Morphological Changes of Length of Prostate in Different Age Groups of Bangladeshi Cadaver.

Benign prostatic hyperplasia is the most common prostatic problem for men older than age 50. It is a condition in men in which the prostate is enlarged but it is not cancerous. The prostate goes through 2 (two) main growth periods as a person ages. The first happens early in pubescence, when the prostate doubles in size. The second stage of growth begins around age twenty five and continues throughout most of a man's life. Benign prostatic hyperplasia often occurs with second growth phase. In the treatment of prostatic disorders, estimation of the length of prostate has been used to select the surgical approach. Transurethral resection of prostate (TURP) is preferred for small glands and open prostatectomy for larger ones. As the prostate gland is dependent on androgen for its growth, the prostatic length reflects the hormonal status of the subjects. This cross sectional descriptive study was conducted in Department of Anatomy, Mymensingh Medical College, Mymensingh, Bangladesh from April 2015 to September 2015 to find out the difference in length of the prostate of Bangladeshi people in relation to age. The present study was performed on 67 postmortem human prostate glands collected from the morgue in the Department of Forensic Medicine, Mymensingh Medical College, by non random purposive sampling technique. The specimens were collected from Bangladeshi dead body, age starting from 10-80 years. All the specimens were classified into 3(three) classes - Group A (upto 18 years), Group B (19-45 years) and Group C (>45 years) according to age. Dissection was performed according to standard autopsy techniques. The length of the prostate was measured and recorded. The mean±SD length of the prostate was 1.76±0.60cm, 2.65±0.56cm and 2.88±0.70cm in Group A, B and C respectively. The maximum mean length of the prostate was in Group C (2.88cm) and minimum was in Group A (1.76cm). It was observed that the length of the prostate was increased with age. Variance analysis shows that mean differences of length of the prostate were highly significant among all age groups. The length of prostate gland was found to be increase with age. For statistical analysis, variations between age groups were analyzed by students unpaired 't' test. The present study will help to increase the information pool on the length of prostate gland of Bangladeshi people.

Traditional healing practices in rural Bangladesh: a qualitative investigation.

BACKGROUND: Traditional healing practice is an important and integral part of healthcare systems in almost all countries of the world. Very few studies have addressed the holistic scenario of traditional healing practices in Bangladesh, although these serve around 80% of the ailing people. This study explored distinctive forms of traditional healing practices in rural Bangladesh. METHODS: During July to October 2007, the study team conducted 64 unstructured interviews, and 18 key informant interviews with traditional healers and patients from Bhabanipur and Jobra, two adjacent villages in Chittagong district, Bangladesh. The study also used participatory observations of traditional healing activities in the treatment centers. RESULTS: Majority of the community members, especially people of low socioeconomic status, first approached the traditional healers with their medical problems. Only after failure of such treatment did they move to qualified physicians for modern treatment. Interestingly, if this failed, they returned to the traditional healers. This study identified both religious and non-religious healing practices. The key religious healing practices reportedly included Kalami, Bhandai, and Spiritual Healing, whereas the non-religious healing practices included Sorcery, Kabiraji, and Home Medicine. Both patients and healers practiced self-medication at home with their indigenous knowledge. Kabiraji was widely practiced based on informal use of local medicinal plants in rural areas. Healers in both Kalami and Bhandari practices resorted to religious rituals, and usually used verses of holy books in healing, which required a firm belief of patients for the treatment to be effective. Sorcerers deliberately used their so-called supernatural power not only to treat a patient but also to cause harm to others upon secret request. The spiritual healing reportedly diagnosed and cured the health problems through communication with sacred spirits. Although the fee for diagnosis was small, spiritual healing required different types of treatment instruments, which made the treatment implicitly expensive. CONCLUSIONS: Traditional healing was widely practiced as the means of primary healthcare in rural areas of Bangladesh, especially among the people with low socioeconomic status. The extent of services showed no decline with the advancement of modern medical sciences; rather it has increased with the passage of time.

Serum Zinc, Copper, Magnesium & Phosphorus Level in Children with Severe Acute Malnutrition (SAM).

Malnutrition is widely prevalent among hospitalized children in most developing countries including Bangladesh. Though malnutrition accounts for the high rate of under 5 mortality sometimes it is overlooked. Keeping in this in mind A comparative cross sectional study was done in Mymensingh Medical College Hospital from 1st October 2009 to 31st May 2011. Children aged 1-5 years with presence of one or more criteria WHM <70%, WHZ-score <-3SD, Bipedal edema & Mid upper arm circumference <110mm were taken as study group and children aged 1-5 years with normal growth allowable normal range of variation is between 3rd and 97th centile curve or median (50th centile) ±2SD of weight for age growth chart (CDC growth chart, USA, 2000) were taken as reference group. Persistent diarrhea, Patients taking medications containing zinc, copper, magnesium, phosphorus & calcium, PEM with shock were excluded from study group. Nutritional assessment was done according to WHO criteria of SAM. Serum Zinc, Copper Magnesium and Phosphorus level were determined by Atomic Absorption Spectrometry using UNICAM - AA Spectrometer, model no. 969, Spain. Total 120 study populations were taken. Ninety Out of 120 were taken as a study group (SAM) & 30 were reference group. In reference group serum Zn, Cu, Mg, P value was 103.80±8.86µg/dl, 135.92±13.57µg/dl, 2.31±0.18mg/dl, 3.96±0.22mg/dl respectively. In study group serum Zn, Cu, Mg, P value was 60.33±11.08µg/dl, 80.60±15.46µg/dl, 1.47±0.22mg/dl, 2.00±0.52mg/dl respectively. All these results show that there is significant difference between study group & reference group. Considering the decreased level of these parameters, close biochemical monitoring and follow up should be emphasized for the children with SAM.

The Bangladesh paradox: exceptional health achievement despite economic poverty.

Bangladesh, the eighth most populous country in the world with about 153 million people, has recently been applauded as an exceptional health performer. In the first paper in this Series, we present evidence to show that Bangladesh has achieved substantial health advances, but the country's success cannot be captured simplistically because health in Bangladesh has the paradox of steep and sustained reductions in birth rate and mortality alongside continued burdens of morbidity. Exceptional performance might be attributed to a pluralistic health system that has many stakeholders pursuing women-centred, gender-equity-oriented, highly focused health programmes in family planning, immunisation, oral rehydration therapy, maternal and child health, tuberculosis, vitamin A supplementation, and other activities, through the work of widely deployed community health workers reaching all households. Government and non-governmental organisations have pioneered many innovations that have been scaled up nationally. However, these remarkable achievements in equity and coverage are counterbalanced by the persistence of child and maternal malnutrition and the low use of maternity-related services. The Bangladesh paradox shows the net outcome of successful direct health action in both positive and negative social determinants of health--ie, positives such as women's empowerment, widespread education, and mitigation of the effect of natural disasters; and negatives such as low gross domestic product, pervasive poverty, and the persistence of income inequality. Bangladesh offers lessons such as how gender equity can improve health outcomes, how health innovations can be scaled up, and how direct health interventions can partly overcome socioeconomic constraints.

An unusual bisnor-clerodane diterpenoid from Polyalthia simiarum.

The stem bark of Polyalthia simiarum has yielded a new bisnor-type clerodane diterpenoid, 2-oxo-14,15-bisnor-3,11E-kolavadien-13-one (1), and three previously known clerodane derivatives, kolavenic acid (2), 16beta-hydroxycleroda-3,13(14)Z-dien-15,16-olide (3), and 16-oxocleroda-3,13(14)E-dien-15-oic acid (4). The structures of these compounds were unambiguously determined by extensive NMR studies as well as by comparison with related compounds. Till now this is the second report of the occurrence of any unusual C-18 clerodane diterpenoid from nature. The crude light petroleum extract and the purified compound 3 demonstrated moderate free radical scavenging activity with IC50 values of 21.5 and 23.5 microg/mL, respectively.

Effect of aqueous extracts of black and green teas in arsenic-induced toxicity in rabbits.

Arsenic causes oxidative stress in the body. Its administration (3 mg/kg/day) for 14 days in rabbits resulted in a significant reduction of whole blood glutathione (GSH), and elevation of thiobarbituric acid reactive substances (TBARS) and the index of nitrite/nitrate (NOx) levels. These are the markers of oxidative stress. Both black tea (BT) and green tea (GT) (Camellia sinensis), when administered to the arsenic-treated rabbits for 14 days, caused a significant elevation of the depleted GSH level to 53.12% and 57.47%, respectively. On the contrary, in the placebo group the level was 26.59%. The BT and GT reduced the elevated TBARS level to 43.27% and 62.28%, respectively, whereas the corresponding level in the placebo groups was 21.24%. The NOx levels were also reduced to 63.62%, 67.67% and 58.94% in BT, GT and the placebo groups, respectively. When arsenic and black tea were given concurrently to another group the results were even more pronounced. The polyphenol components of black and green tea were 27.69% and 29.71% of the dry weight of the total extracts, respectively. These results indicated that arsenic-induced toxicities in rabbits were significantly reversed by the black and green tea polyphenols. The greater activity of green tea than that of black tea correlates with the slightly higher content of polyphenols in green tea.

Effect of zinc on growth of preterm babies.

Zinc is being recognized increasingly as an important element in human growth, development and immunological function. It is probably the most intensely studied microelement in newborn nutrition. Zinc deficiency is common in young infants in the developing world and is associated with reduced immunocompetence and increased rates of serious disease. Preterm neonates are especially vulnerable because of preterm delivery and low birth weight. The preterm baby has very limited stored energy and needs an adequate supply of nutrient. Preterm infant have high zinc dietary requirements as 60% fetal zinc is acquired during third trimester of pregnancy. Low concentration of zinc was found in pre-term low birth weight babies in different studies. Studies showed that before supplementation serum zinc level in preterm low birth weight babies were 62+/-12.4 microgm/dl, 65 microgm/dl, 54+/-14.4 microgm/dl and after supplementation serum zinc level were 105.8+/-16.6 microgm/dl, 86.4+/-24.7 microgm/dl respectively. At the same time mean weight & length of supplementation and without supplementation group were 6084 gm vs. 5280 gm, 2779+/-638.7 gm vs. 2474.6+/-441.8 gm and length 23.7 cm vs. 21.4 cm, 46.49+/-2.6 cm vs. 44.1+/-2.8 cm respectively. So supplementation of zinc in preterm babies causes improved growth and development. Various reports showed beneficial effect of long supplement in early growth of pre-term babies. However long term follow up studies are needed to evaluate the beneficial effect of zinc supplementation on growth of preterm babies.

Antibacterial activity of two limonoids from Swietenia mahagoni against multiple-drug-resistant (MDR) bacterial strains.

Solvent partitioning followed by column chromatography of the MeOH extract of the seeds of Swietenia mahagoni afforded two limonoids, swietenolide (1) and 2-hydroxy-3-O-tigloylswietenolide (2). The compounds were identified by spectroscopic means. The antibacterial activity of these compounds was assessed against eight multiple-drug-resistant bacterial strains (clinical isolates) by the conventional disc diffusion method. While both compounds were active against all test organisms, compound 2 displayed overall more potent activity than compound 1.

Pachypodol, a flavonol from the leaves of Calycopteris floribunda, inhibits the growth of CaCo 2 colon cancer cell line in vitro.

Calycopteris floribunda Lam., commonly known as 'goichia lata or goache lata', is a large climbing woody shrub from Bangladesh, and well distributed in a number of other south-east Asian countries. Traditionally, C. floribunda has been used in colic, as an antihelminthic, astringent and carminative, and for the treatment of diarrhoea, dysentery, jaundice and malaria in many countries including Bangladesh. Pachypodol (5,4'-dihydroxy-3,7,3'-trimethoxyflavone) has been isolated from the leaves of C. floribunda by repeated column chromatography on silica gel, and the structure confirmed by spectroscopic means. While the general toxicity of pachypodol was determined by the brine shrimp lethality assay, the cytotoxic potential of this flavonoid has been evaluated by the Promega's CellTiter 96 Non-Radioactive Cell Proliferation Assay using the CaCo-2 colon cancer cell line (IC(50) = 185.6 microM). A summary of the biological activities of pachypodol reported to date is also presented.

Imidacloprid in processed tea and tea liquor.

Imidacloprid is a newly introduced broad-spectrum chloronicotinyl insecticide and will find its way in agricultural production, particularly in Asia. However, information on the fate of imidacloprid in crop plants is lacking. The degradation of imidacloprid in processed CTC tea and tea liquor was investigated in the present study in which imidacloprid was applied at recommended application rate (30.0 g a.i./ha) and twice the recommended application rate (60.0 g a.i./ha) for three consecutive seasons. Imidacloprid was rapidly dissipated in processed tea following first order reaction kinetics at all application rates and had half-lives of 0.91-1.16 d with the residue in tea liquor found to be below detectable limit on 3rd day samples. The study revealed that imidacloprid is safe for human consumption and will not pose any residual toxicity problem.

Mass screening for antimicrobial resistant Escherichia coli in dairy cows in northern New South Wales.

OBJECTIVE: To describe aspects of the epidemiology of antimicrobial resistance in Escherichia coli shed in the faeces of milking cows in a dairying region of New South Wales. DESIGN: A survey based on multi-stage sampling with repeated measures made within herds for estimating within-herd correlation of resistance status, and with repeated measures made on identical specimens for estimating test-retest reliability. PROCEDURE: From a population of 110 dairy herds, 30 were selected at random and from each herd between 5 and 10 faecal specimens were obtained from fresh manure pats. E coli from faecal specimens were grown on hydrophobic grid membrane filters (HGMF) and replicated onto chromogenic agar and agar containing antimicrobials (gentamicin, ampicillin, tetracycline and sulfamethoxazole). Image analysis was used to assess colony growth. Data were analysed descriptively, by generalised linear mixed models and by Taylor series linearisation to account for attributes of the survey design. RESULTS: Of the 10,279 E coli isolates assessed, 91% expressed no resistance, 7.3% were resistant to sulfamethoxazole, 3.6% to tetracycline, 2.2% to ampicillin and 0.09% to gentamicin. The most common multiple resistance phenotype was ampicillin-tetracycline-sulfamethoxazole (1.8% of isolates). Most multiple resistant isolates appeared clustered within particular herds but were too rare to obtain valid estimates of variance, confidence intervals or intra-herd correlation. The estimated proportion of isolates in the population that were susceptible to all four antimicrobials was 97% (95% CI: 91% to 100%) and 55% of cows had no resistance detected in faecal E coli (95% CI: 27% to 83%). Within-herd correlation of shedding status (any resistance pattern) was absent and test-retest reliability of the measurement system was estimated to be at the lower end of good (0.40) but increased to excellent (0.89) after excluding sulfamethoxazole resistance, which had a greater measurement error. CONCLUSION: Antimicrobial resistance was uncommon in E coli in the population of dairy cows studied. HGMF and image analysis is an effective tool for detecting rare forms of resistant E coli that are not uniformly distributed in livestock populations.

Most Helicobacter pylori strains of Kolkata in India are resistant to metronidazole but susceptible to other drugs commonly used for eradication and ulcer therapy.

BACKGROUND: Helicobacter pylori infection is very common in India, as in other developing countries, but few data exist on the susceptibility of H. pylori to antimicrobial agents commonly used for eradication here. AIM: To determine the antimicrobial susceptibility of H. pylori strains from Kolkata, in eastern India. METHODS: A total of 67 H. pylori strains isolated from gastritis and peptic ulcer patients of Kolkata were examined in the study. Minimum inhibitory concentration to the antibiotics was determined by the agar dilution method. RESULTS: Most of the strains (85%) were resistant to at least 8 microg/mL of metronidazole and 7.5% strains were resistant to tetracycline, which was high when compared with other reports in India. All Kolkata strains were highly sensitive to clarithromycin, furazolidone and amoxicillin. CONCLUSIONS: Our results differed significantly from the few available reports on drug sensitivity profile of H. pylori from other parts of India, namely, Hyderabad, Mumbai and Lucknow. This finding supports the need for rigorous susceptibility testing as a guide to empirical treatment and more generally, to define the resistance patterns of H. pylori in particular geographical areas.

Herbal medicine induced Stevens-Johnson syndrome: a case report.

A severe form of Erythema multiforme (EM), diagnosed as Stevens-Johnson syndrome (SJS) was detected in a 10-year-old Indian male child who took herbal medication of plant origin prescribed by a traditional healer for remission of his fever. The child developed a severe and florid form of mucocutaneous oral ulceration, severe ocular manifestations, along with marked constitutional disturbances and dehydration. An extensive literature search revealed few previous reports of herbal drug induced EM and SJS. In India, traditional therapy with herbal preparation (Ayurvedic medicine) is not uncommon.

Efficacy and trial effectiveness of weekly and daily iron supplementation among pregnant women in rural Bangladesh: disentangling the issues.

BACKGROUND: According to our current understanding, iron absorption with weekly iron supplements is not higher than that with daily supplements (ie, there is no mucosal block). However, community-based trials have repeatedly shown that a weekly regimen is as effective as a daily one. Furthermore, when differences in absorption are found, they are commonly smaller than would be expected on the basis of differences in the amount of iron provided. The possibility of differential compliance between the regimens needs to be evaluated to explain these findings. OBJECTIVE: Taking compliance into account, we compared the efficacy and trial effectiveness of weekly and daily iron supplementation during pregnancy. DESIGN: In Bangladesh, 50 antenatal centers were randomly assigned to prescribe either 2 doses of 60 mg Fe once weekly or 1 dose of 60 mg Fe/d. Compliance was monitored by using a pill bottle equipped with an electronic counting device. Hemoglobin concentrations were measured at baseline and after 4, 8, and 12 wk of supplementation. RESULTS: There was no differential effect per iron tablet between weekly and daily regimens. A 12-wk daily regimen (68% compliance) produced a small but significantly greater hemoglobin response than did the weekly regimen (104% compliance). The first 20 tablets consumed produced most of the effect; after 40 tablets, there was no further response. CONCLUSIONS: There was no evidence of a mucosal block in the daily regimen. Over 12 wk, 50% of the amount of iron in a daily regimen was sufficient for maximum hemoglobin effect. The weekly regimen provided a large part of this amount, explaining the limited difference in effect. It appears that the current international recommendation for iron supplementation in pregnancy is higher than necessary.

Antinociceptive and antidiarrhoeal activity of Zanthoxylum rhetsa.

The methanolic extract of the Zanthoxylum rhetsa Roxb. stem bark, given by oral route to mice at doses of 250 and 500 mg/kg, significantly reduced the abdominal contraction induced by acetic acid and the diarrhoeal episodes induced by castor oil in mice.

Updating of hereditary haemoglobin disorders.

Hereditary haemoglobin disorders (E-beta Thalassaemia & Thalassaemia) are inherited as recessive disorders so that the heterozygote subjects are generally healthy. They commonly present with progressive pallor, thalassaemic facies, splenohepatomegaly & growth retardation. Diagnosis of carriers & patients are usually confirmed by haemoglobin electrophoresis. Transfusion-chelation therapy is usually employed for their treatment. Allogenic bone marrow transplantation is the only definite cure. Gene therapy remains to be the major challenging goal of future curative therapy. During the last 10 years wit medical advances, the number of pregnancies in thalassaemia is increasing. Normal pregnancy can be maintained with regular packed blood cells transfusion given carefully. In Bangladesh, HHD can be prevented by I. carrier identification and marriage counseling, II. passing and enforcing laws against marriage between two carriers, III. introducing thalassaemia in school curriculum and IV. creating public awareness.

Zinc supplementation as adjunct therapy in children with measles accompanied by pneumonia: a double-blind, randomized controlled trial.

BACKGROUND: Zinc deficiency, common in developing countries, is associated with decreased immunocompetence. Zinc supplementation benefits children with acute and persistent diarrhea and prevents pneumonia. Most deaths from vaccine-preventable diseases are from measles and whooping cough; pneumonia is the most common complication of measles and often the proximate cause of related deaths. OBJECTIVE: We evaluated the effect of zinc supplementation on episodes of illness in children with measles accompanied by pneumonia. DESIGN: In a double-blind, randomized controlled trial, children aged 9 mo-15 y who were admitted to the Infectious Diseases Hospital in Calcutta with clinically severe measles accompanied by pneumonia and who had been ill for

Do side-effects reduce compliance to iron supplementation? A study of daily- and weekly-dose regimens in pregnancy.

Side-effects of iron supplementation lead to poor compliance. A weekly-dose schedule of iron supplementation rather than a daily-dose regimen has been suggested to produce fewer side-effects, thereby achieving a higher compliance. This study compared side-effects of iron supplementation and their impact on compliance among pregnant women in Bangladesh. These women were assigned to receive either weekly doses of 2 x 60 mg iron (one tablet each Friday morning and evening) or a daily dose of 1 x 60 mg iron. Fifty antenatal care centres were randomly assigned to prescribe either a weekly- or a daily-supplementation regimen (86 women in each group). Side-effects were assessed by recall after one month of supplementation and used for predicting compliance in the second and third months of supplementation. Compliance was monitored using a pill bottle equipped with an electronic counting device that recorded date and time whenever the pill bottle was opened. Of five gastrointestinal side-effects (heartburn, nausea, vomiting, diarrhoea, or constipation) assessed, vomiting occurred more frequently in the weekly group (21%) than in the daily group (11%, p<0.05). Compliance (ratio between observed and recommended tablet intake) was significantly higher in the weekly-supplementation regimen (93%) than in the daily-supplementation regimen (61%, p<0.05). Overall, gastrointestinal side-effects were not significantly associated with compliance. However, the presence of nausea and/or vomiting reduced compliance in both the regimens-but only among women from the lower socioeconomic group. In conclusion, weekly supplementation of iron in pregnancy had a higher compliance compared to daily supplementation of iron despite a higher frequency of side-effects. The findings support the view that gastrointestinal side-effects generally have a limited influence on compliance, at least in the dose ranges studied. Efforts to further reduce side-effects of iron supplementation may not be a successful strategy for improving compliance and effectiveness of antenatal iron supplementation.