breast cancer and both practices and perceived barriers to breast self-examination among female university students in Bangladesh. A cross-sectional study was carried out with 400 female students of Jahangirnagar University, Bangladesh. Participants were sampled from female dormitories at the university from January to April 2020. Proportionate stratified random sampling was conducted to calculate the study sample from each dormitory. A validated semi-structured self-reported questionnaire was employed to collect data from participants during the survey periods. The questionnaire consisted of demographic variables, items about knowledge about breast cancer, breast self-examination practices and its barriers. We applied descriptive and inferential statistics and data were analyzed using the Statistical Package for the Social Sciences (SPSS). Participants were aged between 18-26 years and comprised university students of first year (20%), second year (24%), third year (22%), fourth year (21%) and Master's (14%). 18% of them reported positive family history (mother, aunt, sister/cousin, grandmother) of breast cancer. The overall mean score of total knowledge items was 15 (SD = 3) out of 43, with an overall correct rate of 34%. The mean score of total knowledge items was significantly higher (p<0.001) among Master's students and students with family members who have had breast cancer. Only one in five students (21%) ever practiced breast self-examination. The mean score of practice of breast self-examination was significantly higher (p<0.001) among participants who reported having family member of breast cancer. Total knowledge score about breast cancer and practice of breast self-examination were significantly correlated with each other (r = 0.54; p<0.001). About 33% participants reported 'lack of knowledge' as the main barrier to practicing breast self-examination followed by 'I do not have the symptoms' (22%), and 'shyness/ uncomfortable feelings' (17%). The study revealed low levels of knowledge about breast cancer and low breast self-examination practices. Our findings highlight the need to develop, implement and promote socially, culturally and demographically appropriate educational interventions programs aimed at breast cancer and breast self-examination awareness and practice in Bangladesh.

Effectiveness of educational intervention on breast cancer knowledge and breast self-examination among female university students in Bangladesh: a pre-post quasi-experimental study.

BACKGROUND: Breast cancer is a global health issue and a leading cause of death among women. Early detection through increased awareness and knowledge on breast cancer and breast cancer screening is thus crucial. The aim of the present study was to assess the effect of an educational intervention program on breast cancer knowledge and the practice of breast self-examination among young female students of a university in Bangladesh. METHODS: A quasi-experimental (pre-post) study design was conducted at Jahangirnagar University in Bangladesh. Educational information on breast cancer and breast self-examination (BSE), demonstration of BSE procedure and leaflets were distributed among 400 female students after obtaining written informed consent. The stepwise procedures of BSE performance were demonstrated with images. Pre-intervention and 15 days post-intervention assessments were conducted to assess the changes in knowledge on breast cancer and practices of BSE. Mc-Nemar's tests and paired sampled t-tests were performed to investigate the differences between pre- and post-test stages. RESULTS: A total of 400 female university students aged 18-26 years were included in the sample. Significant changes were found in knowledge and awareness about breast cancer and BSE practices after the educational intervention. The significant differences were measured in the mean scores of pre-test vs. post-test: breast cancer symptoms (2.99 ± 1.05 vs. 6.35 ± 1.15; p < 0.001), risk factors (3.35 ± 1.19 vs. 7.56 ± 1.04; p < 0.001), treatment (1.79 ± 0.90 vs. 4.63 ± 0.84; p < 0.001), prevention (3.82 ± 1.32 vs. 7.14 ± 1.03; p < 0.001), screening of breast cancer (1.82 ± 0.55 vs. 3.98 ± 0.71; p < 0.001) and process of BSE (1.57 ± 1.86 vs. 3.94 ± 0.93; p < 0.001). Likewise, a significant percentage of change in BSE practices was obtained between pre-test and post-test (21.3% vs. 33.8%; p < 0.001). CONCLUSIONS: Study findings confirm that the study population had inadequate awareness and knowledge at baseline which was improved significantly after educational intervention. A nationwide roll-out with community-based interventions is recommended for the female population in both rural and urban areas.

Investigating Bangladeshi Rural Women's Awareness and Knowledge of Cervical Cancer and Attitude Towards HPV Vaccination: a Community-Based Cross-Sectional Analysis.

Cervical cancer remains a significant disease burden and contributes to prominent cancer-related mortality among women. This study aimed to assess awareness and knowledge of cervical cancer and attitude towards HPV vaccination among rural women in Bangladesh. A cross-sectional study was carried out from September 2019 to January 2020 involving 600 women selected using multi-stage sampling from six rural areas of Bangladesh. Face-to-face interviews were conducted using a semi-structured questionnaire consisting of socio-demographic information, knowledge (20-items) and, attitudes (5-items). Most of the participants (71.8%) were aware of cervical cancer. Women's awareness was significantly associated with marital status, education level, employment status, and internet/social media use (p < 0.05). Mass media was the main source of information and 2.3% of the women had previously undergone cervical cancer screening. Knowledge regarding symptoms, risk factors, and preventive measures was limited with a mean knowledge score of 8.73 (SD: 2.68). Only 5.3% of women had vaccinated against HPV, but the willingness to receive the HPV vaccine was high (76.6%) among those who were not vaccinated. The cost of the HPV vaccine (40.1%) and lack of adequate knowledge (34.3%) were the main reasons behind women's unwillingness to receive the vaccine. Higher odds of willingness to receive the HPV vaccine were found among women aged 15-29 years (aOR: 1.92, CI = 1.21-3.04, p = 0.006), had high education (aOR: 1.93, CI = 1.25-4.42, p = 0.005), and internet/social media users (aOR: 2.32, CI: 1.51-3.56, p < 0.001). These results highlight the urgent need for educational intervention on cervical cancer and the institution of national policies providing HPV vaccination coverage.

Establishing a sentinel surveillance system for the novel COVID-19 in a resource-limited country: methods, system attributes and early findings.

OBJECTIVES: To establish a hospital-based platform to explore the epidemiological and clinical characteristics of patients screened for COVID-19. DESIGN: Hospital-based surveillance. SETTING: This study was conducted in four selected hospitals in Bangladesh during 10 June-31 August 2020. PARTICIPANTS: In total, 2345 patients of all age (68% male) attending the outpatient and inpatient departments of surveillance hospitals with any one or more of the following symptoms within last 7 days: fever, cough, sore throat and respiratory distress. OUTCOME MEASURES: The outcome measures were COVID-19 positivity and mortality rate among enrolled patients. Pearson's χ2 test was used to compare the categorical variables (sign/symptoms, comorbidities, admission status and COVID-19 test results). Regression analysis was performed to determine the association between potential risk factors and death. RESULTS: COVID-19 was detected among 922 (39%) enrolled patients. It was more common in outpatients with a peak positivity in second week of July (112, 54%). The median age of the confirmed COVID-19 cases was 38 years (IQR: 30-50), 654 (71%) were male and 83 (9%) were healthcare workers. Cough (615, 67%) was the most common symptom, followed by fever (493, 53%). Patients with diabetes were more likely to get COVID-19 than patients without diabetes (48% vs 38%; OR: 1.5; 95% CI: 1.2 to 1.9). The death rate among COVID-19 positive was 2.3%, n=21. Death was associated with age ≥60 years (adjusted OR (AOR): 13.9; 95% CI: 5.5 to 34), shortness of breath (AOR: 9.7; 95% CI: 3.0 to 30), comorbidity (AOR: 4.8; 95% CI: 1.1 to 21.7), smoking history (AOR: 2.2, 95% CI: 0.7 to 7.1), attending the hospital in <2 days of symptom onset due to critical illness (AOR: 4.7; 95% CI: 1.2 to 17.8) and hospital admission (AOR: 3.4; 95% CI: 1.2 to 9.8). CONCLUSIONS: COVID-19 positivity was observed in more than one-third of patients with suspected COVID-19 attending selected hospitals. While managing such patients, the risk factors identified for higher death rates should be considered.

Shotgun proteomics of Brassica rapa seed proteins identifies vicilin as a major seed storage protein in the mature seed.

Proteins make up a large percentage of the Brassica seed and are second only to the oil in economic importance with uses for both animal and human nutrition. The most abundant proteins reported in the seeds of Brassica are the seed storage proteins cruciferin and napin, belonging to the 12S globulin and 2S albumin families of proteins, respectively. To gain insight into the Brassica rapa seed proteome and to confirm the presence and relative quantity of proteins encoded by candidate seed storage genes in the mature seed, shotgun proteomics was carried out on protein extracts from seeds of B. rapa inbred line R-o-18. Following liquid chromatography tandem mass spectrometry, a total of 34016 spectra were mapped to 323 proteins, where 233 proteins were identified in 3 out of 4 biological replicates by at least 2 unique peptides. 2S albumin like napin seed storage proteins (SSPs), 11/12S globulin like cruciferin SSPs and 7S globulin like vicilin SSPs were identified in the samples, along with other notable proteins including oil body proteins, namely ten oleosins and two oil body-associated proteins. The identification of vicilin like proteins in the mature B. rapa seed represents the first account of these proteins in the Brassicaceae and analysis indicates high conservation of sequence motifs to other 7S vicilin-like allergenic proteins as well as conservation of major allergenic epitopes in the proteins. This study enriches our existing knowledge on rapeseed seed proteins and provides a robust foundation and rational basis for plant bioengineering of seed storage proteins.

Murine bone marrow mesenchymal stromal cells have reduced hematopoietic maintenance ability in sickle cell disease.

Sickle cell disease (SCD) is characterized by hemolytic anemia, which can trigger oxidative stress, inflammation, and tissue injury that contribute to disease complications. Bone marrow mesenchymal stromal cells (MSCs) tightly regulate hematopoietic stem cell (HSC) homeostasis in health and disease, but their functionality in SCD remains unclear. We identified for the first time that murine SCD MSCs have altered gene signatures, reduced stem cell properties, and increased oxidative stress, due in part to hemolysis. Murine SCD MSCs had lower HSC maintenance ability in vitro and in vivo, as manifested by increased HSC mobilization and decreased HSC engraftment after transplant. Activation of Toll-like receptor-4 through p65 in MSCs further contributed to MSC dysfunction. Transfusions led to an improved MSC and HSC oxidative state in SCD mice. Improving the regulation between MSCs and HSCs has vital implications for enhancing clinical HSC transplantation and gene therapy outcomes and for identification of new molecular targets for alleviating SCD complications.

Trace Metals in Vegetables and Associated Health Risks in Industrial Areas of Savar, Bangladesh.

BACKGROUND: The occurrence of high levels of trace metals in foodstuffs represents a significant threat to human health. Vegetables grown in metal-contaminated soil or irrigated with wastewater can accumulate metals and bioaccumulate in the food chain affecting animals and humans. OBJECTIVES: The present study aimed to measure the levels of lead (Pb), cadmium (Cd), chromium (Cr) and cobalt (Co) in common vegetables grown in the industrial areas of Savar, Bangladesh, and to determine their potential health risks. METHODS: Five vegetables species: jute (Corchorus capsularis), red amaranth (Amaranthus gangeticus), okra (Abelmoschus esculentus), zucchini (Luffa aegyptiaca) and stem amaranth (Amaranthus viridis) were sampled randomly from agricultural fields across each study site. Vegetable samples were digested in a microwave digestion system (Berghof Microwave MWS-2, Germany). Metal concentrations were determined using an atomic absorption spectrophotometer (AA-7000, Shimadzu Corporation, Japan). RESULTS: The range of Pb, Cd, Cr and Co in analyzed vegetables was 0.643-3.362, 0.041-0.049, 1.681-2.431 and 1.612-2.492 mg/kg, respectively. The target hazard quotient (THQ) of Pb in zucchini and stem amaranth and the THQs of Cr in all analyzed vegetables was greater than one. The target carcinogenic risk (TCR) of Pb and Cd for all analyzed vegetables was in the unacceptable range. In all vegetable samples, lead content was detected to be higher than the maximum permissible limits. The THQ values indicate the possibility of non-carcinogenic health risk through consumption of these vegetables. In addition, the TCR values of Pb and Cd indicate a lifetime carcinogenic health risks to consumers. CONCLUSIONS: Consumption of vegetables grown in this area may pose long-term health risks. COMPETING INTERESTS: The authors declare no competing financial interests.

Integrated [18F]FDG PET/MRI demonstrates the iron-related bone-marrow physiology.

We identified predictors for bone-marrow [18F]FDG uptake and MR signals among complete blood count, C-reactive protein (CRP), and anthropometric factors, and demonstrated the bone-marrow physiology using integrated [18F]FDG-PET/MRI. 174 oncology patients without bone-marrow lesions underwent whole-body [18F]FDG-PET/MRI. The standardized uptake value (SUV), apparent diffusion coefficient (ADC), proton density fat-fraction (PDFF), and a reciprocal of T2* relaxation time (R2*) were measured in lumbar vertebrae (L3-5) and bilateral ilia. Vertebrae, pelvis, and ribs were evaluated by 3-point visual scoring on DWI. The association of the PET/MR features with the predictors was examined. Multi-regression analyses identified CRP as the strongest predictor for lumbar and iliac SUVs (standardized coefficient: ß = 0.31 and ß = 0.38, respectively), and for lumbar and iliac R2* (ß = 0.31 and ß = 0.46, respectively). In contrast, age was the strongest factor influencing lumbar and iliac ADCs (ß = 0.23 and ß = 0.21, respectively), and lumbar and iliac PDFFs (ß = 0.53 and ß = 0.54, respectively). Regarding DWI-visual scores, age was the strongest predictor for vertebrae (ß = - 0.47), and the red cell distribution width (RDW) was the strongest predictor for pelvis and ribs (ß = 0.33 and ß = 0.47, respectively). The bone-marrow [18F]FDG uptake and R2* reflect anemia of inflammation (increased granulopoiesis and reduced iron metabolism), whereas bone-marrow DWI and PDFF reflect age and anemia-responsive erythropoiesis.

Zero Echo Time-Based PET/MRI Attenuation Correction in Patients With Oral Cavity Cancer: Initial Experience.

PURPOSE: The aims of this study were to demonstrate the feasibility of zero echo time (ZTE) MRI for jawbone identification, and to evaluate the quantitative performance of F-FDG PET/MRI with ZTE-based attenuation correction (ZTE-AC) compared with PET/CT and PET/MRI with Dixon MR-based AC (Dixon-AC) in patients with oral cavity cancer (OCC). MATERIALS AND METHODS: Thirteen OCC patients underwent whole-body F-FDG PET/CT and subsequent regional PET/MRI with Dixon-AC and ZTE-AC in 1 day. SUVs of the primary OCC and metastatic cervical lymph nodes (CLNs) were measured on PET/CT (SUVCT), PET/MRI with Dixon-AC (SUVDixon), and ZTE-AC (SUVZTE). The SUVs were then compared. RESULTS: The ZTE MRI scans minimized the effects of metal artifacts from dentures, and ZTE-AC maps correctly delineated the jawbones. SUVDixon and SUVZTE had significant positive correlations with SUVCT (Pearson r = 0.97 and r = 0.99 for OCC, and r = 0.98 and r = 0.98 for CLNs, respectively). The mean ± SD of SUVCT, SUVDixon, and SUVZTE were 14.4 ± 8.0, 14.5 ± 8.6, and 15.6 ± 8.8 for OCC, and 6.3 ± 3.0, 8.0 ± 4.0, and 7.6 ± 3.9 for CLNs, respectively. For OCCs, SUVZTE was significantly higher than SUVCT (P < 0.05), whereas there was no significant difference between SUVCT and SUVDixon or between SUVDixon and SUVZTE. For CLNs, SUVDixon and SUVZTE were significantly higher than SUVCT (P < 0.01 and P < 0.05, respectively), and SUVDixon was significantly higher than SUVZTE (P < 0.01). CONCLUSIONS: ZTE MRI can correctly identify jawbones while minimizing the effects of metal artifacts. The ZTE-AC method in F-FDG PET/MRI reduces the underestimation of tracer uptake due to Dixon-AC jawbone errors and improves the quantitative performance of PET for OCC patients.

Chemical Composition and Antioxidant Potential of Essential Oil and Organic Extracts of Euphorbia tithymaloides L. from Kushtia Region.

BACKGROUND: In the traditional system of medicine, leaves and stem bark of Euphorbia tithymaloides L. have been used for the treatment of asthma, persistent coughing, laryngitis, skin diseases and mouth ulcers. Some studies have reported the anti-inflammatory and antimicrobial activities of phytochemicals from the leaf; however, the analysis of essential oil and its antioxidant property is still unexplored. METHODS: This study evaluates the in vitro antioxidant potential of the essential oil and organic extracts from aerial parts of Euphorbia tithymaloides L. RESULTS: Thirty one compounds representing 96.37% of total oil were detected by GC-MS, of which eugenol (22.52%), phenyl ethyl alcohol (14.63%), 3-pentanol (9.22%), caryophyllene oxide (7.73%), isoeugenol (7.32%), pentadecanol (5.14%), spathulenol (5.11%) and α-pinene (3.32%) were the major compounds. The oil and ethyl acetate extract displayed potent DPPH (IC50 = 13.67 and 17.59 µg/mL, respectively) and superoxide (IC50 = 21.83 and 42.34 µg/mL, respectively) radical-scavenging activities among all the tested samples. The oil and methanol extract also exhibited remarkable nitric oxide radical-scavenging activities (IC50 = 90.45 and 112.63 µg/mL, respectively) among other extracts. Furthermore, the methanol extract contained the highest amount of total phenolics as compared to other samples. CONCLUSION: The results demonstrate that the oil and extracts of E. tithymaloides could serve as natural antioxidants for using in pharmaceutical or cosmetic industries.

Epidemiology of childhood intussusception in Bangladesh: Findings from an active national hospital based surveillance system, 2012-2016.

INTRODUCTION: Rotavirus vaccines have significantly decreased the burden of diarrheal diseases in countries that have introduced them into their immunization programs. In some studies, there has been a small association between rotavirus vaccines and intussusception in post-marketing surveillance, highlighting the importance of tracking incidence before and after vaccine introduction. The objective of this study was to describe the epidemiology of intussusception among Bangladeshi children pre-vaccine introduction. METHODS: We conducted active, hospital-based surveillance for intussusception at 7 tertiary care hospitals with pediatric surgical facilities during July 2012 to September 2016. Hospitalized children under 2years of age were identified according to Brighton Collaboration level 1 criteria for intussusception. The frequency and proportion of intussusception among overall surgical admissions, as well as the demographic and clinical information of the cases is described. RESULTS: Overall 153 cases of intussusception among children <2years-old were identified at participating sites over the enrolment period, confirmed by Level 1 Brighton criteria. These cases represented 2% of all surgical admissions under 2years of age. One hundred twelve cases (73%) were male; the median age was 7months; and the median duration of hospitalization was 7days. One hundred forty-six (95%) children with intussusception required surgery, and 11 (7%) died. CONCLUSIONS: Confirmed cases of intussusception represented nearly 2% of pediatric surgical admissions at tertiary referral centers in Bangladesh during the study period and 7% of children with intussusception died. Given the high burden of rotavirus disease in Bangladesh, vaccine introduction is warranted, however, further studies after introduction of rotavirus vaccine are necessary to determine any association between vaccine and intussusception in this setting.

Antioxidant, Antinociceptive and CNS Activities of Viscum orientale and High Sensitive Quantification of Bioactive Polyphenols by UPLC.

Viscum orientale Willd. (Loranthaceae) has long been used in traditional medicine to treat pain, neuropharmacological disorders and various forms of tumor but not yet been reported. The aim of this study is to rationalize the traditional medicinal use of this plant by evaluating the methanol extract of V. orientale leaves (MEVOL) for anti-nociceptive, CNS depressant and antioxidant activities and to quantify the bioactive polyphenols present in this plant. Five polyphenolic compounds namely gallic acid, vanillic acid, caffeic acid, ellagic acid, and quercetin (17.54, 8.99, 99.61, 4523.31, and 100.15 mg/100 g of dry weight, respectively) have been identified in MEVOL using Ultra Performance Liquid Chromatography. Qualitative antioxidant activity determined by Thin Layer Chromatography indicated the presence of antioxidants. In quantitative antioxidant test using 2,2-diphenyl 1-picrylhydrazyl, MEVOL exhibited strong free antioxidant activity in a dose dependant manner (IC50 = 6.63 µg/ml) compared with ascorbic acid (IC50 = 1.91 µg/ml) and butylatedhydroxyanisole (IC50 = 2.27 µg/ml) controls. Total phenolic content determined using Folin Ciocaltu reagent was found to be 73.4 mg gallic acid equivalent/g of extract, while flavonoid content estimated using aluminum chloride colorimetric method was 170.7 mg quercetin equivalent/g of extract. Anti-nociceptive activity of MEVOL measured using acetic acid and formalin induced pain models in mice was significant (p < 0.001). MEVOL showed 65.6 and 88.8% writhing inhibition at 300 and 500 mg/kg body weight, respectively, comparing with standard diclofenac-Na (75.2% inhibition) at 25 mg/kg body weight in acetic acid induced pain model. In formalin induced pain model, paw licking was inhibited 45.93 and 56.4% in early phase and 55.66 and 72.64% in late phase at 300 and 500 mg/kg body weight, respectively, while diclofenac-Na inhibited 60.47 and 61.32% in early and late phase at 10 mg/kg body weight, respectively. In neuropharmacological activity test, overall behavioral test significantly reinforced CNS depressant activity. Spontaneous motor activities were reduced (p < 0.05) in both hole cross and open field tests compared with diazepam. Antioxidant activity of MEVOL is likely due to the phenolic and flavonoid compounds present within the leaf tissues. This study reveals significant in vivo anti-nociceptive and CNS depressant activities which justifies traditional medicinal applications of V. orientale.

Respiratory Viruses Associated Hospitalization among Children Aged <5 Years in Bangladesh: 2010-2014.

BACKGROUND: We combined hospital-based surveillance and health utilization survey data to estimate the incidence of respiratory viral infections associated hospitalization among children aged < 5 years in Bangladesh. METHODS: Surveillance physicians collected respiratory specimens from children aged <5 years hospitalized with respiratory illness and residing in the primary hospital catchment areas. We tested respiratory specimens for respiratory syncytial virus, parainfluenza viruses, human metapneumovirus, influenza, adenovirus and rhinoviruses using rRT-PCR. During 2013, we conducted a health utilization survey in the primary catchment areas of the hospitals to determine the proportion of all hospitalizations for respiratory illness among children aged <5 years at the surveillance hospitals during the preceding 12 months. We estimated the respiratory virus-specific incidence of hospitalization by dividing the estimated number of hospitalized children with a laboratory confirmed infection with a respiratory virus by the population aged <5 years of the catchment areas and adjusted for the proportion of children who were hospitalized at the surveillance hospitals. RESULTS: We estimated that the annual incidence per 1000 children (95% CI) of all cause associated respiratory hospitalization was 11.5 (10-12). The incidences per 1000 children (95% CI) per year for respiratory syncytial virus, parainfluenza, adenovirus, human metapneumovirus and influenza infections were 3(2-3), 0.5(0.4-0.8), 0.4 (0.3-0.6), 0.4 (0.3-0.6), and 0.4 (0.3-0.6) respectively. The incidences per 1000 children (95%CI) of rhinovirus-associated infections among hospitalized children were 5 (3-7), 2 (1-3), 1 (0.6-2), and 3 (2-4) in 2010, 2011, 2012 and 2013, respectively. CONCLUSION: Our data suggest that respiratory viruses are associated with a substantial burden of hospitalization in children aged <5 years in Bangladesh.

Bioactive Polyphenols from the Methanol Extract of Cnicus arvensis (L.) Roth Demonstrated Antinociceptive and Central Nervous System Depressant Activities in Mice.

Cnicus arvensis is used by many ethnic groups for inflammation, pain, and other ailments. In this study, reducing sugar, carbohydrate, alkaloid, steroid, tannin, flavonoid, and saponin groups were identified using standard chromogenic method. In high-performance liquid chromatography, vanillic acid and epicatechin were identified in the extract. Antinociceptive test by acetic acid induced writhing inhibition resulted 43.17 and 95.08% inhibition for 100 and 200 mg/kg body weight, comparing with standard diclofenac Na with 74.86% inhibition for 25 mg/kg body weight. In formalin induced paw licking test for antinociceptive activity, the extract inhibited 69.87 and 75.55% licking for 150 and 300 mg/kg body weight comparing with the inhibition (68.56%) of diclofenac Na for 10 mg/kg body weight at first phase. At late phase, the extract showed 73.12 and 87.46% licking comparing with licking inhibition (71.69%) by diclofenac Na at the same dose. In open field test for CNS depressant activity, the extract showed depression of locomotor activity for 150 and 300 mg/kg body weight comparing with diazepam for 10 mg/kg body weight. All results were statistically significant (P < 0.01). The identified polyphenols are reputed for antinociceptive and CNS depressant activity. The present findings support the use of this plant in pain.