Loss of CASK Accelerates Heart Failure Development.

[Figure: see text].

Bearing Fault Diagnosis Using Multidomain Fusion-Based Vibration Imaging and Multitask Learning.

Statistical features extraction from bearing fault signals requires a substantial level of knowledge and domain expertise. Furthermore, existing feature extraction techniques are mostly confined to selective feature extraction methods namely, time-domain, frequency-domain, or time-frequency domain statistical parameters. Vibration signals of bearing fault are highly non-linear and non-stationary making it cumbersome to extract relevant information for existing methodologies. This process even became more complicated when the bearing operates at variable speeds and load conditions. To address these challenges, this study develops an autonomous diagnostic system that combines signal-to-image transformation techniques for multi-domain information with convolutional neural network (CNN)-aided multitask learning (MTL). To address variable operating conditions, a composite color image is created by fusing information from multi-domains, such as the raw time-domain signal, the spectrum of the time-domain signal, and the envelope spectrum of the time-frequency analysis. This 2-D composite image, named multi-domain fusion-based vibration imaging (MDFVI), is highly effective in generating a unique pattern even with variable speeds and loads. Following that, these MDFVI images are fed to the proposed MTL-based CNN architecture to identify faults in variable speed and health conditions concurrently. The proposed method is tested on two benchmark datasets from the bearing experiment. The experimental results suggested that the proposed method outperformed state-of-the-arts in both datasets.

Inhibition of cardiac potassium currents by oxidation-activated protein kinase A contributes to early afterdepolarizations in the heart.

Reactive oxygen species (ROS) have been shown to prolong cardiac action potential duration resulting in afterdepolarizations, the cellular basis of triggered arrhythmias. As previously shown, protein kinase A type I (PKA I) is readily activated by oxidation of its regulatory subunits. However, the relevance of this mechanism of activation for cardiac pathophysiology is still elusive. In this study, we investigated the effects of oxidation-activated PKA I on cardiac electrophysiology. Ventricular cardiomyocytes were isolated from redox-dead PKA-RI Cys17Ser knock-in (KI) and wild-type (WT) mice and exposed to H2O2 (200 µmol/L) or vehicle (Veh) solution. In WT myocytes, exposure to H2O2 significantly increased oxidation of the regulatory subunit I (RI) and thus its dimerization (threefold increase in PKA RI dimer). Whole cell current clamp and voltage clamp were used to measure cardiac action potentials (APs), transient outward potassium current (Ito) and inward rectifying potassium current (IK1), respectively. In WT myocytes, H2O2 exposure significantly prolonged AP duration due to significantly decreased Ito and IK1 resulting in frequent early afterdepolarizations (EADs). Preincubation with the PKA-specific inhibitor Rp-8-Br-cAMPS (10 µmol/L) completely abolished the H2O2-dependent decrease in Ito and IK1 in WT myocytes. Intriguingly, H2O2 exposure did not prolong AP duration, nor did it decrease Ito, and only slightly enhanced EAD frequency in KI myocytes. Treatment of WT and KI cardiomyocytes with the late INa inhibitor TTX (1 µmol/L) completely abolished EAD formation. Our results suggest that redox-activated PKA may be important for H2O2-dependent arrhythmias and could be important for the development of specific antiarrhythmic drugs.NEW & NOTEWORTHY Oxidation-activated PKA type I inhibits transient outward potassium current (Ito) and inward rectifying potassium current (IK1) and contributes to ROS-induced APD prolongation as well as generation of early afterdepolarizations in murine ventricular cardiomyocytes.

Quantifying public health risks from exposure to waterborne pathogens during river bathing as a basis for reduction of disease burden.

A Quantitative Microbial Risk Assessment (QMRA) technique was applied to assess the public health risk from exposure to infectious microorganisms at bathing areas of three rivers in Bangladesh. The QMRA assessed the probability of illness due to the accidental ingestion of river water impacted by untreated sewage. The simplified QMRA was based on average concentrations of four reference pathogens Escherichia coli (E. coli) O157:H7, Cryptosporidium spp, norovirus and rotavirus relative to indicator bacterium E. coli. Public health risk was estimated as the probability of infection and illness from a single exposure of bathers. The risks of illness were ranged from 7 to 10% for E. coli O157:H7, 13 to 19% for Cryptosporidium, 7 to 10% for norovirus and 12 to 17% for rotavirus. The overall risk of illness at the rivers was slightly higher in children (9-19%) compared to adults (7-16%). The risks of illness in individuals exposed to the river bathing were unacceptably high, exceeding the USEPA acceptable risk of 3-6 illnesses per hundred bathing events. This study gives a basis for reducing the burden of disease in the population by applying appropriate risk management. Findings and methods of this study will be helpful for other countries with similar socio-economic and geographic settings.

Exploring the relationship between age at first drink, low-risk drinking knowledge and drinks counting: six rounds of a country-wide survey in Australia.

OBJECTIVE: Although a reasonable volume of research has been conducted around health impacts of age at first drink of alcohol on adverse health outcomes, the effects of age at first drink of alcohol on knowledge of low-risk drinking and drinks counting habits were rarely researched. The objective of this study is to examine the associations between age at first full serve of alcohol, knowledge of low-risk drinking and frequency of drinks counting. STUDY DESIGN: This is a cross-sectional study. METHODS: Data of six rounds of the National Drug Strategy Household Survey, conducted during the period 2001-2016, were analysed. Multivariable log-binomial regression models were used to explore the associations. RESULTS: Most people drank the first full serve of alcohol during adolescence, and the age at first full serve of alcohol was consumed increased over time. The levels of knowledge of low-risk drinking and frequency of drinks counting increased with age at first drink of alcohol more steeply during adolescence than in the later period. Participants' age at drinking the first full serve of alcohol was significantly associated with knowledge of low-risk drinking and drinks counting. There was an increasing trend of significant risk ratio between knowledge score and the frequency of drinks counting. CONCLUSION: It seems conceivable that those who reported drinking the first full serve of alcohol before 16 years of age were indifferent to drinks counting, and they lacked necessary knowledge of standard drink of alcohol or low-risk drinking. Tailored prevention programs are recommended among adolescents to delay age at first drink of alcohol and to enhance their knowledge base on low-risk drinking.

Proton pump inhibitors and risk of hip fracture: a meta-analysis of observational studies.

We performed a meta-analysis of relevant studies to quantify the magnitude of the association between proton pump inhibitors (PPIs) and risk of hip fracture. Patients with PPIs had a greater risk of hip fracture than those without PPI therapy (RR 1.20, 95% CI 1.14-1.28, p < 0.0001). These results could be taken into consideration with caution, and patients should also be concerned about the inappropriate use of PPIs. INTRODUCTION: Proton pump inhibitors (PPIs) are generally considered as first-line medicine with great safety profile, commonly prescribed for gastroesophageal reflux disease (GERD) and peptic ulcer disease. However, several epidemiological studies documented that long-term use of PPIs may be associated with an increased risk of hip fracture. Although, the optimal magnitude of the hip fracture risk is still undetermined. We, therefore, performed a meta-analysis of relevant studies to quantify the magnitude of the association between PPIs and risk of hip fracture. METHODS: We collected relevant articles using MEDLINE, EMBASE, Google Scholar, and Web of Science from January 1, 1990, to March 31, 2018. We included only the large (n ≥ 500) observational studies with a follow-up duration of at least one year in which the hip fracture patients were identified by a standard procedure. Two of the authors extracted data from each included study independently according to a standardized protocol. RESULTS: A total of 24 observational studies with 2,103,800 participants (319,568 hip fracture patients) met all the eligibility criteria. Patients with PPIs had a greater risk of hip fracture than those without PPI therapy (RR 1.20, 95% CI 1.14-1.28, p < 0.0001). An increased association was also observed in both low and medium doses of PPI taken and hip fracture risk (RR 1.17, 95% CI 1.05-1.29, p = 0.002; RR 1.28, 95% CI 1.14-1.44, p < 0.0001), but it appeared to be even greater among the patients with higher dose (RR 1.30, 95% CI 1.20-1.40, p < 0.0001). Moreover, the overall pooled risk ratios were 1.20 (95% CI 1.15-1.25, p < 0.0001) and 1.24 (95% CI 1.10-1.40, p < 0.0001) for the patients with short- and long-term PPI therapy, respectively, compared with PPI non-users. CONCLUSION: Our results suggest that PPI use is significantly associated with an increased risk of hip fracture development, which is not observed in H2RA exposure. Physicians should, therefore, exercise caution when considering a long-term PPI treatment to their patients who already have an elevated risk of hip fracture. In addition, patients should be concerned about the inappropriate use of PPIs; if necessary, then, they should continue to receive it with a clear indication.

Vision-Based Autonomous Crack Detection of Concrete Structures Using a Fully Convolutional Encoder-Decoder Network.

The visual inspection of massive civil infrastructure is a common trend for maintaining its reliability and structural health. However, this procedure, which uses human inspectors, requires long inspection times and relies on the subjective and empirical knowledge of the inspectors. To address these limitations, a machine vision-based autonomous crack detection method is proposed using a deep convolutional neural network (DCNN) technique. It consists of a fully convolutional neural network (FCN) with an encoder and decoder framework for semantic segmentation, which performs pixel-wise classification to accurately detect cracks. The main idea is to capture the global context of a scene and determine whether cracks are in the image while also providing a reduced and essential picture of the crack locations. The visual geometry group network (VGGNet), a variant of the DCCN, is employed as a backbone in the proposed FCN for end-to-end training. The efficacy of the proposed FCN method is tested on a publicly available benchmark dataset of concrete crack images. The experimental results indicate that the proposed method is highly effective for concrete crack classification, obtaining scores of approximately 92% for both the recall and F1 average.

Probing Endothelial Cell Mechanics Through Connexin 43 Disruption.

The endothelium has been established to generate intercellular stresses and suggested to transmit these intercellular stresses through cell-cell junctions, such as VE-Cadherin and ZO-1, for example. Although the previously mentioned molecules reflect the appreciable contributions both adherens junctions and tight junctions are believed to have in endothelial cell intercellular stresses, in doing so they also reveal the obscure relationship that exists between gap junctions and intercellular stresses. Therefore, to bring clarity to this relationship we disrupted expression of the endothelial gap junction connexin 43 (Cx43) by exposing confluent human umbilical vein endothelial cells (HUVECs) to a low (0.2 µg/mL) and high (2 µg/mL) concentration of 2,5-dihydroxychalcone (chalcone), a known Cx43 inhibitor. To evaluate the impact Cx43 disruption had on endothelial cell mechanics we utilized traction force microscopy and monolayer stress microscopy to measure cell-substrate tractions and cell-cell intercellular stresses, respectively. HUVEC monolayers exposed to a low concentration of chalcone produced average normal intercellular stresses that were on average 17% higher relative to control, while exposure to a high concentration of chalcone yielded average normal intercellular stresses that were on average 55% lower when compared to control HUVEC monolayers. HUVEC maximum shear intercellular stresses were observed to decrease by 16% (low chalcone concentration) and 66% (high chalcone concentration), while tractions exhibited an almost 2-fold decrease under high chalcone concentration. In addition, monolayer cell velocities were observed to decrease by 19% and 35% at low chalcone and high chalcone concentrations, respectively. Strain energies were also observed to decrease by 32% and 85% at low and high concentration of chalcone treatment, respectively, when compared to control. The findings we present here reveal for the first time the contribution Cx43 has to endothelial biomechanics.

Inequality in utilization of cesarean delivery in Bangladesh: a decomposition analysis using nationally representative data.

OBJECTIVE: This study examined the inequality in cesarean section (CS) utilization and its socio-economic contributors. STUDY DESIGN: Retrospective two-stage stratified sample design. METHODS: Data were extracted from two rounds of the Bangladesh Demographic and Health Survey conducted in 2004 and 2014. Concentration Index of CS utilization was calculated using the wealth quintile. Regression-based decomposition method was applied to assess the socio-economic contributors of inequality in CS utilization. RESULTS: The rate of CS utilization increased from 4.98% in 2004 to 24.21% in 2014. The utilization of CS was highly concentrated among the women of higher socio-economic status (SES) in both rounds of the survey. Results of the decomposition models revealed wealth quintile, higher education, higher number of antenatal visits, and being overweight or obese as the critical factors contributing to the inequalities of CS utilization. CONCLUSION: Bangladesh is now observing a rapid rise in CS utilization and women with higher SES are the main client group of this life saving procedure. There may have inadequate access for those who are relatively less advantaged, even when CS is necessary. Strong initiative from the government is necessary to ensure proper access to this service regardless of women's SES.

Loss of the proprioception and touch sensation channel PIEZO2 in siblings with a progressive form of contractures.

Dominant mutations in PIEZO2, which codes for the principal mechanotransduction channel for proprioception and touch sensation, have been found to cause different forms of distal arthrogryposis. Some observations suggest that these dominant mutations induce a gain-of-function effect on the channel. Here, we report a consanguineous family with three siblings who showed short stature, scoliosis, gross motor impairment, and a progressive form of contractures involving the distal joints that is distinct from that found in patients with dominant mutations in PIEZO2. These siblings also displayed deficits in proprioception and touch sensation. Whole-exome sequencing performed in the three affected siblings revealed the presence of a rare homozygous variant (c.2708C>G; p.S903*) in PIEZO2. This variant is predicted to disrupt PIEZO2 function by abolishing the pore domain. Sanger sequencing confirmed that all three siblings are homozygous whereas their parents and an unaffected sibling are heterozygous for this variant. Recessive mutations in PIEZO2 thus appear to cause a progressive phenotype that overlaps with, while being mostly distinct from that associated with dominant mutations in the same gene.

Reliable bearing fault diagnosis using Bayesian inference-based multi-class support vector machines.

This letter presents a multi-fault diagnosis scheme for bearings using hybrid features extracted from their acoustic emissions and a Bayesian inference-based one-against-all support vector machine (Bayesian OAASVM) for multi-class classification. The Bayesian OAASVM, which is a standard multi-class extension of the binary support vector machine, results in ambiguously labeled regions in the input space that degrade its classification performance. The proposed Bayesian OAASVM formulates the feature space as an appropriate Gaussian process prior, interprets the decision value of the Bayesian OAASVM as a maximum a posteriori evidence function, and uses Bayesian inference to label unknown samples.

Macrophage Activation Syndrome in Paediatric Rheumatic Diseases.

Macrophage activation syndrome (MAS) is a potentially fatal complication of rheumatic disorders, which commonly occurs in systemic juvenile idiopathic arthritis (sJIA).This study was carried out with the aims of describing the clinical features, laboratory findings and outcomes of MAS associated with paediatric rheumatic diseases in the Department of Paediatrics, Bangabandhu Sheikh Mujib Medical University (BSMMU) and compare these results with previous studies on MAS. This retrospective study was conducted in the paediatric rheumatology wing of the Department of Paediatrics, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh. Clinical and laboratory profile of all the diagnosed cases of MAS were analyzed from the medical records from January 2010 to July 2015. Among 10 MAS patients, 6 were female and 4 were male. Seven patients of systemic JIA, two patients of SLE and one patient with Kawasaki Disease developed MAS in their course of primary disease. Mean duration of primary disease prior to development of MAS was 2.9 years and mean age of onset was 9.1 years. High continued fever and new onset hepatosplenomegaly were the hallmark of the clinical presentation. White blood cell count and platelet count came down from the mean of 16.2 to 10.2×109/L and 254 to 90×109/L. Mean erythrocyte sedimentation rate was dropped from 56 to 29 mm/hr. Six patients had abnormal liver enzyme level (ALT) and 5 had evidence of coagulopathy (prolonged prothrombin time and APTT) at the onset of disease. Hyperferritinnemia were found in all the patients. Bone marrow study was done in 5 patients but features of hamophagocytosis were found only in 2 patients. All patients received intravenous steroid and 3 patients who did not respond to steroid received additional cyclosporine. Mortality rate was 30% in this series. Macrophage activation syndrome is a fatal complication of paediatric rheumatic diseases among which s-JIA was predominant. Early diagnosis and aggressive therapy is essential to reduce the morbidity and mortality of this illness.

Current Trends of Using Antimicrobials at Obstetrics and Gynaecology Department in a Tertiary Care Hospital.

This cross-sectional descriptive study was done to analyse the current trends of using antimicrobials in various surgical procedures at Obstetrics and Gynaecology department in Mymensingh Medical College Hospital, Mymensingh from July 2014 to June 2015. Among 300 postoperative obstetrics and gynaecological surgery cases, samples were selected as non-random purposive selection method where pattern of using antimicrobials were analysed by SPSS method 20.1 versions. The incidence of antimicrobial resistance is on continued rise with a threat to return to the pre-antibiotic era. This has led to emergence of such bacterial infections which are essentially untreatable by the current armamentarium of available treatment options. Now-a-days variation of choosing antibiotic are quietly accepted in Obstetrics and Gynaecology department as prophylaxis purpose to control life threatening conditions such as postoperative wound infection, septicaemia, urinary tract infection etc. The data analysis revealed that among 300 obstetrical and gynaecological surgeries, Nitroimidazoles (93.33%), Cephalosporins (91%) and Aminoglycosides (59%) group were most commonly used antimicrobials in both obstetrics and gynaecological surgeries. Metronidazole (93.33%), Ceftriaxone (68.66%), Gentamicin (60.33%), Cefuroxime (48%), Flucloxacillin (42%), Cefixime (27%) were the most commonly used antimicrobials at obstetrics and gynaecology department. Combination of Ceftriaxone, Metronidazole and Gentamicin (37.66%), Ceftriaxone and Metronidazole (25.33%), Cefuroxime, Metronidazole and Gentamicin (16%), Ciprofloxacin, Metronidazole and Gentamicin (5.33%) were most commonly used antimicrobials postoperatively. Total mean duration of antimicrobial therapy was 10.45 days. Antibiotics are useful in prevention of infection. But indiscriminately use of antibiotics without any guideline may lead to antimicrobial resistance. So, antimicrobial surveillance committee should be formed by hospital authority to know the local using pattern of antibiotics.

Association between serum vitamin D, retinol and zinc status, and acute respiratory infections in underweight and normal-weight children aged 6-24 months living in an urban slum in Bangladesh.

We conducted a longitudinal assessment in 466 underweight and 446 normal-weight children aged 6-24 months living in the urban slum of Dhaka, Bangladesh to determine the association between vitamin D and other micronutrient status with upper respiratory tract infection (URI) and acute lower respiratory infection (ALRI). Incidence rate ratios of URI and ALRI were estimated using multivariable generalized estimating equations. Our results indicate that underweight children with insufficient and deficient vitamin D status were associated with 20% and 23-25% reduced risk of URI, respectively, compared to children with sufficient status. Underweight children, those with serum retinol deficiency were at 1·8 [95% confidence interval (CI) 1·4-2·4] times higher risk of ALRI than those with retinol sufficiency. In normal-weight children there were no significant differences between different vitamin D status and the incidence of URI and ALRI. However, normal-weight children with zinc insufficiency and those that were serum retinol deficient had 1·2 (95% CI 1·0-1·5) times higher risk of URI and 1·9 (95% CI 1·4-2·6) times higher risk of ALRI, respectively. Thus, our results should encourage efforts to increase the intake of retinol-enriched food or supplementation in this population. However, the mechanisms through which vitamin D exerts beneficial effects on the incidence of childhood respiratory tract infection still needs further research.

Prescription opioid analgesics for pain management in Australia: 20 years of dispensing.

BACKGROUND: Opioid prescribing/dispensing data can inform policy surrounding regulation by informing trends and types of opioid prescribed and geographic variations. In Australia so far only partial data on dispensing have been published, and data for states/territories remain unknown. AIM: Using a range of measures, this study examines 20-year (1992-2011) trends in prescription opioid analgesics in Australia - both nationally and for individual jurisdictions. METHODS: Dispensing data were obtained from the Drug Utilisation Sub-Committee and the Pharmaceutical Benefits Scheme (PBS) websites. Trends in numbers of prescriptions and daily defined dose (DDD)/1000 people/day were examined over time and across states/territories. Seasonal variations in PBS/Repatriation Pharmaceutical Benefits Scheme (RPBS) items for nationwide dispensing were adjusted using a centred moving smoothing technique. RESULTS: In two decades, 165.32 million prescriptions for opioids were dispensed, with codeine and its derivatives the most prescribed formulation (50.1%) followed by tramadol (13.5%) and oxycodone derivatives (12.7%). In terms of DDD/1000 people/day, dispensing increased from 5.38 in 1992 to 14.46 in 2011. There are significant increasing trends for total, PBS/RPBS and under co-payment prescriptions (priced below patient co-payment). The DDD/1000 people/day for items dispensed through PBS/RPBS was highest in Tasmania. CONCLUSION: Prescription opioid dispensing increased substantially over the study period. With an ageing population, this trend is likely to continue in future. A growing concern about harms associated with opioid use warrants balanced control measures so that harms could be minimised without reducing effective pain treatment. Research examining utilisation in small geographic areas may help design spatially tailored interventions. A real-time drug-monitoring programme may reduce undue prescribing and dispensing.

Risk factors for ectopic pregnancy in the Taiwanese population: a retrospective observational study.

OBJECTIVE: The aim of this study is to explore the risk factors for ectopic pregnancy (EP) in the Taiwanese population and to identify any unknown risk factors for EP that could assist awareness and diagnosis. METHODS: This retrospective case-control study utilizes Taiwan's National Health Insurance Research Database (NHIRD). Analysis was conducted with a one million sample database representative of the country's population. The case group comprised of 6637 individuals in the database that coded for EP using the ICD-9 classification system from January 2003 to December 2011. The control group comprised of 13,270 females matched by age that were never diagnosed with EP during the study period. RESULTS: This study provides an analysis of the risk factors of EP utilizing NHIRD. Among the 6637 people diagnosed with EP, logistic regression with age adjustment showed that the highest risk factor was endometriosis (OR = 8.84, CI 5.13-15.23), followed by polycystic ovary (OR = 7.74, CI 3.37-17.79) and benign neoplasm of the ovary (6.01, CI 2.18-16.54). All odds ratios were determined to be statistically significant at p < 0.001. CONCLUSION: This study has identified the diagnosis of endometriosis and polycystic ovaries as the two largest risk factors for EP in Taiwan, and has also newly identified benign neoplasm of ovary and uterine leiomyoma as risk factors for EP.

In Vitro Determination of Minimum Inhibitory Concentration of Aqueous Garlic Extract and Imipenem against Staphylococcus aureus and Escherichia coli.

An interventional study was performed to determine and compare the MICs of aqueous garlic extract (AGE) and Imipenem against standard strains of Staphylococcus aureus ATCC 25923 & Eschericha coli ATCC 25922. The study was conducted in Department of Pharmacology and Therapeutics in collaboration with Department of Microbiology, Mymensingh Medical College, Mymensingh, Bangladesh from July 2014 to January 2015. The MIC of AGE and antibiotic Imipenem were determined with the help of broth dilution method. The MIC of AGE was determined as 400µg/ml and 700µg/ml against Staphylococcus aureus, and Escherichia coli respectively and the MIC of Imipenem was 1µg/ml against Staphylococus aureus and 1.5µg/ml against Escherichia coli. The MICs of Imipenem was much lower in comparison to MICs of AGE for the test organisms. The subculture study showed the same results with that of the primary isolates. From the study it was clearly observed that AGE have anti bacterial effect but is not potent like antibiotic Imipenem. In this regard active ingredient present in garlic needs to be separated & purified for further study.

Response of Dapsone in Refractory Chronic Immune Thrombocytopenia.

This was a prospective study. A total number of 19 patients with chronic ITP with platelet count <50×108/L, treated with dapsone at a dose of 100 mg/day for nine months and followed up to 12 months were included in this study. Among them 13 patients (76.5%) were responded well shortly to dapsone which persisted during Dapsone therapy. Response rate of Dapsone was declining after Dapsone therapy. Response persisted in 6 patients (35.3%) after stoppage of dapsone up to last follow up at 1 year. Mean platelets count during Dapsone therapy was 168.35×108/L. Shorter duration of thrombocypenic patients were responded well. Except one all patients experienced mild to moderate anaemia. Mean fall of Haemoglobin was 1.4gm/dl during dapsone therapy observed which come back to normal shortly after stoppage of dapsone. Only 2 patients were suffered from moderate anaemia. Dapsone syndrome and methemoglobinamia caused permanent discontinuation of therapy in 2 patients (10.5%) which was revert back to normal shortly after stoppage of drug. This study demonstrates that dapsone is an effective, inexpensive and well tolerated treatment for chronic, refractory ITP.

Anti-Bacterial effect of Aqueous Garlic Extract (AGE) determined by Disc Diffusion Method against Escherichia coli.

The study was performed to determine the antibacterial effect of aqueous extract of garlic (Allium sativum) against standard strain of Escherichia coli ATCC 25922. An interventional study was conducted in Department of Pharmacology and Therapeutics in collaboration with Department of Microbiology, Mymensingh Medical College, Mymensingh. Antibacterial effect of AGE was determined by disc diffusion method. Sensitivity of AGE determined in disc diffusion and the zone of inhibition (ZOI) was 4 mm, 10 mm and 20 mm at 25 µg/10 µl, 50 µg/10 µl and 100 µg/10 µl concentrations respectively. From the findings it is clearly determined the extract has definite antibacterial effect upon Escherichia coli. Further studies are required to detect and isolate the active ingredients present in the Garlic extract as well as detail steps of mechanism responsible for antibacterial effect. Then their effects against the studied organism should be studied in vivo separately and its toxicity profile should also be taken into account.

Associations and Risk Factors of Diabetic Maculopathy.

Diabetic maculopathy is characterised by increased capillary leakage in the main retinal vessels and by alterations in the microcirculation of the macula. Maculopathy occurs frequently in type 1 and type 2 diabetic patients. Prevalence is higher in type 2 than in type 1 diabetic patients. Factors associated with the development of maculopathy are mostly unknown. As maculopathy is the main cause of vision deprivation in diabetic patients it is essential to know the associations and risk factors of diabetic maculopathy so that appropriate measures can be taken to prevent as well as treat diabetic maculopathy. We started the research work to find out the relation between diabetic maculopathy and various associated factors and risk factors for patients with diabetic retinopathy with maculopathy. This cross-sectional observational study done at the Department of Ophthalmology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka & National Institute of Ophthalmology & Hospital (NIO & H), Sher-e-Bangla Nagar, Dhaka, Bangladesh from January 2006 to June 2006. In this study out of 50 patients, diabetes was controlled in 20(40%) patients and uncontrolled in 30(60%). A significant percentage of patients (40%) had elevated blood pressure. Diabetic autonomic neuropathy was observed in 24% cases and polyneuropathy was observed in 36% cases. It is evident that diabetic maculopathy has association with dyslipidaemia, abnormal renal function due to nephropathy. This study lighted on the association of diabetic maculopathy with diabetic nephropathy, cardiac abnormalities and diabetic neuropathy.