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Background: Cardiovascular diseases (CVDs) are the leading cause of death in developing nations, especially in low and middle-income countries (LMICs). Bangladesh has been undergoing an epidemiological transition from communicable to non-communicable diseases. This study aimed to investigate the association of risk factors with coronary heart disease (CHD) in patients from Bangladesh. Methods: This cross-sectional observational study was conducted in the department of cardiology, Chattogram Medical College and Hospital, Chattogram, Bangladesh from July 2018 to June 2019. A total of 100 patients were enrolled. Results: This cross-sectional study enrolled 100 CHD patients with a mean age of 53.21±10.29 years. The majority were obese (64, 64.0%), and hypertension was the most prevalent risk factor (77, 77.0%), followed by smoking (65, 65.0%) and dyslipidemia (58, 58.0%). Most patients had triple vessel disease (53, 53.0%), and significant CHD (81, 81.0%). Patients with severe CHD had higher levels of blood LDL-C, triglycerides, and Lp(a). Lp(a) levels, history of dyslipidemia, and LDL-C were independently associated with a Gensini score ?20. These findings emphasize the independent association between Lp(a) and CHD severity, warranting greater attention to patients with elevated Lp(a) levels. Conclusions: This study suggested that Lp(a) is an independent risk factor for CHD in patients from Bangladesh. More attention should be paid to such patients with elevated Lp(a) level.
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Background: Coronary artery disease is a type of heart disease where the arteries of the heart cannot deliver enough oxygen-rich blood to the heart. This study aimed to evaluate the association between neutrophil to lymphocyte ratio (NLR) with the severity of coronary artery diseases. Methods: This cross-sectional study was conducted in the Department of Cardiology, Chittagong Medical College Hospital, Chattogram, Bangladesh during the period from 1 July 2020 to 31 June 2021. 160 patients undergoing elective coronary angiography with the symptoms of coronary artery disease were enrolled in this study. A purposive sampling technic was used. The association between NLR and Gensini score was assessed using Pearson’s or Spearman’s correlation analysis as appropriate. All data were processed, analyzed and disseminated by using MS Excel and SPSS version 23.0 program as per necessity. Results: The mean (±SD) Gensini score of our participants was 42.75 (±29.50) and the mean (±SD) NLR (Neutrophil-lymphocyte ratio) was 2.38 (±1.11). In this study, the AUROC for NLR was found as 0.851 with a P-value of <0.001, indicating a statistically significant association of NLR with the severity of CAD. The scatter dot diagram showed the correlation between NLR and Gensini score. Both the variables were positively correlated and the degree of correlation was found statistically significant (r=0.44; p<0.001) by Pearson’s correlation test. The multivariate logistic regression analysis showed that a high level of NLR had an independent association with severe CAD (with OR being 3.308) along with dyslipidemia. Conclusion: High blood NLR is associated with the severity of CAD and it may be useful for predicting angiographically severe disease.
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Background: Coronary artery disease (CAD) is a major global health issue. Serum uric acid (SUA), a byproduct of purine metabolism, is linked to CAD development and progression. Elevated SUA levels are an independent risk factor for cardiovascular mortality and may indicate endothelial dysfunction. The aim of the study was to the observed associate serum uric acid level with the angiographic severity of CAD. Methods: This observational study was conducted at Chittagong medical college hospital in Bangladesh from October 2020 to September 2021. It included 130 patients and used unpaired t-tests to analyze the association between serum uric acid level and angiographic severity of CAD patients. Ethical clearance was obtained from the institutional review board of Chittagong medical college and hospital. Results: A study of 130 patients found a significant relationship between serum uric acid (SUA) levels and CAD (CAD), vessel involvement, and CAD severity (p=0.001). Patients with CAD had higher SUA levels (mean 5.26±1.32 mg/dL) compared to those without CAD (mean 4.22±1.03 mg/dL). A SUA level range of 3.94-6.58 mg/dL was associated with CAD presence. Gender also showed a highly significant association with SUA levels (p=0.001), while age, BMI, and smoking status did not show significant differences. Conclusions: A strong positive association has been found between serum uric acid level and the severity of CAD. The findings of this study approve the effectiveness of hyperuricemia as an emerging risk factor for CAD.
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Background: Coronary artery disease (CAD) is a major global health issue. Serum uric acid (SUA), a byproduct of purine metabolism, is linked to CAD development and progression. Elevated SUA levels are an independent risk factor for cardiovascular mortality and may indicate endothelial dysfunction. The aim of the study was to the observed associate serum uric acid level with the angiographic severity of CAD. Methods: This observational study was conducted at Chittagong medical college hospital in Bangladesh from October 2020 to September 2021. It included 130 patients and used unpaired t-tests to analyze the association between serum uric acid level and angiographic severity of CAD patients. Ethical clearance was obtained from the institutional review board of Chittagong medical college and hospital. Results: A study of 130 patients found a significant relationship between serum uric acid (SUA) levels and CAD (CAD), vessel involvement, and CAD severity (p=0.001). Patients with CAD had higher SUA levels (mean 5.26±1.32 mg/dL) compared to those without CAD (mean 4.22±1.03 mg/dL). A SUA level range of 3.94-6.58 mg/dL was associated with CAD presence. Gender also showed a highly significant association with SUA levels (p=0.001), while age, BMI, and smoking status did not show significant differences. Conclusions: A strong positive association has been found between serum uric acid level and the severity of CAD. The findings of this study approve the effectiveness of hyperuricemia as an emerging risk factor for CAD.
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Background: Coronary artery disease (CAD) is the primary cause of death in developed countries and is one of the leading causes of disease burden in developing countries. Methods: This descriptive cross-sectional study included 124 purposively selected patients who underwent elective CAG in the department of cardiology, Chittagong medical college hospital, Chattogram, from July 2020 to June 2021. SPSS 23.0 software was used for processing and analysis at the end of the data collection period. Results: According to the Gensini score, patients were categorized into two groups (score <30 and ?30). There were no significant differences between the two groups concerning BMI, smoking, hypertension, DM, F/H of CAD, statin or beta-blocker use, or the levels of hemoglobin, hematocrit, MCV, MCH MCHC, and creatinine. However, the mean age was older, and there were more males in the severe CAD group. The percentage of dyslipidemia was significantly higher in patients with Gensini score ?30 than in patients with <30. RDW (OR: 2.629; 95% CI: 1.425-4.484; p=0.002) and age (OR: 1.058; 95%CI: 1.00-1.111; p=0.027) were independently correlated with the severity of CAD. The AUROC for red cell distribution width (RDW) was 0.915 with a p<0.001 for predicting CAD on CAG. It indicated a statistically significant association of RDW with the presence of CAD. A cut-off value of 13.65% RDW had a sensitivity of 80% and specificity of 84.2% for the prediction of CAD. There were no significant differences between patients with and without angiographic CAD for BMI, hypertension, DM, statin, or beta-blocker use, or of the levels of hemoglobin, hematocrit, MCV, MCH, MCHC, and creatinine. However, the mean age was older, and there were more males in the CAD group. The percentage with dyslipidemia, smoking, and F/H of CAD was significantly higher in patients with CAD than in patients without CAD. The data indicate that only RDW was independently correlated with the presence of CAD (OR: 2.593; 95% CI: 1.347-4.989; p=0.004). Conclusions: RDW is associated with the presence of CAD and suggests that it might be a readily available test for predicting coronary artery diseases.
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Background: Subclinical myocardial dysfunction may exist in post-COVID-19 patients and may carry significance in long term. Methodology: Subjects of long-COVID-19 with historically and radiologically significant pulmonary involvement (without documented cardiac involvement) were evaluated on outpatient follow-up echocardiographically when they had disproportionate shortness of breath (SOB), fatigue, or high pulse rate as perceived by the physicians. The common acute-phase symptoms were noted and scored retrospectively. The assessment included spirometry and measurement of chronic obstructive pulmonary disease (COPD) assessment test (CAT) score with measurement of the left ventricular (LV) and right ventricular (RV) free wall global longitudinal strain as an adjunct to routine two-dimensional and Doppler echocardiography and spirometry. The results were evaluated statistically with respect to the history of hospitalization. Results: The hospitalized (n = 15) and nonhospitalized (n = 10) patients were demographically similar. However, the nonhospitalized patients had higher total symptom score (p = 0.03), anosmia (p = 0.017), and ageusia (p = 0.0019). At follow-up (>3 months of acute illness), the nonhospitalized patients had a better CAT score (p = 0.04), higher change in max pulse rate (p = 0.03), and higher forced expiratory volume in 1 second (FEV1) (p = 0.002), tricuspid annular plane systolic excursion (TAPSE) (p = 0.02), and left ventricular global longitudinal strain (LVGLS) (–17.15 ± 1.19 vs –13.11 ± 1.91) (p = 0.0001). Overall, the two groups formed distinct clusters. The LVGLS and the maximum pulse rate difference in the two chair test (2CT) seem to contribute maximally to the variance between the two groups in multivariate analysis. Conclusion: The subclinical myocardial dysfunction persisting in post-COVID patients (without suspected cardiac affection and lower neuroinflammatory symptoms in the acute phase) with significant pulmonary affection needs further evaluation. They demonstrate a higher max pulse rate difference in the 2CT. This real-world observation demands further investigations
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Understanding the etiology and the tempo of progression with inexorable and self-perpetuating fibrosis [identification of progressive-fibrotic (PF) phenotype of interstitial lung disease (ILD) (PF-ILD)] can help to decide the treatment of diffuse parenchymal lung disease (DPLD) in the real-world practice. An evidence-supported pragmatic approach has been forwarded for such circumstances.
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Callosobruchus chinensis (L.) (Coleoptera: Bruchidae) is one of the major insect pest infesting stored pulses in India. Recourse of synthetic insecticides to protect stored pulses often lead to dangers of the development of resistant strains, toxic residue and users safety. Locally available and less toxic pest management alternatives such as the use of effective botanicals are important. Essential oils of two variants of Cinnamomum verum Presl. Syn. C. zelanicum Blume from North East India (RRL J 1620 and RRL J 1622) were characterized and tested for their biological activity in vapour form against Callosobruchus chinensis (L.). Choice and no-choice tests showed that leaf and bark oil of two variants of C. verum Presl. had significant repellent action and reduced the fecundity and decreased egg hatchability of C. chinenisis (L.). However, leaf oil with higher percentage of eugenol exhibited better activity than the bark oil in both the tests. Hence, the volatile essential oils of both the variants of C. verum Presl. can be used safely as fumigants.
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The aim of this study was to optimize cultural conditions for optimum growth and bioactive metabolite production by Aspergillus strain TSF 146, isolated from the subsurface soils of Brahmaputra plains, Assam, India. Agar disc diffusion assay was used to examine the antagonistic activity of the strain. The effect of different culture media, temperature, pH, incubation period, shaking, inoculum size and various carbon and nitrogen sources on the mycelial growth and bioactive metabolite production in a fixed volume of culture broth were studied. Aspergillus strain TSF 146 grew well and produced optimum bioactive metabolites in Potato dextrose broth medium at 25 °C on the 14th day of the incubation. The optimal mycelial growth, however, was obtained at pH 5.5. Sucrose (2.0 g/l) and asparagine (1.0 g/l) were the best carbon and nitrogen sources respectively for optimum growth and production of active metabolites by the isolate. Inoculum size of 2x1010 spores/ml with periodic shaking at 150 rpm optimized production of bioactive molecules. The results of the present investigation indicated that cultural conditions like carbon, nitrogen and mineral sources as well as physical factors such as temperature, pH, incubation period, inoculum size and shaking greatly affected the growth and production of bioactive metabolites by Aspergillus strain TSF 146.
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Emphysematous bullae are closed air containing spaces in lung parenchyma that may severely compromise lung function in patients of chronic obstructive pulmonary disease (COPD). We describe a simple and minimally invasive procedure to decompress a large emphysematous bullae in a patient with advanced COPD and high surgical risk. Transthoracic decompression of the bulla was accomplished under short-acting anaesthesia and muscle relaxation resulting in significant symptomatic, radiological and functional improvement.
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Décompression chirurgicale , Humains , Mâle , Adulte d'âge moyen , Emphysème pulmonaire/diagnostic , Emphysème pulmonaire/étiologie , Emphysème pulmonaire/chirurgie , ThoraxRÉSUMÉ
Encephalitis is an uncommon manifestation of dengue fever. Here we present a 4-year-old female child from northeastern India with dengue encephalitis. To our knowledge, this is the first reported case of dengue encephalitis from this region.
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Association of symmetric peripheral gangrene (SPG) with falciparum malaria infection is a relatively uncommon clinical entity. Here we report a case of complicated falciparum malaria with SPG involving both lower limbs from the mid-calf downwards, probably due to antibody mediated vasculitis.
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Antipaludiques/administration et posologie , Enfant , Gangrène/traitement médicamenteux , Humains , Perfusions veineuses , Jambe/anatomopathologie , Paludisme à Plasmodium falciparum/complications , Mâle , Quinine/administration et posologieRÉSUMÉ
Arabinosylated lipoarabinomannan (Ara-LAM), a surface glycolipid antigen isolated from avirulent Mycobacterium smegmatis is involved in modulation of host cell signaling. In this study, we investigated Ara-LAM-mediated modulation of impaired immune responses during visceral leishmaniasis caused by protozoan parasite Leishmania donovani. Ara-LAM treatment at dose of 3 microg/ml in L. donovani infected murine peritoneal macrophages as well as J774A.1 macrophage cell line exhibited a distinct up-regulation of pro-inflammatory cytokines like TNF-alpha and IL-12 both at the protein and transcriptional level. In addition, generation of nitric oxide and iNOS expression were also observed. The present study showed that Ara-LAM was significantly effective in elimination of L. donovani parasites from both peritoneal as well as J774A.1 macrophages. Thus, it could be utilized as an immunomodulatory agent in prevention of leishmanial pathogenesis.
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Animaux , Cellules cultivées , Relation dose-effet des médicaments , Immunité innée/effets des médicaments et des substances chimiques , Facteurs immunologiques/administration et posologie , Leishmania donovani/immunologie , Lipopolysaccharides/administration et posologie , Macrophages/effets des médicaments et des substances chimiques , Souris , Souris de lignée BALB CRÉSUMÉ
Malaria is still the most prevalent and devastating parasitic disease worldwide. In recent years drug resistance Plasmodium falciparum malaria has returned to most of the tropical countries of the globe with a vengeance. Due to various atypical manifestations the diagnosis has become confusing and hence the treatment delayed leading to various complications and increased mortality and morbidity. Patient presents with features of severe complicated malaria with multiorgan involvement in the form of malarial crisis needs emergency management in ICU. All fever cases with possible malaria should be investigated and to be treated with intravenous quinine/artimisinine pending confirmation of diagnosis. Any emergency situation that develops during treatment should be treated aggressively as medical emergency.
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Adulte , Antipaludiques/usage thérapeutique , Enfant , Médecine d'urgence/méthodes , Fièvre , Humains , Paludisme à Plasmodium falciparum/complicationsRÉSUMÉ
Let alone the eradication, malaria control itself has amounted to be a challenge, and is detrimental to the all round development of the northeastern region of India. Focal outbreaks are frequent taking heavy tool on human lives. Plasmodium falciparum is the predominant parasite species and is solely responsible for increased morbidity and mortality. The region contributes bulk of P. falciparum cases for the rest of India, and its proportions are increasing. Efficient vectors like Anopheles minimus, Anopheles fluviatilis and Anopheles dirus persistently support transmission of malaria. The present review gives a comprehensive account of the factors responsible for transmission of the disease with focus on vector bionomics, its prevention and control.
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Animaux , Anopheles/parasitologie , Contrôle des maladies transmissibles , Prédisposition aux maladies/parasitologie , Écosystème , Humains , Incidence , Inde/épidémiologie , Lutte contre les insectes/méthodes , Vecteurs insectes/parasitologie , Paludisme à Plasmodium falciparum/épidémiologie , PrévalenceRÉSUMÉ
Primary orbital lymphoma is a rare condition involving primarily the lacrimal glands. We present the second Indian case of right-sided primary orbital lymphoma in an elderly male who presented with the typical features and showed a good response to chemotherapy.
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Diagnostic différentiel , Humains , Appareil lacrymal/anatomopathologie , Lymphome malin non hodgkinien/diagnostic , Mâle , Adulte d'âge moyen , Tumeurs de l'orbite/diagnosticRÉSUMÉ
Due to presence of natural mutant bacilli, existence of the bacilli in several populations and in various sites, combination of two, three or more drugs is necessary to treat tuberculosis and that too for a long time. Inadequate therapy leads to relapse and treatment failure. The cumulative effect of negligence, mistakes and new threats (e.g., HIV infection) has made the treatment difficult today. The National Tuberculosis Control Programme of 1962 has been modified recently by Revised National Tuberculosis Control Programme. The targets are to detect at least 70% of new smear positive cases and to achieve at least 85% cure rate by Directly Observed Therapy Short course (DOTS). Categorisation of patients and treatment recommendations are discussed along with pharmacology of antituberculosis drugs.
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Infections opportunistes liées au SIDA/traitement médicamenteux , Antituberculeux/effets indésirables , Relation dose-effet des médicaments , Calendrier d'administration des médicaments , Association de médicaments , Humains , Inde , Tuberculose pulmonaire/traitement médicamenteuxRÉSUMÉ
Injection of Salmonella typhi 'H' antigen was observed to produce a differential effect on bone marrow and thymus secretory profile depending upon the nutritional status of the host. The paracrine effect of Thy F1 (thymus fraction 1) was more significant (P < 0.01) than the autocrine effect of BIM (Bone marrow immunomodulator) in malnourished mice. BIM moreover, also had a paracrine effect on thymus irrespective of the nutritional status of the host. An improvement in neutrophil population (P < 0.01) and phagocytic myeloperoxidase activity (P < 0.01) was observed in BIM treated malnourished immuno-suppressed mice, whereas no appreciable change was observed by Thy F1. However, Thy F1 irrespective of the nutritional status of the host improved large lymphocyte population in circulation (P < 0.01). These findings indicate that both bone marrow and thymus play a major role in haemopoietic microenvironment of BDF (basal diet fed) control and malnourished mice.
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Animaux , Cellules de la moelle osseuse/physiologie , Cellules cultivées , Hématopoïèse/physiologie , Homéostasie/physiologie , Système immunitaire/physiologie , Mâle , Souris , Granulocytes neutrophiles/immunologie , Troubles nutritionnels/immunologie , Phagocytose/physiologie , Protéines/physiologie , Thymus (glande)/cytologieRÉSUMÉ
Successful implantation of blastocyst is dependent upon a cytokine induced localized immunosuppression at uterus. BIM, a bone marrow secreted bio-immunomodulator (BIM) has been observed to have positive immunomodulatory activity in immunosuppressed cases. As pregnancy is associated with immunosuppression upregulation of the suppressed immune system by injection of BIM (conc. 0.08 microg/g b.wt once in rats b.wt. <150 gm or 0.2 microg/g b.wt thrice in rats weighing > 160 gm) is believed to prevent implantation. The anti-implantation action of BIM is probably mediated via mononuclear cells at site of uterus, the effect is reversible and a single dose did not affect the estrous cycle. Multiple dose of BIM however, produce prolonged diestrous and this is probably an autonomic phenomena.
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Adjuvants immunologiques/isolement et purification , Animaux , Composés azoïques/composition chimique , Liquides biologiques/cytologie , Moelle osseuse/composition chimique , Cytokines/immunologie , Implantation embryonnaire/effets des médicaments et des substances chimiques , Femelle , Numération des leucocytes/effets des médicaments et des substances chimiques , Mâle , Grossesse , Rats , Lymphocytes T/effets des médicaments et des substances chimiques , Bleu de trypan , Utérus/cytologieRÉSUMÉ
Treatment with hepatotoxin namely carbon tetrachloride (CCl4) (0.1 ml/100 g of body weight; twice a week) induced acute hepatic necrosis in Swiss albino mice (male; body weight 30 g +/- 2), with significant alteration in the activities of glutamic oxaloacetic transaminase (GOT); glutamic pyruvic transaminase (GPT); alkaline phosphatase (AP) and serum bilirubin. Administration of a protein fraction isolated from the leaves of C. indicus counteracted the action of CCl4 on transaminase, phosphatase showing hepatoprotection. Daily treatment with a purified protein fraction 'X' from the above plant (0.5 mouse ml i.p; 50-60 micrograms/ml) for a period of 7, 14, 21 days respectively showed decreased activities of serum transaminases alkaline phosphatase and decreased levels of serum bilirubin. These findings were further confirmed by histopathological study of liver.