Malnutrition as a predictor of adverse outcomes of febrile neutropenia in children with acute lymphoblastic leukemia during induction phase chemotherapy

Background: Adequate nutrition is an important concern in children with leukemia. Malnutrition impairs immune function, leading to increased incidence of infection, poor quality of life, as well as death. Febrile neutropenia (FN) has a high prevalence in children with acute lymphoblastic leukemia (ALL) and a poor outcome as well.Methods: This prospective observational study was done in the department of pediatrics hematology and oncology (PHO), BSMMU, from January 2021 to October 2021. A total of 60 patients of ALL were selected purposively. Patients were evaluated by taking anthropometric parameters before getting chemotherapy and were prospectively followed up for the development and outcome of FN until recovery. Statistical analysis was performed by using SPSS (Statistical package for the social sciences) for Windows version 26.0.Result: Analysis of nutritional status as a risk factor for FN based on anthropometric indices, was found statistically significant for, weight for height (?5 years) p=0.036, OR=0.24 (95% CI= 0.06-0.958), weight for age p=0.006, OR=0.23 (95% CI=0.07-0.67), but for BMI for age (>5 years) p=0.28, OD=0.28 (95% CI=0.02-3.19), and height for age p=0.513, OD=0.66 (95% CI=0.18-2.33) no statistically significant value was found. In this study, we found mortality rate was 15%. The mortality rate was significantly worse (27.3%) for patients who were malnourished at diagnosis as compared to those who were well nourished (7.9%) at diagnosis.Conclusions: FN and its complications are more common in malnourished children with ALL. Malnutrition is associated with adverse outcomes of FN in children with ALL.

Implications of Safe Street Foods in Dhaka City: An Opinion

Street foods play an important role in large group of economic people in the Dhaka city. And it is also the major source of income for floating vendors. Huge numbers of vendors sell dishes, snacks, fruits, and beverages in the megacity of Dhaka. The objective of this article is to promote and maintain the hygienic environment of selling street foods among vendors in Dhaka city. Contaminated foods cause various kinds of diarrheal diseases. To prevent this contagious disease food safety needs much more awareness. To ascertain safe street foods, the government and non-government organizations should implement rules and regulations strictly and appropriate programmes should be conducted. The various facets of street foods available in Dhaka city have been briefly described in the present article.

Preservation of histology by phenol-based fixative: mini review of recent findings / Preservación de la histología mediante un fijador basado en fenol: una mini revisión de los hallazgos recientes

SUMMARY: In surgical and anatomical training, use of cadaver remains the most ideal technique. Standard formaldehyde solution preserves cadaveric tissues for an extended period comparing to the unfixed tissues. However, it fails to retain the natural texture, color, and biomechanical features. Phenol based soft embalming methods were developed to maintain these properties, while simultaneously decreasing the biohazard risk. Soft embalming techniques have made the bodies more 'lifelike' and wellfitted for training. Though phenol fixation displays rewarding morphological maintenance, we have scanty evidences on the histological preservation. This mini review primarily discussed the latest reports regarding the effect of phenol-based fixation on the tissue histology. Published literatures revealed phenol-based fixation displayed comparable histological preservation to that ofgold standard paraformaldehyde-based solution. It was concluded that phenol-based solution is an excellent fixative used to preserve tissues for microscopic analysis.

RESUMEN: En el entrenamiento quirúrgico y anatómico, el uso de cadáveres sigue siendo la técnica más ideal. La solución estándar de formaldehído conserva los tejidos cadavéricos durante un período prolongado en comparación con los tejidos no fijados. Sin embargo, no conserva la textura, el color y las características biomecánicas naturales. Se desarrollaron métodos de embalsamamiento blando a base de fenol para mantener estas propiedades y, al mismo tiempo, disminuir el riesgo biológico. Las técnicas de embalsamamiento suaves han hecho que los cuerpos sean más "realistas" y estén mejor preparados para la enseñanza. A pesar que la fijación de fenol muestra un buen mantenimiento morfológico, existe evidencia escasa sobre la preservación histológica. Esta mini revisión se refirió principalmente a los últimos informes sobre el efecto de la fijación en base de fenol en la histología del tejido. La literatura publicada reveló que la fijación a base de fenol mostró una preservación histológica comparable a la de la solución a base de paraformaldehído. Se concluyó que la solución a base de fenol es un excelente fijador utilizado para preservar tejidos para análisis microscópico.

Seroprevalence of Hepatitis B and Hepatitis C in end-stage renal disease patients on maintenance hemodialysis: a single-center study from Bangladesh

Background: Hepatitis B virus (HBV) and Hepatitis C virus (HCV) infections are important causes of morbidity and mortality in hemodialysis (HD) patients. The aim of this study was to estimate the seroprevalence of HBV and HCV among end-stage renal disease (ESRD) patients on maintenance HD.Methods: This cross-sectional study was conducted in the hemodialysis unit of a military hospital of Bangladesh from October 2013 to March 2014 and included 141 maintenance HD patients. All patients were assessed by HBsAg and anti-HCV antibodies in addition to routine liver function tests.Results: The age range of the study subjects were 18-70 years, and the majority (85.11%) were male. Among them 22 (15.60%) were positive for anti HCV, 5(3.5%) were positive for HBsAg, and 3 patients (2.13%) were positive for both HBsAg and anti-HCV. The duration of hemodialysis was higher in anti-HCV positive patients (49±24 vs. 25±10 months, p <0.05) than anti-HCV negative ones. Anti-HCV positive patients in this study received a higher number of blood transfusion (units) than anti-HCV negative patients (7.5±4.3 vs. 2.8±1.7 units, p <0.05). HBsAg positive patients also received a higher number of blood transfusion (units) than HBsAg negative patients (8.2±3.1 vs. 3.2±1.2 units, p <0.05).Conclusions: Hepatitis C virus was the major form of hepatitis in HD patients in this study. The duration of HD was higher in anti-HCV positive patients; the numbers of blood transfusion units were higher in patients positive for HCV and HBV than the negative ones.

Screening for microbial load and antibiotic resistance pattern in Escherichia coli isolated from paper currency circulating in Kushtia, Bangladesh

Background: Paper currency is used for every type of commerce and plays an important role in the life of human beings. They are exchanged and come into contact with different environments and many different individuals during their circulation. Therefore, they can become contaminated with microorganisms and transfer bacteria across environments. The present study was aimed for quantitative assessment of microorganisms in circulated paper currency from Kushtia, Bangladesh and antibiotic resistant profiles of isolated Escherichia coli.Methods: A total of 10 paper currency samples currently in circulation involving three denominations (5, 10 and 500) were randomly collected from individuals involved in various occupations including street beggar, local hotel, bus conductor, poultry seller, vegetable seller, fish seller, commercial bank, ATM booth, tea seller, grocery store in Kushtia city, Bangladesh. Selective culture and biochemical tests were performed for the isolation and identification of microbial pathogens. Antibiotic resistance profiles were evaluated for isolated Escherichia coli using Kirby-Bauer method according to CLSI guidelines.Results: Aerobic mesophilic bacteria, Enterobacteriaceae and Pseudomonas spp. were the highest in paper currency from local hotel and ATM booth. Enterobacteriaceae (including coliforms) were predominantly present in paper currencies collected from local hotel, grocery, fish seller and beggar while Pseudomonas spp. were found in currency notes obtained from ATM booth, poultry farm, vegetable seller and local hotel. Antibiotic resistant profiles of E. coli isolated from local hotel currency showed that 50% of E. coli isolates were multidrug resistant. The highest resistant profile was observed against penicillin (95%) followed by polypeptide (75%), cephalosporin (50%), quinolone (30%) and sulfonamide (5%) groups of antibiotics.Conclusions: Multiple antibiotic resistant pathogenic bacteria are prevalent in paper currency regardless of their sources. Paper currency could contribute in transmission of infectious disease as well as in antibiotic resistance, therefore, should be handled carefully.

Clinical Presentation of Left Atrial Myxoma in Relation to Anatomic and Pathologic Type.

Background: Atrial myxoma is the most common benign cardiac neoplasm. Most of the case series have focused on the variable clinical presentation of myxoma rather than its gross and microscopic features. The objective of our study was to evaluate prevalence of different morphologic types of myxoma and to correlate with their clinical presentations. Methods: 68 patients were included in the study. The study population was divided into two groups- Group-A (n-18) patients having soft (papillary) tumor in the left atrium, Group B (n=50) patients having solid tumor in the left atrium. Results: 88.3% patients suffered illness more than 12 months. 92% of the solid myxomas were located in the septal wall compared to 55.6% of the papillary myxomas (p = 0.031), while one-third (33.3%) the papillary tumors were found in the left atrial free wall compared to only 4% of the solid myxomas (p = 0.048). Fever, congestive heart failure and dyspnoea were significantly predominant in patients with solid myxomas (72% vs. 44.4%, p = 0.036; 92% vs. 22.2%, p < 0.001 and 88% vs. 55.6%, p = 0.010 respectively). Atrial fibrillation and neurologic manifestations were more frequently encountered in the papillary myxoma group. No statistically significant difference was found between the groups (p>0.05) by postoperative complication during in hospital follow up but one mortality in each group. Conclusion: Our findings lend support to the view that different gross left atrial Myxoma tumor types and tumor location predict presentation.

Prevalence of KRAS mutations in metastatic colorectal cancer: A retrospective observational study from India.

BACKGROUND: One of the genetic alterations implicated in tumor progression in colorectal cancers (CRCs) are abnormalities in Kristen Rat Sarcoma (KRAS) gene. Evaluation of KRAS mutation status is an important prognostic factor and has predictive value in deciding first line therapy based on monoclonal antibodies such as Cetuximab and Panitumumab in metastatic CRCs. MATERIALS AND METHODS: In this retrospective study, we analyzed 7 different somatic mutations in Exon 2 of KRAS gene in 299 unselected incidental CRC patients who visited the hospital for clinical management during the period 2009–2013. Most of the tumors were primarily originating from colon and rectum; nevertheless, there were a few from rectosigmoid, sigmoid, ceacum and anal canal in the study group. Genomic DNA extracted from paraffin embedded tumor tissues was screened for 7 point mutations located in Codons 12 and 13 of KRAS gene, using Scorpions amplified refractory mutation system real time polymerase chain reaction technology. Statistical analysis was performed to assess bivariate relationship between different variables that includes: mutation status, mutation type, tumor location, tumor morphology, age and sex. RESULTS: Prevalence of mutation in Codons 12 and 13 was 42.8% in the study group. Well‑differentiated tumors had significantly more mutation positivity than moderately and poorly differentiated tumors (P = 0.001). 92% of the mutations were from Codon 12 and 8% in Codon 13. Glycine to Arginine was relatively more common in rectosigmoid followed by ceacum, while Glycine to Alanine mutation was relatively more prevalent in sigmoid, followed by rectum and rectosigmoid. CONCLUSION: The results suggest a prevalence of KRAS mutation at 42.8% in Indian population indicating that this testing is very crucial for targeted therapy management in metastatic CRC in India. Further analysis on mutation status of other homologues such as NRAS and downstream partner, v‑raf murine sarcoma viral oncogene homolog B1, would add value to understanding the role of anti‑epidermal growth factor receptor therapy in CRC management.

Cytotoxic, Thrombolytic and Membrane Stabilizing Activities of Swietenia mahagoni (L.) Jacq. Flower Extract.

Aims: To investigate cytotoxic, thrombolytic and membrane stabilizing activities of methanol extract and its different Kupchan partitionates of flowers of Swietenia mahagoni. Study Design: Evaluation of cytotoxic activity using brine shrimp nauplii, thrombolytic and membrane stabilizing activities on human RBCs. Place and Duration of Study: Phytochemical Research Laboratory, Department of Pharmacy, School of Health Science, State University of Bangladesh, from April to September, 2013. Methodology: The eggs of brine shrimp nauplii were hatched in artificial sea water for 24 hours. Cytotoxic activity was determined by measuring the percentage of their mortality after application of different partitionates to them. Human RBCs were obtained from 3 healthy volunteers. Thrombolytic activity was calculated by weighing the clot before and after addition of different partitionates while membrane stabilizing activity was evaluated in terms of inhibition of percentage of haemolysis of RBCs by measuring optical density in both hypotonic and heat induced conditions. Results: The highest cytotoxic activity was achieved with the crude methanol extract (LC50 = 0.10±0.01 mg/ml) among the partitionates while vincristine sulfate, the positive control, achieved an LC50 value of 0.40±0.02 mg/ml. While investigating thrombolytic activity, the petroleum ether soluble fraction achieved the highest clot lysis activity (34.30±0.78%) compared to the standard streptokinase (70.27±1.26%). While determining the membrane stabilizing activity, in hypotonic solution induced condition, the crude methanol extract inhibited 84.71±3.25% haemolysis of RBCs whereas in heat induced condition, the aqueous soluble fraction inhibited 86.30±4.98% haemolysis of human RBCs. Here, acetyl salicylic acid (0.01mg/ml) used as reference standard showed 71.91±2.29% and 45.45±4.87% inhibition of haemolysis of human RBCs in hypotonic solution and heat induced conditions, respectively. Conclusion: From our investigation, it can be suggested that, the flower extractives can further be studied extensively to find out their efficacy.

In Silico Modeling and Immunoinformatics Probing Disclose the Epitope Based PeptideVaccine Against Zika Virus Envelope Glycoprotein.

Zika virus (ZIKV) is an aedes mosquito borne pathogen belonging to the member of flaviviridae subgroup is the causative agent of an emerging disease called Zika fever, known as a benign infection usually presenting as influenza like illness with cutaneous rash. Due to recent epidemic outbreaks it is realized as a major health risk which need enhanced surveillance, but no attempt has been made to design an epitope based peptide vaccine against Zika virus. Viral envelope proteins are derived from host cell membrane proteins with some viral glycoproteins and are used to cover their protective protein capsid, help the viruses to enter host cells and help them to avoid the host immune response. In this study, amino acid sequence of ZIKV envelope glycoprotein was obtained from a protein database and examined with in silico approaches to determine the most immunogenic epitopes for B cell and T cell which could induce humoral as well as cell mediated immune response. Both the linear and conformational epitopes for B cell were predicted by immunoinformatics tools housed in IEDB resources. The peptide sequence DAHAKRQTVVVLGSQEGAV from position 121 and peptide sequence from 117-137 amino acids were predicted as most potential B cell linear and conformational epitopes respectively. Epitopes for CD4+ and CD8+ T cell were also predicted by using tools within IEDB resource and peptide sequence MMLELDPPF from position 250-258 amino acids was predicted as most immunogenic CD8+ T cell epitope with immune response evoking ability prediction score (I pMHC) of 0.09139 and conservancy of 52.17%. The innate immune response for ZIKV envelope glycoprotein was determined by interferon (IFN)-gamma effectuation and mimicking capacity by immunoinformatics and molecular docking study respectively. However, this is an introductory approach to design an epitope based peptide vaccine against Zika virus; we hope this model will be very much helpful in designing and predicting novel vaccine candidate.

Evaluation of anti-inflammatory and antidiabetic activity of ethanolic extracts of Desmodium pulchellum Benth. (Fabaceae) barks on albino wistar rats.

Effects of ethanolic extract of Desmodium pulchellum Benth. (Fabaceae) barks on alloxan-induced diabetic rats were investigated. In diabetic rats, blood glucose levels were reduced by 18.64 – 34.04 % on consumption of the extracts, with greater effect exhibited by the 1000mg/kg extract whereas in Glibenclamide treated diabetic rats, blood glucose levels were reduced upto 73.55%. The results suggested ethanolic extract of barks may contribute to the reduction of blood glucose levels and can be useful in the management of diabetes. The acute oral toxicity showed that the ethanolic extract of D. pulchellum barks was safe until 4000mg/kg body weight and no macroscopical organ abnormalities were observed in acute oral models. The investigations on Albino (Wistar) rats at dosage of 100, 200 and 400 mg/kg of ethanolic extract of D. pulchellum barks were made for anitiinflammatory action by using carrageenan induced paw edema and cotton pellete granuloma technique. The results of the study suggested significant dose dependent activity of extracts as compared to control group for both acute and chronic inflammation.

Epidermal growth factor receptor mutation in non-small-cell lung carcinomas: A retrospective analysis of 1036 lung cancer specimens from a network of tertiary cancer care centers in India.

BACKGROUND: Epidermal growth factor receptor (EGFR) mutation plays a vital role in the prognosis of patients with lung cancer. However, there is a dearth of studies on EGFR mutation in Indian population. In this retrospective study conducted at a network of tertiary cancer care centers across India, we evaluated the proportion of EGFR mutation in patients with non‑small‑cell lung carcinomas (NSCLC). MATERIALS AND METHODS: A total of 1036 cases of non‑small lung cancer were assessed for EGFR mutation status using Scorpion amplified refractory mutation system real time polymerase chain reaction method from fine needle aspiration cytology core biopsy, pleural fluid and cell blocks. For a few cases, macro dissection of tumor from H and E slides was also performed for EGFR analysis. EGFR Status was assessed for the most commonly known driver mutations in Exons 18, 19, 20 and 21, which contributes to a total of 29 somatic mutations including the resistance mutation T790M. RESULTS: Around 39% of the cohort was female and 61% were male. Mutation was positive in 40.3% and negative (wild type) in 59.7%. There was 1.8% mutation in exon 18, 24.6% in exon 19, 1.6% in exon 20 and 12.8% in exon 21. 38.2% had a mutation in a single site and 1.1% had a mutation in two sites. Overall mutation was significant in females (50.5% vs. 33.9%) compared with males (c2 = 28.3, P < 0.001). Mutation was significant in exon 21 (16.8% vs. 10.3%, c2 = 9.44, P = 0.002) and exon 19 (30.7% vs. 20.7%, c2 = 13.2, P < 0.001) in females compared with males. CONCLUSION: EGFR is expressed differentially/ mutated in patients with NSCLC. Further studies to unravel the predictors for acquired genetic alterations of EGFR are needed.

Nutrition of Children and Women in Bangladesh: Trends and Directions for the Future.

Although child and maternal malnutrition has been reduced in Bangladesh, the prevalence of underweight (weight-for-age z-score <-2) among children aged less than five years is still high (41%). Nearly one-third of women are undernourished with body mass index of <18.5 kg/m2. The prevalence of anaemia among young infants, adolescent girls, and pregnant women is still at unacceptable levels. Despite the successes in specific programmes, such as the Expanded Programme on Immunization and vitamin A supplementation, programmes for nutrition interventions are yet to be implemented at scale for reaching the entire population. Given the low annual rate of reduction in child undernutrition of 1.27 percentage points per year, it is unlikely that Bangladesh would be able to achieve the United Nations’ Millennium Development Goal to address undernutrition. This warrants that the policy-makers and programme managers think urgently about the ways to accelerate the progress. The Government, development partners, non-government organizations, and the academia have to work in concert to improve the coverage of basic and effective nutrition interventions, including exclusive breastfeeding, appropriate complementary feeding, supplementation of micronutrients to children, adolescent girls, pregnant and lactating women, management of severe acute malnutrition and deworming, and hygiene interventions, coupled with those that address more structural causes and indirectly improve nutrition. The entire health system needs to be revitalized to overcome the constraints that exist at the levels of policy, governance, and service-delivery, and also for the creation of demand for the services at the household level. In addition, management of nutrition in the aftermath of natural disasters and stabilization of prices of foods should also be prioritized.

Acute Coronary Syndrome in the Young - Risk Factors and Angiographic Pattern.

Coronary artery disease (CAD) is a worldwide health epidemic. Acute coronary syndrome is a potentially life-threatening condition and patient may die or become disabled in the prime of life. There is documented evidence that South Asian people develop CAD at a higher rate and also at an early age. If the affected individual is 40 yrs old or below, the tragic consequences are catastrophic. Methods: It was a retrospective observational study to find out the pattern of acute coronary syndrome in the young (40 years old or less) in a military hospital (CMH Dhaka) from July 2007 to July 2008 and to analyze the risk factors and the angiographic characteristics of coronary vessels. Consecutive 64 young patients including both male and female admitted into this hospital were the study subjects. Out of these patients 53 were males and 11 were females. Among these patients coronary risk factors and angiographic pattern were studied. 64 older patients with Acute coronary syndrome (age more than 40 years) were also studied. Results: Out of 64 young patients 15.6% patients presented to this hospital as UA, 9.37% presented as Non-Q MI, 28.12% Acute Anterior MI, 14.06% Acute Anteroseptal MI, 26.56% Acute Inferior MI, 6.25% Acute Infero-posterior MI. Smoking was the most common risk factor among these young patients. 64.06 % patients were smoker. Dyslipidaemia was present among 50 % patients, 37.55 % were hypertensive, 15.62% were diabetic, and 15.62 % were obese. SVCAD was the most common lesion and it was 53.12 %. 26.56% patients had DVCAD and TVCAD was present among 20.31 % patients. In the older group (more than 40 years) most common risk factor was dyslipidaemia (71.88%) and smoking was present among 48.43% patients. Conclusion: Young patients have a different risk factor profile in comparison with older patients. Smoking is a strong and quite common coronary risk factor in the young ACS patients who are 40 years or less. Risk factor identification and control is very crucial in the primary and secondary prevention in young patients with CAD.

Genetic variation of wild and hatchery populations of the catla Indian major carp (Catla catla Hamilton 1822: Cypriniformes, Cyprinidae) revealed by RAPD markers

Genetic variation is a key component for improving a stock through selective breeding programs. Randomly amplified polymorphic DNA (RAPD) markers were used to assess genetic variation in three wild population of the catla carp (Catla catla Hamilton 1822) in the Halda, Jamuna and Padma rivers and one hatchery population in Bangladesh. Five decamer random primers were used to amplify RAPD markers from 30 fish from each population. Thirty of the 55 scorable bands were polymorphic, indicating some degree of genetic variation in all the populations. The proportion of polymorphic loci and gene diversity values reflected a relatively higher level of genetic variation in the Halda population. Sixteen of the 30 polymorphic loci showed a significant (p < 0.05, p < 0.01, p < 0.001) departure from homogeneity and the F ST values in the different populations indicated some degree of genetic differentiation in the population pairs. Estimated genetic distances between populations were directly correlated with geographical distances. The unweighted pair group method with averages (UPGMA) dendrogram showed two clusters, the Halda population forming one cluster and the other populations the second cluster. Genetic variation of C. catla is a useful trait for developing a good management strategy for maintaining genetic quality of the species.

Sensory Neuropathy in Hypothyroidism : Electrophysiological and Clinical Findings.

Peripheral neuropathy may be a manifestation of hypothyroidism which usually develops insidiously over a long period of time due to irregular taking of drugs or lack of thyroid hormone replacement. The present study was designed to observe the clinical and electro-physiological findings in hypothyroid patients in order to evaluate the neuromuscular dysfunction as well as sensory neuropathy. For this purpose, 70 subjects with the age range of 20 to 50 years of both sexes were included in the study. Among them, 40 hypothyroid patients were taken in study group (Group B) and 30aparently healthy subjects were taken as control (Group A). On the basis of their TSH levels, group B was further divided into group B1 with TSH <60 MIU /L or (less severe) and group B2 with TSH >60 MIU /L (severe group). The duration of the disease ranged from 6 months to 5 years. All the hypothyroid patients were selected from Thyroid Clinic, Center of Nuclear Medicine and Ultra sound, Dhaka Medical College and Hospital, Dhaka, during the period from January 2005 to December 2005. Healthy subjects were selected from personal contact. Most of the hypothyroid patients were under hormone replacement therapy. Diagnosis of hypothyroidism was done by serum levels of TT3, TT4 and the TSH. In this study, both TT3, TT4 levels were significantly (P<0.01) lower in hypothyroids in comparison to those of control. The patients were searched for the clinical signs of sensory neuropathy. Clinical findings revealed diminished or absence of most of the deep tendon reflexes. The nerve conduction studies for sensory nerve function were done in all the subjects by electrophysiological technique. All the tests were done in median and ulnar nerve for upper limb and in sural nerve for lower limb and these parameters were measured on the day 1 (one) of their first visit. Data were compared among the different groups. Most of the patients had higher sensory distal latencies (SDL) with lower conduction velocities (SNCV) which were more marked in severe cases. About 67.5% of hypothyroid patients had shown abnormal sensory NCV when compared to that of euthyroids. Therefore, this study concludes that sensory neuropathy may be a consequence of hypothyroidism.

Bilateral giant angiomyolipoma of kidneys: a case report and review of literature.

Angiomyolipoma is uncommon benign tumor of the kidney. Bilateral and multiple lesions are associated with tuberous sclerosis. We report a case with bilateral giant angiomyolipomas in a patient who had no other features of tuberous sclerosis. In this case, the involvement of the kidneys was diffuse rather than usual well-circumscribed lesions.

Energy intake and expenditure of obese and non-obese urban Bangladeshi children.

A case control study was conducted in Dhaka city to measure the energy intake and expenditure among 220 obese children of 4-10 years age group and 220 randomly selected age and sex matched controls. A 24 hour dietary recall was used to assess the energy intake. Data on energy expenditure was obtained by 24 hour physical activity recall. The mean energy intake of obese children (2056 +/- 751 kcal/d) was found to be significantly higher (P<0.001) compared to the non obese (1508 +/- 529 kcal/d). No sex difference was found in both obese and non obese groups. Mean energy expenditure of the obese children (1868 +/- 313 kcal/d vs 1495 +/- 200 kcal/d) was significantly higher than the non-obese (P<0.001). Of the obese, boys expended more energy than the girls (P=0.01). Furthermore, physical activity level (1.40 +/- 0.09 vs 1.35 +/- 0.14) was significantly higher among the non obese than their obese counterpart (P<0.001). However, energy balance was significantly higher among the obese (P<0.001). Dose response of energy balance shows the estimated relative risk of obesity increases with higher level of energy balance (P<0.001). The findings of this study revealed that energy balance as a result of higher energy intake and lower energy expenditure was one of the important risk factors for the development of obesity among the children of Dhaka city. Thus, appropriate interventions like behavioural change regarding food habits and physical activities are recommended.

Prevalence of home deliveries and antenatal care coverage in some selected villages.

A cross sectional study was conducted in 14 selected villages of Gazipur Thana with the aim to find the prevalence of home deliveries and ante natal care coverage. All those females who delivered in the recent past (within last three months) from the selected villages were the study population Data were collected by two trained interviewers with a semi-structured interview schedule. Study result shows that 83% of the respondents received ante natal check-up throughout their last pregnancy. Most of this group (88.5%) received this care from "Health Assistant or 'Family Welfare visitor's while only 3.1% received care from graduate doctors. Out of 505 respondents 91.3% of the respondents was found to have delivered at home while only 8.7% at institutions. Study findings also suggested that there was association of place of delivery with level of education and family income of the respondents. Also there was associations of utilisation of antenatal care with level of education and family income of the respondents.

Effect of pulsed electromagnetic field on healing of experimental nonunion in rat tibiae.

To see the effect of Pulsed Electromagnetic Field (PEMF) on nonunited fracture healing, nonunion was induced in rat tibiae and PEMF was applied on it. Out of five different techniques utilised for inducing nonunion soft tissue interposition was found to be the most suitable and effective method of experimental induction of nonunion. Twenty eight experimental and 15 control rats were finally evaluated for the effect of PEMF applied for up to 8 weeks. After sacrifice of 8 experimental and 4 controls, 6 experimental and 3 controls, again 6 experimental and 3 controls and finally 8 experimental and 5 controls at 2, 4, 6 and 8 weeks respectively of PEMF application no significant difference as to the quality of healing was observed between the experimental and control animals. It was thus concluded that PEMF appeared to have no beneficial effect on the healing of nonunited fractures in experimental set-up.