Comparison of the incidence of post-ERCP pancreatitis between combined rectal indomethacin and sublingual nitroglycerin with that of rectal indomethacin alone

Background: Endoscopic retrograde cholangiopancreatography (ERCP) is now widely accepted as a therapeutic modality for benign and malignant diseases of the pancreaticobiliary tree. Acute pancreatitis is the most common and feared complication of ERCP, associated with substantial morbidity and mortality. This study aimed to compare the incidence of post-ERCP pancreatitis in combined rectal indomethacin and sublingual nitroglycerin with that of rectal indomethacin alone. Methods: This was a randomized controlled trial conducted in the Department of Gastroenterology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh during the period from July, 2019 to September, 2020. In this study, 100 hospitalized patients of >18 years age undergoing ERCP based on clinical indication and proper investigation were included. The study population was randomly divided into two groups - group A (patients who were given indomethacin suppository plus sublingual glyceryl trinitrate) and group B (patients who were given indomethacin alone). Results: In this study, we found that PEP developed in 11 out of 100 patients (11%). Post-ERCP pancreatitis developed in 2 (4%) in group A and 9 (18%) in group B (p=0.025), which was statistically significant. Mild PEP developed in none in group A and 4 (8%) in group B whereas moderate in 2 (4%) in group A and 3 (6%) in group B. Severe pancreatitis occurred in none in group A and 2 (4%) in group B (p=0.231) which was not statistically significant. Conclusions: This study showed that the combination of indomethacin suppository and sublingual GTN is superior to indomethacin suppository alone in preventing post-ERCP pancreatitis.

Risk stratification of newly diagnosed multiple myeloma patients

Background: Multiple Myeloma is a neoplastic proliferation of plasma cells, associated with an M (monoclonal) protein in serum and/or urine and evidence of organ damage. Despite advances in treatment, the disease remains heterogeneous, necessitating a comprehensive understanding of its risk stratification. Risk-adapted initial therapy, maintenance therapy, refractory disease management and prognosis varies according to risk group. The aim of our study is to categorize the newly diagnosed MM patients according to their risk groups. Methods: This cross-sectional observational study was conducted at the Department of Haematology of Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh, from August 2019 to July 2020. A total of 31 newly diagnosed MM patients were enrolled based on specific inclusion and exclusion criteria. Risk stratification was performed using ISS, R-ISS, mSMART criteria and Avets risk group categorization. Result: The majority of the patients were male (64.52%) and aged between 55-64 years (45.16%). Clinical features predominantly included low back pain (74.19%) and general weakness (38.71%). Cytogenetic abnormalities were noted in 38.7% of the patients, with del (13q) being the most common (32.30%). Most patients were in ISS Stage III (70.97%) and R-ISS Stage II (48.39%). According to mSMART criteria, 80.65% were at standard risk while Avet's risk stratification identifies 58.06% were at intermediate risk. Conclusion: The study reveals a high prevalence of patients in advanced ISS stages and intermediate to high-risk categories, emphasizing the need for early and personalized intervention strategies.

Quality of life of workers with disabilities in readymade garments factories in Bangladesh

Background: Bangladesh's readymade garment (RMG) sector has developed as a major employer for individuals with disabilities. The number of workers with disabilities in Bangladesh's RMG industry has grown over the past few years. In Bangladesh, there has no statistics about the quality of life of workers with disabilities after their employment, especially after training-based employment support. Therefore, the researcher is interested to find out the quality of life of workers with disabilities in readymade garments factories in Bangladesh that will determine satisfaction over their life in different aspects. The objectives of this paper were to find out the health-related quality of life and overall satisfaction with life among workers with disabilities in the readymade garment sector in Bangladesh. Methods: This study used a cross-sectional design and recruited 102 participants with disabilities from various Bangladeshi garment factories who ranged up to 18 years by convenient sampling. The WHOQOL questionnaires were used for data collection through a combination of telephone and in-person interviews. Descriptive statistics were used for the data analysis. Results: Among the total participants 63% of them were women and 37% were men. The results revealed that education and job status significantly impacted on QOL. The majority of participants did not need any assistive devices; most of the participants resided in semi-urban areas, and physical disabilities predominated among them. On the other hand, most of the participants reported their quality of life as neither poor nor good but they were satisfied with health-related QOL. Conclusions: QOL is a vast aspect of every human being. This study finally concluded the overall QOL of maximum Workers with Disabilities in Readymade Garments Factories in Bangladesh was just average and most of them were satisfied with their health-related QOL.

Quality of life of workers with disabilities in readymade garments factories in Bangladesh

Background: Bangladesh's readymade garment (RMG) sector has developed as a major employer for individuals with disabilities. The number of workers with disabilities in Bangladesh's RMG industry has grown over the past few years. In Bangladesh, there has no statistics about the quality of life of workers with disabilities after their employment, especially after training-based employment support. Therefore, the researcher is interested to find out the quality of life of workers with disabilities in readymade garments factories in Bangladesh that will determine satisfaction over their life in different aspects. The objectives of this paper were to find out the health-related quality of life and overall satisfaction with life among workers with disabilities in the readymade garment sector in Bangladesh. Methods: This study used a cross-sectional design and recruited 102 participants with disabilities from various Bangladeshi garment factories who ranged up to 18 years by convenient sampling. The WHOQOL questionnaires were used for data collection through a combination of telephone and in-person interviews. Descriptive statistics were used for the data analysis. Results: Among the total participants 63% of them were women and 37% were men. The results revealed that education and job status significantly impacted on QOL. The majority of participants did not need any assistive devices; most of the participants resided in semi-urban areas, and physical disabilities predominated among them. On the other hand, most of the participants reported their quality of life as neither poor nor good but they were satisfied with health-related QOL. Conclusions: QOL is a vast aspect of every human being. This study finally concluded the overall QOL of maximum Workers with Disabilities in Readymade Garments Factories in Bangladesh was just average and most of them were satisfied with their health-related QOL.

Association between BMI and plantar fasciitis among hospital staff in a selected hospital of Dhaka city

Background: Plantar fasciitis described as the inflammation of planter fascia, particularly hampering an individual’s daily living activities related to ankle and foot that impact on quality of life. The study aimed to identify the association between BMI and planter fasciitis among hospital staff in a selected hospital in Dhaka city. Methods: A descriptive cross-sectional study. Results: Mean±SD age of the respondents were 29.03±6.56 years. Among the hospital staff, the majority of the respondents were nurses 31.25%, 13.02% respondents were physician and 2.07% of respondents were physiotherapists, others were pharmacist, lab technician, administration staff, cleaner, security, information technologists and officers from the maintenance department of selected hospital. According to BMI scale the 65% were normal weight, 23% were overweight and only 12% were obese. In this study respondents who have only two family members, have strong relationships with BMI (p<0.00). Besides, the duration of work has a slightly significant relation with BMI (p<0.03) and BMI has a strong impact on level of pain (p<0.01) among respondents. Conclusions: The recommendation for risk variables that have a strong correlation with plantar fasciitis is the working status, duration, and BMI.

Knowledge, attitude and practices regarding dengue and its vector among medical practitioners in Malakand region, Pakistan

Abstract Dengue fever (DF) is increasingly recognized as one of the worlds major mosquito borne diseases and causes significant morbidity and mortality in tropical and subtropical countries. Dengue fever is endemic in most part of Pakistan and continues to be a public health concern. Knowledge, attitude and practices can play an important role in management of the disease. Current study was aimed to determine the level of knowledge, attitude and practices regarding dengue fever among health practitioners, to study the level of knowledge and attitude with preventive practices for dengue fever. A cross sectional study was carried out in medical practitioners of the four districts of Malakand region during October to November 2019. A pre-structured questionnaire was used to collect data from medical practitioners. Data was analyzed using Graph Pad version 5. Significant value was considered when less than 0.05 (at 95% confidence of interval). The results revealed that most of participants have seen dengue vector (62%), the media being the most quoted source of information. Nearly 81.2% participants were aware from transmission of dengue fever is by mosquito bite. Practices based upon preventive measures were found to be predominantly focused towards prevention of mosquito bites rather than elimination of breeding places. Although the knowledge regarding DF and mosquito control measure was quite high among the medical practitioners but this knowledge was not put into practice. Further studies are required to aware the people about dengue and its vector in order to get prevention and control.

Resumo A dengue (DF) é cada vez mais reconhecida como uma das principais doenças transmitidas por mosquitos do mundo e causa significativa morbidade e mortalidade em países tropicais e subtropicais. A dengue é endêmica na maior parte do Paquistão e continua a ser um problema de saúde pública. Conhecimento, atitude e práticas podem desempenhar papel importante no manejo da doença. O presente estudo teve como objetivo determinar o nível de conhecimento, atitude e práticas em relação à dengue entre os profissionais de saúde, para estudar o nível de conhecimento e atitude com as práticas preventivas da dengue. Um estudo transversal foi realizado com médicos dos quatro distritos da região de Malakand de outubro a novembro de 2019. Um questionário pré-estruturado foi usado para coletar dados de médicos. Os dados foram analisados no Graph Pad versão 5. Valor significativo foi considerado quando menor que 0,05 (com intervalo de confiança de 95%). Os resultados revelaram que a maioria dos participantes já viu o vetor da dengue (62%), sendo a mídia a fonte de informação mais citada. Quase 81,2% dos participantes sabiam que a transmissão da dengue é por picada de mosquito. Constatou-se que as práticas baseadas em medidas preventivas se concentravam predominantemente na prevenção de picadas de mosquitos, e não na eliminação de criadouros. Embora o conhecimento sobre DF e medidas de controle de mosquitos fosse bastante elevado entre os médicos, esse conhecimento não foi colocado em prática. Mais estudos são necessários para conscientizar a população sobre a dengue e seu vetor, a fim de se obter prevenção e controle.

Prevalence of intestinal parasitic diseases in school children of rural areas of district Lower Dir, Pakistan / Prevalência de doenças parasitárias intestinais em escolares de áreas rurais do distrito de Lower Dir, Paquistão

Present study was conducted among school children to recognize the prevalence of IPIs in rural communities of district Dir Lower, Pakistan. A sum of 324 samples of stool were collected (210 boys and 114 girls). Used direct smear method and formol ether sedimentation concentration technique for processing the samples. The result shows that 82% (n=266) were found infected comprised 64.8% male and 35.1% females. Children of the age group 10 to 12 years were found extremely infected 94.2% while 4-6 year age group were having minimum ratio of infection 72%. Current study shows mono parasitism in 50.6% of the students while 22.2% were infected with 2 species and 7.40% were infected with three species of parasites. Seven species of intestinal parasites were reported include Ascaris lumbricoid in male (n=122) 58.0% and in female (n=65) 57.0% followed by Hook worm (n=88) 41.9% and (n=44) 38.5%; Tania saginata (n=44) 20.9% and (n=24) 21.0%; Entrobius vermicularis (n=32) 15.2% and (n=16) 14.0%; Trichuris trichura (n=25) 11.9% and (n=22) 19.2%; Hymenolepis nana (n=24) 11.4% and (n=18) 15.7% and Entameoba histolytica (n=16) 7.61% and (n=14) 12.2% in male and females respectively. The study indicates that most occurring intestinal parasite in the current study were Ascaris lumbricoides 58.0% (n=122) followed by hookworms 41.9% (n=88). Male students were more infected than females in the present study.

O presente estudo foi conduzido entre crianças em idade escolar para reconhecer a prevalência de IPIs em comunidades rurais do distrito de Dir Lower, Paquistão. Foram coletadas 324 amostras de fezes (210 meninos e 114 meninas). Método de esfregaço direto usado e técnica de concentração de sedimentação de formol éter para processar as amostras. O resultado mostra que 82% (n = 266) dos infectados eram 64,8% do sexo masculino e 35,1% do feminino. Crianças da faixa etária de 10 a 12 anos foram encontradas extremamente infectadas 94,2%, enquanto a faixa etária de 4 a 6 anos apresentava proporção mínima de infecção de 72%. O estudo atual mostra monoparasitismo em 50,6% dos alunos, enquanto 22,2% estavam infectados com 2 espécies e 7,40% estavam infectados com três espécies de parasitas. Sete espécies de parasitas intestinais foram relatadas incluindo Ascaris lumbricoid em machos (n = 122) 58,0% e em fêmeas (n = 65) 57,0% seguido por anzol (n = 88) 41,9% e (n = 44) 38,5%; Tania saginata (n = 44) 20,9% e (n = 24) 21,0%; Entrobius vermicularis (n = 32) 15,2% e (n = 16) 14,0%; Trichuris trichura (n = 25) 11,9% e (n = 22) 19,2%; Hymenolepis nana (n = 24) 11,4% e (n = 18) 15,7% e Entameoba histolytica (n = 16) 7,61% e (n = 14) 12,2% em homens e mulheres, respectivamente. O estudo indica que os parasitas intestinais que mais ocorreram no presente estudo foram Ascaris lumbricoides 58,0% (n = 122), seguidos por ancilóstomos 41,9% (n = 88). Estudantes do sexo masculino foram mais infectados do que do sexo feminino no presente estudo.

Parasitic contamination of fresh vegetables sold in open markets: a public health threat / Contaminação parasítica de vegetais frescos vendidos em mercados abertos: uma ameaça para a saúde pública

Vegetables eating raw are a leading source of transmission of infective forms of pathogenic internal parasites among human beings. This research was conducted from April to October, 2017 to assess the parasitic contamination of vegetables sold at main vegetable markets in districts Lower Dir and Peshawar, Pakistan. Eight hundred specimens of different vegetables were purchased and soaked in physiological saline solution, shaken with a mechanical shaker for 20 minutes and processed by sedimentation concentration method. Results revealed that only 19.7% (n=158/800) of the vegetables were found to be contaminated with single or multiple parasite species. Ascaris lumbricoides (the large round worm) 12.3% (n=99/800) was the most commonly detected pathogen and Taenia saginata (the beef tapeworm) 1.62% (n=13/800) was the least frequently detected one. Interestingly, significant p value (p>0.05 at 95%CI) between the number of examined and contaminated for all the variables studied including education status of the vendors, markets location, type of vegetables, means of display, washed before display, washing source of water and market type. The findings of this study evidenced that consumption of raw vegetables possesses great risk of getting parasitic infections in Lower Dir and Peshawar districts, Pakistan. Instructing the sellers and the public about parasitic disease transfer and their hygiene can reduce the infection rate of parasites of human origin.

Os vegetais crus são a principal fonte de transmissão de formas infecciosas de parasitas internos patogênicos entre os seres humanos. Esta pesquisa foi realizada de abril a outubro de 2017 para avaliar a contaminação parasitária de vegetais vendidos nos principais mercados de vegetais nos distritos de Lower Dir e Peshawar, Paquistão. Oitocentos exemplares de diferentes vegetais foram adquiridos e embebidos em solução salina fisiológica, agitados em agitador mecânico por 20 minutos e processados pelo método de concentração por sedimentação. Os resultados revelaram que apenas 19,7% (n = 158/800) das hortaliças estavam contaminadas com uma ou várias espécies de parasitas. Ascaris lumbricoides (o verme redondo grande) 12,3% (n = 99/800) foi o patógeno mais comumente detectado e Taenia saginata (a tênia da carne) 1,62% (n = 13/800) foi o menos freqüentemente detectado. Curiosamente, valor de p significativo (p> 0,05 em IC de 95%) entre o número de examinados e contaminados para todas as variáveis estudadas incluindo escolaridade dos vendedores, localização dos mercados, tipo de vegetais, meios de exposição, lavado antes da exposição, fonte de lavagem de água e tipo de mercado. Os resultados deste estudo evidenciaram que o consumo de vegetais crus possui grande risco de contrair infecções parasitárias nos distritos de Lower Dir e Peshawar, no Paquistão. Instruir os vendedores e o público sobre a transferência de doenças parasitárias e sua higiene pode reduzir a taxa de infecção de parasitas de origem humana.

Prevalence of intestinal parasitic diseases in school children of rural areas of district Lower Dir, Pakistan

Abstract Present study was conducted among school children to recognize the prevalence of IPIs in rural communities of district Dir Lower, Pakistan. A sum of 324 samples of stool were collected (210 boys and 114 girls). Used direct smear method and formol ether sedimentation concentration technique for processing the samples. The result shows that 82% (n=266) were found infected comprised 64.8% male and 35.1% females. Children of the age group 10 to 12 years were found extremely infected 94.2% while 4-6 year age group were having minimum ratio of infection 72%. Current study shows mono parasitism in 50.6% of the students while 22.2% were infected with 2 species and 7.40% were infected with three species of parasites. Seven species of intestinal parasites were reported include Ascaris lumbricoid in male (n=122) 58.0% and in female (n=65) 57.0% followed by Hook worm (n=88) 41.9% and (n=44) 38.5%; Tania saginata (n=44) 20.9% and (n=24) 21.0%; Entrobius vermicularis (n=32) 15.2% and (n=16) 14.0%; Trichuris trichura (n=25) 11.9% and (n=22) 19.2%; Hymenolepis nana (n=24) 11.4% and (n=18) 15.7% and Entameoba histolytica (n=16) 7.61% and (n=14) 12.2% in male and females respectively. The study indicates that most occurring intestinal parasite in the current study were Ascaris lumbricoides 58.0% (n=122) followed by hookworms 41.9% (n=88). Male students were more infected than females in the present study.

Resumo O presente estudo foi conduzido entre crianças em idade escolar para reconhecer a prevalência de IPIs em comunidades rurais do distrito de Dir Lower, Paquistão. Foram coletadas 324 amostras de fezes (210 meninos e 114 meninas). Método de esfregaço direto usado e técnica de concentração de sedimentação de formol éter para processar as amostras. O resultado mostra que 82% (n = 266) dos infectados eram 64,8% do sexo masculino e 35,1% do feminino. Crianças da faixa etária de 10 a 12 anos foram encontradas extremamente infectadas 94,2%, enquanto a faixa etária de 4 a 6 anos apresentava proporção mínima de infecção de 72%. O estudo atual mostra monoparasitismo em 50,6% dos alunos, enquanto 22,2% estavam infectados com 2 espécies e 7,40% estavam infectados com três espécies de parasitas. Sete espécies de parasitas intestinais foram relatadas incluindo Ascaris lumbricoid em machos (n = 122) 58,0% e em fêmeas (n = 65) 57,0% seguido por anzol (n = 88) 41,9% e (n = 44) 38,5%; Tania saginata (n = 44) 20,9% e (n = 24) 21,0%; Entrobius vermicularis (n = 32) 15,2% e (n = 16) 14,0%; Trichuris trichura (n = 25) 11,9% e (n = 22) 19,2%; Hymenolepis nana (n = 24) 11,4% e (n = 18) 15,7% e Entameoba histolytica (n = 16) 7,61% e (n = 14) 12,2% em homens e mulheres, respectivamente. O estudo indica que os parasitas intestinais que mais ocorreram no presente estudo foram Ascaris lumbricoides 58,0% (n = 122), seguidos por ancilóstomos 41,9% (n = 88). Estudantes do sexo masculino foram mais infectados do que do sexo feminino no presente estudo.

Parasitic contamination of fresh vegetables sold in open markets: a public health threat

Abstract Vegetables eating raw are a leading source of transmission of infective forms of pathogenic internal parasites among human beings. This research was conducted from April to October, 2017 to assess the parasitic contamination of vegetables sold at main vegetable markets in districts Lower Dir and Peshawar, Pakistan. Eight hundred specimens of different vegetables were purchased and soaked in physiological saline solution, shaken with a mechanical shaker for 20 minutes and processed by sedimentation concentration method. Results revealed that only 19.7% (n=158/800) of the vegetables were found to be contaminated with single or multiple parasite species. Ascaris lumbricoides (the large round worm) 12.3% (n=99/800) was the most commonly detected pathogen and Taenia saginata (the beef tapeworm) 1.62% (n=13/800) was the least frequently detected one. Interestingly, significant p value (p>0.05 at 95%CI) between the number of examined and contaminated for all the variables studied including education status of the vendors, markets location, type of vegetables, means of display, washed before display, washing source of water and market type. The findings of this study evidenced that consumption of raw vegetables possesses great risk of getting parasitic infections in Lower Dir and Peshawar districts, Pakistan. Instructing the sellers and the public about parasitic disease transfer and their hygiene can reduce the infection rate of parasites of human origin.

Resumo Os vegetais crus são a principal fonte de transmissão de formas infecciosas de parasitas internos patogênicos entre os seres humanos. Esta pesquisa foi realizada de abril a outubro de 2017 para avaliar a contaminação parasitária de vegetais vendidos nos principais mercados de vegetais nos distritos de Lower Dir e Peshawar, Paquistão. Oitocentos exemplares de diferentes vegetais foram adquiridos e embebidos em solução salina fisiológica, agitados em agitador mecânico por 20 minutos e processados pelo método de concentração por sedimentação. Os resultados revelaram que apenas 19,7% (n = 158/800) das hortaliças estavam contaminadas com uma ou várias espécies de parasitas. Ascaris lumbricoides (o verme redondo grande) 12,3% (n = 99/800) foi o patógeno mais comumente detectado e Taenia saginata (a tênia da carne) 1,62% (n = 13/800) foi o menos freqüentemente detectado. Curiosamente, valor de p significativo (p> 0,05 em IC de 95%) entre o número de examinados e contaminados para todas as variáveis estudadas incluindo escolaridade dos vendedores, localização dos mercados, tipo de vegetais, meios de exposição, lavado antes da exposição, fonte de lavagem de água e tipo de mercado. Os resultados deste estudo evidenciaram que o consumo de vegetais crus possui grande risco de contrair infecções parasitárias nos distritos de Lower Dir e Peshawar, no Paquistão. Instruir os vendedores e o público sobre a transferência de doenças parasitárias e sua higiene pode reduzir a taxa de infecção de parasitas de origem humana.

Prevalence of intestinal parasitic diseases in school children of rural areas of district Lower Dir, Pakistan / Prevalência de doenças parasitárias intestinais em escolares de áreas rurais do distrito de Lower Dir, Paquistão

Present study was conducted among school children to recognize the prevalence of IPIs in rural communities of district Dir Lower, Pakistan. A sum of 324 samples of stool were collected (210 boys and 114 girls). Used direct smear method and formol ether sedimentation concentration technique for processing the samples. The result shows that 82% (n=266) were found infected comprised 64.8% male and 35.1% females. Children of the age group 10 to 12 years were found extremely infected 94.2% while 4-6 year age group were having minimum ratio of infection 72%. Current study shows mono parasitism in 50.6% of the students while 22.2% were infected with 2 species and 7.40% were infected with three species of parasites. Seven species of intestinal parasites were reported include Ascaris lumbricoid in male (n=122) 58.0% and in female (n=65) 57.0% followed by Hook worm (n=88) 41.9% and (n=44) 38.5%; Tania saginata (n=44) 20.9% and (n=24) 21.0%; Entrobius vermicularis (n=32) 15.2% and (n=16) 14.0%; Trichuris trichura (n=25) 11.9% and (n=22) 19.2%; Hymenolepis nana (n=24) 11.4% and (n=18) 15.7% and Entameoba histolytica (n=16) 7.61% and (n=14) 12.2% in male and females respectively. The study indicates that most occurring intestinal parasite in the current study were Ascaris lumbricoides 58.0% (n=122) followed by hookworms 41.9% (n=88). Male students were more infected than females in the present study.

O presente estudo foi conduzido entre crianças em idade escolar para reconhecer a prevalência de IPIs em comunidades rurais do distrito de Dir Lower, Paquistão. Foram coletadas 324 amostras de fezes (210 meninos e 114 meninas). Método de esfregaço direto usado e técnica de concentração de sedimentação de formol éter para processar as amostras. O resultado mostra que 82% (n = 266) dos infectados eram 64,8% do sexo masculino e 35,1% do feminino. Crianças da faixa etária de 10 a 12 anos foram encontradas extremamente infectadas 94,2%, enquanto a faixa etária de 4 a 6 anos apresentava proporção mínima de infecção de 72%. O estudo atual mostra monoparasitismo em 50,6% dos alunos, enquanto 22,2% estavam infectados com 2 espécies e 7,40% estavam infectados com três espécies de parasitas. Sete espécies de parasitas intestinais foram relatadas incluindo Ascaris lumbricoid em machos (n = 122) 58,0% e em fêmeas (n = 65) 57,0% seguido por anzol (n = 88) 41,9% e (n = 44) 38,5%; Tania saginata (n = 44) 20,9% e (n = 24) 21,0%; Entrobius vermicularis (n = 32) 15,2% e (n = 16) 14,0%; Trichuris trichura (n = 25) 11,9% e (n = 22) 19,2%; Hymenolepis nana (n = 24) 11,4% e (n = 18) 15,7% e Entameoba histolytica (n = 16) 7,61% e (n = 14) 12,2% em homens e mulheres, respectivamente. O estudo indica que os parasitas intestinais que mais ocorreram no presente estudo foram Ascaris lumbricoides 58,0% (n = 122), seguidos por ancilóstomos 41,9% (n = 88). Estudantes do sexo masculino foram mais infectados do que do sexo feminino no presente estudo.

Parasitic contamination of fresh vegetables sold in open markets: a public health threat / Contaminação parasítica de vegetais frescos vendidos em mercados abertos: uma ameaça para a saúde pública

Vegetables eating raw are a leading source of transmission of infective forms of pathogenic internal parasites among human beings. This research was conducted from April to October, 2017 to assess the parasitic contamination of vegetables sold at main vegetable markets in districts Lower Dir and Peshawar, Pakistan. Eight hundred specimens of different vegetables were purchased and soaked in physiological saline solution, shaken with a mechanical shaker for 20 minutes and processed by sedimentation concentration method. Results revealed that only 19.7% (n=158/800) of the vegetables were found to be contaminated with single or multiple parasite species. Ascaris lumbricoides (the large round worm) 12.3% (n=99/800) was the most commonly detected pathogen and Taenia saginata (the beef tapeworm) 1.62% (n=13/800) was the least frequently detected one. Interestingly, significant p value (p>0.05 at 95%CI) between the number of examined and contaminated for all the variables studied including education status of the vendors, markets location, type of vegetables, means of display, washed before display, washing source of water and market type. The findings of this study evidenced that consumption of raw vegetables possesses great risk of getting parasitic infections in Lower Dir and Peshawar districts, Pakistan. Instructing the sellers and the public about parasitic disease transfer and their hygiene can reduce the infection rate of parasites of human origin.

Os vegetais crus são a principal fonte de transmissão de formas infecciosas de parasitas internos patogênicos entre os seres humanos. Esta pesquisa foi realizada de abril a outubro de 2017 para avaliar a contaminação parasitária de vegetais vendidos nos principais mercados de vegetais nos distritos de Lower Dir e Peshawar, Paquistão. Oitocentos exemplares de diferentes vegetais foram adquiridos e embebidos em solução salina fisiológica, agitados em agitador mecânico por 20 minutos e processados pelo método de concentração por sedimentação. Os resultados revelaram que apenas 19,7% (n = 158/800) das hortaliças estavam contaminadas com uma ou várias espécies de parasitas. Ascaris lumbricoides (o verme redondo grande) 12,3% (n = 99/800) foi o patógeno mais comumente detectado e Taenia saginata (a tênia da carne) 1,62% (n = 13/800) foi o menos freqüentemente detectado. Curiosamente, valor de p significativo (p> 0,05 em IC de 95%) entre o número de examinados e contaminados para todas as variáveis estudadas incluindo escolaridade dos vendedores, localização dos mercados, tipo de vegetais, meios de exposição, lavado antes da exposição, fonte de lavagem de água e tipo de mercado. Os resultados deste estudo evidenciaram que o consumo de vegetais crus possui grande risco de contrair infecções parasitárias nos distritos de Lower Dir e Peshawar, no Paquistão. Instruir os vendedores e o público sobre a transferência de doenças parasitárias e sua higiene pode reduzir a taxa de infecção de parasitas de origem humana.

Community Mangrove Aqua-Silviculture (CMAS Culture): An Innovation and Climate Resilient Practice by the Sundarbans Mangrove Forest Dependent Rural Communities of Bangladesh

To adapt to the emergent global climate impacts, the local communities of Khulna, Satkhira and Bagerhat districts in South-Western Bangladesh have spontaneously promoted a number of social innovation using their innovative ideas and traditional knowledge. The present study highlights on this practice called as Community Mangrove Aqua-Silvi-Culture (CMAS) to cultivate some floral and faunal species of the Sundarbans mangrove ecosystem. CMAS is a plot of swampy land with 1 to 1.5 feet deep water bordered by a dyke of 0.5 to1.5 feet height from the water level. The mangrove plant species in CMAS includes Goalpata (Nypa fruticans), Goran (Ceriops tagal), Keora (Sonnerata species), Hargoza (Alanthus ilicifolius), and Baen (Avicennia Species). Besides, there is a canal of about 2-2.5 feet depth that runs along the farm dykes where fish (Telapia, Vetki, Amadi, Tengra, Carps), shrimp (Bagda) and crabs are cultured. For in depth analysis of CMAS, face-to-face interview was conducted in 18 CMAS farms to know about the cultivation method, cost-benefit aspects, environmental and social impact of this unique culture. The farm owners opined that after 13 to 14 months of plantation, which is the shortest in comparison with traditional practice, Golpata and Goran can be harvested usually in January to February. On the other hand, farming seasonality of fish and shrimps varies species to species. However, most of the fish species can be harvested in between May to June in each year. Interestingly, CMAS culture doesn’t need much care and maintenance costs. It is expected that the detailed analysis of CMAS will help the Sundarbans depended local communities more climate resilient.

In-Hospital Outcome of Compromised Small Side Branch after Percutaneous Coronary Intervention.

Background: Side branch occlusion is a well known complication of percutaneous coronary intervention. Although occlusion of small side branches is well tolerated, occlusion of larger side branches may cause more serious complications. After PCI the incidence of complications in patients with compromised side branches smaller than 2 mm is small. Compromising side branches larger than 2 mm can be accompanied by clinical outcomes as non Q-wave MI. This study was undertaken to assess the in-hospital outcomes of compromised small (<2mm) side branch after percutaneous coronary intervention. Methods: This cross sectional analytical study was carried out in the department of cardiology, National Institute of Cardiovascular Diseases, Dhaka during the period of September 2011 to June 2012. A total of 100 consecutive patients with coronary artery disease who underwent elective PCI were included in the study. Study patients were divided into two groups on the basis of presence of compromised small (< 2 mm) side branch. In Group- I, small (< 2 mm) side branch were compromised after PCI and in Group- II, side branches were patent after PCI, with 50 patients in each group. In-hospital outcome were evaluated in both groups. Result: There were no significant differences of the baseline clinical demographics between two groups. Post PCI angina was higher in group I than group II (10.0% vs. 9.0%). Non ST elevation myocardial infarction and significant arrhythmia was identical in both groups (2.0% vs. 2.0%) but hypotension was more in group II than group I (4.0% vs. 2.0%). The findings were statistically insignificant between the study groups. There was no mortality, emergency CABG within 24 hours, ST elevation myocardial infarction, cardiogenic shock or acute left ventricular failure during their hospital course in either group. Conclusion: The present study concluded that compromised small (<2mm) side branch after percutaneous coronary intervention was not associated with adverse in-hospital outcome.

Different Types of Breast Lump in Relation to Different Age Groups.

This prospective observational study was carried out in the inpatient and outpatient department of surgery at Shaheed Ziaur Rahman Medical College Hospital, Bogra, during the period of 01.07.2008 to 31.12.2008 with a view to find out the incidence of breast carcinoma, fibroadenoma or other pathology in different age group. A total 130 patients with palpable breast lump were included in the study. Age of the patients was between 11 to 70 years. In most of the patients with breast lump Fine Needle Aspiration Cytology and biopsy were done. Sometimes ultrasonography, mammography and other routine investigations were also done. Among the study population 53.85% had benign lesions, Breast carcinoma accounted for 46.15% cases, fibroadenoma for 40.76% and fibroadenosis were in 10% cases. Fibroadenoma was common in second and third decade, while carcinoma of breast was common in third and fourth decade in this study. Here we attempted to find out the age incidence of breast lump and its correlation with clinical features, FNAC findings and histopathological report to improve the accuracy of diagnosis and management of breast disease.

Impact of Blood Glucose Levels on Contrast Induced Nephropathy after Percutaneous Coronary Intervention in Patients not known to be Diabetic with Acute Coronary Syndrome.

Background: Contrast-Induced Nephropathy (CIN) is an iatrogenic disorder, resulting from exposure to contrast media. The association between pre-procedural blood glucose levels and CI-AKI risk (regardless of pre-existing diabetes) is unknown. The present study was conducted to evaluate the incidence of CI-AKI in patients with admission hyperglycemia in non-diabetic ACS patients. Methods: This is Prospective, observational study done in the department of Cardiology, National Institute of Cardiovascular Diseases (NICVD), Dhaka. Considering inclusion and exclusion criteria, 50 patients were non diabetic with ACS with normal blood glucose (d”7.8 mmol/l or d”140 mg/dl) in (Group I) and 50 patients were non diabetic with ACS with high blood glucose (>7.8 mmol/l or >140 mg/dl) undergoing percutaneous coronary intervention in (Group II). On admission random blood glucose was measured. Non- ionic low osmolar contrast agents (lopamidol) was used in all patients. Serum creatinine, serum electrolytes was measured and creatinine clearance rate was determined within 24 hours before PCI and day 1 and 2 after PCI. Results: The incidence of CIN was 24% in high blood glucose group and 4% in normal blood glucose group (p=0.004). It was also observed that gradual incremental increase in risk of CIN associated with higher admission blood glucose level. There was positive correlation between s. creatinine and admission blood glucose but it showed negative correlation between CCr and admission blood glucose after PCI in ACS patients not known to be diabetic. Conclusion: The present study reveals that index admission high blood glucose in acute coronary syndrome patients not known to be diabetic is associated with increased incidence of contrast induced nephropathy after percutaneous coronary intervention.

Prolonged QTc Dispersion Correlates with Coronary Artery Disease in Acute ST Elevated Myocardial Infarction (STEMI).

Background: It has been found that there is strong association of QT dispersion and QT dispersion ratio with extent and severity of coronary artery disease. Qualitative importance of QTc dispersion on the base line ECG in patients with MI is recognized clinically but quantification of this phenomenon is less commonly used in clinical practice, which might be a better independent risk predictor of this group of patients. Methods: A total of 100 patients were selected, Study populations sub-divided into two groups on the basis of QTc dispersion. In group I (comparison group): QTc dispersion is <60 milliseconds (msec) in group II (study group) : QTc dispersion e”60milliseconds(msec). 50 patients in each group. QT dispersion was calculated on standard resting 12 lead ECGs. QT interval was measured from the beginning of the inscription of the QRS complex to the point at which the T wave returned to the isoelectric line. Angiographic severity of coronary artery disease was assessed by- Vessel score, Friesinger score and Leaman score. Interpretation of coronary angiogram was reviewed by at least two cardiologists. . Results: The mean vessel score for group I patients was 1.16±0.68 and that of group II patients was 2.30±0.64 and the mean difference was statistically significant (p<0.05). Patients those had single vessel involvement had mean QTc dispersion 57.05, patients those had double vessel disease mean QTc dispersion was 102.00 and patients those had triple vessel involvement had mean QTc dispersion 177.60. There was a strong positive correlation with the QTc dispersion and increasing number of vessel involvement (Pearson’s correlation coefficient). The mean Friesinger score for group I patients was 4.84±2.56 and that of group II patients was 9.80±2.60. The mean difference was significantly (p<0.05) higher in group II patients. There was a strong positive correlation between the QTc dispersion and Leaman score (Pearson’s correlation coefficient). In group I patients 56% had insignificant coronary artery disease and 44% had significant coronary artery disease defined by Friesinger index (n=100). In group II patients 6% had Insignificant coronary artery disease & had 94% significant coronary artery disease. Conclusion: QTc dispersion>60 ms had independent predictive value for the severity of coronary artery disease. The greater the QTc dispersion the higher the number of coronary artery involvement. We observed that there is a positive correlation between prolonged QT dispersion and coronary artery disease severity in terms of Vessel score, Friesinger score, Leaman score.

Serum Creatinine and Blood Urea Nitrogen Levels in Patients with Coronary Artery Disease.

Background: Few studies have assessed the relation of Serum creatinine and serum blood urea nitrogen (BUN) level with the severity of coronary artery disease (CAD). This study investigated the association between high uric acid BUN levels with the presence of Coronary artery disease. Materials and Methods: This study was designed as an observational cohort study. The study was composed of 170 patients admitted at our institution due to symptoms related to CAD. Patients having angiographic evidence of stenosis in coronary artery were as case group and without stenosis control group. Patients with high serum creatinine were defined as serum creatinine concentration with in 80-105 μmol/L and BUN level with in 10-20 μmol/L. The presence of CAD has been defined as the Gensini score being >1. Results: Patients with or without CAD were similar in terms of age (45.22±6.80 years vs. 52.87±9.31 years, p<0.01) and significant age difference was found between patients. Male gender (p<0.001) and smoking habit (p=0.003) were more frequent and statistically significant in patients with CAD. There was a statistically significant difference between the mean serum creatinine levels (92.89±20.82 μmol/L vs 108.68±23.62 μmol/L respectively, p<0.05) and serum blood urea nitrogen level (10.59±6.15 μmol/L vs. 20.37±6.73 μmol/L respectively, p<0.01) of patients with or without CAD. While looking at the correlation coefficient of Gensini score with different factors; S. creatinine, ejection fraction and BUN were significantly correlated at<0.001 and <0.04 and <0.01 level respectively. Increased serum creatinine levels were found to be independent risk factors for the presence of CAD (for serum cretinine hazard ration 3.9, p<0.001 and in case BUN hazard ration 2.08, p<0.001). Conclusion: In conclusion, a significant association has been found between serum creatinine & BUN level and the presence of CAD. In addition to the evaluation of conventional risk factors in daily clinical practice, the measurement of serum creatinine and BUN level might provide significant prognostic benefits in terms of global cardiovascular risk and management of the patients.

Renal function impairment in Hypothyroidism.

Background: Hypothyroidism is an important public health problem in Bangladesh. It is associated with increased risk for atherosclerosis and other complications. The frank development of hypothyroidism is associated with metabolic derangements including dyslipidemia- which is an etiopathologic factor for development of renal impairment. This study was to evaluate whether hypothyroidism is associated with impaired renal function. Methods: Using a cross sectional analytical study design, a total of 111 subjects attending Out Patient Department, Center for Nuclear Medicine and Ultrasound, Bogra Medical College during January 2007 to December 2007 were included purposively. Eighty newly diagnosed hypothyroid patients (Group I) and 31 healthy adults (Group II) were enrolled in this study. Serum thyroid stimulating hormone and serum free thyroxine were assayed by radioimmunoassay. Serum fasting lipid profile, serum creatinine and serum uric acid were estimated by enzymatic colorimetric method. Estimated GFR was calculated using MDRD equation. Results: The mean (±SD) age of in Group I and Group II were 35.59 (±6.91) and 37.35 (±2.78) years and were comparable. In Group I, there were 66 females and 14 males. In Group II, there were 16 females and 15 males. The mean BMI was 25.49 ±2.17 kg/m2 in Group I and 24.24 ±1.99 kg/m2 in Group II. The mean (±SD) Serum total-cholesterol, LDL- cholesterol and tryacylglycerol in Group I were significantly higher than that in Group II. Serum HDL cholesterol in Group I was significantly lower than that in Group II (p<0.001). The mean (±SD) serum creatinine was significantly higher in Group I than Group II (P<0.001). The estimated glomerular filtration rate (eGFR) was lower in Group I compared to Group II (p=0.011). In Group I (Hypothyroid), there were significant correlations of BMI, S Total-Cholesterol, S HDLCholesterol, S LDL-Cholesterol, S triglycerides and S creatinine with serum TSH level. In Group I (Hypothyroid), there were significant positive correlations of BMI and TSH with serum creatinine. Conclusions: Hypothyroidism is associated with dyslipidemia, hyperuricemia and impaired renal function. Therefore, patients presenting with these biochemical abnormalities are recommended to be investigated for hypothyroidism and vice versa.

Demographic Profile, Clinical Presentation & Angiographic Findings in 637 Patients with Coronary Heart Disease.

Cardiovascular diseases are the commonest cause of death globally and are the major contributor to the burden of premature mortality and morbidity. This study analyses various clinical presentations, conventional risk factors, pattern and severity of coronary heart disease on angiography among 637 patients with coronary heart disease and adult congenital heart disease who underwent cardiac evaluation at National Institute of Cardiovascular Disease (NICVD), Dhaka between January 2007 to December 2008. Among them 547 (85.9%) were male and 90 (14.1%) were female. All of them were between 22 to 76 years of age with mean age 50.15±8.8. One hundred sixty nine (25.9%) patients had chronic stable angina & 398 (62.48%) patients subjected for coronary angiography for acute coronary syndrome and or old myocardial infarction and 74 (11.62%) patients with vascular and adult congenital heart disease prior to surgical treatment. Most prevalent risk factors were smoking (60%) and dyslipidaemia (60%). Thirty five percent patients were hypertensive and 10% patient had diabetes. Normal epicardial coronaries were documented in 25.59% patients which includes the patients who underwent coronary angiography prior to surgical treatment. Ninety three (14.6%) had single vessel disease, 119 (18.68%) had double vessel disease, 259 (40.66%) had triple vessel disease and 3 (0.47%) had isolated left main disease.