Knowledge, attitude and practice towards antibiotic use and resistance among the veterinarians in Bangladesh.

BACKGROUND: The emergence of antimicrobial resistance is a growing human and animal health concern around the world. When a number of studies have emphasized the Knowledge, Attitude and Practice (KAP) regarding antibiotic use and resistance in humans, little attention has been paid to the veterinary sector. The aim of this study was to understand the KAP towards antibiotic use and resistance among veterinarians in Bangladesh. METHODS: A cross-sectional online based questionnaire survey was conducted from August to September 2020 among the registered veterinary practitioners. A self-administered Google form questionnaire consisting of 45 questions on knowledge, attitude and practice regarding antibiotic use and resistance was used. For statistical significance test we used Chi-square or Fisher's Exact test and logistic regression for factor analysis. RESULTS: A total of 208 registered veterinarians participated in this study. The study involved a majority of male participants, constituting 85.1%, while 54.8% of the participants held a Masters degree. Around 52% of the veterinarians were poultry practitioners. All respondents were familiar with antimicrobials. The participants (91.4%) knew that antibiotics cannot cure viral infections, while 97.6% believed that frequent antibiotic prescriptions rendered them less effective. Participants claimed that only they were eligible to prescribe drugs for the treatment of animals, and around 80% disagreed with adding antibiotics with feed/water as a growth promoter in livestock. Of the total participants, 87% believed that a local antimicrobial guideline would be more effective than an international one. A multivariable analysis revealed that male veterinarians have 2.37 times higher knowledge regarding antimicrobial use (AMU) and antimicrobial resistance (AMR) (OR = 2.37, CI = 1.01-5.59, p = 0.05). Veterinarians engaged in government services demonstrated a 2.59 times more favorable attitude towards AMU and AMR (OR = 2.59, CI = 0.99-6.73, p = 0.05). Additionally, respondents aged 31-35 were 0.45 times more likely to exhibit good practices (OR = 0.45, CI = 0.2-1.00, p = 0.05). However, gaps in practices were highlighted in our study, suggesting training deficiencies. CONCLUSION: The present study, for the first time conducted in Bangladesh, dictates that future interventions like academic courses, workshops, and seminars on antibiotic usage and resistance are needed to facilitate the knowledge, behavior and practice of veterinarians with regard to the rational use of antibiotics.

Analyzing bifurcation, stability, and wave solutions in nonlinear telecommunications models using transmission lines, Hamiltonian and Jacobian techniques.

This study presents a comprehensive analysis of a nonlinear telecommunications model, exploring bifurcation, stability, and wave solutions using Hamiltonian and Jacobian techniques. The investigation begins with a thorough examination of bifurcation behavior, identifying critical points and their stability characteristics, leading to the discovery of diverse bifurcation scenarios. The stability of critical points is further assessed through graphical and numerical methods, highlighting the sensitivity to parameter variations. The study delves into the derivation of both numerical and analytical wave solutions, aligning them with energy orbits depicted in phase portraits, revealing a spectrum of wave behaviors. Additionally, the analysis extends to traveling wave solutions, providing insights into wave propagation dynamics. Notably, the study underscores the efficacy of the planar dynamical approach in capturing system behavior in harmony with phase portrait orbits. The findings have significant implications for telecommunications engineers and researchers, offering insights into system behavior, stability, and signal propagation, ultimately advancing our understanding of complex nonlinear dynamics in telecommunications networks.

First-principles study of electronic, mechanical, and optical properties of M3GaB2 (M = Ti, Hf) MAX phases.

Integrating ceramic and metallic properties in MAX phases makes them highly desirable for diverse technological applications. In this study, through first-principles density functional theory (DFT), we investigated the physical properties of two new 312 MAX compounds, M3GaB2 (M = Ti, Hf). Chemical stability is confirmed via formation energy assessment, while mechanical stability is established by determining elastic stiffness constants. A thorough analysis of mechanical behaviors includes bulk modulus, shear modulus, Young's modulus, and hardness parameters. M3GaB2 demonstrates elastic constants and moduli closely aligned with other 312 carbides. Understanding the electronic band structure and density of states (DOS) sheds light on metallic properties, with anisotropy in electrical conductivity clarified through energy dispersion analysis. Investigation of photon interaction with titled compounds, including dielectric constants (real and imaginary parts), refractive index, absorption coefficient, photoconductivity, reflectivity, and energy loss function, has been carried out. The potential of M3GaB2 borides as a coating to reduce solar is evaluated based on the reflectivity spectra. These findings deepen our understanding of material properties and suggest diverse applications for M3GaB2 in various technological domains.

Ab Initio Study of the Graphyne-like γ-SiC Nanoflake for Toxic Gas-Sensing Applications.

This study focuses on the geometrical, electronic, and optical properties of the γ-graphyne-like novel γ-SiC nanoflake of the γ-silicon carbide (SiC) monolayer using density functional theory calculations. γ-SiC was revealed to be a stable semiconducting nanoflake confirmed by a negative cohesive energy, real vibrational frequencies, and a 1.749 eV energy gap. The adsorption of COCl2, HCN, PH3, AsH3, CNCl, and C2N2 toxic gases on the γ-SiC nanoflake is also studied, which revealed an attractive gas-nanoflake interaction with the adsorption energy ranging from -0.21 to -0.38 eV. The adsorption results in a significant charge transfer between gas-adsorbent complexes. A significant variation in the energy gap and electrical conductivity was observed due to gas adsorption. γ-SiC showed maximum sensitivity at room temperature for CNCl gas. The entire process of adsorption is exothermic and thermodynamically stable. γ-SiC showed a high absorption coefficient over 104 orders with a significant variation in the absorption peak intensity and blue peak shifting. According to the quantum theory and reduced density gradient analysis, all of the gases are physisorbed on the γ-SiC nanoflake due to van der Waals interactions. The obtained results signify the usability of γ-SiC as a potential toxic gas sensor.

Adult Intestinal Malrotation With Congenital Transverse Meso-Colic Internal Hernia: An Infrequent Cause of Small Bowel Obstruction.

Adult intestinal malrotation along with congenital transverse-mesocolic internal hernia causing small bowel obstruction is extremely rare. Most of these patients don't have any obvious clinical symptoms. Only a few cases have been documented in the English literature. We present the unique case of a 43-year-old male without any prior surgical history who presented with nonspecific abdominal pain and was diagnosed with malrotation of the small intestine by computed tomography (CT) scan and underwent exploratory laparotomy found to have internal herniation through the transverse-mesocolon. The patient underwent an emergency laparotomy; a Ladd's procedure and repair of the hernial orifice were performed. This case highlights the association of adult intestinal malrotation with internal hernias and small bowel obstruction; it also explores the importance of timely diagnosis and adequate management of this condition.

Isolated Perforation of Multiple Jejunal Diverticulae: A Very Rare Cause of Acute Abdomen.

Isolated jejunal diverticular (JD) perforation is extremely rare; it usually presents as a diagnostic dilemma and is often discovered incidentally on laparotomy. Most of these perforations are single. Literature has revealed only one case of multiple small bowel diverticular perforations. We report the first case of simultaneous perforation of four jejunal diverticulae in an 85-year-old male. Small bowel resection and primary anastomosis were performed. The patient had an uneventful post-operative recovery. This case highlights the importance of prompt diagnosis and timely management to reduce the morbidity and mortality of these patients. It should be included in the differential diagnosis in all elderly patients presenting with acute abdomen.

Knowledge, attitudes, and practices regarding antibiotic use in Bangladesh: Findings from a cross-sectional study.

BACKGROUND: Escalating antibiotic resistance presents a notable worldwide dilemma, pointing a large involvement of general population. The objective of this study was to assess knowledge, attitudes, and practices regarding the utilization of antibiotics among Bangladeshi residents. METHODS: A cross-sectional study, conducted from January 01 to April 25, 2022, included 1,947 Bangladeshi adults with a history of antibiotic use, via online surveys and face-to-face interviews using a pretested semi-structured questionnaire. Descriptive statistics, Chi-square tests, and multivariate linear regression models were employed. RESULTS: Mean scores for knowledge, attitudes, and practices were 6.59±1.20, 8.34±1.19, and 12.74±2.59, with correct rates of 73.22%, 92.67%, and 57.91%. Positive predictors for knowledge included being unmarried (ß = 0.10, p = 0.001), higher education (College: ß = 0.09, p = 0.025; Bachelor: ß = 0.22, p<0.001; Master or above: ß = 0.14, p<0.001), various professions (student: ß = 0.57, p<0.001; housewife: ß = 0.33, p<0.001; employee: ß = 0.53, p<0.001; businessman: ß = 0.31, p<0.001; unemployed: ß = 0.15, p<0.001), and residing in semi-urban (ß = 0.32, p<0.001) or urban areas (ß = 0.15, p<0.001). Positive predictors for attitudes included being married (ß = 0.18, p<0.001), specific professions (student: ß = 1.06, p<0.001; housewife: ß = 0.33, p<0.001; employee: ß = 0.86, p<0.001; businessman: ß = 0.37, p<0.001; unemployed: ß = 0.47, p<0.001), higher SES (Lower-middle: ß = 0.22, p<0.001; Middle: ß = 0.26, p<0.001), and residing in semi-urban areas (ß = 0.18, p<0.001); negative predictors included higher education (College: ß = -0.12, p = 0.001; Master or above: ß = -0.09, p = 0.008) and being rich (ß = -0.13, p<0.001). Positive predictors for practices included being married (ß = 0.18, p<0.001), specific professions (student: ß = 0.32, p<0.001; employee: ß = 0.43, p<0.001; businessman: ß = 10, p = 0.034; unemployed: ß = 0.11, p = 0.009), and higher SES (Lower-middle: ß = 0.14, p = 0.009; Middle: ß = 0.38, p<0.001; Higher-middle: ß = 0.15, p = 0.008); negative predictors included higher education (College: ß = -0.21, p<0.001), being rich (ß = -0.12, p<0.001), residing in semi-urban (ß = -0.14, p<0.001) or urban areas (ß = -0.16, p<0.001). CONCLUSIONS: Participants exhibited adequate knowledge and positive attitudes but lagged behind in proper practice of antibiotic use. Proper initiatives should be tailored to enhance prudent antibiotic use and mitigate the risk of antimicrobial resistance.

Green synthesis of zinc oxide nano particles using Allium cepa L. waste peel extracts and its antioxidant and antibacterial activities.

Synthesis of nanoparticles through the green approach using plant and vegetable extracts has gained popularity since they are thought to be efficient and cost-effective materials. This study is designed to synthesize zinc oxide nanoparticles (ZnO-NPs) from onion waste peel extract (Allium cepa L.) via the green synthesis approach. The synthesized ZnO-NPs were characterized by utilizing the UV-Vis spectroscopy, Fourier transform infrared spectroscopy (FTIR), Energy Dispersive X-ray (EDX), Field Emission Scanning Electron Microscopy (FE-SEM) and X-ray Powder Diffraction (XRD)techniques. The nanoparticles formation was confirmed by the UV-Vis sharp absorption spectra at 318 and 322 nm. The synthesized ZnO-NPs size and shape was revealed by the XRD and SEM respectively. Smallest nanoparticle average crystallite size was found 57.38 nm with hexagonal shape. The bioactive functional groups that are in charge of capping and stabilizing the ZnO-NPs was assured by the FTIR data. Further, prepared ZnO-NPs were used to assess their possible antioxidant and antibacterial properties. DPPH test for free radical scavenging showed potential antioxidant properties of the synthesized ZnO-NPs. The antibacterial activity were studied against three clinical strains: P. aeruginosa, E. coli, and S. aureus with the maximum zone of inhibition 13.17 mm, 22.00 mm and 12.35 mm respectively at 100 µg/mL subsequently minimum inhibitory concentration was found 50 µg/mL for P. aeruginosa, and S. aureus whereas 100 µg/mL for E. coli. Antioxidant and antibacterial activity tests appear bio-resource based ZnO-NPs from Allium cepa L. extract have effects on free radical and growth of microorganisms.Therefore, it could be a promising candidates for agricultural and food safety applications as an effective antimicrobial agent against pathogenic microorganisms and also can address future biomedical applications after complete in vivo study.

Phosphorus-doped T-graphene nanocapsule toward O3 and SO2 gas sensing: a DFT and QTAIM analysis.

Tetragonal graphene nano-capsule (TGC), a novel stable carbon allotrope of sp2 hybridization is designed and doped with phosphorus (P) to study the O3 and SO2 gas sensitivity via density functional theory calculation. Real frequencies verified the natural existence of both TGC and P-doped TGC (PTGC). Both TGC and PTGC suffer structural deformations due to interaction with O3 and SO2 gases. The amount of charge transfer from the adsorbent to the gas molecule is significantly greater for O3 adsorption than SO2 adsorption. The adsorption energies for TGC + O3 and PTGC + O3 complexes are - 3.46 and - 4.34 eV respectively, whereas for TGC + SO2 and PTGC + SO2 complexes the value decreased to - 0.29 and - 0.30 eV respectively. The dissociation of O3 is observed via interaction with PTGC. A significant variation in electronic energy gap and conductivity results from gas adsorption which can provide efficient electrical responses via gas adsorption. The blue/red shift in the optical response proved to be a way of detecting the types of adsorbed gases. The adsorption of O3 is exothermic and spontaneous whereas the adsorption of SO2 is endothermic and non-spontaneous. The negative change in entropy verifies the thermodynamic stability of all the complexes. QTAIM analysis reveals strong covalent or partial covalent interactions between absorbent and adsorbate. The significant variation in electrical and optical response with optimal adsorbent-gas interaction strength makes both TGC and PTGC promising candidates for O3 and SO2 sensing.

A first principles study of RbSnCl3 perovskite toward NH3, SO2, and NO gas sensing.

The sensitivity of a RbSnCl3 perovskite 2D layer toward NH3, SO2, and NO toxic gases has been studied via DFT analysis. The tri-atomic layer of RbSnCl3 possessed a tetragonal symmetry with a band gap of 1.433 eV. The adsorption energies of RbSnCl3 for NH3, SO2 and NO are -0.09, -0.43, and -0.56 eV respectively with a recovery time ranging from 3.4 × 10-8 to 3.5 ms. RbSnCl3 is highly sensitive toward SO2 and NO compared to NH3. The adsorption of SO2 and NO results in a significant structural deformation and a semiconductor-to-metal transition of RbSnCl3 perovskite. A high absorption coefficient (>103 cm-1), excessive optical conductivity (>1014 s-1), and a very low reflectivity (<3%) make RbSnCl3 a potential candidate for numerous optoelectronic applications. A significant shift in optical responses is observed through SO2 and NO adsorption, which can enable identification of the adsorbed gases. The studied characteristics signify that RbSnCl3 can be a potential candidate for SO2 and NO detection.

Healthcare seeking behavior and delays in case of Drug-Resistant Tuberculosis patients in Bangladesh: Findings from a cross-sectional survey.

The emergence of Drug-Resistant Tuberculosis (DR-TB) has become a major threat globally and Bangladesh is no exception. Delays in healthcare seeking, proper diagnosis and initiation of treatment cause continuous transmission of the resistant tubercule bacilli through the communities. This study aimed to assess the different health care-seeking behaviors and delays among DR-TB patients in Bangladesh. A prospective cross-sectional study was conducted from November to December 2018, among 92 culture positive and registered DR-TB patients in four selected hospitals in Bangladesh. Data were collected through face-to-face interviews with survey questionnaire as well as record reviews. Among the 92 study participants, the median patient delay was 7 (IQR 3, 15) days, the median diagnostic delay was 88 (IQR 36.5, 210), the median treatment delay was 7 (IQR 4,12) days, and the median total delay among DR-TB patients was 108.5 (IQR 57.5, 238) days. 81.32% sought initial care from informal healthcare providers. The majority (68.48%) of the informal healthcare providers were drug sellers while 60.87% of patients sought care from more than four healthcare points before being diagnosed with DR-TB. The initial care seeking from multiple providers was associated with diagnostic and total delays. In Bangladesh, DR-TB cases usually seek care from multiple providers, particularly from informal providers, and among them, alarmingly higher healthcare-seeking related delays were noted. Immediate measures should be taken both at the health system levels and, in the community, to curb transmission and reduce the burden of the disease.

A-Site Cation Replacement of Hydrazinium Lead Iodide Perovskites by Borane Ammonium Ions: A DFT Calculation.

Organometallic perovskites have become one of the most common multifunctional materials in optoelectronic research fields. This research studies density functional theory calculation on orthorhombic hydrazinium lead iodide (N2 H5 PbI3 ) perovskite by replacing A-site cation with a borane ammonium (BH2 NH3 + ) ion. The perovskite showed a significant structural deformation and an orthorhombic to triclinic phase transition due to A-site ion replacement. The N2 H5 PbI3 perovskite has a band gap of 1.64 eV, suitable for the solar cell absorber layer. The band gap has increased to 2.12 eV after complete A-site ion replacement. All structures showed a high absorption coefficient over 104  cm-1 in the low wavelength region and an increase in refractive index from 2.5 to 2.75 due to ion replacement. All the structures showed high optical conductivity of 1015  s-1 order in the blue wavelength region. These new perovskite structures hold the potential to provide a revolution in optoelectronic research.

The burden of psychological distress and unhealthy dietary behaviours among 222,401 school-going adolescents from 61 countries.

We aimed to calculate the sex-specific prevalence of psychological distress and unhealthy eating habits among adolescents across countries and regions, and to explore their potential associations. We used data from the Global School-Based Health Survey (GSHS) for 61 countries. Psychological distress was defined based on the existence of ≥ 2 factors from the following: loneliness, anxiety, suicide ideation, suicide planning, and suicide attempt. Four unhealthy dietary behaviours were examined: inadequate fruit intake, inadequate vegetable intake, daily consumption of soft drinks, and weekly fast-food consumption. We used random-effects meta-analysis to estimate the overall and regional pooled prevalence. Mixed-effect multilevel logistic regressions were used to estimate adjusted odds ratios (aORs) of unhealthy dietary behaviours in relation to psychological distress. Among 222,401 school-going adolescents (53.3% girls), the prevalence of psychological distress was 17.9%, with girls reporting higher than boys (20.8% vs. 14.9%). Adolescents in the African region reported the highest prevalence (22.5%), while those in the South-East Asia region reported the lowest (11.3%). The prevalence of inadequate fruit intake, inadequate vegetable intake, daily soft drink consumption, and weekly fast-food consumption was 37.0%, 28.5%, 50.0%, and 57.4% respectively. Psychological distress was associated with inadequate fruit intake (pooled aOR = 1.19, 95% CI 1.17-1.23), inadequate vegetable intake (pooled OR = 1.19, 1.16-1.22), daily consumption of soft drinks (pooled aOR = 1.14, 1.12-1.17), and weekly consumption of fast food (pooled aOR = 1.12, 1.09-1.15). Our findings indicate a substantial variance in the burden of psychological distress and unhealthy dietary behaviours across different regions. Adolescents experiencing psychological distress were more likely to have unhealthy dietary habits.

Potential risk zones and climatic factors influencing the occurrence and persistence of avian influenza viruses in the environment of live bird markets in Bangladesh.

Live bird markets (LBMs) are critical for poultry trade in many developing countries that are regarded as hotspots for the prevalence and contamination of avian influenza viruses (AIV). Therefore, we conducted weekly longitudinal environmental surveillance in LBMs to determine annual cyclic patterns of AIV subtypes, environmental risk zones, and the role of climatic factors on the AIV presence and persistence in the environment of LBM in Bangladesh. From January 2018 to March 2020, we collected weekly fecal and offal swab samples from each LBM and tested using rRT-PCR for the M gene and subtyped for H5, H7, and H9. We used Generalized Estimating Equations (GEE) approaches to account for repeated observations over time to correlate the AIV prevalence and potential risk factors and the negative binomial and Poisson model to investigate the role of climatic factors on environmental contamination of AIV at the LBM. Over the study period, 37.8% of samples tested AIV positive, 18.8% for A/H5, and A/H9 was, for 15.4%. We found the circulation of H5, H9, and co-circulation of H5 and H9 in the environmental surfaces year-round. The Generalized Estimating Equations (GEE) model reveals a distinct seasonal pattern in transmitting AIV and H5. Specifically, certain summer months exhibited a substantial reduction of risk up to 70-90% and 93-94% for AIV and H5 contamination, respectively. The slaughtering zone showed a significantly higher risk of contamination with H5, with a three-fold increase in risk compared to bird-holding zones. From the negative binomial model, we found that climatic factors like temperature and relative humidity were also significantly associated with weekly AIV circulation. An increase in temperature and relative humidity decreases the risk of AIV circulation. Our study underscores the significance of longitudinal environmental surveillance for identifying potential risk zones to detect H5 and H9 virus co-circulation and seasonal transmission, as well as the imperative for immediate interventions to reduce AIV at LBMs in Bangladesh. We recommend adopting a One Health approach to integrated AIV surveillance across animal, human, and environmental interfaces in order to prevent the epidemic and pandemic of AIV.

Preparation of chemically and thermally modified water caltrop epicarp (Trapa natans L.) adsorbent for enhanced adsorption of Ni(II) from aqueous solution.

The present study aims to prepare waste water caltrop (Trapanatans L.) epicarp (WCS)-based adsorbents such as raw WCS (WCS-Raw), citric acid-grafted WCS (WCS-CA), acrylamide-grafted WCS (WCS-AM), and calcined WCS (WCS-Si) for Ni(II) removal from aqueous solution in batch adsorption process. The physical and chemical properties of the prepared adsorbents were investigated by different characterization techniques such as scanning electron microscopy (SEM), Fourier-transform infrared (FTIR) spectroscopy, nitrogen adsorption-desorption analyses, and pH at the Point of Zero Charge (pHpzc) in order to assess the suitability and effectiveness of the adsorbents for the removal of Ni(II) by understanding their surface morphology, chemical composition, porosity, and surface charge properties. The experimental Ni(II) adsorption data followed both the Langmuir isotherm and the pseudo-second-order kinetic model suggesting the adsorption process on the prepared adsorbents is well-described by these models. The modified adsorbents WCS-CA, WCS-AM, and WCS-Si exhibited a maximum adsorption capacity of 52.08, 40.32, and 158.73 mg/g, respectively, while WCS-Raw had a capacity of 29.06 mg/g. The thermodynamic study revealed that the adsorption process was feasible, spontaneous, and endothermic. The desorption study demonstrated that the adsorbents could be reused for multiple cycles with minimal loss of activity. The present work evidenced the potential practical applicability and sustainability of the WCS-based adsorbents as promising adsorbents in treating and removing Ni(II) from wastewater.

A first-principles investigation of Cr adsorption on C8 and B4N4 nanocages in aqueous mediums.

Heavy metal removal from polluted environments is one of the vital research areas for better and healthier living. In this research, C8 and B4N4 nanocage-like quantum dots are investigated for heavy metal (Cr) removal applications via density functional theory calculations. The adsorption of up to two Cr atoms has been studied in both air and a water medium. The adsorption of Cr atoms results in significant structural deformation of the adsorbents with a high adsorption energy of -8.74 and -5.77 eV for C8 and B4N4 nanostructures, respectively, which is further increased with an increasing number of Cr atoms. All adsorbents and complex structures showed real vibrational frequencies. Mulliken charge and electrostatic potential analysis reveal a significant charge transfer between adsorbate-adsorbent. The adsorption process causes a decrease in the energy gap of the adsorbents. All the reactions in this study were spontaneous and thermodynamically ordered. QTAIM analysis verifies that the interactions of the adsorbents with Cr atoms are strong partial covalent. The study's findings make C8 and B4N4 nanostructures potential candidates for Cr-detection and removal applications.

BananaLSD: A banana leaf images dataset for classification of banana leaf diseases using machine learning.

Bananas, one of the most widely consumed fruits globally, are highly susceptible to various leaf spot diseases, leading to significant economic losses in banana production. In this article, we present the Banana Leaf Spot Diseases (BananaLSD) dataset, an extensive collection of images showcasing three prevalent diseases affecting banana leaves: Sigatoka, Cordana, and Pestalotiopsis. The dataset was used to develop the BananaSqueezeNet model [1]. The BananaLSD dataset contains 937 images of banana leaves collected from banana fields, which were then further augmented to generate another 1600 images. The images were acquired using three smartphone cameras in diverse real-world conditions. The dataset has potential for reuse in the development of machine learning models that can help farmers identify symptoms early. It can be useful for researchers working on leaf spot diseases and serve as motivation for further researches.

Primary Retroperitoneal Serous Cyst Adenoma: A Case Report and Literature Review.

Primary retroperitoneal serous cyst adenomas (PRSCs) are extremely rare thin-walled cystic lesions whose pathogenesis is not well understood. Clinical presentation varies depending on the lesion's size and location, i.e., larger lesions compress adjacent organs, giving the impression of malignancy. Although advances in imaging techniques enable to identify various characteristics of retroperitoneal cystic lesions, there are no pathognomonic signs to confirm the diagnosis. The exact diagnosis is based on the histology after complete surgical excision. An open surgical approach is considered the traditional method of complete resection; however, laparoscopic techniques have increasingly been employed. Diagnostic aspiration is discouraged due to the potential risk of seeding if the lesion is malignant. We present the case of a 51-year-old woman who underwent complete excision of a large right retroperitoneal cyst, histologically confirmed as PRSC with a review of the background and management options of this phenomenon.

Acute Gastric Dilatation With Ischemia and Perforation Requiring Emergency Total Gastrectomy: A Case of Suspected Abdominal Compartment Syndrome.

Acute gastric dilatation is an uncommon surgical pathology, leading to gastric ischemia, necrosis, perforation, sepsis, and death if untreated. While rare, the development of abdominal compartment syndrome is also a devastating complication of this entity. We present a case of a 42-year-old male with a history of gastric volvulus, presenting with severe acute abdominal distension and multi-organ failure. A diagnosis of acute gastric dilatation was made, with suspicion of abdominal compartment syndrome. Emergency laparotomy was performed when nasogastric decompression failed. Total gastrectomy without anastomosis was performed due to the patient's hemodynamic instability. However, he demised shortly after on the operating table. This case report demonstrates that even with rapid diagnosis and management, acute gastric dilatation continues to be associated with high mortality.

Annual trading patterns and risk factors of avian influenza A/H5 and A/H9 virus circulation in turkey birds (Meleagris gallopavo) at live bird markets in Dhaka city, Bangladesh.

The impacts of the avian influenza virus (AIV) on farmed poultry and wild birds affect human health, livelihoods, food security, and international trade. The movement patterns of turkey birds from farms to live bird markets (LBMs) and infection of AIV are poorly understood in Bangladesh. Thus, we conducted weekly longitudinal surveillance in LBMs to understand the trading patterns, temporal trends, and risk factors of AIV circulation in turkey birds. We sampled a total of 423 turkeys from two LBMs in Dhaka between May 2018 and September 2019. We tested the swab samples for the AIV matrix gene (M-gene) followed by H5, H7, and H9 subtypes using real-time reverse transcriptase-polymerase chain reaction (rRT-PCR). We used exploratory analysis to investigate trading patterns, annual cyclic trends of AIV and its subtypes, and a generalized estimating equation (GEE) logistic model to determine the factors that influence the infection of H5 and H9 in turkeys. Furthermore, we conducted an observational study and informal interviews with traders and vendors to record turkey trading patterns, demand, and supply and turkey handling practices in LBM. We found that all trade routes of turkey birds to northern Dhaka are unidirectional and originate from the northwestern and southern regions of Bangladesh. The number of trades from the source district to Dhaka depends on the turkey density. The median distance that turkey was traded from its source district to Dhaka was 188 km (Q1 = 165, Q3 = 210, IQR = 45.5). We observed seasonal variation in the median and average distance of turkey. The qualitative findings revealed that turkey farming initially became reasonably profitable in 2018 and at the beginning of 2019. However, the fall in demand and production in the middle of 2019 may be related to unstable market pricing, high feed costs, a shortfall of adequate marketing facilities, poor consumer knowledge, and a lack of advertising. The overall prevalence of AIV, H5, and H9 subtypes in turkeys was 31% (95% CI: 26.6-35.4), 16.3% (95% CI: 12.8-19.8), and 10.2% (95% CI: 7.3-13.1) respectively. None of the samples were positive for H7. The circulation of AIV and H9 across the annual cycle showed no seasonality, whereas the circulation of H5 showed significant seasonality. The GEE revealed that detection of AIV increases in retail vendor business (OR: 1.71; 95% CI: 1.12-2.62) and the bird's health status is sick (OR: 10.77; 95% CI: 4.31-26.94) or dead (OR: 11.33; 95% CI: 4.30-29.89). We also observed that winter season (OR: 5.83; 95% CI: 2.80-12.14) than summer season, dead birds (OR: 61.71; 95% CI: 25.78-147.75) and sick birds (OR 8.33; 95% CI: 3.36-20.64) compared to healthy birds has a higher risk of H5 infection in turkeys. This study revealed that the turkeys movements vary by time and season from the farm to the LBM. This surveillance indicated year-round circulation of AIV with H5 and H9 subtypes in turkey birds in LBMs. The seasonality and health condition of birds influence H5 infection in birds. The trading pattern of turkey may play a role in the transmission of AIV viruses in the birds. The selling of sick turkeys infected with H5 and H9 highlights the possibility of virus transmission to other species of birds sold at LBMs and to people.